But the most general cause of nervous disorders is indolence. The active and laborious are seldom troubled with them. They are reserved for the children of ease and affluence, who generally feel their keenest force. All we shall say to such persons is, that the means of prevention and cure are both in their own power. If the constitution of human nature be such, that man must either labour or suffer diseases, surely no individual has any right to expect an exemption from the general rule.
Those however who are willing to take exercise, but whose occupations confine them to the house, and perhaps to an unfavourable posture, really deserve our pity. We have in a former part of the book endeavoured to lay down rules for their conduct; and shall only add, that where these cannot be complied with, their place may, in some measure, be supplied by the use of bracing and strengthening medicines, as the Peruvian bark, with other bitters; the preparations of steel; the elixir of vitriol, &c.
We do not mean to treat of the nature of our sensations, or to give a minute description of the various organs by which they are performed; but to point out some of the diseases to which these organs are most liable, and to shew how they may be prevented or remedied.
No organ of the body is subject to more diseases than the eye; nor is there any one of which the diseases are more difficult to cure. Though more ignorant persons pretend to cure these than any other class of diseases; yet a very superficial acquaintance with the structure of the eye, and the nature of vision, will be sufficient to convince any one of the danger of trusting to them. These diseases often exceed the skill of the most learned physician; hence we may easily infer the danger of trusting them to ignorant quacks, who, without all peradventure, put out more eyes than they cure. But, though the diseases of the eye can seldom be cured, they might often, by due care, be prevented; and, even where the sight is totally lost, many things might be done, which are generally neglected, to render the unhappy person both more useful to himself and to society[155].
The eyes are hurt by viewing bright or luminous objects; keeping the head too long in a hanging posture; violent head-achs; excessive venery; the long use of bitters; the effluvia from acrid or volatile substances; various diseases; as the small-pox, measles, &c. but, above all, from night-watching, and candle-light studies. Long fasting is likewise hurtful to the eyes, and frequent heats and colds are no less pernicious. The eyes are often hurt by the stoppage of customary evacuations; as morning sweats; sweating of the feet; the menses in women; and the bleeding piles in men. All kinds of excess are likewise hurtful to the sight, particularly the immoderate use of ardent spirits and other strong liquors.
In all diseases of the eyes, especially those attended with inflammation, the cool regimen ought to be observed. The patient must abstain from all spirituous liquors. The smoke of tobacco, smoky rooms, the vapours of onions and garlic, and all vivid lights and glaring colours, are carefully to be avoided. The drink may be water, whey, or small beer; and the aliment must be light and of easy digestion.
For preventing disorders of the eyes, issues and setons are of prime use. Every person, whose eyes are tender, ought to have one or more of these in some part of the body. It will likewise be of use to keep the body gently open, and either to bleed or purge every spring and fall. All excess and night studies are to be avoided. Such as do not chuse a seton or an issue, will find benefit from wearing a small Burgundy-pitch plaster between their shoulders.
A gutta serena, or amaurosis, is an abolition of the sight without any apparent cause or fault in the eyes. When it is owing to a decay or wasting of the optic nerve, it does not admit of a cure; but when it proceeds from a compression of the nerves by redundant humours, these may in some measure be drained off, and the patient relieved. For this purpose, the body must be kept open with the laxative mercurial pills. If the patient be young and of a sanguine habit, he may be bled. Cupping, with scarifications on the back part of the head, will likewise be of use. A running at the nose may be promoted by volatile salts, stimulating powders, &c. But the most likely means for relieving the patient are issues or blisters kept open for a long time on the back part of the head, behind the ears, or on the neck. I have known these restore sight, even after it had been for a considerable time lost.
Should these fail, recourse must be had to a mercurial salivation; or what will perhaps answer the purpose better, twelve grains of the corrosive sublimate of mercury may be dissolved in an English pint and a half of brandy, and a table-spoonful of it taken twice a-day, drinking half a pint of the decoction of sarsaparilla after it.
A cataract is an obstruction of the pupil, by the interposition of some opaque substance which either diminishes or totally extinguishes the sight. It is generally an opacity of the crystalline humour. In a recent or beginning cataract, the same medicines are to be used as in the gutta serena; and they will sometimes succeed. But when this does not happen, and the cataract becomes firm, it must be couched, or rather extracted. I have resolved a recent cataract by giving the patient frequent purges with calomel, keeping a poultice of fresh hemlock constantly upon the eye, and a perpetual blister on the neck.
The myopia, or short sightedness, and the presbyopia, or seeing only at too great a distance, are disorders which depend on the original structure or figure of the eye, therefore admit of no cure. The inconveniencies arising from them may however be, in some measure, remedied by the help of proper glasses. The former requires the aid of a concave, and the latter of a convex glass.
A strabismus, or squinting, depends upon an irregular contraction of the muscles of the eye from a spasm, palsy, epilepsy, or an ill habit. Children often contract this disorder by having their eyes unequally exposed to the light. They may likewise acquire it by imitation from a squinting nurse or play-fellow, &c. As this disorder can hardly be cured, parents ought to be careful to prevent it. Almost the only thing which can be done for it is, to contrive a mask for the child to wear, which will only permit him to see in a straight direction.
Spots or specks on the eyes are generally the effect of inflammation, and often appear after the small-pox, the measles, or violent ophthalmias. They are very difficult to cure, and often occasion total blindness. If the specks are soft and thin, they may sometimes be taken off by gentle caustics and discutients; as vitriol, the juice of celandine, &c. When these do not succeed, a surgical operation may be tried: the success of this however is always very doubtful.
The blood-shot eye may be occasioned by a stroke, a fall, retching, vomiting, violent coughing, &c. I have frequently known it happen to children in the hooping-cough. It appears at first like a bit of scarlet, and is afterwards of a livid or blackish colour. This disorder generally goes off without medicine. Should it prove obstinate, the patient may be bled, and have his eyes fomented with a decoction of comphrey roots and elder flowers. A soft poultice may be applied to the eyes; and the body should be kept open by gentle purgatives.
The watery, or weeping eye, is generally occasioned by a relaxation or weakness of the glandular parts of that organ. These may be braced and strengthened by bathing the eye with brandy and water, Hungary-water, rose-water with white vitriol dissolved in it, &c. Medicines which make a revulsion are likewise proper; as mild purgatives, perpetual blisters on the neck, bathing the feet frequently in lukewarm water, &c.
When this disease proceeds from an obstruction of the lachrymal duct, or natural passage of the tears, it is called a fistula lachrymalis, and can only be cured by a surgical operation.
The functions of the ear may be injured by wounds, ulcers, or any thing that hurts its fabric. The hearing may likewise be hurt by excessive noise; violent colds in the head; fevers; hard wax, or other substances sticking in the cavity of the ear; too great a degree of moisture or dryness of the ear. Deafness is very often the effect of old age, and is incident to most people in the decline of life. Sometimes it is owing to an original fault in the structure or formation of the ear itself. When this is the case, it admits of no cure; and the unhappy person not only continues deaf, but generally likewise dumb, for life[156].
When deafness is the effect of wounds or ulcers of the ears, or of old age, it is not easily removed. When it proceeds from cold of the head, the patient must be careful to keep his head warm, especially in the night; he should likewise take some gentle purges, and keep his feet warm, and bathe them frequently in lukewarm water at bed-time. When deafness is the effect of a fever, it generally goes off after the patient recovers. If it proceeds from dry wax sticking in the ears, it may be softened by dropping oil into them; afterwards they must be syringed with warm milk and water.
If deafness proceeds from dryness of the ears, which may be known by looking into them, half an ounce of the oil of sweet almonds, and the same quantity of liquid apodeldoch, or tincture of asafœtida, may be mixed together, and a few drops of it put into the ear every night at bed-time, stopping them afterwards with a little wool or cotton. Some, instead of oil, put a small slice of the fat of bacon into each ear, which is said to answer the purpose very well. When the ears abound with moisture, it may be drained off by an issue or seton, which should be made as near the affected parts as possible.
Some, for the cure of deafness, recommend the gall of an eel mixed with spirit of wine, to be dropped into the ear; others, equal parts of Hungary-water and spirit of lavender. Etmuller extols amber and musk; and Brookes says, he has often known hardness of hearing cured by putting a grain or two of musk into the ear with cottonwool. But these and other applications must be varied according to the cause of the disorder[157].
Though such applications may sometimes be of service, yet they much oftner fail, and frequently they do hurt. Neither the eyes nor ears ought to be tampered with; they are tender organs, and require a very delicate touch. For this reason, what we would chiefly recommend in deafness, is, to keep the head warm. From whatever cause the disorder proceeds, this is always proper; and I have known more benefit from it alone, in the most obstinate cases of deafness, than from all the medicines I ever used.
Though these senses are not of so great importance to man in a state of society, as the sight and hearing; yet, as the loss of them is attended with some inconveniency, they deserve our notice. They are seldom to be restored when lost; which ought to make us very attentive to their preservation, by carefully avoiding whatever may in the least prove injurious to them. As there is a very great affinity between the organs of tasting and smelling, whatever hurts the one generally affects the other.
Luxury is highly injurious to these organs. When the nose and palate are frequently stimulated by fragrant and poignant dishes, they soon lose the power of distinguishing tastes and odours with any degree of nicety. Man, in a state of nature, may perhaps have these faculties as acute as any other animal.
The sense of smelling may be diminished or destroyed by diseases; as, the moisture, dryness, inflammation or suppuration of that membrane which lines the inside of the nose, commonly called the olfactory membrane; the compression of the nerves which supply this membrane, or some fault in the brain itself at their origin. A defect, or too great a degree of solidity, of the small spungy bones of the upper jaw, the caverns of the forehead, &c. may likewise impair the sense of smelling. It may also be injured by a collection of fœtid matter in those caverns, which keeps constantly exhaling from them. Few things are more hurtful to the sense of smelling than taking great quantities of snuff.
When the nose abounds with moisture, after gentle evacuations, such things as tend to take off irritation, and coagulate the thin sharp serum, may be applied; as the oil of anise mixed with fine flour; camphire dissolved in oil of almonds, &c. The vapours of amber, frankincense, gum-mastic, and benjamin, may likewise be received into the nose and mouth.
For moistening the mucus when it is too dry, some recommend snuff made of the leaves of marjoram, mixed with the oil of amber, marjoram and aniseed; or a sternutatory of calcined white vitriol; twelve grains of which may be mixed with two ounces of marjoram-water, and filtrated. The steam or vapour of vinegar upon hot iron received up the nostrils is likewise of use for softening the mucus, opening obstructions, &c.
If there is an ulcer in the nose, it ought to be dressed with some emollient ointment, to which, if the pain be very great, a little laudanum may be added. If it be a venereal ulcer, it is not to be cured without mercury. In that case, the solution of the corrosive sublimate in brandy may be taken, as directed in the gutta serena. The ulcer ought likewise to be washed with it; and the fumes of cinnabar may be received up the nostrils.
If there be reason to suspect that the nerves which supply the organs of smelling are inert, or want stimulating, volatile salts, strong snuffs, and other things which occasion sneezing, may be applied to the nose. The forehead may likewise be anointed with balsam of Peru, to which may be added a little of the oil of amber.
The taste may be diminished by crusts, filth, mucus, aphthæ, pellicles, warts, &c. covering the tongue: it may be depraved by a fault of the saliva, which, being discharged into the mouth, gives the same sensation as if the food which the person takes had really a bad taste; or it may be entirely destroyed by injuries done to the nerves of the tongue and palate. Few things prove more hurtful either to the sense of tasting or smelling than obstinate colds, especially those which affect the head.
When the taste is diminished by filth, mucus, &c. the tongue ought to be scraped and frequently washed with a mixture of water, vinegar, and honey, or some other detergent. When the saliva is vitiated, which seldom happens unless in fevers or other diseases, the curing of the disorder is the cure of this symptom. To relieve it however in the mean time, the following things may be of use; if there be a bitter taste, it may be taken away by vomits, purges, and other things which evacuate bile. What is called a nidorous taste, arising from putrid humours, is corrected by the juice of citrons, oranges, and other acids. A salt taste is cured by plentiful dilution with watery liquors. An acid taste is destroyed by absorbents, and alkaline salts, as powder of oyster-shells, salt of wormwood, &c.
When the sensibility of the nerves which supply the organs of taste is diminished, the chewing of horse-radish, or other stimulating substances, will help to recover it.
The sense of touching may be hurt by any thing that obstructs the nervous influence, or prevents its being regularly conveyed to the organs of touching; as pressure, extreme cold, &c. It may likewise be hurt by too great a degree of sensibility, when the nerve is not sufficiently covered by the cuticle or scarf-skin, or where there is too great a tension of it, or it is too delicate. Whatever disorders the functions of the brain and nerves, hurts the sense of touching. Hence it appears to proceed from the same general causes as palsy and apoplexy, and requires nearly the same method of treatment.
In a stupor, or defect of touching, which arises from an obstruction of the cutaneous nerves, the patient must first be purged; afterwards such medicines as excite the action of the nerves, or stimulate the system, may be used. For this purpose, the spirit of hartshorn, sal volatile oleosum, horse-radish, &c. may be taken inwardly; the disordered parts, at the same time, may be frequently rubbed with fresh nettles or spirit of sal ammoniac. Blistering-plasters and sinapisms applied to the parts will likewise be of use, as also warm bathing, especially in the natural hot baths.
A scirrhus is a hard indolent tumour seated in some of the glands; as the breasts, the armpits, &c. If the tumour becomes large, unequal, of a livid, blackish, or leaden colour, and is attended with violent pain, it gets the name of an occult cancer. When the skin is broken, and a sanies or ichorous matter of an abominably fœtid smell is discharged from the sore, it is called an open or ulcerated cancer. Persons after the age of forty-five, particularly women, and those who lead an indolent sedentary life, are most subject to this disease.
CAUSES.——This disease is often owing to suppressed evacuations; hence it proves so frequently fatal to women of a gross habit, particularly old maids and widows, about the time when the menstrual flux ceases. It may likewise be occasioned by excessive fear, grief, anger, religious melancholy, or any of the depressing passions. Hence the unfortunate, the choleric, and those persons who devote themselves to a religious life in convents or monasteries, are often afflicted with it. It may also be occasioned by the long-continued use of food that is too hard of digestion, or of an acrid nature; by barrenness; celibacy; indolence; cold; blows; friction; pressure; or the like. Women often suffer from the last of these by means of their stays, which squeeze and compress their breast so as to occasion great mischief. Sometimes the disease is owing to an hereditary disposition.
SYMPTOMS.——This disorder seems often very trifling at the beginning. A hard tumour about the size of a hazle-nut, or perhaps smaller, is generally the first symptom. This will often continue for a long time without seeming to increase, or giving the patient great uneasiness; but if the constitution be hurt, or the tumour irritated by pressure, or improper treatment of any kind, it begins to extend itself towards the neighbouring parts by pushing out a kind of roots or limbs. It then gets the name of cancer, from a fancied resemblance between these limbs and the claws of a crab. The colour of the skin begins to change, which is first red, afterwards purple, then bluish, livid, and at last black. The patient complains of heat, with a burning, gnawing, shooting pain. The tumour is very hard, rough, and unequal, with a protuberance, or rising, in the middle; its size increases daily, and the neighbouring veins become thick, knotty, and of a blackish colour.
The skin at length gives way, and a thin sharp ichor begins to flow, which corrodes the neighbouring parts till it forms a large unsightly ulcer. More occult cancers arise, and communicate with the neighbouring glands. The pain and stench become intolerable; the appetite fails; the strength is exhausted by a continual hectic fever; at last, a violent hæmorrhage, or discharge of blood, from some part of the body, with faintings, or convulsion fits, generally put an end to the miserable patient’s life.
REGIMEN.——The diet ought to be light, but nourishing. All strong liquors, and high-seasoned or salted provisions, are to be avoided. The patient may take as much exercise as he can easily bear; and should use every method to divert thought, and amuse his fancy. All kinds of external injury are carefully to be guarded against, particularly of the affected part, which ought to be defended from all pressure, and even from the external air, by covering it with fur or soft flannel.
MEDICINE.——This is one of those diseases for which no certain remedy is yet known. Its progress however may sometimes be retarded, and some of its most disagreeable symptoms mitigated, by proper applications. One misfortune attending the disease is, that the unhappy patient often conceals it too long. Were proper means used in due time, a cancer might often be cured; but after the disorder has arrived at a certain height, it generally sets all medicine at defiance.
When a scirrhous tumour is first discovered, the patient ought to observe a proper regimen, and to take twice or thrice a-week a dose of the common purging mercurial pill. Some blood may also be let, and the part affected may be gently rubbed twice a-day with a little of the mercurial ointment, and kept warm with fur or flannel. The food must be light, and an English pint of the decoction of woods or sarsaparilla may be drank daily. I have sometimes discussed hard tumours, which had the appearance of beginning cancers, by a course of this kind.
Should the tumour however not yield to this treatment, but, on the contrary, become larger and harder, it will be proper to extirpate it, either by the knife or caustic. Indeed, whenever this can be done with safety, the sooner it is done the better. It can answer no purpose to extirpate a cancer after the constitution is ruined, or the whole mass of humours corrupted by it. This however is the common way, which makes the operation so seldom succeed. Few people will submit to the extirpation till death stares them in the face; whereas, if it were done early, the patient’s life would not be endangered by the operation, and it would generally prove a radical cure.
When the cancer is so situated that it cannot be cut off, or if the patient will not submit to the operation, such medicines as will mitigate or relieve the most urgent symptoms may be used. Dr. Home says, that half a grain of the corrosive sublimate of mercury, dissolved in a proper quantity of brandy, and taken night and morning, will often be of service in cancers of the face and nose. He likewise recommends an infusion of the solanum, or night-shade, in cancers of the breasts.
But the medicine most in repute at present for this disease is hemlock. Dr. Stork, physician at Vienna, has of late recommended the extract of this plant as very efficacious in cancers of every kind. The Doctor says, he has given some hundred weights of it without ever hurting any body, and often with manifest advantage. He advises the patient however to begin with very small doses, as two or three grains, and to increase the dose gradually till some good effect be perceived, and there to rest without further increase. From two or three grains at first, the Doctor says he has increased the dose to two, three, or four drachms a-day, and finds that such doses may be continued for several weeks without any bad consequences.
The regimen which the Doctor recommends during the use of the medicine, is to avoid farinaceous substances not fermented, and too acrid aromatics. He says, good wine will not be hurtful to those who are accustomed to it, nor a moderate use of acids; and adds, that the patient should live in a pure free air, and keep his mind as quiet and cheerful as possible.
The Doctor does not pretend to fix the time in which a cancer may be resolved by the use of hemlock, but says he has given it for above two years in large doses without any apparent benefit; nevertheless the patient has been cured by persisting in the use of it for half a year longer. This is at least encouragement to give it a fair trial. Though we are far from thinking the hemlock merits those extravagant encomiums which the Doctor has bestowed upon it, yet, in a disease which has so long baffled the boasted powers of medicine, we think it ought always to be tried.
The powder of hemlock is by some preferred to the extract. They are both made of the fresh leaves, and may be used nearly in the same manner. Dr. Nicholson of Berwick says, he gradually increased the dose of the powder from a few grains to half a drachm, and gave near four drachms of it in the day with remarkably good effects. The hemlock may also be used externally either as a poultice or fomentation. The sore may likewise be kept clean by injecting daily a strong decoction of the tops and leaves into it.
Few things contribute more to the healing of foul sordid ulcers of any kind than keeping them thoroughly clean. This ought never to be neglected. The best application for this purpose seems to be the carrot poultice. The root of the common carrot may be grated, and moistened with as much water as will bring it to the consistence of a poultice or cataplasm. This must be applied to the sore, and renewed twice a-day. It generally cleans the sore, eases the pain, and takes away the disagreeable smell, which are objects of no small importance in such a dreadful disorder[158].
Wort, or an infusion of malt, has been recommended not only as a proper drink, but as a powerful medicine in this disease, It must be frequently made fresh, and the patient may take it at pleasure. Two, three, or even four English pints of it may be drank every day for a considerable time. No benefit can be expected from any medicine in this disease, unless it be persisted in for a long time. It is of too obstinate a nature to be soon removed; and, when it admits of a cure at all, it must be brought about by inducing an almost total change of the habit, which must always be a work of time. Setons or issues in the neighbourhood of the cancer have sometimes good effects[159].
When all other medicines fail, recourse must be had to opium, as a kind of solace. This will not indeed cure the disease, but it will ease the patient’s agony, and render life more tolerable while it continues.
To avoid this dreadful disorder, people ought to use wholesome food; to take sufficient exercise in the open air; to be as easy and cheerful as possible; and carefully to guard against all blows, bruises, and every kind of pressure upon the breasts or other glandular parts[160].
Every person ought, in some measure, to be acquainted with the nature and cure of poisons. They are generally taken unawares, and their effects are often so sudden and violent, as not to admit of delay, or allow time to procure the assistance of physicians. Happily indeed no great degree of medical knowledge is here necessary; the remedies for most poisons being generally at hand, or easily obtained, and nothing but common prudence needful in the application of them.
The vulgar notion, that every poison is cured by some counter-poison, as a specific, has done much hurt. People believe they can do nothing for the patient, unless they know the particular antidote to that kind of poison which he has taken. Whereas the cure of all poisons taken into the stomach, without exception, depends chiefly on discharging them as soon as possible.
There is no case wherein the indications of cure are more obvious. Poison is seldom long in the stomach before it occasions sickness, with an inclination to vomit. This shews plainly what ought to be done. Indeed common sense dictates to every one, that, if any thing has been taken into the stomach which endangers life, it ought immediately to be discharged. Were this duly regarded, the danger arising from poisons might generally be avoided. The method of prevention is obvious, and the means are in the hands of every one.
We shall not take up the reader’s time with a detail of the ridiculous notions which have prevailed among ignorant people in different ages with regard to poisons; neither shall we mention the boasted antidotes, which have been recommended either for preventing or obviating their effects; but shall content ourselves with pointing out the poisons most common in this country, and the means of avoiding their dangerous consequences.
Poisons either belong to the mineral, the vegetable, or the animal kingdom.
Mineral poisons are commonly of an acrid or corrosive quality; as arsenic, cobalt, the corrosive sublimate of mercury, &c.
Those of the vegetable kind are generally of a narcotic or stupefactive quality; as poppy, hemlock, henbane, berries of the deadly night-shade, &c.
Poisonous animals communicate their infection either by the bite or sting. This poison is very different from the former, and only produces its effects when received into the body by a wound.
MINERAL POISONS.——Arsenic is the most common of this class; and, as the whole of them are pretty similar both in their effects and method of cure, what is said with respect to it will be applicable to every other species of corrosive poison.
When a person has taken arsenic, he soon perceives a burning heat, and a violent pricking pain in his stomach and bowels, with an intolerable thirst, and an inclination to vomit. The tongue and throat feel rough and dry; and, if proper means be not soon administered, the patient is seized with great anxiety, hiccuping, faintings, and coldness of the extremities. To these succeed black vomits, fœtid stools, with a mortification of the stomach and intestines, which are the immediate forerunners of death.
On the first appearance of these symptoms the patient should drink large quantities of new milk and sallad oil till he vomits; or he may drink warm water mixed with oil. Fat broths are likewise proper, provided they can be got ready in time. Where no oil is to be had, fresh butter may be melted and mixed with the milk or water. These things are to be drank as long as the inclination to vomit continues. Some have drank eight or ten English quarts before the vomiting ceased; and it is never safe to leave off drinking while one particle of the poison remains in the stomach.
These oily or fat substances not only provoke vomiting, but likewise blunt the acrimony of the poison, and prevent its wounding the bowels; but if they should not make the person vomit, half a drachm or two scruples of the powder of ipecacuanha must be given, or a few spoonfuls of the oxymel or vinegar of squills may be mixed with the water which he drinks. Vomiting may likewise be excited by tickling the inside of the throat with a feather. Should these methods however fail, half a drachm of white vitriol, or five or six grains of emetic tartar, must be administered.
If tormenting pains are felt in the lower belly, and there is reason to fear that the poison has got down to the intestines, clysters of milk and oil must be very frequently thrown up; and the patient must drink emollient decoctions of barley, oatmeal, marsh-mallows, and such like. He must likewise take an infusion of senna and manna, a solution of Glauber’s salts, or some other purgative.
After the poison has been evacuated, the patient ought, for some time, to live upon such things as are of a healing and cooling quality; to abstain from flesh and all strong liquors, and to live upon milk, broth, gruel, light puddings, and other spoon meats of easy digestion. His drink should be barley-water, linseed-tea, or infusions of any of the mild mucilaginous vegetables.
VEGETABLE POISONS, besides heat and pain of the stomach, commonly occasion some degree of giddiness, and often a kind of stupidity or folly. Persons who have taken these poisons must be treated in the same manner as for the mineral or corrosive.
Though the vegetable poisons, when allowed to remain in the stomach, often prove fatal; yet the danger is generally over as soon as they are discharged. Not being of such a caustic or corrosive nature, they are less apt to wound or inflame the bowels than mineral substances: no time, however, ought to be lost in having them discharged.
Opium, being frequently taken by mistake, merits particular attention. It is used as a medicine both in a solid and liquid form, which latter commonly goes by the name of laudanum. It is indeed a valuable medicine when taken in proper quantity; but as an over-dose proves a strong poison, we shall point out its common effects, together with the method of cure.
An over-dose of opium generally occasions great drowsiness, with stupor and other apoplectic symptoms. Sometimes the person has so great an inclination to sleep, that it is almost impossible to keep him awake. Every method must however be tried for this purpose. He should be tossed, shaked, and moved about. Sharp blistering-plasters should be applied to his legs or arms, and stimulating medicines, as salts of hartshorn, &c. held under his nose. It will also be proper to let blood. At the same time every method must be taken to make him discharge the poison. This may be done in the manner directed above, viz. by the use of strong vomits, drinking plenty of warm water with oil, &c.
Mead, besides vomits, in this case, recommends acid medicines with lixivial salts. He says, that he has often given salt of wormwood mixed with juice of lemon in repeated doses with great success.
If the body should remain weak and languid after the poison has been discharged, nourishing diet and cordials will be proper; but when there is reason to fear that the stomach or bowels are inflamed, the greatest circumspection is necessary both with regard to food and medicine.
We shall begin with the bite of a mad dog, as it is both the most common and dangerous animal-poison in this country.
The creatures naturally liable to contract this disease are, as far as we yet know, all of the dog kind, viz. foxes, dogs, and wolves. Hence it is called the rabies canina, or dog madness. Of the last we have none in this island; and it so seldom happens that any person is bit by the first, that they scarce deserve to be taken notice of. If such a thing should happen, the method of treatment is precisely the same as for the bite of a mad dog.
The symptoms of madness in a dog are as follow: At first he looks dull, shews an aversion to food and company: he does not bark as usual, but seems to murmur, is peevish, and apt to bite strangers: his ears and tail droop more than usual, and he appears drowsy: afterwards he begins to loll out his tongue, and froth at the mouth, his eyes seeming heavy and watery: he now, if not confined, takes off, runs panting along with a kind of dejected air, and endeavours to bite every one he meets. Other dogs are said to fly from him. Some think this a certain sign of madness, supposing that they know him by the smell; but it is not to be depended on. If he escapes being killed, he seldom runs above two or three days, till he dies exhausted with heat, hunger, and fatigue.
This disease is most frequent after long, dry, hot seasons; and such dogs as live upon putrid stinking carrion, without having enough of fresh water, are most liable to it.
When any person has been bit by a dog, the strictest inquiry ought to be made whether the animal was really mad. Many disagreeable consequences arise from neglecting to ascertain this point. Some people have lived in continual anxiety for many years, because they had been bit by a dog which they believed to be mad; but, as he had been killed on the spot, it was impossible to ascertain the fact. This should induce us, instead of killing a dog the moment he has bit any person, to do all in our power to keep him alive, at least till we can be certain whether he be mad or not.
Many circumstances may contribute to make people imagine a dog mad. He loses his master, runs about in quest of him, is set upon by other dogs, and perhaps by men. The creature, thus frightened, beat, and abused, looks wild, and lolls out his tongue as he runs along. Immediately a crowd is after him; while he, finding himself closely pursued, and taking every one he meets for an enemy, naturally attempts to bite him in self-defence. He soon gets knocked on the head, and it passes currently that he was mad, as it is then impossible to prove the contrary.
This being the true history of, by far, the greater part of those dogs which pass for mad, is it any wonder that numberless whimsical medicines have been extolled for preventing the effects of their bite? This readily accounts for the great variety of infallible remedies for the bite of a mad dog, which are to be met with in almost every family. Though not one in a thousand has any claim to merit, yet they are all supported by numberless vouchers. No wonder that imaginary diseases should be cured by imaginary remedies. In this way, credulous people first impose upon themselves, and then deceive others. The same medicine which was supposed to prevent the effects of the bite, when the dog was not mad, is recommended to a person who has had the misfortune to be bit by a dog that was really mad. He takes it, trusts to it, and is undone.
To these mistakes we must impute the frequent ill success of the medicines used for preventing the effects of the bite of a mad dog. It is not owing so much to a defect in medicine, as to wrong applications. I am persuaded, if proper medicines were administered immediately after the bite is received, and continued for a sufficient length of time, we should not lose one in a thousand of those who have the misfortune to be bit by a mad dog.
This poison is generally communicated by a wound, which nevertheless heals as soon as a common wound: but afterwards it begins to feel painful, and as the pain spreads towards the neighbouring parts, the person becomes heavy and listless. His sleep is unquiet with frightful dreams; he sighs, looks dull, and loves solitude. These are the forerunners, or rather the first symptoms of that dreadful disease occasioned by the bite of a mad dog. But as we do not propose to treat fully of the disease itself, but to point out the method of preventing it, we shall not take up time in shewing its progress from the first invasion to its commonly fatal end.
The common notion, that this poison may lie in the body for many years, and afterwards prove fatal, is both hurtful and ridiculous. It must render such persons as have had the misfortune to be bit very unhappy, and can have no good effects. If the person takes proper medicines for forty days after the time of his being bit, and feels no symptoms of the disease, there is reason to believe him out of danger.
The medicines recommended for preventing the effects of the bite of a mad dog, are chiefly such as promote the different secretions, and antispasmodics.
Dr. Mead recommends a preventive medicine, which he says he never knew fail, though in the space of thirty years he had used it a thousand times.
The Doctor’s prescription is as follows:
“Take ash-coloured ground liver-wort, cleaned, dried, and powdered, half an ounce; of black pepper powdered, a quarter of an ounce. Mix these well together, and divide the powder into four doses; one of which must be taken every morning fasting, for four mornings successively, in half an English pint of cows milk warm.
“After these four doses are taken, the patient must go into the cold bath, or a cold spring or river, every morning fasting, for a month; he must be dipped all over, but not stay in (with his head above water) longer than half a minute, if the water be very cold. After this he must go in three times a-week for a fortnight longer.
“The person must be bled before he begins to use the medicine[161].”
We shall next mention the famous East India specific, as it is called. This medicine is composed of cinnabar and musk. It is esteemed a great antispasmodic; and, by many, extolled as an infallible remedy for preventing the effects of the bite of a mad dog.
“Take native and factitious cinnabar, of each twenty-four grains, musk sixteen grains. Let these be made into a fine powder, and taken in a glass of arrack or brandy.”
This single dose is said to secure the person for thirty days, at the end of which it must be repeated; but if he has any symptoms of the disease, it must be repeated in three hours.
The following is likewise reckoned a good antispasmodic medicine:
“Take of Virginian snake-root in powder, half a drachm, gum asafœtida twelve grains, gum camphire seven grains; make these into a bolus with a little syrup of saffron.”
Camphire may also be given in the following manner:
“Take purified nitre half an ounce, Virginian snake-root in powder two drachms, camphire one drachm; rub them together in a mortar, and divide the whole into ten doses.”
Mercury is likewise recommended as of great efficacy, both in the prevention and cure of this kind of madness. When used as a preventive, it will be sufficient to rub daily a drachm of the ointment into the parts about the wound.
Vinegar is likewise of considerable service, and should be taken freely, either in the patient’s food or drink.
These are the principal medicines recommended for preventing the effects of the bite of a mad dog. We would not however advise people to trust to any one of them; but from a proper combination of their different powers, there is the greatest reason to hope for success.
The great error in the use of these medicines lies in not taking them for a sufficient length of time. They are used more like charms, than medicines intended to produce any change in the body. To this, and not to the insufficiency of the medicines, we must impute their frequent want of success.
Dr. Mead says, that the virtue of his medicine consists in promoting urine. But how a poison should be expelled by urine, with only three or four doses of any medicine, however powerful, it is not easy to conceive. More time is certainly necessary, even though the medicine were more powerful than that which the Doctor prescribes.
The East India specific is still more exceptionable on this account.
As these and most other medicines, taken singly, have frequently been found to fail, we shall recommend the following course:
If a person be bit in a fleshy part, where there is no hazard of hurting any large blood-vessel, the parts adjacent to the wound may be cut away. But if this be not done soon after the bite has been received, it will be better to omit it.
The wound may be dressed with salt and water, or a pickle made of vinegar and salt, and afterwards dressed twice a-day with yellow basilicon mixed with red precipitate of mercury.
The patient should begin to use either Dr. Mead’s medicine, or some of the others mentioned above. If he takes Mead’s medicine, he may use it as the Doctor directs for four days successively. Let him then omit it for two or three days, and again repeat the same number of doses as before.
During this course, he must rub into the parts about the wound, daily, one drachm of the mercurial ointment. This may be done for ten or twelve days at least.
When this course is over, he may take a purge or two, and wait a few days till the effect of the mercury be gone off. He must then begin to use the cold bath, into which he may go every morning for five or six weeks. If he should feel cold and chilly for a long time after coming out of the cold bath, it will be better to use a tepid one, or to have the water a little warmed.
In the mean time, we would advise him not to leave off all internal medicines, but to take either one of the boluses of snake-root, asafœtida, and camphire; or one of the powders of nitre, camphire, and snake-root, twice a-day. These may be used during the whole time he is bathing.
During the use of the mercurial ointment, the patient must keep within doors, and take nothing cold.
A proper regimen must be observed throughout the whole course. The patient should abstain from flesh, and all salted and high-seasoned provisions. He must avoid strong liquors, and live mostly upon a light and rather spare diet. His mind should be kept as easy and cheerful as possible, and all excessive heat and violent passions avoided with the utmost care.
I have never seen this course of medicine, with proper regimen, fail to prevent the hydrophobia, and cannot help again observing, that the want of success must generally be owing either to the application of improper medicines, or not using proper ones for a sufficient length of time.
Mankind are extremely fond of every thing that promises a sudden or miraculous cure. By trusting to these they often lose their lives, when a regular course of medicine would have rendered them absolutely safe. This holds remarkably in the present case. Numbers of people, for example, believe if they or their cattle were once dipped in the sea, it is sufficient; as if the salt-water were a charm against the effects of the bite. This, and such like whims, have proved fatal to many.
It is a common notion, if a person be bit by a dog which is not mad, that, if he should go mad afterwards, the person would be affected with the disorder at the same time; but this notion is too ridiculous to deserve a serious consideration. It is a good rule, however, to avoid dogs as much as possible, as the disease is often upon them for some time before its violent symptoms appear. The hydrophobia has been occasioned by the bite of a dog which shewed no other symptoms of the disease but listlessness and a sullen disposition.
Though we do not mean to treat fully of the cure of the hydrophobia, yet we are far from reckoning it incurable. The notion that this disease could not be cured, has been productive of the most horrid consequences. It was usual either to abandon the unhappy persons, as soon as they were seized with the disease, to their fate, to bleed them to death, or to suffocate them between matrasses or feather-beds, &c. This conduct certainly deserved the severest punishment! We hope, for the honour of human nature, it will never again be heard of.
I have never had an opportunity of treating this disease, and therefore can say nothing of it from my own experience; but the learned Dr. Tissot says, it may be cured in the following manner:
1. The patient must be bled to a considerable quantity; and this may be repeated twice, or thrice, or even a fourth time, if circumstances require it.
2. The patient should be put, if possible, into a warm bath; and this should be used twice a-day.
3. He should every day receive two, or even three emollient clysters.
4. The wound, and the parts adjoining to it, should be rubbed with the mercurial ointment twice a-day.
5. The whole limb which contains the wound should be rubbed with oil, and be wrapped up in an oily flannel.
6. Every three hours a dose of Cob’s powder should be taken in a cup of the infusion of lime-tree and elder-flowers. This powder is made, by rubbing together in a mortar, to a very fine powder, of native and factitious cinnabar, each twenty-four grains; of musk, sixteen grains[162].
7. The following bolus is to be given every night, and to be repeated in the morning, if the patient is not easy, washing it down with the infusion mentioned above: Take one drachm of Virginian snake-root in powder; of camphire and asafœtida, ten grains each; of opium, one grain; and, with a sufficient quantity of conserve, or rob of elder, make a bolus.
8. If there be a great nausea at the stomach, with a bitterness in the mouth, thirty-five or forty grains of ipecacuanha, in powder, may be taken for a vomit.
9. The patient’s food, if he takes any, must be light; as panado, soups made of farinaceous or mealy vegetables, &c.
10. If the patient should long continue weak, and subject to terrors, he may take half a drachm of the Peruvian bark thrice a-day.
The next poisonous animal which we shall mention is the VIPER. The grease of this animal rubbed into the wound is said to cure the bite. Though that is all the viper-catchers generally do when bit, we should not think it sufficient for the bite of an enraged viper. It would surely be more safe to have the wound well sucked[163], and afterwards rubbed with warm salad-oil. A poultice of bread and milk, softened with salad-oil, should likewise be applied to the wound; and the patient ought to drink freely of vinegar whey, or water-gruel with vinegar in it, to make him sweat. Vinegar is one of the best medicines which can be used in any kind of poison, and ought to be taken very liberally. If the patient be sick, he may take a vomit. This course will be sufficient to cure the bite of any of the poisonous animals of this country.
With regard to poisonous insects, as the bee, the wasp, the hornet, &c. their stings are seldom attended with danger, unless when a person happens to be stung by a great number of them at the same time; in which case something should be done to abate the inflammation and swelling. Some, for this purpose, apply honey, others lay pounded parsley to the part. A mixture of vinegar and Venice treacle is likewise recommended; but I have always found rubbing the part with warm salad-oil succeed very well. Indeed, when the stings are so numerous as to endanger the patient’s life, which is sometimes the case, he must not only have oily poultices applied to the part, but should likewise be bled, and take some cooling medicines, as nitre, or cream of tartar, and should drink plentifully of diluting liquors.
It is the happiness of this island to have very few poisonous animals, and those which we have are by no means of the most virulent kind. Nine-tenths of the effects attributed to poison or venom in this country, are really other diseases, and proceed from quite different causes.
We cannot however make the same observation with regard to poisonous vegetables. These abound every where, and prove often fatal to the ignorant and unwary. This indeed is chiefly owing to carelessness. Children ought early to be cautioned against eating any kind of fruit, roots, or berries, which they do not know, and all poisonous plants to which they can have access, ought, as far as possible, to be destroyed. This would not be so difficult a task as some people imagine.
Poisonous plants have no doubt their use, and they ought to be propagated in proper places; but, as they prove often destructive to cattle, they should be rooted out of all pasture-grounds. They ought likewise, for the safety of the human species, to be destroyed in the neighbourhood of all towns and villages; which, by the bye, are the places where they most commonly abound. I have seen the poisonous hemlock, henbane, wolfsbane, and deadly night-shade, all growing within the environs of a small town, where, though several persons, within the memory of those living in it, had lost their lives by one or other of these plants; yet no method, that I could hear of, had ever been taken to root them out; though this might be done at a very trifling expence.
Seldom a year passes but we have accounts of several persons poisoned by eating hemlock-roots instead of parsnips, or some kinds of fungus which they had gathered for mushrooms. These examples ought to put people upon their guard with respect to the former, and to put the latter entirely out of use. Mushrooms may be a delicate dish, but they are a dangerous one, as they are generally gathered by persons who do not know one kind of fungus from another, and take every thing for a mushroom which has that appearance.
We might here mention many other plants and animals of a poisonous nature which are found in foreign countries; but, as our observations are chiefly intended for this island, we shall pass these over. It may not however be amiss to observe, for the benefit of such of our countrymen as go to America, that an effectual remedy is now said to be found for the bite of the rattle-snake.—The prescription is as follows: Take of the roots of plantain and horehound, in summer, roots and branches together, a sufficient quantity; bruise them in a mortar, and squeeze out the juice, of which give, as soon as possible, one large spoonful; if the patient be swelled, you must force it down his throat. This generally will cure; but, if he finds no relief in an hour after, you may give another spoonful, which never fails.—If the roots are dried, they must be moistened with a little water. To the wound may be applied a leaf of good tobacco moistened with rum.
We give this upon the faith of Dr. Brookes, who says it was the invention of a negro; for the discovery of which he had his freedom purchased, and a hundred pounds per annum settled upon him during life, by the General Assembly of Carolina.
It is possible there may be in nature specific remedies for every kind of poison; but as we have very little faith in any of those which have yet been pretended to be discovered, we shall beg leave again to recommend the most strict attention to the following rules, viz. That when any poisonous substance has been taken into the stomach, it ought, as soon as possible, to be discharged by vomits, clysters, and purges; and, when poison has been received into the body by a wound, that it be expelled by medicines which promote the different secretions, especially those of sweat, urine, and insensible perspiration; to which may be joined antispasmodics, or such medicines as take off tension and irritation; the chief of which are opium, musk, camphire, and asafœtida.
In the first edition of this book the venereal disease was omitted. The reasons however which at that time induced me to leave it out, have upon more mature consideration vanished. Bad consequences, no doubt, may arise from ignorant persons tampering with medicine in this disorder; but the danger from that quarter seems to be more than balanced by the great and solid advantages, which must arise to the patient from an early knowledge of his case, and an attention to a plan of regimen, which, if it does not cure the disease, will be sure to render it more mild, and less hurtful to the constitution.
It is peculiarly unfortunate for the unhappy persons who contract this disease, that it lies under a sort of disgrace. This renders disguise necessary, and makes the patient either conceal his disorder altogether, or apply to those who promise a sudden and secret cure; but who in fact only remove the symptoms for a time, while they fix the disease deeper in the habit. By this means a slight infection, which might have been easily removed, is often converted into an obstinate, and sometimes incurable malady.
Another unfavourable circumstance attending this disease is, that it assumes a variety of different shapes, and may with more propriety be called an assemblage of diseases, than a single one. No two diseases can require a more different method of treatment than this does in its different stages. Hence the folly and danger of trusting to any particular nostrum for the cure of it. Such nostrums are however generally administered in the same manner to all who apply for them, without the least regard to the state of the disease, the constitution of the patient, the degree of infection, and a thousand other circumstances of the utmost importance.
Though the venereal disease is generally the fruit of unlawful embraces, yet it may be communicated to the innocent as well as the guilty. Infants, nurses, midwives, and married women whose husbands lead dissolute lives, are often affected with it, and frequently lose their lives by not being aware of their danger in due time. The unhappy condition of such persons will certainly plead our excuse, if any excuse be necessary, for endeavouring to point out the symptoms and cure of this too common disease.
To enumerate all its different symptoms, however, and to trace the disease minutely through its various stages, would require a much larger space than falls to this part of my subject; I shall therefore confine my observations chiefly to circumstances of importance, omitting such as are either trifling, or which occur but seldom. I shall likewise pass over the history of the disease, with the different methods of treatment which it has undergone since it was first introduced into Europe, and many other circumstances of a similar nature; all of which, though they might tend to amuse the reader, yet could afford him little or no useful knowledge.
The virulent gonorrhœa is an involuntary discharge of infectious matter from the parts of generation in either sex. It generally makes its appearance within eight or ten days after the infection has been received: sometimes indeed it appears in two or three days, and at other times not before the end of four or five weeks. Previous to the discharge, the patient feels an itching with a small degree of pain in the genitals. Afterwards a thin glary matter begins to distil from the urinary passage, which stains the linen, and occasions a small degree of titillation, particularly in the time of making water; this gradually increasing, arises at length to a degree of heat and pain, which are chiefly perceived about the extremity of the urinary passage, where a slight degree of redness and inflammation likewise begin to appear.
As the disorder advances, the pain, heat of urine, and running, increase, while fresh symptoms daily ensue. In men the erections become painful and involuntary, and are more frequent and lasting than when natural. This symptom is most troublesome when the patient is warm in bed. The pain which was at first only perceived towards the extremity, now begins to reach all up the urinary passage, and is most intense just after the patient has done making water. The running gradually recedes from the colour of seed, grows yellow, and at length puts on the appearance of matter.
When the disorder has arrived at its height, all the symptoms are more intense; the heat of urine is so great, that the patient dreads the making water; and though he feels a constant inclination this way, yet it is rendered with the greatest difficulty, and often only by drops: the involuntary erections now become extremely painful and frequent; there is also a pain, heat, and sense of fulness about the seat, and the running is plentiful and sharp, of a brown, greenish, and sometimes of a bloody colour.
By a proper treatment the violence of the symptoms gradually abates; the heat of urine goes off; the involuntary and painful erections, and the heat and pain about the seat, become easier; the running also gradually decreases, grows whiter and thicker, till at last it entirely disappears.
By attending to these symptoms, the gonorrhœa may be generally distinguished from any other disease. There are however some few disorders for which it may be mistaken, as an ulcer in the kidnies or bladder, the fluor albus or whites in women, &c. But in the former of these, the matter comes away only with the urine, or when the sphincter of the bladder is open; whereas in a gonorrhœa, the discharge is constant. The latter is more difficult to distinguish, and must be known chiefly from its effects, as pain, communicating the infection, &c.
REGIMEN.——When a person has reason to suspect that he has caught the venereal infection, he ought most strictly to observe a cooling regimen, to avoid every thing of a heating nature, as wines, spirituous liquors, rich sauces, spiced, salted, high-seasoned and smoke-dried provisions, &c. as also all aromatic and stimulating vegetables, as onions, garlic, shallot, nutmeg, mustard, cinnamon, mace, ginger, and such like. His food ought chiefly to consist of mild vegetables, milk, broths, light puddings, panado, gruels, &c. His drink may be barley-water, milk and water, decoctions of marsh-mallows and liquorice, linseed-tea, or clear whey. Of these he ought to drink plentifully. Violent exercise of all kinds, especially riding on horseback, and venereal pleasures, are to be avoided. The patient must beware of cold, and when the inflammation is violent, he ought to keep his bed.
MEDICINE.——A virulent gonorrhœa cannot always be cured speedily and effectually at the same time. The patient ought therefore not to expect, nor the physician to promise it. It will often continue for two or three weeks, and sometimes for five or six, even where the treatment has been very proper.
Sometimes indeed a slight infection may be carried off in a few days, by bathing the parts in warm milk and water, and injecting frequently up the urethra a little sweet oil or linseed-tea about the warmth of new milk. Should these not succeed in carrying off the infection, they will at least have a tendency to lessen its virulence.
To effect a cure, however, astringent injections will generally be found necessary. These may be various ways prepared, but I think those made with the white vitriol are both most safe and efficacious. They can be made stronger or weaker as circumstances may require; but it is best to begin with the more gentle, and increase their power if necessary. I generally order a drachm of white vitriol to be dissolved in eight or nine ounces of common or rose-water, and an ordinary syringe full of it to be thrown up three or four times a-day. If this quantity does not perform a cure, it may be repeated, and the dose increased[164].
Whether injections be used or not, cooling purges are always proper in the gonorrhœa. They ought not however to be of the strong or drastic kind. Whatever raises a violent commotion in the body increases the danger, and tends to drive the disease deeper into the habit. Procuring two or three stools every second or third day for the first fortnight, and the same number every fourth or fifth day for the second, will generally be sufficient to remove the inflammatory symptoms, to diminish the running, and to change its colour and consistence. It gradually becomes more white and ropy as the virulence abates[165].
When the inflammatory symptoms run high, bleeding is always necessary at the beginning. This operation, as in other topical inflammations, must be repeated according to the strength and constitution of the patient, and the vehemence and urgency of the symptoms.
Medicines which promote the secretion of urine, are likewise proper in this stage of the disorder. For this purpose, an ounce of nitre and two ounces of gum-arabic, pounded together, may be divided into twenty-four doses, one of which may be taken frequently in a cup of the patient’s drink. If these should make him pass his urine so often as to become troublesome to him, he may either take them less frequently, or leave out the nitre altogether, and take equal parts of gum-arabic and cream of tartar. These may be pounded together, and a tea-spoonful taken in a cup of the patient’s drink four or five times a-day. I have generally found this answer extremely well both as a diuretic, and for keeping the body gently open.
When the pain and inflammation are seated high towards the neck of the bladder, it will be proper frequently to throw up an emollient clyster, which, besides the benefit of procuring stools, will serve as a fomentation to the inflamed parts.
Soft poultices, when they can conveniently be applied to the parts, are of great service. They may be made of the flour of linseed, or of wheat-bread and milk, softened with fresh butter or sweet oil. When poultices cannot be conveniently used, cloths wrung out of warm water, or bladders filled with warm milk and water, may be applied. I have often known the most excruciating pains, during the inflammatory state of the gonorrhœa, relieved by one or other of these applications.
Few things tend more to keep off inflammation in the spermatic vessels, than a proper truss for the scrotum. It ought to be so contrived as to support the testicles, and should be worn from the first appearance of the disease till it has ceased some weeks.
The above treatment will sometimes remove the gonorrhœa so quickly, that the person will be in doubt whether he really laboured under that disease. This, however, is too favourable a turn to be often expected. It more frequently happens, that we are able only to procure an abatement or remission of the inflammatory symptoms, so far as to make it safe to have recourse to the great antidote mercury.
Many people, on the first appearance of a gonorrhœa, fly to the use of mercury. This is a bad plan. Mercury is often not at all necessary in a gonorrhœa; and when taken too early, it does mischief. It may be necessary to complete the cure, but can never be proper at the commencement of it.
When bleeding, purging, fomentations, and the other things recommended above, have eased the pain, softened the pulse, relieved the heat of urine, and rendered the involuntary erections less frequent, the patient may begin to use mercury in any form that is least disagreeable to him.
If he takes the common mercurial pill, two at night and one in the morning will be a sufficient dose at first. Should they affect the mouth too much, the dose must be lessened; if not at all, it may be gradually increased to five or six pills in the day. If calomel be thought preferable, two or three grains of it, formed into a bolus with a little of the conserve of hips, may be taken at bed-time, and the dose gradually increased to eight or ten grains. One of the most common preparations of mercury now in use is the corrosive sublimate. This may be taken in the manner afterwards recommended under the confirmed lues or pox. I have always found it one of the most safe and efficacious medicines when properly used.
The above medicines may either be taken every day or every other day, as the patient is able to bear them. They ought never to be taken in such quantity as to raise a salivation, unless in a very slight degree. The disease may be more safely, and as certainly, cured without a salivation as with it. When the mercury runs off by the mouth, it is not so successful in carrying off the disease, as when it continues longer in the body, and is discharged gradually.
Should the patient be purged or griped in the night by the mercury, he must take an infusion of senna, or some other purgative, and drink freely of water-gruel to prevent bloody stools, which are very apt to happen should the patient catch cold, or if the mercury has not been duly prepared. When the bowels are weak and the mercury is apt to gripe or purge, these disagreeable consequences may be prevented by taking, with the above pills or bolus, half a drachm or two scruples of diascordium, or of the Japonic confection.
To prevent the disagreeable circumstance of the mercury’s affecting the mouth too much, or bringing on a salivation, it may be combined with purgatives. With this view the laxative mercurial pill has been contrived, the usual dose of which is half a drachm, or three pills, night and morning, to be repeated every other day; but the safer way is for the patient to begin with two, or even with one pill, gradually increasing the dose.
To such persons as can neither swallow a bolus nor a pill, mercury may be given in a liquid form, as it can be suspended even in a watery vehicle, by means of gum-arabic; which not only serves this purpose, but likewise prevents the mercury from affecting the mouth, and renders it in many respects a better medicine[166].