/ I Wk ^ ^-_ '"•Tec v7 ,^ , ■--^<-<, ,, ■ 5< -o^ 5T7 C CHILDREN, AS ADOPTED AT THE PRESENT DAY. SECOND EDITION '^ B >> BY Gen. GEORGE COOKE, M.D., LL.D., FELLOW OF TIIE ROYAL COLLEGE OF PHYSICIANS AND SURGEONS; CORRESPONDING VACCINATOR OF THE NATIONAL VACCINE INSTITUTION, UNDER THE SANCTION' AND AUTHORITY OF THE BRITISH GOVERNMENT, LONDON; CHANCELLOR OF THE UNIVERSITY, AND PRESIDENT OF THE MEDICAL DEPARTMENT OF THE COLLEGE OF RIPLEY, IN THE UNITED STATES OF AMERICA; FORMERLY ASSISTANT SURGEON IN THE ROYAL NAVY — ERITISH AND FOREIGN HOSPITAL STAFF, AND THE HON. EAST INDIA COMPANY'S SERVICE J THE ONLY ARMY AND NAVY SURGEON LIVING IN AMERICA AT THE PRE- SENT DAY, WHO HAS EVER VISITED THE HOSPITALS OF ENGLAND, FRANCE, BELGIUM, GERMANY, AUSTRALIA AND SOUTH AMERICA ; AND FOR THE LAST TWENTY-TWO YEARS, MEDICAL AND SURGICAL REFEREE IN ALBANY, IN CLINICAL PRAC- TICE, CHRONIC COMPLAINTS, &C, &C, &C. V PUBLISHED BY THE AUTHOR. No. 3 NORTON-STREET, ALBANY, N. Y. 1852*" **$ Northern District of New -York : Be it Remembered, That on the twenty-fifth day of March, Anno Domini L. S. 1852, George Cooke, of the said District, has deposited in this office the title of a book, the title of which is in the words following, to wit : Professional experience in various climates : A complete practical treatise on genital maladies ; with pathological observations on the philosophy of reproduction, spermator- rhoea, and their immediate and remote consequences ; together with the more successful management of the diseases of women and children, as adopted at the present day. By Gen. GEORGE COOKE, M. D., LL. D., Fellow of the Royal College of Physicians and Surgeons ; Corresponding Vaccinator of the National Vaccine Institution, under the sanction and authority of the British Government, London ; Chancellor of the University, and President of the medical department in the College of Ripley, in the United States of America; formerly assistant surgeon in the Royal Navy, British and Foreign Hospital Staff, and the Hon. # East India Company's ser- vice. The only army and navy surgeon living in America at the present day, who has ever visited the hospitals of England, France, Belgium, Germany, Australia, and South America; and for the last twenty-two years, medical and surgical referee in Albany, in clinical practice, chronic complaints, &c, &c, &c. The right whereof he claims as Author, in conformity with An Act of Congress, entitled An Act to amend the several Acts respecting Copy Rights. AURELIAN CONKLING, Clerk of the District. PREFACE Nothing is more certain than that " custom becomes a second nature,' 1 and has great influence upon our bodies. Nay, it has too often more power over the mind than reason itself. The most honest man living, in keeping company with libertines, by degrees forgets the maxims of pro- bity, which he had imbibed from the very breast, and gives himself up to those vices which he sees practiced. If he be so happy as to relinquish that bad company and to meet with better, virtue will triumph in its turn, and he insensibly resumes the wisdom which he had abandoned. In short, all the alterations which are perceivable in the temper, carriage, and manners of most men, have scarce any other foundation than the force of custom. Hence it is evident, that those, who endeavor to ren- der the art of healing familiar to persons of all ranks and degrees, cannot fail to excite malignant clamors from that narrow-minded part of the me- dical profession, who may deem their trade injured by the removal of ths mysterious veil with which it is studiously concealed from vulgar eyes. Armed against the stings of such profound enemies to reformation, and animated by a conscious rectitude of philanthropy, I shall persevere in those endeavors, which, during a long series of years have been already crowned with success, and drawn forth the most flattering testimonies of the invaluable properties of my discoveries in the practice of medicine. Aware, as I am, of the illiberal attempts made to prejudice public opinion in every such undertaking as the present, it is some gratification IV PREFACE. to feel as well as to know that I am not alone in so sacred a cause in be- half of my fellow man. In Physic there is a wide field open for discovery, which, I trust, will call forth the powers of ingenious practitioners. There are many disorders which no physician yet has been able to cure ; but it does not follow from this that all those diseases are incurable. Physicians are not more divided in their opinions, prescriptions, and mode of administering them, than their patients differ in the nature of their diseases, as well as constitu- tions ; therefore, that the reader may be the better enabled to judge of disorders by symptoms, I have in this work pointed out the causes, signs and regimen to be observed in the most malignant cases, as well as the safest and best medicines to be taken, (rejecting, however, those, the use of which in injudicious hands might prove an injury to the patient,) with proper instructions to persons doubtful of the true difference between symptoms of contagion and those often mistaken for them ; for many of my views in relation to disease and its concomitant evils, together with the best treatment therefor, have been obtained during my travels throughout Europe, Asia, South America, Madeira, Barbadoes, Bermuda, Australia, New Guinea, Java, New Zealand and the Falkland Islands. In Australia, I was appointed by the British Government an Assistant Surgeon, I had alternately, the charge of several hospitals, the inmates of which, — men, women and children — averaged between five and sis hundred a day; the same rank and commission I also held in the Boyal Navy, while on a surveying expedition round the coast of New Holland ; and until I obtained my discharge from public service, after my return to England. From these travels, and being afterwards professionally asso- ciated with such celebrated individuals as John Abernethy, Sir Astley Cooper, John Hunter, and others, it is but a natural inference that for variety of diseases, and field for ascertaining the strength and capability of medicine to remove them, my advantages could have been equalled by few, and excelled bv none in the world. PREFACE. V People addicted to reading, not unfrequently add mental to bodily ail- ment, by the avidity with which they lay hold of medical treatises, ob- scene alike in their character and compilation, few of which are calculated for any but the faculty. " The best preservative to keep the mind in health," says Lord Bacon, (and in many instances the body too,) "is the faithful admonition of a professional friend." Unfortunately, the dislike of having not merely our vices, but even our foibles, follies and faults exposed, deters thousands from asking for or receiving what the philoso- pher recommends ; and thus Youth in particular, rush headlong into the vortex of dissipation and death ! To obviate consequences so destructive to the species, and eventually to population, has fallen to my happy lot, by making public the " mirror of their vices," which is pointed out to the deluded of either sex as the " Silent Friend " which they may con- sult without exposure, and with assured confidence of success. Gentle reader, if you are an invalid of the class to which this book re- lates, and in due course of reading have arrived at this page, and should, moreover, have become enlightened as to the cause of your infirmity, the remarks I have to make may interest you. My aim throughout is to ad- dress you in the language of common parlance — of every day life — to make clear to you some of the most important purposes of existence and its laws, on the observance of which such life may be beautified and ren- dered happy. If those ordinances in your own case have been violated, you have undoubtedly much to grieve for ; but at the same time, it may console you to know that it is the order of nature not to part with her children but to gather them around her, and retain them with the affec- tionate solicitude of a parent so long as it is a law they should remain. We all understand what is meant by the instinctive love of life possessed by each and every one of us ; there exists a corresponding tenacity on the part of nature, or call it the world if you will, to retain its subjects, and it. should be comforting indeed to know that except there be a positive break up of the system, an alteration or disease in some important inter VI TREFACE. nal structure of the human being, that life is maintainable, and health recoverable on the simple terms of abandoning the evils which upset them or were abridging them, and by returning or taking to the regula- tions our experience assures us to be salutary and just. Nature is by no means a vindictive task-master, but she is a severe one. We may do much with impunity, but there is a penalty to pay, if we go beyond the mark, and contrition is in vain, except it be accompanied by a total reformation. The careful and well born may almost outlive their lease. We talk of three score and ten ; I have no doubt in my own mind but that man, by prudent living, might render one hundred years a common tenure, and numbers of examples attest the fact. But this, I confess, the more embitters the regrets of those who have forfeited their claims or chances to such a hold, and the eye which glances over these pennings may be one dimmed in their perusal with self-regrets. I come not, however, to rob you of a ray of hope, nor to obscure the path to the temple of health. I would not stand betwixt any man and the sun. I advocate not repining, but contentment. I am a true believer that " whatever is, is right," and " all for the best," and my philosophy teaches me the policy of an immediate reconcilement to what cannot be altered for the better — these are my safeguards ; but I have a stronger one, and which has helped me thus far on my way, and which I would impress upon those whom it may concern, and that is to be up and stirring. No man knows what he can do until he strives. If ill health be your portion, do not sit calmly down and drop into a morbid resignation, under the belief that nature is to cure you — if you are to be cured ; that is not contentment : nor let your indolence induce neglect, and thereby suffer a growing mischief to degenerate into an ir- recoverable infirmity. A man should only be resigned when he knows there is no alternative for him, and should never submit to illness or any misfortune without an effort to avert or remove it. PREFACE. VU If bad habits have possession of you, throw them off — if those (as it has been my aim thus silently to refer to,) cling to you, abandon them at once. If your reflections remind you of other errors, reform them, and study how to live. Consult not only your own feelings but your common sense. If despite your endeavors, the health still flags, seek better counsel than you have gained herein, or that abides in your own intelligence ; but whatever you do, endeavor to avoid foul-faced empiri- cism. The wretch who, under the guise of the Samaritan's ofhce, cruelly plays with the sacred health of his fellow man, and uses the timid fears of the wretched to fill his own coffers, deserves the execration and en- mity of mankind ; but really there is less sympathy for the simple or obstinate who resort to such, when there is scarcely a town, or village, or populous city in the union, in which there may not some qualified and honorable Physician be found. In the present unsettled state of our profession, the public are less protected than, it is hoped, a few years hence will find them. Those who "now practice only to deceive and ruin the deluded victims," (too ignorant to treat them skillfully, too sor- did to spend either time or money for acquiring a correct knowledge of the practice of Physic, not unfrequently renting offices in different parts of the state under assumed names,) will then have a just exposition of their "trickery;" knowledge and experience will raze the weak fabric of their accustomed " impudence and presumption," and every man be left to exercise that discrimination which is his right. A passage occurs in the writings of one of these omnipresent beings, which, for his especial benefit as well as the unsuspecting, I shall here embrace the opportunity of inserting. " A number of offices are rented by the same individuals, which may be located within a stone's throw of each other, or in different sections of the same city " or country " and under assumed and false names, they own each of these offices, to which persons are invited or influenced to go, only to learn to their deep re- gret, that an aggravation of symptoms follow the bad treatment they Vlll PREFACE. have received. The deluded and ruined patient has no redress but to bear silently the wrongs and impositions which have been practiced upon him, as an expose of their villanies would lay open his follies to the world, and sooner than do that, and disgrace his friends, he would rather sink into a premature grave." An ill nearly akin to this indiscriminate trust in others is, the equally unwise faith in ourselves. Well might we add to our worldly gods the science of medicine — it is worthy all honorable worship — it is one of the divine attributes of man, whereby he exhibits, if administered in its proper spirit, the better essence of his nature — it raises him above the privilege of a king. Royalty can confer favor and bestow wealth, but the good and skilled Physician can alone wipe away the tear that money cannot dry up — can alone restore the joy which is but to be found in the return as it were of the dying man to his family. Hail ! blessed gift, which so nearly approximates the mortal to the Creator. Wiser people than yourself will tell you that it is bad to be your own lawyer, it is equally so to be your own Physician. Physic may some day or another be an accomplishment, but at present it is a science — noble in its true light, fearful if abused ; it is not yet the acquirement of a day, nor is the knowledge of it only to be gleaned from college readings. A pro- fessional man must spend the best part of his life in daily commune with the sick and ailing, for his counsel to be worth a doit. What folly for a carpenter to attempt to mend his own watch. With these sentiments and feelings, it is a sad transition from the con- tentedness of the healthy to the despondency of the drooping man, and the romance of the rhapsody fades before the matter of fact, that health, like religious consolation, although to be had for the seeking, if pro- perly sought after, yet in this world of mortality rests so much upon others, that the pained brain or the heart's anguish can only be exchanged for the Physician's fee or the Divine's stipend ; but so it is, and doubt- less will be to the end of time. Man lives by the merchandize of his PREFACE. IX mind, as by the produce of his hands, and the "laborer is worthy of his hire." In presenting these pages for your perusal, let ine at least claim your generous interpretation of them ; let no frigid surmise as to any selfish motives I may have in promulgating them, detract from their simple merit — Truth. If they show a rent in your garments, set about repair- ing it ; if they find you whole and well attired, pass them to others less happy and less fortunate. The common accidents of life give us our relative position; writing is a part of my vocation, and I address those of my own time. A few years doubtlessly will effect such changes, that the subjects I have spent ink and paper upon, and the foibles and frail- ties I have written about, to discourage, will, if not printed in the school primer, at least form a few of the covenants betwixt master and pupil ; and that which is broached now with fear and trembling may become a mother's lesson or a father's chiding. But to those of the immediate hour — the invalid — whose heart may be fluttering with anxiety about his personal safety, I would speak words of encouragement; if, kind reader, you be young — whether manly or fair — of the stronger or feebler sex — if half your summers be passed, or the close of life be nigh at hand, let hope, with observance of the ordi- nances I have been talking about, uphold you through, your struggle ; and, if your faith be as warm as mine in the belief of the statements I have herein made, life may yet prove a blessing — health a luxury — and death, when it arrives, not dreaded, but welcomed as the sun, setting behind the western hills. I may in conclusion add, for the information of those to whom I am not known, that in the compilation of this work I have no other object in view, than an earnest and sincere desire to make others the happy re- cipients of its benefits ; for I am as much above every possible tempta- tion to empiricism or disingenuity of procedure as all who, excusing or encouraging either, must in the same nature of thing?, be considered * PREFACE. below my friendship ; and, in presenting its title page to a discerning public, I give it simply that it may be received and acknowledged worthy of better acceptation, than that of mere charlatanical expressions of imaginative opinions or enthusiastic attestations of visionary success. That its readers may be permitted to enjoy that health, (which many owe under God's blessing to the adoption of the means which it has been my privilege and province, through a long succession of years to recom- mend,) and that they may experience more and more of that happiness, which is the reward of disinterested benevolence, is the sincere desire of The Author. ANALYTICAL TABLE OF CONTENTS. ANNOUNCEMENT. INTRODUCTION. PART I. PHILOSOPHY OF REPRODUCTION. CHAPTER I. The being of God proved from the universality of the generative lawa and functions ; their contemplation calculated to excite suitable ideas of His omnipotence. [Page 11. CHAPTER II. Marriage ; of divine appointment ; its necessity ; its object ; polygamy , its effect on population, number, sex ; monogamy, the natural state of man; its effects, &c; intellectual and physical vigor. [p, 12. CHAPTER III. The anatomy of the organs of generation : in the male ; in the female. [p. 20. CHAPTER IV. The physiology of the male and female genital organs. [p. 25. CHAPTER V. The effect of marriage upon health and disease : causes which influence fecundity and infccundity ; aliment ; occupation ; climate. [p. 33. Xll ANALYTICAL TABLE OF CONTENTS. CHAPTER VI. Particular causes which influence fecundity and the reverse ; those which operate before marriage ; proper age for, and ill effects of prema- ture marriage ; preventive to conception ; proper subjects for marriage ; importance of attention to remove known hindrances, that the time of marriage may not be a disappointment to either party. [p. 36. CHAPTER VII. General cause of " want of offspring" after marriage ; excessive vio- lence and exertion of the generative functions ; unrestrained copulation during pregnancy ; sexual intercourse during the menstrual period ; sera- glio of Solomon ; legend ; hygienic precepts, &c. [p. 51. CHAPTER VIII. Pregnancy ; distinction of the terms of " embryo and foetus ;" signs of pregnancy ; influence of the mother's imagination on the child ; diseases of pregnancy ; hygienic cares during, and preparations for parturition ; signs of its approach ; the lying-in room ; general advice. [p. 55. CHAPTER IX. Menses ; diseases of females ; leucorrhoea ; amenorrhcea ; immoderate evacuation ; chlorosis, or green sickness : prolapsus uteri ; manner of treating each one respectively. [p. 75. PART II. SPERMATORRHOEA. CHAPTER I. An address to parents, teachers, guardians, and all those having charge of children. [p. 8 / . CHAPTER II. Opinions of ancient and modern writers, viz : Of Br. Tissot, on the consequences of this delusive practice ; Mr. Harper, on premature indul- gence, the effects of onanism on the constitution, memory, eyes; M. Linnaeus, on youth and infirmities , Sanctorius, on coition. [p. 91. ANALYTICAL TABLE OP CONTENTS. XOX CHAPTER III. Debility arising from self-abuse ; opinion of ancient writers on the de- generacy of the human race ; precautions for securing a sound constitu- tion ; self-pollution, its frightful and destructive consequences in man and woman ; the union between the physical and mental faculties ; the loss of semen ; opinion of Sir A. Cooper on onanism and its prevention ; quo- tations from Holy Writ on the lust of the flesh; Martial on self-pollution, insanity ; Dr. Armstrong relates an instance of idiocy from secret prac- tices ; thinks he would know persons addicted to this practice from their manner of walking ; Dr. Darwin, an incident of an impotent youth ; phrenologists on the debility of the perceptive and reflective faculties ; consumption caused by secret habits ; epileptic and convulsive diseases and apoplexy resulting from excess ; Hippocrates on tabes dorsalis ; Messrs. Ludwig, Klookof, Hoffman, DeGaester, Aetius, Lomnius and DeLouvain, on the effects of masturbation ; consequences of this practice enumerated ; schirrosity of the prostate gland ; cancer, &c. [p. 98. CHAPTER IV. A very brief description of the male genital organs ; seminal weak- ness ; nocturnal emissions ; impotency a bar to marriage ; sterility or barrenness ; general remarks on tlieir treatment ; diet, drink, cold bath, management of sleep, air, &c, for the more speedy and perfect restora- tion from all diseases arising from self-pollution and excessive venery. [p. 133. PART III. VENEREAL DISEASES. CHAPTER I. Historical account of the origin of Venereal disease, and the supposed time of its appearance in different countries ; opinion of Hunter as to origin of the different varieties of the affection ; Mr. Bell, on the same subject, with experiments ; Vigaroux, on contracting different kinds of diseases from the same woman ; Dr. Hennen and Mr. Evans on the same subject. [p. 163. XIV ANALYTICAL TABLE OP CONTENTS. CHAPTER IT. Gonorrhoea, from what derived ; blennorrheea more appropriate name ; part of the body affected, and character of the affection ; exercise inju- rious ; the discharge ; the opinion of Wallace on the extent of the dis- ease, and what organs may be involved ; chordee : the situation of the disease known by the character of the discharge ; the situation of the affection ascertained by chemical analysis ; time of appearance of gonor- rhoea ; gonorrhoeal opthalmia ; treatment to save the eyes ; directions concerning diet, rest, &c. , during an attack of gonorrhoea ; balanitis, de- scription of the disease and its causes. [p. 168. CHAPTER III. On diseases wiiich succeed to gonorrhoea in the male, viz : Phymosis, its cause and treatment ; paraphymosis, description, from whence it arises, in whom it may occur, and treatment ; stricture, its situation, varieties ; temporary, its cause ; permanent, why so called, and symptoms ; hernia humoralis, or orchitis, its description, cause, use of injections, a case to illustrate ; auxiliaries in its treatment ; gleet, its various causes, symp- toms, and aids to recovery ; schirrosity of the prostate gland, cause of disease ; hermaturia, cause, &c. [p. 177. CHAPTER IY. Gonorrhoea in females, its description and situation. [p. 187. CHAPTER V Prevention to infection. [p. 188. CHAPTER VI. Inoculation to prove the existence of the syphilitic virus ; usual time after inoculation before the pustule appears ; progress from day to day in its development, when the matter is inoculable ; gonorrhoeal pus never produces a chancre, and vice versa. [p. 195. CHAPTER VII. Syphilis, from whence the word is derived ; its divisions ; manner of distinguishing venereal from other diseases. [p. 200. ANALYTICAL TABLE OF CONTENTS. XV CHAPTER VIII. Syphilis, its consequences ; chancre, changes through which it passes in its development ; varieties of chancre, viz : Phagedenic, indurated and phagedenic gangrenous or sloughing; descriptions, &c, pertaining to each ; premonitory symptoms of recovery from chancre; bubo, its varie- ties and treatment; chancres in women. [p. 203. CHAPTER IX. Secondary syphilis ; characteristic symptoms of primary, secondary and tertiary syphilis ; treatment ; syphilis in children. [p. 212. CHAPTER X. Syphilitic diseases of the skin ; the result of neglect ; their varieties, viz : Squamae described, and its tendency ; pustulae described, and class to which it belongs ; papulae, its symptoms, and with what combined ; tubercula, its effects, shape, and size of tuberculous elevations ; ulcers, situation, &c; vegetations, varieties and place of appearance ; syphilitic testicle ; excoriations ; chancres in women. [p. 216. CHAPTER XL Mercury ; its uses and abuses. [p. 226. PART IV. GENERAL HOSPITAL PRACTICE IN EUROPE, ASIA, NORTH AND SOUTH AMERICA. CHAPTER I. EDUCATIONAL QUALIFICATIONS. [p. 533. CHAPTER II. Professional discoveries ; caution to invalids in selecting a medical ad- viser ; opportunities for acquiring a knowledge of medicine. [p. 235. Xvi ANALYTICAL TABLE OP CONTENTS. CHAPTER III. Professional certificates of Henry F. Wilkins, Ely Collins, Gustavus Seymour, Junius Maxwell, Charles F. Brigham, Charles D. Hammond, Lawrence Harter, J. Watson Tule, Ira Eaton, Robert Hervey, D. D. Yates, Charles Mills, Henry Lowber. The opinions of physicians and the press, viz : John Brown. Ezra Horner, James De la Roche, Wm. S. Hardwick, Montreal L'Aurora des Canadas, Jonathan Sweet, B. M. Wistner, James Hutchinson, Charles Underhill, Democratic (Pa.) Ban- ner, Montgomery Republican, J. S. Cameron, John C. Bennett. [p. 238. CHAPTER IV. Diseases to which the genital organs are subject, viz : Gravel, cirso- cele, hydrocele, fistula in perineo, morbid irritability of the urethra, diabetes, their treatment. [p. 258. CHAPTER Y. Structure of the skin, its diseases and affections, viz : Scrofula in adult age and infancy ; scarlatina ; eruptions arising from the use of balsam copaiba ; Java fever ; measles ; herpes ; scald-head and ring- worm ; erysipelas ; blotched face ; nettle rash ; immoderate perspiration ; leprosy, scurvy ; pediculi pubis or crabs, with appropriate treatment attached to each. [p. 261. CHAPTER YI. The human hair : its growth, management and proper treatment. [p. 288- CHAPTER YII. Practical observations on the treatment of rheumatism ; gout ; diar- rhoea ; dysentery ; hemorrhoids or piles. Pectoral essence of boneset. [p. 298.. Concluding remarks ; Yoice of the Press in Albany [p. 308. ANNOUNCEMENT. DR. COOKE CONTINUES TO BE CONSULTED CONFIDENTIALLY AT HIS OFFICE IN THE ALBANY LOCK HOSPITAL No 3. NORTON-STREET, ALBANY, N. Y. ; ESTABLISHED FOR THE PREVENTION AND REMOVAL OF ALL DISEASES REQUIRING PROFESSIONAL SECRECY, WITHOUT MERCURY. OFFICE HOURS FROM 6 A. M., TILL 10 P. M., EVERYDAY. OFFICE OPEN ON SUNDAYS THROUGHOUT THE YEAR. From the extensive and increasing practice of Dr. Cooke, he eon- fines himself wholly to his office, (in no case attending patients at their residences,) devoting his leisure hours to corresponding with patients abroad : who, from bodily infirmity or distance from the city, are for- bidden the privilege of a personal interview. The advantage, resulting from this plan, is that the Doctor can always be seen, thereby avoiding the disappointment to patients in not finding him at his office. The only difficulty, arising from consultation by letter, is the want of precision in delineating the many and varied symptoms which characterize the disease of each patient ; to obviate that barrier as much as possible, a diligent attention to the following suggestions is thought requisite. o xvu1 announcement. Describe " Age, sex and stature. Nature of Constitution. Complexion — fair or dark. Habits, as to occupation, — whether sedentary or ac- tive, out or in-door, &c. Peculiarities relating to hulk, identity, &c, whether mar- ried or single. Case. Symptoms. Duration of illness, and Supposed cause, Described After the patient's own man- ner and subscribed by name and address, or initials, &c, as may be preferred." If this analysis be carried out in detail, the applicant may with cer- tainty expect a satisfactory answer by return mail, bearing in mind — no medicines are trusted out or suffered to leave the office until a reasonable fee has been forwarded. His usual plan in regard to fee, is to tell the patient previous to com- mencing the treatment of his case, for how much he will, with his atten- tive co-operation effect a cure, and when such arrangements have been entered upon, in no case whatsoever to make a second charge. A slight prejudice seems always to exist in regard to the residence or office of a medical man, as though talent and honesty existed only in a Marble Mansion or Aristocratic Villa, and not possible in a respectable building situated, perhaps, in a retired street. Norton-street certainly is not a very aristocratic spot, but is central — its buildings are occupied by respectable families — and, as regards his offices, they are large, convenient, and easy of access ; in size, the whole upper part of the building being fitted up and devoted to the preparation, &c, of his medicines. How far the dweller therein may venture to compete with his profes- sional brethren living in more public streets, public discrimination must determine. INTRODUCTION. *< The knowledge of a disease is half its cure," That regard for brevity which I have shown throughout this labo- rious, but, I trust not useless volume, will be evinced, as far as may be consistent with perspicuity, in my introductory observations. The plan of the work, though novel, is simple ; and its contents, though varied, are for the most part, such as require little more than a recapitulation of their several heads ; in short, if the utility of the design be not apparent, it would be unreasonable to expect that anything which might here be of- fered could render it so. To discuss the nature or merits of one's own performances is, indeed, at all times dangerous ; inasmuch as it is extremely difficult to say all that may be considered necessary, without incurring the charge of egotism ; and, in truth, I feel so little desire for the kind of notoriety which au- thorship confers, that did not experience convince me how injurious it has been to my interests to evade the literary responsibility attached to my own productions, how humble soever their character, this professional treatise in all probability, would either have been anonymously ushered into the world, or have appeared as the work of another. To what extent I may carry a publication to which I have given so com- prehensive a title, will naturally be determined by future contingencies; at present it is sufficient to observe that no inconsiderable progress has been made in preparing suitable materials for a continuation, should the author deem it necessary. But this volume is complete in itself, and, as far as It goes, is intended to supply a deficiency felt by all who have not access ta a well selected medical library, or whose means are too limited to pur- 2 INTRODUCTION. chase larger works of reference ; while it is believed there are not a few who will consider that the unusual portability of a volume, in which so great a mass of useful matter is combined, is a desideratum, the want of which has been often and severely felt. Judicious condensation has been my aim throughout ; and, in endeavoring to avoid prolixity, I hope I have not been led into an opposite extreme ; how far I have succeeded, the public, whose candor is seldom appealed to in vain, must decide. I will therefore no longer trespass on my circumscribed limits, than to make such concise observations as appear indispensable, in noticing the various contents of my work. As the Prognosis and Treatment of disease form the main feature of my undertaking, my observations will properly commence with it ; and in so doing, I feel no hesitation in premising that, if its size and price be considered, there is no publication of a like character with which it may not safely bear the closest comparison ; for, independently of having in- troduced every well authorised mode of treating disease of the nature above alluded to, I have compared my manner of procedure with that of foreign practitioners, and made such improvements, &c. as were thought advisable. I feel it necessary to lay some stress upon this, because, al- though I court comparison, I am aware there are few persons who will take the trouble to ascertain the fact by making such comparison. In the progress of science not only new views are introduced, but a modification, and oftentimes a total change in the "modus operandi" al- ready now in use ; while some theories grow obsolete, others which once, perhaps formed a part of the long catalogue of medical restoratives, are destined at a subsequent period to be known only as cant terms or vulgar jargon. Upon this head so much might be said, that I find it difficult to confine my remarks to the brief limits I have prescribed for them. I can, however, assure, the reader that in the following pages this has been steadily kept in view. Whoever has devoted his time to the compilation of a work fraught with consequences of such vast importance as this is, must confess how much he owes to the mental energies of those profound Medical Jurists who so pre-eminently overcame the difficulties by which they were sur- rounded ; yet the preceding observations could be abundantly confirmed by a reference to tneir own erudite works. The laws of Medicine are not immutable, and the most that can be done to insure their permanence INTRODUCTION. 3 and uniformity is to consult the analogy which exists between the differ- ent theories in vogue at the present day, and make such selections as might tend to the most salutary effects on the human system. For some years past I have been collecting and arranging materials for this work, in which more than ordinary attention has been paid to make it an accurate and competent guide in the detection of disease ; and in so doing, it is not my aim or desire to render my readers independent of the surgeon. This, in many instances, would be a vain and impotent attempt. All that I desire is to give such advice as will lead the suf- ferer to detect the description of the disease he labors under, the best means of cure, and, also, its danger, if neglected, not only at the present time, but that which may arise at a future and perhaps distant period ; for there are some forms of this scourge which so vitiate the blood and undermine the constitution at its source, that the children's children of a man so tainted, are marked as its victims. The Science of Medicine is unlike a mechanic art, where great perfec- tion of some minute part precludes a knowledge of the other part. Each part of this noble study is so united with all the rest, that it does not admit of separation. Expect not, then, to find this or that pill or potion recommended as an infallible cure of any or all species of diseases, with- out reference to kind, duration or stage. The author has no specific to sell or recommend ; all he promises is to give the best advice in his power, and in such language as cannot well be misunderstood ; for habits of attentive and close observation, were necessary to enable him to know, with anything like certainty, either the effects or the power of medicines. The last and most difficult piece of knowledge attained by the author, was — the power of discrimination — that almost instinctive sagacity which penetrates at a glance the idiosyncrasy of the patient be- fore him, and perceives at once the plan of treatment most suited to his case. Indeed, tact, as it has justly been denominated in discriminating diseases in the living body, can only be attained by those who have ac- quired an intimate knowledge of the human frame, and have had long and constant opportunities of visiting and ministering to the sick, parti- cularly in tropical climates, where the early part of his life was spent. Notwithstanding all which advantages he possesses in the science of me- dicine, he has been the subject of prejudice among his professional breth- ren, simply because he departed from the regular practice of visitation, 4 INTRODUCTION. to consultations at home. Such treatment, however, was no more than he expected, and what every physician must expect who, like him, dared to counteract the practice of his medical cotemporaries. The best antidote against popular prejudice is the establishment of some material facts beyond the powers of cavillers to contradict, and produce them before the public in well authenticated cases. This is that sunshine, the genial warmth of which the slender roots of prejudice cannot bear ; truth will then prevail, prejudices subside, and all persons be fairly left to their own inquiries and their own experience. There is no case that has yet been published by him that has not been exactly true to the best of his information and belief, and for which he had not the most authentic evidence attested to by people of great respectability, (a part of whom are residents of this city,) the originals of which are in his possession, which he will, with pleasure, show to any person desiring to see them. As he has no fear nor interest separate from that of the public, his readers are at full liberty to challenge, and, if in their power, to disprove them. Though pleased with the universal approbation he has received, he would not enjoy it at the expense of truth. It is an in- controvertible fact, that the most considerable improvements in medicines have been made by military and naval surgeons, in which latter capacity the Author has honorably acquitted himself. Those who valued themselves on the principles and practice of the old school of medicine, have been the most violent opposers of every new discovery and have displayed the greatest acrimony, rarely adopting it into their own practice till after a long struggle, and public opinion has been fully decided in favor of it. If they evidently see their error, they are too proud and vain to acknowledge it, — a pride totally incompatible with true dignity and elevation of mind, and to which the lives of thousands have been sacrificed. Such physi- cians endeavor to impress upon mankind an opinion of their own under- standing ; which, once effected, serves them instead of genius and science. But happily, the same manly and liberal spirit of enquiry which has en- lightened every other branch of knowledge begins to find its way into medicine — the tyranny of authority and system declines apace — and I am bold to maintain, that, by the introduction and establishment of my dis- coveries while in the Royal Navy during its extensive surveys of discove- ry at the antipodes of England and America thousands have been benefited who would otherwise have long since mingled with the dust, nor can any INTRODUCTION. D of the profession, with any color of argument, invalidate the assertion ; some of whom have urged the necessity of supporting their respectability and dignity against what they are pleased to term " empiricism." My medicines are well tried, their virtues have been proved in thousands of instances ; and, in cases that occur immediately under their own in- fluence, it is certainly better that such prescriptions should be used than any suggested by theory, the effegts of which have not been suf- ficiently ascertained. Others have made a more direct attack upon my preparations, by pretending to have discovered their component parts — they have failed most egregiously — it is a secret which they have not skill to discover, though envy would fain arrive at this desirable object. Like the critics, they overlook their beauties of action, in an eager search for something whereon to exercise their malignity — but I affirm my medicines are as far beyond the powers of research as my fame is above the reach of malice. Silence were perhaps the best remedy to that dart which is hourly shot from the bows of the interested and malevolent, against such medicines ; truly weak indeed is the favorite reed of their quiver. Now it cannot be presumed that the mode of making known the vir- tues of so superior a discipline through the medium of the press is even improper, much less disgraceful. If the remedies the author prescribes are as they are acknowledged to be, of superior efficacy, it becomes a duty to the public that he declare it. And it must not be argued that the medicine is debased by the channel through which society is made acquainted with its virtues ; yet is it not a truth that many a victim of disease has been dissuaded from, nay refused the use of medicines which might have been ministered to his relief perhaps his cure, solely because their uses and properties have been set forth in the columns of a public print ? As if their efficacy had been diminished or destroyed by being declared through that organ — the pride of Franklin — the printing press ; which kings are proud to speak by, and which properly and justly em- ployed, must ever produce the most important and substantial blessings to mankind. No other motive than the utility which may arise to mankind from a proper examination of this work, could have induced the Author to un- dertake it ; the crimes of our fellow creatures afford but a melancholy reflection ; the consideration of which affects, whilst it humiliates, human 6 INTRODUCTION, nature. The idea of softening the miseries that flow from them is itself a sufficient recompense. The difficulty of conveying ideas upon a sub- ject that necessarily requires terms and expressions of an unbecoming tendency, has not passed unobserved ; nor has any precaution been neg- lected to render the language as grateful to the reader as the subject is susceptible of. There are stumbling blocks inseparable therefrom, that could not be dispensed with. Should such important facts as are by their aid enumerated, be passed over in silence ? Certainly not. The sacred writers — the fathers of the church — the ecclesiastical writers, did not think it proper to be passive upon crimes of sensual depravity, because they could not be described without words ! To check the dreadful con- sequences of secret, delusive, and vicious propensities, it is necessary to follow their example, agreeing with St. Augustine; who says, "If what I have written should give offence to any libidinous person, let him rather accuse his own turpitude, than the words I have been obliged to use, in explaining my thoughts upon the generation of man. I hope the wise and modest reader will forgive me for those expressions I was obliged to make use of." The virtuous and enlightened who well know the prone - ness of man to evil, will approve my endeavors to make mankind shun vice, by the dread of present ill and future misery, certain attendants on the crime of self-abuse. Those Zolius's of society and literature, who do nothing themselves, and condemn whatever is done by others, will perhaps say that this work tends more to promote vice than suppress it ; that those who were before ignorant of it, will thence become acquainted with it. To such critics, no reply is necessary. But as there are weak though virtuous minds, upon whom such discourse may make some impression, this general re- flection is due to them : that my professional researches in these respects stand in the same predicament as all books of Morality— they should all be suppressed if it be multiplying vice by displaying its dangers. Holy Writ, the writings of the fathers, and of the casuists, should all be pro- hibited for the same reason. Let the eyes of the youth be open — -let them behold the danger and the evil attendant on the votaries of delusion — that is the surest means of preventing the decay which is complained of in human nature ; and, perhaps, restoring to her in a few generations the strength and power of our ancestors, with which we have little more than an historical acquaintance. INTRODUCTION. 7 It is said by a distinguished writer in his entertaining anecdotes, that the late Lord Mansfield gave this advice to a military gentleman, who was appointed governor of one of the British islands in the West Indies, and who expressed his apprehensions of not being able to discharge his duty as chancellor of his province. " When you decide, never give rea- son for your decision. You will in general decide well ; yet may give very bad reasons for your judgment," and Montaigne, in one of his es- says, treats with great humor, of physic and physicians ; and makes it a charge against them, that they perpetually direct variations in each others prescriptions. " Whoever saw," says he " one physician approve of the prescription of another, without taking something away or adding something to it ? By which some sufficiently betray their art and make it manifest, that they therein more consider their own reputation and consequently their profit, than their patient's interest." " For the smallest quantity of knowledge that a man may acquire he is bound to be contentedly thankful, provided his fate shuts him out from the power of acquiring a larger portion — but whilst the possibility of farther advancement remains, be as proudly discontented as ye will with a little learning. For the value of knowledge is like that of a diamond, it increases according to its magnitude, even much more than in a geo- metrical ratio. One science and literary pursuit throws light upon an- other, and there is a connection, as Cicero remarks, among them all." " Omnes artes, quae ad humanitatem pertinent, habent quoddam com- mune vinculum ; et quasi cognatione qusedam inter se continentur." The force of the foregoing extract would be weakened by any additional re- marks ; but the following lines may, perhaps, be allowed to stand in lieu of a more appropriate conclusion : "Where'er the rays of Science cheer mankind, Or Learning's hallowed light illumes the mind, There Knowledge pours her countless treasures forth, And points to Wisdom, Honor, Fame and Worth; There splendid talents proud distinction claim, There Genius earns a never dying name. Virtue asserts her power, and Merit tries No more in vain to bear away the prize; Tor Truth and Justice there with Freedom reign, And modest Merit follows in their train." PROFESSIONAL EXPERIENCE IN VARIOUS CLIMATES. PART I PHILOSOPHY OF REPRODUCTION. PHILOSOPHY OF REPRODUCTION. CHAPTER I. PROOF OP THE EXISTENCE OP A GOD. In the discussion of this important subject, in respect to the human spe- cies, which includes many physical descriptions and moral inquiries, viz : The physiology and pathology of the generative organs, the effects of the abuse of these organs on fecundity and health ; the moral and physical qualifications for reproduction ; the influence of premature or excessive exercise of the generative functions upon the physical and intellectual man; the influence of monogamy and polygamy upon reproduction, of climate, food and occupation, upon fecundity ; much must arise which will gratify a licentious curiosity ; much in which a depraved mind will revel, and find food for the excitement of an erotic and prurient imagina- tion ; even as Moore describes a fanatic, who would pore over the sacred volume, while he is " Wresting from its page sublime, A creed of lust, of hate, of crime." The intrinsic importance and worth of the investigation is not, however, the less, because it is liable to this abuse ; important information which affects the happiness of every man and woman, which must influence the lives of their future offspring, is not to be withheld because the vicious may, from the same source, gratify a diseased propensity, nor because some good but mistaken people may conscientiously dissent from its reve- lation. The benefit to be derived from this investigation is not confined to the improvement of the physical power and intellectual faculties, for it will add another to the ordinary proofs of the existence of the Deity, of 12 PROOF OF THE EXISTENCE OF A GOD. a great first, and constantly superintending cause, by showing that there is a universality in the order of the generative laws, that each must be complied with ere the living being can be procreated ; that there is such an evident design exhibited in these laws as could only have emanated from a Being who foresaw their operation ; that there is such universal adapta- tion of them as could only have originated in an infinite one. Reproduction in the animal kingdom is universally accompanied by sexual approximation, ejaculation, absorption, fecundation, gestation and dissemination or parturition, and the extent of the career of the living beiDg (as a species) may be determined by the time at which it receives the power of propagating its kind ; the longer a species is in acquiring this power, the stronger will be the vital principle, (stamen vitce,) while its early development in a species is a certain sign of rapid decay and a premature death. The same beautiful order is observed in the propaga- gation of certain plants. The same law attends their powers of reproduc- tion. Does not, then, the contemplation of these wonders of the genera- tive system give rise to the most sublime ideas of the Deity ? Do we not see in it infinite combination, and power, and goodness, associated with the most minute observation ? The Deity, whose mighty arm upholds a world, condescending to extend a superintending care over the propaga- tion of a flower. CHAPTER II. MARRIAGE. " It is not good for man to be alone, I will make him an help-meet for him," said the beneficent Deity, after contemplating his work of creation ; it is no wonder, therefore, that the experience of every reasoning being confirms the fact. This union of the sexes is then the design of God ; its object being the perpetuation of the species, and in creating but one man and one woman, He appeared to point out that this was the unicn best calculated for propagating the creature of his creation ; it is my task to direct attention to the facts which experience has supplied, and thus enable the reader to judge of the correctness of this deduction. I shall also show that the human being is capable, Hke all other animals, of great improvement (both intellectually and physically) in the species ; and that, MARRIAGE. 13 if one half the attention were paid to the physical development, fitness of blood, and absence of close consanguinity, in forming the marriage contract, that we pay to the propagation of the inferior animals, our children would, from age to age, improve, rather than deteriorate, as physiologists assert it now does. It is true we cannot have that absolute knowledge of the physical development which actual examination gives, but much information, even in this respect, might be attained, if man- kind could be impressed with its importance ; that knowledge, however, which we can attain, would be quite sufficient to prevent the sad contracts which are continually formed, and prevent the propagation of children physically aod intellectually imbecile. That monogamy, or the union of one male with one female, is the natu- ral and best condition for man, can not be doubted, if we consider the nearly equal number of the sexes where this state prevails ; pointing out, as it were, the necessity of each male, or female, being provided with one partner and one only. In a state of monogamy, man procreates nearly an equal number of each sex ; male births, however, are greater than females, thus maintain- ing a just balance or distribution of the sexes ; as may be proved by re- ference to the census of the United States taken in the year 1840, from which I gather the following important statistics : The whole number of white male population, were seven millions, two hundred forty-nine thousand, two hundred and sixty-six. The whole number of white female population, six millions, nine hun- dred thirty-nine thousand, eight hundred and forty-two. The whole number of free colored male population, one hundred and eighty-six thousand, four hundred and sixty -nine. The whole number of free colored females, one hundred ninety-nino thousand, seven hundred and seventy-eight. The whole number of male slaves, one million, two hundred forty-six thousand, four hundred and eight. The whole number of female slaves, one million, two hundred forty thousand, eight hundred and five. From the foregoing statement of the different population of the United States, the following seems to be the result : That of white population, the male bear the proportion to the females as 36 to 31. 14 MARRIAGE. That of free colored male to free colored female, as 31 to 33. That of male slave to female slave, as 31 1-6 to 31. From which we perceive that among the whites, and among the blacks, under their immediate control, the majority are male births. That among the free blacks, the majority of births are females, owing no doubt in part, to their habits of loose and unrestrained intercourse, a practice somewhat allied to polygamy. To substantiate my argument more fully, I will introduce an extract from a Memoir read to the Acad, des Sciences, by M. Poisson. " It ap- pears from a great number of accurate observations, that in our climate, more male children are born than females, and the proportion of the former to the latter is generally considered to be as 22 to 21. In the com- parative tables of the population in France, drawn up in the year 1822, by order of the Minister of the Interior, the proportion of males is much greater, it being, in 6,000,000 births as 16 to 15. It is worthy of re- mark that the proportion decreases in illegitimate children ; the number of those born from 1817 to 1822, amounted to 388,277, of whom 189,- 282 were females, giving the proportion of males about 22 to 19 J. From the year 1825, the general result of similar researches has been the same, viz : 16 male to 15 female legitimate children. In 700,000 illegiti- mates born during a period of ten years, the proportion of males to fe- males was 21 to 20. The difference of temperature appears to have no influence on the proportions, for in the southern departments they were found exactly similar to the northern. In large cities only, the number of male births is somewhat diminished, and becomes more equal to that of females." From the foregoing statements, we are led to the following conclusions : 1st. In all countries where monogamy only is allowed — where one man is possessed of one woman — and that woman his lawful wife, more male children are the results of such connection, than female ; 2nd. That among that class of people, who pretend to uphold mono- gamv, and wink not at the enormous crime of adultery, of the number of children born, the female portion invariably equals, and very frequent- ly exceeds the male ; 3rd. That among all nations where unrestrained polygamy is the order of the day, the female portion of the population predominates in numbers, over that of the male. MARRIAGE. 15 Some persons have stated that polygamy is unfavorable to the increase of population, and have pointed to Turkey and Persia as a proof of their position ; it is true that the population of Turkey and other Maho- metan countries where polygamy is tolerated have not increased, but this is not because there are not more children born to a man who has more than one wife, than to him who has but one ; other causes than this ex- plain the decrease in the number of inhabitants in Turkey, Persia, and other countries ; amongst which may be enumerated disease, such as the plague, war and famine ; which cause an increase of deaths superior to the increase of births ; another reason for the non-increase of population is, that although polygamy is permitted, few comparatively avail them- selves of it because of the expense of maintaining women in those coun- tries, and the same cause in a great many instances prevents the poor man from marrying at all. Another cause also operates ; the very early union of the sexes, which greatly tends to prevent females from being prolific. In some countries where polygamy is in vogue, an increase of offspring is avoided by only cohabiting with one. In my travels through New South Wales, I discovered that instances of a plurality of wives were more frequent than a single wife, but what is extraordinary, I did not notice children by more than one. I heard from some of the natives that the first wife claimed an exclusive right to the conjugal embrace, while the second was merely the slave and drudge of both. There then, an increase in the number of births could not be expected. Proof that polygamy increases the number of offspring, may be found amongst the Arabs. " With them," says Yolney, (torn. 1, chap. 23, page 359,) " the power and riches of a Chaik or Chief consists in the number of the tribe, and it is his interest to encourage population, with- out reflecting how it is to be supported ;" this leads to habits of polyga- my, especially where there has been losses of men in war, which depress the body of the people in the most rigid poverty. Niebuhr, in his travels amongst the Arabs, observes, "polygamy multiplies families till many of their branches sink into the most wretched misery, and many of the de- scendants of Mahomet are found in great numbers, all over the East, in extreme poverty. A Mahometan is in some degree obliged to become polygamous from a principle of obedience to his prophet, who makes one of the great duties of man to consist in procreating children to glorify the 18 MARRIAGE. Creator ; individual interest corrects, however, in some degree, the absur- dity of the legislator, and the poor Arab is obliged to proportion his re- ligious obedience to the scantiness of his resources. Yet, still, the direct encouragements to population are great, and nothing can place, in a more striking point of view, the futility and absurdity of such encouragements, than the present state of these countries ; their population, if not less, is not greater than formerly, and the great increase of some families have absolutely pushed others out of existence." It cannot then be denied that more children are born to polygamous unions, but from this practice among the great of the nation, the poor cannot, from want of support, marry at all. Malthus, in his essay on population, says " while the Arabs retain their present manners, (those of a predatory life,) and the country re- mains in its present state of cultivation, the promise of Paradise to every man who had ten children, would but little increase their numbers, but greatly multiply their miseries. Direct encouragements to population have no tendency whatever to change their manners and promote cultiva- tion ; indeed, they have a contrary tendency, as the constant uneasiness from poverty and want, which they would occasion, would encourage the marauding spirit, and multiply the occasions of war. In other nations where polygamy is common, the Tartars and Caucasians for instance, po- pulation is kept down by the practice of selling the daughters of a fami- ly, and the poor being unable to purchase, are without wives, for the price of females is kept up by the practice of polygamy among the rich, and it is said by Pallas, by the scarcity among them of the female sex. In Africa, Park and Bruce say, polygamy is universal and for the ex- press purpose of increasing the number of children. "The Shangalla negroes (says Bruce,) hemmed in on every side by active and powerful enemies, and leading a life of severe labor and of constant apprehension, feel but little desire for women. It is the wife and not the man that is the cause of polygamy. Though they live in separate tribes or nations, yet these nations are subdivided into families. In fighting, each family attacks and defends by itself, and theirs is the spoil and plunder who take it. The mothers, therefore, sensible of the disadvantage of a small family, seek to multiply it by all the means in their power ; and it is by their importunity, that the husband suffers himself to be overcome. The motives to polygamy among the Galla are the same, the first wife courts the alliance of a second for her husband, and the argument she makes MARRIAGE. 17 use of is, that their families may be joined together and be strongs and that her children by being few in number, may not fall a prey to their enemies in the day of battle." Here then we see an increase in the numbers from polygamy, though it is probable, that from the fre- quent wars, and the poverty and misery which exist in those countries, no real increase is made to the population by this practice, though it is probable there would be a deficiency under these circumstances if poly- gamy was not practiced ; for, be it remembered, that from the frequent loss of men in the wars continually going on, the female sex far out num- ber the male ; according to Bruce, they are in the proportion of two or three females to one male ; but this is probably an error in number, though from the above cause and various other accidents to which savage man is obnoxious ; no doubt they greatly outnumber the men. If then the overplus of females were left in a state of celibacy, it is obvious that population would decrease, and that it is owing to polygamy that the number do not rapidly diminish ; it is true that no great increase in many places can be looked for, because, if the country is poor and uncultivated, that is, cannot produce sufficient food for the number requiring it, popu- lation would not increase, though the number of births might, if a man had a dozen wives ; want, disease and misery, would sweep off the old, the feeble and the young. Bruce, in his account of Arabia Felix, says "every sort of provision is exceedingly cheap, and it costs no more to keep a number of wives, than it does so many slaves or servants, their food is the same, and a blue cotton shirt common to all. The conse- quence is celibacy in women is prevented and the number of people in- creased in a fourfold ratio by polygamy to what it is in those countries that are monogamous." (Bruce vol. 1, chap. 9, page 281.) Yolney and Eton, both notice with surprise, that many Christian families residing in Turkey, consist of a greater number of children than do those of the Turks, amongst whom polygamy prevails ; this, says Malthus "is an extraordinary fact, because though polygamy from the unequal distribution of women which it occasions is naturally unfavora- ble to the population of a whole country, yet the individuals who are able to support a plurality of wives, ought certainly, in the natural course of things, to have a greater number of children than those who are confined to one." The reason given by Volney, why it is not so, is that from the very early period of marriage, and the practice of polygamy, the 18 MARRIAGE. Turks become enervated when young, and impotent before they are thirty , this is not, however, the true cause, more children are in reality born to the Turks, who are polygamous, than to the English who have but one wife ; but plague and famine cut off great numbers, especially children, and thus prevent an increase of population. Eton was of opinion, (if things go on in the same manner as they did when he wrote,) the whole Turkish nation would soon become extinct ; he gives better reasons than Yolney, for the decrease or non-increase of" the Mahometan population ; they have a secret vice carried to a great extent amongst the poor, plague, and these terrible disorders that almost always follow it, at least in Asia. Epidemics and endemic maladies which in Asia make as much havoc as the plague itself; famine and the sickness which follow it, and cause a greater mortality than itself. Most of these causes would fall very heavily on the young, and it is obvious that in such circumstances, con- joined with the indolence of the Turks, which prevent them from attend- ing to the culture of the country to its fullest extent, however many children were born, the deaths would counterbalance them, and there- fore, no increase would be perceptible. All the causes which operate against the increase of population in Turkey, are also felt in Persia, except perhaps the plague; the small pox, however, commits great ravages, and in that country although their law giver, Zoroaster, says "to plant a tree, to cultivate a field, and to beget children are meritorious acts," yet travelers, amongst whom are Sir John Chardin, says "that matrimony in Persia is so expensive, that only men of estate will venture upon it, lest it prove their ruin; and when the lower orders do marry, it is late in life, and it is only among the rich that early marriages are formed." The above extracts will, in a measure, show why, in those countries where polygamy is practiced, population has not increased; it is a mis- take to suppose that polygamy does not increase the number of births where there are sufficient women for the purpose, and enough food for the offspring of such marriages ; if the number of women outnumbered by double the number of men, and sufficient nourishment could be found, I say population would be doubled by permitting each man to have two wives. Malthus, when noticing the great loss of men in the French revolution, ob- serves, " Although the law which facilitated divorces to so great a degree, MARRIAGE. 19 "be radically bad "both in a moral and political view, yet, under the cir- cumstances of a great scarcity of men, it would operate a little like the custom of polygamy, and increase the number of children in proportion to the number of husbands." One more proof that polygamous unions are fruitful, may be gleaned from the creed of Mahomet, which was esta- blished by war, which destroyed great numbers of men, hence he made the procreation of children to glorify the Creator, one of the principle du- ties of man, and he who had the most numerous offspring was considered as having best answered the end of his creation. " The prevalence," Malthus observes, " of such moral sentiments had, naturally, a great effect in encouraging marriage ; and the rapid procreation which follow- ed, was partly the effect and partly the cause of incessant war. The va- cancies occasioned by former desolations, made room for the rearing of fresh supplies, and the overflowing rapidity with which these supplies fol- lowed, caused, constantly, fresh incitements to, and fresh instruments for, renewed hostilities. Under the influence of such moral sentiments, it is difficult to conceive how the fury of incessant war should ever abate." Poly- gamy, then, would most likely increase offspring, but would lead to war, famine and disease, to thin the overburthened population. Malthus con- cludes by saying, " It is a pleasing confirmation of the Truth and Divi- nity of the Christian religion, and of its being adapted to a more im- proved state of human society, that it places our duties respecting marriage and the procreation of children in a different light from that in which they were before held. " Another description of polygamy is practiced in some parts of Hindos- tan, especially among the Nayrs ; it is the custom for one Nayr woman to have attached to her two, four or more males ; generally the males are brothers, or blood relatives, so that no alteration may take place in the course of succession. The same thing occurs among the inhabitants of Tibet. Turner in his Embassy to Tibet, ascribes the custom to the fear of having too large a number of inhabitants in an unfertile country. (See Turner's Embassy, part 2, chap. 10.) For the most part the off- spring of monogamy are superior in strength and intellect, to those pro- duced in polygamous unions, and are more frequently of the male sex, it being a well known fact that in those countries where polygamy is tole- rated, many more females are born than males, and that the constitution of children of such unions is bad. The advantages of monogamy, are a 20 MARRIAGE. smaller number of children, their mothers' love, domestic peace and com- fort, and a higher order of strength and intellect in the offspring, and a very near distribution of the sexes. Amongst the disadvantages of poly- gamy, may be enumerated want of domestic love, numerous and feeble offspring, mostly of the female sex, and of a lower order of intellect, and disproportion between the numbers born and the numbers reaching ma- turity. CHAPTEK III. THE ORGANS OE GENERATION. In order that the reader may fully understand all parts of this work, it is necessary that he should be made acquainted with the Anatomy of the organs or parts, which are necessary to reproduction, and generally called sexual organs. It will be my endeavor to convey this knowledge in plain, concise, and untechnieal language ; after a short consideration of the structure of the parts, I shall in the same brief manner proceed to a consideration of the Physiology, or functions, when in a state of health ; that is to say, the use of each part engaged in the generative act, will be explained. The Genital Organs in the male, consist of the penis, scrotum, or bag ; the testicles ; the urethra, or canal through which the urine, &c. pass ; the vesiculas scminales, or seed vessels, and the prostate gland. The Penis, or organ of penetration, is covered for the most part with common skin, but the nut or head, called glans-penis in the adult, is generally bare, the skin either only covering it in part, or leaving it en- tirely free ; that portion of skin which in children covers the glans or head, is called the prepuce ; and is attached to it behind by a bridle or frenum ; nearly in the centre of the glans, is the opening of the urethra ; it is not necessary here to describe minutely the structure of the penis, suffice it to say, that a portion of it consists of cells, almost like a sponge, called corpus spongiosum or erectile tissue, and that it is the rush of blood into them that causes distention or erection of the part. The Scrotum or bag, is situated at the root of the penis, between it and the seat, and is formed of folds of loose skin externally ; is generally THE ORGANS OF GENERATION. 21 oi a dark color, in part covered with hair, and is divided into two por- tions by a seam running up its centre ; this hag contains the testicles, one on each side of the seam. The Testicles, which are contained in the scrotum after birth, are, in the earlier months of life, when yet within the womb, situated in the belly, near the kidney ; but some short time before the child is born, descend and enter the scrotum. This does not, however, always happen, for we find persons in boyhood, and even in manhood, who apparently have but one or perhaps no testicle to be felt in the scrotum ; this does not argue an absence of those organs, but only that they have not made their way into the bag , a person so situated, therefore, has as much virile power as one whose . testicles are in the scrotum. The testicles are of an oval shape, rather flat on each side, and suspended by a ligament or cord on the back part, called the spermatic cord ; they are covered by a white membrane (within the scrotum) and consist of a soft gray pulpy substance, which if allowed to float in water, can be drawn out in thin strings, to the length some- times of two or three feet ; this is the body of the gland which secretes the semen ; all these strings, or more properly tubes, at length unite and form a duct or passage, the vas deferens for the semen which they convey to the vesiculce seminnles or seed vessels ; the testicles are fur- nished with a curious muscle, or moving power, called the cremaster muscle, which causes them to be drawn close to the belly when the penis is erected, and also gives that rolling motion to the testicles which may often be noticed. The Urethra is the canal which proceeds from the bladder, at the lower part of the penis to its extremity, it conveys the urine from the bladder ; the semen and prostatic fluid are also ejected through it ; its length is from seven and a-half to ten inches, into it open the vessels which convey the semen, and is ejected with it in the act of copulation. About an inch or an inch and a-half from the mouth or opening of the urethra, on its lower part, is a small cavity, which is the seat of the well known and troublesome disease, gonorrhoea. The Vesiculce Seminales, (seed vessels,) are two small bags, at the base of the bladder, from whence they extend to the base of the prostate gland ; their length is about two inches, their breadth is only three or four lines ; they contain the semen when secreted by the testicles ; the front portion of each vesicle seminale ends in a narrow tube, which unite 22 THE ORGANS OF GENERATION. with the vas deferens, the tube from the testicles, thus making a common passage or duet, called the ejaculatory duct, which opens into the urethra, and through which the semen, &c. flows. The Prostate Gland is of the shape of a chestnut, and surrounds a part of the neck of the bladder, and it is only mentioned here from its secreting a fluid which mixes with the semen in the act of coition. The organs of generation in the female, are divided into the external or copulative, and the internal or formative. The external organs consist of the mons veneris, the vulva 'pudenda, or labia majora or large lips ; the clitoris; the labia minora, or lesser lips ; the hymen ; and the vagina. The internal organs are, the uterus or womb ; the fallopian tubes, and the ovarium. I shall first consider the anatomy of the external organs : The Mons Veneris is the part in front which is covered with hair, and slightly elevated by a cushion of fat, underneath the skin ; it is immediately above the proper or external organs of generation, and hence has been called mons veneris, or the venereal or venus hill; im- mediately below it, are the labia majora, or the larger lips ; near the mons they are thick and fleshy, but gradually become thin as they de- scend ; they are united above at the mons veneris, and this union is called the superior or upper commissure ; in their descent, they are slightly se- parated, but again unite on the perineum, just above the seat ; this union is called the inferior or lower commissure, it is also called the fourcketta or fork ; externally the labia are covered more or less by hair ; internally they are lined by a delicate mucous membrane, like that of the inside of the lips ; beneath the upper commissure, and within the lips, is the cli- toris or female penis, this body resembles a very small male penis, and like it, is capable of erection but not of emission ; from the clitoris de- scends two folds of membrane, called the labics minorcs nympha, or les- ser lips, they are not unlike in appearance a cock's comb, but are of a paler color ; they join, or are lost, as it is called, on the interior of the labia majora ; the inner surface of these labia is a continuation of the vagina ; between these lips at the upper part, and just below the clitoris, is the meatus urinarius or entrance to the urethra, its situation is marked by a depression or dimple, but as it is not an organ of generation in the female, no farther notice of it is requisite. THE POWER OP GENERATION. 23 The Hymen or Maiden Head, is a thin crescent shaped fold of the li- ning membrane of the large labia, and is placed at the lower part of the vagina, and is also attached to its sides ; there is at the upper part or por- tion of the membrane, wanting, or rather a space left, for the purpose of permitting the menses or monthly discharges to have exit. When the hymen has been raptured by coition, or destroyed by other means, in its place are found several small round bodies, which are called carunculae myrtiformes, from some fancied resemblance they bear to myrtle berries. The Vagina. The orifice of the vagina is about an inch below the clitoris, and within the large lips, in the virgin state, the hymen in a great measure closes it ; the vagina is surrounded at its entrance by a muscle, which gives it the power of contraction in a circular manner ; it is a membranous and dilatable tube, much wider at its upper part than at the lower ; it extends from the vulva or lips, to the neck of the womb, and is about four inches in length, but is of greater length on the lower than upper part, owing to its being curved ; it is very elastic, and hence capable of great dilation ; it is lined by mucus membrane, which is so placed as to form a large number of folds ; these folds are most perceptible in the virgin state, or in those who have not borne chil- dren, in women who have had many children, they are in a great degree obliterated ; the lower or more external part of the vagina is surrounded by erectile tissue, the upper part is nearly free from it. Within the va- gina are a number of glands, for the purpose of secreting mucus to lu- bricate the lining membrane. The Perincsum, which is the space between the lower juncture of the larger labia, and the fundament, is sometimes classed with the organs of generation, but it is only so, inasmuch as the vagina runs on the inside of it. I now direct your attention to the consideration of the internal female or- gans of generation. The uterus, matrix or womb, is situated at the upper part of the vagina, into which its mouth and neck project ; the vagina surrounds and is attached to the body of the womb ; the womb lies be- tween the bladder and the lower bowel, it is kept in its place by four li- gaments, two called broad and two round ; it is of a triangular shape, and is often compared to a pear, two sides of which are flattened, and the nar- row part placed downwards ; it is divided into four parts, viz : the fun- dus or upper and broad part, the body, the neck and mouth* 24 THE POWER OF GENERATION. The necK is about six or eight inches long and, as already observed, projects into the upper part of the vagina, the body tapers gradually from the fundus to the neck ; at the upper part of the body where it joins the fundus, are two angles, into which the fallopian tubes are in- serted, the fundus is the broad and upper part. The size of the unim- pregnated womb is about three inches long and two broad at its upper part, but only one below; it is composed of muscular structure, which admits of much distension or of rapid growth, so as to contain and allow the growth of the foetus ; the internal cavity of the womb is also trian- gular and divided into equal halves by two raised lines, which run along its back and front, at its upper corners or angles, there are two small holes which lead to the fallopian tubes, the cavity of the unimpregnated womb is about three inches by half an inch, the weight of a virgin's womb is not above an ounce. The Fallopian Tubes (so called from their first discoverer, Fallopius,) are attached to the angles of the womb, by a portion, which is narrow and cord-like, the other end of the fallopian tubes is broad and fringed, and attached to the ovarium ; this fringed portion has also a fissure or opening, into which the ovum is received on its liberation from the ova- rium, and hence carried along the tube to the womb, they have, from the circumstance of carrying the ovum, been considered by some Anatomists as^the excretory ducts or tubes of the ovaria ; this tube is of very small diameter where it enters the womb, so small indeed, that a bristle will hardly enter it. The Ovaria or Eg g Receptacles sometimes called female testes, and per- haps not inaptly, the seminal glands of woman, are two small oval bodies, they are compressed and somewhat irregular in their shape and rough on the surface, and are enclosed in the folds of the broad ligaments of the uterus; they are fixed to the angles of the womb by thin fibrous cords, which descend from the lower edge ; the ovarium is enclosed in a thin cover, when an ova is divided it appears a firm but vascular sub- stance, in which are a number of small vesicles, the ovula or eggs of Grraaf, and for this reason called ovula Graafiana. CHAPTER IV. PHYSIOLOGY OF THE ORGANS OP GENERATION. At the age of puberty, which is in this country about from fifteen to eighteen years of age in the male, and from thirteen to sixteen in the female — great changes take place in the appearance, voice, &c, as well as in the organs of generation themselves ; before this time the external and distinctive differences between the two sexes are not well marked, there is the same shrill tone of voice, the same delicate, soft, and smooth skin, and the same lightness of figure in each sex ; but no sooner does the age of puberty arrive, and the organs of procreation begin to be devel- oped, than we find great changes taking place ; in the male, the voice be- comes rougher, the beard and whiskers appear, and hair appears on the genitals, the chest and shoulders enlarge, the mind and body are increased in vigor and endurance of fatigue, and there is also more courage and resolution, the testicles now secrete semen, and there is a desire for sexual intercourse. In the female, the changes at puberty are of equal impor- tance ; there is an increased roundness and fullness of, all the limbs, the bones of the pelf is are enlarged to form the hips, the breasts increase in size, the sexual organs are more perfectly developed, there is hair upon the pubis and mons veneris, the monthly evacuation is established, she is conscious now of being a woman, and becomes more reserved in her manners to, and yet more desirous of attracting the attention of the other sex. The general anatomy of the organs employed in procreation has al- ready been considered ; it, therefore, only remains to take notice of the use or physiology of each particular part ; and for this purpose I will com- mence with the testicles. They it will be remembered are contained within the scrotum ; it is their office to secrete from the extremities or terminate branches of the arteries with which they are freely supplied, a certain fluid, called semen, which is the vivific agent of the male, (see Semen,) this when secreted is carried to the vesicula seminales by a duct or passage called the vas deferens ; in these it is supposed by many au- thors, though denied by John Hunter, to remain until it is required for the purpose of impregnation, and when this is the case it is projected into the urethra through a passage called the ductus communis, together with a secretion from the prostate gland, and with it and other glandular 26 PHYSIOLOGY OP THE ORGANS OP GENERATION. secretions thrown up from the urethra into the receiving organ of the female. The Prostate Gland secretes a white, opaque, and viscid fluid, which is discharged by ten or twelve openings, into the urethra, and mingles in the bulb of the urethra with the semen, and with it is ejected in the act of coition ; the only use of this fluid appears to be that of diluting the semen, and, hence, causing it to be spread over a larger surface. The Urethra, which commences at the bladder, and ends on the glans penis, is the passage through which the urine flows, and which receives in its bulb, the semen, &c, and, hence, conveys these mixed secretions in the vagina. The Penis is capable of considerable elongation and rigidity, from the rush of blood into its cells when desire is excited, and, from this cause, is well fitted for the purpose of penetrating to such a distance into the female organs, as to prevent the loss of the semen, and facilitate its conveyance to the ovum, which it is destined to fecundate ; the semen &c, is expelled with considerable force by certain muscles of the penis, called ejaculatores seminis, or semen ejaculators ; from the delicate texture of the covering of the glands, and its being well supplied with nerves, it is in a great measure the seat of pleasure in the male during the act of coition. The Semen, is heavier than water, is of a peculiar smell, like that of a bone when filed, astringent and alkaline ; it has in it a great number of animalculse, which, however, cannot be seen without the aid of a pow- erful microscope ; the form and size of these living beings differ in differ- ent animals. According to some medical writers these minute animal- culse are present only in the semen of persons whose generative organs are unimpaired by self abuse, and hence considered by them the criterion of judging of the capability of the male to impregnate the ovum of the female. Dr. Wagner observes : " The seminal granules are colorless bodies, with dark outlines, round and somewhat flattened in shape, and measuring from one three -hundredth to one five-hundredth of a line in diameter, and in length scarcely surpassing one fiftieth of a line." The limits and design of this work will not permit the author to dwell longer on these curious animalculae, &c, but should the reader wish for further information on this interesting subject, he may consult the works of Dr. "Wagner, of the University of Gottingen, Prevost, Rostock, and PHYSIOLOGY OF THE ORGANS OP GENERATION;. 27 A. Thompson, (Cyclopoedia of Anatomy, &c, Art. Generation, page 460) in the present day, and also the older ones of Lieuwenhok, who first described them, and Nailer and Spallanzani. The organs of procreation in the female are more complicated and elaborate than those of the male, the latter having only to convey the semen to such a situation in the female that it may readily fecundate the ovum ; this act is soon accomplished ; but the female organs are not only destined to receive the semen, but they have a long series of processes to perform, which require a great length of time ; they receive and convey the seminal fluid to the ovum ; the impregnated ovum is to be carried into the womb ; it is to be there nourished and elaborated until it becomes a perfect child, and finally the female organs bring it forth at the period appointed by nature, a living, sentient being. These processes require, as already observed, a considerable period of time, and work many won- drous changes in the female ; we cannot, therefore, be surprised, that organs destined for such important functions, should be in some measure complex. When considering the Physiology of the male, I commenced with the testes, I will, therefore, in my description of those of the female, com- mence with the organ, which is by many considered analagous to them, viz : the Ovaria, or Egg Vessels. The Ovaria are two in number, one on each side ; they contain in each from fifteen to twenty Graafian vesicles, (so called from their first describer, Grraaf,) or eggs ; these vesicles, which are furnished with an outward covering called the Ovisce, are filled with a yellow viscid matter, something like " white of egg." These vesicles are the germ of the future embryo ; the use then of the ovarium is to contain the seed of the future being ; they are connected to the womb by the fallopian tubes, whose mouths have the power, when under the influence of venereal excitement, at particular times, of attaching themselves to the ovarium, and grasping it firmly ; they receive from the ovarium the little vesicle or egg, and convey it to the womb by a worm-like motion. The Uterus or Womb, which has been likened to the nest of a bird, is for the purpose of receiving the embryo, and nourishing it until it becomes a perfect foetus, or child ; this it does by means of its blood vessels, which, however, do not go directly to the child, but pass through, or rather form a substance, called the placenta, and from it the blood 28 PHYSIOLOGY OF *THE ORGANS OF GENERATION. required to form the child is conveyed to, and from it, by a series of ves- sels, called the umbilical cord, which enters the child's body at the navel. The womb, too, besides the mere nourishing the child, is endowed with the power, at the proper period, of expelling it by means of its muscular contraction, into the vagina, and hence to the world. The womb also secretes the peculiar fluid called the menses or catamenia, which is dis- charged generally about every lunar month, but in some females more frequently, in some less frequently. This fluid, which is like blood in appearance, does not, like blood, coagulate, and is to all intents a secre- tion from the lining membrane of the womb ; it is from six to eight ounces in quantity in all, but the discharge lasts three, four, or six days ; and is evacuated drop by drop. Most physiologists suppose this fluid to be for the purpose of preparing the womb, and other parts, for concep- tion ; others suppose it to be for the purpose of allaying sexual desires ; the former supposition is most likely correct, for we find the menses cease when impregnation takes place, and Mr. Abernethy asserts the latter is equally true ; this discharge is also absent when the process of suckling is going on. The Vagina, is the canal leading from the outer or external parts, to the mouth of the womb, it is for the purpose of receiving the male organ, its external opening is surrounded by erectile tissues, which is supposed to add to the pleasure of the female in sexual intercourse ; through this canal passes the infant in its transit from the womb to the world ; it also conveys the menstrual secretion. The Clitoris, capable of erection like the male penis, is the organ of pleasure in woman during the act of coition. The Labia minores or Nympka, which proceed from the above, most likely add to the woman's pleasure, and they also help to give a proper direction to the stream of urine, as it flows from the urethra of the female. The Hymen. — To this membrane no particular use is given, though by many persons it is considered the padlock or safe-guard to virginity ; that such is not always the fact, the author will prove in the course of this discussion. The External or larger lips do not play any particular part ; they very likely add to the pleasure of both male and female, and by their softness, thickness, and being covered with hair, prevent injury to the more tender parts below. PHYSIOLOGY OF THE ORGANS OP GENERATION. 29 Theories of Generation. — So many have been the theories of genera- tion, that at the end of the seventeenth centurv, Drelincourt had collect- ed from previous authors, no less a number than two hundred and sixty- two, which he pronounced " groundless hypotheses " and Blumenbach, the celebrated German physiologist, when commenting on Drelincourt, says, "there is nothing more certain than that his own theory formed the two hundred and sixty-third" It would not be possible to examine all these, we must content ourselves with a few of the more prominent. Haller* has divided these theories into classes, viz : The Spermatists, who suppose the offspring to proceed entirely from the male ; the Ovists, who suopose it to proceed from the female, and the Syngenesis, who consider it to be the product of both male and female. Again, one class of Ovists suppose the germ of the perfect animal to exist in the ovum, but invisible until it is expanded, unfolded or evolved; this is the theory of evolution. Another class suppose it to be merely formed from dinor- phous, or shapeless materials at the moment it makes its appearance in the ovum or eggs ; this is the theory of Epigenesis. The Spermatists say the male semen furnishes all the vital parts of the foetus, the female organs only affording a proper habitation and nutri- ment for it until it is capable of independent existence. Galen support- ed this doctrine ; it then fell into disrepute, and was revived by Lieuwen- hock, who discovered the seminal animalculse, and regarded them as the rudiments of the foetus ; these animalculae have been considered by some as miniature men, and one author delineates in them the body, limbs, features, and other parts of a full grown human body ; hence they have been called homunculi, and others have lamented the loss of human life, from more than one or two being expelled with the semen, which of course would be lost ; what would this author say of a man wasting these little manakins by having connection with a pregnant woman. Lieuwenhock himself describes the manner most circumstantially in which the animalculae gain the interior of the ovum, and are kept there after their entrance, by a valve. The Ovists, among whom are Aristotle and Pythagoras, and many other ancients, say the female has all the materials required to form the foetus, and the male is only of use in awaking the formative powers in her. Malpighi, Harvey and Vallisneri also consider that the female ovum contains nearly all the rudiments of the foetus, and the male performs a 30 PHYSIOLOGY OF THE ORGANS OF GENERATION. very secondary office in the process of generation. The theory of Syn genesis is, that after sexual intercourse, the products of both sexes com- bine or mix together, and thus form the germ of the foetus ; this theory is of ancient date, a modification of it, termed metamorphosis, according to which a formative substance is held to exist, but which changes its form, to be converted into a new being, was also a favorite theory. Buf- fon and Needham held that all plants and animals had certain organic mole- cules pervading them, and that these molecules were all gifted with produc- tive powers which enabled them when placed in proper situations,* to at- tract one another, and make by their union living bodies ; they state that the superabundant organic molecules, in the process of generation, are collected in the generative organs, and there constitute the rudiments of future living beings. The hypothesis of evolution, or of pre-existing germs, coincides in some measure with that of the Ovists, as they consider the child to be only the offspring of the female, but evolution goes further, by supposing the foetus to exist, with all its organs, in some part of the female before sex ual intercourse, and that it receives, only from the male semen, the pro- perty of vitality, but no part of the body is formed by it. Bonnet, who is the great admirer of this theory, says, " that not only do the parts of the foetus pre-exist in the ovum, before they make their appearance, but that the germs of all animals, to be born in future, also exist at the present time in the female ;" according to him, the first female of any species of animal contains in her ovum, the germs of all future animals of that class, including the one within the other, like a nest of boxes ; from this comparison, which I believe is his own, he called his theory that of " Emboitement." This extravagant theory of pre-exist- ing germs, was espoused by Spallanzani, and many others ; if it was a true one we should have no mules or cross breeds of cattle, or dogs, nor would it ever happen that children would resemble their father, which they frequently do, though they have never seen him, even to the copy- ing of peculiarities of body and mind. The most modern doctrine is that of Epigenesis, promulgated by Cas- per Wolff, in 1759. Harvey and Malpighi ascribe the foetus principally to the female, and Wolff describes a successive production of organs, of the formation of which, previously, there was no trace, and showed, also, that after parts are formed, they experience many most important changes in PHYSIOLOGY OF THE ORGANS OP GENERATION. 31 shape and structure, before they arive at perfection ; this theory of super- formation of parts is considered to be much more probable than that of evolution of pre-existing germs, and is, in a great measure, borne out by the microscopic observations of Meckel, Baer, Rathke, Serres, Rolando, Dutrochet, Prevost, Dumas, and a host of other observers of the present day ; but of this, as of the former theory, evolution, I may ask, if it is true, what becomes of the mules ? It is known that the lion and the tiger may prove prolific with each other, as do the horse and the ass, and the hybrid shows the marks and nature of both parents ; it is not, therefore possible, in all cases, that the rudiments are entirely supplied by the female. Of the manner of Impregnation. — Much difference of opinion is ex- pressed as to when and where the ovulum is impregnated ; nine times out of ten, the semen, there is little doubt, is received by the womb ; and hence carried by the Fallopian tubes to the ovarium itself. Ruysch says he " examined the body of a woman struck dead by a dagger in the act of adultery, and found the semen in the Fallopian tubes," and, when there, comes in contact with the ovulum, which is in a proper state for fecundation; the vesicle, or ovulum, then bursts; and the ovum, which it now is called, is carried into the womb, as already described, leaving a mark behind, which is called a corpus luteum, and becomes the embryo. Such is the ordinary manner in which conception is achieved, but there are many exceptions to the rule ; it may, and has happened, that concep- tion has taken place when it was impossible for the male organ to pene- trate the vagina of the female, it seems, therefore, likely that the lining membrane of the vagina, or even of the labia, may in some cases, be capable of absorbing a portion of semen sufficient to cause impregnation, or that even the aura of it may be sufficient to do so. I have known females to be in labor, and yet there was no perceptible opening into the vagina, and their husbands have declared they were always so ; in one case it was necessary to divide a very thick and strong membrane to a considerable depth, before more than the entrance of the vagina could be got at. Most lecturers on this subject quote the case of Queen Eliza- beth's mare, who, to prevent her from impregnation, had a ring placed through the centre of the lips of the parts, and yet one morning she was found with a colt by her side and the ring torn away. This part of my sub- ject has already lead me to too great a length ; the reader, who is curious, may consult the writers already named. 32 PHYSIOLOGY OP THE ORGANS OP GENERATION. Of the Signs of Virginity. — Is their absence a proof of incontin- ence ? It is generally supposed that the presence of the hymen, at the time of marriage, is a sign of virginity, and it is the only one on which much stress is laid ; thus, the Jews, if they did not find this membrane, or rather, if the husband did not rupture it on his wedding-night, and thus produce more or less bleeding, would return the woman to her friends as unchaste, and her friends, if the opposite happened, preserved ""he sheets, or other cloths, stained with blood, as a proof of her chastity. In the generality of virgins, the hymen, or maiden-head, is present ; the large labia are in close contact, full and elastic, and the lining mem- brane, or inside, of a pale rose color, the orifice of the vagina is con- tracted, and the thin bridle of skin, which unites behind the two larger labia is entire ; the folds, or rugae, of the vagina, are also very perceptible to the touch, or eye. In the generality of women who have had connection, the hymen is broken ; the large labia more or less separated and flaccid ; the color of the lining membrane is paler than in the virgin state ; the entrance of the vagina more parted, and its rugae (folds,) in a measure destroyed, and the bridle or fourchet, especially if they have borne children, is wanting. Though the former is the general appearance in the virgin, and the latter in those who have had sexual intercourse, yet it does not follow, from the absence of the hymen, or flaccidity of the labia, &c, that a woman is unchaste ; accident or disease, may, and often does, destroy the hymen, and some have it absorbed in infancy ; flaccidity of the lips, and non-rigidity of the vagina, are not unfrequently produced by disease. A woman may, on the other hand, have the hymen perfect, or a very small and contracted vagina, and yet have had frequent sexual inter- course. A case is related by Parent du Chatelet, (see his work on Pros- titution in Paris,) of two young women summoning a person before the magistrates for calling them prostitutes, and demanding a medical exam- ination to disprove the point ; the medical man gave it in their favor, and yet on further inquiry, they were found to have been on the town for a considerable period. A Professor of Anatomy relates an instance of the body of a woman, upwards of fifty years of age, being brought into the dissecting room of the London University, in which the hymen EFFECTS OF MARRIAGE. .U> was perfect, yet this woman had been on the town since the ago. of fifteen. If any of my readers marry and do not find the hymen, let them not be uneasy, if their wife is of good moral feelings and of honest parent age ; its absence is no sign of lost chastity. CHAPTER V. THE EFFECTS OF MARRIAGE UPON HEALTH AND DISEASE. Marriage being tie natural state of adult age, there can be no question that it is in many cases, the means of preserving health and prolonging life. Hufeland, the celebrated German says, " There is not one instance of a bachelor having attained to great age. This observation seems as applicable to the female as male sex ; and hence it would appear that a cer- tain exercise of the power of generation is favorable to longevity ; it forms an addition to the vital power, and this power of procreating others seems to be in the most intimate proportion to that of regeneration and restoring one's self" — but a certain regularity and moderation are re- quisite in the employment of it ; and marriage is the only means by which these can be preserved. Marriage, he goes on to say in another chapter, moderates and regulates enjoyment. That sameness which de- ters the libertine from marriage, is highly healthful and necessary, for it prevents that irritation occasioned by a continual change of objects, and which is, therefore, more weakening. It is like plain simple food, com- pared with that which is compounded and luxurious ; the former not only promotes moderation, but also longevity." Daily observation shows us more old people, in proportion of course, who have been mar- ried than those who have remained single. Marriage also has, if we may believe a late writer, much power in preventing the worst of crimes, self- murder. Forbes Winslow, in his Anatomy of Suicide, says, " it has been satisfactorily ascertained that two-thirds of those who destroy themselves are unmarried," — does not this prove that marriage tends greatly to the prevention of mental disease, for I am charitable enough to suppose that no man would dare, uncalled for, to rush into the presence of his Maker, were he not in a state, however temporary, of insanity ? Marriage then 34 EFFECTS OF MARRIAGE. has considerable effect in preserving mind and body in a state of health ; it remains now to show its effects upon disease. The effects of marriage, or to consider it merely in the light of sexual connection, on disease are more clearly shown in reference to the gentle sex, than to man — for man, to his shame be it said, is generally more or less a libertine ; but woman, whom the customs and well being of society trammel in this particular, suffers much from what may be called the want >f fulfilling her destiny on earth, viz : the bearing and nourishing of children. I shall not enter into a particular detail of the diseases in which matrimony is of service, but content myself with a general consi- deration of the subject. The peculiar derangement of the general health, in which there is much languor, loss of appetite, wasting of the body, greenish color of the skin, and many other appearances which lead by- standers to fear consumption, is often cured by marriage, as is most of the forms of nervous and hysteric diseases ; how often do we see the pale, fragile, sickly girl, who appears to have no life in her, shoot into the fine healthy woman, soon after marriage ? Again, do we not often see the beautiful young woman, after she passes a certain age, gradually sink in form, shape and feature, the breasts becoming flat, the limbs less round- ed, and the features sharp and prominent, losing as it were, the charac- teristics of her sex, and becoming before the proper time an old woman, or in other words an old maid, and why is this ? because that part of her system which should have been employed upon the formation of new be- ings, has been idle, or rather been allowed to prey upon her very vitals. Marriage, pregnancy, and the nursing of children, are the proper offices of woman, and when these functions are not performed, disease, prema- ture old age, acidity of temper, and comparatively a short life, may be looked for ; there are many exceptions it is true, but exceptions only prove a general rule. To man, also, the exercise of the generative func- tions is as important as to woman, and marriage is the proper sphere for such exercise ; any other leads to its abuse, which is fraught with evils greater than absolute continence, which will be described in another part of this work. Causes which influence Fecundity and Infecundity. In this para- graph I shall merely glance at the general causes of fecundity and its revere : they are aliment, occupation and climate. The want of suffi- cient food, there is no question, is often a cause of infecundity. so much so, EFFECTS OF MARRIAGE. 35 that famine has been known to decrease the number of births by nearly one-half; M. Villerme states that in the year 1817, one of great scarcity in the east of France, the births diminished one-half of the ordinary number ; on the other hand, too much food, or of too stimulating a description, is not favorable to fecundity, as may be verified by observing the smaller number of children the wealthy have than the poor. Seden- tary occupations, by producing derangement of the general health, are likely to decrease fecundity. Climate and season seem to exert consid- erable power ; I find the greater bulk of progeny to be in cold or tem- perate climates. The inhabitants of Russia, Iceland, &c, are prolific, while the inhabitants of Spain, Peru, Turkey, &c, have but few children ; some warm climates, however, appear to be favorable to fecundity, as Africa and Egypt ; many women who went to the latter place with the French army bore children there, though they were sterile in France. The fecundity of the women of Egypt has been attributed to the use of the waters of the Nile, and so far has this been believed, that the bottled water of that river has been imported into Europe, and eagerly bought by the childless, in hope that it would have the effect of removing their sterility ; the equality of the temperature of Egypt, however, solves the problem of the superior fecundity of the women, without attributing supernatural powers to the waters of the Nile. The same things which cause marsh miasm, viz., heat, moisture, and decaying vegetable matter, is a considerable enemy to fecundity. Season, it would appear, exerts some influence ; M. Villerme says that the six months of the year in which there are most births, occur in the following order : February, March, January, April, November, and September ; these refer the conceptions to, May, June, April, July, February and March. Blundell also says, " though it may be denied that the human female has periodical aptitude (for impregnation) I think there is something genial in the spring season, and we all know that of the vernal months, May, perhaps, is the one which may put in the fairest claim to be the emblem of the blooming virgin." Food, occupation, and climate, though they have an effect on the num- ber of children, or in other words, on the fecundity of women, do not ren- der them sterile, or the male impotent, nor do they act so strongly, as do the particular causes to be pointed out in the next chapter. Grood and sufficient food, active occupation, without over-fatigue, a 36 PUBERTY AND ITS DISEASES. temperate or cool climate, are very favorable to the national increase of population. Famine, sedentary habits, hot or very variable climates, are unfavorable to the increase of mankind, and not so much from any in- crease in the number of deaths, but in the want of an adequate number of births. It has been stated that the habit of using intoxicating liquors to excess, is a cause of failure in the generative functions, as well as be- ing a likely means of producing offspring of a low order of intellect and of but slight physical strength. Combe relates a case, taken from the Phrenological Journal, of a woman who was intoxicated, being impreg- nated by a drunken man, the result of this connection was an idiot ; and he attributes the want of intellect in the children, in many cases, to the intoxication of the parents. Burton, in his Anatomy of Melancholy, remarks: " If a drunken man gets a child, it will never likely have a good brain." I think I have myself known one or two instances where an addiction to the use of spirituous liquors to excess on the part of the woman, has prevented the conception of children. I say, I think this was the reason of their sterility, because, previous to their intemperate habits they were fecund, and afterwards unfruitful. CHAPTER VI. PUBERTY AND ITS DISEASES. There are a number of causes which influence the chances of fecundity, or otherwise, which are present before marriage, and which should be taken into consideration before either sex should enter into that estate. Though not the most important, I will first take into consideration, the proper age for marriage, with the evils which arise from too early mar- riages, and also, too late ones. The proper age for marriage varies in different countries ; as in warm climates, adult age is soon arrived at, and, consequently, decay is sooner expected than in cold ones. In our own country, according to the law, the proper age for marriage is twenty- one in the male, and about eighteen in the female ; but it is generally believed by medical men to be too young, if the persons about to marry are desirous of having healthy children, and of preserving themselves in PUBERTY AND ITS DISEASES. 37 good health to old age, and this because at those ages they have not arrived at their full growth and vigor; therefore, the procreation of children on the part of the male, and the bearing them on the part of the female, is very likely to stop the further development of their powers, and to undermine their constitutions in such manner that old age cannot be looked for except prematurely. There can be no doubt that the best nge for marriage in man is from twenty-five to thirty, and in woman from twenty-one to twenty-five. Each sex at these ages are in full pos- session of all their faculties, bodily and mental, and are in the best situa- tions for having healthy children without injury to themselves. Thou- sands of both sexes have been brought prematurely to the grave from permitting themselves to become boy-fathers and girl-mothers. But be it recollected that when marriage at an early age is spoken of as injurious to the constitution, promiscuous or illicit intercourse is very much worse. When I speak of a man not marrying until twenty-five, I mean that until that time he should really live in a state of celibacy. Very late mar- riages are, perhaps, more conducive to health than premature ones ; for old men procreate much more healthy children than very young ones ; but it is also attended with disadvantages : it is not likely if the parent is far advanced in years, that he will see his offspring grow to maturity. It has sometimes happened that the excitement and disturbance to the nervous system on the wedding night, has been so great in the male, that death has taken place in the act of copulation. Females should not marry late in life, without they are past the age of child-bearing ; for, from disuse, the parts concerned in parturition have become rigid and unfit for the transit of the foetus, and it has hap- pened that women who have married at forty, have either lost their lives or suffered most dreadfully in giving birth to their infant, which in most cases is still-born. Women generally do not have children after the age of forty-five, but many continue to bear children long after that period, and it is nearly as difficult to fix a time when a woman could not possi- bly have a child, as to say when a man could not get one. The proper subjects for marriage are those who have arrived at full adult age, are of sound constitution, not affected with hereditary disease, as scrofula, madness, consumption, gout, &c, who have led a temperate' life, have not been guilty of a certain degrading and secret vice, too pre- valent it is to be feared in the present day, and, above all, who are not 38 PUBERTY AND ITS DISEASES. tainted by the venereal poison, and who in other respects enjoy sound health. It would be well for future generations, if none were permitted to marry but those of good constitutions, not only in themselves but by descent ; thus a healthy vigorous generation would be secured, and dis- ease almost banished from the world in the course of a few years. In choosing a partner for life, some attention should be paid to the size of the partners as regards stature, bulk, &c, as well as other things. It is evident, if a very tall and stout man marry a small and delicate woman, the chance is the children are also large, so much so it may be that she cannot be delivered without the aid of instruments, and perhaps not even then without the loss of life ; do we not often see this happen to the female dog who has had connection with one of her species much larger than herself ? And that which happens to the lower class of animals, is much more likely to occur in the highest form, from the peculiar forma- tion of the pelvis in the latter. There may be great disproportion too in the sexual organs, this, of course, cannot be discovered before mar- riage, therefore, cannot be guarded against. This disproportion is some- times so very considerable, that instead of a woman receiving plea- sure she suffers positive agony from the embraces of her husband, and dreads his approach as the worst of tortures ; in this case all that the husband can do is to have patience, and by kindness and caresses endeavor to remove that sensation of fear which most effectually increases the rigidity, and prevents the dilation of the parts ; let him be gentle and refrain from frequent connection ; let him bear in mind that should his wife have a child, this defect, in all probability, would be removed, and his love be more easily gratified. Marriage between persons of very different ages should not be allowed, because they lead to vice and unhappiness, as well as the propagation of unhealthy, puny offspring, should there be any. The young man who marries an old woman, from inclination, is a fool ; from interest, a knave ; in either case he will soon cease to regard her who cannot answer his amorous advances, and seek other and younger females, and thus seduc- tion and vice, with all their long chain of dire evils, are engendered. She, who, from any motive, consents to wed a man old enough to be her grandfather, cannot hope to be designated any better than a church- licensed prostitute ; for has she not sold her youth, her charms, her very soul, for rank, fashion, money, and along with these, the best and fondest PUBERTY AND ITS DISEASES. 39 hopes of woman, that of being a mother ; which hope she either resigns, or gratifies it, by becoming something even worse than the poor, painted, unfortunate — an adultress ! Believe me, the gilded saloon, the obsequi- ous lackeys, andt he painted chariot of wealth, are but poor recompenses for the absence of the hope of being a happy wife and a virtuous mother. There are certain new causes which should be a complete bar to mat- rimonial union; the first of these is the marriage of near relations by blood, as a too close consanguinity between the persons is sure to deterio- rate the race, and be productive of feeble children; examples of this is found among the old nobility of Spain, where the practice of marriage with blood relations is much followed, we find that, from being one of the finest and most prolific nations in the world, they have now sunk to a feeble bodied and imbecile race. The same thing, from this system of breeding in-and-in, is seen in a marked manner amongst the Jews, who, it is well known, do not marry out of their own sect, and thus they transmit, along with the Jewish face, many hereditary diseases, as gout, scrofula, consumption, madness, epilepsy, &c. &c. ; these would be, in a great measure, counteracted, by marrying into other races, because the good constitution. of the man, in one case, would obviate, materially, the evil, or weakness, in the constitution of the woman, although it would not entirely do away with it, and thus a more healthy offspring would be the result ; while, of course, by the system of close marriages, every evil in the parent is continued in the children, and not only bodily defects, but also mental weaknesses. When it is known that either party, or their near relatives, are afflicted with hereditary disease, such as the above named, it should be a bar to the nuptial contract, for either their children will be afflicted in the same manner, or, as is sometimes the case, the disease may step over that generation and fix itself on the succeeding one ; thus we often find the children of a gouty person free from disease, but their children afflicted with it. The same may be said of the other bodily diseases, and also of those denominated mental. It is hardly necessary to warn against marriage with a person known to be afflicted with venereal taint ; the abhorrence felt for such an one will be the best safeguard against an union, but the warning must be given to the one who may have this dire disease lurking in the system; any one who suspects that such may be the case, should pause long 40 PUBERTY AND ITS DISEASES. oefore contracting so solemn an engagement as that of marriage, and should undergo a proper course of medicine, under the advice of a com- petent medical man, before doing so, or disease may be communicated, not only to the partner chosen for life, but feeble, sickly, diseased, or still-born children may be the consequence of perhaps a cause barely suspected to exist. The late far-famed Mr. Abernethy relates a case where still-born child was born after still-born child, and yet neither parent exhibited traces of the venereal disease ; the husband, however, confessed he had had secondary symptoms of this malady not long before marriage ; on this admission, Mr. A. caused both to take a proper course of alterative medicines, afterwards the lady bore to her husband several healthy children. It should also be borne in mind that what are called secondary symptoms of venereal disease, may make their appearance long after the primary sore has healed, and that these secondary symptoms, without giving rise to any primary ones, may be communicated to another person; the late Sir Astley Cooper relates a striking case of the above nature in his lectures. By many, drunkenness is looked upon as hereditary; this is not, however, always the case, many fathers have sober sons and vice versa, but still, when the parents are dissipated, it is very frequently transmitted to the children, like any other peculiarity of dissipation or habit; it would be well, then, for either man or woman, to pause before he or she form an alliance with one who came of a notoriously drunken stock, for no evil is much greater in life, than that of having a husband or wife prone to inebriety, in short an habitual drunkard ; from this cause alone would spring enough misery to cause life to be a curse, and death, in any form, a blessing. The awful disease, mania, in any of its forms, should be an inseparable objection to marriage with any member of a family so afflicted, for there is no cause to doubt the hereditary nature of this malady; there are whole families, the members of which, from gen- eration to generation, it is well known, are more or less afflicted, at some time of their lives, with madness, and some of these families are noble, and their branches, it is much to be regretted, have been transferred to other noble and wealthy families, and have not failed to propagate their infirmity. Peculiarities of formation of temper, disposition, and even modes of thought are transmitted from parent to children ; thus some families are ■ PUBERTY AND ITS DISEASES. 41 found, the members of which have a supernumerary finger or a want of one of those members, or they may have a redundancy or deficiency of some other part ; temper is often transmitted and also peculiar habits, and this, even, when the children have never known their parent, whose peculiarities they inherit. There is no question but that a great im- provement, both mentally and bodily, would accrue to the offspring, from attention to proper objects of marriage, if none but the perfect were to marry ; but if this were the case, the indifferent specimens of poor humanity would be condemned to hopeless celibacy ; this cannot be the case, and man can never hope to improve the breed of his species to the same extent as he does the breed of cattle, or horses, or even the cultivation of flowers; in the two former instances, none but the best specimens are chosen for breeding, and by crossing one breed with another any defect in one of the parents is counteracted in the offspring by the other parent having the defective organ, or part, in a state of perfection. But man cannot always discover in his charmer the evils of formation that should deter a union, but he can avoid the more glaring defects of formation, disease, and temper, and this it is his duty to do, for the sake of those who are to be the fruit of his marriage, as well as for his own happiness ; and there can be no doubt that by proper attention being paid to natural formation and health, even as far as we can ascertain it, any race of men would be greatly improved, both physically and intellectually. Those who are conscious of physical malformation of the generative organs, or the parts which contain them in the female, viz., the pelvis, .ire not fit objects for marriage, and should not enter into wedlock until such defects are removed, if they admit of remedy by surgical aid ; if they do not, they should not marry at all. The principal malformations in the female sex are those of the pelvis and vagina ; the pelvis may be so small or distorted from disease of the bones during infancy or in after life, that a living child could not pass through it, and the mother's life would most likely be lost during or soon after the necessary operation of delivery had been performed. To such an unfortunate and would-be mother, I proffer a ray of conso- lation — a Preventive to Conception. Must a happy and loving, though passionate husband, in his despair seek the resort of harlots, or the bed of an adulteress ? Must the confiding partner of such a husband forego 42 PUBERTY AND ITS DISEASES. the bestownient of the marital embrace and cause him to perjure his matrimonial vows ? " to be unto her a loving and attentive husband, and To make the rough path of woman's nature even, And open in her breast a joyous heaven !" I wish, however, to be distinctly understood, that in giving publicity to this simple but efficient preventive, it is only to be used when preg- nacy is really impracticable, and, as the strength of the preparation must be proportionate to the age, temperament, habits, &c, of the female, it would be unsafe to give a general formula of the precise prescription. The " Preventive" is a very weak solution of the Sulphate of Copper, prepared according to the London, Edinburgh and Dublin Pharmacopaeas ; and to prevent disappointment in the desired object, it may be necessary to apply personally, or by letter, to the Author, who will hold himself in readiness to impart all desirable information in its preparation and manner of use ; which, when properly compounded and used as may then be directed, is as harmless as pure cold water. Another defect is either the entire absence of the outlet from, or im- perf oration of the vagina ; the former is obvious to the touch, the latter is generally known by the monthly discharge not coming away, and causing a great uneasiness ; the latter is always to be remedied by surgical aid, the former, sometimes by an operation. In the male sex the malformation which prevents an absolute bar to marriage, is the total absence of the penis, though the opposite extreme or very large size of that organ (occasioning great injury to the woman) should almost be considered an obstacle. The absence of the testicles from the scrotum, is no bar to marriage ; they are still lodged where they were before birth ; and not in reality absent ; and a man so situated is quite as capable, some say more so, of begetting children as another. As one of the great objects of marriage is a continuation of the spe- cies, any known cause of impotency on the part of the male, or sterility in the woman, should forbid the nuptial rite ; as it is well known that few unions, to which no children have been born are felicitous ; and nothing is more likely to cause infidelity than a want of offspring, and hence perpetual misery. Impotency is the incapability on the part of either man or woman of partaking in the nuntial embrace. In the woman it can only arise from PUBERTY AND ITS DISEASES. 43 malformation of the organs of generation ; in man it may arise from mal- formation, or from various bodily or mental causes, which will, in anoth- er part of this work, be described. Sterility is the incapability of re- production, though the organs of procreation may, up to a certain point, be capable of performing their functions ; thus a woman may be sterile and not impotent, or impotent from imperforation of the vagina, but not sterile if that was removed. A man who, from excess in women, Onan- ism, diseased testicles, &c, is incapable of procreating, though he has all the organs requisite, is sterile ; of course if he is impotent, he must of necessity be also sterile. Impotence in the male has been ascribed to various causes, the princi- pal ones, however, are malformation, as the misplacement of the opening of the urethra, the natural absence of the penis, or its removal by ope- ration, the removal of both the testes for a diseased state of them, excess in venereal pleasures, Onanism, general debility of the body, paralysis of the muscles of the penis, cold temperament, rendering the man insen- sible to venereal desires and mental causes The first named cause, misplacement of the opening of the urethra, operates by not permitting the semen to be sufficiently ejaculated into the vagina to produce impregnation, but without the misplacement is very great, that is, without the opening is very near the root of the penis, or in the perinaeutu, it will hardly do so, as it is sufficient in many cases, there being an aptitude on the part of the female to become pregnant, that the semen should be merely deposited on the labia for the purpose of producing impregnation, here it is supposed to get mixed with the fe- male secretions, and with them to become absorbed ; this then, without the deformity is very great, will hardly cause impotency if a little care is taken by the male ; let it always be understood that the semen is of so subtle a nature that the smallest quantity, even if diluted, is sufficient to fecundate a woman who is in an apt state to become pregnant. It has been advised by some medical men that when, from the above cause a man is sterile, the semen should be collected and injected into the vagina, immediately after the act of copulation ; it is said it has been done with success ; of this I have no experience, and should not recommend so in- consistent an experiment without the necessity for having children be more urgent than usual. This malformation in some instances, especially if not congenital, can be removed bv art. 44 PUBERTY AND ITS DISEASES. The next cause, want of the penis, is a complete bar to sexual inter- course, though the want of this organ does not prove a man is incapable of procreating, if he had the proper virile organ for conveying the se- men ; on the other hand, men so unfortunately situated, are tormented much by the desire for sexual commerce. If, however there is the pos- sible rudiment of the organ left, in all probability, the man is capable of begetting children, though not of affording much or any pleasure to the female with whom he has intercourse. Such a man should not marry ; should he do so, without his wife is a woman of uncommon virtue, high morality and cool temperament, he may rest assured she will not prove faithful. The absence of the testicles from the scrotum proves nothing but that, in all probability, they are retained in the abdomen ; a man thus formed, is as capable of procreating as one who is natural in this respect ; women, I have heard, have made mistakes on this head, and have had cause to rue their easy faith, and their smattering of learning, which lead to the belief of the absence of danger. Truly, in this case Pope is right, — " a little learning is a dangerous thing." If the testicles have been removed on account of disease, the procrea- tive power is lost, though sometimes the inclination for sexual intercourse remains, and the penis is capable of more or less erection, and even of ejaculation, but the emission in this case, consists of the prostatic fluid and mucus. It is said that the female inhabitants of eastern harems not unfrequently have recourse to their guardian eunuchs to gratify their lust, without danger of becoming pregnant. The testicles may be re- moved by operation, and yet the man be capable of procreating once, by means of the semen which had been secreted, and lodged in the vesicular seminales before the operation, afterwards he is barren ; several cases of this description are related on undoubted authority, one by Sir A. Cooper. One testicle is sufficient for the purpose of generation ; nature in this has been bountiful, as in all the other organs of sense, which are double, not that we could see equally well with one eye as with two, but because be- ing provident of us, our wise and kind Creator has bestowed two, lest accident should deprive us of sight, to which deprivation we should be much more liable if the organ had been single. Excess in Venereal pleasures, especially if practised early in life, and Onanism or masturbation, are very often the cause of men not being capa- PUBERTY AND ITS DISEASES. 45 ble of procreating ; both of them tend to form what is called seminal weak- ness, that is, there will he occasionally throughout the day, almost without any erection of the penis, a fluid ejaculated, which does not, however, possess a fecundating power, hut which weakens so much, that it reduces youth, as far as the generative function is concerned, to the state of old age. The solitary vice, Onanism, (the sin of Onan), masturbation, self-pol- lution, call it what you will, is detrimental, not only to the individuals who practice it, but to future human beings, which will be treated of at length, in the after part of this work. This vice is often acquired at a very early age by children of both sexes, who are committed to the care of nurse-maids ; these ignorant persons, not unfrequently, when they find a child will not sleep, have recourse to playing with their genital organs, for the purpose of soothing them to sleep \ this, of course, prematurely excites the parts, and instances are known of children, from the age of seven to ten, who, already, eagerly practiced this horrid vice ; no child should be allowed to sleep with a nurse-maid, without a thorough knowledge of her character has been pre- viously obtained, and if possible, children should have separate beds. Boarding schools, male and female, are often the hot-beds of self-pol- lution ; the boys in them sleep two in each bed, and the younger soon learns from the older ones this dreadful practice ; ushers of schools have been accused of teaching such things, but I trust for the honor of human nature, that this is false. The girls are no better off, but a greater de- gree of secrecy being observed by females, than males, the truth is not easily arrived at, and to hint to the head of an " Establishment for Young Ladies," that the pale looks and ill health of her pupils, in all probability, proceeded from this vice, conjoined with too little bodily exercise, and tight lacing, would be to procure an immediate intimation that the meddling medical man's services were no longer needed, and, however, honorable, and upright, the medical man may be, he is generally too poor to take such a course, especially when he knows that his self-sacrifice would not. prevent one of these girls from continuing the baleful round denominated female education. When, however, their pale looks and ill health is con- tinually accompanied by excessive nervousness or trembling, indigestion, and permanent costiveness, a dejected carriage, loss of spirits and hysteria, unusual sallowness of the complexion, every effort upon the part of the 46 PUBERTY AND ITS DISEASES. governess ought to be made to satisfy herself on this point ; indeed, when- ever these appearances are present in young women, without any evident hygienic cause, the prevalence of this vice may be suspected, and should insure the attention of their friends — for the frightful ravages this solitary vice makes in the constitution can only be appreciated by those who have seen its effects — as have most medical men. It should be a rule at home, and at school, that children should not go to bed until they are tired by real exercise in the open air, and are so weary, from healthful exertion, that the moment they place their heads on the pillow, they will fall asleep. Volumes have been written on the horrible eifects of this vice, and of venereal excess, in any form ; the writings of the continental physicians are full of examples, and of details, of the most filthy description, especially the work of Tissot ; so disgusting are some of the cases brought forward by him, that although they are true pictures, and valuable to the profession, yet I cannot sully these pages by referring to them. Excess of venereal enjoyment, even when practiced in the manner which nature points out, causes many of the above evils, though not to so great an extent, as does masturbation, both of the practices having con- siderable effect on the powers of the mind. Hufeland, the well known German Author, remarks, " the more we stimulate the generative powers, and waste its juices, the more does the soul lose its faculty of thought, its energy, its acuteness, and its memory. Nothing in the world, can so much, and so irretrievably, ruin the brightest mental powers," — that moral galaxy of the first magnitude, " as excess of this kind." This author makes, in the next sentence, some remarks so applicable to the proper age for intercourse, and the guarded manner in which it should be indulged, that I shall not apologise for quoting them. " It may be asked," he says, "what is meant by excess in physical love? My answer is, when either sex indulges that passion, too early, before the body is completely formed ; females before the age of eighteen, and males before that of twenty-one; when this enjoyment is too often, and too violently repeated, which may be known from the following conse- quences : lassitude, dejection, and loss of appetite ; when one, by fre- quent change of object and circumstances, or by the artificial stimulus of spiceries, heating liquors, and the like, excites new desires in the re- laxed powers, or makes that exertion during the time of digestion ; and PUBERTY AND ITS DISEASES. 47 to include the whole in a few words, when one enjoys physical love with- out marriage ; for it is under the matrimonial tie, which excludes the stimulus of variety, and directs the physical propensity to a higher moral object, that this passion can he physically refined, that is to say, he ren- dered salutary and useful." Everything that has here been said, is applicable in 2* eminent degree, to Onanism also, for that forced and unnatural vice increases, in an ex- traordinary manner, the straining of the organs, a^d the weakening con nected with it. Onanism in either sex does infinitely more mischief than natural enjoyment. Horrid is the impressior stamped by nature on such an offender. He is like a faded rose— a #ee blasted in its bloom— a wandering skeleton. All his fire and s.^it are deadened by this detest- able vice ; and nothing remains but debility, languor, livid paleness, a withered body, and a degraded s^ 1 - Tn ^ eyes lose their lustre and strength, the pupils seem sunk, & features seem distorted and length- ened, the rosy complexion of / outn vanishes, and the visage appears of a pale leaden color. The whole body beco^ es affected, and sensible of the slightest im- pression ; the muscula- P ower is losfc , sleep brings with it no refreshment, every movement is ^tended with torture ; the legs can no longer support the body the han* 8 tremble, aching pains arise in all the limbs, the faculty of thought is j-'eranged, and cheerfulness is vanished. The unhappy sufferer spe^ s little, and as if it were only by force, and all his former liveliness J ? niind is depressed. A youth endowed by nature with genius and taints, becomes dull or totally stupid ; the mind loses all its taste for -nrtuous and exalted ideas, and the imagination is altogether corrupted. QUe slightest circumstances detailed respecting a female, is capable of exciting in him desire, shame, horror, and repentance, and despair of his evils being cured, renders his misery complete. The whole life of such a man is a continued succession of secret re- grets, painful sensations, arising from the consciousness of having brought upon himself internal weakness, irresolution, disgust of life ; and it meed excite no surprise that such a wretch should, at length, become a self- murderer, for no man is so exposed to suicide as the Onanist. The powers of digestion are destroyed, the patient is tormented with flatu- lencies and cramp in the stomach ; the blood is corrupted, the breast is choked up with phlegm, and eruptions and ulcers in the skin ; a desicca 5 48 PUBERTY AND ITS DISEASES. tion and wasting of the whole frame ; epilepsy, asthma, slow fever, de- bility and premature death, are the consequences ; and if these pages meet the eye of any female, whose mind and person has become corrupted by this fascinating and detestable practice, let her be assured that the consequences to her, will be accompanied (if she still persists) with even greater horrors , and let me, for her own sake, pray of her to break off the practice at oncy_it s continuance will totally destroy the beauty both of form andfeaturesV Enough has been sart^I trust, to deter those from this vice, who have not yet plunged into it, ate I h p ej a i so enough to cause those who are its victims to make an effort,Wever painful, to escape from the thrall of this demon. Those who wouldV rea Uy men, should, in their youth, prac- tice a strict continency in every sensv Du t of all things avoid the solitary vice. The cure of this vice depends mO^ on the mind than on medicines ; it must be at once relinquished, or no ^ood can be done, the sufferer will be much aided in his attempts at cure Detention to study, and to taking proper exercise, even to fatigue, by cold baling — the use of the bidet before going to bed, by keeping the bowels we\npen— avoiding lascivious books and prints, — the company of loose persons f either sex, sleep- ing on a matrass, with but a slight covering; if e\ c ti on takes place, by immediately plunging the organ in cold water, and, abw e a ll 5 Dv a proper attention to religion, and by encouraging the idea, that \o "eye of God is ever upon him" noting his seminal filthiness; a virtuCKg attachment to an earthly object, will also greatly aid in destroying this^filthy incli- nation. The broken down constitution may then be amended)^ proper medical means, advised not by the nostrum vender, but by the Vaular medical practitioner ; and remember, so long as the vice is persisted in, nothing can be done. It is not necessary to say, that either man or womai^ guilty of self-clebauchery, is very likely to be impotent, and the con- sciousness of being tainted with such a wee, should debar them from the marriage state, unless they have resolved to abandon it. Greneral debility of the body, from whatever cause arising, may, for the time, produce impotency, that, however, will pass away as strength is acquired ; temporary impotency may also be caused by any exciting or depressing passion, which is in operation during sexual congress. There have been persons of so cold a temperament as to be perfectly insensible to the blandishments of beauty, and without the least desire PUBERTY AND ITS DISEASES. 49 for sexual enjoyments; persons of this kind have, generally, white or fair hair ; they have little or no beard ; the face is pale ; the flesh soft and hairless ; the voice sharp, piercing and bell-like, in its sound; the eyes dull and melancholy ; the shoulders straight, and the form rounded ; the testicles are small and withered, pendulous and soft, the scrotum is flaccid, there is no hair on the pubes, the perspiration is acrid, the sensation of fear is easily excited, and the person displays pusillanimity on the least occasion ; such persons who are said to be of profound lymphatic tem- perament, are impotent, for, from their state of apathy, erection of the penis does not take place. Paralysis of the muscles of the penis, by preventing erection, may also cause impotency ; bad stricture, by preventing the ejaculation of the seminal fluid, is another cause ; large scrotal rupture, or great enlargement of the testicles, from disease, causing the penis to be imbedded in the scrotum, may cause impotency, but generally admits of relief. Mental causes may produce impotency, such as disgust for the object, the mind being occupied by abstruse studies ; excessive desire, which produces so great a rigidity of the penis, that the semen cannot be ejacu- lated; the fear of being impotent is not unfrequently the cause of impotency. Hatred for the wife, or satiety, may cause impotency with her, and yet with another woman, the man may be capable of fulfilling his functions ; excess of respectful love has also produced the same effect ; as also a thousand other mental causes, which might be cited, for impo- tency at one time, and fruitfulness at another, they all admit of cure by moderate abstinence from sexual intercourse, and the use of such means as improve the general health. The causes of impotency in women are congenital malformations, or those produced by diseases, they are, at least, the more obvious ones, absence, or obliterations of the sexual organs, as the vagina, or uterus; the vagina being very small and contracted, or impervious from bands of adhesive matter crossing it, or tumors occupying it, or want of rupture of the hymen, owing to extreme toughness of that membrane ; there are also many other causes of impotency, as great confusion of anatom- ical structure, rendering sex doubtful, cohesion of the labia, &c, &c; some of the causes admit of cure, others do not, it were in vain, in a work of this nature, to attempt to point out all the causes of impotency in woman ; still more idle to suggest a method of cure ; every case requiring 50 PUBERTY AND ITS DISEASES, a separate study from the surgeon. Let it be remembered, that a woman may be impotent, that is, she may be incapable of receiving, in the ordi- nary manner, the embraces of the male, and yet not be sterile ; it is not uncommon to find women, about to be delivered of a child, into whose vagina a quill could not be introduced ; a further consideration of cases of this description would lead us to inquiries of anything but a delicate nature ; they who wish to be further informed on such subjects, are referred to the works of Dupuytren, Buysch, Pared, Smellie, Bordeloque, D. Davis, Blundell, Ryan, &c. &c. The causes of sterility in women, are many ; a frequent one, is leucor- rhoea, or whites ; some women are so irritable and tender, that they will suffer great pain from sexual intercourse, and thus, at least, until such irritability is allayed, sterility is produced ; the absence of the uterus, would, of course, be a cause of sterility, as would also inperviousness of its mouth and neck, or the passage of the fallopian tubes, to the ovaries, being imperforate or absence of these bodies ; in these instances no cure can be looked for, except in the second, namely, imperforation of the mouth of the womb ; if this cause was ascertained, and the defect was occasioned by accident, as inflammation of the part, causing adhesion, it might be remedied by proper instruments, in the hands of a skilful sur- geon ; the first, and two last, cannot be remedied ; in the first, there could be no place in which the foetus could grow ; in the others, there would either be no ovum, or it could not pass into the womb ; all dis- eases, which produce constitutional disturbance, may cause sterility ; as, also, do various displacements of the parts of generation ; to dwell on all the causes of sterilty, would fill a volume, without adding much to the knowledge of the non-medical man ; some of the causes as already shown, admit of relief, by surgical aid, which of them do so, it would be pre- sumptuous in me to pronounce. The moral, or mental causes of sterility in women, nearly resemble those of impotency in men ; they are disgust, fear, hatred, timidity, ex- cess of ardor, &c; excesses in venereal pleasures also prevent conception, thus we find prostitutes seldom bear children while following their occu- pation ; but when they marry, they become prolific, if they confine their favors to one man. I have dwelt longer on the subject of impotency and sterility than I intended, and yet their importance is such that I fear I have not said PUBERTY AND ITS DISEASES. 51 enough. Some of the causes named, could not be known to the persona themselves, and of course, could he deemed no bar to marriage. Habitual intoxication and habits of dissipation, should also bar mar- riage, as marriage with such persons, instead of being a blessing, would be a curse, and there is no doubt that habitual intoxication either prevents a union being prolific, or when offspring is the result of such union, they are of a lower order of mental and bodily strength, than are the children of more temperate persons. The venereal taint is often a cause of a union not being fruitful, as already pointed out. I cannot imagine a man or a woman marrying, knowing they are thus situated, but should such a thing happen, they may reckon on either being barren, or having either dead, or children in a state of loathsome disease, born to them. It would be futile to" rea- son with persons who could, for a moment, entertain the idea of marriage, knowing themselves to be so situated. The idea is too horrible for any one to dwell upon one instant, who is not morally beneath the poor ani- mals whom he dares to call brutes. CHAPTER VII. PROLIFIC AND UNFRUITFUL MARRIAGES — CAUSES, &C. There are several causes which may influence fecundity in healthy persons, and prevent them from having offspring merely from inattention and want of knowledge of a few simple facts. Amongst others, may be cited violence in consummating marital du- ties, which in most instances is unnecessary. Violence may be carried to so great an extent as to produce contusions of the soft parts of the wo- man, so that connection afterwards gives her excessive pain, and hence, places a bar on conception. Disproportion of the genital organs is a source of much mischief. If rash means are resorted to in the consum- mation of marriage, the neck and mouth of the womb may be injured, and sterility be the consequence ; though a little patience and manage- ment is perhaps all that is required to ensure conception. It sometimes, however, happens that there is so very great a dispropor- tion between the male and female organs, that copulation is next to, or 52 PROLIFIC AND UNFRUITFUL MARRIAGES — CAUSES, &C. entirely impossible, without great injury to the female. If the latter, however, is young, time may effect much, aided by very gentle and grad- ual means of dilatation, for the vagina is a canal capable of great exten- sion, if used gently. Roughness and violence, by producing inflamma- tion, would only increase the evil. If the female, however, is of middle age, little or nothing can be hoped. It will be seen from the above, that all violent attempts at coition are to be avoided. If persevered in, great and perhaps irreparable mischief may be done to the woman ; so much indeed that she may never after be able to bear the approach of her husband, or if she does permit his em- braces, it will be with fear and trembling, and this, like other mental emotions, will be sufficient to cause barrenness. They who wish to have children, should avoid too great and frequent an exertion of the genital organs. Nothing is more likely to cause ster- ility than too frequent indulgence in amorous pleasures. When this is the case, it almost reduces the wife to the level of the courtezan, at least as far as her chance of becoming a mother extends. A very frequent cause of miscarriage, is the habit of still continuing to copulate as often during pregnancy as before that event took place ; and thus, unthinkingly, in a thousand cases, are the hopes of the married blighted, who had looked fondly forward to the day which would have made them parents. It is not, perhaps, necessary that during the whole' of the period of pregnancy, sexual intercourse should be absolutely avoided, but it should be indulged in very sparingly in the earlier and middle months, and hardly at all in the latter ones. If the promptings of instinct in the female are listened to, and acted upon, little mischief will arise, for nature tells her plainly, by a feeling of almost disgust, that the approach of the husband will be detrimental to her. And I would advise all men who wish to hear themselves called by the sacred and en- dearing name of father, to control their own clesires and wishes, however difficult it may be, for the sake of their unborn infant, and the loving and chosen one by their side. If they do this, they may hope to see a healthy offspring, and smiling wife and mother around their table, to cheer the evening of their lives, instead of a pale and sickly woman, whose constitution has been ruined, whose blood has been drained by frequent miscarriages, and whose very heart has been wrung by the hopes deferred, which maketh the heart sick — together with this, instead of the PROLIFIC AND UNFRUITFUL MARRIAGES — CAUSES, &C. 53 joyous voices of children, in whom you would agair live, you will have a voiceless and childless home. Choose then between them, a check for a time on your passions, or misery, such only as the old childless can feel, and remember that such would be the work of your own ungovemed passions. It seems almost unnecessary for me to warn my readers against having connection with their wives when the latter have their monthly illness or menses upon them ; the act seems of so objectionable a nature, that I should hope that the very thought would excite disgust. It is expressly forbidden by Scripture, in chapters 16 and 18 of Leviticus ; in the last named chapter, verse 21, the penalty of this, and other unclean acts, is specified: " For whosoever shall commit them, shall be cut off from among My people." And again, chapter 20, verse 18. "And if a man shall lie with a woman, having her sickness, and shall uncover her nakedness, he hath discovered her fountain, and she hath uncovered the fountain of her blood, and both of them shall be cut off from among my people." It has been held in detestation by all nations, and at all times. ©'Is- raeli, in the Curiosities of Literature, tells a rational story, in which the Devil, under the form of Solomon, is discovered in Solomon's harem, by the exhibition of his lust, at this particular time ; and the Jewish Tal- mud, expressly declares coition during the menses, to be one of the sins, for the commission of which women die in child-bed. The anger of God and the hatred of men does not, however, wholly exterminate the abomi- nable desire, and wretches are in existence who induce their wives to submit to this pollution, destroying all delicacy of mind, and expose them to disease in some of the most odious forms ; in woman it may stop the natural discharge, which is replaced by one called leucorrhcea, or whites, a very troublesome complaint, not easily got rid of, and which generally renders a female unprolific. In man, this base indulgence may cause a disease, so like gonorrhoea, that it is sometimes difficult to distinguish the true from the false ; it also frequently occasions excoriations on the penis, through oversight, nearly resembling those of a venereal nature, arising from connection with an abandoned woman. These excoriations are by neglect painful, and tedious of cure, and may be followed by sympathetic bubo, and various other evils ; which may also be communicated to the wife. 54 PROLIFIC AND UNFRUITFUL, MARRIAGES— CAUSES, &C. The disadvantages arising from connection with a woman, who for the time, is declared by the law of God to be unclean, might be further dwelt upon, but it is needless, as a man of sound mind, of religious feel- ings, of cleanliness, in short, he who is not worse than a brute beast, will not debase himself, and his wife, by being guilty of so disgusting a crime. With those who are more debased than the brute, it is in vain to rea- son ; it is in vain to point out God's Holy Law, they understand it not, or disregard it for the sake of a momentary pleasure, degrading to human nature ; such men are not to be restrained by considerations of decency or religion ; let them, be deterred from this atrocity by the consideration of physical pain, the noxious disease to which they expose themselves, and which they may communicate to their wives. I will close this chapter by giving such hygienic and moral precepts, as are likely to be the means of securing a healthy, vigorous, and intellectual offspring ; in them are also embodied the opinions of the celebrated Hufeland. Marry into a family free from hereditary disease, as gout, stone, gravel, herpes, scrofula, mania, diseases of the skin. "Do not marry a woman of a peculiar nervous temperament, those who are nervous, epileptical, hysterical, and subject to convulsions, generally give birth to short-lived infants," this is Hufeland's opinion. I have, however, often known nervous and hysterical women cured by matrimo- ny, and they have borne healthful infants — this precept, is therefore liable to exceptions. Do not marry a woman advanced in life, nor younger than eighteen or twenty ; a man should not marry until he is four or five and twenty. Do not marry delicate, feeble women, and if you wish your children to live long, marry into a family remarkable for longevity. When married — do not indulge in the reproductive act, but when the impulse is strong, and never attempt it during intoxication ; if under such circumstances a child be born, it would probably be a fool or imbe- cile ; it should also be avoided if it produces more than temporary de- pression of spirits, or if it much affects the intellectual and physical powers ; it must also be wholly abstained from during the -presence of the catamenia, or menses ; for a month after child-birth, and be seldom and cautiously indulged in during pregnancy ; it ought not to be performed for two hours after any meal, and the best time is undoubtedly in the PROLIFIC AND UNFRUITFUL MARRIAGES — CAUSES, &C. 55 morning. Men who have very much corporeal or mental excitement should also be moderate in this indulgence, or they will most likely suf- fer ill consequences. Never forget that a pregnant woman is to be considered a laboratory, in which is preparing a new human being, to which the slightest physical and moral emotion is injurious ; on this latter precept I must remark that this reflection ought to secure to the wife, the most watchful care and anxiety of the husband under such circumstances. Several of the above precepts require the attention of women as well as men. CHAPTER VIII. PREGNANCY. When a woman, after a fruitful intercourse, conceives, she is said to be pregnant ; the ovum descends, as already described, into the womb ; the future child is at first nothing more than a small substance of a gela- tinous nature, and is called the embryo ; gradually it increases in size ; in fourteen days it is visible to the unaided eye, and is one-twelfth of an inch in size, is thicker at both ends than in the middle and rather rounded, it is flat and of the consistency of jelly ; from this little mass gradually spring out all the different parts of the foetus. The future human being, for the first three months of its sojourn in the womb, is designated an embryo, after that period until birth it is called a foetus. When pregnancy takes place, various changes occur in the female con- stitution ; these give rise to certain phenomena visible to observers, and have been called the signs of pregnancy ; these have been divided by authors into three classes — those of ordinary occurrence — those of more rare occurrence' — and those, which though common to all women, can only be discovered by careful and skilful manual examination. It must be borne in mind, however, that one, two, or more of the signs about to be detailed, may be simulated by causes unconnected with pregnancy ; but when a woman has many of these signs, and following each other in due succession, the inference may be drawn, and most likely with truth that she is pregnant. 56 PREGNANCY. The more ordinary signs cf pregnancy may, for the most part, he dis- severed hy mere verbal examination. They are — a failure of the usual monthly illness, after "being exposed to the cause of pregnancy — though this may arise from many other causes, and must he accompanied hy other signs, before it can be relied on — the monthly discharge or rather the one resembling it, and perhaps not at definite periods, may go on during the whole time of gestation, though not usual ; there is, however, often one more period of the " illness " after conception has taken place ; this, with some women, is much more profuse than at other times ; with others, it is much more scanty, and some women are enabled by this variation to predict with some accuracy their pregnancy. A certain feeling of irritation or bearing down in the neighborhood of the seat and bladder, and frequent calls to pass urine. A frequent, though not constant sign, in the earlier months, is a swel ling of one or both legs. Considerable alteration of the features are sometimes present; the nose looks sharper, the face thinner, and the circle round the eyes and mouth darker. Alteration of temper is sometimes observable, and not often for the better ; there is much more irritability and nervousness, than before preg- nancy took place. Yomiting or retching in the morning is a pretty general accompani- ment of pregnancy, and is a sign of much value when taken along with others, especially if it has come on suddenly and after sexual intercourse, and not arising from any other obvious cause, and continues morning after morning ; the vomiting generally consists of a little bile or mucus, especially in the morning, though some women are troubled with sick- ness at any* time if they assume the upright position suddenly. The breasts generally enlarge when pregnancy takes place ; they at first are rather smaller than before, soon after, somewhat suddenly enlarge, be- come hard and knotty to the touch, and painful, darting pains and other singular sensations are noticed in them ; the circle around the nipple termed the areola increases in size and deepness in color, and the little pimples on the areola are more elevated than before ; the change of color in the areola is best observed in a first pregnancy, and in a fair woman, afterwards it is more indistinct and may lead to error. The breast, not un- frequently, when gestation is rather far advanced, secretes a milk- like fluid. PREGNANCY 57 Change of sizes, &c, in the breast, is a good sign of pregnancy ; "but care must be taken not to confound the enlargement arising from the person growing stouter with that arising from the specific cause. Some diseases of the womb also cause irritation, and alteration of the breasts, but do not generally produce the peculiar appearance of the areola — neither does the body becoming fatter and along with it the breasts, produce in them the knotty feeling felt on handling them when pregnancy has taken place. Enlargement of the abdomen occurs in the middle and later periods of gestation. The abdomen soon after pregnancy has taken place, will often appear flatter than before, it then gradually increases in bulk, until it rises as high as the pit of the stomach. The enlargement, though to be seen in all pregnant females in the latter months of gestation, is much more perceptible in those who have considerable hollowness in their back, than those of an opposite figure. The abdomen may increase in size from fat ; when this is the case, the fullness is all over the belly, and does not form a circumscribed tumor like that of pregnancy. It may increase from flatulency in the intestines, and this has frequently been the cause of those who wished to have a family, deceiving themselves ; in this case the tumor is elastic, can be pressed out of the way, and as it were, permits the hand to pass into it ; again; dropsy has been mistaken for pregnancy, owing to the enlargement of the abdomen ; in this case fluctuation is felt when the tumor is struck on one side, the hand being placed on the other ; this is not the case in pregnancy unless the bladder is full, or the womb itself is drop- sical. Several diseases of the womb, and of the ovaries, produce enlarge- ment of the abdomen ; and it is frequently difficult for a professional man to distinguish if the tumor be that of pregnancy or not. The movements of the child which are felt in the middle and latter months, are another sign of pregnancy, and a good one if they are accom- panied by the other signs, and are strong ; if very weak, they are not to be depended upon ; even those who have had large families have been deceived by the presence of wind in the intestines. Some women have the power of simulating the movement of a foetus so completely that men of eminence as accoucheurs have been deceived ; these constitute the ordi- nary signs of pregnancy ; the more rare signs occur only in particular individuals ; of such a nature are — The Longings for particular objects, or articles of diet, or the antipathies which they feel for other things which they were before fond of ; some will dislike wine, butter, sugar, or some 58 PREGNANCY. such thing, and this very early in pregnancy. It is often asked, is it dan- gerous to deny a woman the article she longs for ? I should say, not dangerous, but better to indulge her, if the longing is a reasonable one, if only for the sake of peace and quiet, which I much admire, and the cultivation of which I strongly recommend to all well disposed married men ; the effects of ungratified longings on the child, will be spoken of when I consider the subject of the effects of the mother's imagination on the child. Some healthy women, tolerably full in flesh, before pregnancy takes place, as soon as that occurs become very greatly emaciated, the breasts and abdomen enlarge, but all other parts fall away. The very reverse of this is the case with others ; and in such individuals are often a certain sign of gestation having commenced. Frightful dreams at night, and irritability of temper by day, with many women, mark the presence of pregnancy, and to such a degree has the former proceeded, that a celebrated obstetrician relates the case of a lady who hired a nurse to set by her bed-side, and watch her while she slept, that she might awake her whenever her agonized countenance showed she was laboring under one of her terrific dreams. Toothache, affecting the whole side of the face, even when the teeth are sound, night after night, is a frequent sign of pregnancy, as also pains in the fingers and toes, and other parts of the body. Quickening, which takes place between the third and fourth month of gestation, is another excellent sign, and one that is generally felt by all women, but not always so. It consists of a feeling of motion in the ab- domen, accompanied by sickness, perturbation of mind, fluttering of the heart, and a disposition to faint. In some, these symptoms are very prominent, and not to be mistaken, they then form an excellent sign of pregnancy. With other women, they are so slight and obscure, that they are not to be depended upon as a sign of pregnancy, at least, if quicken- ing be the only one present. Blood drawn during pregnancy is generally much more sizy than at other times. This, in combination with other signs, may serve, in doubt- ful cases, to indicate pregnancy. Pregnancy does not often occur when women are suckling, but it is sometimes the case when suckling has been persevered in too long. "When gestation occurs during the period of suckling, the event is generally in- TREGNANCY 59 dicated by the milk "becoming scanty, or ceasing entirely ; this is not in- variably the case, but if a sudden suppression of the milk occurs, without apparent cause, it may be inferred, and with good reason, that pregnancy has taken place. Salivation, or profuse flow of saliva, is another, though rather unusual sign of pregnancy. I have now given, I believe, all the ordinary, and some of the less constant signs, that indicate pregnancy. They all, it will be perceived, are doubtful alone ; combined, they amount almost to certainty. But if it is absolutely necessary to ascertain the fact of pregnancy, beyond a doubt, a surgeon, practising midwifery, must be applied to, as he only will possess sufficient knowledge of the proper manner in which the man- ual and stethoscopic examinations are to be made, and which will put the question at once at rest. The Duration of Human Gestation, is generally considered to be nine calendar months ; some say forty weeks, but Blundell, an authority on these matters, names, as the true ordinary time, thirty-nine weeks and one day, though various circumstances may arise, either to accelerate or re- tard the entrance of the child into the world, without causing a percepti- ble difference in its strength or bulk. If nine calendar months are taken as the time of gestation, a woman may easily reckon when her delivery will take place. It will be nine months and a fortnight, or thereabouts since the last time she was unwell. Nine months from the day of pro- lific intercourse, and five months, or rather more, from the time of quick- ening, as that event, though said to take place between the third and fourth month, really takes place nearer the fourth than the third. The Influence of the Mother's Imagination on the Fcetus, is a point that has engaged the attention of medical and other writers, from a. very early period. Thousands of volumes have been written to prove its in- fluence, and thousands to disprove it. A very slight exertion of com- mon sense, together with a little knowledge of the connecting link be- tween mother and child, would be sufficient to the unbiased mind, to set the question at rest in favor of the non-imaginist. And in taking this stand with the non-imaginist, I am in no wise prejudiced, but am open to conviction ; and when satisfied with better arguments than I am pos- sessed of, will at once retract my sentiments. I am aware of many cases in which the attending circumstances appear to favor the argument 60 PREGNANCY. of the imaginist ; yet, it is not my object here to enter largely on this controverted point, (and were I desirous of so doing, my circumscribed limits would not permit,) on which there are so many opinions. It is allowed by all writers, that there is no nervous connection between the mother and the unborn child: that, indeed, there is no immediate, or rather direct connection between them, for the very blood of the mother, which nourishes the embryo and foetus, passes not directly from one to the other, but from the mother to the iplacenta, and from that to the child. Wild and wonderful tales have been told of children having been born without legs, or feet, or arms, or toes, or marked with a rat, a cat, &c, &c. ; and the general explanation is, the mother has been frightened by a cripple, or an animal of the sort with which the child is supposed to be marked. Most of these marks are, by the force of imagination on the part of the by-standers, made to resemble the animal that frightened the woman ; for be it recollected, that no child has yet been born with what is called a ncevus maternus, or mother's mark, without that mother and her gossips, taxing their memories to account for such mark, by attribut- ing it to some fright the good woman has had — some sight she has seen, or to the want of something for which she has longed. Many children have been born without feet, arms, &c, but what of this ? Does it prove the influence of the mother's imagination on the growth of the foetus ? I answer, without reserve : No ; it proves merely that from some cause, what is called an arrest of development, has taken place. What that cause is, none can explain ; but that it may be from violence, from sick- ness of the foetus, from inherited disease, none can deny. The same sort of anomalies are observed in the vegetable kingdom ; they have discolor- ations, excrescences and unnatural conformations, &c, yet whoever im- putes this to the effect of a fright, or of imagination in the plant or flower ? In the Lying-in-Hospital, some years ago, it was the custom to ask the woman, as soon as her child was born, and before she had seen it, if she had had a fright, or had longed, and not been gratified ; the answer was generally in the affirmative, and, in a very few cases only, was the child found marked, and when it was so, in no one case, did the mark bear the slightest resemblance to the object fixed on by the mother. I firmly believe all tales of marks and deformities from PREGNANCY. 61 fright, to be mere visions of superstition, though it cannot be denied that deformed children are born, and in nine cases out of ten, this proceeds from, as already said, disease in the fetus itself, hereditary malformation, disease springing from the parent, or arrest of development, the latter is very often produced by a much more tangible enemy than fancy, viz : tight lacing; this is the grand cause of crippled and unhealthy children, and delicate and nervous women ; if stays were forever dismissed, we should have healthy females, and these, in their turn, would produce healthy children; but so long as the bones of the chest are forced into an unnatural shape, impeding respiration, and the abdomen is subjected to such pressure as inevitably will affect it, all the organs connected with it must, in consequence, suffer ; we cannot reasonably expect that the little one whose nest is thus rendered smaller than natural, will be born fully developed, and the only wonder is that the present generation are not all crippled and puny ; nor can we expect the tight-laced mother, to be anything but a sickly, nervous creature, for this habit, not only deforms the chest, but in a great measure prevents the organs of digestion from performing their functions, and of course, loss of strength and energy is the consequence. Reform this habit, women of America ! and you will do much to benefit mankind, and believe me, a good figure does not consist in a pinched-in waist, and an enormous bustle ; let Nature have her way, and you may depend you will be more admired and be more healthy, and better fitted to produce sound and long-lived offspring. Although I, in common with the most intelligent of the profession, have no doubt of the absurdity of the doctrine of imaginists, yet I should not advise my fair readers, who may be "as ladies wish to be, who love their lords," to expose themselves needlessly to the sight or contact of frightful objects, for, though as far as producing direct defect on the living tenant of the womb, they need be under no apprehension, yet the indirect influence of their fright might be felt by the unborn one, injuri ously, for, of course anything which acts violently on the circulation of the mother will, in a secondary manner, be reflected upon the child who is nourished by her blood. Diseases of Pregnancy. — From the very great changes which take place, in the economy, when gestation occurs, many diseases which seem peculiar to this state, are set up, thus there is generally more or less fever during pregnancy, owing to the altered state of the blood, and to there 62 PREGNANBY. being a tendency to the formation of more blood than at other times ; this fever is much more noticed towards the latter part of gestation, and in the evening. Pregnancy, however, is not naturally a state of disease, but rather as shown above, one of exaggerated action ; many women pass through it without inconvenience, and others are much more healthy at this, than any other period of their lives ; on the other hand, some suffer much from the diseases or some of those about to be mentioned, but let women in the midst of their sufferings from pregnancy, be grateful to God, for it is a well known fact that pregnancy, though it has diseases peculiar to itself, has, withal, a guardian power, and wards off the approach of other diseases, much more fatal than those caused by itself; even consumption, that scourge which proves fatal to many of the human race, has been arrested in its course by pregnancy; it is a fact, well established, that fewer women die when pregnant than at any other time. The slight fever, already alluded to, is best relieved by attention to the bowels and diet, and, if requisite, a little blood should be taken ; this only will be necessary in the latter months of pregnancy ; there is a fever of more violent nature sometimes met with, in the middle months, and which makes its attack in the same manner as does ague, and is followed by hysterical symptoms, pain and noise in the head, some incoherency, constipation, vomiting, &c. ; this is a more serious affair, requiring med- ical management ; it is very often followed by miscarriage. The Morning Sickness is often very ^distressing, commencing, as it often does, immediately on pregnancy taking place, and continuing until quickening ; sometimes it is not confined to the morning, but continuing through the whole of the day causing much suffering from absolute want of nourishment. It is much relieved by attention to the bowels, either by means of enemas of warm or cold water used every morning ; (and the importance of this mode of relieving the bowels, I wish partic- ularly to impress on the minds of my readers,) or by the use of some gentle purgative, as rhubarb and magnesia, or a table-spoon full of castor oil, The ordinary saline mixture, taken with lemon-juice, in the usual manner of a table spoonful of the latter to two of the former, and drank while effervescing is highly useful, two drops of the dilute hydrocyanic acid may be added to each dose of medicine, which should be taken every four or five hours, if the vomiting is severe. PREGNANCY. 63 Soda water is also serviceable. A very low diet, or one of absolute starvation is sometimes necessary ; the patient being nourished by clysters of broth, milk, &c. A dozen leeches applied to the pit of the stomach is of the greatest service in checking this distressing symptom. Bleeding from the arm, in the young and strong, is also advisable. Bitters and many other remedies have been lauded by various authorities. Hearts- burn is sometimes a distressing symptom, attention to the bowels is requisite ; an emetic may be taken if very severe, but not without medical advice. Magnesia in the dose of a tea-spoon full, generally relieves it, if the bowels are open, and wine, spirits and beer are refrained from. Spas?ns of the Stomach and Bowels, are often caused by indigestible food, costive bowels and irritation of temper ; the bowels should be opened, if the spasm is severe ; blood may be taken in moderate quantity, and a dose of laudanum, combined with tincture of assafoetida and ani- seed water, should .be taken every third or fourth hour, until relief is obtained. C Laudanum, twenty drops. < Tincture of Assafoetida, half a dram. ( Anniseed water, one ounce and a half. Mix for a draught, to be taken every third or fourth hour. In addition to the above means, hot flannels, hot salts, or a fomenta- tion of poppy heads and chamomile flowers should be applied to the abdomen diligently. These means will seldom fail of affording relief; should they not do so, send for medical advice, or miscarriage may ensue. Costiveness. — This cannot exactly be considered a disease, nor can it be peculiar to pregnancy, yet as it is very frequently a most terrible ad- junct to that state, it is proper to devote a small space to it here, and especially as this state invariably aggravates every disease of pregnancy, and is in many instances the active cause of others ; besides, if it is allowed to continue till the time of parturition arrives, the hardened ex- crement in the lower part of the intestines, by diminishing, or rather filling up portions of the cavity, is calculated to render a labor tedious, which otherwise would have been short — to much increase of pain, of labor, and not in a few instances very much aggravate the danger to be apprehended. Attention to the bowels is imperatively demanded through- out the whole period of gestation, but especially in the latter months, for the reason cited above. There are few means better adapted for the purpose of preventing constipation than the habitual use of matinal lave- r> 64 PREGNANCY. merit, this may either be of a pint or more of warm or cold water, and, if requisite, to increase its purgative effect, a little salt may be added ; this simple remedy, with an occasional laxative, as a dose of castor oil, will usually be quite sufficient. Confection of senna or two or three com- pound rhubarb pills, at bed time, say twice a week, will also effectually prevent constipation and the thousand evils arising from it. I recom- mend, however, the lavement, in preference to medicine. One word more : every one who would wish to have their bowels act properly should cultivate a system of regularity, that is, they should fix on some conve- nient hour for the daily evacuation of the bowels, and should not permit anything to prevent them attending to them at that time. If this is per- severed in for a short period, it will soon become as strong a habit as looking for dinner at the usual hour. Costiveness is also a good deal obviated by the use of bread, which is made with a certain proportion of bran mixed with the flour, and by the moderate use of vegetables ; these, however, in some habits cause indi- gestion and flatulency ; when this is the case they must not be continued. The same remark applies to the sub-acid fruits, as strawberries, grapes, gooseberries, &c, &c. ; when they agree they are useful in moderate quantities in obviating constipation ; but with others they are productive of wind, and pains in the stomach and bowels. A tumbler or two of good water, drank immediately on rising in the morning, will also fre- quently obviate habitual costiveness, if the above direction as to regu- larity be attended to. Diarrhoea, or Purging, is sometimes present in the puerperal state ; it may either be a simple discharge from the bowels, which remains pretty natural in appearance, though somewhat thinner than usual ; in this case the health and appetite continues much as usual ; or it may consist of dark foetid evacuations, sometimes accompanied by vomiting of bile. The pulse in this case will be quick, the tongue foul, and a bad taste be noticed in the mouth, and some degree of fever is observable, The former description requires little treatment, without it runs to a consider- able extent. Soda water is a useful adjunct to the treatment. A mo- derate dose of castor oil should be given so as to completely clean the bowels of the morbid matter, and then small doses of rhubarb (four grains,) with from half to one grain of ipecacuanha should be taken two or three times per day, followed by a wine-glass full "of the infusion of PREGNANCY. 65 gentian or camomile. When the tongue becomes cleaner, if the purging still persists, the following mixture will afford much relief: C Mixture of Chalk, six ounces. < Aromatic Confection, half a dram. ( Tincture of Opium, half a dram. Mix — two table-spoons full, to he taken three times per day. Piles frequently accompany pregnancy, they are best relieved by keep- ing the bowels moderately open, with the annexed mixture, taken at bed time. 5 Milk of Sulphur, fifteen grains. ( Magnesia, one scruple. Mix — to be taken in milk or water. Irritation may be relieved by the use of warm fomentations, if very painful, by the application of a few leeches ; when the pain has in a measure subsided, relief is afforded by the use of an ointment combining an astringent and opiate — C Compound Gall Ointment, one ounce. < Camphor, half a drachm. ( Spirits of Wine, ten drops. Mix — to be used three times per day. The diet should be rather spare and no wine or other stimulating fluids can be allowed. Incontinence of Urine, is frequently complained of in the latter periods of gestation, and to so great an extent that the water comes away when the person laughs, or even speaks ; nothing but the birth of the child will relieve this ; it is owing to the head of the child pressing on the neck of the bladder ; it is a favorable though unpleasant symptom ; it is, of course, alleviated by strict attention to the bowels, and cleanliness of the parts over which the urine flows. Many other troublesome affections of the bladder might be cited, but they are often of too grave a nature to be submitted to popular care. Itching of the Genitals often accompanies the above and other diseases of the bladder, it is very troublesome, especially at night ; the bowels should be kept well open and the parts bathed frequently with diluted solution of the acetate of lead ; this gives much temporary relief ; if the itching is great and there is feverishness, a small quantity of blood taken from the arm, is highly useful. Palpitation of the Heart, Fainting, and Difficulty of Breathing, are frequent during pregnancy. The first is relieved during the paroxysm by rest, spirit of sal volatile in water, or by a cup of hot water — the second by the recumbent position, the head being low, cool air, water sprinkled 66 PRECNANCY. on the face, salts held to the nose, and chafing the hands and temples with Cologne water — the third can only be alleviated by knowing the exact cause on which it depends. All the above may be merely caused by pregnancy, but they are also symptoms of disease of the heart, which may prove fatal ; it is, therefore, proper to seek medical advice. Coughing, Spitting of Blood, Vomiting of Blood ; these are some- times present during pregnancy, the cough is often very violent and very dim cult to remove, and by the shaking of the body it causes, is apt to produce abortion. Medical advice must be taken on all these, as they are attended by danger both to the mother and child. Headache, if very severe, of long continuance, if accompanied by dull and suffused eyes, confusion of ideas, and fullness about the head, is dan- gerous — apoplexy or convulsions are near. The ordinary headache is relieved by attention to the bowels and by taking a dose or two of mag- nesia to destroy acidity. Toothache is a tiresome accompaniment of pregnancy, wearing out the woman by want of rest, and irritating her and her husband's temper from the same cause ; extraction is considered dangerous, because it may pro- duce miscarriage ; it may with very nervous women ; and Burns says he has seen it do so a few minutes afterwards. Nevertheless, if the pain is very severe, and the rest has been sometime lost, if the tooth is decayed, and the pain evidently comes from one, it should in many eases be risked, for I think the horrid and continued pain is quite as likely to pro- duce miscarriage as is the momentary pain caused by extraction ; and which is followed by immediate relief ; I have acted often on this reason- ing and never had cause to blame myself for rashness ; certainly if the woman exhibits a morbid dread of the operation it would be better to try various articles that are supposed to give relief instead, for the power of imagination in this case is so great, that the evil of miscarriage may be produced by the mere shock to the nervous system. Fomentations of poppy heads, mallows, camomile, &c, are often of service. A few leeches behind the angle of the jaw, and the operation of a three grain Blue Pill taken at night and in the morning the follow- ing draught : — (Abernethy's.) ( Infusion of Senna, one ounce, i Sulphate of Magnesia, two dra j Manna, one drachm. [Mint water, one ounce. •achms. PREGNANCY. 67 frequently affords signal ease. If the tooth be hollow, the cavity may be rilled with a pill of opium, or lint dipped in laudanum ; if the teeth are sound the lint may be placed along the gums ; a bit of lint saturated in creosote and placed in the tooth produces an almost magical effect ; an increased flow of saliva, puncturing the gums, is frequently productive of ease ; the former may be encouraged by chewing horse radish, or the root of the Pellitory of Spain. Bleeding from the arm is serviceable in long continued cases. I have found the Carbonate of Iron combined with Colchicum of the greatest service, as the pain is often dependent on the same description of irritation of the fifth pair of nerves, that give rise to tic doloreux ; the form I have found of most service is — 5 Carbonate of iron, (sesquioxide of iron) two drachms, I Powdered root of Colcliicum, five grains. Mix, for a powder, to be taken three times a day. While these powders are in use, the bowels should be kept well open, the evacuations, from the action of the iron, will be of a very dark color, but this need not cause alarm, the -powders are of a tonic nature, and generally increase the strength and appetite. A plaster of belladonna, spread on leather, to be had of druggists, placed behind the ear, and covering the angle of the jaw, is also useful, or a blister may be applied in the same situation to remove the skin, and the raw surface dressed with half a grain of acetate of morphine, and three grains of powdered sugar, night and morning ; this never fails to afford relief, let the pain proceed from whatever cause it may ; this is so severe a remedy that a surgeon had better superintend its application. The thousand advertised nostrums for toothache are nothing more than various combinations of creosote, and are much more expensive, without being more useful than that substance. Salivation or increased flow of Saliva is sometimes a symptom of pregnancy, and is occasionally troublesome ; when that is the case, open- ing the bowels freely is advisable, by means of mild laxatives, as castor oil, magnesia, rhubarb, or senna, and the use of a gargle, made of two drachms of alum to a pint of water, three or four times a day. Pain and Tension of the Breasts is often distressing ; the breasts should be well but gently rubbed with warm oil, the bowels kept well open, and, if necessary, a small quantity of blood may be taken from the arm. Nature frequently relieves herself by the secretion and discharge 68 PREGNANCY. of a milk-like fluid. The sudden subsidence of the tension, and decrease in the size of the breasts, very frequently indicate the death of the fetus. Swelling of the Feet, Legs, Thighs, fyc, are often present during gestation ; if moderate and subsiding when the person is recumbent, they need cause no alarm ; if to a great extent, advice should be taken. Great Distension of the Abdomen, causing much inconvenience, is best relieved by a proper bandage, rest and attention to the bowels. Enlargement of the Veins of the Legs need no treatment, if moder- ate ; if of a large size, a bandage should be applied by a surgeon. Cramps in the Legs, fyc. , is best removed by friction and a change of position. Starting of the Navel may take place ; to prevent the rupture be- coming complex, a pad and bandage should be worn. Despondency often felt in pregnancy is usually cured by change of scene and air, and attention to the bowels, together with cheerful com- pany. There are many other diseases possible during pregnancy, as jaundice, convulsions, hysteric convulsions, dropsy, diseases of the kidney and bladder, spasm of the womb, flooding, &c. &c. ; but as these seldom occur, and always require the presence of a medical man, it would be useless to fill further the already somewhat extended catalogue of evils ; let not, however, my readers fear ; many women pass through the period of gestation without experiencing even one of the maladies I have set down and still more with only perhaps one or two of the slighter afflic- tions falling to their lot ; at no period of existence, is so many barriers set up by the goodness of God against death as during pregnancy, hence such cases seldom occur. On the care of the Health during Pregnancy. — At all times a due care of the health should, in some measure, be the study of every one, it is, however, particularly necessary during pregnancy, for then not only does the well being of the individual herself demand it, but also the unborn, upon whom all deviations from health in the mother, are more or less visited ; the principal cares required, are those which relate to exercise, diet, sleep, and proper regulation of the bowels ; if any of these are neglected the physical powers of the mother are deteriorated and through her the health, perhaps the life, of her infant, is sacrificed PREGNANCY. 69 Exercise, on foot, is of the first importance, especially in the earlier months of gestation, it should be taken in the open air, and, if possible, in such a situation that the mind is amused by the scenery of the coun- try, or other tranquil pleasure ; exercise, though beneficial, is not to be sought in the heated midnight ball room ; such exercise as this is more likely to do harm than good by the relaxation of the system, produced by the irritation, caused to the nervous system, during its continuance. The best time to take exercise, if the temperature is high, is the morn- ing and evening. During the heat of the clay, rest should be enjoyed; exercise should not be persevered in until fatigue is felt, or the circula- tion of blood will be hurried, and extreme exhaustion, both of the muscu- lar and nervous energy, will succeed to the over-exertion. To be of ser- vice, exercise should be regularly and moderately taken every day ; it is essential to the well being of both sexes, for without it, health cannot be preserved, or disease warded off. In the latter months of pregnancy, if exercise on foot is very fatiguing, it may be taken instead, in an open, easy carriage. The diet of pregnant women should be rather lower than usual, be- cause the state of gestation itself causes feverishness. Meat may be taken once a day, together with some well boiled vegetables ; breakfast should consist of black tea or weak cocoa, with biscuit, or stale bread. The meal called tea, should be the same; if supper is taken, it should merely be half a pint of thin, cool gruel, and a biscuit. This may seem a low diet, but it should be well understood, especially by those who are, or are about to become mothers, that strength does not arise from taking a large quantity of, or a stimulating description of food; on the contrary, both are followed by oppression and exhaustion. The same remark applies in even a greater degree to the use of spirits, wine and malt liquors. These articles, for a short time, seem to increase the strength and energy ; but how rapidly exhaustion follows, and this exhaustion can only be relieved by another and larger dose of the darling poison ; beware of giving way to this habit, it is fraught with danger, to your own and others happiness ; the author has known hundreds of women become drunkards, who in the first instance, only took a few drops of spirits to relieve the languor, often felt during gestation and lactation ; from a few drops they gradually increase the quantity to a wine-glass full, and this taken three or four times a day ; and in some few instances the infatuation was so great, 70 PREGNANCY. that even before arising from the bed in the morning, a glass of spirits was deemed by the degraded objects, essential to their comfort, and this was followed by another, immediately after their cup of coffee, and so on during the day, until they had consumed a pint of ardent spirits during the four and twenty hours ; this habit continued for some time, in spite of every persuasion to the contrary, but at length their natural good sense and originally strong minds operated, and they determined to rid themselves of the demon which was destroying their very hearts, and I am happy to say a few have succeeded, and are once more becoming the amiable and lovely beings they were, instead of having the most degrading of epithets fixed on their names — that of a female drunkard ; but do not permit yourself, my dear reader, to give way to the habit, for believe me, a woman who has once given herself up to the devil of strong drink, is a woman of ten thousand, if she has the courage to relinquish it. Sleep is of course necessary at all periods of life, but during gestation, the propensity to sleep should rather be checked than encouraged, as if too much indulged in, it occasions a tendency to apoplexy, and always causes exhaustion and languor. The more sleep is taken, the more would be taken. Eight hours is amply sufficient, but if the propensity is in- dulged in, ten, or even twelve becomes too little. Dr. A. T. Thompson relates the case of a young man, who, from indulgence, required sixteen hours out of the four and twenty, and at length suffered a stroke of palsy. Too little sleep may also produce nearly similar diseases, because in that case the brain and nervous system is worn out by over stimulus. Under the head of constipation, I have already dwelt on the necessity of proper attention to the state of the bowels ; little more need be added to the advice there given. One point I have not, I think, mentioned — that is, friction of the abdomen with a rough towel, or horse-hair gloves, for ten minutes or a quarter of an hour; this, together with attention to diet, exercise, an occasional purgative, and an observance of the periodi- city of the evacuation, will in every case have the desired effect. Parturition. — Various things are requisite to be prepared against the all important time of labor ; many of them do not come within the pro- vince of the medical man, some others, however, require a word from him. The choice of a nurse is a very important consideration. She should be strong, comparatively young, healthy, good tempered, patient, and free from bad habits, such as the love of stimulants, &c. If every PREGNANCY. 71 female before she called herself a sick or monthly nurse, was compelled to serve a certain time in a hospital in the one case, and in an institu- tion devoted to parturition in the other, there would not he so many well founded complaints, on the part of medical men, of want of order, clean- liness, and inattention to ventilation, and, in too many cases, an obsti- nate, ignorant, and presumptuous disobedience of the orders given to them, very often to the great detriment of the patient, and not unfre- quently causing the loss of life. No one will confide his life to a medical man unpossessed of a diploma or a lawful license, and yet they (women) permit themselves to be dictated to by an ignorant old woman, because she calls herself an experienced nurse ; and this solely because she is old ; that the nurse should forget that old age and many opportunities do not give experience is natural, that the well informed patient should do so is wonderful. Experience comes not by age, nor by many thousand cases having passed before the eye, it comes only by the habit of observing facts and the power of generalization. Some will see a thing performed a thousand times and yet be ignorant of the manner in which it is done ; yet, generally, the great test of experience in this our day, in a nurse, is age. Nothing can be more fallacious ; a better test would be a certificate signed by the medical men connected with some public charity, setting forth her fitness for the office of nurse ; and no won] an should be allowed to call herself a nurse who is without one. It should be as requisite to them as is the license to practice to a medical man. Besides sobriety, cleanliness, strength, a love of order, &c, &c, a nurse should have something like an education, at least as far as reading and writing extends, or mistakes may occur if medicines have been given according to written or printed directions on the bottles. I have known fatal events to take place from want of knowledge of writing, in one case a nurse gave an embrocation containing opium, instead of an opening draught ; in another, a lotion was administered instead of the mixture. Another requisite for parturition is a friend who is to be in attendance during the time of nature's trial ; she should be judicious, cheerful, free from nervousness, of* strong mind, and the mother of a family. One friend only is required; crowding the " chamber of travail " is reprehensible. The choice of a medical attendant is of course of considerable mo- ment; so many opinions are held as to this or that one's fitness, that I 72 PREGNANCY. shall not attempt a description of whom I consider a proper one, save that he may be a man well versed in the different topics relating to his profession. He who is not overburthened with practice is most likely to be at hand when wanted, and the least likely to be impatient of delay ; but my fair readers must in this please themselves ; they can hardly go wrong, for medical men are now all so well educated, that it would be almost impossible to pick out one from amongst those of any respectability, who is incompetent to fulfil his functions in the chamber of parturition. The clothes for the infant should be ready at the fire; also numerous napkins or doubles, a bandage for the mother, a skein of thread, scissors, tape for bleeding if required, a flannel receiver, and the boiler of the house should be full of hot water, in case the child should be born in a state of asphyxia. When it is thought parturition is near at hand, a redoubled attention to the bowels is requisite ; some gentle laxative should be taken every morning, such as castor oil, which perhaps is the best, from its causing little irritation, so that the bowels are kept free from accumulations of fecal matter, for these accumulations, by their bulk, considerably dimin- ish the size of the passages, and thus render labor more difficult, pro- tracted and dangerous, to say nothing of the filthiness of having the bowels evacuated at the moment the head of the child is born, which is very common when attention has not been paid to this matter. The nipples are often very tender after confinement, and in conse- quence the child gives the mother much pain every time it sucks, owing to fissures or cracks in the nipples ; for a month or two before labor the nipples should be washed two or three times a day with the following lotion : C Sulphate of Zinc, half a drachm. < Tincture of Myrrh, half an ounce. ( Rose Water, seven ounces and a half Mix for a lotion. If a little care of this sort is bestowed on the nipple, few will have cause to complain of pain in fulfilling the office dearest to the heart of woman, and which is at once the most graceful and lovely function, because the most natural and most feminine which woman perforins. Signs of the Approach of Labor. — Occasionally for some days before labor commences, certain signs have been observed which have been de- nominated precursory or premonitory symptoms ; most of them, however, are generally observed but a few hours before labor sets in. The person PREGNANCY. 73 about to be confined observes an alteration in her shape ; she is less, and carries the child lower in the abdomen, this is owing to contraction of the fibres of the womb, rendering it harder and smaller ; if formerly she felt languid and inert she now seems lighter and more active. The change of shape is attended sometimes by an irritation of the bladder, &c, causing a more frequent desire to void the urine and faeces. The parts of generation are somewhat swollen and relaxed, and more moist than before ; the child's movements are stronger than usual ; there are pains about the small of the back, extending as low as the seat ; and from the womb becoming partially open there is a discharge of red mu- cus, called by nurses " the shows," the pain in the back comes and goes at short intervals, sometimes extending to the belly, at others not ; vom- iting and cramps of the thighs are sometimes present ; at this stage the pains continue to increase in vigor, and come at certain intervals ; these signs are a token that the nurse, the friend, and the doctor should be sent for. The Lying-in Room when practicable, should be large and airy, and the windows, such as draw clown from the top, so that a proper ventila- tion may be maintained without fear of cold. It should be carpeted, be- cause carpets are easily cleaned with a brush and damp tea leaves, whereas boards require washing, than which nothing can be more liable to give cold to the patient, caused by the evaporation of the water from the damp floor, she might almost as well be exposed to the dews of heaven ; be- sides carpeted floors cause less noise when trodden upon than boards, and quiet is sometimes most essential. There should be a table in the room furnished with a bottle of brandy, a vial of sal-volatile, a ewer of water, and a drinking-glass ; these may be required for the patient during her labor, but are not to be used ex- cept under the eye of the accoucheur. On the same table should be placed a pin-cushion well furnished with pins of all sizes ; and a little old linen ; these most likely will not be want- ed, but should always be at hand, for any labor however easy in appearance may become complicated and require the use of the lancet ; and all medi- cal men have had to regret the valuable time wasted in hunting all over the house for a tape or ribbon, and its having at length to be sent for to the nearest haberdasher's ; the moments thus lost are sometimes cf the greatest consequence, involving perhaps life itself ; if such articles should be wanted in the night, which by-the-by is very generally the period cf 74 PREGNANCY. parturition, they cannot be procured at all, and some clumsy contrivance must be substituted. The room should also have a chest of drawers, well furnished with nap- kins, towels, and clothes for the mother and child. A towel horse with a large supply of towels is desirable, and another with the napkins to be used by the medical man during the process of labor. The wash basin and ewer should be large and well supplied with water, soap, and a large sponge; there should be a portable water closet and bed pan in the room, and also a covered utensil for receiving the after-birth. All slops, dirty linen, &c, should be removed immediately from the lying-in chamber, both during and after labor is completed. A sofa in the room, is also of great use after, or rather during confine- ment, for it will be necessary to remove the woman to it while her bed is arranged, without getting into an upright position, and thus avoid all dan- ger of flooding ; a second bed in the room, if the apartments are spacious, answers even better than a sofa. The best description of bed for parturition is a French one, because it enables the medical man to give assistance if required, on either side, without too much disturbance to the female ; a horse-hair mattress is much better than a feather bed, as the latter sinks into hollows, and also overheats the patient ; over the bed, or rather mattrass, and under the sheet, should be secured a skin of leather, or several folds of blanket or old counterpane ; this is called " guarding the bed," and is the province of the nurse. Two or three chairs should complete the furniture of the room, a larger quantity being only in the way. If in winter, and there is a fire in the room, no cooking, even for the infant, should be done at it, the smell being often offensive. Perhaps a word may not be out of place on the general management of the female after labor ; without wine, ale, or porter, be ordered by the medical man, none should be taken ; the diet for the first few days should be light, and unstimulating, the bowels should be kept well open, and the body moderately cool. The infant should be applied to the breast soon, and afterwards at stated intervals, and not whenever it cries, or a bad habit will be engendered, which will take greatly from the mother's comfort. During the continuance of the lochial discharge, great cleanliness should be observed ; the nurse should foment her employer night and morning with warm milk and water ; PREGNANCY. 75 there is but very little fear of taking cold. Sitting up, even in bed, should not be attempted, until the discharge has greatly subsided, but the female may be removed from the bed to the sofa, in a reclining position. No visitors should be admitted for at least ten days, and then not noisy ones ; quiet is essential to the newly made mother. The infant should be washed all over, night and morning, and the buttocks &c, after each evacuation of water or faeces, by these means and proper dusting, the chafings will be avoided. In concluding this branch of my treatise, I must add a few words as to the time of leaving the lying-in-room. A horizontal position is ab- solutely necessary during the prevalence of the " Lochia;" when this is quite gone, the feelings of the mother, as to strength, and the medical at- tendant's opinion, must decide the question of fitness. I have known females perfectly restored, and capable of going anywhere, with propri- ety, within a fortnight ; others barely able to leave their room in a month ; and others incapable of so doing in three months. The physi- cian must decide the question. He, therefore, who blames his wife for not being able to attend to her household duties in a fortnight after con- finement, because Mrs. or lady anybody else does, is a BRUTE ; and he who calls a lady a beast for leaving her room within that time, is an IGNORAMUS. Neither one nor the other have any pretension to be classed among reasoning beings ; the first is the worst of the two, inas- much as brutality is more culpable than mere ignorance. CHAPTER IX. 4 FEMALE COMPLAINTS. Menses. — Ancient and modern physicians have endeavored to investi- gate the cause of this flux, which resembles the ocean in ebbing and flowing at certain periods. It is called the menstrual discharge, or flux of the blood, which issues from the uterus every month. It usually begins about the age of thirteen, and ceases on an average between the fortieth and forty-fifth year, which renders these two periods the most critical in the whole life of females ; and the greatest care is then neces- 76 FEMALE COMPLAINTS. sary, as their future health and happiness depend in a great measure on the skilful and careful attendance rendered them at these times. When the important period of menstruation arrives, much depends upon proper management ; a sedentary life, restraint and confinement at that time, are unfavorable ; while moderate exercise, the open air, cheerful society, and indulgence are highly requisite. Hard work, and exposure to much cold and damp air, are too dangerous to he hazarded, even among the poorest people, inured to all kinds of rough weather. In some females the menses are very irregular, sometimes happening on the twenty-seventh day and sometimes on the thirtieth. Duretus says, that some women have their menses twice a month, without the least injury to their health, while others have not had them even once a month. The same irregu- larity is observed in respect to the duration of the flux, for in some it continues three, in others four, and even six days ; however, for the most part, Hippocrates says, that it terminates on the third. This monthly evacuation is the grand criterion of health in the female system. The operations of nature on this occasion afford the philosopher a subject for contemplative wonder and admiration. The quantity usually voided at a time by a healthy female in tem- perate climates, or one nearly allied to our own, is from three to four ounces. The quantity is materially affected by the different degrees of heat and cold, as will be seen from the following : " The Lapland and Samoiede void but a very small quantity, and the Greenland women scarcely any. The nearer we approach the equator, the more the quantity increases ; and in Italy and the south of Europe, it sometimes reaches twelve ounces; under the tropics it is said to raise to twenty ounces." "There are great varieties in this respect, according to constitution. In general, it is more considerable in dark women of ardent temperament, than in fair women of milder character. It is also more copious in towns and among sedentary women, and those who indulge in pleasure, than among country-women and those whose life is laborious and simple." This monthly discharge is as pure as any blood coursing the veins of the person, but in passing through the vagina it is impregnated and ren- dered foul from secretions flowing out of numerous glands situated in the internal coatings and external surface of the vagina. Leucorrhoea or Whites. — This disease generally proceeds from that debilitated state of mind, the result of indolence, excessive venery, long FEMALE COMPLAINTS. 77 residence in large cities, living in close apartments, and want of exercise, the extravagant use of tea, coffee, &c. A sudden check of perspiration, whether produced by natural or artificial means, amongst which may be classed constant neglect in keeping the extremities and other parts of the body properly warm, particularly the hands, arm pits, feet, &c. Also, the sudden drying up of the discharge from suppurating ulcers, derange- ments of menstruation, sudden disappearance of cutaneous eruptions, of diseases of the mucus membrane, &c. Some women have a periodical flow of the whites instead of the usual monthly evacuation ; it is attended with a pain and weight in the loins, cloudy or turbid urine, and a loathing for those things which in health the person delights in acquiring or enjoying. Barren women, and those who are most liable to miscarry, are for the most part troubled with fluor-albus. The feet swell by day, and the face by night ; also difficulty of breathing and a palpitation of the heart. The face is discolored, there is a pain in the small of the back ; and the appetite is lost. It brings on dropsy and consumption, cither of which, if not speedily remedied, put an end to the patient's period of existence. It may be known from venereal disease by the whites ceasing at the menstrual season, and not appearing again until that period is over ; while a " venereal " continues running without cessation, — the " menstrual " not affecting it. . The discharge, — its numerous changes, as regards color, and consisten- cy, are at all times liable to mislead the physician in his diagnosis. M. Lagneau very correctly remarks that " the green or yellow color of the discharge, its greater or less quantity, its ever variable duration, the dif- ferences in the intensity of the inflammation, are not data sufficient to al- low a prudent physician to pronounce positively ; for syphilitic blenor- rhagia is often indolent, lasts but a short time, and furnishes little matter, the color of which is almost always of a milky white ; whilst we daily meet with discharges we are compelled to regard as non-virulent, pre- senting these different phenomena in the most marked manner." Girls of a weakly constitution, as well as married women, also females who are large, fair, nervous, hysterical, and those whose skin is covered with freckles or stains, and finally, no class of women as regards color of hair, or skin, are entirely free from its debilitating effects. 78 FEMALE COMPLAINTS. The affection consists of a discharge or efflux of a whitish, lymphat- tic, aqueous, or serous humor from the vagina. Sydenham says it is sometimes white, occasionally pale, yellow, green or blackish ; sometimes it is sharp and corrosive, at other times foul and fetid. The discharge when sharp, ulcerates and excoriates the surrounding parts, which how- ever soon heal when properly cleansed and anointed with simple cerate. Women who have suffered from this affection for a long time, so that it assumes a chronic form, occasionally possess the vermilion hue in their countenance, yet there is a peculiar, inexpressible and unfailing symptom • in their features, as a whole, readily perceived by the keen eye of an experienced physician ; the face once beaming with health's most precious gems, now pale, the eyes swollen, the countenance wearing an expression of languor and emaciation — all unmistakeable evidences of the " blasted bud or sickly flower." This disease is not unfrequently complicated with many others, among which may be mentioned falling of the womb, and relaxation of the vagina — consequences, and not causes of the disease. " When the discharge is constant, profuse, and of long standing, ex- haustion and degradation of the constitution are soon found to be the unfortunate and necessary res alts of this flux, which never ceases, and which seems to attract to itself the source of all the other excretions, and thus to cause a drain upon the whole economy. The skin now becomes more and more discolored, the emaciation increases, the flesh becomes loose, the breasts are soft, the pulse small and frequent, and the breath fetid ; the eyelids become bloated, the legs are always cold, and the whole body sometimes becomes cedematous. The patient complains of almost continual cholic, and of pains along the vertebral column, in the loins, hips and hypogastric region. She is tormented with constant thirst ; the appetite is lost ; she sufters from habitual pain in the stomach, and from obstinate constipation ; she is subject to nausea, eructations and acid vomiting ; the urine is turbid, flocculent and in small quantity. When leucorrhoea reaches this degree of severity, the* patient acquires a disgust and indifference for everything ; her faculties become enfeebled ; she is unfitted for reproduction as much by her indifference as by the disgust which she inspires ; finally, moral debility and settled despair, together with hectic fever, exhaust the few remains of strength after having destroyed all that lends a charm to life." To discriminate rightly between this and other female diseases with which it may be confounded, inquiry FEMALE COMPLAINTS. 79 should be made as to its cause, duration, quantity, strength of female, her age, temperament, habits of life; other diseases, if any, under which she may be suffering ; whether married or single, &c. Great importance should be attached to age, and duration, as when the disease has been of long standing, and the patient is advanced in life, little or no confidence can be placed in an entire recovery, and in many instances, giving even temporary relief. A knowledge of this fact, no doubt gave rise to the assertion made by Hippocrates in his De Morbus Mulier, " hicjluor senioribus prope incu- rabilis est, et eas usque ad mortem comitatur." Among the more advanced in life this discharge is almost incurable, and it accompanies them even to the grave. The treatment for Leucorrhoea should be an injection made of a decoc- tion of the bark and flowers of the Pommegranate tree — to be used three times a day. Amenorrhea. — This term in its fullest acceptation, means a retention in puberty, or suppression of the menstrual discharge in after-life, subse- quent to its once being established. Among the many causes of Amenorrhcea, are, depression of mind, ex- treme fear or fright, sudden exposure to cold or damp feet, going in the cold air from a crowded apartment in a state of perspiration, bathing the sexual organs in very cold water, especially when unaccustomed to it, taking large draughts of ice-water in the stomach when overheated, particu- larly in summer when the body is in a relaxed state from excessive fatigue, and finally, whatever has a tendency to draw from the uterus to othpr parts of the body, the blood which nature has ordained to be exhaled by that organ. Also, among other causes, might be mentioned, injury done to the genital organs ; acute and chronic inflammation, induration, ulcer- ation, &c. of the womb ; obliteration of the vagina ; imperf oration of the os tincaB and of the hymen. It is often a source of extreme difficulty to determine the real cause of this affection. The Symptoms which characterize the existence of Amenorrhoea, vary according to the primitive cause. The local symptoms are " pain and dragging sensation in the lumbar region, and a sense of weight in the pelvis, and especially behind the pubis. If the non-appearance of the menstruation depends upon a congenital fault of conformation, which, moreover, does not manifest itself until the epoch of puberty ; the men- 7 80 FEMALE COMPLAINTS. strual blood is accumulated in the vagina or in the uterus, and forms above the obstacle a tumor, whose more marked character is that of in- creasing periodically each month, and remains stationary during theinter- vals between the sanguine exhalations." The general symptoms vary in regard to their nature and modifica- tions, and the age, temperament, mode of living, &c. of the female. They are usually, depression of spirits, disappearance of the healthful glow on the cheeks, the enlivening expression of the eye is exchanged for one of an emaciated and lifeless expression, a dark circle is visible around the eye, frequent attacks of headache, a constant difficulty in breathing with a sense of fullness and oppression, extreme susceptibility, dizziness, &c. The mind also suffers in common with the body ; it becomes gloomy, and wandering through scenes of by-gone days, by the aid of a diseased imagi- nation, transforms (to use a familiar expression) "the harmless glow-worm into a frightful bug-bear." IMMODERATE EVACUATIONS. A great flooding from the uterus ought not to be neglected, particu- larly if attended with loss of strength, and which may bring on the other symptoms of lassitude and debility, as want of appetite, crudities from indigestion, a sense of weight from the region of the stomach, an ill-color in the face, a languid pulse, swelling in the feet, and a disturbed sleep without refreshment. When this discharge is occasioned by an error in the patient's regimen, an opposite course to that which induced the disorder must be pursued, together with the discriminating use of proper alterative remedies. This will counteract the morbid affections of the blood, whence it proceeds; and to restrain the Jlux, the patient should be kept quiet and easy, both in body and mind. If it should be very violent, she ought to lie in bed with her head low, and live upon a cool, slender diet, as veal or chicken broths, with stale bread, and the use of the following preparation. ( Peruvian Bark, half a drachm, i Elixir of Yitriol, ten drops, to be taken in a glass of pure port wine, four times a day. If the menses appear in pregnant women, a very good prescription is, 5 Rose Water, two table-spoonfuls, I Laudanum, ten drops, three or four times a day until they are restrained, for opium does not much affect the head when the lower viscera are affected. FEMALE COMPLAINTS. 81 Immoderate evacuations are produced by a sedentary life and want of proper exercise ; hence this is a disorder most commonly found among those who "fare sumptuously every day, and dress in purple and fine linen," but seldom among the poor class of women, who have much ex- ercise, and who live sparingly. It is also occasioned by the too frequent use of salt, high-seasoned victuals, spirituous liquors, violent agitation of the mind, from losses, fear, anger, grief, &c. Violent exercise is as pre- judicial as moderate is serviceable, especially if the patient is subject to this flow from other causes, such as too frequent repetition of the vene- real act, or from a miscarriage. CHLOROSIS, OR GREEN SICKNESS. This affection is an obstruction of the vessels appertaining to the fe- male genitals, when the time for the appearance of the menstrual dip- charge has arrived. Its " appearance is marked by a state of habitual inertia and melancholy; the patient becomes sombre and taciturn, weeps without a cause, and sighs involuntarily; the face becomes bloated, the expression is as it were veiled, the eyes sad and languishing, the eyelid * which are swollen, especially in the morning, are encircled by a blacki; h areola, strongly contrasting with the pearl-white color of the sclerotic coat and the pallor of the lips ; the skin, particularly of the extremities, is dry and cool ; the pulse frequent, rather large, and less easily compressed ; the respiration is difficult ; digestion is deranged; the alvine dejections le- come white, hard and somewhat fluid ; palpitation and fits of pandicula- tion make their appearance, while debility, lassitude, a desire for sleep, or rather for repose;" a difficulty of breathing; a sickness at the stojn- ach when food is brought in the presence of the invalid ; sometimes an unnatural desire of feeding on chalk, coals, soft muddy brook stones, sealing wax, and many other things of an equally hurtful character. These harrassing symptoms seem to augment in point of severity from day to day. The stoppage of the menses is not always the. cause of this affection, as in its progress they sometimes flow regularly. According to Etmuller, the suppression of the menses is rather the effect than the cause of this disease. Sydenham considers this disease to be a species of hysteric affection, which is known by the paleness and discoloration of the facr, lips and whole body; but it indisputably arises, in a great degree, from 82 FEMALE COMPLAINTS. stifling or suppressing the calls of nature at this vernal season or juvenile spring-time of life, which is then most sensibly impressed upon the whole human fabric. That the present system of female education in this country is extreme- ly erroneous, must be evident to every observing eye, or well-informed person. Pent up almost gregariously in seminaries of learning in in- credible numbers, founded on the "speculation system." Young ladies in these schools are secluded from that society in which their future inte- rests and welfare must centre, and associated promiscuously with com- panions of their own age, by which they are exposed to the danger of imbibing all the errors which subsist in juvenile minds. To correct this derangement of the system in its incipient stages, I recommend the use of simple means as, (to use a cant phrase) exercises similar to that of making a feather bed for half-an-hour at a time, or sitting over a moderately heated steam -bath previous to retiring at night, for three-quarters of an hour. In case these simple means are not effective, my usual resort while a family physician, both prior to, and during my residence in the United States, was a compound prepared of the following ingredients, viz : — Gum Myrrh, Castor, Oil of Savin, English Saffron and Alcohol ; or, if the above receipt is not easily obtained, the patient can at intervals during the -day chew small quantities of smut rye, or drink a wine-glass full of an infusion — prepared from the herb Achillea Millefolium — noon and night ; either of which preparations will in mild cases, effect all that is desired. The usual preparations advertised and known by the name of French and Italian Female Monthly Pills, I consider highly deleterious to the constitution, and their use cannot be too strongly deprecated. They are generally made of Galbanum, Myrrh, Assafoetida, Sulphate of Iron, Ex- tract of Savin and Black Hellebore. The two latter articles are very poisonous, and should never be used unless as directed by a skilful phy- sician, and then with great care. Prolapsus Uteri. — Prolapsus Uteri, or Falling of the Womb, is a source of great inconvenience to married as well as single females. It is usually caused by debility, or a previously relaxed state of the tissues of the female genital organs. The inconvenience felt is in proportion to the distance the uterus descends in the vagina ; during its continuance there FEMALE COMPLAINTS. 83 is a discharge occasioned by the irritation it produces, nearly allied to, and by many called Leucorrhcea or Whites. The treatment and medi- cines best adapted, and which in my experience have proved most success- ful, are the following : — C Port Wine, one pint. < Water, one pint. ( Peruvian Bark, one ounce. for an adult a wine-glass full to be taken an hour before dinner, and the same quantity an hour before supper. For a young person, the quantity to be taken in proportion to age. C Port Wine, one pint. < Rain Water, one pint. ( Alum, one drachm. one ounce of which may be used as an injection, three times a day. The patient to recline on a bed or sofa as much of the time as possible du- ring the treatment, moderately using such food as is easy of digestion, and contains considerable nourishment. The patient should avoid the two ex- tremes of heat and cold. If the above simple, but in most cases efficacious treatment does not have the desired effect, a more energetic one must be adopted, which can be obtained by sending symptoms, &c, to the Author's address, which will be promptly attended to. PART II. SPERMATORRHOEA. SPERMATORRHOEA. CHAPTER I. AN ADDRESS TO PARENTS, GUARDIANS AND TEACHERS. " The growing pest whose infancy was weak, And easy vanquished with triumphant sway." Hath to a monster grown ; whose pois'ning breath Brings on old age and premature decay. From innumerable letters which are in my possession, during one of the most extensive practices which has ever fallen to the lot of any one man, and from a knowledge of the generality and effects Of this habit, known and conceived by very few practitioners, it becomes a duty I owe to tbe world, to address indiscriminately all having in charge the rising generation; for " I could a tale unfold Whose lightest word "Would harrow up the soul !" The following case by way of illustration, is worthy a serious attention, and may perchance arrest the wayward youth in his path to destruction. A young man about twenty-five years of age, initiated into these abomi- nations, had a disgust for the marriage state ; in his address to me after his recovery, manifesting an affectionate desire to reciprocate all that a thankful heart could make known, for the benefit he had received, quotes the following beautiful and expressive motto — "Let patience have its perfect work ; if I forget thee, let my right hand forget her cunning." This was the emphatic language adopted by this young man, (at present an eloquent divine ;) whose history I will resume ; and whose safety and privilege to preach the gospel, may be virtually attributed to the advice given him while a collegian, pursuing his theological studies. The Rev 88 AN ADDRESS TO PARENTS, GUARDIANS AND TEACHERS. gentleman, (like most erring youth, too often, and too indiscriminately indulged in vicious and unholy desires and contaminating sins, secretly carried on,) had attained the climax of its evils, when conviction brought its follies home to his heart, and medical aid could alone resuscitate him. In his appeal for relief, he was not only successful, but found in his be- nefactor a friend, of whom he thus speaks in a letter to a fellow laborer in Christian duties. "A more unselfish friend to suffering humanity, or warmer hearted more generous man, never was yet known ; when the virulence of party animosities, and the bitterness of professional griev- ances shall have died away, men will confess that no nobler heart ever throbbed in the human breast. The thousands he has helped — the poor he has aided — the hungry he has fed — the weak he has strengthened — the young in orphanage in every class of society, whom his hand, his in- fluence and his purse, have been ever ready to assist, will all cherish the remembrance of his worth. This truly beneficent man is Dr. G-eorge Cooke, of Albany, N. Y. People may think my words extravagant ; those who know him best, will understand how feebly my pen indicates the excellency of his character. Grod grant him success in all his under- takings. Princeton Theological Seminary, Anno Domini 1851. The anguish of his situation, joined to his exhausted condition, and the consequences of his infatuation, threw him into a profound melancholy, which however yielded to the power of my medicines judiciously administered. Permit me to entreat you who are fathers and mothers, to reflect upon the source from whence the above patient may have derived his misfor- tunes. If parents are deceived sometimes in the choice of those to whom the important charge of forming the mind of their offspring is entrusted, what is there not to fear from those who being hired only to display their corporeal talents, are examined less critically with respect to their morals, without its being known whether they are possessed of any. From the means by which children have been led into the commission of this sin, and from the great difficulty, when once habituated to it, of releasing themselves therefrom, I do most earnestly entreat all con- cerned in training and educating youth, to join with me in endeavoring " to save the fall Of Virtue struggling on the brink of vice ; In waking whispers, and repeated dreams. To hint pure thoughts, and warn the favor'd soul." AN ADDRESS TO PARENTS, GUARDIANS AND TEACHERS. 89 Boys should be watched with the care of love, and with a jealous eye, in all their secret haunts, and private hours, particularly if a disposition be discovered in them to be alone, and a disgust at their playful amuse- ments. And not the boys only, but the assistants — the ushers should be diligently scrutinized, watched and examined by their masters ; for too many instances have I known of their being the fatal cause of many a young man's fall ! Many young and tender plants of both sexes have been blasted by the very hand entrusted with their rearing. Should it be asked, where is the remedy of this evil? the answer is concise, and simply this : be parti- cularly careful in the choice of a preceptor ; watch over the preceptor and his pupil with that vigilance which an attentive and careful father of a family exerts, to know what is done in the darkest recesses of his house. Never leave servants or tutors alone with youth, if you have the least reason for suspicion. The eye of care and of sedulous watchfulness should accompany them even to their most secret retreats. In large schools, young boys are seduced by elder ones to retire and commit this destructive vice. Encourage youth in every action, every thought, and every look, towards the attainment of that which is just and honorable; check in them every thing which has the least tendency to vice. Parents, persuade your children to make you their confidant — teach them to give you the thoughts of their hearts ! Guardians., watch with the most tender care over your little charge ; be unto them as the angel in Paradise, whose sword turned every way to preserve the way of the tree of life ! Guard them from all evil — lead them to all good, and by your conduct allure them to look up to you as, and be you to them, their most faithful friend ! Tutors, feed your flocks like true shepherds, remembering how much depends upon your own example as well as upon your precepts. Your charge is most solemn and most important. Parents ! Guardians ! your country, Heaven itself entrusts to your care its choicest gifts — its greatest treasures! 'Tis yours to form the husband, the parent, the statesman, the patriot, the candidate for a long eternity ! Would young men only take time to consider, that every act of debauchery of this kind strikes deep at the root of the constitution, inevitably hastens those disorders 90 AN ADDRESS TO PARENTS, GUARDIANS AND TEACHERS. they fear, and will in the very flower of their youth bring on all the in- firmities of the most languishing old age, they certainly would abhor and desist from so vile and abominable a practice. il Human nature is burthened with innumerable evils, every man should lend a hand to lessen the dreadful aggregate." Before I dismiss this subject, it is absolutely necessary to remark, that i' ought not to be expected that disorders like those alluded to, which perhaps have been many years in accumulating, can be removed in a few days. Those who wish to restore their health, strength and vigor ought strictly to adhere to the advice and remedies prescribed by their physi- cian ; they should consider, that from implicit confidence and steady per- severance, a cure can only be obtained. A patient, therefore, inatten- tive to his own welfare, cannot expect a cure. Hippocrates justly ob- serves, that " the patient, the physician, and the assistants, ought equally to do their duty." Aretus says, " let the patient have courage, and con- spire with the physician against the disorder. The most stubborn dis- tempers generally give way to this harmony." Experience daily demon- strates the justness of the assertion ; and the author can safely challenge the world to prove one single instance where the remedies he prescribes have failed in producing the most happy and salutary effects, even in the worst of cases, wherein they have been taken regularly and persevered in for a moderate length of time. Persons who have addicted themselves to this vice, generally find themselves disgusted at all amusements, absent minded when in the pre- sence of company, stupid and lifeless everywhere, and if they think at all — feel themselves plunged in the deepest melancholy. From all these miseries, by proper abstinence, medicine, &c, they may obtain relief. But as I observed before, 'perseverance is necessary. In all cases parti- cular attention must be paid to directions in regard to time, and quantity; and above all it must be kept in remembrance that it will be in vain to expect any relief without punctuality ; the merely taking three or four doses of medicine, then leaving off for some days, or taking " old Mrs. Busybody's sure cure for all complaints " for a short time, and then com- mencing with the medicine first prescribed, will never effect a cure ONANIA. 91 CHAPTER II. ONANIA — OPINIONS OF PHYSICIANS AND PHILOSOPHERS. The destructive and pernicious habit of Onanism, is recorded in the 38th Chapter of Genesis, as the crime of Onan, the son of Judah, with a view, no doubt, of transmitting to posterity his chastisement, and we learn from Galen, that Diogenes polluted himself by committing this crime. In scripture, besides the instance of Onan, I find self-pollution termed effeminate, filthy and abominable. How soon the calm, humane and polished man, Forgets compunction, and starts up a fiend." There can be nothing more terrible than what Celsus and Etherus tell us of that abominable vice: The former says that "these pleasures are always hurtful to weak people, and the frequent indulgence in them destroys even the strongest constitution." The latter author draws a most horrid picture of the shocking consequences produced by this vile practice, and says that young people have the appearance and air of old age ; they become pale, effeminate, benumbed, lazy, base, stupid, and even imbecile ; their bodies become bent, their legs are no longer able to carry them ; they have an utter distaste for every thing, and are totally inca- pacitated, and many become paralytic. It will be well to place before the reader, in as brief a form as is con- sistent with a literal outline of the facts a summary of the consequences, physical as well as mental, resulting from the practice of self-pollution. These are two-fold, for such is the mysterious nature of the union, such the relatiou and mutual dependency existing between mind and body, between the purely corporeal and mental portions of our being, that any physically bad habit while it undermines the bodily health, produces a corresponding depression upon the animal spirits ; the brain and nervous system, as the organs of the intellectual principle, become preternaturally weakened and diseased, until one common ruin, involves both alike in destruction. If self-pollution has unhappily gained the mastery over the young spirit, if it become an admitted habit, the energies of the body which ought naturally to be directed to the purposes of nourishment and growth, are employed in the reparation of a criminal loss, and the pur- poses of a natural sustenance, as well as the support of the bodily functions, are altogether suspended, or at least imperfectly provided for. 92 ONANIA. " An idea may be formed of the nature of this loss, and of the sacred guard which health imposes upon its due preservation, by observing the consequences resulting from its unnecessary and too frequent emission. Physicians of all ages have unanimously been of opinion that the loss of an ounce of this humor by the unnatural act of self-pollution would weaken more than that of forty ounces cf blood." As an illustration of its importance, not merely for the direct end it was designed to fulfil in the process of generation, but for other purposes, more evident when retained than in its expulsion; note, for instance, the changes which take place in the animal economy as soon as this valuable fluid begins to be secreted; the voice, the features change, the beard grows, the genitals become covered with hair, the whole body assumes a more rotund and manly appearance, the muscular system requiring that firmness and solidity which chiefly mark the distinction between man and woman. So we know well that the loss of the testicles, or any disease that re- tards their natural secretion is followed by a cessation of those actions peculiar to early manhood, the voice again becoming childish, and the hair soft and feminine. Who then can doubt of the deep importance of this fluid in the animal economy, or feel the slightest wonder at the amount of those evils its imprudent and unnecessary evacuation is sure to entail upon those who are addicted to this propensity ? When this is the case, the mind and the body, sympathising together, experience a complete deterioration of their powers ; the intellectual functions of the former, forego their energy, move with sluggish pace, until at length they become arrested, and the patient is plunged into a state of irretrievable lethargy. The powers of the animal frame are excited by a corresponding impulse, the fluids become thin, poor, and scanty, circulating with languid move- ment, the faculties of the mind, more especially the memory, become the subjects of painful weakness and decay. Perverted indulgence in this horribly unnatural propensity, undermines and poisons all enjoyment, in- ducing sensations so misanthropic as absolutely to unfit the poor sufferer for all the ordinary business and enjoyments of life ; nay, so absolutely is the poor creature subdued by the wretched infatuation, that while per- fectly conscious of the rapid change that is taking place, he appears to have lost all moral power of self-control, or of making the slightest effort to recover his position and reinstate himself among the fellow beings of his race. Torn by the contending passions of remorse and sensuality, his ONANIA. 93 mind becomes the transcript of himself, moody, unhappy, ferocious or childish, often a strange medley of them all, or presenting in the revolu- tion of a few brief hours, as many aspects of character as a fickle, uncer- tain, unmanly intellect can well appropriate. He is led away by an overwhelming infatuation, which exercises the most complete tyranny over his reason, and so becomes by his own act self-degraded below the level of brute creation. Mr. Harper observes that " premature indulgence of amorous desires in the early bloom of youth, is productive of the most ruinous conse- quences. At this period the mind grows warm, and well adapted to imbibe a proper fund and connection of ideas, through the favorable dis- position of the nerves ; the body begins to germinate and gather firmness and vigor from the maturation of its juices, especially those of its glands, which now afford a repository for the lymphatic and nutritive parts of the fluids which are to answer the emergencies of nature ; but the unsea- sonable pursuit of unripe enjoyment blasts these promising fruits, draws off health and the elasticity of the mind from the system through this forbidden channel of pleasure, and inevitably shortens life! When the constitution approaches its zenith or perfect state, should the social im- pulse occasion its disorder and reject control, its effects are too important to be neglected — an exquisite sensibility in the nervous system united with sufficient powers in the circulation on the one hand, a full and cold phlegmatic constitution on the other, are its two extremes of tempera- ment which particularly require indulgence ; the former in order to dimin- ish that plenitude and irritation which, if not removed might produce frenzy, fevers, inflammation, &c, and the latter, on purpose to create that excitement and action in the nerves and vessels which are necessary to prevent obstructions, consumptions, hypochondria, &c." Continued celibacy generally loads the glands, retards the circulation and occasions fulness and stagnation of the vessels. In this state, the mind, unexpanded by the soft fire of mutual rapture, often becomes gloomy, selfish, and contracted, and all its faculties being confined within the narrow compass of ordinary gratifications, are devoted to habits of parsimonious care and contemplative amusement. Temperance is the best pledge for longevity ; nevertheless young peo- ple should, by all means inure themselves to the hardships and asperities of life. Without some share of these, to temper the lethargic effects of 94 ONANIA. indolence, the body sinks into a state of effeminacy and imbecility, and the mind soon becomes as feeble and insignificant as the body. Little irregularities may now and then be committed with impunity, perhaps with benefit ; but frequent shocks of revelry and debauch over- strain the system, indurate the solids, block up the fine vital channels, and hasten the approach of rigid old age ! Of all the various evils that human nature is ordained to suffer, none are more calamitous than those attending seminal pollutions, and which would be difficult to paint in colors so glaring as they merit ; a practice to which youth devote themselves without being acquainted with the enormity of the crime, and all the ills which are its physical consequen- ces. The most clouded melancholy, indifference and aversion for all pleasures, the impossibility of sharing the conversation of company, wherein they are always absent in thought ; the idea of their own un- happiness, the despair which arises from considering themselves the au- thors of their own misery, and the necessity of renouncing the felicities of marriage, are the fluctuating ideas which compel these miserable ob- jects to shut themselves up from the world ; and happy are they who do not, in the midst of despair, put an end to the period of their existence ! A description of the danger to which a person addicted to this vice is exposed, is perhaps the most powerful motive of correction. It is a dreadful portrait, sufficient to make them retreat with horror ! Consider then its principal features : The whole mass fallen to decay- all the bodily senses, all the faculties of the soul, weakened — loss of ima- gination and memory ! Imbecility, shame, contempt and ignominy are his constant attendants ; all the functions disturbed, suspended — capri- cious, disagreeable and disgusting even to one's self— violent pains ever renewing — all the disorders of old age in the prime of youth — and above all incapacity to exercise all the functions for which man was created — besides which — the humiliating consideration of being a useless member of society ; the mortifications to which they are exposed, — lassitude, de- bility, distaste for pleasure, and incapability of enjoying the company of even a friend. An aversion for others as well as one's self — life appears horrible — the dread which every moment impels the victim to commit suicide ! Anguish worse than pain ; remorse, daily increasing. Alas ! alas ! when the soul (no longer weakened by its unity with the body) serves as a fire, that is never extinguished, for an eternal punishment ! " Mod- ONASIA. 95 erate use of coition raises and cheers the noblest faculty of the body and mind. For the grand act of nature (says Falk) is coition ; that function in which nature has levelled the whole animal creation, by rendering the propagation of their species an object of the highest enjoyment : however with the difference, that to all, except MAN, she has prescribed periods of desire ; but man, as a rational being, she has left with full liberty to exercise these blissful moments with discretion. As long as that liberty is not wilfully abused, so long it is agreeable to the laws of God and man ; but the moment it is perverted into debauchery, the abuser sinks below the level of the brute ; and remorse, disease, and self-contempt become the fruits of his labor. Love is engrafted by nature in the human breast, (the mother plant of every virtue) by which we are rendered pleasing to God, happy in ourselves, and useful members of society. It is by this celestial fire that the sexes beget an ardent desire to give and receive something essentially pleasing, which creates in man an idea of felicity not to be described, nor to be compared to anything except heaven itself. If the love is pure, the bliss is the greatest boon man can wish for; but be- ware, Youth, beware : let this noble passion be guided by reason, lest it should hurry thee headlong into lust ; for if that be thy misfortune farewell to love and every social virtue — thou art ruined forever ! Sacred instinct first kindles the ethereal fire : and when that pair meet whose inclinations come in unison, they proclaim to each other with pal- pitating endearments, that there is a secret anxiety for becoming united into one. If this is not repugnant to the laws of chastity, and agreeable to the usages of nations, there now remains nothing but the embrace to complete the felicity, agreeable to the dictates of instinct. If this is con- cluded, and the period arrives, nature then prepares, and the ideas cen- tre in this act only ; the blood increases in velocity, and, like the attrac- tive power of magnetism, they cement as they approach in contact." Excessive venery produces lassitude, weakness, numbness, a feeble gait, headache, convulsions of all the senses, dimness of sight, dullness of hearing, a vacant look, a consumption of the lungs and back, and ef- feminacy. These evils are increased by a perpetual itch for pleasure, to which the mind and body have been so much accustomed, that it is diffi- cult to wean themselves from it. Whence follow obscene dreams, and frequent erections, occasioned by the influx of semen, which however small, becomes a burden and a stimulus, and which will discharge itself 8 96 ONANIA. from the relaxed cells by the very slightest effort. Thus it is that this horrid practice destroys the flowers of our youth, and nips them in the bud. They fall like the first transgressor, when -In an evil hour Forth, reaching to the fruit, she pluck'd, she eat; ***** * Earth felt the wound, and Nature from her seat Sighing through all her works, gave signs of woe That all was lost!" Frequent repetition of the act of self-abuse has been followed, in some instances, with an emission of blood instead of semen. It is universally acknowledged that we are equally ignorant of the nature of the spirit and the nature of matter, but we know that these two parts of man are so in- timately united, that all the change which the one undergoes, is felt by the other. This observation equally points out to us, that of all the dis- orders, there are none which more quickly affect the soul than those of the nervous system. " Absence, distrust, or e'en with anxious joy, The wholesome appetites and powers of life Dissolve in languor; the coy stomach loathes The genial board ; your cheerful days are gone; The gen'rous bloom that flushed your cheeks is fled ; To sighs devoted, and to tender pains ; Pensive you sit, or solitary stray ; You waste your time in musing." Those who addict themselves to this practice are generally disordered in the stomach, and afflicted with loss of appetite, dry coughs, weakness of the voice, hoarseness, shortness of breath on the least exertion, and a relaxation of the whole nervous system. Some are afflicted with a con- siderable loss of strength, paleness; sometimes a slight jaundice; pim- ples often appear on the face, and particularly about the forehead, tem- ples and nose ; leanness ; they are generally affected by change of sea- sons, particularly cold weather; languor of the eyes; weakness of sight and loss of memory. It is notorious that various disorders of the human frame are brought on by dissipation in youth, and the gross violation of those rules which prudence dictates for the preservation of health, and laying a foundation for a long and happy life, with a firm and strong constitution. The bles- ings of health are no sooner lost, than painful experience teaches us the inestimable value of them, and the unhappy patient looks around, too often, alas ! in vain, fbr the menus of their recovery ! OX A MA. 1)7 *' Youth (says M. Linngeus,) is the important period for framing a robust constitution. Nothing is so much to be dreaded as the premature or excessive indulgence of amorous pleasures ; hence arise weakness of sight, vertigoes, loss of appetite, and mental decay. A body that is en- ervated in youth, never recovers itself; old age and infirmities speedily come on, and the thread of life is shortened. No care should be neg- lected that may contribute to the elegance and strength of the body ; the excesses I treat of are equally destructive to both ; for the foundation of a happy old age, is a good constitution in youth. Temperance and mod- eration at that age are passports to happy gray hairs." " 0, blessed health ! thou art above all gold and treasure; it is thou who en- largest the soul, and opens all its powers to receive instruction and relish virtue. He that hath thee has little more to wish for • and he that is so wretched as to want thee, wants everything with thee!" — Sterne. Sanctorius fin-Dished us, in his observations, with the primary cause of this peculiar danger. " Moderate coition (says he) is useful when na- ture solicits it. When it is solicited by the imagination, it weakens all the faculties, and particularly the memory." This is easily explained. Nature in a state of health, does not inspire ideas ; but when the vesi- culse seminales are replete with a quantity of liquor, which has acquired such a degree of thickening as to render its return in the mass of blood difficult, then coition is both necessary and proper; but when we wan- tonly, or without occasion, subject ourselves to lascivious desires, it is the imagination, lustful habits, and not nature that importunes them. The body wastes away, th' infected mind, Dissolves in effeminacy ; forgets Each manly virtue, and grows dead to fame. Sweet Heaven! from such intoxicating charms Defend all worthy breasts! Another cause why those who practice self-pollution are debilitated, is, ndependent of the emission of the seed, the frequency of erection, which, though imperfect, greatly weakens them. Every part that is in a state of tension exhausts the powers, and they have none to lose : the spirits; are conveyed there in large quantities, but they are dissipated, and this occasions weakness. When a person has habituated himself to confine his thoughts to one idea, he becomes incapable of any other. Its empire is fixed, its reign is despotic ! Upon the most serious occasions, he finds his thoughts occu- pied with lustful desires and conceptions, and wishes to withdraw from 98 ONANIA. observation, that he may indulge his darling sin. To such a degree has dissipation in some places arisen, that debauchery with women is looked upon as only a habit ; the most criminal in this respect make no crime of it, and imagine it draws upon them no sort of contempt. But where is the masturbator who dares to acknowledge his infamy ? And should not this necessity of hiding the deed in mystic obscurity be a conviction of the criminality of his acts? It is evident in what manner the constitution is injured more by this habit than by natural connection ; but after excessive coition with a wo- man that is beloved, a man is not sensible of the lassitude which should follow the excess, because the joy which the soul feels, increases the strength of the heart, favors the functions, and restores what is lost. But this is not the case when every effort is strained to obtain a secretion of that fluid, whereby the human frame suffers such convulsions as are scarcely ever capable of being replaced. Why should we commit so great a crime against nature ? Why sink the soul in a sea of woe, and depress the spirits of man ? when "beauty has charms to dilate our hearts and multiply our joys!" ' ' When a long train of ills conspires To scourge oar uncontro^l'd desires." CHAPTER III. SELF-POLLUTION — ITS CONSEQUENCES. " Pleasure is all the reigning theme, Our noon day thought, our midnight dream ; Like the baseless fabric of a vision, They leave but a wreck behind. 7 ' There is not, perhaps, any opinion more universal, nor if I credit the testimony of the oldest writers extant, more ancient than the common one, which supposes a kind of degeneracy, progressive in its nature, in the human race, an unremitting depravation in all the endowments of man, degrading each succession of actors on this great stage, and setting them below their predecessors in every thing truly amiable and ennobling. Every generation complains of its own inferiority in size, figure and SELF-POLLLUTION — ITS CONSEQUENCES. 99 health ; and becomes in its turn an object of admiration to its successor, which to escape the prospect of present debility, deformity and disease, looks back with rapture t< the imaginary pre-eminence of former days. Homer, who lived but a few generations later than the hero he celebrates, thought he could not, with propriety, give Achilles less than the strength of twelve of his own puny cotemporaries ; and the poets who have suc- ceeded Homer in diiferent ages and nations, have not been less liberal to their respective favorites ; not, we may suppose, that they admitted the truth of the common opinion ; but wishing to gratify that love of the wonderful, naturally implanted in the breasts of their auditors, or readers, they were glad to do so by a fiction, which flattered their prejudice, while it excited their admiration. There can indeed be no doubt that the opinion in question is not uni- versally true ; since, if it were, the work of depopulation must have been long since completed, and the earth now, made one vast desert ! Yei , if properly considered, it will be found not to be totally false. For cer- tain it is, that the degeneracy of the age complained of does really take place, and is at all times making rapid progress in a considerable portion of the inhabitants of the globe, that portion which occupies the most conspicuous situation on it, the rich, illustrious and great ; and that, if the breaches made upon human nature, through the sides of these, her seemingly favorite sons, were not continually repaired by the neglected and obscurer, but more useful parts of her offspring, the poor and labo- rious, her creative powers must have been long since at a stand for want of materials to work upon. The families of kings, heroes, and nobles, after dwindling through a short succession of generations, at length totally disappear ; their places are supplied from the pasture or the plough, and the new possessor of wealth and dignity, entails upon his posterity the joint and inseparable acquisition of opulence and infirmity, luxury and disease. The country, the officina gentium, the great work- shop of humanity, is continually sending in supplies from her forests and mountains, and despatching her hearty and prolific sons to fill up the chasms of population ; while cities and great towns, those immense gulphs in which the redundancies of creation are absorbed, stand open night and day to receive the voluntary victims of disease and death. " Noctes atque dies patet atri janua Ditis.'' 100 SELF-POLLUTION — ITS CONSEQUENCES. Considering the notion alluded to under this point of view, we are enable to fix its true import, and we find that to deny the existence of the evil complained of entirely, or to admit beyond a certain extent, are errors equally manifest, but not perhaps equally dangerous. For, if to shun any calamity we are threatened with, it is necessary to be warned of its approach, it must be of infinite consequence to a very considerable portion of mankind ; to the rich, the voluptuous, the sedentary, and the studious ; to all the votaries of pleasure, and most of the suitors of for- tune and fame ; to all the inhabitants of cities and great towns without exception, and to many other orders and descriptions of men under cir- cumstances of less general comprehension ; to all these surely it must be highly important to know, that by a necessary consequence of their several situations and pursuits, they are continually anticipating the ex- istence, intercepting the health and vigor, and precluding the happiness of their unborn posterity, and as far as in them lies, laboring for a total extinction of the human race. This consideration, however, so very weighty and alarming in itself, may be perhaps of a nature too remote to be interesting to many. There would seem to be somewhat of a micros- copic quality in the mind of a good man, in consequence of which we are Argus-eyed to the minutest and least important of our immediate and present concerns, but blind to those of the greatest magnitude, that are removed to ever so small a distance. Insomuch that, if the danger to be apprehended, threatened future generations only, it would be in vain to expect that much attention would be paid to it by the present. But since the pollution that fouls the whole stream must begin at the fountain head ; since those who sow must reap, while their followers only can glean ; since, in a word, we cannot transmit to posterity the effects of our misfortunes, our negligences or our crimes, without first feeling them ourselves ; it would be madness in us not to consider whether there is a possibility, by taking certain precautions, of preventing ; whenever prevention can be obtained, or of palliating, when palliation is the most that can be hoped for. What the precautions to be taken are, in those cases where any pre- caution can be effectual, it is hardly necessary to point out. The common sense and common experience of every one a little advanced in the jour- iu>y of life, informs him abundantly what "he should both do and omit for the 1 ujttcr preservation of his health. Who is it that does not know the SELF-POLLUTION— ITS CONSEQUENCES. 101 importance of temperance and exercise for this great purpose, or is igno- rant that no care in other respects can make adequate amends for want of attention to these points ? If these duties (for there are duties which we owe to ourselves, and these arc of the number,) were as generally observed as their importance is universally acknowledged, the human frame would stand little in need of artificial assistance, and physic would be cultivated rather as an amusing speculation than a practical art. But since necessity, in some instances, ignorance or inattention in others, and passion in a much greater number, induces long and frequent devia- tions from the path that should be followed ; and since these deviations by a continued repetition, exhaust and enfeeble, so as to preclude all possibility of return ; it becomes one of the first duties, as it is one ox the most arduous tasks of the physiciau to take the unhappy wanderer by the hand, assist him to measure back the steps he has so foolishly and fatally trodden, and enable him, if possible, to regain the station from whence he set out. Such are the inevitable dangers, not less mercifully than justly attached by Providence, to an imprudent and excessive enjoyment of those pleas- ures which, under a legitimate sanction, and confined within the limits even then indispensable, are not only harmless but salutary; which not only affect the perpetuation of the species, but contribute both to the bodily and mental health of the individual. But if natural delights are tempered with the bitter but necessary alloys, what shall I say of the various kinds of impious debauchery disavowed by nature and invented by the criminal ingenuity of man ? Is it not reasonable to conclude that they cannot be less destructive in their effects, than enormous in their guilt, and that even here a punishment awaits them in proportion to their offence ? With regard to one, at least, perhaps the most criminal, cer- tainty the most pernicious of all, the odious and despicable practice of self- abuse, this is undeniably the case. So many causes concur to render excess in this species of libertinism, inevitable, and so peculiarly destruct- ive are the consequences of that excess, that an explanation of those causes constitutes a necessary part of a treatise designed, as the present is, to avert or remedy evils, an infinitely large proportion of which are derived from this foul source. If the mind borrows from the body the weakness of childhood, the sprightliness of youth, the maturity of manhood, the decrepitude of old 102 SELF-POLLUTION — ITS CONSEQUENCES. age, the vigor of health, and the languor of disease ; if it seem to be born, grow up and decay with it ; if, during their continuance together it reflects every color and impression that takes place in the animal portion of our being ; in return it communicates all its own sensations and affec- tions, controls and overbears its subject partner, tbe empire which G-od and nature designed it should enjoy. Hence it is that the feelings and desires which naturally originate in the one, may, by being frequently- excited in both together, be adopted as it were, by the other, and arise spontaneously thereto. It unhappily offers two powerful inducements ; it can be practised in seclusion, and its effects on the health are not so sudden and immediately apparent as the paleness, for instance, which succeeds a night of drunk- enness and sleepless revelry. For a time this solitary vice can be con- cealed ; the evil consequences are not known, and, consequently, not anticipated; or if there be some distant foreboding, present excitement banishes the thought and fear of future suffering. It is a practice which once indulged in, is most difficult- to abandon, it grows with our growth; and becomes confirmed at the expense of our strength. The miserable sufferer is not sensible, it may be, for a long time, of the slow yet certain change that is passing over him ; the debility that is perceptible to others, and his paleness, have crept over him so insidiously, that no one part of the body feels weakened more than another; as to the mind, the case is somewhat different, so it is, that a failure in the power of memory, is sometimes the earliest indication of mischief. The spell bound fascination of this unfortunate delusion most com- monly assumes its sway at a very early period ; the secret is propagated in whispers, or by example from boy to boy at school, where children are left in a measure open to the admission of sights and sounds over which the preceptor can only exercise a limited control. There, left to mix with other lads more precocious than themselves, or exposed to the numer- ous snares and temptations presented on every side in all large cities, it requires a more than ordinary amount of watchfulness on the part of those parents and guardians who have the supervision of youth, to prevent the introduction, or to eradicate and avert the consequences of this distress- ful and abominable practice. Under such circumstances, the secret of illusory gratification is soon discovered, a hew source of vivid and exqui- site sensual enjoyment is opened to the ardent imagination ; it is felt to SELF-POLLUTION — ITS CONSEQUENCES. 103 be easily and secretly practicable, and intensely pleasurable. Upon youth this destructive habit commits the most unrestricted ravages, and it will be obvious that inasmuch as it strikes at the very root of society, at the in- crease and propagation of the human race, by enervating and debilitating the spring of life ; no language can be sufficiently strong in reproba- tion of the national, social, and individual miseries resulting from a prac- tice which is not more hurtful and odious among men than it is detestable in the sight of G-od. It is at that early period, when passion predomi- nates, unchecked by the immature reasoning faculties, that the heedless youth runs the greatest risk of contamination. If at this excitable age, the idea be presented, or the example afforded, if the indelicate touch of strange hands disclose to the young subject what may at this time be considered a sixth and a new sense, there takes place such a strange and forced, and unnatural, as well as premature excitement of the genital organs, that, led on by the delusive pleasure, the poor votary of empty and selfish gratification, yields himself an easy, unresisting prey to a spe- cies of criminality, which, if not checked and broken, is certain to draw down upon him either premature decay and an early grave, or that lingering, hopeless hatred of existence, more dreadful than utter extinc- tion itself. Sensibly alive to the absolute impossibility of mixing in the ordinary enjoyments of civilized life, and of deriving from sexual congress any of those thrilling delights, which for the wisest purposes the God of nature has inseparably appended to that act, he becomes a low, melancholy, dis- pirited, dejected being, there passes over his mind a change which induces him to avoid all rational intercourse with his species, the language of his actions practically is, •'' Man delights notnie, nor woman, either." He bids a gloomy farewell to the cheerful society and haunts of men, the busy turmoil of trade, politics, the thousand anxieties of commercial ambition appear to his indolent imagination, as either too great for his hopes or foreign to his desires. Imbued with a moody misanthropy, the natural result of his own vices, he vents his splenetic complaints against the world at large, or if he speaks, it is to declaim respecting the darker side of human feeling and character. Thus he becomes a secluded and isolated being, his mind vegetating on his own prurient and diseased fan- cies. Once, perhaps, there was the budding promise of future usefulness 104 SELF-POLLUTION — ITS CONSEQUENCES. and activity, now how fearfully changed, — the dupe of lust alike horri- ble in imagination, as well as in the act. The blossom of youth, perhaps the flower of manhood, the supremacy of mind all gone, degraded and obliterated. Some continue the practice from feelings of despair. They have become conscious of its ruinous tendency, and very desirous in con- sequence to resist the unmanly habit ; they have sought intercourse with women, but to their dismay have found their powers so strangely and un- expectedly weak, that only an imperfect erection could be commanded ; burning with baffled desire, yet powerless. Or perhaps the seminal fluid, thin, scanty and poor, escapes too readily, and so, ashamed, vexed, dis- pirited, they forego any further attempts, lest they should again be sub- jected to the humiliation of failing in the act, the energetic performance of which is the conscious pride of all who stand erect in the dignity of man. Abashed, the poor guilty sufferer retreats from the quick gaze of his fellow mortals ; he sees, or he fancies he perceives suspicion in the eye of every one who looks steadfastly upon him. His haggard counte- nance, his pale, unmeaning, inexpressive face, — his dull, lack-lustre eye, his thin and tremulous form may well betray him, as most assuredly they do, to the practised observer. In many such cases I have attended the bedside of Hospital patients, who, in view of dying with consumptive complaints, have voluntarily related their own private histories as emanating from this delusive practice. One, I may say, aside from general practice, occurred in this city. He was a young man of respectable parentage and connexions, and was a clerk in a dry-good store, which I was accustomed to frequent. From his demeanor and other unmistakeable evidences I had gleaned, I enter- tained no doubt that he was a victim of Self Pollution. I often talked to, reasoned with, exhorted and forewarned him to sin no -more; but to no purpose. He always evaded the force of my remarks ; but it so hap- pened on an auspicious night that I was summoned by a party of his companions, who apprised me of his sickness, to go and sit up with him, for he was confined to his bed. This circumstance happened the night before he died, — he wanted most anxiously to see me. Well do I re- member his intelligent, too true and pathetic remarks : — " Oh ! (said he,) did they know about my case as much as you ! Oh ! would my Uncle have allowed me the benefit of your advice ! I should not now be obliged to eat and swallow this coarse ice to cure, as they SELF-POLLUTION — ITS CONSEQUENCES. 105 suppose, inflammation of the "bowels ! ' Twas your prophecy that I should die unless I desisted from my boyish practices ! Oh ! could I but again have the privilege of your counsel and advice ! I shall die, dear Doctor, through wilful ignorance of my own follies ; and the skill of my Uncle's doctor cannot save me." The young man lived as he died (aside from his owd conviction of self-destruction,) in the definition of the pub- lic — a pious boy. See, then, in this, a striking illustration of the prophetic warning, "There is nothing done in secret that shall not be revealed," neither " hid" from the recognition of mortals, that shall not ultimately be made even to them, evident as the noon-day. Self-pollution entails upon its victims marks as evident and as legible to the eye that can understand them, as the scars of small-pox. How much more closely are these things preemptible to the eye of Him by whom all our actions are weigh- ed, — to Him who knows the secrets of all hearts ! — from whose scrutini- zing eye nothing can escape ? Can I produce a more fearful illustration of the stupefying effects of Onanism than is evident in this ; that the vic- tim of this abuse fears not in the secrecy of midnight, when knowingly the gaze of God is upon him, to do that which if caught perpetrating, even by a child, or most especially a woman, he would instantly redden with shame, and if possible escape to hide his head from observation for- ever ? Dreadful depravity ! Strange perversity ! Deliberately and se- cretly to poison the power of all manly and natural enjoyment — to de- prive, by worse than suicidal madness, the powers of reason, the throne which is their right — to entail misery on ourselves in this world, and no hope for escape from condemnation in the next. I would fain hope that there are few, who, whatever may have been their actual profligacy, are insensible to the authority, or who will deny the appeals of that religion, which is founded upon the direct and express revelation of God himself. Some men are powerfully under the influence of motives drawn from self-love, from their immediate temporal interest and advantage, a present evil, direct suffering, more powerfully deters them from the various excesses of Sensualism, than the fear of future punish- ment . To such, I may quote the language of Sir Astley Cooper, Bart. , ser- geant-surgeon to the Queen of England, whose eulogiumit is not necessary to repeat, inasmuch as his name has been, is now, and will remain a last- in^ authority. He was accustomed to say, in his public lectures, in refer- 106 SELF-POLLUTION — ITS CONSEQUENCES. ence to a certain class of cases : A If one of these miserable cases could be depicted from the pulpit, as an illustration of the evil effects of a vicious and intemperate course of life, it would, I think, strike the mind with more terror than all the preaching in the world. The irritable state of the patient leads to the destruction of life, and in this way, annually, a great number perish. Undoubtedly the list is considerably augmented from mal- treatment and the employment of injudicious remedies." To different minds it is necessary to produce various arguments and illustrations ; proof and conviction are variously modified, inasmuch as there is something doubtlessly peculiar in the individual construction of each mind ; but I speak at least to those who have not yet cast off all fear, all reverential regard for scripture. It may be that such an one, though apparently left for the present to " commit uncleanness with greediness," is not in the eye of mercy so utterly irreclaimable, it may be, he may yet be permitted to hear the voice of God in his word, and yet live — live not for himself alone, but for the happiness of another destined to be blest by his smile. Without further comment I subjoin a few pas- sages from Holy Writ, which have evident reference to the enormity of the crime of self-pollution. St. Paul, in the 5th chapter of the Epistle to the Ephesians, warns us, " Let no man deceive you with vain words, for because of these things, the wrath of' God cometh upon the children of disobedience." His in- junction is " Keep thyself pure," and again, " unto the pure all things are pure, but unto them that are defiled and unbelieving, nothing is pure, but even their mind and conscience is defiled." How is it possible, in words, to convey a more vivid and revolting picture of the debasements of Sensualism ? Again, " this is the will of God, even your sanctifica- tion, that you should abstain from fornication, that every one of you should know how to possess his vessel in sanctification and honor. Not in the lust of concupiscence, even as the Gentiles, which know not God, for God hath not called us unto uncleanness, but unto holiness." * Epis- tle to the Romans, chap, xiii, verse 13th; "Not in chambering and wan- tonness." " Walk not," says he, " as other Gentiles walk, who being past feeling have given themselves over to lasciviousness, to work all un- cleanness with greediness." Eph, chap, iv, verse 17, 19 ; chap, vi, verse 15 ; " Shall I then take the members of Christ and make them the mem- bers of a harlot ? God forbid !" 1 Cor. chap, iii, verse 16; "Know SELF-POLLUTION — ITS CONSEQUENCES. 107 ye not that your body is the temple of God, and that ye are not your own ?" And in the same Epistle to the Corinthians, chap, iii, verse 17, he solemnly warns us, " If any man defile the temple of God, him shall God destroy, for the temple of God is holy, which temple ye are." Doubtlessly many of these passages refer primarily to excesses with women, but they all point clearly enough, not so much to the act as to the filthy and polluted state of mind and heart, out of which originates all the varied forms of sensuality, not excluding Onanism itself, and which, if* present in any of their disgustful characters, inevitably react upon the mind, rendering it still more corrupt. Even the Pagan world of ancient Rome, immersed in sensuality almost beyond parallel, if I may credit Martial, the most celebrated epigrammatist of the times, and who may be adduced in speaking the language of the great masses of people, these held the practice of self-pollution in worse than abhorred contempt. " Hoc nihil est putes ? Scelus est mihi, crede : sed ingens Quantum vix animo, concipis ipse tuo. You think 'tis nothing, 'tig a crime believe ! A crime so great you scarcely can conceive." " We, however, have a more sure word of prophecy, whereunto, if we take heed we do well." This, certainly, ought ever to be regarded as a powerful inducement to dissuade us, not only from the grosser forms of sensual excess, but to warn the thoughtless against the terrific practice of secret pollution. For God, as the creator of this curiously contrived frame of ours, hath put upon it a measure of his own glory, the shadow of divinity. Our bodies are declared to be the fitting residence of him- self, in his power and presence, he formed, and by that presence sustained us in being. Wherefore our bodies, perishable and mortal though they be, yet partaking of this honor, it is not less our duty than our highest privilege to retain them in honor. If the temple of heathens were not suffered to be profaned by any pollution, how much more ought the thoughtless voluptuary to respect, if not himself, for his own sake, yet the curiously constructed workmanship and frame work of the Great Creator, of that being who will surely avenge himself in pain and agony, inflicted upon the violators of his own laws. We are told, in the unerr ing oracles of truth: " Ye are not your own, for ye were bought with a price, wherefore, glorify God in your bodies and spirits which are his." Paul, speaking of heathens, observes that, " being given up to unclean- 108 SELF-POLLUTION — ITS CONSEQUENCES. liness they dishonored their own bodies ;" and in another place, " that it is the will of G-od that we abstain from uncleanliness." Indeed it would be endless to recapitulate all the scriptural passages relating to the pollutions of the flesh. Let any unprejudiced individual examine the sacred writings for himself, and where distinct mention is made of vicious acts, he will not fail to perceive that there is not any one other crime, so many times named as undeanness, and how can any person be more actually designated, as guilty of this sin, than he who is addicted to self-pollution ? Nay, if we reflect ever so superficially on the ordinary laws of God's moral government and providence, if we think of the natural end and design of marriage, in all countries, and the way in which it is evidently intended our species should be propagated, reason itself would instruct us, that to destroy that end must be very offensive to Grod, as well as unpardonable crime against the well-being of society at large. Whatever be the form of sexual excess, all alike tend to the production of a weakly, puny progeny, beings who are likely to bring uo honor or usefulness to the state, but rather a sickly burden, dying without usefulness. And if this be true of excess in general, it holds infinitely true of self-pollution, justifying the assertion that the crime in and of itself, is monstrous and unnatural ; in its practices filthy, odious m the extreme, its guilt is crying, and its consequences ruinous. It destroys conjugal affection, perverts natural inclination, and tends to extinguish the hopes of posterity. As to the effects of this vicious practice upon the body, they are not less remarkable than the strange debilility that clouds the mind. Let once this forbidden and surreptitious form of delusive enjoyment gain the force of habit, and instantly down falls the barrier of intellectual con- trol. And be it observed, there is no act which so soon matures itself into a confirmed habit. Tobacco and spirituous potations are in the first instance offensive, and time is requisite to reconcile the healthy organs to their use, perhaps a longer period to render them agreeable. But as to the act of self-pollution, its first essay is ushered in with a new, wild, and intoxicating delight. Its very secrecy aids the infatuation. The stream once crossed, the rubicon once passed, all may be done effectually that is evil for time and eternity. To retrace that step, to efface it as a blot from memory and conscience is impossible. And so, often that monitor becomes seared, deadened, hardened, till its feeble voice, from SELF-POLLUTION — ITS CONSEQUENCES. 109 oft repeated criminality, becomes drowned in the mad and urgently loved calls of unnatural passion. And thus it is, that the mind now depraved, becomes not the reasoning governor, but the goad, the stimulant to acts which sooner or later will abolish and destroy completely every vestige of intellect or rationality. All is perverted, turned upside down. Pas- sion, which ought to assume the position of a necessary, yet docile and submissive slave, assumes the reins. The empire which this odious prac- tice assumes over the senses, is beyond description. What moral region does that man live in, what sensibility does he cherish, that now safe and free, would not unite all the energies of his nature, to avoid so fatal a precipice, or if unfortunately the first step be taken, that would not struggle to disentangle himself from the grasp of this smilingly seductive, yet cruelly murderous monster ? As the nervous system suffers, the brain becomes the subject of dis- ease and melancholy indifference ; disgust, misanthropy, pass through their various grades into madness. The startling truth is not to be con- cealed, that self-pollution is frequently the sole cause of insanity. If the happy married man indulges to excess in the legitimate gratification of the matrimonial couch, affections of the head are frequently observed, giddiness, dizziness, an unaccountable uneasiness, want of sleep, or per- haps drowsiness, I know that several celebrated men have actually died in the very act of coition, from the excitement of determined effort and failing power. But resolute persistence in effecting seminal discharges by the requisite friction, which constitutes self-pollution, is far more dan- gerous and deadly. If it do not produce convulsions and sudden death, which is really sometimes the case, the brain is apt to become diseased in a remarkable manner. So Dr. Armstrong was accustomed to teach his pupils of the Borough Schools. " The solitary vice of Onanism," he observes, " produces affections of the head." And he details in one of his lectures the case of a " youth 17 or 18 years of age, who went at the age of ten, to a school where the vice was common, and he became the subject of it, and from being a fine, active, and clever boy, he be- came a 'perfect idiot. His eyes became prominent, his pupils dilated, he had pains in his head and down the course of the spine, loss of me- mory, a silly unmeaning expression of the countenance, and a tottering gait." He declares his conviction, no doubt founded on repeated observ- ation: " I think I should kiiow a -person in the street who has add/did 110 SELF-POLLUTION — ITS CONSEQUENCES. himself to this vice, by merely walking behind him, from his 'peculiar gait." Is this wonderful ? Nay, it is merely illustrative of the value and power of close observation, and it may serve a useful end to alarm some poor infatuated youth, who may foolishly imagine his secret pol- lutions are known only in the recesses of his own conscience. And that these oft repeated acts should really tend to insanity, if I had not the evidence of the fact, it would not be unphilosophical to suppose, for the mind continuously and morbidly directed to this one single idea and the act connected with it, becomes debilitated from the preponderance and perpetual recurrence of the same unchanging train of thought and feel- ing ; and such is the sympathy of the generative organs to the act which impresses them, that the physical and moral sensibilities are there directed as to one common focus, and that which ought to be only a casual state of excitement again to subside into repose, becomes exchanged for a per- manent, and therefore morbidly irritable, condition. It is then mani- festly contrary to the laws of life that any one impression (whatever be its character), should be constantly present, or if it be, health and life are sure to suffer. So the purest and most ardent love produces physical debility, evidently because of the intense occupancy of the mind. How much more debilitating must be impure associations, connected as they are with vicious practices ? No wonder that madness and suicide follow. What but this, together with unavailing remorse — what but a spell- bound fascination he would fain, yet could not forget, induced the poor youth, of whom Dr. Darwin speaks, to blow out his brains, leaving upon record the story of his folly and its punishment : "I am impotent, AND UNFIT TO LIVE." So we know that all efforts which require the exertion of continued imaginative power, tend to madness. Poets, sculptors, painters, the writers of fiction, are all equally susceptible, and this from the exclusive exercise of the faculty of imagination. u Great wits to madness nearly are allied, And thin partitions do their hounds divide." As to the moping, melancholy lover, his woes are rational and natural, and find an easy termination. But the solitary sensualist, he is the vic- tim of the worst, most unbridled and tyrannical lust that can embody. Every fair and virtuous countenance that is new to him, inspires him with some filthy idea, excites and goads him in secrecy to fresh excesses, SELF-rOLLUTION — ITS CONSEQUENCES. Ill m silence he conjures up before diseased fancy some absent object. The nervous system sinks under the rapid, unnatural whirl; denied repose, urged on to forbidden effort, tortured by the continual recurrence of one single idea, reason resigns her tottering throne, and madness, staring madness — or it may be muttering, weeping idiocy, usurps her vacant authority. I regard insanity, then, as the sad and not unfrequent termi- nation of some of these cases. And, it must be obvious, that the same causes which tend to break down the energies of the general system, to bring on disorders of the stomach, and impair constitutional energy, will unquestionably tend to madness, and this because of the excitability of the nervous system, and the absolutely essential preservation of its pow- ers. I am accustomed to read and to hear of frequent instances of gloomy, determined suicide — and the laws of our country, as well as the verdicts of a coroner's jury, generally place a merciful construction upon the act. But I happen to know, from the fact that my attention has been strongly directed to the subject, that among the unknown and unre- cognized causes of suicide, the sense of impotence, as resulting from self- pollution, or the insanity arising from the direct practice of such acts, the weakness of intellect and soul which such vice engenders, may often, without fear of error, be ascribed as the sole and direct cause of suicide. Dr. Armstrong remarks on this subject: "I have met with many indi- viduals who have had, they say, a pre-disposition to self-destruction ; and I find this especially the case when there is an united disorder of the stomach, liver, bowels, and head, which leads to madness." The practi- cal value of this remark is obvious. How fallen from his proud and high estate, how sunk beneath the true nobility of man, is the wretched wreck of humanity, whose deplorable ex- cesses has reduced him to a condition so truly contemptible. Once in the joyous hilarity of youth, he rejoicedinthe entire command of every manly faculty ; now a senseless yet animated mass of helplessness, exciting the com- miseration of those who know not the cause of his ruin, and visited with the bitter scorn of those who, spite of his attempts at concealment, read his degradation stamped upon every feature. Whither may he fly from the plague that is within him — the evil that haunts him alike in darkness and light ? The quiet and refined enjoyments of literary research, once his harmless and delightful recreation, now pall upon his morbid, vitiated taste ; if he read at all, nothing but the more licentious productions of 112 SELF-POLLUTION — ITS CONSEQUENCES. the older dramatists, or the lewd effusions of the reign of the Second Charles, prove sufficiently stimulating ; or these, it may be, are ex- changed for the mawkish sentimentality, the prurient voluptuousness or concealed obscenity of a low circulating library of trashy novels. Forced to contemplate the gloomy spectre, the shadow of his former intellectual and bodily self, it is merciful indeed that loss of memory, in some faint measure, procures for him negatively moments of repose from that mur- derous, racking thought which can dwell alone upon images the most hor- rific and revolting ! To such an one, what misery arises from the acci- dental perception of domestic enjoyments ; he sees a fond father hug to his bosom his first born, and cover its little laughing face with kisses. But for him let fancy complete the picture. There is no perverse practice, no deliberate vice, which so disturbs the natural circulation of the blood in the brain, as the baneful habit of self-pollution. In particular parts of the system the blood may be quick- ened, and this without materially affecting the entire system of vessels ; if this be permitted to occur, the neighboring parts to those affected, are deficiently supplied, and as the result, their functions become perverted, or for a while suspended. When the genital organs are in a state of undue excitement or disease, the circulation of the blood in the brain is disturbed, and hence arise most important deviations from healthful actions. Phre« nologists inform us that the perceptive and reflective faculties resident in the upper and anterior part of the head, become debilitated and deranged, hence all the diseased sensations that torment the votary of Sensualism. The human body is capable of enduring a certain amount of fatigue, if it be divided into daily portions, the surfeit of one dissipated midnight is relieved by the unwearied sleep of the next, but it is possible to overtax our capabilities, and then nature failing under the effort, no reaction suc- ceeds. Mark how large the number of organs and structures engaged, for instance, in any one single act of one of the senses or bodily move- ments ; these are obedient to natural requirements. Let us think for a moment how we overstretch our powers, when we are compelled to call upon imagination to invent a fancied enjoyment, that which instinct, pro- perly directed, could furnish in an instant, without the slightest exertion. For it deserves to be attentively borne in mind that, independently of the drain upon the blood by the frequent emissions of its most brilliant and important secretion, thereby occasioning great debility, there is an- SELF-POLLUTION — ITS CONSEQUENCES. 113 other and collateral cause of weakness arising out of the too frequent and unnatural erections with which some persons are troubled. These have a tendency to generate a species of atony, a palsied and enfeebled state of the male organ, rendering it absolutely useless when really neces- sary. Nay, this remark is not without its practical value, independent! v of bad practices. We ought to perceive that the male sexual organ ha its moments of excitement requiring long periods of repose. The Author knew an instance of a youth, who, anticipating with eager delight a long wished for appointment, found himself at the time suddenly impotent and powerless, not so much from fear, anxiety, or transport,, but doubtless from the absolute weariness and flaccidity of an organ which, from mental causes, had for many hours previously maintained a state of throbbing erection. How much more strongly must these remarks apply in the unnatural state of masturbators, who are liable to an imperfect and tem- porary erection, even from the utterance of a casual word. Such frequent excitement of the genitals brings in its train not local palsy alone, (gene- rative debility of the worst kind,) but general weakness of the severest character. The mortality from consumptive diseases is so alarmingly great as to justify every inquiry that can be instituted, in reference to its obvious, as well as its concealed causes. There are, doubtlessly, some forms of disease of the lungs most accurately resembling genuine tubercular consumption, which are called into existence by the baneful habit of self- pollution. Nay, where the scrofulous tendency or predisposition really exists, there can be no hesitation in affirming that this practice will excite its latent powers to more vigorous action — will call it out and with giant strides cut short the brittle cord of the effeminate victim's existence. Sensual excess, as it is the most certainly fatal, so it is the most inevita- ble and fertile cause of those diseases of the chest which threaten in early life to remove their victim to the tomb. Now, can any hope be more irrational than this, to expect that the treatment of such forms of disease should be correct where self-pollution, in many instances, the concealed cause of them, has been altogether overlooked, unconfessed, or unknown ? Every man and woman has his or her weak point, not merely in mind, but in bodily organization ; but many persons, from accidental causes, (of which this form of vice may surely be enumerated as one,) call into active energy the seeds of disease which otherwise would have lain dor- 114 SELF-POLLUTION — ITS CONSEQUENCES. mant. And as the result of this, the early marks of some disease of the chest are to be noticed in the following order : breathlessness on the slightest exertion, irregular sleep, the sufferer finding it excessively dif- ficult to fall asleep at night, and heavy with greedy rest when the hour of duty bids him arise ; together with these symptoms there is languor, lassitude and other signs of debility ; fever, (which is not an unusual concomitant of the weakness generated by Onanism,) is then perceptible, but chiefly in the evening. There is a loss of appetite, the stomach be- comes capricious, and as the scanty food becomes less perfectly subjected to the digestive process, there results a manifest wasting of the muscular system. Paleness of the countenance, a tumid belly with a distended condition of the legs, an irregular and costive state of the bowels, with frequent changes in the character and appearance of their discharges ; these are the premonitory symptoms which usher in the first stage of consumptive diseases, arising from debauchery. Presently a cough, which had previously been unnoticed, becomes troublesome ; at first no- ticeable chiefly upon'goin'g to bed or rising, but afterwards through the day. As the disease advances, exnectoration, first of mucus, then of a purulent character ensues ; and, before death, purging and profuse night sweats leave no doubt as to the real nature of the disease. There are few writers who, speaking of the predisposing and proximate causes of consumption, have not included "frequent and excessive debaucheries " among the list. Early in the history of these cases, after fever has begun to flush the cheek with a central redness, the urine is high colored, and deposits freely an earthly sediment. In many instances the stomach seems not to fail in its tone ; the tongue, however, is altered, becoming smooth and unnaturally red ; the voice is altered, and the eye assumes an unnatural brightness. The symptoms of consumption produced by self-pollution do not, then, differ materially from those observable when it has arisen from cold, neg- lect, or other imprudence ; perhaps, if there be any one indication which allies it to Sensualism as its cause, it is to be looked for in the violet- colored circle which usually surrounds the eye of the practised Onanist, and that peculiar expression of countenance more easily recognized than described. Epileptic and Convulsive Diseases, are freely produced, excited and called into action by these excesses. The natural intercourse of the sexes SELF-POLLUTION ITS CONSEQUENCES. 115 is bounded by natural capability, but this, by none ; hence, there is ex- citement without power, and as every organ carried above its proper pitch must necessarily rebound and sink, so there must be a correspond- ing stage of depression ; we may easily conceive how this vicissitude, re- peated change and alteration will derange the tranquility of the nervous system, and speedily induce, especially in sensitive, irritable habits, hys- terical and convulsive disorders of the worst kind. It is not unfrequent that Apoplexy occurs from this engorged and irregular condition of the blood vessels of the head, whether arising from Onanism or mere venereal excess : the latter paroxysm terminates itself ; the former, on the contra- ry, may be goaded to an unnatural passion and madness, and if the ves- sels of the brain are not ruptured, it is, that the most dreadful and ex- hausting debility remains behind. If we consider ever so slightly the necessary results of these two causes, namely, the evacuation of the seminal fluid, and the convulsive action of the whole body, the orgasm or thrill this sudden loss is naturally calcu- lated to excite, it will not be difficult to account for most of the disorders that arise in the human body, from this artificial and unusual condition being too frequently repeated. Weakness of the brain, with all its re- sults, idiocy, moping melancholy, or that abstraction which unfits a man for the sober realities of active life, depravation of the digestive organs, whether it evince itself merely as a slow form of indigestion, or that si- lently consuming inflammatory mischief, frequently terminating in can- cerous disorganization ; all these often may, and do result from excessive loss, and unnatural discharges of the male semen. Suppressed action of the skin, the want of a due and natural outlet for perspiration, from this cause alone, as produced by several excesses, arise many of the most severe internal disorders. A due supply of nervous agency from the brain, is absolutely requisite, that the stomach may rightly perform its varied functions ; and if from a weakened brain this supply be denied, the result is, that all the actions of the stomach are feeble ; and so in fact of the liver, in secretion of bile and all other secretory organs. Hence arise, in the first place, a failure of the powers of the mind ; and second- ly, of those of the body ; the understanding becomes weak, the sight, (dependent for its accuracy and clearness upon the nerve of vision,) is dim and clouded, aching in the back, as partaking of the general weakness of the muscular system, is a subject of deep complaint ; bloody urine, loss 116 SELF-POLLUTION ITS CONSEQUENCES. of appetite, pain in the head, and all the ailments of a poor shattered, nervous, hypochondriac, speedily make their appearance. Hippocrates gives an account of two persons in fevers brought on by excessive venery, one of whom escaped, not, however, without great dif- ficulty, after a severe fit of illness, which lasted till the twenty-fourth day ; and the other died of that weakness and debility which he had brought on himself by this horrid and baneful practice — self-abuse. The same celebrated author, in treating of the many diseases which irise from venereal excesses, says that " Tabes Dor salts, or Medulla Spinalis, (a consumption of the spinal marrow,) happens to those who ire over lecherous of self-abuse, or lately married. They are without a fever, and eat heartily, but gradually waste away ; and if you ask the patient how he is affected, he will say, there appears to him as if ants were creeping down the spine (back-bone) from the top of the head ; a great quantity of liquid semen is also discharged when he makes urine or goes to stool ; nor does he retain his semen in his sleep, but has invol- untary emissions, whether he sleeps with his wife or not; and when he takes much exercise, he feels a great uneasiness and debility, a shortness of breath, a heaviness in the head, and a tingling in the ears." Such is the state of these deplorable victims, who, if they have not timely relief, perish with the Lypiria, a most dreadful disease, wherein the internal parts are consumed with a burning heat, and the external frozen with cold. All these complaints have been observed in patients who have indulged themselves in foul pollutions. The symptoms gene- rally observed, were violent pains wandering through the whole body, attended sometimes with a troublesome heat, and sometimes with chilli- ness, especially in the loins, which complaints had continued for three, live, and even eight years, which seemingly resisted the remedies of many of the most skilful physicians in the United States, and having given up their most sanguine hopes of long life, as mere shadows of imagination, applied to me for advice and treatment. Sufhce it to say, by a long and unremitting attention to diet, and proper remedies prescribed in such cases, many of them were restored to health and their friends. The con- sequences which attend these horrid practices are set forth in the following paragraphs. The increase of dangerous consequences * flowing from masturbation, are too obvious to mistake, or need comment upon. The victim is too SELF-POLLUTION — ITS CONSEQUENCES. 11'/ sensible of it himself, from the shocking remorse which follows. When illness has opened his eyes, he sees the crime and danger, and feels " The sting of sin (pleasure) which is death." When the mask is dropped, the real picture of his conduct appears in its most hideous colors, and he finds himself guilty of a crime, the pun- ishment for which Divine Justice ordained nothing less than death, at- tended with all the horrors of a second death. The poet seems to have delineated this mania of both mind and body, in the following impassioned strain : Oh ! that the veil might, drawn aside, display In colors full of light, thy ravages fell destroyer of the human race ! When this done, Gabriel, from his courts descend, Commission'd with th' appalling charge, to man Once like a God — now 'neath the grov'ling brute, To raise him from his low estate, to that From which he fell. Mr. Ludwig, in describing the evils flowing from too copious evacua- tions of any kind, says: "Young people of either sex, who devote themselves to lasciviousness, destroy their health in dissipating those powers which were destined to bring their bodies to the greatest degree of vigor." Mr. Klookof, in his work on disorders of the mind relative to the body, observes, " Too great a dissipation of the semen weakens the spring of the solid parts ; hence arise weakness, laziness, phthisis, dorsal consump- tions, numbness, and a deprivation of the senses, stupidity, madness, fainting and convulsions." " We can easily comprehend," says M. Hoffman, "How there is so close a connection between the brain and testicles ; because these two organs secern from the blood the most subtle and exqusite lympha, which is destined to give strength and motion to the parts, and to assist even the functions of the soul. So it is probable that too great a dissipation of the liquors may destroy the powers of the soul and body.''' 1 "The seminal liquids" says he, in another place " are distributed in the same manner as the animal spirits of the brain, into all the nerves of the body ; it seems to be of the same nature ; wherefore, in proportion as the more is dissipated, the less is secerned from these spirits." M. De Gaster is of the same opinion: " The sperm is the most perfect and important of all the animal liquors, and the most elaborate, being 118 SELF-POLLUTION ITS CONSEQUENCES. the result of all digestion ; its intimate connection with the animal spirits, evinces, that, like them it derives its origin from the most perfect humors. Aetius has left us a record of the ills that are produced by too great a discharge of semen. "Young people" says he "have the air and appearance of old age ; they become pale, effeminate, benumbed, lazy, base, stupid and imbecile ; their bodies become bent, their legs are no longer able to carry them ; they have an utter distaste for every thing, are totally incapacitated, and many become paralytic." ; ' The stomach," says Aetius in another place, " is disordered, all the body is weakened ; paleness, bodily decay, and emaciation succeed, and their eyes sink into the head. Lomnius, in his beautiful commentaries on some of the writings of Celsus, supports the testimony of this author with his own just obser- vations. " Frequent emissions of the seed relax, dry up, weaken, enervate, and produce a crowd of evils; apoplexies, lethargies, epilepsies, faintings, the loss of sight, tremors, palsy, spasms, and every species of the most racking gout." The description which Tulpius, that celebrated physician and burgo- master of Amsterdam, has left us, cannot be read without horror. u The spinal marrow does not only waste, but the body and mind both equally languish, and the man perishes a miserable victim. Samuel Verspretius was seized with a flux of humor extremely sharp, which immediately effaced the hind part of the head and nape of the neck ; from thence it communicated to the spinal marrow, the loins, the buttocks and the thighs; which made this unfortunate man suffer such excruciating pain, that his countenance was entirely distorted, and he was seized with a slow fever, which by degrees consumed him, but not so fast as he desired ; and he was in such a situation, that he frequently invoked death before it snatched Mm from his misery." " Nothing, " says that renowned physician, De Louvain, " weakens the stomach and abridges life so soon." Mr. Hoffman, alluding to the many incidents occasioned by a dissipa- tion of the seed, says, "After frequent nocturnal pollutions, not only the powers are lost, the body falls away, and the face turns pale ; but more- over, the memory fails, a cold sensation seizes the limbs, the sight is clouded, and the voice becomes hoarse; all the body languishes by degrees; disturbing dreams prevent sleep administering relief." In a consultation which was held for a young man-who, among other ills which he had drawn upon himself by masturbation, was afflicted with a great SELF-POLLUTION — ITS CONSEQUENCES. 119 weakness of sight, he says, " that he had seen several examples of people even in advanced age, that is to say, after the body had attained its full vigor, who had not only brought on redness and acute pains in the eyes, but also such a weakness of sight that they could neither read nor write anything whatever." An account of the disorder which gave rise to this consultation, will doubtless be agreeable to the reader. "A young man, at the age of fifteen, having given way to masturba- tion, and having practised it till he was twenty-three, was, at that period seized with such a weakness in his head and eyes, that the latter were frequently afflicted with violent spasms at the time of his seminal emis- sions. When he wanted to read anything, he was taken with such a kind of stupor as intoxication creates ; the pupil was very much dilated, and he suffered exquisite pain in his eyes ; the lids were very heavy, and shut themselves; at night, he was constantly shedding tears; and a great quantity of whitish matter gathered in the two corners, which were very painful. Though he ate with pleasure, he was reduced almost to a skeleton, and as soon as he had done eating, he was in a kind of in- toxication." The same author communicates another observation, of which he was an eye witness, and which I think should find a place here. " A young man, eighteen years of age, who had frequently practiced self- pollution, was on a sudden seized with a weakness, and general tremor in all his members ; his face became red, and his pulse very weak. He was re- lieved from this state in an hour's time, but an incessant languor con- tinued upon him. The fit frequently returned and threw him into great agonies, which at the end of eight days, occasioned a contraction and tumor in the right arm, with a pain in the elbow, which was greatly in- creased with the fit. The disorder increased for a long time, notwith- standing many remedies were prescribed ; at length a cure was performed.'' Such are a few of the effects occasioned by this debasing practice ; much more might be added, but I think that enough has already been said to awaken the careless victim out of his pleasurable dream before it is too late for recovery. These are the testimonies of some of the most ancient as well as modern writers of the day, and T find that the tnost eminent, physicians and philosophers of all i ■ s, although difljeviog ; 120 SELF-POLLUTION — ITS CONSEQUENCES. one point, viz: the vital importance of the "seminal fluid" to the healthy exercise of the animal and intellectual functions of life. Whatever tends to deteriorate or weaken the vital forces, to throw the system into such an unnatural condition as I have described, of necessity, destroys the tone of the stomach indirectly, by its agency on the brain. Hence the evils, which infest the poor, shattered, nervous hypochondriac. Who, looking to the link that closely connects cause with effect, caD suppose, that a fluid so cautiously secreted, can be too rapidly drawD from the system, without the production of consequences which tell, in the first instance upon the brain, spinal marrow, and the whole nervous system, and secondarily upon all the organic functions which are under their guidance and control ? Let not the youthful votary of Sensualism "lay the flattering unction to his soul,'' that his practices leave no indelible trace behind ! " The physiognomy, that faithful mirror of the state of soul and body, gives the first indication of the internal disorder. The complexion and plump- ness, which jointly confer a youthful look, and which is the sole substi- tute of beauty ; for without this, even beauty produces no other effect than cold admiration ; this complexion and plumpness are, I say, the first things that disappear ; then a leanness succeeds, and the skin be- comes rough and tinged of a leaden color ; the eyes lose their wonted brilliancy, and deadened by their languor, express that of the whole frame ; the lips lose their vermilion hue, the teeth their whiteness ; and in a word, it is no uncommon thing for the whole body to receive such a shock as for the shape to be distorted." That the habit of masturbation, is far more deadly and destructive than moderate enjoyment with women, is evident from the fact, that the latter has its limits of capability, whereas the former has none. A well known medical writer, adopts the maxim that, " moderate indulgence in the natural way, is useful, where the wants of the system imperatively demand it, but where solicited by diseased fancy, it weakens all the faculties ; the loss of the seminal fluid occurring not merely when its excretion is salutary, but too frequently for the constitutional powers to bear up against the repeated evacuations." It ought to be borne in mind, that the loss of semen, even in a natural way, ought ever to bear relation rather to v the healthful wants, than to the desires of the body. It ought also to be confined rather within the SELF-POLLUTION — ITS CONSEQUENCES. 121 limits of reparation ; and this power of constitutional restoration varies very widely in different individuals ; a pale, studious, sedentary, tempe- rate man, for instance, and on the contrary, a jovial hearty fox-hunter, accustomed to eat with the appetite of one of his own hounds, drink port very freely, divides his time between active muscular exertion and sound sleep, with a mind open to any animal impulse, and a joke for every pretty woman he may meet. I need no better proof of the importance of the seminal fluid, than the results arising from its too frequent and unnatural discharge. A descrip- tion of the danger, to a person who is addicted to this evil, is perhaps, the most powerful mode of correction. It is a dreadful portrait, suffi- cient to make him retreat with horror. Let us examine and recount some of its principal features. The whole mass fallen to decay ; all the bodily senses and all the faculties of the soul weakened ; the loss of imagination and memory ; imbecility, contempt, shame, ignominy, its constant attend- ants ; all the functions disturbed, suspended, and painful ; continued dis- orders, disagreeable, capricious and disgusting ; violent pains ever re- newing ; all the diseases of old age in the prime of youth ; an incapacity for all the functions for which man was created ; the humiliating charac- ter and knowledge of being an useless load upon earth ; the mortification to which he is daily exposed ; distaste for all decent pleasures ; lassitude and aversion for others, and at length for self; life appears horrible, and the dread which every moment starts at suicide, anguish worse than pain ; remorse, which daily increases, and which, doubtlessly gains fresh strength, when the soul is no longer weakened by its union with the body : and serves perhaps, for an eternal punishment — a fire that is never extin- guished. This is the sketch of the fate reserved for those who act as if they did not fear it. The consequences which attend this horrid practice may be enumerated as follows : I. Involuntary nocturnal emissions ; pains in the back and often in the head ; formication of the spine ; weakness of the memory and sight ; and a mucous discharge from the urethra, especially after strainiug at the discharge of the excrements ; an aching pain, rolling and dependency of the testicles. The testicles being the secretory organs of the genitai juice, are furnished with arteries, veins, lymphatics, and nferves. lik< other srlands, and suspended by the cremaster muscle. 122 SELF-POLLUTION — ITS CONSEQUENCES. II. " All the intellectual faculties are weakened, loss of memory ensues, the ideas are clouded, the patient sometimes falls into a slight mania ; he has an incessant irksome uneasiness, continued anguish, and so keen a remorse of conscience that he frequently sheds tears. He is subject to vertigoes ; all his senses are more or less impaired, but more especially his sight and hearing ;" the former to such a degree in many cases that the patient is unable to perform any kind of exercise in which both body and mind are not at the same time actively engaged ; in the silent hours of midnight the mind is busied in some fancied vision of ob- scene character, and when aroused from his dreams, is many times un- conscious of what has transpired in his mind ; at other times he is aroused with dreams, the most revolting in character, too horrible for a sane mind to be conscious of. III. " The powers of the body gradually decay ;" death with unerring certainty seems to place its fatal signet, long before the victim is relieved of his miseries ; " the growth of such as abandon themselves to these abom- inable practices, before it is accomplished, is greatly prevented. Some cannot sleep at all ; others are in a perpetual state of drowsiness. They are affected with hypochondriac complaints, and are overcome with acci- dents that accompany these grievous disorders — melancholy, sighing, tears, palpitations, and faintings. Some emit a calcareous saliva ; coughs, slow fevers and consumptions, are chastisements which others meet with in their crimes." IV. " The most acute pains are an attendant on those afflicted with the complaint; some complain of pain in their heads, others stomach, in- testines, and heart ; others have external rheumatic pains ; aching numb- ness in all parts of the body when they are slightly pressed." V. " Pimples not only appear in the face," but more especially on the forehead, out of which, on being closely pressed, frequently whitish, cheese- like substances exudes ; (this is one of the most common symptoms) but even real suppurating blisters upon the nose, breast and thighs, often at- tended with a disagreeable sensation." VI. " The genital organs are also afflicted with that disease, whereof they are the primary causes ; many experience an incapacity of erection, others discharge their semen japon the slightest titillation, or the most feeble erection, or in their efforts to stool. " Many are afflicted with gon- orrhoea, which entirely destroys their powers, the discharge resembling / SELF-POLLUTION — ITS CONSEQUENCES. 123 fetid matter, or mucus ; others are tormented with painful priapisms, dysuriae, stranguries, heat of urine, and a difficulty of voiding it." Some have painful tumors upon the testicles, penis, bladder and spermatic chord. In a word, either the impracticability of coition, or a deprivation of the genital liquor, renders every one imbecile, who has for any length of time given away to this crime. VII. In cases of protracted debility, the digestive organs and func- tions of the intestines are often seriously impaired ; some complaining of stubborn constipation ; others of hemorrhoids, or a discharge of fetid matter from the fundament ; " and others of a diarrhoea after each act of masturbation." Such are the sufferings closely connected with the unnatural and per- verted enjoyment of the Sensualist, altogether the reverse of that trans- porting emotion incidental to the caresses of a pure and virtuous affection, which, in some measure counterbalances the luxurious fatigue consequent upon rational and temperate indulgence. To this delicate suscepti- bility, the miserable victim of solitary vice is evidently a stranger. Thr warm and passionate kiss, the unutterable and thrilling embrace which lovers only can feel, lives but in his diseased fancy. For, it cannot be questioned, that nature allots more joy to those gratifications procured in her proper channels, than in those which are repugnant to the natural organization. The joy which only the heart can appreciate, and which must be carefully distinguished from the voluptuousness purely sensual, which even a prostitute may inspire, animates the circulation, aids di- gestion, accelerates all the functions, restores strength and supports it. This, it is, that gives to marriage that sacred, home-felt sweetness which love inspires, and G-od looks down upon approvingly. The debauchee affects to despise marriage ; it is, because owing to the degradation of his soul, there is a purity, and consequently an intensity in such inter- course he can never realize, scoffing at that he can never know. But, if the danger be so great in those who seek none but natural en- joyments, what must it be in the unhappy victims of the vile and de- structive practice alluded to ? The fear of detection, the restraint of shame, the certainty of punishment sooner or later, enable the former to bear up against a temptation which requires the concurrence of a third person to take effect ; but when like the midnight assassin, the vic- tim carries forever about him the instruments and incentives of his own 124 SELF-POLLUTION — ITS CONSEQUENCES. guilt, when no accomplice is necessary, when solitude encourages, and darkness protects, what can hinder the odious propensity taking frequent effect, or the repetition of the act from degenerating into habit ? Add to this, that the infection being, as it almost always is, communicated in childhood or early youth, the weakness of reason, and ignorance or care- lessness of consequences, natural to that age, leave it at liberty to strike root, and establish its empire over the senses ; so that when the period arrives at which Reason ought to exert her influence, the time of amend- ment is past — alas ! never to be recalled ! What the force of habit is in all cases, is sufficiently known to those who observe what passes in themselves and others, and still more so to those who, to that observation, join an attentive consideration of the nature of man, and of the qualities and varied dispositions of which he is composed. Let it not be imagined, however, supposing the practices of debauchery to be formed into a confirmed habit, that the conse- quences are equally destructive, whether it leads to the enjoyment pointed out by nature, or self-abuse; the difference is immense, and entirely to the disadvantage of the latter: this difference depends upon circumstan- ces, the first of which is the facility of obtaining a degree of gratification with an imperfect erection ; — a most dangerous practice which, tending to destroy the tone of the nerves more than any other, brings on paralysis of the organs of generation, and, consequently — totel impotence. The second, a commission of the act in a position or attitude (as sitting or standing) is highly injurious to the muscles of the legs, thighs, back, &c, which by repetition, never fails to induce a diseased state of one or all of them ; for, as all the parts of the body are then strained to the utmost degree of tension, the smallest additional labor is sure to hurt them ; and lastly, the want of a corresponding inspiration to compensate for the necessary expiration. The importance of the insensible perspiration has been already intima- ted ; and it must be observed that it is never so abundant as in the act of coition, or venereal excitement ; in the former, to use the ideas of a learned Professor, " there is a chain of nervo-electricity formed between the parties;" and the one party inspiring what the other expires, each supplise in turn the waste suffered by the other ; whereas, in the latter, the masturbator loses as they do, and gains" nothing in return. That the mind also contributes largely to this difference, will be evident when it is SELF-POLLUTION — ITS CONSEQUENCES. 125 considered that the mental trial and exultation, together with the absence of regret and repentance, which accompany the enjoyment of a beautiful or desired object; animate and invigorate the whole frame; give new • strength and sprightliness to the circulation of all the humors, and promote the generation of the animal spirits, thereby taking off greatly from the ill effects which the superabundance of seminal fluid would have engen- dered ; while on the other hand, the shame, remorse, and despair, which check the anticipated pleasure of the masturbator during the very act, take entire possession of him afterwards, increasing the number and aggravating the character of all the attending evils. This vice soon renders the youth regardless of parental control, and of persons who have the care of him, as well as indifferent to the sports of his equals ; he falls into a distaste for every thing, except the oppor- tunity of indulgence ; all his thoughts at this period are directed to the parts subject to irritation ; sensibility, imagination, passion are inflamed, and as the secretion of the reproductive semen appears to augment as if by an effort of nature to atone for its frequent loss, the body becomes weak from its frequent evacuation. Among such patients an attentive observer cannot but notice their ex- treme susceptibility to external impressions, as for instance, those arising from variations in the temperature, moisture, or dryness of the atmos- phere. His mind becomes conscious of those trifling changes of weather, which men of business, happy in their vocation, regard not. The irrita- ble condition of the mucous membranes of the genital organs, is propa- gated by sympathy to the eye-lids and nostrils, these become weak, red, and watery, and they are susceptible of taking cold, upon very slight causes. So at night, the glare of a candle becomes offensive, and pain- ful to the smarting edges of the lids ; and even in the day, a more fre- quent winking, or discharge of tears, if there be the slightest wind, is very remarkable. Besides which, severe, irregular, and flying pains are apt to infest the patient, often mistaken for common rheumatic affections. But one of the most singular of these effects produced by self-pollution, is an actual reduction in the bulk and thickness of the male organ. It is one of the first and most obvious effects of this strange habit, and what is worse, its power of erection becomes correspondingly destroyed. If we reflect upon the difference between masturbation and the natural act, we shall not wonder at this, Such an one, if the seed vessels are 126 SELF-POLLUTION — ITS CONSEQUENCES. not sufficiently distended with fluid that excites erection, is able by un- natural frictioD to excite a momentary supply — he can command the discharge when nature refuses the necessary firmness for coition. In this way a host of evils are engendered. The testicles are called upon sud- denly and violently to secrete, and the excretory canals to discharge, a thin, weak, unprolific semen, and the nerves of the penis are rendered susceptible of an agreeable titillation, without the natural inseparable adjunct — a firm erection of the organ ; hence when the votary of self- pollution tries to indulge with a female, he cannot assume the requisite solidity to effect penetration, the organ having previously been accus- tomed to the rude friction and stimulus of his own hand, to excrete with- out erection, or if the penis swell for a moment, the genitals of woman do not grasp it with the unnatural force he has been accustomed to apply. Shocking state ! Placing man beneath the brute creation, and which more justly entitles him to the contempt, than pity of his fellow- creatures. It ought not to be omitted, in a work of this nature, that there are other physical consequences, connected with severe suffering, arising from the practice in question. One of the most evil and distressing of those de- fects, which arise from self-pollution, is connected with a feeling of in- tense vexation. I allude to the premature escape of the seminal fluids, in any attempt at sexual intercourse. In these cases, erection is for the most part, usually imperfect, and before an entrance can be effected, the spasmodic and irritable condition of the canal, is such as to cause the ejection of the semen almost without gratification, and certainly without affording the slightest pleasurable emotion to the object of baffled dosire. A failure in the accomplishment of the sexual act may arise from a variety of causes, of which this is one, and it is most traceable to such indulgence in self-pollution, as though not leading to complete impotence, has yet so seriously enfeebled the tone of the retentive organs, that the slightest impulse causes them to discharge their thin and watery contents. Schirrosity of the Prostate Grland and Stricture of the Urethra, are other causes of failure in accomplishing the marital act, of which I will treat in other parts of this work, simply making mention here, that either of them may be caused by self-pollution, undue irritation, from improper treatment for diseases of the organs of generation, &c: SELF-POLLLUTION — ITS CONSEQUENCES. 127 The same influences that entail early decrepitude upon boys, are strongly in operation among the other sex, and this, to an extent, which can only be believed by those whose peculiar province it is to conduct such inquiries, and remedy the evils such practices produce. No class of individuals, excepting those whose lives are devoted to remedial sug- gestions, have the slightest conception of the amount of this wide-spread- ing evil. The same causes which occasion impotency in one sex, are quite sufficient to produce barrenness in the other, laying the foundation of those tedious discharges which sometimes assume the character of semi- nal, at other times of mucous gleet, or glairy discharge of an unhealthy fluid. There are consequences which are common to both sexes ; but among females unfortunately addicted to libidinous indulgence, or solitary sexual pollutions, one of the first consequences of which, is, the formation of an irritable, hysterical constitution. And as the result of this, and from the direction of the polluted thoughts and fancies to the genital organs, these relieve their morbid accumulations of excitability, by a copious secretion and discharge of mucous fluid, generally, only an aug- mentation of the natural secretion, but which, when excessive, is termed in the closet-vocabulary of women, whites, supposing from its colorless appearance that it is a mere variety of the menstrual discharge ; from which, however, it differs in every essential particular. Far be it from me, to assert that in every instance, this glairy mucous discharge is to be attributed to filty practices ; I know that many sober virtuous matrons are troubled with it, and even among them I am not sure, but that in many cases it is traceable to excessive indulgence in unrestrained intercourse with the legitimate occupant of the marriage bed ; but this, at least, is certain, that when the disease arises among unmarried women of a cer- tain age and temperament, self-pollution is one of the most prominent of those causes found to engender this diseased state of the sexual organs. For a more extended description of this disease, I refer the reader to chapter 9th, part first, of this work. In a work of this nature it is exceedingly difficult, and I may say im- possible, to avoid frequent recurrence to anatomical terms and statements ; indeed, to speak of any deviation from the natural action of those com- plex organs, constituting the male and female sexual system, presupposes some familiarity with their structure and functions in a state of health ; 10 128 SELF-POLLUTION — ITS CONSEQUENCES. however, it will be my study to avoid this as completely as is consistent with the professed object of a work intended for popular reference. With this remark I would observe, that there are other causes of barrenness over which the female has no control, and which are dependent upon some physical defect, or fault of organization ; as for instance, the womb itself may be unnaturally small, its ovaries^may be wanting, or the fallo- pian tube may be closed, either from birth or from adhesive inflammation. If these things co-exist, as the consequences of the close and intense sym- pathy existing between the female uterus and the breasts, these latter or- gans are observed to be correspondingly small ; and contrarily, a free developement of the breasts, (if their size be not mistaken for a fatty ac- cumulation,) is always a pretty fair indication of a healthy and natural condition of the female reproductive system. It is a singular thing, that in by far the greater number of sterile women, there is no appreciable or evident disorganization of the sexual structure. Many such women? however, menstruate very sparingly, irregular, or perhaps too frequently and copiously, a fact, which proves, that mere disorder of function is quite sufficient in the absence of disease or alteration of structure, to produce barrenness. There may be want of activity in the ovaria, or, as the ancients not inaptly termed them, the female testicles ; hence we find, that not only barren women are apt to grow corpulent, but also fe- male animals who have been deprived of the ovaria, as well as males, who have suffered mutilation from the removal of the testicles. Undoubtedly there are many women who have entered the marriage relation, whose sterility is dependent upon physical and nervous debility of which the causes are many and exceedingly various, yet natural. Among the accidental and often only temporary causes, may be con- sidered all irregularities in the menstrual function ; that periodical func- tion may be tardily or too hastily repeated ; local inflammation from com- mon causes is also liable to affect the lining mucous membrane of the generative organs. The sexual orgasm may be suspended from fear or dis- gust, and so contact remain unproductive. Besides these, which are natural causes, as I before observed, exces- sive amorous indulgence may engender sterility among women ; hence it is that prostitutes seldom conceive ; nay, in the absence of the excitement to which they are inured, even grow fat-; excessive exertion destroying by over-stimulation, the irritability of the generative organs. The ordi- SELF-POLLUTION — ITS CONSEQUENCES. 129 nary EFFECTS OF EXCESS in the female sex is a slow inflammatory affection of the genital apparatus, producing derangements in the period or in the quantity of the menstrual discharge, sudden loss of blood, and various other painful affections. Sometimes from the extension of dis- eased action, the whole structure of the uterus becomes affected, there is ulceration, and, as a consequence, sterility. Besides which, these ex- cesses affect the tissue of the glands, appropriated after pregnancy to fur- nish the secretions of milk, and so tend to produce CANCER, a disease, not unfrequently attacking the womb itself ; and it is well known, that females laboring under any hardness or disease of the breast, are liable to much increase of suffering on attempting the sexual embrace. The analogy and mode of testing the physical and maternal capabilities, which many engaged in the breeding and rearing of agricultural produce have drawn from the development of the breasts, is by no means either unphi- losophical or indelicate. Any causes, therefore, that tend to interfere with these organs are important. A well known aged English agricul- turist, observes on this subject: "lam afraid that some of the defects of the French women are to be found amongst the superior classes, particu- larly in this country. The young women are generally much more flat-busted than they were sixty years ago. I now see them with different feelings, but I can observe forms with the same eyes, and several observant women have noticed the change. Look at the picture of women a century or a century and a half ago, and the bosoms of the women there represented are not similar to those of modern times." How far secret indulgence in unnatural practices may have tended to this, is a question which the experience of those devoted to this subject can only enable us to decide. Such cases of excess, whether natural, or limited to the artificial excite- ments of self-pollution, are necessarily attended by a train of distressing symptoms, many of them resembling what occur in our own sex, but mo- dified, of course, by their diversity of temperament. The food is ill di- gested, absorption and nutrition are both imperfectly performed, and the body becomes pale and meagre. The heart's action being frequently hurried to strong pulsation ; the other organs are subjected to rapid and diseased excitement. So the lungs become liable to inflammatory action, or there may be enlargement of the heart, spitting of blood ; and, lastly, the most wasting forms of consumptive mischief. 130 SELF-POLLUTION — ITS CONSEQUENCES. To this consummation devoutly to be deplored, other causes are gene- rally found conspiring. Women of the wealthier classes live more arti- ficially; they are restrained, while young and growing, to ornamental works, to their music, and their books ; they seldom go on foot to any distance from home, but are carried on such occasions in an easy, warm soft-cushioned carriage, so that the muscular system acquires no develop ment, as the result of active exercise. Even their music is less attended by the merry dance than it ought to be. Hence those females are deli- cate, diminutive in stature, and less fitted for procreative purposes, whilst the daughters of the farmer, or some bustling house-wife, who compels them to take an active part in the performance of the household duties, become strong, healthy, and in after life, fruitful. Idleness fre- quently engenders loose imaginations ; they, in their turn, lead to habits which weaken the system, and take all powers of exertion, all ability, as well as all willingness, away. I observe also, if a woman becomes sub- ject to this infatuation of self-abuse, the organs of vision, as in man, become weak, unable to bear the broad glare of day, and are sometimes tormented by sparks and black specks, which seemingly dance before the eyes, hearing becomes less acute , a noise, or ringing in the ears, is a troublesome symptom, and generally nervousness is the invariable re suit. The brain loses its powers ; unnaturally excited sensibility, foolish terrors, and deplorable weakness of character, are soon discernible. Then it is that the distinctive appellation of the sex becomes truly applicable ; then it is that without unfeeling harshness, it may be said of woman — " Varium et nmtabile semper fcemina." Fickle and inconstant creature ! the powers of the muscular frame be- come enfeebled; they drag themselves along with effort, or spend too much of their time in bed ; the slightest exertion producing fatigue. So in every voluptuous woman, whether devoted to excess in natural indulgence, or to any disease and unnatural form of stimulation or ex- citement, conception may have really taken place ; but from the too fre- quent repetition of the act, or from other causes, the product of concep- tion may be destroyed in the womb, by sanguine or other exhalations produced by excessive abuse. The wear and tear of constitutional en- ergy in these cases is fearfully rapid. The poor votary of sensualism becomes the wreck of her former self, and at length an existence which is fruitless and burdensome to all who fall within the sphere of its com- SELF-POLLUTION — ITS CONSEQUENCES. 131 pkints and miserable woes, is closed by a death, which leaves memory altogether silent respecting the weakness and frailties of erring humanity. What I propose to the miserable sufferer, under any form of the mul- tifarious evils arising from sensualism, is nothing less than the removal of his immediate sorrows, the pain and weakness which infest his bodily organization, but far higher and nobler aims than these lie concealed beyond the mitigation of present infirmity. I indulge the fond, the am- bitious, the rational wish that my efforts may be instrumental in rescuing the unhappy slave of passion from the moral thraldom in which he is in- volved ; my unceasing aim is to acquire that confidence, that happy mas- tery over the affections of the inner man, which, wielded in the cause of virtue, purity, and truth, may enable me to drag the sensualist from the miry slough of his own vicious, impure, contaminating fancies, and replace him again on that proud elevation befitting a man — befitting the rational lord of the universe — the defence of the weaker sex, and the glory of his own. The moral and mental management of my patients, is, therefore, with me a matter of the greatest importance, and though in glowing language, it is my duty, with others, occasionally to deprecate the criminality of self-indulgence, while we extenuate not the sin, we cannot but sympathize with suffering, with that weakness, the deplora- ble imbecility of our nature, which casts away the rudder of reason, and relinquishes to the winds and the waves the frail bark of humanity. It is mine to point to cheerful activity, insensibly and imperceptibly to lead the unconscious mind away from the morbid train of thought inseparably connected with vicious practices. Inactivity is unquestionably a great cause of this, as well as other vicious propensities. "When the faculties are busied in some particular pursuit, and employed in an industrious calling, the temptations which lead to these practices lose half their force. * There is less desire for the perpetual recurrence to habits which require secrecy, when the mind is roused to duty, or to considerations more con- sonant with the true diguity of human nature. Votaries to these abom- inations feel their degradation, groan under the galling yoke of habit, the soul becomes subservient to the tyranny of its overwhelming influ- ence ; and hence it is obvious that mere medical prescription is insuffi- cient — the spell must be broken, not so directly by an appeal to their fears, as to those higher and better faculties, which though beclouded and tremulously weak, require only the assurance of pity and kindness of a t II I 132 SELF-rOLLUTION — ITS CONSEQUENCES. confidential friend to regain their lost authority. With the majority, it is in vain to dwell on the enormity of the crime, there is little practical and immediate utility in pointing out to them, that the habits of sensual- ism are contrary to the laws of God and man ; such moral sermons, ex- perience tells me have but little effect on young people, who, even more than men of advanced years, will be regulated almost solely in their con- duct by their present interest. Let the young man be taught to feel, that the habits which are destroying his strength render him unable to occupy his position among his fellow men, will inevitably become obvious, and draw down from the beings around him, the expression of their merited and deep contempt. This odious habit forces and weakens the generative organs to so bane- ful an extent, that when the gay luxuriance of youthful passions prompts to the lively intercourse of sexual bliss, they feel, they burn with ex- treme ardor for those endearing blandishments, yet want the necessary power and energy for their gratification. Let the mind picture to itself, an individual, thus placed at the altar of an intensely susceptible woman, where art and nature have both profusely entwined to aid his sensual appetite — "Full in the sight of Paradise, Beholding Heaven and feeling hell." But I forbear to trace his agonizing, helpless predicament. It is said that the hardy soldiers of ancient Rome, preferred death to castration ; and doubtlessly the direct fear and shame of impotence has operated and will continue so to do, in the majority of instances, as a more powerful safe-guard against this crime, than the deepest and most awful appeals to the laws of God. It ought not to be so, but such is the constitution of our nature. It is impossible to regard the gloomy consequences of this pernicious habit, other than as a direct retributive infliction from the hand of that offended being, whose marvellous handiwork in the construc- tion of the human frame, led one of old to exclaim, " I am fearfully and wonderfully made." Let self-respect and adoration for the Great Ar- tificer restrain the thoughtless, or it may be, that drivelling, helpless, premature dotage may (like the mark that was set upon Cain,) place them before they are aware, in a position past all hope and remedy. SEMINAL DISCHARGES. 133 CHAPTER IT. SEMINAL DISCHARGES — EFFECTS AND TREATMENT, ETC. The male genital fluid is produced by the two testicles which hang in the scrotum connected with the common outlet of the seminal and urinary secretions, by the spermatic chord * which is in fact, an artery, certain veins, nerves, and the canal, called the vas deferens, appointed to con- duct the semen from the testicles to certain receptacles, near the base of the bladder, and which cavities closely resemble in function the gall- bladder, inasmuch as there a healthy supply is always expected to be found, distending those receptacles, and producing the desire which pro vokes erection, and leads to the sexual act. Besides these structures, there is placed around the neck of the blad- der, a very peculiar body, in form and size resembling a cloven walnut, styled from its position, the Prostate Gland. This gland secretes its own appropriate fluid, which is thin and very distinct from the semen, but is mostly discharged with it, seemingly, to lubricate the canal and promote its more sudden and convulsive discharge. So that the urinary canal of the male, is the common outlet of three distinct fluids, viz : urine, semen, and prostatic fluid. It remains that I say a few words respecting these ' ' receptacles" for the temporary* reception of semen. They are called vesiculce seminales, or seminal vesicles, from their bladder-like, cellular, or lobular arrangement. There are two, one on each side, corresponding with each testicle, and its excretory duct, they adhere to the posterior and inferior surface of the bladder, surrounded by an abundance of fat, resembling two little folds of intestine, winding in various directions, and branching into numerous divisions. Now, it is into these passages, that slowly and sparingly, is secreted after puberty, that most important secretion, the vitalizing male semen ; a most extraordinary fluid, of a milky, yellowish color, of a peculiar smell, viscid and mucous, of a great specific gravity, indeed, heavier than any other fluid of the human body. Further, it deserves to be noted, that the genital fluid collected in these vesicular receptacles, is retained there for subsequent excretion, and by its stay, experiences changes similar to those of the bile in the gall-bladder, inasmuch as it becomes thicker, acrimonious and more concentrated, bv ♦Many of these remarks are embodied in Part First of this work. For reasons see Preface. 134 SEMINAL DISCHARGES. the removal of its watery portion. In this way, it is then, that desire naturally arises, for the vesiculce seminales are furnished with a peculiar set of absorbent vessels, which, by absorbing the inner watery part, render the remaining part more powerful. These details, though preliminary, are absolutely necessary, essential to a rational comprehension of the organization connected with Seminal Debility, as well as that morbid habit of parts which leads to nocturnal emissions ; for obviously, it is impossible to understand the erratic action of the parts, in a state of disease, unless we comprehend something relating to their natural condi- tion in active health. The act of evacuation is pernicious, just only in proportion as it is unnecessary, and not demanded by the wants of the living system ; hence it is, that the youth devoted to unnatural excesses, inflicts such retribu- tive vengeance on himself; he has the power of exciting these organs, at a moment, when, from previous evacuation, they contain nothing sufficient- ly stimulating to arouse the erection of the penis, and maintain the requisite condition for sexual congress ; in this way he is able to perpetuate a great amount of mischief, and the irritated vessels pour out a thin mucous discharge, possessed of no vivifying power. From this very irritation, the seminal vessels become unable to receive and retain the semen, as it is conveyed thither from the testicles ; a,nd should this miserable fraction of humanity marry, a mere thin gleety drain is all he can furnish to impregnate, it may be a warm, vigorous and healthily organized woman. The solitary creatures, who have reduced themselves to this deplorable state of helplessness, have drained the system, by past excesses of that which the seminal vessels are not, naturally, too irritable to retain ; but which, if now secreted of a healthy character, is expelled, without effort or the excitement inseparable from the generative act. Here, then, I think, I have indicated one among the many forms of seminal weakness. Irritability is its leading feature, and among the many lamented diseases to which the human body is liable, there are none requiring more patience, discrimination, and tact, than this condition of the genital apparatus. In many instances which have fallen under my observation, the emission that has occurred during the night, though mostly accompanied with some lascivious feeling, some indistinctly remembered dream, has not been sufficiently intense and exquisite to waie the sufferer from his sleep. However, the consquences of these oft-repeated discharges is sufficiently SEMINAL DISCHARGES. 135 obvious. A stain upon the linen, and a strange feeling of unrefreshed weariness, are the first thing that arrest attention, and with this, there is the absence of that erection so naturally occurring in the morning, after first waking from the supine position. So that, though each repetition of the weakness is perceptible, in the early stage of this vicious perversity of the parts, after a time, as the fluid escapes away unconsciously, its effects upon constitutional power, are the only signs, yet are they fearful tokens of its debilitating presence. Occurring at more fre- quent intervals than can be fairly ascribed to the stimulus of disten- sion ; if now the most energetic measures are not instantly put in requisition, the parts only require a brief period to become habituated to a weakness, in its results, equally, if not more deplorable than the loss of the same fluid from unnatural stimulation. It is fair to say, that nocturnal emissions, arising out of an irritable condition of the seminal vesicles, though this irritability be mostly ascriba- ble to the previous practice of self-pollution, it is not uniformly so ; and this circumstance, far from simplifying the treatment, renders it burden- some, from the additional difliculty of determining accurately its precise cause. My ample opportunities in such unfortunate cases, justifies the assertion, that I am capable of this delicate discrimination. So, chro- nic inflammation of the sexual apparatus, or of any part of it, especially the lining mucous membrane of the seminal vesicles, or of the membra- neous portion of the urethra, may excite these unnatural and debilitating emissions. An enlarged and incipient cancerous condition of the prostate gland, or irritability of the internal surface of the bladder, frequently the result of improper use of injections in treating gonorrhcea, may sympathetically produce nocturnal emissions, though in the latter instance, the emis- sions are not all of a seminal character. To these, and to many other accidental and predisposing causes of nocturnal emission, a variety of remedies are applicable, as must obviously be determined by the individ- ual history of each case. One thing is certain, that, the difliculty in breaking down the morbid train of action is in proportion to the length of time the parts have been susceptible of this deranged action. Though in the first instance, local irritability and weakness form the principal characteristics of both seminal weakness and that generative debility in- delibly associated with nocturnal emissions ; yet this soon becomes not 136 SEMINAL DISCHARGES. partial nor local, but general; and as the system at large becomes im« plicated, a diseased reaction takes place upon the originally debilitated generative organs. If unimpaired by chronic disease, or undisturbed by the perverting agency of pernicious practices, it is certain that the hu- man seminal apparatus is fitted to supply and expend at proper and chaste intervals, that important secretion during the most active years of a long life. But if manhood be anticipated — if the expulsion of semen be pre- mature, or unnaturally frequent — if it be excited artificially, nocturnal emissions may occur as the consequence of the practice, but seminal or generative debility most certainly will. There may not be impotence and yet congress may be unfruitful, because of the poverty of the too frequently evacuted fluid. But very commonly, even impotence or the incapacity for erection, supervenes upon this. For the ability to per- form effectually the sexual act, requires the compound association of two distinct sets of parts, namely: of the secretory testicle, which provides the vivifying semen, and of the instrument which effects its ejaculation and discharge. Any defect in either may lead to such a want of corres- pondency as sympathetically may be sufficient to abolish the function of the other. And such a want of harmony between the action of the tes- ticles and penis, is doubtlessly a state of disease. Whether the baneful habit of self-pollution or excess with women have engendered this disturbed balance, the effect is the same. Sexual power is sure to be destroyed in the end. The connexion that subsists between dreams, and such ideas as the mindhas been occupied about, in the day time, serves in some measure to explain why masturbators are so subject to nocturnal emissions, being all the day infested, and impressed with un- clean imaginations ; their minds reflect the same objects during the night, and the lascivious dream is followed by an evacuation, which is always ready to be made, when the organs have acquired a considerable degree of irritability. Nothing propagates itself so rapidly as irritation ; it may be, either along a continuous surface, as along the lining membrane of the urethra and cord of the testicles ; or sympathetically, as when from some altered condition of the brain, the fiercest and most uncontrollable and erratic desires are apt spontaneously to occur. With such individu- als, the emission (on attempting intercourse with women) is too quickly discharged. Nocturnal emissions are too "frequent to be recounted ; even the sight of a fascinating creature is sufficient to arouse the dormant SEMINAL DISCHARGES. 137 irritation ; with some, desire is more or less completely extinct, erection is seldom, or exceedingly weak, and associated with this semi-paralytic condition of the genitals, the mind partakes of the prevailing imbecility ; the man, sensibly alive to his calamity, is reduced to the condition of a mono-maniacal hypochondriac, the seminal fluid dribbling away without pleasure, without erections, unconsciously, and not as the natural ejacu- ulatory effort of the muscles, appropriated for its convulsive discharge. No man is justified in entering upon the responsibilities of marMage whose condition approaches even distantly to this. Before he enters into that most solemn engagement, it is his bounden duty, as he would avoid the most refined cruelty to an innocent and affec- tionate woman, to ask his conscience, well and truly, whether there be any bar or impediment to that sacred union ; and if suspicion be even delicately or tremblingly alive, let him wait until reassured of his partially lost powers, that he may, with confidence, lead his blushing bride to the matrimonial altar. If otherwise, the nuptial bed of the helpless, unmanly creature, instead of creating a "secret, yet intensely transporting delight, is converted into a scene of blended mortification, disgust, disappoint- ment and suppressed anger." Now it is that the fair girl laments, when tears are unavailing ; now the cheated bride is made to feel herself the unhappy victim, the scapegoat of a long round of past sensuality — the sins of former years are made to tell upon her devoted head, if not to the communication of actual disease, at least in the deprivation of those enjoyments which, to a certain degree are essential to the happiness of wedded life. Anxious for offspring, yet baffled from year to year, in the feeble embrace of a man who has vowed to love and honor ; — life, health and youth fast wearing away, under a combination of circumstances, so painful that no language can describe them. The reproductive power may not be entirely destroyed by that state of generative debility which is engendered by nocturnal emissions, and yet very painful consequences of another character may unquestionably arise. A healthy female may become pregnant from the feeble yet exhausting effort of a man whose constitutional power is seriously injured if not broken ; yet it would be unfair, unphilosophical, unsupported by any analogy drawn from the history of the lower animals, to expect that this circumstance would not tell most powerfully and detrimentally upon the offspring. The opinions of the learned, in all a 150 SEMINAL DISCHARGES. evil they sometimes occasion by the generation of wind or gas. Tho artichoke is here to be mentioned, and with particular distinction. It abounds in farinaceous matter and sugar, is easy of digestion and affords considerable nourishment. Roots, as potatoes, turnips, parsnips, carrots, &c, afford much nour- ishment. Salads may be used advantageously with animal food; lettuce, endives, dandelion, &c, naturally contain, as do most of the Olera, a very bitter juice, which, in a great measure, is got rid of by culture. Cheese, after dinner, if old, assists digestion ; if new, loads the stomach. Fruits such as abound in sugar, as dried figs, grapes, raisins, prunes, &c, are the best. The following also may be employed: apricots, ap- ples, if sweet, pears, plums, &c. Fruits abounding more in native vege- table acid than saccharine matter, as cherries, gooseberries, strawberries, &c, afford but little nourishment. The fruits to be eaten should be suf- ficiently ripe, and of the very best kind. Apples are most useful in pie and pudding, in which state they may constitute with advantage, a part of the dinner, as may custards, &c. Acid fruits are rendered much more nourishing, and easier of digestion, by heat and the addition of sugar. Cucumbers and melons should very seldom, or never, be eaten ; they contain a mucilaginous matter extreme- ly adhesive, and when ripe, an essential oil ; they are very difficult of fermentation, and, therefore, of digestion. The skin of flat-fish should be eaten, as affording considerable nourishment. The patient's supper, as already noticed, should be light. It may con- sist of dry toast, or well baked Graham bread, boiled tongue or cold boiled beef, black tea, or good sweet milk, &c. Eggs, if new laid, and not boiled hard, afford a very strong nutriment. The yolk contains many unctuous, fat and sulphurous parts ; the white, on the other hand, consists of moist, balsamic parts, like those of serum. Eggs are of all substances, most proper in a weak habit of body, through loss of blood, or the wastings of a fever, which require immediate and substantial nourishment. They are very beneficial to old men, who stand in need of good nutriment, and such as is easy of digestion. — -[Extracts from Dr. Hoffman on Aliment^ (corrected, and with additions, by the AiUhor.) SEMINAL DISCHARGES. 151 Eggs (boiled) ought to be used only when perfectly fresh ; and per- haps the best way of preparing them for the table, is to coagulate them by pouring boiling water on them, and letting them remain about ten minutes; or they may be broken on the surface of cold water, and suffered to heat with a moderate fire. This, perhaps, is the most unexceptionable manner of pre- paring them. After removed from the water, they can be seasoned accord- ing as fancy may dictate. To ascertain whether eggs have been well preserved, it is only necessary to examine their transparency by a candle, and to reject such as appear of a turbid color. When poached and eaten with bread and butter, they are preferred by many. The most excep- tionable manner of preparing eggs, is to fry them in butter, or along with pork ham. They are very palatable done in this manner, but to some are very difficult of digestion. For breakfast, boiled milk and cocoa, or good boiled milk, may be nsed; or milk pottage, or butter-milk, or good black tea, with a good deal of cream; a bit of dry toast, roast chicken, &c, &c. Milk perhaps is one of the greatest of nature's restoratives for those whose stomachs it will sit on; unfortunately, it disagrees with many persons, and when- ever that is the case, it must be boiled ; and if it still disagrees, it should be immediately laid aside. It is often found to be very bad and unfit for use in cities and great towns, but in the country, where animals enjoy better health, and are accustomed to range the fields and feed without restraint on the salutary and medicinal plants that abound on the ver- dant lap of nature, it is found to possess considerable excellence and salubrity. Chocolate may be reckoned among the useful drinks, though it may more properly be classed with aliments. In cocoa there is a very nutri- tive substance, and by mixing it with sugar and aromatics, its oily or noxious qualities are corrected. "Chocolate made with milk (says M. Lewis) is an excellent breakfast for a debilitated constitution. I knew a child, twelve years old, to all appearance in the last stage of a con- sumption, when given over by a physician, recovered by her mother's giving her chocolate only in small quantities often repeated. Indeed, chocolate is an aliment that for weak constitutions cannot be too highly recommended." At all meals it is necessary to use bread well fermented ; and at dinner to drink good cold spring water, or with moderation, <*ood table beer. &c. 152 SEMINAL DISCHARGES. Spirituous liquors in any form are destructive, some malt liquors not a little injurious ; one great injury in the use of malt liquors is caused by the use of aloes instead of hops to make it bitter ; the drastic properties of which are greater than the strength of the invalid can bear, milder means being more salutary in their effects. The catalogue of aliments here recommended is, it may be hoped, suffi- ciently long to allow any patient to select at his own discretion a regimen that may be agreeable as well as salutary. For it is much to be wished that no painful restraint in this respect, nor obligation of living upon dis- agreeable food should retard a recovery which depends in no considerable degree upon the patient's state of mind, who for that reason should en- deavor to keep himself as tranquil and cheerful as possible, and to resist every attack of despondency and uneasiness. We should never neglect to use a sufficient quantity of drink. It too often happens that people from inattention to these calls of nature neg- lect it to such an extent as to cause acidity, obstructions in the abdomen, and a multitude of diseases found so frequently among men of letters, and females who live a sedentary life. But let it be observed, that the best time for drinking is not while one is eating, as the gastric juices are thereby rendered too thin, and the stomach weakened — but about an hour afterwards. " The best drink is water, a liquid commonly despised, and even considered as prejudicial. I will not hesitate, however,," says Dr. Hufcland, " to declare it to be one of the greatest means of prolonging life ; but one great point should be regarded — the water should be fresh, and recently drawn from a spring or running stream, and be put in a vessel well stopped ; for all spring water, like mineral, contains fixed air, which renders it strengthening, and favorable to digestion. Pure fresh water has the following advantages, which ought to inspire us with respect for it. The element of water is the greatest and only promoter of diges- tion. By its coldness, and fixed air, it is an excellent strengthener and reviver of the stomach and nerves ; on account of its abundance of fixed air, and the saline particles it contains, it is a powerful preventive of bile and putrefaction, it assists all the secretions of the body. Without water there could be no excretion ; for according to the latest experiments, oxygen is a component part of it. By drinking water, we actually im- bibe a new stimulus of life." SEMINAL DISCHARGES. 153 It seems unreasonable, then, to suppose that the water which we drink does not furnish us a part of our subsistence. The following fact seems to confirm this idea. It is given by Dr. Anderson, as follows : "In the month of October, 1782, a woman in Rosshire, lived several years without taking any other kind of food besides pure water alone. The fact was authenticated in the most undeniable manner ; and Sir John Lockhart Ross assured me that he visited her after being on that regi- men several years, and found her complexion fresh and clear, her breasts nlump, and her body far from being in that emaciated state he expected." " The very great benefits I have myself experienced, says Mr. Sand- ford, (the ingenious author of " Remarks on Wine and Spirits ," &c, 12 mo., Cadwell and Davies,) " in exchanging the usual stimulant bever- age of fermented liquors, for a more diluting one, leave me no hesitation in pronouncing pure spring water to be unquestionably (with some few exceptions) the best liquor to be taken with our meals, though condemned as prejudicial by some, and rejected for no just reason by others." The following advantages, resulting from its use, may possibly recommend it to those who are unacquainted with its properties, viz : that it is a great promoter of digestion in healthy stomachs, and by its coldness to lower the heat usually generated in this process. It is a powerful preventive of biliary concretions, or gall stones, as they are called, and of urinary calculi, or gravel. It also assists all the secretions of the body ; and, as according to the experiments of Lavoisier, oxygen or vital air is a com- ponent part of it, by drinking it we actually receive fresh vital powers. It is a liquid too, which may be found naturally in all climates, and agreeable to most palates ; many take no other drink during their whole lives, and yet enjoy good health, though engaged in laborious occupations, a proof that water is well suited to answer every ordinary purpose of the animal economy. Sir John Floyer tells us, agreeably to the Immoral doctrines of the day, that " those who use cold water for their common drink have their humors least rarified, and escape those diseases which affect the head, as apoplexy, palsy, blindness, madness, &c." If the virtues of cold water were duly considered, every one would value it as an important medicine. To the use of it children should be bred from their cradles, because all strong liquors are injurious to their constitutions. G-ood wholesome water is, according to Fourcroy, generally to be dis- covered by the following characteristic distinctions; it is very clear ami 154 t SEMINAL DISCHARGES limpid, no extraneous body alters its transparency ; it has no kind of smell ; it has a lively, fresh and almost pungent taste ; it boils readily, without losing its transparency ; it entirely dissolves soap in such a manner as to form a fluid, seemingly homogeneous. Spring or river water, which filtrates or flows through sand, is in continual motion, and not pol- luted with the putrefactions of animal or vegetable substances, is found to possess all these properties. This kind of water passes easily through the stomach and intestines, and is, therefore, favorable to digestion. On the contrary, water which stagnates in subterraneous cavities ; which has no current ; is overgrown with plants, or abounds with insects ; is very shallow, and has a soft muddy bottom, consisting of putrid vegetables, or contains calcareous salts or clay ; all such water is unwholesome. Wa- ters impregnated with the latter substances are called crude or hard, and are oppressive to the stomach, and unfavorable to digestion. The poet seems to give directions for the choice of water in the following lines : " "What least of foreign principles partakes Is best ; the lightest then Avhat bears the touch Of fire the least, and soonest mounts in air, The most insipid, the most void of smell. ****** Tho' thirst were e'er so resolute, avoid The sordid lake, and all such drowsy floods As fill from Lethe, Belgia's slow canals, ("With rust corrupt, with vegetation green, Squalid with generation and the birth Of little monsters,) till the power of fire Has, from profane embraces, disengaged The violated lymph. The virgin stream In boiling, wastes its finer soul in air." Armstrong. It appears that water owes its pleasant, fresh taste, to air which is combined with it ; for, when boiled, the first bubbles that rise consist of air, and the water, after it has lost them, has no longer the same lightness or relish. It recovers these properties by being exposed for some time to the atmosphere, or by being briskly shaken. By distillation, water is ob- tained perfectly pure and separated from the earthy and saline matters generally contained in it, which are left at the bottom of the vessel. Distilled water has an insipid taste, and when drank oppresses the stom- ach with a kind of weight ; but, having been exposed to the open air, and briskly shaken, it recovers its taste r and may be drank with safety ; for distillation does not alter water, it only deprives it of the air which is always united to it, in its ordinary state. No natural fluid is eus- SEMINAL DISCHARGES. 155 ceptible of more combinations than water, and it has, on that account, long held the name of " The great solvent of nature." The scientific author of " Zoonomia" ranks water among the nutri- entia, or substances affording nutriment, in his arrangement of the ma- teria medica contained in that work, and observes, that water must be considered as a part of our nutriment, because so much of it enters into the composition of our solids, as well as of our fluids ; and vegetables are now believed to draw almost the whole of their nourishment from this source. It has, however, other uses in the system besides that of a nour- ishing material, as it dilutes our fluids, and lubricates our solids ; and on all these accounts, a daily supply of it is required. The too nrevalent and mistaken idea that water impoverishes the blood, and is, therefore, hurtful to the constitution ; that it has a tendency to diminish the strength and depress the spirits, has, I believe, prevented many persons from adopting the use of it; but I have abundant in- stances in contradiction to these suppositions, in ancient, as well as modern times. The illustrious Haller, attributed to the use of water alone, the per- fection of all his senses, and particularly that of sight, though he exer- cised his eyes very much in microscopic observations, even to a late peri- od of his life. The late Dr. Benjamin Franklin, who died at the advanced age of eighty-four years, appears to have been well acquainted with the good effects of a water regimen, as well as of the necessity of nourishing the body by solids, rather than fluids ; which he had proved in his own person. He states that when a journeyman printer, he never drank any liquid besides water, during his work. When his fellow laborers ridiculed him for his temperance, and told him that it was impossible to work at the press without strong drink in considerable portions, he discovered to them that he never drank strong liquors, and yet could work better than they who did. He demonstrated to them, likewise, that there was more nourishment in a penny loaf than in a quart of ale ; because there was more grain in one than in the other, and, consequently, that the former would go further towards enabling a man to work than the latter. "John Wilson, of Sosgill, Cumberland, died in April, 1799, at the advanced age of 100 years. He exercised the trade of a blacksmith during 60 years, in all which time his beverage was milk and water, 156 SEMINAL DISCHARGES. with the exception of only two glasses of ale, and one of spirituous li- quors, during the whole course of his life." It has been asserted by the late Dr. Johnson, who for many years never tasted wine, that Waller, who was a lively and cheerful companion, was a water drinker; notwithstanding which, he was enabled by his fertility of mind *to heighten the mirth of Bacchanalian assemblies ; and that his friend Mr. Saville, said: "No man in England should keep him company but Ned Waller without drinking." — BoswelVs Johnson. The late celebrated John Hunter drank no wine for the last twenty years of his life ; notwithstanding which, his mind and body, except disturb ed occasionally by some very extraordinary paroxysms, were never more vi- gorous and active, than during this period ; of which many of the philosophi cal works of this able anatomist and physiologist, now in the hands of the public, may be regarded as affording ample proof. Mr. Hunter was, notwithstanding, well known in his younger days to have been a bon vivant. — Home's Life of Hunter. Dr. Hufeland mentions an instance of a very respectable surgeon-gen- eral of the German army, a Mr. T , who ascribed his healthy and long life of more than eighty years, chiefly to the daily use of fresh spring water, which he drank for upwards of forty years. Between his thirtieth and fortieth years he was a most miserable hypo- chondriac, oppressed with the deepest melancholy, tormented with palpi- tations of the heart, &c, and imagined he could not live six months ; but from the time he began a water regimen, all these symptoms disap- peared, and in the latter half of his life, he enjoyed better health than before, and was perfectly free from hypochondriac affection. The great advantages which the ingenious Dr. Darwin experienced by leaving off fermented liquors, may be seen detailed by himself in the 2d vol. of his Zoonomia, p. 452, where, after having described his own case of gout, and observed that " example has a more forcible effect than sim- ple assertion," he says, "that for upwards of twenty years he has been in the habit of drinking water, and has been kept in perpetual health, except accidental colds, from change of weather ; that before he abstained from fermented liquor, he was subject to piles, gravel and gout, neither of which he has since experienced, except the latter, and that in a very slight degree." SEMINAL DISCHARGES. 157 Dr. A. Fothergill mentions the case of his friend, Dr. B. Pugh, of Milfordcastle, who having from early youth abstained from wine and spirits, declares that at that moment he not only enjoyed superior health and vivacity, but felt himself as capable of every mental and corporeal ex- ertion as he did at twenty-five, though then in his eighty-second year. I believe there are no instances on record of persons having really injured health and endangered their lives by drinking water. On the contrary, it may be urged, with Dr. Armstrong, that " Nothing like pure and simple element dilutes the food, or gives the chyle so soon to flow." Charles Macklin, that veteran of the London stage, who died July 11th, 1797, in his 99th year, used to say that when he found himself ill, during the long course of his life, he always went to bed, took nothing but bread and water, and that by this regimen he was generally relieved from every slight indisposition. Cleanliness and the use of the Cold Bath. — One of the first objects that should be attended to by the patient, while laboring under any of the forms of disease mentioned in this work, should be cleanliness. There is nothing so conducive to general health, as a strict regard to this. Cold bathing is most beneficial in all cases where the patient is laboring from the debility arising from youthful imprudence and indulgence in soli- tary habits. Reason and experience have demonstrated the advantages of the cold bath, and its infinite virtues. The use of cold water bathing- has been proved particularly beneficial in disorders occasioned by mas- turbation and venereal excesses, especially in cases where, independent of impotence, and a simple gonorrhoea, in which the patient was so very weak, and considered incurable. Whatsoever is to be effected by bracing the solids, invigorating their vibrations, and accelerating the motion of the blood, is with certainty to be obtained from the judicious use of the cold bath. The most obvious consequences of bathing is, by a greater pressure upon our bodies, to straiten the vessels, dissolve the humors, and remove any viscid matter adhering thereto. " Of all remedies there is none can surpass the virtue of the cold bath, if proper restoratives are taken when it is used. It cools the body more, helps to strengthen the nerves better, and more effectually contributes to promote perspiration than any internal medicine can do without it ; and with the aid of such •stimulating medicines as are of known efficacy, will do every good that can be expected from it." 158 SEMINAL DISCHARGES. In tabes dorsalis, or dorsal consumption, the cold bath gives a spring even to the inanimate fibres. Celsus, of whose works most have availed themselves, recommends in cases of debility, originating from the early effects of libidinism, strengthening remedies and diet, abstinence from amorous pleasures, and the cold bath. Aretus, joins in the same opinion. Actuarius says, " let the patient take before immersion in the cold bath, and during a course of it, such remedies as strengthen without stimulat- ing too violently the nervous system" There is a class of persons who stand peculiarly in need of the bracing qualities of cold water, viz : the nervous Nervous people often have weak bowels, and may, as well as others, be subject to conges- tions and obstructions of the viscera ; and in this case they will not be able to bear, at first, the effects of cold water ; for them, therefore, and indeed all delicate people, the best plan would be to accustom themselves to its use by the most pleasing and gentle degrees. They ought to com- mence at the warmest season, and gradually use it as the cold increases, till at length they become accustomed to it. I would particularly recom- mend the use of the cold bath to all persons of a debilitated constitution and relaxed fibres, and for weakness of the back and reins, scrofula, swellings, and all nervous affections. The sedentary and studious will also find great relief by pursuing this course, as it will in a great mea- sure supply the place of exercise, and give a healthy tone and vigor to the muscular system. In cases of extreme personal weakness, in hysteric and hypochondriac cases, in nervous disorders, which induce spasms, convulsions, epilepsy, and similar consequences, the shower bath is preferable to immersion. The use of proper remedies and the cold bath together, would be most beneficial, as the combination produces the same effects, and will cure diseases, which other medicines would have tended only to increase if given under similar circumstances. Being strengthening, they reinvigo- rate, and diminish feverish heats of the body, and allay the irregular motions produced by the spasmodic disposition of the nervous system ; for- tifying a weak stomach, and removing the attendant pains ; restoring ap- petite, and facilitating digestion. All the functions, and particularly perspiration are promoted, which renders this treatment so efficacious in all catarrhal and cutaneous diseases. SEMINAL DISCHARGES. 159 In a word, they remove all the disorders occasioned by weakness, unless the patient is afflicted with obstructions and internal ulcerous abscesses, which conditions necessarily exclude the use of the cold bath ; in such a case, a different course of treatment is to be adopted. Much depends upon a due regulation of sleep, especially as the want or disturbance of that great restorative, is one of the most distressing symptoms of the disease j and while treating on this branch of my sub- ject, it may not be considered out of place or even amiss, to make a few extracts from a work (entitled " Gordon on the Intellectual Powers") on the General Management of Sleep, " The chamber in which we sleep should be always large, high-roofed and airy. The bed ought to be large, and not placed near the wall, but at some distance from it, both to avoid dampness which may exist, and to admit a free circulation of air. Curtains drawn round the bed are unhealthy. The bed on which we lie ought always to be rather hard. Hair mattrasses being cooler and less likely to imbibe moisture, are preferred to beds of feathers. The pillow should be pretty hard. Heating beds is pernicious. We ought not to sleep overloaded with clothes. It is more wholesome to lie between sheets. The atmosphere of our chamber should be cool. It is dangerous to sleep in a smoky room. A gentle current of air pervading our sleeping apartment is, in the highest degree, essential to health. Damp beds are highly dangerous. On going to sleep all sorts of restraint must be removed. Night caps, which keep the head hot, are extremely injurious. Sleeping in stockings is a bad and unhealthy habit. The position of sleep ought to be, as nearly as possible, horizontal. The half sitting posture is exceedingly injurious during sleep. Covering the head with bed clothes is a very dangerous custom^ it exhausts the vital air. A full stomach prevents healthy sleep. Sleep becomes wholesome only to the healthy, when taken at those hours pointed out by nature. 12 lt)0 SEMINAL DISCHARGES. Excessive wakefulness prevents the aliment from being digested, and generates crude humors ; excessive sleep produces lassitude and corpu- lency, and utterly debases and stupifies the mind. Inflammations, fevers, and dangerous colds, originate from sleeping in the open air, and from sudden transitions from hot to cold. Late hours are hurtful to the frame. Long exposure to artificial light, is injurious to the sight. The quantity of sleep ought not to be beyond eight hours. No assistance should be sought from opium, in this respect, except in cases of extreme necessity. Although efficacy of medicine in recent contraction of the disease is such, that in most cases, no assistance is required from anything else, yet a due attention to air, exercise, regimen, &c, is, in all cases, proper; in a few, absolutely necessary. The air to be chosen must be pure, and for that reason, cities, thickly settled villages, factories, &c, must be avoided, if possible: but all country air will not answer the end proposed ; it must be dry and tem- perate, as well as pure ; if hot, it exhausts ; if moist it relaxes ; cold, though far from being beneficial is much less hurtful than too great heat.* AYherever the patient is, he must not neglect exercise ; it should be moderate at first, and be augmented by degrees, being always left off before too great fatigue takes place. All exercise is best fasting ; and with regard to the kind of exercise, most conducive to health, none is preferable to walking, when the patient is able to take enough of it. But that being seldom the case when the disease has made any progress, recourse must be had to riding on horseback ; and if the patient is very weak — to a carriage. * Jones, in his Physiological Disquisitions, page 627, says, and says truly, that the happiest situation, and the most promising toward the enjoyment of life and health and every convenience, is near the bottom of a high hill that hath a south erly exposure, with woods and plantations about the head of it, a dry soil of sand and gravel with a mixture of loam, and running waters with green meadows be- fore it, or the sea with a steep and clean shore of gravel. PART III. VENEREAL DISEASE. mi VENEREAL DISEASE. CHAPTER I. HISTORY OF VENEREAL DISEASES. By venereal disease, is meant that peculiar description of malady which is communicated from one person to another in the act of sexual connec- tion. The origin of this singular disease has been the subject of anima- ted discussion ; nor can the question at the present day, he considered as ultimately decided. Fortunately, like many other subjects of curious investigation, our doubts concerning it can have but little bearing upon its treatment ; and a detailed statement of the arguments urged by the advocates of opposite theories, would be inconsistent with the object or limits of this part of the work. The author may, however, state, as a brief exposition of the opinions entertained, that by some, the disease is thought to have made its appearance in Europe about the year 1494. It was thought by others to have broken out at the siege of Naples, and to have been communicated to the French at that time, who, carrying it into France, called it "le Mai de Naples." The Spaniards named it from the French, "Morbus Grallicus;" and the inhabitants of Naples, "las bubos," (hence the word bubo.) From France it travelled to Eng- land and Germany, in both of which countries it was called the "French Disease." The Poles received it from the Germans, and called it the " German Malady." The Russians, tainted by the Poles, called it the "Polish Evil." From Europe, it soon spread into Asia, and was called by the Turks and Persians, the "Frank Infection." The ordinary name given to this disease, was the "French Disease;" and Astruc, an old author, states they (the French) became so ashamed of the name, the disease now having become common and infamous, that it was determined by the Scwztw to designate it the "Venereal Disease," which appellation it bears to the present day in all parts of Europe. It is believed by others, that Columbus imported it among his follow- ers on his return from the New World, in March of 1493. Other au- thors maintain that the disease has existed from the remotest periods, i 164 HISTORY OF VENEREAL DISEASES. and that it prevailed among the Jews, Greeks, and Romans ; and in de- fence of their sentiments, appeal to ancient writers, who have described certain diseases in terms that might be readily applied to many of the venereal affections of the present day. Celsus, a physician, who lived before the birth of Christ, describes eight species of sores arising from sexual intercourse, many of which are still met with ; so that it does not follow that no evil arose from pro- miscuous intercourse then, although the venereal disease, as now under stood, was not then known to exist. It is fully corroborated by history, that about the year 1494, a disease of a most horrid character made its appearance in Europe, the ravages of which were incomparably more terrible than those of any similar disease recorded previously to or since that period. This malady was eminently contagious. It appears to have been communicated from one person to another by mere touch, or residence in the same chamber, and it was thought to be conveyed even by the breath, as appears from the fact that Cardinal Woolsey was indicted for whispering in the King's ear while he was supposed to be laboring under the disease. From a rather laborious investigation of the subject, I am inclined to the opinion that the malady which affected the soldiers at the siege of Naples, and which spread in the short period of two years throughout Europe, was essentially different from any venereal disease of the present day. This appears from the rapidity of its propagation — the severity of its symptoms, and the peculiarity of its contagion. Nor can I imagine that the improved remedies from that to the present day, have converted the scourge of the fifteenth century into the syphilitic disease of the pre- sent day. The venereal disease exhibits itself in one of three distinct forms, when it first makes its appearance. 1. As a discharge of matter from the urethra (gonorrhoea or clap.) 2. As an ulcer or sore on the glans penis, or other part of the organ. 3. As an induration or thickening of the skin, and parts beneath, followed by ulcerations. The two first are those most commonly observed, besides these varieties, various other sores appear on the genital organs which so closely resemble, (though not,) venereal ones, that surgeons of the largest experience can- HISTORY OF VENEREAL DISEASES. 165 not always distinguish the true from the false ; most of these latter ulcers are self-generated from a want of due attention to cleanliness, and hence permitting the secretions of the parts to accumulate and become so acrid as to produce ulceration, careful ablution with soap and water once a day is the best means of preventing these frequent and very troublesome sores ; they may also have their origin from connection with an otherwise pure female, who is at the time out of order. The question, whether syphilis and gonorrhoea arise from the same poison, has given rise to much discussion, but the arguments, observations and experiments of the ablest men who have taken a part in the contro- versy, have left the issue in point undetermined. It was the opinion of Mr. Hunter that these poisons were essentially the same, and that the difference arose from the application of the poison in the case of the gonorrhoea to the inside of the water passage or urethra, and in syphilis to the glans of the penis or some other part, and the experiments which he performed (supposed by some on himself,) confirmed this conclusion. Yet, notwithstanding, he " acknowledges, that the opinion of their ori- ginating from two distinct poisons seems to have some foundation, when the difference in the symptoms and method of cure is considered." The opposite opinion was entertained by Mr. Bell, in support of which he adduces experiments of a most conclusive character, which I shall briefly relate. Matter was taken upon the point of a probe from a chancre on the glans penis, before any application was made to it, and completely intro- duced into the urethra. For the first eight days, the gentleman who made this experiment felt no kind of uneasiness ; but about this period he was attacked with pain in making water. On dilating the urethra as much as possible, nearly the whole of a large chancre was discovered, and in a few days a bubo formed in each groin. No discharge took place from the urethra during the whole course of the disease ; but another chancre was soon perceived in the opposite side of the urethra. The bubos, which, till then, had continued to increase, became stationary, and by prompt and efficient treatment at last entirely disappeared : the chan- cres became clean, and by due contiuuance of medical auxiliaries, a com- plete cure was at last obtained. If this case and another to which I shall presently advert, could be entirely depended upon, they would tend to disprove that part of Mr. 166 HISTORY OF VENEREAL DISEASES. Hunter's theory, accounting for the different effects of the same poison by its application in a case of chancre to a non-secreting surface covered with cuticle, and that of gonorrhoea to a secreting mucous membrane. How- ever this may be, says Bell, I have never seen a chancre within the urethra. The next experiment was made with the matter of gonorrhoea, a por- tion of which was introduced between the prepuce and glans, and allowed to remain there without being disturbed. In the course of the second day, a slight degree of inflammation was produced, succeeded by a dis- charge of matter, which, in the course of two or three days, disappeared. The same experiment was repeated, but no chancre ever appeared from it, Two medical students were anxious to ascertain the point in question ; and with this view they made the following experiment, at a time when neither of them had ever labored under either gonorrhoea or syphilis, and both in these and the preceding experiments, the matter of infection was taken from patients who had never made use of Mercury. A small dossil of lint, soaked in the matter of gonorrhoea, was by each of them inserted between the prepuce and the glans, and allowed to re- main on the same spot for the space of twenty-four hours. From this it was expected chancres would be produced ; but in one a very severe de- gree of inflammation ensued over the whole glans and prseputium, giving all the appearance of what is usually termed gonorrhcea spuria. A con- siderable quantity of fetid matter was discharged from the surface of the inflamed parts, and for several days there was reason to fear an operation would be -necessary for the removal of a paraphymosis. But by the use of saturnine poultices, laxatives and low diet, however, the inflammation abated, the discharge ceased, no chancre took place, and the case got en- tirely well. In the other gentleman, the external inflammation was slight, put in consequence of the matter finding access to the urethra, he was attacked on the second day, with a severe gonorrhoea, with which he was troubled for more than a year. The next experiment was made by the friend of the latter student ; he inserted the matter of gonorrhoea with a lancet, beneath the skin of the praeputium, and likewise into the substance of the glans ; but, although this was repeated three different times, no chancres ensued. A slight degree of inflammation was excited ; but it soon disappeared without any- thing being done for it. His last experiment was attended with more BISTORT OP VENEREAL DISEASES. 167 serious consequences. The matter of a chancre was inserted on the point of a probe to the depth of a quarter of an inch or more, in the ure- thra. No symptoms of gonorrhoea ensued ; but, in the course of five or six days, a painful inflammatory chancre was perceived on the spot to which the matter was applied. To this succeeded a bubo, which ended in suppuration, notwithstanding the immediate resort to medical aid; and the sore that was produced proved both painful and tedious. Ulcers were at last perceived in the throat, nor was a cure effected until a protracted course of medicine had been accomplished, confining the patient to his rooms for the space of thirteen weeks. — On Gonorrhcea Virulent a and Lues Venerea, vol. 1, ed. 2, p. 438. Other facts however, have been recorded, which would tend to establish the existence of but one poison, capable of communicating both forms of the disease. Vigaroux mentions the case of six young Frenchmen, who had connection with the same woman one after another. The first and fourth in the order of succession had chancres and buboes, the second and third gonorrhoea, the fifth chancres, and the sixth bubo. Dr. Hennen mentions an instance in which three men had connection with the same woman within an hour, of whom the first escaped, the second had chan- cres, and the third gonorrhoea, and the author has met with similar cases in his own practice. I cannot, however, regard these cases as fairly entitled to any weight in the determination of the question ; they can be satisfactorily accounted for by the supposition that the female was laboring under both forms of the disease at the same time, or that the person supposed to be infected by them had cohabited with others. It however appears probable, from the observations of Mr. Evans, a dis- tinguished writer on this disease, that certain unhealthy discharges from the female organs, when no ulceration can be detected, are capable of giving rise to ulcerations on the penis, such as would usually be considered as cases of chancre. This gentleman was occasionally present at the surgi- cal examinations of the public women in Valenciennes, and remarked with surprise the limited number of diseases to be observed among them : " At one examination which I attended (says he, ) no less than two hun- dred women of the lowest description, and, of course, the most frequented by soldiers, were examined, and not one case of disease was found among them : nevertheless the military had, and continued to have their usual number of venereal cases ( ulcerations. ) At an inspection I have since 168 HISTORY OF VENEREAL DISEASES. attended, where one hundred women were examined, only two were found with ulcerations : I noticed several with increased secretions, and one with purulent discharge, but these were taken no notice of by the attending surgeons, as they did not come sufficiently under the head of virulent gonorrhoea. That the two women above mentioned as having ulcers, infected the whole of the men diseased in the garrison, during the preceding fifteen days, no one can for a moment admit as likely; but if it be allowed that an altered secretion be sufficient for the produc- tion of this disease, (the ulcus elevatum,) we shall at once have an ex- planation of how it happened that the military hospitals continued to have their usual number of venereal cases, &c." — Evan's on Ulcerations of the Genital Organs, p. 72, 73, fyc. On the whole, from a review of the arguments advanced on both sides, I think the most tenable opinion in the present state of my own knowledge, is, that venereal ulcers are always the result of the application to the parts, of matter from similar ulcerations and that gonorrhoea is a distinct dis- ease, arising from gonorrhoeal matter applied to the membrane lining the urinary canal. In the following pages I shall attempt to draw such an ungarnished picture of these terrible diseases, as will it is hoped, be the means of preventing the young and guileless from being led away by the blandishments of the courtesan to disease, ruin, and perhaps a loath- some death. CHAPTER II. GONORRHOEA. The word gonorrhoea, is derived from the Greek words Tovr\, semen, and psw, to flow or run ; it probably derives its usual name, (though in- appropriate) from the fact that its discharge formerly was supposed to consist of semen ; perhaps a more appropriate name for this disease , its varieties taken collectively, is blennorrhoea, from BXsvva mucus, and psw, to run. „ This disease consists in an inflammation of the membrane, which lines the urinary passage or urethra. This lining membrane is of the class GONORRHCEA. 169 denominated mucous membranes, and during health is the seat of a secre- tion which moistens the surface, and which, owing to inflammation, frequently changes in character and appearance. This inflammation is called gonorrhoea, and is denominated virulent or venereal gonorrhoea, when it is the result of contagion. The former is a complaint of little consequence, and generally disappears in a short time without treatment. The matter in this variety is of a whitish color, and is sometimes copiously discharged, but there is no sense of pain or scalding in passing urine, nor are there any inflammatory symptoms. It usually occurs in debilitated individuals, and frequently arises without any manifest cause, though it may be occasioned by excessive venereal indulgence, violent horse exer- cise, or violent blows on the parts. It generally yields readily to rest and gentle laxatives, but should it tend to pursue a protracted course, a physician should be consulted. The virulent gonorrhoea is a much more troublesome disease, whether we regard the violence of its symptoms, its frequent obstinate continu- ance, the serious affections to which it occasionally gives rise during its continuance, or the painful affections which follow in its train. The first intimation of its existence is a tingling sensation or itching at the extrem- ity or orifice of the urethra; this sensation sometimes extends over the whole extremity or glans of the penis : on examination, the lips of the urethra are observed to be somewhat tumid, and slightly separated, and of a deeper red color than usual and more tender to the touch; the whole of the organ appears more tense and full than in health ; on pressing the glans, a small quantity of whitish matter exudes, which in the course of a day or two becomes more copious. The discharge at first is thin and whitish but soon becomes a yellow or green- ish color, becomes tenacious, somewhat resembling the common matter or pus of sores, and has a peculiar odor. These changes depend on the increase and decrease of the inflammation, and not on the poisonous quality of the matter itself ; for, an irritation of these parts equal to that caused by an attack of gonorrhoea, will produce the same appearance. The itching is succeeded by pain, and the patient suffers severely from an acute scalding or burning sensation, called ardor ic?-mcs, during the voiding of the urine. He now more frequently voids his urine which is discharged in a thin, wire-like or forked stream, in consequence of the contraction of the passage from the inflammatory swelling of the lining 170 GONORRHOEA. membrane. Painful erections of the penis sometimes occur, particularly at night. The inflammation in this stage is considerable, and the glans appears swelled and tense. Considerable pain is felt along the whole course of the urethra and in the perinaeum, which is the name appropria- ted to that part situated behind the scrotum, and between it and the anus.* To the touch the whole length of the urethra on the under sur- face of the penis feels like a projecting cord. This disease at first only penetrates to a short distance into the urethra, but it frequently extends backwards towards the bladder. The " inflammation may be diffused over a wide surface, and may involve at the same time the whole of the urethra, the bladder, the testicles, the glans, and prepuce in the male ; and in the female, the nympha, clitoris, labia, vagina, &c; and thus commencing at the preputial end of the penis, in the fossa navicularis, it not unfrequent- ly creeps slowly on to the posterior parts of the urethra, to the bladder, or to the testicles, while it decreases or ceases in the parts first affected." — Wallace, pp. 237, 238. This is proved by the pain experienced in the perinseum through which the urethra passes, before it reaches the bladder. The irritation often extends to the rectum and produces much uneasiness in it, with frequent and ineffectual attempts to evacuate the bowels. A very painful affec- tion frequently exists called chordee ; this consists in an involuntary and very painful erection of the penis, which, owing to the effects of inflam- mation, is incapable of assuming the ordinary position of erection, but is drawn forcibly downwards or to one side. This symptom annoys the patient most when he is warm in bed, and is sometimes so severe as to render sleep impossible. The external membrane is so violently dis- tended at times, as to be torn to a certain extent, and a discharge of blood is the consequence, which is sometimes highly beneficial. This is the ordinary course of the disease ; but it varies much in dif- ferent individuals, from constitutional causes. In some, the pain is ex- cruciating, while others have but little suffering; and it does not appear that the violence of the symptoms is at all in proportion to those of the disease in the person from whom it has been contracted, since several have been known to have been contaminated by the same individual, and yet to suffer in different degrees. The glands in the groin sometimes * The termination of the intestinal canal. # GONORRHCEA. 171 become inflamed and hard, constituting bubo, which, however, seldom or never proceeds to suppuration. When the inflammation extends along the urethra towards the bladder, all the symptoms are much aggravated. The sense of scalding is more intense, and the pain produced by the frequent erections is such as to render sleep impossible. The matter discharged is of a fetid odor, and frequently streaked with blood. It proceeds from about the middle of the perinaeum, which is painful on pressure. On examining the part, one or two small tumors is often felt. These are small glandular bodies (Cowper's glands) in a state of inflammation. The whole of the under side of the penis is often affected with soreness in consequence of the inflammation of the urethra. This soreness often extends as far as the anus, and becomes an intense pain during erections. The testicles are also considerably painful, and sometimes so sensitive that the slightest touch is disagreeable. When the inflammation extends to the prostate gland, the patient suf- fers from a sense of fullness and tension in all the parts in the neighbor- hood of the anus ; there is a continual desire to void urine, the discharge of which causes excruciating pain ; it is attended with great difficulty, and frequently is passed only drop by drop. This state is generally at- tended by fever, which sometimes is of a very violent character. If in- flammation reaches the bladder, a very uneasy sensation is experienced over the lower part of the abdomen ; shooting pains are felt about the neck of the bladder and anus ; the patient suffers from tenesmus, and an incessant desire to make water. The urine has a turbid appearance, being sometimes mixed with blood and a large quantity of mucus. A discharge of blood from the urethra not unfreqnently occurs in the course of gonorrhoea, when inflammation is high, after which the symptoms, in a general way, are relieved. - From what has been above stated, it will appear at once that the diag- nosis of gonorrhoea is easy, characterized as the disease is by a mucopuru- lent discharge. There are, however, several points which are deserving of attention, as distinguishing the position, intensity, &c, of the affec- tion. The character of the discharge will often give the surgeon some notion of the exact situation of the disease. When he observes a glairy secre- tion, resembling the white of an egg, he is justified in stating (in woman) 172 GONORRHCEA the neck of the uterus is affected. When the discharge is composed of muco-pus, he may he assured that it arises from the urethra, vulva, or vagina, &c. Some assistance may be derived likewise from chemical tests, to decide whence the secretion issues, as it is found that the muco- pus of the vagina is acid, whereas that coming from other sources is alka- line. When the mucous membrane is alone inflamed, the secretion is formed almost solely of mucus. When, however, the sub-mucous tissue becomes affected, we observe the secretion to assume a more or less purulent char- acter in proportion as 'this tissue is affected." The existence of blood, mixed with muco-pus, will generally lead the surgeon to suspect an ulceration of the canal which he cannot examine : but here there are many sources of error, as blood may be poured out in consequence of excessive inflammation. Usually, however, I have been able to distinguish, or at least to suspect, the existence of a chancre, from the appearance of the discharge, when it has a grayish or reddish tint, and is of a thin consistence ; and inoculation has frequently proved these surmises to be correct. Gonorrhoea generally appears about the fourth or fifth day after sexual connection ; seldom earlier than the third, and frequently after the seventh, though it may appear a few hours after connexion, or not until ten or sixteen days have elapsed. The mildness or severity of the disease does not, however, appear to depend in any manner upon the length of time that elapses between the period of infection and the appearance of the disease. The duration of the disease is uncertain, and the probable period of its termination cannot be conjectured from the appearance of the disease at its commencement. The most violent and protracted dis- ease often follows symptoms which at first were mild, while speedy termi- nation is not unfrequent although the first symptoms were severe. The enquiry is often made at what period the discharge ceases to be infectious ? It is difficult to answer the question satisfactorily. Mr. Hunter thought that after the violence of the symptoms had abated, the discharge might still continue for an indefinite period of time and retain the power of communicating contagion. " Gonorrhoea is not always confined to .the organs of generation, or their dependencies ; hence, varieties in its seat ; owing either to the sym- pathies of other parts during the presence of an urethral gonorrhoea, or GONORRHCEA. 173 from the direct application (by accident or carelessness) of the matter to a healthy mucous surface." These varieties in the seat of gonorrhoea, have chiefly been observed in the eye, nose and rectum. As regards the eye, of all the consequences of gonorrhoea, this is perhaps the most terri- ble ; but, thank God, it is not the most frequent ; it is so severe and destructive, that the sight is lost in a very short time if proper means are not promptly resorted to, to remove the inflammation. It is caused by a por- tion of matter being applied to the eye by incautiously touching it with a finger, or anything which has been in contact with the penis or linen, and so received a portion of the discharge. *It has also been known to arise from a drop of the urine of an affected man being accidentally spurted into the eye of a sound person. One eye is for the most part implicated, the attack is unexpected and sudden ; the outer membrane, or coat of the eye, called " conjunctiva," and which also covers the inside of the eyelid, is the first part attacked, it becomes red and blood-shot, and in forty-eight hours loses its transpa- rency ; there is a very considerable discharge of thick matter from be- tween the eyelids, which are greatly swollen, so great indeed is the dis- charge that the quantity of matter is almost incredible ; the disease being allowed to proceed, the interior of the eye becomes implicated, ulceration takes place in its coats, the humors of the eye escape through the opening thus formed, and the eye is forever destroyed, having shrunk up to a mere shrivelled skin. During the progress of this terrific disease, the pain is agonizing, and the disturbance to the constitution most considerable. The treatment to save the eye — in a disease so frightful and rapid in its progress, must be very active, and consists of blood-letting to a large extent, and other energetic means ; but, as even the most skilful and well informed amongst medical men, fail sometimes to save the eye, it would be useless to attempt to teach the unprofessional reader to treat this alarming disease ; the most salutary advice I can give under the cir- cumstances, is to send for surgical aid the moment such a calamity is suspected. A few hints thrown out concerning diet, &c, during a course of treat- ment for gonorrhoea may not be amiss at this place ; here I would say that I object to giving the exact proportions of the different articles en- tering the composition of my medicines for treating venereal diseases, for these reasons: that, (discarding the use of injections or mechanical means 174 GONORRHCEA. in any stage of the disease), were I to give my recipes, if prepared by an illiterate chemist, they might be the means of incalculable injury ; and lastly, those writers giving recipes (as they say) for such treatment, in nine cases out of ten, do not give a recipe of the remedies they actually use, and in thus deceiving the patient, tamper with the health — frequently the life of the one who believes all he reads ; no doubt they give faithful descriptions in their respective medical writings, of the diseases treated by them, but I consider the more honorable way is to point them to a haven where they would be likely to be benefited, and not tampered with. In gonorrhoea — I discard the use of injections and disgusting balsamic medicines. My chief prescriptions are based on the merits of the Bos- welliaSerrata of India, Oleum Peperaceum of Java, and the Eucalyptus Re- sinifera of Australia. In the absence of the preceding remedies, when not able to be obtained, the Resinous Extract of Copaiba and Pulverized Cubebs will prove an efficient remedy, prepared in the following manner : get a small glass mortar, put into it twenty grains of the first article, reduce it to a palpa- ble powder ; add the same quantity of the second article, and mix ; place the mortar near the fire until the articles assume a consistency to form nine pills ; take three of the pills at a dose, three times a day — morning, noon and bed-time ; before commencing them, however, take the follow- ing brisk purgative in a glass of cold water early in the morning ; at bed- time the same evening, commence the pills and continue them, at the above stated times, until cured : — Tartrate of Potash, "J Rochelle Salts, J r^. „v ^i,,,^ r ,„. , M ' • > Oi each, one drachm. Calcined Magnesia, f ' Sweet Spirits of Kitre. ) The usual mode of treating G-onorrhcea thirty years ago, in the Aus- tralian Hospitals, was, at its first appearance, the letting of sixteen ounces of blood from the arm, and if there was chordee, moderate bleeding every third day until it ceased ; and a brisk laxative followed with a 3 or 5 gr. Calomel pill three times a day, until salivation was manifest. I was at that time engaged in the service of Great Britain. Had I then have had the experience of thirty -five years, many lives, no doubt, would have been saved — less constitutions blasted, and disease, comparatively speaking, might have been a stranger to the Colonists. The treatment at that GONORRHCEA. 175 time was an established code in Hospital Practice ; and, as a subordinate, I was acting under the command of a superior officer, whose orders I was bound to obey. On the whole, the symptoms of gonorrhoea seem to be subject to in- finite variety ; the discharge often appears without pain, and the coming on of the pain is not at any stated period after the appearance of tht,- discharge ; there is often no pain at all, although the discharge is in con- siderable quantity and of a bad appearance ; and the pain often goes off while the discharge continues, and will return again ; in some cases an itching is felt for a considerable time, which is sometimes succeeded by pain, though in many cases it continues till the end of the disease. On the other hand, the pain is often considerable, while there is little or no discharge. The neighboring parts sympathize, as the glands of the groin, the testicles, the loins, the upper part of the thighs, and the muscles covering the abdomen. Sometimes the disease appears a few hours after the application of the poison, at other times not till six weeks have elapsed ; lastly, it is often impossible to determine whether the case is a venereal discharge, or rather one produced by application of infectious matter or only an incidental discharge arising from some unknown cause. If after a suspected connection, the symptoms which precede the com- mencement of the gonorrhosal discharge are perceived, the patient, in addition to the use of anti-gonorrhoeal remedies, should give heed to the following simple and plain directions. In diet and drink, he should avoid pickles, peppers, salt-fish, asparagus, and all very highly seasoned food — eating as much good and nourishing food as the demands of nature require : and drinking milk, black tea, water, &c, as much as is needful. Rest is important, and if a speedy cure is sought, the bed or sofa should not be quitted. The moment the discharge makes its appearance, the testicles should be supported by a suspensory bandage made expressly for that purpose ■ this will generally prevent swelled testicle. Much comfort is experienced by soaking the penis in warm water two or three times a day, and by keeping a piece of lint, wet with sugar-of- lead water round the glans-penis ; the lint should be wetted or changed very often. The penis should never be allowed to hang down, but must be kept up against the pubis by a handkerchief or bandage passed round the waist ; 13 176 GONORRHCEA. the penis should be wrapped in a small piece of muslin, projecting over the prepuce a sufficient length to catch and absorb the discharge, never blocking up the passage by putting dry cotton or a thickness of muslin over the orifice of the urethra ; this tends rather to increase than diminish the pain and discharge. No handling of the organ should be allowed, neither should any attempt be made to press out the matter, nor any sexual excitement whatever, be permitted ; if possible forget you have such a thing as a penis. The patient should be careful in keeping the glans-penis clean from all collections of matter, as they, if allowed to remain, may cause excoria- tions, which, by modern writers are called Balanitis. This disease is characterized by more or less redness and a muco- purulent discharge from the surface of the glans-penis, with or with- out excoriations. It rarely occurs alone, but is more frequently complicated with a similar condition of the internal surface of the prepuce. This affection may have a purely venereal origin, or it may succeed to connexion with women laboring under leucorrhma or whites, or other simple inflammatory affection of the vagina, or when this part is covered with secretions of a more or less irritating character. The Menstrual discharge will also frequently occasion Balanitis, and I have often seen great anxiety arise to married men who have suffered from Balanitis, the result of connexion with their wives, in one or other of the above mentioned states. Many persons are predisposed to Balanitis ; the prepuce of such per- sons frequently extending from half to a whole inch beyond the glans- penis, and hence such persons with a natural phymosis, or small praepu- tial opening usually contract that disease from the least exposure. The symptoms that ordinarily characterize the existence of that disease are increased heat and itching of the glans and prepuce, not unfrequently at its commencement pleasurable ; these symptoms may be attended with a phymosis or paraphymosis. When accompanied by the former, and the prepuce can be drawn back, the uncovered glans is red, swollen and tender ; I have seen the former occasionally suppurate, and a sympathetic bubo make its appearance in the groin, which, in short, disappears, by being anointed with camphorated oil. Balanitis may be complicated with gonorrhoea, or with true venereal ulcerations of the glans or prepuce ; it is commonly an acute disease, and GONNORHCEA. 177 generally gives way to proper remedies ; it may, however, through neglect, pass to the chronic state, or exist in such a condition from the commence- ment ; in either case, after release or cure, it is prone to be easily re- produced by slight exciting causes. The continuance of Balanitis in the chronic stage, may occasion enlargement of the sebaceous follicles (fatty seed vessels) vegetation at the base of the glans, thickening and hypertro- phy of the mucous membrane, adhesions between the glans and prepuce, or (according to Roux) " cancer of the penis;" it is also the most com- mon cause of phymosis and paraphymosis. Balanitis may also occur without being complicated with other and more marked venereal symptoms, or it may coexist with chancres of the glans or surface of the prepuce. In these instances where patients present themselves to me after a suspected intercourse, with phymosis and a muco- purulent discharge from the preputial openings, the physician must avoid hasty decision, as it is uncertain whether the disease is complicated with chancre or not; but as it frequently is so, he should be very guarded and cautious in resorting to any operation with the knife unless the danger of gangrene be imminent. In these forms of disease he must, in the first instance, subdue the inflammatory symptoms in the manner as the treat- ment of simple Balanitis; and an antiphologistic treatment must be followed up until the glans can be denuded, and the true nature of the disease with its complications thus made evident. When Balanitis is complicated with chancres the general inflammatory symptoms are to be first removed, and the syphilitic affection then treated specifically. To relieve Balanitis the parts are to be thoroughly cleansed with soap and warm water, and frequently bathed with a simple astringent wash until the penis assumes its usual healthy appearance — no internal remedies being required CHAPTER III. DISEASES WHICH SUCCEED TO GONORRHOEA IN THE MALE. Phymosis. — When the state of the prepuce is such that it cannot be drawn back in such a manner as to uncover the glans, it is denomina- ted phymosis. 178 DISEASES WHICH SUCCEED GONORRHOEA IN THE MALE. Phymosis may exist from birth, but is more frequently the result of gonorrhoea, syphilis, or venereal vegetation, or arises from simple exco- riation, a want of cleanliness predisposing it. It is productive of the greatest inconvenience, and the consequences are sometimes most serious. The appearance presented by this affection, varies according to the de- gree of inflammation. The swelling may be slight, and the parts nearly of a natural color, or the whole organ may be prodigiously enlarged, and the skin of a dark and purplish hue. At other times the prepuce is elon- gated over the glans to the extent of three-fourths to an inch and a quarter, and terminates in a narrow orifice. The consequences of a neglected phymosis may be the destruction of the prepuce and even of the glans, by mortification, though this result is not to be apprehended where the inflammation is not extensive, or of an intense character. Where the inflammation is light, it will in general, readily yield to rest, absti- nence, purgatives, the application of cold wet cloths with lead water, and the injection of tepid castile soap suds, between the glans and pre- puce. The application of leeches to the part, though objected to by some, is a most efficient means of reducing the inflammation. The penis should never be permitted, in this disease, to hang down, as the dependent position favors the accumulation of blood. In cases of greater severity, the most active measures must be resorted to, and it must always be recollected that delay, or an inefficient plan of treatment are highly improper, since the most serious mutilations may be the con- sequence. Physicians are frequently applied to by young men, whose foreskin or prepuce (to use a common expression) has the appearance of being infla- ted with wind ; this should produce no alarm ; its cause being violent exercise, the most appropriate remedy is rest. To relieve Phymosis in its incipient stage, the patient should take a brisk laxative ; and inject warm soap suds under the prepuce and around the glans three times a day, avoiding all violent exercise, stimulating food, drinks, &c. This treatment, in case the disease does not readily yield, should be continued only till a medical man can be consulted, as delay or improper treatment at this stage of the disease is attended with the most fearful results. Farayhymosis. — When the prepuce, after being drawn back, cannot be returned over the glans, paraphymosis is said to exist. DISEASES WHICH SUCCEED GONORRHOEA IN THE MALE. 179 This state of the parts may arise either from inflammatory enlarge- ment of the glans, which is seldom the cause, or from inflammation and consequent swelling of the prepuce, from which it generally results. It may be occasioned by forcing over the glans, a prepuce which is natural- ly small. It may also occur in difficult sexual intercourse. The most frequent cause, however, of the disease, is the retraction of the prepuce behind the glans, when the prepuce is already in a state of inflammation from gonorrhoea or chancre. In the commencement of phymosis, the pa- tient draws back the prepuce with a view of examining the glans ; under these circumstances, he sometimes finds he is unable to return it, and an opposite state of the parts is produced. Incipient phymosis is thus ex- changed for paraphymosis. Paraphymosis may also occur without sexual intercourse or any vene- real affection. Boys sometimes induce it by drawing back the prepuce. By whatever cause induced, the inflamed prepuce operates like a tight cord or ligature behind the glans, impedes or destroys the circulation through the parts, and occasionally, unless relieved, causes mortification of the prepuce and glans. My object in the treatment of this affection, is to relieve the glans of that state of stricture which it labors under ; and this should be effected as speedily as possible. I sometimes succeed in compressing the glans with the fingers, so that the prepuce may be drawn forward. The operation will be much facilitated by the application of cold water to the parts ; or the hand may be rendered cold by artificial means. The glans should be anointed with sweet oil, and pressure made with the fingers around its base or largest part, while at the same time an attempt is made to press it back and to draw the prepuce forward. When the inflammation is so great as to render the reduction by these means impossible, owing to the pain produced by compression, I fre- quently succeed by the application of leeches, and promote the flow of blood by warm fomentations. Should all other means prove unsuccessful and gangrene be threatened, recourse must be had to an operation which consists in dividing the whole of the strangulated portion of skin, to an extent equal to the length of the glans-penis, by a straight-bladed bistoury, introduced flatly, and th$ cutting edge then turned upwards. Stricture. — By a stricture is understood a lessening or contraction of certain parts of the calibre of the urethra (canal which conveys the urine 1 80 DISEASES WHICH SUCCEED GONORRH(EA IN THE MALE. IVoni the bladder ;) they are of two kinds, the spasmodic or temporary caused by a spasm which, for the time, contracts, or entirely shuts up the passage, and the permanent in which there is an actual alteration and disorganization of the part. Temporary Stricture, though a mere spasm of the part may be so violent and complete that no water can be passed, and of course great agony is experienced ; the attack of this description of stricture is gener- ally sudden; for instance, after free drinking, and the removal from a warm room to the cold air, I have noticed it frequently to happen; the proper means to be adopted are to get into a warm bath immediately, or if not at hand, to have hot fomentations applied to the perinseum, seat, and lower belly, and then if the water does not flow, send for a surgeon to pass an instrument called the catheter, so as to draw off the water, or to adopt such other means as he may deem necessary. Permanent Stricture, properly so called, is one in which there is an actual alteration of the canal or passage for the urine ; it is the result, generally, of the inflammation of long continued gonorrhoea; but it is by some surgeons supposed to arise from the use of injections for the cure of that disease; this is not the case, without they have been of such a nature as to increase the disease rather than remove it; undoubtedly the long continuance of gonorrhoea is the cause of the thickening of the mucous membrane, which constitutes stricture Strictures for the most part, are very slow in their growth, and form so insidiously that the patient does not even suspect such a thing, until his surgeon, by passing an instrument meets with considerable obstruc- tion, and informs him of the unpleasant truth. Symptoms of Stricture. — The most prominent symptoms of this de- scription of stricture are diminution of the stream of urine, its being forked or otherwise twisted and unnatural in its discharge from the penis ; and by a few drops being retained when all seemed passed, and which gradually ooze out and wet or stain the shirt ; or there can, after passing water, still be a few more drops evacuated by drawing the hand along the course of the passage, showing that a portion had lodged in it. More or less pain or irritation, sometimes only a sensation is felt in some part of the canal as the urine passes there ; -this is followed, perhaps, at a distant interval, by a more frequent desire to pass water than before, and it often happens that the sufferer is called from bed two, three, or DISEASES WHICH SUCCEED GONORRHOEA IN THE MALE. 181 more times in the night to do so. These are the earliest symptoms of stricture ; the obstruction increases until the urine, passes only by drops ; coition gives pain, and the semen is not evacuated during the act of copulation ; and there is a constant running of mucus ; these symptoms should arouse the sufferer to avail himself of surgical aid, as his own endeavors at a cure would be worse than futile. Until medical aid can be obtained, the best remedial agents are warm baths and diuretics. A warm bath should be taken every night on going to bed, and a teaspoon- ful of the following prescription in a wine glass full of Holland gin and water ( equal parts ) four times a day : Balsam Copaiba, ) ,. , , Solution of Potash, \ ol each ' two ounces ' Hernia Humor alts. — " This term is applied to that species of swelled testicle which arises sympathetically upon any considerable irritation in the urethra, whether excited by strictures, saturnine injections, bougies, or the specific inflammation of gonorrhoea. The generic name now given to it by modern surgical writers is orchitis, from op^i£, a testicle, and which is generally preferable, as possessing the true character of a defini- tion according to the present nomenclature. Orchitis is characterized by a painful swelling and inflammation of the testes and epididymis. It is sudden in its attack, and as sudden disap- pears under appropriate treatment. It is sometimes very violent in its onset, and involves the spermatic cord, and especially the vas deferens, and spermatic veins, which often become varicose. Sometimes it is trans- ferred from one testis to the other. However high the inflammation, it is seldom known to suppurate, and never if proper treatment be adopted, " The disease most frequently arises from previous gonorrhoea, and espe- cially when the discharge has been injudiciously suppressed by astringent or saturnine injections into the urethra. When the tumefaction com- mences, the pain and burning in urinating ceases, and the discharge retires altogether ; but all these symptoms return so soon as the inflammation in the testicle is removed. Strangury to an alarming extent, sometimes accom- panies the swelling and stopping of the discharge, and hence, many judicious practitioners invite the return of the secretion from the ure- thra, thus removing the hernia humoralis more speedily." Hernia humoralis, although most frequently connected with gonorrhoea, may arise, as already intimated, from stricture, bougies, self-abuse, and 182 DISEASES WHICH SUCCEED GONORRHOEA IN THE MALE. the improper use of strongly purgative medicines of a saline or acrimo- nious class ; but so common is it from the use of irritating injections, that many surgeons object to their use, entirely on the ground of their giving rise, not merely to swelling of the seminal glands, but even to diseases of the bladder. They are the hobby and reliance lever, of many practitioners of the present day ; and are perhaps productive of some of the most painful, as well as long continued diseases (if neglected) with which from its general antecedent cause, i. e., gonorrhoea, I am acquainted with. Injections are composed chiefly of Tannin, G-um Kino, Pulv. Cin- ehonse (Peruvian-bark,) Pulv. Myrrh, Liquor Calcis, G-um Catechu, Alum, HydrargyriBichloridum (Corrosive Sublimate,) Sugar of Lead, Grum Opium, and finally, almost everything of a caustic or astringent nature. Let reason take its throne, and I will attempt to delineate the abuses resulting from their use. I am free to acknowledge, that in the first stages of gonorrhoea, cases are known to have been effectually checked, and in a short time, cured, but in many, and by far the greater number of cases, injections produce orchitis, (swelled testicles), &c, of which I shall make brief mention. It is an axiom in the Laws of Nature, that a smaller body is driven on by the force and impetuosity with which it is acted on, or impelled by a larger, when no reasonable cause for obstruc- tion exists. If this law is true, I am prepared to commence my argu- ment. I said in another part of my treatise, that the gonorrhoeal dis- charge is at first situated in the fossa navicularis, and vicinity of the bulb, extending on an average from three-fourths, to one-and-a-half inches down from the orifice of the urethra, and if so situated, the force which usually accompanies a discharge from the syringe will drive the gonorrhoeal matter in the channel towards the scrotum, &c. This matter is capable, if suffered to remain on any mucous surface, of producing excoriation, and inflammation ; and happy is it for the patient, if the matter, or injection fluid does not reach the testicles or bladder, which, if it does, a single case will describe their baneful effects. A young man applied to me for medical aid, about the first of August, 1851. He like many youth of his age, in an unguarded moment contracted gonorrhoea. Not being ac- quainted with the medical part of community in the place where he re- sided, he applied to a certain man (call him no physician, it is an insult to the profession) for relief. DISEASES WHICH SUCCEED C40N0RRHCEA IN THE MALE. 183 Injections were immediately recommended, and faithfully used, for the space of two or three weeks ; at the expiration of which time he was seized with a violent pain, accompanied with a slight swelling in the left testicle. He informed his " adviser," who, discontinuing the injection, urged bathing the parts with cold water, — this done to no avail, he was directed to desist from the use of the cold-bath, and (to use the adviser's words) " apply two or three good warm bread and milk poultices, which would certainly reduce the swelling ;" at the expiration of this time, the testicle had swollen to the size of a medium sized goose egg. He was continually racked with excruciating pain, and sleep was a stranger to him. When he applied to me, he entered my office with cane in hand, (for without its aid he could not walk) and with feeble words, and feebler state of health, attempted to lisp with disconnected accents, the cause of his complaint. Such kind reader, is the brief outline of a single case, numbers could be cited, but my time and space will not permit. The young man in due time recovered, and now enjoys uninterrupted good health. I must not argue against the use of a thing from its abuses ; all I can say for certainty, is, that here I have proof of the danger and impropriety of attempting, or having done for myself what an experienced surgeon would altogether forbid, and which can be done, in another, and far better way. Let the patient think of the ultimate results of inflammation and enlarge- ment of the testicle. It is not merely present suffering, though that may be exquisitely severe ; it is impossible but that the functions of the gland, as a secretory organ destined to preparo and secrete the semen, cannot but be materially injured by destructive inflammation, so that no folly can be greater than losing a single moment in applying for proper ad~ vice under such circumstances. At the first appearance of the swelling, the testicle should be supported by a suspensory bandage, and the following powder taken every noon and night. C Antimonial Powder, one grain, 1 Powdered Nitre, one grain, ( Pulverized Camphor, three gvains. As an auxiliary, the testicle should be rubbed with Camphorated Oil every night on going to bed ; the proportions are. $ Olive Oil, one ounce, | Camphor Gum. thirty grains, 184 DISEASES WHICH SUCCEED GONORRHCEA IN THE MALE. This treatment will, by proper attention to the diet, state of the bowels and rest, if continued for a few days, effect a cure. It is not unfrequently the case that this affection of the generative functions is mistaken for Hydrocele, Sarcocele, &c. It differs from the former by its sudden and severe pain, especially if recent, and if of long standing, (which frequently is the case), by the peculiar hardness of the epididymis, and its non-transparency. It may be distinguished from sarcocele, by its lightness, in comparison to the enormous size it frequently acquires. It may be known from schirrous cancer, or scrofula, by the slowness of its progress in the development and size to which the disease attains. These few hints should be carefully attended to, as many serious, and in time, fatal consequences, may be incurred by making a wrong diagno- sis of attending symptoms. Gleet — Assumes nearly the same changes and appearances as Gon- orrhoea, and no doubt in many instances, is the remnant of Gonor- rhoea without inflammation. Gleet also arises from stricture, from debi- lity which is often caused by Onanism ; it is then called Mucal Gleet, and from ulceration. It is most apt to occur among men of naturally unhealthy habits, and when formed, whatever be its cause, requires the nicest tact and management for its removal. The only modes of distin- guishing Gleet from Gonorrhoea are these, viz : Where there is pain on passing water, irritability of the bladder, tenderness in the perinaeum or neighboring parts, and the discharge plentiful and offensive, staining the linen with a foul spot, it may with certainty be decided to be Gonorrhoea; but where the discharge is next to colorless, like gum water, for instance, and where there is no other local uneasiness than a feeling of relaxation, and it has existed for a long time, often for many years, and was or was not preceded by Gonorrhoea, it may fairly be called a Gleet, or more pro- perly a chronic inflammatory state of the lining membrane of the urethra. Gleet may be produced by loss of tone, in some or the whole portion of the secretive vessels, induced by many of the accidents of life, or physi- cal intemperance, when they not only void various kinds of fluids at in- tervals, which impair the muscular and nervous energy of the generative organs, but render persons laboring under this description of weakness, very susceptible of infection, should they hold sexual intercourse with those who are slightly diseased. Of all diseases, Gleet is the most de- DISEASES WHICH SUCCEED GONORRHCEA IN THE MALE. 185 ceptive, for when the patient, by adopting strict regimen, and abstaining from every stimulant likely to create inflammation, finds himself better, the discharge diminished, and congratulating himself on the supposed de- parture of a troublesome complaint, out it springs again, in all the strength and obstinacy of its character ; and thus, from day to day, and week to week, the patient is harrassed and annoyed. While the slightest appearance of even a clear pellucid discharge remains, as I said before, it is unsafe to attempt intercourse, and therefore a bar is placed against entrance into the marriage state, which may, by neglect or unskilful treatment, be prolonged for a painful length of time. Temperance and regularity of diet and exercise will materially assist the effect of medi- cines, by gradually diminishing the discharge, and ultimately relieving the patient of his long continued torment. Premature mortality has been the consequence of a long continued and neglected gleet ; for it is a reasonable inference that the constant waste of this fluid will exhaust the powers of nature, and lead to an untimely decay of the bodily faculties. Intercourse with women will often cause a return or increased discharge, and when that happens, the person frequently suspects a fresh infection ; but the patient can be relieved from his fears by observing that the old gleety discharge commences immediately after connexion. The remedies I employ in Gleet are Coculus Palmatus, Xanthoria and Salicine ; which are the only real antidotes in connection with Saline Aperient Medicines as often as the latter are required. Prostrate Gland. — An eminent writer says, that the use of this gland is not sufficiently known to enable us to form a correct opinion of the evil results (aside from swelling) arising from its diseased state. Situated as it is, at the connecting link between the urinary and genital apparatus, and forming part of the urethra, if swollen at any time, the result is a partial or entire obstruction of the passage of the urine in its exit from the bladder. A swelled or diseased state of this gland is attributed to several causes, among which the following may be cited: Inflammation of the urethra from neglected or mal-treated gonorrhoea; abscess; calculi formed within the gland ; a dilated or enlarged state of its vessels, &c. Many anatomists of the present day, give it as their opinion that this gland is of itself, not very sensible, from which it may be correctly in- ferred, that it is more liable to chronic than acute forms of disease. 186 DISEASES WHICH SUCCEED GONORRHCEA IN THE MALE. Baillie says that he has seen a common abscess situated in it, and adds that it is also subject to scrofulous disease, as on cutting into it, he has met with the same white curdy matter which is formed in a scrofu- lous absorbent stand, and has, likewise, forced scrofulous pus out of its ducts. Schirrosity, a hardening enlargement, and an incipient cancerous con- dition of this gland, is a disease to which men advanced in life are sub- ject. It is, however, brought on in younger persons by imprudently producing an excitement of the seminal vessels, by long toying with wo- men, or by unnatural means, as Onanism. The frequency of the disease may be in part attributed to the unusual degree of irritation, which, in the present licentious state of society, is kept up in the organs of genera- tion. In treating this disease, the patient should be subject to an antiphlo- gistic regimen, opiates, clysters, leeches, warm baths, and absolute rest, on a sofa or bed. Hermaturia or Bloody Urine, is the result of some injury done to the external organs of generation, or the passing through the urinary channel of any rough instrument, gravel, &c, the imprudent use of terebinthinate medicines, sudden exposure to, or immersion of the parts in a very cold or ice water bath, while suffering under a protracted gonorrhoea. The remedy for its suppression is simple. Common table salt, taken in doses suitable to the age, habits and temperament of the patient, when no irritating or rough substances remain in contact with the mucous lining of the urethra and urinary ducts, will, in most cases, check the flow. The same remedy may be used with advantage in Hcemoptysis, or spitting of blood, and in all cases of bleeding at the lungs, and rupture of a blood vessel. GONORRHOEA IN FEMALES. 187 CHAPTER IV. GONORRHOEA IN FEMALES. Gonorrhoea in the female is for the most part a disease of a very dif- ferent character to that in the male ; the anatomical structure and func- tions of the organs implicated modifying the affection both in its seat, its course, its treatment, and its termination. This disease recognizes for its pathology acute or chronic inflammation of the vulva, vagina, uterus, or urethra ; the inflammation itself being of a specific character, the result of impure cohabitation, and capable of producing gonorrhoea in the male. In the female, gonorrhoea is not con- fined to the urethra ; it is more commonly seated in the vagina, and in the mucous membrane reflected over the neck and mouth of the uterus. It is more difficult to determine its existence in females than in males, nor is it in them attended with so much pain. The disease may be con- founded with a discharge very common in the sex, which is called leucor- rhoea or fluor albus. It is remediable by the same means as are adopted for the treatment of males. Cleanliness is still more essential in women than in men ; the vagina should be thoroughly cleansed and rinsed out three or four times a day with weak castile soap and water ; the wash to be injected in the vagina with a glass female syringe. Also the external parts should be frequently washed with the same liquid. The perinaeum and the inner parts of the thigh should be anointed with white cerate or spermaceti ointment, after each washing to guard against the contact of the matter from the diseased parts, which frequently cause great irritation. 188 INFECTION. CHAPTER V. INFECTION. tl I will visit the sins of the fathers upon the children unto the third and fourth generation." Exodus, chap, xx, verse 5. II faut mieux se marier que de bruler.* I am perfectly aware of the equivocal character of the ground I am now about to occupy ; but is the philanthropist to relinquish his task be- cause he is exposed to danger or inconvenience in its prosecution ? Framed as society is in the present era, with pampered appetites ; accustomed as its members are to stimulating drinks, and that intoxication of the imagi- nation, which is the certain consequence of the present ordinary associa- tions of young, aye, and old men, too, I am sorry to say, promiscuous intercourse of the sexes does, will, and (I might almost say) must exist ; demoralizing as is the habit, pregnant as it is with fatal consequences, which cease not with man's own life, but are borne forward as a curse to posterity. Promiscuous intercourse will, in all cities and large towns exist to an extent that few, save those placed in the position I occupy, are aware of. Knowing this fact myself, I must insist on the moralist assuming it : shall I not then endeavor to guard my reader from the horrible conta- gion ? shall I not present knowledge to him as a shield to ward off the fatal effects of his weakness and his vice ? will not the blessings of thou- sands yet unborn attend the man who will avert from them the conse- quences of that specious disease, which to an extravagant extent is under- mining the physical power of the nation, and which, from the Rightfulness of the scourge appears to have been intended to frighten the vicious of the human race into propriety ? but it has not so done, or these remarks would not have been necessary ; and consequently, never have been written or made public by me ; and here let me suggest that the proba- ble cause which creates the thousands of puny offspring that we see in every crowded thoroughfare, is this habit of intercourse with, we know not who ; it is this which causes nine-tenths of the hereditary diseases to which mankind is liable ; it is this source of impurity that vitiates the blood, and destroys the constitution ; it is this baleful habit that gives •Better to marry than burn. INFECTION. 189 rise to scrofula and consumption, those terrible diseases which destroy the young, the lovely, and the innocent in the spring-time of their bloom ; destroying them as does the worm in the bud," leaving the bereaved parents to grieve and lament, happily unconscious that their own evil acts in the heyday of youth have caused this early blighting of their choicest flower : it would be useless to point out more particularly instances of the evils flowing from venereal taint ; but be assured, dear reader, that they are as numerous as are the sands on the sea shore. It is not the province, had I the talent to do so, of one of my profession to read a homily on this or any other vice ; that I leave to others better qualified for the undertaking ; but I fear the hot blood of youth would not, on this subject, listen even " to the voice of the charmer, charmed he never so wisely," and that, still, the youth of this age would continue to embrace the painted and bedizened prostitute, whose touch is contagion, whose very breath is contamination, and in whose embrace lurks death itself. If, then, as I fear, young men, ye will not be persuaded to refrain from the temptations that are before you at every step, I will endeavor to throw a shield around you that will prevent to yourselves, your wives, and your innocent offspring, the evils which arise from venereal taint ; my motto in defence for this exposition of a prevention is, " that of two evils, choose the least ;" this can only be done by pointing out to you such pro- phylactic or preventive measures as will, with ordinary care, while run- ning your career of vice, prevent your being tainted with this scourge and curse of civilization. There are many ways of contracting this dis- ease other than by illicit intercourse, viz : sleeping in filthy beds, not observing due precaution in places of necessray resort, igniting cigars from strangers, drinking out of a glass, earthen ware or pewter vessels with travellers, and improvident exposures otherwise. The remedies to obtain relief and a permanent cure in either case are the same ; the only difference is, that the disease obtained by illicit intercourse, yields more readily to the effects of the prescribed remedies. I have learned in such cases to adopt an old usage, "an ounce of prevention is worth a pound of cure." But before I proceed to the consideration of the prevention of this dire disease, permit me to throw out a few hints that may put you on your guard against concealed dangers : these hints are founded on the personal experience of one who has seen much of life, and who has learned more from those who have sought him in his medical capacity, and in 190 INFECTION. that capacity who would not, more than a good Catholic does, when con- fessing to his priest, seek to deceive him. 1 st. Always suspect you may be contaminated, whoever may be the woman you may have been familiar with, except she be your wife ; regard her not as free from taint because she may be a wife or mistress; or even because she is your own mistress ; rely upon it that you are not safe with a woman whose duty or privilege it may be to confine her favors to some other man, or who sells them to you for gold or other bribe, perhaps under the semblance of affection. I care not if she be maid, wife, or widow, modest or gay ; if she consent to illegitimate embraces of one man, she will, for the same or a higher bribe, admit a thousand, if she can induce them to believe in the same fool's elysium. Therefore having had connection with any woman save your wife — and I presume you have none, or you are ten thousand times a villain, on account of the danger to which you subject her and your offspring — immediately make use of the measures presently to be pointed out, just in the same manner as if you had recreated yourself with a damsel in North-lane, whom you had picked up in Ferry-street. 2. Be not tempted when intoxicated ; you cannot take care of either your person or purse ; and never, under any consideration, remain all night with your female friend ; if you do the chance of infection is much enhanced, as will presently be explained. 3. As soon as the act is accomplished, get up ; the poison is speedily absorbed, because the parts, when excited, are like a sponge distended by water ; very soon after the excitement is over, they are like a sponge from which the water is pressed ; in this case it must be obvious that it would be impossible to remove that portion of poison which would be inclosed by the new closed pores of the skin, and all the preventives in the world would not avail you if your constitution of itself did not resist the same. 4. Avoid those women who are over-anxious in demanding an examin- ation of their person ; the chance is, they are diseased, and only put on this bravado to throw you off your guard. 5. If, on the other hand, a woman seems very particular in excluding the light, be suspicious, at least, glance at her linen; it may be stained ; and the disgust which I should hope this would occasion, might keep you from her embrace and out of her danger. INFECTION, 191 6. If a woman have her Monthly Illness upon her, let no excite- ment induce you to have intercourse with her ; even drunkenness is no apology for such bestiality, to say nothing of the additional danger of infection. 7. All mock modest of the tribe of milliners, dress-makers, bonnet- makers, stay-makers, &c, &c, are dangerous, for the same reasons, and from not being absolutely on the town, though no better in fact than the dames de salon, will think they have a right to make you pay very " dear for your whistle." 8. Let not those panders to the profligacy of our sex, such as Mother P , or Mother E ~, make you believe that through their means you can purchase the first embrace of any girl — depend upon it, there are very few so depraved as thus coolly to sell themselves. I might as well tell you of a young man who was induced to purchase a warranted country article of this sort, for which he gave a considerable price ,* he was very content with his bargain for a day or two, but at the end of that time he perceived certain suspicious appearances which induced him to apply to me, not for a moment believing that he could have been over-reached ; oh no ! I soon, however, convinced my too confiding friend that if he had not this time unloosed the virgin cestus, and added another to his trophies in the field of Yenus, he had succeeded in adding another to the list of his misfortunes. 9. Remember that a woman may have no appearance of disease ; nay, may not know she has it, and this for a length of time, and yet be able to communicate to different men different forms of infection. A very short-seeing moralist will blame me much for the hints I have already thrown out, and still more shall I be censured by such an one for endeavoring to point out the best method of avoiding infection ; he will say the crime is deserving of punishment ; this is true, but punishment should be confined to the criminal ; it should not be shared with an in- nocent wife ; it should not be entailed with additional violence upon children which are yet to be born ; the most rigid moralist would hardly wish a punishment to descend to a third and fourth generation ; and, though this be the actual curse which G-od has informed us will be so en- tailed, in his infinite mercy He has imparted to man a knowledge which may avert it, and shall we have the wickedness to let this secret perish with us, or withhold the mercy which he has thought proper to offer to his 14 192 INFECTION. erring children ? Away with such an absurdity ! Besides, the object of all punishment ought to be to prevent crime, for the future, in the now guilty one ; and, as far as possible, by its terrors, to deter others from the commission of a like act ; but does the punishment in this instance deter others ? Far from it ; nor is it possible, as society is now consti- tuted, that it should do so. Consider the millions of men who cannot from pecuniary wants marry until late in life, if at all ; whom were they to lead a life of pure celibacy in eight cases out of ten would be an im- possibility, many in that case have recourse to that self-debasing, suicidal practice — masturbation, the evils of which I have set forth in another part of this work ; this cause leaves a great number of females unmarried, and it is difficult, nay, sometimes so impossible for a female to procure subsistence by honorable means, that we can scarcely wonder if they to prolong life, (although that life must be wretched) have recourse to dishonor. In almost all populous cities there are so many poor girls whom the tradesmen inconsiderately curtail in the prices of piece work, that the midnight oil is consumed to such an extent that the poor slave, (if I may be permitted the expression) as an only alternative is, as it were, com- pelled to yield to the ruthless defamer of female virtue, perhaps many times incited by the promise of future marriage ; public opinion is against them ; the least seeming inconsistency in a female is often fanned to a mighty flame, while the other sex can with impunity commit these lesser evils, and nothing is thought of it. This, being once accomplished in a female, her aim is by dress and gaiety to drive away remorse ; new wants are created ; they become hardened in profligacy, and then, by their smiles and other lures, endeavor to seduce the youth of the sex from whom their woes originated. This is the career of many ; but what mul- titudes of unhappy females fall victims to the passions of idle and luxuri- ous man, and crowd our streets with wretches who can only exist by the charms which the neglect o" their seducer may not wholly have de- stroyed ! Exposed to such temptation, shall a young man, and his posterity, be left the "victims to so deadly a disease ? I envy not the moralist who would have this ; his heart is incapable of love for his fellow creatures. Such being my views of the subject, few men, I trust will think me guilty of being the pander of vice because I endeavor to point out the means most likely to eradicate this scourge from the human race. I am doing INFECTION. iy3 no more, in preventing the evil consequences, than do my professional brethren when they endeavor to cure it when it has entered the system, and, alas, too often unsuccessfully. I trust enough has been said, to satisfy any unbiassed mind of the practicability of my purpose : and here I would remark, that if you are in the habit of indulging in promiscuous intercourse, provide yourself beforehand with the specific I shall presently mention ; if you should be captivated by a syren when you have it not about you, as soon as connection is ended, wash the parts with soap and water, and dry them on a clean napkin, then pass your water as soon as possible ; this being done, hasten home and use the following lotion : C Liquor of Potash, one drachm, < Compound spirits of Rosemary, one ounce, I Rose Water, eight ounces. Mix, and apply very freely, by means of a sponge. This application of itself often destroys infection. When the washing, which should embrace the upper part of the thighs, as well as all the external genital organs, is completed, a weak prepara- tion of the compound solution of Alum, as prescribed according to the London Pharmacopoeia may be used on the prepuce and around the glans-penis as a wash, and an injection of the same every morning and evening, after the following order. As a great many persons do not know the best manner of using an in- jection, and by using it unskillfully do more, harm than good, I will throw out a few hints for their guidance. The syringe must be a glass one, and in affections of the generative organs, should never be used under any pretence whatever, except as a preventive immediately after illicit intercourse ; and when so used, should be held by the right hand, the index finger being placed on the button for the purpose of discharging its contents. Place the first finger and thumb of the left hand on each side of the part that emits the water ; this is for the purpose of steadying the mouth or nozzle of the syringe, and retaining the injection when thrown in. Make pressure with the second and third fingers of the left hand on the urethra, through which the urine flows, just before the scrotum con- taining the testicles ; this is to prevent the injection going too far up the passage, and thus causing inflammation. Use a syringe which will contain about a half an ounce of the injec- tion ; for two applications this will be sufficient. 194 INFECTION. Introduce the point of the syringe very carefully, and for a very short distance ; only so far, in fact, as may be necessary to admit of its con- tents being thrown up. Depress the piston slowly, and when half the contents are thrown in, remove the syringe, and retain the injection by means of the thumb and finger, as already directed. It is proper to retain each portion of the injection for a minute or two. Kepeat the whole process four or six times while you are about it, and again two or three times the next day ; of course the use of the syringe is to wash out that description of poison which gives rise to gonorrhoea. The means above recommended are very simple, but the author has every reason to believe them efficacious ; having in former years com- municated these remarks to some of his acquaintances, who have escaped without contamination in every instance, and have proved them worthy of trust, when these hints have been strictly adhered to. If by accident, you are without the lotion, the best thing you can do after frequent ablution, is to use strong spirits externally, in the manner directed for using the lotion, until you can procure it. Finally, if unfortunately from want of caution, or other cause, you find yourself smitten by the plague I speak of, beware of advertised nostrums and penny-catchers, who hold out inducements to cure you in a single day. Such promises, in ninety-nine cases out of a hundred, cannot be realized. They and their nostrums are alike worthless, and only calcu- lated to empty the pocket and ruin the health. If such a fate does be- fal you, apply to a medical man, wo can give you sufficient evidence that he has acquired a thorough knowledge of Medicine and Surgery ; rest assured, he will not betray your confidence, and let no time be lost in making such application. Did I know of any work of a popular nature, likely to benefit you, I would recommend it. All the works, however, that I have seen on the unhappy malady, are either calculated for professional perusal only, or are the baits thrown out by empirics to catch purchasers for their speci- fics. Most books of the latter character, are copies of some English work fraudulently obtained, and thrown before the public. INOCULATION* 195 CHAPTER VI. INOCULATION. Through the kindness of several eminent physicians, some of whom having in charge hospitals containing indigent persons, and others willing to be experimented on, by Inoculation with the different kinds of vene- real virus, and noting the different effects at different times, I am pos- sessed with the result of their experiments and observations, which I will take the liberty of reverting to in these pages ; and in so doing, I would here say, it has not been my peculiar province, situated as I am, to make all the experimental observations to prove what I desire in regard to this important topic ; but I am far from censuring any of my professional brethren for making these experiments, although done many times at great risk of health. Both before and since the time of Hunter, Inoculation has been em- ployed for the purpose of testing the character of syphilitic diseases > and at the present day, M. Eicord, Surgeon to the Parisian Civil Vene- real Hospital, has deduced from an extended series of experiments certain conclusions of great value and importance which he has given to the world in his great work entitled " Traite Pratique des Maladies Veneriennes, ou Kechcrches critiques et experimentales sur l'Inoculation, apliquee a 1' etude de ces Maladies ;" for a more extended account, the reader is re- ferred to the above work. He establishes in the first place, that a chancre, wherever it may be situated, is produced by a specific matter which is secreted by a chancre only ; which matter produces a similar disease whenever placed in cir- cumstances favorable to contagion. This specific matter is only secreted from the surface of a chancre du- ring its first stage, that is, during the period of ulceration, or when the sore is indolent or stationary. At these periods only does a chancre se- crete a specific matter, capable of producing a similar disease by inocu- lation. When the sore begins to heal, and a process of reparation has commenced, it is merely a simple ulcer, does not furnish a specific secre- tion, and is not capable of propagation by inoculation. If the matter from a chancre during the period of ulceration be intro- duced under the epidermis, the following changes are perceptible in its 193 INOCULATION. progress when nothing is done to aggravate or lessen its advances : the first that is perceived is an inflamed spot ; then a small watery pimple ; which, discharging its contents, displays a rapidly enlarging ulcerated sore ; in its centre an excavation is seen extending beneath the skin, ex- cessively painful and sensitive ; a blush of a dark fiery redness is seen around the ulcer, and the skin becomes unusually thickened and indura- ted ; the diseased surface is yellow, its edges are hard and ragged, its outline irregular, and there is a feeling of solidity to the touch. The thickened base is one of the most obvious peculiarities of the true syphi- litic chancre. After the sixth day, the contents of the " pustule" thicken and, (covered with crusts which enlarge at the base,) are formed by suc- cessive strata, and at length assume the form of a truncated cone, with its apex depressed. If the crusts are detached, an ulcer with a hard base extending the whole thickness of the skin in depth is laid bare. The surface of this ulcer is of a deep red color, is foul, and covered with a thick, adhesive pultaceous matter, almost like a false membrane, which cannot be removed by any attempt to clean the sore. The edges of the chancerous surface appear at this period as though they had been dug out from the surrounding parts by a sharp circular instrument. The imme- diate vicinity of the sore is surrounded by a red, dark, or livid margin, more elevated than the surrounding parts. ■ It is also conceded, that chancre in its commencement, is purely a local disease ; that constitutional or secondary affections can only take place after this antecedent ; that they do not occur in all cases, and only after the lapse of a certain period of time. Whatever may be the varieties and complications which subsequently follow or accompany the inoculated chancre, the progress of the latter is in all instances such as I have described it. The pustular form of incipient chancre is only wanting when the parts to which the virus is applied are destitute of epidermis or epithelium, and it is only preceded by phlegmonoid inflammation when the matter has been introduced into the subcutaneous cellular tissue, or into the lymphatic system. The ulcerations completely destroyed or arrested on the third, fourth or fifth day from the application of the poison are not liable to secondary inflam- mation. It is not before the fifth day that the induration of chancres commonly commences, and it is' the indurated* chancre that it is generally followed by secondary symptoms ; this induration seems to indicate that INOCULATION. 197 the affection has become in some measure already constitutional ; as long as there is no induration, the disease is supposed to be merely local. The varied appearances which primary venereal sores present, have given rise to arguments against the identity of the virus, and have led to the promulgation of the theory of a plurality of venereal poisons. Ino- culation, however, sets this matter at rest, for whatever may be the actual character of the sore from which the pus is taken, provided we take it from the first stage of the chancre, that of ulceration or indolence, we obtain by inoculation a regular pustule when the matter is introduced beneath the surface of the epidermis or epithelium ; an ulcer where it is applied to a denuded surface, and an abscess when it is introduced into the cellular tissue, or lymphatic system. The various characters of chancres or primary venereal sores, are due to circumstances which are foreign to the cause that produced them ; these are principally the particular constitution of the patient, his mode of living, the influence of any antecedent or present diseases with which he may be affected, and not least, the local treatment of the sore. It is from one or many of these circumstances that phagedenic ulcers make their appearance in subjects who have contracted their disease from others affected with ulcers of the simplest character. The first stage of chancre, i. e. ulceration or indolence, is the only one from which inoculation is effected. The period of this stage is not limited. The researches of M. Eicord on the diagnosis of buboes, brought hhn to the conclusion that they are of two kinds ; simply inflammatory and virulent, The first, may succeed to gonorrhoea, balanitis, violent exer- cise on horseback or walking, and sudden exposure to cold. The last, is the consequence of the absorption of the syphilitic poison in the sys- tem, which is liable, if neglected, to suppurate. To the pathology of bubo, I shall revert, in a succeeding chapter ; in this place merely detailing the result attained by inoculation from buboes in a condition of suppuration. M. Ricord deduces from his experiments upon buboes in a state of ulcer- ation, the following conclusions : " that a virulent bubo, or one resulting from the absorption of the specific pus of a chancre, is a disease precisely similar to chancre ; merely differing from it in its situation and the anato- mical organization of the parts affected ; that this species of bubo is the only 198 INOCtTLATlON, one capable of prodttcing a pustule by inoculation ; that the symptoms hitJb- erto indicated by. authors with a view of distinguishing the differential diag- nosis between a truly virulent bubo, and one merely inflammatory, are of little value, inoculation being the only certain and pathognomic sign." He admits the existence of buboes which are not preceded by any other syphi- litic affection : these make their appearance at a certain period after impure connection without the intervention of chancres, gonorrhoea, balanitis, or other form of primary irritation, The existence of these buboes is also admitted by Fallopius, Astruc, Swediaur, Bertrande, and Dr. Mordret, in a memoir inserted " in the Beeueil periodique de la Societe de Medicine," for August, 1837. These buboes are termed by the French Surgeons " buboes d'emblee," and may be either simply inflammable or syphilitic M. Bicord insists that when these buboes occur without the intervention of any antecedent form of disease, it is impossible to judge of their true character without recourse to inoculation, and consequently impossible to heal them rationally or well. He maintains that those only which furnish the characteristic pustule of chancre by inoculation, are those only which are capable of being followed by secondary symptoms. Those from which no pustule can be obtained by inoculation are simply inflammatory, and must be treated on general principles. With reference to the test of inoculation itself, some degree of differ- ence of opinion exists, although M. Bicord states that the reason of this is, "that the experiments have not been made in a proper manner." On this point I consider this author's opinion worthy of attention. When- ever inflammation and suppuration of the cellular tissue, or lymphatic- glands of the groin, is owing to any other cause than the occurrence of chancre, the pus secreted furnishes no result from inoculation at what- ever periods, and under whatever circumstances the test be made. Neither does it follow of necessity that buboes succeeding to true chancres will furnish a specific pus; and consequently, by inoculation, a characteris- tic pustule. That this may occur it is necessary that the bubo shall not merely be owing to a simple sympathetic inflammation, but that actual absorption of the specific matter of the chancre shall have taken place. When absorption of the matter from a chancre on the genitals takes place, it is generally confined to the superficial glands of the groin ; and most frequently the syphilitic poison is conveyed to one gland only, although many of the glands in the immediate vicinity of the latter, both super- INOCULATION. 199 ficial and deeply seated, are inflamed and suppurate at the same time, so that the matter taken from one gland shall be purely syphilitic, and give rise, by inoculation, to the characteristic pustule, whilst those in its im- mediate neighborhood, and the cellular tissue, shall be affected with sim- ple phlegmonoid inflammation, the pus from which, shall, when tested by inoculation give a negative result. * It may be very readily conceived, that the irritation produced by the passage of the syphilitic poison through a lymphatic vessel and ganglion may excite in the neighboring organs an inflammation which is not spe- cific, but merely phlegmonous, and this appears to be the true nature of the case. M. Ricord opened a bubo which had succeeded to a chancre, the pus from which produced no result by inoculation. In the centre of the abscess, he discovered an enlarged lymphatic gland, presenting an evident fluctuation ; this was punctured and tested by inoculation, the characteristic pustule of chancre was obtained. Discharges from the urethra are of two kinds, resulting either from the existence of a true syphilitic ulcer in some part of the passage, or owing to gonorrhoea properly so called. Chancres, or syphilitic ulcers of the urethra, to the consideration of which I shall return in a particular ar- ticle, are in all respects, except situation, of the same character as pri- mary sores, and give rise to the same results when the matter is tested by inoculation. The matter of gonorrhoea applied upon a mucous surface produces an inflammation and discharge of the same character. In no instance can it produce a true syphilitic sore ; although by remaining in contact with a mucous surface for a certain period of time, it may occasion a greater or less degree of excoriation, but is not capable of producing a specific ulcer, as the researches of Ricord, t Hernandez, t and others, incontestibly prove. The diseases which are consecutive to gonorrhoea, as sympathetic buboes, &c, do not secrete pus capable of producing a specific ulcer by inoculation, neither do secondary or constitutional symptoms ever succeed to a simple gonorrhoea, I think that in rare cases where secondary symptoms have been said to have followed a simple gonorrhoea, that the diagnosis of the primitive * See Ricord, op. cit. p. 142, et suivantes. t Memoires, sur quelques Faits observes a FHopital des Veneriens, par P. Ri cord. Memoires de l'Academie Royale de Medecine. Tome 2me. % Essai analytique sur la Nonidentite des Virus gonorrhoique et syphilitique j par J. F. Hernandez. Toulon, 1812. Art. iv. 200 INOCULATION. disease has not been exact, that the diseased surfaces have not been properly examined, and the cases have been concealed chancres of the urethra, and not gonorrhoea. It is also extremely probable that such were the forms of disease that embarrassed Dr. Wallace, who says that he had met with some forms of discharges from the urethra, which were beneficially influ- enced by mercury, and which he, according to the best of his medical knowledge, was unable to cure without its exhibition. The pus of gonorrhoea, tested by inoculation, produced no result ; it may be followed by inflammation, but never produces a specific sore ; in- jected into the urethra, it produces a disease like that from which it is the product ; applied externally between the glans and prepuce, it occa- sions inflammation and discharge, balanitis, or gonorrhoea ; a similar effect follows its application upon other mucous surfaces. One remark may be made here in concluding the account of the results obtained by Eicord and others from inoculation as a means of diagnosis in syphilitic diseases, that when it is resorted to in cases of uncertainty, we are to test the mat- ter frequently, from day to day, during the whole process of the disease; for, as in other instances, we may here find that, although we have not succeeded in obtaining a result from the first, second, or even third punc- ture, we may eventually do so ; daily experience in other diseases, vacci- nation in cow-pox, inoculation in small pox, &c, showing that, from cir- cumstances we cannot appreciate, the first puncture may not succeed, when a second or third will be followed by a characteristic pustule. CHAPTER VII. SYPHILIS. In Chapter First of the "Venereal Disease," I divided this disease into three classes : the First, " a discharge of matter from the urethra," has been treated of in the foregoing pages ; it now remains to describe the diagnosis, progress andvaried forms, the Second and Third Classes — "an ulcer or sore on the glans penis, or other parts of the organ, and an induration or thick- ening of the skin, and parts beneath, followed by ulceration" — assume. Authors are at variance as to the origin of the word. Fallopius and Swediaur derive it from tfuv with, and of each, eight ounces: I Guiacum shavings, $ ' ° ' I Loaf sugar, two pounds; [Honey, one pound; The sarsaparilla and guiacum to be boiled in twelve quarts of water down to two ; then add the Anise seed essence, sugar and honey. When the chronic affections, as scrofula, affections of the skin, or chronic diseases of internal organs, complicate constitutional syphilis, the anti-syphilitic treatment may at once be commenced, but it must be framed and conducted with much care, that the accompanying affection of whatever character it may be, may not be aggravated by it. Whenever any of the forms of constitutional syphilis are accompanied by fever, a strict antiphlogistic treatment and regimen arc absolutely ne- cessary. Without a rigorous observance of this rule, no rational hope of success can be expected, and far less realized. Whatever be the charac- ter of the constitutional symptoms, if they are accompanied by local in- flammation, or general excitement, a rigorous antiphlogistic regimen and treatment ought to be followed till the vascular excitement is subdued. An antiphlogistic treatment is not to be adopted where these phenomena are absent, and, of course; its employment as a general rule is to be severely condemned. In many cachectic or scrofulous patients, or those whose constitutions are undermined by chronic disease, an opposite plan of treatment becomes necessary. In the latter instance, a full, nutritious diet is essential to the success of the treatment. My practice at the Lock Hospital has taught me that debilitated and scrofulous patients, 216 SECONDARY SYPHILIS. who have been badly fed, quickly recover their general health, and are cured of syphilis under a full diet, whilst those whose circumstances have enabled them to live well, frequently become cachectic under a restricted diet, their syphilitic affections remaining stationary, and they only recover their health and lose their disease in returning to the habits of living to which they have been accustomed. That the internal treatment adopted against any particular form of constitutional syphilis may have every chance of success, it is also ne- cessary that the stomach and bowels be kept entirely free from all irrita- tion or disease. CCT" Parents who have been indiscreet in their youth, and contracted syphilitic complaints, often, if not relieved from every vestige of the dis- ease previous to marriage, communicate the seeds of syphilitic constitu- tional complaints to their children. When either parent, and more es- pecially the male, is afflicted with chancres on the penis, the disease with the seminal discharge passes (if impregnation takes place) to the womb, and there with the growth of the foetus, lays the foundation of disease. After delivery, to use a figurative expression, the body of the infant is a "mass of putrefaction." The diseased foetus is seldom brought forth at maturity. This affec- tion in some of its forms, I believe, causes more premature deliveries than any other disease to which the human system is subject — disease, &c, superinduced by violence excepted. CHAPTER X. SYPHILITIC DISEASES OF THE SKIN. These diseases are comprehended and described under seven different classes: Exanthemata, Squamae, Pustulse, Papulae, Tubercula, Ulcers, and Vegetations. The Exanthematic form of the syphilides* generally makes it appear- ance under the form of irregular patches of a shining coppery or bronze * From syphilis and (the Greek) eidos. appearance — adopted by Alibert, Ri- cord, Sec, SYPHILITIC DISEASES OF THE SKIN. 217 color, on the onset of the disease ; if there be much accompanying fever they are more inclined to redness, and the bronze or copper color is not marked till the inflammation and fever have disappeared. These patches, rarely confluent, and of about an inch in diameter, are scattered more or less over the whole surface of the body. They more commonly, however, appear on the face, the neck, the forehead, the mammae, or the genitals. They are sometimes accompanied by papulae, and other forms of consti- tutional syphilis, more particularly "iritis," and are frequently succeeded by the squamous or tuberculous forms of disease. These eruptions fre- quently accompany the primary forms of syphilis. The "squamae" are particles of thickened epidermis, become hard, dull, and opaque, and elevated above the surrounding skin by a morbid con- dition of the subjacent dermis, or simply of the rete mucosum. This disease is essentially chronic, and does not generally succeed to any febrile condition of the economy. The syphilitic squamae generally appear in the form of patches more or less diffused, varying from the size of a half dime to that of a half dollar ; the centre of these patches is frequent- ly depressed, they are of a red copper color, changing ultimately to a dull brown, or even black, which is a long time in disappearing. The syphilitic squamae have a tendency to excoriate or ulcerate slightly in the centre, which then becomes covered by a small, dry, thick crust; occasionally, also, their surfaces are traversed by fissures, when there does not exist any apparent ulceration. After the cure of the disease, the dermis remains depressed in the parts corresponding to the centre of the squamous patches. The other symptoms of constitutional syphilis, witii which the squamae are commonly associated, are inflammations and ulcer- ations of the fauces and palate, iritis, pains and diseases of the periosteum and bones. The " Pustulae" are characterized by an elevation of the epidermis, raised by a collection of pus secreted by a circumscribed portion of in- flamed skin. The syphilitic pustulae are frequently complicated with tubercles, and the pustules themselves commonly placed upon a tubercu- lous base. The pustules are again associated with papulae, but are rarely complicated either with squamous, or exanathematous affections. The Syphilitic pustules frequently ulcerate, and give place to a « ore of a char- acteristic appearance, with hard and elevated edges, and a foul surface secreting a sanious pus. T T nlike other pustular di e ea3cs of the skin, rho 218 SYPHILITIC DISEASES OF THE SKIN. syphilitic pustule follows no regular course ; they are developed slowly, and remain stationary for a longer or shorter period, frequently for many weeks, or until an appropriate treatment be adopted. They are situated upon a hard raised base, of a deep brown or coppery red ; this color is better marked when they have continued sometime, than in the commencement of the dis- ease. The syphilitic pustulae strictly belong to that class of syphilitic affec- tions, which are termed secondary, but are sometimes observed to co-exist with a primary venereal sore; they are, under the circumstances, develop- ed upon the skin of the penis, the scrotum, the pubes, or the labiae ; they are situated upon a red indurated base, soon burst, and change into ulcer- ations, having all the character of chancres. The syphilitic pustulae form two distinct groups. The first is com- posed of pustules termed " psydracioe" by Willan ; and by Alibert, "miliary syphilitic pustules." They are small, numerous, arranged in groups, and disposed to become confluent ; each pustule is placed upon a hard base of deep red, or copper color, and resembles an opaque white point, which, when opened, presents a small gray-colored excavation. These excavations ulcerate slowly, or cicatrize, leaving a depressed cicatrix on the skin, of a coppery, or brown color, or become covered with a thin incrustation. To the pustules composing the second group, the term " phlyzacice" is applied. Willan has grouped them under the generic appellation of " syphilitic ecthyma." The phlyzaceous pustules, or the pustules, of syphilitic ecthyma are formed separately and distinctly upon the skin ; not in groups as in the former variety ; they are placed upon a hard, thickened, and conical base, surrounded by a deep red. brown, or copper-colored areola. They commonly ulcerate, and are suc- ceeded by sores with thick, elevated edges, dug out, as it were, from the surrounding parts ; these ulcers secrete an offensive pus, or become cov- ered with thick crusts; they have a tendency to spread, or to remain stationary, and not to cicatrize or assume any healing process, unless an appropriate treatment be resorted to. Sometimes these ulcerations give origin to red, fungous, painful vegetations. The crusts with which they are occasionally covered, are hard, brown, or black, and not of a yellow color, as those which cover the surfaces of broken pustules generally. SYPHILITIC DISEASES OP THE SKIN. 219 The rupture of the syphilitic pustule, and the incrustation of the pus upon the sore thus produced, gives rise to a peculiar form of disease, which Alibert has described as the " crustaceous pustular syphilide ;" but this, it will be perceived, is not a distinct or separate form of disease, but merely the consequence of the breaking of the pustule, and the drying up of the pus upon the sore, or ulcer, which is thus formed. The affec- tion is now characterized by a thick, and very hard crust, most frequently of a conical shape, covering an excavated ulcer, possessing all the char- acters both on its base and edges, of a venereal sore. These ulcers some- times penetrate very deeply, destroying the periosteum, and ultimately producing disease in the bones, over which they are situated. They now enter into the class usually denominated " tertiary symptoms." Should the ulcer heal under the pustule, it leaves behind it a cicatrix of a cop- per color, deeply depressed in the skin. The syphilitic pustulae are amongst the most formidable of the forms of constitutional syphilis, the crusts and ulcerations which succeed to the pustules frequently become so extensive as to cover the entire face, or the greater portion of the body. The constitutional disturbance is, in these instances, so great, as frequently to terminate fatally. The " Papulae " are small, solid, hard elevations upon the skin, con- taining neither lymph nor pus, surrounded by a small inflamed areola, having frequently ulcerations at their apices, which then become covered with small, dry incrustations. The syphilitic papulae are more or less disseminated over the body, arranged in groups, or disposed to be conflu- ent. They are distinguished by their deep red, or copper-color, their tendency to ulcerate, and to form hard incrustations upon their surfaces, which falling off when the ulcer has healed, leave brown copper-colored depressed cicatrices in the skin. The papulae are commonly associated with pustules, tubercles, or squamae ; and almost always accompany syphilitic iritis, ulcers of the mouth and fauces, diseases of the bones, or "periosteum, nocturnal pains, and other symptoms of confirmed constitu- tional syphilis. This affection of the skin sometimes accompanies pri- mary symptoms ; when it does so, it assumes a more or less acute form, and is attended with some fever. This variety of disease has been termed venereal itch, " scabies venerea," on account of the irritation the palpulae occasion ; when they are seated on certain parts of the body, as on the 220 SYPHILITIC DISEASES OF THE SKIN. anus, the prepuce, or the vulva, &c„ it has been described by Lagneau,* as " syphilitic prurigo of the pudendum." It then attacks the labia, prin- cipally on their external surface, the orifice of the vagina, and the clitoris, which parts, on examination, are found covered with small papulae of a deep red color, causing an intolerable itching, principally in the night ; the eruption sometimes extends to the arms, and internal parts of the thighs. The practitioner must be careful in his diagnosis of this disease, to dis- tinguish it from the common prurigo, which so frequently distresses preg- nant females, which is symptomatic of some uterine affection, or conse- quent upon suppression of the menstrual discharge. The " Tubercula " is a much more serious form of the syphilides than either of the foregoing, and is followed or accompanied if unchecked, with some of the most awful consequences of the disease. Some time previous to the appearance of the disease on the surface, the person looks ill, and is generally indisposed, without complaining of any one symptom in particular ; the eye is languid, the countenance pallid and anxious, there is pain in the limbs, tenderness of the head, occasional headache, especially at night, and generally there is a peculiarly unpleasant smell about the person, both before and during the eruptive appearances, at- tended not nnfrequently with violent fever. The tubercles on the skin are deep seated, solid, circumscribed eleva- tions, containing neither lymph nor pus, they differ from the papulae in their size, being much larger, more prominent, and better defined. Sy- philitic tubercles are either isolated or grouped, of a shining red, livid or brown color, surrounded by an areola of a dark red or coppery appearance. These tubercles are prone to become ulcerated, and form excavated sores with thick and elevated edges, and a foul surface, secreting an offensive pus, which, drying up, is transformed into gray or dark colored scabs or crusts, the ulcers apparently healing in the middle, slough at the edges and spread in all directions. The syphilitic tubercle forms the link of connexion between the secondary and tertiary stages of syphilis ; it is the first of that class of diseases, in which the virus appears to have penetra- ted more deeply into the system, and to have produced a disorganization in tissues, which those forms hitherto considered, have left untouched. The tuberculous pustule sometimes occurs as a primary affection, but more commonly as a symptom of constitutional syphilis ; in the former • Expose des symptomes de la maladie venerienne, &.c, Paris, 1812. SYPHILITIC DISEASES OF THE SKIN. 221 instance it is observed in the scrotum, the labia, the vicinity of the arms, or the mammae. The surface of these tubercles is smooth and flat, of a deep red or copper color, varying from the size of a sixpence to that of a shilling ; they are not so much disposed to ulcerate as the other varieties. The more common forms of tubercle are conical, or round elevations, dispersed here and there over the skin, or assembled in groups or clusters, which are also irregularly distributed. The size of these varies from that of a pea to that of a large hazel nut, or filbert ; they are more com- monly situated on the anterior surface of the chest, or the abdomen, on the neck, or the internal part of the arms. Another variety of tubercule is situated more commonly, on the alse and lobule of the nose, or on the forehead ; frequently, also, upon the neck of the uterus, or upon the tongue, where they may be mistaken for can- cerous affections. These tubercles are commonly assembled in circular groups of variable size ; they are so prone to ulcerate, that this termina- tion appears to be one of their natural characters ; when in this condition, they are frequently described under the name of syphilitic lupus. The tubercular syphilides are commonly complicated with a scrofulous, scor- butic or herpetic tendency, or diathesis ; their progress is slow and gene- rally without pain ; they gradually increase in size till they terminate in softening or ulceration. Should this disease continue for a length of time, the throat not un- frequently becomes the recipient of its ravages. A small, white, angry- looking, oval-shaped sore, is first seen either on the velum pendulum pa- lati, (the curtain-like skin at the back of the mouth,) or on the pharynx (the throat) just above the air passage and gullet ; this little sore, if not checked, rapidly spreads until it involves the whole of the back part of the mouth, the pharynx, the tonsils, the velum, and the uvula ; these lat- ter it very soon destroys ; on looking into the throat, nothing is seen but one mass of white ulceration, which exhales a most offensive odor, con- tinuing its march upwards, the lining membrane of the nares becomes im- plicated in the same disease, and this is followed by decay, death, and exfoliation of the spongy bones of the nose, and, of course, by great de- formity occasioned by falling in of that organ. The first symptom in- dicative of the disease attacking the nose, is a certain feeling of dryness being complained of, then pain, obstruction to breathing through the nose and offensive breath, followed by a thick discharge, becoming bloody and 222 SYPHILITIC DISEASES OF THE SKIN. afterwards copious, acrid and foetid, so acrid as to cause excoriation of th& lips and any other part it touches, which causes swelling of the parts and much disfiguration ; the bones then, their coverings being destroyed, ex- foliate and are discharged, leaving the nose either only supported by the skin or completely sunken. Death is to be expected if the dire conta- gion should extend to the upper part of the wind pipe, this is known by the voice becoming husky, hissing or harsh ; by the constant painful cough, causing large quantities of viscid, foetid matter to be expectorated ; by the great difficulty in swallowing even the saliva, the increase of ema- ciation, restlessness and night sweats ; by the rapidity of the pulse and great anxiety of the countenance. Should the epiglottis be implicated it can no longer perform its func- tions, therefore, when attempts are made to swallow, portions of the li- quid or solid food are drawn in the windpipes, causing violent fits of coughing, often threatening life, and in some instances producing sudden death ; generally, however, the poor sufferer is not so fortunate, and the now weary existence is spun out for many weeks, amid tortures, from the contemplation of which, the mind turns with shuddering, in time, the invalid sinks into a welcome grave a mere skeleton, worn out by pain, exhaustion and starvation. The foregoing are the most formidable of all the forms of constitu- tional syphilis, producing great deformity in all the parts invaded by ul- ceration, and exceedingly difficult to cure. Ulcers. — The secondary forms of syphilitic ulceration are comparative- ly rare, unless we take into the account those forms which succeed to the pustular or tubercular varieties of the disease ; indeed, chancres or primi- tive ulcers themselves are most commonly, if not always, preceded by a pustule, or vesicle. These ulcers are, however, sometimes met with, being only preceded by a slight itching or redness of the skin, icceeded immediately by ulceration. They have generally a specific character, are excavated with thickened and defined edges, and a foul surface, secreting an offensive pus. Their situation is generally about the nose, the edges of the mouth, the eyelids, the ears, or the mastoidean region ; they are also common upon the mam- mae, near the umbilicus, in the axillae, the groins, or round the edges of the nails. The constitutional syphilitic ulcer often makes its appearance in form of fissures, depending upon the disposition of the skin in the SYPHILITIC DISEASES OP THE SKIN. 223 parts where the ulceration then takes place ; these varieties are seen upon the skin of the scrotum, in the vicinity of the anus, the umbilicus, or the commissures of the fingers and toes, the folds of the skin of the eye- lids, the lips, the palms of the hands, or soles of the feet. " Vegetations," or excrescences, of varied form and appearance, upon the skin or edges of the mucous membranes, constitute the last variety of the syphilides or venereal disease of the skin. Desruelles divides these into three heads, according to their anatomi- cal structure. First, the vegetations formed by the epidermis, and of a horny or perfectly inorganic character ; second, those termed cellulo-vas- cular, growing from the surface of the mucous membranes, and composed chiefly of blood-vessels ; and, third, those springing from the skin itself, and formed of the elements which enter into the composition of this organ. Vegetations commonly take place from parts which have previously been the seat of inflammation, or long-continued irritation of any kind. Hence they are frequently formed upon the surface of the glans or pre- puce after long-continued balanitis, and upon the cicatrices, or the sur- face of old constitutional ulcers upon the skin. The treatment consists of washing the parts in soap and water, and cautiously applying a small quantity of pyroligneous acid to the excresences with a camel hair brush, and covered with a thin layer of lint : to be applied every third day until the disease is eradicated. There is a species of excrescence rather than vegetation to which the term condyloma or crista galli is commonly applied, which is most usually situated in the vicinity of the anus, between the glans and pre- puce, or on the external parts of generation in the female. Its essential ' character consists in a development or hypertrophy of the skin or mucous membrane, and the subjacent cellular tissue, which then forms a soft, flattened',' indolent tumor, more or less elongated. Sometimes these tu- mors are red, painful and excoriated, secreting an offensive pus, and at others perfectly indolent. They frequently depend upon an ulcer situated in the folds of the integument or mucous membrane. Excoriations may occur from a variety of causes, of which mention may be made of abrasion of the epidermis or epithelium, caused by over exertion in the marital act. The usual place of excoriations is in the neighborhood of the frenum ; it may, however, happen to other parts of the body, especially to those parts against which there is considerable 10 224 SYPHILITIC DISEASES OP THE SKIN. rubbing from the seams of pante, &c. The treatment consists in washing the excoriated surface with castile soap and rain water, twice a day, and after each cleansing, the application of a small quantity of the following powder. 5 Pulv. Starch, half an ounce, ( Pulv. Orris Root, sixteen grains. Over the powder apply dossils of soft lint. Syphilitic Testicle. — This disease, termed also syphilitic sarcocele, occasionally appears as a secondary symptom of constitutional syphilis ; it is clearly to be distinguished from that affection of testicle, which suc- ceeds to gonorrhoea, as well as from sarcocele, depending on other causes not syphilitic. Sir Astley Cooper, on page 104, of his work on Diseases of the Testicles, remarks : " When the venereal poison uffects the testicles, it probably attacks the tendinous structure — for example, the tunica albuginea, and from thence extends into its interior fibres, and not its tubular part ; but this I allow to be hypothetical, and am led to that opinion from the struc- ture of that part most resembling the periosteum in its tendinous compo- sition, and from the very ready and complete recovery of the organ." When the testicle is affected, it gradually enlarges, becomes hard and heavy, and generally presents an uneven surface to the touch ; the indu- ration may also exist in the spermatic cord or epididymis. Chancres in Women. — In females, ulcers of the genitals are frequently more unmanageable than in men. They may attack all the external parts of generation, the interior of the vagina, and the neck of the womb. They sometimes perforate the vagina and attack the rectum, opening a communication between these parts so that the excrement passes through the vagina. Numerous ulcers are frequently observed at the same time - in one female, and the imeasiness they occasion is sometimes so trifling as scarcely to attract the attention of the patient, except when they are temporarily rendered painful by the contact of the urine. When they occur in a bad constitution, or in one laboring under the effects of irregular and intemperate habits, the ulcers frequently give rise to sloughing, which sometimes occasions extensive destruction of the parts, and not unfrequent- ly destroys the unhappy sufferer. " On one occasion," says Sir Astley Cooper, "I visited St. Giles's work-house, and in a small ward belonging to the medical establishment, I saw seven cases of sloughing chancre, and of these seven, five died." The treatment is similar to that of male;.. SYPHILITIC DISEASES OF THE SKIN. 225 with such slight modifications as will be readily suggested by a consider- ation of the peculiarities of the parts. Among the most difficult cases of Syphilis in females, which I ever treated, one occurred in 1817, at Bathurst Plains, the present Gold Re- gions of Australia. The subject was a young woman about twenty-four years of age ; she had led a very dissolute life, and for ten months pre- vious to being admitted into the Hospital under my superintendence, a bloody discharge had constantly flowed from the vagina, followed in a short time afterwards, by mucous tubercles on the thighs, thence extend- ing to, and around the anus, resembling excoriations or superficial chancres. Those around the anus had the appearance of soft mucous or flattened granular masses raised above the surface, which was covered with yellow lymph — all arising, as the girl stated, from neglect and want of cleanli- ness in dressing the venereal chancres situated on and around the labia, which created an immoderate itching of the extremities. My attention was first directed to the removal of the poison from the chancres, and subsequently to healing the sores ; which, with the tubercles, were healed up in two or three weeks, and the patient discharged, cured. Had medical men at the present day ever participated in the same amount of experience in Public Hospitals the author has enjoyed, and have been an eye witness to the sufferings entailed on the female sex by the recklessness of practitioners in treating these complaints in their in- cipient stages — the Venereal Wards of such philanthropic institutions would teach them a salutary lesson to hasten and not retard the total annihilation of disease, however slight or obstinate. General Hospitals — the great nurseries of learning, should be sought early by the young practitioner, after having honorably graduated at a University. He should spend at least three years at the bed-side of pa- tients. Emerging from such schools, which learn men a knowledge of disease as well as human nature — how to feel and how to act in every vicis- situde of fortune, he is the better prepared to herald himself as the guide of the unfortunate — the poor man's friend, the rich man's bliss. 226 MERCURY. CHAPTER XI. MERCURY. Mercury in its metalic state, exerts no action on the animal economy. It has, nevertheless, been administered in large doses, with a view of operating mechanically, and overcoming by its weight, obstructions existing in the ileus, but as it cannot act by its gravity on the ascending part of the bowels, it is not easy to conceive how it should have ever been recommended ; and the issue of the cases in which it has been giv- en, have sufficiently proved the futility of the practice. It was formerly thought that mercurial preparations constituted an unfailing specific for every form of the venereal disease, and that unless this mineral were administered freely, it was the nature of syphilitic affections to go on progressively from bad to worse, till the end was the infallible destruction of life. And during the middle of the last centu- ry, as well as later, when the doctrines of the celebrated Hunter were received with implicit submission, when medical practitioners bowed con- tentedly to the authority of great names, not daring to think for them- selves, or to acquire from patient and personal observation, correct notions of the progress of disease and the action of remedies ; during the existence of such a state of thing, doubtlessly many unfortunate vic- tims of venereal contagion have perished, not so much from the viru- lence of the affection as from the incautious and injudicious operation of active and dangerous, as well as deadly agents, employed professedly for its cure. ( At that time it was thought that if any sore, the result of impure coition, were observed to heal without mercury having been given, that it could not have been venereal, nor likely to be followed by any constitutional symptoms.) When we take into consideration the variety of forms under which syphilitic disease is cloaked, and the general treatment, we cannot but deplore the great loss of life, which is daily occurring from the use of that mineral, which is constantly administered by medical men at the present day ; the blood is poisoned by it, and by being so, it conveys wherever it travels in the arteries and veins, the seeds of disease. The blood thus poisoned goes to the heart, and diseases of this organ are the consequence : it goes to the lungs, and this organ becomes nior- MERCURY. 227 bidly deranged; in fact to whatever part of the system it travels, there it lays the foundation of disease. In cases like these it was formerly the custom of the faculty not to rid the system of the poison which is destroying the unhappy sufferer by inches, and preying upon his vitals, but they have pursued a course of treatment as incorrect with sound theory, as it is repugnant to humanity and common sense. One would have supposed that some drug would have been adminis- tered to counteract the effects of the poison circulating in the veins. Not so ! Instead of so doing, poisons were thrown into the system, in the shape of arsenic, and other mineral poisons ; so that the unfortunate suf- ferer, instead of being benefited was doomed to pass years of misery and unhappiness. In treating the venereal disease, it used to be ( and I am sorry to say it is to some extent at the present,) the practice always to throw into the system immense quantities of mercury. And what were the consequences of this unnatural and inhuman mode of treatment ? The unfortunate being had caries of his bones, copper-colored eruptions made their appearance all over his body, with running sores in the neck, and distorted features. Yes, the rotten skulls which are to be found in anatomical museums, with all the other beautiful specimens of diseased bones, which in our younger days were so abundant in hospitals, in the great majority of cases were the production of long and harrassing courses of mercury. Its rash, indiscriminate use is the means of infinite mischief. Under the notion of its being an antidote for a certain disease, the untutored, think they have only to saturate their system with mercury, and the business is accomplished. Fatal error ! Thousands are annually either mercurialized out of existence, or their constitution so broken, and the functions of nature so impaired, as to render the residue of life miserable. For where is the practitioner of any eminence whose experience beyond a first or second slight infection, has not seen the inefficiency of this boasted mineral ? If physicians and surgeons, those of them who have the care of hospitals in particular were candid enough to give the public all the information they could upon this head, it would be as generally known as it is true, not only that mercury frequently fails in cases where the infection has been contracted for the first time, and that as it loses its energy by repetition ( not indeed against the constitution but against the disease alone,) the cure becomes at each succeeding infection more dan- 228 MERCURY. ^erous, difficult and uncertain than the last ; but that instances every day occur, in which the excessive exhibition of that mineral seems to retard the cure, and be the only obstacle to the entire removal of the disease ; instances in which the patient, reduced by disease and the remedy together to such a state, that certain death must follow any longer per- sistence in the use of mercury ; is sent to the country as a last resource, and there without any other remedy but the absence of mercury alone, recovers his former health and strength. To give the reader an idea of its ill effects upon the system, I will here make an extract from a late publication of the justly celebrated Pro- fessor of Surgery in the London University College, Mr. Liston: " Of the bad effects of mercury on the constitution, much has been said; treati- ses have been written on mercurial pox, a species reported to be much the most violent; and others have detailed an accumulation of evils, un- der the title of mercurial disease. There is no doubt that extensive, deep and sloughy ulcers of the throat are produced by mercury, and of this I saw the following unexceptionable instance : The fauces presented one erctensive mass of ulceration, sloughing at its margins, and the uvula was almost detached. The patient was an old and emaciated woman, who neither had, nor could be supposed to have, any venereal complaint. She employed herself in coating mirrors with quicksilver, and to that ascribed her malady. In fact, her system had been long under mercury, in con- sequence of her occupation. When I visited her, her daughter and hus- onnd, (the latter of whom was paralytic, and almost bed-ridden,) were aiFected from the same cause, with a pustular eruption of the face, and disease of the nostrils and snivelling. Another old woman had numer- ous and deep ulcers of the fauces, tonsils and lips, having been kept un- mercifully under mercury for nine continuous months. She had besides taken it, from time to time, for upwards of four years, though her sole complaint was slight sore throat. Pains of the joints, too, I believe, are attributable to the use of mercury. That mineral has no power to prevent the occurrence of nodes, for these form during its action. Affec- tions of the periosteum are easily excited in some people, who have neither had pox, nor made use of mercury ; but in no instance of vene- real disease, have I observed serious affections of the bones where mer- cury has not been given. Even the advocates for mercurialising, speak of mercurial nodes. It has been asserted, that nodes do not occur when .MERCURY. 229 mercury has been given for liver and other complaints ; but they deform under such circumstances, though not so frequently as when the medi- cine has been given during venereal symptoms. A cachectic state is often produced by a continued use of mercurial preparations, or at least by mercury and disease together, in constitutions not originally strong. It is marked by pale lips ; bloodless conjunctiva; a rough anserine skin ; a relaxed state of the mucous membranes ; haemorrhage from them, partic- ularly from the gums, which may prove fatal, as I have myself witnessed ; exfoliation of the alveolar processes ; slimy stools; pale urine; pains of the limbs ; sores showing great indolence of action, or assuming a malig- nant one ; dropsical symptoms, and other evils, of which a lengthened catalogue might be enumerated. Such symptoms were often met with when mercury was exhibited for every trifling, or suspected sign of dis- ease. " On this subject, a modern writer has well remarked, ' experience has well convinced me, that in no forms of chancre, nor in any other stages of the venereal disease, is it proper to exhibit Mercury in the unmerci- ful quantity, and for the prodigious length of time, which custom, igno- rance and prejudice, used to sanction in former days. Violent saliva- tions ought, at all events to be forever exploded.' When I was an ap- prentice at St. Bartholomew's Hospital, most of the venereal patients in the establishment were seen with their ulcerated tongues hanging out of their mouths, their faces prodigiously swelled, and the saliva flowing out of their mouths in streams. The wards were not sufiiciently ventilated, and the stench was so great, that the places well deserved the appellation of foul (by which name they were designated.) Yet, notwithstanding, mercury was thus pushed, (as the favorite expression was) it was then common to see many patients suffer the most dreadful mutilations, in con- sequence of sloughing ulcers of the penis ; other patients, whose noses and palates were gone ; others who were covered with nodes and dreadful phagedenic sores." This woful picture is not exaggerated, and cannot be too strongly im- pressed on the mind. A small quantity of mercury will violently affect some constitutions, as of those who have been in warm climates, or have taken much of the drug, even in this country. There are also several diseased appearances of the skin caused by mer- cury ; but enough, it is hoped, has been said, to warn against this power- 230 MERCURY. ful agent, which it has been too much the custom, even in our own day, to make as common use of as the more simple contents of the domestic medicine chest. Let it always be remembered, that in all its forms and preparations, mercury is a two-edged sword, and may affect as much or more evil than good. And forget not, Oh ! indulgent reader, that it is the active ingredient of nine-tenths of the quack nostrums for venereal disease, though their vendors warrant them vegetable, but, " by their fruits ye will know them." PART IV. GENERAL HOSPITAL PRACTICE IN EUROPE, ASIA, NORTH AND SOUTH AMERICA. GENERAL HOSPITAL PRACTICE. CHAPTER I. EDUCATIONAL QUALIFICATIONS. At the commencement of the last American war with Great Britain, the Author was called into active Sea Service ; after which he entered the Medical Profession, and soon received the appointment of Assistant Surgeon ; in which capacity he acted both in the British and Foreign Hospital Service, and the Royal Navy, for the space of nearly fifteen years ; and on his return, received from the Navy Board his Certificate of Qualifications. After which he became associated with Messrs. John Abernethy and Stanley; under the former, he attended three full courses of Anatomical Lectures, and three full courses of Lectures on the Theory and Practice of Surgery : and under the latter he attended two full courses of Anatomical Demonstrations, besides many others which he at- tended at the General Hospitals in London ; certificates of which are in his possession, open for inspection. In the year 1 827 he became a resi- dent of the United States, and in 1830, after completing his professional engagements in New- York — founded the celebrated Lock Hospital of this city. In the year 1835 his celebrity as a scientific and well read Surgeon be- coming known and appreciated, as a mark of their personal regard for his literary attainments, the College of Ripley, Ohio, from whence he obtained a, Diploma of Doctor of Medicine, tendered him the Professor- ship of Materia Medica in said College, and subsequently, by an unani- mous vote of the Trustees of the University, elected him President of the Medical Department and Chancellor of the Board of Regents ; which responsible, as well as honorable appointments he still retains. 234 EDUCATIONAL QUALIFICATIONS. In 1842 other honors awaited him. He was elected Brevet Major General of the very regiments in the State of Illinois, who so signally distinguished themselves in the late Mexican War, and during the same year, he received an additional appointment from the same source, of which the following is a copy. Appointed by the Governor. — Major General Cooke of Albany, N. Y. to be Surgeon General of the Militia of the State of Illinois : to take rank from the 24th of June, 1842. " In making the above appointment, Governor Carlin has selected an able, energetic and efficient officer. The duties that will devolve upon him perhaps no man in the State is better qualified to fill ; and we have no doubt he will render due justice to the office which he has been select- ed to superintend." — Illinois Republican. In the year 1846, while on a visit to his birth-place, England, he was solicited by his professional brethren and numerous friends to sit for his bust; this he consented to; and after its completion, it was placed in the Royal Academy of Fine Arts, Trafalgar Square, London, where it still remains — a duplicate of which is in the possession of the Author. While on this visit he made known his discoveries in Medicine, and particularly his anti-syphilitic preparations to the Royal Hospitals of Eu- rope, who, as a deserving tribute, presented him a massive Gold Medal, bearing suitable inscriptions, distinguishing him as a " Physician of Su- perior Talents, Sterling Merit, and Scientific Improvements in the Practice of Medicine." The value of this honor was subsequently enhanced by a Commission bearing date August 11th, 1851, granted by the National Vaccine Establishment, (acting under the sanction and authority of the British Government,) composed of the President and Censors of the Royal College of Physicians and the President of the Royal College of Sur- geons, appointing him Corresponding Vaccinator for the United States of America ; which commission was officially forwarded to him through the Office of Secretary of State, London. Each and every certificate or medal above referred to, Dr. Cooke will at all times take pleasure in showing to any person or persons disposed to question his qualifications. His diplomas for thorough and scientific knowledge, are filed in the County Clerk's office of the City of Albany, where any person desiring may examine the same as to their genuineness. EDUCATIONAL QUALIFICATIONS. 235 Few men, perhaps, have had a larger share of literary, scientific or collegiate honors conferred, from time to time, or enjoyed a more exten- sive Medical Practice, or secured the confidence of the people at large, than the — Author. CHAPTEK II. PROFESSIONAL EXPERIENCE. During my last voyage as Surgeon superintendent onboard the Pallas AN east indiaman, the possibility of subduing venereal disease and its influ- ence by other means than those established by the Navy Board of Hospital Physicians engaged my attention. I soon became satisfied, after repeated experiments that a new era in the practice of medicine had commenced. Before my arrival at Liverpool, I had the satisfaction of being convinced, that all syphilitic cases among the seamen and passengers, during a voy- age of seven months, had been effectually disposed of without recourse to mercury ; and on resigning my commission at the Admiralty office, I made known my discovery to some of my associates whom I subsequent- ly saw after a few years absence, and they informed me that Calomel and blue pill had seen their day. In this age of experiment, one fact is worth a hundred arguments, and it is by this kind of evidence that I seek to be examined. I lay claim to entire originality in my anti-mercurial prescriptions. If I have cured many hundred thousand cases of private disease without recourse to Mer- cury in the medium period allotted for that purpose, surely there is no occasion to go beneath the surface in order to prove that the same course may be pursued on all hands with the same results ; admitting these prac- tical observations to institute an argument that the plan is good to be acted on, it follows that it is equally good for one practitioner as another. Such, then, is a brief allusion to the grounds on which I rest my prefer- ence to the mode of treatment I adopt at the Lock Hospital, established Anno Domini 1830, at Albany, N. Y. To the success attending this superior treatment, I venture to call the attention of the sceptical, being aware that it is only by the combined spirit of inquiry, that the correct- ness or falsity of any doctrine can fairly and finally be put beyond dispute. 236 PROFESSIONAL EXPERIENCE. The late John Abernethy, one of my preceptors after my return from abroad in 1823, always remarkably interested in my views, with a spirit of liberality, transferred to my own hands, the entire charge of several venereal wards in St. Bartholomew's Hospital. He did so from my dis- tinguished success in a complicated case of disease which fell under his medical auspices. An Egyptian gentleman, whom I had once met on a visit at the residence of the then Bishop of New Zealand came to London for professional treatment ; he soon recognized me as one of the Hospital Physicians of that colony, and naturally solicited my advice in what he termed a " peculiar position." I invited him to call on the following morning at the surgery of Mr. Abernethy ; having introduced him to the lecturer, I was requested to take him under my professional charge. On examination I discovered several phagedenic sores were in progress, and a bubo had commenced. He had the very best attendance at one of the principal hotels near Regent's Park, and within one month I accompanied him to the sea shore, where he remained until his return home The British and Foreign Medical Review, alluding to the Royal Grold Medal presented to the author of this work says : " The reformation adopted by Greorge Cooke, Esq., formerly an Assist- ant Surgeon in the Colonies, and now Resident Physician at the Lock Hospital, in the United States of America, for the better management of Venereal Diseases, is one which all Hospital Surgeons will possess — in- deed, which all Surgeons who wish to be well acquainted with their pro- fession, SHOULD." Confirmatory of this opinion, all benevolent institutions having for their object disinterested philanthropy, are lavish in their meed of praise and thankfulness for a bestowal through whose influence so much good is every day manifest in behalf of the unfortunate, and so much wretched- ness prevented. Invalids should always exercise judgment in their selection of a professional attendant, for experience every day conveys a warning voice to the unfortunate, in some shape or other, that all who adopt the name of Doctor, have little authority other than their own, to practice this important branch of Physic and Surgery, and that the impositions to which they are exposed, by employing such men, often subject them to disappointment, disgrace and ruin. A-case in point, which occurred PROFESSIONAL EXPERIENCE. 237 during the compilation of this work, in the vicinity of the Author's resi- dence, will fully and satisfactorily illustrate this fact. A young American advertised his services in the public newspapers, by the name and style of a French Physician — "that he was a member of the Hospital des Veneriennes, Paris — that he could be confidentially consulted on the subject of Private Diseases — that he had had ample opportunities of observing the various modes practised for the relief and cure of a certain class of diseases at all the great schools of Europe, Lon- don, Edinburgh, Paris, and the Continent generally — that his advantages could scarcely have been equalled in ascertaining the best mode of treat- ment in the different varieties of Sexual Diseases." Some misunderstanding having arisen between this Frenchman and one of his patients, resulted in an action-at-law. The "Doctor," having been called, upon his cross-examination, testified that he had never been to Europe, nor visited its Hospitals and Schools ; and that the name under which he advertised, was fictitious. Whereupon the jury, adjudging him guilty of the charges preferred against him, i. e., imposition, and the receiving of money under false pretences, brought in a verdict against him for full amount of money had and received, with costs of court. My ancestors for several centuries past, as well as my father and three elder brothers, being all medical men, I, from my opportunities, com- menced my professional studies at an early age. Scarcely had I attained my eighteenth year, when I had the honor of occupying a position in His Majesty's Service — King William the Fourth — to which few young men of my tender age have ever attained ; and my promotions kept clustering around me until I retired from Sea Service, and became a partner in the general practice of Physic and Surgery with my (now deceased) father, as a family physician ; and I now challenge the whole world — though there be in the city of Albany, over a hundred physicians, and as many hundred thousand in the Union — to show that any one practitioner among them has ever had similar advantages, possessed equal public confidence, and enjoyed as large a share of Professional Experience in Various Cli- mates or parts of the Globe as myself. My extensive popularity at home and abroad, has been a "worm in the core," to a few unprincipled persons residing in this city, who have had the bravado, when called upon through mistake, to represent them- volves to be "Dr, Cooke;" and at other times to unlawfully use my 238 PROFESSIONAL EXPERIENCE. name for disposing of imitations of medicines, which in my hands had gained great celebrity ; and last, not least, to my certain knowledge, within the last few years, one office has been opened in this city, and another in Buffalo, under the name of "Dr. Cook," thereby imposing upon the public and deceiving the Unfortunate, who, too often, are unable to obtain redress for mal-practice, in consequence of their keepers not being responsible men. Very few scientific Surgeons, and certainly not one advertising physi- cian in this city but myself, have ever crossed the Atlantic in their lives' time. This is no fiction, as I am supported in this assertion by the tes- timony of all men of integrity — be they disciples of Medicine, Law, or Divinity, here and elsewhere. CHAPTER III. CERTIFICATES — OPINIONS OF PHYSICIANS AND THE PRESS. tl There are yet great truths to tell, if we had either the courage to announce, or the temper to receive them." — Disraeli. The following cases handed me from time to time, by patients, who (from a sense of gratitude for kindness shown them in the hour when friends were few,) have voluntarily offered their names and influence to induce any one afflicted as they have been, not to trifle with their health by employing persons of whom they have no experimental knowledge. These certificates will elucidate the success of my treatment the inter- est taken in the patients' welfare while under my care, and also give the public a slight idea of the extent of my practice. The public can rest assured that no certificate will, at any time here- after, be published unless, like many of the following, a desire is expressed to have it done. The subject of the following memoir applied to me in July previous, and three months or more having elapsed, he wrote the following history of his case : Darien, Geo. Nov. 22d, 1830. Dr. G-eo. Cooke — My Dear Sir : A sense of gratitude for kindness received, prompts me to send you a statement of my case which you are CERTIFICATES. 239 at liberty to make use of for the benefit of those who may be suffering a s I have done. In the year 1826, 1 took a violent eold by being exposed to rain after having taken mercury, and it immediately deprived me of the use of my limbs and hearing. I applied to several eminent medical men without receiving any relief; and in 1829 the disease terminated in ulcers, which increased to an alarming size. I traveled as much as my means and strength would permit, in search of medical aid, tried the remedies of several physicians, and grew worse. I had an ulcer over my right eye, which had laid the bone nearly bare, and twelve others on different parts of my body. In this state I applied to you. In the spac-r. of ten days the ulcer over my eye and those on my body were nearl y healed, and in less than one month after I commenced taking your invalua ble remedies they were all healed, and my hearing was perfectly restored. I am now an active, healthy man, able to attend to active business : — all from the use of your medicine. I am, Yours, &c, HENRY F. WILKINS. A clear case op conscience — And who is my neighbor ? The good Samaritan, No. 3, Norton street, Albany, N. Y. The trumpet tongues of the people have proclaimed as upon the house tops, the supe- rior excellencies, as a physician of Dr. COOKE, and the supreme confi- dence by which he governs his practice : and I too, have been one of the unfortunate, until pronounced, what I now am perfectly satisfied to be, well. I would therefore advise the afflicted of both sexes, as an auxiliary to their own recovery, to consult his known skill and acquirements as the only means of obtaining a safe and certain cure ; besides a speedy delive- rance from that most loathsome of all maladies, the venereal disease — contending that a candid avowal of his enviable reputation and unrivalled celebrity for curing diseases better, safer, and cheaper than any one else, (the quacks of the day to the contrary notwithstanding,) is worth pub- lication in the newspapers of the day. I must moreover confess that his humanity and benevolence by far exceeds my expectations, and I now publicly acknowledge that his opinions, connected with that class of dis* eases for the removal of which he stands pre-eminent, are at all times 17 240 CERTIFICATES. universally believed to be both correct and accurate, to the very letter. Having successfully prescribed for a case of my own, which at one time threatened my life, I am consequently one good evidence of his superior skill, and am both willing, nay bound by the ties of gratitude and honor, to add this full tribute to his worth, as well as to recommend him as a safe guardian for the unfortunate, who will in my opinion, neither leave, forsake, nor disappoint them, because I feel so thankful for his care, attention and assiduity to rescue me from the hands of the destroyer, where I must inevitably have fallen, mortification having succeeded in- flammation, and to this threatened strangulation. " I am now, thanks to the mercy of Dr. Cooke, recovered." ELY COLLINS. The residence of Mr. Collins can be obtained on application to Dr. Cooke, No. 3, Norton street, who is permitted to refer to him for the in- formation of invalids and strangers. Saratoga Springs, August 22, 1840. G-en. George Cooke, LL. D. : Herewith you receive a proof sketch of my case exactly as it appeared when I first applied to you for relief. Though now, perfectly recovered, I have happily lost every vestige and even the shade of disease : allow me, once more, respected sir, to ask, in form of a testimonial, the publication of my last letter, as the best effort of my pen, in view of all that is justly your claim for a satisfactory accomplishment of what is universally announced an unexpected and mi- raculous cure, since one of those afflicting casualties which occasionally enlist the sympathies of a whole community, the best energies of a praeti tioner of medicine, and the unanimous applause of a grateful republic, has been perhaps wholly evident during the period in which I have had the honor of your friendship and acquaintance. My thanks, and in my opinion, those of the unfortunate, are due to you for the alacrity with which you have so successfully prescribed for my case, no longer than a few months — for the zeal and assiduity with which you universally attend in propria persona to your patients ; and above all, for that spirit of harmony and christian benevolence in which you conduct the institution over which you are destined to preside. Upon the successful result of your labor, as regards myself, I offer you my sincere congratulation : to which, permit me to add the expression of an earnest hope, that the great CERTIFICATES. 241 object of your care, (the welfare of your patients,) may in every instance be similarly enhanced, and that mutual good may be uniformly estab- lished. Being now released from every painful and questionable vestige of disease, I am only doing justice to your exalted character, to add a few brief but pointed remarks. Before application was made to you I re- ceived, what I had thought, the best possible counsel for my relief, and having failed in restoration to health, had wholly despaired of any shade of hope of ultimate recovery. I had availed myself of all the medical talent extant ; practising and advertising physicians without number, had prescribed for my difficulties ; men of eminence and distinction were among them, but they all proved to be but self-named doctors and eelf- conceited men of repute ; all handled, experimentalized and tortured my bodily frame without success. They pocketed my money, and in the end left me worse that at their first interview. I then went on to Sara- toga Springs, where for the first time I heard of your enlightened repu- tation and fame for such complaints. The result of my appeal is, thr.t I appear now before the world a representative of your skill, a living mcmi- ment of your philanthropy, and I hesitate not to say if the medical fa- culty of Albany, and other cities, will go to school under your own ]ie- ceptorship for a few weeks, they would then perhaps be better qualified to assume the guardianship of such an invalid as myself. Believing yen in reality the patriarch of the medical profession, I shall ever bear your kindness and disinterested benevolence in mind, and particularly wlun ever the interests and exigencies of the public good may appear to ren- der it expedient to recommend your advice and assistance. In the m<-n time, I do not allow myself to doubt, but that my esteem for your pnr- sonal welfare will be daily strengthened by feelings of gratitude for the many recent proofs which you have given me, as a paternal regard and solicitude for my well being. I have the honor to be, respected sir, your humble serv't, GUSTAV. SEYMOURE By favor of Archibald Mattieson, Esq. Niagara Falls, August 15th, 1840. Prop. Cooke, M, D.— Dear Sir: Under your invaluable prescrip tions, being restored to perfect health and completely renovated both in 242 CERTIFICATES. body and mind, I feel impelled by a sense of gratitude to make an open and full statement of my case, hoping that the facts which I shall relate will redound to your advantage and fame, and be the means of life to many poor wretches similarly situated with myself. At a period of my life when I was madly giving the rein to my impetuous and ungovernable passions, and at a moment when I was under the pernicious influence of folly and inebriation, I contracted that horrible and loathsome disease, which, I rejoice to say, you have so successfully treated. I immediately sought the advice of the most celebrated physicians, in whose hands I continued for a long time without any perceptible improvement, and who at length announced the terrible fact that my case was hopelessly incura- ble. The agony I then endured may be conceived but not described ; but while growing worse, physically and mentally, I saw your advertise- ment. A ray of hope gleamed through my mind, and I instantly set forward to avail myself of your services. I need only add, that I hope this trespass on your valuable time, will be justified in consideration of my motives. I am, respected sir, Your most obedient servant, JUNIUS MAXWELL. I, CHARLES F. BRIOHAM, of the State of Massachusetts, do cer- tify as follows: — In the month of March, 1840, in Baltimore, I was taken with a disease usually called the Venereal ; I immediately placed myself under the care of a Physician of that city, and took, by his orders, Hun- ter's Red Drop, the sffiaet of which was, to lodge the disease in the glands of my neck. From that city I next went to Philadelphia, and placed myself under another Doctor, whose prescriptions appeared to help me ; having taken what he considered a sufficient quantity of his medicine to cure me, I left and returned home to my native State. Soon after I was taken sick, my limbs became sore ; severe pains shot through my system and a general bloating commenced. After the swelling subsided, ulcers set in upon my shoulder, arms and back. I then applied by letter to a Physician at a distance, who recommended a wash and medicine which he sent ; the effect was to drive the ulcers trom their lodgement and send them to my head, which swelled considerably. Pains still tormented me ; and after using his medicine five or six months, I found I grew worse. I next went to the State of New- York and placed myself under the care CERTIFICATES. 243 of another Doctor. He gave me a medicine which looked like Red Drop, and apparently helped me ; I then paid him, and having given me, as he said, a sufficient quantity to cure me, I left him ; after taking it, it being cold weather, I felt a slight symptom of the disease, and wrote to him for more. He sent some, but it had a contrary eifect to the other. I wrote again telliDg him so, which he answered me by saying that I was : ' oldmaid-ish and whimsical," that I had taken cold and brought on a fever ; that he knew the disease had left me a long time before. He fur- ther stated that he should expect more money from me, or leave the case to myself. I next applied to a celebrated Physician in Massachusetts, who said he could cure me — that I had been prescribed for WRONG- ; that driving ULCERS from one place to another was all that was done. By the use of MERCURY he reduced me so low that I could not stand ; after which he gave me a tonic which brought on a fever, starting a run- ning of the ulcers on the arm and side of my face, which had been nearly healed, and causing a swelling of the roof of my mouth, and a breaking out of an ulcer in my right nostril which eat down through my upper lip upon my jaw. This ulcer apparently started from the under jaw, and passed along the right side of the neck, and then over the cheek bone to the right nostril, where it broke. I next tried a Doctor in my native place, who not understanding my case, prescribed for the ulcers as cancers. In one month I left him and visited Albany, and placed myself under the care of DR. GEORGE COOKE, M. D., LL. D., a Physician celebrated for his wonderful me- dical skill, and fidelity to his patients. When I first entered his HOS- PITAL, I was emaciated to a skeleton, my left arm was in a sling im- moveable, having a large sore extending from half way down to my wrist nearly to my shoulder. I also had one on the left side of my face, very bad ; but the worst feature of the case was my nose — swelled to large dimensions — its appearance was awful. A deep hole was eaten through my lip from my nostrils to my jaw, and it was impossible to breathe, ex- cept through the mouth. After four weeks attention, the sores upon my arm and face were nearly cured ; the nose reduced in size ; my health gaining rapidly, and now November 5th, 1841, I am about returning home well. I Cannot leave this place, however, without leaving behind me this tes- timonial of his exalted talents as a Physician and his priceless worth as a 244 CERTIFICATES. man. His kindness and liberality towards me in my unfortunate situa- tion, calls for all I can say favorable to his character and his business. It has never been my fortune to fall in with one who combines so many qualities of head and heart as Dr. COOKE. He is emphatically the poor man's friend, and a blessing to the human race. To him under Providence am I indebted for my present state of health, and restoration to the bosom of my family and friends. But a few short months since, .^eciety would have loathed me, and death claimed me as his ; now,— thanks to Dr. COOKE, — the hand of the destroyer has been stayed, and health and peace placed once more within my reach. Dr. COOKE'S charges are the easiest of any Physician under whose care I have been. To the five above mentioned, (quacks in reality,) I have paid in one year, $700 to no purpose ; while Dr. COOKE, (the good Samaritan,) has completely cured me in about two months, for a mere trifle. CHARLES F. BRIGHAM. State of New-York, ) City and County of Albany, ) Be it known, that before me IRA HARRIS, a Master in Chancery, in and for the county of Albany, appeared CHARLES F. BRKxHAM, and being duly sworn, doth depose and say that the statement hereto an- nexed is true in every particular. CHARLES F. BRIGrHAM. Sworn the 5th day of November, 1841, before me. Ira Harris, Master in Chancery. Buffalo, November 20, 1842. To the Unfortunate. — During the past season, I had occasion to visit New York city, and while there, imprudently contracted that worst of all diseases the . Immediately, on its first appearance, I made application to a physician who professes to have a remedy for such disor- ders, and remained under his treatment for nearly two months, without experiencing any benefit. I then purchased and used several bottles of " Hunter's Red Drop," which checked it for a short time, when it again broke out with redoubled violence. Thinking that it was useless to make any further effort, I started for home, and had nearly abandoned myself to despair, when my attention was called to the establishment of Dr. COOKE, of Albany. Thither I went, as a last resource, and placed CERTIFICATES. 245 myself under the care of this gentleman. I had not been with him but a few days when I found myself getting better rapidly, and in less than a fortnight I was able to " go on my way rejoicing " — perfectly recovered — and not a vestige of the disease remaining. It is with deep feeling of gratitude that I here add my testimony to the wonderful skill of Dr. Cooke as a physician, and his great worth as a man of benevolence and practical philanthropy. CHARLES D. HAMMOND. Albany, Dec, %th, 1842. I have been an invalid nearly four years, and for the last eight weeks an indoor patient of the Lock Hospital, No. 3, Norton street, Albany, N. Y., under the care of the celebrated Dr. Cooke, who is all he is repre- sented to be, the Grood Samaritan ; a physician to the sick, a father to the fatherless, a friend to the unfortunate. I am now recovered and able to return to the bosom of my family, fully convinced of my capa- bility to cultivate my farm without risk of life or health. The medicines recommended at this Infirmary, are valuable and unsurpassed. I have no doubt that from all I have seen and heard, there is ample reason to believe Dr. Cooke has snatched many sufferers of " disease :: from an untimely grave. The unfortunate, therefore, who are desirous of availing themselves of a practical cure, should by all means patronize this establish- ment, second to none throughout the United States. The assiduous exertion of Dr. Cooke to meet the wishes of his patients, is proverbial ; the sick are at " home " and enjoy the society of perhaps one of the most eminent and philanthropic physicians around the globe — I cheerfully recommend him to the respectful notice of the community at large as a gentleman, a christian and a good citizen. LAWRENCE HARTER. Attest, William Campin. Georgeville, N. J., 1843. Dr. Cooke, of Albany, N. Y., no less distinguished for his religious zeal and benevolence, than for his extensive medical acquirements, has effected a cure in my case which had baffled the skill of thirteen physi- 1M6 CERTIFICATES. elans, " from Maine to Georgia." I have expended nearly $3000 — have tried all sorts of relief — traveled much, and, after seven weeks' attend- ance under Dr. Cooke, am well, married, and never enjoyed better health. I "ive this attestation to a worthy man — worthily conferred. Let the people rejoice that such a friend to humanity as Dr. Cooke exists. JAS. WATSON TULE. I have known the Hon. J. W. Tule several years, and can testify that he is now in the enjoyment of uninterrupted good health, for which he has only to thank Dr. Cooke of Albany, N. Y. Walter Jackson, Sup't. of Navy Yard. Georgeville, N. J. The Hon. J. W. Tule is a gentleman of good moral habits, and his testimony may be relied on. Georgeville, N. J. Richard Silsbee, D. D. Be it known that before me, Ezra Owen, a master in Chancery, in and for the county of Hebron, appeared the Hon. J. W. Tule, and f L. s.] being duly sworn doth depose and say that the statement hereto annexed is true in every particular. Sworn to this 13th day of May, 1843, before me, Ezra Owen, Mas- ter in Chancery. Old Dr. Cooke. — " Men about town " will be saved from much suf- fe ing by application to the Lock Hospital, No. 3, Norton-street, Albany, N. Y. "0 could you but hear the sad stories of those poor distressed patients, who have been induced to visit imposters, we know you would heed the warning voice which now so earnestly and sincerely appeals to you, and that you would at once commit your case, however desperate, into the hands only of an honorable physician — such a man is Dr. Cooke, of Albany, N. Y. Albany, July 8th, 1843, G-en. George Cooke, LL. D. — Sir: I feel I should be doing you the greatest injustice and also incurring discredit to myself, were I to leave the city without first adding my humble testimony of your unparal- leled medical acquirements, in the successful treatment of that awful CERTIFICATES. 247 scourge of the human race, the venereal disease, as an addendum to the many dignified certificates in your favor, and a public but grateful acknowledgment for the services rendered me in my degraded situation in life, which at one time was so wretched, that daily declining under the weight of my complaint, my bones were nearly through my skin. In this deplorable state I applied to you, and to the astonishment of those who had previously attended to my case, your advice and medicine had the happy result of restoring me to perfect health. In the fall of 1841, I was under the care of a physician in Rochester ; I had to pay him, however, his charges without deriving any benefit. I then came to Al- bany, and placed myself under a regular doctor of medicine, and who said he had " graduated at a popular medical institution in the United States." His charges were enormous, but nevertheless I paid him, and had afterwards to leave his dispensary not at all benefited. I then re- turned to Buffalo, employed Dr. Gr. ; who professed to cure such disorders. To him I paid a reasonable fee, but afterwards found myself as far from being well as at first when I set out to get relief. I came on again to Albany, flattering myself if I did not obtain some more encouragement than I first had, at least my money would be refunded. But to no pur- pose ; my money and my health were at stake. On my way to the w'esfl*! met with a doctor who partially helped me, but I could not journey with him as he lived so far distant, I then tried " Hunter's Red Drop," and was assured " after taking the worth of ten dollars," that being the only cer- tain cure, warranted in all cases when all other medicines failed, I could return home secure and free from further apprehensions, by following the printed advices. This did not do its work. I was worse than at fjrst. I then went to the northeast part of Erie county where I wintered, and in the spring, being still an invalid, I came again to this city, when I had the happiness to hear of your return* from England. I immediately made application to the Albany Lock Hospital in Norton-street, and to my great joy had the felicity of consulting you. I had not taken your medi- cine but a few days before I gained relief and strength ; and in three months, I was able to resume my business. I am now well, hale, hearty and strong, and capable of doing a hard day's work. I shall now be a blessing to myself, my wife, my family, and to society. To you I owe my present existence ; long may you live ; happy and prosperous may 248 CERTIFICATES. you dwell ; cheerfully recommending you to the favorable notice of the unfortunate, and relying on their good sense to give you universal patron- age. IRA EATON. o Sworn before me this 8th day of July, 1843. ) Robert D. Watson, Com. of Deeds. \ Oswego, June 6th, 1843. Gen. Geo. Cooke, LL. D. — Sir : In the year 1829, I was exposed, like most other thoughtless youths, to infection and contracted venereal disease ; I applied to Dr. H e, a physician, supposed to be without a rival in his practice, and received not the least benefit : I afterwards em- ployed successively, Drs. E s, G r, C r, and in fact all I could find in New York with similar result ; and lingered along until the year 1832, when the cholera attacked me. Having survived that scourge, I made my way immediately to Philadelphia by the consent of my father ; I then consulted Drs. G e, P e, R h, and several others. My disease had, by this time, become constitutional, and seemed to bid defiance to medical skill ; I returned to my native city, and applied to the city hospital, from whence I was discharged inl 834, as incurable. I then went to Boston, in great mental and bodily anguish, and remained there until 1836, without any alleviation of my sufferings ; I again returned home, and used Swain's Panacea to some extent, receiving but partial relief. I eagerly grasped at every preparation which was offered to the unfor- tunate, but, up to the fall of 1839 I was as far from being well as when I was first attacked with this horrible disease. I was then induced to go to the West ; and on reaching Albany I tried " Hunter's Red Drop," so much lauded for its manifold virtues : but after taking fifteen or twen- ty bottles, I found that my disease was seated too deeply to be affected by such a weak agency. I now lost all hope, and was wavering as to whether I should destroy myself or seek further for relief. So much having been said against you by such (as I afterwards found to be) men as were under the greatest obligations to you, and your character having been misrepresented so much, I was in doubt about consulting you, until I applied to the Rev. Clergy of Albany, who strongly urged me to consult you, assuring me that you was not only -unrivalled as a physician, but that you had the highest claim to the character of a christian and a gen- CERTIFICATES. 249 tlenian. I took their advice, and called on you in the fall of 1842 ; my case was then awful ! — the sores in my throat were putrid — I had a sore on my left eye so deep as to see the bones of the head — my nose had decayed entirely — my forehead was covered with mossy excrescences — my mouth was partially eaten away — I had a deep loathsome sore on my left thigh, which was constantly discharging foul matter — in fact I was a perfect mass of disease, emaciated to a skeleton — my skin like a leper — my hearing difficult, and taste and smell greatly injured. One of my jaws was so much diseased that I was fairly loathsome to myself and a taint to the air I breathed. In this state I applied to you ; my father, from mere curiosity, employed an artist to take a picture of my counte- nance before consultation, (a cut of which is sent) that you may exhibit to the world, with this certificate, if you desire it, what Dr. Cooke, of Albany, has done, can do, and is able to do for others ; and what no one. else can do ! I need not add sir, that I am now well. Three months probation has tested the certainty of my recovery, and you herewith receive the meed of praise so justly your due — the reward of sound skill, benevolence and humanity ; your medicines and your advice are an invaluable blessing to the unfortunate. This, sir, is no flattery ; I speak from experience. The only hope for the unfortunate is Dr. Cooke ! ! I am now on my way to Canada, and cannot depart without giving you this testimony of my sense of your worth as a man and a physician, advising all who are situ- ated as I was, to apply to you without delay, and to adhere implicitly to your directions ; for whenever one man is fortunate enough to save anoth- er from drowning or the flames, gratitude demands that the person so delivered should express his thanks to his deliverer in a becoming manner. So, also, a physician who relieves an unfortunate sufferer from disease is worthy of all praise. You have, therefore, a statement of my case as it first appeared — its progress and ultimate cure. ROBERT HERVEY. West-Point, June 10th, 1843. G-en. G-eo. Cooke, LL. D. — Sir: Allow me to express to you the most sincere and grateful feelings which can emanate from a parent's mind, for having restored my son to perfect and uninterrupted good 25*0 CERTIFICATES. health. For a period of more than seven years, prior to having been placed under your skillful treatment, he was subject to Stricture to such an extent that every one looked on his affliction with the deepest pain and sorrow ; during six long years I employed twenty-five physicians — all extolled for superhuman and magical experience. I am grateful and happy in saying that no one can now discover that my son had ever been so afflicted ; and I am most ready to bear personal testimony to this mi- raculous change, having been effected within three weeks without the slightest pain or inconvenience to my son or the necessity of a surgical operation, as at first advised by others. D. D. YATES. Royal Mail Steamship, Caledonia, Sept. 30, 1843. I have been under the care of Gen. George Cooke, LL. D,, of Al- bany, U. S., both personally and through the medium of correspondence for several months. Before I applied to him my recovery, from what had been but a few days prior to calling on him, was thought past hope. I am going home on the 1st instant well, free from misapprehension or fear of any relapse of my disease. I make this public statement because it is a compliment due a worthy, benevolent man. Dr. Cooke, though he has selected a difficult, important, and objectionable branch of medi- cine, which he treats with extraordinary success in all cases he seems to undertake ; is perfect master of his profession ; and if I may judge from the ignorance of medical men generally throughout the States, not only understands the treatment of that particular class of disease to which he devotes his whole attention, but seems to be the only physician on this side the Atlantic, who can manage such complaints. Possessed of most extensive knowledge and of the most various description, his great expe- rience is rich with the spoils of all sciences and all times. This testimo- nial is presented personally, in presence of a clergyman, to Dr. Cooke, hoping he will avail himself of all the benefits which so important a docu- ment, in support of his integrity, claims and truly due both a christian and a gentleman — cheerfully recommending him to the favorable notice of the unfortunate, who will never be at a loss for a friend in their afflic- tion, while such a philanthropist is permitted to exist — one who is de- servingly entitled to universal patronage. CHARLES MILLS. CERTIFICATES. 251 Having been requested to publish the preceding certificate, I am also proud to say that it is but another proof that I am not singular in merit- ing the approbation of my patients — ;< far and wide." A CARD— To the Hon. George Cooke, M.D. Testimonial.— Re- covered, I cheerfully give you a certificate to the following effect : Until I fortunately became a patient under your auspices, I paid to several practising physicians in Troy, Albany, New- York and Philadelphia, seven hundred and fifty odd dollars. My case, for the information of others suffering as I have, was Seminal Weakness. Your prescriptions saved me from what I thought inevitable, premature death. I respect- fully recommend you to the attention of the unfortunate, assured that you will merit the applause of many more competent to chronicle your reputation, than I am capable of doing justice. Respectfully, &c. HENRY LOWBER, Jr. Yale University, 1843. To give the reader an idea of the importance attached to my profes- sional advice, and also that the public may know the opinions entertained by physicians and the press of my mode of treating disease and the suc- cess attending the same, a few testimonials are here subjoined. Troy, Ren. Co., N. Y., 1833. Dr. GrEO. Cooke — Sir ; I had supposed mercury to be the only re- medy on which dependence could be placed for the cure of syphilis in this country. I have been a practising physician for sixteen years, have seen many cases, and cured in several instances. The gentleman for whom I applied to you is recovered, and allow me to say that "I consider your course a proper one." I shall be pleased to add my further testi- mony to your celebrity when required. Your humble servant, JOHN BROWN, M. D. Philadelphia, Penn.. 1838. Professor Cooke, M. D. — Sir : I have carefully watched the pro- gress of your advices, by letter of the 29th ult,, and were I to omit 252 CERTIFICATES. noticing their wonderful effects for gravel complaints, it would be neither justice to the inventor nor to the public, to whom I consider the remedy a valuable boon, surpassing all other modern and foreign productions for the same purpose. I recommended your " Tasteless Solution" for a case of stricture in the urethra that had baffled experienced operators for many years, which was dissolved in ten days so that the patient pro- nounced himself well ; and the person, on whose behalf I wrote special- ly for your counsel and advice, by the influence of the same medicine, has passed a stone found in the bladder, in small particles, weigh- ing I should think about an ounce and a half, which had so disabled him that he had for years been an invalid, a prisoner to his chamber. His constant exclamations are " many thanks to Dr. Cooke of Albany, for his invention, an operation is not now necessary." I am, very respectfully your faithful servant, Ezra Horner, M. D. The above is an extract of a letter to my address which may be seen at my office, No. 3 Norton-street. GEORGE COOKE, M. D., LL. D. Utica, N Y., Nov. 10, 1842. To whom it may concern : — After an intimate and long acquain- tance with General George Cooke, M. D. LL. D., both personally and professionally, I with great pleasure state that I regard him as posses- sing very superior attainments in the Healing Art, and as a gentleman of much moral and intellectual worth, he needs only to be known to be esteemed, and to be employed, to be valued. JAMES DE LA ROCHE, M. D. Whitesboro, Nov. 19 1842. To the Unfortunate. — Inquiries are often made after the most skilful physician, and the best remedies for repressing disease. Gen. Cooke, of Albany, is here known as a medical man of the " first water." His diligence of research, his style of address, his characteristic benevo- lence and superior celebrity, excels that of any other surgeon. Any one wanting his address can obtain it in letters of gold, if desired, with a guar- antee for recovery. Are you a victim of disease ? are you sick or infirm ? CERTIFICATES. 253 are you in distress ? if you would avoid imposition, employ Dr. Cooke of Albany, and never risk your all in the hands of an inexperienced quack who regards your pockets more than your health. WM. S. HARDWICK, M. D. Nous croyons devoir mentionner le nom du Dr. Cooke d' Albany, N. Y., comme etant hautement, vaute pour une partie de nos papiers d'echange, pour sa retation dans la cure de Syphilis et autre maladies veneriennes ; comme aussi des ecrouelles, fleurs blanches&e. II soigne sans avoir recours au Mercurie, au Caustic et autres remedes generalement employes eans ces cas. Une annouace de lui se trouve dans nos connes. — Montreal L 'Aurora des Canadas. Orleans County, June loth, 1843 Surgeon-General Cooke, LL. D. — The two individuals for whom you prescribed, last April, have strictly attended to the same. Your medicines were manifestly serviceable to them both ; but more so to the female, who at this time requires but little more to perfect a cure. Respecting the man, I advised, in conjunction with your medicine, no change in diet, so that in fourteen days I expect both parties will be well. They are looking to you as the only physician on earth who can cure them, and will pay you a generous fee out of their small estate ; I will hold myself responsible to you, sir, for the payment. These are the first and only patients laboring under syphilis, that have ever applied, in vain, to me in thirty years practice ; and these after taking medicine seven years. I am yours, respectfully, JONATHAN SWEET, M. D. Yates County, N. Y., June, 1843. Gen. George Cooke, LL. D. — When Mr. B r applied to me for advice, I found him laboring under the effects of "disease," in one of its most awful stages. I recommended him the use of Sulphate of 254 CERTIFICATES. Zinc, the Nitrate of Silver in small doses until the approach of strangury, when the symptoms subsided ; but in a week his complaint appeared again, and my prescriptions were afterwards of no material benefit. After ten days, your advice prevailed ; and now, six weeks since you first pre- scribed, he is well, without any fear of return of his disorder. And this is all by your unexampled skill and remarkable celebrity. B. M. WISTNER, M. D. P. S. The above is at your service for publication, if desired. Howard's Hotel, Sept. 24, 1843. Consultation of Physicians. — A consultation of Physicians was convened in this house on the 25th ultimo. At the close of the session, it was unanimously Resolved, That the thanks of the board be and are hereby tendered to Gen. George Cooke, LL. D., of Albany, N. Y., President of the meeting, for his laudable zeal to promote the best interests of the cause for which he was solicited to operate as their Chairman, and that the same be published, as a respectful compliment to this experienced physi- cian and Surgeon, in the Morning Herald. By order of the Board. JAMES HUTCHINSON, Sec'y. Gen. George Cooke, LL. D. — Sir: Captain Wood, commander of the Horatio, sails to-morrow for New- York; when I hand this letter to him he will be instructed to wait on you personally for a package of medicine with the usual advices. On this side the ocean, no one pretending the practice of physic, can be found who virtually understands that old-fashioned disorder — the Venereal — as familiar as yourself. In every town and hamlet of America your fame and celebrity as the only honorable physician, practically versed with the nature, symptoms and treatment of disease, is already established — ere long, the whole world will re-echo your worth as proverbial and universal. This, sir, is no flattery — experience has taught me that these remarks are not mere presumption. CERTIFICATES. 255 The charges for your package, Capt. "VV. will meet promptly. Please hand him a few hundred of your cards. Respectfully, CHARLES UNDERHILL, Jr. Canton, China, March 7tk, 1844. The newspaper advertiser who tries to please every one, has a more difficult task than the old man and his son, who had an only mule, in the fable. The haste with which the daily notices are often necessarily written, produces imperfections, of which, in many cases, no one is better aware than the writer. Each individual reader has a different taste from others ; and the advertisement, which may appear pointless to one, may yet seem full of meaning and interest to another ; but these things often escape the notice of those who have taken the first step in criticism and learned the art of finding fault ! Among the most celebrated physicians of the age is Gen. Cooke, M. D., LL. D., of Albany, N. Y., the founder of the Albany Lock Hospital. He is mentioned in the highest terms of praise for his benevolence and philanthropy, not only by editors of newspapers, but his worth is pro- claimed by the lecturer on literature and from the sacred desk. — Demo- cratic (Pa.) Banner. Dr. Cooke, of Albany, N. Y. — The only physician we hear spoken of in our country as a skilful medical man, well read and master of his profession, is the celebrated Dr. Cooke of Albany, N. Y. His great success in the cure of all diseases of a private nature is universally admitted, and thousands of individuals, the dupes of base and unprincipled quacks are now rejoicing in the efficacy of his medicines. Like the best tree in the " Farmer's apple orchard," so is this far-famed physician in the " Vineyard of Medicine." Both are pelted at simply because they have the best fruit. — Montgomery Republican. New York, December 1850. My Dear Doctor : I am happy to hear you have received a meritorious compliment, the gold medal awarded you for the discovery of that inval- 18 256 CERTIFICATES. liable specific for syphilis. During the whole time I lived at Albany under your kind auspices, I found that when your directions were strictly followed, the paient you allude to in your letter, was always successful in the most formidable cases of venereal disease. I am free to say, though I saw a large portion of Drs. Armsby and March's practice, both at their offices as well as at the Medical College, I never saw any case yield so readily to their mode of treatment ; and, since having been ap- pointed by the Governor of this State, Assistant Surgeon at the Marine Hospital, which affords a large scope for venereal practice, in all its branches, I have used your specific with decided advantage, having never failed to cure the very worst forms of venereal maladies. I remain, my dear Doctor, truly and respectfully, J. S. CAMERON, M. D. Granville, Jan. 6th, A. D. 1852. G-en. George Cooke, M. D., LL. D. — Respected Sir: Yours of the 13th ult., desiring my opinion of the practice pursued in your Insti- tution, is received, and I hasten to reply. Of your system of special practice, I have no hesitancy in saying that there is no place in the world, excepting, perhaps, the Governmental Lock Hospitals of Europe, where private diseases are treated with the same success as at your Hospital. The system of practice pursued by you in such cases, is new and radical and entirely unknown to the profession at large. For promptness in effect, and permanency of the cures, your sys- tem has no rival. The unparalleled rapidity with which I have known some thousands of cases of private diseases treated on the principle of your sys- tem, and at your institi^or, demonstrate conclusively the superiority of 1 your practice over all others.. In such cases, I have repeatedly seen this fact demonstrated while at Albany, by observing the treatment of a set number of private diseases on the allopathic system, and a corresponding number on your system, side by side, cases in all respects similar, wherein the cures performed by your system were consummated in about one- fourth of the time. I have nothing more to suggest. Your principles and remedies for treating such affections, have been so uniformly success- ful, and given such entire satisfaction, that the afflicted have neither sought nor desired any better system. CERTIFICATES. 257 You may expect opposition and persecution ; but in the words of an eminent man, " the blood of the martyrs is the seed of the church:" therefore I bid you God-speed in the alleviation of human sufferings to which many innocent people of both sexes are unfortunately subjected by the machinations and allurements of wicked, designing and unscrupulous persons. If the licentious and degraded libertines were the only sufferers from these loathsome affections, it would be well for them occasionally to suffer a just punishment for their transgressions ; but it is cruel for the innocent to suffer for the conduct of the vile. Viewing it in this light, I can but regard you as one of the benefactors of the human race in establishing an institution and a system of practice, in and by which the worst of human maladies can be so promptly and radically cured I remain, yours, &c, J. C. BENNETT, M. D. From the circumstance of being extensively consulted by the class of invalids I am addressing, and from devoting my attention exclusively to a select branch of the Medical Profession, it must occur that I am not singular in meriting the testimonials, or in catering for the welfare of my patients. My arrangement consists, not only of the Pen and the Confe- rence, but I have the Medicine Chest under my own control. I profess not to be a dispenser of prescriptions, nor are my offices emblazoned with the usual illuminated insignia ; but I have chosen to depart somewhat •from the track of etiquette, and to venture upon a more expedient one, namely, that of prescribing the medicines my faith dwells in ; of having prepared under my own cognizance the various remedies I advocate, whereby assurance is rendered doubly sure, that what I wish to be ad- ministered is at least had, and all possibility of disappointment averted. It must occur to every reflective person that he must be the best ac- quainted with the properties of medicines who first prescribes and then per- sonally administers them to the " unfortunate." The requisite knowledge can only be acquired by going through the gradations of the counter and bedside practice ; and having myself served a fair term to each, besides having been employed in the government service of Great Britain, both as Surgeon in the Navy and in her General Hospitals for many years, prior to my location in the United States, I insist upon being able to appreciate the advantages. To suit city or country visitors or correspondents, my arrangements are so modified, and the facilities for transmission so great, 258 CERTIFICATE* that neither delay nor publicity occur. I do not hereby for a moment, by this procedure, mistrust the whole race of Pharmaeopolists, but it is an indisputable fact, that medicines differ in their qualities and effects as much as wine ; and, like the good vintner, I prefer my own cellar to an- other's, and choose, when solicited, to be my own tapster. The " unfor- tunate " and " afflicted " portion of the human family may consult me, confidentially, as usual, at the Albany Lock Dispensary, at all hours during the day and evening, on the first floor of the Lock Hospital, No. 3 Norton-street, Albany, N. Y. GEORGE COOKE, M. D. CHAPTER IV. GENITAL MALADIES. Gravel. — Gravel is a disease which affects the kidneys, ureters, or blad- der. Its presence is denoted by the appearance of small particles of red, and (sometimes) white sand, or gravel. During its continuance, a con- stant weight or bearing down, attended with pain in the back, and a fre- quent desire to void the urine is felt. When the gravel passes from its lodgment in the kidneys or bladder,' the particles, if rough, cause the most excruciating pain. The treatment which I have found most efficacious in my practice, for gravel, is the continued use of the solution of potash — prepared accord- ing to the London, Dublin, and Edinburgh Pharmacopseias — in doses of from 20 to 60 drops, three times a day, in any warm alkaline drink, and proper moderation in the use of tea, milk, &c, with due attention to keeping the bowels regular. Cirsocele—" Is a varicose distention and enlargement of the spermatic vein, and whether considered on account of the pain which it sometimes occasions, or on account of a wasting of the testicle, which now and then follows, it may truly be called a disease. It is frequently mistaken for a descent of a small portion of omentum. The uneasiness which it occa- sions is a dull pain in the back, generally relieved by a suspension of the scrotum. It has been fancied to resemble a collection of earthworms ; GENITAL MALADIES. 259 but whoever has an idea of a varicose vessel, will not stand in need of an illustration by comparison. It is most frequently confined to that part of the spermatic process, which is below the opening in the abdominal tendon ; and the vessels generally become larger as they approach the testis. In general, the testicle is perfectly unconcerned in, and unaffect- ed by this disease ; but it sometimes happens, that it makes its appearance very suddenly, and with acute pain, requiring rest and ease ; and some- times after such symptoms have been removed, that the testicle is so wasted as to be scarcely discernible, The same effect is also observed from the injudicious application of a truss to a true cirsocele; the vessels, by means of the pressure, become enlarged to a prodigious size, but the testicle shrunk to almost nothing." Potts* Works, Vol. 2. In diseases of the testicle the left is usually affected ; occasional!}', however, the pain, swelling, &c, changes from the left to the right, as in orchitis. The diagnosis of this disease is frequently mistaken for omental hernia, to detect which, Sir Astley Cooper not inaptly remarks, that when large, it dilates during an attack of coughing, and when reclining on a sofa or couch, the swelling subsides, but on resuming an erect posture, or enga- ging in the business pursuits of the day, the swelling returns. He fur- ther remarks that " the only true method of distinguishing the two com- plaints, is to place the patient in a horizontal posture, and empty the swelling by pressure on the scrotum ; then put the fingers firmly upon the upper part of the abdominal ring, and desire the patient to rise ; if it is a hernia, the tumor cannot re-appear, as long as the pressure is conti- nued at the ring ; but if a cirsocele, the swelling returns with increased size, on account of the return of blood into the abdomen being prevented by pressure." Its cure in many instances, particularly if neglected for any length of time, is tedious and protracted. I have found that the suspensory bandage affords relief, and it is, I think, the most powerful ad- juvant that can be applied. As this disease, and some of the following, e. e. Hydrocele, Fistula in Perinseo, <&c, belong to the Operative Surgeon, I deem it out of place here, to recommend other than mild saline aperients, until the patient can avail himself of a family physician, who — from the usual mode of visiting — is the most proper person to prescribe in diseases of this cha- racter. 260 GENITAL MALADIES. Hydrocele is the name usually employed to designate the collection of a quantity of a thin serous fluid in the scrotum, generally occasioned by prior disease, or injury received in one of the testicles, causing much in- convenience and alarm to the patient. This disease in many cases makes its appearance so imperceptibly as regards pain, that the scrotum is distended to an incredible size before he is aware of it. This enlargement not unfrequently produces a bar- rier to sexual engagements, in which instance it causes the covering &c. of the penis to be therein involved ; hindering an erection sufficient to penetrate within the labia majora. Fistula in Perinceo. — When from an ill treated or neglected gon- orrhoea a stricture is formed in the urethra, and all artificial means for its removal have proved abortive, nature seeks to relieve herself of the in- convenience to which she is subject by making an opening through the urethra to pour off the urine, which, though often a means of preventing immediate death, is, of itself, a source of inconceivable detriment to the invalid through life or until it is closed. Nature to accomplish her end forms an ulceration in the urethra on the surface of its enlarged part situated between the stricture and the prostate gland. The urine coming in contact with the ulcerous portions of the urethra, its acetic properties keep up a constant irritation, and in a short time form an abscess, which, during its suppuration makes a fissure difficult to heal, through which the urine passes until the stricture is removed. The continual flow of urine over the ulcerated surface often creates such a febrile action as to produce mortification. When the urine passes into, and fills the corpus spongiosum, it some- times produces mortification in all the parts it has reached, and in short unless energetic means are immediately resorted to the result is fatal. Morbid Irritability of the Urethra. — Of the many varied sympto- matic sensations, few are more provoking and fretting than a continued troublesome itching or pain, which frequently attends the passage of the urine ; there may be no discharge of any kind ; but there is either a con- stant tingling, partially pleasurable sensation, drawing the attention perpetually to the urethra, or there is felt some particular heat or pain during micturition. Those sensations do not always indicate a venereal affection ; they appear to arise occasionally from local irritation, perhaps induced by a morbid condition of the urine, GENITAL MALADIES. 261 The usual mode of treatment (always successful in my practice) con- sists of placing the patient in a warm bath for about twenty minutes, then immediately going to bed and drinking a warm, weak stimulating beverage. This followed up for a few nights in succession, will answer the desired end. Diabetes. — This is a disease of rare occurrence, and is supposed to originate from a disordered state of the kidneys. It consists in a profuse flow of urine, often double the quantity of both fluid and solid food taken in the stomach. Its symptoms are languor, a sense of weariness on the least attempt at exercise, costiveness, pain in the stomach, a con- stant desire of micturition, an ungovernable thirst, and a wasting away of the flesh. The discharge of urine varies, in the course of twenty-four hours, from six to ten quarts. This constant drain debilitates the patient, depresses his spirits, gives rise to a low hectic fever, causes his feet to swell, and generally superin- duces symptoms, by which, unless prompt relief is obtained, the patient is hurried on to a premature end. The means from which the most benefit can be derived are due regula- tion of the bowels and the moderate and continued use of a tonic medi- cine such as the following : Compound tincture of gentian, sixty drops three times a day, i. e., an hour before each meal, and five grains of storax pill every night on going to bed. CHAPTER V. THE SKIN AND ITS DISEASES. The anatomical definition of the word "skin," is, "a large, thick membrane, spread over the whole body, serving as the external organ of feeling, and as a covering and ornament for the parts underneath." Common integuments, or the coverings of the body, consist of the cuticle, or epidermis, with its adjunctives, the nails', rete mucosum; and true skin, cutis, or dermis. To these three layers, or strata, as they may be termed, some anatomists add a fourth, which is denominated the 262 THE SKIN AND ITS DISEASES. adipose membrane. The word " skin," represents the technical expres- sion "common integuments." Bichat, a celebrated French Physician, has divided the organization and functions of the skin into three parts, viz : the dermoid system, or cutis, with the numerous layers on its surface ; the epidermoid system, or cuticle, with the nails; and tbV hairy system, relating only to the hair. The Dermoid System. — In all animals a membrane covers the surface of the body, and is more or less dense. Its thickness is usually well ap- propriated to the bulk and volume of the body which it has to enclose. Its purposes are to protect all the organs which lie beneath it ; to di- vide into compartments a considerable portion of the residue of nutrition and digestion ; and to define the relations between our frames and the surrounding objects. Rees' Encyclopaedia defines it to be in man, "the sensitive limit of his frame, placed at the extremity of his sentient pow- ers, incessantly exposed to external impulses, thus giving rise to the re- lations of his animal life, and connecting his existence to that of external objects." This covering is the skin, or cutis. This membrane is so well proportioned to the external parts over which it is stretched, as it were, that it follows all their inequalities, rendering the prominent projections every where apparent, but nevertheless con- cealing many of the smaller. Hence the difference of the body of any living thing in its entire, and unflayed, or unskinned state. At the dif- ferent openings into the interior of the body, the membrane is reflected and originates the mucous system. The boundaries of the two systems are defined by a reddish line, the mucus being within and the dermoid on the outside of that boundary. The exterior surface of the dermoid system is contiguous to the epider- mis. This surface is characterised by the hairs which are planted in it, the oily matter which habitually covers it, the perspiration deposited on it, and the sense of touch existing in it. There are various kinds of folds perceptible on the exterior surface. Some depend on certain superficial muscles which throw the skin into wrinkles when they contract. The wrinkles of the forehead are thus produced by the epicranius ; the folds around the eyelids are formed by the orbicularis ; the wrinkles or dim- ples of the cheeks by the zygomatic and levator muscles ; and those round the mouth by the orbicularis oris. In fact, all these folds are the THE SKIN AND ITS DISEASES. 263 'result of muscular contractions, the skin not being able to contract as the muscles do. Other wrinkles arise from the movement of particular parts, without reference to the muscles beneath — such as the motions of the palm of the hand and the sole of the foot. In the back of the hand and of the foot, there are numerous wrinkles when those extremities are quite ex- tended ; but they disappear when the members are bent, because the skin is there more loosely than elsewhere. The wrinkles of old age are quite different from those above mentioned, and arise from the disap- pearance of the fatty matter beneath the skin — thus rendering the skin too large for the parts which it covers. In other words, when beings FALL away through old age, their skin fits very loosely, and naturally wrinkles, like a coat that is too large. Organization of the Dermoid System. — The tissue of this system is divided into the corium ; the rete mucosum ; and the papilla;, or villi. The Corium is always white in the human body : it is the essential part which determines the thickness and form of the skin. On the head it is particularly thick and dense in its texture, on account of the numerous hairs that traverse it : in the face it is thin and delicate, especially on the eyelids and lips. Its thickness on the back is nearly double what it is on the front of the body. On the breasts of women it is remarkably thin, and, as a general rule, the corium is thinner in women than in men. The rete mucosum, or reticular body of the skin, is but little distinct from the corium, except that it is a layer of a more mucous nature, and gives color to the surface of the body. In a negro, the rete mucosum is a thin black layer, about as thick as the cuticle itself. Mr. Cruik- shank describes it as being double, and consisting of a grey transparent membrane, and of a black web. *VWe may then conceive " says Bichat, " that the reticular body is a general capillary system, surrounding the cutaneous organ, and forming, with the papillae, a layer between the co- rium and epidermis. In the white part of the human race, it only con- tains white fluids ; in the negro, the fluids are black, and of various tints in the other varieties of the human race. The color of the skin is transmitted to the offspring, and is amazingly altered by the fact of intermarriages amongst the different races. Where a black and a white individual have offspring, the children have the mid- 264 THE SKIN AND ITS DISEASES. die tint between the tints and hues of their parents. If the child of a black man marries a white person, and their child again intermarries with another white individual, and so on, the offspring will be white in the fourth generation ; and vice versa. " The color of the cutaneous organ in the white races " says the en- cyclopaedist before quoted, " is much modified by accidental circumstances. Exposure to the sun's rays produces various shades of a reddish brown color, which effect is commonly called tanning. This alteration is very rapidly produced by going much on the water, in consequence of the re- flection of the light from its surface. That this is the consequence of the cause just assigned, and that the effect is not produced by heat, is rendered obvious by the difference of color in the face and hands, and on those parts of the body which are habitually covered ; also by the brown tint of the face produced by the summer's sun, which offers a remarka- ble contrast to that of the forehead, where it is protected by the hat." Our clothes do not prevent the action of heat upon the skin, but will in- tercept the luminous rays. The pale and sallow complexion of the in- habitants of large cities, compared with the florid complexions of coun- try people, arise from the same cause. Men are blanched like plants when shut out from the influence of the sun. The light brown spots, called freckles, which occur about the head and neck when exposed to the sun and air, are of the same nature with the tanning described. The papilla of the skin are small eminences of its external surface. They are supposed to perforate the reticular body, and consequently to be contiguous by their extremities to the epidermis. They are called villi, when they are small and fine. Malpighi was the first who taught the doc- trine that the external surface of the skin is not level, but is elevated into certain prominences under the cuticle. The papillae are very visible in the hands and feet. We observe narrow longitudinal and slightly prom- inent lines in the cutis, distributed spirally at the ends of the fingers and toes ; from these ridges arise very small conical processes like fine threads or hairs, slightly inclined towards the nail, shorter and more imperfect in the smaller toes and fingers. The organs receive numerous blood-vessels, so as to be much more deeply tinged by colored injections than by the sur- rounding skin. The Epidermoid System. — The exterior epidermis is a transparent stratum, or layer, varying in thickness in different parts, every where THE SKIN AND ITS DISEASES. 265 covering the skin, and immediately exposed to the excitation of external bodies. Various pores penetrate it ; and it has the same inequalities as the cutis. Some of the pores afford a passage for the hairs ; others are vents for exhalation. The transparence of the epidermis is in parts de- stroyed by its thickness, as on the soles and lower surface of the toes ; and on the palms and corresponding side of the fingers. There it is whitish, and even opaque. Hence, in the negro it conceals the black color of the reticular body, which, however, is at the same time less black here than in other parts. The action of air produces scarcely any effect upon the epidermis. When a large piece is exposed, it becomes some- what harder and more consistent, and is torn with greater difficulty. The epidermis is equally destitute of the organic sensibility, and organic insensible contractility; it possesses no circulation, and is susceptible of no diseases which depend on the organic properties. It enjoys scarcely any vital powers at all ; so that I may consider the whole superfices of the body as composed of dead matter. Bichat declares that " its life is extremely obscure : I even doubt whether it can be said to possess life. I am inclined to believe it to be a semi-organized, or rather inorganic body, placed by nature at the point of communication between external dead matter and the living skin, and serving as a gradation between them." Rees's Encyclopedia contains the following interesting information upon the subject : " The epidermis is reproduced very completely after being removed, and differs in that circumstance from most other tissues. How this is effected has been a point greatly disputed by physiologists ; but the explanation has been entirely mechanical and unsatisfactory. That it is deposited by the vessels of the skin cannot be doubted, and we shall probably understand how the process is effected, when we have learned how the vessels make bone, nerve, muscle, &c. This reproduction only takes place on the skin : the thin pellicle covering the cicatrices or scars of other tissues has a completely different texture. The different ex- crescences affecting the cuticle, as corns, &c, result from the exercise of this reproductive power. They are all insensible, have no vessels nor nerves, and possess the same consistence and color as the epidermis. Ex- ternal pressure seems to promote the formation very powerfully : tight shoes produce corns ; and much handling of heavy instruments in hard work produces the thick cuticular covering of the hand in blacksmiths and c*her mechanics." 266 THE SKIN AND ITS DISEASES. Cutaneous Diseases or Eruptions comprise all the variety of discolo- rations, spots, and excrescences which arise on the skin, and which have obtained various denominations, according to the difference of their forms ; such as pimples, pustules, vesicles, scales, rashes, &c. The modification of these, again constitute the different kinds of cutaneous diseases, such as small pox, measles, scrofula, &c. It is of these maladies that I shall now proceed to treat, explaining their symptoms where such an explana- tion is necessary, and suggesting remedies where such suggestions may be safely offered. Scrofula. — Scrofula is a constitutional affection which manifests itself in various symptoms and forms of disease ; swelling of the glands of the neck, ulcers all over the body, rickets, sore-eyes, and swelling of the joints. The first appearance of the disease is most usually between the third and seventh year of a child's age, but it may arise at any period between these and the age of puberty, after which it seldom makes its first attack. It most commonly affects children of a lax habit, with a smooth, soft and fine skin, fair hair, rosy cheeks, and a delicate complexion, which shows a number of blue veins on the face ; but it is not always confined to such appearances. It likewise developes itself in children with large foreheads, enlarged joints, and protruding stomachs. Scrofulous persons are often comely and handsome, and rather distin- guished for acuteness of understanding, and precocity of genius. They are, however, seldom robust, or able to endure much fatigue without having their strength greatly exhausted, and their flesh much wasted ; but when they once begin to regain these, their convalescence is usually rapid. Scrofula prevails more in those climates where the atmosphere is cold and humid, where the seasons are variable, and the weather is un- steady. A long continuance of inclement weather may increase any pre- disposition to scrofula ; and in persons much predisposed to it, any un- common though temporary exposure to wet and cold is sometimes an exciting cause of an immediate attack. Besides climate and exposure to moist air, and atmospherical vicissitudes, every other circumstance which weakens the constitution and impairs the general strength of the system, predisposes to scrofula ; thus breathing impure or tainted air, unfit for respiration, and living upon food of an unwholesome or indigestible na- ture which does not afford proper nourishment to the body, favors an THE SKIN AND ITS DISEASES. 267 attack of scrofula, by reducing the strength of the system, and making the person weakly. The neglect of personal cleanliness and of salutary exercise, indolence and inactivity, the want of warm clothing, confinement in cold damp habitations, &c, may all be regarded as so many exciting causes, and satisfactorily account for the prevalence of the disease among children employed in large manufactories, as Lowell, Mass., Cohoes, N. Y., &c. Scrofula is by no means a contagious disease, but beyond all doubt, is of a hereditary nature, and is often entailed by parents on their children. The patient, it is true, is not born with the disease ; but only with a greater aptitude to receive certain morbid impressions which may bring the latent disposition into action. There are indeed some practitioners who wholly deny that this or any other disease can be acquired upon the hereditary principle — but that a peculiar temperament of body, bias or predisposition in the constitution to some diseases, may-extend from both father and mother to their offspring, has been clearly proved ; for exam- ple, gout is frequently met with in young persons of both sexes who could never have brought it on by intemperance, sensibility, or improper diet, but must have acquired the predisposition to it in this way. "A remarkable circumstance attending the transmission of scrofula is, that although it is a hereditary disease, it does occasionally pass over one generation and appear again in the next ; so that the grandfather and the grandson, (the first and third generations) shall be both scrofulous, while the intermediate one, which holds the more intimate relation of father and son, and connects the two others together, shall be exempt from any attack of the disease." Mr. Cullen, an eminent medical writer, has supposed scrofula to de- pend upon a peculiar constitution of the lymphatic system. One of the most frequent symtoms of this disease is undoubtedly an enlargement of the lymphatic glands, and the frequency and often universality of such swel- lings have induced some physicians to suppose scrofula as depending upon a morbid affection of the lymphatic system ; but many other parts of the body which show little of a glandular structure, are very often the pri- mitive seats of scrofula. A modern writer considers scrofula as a disease arising from, and generated by, disorders of the digestive organs ; but this opinion is ill-founded. It is certainly a disease of very frequent oc- currence in this country, particularly in large manufacturing districts, ap- 268 THE SKIN AND ITS DISEASES. pearing under various forms, and in different degrees of severity, from a state of mildness, which hardly betrays any perceptible external symp- toms, to a state of violence, which produces the most miserable objects of human wretchedness, and wherever it mingles with any accidental or local complaints, it makes all the symptoms more and more difficult to cure, particularly in syphilis. The attacks of scrofula seem much affected or influenced by the periods of the seasons. They usually begin some time in the winter and spring, and often disappear, or are greatly amended in summer and autumn. The first appearance of the disorder is commonly in that of a small oval or spherical tumor under the skin, unattended by any pain or discoloration. These appear in general upon the neck, below the ear, or under the chin ; but in some cases the joints of the elbows or ankles, or those of the fin- gers and toes, are the parts first affected. In these instances, however, there are not found small moveable swellings, but on the contrary, a tu- mor almost uniformly surrounding the joint and interrupting its motion. After some length of time, the tumors become large and more fixed ; the skin covering them acquires a purple or livid color ; and, being much in- flamed, they at last suppurate, and break into little holes, from which at first a little matter, somewhat puriform, oozes out ; but this changes by degrees into a kind of viscid serous discharge, much intermixed with small pieces of a white substance, resembling the curd of milk. These tumors subside gradually, while the ulcers at the same time open more, and spread unequally in various directions. After a while some of the ulcers heal ; but other tumors quickly form in different parts of the body ; and proceed on in the same slow manner as the former ones, to sup- puration. In this way the disease goes on for some years, and appearing at last to have exhausted itself, all the ulcers heal up, without being suc- ceeded by any fresh swellings, but leave behind them ugly puckerings of the skin, and scars of considerable extent. This is the most mild form under which scrofula ever appears. In more violent cases the eyes are particularly the seat of disease, and are afflicted with opthalmia, giving rise to ulceration in the tarsi, and in- flammation of the tunica adnata, terminating not unfrequently in an opa- city of the transparent cornea. In similar cases, the joints become af- fected — they swell, and are incommoded by excruciating, deep-seated pain, which is much increased upon the slightest motion. The swelling THE SKIN AND ITS DISEASES. 269 and pain continuing to increase, the muscles of the limb become much wasted. Matter is soon afterwards formed ; and this is discharged a: small openings made by the bursting of the skin. Being, however, some- what of an acrimonious nature, it corrodes the ligaments and cartilages, and produces a caries of the neigboring bones. By an absorption of mat- ter into the system, hectic fever at last arises, and in the end proves fatal. The bones also of scrofulous persons partake of the general disease in the constitution ; they seem to contain a smaller proportion of animal earth, and a larger of gelatinous matter, than what accords with the com- position of a healthy bone , on which account they are extremely suscep- tible of a morbid action. The diseases in which they are most liable, are general and partial enlargement, inflammation, suppuration, and exfolia- tion. They are also easily fractured, which facility is much increased, especially in the long bones, by the deficiency of solid substance ; for the cylindrical shell is preternaturally thin, and therefore mechanically weak, so that the bones break upon the application of an inconsiderable force. A diseased state of the vertebrae which, in consequence of the softness of their bodies, occasions a protrusion of their spinal processes, and a compression of the medulla, is generally allowed to be closely connected with scrofula. The primary attacks of 'Scrofula often admit of an appa- rent cure, while their sequent are secretly laying the foundation of diseases which undermine the patient's constitution, and unexpectedly manifest their insiduous effects at a distant period of time, when no suspicion was entertained of their existence. When scrofula is confined to the external surface, it is by no means with danger, although on leaving one part it is apt to be renewed in others ; — but when the ulcers are imbued with a sharp acrimony, spread, corrode, and become deep, without showing any disposition to heal, — when deep-seated collections of matter form among the small bones of the hands and feet, or in the joints, or turbercles in the lungs with hectic fever arise, the consequences will be fatal. On opening the bodies of persons who have died of this disease, many of the viscera are usually found in a diseased state, but more particularly the glands of the mesentery, which are not only much tumefied, but often ulcerated ; the lungs are frequently discovered beset with a number of tubercles or cysts, which contain matter of various kinds. Scrofulous glands, on being examined by dissection, feel somewhat softer to the touch f 2*70 THE SKIN AND ITS DISEASES. than in their natural state ; and, when laid open, they are usually found to contain a soft curdy matter mixed with pus. Examinations after death of those who have labored under a disease of the spinal column, have shown that almost all the glands are found in an enlarged, diseased and often suppurated condition ; and that cysts are always discovered connected with the diseased vertebrae that contain curdy, purulent, and other matter of unequal consistence. Scrofula is a disease, the cure of which is of acknowledged difficulty. Its treatment naturally divides itself into two p'eriods : — the first is that in which without any local sore, or other marked symptoms of disease, there is sufficient evidence of a scrofulous predis- position prevalent in the system : the other is that in which some local sore, or other scrofulous symptom, which requires appropriate manage- ment that may either concur with the general treatment of the constitu- tion, or interfere with it, has actually taken place. As scrofula is generally promoted by the slow operation of a number of circumstances, which produce a gradual change in the constitution, there is great reason to expect benefit from placing the patient in a differ- ent situation of circumstances ; if, for instance, the continuance of im- proper diet has seemed to favor the appearance of the disease, an amelio- ration of it will naturally counteract this tendency : a similar advantage will be derived from substituting the respiration of pure and salubrious air instead of what is tainted and unwholesome, and, in like manner, every management conducive to health, and that will invigorate the body, will contribute to correct the disposition to scrofula. The languor and debility which prevail in scrofula, naturally indicate the necessity of em- ploying a plentiful supply of wholesome nourishment in such quantity as the stomach can bear without being overloaded, and of this, light animal food ought to form a fair proportion. The quantity must be regulated by the appetite and powers of digestion. Milk, puddings, rice, andothei farinaceous substances, ought to constitute the remainder of the patient's diet. When there is occasional atony in the stomach and languor, a mod- erate allowance of Port Wine will be likely to prove salutary ; but it will be best to give it between meals with a bit of bread or cake. Every weakly scrofulous person who wishes to recruit his health and strength, should retire to bed early at night, rise early in the morning, and if possible, select for his residence a situation where the air is pure and dry. It is generally recommended to scrofulous persons, who use THE SKIN AND ITS DISEASES, 271 sea bathing, to drink a bottle of the water daily, that it may act as a gentle purgative, and empty the intestinal tube of all feculent matters. When not at the sea-side, a solution of any of the neutral salts, such as potassse tartras, potassse sulphas, &c, may be substituted. In eruptive Scrofula, a small quantity of the following ointment, if used as directed, with a camel hair pencil brush, will be the most proper remedy : — C Arsenic, in powder, four grains, < Pulverized Opium, ten grains, I Hog's Lard, one drachm. the ulcerated parts to be slightly touched with this ointment every night and morning, over which is to be worn a piece of soft muslin, secured with a bandage ; a tablespoon of the Aromatic Mixture of Iron, as prepared by the Dublin Pharmacopoeia, is to be taken regularly four times a day, until all eruptive appearances have subsided. The more direct treatment of adult age, as well as infancy, is so varied, that, to give more general formula for preparing medicine would be futile ; personal application and strict adherence to the advice of a physician, are requisite to ensure recovery. Scrofula in Children. — As this terribk malady is fraught with so much distress and misery to entire families, I have thought it proper to devote a separate article to the treatment of the disease in respect to children. Scrofulous children should be allowed the use of wine and coffee, in very small quantities, at an early age ; and when the child is very delicate, the period of suckling should be prolonged considerably beyond the usual time. But the mother who is predisposed to the disease, or has ever suf- fered from it in her childhood, ought never to suckle her own child. In their studies such children should have amusement rather than fatigue ; for intellectual toil requires bodily repose ; and toil to them is death. With them too, the age of puberty will require more than ordinary atten- tion, that the efforts of nature may be duly seconded. Whatever coun- teracts scrofula, being beneficial, the patient should live on a dry soil, which is exposed freely to the sun, is far from marshes or fogs, and where the temperature is rather warm than cold. The air should be pure. He should also dwell in a house, the walls of which are perfectly dry, and free from all dampness ; and his apartment, besides being clean and airy, should be exposed to the sun's rays, and elevated considerably from the ground. He should sleep on a hard bed. His diet should be half animal 19 272 THE SKIN AND ITS DISEASES. and half vegetable. The dishes should he savory and lightly seasoned ; but he should eat moderately, and never ought to taste of bread which is not leavened. His clothes should keep out the cold in winter, but allow the breeze to impart vigor to the skin in summer. He must keep his feet warm, and cover his head lightly ; and, by guarding against sudden varieties of atmospheric temperature, and using dry friction to the skin, promote a healthy perspiration. His sleep should be moderate : and he ought to arise early ; every means ought also to be employed to prevent a too early marriage. The shower bath may be used every morning during summer. Scarlatina. — The characteristics of Scarlatina are as follow : The fever is the contagious synochia. About the fourth day of the disease the face is a little swelled : a florid redness, in large spots, afterwards coalescing, spreads partially over the skin ; and in about three days more goes off in furfuraceous scales, often succeeded by anasarca. The dis- ease takes its name from the color of the patient's skin. It is divided into three kinds : when unaccompanied with an ulceration of the throat, it is named scarlatina mitis, or simplea ; when attended with such an affection, it is called scarlatina anginosa ; and when accom- panied by their symptoms of malignancy and putrescency, the term scar- latina maligna is applied to it. The two latter are, however, very fre- quently blended together. It has been disputed, whether the scarlet fever and malignant sore- throat ought to be esteemed different diseases, or only varieties of the same disease. In my opinion they are the same in specie, which is confirmed by our finding that they are both epidemical at the same time : even in the same family, where a number of children have been ill either together, or im- mediately after one another, some have had the distinguishing symptoms of scarlet fever, and others of the malignant sore throat. Indeed, it is now pretty well admitted, that scarlatina, in all its forms, as well as th? cynancha maligna, is produced by the same specific contagion. There prevails much doubt amongst practitioners respecting the recur rence of scarlatina, some affirming that they have seen the disease recui in so manifest and unequivocal a form, as to leave no doubt on then minds as to its possibility ; whilst others deny its ever affecting the samj person a second time. Amongst the great number of persons who have THE SKIN AND ITS DISEASES. 273 loeen infected, a few may be admitted, I think, to have gone through it a second time ; but persons who have once been attacked with it, are less susceptible than those who have never had it. Scarlatina attacks persons of all ages, but children and young people are most subject to it, and it appears at all seasons of the year ; but it is more frequently met with towards the end of autumn, or beginning of winter, than at other periods, at which time it often becomes a very prevalent epidemic. Sudden changes from heat to cold, rainy weather and indigestion, may predis- pose the body to be acted upon more readily by the infection. As an epidemic, scarlatina does not always assume precisely the same appearance. This diversity depends probably, in part, upon the varying nature and constitution of scarlatina itself, independently of all intrinsic circumstances ; in part, upon certain contingencies, which are common to all the inhabitants of a whole district of country ; such as the seasons of the year, the temperature of the air, the mildness or inclemency of weather, together with other unknown qualities of the atmosphere ; and partly upon circumstances which apply to individuals subjected to the disease, their general habit of body and constitution, their particu- lar state of health at the time of the attack, and their situation in re- spect to lodging, ventilation and cleanliness. Beyond all doubt scarlatina is of a very contagious nature. Simple contact, inoculation and inhalation, are the different w r ays by which the infection, not only of scarlet fever, but of other contagious disorders, may be introduced into the human body. It is the opinion, however, of Dr. Blackburne, that the chief and only avenues to infection in common, are the mouth and nostrils ; and, consequently, that to guard against its communication through these channels, is the principal, or only necessa- ry precaution. He thinks that the introduction of infectious particles into the human body by simple contact is impossible ; and to support this, he brings forward the testimony of the late philanthropic Mr. Howard, who made no scruple of going into the open air to the windward of a person ill of the plague, and feeling his pulse ; as likewise that of Dr. Russel, who personally attended the sick in the plague, and felt the pulses of a great number. That infection by the simple contact of poi- sonous matter on the skin is far less ready to excite disease than when applied in the subtle state of vapor, to the more irritable surface of the nostrils and bronchiae, is indisputable ; but that it appears universally 274 THE SKIN AND ITS DISEASES. innocuous under every state and condition of the body, may be doubted. The disorders to which scarlatina bears the greatest resemblance, are the measles and cynancha maligna ; but from the former it may be dis- tinguished by attending to the following characteristic remarks, in addi- tion to those noticed under the head of Measles. The efflorescence in scarlatina generally appears on the second day of the fever ; in the mea- sles, it is seldom very evident until the fourth. It is much more full and spreading in the former disease than in the latter, and consists of innum- erable points and specks under the cuticle, intermixed with minute papil- lae, in some cases forming continuous, irregular patches ; in others, coal- escing into an uniform flush over a considerable extent of surface. In the measles the rash is composed of circular dots, partly distinct, partly set in small patches or clusters, and a little elevated, so as to give the sensation of roughness when a finger is passed over them. These patches are seldom confluent, but form a number of crescents, with large, inter- vening portions of cuticle, which retain their usual appearance. The color of the rash is also different in the two diseases, being a vivid red in that of scarlatina, like that of a boiled lobster's shell: but in the measles a dark red, with nearly the hue of a raspberry. During their febrile stage, the measles are distinguished by an obsti- nate, harsh cough, forcing up, in repeated paroxysms, a tough acrimoni- ous phlegm; by an inflammation of the eyes and eyelids, with great sen- sibility to light ; by an increasing discharge from the lachrymal glands, sneezing, &c. Scarlatina is frequently attended with a cough, as also with redness of the eyes ; but on minute observation, it will generally be found that the cough in scarlatina is short and irritating, without ex- pectoration ; that the redness of the eyes is not attended with intolerance of light; that the ciliary glands are not affected, and that although the eyes appear shining and watery, they never overflow. In scarlatina there is usually a peculiar sensation of anxiety, depression, and faintness in all cases which are attended with fever ; whereas, in the measles symptoms of general inflammation are to be met with, except where the disease ap- pears under a malignant form. The following are the chief distinctions between scarlatina mitis and cynancha maligna. The fever in the former is somewhat of an inflamma- tory nature, and is unattended with sloughy ulcerations in the throat ; in THE SKIN AND ITS DISEASES. 275 the latter these are always to be observed, the breath is very foetid, and the accompanying fever is of a typhoid kind. In scarlatina, the skin is of a brighter scarlet, smooth, and always dry and hot ; in cynancha ma- ligna, it is red and pimply, the pimples being redder than the interstices. Scarlatina mi.tis, like all other fevers, begins with languor, lassitude, con- fusion of ideas, chills, and shivering, alternated by fits of heat. The thirst, after a little time, becomes considerable, the skin dry,with anxiety, nausea, and vomiting. The alvine concretions are most commonly of the usual quantity • the urine is high-colored and turbid, and the pulse is weak, and varying from 100 to 120 strokes in a minute. In a few cases, some slight affection of the fauces is perceived. About the second or third day, the scarlet efflorescence appears on the skin, which seldom produces, however, any remission of the fever. On the departure of the efflorescence, which usually continues out only for three or four days, a gentle sweat comes on, the fever subsides, the cuticle, or scarf- skin, falls off in small scales, and the patient gradually regains his former strength and health. Such is the disease in its mildest aspect. In scarlatina anginosa, the patient is seized not only with coldness and shivering, but likewise with great languor, debility and sickness, succeed- ed by heat, nausea, vomiting of bilious matter, soreness of the throat, inflammation and ulceration of the throat, a frequent and laborious breathing, and a quick, small, and depressed pulse. When the efflores- ence appears, it brings no relief; on the contrary, the symptoms are much aggravated, and fresh ones arise. When scarlatina is to terminate, in health, the fiery redness abates gradually, and is succeeded by a brown color; and the skin becoming rough, peels off in small scales, their tumefaction subsides, and health is gradually restored. On the contrary when it is to terminate fatally, the febrile symptoms run very high from the first of its attack, the skin is intensely hot and dry, the pulse is very frequent but small, great thirst prevails, the breath is very foetid, the efflorescence makes its appearance on the second day, or sooner, and about the third or fourth is probably interspersed with large livid spots, and a high degree of delirium ensuing, or haemorrhage breaking out, the pa- tient is cut off about the sixth or eighth day. In some cases, there is a severe purging, which seldom fails to prove fatal. Some again, where the symptoms do not run so high, instead of recovering, as usual, about the time the skin begins to regain its natural color, fall into an atrophy, 276 THE SKIN AND ITS DISEASES. and are carried off in the course of a few weeks. Scarlatina in its mild state, is not usually attended with danger; hut when it partakes much of the cynancha maligna, or discovers a putrid tendency, it often proves fatal. The discharge of a highly acrid matter from the nose, diarrhoea, the fauces of a dark red or purple color, without swelling, ash-colored or brown specks, soon becoming ulcerated, great prostration of strength, delirium, coma, difficulty of breathing, haemorrhages, are very unfavora- ble symptoms. Where scarlet fever is very mild, and wholly unattended by any inflammation or ulceration in the throat, little more will be requisite than to keep the apartment clean and open ; to enforce a light diet without animal food; to direct cooling acidulated liquors for common drink, and to ad- minister gentle medicines suitable to the symptoms that present themselves. In more severe cases, where the skin is very hot and dry, the pulse much accelerated and the head very painful, the first thing to be attended to is the state of the bowels. When they are inclined to be costive the fol- lowing preparation will correct them: — Calcined magensia, > one Sulphate of magnesia, $ » > An even teaspoonful in a glass of cold water every four hours until they are comfortable without relaxation. The same night at bed time, three grains of James' powder, and three times a day afterwards until the febrile stage subsides : after which the following mixture : (Sulphate of magnesia, four ounces; Water, one pint; ■ Sulphuric acid, ninety drops; [Muriated tincture of iron, two hundred and forty drops. One tablespoon every morning and evening ; the above are adult doses : for a child, one-third of each quantity is the proportionate dose. A case quite in character with such symptoms and verging closely on the the loss of the patient occurred in the year 1829, in my practice as a family physician in this city. It was marked by nearly all, and even some worse symptoms than those above delineated : the family alarmed at this stage of the disease, one and all hesitated to act in any capacity whatever at the bed-side; and through necessity, the two-fold duty of nurse and physician devolved upon me. The exigencies of the case demanded my entire at- tention which, until a more favorable change of symptoms took place, and the patient became convalescent, enabled me to carry out the prescrip- tions I have laid down, by which simple treatment I never remember to THE SKIN AND ITS DISEASES. 277 have failed in any one case of this class of fever : having witnessed so many different varieties of fever, I did not hesitate in my treatment. In the Javanese Islands, I at first encountered some difficulty, but by close observation I encountered all obstacles, experiencing in no instance, any detriment to my own health, I would here remark that in all cases of contagious fevers if regular hospital or hardy naval surgeons who have served perhaps half their lives time in what may be deemed general hospitals in foreign climates, (in- stead of young aspirants to honor and professional fame as the gift of State appointments,) were stationed at quarantine, where so much ship and other fevers are ever on the wing, death would not so often make such havoc among them in the midst of their usefulness. To avoid the pestilence that walketh in darkness and at noon-day, the physician should observe suitable precautions in his habits, and mode of liv- ing; and,in a word, bearing in mind that it is imprudent either to remain long- in a ward, or suffer the air to become confined in the same : he should also see that the hospital is thoroughly fumigated as often as it is necessary. By adopting these few, but simple rules, I have ever escaped unharmed and my efforts have been crowned with the most flattering testimonials of gratitude. Eruption from Balsam Copaiba. — Want of accuracy in the opinion of a medical man in regard to the character and situation of disease is often a source of great injury to the patient. The effects of medicines previously given, in their development frequently mislead him, in conse- quence of which, too great care cannot be exercised by both parties. A case in point will perhaps illustrate : About the year 1845, a gentleman whom I had previously attended for Impotence, called on a physician in this city for advice concerning the sudden appearance of a rash, extending nearly over the whole surface of the body — much to his annoyance. The physician, after due examina- tion, declared the rash to be that of Scarlet Fever. Not satisfied with the physician's statement, he asked my opinion. I told him he had no symptoms of Scarlet Fever, other than the rash, which might be pro- duced by a variety of causes. The appearance of this rash gave me con- fidence in declaring my convictions that he had some time previously been using Balsam of Copaiba, which he acknowledged was true ; and for his relief, I advised rest, and abstinence from stimulating food and drinks, 278 THE SKIN AND ITS DISEASES. and recommended him to correct the deranged state of the bowels, and to his surprise 48 hours had not elapsed before every vestige of rash had disappeared, and all inflammatory action had subsided. It may be of interest to some to know the history of the disease under which this gentleman had formerly suffered ; and which gave him confi- dence in again soliciting my advice. In the year 1843 he applied to me for medical aid ; I discovered upon examination and inquiry* that for many years he had been a victim to that self-debasing habit, Onanism. He had persevered in the abuse until all excitability or emotions pe- culiar to his sex, were entirely destroyed. This insensibility to, and in- capacity for sexual engagements had existed for nearly three years. Pre- vious to making his application to me, he had consulted two physicians of respectability in this city, who both alike pronounced his disease incurable; Reader, judge of his feelings on being made acquainted with the opin- ions of these gentlemen ; and the keen remorse of conscience in knowing that his own inconsistent practices had brought him to this pitiful condi-* tion. He had previously made proposals for marriage, and they had been accepted. In this state of mind and body he made his case known to me. I at- tended him faithfully, and in due course of time perfectly recovered his pristine powers, was married, and became the father of two children^ and when called by government obeyed its mandate, and in the late Mexican war, contending for the rights of his country, and the supremacy of her laws fell, with others, in the field of battle. Java Fever. — While in the British service^ the vessel on which I held the appointment of Assistant Surgeon, was sent to the Javanese Islands ; while nearing one of them, (Timor) a deputation was sent out by its governor to ascertain if there was a medical man on board ; I hastened to the shore and found the inhabitants in a pitiful condition ; a fever was prevailing which seemed to baiSe their skill ; and upon inquiry I was not in the least surprised at its fatal effects. Their only medical attendant was a black man, and his professional treatment in all cases— enemas. Several deaths occurred almost every hour in the day before I visited this Island, and previous to going to sea again, I had the pleasure of leaving its inhabitants in a comparatively good state of health. My pre- scriptions were, simple, compared with the treatment at the present day ; THE SKIN AND ITS DISEASES. 279 and singular as it may appear, I did not lose a patient. I had no re- course to the lancet, chiefly confining myself to the most mild medicines, recommending low diet and no stimulants under any consideration what- ever, until convalescent. On my departure, I left samples of all the medicines on board, with general directions for use, with the governor : — this being the first introduction of medicine on that island. Measles.— Measles is an inflammatory and infectious fever, in which there are sneezing, cough, discharge of water from the eyes, and red spots all over the body. There are two species of the disease — the benign and malignant ; that is, one is but a slight attack of all the symptoms, and the other a severe one, in which the spots become dark-purple, and a putrid disposition is evident. Scarlatina so much resembles the disease that it is often taken for it, and the treatment in both being so different, too much caution cannot be observed in distinguishing the character. The eruption in measles rises more above the skin than in scarlatina, and f§els rough to the touch, which is not the case in the latter disease, except a little about the arms. In scarlatina there is seldom a bad cough, the eyelids are not red nor swollen, and they do not run water. In scarlet fever, the eruption ap- pears on the face and arms on the second day ; but in measles it com- mences about the third day slightly on the breast and chin, and does not appear on the hands and arms until the fourth or fifth day. Children are most liable to measles ; but the disease attacks people of all ages, and winter is the most common time. The eruption is preceded usually, by shiverings and chillings, succeeded by heat, thirst, headache, redness of the face and eyes, and pains in the back. The pulse is strong and quick, and there is a dry cough, swelling of the eyelids, difficulty of breathing, and a profuse discharge from the nose. A remission takes place in the symptoms towards morning, which are again increased to- wards evening. About the third or fourth day, spots like flea-bites ap- pear about the face, breast, and neck, and within two days the body is covered with them. They are easily felt a little elevated along the sur- face of the skin. None of their symptoms seem to abate on the appear- ance of the eruption ; but on the contrary, are aggravated. About the fifth or sixth day, the color of the spots change to brown ; and about the ninth day they disappear from the breast and other parts, leaving a des- quamation of the skin. 280 THE SKIN AND ITS DISEASES. When all the symptoms above mentioned, are in a very high degree, and the fever is of a typhoid type, the disease is called malignant measles. It is singular that if the system be impregnated with the con- tagion of measles before inoculation for small pox, it will have its course ; and the latter disease will not show itself until the other subsides. Throughout the whole of the disease the patient should be confined to bed and kept warm ; as the slightest cold might repel the eruption ; but too much heat is just as bad — moderate temperature is the best. An acidulated drink of lemon juice, barley water and sugar should be provided and the following laxative given : $ Senna Tea, three ounces; ( Sal Epsom, two drachms. This mixture must be given in three doses at the distance of two hours between each dose until the bowels are moved. If there is pain in the chest and difficulty of breathing, leeches should be applied : if there is an excess of phlegm in the throat an emetic must be given. If the eruption of nieaSles should be by any chance suppressed before the proper time, an attempt must be made to bring it back. The conse- quence of the striking inward of the eruption produces delirium, anxi- ety, and convulsions. A warm bath must then be given, and warm wine and water administered, with the following powder to be taken every five hours. C Antimonial powder, two grains ; <. Camphor, three grains : ( Sub-carbonate of Ammonia, four grains. If, on the subsiding of the disease, a violent purging prevails, the following powder should be given : $ Compound powder of chalk, half-a-drachm ; ( Rhubarb, pulverized, one scruple. Mix and divide into six powders, one to be taken every three hours. Measles frequently leave behind the foundation of other diseases ; there- fore great attention must be paid to the patient when the symptoms have subsided. A milk diet, small doses of wine, wholesome food and country air, are the best means of recovery. Herpes. — This is an eruption of broad itchy spots dispersed here and there over the skin, of a whitish or red color, which at length run into each other, discharge a thin serous fluid, and either form extensive ulcer- ations or excoriations. After a certain time, scurfy scales appear, which peel off and leave the under surface red ; the same appearances are, how- THE SKIN AND ITS DISEASES. 281 ever, renewed in a successive series, till the disease is either cured or goes off spontaneously, which is rarely the case. Being a complaint con- fined to the skin, it seldom happens that the general health suffers any great change. Its causes may be referred to a want of cleanliness, a low diet, and a damp situation ; hut certain constitutions seem, never • theless, particularly predisposed to herpetic eruptions. When the disease is very bad, it may be necessary to have recourse to the internal use of medicine. A good herpetic pill may be made of ( Submuriate of Mercury, ) f , f i raohm I Precipitated Sulphur of Antimony, \ 01 ea " n > one ar&chm - j Gum Guiacum, pulverized, two drachms; ( Balsam of Copaiba, sufficient to form the mass, to be made into sixty pills, one to three every night at bed time. The effect of a tepid bath, in promoting the natural exudations by the skin, renders it very serviceable in certain herpetic eruptions ; indeed, in all cases of cutaneous foulness, it will be found a most important auxil- iary to internal remedies. A bath prepared from, or saturated witlT the sulphate of potass, has also been employed with great success in the cure of herpes. Scald Head and Ringworm. — This disease most frequently appears upon the head, and is often caught by the use of combs, hats, or caps, which have been previously affected by the disease ; but it is sometimes peculiar to the habit. It is more frequent in warm than in cold climates, and when arrived at an advanced state, is very difficult to cure. Its first symptoms are red pimples, which break out and discharge a thin acrid fluid These pimples appear in circumscribed collections, and ultimately unite into one diseased surface. In some extreme cases the disease extends itself all over the body, and by its intolerable itching continually torments the unhappy patient. Many things have been recommended for the cure of this disease. There is scarcely a family without some particular way of treating it. I do not approve of many of these. A practice is also prevalent of shaving the head, even amongst the profession; but this is wrong. The hair should be cut close, and not shaved off, because the irritation caused by the razor increases the disease. The following plan will cure any case of scald-head. Let the hair be cut close ; then wash the head with warm water and castile soap in the morning ; dry it with a soft cloth, and with a bit of lint wet the spot with a lotion made of — 282 THE SKIN AND ITS DISEASES. Rose water eight ounces : > b j. d eye morning< Sulphate of zinc, two drachms ; ) This done, cover the head with a woolen cap, and at bed time anoint the parts affected, with diluted citrine oin%ient, and replace the cap again. Whenever the hair grows longer, it should be cut : this mode persisted in for a short time will succeed. The bowels during treatment should be regulated with small doses of Magnesia and Rhubarb. Ring Worm, — by some confounded with scald-head — (for the time) a troublesome, disgusting and deforming complaint, usually appearing in distinct and distant patches of an irregularly circular figure, upon the face, neck and forehead, is very easily removed by the continued application of a compound decoction of Nutgalls and Sulphate of Iron every night and morning. Erysipelas. — A learned writer conceives, that this disease is in every instance a modification of inflammation, and that its various forms depend upon accidental circumstances. This doctrine I. consider decided- ly erroneous. There is in it a distinct febrile affection beyond inflamma- tion, because the eruption is preceded by fever: the disease runs a tolerably regular course, is not contagious, and is seldom cut short by treatment. The eruption in this affection is more of scarlet than the tint of the rose ; the burning heat and tingling in the parts are exceed- ingly distressing. The exciting causes of erysipelas are not always apparent ; the disease is commonly attributed to the action of cold or damp air after being heated, or exposure to a strong heat, whether from the direct rays of the sun or fire ; to intemperate or violent emotions of the mind especially anger and grief. In the method of treatment in all stages of real erysipelas, the patient may very properly take a tablespoonful of the solution of acetate of ammonia in a wine glass full of cold water every fourth hour of the day and night ; with the dose taken previously to sleep at night, an even tea- spoonful of finely powdered Castile soap (on account of its peculiarly alkaline properties) must be mixed. To regulate the bowels, a seidlitz powder will be the most consistent aperient. Blotched Face. — I draw a distinction between a blotched and a pim- pled face, because the former is much more -inveterate than the latter. The mode of cure is the following: THE SKIN AND ITS DISEASES. 283 ( Milk of Sulphur, an even tea-spoonful; ( Bi-Carbonate of Soda, five grains, to be taken three times a day in a glass of cold water. A wash made of ^ Rose "Water, six ounces; \ Sulphate of Zinc, two drachms, mix ; wet the face with this lotion, gently dry it, and then touch it over with Cold Cream. In a few days the ointment made of C Diluted Citrine Ointment, one ounce ; < Common Lard, one ounce ; ( White Beeswax, half an ounce, may be used in place of the Cold Cream. Should the sores continue obstinate, the following wash made of ( Rose Water, five ounces; ( Oxy muriate of Mercury, five grains, may be used. This wash and the above ointment are to be used on going to bed at night. Care should be taken not to go into the cold shortly after making use of the above remedies. Nettle Rash. — This disease from being attended with an eruption of the skin, like that produced by the sting of nettles, is called nettle rash. A slight degree of fever often precedes the eruption, and continues dur- ing its progress. The skin becomes, whenever it is affected with this disease, itchy and hot, and frequently continues so for several days. Sometimes the eruption is most perceptible at night; very often the parts affected feel knotty, and swell into lumps. Indigestion and sup- pressed perspiration have each been alleged causes of this disease. By many, the eruption produced by the excessive use of mackerel, mush- rooms, crabs, muscles, herrings, lobsters, &c, is a species of this disease. The treatment is simple. When the stomach is supposed to produce it, an emetic must be taken ; and after sleep the following powder : ( Cream of Tartar, one drachm; I Jalap, half a drachm, Mix, and divide into three parts. One to be taken in a wine glass of cold water in the morning, the others at intervals of three hours. Should the disease be very obstinate, a warm bath may be taken previous to re- tiring. Immoderate Perspiration. — This is generally dependant upon debili- ty. Those people who accustom themselves to a relaxing mode of life, sitting up late, lying in bed late in the morning, drinking warm slops, 284 THE SKIN AND ITS DISEASES. &c. It is also a frequent attendant upon people of sedentary employ- ments. In all these cases indigestion is the exciting cause ; and for its relief, the organs of digestion must be attended to, by means of a proper diet. As a general rule, in immoderate perspirations — let the clothing be light, the air pure and cool, the drink always cold, and the body be suffused or sponged with equal quantities of vinegar or spirits and water, daily: this, with moderate exercise and a wholesome regimen, using bis- cuit instead of bread, will be of great service in checking the complaint. The most proper medicinal auxiliary is an even teaspoonful of the compound powder of Camomile Flowers and Sulphur three times a day, in a wine glass of cold water. Leprosy. — This disease consists of a number of copper-colored spots all over the body, having a scaly and glossy appearance of the skin, fall- ing off of the hair, thickening of the lobes of the ears, hoarseness of the voice, fostid breath, and partial ulcerations. The spots increase, the fea- tures of the face become enlarged, and a general mass of ulceration takes place, under which the unhappy patient droops and sinks. The disease is sometimes hereditary, but more commonly arises from contagion. There is a prediposition to it in certain families beyond doubt. It seldom appears in cold climates to the same extent as in warm ones ; and it is particularly assiduous in its attacks upon negroes. It is possible to remove the disease in its first stages ; but when it be- comes confirmed, I believe it is impossible to cure it. In its incipient stages, I have used the following remedy with marked success. A wine glass full of the decoction of Elm bark an hour before each meal, and five grains of" Plummer's Pill " every night on going to bed. Scurvy. — This disease prevails chiefly in cold northern countries, es- pecially in low damp situations, near large marshes, or great quantities of stagnating water. Sedentary people, of a dull melancholy disposition, are most subject to it. It proves often fatal to sailors on long voyages, particularly on board, or where cleanliness is neglected. It is not necessary to mention the different species into which this dis- ease has been divided, as they differ from one another chiefly in degree. What is called the land scurvy, however, is seldom attended with those highly putrid symptoms which appear in patients who have been long at sea, and which, I presume, are rather owing to confined air, want of ex- THE SKIN AND ITS DISEASES. 285 ercise, and the unwholsome food eaten by sailors on long voyages, than to any specific difference in the disease. The scurvy is occasioned by cold moist air, by the long use of salted or smoke-dried provisions, or any kind of food that is hard of digestion, and affords little nourishment. It may also proceed from the suppression of customary evacuations, as the menses, the hemorrhoidal flux, &c. It is sometimes owing to an heredi- tary taint, in which case a very small cause will excite the latent disorder. Grief, fear, and depressing passions, have a great tendency both to excite and aggravate this disease. The scurvy may be known by unusual weariness, heaviness, and diffi- culty of breathing, especially after motion ; rottenness of the gums, which are apt to bleed on the slightest touch ; a stinking breath ; frequent bleeding at the nose ; crackling of the joints ; difficulty of walking ; some times a swelling and sometimes a falling away of the legs, on which there are livid, yellow, or violet-colored spots ; the face is generally of a pale or leaden color. As the disease advances, other symptoms come on, as rottenness of the teeth, haemorrhages, or discharges of blood from differ- ent parts of the body, foul obstinate ulcers, pains in various parts, espe- cially about the breast, dry scaly eruptions all over the body, &c. At last, a wasting or hectic fever comes on, and the miserable patient is often carried off by a disentery, a diarrhoea, a dropsy, the palsy, or a mortifica- tion of some of the bowels. I know of no way of curing this disease but by pursuing a plan directly opposite to that which brings it on. It proceeds from a vitiated state of the humors, occasioned by errors in diet, air or exercise ; and this cannot be removed but by proper attention to these important articles. If the patient has been obliged to breathe a cold, damp, or confined air, he should be removed as soon as possible to a dry, open, and mode- rately warm one. If there is reason to believe that the disease proceeds from a sedentary life, or depressing passions, as grief, fear, &c, the pa- tient must daily take as much exercise in the open air as he can bear, and his mind should be diverted by cheerful company and other amusements. When the scurvy has been brought on by a long use of salted provisions, the proper method is a diet, consisting chiefly of fresh vegetables, as oranges, apples, lemons, limes, tamarinds, water-cresses, scurvy grass, brook-lime, &c. The use of these with milk, pot-herbs, new bread, and fresh beer or cider, will seldom fail to remove scurvy of this kind, if it 286 THE SKIN AND ITS DISEASES. be taken before it be too far advanced ; but to bave tbis effect, tbey must be persisted in for a considerable time. Tbe most proper drink in tbe scurvy is whey or butter-milk. Wben these cannot be had, perry or spruce-beer may be used. Wort has likewise been found to be a proper drink in the scurvy, and may be used at sea. as malt will keep during the longest voyage. A decoction of the tops of spruce fir is likewise beneficial. Tar-water may be used for the same purpose, or decoctions of any of the mild mucilaginous vegetables, as sarsaparilla, marsh-mallows, roots, &c. A slight degree of scurvy may be carried off frequenly by sucking a little of the juice of a bitter orange or lemon. When the disease affects the gums only, this practice, if continued for some time, will generally carry it off. I would, however, recommend the bitter orange as preferable to lemon ; it seems to be as good a medicine, and is not near so hurtful to the stomach. All kinds of salad are good in the scurvy, and ought to be eaten very plentifully, as spinach, lettuce, parsley, endive, radish, dan- delion, &c. The treatment consists in drinking lime juice and using vinegar on all meat eaten, which should be fresh. Sailors ought to use no salted food. The medicine should be, ( Peruvian Bark, one drachm, I Port wine and water (equal parts) one wine glassful ; to be taken three times a day. To a medical man, enjoying all the facilities of an every day practice at home, with every means at hand to arrest disease and render the afflicted patient less liable to a protracted recovery, his efforts, even then, are too often tedious and unsuccessful, to such an one, I say, to the embarrassments which fall to the lot of a surgeon at sea, thou art a stranger. On a barren shore, as the surgeon superintendent of a crew of many hundreds of persons, many of whom afflicted with scorbutic ailments, the Author had to contend with the disease in all its deformities : bereft of all fresh, and scant of all salt provisions, with no comforts of life where- with to allay the threatening scourge of scurvy, with no port of entry to call on for assistance, his sufferings and fatigue of the body and mind were intolerable. With a mere scanty medicine chest, from which he admin- istered minute doses of Peruvian bark, he arrested the progress of the disease ; after which he accompanied his brother officers and comrades in search of food to satisfy the cravings of a starving crew. Their efforts THE SKIN AND ITS DISEASES. 287 In this respect were successful. They discovered a tree, the fruit of which, from its peculiarity of growth and vegetable appearance, they called the cabbage tree. To obtain fresh diet, they afterwards found washed upon the beach a species of cockle, and at low-water mark, the rock oyster. These unexpected discoveries of food, in connection with the tonic properties of the medicine, saved the settlement from immediate ruin, and the inhabitants, landing as did the pilgrims of New-England, from starvation until relief was at hand. That relief was obtained through the bold and fearless courage of a few, who, starting in a life- boat with a limited supply of provisions, were " tossed on the wave " until (their food being exhausted) they were compelled to cast lots who should die to save the rest. Happily this state of things was of short duration They succeeded in hailing a Mauritian ship, which first took them en board and then bore down to the harbor with sustenance for those left behind. In this condition, they spent three months at Port Macquarie, (now a sea-port town on the eastern coast of New-Holland.) Happy ! thrice happy was it for those, who thus brought to such a point, where no earthly pleasure could yield them relief, and where hum.va power seemed incapable of rendering them assistance, were led to rely on comforts in higher hopes. It may be that these sufferings were sent for instruction ; but it was evident, that this palpable darkness spread before them, like that which inspired the host of Egypt with terror and dismay, had a bright side of hallowed flame, the light and pledge of a present, a protecting, and a guiding Deity. Pediculi Pubis or Crabs. — These diminutive insects are usually caused by a want of cleanliness on the part of females, and they by ac- tual contact communicate them to men. They are generally found be- neath the skin of the pubis, breast, armpits, and those parts covered with hair and least exposed to cold. By their constant irritation they pro- duce a very unpleasant sensation, annoying to such an extent as to actually harrass the unfortunate sufferer, who cannot avoid scratching the parts upon which scales form ; which, if prematurely removed cause them to bleed. The most pleasant and effectual as well as the least objectionable ap- plication, is a small quantity of milk of roses — as is prepared by regular chemists, which may be used morning, noon and night. The parts af- fected are to be kept free from all impurities both during and after treat- ment. • 20 288 THE HUMAN HAIK. CHAPTER VI. THE HUMAN HAIR, The definition of the word " Hair" according to the different ency- clopaedias, is "a small filament issuing out of the pores of the skin of animals, and serving most of them as a tegument or covering." The an- cients considered the hair to be a sort of excrement, fed only with ex- crementitious matter, and no proper parts of a human body. They sup- posed it generated of the fuliginous parts of the blood exhaled by the heat of the body to the surface, and there condensed in passing through the pores. But the moderns are agreed that every hair does properly and truly live, and receive nutriment to fill and distend it like the other parts. I must however, observe, that the life and growth of hairs is different from that of the rest of the body, and is not immediately derived there- from, nor reciprocated therein. It is rather of the nature of vegetation. Hairs grow as plants do out of the earth ; or as some plants shoot from the parts of others, from which, though they may draw their nourish- ment, yet each hair has, as it were a separate life and a distinct economy. Hairs derive their food from certain juices in the body, but not from the nutritious juices : they may accordingly live, though the body be starved. Yea, instances are on record where they have grown after the body itself was dead ; and though this post mortem growth seldom ex- ceeds a few hours, yet instances have been known in which the hair has grown for years after death. Wulferus, in his "Philosophical Collec- tions," gives an account of a "woman buried at Nuremburg, whose grave being opened forty-three years after her death, tresses of hair were found issuing plentifully thro' the clefts of the cofim, insomuch that there was reason to believe that the cofnn had been for some time cover- ed all over with hair. The lid being removed, the whole corpse appeared in its perfect state ; but, from the crown of the head to the sole of the foot, it was covered with a thickly-set profusion of long hair. The sex- ton happened to handle the upper part of the head, when the entire struc- ture fell in at once, leaving nothing in his hand but a handful of hair : there was neither skull nor any other bone* left ; yet the hair was solid v and strong enough." THE HUMAN HAIR. 289 The hair ordinarily appears round or cylindrical, but the microscope also discovers triangular and square ones, which diversity of figure arises from that of the pores, to the shape of which the hairs always accommo- date themselves. Their length depends on the quantity of the proper humor to feed them ; and their color on the quality of that of the hu- mor ; thus it is that at different stages of life the color usually differs. Their extremities split into two or three branches, especially when kept dry, or suffered to grow too long ; so that what appears a single hair lo the naked eye seems a bush when examined through the microscope. A single hair viewed through a microscope seemed to be one single transparent tube, with a pith made up of fibrous substances runniDg in dark lines, in some hairs transversely, in others spirally. The darker medullary parts or lines, he observes, were no other than small fibres con- volved round, and lying closer together than in the other parts of the hair. They run from the bottom to the top of the hair ; and it is most probable that they thus serve to make a gentle evacuation of some humor out of the body. " Hence the hair of hairy animals may not only serve as a fence against cold, but as an organ of insensible perspiration. "- Derham. All true hairs whatever, by their figure agree in certain circumstances. They are all composed of a substance of a horny nature ; they grow upon vascular pulps, which, with the tubular roots that surround them, are enclosed in bulb shaped capsules or investments, that are situated within the skin. In all whiskered animals, the maxillary branches of the fifth pair of nerves are prodigiously large, and form a very intricate plexus between the integuments of the skin. Anatomists are not agreed with respect to the destination of the nerves of hairs ; some have asserted that they enter the root of the hair, but Haller, Bichat, and other eminent authors, were not satisfied that the nerves penetrated the bulb. The office of the pulp is to secrete the matter of which the hair is composed. The hair is origi- nally contained within the cavity of the bulb. When the hairs make their appearance, they carry with them a portion of the cuticle, which is afterwards cast off in fine branny scales. The portion of the hair con- tained within the bulb is called the root, and that which projects beyond the skin the shaft. Although the one part is gradually converted into the other, they have apparently a different composition. The root, as 290 THE HUMAN HAIR. long as the hair continues to grow, is soft and pulpy, and nearly color- less, while the shaft is hard and horny in its texture, and of some de- termined color. Every hair contains a tube, or is hollow interiorly, and admits, as be- fore mentioned, the pulp for a greater or less distance. As the pulp is in- tended for the nutrition of the hair, it is found to extend only to that which is in a state of growth ; and all that portion of the tube of a hair to which the pulp does not extend, is filled with a dry pith or series of cells containing air. Duverney says that when a hair is viewed trans- versely in a microscope, some of the bubbles of air are often perceived He supposes that the air is furnished by the pulp for the nutrition of the hair ; but there is every reason to believe that it is derived from the at- mosphere in consequence of the vacuum produced by the degeneracy or retreat of the vascular pulp, in the same manner as the air of feathers is attracted from the external element. The coloring substance of the hair bears some analogy to that of the skin. Thus I remark that both are darker in hot climates, and nearer the equator ; # and red hair often coincides with the yellow freckles ob- served on the skin of certain persons. In blacks, the color of the hair is sooner changed "by acids than that of the skin. The muriatic acid, first whitens the hair,, which turns yellow on dying, the nitric acid gives it a yellowish hue, and the sulphuric acid leaves it completely black. The different passions have a remarkable influence over the internal substance of the hair. In a very short space of time, grief will often alter its color, and convert it into white, undoubtedly by causing the fluid of the small capillary vessels to be absorbed. Many authors, who have quoted these things, and amongst whom Haller is pre-eminent, have ques- tioned the truth of the fact. Mr. Erastus Wilson, in his recently pub- lished work upon the skin, says : "I cannot give credence to the bleach- ing of the hair in a single night ; or even in a single week : the first step m the change may have been made in a single night, and on that night week the whole of the hairs of the head may have become white at their roots; this is perfectly possible, and the only reasonable explanation of the cir- cumstance. Thus we learn that Marie Antoinette became gray in a short period from grief, as did the unfortunate Queen of Scots. But the error has a foundation in poetry, as well as in fiction, and hence may not THE HUMAN HAIR. 291 easily be dethroned." Lord Byron gives it the weight of his authority in the '* Prisoner of Chilian" : — u My hair is gray, though not with years Nor grew it white In a single night, As men's have grown from sudden fears." Mr. Wilson then goes on to say, " Sir Thomas More, we are told, became gray during the night preceding his execution. According to Borrellus, two gentlemen — the one a native of Languedoc, the other a Spaniard — were so violently affected, the first by the announcement of his condemnation to death, the latter by the base thought of having incurred a serious punishment, that both became blanched in the course of a single night." Instances of the eyelashes blanching through deep mental agitation, are well authenticated. It seems, therefore, incontest- able that grief may change the hair in a very short time, if not with such extreme rapidity as is generally supposed. When the hair does thus turn white, the sheath remains unaltered, retaining its texture, nature and properties : the internal substance only is vitiated. The head is that part of the body on which the hair is most abundant, providing it with a kind of pad by which it is both protected from im- pression of mechanical injury and from the inclemencies of the weather. It is worthy of remark that its limits on the sides of the head never vary, for they always correspond above the ear : but it sometimes extends be- hind, over the upper part of the neck. On the forehead, however, the varieties are infinite, sometimes extending lower down, or sloping higher up ; sometimes tracing a curved line ; at other times forming a complete triangle, the vertex of it corresponding with the middle of the forehead ; but these limits are never traced with any degree of uniformity. The width or contraction of the forehead is exclusively determined by these irregularities, whilst the different degrees of inclination exclusively de- pend on the bones. In this respect, hair contributes in some degree, to the expression of the face ; we say in some degree, because it is much less to the width of the forehead than to the direction approaching the perpendicular, that we refer the grand and majestic air which we ascribe to gods and heroes. It is extremely difficult to eradicate superfluous hair. If you pull the hair out by the roots from those places which it disfigures, such as the nostrils, the ears, the tip of the nose, &c, there are thousands of roots, 292 THE HUMAN HAIR. which never shoot up a single hair, ready to start through the skin the moment you make room for them by pulling out their companions. Old authors recommend depilatories in great variety. The principal of these methods consists in rubbing upon the part from which it is wished to re- move superfluous hair, leaven, parsley water, juice of acacia, the gum of ivy, nut oil, &c. Madame Elise Voiart, in her " Encyclopaedia des Dames," recommends a few drops of dulcified spirit of salt (muriatic acid distilled with rectified spirits of wine) to be applied with a camel hair pencil. Another strong depilatory is C Gum ivy — one ounce ; I GumTabic, \ of eacll > one drachm ' lleduce the whole to a very fine powder and make it up into a liniment, with a sufficient quantity of vinegar." The author who gives this receipt says, " the dust of orpiment is one of the strongest of known poisons, and, as you pound it, be careful that none gets down your throat." M. Bayle gives the following receipt as a depilatory : — " Take equal parts oincsma and quick lime, and having reduced them to a powder separately, let them dissolve for some time in pure water, till they form a strong thick paste. This is to be applied to the part whence the hair is to be removed ; and after it has remained a few minutes, it is to be rubbed off with a wetted cloth, which will at the same time remove the hair to the very roots." Rusma, is a species of vitriol. Orpiment and quick lime form an immediate depilatory ; but great caution is necessary in the use of the composition. Eight parts of lime and one of orpiment, are the propor- tions. Reduce them to a fine powder, mix them thoroughly together, and sift them ; put this powder in a well corked bottle. Use the powder when needed, by mixing it with a seventh part of barley meal or starch, and pour upon the whole a sufficient quantity of warm water to form a paste. Apply this paste to the place from which you design removing the hair. Leave the paste upon it for a few minutes, taking care to moisten it a little that it may not dry too quickly. The hair is removed along with the paste by wiping it away with a towel. In the case of hairy moles, the tweezers should never be used, as they may irritate the excresences and cause cancers. A little of the orpiment and lime paste, well diluted with water, arfd mixed with woodash, will suffice as a depilatory. THE HUMAN HAIR. 293 The fine silky gloss of the hair depends on the internal pulp of it be- ing in a healthy and abundant state, and on the natural oil being freely produced and given out. When this is unhealthy, the oil is either too abundant, in which case its superfluity produces greasy hair; or too scanty, and then the hair is dry and harsh, or thin and lank. Good pomatum, or oil, must be used, to confer upon the hair an artificial gloss when needed. A good recipe for making such oil, is : take a pint of salad oil and put it into a pipkin, with a bag containing half an ounce of alkanet root, cut and bruised ; give the whole a good heat, but not a boiling one, until the oil is completely impregnated with the red color ; then pour the whole into ajar, let it stand till cold, then add an ounce of essence of bergamot, a quarter of an ounce of oil of jasmine, and a quarter of an ounce of eau de millejleurs, (all flower water.) When properly mixed, put the com- pound liquid into small bottles for use. When the hair becomes greasy and dirty, it ought to be washed with warm, not too warm, soft-water and soap. Oil or pomatum should then be applied, before the hair is quite dry. " Frequent wetting of the hair," says Dr. Willich, "is of advantage to the eyes, the ears, and indeed, to the whole body." It is, however, necessary to avoid what hair-cutters term "thinning the hair." After having the hair cut, it should be in- vigorated, by wetting it with hartshorn and water, (two parts hartshorn and one part water,) and brushing it with a stiff hair brush. It is a great mistake to plait the hair of children under eleven or twelve years of age. The process of plaiting more or less strains the hairs in their roots, by pulling them tight, and tending to deprive them of their requisite supply of nutriment, checks their growth. The hair of girls should be cut rather short, and allowed to curl freely. When about twelve, the hair should be twisted into a coil, not too tight, nor tied at the end with a thin thread, but with a piece of ribbon. Mothers whose vanity may be alarmed lest constantly cutting the hair of their daughters should make it coarse, may be assured that they have no cause for this apprehension, if the hair be kept constantly brushed. When there is an inclination to break out in the head, fine combs are very likely to promote it ; and there is no doubt that the heads of chil- dren which are never touched by a fine comb are much cleaner than those which are scratched and scraped every day. If any dirt appear on a child's head which a brush will not take away, that particular part should 294 THE HUMAN HAIR. be washed with soap and water and briskly rubbed with a towel ; in gen- eral, the brush will be found quite sufficient to keep it perfectly clean. The more the head is combed with a tooth comb, the more it will require to be combed. It is an imprudent act of cleanliness to remove all at once the scurf which sometimes gathers on the head, and even spreads over the fore- heads of very young infants : and this is probably one of the reasons- why we so often see the children of persons in easy circumstances tor- jnented just after their birth with that troublesome stuffing m the head which is vulgarly called the snuffles. When the infant is somewhat inured to the external air, at two months old or later, (according to the season of the year,) whatever scurf adheres so firmly to the head as not to come off in washing, may be safely and effectually removed by rub- bing a little butter on a small part of the head one day, and cleaning it with a flannel dipped in Portugal water the next ; then a little more butter should be rubbed on another part of the head, which should be cleaned in the same manner the day after : and in thus removing the scurf by de- grees, the head becomes clean in a very short time, without any danger of cold. In many places the poorer classes have a prejudice against re- moving the scurf from children's heads at all, waiting till it comes off of itself; but this is also an error, and leads to many of the bad conse- quences of dirt, as they neglect to wash the head, which should be done every day as long as scurf is suffered to remain. When the head is once perfectly clean, the best means of preserving it in that state is by a brush, which should be changed from time to time for one harder. The more seldom a fine comb is applied to the head of an infant the better ; and on no account should those of ivory, tortoise-shell or bone ever be used ; for even when they do not wound the skin and produce a sore — as fre- quently happens — they are very likely to augment the production of that substance which they are intended to remove. To avoid that prominent mark of approaching old age, called grey- hair, care must be exercised in its treatment during youth. Avoid con- stricting the skin and strangling the hair at its roots, and every thing that may throw an undue portion of lime in the blood. I say undue be- cause a certain quantity of lime is indispensible in our system for repair- ing the wear and tear of the bones, teeth, &c. The lime necessary for the repair of bone is manufactured by the stomach and liver, along with THE HUMAN HAIR. 295 the blood, from various articles of our diet which contain it. The greatest supply is usually from the water which we drink, or which is em- ployed in the various processes of cooking and preparing liquors. All animal food also contains some portion of lime, as well as some of the sorts of vegetable food. Ascertain then, by chemical trial, whether the water used for your tea, coffee, soups, punch, &c, contains a large pro- portion of lime ; and, if it do, you must either have it chemically puri- fied, or remove to some other place where the water is more free from lime. If water be hard, you may be certain that it contains too much lime to be safely used. Rain-water is the safest for tea and other li- quids. Bread will always contain a portion of lime ; be careful, there- fore, in dealing only with respectable bakers who will not increase that unavoidable quantity by means of adulterating matter (such as whiting,) which contains lime. The influence of disease upon the bodily health, accelerates old age, and in its turn as an indirect cause produces baldness, but its more immediate causes or rather the consequence of the remote causes may be reduced to three, which will be considered in due order. 1st. The contraction of the skin. Since the superabundance of lime in the body is one main cause of grey hair, as has been shown, so is the same constriction of the pores of the skin one of the chief causes of baldness. What surgeons call " cutis anserina.^ (" goose skin") from its resembling the skin of a plucked goose, may be produced by cold, grief, fear, or fever; and in this way the hairs may be partially strangled, preventing the rise of their coloring matter, and of course turning them grey ; or they may be cut off, or snapt short on their exit from the skin, and the roots only left behind, but wholly confined and kept out of view below the skin, the consequence of which will be baldness. As, from various causes, the skin strangles or destroys the hair, the remedies which can remove this state of the skin will be most likely to succeed in effecting a cure. 2nd. The relaxation of the skin. People are often complaining of their hair — not falling off — but coming out in great quantities whenever it has been combed or brushed. By observing them narrowly or enquiring farther, it will be found that the complainants are of a weak or relaxed constitution, affected with indiges- tion, are consumptive, nervous or bilious: or that they have been 296 THE HUMAN HAIR. weakened by intemperance or long illness. It is very common in the weakness which remains after a severe fever, for the whole hair to fall off, or come out. The cause of all this is clear enough. The skin is weakened by the general disorder, and instead of maintaining its natural healthy tone and firmness, becomes relaxed and loose. The pores, also, become enlarged and perspiration much more abundant ; for it is an uniform circumstance that those whose hair is coming out, or has come out, from relaxation, are prone to perspire on the least exertion or expo- sure to heat. When the skin is relaxed, the firm interlacement of the hairs with it is partly destroyed ; and they have, consequently little to hold them except their own roots. Now, by pulling out a hair with the root, and examining it, you will at once see that the root can have ex- tremely little power of retaining it, as the root is soft and pulpy; and, beside, it is naturally fixed in the softer portion of the skin, or, as some anatomists say, in the fat immediately underneath it. The firmness and tone of the outer skin being therefore relaxed, and the hairs owing their chief stability to this, it is not wonderful that they should be loosened and come out. In such cases all oils are most improper, as they tend to relax the skin the more ; and astringents such as Portugal water, or what answers the same purpose, a mixture of Brandy, Vinegar and Salt, in the proportions of one gill each of fourth proof Brandy and Vinegar, and a tablespoon of fine salt, are the proper remedies. 3d. The decay of the roots of the bulbs. Towards the decline of life, the hair feels the influence of the general obliteration that occurs in almost all the exterior vessels. It first ceases to be supplied with coloring matter ; the internal pulp dies, the external part only remains, and the hair of the head turns grey or white, and that of the beard and other parts follow. At an uncertain period after the hair has become white, it falls off, then the small bag which contained the root is obliterated by degrees, and finally disappears. The different changes which the hair, the skin, and all the exterior organs of the body undergo by age, proceed entirely from the laws that over-rule nourish- ment, and not from the action of exterior bodies upon those organs. This forms an important distinction between organic bodies and those which are inorganic. The latter have two different .ways of wasting, by contact of exterior things, one mechanical, by tearing, rubbing, &c; another chemical, by combining with substances, (such, for instance, as the air,) THE HUMAN HAIR. 297 the drier principles of which admit of being combined in a thousand dif- ferent ways, whence both its nature, and that of the different forms it comes in contact with, are changed. All inorganic bodies grow old, in this sense of the word. After a certain time they lose their former appearance. Age stamps the internal as well as the external organs with marks of decay. To ascertain whether the skin of the bald places has entirely lost its tone, or whether the baldness be curable, rub the bald part smartly with the hand for a minute or two ; and if it become easily red, there is hope of a cure ; but if it remain obstinately white and unaffected by the friction, it may be pronounced incurable. A liniment for resuscitating the growth of hair on a bald head, presenting favorable symptoms, may be made of the following : Spirits of Rosemary, an ounce ; Strained honey, half an ounce ; Prepared lard, one ounce • Lavender oil, ten drops. Mix and rub into the roots of the hair twice a day. An ointment for the same, may be made of Simple Cerate, half an ounce; Balsam of Peru, one drachm; Pimento oil, ten drops. Mix and use in the same manner as the last. Amongst the disorders to which the hair is subject, I shall first allude to scales, which are often made a subject of complaint, as tending to in- jure the beauty of the hair. They are the worn fragments of the scarf- skin, that are raised by the comb or brush, and yet dispersed among the hair. No person is or can be altogether free from them. The best remedies for this affection are whatever will strengthen and give tone to the skin. The oils commonly used for the hair are not beneficial ; Por- tugal water will be found efficacious. Pouring cold water over the head will also prove an excellent tonic for the skin. Dandruff attacks infants, and exhibits minute scales ; sometimes it ap- pears in advanced age, and shows scales of a larger diameter. It mani- fests itself at the upper end of the forehead and temples, as a light whitish scurf, set in the form of a horse-shoe ; in other parts of the head there are also other exfoliations of the skin, somewhat longer, flat and semi- pellucid. Sometimes, however, they cover nearly the whole of the scalp, and overlap like the slating on a house-roof. Little attention is 298 THE HUMAN HAIR. necessary to this complaint beyond that of cleanliness ; frequent washing and brushing ; where, however, the scalp is attacked, it is better to shave the head, when the scales may be removed by a careful use of soap and warm water, or by an alkaline lotion. A good application may be com- posed of diluted spirit, in which a few grains of acetate of zinc have been dissolved. CHAPTER VII. MISCELLANEOUS. — RHEUMATISM. The seat of rheumatism is in the membraneous parts of the body. It is sometimes mistaken for the gout. This disorder may occur at all times of the year, but it is most prevalent in the spring and fall, when there are remarkable changes from heat to cold, and vice versa. The rheumatism chiefly attacks persons after a violent exercise, or great heat of the body from any cause, and then being too suddenly cooled. It is also brought on by inebriety, excessive cold, indigestion, im- moderate labor, &c. The pains are sometimes exceedingly acute, so as to render the least motion dreaded by the patient ; they are chiefly wandering, especially in the beginning of the disease, and pass from one joint to another, either of the same or opposite, or of the opposite side of the body, but (if the disease be chronic,) it seldom occasions a swelling, or brings a fever along with it. If the disorder, however, be of the inflammatory kind, its symptoms are most to be dreaded ; the parts affected being frequently inflated with a white swelling, and so distended that the patient can scarce move a limb without the utmost pain. Boerhaave asserts " if the pain lasts long and increaseth, it often deprives the joint, after the most hor- rid pains, of its motion, and makes it stiff by an anchylosis, scarce remov- able by any means whatever." And Van Swieten "has seen in some patients such anchyloses rise in the spine of the back, from rheumatic pains, as made the poor wretches walk with their bodies bent forward, so that during the remainder of their lives they could never stand upright." When it seizes the loins, it is called the Lumbago ; if in the thigh MISCELLANEOUS 299 bone or hip, the Sciatica or Hip-Gout ; and physicians universally agree, that when the rheumatism settles here, it is more difficult and longer in curing than any other external part of the body. The pain is chiefly felt where the head of the thigh bone is received into the acetabulum of the coxendix ; and it will sometimes extend itself to the lower part of the loins, to the thigh, leg, and even to the extremity of the foot, yet out- wardly there is no swelling, or inflammation. &c. Sometimes the pain is so intense and spasmodic, that the patient cannot stand upright, or bear the least motion. All violent motion greatly exasperates the pain. In this disorder a cool and diluting diet, and cold bathing, are recommended. The patient should also ride on horseback, and wear flannel next the skin. The night air should be avoided. Eor treating Rheumatism, I recommend pure Sarsaparilla powder made up either in the form of a pill or syrup ; and for Inflammatory Rheuma- tism, the avoiding of stimulants, and the occasional application of cam- phorated oil to the seat of the disease, accompanied with considerable friction. It is a fact, singular, though unaccounted for, that the use of stimulating liquors irritates rheumatic pains, while in gout the fever and keen sensation to pain, are palliated, and in an incalculably short period, entirely disappear. Gout. — The seat of the Gout is in the joints and ligaments of the bones of the feet ; and, according to Roerhaave the principal times of its invasion are the spring and autumn. The Grout usually seizes the patient suddenly, and without any previ- ous notice of an immediate nature ; sometimes, however, it is preceded by crudities upon the stomach, indigestion, flatulence, costiveness, a sense of heaviness, torpor, &c, which daily increases, till at length the fit oomes on. The place which it first and regularly attacks is always the foot, and chiefly those parts through which the liquids have the most dif- ficult passage, such as are most remote from the heart, and are most pressed and pinched. Aretus says, " the pain first seizes the great toe, next the edge of the heel that first touches the ground when we walk, next the hollow of the foot, and last of all the ankles swell;" from whence Sydenham concludes that the feet are the genuine true seat of the peccant matter." The pain becomes gradually more and more intense till it reaches the highest pitch, sometimes resembling a violent tension and dilaceration of the ligaments, sometimes resembling the gnawing of 300 MISCELLANEOUS. a dog, and sometimes like a close tightness and strong compression ; nay, so lively and exquisite is the pain at times, that the very weight of the bed clothes, or the motion of the bed from a person's walking across the room, become even insufferable. Sometimes it seems stretched to such a degree that the unhappy patient thinks it will burst every moment ; when this is the case it is seldom more than six hours before the pain abates, or twenty-four hours from the commencement of the paroxysm ; after which the parts begin to swell, a gentle perspiration takes place, and the patient obtains rest. After the lapse of a few days, it frequently affects the other foot in the same manner, and the same course of distracting pain and misery must be borne as before ; sometimes it attacks both feet at once, but it generally seizes one after the other. A number of these paroxysms are what is termed a fit of the gout, which is longer or shorter, according to the age, constitution, strength and disposition of the patient's body ; this happens to persons of a vigorous constitution, and whom the gout seldom visits, in about fourteen days, to others for two months ; and some who are debilitated with age, it does not leave till chased away by the summer's heat. After the disease terminates, the patient's good hab- it of body returns in proportion to the severity of the #t. When the gout has been improperly treated, and disturbed by incon- gruous medicines, it assumes a more dangerous appearance, and becomes universal ; it is then called Irregular Gout ', and attacks the hands, wrists, elbows, knees, and other parts of the body, distorting the fingers, &c, and generating chalky substances or concretions about the ligaments of the joints. In this case, the patient is continually tormented with this cruel disorder, a month or two in summer only excepted ; he is also dis- turbed with sickness as well as pain, being subject to head-ache, cough, pains of the stomach, &c. Hippocrates, speaking of the gout, says that it is "the most violent of all the disorders that affect the joints, the hardest to subdue, and the most permanent; yet, however, lasting or troublesome, is by no means dangerous." Persons are seldom visited with the gout till they are upwards of thirty years old. It is brought on by intense study, high living, too great indulgences of the appetite, inebriety, especially the drinking too freely and constantly of rich, generous wines ; also, venereal pleasures used to excess, great exercise, a moist cold air, a contusion, acid gas, as appears MISCELLANEOUS. 301 from the sour sweats and acid eructations so common in athritic par- oxysms. The passions of the mind, and indolence, will produce the gout. Those are particularly subject to it who are of a gross, full habit, whose feet are suffered to perspire in wet stockings, and are too suddenly chilled whilst in a state of perspiration. In the treatment of gout the remedy is at once simple and effective ; and to the inexperienced, a matter of ridicule. Whatever of the substances of the vegetable or mineral kingdom produces in the shortest time, with the least trouble, and is of itself harmless, and easily obtained, that reme- dy should be used in preference to the innumerable compounds sought for in the laboratory of a chemist. As it was said, that among the causes of this complaint, rich wines were by no means the least, I recommend upon the first sensation of pain, or perception of swelling or redness, that, if the patient has been accustomed to drink one pint of wine per day, he now increase the quan- tity to one quart, or at least to as much as he can bear, daily, until the paroxysms subside. All external applications are of little or no avail. As as auxiliary to the above treatment, a teaspoonful of Wine of Col- chicum, prepared from the seed, may be taken two hours after breakfast and at bed time, until all inflammatory action subsides. Diarrhoea. — Diarrhoea consists of a discharge of mucus, sometimes in the form of " clots" in the daily evacuations; there is much pain across the region of the bowels, and frequent tenesmus, and griping, and gener- ally without much fever or inflammation ; although, in most cases a slight fever may be observed. It is distinguished from dysentery by the dis- charges not being bloody, and the absence of scybala. It is sometimes rather difficult to distinguish the difference between these two diseases, as they frequently run into each other. Sometimes the dysentery will change into diarrhoea, and vice versa. It is evident that they frequently arise from the same exciting cause, in a greater or less degree ; and it is evident, also, that a similar treatment proves advanta- geous in both diseases. Therefore, from the similarity of their causes, and of their symptoms, and from the fact of their occurring in or about the same season of the year, and the benefit received from a similarity of treatment in both cases, I am disposed to think them modifications of one and the same disease. I do not say that all diarrhoeas are modifications 302 MISCELLANEOUS. of dysenteries, although a majority of them are found to be so, There are exceptions, as those which arise from poisonous substances taken into the stomach, and those produced by drastic purges ; also those which take place in cases of extreme debility. But more or less of septic acid will be found in the alimentary canal, in almost all cases of diarrhoea ; and it is generally produced or kept up by the presence of this septic acid. In treating diarrhoea the patient should take 5 gs. of blue pill mass with 15 gs. rhubarb, three times a day, and 10 gs. of Dover's powder on going to bed. Continue this treatment until the bowels become regular. When regular, the following cordial mixture will be the most proper antidote against any relapse : Prepared chalk > ^ , , ,,. Powdered white sugar, \ 0f each half an ounce - Mucilage of gum Arabic, two ounces j Aromatic confection, half an ounce j Cinnamon water, one pint. A table spoonful of this mixture to be taken an hour before each meal and at bed-time, for two or three weeks. It is, (I have found to be) the best anti-dysenteric medicine ever used, and recommended in hospital and family practice both for adults and children The most proper diet in Diarrhoea is either Rice, Sago, Arrow Root, Tapioca, Coffee, dry toast, boiled milk with bread, or any such plain varieties. Dysentery. — is the name applied to a disease the characteristic symp- toms of which, are (and to distinguish it from diarrhoea and cholera- morbus) pain in the abdomen, tenesmus, acrid discharges of blood, severe griping, frequent mucous stools, streaked with blood, sometimes with scybala, sometimes spuma, pain in the head, nausea, coldness of the extremities, dry skin, brown tongue, pulse quick and small, and the stools green fetid and slimy, all of which plainly indicate the presence of septic acid in the intestinal canal. Method of Prevention. — A disease may be cured by a mechanical knowledge ef medicine, sometimes without knowing the cause ; but a per- fect knowledge of the causes and also of the circumstances which pro- duce them, are indispensably necessary, in order to adopt a correct method of preventing diseases. It therefore, requires in this case, a degree of penetration and discernment, not only in the physician, but MISCELLANEOUS. 303 al io in the nurse. Young children are most subject to this disease, and hence I will direct my remarks to a mother. She should, in that season when the disease prevails, keep animal sub- stances from their diet, or rather the lean and muscular part of animal substances, and substitute wholly a vegetable diet. The lean part of animals contains a large proportion of the basis of nitric fluids, which, combined with oxygen forms nitrous acid ; and, when communicated to the alimentary canal, proves the cause of dysentery. She must there- fore, prevent its communication from this source. Vegetables, also, con- tain this principle, but in a much less proportion ; therefore, vegetable diet is preferable to animal. It is also necessary to bathe the body all over with alkaline water, or strong soap suds, not only for the purpose of cleansing the skin, but also that the absorbents should take in a sufficient quantity of alkali to de- stroy or neutralize the acid already absorbed ; which bathing should be used at least twice a week. A draught of alkaline salts should be taken occasionally, to destroy the acid which may be accumulating in the stomach and intestines, by means of its quality existing in the diet, and also that which may be communicated to the stomach and intestines, from a deleterious atmosphere, through the medium of the absorbents, lungs &c. Avoiding costiveness is a consideration very necessary in preventing children from getting the dysentery. If the foeces be suffered to remain stagnant in the alimentary canal, they become indurated, and the process of putrefaction commences, producing this fluid which causes the disease. Costiveness also weakens the system, and predisposes it to the operation of pestilential fluids. It should, therefore, be remedied by administering as often as necessary some alkaline or cathartic mixture. Children, to become healthy and robust, should be permitted free exer- cise in pure country air, totally free from marsh miasmata. Avoid extremes of heat and cold, fatigue, long intervals between meals, and also the evening air. Avoid eating unripe and decayed fruits ; acd those that are ripe and sound must be partaken of with moderation. Avoid spirituous liquors, and let the drinks be malt liquors, a moderate quantity of port wine and claret. Eating salt fish about three times a week may prove a means of preventing dysentery. The whole diet should not be inflammatory, but of a wholesome and lightly cordial nature. *■*■*» 21 304 MISCELLANEOUS. The above observations should be attended to, not only for preventing dysentery, but also diarrhoea, cholera-morbus, cholera infantum, cholic, and all bowel complaints. The usual treatment recommended for this disease in an advanced stage is 5 grains of calomel three times a day, until a partial salivation has ta- ken place : then take 5 grs. Dover Powder four times a day until recov- ered. The diet to consist of sago, rice, &c, and when recovering, small quantities of port wine at intervals during the day. This complaint is one of the greatest calamities that ever befel the in- habitants of New Zealand. In that climate it is seldom curable, often hurrying the victim off in the short space of twenty-four hours. In its attack it is very mild, the disease working so insidiously as not even to arouse the slightest suspicion. Like Cholera, it is ushered in with pre- monitory symptoms, which, if attended to in time, readily yield to mild remedies. If suffered to continue, it passes on from a simple relaxation of the bowels to Diarrhoea, and from that to confirmed Dysentery. Du- ring my sojourn at Otaheite, I had charge of a medical man laboring un- der this affection. He permitted it to go unchecked until dysenteric symptoms had made their appearance. I administered of all the different kinds of medicine in the surgery which I thought applicable to his case, without effect. My attention was then directed to restoratives, such as Tapioca, Sago, Yams, &c, but all to no avail. He had now become so debilitated from sheer exhaustion, that, for the space of nine days, he was, as it were, in a "trance:" he was speechless, his eyes closed, and unable to receive any nourishment other than occasionally a teaspoonful of port wine and water — the only apparent symptom of life was a slight warmth. At the expiration of this time he began to amend, and, until able to sit up, sub- sisted on warm boiled rice and eggs, continuing the wine and water at intervals. When able to leave his bed I changed this diet for a more nu- tritious one, consisting of shell-fish, fowls, and animal food ; which, with proper management, restored him to health. From the close attention paid this patient, I became better prepared to treat Dysentery in Tropical climates, making good the old adage, that " Experience is the test of pretension." In the incipient stages leading to Diarrhoea, the reader will find an ex- cellent mode of treatment, which may also be used in Dysentery, with MISCELLANEOUS. 305 trie addition of a teaspoonful of the essence of boneset, (prepared by my- self,) every night at bed time. From the recital of the above, an instructive and lasting lesson should be learned, that although life may be apparently extinct, the body should be kept until mortification or some unmistakable evidence is given that the dust is returning to its mother earth. Perchance, as the reader peruses these lines his eye may be dimmed with tears of regret, alas .' never to be recalled, occasioned by some me- lancholy incident of the premature burial of one, whose smile once en> livened the domestic circle, whom, on being exhumed for removal, per- haps, to that most sacred of all retreats — the Family Burial Ground — curiosity has prompted a friend to raise the " sepulchral covering" and to his surprise the bones were not found to lay in that peculiar position in which they were deposited. Instances of this character, I believe, are of more frequent occurrence than we have an idea of ; especially during the excitement in times of attack of that mysterious but winged messen- ger of death — Asiatic Cholera. Appearances on Dissection. — My dissections in Europe and Asia clear- ly show that no part of the alimentary canal escapes the ruinous effects of this disease. The stomach and intestines have all been found more or less affected by inflammation, suppuration and gangrene. I have never failed to open all the dead bodies of dysenteric cases, whenever I have had an opportunity of doing so, since the year 1814; and I lament that it has not been in my power to dissect many more than my opportunities have allowed me, especially in the last few years of my professional life. The disease always affects the large intestines ; sometimes, however the colon and rectum are only affected ; they assume a black and putrid ap- pearance. The coats are enlarged, much ulcerated on the inside, and gangrenous. The villous coats are sometimes changed into a corrupted and slimy substance of a greenish color. The mesentery glands and omentum are affected, and put on a greenish color. The bile is ropy, thick, and of a dark color. The stomach is sometimes inflamed, which inflammation sometimes extends through the whole intestinal canal. The liver, spleen and kidneys are sometimes affected ; and also the vena cava descendens, though this is of rare occurrence. In some instances the large intestines are inflamed, in others partly mortified, and in others en- tirelv. Purulent water is sometimes found in the cavity of the abdomen. 306 MISCELLANEOUS. Tubercles or excrescences are often found on the inside of the colon and rectum, which are sometimes of a firm consistency, and without appearing to have any cavity. Hemorrhoids or Piles. — Piles are of two kinds, blind and bleeding or open ; although the. name is of Greek origin, signifying a discharge of blood, yet at the present day, both kinds are called indiscriminately by the same name. Blind piles consist of small cysts or sacks varying in size from a pea to that of a hen's egg ; the cysts are at times filled with blood and are very much swollen ; at other times the swelling entirely sub- sides. " It is generally supposed that these tumors or cysts are varicose expansions of the veins of the rectum, and probably, says Bichter, this may sometimes really be the case ; but the disease is not always of this nature. In particular instances, and perhaps in most cases, they arise from an extravasation of blood under the inner coat of the rectum, and then the cyst is altogether formed by this membrane, and not by the vein." Hemorrhoids may be external and internal; and vary in size from a pea to a hen's egg ; if they break very suddenly and discharge blood sufficient to weaken the patient, or cause the adjacent parts to in- flame, they then superinduce other complaints which often lead to ab- scesses and fistulous openings. The most efficient remedy as an external application for Hemorrhoidal affections — whether inward or outward is the following salve, of which the size of a common marble may be used every night a»d noon • f Powdered nutgalls, a quarter of an ounce j I Camphor pulverized, thirty grains; { Opium " thirty grains - } ( Hog's lard, one ounce. Mix, and keep in a glass jar for use. As a medicine, the patient should take a teaspoonful of this electuary every morning and evening : Confection of Senna, > f , Cream of Tartar, 5 01 eactl 0De otmce ' Mix. Diet to be plain — devoid of high-seasoning, peppers, spices and stimulants. Pectoral Essence of Boneset, for Coughs, Colds, fyc. — Prepared only at the Laboratory of the Author. — This compound, possessing all the highly esteemed virtues of the essential oil and extract of the herb Eu- patorium Perfoliatum, from whence it derives its botanic phraseology, which the proprietor having succeeded, in realizing by chemical andphar- MISCELLANEOUS. 307 maceutical process, in testing, by many difficult cases of Asthma, Ca- tarrh, recent attacks of Consumption and Pulmonic Irritability, is in- duced by the duty he owes to society, and the wish to lessen (if possible) the sum of human misery, to adopt this system of communication for the purpose of giving it more publicity, that it may become more extensively useful than if confined to his individual private practice. The great advantage of this preparation, is in its being equally bene- ficial in certain acute stages of diseases of the Bowels and Spasmodic Af- fections, an affliction to which some constitutions are seriously habituated. In each case, taking the ordinary dose as prescribed for a cough, will be found a safe and certain remedy, the paroxysms being instantly set at rest, without the aid of other treatment. Innumerable evils attendant on the calamities of human nature, may be traced to a neglect or partial disregard of simple means, the neglect of a cold, however slight in its incipient stages, and the consequence, a prostration of the physical powers, seldom fail to lessen not only the hap- piest days of man, but consign him a prey to constitutional disease, and eventually a victim to premature dissolution. This, alas ! has ultimately proved the fate of man, ever since once emanated from the hands of his Maker ; but self-preservation being the first law of nature, intelligent medical men, in all ages, have been indefatigably engaged, not only to prevent but to suppress this class of Divine visitations ; and their en- deavors to promote this desirable object have been attended with some success, in most of the maladies to which the human race are subjected; still, it is a lamentable fact, that their attempts to introduce a decided barrier to protracted habitual and pulmonic complaints, have too often proved abortive. This consideration, and with a view to remove any impediment which may stand in the way of a more unlimited use of this sovereign remedy, has induced the proprietor to turn his attention particularly to the more predominant features of the class of diseases for which it is designed, in addition to his professional studies ; and he has now the satisfaction to say, that thirty years exertion in the field of medicine has happily enabled him to select, and qualified him to perfect a compound from the vegeta- ble kingdom, mild and efficacious in its operation, which he confidently asserts will remove the most obstinate coughs, the unpleasant tickling sensation in the throat, which excites frequent coughing, a sore and pain- 308 MISCELLANEOUS. ful breast, spitting of blood, as well as every other complaint of the lungs leading to Consumption, if taken agreeable to the directions ac- companying it. There is nothing perhaps more calculated to teach us that all human powers are vanity and vexation of spirit, than that class of sufferings which has induced the proprietor to prepare means to alleviate ; and he indeed who has practically learned this lesson, at whatever price, has never too dearly paid for the knowledge of it. This excellent compound is, in its present prepared state, a decided improvement on the general specifics derived from the leaves and flowers of Boneset ; and it is hoped that such a medicine, (so much more effica- cious than others of the same derivation, from the immediate and perma- nent relief the use of it affords,) and generally speaking, such a course of its administration, will secure to the proprietor, from that signal suc- cess which has hitherto characterized its choice, a continuation of de- cided proofs that it may not only ever serve as a barrier against prevail- ing mortality, but decrease the sum of misery, that it may at all times merit worthy and universal patronage. This invaluable remedy can be had of the Proprietor, at his only office and place of sale, No. 3 Norton-street, Albany, N. Y. Innumerable certificates of its efficacy in every case of Cough, Cold, and Incipient Consumption, may be examined if desired, as some proof of its superiority over other similar preparations. It has been before the public since 1827, a period of twenty-five years, and it now stands at the head of all specifics — none better if as good. Concluding Remarks. — Before closing my volume, I would address a few words of parting advice to the reader. If you are afflicted, delay not an instant after the first symptoms of disease appear to apply to a skilful physician. Let no false delicacy, no fear of expense, deter you; for you need not hesitate to expose every secret to one whose lot it unfortunately is, daily to witness the inroads made upon health by sensual indulgence. . If you have the means, you are amply remunerated by the best professional advice : and should your circumstances be limited, this will always be considered by a medical man of honor. It has been very far from the intention of the author of- these pages to encourage a belief that you can combat with safety all the varieties of disease described in this work, by any method herein detailed, for, as among these, there arc MISCELLANEOUS. 309 none more dreadful, so there are none which exact more discrimination in their adaptation of remedial means. My object in this treatise has been to impart to you as much information as regards consequences of neglect and treatment as may, warning you of the dangers of sensuality, the better enable you to recognize these affections and guide you, as far as practicable, (when medical aid cannot be obtained) to the most safe and efficacious means of recovery. Want of proper discrimination on the part of patients requiring surgi- cal assistance is almost as much an evil as that of medical knowledge and sound judgment on the part of charlatanic advertisers who sound their own trumpet to beat up victims for dissection. Were the unhappy suf- ferer to be more careful in his choice in this respect he would not so often fall into the hands of such who (to use a flash expression) cannot distinguish between the appearance of a rupture and bubo, nor subject himself to the "round" of fatal consequences which mal-treatment and premature ad- vice produce ; such as marrying before disease is thoroughly eradicated from the system, thereby conveying to the innocent wife and helpless infant that which an empiric had been paid to cure. Of such offices — beware ! the tenants of which, in many instances, practicing under as- sumed (French) names, cannot produce a diploma or certificate to entitle them to public confidence. Ask them for their diplomas, &c, (of which they say they have an abundance) and they endeavor to waive the subject. The Author here takes the liberty of asserting without hesitation or fear of contradiction, that He is the only physician residing in the city of Albany, N. Y., who is in possession of genuine American and European Diplomas in connection with European testimonials. And furthermore, that He is the only advertising Physician in Albany, who, from the fact of being a native of England, and having there acquired His Profes- sion under the most favorable auspices, chiefly in the British Hospital Service, and now practicing under his lawful name, has ever resided on the continent of Europe, or even visited its celebrated Hospitals and Medical Institutions. To satisfy those in doubt, let the patient enquire at the Book Stores, Post Office, or even of the Medical Faculty, &c, in this city, how many persons are doing business in Albany under assumed names — pretending to have traveled in Europe and visited its Hospitals, when in reality they have never traveled 500 miles from home — gullino- 310 MISCELLANEOUS. the afflicted, who, too late, discover their mistake, and are unable to ob- tain redress. The Author, from time to time, previous to his retirement from out door practice, became extensively associated with many eminent Physi- cians, among whom may be mentioned Drs. Vought, of Rochester, Hes- ton, Hurd, Horston and Abbott, of New York city, and the late Alexan- der Hosack, residing at Hyde Park, near New York, and physicians generally throughout the Union. In the year 1834, when on a visit to see the renowned John Randolph of Roanoke, he had, at the residence of Mr. R., the honor of being suc- cessfully consulted in an extreme case of Dyspepsia, by that Sage War- rior, and Patriotic Statesman, Andrew Jackson, late President of the United States ; and about the same time his auspicious communications on the subject of " Foreign Hospitals," were commenced with Sir Henry Halford, President of the Roj^al College of Physicians, London. It is now a source of gratification, in the " evening of his days " to look back through the mazy labyrinths of time, o'er the reminiscences of a life thus spent in the Public Good. May 14th, 1852 — The twenty-third anniversary of the day on which, in 1830, Dr. Cooke commenced the practice of Physic and Surgery in this city — ushers into existence a new and interesting volume of which he has the honor of saying to his patrons, He is the Author — illus- trating not only a synopsis of General, Pathological and instructive infor- mation, but also his Professional experience in various parts of the globe, wherein he has traveled during a series of years, among savage as well as civilized nations : Owyhee, Terra del Fuego and The Brazils, &c, &c.; with a sequel of hardships and privations which seldom fall to the lot of man. This Work, the reader will find, is not embellished with shameless (by some called beautiful) anatomical lithographs. They are permitted to remain the property of their own illustrious and primitive inventors, because, more in character with the works of Aristotle, and consequently better adapted to the purposes of minor authors and plagiarists who are utterly regardless of immorality and obscene parade. Finally, if you labor under a constitution completely broken down, or are of a scrofulous or consumptive habit, be cautious how you submit to the slightest mercurial treatment. Remember that thousands of cases MISCELLANEOUS. 311 demonstrate the certainty of curing venereal diseases of every descrip- tion without mercury ; and that its improper use determines more dread- ful effects than those of the venereal, entirely abandoned to the course of nature. I have dwelt at some length upon the horrors of secret diseases, but the half has not been told ; nor is it possible by any language to con- vey an exaggerated impression of them. Could I but convey you to the chambers of suffering which I have visited, during my extensive travels throughout Europe, Asia and America, you would shrink from the em- brace of lewdness and the charm of the passions, as from the coil of the serpent. In warning you against these vicious indulgences, I have resorted only to argument drawn from physical sufferings, and Heaven knows, these are such, that, to brave them for a transient enjoyment, must be consid- ered an act but little short of insanity ! But permit me to remind you, that physical contamination is but one of the evils resulting from a life of profligacy. There is a moral contamination which is inseparable from a systematic prosecution of vicious pleasures, which is even more deeply destructive to the best interests of man — a contamination which may ad- here to the moral spirit, when divorced from its material companion %V2i VOICE OF THE PRESg rOICJE OF THE PRESS IN ALB AMY. JUST PUBLISHED, PRICE FIFTY CENTS, A new and brilliant work entitled "Professional Experience in Various Cli mates." The most authentic and original Medical Treatise ever presented to the public in the United States of America, by Gen. George Cooke, LL. D., Mem- ber of the Royal College of Physicians and Surgeons, London, and founder of the Lock Hospital, No. 3 Norton-street, Albany, N. Y., to whom a massive Gold Medal was a few years since awarded by some of the Faculty in Europe, bearing the following inscription : Presented to Gen. George Cooke, LL. D., a Physician distinguished for superior talent, sterling merit and scientific improvements in the practice of Medicine. Public opinion and the high estimation in which the Author is held in commu - nity, may be gleaned from the following complimentaries as they originally ap- peared in the newspapers of this city. The very name of this Most Celebrated Physician is a sufficient guarantee to the public ; as no man is more widely known or has been to such an extent — a Public Benefactor. TRIBUTE OF RESPECT. The Young Men's Association, representing the citizens of Albany, through their late President, James I, Johnson, Esq., as a public demonstration of their re- spect for, and gratitude to Gen. Cooke, their venerable patron, some time since made an honorable appropriation to obtain a Life-size Medallion Bust of that gentleman, and have placed it in their Library and Reading room. It is wrought of pure white marble, and secured in a handsome and richly carved case superbly mounted— a work of art which reflects a just meed of praise to its sculptor, as well as manifests a suitable testimonial of the feelings of thou- sands of persons of whom their society is in part composed, who value Gen. Cooke as a well-tried, true and faithful friend. This is not the first time he has consented, for the gratification of his friends, to sit for his bust. On a former occasion, only a few years since, a similar request was made by some of the Nobility of England. A plaster bust was soon consum- mated; the model placed in the National Academy of Fine Arts. Trafalgar Square, London; and a splendid Marble Bust was executed and sent to his resi- dence in the United States. The talented artists were, of the former. E. D. Palmer, of Albany. N. Y. and of the latter, E. IT. Bailer of the Kovai Academy of London. PL v a cn^ ~*-' f PROFESSIONAL EXPERIENCE 15 VARIOUS CLIMATES: ▲ COMPLETE PRACTICAL TREATISE ON WITH PATHOLOGICAL OBSERVATIONS ON THE PHILOSOPHY'OF REPRODUCTION, SPERMATORRHOEA, AND THEIR IMMEDIATE AND REMOTE CONSEQUENCES. TOGETHER WITH THE MORE SUCCESSFUL MANAGEMENT OF DISEASES OF WOMEN AND CHILDREN, AS ADOPTED AT THE PRESENT DAY. SECOND EDITION. BY Gen. GEORGE COOKE, M.D., LL.D., FELLOW OF THE ROYAL COLLEGE OF PHYSICIANS AND SURGEONS ; CORRESPONDING VACCINATOfi OF THE NATIONAL VACCINE INSTITUTION, UNDER THE SANCTION AND AUTHORITY OF THE BRITISH GOVERNMENT, LONDON J CHANCELLOR OF THE UNIVERSITY, AND PRESIDENT OF THE MEDICAL DEPARTMENT OF THE COLLEGE OF RIPLEY, IN THE UNITED STATES OF AMERICA; FORMERLY ASSISTANT SURGEON IN THE ROYAL NAVY — BRITISH AND FOREIGN HOSPITAL STAFF, AND THE HON. EAST INDIA COMPANY'S SERVICE ,' THE ONLY ARMY AND NAVY SURGEON LIVING IN AMERICA AT THE PRE- SENT DAY, WHO HAS EVER VISITED THE HOSPITALS OF ENGLAND, FRANCE, BELGIUM, GERMANY, AUSTRALIA AND SOUTH AMERICA; AND FOR THE LAST TWENTY-TWO YEARS MEDICAL AND SURGICAL REFEREE IN ALBANY, IN CLINICAL PRAC- TICE, CHRONIC COMPLAINTS, &C, &C, &C. PUBLISHED BY THE AUTHOR, No. 3 NORTON-STREET, ALBANY, N. Y. 1852. I 0*~> J> "3 > > -3S- ;> > »3 ."> 2» 5X • >a«JiE>J> 3 » ODDS* €*» 33g? |? J>? J£>®>l^> Hfe , > | EK»>>" > ■•■ > > 1 T3K^>>;^>>>? 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