Part 14

The patient loses his strength sensibly, so as not to be able to be supported by his own limbs. Over his body variously appear red, scarlet, yellow, green, livid and black spots, of various magnitude; some of which will bleed on their own accord; others will break into malignant ulcers, and others again will mortify. The appetite fails; a flux frequently ensues; the urine will be thick and stinking; and the poor wretch gradually dies merely by putrefaction.

The scurvy has had many definitions, and has been divided into various classes. All the difference of the disorder is, that sometimes it is attended with a fever, only in some degrees, more in one habit, than in another; which may be owing either to the nature of the constitution itself, but principally depends on the climate the patient is in: to which I must not forget to add, that frequently the scurvy is complicated with other disorders. I could make many observations on this head, but, this perhaps would serve more to indulge myself than to benefit my reader.

I shall therefore suppose that I have said enough, to proceed to the cure; which I do with the more chearfulness, as I am happy in knowing it by experience to be not only easy, but efficacious.

The first time I ever experienced, and had it in my power to examine into the nature of the _true_ scurvy, I was fortunate enough to discover so much of its corruptive quality, as to hit upon the true antidote; namely, the sacharine quality and acidity of vegetables; and upon this foundation I established my method of cure with success.

I shall not here enumerate the many experiments that I made in the course of these inquiries, but proceed to the result thereof, and the method to be observed.

In the first place, sugar is an article of more virtue, than what is in general known; and of so great a value to seamen, that he ought to esteem it as one of the greatest preservatives of his health. Next to this is vinegar, which is not only a resister of putrefaction, but has a coagulating, and condensing quality to the animal juices; whereby it not only consolidates the fluids without adding acrimony, but on the contrary, absorbs animal acrimony, and braces up the solids.

On the same principle, I have found _dried malt_, to be of great advantage in scorbutic cases; in which, both the saccharine and acidity of vegetables is contained even in a heightened degree,——This being premised, I proceed in the following manner:

When a man is found to have evident signs of the scurvy, let his drink be acidulated with one fourth, or third, &c. of good vinegar, or what is yet better, lemon juice, and well sweetened with sugar.

If there is malt on board, let a malt decoction, or temporary beer be made in the following manner:

No. XLVII

_Take malt bruised, a pound, or three handfuls; sassafrass chips, a small handful; boil it in a gallon of water for an hour, and strain it off for use._

Let this be the constant drink, which in a short time will revive the already tainted habit. Onions, horse-raddish, and mustard, &c. such as will keep on board, should plentifully be made use of, and the pills No. X. should be taken every twenty-four hours, at a time when going to rest.

This method will soon bring the patient to health again, particularly if in the first stage; but when it is come to the second degree, or in a state of rapid decay, more effectual and immediate means must be taken.

Here then I shall present the method, which by experience I know to be efficacious.

No. XLIX

_Take a large tub, (a butt sawed in two) in which place a stool, or something to sit on; Then let the patient be stript naked and seated in the tub; pour into the bottom of the vessel about one gallon of good vinegar; put a blanket all over the patient, and the tub, so that the whole is covered like a hut. Then heat a large poker; which put into the vinegar in order to rise a steam; which continue for about a quarter, or half an hour, or longer, according to the circumstances._

If the patient is very scorbutic, it should be repeated three times a day, or even oftener, for the effect of this steam-bath is so powerful, that I have with pleasure seen the patient when not able to crawl to the tub; he has been so revived by the operation, as to come out of his own accord quite refreshed.

In the mean time the elixir of iron as is described No. XXVIII. should be taken; the mouth often washed with vinegar, lemon juice, or rather with the elixir of the iron, and sugar, should be both plentifully used in the drink, and with the victuals.

Salt provisions should be avoided as much as possible, or else previously well deprived of its salt.

By this method the scurvy may not only be prevented at sea, but even cured in the most inveterate degree.

If however there is an opportunity for the patient to come on shore, it will greatly facilitate his cure; though he should reap no other benefit than the exhalations of the earth in the warmth of the day: and I have with astonishment seen patients devour vegetables in large quantities, and mended surprizingly, even in a few hours; so powerful an antidote is the vegetable effluvia to an animal putrescency.

To conclude, I have only this to observe, that the scurvy is principally owing to defaults with respect to provisions, and the customary way of living in ships in general; and such as might be much amended, both with respect to conveniency, wholesomeness, and expence.

I speak this from long experience, from the many observations I have made, and the good success that have attended my improvements, when it has been in my power to put them in execution. I have many things to offer with respect to provisions at sea; but as that is too extensive to be inserted in this volume, I shall treat of it distinctly. In the mean time give me leave to close these lectures: and being conscious that truth and utility has guided my endeavours through the whole, I lay down my pen for this time, with the pleasing reflection, that I have advanced one step farther in the performance of my duty, and in answering the end of my existence.

FINIS.

EXPLANATION OF THE PLATE.

_Fig. 1._ A common bleeding lancet. A. The blade; which, when it is wiped after bleeding, should always be laid upon the handle B. and wiped but one way, to save the point.

_Fig. 2._ An incision lancet. A. The point of the blade, which ought to incline one way most, in order to make it the better fit for opening of aposthumes.

_Fig. 3._ A bistoury for opening of sores, &c. in general use. A. The blade. B. The handle in which the blade folds.

_Fig. 4._ A pair of strong scissars.

_Fig. 5._ A spatula. A. The part for spreading of plaisters. B. The part for pressing down the tongue; for which reason it is made full of holes that it may the better press down the tongue.

_Fig. 6._ A probe. A. the probe. B. A triangular point on which lint may be wrapped to wipe the sore with, as it is easy taken off again.

_Fig. 7._ A arm tied up for bleeding, with the three veins as they generally appear when swelled up.

_Fig. 8._ A vein of a kind of three orifices. A. Is a longitudinal orifice, which will not let the blood run freely. B. Transverse; in making such orifice the vein is apt to be divided; besides it is not very easily stopped, and will not admit of an orifice large enough to let the blood run out with freedom. C. An oblique opening, the medium between the two former; and always the best orifice.

_Fig. 9._ A key-tooth instrument. A. The handle, made of ivory. B. The comb of the instrument, which should be wrapped round with a little rag, and is that part which rests against the jaw bone. C. The hook which is brought over the tooth. D. The screw at the end of the key, by which the hook is shifted as occasion requires. E. The screw by which the handle is fixed to the instrument.

_Fig. 10._ Common splints used for fractures; these splints are made of thin boards of pine or cedar, glewed on to leather, and then ridged so, that they may easily bend and suit to the limb which they are applied to.

_Fig. 11._ A single headed rowler, or bandage, this bandage is generally used for a fractured arm or leg.

_Fig. 12._ A double-headed rowler, generally for dislocations.

_Fig. 13._ A many-tailed bandage. A. The back part slip, that keeps the bandage together. B. The stitches coming thro’ the bandage. C. The slips of the bandage. D. The part next the ancle, from whence the parts upwards have a gradual increase.

_Fig. 14._ Mr. Sharp’s invented splints, made of paste-board. A. The external splint. B. The leather straps. C. The strap, that comes under the foot. E. The internal splint. F. The loop through which the strap that comes under the foot is put. G. Small iron buttons, on which the straps are fastened.

_Fig. 15._ A leg with the many-tailed bandages. A. The slips laid over each other. B. The under slip that secures the whole. C. A slip that secures the bandage to the foot.

_Fig. 16._ A leg dressed with the splints. A. The bandage. B. The splint. C. The tie knots of the tape that secure the splint to the leg.

_Fig. 17._ The inner view of a leg with Mr. Sharp’s splints.

_Fig. 18._ The external view of the same. These two are copied from Mr. Sharp’s pamphlet.

_Fig. 19._ A clyster syringe. A. the syringe made of pewter. B. A pipe made in such manner, as to enable a man to administer a clyster to himself. C. A common clyster pipe, that occasionally may be screwed on to the syringe.

_Fig. 20._ A clyster pipe and bladder. A. The bladder. B. The pipe. C. The manner of fixing the bladder to the pipe. D. The tying of the bladder when it is filled, with a slip knot; which is handier than the customary way of the cork.

_Fig. 21._ The manner of closing a wound with plaisters, called the dry _suture_.

_Fig. 22._ A common syringe made of ivory.

● Transcriber’s Notes: ○ In Lecture VI, Sect. VI. has been corrected to Sect. V. to match the table of contents. ○ In SECT. VI. on page 118 there is a reference to the authors description of the skin in Lect. I., Sect. VII. The discussion of the skin is actually in Lect. I., Sect. IX. on page 40. ○ There are two SECT. VIII. in LECTURE I. They have been left with

geh duplicate number.

○ The “recipes” for various medicines are numbered somewhat sequentially with Roman numerals across all Lessons and Sections. However there are “recipes” with duplicate numbers (XXII appears three times in Section V of Lect. IV.) and some recipe numbers are missing altogether. ○ Missing or obscured punctuation was silently corrected. ○ Typographical errors were silently corrected. ○ Inconsistent spelling and hyphenation were made consistent only when a predominant form was found in this book. ○ Text that was in italics is enclosed by underscores (_italics_).

End of Project Gutenberg's The Seaman's Medical Instructor, by N. D. Falck