300-571
Evans 15100
The
WILLIAM L.
CLEMENTS
LIBRARY
University of Michigan
Gift of
The Clements Library
Associates







OSTON
THE
DISEASES
INCIDENT
TO
ARMIES.
WITH THE
METHOD, of CURE.
Tranflated from the ORIGINAL of
BARON VAN SWIETEN,
Phyfician to their IMPERIAL MAJESTIES.
To which are Added;
The NATURE and TREATMENT,
of
GUN-SHOT WOUND S.
BY JOHN RANBY, Efquire; SURGEON GENERAL
TO THE BRITISH ARMY.
Likewife,
SOME BRIEF DIRECTIONS,
TO BE
OBSERVED BY SEA SURGEONS
IN ENGAGEMENTS.
Alfo,
PREVENTATIVES of the s CURVY at s E A.
BY WILLIAM NORTHCOTE, SURGEON,
MANY YEARS IN THE SEA SERVICE.
Published, for the Ufe of Military, and Naval Surgeon
IN AMERICA.
PHILADELPHIA:
Printed, and Sold, by R. BELL, in Third-Street.
MDCCLXXVI.

Fluore

THE AMERICAN EDITOR,
TO THE PUBLIC.
GENTLEMAN of the Faculty
A in the City of PHILADELPHIA, who
was one of the Surgeons, in the
Military Service laft War; and who is
defirous of affording every help in his
power, towards a fuccefsful termination of
the prefent AMERICAN Meafures, for the
Defence of LIBERTY. Being of opinion,
that the Publication of the following
excellent Tracts will be attended with
the most falutary influences, in the pre-
fervation of the lives of many of thofe
valuable Citizens of AMERICA, who, as
Soldiers and Sailors, are now contending
for the mighty Prize of FREEDOM: And
would at the fame Time, communicate
worth and dignity to the Military and Naval
Practitioners in the Art of Healing, was
generously pleaſed to beftow, and recom-
mend it to the notice of the Editor, who
humbly apprehendeth, that the intereft of
the Public, will be truly ferved in their
purchafing, as well as his private intereft
in felling, and by fuch favors which reci-
procally gratify, the obligations are, at the
fame time, fettled and continued.

Lately Printed, and now Selling by ROBERT BELL,
in Third Street, PHILADELPHIA.
(Price Five Dollars.)
LECTURE S
ON THE
MATERIA MEDICA,
AS DELIVERED
By WILLIAM CULLEN, M. D.
Profeffor
of MEDICINE in the University
OF
EDINBURG H.
Now Publifhed by Permiffion of the AUTHOR,
And with many CORRECTIONS from the Collation of
different MANUSCRIPTS by the EDITORS.
N. B. The whole of the European Editor's
EMENDANDA, which they inferted at the end, is
carefully inferted at each proper place, throughout the
body of the Work, in this American Edition.
MEMORANDUM.
This excellent Work, contains the very cream of Phyfic,
and is abfolu ely neceffary for all American Phyficians,
who wish to arrive at the top of their Profeffion.

THE PREFACE
TO THE
DIS
ISE A
D
INCIDENT
S
TO
E $
ARMIE S.
T
HE great and frequent inconveniences
attending a military life, are of fuch
a nature, as to make the greateſt ha-
vock even among the moft robust confti-
tutions. It is not, therefore furprifing,
that an Army is feldom or ever without a
great number of fick.
NEVERTHELESS, it has been observed,
that the diftempers moftly prevalent among
the Troops are not in number very confi-
derable.
WE have, for this reafon, thought it
fufficient to ſpeak of thofe, whofe attacks
the foldier is moft fubject to, to defcribe
them in fuch a manner, as they may be
diftinguished from one another by certain
figns; and at the fame time to give an ac-
count of fuch fymptoms as characteriſe the
decreaſe or increaſe of each diforder; and
laftly, to specify the medicines proper for
the cure of the fick, and the diet they are
to obferve.
IT

6.
PREFACE.
IT will be perceived, that, in our little
Effay on this fubject, it was equally ne-
ceffary to be fhort, and to endeavour to
avoid being obfcure.
THIS Work, however, no wife regards
the Phyficians, who, mafters of their art,
and in daily practice, ftand in no need of
the affiftance of thefe first elements.
BUT it often happens, in an army, that
the number of fick is fo great, and they
are difperfed in fo many different places,
that it is impoffible the phyficians fhould
go every where, and give their attendance.
to each individual. In fuch cafes, necef-
fity obliges the fick to be entrusted to per-
fons who cannot be expected to have the
fame knowledge with thofe of the profef-
fion.
FOR the ufe of fuch practitioners, not
fufficiently inftructed, this fmall Tract is
defigned, that, by the figns exactly defcrib-
ed, they may underſtand the nature of the
diftemper, the conduct they are to obferve,
and the remedies proper to be adminiſtered.
AT the end are inferted the RECIPES or
preſcriptions referred to in the courfe of
the Work. They are rendered as fimple
as poffible, and preference given to thoſe
medicines that are eafieft to be procured,
and eafieft to be prepared.
IT

PREFACE.
7
It may not be amifs to premife fome
obfervations, by means of which, fickneſs
may in fome degree be prevented, and the
health of the foldier preferved. We are
fenfible, that, in time of war, it is not al-
ways poffible to obferve exactly all what we
are going to fay; but it cannot but be of
ufe to know what is moft advantageous,
that it may be put in practice, at leaſt when
circumftances permit.
Firft. THE foldier fresh lifted, and torn
at once from his family, no fooner lofes
fight of his village, but he becomes melan-
choly; and tho' a robuft hufbandman,
finds himtelf fcarce able to bear the fatigues
and inconveniences of a military life. It
were to be wifhed, that he could be ufed,
little by little, to this new kind of life; but
in the mean time nothing is better, than
to procure him all kinds of amuſement
and diverfion.
Second. GARDEN ftuff and fresh greens
are a wholeſome nouriſhment for the fol-
dier; ripe fruits are equally good, and never
hurt but by their abufe; but unripe and
acrid fruits are very hurtful. The ufe of
garden ftuft and fruit prevents the fcurvy,
and even cures thofe already attacked with
it.
Third. THE choice of water is effen-
tial.

8
PREFACE.
tial. If there is none to be found abfo-
lutely pure, the preference is to be given
to that leaft loaded with heterogeneous
parts. There is an eafy way to diftinguish
water that is pure, from that which is lefs
fo, by means of oleum tartari per deliquium.
If you let fall a few drops of this in a glafs
of water, if not pure, it becomes inftantly
thick, and milky, whilft the fame opera-
tion produces only a fmall cloud in that
which is more pure.
RIVER Water fhould not be drawn near
the banks; that which is in the middle of
the ftream is always beft.
SOMETIMES, indeed, Troops are re-
duced to the fad neceffity of drinking bad
water; in which cafe it may be much cor-
rected, by mixing a certain quantity of
vinegar. Six ounces, mixed with three
quarts of water, will render the drink even
more agreeable.
THE water may alfo be rendered lefs
hurtful by fteeping in it fome pieces of the
root of the calamus aromaticus. This root is
found every where, especially in marfhy
places, where commonly the water is worst.
Fourth. THE foldier ought to be well
clothed and covered; his fhoes of a thick
and ftrong leather. and the thread they
are fewed with well covered with wax :
If

PREFACE.
if all the feams could be well waxed the
water would be prevented from penetrating.
Fifth. CAMPS ought to be pitched on
a dry fpot, as much as poffible. That
which appears fuch is fometimes quite the
reverſe, becauſe the waters are but at a little
diftance below the furface. It is, however,
very eaſy to know that, by digging the
ground, or even merely by examining the
wells of the neighbouring villages
IF the water is high in the wells, the
foil is damp, ; if the water is low, the
foil is dry.
It would likewiſe be proper to avoid the-
neighbourhood of thick forefts; they
prevent the wind from penetrating, and
render the air of the circumjacent parts
damp and cloſe.
BUT if there is a neceffity of encamping
in a damp ground, the foldiers muſt have
their ftraw changed oftner than ufual.
The officers will be much benefited by
fpreading a waxed cloth under their bed.
IN times of rain, the tighter the tents
are extended, the lefs it penetrates: fmall
trenches dug round the tents contri-
bute to the drynefs of the fpot where the
foldier lies, becauſe they receive the water
that falls from above.
Sixth. WHEN an army remains long
B
in

PREFACE
in the fame camp, the unwhole fome ef-
fluvia from fo many bodies always occafion
ficknefs, unless there happen to be violent
and frequent winds. Theſe exahalations
are moftly to be feared in a hot and moift
air. The changes of camps on this ac-
count, contribute much to the health of
the foldier, more efpecially when the
bloody flux prevails. Hence arifes one
reaſon the more for avoiding the neigh
bourhood of thick forefts, which prevent
the free paffage of the winds.
Seventh. NOTHING is more prejudicial
to the foldier, when heated with work,
than to ftrip, expofe himself to the cool
air, and greedily drink cold water, and ef-
pecially well-water, which commonly is
very much fo. River water is lefs hurtful,
as the rays of the Sun, to which it is con-
ftantly, expofed, prevent its being fo cold.
Eighth. CARE must be taken, during
the great heats, that the foldier on duty
fhould remain expofed to the heat of the
Sun as little as poffible, and that he avoid
fleeping there. The cuiraffiers, efpecially,
when once their cuirafs is thoroughly heat-
ed, are thoſe who fuffer moft by the fun.
Ninth. NEATNESS connot be too much
infifted on. Let foldiers frequently
wath their hands, their face, and their feet;
and,

PREFACE.
and, if the feafon permits, let them bathe
as much as poffible in running water.
Tenth. GREAT care ought to be taken not
to lodge many men together in a ſmall ſpace;
and if it cannot be avoided, let the air be
at leaſt renewed as often as it can, whether
thoſe who lodge together are in health or
fickness; for from hence arife the moft
dangerous, and even the contagious dif-
tempers.
Eleventh. THE bread ought to be well
baked, and made of good and pure flour;
for it is certain, that very dangerous dif-
tempers are occafioned by mufty or fpoiled
bread,
OF

THE
CONTENT S.
Page
REFACE by way of INTRODUCTION, 5
PRE
Of COUGHS,
Of a Sore THROAT,
Of the PLEURISY,
14
15
19
27
Of a PERIPNEUMONY,
Of the RHEUMATISM, and RHEUMATIC PAINS, 39
Of Intermitting FEVERS,
Of Spring INTERMITTENTS,
Of Autumnal INTERMITTENTS;
44
45
51
Of Quartan FEVERS,
55
Of the JAUNDICE,
56
Of the DROPSY,
58
Of VOMITING,
64
Of the COLERA MORBUS,
65
Of a DIARRHEA,
616
67
Of the DYSENTERY,
68
Of an Inflammation of the INTESTINES, 73
Of the PHRENZY,
Of the Hæmorrhage of the NOSE,
Of a continued FEVER,
Of the S CURVY,
77
80
82
89
94
94
99
102
Of the GANGRENE,
Of the LUES VENEREA,
Of the ITCH,
Of WORMS,
RECIPES or PRESCRIPTIONS,
104
Extracts from NORTHCOTE, RANBY, and LIND,
On the following Subjects.
Of WOUNDS of the VEINS, ARTERIES,
NERVES, and TENDONS, with obfervations. 115
Of GUN-SHOT WOUNDS, their Nature and
treatment; with obfervations.
117
DIRECTIONS for SURGEON S, previ-
ous to, and in ENGAGEMENT S. 129
PREVENTATIVES of the SCURVY at SEA. 138
RULES for preferving HEALTH, in WARM
and COLD CLIMATES..
151

OF THE
DISEASES
OF THE
A R M
Y.
F the troops encamp in the fpring, efpeci-
ally early in the feafon, there will in-
fallibly be many fick. The Difeafes,
that principally prevail at that time, are,
very troubleſome Coughs, fore Throats, Pleu-
rifies, Peripneumonies, and Rheumatisms.
THESE Diftempers, tho' not contagious,
do not admit of much motion in the Pa-
tients, wherefore it fhould be endeavoured
to have the Hofpitals nigh hand, and, if the
ftate of the Distemper requires it, to bleed
the Patient, before he be moved, the delay
of which may produce very troubleſome
confequences.
SOMETIMES alfo intermitting Fevers pre-
vail during this feafon, but they generally
are lefs obftinate than thofe that happen in
Autumn. In Spring they are commonly
Tertians, or Quotidians, but feldom Quar-
tans, unleſs in thofe fubjects, who have
been before attacked during the Winter,
and in whom, properly fpeaking, they are
only Relapfes.
C
COUGHS

14
DISEASES
Ca
COUGHS.
YOUGHS are more troubleſome than
dangerous: but if they continue any
of time, and are neglected, they fome-
times degenerate into a Phthifis Pulmonalis.
LET the Patient make ufe of the receipt
No. 1. for his common drink, and drink it
luke-warm; it will be of fervice to add a
fourth part of new milk.
THE Patient muft abftain from wine,
from falt and acid food. Rice, and barley
broth, and new milk, with the yolk of an
egg, will be fufficient nouriſhment.
IF the Cough becomes too violent and
troubleſome, fo as to prevent the Patient
from fleeping, he may take the prefcription
No 2.
Ir the Cough is attended with a Fever,
bleeding will be neceffary to prevent an In-
flammation, which is then to be appre-
hended.
WHEN the Cough diminishes, and the
excretions, which before were without con-
fiftence, become thick, and are eafily ex-
pectorated, the diftemper is at an end.
SORE

OF THE ARM Y.
15
IF
SORE THROAT.
F the action either of fwallowing or refpi-
ration fuffer an impediment, attended
with fenfible pain, and the caufe is in the
neck, or throat, the diforder is called a fore
Throat, (Angina.)
It is a very dangerous diftemper, and
fometimes even mortal; it is known to be
fo, when refpiration is greatly impeded,
the voice extremely fharpened, and the
anxiety very confiderable. A large bleeding
is immediately requifite, and cupping glaf-
fes are to be applied, around and on the nape
of the neck, which often give inftant relief:
the drink No. 1. must be kept conftantly in
the mouth warm; and the poultice No. 3.
applied, and continued hot on the neck,
night and day.
IF the Patient can fwallow, let him take
every hour a cupfull of the drink No. 1. made
hot, with the addition of twenty grains of
purified nitre to each pint. If the rednefs
appears on the neck or breaft, the Patient
often recovers. Otherwife this Difeafe is
frequently mortal; but it is not common.
The following fpecies is much more fre-
quent.
ONE of the tonfils, grows red, fwelled,
and

16
DISEASES
and painful, and the pain commonly ex-
tends itſelf to the internal part of the ear of
the difeafed fide. In a day or two, the
Diſeaſe attacks the gland of the other fide,
while the fwelling difappears from that
which was firft affected. Sometimes the
pulfe is hard and quickened, and fometimes
not at all
IN the firft cafe, the urine appears of a
deeper colour than it is in health; bleeding
is then neceffary; and if the rednefs, fwelling
of the throat, and difficulty of breathing do
not give way, it will be proper to repeat it.
IN the fecond cafe, viz. if the pulfe is na-
tural, there is no neceffity for bleeding, un-
lefs the Patient be of a replete habit.
THE nourishment must be reftrained to
light broth, to which may be added rice or
barley cream.
LET the Patient take a tea-cup of the
drink No. 4. every hour, warm, unless he
fleeps: and let him often keep in his mouth
fome of the medicated tea, No 5. warm,
with which he is alfo to gargle his throat.
NEXT day let him be purged with the
draught No. 6. which, if the diforder does
not abate, he may take it again after two
days, continuing, in the mean time, the ufe
of No. 4. and No. 5. till he can ſwallow
freely

OF THE ARMY.
17
freely, and the rednefs hath difappeared
from the infide of the throat.
Ir the diforder has continued too long, be-
fore relief was applied, or the inflammation
is too confiderable, (to give way,) fuppura-
tion will enfue.
THAT there will be a fuppuration is
known, by the fwelling and redneſs in the
throat continuing above three days, without
any abatement. In this cafe, the Patient is
to keep continually in his mouth fome of
the decoction No. 7. warm, which likewife
may be lightly injected into his throat.
THE cataplafm No. 8. is to be applied, and
kept night and day round about his throat.
If the fwelling of the throat then begins
to grow foft, the abfcefs will foon burft: if
there appear a little ſpot elevated and white,
the concealed lancet (pharyngotomus) may
with all fafety be ufed, to give, by this
means, a freer iffue to the
pus.
The abfcefs being either broke of itſelf or
opened by the lancet, the gargarifm No. 9.
must be frequently ufed, and the cure will
foon be compleated.
WHEN it happens that the fwelling pre-
vents deglutition entirely, a glifter of twelve
ounces of new milk and fix ounces of barley
water is to be adminiftered every four hours,
which the Patient muft retain as long as he
poffibly

18
DISEASES
poffibly can. By this means he be fuf
tained till the abfcefs breaks.
may
THERE is ftill another fpecies of fore
throat, which, in the beginning, is eafily
cured, but by neglect degenerates into a fort
of mortification, and corrodes all the parts
attacked, caufing at the fame time a moft
horrible ftench.
THERE appears on the tonfils, on the
pa-
late, on both fides of the interior part of the
mouth, or within the lips, one or feveral
white fpots, fometimes yellowish, and even
brown, according as the diforder is more or
lefs violent. The places round theſe ſpots
are much inflamed and painful. It fome-
times happens that the patient has no fever;
and the fwelling is never fo confiderable in
this cafe, as in the before defcribed fore throat.
THE laft fpecies generally goes off pretty
foon, by rubbing every two hours lightly the
parts affected with a pencil dipped in the
mixture No. 10. and ufing for a gargarifm
a fimple infufion of elder flowers. It is
proper the Patient fhould drink fome cups
of the fame infufion about four times a day.
It is to be obferved, that the faid fpots in-
creaſe very fuddenly, when the stench of
the mouth is great : in that cafe, the quan
tity of Sp. fal. mar. must be augmented, to
ftop the progrefs of this evil.
The

br THE ARMY.
19
THE
The PLEURIS Y.
HE Pleurify is known by a fharp pain,
and ftitches, felt in the breaft, and at-
tended with a fever.
THIS pain is increaſed by inſpiration, and
leffened by exfpiration, and by holding the
breath; the pulfe is generally hard, as in all
acute and inflammatory difeafes: in violent
Pleurifies the pain is fometimes fo fharp,
that the Patient fcarce dares to draw his
breath, the face grows lived, and he feels
himſelf juft fuffocating; in this ftate the
pulfe is fmall and low.
The Cough is almoft continual, but inter-
rupted by the violent pain: in fome cafes,
this Cough is dry, without any excretion;
in others it is, from the beginning, attend-
ed with excretions; lefs danger is to be ap-
prehended in the laft cafe than in the firft.
THO' the fides of the breaft are moft com-
monly attacked in this diftemper, yet the
anterior and pofterior parts may be equally
affected.
IF the pain is moft fenfibly felt exter-
nally, and chiefly upon touching the part,
the diforder is commonly named a falfe Pleu-
rify, and is to be treated as follows:
BLEEDING is the firft and chief remedy:
let

20
DISEASES
let twelve ounces of blood, or even more,
if the fubject is replete and robuft, be taken
from the arm, on the fide where the pain
is. While the vein is open, let the patient
refpire ftrongly, and cough. Bleeding com-
monly leffens the pain, and fometimes car-
ries it off altogether.
SOME hours after the bleeding, the glyfter
No. 11. ought to be given.
FLANNELS dipt in the fomentation No. 12.
are to be conftantly applied to the place
where the pain is felt; and as it would be
troubleſome to apply this topic during the
night, a plaifter of Labdanum, fpread on
leather or linen, may be applied in its
room.
In the morning this plaifter muſt be taken
off, the part rubbed with the ung. althea and
the medicine No. 12. Let the patient take
every half hour, if he be awake, a fpoonful
of the mixture No. 13. and drink after it
a warm cupfull of the decoction No. 1. to
each pint of which one ounce of honey
fhould be added.
IT often happens, that the pain, which
after bleeding was much leffened, or quite -
ceafed, returns with as much violence as at
firft in this cafe a fecond bleeding is ne-
ceffary, but commonly not fo large as the
firft, which always ought to be very copi-
ous:

OF THE ARMY.
21
bus: if after this the pain ftill returns very
fenfibly, you muft bleed a third time, and
fometimes even a fourth, according to the
violence of the diftemper.
IT muft, however, be obſerved, that
Aight remains of pain, and fuch as but little
impede refpiration, do not require fresh
bleedings: the Patient might by them be
too much weakened, and rendered languid
a long time after.
BLEEDING, therefore, muft only be re-
peated in thofe cafes where the pain is vio-
lent enough to obftruct the breath confider-
ably; the velocity of the pulfe, increafed
commonly at the fame time, fhows the ne-
ceffity for this evacuation.
IT is a good fign, when the pain changes
its place, and affects the clavicles, the
fhoulder-blades, the fhoulders and back;
and that this new pain requires no bleeding.
Thefe changes generally happen about the
fixth day: it is then fufficient to chafe the
parts in pain lightly, and then anoint them
with the ung. alth.
LET the nourishment be light, and con-
fift of thin broth, roafted apples, and well
fermented bread: the decoction No. 1. or
plain barley water with one fourth of new
milk, may ferve for common drink. If
the belly be conftipated, the glyfter No.
11. may be repeated.
D
As

22
DISEASES
As foon as refpiration grows eafier, and
the pain is confiderably diminished, it will
be fufficient to give every two hours a ſpoon-
ful of No. 13. with a cupfull of the de-
coction No. 1. warm after it.
BUT if, notwithstanding feveral bleed-
ings, the pain continues, without any fen-
fible diminution; and above all, if the rat-
tling of the breaft, and want of expecto-
ration fhew the lungs to be filling, a blifter.
is to be applied to each calf of the leg.
A fharp blifter applied on the painful
part has often been attended with very good
effects, even when repeated bleedings had
procured no ceffation of the pain of the fide.
CARE must be taken in this, as well as
in all inflammatory diftempers, that the
Patient be not kept too hot, and that the
air be often renewed.
WHEN the illness begins to grow milder,
by the ufe of the above medicines, freſh
fymptoms will appear, which show the
morbific matter is concocted, and ready to
be expelled.
GREAT care muft then be taken, not to
prevent its courfe, but, on the contrary, to
facilitate it by all the means that art can
fuggeft.
BLEEDING piles are of fervice; a white,
reddiſh, or fometimes a brownish fediment
in

OF THE
23
ARMY.
in the urine is a favourable fymptom: to
encourage its continuance, the fick muft
drink plentifully.
IF in the progrefs of the diftemper, after
the fymptoms grow milder, the excrements
are yellow, and bilious, it is a good fign;
but at the beginning it affords but a bad
prognoftic.
IN general this difeafe is carried off by
expectoration, efpecially if the excretions
are plentiful and diminish the pleuritic pain,
and above all, if they are ripe and reſemble
pus. Sometimes they are glewy, tenacious,
and fanguineous; but there is nothing to
fear from them, if the pain abates, the
fever diminishes, and refpiration becomes
more free. Be cautious, however, not to
repeat the bleeding, which, under thefe
circumftances, must be prejudicial. Some-
times the excretions are yellowish, and mix-
ed with ftreaks of blood, and this alfo is a
favourable fign.
LASTLY, it may be laid down as a ge-
neral rule, that expectoration is to be efteem-
ed a happy fymptom; whenever the excre-
tions are thrown off with eafe, they diminish
the pain and fever, and render the refpira-
tion eaſier.
IN fuch a ftate of the expectoration, the
mixture No. 13. must be laid afide, and the
linctus

24
DISEASES
linctus No. 14. fubftituted in its place; two
fpoonfuls of which are to be given once in
an hour, and leifurely fwallowed, with a
cup of the decoction No. 1. warm after it.
IF the expectoration does not continue,
but fuddenly ftops, and there comes on a
rattling in the breaft, attended with anxiety,
the danger is very great; blifters on the legs
must be applied immediately, the powder
No. 15. be given every four hours, and the
warm decoction No. 1. fweetened with a
little honey, be drank plentifully, till the
fpitting comes on again, and the breaft is
relieved.
THERE comes on fometimes, but not
often, a painful fwelling behind the ears,
or on the thighs, which pain is followed by
a diminution of that of the breaft: in this
cafe, the immediate ufe of the cataplafm
No. 8. or fuch like, is neceffary, to ripen
the fwelling, which is to be opened with a
lancet, as foon as it comes to a head, and
be dreffed afterwards as an ulcer.
THE violence of the distemper may be
fo great, that the most efficacious remedies
are infufficient to overcome it, and to expel
the morbific matter. In this cafe, fuppu-
ration, which is always dangerous, comes
on, and moft commonly the illneſs degene-
rates into a confumption, unleſs means be
found

OF THE
25
ARMY.
found to evacuate the already formed pus.
THAT this is the ftate of the cafe, may
be known by the following fymptoms.
THE pain is ftubborn, and yet lefs violent
than at the beginning: it is attended with
a dry cough, or with unripe excretions ;
there is a continual quickness of the pulfe,
which encreaſes towards night, or when-
ever the patient takes any nourishment; the
cheeks and lips become red; he has fre-
quent fhiverings and night-fweats; the urine
is frothy and pale, and he foon becomes
extremely weak and lean. The abſceſs,
formed in the lungs, is fometimes evacuated
by excretions: when they begin to appear,
and are purulent, the infufion No. 16.
fweetened with a little honey, is to be given
every hour: broths, in which fresh chervil,
lettuce, and parfley roots, are boiled, may
ferve for nouriſhment; and for drink, bar-
ley water, with a fourth part of new milk,
both to be continued till the purulent mat-
ter is quite evacuated.
BUT this does not always happen; the
pus is often formed in a bag; and in that
cafe it must be attempted to draw out this
collection of matter.
A SMALL plaifter applied, and made to
ftick cloſely to the most painful place, will
very proper in the beginning of the ill-
be
nefs;

26
DISEASES
nefs; becauſe if the Pleurify fhould dege-
nerate into an abfcefs, the collection of mat-
ter will point towards that place.
WHEN an Abfcefs is known to be form-
ed, by the figns that have been defcribed,
the marked place is to be corroded by a
light cauftic; and when open, care muſt be
taken to keep up the fuppuration. In fuch
a cafe, there is reafon to hope, as the refift-
ance is the leaft at this place, that the mat-
ter collected will take its courfe, and be dif-
charged by it; for thefe collections are often
lodged between the Fleura and the adjacent
parts.
FOR the fame reafon, a feton on the ſpot
is fuccefsfully ufed; and the pus has often
been ſeen to diſcharge through fuch a paf-
fage procured by art.
IF the matter contained in the abfcefs can-
not be drawn to the external parts, it will
occafion a fwelling of the Pleura towards
the cavity of the breaft; whereby the lungs
will be oppreffed, the anxiety daily increaſe,
the Pleura burft, all the fymptoms fudden-
ly diſappear, but come on again foon, and
the pus fall into the cavity of the breaft.
UNDER thefe circumftances, no other,
method can be ufed but the Paracenthefis,
to difcharge the breaft from the pus there
lodged, and prevent a mortal confumption.
DURING

OF THE
27
ARMY.
DURING this laft trial, the ufe of the me-
dicine No. 16. is to be continued. If,
during the courfe of the diftemper, the pa-
tient can get no fleep, a pint of the emul-
fion No. 17. is to be adminiftered, to which
may occafionally be added an ounce of the
fyrup of white poppies, or more if neceffary.
PERIPNEUMONY.
TH
HIS Diftemper is, properly fpeaking,
an inflammation of the lungs : it is
dangerous, and even more fo than the
Pleurify itſelf, which fometimes degenerates
into a Peripneumony, when the patient is
forced, by exceis of pain, to keep in his
breath.
A DIFFICULTY of breathing, the load
and oppreffion of the breaft, and an acute
and continual Fever, indicate a Peripneu-
mony.. In this diftemper the patient feels
no pain; or if he does complain of any,
it is of fuch a dull one as diftinguishes the
Peripneumony from the Pleurify; which
laft, in infpiration, gives the patient a very
acute pain.
THE pulfe is not fo hard in the difeafe we
are now defcribing, as in the Pleurity and
other inflammatory diftempers; but, on the
contrary, is generally found much fofter.
IF

28
DISEASES
Ir the Peripneumony is violent, there
immediately comes on a great weakness, the
pulfe becomes fmall, foft, unequal; the
refpiration is fhort, frequent, difficult, and
accompanied with a continual cough; the
patient cannot lie down for fear of fuffoca-
tion, but is obliged to fit upright in his bed
his face, eyes, tongue, and lips, become
red and inflamed: thefe fymptoms are fol-
lowed by an infupportable anxiety, and foon
after by a delirium, and death.
ALL the figns, therefore, that we have
recited, give us a very bad prognoftic.
A GREATER hardneſs in the pulfe, a lefs
difficulty in breathing, more eaſe in lying
down, lefs redneſs and fwelling in the face,
the eyes, and the lips, are, on the contrary,
favourable fymptoms.
THIS diftemper requires immediate help,
for very foon it brings the patient into evi-
dent danger.
You must begin by a large bleeding in
the arm, and repeat it in the fame manner
as in a Pleurify, if the anxiety and difficulty
of breathing do not diminiſh. If the blood,
when drawn, remains fluid and thin, and
fcarce coagulates at all, and if after the
bleeding the refpiration is not freer, it is a
bad fign, which indicates, that the thicker
parts are retained in the lungs, and the
thinner

OF THE ARMY.
29
thinner only diſcharged.
In this cafe,
a fresh bleeding would produce no effect,
and only evacuate that part of the blood
which is leaft thick, and could ftill have
made its way thro' the lungs.
SOME hours after the bleeding, it will be
proper to give the glyfter No. 11. Fomen-
tations, ointments, and plaifters, may be
applied to the breaft, but it must not be ex-
pected that theſe fort of things will be attend-
ed with as good fuccefs as in the Pleurify.
It will be better to apply frequently to the
patient's mouth and noftrils, a linen or
fponge foaked in warm water, the vapours
of which may, together with the air, enter
by infpiration into the lungs.
THE diet ought, as in the Pleurify, to be
extremely light, and the broths ftill thinner.
Let the common drink be the decoction
No. 1. or barley-water; but instead of mix-
ing milk with it, add to each pint half an
ounce of pure honey.
WHILE the patient is awake, let him
take every half hour a fpoonful of No. 13.
and drink after it a warm cup of the decoc-
tion No. 1.
IF, on the uſe of thefe medicines, the
anxiety diminishes, the refpiration becomes
freer, the Fever lefs violent, the pulfe more
vigorous and equal, the tongue moift, and
E
every

30
DISEASES
every part of the body, even to the extre-
mities, of an equal heat; if, above all, the
fkin is moist and foft, we may hope for the
beft, and nothing more is required than a
continuance of the fame means, as the in-
flammation of the lungs is beginning to be
refolved, and gradually to decline.
BUT things feldom take this turn, unleſs
the diftemper is not violent, the folid
parts
are fupple, and relief has been applied from
the beginning. It oftner happens, that the
matter of this Difeafe is evacuated by expec-
toration.
The fpitting muft, therefore, be carefully
attended to; and it is a very bad fign, when
at the fame time the patient does not expec-
torate at all, and has a difficulty to breathe,
with a rattling in his throat. The ſpittings
are good, if difcharged fpeedily, copioufly,
and eafily. They fhould be of a proper con-
fiftence; fometimes they appear yellow, and
ftreaked with a little blood; which ought
to give no uneafinefs, for excretions of this
fort are always good, and grow, white in
time.
THE effect they produce is remarkable, by
the diminution of anxiety, the freedom of
refpiration, and the alteration in the pulfe,
which grows ftronger and fuller.
LET the patient, at that time, take two
tea-

OF THE
31
ARMY.
tea-fpoonfuls of the linctus No. 14. and after
fwallowing them foftly, drink a cup of the
warm decoction No. 1.
NOTHING more is to be done under thefe
circumftances; and bleeding, purging, or
exciting fweats, would be detrimental.
WE ought chiefly to guard againſt the
cold air, and cold drinks, for either the one
or the other will ftop the expectoration, and
thereby throw the patient into imminent
danger.
Ir a fuppreffion of the fpitting fhould
happen, and the anxiety be followed by the
rattling of the throat, blifters are to be ap-
plied to the legs, the powder No. 15. is to
be given every four hours, and the fame de-
coction No. 1. be uſed as was ordered for
the Pleurify. The patient is alfo to infpire
by the mouth and noftrils the vapour of
warm water.
It fometimes happens, that, during the
courfe of the diftemper, the patient voids by
ftool a yellow and bilious matter, and is re-
lieved by it. This is alſo a favourable fign,
as has been obferved, in fpeaking of the
Pleurify.
A LARGE and thick fediment in the
urine, at first red, afterwards turning white,
is likewife a good fymptom. When this
happens, the patient muft drink plentifully
as

32
DISEASES
as in the Pleurify. Nevertheless, it rarely
happens that the caufe of the evil is dif-
charged merely by urine; the ſpitting,
which generally comes on about the fame
time, contributes greatly to the entire cure.
WHEN the patient, by the means of thefe
evacuations, begins to find his breaft difen-
gaged, he may have his broth fomewhat
ftronger; but he fhould conftantly take but
little at a time and often, that the lungs
may not afreſh be overcharged by a chyle,
both too crude and too copious. Sometimes
a plentiful bleeding of the nofe gives relief
to the patient; but this feldom happens.
If none of the evacuations here defcribed
are obferved within the fpace of a fortnight,
if the Fever continues pretty ftrong, and the
Cough dry; if the heat extends to the ex-
tremities of the body; if the pulfe is quick,
foft, and wavering; if a difficulty of breath-
ing and fhiverings accompany theſe fymp-
toms; if the cheeks and lips are red, the
thirft great, and, laftly, the Fever ftronger
towards night, it is certain that the inflam-
mation is turning to an Abfcefs.
THE indications of an Abfcefs already
formed in the lungs, befides the ſymptoms
already defcribed, are as follow: A dry
continual obftinate cough, which increafes
when the fick moves, or takes any nouriſh-
ment;

OF THE ARMY.
33
ment; he can only lie on the affected fide,
without its being poffible for him to lie on
the other; he has periodically a little con-
tinued Fever, which augments whenever
he eats, drinks, or ftirs, and is attended
with a redneſs of the lips and cheeks; he
has no appetite, but a violent thirst, and
complains of night-fweats, efpecially of the
head, and the upper part of the breaft; the
urine is fpumous, he is greatly emaciated,
and extremely weak.
WHILE the Abfcefs remains whole, the
purulent tumor increafes more and more; it
preffes upon thofe parts of the lungs which
as yet are found; it obftructs the refpiration,
and, after the moft terrible anxieties, fuffo-
cates the patient.
It is therefore effential, that the Abfcefs
fhould break, and be maturated, in order that
the pus be evacuated. But it may happen to
break in fuch a manner, as to difperfe the
matter into the breaft, and occafion an Em-
pyema, which almoft always proves mor-
tal. This is known to be the cafe, by the
fudden diminution of all the fymptoms,
fometimes attended with flight faintings, and
the total fuppreffion of purulent fpittings.
It is becauſe the Abfcefs is in effect burft,
that the ſymptoms proceeding from the dif-
tention of the purulent bag immediately
ceaſe:

34
DISEASES
ceafe; but the matter fpread in the cavity
of the breaft, growing every day more co-
pious, and more acrid, foon occafions new
fymptoms, worfe than the preceding ones.
THE Paracenthefis is the only means of
help left; but as the ulcer has already cor-
roded the fubftance of the lungs, the fuc-
cefs will be very doubtful: and even tho
the pus is evacuated, the fick perfon gene-
rally dies after the operation.
MUCH more is it to be wifhed, that the
Abfcefs may break in fuch a manner, as to
let the pus fall into the bronchi or air veffels
of the lungs, that fo it may be evacuated by -
fpitting.
WHEN this happens, it is to be feared,
left the bronchi be totally filled and ſtopped
by the quantity of pus fpreading itſelf in-
ftantly, and all at once, and occafioning
thereby a fuffocation: but if the pus that
falls in thefe veffels can ftill be difcharged,
the patient often recovers, tho' the purulent
confumption is always to be apprehended.
THE following are the principal fuccours
which art has found out to forward the open-
ing of the Abfcefs into the bronchi, and the
evacuation of the pus, by expectoration.
As foon as the fymptoms of an Abfcefs,
as defcribed above, are perceived, let the
fick infpire continually by the mouth and
noftrils;

OF THE
35
ARMY.
noftrils the vapour of warm water, to foften
and relax the parts.
LET him take fatter broth, and in larger
quantity, than before, that the ftomach being
filled, the defcent of the diaphragm may be
more difficult, and the Abfcefs more com-
preffed. The patient must be excited to
cough, by applying warm vinegar to his
noftrils, or to cry with a loud voice.
This
may procure a chance of breaking the Abfcefs,
which, if the ftrength of the fick perfon
can bear it, may be ftill forwarded by giving
him an airing in a carriage, on a rough
road, where he may be well fhook.
As it is impoffible to know exactly the
moment when the Abfcefs will break, you
muft repeat, from time to time, the at-
tempts here deſcribed.
IF, when the Abfcefs is broke, the ex-
cretions are purulent, white, and fmooth;
if the fever difappears, or diminishes confi-
derably; if the appetite returns, the thirft
ceafes, and, laftly, the excrements are folid
and natural, there is reafon to hope that
the fick will recover.
Ir, on the contrary, the excretions are
ftained of different colours, with a bad
fmell; if the fever doth not ceafe, or, hav-
ing ceafed, returns again; if the thirft re-
mains

36
DISEASES
mains, and the appetite doth not increaſe, it
is to be feared the patient will fink under it.
WHEN the Abfcefs of the lungs dif-
charges itſelf by means of purulent ex-
cretions, a little rice, or oats boiled in
milk, affords an excellent nourishment;
but care must be taken, that the fick take
not too much at once, but little and
often.
THE infufion No. 15. with a third part
milk and a little honey, will be a proper
drink. He is to take thrice a day the pow
der No. 18. and as the lungs have been fa-
tigued by a continual cough during the day,
fome relaxation ought to be procured in the
night; wherefore let the patient take two
pills No. 19.
If he is fomewhat coftive, it is not amifs,
but if he remains fo feveral days, the glyfter
No. 11. is to be given. If the excretions
diminish little by little, appetite comes on,
ftrength increafes, and the patient gets rid
of his fever, a quick cure may be expected.
WHEN the excretions are confiderably
leffened, the powder No. 18. and infufion
No. 16. are no more to be ufed; inftead of
which, three fmall fpoonfuls of the linctus
No. 20. and after it three cups of the infu-
fion No. 21. may be taken thrice a-day.
Iz, notwithſtanding this, the cough re-
turns

OF
37
THE ARM Y.
turns ftronger towards night, the patient
may continue to take the pills No. 19.
which otherwife are alfo to be left off.
IF, after the Abfcefs in the lungs hath
begun to be evacuated by excretion, this
evacuation fhould fuddenly ftop, an extreme
anxiety fucceeds, together with a rattling in
the breaft, and the fick is in very imminent
danger. This accident is commonly cauſed
by the imprudent admiffion of cold air, or
by fome violent emotion of the mind, as
anger, fear, or fuch like.
A SPEEDY relief muft be given, by
caufing the patient to infpire the vapour of
warm water, both by the mouth and nof-
trils, making him drink freely of the warm
infufion No. 16. and giving him every four
hours the powder No. 13. until the breaſt
be difengaged, and expectoration comes on
again; after which the uſe of the powder is
to be diſcontinued.
It will be of fervice to apply blifters to
the calves of the legs, as has been recom-
mended in the Pleurify.
WHEN the purulent matter is reforbed
by the veins, it fometimes occafions a fud-
den depofit of matter in other parts of the
body, and there caufes an abfcefs, viz. about
the ears, the arms, or thighs. The load
of the breast ceafes at the fame time; and
F
the

38
DISEASES.
the fame remedies are to be ufed, and the
fame rules obferved, as in the cafe of an
Abfcefs after a Pleurify.
As the inflammations of the external
parts may degenerate into ſchirrous hard-
neffes, the fame accident is to be feared in
inflammations of the internal parts: for af-
ter a Peripneumony, there fometimes re-
mains in the lungs a fchirrous and callous
hardneſs, in which cafe there is al-
moft always an adheſion to the Pleura.
Refpiration continues in that cafe difficult
for the reft of life, attended with a little
cough, chiefly after meals, and after exer-
cife; and there is no appearance of any of
the indications of an Abfcefs we have been
defcribing. This accident can rarely be
got the better of; and the little relief that
may be afforded is fcarce to be expected in
a military life, unless it be for the cavalry,
by riding on horfeback.
LASTLY, if the Peripneumony be fo
violent, that the remedies have no effect,
gangrene and death are the confequence.
This is foreſeen, when the patient labours
with intolerable anxiety, falling into ex-
treme and fudden faintneffes, with an un-
equal, feeble, and very quick pulfe, and
the excretions without confiftence, ftinking
and black. All thefe figns indicate a ſpeedy
and inevitable death.
RHEU

OF THE ARMY.
39
RHEUMATISM, and RHEUMATIC
PAINS.
THE general caufe of the Rheumatifm
is the fudden expofition of the body
to the cold after being confiderably
heated, either by work or the weather; ef-
pecially if a perfon, being overcome by the
heat, throws off his cloaths, and refts him-
felf in a damp and cold place,
THE foldier is moft frequently liable to
this diforder, when heated by fatigue, and
expofed to rain, he is obliged to wear his
wet cloaths, without changing them.
THE cold nights, which in Spring and
Autumn fucceed very warm days, are alfo
a caufe of the Rheumatifm. This diftemper
begins with an univerfal fhivering, followed
by heat, thirst, uneafinefs and fever. After a
day or two, and even fometimes fooner,
the patient feels a fharp pain, not confined
to one place, but moving from one limb to
another, viz. at the wrifts, the thoulders,
the knees; and fo different parts of the bo-
dy are in this manner fucceffively affected;
and the articulations, that are attacked, be-
come red and fwelled.
SOMETIMES, in this diforder, the ten-
dinous expanfions covering the mufcles are
attacked,

40
DISEASES
attacked, and occafion an exceffive pain on
the leaft motion of the part affected. Some-
times the Fever ceafes in a few days, though
the pain continues. In general, it is a
very troubleſome diforder, efpecially when
it attacks the loins, as the fick is then con-
fined to a fupine pofture, without motion,
and, as it were, like a log. It often paffes
from the loins to the hips, or upper joints
of the thighs; where, if it remains long
fixed, the cure becomes very difficult.
WHEN the pain fuddenly and often
changes from place to place, it is to be
feared that the cauſe of the illneſs will be
drove inwardly, and attack the lungs or
brain, which would be attended with the
greateſt danger. This accident is difco-
vered by a delirium, or a violent oppreffion
of the breaft, fucceeding a ceffation of pain
in the extremities.
THIS difeafe is feldom mortal; but the
violence of the pains, and their continua-
tion upon an improper treatment, induce
us to employ quick and efficacious reme-
dies. When the diforder is neglected, it
often happens, that the articulations are de-
prived of motion, and there remains for
life an incurable ftiffness of the joint..
(Anchylofis.)
THE method of treatment is as follows.
TAKE

OF THE
41
ARMY.
TAKE ten ounces of blood from the arm
of the affected fide,
LET flannels, imbibed in the warm fo-
mentation No. 12. be conftantly applied to
the part in pain.
THE diet ought to be light, confifting of
fmall broth, with decoctions of barley, oats,
or rice, and with roafted apples.
FOR common drink, ufe the decoction
No. 1. or barley-water with a fourth part
milk.
Two fpoonfuls of the mixture No. 22.
with a cupfull of the infufion No. 23. warm,
may be given every hour, unleſs the pa-
tient be aſleep.
THE following day let him have the
glyfter No. II. and conftantly continue the
medicines No. 22. and 23.
Ir the pain does not give way, and the
Fever continues, the bleeding is to be re-
peated the next day, the fomentation No.
12. and the medicines No. 22. and 23. are
to be continued; after which, the follow-
ing morning, let the patient take the purge
No. 6. omitting during this day the ufe of
No. 22. and 23. and taking at night the
anodyne draught No. 24. Let him after-
wards continue two days longer the uſe of
No. 22. and 23. and on the third day re-
peat

42
DISEASES
peat the purge No: 6. and at night the
draught No. 24.
By this method, we commonly get the
better of this diforder. If a good deal of
a brick coloured fediment appears in the
urine, attended with a general breathing
fweat, it is a good fign.
IT will then be fufficient to compleat the
cure, to keep the patient warm in bed, and
make him take the decoction No. 23.
BUT if, after the uſe of theſe remedies,
the pain ftill continues, and the part af-
fected grows red, leeches are to be applied
upon it.
SOMETIMES the Fever ceafes, the patient
appears recovered, but the pain ftill roves
from one joint to another: in this cafe, let
the patient take half a drachm of Venice foap
made into pills, morning, noon, and night,
drinking after it fix ounces of the infufion
No 23. made warm. He must be kept
from the cold, and the articulations lightly
rubbed with a piece of dry flannel.
It happens likewife fometimes, that the
patient, tho' otherwife recovered, has a
fixed pain left about the articulation of the
hip. Apply in, that cafe a blifter, about
the fize of a crown piece, upon the part
for twelve hours, then take it off, and
pierce

OF THE
43
ARMY.
pierce the bladder it has raifed, that the
lymph amaffed
may flow out, and cure the
wound by means of the plaifter, called
empl. allum coctum.
EIGHT days after the place where the
blifter was applied is healed, apply another,
and proceed as before, and if the pain is
then not entirely vanished, this operation
may be repeated four times: Obferve, when
you take off the blifter, only to pierce the
veficle, and not take the epidermis, for the
place thus made bare, would be extremely
painful, and without any advance towards
the cure.
THOSE who have fuffered of this difor-
der in Autumn, must take care, during the
following winter, not to expofe themfelves
to the cold, and the injuries of the feafon,
for they would certainly have a relapſe.
WHEN by the pain continuing long fixed
in the fame place, the affected articulation
begins to ftiffen, let the part be twice a day
held over the fteam of hot water, then well
wiped with hot linen, lightly rubbed, and
anointed with ung. althea.
INTERMITTING

44 DISEASES
INTERMITTING FEVERS.
A
FEVER is known by a quickness of the
pulfe, ufually attended with laffitude,
languor, weakness, thirft, and feve-
ral other ſymptoms.
WHEN after a fit of feveral hours, it fen-
fibly diminishes, with all its fymptoms,
and at laft abfolutely ceafes, but in fuch a
manner as to return again, it is called an
Intermitting Fever.
THIS Fever has different appellations,
according to the length of the interval be-
tween the fits.
IF it returns every day, it is called a
Quotidian; if there is a day between each
fit, it is called a Tertian; if the return is
after two days free, it is named a Quartan..
THE Intermitting Fever comes on with
gaping, laffitude, debility, colds, fhiver-
ings, tremblings, palenefs of the extremi-
ties, anxieties, ficknefs, and fometimes vo-
mitting. The pulfe is feeble and ſmall, and
the thirst pretty great. Heat fucceeds af-
ter fome time; it infenfibly augments till it
becomes extreme. The body then grows
red, the anxiety diminishes, the pulfe is
fuller and ftronger, the thirft exceffive, and
the patient complains of a violent headach,
and

OF THE
45
ARMY.
and pain in all his limbs; laftly, a general
fweat fucceeds; all the defcribed fymptoms
diminiſh, and the patient often falls into a
fleep, after which he wakes without Fever,
his pulfe is natural, and there remains no-
thing but laffitude, and weakneſs. Some-
times during the hot fit of the Fever,
bilious matters are thrown up with a per-
ception of relief.
THE urine after the Fever, or during the
fweat, is reddifh and frothy; and as foor
as it is cold, there appears on the top a peli-
cle, adhering to the fides of the veffel, at the
bottom of which is depofed a fediment, in
colour refembling pounded brick or bole ar-
moniac.
THIS appearance is, however, feldom
obferved in any other but autumnal inter-
mittent fevers, and it is more fo after feve-
ral paroxyfms. In the fpring Intermittents,
the urine is commonly lefs red, and rather
yellowish, a cloud forms in the middle, and
it depoſes a white fediment, which is a good
fymptom.
Or the two fpecies of Intermitting Fe-
vers we have juft mentioned, the vernal ones
are eaſier cured than the autumnal ones,
which are attended with more troublefome
fymptoms.
THE Intermittents which prevail from
February
G

46
DISEASES
February to July, are called Vernal; and
thofe that begin in the latter end of July,
or beginning of Auguft, and ceafe at the
end of January, or fometimes fooner, are
called Autumnal Intermittents.
AFTER the long and violent heats of the
fummer, if the troops have been much fa-
tigued, there will be many Autumnal
Fevers, and of the moft dangerous kind,
eſpecially if the military operations require
camping in marfhy places.
IN September and October the number
of theſe Fevers is commonly very confider-
able, but there is great hope to fee that
number diminish at the fall of the leaf, ef-
pecially if the winds blow any thing hard.
As there is a great difference between
the Spring and Autumn Fevers, and as the
method of treating them often differ much,
we fhall treat feparately of each.
SPRING INTERMITTENTS.
PRING Intermittents are generally Ter-
S tians, very oftent of a fort, Jone-
very often of a kindly fort; fome-
times double Tertians, but feldomer
than in Autumn.
WE call that Fever a double Tertian,
where a fresh paroxyfm comes on every
day,

OF THE
47
ARMY.
day, but the fit is generally flighter on the
alternate days.
DURING the paroxyfm, it will be fuffi-
cient to take a large quantity of any dilut-
ing liquor, made agreeable to the palate,
but always warm, fince cold draughts
would be hurtful.
THE patient may therefore drink of the
ptifan No. 25. keeping himfelf quiet and in
a moderate degree of heat.
THE fit moft commonly goes off by an
univerfal fweat, which must be kept up by
warm drink, but ought not to be rendered
exceflive by too much covering, or other
means that provoke heat.
JUST at this time, viz. on the going off
of the fit, or as foon as it is over, the pa-
tient must have a mefs of broth with fome
lemon juice, or cream of tartar in it, to
make it acid.
THE intermediate days that are free from
Fever, he may take food fomewhat more
folid, viz. a little meat, provided the fleth
be of young animals: beef will not hurt,
fo it be but tender, but all forts of fat are
to be avoided.
NOTHING is to be eat near the time that
the return of the paroxyfm is expected; the
nouriſhment then taken would load the fto-
mach

78
DISEASES
mach during the fit, and caufe a bad di-
geftion.
FOUR hours, however, before the fit, the
patient may take fome light broth. As in
fpring Agues, the paroxyfms commonly an-
ticipate the time they fhould return at,
regard muſt be had thereto in the taking of
nouriſhment.
Ir the day the patient is without Fever
be ferene, it will be proper for him to uſe
a little exercife; but not to laffitude; he
ought likewife to endeavour to fleep rather
more than ufual.
IT is to be remarked, that thofe foring
Agues often turn to inflammatory diforders,
efpecially in young and fanguine fubjects;
bleeding is therefore proper, efpecially if
the fick have a rednefs in the face, a vio-
lent head-ach, or feel fome pain on the fide
of the breaft.
Ir attended with frequent flatulent erup-
tions, if the tongue is charged, a bitter tafte
in the mouth, or a light vertigo, it will be
proper to give him an emetic.
LET him take four hours before the re-
turn of the fit the powder No. 26. or No.
27. if of a weaker conftitution, as foon as
he fhall have vomited, let him drink warm
water plentifully; he will foon throw it up,
and vomit afresh; he then muft repeat his
drinking,

OF THE ARMY.
49
drinking, and go on in this manner till
what is to be thrown off his ftomach, be
diluted, and his vomiting made eafy.
AFTER Vomiting feveral times, the wa-
ter drank commonly ftays one hour: after
the vomiting hath ceafed, let the patient
have the potion No. 24. and fo wait for the
paroxyfm, during which let him take the
ptifan No. 25. obferving the rules before
laid down.
IF he complains of pains crofs his back,
of grumbling or wind in his bowels, if his
belly is fwelled or hard, he must be purged
in the following manner,
EIGHT hours before the return of the
fit, let him take the purge No. 28. and fix
hours after he hath taken it, that is, two
hours before the fit, give him the draught
No. 24.
Ir the fymptoms, that gave occafion to
the purge, or the vomit, continue, thefe
remedies may be repeated, which however
is but feldom the cafe in fpring Fevers.
OBSERVE, that fometimes emetics do
not evacuate only by vomit, but by ftool
alfo, and that purges act likewife fometimes
by vomit. There is nothing to be feared
when this happens, fince the only object of
thefe remedies is to evacuate the ftomach
and inteftines. After the bowels are thus
81
cleanfed,

50
DISEASES
cleanfed, let the patient take every two
hours a fpoonful of the mixture No. 29.
drinking after it a cup of camomile flower
tea. This remedy must not be used in the
paroxyfm, but only whilft the patient is
without Fever, nor fhould he be waked to
take it.
THIS is the method of treating Spring
Fevers: and there is feldom a neceffity for
ufing the bark.
Ir after the third or fourth paroxyfm,
ulcerated puftules break out about the nofe
or lips, it is a good fign, and the fever
quickly ceafes: but this is not fo fure in
Autumnal Fevers.
IT fometimes happens, tho' rarely, that
after feven or eight fits, the Spring Fever
does not ceafe, nor even confiderably di-
minifh, and that, on the contrary, the fit
become longer and ftronger.
This is par-
ticularly the cafe, where the patients are
fubject to fweat copioufly, as foon as they
are in bed. Here the bark becomes ne-
ceffary.
LET him take every three hours while
the Fever is off, one of the powders
No. 30. in fome wine.
THIS method will foon complete the
cure; and as in the fpring the weather
grows better every day, there is but little
fear of a relapfe.
AUTUM-

OF THE ARMY.
51
AUTUMNAL INTERMITTENTS.
HESE Fevers are more obftinate than
THE
thoſe in the fpring; and of thefe the
worst fort happen commonly after a
very hot fummer.
THEY are alfo harder to be known; for
when they first begin, the fits are fo long,
and the returns fo frequent, that they feem
continued Fevers, with little or no inter-
miffion.
SOMETIMES the Fever abates a little,
and then returns in a few hours, after a
light fhivering. It is only when it begins to
give way its character is first known; it
then appears that the diforder is a true in-
termittent. Thefe Fevers, which at firft
appear to be continued, often degenerate
into Quartans.
SOMETIMES thefe Fevers, which in the
beginning did intermit, after long and re-
doubled paroxyfms, are changed into dan-
gerous continued Fevers.
THESE Fevers are always bilious; the
ftomach and inteftines are filled with putrid
matter, which must be diſcharged without
delay; to poftpone it would be detrimental.
LET the patient take the emetic No. 26.
or 27. having regard, on this occafion, to
what

52
DISEASES
what has been faid on the fubject of inter-
mitting Spring Fevers.
Ir the fkin of the face is tight and red,
the eyes inflamed, and the heat great and
general throughout the body, a bleeding
muft precede the vomit.
ON the contrary, if the face is fhrunk
and pale, and the pulfe not full, bleeding
would hurt, and must be refrained from.
THE Vomit muft be given in the inter-
miffion of the Fever; or if it does not
ceafe entirely, that inftant is to be chofen
when it is leaft violent.
SOMETIMES alfo, in an Autumnal Fe-
ver, it is neceffary to repeat the vomit, that
is, when the naufeous fick nefs, the bitter
tafte of the mouth, and the foulnefs of the
tongue, continue.
THE day the patient takes no vomit, let
him drink the decoction No. 25. adding an
ounce of the oxymel No. 31. to every pint
of the decoction.
AFTER the firft or fecond vomit, the
powder No. 32. is to be taken every four
hours.
THIS method will commonly fucceed in
thefe Fevers; and if before, they were con
tinued, they will become intermittent, fo
that there will be a confiderable interval
from one paroxyfm to another, let the pa-
tient

OF THE ARMY.
53
tient then take the mixture No. 29. follow-
ing the directions given under the head of
Spring Intermittents.
THE food fhould likewife be the fame
as in thefe Fevers; broths made pleafant
with juice of lemon, or cream of tartar,
roafted apples or pears, and well fermented
bread, ought to be the principal nouriſh-
ment, When he begins to recover a little
more ftrength, you may add ſome fleſh
meat, either veal or lamb: a little wine
taken moderately to recruit his ftrength
will do no harm,
BUT as in Autumn the days are conti-
nually growing colder, the recovering pa-
tient muft guard with care against the incle-
mency of the weather, otherwife a relapfe is
much to be feared.
LET him alfo for a fortnight, on his re-
covery, take the quantity of a nutmeg of the
electuary No. 33. in the morning fafting,
an hour before dinner, and an hour after
fupper.
WHEN he has been a month without fe-
ver, give him the pills No. 34. in the morn-
ing fafting; repeat them a fecond time in
eight days, and a third time in eight days
more.
If, after the ufe of the emetic, and other
remedies here defcribed, the fever fhould
H
Rill

54
DISEASES
ftill continue, without any diminution of
the paroxyfms, and if the patient grows
weaker, the ufe of the bark becomes ne-
ceffary: this happens more frequently in
Autumnal, than in Spring fevers.
THE powders No. 30. muft then be made
ufe of, as in Spring fevers, and in a fort-
night be again repeated.
Ir the eyes grow yellow, the fick feel
great anxiety at the orifice of the ftomach,
and the urine is icterical, you must then
(unleſs the extreme weakneſs of the patient
forbid) leave off the uſe of the bark during
the ſpace of a fortnight; inftead of which,
for fome days give him two fpoonfuls of the
mixture No. 35. every three hours, till
thefe ſymptoms are abated: the fever will
return; but during this interval, the fick
having recovered ftrength, will better fup-
port it, and it foon will abfolutely, leave
him.
Ir the ufe of the bark in this cafe was
obftinately purfued, it would bring on fome
chronical and obftinate diforder. It must
be obferved, that when the fever has been
driven away by the bark, the pills No. 34
are not to be made ufe of, for commonly
they bring it on again.
Ir fometimes happens, that thefe fevers
are from the beginning attended with the
worst

OF THE ARMY.
55
worst of fymptoms, an unequal pulfe, a
cadaverous countenance, frequent faintnefs,
and cold fweats. In fome fubjects, thefe
fymptoms are attended with a cardialgia, or
violent pain of the ftomach, and in others
with a fleepy heavinefs, fometimes fo pro-
found that the patient can fcarcely be waked.
In this cafe the bark must be immediate-
ly given; for it is to be feared another fit
could not be bore. The prefcription No.
30. may be uſed.
IF by this means the fever being fuppreff-
ed, the face becomes of the colour of wax,
and anxieties about the orifice of the fto-
mach are complained of, let the remedy
No. 35. be uſed in the manner before ex-
plained.
QUARTAN FEVER S.
HE first thing to be obferved is, that
T bleeding is fcarcely ever proper in
theſe fevers.
1 LET the patient take the emetic No. 26.
or 27. before the fit comes on, following
the method prefcribed in the Spring Inter-
mittents.
BEFORE the next paroxyfm, give him
the purge No. 28. and then the quantity of
a nutmeg of the electuary No. 36. which
he

55
DISEASES
he must leave off while the fever fit is on
him.
IF, after eight fits, the fever does not
diminiſh, and the patient grows weak, he
muft take the powders of bark No. 30.
obferving what has been before faid on that
fubject.
EIGHT days after the fever has left him,
the fame powders No. 30. are to be repeat-
ed, and a third and laft time at the end of
a fortnight, by which means there will be
no fear of a relapfe.
In the intermediate days of the paroxyfms,
the fick may be indulged with more wine
and a freer nouriſhment, in this fort of fever,
than in any other.
THE JAUNDICE.
FTER a Fever, that hath continued
Afor a length of time, and above all,
after an Autumnal Fever, fometimes
the hypocondria remain hard and tenfe, ei-
ther with or without a dull pain; the pa-
tient feels after his meals an anxiety, which
fometimes is followed by vomitings; the
white of the eyes grows yellowish; the
urine is tinged of an obfcure yellow, and
this colour quickly fpreads over the ſuper-
ficies of the body.
THIS

OF THE A R.M Y.
57
THIS illness is alfo a common confequence
of bad nouriſhment; and the foldier is moft.
fubject to its attacks, when a fcarcity of pro-
vifions hath obliged him to live on meats of
difficult digeftion.
LET the patient take every three hours
four fpoonfuls of the mixture No. 35:
drinking after it four ounces of the decocti-
on No.
37. which may any where be eaſily
prepared.
NIGHT and morning let him have half
a drachm of Venice foap in pills, and his
right hypocondrium be rubbed with flannel
every morning, for a quarter of an hour,
while fafting.
THIS method, followed fome days, ge-
nerally renders the body open, and procures
relief; but it must be continued till the
urine recovers its natural colour, and the
yellowneſs diſappears from the eyes and the
fkin.
IF the body is ftill coftive after having
ufed theſe medicines fix days, you must give
the pills No. 34. in the morning, and all
that day abftain from the ufe of the other
medicines, which must be refumed the fol-
lowing days.
EXERCISE is excellent in this diftemper,
above all in open air, if the weather
mits.
per-
FARINACEOUS

58
DISEASES
FARINACEOUS and glairy food is to be
avoided, and broth wherein are boiled cher-
vil, forrel, lettice, endive, or fweet fucco-
ry, is proper to be ufed.
WH
THE DROPSY.
HEN the aqueous part of the blood
is amaffed together, and retained in
any cavity of the body greater or
lefs, this diſeaſe is called a Dropfy.
THE denominations of it are different,
according to the parts of the body affected.
Ir the water is detained in the adipofe
membrane, and thereby caufes a general
fwelling, it is called Anafarca. The fwel-
ling generally begins in the inferior parts,
and gains infenfibly the whole body; the
eyes are languid, the face and body fallow,
the urine in fmall quantity, and the patient
never ſweats. On preffing the fwelled part,
it pits. The fwelled parts, and chiefly the
thighs and feet, are always very cold.
IT is common enough in the Army for
this difeafe to fucceed Intermitting Fevers
of long duration, efpecially in autumn and
winter. The foldier is alfo fubject to it,
when after having fuddenly drank a quanti-
ty of cold water, he refts himfelf in a cold
place: it is alfo frequently the confequence
of

OF THE
59
ARMY.
of a confiderable lofs of blood, either from
wounds, or bleedings too often repeated.
WHEN the Anafarca comes on after a
long Intermittent Fever, evacuations are
not extremely neceffary; but it is common-
ly cured by giving thrice a day, viz. in the
morning fafting, one hour before dinner,
and one hour before fupper, two ounces of
the prepared wine No. 38.
To finish the cure, the patient muſt be
kept warm, either by the natural heat of the
air, or by an artificial one; he ought to be
well covered in the night, keep to dry food,
fuch as meat or fifh roafted; his drink fhould
be little and pure, and as much exerciſe be
ufed as his ftrength will admit of.
can.
IT will be found uſeful to rub the fwelled
parts with warm flannels, as often as you
If the patient voids urine in larger
quantity, and begins to fweat in bed, and
the fwelled parts come down, it is a very
favourable fign.
AFTER the fwelling hath difappeared,
there remains fuch a relaxation in the parts
as threaten a relapfe; this may be prevented
by caufing the patient to wear his cloaths
ftraiter than ufual, and rolling his legs
and thighs with bandages. Bodily exercife
in the open air, and warm weather, does
infinite good.
1
IN

60
DISEASES
IN this manner generally the Anafarca
that fucceeds Intermittent Fevers is cured
happily enough. But when this diftemper
proceeds from other caufes, it often is more
obftinate, and requires large evacuations of
the ferous humour. Many ways are tried
to procure theſe evacuations, but experience
fhews the remedy No. 39. to be fure and
efficacious. The patient is to take a fpoon-
ful of this in the morning; or if, as it fome-
times does, it brings on a vomiting, only
half a fpoonful. The moft common effect
is, however only a fimple fick nefs.
10m
8
THE urine after the ufe of this remedy
comes away in large quantity, and affords
a confiderable relief. It feldom purges;
but if it fhould, does no harm.
THIS medicine is to be taken every day,
till all the ferofities are evacuated, and the
fwelling of the body entirely come down.
If the dofe is not efficacious enough in robuft
conftitutions, it fhould be infenfibly aug-
mented till it procures a large difcharge by
urine. When the patient is on the recovery,
the fame regimen must be obferved as has
been juft defcribed.
$150
SOMETIMES the extravafated lymph is
accumulated in the lower belly, and the
quantity increaſes fo much as to caufe it to
fwell exceffively. When fo, by preffing
balur
with

OF THE ARMY.
61
with one hand on one fide of the belly, and
ftriking on the other with the other hand,
the fluctuation is felt, and water is found
to abound.
WHEN the diftemper is recent, it is
cured often enough only by the uſe of the
remedy No. 39. but if the flux of urine
does not come on in fome days, nor the
fwelling of the belly diminish, hafte muſt
be made to draw off the water by the
punc-
ture. The operation is fafe, and fure e-
nough; but if attempted when the diſeaſe
is more inveterate, it is lefs efficacious.
Ir will be proper, as much as poffible;
to draw off all the water all together at once;
which may be done fafely, by ftraiten-
ing the patient's belly with a bandage, by
little and little, and more and more, as the
water runs off: the faintings and other
accidents will, by this means, be avoided.
AFTER the evacuation procured by the
puncture, the belly must be bound tight
with rollers, and the patient obferve the
diet we have defcribed above.
THE ufe of the remedy No. 38. will be
very proper here. Sometimes the belly
fwells again, and the puncture is then to
be repeated.
As it fometimes, though but rarely,
happens, that the fwelling of the belly is
I
caufed

62
DISEASES
caufed only by wind, and not at all by a
collection of lymph, the moft fcrupulous
attention muſt be uſed in obferving what
the cafe is, becauſe in this laft the
punc-
ture is ſcarce ever of ufe, and, on the con-
trary, generally accelerates death.
THIS laft difeafe is called Tympanites, or
Dropfy of the Belly.
Ift. GENERALLY the belly is not fo ex-
ceffively fwelled as in the Dropfy.blog
2d. THE belly appears elevated before,
and depreffed on the lateral parts.
3d. WHEN the belly is ftruck, the mo-
tion of water is not felt, but it gives a found
fomewhat refembling that of a drum.
4th. Tho' the fick lie on either of his
fides, the form of the belly remains the
fame, the fkin of which is white, extend-
ed, and elaftic.
5th. CoSTIVENESS, and gripings about
the navel, often precede this diftemper.
6th. THE body of the patient is lighter
than in a Dropfy of the Belly, where the
collection of water confiderably augments
the weight.
asd angin bus agul
UPON the whole, this diftemper is more
dangerous than the other, and is often
mortal.
THE cure may be attempted in the fol-
lowing manner. Let the patient's belly be
rubbed

OF
63
THE
ARMY..
rubbed with flannel, for a quarter of an
hour at a time, twice a day; and after
each friction, let it be anointed with the li-
niment No. 49. and for feveral days let him
at night take the powder No. 41.
If the wind begin to pafs by the anus,
and the belly grows lefs, there is room to
hope a cure.
It happens fometimes, that the lymph
collects in the cavity of the breaft; and it
has been often obferved, that foldiers are
fubject to this kind of Dropfy, when, after
having been heated by work, and all in a
fweat, they fuddenly expofe themſelves to
the cold, and greedily drink cold water.
This diſeaſe is known by the preceding
caufes, by the difficulty of breathing, efpe-
cially when the patient begins to fleep, and
by a dry cough; he cannot lie down, but is
obliged to fit up in his bed, his body bent
forwards, and has commonly his feet fwel-
led at the beginning of this diftemper.
It is obferved, that the breaft is fome-
times difengaged when the fwellings of the
legs and thighs become very confiderable;
and that, on the contrary, the breaft be-
comes more oppreffed, when this fwelling
fuddenly diſappears.
This fort of Dropfy, efpecially if not in-
baddur
veterate

64 D IS E AS ES
vetegate, is often fuccefsfully cured by the
ufe of the remedy No. 39.
If this does not anfwer, nothing remains
but the puncture; but we find by expe-
rience that this is but a doubtful means,
and not always attended with fuccefs.b
To 25mit Ils s
gmigusdorove o
Vam Bidi OHT
pont say edi
flom at VOMITING.osmoft ads
di lobos adi abso
19mmut
Ο
UR prefent inquiry does not regard
thofe Vomitings that attend other
Jeang diftempers, as Fevers, nephritic
Cholics, &c. but only thofe occafioned by
bad food, and a loaded ftomach.
M
es The fureft remedy, in this cafe, is to
caufer a large quantity of warm water
to be drank, to render the vomiting and
evacuation of foul matter eafier.wa to 90sql
dIf after this there remains any naufea, or
that the tongue be loaded by a pituitous
glairy matter, a light emetic, fuch as No.
27. fhould be given, and the fame regi-
men obferved as prefcribed in Intermittent
Fevers. Sele-bed to adgids, anT
edgidianT
WHEN the patient has done vomiting,
let him take too fpoonfuls every three hours
of the mixture No. 42. and on the evening
of the day he takes his vomit, let him have
the draught No. 24.
COLERA

OF THE ARMY.
65
ods yd bonus yllula
COLERA
anismer gaidion
MORBUS. St
winston sob ajdr.11
T is a fudden and immoderate evacuation
of the humours, both upwards and
downwards.rw baboods syrie Jon bus
THO' this may happen, at all times of
the year, in confequence of overcharging
the ftomach, and a crapula; yet it is moft
frequent towards the end of the fummer,
and beginning of the autumn. It is often
occafioned in fummer by eating too much
fruit, drinking putrid water, or a great
quantity of new and fweet wine, called
Muft.
dos babels has boor bed
0 THE violence of this diforder is fuch as
to reduce the ftrongeft man in a few hours,
and fometimes to carry him quite off in the
fpace of twenty-four hours. I to nonstr
TO THE thirft is commonly violent, the
anxiety great, the pulfe quick, finall, and
often s unequal. The patient has cold
fweats ; his face is wan and cadaverous,
and his extremities cold.es bo aldo nam
THE thighs or hands are attacked with
fpafms, and fometimes both together; all
thefe fymptoms are foon followed by con-
yulfions, and by death, unlefs prevented by
the moft fpeedy and efficacious remedies.to
Lady EVERY

66
DISEASES
EVERY emetic and purge is to be avoid-
ed, for the moft gentle are hurtful in this
cafe. The patient must be continually tak
ing chicken or veal broth, made fo light as
fcarcely to have the tafte of meat; or, in-
ftead of thefe, panada. A glifter of either
of theſe drinks is likewife to be given, in
order to diſcharge all acrid and irritating
matter from the inteftines.
AFTER this method has been continued
for three or four hours, a fpoonful of the
mixture No. 43. is to be given every half
quarter of an hour, till the vomiting and
loofenefs are either ftopped, or confiderably
diminiſhed.
abrew
WHEN the patient begins to be fome-
what better, it will be fufficient for him to
take only every three hours a fpoonful of
the fame medicine, till he has taken it all.
THOUGH the vomiting and loofenefs
fhould by this means be entirely ſtopped,
let the patient ftill continue, for four days,
to take three fpoonfuls of the fame remedy
No. 43. every night and morning.ognst co
THE beft food, on thefe occafions, is
veal broth with rice in it, taken little at a
time, and often.
noitstub gnol oot
WHEN it happens that the fick lies long
without help, and has had thefe evacua-
tions for feveral hours, and confequently is
grown
gniging

OF THE
67
ARMY.
grown very weak, and especially if he feels
fpafms in his thighs or hands, you muft
immediately recur to the mixture No. 43.
in the manner above defcribed.
oida, gue
ed of
adis A DIARRHOE Absoft
ad of sliwa
W
eith plads to
HEN the ftools are liquid, and
more frequent than ufual, the dif
batni order is called a Diarrrhea.
The pains and gripings of the belly are
not violent in this diftemper; which by
this principally is diftinguifhed from the
Dyfentery, which we fhall treat of after-
wards.
bominimib
As the Diarrhoea fometimes ferves for
the evacuation of bad humours, it follows,
that it is not always hurtful, and that it
may even be advantageous.
It is of fervice when it does not affect
the strength, but, on the contrary, renders
the body more light and alert. On the
other hand, it is hurtful when it brings
on langour and weakness. in
The Diarrhoea, that at firft appeared fer-
viceable, may become detrimental, by its
too long duration, viz. if it lafts four or
five days; for then the body is worn out
by too long a flux, the inteftines excoriate,
a lively pain of the lower belly, with
gripings,

68
DISEASES
gripings, fucceeds, and the Diarrhoea de-
generates into a Dyfentery. boold dow
When the Diarrhoea requires any reme-
dy, you may give the powder No. 44 and
at night the potion No. 24. Veal broth
with rice, and millet boiled in milk to a
thickness, are proper food for the fick.lib.
If the Diarrhoea does not ftop in two
days, the powder No. 44. and potion No.
24. must be repeated, and again in two
days, if it fhould fo long continue. da
To avoid a relapfe, let the patient, on
his recovery, for four nights fucceffively,
take the bolus No. 45. Blos of Halmid
Care must be taken that he be well co-
vered and cloathed, and guarded against
the injuries of cold air.
A
THE
DYSENTERY.do
TWIM
DIARRHOEA too long neglected often
degenerates into a Dyfentery.
BUT it most commonly happens, that it
is not preceded by that diforder; and in
the army it reigns during the heat of fum-
mer, and the beginning of autumn.
A FLUX of the belly, attended with vio-
lent gripings, and very painful ftrainings for
ftool, is called a Dyfentery.
THE

OF THE
69
ARMY.
THE flools are not always accompanied
with blood, as feveral phyficians have pre-
tended, who therefore have called this dif-
order the bloody flux.
NEVERTHELESS, the focal matters are
often reddish and bloody, efpecially if the
diforder has lasted any time.
⚫ THIS diftemper chiefly prevails among
the troops. The caufes that produce it are
as follow:
THE bile grown acrid by the great heats
and the fatigues of war; efpecially if the
foldier, when heated, fuddenly expofes
himſelf to cold air, or fleeps in his cloaths,
foaked with rain: for which reafon it is
often brief in places, where cold nights
fucceed to hot days.
STAGNATING, or marfh water for
common drink.
IT
MEAT, or fish, beginning to be tainted,
mufty bread, or bread made of mufty corn
for food.yanoly
SURE and reiterated obfervations con-
vince us, that fummer fruits fcarce ever
caufe the Dyfentery; but the excels of
them may do hurt.
THIS diftemper proceeding from the
caufes juft defcribed, foon infects a whole
army: the healthy foldiers are more efpe-
cially infected by the putrid exhalations of
K
the

70
DISEASES
the fecal matters, if they uſe the fame bog-
houſes as the fick.
THIS point muft therefore be carefully
attended to, when the Dyfentery prevails
among the troops: it would be proper to
dig deep trenches to ferve for neceffaries
for the fick foldiers, to cover feveral times
in a day the focal matters with earth, and
to have other trenches referved altogether
for thoſe in health.
To change the camp often would alfo be
a proper means to ftop the progreſs of this
diforder; and by what has been faid re-
lative to the caufes, it will appear necef-
fary to take all poffible care to avoid them.
THE manner of treating the Dyfentery
is as follows:
ядяха
Ir the fick is of a fanguine habit, and
has great heat all over his body, or much
Fever, he muft lofe eight or ten ounces
of blood from the arm; but thefe fymp-
toms are rarely met with.
web spo
As the Dyfentery is feldom attended
with a Fever, and then bleeding is of no
ufe, it will be fufficient to give the patient
the powder No. 46. in wine.
AFTER the first vomiting occafioned by
the powder, he muft drink warm water
with a little honey in it; this will excite
fresh vomiting; after which he is ftill to
sup
helu ed of ei aid b
be

OF THE
71
ARMY.
be plied with warm water till he brings it
up as clear as he drank it, and as
38
luog
AFTER the patient fhall have refted two
hours from his laft vomiting, you may give
him fome fmall flices of toafted bread,
foaked in four ounces of cold wine; and
to make it pleafant, a little cinnamon
and fugar may be added. At night let
him take the pill No. 47. 1o ved of
THE fame remedies are to be repeated
next day; and if the diforder is not entire-
ly, or much abated, the third day again.
BUT if the diftemper is confiderably di-
mifhed, it will be proper to leave a day's
interval between the ufe of theſe remedies,
before they are given a third time. RT
EXPERIENCE has fhown, that inftead of
the powder No. 46. that No. 48. with
the pill No. 47. at night, has been given
with good fuccefs. This muft alfo be re-
peated three times, leaving the interval of
one day, except the Dyfentery fhould ftop
fooner. If the remedy No. 48. be too
weak for robuft conftitutions, the dofe
may be increafed to ten or twelve grains.
After thefe evacuations, the patient may,
for feveral days, take at morning, noon, and
night, one drachm of the electuary No. 49.
His drink muft be two parts in three of
barley or millet water, and one of new milk;
and this is to be ufed in large quantities.
FOR

72
DISEASES
FOR food, milk thickened with barley,
oats, millet or rice, may be given; and
when the exceffive ftench of the ftools is
fomewhat abated, meat broth thickened
with the fame pulfes. nisali doul nismas
BUT if the malignity or duration of the
distemper fhould have, in a manner, anni-
hilated the ftrength of the patient, evacuat-
ing medicines must be laid afide, as he is
already but too weak.
THIS is known to be the cafe, by the
violence of the gripings and ftrainings, by
the vacillating fmall pulfe, by the pale
countenance, by the naufeating all food,
and by an unextinguifhable thirst.
LET the patient take every hour one
ounce of the medicated wine No. 50. and
night and morning the pill No. 47.dewol
As the bad fymptoms begin to difappear,
and ftrength to come again, let the pow-
der No. 44. be taken in the morning, and
in the evening, the Pill No. 47. to be re-
peated thrice, with one day's interval, if
the diforder be not over fooner. bas sto
FOR fome days after, let the patient take
one drachm of the electuary No. 49. thrice
a day. sons
disab vidon
SOMETIMES the intestines having been
excoriated, by the frequent paffage of acrid
matters, the patient is very much incom-
moded with a continual inclination to go
to

OF
73
THE ARMY.
to ftool, tho' he avoids little or nothing: in
this fituation he is to have the glyfter No.
51. and to retain it as long as poffible.
Ir, after the evacuations, there fhould
remain fuch like pains in the lower belly,
the patient would receive great relief, by
fwallowing, every day, an egg boiled foft,
with a little fresh butter.
INFLAMMATION of the INTESTINES.
A
N INFLAMMATION of the INTES-
TINES, a very dangerous diftemper,
often arifes from the fame caufes as a
Dyfentery.
IT is difcovered by a violent pain of the
lower belly, which often increaſes upon
the touch; by the fwelling of the belly, by
vomitings, and by conftipation. Thefe
fymptoms are attended, at the fame time,
with an acute and continual Fever, and a
violent heat: the pulfe is hard, the urine
clear, and of a bright red, and there is a
fudden proftration of ftrength.
IF the fymptoms are violent, moft com-
monly death is foon the confequence. Be-
fore the patient expires, the pain ceaſes;
but the extremities become cold and livid,
the face cadaverous, the pulfe fmall, quick,
by of houtsniloni
iw beand

74
DISEASES
and unequal. All thefe are figns of ap-
proaching death; altho' the fick, and thofe
about him, are apt to draw an happy omen
from the ceffation of pain.
violdo
COPIOUS bleeding is immediately to be
had recourfe to, and repeated boldly if the
pains do not go off, or remit confiderably;
or if they return again. Hop on asob
850b 11 12
LET the patient take the glyfter No. 52.
three or four times in a day.
His belly must be conftantly fomented
with flannels fteeped in the fomentation
No. 12.
THE Caul of an animal freſh killed fome-
times produces a good effect.
LET the patient take
warm cup of No. 53.
every
half hour a
ylled nawol
IT is a good fign if the pulfe becomes
equal, and remains fo, if the pain dimi-
nifhes, the fick break wind downward, and
the glyfter bring away with it focal
matter.
o noitel
SOMETIMES, notwithstanding feveral
glyfters, the belly remains obftinately con-
ftipated in this cafe the fumes of tobacco
injected thro' the anus have produced very
good effects.
nog od 01 5adbs
THE drink is to be warm barley water,
and light broths the whole nouriſhment,
until

OF THE AR MY.
75
until three days after the diforder fhall
have entirely ceafed.
AND even then it will be neceffary to
obferve an exact diet for fome time, left
the Inteftines, irritated anew by acrid food,
occafion a relapfe.
THIS diftemper is indeed fo violent, that
if it does not quickly give way to proper
application, it degenerates immediately in-
to a mortal gangrene. But, by the careful
ufe of the above recited remedies, one may
hope to refolve the Inflammation of the
Inteftines.
IF this method has begun to be uſed too
late, if the diftemper lafts, without grow-
ing worſe, three or four days, and a dead
pain fucceeds to the acute pain of the
lower belly; if at the fame time the patient
feels an unuſual heavinefs, and has wander-
ing fhiverings all over his body, it is
certain there is an Abfcefs forming.
ingh
Din
IN which cafe he muft have the fomen-
tation No. 12. conftantly applied on his
belly during the day, and at night a plaifter
of labdanum.do
Ido acreme viled
Ir the Abfcefs feems to be ready to pierce
externally, which may be if the Inteftines
adhere to the peritoneum, it muſt be open-
ed to diſcharge the pus. But this cafe fel-
dom happens. lodw on adoid idgil bra
of
IF

76
DISEASES
Ir the Abfcefs breaks in the cavity of
the lower belly, the confequence is much
to be feared, unless the matter can be
drawn off directly, which is very difficult
to be done: nor is it eafy to judge of the
exiftence of this cafe, becauſe the quantity
of matter from out of this Abfcefs is not
confiderable enough to caufe any remarka-
ble fwelling of the belly.
THE pus is more frequently evacuated by
the anus: the glyfter No. 52. repeated fe-
veral times, after fuppuration is perfected,
facilitates its courfe. By the fmoothing of
the internal coat of the inteftines the evacu-
ation of the matter becomes eafier that
way.
AFTER the pus is evacuated, whether
alone or with the excrements, the patient
muft drink plentifully of the decoction No.
16. fweetened with honey, and is to take
the powder No. 18. three times a day.
LET endive, lettice, chervil, or fuch
like tender herbs, be boiled in broth for
his food; but it muſt be ftrained thro' a
fieve, left any thick fubftances fhould col-
lect into a mafs in the inteftines.
LET him continue this method for three
days after the pus fhall have ceafed paffing
thro' the anus; and by degrees he may re-
turn to his former way of living.
PHRENZY.

OF
THE ARMY. 77
lo vivo
Houm et
PHRENZY.
hawol ads
A
PHRENZY is a continued delirium, at-
tended with an acute Fever. It is
thereby diftinguiſhed from the Deli-
rium, which is fometimes obferved in the
height of Intermitting Fevers, and which
finishes with the fit.
AN extreme heat, and a violent inflam-
matory head-ach, commonly precede the
Phrenzy: the eyes and face are red; the
patients, when afked questions, anſwer
with ferocity; they pluck the knap of their
cover-lids.
THE more frequent caufes of this diftem-
per are, the violent heat of the fun, to
which the foldier is expofed, efpecially if
bare headed, fleeping in that condition,
long watches, extreme emotions of anger,
excefs of wine, brandy, or other fpirituous
liquors.
IN this diftemper the pulfe commonly is
quick, and refpiration ftrong, and not free
quent.
A Phrenzy is very dangerous, and often
occafions fudden death, for it is a true in-
flammation of the meninges, and fome-
times even of the brain itfelf.
GREENISH Vomitings, frequent fpitting,
fhiverings, crude aqueous and pale urine,
L
convulfions,

78
DISEASES
convulfions, and no thirft, are bad figns:
bleeding piles, a flux of the belly, a copi-
ous hæmorrhage of the nofe, give relief to
the patient.
PAIN of the breaft, or of the lower parts,
is good in this illness: a ftrong cough coming
on, fometimes alfo gives eafe.
BLEEDING here is effentially neceffary: it
fhould be large, and chiefly in the foot: if
the Fever and heat continue, it must be re-
peated: and it will be right, after the firft
bleeding of the foot, to open one of the
jugulars.
THE bleedings must be repeated, till the
extreme heat and the violence of the Deli-
rium are abated. While the patient does
not fleep, he must take every hour a cup of
the remedy No. 54. warm.
FOR his common drink, the decoction
No. 25. may
be uſed, and night and morn-
ing the glyfter No. 11. be given.
IF the hæmorrhoids fwell, let leeches be
applied.
Ir will be proper to fhave the patient's
head, and to make him rinfe his mouth
often with warm water: let a compress dip-
ped in oxycrate, or vinegar, and water, in
equal quantities, be applied on his forehead:
fresh and temperate air is moft proper for
him, and he ought to be kept fitting up-
right

OF THE
79
ARMY.
right in his bed, with his head raiſed as
much as poffible.
IT would be alfo proper to make him rife
twice a day, to fet him in an arm chair,
and bathe his feet in warm water.
After
the night bathing, the pafte No.
55. fhould
be applied to the foles of his feet, and lie on
till morning.
DURING the whole time of the illness,
he must be confined to plain barley water,
or water gruel.
IF, after the uſe of theſe remedies, the
Fever begins fenfibly to grow lefs, and the
Delirium to wear off, but the patient can
get no fleep, let him have the emulfion
No. 17. at night, with the addition of an
ounce and a half of fyrup of white poppies.
BUT anodynes must be carefully avoided,
while the illness continues in its force.
AT the beginning of this dangerous dif-
temper, all the remedies here recited muft
be vigorously employed: but when the
heat and Delirium are confiderably dimi-
nished, bleeding and glyfters are no longer
neceffary, the drink No. 25. will be fuffi-
cient, and the nouriſhment may be a little
ftronger.
NOTWITHSTANDING the diminution of
the ſymptoms, it happens often enough, that
the Delirium does not entirely give way:
but

80
DISEASES
but commonly it decreaſes infenfibly, efpe-
cially if feveral times a day, and as much
as his ftrength will permit, the patient is
made to fit up in an arm chair with his
body upright.
HEMORRHAGE of the NOSE.
A
S Bleeding of the Nofe is a pretty
common ſymptom in ardent Fevers,
almoft always giving relief, and
fometimes even curing the diftemper, it is
eafily apprehended, that it must not be too
lightly ftopped.
BUT fometimes the Bleeding of the Nofe
is fo violent, both in fick perfons, and in
thoſe who are in health, that bodily ftrength
is fo wafted, as to bring on total faintings,
fo that even death may enfue.
In this cafe, the too violent Hæmorrhage
muſt be ftopped. To judge when this
ought to be done, requires a little attention
to the following confiderations.
WHILE the pulfe keeps full, and the heat
of the body is every where equal, even to
the extremities, and the lips and the face
keep their red colour, there is no fear from
the Hæmorrhage, was it even violent.
BUT

OF THE
81
ARMY.
BUT when the pulfe begins to undulate,
and the face and lips grow pale, it is time
to ftop the bleeding.
THE means of ftopping it are, applying
bandages to the arms and thighs of the pa-
tient, becauſe the veins being thereby com-
preffed, the reflux of the blood to the
heart is in lefs quantity. The Hæmorrhage
ftopped, the bandages are not to be loofen-
ed all at once, but fucceffively one after
another, in fuch a manner as to leave the
fpace of a quarter of an hour between the
loofening of each bandage.
IF, by the application of the bandages in
the manner defcribed, the Hæmorrhage is
not ſtopped, or if it comes on again after
taking them off, the following method is
to be uſed:
LET a tent of lint imbibed in the ftyptic
No. 56. be put up that noftril from which
the blood came. If fome lint dipped in the
ftiptic be wrapped round a quill, it will be
eafily introduced up the nofe: at first, for
about half an inch, it must be put up ho-
rizontally, then raifing the quill infenfibly,
it is to be pushed gently, and by this means
the lint introduced as far as poffible with-
out hurting the adjacent parts. Afterwards,
by gently compreffing the noftrils, the quill
may be withdrawn, and the lint left in the
noſe,

$2
DISEASES
nofe, where it is to remain for a day or
two, till it falls out of itſelf.
THE agaric of the oak is alfo an effica-
cious remedy for ftopping the bleeding.
Some of the powder No. 57, may be blown
through a quill into the patient's noftrils.
A CONTINUED FEVER.
FEVER, that lafts from the moment
of the firft accefs, without interrup-
tion, to the end of the difeafe, is
called a continued Fever.
THE principal caufes of Fevers of this
fort in an Army, are, exceffive fatigue, and
extreme laffitude, which is its confequence,
eſpecially during the heat of fummer, if
the foldier is under the neceffity of endur-
ing thirst, or drink too much fpiritous li-
quors.
of
FOR the moft fluid and lighteft parts
the blood being by thefe means loft; what
remains, grown more thick and acrid, is in
a ftate to occafion great diforders, and above
all inflammatory ones, becauſe the mafs of
humours fo thickened is now greatly dif-
pofed to inflammation.
WHEN a Fever of this fort produces a
topical inflammation, the difeafe takes its
name

OF THE ARMY.
83
name from the part affected: for the Pleu-
rify, Peripneumony, Phrenzy, fore Throat,
(Quinzy,) Inflammation of the inteſtines,
are often preceded, and always accompa-
nied with a continued Fever.
BUT when it happens that fome of the
above recited caufes occafion this Fever,
and that it affects no part in particular, it is
called fimply a Continued Fever.
THIS Fever is known by the cauſes that
precede it, by the vigour of the time of
life, and a hot and fanguine conftitution, by
a hard and quick pulfe, and chiefly by its
extreme heat, which burns, as it were, the
fingers of him who touches it. The urine
is red, thick, turbid, the tongue dry, the
thirft great; often an intolerable pain of
the head, and an obftructed refpiration.
THIS difeafe, always dangerous, is more
or lefs fo according to the violence of the
defcribed fymptoms.
LARGE bleedings are neceffary in the be
ginning, which are to be repeated till the
great heat and drynefs of the tongue begins
to abate. Barley water is the common and
proper drink; but to every pint ſhould be
added an ounce of the remedy No. 31. of
which let him take largely; let there be
given him every two hours a cup of the de-
coction

84
DISEASES
coction No. 54. and twice a day the glyfter
No. 11.
THIS method is to be continued till the
decline of the diftemper, which is known
by the diminution of heat, of the quick-
nefs of the pulfe, and of thirft; by the hu-
midity of the mouth and tongue, by the
urine being not fo high coloured, and by
the fediment it then depofes. The fame
regimen to be obferved as in the Pleurify.
As the difeafe grows milder, the decoc-
tion No. 25. will be fufficient for common
drink, and let the diet be gradually aug-
mented till he is quite well.
IT is highly neceffary to obferve, that
there is alfo another fort of Continued
Fever, without an inflammatory thickneſs
of the blood, but rather occafioned by a
putrid diffolution of the humours. This
laft fort is much worfe, and more dange-
rous than the other, and very often this
Fever proves contagious.
THIS happens moft frequently, when,
during the great heats, the Army is en-
camped in marfhy places; for then they
refpire an air corrupted with bad effluvia.
This fort of Fever prevails also very
much, where many men, even were they
healthy, are lodged together in a narrow
fpace, where the air cannot be renewed
often

OF THE
85
ARMY.
often enough. Ships of war and hofpitals,
where the fick and wounded are much
ftraitened, are frequently vifited by thefe
Fevers, efpecially if the air cannot be re-
freſhed often enough; becauſe the air then
to be refpired is fo corrupted by the effluvia
from the bodies, the ftink of the excre-
ments, and the putridnefs of the gangrened
parts, that it engenders a very bad, and
truly putrid Fever, which foon grows con-
tagious. It is therefore fometimes called
the Jail or Hofpital Fever. Its particular
fymptoms fhould be exactly defcribed,
thereby to know this diftemper..
It begins by a fhivering, followed by a
heat, but not violent; foon after, the
fhivering again, after which the heat, and
fo the fhiverings and heat alternately.
TOTAL lofs of appetite, fleep difturbed,
and without refreshment, a heavy pain of
the head, affecting efpecially the anterior
part: the pulfe is almoft as in a natural
ftate: the fkin is not always very dry: the
fick languifh on in this manner fome days,
without being able to attend their bufinefs,
yet without being obliged to keep their
bed. The tongue is feldom dry; it is
more commonly foft, moift, and covered
with a fort of cruft of yellowish green.
The patient dozes much, fleeps little, and
feems quite abforbed in profound reveries:
M
in

86
DISEASES
in the progrefs of the illness, comes on
trembling of the hands, hardneſs of hear-
ing, and dimnefs of fight; the pulfe be-
gins to grow feeble, and the patient is de-
firous of cordials and wine. Towards
night, all the fymptoms grow worfe: laftly,
at different times during the courſe of this
diffemper, there appear purple fpots of an
irregular figure.
THE following fymptoms are confidered
as mortal: A fudden proftration of ftrength,
weakness of the fight: the pofture of the
fick, ftretched on his back, and drawing
up his knees to him; reiterated efforts to
get out of bed, black aphthæ, livid pete-
chiæ, and ftripes alfo livid, resembling
the blow of a whip fpread over the body;
the flux of the belly, with lead coloured
or blackish ftools, weaken the patient more
and more.
DEAFNESS is not a bad fymptom in this
diftemper. Nay, it has been obferved, that
patients on their recovery are apt to grow
deaf, and that fometimes they have an
Abfcefs in the conduit of the ear.
BILIOUS ftools, thick urine, a moift
tongue, are good omens, efpecially if the
patient keep up his ftrength.
A NUMBER of little red puftules, or
white and elevated miliary ones, are good,
if

OF THE
87
ARMY.
if at the fame time expectoration is eafy, and
the urine depofes a thick fediment. Laftly,
it is counted a good fign, when an eaſy ſweat
comes on, and relieves the patient, or the
parotids fwell, or there appear white ap-
the.
As the caufes here recited indicate that
all things tend to putrefaction, and that
the ftrength is extremely exhaufted, bleed-
ing can feldom be of ufe, unless in replete
habits, and that but once: for large bleed-
ings abate the ftrength immediately, and
occafion a Delirium. It is very neceffary
that the air be often renewed.
In cafe of a naufea, or weight' felt about
the region of the ftomach, or that the
tongue be covered with a yellowish green
cruft, the patient muft take the emetic
No. 27. and after the firft effect of this
powder, let him drink plentifully of warm
water, that he may vomit eafy, which is
to be repeated, as has been faid in the ar-
ticle of Intermittents.
THE evening after the emetic, let the
patient take the bolus No. 58. and drink
after it fix ounces of the whey No. 59. If
milk cannot be procured, the decoction No.
25. may be fubftituted in its room, obferv
ing to add two ounces of wine,
ounce of oxymel, to every pint.
and half an
This whey,
or

88
DISEASES
or decoction, may ferve for common drink,
efpecially as the fick are fond of vinous and
comforting drinks, and that theſe drinks are
fuitable to this diftemper.
LET him take every fix hours the powder
No. 60. with fix ounces of the above whey,
or decoction.
DEATH, preceded by great anxiety and
convulfions, is often the confequence of ex-
treme languors, when the purples difappear,
or the miliary fpots ftrike in: in which
cafe a ſpoonful of the mixture No. 61. is to
be immediately given, with three ounces of
the whey or decoction No. 25. to be repeat-
ed every three hours till he finds eafe, and
the purples appear again, or the miliary fpots
rife; after which the fame remedies are to
be continued every four hours only. If, in
confequence of this method, an equal
breathing fweat comes on through the whole
body, the patient finds great eafe thereby.
If the belly is conftipated, let the glyfter No.
52. be given.
It is proper to diſcharge the patients from
out of the hospital, as foon as they begin to
recover, that they may breathe a purer air;
otherwife a relapfe is much to be feared,
which is feldom or never got over.
THE

OF
89
THE ARMY.
TH
THE SCURVY
HIS is a common diftemper, and of
difficult cure, more efpecially in fieges
and unhealthy places, where fome-
times the troops are obliged to take up their
winter-quarters.
Ir begins by a numbness of the limbs,
with an unuſual laffitude of the whole body:
after walking, the limbs and muſcles feel
quite fatigued, and, as it were, broken. In
the increaſe of the diftemper, refpiration be-
comes fhort and difficult; fometimes the
thighs (well; at firft the face is pale, then
grows brown, and the fkin is ftained with
fpots of different colours, the mouth begins
to fmell, the teeth loofen in the fockets,
the gums fwell, itch, grow painful, and
bleed on the leaft touch; laftly, wandering
pains affect different parts of the body.
In the progrefs of the diftemper, the gums
putrify and exhale an horrid ftench; the
teeth grow yellow, then black and carious.
Sometimes happen violent hæmorrhages;
very
bad conditioned ulcers break out, elpe-
cially on the thighs; the patient feels vio-
lent and painful fhootings in all his limbs,
which increaſe in the night, and the body
is covered with black fpots. At this period
the

90
DISEASES
the diftemper fuddenly grows worfe, Fevers
come on of different kinds, every thing
grows quickly putrid, and mortal hæmor-
rhages break out of the mouth, the nofe, or
about the anus; the vifcera putrify; and
faintings fucceed, which are foon followed
by death.
THIS diftemper is frequent in winter
quarters, from the following caufes.
NOISOME Vapours, arifing from marshy
grounds and ftagnating waters, inaction,
fcarcity of greens and vegetables, drinking
of corrupted and ftagnating waters, the ufe
of falted and fmoaked flesh and fifh, and of
cheeſe too old and acrid; damp and low
lodgings, and not being open to the courſe
of the winds.
FEAR and forrow alfo occafion this dif-
order, and increaſe it in thofe already at-
tacked with it. By that, and by bad food,
it often makes fuch ravages in befieged
places.
EXPERIENCE fhows, that the humours
in this difeafe are not only putrid and
acrimonius, but alfo condenfed.
THEREFORE, in the cure, care must be
taken to attenuate the vifcofity of the hu-
mours, and to prevent or correct putre-
faction.
WE are to lend all the affiftance of art
to

OF THE ARMY!
91
to prevent, or avoid the caufes, of this evil,
and thereby preferve the foldier from the
ravages of this diftemper.
FIRST, by correcting the impure waters.
This is done by mixing two ounces of vi-
negar, and two ounces of brandy, to every
pot of water. For want of thefe, fome
lices of calamus aromaticus may be fteeped
in the water.
This is a fort of reed, very
common, growing almoft every where, in
fuch low, marfhy, and damp grounds, as
are moft fubject to the Scurvy.
STRONG purges, vomits, and bleeding,
do no fervice in this diftemper.
BUT as bad nourishment is one caufe
that produces the fcurvy, the ftomach and
inteftines must be cleared, and evacuated,
which is cafily done, by gentle and reite-
rated purges, fuch as No. 34. to be taken
three times, with the interval of a day be-
tween each.
THE food fhould be broth, with chervil,
forrel, fpinage, lettice, endive, fuccory,
cabbage, efpecially red cabbage, young
nettle buds and tops, or any other fort of
tender herbage, boiled in it; the preference
to be given to thofe eafieft to come at.
FRUIT quite ripe, ufed moderately, al-
ways produces a good effect: but if neither
fruit nor greens can be procured, the pa-
tient

92
DISEASES
tient muſt have his broth with barley, oats,
or rice; he may eat likewife a little veal,
or fowl, but it must be moderately.
AFTER the uſe of light purgatives, anti-
fcorbutics will be proper, but which are to
be varied according to the different confti-
tution of the patient.
If he feels himself cold, his face pale,
his legs fwell, and his thirft is not great,
let him take two ounces, that is, about a
tea-cup of the decoction No. 62. thrice a
day.
Ir he is hot, his pulfe feverish, his thirst
great, his breath bad, his gums bleeding
and half putrid, the decoction No. 62 is
not fo proper as No. 63. to the quantity of
three ounces thrice a day.
RIPE fruits, and roafted apples and pears,
eafy to be procured, are alfo very proper.
THE remedies are to be continued a
great while. When the limbs move cafier,
and the pain diminishes, the diftemper
grows better, and then exercife and good
food will be fufficient to compleat the cure.
To carry of all relicks, it will be proper, on
recovery, to take fifty drops of the elixir
No. 64. in wine and water, equal quan-
tities, thrice a-day.
ALTHO' it be certain, that when the
diftemper is at an end, the fymptoms
ought

OF THE ARMY.
93
ought likewife to ceafe; yet it is no leſs
true, that after the fcurvy, we often fee
thofe who have been attacked by it fubject
to ulcers of the gums, lips, infide of the
cheeks, and of the palate, which foon
fpread, and corrode thefe parts, and in a
little time turn to a gangrene. Theſe ul-
cers often deceive thofe who do not rightly
underſtand them: they appear in form of
white or yellowifh fpots, red, and inflamed
round the border, and often very painful.
A great ftench accompanies them, and the
fpittle, which comes in plenty, is alfo of
a bad fmell. This evil requires an imme-
diate remedy, otherwife all would foon be
infected with a gangrenous putrid hu-
mour, the teeth would fall out of the
fockets, the jaws would be affected, and
entirely corrupted.
BUT this diforder is eafily got the better
of, by touching the parts lightly and often in
the day with a little lint dipped in the pre-
paration No. 65. Little compreffes, imbued
with the fame, may alſo be applied between
the gums and lip, and renewed from time
to time.
CARE must be taken not to rub the
parts
affected too much, as is the bad cuftom of
fome, for the evil and pain is thereby aug-
mented.
N
IF

94
DISEASES
IF the ftench is great, and the ulcers ex-
tend themſelves rapidly, the quantity of
fpirit of fea falt is to be augmented, till
you get the better of the gangrenous cor-
ruption.
A
THE GANGRENE.
S mention has been made of the
gan-
grane, it may be here proper to take
notice, that the bark taken internally
is a moft efficacious remedy for this dif-
temper, whatfoever part is attacked.
THE patient is to take every four hours
one of the powders No. 30. till the
gan-
grene begins to feperate from the found
parts, and a good fuppuration comes on:
at which time it will be fufficient for him
to take them twice a-day till the ulcer is
mundified.
THE bark is equally proper, when the
fcorbutic ulcers of the infide of the mouth
threaten to gangrene.
nav
LUES
VEN
VENEREA.
ENEREAL diforders are always caufed
by contact, communicated by the
infected to, even, the foundeft bodies.
12
THIS

OF THE
95
ARMY.
THIS Contagion produces many different
diforders, which, according to the different
parts of the body where it fixes, go under
different denominations.cond salov
SMALL ulcers appearing at the extremi-
ty of the penis, or on the prepuce, are
called venereal thancres: if the nervous
papille of the genital parts form little eleva-
tions like warts, they are called venereal.
verrucæ: if the internal fuperficies of the
urethra is affected, there arifes a difficulty
and pain in making water, named
ftrangury, and a running of a yellowish,
greenifh, or fometimes brownish matter;
it is then called a gonorrhoea; if fwellings
in the groins, buboes.ind
a 1
WHEN the virus having gained the blood
circulates with the humours, where-ever it
ftops, it produces evils of different kinds,
for inftance, puftules, and fpots upon the
fkin, that fometimes degenerate into filthy
crufts: ulcers in the adipofe membrane,
not giving way in the leaft to fuch medi-
cines as are proper in other ulcers; which
corroding the adjacent parts, leave pro-
found and frightful cicatrices: thefe ulcers
no fooner difappear from one place, but
they quickly fhow themfelves again in
fome neighbouring part. Voogt og
THE throat most frequently, and the
budi s
roof

96
DISEASES
roof of the mouth, are corroded little by
little by this diftemper: there appears in
thefe parts a fpot, refembling bacon ;
the voice becomes hoarfe, the action of
fwallowing is attended with pain, and the
fpot we spoke of gaining ground by little
and little, deftroys all the foft parts, and at
length attacks the bones of the palate and
mouth; which grow rotten and fall in,
and leave for the reft of life a deformity,
for which there can be no remedy.
THIS diftemper, efpecially if it is inve-
terate, attacks alfo the bones, and caufes
fwellings on them, which if foft, are called
tophi or gummi; if hard, nodes or vene-
real exoftofes; whence enfue very bad ca-
ries, with intolerable pain, worfe in the
night, the warmth of the bed increafing it;
but rather eafier in the day. Lo
WHEN the bones are corroded even to
the marrow, the cure is extremely difficult,
and tho' cured in appearance, it often re-
turns, do
THIS diftemper may be eafily known by
the defcribed fymptoms.
Болтор
THE following is a fafe method of treat-
ing it.
hetool on
LET the patient take, night and morn-
ing, one fpoonful of the medicine No. 66.
drinking after it a pint of barley water with
a third

OF THE ARMY.
97
a third of milk in it, ufing the fame for
his common drink: if milk is difficult to
get, the decoction No. 67. may be fubfti-
tuted in its room.
THIS medicine gives no manner of
trouble to the patients; to fome it procures
fome light ftools, but this feldom; in others
it works by urine and fweat. Its ufe may be
continued with the greateft fafety till all the
fymptoms of the difeafe have abfolutely
diſappeared.on
Ir the weather is mild and temperate,
the patient may go out; but in cold and
damp weather, it is better he fhould keep
his room.
IF the medicine feems to act too flow in
robuft habits, or when the diftemper is in-
veterate, the dofe may be augmented to a
fpoonful and a half: and if in fome days the
fymptoms do not diminifh, two fpoonfuls
may be given every night and morning, in
all four fpoonfuls a-day.
THE time the patient is to continue the
ufe of this medicine, cannot be exactly li..
mited: often, if the diftemper is not very
bad, the cure is performed in three weeks;
if inveterate, it takes up more time. But
it may certainly be ufed along while without
the leaft inconvenience.
WHEN the ulcers cleanfe, and cicatrize,
A when

98
DISEASES
when the rotten parts of the bone ſeparate
and fall off, and when the tumours and
nocturnal pains diminish, the diftemper
gives way to the remedy.o
As to the regimen of the diet, let the
patient have broths with barley, rice, cor
oats, or tender greens, his flesh meat lean,
milk diet, and ripe fruit.spain yde)
FAT and fmoaked or falted meat, efpe-
cially bacon, are bad. edile
THE following remark is neceffary to be
attended to. Sometimes a falivation comes
on from the ufe of this medicine, but this
is but feldom, and almoft only to thofe who
have before made ufe of mercury, either
internally or externally: nevertheless, fali-
vation not being neceffary to the cure, the
ufe of the medicine No. 66. is to be left off
immediately on the firft figns of a ſpitting
coming on. 11
BUT the decoction No. 67. may be fill
continued.
THE figns of an approaching falivation
are as follow.
THE gums begin to fwell, to grow red,
to itch, and become painful, and the breath
to fmell ill. As foon as thefe fymptoms
are remarked, the ufe of the remedy No:
66. muft, as has been before faid, be fuf-
pended: but if in eight or ten days thefe
fymptoms

OF THE ARMY.
099
fymptoms difappear, and the patient is not
cured, it may again be ufed.
phromoo
IF he has a gonorrhoea, he muft drink
plentifully of the decoction No. 67. to take
off the acrimony of the urine; he may
bathe the penis thrice a day, for a quarter
of an hour at a time, in equal quantities of
water and milk warm.en pay of habrols
1r, by fuppreflion of the gonnorrhoea, or
from any other caufe, a tefticle becomes
fwelled and painful, and the fcrotum red;
let him be bled immediately, the fomenta-
tion No. 12. applied to the testicle, and let
him drink plentifully of the decoction No.1.
adding twenty grains of nitre to each pint.
After the rednefs, fwelling, and Fever,
which often attend fwelled tefticles, are
appeafed, it will be proper to make
ufe of the remedy No. 66.
Ir venereal buboes grow hard, a plaifter
of galbanum is to be applied.
aniwell THE
IT C Hil
S a very troublefome diftemper to armies,
and immediately fpreads by contact, un-
lefs the affected foldiers are feparated
from thofe who are well. div
liv bangong
THOUGH all the external parts of the
body

100
DISEASES
body may be affected, yet the Itch moft
commonly ſhows itself firft on the hands,
principally between the fingers: firft ap-
pears a puftule, or two, full of a fort of
clear water, which itch extremely: when
thefe puftules are broke by fcratching, the
water that iffues out communicates the
diforder to the neighbouring parts. It is
not eafy in the beginning to diftinguish the
Itch, unleſs one is well acquainted with
this diforder: but, in its progrefs the
puftules augment both in number and fize;
and when opened by fcratching, a difguft-
ful cruft is formed, and the evil gains the
fuperficies of the whole body.
HITHERTO the Itch hath its feat be-
tween the epidermis and the fkin; but if
it continues long, it makes way through the
fkin into the membrana adipofa, where it
forms fmall ulcers, commonly in great
number. This fort of Itch is the naftieft
and worst, and at the fame time extremely
contagious.
Ir is to be treated in the following
manner.
THE body is to be kept clean, and linen
often changed: if the ſeaſon of the year per-
mit, they must bathe, and in waters im-
pregnated with fulphur, if they can: if
they cannot, experience fhews, that to bathe
bod
in

OF THE ARMY.
IOI
in running water will be of fervice. The
fhirt, breeches, and ftockings, are to be
fcented with brimftone before they are put
on: but this fumigation must be made in
the open air, left the fulphurous vapours
fhould do hurt, if taken in by refpiration.
LET the patient take the purging powder
No. 68. in the morning fafting, and repeat
it every eight days.
On the intermediate days, let him take,
morning, noon, and night, one of the pow-
ders No. 69.
LET the parts affected be anointed every
night with the ointment No. 70.
Ir the Itch covers both the whole body
and all the limbs, they muft not all be a-
nointed together at once; but you may be-
gin by the hands, and the arms; continue
the next day by the feet, legs, and thighs,
and the third day the body; the fourth day
to begin again by the hands and arms, the
fifth the feet, &c. and fo on to the entire
cure.
7189 Jos
200
WHEN the puftules are dry, the crufts fall,
and the ulcers difappear and return no more,
the patient is well.
30100
SOME fpots will, indeed, remain on the
fkin, but thefe marks wear off infenfibly,
and in time quite difappear.
THE patient muft abftain from all man-
ner of falt food during the cure.
O
WORMS.

102
DISEASES
WOR M S.
S with worms.
Sovi
OLDIERS are frequently troubled
Bad food, unwholeſome
water, and other caufes engender them.
Vertigoes, naufea, fudden fwellings of the
lower belly, eſpecially after meals, the heart-
burn, grumbling in the bowels, and trouble-
fome itching of the nofe, are indications of
Worms. Some have a voracious appetite,
others lofe it entirely: the face is pale, and
funk.
BUT all the figns here deſcribed are not
all found at the fame time in each patient;
but the more of them are difcovered, the
more certainty we have of the diftemper.
BUT, after all, the moft convincing fign
is, when the fick void Worms, by vomit
or ftool.
ALL the cure confifts in expelling them
out of the body, but this is not eafy; for
Worms are found to ftick, as it were, to
the Inteftines, fince otherwife they would
come away with the excrements.
IT will, therefore, be proper, in order
to get the better of them, for a couple of
days to give the patient fomewhat, that
by its fmell may, in fome manner, in-
fect

OF THE
103
ARMY.
fect the inteftines; after which to give a
a rough purge.
LET the patient take five grains of afa
foetida in pills every three hours, for two
days.
THE third day let him have the purging
powder No. 71. in the morning fafting,
taking after it a light broth, to be conti-
nued from time to time, till the medicine
has done working.
IF, after this procefs, the fymptoms do
not diſappear, in eight days time the whole
muſt be repeated.
10
teltion b
Towoll eze
RECIPES,

01
RECIPE S.
TREATISE on the referred to, in the
foregoing
DISEASES OF THE ARMY.
1. TAKE of the fpecies for the pecto-
Boil
ral decoction three ounces.
in a fufficient quantity of water for half an
hour, to ftrain three pounds.
2. Take of the mafs for pil. cynogloff.
eight grains. Make two pills for a dofe.
3. Take of the fpecies for the emolli-
ent decoction fix ounces. Boil in fuffici-
ent water to the thicknefs of a cataplafm,
adding towards the end muftard feed
bruifed one ounce, for a poultice.
4. Take flower of elder one ounce.
Let it juft boil up in a fufficient quantity
of water in a clofe veffel: then digeft
warm for half an hour; ftrain two pounds.
To which add, rob of elder one ounce and
a half, pure nitre forty grains. Mix.
5- Take flower of elder, and red rofes,
of each half an ounce, pure nitre one
drachm. Mix. Infufe a pugil of this in
warm water for tea.
6. Take leaves of fenna fix drachms,
water fcurvy grafs two drachms, agaric
one drachm, tamarinds half an ounce.
Boil

RECIPES.
105
Boil for a quarter of an hour, in water
enough; ftrain two ounces, add fyrup of
rhubarb half an ounce. Mix for a draught
to be taken at once.
7. Take of the fpecies for emollient
decoction four ounces.
Boil for half an
hour in water enough to ftrain three
pounds.
8. Take of the refidue after the ftrain-
ing of the laft, at will, add meal of lint-
feed, oil of lintfeed, of each two ounces.
Mix for a cataplafm.
In-
9. Take flowers of red rofes two
pugils, agrimony one handful. Mix.
fufe like a tea for a gargarifin. Add a little
honey.
10. Take honey of rofes half an ounce,
fpirit of fea falt, twenty drops. Mix.
11. Take fpecies for the emollient
decoction two ounces. Boil in water fuf-
ficient, for half an hour; ftrain one pound,
Add fimple oxymel two ounces, pure nitre
one drachm. Mix for a glifter, il avod
12. Take fpecies for emollient decoc-
tion three ounces. Boil an hour in water
fufficient ; ftrain four pounds, Diffolve
Venice foap two ounces. Mix for a fo-
mentation.
Jool
bhad one rose to how 13. Take

106
RECIPE S.
13. Take pure nitre one drachm and a
half, crabs claws two drachms, fyrup of
wild poppies two ounces, barley water ten
cunces. Mix.
14. Take oil of fweet almonds, or, in-
ftead thereof, beft olive oil, two ounces,
one yolk of an egg; to them well beat
add pure honey one ounce, Mix for a
linctus.
up,
15. Take kermes mineral three grains,
crabs claws twenty grains. Mix.
16. Take Paul's betony, agrimony,
ground ivy, golden rod, of each equal
parts. Infufe in warm water for tea.
17. Take cucumber feed half an
ounce, fweet almonds blanched No. 8.
bitter ditto No. 2. Mix with barley wa-
ter one pound: ftrain for ufe, for
emulfion.
an
18. Take myrrh fifteen grains, crabs
claws half a drachm. Mix for a powder.
19. Take of the mafs for pills of hore-
hound fix grains. Make two pills.
20. Take balfam capivi half a drachm,
a yolk of an egg. To them, well rubbed
in a glaſs mortar, add pure honey one ounce.
Mix. hold
21. Take coltsfoot, fcabious, tops of
St. John's wort, of each one handful;
powdered

RECIPE S. 107
powdered liquorifh two ounces. Mix. Infufe
for tea.
22. Take pure nitre one drachm, crabs
claws two drachms, fyrup of marth-
mallows one ounce, barley water ten
ounces. Mix.
23. Take rafping of faffafrafs two
ounces, of the three faunders, of each two
drachms, powder of liquorifh one ounce.
Mix. Infufe for tea.
24. Take liquid laudanum of Syden-
ham, fifteen drops, fyrup of diacodium
half an ounce, barley water one ounce.
Mix for a draught.
25. Take of the fpecies for the antefe-
brile decoction three ounces. Boil for
half an hour, in a clofe veffel, in fufficient
water; ftrain four pounds for ufe.
26. Take tartar emetic fifteen grains,
à powder for one dofe.
27. Take root of ipecacuanha half a
drachm, a powder for one dofe.
28. Take powder of carnachini forty
grains,
29. Take fal. polychreft two drachms,
tartar of vitriol one drachm, fyrup of five
opening roots two ounces, barley water
half a pound, diftilled water of lemon peel
two ounces. Mix.
30. Take

108
RECIPES.
30. Take finely powdered bark one
ounce, to be equally divided into twelve
papers.
31. Take purified honey three pound,
beft wine vinegar, one pound. Mix.
32. Take cream of tartar forty grains,
fal. polychreft twenty grains. Mix. Several
of thefe dofes to be given as occafion may
require.
33. Take theriaca diateffarion, conferve
of wormwood, of each one ounce. Mix.
34. Take pill. rufii thirty grains.
Make feven pills.
35. Take oxymel of fquills two
ounces, fal. polychreft two drachms, vitri-
olated tartar one drachm, common water
eight ounces, fpirit of mint half an ounce.
Mix.
ababog
36. Take fal. polychreft two drachms,
tartar of vitriol one drachm, theriaca dia-
teffar. three ounces, fyrup of five opening
roots, enough to make an electuary.
37. Take dog grafs half a pound,
dandelion, with leaves and all, four ounces.
Cut and bruife them, and boil in a fuffi-
cient quantity of common water, or whey
if conveniently to be had, for half an hour;
ftrain by ftrongly preffing two pounds.
Add pure honey three ounces. Mix.
38.

RECIPE S
109
38. Take tops of common wormwood
two ounces, roots of calamus aromaticus,
gentian, imperatory, of each one ounce,
bay berries one ounce and a half, juniper
berries three ounces, wild carrot feed one
ounce. Cut, bruife, mix. Infufe warm
in a clofe vafe, in, either good wine, or
mead, eight pounds, for twenty four
hours.
39. Take fquills fresh half an ounce.
Infufe in good wine two pounds.
40. Take camphor one drachm. Dif-
folve, by rubbing it with oil of fweet al-
monds one ounce, in a mortar.
41. Take diftilled oil of annifeed gutt. 4.
white fugar forty grains, powdered rhu-
barb fifteen grains. Mix for a powder.
42. Take diftilled water of mint eight
ounces, fpirit of mint half an ounce. Mix.
43. Take diftilled cinnamon water one
ounce, barley water half a pound, pure
opium three grains, crabs claws one drachm
and a half, fyrup of white poppies half an
ounce. Mix.
44.
Take beft rhubarb one drachm,
citrine myrabalans half a drachm. Mix
for a powder.
45.
a bolus.
Take Venice treacle one drachm, for
46. Take ipecacuanha forty grains in a
powder.
P
47.

110
RECIPES.
47. Take crude opium one grain in a pill.
48. Take waxed glafs of antimony eight
grains in powder.
49. Take bole armoniac fix drachms,
gumm. arabic. one drachm, Venice treacle
one ounce and a half, fyrup of wild pop-
pies, enough to make an electuary.
50. Take good wine half a pound, bar-
ley water one pound and a half, cinnamon
water one ounce, white fugar fix drachms.
Mix.
51. Take pure turpentine two drachms,
one yolk of an egg. To them, well mix-
ed, add Venice treacle half an ounce, pure
milk five ounces. Mix for a glyfter.
52. Take fpecies for emollient decoction
two. ounces. Boil in water enough for
half an hour; ftrain ten ounces, add lint-
feed oil two ounces. Mix for a glyfter.c
53. Take leaves of marshmallows two
handfuls, roots of ditto one ounce, bruifed
lintfeed two drachms. Boil half an hour
in water enough to ftrain three pounds.
Add, pure nitre one drachm, pure honey
three ounces. Mix.
54. Take tamarinds three ounces. Boil
a quarter of an hour in water enough to
ftrain three pounds. Add, pure nitre one
drachm, honey two ounces. Mix.
55. Take meal of muftard feed one ounce,
lintfeed one ounce and a half, beans one
ounce, common falt two drachms, vinegar

RECIPES.
III
enough to make a pafte, to be applied to
the foles of the feet.
56. Take white vitriol one drachm, com
mon water one ounce. Mix.
57. Take agaric of the oak, powder it.
58. Take Venice treacle one drachm,
falt of hartfhorn ten grains. Mix for a
bolus.
59. Take new milk two pounds, gene-
rous white wine four ounces.
Boil for an
inftant;ſtrain the whey from the curd for ufe.
60. Take Virginia ferpentine root, con-
trayerva root, of each ten grains, bark half
a drachm, camphor four grains. Mix for
a powder.
61. Take camphor one drachm. Diffolve,
by rubbing in a mortar, and dropping on
fpirits of wine rectified, twenty drops. Add,
white dry fugar two ounces, rub them well
together, pour on white wine vinegar ten,
ounces. Mix. Keep in a well stopt glafs
vafe for uſe.
62. Take horfe-radifh root, fresh ga-
thered and fliced thin, four ounces, leaves
of fcurvy-grafs fresh gathered, marfh tre-
foil, of each two handfuls; fage, one hand-
ful. Cut, mix; infufe in generous wine
fix pounds, in a clofe veffel, with a gentle
heat, for twenty-four hours; ftrain for ufe.
63. Take root of fharp pointed dock,
polypody of the oak, of each half an ounce,
chryftals of tartar three drachms. Boil for

112
RECIPES.
half an hour in milk three pounds; ftrain.
Add, honey, one ounce and a half. Mix
64 Take fpirit of fcurvy-grafs two
ounces, elixir proprietatis Paracelfi one
ounce. Mix.
65 Take fpirit of fea falt one drachm,
honey of rofes one ounce and a half, com-
mon water five ounces. Mix.
66. Take corrofive fublimate twelve
grains, rectified malt fpirit two pounds.
Keep in a clean glafs vial, till the mercury
hath voluntarily diffolved.
67. Take root of marshmallows two
ounces. Boil in a fufficient quantity of wa-
ter for an hour, adding near the end pow-
dered liquorifh one ounce. Strain four
pounds.
68 Take fcammony fifteen grains, fine
fugar ten grains, Ethiops mineral twenty
grains, diaphoretic antimony twenty grains.
Mix for a powder.
69. Take flower of fulphur thirty grains,
Ethiops mineral ten grains. Mix for 21 dofes.
70 Take Ethiops mineral one ounce,
hogs lard three ounces. Mix for an ointment.
71. TakeTurbith mineral five grains, root
of jalap forty grains, fineft white fugar twen-
ty grains. Mix; rub to a very fine pow
der in a glafs mortar.
END OF THE RECIPES.

EXTRACTS
FROM THE
MARINE PRACTICE
OF
PHYSIC AND SURGERY.
WITH SOME BRIEF DIRECTIONS TO BE
OBSERVED BY SEA SURGEONS
IN ENGAGEMENTS, &c.
BY WILLIAM NORTHCOTE, SURGEON,
MANY YEARS IN THE SEA SERVICE.
Including,
The NATURE and TREATMENT,
of
GUN-S HOT WOUND S.
By JOHN RANBY, Efquire; SURGEON GENERAL
TO THE BRITISH ARMY.
PHILADELPHIA:
Printed, and Sold, by R. BELL, in Third-Street.
MDCCLXXVI.

TOA ITX 1
TO SALSAM
LICE

OF WOUNDS OF THE VEINS,
ARTERIES, NERVES, AND TENDONS;
OBSERVATION S.
WITH
IN
'N Wounds of the Veins, the blood flows
with a ſmooth even ftream, of a grofs
confiftence and dark color; and is ordi-
narily reftrained by the common methods,
fuch as dry lint, ftyptics, &c.
If an Artery is wounded, the blood flows
impetuoufly and per faltum, and is of a
florid color; to fupprefs which, if the ori-
fice be acceffible, make a ligature on the
Artery with a crooked needle and waxed
thread, which is the fureft and beft me-
thod: but the hæmorrhage may be fup-
preffed by the torniquet, till the ligature
can be made.
It
If it be not acceffible, and
the Artery runs along the fide of a bone,
apply a fuitable bandage, compreffes, or
bolfters. It is not neceffary to compreſs it
fo much as totally to preclude the acceffion
of any blood, but only to impede its efflux,
and retain the thrombus, fo as to grow to
the fides of the divided arterial coats.
requires great judgment, however, not to
let the compreffion be too fmall, to prevent
an Aneurism. But if the wounded artery
lies within a bone which prevents its late-
ral compreffion, the only means remaining
is to apply dry lint, and retain it forcibly
against the divided orifice. Neither ftyptics
nor cauteries fhould ever be uſed to fup-
prefs an hæmorrhage when ligature or com
preffion can take place.
If a large Nerve be totally divided, at

WOUNDS OF THE VEINS, &c. o
firft it caufes excruciating pain and inflam-
mation by contracting and ftretching the
other branches communicating with its
afterwards the part becomes paralytic, and
either fades by an atrophy, or is confumed
by a mortification. For the arteries being
no longer able to propel their contained
fluids, for want of the Nerves which fup-
ply their coats, the humors are accumulat-
ed, ftagnate, corrupt, and mortify the part.
But if the Nerve (or even a Tendon) be only
half divided, there follows a continual and
flow laceration, a fpreading inflammation,
excruciating pain, fever, delirium, convul-
fions, &c. with a gleet, or thick ferous
difcharge; which fymptoms are in propor-
tion more violent as the Nerve is more di-
ftended or ftretched. bc fly
In order to the cure, if the Nerve lie cove-
red, under the fkin and membrana adipofa,
dilate the Wound, that the medicaments
may penetrate to the part. Drefs with balf.
peruv. warm (dropped in) a pledget of
foft digeftive, and an emollient poultice,
with a proper bandage to take off the diften-
tion. Wounds of the Tendons and Liga-
ments are to be dreffed after the fame man-
ner, only the applications fhould be more
drying.
bas
In the uſe of thefe, if the patient feel the
heat of the topics moderate, then they are
rightly fitted: if the part itch and fmart,
and the aperture become wider, the topics
are ftronger than they ought to be.
OF

OF GUN
SHOT WOUNDS,
WITH
OBSERVATIONS.
THEIR NATURE AND TREATMENT;
"GUN
UN-SHOT Wounds, of all others,
are more complicate, and much more
difficult of cure, than an incifed
Wound, even with lofs of fubftance:
becauſe here the fibres and veffels being
lacerated, their juices extravafated, and
their texture deftroyed, a large digeftion
or fuppuration is neceffary to remove the
injured parts, before the Wound can be
incarned and healed; and hence alfo the
fymptoms of inflammation, pain, &c. are
commonly more violent in Contufed
Wounds."
<<
They are more or lefs dangerous, ac-
cording to their extent, and the part in
which they are feated. Thoſe which extend
into the bones, vifcera, or joints, are of the
worfe kind; and efpecially when any of
the wadding, cloths, or fplinters are car-
ried into the part together with the ball;
for the confequences, in thefe cafes, muft
be inflammations, gangrenes, caries, &c.
which make an amputation neceffary. But
Gun-fhot Wounds in the cranium are
above all the moft malignant and fatal;
though even here we have often furpriſing
P
inftances

118 GUN-SHOT WOUNDS.
inftances of cures made by art and the ef-
forts of nature, when the cafe has appeared
to be defperate.
"The following method is extracted from
Mr. Ranby's excellent Treatife on Gun-
fhot Wounds, whofe penetrating judgment,
and great experience in fuch cafes, muft be
univerfally acknowledged."
"The first intention, in regard of acci-
dents caufed by a mufket or piftol ball, is,
if poffible, to extract the ball, or any
other extraneous body that may be lodged
in the wounded part. And whenever thefe
cafualties are attended with a great effu-
fion of blood, from the rupture of fome
confiderable arterial veffel, it will be abfo-
Jutely neceffary, with all imaginable dif-
patch, to reftrain the bleeding by taking
up the artery with the needle; and, at
the fame time, to be particularly careful
your hold
proves no way elufive.
There is no depending on any applications,
however flyptic, on thefe occafions."
that
"In order to get at the ball, or any other
foreign matter that infefts the wound, I
would adviſe probing or poking to be uſed
as fparingly as poffible; having conftantly
experienced, through the whole courfe of
my attendance in thefe cafes, that fuch a
method is highly detrimental to the patient:
and,

GUN-SHOT WOUNDS. 119
and, indeed, where probing is neceffary,
I would always prefer the finger as the beſt
and trueft probe."
"If a ball, or any other body happens
to be lodged near the orifice, or is found
by the touch to lie under the fkin, though
at fome diftance from the mouth of the
Wound; in the firft cafe it is requifite
immediately to remove fuch extraneous
matter; and, on the other occafion, to cut
upon it, and take it out. But when it is
funk deep, and lies abfolutely beyond the
reach of the finger, I could never bring
myſelf to thrust thofe long forceps the
Lord knows where, with fcarce any.pro-
bability of fuccefs."
"A great number of inftances have oc-
curred to me, where balls have been quietly
lodged in the body; till, after many years,
they have worked themſelves a paffage to-
wards the furface, and were confequently
very easily extracted. In cafe the wound be
occafioned by a mufket or piftol fhot, and
confequently but fmall, it will be neceffary
to dilate it immediately: yet, I think, in
Wounds near a joint, or in very membra-
nous or tendinous parts, the knife, as
well as forceps, fhould be put under fome
reftraint; nor any more opening made,
than

120 GUN-SHOT WOUNDS.
than what is abfolutely requifite for the free
diſcharge of the matter lodged within."
"Wounds in the joints are always dan-
gerous, let them proceed from whatever
cauſe, whether a bullet, or any cutting
inftrument; and membranous or tendinous
parts muft undoubtedly fuffer from their
being thus expofed to the very fenfible im-
preffions of the air. I could produce many
inftances of balls going through mufcular
parts, and the Wounds being healed with
very little trouble. And I have known
Wounds of the fkull from a broad-fword
(both tables having been cut through, and
a confiderable piece loofened) which were
fuffered to bleed for feveral hours, and
did well; nor were attended, at leaft very
feldom, with any feverish complaint;
which was probably owing to the great
quantity of blood loft immediately after the
parts had been injured. If the ball has gone
quite through, both orifices are to be wid-
ened (if in a part where it can be done with
fafety) and particular care is to be taken to
preferve both openings, that efpecially
which is the most depending. No tents
are to be made ufe of, where there is any
poffibility of avoiding them; and I would,
in general, recommend light, eafy dref-
fings, with a flight, moderate bandage, juft
fufficient

GUN-SHOT WOUNDS. 121
fufficient to keep them on the part. Thin
flannel is what I would prefer, in cafe it
can be got."
"Where the wounded perfon has not
fuffered any great lofs of blood, it will be
adviſeable to open a vein immediately, and
take from the arm a very large quantity,
and to repeat bleeding, as circumftances
may require, the fecond, and even the third
day. This timely precaution will pre-
vent a good deal of pain and inflammation,
forward the digeftion, and contribute to-
wards obviating a long train of compli-
cated fymptoms, that are wont otherwife to
interrupt the cure, miferably harraís the
poor patient, and too often endanger his
life."
"For the firft twelve days it will be
proper to obferve a cooling regimen, both
in reſpect of medicines and diet: and as,
in circumftances of this kind, it is neceffary
that the body fhould by all means be open,
a ftool fhould be every day procured, either
by emollient clyfters, or fome gentle lax-
ative. Whatever application is of a hot,
fpiritous nature, I find remarkably injurious
on theſe occafions, and what no wounded
part can in any degree bear."
"Let the firft dreffing be with lint,
dry, or moistened with a little oil, and a
very

122 GUN-SHOT
WOUNDS,
very light bandage; the next with a di-
geftive warmed, and over it the bread and
milk poultice, mixed with a fufficient
quantity of oil to keep it moift: and,
where there is a great tenfion, and the
Wound large, a fomentation. This courfe
is to be continued till the fore is clean;
and then it is to be healed according to
art."
"This method will commonly promote
a conftant, eafy perfpiration, abate the
pain, very much facilitate the digeftion,
and remove all danger of any approaching
inflammation, What induces me to moi-
ften the lint with oil, is the ease that is
procured to a Contufed Wound from fuch
an application, in comparifon with one of
an abforbent, drying difpofition; which,
infteed of giving free liberty to the fanious
blood to diſcharge itfelf, and confequently
preventing an inflammation by unloading
the part, would poffibly obftruct the mouths
of the capillary veffels, and hinder nature
from getting rid of that incumbrance,
which the endeavors to throw off."
"Should an inflammation feize any
part, through the lodgment of a bullet, or
any other foreign body, that could with
fafety have been more immediately extract-
ed; all attempts for diflodging fuch ex-
traneous

GUN-SHOT WOUNDS. 123
traneous matter fhould be poftponed, till
the fwelling has in fome meaſure fubfided,
and the inflammatory difpofition of the
fibres is nearly vanished: unleſs the ball,
or other extraneous body, lies at no great
diftance from the orifice; and there is,
on that account, a certainty of removing
this incumbrance, without any material
trouble to the patient."
"If a Wound be of fuch a defperate
nature, as to require amputation (which is
often the cafe, when it happens in any
particular joint) it would certainly be of
confequence to perform the operation im-
mediately as foon as the patient is brought
down; left by delaying it an inflammation,
which one may very reafonably expect,
fhould obftruct a work that ought rarely to
be entered upon during the continuance of
fo calamitous a circumftance as that of a
fmart engagement. The neglecting this
critical juncture of taking off a limb fre-
quently reduces the patient to fo low a
ftate, and fubjects the blood and juices to
fuch an alteration, as muft unavoidably ren-
der the fubfequent operation, if not entirely
unfucceſsful, at leaft exceedingly dubious.
And in Wounds even where no amputation
is required, it is equally advifeable not to
defer the care neceffary to be taken of them;
left,

124 CUN-SHOT WOUNDS.
left, by the parts being expofed to the air
there might ariſe a ſeries of very dangerous
fymptoms."
"Wounds that border on any confider-
able artery are very apt to bleed afreſh upon
motion, or a return of a free circulation of
the blood into the part which was inter-
rupted at first by the violence of the injury
offered it; and this is almoft always the
the cafe, when the flough begins to fepa-
rate for which reafon one fhould never
attempt to remove it by force; but wait,
with patience, till there be a perfect fepa-
ration of this flough; nor be in the leaft-
wife fhocked at the accident of arteries
thus opening themfelves, which a very
moderate experience will convince one to
be almoſt inevitable. The patient frequently
gives warning of what is coming upon him,
by complaining of a great weight and ful-
nefs in the limbs, which are ever accom-
panied with more or lefs pulfation in them:
an infallible prognoftic of the confequences.
Let the Wound afflict whatfoever part, if
theſe complaints attend it, I inftantly en-
join bleeding and the bark."
"I have known feveral inftances of
perfons lofing their lives from the ſtarting
of an artery before the furgeon could
reach them; particularly where there has
preceded

GUN-SHOT WOUNDS. 125
preceded an amputation. And I dare affirm,
the quantity of blood loft in fome cafes,
which I have obferved to kill, has not a-
mounted to twelve ounces; which I do
not know how to account for otherwiſe,
than by the drain which had been made
from the mafs of blood both before and
during the operation; whence a fudden
gufh, though of fo moderate a portion of
blood, after the great quantity already
loft, gives a check to the circulation, and
caufes immediate death." s
"This reflection, I think, ought to be
a leffon to every practitioner, to be parti-
cularly intent on the faithful difcharge of
his duty in regard of tying the veffels
Repeated bleedings in the beginning draw
after them many advantages: they gene-
rally prevent, and always leffen, any feve-
rifh attacks, and feldom fail to obviate
impofthumations."
"The body muft ever be kept in a lax-
ative ftate; and, when pain puts it on the
rack, immediate recourfe must be had to
the fovereign and almoft divine powers of
opium; next to this I likewife add the
bark, a medicine which no human elo-
quence can extol with panegyric propor-
tioned to its ineftimable virtues. Of fuch
incomparable benefit is it to mankind!
I have

126 GUN-SHOT WOUNDS.
I have known it procure reft, if given in
large dofes, when even opium had been
taken without any manner of effect."
"In all large Wounds, efpecially thofe
made by a cannon-ball, there is conftantly
a great laceration of the membranes, and
parts endowed with an exquifite fenfation.
Theſe are ever attended with an excruci-
ating pain, and a difcharge of a gleety mat-
ter; which, if not reftrained, proves often
of the laft confequence."
"In this unhappy ftate, the bark, given
in dofes of a drachm each, and repeated
every three hours (or oftener, if the fto-
mach will bear it) furprisingly repairs the
breach made in the conftitution by theſe
terrible accidents. Elixir of vitriol taken
three times a-day, in a glass of water, I find
to be of fingular benefit, and to prove a
very good affiftant to the virtues of the
bark. And if the body be coftive, to each
dofe of the bark I add four or five grains of
rhubarb, till that inconvenience is remedied.
Should the bark run off by more than four
or five fucceffive ftools, I take care to check
this effect of it by ordering two or three
drops of laudanum, or two fpoonfuls of
the diafcordium mixture along with it,
every time it is given".
"Where

GUN-SHOT WOUNDS. 127.
"Where the fore difcharges a confider-
able quantity of gleety matter, is flabby,
looks pale and gloffy (which appearances
are ever confequent to a lofs of fubitance)
the bark continually relieves the pain that
is predominant in this cafe, thickens the
matter, leffens its quantity, and quite
changes the complexion of the Wound."
"It is very common in cachectic and
fcorbutic conftitutions (which latter too
much abounds in fea-faring people, efpe-
cially in long voyages) for a fore, the first
eight or ten days after taking off the limb,
to promife all imaginable fuccefs: from
which time it frequently begins to gleet
prodigiously, looks pale, gloffy, and flabby;
and this gleeting, if not checked, foon
proves mortal. In exigencies of this kind,
the bark hardly ever fails to procure relief,
and works an apparent change in a very
fhort space of time; fometimes in twelve
hours."
From what has been here faid by Mr.
Ranby, it is evident that the bark is one
of the beft remedies in contracting the vef-
fels, and reftoring their due action upon the
blood, when too great a quantity of that
neceffary fluid has been loft by a profufe
hæmorrhage, provided the wounded veffels
are

28 GUN-SHOT WOUNDS.
are previouſly clofed up, or well fecured
from a return of the hæmorrhage.
It alſo not only fecures the moſt tender
folids and fmall veffels from being diffolved
by the acrimony of any matter abforbed,
and returned into the whole mafs of blood,
from large Wounds or latent abfceffes
but it likewiſe preferves the texture of the
blood itfelf from being too much broken,
or rendered too watery from the fame
caufe, which would otherwife inevitably
produce a fatal and colliquative hectic.
But where there is too great a fulness, or
too great a ftrength and contractile force of
the folids, and an inflammatory tenacity
or fizinefs in the blood, it may occafion
obftructions, pains, inflammations, and
their confequences, unless it be timely
laid afide upon the appearance of fuch
effects.
SOME

SOME BRIEF DIRECTIONS
PREVIOUS TO, AND IN
ENGAGEMENTS,
&c.
value of an able furgeon, and the
Tneceffity of his affiftance, never more
plainly appears than in dangerous
wounds received in an engagement or battle;
where many brave men muft unavoidably
perish from loss of blood and other caufes,
unless reftored and fnatched, as it were,
from the jaws of death by the skill of their
furgeon. And no doubt, the better opi-
nion the officers and men conceive of their
furgeon, the more fpirits they have for the
action; being confident, the wounds, &c.
they may chance to receive will be properly
treated, and their lives (if poffible) pre-
ferved. Therefore a furgeon of a man of
war fhould have every thing needful, in a
fufficient quantity, always by him in readi-
nefs (but more particularly in time of war)
placed in fome kind of box or drawer by
themfelves. His capital inftruments ſhould
be conftantly kept clean, bright, and in
good order. His apparatus fhould confift
of feveral tourniquets (of which Petit's
fcrew tourniquet is the moft convenient,
as the patient can eafily manage it himself,
after it is fixed) crooked needles of all fizes,
threaded with proper flat ligatures, in pro-
portion to the needle; a large quantity of
portion

130
DIRECTIONS FOR
fcraped (fhort) lint, fome mixed with flour
in a bowl; double and fingle headed rol-
lers (or bandages) of all breadths and lengths,
in good ſtore; for flight wounds and con-
tufions, thofe made of bunting (the fly-part
of an old enfign) will be fufficient; but
for cafes of more confequence, fuch as am-
putations, fractures, diflocations, &c. the
linen rollers must be ufed. He ought to
be furnished with common needles and
thread, with pins in plenty; pledgets of
tow, of what fizes he pleafes; after they
are made, they may be wet with water, or
oxycrate, on the fame board, and dried
either by the galley-fire or in the fun. By
this means he may the better lay them to-
gether (in a drawer or box) without in-
tangling, and they are both much better
and readier to fpread, when wanted, with
any cerate, ointment, or liniment.
Splints of all fizes muft alfo be at hand,
and when uſed armed with tow, or old
linen cloth; likewife bolfters, or compreffes
of cloth, or coarfe tow; but theſe may
be readily made as occafion requires. To
the above add yards of incle, or ftrong
tape, to fecure your fplints in fractures,
and for other ufes. By this method a fur-
geon will always be provided againſt every
accident which may befall his Crew.
When

SEA SURGEONS.
137
When the enemy is in fight, and you are
like to come to an action, as foon as all
hands are called to quarters (if your cock-
pit is not fufficiently large) you must defire
the first lieutenant, with the captain's per-
miffion, to order the carpenters to lay a
platform for your wounded men; if the
cables will not be wanted, in one of the
cable tires, or otherwife in the after-hold,
by clearing of all manner of lumber out of
the way. On the top of a fmooth and
even tire cafk, let there be deals or planks
laid clofe together, over them an old fail,
and upon that fome feamen's bedding from
the purfer's ftore-room (for which you are
to have the captain's order, if he will not
otherwife deliver them) ready made up,
and laid one by another to place your
wounded men on after they are dreft,
that they may lie quiet without being dif-
turbed.
-If the fhip be fmall, and there is no
cock-pit, or fuch as you have not room to
perform your operations in, you must, as
near the after hatchway as is convenient,
have ſome caſk removed out (if there be
not height enough for you to ftand upright
on the platform) that you may have a place
of eight, ten, or twelve feet fquare, to re-
ceive and dreſs your wounded men, and
from

#32
DIRECTIONS FOR
from thence to hand them to their beds!
on one fide of this place let there be fixed
a cheft of a proper height if you have no
other convenient feat) to perform your ope-
rations upon; and on another juft by (or
table) lay all your apparatus, fuch as your
capital inftruments, needles, ligatures, lint,
flour in a bowl, ftyptic, bandages, fplints,
compreffes, pledgets fpread with yellow
bafilicon, or fome other proper digeftive;
thread, tape, tow, pins, new and old
linen cloth, a bucket of water to put your
(punges in, another empty to receive the
blood in your operations; a dry fwab or
two to dry the platform when neceffary;
a water-cafk full of water near at hand,
with one head knocked in, in readineſs
for dipping out occafionally as it may be
wanted. You must alfo have near you your
ung. bafil.-e gum. elem.-fambucin;ol.
lin.-olivar. c. terebinth; balf. terebinth;
tinct. ftyp.thebaic; fp. c. c. per fe.-
vol. aromat.-lavend. c. Wine, punch, or
grog, and vinegar in plenty.
A number of large candles fhould be im-
mediately lighted, as foon as the engage-
ment begins, not forgetting to have your
mates and affiftants properly inftructed in
what part they are to act, that every one
may know his ftation, and what he has to
do,

SEA
133
SURGEONS.
to prevent confufion in time of action.
Here it is neceffary to obferve, that the
furgeon fhould always take peculiar care to
defire the first officer to quarter a fufficient
number of hands with him in the cock-pit,
that he may want no affiftance in the day
of battle, however bloody the engagement
may be.
All things being ordered, and placed as
above in readinefs, and the furgeon's and
purfer's cabbin beds made up, to receive
the captain, or any of his commiffion of-
ficers, who may chance to be wounded;
if you
have any fick on board, that can-
not ſtand to their quarters, let them be put
down with their hammock and bedding into
the hold, fore cockpit, or fheet cable tier,
out of the way before the action begins;
but be fure to keep your platform entirely
for the wounded men. Let one of your
mates or affiftants go to them now-and-
then to fee how they are; or elfe order
one of the ftouteft of the convalefcents to
come to you at times, if he is able, and
acquaint you if any of them are worſe, and
in cafe of faintnefs, to give them a little
cordial, which he fhould have by him for
that purpoſe.
When the action is begun, if more than
one wounded is brought down at a time,
R
always

134 DIRECTIONS FOR
always firft take care of him who is in the
moft immediate danger; but otherwiſe
drefs them as they come, without diftinc-
tion: if any is brought down with a limb
off, or a violent hæmorrhage, and you hap-
pen to be in the midft of an amputation,
or other capital operation, and cannot that
inftant attend, order your mate or affiftant
(for the prefent) immediately to fix a tour-
niquet on the part, to reftrain the flux of
blood from being fatal to the patient, and
do what elfe you may think neceffary, till
you have finished the operation you were
about, and laid the patient in bed.
Never encourage thofe to ftay below
(after their wounds, &c. are dreft) who
have been but little hurt, but infift on their
going up again to their quarters, otherwife
threaten to report them when the engage-
ment is over. I have many times known
cowardly lubbers come tumbling down the
ladder with moft violent groans and com-
plaints, though at the fame time they have
received little or no hurt; and all 1 could
do or fay would not prevail on them to
make a fecond trial of their courage, nor
gol up again till the action was all over.
Nay, I have been told (by thofe quartered
at the fame gun) that fome daftardly-fel-
lows have actually put their feet, or flood
Я
in

SEA SURGEONS.
135
in the way of the carriage, on purpofe to
be hurt, that they might have a plaufible
pretence for going down to the doctor;
which I muft own I have great reafon to
believe, having fometimes met with fuch
contufions in the legs and feet, occafioned
(according to their own confeffion) by the
carriage, but at the fame time fo flight as
was fcarce worth mentioning; though
fometimes very violent, at other times
there was ſcarce any injury or contufion to
be perceived, notwithstanding the moſt
grievous complaints of pain and uneafinefs.
When you are entering on any capital
operation, you fhould ufe your utmoſt en-
deavours to encourage the patient (if he is
fenfible) by promifing him, in the fofteft
terms, to treat him tenderly, and to finifh
with the utmoft expedition; and indeed
you fhould use expedition but not hurry:
you should not make more hafte than the
cafe requires, nor cut lefs than is neceffary,
or leave any mifchief unremedied; for the
neglecting this critical juncture of taking
off a limb, frequently reduces the patient
to fo low a ftate, and fubjects the blood
and juices to fuch an alteration, as muft
unavoidably render the fubfequent opera-
tion, if not entirely unfuccefsful, at least
exceedingly dubious.
Therefore, if a
wound

736
DIRECTIONS FOR
wound be of fuch a defperate nature as to
require amputation (which is often the
cafe in fea engagements) it is certainly
of confequence to perform the operation
immediately as foon as the man is brought
down: and in wounds, even where no
amputation is required, it is equally ad-
vifeable not to defer the care neceffary to
be taken of them.
In regard to the wounded, you fhould
act in all refpects as if you were entirely
unaffected by their groans and complaints;
but at the fame time I would have you be-
have with fuch caution, as not to proceed
rafhly or cruelly, and be particularly care-
ful to avoid unneceffary pain.
When the action is all over, you are then
to go round your patients, and examine if
the wounds have bled any thing confider-
ably fince they were dreft; and if the
hæmorrhage ftill continues, remove the
dreffings very gently and carefully, and ap-
ply fresh ones.100
It is not improper here to remark that
the tourniquets fhould ftill remain on
thofe patients, who have had their limbs
amputated or hot off; that they may be
always in readineſs, in cafe of a fresh hæ-
morrhage; and in cafe there be no affiftant
prefent when it happens, the patient fhould
be

SEA SURGEONS.
137
be inftructed himfelf how to tighten it, if
he feels the wound bleeding, before help
can be procured. You are likewife to fee
that their wounded limbs, &c. lie eafy, and
as they ought; and that the patients are
fupported with proper diet and medicines
fuitable to the fymptomatic fever, &c. as
mentioned under the various heads in
Northcote's Marine Surgeon,
As foon as poffible after the engagement
is ended, and your wounded are all taken
proper care of, acquaint the captain how
many there are wounded, and the nature
of their wounds, if they are like to prove
mortal, &c. And defire he will pleafe to
order cradles forthwith to be made, as ma-
ny as you think neceffary, wherein your
wounded men must be placed, with their
bedding, in a proper birth by themſelves.
The cradles are firft to be well cleated,
and fecured to the deck and fides of the
fhip, placed fo, as that you may eafily go
between to dreſs the people.
As foon as the fhip arrives in a harbour,
the fick and wounded muft be immediately
fent on fhore, where their cures will be
perfected in a much fhorter time than it is
poffible on board in an infalubrious air,
and on fuch diet only as the fhip affords.
It is neceffary the furgeon of the fhip
fhould

138
FOR
DIRECTIONS
fhould give a more particular account of
patients fent to an hofpital, than is the
common practice in the navy, of merely
filling up a fick ticket with the general
name of a difeafe, &c. He ought to ace
quaint the furgeon, or his affiftant at the
hofpital, of the peculiar conftitution of the
patients, the manner they have been treated
from first to laft, the fymptoms, &c. that
have occurred; and what ever other cir-
cumftances he fhould be informed of, in
order to enable him to perform a more
speedy cure.
PREVENTATIVES OF THE SCURVY
AT SEA, &c.
TH
hahnaw
HE best method of preventing the
Scurvy at Sea is a liberal ufe of acids
(particularly thofe of vegetables) and
to avoid eating the fhips falt provifions as
much as poffible, to ufe friction daily,
either with a flesh-brush or coarfe cloth.
Proper exercife, dry linen, and cleanlinefs,
not a little contribute to health.
It appears from many repeated experi-
ments of Dr. Lind, and a number of Sur-
geons in the royal navy, that of all acids,
oranges and lemons have the beft effect in
bloodi
preventing

SEA SURGEONS.
139
preventing and curing the Scurvy (the lat-
ter I fhall here omit mentioning, it being
already laid down in the Marine Surgeon,
Vol. II. Chap. VIII. Sect. VI. Art. Scurvy,
to which the reader is referred). Oranges,
in my opinion, are better than lemons, for
by thefe Lord Anfon's people were fo fpeed-
ily and furprizingly recovered at the iſland
of Tinian. It is certain, when they are
properly and fufficiently ufed, they are an
infallible cure in every ftage and fpecies of
the Scurvy, if there is any degree of natu-
ral ftrength left; and where a diarrhoea,
lientery, or dyfentery are not joined to the
other ſymptoms. Some are apt to think
tamarinds, vinegar, fpirit of falt, elixir of
vitriol, and other acids of the fame kind,
will do as well; but experience (that beft
of maſters) plainly fhews the contrary;
and though acids agree in certain proper-
ties, they differ widely in others. When-
ever theſe fruits are given without fuccefs,
you may be fully affured the diſeaſe is not
the Scurvy; for in the real genuine Scurvy
they were never yet known to fail. How-
ever it is neceffary alfo to obferve that fresh
vegetables of all kind prove a great relief
to fcorbutic patients when fet on fhore.
But as oranges and lemons are apt to
Spoil in keeping, there is now to be had an
excellent

140
DIRECTIONS FOR
excellent quinteffence of thefe fruits, which
may be very advantageously ufed as a fuc-
cedaneum, being but little inferior to the
recent juice.
When you are in countries where oranges
and lemons grow fpontaneously, and can
be procured in great plenty at a ſmall ex-
pence, I fhall here fhew how to bring their
juices, by a very eafy method, into a ſmall
quantity without prejudice to their virtues.
Let the juice of thefe fruits be well
cleared from the pulp, and depurated by
ftanding fome time; after which it may be
poured off from the grofs fediment: let it
then be poured into any clean open veffel
of china or ftone ware, which ſhould be
wider at the top than at the bottom, that
it may evaporate more readily. A china
bafon or punch bowl is moft proper on
account of the form. Put this into a pan
of water over a clear fire; let the water
come almoft to boil, and continue nearly
in that ftate, with the bowl full of juice in
the middle of it, till the juice is found of
the confiftence of a thick fyrup when cold.
The flower the evaporation of the juice is,
the better; that is, it ought to continue
twelve or fourteen hours over the fire:
when it is cold it is to be corked up in a
bottle for uſe.
Two

SEA
141
SURGEONS.
Two dozen of good oranges, weighing
five pounds four ounces, will yield one
pound nine ounces and a half depurated
juice; and when evaporated there will re-
main five ounces of extract, which in bulk
will be equal to lefs than three ounces of
water: fo that twelve dozen of oranges or
lemons may be put into a quart bottle, and
preferved good ſeveral years. When this is
mixed with water, and made into punch,
few are able to diftinguish it from the freſh
juice mixed in the fame manner.
up
However, when the fresh fruit can be
had, the fragrancy of the peel may contri-
bute fomewhat to the cure of the Scurvy;
and when theſe are wanting, the fame thing
may be obtained from a few drops of their
chymical effence, or the aromatic oil con-
tained in their rinds; and if a fmall
quan
tity of this be added to the extract, it will
give it the ſmell and fragrancy of the freſh
fruit in great perfection: or rather add a
little of the outer peel to the extract, a lit-
tle before it is taken off the fire, and then
the niceft tafte will not be able to diftin-
guish the difference between the fresh fruit
and this. The virtues of this extract, thus
made, lie in fo fmall a compaſs, that a
quart bottle full will ferve one man at fea
feveral
S

142
DIRECTIONS FOR
feveral years. In making of it there is lite
tle or nothing flies off but the water.
It will likewiſe be of great ufe to all fea-
faring people to have always with them,
bullace, floes, wild-plums, hips, elder-
berries, goofe-berries, and the like, pre-
ferved in bottles, in the fame manner as the
paftry-cooks keep the latter. Cabbage,
French beans, &c. may be preſerved by
putting them in clean dry ftone pots or jars,
with a layer of falt at the bottom, then a
thin layer of the vegetable covered with
falt, and fo alternately till the pot is full;
then the whole must be preffed down with
a weight, and its mouth quite ftopped with
a cork or timber plug, well pitched over,
that no air or moisture may enter: thus
the vegetable may be kept freſh and green
for a whole
year.
At the time of ufing, the falt is to be
washed off with warm water. This is the
manner by which they preferve that never-
failing remedy Greenland fcurvy-grafs.
Every common failor fhould alſo lay in a
ftock of onions and muftard, for they are
a great prefervative at fea. The Dutch
failors are preferved from the Scurvy by
pickled cabbage. It must be obferved,
likewife, that a foup of boiled cabbage and
onions will cure an adventitious Scurvy in
its

SEA SURGEONS:
143
its firft ftage, either at land or fea, in any
part of the world; and what will cure will
prevent.
Salt provifions fhould always be eaten
with plenty of vinegar, muftard, and onions,
but as little of the meat as poffible, efpe-
cially when the Scurvy begins to make its
appearance in the fhip. Thoſe who have
been weakened by long illnefs fhould be
more particularly guarded against the Scur-
vy, by living on boiled bifcuit, with a few
drops of the quinteffence or extract of le-
mons or oranges, and a fpoonful of wine;
as alfo oatmeal and rice gruels, flummery,
ftewed barley, with raifins or currants,
fago, and wine, &c. But more particu-
larly pickled green cabbage or beans, as
before mentioned, and fmall onions boiled
with the portable foup made weak. Moft
of their food ought to be acidulated with
orange and lemon juice, their quinteffence
or extract.
The infpiffated juice of turnips (a thing
very easily and cheaply procured) is an ex-
cellent kind of ingredient in foup for fea
ufe. The water-dock (hydrolapathum)
the berries mentioned above, and crab,
apples; alfo apples, pears, or any other
fruit, either preferved with coarfe fugar
(by being boiled in it) or elfe brought to a
rob

144
DIRECTIONS FOR
rob or extract, by boiling their expreffed
juices, &c. as already laid down for that
of lemons and oranges, by which means it
may be kept good through the longeſt
voyages. Apples, pears, &c. when well cho-
fen, and well packed in dry tight cafks, will
keep very good for two or three months;
or they may otherwife be cut in flices, and
put upon ftrings in dry weather, by which
they will be dried without lofing their
flavour or tafte; they are then to be care-
fully ftowed in very dry boxes, and aired
fometimes to prevent their mouldering or
being damaged.
Good wine may be made by fermenting
the before-mentioned extracts with water
and fugar; bullace and floes are preferable
to any other (oranges and lemons excepted)
being a noble antifeptic aftringent.
Poor people that winter in Greenland,
under vaft difadvantages in point of air and
diet, preferve themfelves from the Scurvy
by fpruce beer,
The common beer brewed for the ufe of
fhips thould be imbittered with wormwood,
chamomile flowers, or even gentian, rather
than by means of hops; and by the for-
mer it will keep longer than with the latter,
without acquiring any bad property, and
have full as agreeable a tafte; but it ſhould be
plentifully

SEA SURGEON S.
1145
plentifully impregnated with thofe ingre-
dients.
The fhrub black spruce of America makes
a moft wholefome drink, and affords a bal-
fam fuperior to moft turpentines; it is of
the fir kind. A fimple decoction of the
tops, cones, leaves, or even of the green
bark, or wood of thefe, is an excellent
antifcorbutic; but perhaps it is much more
fo when fermented, as in making fpruce
beer, which may be brewed fresh every
two or three days. It is to be made by
pouring boiling water on the tops, cones,
leaves, bark, or wood of the fpruce, or any
other fir, dried or green; the latter may be
eafily carried in bags at fea: but when theſe
cannot be had, a little turpentine or worm-
wood may be fubftituted; which ever be
ufed, it is then to be fermented by the addi-
tion of a proper quantity of molaffes, which,
by its diaphoretic quality, makes it a more
fuitable medicine.
Again, when fpruce cannot be had,
the common fir-tops ufed for fuel in the
fhip should be firft boiled in water, and
then the decoction be fermented with mo-
laffes; to which may be added a ſmall
quantity of wormwood and root of horse-
radish (when it can be got); the fresher it
is drank the better. When other things
are

146
FOR
DIRECTIONS
are wanting, tar-water may be fermented
in the fame manner.
A drink may alſo be brewed the fame way
from the faffafras chips, or from the branches
or berries of the juniper plant: for if the
benefit is fuppofed to depend (as it certainly
does) upon the fermentative quality, or to be
derived from an acefcent, antifeptic, corro-
borative, and balfamic virtue in the reme-
dy, what is more liberally endowed with
thefe qualities than thefe fubftances I have
mentioned?
Befides fresh and preferved fruits, vege-
tables, and the drinks above mentioned,
fermented liquors of all forts are good, but
more particularly cyder; among theſe are
included many wines of every kind; or
the juices of fruits (already taken notice
of) may be fermented with ale, &c.
The late very learned and juftly cele-
brated Doctor Huxham fays," Let all
fhips, that are to proceed on a long cruiſe
or voyage, be fupplied with a fufficient
quantity of found generous cyder; the
rougher, provided it is perfectly found,
the better."
If apples are found of fuch vaft fervice
in the Scurvy, furely the juice of them,
when become a vinous liquor, cannot but
be

SEA SURGEON S.
147
be very falutary, and feems exceedingly well
adapted, as a common drink, to correct by
its acidity the alcalefcent, putrefying quality
of bad, corrupted provifions. This cyder
fhould be at least three months old before
it is ferved in, and quite fine; if it be too
new, and foul, it is apt to give fevere
colics: it fhould be racked off (once at
leaft) from its grofs ley into good and ſweet
veffels, which will contribute to its becom-
ing fine, and prevent it from growing ropy,
in which ftate it is good for nothing: but
if fome of it ſhould turn to vinegar, which
may frequently happen, it will ftill be
very
ferviceable; but it is found, when well
managed, to keep good and found even to
the Indies. Every failor fhould have at
leaft a pint of cyder a day, befides beer
and water.
The prize wines, which are commonly
low and thin, and very frequently spoil by
keeping, might be diftributed among the
fhip's company (efpecially in want of cyder)
to very good purpoſe.
The ventilators fhould be conftantly
worked, once a day at leaft; and the decks
frequently washed or fprinkled with vine-
gar. In cafe of ftinking water, lemon juice,
elixir of vitriol, or vinegar fhould always
be mixed with it, which will render it
much

148 DIRECTIONS FOR
much lefs unwholefome. A fmall drachm
of garlic brandy, or the tincture of bark,
taken in the mornings fafting, and when
going on the night watch, is a great pre-
fervation. See the next Chapter on the
Prefervation of Health, &c.
9
Cream of tartar, being the effential ve-
getable falt of wine, is a very proper fuc-
cedaneum when fruit is wanting; and
orange or lemon peel (or its effence) will
greatly improve the flavour: befides cream
of tartar is the moft grateful of all acids,
fubftituted in the room of the juice of le-
mons and oranges, and beft adapted to the
conftitution of mariners: it is alfo the cheap-
eft; for an allowance of the eighth part
of an ounce a day will not coft the govern-
ment much more than one fhilling yearly
for each man, or eighteen pence at moft.
Two pounds and a half of cream of tartar
will be fufficient to acidulate an hogshead
of water; this, with rum and fugar, will
become a falutary compofition of a cooling,
ftrengthening, antifeptic, and diuretic na-
ture; for there is nothing more repreffes
the inflammatory and intoxicating power
of fpirits than acids. Such a liquor would
prove infinitely more whoelfome than the
grog, wherewith the navy is commonly
ferved

SEA SURGEONS.
149
ferved when fpirits are ufed, both in the
East and West Indies, and elſewhere.
The officers and men (that can afford it)
fhould always carry to fea a very confiderable
quantity of pickles of different kinds, par-
ticularly onions; and preferves and extracts
of all acid fruits, fuch as floes, bullace, dam-
fons, &c. They must all be properly pre-
ferved in glass bottles or ftone jars well tied
over; glazed earthen veffels are very dan-
gerous either for preferves or pickles.
Allowing cyder, &c. to the fleet, in-
deed, may be deemed a very expenfive
project; but where the lives of fo many
brave and uſeful people are in the cafe, I
think (as Dr. Huxham very humanely ob-
ferved) the coft fhould by no means come
into competition with the advantage that
may be received from it. The Romans
conftantly carried with them vinegar and
wine in their fleets and armies, and the
common foldier and failor daily partook of
both; nay, they were at many other con-
fiderable expences to preferve the health of
their armies, &c. Now, if that glorious
prudent people thought the life of a Ro-
man foldier fo valuable, and were at fuch
expence to preferve it, why fhould not we
have as much regard to that of a Britiſh
failor
T

150 DIRECTIONS FOR
failor, who is altogether as brave, and as
uſeful to the Common wealth?
It is neceffary here alfo to remark, that
the ufual method of impreffing feamen on
their return from long and tedious voyages,
void of neceffaries, chagrined at not feeing
their friends and families, and moft com-
monly in a bad ftate of health, and not
allowed time and opportunity to recover
it, hath been the bane of thoufands: and
I moft heartily with, for the honor of the
nation and the good of the public, that a
method of manning our fleet could be
found out more confiftent with common
humanity and British liberty; and like-
wife to have it ferved with more whole-
fome provifion, better beer, and a fufficient
quantity of found generous cyder on board
every fhip, to be ufed at difcretion, and as
neceffity required; from the foregoing re-
marks it is evident what advantages would
accrue from it.
RULES

RULES FOR PRESERVING HEALTH,
IN WAR M, AND COLD CLIMATES, BY
DOCTOR LIND, and SURGEON NORTHCOTE.
EAT itfelf is not fo prejudicial to
H Health as is generally imagined; but
when joined to moisture it is remark-
ed, that it occafions the moft fatal dif-
tempers in all warm climates.
When a fhip rides at anchor near marshy
ground or fwamps, and the wind blows di-
rectly from thence in hot weather, the gun
ports ought to be kept fhut; and if the rides
with her head to the wind, a thick fmoke
fail fhould be conftantly kept up to the fore-
maft, to carry up the fmoke of the galley,
and prevent its coming aft over the ſhip: at
fuch times the men fhould be injoined to
fmoke tobacco, and the fhip fhould often be
fumigated with it, as well as with pitch
and tar; the method of procuring tobacco
to be fo ufed, without any additional ex-
pence to the government, is, inſtead of
burning the great quantities every year feiz-
ed by the coftom-houfe and excife-officers,
to order it to be preferved, and fent to the
dock yards to fupply the fhips deftined for
foreign voyages; it may be either added to
the boatswain's or carpenter's ftores, in fuch
large quantities as may be thought convenient>
for the above ufe of fumigating: to prevent

152
IN
DIRECTIONS
abufe, it should never be uſed without the
captain's order, and always iffued out by
weight; it would likewife be proper that
centinels fhould attend the burning it to
prevent embezzlement, which precaution
in my opinion would be of infinite advantage
on many occafions, and a much more pru-
dent way than the preſent method of con-
fuming it, without the leaft benefit accruing
to any individual.
Boats crews and men employed on fhore,
being moſt expoſed to the open air, fhould
be often relieved, and never fuffered to fleep
on fhore, not even in tents or otherwife, if
to be avoided; but should always be obliged
to return and lie aboard at night: but when
this cannot be complied with, and men are
obliged to remain on fhore, their tents
fhould be very clofe, and erected on the
dryeft fpot they can find, that is, upon dry
fand, gravel, or chalk, near the fea fhore.
The negroes, and fome of the Indians on
the coaft of Guinea, both of whom fleep on
the ground, have conftantly a fire producing
a little fmoke burning in the huts where
they fleep, which corrects the moisture of
the night, and renders the damp of the earth
lefs noxious; therefore if your tent is made
on the grafs, and at a diftance from the fea-
hore, it will be neceffary to obferve the
fame rule: the door of the tent fhould be
towards the fea, and the back part fecured

WARM AND COLD CLIMATES. 153
by double canvas.
All old forfaken houſes,
caves, and fuch like places, fhould be well
purified with large fires; the men fhould
never fleep on the ground, but in their
hammocks, and be very well covered; every
morning and evening they fhould take a
dram of the fpirituous tincture of the bark:
likewife the officers and men, when on
fhore, fhould be allowed a more plentiful,
but not immoderate ufe of vinous liquors.
Dr. LIND fays, that people coming
firft from a cold into a hot climate,
are apt to have plethoric fymptoms
(which in general I have found to be the
cafe in many fouthern voyages, with fome
few exceptions) a pain of the head, giddi-
nefs, a fenfe of the weight, and fulness of
the breaft, and fome are apt to be feized
with ardent fevers and diarrhoeas.
All practitioners have obferved, that new
comers into warm climates are at firft liable
to fevers tending to the ardent kind, and
are very fubject to fevers of the remitting
and intermitting kind, which are the en-
demics of all warm countries at certain fea-
fons of the year; and after fome time they
are apt to fall into fluxes, the yellow-fever,
and othe difeafes depending on a putrefcent
ftate of the juices.
Nothing has been found to be more pro-
ductive of difeafes in thofe warm climates,
than indulging freely in the ufe of fpirits and

154
IN
DIRECTIONS
other ftrong fermented liquors, lying on
the ground, being expofed to damps and
dews, and working hard, or ufing violent
exercife in the heat of the day.
The moft dangerous difeafes in intem-
perate, climates, and voyages to the fouth-
ward, proceed from a continuance of hot,
moift, clofe weather, or from heavy rains,
common at fome feafons of the year be-
tween the Tropics; at firft a few of the
men are feized with the bloody-flux, which
is fucceeded by a malignant fever of the
remitting or intermitting kind, but most
commonly it is like a double tertian: this is
epidemic between the Tropics, and is the
autumnal fever of all hot countries; the
fafety of the patient entirely depends on
the fever's intermitting, or at leaſt on its
temitting fo much as to allow an opportu-
nity of throwing in the bark, which is the
only fovereign remedy in thefe fort of ma-
lignant fevers, though they put on differ-
ent appearances.
The bark might be made extremely pa-
latable by infufing it in fpirits with orange
peel, and the billious fever and the bloody
flux might be prevented by it: four ounces
of bark and two ounces of dried orange
peel will be fufficient for a gallon of fpirits;
and two ounces may be allowed each man
a day when there is an apprehenfion of
thefe malignant difeafes: it will be beft to

WARM AND COLD CLIMATES.
155
take half in the morning on an empty fto-
mach, and the other half when they are
called out to their night watch.
The bark is an excellent medicine for
failors on many accounts, it being the
greateſt antifeptic taken inwardly of any
yet difcovered; but as it is a very expenfive
drug in England, it is not to be fuppofed
that fhips will carry fuch a quantity of
it as to be of common benefit to the whole
crew: though this may unhappily be the
cafe for the poor feamen, yet they may be
fupplied at the cheapest rate with a medicine
of nearly equal goodnefs and efficacy from
our own foil, and if prudently employed,
the fcurvy, that maritime peftilence, will
feldom or never make its alarming appear-
ance among a fhip's crew on long and dan-
gerous voyages, proper care with regard to
cleanlinefs and provifions being obferved;
the medicine here recommended to their
ufe is the fine bark of the English oak,
which is eafily preferved, and may be con-
veniently taken in the quantity of a drachm
at a time, occafionally in powder, extract,
decoction, or tincture. In intermittents
(for poor people) it has been frequently
ufed with fuccefs.
It is neceffary to obferve, that in fultry
climates, or during hot weather in all
places fubject to great rains, where the
country is over-run by thickets, fhrubs, or

156
DIRECTIONS IN
woods, efpecially if there are marshes or
ftagnating waters in the neighbourhood
(which are exceedingly pernicious to the
health of all Europeans) the malignant
difeafes above-mentioned may justly be
dreaded: the fens and marthes even in
England are bad for ftrangers.
The hip fhould never lie fo near the
fhore, as that the mountains (if there be
any) may intercept the fea breezes (or in
the fea term, the fhould never be land
lock'd); the fame precautions are neceffary
in places, either during or foon after the
rainy feafon : in hot climates wind- fails in
in the day-time fhould conftantly be kept
up, and at fea in the night likewife; the
ventilators fhould be continually worked,
and the lower deck ports kept open, when
the weather will permit, from fun rifing to
fun-fet; the decks must be kept cleant
fcraped and washed, but the latter never
after fun-fet. When fickness begins on
board a fhip, the fick fhould immediately
be removed as much as conveniently may
be from the found; the fick-birth fhould
be as airy as poffible, without expofing the
fick to catch cold, and always kept as clean
as may be; the centinels over the fick
fhould conftantly empty and wash the buc-
kets which the fick make use of every
watch.
The fhip (particularly a new one) fhould

WARM AND COLD CLIMATES.
157
be every day fumigated with the fteams of
tar or pitch, and in wet, damp weather,
fires often lighted between decks, with
proper centinels over them to prevent any
danger.
To boil vinegar between decks or in the
hold fills the whole cavity of the hull with
a vapour that is falutary and antifeptic to a
very great degree; and this may perhaps
be the best way of ufing vinegar to prevent
a corruption of the air, or the fpreading of
difeafes; fumes of tobacco (as already men-
tioned) may be employed to the fame pur-
poſe with good fuccefs.
The cloaths of the fick and the fick
birth ought particularly to be fumigated
their foul cloaths fhould always be inftantly
fprinkled with vinegar, or tied to a rope
and plunged into the fea, to wash them
from all feeds of contagion; vinegar fhould
alfo be difperfed plentifully every where
through the fhip, cloths dipt in it hung up
in all parts, and fresh vinegar frequently
fprinkled upon them, to keep the vapour
of it continually afloat, but especially the
fick birth ought to be daily well waſhed
with vinegar.
The ufe of cold bathing-tubs under the
fore caftle, and bathing in the fea early in
the morning, have been found extremely
beneficial in hot countries, for this practice
U

158
IN
DIRECTIONS
not only braces up the fibres, and contri
butes to health but cleanlinefs likewife, and
promotes perfpiration; but then the people
fhould not ftay too long in the water, nor
go in when overheated with work or liquor,
nor when the ftomach is full, or there is
an eruption with a prickly heat on the fkin.
Diarrhoeas and other complaints, the ef-
fects of great heat, have been cured by
bathing, and their returns prevented.
Wine is the best of all cordials in the de-
cline of fevers, (provided it is found and
good) and is a much better restorative than
rum, or any other fpirits however mixed
or prepared; it is likewife an excellent
means to prevent infection; fome cafks of
Madeira Wine (which keeps good in all
climates) fhould be preferved for the ufe of
the fick in thefe voyages.
The fwallowing large draughts of undi-
luted fpirits has always the moft fatal con-
fequences in every climate; but when they
are converted into punch, they become
very falutary, preventing difeafes which a-
rife from hot and moift weather, and the
tendency to corruption in the animal fluids,
which is conftantly induced thereby; as
cleanlinefs alone greatly contributes
to
health, it may not be amifs to propofe,
that when at fea, the feamen and marines
fhould be muftered when the feparate
watches are called every Sunday, and pafs

WARM AND COLD CLIMATES. 159
in review by the officer of the watch, and
thoſe that are then dirty, having a foul fhirt,
troufers, &c. fhall have their allowance of
liquor, whether beer, wine, or grog, ftopt
for that day (by the captains order); for
the fecond offence to ftand in the pillory on
the quarter-deck, and for the third, to
receive a dozen lashes at the gangway: the
fame notice might be taken of their ham-
mocks, when the captain thinks proper to
have them examined; by this method the
people would always be wholeſome and
clean, and confequently much healthier,
for in every fhip, there are a number of
dirty lubbers, particularly among the wafte
guard and marines; and the cooks mates
and his attendants are generally as bad,
as any.
I thall here only mention that when men
are feized with inflammatory fymptoms on
entering into warm climates, they may
be blooded freely; afterwards they do not
eafily bear fuch copious evacuations, but
rather require to have them made in fmaller
quantities, and very early and frequent, as
inflammations make a rapid progrefs in
warm countries.
Doctor Lind fays, many practitioners
difapprove of bleeding in thofe countries.
which lie under the torrid zone, on a fup-
pofition that the blood is too much diffolv-
ed, but he thinks (very juftly) that this

160
IN
DIRECTIONS
rule will admit of many exceptions, and
that failors being ftrong and expofed to
greater viciffitudes of heat and cold, and
more exceffes and other accidents, bear
freer bleeding in general than any other fet
of people. After fome time the difeafes in
thefe warm climates tend to the putrid
kind, and then must be treated as fuch.
In warm climates the fhips are generally
moft healthy at fea, where the air is dry
and ferene, and the heat moderated by
refrefhing breezes.
RULES FOR PRESERVING
HEALTH,
IN COL D CLIMATES.
N northern climates and channel cruiz-
ing, though the cold is intenfe, yet if
the air is pure and dry and the men are
well cloathed, there are few difeafes; but
when the weather is unfettled, cloudy,
wet and rainy, the ufual confequences are
colds, attended with feverish and inflam-
matory fymptoms, and especially rheu-
matic, pleuritic, and peripneumonic com-
plaints; thefe laft require plentiful evacu-
ations, but chiefly bleeding, which, when
timely and freely ufed, will prevent con-
fumptions and chronic rheumatifms.
When the men are almoft conftantly
wet and chill from bad weather, and un-
dergo an uncommon degree of fatigue, it

WARM AND COLD CLIMATES.
161
will be proper to let them have the follow-
ing mixture, viz. a pint of fmall beer, and
a quartern of brandy fweetened with mo-
laffes, to which may be added as much
vinegar as will render the mixture palata-
ble; or, inftead of the laft, cream of tar-
tar; this the Ruffians call afbbetten. Dry
beds and cloathing are moft neceffary arti
cles; for it is obfervable that the moft
naked ragged fellows are principally at-
tacked with winter difeafes.
The fcurvy is a difeafe common in the
winter and fpring; the method to prevent
which is already laid down in the preceding
fection, and to which the reader is referred.
Dr. Lind fays, the moft proper cordial
dram a failor can ufe in the winter is
gar-
lic brandy, for a fmall quantity of it, not
only warms the ftomach, but keeps the
breaft, kidneys, and fkin free from obftruc-
tions; but neither this nor any other dram
fhould be given to a man almoft chilled to
death with cold, having his limbs quite
benumbed, and their extremities froft bit
(as it is called); for, in this cafe, it has
often proved fatal; but he fhould be im-
mediately put into a warm bed, and have
fome warm gruel, fage tea, or fome fuch
diluting liquor, given him; after which a
dram may be allowed, when it will
lefs dangerous, and more beneficial.
prove

162
IN
DIRECTIONS
A very remarkable cafe to this purpofe is
related by Hildanus, viz. a man was found
quite fliff and frozen all over; he was put
into cold water, and immediately the icy
fpicula' were diſcharged from all parts of
his body, fo that he feemed covered with
an icy cruft; he was then put into a warm
bed, took a cordial draught, and a
plentiful fweat followed; after which he
recovered with the lofs of the laft joints of
his fingers and tocs. De Gangræna, chap.
XIII.
People who are benumbed with cold in
frofty weather, ought never to be brought
immediately near a fire; for that has been
found either to caufe immediate death, or
gangrenes of the extremities. Any kind
of fruit frozen, when put immediately to
the fire, will turn foft and rot; but if put
into cold water, it throws out the icy
fpicula, and recovers fo as to be almoft as
good as before, which, proves the above
method ufed with the man to be right.
In cold rainy weather, tea' made with
fage, faflafras, or a few roafted juniper ber-
ries, with the addition of a little garlic
brandy, will be very beneficial; likewife a
man will never be fo liable to catch cold
when he is wet upon the deck, and ufes
exercife, as when he is below in his wet
cloaths, or fleeps in them, or in a damp
bed; when he goes upon deck he ſhould

WARM AND COLD CLIMATES.
163
eat a bit of bifcuit, and drink a little afhbet-
ten, and then the weather will probably.
have but little power to alter his health for
the worſe.
When a failor happens to be dead drunk,
his head fhould be raifed, and a fpunge
dipped in vinegar fhould be held to his nofe;
and if he can drink, he fhould have warm
water mixed with vinegar; bleeding will
likewife be proper, and a gentle emetic
which operates fpeedily, fuch as the
oxymel. fcillitic. fal vitriol. &c.
Likewife dipping the feet in cold water
will take off the preffure from the brain;
and folutive clyfters will abate the diften-
fion; it is but too well known how many
people loſe their lives by exceffive drinking,
and fpirituous liquors; the fame treatment
will be ufeful after a large dofe of opium.
Thefe methods here laid down (chiefly
taken from Doctor Lind) but partly from
others, I have practifed for many years in
the royal navy; and with the bleffing of God
it has in general been attended with great
fuccefs; for which reafon I can the more
ftrongly recommend it; if it be true, as was
publiſhed in December 1760, taken as is
fuppofed from returns made to the Houfe of
Commons, that of 185,000 men, railed for
the fea-fervice during the late war, above
130,000 perifhed by difeafes; and that two
thirds of this number may be fafely charged

164
&c.
DIRECTIONS,
to the accousit of diſeaſes that take their rife
from putrefaction; furely every motive of
policy and humanity fhould excite men to
endeavour at finding out fomewhat to check
that fatal and deftructive diathefis; for if fea-
men could be preferved free from it other
kinds of difeafes would feldom endanger
them.
FINI S.
Philadelphia, May 6th, 1776.
Shortly will be Published by ROBERT BELL,
in Third Street,
A NEW EDITION OF
PLAIN
CONCISE
PRACTICAL REMARKS,
ON THE TREATMENT OF
WOUNDS AND FRACTURES;
To which is Added, An APPENDIX,
ON
CAMP AND MILITARY HOSPITALS;
PRINCIPALLY
Defigned, for the Ufe of young Military and Naval
Surgeons in NORTH-AMERICA.
By JOHN JONES, M. D.
Profeffor of Surgery, in King's College, New York.
N. B. At faid Bell's next door to St. Paul's Church
in Third Street Philadelphia; Are now felling,
SIMES's MILITARY GUIDE, two volumes,
in neat bindings, price three dollars;
Alfo, great variety of new and old BOOKS ;
Likewife, all the neweft political Pamphlets;
Either for, or againft, INDEPENDENCY.







16661
776 Swieten, Gerard, früherr von
Sw