Part 6

This is an external application, for bruises and other inflammations, where discussion, or dispersion of humours is necessary, its chief benefit is in sprains, dislocations, and fractures. I have this however to observe with the camphorated spirit, that though it is exceedingly useful in the forementioned, and in some rheumatic cases, yet it should be used with caution, and not too plentifully, as it is liable to dry up the vessels, and might incline the limb to wasting, if too freely made use of.

B. _Liniment of soap._

_Take spirit of wine rectified one quart, distilled oil of rosemary one drachm, camphor one ounce, castile soap half a pound; cut the soap small, and let the whole be mixed and dissolved._

This is an excellent external medicine for sprains, rheumatism, bruises, &c. This medicine is commonly called opideldock, and in all such cases is far superior to the spirit of camphor singly; unless where the constitution is sluggish, and requires a greater stimulus; in general, however, this excellent composition will supply the place of both.[10]

Footnote 10:

Since these compositions are so easily made, they might occasionally be prepared on board; Instead thereof, I would advise the seaman to furnish the box with camphor and soap; and instead of rectified spirit, good rum or brandy will answer equally as well.

C. _Sweet oil_: This ought to be pure and good; it is of many uses in medicine, which I shall treat of as occasion requires.

D. _Sweet spirit of nitre._

_This is a spirit distilled from spirit of wine one quart, and spirit of nitre half a pound, according to the art of chymistry._

In regard to its virtue, it is an excellent medicine in most acrimonious cases, and acts principally as a gentle diuretic; besides this, it is of an antispasmodic and antiputrescent quality, and therefore useful in all kinds of inflammatory disorders, particularly of the putrid kind of fevers; which I shall, in the course of this work, take notice of.

E. _Honey_: This is a useful article, which ought to be plenty, and of the best kind; it is particularly useful for making gargles, clysters, poultices, &c. &c. as shall be farther specified.

F. _Yellow basilicon_:

_Take olive oil, yellow bees wax, yellow rosin, Burgundy pitch, of each half a pound, turpentine two ounces; melt the whole, and mix them properly._

This is an external digestive application to cleanse ulcers, and to make them discharge good matter, by which the inflammation will abate.

G. _Elixir of Vitriol_:

_Take stomachic elixir one pint, oil of vitriol four ounces; mix them, and filter it through paper._

This is an excellent elixir for weak stomachs, that proceed from bile and other causes of indigestion; it is also a great specific against the scurvy, and the like habits; as also in feverish complaints. The dose is from 20 to 40 or 60 drops, in a little water.

H. _Elixir proprietatis_:

_Take of myrrh in powder one ounce and an half, succotrine aloes in powder an ounce, saffron four ounces, of dulcified spirit of vitriol six ounces, of rectified spirit of wine twenty-four ounces; digest them in a sand heat for four days, and then pour off the elixir from the dregs._

This elixir is an excellent stomachic, it will promote digestion, strengthen the stomach, and create an appetite; it will also keep the body gently open, and on that account be of great benefit against many ailments in the bowels. The dose is about a drachm or two, or a middling spoonful; to be taken either by itself, or in a glass of wine, and makes a most agreeable bitter.

I. _Lenitive Electuary_:

_Take dried figs one pound, tamarinds, cassia, french prunes, each half a pound, sena leaves eight ounces, coriander seed four ounces, liquorice root three ounces, double refined sugar two pounds and an half; reduce the sena and coriander to a powder, and sift it through a sieve, boil the figs, cassia, prunes, and liquorice into a pulp, and strain these also, then mix the powder gradually amongst it, and make it, with the help of the sugar, into an electuary._

This electuary is a gentle cathartic, keeping the body coolly open, and therefore very useful in fevers, and weak constitutions when openness of the body is required. The bigness of a large nutmeg is a dose, which may occasionally be repeated.

K. _Turner’s Cerate_:

_Take olive oil a pint, yellow bees wax and prepared calamine stone, of each half a pound; melt the wax and oil, and mix the calamine stone: keep stirring till it is cool._

This is a healing cerate, very useful in scalds and burns; as also to dress blisters with; likewise for the external dressing of sores, when near healing, or to keep other dressings on.

L. _Fever powders_:

_Take purified nitre powdered half a pound, crabs eyes prepared four ounces, cinnabar of antimony finely prepared two ounces, calomel one drachm, and mix them._

This is the celebrated antispasmodic powder of the great _Stahl_, with some considerable amendment by means of the calomel; which, in the course of a long practice, I have found the most beneficial for fevers. There is not a kind of fever to which mankind are subject, either at shore or at sea, but what this powder may with safety and with great benefit be applied. A scruple, or half a drachm is a dose, and which may be repeated, as the ardency of the fever shall require.

M. _Stomach powder_:

_Take purified nitre prepared and chalk, of each eight ounces, nutmeg two ounces; reduce all to a fine powder, and let them be properly mixed._

This is an excellent powder against the heart-burn, or other crudities of the stomach and bowels; for whilst it absorbs the crudities and accidities in the first passage, it is at the same time a gentle digestive, and withal a carminative: Hence in heart-burn, belching, and other disagreeable symptoms of depraved appetite it is highly useful.

N. _Calomel_:

_This is a dulcified mercury, made of sublimate mercury four ounces, pure quicksilver three ounces; intimately mixed, and sublimed six times, according to the art in chymistry._

This is the safest and gentlest of all mercurial preparations, and if judiciously administered, may be deemed one of the greatest of all medicines. I shall therefore be somewhat particular on this head. In the first place, it should be faithfully prepared; and secondly, levigated as fine as is possible; to do this therefore, I have in my Treatise on the Venereal Disease, recommended it to be ground with a little water on a flat marble, to the finest degree possible, and then dried up for use. The fineness of this excellent medicine is of the greatest importance, and ought to be strictly attended to, for not only much mischief has been done by its rough particles in the bowels, but it must follow, that the finer it is, the farther it goes. And with all mercurials, it should be strictly observed, the less quantity we can make do, the more we may hope for success.

There is not an acrimony in the human body but what may be corrected by this universal antacrid medicine, if properly administered. In venereal cases, it should be one of the first, and the principal remedy throughout the cure; but care should be taken that the quantity be small, and adapted to the strength of the patient, and to prevent it from falling on the salivary glands, and thence to produce salivation. The dose should never exceed one grain, a quantity sufficient for twenty-four hours, except where there is evacuation, or other discharges of the body required; in which case it may be occasionally increased, especially in malignant fluxes, or when purges are given, or in other evacuations.

It may be made up in many forms; the best, however, is in pills, with a little flower and water, &c. or it may occasionally be mixed up with other medicines, as I shall frequently have occasion to speak of.

O. _Precipitate_:

_This is made up of equal weight of Quicksilver and compound Aqua Fortis, well mixed, evaporated to dryness, in a broad bottomed vessel, by a sand heat, according to the art of chymistry; in which operation it turns red._

This is an excellent medicine, applied to all kinds of ulcers, as it will correct the malignity of the matter, take off fungous flesh, bring on a kind suppuration.

It will also clear the skin from all kinds of breaking-out, and perfectly destroy lice, nits, &c. It should, however, like the former, be levigated very fine, for thereby it loses greatly its sharpness, and becomes more efficacious. It should also be mixed with some cerate, ointment, or other dressing, and never, or very seldom, be used by itself, as I shall hereafter point out.

P. _Mercurial Ointment_:

_Take hogs lard eight ounces, purified quicksilver one ounce, Venice turpentine two drachms; rub the mercury into the turpentine in a mortar, till the quicksilver disappears, then mix the whole together._

This is popularly called Unction, and peculiarly useful in venereal cases, as also to destroy a particular vermin called _Crab-Lice_, and other foulnesses. But I must here give a caution against the too free use of mercurial ointment, as it is not only apt to bring on salivation, but if the mercury is adulterated with lead, (as sometimes is the case) it is liable to occasion many incurable pains in the limbs; and by this the remedy may prove worse than the disease.

Q. _Rhubarb._ This is a necessary article in all kind of fluxes, and relaxations in the bowels; for, besides that it purges gently, it has withal such an astringency as to brace up the weakened vessels, and to restore their proper tone again.

The dose of rhubarb is one scruple; which should be mixed with some fine chalk, or _Stomachic Powder_. (M.) about equal quantity, particularly in the beginning of fluxes.

R. _Jalap._ This of all purging medicines is undoubtedly the best, when purging is required. The dose is from a scruple to half a drachm, mixed up into a draught, with a little syrup and water, or any other form. A grain or two of calomel is ever a proper addition, let the case be what it will, that requires purging.

S. _Ipecacuanha._ This is the best of vomiting medicines; to be given about a scruple, either in form of a little draught, or in a bolus.

Vomits are often of more benefit than purges; not so much on account of cleansing the stomach, as by the agitation it gives to the whole body; whence it is brought into perspiration, and thereby promotes the circulation of the fluids that was obstructed.

T. _Liquid Laudanum_:

_Take purified opium one ounce; cinamon and cloves, of each one drachm; white wine one pint, steep them for a week without heat, and filter it for use._

This is a medicine of much use in painful and restless diseases, but should never be had recourse to, unless the greatest necessity require it. For, whilst it lulls the nerves from their irritation, it is apt to weaken their tone, and by that, greatly lessen the strength of the whole body; but where really requisite, it is a happiness that ease can be given, by which to relieve nature in pain that it may be restored again to tranquillity. The dose of this tincture is from 10 drops upwards to 30.

U. _Essential Oil of Peppermint_: This is one of the most grateful nervins in the whole materia medica; and at the same time the least stimulant. In all cases where there is weakness and feebleness, I would advise this in preference of spirit of hartshorn, or any other stimulant whatever. It warms the stomach, comforts the bowels, and infuses a liveliness over the whole nervous system. The dose is from 3 or 4 to 6 drops, on a little lump of sugar, and dissolved either in a glass of wine, or water; which may be repeated occasionally, without the least hurt to the constitution.

W. _Turlington’s Balsam_:

_Take St. Johns worth a small handful, rectified Spirit of wine two quarts; digest them for a few days, then strain and filter the extracts; then take Angelica root, Olebanum, Myrrh, and Socotorine Aloes, of each one ounce; Styrax, Benzoin, and Peruvian balsam, of each an ounce and a half; digest the whole in a slow heat for some days, and filter the balsam off for use._

This is the genuine receipt of the celebrated _Turlington’s Balsam_, and an excellent medicine it is, for many purposes. Externally, it is an efficacious remedy for all green wounds, cuts, bruises, &c. if immediately applied.

But particularly for internal uses, its virtues are great: It warms the stomach, promotes good digestion, enriches the blood, warms the whole system, and, above all, is a sovereign remedy in all rheumatic complaints. The dose is about a tea spoon full, in a glass of wine, or any other convenient vehicle; and on all occasions, where bitters are made use of, this ought to have the preference, being one of the best stomachics. But at the same time it should be observed, that where there is a fever in the system, it ought to be avoided, as it is remarkably heating in its nature, and therefore agrees best with cold constitutions, and where the habit is weak.

Here then I shall end this lecture; and only observe, that though there are various other medicines of the greatest importance, as well for external as for internal uses, I have purposely avoided them, as their application requires more care, than what we may expect from men who have not made medicine their peculiar study. At the same time I must also confess, that the forementioned will be sufficient, if managed as I have already intimated. It is a maxim with me, ’tis not so much the medicines themselves whereon the success depends, as the judgment requisite to know how and when properly to make use of them.

I must likewise take notice, that I have purposely adhered as close to the recipes of the Dispensatory as I could with propriety, because it may the better suit the apothecarys’ shops in all parts of the world; and that when a medicine is wanted it may the easier be supplied. It would have been an easy matter for me to alter every medicine in its composition; but I conceive this would have tended but to raise difficulties in procuring them, and taken away from the general utility of the book.

LECTURE III.

OF

ACCIDENTS,

AND THEIR

Proper Method of Treatment.

I Shall now proceed to the actual assistances that the human body stands in need of, when the order of health is impaired. This is the noblest office, in which mankind can possibly give aid to each other.

Health is certainly the greatest blessing this side of the grave; and what service can we render to our fellow creature, so valuable, as to assist him in the hour of distress.

From this consideration it naturally follows, what caution it also requires, and how circumspect every one ought to be, who takes upon him that noble office.

Before therefore I begin this important lecture, let me request of the reader the strictest attention, and never to act before the ailment, as well as the method of treatment is thoroughly understood; since nothing less than health, and even life itself, is liable to be the forfeit of a fatal error.

Mankind are ever liable to accidents, how cautious soever their conduct in life may be: But seamen, particularly are more so; not only from their occupation, but from the precariousness of the element on which they are dependant, and which so often exposes them to the most imminent danger.

I shall divide the accidents of bodily dangers, into falls, wounds, bruises, dislocations, fractures, scalding, burning, and drowning; and treat on each part separately, in as plain a manner as is in my power.

SECT. I.

_Of Falls_

The man who falls, is partly bereft of his senses, or his presence of mind, and particularly so the more timorous he is of his own preservation; add to this, because he is unaccustomed to it; for custom makes us familiar in every thing: Thence we perceive the different effect in different persons in their falling; for some will fall with a good deal of judgment, prevent some unlucky blow or other; whilst another shall fall as heavy as a dead log, or like one drunk, without having the least chance of saving himself in any shape. I remember once I fell from the puttock shrowds of the fore-top, but providentially escaped without the least injury, my watch chain having catched some how, which I endeavoured to save. I confess this in a great measure was owing to good fortune; at the same time I was naturally very active, and having acquired a flight of jumping off the main-deck into the hold of a light ship, I thereby had habituated myself to stop my breath, and a presence of mind which principally saved me when I thus fell in good earnest. I only mention this to shew, that the greatest mischief in falling proceeds from timorousness and surprise. I knew a wag, who would play pranks that way to astonishment; he could let himself fall from any part of the rigging, catching as he came down like a cat, make all hands come round to his assistance, and then laugh at their credulous good nature.

A man who falls is apt to lose his breath, particularly if he is not very careful, and has not presence enough to stop it the moment he finds himself fall; and the instant he loses his breath, he loses also his mental faculties; consequently comes motionless and exposed to every fatality. Thence we generally find a man, who has fallen from a considerable height, lays motionless like death on the spot, even though he has not received the least injury otherwise.

_The Method._

When I have been called to such an accident, and found my patient motionless; I have untied his neckcloth taken him by the coller of his jacket, and shaken him heartily; which in the space of half a minute has brought him to, with a heavy sigh. Next I have bled him without loss of time, but not too copiously; after which I have examined him, and acted according to circumstances.

A person falling is liable to a number of dangerous consequences, not mentioning immediate death. The consternation, the shock, fright, terror &c. are as alarming and dangerous as the external hurt itself. The brain, and the blood vessels in that part are very delicate, and by the shock, as well as the want of respiration, they often burst; thence an apoplexy is liable to hurry the patient from the stage.

A fever generally attends a fall, which ought to be strictly attended to; after, therefore, the patient is bled, and seems to have recovered his reason, he should have every six hours a dose of the _Fever Powders_, (L.) and drink some balm tea, in order to get into a gentle perspiration, which will in this respect soon recover his health again, and enable him to do his duty.

SECT. II.

_Of Wounds_

A Wound is an unnatural separation of any part of our body, whereby the order of circulation is hindered, the solids divided, and the fluids let out; suddenly caused by some violent means or other. But when such a separation becomes ulcerated, it loses the apellation of wound, and is called a sore, or ulcer.—This distinction is requisite to be taken notice of; for wounds and sores are often confounded, which shews not only ignorance, but as their nature is materially different, their method of treatment is not less so; and ought therefore previously to be understood.

Wounds are best distinguished into three different kinds; cut wounds, bruised wounds, and gun-shot wounds. I shall briefly shew how to treat each in particular.

_Cut Wounds._

A Cut wound is barely a separation of parts; and the sharper the instrument with which the wound was made, the easier will the wound be to heal up again.

It is however a natural thing to observe what parts of the body is wounded, for tho’ nature is kind in uniting the parts, yet some parts are more easier healed than others.——Observe therefore

_The different Methods._

If an artery is wounded (which is known by the blood being of a florid colour and spinning out by starts) care should be taken to have it stopt to prevent bleeding to death. But in this you should not be too scrupulous. Two or three ounces from a wound makes a great shew; and very often a little blood lost is of great benefit to the healing. Should, however, the blood gush from the wound violently, especially from an artery, make a compress of lint, strewed with _Powder’d Allum_, (17) which secure well on the parts with a roller, laying over it a compress, with _Spirit of Wine and Camphor_; (A) if that should not be yet sufficient, put a piece of money in a compress, and secure it on the wound, that is, provided the part of the body will admit of it, such as the arms or the legs, &c.

Let the ligature, or the first dressing, lie on for two or three days, and, if no hindrance to the patient, longer. If all these things are not sufficient, recourse must be had to the needle.

In every other kind of cut wounds, care should be taken to have it first cleaned with some water; (a small matter of vinegar, and brandy may be mixed with it) next, let the lips of the wound be well closed, dressed with dry lint, and _Turlington’s Balsam_ (W), and over which, a compress with _Camphor Spirits_ (A).

Plaisters, salves, &c. in green cut wounds, are altogether needless. All that is required to healing, is to keep the wound clean, to give it rest, and not to aggravate it with any thing acrimonious. _Turlington’s Balsam_ (W) is admirable, but yet it suits small wounds better than large ones.

As a finger is very liable to be cut, and sometimes gives a great deal of trouble, I will here give a simple and expeditious remedy:—If you have cut your finger, wash it in a little salt or fresh water; tie it round with a good long thread, not too tight,—take care that your wooling may keep on without being removed; and a day or two will heal it up, without any farther plaistering. If inflammation attends the wound, methods should be taken accordingly, by bleeding, fever powders, &c.

_Of Bruised Wounds._

These kinds of wounds are of a worse nature, and are not so kind to heal as the former; for here the parts seem to be torn to pieces, so that there is not only a separation of parts, but a destruction of a great many tender fibres all round the wound.

Hence we see in such cases a great deal of swelling, inflammation, and pain attend it; for the blood being hindered, the circulation naturally swells up the parts; and the nerves being lacerated also, must occasion great pain. Hence it must follow, that nature must first get rid of the obnoxious and torn part before she will consent to unite the wound again; and this must be performed by suppuration.

In small cases, nothing is more beneficial than _Diachylon Plaister_, (20) which assuages the inflammation, corrects the acrimony, and brings the wound to a good state.

Broken shins often occur on board a ship, which is of that species of wounds. And as from such a case, (though in general slighted) many evils have arisen, I would caution the mariner to apply immediately _Diachylon Plaister_ (20) to a broken shin; by which he will prevent having an ulcerated leg; a thing very troublesome.

If the bruised wound is on other parts, and the parts all round are bruised, care should be taken that it is cleaned as before directed, and a pledget of lint, with _Yellow Basilicon_, (F) will be necessary; over which a compress with _Spirits of Wine and Camphor_, (A) or rum, may be applied; and afterwards, when it begins to heal, it may be dressed with dry lint.