Chapter II: Part 2

"An old Roman, who was always ready to return to the Cultivation of his Field, subsisted himself and his Family from one Acre of Land. A Savage, who neither sows nor cultivates, consumes, in his single Person, as much Game as requires fifty Acres to feed them. Consequently _Tullus Hostilius_, on a thousand Acres, might have five thousand Subjects: while a Savage Chief, limited to the same Extent of Territory, could scarcely have twenty: such an immense Disproportion does Agriculture furnish, in Favour of Population. Observe these two great Extremes. A State becomes dispeopled or peopled in that Proportion, by which it recedes from one of these Methods, and approaches to the other." Indeed it is evident, that wherever there is an Augmentation of Subsistence, an Increase of Population will soon follow; which again will still further facilitate the Increase of Provisions. In a State thus circumstanced Men will abound, who, after they have furnished sufficient Numbers for the Service of War, of Commerce, of Religion, and for Arts and Professions of every kind, will further also furnish a Source for Colonies, who will extend the Name and the Prosperity of their Nation to distant Regions. There will ensue a Plenty of Commodities, the Superfluity of which will be exported to other Countries, to exchange for other Commodities, that are not produced at home; and the Balance, being received in Money, will make the Nation rich, respectable by its Neighbours, and happy. Agriculture, vigorously pursued, is equal to the Production of all these Benefits; and the present Age will enjoy the Glory of restoring it, by favouring and encouraging Cultivaters, and by forming Societies for the Promotion of Agriculture.

I proceed at length to the fourth Cause of Depopulation, which is the Manner of treating sick People in the Country. This has often affected me with the deepest Concern. I have been a Witness, that Maladies, which, in themselves, would have been gentle, have proved mortal from a pernicious Treatment: I am convinced that this Cause alone makes as great a Havock as the former; and certainly it requires the utmost Attention of Physicians, whose Duty it is to labour for the Preservation of Mankind. While we are employing our assiduous Cares on the more polished and fashionable Part of them in Cities, the larger and more useful Moiety perish in the Country; either by particular, or by highly epidemical, Diseases, which, within a few Years past, have appeared in different Villages, and made no small Ravages. This afflicting Consideration has determined me to publish this little Work, which is solely intended for those Patients, who, by their Distance from Physicians, are deprived of their Assistance. I shall not give a Detail of my Plan, which is very simple, in this Part; but content myself with affirming, I have used my utmost Care to render it the most useful I possibly could: and I dare hope, that if I have not fully displayed its utmost Advantages, I have at least sufficiently shewn those pernicious Methods of treating Diseases, that should incontestably be avoided. I am thoroughly convinced, the Design might be accomplished more compleatly than I have done it; but those who are so capable of, do not attempt, it: I happen to be less timid; and I hope that thinking Persons will rather take it in good part of me, to have published a Book, the composing of which is rather disagreeable from its very Facility; from the minute Details, which however are indispensable; and from the Impossibility of discussing any Part of it (consistently with the Plan) to the Bottom of the Subject; or of displaying any new and useful Prospect. It may be compared, in some Respects, to the Works of a spiritual Guide, who was to write a Catechism for little Children.

At the same time I am not ignorant there have already been a few Books calculated for Country Patients, who are remote from Succour: but some of these, tho' published with a very good Purpose, produce a bad Effect. Of this kind are all Collections of Receipts or Remedies, without the least Description of the Disease; and of Course without just Directions for the Exhibition, or Application, of them. Such, for Example, is the famous Collection of Madam _Fouquet_, and some more in the same manner. Some others approach towards my Plan; but many of them have taken in too many Distempers, whence they are become too voluminous. Besides, they have not dwelt sufficiently upon the Signs of the Diseases; upon their Causes; the general Regimen in them, and the Mismanagement of them. Their Receipts are not generally as simple, and as easy to prepare, as they ought to be. In short, the greater Part of their Writers seem, as they advanced, to have grown tired of their melancholy Task, and to have hurried them out too expeditiously. There are but two of them, which I must name with Respect, and which being proposed on a Plan very like my own, are executed in a superior Manner, that merits the highest Acknowlegements of the Publick. One of these Writers is M. _Rosen_, first Physician of the Kingdom of _Sweden_; who, some Years since, employed his just Reputation to render the best Services to his Country Men. He has made them retrench from the Almanacs those ridiculous Tales; those extraordinary Adventures; those pernicious astrological Injunctions, which there, as well as here, answer no End, but that of keeping up Ignorance, Credulity, Superstition, and the falsest Prejudices on the interesting Articles of Health, of Diseases, and of Remedies. He has also taken Care to publish simple plain Treatises on the most popular Distempers; which he has substituted in the Place of the former Heap of Absurdities. These concise Works however, which appear annually in their Almanacs, are not yet translated from the _Swedish_, so that I was unqualified to make any Extracts from them. The other is the Baron _Van Swieten_, first Physician to their Imperial Majesties, who, about two Years since, has effected for the Use of the Army, what I now attempt for sick People in the Country. Though my Work was greatly advanced, when I first saw his, I have taken some Passages from it: and had our Plans been exactly alike, I should imagine I had done the Publick more Service by endeavouring to extend the Reading of his Book, than by publishing a new one. Nevertheless, as he is silent on many Articles, of which I have treated diffusively; as he has treated of many Distempers, which did not come within my Plan; and has said nothing of some others which I could not omit; our two Works, without entering into the Particulars of the superior Merit of the Baron's, are very different, with Regard to the Subject of the Diseases; tho' in such as we have both considered, I account it an Honour to me to find, we have almost constantly proceeded upon the same Principles.

The present Work is by no means addressed to such Physicians, as are thoroughly accomplished in their Profession; yet possibly, besides my particular medical Friends, some others may read it. I beg the Favour of all such fully to consider the Intention, the Spirit, of the Author, and not to censure him, as a Physician, from the Composition of this Book. I even advise them here rather to forbear perusing it; as a Production, that can teach them nothing. Such as read, in order to criticize, will find a much greater Scope for exercising that Talent on the other Pamphlets I have published. It were certainly unjust that a Performance, whose sole abstracted Object is the Health and Service of my Countrymen, should subject me to any disagreeable Consequences: and a Writer may fairly plead an Exemption from any Severity of Censure, who has had the Courage to execute a Work, which cannot pretend to a Panegyric.

Having premised thus much in general, I must enter into some Detail of those Means, that seem the most likely to me, to facilitate the beneficial Consequences, which, I hope, may result to others, from my present Endeavours. I shall afterwards give an Explanation of some Terms which I could not avoid using, and which, perhaps, are not generally understood.

The Title of _Advice to the People_, was not suggested to me by an Illusion, which might persuade me, this Book would become a Piece of Furniture, as it were, in the House of every Peasant. Nineteen out of twenty will probably never know of its Existence. Many may be unable to read, and still more unable to understand, it, plain and simple as it is. I have principally calculated it for the Perusal of intelligent and charitable Persons, who live in the Country; and who seem to have, as it were, a Call from Providence, to assist their less intelligent poor Neighbours with their Advice.

It is obvious, that the first Gentlemen I have my Eye upon, are the Clergy. There is not a single Village, a Hamlet, nor even the House of an Alien in the Country, that has not a Right to the good Offices of some one of this Order; And I assure myself there are a great Number of them, who, heartily affected with the Distress of their ailing Flocks, have wished many hundred Times, that it were in their Power to give their Parishioners some bodily Help, at the very Time they were disposing them to prepare for Death; or so far to delay the Fatality of the Distemper, that the Sick might have an Opportunity of living more religiously afterwards. I shall think myself happy, if such truly respectable Ecclesiastics shall find any Resources in this Performance, that may conduce to the Accomplishment of their beneficent Intentions. Their Regard, their Love for their People; their frequent Invitations to visit their principal Neighbours; their Duty to root out all unreasonable Prejudices, and Superstition; their Charity, their Learning; the Facility, with which their general Knowlege in Physics, qualifies them to comprehend thoroughly all the medical Truths, and Contents of this Piece, are so many Arguments to convince me, that they will have the greatest Influence to procure that Reformation, in the Administration of Physick to poor Country People, which is so necessary, so desirable, an Object.

In the next Place, I dare assure myself of the Concurrence of Gentlemen of Quality and Opulence, in their different Parishes and Estates, whose Advice is highly regarded by their Inferiors; who are so powerfully adapted to discourage a wrong, and to promote a right Practice, of which they will easily discern all the Advantages. The many Instances I have seen of their entering, with great Facility, into all the Plan and Conduct of a Cure; their Readiness and even Earnestness to comfort the Sick in their Villages; and the Generosity with which they prevent their Necessities, induce me to hope, from judging of these I have not the Pleasure to know, by those whom I have, that they will eagerly embrace an Opportunity of promoting a new Method of doing good in their Neighbourhood. Real Charity will apprehend the great Probability there is of doing Mischief, tho' with the best Intention, for want of a proper Knowledge of material Circumstances; and the very Fear of that Mischief may sometimes suspend the Exercise of such Charity; notwithstanding it must seize, with the most humane Avidity, every Light that can contribute to its own beneficent Exertion.

Thirdly, Persons who are rich, or at least in easy Circumstances, whom their Disposition, their Employments, or the Nature of their Property, fixes in the Country, where they are happy in doing good, must be delighted to have some proper Directions for the Conduct and Effectuation of their charitable Intentions.

In every Village, where there are any Persons, of these three Conditions, they are always readily apprized of the Distempers in it, by their poor Neighbours coming to intreat a little Soup, Venice Treacle, Wines, Biscuits, or any thing they imagine necessary for their sick Folks. In Consequence of some Questions to the Bystanders, or of a Visit to the sick Person, they will judge at least of _what kind_ the Disease is; and by their prudent Advice they may be able to prevent a Multitude of Evils. They will give them some Nitre instead of Venice Treacle; Barley, or sweet Whey, in lieu of Soup. They will advise them to have Recourse to Glysters, or Bathings of their Feet, rather than to Wine; and order them Gruel rather than Biscuits. A man would scarcely believe, 'till after the Expiration of a few Years, how much Good might be effected by such proper Regards, so easily comprehended, and often repeated. At first indeed there may be some Difficulty in eradicating old Prejudices, and inveterately bad Customs; but whenever these were removed, good Habits would strike forth full as strong Roots, and I hope that no Person would be inclined to destroy them.

It may be unnecessary to declare, that I have more Expectation from the Care and Goodness of the Ladies, than from those of their Spouses, their Fathers, or Brothers. A more active Charity, a more durable Patience, a more domestic Life; a Sagacity, which I have greatly admired in many Ladies both in Town and Country, that disposes them to observe, with great Exactness; and to unravel, as it were, the secret Causes of the Symptoms, with a Facility that would do Honour to very good Practioners, and with a Talent adapted to engage the Confidence of the Patient:--All these, I say, are so many characteristical Marks of their Vocation in this important and amicable Duty; nor are there a few, who fulfil it with a Zeal, that merits the highest Commendation, and renders them excellent Models for the Imitation of others.

Those who are intrusted with the Education of Youth, may also be supposed sufficiently intelligent to take some Part in this Work; and I am satisfied that much Good might result from their undertaking it. I heartily wish, they would not only study to _distinguish the Distemper_ (in which the principal, but by no means an insuperable Difficulty consists; and to which I hope I have considerably put them in the Way) but I would have them learn also the Manner of applying Remedies. Many of them have; I have known some who bleed, and who have given Glysters very expertly. This however all may easily learn; and perhaps it would not be imprudent, if the Art of bleeding well and safely were reckoned a necessary Qualification, when they are examined for their Employment. These Faculties, that of estimating the Degree of a Fever, and how to apply and to dress Blisters, may be of great Use within the Neighbourhood of their Residence. Their Schools, which are not frequently over-crouded, employ but a few of their daily Hours; the greater part of them have no Land to cultivate; and to what better Use can they apply their Leisure, than to the Assistance and Comfort of the Sick? The moderate Price of their Service may be so ascertained, as to incommode no Person; and this little Emolument might render their own Situation the more agreeable: besides which, these little Avocations might prevent their being drawn aside sometimes, by Reason of their Facility and frequent Leisure, so as to contract a Habit of drinking too often. Another Benefit would also accrue from accustoming them to this kind of Practice, which is, that being habituated to the Care of sick People, and having frequent Occasions to write, they would be the better qualify'd, in difficult Cases, to advise with those, who were thought further necessary to be consulted.

Doubtless, even among Labourers, there may be many, for some such I have known, who being endued with good natural Sense and Judgment, and abounding with Benevolence, will read this Book with Attention, and eagerly extend the Maxims and the Methods it recommends.

And finally I hope that many Surgeons, who are spread about the Country, and who practice Physic in their Neighbourhood, will peruse it; will carefully enter into the Principles established in it, and will conform to its Directions; tho' a little different perhaps from such as they may have hitherto practiced. They will perceive a Man may learn at any Age, and of any Person; and it may be hoped they will not think it too much Trouble to reform some of their Notions in a Science, which is not properly within their Profession (and to the Study of which they were never instituted) by those of a Person, who is solely employed in it, and who has had many Assistances of which they are deprived.

Midwives may also find their Attendance more efficacious, as soon as they are thoroughly disposed to be better informed.

It were heartily to be wished, that the greater Part of them had been better instructed in the Art they profess. The Instances of Mischief that might have been avoided, by their being better qualify'd, are frequent enough to make us wish there may be no Repetition of them, which it may be possible to prevent. Nothing seems impossible, when Persons in Authority are zealously inclined to prevent every such Evil; and it is time they should be properly informed of one so essentially hurtful to Society.

The Prescriptions I have given consist of the most simple Remedies, and I have adjoined the Manner of preparing them so fully, that I hope no Person can be at any Loss in that Respect. At the same time, that no one may imagine they are the less useful and efficacious for their Simplicity, I declare, they are the same I order in the City for the most opulent Patients. This Simplicity is founded in Nature: the Mixture, or rather the Confusion, of a Multitude of Drugs is ridiculous. If they have the very same Virtues, for what Purpose are they blended? It were more judicious to confine ourselves to that, which is the most effectual. If their Virtues are different, the Effect of one destroys, or lessens, the Effect of the other; and the Medicine ceases to prove a Remedy.

I have given no Direction, which is not very practicable and easy to execute; nevertheless it will be discernible, that some few are not calculated for the Multitude, which I readily grant. However I have given them, because I did not lose Sight of some Persons; who, tho' not strictly of the Multitude, or Peasantry, do live in the Country, and cannot always procure a Physician as soon, or for as long a Time, as they gladly would.

A great Number of the Remedies are entirely of the Country Growth, and may be prepared there; but there are others, which must be had from the Apothecaries. I have set down the Price [7] at which I am persuaded all the Country Apothecaries will retail them to a Peasant, who is not esteemed a rich one. I have marked the Price, not from any Apprehension of their being imposed on in the Purchase, for this I do not apprehend; but, that seeing the Cheapness of the Prescription, they may not be afraid to buy it. The necessary Dose of the Medicine, for each Disease, may generally be purchased for less Money than would be expended on Meat, Wine, Biscuits, and other improper things. But should the Price of the Medicine, however moderate, exceed the Circumstances of the Sick, doubtless the Common Purse, or the Poors-Box will defray it: moreover there are in many Country Places Noblemens Houses, some of whom charitably contribute an annual Sum towards buying of Medicines for poor Patients. Without adding to which Sum, I would only intreat the Favour of each of them to alter the Objects of it, and to allow their sick Neighbours the Remedies and the Regimen directed here, instead of such as they formerly distributed among them.

[7] This oeconomical Information was doubtless very proper, where our
judicious and humane Author published it; but notwithstanding his
excellent Motives for giving it, we think it less necessary here,
where many Country Gentlemen furnish themselves with larger or
smaller Medicine Chests, for the Benefit of their poor sick
Neighbours; and in a Country, where the settled parochial Poor are
provided with Medicines, as well as other Necessaries, at a
parochial Expence. Besides, tho' we would not suppose our Country
Apothecaries less considerate or kind than others, we acknowledge
our Apprehension, that in such Valuation of their Drugs (some of
which often vary in their Price) might dispose a few of them,
rather to discountenance the Extension of a Work, so well intended
and executed as Dr. _Tissot's_; a Work, which may not be wholly
unuseful to some of the most judicious among them, and will be
really necessary for the rest. _K._

It may still be objected, that many Country Places are very distant from large Towns; from which Circumstance a poor Peasant is incapable of procuring himself a seasonable and necessary Supply in his Illness. I readily admit, that, in Fact, there are many Villages very remote from such Places as Apothecaries reside in. Yet, if we except a few among the Mountains, there are but very few of them above three or four Leagues from some little Town, where there always lives some Surgeon, or some Vender of Drugs. Perhaps however, even at this Time, indeed, there may not be many thus provided; but they will take care to furnish themselves with such Materials, as soon as they have a good Prospect of selling them, which may constitute a small, but new, Branch of Commerce for them. I have carefully set down the Time, for which each Medicine will keep, without spoiling. There is a very frequent Occasion for some particular ones, and of such the School-masters may lay in a Stock. I also imagine, if they heartily enter into my Views, they will furnish themselves with such Implements, as may be necessary in the Course of their Attendance. If any of them were unable to provide themselves with a sufficient Number of good Lancets, an _Apparatus_ for Cupping, and a Glyster Syringe (for want of which last a Pipe and Bladder may be occasionally substituted) the Parish might purchase them, and the same Instruments might do for the succeeding School-master. It is hardly to be expected, that all Persons in that Employment would be able, or even inclined, to learn the Way of using them with Address; but one Person who did, might be sufficient for whatever Occasions should occur in this Way in some contiguous Villages; with very little Neglect of their Functions among their Scholars.

Daily Instances of Persons, who come from different Parts to consult me, without being capable of answering the Questions I ask them, and the like Complaints of many other Physicians on the same Account, engaged me to write the last Chapter of this Work. I shall conclude this Introduction with some Remarks, necessary to facilitate the Knowledge of a few Terms, which were unavoidable in the Course of it.

The Pulse commonly beats in a Person in good Health, from the Age of eighteen or twenty to about sixty six Years, between sixty and seventy Times in a Minute. It sometimes comes short of this in old Persons, and in very young Children it beats quicker: until the Age of three or four Years the Difference amounts at least to a third; after which it diminishes by Degrees.

An intelligent Person, who shall often touch and attend to his own Pulse, and frequently to other Peoples, will be able to judge, with sufficient Exactness, of the Degree of a Fever in a sick Person. If the Strokes are but one third above their Number in a healthy State, the Fever is not very violent: which it is, as often as it amounts to half as many more as in Health. It is very highly dangerous, and may be generally pronounced mortal, when there are two Strokes in the Time of one. We must not however judge of the Pulse, solely by its Quickness, but by its Strength or Weakness; its Hardness or Softness; and the Regularity or Irregularity of it.

There is no Occasion to define the strong and the feeble Pulse. The Strength of it generally affords a good Prognostic, and, supposing it too strong, it may easily be lowered. The weak Pulse is often very menacing.

If the Pulse, in meeting the Touch, excites the Notion of a dry Stroke, as though the Artery consisted of Wood, or of some Metal, we term it _hard_; the opposite to which is called _soft_, and generally promises better. If it be strong and yet soft, even though it be quick, it may be considered as a very hopeful Circumstance. But if it is strong and hard, that commonly is a Token of an Inflammation, and indicates Bleeding and the cooling Regimen. Should it be, at the same time, small, quick and hard, the Danger is indeed very pressing.

We call that Pulse regular, a continued Succession of whole Strokes are made in equal Intervals of Time; and in which Intervals, not a single Stroke is wanting (since if that is its State, it is called an intermitting Pulse.) The Beats or Pulsations are also supposed to resemble each other so exactly in Quality too, that one is not strong, and the next alternately feeble.

As long as the State of the Pulse is promising; Respiration or Breathing is free; the Brain does not seem to be greatly affected; while the Patient takes his Medicines, and they are attended with the Consequence that was expected; and he both preserves his Strength pretty well, and continues sensible of his Situation, we may reasonably hope for his Cure. As often as all, or the greater Number of these characterizing Circumstances are wanting, he is in very considerable Danger.

The Stoppage of Perspiration is often mentioned in the Course of this Work. We call the Discharge of that Fluid which continually passes off through the Pores of the Skin, _Transpiration_; and which, though invisible, is very considerable. For if a Person in Health eats and drinks to the Weight of eight Pounds daily, he does not discharge four of them by Stool and Urine together, the Remainder passing off by insensible Transpiration. It may easily be conceived, that if so considerable a Discharge is stopt, or considerably lessened; and if this Fluid, which ought to transpire through the Skin, should be transfered to any inward Part, it must occasion some dangerous Complaint. In fact this is one of the most frequent Causes of Diseases.

To conclude very briefly--All the Directions in the following Treatise are solely designed for such Patients, as cannot have the Attendance of a Physician. I am far from supporting, they ought to do instead of one, even in those Diseases, of which I have treated in the fullest Manner; and the Moment a Physician arrives, they ought to be laid aside. The Confidence reposed in him should be entire, or there should be none. The Success of the Event is founded in that. It is his Province to judge of the Disease, to select Medicines against it; and it is easy to foresee the Inconveniences that may follow, from proposing to him to consult with any others, preferably to those he may chuse to consult with; only because they have succeeded in the Treatment of another Patient, whose Case they suppose to have been nearly the same with the present Case. This were much the same, as to order a Shoemaker to make a Shoe for one Foot by the Pattern of another Shoe, rather than by the Measure he has just taken.

_N. B._ Though a great Part of this judicious Introduction is less applicable to the political Circumstances of the British Empire, than to those of the Government for which it was calculated; we think the good Sense and the unaffected Patriotism which animate it, will supersede any Apology for our translating it. The serious Truth is this, that a thorough Attention to Population seems never to have been more expedient for ourselves, than after so bloody and expensive, though such a glorious and successful War: while our enterprizing Neighbours, who will never be our Friends, are so earnest to recruit their Numbers; to increase their Agriculture; and to force a Vent for their Manufactures, which cannot be considerably effected, without a sensible Detriment to our own. Besides which, the unavoidable Drain from the People here, towards an effectual Cultivation, Improvement, and Security of our Conquests, demands a further Consideration. _K._

_ADVICE_ _TO THE_ _PEOPLE_,

With Respect to their _HEALTH._

*__Chapter I.__*

_Of the most usual Causes of popular Maladies._

__Sect.__ 1.

The most frequent Causes of Diseases commonly incident to Country People are, 1. Excessive Labour, continued for a very considerable Time. Sometimes they sink down at once in a State of Exhaustion and Faintness, from which they seldom recover: but they are oftener attacked with some inflammatory Disease; as a Quinsey, a Pleurisy, or an Inflammation of the Breast.

There are two Methods of preventing these Evils: one is, to avoid the Cause which produces them; but this is frequently impossible. Another is, when such excessive Labour has been unavoidable, to allay their Fatigue, by a free Use of some temperate refreshing Drink; especially by sweet Whey, by Butter-milk, or by [8] Water, to a Quart of which a Wine-glass of Vinegar may be added; or, instead of that, the expressed Juice of Grapes not fully ripe, or even of Goosberries or Cherries: which wholesome and agreeable Liquors are refreshing and cordial. I shall treat, a little lower, of inflammatory Disorders. The Inanition or Emptiness, though accompanied with Symptoms different from the former, have yet some Affinity to them with Respect to their Cause, which is a kind of general Exsiccation or Dryness. I have known some cured from this Cause by Whey, succeeded by tepid Baths, and afterwards by Cow's Milk: for in such Cases hot Medicines and high Nourishment are fatal.

[8] This supposes they are not greatly heated, as well as fatigued, by
their Labour or Exercise, in which Circumstance free and sudden
Draughts of cooling Liquors might be very pernicious: and it
evidently also supposes these Drinks to be thus given, rather in
Summer, than in very cold Weather, as the Juice of the unripe
Grapes, and the other fresh Fruits sufficiently ascertain the
Season of the Year. We think the Addition of Vinegar to their Water
will scarcely ever be necessary in this or the adjoining Island, on
such Occasions. The Caution recommended in this Note is abundantly
enforced by Dr. _Tissot_, Sec. 4: but considering the Persons, to whom
this Work is more particularly addressed, we were willing to
prevent every Possibility of a Mistake, in so necessary, and
sometimes so vital a Point. _K._

Sec. 2. There is another Kind of Exhaustion or Emptiness, which may be termed real Emptiness, and is the Consequence of great Poverty, the Want of sufficient Nourishment, bad Food, unwholesome Drink, and excessive Labour. In Cases thus circumstanced, good Soups and a little Wine are very proper. Such happen however very seldom in this Country: I believe they are frequent in some others, especially in many Provinces of _France_.

Sec. 3. A second and very common Source of Disorders arises, from Peoples' lying down and reposing, when very hot, in a cold Place. This at once stops Perspiration, the Matter of which being thrown upon some internal Part, proves the Cause of many violent Diseases, particularly of Quinseys, Inflammations of the Breast, Pleurisies, and inflammatory Cholics. These Evils, from this Cause, may always be avoided by avoiding the Cause, which is one of those that destroy a great Number of People. However, when it has occurred, as soon as the first Symptoms of the Malady are perceiveable, which sometimes does not happen till several Days after, the Patient should immediately be bled; his Legs should be put into Water moderately hot, and he should drink plentifully of the tepid Infusion marked No. 1. Such Assistances frequently prevent the Increase of these Disorders; which, on the contrary, are greatly aggravated, if hot Medicines are given to sweat the Patient.

Sec. 4. A third Cause is drinking cold Water, when a Person is extremely hot. This acts in the same Manner with the second; but its Consequences are commonly more sudden and violent. I have seen most terrible Examples of it, in Quinseys, Inflammations of the Breast, Cholics, Inflammations of the Liver, and all the Parts of the Belly, with prodigious Swellings, Vomitings, Suppressions of Urine, and inexpressible Anguish. The most available Remedies in such Cases, from this Cause, are, a plentiful Bleeding at the Onset, a very copious Drinking of warm Water, to which one fifth Part of Whey should be added; or of the Ptisan No. 2, or of an Emulsion of Almonds, all taken warm. Fomentations of warm Water should also be applied to the Throat, the Breast and Belly, with Glysters of the same, and a little Milk. In this Case, as well as in the preceding one, (Sec. 3.) a _Semicupium_, or Half-bath of warm Water has sometimes been attended with immediate Relief. It seems really astonishing, that labouring People should so often habituate themselves to this pernicious Custom, which they know to be so very dangerous to their very Beasts. There are none of them, who will not prevent their Horses from drinking while they are hot, especially if they are just going to put them up. Each of them knows, that if he lets them drink in that State, they might possibly burst with it; nevertheless he is not afraid of incurring the like Danger himself. However, this is not the only Case, in which the Peasant seems to have more Attention to the Health of his Cattle, than to his own.

Sec. 5. The fourth Cause, which indeed affects every Body, but more particularly the Labourer, is, the Inconstancy of the Weather. We shift all at once, many times a Day, from Hot to Cold, and from Cold to Hot, in a more remarkable Manner, and more suddenly, than in most other Countries. This makes Distempers from Defluxion and Cold so common with us: and it should make us careful to go rather a little more warmly cloathed, than the Season may seem to require; to have Recourse to our Winter-cloathing early in Autumn, and not to part with it too early in the Spring. Prudent Labourers, who strip while they are at Work, take care to put on their Cloaths in the Evening when they return home. [9] Those, who from Negligence, are satisfied with hanging them upon their Country Tools, frequently experience, on their Return, the very unhappy Effects of it. There are some, tho' not many Places, where the Air itself is unwholsome, more from its particular Quality, than from its Changes of Temperature, as at _Villeneuve_, and still more at _Noville_, and in some other Villages situated among the Marshes which border on the _Rhone_. These Countries are particularly subject to intermitting Fevers; of which I shall treat briefly hereafter.

[9] This good Advice is enforced in a Note, by the Editor of _Lyons_,
who observes, it should be still more closely attended to, in
Places, where Rivers, Woods or Mountains retain, as it were, a
considerable Humidity; and where the Evenings are, in every Season,
cold and moist.--It is a very proper Caution too in our own
variable Climate, and in many of our Colonies in North _America_.
_K._

Sec. 6. Such sudden Changes are often attended with great Showers of Rain, and even cold Rain, in the Middle of a very hot Day; when the Labourer who was bathed, as it were, in a hot Sweat, is at once moistened in cold Water; which occasions the same Distempers, as the sudden Transition from Heat to Cold, and requires the same Remedies. If the Sun or a hot Air succeed immediately to such a Shower, the Evil is considerably lighter: but if the Cold continues, many are often greatly incommoded by it.

A Traveller is sometimes thoroughly and unavoidably wet with Mud; the ill Consequence of which is often inconsiderable, provided he changes his Cloaths immediately, when he sets up. I have known fatal Pleurisies ensue from omitting this Caution. Whenever the Body or the Limbs are wet, nothing can be more useful than bathing them in warm Water. If the Legs only have been wet, it may be sufficient to bath them. I have radically, thoroughly, cured Persons subject to violent Cholics, as often as their Feet were wet, by persuading them to pursue this Advice. The Bath proves still more effectual, if a little Soap be dissolved in it.

Sec. 7. A fifth Cause, which is seldom attended to, probably indeed because it produces less violent Consequences, and yet is certainly hurtful, is the common Custom in all Villages, of having their Ditches or Dunghills directly under their Windows. Corrupted Vapours are continually exhaling from them, which in Time cannot fail of being prejudicial, and must contribute to produce putrid diseases. Those who are accustomed to the Smell, become insensible of it: but the Cause, nevertheless, does not cease to be unwholesomly active; and such as are unused to it perceive the Impression in all its Force.

Sec. 8. There are some Villages, in which, after the Curtain Lines are erased, watery marshy Places remain in the Room of them. The Effect of this is still more dangerous, because that putrify'd Water, which stagnates during the hot Season, suffers its Vapours to exhale more easily, and more abundantly, than that in the Curtain Lines did. Having set out for _Pully le Grand_, in 1759, on Account of an epidemical putrid Fever which raged there, I was sensible, on traversing the Village, of the Infection from those Marshes; nor could I doubt of their being the Cause of this Disease, as well as of another like it, which had prevailed there five Years before. In other Respects the Village is wholesomly situated. It were to be wished such Accidents were obviated by avoiding these stagnated Places; or, at least, by removing them and the Dunghils, as far as possible from the Spot, where we live and lodge.

Sec. 9. To this Cause may also be added the Neglect of the Peasants to air their Lodgings. It is well known that too close an Air occasions the most perplexing malignant Fevers; and the poor Country People respire no other in their own Houses. Their Lodgings, which are very small, and which notwithstanding inclose, (both Day and Night) the Father, Mother, and seven or eight Children, besides some Animals, are never kept open during six Months in the Year, and very seldom during the other six. I have found the Air so bad in many of these Houses, that I am persuaded, if their Inhabitants did not often go out into the free open Air, they must all perish in a little Time. It is easy, however, to prevent all the Evils arising from this Source, by opening the Windows daily: so very practicable a Precaution must be followed with the happiest Consequences.

Sec. 10. I consider Drunkenness as a sixth Cause, not indeed as producing epidemical Diseases, but which destroys, as it were, by Retail, at all times, and every where. The poor Wretches, who abandon themselves to it, are subject to frequent Inflammations of the Breast, and to Pleurisies, which often carry them off in the Flower of their Age. If they sometimes escape through these violent Maladies, they sink, a long Time before the ordinary Approach of old Age, into all its Infirmities, and especially into an Asthma, which terminates in a Dropsy of the Breast. Their Bodies, worn out by Excess, do not comply and concur, as they ought, with the Force or Operation of Remedies; and Diseases of Weakness, resulting from this Cause, are almost always incurable. It seems happy enough, that Society loses nothing in parting with these Subjects, who are a Dishonour to it; and whose brutal Souls are, in some Measure, dead, long before their Carcases.

Sec. 11. The Provisions of the common People are also frequently one Cause of popular Maladies. This happens 1st, whenever the Corn, not well ripened, or not well got in, in bad [10] _Harvests_, has contracted an unwholesome Quality. Fortunately however this is seldom the Case; and the Danger attending the Use of it, may be lessened by some Precautions, such as those of washing and drying the Grain completely; of mixing a little Wine with the Dough, in kneading it; by allowing it a little more Time to swell or rise, and by baking it a little more. 2dly, The fairer and better saved Part of the Wheat is sometimes damaged in the Farmers House; either because he does not take due Care of it, or because he has no convenient Place to preserve it, only from one Summer to the next. It has often happened to me, on entering one of these bad Houses, to be struck with the Smell of Wheat that has been spoiled. Nevertheless, there are known and easy Methods to provide against this by a little Care; though I shall not enter into a Detail of them. It is sufficient to make the People sensible, that since their chief Sustenance consists of Corn, their Health must necessarily be impaired by what is bad. 3dly, That Wheat, which is good, is often made into bad Bread, by not letting it rise sufficiently; by baking it too little, and by keeping it too long. All these Errors have their troublesome Consequences on those who eat it; but in a greater Degree on Children and Valetudinarians, or weakly People.

[10] Thus I have ventured to translate _Etes_ (_Summers_) to apply it to
this and the neighbouring Islands. Their Harvests in _Swisserland_
perhaps are earlier, and may occur in _August_, and that of some
particular Grain, probably still earlier. _K._

Tarts or Cakes may be considered as an Abuse of Bread, and this in some Villages is increased to a very pernicious Height. The Dough is almost constantly bad, and often unleavened, ill baked, greasy, and stuffed with either fat or sour Ingredients, which compound one of the most indigestible Aliments imaginable. Women and Children consume the most of this Food, and are the very Subjects for whom it is the most improper: little Children especially, who live sometimes for many successive Days on these Tarts, are, for the greater Part, unable to digest them perfectly. Hence they receive a [11] Source of Obstructions in the Bowels of the Belly, and of a slimy Viscidity or Thickishness, throughout the Mass of Humours, which throws them into various Diseases from Weakness; slow Fevers, a Hectic, the Rickets, the King's Evil, and Feebleness; for the miserable Remainder of their Days. Probably indeed there is nothing more unwholesome than Dough not sufficiently leavened, ill-baked, greasy, and soured by the Addition of Fruits. Besides, if we consider these Tarts in an oeconomical View, they must be found inconvenient also for the Peasant on that Account.

[11] The Abuse just mentioned can scarcely be intended to forbid the
moderate Use of good Pastry, the Dough of which is well raised and
well baked, the Flower and other Ingredients sound, and the Paste
not overcharged with Butter, even though it were sweet and fresh.
But the Abuse of Alum and other pernicious Materials introduced by
our Bakers, may too justly be considered as one horrible Source of
those Diseases of Children, &c. which our humane and judicious
Author mentions here. What he adds, concerning the Pastries being
rendered still more unwholesome by the sour Fruits sometimes baked
in it, is true with Respect to those Children and others, who are
liable to Complaints from Acidities abounding in the Bowels; and
for all those who are ricketty or scrophulous, from a cold and
viscid State of their Humours. But as to healthy sanguine Children,
who are advanced and lively, and others of a sanguine or bilious
Temperament, we are not to suppose a moderate Variety of this Food
injurious to them; when we consider, that the Sharpness and Crudity
of the Fruit is considerably corrected by the long Application of
Fire; and that they are the Produce of Summer, when bilious
Diseases are most frequent. This suggests however no bad Hint
against making them immoderately sweet. _K._

Some other Causes of Maladies may also be referred to the Article of Food, tho' less grievous and less frequent, into a full Detail of which it is very difficult to enter: I shall therefore conclude that Article with this general Remark; that it is the Care which Peasants usually take in eating slowly, and in chewing very well, that very greatly lessens the Dangers from a bad Regimen: and I am convinced they constitute one of the greatest Causes of that Health they enjoy. We may further add indeed the Exercise which the Peasant uses, his long abiding in the open Air, where he passes three fourths of his Life; besides (which are also considerable Advantages) his happy Custom of going soon to Bed, and of rising very early. It were to be wished, that in these Respects, and perhaps on many other Accounts, the Inhabitants of the Country were effectually proposed as Models for reforming the Citizens.

Sec. 12. We should not omit, in enumerating the Causes of Maladies among Country People, the Construction of their Houses, a great many of which either lean, as it were, close to a higher Ground, or are sunk a little in the Earth. Each of these Situations subjects them to considerable Humidity; which is certain greatly to incommode the Inhabitants, and to spoil their Provisions, if they have any Quantity in Store; which, as we have observed, is another, and not the least important, Source of their Diseases. A hardy Labourer is not immediately sensible of the bad Influence of this moist and marshy Habitation; but they operate at the long Run, and I have abundantly observed their most evident bad Effects, especially on Women in Child-bed, on Children, and in Persons recovering of a preceding Disease. It would be easy to prevent this Inconvenience, by raising the Ground on which the House stood, some, or several, Inches above the Level of the adjacent Soil, by a Bed of Gravel, of small Flints, pounded Bricks, Coals, or such other Materials; and by avoiding to build immediately close to, or, as it were, under a much higher Soil. This Object, perhaps, may well deserve the Attention of the Publick; and I earnestly advise as many as do build, to observe the necessary Precautions on this Head. Another, which would cost still less Trouble, is to give the Front of their Houses an Exposure to the South-East. This Exposure, supposing all other Circumstances of the Building and its Situation to be alike, is both the most wholesome and advantageous. I have seen it, notwithstanding, very often neglected, without the least Reason being assigned for not preferring it.

These Admonitions may possibly be thought of little Consequence by three fourths of the People. I take the Liberty of reminding them, however, that they are more important than they may be supposed; and so many Causes concur to the Destruction of Men, that none of the Means should be neglected, which may contribute to their Preservation.

Sec. 13. The Country People in _Swisserland_ drink, either 1, pure Water, 2, some Wine, 3, Perry, made from wild Pears, or sometimes Cyder from Apples, and, 4, a small Liquor which they call _Piquette_, that is Water, which has fermented with the Cake or Husks of the Grapes, after their Juice has been expressed. Water however is their most general Drink; Wine rarely falling in their Way, but when they are employed by rich Folks; or when they can spare Money enough for a Debauch. Fruit Wines and the [12] _Piquettes_ are not used in all Parts of the Country; they are not made in all Years; and keep but for some Months.

[12] This Word's occurring in the plural Number will probably imply, the
_Swiss_ make more than one Species of this small Drink, by pouring
Water on the Cake or Remainder of their other Fruits, after they
have been expressed; as our People in the Cyder, and perhaps in the
Perry, Counties, make what they call _Cyderkin_, _Perkin_, _&c._ It
should seem too from this Section, that the laborious Countrymen in
_Swisserland_ drink no Malt Liquor, though the Ingredients may be
supposed to grow in their Climate. Now Beer, of different Strength,
making the greater Part of our most common Drink, it may be proper
to observe here, that when it is not strong and heady, but a
middling well-brewed Small-beer, neither too new, nor hard or sour,
it is full as wholesome a Drink for laborious People in Health as
any other, and perhaps generally preferable to Water for such;
which may be too thin and light for those who are unaccustomed to
it; and more dangerous too, when the labouring Man is very hot, as
well as thirsty. The holding a Mouthful of any weak cold Liquor in
the Mouth without swallowing 'till it becomes warm, there, and
spurting it out before a Draught is taken down would be prudent;
and in Case of great Heat, to take the requisite Quantity rather at
two Draughts, with a little Interval between them, than to swallow
the Whole precipitately at one, would be more safe, and equally
refreshing, though perhaps less grateful. _K._

Our Waters in general, are pretty good; so that we have little Occasion to trouble ourselves about purifying them; and they are well known in those Provinces where they are chiefly and necessarily used. [13] The pernicious Methods taken to improve or meliorate, as it is falsely called, bad Wines, are not as yet sufficiently practiced among us, for me to treat of them here: and as our Wines are not hurtful, of themselves, they become hurtful only from their Quantity. The Consumption of made Wines and _Piquettes_ is but inconsiderable, and I have not hitherto known of any ill Effects from them, so that our Liquors cannot be considered as Causes of Distempers in our Country; but in Proportion to our Abuse of them by Excess. The Case is differently circumstanced in some [14] other Countries; and it is the Province of Physicians who reside in them, to point out to their Country-Men the Methods of preserving their Health; as well as the proper and necessary Remedies in their Sickness.

[13] The bad Quality of Water is another common Cause of Country
Diseases; either where the Waters are unwholesome, from the Soils
in which they are found, as when they flow through, or settle, on
Banks of Shells; or where they become such, from the Neighbourhood
of, or Drainings from Dunghills and Marshes.

When Water is unclear and turbid, it is generally sufficient to let
it settle in order to clear itself, by dropping its Sediment. But
if that is not effected, or if it be slimy or muddy, it need only
be poured into a large Vessel, half filled with fine Sand, or, for
want of that, with Chalk; and then to shake and stir it about
heartily for some Minutes. When this Agitation is over, the Sand,
in falling to the Bottom of the Vessel, will attract some of the
Foulness suspended in the Water. Or, which is still better, and
very easy to do, two large Vessels may be set near together, one of
which should be placed considerably higher than the other. The
highest should be half filled with Sand. Into this the turbid, or
slimy muddy Water is to be poured; whence it will filter itself
through the Body of Sand, and pass off clear by an Opening or
Orifice made at the Bottom of the Vessel; and fall from thence into
the lower one, which serves as a Reservoir. When the Water is
impregnated with Particles from the Beds of Selenites, or of any
Spar (which Water we call hard, because Soap will not easily
dissolve in it, and Puls and other farinaceous Substances grow hard
instead of soft, after boiling in it) such Water should be exposed
to the Sun, or boiled with the Addition of some Puls, or leguminous
Vegetables, or Bread toasted, or untoasted. When Water is in its
putrid State, it may be kept till it recovers its natural sweet
one: but if this cannot be waited for, a little Sea Salt should be
dissolved in it, or some Vinegar may be added, in which some
grateful aromatic Plant has been infused. It frequently happens,
that the publick Wells are corrupted by foul Mud at the Bottom, and
by different Animals which tumble in and putrify there. Drinking
Snow-water should be avoided, when the Snow is but lately fallen,
as it seems to be the Cause of those swelling wenny Throats in the
Inhabitants of some Mountains; and of endemic Cholics in many
Persons. As Water is so continually used, great Care should be
taken to have what is good. Bad Water, like bad Air, is one of the
most general Causes of Diseases; that which produces the greater
Number of them, the most grieveous ones; and often introduces such
as are epidemical. _E. L. i.e._ the Editor of Lyons.