.dt The Seaman's Medical Instructor, by N. D. Falck, M.D.—A\
Project Gutenberg eBook
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THE|SEAMAN’S|Medical Instructor,
.nf c
IN A COURSE OF
LECTURES
ON
ACCIDENTS AND DISEASES
INCIDENT TO SEAMEN,
IN THE VARIOUS CLIMATES
OF THE WORLD.
CALCULATED FOR
SHIPS THAT CARRY NO SURGEON.
The Whole delivered in a plain Language, and founded
on a long and successful Experience.
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.hr 80%
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By N. D. FALCK, M. D.
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LONDON:
PRINTED FOR EDWARD AND CHARLES DILLY.
M,DCC,LXXIV.
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THE||PREFACE.
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If we consider the many benefits that navigation
contributes to commerce in general,
and how much the prosperity of
nations are indebted to its source, we must
without hesitation declare seamen, a most
respectable part of mankind; and if we reflect
a moment, on the many hazards and perils
they are exposed to on that precarious element,
and the advantages we reap from their
toil, the common feelings of human society,
must awake and remind us, not only how
much we are obliged as social members,
even from a motive of self interest, to
study their preservation, but as fellow creatures,
how forcibly our duty calls us to
give them every aid in our power, and
to lighten the burthen of their many
toils.
// 004.png
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A ship at sea may be considered as a floating
kingdom; and the subjects, however few
in number, are not only liable to the same accidents
as those on shore, but to many more,
peculiar to that precarious and fluctuating
element that surrounds them. For this
reason there are many things requisite to be
known by the mariners besides the art of
conducting a ship from port to port.
Of all the various knowledges that distinguish
the human species from the brute creation,
what is of more value than that which
tends to the preservation of life and health? I
believe that every man who is actuated by
motives of philanthropy will with me wish,
that mankind in general would advert more
to it in the principles of education, than what
they at present do. Indeed it is astonishing
that so valuable an acquisition, as to
have some knowledge of the body we possess,
and its preservation, should be so totally neglected,
as to be entirely excluded from
education; an acquisition that not only
// 005.png
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enlivens the mind, but in itself is so very
essential to our existence; yet what is more
to be wondered at, is, that a seaman who
launches into the main ocean, is cut off
from every assistance, in case of an accident
or sickness, and rendered wholly unable to
give the least aid to himself, or those who
are entrusted to his care. Large ships I own
are exempt from this observation: but are
not the lives of men on board of small ships
equally as valuable, and worth preserving,
as those of greater burthen?
I am not the first who has had the welfare
of seamen at heart; various writers, and men
of abilities too, have presented the world with
observations, that undoubtedly have proved
beneficial to that class of men; but then these
books were neither intended, nor fit to be
put into the hands of such seamen, as actually
stand most in need of those very observations
they have made, and only intended for the
perusal of men of physical talents; nevertheless
they merit for their labour public thanks,
// 006.png
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as useful members of society. But if we take
an impartial view of the number of seamen,
I believe the greatest part are employed in
small ships, that either carry no surgeon, or
(I am sorry to say it) sometimes one they had
better be without; especially in war time,
when they stand most in need of a good one.
To benefit these men, and at the same time to
make that benefit universal, is the plan I have
aimed at; and I believe this is the first attempt
of the kind; at least I know of none whose
steps I have followed in this design.
Should I ask physical writers why they
have neglected so valuable a part of society as
seamen, in giving them their friendly instructions
respecting their health, I doubt not,
but the majority would reply, that the education
of masters of ships and seamen in general,
has not enabled them to understand a subject so
much above their comprehension, or sphere.
But if seamen have not the advantage of an
extensive education, are they divested therefore
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of common sense and understanding? and
is it not possible to deliver them instructions,
dressed in so plain a language as to adapt it to
their capacity?
Nevertheless, though men of abilities have
not thought seamen worth their pen, others
have; but such whose pursuit in life has been
stimulated by motives of a different cast.
Those have furnished seamen not only with
directions to cure all diseases, but even given
them medicines to do it with, into the bargain;
or to speak more seriously, given them
directions how to use such medicines as would
yield the most profit to the apothecary, who
with pretended wisdom equipt them out:
and I am apt to think, that kind of quackery
has stolen away the lives of many valuable
seamen.
It is universally asserted that seamen are not
fond of reading; this in a great measure is
true, but far from being a general rule; and
though blind prejudice has given them an
aversion to every thing physical, yet I will
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venture to say so much in their behalf, that
hitherto nothing has been offered to them that
could alter their opinion in this respect, or
open their eyes, in shewing them the beauties
of that useful study, and in how small a compass
its true principles might be contained.
Physic like religion is rendered intricate and
abstruse, the more it abounds in errors and
absurdities; but truth like the brilliant sun,
drives away all the phantoms of perplext mysteries,
and proves that both alike are simple
and beautiful, founded on reason, and
that its most useful part is comprehensive to
common understanding. This pleads in favour
of my attempt, and with every man
of sense, must overpower prejudice.
That I might the better succeed in my intention,
I have begun the whole at the first principles,
namely the mechanism of the human
body; for I cannot see how any man can pretend
to know the nature of diseases, or presume
to administer any thing with certainty, without
he has some knowledge of the parts that
// 009.png
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suffer: this then is the subject of my first
lecture; and to make it the more pleasing,
and to entice the reader to pursue, I have stript
it of every thing pedantic, or the unnecessary
perplexing particulars, and confined myself
to such things only, as gives a concise
and true idea of the whole animal system;
and if I may be allowed to judge from the
opinion of some of my learned friends, I
flatter myself, that my readers, physical or not,
will give me their sanction, as well with
respect to plainness of language, as conciseness
of the subject, and the utility of such a
short dissertation, founded on experience,
and stript of prejudice and errors.
The second lecture contains equally as
copious a subject as the first; contracted in
a very small compass, and which I hope will
give as much satisfaction as the forementioned.
Out of the whole Materia Medica, I have
chosen but very few medicines, and these
I have confined myself to throughout the
// 010.png
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whole book. Many surgeons at sea will not,
I know, be contented with so small an assortment;
and I remember the time that such an
observation might have been applicable to myself;
but as I have by long experience learned
to shake off prejudices, and been taught by
the help of philosophy to pry into the nature
of things in general, I solemnly declare, that
now, I would venture to go to any part of
the globe, not only with that little assortment
of medicines I have mentioned, but even with
many less. The emetick tartar, sublimate mercury
and the bark are powerful medicines; but
they should be in very skillful hands, otherwise
they are rank poisons, and therefore
I have omitted them here; but strictly
speaking, every good medicine is the same.
I have two maxims in physic, which I
strictly attend to; one is, that to my friends
I give the least medicines; the other is, that
the principal virtue of a medicine depends on
its application.
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The form of the medicine box, I have
constructed so as it appears to me most convenient
and handy; and every kind of medicine,
I would advise to have labeled with
their proper names, as well as with another
mark that may take the eye at first sight; and
the more to prevent mistake, one label should
be fixt on the pot that contains the medicine,
and the other on the box: for in medicines
too much caution cannot be used.
One thing with respect to the medicines,
I have omitted, and that is their quantity
requisite for the box, and their prices: I
intended to have taken notice of this, but
found that that could not with exactness be
ascertained, unless entering into another subject,
and that would take off from the conciseness
of my plan. As I have however
many other things respecting the benefit of
seamen to offer, peculiarly respecting distant
climates, I shall take notice of this, where it
may come in, more pertinently to the subject:
till then, that must be left to the management
// 012.png
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of the apothecary who is applied to for fitting
out the box. If he is a man of candour and
judgment he cannot be much out of his
calculation, when he knows the number of
hands, and the voyage intended.
With respect to the other lectures, I have,
as near as it was practicable, divided them
into their different classes and sections; at
the same time the whole is so linked together,
that one lecture must support the other. And
as I have throughout the whole course of
the book differed more or less from the general
mode of practice, I must hereby declare,
that I have in this consulted my own experience
more than any other authority,
without fear of censure, or hope of applause,
any farther than of truth, and my own
conscience.
Though I have principally written with
an intent to be understood by masters of ships
who carry no surgeon; yet I am well persuaded
that every practitioner, whether on sea
// 013.png
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or shore, will find many things to his improvement.
With respect to my receipts, they are simple
and powerful; yet I do not enjoin so strict
a conformity to them, by the practitioner, who
has an extensive knowledge of the materia medica,
and is prepossessed in favour of some
particular medicines; but as he will discover
my indications, it may serve greatly to compare
that of mine with his own, and then he
may judge for himself. I have touched very
slightly on the requisite diet for patients on
board a ship; though this is an essential
article regarding health in general: But I
found that subject also of so very extensive
a kind, that it would swell the book;
but as I have many valuable things to offer
of the same nature, I must beg, that in the
mean time, the reader will be satisfied with
the universal observations in general; namely,
that temperance is the principal object
and that patients who are deprived of exercise
ought to have the most easy digesting
// 014.png
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food. Copper and lead are pernicious; but
iron and earthen ware are safest either on sea
or shore.
In order to render the book as useful
as my zeal has intended, I recommend it a
fair perusal, from the first page to the last;
a book of this nature is apt to be looked
into, only when advice is wanted: that method
is wrong; and in such a case, the best
book in the world is apt to mislead. It is
not enough that we know what we are to
do with such and such disorders, but we
should previously know what the disorder
is; and how shall we know that, without
having some idea of the evil before it comes
on?
A book of this size is soon perused;
taking a lecture or a section at a leisure time
on board, will soon send the reader through
the whole; and I flatter myself, that one
perusal will lead to the second, when then it
may be referred to for advice with safety; and
// 015.png
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I hope a study so essential to self-preservation,
will be viewed in a more agreeable light,
than it has hitherto been.
To compleat the whole, a copper-plate
is annexed, wherein the most material utensils
are exhibited, which was scarce capable to be
explained by bare description, to men unacquainted
with surgery.
To conclude, I must beg leave to observe,
that the respect and esteem, with which I
have been constantly honoured by every
worthy seaman, whose life and health were
committed to my care, have I confess, stimulated
my endeavours, to offer them this
book as a grateful return. And I am happy
to reflect, that my experience in life
enables me to make it worth their acceptance.
May they reap that benefit from it,
which my heart has intended them; and this
is all the reward I wish to obtain.
.rj
N. D. FALCK.
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ERRATA.[#]
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Page #5#. line 22. for cataplexy, read apoplexy. Page #6#. line
16. read, that a pressure on that part, not only occasions an
apoplexy, but even stops life itself. Page #26#. line 17. for
theirs, read thus. Page #35#. for Sect. vii. read viii. and following
ix. x. Page #61#. line 4. for five or six, read about
four or five. Line 21. for iniform, read inform. Page
#91#. line 18. read, in order to get into. Page #131#. line 29.
for purify, read putrefy. Page #135#. line 12. delete them.
Page #142#. line 2. from the bottom, read, and is a sufficient.
Page #158#. line 6. for malignitus, read malignities. Page #239#.
line 7. read, the patient when not able to crawl to the tub,
so revived &c.
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These errors have been corrected for this ebook (May, 2019).
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To the BINDER.
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The Copper-Plate and its Explanation are to be placed at
the End of the Book.
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THE||CONTENTS.
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.hr 50%
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LECTURE I.
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An anatomical and physiological description of the human body
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.ta l:10 h:20 r:5
Sect. I.|Of the composition and close connection\
of parts in the human body|#2#
Sect. II.|Of the brains and nerves|#5#
Sect. III.|Of the heart and lungs|#9#
Sect. IV.|Of the circulation of the blood|#12#
Sect. V.|Of the joint connection of the\
brains, heart, lungs, &c.|#15#
Sect. VI.|Of chylifaction, and nutrition|#19#
Sect. VII.|Of the bones, muscles, ligaments,\
tendons and their connection.|#28#
|A skeleton of the human body|#31#
Sect. VIII.|Of the urinary organs and genital parts|#35#
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Sect. IX.|Of the skin|#40#
Sect. X.|Of the external senses|#43#
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.hr 50%
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LECTURE II.
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On the requisite means and medicines towards restoring health.
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Sect. I.|Of the pulse|#50#
Sect. II.|Of the effects of bleeding|#55#
Sect. III.|Of the operation of bleeding|#58#
Sect. IV.|Of the requisite medicines useful at sea|#63#
|A plan of a medicine box—#64#. Of\
utensils, and medicines—#65#. Lancets,\
ibid. scissars, probe, spatula—#66#. Bistouries,\
and incision lancets, teeth instruments,\
syringes—#67#. Clyster pipes and\
bladders, clyster syringe, scales and\
weights—#68#. Splints—#69#. Bandages,\
rags, tow, lint, tape, needles, thread and\
pins—#70#. Camomile flowers, balm, sage,\
sassafrass—#71#. Oatmeal, cinamon, allum,\
chalk—#72#. Salts, diachylon plaister—#73#.\
Mercurial plaister, blistering\
plaister—#74#. Spirits of wine and\
camphire—#75#. Liniment of soap, sweet\
oil, sweet spirit of nitre—#76#. Honey, yellow\
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basilicon; elixir of vitriol—#77#. Elixir\
proprietatis, lenitive electuary—#78#.\
Turner’s Cerate, fever powders, stomachic\
powder—#79#. Calomel—#80#. Precipitate—#81#.\
Mercurial ointment—#82#.\
Rhubarb, jalap, ipecacuanha, liquid laudanum—#83#.\
Essential oil of peppermint,\
Turlington’s balsam|#84#
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LECTURE III.
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On accidents, and their proper method of treatment
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.ta l:10 h:20 r:5
Sect. I.|Of falls|#89#
Sect. II.|Of wounds—91. Cut wounds|#92#
|bruised wounds—94. Gun-shot wounds|#96#
Sect. III.|Of bruises|#98#
Sect. IV.|Of dislocations|#99#
|Dislocation of the arm with the shoulder|#101#
|Dislocation of the elbow or the knee|#103#
|Of spraining the wrist, or ancle|#103#
|Dislocation of the thigh bone|#104#
Sect. V.|Of fractures|#107#
|A fracture of the skull|#108#
|Fracture of the arm|#109#
|A fracture of the thigh bone|#110#// 020.png
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|A fractured leg|#111#
|Compound fractures|#114#
|Conclusive observations on fractures|#115#
Sect. VI.|Of scalding|#118#
Sect. VII.|Of burning|#119#
Sect. VIII.|Of drowning|#120#
|The method to recover a drowned person|#123#
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LECTURE IV.
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On external diseases, and their cure
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Sect. I.|Of inflammation|#130#
|Of resolution|#132#
|Of suppuration|#133#
|Of tumours|#134#
|Of mortification|ibid.
Sect. II.|Of ulcerations|#137#
Sect. III.|Of the diseases of the skin|#142#
|Of the itch|ibid.
|Of boils|#144#
|Of ring-worms, daw-worms, &c. &c.|#145#
|Of the lousy disease|ibid.
Sect. IV.|Of promiscuous disorders|#148#
|Of the tooth-ach|#149#
|To draw a tooth|ibid.
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|Of sore eyes|#152#
|Of the ear-ach|#153#
|Of hoarseness and sore throat|#154#
Sect. V.|Of the venereal disease|#156#
|Of the gonorrhœa|#157#
|Of the phimosis and paraphimosis|#158#
|Of the chordee, and priapism|#159#
|Of the dysuria|ibid.
|Of shankers|#160#
|Of the bubo|#161#
|Of swelled testicles|#162#
|Of venereal excrescences|#163#
|Of the second infection|#164#
Sect. VI.|Of the bite of venomous animals|#166#
|To cure the bite of a rattle snake|#167#
Sect. VII.|Of the bite of a mad dog|#170#
|The signs of a mad dog|#171#
|The effect of a bite of a mad dog|#172#
|Of the cure of the bite of a mad dog|#173#
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LECTURE V.
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Of fevers and inflammatory diseases, and their proper method of treatment
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Sect. I.|Of fevers in general|#182#
Sect. II.|Of accidental fevers|#184#// 022.png
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Sect. III.|Of a cold|#192#
Sect. IV.|Of intermitting fevers, and agues|#193#
Sect. V.|Of putrid and malignant fever|#203#
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.hr 50%
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LECTURE VI.
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Of the various internal diseases, and their method of cure
.nf-
.ta l:10 h:20 r:5
Sect. I.|Of diseases of the head, of the apoplexy|#208#
|Of the phrenzy and delirium|#210#
|Of a stupor and lethargy|#211#
|Of a violent head-ach|#213#
Sect. II.|Of diseases of the neck|#214#
|Of the malignant sore throat|ibid.
Sect. III.|Of diseases in the breast|#219#
|Of the cough|ibid.
|Of the pleurisy, and a peripneumony|#221#
Sect. IV.|Of diseases of the bowels, and the\
alimentary canal.|#224#
|Of a Depraved Appetite|#225#
|Of the Colic|#228#
|Of looseness, and bloody flux|#230#
Sect. V.|Of the Scurvy|#233#
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LECTURE I.
.sp 2
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AN
Anatomical and Physiological Description
OF THE
HUMAN BODY.
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The mechanism of the human body is
so wonderfully, so curiously, and so
wisely contrived, that the more we examine
it, the more we must with admiration acknowledge,
that nothing but an Almighty Being
could be its author. This incomprehensible
Being let us ever remember to reverence and
adore, when we examine into the stupendous
contrivance of our fabric; HE is the fountain,
the benevolent upholder of nature, and all
the creation; in whom we live, breathe, and
have our being.
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SECT. I.
.h4
Of the Composition and close Connection of Parts in the Human Body.
.sp 2
The human body is composed of solids
and fluids; these are so closely, and so
intimately combined with each other, that
we find upon a physical enquiry and examination,
they are scarce separable. They aid
and give action to each other, and life depends
not on each singly, but on the united,
and on the separate spur, and on the soul of
activity each gives to the other: Their substances
form the body, and their action produces
the operation of the mind.
Whilst every thing moves free and agreeable
to the talk prescribed by nature, the
automaton is in a state of health; body and
mind enjoy peace and tranquility. So
closely are body and mind in the most perfect
bond of friendship, that they share pleasure
and pain sympathetically with each other;
and reciprocally contribute to each other’s
welfare.
With what satisfaction is the mind continually
engaged to give pleasure to the body!
and with what alacrity are for ever the Members
ready to obey the will! Happy harmony,
by which we so wonderfully exist!
// 025.png
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The solids are the canals and springs of life,
and the fluids, which circulate in those canals,
nourish them, and set the springs in action.
By the solids we understand,
1st The bones; the frame and support
of our wonderful structure.
2dly. Gristles or cartilages; which cover
the ends of the bones, in order to make them
move with ease and agility.
3dly. Muscles; the fleshy parts, which by
a nervous sensation, are induced, either voluntarily
or involuntarily, to contract or
dilate themselves, in order to give motion
to the various parts of our body, to which
they are fastened or destined to move.
4thly. Tendons; the chords as it were, by
which the muscles are fastened to the bones,
so as to make them follow the contraction
of the muscles.
5thly. Ligaments; the chords by which the
bones are connected with each other, and which
give a firmness to their contact and articulation.
6thly. Arteries; the canals which transport
the blood from the heart, to all the parts of
the body.
7thly. Veins; the canals which carry the
blood from the remotest arteries (in the most
minute parts of the body) back again to the
heart, for a new rotation of the blood.
8thly. Lymphatic Vessels; which are small
cellular canals, that convey the lymph in
different parts of the body.
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9thly. Glands; which are kernels formed
to secrete or separate various humours from
the blood.
10thly. Nerves; these are medullary
branches springing from the brain, and distributed
in the most minute parts of the
body; ordained to give the act of sensation,
as the soul of animal activity.
11thly. Hair and nails; these are a horny
substance, and appropriated either for defence
or warmth of the different parts where
they are placed.
The fluids; are, 1st. Blood; which is circulated
in the arteries and veins, and is the
nutriment and source of life.
2dly. The different humours separated by
the glands from the blood; of which there
are many, as the lymph, serum, spittle, seed,
chyle, urine, gall, &c. appropriated to different
uses, as hereafter will be described.
3dly. Fat, and marrow in the bones; which
are designed not only as a store of nourishment,
but to lubricate and warm the parts
where they are lodged.
These are the principal materials which
compose our wonderful machine. There are
various other parts mentioned by Anatomists,
both solids and fluids; but as this is designed
only to give a universal idea of the most
material parts of the structure of this stupendous
fabric, we will let this definition suffice,
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and now consider with what order the principal
organs of life act, either in consort, or
in opposition to each other.
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SECT. II.
.h4
Of the Brains and Nerves.
.sp 2
The brains are by all Physiologists
esteemed the most mysterious organs of
life, being the fountain of the nerves, the
organs of sensation, and hence allowed by all
to be the seat of the soul, or the sanctum
sanctorum of the human understanding.
They are distinguished into the common or
great brain called cerebrum; the small part
called cerebellum; and the spinal marrow, which
projects down the back-bone. The great
brain is divided into two great lobes, seated
in the upper and fore part of the skull, of
which it takes in the greatest cavity. It is
so exceedingly sensible, that the least pressure
puts an immediate stop to the sensation of
the animal; and which is generally termed
a apoplexy.[#]
.pm fn-start // A
Hence in a fracture of the skull, or any other heavy contusion,
where the brain is compressed either by the fractured
bone, or the extravasated blood, the patient will remain in a
state of stupefaction, till either the fracture is reduced,
or the extravasated blood removed by trepannation; after
which he immediately comes to himself, as if suddenly revived
from a trance.
.pm fn-end
// 028.png
.pn +1
This part of the brain, though it is so exquisitely
sensible, seems to be designed by
nature as preparatory to the cerebellum, the
immediate root of the nerves.
The cerebellum is the lesser, but the more
material part of the brains. It is seated in
the hinder cavity of the skull, (which for
the sake of protecting this exquisite sensible
organ, is remarkably strong and firm) and
from thence as the fountain of life itself, the
nerves, the instruments of sensation in the
whole animal frame, take their commencement:
For whereas the other is so sensible,
as that the least pressure will cause a stupor;
this is so far superior in point of exquisite
sensibility, that a pressure on that part, not only
occasions an apoplexy, but even stops life itself.
From this cerebellum prolongates the marrow
in the back-bone, called medulla spinalis,
which is but a continuation of the same, and
is equally sensible, and of the same substance
with the former.
The whole brain, that is, the great brain,
the small brain, spinal marrow, together
with all the nerves which spring from thence,
are covered with two coats, called the external
stronger coat, dura mater; and the thinner
and inner coat, pia mater; which continue
with each nerve, even to its smallest
// 029.png
.pn +1
ramification. The whole in a living subject
is in a continual motion peculiar to itself.[#]
.pm fn-start // A
This motion in the brain is not unlike the peristaltic
motion; this is an observation too seldom taken notice of by
anatomists, though evidently plain in living animals, and is
of singular service in physiological enquiries.
.pm fn-end
From the cerebellum, and medulla spinalis,
all the nerves take their commencement and
origin. Ten pair spring forth from the part
in the skull; the principal are those which
form the various senses, tasting, smelling,
hearing, and seeing, and that common to all,
feeling. From the medulla spinalis, or marrow
in the back-bone, proceed thirty pair of
nerves, which spread themselves variously
over the whole system.
All nerves have this in common with each
other, namely, exquisite sensibility; but in
other respects they differ however widely;
particularly the nerves destined for some of
the external senses.
It is from that common quality feeling,
that they become the subtile springs of life;
and give an edge to all the animal functions.
There is nothing so plentifully, and nothing
more curiously interwoven with every other
substance, as the nerves; and so amazingly
quick is their sensation, that the very instant
a single nerve, even the smallest and remotest
in the system, is affected, the soul, or the
common sensorium, is sensible of the identical
part so affected.
// 030.png
.pn +1
It has been asserted, that this amazing quick
conveyance of the sensation of the nerves,
is owing to a subtile nervous fluid;
but on a rational reflection, and a just enquiry
into the animal œconomy, it must appear,
that such conveyance of a fluid is inconsistent
with probability and experience: For, neither
are the nerves tubulous, nor has there
ever been discovered any circulating humour
in them. And secondly, is it consistent with
reason, that a conveyance of a fluid from the
toe to the finger, should be so momentarily
quick, as is sometimes experienced in the
gout, and other the like ailments? That the
quick transposition of sensation of the nerves,
is rather effected on a principle of vibration,
appears more probable, and will admit of a
more convincing experiment; which may be
exemplified in the following manner: Suppose
(in the language of a seaman) a rope
runs from the top-mast-head, or any other
part of the rigging, to the deck, and is kept
tought and free from any interception; then
it will be evident, that the least touch at one
end will instantaneously be conveyed to the
other end; in like manner the nervous sensation
may be communicated, perhaps not
unlike electricity; which similarly will in
an instant be conveyed to any part, by a
direct communication, but equally subject to
be intercepted.
// 031.png
.pn +1
Hence, a paralytic limb will lose, together
with its irritable sensibility, its circulation of
fluids, and its nourishment; and recover
again when the pressure or interruption is
ceased. Hence also, spasmodic contractions
will be affected at the irritation of some
principal parts, and from this instantaneous
irritability, the motion of every part is
thought to obey the will.
.sp 2
.hr 60%
.h3
SECT. III.
.h4
Of the Heart and Lungs.
.sp 2
The heart is a muscular body, situated
in the breast or chest, somewhat between
the lobes of the lungs, and formed by nature
to be the principal organ for the circulation
of the blood and other fluids.
Its structure is wonderful, and of a most
curious piece of mechanism. It has two
principal cavities, called ventricles, which are
separated length-ways by a wall, and distinguished
into the right and left.[#]
.pm fn-start // A
They might with equal propriety, be termed anterior, or
foremost, and posterior or hindermost.
.pm fn-end
Each of these cavities or ventricles, have
particular valves, call’d ears, or auricles;
which perform the function somewhat similar
// 032.png
.pn +1
to the suckers of a pump: By these contrivances
the heart receives the blood from
the veins, and expels it again by the arteries,
to every part of the human body; in a manner
that I shall hereafter describe.
The lungs are organs immediately concerned
in the circulation of the blood also;
their function is to receive the air, to purify
it, to circulate, and to distribute it in due
proportion in the sanguineous mass, and to
extract and expel that part of air already
made use of; and thus act the part of ventilators
in the animal œconomy.
They are divided into two lobes. These
lobes are a continuation of little bladders,
that have an immediate continuation with
the wind-pipe, aspera arteria. The wind-pipe
from the larynx down to the very
lungs, is protected externally with semicircular
gristles, in order to keep it always
open, and so shelter it from external injury;
when it enters the lungs it spreads itself into
numberless branches like a tree, and sends
ramifications into every little air-bladder in
the lungs.
All along these ramifications and the air-bladders,
are arteries, veins, and lymphatic
vessels, which have an immediate communication
with the heart, by means of the
pulmonary arteries and veins.
// 033.png
.pn +1
Now at the instant of inspiration, these
little bladders in the lungs are filled with
air, which infuses itself by the small arteries
into the whole mass of blood; and at the
expiration again, the air which has been
made use of, and drawn from the neighbouring
little veins, is again expelled by the wind-pipe
through the mouth: And thus is respiration
performed by alternate motions of
the lungs; receiving the fresh, and alternately
expelling the foul air again; thence
justly may they be deemed the ventilators
of the human automaton, and a principal
organ of life, in the animal creation
in general.
The upper part of the wind-pipe, which
is in the fauces of the mouth, is called the
larynx. This is the organ of voice.
In this animal mechanism is contained, all
the variety of formation requisite to every
kind of sound that can be performed upon
any instrument whatever. Its parts are
chiefly of a gristly substance, at the same
time exquisitely delicate, with nerves and
glands; from whence it is subject to diseases
on the slightest indisposition.
In men it is larger than in women; hence
their voice is rougher; which generally increases
by exercise of the voice also. Its
formation is very complex, and too tedious
here to enter upon; we will therefore pass
// 034.png
.pn +1
it over, and hereafter say as much as relates
to its preservation, and giving it relief when
disordered.
.sp 2
.hr 60%
.h3
SECT. IV.
.h4
Of the Circulation of the Blood.
.sp 2
We shall now consider the circulation of
the blood; the grand source of our
existence. At the contemplation of which
we must be lost in admiration, at the wonderful
wisdom of its contrivance; and with
uplifted eyes adore the cause of its motion!
The Heart, as I before observed, has two
chambers or ventricles, distinguished by the
right and left; each of these chambers have
also a valvular cavity call’d auricle, or ear.
Each ventricle opens itself into an artery and
auricle; and each auricle opens itself into a
ventricle and vein. These openings have
valves, which open and shut alternately, and
by this, prevent any confusion or hindrance
in the influx and efflux of the blood.
The right ventricle is the longest and
greatest, but weakest: From this ventricle
springs forth the pulmonary artery, which
spreads itself throughout the Lungs.
// 035.png
.pn +1
The right auricle is also the largest; in
which opens itself the large vein, called vena
cava; as the common trunk that receives the
blood from all its branches spread over the
whole human body.
The left ventricle is shorter, but the walls
are considerably stronger than that of the
right ventricle. Here begins the aorta, or
the great artery, by which the blood is sent
to all the parts of the human body.
The left auricle is also somewhat smaller
than the right; and in that opens itself the
pulmonary vein, which returns the blood
from the lungs, after it has received its necessary
assistance from the vesicles of air in
the lungs.
This premised and understood, the circulation
is performed in the following manner:
The right ventricle being full of blood,
contracts itself. This contraction is called
the systole, by which it forces the blood
through the pulmonary artery into every
part of the lungs, even into every vesicle;
where it receives a portion of the air, drawn
in by the wind-pipe.
At the end of these arteries join the ramifications
of the pulmonary vein, which receives
the blood from the ramifications of the arteries,
by anastomosation; which, by little
quantities, these veins gather gradually into
little branches, and at last become one common
// 036.png
.pn +1
trunk, which empties the blood into the
left auricle of the heart.
From the left auricle it is let, by means
of a peculiar constructed valve, into the left
ventricle; which, by a dilation called the
diastole, receives it from its auricle.
Immediately upon this reception, the systole
or contraction takes place, and the blood
is forced into the great universal artery, aorta;
by which it is farther transported into every
part of the human body.
This artery spreads as it goes, and continually
decreases in magnitude, as it becomes
numerous in branches; until it terminates
into the smallest ramification in the remotest
part of the body.
The systolic contraction, and the diastolic
dilation, which alternately take place in the
heart, continue throughout the arteries from
the great trunk to the remotest capillary ramifications,[#]
by which means the blood is
transported with more certainty and facility
to the minutest part.
.pm fn-start // A
Concerning this great act of continued systole and diastole,
Anatomists have greatly varied; but from the structure
of the arteries, and the continued pulsation, this way of transporting
the blood is confirmed both by reason and experience.
.pm fn-end
At the extremity of these arteries the veins
take their commencement, in ramifications
equally small with the former; these take up
the blood from the arteries, by many infinite
// 037.png
.pn +1
small quantities, and carry it gradually back
from those extremities to the heart again,
for a new rotation.
These veins commencing infinitely small,
but gradually gathering, become branches, and
at length form one general trunk, called the
vena cava, (or the great universal vein); and
this empties itself again into the right auricle;
from whence it is let again into the right ventricle,
whence it came; then again forced
into the lungs; thence back again into the
left ventricle; from thence all over the whole
body, and continues the Circulation.
.sp 2
.hr 60%
.h3
SECT. V.
.h4
Of the Joint Connection of the Brain, Heart, Lungs, &c.
.sp 2
These are the principal actions in the
grand movement of the human automaton.
The nerves are the subtile springs of the
sensation, by which the whole becomes sensible
of irritation, and agitated to its functions.
Their ramifications are extended ad
infinitum, and so curiously distributed, that
though there is not a part in the whole system
exempt from their spreading, yet they
// 038.png
.pn +1
are distributed with such regularity, that
they don’t interfere with each other. A regularity
absolutely requisite to the order in
the animal œconomy: For whereever the
vibration of the nerves is obstructed, life or
motion must in consequence cease.
The lungs are the ventilators in the system:
they receive and let in the air; they
sift it from all its gross particles, and extract
the useful parts from this universal element
of life; thus they give from every little vesicle,
a due proportion of extracted air to the
blood by the adjacent veins; and by the neighbouring
arteries, again extract the foul air
from the circulated blood, which by the
mouth and nostrils is expelled again; at that
instant a fresh quantity of air is drawn in
again for a new supply.
Thus by intervals, the lungs, like a perfect
ventilatory machine, repeatedly, and without
intermission, keep time with systolic and
diastolic motions of the heart, in exchanging
fresh and foul air for the support of this
wonderful animal structure. This is the
function of breathing respiration, namely
inspiration, or the drawing in the fresh air;
and expiration, the expelling the foul air.
The heart may be considered as the grand
perpetual pumping engine, constructed on
principles, so as to have the least friction
possible.
// 039.png
.pn +1
This curious pump, the heart, sends the
fluid of life, the blood, to all the parts, even
the remotest in the whole machine. The
arteries are the canals of the conveyance;
they are strong elastic tubes, whose fibres are
of spiral direction, and receive from the heart
a power of contraction; which is continued
from the heart in the moment of the systole,
even to the remotest and most minute ramifications;
by which the blood is pushed
along to the minutest extremities. This is
immediately succeeded with a diastolic reception
of a fresh quantity of blood; so that on
succession, the diastole and systole is perpetuated
not only in the heart, but throughout all
the arteries, in a friendly correspondence over
the whole system: And this constitutes the
pulse.
The veins, however, are somewhat of a
different texture from the arteries; whilst the
arteries transport the blood by an elastic and
pulse-like contraction, the veins on the contrary,
receive it from them at the extremities,
in an easy and imperceptible gradation;
for whereas the fibres in the arteries are in a
spiral direction, elastic and strong, the coat
of the veins are tender, and the fibres more
longitudinal.
Hence, the wounds in the arteries and veins
differ greatly; for whilst the arteries are for
ever in a strong agitation, the veins
// 040.png
.pn +1
perform their functions with less exercise;
and therefore the wounds in arteries are always
attended with danger, whilst the veins
heal easy. From the same reason also, the
arterial blood differs from the venal; for as
the arterial blood is sent to all the Parts, as
the grand nutriment, from whence the glands
secrete their peculiar humours; the veins
only transport it back again, to prepare
it for a new rotation. Whence the
blood in the arteries is of a high colour, and
of a more alkalascent nature, than that in the
veins.
Collateral with the minute ramifications of
the veins and arteries, over the whole
system, are the lymphatic vessels, which separate
from the blood as it passes along, a
transparent lymphatic humour, adapted for
the different parts, which they are connected
with.[#] These vessels are materially different,
from either arteries and veins in their structure,
and justly to be compared to a continuation
of little cells; so constructed, as to transport
the humours, without admitting a return.
.pm fn-start // A
An opinion has lately been broached, that the lymphatics
are all absorbing vessels, of the same nature with the lacteals,
and that they all join to empty themselves in the subclavian vein
to the common mass of the blood; but this to me, seems too
general, and contradicts experience.
.pm fn-end
From hence we see plainly how these three
organs, the brains, the lungs, and the heart,
// 041.png
.pn +1
are concerned, and mutually assist each other
in the actions, and circulation of the fluid of
life; nothing could move without the sensation
of the nerves; these could not exist
without the blood, from which they receive
their support; the blood could not circulate
without the heart, arteries, and veins;
and in them it could not move with a necessary
freedom, except its being supplied
with a sufficiency of air from the lungs: So
that evidently all three are so interested in
this grand movement, that the stopping of
the one, must needs be the stopping of the
whole.
.sp 2
.hr 60%
.h3
SECT. VI.
.h4
Of Chylifaction and Nutrition.
.sp 2
In the preceding we have briefly considered
the state of the fluid of life, and
mechanical instruments of their motion in the
human machine. In this we will consider
how the whole is supported, and the vital
lamp, from time to time, becomes supplied.
Under this consideration we will examine
the canal of food, and the various changes
the morsel undergoes from the time we take
it in our mouths, till the nutriment is reduced
// 042.png
.pn +1
to blood, and the remaining dross is expelled
the body as useless.
The animal functions towards chylifaction
and nutrition, are mastication, or chewing the
food; deglutition, or swallowing; digestion;
chylifaction; nutrition; and the excretion of
the fæces.
In order therefore to understand this clearly,
it becomes necessary to describe the organs
which nature has formed for the requisite
performances thereof.
In the first place then, smelling is that sensation
which nature has given to every animal,
that has a choice of food, as the first
safe-guard to inform it of any thing agreeable
or disagreeable, useful or pernicious to
its body; its seat is in the nose chiefly, but
we find by experience, that it has a friendly
connection with our palate and stomach;
for the effluvia of any thing will either
create a desire, or give us the greatest aversion
to every substance that throws out a
flavour.
It is performed by means of a subtile
spreading of nerves, peculiarly delicate; which
continues through the membrane of the nose,
the roof of the mouth, gullet, and the
very stomach.
Taste is the next sensation, which nature
has given us, not only as a distinguisher of
proper food, but a sensation from which we
receive many luxurious pleasures; and to
// 043.png
.pn +1
the indulgence of this sensation, most evils
and plagues to mankind, take their origin.
The tongue is the principal instrument of
that peculiar quality; but if we examine
somewhat closer into this affair, we shall find
that the soul of pleasure and pain of that sensation,
as well as that of smelling, has its
seat in the stomach; for that which will
taste pleasing and good at the first approach,
will soon lose its relish when the stomach is
gratified: and, if any thing tastes disagreeable,
the stomach receives it with reluctance,
and will ever incline to discharge it again.
The tongue is an instrument (if I may be
allowed the term) very curiously constructed;
it is moved by a variety of muscles, and
serves not only for tasting, but also as a
labourer, to shovel and to turn our meat between
our grinders; so that nothing may
escape being well masticated, and intermixed
with that fine digesting balsam, the spittle,
in order that it may be easily swallowed.
Besides this, it makes the most requisite
instrument for the noble and excellent faculty
of speaking; which forms one of the
principal characteristics that distinguishes man
from the brute creation.
The gullet or oesophagus, is the canal which
conveys drink and food from the mouth to
the stomach; this canal is a muscular, tendinous,
and vascular tunic.
// 044.png
.pn +1
The commencement of it is in the mouth,
and is called the pharynx; a curious structure,
that receives the food, and by its contractive
motion, and the help of the tongue,
forces the aliment into the stomach.
The stomach is much like the bag of a
Scotch bag-pipe; it lies immediately under
the diaphragm or midriff, covered partly on
the right side with the liver, and on the
left side with the spleen. The left and superior
part, is continued with the oesophagus;
and the right and inferior part, or orifice,
commences the intestines.
The first orifice is called the mouth of the
stomach; and the second the pylorus, or
porter: At the porter there is a curious valve
which lets the aliment out by small parcels
into the intestines, where it undergoes its
various other changes.
The stomach has three teguments, a muscular,
a tendinous, and nervous coat; this nervous
coat has another slimy one, but this in
reality, is a delicate lining, interwoven with
nerves, and the ramifications of fine blood
vessels.
The intestines or guts, are a continuation
of the stomach, they are a canal which is
generally reckoned six times as long as the
subject it is taken from; it is distinguished
in small tenuia, and wide crassa.
// 045.png
.pn +1
Each again is divided into three parts:
the tenuia, or small narrow intestines, are
the duodenum, or twelve finger-gut; the
jejunum; the ileum: The wide or crassa, is
divided into the cæcum; the colon; and the
rectum.
Throughout the whole canal of intestines
are numbers of little vessels, called lacteals,
which lead the chyle, extracted from the aliment,
into a receptacle, which is lodged in
the mesentery, and from thence, by another
duct call’d the thoracic duct, is carried along
the back-bone upwards, and joins to the left
subclavian vein, where the chyle gradually
commences to be blood.
This short description we will let suffice,
and now enter upon the action itself.
The morsel now, which is designed for
food, is taken into the mouth, masticated
with the teeth, turned about with the tongue;
and as the mouth is at work, the saliva or
spittle is squeezed from the salival glands,
and thus intermixed with the aliment; when
enough chewed and moistened with this saliva,
it is conveyed to the pharynx, or swallow,
which receives it, and, by its contraction,
forces it into the oesophagus; and by
a repeated contraction, is carried down into
the stomach.
There it is again moistened with saponaceous
liquid, or pancreatic juice; by which
// 046.png
.pn +1
and by a perpetual motion of the stomach, it
is brought into a state of digestion; then by
small degrees entered through the pylorus or
porter, into the first division of the gut, the
duodenum.
This gut is about twelve fingers long;
and whilst the aliment is there, it is intermixed
with the gall, which is a liquor separated
by the liver, and contained in the gall
bladder; this liquor, the gall, is carried into
the duodenum, by a small duct, called the
ductus cysticus; where also enters another
kind of liquor called the pancreatic juice.
When the aliment is thus prepared, and
fit for a particular state of dissolution, it is
carried into, and through the jejunum. This
gut is in length about twelve or thirteen
hands breadth, and its motion somewhat
brisk; through which the aliment passes
pretty quick, and hence, generally is somewhat
empty.
As it passes through this part, the chyle
is separated from it by the lacteals, which are
small vessels that separate the chyle from the
aliment, and abound there more than in any
other part of the gut.
From thence it comes into the ileum; that
is the longest of all the divisions of the guts,
and is in length about twenty-one hands
breadth; it has a great many circumvolutions,
and next to the jejunum, has many lacteals
to separate the chyle.
// 047.png
.pn +1
Now the aliment comes into the wide gut,
and gradually becomes fæces; and first, the
cæcum: This part is rather an appendix only,
and hangs from the main part like a finger
to a glove. The use of this gut has been
much controverted by anatomists; it seems
however, very probable, that this appendix
is designed to keep the aliment in for further
digestion, as it now begins to putrefy, and
becomes fæces or excrement.
From thence it enters the colon, which is
a long, and very winding intestine; it runs
up along and about the liver, touches the
gall bladder, and the spleen; from thence
it descends again to the os sacrum. It has
but few lacteals, and is, as it were, the last
drainer of the fæces: It is this intestine
which is the seat of the Colic, and of most
other complaints of the belly.
Next to this comes the last and straightest,
the rectum; this gut is closely adherent to
the sacrum, and ends in the fundament;
which is provided with muscles to open and
shut the anus, in order to contain the fæces,
and discharge it.
The mechanism of chylifaction in the human
body differs from the brute creation in
general, except that most contemptible of
the whole, the hog; to which it bears a very
near resemblance, insomuch that there is very
little distinction.
// 048.png
.pn +1
Both have that advantage over the generality
of terrestrial animals, that they are
confined to no particular food; which favours
greatly the luxury of the one, and the
beastiality of the other.
The brute creation are generally distinguished
into carnivorous and granivorous:
The first is that kind which feeds upon flesh;
and the latter upon grain and vegetables.
Upon examination however, we find, that
the stomach and guts are peculiarly adapted
to their food; and that grass agrees no more
with the dog, than mutton does with the
horse.
But man is so happily made, that any
thing which is food, is proper for him, and
he may become used to it; and thus is either
carnivorous or granivorous.
The whole canals, from the stomach to
the anus, is in a continual vermicular motion,
which is called the peristaltic motion; by this
the aliments are dissolved, and disunited;
and as they pass along, are drained by the
lacteals, of their nutriment or chyle.
These lacteals are, by means of a membrane
(with which they are surprisingly interwoven,
and connected to the whole canal)
called the mesentery, lead regularly into one
common cistern, lodged almost in the middle
of the intestines, in that membrane, called
the receptacle of chyle; and from thence the
// 049.png
.pn +1
chyle is carried by a duct up along the back-bone,
called the ductus thoracicus, into the
left subclavian vein, where it gradually commences
to be blood.
By this mechanism we are nourished, and
the substance of our food converted into
blood, and transported through the whole
animal machine, for the support of every
part of its wonderful composition.
As all animals which feed upon flesh, are
more subject to diseases, nature has provided
them with these advantages: that when any
thing is obnoxious to their nature, and received
into their stomach, or their being over
loaded, it can discharge itself of so troublesome
a burthen, by vomiting, which is effected
thus: when the inner coat of the stomach,
which is irritable and nervous, is stimulated
by whatever is obnoxious, it will cause in
the whole stomach, a contraction; and by
that, force its contents to the shortest direction
of evacuation, namely, by the canal of
the oesophagus, through the mouth. This
expulsion is peculiar to carnivorous animals
only.
Purging or discharging by the fundament
is common to all animals of whatever kind;
and is performed by an irritation in the intestines,
by which the peristaltic motion is
increased; to this I must add a reversion of
the secretion of the lacteal vessels, by which
// 050.png
.pn +1
the humours are increased, the motion accelerated,
and the fæces discharged, without
giving any nourishment to the body, and
consequently the system diminished.
Digestion is that act by which the aliment
or food is prepared, so as to produce a good
chyle, and consequently good blood, for the
nourishment of the body. Though no animal
has a more delicate stomach than man,
yet it must be observed, that none has a
stomach better adapted for all kinds of food.
Whence therefore in the common course
of life, temperance and gentle exercise is
what nature requires to maintain health.
But nothing becomes more obnoxious to
that blessing, than gluttony, voluptuousness,
and idleness.
.sp 2
.hr 60%
.h3
SECT. VII.
.h4
Of the Bones, Muscles, Ligaments, Tendons,\
and their Connections.
.sp 2
The bones may be considered as the timber-work
of the human frame; by
which this wonderful fabric is supported,
and kept in its due form, that the whole
may be brought into its various movements,
without confusion or obstruction to each
other.
// 051.png
.pn +1
The bones are the most solid parts of the
human body, composed of hard and indurated
fibres, striated over each other, in a
manner peculiar to that substance. The
bony fibres are in themselves insensible, yet
as the parts are variously distributed with
arteries and veins, and that the nerves must
necessarily have a share in their formation,
they have a peculiar sensibility, which is
perceptible in some parts more than others;
they cannot strictly speaking, be deemed
quite insensible.
The whole bony frame is covered with a
tendinous and nervous tegument, called periosteum;
except such parts of the teeth as
are designed for mastication, which are provided
with a peculiar enamel, that is harder
than the rest of the bony substance.
The periosteum is exquisitely sensible, and
is the safe-guard to the substance of the
bone, which is delicately tender notwithstanding
it is not so sensible as the skin that
covers it; insomuch that it will become carious
on the least exposure to the air, or the
attack of any foreign body of matter whatever;
whence in wounds and fractures in general,
great attention should be paid to the substance
of the bone, being very subject to become
carious and to exfoliation, which is
of the greatest consequence; but of this I
shall say more in another place.
// 052.png
.pn +1
The marrow is principally designed for
the nourishment of the bones; which is evident
from its being plentiest in young people,
when the bones are strongest; and that when
it is deficient, they become brittle, and lose
their tenacity.
The marrow is contained in a cellular
substance, partly in vesicles of a nervous texture,
and partly bony cells. At the ends of
the long bones the texture is more spungy
than in the middle, where the cavity is less,
but the substance is most compact. Though
anatomically there is no perceptible circulation
in the bones, yet, that a circulation is
actually existing, is evident, from a liquor
oozing out from the ends of a fractured
bone in the living animal; by which a fractured
bone again unites, and this is called
the callus; and whilst in its liquid state, resembles
the white of an egg, which gradually
ossifies, and becomes as hard as the main
substance of the bone.
The number of bones differ somewhat in various
subjects; ordinarily they amount to two
hundred and fifty-two: In the head sixty-three;
in the trunk seventy; in the arms and
hands sixty; and in the legs and feet sixty.
As the bones are the support of the animal
fabric, I have inserted in the next page,
a catalogue of the human skeleton, which
occasionally may be referred to:
// 053.png
.pn +1
.sp 2
.h4
A Skeleton of the Human Body.
.nf c
Bones in the Head.
The Skull.
The Forehead.
.nf-
.ta h:15 r:6
Os Frontis|1
.ta-
.nf c
The Hindhead.
.nf-
.ta h:15 r:6
Os Occipitis|1
.ta-
.nf c
The Sides of the Head.
.nf-
.ta h:15 r:6
Ossa Parietalia|2
.ta-
.nf c
The Temples.
.nf-
.ta h:15 r:6
Ossa Temporum|2
.ta-
.nf c
The Basis of the Skull.
.nf-
.ta h:15 r:6
Os Ethmoides|1
Os Sphenoides|1
.ta-
.nf c
The Bones of Hearing.
.nf-
.ta h:15 r:6
Ossicula Auditus|8
.ta-
.nf c
The Face.
The Upper-Jaw.
.nf-
.ta h:15 r:6
Ossa Malæ|2
——Maxillare|2
——Unguis|2
——Nasi|2
——Palati|2
Os Vomer|1
.ta-
.nf c
The Under-Jaw.
.nf-
.ta h:15 r:6
Maxilla Inferior|1
.ta-
.nf c
The Teeth.
.nf-
.ta h:15 r:6
Dentes Incisivi|8
——Canini|4
——Molares|20
.ta-
.nf c
The Tongue-Bone.
.nf-
.ta h:15 r:6
Os Hyoides, is composed of|3
|—
|63
.ta-
.nf c
Bones in the Trunk.
The Spine.
.nf-
.ta h:15 r:6
Vertebræ Cervicis|7
——Dorsi|12
——Lumborum|5
.ta-
.nf c
The Ribs.
.nf-
.ta h:15 r:6
Costæ Vera|14
——Spuria|10
.ta-
.nf c
The Shoulders.
.nf-
.ta h:15 r:6
Scapula|2
Claviculæ|2
.ta-
.nf c
The Hip and Bason.
.nf-
.ta h:15 r:6
Os Sacrum, is composed of|6
Os Coxygis, is composed of|3
Ossa Innomenata, composed of|
——Ischium|2
——Ilium|2
——Pubis|2
.ta-
.nf c
The Breast.
.nf-
.ta h:15 r:6
Sternum, is composed of|3
|—
|70
.ta-
.nf c
Upper Extremities.
The Upper Arm.
.nf-
.ta h:15 r:6
Os Humerus|1
.ta-
.nf c
The Under Arm.
.nf-
.ta h:15 r:6
Ulna|1
Radius|1
.ta-
.nf c
The Wrist.
.nf-
.ta h:15 r:6
Ossa Carpi|8
.ta-
.nf c
The Hand.
.nf-
.ta h:15 r:6
Ossa Metacarpi|4
.ta-
.nf c
The Fingers.
.nf-
.ta h:15 r:6
Ossa Digitorum|15
|—
|30
.ta-
.nf c
Under Extremities.
The Thigh.
.nf-
.ta h:15 r:6
Os Femoris|1
.ta-
.nf c
The Knee Pan.
.nf-
.ta h:15 r:6
Patella|1
.ta-
.nf c
The Leg.
.nf-
.ta h:15 r:6
Tibia|1
Fibula|1
.ta-
.nf c
Ancle.
.nf-
.ta h:15 r:6
Ossa Tarsi|7
.ta-
.nf c
Foot.
.nf-
.ta h:15 r:6
Ossa Metatarsi|5
.ta-
.nf c
Toes.
.nf-
.ta h:15 r:6
Digitorum|14
|—
|30
.ta-
.sp 2
// 054.png
.pn +1
The connection of the bones are in various
ways; those connections that are designed
for rest, are by close contact of parts, and
are called sutures or seams; such are the bones
of the skull with themselves and the face.
Those connections which are designed for
motion are called articulation. Some of the
articulations have but an obscure motion, as
the ribs with the back-bone, and the back
with itself, &c. Others have an angular
motion, as the elbows and knees; and others
again have an universal motion, as the arm-bone
with the shoulder, and the thigh bone
with the hip. The sutures, and such connections
as have no motion, are merely dovetailed
into one another in close connection;
but those articulations that are designed for
motion are connected by cartilages, either
in close contact, or so as to move slippery
over one another.
The ligaments are those tough tendinous
parts, by which the articulations designed for
motion are joined together; at some parts
they cover the joints only, and at others,
they are immediately fastened to each other,
besides the external coverings; those ligaments
are very strong and elastic, and have
a close connection with the nerves that pass
by them.
The surrounding ligaments of all moveable
joints, form a capsular-bag, which contains
// 055.png
.pn +1
a slippery liquor, called synovia, that
lubricates the ends of the bones covered with
cartilages, that they may move with ease
and agility over one another.
Muscles are the fleshy parts on the human
body, appointed for motion. They are a composition
of arteries, veins, nerves, and tendons.
Muscles are generally divided into two kinds;
those for necessary or involuntary motion,
and those for voluntary. Some again are
fastened at each end to some of the bones at
their extremity, and contract themselves in a
straight direction; others again are annular,
or in the form of a ring; and by this manner
open and shut. The first kind are generally
divided into three parts, the head,
belly, and tail. The whole muscle begins
and ends in a tendon, by which it is fastened
to the part it is designed to move; which,
when the belly of the muscle contracts itself,
must consequently draw both bones nearer
together, fastened to the head and tail; and
thus performs the motion. Some of these
muscles act in consort, and others in opposition
to each other.
The tendons are the principal parts of the
muscle; and that part thereof, as before observed,
which is fastened in the bones, namely,
at the head and tail of the muscle, and
is the chord, as it were, by which the limb
is brought into motion.
// 056.png
.pn +1
A tendon is a hard, substantial, flexible,
and elastic body, which, at the head of the
muscle, is very compact; but as it enters
the muscle, spreads its fibres over the whole
body, gathers again at the tail, in as
compact a manner as it began, and continues
in this chord-like texture till it fastens itself
at its appropriated place.[#]
.pm fn-start // A
It must be observed however, that tendons take on many
various forms, as different as the muscles; which would
be too tedious here to particularize.
.pm fn-end
The tendons and ligaments are of equal
substance, and differ in nothing but their various
uses; namely, the ligaments to connect
the articulation; and the tendons, or the
ends of the muscles, to give motion. The
muscles are a composition of the tendinous
fibres, plentifully intermixed with small ramifications
of blood vessels; all which compose
the fleshy part thereof. Hence, the
tendons being white and hard, the muscles
gradually grow softer and redder in the middle
of them; and they verge gradually to become
tendinous at the tail, the same as the head.
Hence, from the close texture of the tendons,
they are very painful when wounded,
or otherwise hurt; but as the muscles are
softer and more pliable, their wounds and
other accidents are of less consequence, and
not so dangerous as the former.
The number of muscles are undetermined,
for though the principal muscles are so distinct
that they cannot be mistaken as to their
// 057.png
.pn +1
form and use, yet there is so great a number
of small ones, or so many of the great ones
capable of being subdivided again, that anatomists
have not, as yet, agreed about their
number.
.sp 2
.hr 60%
.h3
SECT. VIII.
.h4
Of the Urinary Organs and Genital Parts.
.sp 2
The kidnies, the ureters, the bladder, and
the urethra, are the principal urinary
organs. The kidnies receive two arteries
called the emulgent arteries, from the great arterial
trunk, called aorta, before described;
they each send also two veins back again,
accompanying the arteries to the vena cava.
Whilst the blood is circulated in the kidnies,
the urine is secreted in many small quantities,
and carried from each kidney by a tendinous
tube, the bigness generally of a small goose
quill, called the ureter to the bladder. The
ureters enter the bladder between its lamillas,
so as not to admit of a return. Hence, a
bladder in its natural position is both wind
and water tight, and if reversed, is neither.
The bladder of urine is of a tendinous
and nervous texture, and capable of great
extension, but at the same time exquisitely
// 058.png
.pn +1
sensible. The neck of the bladder is very
muscular, and by this forms a sphincter, or
annular muscle, by which the urine is retained;
and as it is of a very sensible nature,
this part is subject to inflammatory
constrictions; great pain, and many evils
have there been occasioned, either from venereal
cases, or gravelous complaints.
From the neck of the bladder to the end
of the penis, is the urethra; which canal
serves for the emission of the urine, as well
as that of the seed.
The whole is lined with a number of
very little glans, to lubricate and protect
the sensitive lining from the sharpness of the
urine.
These are the urinary organs. We will
in the next place, proceed to the organs of
generation.
The testicles are the principal instruments
for forming the human seed; they are generally
two in number. The testicles receive
the blood, of which they secrete the seed,
from the aorta, about the same parts, whence
the emulgent arteries project. These arteries
run down from the aorta to the testicles,
in a very contorted and winding manner,
accompanied by the veins which return back
again from the testicles, and fix themselves
in the ascending vena cava. These contorted
and interwoven vessels are called the spermatic
// 059.png
.pn +1
vessels, which carry the blood from the
arteries in little quantities, and slowly return
it again into the great vein.
Whilst the blood is circulated in the testicles,
the seed is secreted in them; but as it
is secreted, it is transported back again from
thence by tubes, called vasa deferentia, towards
the neck of the bladder, where there
are two irregular bladder-like vessels, wherein
the seed is contained, and kept for use,
called the vesiculæ seminales.
In these seed bladders the seed is kept for
use, till it is wanted. They are remarkably
delicate and nervous; and when they are
filled with seed, they stimulate all the organs
of generation with a desire for venery.
The penis, or the manly member of generation,
is partly covered with the common
skin; the foremost part of which, that covers
the glans, is called the præpuce. This
præpuce is tied underneath to the substance
of the penis, by what is called the frænum.
The inner part of the penis is composed
of two kinds of bodies, the cavernous bodies
of the penis, and the cavernous body
of the urethra. The first are bodies enveloped
in their peculiar teguments, and
make the greatest part of the penis. Each of
these bodies takes its origin from the erecting
muscle of the penis, which is near the
pubis; through each of them goes an artery
// 060.png
.pn +1
and a nerve, which spread themselves
through these bodies.
These bodies are full of cavities, which
have all a communication with one another.
The cavernous body of the urethra continues
from the bulb, near the neck of the bladder all
along to the end of the penis, and includes the
glans, or the nut of the yard; and is much
of the same substance with the former. At
the back of the penis, goes along the large
vein, called the vena penis, which spreads itself
all along into numberless branches that connect
themselves with the ramifications of the
arteries throughout all the cavernous bodies;
and from thence is caused the erection, as I
shall presently describe. The glans, or the
nut of the yard, is remarkably delicate and
sensible, as being the seat of pleasure in coition;
it is also of a cellular substance, and in
one continuation with the cavernous body
of the urethra.
Its sensation is greatly heightened by the
frænum being tied underneath, from the præpuce
to that part which keeps it, as it were,
in an agreeable constriction when erect.
The penis is allowed two pair, and
a single muscle. The first pair is the erectores,
which take their origin from the fleshy
protuberances of the ischium, and lose themselves
in the cavernous body of the penis.
The second pair of muscles is the transversales;
// 061.png
.pn +1
these take their rise near the forementioned,
and fasten themselves at the root of
the penis. The fifth is the accelerator, or
the odd muscle; this muscle takes its commencement
from the cavernous body of the
urethra, and grasps the whole penis, and
adheres to the sphincter of the anus; the muscles
aid and assist each other in the erection
of the penis, which happens in the following
manner:
At the influx of the animal spirits, the
vena penis, or the great vein in the penis is
somewhat contracted, whence the blood is
forced into the cavernous bodies of the penis
and that of the urethra, as the reflux of the circulating
blood from the arteries is hindered;
hence, the cellulæ of the cavernous bodies are
obliged to swell up and distend all the parts,
and thus make the penis turgid and erect;
when the penis is further titillated by the
friction of coition, the parts become generally
irritated to an agreeable constriction,
whereby the seed rushes from the seed-bladders
into the urethra, and is thus forcibly
ejected in the time of ejaculation; then the
whole fabric slackens, the constriction of the
great vein relaxes, the blood regains its free circulation,
and the penis becomes slack again.
These are the faint out-lines of the genital
parts; but to have a full description and
comprehension of the peculiar properties of
// 062.png
.pn +1
the genitals of both sexes, and also the sacred
act of generation, I recommend
to a serious perusal of the anatomical and
physiological description of the genital parts
of both sexes, in my Treatise on the Venereal
Disease, where they will find a full and satisfactory
account.
.sp 2
.hr 60%
.h3
SECT. VIII.
.h4
Of the Skin.
.sp 2
The whole human automaton is covered
with a skin, the mechanism of which
is not less curious than what we have already
described.
It is a texture curiously interwoven with
an infinite number of tendons, arteries, veins,
nerves, and lymphatic vessels. The tendons
form the net-work of the whole, and give
it an elasticity, from whence it requires a
muscular motion; and the rest add each
their parts, as I shall hereafter describe.
The skin, universally over the whole body,
is divided into three parts; but in most
parts it is found to have four.
The external, is the cuticula, or scarf
skin; this is a horny and insensible substance,
formed by nature as a shelter for the next
// 063.png
.pn +1
part of the skin, which is exceedingly sensible;
on examination it appears to be a
horny substance, and as it were, little scales
continued from the immediate skin, which
on any external injury, such as repeated
friction, fire, scalding, or blistering, separates
from the main skin. The next is the real
skin, called cutis; This is strongly interwoven
with tendinous and nervous fibres, interspersed
with numberless ramifications of
arteries, veins, and lymphatic vessels; whence
it is not only exquisitely sensible, but elastic,
and on the least injury, subject to bleed.
On the external surface is a very thin
plexus, called the reticulare; which has the
tinge of the natural hue of the skin, and distinguishes
the complexion of the negro, the
tawny, and white, from each other.
The structure of the cutis is peculiarly
curious, and may justly be considered as a
continued secretory and excretory gland; or more
properly, like the bark of a tree; for whilst
there is continual transpiration from the
body, it, at the same time, is capable to absorb
the subtile particles of whatever surrounds
it, and exclude the grosser. Over the whole
surface are innumerable little pores, which
are nothing but the little openings of the
various lymphatics, and of the blood vessels
corresponding with their peculiar glandules,
called the milliary glans; between those on
// 064.png
.pn +1
the hairy parts, the hair is planted as it were,
with their distinct roots, corresponding with
the hue of the subject they belong to.
These pores widen or contract according to
the internal or external warmth of the body;
which when they contract, cause a kind of
roughness, or continuation of little warts;
and on the contrary, when dilated, smooth
the skin. Next to this follows the fat skin,
or membrana adiposa; which is a continuation
of cells, wherein the fat is contained,
and has an immediate communication with
the neighbouring blood and lymphatic vessels.
This part is not universal, for some
parts of the face, the genitals, &c. are without
it. The last of all is the membranosa, a
thin parchment-like texture, which adheres
spontaneously to whatever part it covers,
either periosteum, the tendons, ligaments, or
muscles.
These are the four principal divisions of
the skin; but that which is the principal, is
the second mentioned, namely, the cutis; on
which I shall have occasion to offer something
hereafter, that may prove of the greatest
advantage to the sea-faring people, for
whose benefit I have particularly intended
these Lectures.
// 065.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. IX.
.h4
Of the External Senses.
.sp 2
Feeling is the universal sensation of
the nerves, on which all other senses
depend, as the subtile spring of life itself.
What it is, and whence it proceeds, has already
in the foregoing been explained; namely,
a sensation of the nerves, by which we
perceive an idea of hard or soft, wet or dry,
hot or cold, or in general terms, pleasure or
pain. The peculiar seat thereof seems to be
placed at the ends of our fingers; whether
this is the absolute seat ordained by nature,
or rendered so by custom, is not my business
here to enquire; perhaps, both conjoin to
make it there most perfect, as best suited for
that purpose.
Taste is the next sensation of the nerves,
regarding an immediate approach and action
of substances themselves, in order to distinguish
betwixt the nature of foods, by which
we are enabled to form an idea of salt, sweet,
sour, bitter, sharp, or mild; which according
to their mixture and proportion, render taste
agreeable or disagreeable. Its seat is principally
in the tongue; but that it extends to
the very stomach itself, is evident, from the
immediate consent of parts; namely, that
// 066.png
.pn +1
what is disagreeable to the palate, will ever
be nauseous to the stomach: Of which I shall
say more hereafter.
Smelling is that sensation given to the animal
creation, as a friendly messenger of
taste, in order to enable us the better to
chuse our food. It is actuated by means of
the olfactory nerves spread in the pituitary membrane
of the nose, and has an immediate communication
with the brain; which nervous
plexus is actuated by odorous particles, exhaling
from substances, by which the olfactory
nerves are stimulated agreeably, or disagreeably,
as the first intelligence to the palate,
or to the whole consent of the nervous system.
Hearing is that sensation of the nerves
which is occasioned by the vibration of the
air, and forms the sound, which enters the
cavity of the ear, and tremulates and puts in
action, the organs of hearing. The ear is
perhaps as curious a piece of mechanism to
our conception, as any part whatever we
shall meet with in anatomy.
To the organs of hearing we must reckon
the external and internal auditory, divided
by a thin membrane, which is a thin spreading
of nerves, called the drum; within
this, or in the internal cavity, we observe,
// 067.png
.pn +1
1st. Four little bones called, from their forms,
the hammer, malleus; the anvil, ancus; the
stirrup, stapes; and roundling, orbicularis.
2dly. Their peculiar muscles. And, 3dly. Two
considerable cavities, the labyrinth and aqueduct.
How hearing is actually brought
about, Anatomists have not as yet agreed;
and which would be too tedious here to enquire
into. That the little hammer is perpetually
moving on the tympanum, according
to the different sounds, may be one part;
which, however, is greatly assisted by the
other organs.
The labyrinth, with many turnings and
windings, penetrates through the skull and
forms part of the aqueduct, by which the
sound is modulated and magnified, so as to
cause the distinction between them, and convey
the idea of their sonorousness to the
common receptacle of sensation.
Seeing is that great faculty by which the
form, colour, and motion of objects is represented
to our ideas. The principal conveyer of
this wonderful sensation, is the optic nerve; the
eye is a telescope finished to the greatest perfection;
or like a camera obscura, where objects
are pictured to the utmost nicety, and
a due proportion observed in their nature. It is
a globe enrolled with a strong tendinous coat,
and filled with three kinds of humours perfectly
// 068.png
.pn +1
clear and transparent, which differ in nothing
but their various degrees of liquidity and
form. Each of these humours is enclosed
in a delicate thin transparent membrane.
The external coat of the eye is called the
cornea, from its resemblance to horn, being
a continuation of the dura mater and pia
mater; and is every where opaque, except at
the entrance of the light, which is called
pupilla, and projects somewhat beyond the
spherical form of the eye, similar to the
crystal of a watch. Inside the cornea it is
lined with a spreading of the optic nerves,
called the retina, where objects are reflected;
by which the ideas are immediately conveyed
to the brain.
The humours are the following: The
aqueous humour, the most external, which is
designed for collecting the rays of light;
the second is the crystaline humour, which is
in the form of a magnifying lens, and invested
with a subtile transparent tegument,
and so curiously fixed, as to be contracted
and dilated, according as the objects are near,
or removed from the eye; and accordingly
the crystaline humour requires to be flattened
or thickened; the last is the vitrous humour,
which fills the remaining cavity of the eye;
this humour serves to spread the objects
again on the retina, and arrange them in
their natural order, so that the picture of the
// 069.png
.pn +1
objects viewed, may be preserved in its due
proportion and regularity.
Now the act of vision is performed thus:
The convex transparent part of the cornea
faces at once every object which comes within
the direct lines thereof, and this is termed
a full view.[#] This view enters through the
aqueous humour, where the whole is contracted
according to its convex and concave
form, so as to make it fit to enter the pupilla,
which is a muscular continuation of the sclerotis,
and called the uvea; and from thence the
whole view passes through the crystaline
lens, by which the view is again magnified,
and passed through the vitrous, and the
whole depicted on the retina, in the same
concave curve, and at equal angles in which
it was first received, and apparently the same
magnitude; thence representing the objects
in their natural perfection, figure, colour,
magnitude, and motion.
.pm fn-start // A
It is the general received opinion, that objects are reversed
in the representation on the retina of the eye. This
is however a mistake; I hope on another subject to prove this
in a full and satisfactory manner.
.pm fn-end
When, however, an object is singled out
of the whole view for particular attention,
the uvea then contracts or dilates, which,
together with the muscular action of the
whole ball, proportions all the humours
suitable to the magnitude and distance of the
// 070.png
.pn +1
object under examination, and the quantity
of light; and to make the eye more capable,
the lids are frequently moving, in order to
moisten and varnish, as it were, with a liquid
pressed from the innermost gland, called
canthus major, to keep the surface smooth,
and assist its transparency. If this intense
looking is continued beyond the strength
of this noble organ, it relaxes from its proper
destined expansion, and the objects are
rendered obscure.
Darkness is ease and rest to the eye, because
it is then out of action; whilst light
always keeps it in exercise; And in diseases
of the eyes, light should be kept away as
much as possible.
Here then I shall beg leave to conclude
this short description of the wonderful structure
of our frame; which when we duly
consider, will never fail of filling our breasts
with a sense of admiration; and induce us to
lift up our souls with reverence and gratitude,
to that incomprehensible GREAT CAUSE,
by whose wisdom we are formed; and by
whose goodness we exist.
// 071.png
.pn +1
.sp 2
.pb
.sp 4
.h2
LECTURE II.
.nf c
ON THE NECESSARY
MEANS AND MEDICINES
REQUISITE TOWARDS
RESTORING HEALTH.
.nf-
.hr 60%
.sp 2
Having, in the preceding lecture,
given a general view of our wonderful
structure, I shall, in this, endeavour to lay a
foundation of the healing art, in order to
assist nature when impaired by the attack of
disease, or any unforeseen accidents.
But that I may become useful, and yet
concise, I will, without loss of time, lead the
reader to the principal distinction between
health and disease; for without forming a
proper judgment of an ailment, there can
be no reasonable intention of cure. I shall
// 072.png
.pn +1
therefore beg leave to solicit a serious
attention to the following important observations,
particularly, as they are founded upon
the purest principles of physic, authenticated
by happy success in an extensive practice,
and communicated by the dictates of a
candid and well disposed heart, that wishes
Existence only as a useful member to society.
.sp 2
.hr 60%
.h3
SECT. I.
.h4
Of the Pulse.
.sp 2
When we consider the admirably curious
structure of the human mechanism,
it must clearly appear, how easily the
animal œconomy may become disordered.
But so kind has the ALLWISE AUTHOR of
our existence been to his creatures, that on
the slightest indisposition, the whole system
is sensible of the least disagreeable sensation;
and every part, with a social and sympathetic
friendship, is ready to relieve the fabric
from whatever is obnoxious, and causes the
disturbance.
As nothing has a greater share in life than
the blood, so nothing likewise on the least
indisposition, is sooner set in commotion,
and gives the alarm, than this very liquor,
in which life itself is contained; and the circulation
// 073.png
.pn +1
of this fluid in the arteries, furnishes
us with the greatest prognostic, namely, the
pulse, by which we may, with any degree of
certainty, judge of the state of the body, and
foretell good or bad events. How beneficial
it is then to be acquainted with this knowledge,
I shall leave to every rational being
to determine.
Every artery in the living body constitutes
a pulse, as has been explained in Sect. V. in
the foregoing lecture.
And it is demonstrative from simple reason,
that the pulsation of such arteries must
be in proportion to their magnitude, greatest
in the heart, whence they take their origin;
till the vibration must gradually be lost to
the touch, as they become insensibly small,
and lose themselves in their ramificatory capillary
tubes.
The artery which is most convenient to
our examination, is that which lays immediately
to the touch on our wrist, below
the thumb, on the radius, just below the
knuckle of that bone; and it is there we are
best able to distinguish the pulsation of the
arteries, as being most exposed to the external
touch; because it is immediately between
the skin and the flat of that bone.
Thus much premised, we will first consider
the pulse in the sound state; and next
// 074.png
.pn +1
make a comparison with that in people labouring
under diseases.
In a full grown man, in the vigour of
health, the pulse ordinarily beats once to
every second, that is, 60 times in a minute,
3600 in an hour, and 31,536,000 times in
a year. It varies however in different subjects,
according to the stature, temperament,
condition, time, and action of the same; insomuch,
that two persons equally in a good
state of health, shall, however, differ widely
in their pulses. Yet, notwithstanding, there
are peculiar signs, which will ever make a
true distinction between health and sickness;
practice however is requisite to form a proper
judgment of such distinction.
In order to lay a proper foundation to understand
the nature of this great prognostic,
I shall divide the pulse into the following
classes:
1st. A full, slow, and regular pulse, denotes
a perfect state of health; for whilst the blood
moves regularly in the arteries, without pain
to the nervous system, or disturbance to the
animal œconomy, the pulse will beat precisely
regular, without trembling, fluttering,
hurry, distinction, or feebleness, and discover
to the touch, a peculiar easiness; and this,
every one, who wishes to become master of
that subject, should carefully attend to.
// 075.png
.pn +1
2dly. A full and quick pulse, indicates a fever;
for by the irritation of the nerves, the
vibration of the arteries are accelerated. If a
gentle perspiration attends it, it may be deemed
salutary; and with this pulse it appears, that
nature makes a vigorous effort to expel what
is obnoxious: therefore in such a pulse, a
gentle perspiration generally gives relief.
3dly. A full, quick, and hard pulse, denotes
great irritability in the nerves, and a redundancy
of blood; this is the pulse of a fever;
and here bleeding, if timely applied, is very
requisite, as also medicines which promote
perspiration.
4thly. A small and quick pulse, denotes an
irritability in the nervous system, and a contraction
of the arteries; this is generally the
pulse which attends sudden shocks and frights,
as also in the cold fits of agues. The causes
should carefully be attended to: if, from a
sudden shock, bleeding is useful; but in the
latter case, it is hurtful. It seldom lasts
long, and a full feverish pulse generally follows,
and the state of the patient ought here
to be the guide: for, the same pulse may
proceed from too great a plenty of blood, as
well as from a deficiency; consequently requires
different treatment; and this shall be
pointed out more fully hereafter.
5thly. An irregular full pulse, is at all
times a bad one; many may be the causes,
// 076.png
.pn +1
and generally denotes a great confusion in
the nervous system, and in the circulation of
the blood. This pulse is generally the attendant
on violent inflammations, phrenzy, delirium,
&c. and if it continues any time, forebodes
great danger: bleeding in time is
greatly requisite, and other remedies, in order
to assist the nerves, and bring the circulation
to its proper regulation again.
6thly. An irregular small pulse, is frequently
the attendant of an emaciated constitution,
putrid fevers, and consumptions; and this
dangerous pulse too generally forebodes the
approach of death. The more irregular the
pulse grows, small, weak, trembling, and leaves
off by irregular intervals, the sooner dissolution
is at hand; till at last, the pulse entirely
disappears, and life ceases. But dangerous as
this pulse is, yet it must be observed, that it
often appears in the strongest constitutions,
as in sudden emotions of the mind, falls, &c.
or in a swooning. This is also the last and
the first pulse in suffocations; or in other
words, the struggling pulse between life and
death.
These few distinctions of the pulse we
will let suffice, as they, when properly attended
to, will in all cases enable us to make
a true distinction between health and the different
stages of sickness, and accordingly
direct us to a true method of cure.
// 077.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. II.
.h4
Of the Effects of Bleeding
.sp 2
There is, perhaps, not a greater remedy
in medicine than bleeding; but good
and effectual as it is, yet I will venture to
say, there is none more pernicious than this,
if injudiciously applied. As I value the life
of my fellow creatures, I would at all times
caution them against the injudicious application
of this operation, being persuaded, that
more have lost their lives by the lancet, than
by the sword, and pestilence itself. Not to
be tedious on this important subject, I shall
give here some very few rules, whereby a
patient may be judged in a proper state for
bleeding; and likewise, where that operation
ought to be avoided: for all the service we
can possibly hope and receive from bleeding,
is to lessen the quantity of blood, by which
the whole body becomes relaxed, consequently
less liable to the inflammatory irritation,
that a too great quantity of blood might occasion;
but on the contrary, if the solids are
but weak, and the blood poor, we only augment
the evil by bleeding, which we would
wish to remove, as thereby the system becomes
weakened, and not able to disengage
itself from the obnoxiousness it is incumbered
// 078.png
.pn +1
with; and thus proves the very destruction
it was intended to remedy. The notion of
drawing off the bad blood by bleeding, is very
erroneous and absurd; the whole is too intimately
mixed, and will ever generate the
same again till the disease is removed.
.h4
Bleeding is requisite
1st. When a strong robust person, of a
full and sanguine complexion, by accident
receives a heavy contusion; a broken limb;
or wound, whereby the parts become inflamed;
a fever like to ensue; and that the
pulse becomes hard and full, the veins distended,
&c. &c.
2dly. When such a person receives a great
shock, fall, terror, or any other strong emotion
of the mind; whereby the blood becomes
rarefied, or threatens a fever.
3dly. In the beginning of pleurisy, peripneumony,
sudden and violent fevers, great
colds, &c. as also scalding, burning, apoplexies,
convulsions, palpitations, suffocations,
and all such dangerous violent disorders; in
these cases only bleeding is useful, and then
it ought to be performed immediately, and
with great moderation: six or eight ounces
is enough from the strongest man; if requisite,
it may be easily repeated, but if overdone,
it is not so easily replenished.
// 079.png
.pn +1
.h4
Bleeding in general is hurtful
1st. In agues, notwithstanding the violent
paroxysm of the hot fit, because the solids
are here too much relaxed.
2dly. In all contagions distempers; this
is a circumstance worthy the greatest attention.
Reason and experience prove that
bleeding here is very improper; for by bleeding,
the contagious miasmata is drawn only
the more into the whole mass of blood, and
this is the fatal stumbling block, by which
thousands have lost their lives. The manner
of treating such distempers with success, I
shall shew in its proper place.
3dly. In all old standing diseases, where
there is a low, weak, though quick pulse;
for in such cases bleeding is very improper,
as the system is already too much reduced.
4thly. In all dropsies, scurvies, lentors,
consumptions, &c. for here instead of bleeding
and lessening the power of the solids, the
patient wants strengthening, and has no
blood to spare.
5thly. In all rheumatic and gouty complaints;
for here nature must be assisted in
order to throw off what is painful, by such
means as will strengthen the solids, expell
what is obnoxious, and prevent it from returning
to the blood, or falling upon some
more important part.
6thly. In all venereal cases, particularly if
recent; as by bleeding, the pox will unavoidably
// 080.png
.pn +1
be the consequence; as the venereal virus
will be absorbed in the whole mass of blood.
7thly. In all paralytic cases, and such
weaknesses where the strength of the body is
already impaired.
8thly. and lastly, In the time of other evacuations
of the body; as purging, fluxes,
bloody fluxes, &c. and particularly when the
body is in a sweat, or perspiration. From
this, I hope, the good and bad effects of
bleeding will be understood in many other
cases, which would be too tedious to mention
here; I shall therefore proceed to the operation
of bleeding itself.
.sp 2
.hr 60%
.h3
SECT. III.
.h4
Of the Operation of Bleeding.
.sp 2
Bleeding is thought in general to be
a very simple performance; but in fact,
there is not an operation in all surgery, requires
more care, or is liable to more dangerous
consequences, if ill performed.
It is not only the opening a vein, but it
is to open it properly, (taking care not to
prick an artery or tendon) to take away a
sufficient quantity of blood, and to heal up
the orifice again.
In the bend of the arm are three distinct
veins, the head, median, and basilican.
// 081.png
.pn +1
The ancients, before the discovery of the circulation
of the blood, fancied the head, or
upper vein, carried the blood from the head;
the median, or middle, from the breast; and
the basilican, from the liver, &c. but this idle
conjecture is laid aside, as being highly absurd.
When it is remembered what was said
in the first Lecture, in Sect. V. of the circulation
of the blood, it will then plainly appear,
that all these veins become one before
they enter the body; so that there can be
no difference as to their quality in being
opened: either therefore, which lays most
conspicuously easy, is the vein that should
be chosen; for the arms of people differ in
this respect, as much as their features.
In order to chuse therefore properly, examine
with the finger how the veins lie;
if upon a flat hard substance, it is a tendon;
if a pulsation is perceived, there is an artery;
both which ought to be avoided if there
is a vein that lays more free and conspicuous
to the sight and touch. If however it cannot
be avoided, the vein ought to be opened with
the greatest caution, for the pricking of a
tendon would not only be exquisitely painful,
but endanger the arm by inflammation,
and even life itself; and the pricking of the
artery would endanger the patient’s bleeding
to death, or else form an anauresma, (which
is a bag of blood protruding from the artery)
// 082.png
.pn +1
equally dangerous to the life of the patient.
In general the middle vein is the safest and
most convenient, provided it does not cross
the tendon: for the upper vein lies frequently
very deep, and is but small, and the lower
frequently crosses a tendon, or lies immediately
over an artery.
However, one or the other will frequently
suit, and, with caution, the operation may
be performed with ease.
As to the choice of the arm, it can make
no difference in regard to the effect, whether
it is the right or left, for the veins of both
arms end at last in the great trunk of the
vena cava, before they enter the heart.
To the operator, however, the right is the
handiest, and to the patient, the left is most
convenient. In that arm however where
the best vein offers, that should be chosen.
When the arm is fixed on, then tie it up.
The place should be on the upper arm, about
two inches from the bend, and the vein fixed
on to be bled, first drawing up the skin a
little, and laving on the ligature twice round
the arm, drawn together with a draw knot;
the reason of laying on the ligature above
the intended orifice of the vein, is plain, as it
stops the reflux of the blood, which is transfused
from the heart by the arteries towards
the fingers, from thence taken up by the
veins, and by the ligature prevented from
// 083.png
.pn +1
flowing back again, and consequently distends
the veins, and swells them up.
When the ligature is laid on, (which may
be a garter, or a piece of tape, about four or
five feet long) and the veins are swelled up,
then open the vein. Bend the lancet so that
the blade and handle may make an acute angle;
take the blade between the thumb and
fore finger in the right hand, if the right arm
is bled, but if the left arm, the lancet ought
to be held in the left hand,[#] and open the
vein obliquely, so that the lancet cuts all the
while, stretching the vein a little downwards
with the opposite thumb. The lancet should
cut a little slantingly, for if perpendicular,
it would not only cause much pain, but be
apt to slip through the vein, prick a tendon
or artery, and occasion dangerous mischief.
.pm fn-start // A
This is the proper method of bleeding; for a bleeder
ought to be equally dexterous with the left hand as with the
right, which custom soon makes familiar; but those who are
awkward with the left hand, must stand behind the left arm
to bleed, which method may be adapted rather than to risk
danger.
.pm fn-end
The orifice should be somewhat obliquely
in the vein, neither directly length-ways, as
the veins would be apt to slip, and the orifice
not sufficiently opened to let the blood
pass freely; neither should the opening be
right across, as thereby the vein might be divided,
and the blood not be easily stopt, or
the orifice heal up. When now the vein is
// 084.png
.pn +1
well opened, let the blood run, (the arm a
little bent) till it changes to a higher colour,
the surest sign of being enough, and this
will be in about four, six, or eight ounces,
according to the constitution of the patient.
This simple rule I would advise to be attended
to, for whatever may be pretended
about presaging the quantity of blood beforehand,
certain it is, it cannot be ascertained
but in the time of bleeding.
When it is time to leave off, slacken the
ligature, and gradually untie it, when generally
the blood ceases to run; draw close the
orifice, and wipe it clean all round. Let the
patient bend the arm a little, and close the
orifice very close, then lay a four-folded dry
compress, the bigness of a crown, of clean
tolerable fine linen rag, and tie the arm up:
lay the ligature (a garter or a piece of tape
about four feet long) at the middle of the
compress, the one half round the upper arm,
the other on the lower arm, alternately, so
that they always cross each other in the
bend of the arm on the compress, till at last
it is either tied or pinned; care being taken
that it neither be too tight or too slack, so
that the arm may be bent or extended with
tolerable ease. Let the ligature remain on
twenty-four hours, when all will be closed up.
What is to be done if unfortunately a tendon
or an artery should be pricked, I shall
mention hereafter.
// 085.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. IV.
.h4
On the requisite Medicines to be used at Sea
.sp 2
As my greatest ambition in this life tends
only in becoming useful, I shall studiously
avoid that false pride of appearing learned.
There is perhaps not a medicine in the modern
materia medica, but what I have examined
into, and opportunely experienced the
virtue of; but so often have I been deceived
in my expectations, that out of the many
hundreds, with which I am acquainted, there
are not above a score, or at farthest two,
which in any case whatever I should expect
any benefit from. Yet I mean not to throw
out prejudices, for every physical man has his
favourite medicine, and we are all apt to
praise the bridge that carries us well over.
The little assortment of medicines however,
which I here offer, I know from experience to
be good, and as such I recommend them. I
have plowed the ocean myself, visited most
climates in the known world, and in my practice
on that precarious element, drawn such
observations, as makes me happy to think, that
they may prove useful to a class of men, who
daily experience the uncertainty of human life.
In the first place I shall draw the plan of a
sea medicine box, as may suit a ship that carries
no surgeon; in which I shall endeavour
to be so plain as I hope will prevent any mistake.
// 086.png
.pn +1
.sp 2
.nf c
The MEDICINE CHEST.
.nf-
.if h
.il fn=medchest.jpg w=600px
.if-
.if t
.nf l
+——————————————+—————————+————————+————————+——————————+————————————+
|{Lancets|A.|B.|C.|D.|11 Camomile|
|{Scissars|Spt. of Wine|Liniment of|Sweet Oil.|Sweet Spirit|12 Balm|
|1 {Probe|and Camphor.|Soap.||of Nitre.|13 Sage|
|{Spatula +—————————+————+———+——+—————+——————————+ 14 Sassafrass|
|{Teeth Instruments|E.|N.|O.|P.|G.|15 Oatmeal|
|2 Syringes|Honey.|Calom.|Fine Prec.|Me. Oi.|Elixir of|________________________|
|3 Clyster Pipes & Bladder| +————+——————+—————+ Vitriol.||
|4 Scales and Weights|___________________|Q.|R.|S.|____________________|16 cinamon, &c.|
|____________________________||Rhub.|Jalap.|Ipecac.||17 Allum|
||F. +————+——————+—————+ H.|18 Chalk|
|5 Splints|Yellow Basilicon.|T.|U.|W.|Elixir Proprietat.|19 Salts|
|6 Bandages||Liq. L.|E. O. Pep.|T’s. Ba.||________________________|
|7 Rags|___________________|_________|____________|__________+——————————+|
|8 Tow||||||
|9 Lint|I.|K.|L.|M.|20 Diachylon Plaister|
|10 Tapes, Thread, Needles|Linitive|Turner’s|Fever Powder.|Stomach|21 Mercurial Plaister|
|and Pins|Electuary.|Cerate.||Powder.|22 Blistering Plaister|
+——————————————+—————————+————————+————————+——————————+————————————+
.nf-
.if-
// 087.png
.pn +1
.nf c
Of the Utensils.
.nf-
First then, I shall speak of the utensils
and the instruments which must necessarily
belong to a medicine box, be it ever
so small.
In the box, No. 1.
Lancets: There ought to be three or
four, and they should always be kept clean
and bright in a case, free, as much as may best
from the dampness of the sea air. The best
method for this is, to wipe them often with
a dry clean linen cloth, warmed by the fire,
(taking care in the wiping of them, that the
blade of the lancet lays upon one of the handles,
by which the point is preserved) and
when properly cleaned, wrap the whole case
up in a large piece of dry paper. Let it be
a constant rule, to clean them well every
time they are made use of.
And here I must remark once for all, that
all iron or steel instruments are ever best preserved
clean and bright, by rubbing them
clean with a warm dry cloth, and then wrapping
them up in clean dry paper; by which
method I have preserved my capital instruments
with the same brightness, as they came
out of the workman’s hands throughout my
voyages, notwithstanding they have been
made use of, and frequently too.
// 088.png
.pn +1
The notion of oiling or greasing instruments
is very erroneous, and so far from preserving
them, that it will never fail of making
them more rusty. The wiping them
quite clean and dry, and wrapping them up
in warm dry paper, is certainly the best secret
for keeping all iron or steel bright at
sea, and deserves strictly to be attended to.
Scissars: There ought at least to be two
pair, one for common use, and the other for
particular purposes; and if the last mentioned
are crooked, they are certainly much the
better, being very handy on many occasions.
The best pair should be carefully preserved
as already directed.
Probe: A probe is very requisite for
searching of wounds, &c. It should be of
good silver, and the smaller it is in thickness,
even like a small wire, the better for use,
as it will bend and twist agreeable to the
place it is to search. At one end it should
have a neat smooth button, and at the other,
be triangularly pointed, like a sail needle, in
order to wrap lint round it to clean sores
with; its length should be six or eight inches.
Spatula: ’Tis not much matter what
the spatula is made of, whether silver or
iron, be it what it will, (provided it is neither
brass nor copper) one end should be
flexible, so as to be handy in spreading salves
// 089.png
.pn +1
upon lint, or for other the like purposes;
whilst the other should be more stiff, being
very useful for pressing the tongue down,
in looking and examining the throat. It
should be about six or eight inches long, and
an inch broad.
Bistouries and Incision Lancets: A bistoury,
or neat sharp cutting knife, is very useful
indeed in many cases. And a large incision
lancet, in the form of a common lancet,
except that the point inclines more one way,
is very necessary for opening aposthumes, and
where a collection of matter has been formed.
Teeth Instruments: Of the whole tribe
there is certainly none more universal than
the key; this ought to have three different
hooks, and so that they may shift and unshift,
according as the operation requires. The
gum lancet I have no notion of, I never saw
any occasion for it, and am apt to think it
rather an hindrance to the operation. The
instrument should be kept clean in the same
manner as I have said before.
2. Syringe: Each box ought at least to have
two. Ivory is the best substance they can
be made of; they ought to be pretty thick
and stout, as they are liable to warp. A
small one with a neat pipe, slender, and a
button to it, will be very useful for
the clap, or other cases, where injections are
requisite. A larger one for the ulcerated
// 090.png
.pn +1
sore throat, or other the like cases, where
quantities are required to be injected.
3. Clyster Pipes and Bladders: There ought
to be sundry. I would have them previously
mounted; and to prevent the bladder from
being decayed, or eaten up by vermin, or
moths, fill them up with wormwood; a
method I have found very effectual.
When they are to be made use of, they
are easily softened by a little lukewarm water.
The general method of mounting the
bladder on the pipe, is, by the assistance of a
cork in the pipe, which is to be drawn by a
string, when the clyster is injected; for my
part, I found it always a hindrance; and
therefore instead of the cork, I always chose
to secure the whole with a string, tied
with a slip knot, which when the pipe is
introduced, is much more easily undrawn.
A clyster syringe of pewter, that holds at
least a pint, or a pint and an half, is far more
preferable at sea, and might easily be made
with an additional pipe, by which a man
may be the operator himself.
4. Scales and Weights: This is a requisite
article, in order to proportion the doses of
medicines. The scales need scarce any description,
as they require no more than their
being of an equal length, and the whole in
equilibrio.
// 091.png
.pn +1
The Apothecaries weights come in the following
order, and signified by these characters:
.in +2
.nf l
1℔—A Pound is 12 Ounces.—℥xii.
℥i.—An Ounce is 8 Drachms.—ʒviii.
ʒi.—A Drachm is 3 Scruples.—℈iii.
℈i.—A Scruple is 20 Grains.—gr.xx.
.nf-
.in -2
These marks are generally stampt upon
the pieces. As a pound and ounce are not
generally used in the proportioning of doses,
they are omitted in the common little
boxes prepared for that purpose. The rest,
drachms, scruples, and grains, are marked
upon the requisite pieces; and which at the
first inspection may easily be understood.
I shall next proceed to another division
of the chest or box.
5. Splints: Of those there should be at least
four pair; two pair for broken legs, and
two pair for broken arms. They are generally
made of very thin deal boards, pasted
on leather, and slit, so as to bend to the parts
applied, sideways, but remain stiff length-ways.
Paste-boards may however be made use of
with good success; and if the paste-boards
are kept in sheets, they have the advantage,
that splints may be made of them occasionally;
but by fomentation they are apt to
become soft and flabby, which ought to be
guarded against.
// 092.png
.pn +1
6. Bandages: There ought to be three or
four long ones, two or three yards each, torn
length-ways off an old sheet, not too much
worn, stitched together so as not to make
a seam, three fingers broad, and neatly
rolled up, so that they always may be ready
for use.
7. Rags: are a most requisite article at sea,
and I can only say, the more there are the
better. They should by all means be clean,
and neither too coarse nor too fine.
8. Tow: is also a very requisite article. A
good large bundle should be provided, and
it should be cleared from the shaggins, as
they render it stiff and unpliable: the grey
is generally the best for medicinal purposes.
9. Lint: should also be somewhat plenty; but
as this may be made at leisure, the quantity
of that is not so material. Lint in the common
method is best made from rags torn
length-ways, about three fingers broad, and
the transverse thread drawn by the help of a
knife.
10. Tape: is very useful, particularly that of
two fingers breadth, and ought to be pretty
fine. At least a dozen of yards should be
provided.
Needles, threads, and pins should by no
means be omitted, being highly useful on
many occasions.
// 093.png
.pn +1
Secondly. I shall now proceed to the herbs,
which need but be few, as they are very subject
to decay.
11. Camomile flowers are much used by some,
and supposed to strengthen the stomach; I
could never think them of that effect. When
however a vomit is given, camomile tea is
very useful, and promotes greatly the operation;
but it should not be made too strong:
as much as may be taken between three fingers,
pouring on it a quart of scalding water,
and thus made into a tea. But that kind of
tea should not be too often repeated, unless
it particularly agrees with the stomach.
12. Balm: This is an excellent herb on many
occasions; it is cooling, and there is not
a tea I have more to recommend to sea-faring
people, let their ailment be what it will;
it is of a balsamic and healing nature, and
will not easily pall on the stomach, except
where there is an universal weakness in the system;
where then what is more warming to the
body than balm, may with propriety be added.
13. Sage: This is an herb of a more hot nature;
and in fevers should be used with caution,
unless where a transpiration is required.
It promotes urine and perspiration, in many
cases it may be used with the balm, and then
makes a very good tea, both for the sick as
well as those in health.
14. Sassafras: This is one of the warming and
balsamic woods, which, if it is mixed with
// 094.png
.pn +1
lignum vitæ chips, makes an excellent decoction
for all rheumatic complaints, and where
the blood wants to be diluted or purified.
15. Oatmeal: This article cannot strictly
be deemed a medicine, yet, as water gruel is
frequently wanted, that of oatmeal I think
the best; besides, it is excellent for making
poultices, being of a softening and rich quality.
But if it should be wanting, pounded
biscuit will answer the purposes. In regard
to diet, I shall say more in its proper place.
16. cinamon: This is a necessary article
at sea, as it is of a gentle astringent nature,
together being very warming, and is undoubtedly
the best of all the spices, where the
bowels are weak. Its peculiar uses I shall
speak more of hereafter, when I come to
treat on loosenesses and fluxes, and such diseases
where it is useful.
17. Allum: This astringent medicine is
very useful for gargles, for scurvy gums, and
various other uses. Burned allum (which
may be done by exposing a piece on a fire
shovel over the fire till it is bubbled up and
become of a white cake) is an excellent medicine,
for gently checking proud flesh in
ulcers; besides which, it makes an excellent
tooth powder.
18. Chalk, is as necessary an article as any
medicine, and so useful is it in long voyages,
that a ship should be well stored with it; for
// 095.png
.pn +1
it is not only an excellent absorbent, and
will stop fluxes, when made use of in decoctions
for that purpose, but, makes also a great
purifier of water, and thereby contributes
greatly to the preservation of health; as I
shall hereafter further take under a stricter
consideration.
19. Salts: Glauber’s purging salts, is a
medicine which has had many virtues ascribed
to it; as a cooling purge it is very well, but
further I cannot recommend it: An ounce,
or an ounce and an half is the dose; and it
will be best to dissolve it in a tea cup of water
over night, so that it may be taken early
in the morning, and worked off with drinking
gradually some tea after every motion.
20. Diachylon plaister:
Take lytharge fine prepared one pound, oil of
olive one quart, boil them over a gentle fire,
putting into the pan a little water, stir it all
the while, and take care it does not burn; continue
boiling, till it becomes of a consistency of a
plaister, and make it into rolls; which, according
to art, is best done before it is quite cold,
upon a wet marble slab, and wet hands, and
then put up in paper, previously rubbed over
with some soap, to prevent it from sticking.
There is not a medicine so generally useful
for all hands on board, as this very
plaister, in case of cuts, bruises, or sores of
any kind; it is not only the medicine box
// 096.png
.pn +1
that should be well provided with it, but
every man on board, I advise to have a roll,
and some spread on cloth in his chest; for
in every little accident, a cut, a broken
nose, or broken shin, &c. to which a seaman
is liable, nothing is handier, and nothing
is more beneficial than this plaister, as it will
prevent inflammation and festering, heal it
up, and prevent small sores from becoming
great ones.
21. Mercurial plaister:
Take of the diachylon one pound, purified
mercury half a pound, triturate the mercury
with a little hog’s lard or turpentine, then melt
the diachylon, and incorporate the triturated
mercury into it.
This is principally fit for venereal cases,
for buboes, and other hard tumours; it may
also be put to shankers and very bad ulcers;
but it should never be used unless necessity
requires it.
22. Blistering plaister:
Take Spanish flies eight ounces finely powdered,
common drawing plaister one pound, melt
the plaister and sprinkle the powdered Spanish
flies till all is well incorporated, then make it into
rolls according to art.
This is intended for rising blisters. In
regard to the use of this, I have only to
observe, that it should be made use of only,
// 097.png
.pn +1
when the greatest necessity requires it; that
is, in bringing on a crisis of a fever, which
I shall point out in its proper place. At
present I shall only speak of its application.
Whatever place is intended to be blistered,
either the neck, between the shoulders, or
the calf of the leg, let the place first be
cleaned with a little vinegar, and rubb’d till
it becomes red, then let the blistering plaister,
the bigness of the palm of the hand, pretty
thickly spread, (best upon leather) be laid on the
part, and remain there for about twelve hours,
and be tied on, that it may not shift: at that
time the blister will rise; let it be cut to let
the water out, (but care should be taken not
to pull off the skin, as is frequently practiced)
dress it with Turner’s Cerate, spread
upon a thin rag, (or what is still better, dry
lint) and let that dressing be shifted once every
twelve hours, till all is healed up.
I shall now proceed to the inner part of
the chest.
A. Spirit of wine camphorated.
Take spirit of wine rectified one quart, camphor
two ounces, mix it, and let the camphor
be dissolved in it.
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
// 098.png
.pn +1
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.[#]
.pm fn-start // A
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.
.pm fn-end
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.
// 099.png
.pn +1
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.
// 100.png
.pn +1
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
// 101.png
.pn +1
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
// 102.png
.pn +1
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
// 103.png
.pn +1
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.
// 104.png
.pn +1
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.
// 105.png
.pn +1
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.
// 106.png
.pn +1
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,
// 107.png
.pn +1
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,
// 108.png
.pn +1
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.
// 109.png
.pn +1
.sp 2
.pb
.sp 4
.h2
LECTURE III.
.nf c
OF
ACCIDENTS,
AND THEIR
Proper Method of Treatment.
.nf-
.hr 60%
.sp 2
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
// 110.png
.pn +1
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.
// 111.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. I.
.h4
Of Falls
.sp 2
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
// 112.png
.pn +1
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.
.h4
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
// 113.png
.pn +1
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.
.sp 2
.hr 60%
.h3
SECT. II.
.h4
Of Wounds
.sp 2
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
// 114.png
.pn +1
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.
.h4
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
.h4
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
// 115.png
.pn +1
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
// 116.png
.pn +1
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.
.h4
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.
// 117.png
.pn +1
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.
As these kind of wounds are liable of becoming
ulcers, great care should be taken in
the beginning to treat them properly.—Wounds
in general should not be dress’d or
look’d to too often; in general it aggravates
the parts, and retards healing. A wound
// 118.png
.pn +1
should not be opened the first three days after
the first dressing: nature is very kind, and
requires care only to replenish what is deficient.
When an ulcer has commenced, see the
treatment under that head.
.h4
Gun-shot Wounds.
These are the most terrible of all sorts
of wounds; for it is not only the contusion
that attends them, but frequently the
ball forces strange things, as cloaths, &c. into
the wound with it.
Gun-shot wounds at best are tedious in
their healing, but very often, from their
nature, liable to mortification, and thence
become dangerous. Besides, it is seldom
that the fleshy parts alone are wounded, but
they frequently penetrate into the very bones
themselves.
The first care in gun-shot wounds, is to
extract the ball, or whatever is forced into
the wound; in the next place, the wound
should be dressed with Yellow Basilicon, (F)
mixed with fine Precipitate (O).
.h5 id=I
No. I
.pm quote-block-start
Take Basilicon one ounce, fine Precipitate
one scruple, and mix them.
The parts all round should be well fomented
with warm claret, intermixed with
Spirits of Wine and Camphor.
.pm quote-block-end
// 119.png
.pn +1
If the patient is full-bloody, and no blood
lost by the wound, he should be blooded, and
immediately treated as a patient in a fever.
If the pain in the parts become violent,
eight or ten drops of liquid laudanum (T), together
with thirty or forty drops of sweet spirit
of nitre (D), should be given once, twice,
or thrice a day. If the wound begins to
discharge plenty of matter, it should be
dressed with the same dressing often. But if
the parts become black, very fœtid, the patient
in great pain, and grows faint, a mortification
is to be feared; which I shall treat of
in its proper place.
When the suppuration is unkind, and the
parts are much inflamed, a poultice will be
very proper.
.h5 id=II
No. II
.pm quote-block-start
Take oatmeal (15) or (if that is not on board)
biscuit pounded about three spoonfuls, honey one
spoonful, water a sufficient quantity to boil it
into soft poultice; in which put of sweet oil about
half a spoonful. This poultice should be renewed
twice a day at least, and put on as warm as possible
it can be borne.
.pm quote-block-end
As gun-shot wounds are apt to degenerate
into malignant ulcers, I shall refer the reader
to the treatment of ulcers in general.
// 120.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. III.
.h4
Of Bruises.
.sp 2
Bruises, in whatever degree, have more
or less some blood and other vessels torn
and injured, and may properly be considered
as wounds under whole skin. It is from the
tearing to pieces blood vessels, whereby the
blood extravasates from their natural channels,
that occasions the swelling. If the bruise is but
slight, the vessels are soon enabled to circulate
the humours; but if the contusion is great,
the extravasated humours are apt to corrupt,
and make a collection of matter; thence an
aposthume and ulcer must naturally follow.
Bruises on fleshy parts are not so bad by
far, as on the joints, because the fibres in the
muscles are more pliable, and sooner unite;
the ligaments on the joints are very rigid,
and extremely sensible; for which reason
also, they are generally more painful and tedious
in their cure.
The first intention is to disperse the extravasated
humour, and to strengthen the tone of
the injured fibres. To this intention the parts
should immediately be bathed with spirit of
wine and camphor (A). But if the bruise is
immediately on the joints, the linament of
soap (B) is still superior. A bandage over the
// 121.png
.pn +1
part, so as to keep it in rest as much as possible,
is also of great service. If, however,
the part is so very much bruised, that there
appears a collection of crumous blood, and
that an aposthume is actually the consequence,
recourse may be had to the above poultice in
order to ripen it the more, and bring it the
sooner to a head; and then treat it as a common
ulcer. But that seldom is the case.
If the contusion is great, and the patient
is full of blood, bleeding is necessary; for in
such a case a fever is apt to ensue, which
should be guarded against, and the patient
treated accordingly.
.sp 2
.hr 60%
.h3
SECT. IV.
.h4
Of Dislocations
.sp 2
There are many accidents by which
a limb may become dislocated; the reduction
of which is a material point in surgery.
But if a surgeon is not at hand, a man
ought nevertheless, not to remain in that painful
and deplorable state, that endangers not
only the limb of becoming useless, but even
the loss of life itself.
I shall proceed therefore in my directions
as plain as possible, avoiding every expression
that may render this operation prolix.
// 122.png
.pn +1
It must first of all be remembered what was
said of joints, articulations, and ligaments in
the first lecture under that head. We must
thence observe, that a dislocation of the upper
arm with the shoulder is the most common
that happens, because of the great variety
of motion, and the flatness of the head of the
arm-bone, and the cavity of the shoulder
blade. Next to this is the thigh bone, with
the hip. But this is done by much greater
force, and therefore more troublesome in reducing.
All other joints that are angular are
seldom really dislocated, being stronger secured,
and cannot be separated from their articulation,
without first tearing the ligamentous
capsula that surround them; yet nevertheless,
some are subjected to be partly dislocated;
and this is what is commonly called
sprains.
Dislocations may be from two causes; first
from violence, secondly from weakness of the
ligament. In the latter case the reduction
is the easiest, but the limb is apt to slip out
again by the least accident.[#]
.pm fn-start // A
I remember a man who frequently had his shoulder dislocated,
and was his own operator in reducing it again. The
first time the accident happened in the ship I was surgeon of, I
was naturally called to his assistance: “Stop Doctor,” (said
Tom) “I have got a tackle in my chest, and I will soon bouse it
in again;” and sure enough, he had a pully, with which he
immediately reduced it.
.pm fn-end
// 123.png
.pn +1
I shall briefly consider each kind of dislocation,
that an accident makes a man liable to.
.h4
Dislocation of the Arm with the Shoulder.
The dislocation of that, may be two ways;
(viz) downwards, and forwards; but it cannot
be backwards nor upwards; except some
part of the shoulder-blade be broke.——The
best method to examine the patient what
kind of dislocation it is, (especially to one unacquainted
with these branches of surgery) is
strictly to compare both shoulders, and the
difference will be very plain, both to sight and
touch.
If the dislocation is downwards that is,
the head of the arm-bone, slipt in the arm-pit,
there will be a cavity on the top of the shoulder,
different from the sound arm, and the
elbow will be drawn upwards, without being
able to be moved either towards the body; or
so, as the patient to put his hand out without
the greatest pain.
When this is found to be the case, then, in
order to reduce it, set the patient low, on a
steady seat. Take a napkin or towel, of which
make a girt; put one part over your neck,
and the other part under the arm-pit. Let
an assistant hold the patient steady, another
take hold of the patient’s arm, with the elbow
bent, and extend it gradually; then with both
// 124.png
.pn +1
your hands take the arm, and whilst you lift
up the arm by help of the napkin resting on
your neck, you press gently down the arm
with your hands like a lever; in the mean time
the assistant extends, and thus you reduce it;
which you will hear by its snapping: upon
which the patient will be able to move his
arm in all kind of direction, without much
pain.
If the head of the arm-bone is dislocated forwards,
there will be a cavity backwards on the
shoulder, and the elbow will stick backwards,
and remain motionless, with great pain. In
this case, as before, let the patient sit low, and
with the help of the napkin, and assistances,
first extend the arm forwards; then like a lever
bring the head of the bone in its cavity;
which, like the former, will be perceived by
a snapping, and the voluntary motion of the
patient’s arm.
When the shoulder is reduced, secure the
whole with a long double-headed bandage,
cross-wide over the shoulders, and round the
body. Foment it night and morning with
spirits of wine and camphor (A). Keep the arm
close to the body, with the elbow bent, and
wear it in a sling, that it may be free from
motion till it is well.
// 125.png
.pn +1
.h4
Dislocation of the Elbow, or the Knee.
The elbow, as I said before, is very seldom
dislocated, unless fractured, and the
ligament tore at the same time; and when so,
the case is terrible. But very often those
joints receive a wrench, which, though nothing
out of its place, is often very painful,
on account of the many tendons that surround
the parts. The only thing in such
wrenching, is to foment it with spirit of
wine and camphor (A), or else the saponaceous
linament (B). The same method should be observed
with the knee, securing it well with a
bandage, in order to give it rest to recover:
For rest is a principal remedy.
.h4
Of spraining the Wrist, or Ancle.
The wrist and ancle are complicated
joints, and thence capable of a great
number of motions, and subject to a variety
of sprainings, but not a perfect dislocation;
nevertheless, they are very painful, and sometimes
tedious in getting well. Whatever
be the matter, the sick part should be
compared with the sound, and the difference
is soon seen.
// 126.png
.pn +1
If it so happens, that there appears a perceivable
difference, the parts should be gently
extended, and reduced; and all that is to
be done, is the securing it well with a bandage,
and fomenting it with Spirits of Wine
and Camphor, (A) or, what is yet better, Linament
of Soap. (B)
The thumb, however, is liable to be dislocated,
which is easily perceived; which
should be immediately reduced, and secured
with a bandage, and treated as already directed.
.nf c
Dislocation of the Thigh Bone.
.nf-
The articulation of the thigh bone with
the hip is similar to the shoulder, with
regard to the head of the bone, and the pan
in which it moves, except that it is much
deeper. It must be a great force that drives
it out of its articulation, and consequently very
difficult to be reduced. It may either be
dislocated inwards, or backwards.
If the dislocation is inwards, which is the
most common, the toes will be turned outwards,
and the whole leg and thigh will be
somewhat shorter than the other; so likewise,
if it is dislocated backwards, the leg and
thigh will appear shorter, but the toes will
be bent inwards. The best way of determining,
as I have said before, is to make a
just comparison of the sick and sound leg.
// 127.png
.pn +1
The reduction is somewhat difficult, and
will sometimes baffle the most experienced
surgeon, because the acting muscles are very
strong; and when they have first begun to
contract the parts, they will not easily suffer
themselves to be relaxed. Nevertheless, lay
the patient upon his back or on the sick side,
upon a steady table; let an assistant hold him
fast, another extend the thigh, so as to have
the knee bent; the operator having a napkin
resting on his neck, and under the thigh of
the patient, similar to the method directed before
by the shoulder; and then with both
hands bend the thigh, as with a lever, into its
socket again; when it will give a loud snap,
coming into its proper place.
It very frequently happens in this heavy
dislocation, that either the articulation is not
reduced, or that it immediately slips out again
when reduced; so that the patient will never
recover the former use of that limb more.
In this case nature is very kind, and the part
where the bone slips into will become callous,
and form as it were a new acetabulum; by
which the patient in time comes to walk,
though (as it may be supposed) but lamely.
In the course of my practice I have met with
but two perfect dislocations of the thigh,
both of them perfectly recovered; but it
must be remembered, they had youth on their
side, and the greatest care joined to favourable
circumstances.
// 128.png
.pn +1
At best however, it is an ugly accident,
for it is not only that the ligaments that surround
the joint are generally torn, but
very often the thigh bone is fractured at the
same time. It requires more skill than one
would suppose, to determine which is the
case, whether a fracture, dislocation, or both;
and am apt to believe they are often confounded
with each other.
When the dislocation is reduced it should
be well secured with a long double-headed
bandage; the patient kept still, the part
well fomented, and if requisite, some blood
taken away: a fever generally attends, which
should be duely taken care of.
On the whole, dislocations when they proceed
from violence, are sometimes attended
with severe symptoms, the parts being very
sensible, and it will require sometime for
the patient to recover his strength again.—Care
therefore should be taken to keep the
parts warm, and give them as much rest as
possible.
A strengthening plaister spread upon leather,
and put for a constancy round the parts after
the inflammation is gone of, will also prove of
singular service.
// 129.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. V.
.h4
Of Fractures
.sp 2
We come now to fractures. There is
something terrible in the sound of
broken bones; and yet in common they are by
far more easier managed and healed than
a dislocated joint: nature is very kind;
from the fractured parts of a broken bone,
there exsudes a gelatenous matter called
Callus, that very soon glews them together
again, and makes them stronger than ever.
As easy as a fracture is ruined, as easily it
may be well treated. I shall therefore lay
down some few rules, which if properly observed,
will ever be attended with success, as
they are founded upon happy experience, in
my own practice.
In the first place, a fracture should be reduced
as soon as possible. Secondly, the part
should have as much rest as possible till the
callus is formed, or the bone knitted together
again. Thirdly, bandages should not be laid
on too tight. Fourthly, camphorated fomentations
should not be too plentifully made
use of. Fifthly, the habit of body should be
kept in a slate of health; and Sixthly, the
diet during the time should be wholesome
and sparing.
// 130.png
.pn +1
With regard to the reduction, it was formerly
a great error for a limb to be stretched
out in an extensive posture; for the extension
of the muscles contracted the limb, and
made the reduction both painful and troublesome.
I shall here recommend a better method;
namely to have the muscles in a flexible position,
during the operation and the cure.
But to proceed to particulars.
.h4
A Fracture of the Skull.
This accident is frequently attended with
many bad symptoms, and often requires
the operation of the trepan; which I shall here
pass over, being too prolix for this place. I have
only to observe, that we have frequent instances
of the patient doing well without any
other help than bleeding; and where there is
no surgeon on board, this is the only remedy
first to fly to, and gives the greatest chance
for the patient’s life: next to this, shave the
head, and treat him as circumstances shall
direct, without meddling with the fracture,
any farther than applying gentle fomentations,
with flowers of chamomile (11) boil’d in claret,
and some linament of soap (B) added to it;
and if there is any wound, have it properly
dressed as directed in the article of wounds.
// 131.png
.pn +1
.h4
Fracture of the Arm.
If the upper arm is fractured, proceed
in the following manner:
First of all be sure it is a fracture; to know
this, put one hand on the middle of the arm,
and the other on the elbow, move it gently
to and fro, and if there is a fracture, you will
find it crackle by the touch, which sometimes
is so distinct as to be heard. The arm at
the same time is somewhat swelled, and
either the patient cannot move it, or else it
is attended with very great pain.
When the fracture is certain, then proceed
in the following manner; Let the patient sit
upon a low chair, or chest, let an assistant hold
him steady, and let another lift up the arm, and
extend it gradually, horizontal to the shoulder,
keeping the elbow bent somewhat all the while.
Then with both your hands gently press
the fractured bone, so that it may feel perfectly
joined again. Sometimes it happens
that the ends of the bones are somewhat slipt
over each other; in which case, extension is
the more requisite.
When this is done, then take a bandage of
about two yards long, first rolled up, and
wrung out of spirit of wine and camphor (A.);
begin near the elbow, and lay it smoothly on,
laping over a little; and proceed gradually till
it comes to the shoulder, and then return
with it back again till it is done.
// 132.png
.pn +1
This bandage should not be too tight,
nor too slack, but so as immediately to suit
the arm exactly. Over this bandage again, lay
a double folded rag, called a compress, so as
to cover the bandage; and over this again two
splints, one above, and another below; which
tie gently together with some tape in three
places. Then put the arm into a sling;
cover up the whole arm and hand, and let the
patient go to rest.
If the fracture is upon the under arm, the
reduction is a little more difficult; but only
in the care it requires of reduction. As there
are two bones in the under arm, it should
well be examined which it is, or if both. In
reducing of it, let the arm be bent as before;
one assistant to hold the patient, one to hold
the elbow, and another the wrist; gently extending,
till the fracture is reduced, as before
directed, and the bandage, compress, and
splints, put on according to the same Method.
In this fracture the wrist and hand should
be kept from moving; as the motion of their
muscles will be apt in a great measure to
hinder the bones from uniting again.
.h4
A fractured Thigh bone.
This is of very great importance; which,
from its situation, and the strength of
the muscles, in general, even by the best
method is very difficult to reduce.
// 133.png
.pn +1
Let the patient lay on the opposite side,
and with the knee bent; let the limb be extended
by assistances, and carefully set it according
to the situation, similar to the beforementioned
method.
This limb requires a very long bandage,
and very large splints. The method of treatment
must be as before, and the patient must
be well secured in bed. He should not lie constantly
upon his back in a straight posture, as
formerly was practised; but most part upon
either side, with his knee bent, which should
be kept bent as much as possible; if he can lay
chiefly upon his sick side, so much the better;
he may also move a little his joints, in order
to prevent them from growing stiff.
.h4
A fractured Leg.
This accident is more common, and
therefore ought to be paid the greatest
attention to.
To know for certain whether the leg is
fractured, let the patient lay on his back or
on either side, with his leg and thigh bent,
so that the muscles are entirely at ease, and
out of action. Let an assistant hold up the
leg by the knee; then take with one hand the
ancle, with the other the middle of the leg,
and move the ancle to and fro, holding the
// 134.png
.pn +1
other hand steady, and if you feel a crackling,
and the patient feels great pain in those parts,
the leg is certainly fractured; particularly if
the patient could not stand upon it before.
This being fully discovered, we must next examine
which bone is fractured, the Tibia or Fibula;
and then proceed in the following manner.
Let the patient lie as before directed;
one assistant holding the knee in a bent position,
another holding the leg near the foot,
both gradually extending.
Then with both your hands reduce the
fracture, by gently pressing it with the palm of
your hand while it is extending. Then lay on
a long roller; or, what is still better, a many-tailed
bandage, which is made thus: Take
nine or ten slips of linen, about two inches
broad, increasing from twelve to twenty
inches in length, laying over each other about
half an inch. The whole bandage must
be secured with a slip of linen behind, so as
to make the breadth of the bandage the length
of the leg; either of these must be previously
wrung out in camphor spirits.
If you make use of the roller, begin laying
it on from the ancle, going gradually upwards,
folding each round over half an inch
at a time; and under the calf of the leg,
give the bandage a single twist, by which it
will always suit. Continue this till the whole
is finished.
// 135.png
.pn +1
Over this again put a compress, and then
put on the splints, (previously bolstered with
some tow) which secure with tape, as before
observed with the fracture of the arm.
The many-tailed bandage is however superior
to the roller, in the fracture of the Leg.
The method of laying it on is this: the patient
laying upon his back, with his thigh lifted
upwards by the assistant, put the bandage under
the calf of the leg; then begin from the
ancle upwards, folding over alternately the
tails of the bandage, so that they secure each
other. When this is compleated, put over
the whole a Compress, as before directed, as
also the Splints; or in the room of common
splints, put on the new invented splints of Mr.
Sharp; of which a ship should have three or
four pair of different sizes, both for the right
and left leg.
When this is performed, the patient should
be put to rest as soon as possible; and he will
lay easiest upon the side where the fracture is,
with his thigh and leg bent forwards. This
position suits not only best on board a ship
where the motion is continually apt to disturb
the sick part, but is also most natural both for
ease, and for healing; as the muscles are all at
rest, and adds firmness and ease to the body.
// 136.png
.pn +1
.h4
Compound Fractures.
When a fracture is attended with a
wound, it is needless to observe, that
the case is of a more dangerous nature. If
the contusion has been so great, as to splinter
the bones, such splints as are loose, and seem
to prick through the flesh, should by all
means be removed. Violence must however
be avoided; for by a little patience, nature will
of her own accord separate and discharge
them.
Gentleness should ever be observed in surgery,
though not a timid weakness, by being
defective in dressing properly. The reduction
of the fracture should be conducted the same
as before, with this difference, that always a
many-tailed bandage should be chosen, so that
it may be opened when requisite.
The dressing of the wound should be the
simplest possible; for the nature of bone is so
delicate, that it will neither bear to be much
exposed to the air, nor suffer any greasy salve
or ointment to come near it; both are liable
to corrode it, and bring on a carious, which is
of a most dangerous tendency. Dry lint therefore
is the best, particularly near the fractured
bone.
In short, it is to be treated cautiously, like
an ulcer, and the greatest care to be taken,
// 137.png
.pn +1
that the arm, leg, or whatever fractured part
it is, be kept steady, and no oftener dressed
than what is absolutely necessary.
.h4
Conclusive Observations on Fractures.
In the obscure times of surgery, various
medicines were applied to broken bones,
with a notion to unite them the sooner.
This, however, is entirely exploded from
modern practice.
The inflammation that generally attends
fractures requires however a fomentation of
Camphor Spirits (A), in order to disperse the
obstructed humour; but if there is no inflammation,
the part undoubtedly is the better
without such applications; as then there will
be nothing to hinder a free circulation; for
which reason, fomentation should be used as
sparingly as possible.
It is well known too, with what difficulty
the fractured bones were set formerly, owing
principally to the limb being stretched out in
a position that excited all the muscles to contraction.
This is also here obviated.
In reducing therefore a dislocation or fracture,
the muscles should be as much at rest as
possible, both in the operation, as well as during
// 138.png
.pn +1
the whole time of the cure. It is for that
very reason my direction in this respect differs
from what has been delivered to us by
authors on that subject, particularly such, as
might be expected to fall into the hands of
a seaman.
Another error has been practised, namely,
the laying on the bandage very tight. It was
supposed, that that would strengthen the
limb, and make the bone smooth; but it has
sometimes prevented the bones from growing
together at any rate. The bandage to be sure
should not be too slack, for then we might as
well lay it aside entirely. A bandage certainly
is necessary, but merely as a support,
and it should never be tighter than what the
patient can well bear.
In simple fractures, the first dressing should
be so permanent, as to have no need for being
removed, at least for six, seven, eight,
nine days, or more; if the patient don’t feel
uneasy. For my own part, having ever been
successful in fractures, I have not opened the
first dressing for a fortnight, and sometimes
three weeks.
The laying stretched upon the back when
a leg is fractured, is altogether needless, troublesome,
and even a hindrance to the healing.
The patient should have a good wide cot, and
so that it may swing pretty easy; or else entirely
confined, when the ship has much motion;
and having the leg well secured with splints,
// 139.png
.pn +1
he may safely lay on what side he pleases, provided
he does not sit up in the bed (though
he may out of it) for the first three weeks;
for that strains the muscles very much.
The diet should be sparing, the body kept
open, and a temperate warmth should be preserved,
in order to promote perspiration.
Drinking of strong liquors should by all means
be avoided, and the diet should be as fresh as
the circumstances will permit.
Six weeks is generally the time allowed for
the cure; that however is no certain rule. If
the fracture is simple, and the constitution
good, then at a month’s time a small trial
may be made by the help of crutches, or
a trusty mess-mate, in a calm day; but if
it occasions the least pain, it should be
postponed.
This is then all I have of consequence to
observe in simple fractures; which holds good
also with compound ones, except that the
wound requires to be dressed oftener; but the
greatest care should be taken, that it is
done in a manner, so as not to disturb the
knitting of the bone.
// 140.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. VI.
.h4
Of Scalding
.sp 2
Scalding is another accident of much
consequence, which ought to be remedied
by times, in order to prevent the many evil
consequences of inflammation it is liable to
produce.
I must first of all refer the reader to what
I have said on the skin, Lect. I. Sect. VII. for
farther than this we will not suppose a scalding
proceeds, unless it is very dreadful indeed.
The nature of scalding then, is this: the
hot water coming upon the body, separates
immediately the scarf skin from the real skin,
thereby opens the lymphatic vessels, so that
they discharge their lymph under the cuticula,
and thence arise blisters. But withal, the heat
of the water irritating the nerves, they are
excited to contract and constrict the delicate
vessels, and hinder the circulation;
thence ensues the fiery colour and inflammation,
and create acrimonious tendencies.
Thence we learn, that a relaxation of the solids
is to be relaxed, and the humours to be rectified.
The moment a man has scalded himself,
immediately apply Turner’s Cerate (K), spread
upon a rag, to the part. What is equally as
efficacious, and sometimes better, is the Linament
of Soap (B). If notwithstanding this,
// 141.png
.pn +1
blisters arise, open them not, but let them remain
with the application on them, whereby
a cure will soon be facilitated; but if they
break open on their own accord, or that the
scarf skin was scalded off, then apply on the
sore, Turner’s Cerate (K), intermixed with a
little Calomel (N), and levigated Precipitate
(O), which will prove very beneficial.
.h5 id=III
No. III
.pm quote-block-start
Take Turner’s Cerate (K) one Ounce, Calomel,
and fine Precipitate (O) of each ten grains, and
mix it.
.pm quote-block-end
This spread upon a little lint will prove a
fine healer. If the Diachylon Plaister (20) can
be applied, it will also prove so powerful an
antiphlogistic, that any other will be unnecessary.
.sp 2
.hr 60%
.h3
SECT. VII.
.h4
Of Burning
.sp 2
This is of the same nature with scalding,
but is liable to become more pernicious,
in proportion to the bulk and heat of the
body that does the mischief. If it is slight,
the treatment is equal with the former; but
if it has penetrated deeper, it follows, that
the inflammation is greater, and consequently
the treatment requires more care.
// 142.png
.pn +1
If the sore so burned is deep, and thence
an eschar in the parts, digestive medicines
should be applied. It will not be amiss to
put a little Mercurial ointment (P) in the poultice.
If the inflammation is very great, Bleeding,
and other methods requisite to prevent
a fever, should be observed. In general, the
ointment No. #III:III#. will ever be found Efficacious.
.sp 2
.hr 60%
.h3
SECT. VIII.
.h4
Of Drowning
.sp 2
A Man who unfortunately falls over board,
and is taken up for drowned (immediately)
should not be given up for lost. As
this is a circumstance of the utmost consequence
to a sea-faring man, I shall think my
time well rewarded in explaining the method
of recovery contributing to the preserving
the life of my fellow creature.
There are different ways of drowning; and
according to the nature of the accident, the
probability of recovery is founded.
A man, before he comes into the water,
may receive an unlucky blow, that will not
only stun him, but make him expire his
breath (which is generally the case in high
falls) as before observed. In this case his senses
are benumm’d, and by the inspiration apt to
// 143.png
.pn +1
draw in a quantity of water into his lungs instead
of air; thence, both from the blow, and
from the total stoppage of respiration, he may
have some blood vessels burst, both in the lungs
and in the brains, whereby he is instantly irrecoverably
dead, beyond all hopes. In this
case it may happen, that either way, separately,
is enough to kill him.
A man may also, in the very act of drowning,
swallow a prodigious quantity of water;
not only filling his stomach and intestines;
but thence forcibly infuse the water into the
lacteals, thereby overload them, and force it into
the blood vessels that they burst. The great
quantity of cold water will also be apt to chill
the stomach and intestines; thereby destroy
the sensibility, and prevent them from performing
the peristaltic motion; and by the universal
consent, destroy the whole nervous system,
which is the spring of life, that promotes
the blood to circulation, and consequently stops
the animal motion, and life itself.
But the most common way of drowning is
by suffocation; namely, a sudden constriction
of the respirative organs; whereby the
supply of the air is cut off, and consequently
the circulation of the blood must stop. This
is verified by the frequent instances we have
of people drowned, who have scarce any
water, either in their bellies or in their
lungs.
// 144.png
.pn +1
To understand this properly, we must first
observe, that a continual supply of fresh air
is requisite for the circulation of the blood;
partly and principally for its motion, and
partly from the nourishment the blood actually
receives from the air. In the next place, we
must also consider, that the lungs, appropriated
barely for respiration, are so very delicate
in the irritability throughout the larynx,
aspera, bronchea, and vesicles themselves,
that the least heterogeneous particle stimulates
them to a convulsive expulsion, of what
seems obnoxious to them, and thence excites
a cough. But, when the parts are too irritating,
the lungs are excited to a universal constriction,
and occasions strangling. This
we find is the case when in drinking or swallowing
our aliment, that the least morsel happens
by mischance coming the wrong way
(as it is called) that is, into the larynx, occasions
a heavy cough, or even a suffocation;
to obviate which, nature has formed the epiglottis
in the larynx, like a flap, that opens
in respiration, but is always shut in the act of
deglutition, except by some mischance or
other, that it becomes lame, and unable to
do its office.
These circumstances considered, we shall
not only be able to account for the act of
drowning, but discover the principles that
// 145.png
.pn +1
furnishes us with probabilities of restoring life
again.
I have mentioned three kinds of drowning
that at present occurs to my memory; and
unless that some blood vessels, either in the
lungs or in the brains, or in some other
principal viscera are burst; or, that the lungs
are so much filled with water, as to be unable
to recover their respirative functions again,
(which is seldom the case) or, that the whole
nervous system has received a universal paralytic
shock by the chill of the Water in the
stomach, so as to be robbed of its irritability,
either way of drowning is recoverable.
For the whole mystery consists, in setting the
animal automaton or clock-work in motion,
again; to stimulate the nerves to their sensation;
to set the heart a pumping; and the lungs, in
order to push forward the fluids, in respiration.
I could say much on the subject; but philosophy
aside, let us endeavour to recover the
man to life again.
.h4
The Method to recover a drowned Person.
Three things are to be the intention to
restore life in a person taken up for
drowned.
1. To liquify the fluids. For the moment
the circulation of the fluids is stopt, the blood
// 146.png
.pn +1
and lymph congeals; and after this, putrefaction
gradually commences.
2. To stimulate the nerves. For on the
irritability of the nerves life itself depends;
and which sets every thing in the animal fabric
in motion.
3. To restore respiration. For without this,
neither can the blood circulate nor the nerves
have sensibility.
The moment therefore you receive the person
drowned, strip him of his wet cloaths,
and wrap him up in three or four dry blankets;
if his belly is swelled with water lay
him across a chair or barrel upon his belly, in
order to make him void the water; but in this
spend not much time, but be as quick as possible.
Take a good quantity of salt, the
more the better, with which employ three
or four handy men to rub him all over;—his
temples, his wrist, his arms, his
breast, his back, his groins, his knees, his
ancles, &c. let this friction either be by the
hands or rough woollen cloaths pretty briskly;
and, whilst this is doing, let one apply his
mouth to that of the patient, stop his nostrils,
and with all effort blow gradually into
his lungs, and try to make him breathe. If
the lungs are open to this, there is a good prospect
of recovery, and let the breathing into
the lungs be briskly repeated. In the mean
time, try to open a vein in the arm; if the
head is bloated, as it frequently is, open the
// 147.png
.pn +1
jugular vein, or whatever vein that appears
distended in and about the head.
On signs of life, continue the friction
briskly, rub some essential oil of peppermint
(U) in and about his nostrils. If he recovers,
at first he will open his eyes, heave his breast,
his heart will beat, and gradually he will move
some of his limbs. If he opens his mouth put
a little salt in it at first, next give him the
following draught.
.h5 id=IV
No. IV
.pm quote-block-start
Take essential oil of peppermint (U) six drops,
upon a lump of sugar, which dissolve in a table
spoonful of elixir proprietatis (H).
.pm quote-block-end
If he inclines to vomiting, promote it
with decoction of camomile (11) or a vomit
of ipecacuanha (S); besides all this, blankets
should continually be warming, so as
to preserve a warmth of the body.
If he is fortunately brought to life, put
him directly into a warm bed, and give him
a dose of the fever powder, and let him drink
freely of good sage punch, in order to promote
a perspiration, which is here very requisite.
.h5 id=V
No. V
.pm quote-block-start
Take sage about a pugil (that is as much as
you can well take betwixt three fingers) on
this pour boiling water, one quart; to which add
sugar and good old Jamaica rum, sufficient to
make it agreeable, but not too strong. Or instead
of this give him some mulled wine.
.pm quote-block-end
// 148.png
.pn +1
A fever always attends a patient after the
recovery of Drowning; therefore care should
be taken when he is brought to himself,
that he is not over heated by liquor; as this is
liable to throw him into a disease as dangerous
as the narrow chance he has just escaped.
Should however the above methods not
succeed, you must not despair. If the lungs, or
the larynx seem so contracted that it appears
impossible to blow breath into him by the
mouth, recourse must be had to bronchotomy,
that is, opening the wind-pipe betwixt the
third and fourth cartilage; to which a man
should put his mouth and inflate the lungs; the
throat should be tickled with a feather, a little
pepper blown up the nostrils and the body here
and there scratched with pins, or small
wounds made in the legs and arms, and plentifully
rubbed with salt. If there is salt
enough to do it, the patient ought to be covered
all over.
We have instances that patients, after two
hours application, have been brought to life
again; therefore every means possible should be
tried. Of all the various stimulants, salt, or potashes,
is the best; spirits must not be made use
of, nor indeed vinegar, in the time of recovery;
as that is liable to congeal the blood, and prevent
it from circulation, till the recovery is
procured; when the sage punch, or mulled
wine, or some other cordial may be proper.
Spirits of hartshorn, if it is on board may also,
with propriety, be held to the nose, or poured
// 149.png
.pn +1
a little down the throat, as that is stimulating,
but not coagulating.
When at length the patient has recovered,
let him take the forementioned draught No.
#IV:IV#. as also the warm sage punch No. #V:V#. and
take all possible care for his recovery.—If
Bronchotomy was obliged to be performed,
let the wound carefully be washed, closed, and
dress’d with dry lint; over which lay a compress
with warm claret intermixed with camphor
spirits; and the more to favour the healing,
let his head constantly be inclined; rest
should also be promoted as much as possible,
for which purpose 8 or 10 drops of liquid
laudanum will be very proper; likewise silence
should be strictly imposed on him; and that
should be a material object to be observed, by
those who tend him. In every respect else, let
him be treated as is directed under the head
of fevers and other circumstances, as they
shall occur.
Here then I shall conclude this lecture,
and beg leave to observe, that as mankind
are ever liable to accidents, particularly that
class I have here devoted myself to serve, it
behoves us ever to be provided with preconsiderations,
that we may be always ready to give
our friendly assistance in the hour of distress.
In time of need, the mind is too much hurried
to read with any attention; and dangers particularly
from accidents admits of no delay.
// 150.png
.pn +1
The prudent seaman, especially the father
of his Crew will therefore make himself acquainted
with all these circumstances in his
hours of tranquillity, by which he may ever
be ready with his friendly aid, and receive the
blessing of him that is benefited by his Humanity
and generous care.
// 151.png
.pn +1
.sp 2
.pb
.sp 4
.h2
LECTURE IV.
.nf c
ON
EXTERNAL DISEASES,
AND THEIR
CURE.
.nf-
In this lecture I shall treat of external disorders,
which may take their origin either
from injuries, or from internal acrimony of
habit; for whatever disturbs the animal œconomy,
prevents the natural order of the fibres,
and those again when in disorder, corrupt
the fluids.
Be the causes what they will, certain it is,
that there is a strict connexion between the
external and the internal parts, to which due
regard ought ever to be paid. I shall without
delay proceed to their various kinds.
// 152.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. I.
.h4
Of Inflammation
.sp 2
When either the solids are so injured
that they will not transmit the circulation
with their natural freedom; or when
the humours are become so acrimonious, as to
constrict the small tubes, that part of the
fluids becomes confined in them, there must
then of course be an obstruction of the circulation
of the fluids, thence accumulation must
follow and consequently swell the parts. And
this is the nature of an inflammation.
The blood being obstructed, the parts must
naturally swell; the blood being forced into
the small lymphatic vessels, thence proceed
the redness; and lastly, from the vessels being
distended and irritated by the stagnated humours,
proceeds the pain.
An inflammation terminates three different
ways. When the solids relax, or the fluids
become attenuated, so that the accumulated
humours disperse, and are admitted a free
circulation again, it is termed resolution; and
this is the best and most favourable way for
an inflamed and tumified part to terminate.
When some of the small vessels by the
over-stretching of their contained humours
break, together with the lymphatic vessels,
// 153.png
.pn +1
and the extravasated blood intermixed with
lymph is converted into matter, it is termed
a suppuration; this is also a favourable way
of termination, provided the matter is properly
concocted and discharged, and the parts
properly healed up again. And this ought to
be the second indication when the first does
not succeed.
When however the imprisoned humours
enclosed by their tubulæ are inspissated, and
mix irregularly with the solids that contain
them, obstinate tumours are apt to ensue.
This is the third kind of termination, and
should be avoided if possible; for it either becomes
tedious, or occasions malignant ulcers;
which in glandulous parts are the first foundation
of cancers.
But, when the humours that are obstructed
get malignantly corrupted into a pernicious
acrimony, and stimulate the distended solids,
so that they stretch beyond their natural tone,
without admitting any circulation, the parts
become insufferably painful; the patient is
restless, anxious, and attended with an acute
fever; the humours become offensive and
fœtid, and the parts at length turn of
a livid colour, and this is then called a
gangrene. Gradually the parts begin to
putrefy and grow black, the humours acquire
a cadaverous fœtor, the solids lose their
natural texture, and die. This is called a
// 154.png
.pn +1
sphacelus, or mortification; and unless the mortified
parts are removed from the sound,
death must inevitably be the consequence.
These are the different terminations of inflammation;
and whether the cause is from
external injuries, or from internal acrimony,
the indication must ever be the same, I shall
consider each separately.
.h4
Of Resolution.
Inflammation that attends wounds,
contusions, &c. should be dispersed by the
application I have already mentioned in the
foregoing lectures, viz. camphorated spirit (A),
or liniment of soap (B), the first suits best
the fleshy part, and the latter the inflammation
on the joints and tendinous parts. But
when with the inflammation a wound is
compounded, and is obstructed in its suppuration,
recourse should be had to poultices;
as thereby the fibres may be the more relaxed,
so that the ulcer may the freer discharge
the matter, thence drain the inflamed
part of the obstructed humour, and consequently
remove the cause of the inflammation.
// 155.png
.pn +1
.h4
Of Suppuration.
When an inflammation arises from an
internal cause, there generally is some
acrimonious humour that wants to be discharged;
in this case resolvents is not always
safe, as it is ever apt to increase the
pain and inflammation. Of that kind
are the boils and swellings under the armpits,
hams, and other parts. In this case,
poultices should be applied as warm as possible;
the ingredients may be oatmeal, or biscuit
powdered, honey and a little butter, warm
and largely applied. When the swelling increases,
grows red, and acquires a top, together
with constant throbbing, it is a sign that
matter is forming, which is the more confirmed
by its growing soft. When the fluctuation
of matter is actually felt, and that
the top becomes somewhat of a black and
yellow colour, it then is mature for being
opened, in order to let out the matter, which
is best performed with a lancet: this being
done, apply the poultices again. And when
the matter is fully discharged, lay on
the diachylon plaister, in order to heal up the
part. Should however an ulcer be the result,
it must then be treated accordingly, as will
be directed under that head.
// 156.png
.pn +1
.h4
Of Tumours.
When inflammations will neither disperse
nor come to suppuration, it is
apt to form hard tumours; sometimes they
are indolent, at other times very painful. In
this case, nothing is better applied, than mercurial
plaister (21), and especially if there is
any venereal taint in the habit. At the same
time, whenever tumours are dispersing, care
should be taken to use internal medicines, in
order to correct the acrimony, and a purge
now and then, in order to incline the humours
to be carried off. If, however, they
incline to suppuration, poultices should be
again applied; and to bring them sooner to a
head, purges should be omitted, till after the
matter is discharged.
.h4
Of Mortification.
A Mortification has two degrees; gangrene,
the beginning, and sphacelus the
compleated mortification. When an inflammation
will neither disperse, suppurate, nor
become indurated, but, on the contrary, increase
with a burning inflammation, and is
prodigious painful; when the swelling continually
increases, the parts become uncommonly
tender, attended with a numbness; the
// 157.png
.pn +1
colour changing from a fiery red into a livid ash
colour, and the cuticula seems to separate on
the touch, a gangrene has commenced. In this
melancholy case there is no time to lose.—Apply
the following powerful medicine,
which in a gangrene, and even a sphacelus,
has proved beneficial to a miracle.
.h5
No. VI
.pm quote-block-start
Take Mercurial Ointment (P) one ounce; Calomel
(N) and Powder’d Precipitate (O) of each
one drachm; Oil of Peppermint (U), one drachm;
Spread this upon a rag, and apply it to the
gangrenous part.
.pm quote-block-end
If a sphacelus has commenced, the skin
turned livid, attended with a cadaverous fœture,
and seems to the touch to be rotten, it
must be scarified to the quick with the lancet,
and then the above remedy applied. But if
it has already reached the bone, (which a mortification
soon will) and seems to make a rapid
progress, all external remedies are of little
avail, and nothing but amputating the limb
can save life. But as that operation ought to
be performed by a skilful surgeon, I shall
therefore omit it here; only observe, that there
are very few cases, but that this dreadful
catastrophe may be prevented, if timely assistance
is given.
To conclude this section, I think it requisite
to observe, that a gangrene and sphacelus,
or mortification, is far from being so
often the case as many from the pain they
// 158.png
.pn +1
undergo, are apt to persuade themselves. A
common boil, whilst it is in an inflamed state,
is sometimes so very painful as to put the patient
in a fever, and will be excessively tender.
But, notwithstanding, a suppuration is the
result.
A gangrene and mortification is only to be
dreaded, when a whole limb is inflamed, such
as an arm, a leg, &c. When the inflammation
is dreadful, that the blood can find no
passage at all, but is obstructed on all sides,
then the part must naturally die, and become
cadaverous. The cause of this misfortune
may be either a heavy contusion, a
compound fracture, a gun-shot wound, or an
internal malignity of the bone itself; and as
a caution, I must also add, that pricking a
tendon in bleeding may occasion this dreadful
malady.
There is another kind of mortification
which proceeds from a bad habit of body, a
poorness of constitution, or when the whole
mass of blood is corrupted by the scurvy.
This shall be taken notice of in its proper
place.
// 159.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. II.
.h4
Of Ulcerations
.sp 2
This is a part of surgery that many pretend
to, but what very few really understand.
There are however laws in the animal
œconomy, which when they are violated,
leads us to trace its many evil consequences.
An ulcer is a dissolution of solids, occasioned
by acrimonious humours, which not
only act spontaneously upon each other, but
prevent the remaining circulating part from
the formation of unnatural substances.
Exulceration, strictly speaking, is what
every part of the animal fabric is subject to;
from the external surface, to the very substance
of the bone itself. In this sense, every
eruption, as well as the carius of the bones
come under that denomination; but more
particularly, the corruption of the softer
parts on the surface of our body, is here the
subject.
I shall not enter into a detail of the many
kinds of ulcers generally enumerated; they
have all in common an corruptive acrimony,
and a depraved accretion of excressence in their
nature; which differ only, according to the
parts ulcerated, and the habit of body; and I
// 160.png
.pn +1
have ever found in my practice, that one proper
method serves for all; I shall therefore in a
simple manner give such directions as will
ever be attended with success.
The principal intention is to correct the
malignity of the humour peculiar to ulcers; to
bring them into a good suppuration, and nature,
all kind Nature! will perform the rest.
When an ulcer is inflamed all round, filled
up with fungous substance, of various colours,
the matter thin, ferous, and is very
fœtid; then first wash the sore gently with
some good soap suds, or let the part ulcerated
be steeped in it for some little time, which
will draw out the malignity; then apply the
following dressing:
Take the powder of burn’d Allum (17),
and with a little lint dab it all over the fungous
part, then spread a pledget of the salve
mentioned in gun-shot wounds, No. #I:I#. and
over which apply a good warm poultice there
also mentioned. Let this dressing be repeated
twice or thrice a day, till the inflammation
ceases, and the fungous substance becomes
reduced; when then, the washing, the allum
and poultice may be left off, but the mentioned
salve continued till the sore looks of a pale
red, and begins all round the edge to heal up.
Cleanliness is very commendable; but in
this case, when a sore looks well, the matter
becomes of a pale yellow; wiping should be
very sparingly; and then, dressing once a day
// 161.png
.pn +1
(the morning) is full sufficient; for by wiping,
and often meddling with it, the small
granulations of the flesh is hindered from
growing, and healing is retarded.
A sore leg is very troublesome, and very
often attended with pain and expence, to no
purpose. It generally swells, is inflamed and
troublesome at night. Let the leg be bathed
every night, (with the open sore) in some
good warm soap suds; or instead of that, take
what you can have plenty of, namely, sea
water. If you can have it warm, it is well,
if not, make use of it cold, rather half a
dozen times of the day, than omitting it altogether;
and by dressing the leg as before
directed you’ll have reason to thank me for
my good advice.
Sometimes the bone is affected; in which
case, the cure with the best dressing in
the world will frequently be tedious. A
sore of this kind will not heal till the bone
has discharged a scale, (termed exfoliation.)
But tedious as it is, very often it is made
more so, by unnecessary trouble. Without
intending to give offence to my brother surgeons,
I have frequently seen bad consequences
attending methods taught with diligence
in hospitals; take my word for it, you
will do no good with your scraping tools,
// 162.png
.pn +1
throw them over board, and you’ll succeed
better than using them in this case.
The bones, though the hardest, are the
most delicate parts in the whole body; but
when it is affected, nature forms a new periosteum
over the sound part, and gradually
pushes forward the decayed scale. This wonderful
work is performed by nature only,
and must not be disturbed. By scraping,
and boring of it, the tender periosteum will
only be molested, the sound bone will become
foul again, and so you may go on for ever;
and I never saw a sore of that kind healed up
by this improper method, till nature over-powered
art, or the surgeon was tired with
scraping, perforating, &c. but I have known
many amputations in consequence of it, and
many lives lost in consequence of that
again; yet there is no rule without exception.
There are cases where operations of that kind
on the bones is required; but that ought to be
referred to a judicious and experienced surgeon.
When the sore remains fungous, the proud
flesh sprouts out in little bunches, and the
matter is muddy and stinking, it is almost a
sure sign the bone is foul; and if you examine
with a probe, you may generally feel it,
or even see it, and the bone, is sometimes
black, brown, &c. and generally very rough
on the surface. In such a case, continue the
dressing as before observed, and frequently
// 163.png
.pn +1
examine whether the scale loosens; at the
same time examine (not too roughly) which
way the scale inclines, also the bigness of it;
and if there is a probability of extracting it,
so that the fungosity only stops it, then
freely use a bistoury to make way for it; but
in this be not in too great a hurry, for care
should be taken (as I have said above) not to
extract the scale, till the separation from
the fresh bone is mature.
If an ulcer is sinous, inject in the sinus,
a mixture of burnt allum and water, viz.
.h5
No. VII
.pm quote-block-start
Take water two ounces; burnt allum (17) two
drachms; mix them well for injection. After
two or three dressings with this, inject the
antacrid injection.
.pm quote-block-end
.h5 id=VIII
No. VIII
.pm quote-block-start
Take two ounces of water, with one scruple of
calomel (N), as I have described in my treatise
on the venereal disease.
.pm quote-block-end
This is the proper management of ulcers
in general, and will ever be attended with
success, even in the most inveterate kind.
In venereal ulcers, the mercurial ointment
with the precipitate, may be applicable, especially
in shankers. I shall therefore end
this section, for having directed the management
of the worst of ulcers, the inferior
kind will of course yield to the same
method.
// 164.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. III.
.h4
Of Diseases of the Skin
.sp 2
Under this head I shall consider all
kinds of breaking out, exclusive of that,
which attends inflammatory and acute fevers,
as they are all of one nature, and will all yield
to one method of cure.—All proceed from
a corrupted humour, which nature endeavours
to expell from the body, by driving them
to the surface, as that is the least resisting part.
.h4
Of the Itch.
The itch may either proceed from original
acrimony, or it may be catched from
a mess-mate who is infested with the disease.
In itself it is of different kinds, but the diversity
in this respect depends principally on
the habit of body afflicted with it. Sometimes
it is dry, scaly, and attended with very
great itching; in that case, it proceeds generally
from a scorbutic habit, and is attended
with a slow inward fever. Sometimes it is
more moist, and utters itself with bladders all
about the hands, particularly betwixt the
fingers, and is a sufficient testimony of the
disorder. The principal indication is to purify
// 165.png
.pn +1
the blood; and in the mean time recourse
may be had to external means. A purge is
first requisite.
.h5 id=IX
No. IX
.pm quote-block-start
Take powder of jalap (R) one scruple; calomel
(N) three grains, mix it with a little sugar and
water, and let the patient take it early in the
morning, working it off with balm or any other
tea; after this some pills may be made of
calomel.
.pm quote-block-end
.h5 id=X
No. X
.pm quote-block-start
Take stomach powder (M) two scruples, calomel
(N) one scruple; sugar about one scruple;
mix them, and with a few drops of water make
it into a mass, and divide it into twenty pills.
Of which let him take one every morning
and night.
.pm quote-block-end
Externally make use of the following:
.h5 id=XI
No. XI
.pm quote-block-start
Take Turner’s Cerate (K) two ounces;
Precipitate (O) two drachms;
mix them.
.pm quote-block-end
Let this be sparingly rubb’d on the itchy
part; if it should be too hard, mix with it a little
sweet oil. When the pills are all used, another
purge like the former may be given; after
which if requisite, a few of the same
pills, one every night, will not be amiss.
Should it be very obstinate, a little mercurial
ointment (P) about one drachm to the
above quantity may be added; particularly if
the ship is in a warm climate. Should these
medicines seem to affect the mouth, as people
// 166.png
.pn +1
vary much in this respect, a purge will
set all to rights again. This is a safe and
expeditious method of curing the rankest itch,
even of the worst kind. If however there
is a fever attending, a few fever powders (L)
should be given when going to rest, in order
to promote perspiration; at the same time
using the before mentioned medicines. In
regard to the scorbutic itch, that I shall take
notice of, under the title of that disorder.
During the cure of the itch, a decoction of
the sassafras (14) should be drank, as that is a
great purifier of the blood.
.h4
Of Boils.
Boils are sometimes very troublesome,
and at times exquisitely painful; especially
when they are on tendinous parts: they
are always a sign of foul blood, and nature
very often that way frees the body from diseases.
They may frequently be dispersed in
the beginning of their coming, by pressing,
and gently pinching them: but unless they
are very numerous, such a method is unsafe;
because it forces into the blood again what
nature endeavours to discharge. The best
method is to bring them to a head as soon as
possible, to which purpose I shall here recommend
a paste that is very powerful.
.h5
No. XII
.pm quote-block-start
Take oatmeal and make it into a paste with
honey (E); this will speedily ripen them, and facilitate
the collection of matter.
.pm quote-block-end
// 167.png
.pn +1
Should the boil not open of its own accord,
and matter should be observed to fluctuate
in it, open it with the incision lancet;
and continue with your honey paste, till
the core is discharged; when the diachylon
plaister will heal it up.
.h4
Of Ring Worms, Daw Worms, &c. &c.
These are very troublesome, and though
at first they seem but insignificant, very
often they lay the foundation to stubborn
evils. In fact they are but a peculiar kind of
itch; and the very same remedy that is
recommended above for the itch, is equally
powerful to remove this: what necessity
is there then, of increasing words with a
tedious description of their various appearances;
since they will all yield to one substantial
remedy?
.h4
Of the Morbis Pedicularis, or, Lousy Disease.
It is an unhappy circumstance on board a
ship, when a man is afflicted with this
filthy distemper; and such a man is as pernicious
to a ship’s crew, as a rotten sheep in
a whole herd. If it proceeds from a lazy
filthiness of body, a gentle washing with a
good scrubbing-brush, and rubbing the back
// 168.png
.pn +1
with the boatswain’s towel,[#] is a pretty amusement
enough to circulate the blood and
to excite cleanliness. But sometimes this disorder
has its seat in the very blood itself,
and that filthy vermin will breed under the
skin, and eat their way through, by clusters.—I
have opened boils as big as pigeons eggs,
from which large bunches of lice have followed the lancet.
.pm fn-start // A
A cat of nine tails.
.pm fn-end
These patients are in every respect wretched,
and are actually objects of pity. They
generally have a pale, sullen, heavy, half-starved,
cowardly, in short a lousy, look; habitually
lazy, and seem to be void of every
manly passion; neither good nor ill-natured;
and are stimulated by nothing but pusillanimity;
and as they seem neither sick nor
well, I say they are objects both of pity and
contempt; though the latter is unjust, because
they cannot help it.
The reason of all this wretchedness is because
the blood is degenerated into a lifeless
mass of pituitous corruption; and wants that
spirit which gives a relish to life. Hence
we see in this one instance, how much the
mental faculties depend upon the state of the
body.
In order to cure this unhappy patient, the
blood must be purified, and the whole system
// 169.png
.pn +1
stimulated to a brisk circulation. Nothing less
than mercury will do the one, and stimulants
together with exercise, effect the other.
In the first place give him the following
medicine.
.h5
No. XIII
.pm quote-block-start
Take ipecacuanha (S) one scruple; jalap (R)
ten grains; calomel, (N) four grains; make it
into a draught or bolus.
.pm quote-block-end
Let him take this in a morning upon a
fasting stomach, and let him drink plenty of
chamomile tea after every vomiting; then
give him the following electuary.
.h5
No. XIV
.pm quote-block-start
Take lenitive electuary (I.) two ounces; black
pepper powdered, two drachms; calomel (N), one
scruple; mix them.
.pm quote-block-end
Of this let him take every morning one
tea spoonful; upon which let him rub himself
all over with the mercurial cloth as follows,
till he comes by this exercise into a
breathing sweat, at least for an hour; and for
the rest of the day keep him in continual
exercise.
.h5 id=XV
No. XV
.pm quote-block-start
The mercurial cloth.
Take a cloth or rag as much as half a yard
square, upon which spread one ounce of mercurial
ointment; let the patient work this into the cloth
with his hands, so that it is equally all over alike.
.pm quote-block-end
With this cloth let him rub his wrists,
// 170.png
.pn +1
arms, shoulders, top of his head, his back,
knees, waist, thighs, and legs; and continue
this rubbing once every morning with the
same cloth for a whole month, putting the
cloth in his pocket when he has done.
His sores may be dressed with the above ointment No. #XI:XI#.
The decoction of sassafras, and
a dram of spirits, with a little Turlington’s
Balsam after his morning’s exercise, will prove
greatly to facilitate the cure. This is the
method I have pursued with this filthy disorder;
and I have succeeded to my most sanguine
expectations. And by this, I have been
fortunate enough to be the means of making
men again, of wretches that were a burden
to themselves, and a nuisance to the people
that were obliged to associate with them.
.sp 2
.hr 60%
.h3
SECT. IV.
.h4
Of Promiscuous Disorders.
.sp 2
Having thus treated on the most material
ailments that want immediate assistance,
I shall in this section consider promiscuous
disorders, that have no relation to each other;
but set them down as they occur to my
memory.
// 171.png
.pn +1
.h4
Of the Tooth-Ach.
Those who have experienced the tooth-ach,
best know how much they have
wished for ease. No man can preserve attention
to his affairs, who has bodily pain;
and a severe tooth-ach is enough to disturb
both body and mind.—But what is to be
done?
Tooth-achs are of two kinds;—It may
either proceed from cold, or from a decayed
tooth, or from both. If the tooth is decayed,
the sooner you have it out the
better; but if your tooth is sound, then
it is as unreasonable to draw it, as it would
be to sling you over board, because you feel
the pain. In regard to drawing the tooth,
take this direction.
.h4
To draw a Tooth.
Observe first, what tooth it is; and
shift the hook on the key instrument accordingly.
Ordinarily the hook is to be inside,
and the comb outside. When this is
adjusted, wrap a little rag on the comb of
the key, so that it may bear a little softly on
the gums.—Then seat the patient steady on
a chair or chest, (and if he is a coward, let
somebody hold his hands, but a man of spirit
will not want this officiousness) place
yourself right before him—then fix the instrument
on the tooth, the hook inwards,
and the comb outwards; the hook on the
// 172.png
.pn +1
tooth close to the gum, pushed a little towards
the jaw bone, and be careful that you
have hold but of one tooth, and the right one.
When your instrument is fixed as gentle as
possible, without giving pain, (for if you
fumble too long, and give pain, you intimidate
the patient) I say then, when you have
fixed your instrument properly on all sides, so
that you have the condemned tooth, and no
more; then shift your hand so, that you may
have a good and firm hold, allowing for the
turning of your hand.—Thus being ready,
give your hand a gradual, and steadfast
turn, and wrench the tooth out of its
socket. In this you must be calmly resolute,
neither spare your strength if requisite, nor
let an untimely compassion get the better of
your duty; but keep your hold till you have
performed the operation. When the tooth is
out of its socket, it will sometimes hang a little
by the gum; introduce your fingers, and
they may nimbly perform the rest if requisite.—It
will sometimes happen, especially
by the grinders, that a little of the jaw bone
follows, sticking to the tooth;—let this not
frighten you, it is sometimes impossible to
avoid it; but not to frighten the patient with
it, pick it off before he perceives it.
The moment the tooth is out, introduce
your thumb and fore finger, and compress
the socket of the drawn tooth; by which you
// 173.png
.pn +1
replace every thing in order again; and after
which, one dram of good old stingo, for washing
the mouth, and another for comforting the
heart, will make the patient forget all the
pain he felt in the operation.
This method is certainly the most substantial
for the tooth-ach. But sometimes
this is not practicable, either because that the
stump is so rotted as not to suffer a hold; or that
none on board are intrepid or capable enough
to perform the operation; in this case a Palliative
will be very acceptable.—Turlington’s
Balsam (W), upon a little lint put into the
hollow tooth will frequently give ease, a
little Spirits of Wine and Camphor (A), or if
very raging, a little Liquid Laudanum (T).
But as I have said, they are only palliatives; and
neither spirits, or any thing else can be depended
upon for a certainty. Sometimes
stopping up the hollow tooth with wax, with
lead, or sometimes putting in a little saltpetre
will give ease—each method may do,
and each method may fail: so that sometimes
if the tooth is not extracted, all powerful Patience
at last must step in and prove the best
doctor, till nature recovers, and comforts the
patient with the balm of Ease.
Very frequently a cold occasions this
troublesome pain; in which case the head
should be well muffled up, in order to bring
on a perspiration, and a blister behind the ear
// 174.png
.pn +1
also of singular service—rubbing the face also
with some spirits of wine and camphor
is of great benefit, and attention should be
had, if there be any fever in the system.
.h4
Of sore Eyes.
Bad weather sometimes will effect the
eyes, whence they will become raw and
blood shot; which ought to be remedied in
time, in order to prevent further inflammation.
In this case make the following eye water.
.h5
No. XVI
.pm quote-block-start
Take Alum, One Scruple.
Fine Sugar, Two Scruples.
Spirit of Wine, and Camphor (A) Ten Drops.
Fresh Water, Three Ounces.
.pm quote-block-end
Mix them in a vial, and hang it up so that
it may settle; then pour off the clear into another
vial, which keep for use.
Of this excellent eye-water, drop a few
drops into the blood-shot eye, which in a
little time, will bring it to health again.——If
the eye lids are raw and inflamed, Turner’s
Cerate, or what is yet better, No. #XI:XI#. which
prove very beneficial.—Should the inflammation
be very heavy, apply the following
poultice, from which you may expect great
benefit.
.h5
No. XVII
.pm quote-block-start
Take Oatmeal, and Sugar powdered an equal
// 175.png
.pn +1
quantity, and make it into a poultice with the
yolk of eggs; upon which pour a few drops of
the spirit of Camphor.
.pm quote-block-end
This kind of poultice you will find very
cooling and agreeable to the eye, in order to
assuage the pain; or take the following.
.h5 id=XVIII
No. XVIII
.pm quote-block-start
Take the white of an egg upon a stone, or
pewter plate, which rub with a piece of alum, till
you get a fine white cream-like substance.
.pm quote-block-end
This is a fine cooling application. The
Camphor agrees very well with some people,
but with others it will not, in which case the
last is preferable; or the spirits of camphor may
be rejected from the other receipts.
.h4
Of the Ear-Ach.
The causes of that complaint are
many. I shall only here observe two
kinds; namely that proceeding from cold,
and that which is occasioned from hardened
ear wax.
In the first case, be very cautious how you
tamper with your ears—a few drops of the
spirit of Camphor upon a bit of lint, and that
gently put into the ear, will sometimes perform
great benefit; but never drop any thing
considerable into the ear itself; it is frequently
dangerous; from more reasons than what
I here have room to enter into.
In cases where the ear wax is hardened,
// 176.png
.pn +1
put in a little slice of rusty bacon, or a bit of
fat ham, which you will find very powerful
in softening the ear wax; and then
with gentleness you may pick them; take
care however not to go too deep.——Ear-ach
frequently follows a heavy fit of sickness; in
which case you can’t do any thing better with
safety, than keeping them warm.
.h4
Of Hoarseness and Sore Throat.
There are many degrees of this ailment.
I shall first mention that of a common
cold; which is either without a fever, or only
a slight one.
Immediately on perceiving symptoms of
a sore throat, a gargle should be applied.
This, make of the following ingredients.
.h5
No. XIX
.pm quote-block-start
Take vinegar, and water, each four ounces.
Alum powdered half an ounce.
Honey about a good spoonful.
.pm quote-block-end
This gargle should be used two or three
times of the day——if it is warm, it is so
much the more powerful——a mouthful
at a time is sufficient. If the palate is down,
.h5
No. XX
.pm quote-block-start
Take alum powdered, common salt, of each
two drams, black pepper, ten grains, mix it into
a powder.
.pm quote-block-end
Of this powder take a little on the tip of
// 177.png
.pn +1
your spatula, and apply it to the palate,
when it will immediately shrink up; and frequently
make the person who before was
hoarse, speak immediately quite clear again
with a distinct voice; then proceed with the
gargle as above directed.
But if the sore throat is of a more malignant
nature, the parts inflamed and swelled,
the patient seeming almost strangled, and attended
with a high fever; it is certainly the
quincey, and should be treated accordingly.
In this case you must bleed freely and repeatedly,
and give the fever powders, as will
be directed in the treatment of the fever,
and the management of the quincey.
The gargle notwithstanding should be
plentifully used——a blistering plaister betwixt
the shoulders, and if need requires, on
the calves of the legs, the bigness of the
palm of the hand, will also prove of singular
service; and in every respect the treatment,
as I shall observe under its proper head.
// 178.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. V.
.h4
Of the Venereal Disease
.sp 2
I have written and published a full
treatise of this disease; divided in three
parts; namely, I. An anatomical and physiological
description of the genital parts of
both sexes. II. An ætiological enquiry in
the various stages of this disease. III. A true
and rational method of cure. Nevertheless I
shall here concisely give a safe method of the
cure, in its various local degrees. But to
those who would wish to know more circumstantial
the true nature of that malady, and
of the animal œconomy, I must refer to the
above treatise.
The venereal disease may be considered in
different degrees; namely the first and second
infection.
To the first, I consider the gonorrhœa or
clap, the phimosis, paraphimosis, chordee, priapism,
shankers, dysuria, bubo, swelled testicles,
and venereal excrescences, in their various degrees,
in a local state. To the second infection,
I consider those diseases that proceed
from the venereal virus, infecting the whole
mass of blood; namely cutaneous diseases;
glandular diseases; diseases of the bones; dry
pox; and the confirmed lues itself.
// 179.png
.pn +1
The first infection is what I shall here briefly
consider, and give such remedies, which
though simple and few, will prove efficacious.
But the second I shall here only consider
in the general.
.h4
Of the Gonorrhœa.
The gonorrhœa or clap, commences with
an agreeable tickling in the urethra, attended
with a thin limpid ouzing, which however
soon degenerates into a disagreeable pain.
A discharge of sharp fœtid matter, gradually
commences with a scalding of urine; the præpuce
and glans sometimes swells, with inflammation
and a painful involuntary erection,
which adds considerable pain to the patient,
and under which, the whole system seem disordered.
When all these symptoms appear, there is
no room left to doubt a confirmed clap.
The first thing to be done, is to take some
of the fever powders (L) in order to promote
a perspiration, and to abate the scalding
of the urine.
In the next place, and which is the principal
object; have immediate recourse to
my antacrid injection, which is simply this,
.h5 id=XXI
No. XXI
.pm quote-block-start
Take clean water one ounce,
Calomel (N) one scruple,
Mix it, and shake it when it is made use of.
.pm quote-block-end
// 180.png
.pn +1
Let this be injected up into the urethra,
three times of the day, which if duely performed
will stop the evil in its first bud; and
prevent all the generally attending consequences.
For it perfectly eradicates all the
malignities of the venereal virus; prevents
shankers, priapism, chordee, and any farther
spreading of the infection. At the same
time the calomel should be given internally;
namely the pills, No. #X:X#. to be taken every
morning one.
.h4
Of the Phimosis, and paraphimosis.
A Phimosis is when the præpuce is so
swelled, that the glans cannot be uncovered;
and a Paraphimosis is when the
præpuce is swelled behind the glans, so as
not to cover the glans. Either way proceeds
from the venereal virus having insinuated
itself into the præpuce.
If the injection, No. #XXI:XXI#. is made use of in time,
all this will be prevented; but sometimes it is
of a very stubborn nature. If the inflammation is
very great, the poultice, No. #II:II#. should immediately
be applied, to which it will yield;
being of a very powerful quality, particularly,
if to the poultice mercurial ointment (P)
two drachmes is added, by which it becomes
an immediate antidote to the venereal virus.
// 181.png
.pn +1
.h4
Of the Chordee, and Priapism.
A priapism is an involuntary erection; and
the chordee is a stricture in the urethra,
by which the penis is bent either ways, according
to the seat of the contraction, this
however is generally downwards; whereby
it makes the involuntary erection prodigiously
painful.
It proceeds from some imprisoned virus
in the urethra; which together with its contraction,
irritates the penis to erection.
The antacrid injection No. #XXI:XXI#. will generally,
if timely applied, prevent this; but if by neglect,
or the great virulence of the venom, it
has actually commenced, recourse should be
had to mercurial ointment; which should
three or four times of the day be rubbed on the
penis. Should the priapism be very violent,
the poultice, No. #II:II#. with the addition
of mercurial ointment (P) must be applied.
.h4
Of the Dysuria.
The dysuria is a scalding of the urine
in the urethra; this likewise is obviated
by timely using the injection, No. #XXI:XXI#. or No. #VIII:VIII#.
But when it is actually become
troublesome, drink plentifully of diluting
// 182.png
.pn +1
drinks, such as balm tea, &c. and take a few
fever powders which will soon set this to
right again; particularly as that is a symptom
which generally vanishes, as the disease becomes
milder.
.h4
Of Shankers.
These are little ulcers coming upon the
glans, the frænum, and the præpuce
of the yard. They are not only troublesome,
but sometimes tedious in the cure; the antacrid
injection No. #XXI:XXI#. if timely applied,
will generally prevent them.
But sometimes these very unwelcome visitors
will appear even without a clap; and
then they generally gain great ground, before
timely remedies can be applied.
The injection No. #XXI:XXI#. should in this case
be injected betwixt the præpuce and glans; but
if this is not sufficient, apply the following.
.h5 id=XXII
No. XXII
.pm quote-block-start
Take mercurial ointment, two drachmes;
calomel (N), two scruples; precipitate (O),
ten grains. Mix it into an ointment.
.pm quote-block-end
By the dressing with this, all the shankers
will speedily heal up.
If warts sprout out, they should immediately
be cut off, with a pair of good sharp
scissars, and then dressed with the above
ointment.
// 183.png
.pn +1
Shankers, when they appear, without a
previous gonorrhœa or clap, ought always
to be taken as a forerunner of the pox itself;
and the patient must have immediately recourse
to the mercurial pills, No. #X:X#. one to be
taken night and morning, in order to prevent
the threatening evil consequences.
.h4
Of the Bubo.
A Bubo is a swelling that appears on a venereal
infection, sometimes in one, sometimes
in both groins. This swelling proceeds
either from a transposed virus, or comes as
the first messenger of a venereal infection.
A bubo appears with symptoms of a heavy
dull pain in the groin, which on examination
discovers itself with a little kernel that
is painful to the touch: If left to itself it
gradually encreases both in bulk as well as
in pain, and at length forms a collection of
matter.
The moment a bubo appears, take a purge, No. #IX:IX#.
rub the part in the groin with mercurial
ointment, and spread a mercurial plaister
the bigness of a crown-piece, which, (the
hair being removed,) lay on the part; let it
remain on, till it separates from the skin,
and the swelling is dispersed; the patient
should be kept warm, and not have much
// 184.png
.pn +1
exercise; at the same time the body should
be kept open.
By this means the bubo will soon disperse,
and the virus be destroyed in its first bud.
But if it has already gained too much head to
be dispersed, and matter is formed, it becomes
larger and soft, and a fluctuation of
matter is felt, then suppuration must be promoted;
and when ripe be opened as soon
as possible, for an outlet of the matter.
When it is come to its maturity, (that is
the matter plainly perceived,) open it and
dress it like an ulcer, first with the ointment, No. #I:I#.
and when it discharges pretty well,
dress it with the ointment, No. #XXII:XXII#.
By this management, though easy, you will
not fail of success.
.h4
Of Swelled Testicles.
The venereal virus is liable to attack the
testicles, which makes one of the most
disagreeable circumstances of all venereal diseases;
sometimes one, and sometimes both
will be the seat of this complaint.
It begins with a heavy dull pain, attended
with a disagreeable tightness in the spermatic
vessels, leading from the testicle into the
bowels. Gradually the testicle swells, becomes
hard and grows very painful, and if
not timely remedied, a suppuration, or a
// 185.png
.pn +1
scirrhus, or even a gangrene and sphacelus,
may be the consequences.
The moment the pain in the testicles is
perceived, remove the hair all round the
scrotum, and apply a mercurial plaister spread
upon leather; over which put a suspensorium,
and tie it up to the body as tight as it can be
borne; which together with a purge, No. #IX:IX#.
will not fail of giving immediate relief.
The patient should be kept as quiet as
possible; for hard labour not only retards
the cure, but becomes very painful. Should
this not be sufficient, apply the poultice, No. #II:II#.
with the mercurial addition as warm
as sufferable, and repeat it as often as it is necessary
for keeping it warm to the part. By
this method it will not fail of dispersing.
Should it however against all expectation
come to a suppuration, it must be opened the
same as another aposthume, and treated accordingly.
But should a scirrhus, or a mortification
ensue, extirpation is the only recourse.
For which see my treatise.
.h4
Of Venereal Excrescences.
Besides all these disorders before mentioned
that are the consequence of impure coition,
there is one more to be mentioned, and
that is a variety of disagreeable excrescences,
which sometimes arise about the penis, the
// 186.png
.pn +1
scrotum perinæum, and about the fundament.
When these appear, I generally take it for
granted, that the pox is in the blood, and
the patient ought to be treated accordingly.
If there is a possibility of extirpating them,
either by a bistoury, or a pair of good sharp
scissars, it ought to be done, and dressed with
the following ointment.
.h5
No. XXII
.pm quote-block-start
Take mercurial ointment (P), and precipitate
(O) equal parts: mix them.
.pm quote-block-end
The roots of these stubborn companions are
frequently seated very deep; if this is particularly
taken notice of, together with proper
internal medicines, the excrescences taken away
at the root, and the ointment applied, they
may all of them soon be drove off from the
field.
.h4
Of the second Infection.
In regard to the second infection, this is too
tedious here to enter into, and to do properly
justice, I must refer the reader to the
treatise itself.
All I have at present to say, is, that my method
of cure is particularly easy and simple, in
itself; and I am happy to think at the same
time, that it is more efficacious, than any
former method, or practice, made use of.
The antacrid injection No. #XXI:XXI#. is the most
efficacious for subduing the gonorrhœa, and
all the evil consequences in that part; and the
// 187.png
.pn +1
other mercurial preparations in the manner I
have recommended them, is equally powerful.
I am utterly averse to salivation; it is using
mercury as a poison; very few have ever
been cured by it, and those few have been
more indebted to their good constitution,
than the treatment which they have with so
much danger undergone. But many, very
many, have had their constitutions ruined
by salivation, past the art of man to recover;
and thousands have been sent miserable
objects to the grave.
I am also averse to bleeding in venereal
cases, unless the greatest necessity requires it;
for in general it serves only to infect all the
fluids, since the veins emptied, will naturally
absorb from all parts of the body, and
thence liable to infect the whole mass of
blood. Purging needs but be used very sparingly.
Mercury inwardly taken, should be used
with the greatest moderation, and taken in
very small doses; for with such judicious management
it becomes one of the best medicines
in the whole Materia Medica; but if
abused, it is converted into a poison. The
decoction of the sassafras should be plentifully
made use of during the whole course of the
venereal disease.
And lastly, from the real effect that the
mercury has on the blood, I must add, that
// 188.png
.pn +1
the same gentle method with respect to
its internal use, as is recommended for
the first infection, must also be pursued
for the second infection; let the malignities
be ever so bad, even in the most inveterate
diseases of the bones themselves;
with this difference, that in proportion as
the disease is engrafted, time must be allowed
for the cure.
Nature may be led by the gentle hand
of assistance, and tenderness; but he who
attempts to do good by main force, acts
as a fool, and deceives not only himself,
but those who are so unfortunate, as to
trust to his pretended skill.
.sp 2
.hr 60%
.h3
SECT. VI.
.h4
Of the Bite of Venomous Animals
.sp 2
It has been observed by all diligent inquirers
into nature, that poisons are
of two kinds, with respect to their effect in
the animal œconomy. One kind will destroy
if taken inwardly, but not have such ill
consequences in wounded parts, externally.
Another kind will be fatal in wounds;
at the same time it does not affect the
viscera.
// 189.png
.pn +1
The first which destroys internally, are
poisons, either from corrosive minerals, or
vegetables; but of the latter, namely what
seems inoffensive taken in the mouth, is
the poison that follows the bite of most
venomous animals whose poison are natural;
such is the scorpion, the adder, the rattle
snake, &c. whose poison have by various
experiments, been found to be attended
with no ill consequences internally taken.
This was known to the ancients, as well
as to us; for we find Celsus,[#] to have
spoken of this in his medical works.
.pm fn-start // A
Nam venenum serpentis, ut quaedam etiam venatoria
venena, quibus Galli præcipue utuntur non gusto, sed in vulnere
nocent. Ergo quisquis, exemplum Psylli secutus, it vulnus
exsuxerit, et ipse tutus erit, et tutum hominem præstabit.
Medicin. lib. v. c. 27.
.pm fn-end
Without any farther preface, I shall proceed
to give the immediate remedies for
such unfortunate accidents as happen by
the bite of these animals.
.h4
To Cure the Bite of a Rattle Snake.
The poison from this venomous beast,
is more deadly than any other of the
serpentine tribe. If its venom by a wound
is infused into the blood, a mortification, and
speedy death must follow.
The part bit, should immediately be sucked
// 190.png
.pn +1
with the mouth, either of the patient itself,
or one who will risk himself to be so
much the friend of the wounded. Dr. Mead
has recommended, that oil should be held
in the mouth all the time of sucking, but
we have it from good authority, that the
spittle itself is an antidote to that kind of
poison.
It is needless to say, that the person who
sucks the poison, should frequently spit out,
as not to run the risk of swallowing it; and
care should be taken, that his mouth is free
from sores, or wounds.
When this is performed for a quarter of an
hour, the part should be dressed with mercurial
ointment (P). Sweet oil is much recommended,
and may be plentifully used as an
embrocation to the inflamed part; particularly
if the oil is impregnated with camphor.
.h5
No. XXII
.pm quote-block-start
Take oil (C) two ounces; camphor, one
scruple; mercurial ointment, one drachm; mix
it.
.pm quote-block-end
The patient should take a vomit of ipecacuanha
(S) one scruple; and a few drops of
the essential oil of peppermint (U), on a lump
of sugar, and dissolved in water, which should
be repeated after the operation of the vomit
as often as occasion requires. The fat
of a rattle snake, is accounted a sovereign
specific, if applied immediately to the wounded
// 191.png
.pn +1
part, and the patient drinking a decoction
made of snakeroot.
The same remedy here recommended to
the bite of a rattle snake, (namely, sucking
the fresh made wound) is also recommended
to all other venomous bites. The viper, the
adder, the santapea or scolopandra, the scorpion,
tarantula, &c.
That oil is an antidote, (or as we may say
a poison) to all these venomous animals is
evident from their expiring in great agony,
when oil is poured on them; but whether
this effect is because of the penetration it has
on their bodies, or annihilating their poison,
is as yet undetermined.
I was once told a secret for the sting of a
scorpion, avered to have been experienced,
by a commander of a ship, trading to the
bay of Honduras, viz. that the part stung by
a scorpion should be touched with the glans
of the penis, which would immediately draw
out the poison, without effecting the glans
that touched it; and it differs not, whether
the patient himself or any other person does
it.——If there is any virtue in this, I own it
is beyond my comprehension.——I thought
proper however to mention it, though I cannot
advise it as a safe experiment, unless
farther confirmed by those who have actually
experienced it.
I have however a great opinion of mercurials
// 192.png
.pn +1
in such exigencies; and would advise
recourse to be had to it immediately, both
external as well as internal; this we are at
least assured of, it cannot be attended with
danger.
.sp 2
.hr 60%
.h3
SECT. VII.
.h4
Of the Bite of a mad Dog
.sp 2
There are many surprizing things in
nature, in so much, that ocular demonstration
can only convince us of their existence.
Amongst those wonderful phenomenons,
the direful effect of the bite of a
mad dog is equally astonishing as it is melancholy.
That dogs and wolves are more liable to
madness of this kind, called the Rabies, is
because of their deficiency of external perspiration;
and are obliged to supply that defect
with their open mouth and their lolling-out
the tongue; whence their blood is subject
to become overheated, and thence generate
a malignant inflammation, which infects
the saliva with this direful poison. But
the astonishment is, why it should have so
very powerful a contagion as to infect the
mass of blood of every animal that receives
// 193.png
.pn +1
the least atom of it? Yet so it is, confirmed
by sad experience.
From frequent observation we are able
however to communicate such signs, which
attend the symptoms of madness in a dog,
whereby we may the better avoid the danger
of being plunged into the most deplorable
misery by this wretched animal.
.h4
The Signs of a mad Dog.
The dog with symptoms of madness evidently
discovers a malignant fever; he
runs confusedly forwards; the tongue hangs
out of the mouth with much slabber;
his head hangs downwards; his eyes
look dull and heavy; his tail is drawn up
between his legs; and in every respect he
has all the sign of confused wildness and
pain; he runs confusedly forward, and snaps
about him without distinction of persons or
fear. He is always restless; will neither eat
nor drink; and is terrified at the sight of
water; the tongue hanging out of his
mouth, grows black; and at last expires
a spectacle of horror, unless the poor beast is
put out of his misery, and thereby many
dreadful consequences prevented.
// 194.png
.pn +1
.h4
The Effect of the Bite of a mad Dog.
So subtile is this fatal poison, that the
symptoms do not appear immediately;
but the part bitten will sometimes even heal
up, the same as any other wound; and two,
four, or six months after the injury, the
symptoms of the malady will appear and
gradually reduce the patient to the most deplorable
state in nature.
The first symptoms of the disease are, a
pain in the part where he was bit, which
gradually spreads all around; the whole body
in general is attended with a dull heavy pain,
a lassitude and weariness. The mind grows
depressed and anxious, together with a loss
of appetite and a nausea at the stomach; and,
in particular, a difficulty of swallowing, sore
throat, and accumulation of spittle.
Soon these symptoms encrease. The peculiar
soreness of the throat, which renders the
swallowing liquids very painful, begins to create
the utmost horror and dread of every thing
that is liquid; and this first gives rise to the
Hydrophobia, or dread of water, which compleats
the patient’s misery in this terrible disorder.
The eyes become full and staring, the face
bloated, florid intermixed with lividness;
the mind is impaired; rage, lust and mischief,
agitates the confused will; at length,
// 195.png
.pn +1
convulsions, foaming of the mouth, priapisms,
and seminal emissions, barking, howling,
and endeavouring to bite every thing near,
ends the wretched life of the most deplorable
object in nature.
.h4
Of the Cure of the Bite of a mad Dog.
With respect to the remedies, we have
had many delivered to us; but few
indeed with success. Before I enter on the
best method that I know, by experiment, to
recommend, I must beg leave to mention a
peculiar successful instance, in the course of
my practice, in this deplorable case.
A mad dog on shore, in the West-Indies,
bit two men, one belonged to my ship’s crew,
the other to a ship in the same harbour; both
were bit in the calf of the leg. It happened
that the surgeon of the other ship and myself
were immediately at hand at the time of the
accident. I was for cutting the part bitten
fairly out without delay; to which the man
of my ship readily contented; and it was
done accordingly upon the spot, having fortunately
my pocket instruments about me. But
this operation was not approved of by Mr.
E——; nor suited it the timidity of the man
belonging to his care; it was therefore omitted.
When I had performed the operation,
viz. (as near as I can guess) I cut
more than an ounce and a half of flesh out
of the gastrocnemius muscle (every where
// 196.png
.pn +1
round the bitten part) I spread a pledget with
basilicon, mixed with precipitate, and laid it
on the wound, having first let it bleed, perhaps
six or eight ounces; over the pledget
I laid plenty of dry lint; and when he was
carried on board, I fomented it with spirits of
wine and camphor, in which sublimate mercury
was dissolved (about one grain to about
four ounces of the spirit). Inwardly I gave
him one grain of calomel every morning and
night for at least a fortnight. The sore I
continued to dress with mercurial ointment;
which within a month healed up perfectly
sound. From the mercurial treatment, the
patient had a small ptyalism, which I checked
by gentle cathartics. My patient, by this
severe, though efficacious method, recovered
perfectly well, and remained so at least three
months after the accident, when we parted.
The other unfortunate man, however, had
not so good luck; for, as I was afterwards
informed (the ship going soon to sea after
the accident) the unhappy sufferer died a
horrible object, raving mad in the hydrophobia.
Mercury is certainly the greatest antacrid
we have; and I am firmly of opinion, that in
this case it is the most powerful of any medicine
that is yet known.
The cold bath is strenuously recommended
by Dr. Mead; and since his recommending it,
// 197.png
.pn +1
is generally practised on suspicion of this misfortune;
but in real cases, very seldom with
the wished-for success. Yet, Reason says much
in its favour, and should by all means be had
recourse to. Others have recommended
strong salt brine, which also is not to be rejected.
Before I lay down the method to be observed,
I shall first give Dr. Mead’s recipe
in his own words.
“Let the patient be blooded at the arm
nine or ten ounces. Take of the herb called
in Latin, lichen cinereus terrestris; in English
ash-coloured ground liverwort, cleaned, dried,
and powdered half an ounce. Of black pepper
powdered, two drachmes, mix these well
together, and divide the powder into four
doses, one of which must be taken every
morning fasting, for four mornings successively
in half a pint of cow’s milk warm.
After these four doses are taken, the patient
must go into the cold bath, or a cold spring,
or river, every morning fasting for a month:
he must be dipt all over, but not stay in
(with his head above water) longer than
half a minute, if the water be very cold.
After this he must go in three times a week
a fortnight longer.”
But to speak my real sentiments, I have
no great opinion of this recipe; yet as other
methods may be pursued along with it, I
thought proper to insert it, as in a malady of
// 198.png
.pn +1
this consequence, nothing should be left undone
that is practicable with propriety.
Celsus I think was the first who recommended
cold bathing[#]; but indeed to a degree
of drowning and reviving the patient
again alternately. In the mania itself, it carries
much reason with it in this miserable extremity,
for the poor wretch at the eve of expiring,
a spectacle of horror, may as well run
the risque of drowning; and besides, the shock
that plunging gives to the whole system, may
probably work an alteration in the malignant
habit.—But alas! when the hydrophobia
has actually commenced; Death, and death
only—can give relief! Yet let it ever be a
maxim, (and especially with a seaman) never
to forsake hope; for despair is only a punishment
reserved for the damned. I repeat it;
no means should be left untried, that has the
least prospect of recovery.
.pm fn-start // A
Unicum remedium est, nec opinantem in piscinam non
ante ei provisam projicere, et, si natandi scientiam non habet,
modo mersum bibere pati, modo attollere; si habet, interdum
deprimere, ut invitus quoque aqua satietur: sic enim
simul et sitis, et aquæ metus tollitur. Lib. v. cap. 27.
.pm fn-end
But to avoid being tedious, I will proceed
to the method I would have pursued in an accident
of that terrible kind.
If you by the before description find that
the dog who gave the wound is actually mad,
then without a moment’s delay let the piece
// 199.png
.pn +1
bit, be cut fairly out; if that is not practicable,
apply immediately the ointment made
of mercurial ointment and precipitate, No. #XXI:XXI#.
Over which apply mercurial plaister. Give one
of the pills No. #X:X#. every morning and night,
and continue this course for a whole month.
Let the plaister remain on the place a good
while after the sore is healed up.
This method I pursued with a gentleman,
and a little boy in New-York, who both were
bit by the same dog, without provocation, the
dog having never attempted the like before;
upon which he was immediately shot, and
was found to have all the signs of madness.——The
accident happened at noon, and I
was immediately sent for; but not being in
the way, my assistant dressed it with basilicon,
and laid over it a compress with spirit of wine
and Camphor, supposing it of no consequence,
as the wound was but very small. But on my
hearing of it in the evening, I went that moment
to their assistance, removed the dressing
and applied what I have before mentioned.
I was not mistaken, for the sore and all around,
after some time grew angry, and had
an unfavourable appearance; but with diligent
attendance gradually became better.—— The
little boy was bit deeper than the gentleman;
His wounds were on both sides of the tendo
achillis: But the gentleman’s wound was a
// 200.png
.pn +1
little above the maleolus externus on the right
leg, inclining to the tendo achillis.
It was in the month of July—I ordered
bathing every morning and night, which
suited the season. In the mean time, during
three months, I gave one grain of calomel
every morning and night; and every thing
succeeded to our wishes.
But to return; should the mercurial medicines
go to the mouth, a gentle cathartic
will divert this, for I am an utter enemy to salivation.
If however these remedies are administered
too late, so that, notwithstanding all
those applications, the patient should grow
melancholy, have a difficulty in breathing,
and a sore throat; but especially a pain in the
sore, or bitten part, recourse should be had to
frequent cold bathing, or rather plunging;
mercurials should be continued, and every
method pursued as will be advised in the putrid
malignant fevers.
Should the patient however be seized with
madness, care should be taken that those
about him have no wounds where the least
of his spittle may be introduced; and that
the deplorable patient is rendered incapable
to make any wounds or mischief on himself,
or those who attend him; as he will be apt to
snap and bite about him like a dog. He
should be sewed up in a hammock, to which
his arms should also be confined: in this method
// 201.png
.pn +1
he may, by help of a tackle, be plunged
up and down in the sea, but not his head
under water. This is far superior to the
unnatural and cruel way of smothering with
beds, where the patient has no chance at all
left.
The subject is melancholy; but, willing
to contribute all the relief in my power to
the distressed, I have been insensibly led on;
and summed up all that might promise success.
Innumerable are the remedies delivered
to us, but few prove successful if the case
be real.
Of all, I never knew any meet with better
success than where mercury was concerned;
and as I have been so fortunate as to have
experienced the exalted virtue of that great
medicine, in this and other deplorable cases,
I stand so much upon the firmer grounds, to
recommend it beyond any other medicine
that I am acquainted with at present.
To conclude, I think it requisite to observe,
that, dreadful as the bite of a mad dog is,
when the poison has infected the unfortunate
patient, yet this unlucky accident happens
much seldomer, than mankind from the
dread of the misfortune, are apt to apprehend
it does. Many nostrums are published as
specifics, and their virtue artfully confirmed,
with cases of being bit by dogs, that had however
not the least symptom of madness; and
// 202.png
.pn +1
thence cures enumerated, that could have no
foundation on reality; by which artifices
much mischief has been done in real cases.
Due observance should therefore be had to
the state of the dog that has given the wound,
and the circumstances attending; that either
the patient may not be brought into unnecessary
pain, or that proper and substantial
remedies may not be neglected.
// 203.png
.pn +1
.sp 2
.pb
.sp 4
.h2
LECTURE V.
.nf c
OF
FEVERS AND
INFLAMMATORY DISEASES,
AND
THEIR PROPER METHOD OF TREATMENT.
.nf-
We now proceed to the more internal
diseases; in which, the various steps
that we intend to take of restoring health
again, must be guided with the greatest caution,
as the seat of the malady is hid from our
external examination.
It is for this very reason I designed previously
to prepare the reader with the two
first lectures; particularly the second, I must
beg the reader thoroughly to examine, and
to understand; for on this will in a great
measure depend the proper application of the
various experienced remedies, which I here
mean to unfold.
// 204.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. I.
.h4
Of Fevers in General
.sp 2
Hippocrates, the father of physic,
was wont to say, “A fever is so universal,
that no patient dies without it.” This
is so true, that there is hardly an exception
to it, even in the most momentary apoplexy
itself.
To conceive this properly, we must observe,
that every diminutive part in the animal
fabric, like in a commonwealth, is endued
with a sense of self-preservation; and
the whole fabric is in so strict a conjunction
with all its various particles, both solids
and fluids, that nothing which may cause the
least disturbance can pass unnoticed; but, let
the injury be where it will, every individual
particle, as a member of the whole animal
state, feels the shock, and is immediately
concerned for its own preservation.
This then is the cause of a fever in the general
sense; and thence we shall be led to
understand what this disturbance in its nature
actually is; namely, an unnatural action
of the solids upon the fluids.
Now as the fluids are the most yielding
parts, that must submit to the pressing motion
// 205.png
.pn +1
of the solids, we may without much
difficulty, see one principle reason of its being
set into a disturbed commotion, when the irritability
of the nervous fibrillæ are acted
upon.
Again, when we consider that the blood is
liable to become acrimonious, and thence by
its stimulus apt to act upon the coats of its
containing vessels, we see demonstratively
plain, how the solids are subject to be excited
to act upon the very blood that stimulates
them.
Moreover, as motion must naturally produce
heat, and heat motion, and motion
expansion, and expansion rarefaction, we at
once bring to view the principal laws of mechanism,
that governs the human automaton
in the various degrees of health as well as
disease. However, let me not forget to whom
I write, but haste to the point I am at.
A fever may proceed from many different
causes, and may affect many different constitutions,
and also produce many different
effects; it is therefore just that a proper distinction
should be made.
Indeed, it is a subject that cannot be too
minutely handled; because it is scarce possible
that there is a disease void of a fever in
some degree or other.—But preciseness and
utility is the object I have in view.
// 206.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. II.
.h4
Of Accidental Fevers.
.sp 2
How uncertain is human life! One moment
in a perfect state of health, the
next perhaps no more; or confined under the
painful sensations both of body and mind!
Every accident is liable, and unavoidably
must bring on a fever; and this, like fire,
should be extinguished in its earliest commencement.
But in that, as I have before
observed, the constitution should principally
be consulted.
I have in the lecture of accidents, at every
opportunity, recommended bleeding, but always
with a proviso, if requisite; and, as this
is of more consequence than generally is supposed,
I find it necessary here to expatiate
farther on it.
In the first place, no man should be bled
who has lost a considerable quantity of blood,
unless indeed he was known in his state of
health to be very strong and robust; and that
the fever sets on with such fury, that the
system requires absolutely to be reduced; for
the solids and fluids have such a strict dependance
amongst themselves, that they
keep each other in an equipoise. If therefore
the blood is of an acrimonious nature, and
// 207.png
.pn +1
at the same time impoverished by lessening
its quantity, the coats of the arteries and
veins will be the more stimulated; thence
the fever will naturally encrease, and generate
more acrimony; which at length will destroy
the patient. I have been an eye witness
more than once, that the fever has actually
increased upon every repeated bleeding, till
the whole supply of life was spent; and all
my persuasions have not been listened to till
too late. Nay, a fever is sometimes absolutely
necessary; and proves to some constitutions a
remedy on its own account, provided it is
properly treated, and kept within due bounds.
Secondly, If the constitution of the patient
before the accident was but slender, and of a
phlegmatic nature, bleeding should be very
little or cautiously performed; for the blood
of itself being but poor, must naturally be
impoverished by being lessened; and whilst
the tenseness of the fibres is lost, it is the
more acted upon and rendered more acrimonious,
and still unable to strengthen the
tone of the irritated fibres; whence a relaxed
body, together with a poor acrimonious blood,
and all its evil tendencies must be the consequence.
Let it once for all be observed, that all the
benefit we can possibly hope and expect from
bleeding, is to lessen the whole system, to
reduce the quantity of the fluids, and to relax
// 208.png
.pn +1
the solids. This lessening of the system
I must own is very often highly necessary;
But, let us not fall into the ridiculous notion
to suppose that bleeding will draw off the
bad blood, and leave the good behind; far
otherwise; the quantity of the blood is soon
replenished, but the quality becomes impoverished.
The principle intention in fevers of whatever
kind, should be to promote perspiration.
This is the grand restorative of nature; and
I cannot recommend it too much. Nature
designed this evacuation in the formation of
man; and by that, fevers were cured in time
of yore, many ages before art contrived either
lance or lancets.
But here let me not forget another great
caution; namely, not to mistake profuse
sweating for perspiration; for this is an
extreme into which many have erroneously
fallen. Nature frequently produces a sweat
without force or compulsion; and if so, it
should be favoured, but never brought on by
stimulants, or strong forcing medicines.
Perspiration, sweat and urine, are the natural
evacuations intended, for the purifying
the system from animal acrimony; and
when these excretions are in a just balance
with the secretions of the fluids and motion
in the system, without pain or fatigue; then
nature is at peace with itself.
// 209.png
.pn +1
Lastly, I must observe, that the stomach is
an organ which, by the nervous consent, carries
on an immediate correspondence with
every part in the human fabric; whence this
viscera should likewise ever be consulted in
fevers; that is, never to impose on it any aliment
against its own inclination and appetite.
The want of appetite in a fever is a natural
cause, and very often is in the patient’s favour;
but the mistaken notion, that a patient
must eat, even against his inclination, in
order to recover strength, is not only highly
absurd, but has been the destruction of many,
who otherwise would have recovered, had
they with patience waited the kind dictates
of Nature.
Let the system be free from diseases, and the
stomach will soon crave food, when there is
a probability that the aliment may be converted
into good blood; but whatever is
forced into the stomach before that time, will
instead of nourishing the body, only add fuel
to the destructive fire, and encrease the already
malignant blood.
Upon the principles of these observations,
I shall lay down the rules that should
be religiously observed in accidental fevers;
and when they are well considered, we shall
find that they will hold good also in all other
kind of fevers, notwithstanding they arise
from internal acrimony of the body; for the
// 210.png
.pn +1
difference is barely this, whether the fire is
kindled within or from without;—but to
proceed.
Whatever then be the accident, a fall, a
wound, a fracture, dislocation, bruise, &c.
observe what the patient was before the accident.
If the patient was a stout hearty man, it
naturally follows, that the fibres of his body
were also in a rigid robust state; and the
quantity and richness of the blood was in a
due proportion; for this very reason, health
being at such an acmé, a fever is the more to
be feared, and ought studiously to be avoided.
If this patient has not lost any blood by the
accident, by all means bleed him; but never
exceed eight ounces at farthest; it is as much
as the strongest man ought to lose at once.
In the next place, perspiration should be
the principal object in view. To this end,
let the patient immediately after bleeding go
to rest, and take a dose of the Fever Powder
(L); upon which let him drink plenty of
Balm Tea (12); which will generally bring
on a perspiration.
If however the fever increases, the pulse
continues to beat hard and full, the head-ach,
difficulty of breathing, a great draught
and delirium should ensue, bleeding indeed
may be repeated, provided it is within the
same twenty-four hours; but if the symptoms
// 211.png
.pn +1
come on beyond that time, then bleeding
will seldom prevail, or do any good, but
rather mischief; for by this time, the fever
is generally agitated by acrimony, and the
blood is of its own accord poor enough without
being made more so by bleeding.
In the symptoms which I mentioned, regard
should be had to the body being gently
kept open, not by purges but by clysters;
for purges in fevers are precarious, and liable
to bring on heavy fluxes. If the patient under
this high fever is costive, give him the following
clyster.
.h5 id=XXIII
No. XXIII
.pm quote-block-start
Take warm water one pint, or something more;
in which scrape about one ounce of castile or hard
soap, and let it perfectly dissolve; then add a
spoonful of honey to it, and let it be as warm as
that it may be easily borne to your cheek.
.pm quote-block-end
Let the patient keep this clyster within
him as long as he can, till it comes away
with a stool.
If the patient is sick at the stomach, a vomit
of ipecacuanha (S) or No. #XXVI:XXVI#, will be very
proper, and nothing in such a case can be given
more safety and better advantage; for it is
not only the stomach that gets relieved, but
the whole body is brought thereby into perspiration,
by the universal strain it occasions.
After the vomit, or after the clyster, give
the following draught.
// 212.png
.pn +1
.h5 id=XXIV
No. XXIV
.pm quote-block-start
Take of fever powder (L) one scruple; common
water or balm tea, one ounce or half a tea cup
full; then take a lump of sugar, on which
pour essential oil of peppermint (U) three drops;
liquid laudanum (T) eight drops; sweet spirit
of nitre (D) thirty drops; and mix them with
a tea spoon.
.pm quote-block-end
This draught will not only promote perspiration,
but it will comfort the stomach,
and incline the patient to an agreeable rest;
by which he will be greatly refreshed. If
occasion requires, it may be repeated every
six hours.
If rest comes of its own accord, the liquid
laudanum (T) may be omitted; and if the
stomach does not stand in need of any carminatives,
the oil of peppermint (U) may also be
omitted, &c. The constant drink when dry
may be balm tea; in which, if it suits the
palate of the patient, a slice of lemon may be
put, and then sweetened with sugar.
The diet, as I have before observed, should
be sparing; and the patient’s palate in this
should principally be consulted. The following
water gruel, or rather wine soup, or
whatever other name it may acquire, I have
often ordered to my patients at sea; and
which has suited most stomachs, and proved
an agreeable mess.
// 213.png
.pn +1
.h5
No. XXV
.pm quote-block-start
Take oatmeal, or pounded biscuit, a couple of
spoonfuls; water, a quart; a small handful
of raisins; a little allspice, a little mace, tied
up in a fine rag; which boil together in a tin
saucepan till consumed to a pint and a half; then
add a gill of good wine, red or white, and sweeten
it with sugar to suit the palate. You may put
a little lemon peel in, to give it an agreeable
flavour.
.pm quote-block-end
A little roasted fresh meat will hurt nobody;
and broths most certainly are good,
particularly if the body is costive; but when
the body is inclined to looseness, I have
known the best broth to produce a dangerous
flux; and this should be taken notice of.
If the patient however who has met with
the accident is of a puny weak constitution,
or has lost a sufficient quantity of blood by
the wounds, bleeding then is not so requisite
as in the former case; though the treatment
otherwise must be equally the same.
By this method of proceeding, there is
little fear but that the patient will soon perfectly
recover, even in the highest fever that
may suddenly befall a man from an accident;
provided the injury is not of a dangerous tendency.
But as an acrimonious habit of body
is liable on its own accord to diseases, it is
easily imagined that an accident may become
accessory, and heighten the malignity; hence
// 214.png
.pn +1
often a fever of that kind is liable to degenerate
into a malignant one, or even from the
accident itself, when of a dangerous nature;
and this I shall explain as I proceed. I shall
therefore leave the accidental fever that proceeds
from an external cause, and proceed to
those which take their origin internally.
.sp 2
.hr 60%
.h3
SECT. III.
.h4
Of a Cold.
.sp 2
The fever now to be treated of is
the most common amongst mankind;
especially seamen, who are ever exposed, to
have the perspiration obstructed. It however
would save many from the grave, and
almost as many from being food for the fish,
was it a little more regarded than what it actually
is.
The sound of a cold is so gentle, that custom
has almost made it effeminacy to pay any
regard to it; and yet, if we maturely examine,
we shall find the most malignant, acute, and
mortal diseases, first make their appearances
by the symptoms of a cold,——But
let us proceed to particulars. A cold is an
obstruction of perspiration; which may
// 215.png
.pn +1
become destructive to the animal œconomy
if neglected, in so much, that it may be considered
as the first foundation of most diseases.
In my treatise on diseases of the lungs, I
have enumerated the many causes of a cold
to which mankind are liable, and their precautions
to avoid them. To sea-faring men,
I have one principal cause to mention whereby
they make themselves subject to colds,
and sow the seed of many dangerous diseases
in their system, and that is their carelessness
in shifting, after getting wet; in this
respect, I have however a remedy to offer,
which is as valuable and as efficacious to their
preservation, as it is easily put in execution.
The remedy is simply this:
A man who has been exposed on duty in
the rain, and is become thorough wet,
should not only shift himself in dry cloaths,
but previously wash all over with sea water:
if he carefully observes this, he will
never get cold on that account. I have not
only experienced this personally many times,
but ever found it productive of salutary effects
to those I have persuaded to it.——If we but
make some observations on the accidental occurrences
that happen at sea, we shall see the
just foundation of this. When do we find a
man who is continually washed by the sea to
have a cold? while on the contrary a
// 216.png
.pn +1
foul rainy day, will almost breed a general
sickness.——These observations first brought
me on the notion of washing the body with
salt water, and having verified it by experiment,
I soon saw the propriety of it; namely,
that the fresh water being of a sluggish
nature, and having a tendency to putrefaction,
is not only apt to infuse a putrescency into
the system, but from its slimy nature apt
to clog up the pores, and thus obstruct perspiration;
whilst on the contrary, salt water
is not only antiseptic, but stimulates the pores
of the skin to their secretory and excretory
functions.——Nay so perfectly have I experienced
this remedy, that I have persuaded
the people to salute one another by way of play
with buckets of sea water on a foul rainy day,
and with pleasure I have experienced that they
have all remained brisk and hearty after it, and
evidently seen the difference, that on a similar
day the sea water play being omitted, scarce
one who has been thorough wet, escaped a cold
in some degree or other.——I must not forget,
that a draught of grog is likewise no bad preservative.
But this is best taken when the
watch is out, and that rest and sleep can be
indulged upon it, as that will then be apt
to throw them into a gentle perspiration;
whilst however their watch is upon deck, the
best warmth is that which is produced by exercise;
except liquors is taken with the greatest
moderation.
// 217.png
.pn +1
But when a cold has actually commenced,
care should be taken immediately to have it
subdued in time. The term cold however is a
very vague expression, that includes a great
many disorders, occasioned by an obstruction
of perspiration, which all in turn shall be
taken notice of: But as I am now on
the subject of fevers, I shall confine myself
to that at present, and consider the cold as
it affects the body universally; namely headaches,
a weakness in all the limbs; intermittent
fevers, intermixed sometimes with flushes
of heat, and at other times shivering, chilling,
&c.
These are not only the symptoms of a cold,
but of almost all inflammatory fevers; which
in fact, the cold is a commencement of.
Now all that nature requires is a perspiration;
for thereby the imprisoned acrimony is
expelled, and which nature is always engaged
to throw off from the system.—To this intention,
if the patient is rich of blood, bleeding
should be performed; but with such caution,
as I have before recommended. Next
give the fever powder (#I:I#), together with a
good quantity of balm tea, or if the constitution
is of a phlegmatic habit, sage tea, or
even sage punch ( No. #V:V#.) will not be improper;
but care should be taken, that if
there is much fever, all those things should
be omitted, as it is liable to increase the
// 218.png
.pn +1
fever. If there is a nausea at the stomach,
give a vomit: take the following:
.h5 id=XXVI
No. XXVI
.pm quote-block-start
Take Ipecacuanha (S), one scruple: sugar a
little lump: water half a Tea cup full, and make
it up into a draught.
.pm quote-block-end
This vomit should be well worked off with
chamomile tea, or even common luke warm
water; first letting the vomit operate, and
then drinking plenty of the water after every
operation. When this is over, the patient
should keep his bed or hammock, and take either
the fever powder (L), or the before mentioned
draught, No. #XXIV:XXIV#.
The catarrhal fever, and all the other
symptoms of cold, viz. cold in the head,
cough, hoarseness, &c. generally keep one
another company, leave the patient generally
at one time; and in fact, one method of
cure, namely, promoting a perspiration, serves
for all; for thereby the obstructions become
removed, and nature is restored to its primitive
tranquillity again.
// 219.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. IV.
.h4
Of Intermitting fevers, and Agues.
.sp 2
There is scarce a disease that makes
a patient more wretched, and unhappy,
than the fever and ague. The causes of these
kind of fevers is principally from a pituitous,
or slimy blood, together with its being loaded
with acrimony; and a flacidity of the
moving fibres.
They are divided into various classes;
though in fact all of one nature. When the
ague with its succeeding fever comes on regularly
every day, it is called quotidian, or
every day’s ague; when every second day, tertian,
or third day’s ague, and when every
third day; a quartan, or fourth day’s ague.
There are many other classes as subdivisions
of these, but they are the mere speculations
of physical pedants, who are ever sworn enemies
to plain understanding, and delight in
perplexities; which therefore, we shall neither
spend paper nor time upon to recount.
Suffice it, let their paroxysms return at
what stated period of time they will, either
regularly or irregularly, they differ in nothing
but this, that the farther the fits are distanced,
the severer they generally are, when they come
on; and the more regular, the more obstinate
// 220.png
.pn +1
in their cure; though in this even there
are exceptions.
It is surprizing to imagine, how many different
opinions have been sent into the world
concerning the returns of the periodical fits
of the ague; and equally astonishing, how
few with any probability of truth or reason.
I shall not here enter into an enquiry of
this nature; certain it is, that at the stated
times of these returning fits of the ague, there
is an obstruction in some particular part of the
system, that corresponds with the dated time of
the circulation of fluids in such parts—which
when disturbed, effects by the nervous consent,
the whole animal structure.
The principal intention in all intermitting
fevers, should be to correct the petuity
and acrimony of the blood; to remove the
obstructions; and to strengthen the solids.
With respect to the blood, it is an inevitable
consequence, that when it is loaded
with a vicidity and lentor, that it will ever
occasion a depraved nutrition; and hence we
see, that people labouring under agues, and
intermittent fevers of any kind, have a
depraved appetite, and many disagreeablenesses
in the first passages.
The intermittent fever and ague approach
with the following symptoms, viz. a heavy
dull head-ach, a shivering chill all over the body,
with a yawning, &c. pain in all the limbs attended
// 221.png
.pn +1
with weariness, a nausea at the stomach,
a depressed pulse; which after it has lasted for
half an hour, changes into a burning heat, a
throbbing head-ach, pain in the loins, and
in every limb, a great draught, a full hard pulse,
and which at last terminates in a profuse
sweat; this seems to give the patient ease, for
one, two, or three days; and then attacks
the patient with the same symptom, increasing
every time, and reduces the patient both
in body and spirit.
The first thing to be done is to give a vomit,
like No. #XV:XV#. and XXVI. This is
best taken at the approach of the cold fit, and
worked well off with plenty of luke warm
water. After the operation of the vomit is
over, let the patient take the following
draught.
.h5
No. XXVII
.pm quote-block-start
Take fever powder (L), thirty grains; calomel
(N), one grain; elixir of vitriol (G), sixty,
or seventy drops; essential oil of peppermint (U),
four drops upon a little lump of sugar; to which
add water, half a tea cup full.
.pm quote-block-end
This draught will not only promote perspiration,
but help to dissolve the siziness in
the blood; and may therefore be repeated
every six hours, for a few days. But the
patient should always be kept moderately warm
upon it, that it may work by perspiration.—This
// 222.png
.pn +1
simple method I have known put the
patient to rights again, after a severe onset.
But sometimes this wretched disorder will
require more powerful medicines to keep it
in subjection. When the fibres are debilitated,
and the blood still retains its viscid corruptive
quality, the ague is apt to hang on
the patient a long time, the succeeding
fever apt to melt the patient down to a mere
skeleton, and even destroy him. In this it is
requisite to brace up the solids, and to infuse
an astringency into the blood.
To this intent, the Peruvian bark is now
frequently prescribed, and if judiciously
administered it is an excellent medicine; but
as it is liable however, to be improperly given,
and then productive of irreparable mischief,
I have purposely omitted it in this catalogue;
nevertheless, I shall give in its stead a medicine,
superior both in virtue, and by far more
safe in the application; not only in this kind
of complaint, but in scorbutic cases, as I shall
hereafter take notice of. The medicine is
this,
.h5 id=XXVIII
No. XXVIII
.nf c
Elixir of Iron.
.nf-
.pm quote-block-start
Take a quantity of rusty iron, the smaller the
pieces are, the better, for the less quantity will
do; pour on it good strong vinegar, sufficient to
cover it; let them steep till the vinegar becomes of
a deep brown colour, which it soon will, and at length
// 223.png
.pn +1
acquire a consistence of a black elixir.
The vessel should be either stone or glass; but what
is yet better is an iron pot, which of itself will
contribute to the medicine.
.pm quote-block-end
If the patient therefore, after the vomit, and
the above draught, is attacked again with
the fit of the ague, and succeeding fever,
have immediate recourse to your elixir of
iron.——Let him take after the fever is
off, every three hours, a table spoonful
of the elixir, and should it seem to come
up again at first (which it sometimes will,
particularly if the stomach is yet foul) give
immediately another spoonful, and repeat this
at least three times of the day.
A little gentle exercise upon taking the
elixir is highly beneficial; and if it throws a
gentle warmth over the body, and brings it into
a gentle perspiration, you are sure of success.
The quantity of it should be adapted to the
condition of the patient, and the strength of
the stomach; if it sits easy, a larger quantity
may be taken, and seldomer; and if it is more
nauseous, a smaller dose and oftener.—Should
the fits seem obstinate, the following electuary
may be used; and is a powerful specific.
.h5
No. XXIX
.pm quote-block-start
Take stomach powder (M), two drachmes;
nutmeg powdered, one drachm; powdered alum
(17), half a drachm; essential oil of peppermint
// 224.png
.pn +1
(U), twenty drops; calomel (N), ten grains;
honey (E), one ounce: the whole well mixed.
.pm quote-block-end
Of this let the patient take every eight, or
twelve hours, the bigness of a nutmeg, taking
his elixir as before observed; and this will
ever prove successful in the most obstinate
case.
As patients of that kind at sea, have ever
a taint of the scurvy in their composition, or
at least have a tendency towards it, exercise
and freshness of food, will prove one of the
restorative means. The malt decoction should
also be their drink, as well as in the scurvy.
To conclude, I shall only observe, that
bleeding in agues must at all events be omitted,
as being absolutely pernicious, as it
cannot fail of impoverishing the blood; which
is the principle source of the disorder. Also,
in the intermitting time, exercise should be
observed, and the diet should, when the
stomach craves, be good. Sometimes indeed,
the stomach is too ravenous and greedy; but
that is a default which proceeds from the
same cause as that which makes it loath its
victuals; a vomit in either case is the most
effectual medicine, and may be repeated as
often as it is requisite, without the least fear
of injury, particularly in this disease.
// 225.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. V.
.h4
Of Putrid and Malignant Fevers.
.sp 2
I Shall on this head restrain myself from
saying more than what is absolutely requisite
to the cure. It seldom happens to infect
a ship’s crew at sea, unless the ship has
carried it from some place where the disease
was contagious.
Though notwithstanding, great sickness on
board may give rise to it, if care is not taken
to prevent it. I would therefore ever advise, in
case of sickness, to steam the birth with vinegar;
namely, taking a vessel with vinegar,
in which put a hot iron, and thereby raise a
steam, which is a powerful preservative.
A putrid fever may be generated from the
contaminated atmosphere of a sick person,
though it rarely is the case; yet prudence
demands every precaution that is in our
power.
The fever that I now speak of is of the
malignant kind, and peculiar to the hotter
climates.
The patient is seized first with a shivering
chilliness, which is soon succeeded with a
weak unequal fluttering pulse; the body is
seized with a universal pain, together with a
great debility; the mouth is hot and dry;
// 226.png
.pn +1
the respiration depressed; and the mind labours
under a heavy anxiety.—The fever continues,
though not very high; and the pulse
not very full;—a delirium or else a stupor
ensues; the urine becomes deep coloured,
and has an oily skim at top; and the patient
is in so imminent a state of danger, that, unless
a favourable crisis happens soon, twenty-four
hours rapid progress is liable to put him
beyond all help. The first and immediate
remedy should be a vomit, No. #XXVI:XXVI#, which
is the grand step to be taken in all fevers;
not so much for the sake of cleansing the
stomach, as for the universal ease it gives to
nature.
The next step is to correct the putrescent
acrimony in the system; for which purpose
make the following draught.
.h5 id=XXX
No. XXX
.pm quote-block-start
Take fever powder (L) one scruple; elixir of
vitriol (G) thirty drops; sweet spirit of nitre
(D) thirty drops; calomel (N) two grains;
essential oil of peppermint (U) four drops; upon
a lump of sugar; and half a tea cup full of water.
.pm quote-block-end
Let the patient take this draught every six
hours; and after four have been taken, the
calomel should be omitted. If the nerves
seem to be affected, the essential oil of peppermint
may be increased. If a delirium should
come on, the liquid laudanum (T) from ten
to twelve drops and upwards may be given
in the draught.
// 227.png
.pn +1
I know many will think it odd, that I
should give calomel in a fever; but all this
is merely the effect of blind prejudice; a
better medicine than calomel is not in all
Nature, if judiciously applied; and so fortunate
have I been in my success with this
exalted medicine in contagious fevers, that I
have preserved myself and my patients in the
midst of Death’s spreading horror around us.
But to proceed; if the patient continues to be
dry on the surface of the skin, and perspiration
seems backward, a blister betwixt the shoulders,
the bigness of the palm of the hand[#],
will greatly facilitate the crisis or turn of the
fever; but let it not be erroneously supposed,
that a blister will draw off the bad humour,
or that it does good by such an operation; for
this notion has proved destructive to many
patients. All the good a blister does is to
spur on the animal function; by which sometimes
the acrimony is thrown off from the
system; but if thus irritating the system be
overdone, or wrong applied, it is productive
of many additional evils to the disease; causes
spasms, strictures, and other acute disorders,
that of themselves may become mortal.
Therefore blisters should never be used
but when the body is defective of perspiration,
or when the debilitated system is defective
in its excretory functions.
.pm fn-start // A
The method how to apply a blister is described under the
article of Blister Plaister, in the second section, p. 75.
.pm fn-end
// 228.png
.pn +1
When the patient is rid of the fever,
a general weakness will be left behind; this
is best assisted with the elixir of iron; and now
and then as a stomachic, a tea spoonful of
Turlington’s balsam (W), or some few drops
of oil of peppermint (U), as also the malt decoction,
and fresh diet.
Malignant fevers are generally attended
with eruptions on the skin, which is sometimes
in favour of the patient, and therefore
by no means to be hindered; but if there appears
purple spots on the skin, and that they
incline to turn black, it is rather a dangerous
symptom, and indicates very little hope of
the patient’s recovery.
The same method as above must be observed;
which if medicine can avail, will
afford benefit.
On the whole, I have this to observe, that
all acute fevers are liable to become malignant
and putrid; and in my practice I never
found, that there was any real distinction to
be made in the method of cure, whether the
acrimony was generated in the habit by disease,
or introduced by contagion; and if I
may be allowed to judge by comparison, it
must appear that my method is superior to
the more general doctrine; because I have
ever found it to be attended with much more
success.
// 229.png
.pn +1
.sp 2
.pb
.sp 4
.h2
LECTURE VI.
.nf c
OF THE
VARIOUS INTERNAL DISEASES,
AND
THEIR METHOD OF CURE.
.nf-
Having in the foregoing said what
I thought most material to be observed
in fevers, as the universal disorder that
attends almost every ailment in the human
body, I shall for regularity sake, treat on the
most material diseases, as they may seem to
follow in order in the various divisions of the
human body; and be as concise in their description
and cure, as their nature will admit of.
// 230.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. I.
.h4
Of Diseases of the Head,|Of the Apoplexy.
.sp 2
The apoplexy is a disease, wherein the
patient falls down motionless, void of
sense and sensation, and is, in fact, a temporary
death. It will scarce however admit of a
strict definition; for there are not only various
degrees of this disorder, but even
different disorders under the same denomination,
that have quite distinct different causes
for their effect. Many indeed may be accounted
for, but many more cannot.
The brain is the root of the nerves, and
consequently the fountain of all sensation,
and life itself. That part of the human fabric
is extremely delicate, and blood vessels
plentifully distributed. When therefore
these vessels become either so distended with
blood, so as to press the substance of the
brain, that it is hindered from its motion,
confusion to the animal œconomy must naturally
ensue; thence an apoplexy in its various
gradations is liable to be the consequence;
but as the vessels in such a distention
are liable to break, and the extravasated blood
pressing the brain more forcibly without a
chance of dispersing, we plainly see one reason,
// 231.png
.pn +1
why such a malady is apt to turn out
fatal, as we find it sometimes does.
Such causes may either proceed from external,
or internal injuries; thence we see
that a heavy fall, or contusion on the head,
may occasion an apoplexy, or at other times, a
congestion of blood to the head may produce
the same malady.
Sometimes the patient is motionless; and to
all appearance dead, and nothing but a faint
pulsation remains; at other times there is indeed
more signs of life, but more terrible in
appearance,—namely a convulsive breathing
and foaming at the mouth, without the least
signs of sensation or perception; in which case
there is much to be feared, that vessels in the
brain are burst.
However in all these extremities, nothing
can contradict the indication of bleeding, except
extreme weakness, and debility of the
system; which here is very rarely the case.—After
bleeding, a large blister between the
shoulders should immediately be applied, and
treated as directed in the second lecture, page
75.—A draught like No. #XXX:XXX#. will also be
of singular service, till the patient comes to;
after which he will require such treatment
as is directed under fevers; for that disorder
will always attend the shock that the apoplexy
gives to the animal system.
// 232.png
.pn +1
.h4
Of the Frenzy and Delirium.
When the root of the nerves are stimulated
by acrimony, so as to heighten
their sensibility, or set their regulated perception
in confusion, the ideas become bewildered,
and the sensations act at random.
This is generally the case with patients in acute
and malignant fevers; and this conception
differs from dreaming in this respect, that the
phantoms of the confused imagination may
be somewhat guided by the objects around
them; as they may be said to dream with their
eyes open and full awake.
When the frenzy attends acute fevers, the
blood is generally in a great confusion, and
the pulse high and fluctuating. Yet bleeding
should by all means be avoided, unless indeed
the disorder has come on remarkably sudden.
Blisters here are requisite; and in order to
take off the stimulus of the nerves, give the
patient the following draught.
.h5
No. XXXI
.pm quote-block-start
Take Fever Powder (L) one Scruple; Liquid
Laudanum, (T) ten Drops; Spirit of Wine
and Camphor (A) twenty Drops; Essential Oil
of Peppermint (U), four Drops upon a lump
of Sugar; Water half a Tea Cup full.
.pm quote-block-end
This draught may be taken every fourth or
sixth hour; and now and then a grain of calomel
// 233.png
.pn +1
may with great success be added to it.
Cooling clysters in this case are also of singular
service; for example:
.h5 id=XXXII
No. XXXII
.pm quote-block-start
Take cold water, eight ounces; Nitre, or instead
of this[#] Fever Powder (L) two drachms;
spirits of Camphor (A) thirty drops, mix them.
.pm quote-block-end
.pm fn-start // A
The fever powder may be steept in a little water before
hand, and the clear poured off, because nothing but the nitre
here is useful.
.pm fn-end
If the patient is very costive, a little honey
and soap may be added, previously dissolved;
which will both open the body, and promote
urine.
For the rest, every method must be taken as
is already observed in fevers.
.h4
Of a Stupor, and Lethargy.
This is a symptomatic affliction, that attends
acute and malignant fevers, in its
nature quite opposite to the former; in which
the nervous system is benumbed, and have lost
their sensation; this is very apt to succeed,
but seldom precede the Frenzy. When a
patient lays in that kind of stupefaction in a
continual dosing, there is in general little
hopes of recovery; nevertheless remedies
must be applied.
// 234.png
.pn +1
Blisters here are very proper, and these should
be pretty large. Horse radish should be
frequently held to the nose, which has a reviving
quality, and is very innocent with
respect of adding acrimony to the system.
A vomit has often in this extremity proved
very beneficial; which the patient’s weakness
should not retard, unless very weak and
near the end indeed. The following draught
may also prove highly beneficial.
.h5
No. XXXIII
.pm quote-block-start
Take Sweet Spirit of Nitre (D) one drachm;
Essential Oil of Peppermint (U) ten drops upon
a lump of sugar; water one ounce, mix them.
.pm quote-block-end
Let the patient take this every four or six
hours, till he comes to himself again:
But care should be taken that a good sound
sleep, is not mistaken for a stupor; for it frequently
happens that a patient upon a favourable
crisis will fall into a long sound deep, that
terminates all his danger; if therefore the patient
breathes freely, and has a moistness all
over the body, together with a tolerable regular
pulse, disturb him not; but let nature finish
her gracious work.—This kind of sleep
is materially different from the stupor, wherein
the patient neither sleeps nor wakes, but
is equally insensible when the eyes are open, as
when they are shut.
// 235.png
.pn +1
.h4
Of a Violent Head-Ach.
A Violent head-ach often attends fevers,
or comes spontaneously without; it generally
precedes a delirium, as the irritation
of the nerves is the principal cause thereof.
The first intention must be to draw the
humours from the head. A compress with
vinegar, in which is dropt a little spirits of
wine and camphor, is of great service, and
will often have the defined effect to carry it
off. Warm foot-baths also is of great use;
a blister may be applied, and the draught No. #XXXIV:XXXIV#.
will also prove of great service.
The head-ach may proceed from many
other different causes, and in the general is
only a symptomatic affection; therefore particular
attention should be had to the primitive
seat of the disorder.—Frequently a foul
stomach will occasion the head-ach, and a vomit
most times prove the best application.
// 236.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. II.
.h4
Of Diseases of the Neck
.sp 2
The diseases in that part, are indeed very
numerous; but as they have so strict a
connexion amongst themselves, the classes
may be considered but very few; of which
some have been already taken notice of.
.nf c
Of the malignant Sore Throat.
.nf-
Every body who is liable to catch cold,
is frequently apt to have a hoarseness
and consequently in some degree, more or
less, a sore throat. If a fever attends it, methods
should be used accordingly, as is mentioned
under the head of colds: with respect
to the throat, use the gargle, No. #XVIII:XVIII#.
pretty frequently, and the disorder will soon
go off again.
But when an ulcerated sore throat is attended
with a malignant fever and inflammation,
it is called a quincey; this case is alarming,
and requires very careful treatment; for first
we must observe, that the larynx is of a
very complicate and curious structure; and
secondly, it is composed of various, and delicate
materials; namely, cartilages, membranes,
muscles, and glands.
The glands are very numerous in the various
parts of the composition, whence the
// 237.png
.pn +1
inflammation becomes not only painful, but
is apt to swell up and obstruct respiration;
wherefore an inflammation in such parts becomes
highly dangerous to the life of the patient.
When the patient perceives a burning pain
in the throat, and the parts all round swell
up, respiration becoming difficult, add to this
a hoarseness, great difficulty in swallowing,
there is no time to lose, for immediate assistance
is wanting.
Bleeding is indispensably necessary, particularly
if the inflammation is sudden; warm
foot-bathing also is highly requisite; to remove
the humours downwards; a gargle
should also immediately be applied like the
foregoing No. #XVIII:XVIII#. with the addition of a
little camphor spirits. Externally apply the
poultice, No. #II:II#. and give the following
draught.
.h5 id=XXXIV
No. XXXIV
.pm quote-block-start
Take fever powder (L), one scruple; calomel
(N), two grains; liquid laudanum (T), twelve
drops; water two spoonfuls; mix it into a draught.
.pm quote-block-end
This may be given every six hours, for
two days successively; and this generally will
break the disorder. The patient should be
made to drink as freely as he possibly can;
and perspiration should ever be promoted.
A blister as the case requires, may also be
used with much advantage. If the body is
// 238.png
.pn +1
bound, clysters may tend to incline the humours
to be drawn down from the part.
.h5
No. XXXV
.pm quote-block-start
Take Glauber’s salts (19), one ounce and a
half; honey (E), one spoonful; hot water, a
pint and a half.
.pm quote-block-end
Sometimes the inflammation is so very
great, as to choak up both the passage of
respiration, as well as that of deglutition; so
that the poor afflicted patient can neither
breathe, nor swallow; and is not only liable to
be suffocated, but even starved to death, besides
the danger from the malignant inflammation.
In this exigency, have recourse to the following
simple but excellent remedy.
.h5
No. XXXVI
.pm quote-block-start
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.
.pm quote-block-end
// 239.png
.pn +1
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.
.h5 id=XXXVII
No. XXXVII
.pm quote-block-start
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.
.pm quote-block-end
.h5 id=XXXVIII
No. XXXVIII
.pm quote-block-start
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.
.pm quote-block-end
.h5 id=XXXIX
No. XXXIX
.pm quote-block-start
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.
.pm quote-block-end
These clysters are perfectly safe, and very
nourishing. Some have added salt to the animal
// 240.png
.pn +1
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.
// 241.png
.pn +1
.sp 2
.hr 60%
.h3
SECT. III.
.h4
Of Diseases in the Breast
.sp 2
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.
.h4
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
// 242.png
.pn +1
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.
// 243.png
.pn +1
Let the patient take a draught or two
of good sage punch, No. #V: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.
.h5
No. XL
.pm quote-block-start
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.
.pm quote-block-end
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.
.nf c
Of the Pleurisy, and Peripneumony.
.nf-
The pleurisy is an inflammation of the
lining of the inside of the pectoral cavity
// 244.png
.pn +1
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.
// 245.png
.pn +1
.h5 id=XLI
No. XLI
.pm quote-block-start
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.
.pm quote-block-end
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: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.
// 246.png
.pn +1
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: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.
.sp 2
.hr 60%
.h3
SECT. IV.
.h4
Of Diseases of the Bowels, and the Alimentary Canal
.sp 2
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.
// 247.png
.pn +1
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.
.h4
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
// 248.png
.pn +1
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
// 249.png
.pn +1
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
// 250.png
.pn +1
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.
.h4
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.
// 251.png
.pn +1
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: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,
.h5
No. XLII
.pm quote-block-start
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.
.pm quote-block-end
Let the patient take this immediately; a
little Turlington’s balsam (W) about a tea
spoonful, also is very beneficial. If the pain
// 252.png
.pn +1
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.
.h4
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,
// 253.png
.pn +1
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:
.h5
No. XLIII
.pm quote-block-start
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.
.pm quote-block-end
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.
.h5
No. XLIV
.pm quote-block-start
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.
.pm quote-block-end
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:
.h5
No. XLV
.pm quote-block-start
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.
.pm quote-block-end
// 254.png
.pn +1
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:XXXVII#,
#XXXVIII:XXXVIII#, #XXXIX: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:
.h5
No. XLVI
.pm quote-block-start
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.
.pm quote-block-end
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.
// 255.png
.pn +1
By this treatment the most inveterate
bloody flux may be subdued, especially with
the help of patience, cautious diet, and cleanliness.
.sp 2
.hr 60%
.h3
SECT. V.
.h4
Of the Scurvy
.sp 2
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
// 256.png
.pn +1
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
// 257.png
.pn +1
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.
// 258.png
.pn +1
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
// 259.png
.pn +1
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.
// 260.png
.pn +1
If there is malt on board, let a malt decoction,
or temporary beer be made in the
following manner:
.h5
No. XLVII
.pm quote-block-start
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.
.pm quote-block-end
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: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.
.h5
No. XLIX
.pm quote-block-start
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;
// 261.png
.pn +1
which continue for about a quarter, or half an
hour, or longer, according to the circumstances.
.pm quote-block-end
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: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.
// 262.png
.pn +1
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.
.sp 2
.nf c
FINIS.
.nf-
.sp 2
// 263.png
.pn +1
// 264.png
.pn +1
.pb
.if h
.il fn=i264.jpg w=600px
.if-
.if t
.sp 2
[Illustration: Medical Instruments.]
.if-
// 265.png
.pn +1
.sp 4
.h2
EXPLANATION of the PLATE.
.sp 2
.in +2
.ti -2
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.
.ti -2
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.
.ti -2
Fig. 3. A bistoury for opening of sores, &c.
in general use. A. The blade. B. The
handle in which the blade folds.
.ti -2
Fig. 4. A pair of strong scissars.
.ti -2
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.
.ti -2
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.
.ti -2
Fig. 7. A arm tied up for bleeding, with
the three veins as they generally appear
when swelled up.
// 266.png
.pn +1
.ti -2
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.
.ti -2
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.
.ti -2
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.
.ti -2
Fig. 11. A single headed rowler, or bandage,
this bandage is generally used for a fractured
arm or leg.
.ti -2
Fig. 12. A double-headed rowler, generally
for dislocations.
// 267.png
.pn +1
.ti -2
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.
.ti -2
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.
.ti -2
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.
.ti -2
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.
.ti -2
Fig. 17. The inner view of a leg with Mr.
Sharp’s splints.
.ti -2
Fig. 18. The external view of the same.
These two are copied from Mr. Sharp’s
pamphlet.
.ti -2
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.
// 268.png
.pn +1
.ti -2
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.
.ti -2
Fig. 21. The manner of closing a wound
with plaisters, called the dry suture.
.ti -2
Fig. 22. A common syringe made of ivory.
.in 0
.sp 2
.pb
\_ // this gets the sp 2 recognized.
.sp 2
.dv class=tnbox // TN box start
.ul
.it Transcriber’s Notes:
.ul indent=1
.it In Lecture VI, Sect. VI. has been corrected to Sect. V. to match\
the table of contents.
.it 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#.
.it There are two SECT. VIII. in LECTURE I. They have been left with
geh duplicate number.
.it 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.
.it Missing or obscured punctuation was silently corrected.
.it Typographical errors were silently corrected.
.it Inconsistent spelling and hyphenation were made consistent only when a\
predominant form was found in this book.
.if t
.it Text that was in italics is enclosed by underscores (_italics_).
.if-
.ul-
.ul-
.dv- // TN box end
\_