Chapter XXXIII: Introduction (5)

Our countryman, the celebrated Captain COOK, has shewn how far, by
proper care and attention, the diseases formerly so fatal to seamen
may be prevented. In a voyage of three years and eighteen days, during
which he was exposed to every climate, from the 52° north to the 71°
of south latitude, of one hundred and eighteen men composing the
ship’s company, he lost only one, who died of a _phthisis pulmonalis_.
The principal means he used were, to preserve a strict attention to
cleanliness, to procure abundance of vegetables and fresh provisions,
especially good water, and to allow his people sufficient time for
rest.

Footnote 25:

The appellation of sedentary has generally been given only to the
studious; we can see no reason, however, for restricting it to them
alone. Many artificers may, with as much propriety, be denominated
sedentary as the studious, with this particular disadvantage, that
they are often obliged to sit in very awkward postures, which the
studious need not do, unless they please.

Footnote 26:

A person of observation in that line of life told me, that most
taylors die of consumptions; which he attributed chiefly to the
unfavourable postures in which they sit, and the unwholesomeness of
those places where their business is carried on. If more attention was
not paid to profit than to the preservation of human lives, this evil
might be easily remedied; but while masters only mind their own
interest, nothing will be done for the safety of their servants.

Footnote 27:

The poor, indeed, are generally the first who suffer by unsound
provisions; but the lives of the labouring poor are of great
importance to the state: besides, diseases occasioned by unwholesome
food often prove infectious, by which means they reach people in every
station. It is therefore the interest of all to take care that no
spoilt provisions of any kind be exposed to sale.

Footnote 28:

In most eastern countries it was customary to bury the dead at some
distance from any town. As this practice obtained among the Jews, the
Greeks, and also the Romans, it is strange that the western parts of
Europe should not have followed their example in a custom so truly
laudable.

Footnote 29:

One cannot pass through a large church or cathedral, even in summer,
without feeling quite chilly.

Footnote 30:

We have daily accounts of persons who lose their lives by going down
into deep wells and other places where the air stagnates; all these
accidents might be prevented by only letting down a lighted candle
before them, and stopping when they perceive it go out; yet this
precaution, simple as it is, is seldom used.

Footnote 31:

A year seldom passes that we do not hear of some hospital physician or
surgeon having lost his life by an hospital fever caught from his
patients. For this they have themselves alone to blame. Their patients
are either in an improper situation, or they are too careless with
regard to their own conduct.

Footnote 32:

It is not necessity, but fashion, which makes the use of carriages so
common. There are many people who have not exercise enough to keep
their humours wholesome, who yet dare not venture to make a visit to
their next neighbours, but in a coach or sedan, lest they should be
looked down upon. Strange, that men should be such fools as to be
laughed out of the use of their limbs, or to throw away their health,
in order to gratify a piece of vanity, or to comply with a ridiculous
fashion!

Footnote 33:

Cheyne.

Footnote 34:

Sedentary occupations ought chiefly to be followed by women. They bear
confinement much better than men, and are fitter for every kind of
business which does not require much strength. It is ridiculous enough
to see a lusty fellow making pins, needles, or watch-wheels, while
many of the laborious parts of husbandry are carried on by the other
sex. The fact is, we want men for laborious employments, while one
half of the other sex are rendered useless for want of occupations
suited to their strength, &c. Were girls bred to mechanical
employments, we should not see such numbers of them prostitute
themselves for bread, nor find such a want of men for the important
purposes of navigation, agriculture, &c. An eminent silk manufacturer
told me, that he found women answer better for that business, than
men; and that he had lately taken a great many girls apprentices as
silk-weavers. I hope his example will be followed by many others.

Footnote 35:

Golff is a diversion very common in North Britain. It is well
calculated for exercising the body, and may always be taken in such
moderation, as neither to overheat nor fatigue. It has greatly the
preference over cricket, tennis, or any of those games which cannot be
played without violence.

Footnote 36:

Men of every occupation, and in every situation of life, have lived to
a good old age; nay some have enjoyed this blessing whose plan of
living was by no means regular: but it consists with observation, that
all very old men have been early risers. This is the only circumstance
attending longevity, to which I never knew an exception.

Footnote 37:

_That colds kill more than plagues_, is an old observation; and, with
regard to this country, it holds strictly true. Every person of
discernment, however, will perceive, that most of the colds which
prove so destructive to the inhabitants of Britain are owing to their
imprudence in changing clothes. A few warm days in March or April
induce them to throw off their winter garments, without considering
that our most penetrating colds generally happen in the spring.

Footnote 38:

This madness seems to have pervaded the minds of mothers in every age
and country. Terence, in his Comedy of the Eunuch, ridicules the Roman
matrons for attempting to mend the shape of their daughters.

Footnote 39:

We often see persons, who are rendered quite lame by the nails of
their toes having grown into the flesh, and frequently hear of
mortifications proceeding from this cause. All these, and many other
inconveniences attending the feet, must be imputed solely to the use
of short and strait shoes.

Footnote 40:

The celebrated Boerhaave used to say, that no body suffered by cold
save fools and beggars; the latter not being able to procure clothes,
and the former not having sense to wear them. Be this as it may, I can
with the strictest truth declare, that in many cases where the powers
of medicine had been tried in vain, I have cured the patient by
recommending thick shoes, a flannel waistcoat and drawers, a pair of
under stockings, or a flannel petticoat, to be worn during the cold
season at least.

Footnote 41:

Rousseau.

Footnote 42:

Addison.

Footnote 43:

We may form some notion of the immense quantity of ardent spirits
consumed in Great Britain from this circumstance, that in the city of
Edinburgh and its environs, besides the great quantity of foreign
spirits duly entered, and the still greater quantity which is supposed
to be smuggled, it is computed that above two thousand private stills
are constantly employed in preparing a poisonous liquor called
_Molasses_. The common people have got so universally into the habit
of drinking this base spirit, that when a porter or labourer is seen
reeling along the streets, they say, _he has got molassed_.

Footnote 44:

It is amazing that our improvements in arts, learning, and politeness,
have not put the barbarous custom of drinking to excess out of
fashion. It is indeed less common in South Britain than it was
formerly; but it still prevails very much in the North, where this
relic of barbarity is mistaken for hospitality. There no man is
supposed to entertain his guests well, who does not make them drunk.
Forcing people to drink, is certainly the greatest piece of rudeness
that any man can be guilty of. Manliness, complaisance, or mere
good-nature, may induce a man to take his glass, if urged to it, at a
time when he might as well take poison. The custom of drinking to
excess has long been out of fashion in France; and, as it begins to
lose ground among the politer part of the English, we hope it will
soon be banished from every part of this island.

Footnote 45:

Mr. Pot, in his surgical observations, mentions a disease which he
calls the chimney-sweeper’s cancer, as it is almost peculiar to that
unhappy set of people. This he attributes to neglect of cleanliness,
and with great justice. I am convinced, that if that part of the body
which is the seat of this cruel disease was kept clean by frequent
walking, it would never happen. The climbing boys, as they are called,
are certainly the most miserable wretches on the face of the earth;
yet, for cleaning chimnies, no such persons are necessary.

Footnote 46:

In ancient Rome the greatest men did not think cleanliness an object
unworthy of their attention. Pliny says, the _Cloacæ_, or common
sewers for the conveyance of filth and nastiness from the city, were
the greatest of all the public works; and bestows higher encomiums
upon Tarquinius, Agrippa, and others who made and improved them, than
on those who achieved the greatest conquests.

How truly great does the emperor Trajan appear, when giving directions
to Pliny his proconsul, concerning the making of a common sewer for
the health and convenience of a conquered city?

Footnote 47:

Thou shalt have a place also without the camp, whither thou shalt go
forth abroad; and thou shalt have a paddle upon thy weapon: and it
shall be when thou shalt ease thyself abroad, thou shalt dig
therewith, and shalt turn back, and cover that which cometh from thee,
&c.

Deuter, chap. xxii. ver. 12, 13.

Footnote 48:

As it is impossible to be thoroughly clean without a sufficient
quantity of water, we would earnestly recommend it to the magistrates
of great towns to be particularly attentive to this article. Most
great towns in Britain are so situated as to be easily supplied with
water; and those persons who will not make a proper use of it, after
it is brought to their hand, certainly deserve to be severely
punished. The streets of great towns, where water can be had, ought to
be washed every day. This is the only effectual method for keeping
them thoroughly clean; and, upon trial, we are persuaded it will be
found the cheapest.

Some of the most dreadful diseases incident to human nature might, in
my opinion, be entirely eradicated by cleanliness.

Footnote 49:

Were the tenth part of the care taken to prevent the importation of
diseases, that there is to prevent smuggling, it would be attended
with many happy consequences. This might easily be done by appointing
a physician at every considerable sea-port, to inspect the ship’s
company, passengers, &c. before they came ashore, and, if any fever or
other infectious disorder prevailed, to order the ship to perform a
short quarantine, and to send the sick to some hospital or proper
place to be cured. He might likewise order all the clothes, bedding,
&c. which had been used by the sick during the voyage, to be either
destroyed, or thoroughly cleansed by fumigation, &c. before any of it
were sent ashore. A scheme of this kind, if properly conducted, would
prevent many fevers, and other infectious diseases, from being brought
by sailors into sea-port towns, and by this means diffused all over
the country.

Footnote 50:

There is reason to believe that infection is often conveyed from one
place to another by the carelessness of the faculty themselves. Many
physicians affect a familiar way of sitting upon the patient’s
bedside, and holding his arm for a considerable time. If the patient
has the small-pox, or any other infectious disease, there is no doubt
but the doctor’s hands, clothes, &c. will carry away some of the
infection; and, if he goes directly to visit another patient without
washing his hands, changing his clothes, or being exposed to the open
air, which is not seldom the case, is it any wonder that he should
carry the disease along with him? Physicians not only endanger others,
but also themselves, by this practice. And indeed they sometimes
suffer for their want of care.

Footnote 51:

The ancients would not suffer even the temples of their gods, where
the sick resorted, to be built within the walls of a city.

Footnote 52:

The conduct of parents with regard to the disposal of their children
in marriage is often very blamable. An advantageous match is the
constant aim of parents; while their children often suffer a real
martyrdom betwixt their inclinations and duty. The first thing which
parents ought to consult in disposing their children in marriage, is
certainly their inclinations. Were due regard always paid to these,
there would be fewer unhappy couples, and parents would not have so
often cause to repent the severity of their conduct, after a ruined
constitution, a lost character, or a distracted mind, has shewn them
their mistake.

Footnote 53:

It has long been an observation among physicians, that the appearances
of the urine are very uncertain, and very little to be depended on. No
one will be surprised at this who considers how many ways it may be
affected, and consequently have its appearance altered. The passions,
the state of the atmosphere, the quantity and quality of the food, the
exercise, the clothing, the state of the other evacuations, and
numberless other causes, are sufficient to induce a change either in
the quantity or appearance of the urine. Any one who attends to this,
will be astonished at the impudence of those daring quacks, who
pretend to find out diseases, and prescribe to patients from the bare
inspection of their urine. These impostors, however, are very common
all over Britain, and by the amazing credulity of the populace, many
of them amass considerable fortunes. Of all the medical prejudices
which prevail in this country, that in favour of _urine doctors_ is
the strongest. The common people have still an unlimited faith in
their skill, although it has been demonstrated that no one of them is
able to distinguish the urine of a horse, or any other animal, from
that of a man.

Footnote 54:

I never knew a more remarkable instance of the uncertainty of the
weather in this country, than happened while I was writing these
notes. This morning, August 14, 1783, the thermometer in the shade was
down at fifty-three degrees, and a very few days ago it stood above
eighty. No one who reflects on such great and sudden changes in the
atmosphere, will be surprised to find colds, coughs, rheums, with
other affections of the breast and bowels, so common in this country.

Footnote 55:

If a person suspects that his bed is damp, the simple precaution of
taking off the sheets and lying in the blankets, with all, or most of
his clothes on, will prevent all the danger. I have practised this for
many years, and never have been hurt by damp beds, though no
constitution, without care, is proof against their baneful influence.

Footnote 56:

People imagine if a good fire is made in a room after it has been
washed, that there is no danger from sitting in it; but they must give
me leave to say that this increases the danger. The evaporation
excited by the fire generates cold, and renders the damp more active.

Footnote 57:

The tap-rooms in London and other great towns, where such numbers of
people spend their evenings, are highly pernicious. The breath of a
number of people crowded into a low apartment, with the addition of
fires, candles, the smoke of tobacco, and the fumes of hot liquor, &c.
must not only render it hurtful to continue in such places, but
dangerous to go out of them into a cold and chilly atmosphere.

Footnote 58:

Dr. Lind says, that twenty or twenty-five drops of laudanum put into a
cup of the patient’s drink, and given about half an hour after the
commencement of the hot fit, promotes the sweat, shortens the fit,
relieves the head, and tends greatly to remove the disease.

Footnote 59:

It has lately been observed, that the red bark is more powerful than
that which has for some time been in common use. Its superior efficacy
seems to arise from its being of a more perfect growth than the quill
bark, and consequently more fully impregnated with the medical
properties of the plant.

Footnote 60:

In intermitting fevers of an obstinate nature, I have found it
necessary to throw in the bark much faster. Indeed the benefits
arising from this medicine depend chiefly upon a large quantity of it
being administered in a short time. Several ounces of bark given in a
few days will do more than as many pounds taken in the course of some
weeks. When this medicine is intended either to stop a mortification,
or cure an obstinate ague, it ought to be thrown in as fast as the
stomach can possibly bear it. Inattention to this circumstance has
hurt the reputation of one of the best medicines of which we are in
possession.

Footnote 61:

There is reason to believe, that sundry of our own plants or barks,
which are very bitter and astringent, would succeed in the cure of
intermittent fevers, especially when assisted by aromatics. But as the
Peruvian bark has been long approved in the cure of this disease, and
is now to be obtained at a very reasonable rate, it is of less
importance to search after new medicines. We cannot however omit
taking notice, that the Peruvian bark is very often adulterated, and
that it requires considerable skill to distinguish between the genuine
and the false. This ought to make people very cautious of whom they
purchase it.

Footnote 62:

In obstinate agues, when the patient is old, the habit phlegmatic, the
season rainy, the situation damp, or the like, it will be necessary to
mix with two ounces of the bark, half an ounce of Virginian
snake-root, and a quarter of an ounce of ginger, or some other warm
aromatic; but when the symptoms are of an inflammatory nature, half an
ounce of salt of wormwood or salt of tartar may be added to the above
quantity of bark.

Footnote 63:

Arsenic has of late been recommended as an infallible remedy in the
ague; but I would advise that it should be used only under the eye of
a physician.

Footnote 64:

See Appendix, _Saline mixture_.

Footnote 65:

See Appendix, _Pectoral decoction_.

Footnote 66:

See Appendix, _Pectoral infusion_.

Footnote 67:

See Appendix, _Volatile liniment_.

Footnote 68:

See Appendix, _Arabic emulsion_.

Footnote 69:

See Appendix, _Oily emulsion_.

Footnote 70:

See Appendix, _Solution of gum ammoniac_.

Footnote 71:

See Appendix, _Decoction of seneka-root_.

Footnote 72:

Two things chiefly operate to prevent the benefits which would arise
from sailing. The one is, that physicians seldom order it till the
disease is too far advanced; and the other is, that they seldom order
a voyage of a sufficient length. A patient may receive no benefit by
crossing the channel, who, should he cross the Atlantic, might be
completely cured. Indeed we have reason to believe, that a voyage of
this kind, if taken in due time, would seldom fail to cure a
consumption.

Footnote 73:

Though I do not remember to have seen one instance of a genuine
consumption of the lungs cured by medicine, yet I have known a West
India voyage work wonders in that dreadful disorder.

Footnote 74:

Sheffield.

Footnote 75:

I have often known persons of a consumptive habit, where the symptoms
were not violent, reap great benefit from the use of oysters. They
generally ate them raw, and drank the juice along with them.

Footnote 76:

See Appendix, _Vulnerary decoction_.

Footnote 77:

See Appendix, _Chalybeate wine_.

Footnote 78:

See Appendix, _Mustard-whey_.

Footnote 79:

See Appendix, _Vomiting Julep_.

Footnote 80:

See Appendix, _White Decoction_.

Footnote 81:

When the patient is low, ten grains of Virginian snake-root, and the
same quantity of contrayerva-root, with five grains of Russian castor,
all in fine powder, may be made into a bolus with a little of the
cordial confection or syrup of saffron. One of these may be taken
every four or five hours.

The following powder may be used with the same intention: Take wild
Valerian-root in powder one scruple, saffron and castor each four
grains. Mix these by rubbing them together in a mortar, and give one
in a cup of wine-whey, three or four times a-day.

Footnote 82:

The bark may likewise be very properly administered, along with other
cordials, in the following manner: Take an ounce of Peruvian bark,
orange-peel half an ounce, Virginian snake-root two drachms, saffron
one drachm. Let all of them be powdered, and infused in an English
pint of the best brandy for three or four days. Afterwards the liquor
may be strained, and two tea-spoonfuls of it given three or four times
a-day in a glass of small wine or negus.

Footnote 83:

Deafness is not always a favourable symptom in this disease. Perhaps
it is only so when occasioned by abscesses formed within the ears.

Footnote 84:

The late Sir John Pringle expressed a concern lest these cautions
should prevent people from attending their friends or relations when
afflicted with putrid fevers. I told him I meant only to discourage
unnecessary attendance, and mentioned a number of instances where
putrid fevers had proved fatal to persons, who were rather hurtful
than beneficial to the sick. This sagacious physician agreed with me,
in thinking that a good doctor and a careful nurse were the only
necessary attendants; and that all others not only endangered
themselves, but generally, by their solicitude and ill-directed care,
hurt the sick.

Footnote 85:

Take two ounces of the shavings of hartshorn, and the same quantity of
sarsaparilla, boil them in two English quarts of water. To the
strained decoction add a little white sugar, and let the patient take
it for his ordinary drink.

Footnote 86:

In the _commercium literarium_ for the year 1735, we have the history
of an epidemical miliary fever, which raged at Strasburgh in the
months of November, December, and January; from which we learn the
necessity of a temperate regimen in this malady, and likewise that
physicians are not always the first who discover the proper treatment
of diseases. “This fever made terrible havock even among men of robust
constitutions, and all medicine proved in vain. They were seized in an
instant with shivering, yawning, stretching, and pains in the back,
succeeded by a most intense heat; at the same time there was a great
loss of strength and appetite. On the seventh or ninth day the miliary
eruptions appeared, or spots like flea-bites, with great anxiety, a
delirium, restlessness, and tossing in bed. Bleeding was fatal. While
matters were in this unhappy situation, a midwife, of her own accord,
gave to a patient, in the height of the disease, a clyster of
rain-water and butter without salt, and for his ordinary drink a quart
of spring water, half a pint of generous wine, the juice of a lemon,
and six ounces of the whitest sugar, gently boiled till a scum arose,
and this with great success; for the belly was soon loosened, the
grievous symptoms vanished, and the patient was restored to his
senses, and snatched from the jaws of death.” This practice was
imitated by others with the like happy effects.

Footnote 87:

The ingenious Dr. Lind, of Edinburgh, in his inaugural dissertation
concerning the putrid remitting fever of Bengal, has the following
observation: “Indusia, lodices, ac stragula, sæpius sunt mutanda, ac
aëri exponenda; fœces sordesque quam primum removendæ; oportet etiam
ut loca quibus ægri decumbunt sint salubria, et aceto conspersa;
denique ut ægris cura quanta maxima prospiciatur. Compertum ego habeo,
medicum hæc fedulo observantem, quique ea exequi potest, multo magis
ægris profuturum, quam medicum peritiorem hisce commodis destitutum.”

“The patient’s shirt, bed-clothes, and bedding, ought frequently to be
changed, and exposed to the air, and all his excrements immediately
removed; the bed-chamber should be well ventilated, and frequently
sprinkled with vinegar; in short, every attention should be paid to
the patient. I can affirm, that a physician who puts these in practice
will much oftener succeed than one who is even more skilful, but has
not opportunity of using these means.”

Footnote 88:

Convulsion-fits are no doubt very alarming, but their effects are
often salutary. They seem to be one of the means made use of by Nature
for breaking the force of a fever. I have always observed the fever
abated, and sometimes quite removed, after one or more
convulsion-fits. This readily accounts for convulsions being a
favourable symptom in the fever which precedes the eruption of the
small-pox, as every thing that mitigates this fever lessens the
eruption.

Footnote 89:

I have known a nurse, who had the small-pox before, so infected by
lying constantly a-bed with a child in a bad kind of small-pox, that
she had not only a great number of pustules which broke out all over
her body, but afterwards a malignant fever, which terminated in a
number of imposthumes or boils, and from which she narrowly escaped
with her life. We mention this to put others upon their guard against
the danger of this virulent infection.

Footnote 90:

This observation is likewise applicable to hospitals, workhouses, &c.
where numbers of children happen to have the small-pox at the same
time. I have seen above forty children cooped up in one apartment all
the while they had this disease, without any of them being admitted to
breathe the fresh air. No one can be at a loss to see the impropriety
of such conduct. It ought to be a rule, not only in hospitals for the
small-pox, but likewise for other diseases, that no patient should be
within sight or hearing of another. This is a matter to which too
little regard is paid. In most hospitals and infirmaries, the sick,
the dying, and the dead, are often to be seen in the same apartment.

Footnote 91:

Though this operation can never do harm, yet it is only necessary when
the patient has a great load of small-pox, or when the matter which
they contain is of so thin and acrid a nature, that there is reason to
apprehend bad consequences from its being too quickly resorbed, or
taken up again into the mass of circulating humours.

Footnote 92:

I have of late been accustomed, after the small-pox, to give one, two,
three, four, or five grains of calomel, according to the age of the
patient, over night, and to work it off next morning with a suitable
dose of jalap.

Footnote 93:

A critical situation, too often to be met with, first put me upon
trying this method. A gentleman who had lost all his children except
one son by the natural small-pox, was determined to have him
inoculated. He told me his intention, and desired I would persuade the
mother and grandmother, &c. of its propriety. But that was impossible.
They were not to be persuaded, and either could not get the better of
their fears, or were determined against conviction. It was always a
point with me not to perform the operation without the consent of the
parties concerned. I therefore advised the father, after giving his
son a dose or two of rhubarb, to go to a patient who had the small-pox
of a good kind, to open two or three of the pustules, taking up the
matter with a little cotton, and as soon as he came home to take his
son apart, and give his arm a slight scratch with a pin, afterwards to
rub the place well with the cotton, and take no farther notice of it.
All this he punctually performed; and at the usual period the
small-pox made their appearance, which were of an exceeding good kind,
and so mild as not to confine the boy an hour to his bed. None of the
other relations knew but the disease had come in the natural way, till
the boy was well.

Footnote 94:

Mr. TRONCHIN communicates this disease by a little bit of thread dipt
in the matter, which he covers with a small blistering-plaster. This
method may no doubt be used with advantage in those cases where the
patient is very much alarmed at the sight of any cutting instrument.

Footnote 95:

“Many and great,” says this humane author, “are the dangers attending
the natural infection, from all which the inoculation is quite secure.
The natural infection may invade weaker distempered bodies, by no
means disposed for its kindly reception. It may attack them at a
season of the year either violently hot or intensely cold. It may be
communicated from a sort of small-pox impregnated with the utmost
virulence. It may lay hold upon people unexpectedly, when a dangerous
sort is imprudently imported into a maritime place. It may surprise us
soon after excesses committed in luxury, intemperance, or lewdness. It
may likewise seize on the innocent after indispensably watchings, hard
labour, or necessary journies. And is it a trivial advantage, that all
these unhappy circumstances can be prevented by inoculation? By
inoculation numbers are saved from deformity as well as from death. In
the natural small-pox, how often are the finest features, and the most
beautiful complexions, miserably disfigured? Whereas inoculation
rarely leaves any ugly marks of scars, even where the number of
pustules on the face has been very considerable, and the symptoms by
no means favourable. And many other grievous complaints, that are
frequently subsequent to the natural sort, seldom follow the
artificial. Does not inoculation also prevent those inexpressible
terrors that perpetually harass persons who never had this disease,
insomuch that when the small-pox is epidemical, entire villages are
depopulated, markets ruined, and the face of distress spread over the
whole country? From this terror it arises, that justice is frequently
postponed, or discouraged, at sessions or assizes where the small-pox
rages. Witnesses and juries dare not appear; and by reason of the
necessary absence of some gentlemen, our honourable and useful judges
are not attended with that reverence and splendour due to their office
and merit. Does not inoculation, in like manner, prevent our brave
sailors from being seized with this distemper on shipboard, where they
must quickly spread the infection among such of the crew who never had
it before, and where they have scarce any chance to escape, being half
stifled with the closeness of their cabins, and but very indifferently
nursed? Lastly, with regard to the soldiery, the miseries attending
these poor creatures, when attacked by the small-pox on a march, are
inconceivable, without attendance, without lodgings, without any
accommodation; so that one of three commonly perishes.”

Footnote 96:

By a well-laid plan for extending inoculation, more lives might be
saved at a small expence, than are at present preserved by all the
hospitals in England, which cost the public such an amazing sum.

Footnote 97:

I do not know any disease wherein bleeding is more necessary than in
the measles, especially when the fever runs high: in this case I have
always found it relieve the patient.

Footnote 98:

Attempts have been made to communicate the measles, as well as the
small-pox, by inoculation, and we make no doubt but in time the
practice may succeed. Dr. Home of Edinburgh says, he communicated the
disease by the blood. Others have tried this method, and have not
found it succeed. Some think the disease would be more certainly
communicated by rubbing the skin of a patient who has the measles with
cotton, and afterwards applying the cotton to a wound, as in the
small-pox; while others recommend a bit of flannel which had been
applied to the patient’s skin, all the time of the disease, to be
afterwards laid upon the arm or leg of the person to whom the
infection is to be communicated. There is no doubt but this disease,
as well as the small-pox, may be communicated various ways; the most
probable, however, is either from cotton rubbed upon the skin, as
mentioned above, or by introducing a little of the sharp humour which
distils from the eyes of the patient into the blood. It is agreed on
all hands, that such patients as have been inoculated had the disease
very mildly; we therefore wish the practice were more general, as the
measles have of late become very fatal.

Footnote 99:

Sydenham.

Footnote 100:

In the year 1774, during winter, a very bad species of this fever
prevailed in Edinburgh. It raged chiefly among young people. The
eruption was generally accompanied with a quinsey, and the
inflammatory symptoms were so blended with others of a putrid nature,
as to render the treatment of the disease very difficult. Many of the
patients, towards the decline of the fever, were afflicted with large
swellings of the submaxillary glands, and not a few had a suppuration
in one or both ears.

Footnote 101:

See Appendix, _White Decoction_.

Footnote 102:

See Appendix, _Spirit of Mindererus_.

Footnote 103:

The country people in many parts of Britain call this disease a
_blast_, and imagine it proceeds from foul air, or ill wind, as they
term it. The truth is, they often lie down to rest them, when warm and
fatigued, upon the damp ground, where they fall asleep, and lie so
long as to catch cold, which occasions the erysipelas. This disease
may indeed proceed from other causes, but we may venture to say, that
nine times out of ten it is occasioned by cold caught after the body
has been greatly heated or fatigued.

Footnote 104:

See Appendix, _Decoction of Woods_.

Footnote 105:

Any foreign body lodged in the eye may be expeditiously removed by
passing a small hair pencil between the eye-lid and the ball of the
eye. In some places, the peasants do this very effectually, by using
their tongue in the same manner.

Footnote 106:

As most people are fond of using eye-waters and ointments in this and
other diseases of the eyes, we have inserted some of the most approved
forms of these medicines in the Appendix. See Appendix, _Eye-water_
and _Eye-salve_.

Footnote 107:

Dr. Home.

Footnote 108:

See Appendix, _Spanish Infusion_.

Footnote 109:

In a former edition of this book I recommended, for an obstinate
tickling cough, an oily emulsion, made with the paregoric elixir of
the Edinburgh Dispensatory, instead of the common alkaline spirit. I
have since been told by several practitioners, that they found it to
be an excellent medicine in this disorder, and every way deserving of
the character which I had given it. Where this elixir is not kept, its
place may be supplied by adding to the common oily emulsion, an
adequate proportion of the _Thebaic tincture_, or liquid laudanum.

Footnote 110:

Some complain that the pitch plaster adheres too fast, while others
find difficulty in keeping it on. This proceeds from the different
kinds of pitch made use of, and likewise from the manner of making it.
I generally find it answer best when mixed with a little beeswax, and
spread as cool as possible. The clear, hard, transparent pitch answers
the purpose best.

Footnote 111:

See Appendix, _Hiera Picra_.

Footnote 112:

Some think the air ought not to be changed till the disease is on the
decline; but there seems to be no sufficient reason for this opinion,
as patients have been known to reap benefit from a change of air at
all periods of the disease. It is not sufficient to take the patient
out daily in a carriage. This seldom answers any good purpose; but
often does hurt, by giving him cold.

Footnote 113:

See Appendix, _Vomiting Julep_.

Footnote 114:

Dr. DUPLANIL says, he has seen many good effects from the kermes
mineral in this complaint, the cough being frequently alleviated even
by the first dose. The dose for a child of one year old, is a quarter
of a grain dissolved in a cup of any liquid, repeated two or three
times a-day. For a child of two years the dose is half a grain; and
the quantity must be thus increased in proportion to the age of the
patient.

Footnote 115:

Some recommend the extract of hemlock as an extraordinary remedy in
the hooping-cough; but so far as I have been able to observe, it is no
way superior to opium, which, when properly administered, will often
relieve some of the most troublesome symptoms of this disorder.

Footnote 116:

When quicksilver is given in too large quantities, it defeats its own
intention, as it drags down the bottom of the stomach, which prevents
it getting over the Pylorus. In this case the patient should be hung
up by the heels, in order that the quicksilver may be discharged by
his mouth.

Footnote 117:

See Appendix, _Anti-hysteric Plaster_.

Footnote 118:

As the smoke of tobacco thrown into the bowels will often procure a
stool when all other means have failed, an apparatus for this purpose
ought to be kept by every surgeon. It may be purchased at a small
expence, and will be of service in several other cases, the recovery
of drowned persons, &c.

Footnote 119:

The Ureters are two long and small canals, one on each side, which
carry the urine from the bason of the kidneys to the bladder. They are
sometimes obstructed by small stones of gravel falling down from the
kidneys, and lodging in them.

Footnote 120:

I knew a gentleman who has had several abscesses of the liver opened,
and is now a strong and healthy man, though above eighty years of age.

Footnote 121:

I have been twice brought to the gates of death by this disease, and
both times it was occasioned by eating rancid bacon.

Footnote 122:

See Appendix, _White Decoction_.

Footnote 123:

See Appendix, _Tincture of Roses_.

Footnote 124:

See Appendix, _Lime-water_.

Footnote 125:

The caustic alkali may be prepared by mixing two parts of quicklime
with one of pot-ashes, and suffering them to stand till the lixivium
be formed, which must be carefully filtrated before it be used. If the
solution does not happen readily, a small quantity of water may be
added to the mixture.

Footnote 126:

The manner of making this broth is, to take a sheep’s head and feet
with the skin upon them, and to burn the wool off with a hot iron;
afterwards to boil them till the broth is quite a jelly. A little
cinnamon or mace may be added, to give the broth an agreeable flavour,
and the patient may take a little of it warm with toasted bread three
or four times a-day. A clyster of it may likewise be given twice
a-day. Such as cannot use the broth made in this way, may have the
head and feet skinned; but we have reason to believe that this hurts
the medicine. It is not our business here to reason upon the nature
and qualities of medicine, otherwise this might be shewn to possess
virtues every way suited to the cure of a dysentery which does not
proceed from a putrid state of the humours. One thing we know, which
is preferable to all reasoning, that whole families have often been
cured by it, after they had used many other medicines in vain. It
will, however, be proper that the patient take a vomit, and a dose or
two of rhubarb, before he begins to use the broth. It will likewise be
necessary to continue the use of it for a considerable time, and to
make it the principal food.

Footnote 127:

The learned and humane Dr. Rutherford, late professor of medicine in
the university of Edinburgh, used to mention this food in his public
lectures with great encomiums. He directed it to be made by tying a
pound or two of the finest flour, as tight as possible, in a linen
rag, afterwards to dip it frequently in water, and to dredge the
outside with flour, till a cake or crust was formed around it, which
prevents the water from soaking into it while boiling. It is then to
be boiled till it becomes a hard dry mass, as directed above. This,
when mixed with milk and water, will not only answer the purpose of
food, but may likewise be given in clysters.

Footnote 128:

I lately saw a young man who had been seized with a dysentery in North
America. Many things had been tried there for his relief, but to no
purpose. At length, tired out with disappointments from medicine, and
reduced to skin and bone, he came over to Britain, rather with a view
to die among his relations, than with any hopes of a cure. After
taking sundry medicines here with no better success than abroad, I
advised him to leave off the use of drugs, and to trust entirely to a
diet of milk and fruits, with gentle exercise. Strawberries was the
only fruit he could procure at that season. These he ate with milk
twice, and sometimes thrice a-day. The consequence was, that in a
short time his stools were reduced from upwards of twenty in a-day, to
three or four, and sometimes not so many. He used the other fruits as
they came in, and was in a few weeks so well as to leave that part of
the country where I was, with a view to return to America.

Footnote 129:

See Appendix, _Decoction of Logwood_.

Footnote 130:

See Appendix, _Decoction of Sarsaparilla_.

Footnote 131:

When the pain is very violent, and does not yield to small doses of
laudanum, the quantity may be increased. I have known a patient in
extreme pain take three hundred drops in twenty-four hours; but such
doses ought only to be administered by a person of skill.

Footnote 132:

This may always be prevented by the operator striking upon the teeth
with any piece of metal, as this never fails to excite the pain in the
carious tooth.

Footnote 133:

These are prepared by steeping or soaking pease in water, and
afterwards drying them in a pot or kiln till they be quite hard. They
may be used at pleasure.

Footnote 134:

That worms exist in the human body there can be no doubt; and that
they must sometimes be considered as a disease, is equally certain:
but this is not the case so often as people imagine. The idea that
worms occasion many diseases, gives an opportunity to the professed
worm-doctors of imposing on the credulity of mankind, and doing much
mischief. They find worms in every case, and liberally throw in their
antidotes, which generally consist of strong, drastic purges. I have
known these given in delicate constitutions to the destruction of the
patient, where there was not the least symptom of worms.

Footnote 135:

A medical writer of the present age has enumerated upwards of fifty
British plants, all celebrated for killing and expelling worms.

Footnote 136:

A powder for the tape-worm resembling this, was long kept a secret on
the Continent; it was lately purchased by the French king, and will be
found under the article _Powder_, in the Appendix.

Footnote 137:

We think it necessary here to warn people of their danger who buy
cakes, powders, and other worm medicines, at random from quacks, and
give them to their children without proper care. The principal
ingredients in most of these medicines is mercury, which is never to
be trifled with. I lately saw a shocking instance of the danger of
this conduct. A girl who had taken a dose of worm powder, bought of a
travelling quack, went out, and perhaps was so imprudent as to drink
cold water during its operation. She immediately swelled, and died on
the following day, with all the symptoms of having been poisoned.

Footnote 138:

The very name of an operation is dreadful to most people, and they
wish to try every thing before they have recourse to it. This is the
reason why tapping so seldom succeeds to our wish. I have had a
patient who was regularly tapped once a month for several years, and
who used to eat her dinner as well after the operation as if nothing
had happened. She died at last rather worn out by age than by the
disease.

Footnote 139:

Some make a secret of curing the gout by _muscular exercise_. This
secret, however, is as old as Celsus, who strongly recommends that
mode of cure; and whoever will submit to it, in the fullest extent,
may expect to reap solid and permanent advantages.

Footnote 140:

See Appendix, _Warm Plaster_.

Footnote 141:

The scrophula, as well as the rickets, is found to prevail in large
manufacturing towns, where people live gross, and lead sedentary
lives.

Footnote 142:

Sir John Pringle observes, that though this disease may seem trifling,
there is no one in the army that is more troublesome to cure, as the
infection often lurks in clothes, &c. and breaks out a second, or even
a third time. The same inconveniency occurs in private families,
unless particular regard is paid to the changing or cleaning of their
clothes, which last is by no means an easy operation.

Footnote 143:

The itch is now by cleanliness banished from every genteel family in
Britain. It still however prevails among the poorer sort of peasants
in Scotland, and among the manufacturers in England. These are not
only sufficient to keep the seeds of the disease alive, but to spread
the infection among others. It were to be wished that some effectual
method could be devised for extirpating it altogether. Several country
clergymen have told me, that by getting such as were infected cured,
and strongly recommending an attention to cleanliness, they have
banished the itch entirely out of their parishes. Why might not others
do the same?

Footnote 144:

After copious evacuations, large doses of æther have been found very
efficacious in removing a fit of the asthma. I have likewise known the
following mixture produce very happy effects: To four or five ounces
of the solution of gum-ammoniac add two ounces of simple
cinnamon-water, the same quantity of balsamic syrup, and half an ounce
of paregoric elixir. Of this two table-spoonfuls may be taken every
three hours.

Footnote 145:

I knew a woman who in a violent fit of anger was seized with a
sanguine apoplexy. She at first complained of extreme pain, _as if
daggers had been thrust through her head_, as she expressed it.
Afterwards she became comatose, her pulse sunk very low, and was
exceeding slow. By bleeding, blistering, and other evacuations, she
was kept alive for about a fortnight. When her head was opened, a
large quantity of extravasated blood was found in the left ventricle
of the brain.

Footnote 146:

The learned Dr. Arbuthnot advises those who are troubled with
costiveness to use animal oils, as fresh butter, cream, marrow, fat
broths, especially those made of the internal parts of animals, as the
liver, heart, midriff, &c. He likewise recommends the expressed oils
of mild vegetables, as olives, almonds, pastaches, and the fruits
themselves; all oily and mild fruits, as figs; decoctions of mealy
vegetables; these lubricate the intestines; some saponaceous
substances which stimulate gently, as honey, hydromel, or boiled honey
and water, unrefined sugar, &c.

The Doctor observes, that such lenitive substances are proper for
persons of dry atrabilarian constitutions, who are subject to
astriction of the belly, and the piles, and will operate when stronger
medicinal substances are sometimes ineffectual; but that such lenitive
diet hurts those whose bowels are weak and lax. He likewise observes,
that all watery substances are lenitive, and that even common water,
whey, sour milk, and butter-milk, have that effect;—That new milk,
especially asses milk, stimulates still more when it sours on the
stomach; and that whey turned sour will purge strongly;—That most
garden fruits are likewise laxative; and that some of them, as grapes,
will throw such as take them immoderately into a cholera morbus, or
incurable diarrhœa.

Footnote 147:

Many people imagine, that tea has no tendency to hurt the nerves, and
that drinking the same quantity of warm water would be equally
pernicious. This however seems to be a mistake. Many persons drink
three or four cups of warm milk and water daily, without feeling any
bad consequences; yet the same quantity of tea will make their hands
shake for twenty-four hours. That tea affects the nerves, is likewise
evident from its preventing sleep, occasioning giddiness, dimness of
the sight, sickness, &c.

Footnote 148:

See Appendix, _Electuary for the Epilepsy_.

Footnote 149:

Many nervous people find great benefit from eating a dry biscuit,
especially when the stomach is empty. I look upon this as one of the
best carminative medicines; and would recommend it in all complaints
of the stomach, arising from flatulence, indigestion, &c.

Footnote 150:

Though the patient may begin with this quantity, it will be necessary
to increase the dose gradually as the stomach can bear it. Æther is
now given in considerably greater doses than it was in Dr. Whytt’s
time.

Footnote 151:

When hysteric fits are occasioned by sympathy, they may be cured by
exciting an opposite passion. This is said to have been the case of a
whole school of young ladies in Holland, who were all cured by being
told, that the first who was seized should be burnt to death. But this
method of cure, to my knowledge, will not always succeed. I would
therefore advise, that young ladies who are subject to hysteric fits
should not be sent to boarding schools, as the disease may be caught
by imitation. I have known madness itself brought on by sympathy.

Footnote 152:

Though antispasmodics and anodynes are universally recommended in this
disease, yet all the extraordinary cures that I ever knew in hysteric
cases, were performed by means of tonic and corroborating medicines.

Footnote 153:

Some persons afflicted with cramps pretend to reap great benefit from
small bundles of rosemary tied all night about their feet, ancles, and
knees.

Footnote 154:

Armstrong on Health.

Footnote 155:

It is a pity those who have the misfortune to be born blind, or who
lose their sight when young, should be suffered to remain in
ignorance, or to beg. This is both cruelty and want of economy. There
are many employments of which blind persons are very capable, as
knitting, carding, turning a wheel, teaching languages, &c. Nor are
instances wanting of persons who have arrived at the highest pitch of
learning, without having the least idea of light. Witness the late
famous Nicholas Sanderson of Cambridge, and my worthy friend Dr.
Thomas Blacklock of Edinburgh. The former was one of the first
mathematicians of his age, and the latter, besides being a good poet
and philosopher, is master of all the learned languages, and a very
considerable adept in the liberal arts.

Footnote 156:

Though those who have the misfortune to be born deaf are generally
suffered to continue dumb, and consequently are in a great measure
lost to society, yet nothing is more certain than that such persons
may be taught not only to read and write, but also to speak, and to
understand what others say to them. Teaching the dumb to speak will
appear paradoxical to those who do not consider that the formation of
sounds is merely mechanical, and may be taught without the assistance
of the ear. This is not only capable of demonstration, but is actually
reduced to practice by the ingenious Mr. Thomas Braidwood of
Edinburgh. This gentleman has, by the mere force of genius and
application, brought the teaching of dumb persons to such a degree of
perfection, that his scholars are generally more forward in their
education than those of the same age who enjoy all their faculties.
They not only read and write with the utmost readiness, but likewise
_speak_, and are capable of holding conversation with any person in
the light. What a pity any of the human species should remain in a
state of idiotism, who are capable of being rendered as useful and
intelligent as others! We mention this not only from humanity to those
who have the misfortune to be born deaf, but also in justice to Mr.
Braidwood, whose success has far exceeded all former attempts this
way; and indeed it exceeds imagination itself so far, that no person
who has not seen and examined his pupils, can believe what they are
capable of.—As this gentleman, however willing, is only able to teach
a few, and as the far greater part of those who are born deaf cannot
afford to attend him, it would be an act of great humanity, as well as
of public utility, to erect an academy for their benefit.

Footnote 157:

A gentleman, on whose veracity I can depend, told me, that after using
many things to no purpose for an obstinate deafness, he was at last
advised to put a few drops of his own urine warm into his ears every
night and morning, from which he received great benefit. It is
probable that a solution of _sal ammoniac_, in water, would produce
the same effect.

Footnote 158:

London Medical Essays.

Footnote 159: