CHAPTER XIX.

OF INVOLUNTARY DISCHARGES OF BLOOD.

SPONTANEOUS or involuntary discharges of blood often happen from various parts of the body. These, however, are so far from being always dangerous, that they often prove salutary. When such discharges are critical, which is frequently the case in fevers, they ought not to be stopped. Nor, indeed, is it proper at any time to stop them, unless they be so great as to endanger the patient’s life. Most people, afraid of the smallest discharge of blood from any part of the body, fly immediately to the use of styptic and astringent medicines, by which means an inflammation of the brain, or some other fatal disease, is occasioned, which, had the discharge been allowed to go on, might have been prevented.

Periodical discharges of blood, from whatever part of the body they proceed, must not be stopped. They are always the efforts of Nature to relieve herself; and fatal diseases have often been the consequence of obstructing them. It may, indeed, be sometimes necessary to check the violence of such discharges; but even this requires the greatest caution. Instances might be given where the stopping of small periodical flux of blood from one of the fingers has proved fatal.

In the early period of life, bleeding at the nose is very common. Those who are further advanced in years are more liable to hæmoptoe, or discharge of blood from the lungs. After the middle period of life hæmorrhoidal fluxes are most common; and, in the decline of life, discharges of blood from the urinary passages.

Involuntary fluxes of blood may proceed from very different, and often from quite opposite, causes. Some-times they are owing to a particular construction of the body, as a sanguine temperament, a laxity of the vessels, a plethoric habit, &c. At other times they proceed from a determination of the blood towards one particular part, as the head, the hæmorrhoidal veins, &c. They may likewise proceed from an inflammatory disposition of the blood, in which case there is generally some degree of fever: this likewise happens when the flux is occasioned by an obstructed perspiration, or a stricture upon the skin, the bowels, or any particular part of the system.

But a dissolved state of the blood will likewise occasion hæmorrhages. Thus, in putrid fevers, the dysentery, the scurvy, the malignant small-pox, &c. there are often very great discharges of blood from different parts of the body. They may likewise be brought on by too liberal an use of medicines which tend to dissolve the blood, as cantharides, the volatile alkaline salts, &c. Food of an acrid or irritating quality may likewise occasion hæmorrhages; as also strong purges and vomits, or any thing that greatly stimulates the bowels.

Violent passions or agitations of the mind will likewise have this effect. These often cause bleeding at the nose, and I have known them sometimes occasion an hæmorrhage in the brain. Violent efforts of the body, by overstraining or hurting the vessels, may have the same effect, especially when the body is long kept in an unnatural posture, as hanging the head very low, &c.

The cure of an hæmorrhage must be adapted to its cause. When it proceeds from too much blood, or a tendency to inflammation, bleeding, with gentle purges and other evacuations, will be necessary. It will, likewise, be proper for the patient in this case to live chiefly upon a vegetable diet, to avoid all strong liquors, and food that is of an acrid, hot, or stimulating quality. The body should be kept cool, and the mind easy.

When an hæmorrhage is owing to a putrid or dissolved state of the blood, the patient ought to live chiefly upon acrid fruits, with milk, and vegetables of a nourishing nature, as sago, salop, &c. His drink may be wine diluted with water, and sharpened with the juice of lemon, vinegar, or spirits of vitriol. The best medicine in this case is the Peruvian bark, which may be taken according to the urgency of the symptoms.

When a flux of blood is the effect of acrid food, or of strong stimulating medicines, the cure is to be effected by soft and mucilaginous diet. The patient may likewise take frequently about the bulk of a nutmeg of Locatelli’s balsam, or the same quantity of spermaceti.

When an obstructed perspiration, or a stricture upon any part of the system, is the cause of an hæmorrhage, it may be removed by drinking warm diluting liquors, lying a-bed, bathing the extremities in warm water, &c.

OF BLEEDING AT THE NOSE.

BLEEDING at the nose is commonly preceded by some degree of quickness at the pulse, flushing in the face, pulsation in the temporal arteries, heaviness in the head, dimness of the sight, heat and itching of the nostrils, &c.

To persons who abound in blood, this discharge is very salutary. It often cures a vertigo, the head-ach, a phrenzy, and even an epilepsy. In fevers, where there is a great determination of blood towards the head, it is of the utmost service. It is likewise beneficial in inflammations of the liver and spleen, and often in the gout and rhumatism. In all diseases where bleeding is necessary, a spontaneous discharge of blood from the nose is of much more service than the same quantity let with a lancet.

In a discharge of blood from the nose, the great point is to determine whether it ought to be stopped or not. It is a common practice to stop the bleeding, without considering whether it be a disease, or the cure of a disease. This conduct proceeds from fear; but it has often bad, and sometimes fatal, consequences.

When a discharge of blood from the nose happens in an inflammatory disease, there is always reason to believe that it may prove salutary; and therefore it should be suffered to go on, at least as long as the patient is not weakened by it.

When it happens to persons in perfect health, who are full of blood, it ought not to be suddenly stopped, especially if the symptoms of plethora, mentioned above, have preceded it. In this case it cannot be stopped without risking the patient’s life.

In fine, whenever bleeding at the nose relieves any bad symptom, and does not proceed so far as to endanger the patient’s life, it ought not to be stopped. But when it returns frequently, or continues till the pulse becomes low, the extremities begin to grow cold, the lips pale, or the patient complains of being sick or faint, it must immediately be stopped.

For this purpose the patient should be set nearly upright, with his head reclining a little, and his legs immersed in water about the warmth of new milk. His hands ought likewise to be put in luke-warm water, and his garters may be tied a little tighter than usual. Ligatures may be applied to the arms, about the place where they are usually made for bleeding, and with nearly the same degree of tightness. These must be gradually slackened as the blood begins to stop, and removed entirely as soon as it gives over.

Sometimes dry lint put up the nostrils will stop the bleeding. When this does not succeed, dossils of lint, dipped in strong spirits of wine, may be put up the nostrils, or if that cannot be had, they may be dipped in brandy. Blue vitriol dissolved in water may likewise be used for this purpose, or a tent dipped in the white of an egg well beat up, may be rolled in a powder made of equal parts of white sugar, burnt alum, and white vitriol, and put up the nostrils from whence the blood issues.

If the genitals be immersed for some time in cold water, it will generally stop a bleeding at the nose. I have not known this fail.

Sometimes, when the bleeding is stopped outwardly, it continues inwardly. This is very troublesome, and requires particular attention, as the patient is apt to be suffocated with the blood, especially if he falls asleep, which he is very ready to do after losing a great quantity of blood.

When the patient is in danger of suffocation from the blood getting into his throat, the passages may be stopped by drawing threads up the nostrils, and bringing them out at the mouth, then fastening pieces of sponge, or small rolls of linen cloth to their extremities, afterwards drawing them back, and tying them to the outside with a sufficient degree of tightness.

After the bleeding is stopped, the patient ought to be kept as easy and quiet as possible. He should not pick his nose, nor take away the tents or clotted blood till they fall off of their own accord, and should not lie with his head low.

Those who are afflicted with frequent bleeding at the nose, ought to bathe their feet often in warm water, and keep them warm and dry. They ought to wear nothing tight about their necks, to keep the body as much in an erect posture as possible, and never to view any object obliquely. If they have too much blood, a vegetable diet, with now and then a cooling purge, is the safest way to lessen it.

But when the disease proceeds from a thin dissolved state of the blood, the diet should be rich and nourishing, as strong broths and jellies, sago-gruel, with wine and sugar, &c. Infusions of the Peruvian bark in wine ought likewise to be taken, and persisted in for a considerable time.

OF THE BLEEDING AND BLIND PILES.

A discharge of blood from the hæmorrhoidal vessels is called the bleeding piles. When the vessels only swell, and discharge no blood, but are exceeding painful, the disease is called the Blind Piles.

Persons of a loose spongy fibre, of a bulky size, who live high, and lead a sedentary inactive life, are most subject to this disease. It is often owing to an hereditary disposition. When this is the case, it attacks persons more early in life than when it is accidental. Men are more liable to it than women, especially those of a sanguine, plethoric, or a scorbutic habit, or of a melancholy disposition.

The piles may be occasioned by an excess of blood, by strong aloetic purges, high-seasoned food, drinking great quantities of sweet wines, the neglect of bleeding or other customary evacuations, much riding, great costiveness, or any thing that occasions hard or difficult stools. Anger, grief, or other violent passions, will likewise occasion the piles. I have often known them brought on by sitting on the damp ground; a pair of thin breeches will excite the disorder in a person who is subject to it, and sometimes even in those who never had it before. Pregnant women are often afflicted with the piles.

A flux of blood from the anus is not always to be treated as a disease. It is even more salutary than bleeding at the nose, and often prevents or carries off diseases. It is peculiarly beneficial in the gout, rheumatism, asthma, and hypochondriacal complaints, and often proves critical in colics and inflammatory fevers.

In the management of the patient, regard must be had to his habit of body, his age, strength, and manner of living. A discharge which might be excessive and prove hurtful to one, may be very moderate and even salutary to another. That only is to be esteemed dangerous which continues too long, and is in such quantity as to waste the patient’s strength, hurt the digestion, nutrition, and other functions necessary to life.

When this is the case, the discharge must be checked by a proper regimen and astringent medicines. The diet must be cool and nourishing, consisting chiefly of bread, milk, cooling vegetables, and broths. The drink may be orange-whey, decoctions or infusions of the astringent and mucilaginous plants, as the tormentil-root, bistort and marshmallow-roots, &c.

Old conserve of red roses is a very good medicine in this case. It may be mixed with new milk, and taken in the quantity of an ounce three or four times a-day. This medicine is in no great repute, owing to its being seldom taken in such quantity as to produce any effects; but when taken as here directed, and duly persisted in, I have known it perform very extraordinary cures in violent hæmorrhages, especially when assisted by the tincture of roses; a tea-cupful of which may be taken about an hour after every dose of the conserve.

The Peruvian bark is likewise proper in this case, as a strengthener and astringent. Half a drachm of it may be taken in a glass of red wine, sharpened with a few drops of the elixir of vitriol, three or four times a-day.

The bleeding piles are sometimes periodical, and return regularly once a month, or once in three weeks. In this case they are always to be considered as a salutary discharge, and by no means to be stopped. Some have entirely ruined their health by stopping a periodical discharge of blood from the hæmorrhoidal veins.

In the blind piles, bleeding is generally of use. The diet must be light and thin, and the drink cool and diluting. It is likewise necessary that the body be kept gently open. This may be done by small doses of the flower of brimstone and cream of tartar. These may be mixed in equal quantities, and a tea-spoonful taken two or three times a day.

Emollient clysters are here likewise beneficial; but there is sometimes such an astriction of the anus, that they cannot be thrown up. In this case I have known a vomit have a very good effect.

When the piles are exceeding painful and swelled, but discharge nothing, the patient must sit over the steam of warm water. He may likewise apply a linen cloth dipped in warm spirits of wine to the part, or poultices made of bread and milk, or of leeks fried with butter. If these do not produce a discharge, and the piles appear large, leeches must be applied as near them as possible, or, if they will fix upon the piles themselves, so much the better. When leeches will not fix, the piles may be opened with a lancet. The operation is very easy, and is attended with no danger. Various ointments, and other external applications, are recommended in the piles; but I do not remember to have seen any effects from these worth mentioning.

Their principal use is to keep the part moist, which may be done as well by a soft poultice, or an emollient cataplasm. When the pain, however, is very great, a liniment made of two ounces of emollient ointments, and half an ounce of liquid laudanum, beaten up with the yolk of an egg, may be applied.

Aloes, which form a principal ingredient of most of the advertised purgative pills, very frequently occasion the piles. A spoonful of castor oil, taken occasionally at night, is a much better, as well as a safer, remedy for habitual costiveness.

A weak solution of lead with a little laudanum, is a good external remedy; as is also an ointment of two-third hog’s-lard, and one-third galls finely pulverised. An injection of lime-water, or of an infusion of galls, may be used with advantage when the piles are seated high.

The pain may be removed by an emetic, or by taking twice a-day thirty drops of balsam of copaiva on a bit of sugar. A pile having a narrow neck is best extirpated by the knife; if it be large, or its basis broad, a double ligature may be passed through, and tied on each side.

Piles ought to be duly attended to, otherwise they often produce a fistula. This painful disorder may be discovered by stains on the linen proceeding from a small orifice near the anus. In this complaint, such stimulants should be applied as produce a more active inflammation on the sides of the ulcer, so as to make them adhere together. With this view, irritating injections, properly persisted in, have been successfully used. A wine glass of sea-water, taken every night for several weeks, has also been found useful.

But the only certain and radical cure is the knife. By the operation of cutting, the ulcer is reduced to a simple wound, and healed as such. The sooner this operation is recurred to, the better; because the disorder gradually spreads in different directions through the cellular substance which surrounds the rectum, and new orifices are formed which render it more difficult to be cured.

The best means of performing this operation is by incision. It is, however, also done by passing a thread of silk, or flexible gold wire, in at the external orifice of the fistula, and bringing it out at the anus, then twisting the ends together, and daily repeating this till it cuts its way out.

OF THE DYSENTERY, OR BLOODY FLUX.

THIS disease prevails in the spring and autumn. It is most common in marshy countries, where after hot and dry summers it is apt to become epidemic. Persons are most liable to it who are much exposed to the night air, or who live in places where the air is confined and unwholesome. Hence it often proves fatal in camps, on ship-board, in gaols, hospitals, and such like places.

CAUSE.—The dysentery may be occasioned by any thing that obstructs the perspiration, or renders the humours putrid; as damp beds, wet clothes, unwholesome diet, bad air, &c. but it is most frequently communicated by infection. This ought to make people extremely cautious in going near such persons as labour under the disease. Even the smell of the patient’s excrements have been known to communicate the infection.

SYMPTOMS.—It is known by a flux of the belly, attended by violent pain of the bowels, a constant inclination to go to stool, and generally more or less blood in the stools. It begins, like other fevers, with chilliness, loss of strength, a quick pulse, a great thirst, and an inclination to vomit. The stools are at first greasy and frothy, afterwards they are streaked with blood, and at last have frequently the appearance of pure blood, mixed with small filaments resembling bits of skin. Worms are sometimes passed both upwards and downwards through the whole course of the disease. When the patient goes to stool, he feels a bearing down, as if the whole bowels were falling out, and sometimes a part of the intestine is actually protruded, which proves exceeding troublesome, especially in children. Flatulency is likewise a troublesome symptom, especially towards the end of the disease.

This disease may be distinguished from a diarrhæa, or looseness, by the acute pain of the bowels, and the blood which generally appears in the stools. It may be distinguished from the cholera morbus by its not being attended with such violent and frequent fits of vomiting, &c.

When the dysentery attacks the old, the delicate, or such as have been wasted by the gout, the scurvy, or other lingering diseases, it generally proves fatal. Vomiting and hiccuping are bad signs, as they show an inflammation of the stomach. When the stools are green, black, or have an exceeding disagreeable cadaverous smell, the danger is very great, and it shows the disease to be of the putrid kind. It is an unfavourable symptom when clysters are immediately returned; but still more so when the passages are so obstinately shut, that they cannot be injected. A feeble pulse, coldness of the extremities, with difficulty of swallowing, and convulsions, are signs of approaching death.

REGIMEN.—Nothing is of more importance in this disease than cleanliness. It contributes greatly to the recovery of the patient, and no less to the safety of such as attend him. In all contagious diseases the danger is increased, and the infection spread, by the neglect of cleanliness; but in no one more than this. Every thing about the patient should be frequently changed. The excrements should never be suffered to continue in his chamber, but removed immediately, and buried under ground. A constant stream of fresh air should be admitted into the chamber; and it ought frequently to be sprinkled with vinegar, juice of lemon, or some other strong acid.

The patient must not be discouraged, but his spirits kept up in hopes of a cure. Nothing tends more to render any putrid disease mortal, than the fears and apprehensions of the sick. All diseases of this nature have a tendency to sink and depress the spirits, and when that is increased by fears and alarms from those whom the patient believes to be persons of skill, it cannot fail to have the worst effects.

A flannel-waistcoat worn next the skin has often a very good effect in the dysentery. This promotes the perspiration without over-heating the body. Great caution, however, is necessary in leaving it off. I have often known a dysentery brought on by imprudently throwing off a flannel waistcoat before the season was sufficiently warm. For whatever purpose this piece of dress is worn, it should never be left off but in a warm season.

In this disease the greatest attention must be paid to the patient’s diet. Flesh, fish, and everything that has a tendency to turn putrid or rancid on the stomach, must be abstained from. Apples boiled in milk, water-pap, and plain light pudding, with broth made of the gelatinous parts of animals, may constitute the principal part of the patient’s food. Gelatinous broth not only answers the purpose of food, but likewise of medicine. I have often known dysenteries, which were not of a putrid nature, cured by it, after pompous medicines had proved ineffectual.^*

Another kind of food very proper in the dysentery, which may be used by such as cannot take the broth mentioned above, is made by boiling a few handsful of fine flour, tied in a cloth, for six or seven hours, till it becomes as hard as starch. Two or three table-spoonsful of this may be grated down, and boiled in such a quantity of new milk and water as to be of the thickness of pap. This may be sweetened to the patient’s taste, and taken for his ordinary food.^*

In a putrid dysentery the patient may be allowed to eat freely of most kinds of good ripe fruit; as apples, grapes, gooseberries, currant-berries, strawberries, &c. These may either be eaten raw or boiled, with or without milk, as the patient chooses. The prejudice against fruit in this disease is so great, that many believe it to be the common cause of dysenteries. This, however, is an egregious mistake. Both reason and experience show, that good fruit is one of the best medicines, both for the prevention and cure of the dysentery. Good fruit is in every respect calculated to counteract that tendency to putrefaction, from whence the most dangerous kind of dysentery proceeds.† The patient, in such a case, ought therefore to be allowed to eat as much fruit as he pleases, provided it be ripe.

The most proper drink in this disorder is whey. The dysentery has often been cured by the use of clear whey alone. It may be taken both for drink, and in form of a clyster. When whey cannot be had, barley-water sharpened with cream of tartar may be drank, or a decoction of barley and tamarinds; two ounces of the former and one of the latter may be boiled in two English quarts of water to one. Warm water, water-gruel, or water wherein hot iron has been frequently quenched, are all very proper, and may be drank in turns. Camomile-tea, if the stomach will bear it, is an exceeding proper drink. It both strengthens the stomach, and, by its antiseptic quality, tends to prevent a mortification of the bowels.

MEDICINE.—At the beginning of this disease it is always necessary to cleanse the first passage. For this purpose a vomit of ipecacuanha must be given, and wrought off with weak camomile-tea. Strong vomits are seldom necessary here. A scruple, or at most half a drachm of ipecacuanha, is generally sufficient for an adult, and sometimes a very few grains will suffice. The day after the vomit, half a drachm, or two scruples of rhubarb must be taken; or what will answer the purpose rather better, an ounce or an ounce and a half of Epsom salts. This dose may be repeated every other day for two or three times. Afterwards small doses of ipecacuanha may be taken for sometime. Two or three grains of the powder may be mixed in a table-spoonful of the syrup of poppies, and taken three times a-day.

These evacuations, and the regimen prescribed above, will often be sufficient to effect a cure. Should it, however, happen otherwise, the following astringent medicines may be used.

A clyster of starch, or fat mutton-broth, with thirty or forty drops of liquid laudanum in it, may be administered twice a-day. At the same time an ounce of gum arabic, and half an ounce of gum tragacanth, may be dissolved in an English pint of barley-water over a slow fire, and a table-spoonful of it taken every hour.

If these have not the desired effect, the patient may take, four times a-day, about the bulk of a nutmeg of the Japonic confection, drinking after it a tea-cupful of the decoction of logwood.

Persons who have been cured of this disease are very liable to relapse; to prevent which, great circumspection with respect to diet is necessary. The patient must abstain from all fermented liquors, except now and then a glass of good wine; but he must drink no kind of malt-liquor. He should also abstain from animal food, as fish and flesh, and live principally on milk and vegetables.

PAIN OF THE STOMACH, &c.

THIS may proceed from various causes, as indigestion; wind; the acrimony of the bile; sharp, acrid, or poisonous substances taken into the stomach, &c. It may likewise be occasioned by worms; the stoppage of customary evacuations; or from a translation of gouty matter to the stomach, the bowels, &c.

Women in the decline of life are very liable to pains of the stomach and bowels, especially such as are afflicted with hysteric complaints. It is likewise very common to hypochondriac men of a sedentary and luxurious life. In such persons it often proves so extremely obstinate as to baffle all the powers of medicine.

When the pain of the stomach is most violent after eating, there is reason to suspect that it proceeds from some fault either in the digestion or the food. In this case the patient ought to change his diet, till he finds what kind of food agrees best with his stomach, and should continue chiefly to use it. If a change of diet does not remove the complaint, the patient may take a gentle vomit, and afterwards a dose or two of rhubarb. He ought likewise to take an infusion of camomile-flowers, or some other stomachic bitter, either in wine or water. I have often known exercise remove this complaint, especially sailing, or a long journey on horseback, or in a carriage.

When a pain of the stomach proceeds from flatulency, the patient is constantly belching up wind, and feels an uneasy distension of the stomach after meals. This is a most deplorable disease, and is seldom thoroughly cured. In general, the patient ought to avoid all windy diet, and every thing that sours on the stomach, as greens, roots, &c. This rule, however, admits of some exceptions. There are many instances of persons very much troubled with wind, who have received great benefit from eating parched peas, though that grain is generally supposed to be of a windy nature.^*

This complaint may likewise be greatly relieved by labour, especially digging, reaping, mowing, or any kind of active employment by which the bowels are alternately compressed and dilated. The most obstinate case of this kind I ever met with was in a person of a sedentary occupation, whom I advised, after he had tried every kind of medicine in vain, to turn gardener; which he did, and has ever since enjoyed good health.

When a pain in the stomach is occasioned by the swallowing of acrid or poisonous substances, they must be discharged by vomit: this may be excited by butter, oils, or other soft things, which sheath and defend the stomach from the acrimony of its contents.

When the pain of the stomach proceeds from translation of gouty matter, warm cordials are necessary, as generous wine, French brandy, &c. Some have drank a whole bottle of brandy or rum in this case in a few hours, without being in the least intoxicated, or even feeling the stomach warmed by it. It is impossible to ascertain the quantity necessary upon these occasions. This must be left to the feelings and discretion of the patient. The safer way, however, is, not to go too far. When there is an inclination to vomit, it may be promoted by drinking an infusion of camomile flowers, or carduus benedictus.

If a pain of the stomach proceeds from the stoppage of customary evacuations, bleeding will be necessary, especially in saguine and very full habits. It will likewise be of use to keep the body gently open by mild purgatives; as rhubarb or senna. When this disease affects women in the decline of life, after the stoppage of the menses, making an issue in the leg or arm will be of peculiar service.

When the stomach is greatly relaxed, and the digestion bad, which often occasions flatulencies, the elixir of vitriol will be of singular service. Fifteen or twenty drops of it may be taken in a glass of wine or water twice or thrice a-day.

Persons afflicted with flatulency are generally unhappy, unless they be taking some purgative medicines: these, though they may give immediate ease, tend to weaken and relax the stomach and bowels, and consequently increase the disorder. Their best method is to mix purgatives and stomachics together. Equal parts of Peruvian bark and rhubarb may be infused in brandy or wine, and taken in such quantity as to keep the body gently open.

Although it is difficult to prescribe a general medicine for a disorder proceeding from such a diversity of causes; a plaster may be recommended, which will give relief in most cases. Let it be made of any adhesive plaster, with the addition of a drachm and a half, or two drachms, of powdered opium when warm, and spread on a piece of leather large enough to cover the whole stomach, where it should be kept as long as it will stick.

WANT OF APPETITE.

This may proceed from a foul stomach, indigestion, the want of free air and exercise; grief, fear, anxiety, or any of the depressing passions; excessive heat, the use of strong broths, fat meats, or any thing that palls the appetite, or is hard of digestion; the immoderate use of strong liquors, tea, tobacco, opium, &c.

The patient ought, if possible, to make use of an open dry air, to take exercise daily on horseback or in a carriage, to rise betimes, and to avoid all intense thought. He should use a diet of easy digestion, and should avoid excessive heat and great fatigue.

If want of appetite proceed from errors in diet or any other part of the patient’s regimen, it ought to be changed. If nausea and retchings show that the stomach is loaded with crudities, a vomit will be of service. After this a gentle purge or two of rhubarb, or any of the bitter purging salts, may be taken. The patient ought next to use some of the stomachic bitters infused in wine. Though gentle evacuation be necessary, yet strong purges and vomits are to be avoided, as they weaken the stomach, and hurt digestion.

Elixir of vitriol is an excellent medicine in most cases of indigestion, weakness of the stomach, or want of appetite. From twenty to thirty drops of it may be taken twice or thrice a day in a glass of wine or water. It may likewise be mixed with the tincture of the bark, one drachm of the former to an ounce of the latter, and two tea-spoonsful of it taken in wine and water as above.

The chalybeate waters, if drank in moderation, are generally of considerable service in this case. The salt-water has likewise good effects, but it must not be used too freely. We would advise all who are afflicted with indigestion and want of appetite, to repair to these places of public rendezvous. The very change of air, and the cheerful company, will be of service; not to mention the exercise, dissipation, amusements, &c.

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

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

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