pi. / 2*?
THE PROPERTY
of . .
JONATHAN HAVENS, ,
Decltertown, TSl.fSJ?.
- - .■ - y
A
POCKET FORMULAKY
A X 1>
PHYSICIAN'S MANUAL,
EMBRACING THK
ART OF COMBINING AND PRESCRIBING MEDICINES
TO THE BEST ADVANTAGE;
WITH
MANY VALUABLE RECIPES, TABLES, ETC.
ADAPTED TO
THE PROFESSION THROUGHOUT THE UNITED STATES.
BY
THOMAS. S. POWELL, M. D.
OF SPARTA, GEORGIA.
'■ lie who does his best, however little, is always to be distinguished
from him who does nothing."—Dr. Johnson.
SAVANNAH:
W. THORNE WILLIAMS.
1855.
Entered according to act of Congress, in the year 1855,
BY THOS. S. POWELL, M. D.,
the Clerk's Office of the District Court of the United States
for the Southern District of Georgia.
TO THE
MEDICAL PROFESSION
THROUGHOUT THE UNITED STATES,
t s WL orfe
IS RESPECTFULLY DEDICATED
b r
THE AUTHOR.
PREFACE.
We offer to th.e medical profession this little manual
■with some mistrust, in this day of new books and multi¬
tudinous publications ; but believing, as we do, that it will
fill a desideratum in the wants of the profession, especially
the younger portion of it, we have determined to confide it
to their care, relying upon their accustomed generosity for
its support.
We claim no originality, except in the arrangement of
the work, as it is manifest that it must be necessarily a
simple compilation of the accumulated experience of ages.
This much we claim for it, and for the part we hav-e in it.
To various authors, whom we have consulted, we owe
much; from one we have gathered a grain, and from another
a sheaf, and this, having been done for our own benefit, in
a series of years, while engaged in the practice of medi¬
cine, has resulted in a book, without our being able to give
credit to all. We mention, however, as the most promi¬
nent among them, the names of Wood and Bache, Ellis
and Bull on Maternal Management of Children, Thomp¬
son's Conspectus, etc.
TABLE OF CONTENTS.
PART I.
The Art of Prescribing Medicines . . .13
General Questions to Patients . . . . .14
Of the Tongue . . . . . . .17
Of the Stools 19
Of the Pulse . . . 20
Of the Urine ........ 21
Of the Perspiration ...... 22
Of the Respiration . 23
Of the Examination of Children .... 24
Prognostics ........ 25
Table of Abbreviations used in Prescriptions . . 28
Table of Symbols and Signs used in Prescriptions . 33
Table of Weights and Measures .... 34
Temperature of Baths ...... 35
PART II.
Approved Medicines in Daily Use
Pills
Powders .....
Mixtures ....
Collyria, or Eye-waters .
Gargles and Mouth-washes
Ointments and Liniments
Cataplasms, or Poultices
Fomentations ....
Clysters
PART III.
Miscellaneous Medical Intelligence useful to thb
Young Practitioner 94
Signs of Pregnancy 95
Natural Labor .96
Signs of Labor 96
Care of the Child ....... 98
Of Mothers who ought not to Suckle . . . 100
Of a Wetnurse 101
General Directions 102
52
53
66
80
82
84
87
89
90
viii
TABLE OF CONTENTS.
Rules for Nursing the Infant
Clothing .
Signs of Disease
The Breathing
The Sleep
The Stools
The Cry .
Inquiries concerning the Sick Room
Of Phlebotomy, or Bloodletting
The means of Fumigating Chambers, &c.
Of Diet
Of Drink . . . .
Dietetic Preparations
PART IY.
Medical and Miscellaneous Statistics
Poisons
Hints to Dyspeptics ......
Table of Articles of Diet, and the time required for
their Digestion .......
Table of Physicians
Table of Diseases in different Months
Table of percentage of Deaths ....
Tables of Meteorology
Table showing the difference between Minims, Drops,
and Grains, &c
Table of the "Strength of Wines ....
PART V.
Medical Ethics .
Chapter I. Of the Duties of Physicians to their Pa¬
tients, and of the Obligations of Patients to their
Physicians ........
Chapter II. Of the Duties of Physicians to each other
and the Profession at large .....
Some of the means of acquiring Business, and the
causes which prevent its acquisition, and occasion
the loss of it in the Profession of Medicine .
Fee Bill . . .
List of Medicines, Shop Furniture, and Surgical In¬
struments required by a Physician at the outset of
his practice
Law points concerning Physicians ....
Form of Will
Concl"«'on ........
PAGE
102
104
105
ior
107
108
108
110
113
118
120
120
122
129
129
134
134
137
138
139
140
141
142
144
144
148
157
161
164
166
167
170
PART I.
THE ART OF PRESCRIBING MEDICINES.
In prescribing a Medicine, we should always remember that
there are many circumstances which influence its action, and
the dose in which it is to be given.
The most important of these are—Sex, Temperament, Age,
Habit, Climate, Idiosyncrasy, and last, but not least, the condi¬
tion of the stomach. There are various tables for the gradua¬
tion of doses to the respective ages, but the one devised by
Gaubius is generally adopted, which is as follows: —
For an adult, say from 21 to 60.
Suppose the dose to be 1 drachm, or one. That for a person
from—
14 to 21 years would be
7 to 14
4 to 7
4
3
2
1
2 scruples, or $.
will only require J dr.
J scruple,
15 grains,
10 "
or
or i.
or | .
or l-
orlV
Above 60, an inverse gradation should be observed.
This table, in the main, is correct; but it will not do for
estimating the doses of certain medicines—such as castor oil,
opium, and calomel. Opiates affect children more powerfully
than adults; but children bear larger doses of calomel than
adults, in proportion to age, particularly up to two years of age.
Sex.—Women, in general, require rather smaller doses of any
active medicine than men; but so much depends upon habits
of life, temperament, &c., that the exceptions are almost as
numerous as the examples.
Temperament also exercises much influence on the dose of
9
14
POCKET FORMULARY.
certain medicines. A person of a nervous temperament is un¬
able to bear with impunity an amount of opium that would
scarcely act on a phlegmatic person; while the sanguineous are
more readily affected by the action of stimuli, &c.
Idiosyncrasy has more influence than either sex or tempera¬
ment, on the action of medicines ; sometimes it is very striking—
for example, in some cases, opium, or any of its preparations,
cannot be given without producing the most distressing symp¬
toms ; while, in others, the smallest doses of calomel will cause
salivation; therefore, always listen to what your patients tell
you about their peculiarities.
Habit.—This has an important influence on the operations of
medicines. Persons, in the habitual use of stimulants and nar¬
cotics, require larger doses to affect them when laboring under
disease; while those who have habituated themselves to the use
of saline purgatives are more easily affected by these remedies.
Climate, also, has an influence in modifying the action of medi¬
cines. Narcotics act more powerfully in hot than in cold cli¬
mates, therefore, smaller doses are required in the former; but
the reverse is the case with respect to calomel.
The influence of disease on the operations of medicines is
sometimes remarkable. For example, in severe pain, opium
can be administered in doses that cannot be borne with impu¬
nity in a state of health ; but this is still more the case in teta¬
nus, in which scruple doses have been given without any marked
effects; also, mercury can be given in larger doses in a febrile
condition without causing salivation, owing to the rapidity of
the circulation.
The condition of the stomach, also, has its influence, and
should be inquired into at all times, otherwise the most danger¬
ous results may follow the use of medicines that would have
acted beneficially had the stomach, the common receptacle,
been in a good condition to receive them. I have known cases
protracted by giving medicines without inquiring into the state
of the stomach—particularly supposed cases of worm fever.
GENERAL QUESTIONS TO PATIENTS.
The first duty of the physician, in his actual visits to the sick,
is to form a correct diagnosis of the diseases. To do this, he
should get the history, the symptoms, or changes in functions,
the effects of remedies, and the morbid anatomy or changes in
structure. This can be best done by interrogating the patient
in the following manner:—
THE ART OF PRESCRIBING MEDICINES.
15
Q. Of what age is the patient? Has he, prior to liis pre¬
sent illness, enjoyed good health ? Is his constitution naturally
good, or impaired by any irregularity?
In acute diseases—as inflammation of the lungs, pleurisy,
inflammatory fever, &c., the propriety of bloodletting, its ex¬
tent and repetition, as "well as the use of aperient and dia¬
phoretic medicines, must, in a great measure, depend on the
age, natural constitution, and habits of the patient.
Q. Hew long has he been ill ? On what day did he feel the
earliest symptoms ? In what manner was he attacked ? Is the
complaint stationary; or is the patient worse, or better, and
in what respect ?
In fevers of all kinds, it is of great importance that the prac¬
titioner should be acquainted with the stage and nature of the
disease, and whether the patient be in a convalescent state.
Authors divide diseases, from the period of their duration,
into two kinds, named acute and chronic. The period of an
acute disease has been limited to within forty days; if it ex¬
tends beyond that time, it is regarded as chronic. The general
symptoms of acute disease are a quick pulse, heat of skin, thirst,
furred tongue, pain in the loins or limbs, and incapacity of at¬
tention or exertion of mind. These distinctions are not sanc¬
tioned by practice in many instances; for some diseases continue
in an active state a much longer period; and some chronic dis¬
eases exhibit symptoms of an acute nature; but it is of great
importance in all diseases to decide whether it be acute or sub¬
acute.
Q. Are the bowels properly relieved, or in a regular state?
In all diseases it is absolutely necessary to be acquainted with
the state of the bowels. In acute or inflammatory diseases,
they should be kept open, and in chronic complaints costiveness
should be avoided. If purging should occur without the aid of
medicine, during inflammatory fever, it should not be checked,
but moderated.
Q. Is he troubled with or subject to piles, or easily affected
by purgatives ? Are his bowels irritable ?
In such cases we should not use aloes or other drastic purga¬
tives, unless it be advisable to reproduce them, for many com¬
plaints follow the suppression of them.
Q. Is he affected with slight shivering (rigors) ? Is he
feverish ? Does he complain of pain in the head or chest ?
16
POCKET FORMULARY.
In rheumatism or diseases of the lungs, it is of great conse¬
quence to be acquainted with the state of the system; for in
case of fever or a feverish disposition, indicated by rigors,
increased heat, pains in the head or chest, and quickness of
pulse, guaiac, for instance, and other stimulating medicines,
-would be injurious in the former disease, and the narcotic stimu¬
lants in the latter.
Rigors connected with cough and short breath indicate some
serious mischief to be going on in the lungs. When rigors
attend acute pain in the bowels, the disease may be suspected
to be of an inflammatory nature, and not simply a colic. In
cases of deep-seated pains, particularly in the loin, rigors denote
the pain to arise from inflammation, and if the rigors continue
to recur for a week or ten days after the first attack of pain,
the disease is not to be considered rheumatic, but inflammatory,
and that suppuration is probably taking place.
Q. Is he restless or quiet ? Has he been accustomed to
taking laudanum, and in what quantity ?
In super-irritative and sub-irritative diseases, a knowledge of
these circumstances will determine whether laudanum may be
administered alone or added to any other medicine; and the
dose.
Q. Is he affected with shivering fits, or cold spells ? Are
they succeeded by heat and perspiration ?
All inflammatory diseases are generally ushered in with rigors
which are succeeded by an increased heat of the body, and
sometimes by perspiration. These symptoms, occurring during
inflammatory fever, or local inflammation, so deceive an inex¬
perienced practitioner as to lead to the improper exhibition of
antiperiodics. In doubtful cases, it will be necessary to inquire
how often the shiverings occur, and if only once a day, at what
period, and how long they last; and also the degree of heat and
perspiration; and particularly, if there be any intermission or
remission of the fever after the termination of the perspiration
till the recurrence of the rigors or cold sensations. This is
important, as they may be symptomatic of some local mischief
that may be going on in the system.
Q. Did he ever take an emetic? What was its general
effects ?
Some people suffer so much during the operation of an emetic
that it should not be given, as in such cases it is often produc¬
tive of mischief.
THE ART OP PRESCRIBING MEDICINES. 17
Q. Has he ever been affected in the same manner, and "when,
and how often ?
When a patient is found in an insensible state, this question
put to his friends •will in some degree enable the practitioner to
determine whether the disease be apoplexy, catalepsy, the stupor
following epilepsy, a fit of intoxication, or swooning. If the
patient has been similarly affected, the doctor has the advantage
of inquiring what was then done and its effects. Females are
frequently troubled with swooning fits from disease of the spine,
heart, and stomach, but most frequently from ulceration or po¬
lypus of the os tincse, or some disease of the uterus; therefore
the condition of the uterus, as well as the spine, heart, and
stomach, should be particularly inquired into. The use of the
speculum is the only correct way of learning the condition of
the womb, and should be used more than it is; no sensible
woman will object to it, if approached properly, when her health
is seriously involved.
OF THE TONGUE.
The condition of the alimentary canal is revealed, in part, by
the state of the tongue ; therefore, it is necessary to know its
appearance in health as well as in disease. In healthy persons,
as well as in diseased, it presents a variety of appearances. In
some it is habitually clean, in others slightly furred; in some
florid and indented, in others pale ; in some compact and firm,
in others flaccid ; in some covered with a white fur, particularly
in the morning before taking food. Hence the importance of
asking the following questions :—
Q. "What is the natural appearance of his tongue ? Does it
present an appearance different from that in health ? In what
particular ?
Q. Is the tongue furred, and of what color? Is there a dis¬
agreeable taste in the mouth, nausea in the stomach, or loss of
appetite ?
These questions will determine the propriety of exhibiting an
emetic or drastic cathartic. Physicians, in almost every disease,
particularly in fevers, examine the state of the tongue, for
from the tongue a judgment may be formed concerning the
nature, increase, and remission of fever.
If swollen, it is inflammation of the tongue itself (glossitis),
2*
18
POCKET FORMULARY.
or of the adjacent parts, frequently from salivation, or in ma¬
lignant disease.
A yellow, loaded, and bitter tongue is indicative of bilious
fever or biliary derangements.
It, however, should be remembered that fur collects on the
tongue in almost all severe diseases. Thus the tongue is loaded
with a white fur in the first stages of fever, in catarrh, in
quinsy, and in acute rheumatism, as in inflammations.
A pale and tumid tongue, with large papillae, is indicative of
gastric debility and deficiency of the red particles in the blood,
as in chlorosis.
A white and slightly loaded tongue indicates inflammation or
high irritation of the mucous membrane of the stomach and
intestinal canal.
A livid tongue indicates some disease of the heart or lungs
which greatly affects the respiration. When red at the tip 01*
edges, or both, it is indicative of inflammation of the stomach
and intestines. You will also find it morbidly red and tender in
some forms of scarlatina and typhoid fever, after the disappear¬
ance of the fur.
A contracted and pointed tongue is frequently an attendant
of cerebral or meningeal inflammation, and if drawn to one side
indicates threatened paralysis.
A flabby and dilated tongue occurs in congestive states of
fever.
Florid papillae, protruding through a layer of white fur are
characteristic of scarlatina; and a similar appearance exists in
some cases of acute dyspepsia. But generally, in dyspepsia,
the appearance of the tongue is very variable; sometimes a
thick fur collects at the base of the tongue, while the edges and
apex are of a bright red. Sometimes the fur extends over the
whole surface.
A white and sometimes brown tongue, clammy and somewhat
dry, is indicative of remittent fever.
A tongue covered with a dark scurf, and very dry, attended
with wandering of the mind and dejected countenance, leads us
to suspect the fever to be putrid, or strongly disposed to it.
A dark brown, hard, shrivelled tongue, makes the prognosis
almost certainly fatal. Keeping the tongue between the teeth,
without retracting it, is a bad sign.
A red, smooth, and shining tongue, dry around the edges, in¬
dicates considerable danger; it denotes gastric inflammation,
and strong medicines should be avoided.
When the tongue becomes moist, and begins to clean off, the
patient may be considered in a convalescent state.
THE ART OF PRESCRIBING MEDICINES.
19
When the tongue cleans uniformly from the point backwards,
convalescence is rapid ; but when it cleans irregularly in scales,
from behind forward, the patient convalesces slowly.
The gums, from their proximity to the tongue, may be men¬
tioned here, though they are signs rather of the state of the
circulation than of the digestive organs. The gums are florid
in plethoric states of the system; pale in anaemia; livid in cases
where the functions of respiration are much impeded ; swollen
and hard in scurvy and purpura hemorrhagica, in which dis¬
eases they bleed on the slightest touch; swollen, with an in¬
flamed line, in cases of salivation; marked with a blue line at
the margin of the teeth in poisoning by lead. The tips and
lining membrane of the mouth, like the gums, inform us as to the
state of the circulation. The existence or absence of thirst, and
the odor of the breath, are points that should not be forgotten
in inquiring into the state of the digestive organs.
OF THE STOOLS.
Q. Are the stools pale, dark, or bilious? In jaundice, the color
of the stools shows whether there be any obstruction to the free
passage of the bile into the intestinal canal. If they are dark,
slimy, and offensive, it is evident that digestion does not go on
well, and that there is irritation in the intestinal canal. If they
are pale, it is a proof there is a deficiency of the secretion of
bile.
Q. Are the stools copious, hard or liquid, and is there any
irritation of the rectum, or inclination to go to stool without be¬
ing able to evacuate the feces ?
The quantity of feces discharged is of as great consequence
as frequency; for a person may have frequent motions from irri¬
tation at the fundament, and yet not be purged. The matter
evacuated is often nothing but mucus, from irritation in the
large intestine, which is termed tenesmus and not purging. In
cases of purging, it is necessary to inquire whether the stools
are soft, or whether they come away in hard lumps with a
quantity of slime. When the discharge consists of soft or copi¬
ous liquid feces, it is termed diarrhoea; but when they are slimy
and bloody, or hard and lumpy and attended with griping pain,
it is termed dysentery. It is important to keep this distinction
in mind, as many lives have been lost by treating dysentery for
diarrhoea. In order to avoid this, the practitioner should al-
20
POCKET FORMULARY.
ways examine the character of the stools minutely, and. he will
soon learn the proper distinctions better than we can define them
on paper.
OF THE PULSE.
Q. Is the pulse weak, strong, quick, frequent, or does it in¬
termit ?
By the pulse we judge of the state of the circulation with re¬
spect to fulness and the state of the nervous system; for, the
heart and arteries receiving their power of action from the brain,
the manner in which the pulsation is performed will show whether
the nervous or cerebral system is in a state of irritation. To
draw an accurate conclusion from the state of the pulse during
disease, we should have some knowledge.of it when in health,
for the pulse differs materially in different subjects.
At birth, it beats from 130 to 140 in a minute. The mean rate
for the first month is 120; the limits during the first year are 106
to 120 ; for the second year from 90 to 100; for the third year 80
to 90 ; nearly the same for the fourth, fifth, and sixth years ; in
the seventh year, the pulse is about 78 to 80 ; from the twelfth
year it differs but little from that of adult age, which is estimated
at from GO to 80 according to the age, size, and constitution.
The common standard of frequency maybe placed at from 70
to 75 beats in a minute. From the 45th to the 60th year, the
pulse gradually becomes slower. After this period, it again
rises in frequency, generally more frequent in women than in
men. Climate influences the pulse more frequently in hot than
in cold countries. It must also be remembered that the pulse
in health varies in the course of the day; slower in the morn¬
ing; most frequent soon after dinner; slower during sleep than
in the waking state. Position of body also makes some differ¬
ence; slower when lying down. Slower when sitting than
standing.
Mental excitement influences the pulse; joy and anger render
it fuller, and fear depresses it. Therefore the physician should
not examine the patient's pulse as soon as he enters the room.
A full or oppressed pulse indicates the sanguiferous system to
be overloaded. A small frequent pulse, with a cool skin, indi¬
cates weakness or congestion. It is important to draw a proper
distinction here; to bleed with a weak pulse might destroy life,
while in congestion it would save it. A quick pulse shows great
irritation of the cerebral or nervous system. It often happens
that a pulse, indicative of great weakness, is attendant on in-
THE ART OP PRESCRIBING MEDICINES.
21
flammation of the lungs, stomach, intestines, and brain, but in
these and the like examples, the nature of the malady, and not
the state of the pulse, must determine the necessity of blood¬
letting.
We have no infallible index to direct us. It. is impossible,
from the state of the circulation in fever, to point to any certain
criterion for the employment of the lancet. The state of the
pulse is often ambiguous and deceptive; circumstances require
the nicest discrimination, as the result is often very different in
cases seemingly analogous. A precipitate decision is fraught
■with danger, and a mistake may be certain death. Bleeding in
typhoid fever is seldom admissible.
When the pulsations rapidly follow each other, the pulse is
said to be frequent; it may also be full, strong, and hard, or
soft, small, or weak. A full, tense, and strong pulse is when
the artery swells boldly under the finger, and resists its pres¬
sure more or less. A hard corded pulse is that in which the
artery feels like the string of a violin or a piece of tightened
catgut, giving considerable resistance to the pressure of the
finger. When the pulsations are performed with great celerity,
although the intervals be long, the pulse is termed quick.
A slow pulse may therefore be quick, and a frequent pulse
not quick; the term quick applying to the pulsation, and not
to the interval of the pulsation to which the term frequent
applies. When the strokes do not follow the usual inter¬
val, and sometimes not till after twice, thrice, or four times
the usual space, it is termed intermittent. It arises from an un¬
equal influx of the blood into the heart from increased irrita¬
bility or disease of the organ itself. Sometimes it is produced
by pressure of a tumor, or water in the chest, or pericardium.
It is, however, in some people, common even in a state of health.
The pulse of several domestic animals is as follows: the horse,
from 82 to 38 per minute; the ox or cow, 25 to 42; the ass, 48
to 54 ; the sheep, 70 to 79; the goat, 72 to 76; the dog, 90 to
100 ; the cat, 110 to 120; the rabbit, 120; the guinea pig, 140;
the duck, 124 ; the hen, 140.
OF THE URINE.
Q. Of what color and consistence is the urine ? Does it de¬
posit a sediment when a fever is abating and drawing to a favor¬
able crisis ?
The urine in fevers generally deposits a lateritious sediment.
In putrid fever it emits an offensive smell, and is often tinged with
22
POCKET FORMULARY.
blood. In the last stage of pulmonary consumption, it is also offen¬
sive to the smell, and deposits a -whitish matter. In cases of pain
in the loins, the state of the urine will often determine whether
the kidneys are the seat of the disease. In hysterical affections,
the urine is pale and thin. In debilitated individuals, it has a
frothy head, which often remains a considerable time on account
of its abounding with viscid and oily particles. When the sto¬
mach is disordered, it deposits a sediment resembling brick-
dust.
Q. Does the patient void much urine ?
An excessive evacuation of urine, like excessive perspiration,
is a frequent cause of debility and emaciation of the body. In
dropsical cases it is of great consequence to know whether the
kidneys perform their office, for dropsy will sometimes arise from
a sluggish state of the kidneys.
OF THE PERSPIRATION.
Q. Is the patient troubled with night-sweats? Are they pre¬
ceded by rigors and heat? At what time do they come on?
Are thfty copious, confined chiefly to the breast, and do they
smell strong?
In cases of inflammatory fevers perspiration may be considered
critical, and should not be checked unless they are so excessive
as to weaken the patient.
Q. Is the skin moist, or dry and hot ?
In all fevers and internal inflammatory attacks, it is very ne¬
cessary to attend to the state of the skin, for in those complaints
it is of the first consequence to produce a moist surface. By
the evaporation of perspirable matter, superabundant heat, and,
probably, electric matter are conducted from the body. A dry
skin, on the contrary, indicates the accumulation of heat in the
system.
The perspiration is very analogous to the urine, and when either
of these secretions is diminished the other is generally increased,
so that they who perspire the least urinate the most, and vice
versa; copious perspiration, attended with a sense of general
lassitude and a feeble pulse, indicates great debility or laxity of
the cutaneous vessels.
THE ART OF PRESCRIBING MEDICINES.
23
OF THE RESPIRATION.
Q. Is the breathing attended with difficulty ?
In inflammatory fevers, difficulty of breathing indicates great
plethora or a determination of blood to the lungs. In either
case, the loss of blood and evacuating remedies are necessary.
In dropsy of the abdomen or extremities, the state of the breath¬
ing will determine whether there be an effusion of serum in the
chest. When shortness of breath comes on rather suddenly,
attended with rigors and acute pains in the chest and side,
termed stitches, it denotes inflammation of the lungs or pleu¬
risy.
Q. Is there any expectoration, and is it difficult ? What ap¬
pearance and taste ?
In all coughs it is necessary to inquire whether the patient
expectorates, and its appearance. Cough generally terminates
in an expectoration of a clear mucus, which has frequently a
saltish taste. In chronic cough, its violence will, in a great mea¬
sure, depend on the tenacity of the phlegm. In such cough, it
is of great consequence to produce a secretion of mucus that
will require little exertion to bring up. In inflammation of the
lungs, it is necessary to attend to the appearance of the mucufe
expectorated; if it be clear and come up freely, it is a very favor¬
able omen; if tinged with blood, it often indicates the propriety
of bleeding. If great difficulty of breathing and cough be not
attended with expectoration, the patient may be considered in
great danger. In cases of cough attended with emaciation of
the body, by the appearance and the quantity of the mucus ex¬
pectorated, the practitioner is enabled to ascertain whether the
lungs are ulcerated. If the matter is opaque, of a yellowish
appearance, offensive to the taste, sometimes tinged with blood,
and the patient be affected with hectic fever or much emacia¬
tion, his case is probably pulmonary consumption.
Q. What remedies has he taken, and with what effect ?
By being acquainted with what has been done for the patient
and the effect thereby produced, the practitioner has the great
advantage of knowing what is left undone, and of forming an
opinion of the situation of the patient.
24
POCKET FORMULARY.
OF THE EXAMINATION OF CHILDREN.
In the diseases of children, the following questions will be ne¬
cessary :—
1. The age of the child.
2. Is it cutting a tooth, and how many teeth has it?
In cases of purging or fever, this will determine whether it
arises from the teething.
3. Is it rickety ?
4. Has it had the hooping-cough, smallpox, measles, scar¬
let fever? and do any of those diseases prevail in the neighbor¬
hood ?
When a child is affected with fever, it will be very necessary
to make those inquiries, as it may probably be indisposition pre¬
ceding some eruptive fever.
5. Has it a large belly, with emaciated limbs and large
joints ?
These are symptoms of great weakness approaching to rick¬
ets, and often,arise from worms.
We must also bear in mind that many diseases, particularly
those in which the nervous system is principally involved, will
recur unless the disposition of the system to the disease be ef¬
fectually destroyed by a perseverance in the medicine. Hence,
in consequence of a patient discontinuing the medicine when he
finds himself well, in a few days he will experience a relapse,
and because it has only produced temporary relief, it is very
common for the patient to object to a further trial of it. Now
had he continued it for a little time longer, the disposition to the
disease might have been entirely overcome. Of this class of
diseases are intermittent fever, nervous headaches, insanity, &c.
As many diseases are produced by the mind, and as all are
more or less influenced by it, we must also attend to its condi¬
tion as well as that of the body. No medical man of experience
will doubt that diseases are rendered more obstinate by suffer¬
ing the mind to give way to them. If courage will secure a
person against the contagion of an infectious fever or an epi¬
demic, it is clear that mental exertion and composure must be
of great service under disease. Quacks owe a great deal of
their occasional success to their command over the feelings of
their patients. The advantages to be derived from them might
be an hundred times greater were they properly directed by
regular bred physicians.
One great difficulty with which physicians have to contend,
particularly in a country practice, is the officiousness of nurses
THE ART OP PRESCRIBING MEDICINES.
25
and visitors in relating cases of a similar character to the one
under treatment, which terminated fatally, or with ominous
looks and long faces, filling the mind of the patient, so prone to
depression, with the idea of imminent danger, and perhaps a fatal
termination. This should be guarded against by every means
in the power of the physician, as he values the comfort, not to
say the life, of his patient.
PROGNOSTICS.
In every disease, the medical attendant should be, and is ex¬
pected to be, able to give a pretty correct opinion of the degree
of danger which hangs over the patient; hence it is necessary
for him to keep posted on the prognosis of all diseases ; but it
will not be expected in a book like this for us to enter into any
minute details on the subject, therefore we will only give the
most leading prognostics.
In fevers, the more the febrile attack is diffused over the sys¬
tem, the less dangerous it is. Delirium alone should excite no
alarm, unless it be very high, or of the low muttering, incohe¬
rent kind. In jaundice, and in diseases of the chest, it is
alarming, and in the latter stage of pulmonary consumption its
presence always indicates the approach of death.
In intermittent fever, a complete chill is favorable, as it fore¬
tells an efficient reaction. The premature appearance of the
paroxysm, complicated with other diseases, is unfavorable.
In continued fevers, a sense of internal heat, with cold skin, or
the peculiar heat called calor mordax, petechia, ecchymosis, &c.,
with a disposition to slide down in the bed—craw-fishing, as
Dr. Chapman would say—are extremely dangerous symptoms.
Deafness is not unfavorable in this fever.
Great confusion of thought, loss of recollection of the most
recent occurrences, a restless, wandering eye, and a correspond¬
ing vacancy or confusion of countenance, are always to be
dreaded in fevers and in diseases of the brain. An expression
of great anxiety is equally alarming in all acute diseases, and a
presentiment of death is also to be dreaded.
In yellow fever, Dr. Chapman says cases marked by forcible
reaction and high fever are most favorable.*
* Dr. Chapman considers yellow fever to consist in the action of
an extremely virulent poison upon the stomach, producing excessive
disorder of that viscus, and involving other parts sympathetically.
And, like other epidemics influenced by various agencies, assuming
26
POCKET FORMULARY.
In pneumonia, or inflammation of the lungs, pallidness of the
countenance, with a slight degree of lividity, are symptoms of
danger. Tlie supervention of diarrhoea is also unfavorable.
Dr. Chapman says that all diseases of the heart are invested
with extraordinary danger; yet some cases may be cured, and,
others so palliated that life may be prolonged with considerable
comfort. Fainting (syncope) is to be considered alarming in dis¬
eases of the heart, or during profuse bleeding from the nose, or
from any other part. Deep sighing also, under such circum¬
stances, is most unfavorable, and often indicates rapid dissolu¬
tion.
Affections of the valves of the heart are always formidable ;
though, if taken in the commencement, and where it is dependent
on mere thickening from chronic inflammation, it may be
removed.
Palpitations in nervous affections of the heart do not generally
lead to any serious consequences.
The prognosis in acute inflammation of the throat is generally
favorable. Death, however, may occur suddenly from suffoca¬
tion.*
Dysentery is sometimes very fatal. In cholera morbus, the
issue is uncertain. In cholera infantum, a prognosis is very
hazardous, since the most favorable-looking cases are apt to
various forms ; sometimes inflammatory,and sometimes congestive,
sometimes the two conditions blended, and sometimes I think it
assumes a typhoid form, and is blended with our low forms of imper¬
fect remittent fevers. I think the manner in which it has prevailed
in many places south for several summers, will bear me out in this
opinion. Hence you see the importance of treating it according to
the form it assumes in your city, without any regard to its nature in
other places in different latitudes, and surrounded by different
circumstances. In short, it should be treated as all fevers should
be, according to the type it assumes. Do not bleed the first case
because bleeding is recommended by some authors ; don't give the
second one large doses of calomel, when he is already loose
in his bowels, because it benefited some one of a bilious tempera¬
ment and constipated habits. Examine each case closely, and
endeavor to make a prescription to suit the symptoms, taking into
consideration the circumstances that influence the operation of
medicines. In this way you will prove successful. It is always
best to wait for the disease before you treat it.
* The erysipelatous variety of sore throat, Dr. Chapman says,
proceeds from gastric disorders ; in such cases, the stomach should
be attended to as well as the throat.
THE ART OP PRESCRIBING MEDICINES. 21
terminate fatally, and vice versd. The appearance of dark, bili¬
ous, or natural stools is a most propitious sign. A pink- colored
fluid is almost certain indication of death.
In colic, the ejection of stercoraceous matter is an almost
fatal sign.
Chronic or subacute peritonitis is usually curable when no
structural lesions have taken place.
Thin and glairy sputse denote a continuance of irritation, -while
thick yellow sputae indicate the approach of convalescence.
Catarrh, however, from the danger of its complications or de¬
generations, should never be neglected.
In croup, treated early and judiciously, the prospect is good;
but when the breathing is audible, or when there is a crowing
sound in inspiration, or a cooing or croaking respiration, danger
is present, and there is no time to lose.
In hooping-cough, when the paroxysms suddenly increase in
violence, and the face becomes livid, and the thumbs are drawn
across into the palms of the hands, the appearance of convul¬
sions may be anticipated.
The sudden disappearance of pain in inflammatory affections
of the bowels, is always to be dreaded.
Rigors invariably excite alarm, but they are only dangerous
in chronic internal diseases, in which they often indicate the
formation of pus or the existence of suppuration.
Hiccough, in the advanced stages of either acute or chronic
disease, is invariably alarming.
Retention of urine, as well as its involuntary discharge, is
always an unfavorable symptom.
The sudden disappearance of swelling of the legs in chronic
organic diseases, is indicative of approaching death.
Diarrhoea is, under every circumstance, an unfavorable event
when it occurs either in fevers or in the termination of chronic
diseases; and the passing of involuntary stools, when scarcely
any diarrhoea exists, is equally to be dreaded.
Great and continued, or progressing emaciation, in chronic
disease, and what is termed the facies Hippocratica, are to be
dreaded.
In consumption, partial sweating, as of the head, the chest,
or the limbs, is always an unfavorable symptom. When preg¬
nancy occurs in a woman laboring under consumption, the dis¬
ease is arrested until after delivery, as if Providence threw a
shield over the mother for the safety of the offspring; but, as
soon as the confinement is over, the malady proceeds more
rapidly than before.
28
POCKET FORMULARY.
Excoriations on the parts in which the body rests—for in¬
stance, the haunches or the lower part of the back—especially
if these become livid and sloughy, always indicate extreme
danger.
Great difficulty of breathing, even to a feeling of suffocation,
is not necessarily hazardous in asthma; for, although few dis¬
eases are so little under control by the interference of the phy¬
sician, yet asthma seldom proves fatal unless it tends to the
production of other diseases.
Coma, or an irresistible propensity to sleep, following the
sudden suppression of gout, or the cessation of periodical bleed¬
ing in piles, or the healing of old sores, is always alarming.
General sweats are more favorable than local ones.
Critical sweats take place more frequently between midnight
and morning than at any other time.
In phthisis, night-sweats are amongst the most unfavorable
symptoms. Frequently, they alternate with diarrhoea.
(Edema about the ankles may arise from any cause of general
debility, such as chlorosis, convalescence from acute disorders,
or simply remaining for a long time in the erect posture ; but,
aside from these connections, it is to be dreaded as one of the
first evil signs of valvular disease of the heart. (Edema of the
eyelids and face, which may also proceed from the same debili¬
tating causes, is, in their absence, a strong indication of Bright's
disease of the kidney.
All diseases not involving organic changes are, with a few
exceptions, more or less under the control of medicine, and ar^
consequently, curable. But some diseases, in which do organic
changes have been discovered, are nevertheless incurable. This
is the case with spasmodic asthma, which has rarely, if ever,
been cured.
TABLE OF ABBREVIATIONS USED IN PRESCRIPTION.
abbreviations. technical. definition.
iia Ana.
Ad 2 vie. Ad duas vices.
Ad 3 tiam vicem. Ad tertiam vicem.
Of each ingredient.
At twice taking.
For three times.
Abs. febr. Absente febre. In the absence of the
fever.
Abdom. Abdomen or abdomini. The belly or to the belly.
Ad li^t. Ad libitum. At pleasure.
Ad def. animi. Ad defectionem animi. To fainting.
THE ART OP PRESCRIBING MEDICINES.
29
Ad gr. acid.
Add.
Ajac.
Admov.
Adst. febre.
Altern. horis.
Alvo adst.
Aq. astr.
Aq. bull.
Aq. com.
Aq. fluy.
Aq. mar.
Aq. niv.
Aq. pluv.
Aq. ferv.
Aq. font.
Bis in d.
Bib.
B. M.
Bull.
But.
B. V.
C.
Caerul.
Cap.
Calom.
C. C.
Coch.
Cocli. ampl.
Cyat. i.
Coch. parv.
Col.
Color.
Comp.
Cong.
Cont. rem.
Ad gratam aciditatem.
Addeoraddentum, ad-
dendus or addendo.
Ajacens.
Admove or admoveatur
or admoveantur.
Adstante fcbre.
Alternis horis.
Alvo adstricta.
Aqua astricta.
Aqua bulliens.
Aqua communis.
Aqua fluvialis.
Aqua marina.
Aqua nivalis.
Aqua pluvialis.
Aqua fervens.
Aqua fontana or aqua
fontis or aqua fon-
talis.
Bis in dies.
Bibe.
Balneum marise or
balneum maris.
Bulliat or bulliant.
Butyrum.
Balneum vaporosum.
Cum.
Cseruleus.
Capiat.
Calomelas.
Cornus cervi.
Cochlear or cochleare.
Cochleare amplum.
Cyathus.
Cochleare parvum.
Cola.
Coloretur.
Compositus, a, um.
Congius.
Continuentur remedia.
3*
To an agreeable sour¬
ness.
Add or let be added, to
be added or by adding.
Adjacent.
Apply or let be applied.
When the fever is com¬
ing on.
Every other hour.
When thebellyis bound.
Frozen water.
Boiling water.
Common water.
River water.
Sea water.
Snow water.
Rain water.
Hot water.
Spring water.
Twice a-day.
Drink.
j- A salt-water b&th.
Let boil.
Butter.
A vapor bath.
With.
Blue.
Let the patient take.
Calomel or the chloride
of mercury.
Hartshorn.
A spoonful.
A tablespoonful.
A glassful.
A small teaspoonful.
Strain.
Let it be colored.
Compounded.
A gallon.
Let the medicines be
continued.
30
POCKET FORMULARY.
Cont.
Coq.
Coq. admed. con-
sumpt.
Coq. in S. A.
Cort.
C. V.
C. M. S.
C. N.
Crast.
Cuj.
Cujus 1.
Chart.
Collyr.
Collutor.
Dec.
De d. in d.
Det.
Dieb. alt.
Dieb. tert.
Diluc.
Dil.
Dim.
D. in 2 plo.
D. in p. asq.
D. P. or D. in
prop.
Donee alv. bisdej.
Donee alv. sol.
fuer.
D.
Decoct.
Ejusd.
Enem.
Exhib.
F.
F. fil. xii.
Feb. dur.
F. v$Saes.
F. H.
Contunde.
Coque.
Coque ad medietatis
consumptionem.
Coque in sufficiente
quantitate aquae.
Cortex.
Cras vespere.
Cras mane sumendus.
Cras nocte.
Crastinus.
Cujus.
Cujus libet.
Chartula.
Collyrium.
Collutorium.
Decanta.
De die in diem.
Detur.
Diebus alternis.
Diebus tertiis.
Diluculo.
Dilue, dilutus.
Dimidius.
Detur in duplo.
Dividetur in partes
lequales.
Directione propria.
Donee alvus bis dejice-
tur.
Donee alvus soluta fu-
erit.
Dosis.
Decoction.
Ejusdem,
Enema
Exhibeatur.
Fac.
Fac pilulas duodecim.
Febre durante.
Fiat vensesectio.
Fiat haustus.
Bruise.
Boil.
Boil to the consumption
of half.
Boil in a sufficient quan¬
tity of water.
Bark.
To-morrow evening.
To be taken to-morrow
morning.
To-morrow night.
For to-morrow.
Of which.
Of any.
A small paper.
An eye-water.
A mouth-wash.
Pour off.
From day to day.
Let it be given.
Every other day,
Every third day.
At break of day.
Diluted.
One-half.
Let twice as much be
given.
Let it be divided into
equal parts.
TVith a proper direction.
Until the bowels have
been twice evacuated.
Until the bowels shall
be opened.
A dose.
A decoction.
Of the same.
A clyster.
Let it be exhibited.
Make.
Make twelve pills.
During the fever.
Bleed.
Let a draught be made.
THE ART OF PRESCRIBING MEDICINES.
31
F. L. A.
F. S. A.
Gel. quav.
Gr. vi. fond.
Gtt.
Har. pi. sum. 3.
H. D. or hor. de-
cub.
H. S. or hor. som.
Fiat lege artis.
Fiat secundum artein.
Gelatina quavis.
Grana sex fondere.
Gutta.
Harum pilularum su-
mantur tres.
Hora decubitus.
Hor a somni.
Haust.
In d.
In fulm.
Inf.
Inj. enem.
Lat. dol.
Haustus.
In dies.
In fulmento.
Infunde.
Injiciatur enema.
Lateri dolenti.
M. Misce.
Mane pr. Mane primo.
Mani. Manipulus.
Min. Minimum.
M. P.
Massa pilularum.
M. x.
Mistura.
More
diet.
More dicto.
More
sol.
More solito.
M. F.
Mixt.
Misce fiat mixtura.
M. F.
Pil.
Misce fiat pilulse.
M. F.
P.
Misce fiat pulvis.
N. tr.
S. num.
Ne tradas sine nummo.
Opt. Optimus.
Omn. hor. Omni hora.
Let it be made by the
rules of art.
Let it be made accord¬
ing to art.
In any kind of jelly.
Six grains by weight.
A drop.
Let three of the pills be
taken.
At the hour of going to
bed.
Just before going to
sleep, or on retiring
to rest.
A draught.
From day to day, or
daily.
In gruel.
Pour in.
Let a clyster be given.
On the.side that is pain¬
ful.
Mix.
Very early in the morn¬
ing.
A handful.
The sixtieth part of a
drachm measure.
A pill mass.
A mixture.
In the manner directed.
In the usual manner.
Mix to form a liquid
mixture.
Mix to form pills.
Mix to form powder.
Do not deliver it unless
paid. Used by apo¬
thecaries as a caution
to the clerk, when
the presence of the
customer prevents a
verbal direction.
The best.
Every hour.
32 POCKET FORMULARY.
Omn. bid.
Omni biduo.
Every two days.
Omn. bih.
Omni bihora.
Every two hours.
O
s
o
*1
omn.
Omni mane.
Every morning.
man.
O
$25
©
omn.
Omni nocte.
Every night.
noct.
P.ae.part.sequal.
Partes sequales.
Equal parts.
Post sing.
sed.
Post singulas sedes li-
After every loose stool.
liq.
quidas.
According as circum¬
stances arise. That
is, occasionally.
P. r. n.
Pro re nata.
P. rat. set.
Pro ratione cetatis.
According to the age
of the patient.
Pulv.
Pulvis.
A powder.
Q. S.
Quantum sufficiat.
As much as is sufficient.
Repet.
Repetatur.
Let it be continued.
S. A.
Secundum artem.
According to art.
Scat.
Scatula.
A box.
Sol.
Solve.
Dissolve.
S.
Signa.
Write.
Semidr.
Semi drachma.
Half a drachm.
Semih.
Semi hora.
Half an hour.
Sesunc.
Secuncia.
An ounce and a half.
Sing.
Singulorum.
Of each.
St.
Stet.
Let it stand.
S. Y.
Spiritus vinosus.
Ardent spirits of any
strength.
T. 0.
Tinctura opii.
Tincture of opium,
generally confound¬
ed with laudanum,
which is properly the
wine of opium.
T. 0. C.
Tinctura opii campho-
rata.
• Paregoric elixir.
Y. S.
Venae sectio.
Opening a vein.
Tlie above is quite a full list of abbreviations which are more
or less met with in prescriptions—but we would advise physi¬
cians to avoid them as much as possible; the practice is objec¬
tionable, and in many cases dangerous to the reputation of the
physician, and life to the patient. We could relate some alarm¬
ing, and amusing mistakes that have occurred in this way,
within our knowledge. It should also be remembered that the
abbreviations used to designate certain medicines, are equally
THE ART OF PRESCRIBING MEDICINES.
33
applicable to others. In such cases, if you are not very certain
you are right, after thinking twice before you commence, I would
advise you to give it in plain English rather than make an un¬
certainty. In writing directions for taking medicine, always
express numbers in words, not in figures.
TABLE OF SYMBOLS AND SIGNS USED IN PRESCRIP¬
TIONS.
SYMBOLS. TECHNICAL. DEFINITION.
R. Recipe. Take.
Minimum. The 60th part of a drachm.
Gtt. Guttas. Drops.
9- Scrupulus, vel A scruple, equal to 20 grains,
Scrupulum. j Troy.
g. Drachma. A drachm.
3. Uncia. An ounce, Troy; or, in liquids, the
16th part of a wine pint, or the
20th part of the imperial pint,
ft. Libra. A pound weight.
0. Octarius. A pint.
Ss. Semis. Half.
Gr. Granum or grana. A grain, or grains,
Fl. Fluid. Used as a prefix to certain meas¬
ures to distinguish them from
weights, thus : . fluid uncia.
Formerly the symbols or signs used in chemistry and phar¬
macy as substitutes for words, were numerous. At the present
time they are very few. The above, alone, deserve notice. It
is to be regretted that some other character cannot bo substi¬
tuted, either for the ounce or the drachm, for they being so
similar, a mistake is easily made, in the hurry of writing, by
the physician, or in putting up the prescription by the apothe¬
cary, or a mistake in typography, may lead to prescriptions of
the most dangerous character, as was the case in Ellis's Formu¬
lary. The § being used for the g, resulted in theMeath of
the distinguished Dr. Baber, of Macon, who put up a prescrip¬
tion of Scheeles' concentrated prussic acid for a patient, and
on his refusing to take it, from a caution given him by the apo¬
thecary, drank it himself, to give confidence to the patient, and
was dead in two hours.
34
POCKET FORMULARY.
TABLE OF WEIGHTS AND MEASURES.
20 grains make 1 scruple ;
3 scruples
8 drachms
60 minims
8 drachms
16 ounces
1 drachm;
1 ounce.
1 fluidrachm;
1 fluidounce;
1 pint.
Apothecaries' weights, by which all medical preparations ought
to be weighed, are divided into pounds, ounces, drachms, scru¬
ples, and grains.
A pound ft contains twelve ounces;
An ounce ^ " eight drachms;
A drachm % " three scruples;
A scruple J) " twenty grains;
A grain gr.
Apothecaries' measures, by which all medicines are com¬
pounded, consists of gallons, pints, ounces, drachms, and minims.
A gallon Cong, contains eight pints;
A pint 0 " twenty fluidounces;
A fluidounce fsj " eight fluidrachms;
A fluidrachm f 3 " sixty minims;
A minim "I
Measures which are used for convenience, which, although
far from being uniform, may be used without danger for ordi¬
nary purposes. Drs. Wood and Bache estimate that the
Teacup contains four fluidounces ;
Wineglass " two "
Tablespoon " half a fluidounce;
Teaspoon " a fluidrachm.
Dr. Christison gives a somewhat different calculation; he con¬
siders
A tumbler contains eight fluidounces;
Breakfast-cup " " "
Teacup " five "
Wineglass " two "
Tablespoon " half a fluidounce;
Dessertspoon " two drachms;
Teaspoon " one drachm.
THE ART OP PRESCRIBING MEDICINES.
35
In both these estimates, the teaspoonful is noted too low; they
apply very well to the teaspoonful formerly used, but not to the
much larger kind now in general use; therefore, they ought not
to be used as measures for the exhibition of potent medicines.
The measure of temperature used by all the colleges is Fahren¬
heit's thermometer, 212° on the scale of which marks the boiling
point of water, and 32° the freezing point; between 90° and 100°
denote the gentle heat (calor lenis) of the Pharmacopoeias.
TEMPERATURE OF BATHS.
The hot bath from 98° to 106°
The warm " " 96° " 98°
The tepid " " 62° " 96°
The vapor " " 100° " 130°
PART
APPROVED MEDICINES
We here present a tabular view of the most useful medicines
for adults, effects upon the system, and diseases in which they
authors and practitioners, which have stood the test of expe-
COMMON NAMES.
OFFICINAL.
DOSES FOR ADULTS.
Aloes, powder.
Aloes, tincture.
Alum.
Pulv. aloes.
Tinctura aloes.
Alumen.
vi to xii gr.
gi to ^ss.
v to x gr.
Assafetida.
Assafcetida.
v to x gr.
Assafetida, tinc¬
ture.
Aconite, powder.
Tinct. assafoetidae.
Aconiti, pulvis.
i to ii drachms,
i to ii gr.
Aconite, extract.
Aconite, tincture.
Balsam of copaiva.
Aconiti, ext.
Aconiti, tinct.
Copaiba.
^ to i gr.
x to xx drops,
x to xx drops.
Bloodroot, powder.
Pulv. sang. Cana-
den.
x to xx gr.
Bloodroot, tincture.
Belladonna, or dead¬
ly nightshade.
Tinet. sang. Canad.
Pulv. belladonnse.
3'i to gas.
i to ii gv.
Belladonna, extract.
Blue vitriol.
Ext. belladonnse.
Cupri sulphas.
1 to £ gr.
i to v gr.
Blue pill.
Pil. hydrargyri.
v to x gr.
II.
IN DAILY USE.
in general practice, with the common and officinal names, doses
are generally used; also various recipes from the most approved
rience, with directions when and how to be administered.
EFFECTS, &C.
DISEASES PROPER FOR, &C.
Purgative.
Astringent.
Antispasmodic.
Sedative, narco¬
tic.
Stimulant, blen-
norrhetic, and
diuretic.
Acrid emetic,
with stimulant
and narcotic
powers.
Narcotic.
Narcotic.
Alterative.
Obstinate costiveness.
Flooding, colliquative sweats, diabetes,
chronic dysentery, diarrhoea; its local
applications are numerous.
Asthma, hysteria, flatulence, hooping-
cough.
Rheumatism, neuralgia, gout, phthisis,
catarrhal fevers.
The diseases of mucous membranes,
chronic dysentery, leucorrhoea, gonor¬
rhoea, gleet.
Typhoid pneumonia, catarrh, amenor-
rhoea from torpor of the liver.
All nervous diseases; in neuralgia it
is one of the most effectual remedies in
our possession. Dilates the pupil.
In full doses, emetic; in small doses,
tonic and astringent.
38
POCKET FORMULARY.
COMMON NAMES.
OFFICINAL.
DOSES FOR ADULTS.
Calomel.
Hydr. chlor. mit.
v to xx gr.
Camphor.
Camphor julap.
Camphora.
vi to xii gr.
i to 5ii.
Castor oil.
01. ricini.
i to $i.
Castor, powder.
Castor, tincture.
Catechu, tincture.
Chalk, prepared.
Cinnamon, powder.
Cinnamon, oil.
Cinnamon, tincture.
Pulv. castorei.
Tinctura castorei.
Tinct. catechu.
Creta preparata.
Pulv. cinnamomi.
Oleum cinnamomi.
Tinct. cinnamomi.
v to x gr.
i to ii drachms,
i to ii drachms,
x to xv gr.
v to x gr.
i to iii drops,
i to iii drachms.
Carbonate ammonia.
Carbonate iron.
Ammon. carb.
Ferri carb. pilul.
v to x gr.
x to xx gr.
Carbonate magne¬
sia.
Carbonate soda.
Magnes. carb.
Sodae carb.
$ to i dr.
x to xx gr.
Oolchicura root,
pQwder.
Pulv, colchici ra-
dicis.
ii to viii gr.
Colchicum, wine.
Colocynth, cd. ex¬
tract.
Vin. colchici.
Ext. colocynth. c.
gtt. x to gss.
v to x gr.
Cream of tartar.
Potassas bitartras.
gss to ^i.
Corrosive sublimate.
Cubebs, powder.
Hydrargyri chlo-
ridum corrosivum.
Pulv. cubebse.
A to i gr.
oSS to giii.
APPROVED MEDICINES IN DAILY USE.
39
EFFECTS, &C.
Purgative.
Antispasmodic.
Antispasmodic
febrifuge.
Purgative.
Antispasmodic.
Antispasmodic.
Astringent.
Astringent.
Stomachic.
Stimulant.
Astringent.
Stimulant.
Tonic and em-
menagogue.
Antacid.
Antacid.
Dras. cathartic.
Cathartic, diu¬
retic and refri¬
gerant.
Alterative.
DISEASES PROPER FOR, &C.
Stimulant
diuretic.
and
Intestinal affections, accompanied with
constipation or hepatic derangement.
Hooping-cough, convulsive fits.
Nervous fever, convulsive fits.
Intestinal affections, accompanied with
constipation.
Convulsive fits, nervous irritability.
Convulsive fits, nervous irritability.
Chronic looseness, flooding, &c.
Looseness, acidity.
Indigestion, flatulence.
Flatulency, colicky pains.
Looseness, and as an adjuvant to creta¬
ceous mixtures.
Typhoid fever.
Neuralgia, chorea, chlorosis, and those
diseases in which the blood is defi¬
cient in coloring matter.
All cases which require a laxative
antacid.
Diseases attended with acidity of sto¬
mach, as gout, uric acid gravel, and
certain forms of dyspepsia.
Gout and rheumatism, especially when
of a shifting or neuralgic character.
Dropsy and various affections depend¬
ing on disordered action of the brain.
(See Pilulae Catharticae Compositse.)
Dropsical affections and cutaneous fe¬
brile affections.
Syphilis, cutaneous diseases, and chro¬
nic rheumatism.
Gonorrhoea, gleet, and as a stomachic
and carminative in disorders of the
digestive organs.
40
POCKET FORMULARY.
COMMON NAMES.
OFFICINAL.
DOSES FOR ADULTS.
Cubebs, tincture.
Tinctura cubebse.
3l t0 3"-
Cubebs, oil.
Oleum cubeboe.
v to x drops.
Dover's powder.
Digitalis, tincture.
Elixir vitriol.
Pulv. ipecacuanhae
et opii, or pulvis
Doveri.
Tr. digital.
Acid, sulph. arom.
v to xv gr.
x drops,
x to xxx drops.
Epsom salts.
Magnes. sulphas.
§i to ii.
Ergot, powder.
Ergot, wine.
Foxglove.
Pulv. ergotse.
Vin. ergotse.
Digitalis.
xv to xx gr.
gi to ii.
i gr.
Galls, powder.
Pulv. gallse.
x to xx gr.
Gamboge, powder.
Pulv. gambogiss.
iii to viii gr.
Gentian, powder.
Pulv. gentianse.
xii to xxv gr.
Gentian, extract.
Gentian, tincture.
Glauber's salts.
Guaiac powder.
Ext. gentianse.
Tinct. gentianae.
Sodse sulphas.
Pulv. guaiaci re-
sinae.
ii to vi gr.
to 3ii.
Si-
gr. v to 9i.
Guaiac, tincture.
Tinct. guaiaci.
3i-
Guaiac, ammoniated
tinct.
Tinct. guaiaci am-
moniftta.
3i-
APPROVED MEDICINES IN DAILY USE. 41
EFFECTS, &C.
DISEASES PROPER FOR, &C.
Stimulant and
diuretic.
Stimulant and
diuretic.
Narcotic, dia¬
phoretic;.
Tonic and as¬
tringent.
Cathartic.
Narcotic, seda¬
tive and diu¬
retic.
Astringent.
Cathartic.
Tonic.
Tonic.
Tonic.
Cathartic.
Stimulant.
Alterative and
emmenagogue.
Rheumatism, pneumonia, dysentery,
diarrhoea, and the various hemor¬
rhages, especially that from the uterus.
Typhoid fevers, colliquative sweats,
passive hemorrhages, and diarrhoea,
dependent on a relaxed state of the
mucous membrane of the intestine.
Fevers and inflammatory affections, colic
and obstinate constipation.
Hemorrhages, and to aid parturition.
Diseases of heart, lungs, and dropsy.
It is seldom employed as an internal
remedy, though occasionally prescribed
in chronic diarrhoea.
It is much employed in dropsy, attended
with torpid bowels.
All cases of disease dependent on pure
debility of the digestive organs. Dys¬
pepsia, gout, amenorrlioea, hysteria,
intermittent fevers.
Fevers.
It is mostly used in chronic rheumatism,
gouty affections, and amenorrhoea and
dysmenorrhoea.
4*
42
POCKET FORMULARY.
COMMON NAMES.
OFFICINAL.
DOSES FOR ADULTS.
Hellebore, black.
Helleborus niger.
gr. x to 9 i.
Hellebore, extract.
Hellebore, tincture.
Extr. hellebori
nigri.
Tinct. hellebori
y to x gr.
Si-
Hive syrup.
Hoffman's anodyne.
nigri.
Syrupus scillae
compos.
Spirit, ether, c.
3ss to 3i.
gss to gi.
Hydrocyanic acid.
Acid. Hydroeyani-
cum dilutum.
i to ii drops.
Iodide of iron.
Iodide of iron, solu¬
tion.
Iodide of potassium.
Ferri iodidum.
Liquor ferri iodidi.
Iodidi potassium.
iii to viii gr.
x to xx drops.
v to xv gr.
Iodine, tincture.
Tinct. iodinii.
v to xx drops.
Iron, subcarbonate.
Ferri sub-carb.
gr. x to 3ss.
Iron,muriated tinct.
Iron, phosphate.
Jalap, powder.
Ferri chlorid. tinct.
Ferri phosph.
Pulv. jalapoe.
x to xx drops,
v to x gr.
x to xx gr.
Jalap, extract.
Jalap, tincture.
Ext. jalapae.
Tinct. jalap®.
v to xx gr.
£i to £ii.
APPROVED MEDICINES IN DAILY USE.
43
EFFECTS, &C.
DISEASES PROPER FOR, &C.
Cathartic and
emmenagogue.
Emetic and ex¬
pectorant.
Antispasmodic.
Sedative.
Tonic, altera¬
tive, and em¬
menagogue.
Diuretic, alter¬
ative.
Tonic and alte¬
rative.
Tonic.
Tonic.
Tonic.
Cathartic.
Dropsy and amenorrhoea. Dr. Mead
considered it superior to all other
medicines as an emmenagogue.
Croup and other pectoral affections.
Hysteria, convulsions, and nervous irri¬
tation, and want of sleep from this
cause.
Phthisis and various affections of the
chest, attended with dyspnoea or cough,
such as asthma, hooping-cough and
chronic catarrh.
It is chiefly employed in scrofulous com¬
plaints and chlorosis, atonic amenor¬
rhoea, and leucorrhoea.
Bronchial affections, engorgement of
the liver, secondary syphilis, chronic
rheumatism.
It is used in diseases of the absorbent
and glandular systems, in glandular
enlargements and morbid growths, en¬
largement of the liver, spleen, testes,
uterus, in chronic diseases of the ute¬
rus. (See U. S. D.)
Iron is given in neuralgia, chorea, chlo¬
rosis, and in all diseases in which the
blood is deficient in coloring matter.
(See U. S. D.)
Dropsical complaints; it is much used,
combined with the bitartrate of potas-
sa, and in bilious fever, with calomel.
44
POCKET FORMULARY.
COMMON NAMES.
OFFICINAL.
DOSES FOR ADTJ1TS.
James's powder
Juniper oil.
Pulvis Jacobi.
01. juniperi.
iii to x gr.
gtt. iii to vi.
Kino, powder.
Kino, tincture.
Pulv. kino.
Tinct. kino.
x to xx gr.
5SS t0 3*'
Laudanum.
Tinct. opii.
xx to xxv drops.
Lead, acetate.
Plumbi acetas.
i to iii gr.
Lime-water.
Aqua calcis.
§ss to ii.
Lobelia, powder.
Pulv. lobelise.
v to x gr.
Lobelia, tincture.
Morphia, acetate.
Morphia, muriate.
Morphia, sulphate.
Tinct. lobeliae.
Morphise acetas.
Morphise murias.
Morphiae sulphas.
gas to £i.
gr. i to {.
gr. \ to i.
gtt. 1 to i.
Manna.
Manna.
to ii.
Musk.
Moschus.
x to xx gr.
APPROVED MEDICINES IN DAILY USE.
45
EFFECTS, &C.
DISEASES PROPER FOR, &C.
Diaphoretic.
Diuretic.
Astringent.
Narcotic.
Astringent.
Antacid, tonic
and astringent.
Emetic.
Emetic.
Narcotic.
Narcotic.
Narcotic.
Gentle laxative.
Antispasmodic.
Febrile diseases.
Debilitated cases of dropsy in connec¬
tion with digitalis.
Chronic dysentery and diarrhoea, not
attended with febrile excitement or
inflammation, hemorrhages, particu¬
larly from the uterus.
It is used to mitigate pain, induce sleep,
allay inordinate action, diminish mor¬
bid irritability, and is more or less em¬
ployed in almost every disease inci¬
dent to the human frame.
Hemorrhage from the lungs, intes¬
tines, and uterus, dysentery and diar¬
rhoea.
Dyspepsia, with acidity of the sto¬
mach, diarrhoea, diabetes, and gravel,
and nausea, and vomiting. (See
U. S. D.)
Catarrh, croup, pertussis, and other
laryngeal and pectoral affections. It
has proved most useful in spasmodic
asthma. I have known it to cut short
the paroxysm in a few moments.
They are applicable to all cases where
the object is to relieve pain, quiet
restlessness, promote sleep, or allay
nervous irritation in any shape. Less
stimulant, less disposed to constipate
the bowels than opium.
Costiveness in children and pregnant
women.
Hysteria, asthma, palpitation, convul¬
sions of infants, and in obstinate
hiccough.
46
POCKET FORMULARY.
COMMON NAMES.
OFFICINAL.
DOSES FOR ADULTS.
Myrrh, powder.
Pulv. myrrhse.
gr. x to 5i.
Nitre, sweet spirits
of.
Spts. ether, nitrici.
3i to 3ii.
Nitric acid.
Acid, nitricum.
i to iii drops.
Nitric acid, diluted.
Acid. nit. dil.
x to xi drops.
Nux vomica, pow¬
der.
Pulv. nucis vo¬
micae.
iii to v gr.
Nux vomica, tinc¬
ture.
Nux vomica, ex¬
tract.
Opium.
Tr. nuc. vom.
Ext. nuc. vomic.
ale.
Opium.
v to xx drops.
$ to i gr.
i to ii gr.
Paregoric, elixir.
Tinct. opii camph.
4
3'i to 3 88.
APPROVED MEDICINES IN DAILY USE.
EFFECTS, &C.
DISEASES PROPER FOR, &C.
Stimulant, tonic,
and expectorant.
Diaphoretic, diu
re tic, and anti¬
spasmodic.
Tonic, antisep¬
tic, antisyphi-
litic, escharo-
tic.
In small doses
it is tonic, diu¬
retic ; in large
doses its action
is chiefly on
the nerves of
motion. (See
XT. S. D.)
Stimulant in
small doses, in
larger, narco¬
tic, antispas¬
modic, dia¬
phoretic, seda¬
tive, anodyne.
See Opium and
Camphor.
Chronic catarrh, phthisis, asthma, and
other pectoral affections in which
the secretions are abundant, but not
easily expectorated, chlorosis, amenor-
rhoea, combined with chalybeates and
other tonics.
It is employed in febrile affections, in
nausea, flatulence, to allay restlessness,
and promote sleep.
The strong acid is seldom used for any
other than pharmaceutical purposes.
The diluted is used in fevers of the
typhoid kind, in chronic affections of
liver, attended with a redundant and
hasty formation of bile, and in dys¬
pepsia. It is also very useful in the
cure of old ulcerated legs.
It is used in dyspepsia, pyrosis, gastro-
dynia, chronic dysentery, hysteria,
rheumatism, spasmodic asthma, palsy,
incontinence of urine from paralysis
of the sphincter, amaurosis, and other
nervous affections. (See U. S. D.)
All painful affections where the in¬
flammatory diathesis is not very con¬
siderable, diarrhoea, dysentery, .cho¬
lera, pyrosis, convulsive and spasmodic
diseases. (See U. S. D.)
The same diseases as opium or its pre¬
parations. (See Laudanum.)
48
POCKET FORMULARY.
COMMON NAMES.
OTJICINAL.
DOSES FOR ADULTS.
Peruvian
powder.
bark,
bark,
Peruvian
tincture.
Peruvian bark,
Huxham's tinct.
Peruvian bark,
extract.
Pinkroot, powder.
Pinkroot, infusion
of.
Quassia, extract.
Quassia, infusion.
Quassia, tincture.
Quinine, sulphate.
Quinine, acetate.
Quinine, citrate.
Quinine, muriate.
Rhubarb, powder.
Rhubarb, tincture.
Pulv. cinchonas.
Tr. einchobse.
Tr. cinchon. c.
Ext. cinchonae.
Pulv. spigeliae.
Infusum spigeliae.
Ext. quassiae.
Infus. quassiae.
Tinct. quassiae.
Quiniae sulphas.
Quiniae acetas.
Quiniae citras.
Quiniae murias.
Pulv. rhei.
Tinctura rhei.
9i to §ss.
31 to 3ii.
gi to Sii.
i to v gr.
gr. x to 9i.
gss to gi.
i to iii gr.
31.
3i-
i to xx gr.
i to xx gr.
i to xx gr.
i to xx gr.
gr. x to £ss.
Sii to §88.
APPROVED MEDICINES IN DAILY USE.
EFFECTS, &C.
DISEASES PROPER FOR, &C.
Tonic, antipe-
riodic, and fe¬
brifuge.
Anthelmintic.
Tonic, stoma¬
chic.
Tonic, anti-
periodic, and
febrifuge.
Tonic, anti-
periodic, and
febrifuge.
Tonic, anti-
periodic, and
febi'ifuge.
Tonic, anti-
periodic, and
febrifuge.
Purgative, sto¬
machic, astrin¬
gent.
Diseases attended with deficient action:
miasmatic fevers. (See TJ. S. D.)
It is used in worm fever, and in remit¬
ting and intermitting fevers of infancy,
with quinsy.
Used in intermittent and bilious fevers,
dyspepsia, and in hysteria, united with
tincture of valerian.
In intermittents and all periodic dis¬
eases, as a tonic ; also as a febrifuge in
bilious remittents, and whenever tonics
are indicated; may be used with ad¬
vantage endermically or by enema,
where the stomach is irritable.
The last three preparations are supposed
to be better adapted to those excitable
persons with whom the sulphate does
not agree, and in cases of weak diges¬
tive powers. There are other prepa¬
rations that should be used, as ferro-
cyanate of quinine, and citrate of
quinia and iron. (See U. S. D.)
Costiveness from laxity of bowels, par¬
ticularly of children, and diarrhoea:
externally the powder is sprinkled over
ulcers, to assist their granulation and
healing.
50
POCKET FORMULARY.
COMMON NAMES.
OFFICINAL.
DOSES FOB ADULTS."
Rhubarb, syrup.
Silver, nitrate.
Syrupus rhei.
Argenti nitras.
2>i to gss.
i toigr.
Squill, powder.
¥
Pulv. scillse.
i to v gr.
Squill, syrup of.
Strychnine.
Tannin or tannic
acid.
Syr. scillse.
Strychnia.
Acidum tannicum.
3ss to g\.
TV to i gr.
ii to iv gr.
Uva ursi, powder.
Uvae ursi pulv.
9i to 3i.
Uva ursi, infusion of.
Uva ursi, syrup of.
Valerian, tincture.
Valerian, fluid ext.
Infus. uvae ursi.
Syrup, uvae ursi.
Tr. valerian.
Val. ext. fl.
gi to gii.
3l to 3ii.
3i to 3ii.
x to xx drops.
Wormseed oil.
Wild cherry, infu¬
sion of.
01. chenopod.
Inf. prnn. Virg.
gtt. ii to gr. vi.
§i- '
Wild cherry, syrup
of.
Zinc, sulphate.
Syr. prun. Virg.
Zinci sulphas.
£>i to 3'ii.
ss to ii gr.
APPROVED MEDICINES IN DAILY USE.
51
EFFECTS, &C.
DISEASES PROPER FOR, &C.
Tonic, anti¬
spasmodic, es-
charotic.
Expectorant
and diuretic.
Spastic.
Astringent.
Tonic, diuretic,
and astringent.
Antispasmodic,
tonic, emme-
nagogue.
Anthelmintic.
Sedative, tonic.
Chorea, epilepsy, dyspepsia, and irri¬
table conditions of the mucous mem¬
brane of the stomach and bowels;
locally to erysipelas, enlarged tonsils,
fungous ulcers, warts, and venereal
chancres, &c. (See U. S. D.)
Pulmonary complaints, humoral asthma,
pertussis, dropsy, combined with a
mercurial.
Paralysis.
Excessive sweats, diarrhoea, and most
forms of hemorrhage, after a sufficient
reduction of arterial action. (See U.
S. D.)
Diseases of bladder and dropsies.
Hysteria, epilepsy, hemicrania, chlo¬
rosis.
See U. S. D.
Debilitated states of the stomach or ge¬
neral system, attended with irritation
and nervous excitability ; it allays the
action of the heart, and is useful in the
hectic fever of scrofula and consump¬
tion, and in dyspepsia. (See XI. S. D.)
Emetic, tonic, See U. S. D.
externally as¬
tringent.
The doses given in the above table are for adults, but are
moderate, and may be lessened or increased as the patient may
appear to have less or more vigor than is common to others.
Doses for children can be calculated by the table on page 3,
giving the doses for all ages.
52
POCKET FORMULARY.
PILLS.
Composing Pill.
g,.—Pulveris Opii* gr. x;
Saponis gss.
Beat together, and form the 'whole into 20 pills. When a
quieting draught will not sit upon the stomach, one, two, or
three pills may be taken, as occasion requires.
Stomachic Pill.
]J.—Extract. Gentianas gii;
Pulveris Rhei,
Potassse Sulphatis, aa gi;
Olei Menthse Piper. Tt^xxx ;
Syrupi Simplicis q. s.
Misce, et divide in pilulas 1.
Signa.—Three or four to be taken twice a day for invigorat¬
ing the stomach and keeping the bowels gently open", in seden¬
tary and dyspeptic persons.
Corroborant Pill.
R.—Ext. Cinchonse,
Ferri Sulphatis, aa gi.
Misce, et divide in pilulas 1.
Signa.—Two to be taken three times a day, in disorders
arising from excessive debility or relaxation of the system.
Deobstruent Pill.f
Be-—Ferri Sulphatis,
Pulveris Aloes Soc.,
Myrrhse, aa. gi.
Misce, et divide in pilulas xl.
Signa.—Two to be taken evening and morning, in obstruction
of the menses.
* Opium, in a majority of cases, disposes to sleep; but many
cases will be met with in which it produces wakefulness. In such
casea I have found the Ext. of Hyoscyamus a good substitute.
t In consumption, the cessation of the menses is generally
considered of a very unfavorable import.
APPROVED MEDICINES IN DAILY USE.
53
Emmenagogue Pill.
R.—Ferri Sulph. gi;
Galbani,
Assafoetidse,
Aloes Soc., aa gss;
Tr. Assafceti. q. s.
Misce, et divide in pilulas lx.
Signa.—Give two morning and night. An excellent pill in
amenorrhoea.
Tonic Pill.
R.—Ferri Sulphatis gr. x ;
Ext. Kramerise gi;
Pulv. Aloes 9 i;
Olei Carui gtt. x ;
Syrupi Simplicis q. s.
Misce, et divide in pilulas lx.
Signa.—Two to be taken twice daily. Useful in chlorosis,
amenorrhoea, leucorrhoea, dropsy, gleet, &c.
Tonic Pill.
R.—Ext. Cinchonae,
Ext. Gentianse, aa
Ferri Sulphatis gss;
Pulv. Myrrhse gi;
Olei Carui gtt. x;
Syrupi Zingiberis q. s.
Misce, et divide in pilulas lx.
Signa.—Three to be taken two or three times a day, in cases
where the vis vitas is impaired, chlorotic cases, &c.
Tonic and Nervine, Pill.
R.—Sul. Quinise,
Zinci Oxidi, aa giss;
01. Valerian, q. s.
Misce, et divide in pilulas xxviii.
Signa.—Give one pill morning and night.
5*
54
POCKET FORMULARY.
Anti-dyspeptic Pill.
R.—Ferri Sulphatis gi;
Ext. Gentianse q. s.
Misce, et divide in pilulas xxx.
Signa.—One to be taken morning, noon, and night, in dys¬
pepsia and amenorrhoea.
Tonic and Laxative Pill.
R.—Ext. Gentianse gss;
Pulv. Aloes Jji;
Syrupi Simplicis q. s.
Misce, et divide in pilulas xxxv.
Signa.—Take one to three for a dose. These are excellent
and safe laxatives in dyspeptic cases.
Laxative Pill.
R.—Pulv. Aloes gi;
Gambogise gr. x;
Saponis et Aquae q. s.
Misce, et divide in pilulas xxxiv.
Signa.—One, two, or three to be given when necessary, for
torpid bowels.
Cathartic Pill.
R.—Hydrargyri Chloridi Mitis ^i;
Pulv. Gambogise gr. viii;
Syrupi Simplicis q. s.
Misce, et divide in pilulas viii.
Signa.—Two or three pills every three hours are a powerful
cathartic, well adapted to the treatment of the highest grades
of inflammatory fever, except such as affect the lungs and in¬
testinal canal. In inflammation of the womb, they are the best
remedy I have ever used (Dr. Fort).
Tonic Astringent Pill.
R.—Copaibse,
Ext. Gentianse, aa giiss;
Ferri Sulphatis,
Pulv. Kino, aa gr. lxxx;
Syrupi q. s.
Misce, et divide in pilulas singulas gr. iss.
Signa.—Take from one to three, three or four times a day,
for chronic mucous discharges and leucorrhoea.
APPROVED MEDICINES IN DAILY USE.
55
Anti-chlorotic Pill.
R.—Pulv. Ferri per Hydrogen giiss;
Ext. Cinchonae,
Pulv. Rhei, aa lxxxv.
Syrupi q. 8.
Misce, et divide in pilulas lxxx.
Signa.—Take from one to six daily in chlorosis, and anaemia,
■with constipation and loss of power in the digestive canal.
Anti-leucorrhceal Pill.
R.—Argenti Oxid. gr. xlviii;
Pulv. Ferri per Hydrog.,
Assafoetidae, aa giss.
Misce, et divide in pilulas xlviii.
Signa.—One to be taken morning and night in leucorrhoea,
attended with anaemic condition of the system.
Cook's Cathartic Pill.
R.—Hydrargyri Chloridi Mitis,
Pulv. Rhei,
Aloes, aa gr. xxx.
Misce, et divide in pilulas xxxii.
Signa.—Three pills are a safe cathartic in torpor of the liver
and bowels, accompanying bilious fever. Dose from one to
four at bed-time.
Dr. Calo's Anti-bilious Pill.
R.—Pulv. Aloes,
Jalapse,
Rhei, aa gr. x;
Gambogise gr. xx;
Ipecacuanhas,
Hydrargyri Chloridi Mitis, aa gr. x;
Syrupi q. s.
Misce, et divide in pilulas xl.
Signa.-—Dose from one to three at bed-time.*
* Bathing the head with cold water every morning has been very
serviceable in some cases of palpitation of the heart. Bathing the
feet in cold water every morning is a good habit with persons
that take cold easily.
56
POCKET FORMULARY.
Dr. Massifs Anti-bilious Pill.
R.—Ext. Colocynth. Comp.,
Scammonii,
Pulv. Aloes,
Pilulse Hydrargyri,
PuIy. Scillse, aa Qi;
Ext. TaraxaciQii.
Misce, et divide in pilulas xxx.
Signa.—Dose, two every night. They are valuable in bilious
fever and inflammation of the liver.
Alterative Pill.
R.—Pilulse Hydrargyri gr. x;
Pulv. Rhei,
Soda Bicarbonatis, aa gr. xii;
Syrupi Rhei Aromatici q. s.
Misce, et divide in pilulas xii.
Signa.—These are an excellent alterative in derangement
of the liver. One, twice or three times a day.
Plummet's Pill.
R.—Hydrargyri Chloridi Mitis,
Antimonii Sulphureti Aurati, aa gss ;
Guaiaci Resinae 5ji;
Copaibse q. s.
Misce, et divide in pilulas lx.
Signa.—These pills were recommended by Professor Plummer
in leprosy, secondary syphilis affecting the skin, gleet, old
ulcers, &c. &c.
Anodyne Pill.
R.—Ext. Opii gr. x;
Antimonii Sulphureti Prsecipitati gr. iii;
Potassae Nitratis gr. xxiv;
Syrupi q. s.
Misce, et divide in pilulas vii.
Signa.—One at bed-time in rheumatic affections, to diminish
, pain and produce diaphoresis.
APPROVED MEDICINES IN DAILY USE.
Antispasmodic Pill.
R.—Camphorae,
Ammon. Carbon., aa gr. iii;
Pulv. Ipecac, gr. i;
Ext. Hyoscyami gr. iv ;
Mucilaginis q. s.
Misce, et divide in pilnlas iii.
Signa.—One or two for a dose.
Another.
R.—Moschi J^ss ;
Camphorse^i;
Ammoniaci Q ii;
Opii gr. iv.
Misce, et divide in pilulas singulas gr. iv.
Signa.—The dose may be four or five in the twenty-four
hours, in nervous diseases.
Anti-neuralgic Pill.
R.—Ext. Conii gi;
Ferri Carbonatis Pilul. giss.
Misce, et divide in pilulas xx.
Signa.—One, three times daily, in neuralgic affections or irri¬
tation of the spine.
Composing Pill in Pulmonary Irritation.
R.—Ext. Conii,
Pulv. Doveri, aa gr. v.
Misce, fiant pilulse ii.
Signa.—To be taken at bed-time, to relieve the restlessness
occasioned by pulmonary diseases, rheumatic or other local
pains.
Anti-dropsical Pill.
I£.—Hydrargyri Chloridi Mitis,
Pulv. Scillse, aa, gr. xii;
Confect. Rosse q. s.
M., fiant pilulas xii.
Signai—One, night and morning, in dropsies depending upon
visceral derangements. This preparation is one of the most
celebrated of the diuretics, and, where disease of the liver
causes the effusion, is decidedly one of the best. When the
calomel affects the mouth, it should be omitted, and the squill
combined with some other diuretic.
58
POCKET FORMULARY.
Another.
R.—Pulv. Digitalis gr. xii;
Hydrargyri Chloridi Mitis gr. vi;
Pulv. Opii gr. iv;
Confect. Rosse q. s.
Misce, et divide in pilulas xii.
Signa.—One to be taken every eight hours, in hydrothorax
and ascites, when the quickness of the pulse demands the digi¬
talis.
Anti-icteric Pill.
R.—Pulv. Rhei Qi;
Saponisgss;
Hydrargyri Chloridi Mitis gr. xii.
Misce, et divide in pilulas xxiv.
Signa.—Two or three to be taken at bed-time. Emetics,
purges, fomentations about the stomach and liver, and exercise
will seldom fail to cure jaundice when it is a simple disease;
and, when complicated with dropsy, a scirrhous liver, or other
chronic complaints, it is hardly to be cured by any means.
Soap has been looked upon as a kind of specific. *
Anti-asthmatic Pill.
R.—Pulv. Scillse gii;
Pulv. Assafoetidae gi;
Misce, et divide in pilulas xxx.
Signa.—Two to be taken twice or thrice a day. Useful in
chronic asthma.
Another.
R.—Pulv. Digitalis gr. vi;
Scillse gr. xii;
Syrupi Tolutani q. s.
Misce, et divide in pilulas xii.
Signa.—One to be taken three or four times daily, in pituitous
asthma.
* " When jaundice appears," says some author, " it may be
reckoned a proof of the patient's being a veteran worshipper at the
shrine of Bacchus. The drunkard should be taught to look into a
glass, that he might spy the changes in his countenance. The first
stage will present him with redness of the eyes, the second will
exhibit the carbuncle nose, and the third an obstinate jaundice."
APPROVED MEDICINES IN DAILY USE. 59
Another.
R.—Pulv. Digitalis gr. v;
Opii gr. v.
Misce, et divide in pilulas x.
Signa.—One every four hours in spasmodic asthma. A tea-
spoonful of Tinct. of Castor and Saffron mixed together in a
cup of Valerian Tea, twice or thrice a day, is an excellent
remedy for spasmodic asthma. A strong cup of coffee will
sometimes give ease in an asthmatic paroxysm. In nervous
asthma, antispasmodics and tonics are the most proper medi¬
cines. Paregoi'ic, Peruvian Bark, Iron, bitter infusions, &c. ;
in short, everything that braces the nerves or abates spasms.
Galvanism is the most efficacious in relieving habitual asthma,
and issues have a good effect; they may be set eithe$»fn the
back or side, and should never be allowed to dry up. Issues
are extremely proper in most chronic diseases.
Anti-hysteric Pill.
—Camphorse,
Assafoetidee, aa giii;
Ext. Belladonnse Qi;
Opii gr. x ;
Syrupi q. s.
Misce, et divide in pilulas lxx.
Signa.—One to be taken the first day, and increase one each
day until six are taken daily, if necessary.
Dr. Cross's Anti-cholera Pill.
]J.—Pulv. Opii gr. ss ad iii ;
Pulv. Capsici gr. ii;
Hydrargyri Chloridi Mitis gr. iv ad xii.
Misce, et ft. pilul. una.
Signa.—Dose, one every two hours, varying according to
circumstances. This is said to be good, but I should treble
the quantity of opium.
Anti-dysenteric Pill.
JJ.—Pilulae Hydrargyri gr. xxiv;
Pulv. Ipecac, gr. iv ;
Opii gr. ii vel iii.
Misce, et divide in pilulas viii.
Signa.—One every four, six, or eight hours.
60
POCKET FORMULARY.
Astringent Pill.
R.—Aluminis,
Pulv. Kino, aa 3iss;
Syrup, q. s.
Misce, et divide in pilulas Ixx.
Signa.—From two to eight to be taken daily, in chronic
diarrhoea and chronic menorrhagia.
Anti-diarrheal Pill.
R.—Pilulse Hydrargyri gss ;
Pulv. Opii gr. xx;
Ipecacuanhse 3SS*
IMr^^et divide in pilulas xv.
Sigmfr—One every six or eight hours until the discharges are
arrested.
Another.
R.—Pulv. Opii gr. iss;
Hydrargyri Chloridi Mitis gr. iii;
Ipecacuanhse gr. iii.
Misce, et divide in pilulas x.
Signa.—One to be taken night and morning, in chronic
diarrhoea.
Anti-syphilitic Pill.
R.—Hydrargyri Chloridi Corrosivi gr. ss ;
Ext. Cinchonse gr. x;
Opii gr. ss;
Pulv. Glycyrrhizse q. s.
Ut fiant pilulae ii.
Signa.—The two pills may be taken one in Jhe morning and
the other at night. Dupuytren was partial to these pills in the
treatment of syphilis; their action must be closely watched.
Another.
R.—Hydrargyri Chloridi Mitis gr. xv ;
Aquae Destillatse gtt. xxx vel xl;
Corvfect. Rosse ^i;
Pulv. Glycyrrhizae q. s.
M., fiant pilulae xl.
Signa.—One pill three times a day, in syphilis. As sali¬
vation rapidly follows the use of Calomel, its effects must be
watched.
APPROVED MEDICINES IN DAILY USE. 61
Creasote Pill.
R.—Creasoti gtt. x;
Pulv. Glycyrrhizae,
Mucilaginis aa q. s.
Misce, et divide in pilulas xx.
Signa.—Give one three times a day, in bronchitis, neuralgia,
irritable stomach, hsematemesis, &c.
Anti-intermittent Fever Pill.
R.—Quinise Sulphatis gr. xvi;
Mucilaginis q. s.
M., fiafnt pilulse viii.
Signa.—One to be taken every hour, in the apyrexia of inter¬
mittent fever, commencing eight hours before the expected
chill. In fever, where the remission is short, say one, two, or
three hours, give them at once, or in two doses.*
Tonic Alterative Pill.
R.—Pilulse Hydrargyri,
Quinise Sulphatis,
Pulv. Aloes, aa gr. xii ;
Syrupi Rhei Aromatici q. s.
Misce, et divide in pilulas xii.
Signa.—One, three times a day for a few days, after bilious
intermittent fever, to strengthen or regulate the secretions of
the liver and bowels.
A nti-rheumatic Pill.
R.— Hyd. Chlor. Mitis,
Antimon. Sulph. Aurat., aa gr. xii;
Guaiaci Resinse,
Colchici Ext. Acet., aa gr. xxiv.
Misce, et divide in pilulas xii.
Signa.—Take one three times a day.
* Dr. Chapman regarded Arsenious Acid or Sulphate of Copper
as superior to Quinine in chronic cases of intermittent fever, and also
as respects completeness and permanency of cure. In intermittent
developing itself merely on some organ, the eye or ear, for instance,
or as a nervous disease, the treatment will be the same as in a
normal presentation. Intermittents being blended with a more
serious disease, as dysentery, should not be disregarded altogether,
but only till the more urgent affection be cured.
6
62
POCKET TORMHLARY.
Dr. Cartwright's Anii-gout Fill.
R.—Guaiac. Resin. Qii;
Pulv. Aloes 31;
Camphorae Qi;
Saponis Cast. gii.
Misce, et divide in pilulas xxxvi.
Signa.—Two to be taken every night at bed-time. Dr. Cart-
wright states that, after having been a martyr to gout, he was
entirely exempted from it by the use of the above pill. (See
Anti-gout Mixture.)
Many have thought that they had the remedy for gout, as
quacks think they have for all diseases, but there is no malady
which ^hows the imperfections of medicine, or sets the' advan¬
tages of temperance and exercise in a stronger light, than
gout. It has been so often induced by excess of wine and idle¬
ness that, in every age, it has justly been styled the offspring
of Bacchus. As a means of preventing gout, universal temper¬
ance and muscular exercise claim primary attention. This
course is as old as Celsus, who stro"ngly recommends it, and
whoever will submit to it in the fullest extent may expect to
reap solid and permanent advantage. Hippocrates observes
that women seldom have the gout, and never before the age of
forty-five. Hard drinking is particularly injurious; it brings
on premature decay, and, more than any other cause, paves
the way for the diseases of age before the meridian of life.
Dr. Graves's Eydragogue Cathartic Pill.
R.—Pulv. Jalapte,
Rhei,
Scammonii, aa gr. y ;
Elaterii gr. ss;
Bitartratis Potassae,
Sulphatis Potassae, aa gss;
Syrupi Zingiberis q. s.
Misce, et divide in pilulas iv vel vi.
Signa— Take at once. This is an excellent pill to clear the
chest, relieve breathing, and diminish the dropsical effusion.
Aperient or Diaphoretic Pill.
R-—Hyd. Chi. Mitis,
Jalapse Pulv., aa gr. xx;
Ant. et Potas. Tart. gr. li;
Syrupi q. s.
Misce, et divide in pilulas viii.
Signa.—Dose, two at bed-time; repeat in the morning, if
necessary. A good anti-bilious pill (Ewell).
APPROVED MEDICINES IN DAILY USE.
63
POWDERS.
Cathartic Powder.
R.—Hydrargyri Chloridi Mitis,
Pulv. Rhei, aa gr. x ;
Ipecacuanha gr. iii.
Miscc et'Signa.—To be taken at once, in syrup or molasses.
This is an excellent cathartic in bilious fever, &c.
Another.
R.—Hydrargyri Chloridi Mitis gr. v;
Pulv. Jalapse,
Rhei, aa gr. v.
Misce et Signa.—To be given as the former.
Another.
R.—Pulv. Rhei 9i;
Magnesise ^ii;
Olei Cinnamomi gtt. i.
Misce et Signa.—To be given in syrup, sugar, or -water.
Another.
R.—Potassse Bitartratis gii;
Pulv. Jalapse gi.
Misce, et divide in chartulas vi.
Signa.—Give one every three hours, until they operate, in
syrup of some kind. A good cathartic in dropsy.
Another.
R.—Magnesise Sulphatis ^i;
Antimonii et Potassse Tartratis gr. ss.
Misce et Signa.—To be dissolved in six ounces of water, and
taken for a dose. An excellent cathartic in inflammatory affec¬
tions originating from cold.
Another.
R.—Sulphuris Sublimati ^ss ;
Potaesce Bitartratis ^i.
Misce et Signa.—Mix in sufficient quantity of molasses, and
give a teaspoonful two, three, four, or five times a day, as may
be necessary, to move the bowels, to children in some diseases
of the skin.
64
POCKET FORMULARY.
Laxative and Alterative Powder.
R.—Hydrargyri Chloridi Mitis gr. iv;
Magnesiae Sulphatis gr. xvi.
Misce, et divide in pulveres iv.
Signa.—Give one in syrup every six or eight hours, until they
operate. This is a most excellent powder to move the bowels
in advanced stages of fevers.
Astringent Powder.
R.—Aluminis gr. v;
Pulv. Opii gr. i;
Hydrargyri Chloridi Mitis gr. i.
Misce in pulverem i.
Signa.—To be given in syrup—blackberry, if convenient—
every six or eight hours, in dysentery with bloody mucous dis¬
charges. As soon as bile is discovered in the operations, the
calomel may be omitted.
Another.
R.—Plumbi Acetatis gr. ii;
Pulv. Opii gr. i.
Misce in pulverem i.
Signa.—Give one every half hour, in profuse flooding. In
hemoptysis and other hemorrhages, give according to circum¬
stances.
Emetic Powder.
R.—Antimonii et Potassse Tartratis gr. i;
Pulv. Ipecacuanhse Qi.
Fiat pulvis.
Signa.—To be taken in a wineglassful of sweetened water.
An active emetic.
A milder one of the same.
R.—Antimonii et Potass® Tartratis gr. iss ;
Pulv. Ipecacuanhse gr. xv.
Misce, et divide in pulveres iv.
Signa.—One to be taken every ten or twenty minutes, in
warm water, until vomiting is excited.
APPROVED MEDICINES IN DAILY USE. 65
Febrifuge Powder.
R.—Ipecacuanhte gr. xii;
Potassae Nitratis gii.
Misce, et divide in ckartulas xii.
Signa.—One to be taken every two or three hours (Ewell).
Stimulant Diaphoretic Powder.
R.—Pulv. Guaiaci Resinsey
Potassse Nitratis, aa gi;
Pulv. Ipecacuanhse gr. ii.
Fiat pulvis in chartulas sex dividendus.
Signa.—One to be taken every three hours in syrup or mo¬
lasses. A good remedy in rheumatism and gout, after suffi¬
cient depletion.
Refrigerant Diaphoretic and Alterative Powder.
R.—Potassse Nitratis gi;
Antimonii et Potassse Tartratis gr. i;
Hydrarg. Chloridi Mitis gr. vl.
Misce, et in chartulas sex divide.
Signa.—One to be taken every two hours in syrup or mo¬
lasses. Used in bilious fevers.
Anti-rheumatic Powder.
R.—Sulphuris gii;
Pulv. Guaiaci Resin.,
Radic. Colchici, aaQi.
Misce, et divide in chart, viii.
Signa.—Give one every four hours, until the bowels are tho¬
roughly moved. After this, one may be used night and morning.
Astringent and Alterative Powder.
R.—Hydrarg. Chloridi Mitis gr. i;
Plumbi Acetatis gr. ss.
M., et div. in chartulas iv.
Signa.—One every three hours, in. cholera infantum. The
above dose is adapted to any age between ten and twenty
months. (Dr. T. D. Mitchell.)
6*
66
POCKET FORMULARY.
Laxative and Antacid Powder.
R.—Pulv. Rhei gr. x ;
Magnesise Carbonatis gss.
Misce ei Signa.—To be taken in syrup or molasses. Used in
diarrhoea and dyspepsia, &c.
Tonic Powder.
R.—Pulv. Cinchona gii;
Ferri Subcarbonatis,
Pulv. Zingiber., aa 3ii.
M., et div. in chartulas xii.
Signa.—One to be taken three times daily in syrup. Excel¬
lent in relaxed states of the system, chronic chills, &c.
Substitute for Dover's Powder.
EL—Morphias Sulphatis gr. ii;
Pulveris Glycyrrhizae,
Cretse Preparatse,
Camphorse, aa Qii.
Misce et Signa.—This compound may be used in all cases in
which Dover's Powder is employed. Dose, ten grains, con¬
taining the sixth of a grain of Morphia.
MIXTURES.
Twining's Cathartic Spleen Mixture.
]J,—Pulv. Jalap.,
Rhei,
Colombse,
Zingiberis,
Potassae Bitartratis, aa ;
Ferri Sulphatis ^ ss ;
Tinct. Sennse giv;
Aquas Menthse Pip. §x.
Misce et Signa.—Give one ounce and a half for an adult, at 6
A. M., to be repeated at 11 A. M., daily. This is an excellent
purgative tonic in engorgement of the spleen. Cup, and apply
a sinapism, if necessary.* '
* Costiveness is generally a forerunner of the disease, and in
many cases seems to have been the principal exciting cause.
APPROVED MEDICINES IN DAILY USE. 6T
Aperient Mixture.
R.—Sennae ;
Aquae Bullientis Oj.
Infuse for half an hour, and add:—
Magnesiae Sulphatis ^ss;
Tinct. Sennae Compositae ^i.
Signa.—Three tablespoonfuls to be taken every two or three
hours, until it operates, in cases of obstinate costiveness or
colic. A laxative clyster will be necessary, if a speedy evacua¬
tion be required.
Laxative Absorbent Mixture.
R.—Magnesiae Carbonatis gi;
Pulv. Rhei gr. x;
Aquae Dest. ^iii;
Aquae Cinnamomi,
Syrupi Simplicis, aa If i.
Misce et Signa.—A tablespoonful may be taken for a dose,
and repeated three times a day, if necessary. To a young
child, half a spoonful will be sufficient. As most diseases of
infants are accompanied with acidity, this mixture may be
given with a view either to correct these, or to open the bowels.
Another.
]£.—Magnesiae Carbonatis £ss;
Sulphatis giii;
Tinct. Rhei g ss;
Hyoscyami £ss ;
Aquae Menthae Pip. giv.
Misce et Signa.—A tablespoonful to be taken two or three
times a day. This is an excellent remedy for nervous consti¬
pated persons.
Another.
JJ..—Magnesiae Carbonatis 31;
Pulv. Rhei gr. x ;
Tinct. Opii gtt. vi;
Menthae Piperitae gtt. vi;
Aquae Dest. ^ii.
Misce et Signa.—A teaspoonful to be given every two or three
hours, until it operates, in cases of gripes and flatulence affecting
children.
68
POCKET FORMULARY.
Dr. Dewees's Anti-colic Mixture.
R.—Magnesias Carbonatis gss ;
Tincturas Assafoetidse gtt. lx;
Opii gtt. xx ;
Saccliari Albi gi;
Aquse Destillatas gi.
Misce et Signa.—Twenty-five drops to be given to an infant of
two to four weeks old, in flatulent colic, diarrhoea, &c.*
Anti-diarrb.ce.al Mixture.
R.—Copaibse,
Spts. iEther. Nitrici, aa, gv;
Ferri Liquor. Nitrat. ^iii;
Tr. Opii^ss;
Sacch. Albi,
Acacise Pulv., Sa^ss;
Aq. Cinnara. q. s. ut fiant ^viii.
Signa.—Dose for an adult, one tablespoonful three times a
day. This is excellent in some cases of chronic diarrhoea.
Anti-diarrhcaal Mixture for Infants.
R.—Magnes. Sulpliatis gi;
Tinct. Rhei £ii;
Aqute Carui gvii.
Misce et Signa.—Take a teaspoonful every six hours. This is
an excellent remedy when the evacuations are abundant but
fecal, and unattended with tenesmus.
Another.
R.—01. Ricinigi;
Pulv. Acac. Qi;
Syrup. Simp, gi;
Tinct. Opii gtt. iv;
Aqure Aurant. Flor. gvii.
Misce et Signa.—Give a teaspoonful every four hours. In in¬
flammatory diarrhoea, if there is no great irritability of stomach,
I think highly of the above mixture.
Tenesmus is treated by Laudanum and Mucilage enema.
* If the patient makes a noise with his teeth, particularly when
asleep, the existence of worms in the stomach may be suspected.
APPROVED MEDICINES IN DAILY USE. 69
Anti-diarrhoeal Mixture.
R.—Argent. Nitrat. Crystall. gr. | ;
Aqua Destill. gii;
Pulv. Acac. 3 ii 1
Sacch. Albi gii.
Misce et Signa.—-A teaspoonful of tliis mixture is to be given
every two hours, in advanced and obstinate cases of diarrhoea
occurring in children, especially in newly-weaned infants.
Dr. Massifs Anti-diarrhoeal Mixture.
R.—Cretse Preparatse gii;
Sacchari Albi,
Pulv. Acacise, aa q. s.;
Olei Cinnamomi gtt. iii;
Tinct. Opii gi;
Kino gii;
Catechu gi;
Aquse Destillatse §iv.
Misce et Signa.—Give a tablespoonful every two hours to cor¬
rect the secretions, when the diarrhoea is the result of acid
generated in the primse viae.
Dr. Hun's Anti-diarrhoeal Mixture.
R.—Olei Cajuputi,
Caryophylli,
Menthae Piperitse,
Anisi, aa §i;
Alcohol ^iv.
Misce et Signa.—Dose, from one to two drachms in hot brandy
and water or syrup. This will afford the most speedy relief in
diarrhoea accompanied with pain.
Astringent Anti-diarrhoeal Mixture.
R.—Tinct. Catechu gi;
Opii gss ;
Camphorse §ss;
Myrrhse §ss;
Capsici gss.
Misce et Signa.—From one to two teaspoonfuls for adults; 12
to 24 drops to children one year old. It should not be given
until the discharges have been sufficient to empty the bowels
completely. In most cases of mere looseness, a teaspoonful
to
POCKET FORMULARY.
given, in a warm glass of water, three times, will be sufficient
to effect a cure.
People predisposed to pulmonary consumption are very sub¬
ject to diarrhoea, and in them it generally proves very obstinate;
and, when imprudently checked by astringent medicines, is
generally succeeded by cough and other symptoms of incipient
consumption. In such cases, we should moderate, instead of
restraining it. Persons subject to diarrhoea, from changes of
the weather, or when excited by mental emotions, or on any slight
deviation from an accustomed mode of living, should wear flannel
next the skin.
Hope's Mixture.
JJ.—Aquse Camphorae giv;
Acidi Nitrici gtt. iv;
Tinct. Opii gtt. xl vel lx.
Fiat Mistura.
Signa.—Dose, a tablespoonful every two hours, in diarrhoea
and dysentery.
Anti-dysenteric Mixture.
R.—Limonum Succi vel
Aceti t^ii;
Sodii Chlor. gss ;
Infus. Menthse Pip. Oss;
Sacchar. Alb. q. s.
Misce et Signa.—Dose, a wineglassful every two or four hours.
(Ewell.)
Anti-cholera Mixture.
R.—Tinct. Opii gi;
Liquor. Ammonise,
Tinct. Olei Menthce Piperitse, iia gss ;
iEtlier gtt. xxv;
Tinct. (Jamphorse,
Capsici, aa gi.
Misce et Signa.—Give immediately; if the patient throws it
up, repeat at once. This is said to be, and doubtless is, an ex¬
cellent prescription in extreme cases, when the patient is
cramped.
APPROVED MEDICINES IN DAILY USE.
U
Anti-hysteric Mixture.
R.—Tinct. Assafoetidfe gii;
Spiritus Ammoniae Aromatici gii;
Aquae Camphorae ^vii.
Misce et Signa.—Give two tablespoonfuls every three or four
hours.
Another.
R.—Tinct. Carui j|ss ;
Aquae Camphorae '3;v;
Spiritus JEtheris Compos, gi;
Tinct. Opii,
Lavandulae, aa gtt. xxx.
Misce et Signa.—Give two tablespoonfuls three times a day.
Another.
R.—Spt. iEther. Compos.,
Tinct. Valerianae, aa^i;
Misce et Signa.—A teaspoonful for a dose, with a wineglass of
water, pro re nata, shaking the phial each time.
Anti-asthmatic Mixture.
R.—Misturse Ammoniaci ^iv;
Syrupi Scillae giii;
Vini Antimonii gtt. lx ;
Aceti gss.
Misce et Signa.—Give two tablespoonfuls often, or when either
the cough or shortness of breath is troublesome. (See Anti¬
asthmatic Pill.)
Another.
R.—Galbani gii;
Aceti Scillae,
Aquae Foeniculi, aa §iiss;
Liquor. Ammoniae Acetatis gii;
Spiritus iEtheris Nitrici gi;
Syrupus Altheae gss.
Misce et Signa.—Dose, three or four teaspoonfuls a day. In
humid asthma, this is equal, if not superior, to any remedy that
we know of.
72
POCKET FORMULARY.
Another.
—Vim Antimonii gss ;
Tinct. Lobelise giii;
Opii Camph. ^ss.
Misce et Signa.—Take a teaspoonful every hour until re¬
lieved.*
Anti-rheumatic Mixture.
R.—Tinct. Guaiac. Ammoniat. §ss;
Mel. § ss;
Aquse Camphorte |jvi.
Misce et Signa.—Take two tablespoonfuls three or four times
a day, in chronic rheumatism; rub well the affected parts with
Anti-rheumatic Liniment.
Another.
1J. —Vini Antimonii ^i;
Tinct. Opii gtt. lxxx;
Aquse Camphorse §iv.
Misce et Signa.—Give two tablespoonfuls twice or three times
a day, as the case may require, in acute rheumatisin, when the
pain is very severe and skin hot.f
Diaphoretic Mixture.
—Aquae Camphorae §v;
Liquor. Ammonise Acetatis ^iii;
Spiritus iEtheri. Nitrici giii.
Misce et Signa.—Give three tablespoonfuls every four or six
hours, in deep-seated inflammations, particularly of the hip
joint.
* If the person be advanced in years, or affected with swelling
of the legs, an issue or seton is improper. " The asthmatic pa¬
tient," says Aretffius, "loves walking in the open air with his
mouth open, and is dissatisfied with the largest house, which seems
too small to breathe in."
t Whatever remedies are used in chronic rheumatism, it will be
absolutely necessary to persevere with them for a considerable
length of time, in order to obtain from them the desired advantage.
APPROVED MEDICINES IN DAILY USE. 73
Another.
R.—Tinct. Opii gtt. xxv ;
Spiritus iEtlieris Nitrici £i;
Yini Antimonii gi;
Aquas Dest. ^ss.
Misce et Signa.—To be given at a dose pro re nata, in dropsy.
Diuretic Mixture.
R.—Aquse Menthae Pip. §v ;
Yini Aceti sjvi;
Spiritus iEtheris Nitrici gss ;
Syrupi Zingiberis giss.
Misce et Signa.—Two teaspoonfuls to be taken three times a
day, in obstruction of the urinary passages.*
Sudorific Mixture.
R.—Liquor. Ammonise Acetatis 5jiii;
Ipecacuanhse gr. x;
Tinct. 01. Menthse Piperita gtt. xv;
Aquae Dest. gv.
Misce et Signa.—Three tablespoonfuls to be taken every two
hours, until it produces the desired effects.
* A majority of cases of retention of urine arise from an enlarge¬
ment of the prostate gland, and, for their relief, require the use of
the catheter. They demand prompt assistance, and if relief be too
long delayed, the consequences are most serious. Bleeding, warm
fomentations, emollient clysters,mucilaginous drinks, &c., are to be
resorted to, according to the symptoms of the patient. The follow¬
ing infusion more speedily produces reliefthan anything I ever tried.
It may be thus prepared : Pour upon an ounce of the leaves of uva
ursi, an ounce of gum Arabic, and half an ounce of cream of tartar,
a pint of boiling water. After simmering gently for five or ten
minutes, stir it up that the gum may be well dissolved ; pour it off,
and sweeten with sugar. Dose, a wineglassful three or four times a
day. During an attack of obstruction of urine, the dose may be
repeated every half hour. Dr. Vander Broeck says that large
cupping-glasses applied to the superior or external parts of the
thighs will, nine times in twelve, relieve retention of urine depend¬
ent upon cerebral affection.
7
74
POCKET FORMULARY.
Anti-nervous Mixture.
R.—Ext. Kramerise jiss ;
Aquse Camphorae ^vi;
Spiritus Ammonias Aromatici gii;
Spiritus Lavandulae Compositi gii.
Misce et Signa.—Give two tablespoonluls three or four times a
day. For general nervousness, irritability, and periodical
headache, this is a very valuable remedy.
Mixture for Cramp in the Stomach.
R.—JEtheris gii;
Sacchai'i Albi,
Pulv. Acacise,'aa giss;
Tinct. Opii gtt. lx ;
Aquse Cinnamomi gii.
Misce et Signa.—Give a teaspoonful every hour in cramp of
the stomach.
Anti-pertussis Mixture.—Mixture for Hooping Cough.
R.—Tinct. Assafoetidte 31 ;
Ipecacuanhas gr. x ;
Tinct, Opii gtt. x ;
Aquse Dest. ^ii.
Misce et Signa.—Give to a child two years old a teaspoonful
every four hours, increasing ten drops for every additional
year. *
(Brown Mixture.
R.—Pulv. Ext. Glycyrrhizse,
Acacise, aa gii;
Aquas Ferventis §iv;
Misce, fiat solutio et adde:—
Tinct. Opii gtt. xl;
Spt. iEtheris Nitrici gi;
Vini Antimonii gii.
Signa.—Take one tablespoonful for a dose, pro re nata, in
catarrh and common winter cough.
* Croup is dangerous from the suddenness of the attack and the
rapidity of its progress, and requires the most prompt and decided
measures to prevent suffocation, and should not be neglected.
APPROVED MEDICINES IN DAILY USE. 75
Expectorant Mixture.
R.—Syrupi Scillse Jss;
Tinct. Qpii Camphoratae gii;
Vim Antimonii gi;
Pulv. Acacise gss;
Aquce Dest. ^iii.
Misce et Signa.—A teaspoonful every two or four hours. This
is for children. *
Alterative Mixture.
R.—Iodinii gr. iii;
Potassii Iodidi gr. vi;
Aquae §i.
Solve et Signa.—Take from six to ten drops thrice a day, in a
draught of water. It is used in catarrh, phthisis, and in syphi¬
lis, combined with scrofula.
Griffith's Myrrh Mixture.
R.—Myrrh® 31;
Ferri Sulphatis ^i;
Potassse Carbonatis gi;
Sacchari gii;
Aquae !|vi.
Fiat Mistura.
Signa.—Dose, a tablespoonful, according to circumstances.
Given as a tonic in phthisis.
Tonic and Anti-periodic Mixture.
R.—Sul. Quinise,
Salicin, aa gi;
Liq. Potas. Arsenitis gi;
Ferri Subcarb. gss;
Aqnse Font. §viii.
Dissolve the Quinine and Salicin in giv of the water, by
* The principal object in the treatment of pneumonia and pleurisy
is to unload the vessels of the Jungs by bleeding, and such remedies
as are calculated to produce a determination ofblood to the surface
of the body; but,if the constitution of the patient be naturally
weak, the extraction of blood from the chest by cupping or leeches
will often prove more serviceable than general bleeding.
POCKET FORMULARY.
means of Sulph. Acid q. s. ; then add the mineral solution and
Iron. Shake well, and add the remainder of the water.
Signa.—Dose for an adult, one teaspoonful three times a day.
Good in chronic chills.
Anti-periodic Mixture.
Jjt.—Sulphatis Quinise gr. xx;
Acidi Sulphurici gtt. i;
Sacchari Albi 31;
Aquse Cinnamomi ^iiss.
Misce et Signa.—A teaspoonful for a dose every hour, during
the apyrexia of intermit tents.*
Another,
R.—Liquoris Potassse Arsenitis gtt. xxx;
Tinct. Opii gtt. xx ;
Spiritus Lavandulae Compositi gi;
Aquas Cinnamomi ^iv.
Fiat Mistura et Signa.—A tablespoonful for an adult, a tea¬
spoonful for a child two to four years old, every two or three
hours, during the apyrexia of intermittents, watching the1
effects, f
* How to take Quinine without tasting it? Dr. W. H. Edwards
says that Quinine may be taken without tasting its bitterness by
putting the salts in powder in the middle of a tablespoonful of thick
mucilage of slippery elm, so as not to touch the spoon, and imme¬
diately swallowing it.
t In the very early stage of remittent or congestive fever of
the South, it may, eight times out of ten, be cut short at once by the
use of Quinine, either by the mouth or rectum; but where it has
degenerated, lost its paroxysmal tendency, and become seated, our
object should be to husband the strength, our treatment systematic,
and our remedies directed to palliate its violence until its course is
run. This truth should not be forgotten, as I am certain many
lives have been lost by not doing enough sometimes in the early
stage, and doing too much in the advanced. Dr. Rush said disease
was a lawless evil. To understand its nature it should be inspected
every hour of the day and night. This is particularly true in refer¬
ence to typhoid fever; to be successful, we must watch its symp¬
toms, and accommodate our remedies to them, and not to our
convenience. Remember that the cure often turns upon a remedy
being used not only on a certain day, but a certain hour. Our late
epidemic of yellow fever in Savannah would furnish many proofs
of the truth of this remark.
APPROVED MEDICINES IN DAILY USE.
Alterative Mixture.
R.—Tinct. Iodinii 31;
Mucilaginis Acacise Hjii;
Aquse Destillatas ^vi.
Fiat Misturas et Signa.—A tablespoonful every two hours, em¬
ployed in cases of ulceration, accompanied by purulent dis¬
charge from the meatus auditorius, and in the scrofulous
diathesis.
Anti-urticaria Mixture.
1£.—Quin. Sulph. gr. xii;
Ammon. Carb. 5ji;
Magnes. Carb. §ss;
Aquae Fon. §viii.
Fiat Mistura et Signa.—Take one tablespoonful thrice a day.
Emmenagogue Mixture.
R.—Tinct. Aloes ^ss;
Ferri Chloridi Tinct. gss;
Tinct. Valerianae §ss.
Misce et Signa.—Take a teaspoonful in Chamomile Tea two or
three times a day.
Imperial Mixture or Drink.
R.—Potassse Bitartratis gss;
Aurantii Cort. giv;
Sacchari Albi ^iv;
Aquee Bullientis Oiii.
Macera per horam in vase leviter clauso et cola.
Signa.—Take a wineglassful or more, ad libitum. This is an
excellent cooling laxative, diuretic and refrigerant, in febrile
diseases, particularly in scarlet fever. In fact, in most cases,
this is all that is necessary to give, with proper attention to the
throat.* (See Gargles.)
* Scarlet Fever.—All that is requisite in the treatment, in a ma¬
jority of cases, is to keep the patient in a moderate and equable
temperature, to enforce a light diet, keep the throat well swabbed,
the bowels opened with cooling, acidulated, gentle aperients—the
imperial dHnk is the best (ad libitum). If the skin is hot and dry, a
warm bath, every two or three hours, is a charming sedative 5 it
moderates the fever, and disposes the patient to a calm sleep.
7*
18 POCKET FORMULARY.
Anti-gout Mixture.
]J.—Tinct. Guaiac. Ammoniat. ^vi;
Aquse Camphorse §vi;
Tinct. Rhei 5|ss ;
Mel. 188.
Mix, by rubbing the honey and the Guaiac up in a glass
mortar, and then add the other articles by degrees.
Signa.—Give two tablespoonfuls every four or six hours, and
rub with the Anti-rheumatic Liniment.
Anti-gonorrhoea! Mixture.
]£.—Copaibse,
Spt. JEtheris Nitrici, aa gss;
Pulv. Acacise,
Sacch. Alb., aa gi;
Spt. Lavand. Comp. gii;
Tinct. Opii gi;
Aquas Destill. §iv. F. M.
A tablespoonful for a dose three times a day. Shake before
using.
Another.
R.—Pulv. Cubebse gi;
Aluminis gi;
Pulv. Acacia,
Sacchar. Alb., aa gss;
Aquse Menth. Pip. §xii.
Misce et Signa.—Dose, three tablespoonfuls four times a day.
Shake before using.
Another.
R.—Copaibse,
Tinct. Cubebse,
Catechu,
Spt. Athens Nitrici, aa ;
Tinct. Opii Camph. ||iss;
Pulv. Acacise,
Sacchar. Alb., aa §ss;
Aquae Menthse Pip. ^ivss.
Misce et Signa.—Take one tablespoonful two or three times a
day. Shake before using.
APPROVED MEDICINES IN DAILY USE. 19
Another.
R.—Copaibse,
Spt. iEtheris Nitrici,
Spt. Lavandul., aa ^ii ;
Pulv. Acacise §i;
Carb. Sodse sjii;
Tinct. Opii gii;
Spiritus Genevse (Gin) gviii.
Misce et Signa.—Take two teaspoonfuls three times a day.
Shake before using.
Olei Terebinth, gii;
Tinct. Opii gtt. 1;
Aquas giv.
Misce et Signa.—Take two teaspoonfuls three times a day.
R.—Copaibse §i;
Acacise ^ss;
Aquae Cinnamomi gii;
Syrup. §i;
Tinct. Gentianse Comp. §ss;
Cubebse §i;
Aquae Fluvialis Jiss ;
Tinct. Lavandul. Comp. giiss.
Misce et Signa.—Dose, tablespoonful three or four times a day.
(Dr. Pancoast.)
R.—Copaibse Resin.,
Alcohol.,
Syrup. Balsam. Tolut., aa ;
Aquse Menth. Pip.,
Aquas Flor. Aurantii, aa ^i;
Spt. ^theris Nitrici 5jii.
Misce et Signa.—Take from two to six tablespoonfuls daily.
Shake before using.
Another.
R.—Copaibse §i;
Pulv. Acacias gii;
Sacchari gi;
Spt. either. Nit. §iss ;
Another.
Chopard's Anti-gonorrhoeal Mixture.
80
POCKET FORMULARY.
Dr. P. F. Foe's Anti-gonorrhceal Mixture.
R.—Copaibae,
Pulv. Cubebae,
Pulv. Acacise, aa §ii;
Syrup. Buchu vel Uyse Ursi §iv;
Aquae Cinnamomi Oi.
Misce et Signa.—Dose, an ounce three times a day.
COLLYRIA, OR EYE-WATERS.
Astringent Gollyria.
R.—Liquoris Plumbi Acetatis gtt. xii ;
Vini Opii gtt. xl;
Aquae Rosae ^iv.
Ft. collyrium.
This should be applied with a linen rag four or five times a
day.
R.—Sulphatis Zinci,
Acetatis Plumbi, aa gr. vi ;
Aquae Rosas §iv.
Misce.—To be filtered. To be used as the above.
Collyrium of Vinegar.
R.—Aceti Destillati §i;
Spiritus Vini Diluti 3 ss;
Aquae Rosae :§viii.
Fiat Mistura.—Excellent to weak eyes, after depletion.*
Collyrium of Corrosive Sublimate.
R.—Hydrargyri Chlorid. Corros. gr. ii;
Aquae Destillatae §viii.
Fiat Solutio.—Good in gonorrhoeal and scrofulous ophthalmia.
* Inflammation or redness of the eyes is not unfrequently the distin¬
guishing badge of the drunkard, as if to point him out by the finger of
scorn. Who hath woe, who hath sorrow, who hath contentions, who
hath babbling, who hath wounds without cause, who has redness of
eyes t says So]omon ; they that tarry at the wine, they that go to seek
mixed wines. In such case, it is best to take a strong temperance
pledge, and adhere to it. But when inflammation of the eyes occurs
in subjects whose absorbent system is naturally delicate (termed the
scrofulous habit), it will require, in addition to the eye-waters, the
treatment recommended for scrofula.
APPROVED MEDICINES IN DAILY USE. 81
Collyrium of Copper.
R.—Sulphatis Cupri gr. v ;
Camphorae gi;
Aquae Bullientis ^viii.
Rub the camphor with the water, then strain and add the
copper. This is most excellent in the purulent form. A good
application to infants.*
Collyrium of Iodine.
R.—Iodidi Potassii gr. xxiv;
Iodinii gr. i;
Aquae Rosse !|vi.
Misce, et apply three or four times a day. It may be used
with benefit in scrofulous ophthalmia, and ulcerations of the
cornea and conjunctiva.
Collyrium of Nitrate of Silver.
R.—Nitratis Argenti gr. ii;
Aquae Destillatae §ii;
Fiat solutio.
At the close of acute ophthalmia.
Collyrium of Alum.
R.—Aquae Rosae,
Aquae Destill., aa §ii;
Aluminis Qi.
Misce.—Used in chronic inflammation.
The above recipes are intended principally for chronic sore
eyes, when they remain weak and tender after the inflammation
has partially subsided. In acute inflammation of the eye, bleed¬
ing and purgative medicines are always necessary; and, if the
heat and pain be great, a poultice of bread and milk, softened
with sweet oil or fresh butter, may be applied to them at least
all night, and they may be bathed with lukewarm milk and
* People subject to inflammatory attacks of the eyes or eyelids,
should pay particular attention to the state of the digestive organs ;
on any symptoms of indigestion or determination of blood to the
head, they should take a cathartic. Infants born in winter are very
subject to sore eyes, from the action of the cold air on them. All that
is requisite in a majority of such cases, is to keep the head warm
and wash the eyes with fresh rose-water.
82
POCKET FORMULARY.
water, slippery-elm or sassafras-pith water. If the inflamma¬
tion is slightly purulent, apply the alum cataplasm every three
or four hours, and, if of long standing, a seton should be put
upwards and downwards between the shoulder blades. It may
be dressed twice a day with basilicon cerate. I have read of
persons who had been blind for a considerable time, that re¬
covered sight by means of a seton placed as above.
gaiigles, mouth-Washes, &c.
Cooling Gargle.
R.—Aquas Dest. gvi;
Potassse Nitratis giss;
Mellis Despumati gi.
Misce.—This is a cooling gargle, and may be used in fever for
cleaning the tongue and fauces.
Discutient Gargle.
R.—Potassse Nitratis ^i;
Pulv. Acaciae sjiii;
Aquae Dest. Oss.
Solve et Signa.—To be used frequently for inflammatory sore
throat.
Detergent Gargle.
R.—Infusi Salvii Oss;
Mellis Despumati §i;
Tinct. Myrrhae,
Spiritus iEtheris Nitrici, aa ^ss.
Misce.—This is an excellent gargle in ulcerated sore throat.
Astringent Gargle.
R.—Corticis Quercus Falcatae gss;
Aquse Oi.
Boil for a quarter of an hour, then add :—
Aluminis gii;
Vini Oporto 5 iv.
Misce et Signa.—To be used every two or three hours in cases
of relaxation or falling down of the palate.
APPROVED MEDICINES IN DAILY USE. 83
Acidulated Gargle.
R.—Rosae Gallicse ^ii;
Aquse Bullientis Jvi.
Fiat infusum, cola et adde:—
Mellis Despumati gi;
Acidi Sulphurici Diluti gtt. xxx.
Fiat Gargarysma.—For inflammation of the throat and fauces,
mouth, &c.
Gargle of Borax, #c.
R.—Boratis Sodae gi;
Tinct. Myrrhae % ss;
Mellis Despumati §i;
Aquae Koste vel Dest. Sjiv.
Fiat Gargarysma.—To be used as a gargle or mouth-wash, in
ptyalism or scorbutic affections of the gums. Omit the Myrrh
and water, and there is nothing better for the thrush in
children.
Gargle for Chronic Sore Throat.
R.—Sulphatis Quinias gr. xv;
Cupri gr. xvi;
Acidi Sulphurici Aromatici ^i;
Aquae ^ viii.
Fiat Mistura et Signa.—To be used frequently in chronic and
obstinate sore throats.
Muriatic Acid Gargle.
R.—Infusi Cinchonae f^iv ;
Mellis Despumati f§i;
Acidi Muriatici gtt. x vel xviii.
Fiat Gargarysma.—In chronic inflammation, 'when the pain
and swelling have been reduced by depletion.
Wash of Sulphate of Copper, $c.
R.—Cupri Sulphatis gii ;
Pulveris Cinchonas ]§ss;
Aquae Destill. f^iv.
Misce et Signa.—In the gangrenous sore mouth of children,
applied to the full extent of the ulceration of excoriation.
84
POCKET FORMULARY.
Wash in Ptyalism.
R.—Creasoti,
Olei Terebinth., aa gtt. xx;
Aquae Dest. giv;
Pulv. Acacia; q. s.
Signa.—Wash the mouth and gums every two or three hours.
OINTMENTS AND LINIMENTS.
Ointment for Piles.
R.—Adipis gi;
Liq. Plum. Subac. gtt. xxv ;
Tinct. Opii gi.
Misce bene.
Signa.—Anoint the parts twice a day.
Another.
R.—Pulv. Gallse gss;
Hyoscyami Fol. gss ;
Adipis
Misce bene.
Signa.—Apply it to the parts every morning.
Ointment for Itch.
R.—Sulphuris Sublimati ^ii;
Adipis giv;
01. Lavandulae gi.
Fiat Unguentum.—To 'be rubbed on the parts affected every
night, till the eruption disappears. The internal use of sulphur
will, in all cases, assist its external application.
Stramonium Ointment.
R.—Stramonii Fol., contus., Bi;
Adipis Ifiiii.
Let them simmer together over a gentle fire, till the leaves
become crisp and dry. Then press out the lard, return it into
the vessel when cleansed, and add six ounces of beeswax; set
the whole on the fire, when the wax has melted, remove the
vessel and strain. This ointment is excellent for external in¬
flammations and piles and burns; and, if colored with Bed
Precipitate, it is the very best for old indolent ulcers. I would
advise all to make enough in the spring to do them a year.
APPROVED MEDICINES IN DAILY USE. 85
Ointment for Blistering in half an hour.
R.—Adipis partes xxxii;
Olei Amyg. Dulc. partes ii;
Liquoris Ammouise Fort, partes xvii.
Melt the lard, add the oil, then the ammonia, "which must be
strong, and keep the contents of the bottle well mixed by shaking
them until cold.
Iodine Ointment.
R.—Iodiniigr. iii;
Adipis gii.
Fiat Unguentum.—Applied to scrofulous swellings, when the
skin is unbroken.
Ointment of Iodide of Zinc.
R.—Zincilodidi gi;
Adipis §i.
Fiat Unguentum.—A drachm to be rubbed on twice a day in
tumors.
Devergie's Ointment for Chilblain.
R.—Adipis sjviiss;
Creasoti gtt. x;
Liquoris Subacetatis Plumbi gtt. x;
Aq. Ext. Opii gr. i.
Misce.
Signa.—Apply to the affected parts.
Ointment for Diseases of the Skin.
R.—TJnguenti Hydrargyri Nitratis ^iss ;
Sulphuris Sublimati 5ji;
Adipis ^iii.
Fiat Unguentum.—This ia a good application for almost all
affections of the skin.
Emollient Ointment.
R.—Olei Palmae flsii ;
Olei Olivae Oi;
Terebinthinae ^iv;
Cerse Flavse §vi.
Melt the wax in the oils, and then add the turpentine and
8
86
POCKET FORMULARY.
strain the ointment. This is a most excellent application for
inflamed parts, &c.
Poke-root Ointment.
R.—Phytolacca Kadicis §iii;
Adipis ffii.
Boil for a quarter of an hour and strain. This ointment has
quite a reputation in Virginia, with the old ladies, for all kinds
of old sores and ulcers, and it is an excellent application to in¬
dolent and purulent ulcers and sores.
Br. Cato's Ointment for old Sores.
R.—Olei Olivse,
Sevi,
Terebinthinae,
Cerse Flavse, aa ^iii;
Cupri Sulphatis,
Acetatis, aa j|i.
Melt the first, second, and fourth articles together, and then
add the other ingredients, and stir until it cools. This is one of
the best ointments I have ever used on old indolent ulcers and
sores.
Ointment of Belladonna.
R.—Extracti Belladonnse gii;
Aquae Destillatse §ii;
Adipis ;jii.
Misce.—Employed by M. Chaussier, as a direct application to
the neck of the uterus in case of rigidity.
Ointment for Hydrocephalus.
R.—Hydrargyri Iodidi partes ii;
Potassii Iodidi " in;
Camphorse " ii;
Adipis " xxxii.
Misce et Signa.—To be rubbed on the head, in hydrocephalus;
in doses of half a drachm to a drachm.
Liniment for Burns.
R.—Olei Olivse,
Lini,
Aquae Calcis, aa !§i vel ii.
Misce bene.—This forms an excellent application for recent
scalds and burns.
APPROVED MEDICINES IN DAILY USE.
81
Volatile Liniment.
R.—Olei Olivse,
Aquse Ammonioa, aa 31.
Misce.—To be applied to bruises, rheumatic parts, &c., and
to the neck in inflammation of the throat.
Anti-rheumatic Liniment.
R.—Tinct. Opii,
Belladonnse,
Pulv. Camphorte,
Aquas Ammorriae,
Olei Terebinthinae,
Sassafras,
Origani, iia ^ii;
Tinct. Capsici Oi.
Misce.
Creasote Liniment.
R.—Creasoti gtt. x;
Olei Olivse §i.
Fiat Linimentum.—Used in herpes, &c.
CATAPLASMS OR POULTICES.
Cataplasms or poultices are modifications of fomentations.
They generally consist of pulpy substances, capable of absorb¬
ing moisture. They are chiefly intended either to act as
discutient, revulsive, or to promote suppuration. Poultices
should never be heavy, nor very bulky, but they should be fre¬
quently repeated when used as fomentations in colic and in in¬
flammation of the bowels, and they should be made with a
decoction of, hops or poppy heads, instead of water.
Mustard Cataplasm.
Take of Mustard one part; Corn-meal two parts; Vinegar
enough to make a cataplasm.
Cataplasm of Pepper, $c.
Take of Mustard two tablespoonfuls; Black Pepper and pow¬
dered Ginger, each two tablespoonfuls; Simple Syrup enough
to make a cataplasm.
88
POCKET FORMULARY.
To be applied to the region of the stomach in severe pain or
sickness, or to the soles of the feet when revulsion is required.
Emollient Cataplasm.
Take of ground Flaxseed and Corn-meal equal parts; Gou¬
lard's Extract of Lead gi; Water or Milk enough to make a
cataplasm.
The milk or water may be warmed if desirable.—Applied to
inflammatory tumors.
Yeast and Charcoal Cataplasm.
Take of Yeast a sufficient quantity, and thicken it to the
proper consistence with Charcoal and Slippery-elm Bark, finely
pulverized.
This is a very useful application to ulcers in a gangrenous
or mortified condition.
Alkaline Cataplasm.
Take of Lye, rather weak, warm it and stir in of Slippery-
elm bark, or Flaxseed, or Meal sufficient to form a poultice.
This is a most excellent poultice, and should be used more
than it is. It is useful in inflammation of the breast and other
parts, felons, wounds, fistulse, &c.
Discutient Cataplasm.
Make a very strong tea of White or Red-oak Bark, and thicken
with Corn-meal to the consistence of a poultice. Apply it as hot
as can be borne, and change it every two hours.
Another.
Take of Milk half a pint or more; of the inner bark of the
common Bay-tree Root a sufficient quantity to form a poultice.
The bark can be easily scraped or rasped off.
I have known this poultice to decrease inflammation of the
Abreast that looked impossible to be cured in any other way than
by suppuration. It should be applied two or three times a day.
In most cases it is best warm. Try it.
Emollient Cataplasm.
Take of White Lily Root four ounces; fat Figs and raw
Onions, bruised, of each one ounce; Yellow Basilicon Ointment
APPROVED MEDICINES IN DAILY USE.
89
two ounces; Corn Meal as much as necessary. Boil the root
along with the figs in a sufficient quantity of water, then bruise
and add to them the other ingredients so as to form the whole
into a soft cataplasm. Where it is necessary to promote sup¬
puration, this cataplasm may be used with great advantage.
Another.
Take of Meal half a pint; strong Beer-grounds a sufficiency
to form a poultice; then add one drachm of Camphor; dissolve
in half an ounce of Spirits of Turpentine. Mix well together.
To be applied as they are above.
Cataplasm of Alum, commonly called Alum Curd,
Is made by briskly agitating the whites of two Eggs with a
lump of Alum till a coagulum is formed.
It is useful in some cases of ophthalmia, when attended with
a watery excretion, if applied to the eye between two pieces of
linen rag. The alum curd has been found an efficacious remedy
applied to cuts, burns, and chilblains, previously to the skin's
cracking and becoming sore.
Saturnine Poultice.
Crumbs or slices of bread are to be soaked in lead-water,
which are afterwards to be simmered in an earthen vessel over
a gentle fire to a due consistence. To superficial inflammation.
This form of cataplasm may be used by making a dough of
corn-meal and lead-water.
FOMENTATIONS.
Fomentations are generally intended either to ease pain by
taking off tension and spasm, or to brace and restore the tone
and vigor of those parts to which they are applied. The first of
these intentions may generally be answered by warm water, and
the second by cold. Certain substances, however, are usually
added to water with a view to heighten its effects, as anodynes,
narcotics, astringents, &c. We shall, therefore, subjoin a few
of the most useful medicated fomentations.
Anodyne Fomentation.
Take of Laudanum four ounces; Water one pint; mix. For
R*
90
POCKET FORMULARY.
painful affections of the joints, as chronic rheumatism, &c.
Hops dipped in hot vinegar will answer as well.
Aromatic Fomentation.
Take of Ginger or Pepper and garden Jlint each one ounce ;
say Wine, or any kind of spirits, a pint. Boil them a little, and
strain the liquor. Pains of the bowels, which accompany
dysenteries and diarrhoeas, flatulent colics, uneasiness of the
stomach, and retchings to vomit, are frequently abated by
fomenting the abdomen or region of the stomach with the warm
liquor.
Strengthening Fomentation.
Take of Oak Bark, say two ounces ; Water three pints. Boil
the water with the bark to the consumption of one-third; then
strain the remaining decoction. This astringent liquor is em¬
ployed as an external fomentation to weak parts, to prolapsus
ani, &c.
There are a number more used in domestic practice, and fre¬
quently with good success, containing Jamestown Weed (Stra¬
monium), Mullein Leaves (Yerbascum Thapsus), Tansy, Pine
Tops, &c.
CLYSTERS.
This class of medicine is of more importance than is gene¬
rally imagined. Clysters serve not only to evacuate the contents
of the bowels, but as fomentations in inflammation of the blad¬
der and lower intestines, and also to convey very active medi¬
cines into the system when they will not sit upon the stomach,
Opium and Quinine, for example. We have cured many cases
of imperfect remittent fever, where the stomach could not retain
cold water, by injecting fifteen to thirty grains of Quinine with
fifteen drops of Laudanum, when the fever was at its lowest,
which is most frequently between 1 and 7 o'clock A. M. Here
I would remind young physicians of the importance of seeing
such patients between midnight and day. I have no doubt
many valuable lives have been lost from the lack of this pre¬
caution. Visits are generally made from 10 to about the time
that the fever is rising, and too late for the Quinine, so a day is
lost; and, what is worse, the true character of the disease is not
comprehended by the physician, and thus day after day the
fever rises and falls under a milk-and-water treatment, and
APPROVED MEDICINES IN DAILY USE.
91
patients finally succumb for the lack of a timely visit and pre¬
scription in the outset.
The following are some of the most effective clysters that we
know of, after considerable experience in the use of them:—
Common Clyster.
Take of Flaxseed Tea or Corn-meal Gruel from one to two
pints; Sweet Oil two or three ounces; Common Salt one tea-
spoonful ; Brown Sugar two tablespoonfuls. M.
Simple and Emollient Clyster.
Milk and Water in equal parts; Flaxseed Tea; Mallow Tea;
Infusion of Quince Seed; Barley Water; Mucilage of Gum
Arabic or Slippery Elm; thin Starch. Half a pint of either
of these should be administered a little more than milk-warm.
They are useful and efficacious where mere relaxing and emol¬
lient effects are required.
Purgative Clyster.
Take of Boiling Water one pint; Senna Leaves one ounce;
Coriander Seed, well bruised, one drachm. Infuse about one
hour in a covered vessel; strain; then add Salt one teaspoon-
ful; Molasses one tablespoonful. Stir until the salt is dis¬
solved. To be applied milk warm.*
Laxative Clyster.
Take of Epsom Salts two ounces, dissolve in a quarter of a
pint of warm gruel or broth, with an ounce of fresh butter or
sweet oil.
Anodyne Clyster.
Take of Starch, Jelly, or Water half a pint; Laudanum forty
drops. Mix. The whole to be injected in cases of dysentery,
violent purging, and pain in the bowels.-j-
* Dr. Chapman thinks in the advanced stages of disease that it is
always better to administer our medicines by injection, the rectum
then presenting a more susceptible surface than the stomach. In this
way, sometimes a cure is effected when the case seems desperate.
+ A pill of Opium inserted into the anus will frequently produce
the same good effect as injections of starch and laudanum.
92:
POCKET FORMULARY.
Anti-spasmodic Clyster.
Take of Tinct. of Assafcetida half an ounce ; Laudanum forty
drops; Gruel half a pint. Mix. For spasmodic affections of
the bowels.
Nutrient Clyster.
Take of good Beef Tea, thickened with Arrowroot, twelve
ounces. In cases of extreme debility of the body, or when the
patient cannot take food by the mouth, through some obstruc¬
tion in the throat, this affords considerable support to the sys¬
tem, and has been the means of preserving the lives of patients
till the cause has been removed. It should be thrown up with
a flexible tube longer than the clyster pipes in common use,
which should be gently introduced up the rectum.
Astringent Injections for Leucorrhoza and Gonorrhoea.
R.—Sulph. Zinci gr. x ;
Tinct. Opii gss;
Aquse Rosse ^iv.
Misce et Signa.—To be injected several times a day.
R.—Aluminis gr. x ;
Aquae Rosse §iv.
Misce et Signa.—To be used frequently.
R.—Aquse Destillatse !|iv;
Plumbi Acet.
Misce.
R.—Zinci Sulph.,
Plumbi Acet., aa ^iss ;
Aquse Dest. ^viii.
Solve. Filter, and use for injection.*
R.—Vini Rub. §vi;
Acidi Tannici gr. xviii.
Misce. Use as the above.
* In the treatment of leucorrhoea, care should be taken to ascer¬
tain whether inflammatory irritation exist about the uterus, and, if it
be present, to remove it by suitable treatment and regimen before
we have recourse to astringent injections.
APPROVED MEDICINES IN DAILY USE.
98
R.—Aquse Dest. giv;
Argent. Nit. gr. i ad xxx.
Misce.
R.—Liquor. Sodae Chlorinatae 51;
Aquse Dest. §iv ad y.
Misce et Signa.—Inject three or four times a day.
R.—Zinci Sulph. 31;
Plumbi Acet. gi;
Liquor. Sodas Chlorinatae gss ;
Sacchari Albi gi;
Pulv. Alum, gss;
Rosae Gallicse ^ss;
Aquae Destill. Oi.
Misce; simmer all gradually over a slow fire fifteen or twenty
minutes; strain, and when cold put into a bottle and cork tight.
To be injected two or three times a day.
R.—Hydrargyri Chloridi Mitis gi;
Pulv. Acaciae Zi;
Tinct. Opii f Jjss;
Aquae f^viii.
Fiat Mist.—For chronic gonorrhoea or gleet.
R.—Cupri Sulphatis gr. vi;
Aquae Destill. f^vi;
Tinct. Opii f ^i;
Fiat Solutio.—To be injected in chronic gonorrhoea.
R.—Acidi Pyrolignei %i;
Aquas Destill. ^viii.
Fiat Injectio.—To be injected twice a day, with a silver or
glass syringe, in gonorrhoea or purulent discharge from the
meatus auditorius.
R.—Catechu gr. xxi;
Aquae Destill. f sjvi.
Fiat Injectio.—To be used four or five times a day for the ear.
PART III.
MISCELLANEOUS MEDICAL INTELLIGENCE USEFUL
TO THE YOUNG PRACTITIONER.
SIGNS OF PREGNANCY.
The diagnosis in the early month is very difficult. Hence
the importance of being very particular in giving an opinion, or
administering medicine.
The first rational sign is suppression of the menses; but we
must remember that this cannot positively be relied upon.
There are other constitutional changes that are equally un¬
certain, viewed separately; but collectively they will assist in
forming a correct diagnosis. For instance, changes in disposi¬
tion and tastes; fainting, headaches, toothaches, palpitations,
&c.; buffy coat in the blood when drawn; altered function of
stomach and bowels; morning sickness; heart-burn; diarrhoea;
irritation about the bladder or rectum; oedema of the lower
extremities, one or both; change in the color of the skin, &c.;
movements of the foetus as felt by the mother at the time of
quickening and after, or by the practitioner through the abdomi¬
nal parietes; the areola and inflated state of the nipples. After
the fourth month, the souffle of the uterine circulation may be
heard ; and after the fifth, the short, ticking, double strokes of
the foetal heart; these last are a certain sign of pregnancy;
they average from 100 to 150 in a minute. The two other cer¬
tain signs of pregnancy do not occur until the seventh month ;
viz: the ability to feel the head of the child per vaginam, and
its movements through the abdomen.
MISCELLANEOUS MEDICAL INTELLIGENCE. 95
NATURAL LABOR.
Previous to any particular hints or directions, it is well to
remark that very few cases of labor need the interposition of
art. It would be well to remember this truth, and not make an
unnecessary display of ignorance by employing forceps and
other alarming instruments. In natural labor there are three
stages: the first commences with uterine contractions, and ter¬
minates with the full dilatation of the os uteri and rupture of
the membranes; the second terminates with the birth of the
child ; the third with the expulsion of the placenta.
SIGNS OF LABOR.
The pain attending it is of a peculiar character. A real
labor-pain is situated in the back and loins; comes on and goes
off regularly. A false pain is in the abdomen; comes and goes
irregularly; produces a pinching, griping sensation; has no
effect upon the os uteri, &c. The patient may sit up or walk
about as she pleases, until the os uteri be nearly dilated, when
she should lie down. The bed should be protected from injury
attendant on the discharges, by some thick folded covering; the
neatest method is Hodge's. (See Warrington, Obstetrician's Cate¬
chism.) The patient should have her night-dress drawn up, and
pinned around the waist to prevent it being soiled, and a sheet
pinned around the body should occupy its place. The usual ob¬
stetric position, in this country and England, is on the left side,
with the back turned to the accoucheur and the hips well towards
the edge of the bed, with the knees of the patient somewhat
drawn up. She should be allowed the support of a handker¬
chief, a rope, or twisted sheet fastened to the bed-post against
which her feet are fixed. It will be better to pass a short, round,
strong stick through the loop, that, with either hand, she may
pull with equal force during a strong bearing-down pain.
Should there be an inclination to pass anything from the
bowels or bladder, it should not be resisted.
After the bearing-down pains have continued some time, the
os uteri and passages are perfectly dilated, and the bag of water
comes low down, breaks, and is brought away ; the head of the
child almost immediately approaches the external parts. As
soon as the head enters the vagina, the abdominal muscles are
called into involuntary action, and the violent straining pains
96
POCKET FORMULARY.
of the second stage commence. Now is the time the patient
calls for help; and this is the time to help. As the child's
head, which is the part most frequently presented, begins to
protrude and press upon the perineum, the latter must be sup¬
ported with a soft cloth or a folded towel, applied to it with the
palm of the left hand; with the right hand we should ascertain
whether the cord be around the child's neck, &c. Let this slip
over the shoulders—the anterior one first. There is another mode
of supporting the perineum, which has many advantages, and I
invariably adopt it. It consists in so applying the right hand
that the thumb, when adducted, forms with the index finger the
letter V. Support is thus given with the palm of the hand, or
rather the fleshy part of the thumb, to the perineum, while the
thumb and forefinger protect either labium. A soft napkin
may be interposed to protect the hand. Let this pressure be
continued until the head emerges from the vagina. Let the
body of the child be expelled slowly; the uterus contracts better,
the placenta is more readily detached, and there is less liability
to hemorrhage. Support with the left hand the head and body
of the child, as they successively come into the world. As soon
as the child is born, bring it out from under the bed-clothes;
wrap it up in a warm cloth; a flannel petticoat is generally best
and most convenient. Wait till the cord has ceased to beat and
the child has begun to cry stoutly, before you apply the liga¬
ture to the cord. Generally there is no need of hurry. If the
child is healthy, it will begin to breathe, and with its first
breath will begin to cry. When the action of the lungs is well
established by the child's crying, tie the navel-string closely
with a piece of narrow tape twine, or any convenient string,
about two inches from its abdomen, and another more distant,
and cut between them, and very carefully deliver the child to
the nurse. Lay your hand upon the abdomen to ascertain if
there is a second child ; if so, the uterus will be found nearly as
large as before labor; if not, it will be contracted to the size
of the child's headf or smaller. If there be a second child, its
expulsion must be conducted on the same principle as that of
the first; during all of this time you should not forget the first
child. See that it is washed tenderly, and dressed quickly and
properly.
The membranes of the twin may be ruptured in the course of
half an hour, or when they protrude, for the passages are per¬
fectly dilated, and there is always danger that the placenta of
the first child may become separated and cause hemorrhage.
This fact must not be forgotten.
MISCELLANEOUS MEDICAL INTELLIGENCE. 91
Should the second child present with the arm, back, or shoul¬
der, turning should be performed immediately; otherwise wait
four hours for the uterus to contract before interposing art,
unless in cases where hemorrhage or any other circumstances
demand immediate delivery.
During the first hour after labor, ascertain every now and
then, whether the fundus be contracted, otherwise we are never
secure against hemorrhage, especially internal. So long as the
placenta is retained, there is more or less danger of hemorrhage.
If long retained, the passage will have contracted so as to make
the removal difficult and dangerous. For these reasons the
placenta should not be suffered to remain in the uterus for more
than an hour and a half or two hours after birth of the child.
Grasp the uterus gently with the hand through the integu¬
ments, and use slight friction upon the fundus. This will, in
many cases, be sufficient to produce contraction of the womb,
and expulsion of the secundines.
Should this fail, you should, in the course of ten or fifteen
minutes, wind the navel string around the first two fingers, and
gently draw upon it for a moment or two. (Be very careful not
to break it.) Introduce the examining finger, and if you can
reach the insertion of the cord, the placenta is, in all probability,
detached. Press it backwards into the hollow of the sacrum,
and then bring it gently forward in the direction of the vagina.
As it approaches the os externum, twist it round three or four
times; the membranes will thus come away without laceration.
Should this fail, the hand, well lubricated on the outer sur-
fnce, is to be introduced into the uterus. The placenta should
not be withdrawn suddenly, but the uterus should be suffered
to expel it with the hand by its own contractions. Examine the
secundines after removal, to see if they are entire, and ascertain
that the uterus is well contracted. The next thing, say after
the lapse of ten or fifteen minutes, is to turn the patient, so
that dry cloths can be neatly placed over those which were
soiled during labor; and the bandage should be unfolded and
brought smoothly down on the back and applied.
If the uterus has well contracted into a small globe, it will not
be necessary to apply the bandage very tightly; but if the uterus
appear indisposed to contract firmly, or if there be any signs of
hemorrhage, it will be proper to draw the bandage tightly over
the patient's pelvis and lower part of the abdomen. It is best
to begin the tightening of the bandage from below upwards.
Unless she has been greatly prostrated by long and violent
labor, or by hemorrhage, it is best, as soon as convenient, to
have the patient placed comfortably upon the dry part of the
Q
98
POCKET FORMULARY.
bed, the place prepared for her to lie in after delivery. This
being done with as little fatigue as possible, she should be sup¬
plied with some cool drink or light nourishment. She should
not be allowed to rise up for any purpose for several days. Her
nourishment should be given her from a spout-cup, or a tube,
or from a spoon. She should take a dose of castor oil, or cal¬
cined magnesia, on the third day, if necessary. If after pains
occur, you should always inquire into the cause before prescrib¬
ing for them, as the indication of treatment differs greatly. If
they depend upon the condition of the nervous system, you
should give anodynes, such as camphor, morphia, &c. If they
depend upon irritation in the bowels, as flatulence, feces, &c.,
direct warm injections. If the patient is very feverish, bleed.
If dependent upon the want of tonic contraction of the uterus,
give ergot.
CARE OF THE CHILD.
The child should be anointed with lard and sweet oil, in order
to remove a white scurf which more or less covers the skin of a
new-born infant, and which soap alone will not remove. The
soap should be mild, bland, and not strongly alkaline. When
the scurf is well rubbed with the oil, wash the whole body with
soap and lukewarm water, taking care not to wash the eyes with
the same cloth with which the body was washed. Bind up the
navel-string as you would a sore finger, being careful that the
navel shall protrude through the aperture in the centre of the
covering, lay it against the belly, and put a band around the
bowels to keep it securely. If you grease it at all, simple lard
is the best application. Do not use any medicated ointments,
or apply burnt cotton to the part. I believe that two-thirds of
the cases of tetanus that we meet with in children from one to
two weeks old are produced in this way.
After putting on the belly-band or roller, the child may be
dressed according to the desire of the mother or friend, provided
it be done quickly, and the clothing be such as to keep the child
sufficiently warm, and allow it the necessary freedom of motion.
As soon as this is done, and the mother made comfortable, the
child should be put to the breast, that the instinct with which
children are born may not be lost, and because the earlier the
child is put to the breast the more fully does the uterus con¬
tract, the sooner is the milk secreted, the more easily does the
child draw out the nipple, the sooner is the meconium purged
off, and the less chance will there be of the mother suffering
MISCELLANEOUS MEDICAL INTELLIGENCE. 99
from milk fever, sore nipples, distended, painful, and knotty
breasts, milk abscess, or the child from flatulence, disordered
stomach and bowels, aphthse, &c. In most cases, it will be
necessary to give the child one or two teaspoonfuls of pure olive
oil. Always examine the oil before it is given, as most of the
sweet oil kept in the shops is more poisonous and griping than
the meconium. In some healthy mothers, particularly in first
confinement, there is a deficiency of milk until the third or
fourth day after delivery; in such cases it must be supplied by
an artificial diet as like the breast milk as can be secured. (See
Dietetic Preparations.) A few spoonfuls are to be given through
the sucking-bottle. This will secure the infant's stomach from
repletion. The breast milk being in a few days fully esta¬
blished, and furnished in sufficient quantity, this artificial food
is to be put aside, and the child is to obtain its nourishment
from the breast alone. A teaspoonful of water every morning
will frequently prevent the thrush, a very common and trouble¬
some disease of children.
When the meconium lodges in the intestines more than twenty-
four hours, it produces much disturbance. The child is griped,
screams much, and refuses the breast; and both mother and
nurse become so annoyed or distressed by it as to be tempted to
resort to some artificial means of quieting it, as by giving it
warm tea, such as catnip, aniseed, &c.; or, under an impres¬
sion that it is hungry, will feed it with gruel, bread, and water,
or boiled crackers, &c. &c. Physicians should inquire into all
these things, so as to avoid such difficulties. However, when
such cases occur, two grains of Sodse Carb. in a teaspoonful of
warm water, and repeated p. r. n., will give relief.
After the first week, where the bowels are constipated and
unhealthy in color, the following laxative will be useful:—
R.—Hydrarg. cum Creta,
Sodse Carb., aa gr. ii.
M. ft. pulvis.
"Where there is diarrhoea, with unhealthy watery evacuations,
you will find relief from—
R.—Hydrarg. cum Creta,
Pulv. Rhei, aa gr. ii.
M. ft. pulvis.
Where the diarrhoea is very severe, and the child appears in
a state of collapse, use the following enema with the above
mentioned powder:—
100
POCKET FORMULARY.
|&.—Amyli 3i ;
Tinct. Catechu gtt. xv—xxv.
Ft. enema.
Five drops of Tinct. Opii may occasionally be substituted for th
Catechu, or added; but opium in any form "with young chil
dren is a dangerous remedy, and requires careful watching.
It is an alarming truth, that the bills of mortality show tha
one child in five dies within a year after birth, and one in thre
before the completion of the sixth year. In some great citieE
the rate of mortality is still more frightful; in others it ma,
not be so great; but whatever it is, it might be greatly dimi
nished, if the family physician would feel it his duty to instruc
the mother as much how to nurse, clothe, and manage her child
at least till after the teething stage, as how to wash and cloth
and manage it immediately after birth—a duty which strike
my mind as equally imperative, and, were it faithfully die
charged by all family physicians, would result in much good.
The distress of witnessing a suffering infancy cut short by a
early death, just as the dear little child, the father's pleasure
the mother's life, was beginning to reward all their cares an
anxiety, might be prevented in hundreds of cases. Then pet
mit me, young doctors, to entreat you to acquire a thoroug
familiarity with all the diseases of children, rules of nursing
clothing, dieting at different ages, &c., and to discharge you
whole duty fearless of consequences, even if you should thu
offend some good, kind old grandmother that was brought u
under the vulgar errors in nursing, and would have the child t
eat a little morsel of everything, and the mother to eat to pre
vent it from getting sick.
It will not be expected that, in a small book like this, I shoul
give in full the rules for the nursing, clothing, and managemen
of children; hence, I shall merely give a few hints on some point
which require more than usually grave consideration.
OF MOTHEKS WHO OUGHT NOT TO SUCKLE.
There are some women who ought never to undertake th
office of suckling, not so much on account of their own healt
as on account of that of their offspring.
A woman who has a consumptive and strumous taint in he
constitution should not suckle her infant. No fact in medicin
is better established than that which proves the transmissio
from parents to children of a constitutional liability to pulmt
MISCELLANEOUS MEDICAL INTELLIGENCE. 101
nary disease, and especially to consumption; and if the infant
be nourished from such a parent, this hereditary predisposition
■will be confirmed in a majority of cases. Mothers of a highly
susceptible nervous temperament, who are excited and agitated
by the ordinary occurrences of the day, will do their offsprings
more harm than good by attempting to suckle them, as their
milk will be totally unfit for healthy nourishment. Children
have frequently died, shortly after nursing, in cases where the
mother has previously been under great excitement. The habit
of passively yielding to every transient emotion—a habit en¬
tirely too common among certain women—should, in view of the
grave effects attending it, be especially guarded against; self-
control should be carefully cultivated. The mother who only
nurses her infant when it suits her convenience, ought not to
engage in this duty at all. With such a mother, if the child
does not sicken, pine, and die, it will not have to thank her for
its good fortune.
The child, then, under the foregoing circumstances, should
be provided with its support from another source, and it is the
physician's duty to suggest the best of all sources—a wet-nurse.
This being decided on, his next duty is to give instructions con¬
cerning the qualities she must possess.
OF A WET-NURSE.
The first point to be inquired into is her general health. A
wet-nurse should be clean, healthy, sober, and temperate. Next,
the condition of her breast—the quality of her milk—its age,
and her own. Her milk should not be more than two or three
months old, and she should be middle-aged, because, at this
period, she will have more milk than the very young, and more
and better milk than the old. If the milk be too old, the infant
suffers from the oppression of food too heavy for its digestive
power. In fact, such milk has been observed to be very injuri¬
ous.
As to the diet of the wet-nurse, it should not differ much
from that to which the individual has been accustomed. It is
erroneous to suppose that a woman, when nursing, requires to be
much more highly fed than at other times. She should be pro¬
vided with a wholesome mixed animal and vegetable diet, and
a moderate quantity of malt liquor, in case the latter be found
necessary. As a general rule, however, porter, wine, or any
stimulant is quite unnecessary if she be in sound and vigorous
9*
102
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health. I very much suspect that the process of teething, in
some cases, is rendered painful and difficult by the stimulants
taken by the mother or nurse.
GENERAL DIRECTIONS.
The nurse should take exercise daily in the open air. Spong¬
ing the whole body with cold water with salt in it, every day or
two, should be insisted upon if possible. She should never be
allowed to have medicines of any kind at her command, to ad¬
minister to the child whenever she may think proper. Children
have frequently been destroyed by the nurse giving them lauda¬
num to secure for herself a good night's repose.
RULES FOR NURSING THE INFANT.
The Plan to be followed until the first Teeth, appear.—For a week
or ten days the appetite of the infant must be the mother's or
'the nurse's guide as to the frequency in offering the breast.
The week or ten days having expired, the infant is to be
nursed until the end of the lying-in month, at regular intervals
of every four hours, night and day. This will allow sufficient
time for each meal to be digested and the stomach to regain the
time necessary for the digestion of the next, and tend very
essentially to promote the due and healthy action of the bowels.
The lying-in month having expired, it is advisable to alter
the periods of night-nursing, or rather to do away with night-
nursing altogether ; that is, to suckle the infant as late as ten
o'clock P. M., and not put it to the breast again until about
five o'clock the next morning.
If parent or nurse be a healthy woman, the quantity of milk
supplied by the breast will generally be found sufficient to afford
adequate nourishment to the child without additional nourish¬
ment. If, however, after the expiration of some months, a de¬
ficiency should exist, it must be made up by the mixture of
cow's milk and water, and of this alone; if it agrees with the
child, it must be given too through the sucking-bottle until the
teeth appear, after which time an alteration in the kind of food
and the mode of exhibiting it may be adopted.
In the choice of food, the mother should be guided by the ad¬
vice of her physician and circumstances; the physician should
be guided by the condition and health of the child, and not by
MISCELLANEOUS MEDICAL INTELLIGENCE. 103
another child, because it was of the same age. There are many
other points in the rules of the nursery that the physician should
instruct mothers in, but the above are the most important, and
should be observed until the infant is weaned entirely from the
breast, which should generally take place between the ninth and
twelfth month. It should be effected gradually.
Bathing and Cleanliness.—It is also the duty of the family phy¬
sician to instruct the mother how to bathe her child. Too much
attention cannot be paid to cleanliness—it is essential to the
infant's health, when properly done. The principal points to
which especial attention should be paid are the following:
Temperature of the water. In the early weeks of the infant's
life it should, as soon as taken from its bed in the morning, be
washed in warm water, from 96° to 98°, and be put into a bath
of the same temperature for a few minutes every evening before
it is put to rest. To bathe a delicate infant of a few days or
even weeks old in cold water, with a view to "harden" the con¬
stitution (as it is called) is the most effectual way to undermine
its health, and entail future disease. By degrees, however, the
water, with which it is sponged in the morning, should be made
tepid—the evening bath being continued warm enough to be
grateful to the feelings.
A few months having passed by, the temperature of the water
may be gradually lowered until cold is employed, with which
it may be either sponged or even plunged into it every morning
during summer. If plunged into cold water, however, it must
be kept in but a few minutes, for, at this period especially, the
impression of cold continued for any considerable time, de¬
presses the vital energies and prevents that healthy glow on the
surface which usually follows the momentary and brief action
of cold, and upon which its usefulness depends; with some
children, indeed, there is such extreme delicacy and deficient
reaction as to render the cold bath hazardous—no warm glow
over the surface takes place, when its use inevitably does harm;
its effects, therefore, must be carefully watched.
Drying the Skin.—The surface of the skin should always be
carefully and thoroughly rubbed dry with flannel; indeed, more
than dry, for the skin should be warmed and stimulated by the
assiduous gentle friction made use of. For this process of
washing and drying must not be done languidly, but briskly and
expeditiously, and will then be found to be one of the most
effectual means of strengthening the infant. It is especially
necessary carefully to dry the armpits, groins, and nates ; and,
if the child is very fat, it will be well to dust over these parts
with hair-powder or starch contained in a muslin bag. This
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prevents excoriations and sores, -which are frequently very
troublesome. Soap is only required to those parts of the body
which are exposed to the reception of dirt.
If a child is of a delicate and strumous constitution, the cold
bath during the summer is one of the best tonics that can be
employed, provided it is succeeded by a glow, a feeling of in¬
creased strength, and a keen appetite; if not, it ought at once
to be abandoned for the warm or tepid bath. The opinion that
warm baths generally relax and weaken is erroneous, for in all
cases, when properly employed, they give tone and vigor to the
whole system ; just as the cold bath does to the more robust,
and those that it suits. This should be remembered by physi¬
cians, and not allow mothers to bathe their little delicate babes
in cold water, simply because some kind friend had been in and
advised it, because her fine, fat, strong boy had been taking it
every morning, and, of course, improving every hour. The
above hint is dropped merely to remind young physicians that
every case should be treated according to its symptoms and
circumstances, and by the rules as laid down under the " Art of
Prescribing Medicines."
CLOTHING.
Infants are very susceptible of the impressions of cold. A
proper regard, therefore, to a suitable clothing of the body is
essential to their enjoyment of health. Unfortunately, an
opinion is prevalent that the tender child has naturally a great
power of generating heat and resisting cold, and from this popu¬
lar error have arisen the most fatal results; therefore, the phy¬
sician cannot too often make it known to mothers that children,
instead of being warmer than adults, are generally a degree or
two colder, and, moreover, part with their heat more readily.
These facts show how absurd must be the folly of that system
of " hardening the constitution and showing off," which induces
some parents to expose their dear little children to the cold,
cutting currents of an easterly wind in the lightest clothing.
It is as cruel as absurd.
The leading principles which a physician should give a patient
to guide her in clothing her infant, are as follows:—
The material and quantity of the clothes should be such as to
preserve a sufficient proportion of warmth to the body, regu¬
lated, therefore, by the season of the year and the delicacy or
strength of the infant's constitution.
MISCELLANEOUS MEDICAL INTELLIGENCE. 105
They should also possess lightness as well as warmth, and
therefore flannel and calico are the best materials to use.
They should be so made as to put no restrictions on the free
movements of all parts of the child's body—loose and easy, as
the babe can itself give no explanations of the inconveniences it
suffers.
The clothing should be changed daily ; this is eminently con¬
ducive to health.
With regard to caps, I am at a loss to speak. I think, how¬
ever, it is one of the old customs that should be continued;
they should be made of thin material, with no under cap. The
head is to be kept cool, not warm. As soon as the hair begins
to grow, provided it is not very cold weather, caps may with
advantage be left off altogether, night as well as day.
The change in short clothing should always be avoided in cold
weather.
Notwithstanding all the rules of nursing and the manage¬
ment of children may be closely observed by the mother, accord¬
ing to the direction of her physician, children will sometimes
get sick, and, very wisely, the doctor is sent for; therefore it
will not be thought amiss to drop a few hints on the
SIGNS OF DISEASE.
The signs of disease are manifested separately by the counte¬
nance, the breathing and cough, the manner of sleep, in the
cry, the gestures, and in the stools.
The Countenance.—In health, the countenance of a child is
expressive of serenity in mind and body; but, if the child be
unwell, this expression will be changed, and in a manner which,
to a certain extent, will indicate what part of the system is at
fault. The brows will be contracted if there is pain, and its
seat is in the head. This is frequently the very first outward
sign of anything being wrong, and will occur at the very onset
of disease ; if, therefore, observed at an early period, and pro¬
per remedies used, its notice may prevent one of the most fear¬
ful of infantile complaints.
But if this sign or symptom is passed by unheeded, and the
above disease be threatened, soon the eyes will become fixed and
staring, the head hot and moved uneasily from side to side upon
the pillow, or lie heavily upon the nurse's arm; the child will
start in its sleep, grinding its teeth, and awake alarmed and
screaming; its face will be flushed, particularly the cheeks, as
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if rouged; its hands hot and feet cold ; its bowels obstinate.'
costive, or its motions scanty, dark-colored, and foul.
If the lips are drawn apart so as to show the teeth or gum
the seat of the pain is in the bowels. This sign, however, w:
only be present during the actual existence of suffering; 3
therefore, there be any doubt whether it exist, press upon tl
stomach and watch the effect on the expression of the count
nance. If the pain arise simply from irritation of the bowel
excited by undigested matter, it will be temporary, and the sij
will go and come just as the spasm may occur, and slight rem
dial measures will give relief. If, however, the disease be mo
serious, and inflammation ensue, this sign will be more co
stantly present, and soon the countenance will become pale
sallow and sunken; the child will dread motion, and lie up
its back, with the knees bent up to the belly; the tongue w
be loaded; and in breathing, while the chest will be seen
heave with more than usual effort, the muscles of the be!
will remain perfectly quiescent.
If the nostrils are drawn upwards, and in quick motion, p£
exists in the chest. This sign, however, will generally be t
accompaniment of inflammation of the chest, in which case, t
countenance will be discolored, the eyes more or less starii
and the breathing will be difficult and hurried; and, if t
child's mode of respiring be watched, the chest will be observ
to be unmoved, while the belly quickly heaves with every :
spiration.
Convulsions* are generally preceded by some changes in 1
countenance. The upper lip will be drawn up, and is occasi<
ally bluish or livid. Then there may be slight squinting, o
singular rotation of the eye upon its own axis, alternate flushi
or paleness of the face, and sudden animation, followed by li
guor. These premonitory signs will sometimes manifest the
selves many hours, and sometimes days, before the atts
occurs ; and, if noticed in time, and suitable medical aid be
sorted to, the occurrence of a fit may be altogether preventei
The state of the eyes should always be attended to. In hea
they are clear and bright, but in disease they become dull, s
give a heavy appearance to the countenance; though, after 1<
* During teething, convulsions are more frequent than at
other period; not that they so commonly arise from the irrital
caused by the cutting of a tooth, as is generally thought, for i
more often the result, even at this time, of irritation of the bow
from some error in diet, which is the great source of convuli
affections.
MISCELLANEOUS MEDICAL INTELLIGENCE. 107
continued irritation, they will assume a degree of quickness
which is very remarkable, and a sort of pearly brightness which
is better known, from observation than it can be from descrip¬
tion. The direction of the eyes, too, should be regarded; for
from this we may learn something. When the infant is first
brought to the light, both eyes are scarcely ever directed to the
same object. This occurs without any tendency to disease, and
merely proves that regarding one object with both eyes is only
an acquired habit. But when the child has come to the age
when the eyes are by habit directed to the same object, and
afterwards it loses that power, this circumstance alone may be
looked upon as a frequent prelude to disease affecting the head.
THE BREATHING.
The breathing of a child in health is formed of equal inspira¬
tions and expirations, and it breathes quietly, regularly, inaudi-
bly, and without effort. But let inflammation of the air-tubes
of the lungs take place, and the respiration will become in a
few hours so quickened and hurried, and perhaps audible, that
the attention has only to be directed to the circumstance to be
at once perceived. Now all changes which occur in the breath¬
ing from its healthy standard, however slight the shades of
difference may be, it is most important should be noticed early.
For many of the complaints of the chest, although very formid¬
able in their character, if only noticed early by the physician,
may be arrested in their progress, but otherwise they may get
beyond the control of art. Physicians should make themselves
acquainted with the breathing of children in health, and they
will readily mark any change which may arise in disease. A
cough should also be noticed. Hoarseness is generally a pre¬
monitory symptom of croup ; a disease excessively rapid in its
progress, and requiring the most prompt and decided treatment.
THE SLEEP.
The sleep of an infant in health is quiet, composed, and re¬
freshing. In very early infancy, when not at the breast, it is
for the most part asleep in its cot; and although, as the months
advance, it sleeps less, yet when the hour of repose arrives, the
child is no sooner laid down to rest than it drops off into a quiet,
peaceful slumber. Not so if ill. Frequently it will be unwil-
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ling to be put into its cot at all, and the nurse will be obliged
to take the infant in her arms. It will then sleep but for a
short time, and in a restless and disturbed manner. If it suffer
pain, however slight, the countenance will indicate it, and as
when awake so now. If there is anything wrong about the
head, the contraction of the eyebrow and grinding of the teeth
will appear ; if anything wrong about the bowels, the lips will
be drawn apart, showing the teeth or gums; and in both in¬
stances there will be great restlessness and frequent startings.
THE STOOLS.
The stools of a healthy infant will be of a lightish yellow
color, the consistence of thin mustard, having little smell, smooth
in appearance, and therefore free from lumps or white curded
matter, and passed without pain or any considerable quantity
of wind. And, as long as the child is in health, it will have
daily two or three, or even four of these evacuations. But, as
it grows older, they will not be quite so frequent; they will be¬
come darker in color, and more solid, though not so much so as
in the adult.
Any deviation, then, from the above characters is, of course,
a sign of something wrong; and, as a deranged condition of the
bowels is frequently the first indication we have of approaching
disease, their appearance, color, and the manner in which they
are discharged are the points principally to be inquired into by
physicians. If the stools have a very curdy appearance, or are
too liquid or green, or dark-colored, or smell badly, they are
unnatural. And it should be borne in mind that, in a healthy
child, the motion is passed with but little wind, and as if squeezed
out; but in disease it will be thrown out with considerable force,
which is a sign of great irritation. The number of stools passed
within the four-and-twenty hours it is important to note.
THE CRY.
By crying, the infant, for the most part, manifests its sensa¬
tions and wants. A physician, therefore, should learn to dis¬
tinguish with accuracy that cry which denotes hunger, and that
which proceeds from pain and other causes. It is important
for a young physician to make himself acquainted with this
subject, and not believe that it is all "guess-work, as it regards
MISCELLANEOUS MEDICAL INTELLIGENCE. 109
the complaints of young children, because they can't explain
anything," to use the language of Dr. Meigs. " I feel more at
home in asking a child -what is the matter with it than in ask¬
ing an adult. I can always know what is the matter with a
child, for it never misleads me ; but men and women constantly
mislead me, or endeavor to do so. And so they will you, my
young doctor; and if you don't wish to show your credulity,
which in our profession, is ignorance, you must < keep a good
look-out' for the truth."
The cry of pain and suffering is variously expressed. If a
child that is usually placid and cheerful gets fretful, fractious,
and crying, with its fingers continually going to its mouth, this
denotes toothache and pain, caused by a coming tooth press¬
ing against a tender and inflamed gum.
If a child not accustomed to cry much, on some occasion is
perpetually crying, this denotes some continued recurring pain¬
ful sensation somewhere.
If a child cry violently loud, with frequent intervals of rest,
and at the same time drawing up its legs towards its body, it is
a sign that it is suffering from disorder and pain in the bowels.
If a child cry violently, as if it would go into convulsions,
you may venture to say perhaps it has the earache. But, be¬
fore you apply the remedy, apply Dr. Meigs's diagnostical test,
which is to put the pulp of your thumb on the meatus audi-
torius, and suddenly press the cartilaginous tube inwards upon
the ear, and, if it cry violently, you may know you are right,
and direct your efforts to cure the suffering baby.
If a child has pain in the head, there will be an occasional
scream, short, sharp, and quick.
If a child has pain in any of its joints, it will cry occasionally
only, which will coincide with some spontaneous or forced mo¬
tion of the joint.
If a child have a disease of the lungs, it will utter a peculiar cry;
this will be modified by the modification of the respiratory move¬
ment involved in the pulmonary disease. In like manner will it
tell if the pain be in the urinary bladder or lower part of the
rectum. I can't describe the sound; but every doctor ought to
know it, for in this way nature speaks the truth.
The following observations by Dr. Meigs are so strikingly
illustrative of my present purpose that, although I fear I am
making my little book too large for the pocket, I cannot refrain
from inserting them here : " The brain speaks, the lungs, the
stomach, the bowels, the teeth, the joints, the marrow, the
organs of the senses—each has a language of its own; so that
the body may be compared to a great polvelot. since so many
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organs as it hath so many vernaculars hath it. There is a rich
mine of diagnosis in the physiognomical expressions of the hu¬
man face, but no man can write them ; an artist may paint, but
no print can print them; he that would possess the wealth of
such treasures must dig for them himself in the clinical mine.
One may look through the eyes down into the soul, into the
most intimate life-cell, and read its expression there, because
the cerebrospinal axis and the ganglionic nerves often express
their patible conditions clearly and plainly through the eyes.
The whole temper of man, moral and intellectual, as well as
physical, is written in legible characters upon his countenance.
" There is nothing more common among men than to trust or
abhor their brethren upon the faith of their physiognomical
expression as to intelligence, as to probity, as to purposes. In
like manner, his health and security, and his prospects as to
life and death are discoverable by a glance at his face, gesture,
or decubitus."
INQUIRIES CONCERNING THE SICK-ROOM.
Choice and Furnishing of the Sick-room.—In every case of dis¬
ease, however slight its nature, the sleeping apartment of the
sick should be airy and well ventilated, and, if possible, large,
lofty, and with a northern aspect, in order to avoid the heat of
the mid-day or the afternoon sun; the windows should be capa¬
ble of being opened by drawing down the uppermost sash, an
advantage however, which cannot always be obtained. No room
should be used in cities as a sick-room, unless it has a chimney,
but neither the chimney-board nor soot-board of the apartment
should be put up even in summer. No article of unnecessary
furniture should be permitted to remain in the room, and that
which is left in it should be of a description fitted to administer
to the convenience of the invalid.
Two tables are sufficient—one of them may be small, the
other large, for the accommodation of medicines not in im¬
mediate use, and also for spare glasses and other necessary
articles. A sofa, if the apartment be sufficiently large to admit
of it, is a very important piece of furniture in the sick-room;
the erect or the sitting posture being injurious, in many dis¬
eases, and when the sick-bed requires to be made, a sofa
affords the means of removing the patient from the bed with as
little inconvenience to him as possible.
If there is not space for a sofa, there should be an invalid or
reclining-chair; and when circumstances will permit, it should
MISCELLANEOUS MEDICAL INTELLIGENCE. Ill
be of that kind which is susceptible of a variety of changes so
as to vary at pleasure the position of the patient. There should
not generally be more than two other chairs in the room. If
there be a looking-glass in the apartment, it should not be in a
situation which admits of the patient's seeing himself.
The washing-stand will require two additional basins, a tum¬
bler, and a large bucket or jug under the table, always full of
water.
There should be no kettle nor any implement of cooking in
the sick-room, even in winter, and when a fire is required.
A carpet over the floor is best; when there is no carpet the
floor should be swept, never washed. An invalid may as well
sleep in a swamp as in a room the floor of which is frequently
washed.
The French bedsteads, without curtains, are those best
adapted for the sick-room.
Ventilation is always of primary importance; it is particu¬
larly demanded in those fevers in which miliary eruptions dis¬
play themselves. Under no circumstances is it so essential as
in febrile diseases of an infectious kind, such as smallpox and
scarlet fever.
Next to ventilation nothing is of more importance than the
regulation of the temperature of the sick-room, avoiding both
extremes of elevation or of depression; but much depends on
the nature of the disease.
The best general temperature of a sick-room is 60° F., and
it is preferable to regulate this rather by the thermometer than
by the sensation of the patient or the nurse. So important is the
regulation of the temperature, especially in fevers, that it often
does more good than any other remedial measure. I have seen
patients laboring under high delirium in a close, ill-ventilated
room, become rapidly quite collected by merely lowering the
heat of the apartment twelve or fifteen degrees. On the con¬
trary, even a moderate depression of the usual temperature of
the sick-room, in pulmonary disease, will excite coughing and
augment the severity of all symptoms. The temperature is too
little attended to by physicians generally.
In convalescence the temperature of spring and autumn
ought to be maintained as near as possible, at 55° to 60° F.
The air of sick-chambers should be frequently renewed.
Cleanliness in the sick-room is also essential, yet it may be
carried so far as to become an annoyance to the invalid, and,
consequently to prove injurious. It is not requisite to sweep
the room daily, or to dust and to arrange the furniture every
morning, provided order be preserved in the room, and nothing
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but what is immediately necessary for the comfort and conveni¬
ence of the invalid be permitted to remain in it.
The period generally chosen for cleaning and arranging the
sick-room, should be the morning, as after a night's rest the
patient is more able to bear the little noise and bustle which it
always more or less occasions.
Some very excellent people are in the habit of neglecting this
duty until the doctor rings the bell, or knocks at the door; then
everything being out of place, they go to work to place them,
like a chicken with its head off, first against the bedpost then
over a chair, and all over the room. The doctor comes in and
finds his patient confused and excited, the pulse quick, and if
he is not a good judge of the pulse and countenance, so as to
detect the cause of the excitement, he will perhaps bleed, and
if he surmises the cause, it detains him perhaps half an hour
longer than would have been necessary if the patient had not
been thus excited. So you see, my young doctor, that this is
all wrong. Yes, you say it is; but ask me whose business is it
to correct these little errors that are attended with so much
danger and inconvenience? I say it is the doctor's business;
your business so far as your practice extends. You ask me
then how you are to do it. I will tell you, it is the easiest thing
possible. In the first place, when you are called to visit the
sick, always go, and with a pure motive to do, if possible, what
you have been sent for to do—to cure or relieve the suffering ;
then, the first time you see anything done that is to the injury of
the patient, take the friend or friends out, say in a very courteous,
polite manner, that such and such things should not be done.
If you see it again, tell them politely, but positively that it must
not be. done. If you discover it the third time, take the friends
out and tell them that the patient is very ill, and for his reco¬
very it is important for your directions to be carried out, not
only in giving the medicines at stated periods, but also in
every other particular, and if it cannot be done you will be
compelled to request them to relieve you and procure the ser¬
vices of a doctor who practices alone for money. This is best
spoken in the softest and mildest tone and manner. Adopt
this course, and you will have but few difficulties, and your end
will be peaceful.
If it should be necessary to hire a sick-nurse, it will be ex¬
pected from you to give some instructions on the qualifications-
which a nurse should possess. On this subject I shall merely
say that a nurse should be not under twenty-five or over fifty
years of age ; strong, healthy, of good temper, obliging disposi¬
tion, clean and neat in her person, of sober habits, and not dis-
MISCELLANEOUS MEDICAL INTELLIGENCE. 113
posed to gossip, and good-looking if possible; but a good nurse
should not be refused because she is homely, although we do
think good looks a recommendation anywhere, and particularly
in a nurse. Nothing sinks deeper in the minds of nervous in¬
valids than an ugly, harsh look from the nurse. Hence doctors
should advise those good, efficient, old, homely nurses that what
they lack in beauty they make up in cheerfulness and winning
smiles.
Having arranged the sick-chamber to your notion, procure a
suitable nurse, and, of course, understand the temperament,
habit, idiosyncrasy and disease of your patient. His fever rises,
and it becomes necessary to bleed, cup, or leech him. I ima¬
gine I hear some young doctor, who is yet to see his first patient,
say: " A few hints on these points, if you please." I would ad¬
vise the friends of that young man to give him a trial; I will
vouch for his doing all he does do right. It would be well for
all young physicians to remember an old but true adage: "The
first impression is the most lasting."
OF PHLEBOTOMY OR BLOODLETTING.
The operation of bleeding being so frequently performed by
planters, it is generally regarded by the public as a very trivial
operation; but this is a mistake, as it is a very important opera¬
tion, and hence many expert surgeons have almost an invincible
dislike to it, while the person ignorant of the great nicety, steadi¬
ness, and exactness necessary, as well as its effects on the con¬
stitution, perfoi'ms it with the greatest freedom, but not with
uniform success, as is proved by the many melancholy cases of
wounded tendons and punctured arteries that are met with by
physicians, and admitted into our hospitals.
Bleeding is usually performed at the bend of the arm, and
the vein selected should, if possible, be the median-cephalic
fthat which runs from the centre of the bend towards the outer
side of the arm). This vein is not only more safe and conveni¬
ent for opening, but the blood flows more freely from it, which,
in many acute diseases, is of great consequence; for it is a well-
established fact that the speedy extraction of a few ounces of
blood is more beneficial than double the quantity taken slowly
from a small vein or orifice.
The person being properly seated in a good light, a ligature
or bandage of tape or ribbon should be tied round the upper
arm a little above the elbow, say about three fingers' breadth,
10*
114
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sufficiently tight to compress the veins so as to prevent the re¬
turn of blood, but not so tight as to prevent its passing by the
brachial artery, for after the ligature is applied the pulse should
continue to beat, otherwise the vein -will scarcely bleed tifter it
is opened. The arm should be extended, and if the vein does
not rise well the patient should shut his hand or grasp a stick;
the physician should then take the arm into his left hand, and
if the vein appear loose under the skin he should place the
thumb of his left hand on it about an inch and a half or two
inches below the part he has fixed on to make the puncture.
The lancet, being firmly held between the forefinger and thumb
of the right hand, is then to be steadily introduced into the
vein obliquely, and taken out by elevating the point directly
upwards, so as to enlarge the puncture. When sufficient blood
has been taken, the ligature is removed, the thumb placed on
or just below the orifice to check the bleeding, and the wound
is closed by a small compress of lint; this is secured by a band¬
age passed diagonally across the bend of the arm, the ends
being carried around, one above the other, below the elbow,
brought in front, and made to cross each other immediately
over the puncture, in the form of the figure 8; they are then
secured by tying them together.
Bleeding may be performed, also, at the back of the wrist,
at the ankle, and at the neck. The best vein to select, in the
first of these situations, is that which is seen running up the
arm from the back of the thumb. That in the second is the
internal saphena, which is seen taking its course from the
great toe along the internal border of the leg, in front of the
inner ankle. The external saphena, which passes behind the
outer ankle, may be opened if it appear the larger of the two,
which is rarely, however, the case. The mode of opening these
veins is similar to that described for the bend of the arm; but,
in addition, it is usual to immerse the hand or foot in warm
water to promote the bleeding. The external jugular vein, on
either side of the neck, is sometimes opened in cases of apoplexy
in adults, and in children when the veins at the elbow are hidden
by fat. It is an operation neither dangerous nor difficult, and
is performed in the following manner: The vein is to be com¬
pressed just above the collar-bone, either with the thumb of the
operator's left hand, or by placing upon it a thick pledget of lint,
&c., confined there by a bandage tied under the opposite armpit;
the vein being then fixed by two fingers of the left hand, an
opening is to be made in a direction rather across it, and this
should be somewhat wider than is usually made in bleeding at
the arm. The stream of blood may be directed into the basin
MISCELLANEOUS MEDICAL INTELLIGENCE. 115
by a folded card, or other similar contrivance, to prevent its
trickling down the breast; and when a sufficient quantity has
been taken away, a piece of common sticking-plaster is to be
placed on the orifice, and over that a pledget, which is to be
kept in place by a bandage or handkerchief, wound gently
round the neck.
Cupping.—By the word cup, is understood a little bell-glass,
three to four inches high, from which we exhaust the air, so that
"when applied on the skin it may cause a congestion of this mem¬
brane, from the pressure of the atmosphere upon the parts around
the cup itself. These cups, though made of various materials,
yet differ chiefly in the manner in which the air within them is
exhausted; some being slightly open at the top, and fitted to re¬
ceive the end of a small air-pump ; others being entirely closed,
and exhausted by the use of fire, applied internally in different
ways. Whenever the cup is simply applied on a part, it causes
a flow of blood and temporary fulness of the vessels in the
skin; but when the flesh is cut after this application of the cup,
the blood will flow freely from the incisions, on the exhausted
cup being again placed over the part, though it could not do so
previously. This mode of depletion is termed cupping, or the
application of wet cups, in contra-distinction to dry cupping, or
that in ■which the cup is applied merely to draw the blood to the
surface. When it is desirable to exhaust a cup, it may be done
either with the pump, by fitting it to the cup as prepared for it,
applying the latter to the part perpendicularly, and then work¬
ing the piston once or twice as in any ordinary syringe; or by
the use of fire to rarefy the air within the cup itself.
With the latter view, various means have been employed;
thus the air may be rarefied either by the rapid insertion of a
candle or little torch, followed by the instant application of the
cup to the part; or else fire may be placed in the cup and it at
once put on the skin. To do this, some practitioners shake a
little alcohol around the inside of the cup, pour out what flows
readily, and inflame the little that adheres to the glass by a
lighted piece of paper; others introduce small balls of inflamed
cotton saturated with alcohol; others simply use pieces of burn¬
ing paper; but the two last cause unnecessary pain, by burning
the skin on which they fall. The best and neatest way of ex¬
hausting a cup, is the following: Cut several pieces of letter-
paper, slightly glazed, into strips about one inch and a half
wide. Wrap this round the end of the fore-finger, so that about
one-third of its width shall project beyond the end of the finger,
and having thus formed a little tube, tear off the remainder of
the strip, and twist the part projecting beyond the finger, so as
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POCKET FORMULARY.
to close up the tube, and form a little cap like a thimble. Dip
the open end of this thimble lightly into alcohol; a small por¬
tion will adhere to its glazed surface; touch it in a candle;
throw it into the glass, and apply the latter at once to the part.
The shape of the thimble is such that it will nearly always fall
on its apex, or twisted end, whilst the part wet with the alcohol,
or the base, will stand uppermost and sufficiently far from the
skin to prevent its being burnt. Having by either of these modes
exhausted a cup, allow it to remain on the surface of the part
till the skin under it has become turgid, then, if blood is to be
taken, cut the integuments by means of the scarificator, and
reapply the cup as before ; removing it when filled or half filled
with blood, and again applying it, if necessary. In order to re¬
move the cup, introduce the nail of the fore-finger under its
edge, and gently force the cup on to its side, so as to allow the
air to enter. After wet cupping, the parts should be cleansed,
and covered with cerate or an oiled rag.
If the regular cupping apparatus, as furnished by the cut¬
ler, is not at hand, we may perform the operation very well by
using wine-glasses or tumblers; scarifying the parts, if blood is
to be taken, by rapid punctures of a thumb-lancet, bistoury, or
sharp pen-knife.
In using the scarificator, the operator should regulate the
depth of the lancets, previous to its application, and then place
it firmly in contact with the skin before touching the spring, so
as to avoid the lacerated incision which will probably otherwise
result from the cut of the lancet, if loosely applied.
Leeching.—Leeches afford the most effectual means of ab¬
stracting blood locally, being often applicable to parts which,
from their situation or great tenderness, would not admit of the
use of cups, and, in the case of infants, are always preferable to
the latter.
In order to apply them with ease to any part, care should be
taken to free it, by washing, from all medicaments, and by
shaving from all the hair or down on the skin. If the leech is
very active or hungry, it will readily attach itself to the part
when thus cleansed; but generally it is necessary to moisten the
surface with a little blood, or with milk, or with sugar and
water, when the leech will readily leave the vessel containing
it, and attach itself to the skin. If it is desirable to attach a
leech to any one point, place it in a large quill or glass tube,
and put this directly on the part; when, as the animal cannot
escape, it will readily adhere. But when the part is not so cir¬
cumscribed, it suffices to apply the edge of the cup containing
them just below the point, and let them crawl on to it; or place
MISCELLANEOUS MEDICAL INTELLIGENCE. 117
them under a tumbler, and, by confining their wandering, cause
them to attach themselves to the portion beneath the glass.
Where blood is wanted to induce them to bite, it may be
readily obtained by tying a string tightly around the extremity
of the finger, so as to render it turgid, and then lightly pricking
it with a lancet; the blood escapes in points, and may then be
smeared on the part. This operation causes no pain, unless
very often repeated on the same finger. But if a part is tho¬
roughly cleansed from all secretions, hairs, &c., and care is taken
in the preservation of the leech, it will attach itself without ne¬
cessitating this operation.
Leeches continue to draw blood until they are gorged, when
they drop off. But if it becomes necessary to remove them be¬
fore they are thus filled, it should be done by washing them with
a little salt and water, and not by pulling them off; as this is
very apt to leave the teeth in the wound, where it serves as an
irritant, besides being destructive to the leech. Six American
leeches are calculated to draw one ounce of blood; but as their
bites frequently bleed as much as the animal itself drew, this
is but an approximation to the quantity. Some persons are in
the habit of cutting off the tail of the leech, in order to cause
it to continue sucking for a long time, as the blood passes out
as fast as swallowed; but it is a barbarous practice, and of
course destructive to the utility of the animal. After the leech
has come away, the bites continue to bleed, and this may often
be encouraged by the application of flannels, and cloths wrung
out of hot water. But if it is not desirable to take this extra
amount of blood, cover their bites with a piece of linen, moisten¬
ed in sweet oil, or spread with fresh. lard or cerate. Occasion¬
ally it happens, in the case of children or weakly individuals,
that the after-bleeding is profuse and debilitating, and that it is
absolutely necessary to arrest it at once. Various measures
have, therefore, been recommended, but I have generally found,
under these circumstances, that it is only necessary to touch
each bite with a sharp-pointed piece of lunar caustic, or to dry
the spot thoroughly, and then apply over it a small piece of
patent lint or cotton, wet with collodion. A hot needle, stitches,
&c., have been recommended, but the above is less painful, and
more readily applied. In our large cities, where leeching is the
peculiar business of a class of individuals, there is generally no
difficulty in their employment; but with the country practitioner
it is different, as he must preserve and apply them himself, and
this is found to be a very onerous duty. Let it, however, be
recollected, that their application is sometimes a matter of ab¬
solute necessity; that, as above shown, it is simple, and two
118
POCKET FORMULARY.
of the objections to their use are removed. Their preservation
is then the only point of difficulty, and this may be obviated by
a slight attention to the habits of the animal. The leech, when
gorged, remains inactive or unfit for use for several weeks, and
is also liable to disease, by which numbers are lost. All that is
necessary to guard against this, is perfect rest in a vessel of
fresh water; in a few weeks they will again be fit for use. The
preservation of them by the following rules is easy, and always
insures a supply: Never squeeze them to cause them to dis¬
gorge, it brings on disease. Place them in clean water, and
change it frequently. Then, in order to keep them in health
and ready for use, place them in a cool place, and arrange a
mixture of moss, turf, and fragments of wood at the bottom of
the vessel containing them, laying a few stones on the pieces to
keep them in position. Place in it, also, a piece of wood or
earthenware filled with small holes, so that the leech may keep
up its natural habits, and by drawing itself through the holes
in the board or through the moss, sticks, or stones, free itself
from the secretion of slime found on its body, which otherwise
becomes the cause of disease. By changing the water occasion¬
ally, and keeping the trough, tub, or jar, covered with a piece
of muslin, in a cellar, any practitioner can always have a supply
of these useful animals at his command. Let it be recollected,
however, that those which have been used are to be kept sepa¬
rate from the others for about two months, when they may be
replaced in the trough till again called for.
THE MEANS OF FUMIGATING INFECTED CHAMBERS,
ETC., AND PREVENTING THE PROGRESS OF CONTA¬
GIOUS DISEASES.
The Nitrous Fumigation, in the form of Gas.—The gas or
vapor is obtained by pouring one ounce of sulphuric acid upon
two ounces of the nitrate of potash, in a large tea-cup placed
in a basin containing hot water; the gas required will be imme¬
diately disengaged.
This quantity will be sufficient for a small apartment, and
may be used in a sick-room, provided it be placed at some dis¬
tance from the patient. If the room bfe large, two cups should
be used; and, if intended to fumigate a whole house, several
should be placed in various parts, closing the doors and windows
for half an hour.
The chloride of lime and soda are also powerful disinfecting
MISCELLANEOUS MEDICAL INTELLIGENCE. 119'
agents, almost instantaneously destroying every bad smell, and
all effluvia arising from animal or vegetable decomposition, and
effectually preventing their deleterious influence.
Directions for the Use of the Chloride of Lime.—To a pound of
the chloride of lime add four gallons of water; stir the mixture
well; and, after allowing it to settle for a short time, pour off
the clear solution, and keep it in well-corked bottles.
In large towns and cities suffering from infectious or conta¬
gious disorders, it is strongly recommended to sprinkle the rooms
morning and evening with the mixture, and to place some of it
in shallow dishes or basins in the different rooms, particularly
the bedrooms.
In typhus or putrid fevers, infectious complaints, &c., the
mixture should be sprinkled about the room and bed-linen occa¬
sionally, the usual precaution for renewing the air of the room
being equally attended to. A wineglassful added to the water
of a night-chair or bed-pan will prevent any smell.
The effluvia from drains, sewers, cesspools, &c., will) be de¬
stroyed by pouring into them a quart of the mixture added to a
pailful of water, and repeating the operation until the smell
ceases.
Water in cisterns may be purified, and all the animaloulae de¬
stroyed, by putting into it a small quantity of the pure liquid,
say about one pint to one hundred gallons of water.
Bugs may be destroyed by well washing the joints of bed<-
steads and all crevices with the pure liquid.
Stables and slaughter-houses may be purified by the same
process.
Directions for the Use of the Chloride of Soda.—This prepara¬
tion will retain its properties for a considerable time, if kept
from the light in a glass bottle well stopped ; and, when used,
it must be mixed in the proportion of one ounce or two large
spoonfuls to each pint of water. The use of this mixture is
regulated by precisely the same rules as are given for that pre¬
pared with the chloride of lime. It has been most successfully
applied in the following cases, viz., carbuncles, hospital gan¬
grene, ill-conditioned ulcers, ulcerated sore-throats, and fetid
discharges of every description. The proportions to be used
vary according to the state of the disease. Generally, it is best
to commence with one part of the soda to eight of water. Fre¬
quent repetitions of a weak solution are more effectual than the
stronger mixtures.
120
POCKET FORMULARY.
OF DIET.
Diet consists in that course of eating and drinking which
every man employs for the support of life, and varies therefore
with everjr individual in a certain degree, according to taste and
circumstances. It is not an easy matter to ascertain the exact
quantity of food proper for every age, sex, and constitution, or
the exact proportion of animal and vegetable nourishment which
is most conducive to health. This cannot, perhaps, be fully
ascertained; but we may admit, as a general rule, that two-
thirds or three-fourths of vegetable to one-third or fourth of
animal food is the most proper.
Three meals in a day are as many as nature requites, and
certainly as much as the stomach can properly digest. Dinner
ought to form the chief of these. Hearty suppers, particularly
of meat, in which some people indulge themselves previously to
their retiring to rest, are highly prejudicial to health, hence the
old adage—
" Great suppers a very great evil we call ;
That your sleep may be sound let your supper be small."
Of Diet under Disease.—If it be necessary to pay attention to
diet in health, as all will admit, it is certainly still more so
under disease ; therefore we will give the form suited to the
different stages:—
Low or Fever Diet may consist of panada gruel; milk thickened
with arrowroot; plain bread pudding; arrowroot; tapioca; jellies;
rice; milk; chicken or veal tea. Drink barley-water, acidulated
with lemon or orange whey ; imperial drink ; thin gruel; balm,
sage, or mint tea.
Restorative or Convalescent Diet.—Rice or bread pudding;
hartshorn, isinglass, or calves'-feet jelly ; fresh oysters or shell¬
fish ; veal, fowl, rabbit, and lamb. Drink genuine porter ; port
or claret wine with water ; weak pure brandy and water.
Generous or Full Diet.—Rice or bread pudding; broth; soup;
oyster and shell-fish; veal, lamb, mutton, beef, pork, &c;
jelly of hartshorn, ealves'-feet, or isinglass: meat soup, with
vegetables. Drink porter; sherry, port, or claret wine; or
brandy diluted with water, if necessary.
OF DRINK.
Drink, as is well known to all, is that supply of liquid which
the body requires to repair its fluid parts, and the necessity of
MISCELLANEOUS MEDICAL INTELLIGENCE. 121
this supply, as well as its quantity, are both pointed out by a
certain feeling which the want of it excites, named thirst.
Therefore you perceive, from the purpose that drink is naturally
designed to serve, the liquid composing it should be of the sim¬
plest and most diluent kind; hence water is the drink of all
animals, and also of man in his natural state. But, along with
refinement, this part of aliment, as well as food, has changed
the simplicity of its nature ; it has become impregnated with a
variety of foreign matters, which stimulate and disorder the
system, and thus, instead of answering the original intention of
nature as a pure elementary fluid in allaying thirst, it is formed
only to please the palate and to create a desire for the enjoy¬
ment of it beyond what either nature requires or reason ap¬
proves. Drinking is indispensably necessary to the support of
animal life. The use of it, however, like that of food, requires
certain regulations, and we are more apt to exceed in the pro¬
portion of drink than of food. There are many people, how¬
ever, who scarcely ever drink except at meals, the time when
water or dilution is least necessary, as its immoderate indulg¬
ence at meals dilutes the gastric juice, and thereby retards,
instead of hastening, digestion, and makes the food pass off
quickly. Hence the mass of blood is thinned by it, and general
debility ensues, distinguished by universal relaxation and too
copious a discharge of different excretions; so it will be per¬
ceived that excess in drinking as well as eating should be
avoided.
A glass of cold water early in the morning is the best tonic;
it will give vigor and tone to the stomach, and prepare it for
the approaching meal. It will remove any viscid phlegm which
may be collected in it, and which may vitiate the appetite for
the morning repast, much better than a glass of the distilled
spirits of the country. At first, this cold water beverage may
be disagreeable; but, if continued for a few mornings, it will
prove a refreshing and agreeable relish. I have known many
feeble persons to become strong by the use of this natural beve¬
rage prepared by God to nourish and invigorate his creatures.
There are, however, many cases of indigestion or atonic dyspep¬
sia in which a teasp'oonful or two of brandy, added to half a glass
of water, and drunk immediately after dinner, will be of great
benefit. We should be careful not to continue the brandy too
long, lest we augment the disease, instead of relieving it, as the
continued use of spirits disorders the stomach by its chemical
action on the internal coat, thereby producing a vitiated secre¬
tion of the gastric juice, the effect of which is indigestion, the
very disease we are endeavoring to cure.
1 1
122
POCKET FORMULARY.
The prevalency of indigestion with ladies, particularly in the
South, may be justly attributed to inactive life and to error in
diet; but with the men and the slaves of the same section it is
more frequently produced by the excessive use of spirituous
liquors and tobacco. The best treatment in such cases is cold
water in the place of liquor, and poplar bark in the place of
tobacco, the juice to be swallowed. I have known many cases
cured by this treatment.
DIETETIC PREPARATIONS.
Biscuit Jelly.
White Biscuit four ounces ; Water four pints ; boil down one-
half ; strain; evaporate to one pint. Add White Sugar q. s. ;
Wine four ounces; Cinnamon Water one drachm. In debility
of the digestive organs.
Hartshorn Jelly.
Hartshorn Shavings one ounce; Water four pints; boil to
two pints ; strain. Warm again ; add Orange Juice an ounce;
White Sugar six ounces or q. s. ; Wine five ounces.
Sago Jelly.
Soak Sago in water for an hour; pour it off, adding more ;
boil till the Sago is transparent; then add Wine and Sugar q. s.
Isinglass Jelly.
Isinglass two ounces ; Water two pints; boil to one ; strain:
and add Milk one pint; White Sugar Candy one ounce. Nutri¬
tive.
Chicken Jelly.
Cut a Chicken into small pieces, bruise the bones, and put
the whole into a stone jar, with a cover that will make it water¬
tight. Set the jar in a large kettle of boiling water, and keep
it boiling for three hours •, then strain off the liquid, and season
it slightly with salt, pepper, and mace, or with loaf sugar and
lemon-juice, according to the condition of the patient for whom
it is intended.
MISCELLANEOUS MEDICAL INTELLIGENCE. 123
Rice Jelly.
Mix a quarter of a pound of Rice, picked and washed, with
half a pound of Sugar, and just sufficient Water to cover it.
Boil till it becomes a glutinous mass; then strain, and season
with whatever may be thought proper.
Bread Jelly.
Boil a quart of Water, and suffer it to cool. Take one-third
of a sixpenny loaf of Bread, slice it, pare oif the crust, and toast
to a light brown. Then put it into the water, place it on hot
coals in a covered pan, and boil it gently till you find it dissolved
by straining through a cloth, and set it away for use. When
it is to be taken, warm a teacupful, sweeten it with sugar, and
add a little grated lemon-peel.
Arrowroot Jelly.
Mix three tablespoonfuls of best Bermuda Arrowroot in a tea¬
cup of water quite smooth, cover it, and let it stand a quarter
of an hour. Put the yellow peel of a Lemon into a pint of wa¬
ter, and boil to one-half. Then take out the Lemon-peel, and
pour in the dissolved Arrowroot, while the water is still boiling;
add sufficient White Sugar to sweeten it well, and let it boil to¬
gether for five or six minutes. It may be sweetened, if thought
necessary, with two teaspoonfuls of Wine and some grated Nut¬
meg. It may be boiled in milk instead of water, or in wine and
water, according to the condition of the patient.
Port Wine Jelly.
Melt an ounce of Isinglass in a little warm water ; stir it into
a pint of Port Wine, adding two ounces of Sugar Candy, one
ounce of Gum Arabic, and half a Nutmeg grated. Mix all well,
and boil it ten minutes, or till thoroughly dissolved. Then
strain through muslin and cool.
Tapioca Jelly.
Take of Tapioca two spoonfuls; Water one pint; boil gently
for an hour, or until it assumes a jelly-like appearance. Add
Sugar, Wine, and Nutmeg, with Lemon juice to suit the taste and
the nature of the case. This is improved by washing the Ta¬
pioca well, and allowing it to steep for five or six hours, chang¬
ing the water three times, then proceed as before.
124
POCKET FORMULARY.
Sago.
Wash in two or three waters, and let it soak for two or three
hours. To a teacupful of Sago allow a quart of Water, and
some of the peel of a Lemon. Simmer till all the grains look
transparent. Then add Wine and Nutmeg, and boil together for
a few minutes (or plain with milk).
Barley Water.
Wash clean some Pearl Barley, and to two ounces of Barley
add one quart of Water. Add a few Raisins or some Lemon-
peel and Sugar, and boil slowly till reduced one-half; then
strain and sweeten. As nourishment in inflammatory diseases.
Rice Water.
Take of Rice two ounces, wash it well, and add two quarts of
Water. Boil for an hour and a half, and then add Sugar and
Nutmeg as much as may be required. To be taken ad libitum.
Mixed with milk, this is an excellent diet for children.
Chicken Water.
Take half a Chicken divested of all fat, and break the bones;
add to this half a gallon of Water, and boil for half an hour.
Season with salt.
Beef Tea.
Take of lean Beef cut into shreds one pound; Water one
quart; boil it for twenty minutes, taking off the scum as it
rises. After it grows cold, strain the liquor.
Essence of Beef.
Take of lean Beef sliced one pound, put it into a bottle or jar
closely corked. Place this in a vessel of cold water and boil for
an hour or more. Then decant and skim the liquid. Chicken
tea may be made in the same way. Very nourishing and palat¬
able.
Liebiff's Soup.
To prepare this broth, half a pound of the flesh of a recently
killed animal (beef, or the flesh of a fowl) is chopped fine, and
well mixed with a pound and an eighth of distilled Water, to
MISCELLANEOUS MEDICAL INTELLIGENCE.
125
which four drops of pure Muriatic Acid, and from half to a
drachni of Common Salt, have been added. After an hour, the
whole is thrown on a common hair sieve, and the fluid is allowed
to run off without pressure. The first portion, which is turbid,
is poured back, until the fluid runs off quite clear. On to the
fleshy residue in the sieve half a pound of distilled water is
thrown in small portions. In this way a pound of fluid (cold
extract of meat) is obtained, of a red color, and an agreeable
taste of broth. The sick are allowed to drink a cupful cold at
pleasure. It must not be heated, as it then becomes turbid,
and deposits a thick coagulum of animal albumen and hsematin.
Wine Whey.
Boil a pint of Milk, and when boiling add a large wineglass
of Sherry or Madeira Wine. Let it boil again, and then remove
it from the fire, and let it stand a few minutes. Then remove
the curd, pour the whey into a bowl, and sweeten it.
Rennet Whey.
Wash a small bit of Rennet about two inches square in cold
water, to remove the salt. Put it into a teacup, and pour on
lukewarm water enough to cover it. Let it stand all night, and
in the morning stir Rennet Water into a quart of warm Milk;
cover it, and set it near the fire till a firm curd is formed. Pour
off the whey, and it will be found a very cooling and palatable
drink.
Corn-Meal Gruel.
Take of Corn Meal one handful; Water two quarts; boil it
till only one quart remains ; then strain off the liquor, and sea¬
son it to the palate with salt, sugar, and nutmeg, to which may
be added a spoonful or two of wine. ,
Rice Gruel.
Take of ground Rice one ounce; Cinnamon one drachm;
Water two pints. Boil for forty minutes, -adding the Cinnamon
near the conclusion. Strain and sweeten, and add Wine, if
necessary.
Rice Milk.
Take a large teacupful of Rice, washed nicely; Water one
pint. Boil it for about half an hour, then add a quart of new
11*
126
POCKET FORMULARY.
Milk. Let it simmer over a slow fire till it is sufficiently done,
and then add to it a little Sugar and Nutmeg.
Rice Caudle.
When the water boils, pour into it some grated Rice mixed
with a little cold water; when of a proper consistence, add
Sugar, Lemon-peel and Cinnamon, and a glass of Brandy to a
quart. Boil all smooth.
Bran Tea.
Take of fresh Wheat Bran one pint; Water three quarts.
Boil down one-third, strain, and add Sugar, Honey, or Molasses,
according to the taste of the patient.
Lemonade.
Take of fresh Lemon juice four ounces; fresh Lemon-peel
half ounce; White Sugar four ounces; Boiling Water three
pints. Let them stand till cold, and then strain off for use. In
fevers, a little Spirits of Nitre may be added.
Medicated Lemonade.
Take of White Sugar one pound; Tartaric Acid quarter of an
ounce ; Essence of Lemon 30 drops ; Water three quarts. Mix.
Tamarind Water.
Put Tamarinds into a pitcher or tumbler till it is one-third
full, then fill it up with cold water; cover it, and let it infuse
for a quarter of an hour or more.
Molasses Posset.
Put into a saucepan a pint of the best Molasses, a teaspoonful
of powdered White Ginger, and a quarter of a pound of fresh
Butter. Simmer on hot coals for half an hour, stirring fre¬
quently. Then stir in the juice of two Lemons, or two table-
spoonfuls of Vinegar; cover the pan, and let it stand by the fire
five minutes longer.
Cocoa.
Boil two ounces of good Cocoa in a quart of water, and, as
soon as it boils, set it on coals to simmer gently for an hour or
more. To be used hot.
MISCELLANEOUS MEDICAL INTELLIGENCE. 121
Toast Water.
Toast some pieces of Bread brown (not burnt), then put them
into a pitcher, and fill it up -with boiling -water. Let it stand
till cold, then strain it and put it into a decanter.
Pectoral Water.
Take of common Barley and Raisins stoned, each two ounces;
Liquorice Root half an ounce; Water two quarts. Boil the
water first with the barley, then add the raisins, and afterwards,
near the latter end of the boiling, the liquorice. The decoction
then will be fully completed, when one quart only of the liquor
will be left after straining.
Imperial Drink.
Take of Cream of Tartar one drachm; the outer rind of fresh
Lemon or Orange-peel half a drachm ; Loaf Sugar one ounce ;
Boiling Water two pints. When they have stood in a pitcher
about ten minutes, strain off the liquor.
Flaxseed Tea.
Take of Flaxseed one ounce; White Sugar one ounce and a
half; Lemon-juice two tablespoonfuls ; Boiling Water two pints.
Infuse them in a pitcher some hours, and then strain off the
liquor. An ounce of Liquorice, shaved, may sometimes be used
instead of sugar.
Chicken Broth.
Take a middling-sized Chicken, divide it into two parts; put
one-half into a saucepan with a quart of water; season with a
little salt; as the scum rises take it off; then may be added a
small bundle of parsley and a crust of bread. When they have
boiled about three-quarters of an hour, the parsley may be taken
out, and the broth will be fit for use, or it may be used seasoned
only with salt. Mutton broth can be made in the same way.
Bread Pudding.
Take of crumbs of Bread about half a pound ; new Milk about
three-quarters of a pint. Pour the milk boiling hot upon the
bread, and let it stand about an hour covered close up; then
add the yolks of two eggs well beaten; a little grated nutmeg;
128
POCKET FORMULARY.
about a spoonful of rose-water ; a little salt and sugar also, if
agreeable. Beat the bread well, and mix the whole together
with a spoon. Tie it then close up in a clean linen cloth, and
when the water boils put it in ; boil about three-quarters of an
hour, then take it out, lay it upon a plate, and pour over it
some melted butter, mixed with a little mountain wine, if there
be no objection, and sprinkle a little sugar over all. This is a
good convalescent diet.
Rice Pudding.
Wash and pick some Rice; throw among it some Pimento
finely powdered, but not much; tie the Bice in a cloth, and
leave room for it to swell. Boil it in a quantity of water for an
hour or two. When done, eat it with butter and sugar, or milk.
Put lemon-peel, if you please. It is very good without spice,
and eaten with salt and butter.
Or swell the rice with a very little milk over the fire; then
add some more milk, an egg, sugar, allspice, and lemon-peel.
Bake in a deep dish.
Custard Pudding.
Mix by degrees a pint of good Milk with a large spoonful of
Flour, the yolks of four Eggs, and a little pounded Cinnamon.
Butter a basin that will exactly hold it, pour the batter in, and
tie a floured cloth over. Put it in boiling water over the fire,
and turn it about a few minutes to prevent the egg going to one
side. Half an hour will boil it.
PART IV.
MEDICAL AUD MISCELLANEOUS STATISTICS.
The following table is intended to embrace a variety of tables
containing much valuable information to the practitioner, and
affording at a glance much that might otherwise require hours
of research.
POISONS.
We present the following table of poisons under two general
heads: First, the corrosive, or those which act specifically on
the coats of the stomach and intestinal canal; and second, the
sedative, or those which destroy life by depriving the nervous
system of that power by which the great functions of animal
life are carried on and sustained. This division is the most
natural, as not only the effect of each class upon the system is
entirely dissimilar, but the treatment requisite to be had is of a
distinct and marked character.
Corrosive Poisons.
antidotes and treatment.
Magnesia, Chalk, Whiting, in milk or
water; mucilaginous or soapy liquid, in
large quantities. When Sulphuric Acid
has been taken, the use of much water will
be improper.
Stomach-pump; mechanical irritation of
the fauces; Magnesia, Chalk, Whiting, in
small quantities of liquid ; Muriate of Lime,
diluted.
The strong Mine¬
ral Acids.
Nitric Acid.
Muriatic Acid.
Sulphuric Acid.
Oxalic Acid.
130
POCKET FORMULARY.
The strong Alka¬
lies.
Ammonia.
Fotassa.
Soda.
Lime.
Creasote.
Antimony, Salts of.
Tartar Emetic.
Butter of Anti¬
mony.
Baryta.
Barii Chloridum.
Copper, Salts of.
Acetate.
Carbonate.
Nitrate.
Sulphate.
Gold, Salts of.
Silver, Salts of.
Nitrate (Lunar
Caustic).
Tin, Salts of.
Chloride (Dyer's
Liquid).
Iron, Salts of.
Lead, Salts of.
Zinc, Salts of.
Mercury, Salts of.
Bichloride (Cor¬
rosive S.),
Bicyanide.
Iodide.
Nitrate.
Nitre.
Phosphorus.
ANTIDOTES AND TREATMENT.
Stomach-pump; emetics, diluents, de¬
mulcents, Olive Oil, diluted Vinegar, Lemon-
juice, or Citric Acid, ad libitum.
Albumen; 'white of eggs ; milk ; wheat
flower.
Astringent infusions, as of Galls, Oak
Bark, Peruvian Bark, Columbo, Kino, Cate¬
chu, or Green Tea, very strong, with co¬
pious draughts of warm water.
Alkaline Sulphates (Epsom or Glauber
Salts), in solution ; stomach-pump.
Demulcents ; Albumen, as milk or whites
of eggs in solution ; flour and water. Vine¬
gar must be avoided.
Sulphate of Iron, with a free use of
mucilaginous drinks.
Chloride of Sodium (common salt) in
large quantity of water ; stomach-pump.
Stomach-pump; emetics, diluents, de¬
mulcents, milk, or four whites of eggs.
Carbonate of Soda, with mucilaginous
drinks.
Sulphate of Magnesia (Epsom Salts), or
diluted Sulphuric Acid.
Diluents; Carbonate of Soda, with de¬
mulcents, milk, albumen.
Albumen, as whites of eggs, in large
quantity ; flour and water; milk.
Warm demulcents ; Magnesia; stomach-
pump.
MEDICAL AND MISCELLANEOUS STATISTICS. 131
Gaseous Poisons.
Carbonic Acid.
Sulphuretted Hy¬
drogen.
Carburetted Hy¬
drogen.
Alcohol, or Spirit¬
uous Liquors.
Opium.
Morphia, &c.
Hydrocyanic Acid.
Oil of Bitter Al¬
monds.
Oil and Water of
Wild Cherry—
Laurel.
Aconitum - Napel-
lus (Aconite).
Atropa-Belladonna
(Deadly Night¬
shade).
Conium Maculatum
(Spotted Hem¬
lock).
Colchicum.
Digitalis.
Helleborus Niger
(Black Helle¬
bore).
Stramonium.
Sedative Poisons.
The open air. Asphyxia must be treated
by copious effusions of cold water to the
head and face, if the surface is warm, and
bloodletting; mechanical excitement of re¬
spiration by manipulating the thorax and
abdomen; feet in hot water and friction to
the chest.
An emetic should be given, followed by
copious draughts of warm water; congestion
of the brain and other symptoms to be
treated on general principles.
As the best prophylactic to this poison,
we would suggest the temperance pledge
rigidly conformed to.
Stomach-pump ; emetics, as Tartar Eme¬
tic, Sulphate of Copper or Zinc; external
excitation; keep in motion; mechanical
excitement of respiration ; cold affusion to
the head and face ; feet in hot water ; elec¬
tro-magnetism ; internal stimulants; Am¬
monia, coffee, vegetable acids.
Same as in Opium. Mixed Oxides of
Iron, obtained by precipitating solution of
green Sulphate with Potash.
Same as in Hydrocyanic Acid.
The same.
The general treatment in poisoning by
the other simple narcotics and acrid nar¬
cotics in this list is the same as in Opium.
Emetics, stomach-pump, followed by the
administration of purgatives. No antidote
can be relied upon; but, as Tannin decom¬
poses these alkaloids, the free use of decoc¬
tion or infusions containing it may be given
with advantage.
(In poisoning from Digitalis, the recum¬
bent posture, to prevent syncope.)
132
POCKET FORMULARY.
Sedative Poisons—continued.
Tobacco.
Veratrum, &c.
Nux Vomica.
Strychnia.
Veg. Astringents; Conium; Ether; Chlo¬
roform.
Points necessary to be observed in investigating cases of Poisoning.
When a practitioner is called to a case of poisoning, it is his
duty not only to make every effort to save life, but to observe
and note down every circumstance which may tend to detect
the perpetrator of the crime.
The following are the principal points which demand the
attention of a medical jurist, in all cases of suspected poisoning,
with respect to
1. The time of their occurrence ; their nature.
2. The exact period at which they were observed to take
place; after a meal, or after food or medicine had been taken.
3. The order of their occurrence.
4. Whether there was any remission or intermission in their
progress, or whether they continued becoming more and more
aggravated until death.
5. Whether the patient had labored under any previous ill¬
ness.
6. Whether the symptoms were observed to recur more vio¬
lently after a particular meal, or after taking any particular
kind of food or medicine.
7. Whether the patient has vomited; the vomited matters, if
any, especially those first ejected, to be procured; their color
noted, as well as their quantity.
8. If none be procurable, and the vomiting has taken place
on the dress, furniture, or floor of the room, then a portion of
the clothing, or carpet may be cut out and reserved for analysis.
9. Endeavor to ascertain the nature of all the different arti¬
cles of food or medicine last taken. *>
10. Ascertain the nature of all different articles of food used
at a meal.
11. Any suspected articles of food, as well as the vomited
matter, to be sealed up in a proper vessel and reserved for
analysis. '
12. Note down in their own words all explanations voluntarily
Symptoms.
MEDICAL AND MISCELLANEOUS STATISTICS. 133
made by parties present, or who are supposed to be concerned
in the suspected poisoning.
13. Whether more than one person partook of the food or
medicine; if so, whether all these persons were affected, and
how.
14. Whether the same kind of food or medicine had been
taken before by the patient or other persons without ill effects
following.
In the event of the death of the patient, it will be necessary
for a practitioner to note down—
15. The exact time of death, and thus determine how long a
period the person has survived after having been first attacked
with the symptoms.
16. Observe the attitude and position of the body.
17. Observe the state of the dress.
18. Observe all surrounding objects. Any bottles, papers,
packets, weapons, or spilled liquids lying about should be col¬
lected and preserved.
In the event of a post-mortem examination being ordered by
a coroner—
19. Note the external appearance of the body, whether the
surface be livid or pallid.
20. Note the state of countenance.
21. Note all marks of violence on the person, or discomposure
of the dress, marks of blood, &c.
22. If found dead, when was the deceased last seen living, or
known to have been alive.
23. Note all circumstances leading to a suspicion of suicide
or murder.
Inspection of the body:—
24. Observe the state of the abdominal viscera.
25. If the stomach and intestines be found inflamed, the seat
of inflammation should be exactly specified, also all marks of
ulceration, effusion of blood, corrosion, or perforation.
2G. The contents of the stomach should be collected in a clean
vessel; their color, odor, and nature specified.
27. The contents of the duodenum should be separately col¬
lected.
28. Observe the state of the large intestines, especially the
rectum.
29. The state of the larynx, fauces, and oesophagus, whether
there be in these parts any marks of inflammation or corrosion.
30. Note all morbid changes in the thoracic viscera and the
brain.
12
134
POCKET FORMULARY.
HINTS TO DYSPEPTICS.
Tlie following articles had generally better be avoided by dys
peptics:—
Cream, Mashed potatoes, Sprats,
New bread, Sausages, Eels,
Hot rolls, Stuffing of meats, Cheese,
Fat bacon, Ditto of poultry and game, Pastry in all its shapes
Green tea, Smoked beef, Salads,
Buns, Salt meat, Raw vegetables,
Sweet biscuits, Peas, suet, &c., Cucumbers,
Rich soups, Marrow puddings, Radishes,
Pork, Fried fish, Lettuces,
Beef, Boiled salmon, Nuts, walnuts,
Veal, Mackerel, Cocoanuts,
Ham, Shrimp and other sauces, Almonds and filberts.
A person in health may partake of every one. This array o
"forbidden fruit" is only for "invalids." As to quantity, ever;
person should regulate that by his feelings ; he ought to kno'v
when he has eaten enough; it is impossible for a physician ti
say how much in general is requisite for every individual, for on
appetite and capacities vary every day. We can say this much
however, that more maladies are created by over-feeding thai
under-feeding, and that a majority of us consume more thai
there is really any occasion for. Every man in search of healtl
should reflect for himself.
TABLE
Of Articles of Diet, with the time required for their Digestion.
Articles. How Dressed. Time of Digestioi
h. m.
Rice ..... Boiled 1 0
Sago « 1 45
Tapioca . . . . " 2 0
Barley 20
Milk ....." 20
* Ditto Raw 2 15
* Tripe Boiled 1 0
Venison steak . . . Broiled 1 35
Turkey .... Roasted or boiled 2 30
MEDICAL AND MISCELLANEOUS STATISTICS. 135
Articles. How Dressed. Time of Digestion
h.
in.
•""Goose ....
Roasted
o
30
*Pig, sucking
"
2
30
Lamb .....
"
2
30
Chicken ....
"
2
45
*Eggs .....
Hard boiled
3
30
Ditto .....
Soft
3
0
*Ditto .....
Fried
3
30
-Custard ....
Baked
2
45
■"■Salmon ....
Boiled
1
30
Oysters ....
Raw
2
55
*Ditto .....
Stewed
2
30
Beef
Roast
3
30
Beef steak ....
Broiled
3
0
*Pork steak ....
a
3
15
*Ditto, fat and lean
Roasted
5
15
* Ditto, recently salted .
Boiled
4
30
Mutton ....
Roasted
3
15
Ditto .....
Broiled or boiled 3
0
*Veal
Broiled
4
0
*Ditto, cutlets
Fried
4
30
Fowls
Boiled
4
0
*Ducks ....
Roasted
4
0
^Butter ....
Melted
3
30
*Cheese, old strong
Raw
3
30
*Soup, beef, vegetables, & bread Boiled
4
0
*Soup, bean
It
3
0
Ditto, barley
U
1
30
Ditto, mutton
U
3
30
Chicken soup
U
3
0
■^Hashed meat, and vegetables
Warmed
2
30
* Sausages, fresh .
Boiled
3
20
* Heart, animal
Roasted
4
0
*Beans ....
Boiled
2
30
Bread
Baked
3
30
Dumpling, apple .
Boiled
3
0
Apples .....
Raw
2
50
^Parsnips ....
Boiled
2
30
"^Carrots ....
a
3
15
^Turnips ....
a
3
30
Potatoes ....
a
3
30
*Cabbage ....
a
4
30
Those articles in the above Table marked *, should be avoid-
136
POCKET FORMULARY.
ed, or eaten very spai'ingly by the invalid, for it does not follow
that that which is the more readily soluble is the most suitable
to a morbidly sensitive stomach. This list is founded upon ex¬
periments made on small quantities. Of course, the more there
be taken the more time is required on account of the process
of digestion occasioned by the absolute irritation from the dis¬
tension of the stomach. As far as my experience is concerned,
I would rather have the reader rely upon his own judgment for
his guide, than the time stated on the outer margin, as the time
varies with the health and seasons, and with perfect or imper¬
fect mastication.
MEDICAL AND MISCELLANEOUS STATISTICS. 137
TABLE
Of Physicians. Made out by Dr. C. A. Lee ,from the Census of 1850.
States.
Number of
Physicians.
Population.
Ratio of
physicians to
population.
Number of
inhabitants to
square miles.
Maine . .
659
583,169
854
12.5
New Hampshire
623
317,976
510
39.6
Vermont . . .
663
314,120
473
39.26
Massachusetts .
1,643
994,514
605
137.17
Rhode Island .
217
146,545
679
122.95
Connecticut.
560
370,792
662
78.06
New York . .
5,060
3,097,394
612
67.33
New Jersey . .
608
489,555
801
71.46
Pennsylvania .
4,071
2,311,786
570
49.19
Delaware . .
114
91,532
838
43.17
Maryland . .
990
583,034
588
53.00
Dist. of Columbia
104
51,687
496
1033.74
Virginia . . .
2,163
1,421,661
657
23.17
North Carolina .
1,083
869,039
802
19.1
South Carolina .
905
668,507
738
23.87
Georgia . . .
1,295
906,185
699
15.62
Florida . . .
135
87,445
647
1.48
Alabama . . .
1,264
771,623
610
15.21
Mississippi . .
1,217
606,526
498
12.86
Louisiana . .
912
517,762
567
12.52
Texas ....
616
212,592
346
0.65
Arkansas . .
449
209,897
465
4.02
Tennessee . .
1,523
1,002,717
658
22.79
Kentucky . .
1,818
982,407
540
26.07
Ohio ....
4,263
1,980,329
464
49.55
Michigan
854
397,654
465
7.07
Indiana . .
2,170
988,416
455
29.24
Illinois . . .
1,402
851,470
607
15.37
Missouri . . .
1,351
682,044
504
10.49
Iowa ....
542
192,214
354
3.77
Wisconsin
581
305,391
525
5.66
California . .
626
92,597
147
0.49
Territories.
Minesota . . .
13
6,077
467
0.04
New Mexico
9
61,547
6,838
0.29
Oregon . . .
45
13,294
295
0.04
Utah ....
16
11,310
711
0.06
138
POCKET FORMULARY.
The total indicates the ratio of practitioners to the ■whole
population to be one in 511. There are more physicians in
California to the inhabitants than any other State, being one in
147. And so of most of the new States. More in Georgia
than South Carolina, and more in Alabama, Mississippi, Lou¬
isiana, and Texas, than Georgia. This will doubtlesfe be a good
lesson to many of our young professional aspirants.
TABLE
Exhibiting the Different Classes of Disease, as occurring each
Month, for a series of Years, in the Practice of Dr. E. M. Pen¬
dleton, Sparta, Ga.
GENERAL CLASSES OF
DISEASE.
| January.
| February.
' March.
| April.
k.
e
c
s
"5
1-5
August.
September.
October.
&-
3
>
o
»
December.
Total.
Digestive .
Jiespiratory
Braiu and nerves
Osseous
Urinary . .
"Visual
Cutaz/eous
Articular .
1'emale
Abfcess . .
I'i'riodic fevers .
Continued fevers
Kruptive fevers
Injuries
All others
35
30
17
8
4
4
e
8
32
8
e
6
7
6
14
51
53
21
12
3
1
8
25
7
4
5
14
19
11
53
49
16
19
11
5
2
8
4
5
6
6
7
10
13
106
57
20
10
12
5
13
6
52
8
9
10
5
12
16
117
36
24
19
11
4
6
49
14
11
13
6
12
13
8S
24
18
22
11
7
4
7
37
14
8
3
18
11
100
34
20
23
11
7
8
35
7
31
0
4
17
14
106
21
21
21
9
2
9
7
50
20
58
9
5
12
17
life
28
18
17
6
2
8
7
40
15
108
7
8
14
20
101
65
14
9
14
2
4
4
35
13
70
11
3
18
12
50
106
15
9
3
1
9
6
28
9
29
3
4
16
15
46
51
12
17
10
3
12
3
31
18
6
6
6
17
13
97
55
21
186
107
43
82
76
455
130
846
79
74
171
169
Aggregate .
194
239
253
341
342
275
314
367
416
375
303
251|3,662
MEDICAL AND MISCELLANEOUS STATISTICS. 139
TABLE
Showing the Percentage of Deaths in the cases presented in the
preceding Table.
Diseases.
No. of Cases.
Deaths.
Per Cent.
Diai-rhoea
252
1
5.5
*Gastro-enteritis
94
5
5.3
Hepatitis
21
o
9.5
Worm fever
86
2
2.3
Dysentery
33
1
3.0
Puerperal convulsions
8
5
62.5
Uterine hemorrhage
18
3
16.2
Metritis ....
13
2
15.3
Dentition
43
2
4.6
Phrenitis .
5
2
40.0
Scarlatina
3
1
33.3
Organic diseases of heart
4
3
75.0
Intermittent fever .
209
0
0
Colic ....
107
0
0
Dyspepsia
81
0
0
Pneumonia
44
6
13.6
Phthisis pulmonalis
8
7
87.5
Bronchitis .
49
2
4.0
Hooping-cough
22
2
9.0
Croup ....
14
1
7.1
Delirium tremens .
5
1
20.0
Common continued fever
31
4
12.9
Inflammatory fever
48
3
6.2
Influenza
186
2
1.1
Bilious fever .
119
0
0
Inflammation of bladder .
6
1
16.6
Tetanus
2
1
50.0
Catarrhal fever
90
3
3.3
Rubeola
25
0
0
Erysipelas
16
0
0
* This includes gastritis, enteritis, and gastro-enteritis proper.
140
POCKET FORMULARY.
TABLE
Exhibiting the Climate, and condition of the Atmosphere for the two
Years of the time in which the above Practice occurred at Sparta,
Ga. (Lat. 33° 17/ 80" N., Long. 50° S. W. of Washington.
Elevation above the sea, 550 feet.) By E. M. Pendieton.
Months.
Barometer.
Thermometer.
Mean. J Range.
Clear sky.
Cloudy sky.
Haiti in
inches.
1850.
January
29.36
52.5
12.6
213
417
6.26
February .
29.35
49.4
14.9
255
405
4.27
March . .
29.39
55.6
13.6
217
405
7.70
April . .
29.40
63.3
15.6
205
395
5.31
May . . .
29.37
68.8
13.7
357
263
4.17
June . .
29.40
76.0
14.8
332
268
1.03
July . . .
29.38
80.5
12.6
332
288
5.23
August . .
29.38
80.5
13 9
370
250
3.64
September .
29.39
75.4
15.7
353
247
0.3-5
October . .
29.40
63.2
19.4
465
155
2.48
November .
29.46
55.1
16.9
362 •
238
5.45
December .
29.44
51.3
12.5
198
422
7.27
29.39
64.3
14.6
3659
3653
53.26
1851.
January
29.50
49.4
13.7
234
38fi
3.29
February .
29.55
44.7
15.9
237
323
4.83
March . .
29.48
57.2
17.0
307
313
5.88
April . .
29.37
62.1
14.9
287
313
8.07
May . . .
29.49
72.2
15.6
355
265
0.93
June . .
29.43
77.1
13.7
284
316
6.44
July . . .
29.43
81.5
15.2
374
246
3.13
August . .
29.45
78.5
11.9
273
347
4.40
September .
29.51
71.7
15.0
333
267
0.90
October. .
29.44
64.6
18.5
472
148
1.19
November .
29.42
52.0
15.3
302
318
6.53
December .
29.53
48.8
15.1
345
275
1 80
29.48
64.1
15.1
3803
3517
47.39
MEDICAL AND MISCELLANEOUS STATISTICS. 141
TABLE
Showing the Difference between Minims, Drops, and Grains of vari¬
ous Medical Liquid Preparations of the Pharmacopoeia of the
United Slates, $c.
a
<I-I
°.£ a
o .9 to
2.5 3
°d®
CC d
a o'i
2Jf
a °
at
a o M
§■
& O H
a-s-a
3 U H
£ ^3 O
7-i <N
B - O
a 01
at- o
lMQ'
Sulphuric acid ....
30
13.3
25
16
■ —■ ■ ether . . .
50
8
60
6
Rectified alcohol ....
46
8.6
57
7.1
Nitric acid .....
28
14.2
22.2
18
Acetic acid (crystallizable)
40
10
40
10
Muriatic acid .....
18
22.2
18.1
22
Oil of vvormseed ....
40
10
50
8
peppermint, of aniseed )
sweet almond, olive >
40
10
43.5
9
ricinus )
cloves
40
10
36
11
cinnamon ....
40
10
32
12.5
Copaiba ......
40
10
40
10
Diluted alcohol ....
40
10
42
9.5
Tinct. of hydriodate of potassa, can-"")
tharides, kino, digitalis, assafetida, t
40
10
43
9.4
sulphuric acid, colchicum, opium, f
valerian, guaiacum J
Tinct. (volat.) of valerian, of guaiacum
40
10
50
8
of muriate of iron
44
9.1
50
8
Wine (Teneriffe) ....
26
15.3
25
16
■ antimonial ....
24
16.6
25
15.3
of opium (Sydenham's laud.)
26
15.3
29
13.7
——— of colchicum root)
of colchicum seed 5
25
16
29
13.7
Vinegar (distilled) ....
19
21
20
20
of opium (black drop) )
■ of colchicum >
26
15.3
25
16
of squill )
Water (distilled) ....
15
26.6
17.5
24.8
— solution of hydrocyanic acid*
15
26.6
17.5
24.5
sulphuric acid (1 to 7)
nitric acid "
17
23.5
17
23.5
17
23.5
17
23.5
ammonia (strong) .
18
22.2
18.5
22
(weak)
15
26.6
20
20
hydriod. of potassa
18
22.2
20
20
arsenite of potassa
19
21
20
20
* Prepared according to the London Apothecaries' Hall.
142
POCKET FORMULARY.
TABLE
Of the Strength of Wines.
Port, weakest
mean of seven wines
strongest
White port .
Sherry, weakest
By Ciikistison.
Per ct. of abso¬
lute alcohol
by weight.
14.97
16.20
17.10
14.97
13.98
mean of thirteen wines, includ- ) gj
ing those very long kept in cask j
strongest .... 16.17
— mean of nine wines very long \ ^ ^
kept in cask in the East Indies j
Madre da Xeres ..... 16.90
Madeira, strongest / kept long in cask "I 14.09
weakest \ in East Indies J 16.90
Teneriffe, long in cask at Calcutta . 13.84
Sercial 15.45
Dry Lisbon ...... 16.14
Shiraz ....... 12.95
Amontillado ..... 12.63
Claret, a first growth of 1811 . . 7.72
Chateau Latour, first growth of 1825 . 7.78
Bosau, second growth of 1825 . . 7.61
Ordinary claret, a superior " vin ordinaire" 8.99
Rives Altes . . . . . .9.31
Malmsey ...... 12.86
Rudesheimer, superior quality . . 8.40
inferior " . . 6.90
Hambacher, superior quality . . 7.35
Giles's Edinburgh ale, before bottling . 5.90
The same ale two years in bottle f . 6.06
Superior London porter, 4 mos. bottled 5.36
The results of the above Table were obtained by distillation,
which was applied with such contrivance for accuracy that
nearly the whole spirits and water were distilled over without a
trace of empyreuma, and without the loss of more than between
two and six grains in 2,000. From the quantity and density of
the spirits, the weight of absolute alcohol of the density 793.9,
as well as the volume of proof-spirits of the density 920, -was
MEDICAL AND MISCELLANEOUS STATISTICS.
143
calculated from the tables of Richter, founded on those of Gil¬
pin. Dr. Christison remarks that the alcoholic strength of
various samples of the same kind of wine bears no relation
whatever to their commercial value, and is often very different
from what would be iiidicated by the taste even of an experi¬
enced wine-taster.
PART Y.
MEDICAL ETHICS.
Believing as we do that it is essential to all practising phy¬
sicians to understand, as far as possible, each other's views in
reference to what is termed medical etiquette, so that they may
respect each other's feelings, and do as they would be done by,
we have introduced the Code of Medical Ethics adopted by the
American Medical Association, in the absence of anything better
on that subject.
CHAPTER I.
of the duties of physicians to their patients, and of the
obligations of patients to their physicians.
Art. I.—Duties of Physicians to their Patients.
1. A physician should not only be ever ready to obey the calls
of the sick, but his mind ought also to be imbued with the great¬
ness of his mission, and the responsibility he habitually incurs
in its discharge. These obligations are the more deep and
enduring, because there is no tribunal, other than his own
conscience, to adjudge penalties for carelessness or neglect.
Physicians should, therefore, minister to the sick with due im¬
pressions of the importance of their office; reflecting that the
ease, the health, and the lives of those committed to their charge,
depend on their skill, attention, and fidelity. They should
study, also, in their deportment, so to unite tenderness with firm¬
ness, and condescension with authority, as to inspire the minds of
their patients with gratitude, respect, and confidence.
2. Every case committed to the charge of a physician should
MEDICAL ETHICS.
145
be treated with attention, steadiness, and humanity. Reason¬
able indulgence should be granted to the mental imbecility and
caprices of the sick. Secrecy and delicacy, when required by
peculiar circumstances, should be strictly observed; and the
familiar and confidential intercourse to which physicians are ad¬
mitted in their professional visits, should be used with discre¬
tion, and with the most scrupulous regard to fidelity and honor.
The obligation of secrecy extends beyond the period of profes¬
sional services; none of the privacies of personal and domestic
life, no infirmity of disposition or flaw of character, observed
during professional attendance, should ever be divulged by him,
except when he is imperatively required to do so. The force
and necessity of this obligation are, indeed, so great, that, pro¬
fessional men have, under certain circumstances, been protected
in their observance of secrecy by courts of justice.
3. Frequent visits to the sick are in general requisite, since
they enable the physician to arrive at a more perfect knowledge
of the disease, to meet promptly every change which may
occur, and also tend to preserve the confidence of the patient.
But unnecessary visits are to be avoided, as they give useless
anxiety to the patient, tend to diminish the authority of the
physician, and render him liable to be suspected of interested
motives.
4. A physician should not be forward to make gloomy prog¬
nostications, because they savor of empiricism, by magnifying
the importance of his services in the treatment or cure of the
disease. But he should not fail, on proper occasions, to give
to the friends of the patient timely notice of danger, when it
really occurs; and even to the patient himself, if absolutely ne¬
cessary. This office, however, is so peculiarly alarming when
executed by him, that it ought to be declined whenever it can
be assigned to any otter person of sufficient judgment and deli¬
cacy; for the physician should be the minister of hope and com¬
fort to the sick, that, by such cordials to the drooping spirit he
may smooth the bed of death, revive expiring life, and counter¬
act the depressing influence of those maladies which often dis¬
turb the tranquillity of the most resigned in their last moments.
The life of a sick person can be shortened, not only by the acts,
but also by the words or manner of a physician. It is, there¬
fore, a sacred duty to guard himself carefully in this respect,
and to avoid all things which have a tendency to discourage the
patient and to depress his spirits.
5. A physician ought not to abandon a patient because the
case is deemed incurable; for his attendance may continue to
be highly useful to the patient, and comforting to the relatives
is
146
pocket formulary.
around him, even in the last period of a fatal malady, by alle¬
viating pain and other symptoms, and by soothing mental an¬
guish. To decline attendance, under such circumstances, would
be sacrificing to fanciful delicacy and mistaken liberality, that
moral duty which is independent of, and far superior to, all
pecuniary consideration.
6. Consultations should be promoted in difficult or protracted
cases, as they give rise to confidence, energy, and more enlarged
views in practice.
7. The opportunity which a physician not unfrequently en¬
joys, of promoting and strengthening the good resolutions of his
patients, suffering under the consequences of vicious conduct,
ought never to be neglected. His counsels, or even remon¬
strances, will give satisfaction, not offence, if they be proffered
with politeness, and evince a genuine love of virtue, accompanied
by a sincere interest in the welfare of the person to whom they
are addressed.
Art. II.—Obligations of Patients to their Physicians.
1. The members of the medical profession, upon whom are
enjoined the performance of so many important and arduous
duties towards the community, and who are required to make
so many sacrifices of comfort, ease, and health, for the welfare
of those who avail themselves of their services, certainly have
a right to expect and require that their patients should enter¬
tain a just sense of the duties which they owe to their medical
attendants. ,
2. The first duty of a patient is to select as his medical ad¬
viser one who has received a regular professional education. In
no trade or occupation do mankind rely on the skill of an un¬
taught artist; and in medicine, confessedly the most difficult
and intricate of the sciences, the world ought not to suppose
that knowledge is intuitive.
3. Patients should prefer a physician whose habits of life are
regular, and who is not devoted to company, pleasure, or to any
pursuit incompatible with his professional obligations. A pa¬
tient should, also, confide the care of himself and family, as
much as possible, to one physician; for a medical man who has
become acquainted with the peculiarities of constitution, habits,
and predispositions of those he attends, is more likely to be
successful in his treatment than one who does not possess that
knowledge.
A patient who has thus selected his physician, should always
MEDICAL ETHICS.
14t
apply for advice in what may appear to him trival cases, for the
most fatal results often supervene on the slightest accidents. It
is of still more importance that he should apply for assistance
in the forming stage of violent diseases; it is to a neglect of
this precept that medicine owes much of the uncertainty and
imperfection with which it has been reproached.
4. Patients should faithfully and unreservedly communicate
to their physician the supposed cause of their disease. This is
the more important, as many diseases of a mental origin simu¬
late those depending on external causes, and yet are only to be
cured by ministering to the mind diseased. A patient should
never be afraid of thus making his physician his friend and' ad¬
viser ; he should always bear in mind that a medical man is
under the strongest obligations of secrecy. Even the female
sex should never allow feelings of shame or delicacy to prevent
their disclosing the seat, symptoms, and causes of complaints
peculiar to them. However commendable a modest reserve
may be in the common occurrences of life, its strict observance
in medicine is often attended with the most serious consequences,
and a patient may sink under a painful and loathsome disease,
which might have been readily prevented had timely intimation
been given to the physician.
5. A patient should never weary his physician with a tedious
detail of events or matters not appertaining to his disease.
Even as relates to his actual symptoms, he will convey much
more real information by giving clear answers to interrogatories,
than by the most minute account of his own framing. Neither
should he obtrude the details of his business nor the history of
his family concerns.
6. The obedience of a patient to the prescriptions of his phy¬
sician should be prompt and implicit. He should never permit
his own crude opininns as to their fitness to influence his atten¬
tion to them. A failure in one particular may render an other¬
wise judicious treatment dangerous, and even fatal. This re¬
mark is equally applicable to diet, drink, and exercise. As
patients become convalescent, they are very apt to suppose that
the rules prescribed for them may be disregarded, and the con¬
sequence but too often is a relapse. Patients should never
allow themselves to be persuaded to take any medicine whatever
that may be recommended to them by the self-constituted doctors
and doctresses, who are so frequently met with, and who pre¬
tend to possess infallible remedies for the cure of every disease.
However simple some of their prescriptions may appear to be,
it often happens that they are productive of much mischief, and;
148
POCKET FORMULARY.
in all cases they are injurious, by contravening the plan of
treatment adopted by the physician.
7. A patient should, if possible, avoid even the friendly visits
of a physician who is not attending him; and, when he does re¬
ceive them, he should never converse on the subject of his dis¬
ease, as an observation may be made, without any intention of
interference, which may destroy his confidence in the course he
is pursuing, and induce him to neglect the directions prescribed
to him. A patient should never send for a consulting physician,
without the express consent of his own medical attendant. It
is of great importance that physicians should act in concert;
for, although their modes of treatment may be attended with
equal success when employed singly, yet conjointly they are
very likely to be productive of disastrous results.
8. When a patient wishes to dismiss his physician, justice and
common courtesy require that he should declare his reasons for
so doing.
9. Patients should always, when practicable, send for their
physician in the morning, before his usual hour of going out;
for, by being early aware of the visits he has to pay during the
day, the physician is able to apportion his time in such a man¬
ner as to prevent an interference of engagements. Patients
should also avoid calling on their medical adviser unnecessarily
during the hours devoted to meals or sleep. They should al¬
ways be in readiness to receive the visits of their physician, as
the detention of a few minutes is often of serious inconvenience
to him.
10. A patient should, after his recovery, entertain a just and
enduring sense of the value of the services rendered him by
his physician; for these are of such a character that no mere
pecuniary acknowledgment can repay or cancel them.
CHAPTER II.
of the duties of physicians to each other and the
profession at large.
Art. I.—Duties for the support of Professional Character.
1. Every individual, on entering the profession, as he becomes
thereby entitled to all its privileges and immunities, incurs an
obligation to exert his best abilities to maintain its dignity and
honor, to exalt its standing, and to extend the bounds of its
usefulness. He should, therefore, observe strictly such laws as
are instituted for the government of its members; should avoid
MEDICAL ETHICS.
149
all contumelious and sarcastic remarks, relative to the faculty
as a body; and •while, by unwearied diligence, he resorts to
every honorable means of enriching the science, he should en¬
tertain a due respect for his seniors, who have, by their labors,
brought it to the elevated condition in which he finds it.
2. There is no profession from the members of which greater
purity of character, and a higher standard of moral excellence,
are required, than the medical; and to attain such eminence, is
a duty every physician owes alike to his profession and to his
patients. It is due to the latter, as without it he cannot com¬
mand their respect and confidence; and to both, because no
scientific attainments can compensate for the want of correct
moral principles. It is also incumbent upon the faculty to be
temperate in all things, for the practice of physic requires the
unremitting exercise of a clear and vigorous understanding, and,
on emergencies, for which no professional man should be unpre¬
pared, a steady hand, an acute eye, and an unclouded head,
may be essential to the well-being, and even to the life, of a
fellow-creature.
3. It is derogatory to the dignity of the profession to resort
to public advertisements of private cards or handbills, inviting
the attention of individuals affected with particular diseases;
publicly offering advice and medicine to the poor gratis, or
promising radical cures; or to publish cases and operations in
the daily prints, or suffer such publications; to boast of cures
and remedies; to adduce certificates of skill and success, or to
perform any other similar acts. These are the ordinary prac¬
tices of empirics, and are highly reprehensible in a regular
physician.
4. Equally derogatory to professional character is it for a phy¬
sician to hold a patent for any surgical instrument, or medicine;
or to dispense a secret nostrum, whether it be the composition
or exclusive property of himself or of others. For, if such
nostrum be of real efficacy, any concealment regarding it is in¬
consistent with beneficence and professional liberality; and, if
mystery alone give it value and importance, such craft implies
either disgraceful ignorance, or fraudulent avarice. It is also
reprehensible for physicians to give certificates attesting the
efficacy of patent or secret medicines, or in any way to promote
the use of them.
Art. II.—Professional services of Physicians to each other.
1. All practitioners of medicine, their wives, and their chil¬
dren while under the paternal care, are entitled to the gratui-
13*
150
POCKET FORMULARY.
tous services of any one or more of the faculty residing near
them, whose assistance may be desired. A physician afflicted
with disease is usually an incompetent judge of his own case;
and the natural anxiety and solicitude which he experiences at
the sickness of a wife, a child, or any one who by the ties of
consanguinity is rendered peculiarly dear to him, tend to ob¬
scure his judgment, and produce timidity and irresolution
in his practice. Under such circumstances, medical men are
peculiarly dependent upon each other, and kind offices and pro¬
fessional aid should always be cheerfully and gratuitously
afforded. Visits ought not, however, to be obtruded officiously;
as such unasked civility may give rise to embarrassment, or in¬
terfere with that choice on which confidence depends. But, if
a distant member of the faculty, whose circumstances are afflu¬
ent, request attendance, and an honorarium be offered, it should
not be declined ; for no pecuniary obligation ought to be imposed
which the party receiving it would wish not to incur.
Art. III.—Of the duties of Physicians as respects vicarious offices.
1. The affairs of life, the pursuit of health, and the various
accidents and contingencies to which a medical man is peculiarly
exposed, sometimes require him temporarily to withdraw from
his duties to his patients, and to request some of his professional
brethren to officiate for him. Compliance with this request is
an act of courtesy, which should always be performed with the
utmost consideration for the interest and character of the family
physician; and when exercised for a short period, all the pecu¬
niary obligations for such services should be awarded to him.
But if a member of the profession neglect his business in quest
of pleasure and amusement, he cannot be considered as entitled
to the advantages of the frequent and long-continued exercise
of this fraternal courtesy, without awarding to the physician
who officiates the fees arising from the discharge of his profes¬
sional duties.
In obstetrical and important surgical casSs, which give rise
to unusual fatigue, anxiety and responsibility, it is just that the
fees accruing therefrom should be awarded to the physician who
officiates.
Art. IV.—Of the duties of Physicians in regard to Consultations.
1. A regular medical education furnishes the only presump¬
tive evidence of professional abilities and acquirements, and
ought to be the only acknowledged right of an individual to the
exercise and honors of his profession. Nevertheless, as in con-
MEDICAL ETHICS.
151
sultations the good of the patient is the sole object in view, and
this is often dependent on personal confidence, no intelligent
regular practitioner who has a license to practise from some
medical board of known and acknowledged respectability, re¬
cognized by this Association, and who is in good moral and pro¬
fessional standing in the place in which he resides, should be
fastidiously excluded from fellowship, or his aid refused in con¬
sultation, when it is requested by the patient. But no one can
be considered as a regular practitioner, or a fit associate in con¬
sultation, whose practice is based on an exclusive dogma, to the
rejection of the accumulated experience of the profession, .and
of the aids actually furnished by anatomy, physiology, pathology,
and organic chemistry.
2. In consultations, no rivalry or jealousy should be indulged;
candor, probity, and all due respect should be exercised towards
the physician having charge of the case.
3. In consultations, the attending physician should be the first
to propose the necessary questions to the sick, after which the
consulting physician should have an opportunity to make such
further inquiries of the patient as may be necessary to satisfy
him of the true character of the case. Both physicians should
then retire to a private place for deliberation, and the one first
in attendance should communicate the directions agreed upon
to the patient or his friends, as well as any opinions which it
may be thought proper to express. But no statement or dis¬
cussion of it should take place before the patient or his friends,
except in the presence of all the faculty, attending by their
.common consent; and no opinions or prognostications should be
delivered, which are not the result of previous deliberation and
concurrence.
4. In consultations, the physician in attendance should deliver
his opinion first; and when there are several consulting, they
should deliver their opinions in the order in which they have
been called in. No decision, however, should restrain the attend¬
ing physician from making such variations in the mode of treat¬
ment, as any subsequent unexpected change in the character of
the case may demand. But such variation, and the reasons for
it, ought to be carefully detailed, at the next meeting in consul¬
tation. The same privilege belongs also to the consulting phy¬
sician, if he is sent for in an emergency when the regular at¬
tendant is out of the way, and similar explanations must be
made by him, at the next consultation.
5. The utmost punctuality should be observed in the visits of
physicians when they are to hold consultation together, and this
is generally practicable, for society has been considerate enough
152
POCKET FORMULARY.
to allow the plea of a professional engagement to take prece¬
dence of all others, and to be an ample reason for the relinquish¬
ment of any present occupation. But as professional engage¬
ments may sometimes interfere, and delay one of the parties,
the physician who first arrives should wait for his associate a
reasonable period, after which the consultation should be con¬
sidered as postponed to a new appointment. If it be the attend¬
ing physician who is present, he will of course see the patient
and prescribe; but if it be the consulting one, he should retire,
except in case of emergency, or when he has been called from a
considerable distance, in which latter case he may examine the
patient, and give his opinion in writing and under seal, to his
associate.
6. In consultations, theoretical discussions should be avoided,
as occasioning perplexity and loss of time; for there may be
much diversity of opinion concerning speculative points, with
perfect agreement in those modes of practice which are founded,
not on hypothesis, but on experience and observation.
7. All discussions in consultation should be held as secret and
confidential. Neither by words or manner should any of the
parties to a consultation assert or insinuate, that any part of the
treatment pursued did not receive his assent. The responsibility
must be equally divided between the medical attendants—they
must equally share the credit of success as well as the blame of
failure.
8. Should an irreconcilable diversity of opinion occur when
several physicians are called upon to consult together, the opin¬
ion of a majority should be considered as decisive; but if the
numbers be equal on each side, then the decision should rest
with the attending physician. It may, moreover, sometimes
happen, that two physicians cannot agree'in their views of the
nature of a case, and the treatment to be pursued. This is a
circumstance much to be deplored, and should always be avoid¬
ed, if possible, by mutual concessions, as far as they can be
justified by a conscientious regard for the dictates of judgment.
But in the event of its occurrence, a third physician should, if
practicable, be called to act as umpire; and if circumstances
prevent the adoption of this course, it must be left to the patient
to select the physician in whom he is most willing to confide.
But as every physician relies upon the rectitude of his judgment,
he should, when left in the minority, politely and consistently
retire from any further deliberation in the consultation, or par¬
ticipation in the management of the case.
9. As circumstances sometimes occur to render a special con¬
sultation desirable, when the continued attendance of two phy-
MEDICAL ETHICS.
153
sicians might be objectionable to the patient, the member of the
faculty ■whose assistance is required in such cases, should sedu¬
lously guard against all future unsolicited attendance. As such
consultations require an extraordinary portion of both time and
attention, at least a double honorarium may be reasonably ex¬
pected.
10. A physician who is called upon to consult, should observe
the most honorable and scrupulous regard for the character and
standing of the practitioner in attendance; the practice of the
latter, if necessary, should be justified as far as it can be con¬
sistently with a conscientious regard for truth, and no hint or
insinuation should be thrown out which could impair the confi¬
dence reposed in him, or affect his reputation. The consulting
physician should also carefully refrain from any of those extra¬
ordinary attentions or assiduities, which are too often practised
by the dishonest for the base purpose of gaining applause, or
ingratiating themselves into the favor of families and indi¬
viduals.
Art. V.—Duties of Physicians in cases of interference.
1. Medicine is a liberal profession, and those admitted into
its ranks should found their expectations of practice upon the
extent of their qualifications, not on intrigue or artifice.
2. A physician, in his intercourse with a patient under the
care of another practitioner, should observe the strictest caution
and reserve. No meddling inquiries should be made ; no dis¬
ingenuous hints given relative to the nature and treatment of his
disorder; nor any course of conduct pursued that may directly
or indirectly tend to diminish the trust reposed in the physician
employed.
3. The same circumspection and reserve should be observed
when, from motives of business or friendship, a physician is
prompted to visit an individual who is under the direction of
another practitioner. Indeed, such visits should be avoided,
except under peculiar circumstances, and when they are made,
no particular inquiries should be instituted relative to the nature
of the disease, or the remedies employed, but the topics of con¬
versation should be as foreign to the case as circumstances will
admit.
4. A physician ought not to take charge of, or prescribe for
a patient who has recently been under the care of another mem¬
ber of the faculty in the same illness, except in cases of sudden
emergency, or in consultation with the physician previously in
attendance, or when the latter has relinquished the case or been
154
POCKET FORMULARY.
regularly notified that his services are no longer desired. Under
such circumstances no unjust and illiberal insinuations should
be thrown out, in relation to the conduct or practice previously
pursued, which should be justified as far as candor and regard
for truth and probity will permit; for it often happens that pa¬
tients become dissatisfied when they do not experience immedi¬
ate relief, and, as many diseases are naturally protracted, the
want of success in the first stage of treatment affords no evi¬
dence of a lack of professional knowledge and skill.
5. When a physician is called to an urgent case, because the
family attendant is not at hand, he ought, unless his assistance
in consultation is desired, to resign the care of the patient to
the latter immediately.
6. It often happens, in cases of sudden illness or recent acci¬
dents and injuries, owing to the alarm and anxiety of friends,
that a number of physicians are simultaneously sent for; under
these circumstances courtesy should assign the patient to the
first who arrives, who should select from those present any addi¬
tional assistance that he may deem necessary. In all such
cases, however, the practitioner who officiates should request
the family physician, if there be one, to be called, and unless his
further attendance be requested, should resign the case to the
latter on his arrival.
7. When a physician is called to the patient of another prac¬
titioner, in consequence of the sickness or absence of the latter,
he ought, on the return or recovery of the regular attendant,
and with the consent of the patient, to surrender the case.
8. A physician, when visiting a sick person in the country,
may be desired to see a neighboring patient who is under the
regular direction of another physician, in consequence of some
sudden change or aggravation of symptoms. The conduct to
be pursued on such an occasion is to give advice adapted to the
present circumstances; to interfere no further than is absolutely
necessary with the general plan of treatment; to assume no
further direction, unless it be expressly desired; and, in this
last case, to request an immediate consultation with the prac¬
titioner previously employed.
9. A wealthy physician 'should not give advice gratis to the
affluent, because his doing so is an injury to his professional
brethren. The office of physician can never be supported as an
exclusively beneficent one ; and it is defrauding, in some degree,
the common funds, for its support, when fees are dispensed with
which might justly be claimed.
10. When a physician who has been engaged to attend a case
of midwifery is absent, and another is sent for, if delivery is ac-
MEDICAL ETHICS.
155
complished during the attendance of the latter, he is entitled to
the fee, but should resign the patient to the practitioner first
engaged.
Art. VI.—Of differencet between Physicians.
1. Diversity of opinion and opposition of interest may, in the
medical as other professions, sometimes occasion controversy
and even contention. Whenever such cases unfortunately occur,
and cannot be immediately terminated, they should be referred
to arbitration of a sufficient number of physicians, or a court-
medical.
As peculiar reserve must be maintained by physicians to¬
wards the public, in regard to professional matters, and as there
exists numerous points in medical ethics and etiquette through
■which the feelings of medical men may be painfully assailed in
their intercourse with each other, and which cannot be under¬
stood or appreciated by general society, neither the subject-
matter of such differences nor the adjudication of the arbitra¬
tors should be made public, as publicity in a case of this nature
may be personally injurious to the individuals concerned, and
can hardly fail to bring discredit on the faculty.
Art. VII.—Of Pecuniary Acknowledgments.
1. Some general rules should be adopted by the faculty, in
every town or district, relative to pecuniary acknowledgments
from their patients; and it should be deemed a point of honor
to adhere to these rules with as much uniformity as varying
circumstances will admit.
of the duties of the profession to the public, and of the
obligations of the public to the profession.
Art. 1.—Duties of the Profession to the Public.
1. As good citizens, it is the duty of physicians to be ever
vigilant for the welfare of the community, and to bear their part
in sustaining its institutions and burthens; they should also be
ever ready to give counsel to the public in relation to matters
especially appertaining to their profession, as on subjects of
medical police, public hygiene, and legal medicine. It is their
province to enlighten the public in regard to quarantine regula¬
tions—the location, arrangement, and dietaries of hospitals,
asylums, schools, prisons, and similar institutions—in relation
to the medical police of towns, as drainage, ventilation, &c., and
156
POCKET FORMULARY.
in regard to measures for the prevention of epidemic and con¬
tagious diseases; and when pestilence prevails, it is their duty
to face the danger, and to continue their labors for the allevia¬
tion of the suffering, even at the jeopardy of their own lives.
2. Medical men should also be always ready, when called on
by the legally constituted authorities, to enlighten coroners' in¬
quests and courts of justice, on subjects strictly medical—such
as involve questions relating to sanity, legitimacy, murder by
poisons or other violent means, and in regard to the various
other subjects embraced in the science of Medical Jurispru¬
dence. But in these cases, and especially where they are
required to make a post-mortem examination, it is just, ia
consequence of the time, labor and skill required, and the re¬
sponsibility and risk they incur, that the public should award
them a proper honorarium.
3. There is no profession, by the members of which eleemo¬
synary services are more liberally dispensed than the medical;
but justice requires that some limits should be placed to the
performance of such good offices. Poverty, professional bro¬
therhood, and certain public duties should always be recog¬
nized as presenting valid claims for gratuitous service; but
neither institutions endowed by the public or by rich indivi¬
duals, societies for mutual benefit, for the insurance of lives,
or for analogous purposes, nor any profession or occupation,
can be admitted to possess such privilege. Nor can it be
justly expected of physicians to furnish certificates of inability
to serve on juries, to perform militia duty, or to testify to the
state of health of persons wishing to insure their lives, obtain
pensions or the like, without a pecuniary acknowledgment.
But to individuals in indigent circumstances, such professional'
services should always be cheerfully and freely accorded.
4. It is the duty of physicians, who are frequent witnesses of
the enormities committed by quackery, and the injury to health
and even destruction of life caused by the use of quack medi¬
cines, to enlighten the public on these subjects, to expose the
injuries sustained by the unwary from the devices and preten¬
sions of artful empirics and imposters. Physicians ought to use
all the influence which they may possess, as professors in col¬
leges of pharmacy, and by exercising their option in regard to
the shops to which their prescriptions shall be sent, to discou¬
rage druggists and apothecaries from vending quack or secret
medicines, or from being in any way engaged in their manufac¬
ture and sale.
MEDICAL ETHICS.
157
Art. II.—Obligations of the Public to Physicians.
1. The benefits accruing to the public directly and indirectly
from the active and unwearied beneficence of the profession,
are so numerous and important, that physicians are justly en¬
titled to the utmost consideration and respect from the commu¬
nity. The public ought likewise to entertain a just appreciation
of medical qualifications—to make a proper discrimination be¬
tween true science and the assumption of ignorance and empiri¬
cism, to afford every encouragement and facility for the acquisi¬
tion of medical education—and no longer to allow the statute
books to exhibit the anomaly of exacting knowledge from phy-
s'icians, under liability to heavy penalties, and of making them
obnoxious to punishment for resorting to the only means of ob¬
taining it.
SOME OF THE MEANS OF ACQUIRING BUSINESS, AND
THE CAUSES WHICH PREVENT ITS ACQUISITION,
, AND OCCASION THE LOSS OF IT IN THE PROFES¬
SION OF MEDICINE.
This subject is an interesting one, particularly in this day of
humbuggery, and, if properly studied, will be useful not merely
by enabling the honorable practitioner to avoid what may be
considered wrong in himself, but to detect it in others. For
it is true that, while merit does not always rise to the eminence
it deserves, yet, when successful, it is generally more per¬
manent, and with a class more appreciating, because more
refined and intelligent. Hence our advice to all young men is
to base their hope of success on the honorable methods of pro¬
curing business, as a good conscience and right motives wilL
weigh down much of the empty applause of the multitude. It
is not dishonorable to avail one's self of fortuitous circumstances
to advance one's reputation as a skilful practitioner, and what
might otherwise be wrong loses much of its criminality when we
have to contend with quacks and charlatans; but a straight¬
forward, high-minded professional course will ultimately obtain
the victory in a community whose opinion is of value to an
honorable physician.
To make the matter more explicit, we have divided what we
propose on this head into three parts, most of which are ex¬
tracted from the learned and accomplished Rush.
14
158
POCKET FORMULARY.
I.—The Honorable Methods of Acquiring Business.
1. Great application to study, in order to aid observation, arid
the effort to improve experience as much as possible by reading
and conversing with honorable brethren upon medical subjects.
2. Punctuality in visiting patients, and fidelity in complying
with engagements.
3. Inoffensive and acceptable manners, consisting in the
habitual exercise of self-denial as far as it relates to the temper,
and in universal civility or politeness.
4. Sympathy with the sick.
5. Attendance upon the poor. Boerhaave, Fothergill, and
Cullen owed their sudden elevation into extensive and profitable
business chiefly to their being often observed going in and com¬
ing out of the huts of poor people.
6. A regard to decency in dress.
7. A respect for religion, and regular attendance upon public
worship.
8. To cure one's patients as soon as possible.
II.—The Artificial and Accidental Means of Acquiring Business.
1. The patronage of a great or rich man, or of a fashionable
lady, or of several powerful families.
2. The patronage of a political party.
3. The patronage of a religious society.
4. To be frequently called out of church, and some good
friend "to pray publicly for the recovery of the patient.
5. Splendid or popular acts of friendship or humanity, which
indicate neither learning nor skill in the profession of medicine.
6 Great, taciturnity, a sententious mode of conversing, or the
[practice of nodding instead of speaking in company.
7. 'Eccentricity of manners and conduct.
-8. A rejection of the principles of reason in medicine.
9. Great minuteness in inquiring into the symptoms of dis-
-eases; the inspection of lips and teeth by a magnifying glass,
"the tasting the urine and sweats, the smelling the feces, and
even getting into bed with sick people in order to discover the
quality of their perspiration, have all been practised with suc¬
cess as a means of acquiring reputation and business in medi¬
cine.
10. An affectation of a sudden and intuitive knowledge of a
patient's case by feeling but a few strokes of his pulse, or by
barely looking at his countenance.
11. Walking or riding without any definite object, particu
larly in rainy and stormy weather.
MEDICAL ETHICS.
159
12. Speaking in all companies of the number or the rank of
patients, or ordering a servant to remain with a carriage before
the doors of persons of distinction who are not sick.
13. Prescribing for distressing symptoms only, without a due
regard to the nature and danger of the patient's disease.
14. An elegant or beautiful person.
III.—The Dishonorable Methods of Acquiring Business.
1. Opposing the principles and traducing the practice and
characters of brother physicians.
2. Traducing new and popular remedies. The clamors and
slanders against quinine, opium, mercury, and the lancet have
been fruitful sources of business to many physicians.
3. Performing great and sudden cures by some of those reme¬
dies in a disguised form, extolling, at the same time, the powers
of nature in all diseases, and recommending only simple and
domestic medicines.
4. Taking undue advantage of brother physicians in consulta¬
tions by unnecessary examination, by extraordinary degree of
attention to their patients, neglecting, at the same time, their
duty to their own.
5. Publishing accounts of cases that never existed, and of
cures that have never been performed.
6. Flattering the prejudices of cities, towns, and countries
upon the subject of health and prosperity.
7. Charging half price.
IV.—The Just Causes of the Loss of Business are:—
1. Ignorance in medicine.
2. A fondness for pleasure more than the profession, disco¬
vered by constantly frequenting saloons, theatres, cockpits,
horse-races, and other places of public amusement.
3. Delay in complying with calls to sick people, a want of
punctuality in subsequent visits to them, of cleanliness and
neatness in the preparation of their medicines, and of correctness
in the directions which accompany them.
4. Inattention to the history of tedious cases. There is no¬
thing a patient so deeply resents as this kind of treatment.
5. A careless or superficial examination of a disease. A
neglect to ask questions rendered important by long practice
has often created a suspicion of incapacity or negligence in a
physician, and been the cause of the loss of his business.
6. A harsh and indelicate mode of behavior, consisting of
short answers to questions, and of improper rebukes for not
complying with prescriptions.
160
POCKET FORMULARY.
7. Drunkenness, profanity, impiety, and brutal manners.
8. An unfavorable prognostic of the issue of a disease, espe¬
cially if it be delivered in an abrupt and unfeeling manner.
9. Refusing to go out in the night, and deserting old patients
during the prevalence of mortal epidemics.
10. High and extravagant charges.
V.—The Unjust Causes of the Loss of Business are:—
1. The discovery and propagation of new principles, or of
new modes of practice in medicine.
2. The early declaration of the existence of pestilential dis¬
eases in a city or country, and of their originating in domestic
causes.
3. The neglecting to name a disease, or calling it by an im¬
proper name, at the outset.
4. Making light of a disease. Dr. Rush relates a case where
a physician was called to see a child a little indisposed from
teething. He told the parents that its disease was of a trifling
nature, and that it would cure itself. The next day, the phy¬
sician called again to visit the child. Upon asking how it was,
the mother told him he had mistaken its disease, that her neigh¬
bors had told her it was a very dangerous one, and that she had
sent for another physician who was of their opinion, and that he
had sent the child a medicine which had in a few hours per¬
fectly cured it.
5. Medicines prescribed unsuccessfully, especially if they
give pain.
6. The want of popular and engaging manners.
7. Sickness in a physician, and necessary excursions from
home in order to acquire health, have often dissolved forever
the connection which united him to a numerous circle of patients.
8. Unpopular opinions in politics, religion, and temperance
have sometimes been the cause of physicians losing some busi¬
ness.
9. Writing poetry, and upon subjects unconnected with medi¬
cine. Mankind, in general, consider medicine as a trade, and
that physician to be the most dexterous workman who knows
the least of other things. This impression is often sanctioned
by physicians of limited education. They forget that a mere
physician—that is, one who knows nothing but the sciences
which are supposed to belong exclusively to his profession—is a
nonentity. To deserve that title in its extensive import, it is
necessary for us to know something of the principles and prac¬
tice of every art and pursuit of man.
MEDICAL ETHICS.
161
10. By sending in their accounts "when due. In most of cases,
however, when the debt is paid the hostility ceases. Therefore,
I would advise every physician to settle with his patrons once
a year at least.
From a view of the various means used by our profession to
procure business, one would very readily suppose that success
in it were as much the effect of chance as a high prize in a lot¬
tery. But it is consoling to reflect that this is far from being
universally true. Some of the most distinguished and richest
physicians that have lived were noted for their prudence, talents,
and knowledge, and strict observance of the rules of medical eti¬
quette. I am proud to say to the young talented physician,
that the chances of success are rapidly growing in favor of the
one that deserves it. And if every regular physician will carry
this little manual in his pocket, and live and practice up to the
duties of physicians as laid down in the medical ethics, the day
is not far distant when quackery of every kind, Homoeopathy,
Hydropathy, Thomsonianism, and the like, will be buried with¬
out the hope of a resurrection.
FEE BILL.
For the benefit of young practitioners, we introduce the out¬
lines of a fee bill adopted by the Georgia Medical Society, which
may serve them in going to a new place to have their charges
fixed (as they should be) in accordance with the rates of the
established physicians of the place, as nothing can better pro¬
tect the profession from dwindling into a mere trade, and from
becoming the theatre of ignoble strife with all the quacks and
charlatans in the country.
Practice of Medicine.
Visit in town.
Visit on board ship in stream.
" " after dark.
Visit by request after dark and before 10 P. M.
Visit after 10 P. M.
Rising from bed and prescribing without visit.
Visit in the country, per mile.
Visit in the country, per mile, after dusk.
Visit by water, day or night, per mile.
Visit and consultation.
After the first visit, the ordinary fees only to be charged by
the consulting physician.
14*
162
POCKET FORMULARY.
Advice in common cases.
Advice in extraordinary cases.
Giving a medical opinion on a negro offered for sale.
Not more than three visits per diem to be charged, unless
made by request.
Written advice for the continued or entire treatment of a case,
such advice not being on the footing of a single prescription.
For a certificate of the state of health of an individual.
Practice of Midwifery.
Simple obstetric case.
Slaves.
Preternatural and complicated cases, not requiring instru¬
ments.
For turning ; or for instrumental labors.
Examination per vaginam during labor, and giving an opinion.
Restoring retroverted uterus.
Reducing prolapsus uteri and retaining it by pessary.
Delivering placenta alone.
Attendance on a case of abortion.
Any medical attendance after five days from delivery to be
charged as usual.
Surgical Practice.
Trepanning.
Subsequent treatment according to the charges for visits and
dressing—not to exceed
Trepanning slaves.
Operation for cataract and do.
" artificial pupil and do.
" fistula lachrymalis and do.
" extirpating eye and do.
" extracting polypus and do.
" trichiasis, ectropion, entropion, pterygium, or
strabismus, each
" extirpating tonsil gland.
" cutting off uvula.
" staphyloraphy and do.
" brachial aneurism and do.
" * popliteal.
Tying subclavian and do.
Operation for varicose veins.
Tying up an artery in a wound, not specified above.
MEDICAL ETHICS.
163
Paracentesis thoracis.
" abdominis.
Tapping hydrocele ■without injection.
Radical treatment of hydrocele.
Hernia and subsequent treatment.
Reducing strangulated hernia (per taxis).
Applying a truss.
Lithotomy or lithotrity and subsequent treatment.
Extracting stone from the urethra by incision or otherwise.
Operation for phimosis or paraphimosis.
Extirpation of the testicle.
Puncture of the urinary bladder.
Introduction of catheter, male or female.
Treatment of permanent stricture.
Treatment of gonorrhoea.
Treatment of syphilis.
Extirpating hemorrhoids.
Division of the frsenum linguae.
Extirpating cancerous lip.
Extracting foreign bodies from oesophagus and other passages.
Operation for ranula.
Tracheotomy and laryngotomy.
Operation for fistula in ano.
" " perineo.
Operation for hare-lip.
Perforation of the antrum maxillare.
Excision of mamma.
Tenotomy.
Amputation at the shoulder joint.
" arm or forearm.
" thigh or leg.
" finger or toe.
" metatarsal or metacarpal.
" penis.
Treatment of simple fracture of lower jaw.
" " nose.
" " clavicle.
" " arm or forearm.
" " thigh.
" " leg.
" " olecranon.
" " patella.
" " finger or toe.
" " rib.
Compound fractures to be charged double simple cases.
164
POCKET FORMULARY.
Reducing luxation of the jaw.
" clavicle, shoulder, arm, or ■wrist.
" hip.
" knee or ankle.
" linger or toe.
" patella.
Dressing common ulcers.
Extirpating tumors.
Opening common abscess.
Venesection or extracting tooth.
Insertion of seton or issue.
Scarification and cupping.
Application of leeches.
Arteriotomy.
Arresting epistaxis.
Vaccination, whites.
" slaves.
" " per dozen.
Medical certificates.
Electricity.
Attendance at court involving a medical opinion.
Making a post-mortem examination by request, for each phy¬
sician.
(Not more than two to be employed, except by special request.)
LIST OF MEDICINES, SHOP FURNITURE, AND SURGI¬
CAL INSTRUMENTS REQUIRED BY A PHYSICIAN AT
THE OUTSET OF HIS PRACTICE.
1 lb. tinct. opii.
1 lb. " camph.
\ 1 lb. copaibse.
1 lb. sp. aether, nit.
' - § lb. " lavand. comp.
yvl lb. liq. ammon.
SA oz. acid, muriatic.
J 4 oz. " nitric,
t 8 oz. " sulphuric.
4 oz. " tartaric.
J 1; lb. hyd. chlor. mit.
I, -6 pz. jalapae.
Ij, § oz. rhei.
2 oz. acid, citric.
/ 1 oz. " benzoic.
< n 1 oz. " tannic.
1 oz. " arsenious.
-"^rS-ez. magnes. calcin.
f lb. potass, bitart.
1 lb. sodae bicarb.
* l|y'l lb. camphor.
y l'lb. sulphur, sub.
' -V 1 lb. gum. acaciae.
8 oz. tinct. myrrhse.
» </ 8 oz. " fer. chlor.
. */" 8 oz. ether.
MEDICAL ETHICS.
165
6 oz. aloes.
"8 oz. assafoetidae.
8 oz. plumbi acet.
8 oz. ammon. carb.
8 oz. cupri sulph.
4 oz. zinci sulph.
8 oz. cretas prepar.
4 oz. potass, carb.
^ 2 oz. " iodid.
4 oz. " nitrat.
4 oz. ferri carb.
1 vel 2 oz. quinige sulph.
4 oz. liq. plumbi acet.
; ' 1 dr. morph. sulph.
1 oz. iodinii.
1 oz. argent! nit.
1 oz. hyd. chlor. cor.
i 1 oz. " oxid. rub.
4 oz. vin. ipeca«.
8 oz. " rad. eolchic.
1 oz. ol. menth. pip.
2 0 ol. ricini.
2 0 ol. olivae.
M oz. pil. hydrarg.
3 oz. ext. coloc. comp.
2 oz. " gentian.
2 oz. " taraxac.
1 oz. " jalap.
J oz. " bellad.
1 oz. " hyosc.
8 oz. alum.
1 lb. eupator.
4 oz. boracis.
2 oz. colombae.
4 lbs. mag. sulph.
3 oz. foenicul.
4 oz. gallarum.
8 oz. gentian.
2 oz. hellebor.
4 oz. mannae.
»"l 8 oz. sp. eth. comp.
8 oz. " ammon. arom.
8 oz. syr. rhei arom.
8 oz. " scillae.
8 oz. " " comp.
fiL-fOi. " tolutan.
8 oz. acid, sulpk. arom.
' 2 oz. pulv. ipecac.
2 oz. pulv. ipecac et opii.
2 oz. ant. et potass, tart.
3-oz. ergotse.
2 oz. pulv. cantharidis.
« k-< 4 oz. liq. potass, arsen.
1 oz. ol. cinnam.
« /' 1 oz. pulv. digitalis.
1 oz. " gambog.
* " 1 oz. " opii.
■, -r, 1 oz. " scillae.
► 1 oz. creasoti.
* ' ^J it02, v
* / 2 0 turpentine.
3 cong. alcohol.
, J oz. ext. stramon.
* < | lb. ung. hydrarg.
2 oz. " " nit.
\ lb. cerat. cantharid.
4 oz. " resinse.
4 oz. " simplicis.
1 oz. " plumbi subacet.
£ lb. spigeliae.
4 oz. quassiae.
8-oz. earsaparillae.
4oz. senegae.
£ lb. serpentariae.
8-oz. sennse.
8-ez. uvae ursi.
4-ea.. valerian.
3 lbs. prun. Virg.
--v ^ ' . .' .
166
POCKET FORMULARY.
] mortar and pestle. -<«
1 pill tile.
1 graduated measure.
Scales and weights.
1 speculum.
1 stomach tube.
1 nursing bottle.
6 nipple shields.
1 scarificator.
2 spatulas.
1 gross vials, assorted.
1 funnel.
2 syringes, 8 and 10 oz. enema.
1 vagina syringe (Dr. Chase's).
2 womb syringes.
1 breast pipe. *
2 quires paper, wrapping.
1 gross corks, assorted.
8 papers of pill boxes. *
1 female catheter, silver.
1 tin of adhesive plaster.
3 catheters, elastic.
3 bougies.
6 cupping glasses.
2 thumb lancets.
1 pocket case instruments.
1 set teeth extractors.
1 sheepskin.
12 quart specie bottles.
12 " tincture bottles,
12 pint specie bottles.
12 " tincture bottles.
12 half pint salt mouth bottles,
glass stopper.
12 half pint salt mouth tincture
bottles.
LAW POINTS CONCERNING PHYSICIANS.
In most of the States of the Union, to practice medicine or
surgery, the possession of a license or diploma from some in¬
corporated medical college or State society, is necessary. With¬
out this diploma or license, a practitioner cannot recover a fee
or compensation for professional services. Unfortunately, how¬
ever, in some of the States, the regularly educated practitioner
has no advantage over the quack and charlatan, and, in actions
to recover bills for professional services, the law makes no dis¬
tinction in favor of the possessor of a license or diploma.
In those States where a diploma or license is required, a prac¬
titioner who shall undertake a case, without diploma or license,
is guilty of felony if the patient die through his mismanage¬
ment.
Neglect or unskilful management of a patient, on the part of
a physician, surgeon, or apothecary, renders the latter liable to
an action for damages, and large amounts have frequently—and
very often most unjustly—been recovered under such circum¬
stances. In the treatment of surgical cases, particularly, too
much circumspection cannot be employed by the practitioner.
Mere want of success in the treatment of a case can never,
however, render a physician liable to damages or punishment.
If he treat the case according to the modes of practice in best
MEDICAL ETHICS.
161
repute, and "with all possible attention, he cannot be held re¬
sponsible for the result.
A physician is bound, under the rules of common law, to
testify, in courts of justice, in matters concerning his patients,
even though his information be obtained confidentially. In some
of the States, however, special statutes exist on this subject,
and the practitioner should inform himself thereupon. Unless
compelled by law to disclose them, he should always regard
communications, or facts to which he becomes privy in profes¬
sional attendance, as the subjects of inviolable secrecy.
FORM OF WILL.
As physicians will often be called upon to visit patients at
those stages of disease in which it is common for them to make
their wills, and in which legal aid cannot be obtained for that
purpose, it may not be improper to add in this place a form of
a will, that you may assist a dying patient in disposing of his
property in a correct manner; but I would advise you not to
write a will if a lawyer can be had, or if it can be done by any
one else present as correctly. And also let me advise you never
to suffer a patient to die who has a right, and is in a condition
to make a will, without informing his friends of his probable or
approaching dissolution, and suggesting to them the propriety
of his performing that act. We owe this duty to his family and
to society. The suggestion to the patient should never come
directly from a physician; he should at all times appear to him
as a minister of hope. By means of a contrary practice, sick
people, I believe, have sometimes been hurried out of the world.
State of Georgia,
Hancock County.
In the name of God, Amen, I , being of sound and
disposing mind and memory, and considering the uncertainty of
this mortal life, do make and declare this my last will and testa¬
ment, in manner and form following:—
Item First.—[Here state, if desired, what disposition the
testator wishes to be made of his body after death.]
Item Second.—[Here state what disposition the testator wishes
to be made of his property relative to the payment of debts.]
Item Third.—I give, bequeath, and devise to my son,
[here describe the land given], with all the rights, members,
and appurtenances to the said land, in anywise apper¬
taining or belonging; to have and to hold to him, the said
168
POCKET FORMULARY.
, his lieirs and assigns forever. I also give and bequeath
to him [here describe the property], and the sum of
dollars, to be paid to him by my executor [here state
when and how].
Item Fourth.—I give, bequeath, and devise to my daughter,
[here state what property, &c.], to her sole and sepa¬
rate use, for and during her natural life, free and exempt from
the debts and liabilities of her present or future husband. [This
clause may be left out if the testator does not wish to settle the
property on his daughter. If the testator wishes the property
to revert back to his family should his daughter die without an
heir, state the fact.]
Item Fifth.—I give, bequeath, and devise to my wife,
[here make a statement of the property, &c.], during her na¬
tural life, free from the debts or control of any future husband,
and to her sole and separate use, the aforesaid property, and
after her death to [here state to whom, &c.], and to their heirs
and assigns forever.
Item Sixth.—I give, bequeath, and devise to my son,
[here state the property, &c.], for his natural life; and, after
his death, it is my will and desire that said property be [here
state the desired disposition plainly, &c.].
Item Seventh. —I give and bequeath unto my friend, ,
the sum of .
Item Eighth.—The residue of my property, both real and per¬
sonal, wherever found or whatever it may be [here state what
disposition the testator may wish to make of it].
Item Ninth.—I hereby constitute and appoint my trustworthy
friend, , guardian of the person and property of mj
daughter, , during her minority.
Item Tenth.—I hereby constitute and appoint my friend,
, executor, and my beloved wife, , executrix, o:
this my last will and testament, hereby revoking all other!
heretofore made by me.
Witness my hand and seal, this the first day of May, in th<
year of our Lord one thousand eight hundred and fifty-five,
. [L.S.]
Signed, sealed, delivered, and published by , as hii
last will and testament, in the presence of us, the subscribinj
witnesses, who subscribed our names hereto in the presence o
said testator (at his special instance and request), and in th
presence of each other, this May 1st, 1855.
A B,
C D,
E F.
MEDICAL ETHICS.
169
Form of Codicil.
State of Georgia,
Hancock County.
Whereas I, , having made my last will and testament
iu writing, bearing date, &c. [here give the date, names of sub¬
scribing witnesses, &c.]. Now I do by this, my written instru¬
ment, which I hereby declare to be a codicil to my said will, to
be taken as a part thereof [here follows such addition, altera¬
tion, or revision as the testator may desire].
[Note.—The codicil should be executed the same as the will.]
Practical Remarks.
Whatever difference there may be in the laws relating to
wills in the different States, the following circumstances, I be¬
lieve, are required by most of them, in order to render them
valid.
1. The person making a will must be of sound and disposing
mind and memory.
2. It should be subscribed by two or more credible witnesses.
In Georgia, there must be three witnesses.
3. The witnesses should be of the age of discretion, say above
fourteen years old, and should not be the heirs of any part of
the property bequeathed in the will.
4. A legacy bequeathed to an executor who owes anything to
the estate of a testator, cancels the debt unless the estate should
afterwards appear to be insolvent.
5. If a man have made a will, and have added to his real
property after he has made his will, it will be necessary for him
to add what is called a codicil to it, or to make a new one. If
from the transient duration of a man's reason, or the appear¬
ance of a speedy termination of his disease in death, or if, from
the want of implements for writing, or if he should be unable to
subscribe his name, or to make a substitute for it by a mark,
he may dispose of his property and name his executors verbally.
There should be three or four witnesses present, and the be¬
quests of the deceased should be committed to writing within
six days.
15
CONCLUSION.
To the Members of the Profession—
I have completed my little manual, and on tlie score of bulk
it can certainly make no pretensions. The author, however,
has only intended it to be a book of hints. If you will wear
it in your left side coat pocket, and take daily counsel^ from its
records—it will certainly not make you scholars or physicians,
but it will often be a secret monitor in times of "need," and
guide you safely over many rugged paths in the profession of
your choice ; and lastly, but not least, it will teach you your duty
to your brethren, and their duty to you, which is not only im¬
portant for your own happiness, but often for the good and
safety of the sick.
I have no doubt that some of its pages will meet with some
opposition, as every benevolent project has from time imme¬
morial.
When Moses went to his brethren in Egypt and entreated them
"not to do wrong one to another," the reply was: "Who made
thee ruler and judge over us?"
When the Saviour of men offered his life for the redemption
of the world from the evil of sin, the cry of those who ought to
have been the most grateful, was: " Crucify him; crucify him."
Hence, we cannot expect to escape the criticisms and the ana¬
themas of some ; but with the good and the wise we trust our
little book will receive a hearty welcome, and its motives be pro¬
perly appreciated. We hope it will not have a tendency to in¬
duce any to recline on their beds of indolence and ease, but
stimulate them to noble deeds—to study hard the elaborate
truths and matchless beauties of the noblest and most humane
of all the arts the genius of man ever devised—the art of heal¬
ing—the science of medicine.
Since writing the above, I have been presented with an intro¬
ductory lecture, delivered October 13, 1854, by Dr. Alfred
CONCLUSION.
in
Stills, Professor of the Theory and Practice of Medicine in the
Medical Department of Pennsylvania College; and it is so elo¬
quently and beautifully illustrative, and so pertinent to my pre¬
sent purpose, that I cannot refrain inserting that portion that so
clearly and beautifully answers the question—What is medicine ?
"Of all departments of knowledge, medicine is the most com¬
prehensive. Soul, life, and body, with the external world, are
its subjects. It is concerned with all of man's earthly con¬
ditions and relations. No other science has any such preten¬
sions. To announce such a proposition may seem startling, no
doubt, but it is, nevertheless, true. All other sciences are more
partial and incomplete. Theology ignores the body of man;
Law does not recognize his soul; and the Physical Sciences re¬
gard him only as a machine, or as a congregation of lifeless
elements. Medicine alone embraces both his material and his
spiritual nature, and writes his history from the time when the
lord of creation was no bigger than a grain of mustard-seed, to
the moment when, after having been the scourge or the bene¬
factor of his age, he shrinks at last into a handful of dust.
"Medicine is a composite science. (At some point it touches
all other sciences, and borrows from each wherewith to adorn
and enrich itself. In the present age, when its principles are
ranked, by general consent, among those of the inductive sci¬
ences, it is difficult, at first sight, to understand why it should
have been so closely allied to metaphysics, both in ancient times
and modern, and indeed until a very recent date. But such was
the fact: so close was the alliance that it amounted almost to
identity, for each dominant sect of philosophers was represented
by some school of medicine, which explained the vital functions
and the phenomena of disease according to its own theory of
life. A close approach to the same sort of connection may be
noticed in modern times between medical systems and physio¬
logical theories. In the last century, a dominant school explained
all the phenomena of disease upon mechanical principles, for in
them they seemed to find a solution of all the problems that
concerned the natural actions of the body. At the present mo¬
ment, a large portion of the medical world confides in theories
which chemistry has given birth to in its somewhat ambitious
scheme of subjecting the phenomena of life and of disease to
the same laws which govern the reactions among particles of
dead matter. Thus medicine may occasionally suffer by its
union with the sister sciences; yet it unquestionably derives
from them far more benefit than it sustains injury. They enlarge
its scope, and augment its powers; by widening the basis on
which it rests, they insure its stability; they perpetually in-
112
POCKET FORMULARY.
crease its tendency to assume a scientific form ; and thus aug¬
ment the difficulties of counterfeiting a knowledge of its mys¬
teries, while they render its control over the causes and issues
of disease more prompt and certain.
" Such an object, then, as medical science may well oppress the
mental eye with its grandeur. Regarded from whatever point of
view, its vast proportions and extent fill the mind with reve¬
rence. Medicine is the oldest of arts, the largest, save one, of
literatures, the most comprehensive of sciences,i and of all pur¬
suits the noblest and most humane. No mind, however capa¬
cious, can embrace so vast a subject, and certainly none can
cultivate all of its departments with equal success. This has
never, indeed, been done. But because medicine is so many-
sided, it is attractive to persons of all tastes, and lends itself to
the accomplishment of various objects. It is suited also to
every grade and peculiarity of talent, from that of the unlearned
practitioner—who sees but little variety in his sequestered field
of observation, and needs but simple means in the ordinary ex¬
ercise of his art—up to that of the renowned teacher who stands
at the head of some metropolitan school or hospital, conducts a
wide and diversified practice, and unfolds to others the mysteries
of life, of organization, or of disease. An immense chasm sepa¬
rates the simple physician, whose duties are altogether practical
and confined to the domestic bed-side, from the pre-eminent
man of science, the Galen, or the Hoffman of his age, whose
opinion carries with it an almost religious sanction, whose doc¬
trines are a law to his brethren, and are appealed to as authority
by the whole civilized world.
"Within the interval that divides two such extremes froife one
another, there are spheres, any one of which is sufficient to
absorb all the faculties of the mind. Between simple routine
and scientific knowledge, there are many grades of honorable
and useful occupation, and a scope for all talents and all tastes.
This it is that forms one of the peculiar charms of medicine—
one which has allured many into our halls, and even into our
very ranks, who sought at first no other object than the grati¬
fication of a taste for knowledge. They were, perhaps, repelled
by the dogmatic conclusions of theology, and the arbitrary
principles of law, as much as they were fascinated by the pe¬
rennial freshness and infinite variety of medicine. Unlike other
departments of study, it is at once venerable for its antiquity,
and charming for its immortal youth. Its form is dignified and
hoary, but its spirit has all the vigor, and buoyancy, and onward
movement of youth. It commands acquiescence by the au¬
thority of illustrious names, and by the demonstration of recent
CONCLUSION.
113
facts. It has equal charms for the scientific, the literary, and
the practical cultivator. The most logical may find in it full
scope for their reason, the most refined for their taste, and the
most benevolent for their feelings. It is, indeed, an epitome of
all other knowledge, whether abstract and metaphysical, or
whether material and inductive, or descriptive.
"Even to the historical student, Medicine is full of interest.
Its records are among the most ancient. We need do no more
than mention the earliest of all, those Egyptian precepts which
are alluded to in the writings of Moses, and those hygienic and
medical precepts contained in the laws of the Hebrews, and
doubtless also of Egyptian origin, or to those equally ancient
treatises, which are still preserved among the sacred books of
the Indo-Asiatic nations, and of the Chinese. In all of these
cases, medicine borrowed its authority from religion ; its prin¬
ciples and precepts were held to have been supernaturally
communicated to man, and observance of them was enforced by
religious sanctions. So, too, in Greece, the cradle of our own
medical science, the first conspicuous name on the roll of our
profession was no less than a demi-god, Esculapius, the son of
Apollo and the nymph Coronis. Between his epoch and that in
which medicine assumed the form of a human science, much
time must have elapsed, for the works which pass under the
name of Hippocrates are clearly, and even avowedly, the ex¬
pression of an existing condition of the science and the art of
which they treat. Upon these, our earliest annals, the student
of history may pause with wonder. In reading them, he will
be amazed that so much of what is essential to the knowledge
and cure of diseases should have been accurately known at a
time when Germany, France, and Britain were inhabited by
painted savages, and nearly two thousand years before America
was discovered. As upon page after page he meets with de¬
scriptions and precepts which modern works have made familiar
to him, he will for the first time understand something of the
immense treasure which antiquity has bequeathed to us, and
the grounds of that reverence which for so many centuries the
world has paid to the name of Hippocrates. As he descends
along the historic stream, and studies the writings of the Greek,
the Roman, the Arabian, and modern European physicians, he
will be amazed to find that, however much the current may
widen and deepen by the constant accession of new elements,
it still remains essentially the same. In every age, indeed, the
face of the waters and the banks may have changed their
aspect; little turbid creeks, the ephemeral inventions of the
learned unwise, have for a brief space stained the surface of the
15*
m
POCKET FORMULARY.
clear waves, and then sunk to the bottom; tawdry and elabo¬
rate edifices have been erected upon the shore, in which some
system-builder has thought to dwell immortally—but the great,
steady, onward rush of the current has swept away their foun¬
dations and scattered their ruins.
"The essential immutability of medicine is one of its grandest
features. It is one which our imperfect systems of education
leave too much out of sight. The student is struck by the muta¬
bility rather than by the permanency of medical science, and
thus one of the strongest motives that can operate upon the
human mind, the love of stability, is altogether lost upon him.
The true student of history, however, sees development in suc¬
cessive changes, and an advance towards that perfection of know¬
ledge and remedial power which medicine has been constantly
approaching. It is very true, indeed, that the progress towards
this goal has never been uniform. At times, perhaps, the move¬
ment has even been retrograde. But the student will clearly
perceive that an immense addition has been made to knowledge
between almost any two epochs of our history, and at some,
like the present, with marvellous rapidity. He will perceive
that the phenomena of disease have at all times been described
in essentially the same manner, and that improvements in the
art of observation have depended less upon original sagacity,
which must have remained almost unchanged, than upon the
application to medicine of collateral aids drawn from other
natural sciences. Thus, to cite a single and familiar example,
the recent improvements in chemistry have multiplied pheno¬
mena for the investigation of the physiological and pathological
inquirer. They have furnished new facts. They do not change
the well-established results of antecedent investigation, they
only explain them.
" In whatever age any truth may be added to the stock of
positive knowledge, its existence is permanent. It can no more
perish than matter can be annihilated. Even less changeable
than matter, which may be resolved into its ultimate atoms
and then recomposed in absolutely new forms, whatever truth
represents a material feet is no less immutable than God, and is
as lasting as the universe. Hence it is that the student of his¬
torical medicine enjoys a peculiar advantage. Inquirers into
political or social history find that it is marked by distinct and
independent epochs, each one of which has its own stage of de¬
velopment decline, and decay, and is succeeded by an entirely
new era, in which different elements combine, and evolve new
forms. But medicine is the child of Time, and must advance
from one stage of perfection to another, until Time itself shall
CONCLUSION.
175
be no more, and with mortality the ministers to mortal ills shall
cease from the earth.
'•But there is much else of interest in medical history. War
has occupied the largest share of the attention of the human
race, and left the deepest traces in society, far deeper, indeed,
than the marks of those who have labored to spread the bless¬
ings of peace. And medicine, too, has had its polemics. The
acrimonious quarrels of rival or opposing factions have caused
more volumes to be written, and more skill and energy to be
displayed, than were ever rallied to the cause of truth. And
these violent and prolonged disputes have injured the cause of
science no less than wars have hindered the progress of civiliza¬
tion.
" Science is the child of peace. The voice of wisdom is only
listened to when the din of arms has ceased. In the successive
periods of conflict and repose, the historical student can trace
the alternately bright and cloudy periods of our art. He beholds
it slumbering in an almost death-like trance during the ' dark
ages' of Christendom, when its spirit seemed to have fled for an
asylum against persecution and violence, or cold neglect, to the
Arabians and the Moors. The school of Salernum, in Italy,
was, for several hundred years, almost the only one of Europe
where some fitful gleams showed that the life of the medical
body was not utterly extinct. But it has not bequeathed to us
a single great name. During the twelfth, thirteenth, and four¬
teenth centuries, scarcely one illustrious light is visible in the
thick darkness. But towards the close of the fifteenth century
there appeared suddenly, and with a splendor like the breaking
of a new day, a brilliant galaxy. This was a period of general
awakening, and the same causes, doubtless, which produced a
Henry VIII. in the political, and a Luther in the religious world,
gave birth to Linacre, to Frascator, to Fernel, to Fallopius, to
Sylvius, and to Paracelsus in the medicalt Society had now
received the form which it essentially possesses at the present
day. As it developed itself more and more towards the substi¬
tution of the law of liberty for the caprice of tyranny, the num¬
ber of cultivated minds grew constantly greater, and laborers in
the fields of science were surprisingly multiplied. Periods did
indeed occur, when the voice of learning was drowned in the
shouts of battle or the yells of a mob. Such was the memora¬
ble one, at mention of which Europe thrills even now; when
demons of perdition seemed let loose to plague mankind ; when
to be a cultivator of the arts of peace insured conviction of in-
civism and condemnation to the bloody knife. Then, indeed,
the adepts of our science hid like hunted hares, or fled panic-
It6 POCKET FORMULARY.
stricken across the frontier of their devoted country. But
when the tempest had declined, and the land had ceased to be a
vast military camp, the nobler energies of the nation displayed
themselves with unexampled power in the career of science.
With rare intervals, and almost up to the present time, France
continued to produce medical works of more profound research,
richness of discovery, brilliancy of suggestion, and utility to
mankind, than during any other equal period of her whole
history.
" One of the most remarkable features of human annals is,
that certain periods have been distinguished by great leaders
or rulers. Great men stamp their image upon their time. It
is vain to plead the dogma of a natural equality of men. Na¬
ture gives the lie to such a theory, and points, for its refutation,
to the renown of the very men who sanctioned the specious fal¬
lacy. Hero-worship is established by the common consent of
mankind, and no amount of railing can do away with it. The
age of Pericles, the Augustan age, the age of Louis XIV., and
others, will still continue to be types of glory and objects of
admiration. The care taken of men of genius by patrons of
science, literature, and art, and the homage rendered in return,
have always been marks of a high civilization. In none but
half-civilized countries do such persons lack national encourage¬
ment. The ruler who signalizes his reign by generous acts to
men of letters is far surer than the military chieftain of attach¬
ing his name to an historical period. I know of no great war¬
rior who has done so, but the distinction has been gained by one
whose weapon was the crosier of St. Peter, and who is cele¬
brated when we speak X)f 'the age of Leo X.' And we, too,
have our kings and princes. Their reigns are to be measured
by centuries and not by years, and their kingdoms are bounded
not by mountains and rivers, but by oceans. Our sages of Cos
and Pergamus, of Alexandria and Rome, of London, Paris, or
Vienna, may vie with any that the pages of history commemo¬
rate for the extent, duration, and stability of their power.
Kingly authority could not ennoble them, although it often con¬
ferred upon them rank, emoluments, and power. It could not
degrade them, though it sometimes persecuted and reviled them.
They not only fostered science ; they taught it by precept and
example. They ruled by the unseen but all-powerful sceptre
of genius and learning over more nations than ever acknow¬
ledged the sway of Rome. And they were even more honored
and obeyed when dead than they had been in the zenith of their
lives.
" There are some striking analogies between the history of
CONCLUSION.
in
the medical profession and of the popular element in nations.
We know that anciently the masses of the people were degrad¬
ed by political and social servitude. Domestic slavery, not of a
foreign and dissimilar, but of a similar and even of the same
race as the masters, was common in all the republics of Greece,
and also in Rome. For many centuries after the fall of the
Roman empire, serfdom prevailed in Europe, and still exists in
Russia. Now everywhere but among the Romans, whose war¬
like and rugged disposition could never receive the delicate
polish of high civilization, the physician was regarded as belong¬
ing to the privileged classes of society, and often received dis¬
tinguished honors. Surgeons, it is true, occupied an inferior
rank, and were employed to perform the manual operations
which physicians directed. Anciently, they were nearly always
slaves or freedmen, and, indeed, until very recent times, had
more in common with barbers than with physicians To this
day, in England, the title of physician is higher, and his emolu¬
ments generally greater, than those of the surgeon, and the
Fellows of the Royal College of Physicians still form a profes¬
sional aristocracy. But such distinctions are fast becoming
merely nominal in England, and upon the Continent are alto¬
gether so. Hence, it is evident that the medical profession and
the community have obeyed the same general law by which
classes that were formerly separated by distinction and privilege
tend to be merged into a single one. iHe who would now rise
above his fellows, must owe his elevation to deeds that deserve it}
"In this country, where rank has never been legalized, nei¬
ther birth nor social position gives claims to popularity or to
political preferment; on the contrary, they are rather obstacles
to political success. Every man who feels within him the genius
to command, may, if he will but use the means, rise to whatever
station he prefers. Chance or personal favor may hasten his
elevation, or accident defeat it for a time, but if he strongly
wills, he must succeed in attaining it. So, too, in Medicine.")
The aspirant does not, as in other countries, find in every avenue
a barrier formed by his lack of preparation, his immature age,
or his obscure condition. Nowhere else is the best professional
education so accessible to all who seek it. The vast numbers
who annually resort to the schools are evidence enough of this.
Of their subsequent career they are themselves the masters;
the reins are in their own hands, and whatever goal they have
the strength and resolution to reach, they must sooner or later
win.
"Yet the way is not smoother than the political arena, nor
the rivalry freer from shocks and stratagems. The shallow
178
POCKET FORMULARY.
politician, the trickster of popular favor, the great man's fami¬
liar spirit, the creature of accident, may sometimes glide into
place and power. But far oftener the swift is the winner of the
race, and the strong of the battle. And thus in the medical
commonwealth it may happen that the smooth and plausible
deceiver, the crafty panderer to the sins and follies of patients,
the cringing sycophant of doctors of renown, the oracular ex¬
pounder of solemn nonsense, or even the insolent denouncer of
all science, the dealer in shameless imposture, the trader in
nostrums, the brazen-browed quack, in fine—may plate his sins
with gold, and be worshipped by the people, as was the golden
calf of ancient times. But his end is amidst the tortures of a
guilty conscience, and the execrations of his victims. Apart
from such as these, and above them in an atmosphere they can¬
not breathe, the great body of the medical profession, the true
physicians, present an example of pure and noble aims, and of
devotion to knowledge and benevolence, which bring their inse¬
parable rewards, a clear conscience, the blessings of humanity,
and a sufficiency of this world's goods.
" These are only a few of the analogies which must occur to
the student of general and medical history. But time would
fail me to extend the parallel, and I turn to another phase of
medicine. It is a science, and none other possesses attractions
so numerous, so various, or so unfading. Though you should
never feel a pulse, nor listen to the touching narratives of the
sick, Medicine would still be able to absorb all of your faculties
and affections. Physiology and Anatomy greet you with their
wondrous revelations, tracing man's development from the
microscopic point at which his existence begins, and leading
you among the diversified and intricate organs that sustain his
life and his relations with the external world. Or, with Patho¬
logy as a guide, you may explore the ravages wrought by dis¬
ease in the organism, and learn to detect the earliest changes
in the normal condition of the textures, the mode of their deve¬
lopment, and of their interference with health or life. Or, turn¬
ing from such sad though pre-eminently useful contemplations,
you may go where the trees wave and the plants bloom, whose
roots, or bark, or leaves, or flowers, conceal the balm that
assuages pain or makes the sick man whole. Or you may enter
the laboratory, where the subtle essence of vegetable and mine¬
ral is evolved, to become a docile minister to humanity in your
hands. Whether you roam the hills and dells in quest of the
one, or eagerly watch the delicate process that is to evolve the
other, you cannot but feel that the book of Nature holds no
marvels more fascinating and no wisdom more useful.
CONCLUSION.
179
" Thus might I pursue the subject. For of all the natural
sciences there is not one, except Astronomy, which does not
furnish a field for the studious physician. Nor need Astronomy
be absolutely excepted; for historically, and under the more
mystic form of Astrology, this science was once the handmaid
of Medicine. The planets were thought to rule the phases of
disease, and the full moon has been charged with many an out¬
break of lunacy. But time would fail me, and I hasten on.
" Gain, mercenary gain, may serve as a motive to study and
practice Medicine. Health is the essential condition of happi¬
ness to nearly all men. Sickness is the privation, and death,
in a worldly view, is the negation of happiness. Health, there¬
fore, is a priceless treasure. No payment can be an equivalent
for the preservation of health or life. Whether he who has been
rescued from the flames or from the waves present his deliverer
with a penny or a thousand dollars, the reward is equally in¬
adequate if measured by the service alone. Hence it is that
the fees of physicians are called honoraria; they are given as
tokens of gratitude and respect,, and not as equivalents for
services rendered. To make use therefore of one's power over
life and health to extort a price for saving either; to play upon
the fears of the wealthy, the hypochondriacal, the victims of
temptation or of sensual excess, in order to enforce a claim for
exorbitant fees, is merely to act the part of a footpad, and, in
almost the same words, to cry, ' Tour money or your life!'
"Medicine, it is true, is seldom a road to wealth. Physi¬
cians too often spend their years in exhausting labor, and leave
their children to fight the battle of life for themselves. Yet in
spite of this their great need, nothing is so rare as an avaricious
physician. Some have been grasping, but it was only that they
might be prodigal. Wherever one has been both niggardly and
rapacious, his brethren have shunned him as a monster, and he
has lived a solitary and despised life. Although medicine must
needs be practised for a livelihood—for even they who serve
the altar must live by the altar—he is generally happiest and
most successful who views his gains as an incident of his pro¬
fession, and not as its leading object. His daily bread is sweet¬
ened not by daily toil alone, but also by a consciousness of hav¬
ing mitigated human sorrow, and sometimes by the sweet incense
of grateful hearts; for the crowning charm of medicine is to
be a benevolent art. If the most exalted genius, the most
incessant and fatiguing toil, the clearest judgment, and the
longest and most varied experience are necessary to perfect a
physician, let it never be forgotten that all this talent, learning,
and devotion have no other object than the cure of the eick.
180
POCKET FORMULARY.
And let not those whose fastidiousness is shocked by the seen
which fill the chamber of the sick and dying.sneer at the digni
of our office. None can be more dignified; for by precept ai
by practice it was placed first of human callings by the mo
exalted Being that ever trod this earth. Even among the he
then, as already remarked, Religion and Medicine were unite
and the priest was also the physician. To the Christian pries
hood, too, we mainly owe the preservation of our literature ai
our traditions during the darkness of the Middle Ages.
" Whoever is about to embrace the medical profession shou
know that, perhaps for many years, he must bestow the frui
of his knowledge and the resources of his skill upon those w'
have little to repay them; that after, it may be a life-lo:
practice, he will have to reckon far more labor performed gi
tuitously than fully recompensed. If this prospect affright
chill him, the true spirit does not animate his heart, and he h
better turn back while he may do so without disgrace. But
on the contrary, he yearns for the time when he shall have t
power to arrest disease, to- call back the departing spirit,
restore the babe to its mother, the parent to children over wh<
the dread doom of orphanage was hanging, the gifted and v
tuous citizen to the State—then may we greet him with a heai
welcome, and predict for him an honorable name and station.
" The good physician ! how many of us can recall the portr
of such an one! Grave in his gait, simple in his attire, refin
in his manners, his countenance radiant with a genial smile,
impressed with a winning seriousness that bespeaks sympat
with human sorrow, a man beloved and trusted in the domes
circle, whose sobriety of thought and demeanor inspire respe
whose habitual candor wins for him the honor of the learn
and the reverence of the humble, whose hand follows secre
the promptings of his heart, and who neither extorts reluct?
thanks from the surly boor nor from the humiliation of 1
fallen in rank and fortune: such men there have been, a
such still adorn our ranks and dignify human nature. If ]
always the most renowned in the annals of science, nor m
assured of posthumous fame, their names are nevertheless e
balmed in the hearts of thousands ; and doubtless those amc
them who have been gathered to their rest may see that, ai
all, they have gained a high and enduring reward, a rewi
denied to those who, while they enriched science by discove
despised the blessing promised to ' the man that provideth
the sick and needy.'
■ 4" Gentlemen, I have drawn for you a picture of the proi
sion you are about to enter. Are its shadows here and th
CONCLUSION.
181
sombre and forbidding? Yes; but the lights are warm, and
strong enough to make the gloom invisible and unfelt. Is the
dedication you are about to make a solemn one ? Yes; but it
secures to you knowledge and power meet for the loftiest aspi¬
rations of the mind, a boundless field for the nobler emotions of
the heart. Dedicate your talents and your hearts to humanity,
and then, whether in a public career you seek the title of Great
or Good, or whether you glide through the more sequestered
paths of literary labor, remember that, for good or evil, your
fate is in your own hands. Be hopeful, and zealous, and con¬
stant ; let nothing divert you from your goal; let your hearts
throb with a noble ambition to honor your name, your Alma
Mater, and your country, to bless mankind while you live, and
to earn their blessings when you die. ?
" c Since all must life resign,
Those sweet rewards which decorate the brave
'Tis folly to decline,
And steal inglorious to the silent grave.' "
DR. CHAPMAN.
At considerable expense, we have presented, as our frontis¬
piece, an exact likeness of the illustrious teacher and practi¬
tioner of medicine, and, for the benefit of the reader, subjoin
the following brief sketch:—
Nathaniel Chapman, M. D , was born on the 28th of May,
1780, in Fairfax County, Virginia. He graduated in medicine
at the University of Pennsylvania, in 1801. In 1808, on ac¬
count of extraordinary talent and learning, he was elevated to
the adjunct Professorship of Obstetrics in the University of
Pennsylvania. In 1813, he was elected to the Professorship of
Materia Medica. In 1816, he was transferred, by a unanimous
vote, to the chair most congenial to his tastes and acquisitions,
that of the Institutes and Practice of Physic and Clinical Medi¬
cine, which position he held till within three years of his death,
which took place on the 1st July, 1853.
" Let every healing plant his grave adorn,
Saviour of many millions yet unborn."
1G
Robert W. Woodruff
Library
Boles Collection
special collections
emory university