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<h1><span style="font-size: 80%">AN</span><br />
ACCOUNT<br />
<span style="font-size: 70%">OF THE</span><br />
<span style="font-size: 90%">DISEASES</span><br />
<span style="font-size: 50%">Which were most frequent in the</span><br />
<span class="smcap">British Military Hospitals</span><br />
<span style="font-size: 80%">in Germany,</span><br />
<span style="font-size: 70%">From January 1761 to the Return of the Troops</span><br />
<span style="font-size: 80%">to England in March 1763.</span></h1>

<p class="sub">To which is added,<br />
An ESSAY on the Means of Preserving the Health<br />
of Soldiers, and conducting Military Hospitals.</p>


<p class="author">By DONALD MONRO, M.D.<br />
<small><span class="smcap">Physician</span> to his <span class="smcap">Majesty&#8217;s Army</span>, and to</small><br />
<small><span class="smcap">St. George</span>&#8217;s Hospital.</small></p>


<p class="publisher">LONDON:<br /><br />
Printed for <span class="smcap">A. Millar</span>, <span class="smcap">D. Wilson</span>, and <span class="smcap">T. Durham</span>,<br />
in the Strand; and <span class="smcap">T. Payne</span>, at the Mews-Gate.<br />
<br />
MDCCLXIV.</p>


<h2><a name="TO_THE_KING" id="TO_THE_KING"></a>TO THE<span class='pagenum'><a name="Page_iii" id="Page_iii">[iii]</a></span><br />
<span style="font-size: 150%; letter-spacing: 0.15ex">KING</span>.</h2>


<p style="padding-left: 2em; font-size: 80%">May it please Your <span class="smcap">Majesty</span>,</p>

<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>o</span> permit me to lay at your
Feet the following Sheets,
published with a View to be useful
to those, who hereafter may
have the Care of the Health of
your <span class="smcap">Majesty</span>&#8217;s Troops.<span class='pagenum'><a name="Page_iv" id="Page_iv">[iv]</a></span></p>

<p><span class="smcap">Your Majesty</span>&#8217;s particular
Inquiries into the State of Your
Military Hospitals, in every
Quarter of the World, in the
Time of the late glorious and
successful War; Your Concern
for every Officer and Soldier
who suffered either by Sickness
or by Wounds in the Cause of
their King and Country; and
Your Solicitude to procure them
every possible Assistance and Relief,
cannot fail to excite the
highest Admiration of Your
<span class="smcap">Majesty</span>&#8217;s Goodness in the<span class='pagenum'><a name="Page_v" id="Page_v">[v]</a></span>
Breast of every Subject, and the
warmest Gratitude in the Heart
of every Soldier.</p>

<p>The Knowledge of these Circumstances
induced me to flatter
myself, that a Work of this
Kind would be agreeable to Your
<span class="smcap">Majesty</span>; and should this Attempt
towards pointing out the
Means of alleviating those Miseries,
which necessarily attend
a Military Life in the Time of
Service, be acceptable, I shall
obtain the utmost of my Wishes;<span class='pagenum'><a name="Page_vi" id="Page_vi">[vi]</a></span>
it being the greatest Ambition
of my Heart ever so to act as to
merit Your <span class="smcap">Majesty</span>&#8217;s Approbation,
and to subscribe myself,</p>

<p class="sig"><span style="padding-right: 2em">May it please Your <span class="smcap">Majesty</span>,</span><br />

Your <span class="smcap">Majesty</span>&#8217;s most dutiful Subject,<br />

<span style="padding-right: 4em">And most faithful</span><br />

<span style="padding-right: 2em">and humble Servant,</span><br />

<span style="font-size: 130%">DONALD MONRO.</span></p>



<h2><a name="THE_PREFACE" id="THE_PREFACE"></a>THE<span class='pagenum'><a name="Page_vii" id="Page_vii">[vii]</a></span><br />
<span style="font-size: 130%; letter-spacing: 0.15ex">PREFACE.</span></h2>

<p class="newchapter"><span class="firstword"><span class="dropcap">A</span>mong</span> the numerous Authors
of Observations in the Art of
Physick, there are but few who have
expressly written on the Treatment of
those Distempers, most generally incident
to an Army in the Field: The
following Work, therefore, seems to
have a fair Claim to be acceptable to
the Publick, having been compiled
during the Author&#8217;s Attendance on the<span class='pagenum'><a name="Page_viii" id="Page_viii">[viii]</a></span>
<i>British</i> Military Hospitals in <i>Germany</i>
in the late War; and in order to
render it of still further Use, he has
occasionally added, by Way of Note,
the Practice of some of the most eminent
Physicians in similar Diseases, as
well as a few Histories of Cases which
passed under his own Care at <i>St. George</i>&#8217;s
Hospital, <i>London</i>.</p>

<p>To avoid the Repetition of the
Composition of particular Medicines,
and the Interruption that would be
given by their being inserted in the
Body of the Work, a small Pharmacop&#339;ia
is added, to which his Practice
in the Army Hospitals was chiefly
confined.<span class='pagenum'><a name="Page_ix" id="Page_ix">[ix]</a></span></p>

<p>In a commercial Country like our
own, where Numbers of Hands are
constantly wanted for the carrying on
our Manufactories, we have a strong
political Argument to add to that
drawn from the Dictates of Humanity,
why the Life of every individual should
be most carefully attended to.</p>

<p>The Preservation of the Lives of
Soldiers is then with us a Matter of the
highest Importance, in order to make
as low as possible the Number of Recruits
who must be perpetually drawn
off for the Service of War. The Author
has, therefore, in this Treatise,
endeavoured to point out the Means
most likely to keep Men healthy when<span class='pagenum'><a name="Page_x" id="Page_x">[x]</a></span>
employed in different Services; and
also the Manner in which Military
Hospitals ought to be fitted up, and
conducted.&mdash;As he was never in any
of the warm Climates, nor ever at Sea
along with Troops aboard of Transports,
whatever is mentioned relative
to such Situations, is to be understood
as taken from printed Accounts of these
Subjects, or collected from the Conversation
of physical Gentlemen, who
were employed on such Services during
the two last Wars.</p>

<p>It is but Justice here to observe,
that the Marquis of <i>Granby</i>, Commander
in Chief of the <i>British</i> Troops
in <i>Germany</i>, as well as the Rest of the<span class='pagenum'><a name="Page_xi" id="Page_xi">[xi]</a></span>
General Officers employed on the <i>German</i>
Service, always paid the greatest
Attention to the Soldiers when sick in
Hospitals; and were particularly ready
in giving Orders for all such Things as
were necessary or proper for them.</p>

<p style="font-size: 90%; padding-left: 4em">
<span class="smcap">Jermyn-Street</span>,<br />
<span style="padding-left: 2em">April 15, 1764.</span>
<span class='pagenum'><a name="Page_xii" id="Page_xii">[xii]</a></span></p>



<h2><a name="CONTENTS" id="CONTENTS"></a><span style="font-size: 130%; letter-spacing: 0.15ex">CONTENTS</span>.<span class='pagenum'><a name="Page_xiii" id="Page_xiii">[xiii]</a></span></h2>

<table summary="contents">
<tr><td class="ral" colspan="2"><span class="smcap">Page.</span></td></tr>

<tr><td class="lal">Of the Malignant and Petechial Fever,</td><td class="ral"><a href="#Page_1">1</a></td></tr>

<tr><td class="lal">Of the Dysentery,</td><td class="ral"><a href="#Page_57">57</a></td></tr>

<tr><td class="lal">Of the Cholera Morbus,</td><td class="ral"><a href="#Page_97">97</a></td></tr>

<tr><td class="lal">Of the Inflammatory Fever,</td><td class="ral"><a href="#Page_104">104</a></td></tr>

<tr><td class="lal">Of the Angina,</td><td class="ral"><a href="#Page_109">109</a></td></tr>

<tr><td class="lal">Of the Pleurisy,</td><td class="ral"><a href="#Page_111">111</a></td></tr>

<tr><td class="lal">Of the Peripneumony,</td><td class="ral"><a href="#Page_115">115</a></td></tr>

<tr><td class="lal">Of the Cough and Consumption,</td><td class="ral"><a href="#Page_124">124</a></td></tr>

<tr><td class="lal">Of the Epidemical Catarrhal Fever of
<i>April</i> 1762,</td><td class="ral"><a href="#Page_137">137</a></td></tr>

<tr><td class="lal">Of the Rheumatism,</td><td class="ral"><a href="#Page_141">141</a></td></tr>

<tr><td class="lal">Of the Autumnal Remitting Fever,</td><td class="ral"><a href="#Page_154">154</a></td></tr>

<tr><td class="lal">Of the Intermitting Fever, or Ague,</td><td class="ral"><a href="#Page_179">179</a></td></tr>

<tr><td class="lal">Of the Jaundice,</td><td class="ral"><a href="#Page_206">206</a></td></tr>

<tr><td class="lal">Of Tumours of the Breast,</td><td class="ral"><a href="#Page_216">216</a></td></tr>

<tr><td class="lal">Of Paralytic Complaints,</td><td class="ral"><a href="#Page_219">219</a></td></tr>

<tr><td class="lal">Of an Incontinency of Urine,</td><td class="ral"><a href="#Page_223">223</a><span class='pagenum'><a name="Page_xiv" id="Page_xiv">[xiv]</a></span></td></tr>

<tr><td class="lal">Of a Stoppage of Urine,</td><td class="ral"><a href="#Page_227">227</a></td></tr>

<tr><td class="lal">Of the Epilepsy,</td><td class="ral"><a href="#Page_237">237</a></td></tr>

<tr><td class="lal">Of the Small-Pox,</td><td class="ral"><a href="#Page_243">243</a></td></tr>

<tr><td class="lal">Of Erisypilatous Swellings,</td><td class="ral"><a href="#Page_245">245</a></td></tr>

<tr><td class="lal">Of the Scurvy,</td><td class="ral"><a href="#Page_250">250</a></td></tr>

<tr><td class="lal">Of the Itch,</td><td class="ral"><a href="#Page_265">265</a></td></tr>

<tr><td class="lal" style="padding-bottom: 1em">Table of Diet used in the <i>British</i> Military
Hospitals in <i>Germany</i>,</td><td class="ral"><a href="#Page_273">273</a></td></tr>

<tr><td class="lal" style="line-height: 250%; border-top: solid black 1px; border-bottom: solid black 1px; padding-top: 0.5em; padding-bottom: 0.5em">
<span class="smcap">Pharmacopoeia</span> in usum Nosocomii
militaris regii Britannici 1761,</td><td class="ral" style="line-height: 250%; border-top: solid black 1px; border-bottom: solid black 1px; padding-top: 0.5em; padding-bottom: 0.5em"><a href="#Page_275">275</a></td></tr>

<tr><td class="lal" style="padding-top: 1em"><span class="smcap">Of the Means</span> of Preserving the Health
of Soldiers on Service,</td><td class="ral"><a href="#Page_309">309</a></td></tr>

<tr><td class="lal">&mdash;&mdash; in Winter, and in cold Climates,</td><td class="ral"><a href="#Page_313">313</a></td></tr>

<tr><td class="lal">&mdash;&mdash; aboard of Transport Ships,</td><td class="ral"><a href="#Page_323">323</a></td></tr>

<tr><td class="lal">&mdash;&mdash; in warm Climates,</td><td class="ral"><a href="#Page_331">331</a></td></tr>

<tr><td class="lal">Of healthful and unhealthful Grounds for
the Encampment of Troops,</td><td class="ral"><a href="#Page_338">338</a></td></tr>

<tr><td class="lal">Of keeping Camps clean,</td><td class="ral"><a href="#Page_344">344</a></td></tr>

<tr><td class="lal">Of supplying an Army with Straw and with
Provisions, and obliging the Soldiers to
buy a certain Quantity of Meat daily,</td><td class="ral"><a href="#Page_346">346</a><span class='pagenum'><a name="Page_xv" id="Page_xv">[xv]</a></span></td></tr>

<tr><td class="lal">Of Water, and the Means of correcting its
bad Qualities in Camps,</td><td class="ral"><a href="#Page_348">348</a></td></tr>

<tr><td class="lal">Of vinous and spirituous Liquors,</td><td class="ral"><a href="#Page_350">350</a></td></tr>

<tr><td class="lal" style="padding-bottom: 1em">Of keeping Men healthful in Quarters after
an active Campaign,</td><td class="ral"><a href="#Page_354">354</a></td></tr>

<tr><td class="lal" style="border-top: solid black 1px; padding-top: 1em">
Of <span class="smcap">Military Hospitals</span>,</td><td class="ral" style="border-top: solid black 1px; padding-top: 1em"><a href="#Page_355">355</a></td></tr>

<tr><td class="lal">Of the Manner in which the Antients disposed
of their Sick and Wounded,</td><td class="ral"><a href="#Page_356">356</a></td></tr>

<tr><td class="lal">Of the Hospitals wanted for an Army acting
on a Continent,</td><td class="ral"><a href="#Page_357">357</a></td></tr>

<tr><td class="lal">Of the Houses most fit for Hospitals,</td><td class="ral"><a href="#Page_361">361</a></td></tr>

<tr><td class="lal">Of fitting them up, and distributing the
Sick in them,</td><td class="ral"><a href="#Page_363">363</a></td></tr>

<tr><td class="lal">Of preventing infectious Disorders from
being generated or spreading among the Sick,</td><td class="ral"><a href="#Page_366">366</a></td></tr>

<tr><td class="lal">Of the Diet of Military Hospitals,</td><td class="ral"><a href="#Page_372">372</a></td></tr>

<tr><td class="lal">Of providing the Flying Hospital,</td><td class="ral"><a href="#Page_380">380</a></td></tr>

<tr><td class="lal">Of Hospitals on Expedition Service,</td><td class="ral"><a href="#Page_380">380</a></td></tr>

<tr><td class="lal">Of a Guard for Hospitals,</td><td class="ral"><a href="#Page_382">382</a></td></tr>

<tr><td class="lal">Of the Nurses and Patients, and Orders for
them,</td><td class="ral"><a href="#Page_383">383</a><span class='pagenum'><a name="Page_xvi" id="Page_xvi">[xvi]</a></span></td></tr>

<tr><td class="lal">Of a convalescent Hospital,</td><td class="ral"><a href="#Page_389">389</a></td></tr>

<tr><td class="lal">Of the Physicians, Surgeons, Apothecaries,
and Mates,</td><td class="ral"><a href="#Page_393">393</a></td></tr>

<tr><td class="lal">Of the Direction of Military Hospitals,</td><td class="ral"><a href="#Page_394">394</a></td></tr>

<tr><td class="lal">Of the Purveyor or Commissary of the
Hospital,</td><td class="ral"><a href="#Page_396">396</a></td></tr>

<tr><td class="lal">Orders for the Mates,</td><td class="ral"><a href="#Page_397">397</a></td></tr>

<tr><td class="lal">Of Precautions for guarding against infectious
Disorders,</td><td class="ral"><a href="#Page_400">400</a></td></tr>

<tr><td class="lal" style="border-bottom: solid black 1px; padding-bottom: 1em">Of a Military Inspector and Officers on
convalescent Duty,</td><td class="ral" style="border-bottom: solid black 1px; padding-bottom: 1em"><a href="#Page_403">403</a></td></tr>
</table>



<table summary="errata" class="errata">

<tr><th colspan="5"><span class="smcap">Errata Corrigenda.</span></th></tr>

<tr><td rowspan="15" valign="top">Page</td><td class="rall"><a href="#Page_13">13</a>,</td><td rowspan="15" valign="top">line</td><td class="rall">11,</td><td class="lall">for <i>Pleuretic</i>, read <i>Pleuritic</i>.</td></tr>

<tr><td class="rall"><a href="#Page_18">18</a>,</td><td class="rall">10,</td><td class="lall">of Notes, for <i>Acadamy</i>, read <i>Academy</i>.</td></tr>

<tr><td class="rall"><a href="#Page_28">28</a>,</td><td class="rall">22,</td><td class="lall">for <i>Cinamon</i>, read <i>Cinnamon</i>.</td></tr>

<tr><td class="rall"><a href="#Page_35">35</a>,</td><td class="rall">5,</td><td class="lall">of Notes, for <i>Calomile</i>, read <i>Calomel</i>.</td></tr>

<tr><td class="rall"><a href="#Page_51">51</a>,</td><td class="rall">12,</td><td class="lall">dele <i>used in this Way</i>.</td></tr>

<tr><td class="rall"><a href="#Page_166">166</a>,</td><td class="rall">12,</td><td class="lall">of Notes, for <i>which almost depend</i>, read
<i>which almost always depend</i>.</td></tr>

<tr><td class="rall"><a href="#Page_207">207</a>,</td><td class="rall">13,</td><td class="lall">of Notes, for <i>Vena postarum</i>, read <i>Vena portarum</i>.</td></tr>

<tr><td class="rall"><a href="#Page_259">259</a>,</td><td class="rall">4,</td><td class="lall">for <i>appeared</i>, read <i>appear</i>.</td></tr>

<tr><td class="rall"><a href="#Page_261">261</a>,</td><td class="rall">1,</td><td class="lall">of Notes, for <i>became</i>, read <i>become</i>.</td></tr>

<tr><td class="rall"><a href="#Page_280">280</a>,</td><td class="rall">20,</td><td class="lall">for <i>Chamamel</i>, read <i>Cham&aelig;mel</i>.</td></tr>

<tr><td class="rall"><a href="#Page_290">290</a>,</td><td class="rall">4,</td><td class="lall">for <i>3<sup>tis</sup> 4<sup>tiis</sup></i>, read <i>3<sup>tiis</sup> 4<sup>tis</sup></i>.</td></tr>

<tr><td class="rall"><a href="#Page_293">293</a>,</td><td class="rall">13,</td><td class="lall">for <i>Mithridatum</i>, read <i>Mithridatium</i>.</td></tr>

<tr><td class="rall"><a href="#Page_336">336</a>,</td><td class="rall">12</td><td class="lall">&amp; 13, for <i>bathe themselves as often</i>, read
<i>bathe early in the Morning as often</i>.</td></tr>

<tr><td class="rall"><a href="#Page_352">352</a>,</td><td class="rall">7,</td><td class="lall">for <i>in Bilanders</i>, read <i>and were to go in Bilanders</i>.</td></tr>

<tr><td class="rall"><a href="#Page_353">353</a>,</td><td class="rall">2,</td><td class="lall">for <i>the least Appearance of the Malignant Fever</i>,
read <i>the Malignant Fever appearing</i>.</td></tr>
</table>



<h2><a name="OF_THE_FEVER" id="OF_THE_FEVER"></a>OF THE<span class='pagenum'><a name="Page_1" id="Page_1">[1]</a></span><br />
<span class="smcap">Malignant</span> and <span class="smcap">Petechial</span><br />
<span style="font-size: 130%; letter-spacing: 0.15ex">FEVER.</span></h2>


<p class="newchapter"><span class="dropcap">A</span> Malignant Fever, and Fluxes, began to
appear among the Soldiers in Autumn,
1760, while the Allied Army remained encamped
about <i>Warbourg</i>, from the Beginning
of <i>August</i> till the 13th of <i>December</i>, when they
went into Cantonments. During that Time,
there had been a continued Rain for some
Months, and the Camp and neighbouring
Fields, and Villages, were not only filled with
the Excrements of such a numerous Army,
but likewise with infinite Numbers of dead
Horses, and other dead Animals, which had
died in doing the necessary military Duties,
and in bringing Forage, Provisions, and other<span class='pagenum'><a name="Page_2" id="Page_2">[2]</a></span>
Necessaries, to the Camp: besides this, the
Field where there had been an Action on the
31st of <i>July</i>, and where many of the Dead
were scarce covered with Earth, was in the
Neighbourhood of the Camp.</p>

<p>Not only the Soldiers, but the Inhabitants
of the Country, who were reduced to the
greatest Misery and Want, were infected with
the Malignant Fever, and whole Villages almost
laid waste by it.</p>

<p>Such a Number of Soldiers was sent to
<i>Paderborn</i> as crowded the Hospitals there, and
increased the Malignancy of the Distempers
so that a great many died.</p>

<p>When I arrived at <i>Paderborn</i>, in the
Beginning of <i>January</i> 1761, the Fever
was upon the Decline in the General
Hospitals, though it was still rife; but by
sending off a Party of Convalescents to <i>Hervorden</i>,
which thinned the Hospitals, it became
less frequent, and but few died. The
Guards marched upon the Expedition into
<i>Hesse</i>, on the eleventh of <i>February</i>, which gave
us full Room for billetting all our Convalescents,
and thinning the Wards; by which Means<span class='pagenum'><a name="Page_3" id="Page_3">[3]</a></span>
the Fever almost entirely ceased in all the Hospitals
we had before they went away; though
there still remained about four hundred sick.</p>

<p>When the Guards marched out of <i>Paderborn</i>,
they left the Care of their Sick to us,
who belonged to the General Hospital: the
first Regiment of Guards left sixty sick;
the second, twenty-nine; the third, twenty-eight;
and the Granadiers, fifteen, in their
regimental Infirmaries; who were mostly ill
of the Malignant Fever: amongst whom the
Infection was so very strong, that, although I
procured the Sick new airy Houses for Hospitals,
which were kept as clean and well-aired
as possible, and procured clean Bedding, and
clean Linen for every Man, and had the Sick
laid thin, yet several died, and it was some
Time before we got entirely free of the Infection.
The first and third Regiments suffered
most, owing to all the Sick of each Regiment
being put into a particular Hospital by themselves,
which kept up the Infection, so that
they lost one-third of those left ill of this Fever;
and many of the Nurses, and People
who attended them, were seized with it. But<span class='pagenum'><a name="Page_4" id="Page_4">[4]</a></span>
not being able to procure particular Houses for
the Sick of the <i>Coldstream</i> or Second Regiment,
and for the Granadiers, I distributed
them through the different Hospitals we had
then in Town, where the Contagion had
ceased; and by their being thus scattered,
while they were kept very clean, and at as great
a Distance as possible, from the other Patients
in the Wards where they were put, they lost
few in Proportion to the first and third Regiments,
and the Disorder did not spread.</p>

<p>About the End of <i>May</i>, the Weather was
very warm at <i>Osnabruck</i>; when this Fever began
to make its Appearance in the Corner of a
large Ward, which was next to one kept for
salivating venereal Patients; and only divided
from it by means of a few thin Deals. Perceiving
a strong Smell in this Place, I suspected
that the Fever arose from the foul Steams
coming from the next Ward, and therefore
ordered the salivating Ward to be thinned, and
removed all the Sick from the Places near that
Ward; and ordered those that had catched the
Fever to be put into large airy Places; by
which means the Infection spread no further,<span class='pagenum'><a name="Page_5" id="Page_5">[5]</a></span>
and only one, out of six or seven who had got
the Fever, died.</p>

<p>At the End of <i>June</i>, the Weather was
very hot at <i>Bilifield</i>, and the Fever began
to shew itself by the Hospital being overcrowded,
by a greater Number of Sick being
sent from the Army than we had proper Places
to put them in; but it was put a Stop to in a few
Days, by the Removal of the Hospital. Seventy
Sick were left behind to the Care of a
Mate, most of them ill of the Fever, of
whom twelve died.</p>

<p>In the Beginning of <i>August</i>, a few Men
were taken ill of the same Fever at <i>Munster</i>,
in one of the Hospitals which was too
much crowded; but its further Progress was
stopped by sending a Number of recovered
Men to Billet.</p>

<p>In <i>November</i> and <i>December</i> 1761, and
<i>January</i>, <i>February</i>, and <i>March</i> 1762, we
had several Men sent from Quarters in the
Town of <i>Bremen</i> to the Hospital, sick of the
Petechial Fever: they were quartered on the
Ground-floors of low damp Houses, and fresh
Meat and Vegetables so dear that they could<span class='pagenum'><a name="Page_6" id="Page_6">[6]</a></span>
not afford to buy them; but were obliged to
live mostly on salt Provisions. I was told likewise
that the spotted Fever was frequent among
the lower Class of the Inhabitants. Some
few were seized with this Fever in the Hospital
itself; yet as the House was not crowded,
and we had a Number of small airy Wards,
the Infection did not spread; and we had but
one or two who died of this Fever during
the Winter, in the Hospital I attended.</p>

<p>In Summer 1762, we had only ten or
eleven ill of this Fever in the Hospital at <i>Natzungen</i>,
and only one died.</p>

<p>When the Troops marched from their Cantonments,
in <i>December</i> 1762, towards the
Borders of <i>Holland</i>, the twentieth and twenty-fifth
Regiments of Foot left behind them, at
<i>Osnabruck</i>, thirty sick; five of whom had Symptoms
of the Hospital Fever, though no Petechi&aelig;
appeared; three recovered, and two died
suddenly, being lodged in large open Wards
(the only Places we had to put them in) with
the Windows all broke, in very cold frosty
Weather.<span class='pagenum'><a name="Page_7" id="Page_7">[7]</a></span></p>

<p>In <i>January</i> 1763, we had only three Patients
in this Fever, with the Petechi&aelig; upon
them, who all recovered. After this we had
none taken ill of it at <i>Osnabruck</i>, while I remained
there, which was till the twenty-fifth
of <i>March</i>.</p>

<p>This Malignant Fever begun variously in
different Subjects; for the most part with Cold
and Shivering, Pain in the Head, and other
Symptoms, commonly described as peculiar
to this Fever. In some, it begun with a sharp
Pain of the Side, or other Parts, attended with
acute inflammatory Symptoms; in others, it
put on the Appearance of the common, low,
or nervous Fever, for a Day or two. Blood
drawn in the Beginning from some Patients
did not seem much altered; from others it
threw up a strong inflammatory Buff<a name="FNanchor_1_1" id="FNanchor_1_1"></a><a href="#Footnote_1_1" class="fnanchor">[1]</a>; but
<span class='pagenum'><a name="Page_8" id="Page_8">[8]</a></span>where the Fever had continued some time,
it was commonly of a loose Texture, and of
a livid Colour; unless when the Sick were accidentally
seized with pleuritic Stitches, or
other Disorders of this kind.</p>

<p>The Reason of this Difference of Symptoms in
the Beginning, and of these different Appearances
of the Blood, seemed to be, that such Patients
as laboured under Pleurisies, low or other Fevers,
being brought into Hospitals where the
Malignant Fever was frequent, had their original
Disorders changed into this Fever by
breathing a foul infected Air, and by their
Communication with those ill of the Fever, and
of Fluxes; at other Times, a mere Acrimony
of the Blood, set in Motion by a supervening
Fever, determined the Disorder to be of this
kind: and I always observed, that those Men
were most apt to catch this Fever, whose Constitutions
<span class='pagenum'><a name="Page_9" id="Page_9">[9]</a></span>had been broke down by previous
Disorders.</p>

<p>The Fever appeared in different Forms.
Some had only a Quickness of the Pulse, attended
with a slight Head-ach and Sickness,
Whiteness of the Tongue and Thirst, and a
Lowness and Languor; which continued for a
Week or more, and then went off, either insensibly,
or with a profuse Sweat, succeeded by a
plentiful Sediment in the Urine. Most of those
who fell into profuse kindly-warm Sweats recovered,
the Sweat carrying off the Fever.
These profuse Sweats continued for twelve or
twenty-four Hours, and sometimes for two,
three, or four Days. In those who had the
Fever in this slight Degree, the Petechi&aelig; seldom
appeared; and it was only known to be
this sort of Fever by the other Symptoms, and
the Malignant Fever being frequent at that
time in the Hospitals. Dr. <i>Pringle</i><a name="FNanchor_2_2" id="FNanchor_2_2"></a><a href="#Footnote_2_2" class="fnanchor">[2]</a> very justly
observes, &#8220;That these low Degrees of this
Fever are hardly to be characterised, and are
only to be discovered, in full Hospitals, by
<span class='pagenum'><a name="Page_10" id="Page_10">[10]</a></span>observing Men languish; though the Nature
of the Illness, for which they come in, should
seem to admit of a speedier Cure.&#8221;</p>

<p>For the most Part the Fever appeared with
more violent Symptoms, the Tongue became
more parched and dry, more or less of a Delirium
came on, attended with the other
Symptoms commonly described as peculiar to
this Fever.</p>

<p>When the Petechi&aelig; appeared, they came
out on the fourth, fifth, sixth, or seventh
Day; seldom after the eleventh or twelfth<a name="FNanchor_3_3" id="FNanchor_3_3"></a><a href="#Footnote_3_3" class="fnanchor">[3]</a>.
They appeared mostly on the Breast, Back,
<span class='pagenum'><a name="Page_11" id="Page_11">[11]</a></span>Arms, and Legs, and sometimes, tho&#8217; rarely,
on the Face. They had exactly the Appearance
described by Dr. <i>Pringle</i>, either like small
distinct Spots of a reddish Colour, or the Skin
looked sometimes as if it had been marbled, or
variegated as in the Measles, but of a Colour
more dull and lured. As they began to disappear,
they inclined to a dun or brown Colour,
and looked like so many dirty Spots. I
never saw them rise above the Skin; nor did I
once see any miliary Eruptions in this Fever;
which agreed exactly with what Dr. <i>Pringle</i>
had observed in the former War, and in the
Beginning of this; however, we ought not
to conclude from thence that miliary Eruptions
are never observed in Fevers of this kind; for Dr.
<i>Huxham</i><a name="FNanchor_4_4" id="FNanchor_4_4"></a><a href="#Footnote_4_4" class="fnanchor">[4]</a>, Dr. <i>Hasenohrl</i><a name="FNanchor_5_5" id="FNanchor_5_5"></a><a href="#Footnote_5_5" class="fnanchor">[5]</a> and Dr. <i>Lind</i><a name="FNanchor_6_6" id="FNanchor_6_6"></a><a href="#Footnote_6_6" class="fnanchor">[6]</a>,
<span class='pagenum'><a name="Page_12" id="Page_12">[12]</a></span>besides many other good Practitioners, mention
their having seen them.</p>

<p>Many had no Petechi&aelig; through the whole
Course of the Disorder; but in all who were
very bad, the Countenance looked bloated, and
the Eyes reddish and somewhat inflamed; and
though the Skin was commonly dry, yet the
<i>Perspiration from the Lungs</i> was strong. By
these Circumstances one might frequently discover
that the Patient laboured under the malignant
Fever, without asking any Questions.</p>


<p class="break">When Men were taken ill of a Fever, which
we suspected to be of the malignant kind, our
first Care was to lay them in airy Places, separate
as much as possible from the other
Men, and to keep them extremely clean;
and they were put on low Diet, and allowed
as much Barley or Rice-water as they chose to
drink, which was commonly ordered to be acidulated
with the <i>Spiritus Vitrioli</i>.</p>

<p><span class='pagenum'><a name="Page_13" id="Page_13">[13]</a></span></p><p>For the first two or three Days we could
seldom distinguish, with Certainty, that the
Fever was of the malignant kind, though we
had often Reason to suspect it. The Pain of
the Head, the Fulness and Quickness of the
Pulse, and other Symptoms, led us commonly
to take away more or less Blood, which
the Patient bore easily, and for the most part
it gave Relief<a name="FNanchor_7_7" id="FNanchor_7_7"></a><a href="#Footnote_7_7" class="fnanchor">[7]</a>. We seldom repeated this
Evacuation where we suspected the Fever to
be of the malignant kind, unless a pleuritic
Stitch, an acute Pain of the Bowels, or some
other accidental Symptom, required it; or the
Patient was strong, and there were evident
Symptoms of Fullness immediately before we
<span class='pagenum'><a name="Page_14" id="Page_14">[14]</a></span>intended giving the Bark, as shall be mentioned
afterwards; for under other Circumstances,
if the Blooding was repeated, and other Evacuations
used freely, I always observed that it
did Harm, and was apt to sink the Patient too
much; as Dr. <i>Huxham</i>, Dr. <i>Pringle</i>, and
other good Practitioners, have remarked.</p>

<p>After Bleeding, if the Patient was costive,
or complained of Gripes, he had a Dose
of Rhubarb, or Salts, or a laxative Clyster;
but where there was much Sickness
of the Stomach, we gave a gentle Emetic<a name="FNanchor_8_8" id="FNanchor_8_8"></a><a href="#Footnote_8_8" class="fnanchor">[8]</a>
in the Evening, and the Purge next Morning.
<span class='pagenum'><a name="Page_15" id="Page_15">[15]</a></span>And if in the Course of the Disorder the
Sickness and Nausea returned, attended with
Griping and Costiveness, or very fetid loose
Stools, these Medicines were repeated, and
a gentle Opiate given in the Evening after
their Operation.</p>

<p>After Evacuations, if the Pulse kept up, we
commonly gave nothing but the saline Draughts,
with the <i>Pulvis contrayerv&aelig;</i>, or some temperate
Medicine, for the first Day or two. As soon
as we could distinguish the Fever to be of the
malignant kind, and that the Pulse rather
sunk, we joined some of the Cordials to the
saline Medicines, and allowed the Patient
<span class='pagenum'><a name="Page_16" id="Page_16">[16]</a></span>more or less Wine, according to the Degree
of the Fever. Dr. <i>De Haen</i> has found Fault
with Dr. <i>Pringle</i> and Dr. <i>Huxham</i>, for administering
cordial Medicines and Wine in the
low State of this Fever; but nothing answered
so well with us as these Remedies under such
Circumstances; and I have frequently seen
every Symptom changed for the better by their
Use; and even when I gave the Bark, in the
Manner recommended by <i>De Haen</i>, I often
found it necessary to join the free Use of Wine<a name="FNanchor_9_9" id="FNanchor_9_9"></a><a href="#Footnote_9_9" class="fnanchor">[9]</a>,
<span class='pagenum'><a name="Page_17" id="Page_17">[17]</a></span>Cordials and Blisters<a name="FNanchor_10_10" id="FNanchor_10_10"></a><a href="#Footnote_10_10" class="fnanchor">[10]</a>, in order to support the
Patient&#8217;s Strength.</p>
<p><span class='pagenum'><a name="Page_18" id="Page_18">[18]</a></span></p>
<p>After reading the Treatises of Dr. <i>De Haen</i>
and Dr. <i>Hasenohrl</i>, on this Fever, I resolved
on giving the Bark<a name="FNanchor_11_11" id="FNanchor_11_11"></a><a href="#Footnote_11_11" class="fnanchor">[11]</a> in large Quantities,
and found it to answer the Recommendations
given by these Gentlemen; and
shall relate here two or three Cases, out
of above a hundred and fifty, in which I
gave it.</p>

<p>I. <i>Robert Wilson</i>, of the Second Regiment
of Foot Guards, on the 19th of <i>February</i> 1761,
was seized with a Shivering and Coldness, succeeded
<span class='pagenum'><a name="Page_19" id="Page_19">[19]</a></span>with Heat, Thirst, a short dry Cough,
Difficulty of Breathing, Head-ach, and slight
Stitches in his Breast; some Blood was taken
away, which was sizy, and he was ordered
two Ounces of the <i>Sperma Ceti</i> Mixture, with
the <i>spiritus mindereri</i>, every two or three
Hours. He continued without any manifest
Alteration in the Symptoms, till the 21st,
when a Number of dun Petechi&aelig; appeared all
over his Body, particularly on his Breast. The
Stitches and Cough were then much easier,
and he had his Medicines as before. On
the 22d, he was seized with a Delirium,
and was somewhat comatose; when he was
ordered a Drachm of the Bark every six Hours.
The 23d, the comatose Symptoms had increased,
and he had slight Twitchings of the Tendons,
a dry brown-coloured Tongue, and a
Faultering in his Speech. The Bark was continued,
with the Addition of two Spoonfuls
of Mountain Wine every two Hours. On the
24th, he had several loose Stools. The 25th, he
was still loose, and went on as before, with the
Addition of six Grains of the <i>Pilul&aelig; saponace&aelig;</i><span class='pagenum'><a name="Page_20" id="Page_20">[20]</a></span>
in the Evening. The 26th, the Petechi&aelig;
were not so apparent as before, but he had
still the nervous Symptoms, and his Breathing
grew more difficult; and therefore a Blister
was applied between his Shoulders, and his
Medicines continued; as they were likewise
on the 27th, without any Alteration in the
Symptoms. On the 28th, his Tongue became
moister, and the Pulse, which had been low
and quick the four preceding Days, became
fuller and slower. On the 29th, he was much
more sensible, his Tongue more moist, and
the Twitchings of the Tendons much less; and
in the Evening he fell into a profuse Sweat,
which lasted all the 30th. On the 1st of
<i>March</i>, his feverish Symptoms were much
abated, his Pulse was calmer, his Skin moist,
his Drought less, and his Urine dropt a plentiful
Sediment. On the 2d, his Fever was
almost entirely gone, but he had still a
Cough, and spit up a viscid Matter. He was
ordered to go on as before, with the Addition
of two Spoonfuls of the <i>Sperma Ceti</i>
Mixture, and the <i>Spiritus Mindereri</i>, when<span class='pagenum'><a name="Page_21" id="Page_21">[21]</a></span>
his Cough was troublesome. He followed
this Course till the 7th, when, his Cough
and Fever being gone, he was ordered a
Dose of Tincture of Rhubarb; after which he
recruited his Strength daily, without the Assistance
of any more Medicines.</p>

<p>II. On the 5th of <i>March</i> 1761, <i>Thomas Stagg</i>,
of the Second Regiment of Foot Guards,
was seized with the same Symptoms as <i>Robert
Wilson</i> had been in the Beginning of his Fever,
but in a more violent Degree. He was blooded
to about twelve Ounces, and was ordered a saline
Draught every six Hours. On the 6th, the
Blood, which had been drawn the Day before,
had thrown up a slight Buff; it appeared to
contain but a small Proportion of Serum, and
the Crassamentum was of a loose Texture.
The feverish Symptoms had increased, with
the Addition of a Delirium: pergat. On the
7th, the Delirium was grown more violent, so
that he could scarce be kept in Bed; his Breathing
was difficult, his Eyes red and florid: A
Blister was applied to his Back, and the saline
Mixture continued. On the 8th, there was
no Alteration in the Course of that Day; but<span class='pagenum'><a name="Page_22" id="Page_22">[22]</a></span>
being lower towards Night, Blisters were applied
to his Legs, and he was ordered to have a
Pint of Wine allowed him in twenty-four
Hours. On the 9th, the Petechi&aelig; appeared
over his whole Body, of a broad dunnish kind;
his Breathing became easier, and his Pulse
stronger, though the Delirium was still as
bad as before: He was ordered a Drachm of
the Bark every fourth Hour in a saline Draught.
On the 10th, the Bark gave him several loose
Stools, but the Petechi&aelig; were of a more florid
Colour; the Delirium was less, and his Tongue
moist, and therefore he was ordered to continue
the same Medicines as the Day before,
with the Addition of ten Grains of the <i>Pilul&aelig;
saponace&aelig;</i> in the Evening. The 11th Day,
he fell into a fine breathing Sweat, his Pulse
became fuller and slower, and the Delirium
abated: p. The 12th, his Pulse was regular,
and the Delirium gone, and he was much
inclined to sleep. The 13th, after a calm
Sleep, which had lasted twelve or fourteen
Hours, he became quite free of Fever. After
this he continued the Use of his Medicines<span class='pagenum'><a name="Page_23" id="Page_23">[23]</a></span>
for some Days, and recovered his Health
and Strength daily.</p>

<p>III. On the 23d of <i>May</i> 1761, <i>Lionel Thompson</i>,
of the First Regiment of Foot Guards,
was seized with all the Symptoms of a Peripneumony,
attended with a high Fever, for
which he was ordered to be blooded. After
losing eight Ounces of Blood, he fell into a
fainting Fit; on recovering out of which, his
Breathing being still much affected, he had a
Mixture made of four Ounces of the <i>Lac Ammoniacum</i>,
and one of the <i>spiritus mindereri</i>,
of which he was desired to take two Spoonfuls
every four Hours. The 24th, the Symptoms
the same: He complained of having had no
Stool for some Days, and took half an Ounce
of the <i>sal catharticum amarum</i>, which gave
him two loose Stools. On the 25th, his Pulse
was small and quick, his Breathing difficult; he
was low, and had a slight Delirium: A large
Blister was applied between his Shoulders, and
the Medicines continued. On the 26th, in
the Morning, the Petechi&aelig; appeared, and
his Breathing was freer: He was ordered a
Drachm of the Bark, in a saline Draught, every<span class='pagenum'><a name="Page_24" id="Page_24">[24]</a></span>
four Hours. The 27th, the Pulse better: p. The
28th, was more sensible, and had a kindly warm
Moisture all over the Skin. The 29th, the Fever
was much abated, and his Tongue, which was
before parched and dry, became moist and white:
He continued the Use of the Cortex for three
Days more, which removed the Fever; and
being costive, he took a Dose of the Tincture
of Rhubarb. After this he used the Bark for
a few Days longer, and got perfectly well.</p>

<p>After giving the Bark<a name="FNanchor_12_12" id="FNanchor_12_12"></a><a href="#Footnote_12_12" class="fnanchor">[12]</a> with Success, in the
two first of the Cases mentioned, and to two
<span class='pagenum'><a name="Page_25" id="Page_25">[25]</a></span>young Gentlemen, Mates of the Hospital, who
had caught the Fever from their Attendance on
the Sick, I gave it to above a hundred and
fifty at <i>Paderborn</i>, and elsewhere, during my
Attendance in the Military Hospitals in <i>Germany</i>;
and although it did not answer in every
Case, yet it was found to have a better Effect
than any other Remedy that was tried. We
joined different Medicines with it, according to
the State of the Patient. We gave the <i>Confectio
cardiaca</i>, <i>Rad. serpent. Virg.</i> and other cordial
Medicines, and Wine, when the Pulse was low;
<i>Oxymel scilliticum</i>, and other Pectorals, when
<span class='pagenum'><a name="Page_26" id="Page_26">[26]</a></span>the Breathing was difficult; Opiates, where the
Patient was inclined to be too loose; the <i>spiritus
mindereri</i>, and other Diaphoretics, when
we wanted to promote a free Perspiration; and
we applied Blisters as Occasion required.</p>

<p>When the Patient was strong, the Pulse
quick and full, the Eyes looked red, and the
Breathing was difficult, after the Petechi&aelig; appeared;
I took away more or less Blood before
giving the Bark. Most Practitioners of late
Years have been against Bleeding in this Stage
of the Disorder; but trusting to the Assurances
given by Dr. <i>Hasenohrl</i> of its being safe, nay of
Advantage to bleed at this Time, if the Symptoms
required it, I ventured upon it, and found
it to be of the greatest Service, in many Cases,
in the Hospitals at <i>Paderborn</i> and elsewhere;
and particularly in two Cases at <i>Bremen</i>, and
one at <i>Osnabruck</i>, where it gave immediate Relief,
and seemed to shorten the Disease much.
One of the Patients at <i>Bremen</i>, <i>Robert Ellis</i>,
belonged to an Independant Company; the other,
<i>Francis Hamstan</i>, of the 24th Regiment, had formerly
had his Skull fractured, and took the Fever,
while he was in the Hospital, for violent Head-achs,<span class='pagenum'><a name="Page_27" id="Page_27">[27]</a></span>
which he had been subject to, at times,
ever after his Skull had been fractured. The
Case at <i>Osnabruck</i> was a Nurse of the Hospital,
whose Name was &mdash;&mdash; <i>Andrews</i>, a Woman
about twenty-five Years of Age, who, after attending
a Dragoon in the Small Pox, and suckling
at the same time her own Child, then in the
same Disorder, was, on the 18th of <i>January</i>
1763, attacked with a Fever. I saw her for
the first time on the 20th, and found her Pulse
quick, full, and strong. She complained of a
violent Head-ach; for which she was blooded,
and took the saline Mixture, with Nitre and
Contrayerva. Next Day, the 21st, her Blood
appeared very sizy, and she complained of having
been costive for some Days. We gave her
immediately an Ounce of the <i>sal catharticum
amarum</i>, which operated well. She continued
much in the same Way the 22d, and had
some loose Stools that Day. Being still inclined
to be loose the 23d, instead of her former
Medicines, she was ordered the <i>spiritus mindereri</i>
Mixture, with Mithridate. This checked
the Purging, but did not stop it entirely. The Fever<span class='pagenum'><a name="Page_28" id="Page_28">[28]</a></span>
went on, without any remarkable Change,
till the 27th; at which time the Petechi&aelig; appeared
all over her Body, attended with a Redness
of the Eyes, and a violent Oppression and
Pain of her Head, and a quick Pulse. I ordered
six Ounces of Blood to be taken away immediately,
and a large Blister to be applied to
her Back, and, at the same time, ordered her
a cordial Mixture, with half an Ounce of the
Extract of the Bark in it, to be taken every
twenty-four Hours. The 28th, her Pulse was
not so hard, her Head was much easier, the
Redness of her Eyes was much less, and the Petechi&aelig;
had begun to die away. The Blood
which was taken away the Day before, had a
thin Buff at the Top, but the <i>Crassamentum</i> underneath
was of a dark Colour, and of a loose
Texture: p. On the 29th, she told me that
she had had two or three loose Stools, and
she was lower than the Day before; and therefore
a Drachm of Mithridate, and two Drachms
of the Tincture of Cinnamon, were added to her
cordial Mixture, with the Cortex; and she was
allowed half a Pint of Red Wine, mulled with<span class='pagenum'><a name="Page_29" id="Page_29">[29]</a></span>
Cinnamon, <i>per</i> Day. 30th, Her Tongue rather
moister than the Day before; and she not so low,
but she was still inclined to be loose; and therefore
was ordered the anodyne Draught at Nights,
and to continue the other Medicines. 31st, She
was still inclined to be loose; but her Pulse kept
up, her Tongue was moister, and she found herself
pretty easy: p. <i>Feb.</i> 1st, Her Pulse
pretty strong, and she found herself much
cooler, and freer from the Fever, and complained
of a Dullness of Hearing. On the 2d, in
the Morning, she felt a warm Moisture all over
her Skin, which, about Noon, broke out into a
profuse Sweat, and continued till the 4th; when
it went off, and her Urine let fall a copious
whitish Sediment. She had then little or no
Fever. The Dullness of Hearing still continued,
though it was much less than before. After
this the Deafness went gradually away. She
continued the Use of the cordial Mixture, with
the Cortex, till the 12th, and recovered Strength
daily. After this, she had no other Medicine,
except two Doses of the Tincture of Rhubarb,<span class='pagenum'><a name="Page_30" id="Page_30">[30]</a></span>
and was soon in good Health, and able to discharge
her Duty as a Nurse.</p>

<p>However, it ought to be observed, that we
must not bleed so freely, in this or any other
Stage of the Malignant Fever, as in acute inflammatory
Disorders, otherwise we shall sink the Patient,
and hurry him to his Grave; and that
Bleeding can only take place with Safety and
Advantage, under the Circumstances above-mentioned,
immediately before giving the Bark
freely; or where some accidental sharp Pain in
the Breast, or Bowels, or some other violent
Symptom, may require it. They err equally,
who recommend Bleeding freely in this Fever,
with those who entirely forbid its Use.</p>

<p>Although we found the Bark to be in general
the best Remedy in this malignant Petechial
Fever, yet it did not answer in every Case; for
in some we found other Remedies had a better
Effect: And therefore, when we observed that,
notwithstanding the Use of the Bark, the Patient
sunk, and the Symptoms grew worse, we
did not persist obstinately in its Use, but tried
the Effect of other Medicines.<span class='pagenum'><a name="Page_31" id="Page_31">[31]</a></span></p>

<p>Towards the End of <i>May</i> 1761, two Soldiers
in the Hospital, at <i>Osnabruck</i>, were taken
ill of this Fever; who, after using the Bark
freely, and being allowed a Pint of Red Wine
<i>per</i> Day, for some Days together, began to sink,
and had a Delirium and other bad Symptoms
hastening on: upon which I laid aside the Use
of the Bark, and ordered each of them a Blister
to the Back, and to take a cordial Draught,
with fifteen Grains of Musk in it, every four
Hours; and to have their Wine mulled with Cinnamon;
and although at that Time they were
both so low that I scarce imagined they would
live twenty-four Hours, yet next Day I found
them greatly mended; and they had a kindly
warm Moisture all over their Skin, and the Pulse
had rose considerably in both. By the Continuance
of the same Medicine the feverish
Symptoms gradually abated, and they both got
well.</p>

<p>About the same time, having given the Bark
freely for some Days, and applied a Blister, to
another Patient, after the Petechi&aelig; had appeared,
I found him one Morning so low that his<span class='pagenum'><a name="Page_32" id="Page_32">[32]</a></span>
Pulse could scarce be felt. He could not speak;
he had a Delirium, and rather a Tremor than a
<i>subsultus tendinum</i>, and he had all the Appearance
of a dying Man. However, as he still
swallowed whatever was put in his Mouth, I
changed the Bark Mixture for Draughts, which
contained a Scruple of the <i>confectio cardiaca</i>,
and seven Grains of the <i>sal vol. corn. cerv.</i><a name="FNanchor_13_13" id="FNanchor_13_13"></a><a href="#Footnote_13_13" class="fnanchor">[13]</a>
<span class='pagenum'><a name="Page_33" id="Page_33">[33]</a></span>each, and ordered one to be given immediately,
and afterwards to be repeated every four Hours;
and, in the Intervals, to give him frequently a Tea-cup
full of Red Wine, mulled with Cinnamon;
and to apply two large Blisters to his Legs. Next
Day, his Pulse had rose; and by the Continuance
of the same Remedies it became gradually
fuller and stronger, and the third Day after he
recovered his Voice; and a warm kindly Moisture
which ended in a profuse Sweat coming
on, the feverish Symptoms went off soon after,
and he recovered his Health.</p>

<p>At <i>Bremen</i> there were two Men, one in <i>January</i>,
and the other in <i>February</i> 1762, on
whom the Cortex had but little Effect, who
recovered by the free Use of Mixtures, with
the <i>confectio cardiaca</i> and <i>rad. serpentari&aelig;</i>, and
<span class='pagenum'><a name="Page_34" id="Page_34">[34]</a></span>of Wine, with the Application of large Blisters.
Several Cases of this kind occurred in
the Hospitals, where the Bark did not answer.</p>

<p>There is one thing to be observed with respect
to Malignant Fevers, which is, that if
ever they appear in large crowded Hospitals,
unless we can thin the Wards, and procure
a free Circulation of Air, and keep the Hospital
and Sick extremely clean, the Fevers will
continue to spread, and great Numbers will die;
and even the most efficacious Remedies will
have little or no Effect. And that when once
the Infection is grown strong, it requires the
greatest Care, and some Time, before it can be
entirely got the better of. And that if a great
number of Men, ill of this Fever, be kept in
the same Ward, they will help to keep up the
Infection; and therefore it is always proper,
when it can possibly be done, to lay but a few
of them in one Ward; not above one-third of
the Number generally admitted.</p>

<p>Many of the Patients, towards the Height
of this Fever, sooner or later, had a Purging,
which seldom proved critical; and some were<span class='pagenum'><a name="Page_35" id="Page_35">[35]</a></span>
seized with the Flux. A gentle <i>diarrh&#339;a</i>, such
as did not sink the Patient, was commonly of
Service; but when violent, or a Dysentery came
on, the Case was always dangerous; for whatever
stopped the Flux increased the Fever; and,
if the Purging or Flux continued, it sunk the
Patient. Such Fluxes we treated in the Manner
to be mentioned afterwards, when we come
to the History of the Dysentery.</p>

<p>In this Fever, it was common for Patients to
vomit Worms<a name="FNanchor_14_14" id="FNanchor_14_14"></a><a href="#Footnote_14_14" class="fnanchor">[14]</a>, or to pass them by Stool, or,
what was more frequent, to have them come
up into their Throat and Mouth, or sometimes
into their Nostrils, while they were asleep in
Bed, and to pull them out with their Fingers.
The same Thing happened to most of the <i>British</i>
Soldiers, brought to the Hospitals for other
feverish Disorders as well as this. Dr. <i>Pringle</i><a name="FNanchor_15_15" id="FNanchor_15_15"></a><a href="#Footnote_15_15" class="fnanchor">[15]</a>
<span class='pagenum'><a name="Page_36" id="Page_36">[36]</a></span>when he mentions Worms being observed in
this Fever, seems to embrace <i>Lancisius</i>&#8217;s Opinion;
and believes that these Worms are not the
Cause of the Fever; but being lodged in the
Intestines, before the Fever comes on, they are
annoyed by the Increase of the Heat, and the
Corruption of the Humours, in the Cavity of
the Intestines of Persons labouring under Fevers,
especially of the putrid Kind; and so they
begin to move and struggle to get out. This
seemed evidently to be the Case with many
of the Patients we had; though in some the
Worms seemed to have given Rise to the Fever,
which the bad State of the Patient&#8217;s Humours,
or the infected Air of Hospitals, determined to
be of this Kind. In many, the Fever lessened,
or went off entirely, soon after; and they were
no more affected with Symptoms of Worms.
But some notwithstanding were subject to frequent
Sickness, Pain of the Stomach, and Uneasiness
in the Bowels, and discharged some
Worms from Time to Time. Others had frequent
Relapses into Fevers, which seemed to be
owing to the Irritation of these Insects.<span class='pagenum'><a name="Page_37" id="Page_37">[37]</a></span></p>

<p>It is no Wonder that Worms of the round
Kind should be productive of troublesome Symptoms,
and occasion these Relapses; since we
know that they have sometimes perforated the
Intestines, and been found in the Cavity of the
Abdomen<a name="FNanchor_16_16" id="FNanchor_16_16"></a><a href="#Footnote_16_16" class="fnanchor">[16]</a>.</p>

<p>As soon as we observed a Patient to be troubled
with Worms, if his present Situation did
not prevent it, we gave twenty-five or thirty
Grains of Rhubarb, with five or six Grains of
Calomel; and if there was much Sickness, we
likewise gave an Emetic; which, in more than
one Case, brought up two or three Worms of
the round Kind, and gave great Relief. But
where the Fever was violent, we were obliged
to neglect this Symptom of Worms for the present;
and when the Fever was over, if there still
<span class='pagenum'><a name="Page_38" id="Page_38">[38]</a></span>remained any Symptoms of Worms, we gave
the purgative Medicine once or oftener, and in
the Intervals gave the <i>pulvis stanni</i>, or an Infusion
of Camomile Flowers; and in some Cases, oily
Medicines. By these Means most of the Patients
got well and recovered their Health, and
seemed to be freed, at least for the present, from
these troublesome Insects; though a few continued
to complain of Sickness, and other Symptoms
of Worms, for some Time afterwards.</p>

<p>What was the Cause of the Army&#8217;s being so
much troubled with Worms of the round Kind,
is not easy to ascertain; unless it was owing to
the great Quantity of crude Vegetables, and
Fruits, which the Soldiers eat in the Course of
the Summer and Autumn, and to the bad Water
they were often obliged to drink.</p>

<p>In the Malignant Fever at <i>Paderborn</i>, many
complained of a Dysuria, and some of a Suppression
of Urine, especially towards the Decline
of the Fever; and others, of a Scalding and
Pain in making Water, though they had no venereal
Complaint. These Symptoms appeared
in other Places, but not near so frequently as at<span class='pagenum'><a name="Page_39" id="Page_39">[39]</a></span>
<i>Paderborn</i>. Decoctions of Gum Arabic, with
some of the <i>spiritus nitri dulcis</i>, and oily Mixtures,
and Opiates, commonly gave immediate
Relief, and soon removed this Complaint.</p>

<p>One of the first salutary Symptoms which
most generally appeared in those who recovered,
was a Dullness of Hearing, or Deafness<a name="FNanchor_17_17" id="FNanchor_17_17"></a><a href="#Footnote_17_17" class="fnanchor">[17]</a>;
which came on about the Height of the Fever,
and continued a longer or shorter Time, generally
till the Fever was entirely gone; and sometimes
for a considerable Time afterwards. For
<span class='pagenum'><a name="Page_40" id="Page_40">[40]</a></span>the most Part we did nothing for this Complaint,
and it went off as the Patient recovered
his Strength. When it continued long,
Blisters applied behind the Ears, or on the
Neck, and washing the <i>meatus auditorius</i> with
the emollient Decoction, in which a small Quantity
of Soap was dissolved, proved of Service.</p>

<p>Swellings of the parotid Glands appeared in
many Subjects, towards the Decline of the Fever,
which came to Suppuration, and proved
critical. In two only, out of those I attended
while in <i>Germany</i>, they came on early in the Fever,
<span class='pagenum'><a name="Page_41" id="Page_41">[41]</a></span>but did not suppurate. Both Patients died;
all the rest recovered, except one old Man, an
Invalid at <i>Bremen</i>; who, after having one Swelling
appear on the right Side, which came to
Suppuration, and seemed critical, relapsed into
the Fever; and another formed on the other
Side, which came likewise to Suppuration, and
the Fever ceased, after having reduced him very
low; but the great Discharge from the Sores
wasted him gradually, and he died hectic in
about a Month after the Fever had left
him<a name="FNanchor_18_18" id="FNanchor_18_18"></a><a href="#Footnote_18_18" class="fnanchor">[18]</a>.</p>
<p><span class='pagenum'><a name="Page_42" id="Page_42">[42]</a></span></p>
<p>As soon as these Swellings of the parotid
Glands appeared, we endeavoured to bring
them forward to Suppuration, by the Application
of emollient Cataplasms, or of gummous
Plaisters; and had them opened as soon as a Fluctuation
of Matter was to be felt, and afterwards
treated them as common Abscesses. <i>Riverius</i><a name="FNanchor_19_19" id="FNanchor_19_19"></a><a href="#Footnote_19_19" class="fnanchor">[19]</a>
very justly observes, that when such
Tumours encrease in such a Manner as to endanger
Suffocation, they ought to be opened
before they come to Maturation; and Dr.
<i>Pringle</i><a name="FNanchor_20_20" id="FNanchor_20_20"></a><a href="#Footnote_20_20" class="fnanchor">[20]</a> desires us not to wait for a Fluctuation
of Matter, but to open the Abscess as soon
as it can be supposed to have formed.</p>

<p><span class='pagenum'><a name="Page_43" id="Page_43">[43]</a></span></p><p>In <i>February</i> 1761, three Patients in the Decline
of this Fever had Buboes formed in the
Groin, which proved critical. At first, on observing
them, I suspected them to be venereal;
but on examining the Patients, they obstinately
denied their having any Reason to suspect any
such Cause; and the favourable Manner in
which they healed without the Appearance of
any other venereal Symptom, made me believe
what they asserted to be true; especially as such
People are not shy in owning Complaints of
that Kind. The first Patient I saw who had a
Bubo in the Decline of one of these Malignant
Fevers, was a Woman, Wife to a Soldier of
the thirty-seventh Regiment of Foot; she had
a Child at her Breast, and her Husband was
living with her at the Time she was taken ill
of the Fever, and neither of them had the least
venereal Complaint. In a few Days afterwards,
two Soldiers in other Hospitals, towards the
Decline of very bad Petechial Fevers, had likewise
Buboes formed in the Groin, without any
Suspicion of a venereal Taint. Except in these
three, I did not see any critical Buboes appear
in this Fever while I was with the Troops in<span class='pagenum'><a name="Page_44" id="Page_44">[44]</a></span>
<i>Germany</i>; tho&#8217; Mr. <i>Lovet</i>, who served as a Mate
to the Hospitals, and who was at <i>Hoxter</i>, where
we had another Hospital established, while I
was at <i>Paderborn</i>, told me, that, in the Beginning
of the Year 1761, they had several Men
in the Hospital ill of this Fever, who had critical
Buboes formed in the Groins and Armpits<a name="FNanchor_21_21" id="FNanchor_21_21"></a><a href="#Footnote_21_21" class="fnanchor">[21]</a>.</p>

<p>About the same Time that these Buboes appeared,
severals towards the Decline of this
Fever complained of a Pain all along the Spermatic
Chord; and soon after a Swelling of the
Testicle appeared<a name="FNanchor_22_22" id="FNanchor_22_22"></a><a href="#Footnote_22_22" class="fnanchor">[22]</a>. However, this Complaint
was not peculiar to those who had the
<span class='pagenum'><a name="Page_45" id="Page_45">[45]</a></span>Fever; for others recovering from Fluxes, and
other Disorders, were likewise affected with
such Swellings. I did not observe any Symptom
of this Kind in Fevers while I was with
the Troops in <i>Germany</i>, except in <i>January</i>,
<i>February</i>, <i>March</i>, and <i>April</i> 1761. By Bleeding,
and applying emollient Fomentations and
Cataplasms, and bathing the Parts with <i>spiritus
mindereri</i> on the first Attack of the Pain,
the Swelling of the Testicle was prevented;
but where no Mention was made of this Pain
till the Swelling had already begun, it commonly
ended in a Suppuration of the Scrotum
or Testicle, which healed very kindly. We
had no Reason to suspect any venereal Taint
in any of them.</p>

<p>Many, while recovering from this Fever,
were seized with an Ophthalmia, or Inflammation
of the Eye; for the most part of one Eye
only, sometimes of both. When the Patients
were strong, they were blooded, and had Blisters
applied behind the Ears; and sometimes,
where the Pain was great, had Poultices of
Bread and Milk applied to the inflamed Eye;
which, with the Assistance of some cooling Physick,<span class='pagenum'><a name="Page_46" id="Page_46">[46]</a></span>
commonly removed this Complaint; tho&#8217;
in some obstinate Cases we were obliged to repeat
the Evacuations, to apply Leeches to the
Temples; and after the acute State of the Disorder
was passed, to order the Eye to be washed
frequently with the Collyrium vitriolicum, or
Collyrium Saturninum, before we got the better
of this Complaint. However, it ought to
be observed, that if these astringent Collyria
were used too soon, they did hurt. When
these Ophthalmias were neglected in the Beginning,
the Inflammation frequently rose to a
great Height, and left an Obscurity or Philm
over the Cornea, which remained an Impediment
to the Sight not to be removed.</p>

<p>Towards the Decline of these Fevers, and very
often during the Course of them, many complained
of Pains in their Feet and Toes, which
sometimes ended in Mortifications, especially
where the Patients lay in very cold Wards.
For the most Part, the Mortification extended
no further than the Ends of the Toes, tho&#8217; in
some it spread over the Feet, and in two or
three advanced up the Leg. Several lost one<span class='pagenum'><a name="Page_47" id="Page_47">[47]</a></span>
or more Toes; and in <i>February</i> 1761, one
Man lost Half of each Foot; another lost both
Feet, and Part of each Leg. Both got the better
of the Fever, tho&#8217; the Man who lost both
Feet languished a long time afterwards. These
Pains of the Feet and Toes, and the Mortifications
which followed, were for the most part
owing to the Patients being exposed to too
much Cold while they were very weak, the
Circulation languid, and the Juices vitiated by a
putrid Distemper; by which means the Vessels
were rendered incapable of carrying on the
Circulation in their extreme Branches<a name="FNanchor_23_23" id="FNanchor_23_23"></a><a href="#Footnote_23_23" class="fnanchor">[23]</a>.</p>

<p>As soon as the Sick began to complain of
these Pains of the Toes and Feet, I found the
best Remedy to be, the Bathing of the Feet in
<span class='pagenum'><a name="Page_48" id="Page_48">[48]</a></span>warm Water, or in warm aromatic Fomentations;
and, after keeping the Feet for some time
in these warm Liquors, to dry them well, and then
rub them with the <i>linimentum saponaceum</i>, or <i>linimentum
volatile</i>, and wrap them up in Flannel.
And if ever any Lividness or Redness appeared
on the Parts, we gave plentifully of the Cortex
and Cordials, if not contra-indicated by the other
Symptoms. When Vesicles arose on the
Part, and a Gangrene formed, we directed the
Parts to be scarified, and proper Dressings to be
applied, while warm aromatic Fomentations
and Cataplasms were used.</p>

<p>In <i>January</i> 1762, one Patient, ill of the
Petechial Fever at <i>Bremen</i>, had a Lividness and
Blackness, threatning a Mortification, which appeared
at the End of his Nose. I expected for
some Days, that, if he recovered, he would lose
Part of his Nose; but, by giving him large and
repeated Doses of the <i>cortex</i> and <i>confectio cardiaca</i>,
in a Mindereri Mixture, and allowing
him the free Use of Wine, its further Progress
was prevented; and as the Patient got clear of
the Fever, the Nose recovered its natural Colour,<span class='pagenum'><a name="Page_49" id="Page_49">[49]</a></span>
and only the scarf Skin peeled off from
the End of it.</p>

<p>When the Fever continued long, and reduced
the Patients low, it was very common for
the Back, and Parts on which the Weight of
the Body rested, to mortify. As soon as any
thing of this Kind was observed, we ordered
such Parts to be covered with proper Dressings,
and gave the Bark and Cordials freely; and
took care to make the Patient change his Posture;
and by Pillows prevented as much as possible
the Weight of the Body from resting on
that Part. By this Treatment, many recovered,
where the Fever was on the Decline, and
the Strength not too much exhausted; even
tho&#8217; a very large Surface of the Skin had mortified;
but where the Patients were very low,
and the Fever still continued, or where it was
complicated with a Flux, which kept them
perpetually nasty, and exhausted the Strength,
it generally proved fatal.</p>

<p>Patients, who were reduced very low by this
Fever, or by repeated Relapses, were subject
to oedematous Swellings; especially of the Feet,<span class='pagenum'><a name="Page_50" id="Page_50">[50]</a></span>
towards the Evening, after sitting up all the Day.
These Swellings generally went away as the
Sick recovered their Strength; but in some
Cases they continued obstinate, and ascended towards
the Thighs; and in some spread all over the
Body, and terminated in an universal Anasarca.</p>

<p>When these Swellings were recent, and confined
to the Feet and Legs, commonly the
Bark joined to the lixivial Salts, or the Oxymel
of Squills, or other Diuretics, and a Purgative
once or twice a Week, removed them. In
some, an Infusion of Horse-radish had a good
Effect; in others, Sweats brought out by
means of <i>Dover</i>&#8217;s Powder, or of the <i>gutt&aelig; antimoniales
anodyn&aelig;</i>.</p>

<p>Sometimes these Swellings were very obstinate,
and resisted the Force of all internal Remedies.
In such Cases, Punctures made in the Feet, or
lower Part of the Legs, which furnished a
Drain for the Water, had a good Effect. Blisters
applied to the Legs were of Service to
some. When the Punctures were made, or
the Blisters applied, before the Patient&#8217;s
Strength was exhausted, provided that he laboured<span class='pagenum'><a name="Page_51" id="Page_51">[51]</a></span>
under no other Disorder but these oedematous
Swellings, which proceeded from
Weakness, I never observed any bad Effects
from them; tho&#8217; I used them both repeatedly
in a Variety of Cases. But if the Patient was
very weak; or had a Hectic Fever or Purging;
or other Disorders, and the oedematous Swellings
large; then oftentimes the great Discharge
exhausted his Strength, and a Gangrene and
Death were the Consequence.</p>

<p>One of the most remarkable Instances of the
good Effects of Blisters, was
in the Case of a Soldier at <i>Paderborn</i>; <i>Thomas
Hope</i>, of the Second Regiment of Foot Guards,
after a Fever of this Kind, was swelled all
over, especially about the Face and Neck,
and had a Difficulty of Breathing: after having
tried Variety of Medicines for this Complaint,
without any Effect, he had a large Blister
applied to his Back, and took the Cortex
in a Mixture, with the Oxymel of Squills.
As soon as the Blister began to discharge, the
Swellings decreased; and were afterwards entirely
removed by the Help of one or two Doses<span class='pagenum'><a name="Page_52" id="Page_52">[52]</a></span>
of Physic, and the continued Use of the Medicines
before prescribed. Three other Men in
the Hospital at <i>Osnabruck</i>, in <i>May</i> 1761, having
oedematous Swellings of the Feet and Legs,
which yielded to no internal Remedies, had
Blisters applied to their Legs, used the Cortex,
with the lixivial Salts, two or three Times a
Day, and a Purge every fourth Day; which removed
the Swellings in a short Time.</p>

<p>Some of the Soldiers, who had repeated
Hospital Fevers, had their Blood so much broke
down, as to be subject to profuse H&aelig;morrhages
from the Nose; and some of them passed
Blood likewise by Stool; which reduced
them to a very low State, sometimes attended
with imminent Danger. In such Cases we
found nothing to answer so well as to give
freely of the Bark; to acidulate their Drinks
with the <i>spiritus vitrioli</i>; to allow them as
much Red Wine as the Strength and present
Circumstances could bear; and at the same
Time to support the Patient&#8217;s Strength by
a mild Diet, of light Digestion; as Water or
Rice Gruel, Panado, weak Broth, and the<span class='pagenum'><a name="Page_53" id="Page_53">[53]</a></span>
like. When there was a Tendency to a Diarrh&#339;a,
we were obliged to add some of the <i>electuarium
diascordii</i> to the Cortex, and frequently
to give an Opiate in the Evening. One
Case, where this Method of Cure had a very
remarkable good Effect, I had under my Care
at <i>Paderborn</i>. A Soldier who lay in one of
the lower Wards of the Jesuits Hospital, after
a Malignant Fever, attended with a Flux, used
to bleed at the Nose, to four, five, or six Ounces
at a Time; and once or twice lost near a
Pint of Blood, of a dark Colour, very thin
and watery, and of so loose a Texture, that
the grumous Part scarcely coagulated. This
Evacuation brought him so low, that he could
scarce turn himself in Bed; and his Pulse
might be said rather to flutter than beat:
By the continued Use of the Bark, and
of Cordials, and Drinks acidulated with <i>spiritus
vitrioli</i>, and some Spoonfulls of mulled
Red Wine every two or three Hours,
he was restored to Health and Strength. The
only Accident which happened during the
Cure, was a Threatening of a Looseness, and the
Return of his Flux; which however was stopt<span class='pagenum'><a name="Page_54" id="Page_54">[54]</a></span>
by a Dose of the <i>tinctura rhei</i>; by joining some
of the <i>electuarium diascordii</i> with the Bark, and
giving an Opiate in the Evening.</p>


<p class="break">Putrid Malignant Fevers, attended with
Eruptions, are taken Notice of by <i>Hippocrates</i><a name="FNanchor_24_24" id="FNanchor_24_24"></a><a href="#Footnote_24_24" class="fnanchor">[24]</a>,
and other antient Authors<a name="FNanchor_25_25" id="FNanchor_25_25"></a><a href="#Footnote_25_25" class="fnanchor">[25]</a>; but
whether they meant that particular Sort of
Eruption which we now call Petechi&aelig;, is uncertain;
as their Descriptions are not clear
enough to distinguish it from the Miliary and
other Kinds. But since the Year 1500, we
have had many accurate Accounts of Fevers of
this Kind, which have appeared in different
Parts of the World: from all which it appears
that such Fevers generally take their Rise either
from some antecedent Acrimony of the
Blood; or, what is more frequent, from some
Source of Corruption or Contagion; from the
Use of putrescent animal Food, and a Want
of fresh Vegetables and acescent Liquors; from
<span class='pagenum'><a name="Page_55" id="Page_55">[55]</a></span>the putrid Steams of corrupted animal Substances;
from the moist putrid Vapour of low
marshy Places in Summer, where there is stagnating
Water, which corrupts by the Heat;
from the foul Air of crowded Hospitals, Jails,
and Ships; and from such like Causes<a name="FNanchor_26_26" id="FNanchor_26_26"></a><a href="#Footnote_26_26" class="fnanchor">[26]</a>.</p>

<p>When once this Fever begins, it is observed
to be of a contagious Nature, and (if proper
Care is not taken) to affect those who attend
the Sick, or who live in the same Room, and
breathe the same Air with them.</p>

<p>Many Authors have reckoned the Malignant,
Petechial, and Pestilential, to be distinct
Species of Fevers; and have treated each of
them under a particular Head. But <i>Riverius</i><a name="FNanchor_27_27" id="FNanchor_27_27"></a><a href="#Footnote_27_27" class="fnanchor">[27]</a>
has very justly observed, that they all
belong to the same pestilential Tribe, and only
differ from one another in the Degree of Infection,
<span class='pagenum'><a name="Page_56" id="Page_56">[56]</a></span>and the Violence of the Symptoms<a name="FNanchor_28_28" id="FNanchor_28_28"></a><a href="#Footnote_28_28" class="fnanchor">[28]</a>;
and that they are to be cured by the same general
Treatment, and the same Medicines.</p>


<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_1_1" id="Footnote_1_1"></a><a href="#FNanchor_1_1"><span class="label">[1]</span></a> Dr. <i>Huxham</i>, in his <i>Treatise on the ulcerous sore Throat</i>,
p. 36, says, &#8220;I have very often met with this buffy or
sizy Appearance of the Blood in the Beginning of Malignant
Fevers; and yet, Blood drawn two or three Days
afterwards, from the same Persons, hath been quite loose,
dissolved, and sanious as it were.&#8221; And in his <i>Essay on Fevers</i>,
chap. viii. p. 108. says, &#8220;The first Blood frequently
appears florid; what is drawn twenty four Hours after, is
commonly livid, black, and too thin; a third quantity,
livid, dissolved, and sanious. I have sometimes observed the
Crasis of the Blood so broke as to deposite a black Powder, like
Soot, at the Bottom, the superior Part being either a livid
Gore, or a dark green, and exceedingly soft Jelly.&#8221;</p></div>

<div class="footnote"><p><a name="Footnote_2_2" id="Footnote_2_2"></a><a href="#FNanchor_2_2"><span class="label">[2]</span></a> <i>Observations on the Diseases of the Army</i>, part III. chap.
vii. sect. 3. third Edition, 1761.</p></div>

<div class="footnote"><p><a name="Footnote_3_3" id="Footnote_3_3"></a><a href="#FNanchor_3_3"><span class="label">[3]</span></a> <i>Ramazini</i>, in his Treatise <i>De Constitutionibus annorum</i>,
1692, 3, 4, <i>in Mutinensi civitate</i>, Sect. 19. mentions the Petechial
Fever which had been frequent the three foregoing
Years; in which the Petechi&aelig; appeared commonly on the
fourth or seventh Days, and almost all those died in whom they
appeared on the first Day. These Spots came out first on the
Neck, the Back and Breast; and it was observed that none
escaped unless these Spots extended themselves as far as the
Nails of the Toes, vanishing by Degrees on the upper Parts.
He tells us likewise, that this Fever was attended with an Inflammation
of the Throat, which, about the Height of this
Disorder, terminated in a white ulcerous Crust. This sore
Throat should seem to be the same which we now call <i>the malignant
ulcerous sore Throat</i>, which I never once saw while I was
with the Troops in <i>Germany</i>.</p></div>

<div class="footnote"><p><a name="Footnote_4_4" id="Footnote_4_4"></a><a href="#FNanchor_4_4"><span class="label">[4]</span></a> Dr. <i>Huxham</i>, in his <i>Essay on Fevers</i>, ch. viii. p. 97, tells
us, that sometimes, about the eleventh or twelfth Day, on the
coming on of profuse Sweats, the Petechi&aelig; disappear, and vast
Quantities of small white miliary pustules break out.</p></div>

<div class="footnote"><p><a name="Footnote_5_5" id="Footnote_5_5"></a><a href="#FNanchor_5_5"><span class="label">[5]</span></a> Dr. <i>Hasenohrl</i>, in his Treatise <i>De Febre Petechiali</i>, cap. i. p.
12. relates a very particular Case, where the Petechi&aelig; appeared
on the fourth, and the white miliary Eruptions on the seventeenth
Day of the Fever.</p></div>

<div class="footnote"><p><a name="Footnote_6_6" id="Footnote_6_6"></a><a href="#FNanchor_6_6"><span class="label">[6]</span></a> Dr. <i>Lind</i>, in his <i>second Paper on Fevers</i>, p. 105. mentions
Spots which rise above the Surface of the Skin, and are of the
miliary kind, as common in contagious Fevers, as he observed
among the <i>French</i> Prisoners in <i>Winchester</i> Castle, in the Beginning
of the Year 1761.</p></div>

<div class="footnote"><p><a name="Footnote_7_7" id="Footnote_7_7"></a><a href="#FNanchor_7_7"><span class="label">[7]</span></a> Dr. <i>Huxham</i>, tho&#8217; he says &#8220;yet Bleeding to some Degree
is most commonly requisite, nay necessary, in the strong and
plethoric;&#8221; yet he afterwards makes the following Remark:
&#8220;Besides, the Pulse in these Cases sinks oftentimes surprisingly
after a second Bleeding, nay sometimes after the first, and
that even where I thought I had sufficient Indications from
the Pulse to draw Blood a second time.&#8221; See his <i>Essay on Fevers</i>,
chap. viii. And Dr. <i>Pringle</i> observes, that in the second
Stage of the Disorder large Bleedings have generally
proved fatal, by sinking the Pulse, and bringing on a Delirium.
<i>Observations on the Diseases of the Army</i>, part III. chap. vii.
sect. V.</p></div>

<div class="footnote"><p><a name="Footnote_8_8" id="Footnote_8_8"></a><a href="#FNanchor_8_8"><span class="label">[8]</span></a> Dr. <i>Pringle</i> advises giving a Vomit, by way of Prevention,
on the first Appearance of the Symptoms, and at Night to
force a Sweat, by giving a Drachm of Theriac with ten Grains
<i>Sal volat. Corn. cervi</i>, and some Draughts of Vinegar-whey,
and to repeat the same the following Night; and says, he has
often seen those Symptoms removed which he apprehended to
be Forerunners of this Fever received by Contagion; but previous
to Vomits, or Sweats, if the Person be plethoric, it will
be necessary to take away some Blood. <i>Observ.</i> part III. ch. vii.
sect. 5. Dr. <i>Lind</i>, in his <i>second Paper on Fevers</i>, p. 66. says,
&#8220;To all who are supposed to be infected by Fevers, during
this Stage of Rigours, a gentle Vomit is immediately
to be exhibited before the Fever be formed, and before the
Fulness or Hardness of the Pulse renders its Operation dangerous.
If the Vomit be delayed too long, and especially if
Bleeding must precede it, the most certain and favourable
Opportunity of procuring Safety for the Patient is
past.&mdash;That he has found it equally serviceable in
preventing Relapses, when it is given at the Return of the
Shiverings.&#8221; A loose Stool, or two, should be procured
by the Emetic or Clysters, and he advises Sweating immediately
after, in the manner recommended by Dr. <i>Pringle</i>. At
other times &#8220;he gave five Grains of Camphire every four
Hours, with large Draughts of Vinegar-whey. Eight
Persons in ten, he says, got quite well by this Treatment.&#8221;
</p><p>
I have never had sufficient Opportunities of trying this
Method of Prevention, to determine any thing certain about
it; but it may be worth while to practise it.</p></div>

<div class="footnote"><p><a name="Footnote_9_9" id="Footnote_9_9"></a><a href="#FNanchor_9_9"><span class="label">[9]</span></a> <i>Petrus a Castro</i>, in his Account of a Petechial Fever,
which was frequent at <i>Verona</i>, tells us, that the Sick had a
great Thirst, and an Aversion to Meat, but all of them had
the strongest Desire for Wine, and were perpetually asking for
it, even those who at other Times used to be very temperate;
and that this proceeded from an Instinct of Nature, which wanted
something to support the Strength. <i>De Feb. Malig.</i> sect. iii. chap.
26. Dr. <i>Huxham</i>, in his <i>Essay on Fevers</i>, has the following very
judicious Remark on the Use of Wine: &#8220;In this View, and in
those above-mentioned, I cannot but recommend a generous red
Wine as a most noble, natural sub-astringent Cordial, and perhaps
Art can scarce supply a better. Of this I am confident,
that sometimes at the State, and more frequently in the Decline
of putrid Malignant Fevers, it is of the highest Service,
especially when acidulated with Juice of <i>Seville</i> Orange or
Lemon. It may be also impregnated with some Aromatics,
as Cinnamon, <i>Seville</i> Orange Rhind, red Roses, or the like, as
may be indicated, and a few Drops of <i>Elix. Vitrioli</i> may be
added. Rhenish and French White Wines, diluted, make a
most salutary Drink in several Kinds of Fevers, and generous
Cyder is little inferior to either. The <i>Asiatics</i>, and other
Nations, where pestilential Disorders are much more rife
than with us, lay more Stress on the Juice of Lemons in
these Fevers than on the most celebrated <i>Alexipharmac.</i>&#8221; Chap,
viii. second Edit. p. 123, 4.
</p><p>
Acid and acescent Liquors have very justly been recommended
and used by most late Practitioners, in this as well as
in other malignant Diseases. Vinegar-whey, Barley-water acidulated
with Lemon-juice, and such other Liquors, make good
Drinks for the Sick; but we were obliged, for the most part,
to use the vitriolic Acid for acidulating the Patient&#8217;s Drink,
as it was the easiest procured and carried about with the Flying
Hospital.</p></div>

<div class="footnote"><p><a name="Footnote_10_10" id="Footnote_10_10"></a><a href="#FNanchor_10_10"><span class="label">[10]</span></a> If the preventive Method does not succeed, Dr. <i>Lind</i>
advises to have recourse to Blisters; and says, that sixteen out
of twenty will next Morning be free of the Fever. But adds,
this is said, provided the Source of their Infection be not so
highly poisonous as it was in the Garland Ship, or in other
such violent Contagions. Dr. <i>Pringle</i> mentions his having applied
Blisters early, but without relieving the Head, or preventing
any of the usual Symptoms. I have often ordered
Blisters pretty early in the Disorder; and though I have frequently
found them of use in keeping up the Pulse, and relieving
the Head, and other Symptoms, yet I never saw them
have such an immediate Effect as Dr. <i>Lind</i> mentions.</p></div>

<div class="footnote"><p><a name="Footnote_11_11" id="Footnote_11_11"></a><a href="#FNanchor_11_11"><span class="label">[11]</span></a> It is long since the <i>Peruvian</i> Bark has been used by
Practitioners in Malignant Disorders, though I do not know
that any body gave it in this Fever to the Amount of an
Ounce per Day, before Dr. <i>Haen</i> and Dr. <i>Hasenohrl</i>. Dr. <i>Ramazini</i>
mentions its having been tried in the Petechial Fever,
in the Years 1692, 3, 4. And in a Treatise on the Plague in
the <i>Ucrane</i>, published at <i>Petersburgh</i>, in the Year 1750, we
are told, that in the <i>French</i> Translation of the Philosophical
Transactions for the Year 1732, there is a Note to p. 264,
telling, that Mr. <i>Amyand</i> informed the Academy of Surgery at
<i>Paris</i>, that Mr. <i>Rushworth</i>, Surgeon, had wrote to Sir <i>Hans
Sloane</i>, on the 23d of <i>May</i> 1723, that when he was Surgeon
to a Ship, in the Year 1694, he had cured some Men ill of the
Malignant Fever, attended with pestilential Buboes, by means
of the <i>Peruvian</i> Bark. Dr. <i>Huxham</i> has recommended a Tincture
of the Bark; and Dr. <i>Pringle</i>, a strong Decoction of it, with
some of the Tincture, in these Malignant Fevers.</p></div>

<div class="footnote"><p><a name="Footnote_12_12" id="Footnote_12_12"></a><a href="#FNanchor_12_12"><span class="label">[12]</span></a> The <i>Peruvian</i> Bark has not only been found useful in this
Malignant Fever, but has likewise been recommended in the
Plague. See <i>Morton Oper. Append. secund. Exercitat. Hist. Febr.
Ann. 1658, ad. an. 1691. complexa</i>. In the Small Pox, see <i>Medical
Essays</i>, vol. V. art. x. and has been found serviceable in the
putrid Disorders of the <i>West Indies</i>, as taken Notice of by Dr.
<i>Hillary</i>; and in the malignant ulcerous sore Throat in this
Country, as Dr. <i>Wall</i> and others have observed. And in
thirty-five Cases of the malignant ulcerous sore Throat, in
which I gave it, joined with Cordials, and the Use of Acids,
I did not lose one Patient. Nine of them were strong People,
and had plethoric Symptoms, and were blooded in the Beginning;
and seven of them were costive, and took a Dose of gentle
laxative Physic before taking the Bark. The rest had no
Symptoms which seemed to require these Evacuations. However,
it ought to be observed, that this is a Disorder of the
malignant kind; and that although some well-timed gentle
Evacuations may be serviceable in the Beginning, before giving
the Bark; yet too free, or even gentle Evacuations, injudiciously
made, will sink the Patient, and infallibly do Mischief.
</p><p>
The free Use of the Bark has long been found serviceable
in Mortifications and foul Sores, where the Juices tend too
much to the Putrescent; and has been strongly recommended
by Mr. <i>Ranby</i>, Serjeant Surgeon to his Majesty, in the Cure of
Gunshot Wounds. See his <i>Treatise on Gunshot Wounds</i>.</p></div>

<div class="footnote"><p><a name="Footnote_13_13" id="Footnote_13_13"></a><a href="#FNanchor_13_13"><span class="label">[13]</span></a> Dr. <i>Huxham</i>, in his <i>Treatise on the ulcerous sore Throat</i>,
p. 54, &amp;c. condemns the Use of the volatile alcaline Salts, in
Fevers of the putrid, pestilential, or petechial kind, as being
apt to heat too much, and to hasten the Dissolution and consequent
Putrefaction of the Blood. However, I cannot help
thinking that they are the best Remedies we can use on some
particular Occasions, even in this Fever; for we have no Remedy
which gives such a sudden and brisk <i>Stimulus</i> to the Fibres
as they do. And I have known many Cases of Patients who were
extremely low, and whose Pulse was scarce to be felt, and
others who were apt to fail into fainting Fits, who have been
preserved by large and repeated Doses of these Salts, and the
free Use of Wine, and acescent Liquors, to correct their alcaline
Acrimony in the Blood. Though as soon as such Patients
had recovered from this low State, I laid these Medicines aside;
because I cannot help agreeing with the Doctor in the Belief, that
their continued Use will produce the Effects he mentions. For
although it be true, that these Salts, when mixed with putrescent
Liquors, or with dead animal Substances, resist Putrefaction,
and, like ardent Spirits and Vinegar (the other Products
of Fermentation) check and put a Stop to that very Process
which produced them: Yet it is also true, that, when mixed
with the Blood of living Animals, they stimulate the Vessels,
and increase the Heat and <i>Momentum</i> of the Blood, and dissolve
it; and therefore I cannot but disapprove the continuing their
Use longer than is immediately necessary.</p></div>

<div class="footnote"><p><a name="Footnote_14_14" id="Footnote_14_14"></a><a href="#FNanchor_14_14"><span class="label">[14]</span></a> Some Men passed only one Worm; others, two or three;
some, six or seven; and one Man, of the Guards, in <i>January</i>
1763, after passing three by Stools in the Course of a Fever of
this Kind, discharged fourteen more upon taking a Dose of
Rhubarb and Calomel after the Fever was over.</p></div>

<div class="footnote"><p><a name="Footnote_15_15" id="Footnote_15_15"></a><a href="#FNanchor_15_15"><span class="label">[15]</span></a> <i>Observations on the Diseases of the Army</i>, part iii. chap.
iv. Note to p. 213. third Edition.</p></div>

<div class="footnote"><p><a name="Footnote_16_16" id="Footnote_16_16"></a><a href="#FNanchor_16_16"><span class="label">[16]</span></a> See <i>Hoffman</i>&#8217;s Works, vol. III. chap. x. <i>River. Observ.
commun.</i> Obs. 13. <i>of Observations found in a Library.</i> <i>Bonetus&#8217;s
Sepulchret. anatom.</i> tom. II. <i>Gualther van Doeveren&#8217;s Inaugural
Dissertation de Vermibus intestinalibus</i>, published at <i>Leyden</i>,
1753; and <i>Lancisi</i>&#8217;s Works; for Cases where the internal Coats
of the Stomach, and Intestines, have been eroded, and all the
Coats perforated by Worms of the round Kind.</p></div>

<div class="footnote"><p><a name="Footnote_17_17" id="Footnote_17_17"></a><a href="#FNanchor_17_17"><span class="label">[17]</span></a> <i>Riverius</i> tells us, that, according to <i>Hippocrates</i>&#8217;s Doctrine,
Deafness is a very dangerous Symptom in the Beginning
of acute Disorders, though it be a good Omen, and portends
Health, when it does not appear till the Height of Fevers,
especially those of a malignant Kind; and adds, that he himself
has a thousand Times observed, that those labouring under
this Fever have recovered, when this Symptom of Deafness
came on at the Height (<i>in statu</i>) though the other Symptoms
threatened much Danger. <i>Prax. Medic.</i> lib. XVII. sect. iii.
cap. i. p. 451.
</p><p>
This Symptom of Deafness occurs in other Fevers as well as
in this, and often proves a good Symptom in them likewise, as
I have frequently observed. Two remarkable Examples of which
I had under my Care in St. <i>George</i>&#8217;s Hospital, in the Year 1759.
On the 17th of <i>January</i> 1759, <i>James Donaldson</i>, a young Man of
nineteen Years of Age, was admitted into the Hospital for a Fever,
attended with a Stupor and a Delirium, a parched dry
Tongue, and other Symptoms of a Fever of the inflammatory
Kind, for which he had been blooded, and used other Evacuations.
On the 19th, after the Application of a Blister, he was
seized with almost an entire Deafness; after which, all his other
Symptoms became milder, and he mended daily, and was entirely
free from the Fever by the 30th. On the 10th of <i>April</i>
1759, a Youth, <i>John Young</i>, fifteen Years of Age, was admitted
into the same Hospital for a Fever, which had already continued
fourteen Days. His Speech was affected, and he had entirely
lost the Use of his Limbs, was delirious, and had other
bad Symptoms. On the 12th, his Hearing became exceedingly
dull, and he recovered daily afterwards, and was discharged,
cured, the 2d of <i>May</i>, having recovered the Use of his Legs as
well as got free of the Fever.</p></div>

<div class="footnote"><p><a name="Footnote_18_18" id="Footnote_18_18"></a><a href="#FNanchor_18_18"><span class="label">[18]</span></a> But although these parotid Swellings were in general so
favourable with us, we are not to imagine that this will always
be the Case: for <i>Riverius</i>, though he speaks of these Swellings
proving for the most part critical; yet he tells us, that, in the
Year 1623, this Fever was epidemic at <i>Montpelier</i>, and that almost
one half of the Sick died; and particularly, that most of
those who had Swellings of the parotid Glands appearing about
the 9th or 11th Day, were carried off within two Days of their
Appearance. Having attended several who died from the Swellings
not coming to Suppuration, he began to consider in his own
Mind, what might be the Cause of their Death, and concluded,
that it was owing to there being a greater Quantity of morbid
Matter in the Blood than the Part was able to contain, and that
Evacuations by blooding and purging were the only Remedies
which were likely to give Relief; and therefore, in the first
Case of this Kind, in which he was afterwards consulted, he ordered
three Ounces of Blood to be taken away, notwithstanding
the Patient was so low that the Surgeon was afraid he
would have died in the Operation: The Pulse rose on bleeding,
and he ordered four Ounces more to be taken in three or
four Hours afterwards: The Pulse rose still more, and he ordered
a Dose of Sena and Rhubarb to be taken next Day, and
the Patient recovered. And he adds, that all those who were
treated in this manner got well. <i>Prax. Med. Lib.</i> XVII. <i>sect.</i>
iii. <i>cap.</i> 1.</p></div>

<div class="footnote"><p><a name="Footnote_19_19" id="Footnote_19_19"></a><a href="#FNanchor_19_19"><span class="label">[19]</span></a> Ibid.</p></div>

<div class="footnote"><p><a name="Footnote_20_20" id="Footnote_20_20"></a><a href="#FNanchor_20_20"><span class="label">[20]</span></a> <i>Pringle&#8217;s Observations on the Diseases of the Army</i>, Part
III. chap. vii.</p></div>

<div class="footnote"><p><a name="Footnote_21_21" id="Footnote_21_21"></a><a href="#FNanchor_21_21"><span class="label">[21]</span></a> This Symptom of Buboes is taken Notice of by Authors,
but does not seem to be so frequent as many of them
would make us believe. Neither Dr. <i>Huxham</i> nor Dr. <i>Pringle</i>
mention their having seen such Buboes; and Dr. <i>Lind</i> says,
that he never saw them till the Beginning of the Year 1763.</p></div>

<div class="footnote"><p><a name="Footnote_22_22" id="Footnote_22_22"></a><a href="#FNanchor_22_22"><span class="label">[22]</span></a> <i>Hippocrates</i> takes Notice of Swellings of the Testicles in
Fevers. He tells us, that a Man from Alcibiades had his left
Testicle swell before the Crisis of a Fever. <i>See his Second Book
on Epidemics</i>, sect. ii. And he mentions this Symptom as a
Crisis in the ardent Fever. <i>See his Book on Crises</i>, sect. xi.&mdash;And
Dr. <i>Antonio Lizzari</i>, in a Treatise which he published on
the <i>Acute Diseases which were frequent at Venice, and all over
Italy, in the Years 1761, 62</i>, tells us, that Abscesses of the
Scrotum and Testicles frequently followed the Measles.</p></div>

<div class="footnote"><p><a name="Footnote_23_23" id="Footnote_23_23"></a><a href="#FNanchor_23_23"><span class="label">[23]</span></a> These Pains and Mortifications of the Feet and Toes
were not confined to those who were brought low by malignant
Fevers; for, during the very hard Frost in the Beginning of
the Year 1763, many of the Patients who lay in very large
open Wards in the Hospital at <i>Osnabruck</i>, were affected in the
same Way. One Man had both Feet, and Part of each Leg,
compleatly mortified, and died in about nine Days after the
first Appearance of the Mortification. One lost half of one Foot,
and some Toes of the other; and the third lost the first Joint of
some of his Toes, and the Ends of others.</p></div>

<div class="footnote"><p><a name="Footnote_24_24" id="Footnote_24_24"></a><a href="#FNanchor_24_24"><span class="label">[24]</span></a> <i>Hippocrat.</i> lib ii. popul. sect. iii. text. 2.</p></div>

<div class="footnote"><p><a name="Footnote_25_25" id="Footnote_25_25"></a><a href="#FNanchor_25_25"><span class="label">[25]</span></a> <i>Aetius Tetrab.</i> ii. sect. i. cap. 129. <i>Actuar.</i> lib. i.
cap. 23.</p></div>

<div class="footnote"><p><a name="Footnote_26_26" id="Footnote_26_26"></a><a href="#FNanchor_26_26"><span class="label">[26]</span></a> See these Causes mentioned by <i>Riverius</i>, and since more
fully explained by Dr. <i>Pringle</i>, <i>Observations on the Diseases of
the Army</i>, part iii. chap. vii.</p></div>

<div class="footnote"><p><a name="Footnote_27_27" id="Footnote_27_27"></a><a href="#FNanchor_27_27"><span class="label">[27]</span></a> <i>River. Prax. Med.</i> lib. xvi. sect. iii. Pr&aelig;fat.</p></div>

<div class="footnote"><p><a name="Footnote_28_28" id="Footnote_28_28"></a><a href="#FNanchor_28_28"><span class="label">[28]</span></a> The Malignant or Hospital Fever, and Petechial, seemed
to me to be entirely the same Disorder, and the Petechial Spots
to be only a Symptom which appeared sometimes, but not always.
And <i>Riverius</i> says, the Petechi&aelig; do not always appear;
but when they do, it is a most certain Sign of a Pestilential Fever.
See his <i>Prax. Med.</i> cap. xvi. sect. iii.</p></div>
</div>


<h2><a name="DYSENTERY" id="DYSENTERY"></a>OF THE<span class='pagenum'><a name="Page_57" id="Page_57">[57]</a></span><br />
<span style="font-size: 130%; letter-spacing: 0.15ex">DYSENTERY</span>.</h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>he</span> Dysentery generally began to appear
soon after the Army took the Field;
and became frequent about the End of <i>July</i>,
and continued so till the Army went into Winter-Quarters;
and through the Winter, many
of those, who had this Disorder in Autumn,
relapsed, upon returning to their Duty; or by
drinking too freely of spirituous Liquors, and
being irregular in their Living.</p>

<p>It is now generally agreed upon, that this
Disorder is entirely produced by such Causes as
make the Juices become too putrescent, and
turn the Flow of Humours to the Bowels; and
in the Camp it seemed to arise principally from
an obstructed Perspiration caused by the Men&#8217;s<span class='pagenum'><a name="Page_58" id="Page_58">[58]</a></span>
lying in the Field, and doing the necessary
Military Duties in all Sorts of Weather; at the
same Time being often exposed to the putrid
Steams of dead Horses, of the Privies, and of
other corrupted Animal or Vegetable Substances<a name="FNanchor_29_29" id="FNanchor_29_29"></a><a href="#Footnote_29_29" class="fnanchor">[29]</a>,
after their Juices had been highly exalted
by the Heat of Summer.</p>
<p><span class='pagenum'><a name="Page_59" id="Page_59">[59]</a></span></p>
<p>At the Time the Petechial Fever was frequent
at <i>Paderborn</i> in <i>January</i>, <i>February</i>, and
<i>March</i> 1761, the Flux frequently accompanied
<span class='pagenum'><a name="Page_60" id="Page_60">[60]</a></span>it; and we had in the Hospitals likewise a Number
of old Cases of this Kind, the Remains of the
preceding Campaign about <i>Warbourg</i>; besides
some Men who had relapsed during the Winter,
and were sent to us when the Troops marched,
upon the Winter-Expedition, into the Country
of <i>Hesse</i>. In <i>May</i> and <i>June</i>, what Fluxes
we had at <i>Osnabruck</i>, were the remaining old
Cases of the Hospitals of <i>Munster</i>, <i>Paderborn</i>,
<i>Hoxter</i>, and <i>Niehms</i>. Some few recent ones
were sent to <i>Bilifield</i> about the End of <i>June</i>,
and above 300 to <i>Munster</i>, in <i>July</i> and <i>August</i>.
Those sent to <i>Bremen</i>, in <i>November</i> and <i>December</i>,
had continued for some time before they
reached us; but a good many of the Soldiers
in the Garrison were taken ill of this Disorder,
and sent immediately to the Hospital. In the
<span class='pagenum'><a name="Page_61" id="Page_61">[61]</a></span>Beginning of <i>May</i> we had but four ill of this
Complaint in the Hospital I attended; and there
were not above six or seven, among the Sick
sent down from the Army, in the Middle of this
Month. In <i>June</i> there were but two sent to the
Hospital at <i>Minden</i>; and not above ten among
the Sick sent to <i>Natzungen</i> in the Beginning of
<i>July</i>; tho&#8217; towards the Middle of this Month
they began to be more frequent; and continued
to be more so in <i>August</i> and <i>September</i>; and
in the Hospital at <i>Osnabruck</i> we had not above
five or six ill of this Disorder, in <i>December</i>
1762, and in <i>January</i>, <i>February</i> and <i>March</i>
1763.</p>

<p>The Dysentery commonly begun with Sickness
and Gripes, succeeded by a Purging, and
attended with more or less Fever. Very soon
the Gripes became more severe, attended with
a Flatulency in the Bowels, and often with a
Tenesmus. The Stools were chiefly composed
of Mucus, mixed with Bile, and more or less
Blood: tho&#8217; sometimes no Blood could be observed
in them; and then the Soldiers used to
say they had the White Flux.<span class='pagenum'><a name="Page_62" id="Page_62">[62]</a></span></p>

<p>After eight, ten, or twelve, Days, if the Disorder
was not complicated with any other, there
remained little or no Fever, unless where some
Accident supervened; tho&#8217; in Cases which terminated
fatally, towards the latter End came on a
Fever of a low malignant Kind, attended with
black fetid Stools, Lientery, Hiccup, Stupor,
and other bad Symptoms.</p>

<p>It often happened, that, after the Dysentery
had continued for some Time, the Sick complained
for a Day or two of severe Gripes; and
then discharged along with the Stools little
Pieces of hardened Excrements; at other
Times, tho&#8217; more rarely, little Pieces of white
Stuff like Tallow or Suet: Frequently small
Filaments, and little Pieces of Membranes, were
found floating in the Stools; and it was very
common for the Sick to vomit up Worms of
the round Kind, or discharge them by Stool<a name="FNanchor_30_30" id="FNanchor_30_30"></a><a href="#Footnote_30_30" class="fnanchor">[30]</a>.</p>

<p>In the Course of the Disorder, the Men often
complained of a violent Pain of the Rectum,
<span class='pagenum'><a name="Page_63" id="Page_63">[63]</a></span>near the Fundament, which was most excruciating
when they went to Stool; it continued for
some Days, sometimes for a Week or more; and
then they passed more or less of a Yellow Pus
with their Excrements, and the violent Pain
ceased. Mr. <i>A. Tough</i>, one of the Apothecaries to
the Military Hospital in <i>Germany</i>, was the first
who told me that I should find Pus mixed with
the Stools: on my mentioning a Case of this
Kind, which had been relieved by Bleeding,
and Clysters often repeated; he told me he had
observed it frequently at <i>Gibraltar</i>; and was at
a Loss to understand the Nature of the Symptom,
till he observed the Matter in the Stools;
which at once shewed him that it had been originally
an acute Inflammation of the Part, and
pointed out to him the proper Method of
Cure.</p>

<p>Oftentimes the Bilious and Malignant Fevers
terminated in the Dysentery; or were accompanied
with it, when it might be looked upon as a
Symptom of these Fevers.</p>

<p>The Appearances we found after Death in the
Bodies of some Patients, who died of old Fluxes<span class='pagenum'><a name="Page_64" id="Page_64">[64]</a></span>
at <i>Bremen</i>, were: In all of them the Rectum was
inflamed, and partly gangrened, especially the
internal Coat. In two the lower Part of the
Colon was inflamed, and there were several livid
Spots on its great Arcade. In one whose Body
was much emaciated, and who had been seized
with a violent Pain of the Bowels two Days before
his Death, all the small Guts were red and
inflamed; and in another there were livid gangrened
Spots on the Stomach<a name="FNanchor_31_31" id="FNanchor_31_31"></a><a href="#Footnote_31_31" class="fnanchor">[31]</a>.</p>

<p>There was no Disorder we were more successful
in the Cure of, than recent Fluxes; but
after they had continued for Weeks, and were become
in a manner chronic, they often foiled all<span class='pagenum'><a name="Page_65" id="Page_65">[65]</a></span>
our Endeavours, and a great Number died<a name="FNanchor_32_32" id="FNanchor_32_32"></a><a href="#Footnote_32_32" class="fnanchor">[32]</a>.</p>

<p>Upon my first being employed in the Military<span class='pagenum'><a name="Page_66" id="Page_66">[66]</a></span>
Hospitals in <i>Germany</i>, I was surprised to see so
many of the old Dysenteric Cases end fatally;
and imagined I had not fallen upon the Right
Method of treating them: but upon consulting
the other Physical People<a name="FNanchor_33_33" id="FNanchor_33_33"></a><a href="#Footnote_33_33" class="fnanchor">[33]</a> employed in the same
Service, I found them as unsuccessful, as myself,
after having tried a Variety of Remedies: And
at last, I was convinced, that when once the Flux
had continued long, and injured the Structure of
the Intestines to a certain Length, a Gangrene
<span class='pagenum'><a name="Page_67" id="Page_67">[67]</a></span>will often form by slow Degrees; and the Disorder
end fatally, notwithstanding the Use of what
are esteemed the most efficacious Remedies; and
that, when this Disorder is violent, the Cure
principally depends upon an early and speedy
Application of proper Remedies, before the
Strength be exhausted, or the Structure of the
Bowels too much hurt. The bad Success we
had in treating these old Cases, may perhaps
surprise those who have never practised except
in healthful Cities, where the Disease is commonly
mild, and People apply soon for Advice.
But all those Gentlemen who have had
the Care of Military Hospitals, where the Dysentery
has been frequent, and where the Sick
have been often sent a great Way, before they
reached the Hospitals, must be convinced of the
Truth of what is here asserted.</p>

<p>In the Treatment of this Disorder, as well as
of the Malignant Fever, nothing contributed
more to the Cure, than keeping the Sick as
clean as possible, and in large airy Wards.<span class='pagenum'><a name="Page_68" id="Page_68">[68]</a></span></p>

<p>Most of the recent Fluxes, which I saw, were
at first attended with a good deal of Fever, and
Pain in the Bowels; and required more or less
Blood to be taken away, according to the
Strength of the Patient, and the Violence of
the Symptoms.</p>

<p>When the Patients were strong, and complained
of sharp Pain of the Bowels, attended
with a Fever, we used the Lancet freely,
nor were we discouraged from bleeding in the
Beginning by the low quick Pulse which often
attended the Disorder; and we frequently
found the Pulse rise as the Blood flowed from
the Vein. But when the Sick were low and
weak, without much Pain or Fever, and the
Pulse was soft, we were more sparing of the
vital Fluid<a name="FNanchor_34_34" id="FNanchor_34_34"></a><a href="#Footnote_34_34" class="fnanchor">[34]</a>.</p>
<p><span class='pagenum'><a name="Page_69" id="Page_69">[69]</a></span></p>
<p>As the Disorder was for the most part attended
with Sickness in the Beginning, we gave
a Vomit after bleeding; which not only discharged
the Contents of the Stomach, and a
Quantity of Bile, but relieved the Sickness, and
frequently threw the Patient into a breathing
Sweat; and made the Purgatives which were
given next Day operate more freely, and with
more evident good Effects than where no Vomit
had been administered.&mdash;If in the Course of
the Disease the Sickness returned, the Emetic
was repeated; and we often observed, when the
Flux was obstinate, that well-timed Vomits
<span class='pagenum'><a name="Page_70" id="Page_70">[70]</a></span>greatly promoted the Cure.&mdash;The Vomit we
commonly employed was the Powder of Ipecacuana,
which we gave from ten to twenty
Grains; and where the Patient was strong, and
we wanted to make a free Evacuation, we
added one, two, or three Grains of the Tartar
Emetic; which encreased the Strength of the
Vomit, and commonly operated likewise by
Stool<a name="FNanchor_35_35" id="FNanchor_35_35"></a><a href="#Footnote_35_35" class="fnanchor">[35]</a>, as Dr. <i>Pringle</i> has observed.</p>

<p>Next Day we ordered a Purge to empty the
other Parts of the alimentary Canal. The Purgative,
that at first was most employed for this
Purpose, was Rhubarb; but upon repeated
Trials we did not find, that, in general, it answered
so well, in this first Stage of the Disorder,
as the <i>sal catharticum amarum</i>, with Manna
<span class='pagenum'><a name="Page_71" id="Page_71">[71]</a></span>and Oil; which operated without griping or
disturbing the Patient, procured a freer Evacuation,
and gave greater Relief than any other purgative
Medicine we tried. Mr. <i>Francis Russel</i>,
Surgeon to the <i>British</i> Military Hospital in <i>America</i>,
who was formerly Surgeon to the Island of
<i>Minorca</i>, was the first Person who informed me
(in the Year 1757) of the Use of the <i>sal catharticum
amarum</i> in the Dysentery; he told me,
that the Year before (1756) the Dysentery had
been very frequent and very fatal at <i>Gibraltar</i>;
and, after trying Variety of Medicines, he
had found nothing give more Relief, or contribute
more to the Cure, than repeated Doses of
these Salts.</p>

<p>As a great Part of the Cure depended on the
frequent Use of gentle Purges<a name="FNanchor_36_36" id="FNanchor_36_36"></a><a href="#Footnote_36_36" class="fnanchor">[36]</a> in the Beginning,
<span class='pagenum'><a name="Page_72" id="Page_72">[72]</a></span>to carry off the corrupted Humours; the
Purgative was repeated every second, third, or
fourth Day, as the Case required; the Operation
<span class='pagenum'><a name="Page_73" id="Page_73">[73]</a></span>of the former Purge, and the Symptoms,
determining the Frequency of the Repetition.
<span class='pagenum'><a name="Page_74" id="Page_74">[74]</a></span>It was surprising with how little Loss of Strength
the Sick bore the Operation of these Purges; I
have sometimes given them to strong People
<span class='pagenum'><a name="Page_75" id="Page_75">[75]</a></span>every Day, for two, three, or four Days successively;
and observed that the Patient, instead
of being weakened, seemed stronger, and more
brisk and lively, after the Operation of each,
from the Relief it gave; by evacuating those
putrid, corrupted Humours, which kept him
perpetually sick and uneasy, while they remained
within the Bowels.</p>

<p>Though Rhubarb did not answer so well in
the Beginning as the saline Purges; yet afterwards
in the Course of the Distemper, when
the Patient did not complain much of Gripes,
half a Drachm of Rhubarb, either by itself or
in a saline Draught, proved a good gentle
Purge; and given with six or seven Grains of
Calomel, was found to be a good Medicine,
when the Disorder was attended with Worms.</p>

<p>In the Evening, after the Operation of the
Purge, we gave an Opiate; and repeated it at
Nights, in the Intervals between the Purges;
but were obliged to be very sparing of the Dose,
while the Disorder continued in its acute State;
the Opiate was only given in a Quantity sufficient
to mitigate the Pain, and to procure Rest,<span class='pagenum'><a name="Page_76" id="Page_76">[76]</a></span>
but never so as to stupify the Patient, or prevent
a due Discharge by Stool; though we were
often obliged to encrease the Dose, as Use made
it familiar to the Patient.</p>

<p>In the Intervals between the Purges, we
gave in the Day, the Mindereri Draughts with
the Mithridate; or the saline Draughts with
the Addition of four Drops of the <i>tinctura thebaica</i>;
or some such mild diaphoretic, every
four or six Hours; which helped to keep up a
free Perspiration, without any Danger of stopping
the Purging; and for the most part answered
much better than the Diascord, or Philonium,
or other strong Astringents and Opiates
commonly prescribed for this Purpose; which
were always liable to check the Purging too
much, and bring on severe Gripes attended
with Heat and Fever<a name="FNanchor_37_37" id="FNanchor_37_37"></a><a href="#Footnote_37_37" class="fnanchor">[37]</a>; and therefore we seldom
made Use of them in this first Stage of the
Disorder.</p>
<p><span class='pagenum'><a name="Page_77" id="Page_77">[77]</a></span></p>
<p>If the Patient was attacked with severe
Gripes<a name="FNanchor_38_38" id="FNanchor_38_38"></a><a href="#Footnote_38_38" class="fnanchor">[38]</a>, and a Tenesmus, which the Purgatives
and gentle Opiates did not relieve, we ordered
the Abdomen to be fomented with warm
Stupes; and the Patient to drink freely of warm
Barley or Rice-water, or of weak Broth<a name="FNanchor_39_39" id="FNanchor_39_39"></a><a href="#Footnote_39_39" class="fnanchor">[39]</a>, or
an Infusion of Camomile Flowers, as recommended
by Dr. <i>Pringle</i>; and ordered first Clysters
of large Quantities of the plain emollient
Decoction to be given; and if the Gripes still
<span class='pagenum'><a name="Page_78" id="Page_78">[78]</a></span>continued, to be repeated in small Quantities,
with the Addition of a Drachm or two of the
<i>tinctura thebaica</i>; for we observed that Opiate
Clysters often gave more Relief, than Anodynes
administered in any other Way; and sometimes,
when a Tenesmus was very troublesome,
the common oily Clyster, with a little Diascord,
and <i>tinctura thebaica</i>, or the Starch Clyster,
gave more Ease than any other.&mdash;In some
Cases, where the Pain was sharp, attended with
a Fever, we were obliged to take away more or
less Blood; and sometimes also to apply a Blister
to that Part of the Abdomen where the
Patient felt most Pain.</p>

<p>During this Course, the Patients used the
common low Diet of the Hospital; when they
loathed the Rice-Gruel, they had Panado
with a little Red Wine and Sugar; or Water-gruel,
when it could be got, in its Place.&mdash;Their
common Drink was Barley or Rice-water;
of which it was recommended to them to drink
plentifully; as nothing contributed more to the
Cure than the free Use of such Liquors, to dilute<span class='pagenum'><a name="Page_79" id="Page_79">[79]</a></span>
and blunt the Acrimony of the Fluids<a name="FNanchor_40_40" id="FNanchor_40_40"></a><a href="#Footnote_40_40" class="fnanchor">[40]</a>. In
some Cases, when the Purging was violent, and
not accompanied with the malignant Fever, the
<i>decoctum album</i> was found to be a good Drink;
and we added occasionally a few Drops of the
<i>tinctura thebaica</i>.</p>

<p>Such were the chief Remedies we used in
the first Stage of this Disorder; but after some
Weeks, when the Fever had abated, and free
Evacuations had been made, and the Complaint
become in a manner chronic, we were obliged
to try other Methods; and found that the best
Way of treating this Disorder, was, to endeavour
to brace and restore the Tone of the Intestines,
by means of the corroborating and gentle
astringent Medicines, mixed with Opiates;
<span class='pagenum'><a name="Page_80" id="Page_80">[80]</a></span>while mild Purgatives were given at proper Intervals.</p>

<p>The Patients were kept to the same low Diet
as before, with the Addition of a little Wine
or Brandy. They were allowed from a Gill to
a Pint of red Wine <i>per</i> Day, which was commonly
mulled before it was given them; when
the Wine griped them, which it frequently did,
they took in its Stead Half a Gill or a Gill of
Brandy, mixed with a Pint or a Quart of Barley
or Rice-water, or of the <i>decoctum album</i>.</p>

<p>In this Stage of the Disorder we found, that
the same Medicines would not answer with all,
and therefore we were obliged to try Variety<a name="FNanchor_41_41" id="FNanchor_41_41"></a><a href="#Footnote_41_41" class="fnanchor">[41]</a>;
<span class='pagenum'><a name="Page_81" id="Page_81">[81]</a></span>and indeed, unless where the Violence of the
Disorder had abated by the Use of Evacuations,
the Event was always very doubtful; for when
the Complaint had continued long and become
chronic, and the Structure of the Intestines
was much hurt, before the Sick were sent to us;
or when it continued obstinate, and yielded but
little to Evacuations, and the other Methods
used in the first Stage, even Remedies esteemed
<span class='pagenum'><a name="Page_82" id="Page_82">[82]</a></span>the most efficacious oftentimes proved unsuccessful,
and at length the Patient died.</p>

<p>A Spoonful of the <i>mixtura fracastorii</i>, taken
after every loose Stool; and an anodyne Draught
at Night, had a good Effect with some&mdash;Repeated
Doses of the <i>philonium Londinense</i> answered
better with others, who were low, and
required a Remedy that was warm and cordial&mdash;And
others found more Benefit from the
Mindereri Draughts, with Mithridate, or the
<i>confectio cardiaca</i>, or the Theriac anodyne Boluses.</p>

<p>The <i>mixtura Campechensis</i>, both alone and
with <i>tinctura thebaica</i>, checked the Purging,
and gave Relief sometimes; and the Addition
of some of the Extract of Bark and Tincture
of Cinnamon, seemed to encrease its Efficacy in
one or two old Cases, at <i>Bremen</i>; but it afterwards
occasioned such Sickness, that we did not
continue its Use.</p>

<p>In other inveterate Dysenteries, where we
thought that a strong Astringent was wanted,
we added a small Proportion of Allum to the
<i>Campechense</i> Julep, which on first using seemed<span class='pagenum'><a name="Page_83" id="Page_83">[83]</a></span>
to be serviceable; but at other Times it occasioned
a Tenesmus and Gripes; and therefore
we were obliged to be very cautious how we
used it.</p>

<p>Equal Parts of the <i>electuarium diascordii</i> and
<i>electuarium corticis</i>, taken in the Quantity of a
Drachm twice or thrice a Day, was of Use in
many old Fluxes<a name="FNanchor_42_42" id="FNanchor_42_42"></a><a href="#Footnote_42_42" class="fnanchor">[42]</a>, though it made other
Patients so sick, that they were obliged to lay
it aside.</p>

<p>We tried likewise in this Stage of the Disorder,
repeated small Doses of the Ipecacuana;
but it occasioned such Sickness, that we did not
persist in its Use.</p>
<p><span class='pagenum'><a name="Page_84" id="Page_84">[84]</a></span></p>
<p>In other Cases, we gave from two to five
Grains of the Ipecacuana, mixed with Opium,
in different Proportions (from three Grains to
ten of the Ipecacuana to one of the Opium),
every four or six Hours; it gave sometimes a
little present Ease, at other Times it occasioned
Sickness; we often continued its Use for ten,
twelve, or fourteen Days; but it seldom produced
any remarkable Change for the better,
and we were obliged to have Recourse to other
Remedies.</p>

<p><i>Dover</i>&#8217;s Powder was given in large Doses,
from one Scruple to two; and proved a good
Sudorific and Anodyne in some Cases; though
in others it made the Patients sick, without
producing any good Effect.&mdash;It commonly answered
better, when used occasionally as a Sudorific,
than when constantly continued.</p>

<p>During the Use of these Remedies, it was
necessary to repeat the Purgatives from Time to
Time; or to mix them occasionally with the
other Medicines, in order to carry off any corrupted
Humours, or Excrements that might
be lodged In the Cavity of the Intestines; for<span class='pagenum'><a name="Page_85" id="Page_85">[85]</a></span>
when this was neglected, the Patients were
often seized with Sickness and Gripes, and a
more violent Purging than before:&mdash;And if
at any Time they complained of Gripes,
and passed little Pieces of hardened Excrements,
it was mostly a certain Sign that a Purge was
indicated; and, on such Occasions, it generally
gave Relief; and when attended with Sickness,
a Vomit was given before the Purge.&mdash;Clysters
were used as in recent Cases,
where the Sick were low, or had much
Pain of the Bowels<a name="FNanchor_43_43" id="FNanchor_43_43"></a><a href="#Footnote_43_43" class="fnanchor">[43]</a>, or complained of a
Tenesmus.</p>
<p><span class='pagenum'><a name="Page_86" id="Page_86">[86]</a></span></p>
<p>In some old Dysenteries, where the villous
Coat of the Intestines was much injured, I gave
the Cordial Draughts, with the Addition of Half
a Drachm of the <i>balsamum copaivi</i>, a Scruple
of the Extract of the Bark, and five Drops of
<span class='pagenum'><a name="Page_87" id="Page_87">[87]</a></span>the <i>tinctura thebaica</i>, three Times a Day. At
first, this Medicine seemed to promise much,
particularly in the Case of an old Invalid, <i>William
Brookes</i>; who had been long ill of a Flux,
attended with Gripes and a Tenesmus. He
had used Variety of Remedies, without receiving
any Benefit. For the first Fortnight,
after he began the Use of this Medicine, he
rested well, and found great Relief; and seemed
to be in a fair Way of doing well. But
the Disorder being too far advanced before
he began to use it, he relapsed, and
died. On opening his Body, the inner Coats
of the Rectum and the lower Part of the Colon
seemed to be reduced almost to a gelatinous
Substance, and the other Coats were
black, approaching to a Gangrene.&mdash;The same
Medicine gave Relief in other Cases, but they
were too far advanced before it was administered.
In these Cases, when the villous Coat of
the Intestines was inflamed and very irritable,
the mucilaginous Medicines, the <i>pulvis e tragacantha</i>,
and such others, were of Service;
and frequently Starch Clysters and Anodynes<span class='pagenum'><a name="Page_88" id="Page_88">[88]</a></span>
gave Relief, when other Remedies had little
Effect. Flower, boiled with Milk, and sweetened
with Sugar, and given for Breakfast, as
mentioned by Dr. <i>Pringle</i>, proved a good Palliative
to some; and the Starch and Gum Arabic,
dissolved in Water, a good Drink to others.&mdash;Lime
Water and Milk, drank to the Quantity
of a Pint or a Quart a Day, was of use to
a few, though it did not agree with all.</p>

<p>It was very common for Patients bad in the
malignant Fever to be seized likewise with the
Flux. Such Cases were always extremely
dangerous; and when the Fever was bad, we
were often obliged to neglect the Flux, and only
attend to the Fever.&mdash;When the Purging was
violent, and appeared very early in the Fever,
it often sunk the Patients, and soon carried
them off: but where it was moderate, and did
not appear till towards the Height or the Decline
of the Fever, it often proved a Crisis to
the Disorder.</p>

<p>When such Fluxes appeared early attended
with sharp Pain of the Bowels,
and Signs of Inflammation; if the Patient<span class='pagenum'><a name="Page_89" id="Page_89">[89]</a></span>
was strong, we began the Cure with opening
a Vein, which the Patient bore easily,
and it gave Relief; but when the Symptoms
were mild, without any acute Pain, the
Bleeding was omitted.&mdash;Commonly the Bowels
were loaded with corrupted Humours, when
this Symptom appeared; and, therefore, we
found it of Advantage to give a Dose of the
Salts with Manna and Oil, or some other gentle
Purge, to carry them off; and in the Evening
an Opiate to ease the Pain and procure
the Patient Rest.</p>

<p>After this we gave the Mindereri Draughts
with Mithridate; and as soon as the Petechi&aelig;
appeared, or we observed any Remissions
in the Fever, the Patient took every four or
six Hours, a Drachm of an Electuary, composed
of equal Parts of the <i>electuarium corticis</i>
and the <i>electuarium diascordii</i><a name="FNanchor_44_44" id="FNanchor_44_44"></a><a href="#Footnote_44_44" class="fnanchor">[44]</a>; or Half
<span class='pagenum'><a name="Page_90" id="Page_90">[90]</a></span>a Drachm of the Powder of the Bark, or a
Scruple of the Extract, in the Mindereri
Draughts, with four or five Drops of the <i>tinctura
thebaica</i>; and we repeated the Opiate in
the Evening, always proportioning the Quantity
of it to the Effects of the former Dose, and the
Violence of the Purging.</p>

<p><span class='pagenum'><a name="Page_91" id="Page_91">[91]</a></span></p><p>On the second or third Day, we repeated the
Purge; or, if the Patient was weak, ordered a
Clyster to be administered in its Place; in order
to prevent the putrid Fluids and Excrements
from being accumulated in the Bowels:&mdash;In
other respects we treated it as when the
Disorder was not complicated with the malignant
Fever.</p>

<p>This Method, though it did not succeed
with all, yet it answered better than any other
I tried;&mdash;and it ought to be remarked, that
although it had such a good Effect in Cases attended
with the malignant Fever, or where the
Fever inclined to the intermittent Kind, it did
not answer so well in other recent Cases, but
often made the Patient sick.</p>

<p>In military Hospitals, Fluxes are liable to be
complicated with other Disorders, as well as
with the malignant Fever; especially with
Coughs, and pleuritic and peripneumonic Symptoms,
when the Weather begins to be cold, in
<i>October</i> and <i>November</i>.&mdash;In such Cases, when
the Patients were strong, we were often obliged
to bleed freely, to apply Blisters, and in the<span class='pagenum'><a name="Page_92" id="Page_92">[92]</a></span>
Beginning treat the Disorder as inflammatory;
having at the same Time an Eye towards the
Flux, in the other Medicines we prescribed.</p>

<p>Patients, who have had the Flux long, are
apt to have their Legs swell at Nights; or to
swell all over as soon as the Flux has stopped.
Such oedematous or anasarcous Swellings, we
treated nearly in the same Manner as those
which followed the petechial Fever; only that
we durst not at first be so free with the Use of
Purgatives; for as the Bowels remained weak
and easily irritated, such Medicines were apt to
bring back the Flux; and therefore, in the Beginning,
we were for the most part obliged to
attempt the Cure by Diuretics and Diaphoretics;
and to be sparing of the Use of Purgatives,
especially of those of the hydragogue
Kind; though if the Swellings continued for
some Time after the Flux was gone off, and
the Patients were strong, we then ventured to
give Purges at proper Intervals:&mdash;And Blisters
and Scarifications removed them in several Instances
both at <i>Paderborn</i> and <i>Osnabruck</i>.<span class='pagenum'><a name="Page_93" id="Page_93">[93]</a></span></p>

<p>In <i>December</i>, 1761, we had a Case of this
Kind where the <i>oxymel scilliticum</i> was of remarkable
Service. A Soldier, belonging to the
Guards, after a Flux, swelled all over, and made
but a very small Quantity of Water. He took
Medicines of different Sorts for some Weeks,
but received no Benefit till we gave him the
Oxymel Mixture; after taking a few Doses he
made Water very freely, and in large Quantities,
and the Swellings of his Body and Scrotum
began immediately to subside; and by continuing
its Use for a Fortnight, the Swellings
entirely disappeared, and he recovered his
Health and Strength.&mdash;The Oxymel, at the
same Time that it promoted a Flow of Urine,
kept his Body gently open, but did not occasion
any Return of the Flux.</p>

<p>At the Beginning of <i>January</i>, 1762, one
<i>Carter</i>, a Soldier of the Eleventh Regiment of
Foot, laboured under an universal Anasarca;
which about two Months before had succeeded
a Flux. He made but very little Water,
and that of a high red Colour. He took Variety<span class='pagenum'><a name="Page_94" id="Page_94">[94]</a></span>
of Medicines, as Purges, Vomits, <i>Dover</i>&#8217;s
Powder, lixivial and neutral Salts with Opiates,
Infusions of Horse-Radish, all without Effect;
till he was ordered small Doses of Calomel,
three Grains Morning and Evening. After the
third Dose he began to make Water freely;
and by the 24th of <i>January</i> the Swellings were
all gone, and he was shipped off for <i>England</i>
the 8th of <i>February</i>; having been discharged
from his Regiment. The Ship, he went aboard
of, was detained in the River <i>Weser</i> for above
six Weeks, and the malignant Fever broke out
aboard the Transport: He took the Distemper,
and got well of it; but towards the Decline
was seized with a Return of the Flux,
which carried him off.</p>

<p>When these oedematous Swellings came after
the Purging was stopt, if the Patient&#8217;s Strength
was not much exhausted, and he laboured under
no other Disorder, he commonly got the
better of it:&mdash;But when the Strength was gone
before the Swellings appeared, the Disorder
often ended in a confirmed Dropsy, and at last<span class='pagenum'><a name="Page_95" id="Page_95">[95]</a></span>
in Death; and when the Swellings were universal
over the Body, while the Flux yet continued,<span class='pagenum'><a name="Page_96" id="Page_96">[96]</a></span>
it was a Sign of great Weakness, and they
did not survive it long<a name="FNanchor_45_45" id="FNanchor_45_45"></a><a href="#Footnote_45_45" class="fnanchor">[45]</a>.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_29_29" id="Footnote_29_29"></a><a href="#FNanchor_29_29"><span class="label">[29]</span></a> The Dysentery has been long alledged to arise from a
putrescent Cause in Camps; from the Smell of corrupted dead
Animals, and of Excrements, during the Heat of Summer.
<i>Ramazini</i>, in his Chapter on Camp-Diseases, informs us,
that Dr. G. <i>Erric Barnstorff</i>, Physician to the Duke of <i>Brunswick</i>,
who served five Campaigns with the <i>Brunswick</i> and
<i>Lunenburg</i> Troops in <i>Hungary</i>, told him, that the Camp Diseases,
particularly the Malignant Fever and Dysentery, took
their Rise from the Troops remaining long encamped on the
same Ground, and being exposed to the corrupted Steams of
the Bodies of dead Men, Horses, and other Animals, which
lay unburied; and of Excrements, which were not covered
with Earth. And these Causes have since been particularly taken
notice of by Dr. <i>Pringle</i>, in his <i>Observation on the Diseases
of the Army</i>.
</p><p>
Many have imputed the Cause of this Disorder to the eating
of Fruit in excess, because it generally appears about the
Middle of Summer, the Time the Fruit begins to be in Season,
and continues through the Autumn. But from later Observations
this should seem to be a vulgar Error. Dr. <i>Pringle</i>
(part i. ch. iii. p. 20.) tells us, that, in the Year 1743, this
Sickness began and raged before any Fruit was in Season, except
Strawberries, (which from their high Price the Men never
tasted) and ended about the Time the Grapes were ripe; which
growing in open Vineyards were freely eat by every body.
And Dr. <i>Tissot</i>, in a Treatise which he published, called <i>Avis
au Peuple sur la Sant&eacute;</i>, in his Chapter on the <i>Dysentery</i>, &sect; 320,
says, that ripe Fruit, especially the Summer-Fruits, are so far
from being the Cause of the Disorder, that they are the great
Preservatives against it: he says, that, in the Years which the
Fruit is most plentiful, the Dysentery is least frequent; and
he relates several Instances where the Use of ripe Grapes proved
a Cure for the Disorder. Eleven People were attacked by
the Dysentery, nine eat Fruit, and all recovered; the other
two, a Grandmother and Child, from Prejudice, eat none,
and both died. A Regiment of <i>Swiss</i> Soldiers, in Garrison in
the South of <i>France</i>, had the Dysentery very frequent among
them. The Captains purchased some Acres of a Vineyard, and
carried the sick Soldiers to the Field, and gave them the
Grapes to eat; and ordered the Men in Health to live upon
them chiefly. After this not one Person died, nor was any
one seized with the Distemper.&mdash;In an Account of a Treatise
on the Dysentery, published at <i>Hamburg</i> in 1753, which was
epidemical the Year before, in <i>August</i> and <i>September</i>, we are
told, that it did not proceed, as is commonly believed, from
the eating of Fruit; for it was observed, that those who eat
Fruit freely escaped better than those who abstained from it altogether.
<i>Vide Comment. de Rebus in Hist. Nat. &amp; Medecin.
Gestis</i>, vol. II. par. iv. sect. v.
</p><p>
Generally in <i>August</i> and <i>September</i> we have People admitted
into <i>St. George</i>&#8217;s Hospital for the Dysentery; who have certainly
not catched the Disorder from eating of Fruit, but from working
in the Fields, and being exposed to Causes similar to those
which produce the Dysentery in Camps.</p></div>

<div class="footnote"><p><a name="Footnote_30_30" id="Footnote_30_30"></a><a href="#FNanchor_30_30"><span class="label">[30]</span></a> Most Authors, who treat of the Dysentery, mention this
Symptom of Worms; and Dr. <i>Huxham</i> tells us, that, in some
Seasons, he has seen round Worms in the Stools of most of the
Dysenteric Patients. <i>De Aere</i>, vol. II. p. 98.</p></div>

<div class="footnote"><p><a name="Footnote_31_31" id="Footnote_31_31"></a><a href="#FNanchor_31_31"><span class="label">[31]</span></a> From the Accounts we have in Authors, of the Dissection
of the Bodies of Persons who died of the Dysentery, it would
appear; that there is no Part of the alimentary Canal which has
not some time or other been found inflamed, or in a state of
Suppuration or Gangrene; and the Liver, Spleen, and other
Viscera, have likewise been found diseased, but the Rectum
and Colon have almost in all been more or less affected. The
following Account I had, in the Year 1748, from the late Dr.
<i>L. Fraser</i>, who afterwards practised in the Island of <i>Nevis</i>, two
Days after the Patient died. <i>Mary Reid</i>, a Woman thirty
Years of Age, was taken ill of a Dysentery, which in Three
Weeks Time killed her. In her Life-time she complained,
more than ordinary, of Gripes in her Belly, especially in her
Left Side. Her Body was opened in Presence of Dr. <i>Dundas</i>,
who had attended her, during her Illness. All the Intestines and
Mesentery were inflamed, especially the Colon and Rectum;
the internal Side of which was quite in a mortified State, and
contained little Vesicles full of a putrid fetid Liquor, Numbers
of which she had evacuated by Stool some Days before her
Death.</p></div>

<div class="footnote"><p><a name="Footnote_32_32" id="Footnote_32_32"></a><a href="#FNanchor_32_32"><span class="label">[32]</span></a> While this Sheet was in the Press, I received Dr. <i>Pringle</i>&#8217;s 4th
Edition of his <i>Observations on the Diseases of the Army</i>, and Dr.
<i>Baker</i>&#8217;s Treatise on the <i>Dysentery which was epidemic in London
in the Year 1762</i>. Both these Gentlemen give an Account of
the Dissection of the Bodies of some People who died of the
Dysentery; where, besides the common Appearances of the inner
Surface of the Rectum and Colon being covered with a
bloody Slime, and their internal Coats being inflamed, gangrened,
or in a putrid State, there were observed on the Inside of the
lower Part of the Colon, and upper Part of the Rectum, a Number
of little Tubercles, or Excrescences, which resembled the
Small Pox, of a flat Sort at the Height of the Disorder; but
differed from them in this, that they were of a firm Consistence,
without any Cavity: they were believed to take their Rise from
the cellular Membrane, which lies immediately above the villous
Coat. Perhaps such Tubercles might have been found in the
Colon and Rectum of those Bodies we opened; but not looking
for them, they may have passed unobserved.
</p><p>
<i>Morgagni</i>, in his Book lately published, <i>de Sede &amp; Causis
Morborum</i>, epist. xxxi. is of Opinion, that the Filaments, and
Pieces of Membranes, which are frequently observed in the
Stools, are often formed of inspissated Mucus and Lymph, and
other Liquors; and not the Fibres, or Pieces of the villous Coat
of the Intestines, as alledged by many Authors.</p></div>

<div class="footnote"><p><a name="Footnote_33_33" id="Footnote_33_33"></a><a href="#FNanchor_33_33"><span class="label">[33]</span></a> Mr. <i>Cleghorn</i>, in his <i>Account of the Diseases of the Island of
Minorca</i>, says, &#8220;That almost all the Dysenteries which fell under
my Observation, unless they were speedily cured in the
Beginning, at best proved obstinate, and too frequently fatal,
in spite of the many boasted Specificks for this Distemper.&#8221;
chap. v. p. 228.&mdash;The physical Gentlemen employed on the
<i>American</i> Service have told me, that the old Flux Cases were
as fatal in <i>America</i>, as we found them in <i>Germany</i>. I would not
from thence have it believed, that every old Flux was to be
looked on as a lost Case; and for that Reason given up, and no
Attempts be made to cure it; for many, by great Care, and
Strength of Constitution, have gradually surmounted the Disorder,
and recovered their Health; especially when they got over
the Winter, and lived till the warm Weather began.</p></div>

<div class="footnote"><p><a name="Footnote_34_34" id="Footnote_34_34"></a><a href="#FNanchor_34_34"><span class="label">[34]</span></a> Although Bleeding, in the Beginning, has been recommended
by <i>Sydenham</i>, <i>Huxham</i>, <i>Pringle</i>, and other Practitioners;
yet it has been reckoned unnecessary in this Disorder by some
late Authors. But in most of the recent Cases I saw, it was extremely
necessary, and contributed greatly to the Relief as
well as the Cure of the Patient; indeed where the Disorder had
already continued some time, and the Fever was gone off before
the Patient was sent to us; and the Disorder had become in
a manner chronic, and the Patient low, then bleeding was unnecessary,
and would have probably done Hurt. Mr. <i>Francis Russel</i>
told me, that when the Dysentery was epidemical at <i>Gibraltar</i>,
in Summer 1756, he found that by bleeding such Patients
as he met with at the first coming on of the Symptoms, and by
giving them immediately a Vomit, and afterwards a sudorific
Draught, the Disorder was rendered mild, and few of those
died.</p></div>

<div class="footnote"><p><a name="Footnote_35_35" id="Footnote_35_35"></a><a href="#FNanchor_35_35"><span class="label">[35]</span></a> Mr. <i>W. Russel</i>, who was with the Hospital at <i>Martinico</i>,
told me, that, when he was there, he found the Vomit with the
Tartar Emetic to be far preferable to any other, in all Cases
where there was much putrid Bile lodged in the alimentary
Canal; as it speedily carried off those corrupt Humours, which
were often productive of the greatest Mischiefs, if they remained,
but for a short Time, pent up within the Bowels.</p></div>

<div class="footnote"><p><a name="Footnote_36_36" id="Footnote_36_36"></a><a href="#FNanchor_36_36"><span class="label">[36]</span></a> Variety of Medicines have been recommended to answer
this Purpose.
</p><p>
The <i>vitrum ceratum antimonii</i> proved often too rough a Medicine,
and therefore we laid it almost entirely aside.
</p><p>
Repeated small Doses of the Ipecacuana, from four to six
Grains, operated both as an Emetic, and kept up a Purging;
but they made the Men so sick, that we could not prevail upon
them to continue their Use. Mr. <i>Francis Russel</i> told me, that,
in the Year 1756, he found a few Grains of Rhubarb added
to each Dose, made it operate more as a Purgative, and did
not make the Men so sick.&mdash;Dr. <i>Akenside</i> proposes giving the
Ipecacuana in so small Doses as one or two Grains every six
Hours, in a Draught made of Mint-water, and Half a Drachm
of <i>confectio cardiaca</i>; and, after bleeding and vomiting once,
seems to depend almost entirely on the Use of this Medicine for
the Cure of the Dysentery. See his <i>Comment. de Dysenteria</i>,
cap. 2.
</p><p>
The watery Tincture of Rhubarb, recommended by <i>Degnerus</i>,
we tried in some Cases at Bremen; and found it to be a
good mild Purge, but not to answer so well as the Salts and
Manna in recent Cases. Mr. <i>William Russel</i> told me that they
found this watery Tincture of Rhubarb to answer better in
<i>America</i> than any other of the Preparations of Rhubarb.
</p><p>
Calomel has been recommended by many as a Purge in Dysenteries;
and Dr. <i>Huxham</i> (<i>de Aere</i>, Vol. II. P. 100) assures
us, that he has often experienced the good Effects of it, especially
when the Patient at the same time had Worms; in such
Cases we joined it to Rhubarb as mentioned in the Text, or
gave a Calomel Bolus over Night, and a Purge next Morning.
Dr. <i>Duncan</i>, Physician to his Majesty, told me, that he found
the following Method of Cure always successful in the Dysentery,
which was epidemic in <i>London</i> in the Year 1762.
</p><p>
If the Patient was Plethoric, or had much Fever, he ordered
more or less Blood to be taken away; and then gave four
Ounces of the following Julep, every Half Hour, till it both
vomited and purged. &#8478; <i>Tartar. emetic. gr.</i> iij <i>Mann&aelig; elect.
Unc.</i> ij <i>solve in Aq. hordeat. Lib.</i> 1.&mdash;The next Day, and for
five or six Days more, the Patient took so much of a Decoction,
of Manna, Tamarinds, and soluble Tartar, as kept up a free
Discharge by Stool.&mdash;If the Irritation and Griping were severe,
he found that a Solution of Manna, in the common Almond
Emulsion, was sufficient.
</p><p>
When the Pain, or Tenesmus, was violent, a Clyster, of
Chicken Broth, or of an Infusion of Linseed, with an Ounce or
two of Oil of sweet Almonds dissolved in the Yolk of an Egg,
injected once or twice a Day, was of great Use.
</p><p>
Upon the whole, he was always pleased when he saw large
excrementitious Stools come away; and when that could be
procured by a gentle Method, he was the more pleased.
</p><p>
This Disorder was very often cured in a few Days, and in
that Case he dropt the further Use of Medicines; but when it
exceeded the Period of six or seven Days, he then added thirty
or forty Drops of the <i>tinctura thebaica</i> to the Clysters; and
ordered a Scruple of the Extract of the Logwood to be taken
thrice a Day in some proper Vehicle.
</p><p>
The Patient&#8217;s Diet was Rice-Gruel, Sago, Panado, and such
like; no Animal Food, not so much as Chicken-Broth, was
allowed in the Beginning of the Distemper, nor even Oil, Butter,
or Fat of any Kind. The common Drink was Almond
Emulsion, Rice-Water, or Barley-Water with Gum Arabic.
</p><p>
Dr. <i>Duncan</i> lost but one Patient out of Eighty, whom he had
under his Care that Season; and he was delirious, had a high
Fever, and a <i>subsultus tendinum</i> before the Doctor was called
to him, and he died the next Day.
</p><p>
The late Dr. <i>Young</i>, of <i>Edinburgh</i>, seems to have had a very
just Notion of this Disorder, and of the proper Method of
treating it; for, in his Treatise on Opium, sect. vii. he says,
&#8220;I am convinced from Experience, that most of the Dysenteries
I have hitherto met with, might have been cured by
purging mildly, but constantly; and at the same time abating
the Acrimony in the great Guts by emollient Clysters, and
in the small ones by Plenty of Absorbents, and a Diet of
Chicken Broth: But it must be observed with regard to Purgatives,
that Manna agrees best with some, Rhubarb with
others, Jalap, Mercury, and toasted Rhubarb with others;
while others are sooner cured by emollient Clysters. I use
Opium only when the Disease is mild, or after its Violence is
abated by Evacuants and Emollients.&#8221;
</p><p>
Scammony, Aloes, and the other strong resinous and hydragogue
Purges, are hurtful, and occasion Pain. I always observed, that
those Purges answered best which made the freest Evacuation,
and acted with the greatest Ease to the Patient; of which the
Salts and Manna answered best of any I have hitherto used.</p></div>

<div class="footnote"><p><a name="Footnote_37_37" id="Footnote_37_37"></a><a href="#FNanchor_37_37"><span class="label">[37]</span></a> <i>Sydenham</i>, <i>Huxham</i>, and all good Practitioners, have taken
Notice of the bad Effects of the too free Use of Astringents,
and given Cautions against it.</p></div>

<div class="footnote"><p><a name="Footnote_38_38" id="Footnote_38_38"></a><a href="#FNanchor_38_38"><span class="label">[38]</span></a> If the Patient was suddenly attacked with sharp Pain of
the Bowels and Gripes, on a Day in which he had not Physic,
a Dose of the Salts and Manna was commonly given immediately,
to empty thoroughly the first Passages.</p></div>

<div class="footnote"><p><a name="Footnote_39_39" id="Footnote_39_39"></a><a href="#FNanchor_39_39"><span class="label">[39]</span></a> Mr. <i>W. Russel</i> told me, that he and Dr. <i>Huck</i> found the free
Use of the following Emulsion, made of Bees Wax, to be of great
Use after Evacuations, where there was much Pain of the Bowels,
in recent Cases of Fluxes in the Hospitals in <i>America</i>. &#8478;. Cer&aelig;
alb. vel flav&aelig; drachmes tres. Sapon. alb. Hispan. drachmam
unam. Aqu&aelig; fontan&aelig;, unciam unam, liquefiant super ignem
in vase ferreo, agitando spatula, &amp; dein infunde in mortarium
marmoreum, &amp; adde paulatim aq. fontan&aelig;, libras duas syrupi
sacchari. spiritus vini gallici tenuis, vel aqu&aelig; alicujus spirituos&aelig;
ana unciam unam, terendo optime ut fiat emulsio.
</p><p>
This Method of dissolving Bees Wax, in a Watery Liquor,
is entirely new; for before this we knew of no Way of making
it miscible with Water.</p></div>

<div class="footnote"><p><a name="Footnote_40_40" id="Footnote_40_40"></a><a href="#FNanchor_40_40"><span class="label">[40]</span></a> Dr. <i>Huxham</i> (<i>de Aere</i>, Vol. II. p. 107.) says, there is no
Disorder in which a diluting, sweetening Drink is more necessary
than in this; that he has done great Service among the
Poor by luke-warm Water; that, after emptying the Bowels
thoroughly, he has sometimes cured this Disorder by the Use
of pure Water, and a small Quantity of Opium. And <i>Baglivi</i>
(<i>Prax. Med.</i> lib. i.) tells us, that the drinking of common
Whey, and throwing up frequent Clysters of it, had cured
many, and that this was looked upon as a Specific, and kept
a Secret by some.</p></div>

<div class="footnote"><p><a name="Footnote_41_41" id="Footnote_41_41"></a><a href="#FNanchor_41_41"><span class="label">[41]</span></a> Dr. <i>Pringle</i>, in the <i>fourth Edition of his Observations</i>, just
published, in treating of the third or last Stage of the Dysentery,
remarks, that this is the Time for Astringents, which
ought not to be given sooner, or at least very sparingly. And
he tells us, that, in the former Editions of his Work, he mentioned
those Compositions which he had most frequently used,
but that he had now laid most of them aside; and at present
trusts to Vomits, and to a Milk Diet, for the perfect Cure.
</p><p>
He says, &#8220;Whenever therefore the Patient is in this State,
and especially when his Pulse is quick, and he complains of
inward Heat, I began with giving him a Scruple of Ipecacuana;
and the next Day I put him upon the Milk-Diet; which
I continue till all the hectic Symptoms are gone, and till the
Bowels have recovered their Tone. During this Course I
have seldom had Occasion for any other Medicine, excepting
the Chalk Julep mentioned before, which I use for correcting
that strong Acid so incident to relaxed Stomachs. Sometimes
also I add an Opiate to procure Rest at Night; but after
a few Days these are likewise laid aside. All that I require
(which indeed is often hard to obtain) is a strict Perseverance
in the low Diet: and now and then a Repetition of the Vomit,
upon any new Disorder of the Stomach, or great Laxity of
the Bowels.
</p><p>
&#8220;Whilst the Patient continues in this Course, I forbid all animal
Food and fermented Liquors; and besides Milk, I allow
only the Preparations of Grain, Sago and Salop.&#8221; See
Part iii. ch. vi. p. 289, 290.</p></div>

<div class="footnote"><p><a name="Footnote_42_42" id="Footnote_42_42"></a><a href="#FNanchor_42_42"><span class="label">[42]</span></a> I had lately a very remarkable Instance of the Effects of
this Medicine, in the Case of one <i>Gilchrist</i>, a middle-aged Man,
by Trade a Taylor; who was admitted into <i>St. George</i>&#8217;s Hospital
the 20th of <i>July</i>, 1763, for an old Flux, which had continued
above six Months, and reduced him very low: He had
taken a great many Medicines without any Effect. After giving
him a Vomit and two Doses of Tincture of Rhubarb, I
gave him four Grains of the Powder of Ipecacuana with Opium
three Times a Day; but that having no Effect, after using it
for above a Fortnight, I ordered him the Electuary of Diascord
and Cortex; from the Time he began to use this Medicine, he
mended daily; and was dismissed in good Health the 26th of
<i>September</i>.</p></div>

<div class="footnote"><p><a name="Footnote_43_43" id="Footnote_43_43"></a><a href="#FNanchor_43_43"><span class="label">[43]</span></a> On the 21st of <i>November</i>, 1759, <i>Hanah Meredith</i>, a middle-aged
Woman, was admitted into <i>St. George</i>&#8217;s Hospital for a
Flux, which she had six or seven Weeks; she had no Fever,
but complained much of Sickness and Gripes, and her Disorder
had reduced her very low. During the two first Weeks of
her being in the Hospital, she had two Vomits of Ipecacuana
and four Doses of Rhubarb; and in the Intervals anodyne
and astringent Medicines, which made no Alteration in her
Complaints. On the 2d of <i>December</i>, she told me, that two
Years before she had had a Flux for above three Months, which
had yielded to no Remedies till she was ordered repeated Clysters,
and that they had made a Cure in a short Time. I then
ordered an emollient Clyster with a drachm of the <i>electuarium
diascordii</i>, and a Scruple of the <i>tinctura thebaica</i>, to be given
twice a Day, which gave her almost immediate Relief; and
with the Assistance of some Doses of Rhubarb, and one or two
Vomits and occasional Opiates, removed her Disorder by the
Middle of <i>January</i>; though she remained long weak, and troubled
at Times with Gripes; but these Complaints were at last
got the better of by her taking some Doses of Rhubarb, and
drinking daily a Pint of Lime Water mixed with Half a Pint
of Milk.
</p><p>
<i>Sarah Spencer</i>, a middle-aged Woman, was admitted into <i>St.
George</i>&#8217;s Hospital the 9th of <i>November</i>, 1763, for a Flux, which
had continued for two Months, and reduced her very low. She
complained much of Sickness and Gripes; her Stools were
mostly composed of Mucus and Blood; her Pulse was low, and
she had no Fever, but a Whiteness of the Tongue, and complained
of Thirst.&mdash;The first Day she had a Vomit, and next
Day a Dose of the purging saline oily Draught.&mdash;She was ordered
to have an emollient Clyster, with a Drachm of Diascord,
and as much <i>tinctura thebaica</i>, given her every Evening;
and to have a Dose of the saline oily Purge twice a Week, and
Opiates occasionally; by following this Course, and drinking
at Times the Chalk Julep, her Disorder was removed, and she
was discharged the Hospital on the 30th of the same Month.</p></div>

<div class="footnote"><p><a name="Footnote_44_44" id="Footnote_44_44"></a><a href="#FNanchor_44_44"><span class="label">[44]</span></a> This Practice of giving the Cortex with Opiates in the
Dysentery is not new; for Dr. R. <i>Morton</i>, in his Appendix to
his second Exercise on the Fevers, which appeared from 1658
to 1691, observes, that after the Plague of 1666 had ceased, a
Fever from a milder Poison, attended with Gripes and Dysentery,
began to make its Appearance. As the common Methods
of Cure proved unsuccessful, and Dr. <i>Morton</i> observed
Exacerbations and Remissions, he resolved to give the Bark
mixed with Laudanum; and found it answer his Expectation.
The first Patient to whom he gave it, was a man in <i>Long Lane</i>,
who laboured under a Tertian Dysentery; upon observing a
Remission, he ordered a Drachm of the Bark, mixed with a
Grain of Opium, to be given every four Hours for six Times;
and this removed both the Fever and Dysentery.&mdash;He says, he
afterwards gave it, with equal Success, in the Quotidian Dysenteries,
where he observed Exacerbations or Remissions; and he
adds, that he does not doubt but that it will answer as well in
Epidemical Diarrh&#339;a&#8217;s, and Camp Fevers attended with such
Symptoms.
</p><p>
Dr. <i>Whytt</i> of <i>Edinburgh</i> has given with Success a strong Decoction
of the Bark, mixed with the <i>confectio japonica</i> of the
<i>Edinburgh</i> Dispensatory, in the bad State of the Dysentery,
when the Mouth and alimentary Canal were threatened with
Aphth&aelig;, and even sometimes after they had appeared. And
Dr. <i>Pringle</i> mentions his having given the Decoction of the
Bark, with Snake-Root and some Drops of Laudanum, in the
Dysentery complicated with the malignant Fever. See <i>Note
to Page 245 of his third Edition on the Diseases of the Army</i>.</p></div>

<div class="footnote"><p><a name="Footnote_45_45" id="Footnote_45_45"></a><a href="#FNanchor_45_45"><span class="label">[45]</span></a> Many other Medicines have been used for the Cure
of old Dysenteries,&mdash;The <i>Conessi Bark</i>, recommended
as a Specific in Diarrh&#339;as, cured a Dysentery which had
yielded nothing to a Variety of Medicines. <i>Edinburgh Medical
Essays</i>, <i>Vol.</i> III. <i>Art.</i> iv.&mdash;The <i>cortex eleutheri&aelig; vel cascarill&aelig;</i> is
much recommended for the Cure of Dysenteries in the <i>Memoir.
de L&#8217;Academie des Sciences a Paris</i> 1719, and is still in great Repute
among the <i>Germans</i>.&mdash;The Decoction of the <i>semiruba</i> Bark
was found to have a good Effect in the Dysentery, where the
Patient continued to void Blood with his Stools; and when the
Stools were only liquid, without a Mixture of Blood, some of
the Cascarilla added to the Decoction encreased its Efficacy.
See <i>Degnerus</i>&#8217;s Treatise <i>de Dysenteria</i>, <i>cap.</i> iii. <i>sect.</i> 55. These
and many other Remedies have been tried in obstinate Dysenteries.
</p><p>
From what I have observed myself, and from the Accounts
of others, I am now convinced, that such Cases as are not already
too far gone, are most likely to be cured,
</p><p>
1. By keeping the Patients on a low Diet, composed principally
of Milk, Sago, Rice, Salop, and such other Things as are
recommended by Dr. <i>Pringle</i>; allowing weak Broths, and a
small Quantity of white Meat, as they recover their Strength.
The common Drink to be Barley or Rice-Water, Toast and
Water, <i>Bristol</i> Water, Almond Emulsion, and such like.&mdash;By
making them wear some additional Cloathing, and guarding
carefully against catching cold.&mdash;Errors of Diet and Exposure
to Cold being the most frequent Causes of Relapses into this
Disorder.
</p><p>
2. By giving from Time to Time a Dose of some mild Purge;
such as a little Manna and Salts; a Solution of Manna in Almond
Emulsion; twenty or thirty Grains of Rhubarb, in a saline
Draught, or such like; and occasionally gentle Emetics.
</p><p>
3. By the Use of some of the mild Astringents and Corroborants.&mdash;The
Bark, with Astringents and Opiates, agreeing best
with some&mdash;Decoctions of the Semiruba with others&mdash;Chalk in
Electuaries, or Juleps, with others&mdash;anodyne and astringent
Clysters with others&mdash;while others receive more Benefit from
other Remedies&mdash;and severals find themselves better when they
use no Medicines of this Kind.
</p><p>
4. And by the occasional Use of Opiates, and a free Air:
And by moderate Exercise on Horseback, or in a Machine in
the convalescent State.
</p><p>
I ought not to omit mentioning, that I have seen some Cases
where Evacuations had been used in the Beginning, which,
after they had continued for some Time, were cured by a
regular Diet of Broths, and white Meats; riding daily on Horseback;
and drinking a generous good Claret Wine. However,
it ought to be remarked, that this Method only succeeded
where the Disorder was mild, and its Violence had abated by
previous Evacuations.</p></div>
</div>


<h2><a name="CHOLERA" id="CHOLERA"></a>OF THE<span class='pagenum'><a name="Page_97" id="Page_97">[97]</a></span><br />
<span style="font-size: 130%; letter-spacing: 0.15ex">CHOLERA MORBUS</span>.</h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>he</span> Cholera Morbus, or a sudden and
violent Vomiting and Purging, was
very frequent in <i>July</i> and <i>August</i> 1701; and
several were attacked with it at <i>Munster</i>.&mdash;It
was attended with great Sickness, with Pain,
and Inflation of the Abdomen, Thirst, and a
small quick Pulse: Some had it in a pretty violent
Degree, but in general it was mild; and
although the Sickness, Vomiting, and Purging,
continued, in one or two Cases, for above a
Day; yet none of those died whom I saw.</p>

<p>This Disorder weakens the Patient much, in
a short Space of Time; and sometimes, when
violent, kills in less than twenty-four Hours.
It is always most frequent in Summer and the<span class='pagenum'><a name="Page_98" id="Page_98">[98]</a></span>
Beginning of Autumn; and is taken Notice of
by <i>Hippocrates</i>, <i>Aret&aelig;us</i>, <i>Celsus</i>, and other antient
Authors; and is very accurately described
by many of them.&mdash;It is of the bilious Kind;
and the Cure principally depends upon the free
Use of warm mild Liquors in the Beginning;
to dilute and blunt the Acrimony of the Bile,
and other Fluids, and to promote their Discharge;
and afterwards of gentle Cordials to
support the Strength; and warm Fomentations
to allay the Pain when violent; and mild Opiates
to procure Rest; and if the Sickness or
Griping remains next Day after the Cholera is
stopt, to give a Dose of Physic and an Opiate
in the Evening.</p>

<p>An Officer, who had been wounded on the
15th of <i>July</i>, at the Battle of <i>Fillinghausen</i>,
began afterwards to live very freely, and was
on the 4th of <i>August</i> seized in the Night with
the Cholera.&mdash;About ten o&#8217;Clock next Day I
was sent for; and found him in violent Agony,
with sharp Pain in the Bowels, Reachings, and
Strainings to Vomit, and Spasms and Cramps
in the Bowels, Legs, and Arms.&mdash;He had large<span class='pagenum'><a name="Page_99" id="Page_99">[99]</a></span>
red Blotches on his Extremities, and no Pulse
was to be felt at the Wrist, and rather a Fluttering
than a Beating at the Heart.&mdash;He had
vomited and purged much in the Night before
I saw him, but the Purging had begun to
abate.&mdash;I immediately ordered him an emollient
Clyster, and a saline Draught, with the
<i>confectio cardiaca</i>, and five Drops of liquid Laudanum;
which, if he vomited up, was to be
repeated soon after; if not, only once in four
Hours: And he was directed to drink freely of
weak Chicken Broth, warm.&mdash;Two Hours
afterwards we found him in the same Situation;
still no Pulse to be felt, which prevented
us from bleeding him; and the violent Pain
of the Stomach and Bowels, and the Cramps,
continued. We then ordered Flannels, dipped
in a warm emollient Decoction, to be kept
constantly applied to his Belly, dipping them in
the warm Decoction as soon as they began to
grow cool; his Clyster to be repeated with the
Addition of a Drachm of the <i>electuarium e baccis
lauri</i>, and Half a Drachm of the <i>tinctura
thebaica</i>; a Scruple of Castor, and Half a<span class='pagenum'><a name="Page_100" id="Page_100">[100]</a></span>
Drachm of Spirit of Lavender, to be added to
each of his Draughts; and a Blister to be prepared,
in case these Medicines gave no Relief.&mdash;Soon
after, beginning to use the Fomentations,
the Cramps and Pains began to abate;
about four o&#8217;Clock in the Afternoon we could
perceive a Fluttering of the Pulse at the Wrist,
and all the Pains and Cramps were much easier;
so that there was no occasion for the Blister.&mdash;Next
Morning he was very easy, but
low, and inclined to be sick; for which his
Cordial Draughts were repeated every six
Hours.&mdash;The third Day, as he complained of
a little Griping in the Bowels, we ordered him
a Dose of Tincture of Rhubarb, and an Opiate
in the Evening, which entirely removed these
Complaints, and he was abroad and well next
Day.</p>

<p>One Soldier, who had a good deal of Fever,
and complained of acute Pain in the Bowels,
along with the Vomiting and Purging, was
blooded; and drank freely of warm Barley-Water
while the Vomiting continued.&mdash;After
throwing up a Quantity of green bilious Matter,<span class='pagenum'><a name="Page_101" id="Page_101">[101]</a></span>
the Vomiting ceased; and the Gripes and
Purging became less violent.&mdash;In an Hour
after, being able to retain some very weak
Broth in his Stomach, he drank plentifully of
it through the Day; and the Purging being
abated towards Night, he took an anodyne
Draught; and next Day, having still a little
Sickness remaining, had a Dose of Physic and
an Opiate at Night, which removed all his
Complaints.</p>

<p>The Rest, who were attacked with the
Cholera at <i>Munster</i>, were treated much in the
same Way; only as they had not such acute
Pain and Fever as this Man, it was thought
unnecessary to bleed them.</p>

<p>The Antients<a name="FNanchor_46_46" id="FNanchor_46_46"></a><a href="#Footnote_46_46" class="fnanchor">[46]</a> recommended drinking
freely of warm Water in the Beginning, and
the Use of both cold and hot Fomentations of
the Stomach and Belly;&mdash;and in the low State,
the Use of Wine, mixed with Water, and Polenta<a name="FNanchor_47_47" id="FNanchor_47_47"></a><a href="#Footnote_47_47" class="fnanchor">[47]</a>;
and to apply Rue, with Vinegar, and
<span class='pagenum'><a name="Page_102" id="Page_102">[102]</a></span>other strong smelling Things, to the Nostrils;
besides Variety of other Remedies.&mdash;When
Convulsions happen, <i>Celsus</i><a name="FNanchor_48_48" id="FNanchor_48_48"></a><a href="#Footnote_48_48" class="fnanchor">[48]</a> advises to anoint
the Belly with warm Oil; and if that does not
remove them, to apply Cupping-Glasses or
Mustard to the Stomach; and, after sleeping,
to abstain the second Day from Drink; and the
third, to go into the Bath; and if any thing of
a Fever remains after the Cholera is suppressed,
to give a Purge.</p>

<p>Dr. <i>Sydenham</i><a name="FNanchor_49_49" id="FNanchor_49_49"></a><a href="#Footnote_49_49" class="fnanchor">[49]</a> trusts principally to drinking
freely of Chicken Broth, and throwing up
Clysters of the same, and afterwards giving
Opiates.</p>

<p>Dr. <i>Ayton Douglas</i>, in the sixth Volume of
the <i>Edinburgh</i> Medical Essays<a name="FNanchor_50_50" id="FNanchor_50_50"></a><a href="#Footnote_50_50" class="fnanchor">[50]</a>, recommends
a Decoction of Oat Bread, baked without
Leaven or Yest, and carefully toasted as
brown as Coffee, but not burnt; as a Remedy
very grateful to the Stomach, and useful in
stopping the Vomiting, and sometimes the
Purging too: And he relates several Cases
<span class='pagenum'><a name="Page_103" id="Page_103">[103]</a></span>where it had a good Effect. After the Vomiting
was stopped, he added the Use of mild
Opiates; and, where the Patient was low,
Wine and other Cordials.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_46_46" id="Footnote_46_46"></a><a href="#FNanchor_46_46"><span class="label">[46]</span></a> See <i>Aret&aelig;us</i>, Lib. ii. Cap. 4. and <i>Celsus</i>, Lib. iv. Cap.
11.</p></div>

<div class="footnote"><p><a name="Footnote_47_47" id="Footnote_47_47"></a><a href="#FNanchor_47_47"><span class="label">[47]</span></a> The Polenta seems to have been nothing but toasted Barley
Meal. See <i>Plinii Hist. Natural.</i> Lib. xxii. Cap. 25.</p></div>

<div class="footnote"><p><a name="Footnote_48_48" id="Footnote_48_48"></a><a href="#FNanchor_48_48"><span class="label">[48]</span></a> <i>Celsus loco citato.</i></p></div>

<div class="footnote"><p><a name="Footnote_49_49" id="Footnote_49_49"></a><a href="#FNanchor_49_49"><span class="label">[49]</span></a> <i>Processus integ. de Cholera.</i></p></div>

<div class="footnote"><p><a name="Footnote_50_50" id="Footnote_50_50"></a><a href="#FNanchor_50_50"><span class="label">[50]</span></a> Art. 65.</p></div>
</div>


<hr />
<h2><a name="INFLAMMATORY" id="INFLAMMATORY"></a>OF THE<span class='pagenum'><a name="Page_104" id="Page_104">[104]</a></span><br />
<span class="smcap" style="font-size: 130%; letter-spacing: 0.15ex">Inflammatory Fever</span>.</h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">O</span>n</span> the Return of the Troops from the
Winter Expedition into the Country of
<i>Hesse</i>, in the Year 1761, we had several Men
seized with Inflammatory Fevers without any
topical Inflammation; and at the Opening of
each Campaign had always Numbers sent to
the Hospitals ill of this Disorder. Towards
the End of the Campaigns, and throughout the
Winter, many were seized with Inflammatory
Fevers; but these were mostly complicated,
with pleuritic, or peripneumonic Symptoms, or
other topical Inflammations, or with rheumatic
Complaints.</p>

<p>In the Inflammatory Fever, the Sick were
seized at first with cold and hot Fits, succeeded<span class='pagenum'><a name="Page_105" id="Page_105">[105]</a></span>
by Pain in the Head and all over the Body.
The Pulse was strong and quick, and the Blood
sizy; attended with other Appearances commonly
observed in such Fevers.</p>

<p>As the Summer advanced, this Fever was
often accompanied with bilious Symptoms,
with Sickness, and vomiting of bilious Matter,
and very frequently with a Purging: Towards
the End of Summer it ceased, and was succeeded
by the bilious remittent Fever.&mdash;And
it was no uncommon Thing to see those Fevers,
which originally were entirely of an inflammatory
Nature, after the sick had been
some Days in a crowded Hospital, partake a
good deal of the Nature of the Malignant Fever,
or be changed entirely into it.</p>

<p>We treated these Fevers in the common
antiphlogistic Method.&mdash;We blooded freely
in the Beginning; gave the saline Draughts
with Nitre and other cooling Medicines; and
made the Patients drink plentifully of small
Liquors:&mdash;And when they were inclined to
be costive, gave mild Purges, or emollient
laxative Clysters. We afterwards applied Blisters;<span class='pagenum'><a name="Page_106" id="Page_106">[106]</a></span>
and if the Pulse began to sink, gave
Cordials, Wine, and other Remedies commonly
employed in such Cases;&mdash;and towards
the Decline of the Fever endeavoured to promote
such Evacuations as were pointed out by
Nature, and likely to prove critical.</p>

<p>When the Case was complicated with bilious
Symptoms in the Beginning, we were obliged
to have particular Regard to the first Passages.
If the Patient complained much of
Sickness, we gave a gentle Vomit in the Evening,
after bleeding; and a Purge next Day, to
carry off any bilious or corrupted Humours that
might be lodged in the Stomach or Intestines;
and we found that these Evacuations gave Relief,
and generally mitigated all the Symptoms.</p>

<p>If at any Time during the Fever a Looseness
came on, especially when attended with
Gripes, we gave a Dose of some gentle Physic,
which made a free Evacuation; and an
Opiate in the Evening after its Operation; and
afterwards we found it answer better to attempt
rather to moderate, than wholly stop the Purging<span class='pagenum'><a name="Page_107" id="Page_107">[107]</a></span>
by strong Astringents, and Opiates; unless
where the Evacuation by Stool was so great as
to be in Danger of sinking the Patient.</p>

<p>The <i>pulvis antimonialis</i>, composed of ten
Parts of the <i>pulvis e chelis</i>, and one Part of the
Tartar emetic, given in small Doses, was serviceable
in many of these Fevers, after free
Evacuations had been made.</p>

<p>Two Patients, one a Soldier of the Twentieth
Regiment, the other a <i>German</i> Waggoner,
were taken ill of this Fever about the 25th of
<i>December</i>, 1762: They were both blooded
freely, and had a Dose of Physic in the Beginning;
and the saline Draughts with Nitre and
other cooling Remedies; and had Blisters applied
without producing any considerable
Change in their Disorder.&mdash;On the 5th of <i>January</i>,
1763, they both complained much of
Thirst, and were inclined to be costive; their
Tongues were parched, their Pulses quick and
small, and their Skins dry; they were restless
at Nights, and the Soldier had a slight Delirium.&mdash;I
ordered each of them four Grains of
the <i>pulvis antimonialis</i> every four Hours.<span class='pagenum'><a name="Page_108" id="Page_108">[108]</a></span></p>

<p>6th. Next Day the Soldier told me, he had
had four loose Stools; his Senses were much
clearer, the Pulse calmer and slower, and he
said he found himself lighter and easier, and
less feverish, than he had been since he was
first taken ill. The Medicine was continued,
with the Addition of an anodyne Draught at
Night.&mdash;7th. I found him in a fine breathing
Sweat, and he told me he had slept well in the
Night: p.&mdash;8th. The Sweat continued till
this Morning, and on going off his Urine let
fall a copious white Sediment, and left him free
from the Fever; after which he mended daily.</p>

<p>The Waggoner, after taking the third Dose
of the Powders, had a warm Moisture upon
the Skin.&mdash;On the 6th was cooler and without
much Fever, and had had one Stool.&mdash;7th. The
warm Moisture ended in a profuse Sweat,
which carried off the Fever, and he continued
to recover daily.</p>



<h2><a name="ANGINA" id="ANGINA"></a>OF THE<span class='pagenum'><a name="Page_109" id="Page_109">[109]</a></span><br />
<span style="font-size: 130%; letter-spacing: 0.15ex">ANGINA;</span><br />
OR,<br />
<span class="smcap" style="letter-spacing: 0.15ex; font-size: 130%">Sore Throat</span>.</h2>

<p class="newchapter"><span class="firstword"><span class="dropcap">M</span>any</span> of the Soldiers during the Campaign
were seized with Inflammations
of the Throat, especially when the Nights were
cold and moist after warm Days; and when
they did Duty in cold wet Nights in the Winter
Season.&mdash;All of them I saw in <i>Germany</i> were
of the inflammatory Kind; I did not observe
any that were malignant.</p>

<p>They were treated in the antiphlogistic
Method.&mdash;The Patients were blooded liberally<span class='pagenum'><a name="Page_110" id="Page_110">[110]</a></span>
in the Beginning&mdash;took the cooling nitrous
and saline Medicines&mdash;gentle Diaphoretics and
Purgatives&mdash;and used frequent Gargarisms.</p>

<p>Sometimes a Flannel rubbed with camphorated
Oil, or the <i>linimentum volatile</i>, and applied
round the Neck, was of Service.&mdash;And
frequently after bleeding sufficiently, where the
Breathing or Swallowing was difficult, the Application
of a large Blister to the Neck gave
speedy Relief.</p>



<h2><a name="PLEURISY" id="PLEURISY"></a>OF THE<span class='pagenum'><a name="Page_111" id="Page_111">[111]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%">PLEURISY.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>he</span> Pleurisy, or an acute Inflammation
of the Side, was most frequent among
the Soldiers towards the latter End of the Campaigns;
though some were attacked with it at
all Times of the Year, from doing Duty in all
Sorts of Weather.</p>

<p>We followed the antiphlogistic Method of
Cure; and ordered plentiful Bleeding in the
Beginning, till the Violence of the Pain began
to abate, or the Patient grew faint;&mdash;and the
Side to be fomented with Flannels dipped in
warm emollient Decoctions, and afterwards
rubbed with volatile Liniments: At the same
Time the Patient drank freely of warm diluting<span class='pagenum'><a name="Page_112" id="Page_112">[112]</a></span>
Liquors, as Barley Water, the pectoral Decoction,
and such like; and took the saline
and other cooling Medicines, mixed occasionally
with Sperma Ceti, or some other soft
Pectorals, if there was a tickling Cough.&mdash;When
the Patient was costive, we gave a Dose
of Salts, or some other mild Physic, or laxative
Clysters.</p>

<p>If the Pain continued very acute, we repeated
the Bleeding as often as Necessity seemed
to require, and the Pulse could bear; and
immediately after the second Bleeding ordered
a large Blister to be applied to the Part affected.</p>

<p>Physicians formerly used to forbid Bleeding
after the fourth Day, if it had been omitted so
long; but when no Symptoms of Suppuration
had already appeared, on whatever Day of the
Disorder it happened, I ordered plentiful Bleeding,
the same as in recent Cases; and never
found any Disadvantage, but often great Service
from this Practice.</p>

<p>When the Sharpness of the Pain was gone,
and the Pulse became soft, very often a dull<span class='pagenum'><a name="Page_113" id="Page_113">[113]</a></span>
Pain remained for some Time in the Part.&mdash;In
some Cases a brisk Purge removed it;&mdash;in
others, cupping above the Part, and afterwards
rubbing it with the volatile Liniments, did Service;&mdash;in
others, gentle Opiates at Night, especially
where there was a tickling Cough;&mdash;and
in one or two Cases, this Pain did not go
away, till the Patient was ordered to drink every
Day for some Time, a Quart of the Decoction
of Sarsaparilla with the antimonial Wine.</p>

<p>In the Course of this Disorder, if a kindly
Moisture broke out on the Skin, which gave
Relief, this was encouraged by the Use of mild
warm Liquors; or if the Patient began to spit
up a viscid or yellowish Mucus, we endeavoured
to keep up the Expectoration by the Use of
mild Pectorals; and if a Purging came on, we
were careful not to check it too soon, unless it
was so violent as to be in Danger of sinking the
Patient.</p>

<p>When an Inflammation of the Side came to
Suppuration, which happened in one or two
Cases at <i>Osnabruck</i>, in <i>May</i> 1761; as soon as a
Fluctuation of Matter was to be felt, an Incision was<span class='pagenum'><a name="Page_114" id="Page_114">[114]</a></span>
was made in the Part, and the Matter discharged;
after which the Sore healed kindly,
and the Patients recovered<a name="FNanchor_51_51" id="FNanchor_51_51"></a><a href="#Footnote_51_51" class="fnanchor">[51]</a>. I am persuaded,
was this Operation oftener performed, many
would recover who die consumptive.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_51_51" id="Footnote_51_51"></a><a href="#FNanchor_51_51"><span class="label">[51]</span></a> Dr. <i>Mead</i> advises, where the Lungs and Pleura grow together,
and an Abscess forms, to open it with Caustic; and afterwards
to keep the Ulcer open during the Patient&#8217;s Life:
For he says, he has often seen, where such Sores were healed
up, that the Patient died soon after by an Efflux of Matter upon
the Breast. <i>Monita Medica</i>, Cap. i. Sect. 7.</p></div>
</div>


<h2><a name="PERIPNEUMONY" id="PERIPNEUMONY"></a>OF THE<span class='pagenum'><a name="Page_115" id="Page_115">[115]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%">PERIPNEUMONY.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>he</span> Soldiers were subject at all Times
to the Peripneumony, or Inflammation
of the Lungs, from doing Duty in cold wet
Weather, and from their irregular Way of
living; but more particularly towards the End
of the Campaigns, and in Winter.</p>

<p>This Disorder was much more dangerous
and fatal than the Pleurisy, especially when
neglected in the Beginning; for then Bleeding
had seldom any Effect; the Difficulty of Breathing
encreased, the Patient was seized with an
Orthopnea, and such an Anxiety and Sense of
Suffocation, that he could not sleep; and the
Pulse sunk; and in these Cases Death only afforded
Relief. This we experienced in many<span class='pagenum'><a name="Page_116" id="Page_116">[116]</a></span>
Men who had lain neglected in Quarters, for
two, three, four, or five Days, before they were
brought to the Hospital.</p>

<p>In most of the Bodies of those who died of
this Disorder, and were opened after Death;
we found the Lungs violently inflamed, with
livid or gangrenous Spots on their Surface; and
more or less of a watery Serum extravasated
into the Cavity of the Chest.</p>

<p>Three had Suppurations in the Lungs. In
one, who had lain sick in Quarters for ten Days
or upwards, before he was sent to the Hospital,
the right Cavity of the Thorax was found full
of a watery Serum; and the Lobes of the Lungs
on the same Side almost entirely wasted; and
what remained seemed as it were composed of
thickened Membranes, resembling those formed
by the coagulable Lymph, or what is called
by some (though improperly) the fibrous Part
of the Blood. The Lobes in the left Side
seemed to be in a sound State, or at most but
slightly inflamed. From the right Lobes of
the Lungs being so much wasted, I suspected
that the Patient had probably laboured long<span class='pagenum'><a name="Page_117" id="Page_117">[117]</a></span>
under some Disorder of the Breast; but I
could not from Enquiry obtain any Information
in this Particular; nor did he ever mention
such a Thing during the few Days he lived
after being brought into the Hospital; he said,
he had only been ill for eight or ten Days before;
but Soldiers afflicted with chronic Distempers,
when they are seized with violent
Symptoms, or acute Diseases, are apt to reckon
the Beginning of their Disorder, only from the
Time they are taken ill in a violent Manner;
and never to take any Notice of their former
Complaints.</p>

<p>Another Soldier, about the Middle of <i>February</i>,
1762, remained in Quarters five Days
after being taken ill with a Pain of the Breast,
and a Difficulty of Breathing; the sixth Day
he was brought to the Hospital in the Morning,
and I saw him about eleven o&#8217;Clock; he
then had all the Symptoms of the true Peripneumony,
attended with a strong hard Pulse.
He was immediately blooded as freely as his
Pulse would bear, had Blisters applied, and
other Remedies used; notwithstanding which,<span class='pagenum'><a name="Page_118" id="Page_118">[118]</a></span>
on the eighth Day from that Time, he began
to throw up a purulent Matter in great Quantity,
attended with a constant hectic Heat, and
Fever; which sunk him so fast, that he died
the tenth Day, after he first began to expectorate.</p>

<p>On the 2d of <i>March</i>, a Soldier, of the Fifty-first
Regiment of Foot, was brought to the
Hospital, with a violent Pain in the left Side,
and a great Difficulty of Breathing. Upon examining
him, he told me, that about two Years
before he had had a violent Stitch in his left
Side, towards the lower Part of the Thorax;
that ever since he had been subject to a Difficulty
of Breathing; and at Times to a Pain in the
Side; but that he had only been seized with
the violent Pain and Difficulty of Breathing he
then complained of, about five Days before,
occasioned by catching Cold, on being billeted
in a low, cold, and damp House.&mdash;His Pulse
was quick, the Pain of his Side and Difficulty
of Breathing so great, that he could not sleep,
nor lie down, but was obliged to sit constantly
in an erect Posture; his Tongue was<span class='pagenum'><a name="Page_119" id="Page_119">[119]</a></span>
white and furred, and he had had no Stools for
three Days: He was ordered to be blooded immediately;
and to take a Dose of Salts; and his
Side to be rubbed with the <i>linimentum volatile</i>.
3d. His Breathing and Pain of the Side were
easier; he had slept a little in the Night, and
could lie on his right side, but not on his left.
He was ordered the Squill Mixture. 4th. His
Breathing was worse; he was blooded a second
Time; had a large Blister applied to his Side,
and was ordered to continue the Use of
the Squill Mixture. On the 5th, 6th, and
7th, he seemed easier, though the Breathing
was still much affected, and his Pulse quick
and low, attended with a hectic Heat. On the
8th, he told me that his left Side was swelled:
On examining, I observed a Fullness in that
Side of the Thorax; and on pressing with my
Fingers between the Ribs, I thought I felt an
obscure Fluctuation of a deep-seated Fluid.
From these Appearances, and the History of
the Case, I judged that there was a Collection
of some Fluid within the Cavity of the Chest;<span class='pagenum'><a name="Page_120" id="Page_120">[120]</a></span>
and that the only Means left to give Relief,
was to make an Opening into the Cavity, and
so evacuate the Fluid. I therefore proposed to
him the Operation of the Empyema, to be performed
immediately; which he several Times
obstinately refused to submit to: He allowed a
Seton to be put in his Side, but that did not
answer the End proposed: He languished six
Days longer; and died the 14th of <i>March</i>.
Next Day an Opening was made in the Thorax,
in the Part where the Operation was proposed
to have been performed; as soon as the
Pleura was cut through, some Quarts of Water
rushed out. We then opened the Thorax,
and found still some Water in the left Cavity.
The Pericardium was thickened, and slightly
inflamed, and adhered to the Diaphragm;
which was likewise a little thickened and inflamed
in the adhering Part; the Lungs on
that Side were much compressed, and contracted
by the Pressure of the Water; but on being
inflated and cut, seemed in a sound State,
except that they were slightly inflamed. The<span class='pagenum'><a name="Page_121" id="Page_121">[121]</a></span>
Lungs of the left Side adhered every-where
firmly to the Thorax, but seemed otherwise
sound; having no Tubercles, Suppuration, or
other Disorder, that we could observe in cutting
them. The Heart and Blood Vessels were
sound, and no other polypous Concretions were
observed within their Cavities, but such as we
find in most dead Bodies; which seem to be
formed of the coagulable Lymph in <i>articulo
mortis</i>. The Viscera of the Abdomen were in
a sound State.</p>

<p>We treated the Peripneumony nearly as the
Pleurisy. We bled freely in the Beginning,
till the Breathing became easier, or the Pulse
began to sink; taking Care not to be deceived
by a low oppressive Pulse, which generally rose
upon Bleeding. We applied large Blisters;
gave the mild Pectorals freely, and plenty of
warm diluting Liquors, Barley Water, the pectoral
Decoction, and such like; which afforded
more Relief than any other Medicines. We
gave too saline Purges, and laxative Clysters occasionally;
and in some Cases ordered the<span class='pagenum'><a name="Page_122" id="Page_122">[122]</a></span>
Steams of warm emollient Decoctions with
Vinegar to be drawn into the Lungs.</p>

<p>By this Treatment most of them, who applied
early for Relief, got the better of the
Disorder.</p>

<p>When the Expectoration began, the Patient
continued the free Use of the mild Pectorals,
and diluting Liquors; and no Medicines were
given that might in the least tend to stop it;
other Evacuations were omitted, unless where
the Pain of the Breast, or the Difficulty of
Breathing increased; in which Case, if the
Pulse kept up, I ordered a Vein to be opened,
and a suitable Quantity of Blood to be taken
away; no other Remedy affording any Relief,
till this Evacuation was made. Where the
Patient was costive, we frequently ordered
laxative Clysters, or a mild Purge, and found
them beneficial: But where no such Symptoms
occurred, it was best, for the most part,
to omit all Evacuations of this Kind, after a
free Expectoration had begun, and to trust to
it for carrying off the Disorder.<span class='pagenum'><a name="Page_123" id="Page_123">[123]</a></span></p>

<p>In some Cases, where the Expectoration stopt
suddenly after bleeding, we gave with Advantage
a gentle Vomit, as recommended by Dr.
<i>Huxham</i><a name="FNanchor_52_52" id="FNanchor_52_52"></a><a href="#Footnote_52_52" class="fnanchor">[52]</a>.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_52_52" id="Footnote_52_52"></a><a href="#FNanchor_52_52"><span class="label">[52]</span></a> Some late Authors seem to look upon the <i>Pleurisy</i> and
<i>Peripneumony</i> as the same Disorder: However, though it be
true, that when the <i>Pleura</i> is inflamed, the Surface of the contiguous
Lungs is generally in the same State; and that, when
the <i>Lungs</i> are inflamed, the Pleura is often affected; yet as I
have frequently seen the true Peripneumony without that sharp
Pain of the Side which characterizes the Pleurisy; and upon
opening the Bodies of People who have died of the Peripneumony,
have found the Lungs violently inflamed and livid, and
so filled with Blood as to sink in Water, without the Pleura being
much diseased; and upon opening the Thorax of others
who died of the Pleurisy, have found the intercostal Muscles
and Pleura violently inflamed with livid Spots, and only a
small Portion of the Surface of the contiguous Lungs affected;
I cannot help still looking upon them as distinct Disorders;
though they require nearly the same Treatment, and are often
complicated together.</p></div>
</div>


<h2><a name="COUGH" id="COUGH"></a>OF THE<span class='pagenum'><a name="Page_124" id="Page_124">[124]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%"><span class="smcap">Cough</span> and <span class="smcap">Consumption</span>.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">C</span>oughs</span> were very frequent during the
Winter, and when the Weather was wet
and cold. They were often accompanied with
Pains of the Breast; and, when neglected,
Obstructions, Tubercles, and Suppurations,
were apt to form in the Lungs, and the Disease
to end in a Consumption, or <i>Phthisis Pulmonalis</i>.</p>

<p>When Coughs were slight, guarding against
further Cold, and the Use of mild Pectorals and
warm Drinks, removed them. But when the
Patient complained of a Pain and Tightness
about the Breast, it was always necessary to
take away more or less Blood; and after Bleeding
to give some of the mild Pectorals, such as<span class='pagenum'><a name="Page_125" id="Page_125">[125]</a></span>
the Sperma Ceti or oily Mixtures; and, if a
Fever attended, to join the Use of Nitre, or of
the saline or mindereri Draughts; and, if a
tickling Cough was troublesome, to give frequently
a Tea Spoonful of the oily Linctus, acidulated
either with the Spirit of Vitriol, or the
<i>oxymel scilliticum</i>. The mild Diaphoretics,
such as the mindereri Draughts, given along
with warm Drinks, to promote a free Perspiration,
or Sweat, were used with Advantage;
when the Patients kept in Bed, and lay in
Wards which had Stoves in them.</p>

<p>If the Cough and Pain of the Breast were
not relieved by these Means, the Patient was
bled a second Time, and a Blister applied to the
Side immediately after; which often removed
most of the Complaints. When it did not,
we gave the pectoral Decoction for common
Drink; and if there was a Shortness or Difficulty
of Breathing, the squill Mixture, or <i>lac
ammoniacum</i>, with Oxymel; and occasionally
gentle Purges: And if at any Time of the
Disorder the Tightness and Pain of the Breast<span class='pagenum'><a name="Page_126" id="Page_126">[126]</a></span>
returned violent, we took away some Blood,
no other Remedy affording Relief.</p>

<p>When there was little or no Fever, and a
thin Rheum kept up a tickling Cough, nothing
had a better Effect than to add some
Drops of the <i>tinctura thebaica</i>, or some of the
<i>elixir paregoricum</i>, to the oleagenous or squill
Mixtures; or to give an Opiate Draught or
Pill at Bed-Time, which eased the Cough,
and procured the Patient Rest.</p>

<p>At all Times it was necessary, when the
Cough was violent, attended with Pains of the
Breast, to keep the Patients on low Diet; and
in as free and pure Air as the Nature of the
Hospitals would admit of; for we often found
that those Men who had laboured long under obstinate
Coughs, which threatened Consumptions
in small crowded Wards, recovered surprisingly
on being removed to a freer Air; of which we
had a remarkable Instance in the Hospital at
<i>Bremen</i>, in <i>January</i> 1762; upon removing
some Men, afflicted with very bad Coughs,
out of small Wards, which were damp, into
one large one, which was dry and airy.<span class='pagenum'><a name="Page_127" id="Page_127">[127]</a></span></p>

<p>When the Weather was good, we made the
Patients walk out a little in the Day-Time;
for we observed, that remaining always in the
Hospital, and breathing nothing but a foul Air,
helped to encrease the Disorder.&mdash;When we
knew the Men to be sober, and not apt to
commit Irregularities, we used to procure them
good Billets, and make them come daily to the
Hospital for their Medicines.</p>

<p>Equal Parts of Lime-Water and Milk,
drank to the Quantity of a Quart a Day, was
of Use to some; and the <i>infusum amarum</i>, and
other gentle Bitters, taken to the Quantity of
an Ounce or two, Morning and Evening, to
others<a name="FNanchor_53_53" id="FNanchor_53_53"></a><a href="#Footnote_53_53" class="fnanchor">[53]</a>.</p>
<p><span class='pagenum'><a name="Page_128" id="Page_128">[128]</a></span></p>
<p>A Decoction of the Cortex removed some
Coughs which had continued for a considerable
Time. In one or two of these Cases, slight
hectic Symptoms had already appeared<a name="FNanchor_54_54" id="FNanchor_54_54"></a><a href="#Footnote_54_54" class="fnanchor">[54]</a>.
However, for the most part, where-ever Obstructions
of the Lungs were confirmed, or
there were evident hectic Symptoms without
<span class='pagenum'><a name="Page_129" id="Page_129">[129]</a></span>a free Discharge of purulent Matter, the Bark
did no Service; but rather heated and increased
the Fever, and made the Sick more restless and
uneasy.&mdash;It was of most Use where there
seemed to be no confirmed Obstructions, but
the Vessels much relaxed; which we judged
to be the Case from the Patients having no
fixed Pain, nor the Breathing much affected.
If the Sick were plethoric, or in the least feverish,
we ordered a little Blood to be taken
away, before we began the Use of this Medicine.</p>

<p>In similar Cases, I have sometimes observed
good Effects from the Use of the Balsam <i>Copaivy</i>,
or <i>Peru</i>; given either in Juleps or made
up into an Electuary, as in the <i>electuarium e
spermate ceti cum balsamo</i>; but in whatever
Form they were given, if there were confirmed
Obstructions of the Lungs, they rather
heated and inflamed, than did any real Service.</p>

<p>When Coughs continued long, attended
with Pain in the Side, Difficulty of Breathing,
and Hectic Fever and Night Sweats, we always<span class='pagenum'><a name="Page_130" id="Page_130">[130]</a></span>
had Reason to suspect, that the Disorder would
terminate in a confirmed Consumption. When
this was threatened, we found, that the principal
Thing to be done, was to keep the Patients
cool; and to endeavour to allay the hectic
Heat and Fever; and to retard, as much as
possible, the Progress of the Disorder. When
the Case was recent, we were sometimes so
lucky as to make a Cure; but after it was confirmed,
it for the most part ended fatally.</p>

<p>We kept the Patients upon a low Diet; and
where-ever Milk was to be got easily, we allowed
them a Pint a Day<a name="FNanchor_55_55" id="FNanchor_55_55"></a><a href="#Footnote_55_55" class="fnanchor">[55]</a>; which was either
mixed with Water and given for Drink,
or they took it to Breakfast or Supper.&mdash;Their
common Drink was either Barley Water or
the pectoral Decoction; which was occasionally
acidulated with a few Drops of Spirit of
<span class='pagenum'><a name="Page_131" id="Page_131">[131]</a></span>Vitriol; and we gave at the same Time the
cooling Medicines, such as Nitre, the saline or
mindereri Draughts, mixed at Times with
Sperma Ceti, or some other of the mild Pectorals.</p>

<p>The opening a Vein, and taking away from
four to eight Ounces of Blood<a name="FNanchor_56_56" id="FNanchor_56_56"></a><a href="#Footnote_56_56" class="fnanchor">[56]</a>, whenever
the Pain of the Breast was troublesome, or the
Patient was hot and restless at Nights from the
Hectic Fever, gave the greatest Relief of any
Thing we tried; and these repeated small
Bleedings were so far from wasting the Patient&#8217;s
Strength, that they rather seemed to prevent
its being exhausted so fast as otherwise it
would have been, by allaying the Force of the
Hectic Fever.</p>

<p>At this Stage of the Disorder, we put in Setons,
or ordered Issues, to serve as a Drain to
carry off the Matter, and found them of Advantage
in some Cases. When the Patients
<span class='pagenum'><a name="Page_132" id="Page_132">[132]</a></span>complained of any fixed Pain, we always made
the Issues as near the Part affected as possible<a name="FNanchor_57_57" id="FNanchor_57_57"></a><a href="#Footnote_57_57" class="fnanchor">[57]</a>.
On the 5th of <i>May</i>, 1762, a Man,
belonging to the Eighty-eighth Regiment of
Foot, was sent to the Hospital at <i>Bremen</i> for
an H&aelig;moptoe, attended with a constant hectic
Heat and Fever.&mdash;After being blooded, and
using the cooling Remedies without Success,
he had four Pea Issues made in his Back; and
had a slight Decoction of the Cortex, acidulated
<span class='pagenum'><a name="Page_133" id="Page_133">[133]</a></span>with Spirit of Vitriol. As soon as the Issues
began to discharge freely, the hectic Heat,
Fever, and Spitting of Blood, diminished daily;
and he recovered his Health and Strength in a
short Time. However, it ought to be observed,
that although these Drains are sometimes
efficacious, yet, when the Disease is far advanced,
the Mischief is generally too deep rooted
for them to be of any Service.</p>

<p>The Bark, and natural Balsams, for the most
part were prejudicial, and encreased the Hectic
Heat and Fever; except in one or two Cases,
where the Disorder seemed to depend on a Vomica
of the Lungs, and the Patient coughed up
the Matter freely.&mdash;In one Case they were of
considerable Service; the Patient was very low,
and had the Night Sweats, but coughed up the
Matter freely: On using the Decoction of the
Bark, and the <i>electuarium e spermate ceti cum
balsamo</i>, the Matter expectorated became
thicker, and of a more balmy Consistence,
without any Increase of Heat or Fever; after
which the Symptoms became gradually milder,
and the Patient recovered.<span class='pagenum'><a name="Page_134" id="Page_134">[134]</a></span></p>

<p>In the Course of this Disorder the Patients
often became very hot and restless, and were
troubled with Gripes, succeeded by a Purging:
These Symptoms were most readily removed
by a Dose of Rhubarb, or of some other mild
Purge; for they generally proceeded from
corrupted Humours lodged in the Intestines.
In the Evening, after the Operation of
the Purge, we gave an Opiate to procure the
Patient Rest.&mdash;When the first Dose of Physic
did not stop the Purging, we repeated the Opiates
at Nights, and in a Day or two gave another
Purge; and if there was much Sickness,
or Load at the Stomach, gave likewise a gentle
Emetic.</p>

<p>If the Purging still continued, we were obliged
to join the Use of Astringents along with
the Opiates. In some Cases, I found good Effects
from equal Parts of Milk and Water boiled
with Rose Leaves, Pomegranate Bark, Balaustine
Flowers, and Cinnamon, as recommended by
Dr. <i>Mead</i> in his <i>Monita Medica</i><a name="FNanchor_58_58" id="FNanchor_58_58"></a><a href="#Footnote_58_58" class="fnanchor">[58]</a>; it served
<span class='pagenum'><a name="Page_135" id="Page_135">[135]</a></span>both for Food and Medicine.&mdash;When Opiates
and Astringents were given to stop the Purging
at its first Appearance, before the Bowels were
emptied, they always did Mischief; and increased
the Heat and Fever: And although
they stopt the Purging for a few Hours, it always
broke out with greater Violence afterwards.</p>

<p>When the Sick were attacked with a Shortness
and Difficulty of Breathing, which was
not relieved by Evacuations, and the Use of
cooling Medicines, and Pectorals, and Blisters,
nothing gave so much Ease, or had such a good
Effect, as a gentle Vomit; for it often removed
the immediate Oppression from the Breast, and
helped to pump up the Matter from the
Lungs.</p>

<p>In the advanced State of the Consumption,
the Cough was always very troublesome; and
the Sick found no Relief but from Opiate Medicines,
which, in such Cases, cannot be expected
to do more than give a little present
Ease.&mdash;As they were apt to obstruct the free
Expectoration, we generally mixed them with<span class='pagenum'><a name="Page_136" id="Page_136">[136]</a></span>
some <i>oxymel scilliticum</i>, or <i>tinctura f&#339;tida</i>,
which took off a good deal of their suffocating
Quality.</p>

<p>Dr. <i>Barry</i><a name="FNanchor_59_59" id="FNanchor_59_59"></a><a href="#Footnote_59_59" class="fnanchor">[59]</a> advises for the Cure of a
Consumption, to make an Incision or Aperture
into the Side; where-ever there is a fixed Pain
attended with a Weight, a Hectic Fever, and
other Symptoms of an evident Suppuration:
He says the Pleura is thickened, and the Lungs
adhere at the Part where they are exulcerated;
and that by the Operation the Pus may be evacuated,
and a Cure made; and he gives several
Instances of the Success of the Operation,
when performed in Time.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_53_53" id="Footnote_53_53"></a><a href="#FNanchor_53_53"><span class="label">[53]</span></a> Asses Milk, and <i>Bristol</i> and <i>Seltzer</i> Waters, which are
found so serviceable in pulmonic Disorders, could not be had
in the military Hospitals; and riding on Horseback was too
expensive a Remedy for a Soldier.
</p><p>
In chronic Cases, where we suspect Obstructions and Tubercles
to be formed in the Lungs, which have not already come
to Suppuration, Dr. <i>Russel</i> recommends the Use of Sea Water
for resolving them; but we were at too great a Distance from
the Sea to try this Remedy. See his <i>Treatise on Sea Water</i>,
Page 17.</p></div>

<div class="footnote"><p><a name="Footnote_54_54" id="Footnote_54_54"></a><a href="#FNanchor_54_54"><span class="label">[54]</span></a> <i>Mary Shepperd</i>, a Woman twenty-six Years of Age,
was admitted into <i>St. George</i>&#8217;s Hospital the 6th of <i>June</i>,
1759, for a Cough; attended with a constant hectic Fever and
Night Sweats, which had begun in the Month of <i>April</i>, after
the Measles. She complained likewise of having the <i>fluor albus</i>,
and she had been blooded more than once before she came to
the Hospital.&mdash;I at first gave her some of the mild Pectorals;
and a Solution of White Vitriol in Water, <i>utenda pro inject. uterina</i>.
After a Week, finding no Alteration in her Complaints,
I advised her to become an Out-patient; and to go down to her
Friends in the Country, to live upon a Milk Diet; to take gentle
Exercise, and continue the Use of her Medicines; which
she did, but without any Alteration in her Disorder, till the
6th of <i>July</i>, when I ordered her to take thrice a Day two
Ounces of the Decoction of the Cortex, along with a saline
Draught. Immediately, on beginning to use this Medicine,
her Disorder began to take a favourable Turn; her Fever and
Night Sweats left her, her Cough became easier, and she recovered
Health and Strength daily. She came to the Hospital
the 15th of <i>August</i>, seemingly in good Health, to return Thanks
for her Cure.</p></div>

<div class="footnote"><p><a name="Footnote_55_55" id="Footnote_55_55"></a><a href="#FNanchor_55_55"><span class="label">[55]</span></a> In private Practice, at this Stage of the Disorder, the Use
of Asses Milk, and drinking the <i>Bristol</i> Water at the <i>Bristol</i>
Wells, and riding on Horseback daily, are justly ranked
amongst the most efficacious Remedies; and going into the
more southern Climates, as the South of <i>France</i>, <i>Portugal</i>, or
<i>Italy</i>, where the Air is warmer, more constant, and dry, than
in <i>England</i>, has often been found to produce good Effects.</p></div>

<div class="footnote"><p><a name="Footnote_56_56" id="Footnote_56_56"></a><a href="#FNanchor_56_56"><span class="label">[56]</span></a> This Practice has been strongly recommended by Dr.
<i>Mead</i>, in his <i>Monita Medica</i>, Sect. x. and by an anonymous
Author in the <i>Edinburgh Medical Essays</i>, Vol. IV. Art. 28. and
Dr. <i>Mead</i> says, when Things have not been quite desperate, he
has seen good Success from it.</p></div>

<div class="footnote"><p><a name="Footnote_57_57" id="Footnote_57_57"></a><a href="#FNanchor_57_57"><span class="label">[57]</span></a> In <i>June</i>, 1748, a Servant Girl came to ask my Advice for
a Cough, attended with a constant Hectic Fever and Night
Sweats, which had begun some Months before, on catching
Cold. The Matter she spit up was yellow, and had the Appearance
of Pus; and she complained of a Pain in the left Side
of the Thorax. I ordered her the saline Mixture with Sperma
Ceti to be taken thrice a Day, to lose a little Blood, to drink
an Infusion of Linseed sweetened with Honey, and to have a
Seton put in her Side at the Part where she complained of
Pain; advising her to go home to her Father, who was a Farmer
in the Country, and to live upon a Milk and Vegetable
Diet, and ride on Horseback whenever she could conveniently.
She seemed so far gone in a Consumption, that I scarce expected
to see her again; but, in the Month of <i>December</i>, she
came to return me Thanks for her Cure, seeming then to be in
good Health. She told me, that, as soon as the Seton began to
discharge freely, she found Relief; and mended afterwards
daily, by following the Directions I had given her.</p></div>

<div class="footnote"><p><a name="Footnote_58_58" id="Footnote_58_58"></a><a href="#FNanchor_58_58"><span class="label">[58]</span></a> <i>Sect.</i> x. <i>de Febrib. lentis sive Hecticis.</i></p></div>

<div class="footnote"><p><a name="Footnote_59_59" id="Footnote_59_59"></a><a href="#FNanchor_59_59"><span class="label">[59]</span></a> <i>Treatise on the Digestions</i>, p. 410.</p></div>
</div>


<h2><a name="INFLUENZA" id="INFLUENZA"></a>OF THE<span class='pagenum'><a name="Page_137" id="Page_137">[137]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%">Epidemical <span class="smcap">Catarrhal Fever</span></span><br />
Of APRIL, 1762;<br />
CALLED,<br />
<span class="smcap" style="letter-spacing: 0.15ex; font-size: 130%">The INFLUENZA.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">A</span>fter</span> a very cold severe Winter at
<i>Bremen</i>, the Weather, from being very
cold, became of a sudden extremely hot, about
the 10th of <i>April</i>. In a few Days after, many
People were seized with a violent Catarrhal
Disorder. It often began with such a Cold
and Shivering, that many imagined at first that
they were going to have Agues; but soon after
they were attacked with a Cough, and a Difficulty<span class='pagenum'><a name="Page_138" id="Page_138">[138]</a></span>
of Breathing, and Pain of the Breast, with
a Head-Ach, and Pains all over the Body, especially
in the Limbs.&mdash;The first Nights they
commonly had profuse Sweats.&mdash;In several, it
had the Appearance of a remitting Fever, for
the two or three first Days.&mdash;Many had a slight
Inflammation of the Throat, and a Hoarseness.
In all it was attended with an acute Fever in the
Beginning, and the Urine was of a high Colour;
and when the Disorder had put on the
Appearance of a Remittent Fever in the Beginning,
it dropt a Sediment towards Morning after
the second Day; and did the same in all, when
the Disorder was going off.&mdash;Some had a
Purging, but the greater Number were rather
inclined to be costive.&mdash;The Cough in many
was very violent; and the Patients, after each
Fit of Coughing, had Reachings, or Strainings
to vomit, exactly resembling those which come
after violent Fits of the Hooping Cough.&mdash;At
first the Patients spit up only a little Phlegm;
but in the Decline of the Disorder, they expectorated
freely.&mdash;The violent Cough and
Feverishness generally continued for four, five,<span class='pagenum'><a name="Page_139" id="Page_139">[139]</a></span>
or six Days; with others it continued longer;
and some had a Cough for two or three Weeks
after the Fever left them.</p>

<p>This Catarrhal Fever seized most of the
People of the Town of <i>Bremen</i>; and there were
very few of the <i>British</i> who escaped it; at the
same Time, it was epidemical in most Countries
in <i>Europe</i>.</p>

<p>We treated it entirely as an inflammatory
Disorder, and none died who applied early for
Relief.&mdash;Most People recovered by one plentiful
Bleeding, and taking the mild cooling Medicines,
such as the <i>mixtura e spermate ceti cum
nitro</i>, the saline or mindereri Draughts, or such
like. When the Fever and Difficulty of Breathing
continued after the first Bleeding, in a Day or
two a Vein was opened a second Time; and
immediately after a Blister was applied to the
Back, which commonly removed the Fever,
and relieved the Breathing.&mdash;When the Patients
were inclined to be costive, a Dose of
Physic was of Service.</p>

<p>None of the <i>British</i> died, except one or two
of the Soldiers, who remained in Quarters after<span class='pagenum'><a name="Page_140" id="Page_140">[140]</a></span>
being taken ill; and, instead of bleeding and
living low, indulged in the Use of spirituous
Liquors; and were not brought to the Hospital,
till they were in the last Stage of a Peripneumony.&mdash;Many
of the Inhabitants of the
Town died of this Disorder, which was probably
owing to Want of Care.</p>



<h2><a name="RHEUMATISM" id="RHEUMATISM"></a>OF THE<span class='pagenum'><a name="Page_141" id="Page_141">[141]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%">RHEUMATISM.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>he</span> Rheumatism is one of the Disorders
most generally to be met with in military
Hospitals. There were at all Times some
Men in our Hospitals labouring under Rheumatic
Fevers, or other rheumatic Complaints;
though we never had at any one Time a great
Number; owing probably to the Weather being
very favourable in both the Campaigns of
1761 and 1762.&mdash;It was always most frequent
when the Weather was wet and cold; both
during the Campaign, and when we were in
Winter Quarters.<span class='pagenum'><a name="Page_142" id="Page_142">[142]</a></span></p>

<p>It commonly began either, 1. With an
acute Fever, and Pains all over their Body: or,
2. With Pains in particular Parts, as the
Shoulders, Legs, Arms, Knees, and sometimes
of the Side, attended with some Degree of a
Fever.&mdash;The first was the most common Form
it assumed, when Men were attacked with it in
the Field or in Garrison; owing to their doing
Duty in cold wet Weather.&mdash;The other Causes
generally took place when they had been formerly
subject to rheumatic Complaints, and
had caught Cold; or after they had been weakened
and reduced low by Fevers, Fluxes, or
other Disorders.</p>

<p>We had but very few Rheumatisms accompanied
with Swelling, Pain, and Inflammation
of the Joints of the Knees and Wrists, &amp;c.
which are so common in our Hospitals about
<i>London</i>. I did not meet with above a Dozen
Cases, of this Kind, whilst in <i>Germany</i> with the
Army.</p>

<p>When the Rheumatism began with Pains all
over the Body, attended with a High Fever, we
treated it at first entirely as an Inflammatory<span class='pagenum'><a name="Page_143" id="Page_143">[143]</a></span>
Fever<a name="FNanchor_60_60" id="FNanchor_60_60"></a><a href="#Footnote_60_60" class="fnanchor">[60]</a>. We blooded freely, and repeated
this Evacuation often<a name="FNanchor_61_61" id="FNanchor_61_61"></a><a href="#Footnote_61_61" class="fnanchor">[61]</a>, if the Blood continued
sizy, and the Pains violent; provided the
Pulse was strong. When the Pleura, the
Lungs, or any other of the Viscera were affected,
we blooded as freely as we should have
done in acute Inflammations of these Parts:
<span class='pagenum'><a name="Page_144" id="Page_144">[144]</a></span>We gave the saline Draughts with Nitre<a name="FNanchor_62_62" id="FNanchor_62_62"></a><a href="#Footnote_62_62" class="fnanchor">[62]</a>;
and Plenty of Barley Water and other weak
diluting Liquors; and gentle Physic once or
twice a Week; and afterwards applied Blisters,
which often relieved both the Pains and
Fever.</p>

<p>After some Days, if the Pains still remained,
we continued the saline Draughts with Nitre
throughout the Day; and in the Evening endeavoured
<span class='pagenum'><a name="Page_145" id="Page_145">[145]</a></span>to promote a free Perspiration by
Means of the mild Diaphoretics, such as the
mindereri Draughts with Mithridate, in Doses
frequently repeated; at the same Time, the
Patient kept in Bed, and drank freely of mild
diluting Liquors. Sometimes we gave twenty,
thirty, or forty Drops of Spirits of Hartshorn,
in repeated Draughts of warm Barley Water:
or a like Quantity of the Antimonial Wine,
used in the same Manner: or from sixty to a
hundred Drops of the Antimonial Wine, mixed
with one-fourth Part of the <i>tinctura thebaica</i>,
in a large Draught of some warm Liquor;
which I have observed, in many Cases,
to have a better Effect, than most other Medicines
used for this Purpose; as it acts both as an
Opiate in easing the Pain, and procuring Rest;
at the same Time that it promotes a free Perspiration,
or gentle Sweat, to carry off the Distemper.</p>

<p>But it should be observed, that, in the Beginning
of Rheumatic Fevers, forced Sweats
generally did Hurt, and often increased both
the Pain and Fever; and that in general we<span class='pagenum'><a name="Page_146" id="Page_146">[146]</a></span>
had greater Success, and made speedier Cures,
when we did not attempt to promote Sweating,
till after other Evacuations had been sufficiently
made, and the Fever had begun to
abate; and that in this Fever, when we did
attempt to procure Sweats, the milder Diaphoretics,
with Plenty of weak diluting Liquors,
answered better than those of a more heating
Nature; though after the Fever was gone,
and the Pains still continued, sometimes the
stronger Sudorifics, such as G. Guaiac, and its
volatile Tincture, <i>Dover</i>&#8217;s Powder, and the
like, best answered the Purpose, and carried off
the Distemper, when the milder ones had little
Effect.</p>

<p>I have often observed, where Sweating made
no Change in the Distemper, that keeping
up a free Perspiration by Means of the Decoction
of the Sarsaparilla with the Antimonial
Wine, or small Doses of the <i>pulvis antimonialis</i>
(<i>gr.</i> v.), given twice or thrice a Day, removed
Rheumatisms, which had resisted the Force of
other Remedies.<span class='pagenum'><a name="Page_147" id="Page_147">[147]</a></span></p>

<p>Sometimes the cold Bath<a name="FNanchor_63_63" id="FNanchor_63_63"></a><a href="#Footnote_63_63" class="fnanchor">[63]</a> removed Pains
which had not yielded to internal Medicines;
but it ought to be observed, that when Patients
went into the cold Bath while the Feverishness
still remained, and the Blood continued sizy,
or before free Evacuations had been made,
oftentimes, instead of giving Relief, it made the
Disorder worse, and more obstinate<a name="FNanchor_64_64" id="FNanchor_64_64"></a><a href="#Footnote_64_64" class="fnanchor">[64]</a>.</p>

<p>When the Rheumatism was confined to a
particular Part, attended with Fever, we treated
it as the acute Rheumatism. Fomenting the
Part with warm emollient Decoctions, and
<span class='pagenum'><a name="Page_148" id="Page_148">[148]</a></span>rubbing it afterwards with the volatile, or saponaceous
Liniments, often gave Ease; and the
Application of Cupping-Glasses and Blisters
frequently removed the Disorder. In some
Cases, where the first Blister did not relieve,
the Application of a second, and afterwards
keeping up a Discharge from the Part by
Means of the Epispastic Ointment, carried off
the Pain. In others, where the mild Diaphoretics
were ineffectual, Sweating, with the G.
Guaiac, or <i>Dover</i>&#8217;s Powder, and such other
Medicines, after the Fever was gone, removed
the Complaints<a name="FNanchor_65_65" id="FNanchor_65_65"></a><a href="#Footnote_65_65" class="fnanchor">[65]</a>.</p>
<p><span class='pagenum'><a name="Page_149" id="Page_149">[149]</a></span></p>
<p>When the Rheumatism was attended with
Inflammation and Swelling of the Joints, we
blooded freely, gave cooling Purges, and the
saline Draughts with Nitre, along with Plenty
of weak diluting Liquors, and prescribed a cool
low Diet.</p>

<p>After the Violence of the Fever and Inflammation
was abated, fomenting the Parts, and
rubbing them with the saponaceous or volatile
Liniments, sometimes hastened the Discussion
of the Swelling; as did likewise the Application
of Blisters<a name="FNanchor_66_66" id="FNanchor_66_66"></a><a href="#Footnote_66_66" class="fnanchor">[66]</a>, after the Inflammation was
<span class='pagenum'><a name="Page_150" id="Page_150">[150]</a></span>entirely gone; but it ought to be noticed, that
if volatile Liniments or Blisters are used too
soon, they will sometimes occasion violent Inflammation
and Pain<a name="FNanchor_67_67" id="FNanchor_67_67"></a><a href="#Footnote_67_67" class="fnanchor">[67]</a>.</p>

<p>Rheumatic Cases of this Kind are often very
obstinate, and require a considerable Length of
Time before they are got the better of; and
frequently more or less of the Swelling, especially
of the Wrists and Joints of the Fingers,
remains ever after; and Patients, who have
once had the Rheumatism in this violent Degree,
are always subject to Relapses; as are even
those who have had the Rheumatism but
slightly.</p>

<p>Mercury<a name="FNanchor_68_68" id="FNanchor_68_68"></a><a href="#Footnote_68_68" class="fnanchor">[68]</a> has been recommended in the
<span class='pagenum'><a name="Page_151" id="Page_151">[151]</a></span>Cure of Rheumatisms; but I never found it do
any Service by itself, except in Cases complicated
with venereal Symptoms; though I have
often given it, and even sometimes gone so far
as to raise a Salivation, where the Pains were
most severe in the Night; and the Patient, at
the same Time, thought he had some Reason
to suspect a venereal Taint, though no external
Symptom appeared. However, many good
Practitioners have recommended small Doses
of Calomel to be given at Nights, and next
Morning a Purge; in which Way, I think,
I have observed good Effects from its
Use.</p>

<p>The Bark was frequently of Use in restoring
the Strength, and removing those rheumatic
Pains which remained after Fevers,
and other Disorders; but, in other Cases, it
had little Effect.</p>

<p>When the Rheumatism continues long, and
has taken deep Root, <i>Sydenham</i><a name="FNanchor_69_69" id="FNanchor_69_69"></a><a href="#Footnote_69_69" class="fnanchor">[69]</a> advises to
bleed from Time to Time, at some Weeks
Distance; which, he says, will either entirely
<span class='pagenum'><a name="Page_152" id="Page_152">[152]</a></span>remove the Disease, or bring it to that Condition,
that the Remains of it will be easily extirpated
by an Issue; and giving some of the
volatile Salts in <i>Canary</i> Wine, Morning and
Evening. I have always observed in rheumatic
Cases, which continued long, that, after free
Evacuations, the Patients received more Benefit
from a mild low Diet, continued for some
Time, and the Use of diluting Decoctions with
mild Diaphoretics, while they took gentle
Purges once or twice a Week, than from any
other Remedies.</p>

<p>I have given Half an Ounce of Soap a Day,
for a considerable Time, in some old rheumatic
Cases, in the Manner recommended by the
late Dr. <i>John Clerk</i> of <i>Edinburgh</i>, as mentioned
by Dr. <i>Pringle</i>; and, I think, with Advantage;
but have not had sufficient Trials to ascertain
the Merits of this Medicine.</p>

<p>Dr. <i>Sydenham</i>, in treating of the Rheumatism,
which he calls scorbutic, says; that after
it had resisted Bleeding, Purging, low Diet,
and other Remedies, he has cured it by giving
thrice a Day two Drachms of an Electuary<span class='pagenum'><a name="Page_153" id="Page_153">[153]</a></span>
made of <i>conserv. cochlear. horten. recent. unc.</i> ij.
<i>lujul. unc.</i> i. <i>pulv. ar. comp. drachm</i> vi. <i>cum syrup.
aurant.</i> q.&nbsp;s. drinking after it three Ounces
of a Water drawn from <i>Brunswick</i> Beer, and
some of the antiscorbutic Plants.</p>

<p>There is no Disorder which Soldiers are so
apt to counterfeit as the Rheumatism, when
ever the Duty in the Field is severe; but while
there is no Fever or Size in the Blood, or other
evident Marks of the Distemper, and the Men
look healthy, there is always Reason to suspect
Imposture.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_60_60" id="Footnote_60_60"></a><a href="#FNanchor_60_60"><span class="label">[60]</span></a> <i>Sydenham</i>, in treating of this Disease, orders Bleeding,
and that to be repeated next Day; and afterwards every other
Day, two, three, or four Times, or more, as the Patients
Strength can bear it; and on the intermediate Days to give a
purgative Clyster. But in young People, and those who have
lived regularly, he says, that a very low Diet will cure as effectually
as Bleeding and Medicines; That the Patients must
live four Days on Whey alone, but after this may eat Bread for
Dinner; and on the last Days for Supper also; and when the
Symptoms begin to abate, he allows them to eat boiled Chicken,
or other light Food; but says they must live every third Day
on Whey, till their Strength returns. <i>Precess. Integr. de Rheumatismo</i>.</p></div>

<div class="footnote"><p><a name="Footnote_61_61" id="Footnote_61_61"></a><a href="#FNanchor_61_61"><span class="label">[61]</span></a> A Remark of Dr. <i>Huxham</i>&#8217;s deserves to be taken Notice
of here: He tells us, that there are some Kinds of Rheumatisms,
<i>viz.</i> those which come from a sharp serous Rheum, which do
not bear the free Use of the Lancet; that plentiful Bleeding
does more Hurt than Good; and that, in such Cases, the Medicines
which bring out breathing Sweats, and at the same
Time correct the Acrimony of the Blood, joined with gentle
Opiates, have a much better Effect. <i>De Aere</i>, Vol. II. p. 185.</p></div>

<div class="footnote"><p><a name="Footnote_62_62" id="Footnote_62_62"></a><a href="#FNanchor_62_62"><span class="label">[62]</span></a> Dr. <i>Brocklesby</i>, in his <i>Observations on military Diseases</i>,
recommends the Use of large Quantities of Nitre dissolved in
Water Gruel, or Sage Tea, (in the Proportion of two Drachms
of the Nitre to a Quart of the Liquor) in acute Rheumatisms.
He says, &#8220;I am assured from numberless Instances, that in
stout young Men, by taking six hundred Grains (ten Drachms)
daily, for four or five Days successively, and diluting plentifully,
as before recommended, plain Nitre proves the most
powerful and best Sudorific, in such Complaints, that I have
ever tried; and this Quantity, and even more, may be retained
in the Stomach, and pass through the Course of the
Circulation, by only diluting properly with those thin attenuating
Beverages as before recommended. Such Quantities,
in three or four Days, seldom failed wonderfully to relieve
the Patient, and very often to cure him entirely, by the
most plentiful and profuse Sweats.&#8221; <i>See from p. 116, to p.
124.</i>
</p><p>
I have never hitherto given Nitre in such large Quantities as
here recommended by Dr. <i>Brocklesby</i>.</p></div>

<div class="footnote"><p><a name="Footnote_63_63" id="Footnote_63_63"></a><a href="#FNanchor_63_63"><span class="label">[63]</span></a> I have frequently ordered the warm Bath with Advantage
in Rheumatic Cases in <i>St. George</i>&#8217;s Hospital; but we had no
Convenience of this Kind with the flying Hospital in <i>Germany</i>.</p></div>

<div class="footnote"><p><a name="Footnote_64_64" id="Footnote_64_64"></a><a href="#FNanchor_64_64"><span class="label">[64]</span></a> This I have seen many Instances of, particularly in the
Case of <i>Ann Walker</i>, a Woman of twenty three Years of Age,
who was under my Care in <i>St. George</i>&#8217;s Hospital, in <i>May</i>, 1759.
Before she came to the Hospital, she had been blooded, and
had gone into the cold Bath four Times, which, she told me,
had increased her Pains to a violent Degree; in which State
she had continued for some Weeks before she came to the Hospital;
but by being blooded, and taking the cooling saline
Medicines, with gentle Purges, and mild Diaphoretics, she got
well in a Month&#8217;s Time.</p></div>

<div class="footnote"><p><a name="Footnote_65_65" id="Footnote_65_65"></a><a href="#FNanchor_65_65"><span class="label">[65]</span></a> Warm Water, pumped upon the Part, often removes such
rheumatic Pains as have resisted the Force of internal and other
Remedies. On the 29th of <i>August</i>, 1759, <i>Mary Ward</i> was admitted
into <i>St. George</i>&#8217;s Hospital for rheumatic Pains of the
Arms, Legs, and Knees, attended with Fever, which all yielded
to Evacuations, and the Use of cooling Medicines, mild
Diaphoretics, and of the warm Bath, except the Pain of the
Knee; which, after it had resisted the Course above-mentioned,
was at last removed by pumping warm Water on the
Part, three Times a Week; joined to the Use of Fomentations
and volatile Liniments.</p></div>

<div class="footnote"><p><a name="Footnote_66_66" id="Footnote_66_66"></a><a href="#FNanchor_66_66"><span class="label">[66]</span></a> <i>Ann Ragen</i>, a Woman about thirty-three Years of Age,
was admitted into <i>St. George</i>&#8217;s Hospital the 17th of <i>January</i>,
1759, for rheumatic Pains of her Legs and Arms, and a Swelling
of her right Knee. Free Evacuations, and the Use of cooling
Medicines, and mild Diaphoretics, removed all her other
Complaints, except the Swelling of the Knee, by the Middle of
<i>February</i>, when I ordered a Blister to be applied to it; after
which the Swelling gradually decreased, and she was discharged,
cured, the 20th of <i>March</i>.&mdash;<i>Rachael Hyde</i>, a Woman
twenty-four Years of Age, was admitted into <i>St. George</i>&#8217;s Hospital
the 9th of <i>May</i>, 1759, for similar Complaints, which were
removed by the same Means, all except the Swelling of the
Knee. A Blister was applied, and most of the Swelling went
away, but returned soon after: It was at last removed by the
Use of the warm Pump three Times a Week, and drinking a
Pint of the Guaiac Decoction daily.</p></div>

<div class="footnote"><p><a name="Footnote_67_67" id="Footnote_67_67"></a><a href="#FNanchor_67_67"><span class="label">[67]</span></a> I have sometimes ordered Leetches to be applied to such
Swellings (as recommended by Dr. <i>Pringle</i>), and found them to
be of Service; and, at other Times, I have applied emollient
Fomentations and Poultices, which have given great Ease to the
Patient.&mdash;I have seen Setons or Issues, made near the Part affected,
afford considerable Relief.</p></div>

<div class="footnote"><p><a name="Footnote_68_68" id="Footnote_68_68"></a><a href="#FNanchor_68_68"><span class="label">[68]</span></a> Dr. <i>Musgrave</i>, in his Treatise <i>de Arthritide Symptomat.</i>
p. 30, cap. ii. sect. 10, says, he has known a Salivation, raised
by Mercury, cure the Rheumatism.</p></div>

<div class="footnote"><p><a name="Footnote_69_69" id="Footnote_69_69"></a><a href="#FNanchor_69_69"><span class="label">[69]</span></a> Vide <i>Sydenham. Opera.</i> sect. vi. cap. 5.</p></div>
</div>


<h2><a name="AUTUMNAL" id="AUTUMNAL"></a>OF THE<span class='pagenum'><a name="Page_154" id="Page_154">[154]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%">Autumnal Remitting Fever.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>he</span> Remitting Autumnal Fever, called
by the Antients &#963;&#965;&#957;&#949;&#967;&#951;&#962;, was also one of
the most frequent Disorders during the Campaign.</p>

<p>This Fever is observed in most Countries,
after the Juices have been highly exalted by
the Heat of Summer; and People are exposed
to the Heats of Mid-Day, and to the cold
Damps of the Night. We observe it every
Year in the Neighbourhood of <i>London</i>, especially
among the labouring People, who work
in the Fields, towards the End of Summer,
and in Autumn; but it is generally in a milder
Degree than in Armies, where Men are more
exposed to the Vicissitudes of the Weather.<span class='pagenum'><a name="Page_155" id="Page_155">[155]</a></span></p>

<p>As we go further towards the South, this,
as well as other bilious Disorders, becomes more
frequent.</p>

<p>This Fever is reckoned the endemic Distemper
of the <i>West Indies</i>, of the Coast of <i>Guinea</i>,
and other Places in the Torrid Zone; but in
those warm Countries it appears in a more violent
Degree; makes a much more rapid Progress;
and proves far more fatal than in our
cooler and more temperate Climate. And it
is observed to be always most frequent and
most fatal where a Country is covered with
Wood, or is marshy; and where there are frequent
Fogs, and much stagnating Water,
which corrupts by the Heat of Summer.</p>

<p>In <i>January</i>, <i>February</i>, and <i>March</i> 1761,
we had none of those Remitting Fevers at <i>Paderborn</i>.
In <i>April</i>, some few of the Soldiers,
on their Return from the Winter-Expedition
into <i>Hesse-Cassel</i>, had Fevers attended with bilious
Symptoms; but they were rather of the
continued, inflammatory Kind, and tending to
malignant, than such as could be called remitting.<span class='pagenum'><a name="Page_156" id="Page_156">[156]</a></span></p>

<p>The first Time that I saw much of this Fever,
was among the Sick sent to <i>Bilifield</i> in the
End of <i>June</i> 1761; soon after the Army took
the Field. The Remissions were short, and it
partook much of the Nature of the common
Inflammatory Fever; and most of them were
cured by the antiphlogistic Method. A Day
or two before we left this Place, it began to
change into the Malignant Hospital Fever,
from the Sick being too much crowded.</p>

<p>In the Middle of <i>July</i>, about Twelve Hundred
Sick were sent to the Hospital at <i>Munster</i>;
and about one-third Part were ill of this Remitting
Fever. It did not partake near so
much of the inflammatory Nature as at <i>Bilifield</i>;
the Remissions became much more evident;
and it was attended much oftener in the
Beginning with bilious Vomiting and Purging;
and in some few the Disorder turned to a Dysentery.
About eight or nine had it changed
into the Hospital Fever, from the Wards in
one of the Hospitals being too much crowded;
and in some few the Disorder terminated in regular
Agues. In <i>November</i> severals were taken<span class='pagenum'><a name="Page_157" id="Page_157">[157]</a></span>
ill of it in the Garrison of <i>Bremen</i>, which
mostly ended in a regular Intermittent, the endemic
Distemper of the Place. Towards the
End of <i>December</i> we had none of these Remitting
Fevers, the Disorders turning more to the
inflammatory Kind.</p>

<p>In <i>June</i> 1762, this Fever began to appear
again among the Sick, sent from the Army, to
the Hospital at <i>Natzungen</i>; and it continued
to be frequent through the Summer and Autumn;
and the greatest Part of these Fevers this
Year terminated in regular Agues, mostly in
Tertians, and were cured by the Bark; whereas
the Year before very few terminated this
Way.</p>

<p>This Disorder in the Beginning had commonly
the Appearance of a continued Fever;
and many had a Sickness and Vomiting, and
threw up a Quantity of yellow Bile, mixed
with the Contents of the Stomach. In a few
Days, especially after Bleeding, the Remissions
became clear; tho&#8217; on its first Appearance in
<i>June</i> 1761 they were short, and rather obscure;
and it seemed still to partake a good deal of the<span class='pagenum'><a name="Page_158" id="Page_158">[158]</a></span>
Nature of the common Inflammatory Fever,
the Blood being very sizy; but as the Season advanced,
the Remissions became more evident,
and the Paroxysms more like those of an Ague;
and the Blood less sizy, tho&#8217; at all Seasons of
the Year it had some Appearance of an inflammatory
Buff in this Disorder. The Sick were
restless and uneasy at Night; but commonly
felt themselves cooler and lighter in the Day-Time:
and although they had no cold Fit, as
the Fever came on at Nights, and many of
them no Breathing Sweat, as they became
cooler and freer from the Fever in the Morning;
yet the Fits were so remarkable, that
many of the Patients used to say they had
a regular Fit of an Ague every Night, or towards
the Morning; and some few, that they
had the Fit every second Night. As the Season
advanced, the Remissions appeared more
distinct. However, there was always a good
Number in whom the Fever went on in a continued
Form, through its whole Course, without
any Signs of Remission; tho&#8217; they had all
the other Symptoms of this Fever. In a few<span class='pagenum'><a name="Page_159" id="Page_159">[159]</a></span>
Instances the Fever, after it came to remit,
changed again into a continued Form.</p>

<p>The Heat in the Time of the Paroxysms
rose high, and several were delirious during
its Continuance<a name="FNanchor_70_70" id="FNanchor_70_70"></a><a href="#Footnote_70_70" class="fnanchor">[70]</a>; but were quite sensible in
the Intervals, though never wholly without
the Fever.</p>

<p>At the End of <i>July</i> 1761, four or five were
attacked with a Bleeding at the Nose, in the
Time of the Paroxysms, and became cooler
afterwards; but it did not prove a Crisis in any
of them.</p>

<p>The Urine in the Beginning was commonly
of a high Colour, though sometimes it was
pale and limpid: At first it deposited no Sediment;
but when the Fever came to remit,
there was often a small Sediment after each
Paroxysm; and as the Fever was going off,
it let fall a Sediment in all<a name="FNanchor_71_71" id="FNanchor_71_71"></a><a href="#Footnote_71_71" class="fnanchor">[71]</a>.</p>

<p><span class='pagenum'><a name="Page_160" id="Page_160">[160]</a></span></p><p>Some at first were inclined to be costive;
others had a Sickness and Purging; and several
of those who were costive in the Beginning,
were in the Course of the Disorder attacked
with a Purging; and others, after some previous
Complaint of the Stomach, were seized
with both Vomiting and Purging. In general,
after the Sick continued some Days in the Hospital,
they were inclined to be loose; which
was a favourable Circumstance, when this
Evacuation was not so great as to be in Danger
of sinking the Patient. Some were attacked
with a Dysentery.</p>

<p>In this, as well as in most other Fevers, the
Sick frequently passed by Stool Worms of the
round Kind; and sometimes they vomited
them up, or the Worms came up into their
Mouth or Nostrils while they lay asleep in Bed;
and some towards the Height were afflicted
<span class='pagenum'><a name="Page_161" id="Page_161">[161]</a></span>with Deafness, which was commonly a favourable
Symptom.</p>

<p>Most of those ill of this Disorder had a yellowish
Colour of the Countenance, which went
off with the Fever. It was more observable in
some than in others; in general, it was slight;
some few became yellow all over<a name="FNanchor_72_72" id="FNanchor_72_72"></a><a href="#Footnote_72_72" class="fnanchor">[72]</a>; particularly
one Man, in the Hospital at <i>Munster</i>,
who, after being seized with violent Vomiting
and Purging, Convulsions, and Twitchings of
the Tendons, and Hiccup, became yellow,
as in the deepest Jaundice. This Symptom
of Yellowness arises from a Redundancy
and Absorption of Bile; and is sometimes observed
in other Fevers as well as this<a name="FNanchor_73_73" id="FNanchor_73_73"></a><a href="#Footnote_73_73" class="fnanchor">[73]</a>; for
<span class='pagenum'><a name="Page_162" id="Page_162">[162]</a></span>while we were at <i>Paderborn</i> in <i>February</i> 1761,
two Men were brought to the Hospital in Fevers,
attended with this Symptom. They were
both delirious, with parched dry Tongues, slight
<span class='pagenum'><a name="Page_163" id="Page_163">[163]</a></span>Twitchings of the Tendons, and other bad
Symptoms; and one of them had a continual
Vomiting and Purging. They both died, and
the Body of him who had the Purging was
opened. All the Bowels, especially the Colon,
were tinged with a yellow Bile, and had
a slight Degree of Inflammation all over their
Surface; the Gall-Bladder was distended with
a very dark-coloured Bile; but no Concretions
were found in its Cavity, or in the bilious
Ducts; nor Mucus, or any other Thing obstructing
these Passages. The Surface of the
Lungs seemed slightly inflamed; and there
was a small Quantity of greenish Serum in the
Cavities of the Thorax. I could not learn the
Histories of these two Mens Disorders, before
they were brought to the Hospital; but, from
the Symptoms, was inclined to believe, that the
Fevers had been of the malignant or petechial
Kind; and that the yellow Colour was only
an accidental Symptom of it; for on one of
the Men we could perceive obscure Traces of
dun petechial Spots on his Breast and Arms;
and the malignant Fever was frequent at this<span class='pagenum'><a name="Page_164" id="Page_164">[164]</a></span>
Time among the Troops, and the bilious autumnal
Fevers had ceased long before.</p>

<p>I could not observe any certain critical Days,
or Periods, when this Disorder terminated.&mdash;Some,
who had it slightly, got well in a few
Days; with others, it continued longer: Some
continued long feverish, and would seem cooler
and freer from Fever for a Day or two, and
then grow worse again; and many had repeated
Relapses.</p>

<p>Neither could I observe any regular Crisis in
this Fever. Sweat was the Discharge which
oftenest proved critical. Many seemed to
be relieved by a Purging; but as the greater
Part had a Looseness after some Days,
which continued often through the Disorder,
without producing any very sudden Change in
the Symptoms, it seemed to be a favourable
Circumstance; though it seldom carried off the
Fever so suddenly as to be manifestly critical.
The Urine broke, and dropt a Sediment, for
the most part, as the Fever took a favourable
Turn.<span class='pagenum'><a name="Page_165" id="Page_165">[165]</a></span></p>

<p>When this Fever proved mortal, it commonly
assumed a continued Form; the
Tongue became parched and dry, the Patient
delirious, with Twitchings of the Tendons,
Hiccup, and other fatal Presages; while others
were seized with a violent Diarrh&#339;a, or Dysentery,
which sunk them irrecoverably.</p>

<p>In the Beginning, it was absolutely necessary
to bleed the Patients freely; and frequently to
repeat the Evacuation, where the Symptoms
required it. The Blood was of a florid Colour,
and commonly threw up more or less of
an inflammatory Buff.</p>

<p>In these Fevers, we were obliged to have
particular Regard to the first Passages, especially
in the Beginning of the Disorder; for
they were generally loaded with bilious Humours<a name="FNanchor_74_74" id="FNanchor_74_74"></a><a href="#Footnote_74_74" class="fnanchor">[74]</a>;
which, if suffered to remain in the
<span class='pagenum'><a name="Page_166" id="Page_166">[166]</a></span>Bowels; were either absorbed, and increased the
Heat and Fever, or brought on a violent Diarrh&#339;a;
and therefore, after Bleeding, we gave
<span class='pagenum'><a name="Page_167" id="Page_167">[167]</a></span>a Vomit in the Evening, and next Day a Dose
of some gentle Purge, as Rhubarb or Salts;
to carry off these putrid, bilious Humours:
And afterwards, in the Course of the Disorder,
if the Patient was costive, and grew hot, restless,
and uneasy, we either repeated the Purge,
or gave laxative Clysters, which generally removed
<span class='pagenum'><a name="Page_168" id="Page_168">[168]</a></span>these Symptoms.&mdash;Frequently after the
Operation of the Emetic, the Patient had some
loose Stools, from the Gall Bladder&#8217;s being
emptied in the Strainings to vomit. Such Stools
were always bilious, as were commonly those
procured by purgative Medicines.</p>

<p>After emptying the Bowels, we gave the
cooling, and mild Diaphoretics, such as the
saline and mindereri Draughts, joined occasionally
with Nitre, or the Contrayerva
Powders; while we made the Patient drink
plentifully of warm diluting Liquors; which
we found to answer in general better than any
other Remedies: They brought the Remissions
to be more evident, and the Paroxysms to
be milder, at the same Time that they kept up
a free Perspiration, as a Means to carry off the
Distemper.</p>

<p>In some Cases we gave the Antimonial
Powder, made of one Part of Tartar Emetic,
and ten of the <i>pulvis e chelis</i>, in small Doses,
from two to four Grains every four or six Hours.
The first Doses of this Powder sometimes made
the Patient sick, and acted as a Purgative, and<span class='pagenum'><a name="Page_169" id="Page_169">[169]</a></span>
kept up a free Perspiration; at other Times,
it produced no visible Effect. In some Cases,
where it was given early, it operated both by
Stool, and as a Diaphoretic, and removed the
Fever<a name="FNanchor_75_75" id="FNanchor_75_75"></a><a href="#Footnote_75_75" class="fnanchor">[75]</a>; and it was of Use in others, towards
<span class='pagenum'><a name="Page_170" id="Page_170">[170]</a></span>the Decline of the Fever; but we were often
obliged to lay it aside; for it either acted too
roughly, or produced no visible Effect or Alteration
in the Disorder.</p>

<p>When the Fever came to remit, we were
obliged, for the most part, to continue the Use
of the mild Diaphoretics, as before; for, although
the Disorder put on a remitting Form,
the Bark had very little Effect in stopping it<a name="FNanchor_76_76" id="FNanchor_76_76"></a><a href="#Footnote_76_76" class="fnanchor">[76]</a>,
<span class='pagenum'><a name="Page_171" id="Page_171">[171]</a></span>unless where the Fever changed into a regular
Quotidian or Tertian Ague.&mdash;In the Year
1761, very few of these Fevers turned to regular
Intermittents; but, in the Year 1762, the
greater Part of them terminated in regular
Agues, and were cured by the Bark<a name="FNanchor_77_77" id="FNanchor_77_77"></a><a href="#Footnote_77_77" class="fnanchor">[77]</a>.</p>

<p><span class='pagenum'><a name="Page_172" id="Page_172">[172]</a></span></p><p>In the Year 1761, we tried the Bark in various
Forms in many Cases, where the Patient
had been blooded and purged in the Beginning,
and used the cooling Medicines; and where
<span class='pagenum'><a name="Page_173" id="Page_173">[173]</a></span>the Remissions were very clear: Yet it had no
Effect in removing the Disorder, except in two
or three Cases at <i>Munster</i>, where the Paroxysms
assumed a tertian Form; for the most
part, it made the Patients more hot and feverish,
and we were obliged to leave off using it,
as it was in Danger of changing the remittent
into a continued Fever. However, it was of
Service after the Fever came to a Crisis, and
was going off; and Dr. <i>Pringle</i> has very justly
observed, that it hastened the Recovery, and
that those who used it were less subject to Relapses
than such as did not; and therefore we
commonly gave it in a convalescent State.&mdash;Before
giving the Bark, I always found it of
Advantage to give a Dose of Rhubarb, or of
some other Purgative, or to mix some Rhubarb
with the first Doses, so as to procure the Patient
some loose Stools.</p>

<p>When either the Fever went on without
Intermission, or changed into a continued
<span class='pagenum'><a name="Page_174" id="Page_174">[174]</a></span>Form, or the Patient continued hot and feverish
through the Day, with a Head-Ach, and
other feverish Symptoms, nothing answered
better, after free Evacuations had been made,
than to apply a large Blister to the Back; and
to make the Patient drink freely of cooling diluting
Liquors; which generally relieved the
Head, and abated the Violence of the other
Symptoms.</p>

<p>When a Purging came on in the Course of
this Disorder, if there was much Fever, with a
strong throbbing Pulse, Gripes and Pain of
the Bowels, some Blood was taken away; and
immediately after the Patient took a Dose of
Salts and Manna, or of Rhubarb; and an Opiate
in the Evening after its Operation: But if
there was little or no Fever, or sharp Pain,
Bleeding was omitted; and if the Patient complained
of Sickness, a few Grains of Ipecacuana
were given previous to the Purge.</p>

<p>After this, if the Purging was moderate, and
did not sink the Patient, we did nothing to
stop it; but if it was violent, we gave the mindereri
Draughts with Mithridate, and the Chalk<span class='pagenum'><a name="Page_175" id="Page_175">[175]</a></span>
Julep in the Day, and an Opiate at going to
Rest; and occasionally used the emollient and
anodyne Clyster; and, if necessary, repeated
the Emetic and Purge.</p>

<p>The Hiccup seldom appeared in this Fever
till the Patient was reduced very low, and was
commonly the Forerunner of Death. Some
few, who had a Purging and Vomiting, were
taken with a Hiccup, attended with Sickness,
and Load at the Stomach, which seemed to depend
on bilious Humours lodged in the Stomach
and Bowels. This induced me to give
a few Grains of the Ipecacuana; and to make
the Patients drink an Infusion of Camomile
Flowers till they vomited freely, and afterwards
to take some mild Purge, or use laxative
Clysters; after which they found themselves
easier, and an anodyne Draught, with
twenty or twenty-five Drops of the <i>tinctura
thebaica</i>, put an End to the Hiccup. Others
required the Use of Cordial Draughts, mixed
with Opiates; and repeated Clysters and Fomentations,
before they found Relief.&mdash;The
Application of a Blister removed the Hiccup<span class='pagenum'><a name="Page_176" id="Page_176">[176]</a></span>
in one, after the above Remedies had
proved ineffectual; as did the Musk Julep with
Opium, and the Application of an aromatic
Plaister to the Stomach, in another Patient.</p>

<p>Several of them complained of a burning
Heat and Pain in making Water; which
commonly went off by drinking freely of the
Gum Arabic Decoction, with the dulcified
Spirit of Nitre, and the Use of oily Draughts;
though in some it required the Assistance of
Opiates, and of Fomentations and Clysters,
before it was got the better of.</p>

<p>The Symptom of Worms we were often obliged
to neglect till the Fever was over, and
then we treated it as formerly mentioned.</p>

<p>The Deafness, though not near so frequent
in this as the Malignant Fever, was rather a
favourable Symptom, and mostly went away of
itself; though in a few Cases, where it continued
long, we applied Blisters behind the Ears,
or to the Neck, with Advantage.</p>

<p>Many, especially those who were brought
low, complained, after the Crisis of the Fever,
of Restlessness, and Want of Sleep; which,<span class='pagenum'><a name="Page_177" id="Page_177">[177]</a></span>
however, went off as their Strength returned:
Where it fatigued them much, and kept them
low, we gave a Cordial anodyne Draught at
Night; and if that did not answer, commonly
the Addition of a few Glasses of Wine in the
Afternoon had the desired Effect.</p>

<p>Others, in their convalescent State, complained
of such a Giddiness, and Lightness of the
Head, that they could neither walk nor stand;
others, of a Dimness of the Eyes. These
Symptoms, for the most part, went off as the
Patients gathered Strength: The Use of the
Bark, with now and then a Glass of Wine,
hastened the Cure; and in two or three Cases
we were obliged to give a Dose or two of some
gentle Physic, and to apply a Blister, before the
Patient got the better of them.</p>

<p>As the Sick were recovering, it was common
for them to complain of Pains of the Shoulders,
Arms, and Legs, which also left them as
they recovered their Strength; where they did
not, the saline Draughts, and a low Diet, generally
had a good Effect; and where it had not,
we treated them as rheumatic Complaints.<span class='pagenum'><a name="Page_178" id="Page_178">[178]</a></span></p>

<p>When the yellowish Colour of the Countenance
remained after the Fever, we kept the
Patient on a low Diet; and his Body open by
Means of the saline Draughts, with a few
Grains of Rhubarb, or by giving Half a
Drachm, or two Scruples of the Soap Pills
with Rhubarb daily; which, for the most
part, removed the Yellowness soon. Two only
had a Jaundice remain after the Fever, and both
were cured in a short Time.</p>

<p>In other Respects, the Treatment of this
Fever, when it degenerated into a continued
Form, had nothing particular in it; nor differed
from the common Practice of giving
cooling Medicines when the Fever was high,
and supporting Nature by the Use of Cordials
and Wine, and the Application of Blisters, &amp;c.
when low; and promoting such Evacuations as
Nature pointed out for a Crisis.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_70_70" id="Footnote_70_70"></a><a href="#FNanchor_70_70"><span class="label">[70]</span></a> I did not see the Delirium rise so high, nor the Paroxysms
so severe, as in the Marsh Fever described by Dr.
<i>Pringle</i>.</p></div>

<div class="footnote"><p><a name="Footnote_71_71" id="Footnote_71_71"></a><a href="#FNanchor_71_71"><span class="label">[71]</span></a> Dr. <i>Hillary</i> says the Symptoms of this Fever in <i>Barbadoes</i>
were much the same as those of the &#963;&#965;&#957;&#949;&#967;&#951;&#962;, or continued Remitting
Fever in England; except only that the Urine in this hot
Climate never deposits any lateritious Sediment, nor very
rarely in any intermitting or any other Fever, except when a
Crisis happens that Way. <i>Observations on the Diseases of Barbadoes</i>,
p. 23.</p></div>

<div class="footnote"><p><a name="Footnote_72_72" id="Footnote_72_72"></a><a href="#FNanchor_72_72"><span class="label">[72]</span></a> Dr. <i>Pringle</i> takes Notice of this yellow Colour or Jaundice.
He says, &#8220;some grow yellow, as in the Jaundice. This was
found more frequent during the first Campaign than afterwards;
it was an unfavourable, but not a mortal Symptom.&#8221;
<i>Observ.</i> part iii. ch. 4.&mdash;<i>Hippocrates</i> mentions the Jaundice occurring
in Fevers, <i>Aphor.</i> iv. &sect; 62 &amp; 64; and he reckons it
a favourable Symptom in ardent Fevers, where it happens on
the seventh Day. See <i>Book on Crises</i>&#8217;s, sect. 3.</p></div>

<div class="footnote"><p><a name="Footnote_73_73" id="Footnote_73_73"></a><a href="#FNanchor_73_73"><span class="label">[73]</span></a> Does this Fever, when accompanied with this universal
Yellowness of the Skin, approach to the Nature of the yellow
Fever of the <i>West Indies</i>? As I had so few Cases of this Kind
under my Care, I cannot determine any thing about it from my
own Experience; but, from the Accounts of others, I should
believe them to be very different Disorders.&mdash;In the yellow Fever
of the <i>West Indies</i>, the Blood appears quite loose and dissolved,
without the least Appearance of Size, even on the first
Day; and the general Yellowness appears on the third or
fourth, with Signs of a total Dissolution, and gangrenous Diathesis
of the Blood: Whereas, in the Remitting Fever of <i>Jamaica</i>,
Mr. <i>Nasmith</i> tells us, (See Dr. <i>Lind</i>&#8217;s first Paper on Fevers),
there is always an inflammatory Diathesis of the Blood.
The Yellowness in both depends on a Redundancy and Absorption
of Bile; but in the yellow Fever of the <i>West Indies</i>, the
Bile is in a much more putrescent State, and a great Part of
the Cure depends on the early and speedy Evacuation of it.&mdash;In
the yellow Fevers which appeared in <i>Haslar</i> Hospital, which
are taken Notice of by Dr. <i>Lind</i>, in his <i>Two Papers on Fevers</i>,
the Blood was in quite a different State from what it is in the
Yellow Fever of the <i>West Indies</i>; the Blood drawn from two
of these Patients became covered with a thick yellow Gluten,
and the Serum was of the Consistence of a thin Syrup, and of a
deep yellow Tinge, and tasted bitter; and in another who was
bled two Days before his Death, it threw up the same thick
yellow Gluten, tho&#8217; the red Part below was quite loose.</p></div>

<div class="footnote"><p><a name="Footnote_74_74" id="Footnote_74_74"></a><a href="#FNanchor_74_74"><span class="label">[74]</span></a> According to Dr. <i>Hillary</i>&#8217;s Account of the Yellow Fever
in the <i>West Indies</i>, which is attended with bilious Vomiting, it
bears bleeding once or twice, but not a third Time, before
the third Day, but not at all after that Time; and after
Bleeding a great Part of the Cure depends on carrying off as
much of the putrid Bile as expeditiously and safely as possible,
which he says is to be done by making the Patients drink freely
of warm Water (sometimes mixed with a little simple Oxymel
or Green Tea) so as to vomit seven or eight Times; and
then to give a grain, or a Grain and a half of Opium, to procure
Rest, and to settle the Stomach; to make the Patient take
nothing for two Hours after; and then, if he has not had a
Stool, to give a laxative Clyster; after six Hours Rest, to
give a gentle Purge, to carry off as much as possible of the
bilious corrupted Humours; and in the Course of the Disorder
to repeat the Purge, as often as the Patient is attacked with
an Anxiety, and a painful burning Heat about the Pr&aelig;cordia;
which almost always depend on bilious corrupted Humours pent up
within the Bowels; and to endeavour to support the Patient&#8217;s
Strength, and stop the putrescent Diathesis of the Fluids by
suitable Antiseptics, of which he found a watery Infusion of
Snake Root, mixed with <i>Madeira</i> Wine and Syrup of Poppies,
to answer the best of any Thing he tried, and to sit easiest on
the Stomach; and to this he added the Use of Cordials, and
of strong Wine Whey as the Patient became lower.
</p><p>
Dr. <i>Hillary</i>&#8217;s Purge was: &#8478;. Mann&aelig; sescunc. vel unc. ij.
Tamarind. cond. unc. i. Tartar vitriolat. gr. x. solve in seri
lactis pr&aelig;parat. cum Vin. Maderiens. unc. vi. Colatur&aelig; adde
Tinct. Sen&aelig; unciam dimidiam. Divide in Partes quatuor, &amp;
capt. &aelig;ger unam omni hora donec laxetur alvus.
</p><p>
His Infusion of Snake-Root was prepared in the following
Manner:
</p><p>
&#8478;. Rad. Serpent. Virgin. drachm. ij. Croci Angl. drachmam
dimidiam, infunde per horam vase clauso in aq. bull. q.&nbsp;s. &amp;
dein unc. vi. Colatur&aelig;, adde aq. Menth. simp. unc. ij. Vin.
Maderiensis, unc. iv. Syrup. Croci vel Syr. e Mecon. unc. i.
Elix. Vitriol. acid. q.&nbsp;s. ad gratum saporem M. capiat &aelig;ger
cochlear. ij. vel iij. omni hora vel secunda quaq; hora vel s&aelig;pius
pro re nata.
</p><p>
The Stomach is so irritable in the Beginning of this Disorder,
as to reject the saline Draughts, Nitre, and such other Medicines.
Nor will the Bark, which might be judged a very
proper Medicine in the second Stage of the Disorder, lie upon
the Stomach, but is thrown up immediately, in whatever Form
it is given. However, a Gentleman who had practised long
in the <i>West Indies</i> told me, that although the Patient could not
retain it in his Stomach, yet that he had found great Service,
after the Bowels were emptied, from the Bark used freely in
Clysters.
</p><p>
Dr. <i>Hillary</i> disapproves of the Use of Blisters in the advanced
State of these Fevers.</p></div>

<div class="footnote"><p><a name="Footnote_75_75" id="Footnote_75_75"></a><a href="#FNanchor_75_75"><span class="label">[75]</span></a> Dr. <i>Millar</i>, one of the Physicians to the Army, told
me in <i>Germany</i>, that he had given this antimonial Powder with
great Success in the Remitting Fever, while the Eighth Regiment
of Foot (to which he was formerly Surgeon) lay in <i>England</i>.&mdash;Dr.
<i>Pringle</i>, in his fourth Edition of his <i>Observations</i>,
Part iii. ch. iv. tells us, that having given a mild Purge immediately
after Bleeding, he next Morning, when there was almost
always a Remission, gave a Grain of the Tartar Emetic,
with twelve Grains of Crabs-Eyes, and repeated the Dose in
two Hours, if the first had little or no Effect; at any Rate, in
four Hours. This Medicine not only vomited, but generally
opened the Body, and raised a Sweat. By these Evacuations,
the Fever was sometimes quite removed, but always became
easier.&mdash;This Medicine he usually repeated the second or third
Day; if not, he opened the Body with some mild Laxative, or
a Clyster; and continued this Medicine, till the Fever went
gradually off, or intermitted.&mdash;Dr. <i>Pringle</i> says, that Dr. <i>Huck</i>
treated this Fever in a Method similar to this, both in <i>North
America</i> and in the <i>West Indies</i>. In the Beginning he let Blood;
and in the first Remission, gave four or five Grains of Ipecacuana,
with Half a Grain of Tartar Emetic: This Medicine he
repeated in two Hours, taking Care that the Patient should not
drink before the second Dose; for by that Means the Medicine
passed more readily into the Bowels, before it operated by vomiting.
If, after two Hours more, the Operation either Way
was small, he gave a third Dose; which commonly had a good
Effect in carrying off the Bile; and then the Fever either went
quite off, or intermitted so far as to admit the Bark. On the
Continent he found no Difficulty after the Intermission; but
in the Islands, unless he gave the Bark upon the first Intermission,
though imperfect, the Fever was apt to assume a continual
and dangerous Form. Dr. <i>Huck</i> never varied this Method,
but upon a stronger Indication to purge, than to vomit. In
which Case he made an eight Ounce Decoction, with Half an
Ounce of <i>Tamarinds</i>, two Ounces of <i>Manna</i>, and two Grains of
<i>Emetic Tartar</i>; and dividing this into four Parts, he gave one
every Hour, till the Medicine operated by Stool.</p></div>

<div class="footnote"><p><a name="Footnote_76_76" id="Footnote_76_76"></a><a href="#FNanchor_76_76"><span class="label">[76]</span></a> Dr. <i>Hillary</i>, in mentioning the Remitting Fever of the
Island of <i>Barbadoes</i>, says: In those who were blooded, and
took an Emetic afterwards, and then the saline Draughts, the
Fever was generally carried quite off by a critical Sweat on the
seventh or ninth Day; in some few it came to intermit regularly
after that Time; and was soon cured by the <i>cortex Peruviana</i>,
given with the saline Draughts, and seldom effectually
without them; though these irregular ingeminated Fevers often
remitted, and sometimes seemed to intermit; yet if the <i>cortex
Peruviana</i> was given too soon in the Disease, before it intermitted
regularly (as I have more than once seen, where it had
been injudiciously given), it generally caused the Fever to become
continual and malignant. <i>Observat. on the epidemic Diseases
of Barbadoes</i>, p. 22.</p></div>

<div class="footnote"><p><a name="Footnote_77_77" id="Footnote_77_77"></a><a href="#FNanchor_77_77"><span class="label">[77]</span></a> Mr. <i>Cleghorn</i>, after giving a very accurate Account of
Tertian Fevers, as they appeared in their various Forms of true,
of double, and triple Tertians, and of Semi-Tertians, in the
Island of <i>Minorca</i>, tells us, that he first attempted the Cure by
profuse Evacuations; but afterwards learnt from Experience,
that they were unnecessary; and that Bleeding and Purging
once or twice in the Beginning, was all that was in general requisite;
and if on the fifth Day the third Revolution was not
attended with more threatening Symptoms than the second, and
the Patient bore it easily, he frequently trusted the whole Business
to Nature; which commonly terminated the Fever about
the fourth or fifth Revolution; and for the most part with an
Increase of some natural Evacuation.&mdash;But if the Paroxysm on
the fifth Day was the longest and most severe that happened,
attended with any doubtful or dangerous Symptom, he ordered
two Scruples of the Cortex to be given every two or three
Hours; so that five or six Drachms may be taken before next
Day at Noon; lest, if this Interval escaped, he should not have
found a favourable Opportunity of giving a sufficient Quantity
of the Medicine afterwards; as the Fits about this Period are
wont to become double, subintrant, or continual.&mdash;This did
not always put an immediate Stop to the Fever, but it invigorated
the Powers of the Body, and prevented or removed the
dangerous Symptoms. Having given the Bark on the fifth
Day, if a Fit came on the sixth, and declined the same Evening,
he gave some more Doses of the Bark to mitigate the Fit
on the seventh; yet sometimes this Fit of the sixth united with
that of the seventh, and the Patient had the Heat, Restlessness,
Raving, and other Complaints, greatly augmented, and the
Case seemed more desperate than ever; which, however, were
more dangerous in Appearance than Reality, and went off with
a profuse Sweat next Morning; after which he gave the Bark
freely as before; and this either stopt the Fits, or made them so
moderate, as that they yielded quickly to the same Sort of Management.&mdash;By
this Method, when Assistance is called timely,
Mr. <i>Cleghorn</i> says, the most formidable Intermitting and Remitting
Tertians, may be certainly and speedily brought to a happy
Conclusion about the End of the first Week, or Beginning of
the second. See <i>Observ. on the epidemic Diseases in Minorca</i>,
chap. iii. p. 187, &amp;c.</p></div>
</div>



<h2><a name="AGUE" id="AGUE"></a>OF THE<span class='pagenum'><a name="Page_179" id="Page_179">[179]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%">Intermitting Fever, or Ague.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>his</span> Disorder belongs to the same Tribe
of Diseases as the Remitting Fever. We
call it an Intermitting Fever, or Ague, when
the Paroxysms are distinct, begin with a cold
and hot Fit, and go off with a Sweat; and the
Patient is cool, and free from the Fever in the
Intervals between the Fits.</p>

<p>Many have been the Causes alledged to produce
this Disorder. The great Quantity of
Bile that is often thrown up in the Fit, has
caused it to be ranked among the bilious Diseases;
and the Seasons of the Year in which
it is most frequent, and the low moist Situation
of the Places where it is endemic, have made
Practitioners suspect, that an obstructed Perspiration,<span class='pagenum'><a name="Page_180" id="Page_180">[180]</a></span>
and a Tendency in the Juices to the
Putrescent, are the Cause of it.</p>

<p>But whatever Cause we may suppose to give
Rise to the first feverish Fit, it is difficult from
hence to account for the regular Returns of the
Paroxysms and Intermissions: For my own
Part, after considering Intermittents, which
observed a regular <i>Type</i> in the Course of a
Salivation<a name="FNanchor_78_78" id="FNanchor_78_78"></a><a href="#Footnote_78_78" class="fnanchor">[78]</a>; their being so easily stopt by the
Bark without any sensible Evacuation; their
being sometimes put away by a Stimulus externally
applied<a name="FNanchor_79_79" id="FNanchor_79_79"></a><a href="#Footnote_79_79" class="fnanchor">[79]</a>, or by a Fright, or sudden
Plunge into cold Water<a name="FNanchor_80_80" id="FNanchor_80_80"></a><a href="#Footnote_80_80" class="fnanchor">[80]</a>; their returning
<span class='pagenum'><a name="Page_181" id="Page_181">[181]</a></span>after slight Errors in Diet, and sometimes by
the Operation of a Purge, or of Bleeding;
their attacking sometimes only particular Parts,
and many such Accidents in these Fevers, I
must confess, that I am unable to form any Idea,
either of their Origin, Seat, or Cause<a name="FNanchor_81_81" id="FNanchor_81_81"></a><a href="#Footnote_81_81" class="fnanchor">[81]</a>.</p>

<p>The Soldiers were subject to this Disorder,
particularly in Spring, if they took the Field
soon, and in Autumn: The Frequency of it was
in a great Measure determined by the Nature
of the Ground on which they were encamped,
or the Situation of the Garrison or Town in
which they were quartered; for the lower and
moister the Camp or Garrison, and the more
<span class='pagenum'><a name="Page_182" id="Page_182">[182]</a></span>moist the Season, the more subject an Army is
to Agues; and the drier the Situation of the
Camp or Garrison, and the finer and drier the
Weather is, the freer they are from Disorders
of this Kind.</p>

<p>In Winter 1761, we had but very few
Agues in the Hospitals; but on the Return of
the Troops from the Expedition into <i>Hesse-Cassel</i>,
and during the Spring, some (though
not many) were attacked with Quotidian and
Tertian Agues, and but very few with Quartans.&mdash;In
<i>July</i> and <i>August</i> they were more
frequent, and accompanied with more bilious
Symptoms. At <i>Bremen</i>, during the latter End
of Autumn, and throughout the Winter and
Spring 1762, we had Agues of all Sorts, and
many inveterate Cases; and all this Spring,
and during the Summer and Autumn, the
Ague was the epidemic Disorder all over <i>Westphalia</i>,
as well as among the Troops.</p>

<p>In Spring 1761, what Agues we had were
mostly Tertian, some Quotidian, and but two
or three of the Quartan Kind. They were,
for the most part, mild, and yielded to the Bark.&mdash;Some<span class='pagenum'><a name="Page_183" id="Page_183">[183]</a></span>
of them began in the Form of a continued
Fever; but after Bleeding, and the Use
of the cooling Medicines for a few Days, they
began to remit, and at last ended in regular
Quotidian or Tertian Agues: Others, at first,
appeared in Form of Remittent Fevers, attended
with a strong throbbing Pulse; but changed
to regular Intermittents by pursuing the antiphlogistic
Method of Cure; and some from the
Beginning assumed the Type of Quotidian or
Tertian Agues, but often attended with a good
deal of Fever, for the first two or three Days;
and some had a slight Delirium in the Time of
the Paroxysms, and the Pulse was not quite settled
in the Intervals. In such Cases, where
the Patient was strong, nothing answered so
well as to take away some Blood; and to
give the saline Draughts with Nitre till the
Fever was moderated, before we gave the
Bark.</p>

<p>In general, there is a Prejudice against bleeding
in Agues, after they become regular; but
I have always observed, both in <i>England</i> and
in <i>Germany</i>, that where Patients are strong and<span class='pagenum'><a name="Page_184" id="Page_184">[184]</a></span>
plethoric, and the Fever in the Paroxysms rises
high, or the Pulse remains quick in the Intervals,
that taking away more or less Blood, and
giving the antiphlogistic Medicines in the Beginning,
eased the Patient, moderated the Fever,
and made it safer to give the Bark soon;
and I never saw the least Inconvenience from
the Practice; but, on the contrary, have seen
several Intermittent Fevers change into continued
ones from the Neglect of this Evacuation;
and have seen Cases where the Bark, instead of
stopping the Ague, rather increased the Fever,
till the Patient was blooded, and had pursued
the antiphlogistic Method for some Time; after
which the Bark had its proper Effect, and
put an End to the Disorder.</p>

<p>As soon as these Agues became regular, and
the Patient was quite cool, and free from any
Fever in the Intervals, we gave the Bark;
which soon put a Stop to the Paroxysms, without
the least bad Consequences; but, before
giving the Bark, we always took Care to empty
the first Passages by the Use of Emetics and
Purgatives, where there was no Symptom to<span class='pagenum'><a name="Page_185" id="Page_185">[185]</a></span>
forbid their Use: In Cases where the Patient
was weak, and the Fits so violent as to make
it necessary to stop the Ague, before we had
Time to administer Emetics or Purgatives, we
added so much Rhubarb to the first Doses of
the Bark as procured the Patient some loose
Stools, as recommended by Dr. <i>Mead</i><a name="FNanchor_82_82" id="FNanchor_82_82"></a><a href="#Footnote_82_82" class="fnanchor">[82]</a>; which
<span class='pagenum'><a name="Page_186" id="Page_186">[186]</a></span>did not prevent its stopping the Ague, at the
same Time that it answered the End proposed
of carrying off any putrid Humours that might
be lodged in the Intestines.</p>

<p>In <i>England</i>, Vernal, Quotidian, and Tertian
Agues, frequently go off after Bleeding,
and taking some Emetics and Purges, and the
saline Draughts, and cooling Medicines, for
some Time, without the Use of the Bark; but
in <i>Germany</i> very few yielded to this Treatment,
and we were obliged to give the Bark<a name="FNanchor_83_83" id="FNanchor_83_83"></a><a href="#Footnote_83_83" class="fnanchor">[83]</a>
before we could put a Stop to them.</p>

<p><span class='pagenum'><a name="Page_187" id="Page_187">[187]</a></span></p><p>In the End of <i>July</i>, and Beginning of <i>August</i>,
the aguish Cases we had at <i>Munster</i> continued
to be of the Quotidian or Tertian Kind.
The greatest Part of them began in the Form
of continued Fevers, tending more to the bilious
Kind than the preceding Months, and many
of the Sick had bilious Vomitings in the cold
Fits; and the Agues we had in Spring, and
during the Campaign 1762, were of the same
Nature, and required the same Treatment.</p>

<p><span class='pagenum'><a name="Page_188" id="Page_188">[188]</a></span></p><p>Those Cases, which began in the Form of
continued Fevers, were treated as such till they
began to have regular Intermissions; they then
yielded to the Bark.</p>

<p>Some were attended with the Dysentery; and
the Purging and Gripes were most severe on the
Days of the aguish Paroxysms. In such Cases,
we were frequently obliged at first to neglect
the Ague, and to treat the Disorder entirely as
a Flux. Where there was much Fever, the
Patient strong, and the Pains in the Bowels
acute, we ordered Bleeding; and after it a gentle
Emetic, and some Doses of the saline oily
Purge, or of Rhubarb; and gentle Opiates in
the Evening, and other Medicines proper in
the Dysentery, till its Violence was abated, before
we gave the Bark: though in some Cases,
where the aguish Paroxysms were very severe,
and helped to increase the Purging, and the Patient
was in Danger of sinking, we gave the
Bark, notwithstanding the Flux still continued;
and the Method we followed was the same
as that I formerly mentioned, where it
was complicated with the Malignant Fever;<span class='pagenum'><a name="Page_189" id="Page_189">[189]</a></span>
which was to give the Bark, mixed with Diascord,
and Opiates, or other Medicines proper
for the Dysentery, in the Intervals between
the Purges.</p>

<p>By this Treatment, very often both the Flux
and Ague went off. However, it ought to be
observed, that unless the aguish Paroxysms
were severe, and in Danger of sinking the Patient,
or that the Disorder had continued for
some Time, and the Paroxysms were distinct,
we seldom gave the Bark till the Violence of
the Flux was abated: And where-ever much
Griping and Pain in the Bowels attended the
Flux and Ague, there Bleeding as well as Purgatives
were necessary, before exhibiting the
Bark; which seldom or ever agreed with
them, till there was an evident <i>Apurexia</i>, or
Absence of Fever in the Intervals between the
Fits. Where these Cautions were neglected,
the Bark generally made the Patients worse;
and we were obliged to omit it, till the Violence
of the Purging was over.</p>

<p>Some Agues were accompanied with the
Jaundice, though not in such a high Degree as<span class='pagenum'><a name="Page_190" id="Page_190">[190]</a></span>
in the confirmed State of that Disorder; and
commonly in the Beginning the Pulse continued
rather quick, in the Intervals between the
Paroxysms; and the Patients complained of
some Degree of Sickness for the first two or
three Days. With those the Bark always disagreed,
till the Feverishness between the aguish
Paroxysms was gone; and we found, that
the best Method of treating them, was to
bleed in the Beginning, if there was much Fever;
and then to give a Vomit and Purge, and
to repeat them, if necessary; and where there
was no Purging, to give the saline Draughts,
and other cooling Medicines; and to add a few
Grains of Rhubarb, or to give so much of the
<i>pilul&aelig; saponac&aelig; cum rheo</i>, daily, as procured
one or two loose Stools.</p>

<p>After the Ague had regular Intermissions,
and the Patient was quite cool, and without
Fever in the Intervals, if the Disorder did
not yield to the above Treatment, which
it seldom did, we then gave the Bark freely;
even though the slight icteric Symptoms still
remained; and it put an End to the Ague, and<span class='pagenum'><a name="Page_191" id="Page_191">[191]</a></span>
removed the Jaundice at the same Time, without
the least Inconvenience to the Patient. In
such Cases, we generally used to add a few
Grains of Rhubarb to the first Doses of the
Bark; or gave the Bark made up into Pills with
Soap, and added occasionally a few Grains of
Rhubarb.</p>

<p>Several of those who had the icteric Symptoms
along with the Ague, had bilious Vomitings
in the Time of the cold Fit; they found
themselves sick, with a bitter Taste in their
Mouth, before the Approach of the aguish Paroxysm;
and many of them, though they took
Emetics, which operated freely at this Time,
yet did not vomit up the Bile; but the Sickness
and bitter Taste continued till the cold
Fit came on, when they vomited Bile in large
Quantities. In such Cases, after the Use of
Emetics and Purges, and the Ague was
brought to have regular Paroxysms, with free
Intermissions, the Bark, given as just now
mentioned, removed the Ague and icteric
Symptoms, without the least bad Consequences.<span class='pagenum'><a name="Page_192" id="Page_192">[192]</a></span></p>

<p>Many Practitioners of great Repute have been
prejudiced against the Bark; and tell us, that
the free Use of this Medicine often lays the
Foundation of Obstructions in the abdominal
Viscera, especially when it has been given
where there was an icteritious Colour in the
Eyes and Countenance; and that, in such
Cases, we ought not to give the Bark till these
Icteric Symptoms are gone. At first, I was
very cautious of giving it under such Circumstances;
till meeting with some Cases where
the Paroxysms were severe, and became more
frequent, while the Patient was so low, as to
be in Danger of sinking under the Disorder, I
gave the Bark freely, as the only Remedy capable
of preserving Life; which not only stopt
the Ague, but carried off the icteritious Symptoms<a name="FNanchor_84_84" id="FNanchor_84_84"></a><a href="#Footnote_84_84" class="fnanchor">[84]</a>,
and restored the Patients to perfect
Health.</p>
<p><span class='pagenum'><a name="Page_193" id="Page_193">[193]</a></span></p>
<p>After this I gave it freely, in the Manner
above mentioned, to some Hundreds, with
great Success; and I never saw any Mischief
follow from using it: Indeed sometimes, where
it was given rather too soon, it did not sit easy
on the Stomach; and made the Patients hot and
restless; but, by laying it aside, these Effects
immediately ceased; and generally, after a little
Time, the Paroxysms became milder and
more distinct, when the Bark was again administered,
agreed with the Stomach, and put an
End to the Disorder; and I am now convinced,
from Experience, that the Cases in which
the Bark has done Mischief, or given Rise to
Obstructions of the abdomenal Viscera, are but
very rare; and that these Mischiefs mostly
arise from the Obstinacy of the Disorder, and
not from the Use of this Drug; for I have oftener
observed these Obstructions where little
or no Bark had been used, than where it was
given freely<a name="FNanchor_85_85" id="FNanchor_85_85"></a><a href="#Footnote_85_85" class="fnanchor">[85]</a>. What probably has given
<span class='pagenum'><a name="Page_194" id="Page_194">[194]</a></span>Rise to the Belief of the Bark&#8217;s doing so much
Mischief, is, that in <i>Holland</i>, and other low
fenny Countries, where Agues are endemic,
they are oftentimes extremely obstinate, and
yield hardly to any Remedies; and if they
are stopt by the Bark, they often return soon
after, and by their long Continuance give
Rise to Obstructions of the abdomenal <i>viscera</i>,
which have been attributed to the Use of this
Specific.</p>

<p>In some few Cases a Purging accompanied
these icteric Symptoms, which we treated
much in the same Manner as when the Ague
was complicated with the Flux; we gave
Emetics and Purgatives; and the mindereri
Draughts with Mithridate, throughout the
Day, and Opiates at Night, if the Purging
was violent; if it continued, accompanied
with regular aguish Fits, the Bark, with
Astringents, generally removed both.</p>

<p><span class='pagenum'><a name="Page_195" id="Page_195">[195]</a></span></p><p>In the latter Part of the Year 1761, and
during Spring 1762, we had at <i>Bremen</i> many
Patients in Agues of all Sorts; as Quotidians,
Tertians, Quartans, and irregular Agues of a
very obstinate Nature. The Town of <i>Bremen</i>
is large and well built, situated in a low
sandy Plain, with the <i>Weser</i> dividing the old
from the new Town; generally a considerable
Part of the Environs is covered with
Water in the Winter, and frequently the
<i>Weser</i> breaks down some of the Dikes, and
overflows all the Country round; and every
Time the River overflows its Banks, the Cellars
of all the new Town, and of that Part
of the old Town next the River, are filled
with Water. All the Year round, on digging
two or three Feet deep into the Ground, you
come at Water.</p>

<p>Agues are endemic in this Place, and great
Numbers of the lower Class of People are
afflicted with them at all Times of the Year,
especially in Spring and Autumn.</p>

<p>Some of the Sick sent down from the Army
were bad of Agues; but the greatest Number<span class='pagenum'><a name="Page_196" id="Page_196">[196]</a></span>
we had in Hospitals was composed of such as
took it in Town; either from doing Duty on
the Ramparts, or from lying in bad Quarters,
or getting drunk and exposing themselves to
Wet and Cold; and many Men of the invalid
Companies who had come from <i>Embden</i>
brought with them old inveterate tertian and
quartan Agues.</p>

<p>Most of the recent Cases were easily cured
by the Methods already mentioned; though
they often continued longer, required a greater
Quantity of the Bark to stop them, and a
longer Continuance of its Use to make a Cure,
than at other Places, which were more dry,
and higher situated.</p>

<p>The most obstinate of the recent Cases were
the irregular Intermittents, which had regular
Paroxysms, but where the Pulse was not
settled in the Intervals; which we were obliged
to treat as Remitting Fevers till the Paroxysms
became quite distinct, and the Patient was
cool and free from any Fever in the Intervals;
after which they commonly yielded to the
Bark.<span class='pagenum'><a name="Page_197" id="Page_197">[197]</a></span></p>

<p>But many of those Agues which had continued
for some Time, especially with those
Invalids who came from <i>Embden</i>, or who had
brought on frequent Relapses by their own
Irregularities, were very obstinate. With many
the Bark had no Effect; and its Use persisted
in seeming rather to exasperate the Paroxysms,
and to do Hurt. Nor had almost
any Remedy we tried a better Effect. We
gave the following Medicines to divers Patients;
the saline Draughts and cooling Medicines;
Infusions of Camomile Flowers and
of other Bitters; Dr. <i>Morton</i>&#8217;s Powders of Camomile
Flowers, Salt of Wormwood, and
diaphoretic Antimony; Dr. <i>Mead</i>&#8217;s Powders
of Camomile Flowers, Salt of Wormwood,
Myrrh, and Alum; Alum and Nutmeg;
large Doses of <i>sal ammoniac</i>; large Quantities
of Spirits of Hartshorn; the antimonial Drops
and Powders; to some we gave Emetics, both
in the Intervals and immediately before the
Fits. In some we tried to promote Sweats
before the Approach of the Fits, by making
them drink freely of warm Liquors while<span class='pagenum'><a name="Page_198" id="Page_198">[198]</a></span>
they kept in Bed, and took diaphoretic Medicines;
and to others we applied Blisters.&mdash;But
all did not put a Stop to some of those Agues.</p>

<p>With some the Disorder continued till it
broke down the Crasis of the Blood, and
brought on a general Relaxation of the Fibres;
and the Patients became cachectic, and fell into
Dropsies, or were seized with Diarrh&#339;as,
of which they died. Some had Obstructions
formed in the Liver or Spleen, or other <i>viscera</i>,
and fell into the Jaundice and Dropsies, which
carried them off.&mdash;In the Bodies, of several
whom we opened, we found Indurations of the
Liver and Spleen&mdash;in two of them Suppurations
of the Liver&mdash;and in one, who had had
the Ague at <i>Embden</i>, and had long complained
of one of those Swellings towards the
left Side of the <i>abdomen</i>, called the <i>Ague
Cake</i><a name="FNanchor_86_86" id="FNanchor_86_86"></a><a href="#Footnote_86_86" class="fnanchor">[86]</a>, the Spleen was so much enlarged
as to weigh above four Pounds.</p>
<p><span class='pagenum'><a name="Page_199" id="Page_199">[199]</a></span></p>
<p>Some, whose Constitutions were worn out
by these obstinate Agues, fell into Consumptions
and other pulmonic Disorders in the Winter,
of which they died. One Man died in
the cold Fit<a name="FNanchor_87_87" id="FNanchor_87_87"></a><a href="#Footnote_87_87" class="fnanchor">[87]</a>.</p>

<p>Where-ever the Ague continued long, and
the Bark had no Effect, we were obliged to
lay it aside, and to try other Remedies adapted
to the present Circumstances of the Patient.</p>

<p>The mild Methods succeeded best; giving
the saline Draughts and gentle cooling Medicines
to such as were strong and plethoric,
and had the aguish Paroxysms violent; and
the gentle Aromatics and Bitters, or Chalybeats,
to those of a weakly Habit, or whose
Fibres had been much relaxed, and their Constitutions
<span class='pagenum'><a name="Page_200" id="Page_200">[200]</a></span>greatly injured by this or any other
preceding Disorder.</p>

<p>During these Courses, we gave at Times
gentle Emetics; and if the Patient complained
of Gripes and Purging, which they frequently
did, in the Course of this Disorder,
we gave a Dose of Rhubarb, or of some other
mild Purge; and after it other Medicines proper
for this Complaint.</p>

<p>By these Methods frequently the aguish Paroxysms
became gradually milder, and at last
vanished. At other Times, after they had
continued for five or six Weeks, we again
gave the Bark, and found it to have the proper
Effect. With others they continued thro&#8217;
the Winter, and went off of themselves in the
Spring. With others they still continued; and
as no Medicines nor Time seemed to have any
Effect in that Country, we recommended
their being sent over to <i>England</i> for Change
of Air, as the only Means likely to remove
the Disorder.</p>

<p>Two Agues which had resisted the Use of
the Bark were cured by Powder of Camomile-Flowers,<span class='pagenum'><a name="Page_201" id="Page_201">[201]</a></span>
Salt of Wormwood, and diaphoretic
Antimony; and one by the Use of the aluminous
Powders, with Myrrh.&mdash;One Invalid,
who had long been ill of an obstinate Tertian,
on catching Cold, was seized with an Inflammation
of his Throat, for which he was blooded,
and took a mild Purge; next Day there
appeared a Swelling of one of the parotid
Glands, which we endeavoured to bring to
Maturation, by the Application of emollient
Cataplasms; after some Days it went entirely
away, without coming to Suppuration;
but as there remained still a Confusion of the
Head, and a Quickness of the Pulse, a large
Blister was applied to the Back, which continued
running for some Days; after it dried
up he fell into a Fit resembling that of an Epilepsy,
and next Day had another Fit of the
same kind; from the Time the Swelling first
appeared till the Time he had the first Fit, he
had no Ague, but it returned the second Day
after the second epileptic Fit; another Blister
was applied, and he had no Return of the epileptic
Fits, though his Ague continued obstinate<span class='pagenum'><a name="Page_202" id="Page_202">[202]</a></span>
till <i>March</i>, at which Time he was sent
to <i>England</i><a name="FNanchor_88_88" id="FNanchor_88_88"></a><a href="#Footnote_88_88" class="fnanchor">[88]</a>.&mdash;About the same Time the
aguish Fits of two others were stopt by the
Application of Blisters, though they returned
in both soon after.</p>

<p>Excepting in these few Cases, I found no
Medicines effectual in stopping those Agues,
which had resisted the Bark when properly
given, though we tried a vast Variety in different
Cases. The <i>cortex cascarill&aelig;</i>, or <i>eleutheri&aelig;</i>,
was given freely, both in Decoction
and Substance, in four Cases, which had not
yielded to the Bark, but without producing
any good Effect; we had not an Opportunity
<span class='pagenum'><a name="Page_203" id="Page_203">[203]</a></span>of trying this Bark in more Cases of this kind,
nor in Fluxes, the small Quantity of it which
had come from <i>England</i> being all expended.</p>

<p>A Soldier of one of the Regiments of Guards,
who was admitted into the Hospital for &#339;dematous
Legs, and the Remains of a very bad
Flux, which he had had ever since the preceding
Autumn; after being cured of the Flux,
and most of the &#339;dematous Swellings, was
seized with an intermitting Complaint in <i>February</i>.
He had no regular hot and cold Fits;
but every second Day, after a slight Shivering
and Cold, he was seized with Gripes and a Purging.
In one or two of the Fits his Pulse was
very quick, and the Pain of the Bowels very
acute and severe; which obliged us to blood
him, and give him a Dose of the saline oily
Purge; after which we treated the Disorder
as a Flux complicated with the Ague, and
gave the Bark mixed with Diascord, and gentle
Opiates at Nights, and at Times gentle Purgatives;
the Ague and Diarrh&#339;a stopt very
soon, and in a few Weeks he got free of all
Complaints, though he still continued weak,<span class='pagenum'><a name="Page_204" id="Page_204">[204]</a></span>
till he was sent to <i>England</i>, about the Beginning
of <i>April</i>.</p>

<p>Many, especially those whose Constitution
had been shaken by this or some other Disorder,
complained of flatulent Swellings of the
Stomach and Bowels, which affected them either
while the Ague continued, or soon after it
was stopped, and were very troublesome and
uneasy. For the most part, these Swellings
were removed by the Use of cordial Medicines
mixed with the Bark, or a Course of Bitters,
and some Doses of Rhubarb given at proper
Intervals. In some Cases, where they were
attended with Sickness, and the Stomach seemed
to be loaded, a Vomit gave Relief. Very
often these Symptoms continued for Weeks
after the Ague had left them, and did not go
entirely off, till the Patient recovered his
Strength.</p>

<p>In <i>February</i>, <i>March</i>, and <i>April</i>, 1761, severals
of the Soldiers in the Hospital at <i>Paderborn</i>
complained of periodical Head-Achs,
which returned in most, every Day; in others,
only every second; and afterwards Cases of<span class='pagenum'><a name="Page_205" id="Page_205">[205]</a></span>
this Kind occurred at different Times as long
as the Army continued in <i>Germany</i>. These
Head-Achs generally began in the Forenoon,
were very violent while they lasted, and confined
the Patient to his Bed for some Hours.
During the Pain, the Pulse was quick; but in
the Intervals the Patients were quite cool, and
without Fever. Sometimes, tho&#8217; not always,
the Urine deposited a little Sediment as the
Head-Ach was going off. Commonly the
Pain was all over the Head, but most severe in
the Forehead; though sometimes it was confined
to one Side only.</p>

<p>These Head-Achs we treated entirely as
Agues of the same Type. When the Patient
was strong, some Blood was taken away, and
afterwards we prescribed an Emetic and Purge,
and then gave the Bark liberally, which generally
put an End to the Complaint, without
any bad Consequences attending.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_78_78" id="Footnote_78_78"></a><a href="#FNanchor_78_78"><span class="label">[78]</span></a> See <i>Van Swieten</i>, Vol. II. p. 537.</p></div>

<div class="footnote"><p><a name="Footnote_79_79" id="Footnote_79_79"></a><a href="#FNanchor_79_79"><span class="label">[79]</span></a> A Gentleman told me, that he was once cured of an Ague
in the Country, by applying a Poultice of Garlic to his Wrists,
and letting it lie on till it inflamed and blistered the Part.&mdash;I
have seen Blisters cure an Ague.&mdash;In the <i>Edinburgh Med. Essays</i>,
Vol. II. Art. v. we have an Account of Agues being cured by
the Application of Poultices of recent Erigerum (Groundsel)
applied to the Stomach on the Days free from the Paroxysm,
which caused strong Vomiting.</p></div>

<div class="footnote"><p><a name="Footnote_80_80" id="Footnote_80_80"></a><a href="#FNanchor_80_80"><span class="label">[80]</span></a> See an Account of an Ague being cured by the Patient
being pushed into a Pool of Water without any previous Notice,
and being much frightened, in <i>Mason&#8217;s Account of Agues</i>,
p. 222.</p></div>

<div class="footnote"><p><a name="Footnote_81_81" id="Footnote_81_81"></a><a href="#FNanchor_81_81"><span class="label">[81]</span></a> The common Account given of the Cause of Agues,
and of the regular Return of their Paroxysms, has been: That
the Ague takes its Rise from some Sort of Matter, bilious, or whatever
it may be, either mixed with the Blood, or lodged in the
Bowels, or in some other Part of the Body; that a great Part
of this Matter is thrown out of the Body, in the Time of the
Paroxysm; but that so much remains as serves by Way of a
Ferment to assimilate other Particles to its own Nature; which,
when collected in a certain Quantity, produce a new Fit; and,
according to the Time that it takes to produce this Quantity,
the Disorder assumes the Form of a Quotidian, Tertian, or
Quartan Ague.</p></div>

<div class="footnote"><p><a name="Footnote_82_82" id="Footnote_82_82"></a><a href="#FNanchor_82_82"><span class="label">[82]</span></a> Mr. <i>Cleghorn</i>, while at <i>Minorca</i>, after Evacuations, gave
the Bark at the End of the third Period, as we observed before;
but where the Fever had been neglected till about the third or
fourth Period, or badly treated in the Beginning, and the
Bowels were inflamed or overcharged with corrupted Gall, he
was obliged to endeavour to palliate the most pressing Complaints,
and to watch Evening, Night, and Morning for a Remission,
and then immediately to fly to the Bark, as the only
Remedy that could avert the Danger. If the Patient was
strong, he gave Half an Ounce of the Bark, with six Drachms
of the <i>sal catharticum amarum</i>, divided into four equal Parts,
of which the Patient took one every two Hours; the Effect of
which was, that the next Fit was mitigated, and an Intermission
commonly ensued, in which the Bark was repeated without the
Purgative, to finish the Cure.&mdash;But where the Patient was excessively
feeble, and there was a manifest Risk of his dying in next
Fit, he gave Cordials with the Bark, instead of the <i>sal catharticum</i>;
and endeavoured to throw in six or seven Drachms in
the Space of ten or twelve Hours; he having found by Experience,
that if a smaller Quantity is given, the Paroxysms come
on earlier than usual, and make all Attempts to preserve Life
unsuccessful. See his <i>Account of the epidemic Diseases of Minorca</i>,
cap. iii. 2d edit. p. 192.</p></div>

<div class="footnote"><p><a name="Footnote_83_83" id="Footnote_83_83"></a><a href="#FNanchor_83_83"><span class="label">[83]</span></a> Sometimes, when Patients are reduced low by Agues,
the Stomach becomes so squeamish as to reject the Bark in every
Shape it can be given; in such Cases, when the Ague cannot
be stopped by other Means, it may be administered with great
Advantage in Clysters, of which the following is a very remarkable
Instance.&mdash;<i>William Hadderell</i>, a Lad seventeen Years
of Age, in the End of the Year 1761, was attacked with a severe
Tertian Ague, in which a Mortification came on his left
Foot, and one-half of it dropt off; notwithstanding, his Ague
continued to attack him every second Day, and the Sore continued
running on the 12th of <i>October</i> 1763, when he was admitted
into <i>St. George</i>&#8217;s Hospital. He was reduced extremely
low; and the Sore of his Foot looked so bad, that it was at
first imagined he must lose his Leg. He was ordered some
Vomits, and a Purge, and cooling Medicines, and afterwards
to take the Bark freely; but his Stomach rejected it, in
whatever Form it was given. Other Means were then tried to
stop his Ague, but with no Effect, till the 7th of <i>November</i>,
that I ordered two Drachms of the Powder of the Bark to
be given him twice a Day in an emollient Clyster, with Half a
Drachm of the <i>tinctura thebaica</i>, which stopt his Ague in three
Days; and he had had no Return of it on the 28th of <i>January</i>
1764, and had recruited his Health and Strength, and the Sore
of his Foot was greatly lessened. Dr. <i>Harvey</i> (who teaches
Midwifery in <i>London</i>) told me, that he has cured Children of
Agues by Bark Clysters, after the Bark Waistcoats, and other
Means used, had proved unsuccessful.</p></div>

<div class="footnote"><p><a name="Footnote_84_84" id="Footnote_84_84"></a><a href="#FNanchor_84_84"><span class="label">[84]</span></a> This agrees with what Mr. <i>Cleghorn</i> remarks of Tertian
Fevers in his <i>Observations on the epidemic Diseases of the Island of
Minorca</i>, who says, &#8220;where there is an icteritious Colour of the
Eyes, we are likewise told, that the Cortex should not be administered;
though, in my Opinion, it is for the most part
dangerous to delay it, after the first Appearance of that
Symptom.&#8221; Chap. iii. 2d edit. p. 205.</p></div>

<div class="footnote"><p><a name="Footnote_85_85" id="Footnote_85_85"></a><a href="#FNanchor_85_85"><span class="label">[85]</span></a> Dr. <i>Pringle</i> takes Notice, that these Obstructions happened
as often without as with the Bark; and therefore seemed
to depend on the long Continuance and Obstinacy of the Intermittent.
<i>Observ.</i> part iii. chap. iv. sect. 2. p. 179. 3d Edit.</p></div>

<div class="footnote"><p><a name="Footnote_86_86" id="Footnote_86_86"></a><a href="#FNanchor_86_86"><span class="label">[86]</span></a> I have seen the dead Bodies of four People opened, who
had those Swellings of the left Side, commonly called the <i>Ague
Cake</i>, which had come after Agues; and in all the Swelling
was owing to an Enlargement of the Spleen.</p></div>

<div class="footnote"><p><a name="Footnote_87_87" id="Footnote_87_87"></a><a href="#FNanchor_87_87"><span class="label">[87]</span></a> The cold Fit is the most dangerous Time of the Paroxysm,
and the greatest Part of those who die of Agues die at
this Time; one or two Instances of which I saw in the Military
Hospital at <i>Edinburgh</i> in the Year 1746.&mdash;<i>Van Swieten</i>
says he has seen the trembling and shaking so great in the
Time of the cold Fit of Quartans, that the Teeth have dropt
out of the Head. <i>Comment. in sect.</i> 749. <i>Aphorism. Boerhaav.</i>
vol. II. p. 511.</p></div>

<div class="footnote"><p><a name="Footnote_88_88" id="Footnote_88_88"></a><a href="#FNanchor_88_88"><span class="label">[88]</span></a> On the 29th of <i>August</i> 1759, a Man (<i>Murdoch Brinnen</i>)
about thirty Years of Age, was admitted into <i>St. George</i>&#8217;s Hospital
for a very large Swelling of the parotid Glands and
neighbouring Parts, which had come three Days before, after
a Fit of the Tertian Ague, which did not return afterwards.
The Swelling was discussed by the Application of emollient
Cataplasms, which were intended to have brought it to Suppuration.
He had no Return of the Ague, nor did any bad Consequence
follow the Discussion of the Tumour, and the Cure
was completed by a few Doses of Physic, and a Decoction of
the Bark, which restored him to his Strength, and carried off
the little Heat and Feverishness which remained.</p></div>
</div>



<h2><a name="JAUNDICE" id="JAUNDICE"></a>OF THE<span class='pagenum'><a name="Page_206" id="Page_206">[206]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%">JAUNDICE.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>he</span> Jaundice, or a yellow Colour of the
Eyes and Skin, occasioned by an Absorption
of Bile into the Blood, was another
Distemper which appeared towards the End
of each Campaign.</p>

<p>This Disorder, for the most part, takes its
Rise<a name="FNanchor_89_89" id="FNanchor_89_89"></a><a href="#Footnote_89_89" class="fnanchor">[89]</a> from Calculi lodged in the biliary
Ducts<a name="FNanchor_90_90" id="FNanchor_90_90"></a><a href="#Footnote_90_90" class="fnanchor">[90]</a>; and sometimes from a viscid Mucus
<span class='pagenum'><a name="Page_207" id="Page_207">[207]</a></span>or Pituita obstructing those Passages<a name="FNanchor_91_91" id="FNanchor_91_91"></a><a href="#Footnote_91_91" class="fnanchor">[91]</a>; and it
may be brought on by a Tumour, or any other
Cause<a name="FNanchor_92_92" id="FNanchor_92_92"></a><a href="#Footnote_92_92" class="fnanchor">[92]</a>, compressing these Ducts, so as to
prevent the free Flow of the Bile into the Cavity
of the Intestines.</p>

<p>The yellow Colour, or Jaundice, observed
in the Ague, and some other bilious Disorders,
seems to arise sometimes from Spasms of the
Ducts; or from too great a Quantity of Bile secreted
and absorbed into the Blood, which
seems evidently to be the Case where large
<span class='pagenum'><a name="Page_208" id="Page_208">[208]</a></span>Quantities of Bile are either vomited or discharged
by Stool; a Proof that the biliary
Ducts are clear, and free from Obstructions.</p>

<p>In the End of the Campaign of 1760, after
a continued Rain for many Weeks, the Jaundice
had been very frequent, and in a Manner
epidemical, among the Troops, for some Time
before they left the Field; and in passing thro&#8217;
<i>Munster</i>, about the End of <i>December</i>, I observed
several ill of that Distemper in Hospitals, and
met with a few Cases of this Kind in the Hospitals
at <i>Paderborn</i> in <i>January</i> 1761; but during
the Spring and Summer, we had only one
or two now and then sent to the Hospitals for
this Complaint; though towards the End of
the Campaign it became more frequent, and
several were sent down to <i>Bremen</i>; and some
of the Garrison were likewise affected with it.
During the Winter not above four or five were
sent to the Hospitals I attended, and but a few
to the flying Hospital, during the Campaign
1762. It frequently appeared in dropsical
Cases, depending on obstructed Viscera.<span class='pagenum'><a name="Page_209" id="Page_209">[209]</a></span></p>

<p>Those in whom the Jaundice was the original
Disorder, and not complicated with any
other, generally got well soon; but where it
appeared in dropsical Cases, depending on obstructed
Viscera, it was commonly fatal.</p>

<p>In the Beginning of this Disease, Patients
usually complained of Sickness, Heat, Thirst,
and other feverish Symptoms; and some had a
Vomiting, and Pain of the Stomach, for a Day
or two before the Jaundice appeared; the Urine
was always of a deep Colour from the first;
and about the second or third Day the Skin,
and the Whites of the Eyes, began to be tinged
with a yellow Colour, attended with the
common Symptoms of this Disorder.</p>

<p>Such was the Manner in which the Jaundice
began in those who were taken ill in Garrison;
but those sent us from the Army could
seldom give any accurate Account of their own
Cases.</p>

<p>In the Course of this Disorder, the Sick
were inclined to be costive, though some few
had a Diarrh&#339;a; several, who had been reduced
by Fevers, or other Complaints, before the<span class='pagenum'><a name="Page_210" id="Page_210">[210]</a></span>
Jaundice appeared, were attacked with violent
H&aelig;morrhages from the Nose; and two had
like to have died of them before the Bleeding
was stopped. The H&aelig;morrhages did not
prove critical, but seemed to depend on a dissolved
State of the Blood.</p>

<p>On the Patient&#8217;s being first taken ill, if he
was plethoric or feverish, or complained of
Pain, attended with Sickness and Vomiting,
some Blood was taken away. Next Day we
gave twenty-five or thirty Grains of Rhubarb
in a saline Draught, and afterwards the common
saline and other cooling Medicines, till
the Fever was abated. If the Pain and Fever
did not abate, a Vein was opened a second
Time, and a few Drops of the <i>tinctura thebaica</i>
were added to the saline Draughts, while
emollient Clysters were frequently administered,
and the Stomach and Belly fomented
with Flannels dipped in warm emollient Decoctions.</p>

<p>When the Pain and Fever were gone, we
then gave a gentle Vomit in the Evening, and
next Day a Dose of Rhubarb; and afterwards<span class='pagenum'><a name="Page_211" id="Page_211">[211]</a></span>
so much of the <i>pilul&aelig; saponace&aelig; cum rheo</i> daily
as kept the Body open; or the saline Draughts
with five or six Grains of Rhubarb in each, or
such a Quantity as answered the same Purpose
as the Pills; and from Time to Time repeated
the Emetic<a name="FNanchor_93_93" id="FNanchor_93_93"></a><a href="#Footnote_93_93" class="fnanchor">[93]</a> and Purge.</p>
<p><span class='pagenum'><a name="Page_212" id="Page_212">[212]</a></span></p>
<p>Most of the icteric Cases we had, which
were not complicated with other Disorders,
yielded to the above Treatment in about twelve
or fourteen Days. Two or three remained obstinate
for a longer Time. To one I ordered
a Quart of the pectoral Decoction, made with
Parsly Roots instead of the Linseed, to be drunk
daily along with the Soap Pills; and the Jaundice
disappeared in about eight or ten Days.
One who had the Disease more obstinate than
the rest, and complained for some Time of a
Tension and Uneasiness about the Liver, was
<span class='pagenum'><a name="Page_213" id="Page_213">[213]</a></span>ordered to have the right Side fomented Morning
and Evening, and to rub it for some Time
after with the <i>linimentum saponaceum</i> and to
drink the Decoction of Sarsaparilla after the
Soap Pills; and by continuing this Course for<span class='pagenum'><a name="Page_214" id="Page_214">[214]</a></span>
about three Weeks, the Disorder went off<a name="FNanchor_94_94" id="FNanchor_94_94"></a><a href="#Footnote_94_94" class="fnanchor">[94]</a>.</p>

<p>The H&aelig;morrhage from the Nose commonly
stopped soon. Where it was violent, we kept
<span class='pagenum'><a name="Page_215" id="Page_215">[215]</a></span>the Patient cool, and applied Cloths dipped in
Vinegar and Water to the Nose.&mdash;In two
Cases, one at <i>Munster</i>, the other at <i>Bremen</i>,
the Patients were hot and feverish, and a Vein
was opened, and eight or ten Ounces of Blood
taken away; and in one Case nothing took
Effect till we gave repeated Doses of the <i>tinctura
saturnina</i> in a common acid Julep.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_89_89" id="Footnote_89_89"></a><a href="#FNanchor_89_89"><span class="label">[89]</span></a> Obstructions and Scirrhi of the Liver have been assigned
as the Cause of the Jaundice; but as we have so many
Cases of this Kind related where no Jaundice appeared, it is
now much doubted, whether such Obstructions, which do not
affect the Ducts, are capable of producing this Disorder.</p></div>

<div class="footnote"><p><a name="Footnote_90_90" id="Footnote_90_90"></a><a href="#FNanchor_90_90"><span class="label">[90]</span></a> We have numerous Cases in <i>Bonetus</i>, and other physical
Observations, where Calculi have been found in the Gall Bladder,
and Ducts of People who have died of the Jaundice; and
I have frequently found two, three, and sometimes twelve, fifteen,
or twenty, such bilious Calculi in these Cavities.</p></div>

<div class="footnote"><p><a name="Footnote_91_91" id="Footnote_91_91"></a><a href="#FNanchor_91_91"><span class="label">[91]</span></a> Viscid Mucus or Pituita, or viscid Bile, has been observed
frequently to obstruct the Ducts. Dr. <i>Coe</i> says, sometimes
icteric Patients discharge very thick Bile, almost as viscid
as Bird-Lime. See his <i>Treatise on biliary Concretions</i>, chap. ii.
where he has collected a great Number of icteric Cases, in
which the Bile has been found quite viscid after Death.</p></div>

<div class="footnote"><p><a name="Footnote_92_92" id="Footnote_92_92"></a><a href="#FNanchor_92_92"><span class="label">[92]</span></a> See the Case of a Jaundice in <i>Bonetus&#8217;s Sepulchretum Anatomicum</i>,
tom. II. p. 326, where the Sides of the common biliary
Duct were compressed by an Enlargement of the Glands
about the <i>vena portarum</i>; and we sometimes meet with a Jaundice
in pregnant Women which goes off after Delivery, and
seems to have been caused by the Pressure of the Uterus and
indurated F&#339;ces in the Colon. <i>Van Swieten</i> says, he has seen
this very frequently, vol. III. sect. 918, p. 95.</p></div>

<div class="footnote"><p><a name="Footnote_93_93" id="Footnote_93_93"></a><a href="#FNanchor_93_93"><span class="label">[93]</span></a> Vomits are reckoned amongst the most efficacious Remedies
in this Disorder, and I have often seen good Effects follow
their Use.&mdash;<i>Janet Crags</i>, a Woman thirty Years of Age, was,
on the 21st of <i>December</i> 1758 admitted into <i>St. George</i>&#8217;s Hospital
for a Jaundice of some Months Continuance. Her Eyes and
Skin were not of the common icteric Colour, but of a dark
livid yellow, for which Reason both she and the Nurses termed
her Disorder the Black Jaundice. She at first complained of a
Difficulty of Breathing, and a Weight and Oppression about the
Region of the Liver, for which she was blooded, took some
Doses of Physick, and the Soap Pills with Rhubarb; but these
produced no Change in her Complaints. On the 29th she had a
Cough, and complained much of Sickness and Difficulty of
Breathing, for which she was ordered a Vomit, and afterwards
to take the Squill Draught Morning and Evening, which occasioned
a Purging and Gripes. On the 5th of <i>January</i> 1759,
the Looseness still continuing, I ordered her to leave off the
Use of the Squill Draughts, and to take only some Rhubarb in
an oily Draught every Night at Bed-Time. On the 8th, tho&#8217;
the Purging had increased, I did not chuse to check it, as I suspected
it would prove a Crisis to the Disorder, and therefore
only ordered her the Cordial Draughts and Wine to support
her Strength. The Looseness continued till the 15th, when
most of the icteric Symptoms were gone, and by the 30th they
entirely disappeared. However, she continued low, and subject
to Flatulencies for some Months afterwards, which were
at last removed by the continued Use of Cordials, gentle Bitters,
a nourishing Diet, and repeated Doses of Rhubarb; and
on the 2d of <i>May</i> she was discharged in a firm State of Health.
</p><p>
Dr. <i>Coe</i> says, &#8220;I have more Reason to be satisfied of the
Effect of Vomits in dislodging these Calculi, than of any
other, or indeed of all other Medicines.&#8221; <i>Treatise on biliary
Concretions</i>, chap. ii. p. 253. Besides viscid Humours, which
Vomits bring away from the biliary Passages, how often are
Gall Stones likewise found in the Stools after the Operation of
a Vomit? <i>Ibid.</i> p. 256.</p></div>

<div class="footnote"><p><a name="Footnote_94_94" id="Footnote_94_94"></a><a href="#FNanchor_94_94"><span class="label">[94]</span></a> Sometimes the warm Bath has a good Effect after other
Remedies have afforded no Relief. In the Year 1743, a young
Gentleman, a Student of Physic at <i>Edinburgh</i>, had a Jaundice
for which he had taken Variety of Medicines, and rode daily
on Horseback for some Weeks, without receiving any Benefit:
At last, by my Father&#8217;s Advice, he took a brisk Dose of Physic,
and before it began to operate had a large Quantity of
warm Whey thrown up by way of a Clyster, and went immediately
into the warm Bath. In the Bath he was taken with a
violent Inclination to go to Stool; and after coming out, had
a great Number of bilious Stools that Day, and next Morning
was still inclined to be loose; and in a few Days all the icteric
Symptoms vanished. On the 20th of <i>July</i> 1763, a middle aged
Woman, <i>Elizabeth Hosier</i>, was admitted into <i>St. George</i>&#8217;s Hospital
for a Jaundice, which came about a Fortnight before. She
had been blooded, and had taken some Medicines, before I saw
her. I ordered her a Vomit and Purge, and to take too Scruples
of the Soap Pills and Rhubarb daily; and four Days afterwards
the Vomit and Purge were repeated, but without making
any Change in her Disorder. On the 29th she went into
the warm Bath, and took a Vomit immediately on coming out.
After the Vomit she had some loose Stools, and the icteric
Symptoms went all off in a few Days. She continued well for
some Months; but I have been told, that she has since relapsed.
</p><p>
When the Jaundice continues obstinate, there is hardly any
Thing has often a better Effect than the continued Use of Decoctions
of the Juices of succulent Plants, of Whey in the Spring,
Soap, and such like Medicines. The Baron <i>Van Swieten</i> tells us,
that he has cured many obstinate Jaundices by making the Patients
drink daily a Pint or two Pints of a Decoction of Grass,
Dandelion, Fumaria, Succory, and such like, prepared in
Whey; to each Pint of which he added Half an Ounce of <i>sal
polychrest</i>, and an Ounce or two of Syrup of the five aperient
Roots; and by ordering them to drink the Spa Water in Summer,
and take freely of Soap, along with a Decoction of the
aperient Roots, in Winter. In those who were cured by these
Remedies, he says, Stones, or a kind of a grumous calculous
Matter, were always found in the Stools, as the Jaundice was
going off. He relates one very particular Case of a Lady of
sixty Years of Age, who had had a black Jaundice for twelve
Years, and was cured by continuing the Use of these Medicines
for eighteen Months; during the last six Months of
which she had a Looseness, and constantly discharged by Stool
a fetid granulated Matter of the Colour of Clay;&mdash;and another
singular Case of a Man who was cured by living mostly upon
Grass, and a Decoction of it, for two Years together. The
Man came at last to devour such Quantities of it, and could
distinguish the good Sort from the bad so well, that the Farmers
often used to drive him out of their Fields. Vol. III. &sect;. 950.
</p><p>
<i>Glisson</i> tells us, that Cattle are subject to bilious Concretions
in Winter, which are dissolved and evacuated in the Spring,
when they begin to move much about, and to eat the new Grass,
which purges them. <i>Oper.</i> vol. II. <i>Anat. Hepat.</i> chap. vii.
p. 104.
</p><p>
Dr. <i>Russel</i> greatly recommends the Use of Sea Water along
with the saponaceous Medicines. See his <i>Treatise on the Use of
Sea Water</i>.</p></div>
</div>



<h2><a name="TUMOURS" id="TUMOURS"></a>OF<span class='pagenum'><a name="Page_216" id="Page_216">[216]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%"><span class="smcap">Tumours</span> of the <span class="smcap">Breast</span>.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">I</span>n</span> <i>May</i> 1761, a great many of the Patients,
who had been in Hospitals the preceding
Winter, had Tumours formed on the external
Part of the Breast, which they shewed me at
<i>Osnabruck</i>. They began in the Form of indolent
Tumours, and came slowly to Suppuration.
For the most part, the Suppuration was only
partial, and the Tumour, on being opened,
discharged a very small Quantity of Matter.
Some of them, though they felt soft, and
seemed to contain Matter, yet, upon being
opened, discharged only a small Quantity of
black Blood. None of them melted down
entirely into Pus, or came fully to Suppuration,
and healed kindly as Abscesses which succeed<span class='pagenum'><a name="Page_217" id="Page_217">[217]</a></span>
acute Inflammations. But after a small Quantity
of Matter was discharged, for the most
part, there still remained a hard Tumour, which
felt as if it was a Swelling of the Bone, or Cartilage
below; and in some the Surface of the
Bone was found rough at the Bottom of the
Abscess.</p>

<p>These Tumours seldom rose high, and were
most of them situated at the lower Part of the
Sternum, or a little to one Side of it, commonly
on the left Side, above the <i>cartilago ensiformis</i>.
Some Patients had only one, others two,
and some three such Tumours. The first of
them I saw was on the left Side, which, on
being felt, gave exactly the same Sensation as
when the Cartilages of the Sternum are begun
to be raised by an Aneurism of the Aorta; only
no Pulsation was to be perceived; and most of
them had the same Appearance.</p>

<p>The Patients, who had such Tumours, commonly
complained of Pains of their Breast.
One or two, after these Tumours came to Suppuration,
seemed to recover their Health, and
to feel no Uneasiness, tho&#8217; some of the Swelling<span class='pagenum'><a name="Page_218" id="Page_218">[218]</a></span>
remained: But many of them were inclined to
be hectic, and seemed likely to grow consumptive.</p>

<p>Being ordered up to the flying Hospital in
<i>June</i>, and the Sick going down to <i>Bremen</i>, I
had no Opportunity of seeing the Event of
these Tumours, or of examining the Bodies of
those who died with them. One I accidentally
met with the following Winter at <i>Bremen</i>,
who died of a Consumption and Diarrh&#339;a.
He had a large Abscess, which penetrated
into the Cavity of the Chest, and discharged
a great Quantity of very fetid Matter,
at the Part where one of these Tumours had
been seated, and the Sternum and Ribs were
carious all round the Abscess.</p>



<h2><a name="PARALYTIC" id="PARALYTIC"></a>OF<span class='pagenum'><a name="Page_219" id="Page_219">[219]</a></span><br />
<span class="smcap" style="letter-spacing: 0.15ex; font-size: 130%">Paralytic Complaints.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">S</span>ome</span> of the Soldiers, from lying out in
the Nights on the wet Ground, and from
doing Duty in cold rainy Weather, were seized
with a Pain and Numbness all over, and lost
the Use of their Limbs, which in some was succeeded
with a Palsy of these Parts: But the
greatest Number of those afflicted with Paralytic
Symptoms were seized with them either
in Fevers, or after feverish and other Disorders.
The Number, who were attacked with Complaints
of this Kind, were but few.</p>

<p>When Men were suddenly taken with Pain
and Numbness all over, we found that the best
Method of treating them was to put them to
Bed, and give them Plenty of mild warm diluting<span class='pagenum'><a name="Page_220" id="Page_220">[220]</a></span>
Liquors for Drink; and if there was
much of a Fever, to open a Vein, to give the
cooling antiphlogistic Medicines, and apply
Blisters; and if these Complaints still remained,
to endeavour to promote a breathing Sweat,
by means of Diaphoretics and warm Drinks.
Several who were brought to the Hospital,
soon after being seized in this Manner, got
well; but in some few, one or other of the
Limbs would begin to waste, and remain paralytic
afterwards.</p>

<p>Those who had the true confirmed Palsy
seldom remained long enough with us to be
cured. Two or three received Benefit from
Blisters applied to the Parts, and from Issues;
drinking at the same time the Decoction of
the Woods, or of Sarsaparilla, and taking the
volatile Tincture of Guaiac or Valerian<a name="FNanchor_95_95" id="FNanchor_95_95"></a><a href="#Footnote_95_95" class="fnanchor">[95]</a>,
<span class='pagenum'><a name="Page_221" id="Page_221">[221]</a></span>and being sweated by the Use of <i>Dover</i>&#8217;s
Powder, or other Diaphoretics.</p>

<p>One Man of the 51st Regiment of Foot,
after doing Duty in very cold wet Weather,
in the Beginning of the Year 1762, was seized
with a Palsy of one Side of his Face, which
<span class='pagenum'><a name="Page_222" id="Page_222">[222]</a></span>prevented him from speaking distinctly, and
was an Impediment to his eating. He mended
much after being blooded, and having a
large Blister to his Neck, kept open for some
time by means of the epispastic Ointment.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_95_95" id="Footnote_95_95"></a><a href="#FNanchor_95_95"><span class="label">[95]</span></a> On <i>Wednesday</i> the 1st of <i>February</i> 1764, <i>Margaret Julion</i>,
a Woman between fifty and sixty Years of Age, was admitted
into <i>St. George</i>&#8217;s Hospital for an entire Loss of Speech,
which seemed to depend on a paralytic Disorder of the Parts
about the Larynx. The Account her Friends who came with
her to the Hospital gave of her Case was, that she had been
for five Months troubled at Times with Pains of her Bowels,
and a Purging; that on <i>Sunday</i> se&#8217;night before coming to
the Hospital, she had suddenly lost the Use of her Speech, and
had not spoke since that Time, though she seemed to hear and
understand whatever was said to her. I asked her some Questions,
which she answered distinctly by Signs. She had no
paralytic Complaint of her Face, Arms, Legs, or any other
Part of her Body, and swallowed both Fluids and Solids with
Ease. She had no Fever, and seemed to complain of nothing
but the Loss of Speech.&mdash;A Blister was applied to her Neck,
and she was ordered the saline Draughts, with a Scruple of
Powder of Valerian in each, to be taken three Times a-day,
and a Dose of sacred Tincture, to be taken twice a-Week.
She followed this Course for a Fortnight, when another Blister
was applied to the Fore-part of the Neck, and the Powder of
Valerian in the Draughts was changed for two Drachms of the
<i>tinctura valeriana volatilis</i>. At the End of three Weeks she
could pronounce the two Words <i>Why</i>, <i>What</i>. She continued
the same Course till this Day, the 16th of <i>March</i>, and can now
pronounce many Words and short Sentences.</p></div>
</div>


<h2><a name="INCONTINENCY" id="INCONTINENCY"></a>OF AN<span class='pagenum'><a name="Page_223" id="Page_223">[223]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%"><span class="smcap">Incontinency</span> of <span class="smcap">Urine</span>.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">A</span>n</span> Incontinency of Urine was another
Complaint frequent among the Soldiers;
but it seemed to me to be counterfeited
by many. All, who had it, said that they had
received some Hurt<a name="FNanchor_96_96" id="FNanchor_96_96"></a><a href="#Footnote_96_96" class="fnanchor">[96]</a> or Sprain of the Back,
<span class='pagenum'><a name="Page_224" id="Page_224">[224]</a></span>or a Kick from a Horse, or that a Carriage
had run over them.</p>

<p><span class='pagenum'><a name="Page_225" id="Page_225">[225]</a></span></p><p>Those who really had the Disorder seemed
to have received such an Injury of the Bladder,
or Kidneys as required a considerable Space of
Time to get the better of; and by reason of
the short Time we had them under our Care
at the flying Hospital, they seldom received
<span class='pagenum'><a name="Page_226" id="Page_226">[226]</a></span>much Benefit. One or two thought they grew
better on taking the Bark and Balsam of <i>Peru</i>;
at the same Time they bathed Morning and
Evening the lower Part of the Abdomen and
Perin&aelig;um, with Flannels dipped in gentle
astringent Liquors, applied cold. Blisters applied
to the <i>os sacrum</i> had no Effect.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_96_96" id="Footnote_96_96"></a><a href="#FNanchor_96_96"><span class="label">[96]</span></a> A Soldier in the Hospital at <i>Paderborn</i> used to discharge
his Water involuntarily, and mixed with Pus, which came from
some violent Blows he had received on the Back.
</p><p>
<i>John Pearce</i>, a young Man about eighteen Years of Age,
was admitted into <i>St. George</i>&#8217;s Hospital, the 10th of <i>April</i>
1759, for a Pain of his Side, and a Complaint of the Bladder.
The Account which he gave of his own Case was, that, some
Months before, he had received a violent Blow with a Cricket-Bat
on the left Side, on the Region of the Kidney; and that
ever since he had had a sharp Pain in that Part, and sometimes
had a Stoppage of Urine, and at other Times it came away
insensibly. His Pulse was rather quick, but low, and he had
a feverish Heat. He at first took some cooling Medicines;
but on the 20th, being low and faint, he had some of the
f&#339;tid Julep. On the 23d he was attacked with a sharp Pain
in the Belly and Side, had a Stoppage in making Water,
a quick and full Pulse, and most of the Symptoms of the
Stone. He was ordered to be blooded immediately, to take
the saline Draughts every four Hours; and as he was inclined
to be costive, to take as much lenitive Electuary as to
procure him a loose Stool; and it was recommended that he
should be sounded as soon as the Violence of the Fever was
over. On the 25th he continued much in the same Way, and
had made some Water, which was intolerably f&#339;tid. Half a
Drachm of the dulcified Spirit of Nitre, and five Drops of the
<i>tinctura thebaica</i>, were added to each of his Draughts, as the
Pain and Difficulty of making Water had increased. On the
26th his Pulse rose, and became very hard and quick; the Pain
in his Side, and the Dysuria, became more violent; and about
Twelve o&#8217;Clock he had a convulsive Fit, resembling that of an
Epilepsy; after coming out of the Fit, as the Fever and Pain
had increased, he was blooded; the Belly was fomented and
embrocated, and he took the oily Draughts four Times a-Day;
his Blood immediately threw up a very thick Buff. He remained
pretty easy the rest of the Day; but about the same
Time next Day, he had another convulsive Fit, and died.
</p><p>
On opening his Body, we found about two or three Pints of
a dark-coloured f&#339;tid Water in the Abdomen; on cutting
through, and squeezing the right Kidney, there came out a
thin purulent Matter every where from its Substance, though
it appeared sound; on raising and cutting through the Peritoneum,
covering the left Kidney, there was a Discharge of about
a Pint of black and very f&#339;tid Water, which had every where
surrounded this Kidney; and there were six mortified Spots
on its Surface, as large as the End of one&#8217;s Finger, with a
Depression in each about a Quarter or Half an Inch deep;
most of the Substance of this Kidney seemed diseased, and it
was full of Suppurations. The Bladder was contracted and
thickened, and contained a rough Stone, which weighed three
Ounces. The rest of the <i>viscera</i> were sound. This Stone had
certainly been in the Bladder long before the young Fellow
received the Blow with the Cricket-Bat; but the Injury done
the Kidney had probably aggravated the Symptoms.
</p><p>
I do not remember ever to have seen convulsive Fits, such as
this young Man had, in acute Diseases, except in one Case of
a slow Fever, which came by taking Cold after a Salivation,
and which I attended, along with Dr. <i>Pringle</i>. The Gentleman
had three Fits exactly of the same kind as this young
Man, at twenty-four Hours Distance from one another, and
he died of the third.</p></div>
</div>


<h2><a name="STOPPAGE" id="STOPPAGE"></a>OF A<span class='pagenum'><a name="Page_227" id="Page_227">[227]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%"><span class="smcap">Stoppage</span> of <span class="smcap">Urine</span>.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">W</span>e</span> formerly mentioned, that in acute
Diseases many complained of a Stoppage
or Difficulty of making Water; and<span class='pagenum'><a name="Page_228" id="Page_228">[228]</a></span>
others had this Complaint from Strictures of
the Urethra, or Disorders of the Bladder or
Kidneys<a name="FNanchor_97_97" id="FNanchor_97_97"></a><a href="#Footnote_97_97" class="fnanchor">[97]</a>.</p>

<p>Where it depended on Strictures of the Urethra,
Bougies introduced into that Passage,
<span class='pagenum'><a name="Page_229" id="Page_229">[229]</a></span>and worn for some Time, were of great Service.
The Patients were at the same time ordered
<span class='pagenum'><a name="Page_230" id="Page_230">[230]</a></span>to live on a cool Diet, and to drink the
<i>decoctum Arabicum</i>, or an Infusion of Linseed,
or such other mild mucilaginous Liquors;<span class='pagenum'><a name="Page_231" id="Page_231">[231]</a></span>
and to take oily Medicines and Opiates
occasionally, and gentle Laxatives, to keep the
Body open; which Method of Treatment generally<span class='pagenum'><a name="Page_232" id="Page_232">[232]</a></span>
gave Relief. Where the Patients were
plethoric, or complained of Pain, or the Disorder<span class='pagenum'><a name="Page_233" id="Page_233">[233]</a></span>
was attended with a Fever, Bleeding was
often necessary.</p>

<p>When the Stoppage of Urine seemed to<span class='pagenum'><a name="Page_234" id="Page_234">[234]</a></span>
arise from an Inflammation of the Kidneys or
Bladder, or other Diseases of these Parts, we
treated it accordingly; and where the Fever
was considerable, we made Evacuations, and<span class='pagenum'><a name="Page_235" id="Page_235">[235]</a></span>
gave plenty of diluting Liquors, and the cooling
saline Medicines, and afterwards those of
the soft, mucilaginous, and oily Nature, and<span class='pagenum'><a name="Page_236" id="Page_236">[236]</a></span>
mild Diuretics and Opiates.</p>

<p>When the Disorder, in its Progress, became
chronical, the Sick were commonly sent down
to the fixed Hospital, so that we had no Opportunity
of examining the Bodies of such as
might die of this Complaint.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_97_97" id="Footnote_97_97"></a><a href="#FNanchor_97_97"><span class="label">[97]</span></a> It is often very difficult to judge of the Cause, or to be
able to determine exactly the Seat of these Disorders before
Death; as the following Cases will shew.
</p><p>
<i>John Waden</i>, a middle-aged Man, was admitted into <i>St.
George</i>&#8217;s Hospital the 10th of <i>April</i> 1759, for a Swelling of
the Abdomen, and a Difficulty of making Water, which he
said begun about two Months before, with a violent Pain in
his Back and Belly, occasioned by his being employed in making
of Cyder in a very cold Cellar. He had not had a Stool
for some Days: at first he took a Dose of Physic, and some of
the saline Draughts; but in a Day or two complained that his
Belly had grown to a monstrous Size, and that he had not
made Water for above twenty-four Hours; on examining, we
found the Bladder so much distended as to reach up to the Navel;
and upon a Catheter&#8217;s being introduced, above two
Quarts of Water were drawn off, and the Swelling immediately
subsided; but in the Afternoon was as large as before,
the Bladder seeming to be in a paralytic State. During the
Months of <i>May</i> and <i>June</i>, his Water was drawn off twice a-Day;
he had his Belly fomented with emollient, astringent,
and other Decoctions, and embrocated with Liniments; was
blooded once when feverish, took Cordials, the Bark, Myrrh,
and a Variety of Medicines, without any Effect. On the 3d
of <i>July</i>, a flexible Catheter was introduced into the Bladder,
and left there, in order that the Urine might drain away as fast
as it was secreted, and the Bladder be allowed to contract, and
recover its Tone. The Catheter gave him no Pain, and he
thought himself much easier by the Bladder&#8217;s never being too
much stretched; but on taking out the Catheter some Days
after, he had the same Stoppage of Water as before. On consulting
with Dr. <i>Batt</i> and the other Physicians, it was agreed
to give two Grains of the Powder of Cantharides, with three
Grains of Camphor and ten of Sugar, rubbed well together in
a Mortar, twice a-Day; and to continue the Use of the flexible
Catheter. He found no Uneasiness or Strangury from the
Use of the Cantharides, and thought he passed his Water more
freely, when the Catheter was taken out; but after fourteen
Days, finding no Change for the better, and being free from
any Fever, he was ordered into the cold Bath; the two first
Days he found himself more lively and brisk; but the third
Day was chilly and cold after coming out of it, and therefore
was desired to leave it off; some Days after he became hectic,
and I observed Pus in his Water, which he said he had passed
with his Urine for above three Months; after this he languished
for near a Month, and died upon the 25th of <i>August</i>.&mdash;Upon
examining his Body next Day, we found the thoracic
Viscera in a sound State, except that the Lungs adhered a little
on the right Side. Both Kidneys were diseased; they were
inflamed, and seemed enlarged; and on cutting them, had
Tubercles dispersed every where through their Substance,
which had come to Suppuration, and contained a good deal of
Matter; the lower Part of the left Kidney was mortified, and
contained two or three Ounces of a black f&#339;tid Liquor. The
Bladder of Urine was contracted, and its Coats greatly thickened,
and the internal Coat much inflamed; and there was a
Cyst full of Matter, about Half the Size of a Walnut, between
the muscular and villous Coats, towards the lower Part of the
right Side of the Bladder; and there were two large Cysts,
containing a small Quantity of Matter, though capable of containing
near two Ounces each; one situated between the <i>vesicul&aelig;
seminales</i> and Rectum, the other between the <i>vesicul&aelig;</i> and
Bladder, which opened into the Urethra by one common Orifice,
capable of admitting a large Quill, at the Side of the <i>caput
galinaginis</i>. The rest of the Viscera were in a sound State.
</p><p>
<i>Mary Hibbard</i>, a Woman twenty-four Years of Age, was
admitted into <i>St. George</i>&#8217;s Hospital, the 6th <i>June</i> 1759, for a
Complaint of her Bladder. The Account she gave of herself
was, that, about <i>Christmas</i> 1758, she had parted with some
Gravel; and about fourteen Days before coming to the Hospital,
she was seized with a violent Pain in her Back and Loins,
attended with a Sickness and Nausea; and very soon after
complained of a violent Pain in the lower Part of her Belly,
and with a perpetual Inclination to make Water, though she
felt a sharp Pain and Difficulty in doing it; and that these
Complaints still remained. Her Pulse was quick and strong,
and she was inclined to be costive. She was immediately
blooded, took the oily Draughts three Times a-Day, the <i>decoctum
furfuris</i> for common Drink, and so much lenitive Electuary
as procured her a Stool next Day. As there was a strong
Suspicion of her having a Stone, she was sounded; but nothing
at all was to be felt in the Bladder. Her Medicines eased her
Pain in making Water, but not the Pain in her Back. On the
16th her Water was thick and turbid, and deposited a brown
Sediment; and the Difficulty in making Water still remained;
instead of the lenitive Electuary she was ordered the Rhubarb oily
Draught to be taken every Night. On the 18th, there being no
Change in her Disorder, she had Draughts made of an Ounce
and a Half of simple Mint Water, Half a Drachm of the dulcified
Spirit of Nitre, and five Drops of the <i>tinctura thebaica</i>, and
Syrup three Times a-Day; but on the 22d she complained, that since
she left off the oily Medicines, her Pain and Difficulty in making
Water had grown worse; she was therefore ordered the
saline and oily Draughts alternately, and to take the Rhubarb
oily Draught occasionally when costive, which removed these
Complaints; and they did not return while she remained in
the House; but on the 4th of <i>July</i>, the Day before she was to
have been discharged as cured, she was attacked with a sharp
Pain in her Hip and Loins, and about the <i>os coccygis</i>; which
increased till the 9th, and extended itself all along the Outside
of the right Thigh; it was most acute about the <i>os coccygis</i>;
but on examining, nothing was to be observed externally:
This Pain continued more or less all that Month, and till
the End of the next, and so obstinate as not to be altered by
bleeding, and the Use of Liniments, Blisters, cooling Medicines,
Opiates, warm Baths, and other Remedies. On the
20th of <i>August</i>, a strengthening Plaister was applied to her
Back, which gave immediate Relief, and she was discharged
cured the 29th. She continued well till <i>October</i>, when she was
attacked with a violent Fever at <i>Hounslow</i>, and was brought to
the Hospital on the 24th of that Month, and the tenth Day of
the Fever. She died the 3d of <i>November</i>. During the Course
of the Fever, she only complained once of a Difficulty of making
Water.&mdash;After Death I had her Body opened, when the
only Thing particular which we could observe, was the urinary
Bladder about four times the natural Size; it seemed to
be flaccid, and in a State of Relaxation; the Kidneys were
sound, and no Signs of any Distemper could be observed about
the Uterus or Rectum, or near the <i>os coccygis</i>.&mdash;When she was
first in the Hospital, I desired her always to examine her Urine;
but she never observed that she passed any Sand, Gravel,
or any thing of that kind.
</p><p>
<i>Thomas Jacey</i>, an elderly Man, was admitted into <i>St. George</i>&#8217;s
Hospital the 14th of <i>March</i> 1759, for a Pain in his Back, and
a Difficulty and Pain in making Water, which was often mixed
with grumous Blood; but he had never observed any Sand or
Gravel in it. His Pulse was quick and full, attended with Heat
and Thirst; and he was inclined to be costive; he was at first
blooded, and took a Dose of laxative Mixture, and two Ounces
of the Tincture of Roses, four Times a Day, and the <i>decoctum
malv&aelig;</i> for common Drink. At first he seemed relieved,
and passed no grumous Blood for some Days; but on the 26th,
as he complained much of a Pain in making Water, the Tincture
of Roses was changed for the oily Draughts, and he was
ordered the Rhubarb oily Draught occasionally. On the 9th
of <i>April</i> he fell suddenly into a comatose Way, and remained so
till the 12th, when he died, notwithstanding the Use of divers
Remedies.&mdash;Upon examining his Body, both Kidneys were
found in a sound State; the Intestines covered with slight inflammatory
Spots, the Bladder of Urine quite contracted,
schirrhous, and greatly thickened; and its internal Surface
rough and eroded, with one or two black Spots on it, and some
grumous Blood lying on its Surface. The other viscera were
sound.
</p><p>
In Ulcers of these Organs, the natural Balsams, mixed with
soft Things, are often of great Service; of which the following
Case is an Example.&mdash;<i>William Lumley</i>, a Boy nine Years
of Age, was admitted into <i>St. George</i>&#8217;s Hospital, the 6th of
<i>September</i> 1759, for a Pain in the Bladder, and a Difficulty in
making Water, which was always more or less mixed with
Matter. At first there was a Suspicion of his having the
Stone; but on sounding, none was to be found. From the
Symptoms, it appeared as if there was an Ulcer in the Bladder
near to its Neck; the Boy had a Cough, was very low,
and inclined to be costive; at first he took three Spoonfuls of
the Sperma Ceti Mixture four Times a-Day, and a Dose of
Physic; but the Symptoms still remaining, on the 2d of <i>October</i>
he was ordered to take a Scruple of the <i>electuarium e
spermate ceti</i> three or four Times a Day, and to have the Gum-Arabic
Decoction for his common Drink. By continuing the
Use of these Things, and taking some opiate and laxative Medicines
occasionally, he mended by slow Degrees, and all his
Symptoms went off; and he recovered his Health and Strength,
and returned Thanks for his Cure the 18th of <i>January</i> 1760.
</p><p>
The following Account of a remarkable Suppression of Urine
I had in a Letter, dated the 25th of <i>November</i> 1757, from Mr.
<i>Pearson</i>, one of the Surgeons to his Majesty&#8217;s Military Hospitals,
who then served as a Mate.
</p><p>
<i>James Ruffendal</i>, aged Twenty, of a delicate Habit, was, in
the Middle of <i>July</i> last, seized with a violent Pain in both
Kidneys, which extended along the Ureters to the Bladder, and
remained in the same Situation for about three Weeks; during
which Period his Urine began to decrease in Quantity, and the
voiding of it was attended with acute Pain about the Neck of the
Bladder. The Secretion then totally stopt; he remained for upwards
of five Weeks in the Hospital at <i>Dorchester</i>, and made no Water;
at the End of which Time I first visited him along with
Mr. <i>Adair</i>. He complained then of a slight Pain in his Kidneys,
and told us he had a tolerable Appetite, sweated little,
and voided every Day four or five Liquid Stools. He was ordered
Boluses of Camphor, and <i>sal. vol. c. cervi</i>, and every
Night a Dose of <i>tinctura cantharidum</i>; which he continued to
take for a Fortnight without receiving the least Benefit. I
then blooded him to the Quantity of ten Ounces, and gave
him an Emetic of six Drachms of the <i>vinum ipecacoanh&aelig;</i>, and
two Ounces of the Oxymel of Squills, which operated very
well; and afterwards ordered him to take one of the following
Boluses every four Hours. &#8478; Sapon. dur. Hispan. drachm. i.
Sal. Absynth. gr. vi. Calc. Viv. gr. x. Balsam. Peruv. q.&nbsp;s.
ut fiat Bolus. These he continued to take for twelve Days.
On the Morning of the 14th of <i>October</i>, he was suddenly seized
with an acute Pain in both Kidneys, and about Noon
voided upwards of Half a Pint of straw-coloured Urine, which
let fall a clay-coloured Sediment. As he was feverish, I took
away twelve Ounces of Blood, and ordered him Barley-Water
with Nitre for Drink. He was easy in the Night, and made
upwards of two Pints of Urine, which deposited a Sediment of
a gelatinous Consistence. Next Morning the Pain increased,
especially in his Right Side, and ten Ounces more of Blood
was taken away. This lowered the Pulse, and considerably
abated the Pain. Both this and the Blood taken away the
Day before threw up an inflammatory Buff. He was ordered
to continue the Use of the Barley Water with Nitre, and to
take three Spoonfuls of a Mixture with <i>spiritus mindereri</i> every
two Hours. He had an easy Night, and was next Day free
from Fever; but complained of an Uneasiness in his Stomach
and Nausea. He was ordered a Scruple of the Powder of Ipecacoanha,
which vomited him, and procured him a Stool. He
was easy in the Night; but in the Morning was hot, and complained
of a Pain in his Right Kidney, and all over his Bones,
as he expressed it. I then gave him a Mixture, with <i>spiritus
mindereri</i>, and the <i>pulvis contrayerva comp.</i> of which I desired
him to take some Spoonfuls frequently. This procured him
a plentiful Sweat, which removed the Fever and Pain: these
Symptoms returned next Day, but were removed by the same
Means. I remained at <i>Dorchester</i> for a Week after, and he recovered
his Strength and Appetite as much as could be expected
in so short a Time; but he still complained of Pain in
his Right Kidney, tho&#8217; he made Water freely. By a Letter I
received from the Gentleman whose Care I left him under, I understood
he had a Relapse, which he has since got the better of.
</p><p>
I forgot to inform you, that his Father died of the same
Complaints, after being six Months without secreting a Drop
of Urine; and his Brother died of the same in about ten
Weeks.</p></div>
</div>


<h2><a name="EPILEPSY" id="EPILEPSY"></a>OF THE<span class='pagenum'><a name="Page_237" id="Page_237">[237]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%">EPILEPSY.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>he</span> Epilepsy, or Falling Sickness, attacked
a Number of Men, from the
severe Duty of long Marches in hot Weather,
and afterwards lying out on the cold Ground,
exposed to the Damps of the Night<a name="FNanchor_98_98" id="FNanchor_98_98"></a><a href="#Footnote_98_98" class="fnanchor">[98]</a>.</p>

<p>It was very seldom that Men were cured of
this Disorder in the military Hospitals. We
had some few Instances, indeed, where Relief
seemed to be obtained by Rest, a regular
<span class='pagenum'><a name="Page_238" id="Page_238">[238]</a></span>Diet, gentle Evacuations, and Issues<a name="FNanchor_99_99" id="FNanchor_99_99"></a><a href="#Footnote_99_99" class="fnanchor">[99]</a>; but
even those Men generally relapsed as soon as
<span class='pagenum'><a name="Page_239" id="Page_239">[239]</a></span>they were sent to their Regiments, and began
to do Duty. All who had these Fits after
being some Time with their Regiments, were
at last discharged, and sent home. However,
before Men are discharged for Fits, they should
be watched very narrowly for some Time; for
there is no Disorder which Soldiers are more
apt to counterfeit than this.</p>

<p>It is no Wonder that Soldiers, during the
Time of Service, should seldom be cured of
these Fits; for in Adults it is not often cured
<span class='pagenum'><a name="Page_240" id="Page_240">[240]</a></span>even in private Practice, with all the Conveniencies
and Advantages to be wished
for; and generally the few that do get well,
require a considerable Length of Time to accomplish
the Cure; and we find from daily
Experience, as well as from examining the
Records of Medicine, that the Cures that have
been made, have mostly been performed either<span class='pagenum'><a name="Page_241" id="Page_241">[241]</a></span>
by a Change of Air, such as going from a cold
to a hot Climate<a name="FNanchor_100_100" id="FNanchor_100_100"></a><a href="#Footnote_100_100" class="fnanchor">[100]</a>, by some remarkable
Change of Life<a name="FNanchor_101_101" id="FNanchor_101_101"></a><a href="#Footnote_101_101" class="fnanchor">[101]</a>, or some accidental Disorder;<a name="FNanchor_102_102" id="FNanchor_102_102"></a><a href="#Footnote_102_102" class="fnanchor">[102]</a>
or by Issues or Drains<a name="FNanchor_103_103" id="FNanchor_103_103"></a><a href="#Footnote_103_103" class="fnanchor">[103]</a>; or by the
Removal of some acrid or irritating Substance,
or such like<a name="FNanchor_104_104" id="FNanchor_104_104"></a><a href="#Footnote_104_104" class="fnanchor">[104]</a>; or by preventing the
Cause<a name="FNanchor_105_105" id="FNanchor_105_105"></a><a href="#Footnote_105_105" class="fnanchor">[105]</a>; and that those Medicines called
Specifics have in general had but little Share in<span class='pagenum'><a name="Page_242" id="Page_242">[242]</a></span>
the Cure.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_98_98" id="Footnote_98_98"></a><a href="#FNanchor_98_98"><span class="label">[98]</span></a> I saw above twenty Men, while I was in <i>Germany</i>, who
attributed the Epileptic Fits they were attacked with to these
Causes, and said they had never had the Epilepsy before; besides
others, who had been formerly subject to these Fits, who
declared, that the Disorder was brought back by the same
Means.</p></div>

<div class="footnote"><p><a name="Footnote_99_99" id="Footnote_99_99"></a><a href="#FNanchor_99_99"><span class="label">[99]</span></a> <i>William Wilson</i>, a Boy fourteen Years of Age, was admitted
into <i>St. George</i>&#8217;s Hospital, <i>Sept.</i> 20, 1758, for Epileptic
Fits, which he had been subject to for some Time, and which
generally seized him three or four Times a Week. He took
Variety of Medicines without any Effect till the 6th of <i>November</i>,
when I ordered him to take eight Grains of the <i>pilul&aelig; f&#339;tid&aelig;</i>
Morning and Evening, and Physic twice a Week, and a
Seton to be made in his Neck. After the Seton began to run,
he had but three or four slight Fits in <i>November</i>, and none the
following Month; and he was discharged the Hospital the 3d
of <i>January</i> 1759, seemingly in good Health, with Directions to
keep the Seton running at least for some Months after he went
home, and to come again to the Hospital if he should have any
Return of his Fits; but we never heard more of him.
</p><p>
<i>Mary Hacket</i>, a Girl of nineteen Years of Age, was admitted
into <i>St. George</i>&#8217;s Hospital the 14th of <i>February</i> 1759, for Fits.
The Account she gave of her Case, was, that about five Years
before she was seized with the first Fit, after a Fright; three
Years afterwards she had a second Fit, and for some Time after
had a Fit commonly once a Month, about the Time of the
full Moon; and since had them more frequently; that the Fits
began with a Trembling and Shaking of the right Foot, and
she had frequent pricking Pains in the right Thigh, and what
she called convulsive Tremors in the right Leg and Foot. She
was regular in her menstrual Discharge. At the Time she
came into the Hospital, she was feverish, and complained much
of a sharp Pain in the right Thigh: She was blooded, and took
some cooling Medicine, and had no Fit till the 9th of <i>March</i>:
She then took the fetid Pills and camphorated Julep twice a
Day; but still the Fits returned frequently. She then had
the Bark, Valerian and Purging Doses successively, and used
the warm Bath; but without any Effect. On the 7th of <i>May</i> a
Blister was applied to her right Foot, which was intended to
be kept open; but an Inflammation coming on that Leg and
Foot, it was suffered to dry up, and an Issue made in the same
Leg. From the Time the Blister was applied, she had no Fit
while she remained in the Hospital. She was discharged the
15th of <i>July</i>, seemingly in good Health; though during that
Period she had some little Tremors in her Foot, and was subject
to be low and faintish, which was always relieved by cordial
anodyne Medicines. After going out of the Hospital, she
remained in good Health for seven or eight Months, when I was
told her Disease had returned as violent as ever.</p></div>

<div class="footnote"><p><a name="Footnote_100_100" id="Footnote_100_100"></a><a href="#FNanchor_100_100"><span class="label">[100]</span></a> <i>Hippocrates</i> lays the chief Stress of the Cure upon Change
of Air, Aphor. 4, 5, sect. ii. The Baron <i>Van Swieten</i> says, he has
known a great Number cured by going to the <i>East Indies</i>; many of
whom have remained well ever after, while others had a Return
of the Disorder when they came back to <i>Holland</i>. <i>Comment.</i>
vol. III. p. 436. sect. 1080.</p></div>

<div class="footnote"><p><a name="Footnote_101_101" id="Footnote_101_101"></a><a href="#FNanchor_101_101"><span class="label">[101]</span></a> <i>Celsus</i> has long ago observed, that the Appearance of the
Menses in Girls, and of Puberty in Boys, often removes this
Disorder, lib. iii. cap. xxiii.&mdash;On the 22d of <i>November</i> 1758,
<i>Mary Evans</i>, a Girl of eighteen Years of Age, was admitted
into <i>St. George</i>&#8217;s Hospital for Fits. She had never had the
Menstrua; but, for above two Years, found regularly, once a
Month, a Fulness in her Breasts, and had a slight Head Ach,
and other Symptoms which generally precede this Discharge;
and were succeeded with violent Epileptic Fits, which continued
returning frequently for two or three Days, and then went
off; and she had no more Symptoms of them, till about the
same Time next Month. She was ordered to take ten Grains
of the <i>pilul&aelig; f&#339;tid&aelig;</i> Morning and Evening, and a Dose of Physic
twice a Week; and as I found that she became plethoric
near the Time her Fits used to return, I began to imagine, that
both the Fits and Stoppage of the Menstrua were owing to too
great a Fullness of the Vessels, which prevented the Heart and
vascular System from having such free Play, as to drive the
Blood through the extreme uterine Vessels: I therefore ordered
seven Ounces of Blood to be taken away from her immediately.
In three Days Time the menstrual Discharge began to make its
Appearance; and on the 10th of <i>January</i> she was discharged
the Hospital, seemingly in good Health, after the menstrual
Discharge had returned for two regular Periods, without any
Appearance of Epileptic Fits. She was desired to come back
to the Hospital, if the Fits returned; but I never heard more
of her.</p></div>

<div class="footnote"><p><a name="Footnote_102_102" id="Footnote_102_102"></a><a href="#FNanchor_102_102"><span class="label">[102]</span></a> <i>William Glen</i>, a Patient in the <i>Royal Infirmary</i> at <i>Edinburgh</i>
in <i>September</i> 1747, was freed from Epileptic Fits, which used to
return ten or twelve Times a Day, for a Quarter of a Year, by
a Diarrh&#339;a coming on; but they afterwards returned.
</p><p>
<i>A Man</i> subject to the Epilepsy was cured of it by a Quartan
Ague, and had afterwards no Return of the Disorder. <i>Miscell.
Curios. Dec. 3. Ann. 3.</i> p. 34.</p></div>

<div class="footnote"><p><a name="Footnote_103_103" id="Footnote_103_103"></a><a href="#FNanchor_103_103"><span class="label">[103]</span></a> There are numerous Instances of the good Effects of
Issues and Drains in diverse Authors. <i>Tulpius</i>, <i>Van Swieten</i>,
&amp;c.</p></div>

<div class="footnote"><p><a name="Footnote_104_104" id="Footnote_104_104"></a><a href="#FNanchor_104_104"><span class="label">[104]</span></a> <i>La Motte</i> gives one Instance of a Person being cured of
the Epilepsy by voiding five Stones, <i>Chirurg.</i> vol. II. p. 20;
and of another who died of the Fits from a triangular Stone
remaining in the Kidneys, <i>ibid.</i> p. 416. Dr. <i>Short</i> cured a Woman
of an Epilepsy of twelve Years standing, by extirpating a
cartilagenous Substance, about the Bigness of a large Pea, seated
on the gastronemei Muscles, above a Nerve which he cut
asunder. <i>Edin. Medic. Essays</i>, vol. IV. Art. 27.</p></div>

<div class="footnote"><p><a name="Footnote_105_105" id="Footnote_105_105"></a><a href="#FNanchor_105_105"><span class="label">[105]</span></a> <i>Galen</i>, tells us, of his having prevented the Epileptic Fits
in a Boy, who used to have one whenever he was hungry, by
making him carry Bread in his Pocket, and eat a little as soon
as he found the least Symptoms of Hunger. <i>De Loc. Affect.</i>
lib. v. cap. vi.&mdash;And <i>Van Swieten</i> mentions how he cured a
Boy, who had a Fit every full Moon; whose under Lip used to
fall a Trembling before it began (a Symptom which, he says,
often precedes Vomiting); by giving a Vomit every Month,
for six Months successively, three Days before the full Moon,
and an Opiate in the Evening after its Operation; and by putting
him under a Course of strengthening Medicines. It was
observeable, that if he vomited in the Time of the Paroxysm,
it was soon at an End. See his <i>Comment.</i> vol. III. p. 439. sect.
1050.</p></div>
</div>


<h2><a name="SMALLPOX" id="SMALLPOX"></a>OF THE<span class='pagenum'><a name="Page_243" id="Page_243">[243]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%">SMALL-POX.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>he</span> Small-Pox appeared at <i>Paderborn</i>
in the Spring 1761, and five had the
distinct Kind, who recovered. Six or seven
had them at <i>Osnabruck</i> in <i>May</i> and <i>June</i>, and
one Man and a Child died of the confluent
Kind. Four had the distinct Kind at <i>Munster</i>
in <i>July</i> and <i>August</i> who all did well. During
the Winter, we had sixteen in the Hospital I
attended at <i>Bremen</i>; ten had the distinct Kind,
and all recovered; five had the confluent Kind,
of whom two died; as did also one who was
brought to the Hospital with all the Symptoms
of the most malignant Kind. Two were sent
to <i>Natzungen</i> in <i>July</i>, both ill of the confluent
Kind; the one died two Hours after his Arrival;<span class='pagenum'><a name="Page_244" id="Page_244">[244]</a></span>
the other recovered: And we had only
two in the Hospital at <i>Osnabruck</i> in Winter
1762-63, and both did well.</p>

<p>There was nothing particular either in the
Course or Treatment of this Disorder, different
from what we meet with in daily Practice;
only as the Soldiers, who were attacked with
it, were strong, and in full Health, they required
Bleeding and gentle Evacuations, and a
cooling Regimen, on the first Appearance of
the Symptoms.</p>

<p>The malignant Kind required the Use of
Acids, and the Bark; which last, could often
only be administered by Way of Clyster, as
the Sick could not swallow it: In short, we
treated the Patients much in the same Way as
in the malignant Fever, Allowance only being
made for the present Circumstances.</p>

<p>Luckily this Disorder never spread much in
the Army, while I was in <i>Germany</i>.</p>



<h2><a name="ERISYPILATOUS" id="ERISYPILATOUS"></a>OF<span class='pagenum'><a name="Page_245" id="Page_245">[245]</a></span><br />
<span class="smcap" style="letter-spacing: 0.15ex; font-size: 130%">Erisypilatous Swellings</span>.</h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">I</span>n</span> <i>January</i> 1762, several Patients in the
Hospitals I had the Care of at <i>Bremen</i>,
had shining watery Swellings of the Face, or
Extremities; which came suddenly, and were
attended with a slight Degree of Inflammation,
and watery Blisters rising above the Skin,
and some Degree of Fever. The Blisters were
not small, round, and angry, as in <i>St. Antony</i>&#8217;s
Fire; but larger, and of an irregular Figure,
resembling those raised when People are scalded
by boiling Water. The Swellings did not pit
on being pressed, as the oedematous Swellings
commonly do: They gave Pain when pressed,
but the Inflammation was not in that high
Degree as it is in the common Phlegmon:<span class='pagenum'><a name="Page_246" id="Page_246">[246]</a></span>
The Blood was sizy, and the Water of a high
Colour. The Disorder seemed to be a Species
of the Erisypelas.</p>

<p>Between the 9th and 12th of <i>January</i>, three
Patients were seized with such Swellings.</p>

<p>The first was a Dragoon, who had just recovered
from a Flux, and a bad Cough. On
the 9th, he was suddenly seized in the Night
with a large Swelling of his Face, Hands, and
Arms, which had a shining oedematous Appearance,
with a small Degree of Redness, and
was painful when pressed; and he had two or
three watery Blisters rose on the Back of each
Hand above the Division of the Fingers, attended
with a quick full Pulse, a feverish Heat
and Thirst, a Cough, and somewhat of a Difficulty
of Breathing, and high-coloured Water;
and he was inclined to be costive. He was
immediately blooded, had a saline Mixture
with Contrayerva and Nitre, and was ordered
to take a Purge in the Morning. Next Day
the Blood had thrown up an inflammatory
Buff, the Fever was abated, and the Breathing
easier; but the Cough and Swelling still remained.<span class='pagenum'><a name="Page_247" id="Page_247">[247]</a></span>
He then took a Julep made of equal
Parts of the Saline and Sperma Ceti Mixtures,
which eased the Cough. The fourth Day the
Pulse was soft, and the Swellings still in the
same Situation, and the Breathing a little affected.
A large Blister was applied to his Back,
which discharged plentifully, relieved the
Breathing, and lessened the Swellings considerably.
The Cough and some Degree of
Swelling still remained; but were removed
by the Use of the Sperma Ceti Mixture with
Oxymel, gentle Opiates, and some Doses of
Physic.</p>

<p>The second was a Man of the Twentieth
Regiment of Foot, who had been some
Months in the Hospital for a hectic Complaint;
he was taken ill, the same Night as the
Dragoon, with a Swelling of his whole Face,
particularly the Lips, which had a shining watery
Appearance, and a slight Degree of Redness,
attended with a strong Fever; and was
cured by Bleeding, Purging, the Use of the
saline Medicines, and the Application of a
Blister.<span class='pagenum'><a name="Page_248" id="Page_248">[248]</a></span></p>

<p>The third was an Invalid, who had been admitted
for a pleuritic Complaint, which he had
got the better of. He was attacked, the second
Night after the other two, with a shineing,
watery, reddish Swelling, of his right
Hand and Arm, up as far as the Joint of the
Shoulder; four large watery Bladders likewise
appeared on the fore Part of his Arm, above
the Joint of the Elbow. Bleeding, with the
cooling Medicines, and two Doses of Salts,
carried off the Fever, and lessened the Swelling,
in about seven Days Time; but a little of it,
with a Stiffness, still remained; which at last
was removed by the Use of aromatic Fomentations,
rubbing with the <i>linimentum saponaceum</i>,
and taking two Doses of Physic.</p>

<p>Within less than a Fortnight, five or six
more were seized with Swellings of the same
Kind on some of the Extremities, and all got
well by nearly the same Treatment; excepting
one Man, who was in a very low State,
and had a large deep Ulcer on his Hip, where
there had been a Mortification from his lying
on that Part in a Fever. The Swelling at first<span class='pagenum'><a name="Page_249" id="Page_249">[249]</a></span>
seemed to give Way; but on the third or
fourth Day, having got a severe Cough, the
Swelling increased, and the Inflammation began
to look livid, and the Discharge from the
Sore to look bad; and, notwithstanding various
Means were used, a Mortification of the Part
came on, and he died the seventh Day.</p>



<h2><a name="SCURVY" id="SCURVY"></a>OF THE<span class='pagenum'><a name="Page_250" id="Page_250">[250]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%">SCURVY.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>he</span> true Scurvy, attended with spungy
fetid Gums of a livid Colour, with livid
Blotches, and Ulcers of the Legs, and other
Symptoms, began to shew itself at <i>Bremen</i> in <i>January</i>
1762; tho&#8217; we had not the least Appearance
of this Disorder in the Hospitals at any
other Place, while I was with the Troops in
<i>Germany</i>.</p>

<p>A great Variety of Disorders have been called
by the Name of Scurvy: and the Disease has
been divided into hot and cold; into the Acid,
the Alcaline; and the Muriatic, according to the
different Fancies of Authors, and the Causes
they imagined it took its Rise from; but, from
later and more accurate Observations, Dr. <i>Lind</i><span class='pagenum'><a name="Page_251" id="Page_251">[251]</a></span>
has justly remarked, that the true Scurvy has
been found to be the same in all the different
Parts of the Globe, and to take its Rise from
similar Causes; from Cold and Moisture, and
living much upon salted Provisions, joined to
a Want of fresh Vegetables, and of good generous
fermented Liquors; and hence it is most
frequent in low marshy Places in northern Climates,
where there is a Scarcity of fresh Vegetables;
and where the Inhabitants live much
upon salted Provisions in Winter; and aboard of
Ships in long Voyages or Cruizes, especially in
the northern Seas; and hence this Disorder
was so frequent at <i>Quebec</i> the first Winter it was
in our Possession; and in some of the other Forts
in <i>North America</i>, which were taken so late in
the Year, that the Troops had not sufficient
Time to lay in a Stock of Vegetables, and of
fresh Meat to be preserved by the Frost<a name="FNanchor_106_106" id="FNanchor_106_106"></a><a href="#Footnote_106_106" class="fnanchor">[106]</a>; but
were obliged to live mostly on Ship Provisions.</p>
<p><span class='pagenum'><a name="Page_252" id="Page_252">[252]</a></span></p>
<p>It is observed, both at Sea and Land, that
where the Scurvy rages, those People are least
subject to it who are well cloathed; who live
in dry Habitations, or lie in dry Births; who
take proper Exercise, without being too much
exposed to the Inclemency of the Weather;
and who live well, and drink good Beer, Cyder,
or Wine; as has been remarked by Dr.
<i>Pringle</i>, Dr. <i>Lind</i>, and others.</p>

<p>At <i>Bremen</i> the Disorder was only observed
among the Soldiers; not one of the Gentlemen
belonging to the Hospital, or to the Commissariate,
nor one of the military Officers, not
even of the Serjeants, having the least Symptom
of it. The Reason of its being frequent
among the Soldiers was, that the Place is situated
on a Plain naturally very damp; and the
Soldiers were quartered in very low damp
Houses; at the same Time, no Vegetables or
<span class='pagenum'><a name="Page_253" id="Page_253">[253]</a></span>Greens were to be bought in the Market; and
fresh Meat, and other fresh Provisions, were at
so high a Price, that the Soldiers could not
afford to buy them; but were obliged to live
on salted Meat, and salted Herrings, during the
Winter; and what little Money they had remaining,
they laid out on spirituous Liquors,
which were sold cheap.</p>

<p>The Cure of this Disorder requires&mdash;living
in a dry comfortable Place&mdash;good Cloathing&mdash;light
Food of easy Digestion, such as good
Bread, Panado, Milk, Whey, Broths made of
fresh Meats&mdash;white Meats, with Greens, or
other Vegetable, &amp;c.&mdash;the Use of Liquors of
the acid or acescent Kind, or the moderate Use
of Beer, Cyder, good Wine, or weak Punch<a name="FNanchor_107_107" id="FNanchor_107_107"></a><a href="#Footnote_107_107" class="fnanchor">[107]</a>&mdash;And,
by Way of Medicine, gentle Purges,
mild Diaphoretics; the free Use of acid or acescent
Fruits, Lemons, Oranges, Apples, Pears,
<span class='pagenum'><a name="Page_254" id="Page_254">[254]</a></span>Currans, Grapes, &amp;c. and of the antiscorbutic
Plants and their Juices, as Succory, Endive,
Water-Cresses, Scurvy-Grass<a name="FNanchor_108_108" id="FNanchor_108_108"></a><a href="#Footnote_108_108" class="fnanchor">[108]</a>, &amp;c. on which
a great Part of the Cure principally depends;
and the Use of some of the strengthening Bitters<a name="FNanchor_109_109" id="FNanchor_109_109"></a><a href="#Footnote_109_109" class="fnanchor">[109]</a>,
of which the Bark is not the least efficacious.</p>

<p>Bleeding is seldom requisite, except where
there is much Heat or Fever; or a sharp Pain
<span class='pagenum'><a name="Page_255" id="Page_255">[255]</a></span>of the Side, or Difficulty of Breathing, or some
Symptom of the like Kind; it is then sometimes
necessary to take away some Blood: And
in obstinate Cases, it is often found of Use to
promote Sweats, by making the Patient, while
in Bed, drink freely of warm Whey, or Sack
Whey, mixed with the scorbutic Juices; or
warm Barley Water, or the like, mixed with a
small Quantity of the Antimonial Wine, or some
other mild Diaphoretic.</p>

<p>And where the Patient is strong, and there
is no Danger of H&aelig;morrhages, warm aromatic
Baths have sometimes been found serviceable;
but they are not to be used where the
Patient is weak.</p>

<p>The first Time I saw this Disorder at <i>Bremen</i>,
was in an old Invalid, <i>James Long</i>, who
had come from <i>Bristol</i> to <i>Embden</i>, and from
thence to <i>Bremen</i>. He was some Weeks in the
Hospital before I discovered his Disorder to be
the Scurvy. He at first complained only of
great Weakness, and such a Giddiness, when
he got out of Bed, that he could not walk, and
of what he called flying rheumatic Pains of his<span class='pagenum'><a name="Page_256" id="Page_256">[256]</a></span>
Legs. He had no other visible Complaint; all
which, I imagined, proceeded from Old-Age,
and being worn out in the Service. At last,
on the 25th of <i>January</i>, he complained of his
Gums being sore; and, on examining him, I
found his Breath fetid, his Gums swelled, soft,
and spungy, his Legs covered with scorbutic
Blotches, and other Symptoms, which evidently
proved his Disorder to be the true
Scurvy.</p>

<p>Upon which, I ordered him a low Diet, with
the Addition of Greens for Dinner, and a Quart
of Lemonade, with a Gill of Brandy in it, <i>per</i>
Day, for his common Drink; and, by Way of
Medicine, a Decoction of the Bark, with the
Elixir of Vitriol; and, at the same Time, ordered
his Gums to be scarified, where they
were most swelled and spungy; and to be
washed frequently with an astringent Gargle;
and to be rubbed now and then with burnt
Alum<a name="FNanchor_110_110" id="FNanchor_110_110"></a><a href="#Footnote_110_110" class="fnanchor">[110]</a>. By these Means, in a Fortnight&#8217;s
<span class='pagenum'><a name="Page_257" id="Page_257">[257]</a></span>Time, his Gums became firmer, and his scorbutic
Symptoms decreased. During that Course
he took cold, and had a Stitch in his Side, for
which he was blooded. The Blood threw up
a very thin Buff, which was not of a firm Consistence<a name="FNanchor_111_111" id="FNanchor_111_111"></a><a href="#Footnote_111_111" class="fnanchor">[111]</a>;
the Crassamentum below was of
<span class='pagenum'><a name="Page_258" id="Page_258">[258]</a></span>a blackish Colour and of a loose Texture, and
the Serum in a large Proportion. By the 2d
of <i>March</i> his Gums had recovered their natural
Firmness and Texture, and the scorbutic
Spots and Pains of the Legs were gone, and he
had recovered his Strength; the only remaining
Complaint was a little Swelling about the
Ankles, for which he continued the same
Course, and took a Dose or two of Physic.
By the 16th of <i>March</i> all these Symptoms
were gone, and he was dismissed the Hospital
free from all Complaints. I saw him well the
last Week in <i>May</i>; and he told me, he had
had no scorbutic Symptom since he left the
Hospital.</p>

<p><span class='pagenum'><a name="Page_259" id="Page_259">[259]</a></span></p><p>In the Beginning of <i>February</i>, another of
the Invalids, who had been in the Hospital for
a Fever and rheumatic Complaints, had Blotches
appear on his Legs, complained of great
Weakness, and fainted away in attempting to
walk; which made me suspect his Disorder
to be the Scurvy; and, on examining him, I
found his Gums soft and spongy, attended with
the other Symptoms of the true Scurvy. I put
him nearly on the same Course as in the last-mentioned
Case: He used a low Diet, with the
Addition of Greens for Dinner, which he eat
with a little Butter and Vinegar; and he had
a Quart of Lemonade, with two Ounces of
Brandy, for his common Drink during the
Day; and, by Way of Medicine, a Decoction
of the Bark, with two Drachms of the <i>confectio
cordiaca</i> to each Half Pint, which he took
by Spoonfuls. Next Day he complained of a
Pain in his Leg; and, on examining it more
particularly, I found a large livid Blotch, yellow
all round the Edges, on the fore Part,
and a Tension all over that Leg. As he
was so extremely low, as to be in Danger of<span class='pagenum'><a name="Page_260" id="Page_260">[260]</a></span>
fainting whenever he sat up, I was afraid lest
a Mortification should ensue; and therefore
ordered his Leg to be bathed Morning and
Evening with a warm aromatic Fomentation,
and a Poultice of Theriaca to be applied after
it; and desired him to take as much of the
Decoction of the Bark with the Cordial as possible;
and allowed him a Glass of Mountain
Wine every two or three Hours. By the
Continuance of this Course for some Weeks,
the livid Blotches, Pain, and Stiffness of his
Leg, and most of the other scorbutic Symptoms,
went away; his Gums were restored to
their natural Firmness; and he recovered his
Strength so much as to be able to sit up all
Day long; though he still remained very
weak when he was sent to <i>England</i>, in
<i>March</i>.</p>

<p>In <i>February</i> and <i>March</i>, seven or eight more
scorbutic Patients were sent to the Hospital I
attended, who were all treated in the same
Manner; and all did well. About the Middle
of <i>February</i> this Distemper began to shew itself
in the other Hospital attended by Dr. <i>Miller</i>,<span class='pagenum'><a name="Page_261" id="Page_261">[261]</a></span>
who treated the Patients nearly in the same
Way, and they all recovered.</p>

<p>On the 5th of <i>April</i>, a young Man, belonging
to the Eighth Regiment of Foot, came to
the Hospital with all the Symptoms of the true
Scurvy; his Gums were spungy and f&#339;tid; he
had livid Blotches on his Legs, and Contractions
of the Hams, and a Stiffness and Hardness
in the Calves of both Legs<a name="FNanchor_112_112" id="FNanchor_112_112"></a><a href="#Footnote_112_112" class="fnanchor">[112]</a>. By following
the same Course as the others, and the
Use of frequent Fomentations, and rubbing the
contracted Parts with soft Liniments, he mended
daily; and, after taking a Dose or two of
Physic, was dismissed perfectly recovered on
the 10th of <i>May</i>. At his first Admission into
the Hospital, he was taken with a severe Cough,
<span class='pagenum'><a name="Page_262" id="Page_262">[262]</a></span>attended with Pain of the Breast, and a Spitting
of Blood for a Day or two, for which he
was blooded. His Blood threw up a little
Buff; the Crassamentum was of a blackish Colour
and of a loose Texture, with a good Proportion
of a yellowish Serum. This Bleeding
relieved the Complaints of his Breast, and he
had no Return of them while he remained in
the Hospital.</p>

<p>The first Week in <i>May</i> four Invalids were
admitted into the Hospital for this Disorder.
The first had spungy Gums, a f&#339;tid Breath,
his Legs swelled and hard, and of a deep purple
Colour. The second was a Case at first of
a more doubtful Kind; there were no spungy
Gums, though an offensive Breath; his Ancles
and Feet were swelled, attended with Pain and
Uneasiness, and a great Weakness and Lassitude;
but no Fever, nor any livid Blotches.
The Swelling of the Feet and Ancles seemed
at first Sight rather gouty or rheumatic, than of
the scorbutic Kind; but from the Man&#8217;s Way
of Life, and the Disorder being so frequent, we
discovered it to be the Scurvy. The third had<span class='pagenum'><a name="Page_263" id="Page_263">[263]</a></span>
a very f&#339;tid Breath and spungy Gums, livid
Spots and fungous Ulcers<a name="FNanchor_113_113" id="FNanchor_113_113"></a><a href="#Footnote_113_113" class="fnanchor">[113]</a> on his Legs, with
Pains and Weakness all over. The fourth had
also spungy Gums and a f&#339;tid Breath, Pains of
the Legs and Arms, livid Blotches on his Legs,
great Hardness and Contraction of the right
Ham, and a livid hard Swelling on the Outside
of the left Thigh, immediately above the
Knee.</p>

<p>We treated them all four in the Method
above-mentioned, adding a Mess of Greens to
<span class='pagenum'><a name="Page_264" id="Page_264">[264]</a></span>Dinner, giving Lemonade for Drink, and the
Bark, with Elixir of Vitriol, by Way of Medicine.
The Parts that were hard and swelled,
were fomented, and rubbed with soft Liniments,
and Poultices were applied to the hard
Swelling on the Outside of the left Thigh; and
the Ulcers of the Legs dressed with Digestives,
and occasionally washed with spirituous Tinctures,
and touched with Escharotics. Before
I left <i>Bremen</i>, the first Week in <i>June</i>, the first
and second Patients were perfectly recovered,
and the third and fourth almost well. All of
them had had the Disorder some Months before
they came to the Hospital.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_106_106" id="Footnote_106_106"></a><a href="#FNanchor_106_106"><span class="label">[106]</span></a> In <i>Quebec</i>, and other northern Parts of <i>North America</i>, as
soon as the Frost sets in, they kill their Meat intended for their
Winter Store, and hang it up: It soon freezes, and will keep
in this Manner all through the Winter. They preserve Vegetables
in the same Way; and when they intend to make Use of
either, they put so much as they want into cold Water for some
Time, which draws the Frost out of it; and then they boil or
roast it, as they think proper.</p></div>

<div class="footnote"><p><a name="Footnote_107_107" id="Footnote_107_107"></a><a href="#FNanchor_107_107"><span class="label">[107]</span></a> The free Use of raw Spirits is found to be very prejudicial;
but a moderate Quantity of these Spirits, diluted with
Water, and acidulated with Lemons or Oranges (or with Cream
of Tartar, or Tamarinds, when the former cannot be got), and
made into Punch, is found to be a good Antiscorbutic.</p></div>

<div class="footnote"><p><a name="Footnote_108_108" id="Footnote_108_108"></a><a href="#FNanchor_108_108"><span class="label">[108]</span></a> Most ripe Fruits, particularly Lemons and Oranges, and
esculent Herbs, and many Kinds of Roots, such as Horse-Radish,
Onions, Leeks, and many others, have been found the most
useful Remedies in the Cure of the Scurvy. Decoctions and
Infusions of Fir-Tops, of Spruce, and of other Species of the
Pine-Tree; and Beer made of these Infusions, by fermenting
them with Molasses, are approved Antiscorbutics: and when
such Remedies cannot be got, Infusions of the common Bitters,
and weak Punch, made with Tamarinds or Cream of Tartar,
have proved serviceable; and where these Acids cannot be had,
the Mineral Acids may be used for acidulating the Drink.
However, it ought always to be remembered, that fresh Vegetables
and Fruits, and vegetable Acids, produce much better
Effects in the Scurvy, than any other Sorts of Remedies; and
ought always to be used, when they can be got.</p></div>

<div class="footnote"><p><a name="Footnote_109_109" id="Footnote_109_109"></a><a href="#FNanchor_109_109"><span class="label">[109]</span></a> Most of the common Bitters have been strongly recommended
in this Disorder, Gentian, Trifoil, Wormwood, &amp;c.&mdash;as
likewise aromatic Bitters and Aromatics; such as <i>calamus
aromaticus</i>, Carvi Seeds, Winters Bark, Cinnamon, and many
others.</p></div>

<div class="footnote"><p><a name="Footnote_110_110" id="Footnote_110_110"></a><a href="#FNanchor_110_110"><span class="label">[110]</span></a> Dr. <i>Lind</i>, who has wrote one of the best Treatises on this
Disorder, and who had a great Deal of Practice himself, says,
&#8220;When first the Patient complains of an Itching and a Spunginess
of the Gums, with loose Teeth, either a Tincture of
the Bark in Brandy, or aluminous Medicines, will be found
serviceable in putting a Stop to the Beginning Laxity of
these Parts.&#8221; When the Putrefaction increases, he recommends
the Use of some of the mineral Acids. See his <i>Treatise
on the Scurvy</i>, part ii. chap. v. p. 201.&mdash;<i>Van Swieten</i> says, he
never found any Thing answer better than a Gargle made of
four Ounces of Elder or Rose Water, acidulated with a Drachm
of the Spirit of Sea Salt; and where the Gums were very putrid
and gangrened, he has been obliged to touch them slightly
with the pure Acid Spirit, and some Hours after to have them
washed with the Gargle just mentioned. Vide <i>Comment.</i> vol. III.
p. 629, sect. 1163.
</p><p>
If the Spunginess of the Gums sprout out into a luxuriant
Fungus, it is sometimes requisite to cut such Funguses away,
and to wash the Sores frequently with gentle astringent or acid
Liquors.</p></div>

<div class="footnote"><p><a name="Footnote_111_111" id="Footnote_111_111"></a><a href="#FNanchor_111_111"><span class="label">[111]</span></a> Dr. <i>Huxham</i> observes, that, after the Disease has continued
some Time, the Blood appears a mere Gore as it were, not separating
into Serum and Crassamentum as usual, but remaining
an uniform half-coagulated Mass, generally of a more livid or
darker Colour than common; though sometimes it continues
long very florid; but it always putrifies soon. See his <i>Essay on
Fevers</i>, chap. v.
</p><p>
There is something very particular in the Nature of this
Disorder, according to an Observation of Dr. <i>Lind</i>&#8217;s; who
says, &#8220;That the Scurvy is a Disease in its Nature very opposite
to that of a Fever; insomuch, that even an Infection
is long resisted by a scorbutic Habit; and those of a scorbutic
Habit being seized with the Fever, was a Proof of its
proceeding entirely from Infection.&#8221; See his <i>First Paper on
Fevers</i>, p. 4.</p></div>

<div class="footnote"><p><a name="Footnote_112_112" id="Footnote_112_112"></a><a href="#FNanchor_112_112"><span class="label">[112]</span></a> If the Swellings become large, stiff, and painful, Dr.
<i>Lind</i> recommends that the Legs should be frequently bathed
and fomented; or, what he has found preferable, to be exposed
to their Steams, after being well covered with Blankets.
After this Operation, he advises the Limb to be rubbed with
some mild Oil, such as <i>oleum palm&aelig;</i>, or Salad Oil; and if the
Swellings resist both the general Cure and these Applications,
the Limbs to be sweated with Spirits. See his <i>Treatise on the
Scurvy</i>, part ii, chap. v.</p></div>

<div class="footnote"><p><a name="Footnote_113_113" id="Footnote_113_113"></a><a href="#FNanchor_113_113"><span class="label">[113]</span></a> &#8220;Ulcers on the Legs, or any other Part of the Body,
require pretty much the same Treatment, <i>viz.</i> very gentle
Compression, in order to keep under the Fungus, and such
antiseptic Applications as have been recommended for putrid
Gums, <i>viz. mel rosat.</i> acidulated with <i>spiritus vitrioli</i>,
<i>ung. &AElig;giptiacum</i>, &amp;c. but nothing will avail where the Patient
cannot have Vegetables and Fruits.&#8221; <i>Dr. Lind&#8217;s Treatise
on Scurvy</i>, part ii. chap. v. p. 204. And he recommends,
if the Swellings and Ulcers of the Legs neither yield to the general
Cure nor to the Methods here proposed, that a slow and
gentle Course of Mercury should be tried, after the scorbutic
Taint is a good deal removed, and the Gums are sufficiently
firm; and to give along with it a Decoction of the Woods, or
of Sarsaparilla; but this Method ought not to be attempted till
the Gums have acquired a proper Firmness. See <i>ibid.</i> part ii.
chap. v.</p></div>
</div>


<h2><a name="ITCH" id="ITCH"></a>OF THE<span class='pagenum'><a name="Page_265" id="Page_265">[265]</a></span><br />
<span style="letter-spacing: 0.15ex; font-size: 130%">ITCH.</span></h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>here</span> was no Disorder so common in
the military Hospitals as the Itch. It
is of an infectious Nature, and now most commonly
believed to be entirely owing to little
Insects lodged in the Skin, which many Authors
affirm they have seen in the Pustules by
the Help of a Microscope; and that the Disorder
is entirely communicated by Infection, and
does not arise from any Fault in the Fluids or
Solids.</p>

<p>It has been found by Experience, that internal
Medicines have little or no Effect in removing
this Disorder; and that only external
Remedies, which come immediately in contact
with the Parts affected, are capable of making a<span class='pagenum'><a name="Page_266" id="Page_266">[266]</a></span>
Cure; which has been brought as a farther
Proof, that the Itch is owing to Animalcules or
Insects; as it is alledged, that no Remedies will
cure the Distemper, but such as are capable of
killing them.</p>

<p>The Medicines, which are most commonly
used for the Cure, are <i>Mercury</i>, <i>White Helebore</i>,
and <i>Sulphur</i>.</p>

<p>Mercurial Frictions on the Part are often
made use of, and sometimes with Success,
though they are by no Means to be depended
upon for a Cure; besides that, they are liable
to throw the Patients into a Salivation, as I
have seen happen more than once; for which
Reasons I would never recommend this Method
where the Patient labours under no other
Disorder which requires the Use of Mercury,
and would confine it entirely to Cases where
Patients, having the Itch, labour, at the same
Time, under the <i>Lues venerea</i>, and require the
free Use of mercurial Frictions; under such
Circumstances the mercurial Ointment may be
as well rubbed on the Parts affected with the
Itch as upon any other.<span class='pagenum'><a name="Page_267" id="Page_267">[267]</a></span></p>

<p>The Powder of the Root of <i>White Helebore</i>,
made up into an Ointment with Hogs Lard,
or a strong Decoction of it in Water, rubbed
on the Parts, will often cure the Itch; but it is
a sharp Medicine, and generally smarts, and
sometimes inflames the Parts on which it is
rubbed; and therefore it is not so commonly
used, as we know a much surer and milder
Remedy. Though I have cured some People
with the Helebore Lotion without any Inconvenience,
who would not use the Sulphur on
Account of its Smell.</p>

<p><i>Sulphur</i> is the most certain and easy Cure
for the Itch of any we know, and perhaps is
more certain in the Cure of this Disorder than
almost any other Medicine in any other Disorder
whatever. We used it in Form of the
Sulphur Ointment of the <i>London Dispensatory</i>,
of which one, two, or more Drachms were
rubbed in every Night, in Proportion to the
Extent of the Parts affected. These Unctions
were continued from four or five to ten or
twelve Nights, according to the Violence and
Continuance of the Disorder. Most were cured<span class='pagenum'><a name="Page_268" id="Page_268">[268]</a></span>
in a few Days; others required a longer Time.
As the sulphureous Unctions tend to obstruct
the Perspiration, we generally ordered a Purge
to be given before rubbing the Sulphur Ointment,
and in full Habits sometimes ordered a
little Blood to be taken away; and put them
all under a low Diet. After the Disorder
seemed to be removed, they took another Dose
or two of Physic to carry off any Impurities
that might have been thrown upon the Bowels,
during the Use of the Sulphur Ointment. In
inveterate Cases, the Sulphur was given internally
at the same Time that the Patient rubbed
with the Ointment.</p>

<p>It is generally believed (though denied by
some) that Sulphur, taken internally, enters the
Blood; and its Steams are thrown off by the
perspiratory Vessels, and assists more effectually
to destroy the Insects and their Ovula, which
give Rise to the Itch; but whether this Effect
be true or not, I found it to answer another
very good Purpose; which was to keep the
Belly rather loose, while the Patient used the
Unction; and by this Way it carried off those<span class='pagenum'><a name="Page_269" id="Page_269">[269]</a></span>
Humours, which ought to have passed off by
the Skin; and for that Reason, when it had
not that Effect, we joined some Lenitive Electuary
to it.</p>

<p>There is one Thing to be observed with
regard to sulphureous Unctions, which is, that
we ought not to use them too soon with People
recovering out of Fevers, or other Disorders
which bring them low; otherwise there
will be Danger of bringing on a Relapse, which
I have often observed to happen in military
Hospitals, where the Itch has appeared as the
Patients were recovering from Fevers and other
Disorders, and the Unctions were used too
soon: But whether these Relapses were owing
to the sulphureous Unction&#8217;s stopping up the
Pores of the Skin, and obstructing a free Perspiration,
or to the Patient&#8217;s being more apt to
take Cold while they used the Sulphur Ointment,
than at any other Time, is what I cannot
determine; but to me it seems most probable,
that these Unctions rather obstruct the
Perspiration; and that when they are used too
soon with People recovering from Fevers, especially<span class='pagenum'><a name="Page_270" id="Page_270">[270]</a></span>
those of the putrid Kind, they prevent
those Particles from passing off by the Skin,
which it was necessary should be evacuated, in
order to free the Body from the Seeds of the
Fever, or other Disorders the Patients laboured
under. But however this be, Experience has
shewn, that we ought not to attempt the Cure
of the Itch, in Patients so circumstanced, till
their Strength be in a great Measure re-established,
otherwise there will be Danger of a
Relapse; and likewise, that Patients using Sulphur
externally, ought to be particularly on
their Guard against Cold.</p>

<p>This Observation of Peoples being so apt to
relapse after Fevers by the too early Use of sulphureous
Unction, is a strong Proof of the Usefulness
of keeping the Body open during the
Time of Rubbing and of Purging the Patient
afterwards; as by these Means we may carry
off by the Bowels those Particles which could
not pass by the Skin; and I think, so far as I
have been able to observe, those People have
been less subject to relapse into Fevers where
this Caution has been used, than where it has
been neglected.<span class='pagenum'><a name="Page_271" id="Page_271">[271]</a></span></p>

<p>That Species of the Itch where it forms
small Ulcers or Pustules in the Skin, is the
worst Kind, and most contagious, and seems to
take its Rise from the common Itch continuing
long, and making its Way deeper into the
Skin. The Cure is the same, only this requires
more frequent Unctions, and those to be continued
longer, than before the Disorder has taken
such deep Root.</p>

<p>It is no uncommon Thing to see the Itch
appear again, some Weeks after it has seemingly
been cured by the Use of sulphureous Unctions;
which most commonly happened to those who
were in too great a Hurry to get well, and left
off the Use of the Unctions too soon. Such
Returns of the Itch were generally cured by
the Repetition of the same Treatment as before.<span class='pagenum'><a name="Page_272" id="Page_272">[272]</a></span></p>



<h2><span style="letter-spacing: 0.15ex; font-size: 130%"><a name="TABLE_of_DIET" id="TABLE_of_DIET"></a>TABLE of DIET.</span><span class='pagenum'><a name="Page_273" id="Page_273">[273]</a></span></h2>


<p class="negative">The following is a Copy of the Table of Diet
which was used in the Hospital all the Time
I was with the Troops in <i>Germany</i>:</p>

<table summary="diet" class="diet">

<tr><td>&nbsp;</td><td style="text-align: center"><i>Breakfast.</i></td><td style="text-align: center"><i>Dinner.</i></td><td style="text-align: center"><i>Supper.</i></td></tr>

<tr><td style="width: 12%; border-right: solid black 1px">Full Diet,</td>
<td style="width: 25%; border-right: solid black 1px">One Pint of Rice Gruel;
made with two Ounces of
Rice, one Spoonful of fine
Flower, a little common
Salt, and fine Sugar.</td>
<td style="width: 25%;  border-right: solid black 1px">One Pound of Meat.</td>
<td style="width: 25%">As Breakfast.</td></tr>

<tr><td colspan="4" style="line-height: 1%; border-bottom: solid black 1px">&nbsp;</td></tr>
<tr><td colspan="4" style="line-height: 1%">&nbsp;</td></tr>

<tr><td style="width: 12%; border-right: solid black 1px">Middle Diet,</td>
<td style="width: 25%; border-right: solid black 1px">As above.</td>
<td style="width: 25%;  border-right: solid black 1px">One Pint of Broth, Half a Pound of Meat.</td>
<td style="width: 25%">As above.</td></tr>

<tr><td colspan="4" style="line-height: 1%; border-bottom: solid black 1px">&nbsp;</td></tr>
<tr><td colspan="4" style="line-height: 1%">&nbsp;</td></tr>

<tr><td style="width: 12%; border-right: solid black 1px">Low Diet,</td>

<td style="width: 25%; border-right: solid black 1px">As above, or according to the Patient&#8217;s Stomach or Indisposition.</td>

<td style="width: 25%;  border-right: solid black 1px">One Pint of Broth; or Half a Pint of Panado, with two Spoonfuls of Wine, and a
Quarter of an Ounce of fine  Sugar.</td>

<td style="width: 25%">As Breakfast.</td></tr>
</table>

<p>The daily Allowance of Bread was a Pound<span class='pagenum'><a name="Page_274" id="Page_274">[274]</a></span>
to those on full and middle Diet, and Half a
Pound to those on low Diet, or a Pound, if so
ordered by the Physician.</p>

<p>Those on full and middle Diet were allowed
daily three Pints of Barley or Rice Water;
to each Pint of which were added two Spoonfuls
of Brandy, and a Quarter of an Ounce of
Lump Sugar. Small Beer was mentioned in
the Diet Table; but this we could never have
good; and therefore was not used.</p>

<p>Those on low Diet were allowed Barley or
Rice Water; to which some Wine or Brandy
was occasionally added, if ordered so by the
Physician.</p>

<p>Besides this, the Physician might order an
additional Quantity of Wine, Brandy, or Milk,
or Water Gruel, or any other Articles which
he thought proper for the Sick under his Care,
and which could be got easily.</p>



<h1 style="padding-top: 2em"><a name="PHARMACOPOEIA" id="PHARMACOPOEIA"></a>PHARMACOP&#338;IA<span class='pagenum'><a name="Page_275" id="Page_275">[275]</a></span><br />

<span style="font-size: 60%">IN USUM</span><br /><br />

Nosocomii Regii Militaris<br />
Britanici.<br /><br />

<span style="font-size: 50%">MDCCLXI.</span><span class='pagenum'><a name="Page_276" id="Page_276">[276]</a></span></h1>



<h2><a name="PHARMA" id="PHARMA"></a><span style="font-size: 130%; letter-spacing: 0.15ex">PHARMACOP&#338;IA</span><span class='pagenum'><a name="Page_277" id="Page_277">[277]</a></span><br />

IN USUM<br />

Nosocomii Regii Militaris.<br />

Ann. <span class="smcap">Mdcclxi.</span></h2>


<h3>AQU&AElig; SIMPLICES ET SPIRITUOS&AElig;.</h3>

<div class="blockquot">
<p class="newchapter"><span class="firstword"><span class="dropcap">A</span>qua</span> Alexeteria.<br />
&mdash;&mdash; Bacc. Juniperi.<br />
&mdash;&mdash; Cinnamomi.<br />
<span style="padding-left: 2.4em">&mdash;&mdash; Menth&aelig; vulgaris.</span><br />
<span style="padding-left: 2.4em">&mdash;&mdash; Menth&aelig; piperitidis.</span><br />
<span style="padding-left: 2.4em">&mdash;&mdash; Nucis moschat&aelig;.</span><br />
<span style="padding-left: 2.4em">&mdash;&mdash; Pulegii.</span><br />
<span style="padding-left: 2.4em">&mdash;&mdash; Rut&aelig;.</span><br />
</p>
</div>

<div class="blockquot">
<p>Vel ali&aelig; aqu&aelig; hujus generis pr&aelig;parari possint,
terendo in mortario vitreo elaeosacchara
pr&aelig;parata, cum oleis essentialibus, et sacchari
albi 12<sub>la</sub> quantitate; et dein addendo aqu&aelig;<span class='pagenum'><a name="Page_278" id="Page_278">[278]</a></span>
fontan&aelig; vel spiritus vini tenuis quantitatem sufficientem<a name="FNanchor_114_114" id="FNanchor_114_114"></a><a href="#Footnote_114_114" class="fnanchor">[114]</a>.</p>
</div>

<p class="recipe">Aqua calcis simp. Ph. Lond.</p>

<div class="blockquot"><p>Dosis a lib. i. ad lib. ij. in die.</p></div>

<p class="recipe">Aqua Hordeata. Ph. Lond.</p>

<div class="blockquot"><p>Utenda pro potu.</p></div>


<h3>BOLUS.</h3>

<p class="recipe">Bolus anodynus astringens.</p>

<div class="blockquot"><p>&#8478; Theriac&aelig; andromachi, drachm. dimid.
opii, gr. i.&nbsp;M. pro dosi semel vel bis die.</p></div>

<p class="recipe">Bolus e rheo cum mercurio.</p>

<div class="blockquot"><p>&#8478; Pulv. rhei, gr. xxv. calomel, gr. v. syrup
sacchari, q.&nbsp;s.</p></div>

<p class="recipe">Bolus e calomel.</p>

<div class="blockquot"><p>&#8478; Calomel gr. v. conserv. rosar. scrup. i.&nbsp;M.</p></div>

<p class="recipe">Bolus mercurialis.<span class='pagenum'><a name="Page_279" id="Page_279">[279]</a></span></p>

<div class="blockquot"><p>&#8478; Argenti vivi, gr. x. extingue in balsam
copaivi, q.&nbsp;s. et adde conserv. rosar. q.&nbsp;s.</p></div>

<p class="recipe">Bolus e scordio cum rheo.</p>

<div class="blockquot"><p>&#8478; Elect. e scordio, scrup. i. pulv. Rhei, gr.
x. syrup, q.&nbsp;s. ut fiat bolus sumendus semel,
bis, terve die.</p></div>


<h3>COLLYRIA.</h3>

<p class="recipe">Collyrium saturninum.</p>

<div class="blockquot"><p>&#8478; Sacchari saturni, salis ammoniaci crudi
ana gr. vi. solve in aq. fontan&aelig;, unc. xij. adde
pro re nata tinct. thebaic&aelig;, drachm. i.</p></div>

<p class="recipe">Collyrium vitriolicum.</p>

<div class="blockquot"><p>&#8478; Vitrioli albi, drachm. ss. solve in aq. fontan&aelig;,
lib. i.</p></div>

<div class="blockquot"><p>Confectio cardiaca. Ph. Lond.</p>

<p>Conserva cynosbat. Ph. Lond.</p>

<p>Conserva rosar. Ph. Lond.<span class='pagenum'><a name="Page_280" id="Page_280">[280]</a></span></p></div>


<h3>DECOCTA.</h3>

<p class="recipe">Decoctum album. Ph. Lond. utendum pro potu.</p>

<p class="recipe">Decoctum arabicum.</p>

<div class="blockquot"><p>&#8478; Gum. arabici, unc. dimid. coque in aq.
hordeat&aelig; bullientis, lib. ij. ad solutionem Gummi.
utend. pro potu.&mdash;addi possit pro re nata
spirit. nitri dulcis, drachm. ij.</p></div>

<p class="recipe">Dococtum corticis Peruviani.</p>

<div class="blockquot"><p>&#8478; Cort. Peruv. crass. pulv. unc. i. coque in
aq. fontan. lib. iij. ad lib. ij. Colatur&aelig; adde
tinct. cort. Peruv. unc. i. spirit vini Gallici sescunc.
Dosis ab uncia i. ad unc. iv. bis ter.
quaterve die.</p></div>

<p class="recipe">Decoctum cort. cum serpentaria.</p>

<div class="blockquot"><p>Fit addendo decocto cort. Peruv. sub sinem
coctionis, rad. serpentari&aelig; virgin. contus.
unc. dimid. Dosis ab unc. i. ad unc. iij. ter quaterve
die.</p></div>

<p class="recipe">Decoct. commun. pro clyster.</p>

<div class="blockquot"><p>&#8478; Flor. vel herb. cham&aelig;mel. unc. i. coque
in aq. fontan. lib. i.ss. ad lib. i. &amp; cola.<span class='pagenum'><a name="Page_281" id="Page_281">[281]</a></span></p>
</div>

<p class="recipe">Decoctum ligni guaiaci.</p>

<div class="blockquot"><p>&#8478; Ligni guaiaci ras. lib. ss. aq. fontan&aelig; bullientis,
cong. ij. macera per noctem; mane
coque ad congium. i. &amp; cola; Capiat a lib. ss.
ad lib. ij. die.</p></div>

<p class="recipe">Decoctum nitrosum.</p>

<div class="blockquot"><p>&#8478; Coccinel. scrupul. i. coque in aq. fontan.
lib. ijss. ad lib. ij. &amp; dein adde salis nitri,
unc. i. sacchar. albi sescunc. Colatur&aelig; addi
possit pro re nata aq. alicujus spirit. unc.
ij. Dosis ab unc. i. ad unc. iv. 4<sup>tis</sup> vel 6<sup>tis</sup>
horis.</p></div>

<p class="recipe">Decoctum pectorale.</p>

<div class="blockquot"><p>&#8478; Fol. herb. malv&aelig;, unc. ij. feminum lini,
unc. dimid. coque in aq. fontan. lib. ivss. ad
lib. iv. addendo sub finem coctionis rad glycyrrhiz
sescunc. vel mellis optimi, unc. i. Cola pro
potu.&mdash;Adde pro re nata aceti, sescunc.</p></div>

<p class="recipe">Decoctum rad. sarsaparill&aelig;.</p>

<div class="blockquot"><p>&#8478; Rad. sarsaparill&aelig;, unc. iij. coque in aq.
fontan. lib. iij. ad lib. ij. adde sub finem coctionis
ligni sasafras, drachm. i. rad. glycyrrhiz&aelig;,<span class='pagenum'><a name="Page_282" id="Page_282">[282]</a></span>
drachm. ij. Colatur&aelig; capiat a lib. i. ad lib. ij.
in die.&mdash;Adde pro re nata vini antimonialis,
drachm. ij.</p></div>


<h3>ELECTARIA.</h3>

<p class="recipe">Elect. astringens balsamicum.</p>

<div class="blockquot"><p>&#8478; Specier. e scordio, pulv. e tragacanth.
comp. ana unc. i. tinctur&aelig; thebaic&aelig;, drachm.
ij. syrup sacchari, q.&nbsp;s. ut fiat elect. Dosis ad
molem N.&nbsp;M. bis, ter. quaterve in die.</p></div>

<p class="recipe">Elect. corticis Peruviani.</p>

<div class="blockquot"><p>&#8478; Pulv. cort. Peruv. unc. iv. syrup sacchari,
q.&nbsp;s. Dosis a scrup. i. ad drachm. unam, bis,
ter, 4<sup>r</sup>. 6<sup>ties</sup>. vel decies die.</p></div>

<p class="recipe">Elect. corticis anodynum.</p>

<div class="blockquot"><p>&#8478; Elect. cort. Peruv. unc. 1<sup>nam</sup>. elect. e
scordio unciam dimidiam, vel tinct. thebaic&aelig;
scrup. ij.</p></div>

<p class="recipe">Elect. corticis astringens.</p>

<div class="blockquot"><p>&#8478; Elect. cort. Peruv. semunc. pulv. rad.
tormentil, lapidis cancror. pp<sup>t</sup>. singulorum,
drachm. i. syrup, q.&nbsp;s.<span class='pagenum'><a name="Page_283" id="Page_283">[283]</a></span></p></div>

<p class="recipe">Elect. cort. cum serpentaria.</p>

<div class="blockquot"><p>&#8478; Elect. cort. Peruv. unc. i. pulv. rad. serpentar.
virgin. cort. canel. alb. ana, drachm ij.
syrup. q.&nbsp;s.</p></div>

<p class="recipe">Elect. cort. cum sale ammoniac.</p>

<div class="blockquot"><p>&#8478; Elect. cort. Peruv. sescunciam. sal. ammon.
crud. drachm. i.</p></div>

<p class="recipe">Elect. e baccis lauri. Ph. Lond.</p>

<p class="recipe">Elect. lenitiv. Ph. Lond.</p>

<p class="recipe">Elect. lenitivum cum sulphure.</p>

<div class="blockquot"><p>&#8478; Elect. lenitiv. lib. ss. flor. sulphuris, unc.
ij. Dosis, moles, N.&nbsp;M. vel ad semunc. pro
re nata.</p></div>

<p class="recipe">Elect. lenitivum compositum.</p>

<div class="blockquot"><p>&#8478; Elect. lenitiv. lib. i. pulv. jalap. unc. i.
sal. nitri, drachm. ij. syrup. q.&nbsp;s. Dosis a drach.
i. ad drach. iv. pro r.&nbsp;n.</p></div>

<p class="recipe">Elect. lenitivum balsamicum.</p>

<div class="blockquot"><p>&#8478; Elect. lenitiv. comp. unc. ij. bals. copaiv.
unc. i. gum guaiac. unc. ss. M. Dosis, cochleare
the&aelig;, h.&nbsp;s. vel mane &amp; vesperi.<span class='pagenum'><a name="Page_284" id="Page_284">[284]</a></span></p></div>

<p class="recipe">Electuar. e scordio vel diascordium. Ph. Lond.</p>

<p class="recipe">Elect. e spermat. ceti.</p>

<div class="blockquot"><p>&#8478; Balsam Peruv. unc. i<sup>m</sup>. misce optime
cum mucilag. gum arab. sescunciam &amp; adde
spermat. ceti, conserv. rosar. ana unc. xij. syrup
sacchar. q.&nbsp;s. dosis, a dimidi&acirc; drachma bis
die ad drachm. i<sup>m</sup>. quater vel sexties die.</p></div>

<p class="recipe">Elect. stomachicum.</p>

<div class="blockquot"><p>&#8478; Conserv. cynosbat. unc. iv. pulv. rad. zinziber.
drachm. ij. canell. alb. unc. i. rubigin.
martis, drachm. ij. syrup. q.&nbsp;s. dosis a scrup. i.
bis terve die ad semidrach. 4<sup>tis</sup> horis.</p></div>

<p class="recipe">Elect. e scammon. Ph. Lond.</p>


<h3>ELIXIR.</h3>

<p class="recipe">Elix. aloes. Ph. Lond.</p>

<p class="recipe">Elix. paregoricum. Ph. Lond.</p>

<p class="recipe">Elix. vitrioli acid. Ph. Lond.<span class='pagenum'><a name="Page_285" id="Page_285">[285]</a></span></p>


<h3>ENEMATA.</h3>

<p class="recipe">Enema commune laxativ.</p>

<div class="blockquot"><p>&#8478; Aq. fontan. calid. unc. xij. elect. lenitiv.
semunc. sal. cathartici amari, unc. i.&nbsp;M.</p></div>

<p class="recipe">Enema commun. oleos.</p>

<div class="blockquot"><p>&#8478; Aq. fontan. bullient. unc. x. mucilag. gum
arabic. unc. i<sup>m</sup>. olei olivar. unc. ij. adde pro re
nata elect. e scord. drachm. ij. vel. tinct. thebaic.
drachm. i.</p></div>

<p class="recipe">Enema ex amylo.</p>

<div class="blockquot"><p>&#8478; Aq. fontan. calid. unc. iv. gelatin. amyli,
unc. v. elect. e scord. drachm. i.&nbsp;M.</p></div>

<p class="recipe">Enema terebinth.</p>

<div class="blockquot"><p>&#8478; Terebinth commun. drachm. vi. solve in
vitello ovi &amp; adde enemat. oleos. unc. x.</p></div>

<p class="recipe">Emplastrum vesicatorium. Ph. Lond.</p>


<h3>FOTUS.</h3>

<p class="recipe">Fotus communis.</p>

<div class="blockquot"><p>&#8478; Fol. malv. flor. cham&aelig;mel. singulorum,
m.&nbsp;i. coque in aq. fontan. q.&nbsp;s.<span class='pagenum'><a name="Page_286" id="Page_286">[286]</a></span></p></div>

<p class="recipe">Fotus commun. spirit.</p>

<div class="blockquot"><p>&#8478; Fotus commun. lib. ij. aceti, lib. i. spirit.
vini tenuis, lib. ss. M. pro fotu.</p></div>

<p class="recipe">Fotus cum sale ammoniac.</p>

<div class="blockquot"><p>&#8478; Fotus commun. lib. ij. sal ammoniac crud.
unc. i.</p></div>

<p class="recipe">Fotus volatilis.</p>

<div class="blockquot"><p>&#8478; Fotus commun. q.&nbsp;s. asperge panno statim
ante applicationem spiritus sal. ammoniac,
q.&nbsp;s.</p></div>


<h3>GARGARISMATA.</h3>

<p class="recipe">Gargarisma commune.</p>

<div class="blockquot"><p>&#8478; Aq. hordeat. unc. xij. sal. nitri, drachm. i.
mellis semunc. M. adde pro re nata spirit. vin.
unciam i.</p></div>

<p class="recipe">Gargarisma acidum.</p>

<div class="blockquot"><p>&#8478; Aq. hordeat. unc. xij. spirit. vini gallici,
unc. i. aceti sescunc. tinct. myrrh&aelig;, drachm. ij.
M.</p></div>

<p class="recipe">Gargarisma volatile.</p>

<div class="blockquot"><p>&#8478; Aq. hordeat. unc. xij. spirit. vin gallic.
unc. ij. sal. vol. ammoniaci, drachm. i.&nbsp;M.<span class='pagenum'><a name="Page_287" id="Page_287">[287]</a></span></p></div>


<h3>GUTT&AElig; ANTIMONIALES ANODYN&AElig;.</h3>

<div class="blockquot"><p>&#8478; Vini antimonialis, unc. i<sub>m</sub> tinct. thebaic.
drachm. ij. dosis a gutt. 30 ad 40 bis terve die,
vel a gutt. 60 ad 140, h.&nbsp;s. in potu tepido.</p></div>


<h3>HAUSTUS.</h3>

<p class="recipe">Haustus simplex.</p>

<div class="blockquot"><p>&#8478; Aq. fontan. sescunc. spirit. vini gallici
drachm. i. ss. sacchar alb. drachm. dimidiam
M.&mdash;Haustus pr&aelig;parari possit aqua aliqua simp.
et spirit. loco aq fontan. &amp; spirit. vini gallici
pro re nata.</p></div>

<p class="recipe">Haustus anodynus.</p>

<div class="blockquot"><p>&#8478; Haust. simp. sescunc. tinct. thebaic. gutt.
xx. M.</p></div>

<p class="recipe">Haustus camphoratus.</p>

<div class="blockquot"><p>&#8478; Camphor&aelig;, gr. iij. tere in mortario cum
sacchar. alb. drach. dimid. &amp; dein adde mucilag.
gum arabici, drachm. ij. haust. simp. sescunciam.
M.&nbsp;s. a. Dosis repetenda, 4<sup>ta</sup> vel 6<sup>ta</sup>. quaque
hora.<span class='pagenum'><a name="Page_288" id="Page_288">[288]</a></span></p></div>

<p class="recipe">Haust. emetic. antimonialis.</p>

<div class="blockquot"><p>&#8478; Vini antimonialis semunciam. Dari possit
ad drachm. x. pro r.&nbsp;n.</p></div>

<p class="recipe">Haust. emeticus scilliticus.</p>

<div class="blockquot"><p>&#8478; Oxymel. scillit. drachm. x. aq. fontan.
semunc. pulv. rad. ipecacoan. gr. vi.</p></div>

<p class="recipe">Haustus cardiacus.</p>

<div class="blockquot"><p>&#8478; Haust. simp. sescunciam confect. cardiac.
scrup. i<sup>m</sup>. M.&nbsp;f. haustus repetendus 4<sup>tis</sup>. vel 6<sup>tis</sup>.
horis&mdash;adde pro re nata sp. lavend. comp. dr. i.</p></div>

<p class="recipe">Haustus cardiacus oleosus.</p>

<div class="blockquot"><p>&#8478; Ol. essential. menth. gutt. ij. tere in mortario
vitreo cum sacchar. alb. drachm. dimid. &amp;
adde haust. simplicis sescunc. tinct. stomachic.
drachm. i.&nbsp;M.&mdash;adde pro re nata tinctur. thebaic.
gutt. x.</p></div>

<p class="recipe">Haustus lixiviosus anodynus.</p>

<div class="blockquot"><p>&#8478; Haust. simp. sescunciam, lixivii tartari,
drachmam dimidiam tinctur&aelig; thebaic&aelig;, gutt.
xx. cap. h.&nbsp;s. vel mane &amp; vesperi.<span class='pagenum'><a name="Page_289" id="Page_289">[289]</a></span></p></div>

<p class="recipe">Haustus e mithridatio.</p>

<div class="blockquot"><p>&#8478; Haust. simp. sescunc. mithridat. scrup. i.
aceti vin. drachm. iij. dosis repetenda 4<sup>tis</sup>. vel
6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Haustus oleosus communis.</p>

<div class="blockquot"><p>&#8478; Mucilagin. gum arabici, drachm, iv. ol.
olivar, drachm. v. misce s.&nbsp;a. &amp; adde haust.
simp. sescunciam. Repet. 4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Haustus oleosus cum rheo.</p>

<div class="blockquot"><p>&#8478; Haust. oleos. communis, unc. ij. tinct.
rhei sescunc. vel pulv. rhei, gr. xxv. tinct. thebaic.
gutt. xv. M. fiat haustus sumendus vel h.&nbsp;s.
vel primo mane.</p></div>

<p class="recipe">Haustus purgans.</p>

<div class="blockquot"><p>&#8478; Infus. sen&aelig;. unc. iij. sal. glauber. drachm.
iij. spirit. vin. gallici, drachm. ij. sacchar. alb.
drachm. dimid. capiat mane.</p></div>

<p class="recipe">Haustus salinus communis.</p>

<div class="blockquot"><p>&#8478; Aceti vinosi vel succ. limonum semunciam,
sal. absynth. scrup. i. vel ad saturationem, haust.
simp. sescunciam adde pro re nata pulv. contrayerv.<span class='pagenum'><a name="Page_290" id="Page_290">[290]</a></span>
comp. scrup. i. vel pulv. contrayerv. cum
nitro, scrup. ij.&mdash;Haustus pr&aelig;parari possit cum
salis diuretici drachma dimid. loco acidi &amp; salis
absynthii. Dosis repetend. 3<sup>tiis</sup>. 4<sup>tis</sup>. vel 6<sup>tis</sup>.
horis&mdash;Eodem modo sit haustus cum spirit.
mindereri uncia dimidi&acirc;.</p></div>

<p class="recipe">Haust. salin. cum confect. cardiaca.</p>

<div class="blockquot"><p>&#8478; Haust. salin. commun. unc. ij. confect.
cardiac. scrup. i.&nbsp;M. repet. 4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Haust. salin. cum mithridatio.</p>

<div class="blockquot"><p>&#8478; Haust. salin. commun. unc. ij. mithridatii,
scrup. i.&nbsp;M. sumend. 4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Haustus salin. cum rheo.</p>

<div class="blockquot"><p>&#8478; Haust. salin. com. uncias ij. pulv. rhei, gr.
xxv. M. capiat mane.</p></div>

<p class="recipe">Haustus salin. cum phu.</p>

<div class="blockquot"><p>&#8478; Haust. salin. commun. unc. ij. pulv. rad.
valerian. sylvestris, scrup. ij. Dosis repetend.
2<sup>dis</sup>. 4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Haust. salinus succinatus.</p>

<div class="blockquot"><p>&#8478; Haust. salin. commun. unc. ij. sal succini,<span class='pagenum'><a name="Page_291" id="Page_291">[291]</a></span>
pulv. castorei singulorum, gr. x.&nbsp;H. repetend.
4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Haust. salinus purg. oleosus.</p>

<div class="blockquot"><p>&#8478; Mann&aelig; op<sup>t</sup>. semunc. olei olivar. drachm.
vi. vitelli ovi q.&nbsp;s. tere in mortario, addendo
paulatim sal cathartici amari, unc. i. solutam in
aq. fontan. calid. unc. iij. spirit. vini gallici vel
aq. alicujus spirituos&aelig;, drachm. iij. M.&nbsp;s. a pro
dosi matutino.</p></div>

<p class="recipe">Haustus volatilis.</p>

<div class="blockquot"><p>&#8478; Haust. simp. sescunciam sal. vol. c. cervi,
gr. x.&nbsp;M. H. repet. 4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.</p></div>


<h3>INFUSA.</h3>

<div class="blockquot"><p>Infusum amarum. Ph. Lond. Addi possit pro
re nata in pr&aelig;parando spirit. vini tenuis, lib. ss.
ad lib. ij. infusi. Dosis ab unc. i<sup>na</sup>. bis die ad
unc. ij. ter. die.</p></div>

<p class="recipe">Infusum raphani rusticani.</p>

<div class="blockquot"><p>&#8478; Rad. raphani rusticani, unc. ij. baccar.
juniper, unc. i<sup>nam</sup>. cort. canell. alb. drachm. ij.<span class='pagenum'><a name="Page_292" id="Page_292">[292]</a></span>
aq. fontan. bullient, lib. iv. infunde per noctem
leni calore. Colatur&aelig; adde spirit. vini gallici
unc. iv. Dosis ab. unc. i. bis terve die ad unc.
iv. 6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Infusum sen&aelig; commun. Ph. Lond.</p>


<h3>JULEPUM E MOSCHO.</h3>

<div class="blockquot"><p>&#8478; Mosch. drachmam i<sup>m</sup>. tere optime in
mortario cum sacchar. alb. drachm. iij. &amp; adde
mucilagin. gum arab. dr. iv. Haust. simp.
unc. vi. Dosis unc. ij. 4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.</p></div>


<h3>LINCTUS.</h3>

<div class="blockquot"><p>&#8478; Conserv. cynosbat. unc. iv. ol. olivar. syrup.
sacchari vel mellis ana unc. ij. adde pro re nata
spirit. vitrioli tenuis, drachm. iv. Dosis cochleare
the&aelig; urgente tussi.</p></div>


<h3>LINIMENTA.</h3>

<p class="recipe">Liniment. saponaceum. Ph. Lond.<span class='pagenum'><a name="Page_293" id="Page_293">[293]</a></span></p>

<p class="recipe">Linimentum camphoratum.</p>

<div class="blockquot"><p>&#8478; Olei olivar. unc. ij. camphor&aelig;, drachm.
ij. M.</p></div>

<p class="recipe">Linimentum volatile. Ph. Lond.</p>

<p class="recipe">Linimentum volatile commune.</p>

<div class="blockquot"><p>&#8478; Olei olivar. unc. iij. spiritus salis ammoniaci,
dr. vi. M.</p></div>


<h3>MELLA.</h3>

<p class="recipe">Mel cum borace.</p>

<div class="blockquot"><p>&#8478; Mellis optimi, unc. i. pulv. subtilissim.
boracis, dr. i.&nbsp;M.</p></div>

<p class="recipe">Mel &AElig;gyptiacum. Ph. Lond.</p>

<p class="recipe">Mel rosaceum. Ph. Lond.</p>

<p class="recipe">MITHRIDATIUM. Ph. Lond.</p>


<h3>MIXTUR&AElig;.</h3>

<p class="recipe">Mixtura acida communis.</p>

<div class="blockquot"><p>&#8478; Haust. simp. unc: viij. spirit. vitrioli tenuis,
scrup. ij. vel ad gratam aciditatem. Dosis
ab. unc. ij. ad unc iv. 4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.<span class='pagenum'><a name="Page_294" id="Page_294">[294]</a></span></p></div>

<p class="recipe">Mixtura ammoniaca.</p>

<div class="blockquot"><p>&#8478; Gum ammoniaci, drachm. i. solve in
haust. simp. unc. vi. Dosis ab. unc. i. ad unc.
ij. bis terve in die.</p></div>

<p class="recipe">Mixtura ammon. cum oxymel.</p>

<div class="blockquot"><p>&#8478; Mixt. ammoniac. unc. vi. oxymel scillit.
drachm. vi. Dosis a cochlear. i. ad unc. ii. ter.
4<sup>rve</sup>. die.</p></div>

<p class="recipe">Mixtura ammoniac. anodyna.</p>

<div class="blockquot"><p>&#8478; Mixt. ammoniac. cum oxymel. unc. vi.
tinct. thebaic. drachm. dimid. Dosis a cochlear.
i. ad iv. 4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Mixtura Campechensis.</p>

<div class="blockquot"><p>&#8478; Extract. ligni Campechensis, drachm. iij.
solve in haust. simplic. unc. vi. adde pro re nata
tinct. thebaic. gutt. xxx. vel Philon. Londinen.
drachm. i. Dosis ab. unc. i. ad unc. iij. bis,
ter, 4<sup>rve</sup>. die.</p></div>

<p class="recipe">Mixtura f&aelig;tida.</p>

<div class="blockquot"><p>&#8478; G. asaf&aelig;tid. drachm. i. solve in haust.
simp. unc. vi. Dosis ab. unc. i. ad unc. iij.
4<sup>r</sup>. die.<span class='pagenum'><a name="Page_295" id="Page_295">[295]</a></span></p></div>

<p class="recipe">Mixtura f&aelig;tida volatilis.</p>

<div class="blockquot"><p>&#8478; Mixt. f&aelig;tid. unc. vi. spirit. volat. sal.
ammon. drachm. i. Dosis ab. unc. i. ad unc.
ij. bis, ter, 4<sup>rve</sup>. die.</p></div>

<p class="recipe">Mixtura fracastorii.</p>

<div class="blockquot"><p>&#8478; Haust. simp. unc. viij. Elect. e scordio,
drachm. iv. Dosis ab. unc. i. ad unc. ij. 4<sup>tis</sup>.
vel 6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Mixtura japonica.</p>

<div class="blockquot"><p>&#8478; Haust. simp. unc. vi. Tinct. japonic.
unc. i. adde pro re nata tinct. thebaic. dr. i.</p></div>

<p class="recipe">Mixtura laxativa.</p>

<div class="blockquot"><p>&#8478; Elect. lenitiv. unc. i. Mann&aelig; semunc.
coque in aq fontan. unc. xvi. ad unc. xij. Colatur&aelig;
adde sal. cathartici amari. sescunciam.
spirit. vini gallici, unc. i. Dosis ab. unc. ij. ad
unc. xij.</p></div>

<p class="recipe">Mixtura purg. antimonial.</p>

<div class="blockquot"><p>&#8478; Elect. lenitiv. sescunc. mann&aelig; semunc.
coque in aq. fontan. unc. xx. ad unc. xvi. &amp;
dein solve tartar. emetici, gr. x. Colatur&aelig; dosis
ab. unc. i. ad unc. iv. omni hora vel omni<span class='pagenum'><a name="Page_296" id="Page_296">[296]</a></span>
2<sup>da</sup>. vel 3<sup>tia</sup>. vel 4<sup>ta</sup>. hora, donec laxetur
alvus.</p></div>

<p class="recipe">Mixtura oleosa volatilis.</p>

<div class="blockquot"><p>&#8478; Haust. simp. unc. vi. ol. olivar. unc. iij. spirit.
volatil. salis ammoniaci drachmam i<sup>nam</sup>. M.
Dosis ab. unc. i. ad unc. iij. 3<sup>tiis</sup>. vel 4<sup>tis</sup>.
horis.</p></div>

<p class="recipe">Mixtura scillitica.</p>

<div class="blockquot"><p>&#8478; Haust. simp. unc. vi. oxymel scillitic.
drachm. vi. Dosis a drachm. iv. ad unc. ij.
bis, ter, 4<sup>rve</sup>. die.</p></div>

<p class="recipe">Mixtura e spermat. ceti.</p>

<div class="blockquot"><p>&#8478; Spermat. ceti, drachm. ij. solve in vitello
ovi &amp; adde haust. simp. unc. vi. adde, pro re
nata, tinct. thebaic. scrup. ij. Dosis ab. unc. i.
ad unc. ij. 4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Mixtura e spermat. ceti cum balsamo.</p>

<div class="blockquot"><p>&#8478; Balsam. copaiv. drachm. ij. tere in mortario
cum mucilag. gum arabici, drachm. iij. &amp;
dein adde mixtur. e spermat. ceti, unc. vi. Dosis
ab. unc. i. ad unc. iij. 4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.<span class='pagenum'><a name="Page_297" id="Page_297">[297]</a></span></p></div>


<h3>MUCILAGO. G. ARABICI.</h3>

<div class="blockquot"><p>&#8478; G. arabici pulv. unc. iv. solve in aq. pur&aelig;
bullient. unc. x.</p></div>

<p class="recipe">Oxymel scillit. Ph. Lond.</p>

<p class="recipe">Philonium Londinen. Ph. Lond.</p>


<h3>PILUL&AElig;.</h3>

<p class="recipe">Pilul&aelig; f&aelig;tid&aelig;.</p>

<div class="blockquot"><p>&#8478; Gum asaf&aelig;tid. myrrh. ana drachm. i. sapon.
alb. hispan. drachm. ij. Tinct. fuliginis q.&nbsp;s.
Dosis a gr. x. ad drachm. dimid. bis terve die.</p></div>

<p class="recipe">Pilul&aelig; guaiac.</p>

<div class="blockquot"><p>&#8478; Sapon. albi hispanici semunc. gum guaiac,
scrup. iv. syrup. q.&nbsp;s. Dosis a scrup. i. ad
drachmam dimidiam bis terve die.</p></div>

<p class="recipe">Pilul&aelig; gummos&aelig;. Ph. Lond.</p>

<p class="recipe">Pilul&aelig; mercuriales.</p>

<div class="blockquot"><p>&#8478; Argenti vivi semunc. extingue in balsam.
copaiv. q.&nbsp;s. &amp; adde pulv. glycyrrhiz. gum<span class='pagenum'><a name="Page_298" id="Page_298">[298]</a></span>
guaiac. singulorum, drachm. vi. syrup. q.&nbsp;s. ut
fiat massa. Dosis a scrup. ss. ad drachmam
dimidiam semel vel bis die.</p></div>

<p class="recipe">Pilul&aelig; rufi. Ph. Lond.</p>

<p class="recipe">Pilul&aelig; saponace&aelig;. Ph. Lond.</p>

<p class="recipe">Pilul&aelig; saponace&aelig; cum rheo.</p>

<div class="blockquot"><p>&#8478; Sapon. alb. hispanici, drachm. vi. pulv.
rhei, drachm. ij. syrup. sacchari q.&nbsp;s. Dosis a
scrup. i. ad scrup. ij. bis terve die.</p></div>

<p class="recipe">Pilul&aelig; scillitic&aelig;.</p>

<div class="blockquot"><p>&#8478; Pulv. glycyrhiz. rad. scill. exsiccat ana
drachm. dimid. rad. zinziber. drachm. i. sapon.
alb. hispan. drachm. ij. syrup. q.&nbsp;s. Dosis a
gr. iv. ad. gr. xvi. bis terve die.</p></div>

<p class="recipe">Pilul&aelig; stomachic&aelig;.</p>

<div class="blockquot"><p>&#8478; Pulv. canell. alb. drachm. ij. extract. rad.
gentian. dr. i. mucilag. gum arabici q.&nbsp;s. Dosis
a scrup. i. ad drachmam dimid. bis die&mdash;adde
pro re nata rubigin. martis drachmam
dimid.<span class='pagenum'><a name="Page_299" id="Page_299">[299]</a></span></p></div>


<h3>PULVERES.</h3>

<p class="recipe">Pulvis astringens.</p>

<div class="blockquot"><p>&#8478; Pulv. canell. alb. rad. tormentill. singulorum,
drachm. i.&nbsp;M. Dosis a scrup. i. ad
drachm. i.</p></div>

<p class="recipe">Pulvis aluminosus.</p>

<div class="blockquot"><p>&#8478; Alumin. crud. terr&aelig; japonic&aelig; ana partes
&aelig;quales dosis a gr. viij. ad drachmam dimidiam.</p></div>

<p class="recipe">Pulv. anodynus Doveri.</p>

<div class="blockquot"><p>&#8478; Sal. nitri, tartari vitriolati singulorum, unc.
iv. in crucibulum candens injice, agitetur donec
deflagratio &amp; scintillatio desinat, &amp; adde opii
concisi, unc. i. &amp; in pulverem redige addendo
rad. glycyrrhiz. ipecacoanh&aelig; subtilissime pulver.
ana, unc. i. &amp; dein probe misceantur omnia.
Dosis a gr. x. ad scrup. ij. vel ad drachmam
1<sup>nam</sup>.</p></div>

<p class="recipe">Pulvis antimonialis.</p>

<div class="blockquot"><p>&#8478; Pulv. e chel. cancror. drachm. x. tartari
emetici, dr. i.&nbsp;M. fiat pulv. subtilissimus. Dosis
a gr. iij. ad gr. x. 4<sup>ta</sup>. vel 6<sup>ta</sup>. quaque hora.<span class='pagenum'><a name="Page_300" id="Page_300">[300]</a></span></p></div>

<p class="recipe">Pulvis cardiacus.</p>

<div class="blockquot"><p>&#8478; Pulv. canell. alb. drachm. i. rad. zedoari&aelig;,
drachm. ij. rad. serpentar. drachm. i.&nbsp;M. dosis
a scrup. i. ad drachm. i. 4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Pulvis cham&aelig;melinus.</p>

<div class="blockquot"><p>&#8478; Pulv. flor. cham&aelig;mel. drachm. iij. aluminis,
g. myrrh. ana drachm. i. Dosis a scrup.
i. ad scrup. ij.</p></div>

<p class="recipe">Pulv. contrayerv. comp. Ph. Lond.</p>

<p class="recipe">Pulv. contrayerv. cum nitro.</p>

<div class="blockquot"><p>&#8478; Pulv. contrayerv. comp. unc. iv. salis nitri,
drachm. i.&nbsp;M. Dosis a scrup. i. ad drachm. i.
4<sup>tis</sup>. vel 6<sup>tis</sup>. horis.</p></div>

<p class="recipe">Pulvis emeticus.</p>

<div class="blockquot"><p>&#8478; Pulv. ipecacoanh&aelig;, scrup. i. tartar emetici,
gr. ij. Dosis a gr. xi. ad gr. xxii.</p></div>

<p class="recipe">Hiera picra. Ph. Lond.</p>

<p class="recipe">Pulv. Ipecacuanh&aelig; cum opio.</p>

<div class="blockquot"><p>&#8478; Pulv. rad. ipecacoan. gr. x. opii, gr. ij.
dosis a gr. iij. ad gr. xij.<span class='pagenum'><a name="Page_301" id="Page_301">[301]</a></span></p>
</div>

<p class="recipe">Pulv. e jalapio.</p>

<div class="blockquot"><p>&#8478; Pulv. rad. jalapii, drachm. vi. rad. zinzib.
drachm. ij. Dosis a scrup. i. ad scrup. ij.</p></div>

<p class="recipe">Pulv. jalapii cum nitro.</p>

<div class="blockquot"><p>&#8478; Pulv. rad. jalap. drachm. iv. salis nitri
drachm. i<sup>m</sup>. Dosis a scrup. i. ad scrup. ij.</p></div>

<div class="blockquot"><p>Magnesia alba.</p></div>

<p class="recipe">Pulv. nitrosus.</p>

<div class="blockquot"><p>&#8478; Pulv. e chel. cancror. drachm. iij. nitri,
drachm. i.&nbsp;M. Dosis a scrup. i. ad scrup. ij.
vel ad drachmam. i.</p></div>

<p class="recipe">Pulv. nitrosus camphoratus.</p>

<div class="blockquot"><p>&#8478; Pulv. nitros, scrup. ij. camphor&aelig;, gr. v.
M. Dosis a scrup. i. ad scrup. ij.</p></div>

<p class="recipe">Pulv. nitrosus cum gum guaiac.</p>

<div class="blockquot"><p>&#8478; Sal. nitri, drachm. ij. gum guaiac. drachm.
dimid. Dosis a gr. v. ad drachm. dimid.</p></div>

<p class="recipe">Pulv. plummeri.</p>

<div class="blockquot"><p>&#8478; Calomel, sulph. aurat antimonii ana dr. ij.<span class='pagenum'><a name="Page_302" id="Page_302">[302]</a></span>
tere in mortario ut fiat pulv. subtilissimus.
Dosis a gr. ij. ad gr. x. vel ad scrup. i<sup>m</sup>.</p></div>

<p class="recipe">Pulvis stanni. Ph. Lond.</p>

<p class="recipe">Pulv. e spermat. ceti cum nitro.</p>

<div class="blockquot"><p>&#8478; Spermat. ceti, drachm. ij. sacchar. albi
sal. nitri ana unc. i<sup>m</sup>. Dosis a scrup. dimid. ad
drachmam i.</p></div>

<p class="recipe">Pulv. e tragacanth. Ph. Lond.</p>


<h3>SALES ACIDI.</h3>

<table class="salts" summary="sales acidi">
<tr><td>&nbsp;</td><td>&nbsp;</td><td style="text-align: center; line-height: 200%" colspan="2">PR&AElig;PARATIONES.</td></tr>

<tr><td rowspan="4" style="width: 5%; border-right: solid black 1px">Acida mineralis</td><td style="width: 10%; padding-left: 1em; border-right: solid black 1px">Spir. vitrioli fortis</td><td style="width: 8%; border-right: solid black 1px">&nbsp;</td><td rowspan="4" style="width: 5%; padding-left: 1em">&AElig;ther.</td></tr>
<tr><td style="padding-left: 1em; border-right: solid black 1px; width: 10%">&mdash;&mdash;&mdash;&mdash;&nbsp; tenuis</td><td style="padding-left: 1em; border-right: solid black 1px; width: 8%">Spir. vitrioli dulcis</td></tr>
<tr><td style="padding-left: 1em; border-right: solid black 1px; width: 10%">Spiritus nitri</td><td style="padding-left: 1em; border-right: solid black 1px; width: 8%">Spir. nitri dulcis</td></tr>
<tr><td style="padding-left: 1em; border-right: solid black 1px; width: 10%">Spir. salis marini</td><td style="padding-left: 1em; border-right: solid black 1px; width: 8%">Spir. salis dulcis.</td></tr>
<tr><td colspan="4" style="line-height: 100%">&nbsp;</td></tr>
<tr><td rowspan="4" style="width: 5%">Varietat. acid. vegit.</td>
<td colspan="3" style="padding-left: 1em; border-left: solid black 1px">Acetum.</td></tr>
<tr><td colspan="3" style="padding-left: 1em; border-left: solid black 1px">Spiritus aceti vel acetum distillatum.</td></tr>
<tr><td colspan="3" style="padding-left: 1em; border-left: solid black 1px">Succus limonum.</td></tr>
<tr><td colspan="3" style="padding-left: 1em; border-left: solid black 1px">Chrystalli tartari.</td></tr>
<tr><td colspan="4" style="line-height: 100%">&nbsp;</td></tr>
<tr><td rowspan="2" style="width: 5%">Acid. anomal.</td>
<td colspan="3" style="padding-left: 1em; border-left: solid black 1px">Sal. succini.</td></tr>
<tr><td colspan="3" style="padding-left: 1em; border-left: solid black 1px">Sal. sedativus Hombergeri.</td></tr>
</table>


<h3>SALES ALCALINI.<span class='pagenum'><a name="Page_303" id="Page_303">[303]</a></span></h3>

<table class="salts" style="width: 60%">

<tr><td rowspan="2" style="width: 19%; border-right: solid black 1px">Alcal. vegit.</td>
<td style="padding-left: 1em">Sal. absynthii.</td></tr>
<tr><td style="padding-left: 1em">Sal. tartari.</td></tr>
<tr><td colspan="2" style="line-height: 100%">&nbsp;</td></tr>

<tr><td style="width: 19%; border-right: solid black 1px">Alcal. min.</td>
<td style="padding-left: 1em">Sal. alcali mineral. seu soda, seu natrum.</td></tr>
<tr><td colspan="2" style="line-height: 100%">&nbsp;</td></tr>

<tr><td rowspan="2" style="width: 19%; border-right: solid black 1px">Alcal. vol.</td>
<td style="padding-left: 1em">Sal. volatilis c. cervi.</td></tr>
<tr><td style="padding-left: 1em">Sal. volatilis sal. ammoniaci.</td></tr>
</table>


<h3>SALES NEUTRI.</h3>

<p><span class="smcap">Sales Neutri</span>, qui fiunt ex <span class="smcap">Alcali</span> et <span class="smcap">Acido</span>.</p>

<table summary="sales neutri" style="width: 70%; margin-bottom: 1em">
<tr><td>&nbsp;</td><td>Tartarus vitriol.</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 20%; padding-left: 1em">vegetab.</td><td rowspan="3" style="padding-left: 1em">vitrioli.</td><td>&nbsp;</td></tr>
<tr><td>&nbsp;</td><td>Sal. glauberi</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 20%; padding-left: 1em">minerali</td><td>&nbsp;</td></tr>
<tr><td>&nbsp;</td><td>Sal. am. vitrioli</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 20%; padding-left: 1em">volatili</td><td>&nbsp;</td></tr>

<tr><td colspan="5" style="line-height: 100%">&nbsp;</td></tr>

<tr><td>&nbsp;</td><td>Sal. nit. com.</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 20%; padding-left: 1em">vegetab.</td><td rowspan="3" style="padding-left: 1em">nitri.</td><td>&nbsp;</td></tr>
<tr><td>&nbsp;</td><td>Nit. cubicum</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 20%; padding-left: 1em">mineral.</td><td>&nbsp;</td></tr>
<tr><td>&nbsp;</td><td>Sal. am. nitrosum</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 20%; padding-left: 1em">volatili.</td><td>&nbsp;</td></tr>

<tr><td colspan="5" style="line-height: 100%">&nbsp;</td></tr>

<tr><td>&nbsp;</td><td>Sal. digest. sylvii</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 20%; padding-left: 1em">vegetabil.</td>
<td rowspan="3" style="padding-left: 1em">Sal. marini.</td><td>&nbsp;</td></tr>
<tr><td>&nbsp;</td><td>&mdash;&mdash; marin. com.</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 20%; padding-left: 1em">minerali</td><td>&nbsp;</td></tr>
<tr><td>&nbsp;</td><td>&mdash;&mdash; ammon. com.</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 20%; padding-left: 1em">volatili</td><td>&nbsp;</td></tr>

<tr><td colspan="5" style="line-height: 100%">&nbsp;</td></tr>

<tr><td rowspan="5" style="width: 20%; border-right: solid black 1px">Varietates salis neutri comp. ex alcal. &amp; acid. vegitab.</td>
<td style="padding-left: 1em">Sal. diureticus</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 25%; padding-left: 1em">vegetab.</td><td style="padding-left: 1em">aceti.</td>
<td rowspan="5" style="width: 5%; border-left: solid black 1px; padding-left: 1em">Vegetabil.</td></tr>
<tr><td style="padding-left: 1em">Tartar. tartar.</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 25%; padding-left: 1em">veget. tartari</td><td style="padding-left: 1em; width: 20%">chryst. tartar.</td></tr>
<tr><td style="padding-left: 1em">Sal. citratus com.</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 25%; padding-left: 1em">veget. absynth.</td><td style="padding-left: 1em">succ. limonum.</td></tr>
<tr><td style="padding-left: 1em">Sal. de seignette</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 25%; padding-left: 1em">minerali</td><td style="padding-left: 1em">chryst. tartar.</td></tr>
<tr><td style="padding-left: 1em">Spir. mindereri.</td><td style="border-right: solid black 1px; border-left: solid black 1px; width: 25%; padding-left: 1em">volatili</td><td style="padding-left: 1em">acet. distillat.</td></tr>
</table>

<p>Hi omnes sales neutri pr&aelig;parari possint<span class='pagenum'><a name="Page_304" id="Page_304">[304]</a></span>
pro usu medico admiscendo Alcali &amp;
acidum ad saturationem; alii vero in crystallos
redacti, s.&nbsp;a. commodius circumferuntur
pro usu militari; alii ut <i>sal. citratus comm.</i>
et <i>spiritus mindereri</i> facilius pr&aelig;parantur ad
miscendo alcali &amp; acidum ad saturationem pro
re nata<a name="FNanchor_115_115" id="FNanchor_115_115"></a><a href="#Footnote_115_115" class="fnanchor">[115]</a>.</p>


<p class="recipe">Solutio mercurii corrosivi sublimati.</p>

<div class="blockquot"><p>&#8478; Mercur. corrosiv. sublimat. gr. vi. spir.
vini gallici, unc. xii. M. fiat solutio. Dosis a
semunc ad unc. i. die.</p></div>

<p class="recipe">Species aromatic&aelig;. Ph. Lond.<br />
&mdash;&mdash; e scordio. Ph. Lond.</p>

<p class="recipe">Tartar. emetic. Ph. Lond.</p>

<p class="recipe">Theriaca andromachi. Ph. Lond.
<span class='pagenum'><a name="Page_305" id="Page_305">[305]</a></span></p>

<h3>TINCTUR&AElig;.</h3>

<table summary="tincturæ" style="width: 35%">
<tr><td>Tinctura amara.</td><td rowspan="10" style="border-left: solid black 1px; padding-left: 1em">Pharm. Lond.</td></tr>
<tr><td>&mdash;&mdash;&mdash; corticis Puruv.</td></tr>
<tr><td>&mdash;&mdash;&mdash; martis in sp. sal.</td></tr>
<tr><td>&mdash;&mdash;&mdash; japonica.</td></tr>
<tr><td>&mdash;&mdash;&mdash; melampodii.</td></tr>
<tr><td>&mdash;&mdash;&mdash; myrrh&aelig;.</td></tr>
<tr><td>&mdash;&mdash;&mdash; sacra.</td></tr>
<tr><td>&mdash;&mdash;&mdash; saturnina.</td></tr>
<tr><td>&mdash;&mdash;&mdash; serpentari&aelig;.</td></tr>
<tr><td>&mdash;&mdash;&mdash; thebaica.</td></tr>
</table>

<p class="recipe">Tinctura rhei.</p>

<div class="blockquot"><p>&#8478; Pulv. rad. rhei, unc. ij. semin. cardamom
minor. decortic. semunc. vini alb. hisp. lib. ij.
sp. vini gallici, unc. viij. digere sine calore &amp;
cola. Dosis ab. unc. i. ad unc. iij.</p></div>

<p class="recipe">Tinctura stomachica.</p>

<div class="blockquot"><p>&#8478; Cort. canell. alb. semunc. cort. aurantior.
unc. i. semin. cardam. minor. decort. drachm.
ij. spirit. vini gallici lib. ij. digere sine calore &amp;
cola. Dosis a semunc ad unc. i. bis terve die.&mdash;Adde
pro re nata vin alb. hisp. lib. i.<span class='pagenum'><a name="Page_306" id="Page_306">[306]</a></span></p></div>


<h3>UNGUENTA.</h3>

<p class="recipe">Unguenta c&aelig;rulea vel mercurial. Ph. Lond.</p>

<p class="recipe">Unguentum sulphuratum. Ph. Lond.</p>


<h3>VINA.</h3>

<table summary="vina" style="width: 30%">
<tr><td>Vinum amarum.</td><td rowspan="3" style="border-left: solid black 1px; padding-left: 1em; width: 45%">Pharm. Lond.</td></tr>
<tr><td>&mdash;&mdash;&nbsp;&nbsp; antimoniale.</td></tr>
<tr><td>&mdash;&mdash;&nbsp;&nbsp; chalybeatum.</td></tr>
</table>


<h3>VITRUM CERATUM ANTIMONII.</h3>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_114_114" id="Footnote_114_114"></a><a href="#FNanchor_114_114"><span class="label">[114]</span></a> Such <i>Elaeosacchara</i> (as they are called), made by rubbing
the essential Oils with twelve Times the Quantity of Sugar,
may at all Times be prepared at the fixed Hospital, and
carried about with the flying Hospital, much more conveniently
than the simple or compound Waters themselves.</p></div>

<div class="footnote"><p><a name="Footnote_115_115" id="Footnote_115_115"></a><a href="#FNanchor_115_115"><span class="label">[115]</span></a> This Table of neutral Salts is nearly the same as one I
have seen, which was said to be a Copy of that given yearly
by Dr. <i>Cullen</i>, Professor of Chymistry in the University of <i>Edinburgh</i>,
to his Pupils; and as that published by Dr. <i>Vogel</i>, in
his <i>Institutiones Chymi&aelig;</i>, sect. 629. These neutral Salts are
likewise taken Notice of by <i>Macquer</i>, in his <i>Elemens de Chymie</i>,
and other late chymical Authors.</p></div>
</div>


<h1 style="padding-top: 2em"><a name="ESSAY" id="ESSAY"></a><span style="font-size: 60%">AN</span><span class='pagenum'><a name="Page_307" id="Page_307">[307]</a></span><br />
<span style="letter-spacing: 0.15ex">ESSAY</span><br />
<span style="font-size: 60%">ON THE</span><br />
<span class="smcap">Means</span> of Preserving the Health of <span class="smcap">Soldiers</span><br />
<span style="font-size: 60%">on <span class="smcap">Service</span>.</span><br />
<span style="font-size: 60%">AND</span><br />
<span style="font-size: 60%">Conducting <span class="smcap">Military Hospitals</span>.</span><span class='pagenum'><a name="Page_308" id="Page_308">[308]</a></span></h1>



<h2><a name="MILITARY" id="MILITARY"></a><small>OF THE</small><span class='pagenum'><a name="Page_309" id="Page_309">[309]</a></span><br />
Means of Preserving the Health<br />
of Soldiers on Service.</h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">T</span>he</span> Life of <i>British</i> Soldiers on Service,
in Time of War, is so very different
from what they lead in Time of Peace, as to
subject them to many Inconveniences and Diseases.</p>

<p>In Time of Peace, Soldiers are quartered
either in Towns or Garrisons, where they are
under the Eye of their Officers, who take Care
that they keep themselves clean, and provided
with Necessaries; they lie either in private
Houses or in Barracks, where they have a good
Bed, regular Meals of wholesome Provisions,
and enjoy most of the other Necessaries of<span class='pagenum'><a name="Page_310" id="Page_310">[310]</a></span>
Life in common with the lower Class of People,
their Duty is easy, they mount Guard but seldom,
and in other Nights enjoy an undisturbed
Rest.</p>

<p>Whereas, during the Time of an active Campaign,
they are seldom in Houses; they lie in
Tents upon the Ground, which is often bare,
and at best covered only with Straw and a
Blanket; and sometimes they are obliged, after
fatiguing Marches in wet Weather, to lie
on the bare Ground, without even a Tent to
cover them; they must stand Centinel, and be
upon Pikets and other Out-Posts in the Night,
during all Kinds of Weather; besides performing
long fatiguing Marches, and other military
Duties; and when near an Enemy, they are
perhaps on Duty every second or third Night,
besides working Parties, and other Duties of
Fatigue; and what Rest they have is interrupted
by frequent Alarms. They have often
but little Time or Convenience to make themselves
clean. Provisions are sometimes scarce,
and frequently on long Marches they have no
Opportunity of dressing what they can get:<span class='pagenum'><a name="Page_311" id="Page_311">[311]</a></span>
Water is sometimes difficult to be come at, and
what is to be got, is bad. And it frequently
happens, that neither Beer, Wine, nor Spirits,
can be purchased for Money. In fixed Camps,
they are often exposed to the putrid Effluvia
of dead Bodies, of dead Horses, and other Animals,
and of the Privies and Dung of the
Horses<a name="FNanchor_116_116" id="FNanchor_116_116"></a><a href="#Footnote_116_116" class="fnanchor">[116]</a>; and, in some Encampments, likewise
to the unwholesome Vapours of marshy
Ground, and of corrupt stagnating Water: All
which, joined to the other Hardships and Inconveniences
unavoidably attending a military
Life in Time of Service, often give Rise to numerous
Diseases, which weaken an Army in a
most surprising Manner; and therefore Commanders
ought to use every Means in their
<span class='pagenum'><a name="Page_312" id="Page_312">[312]</a></span>Power, consistent with the necessary military
Operations, to preserve the Health of the Soldiers.</p>

<p>Diseases are more or less frequent in Armies
according as the Season is hot or cold, wet or
dry; according to the Nature of the Climate,
and the Time of the Year in which military
Operations are carried on; the Nature of the
Ground on which the Army is encamped, or
the Situation of the Towns or Villages in which
they are cantonned; the Cleanness, Neatness,
and Dryness of the Camp, and of the Tents
or Houses in which the Soldiers are lodged;
according as the Men are supplied with Provisions,
and good Water, good Beer, Wine, or
other fermented Liquors; or are well cloathed,
and well furnished with Straw and Blankets; in
proportion as the Duty is more or less severe;
and to the Care taken of such as are attacked
with Sickness.</p>

<p>Soldiers generally enjoy good Health in cold
dry Weather, even during the Time of severe
Frost; if they be kept in Exercise, be well
cloathed, and well supplied with Provisions and<span class='pagenum'><a name="Page_313" id="Page_313">[313]</a></span>
good Liquors, and with Wood; as the Troops,
both in <i>Germany</i> and <i>North America</i>, experienced
during the late War; but Cold joined to
Moisture was observed always to be productive
of Diseases.</p>

<p>Nor is mere Heat of itself such an Enemy
to Health<a name="FNanchor_117_117" id="FNanchor_117_117"></a><a href="#Footnote_117_117" class="fnanchor">[117]</a> as is generally apprehended; but
when joined to Moisture, is observed to give
Rise to the most fatal Disorders in the warm
Climates.</p>

<p>In our northern Climates the Winters are
cold, and the Weather variable; sometimes it
is cold and rainy, at other Times thick and
foggy; sometimes we have fair Weather and
Sunshine, at other Times Frost and Snow;
and sometimes it happens that we have all these
different Sorts of Weather in the same Day.
During this Season, Soldiers are subject to
Coughs, Pleurisies, Peripneumonies, Rheumatisms,
and other Disorders of the inflammatory
<span class='pagenum'><a name="Page_314" id="Page_314">[314]</a></span>Kind. And in very intense Frost, they are
liable to have their Limbs benumbed with
Cold, and their Extremities Frost bit (as it is
called).</p>

<p>And where there is a Want of fresh Provisions,
and they are obliged to live on salted
Meat, and cannot have Greens, Pot Herbs, Roots,
or other fresh Vegetables, nor be properly supplied
with Beer, Cyder, Wine, or other generous
fermented Liquors, they, as well as Sailors,
are subject to the Scurvy<a name="FNanchor_118_118" id="FNanchor_118_118"></a><a href="#Footnote_118_118" class="fnanchor">[118]</a>; especially if they
be encamped or quartered in low damp Places.</p>

<p>The best Means of guarding against inflammatory
Disorders, and other Mischiefs arising
from Cold, whether in Camp or in Quarters,
is, to take Care that the Soldiers be well
cloathed; that they lie dry, and be well provided
with Straw and Blankets, and with
Wood; and to prevent, as much as possible,
<span class='pagenum'><a name="Page_315" id="Page_315">[315]</a></span>their exposing themselves to sudden changes
from Heat to Cold.</p>

<p>In these northern Climates, it would be right
to allow every Soldier on Service a Flannel
Waistcoat, a Pair of worsted Gloves, and a warm
woollen Stock, or a Neckcloth, to wear when
on Duty in cold and wet Weather, as soon as
the Winter begins to set in<a name="FNanchor_119_119" id="FNanchor_119_119"></a><a href="#Footnote_119_119" class="fnanchor">[119]</a>. Dr. <i>Pringle</i>
mentions the Advantage the Troops received
<span class='pagenum'><a name="Page_316" id="Page_316">[316]</a></span>from the Flannel Waistcoats supplied by the
Quakers, in the Winter Campaign of 1745-6,
in <i>Britain</i>; and those Regiments who had them
for their Men towards the End of the Campaigns
in <i>Germany</i>, found that they contributed
greatly to keep the Men in Health.
Officers ought to take particular Care that the
Men be well provided with good strong Shoes
and Stockings; and where the Troops remain
late in the Field, if the Government allowed a
Pair or two extraordinary of each to every Foot
Soldier, it would be of great Use to the Service.</p>

<p>Blankets ought to be provided for each Tent,
and those carried along with the Regiment, so
as to be always ready for the Men when they
come to their Ground. During the late War
in <i>Germany</i>, a Couple of Blankets were allowed
for each Tent of the <i>British</i> Troops, and
each Company carried their Blankets covered
with an Oil Cloth on a Horse; so that they
were always up with the Regiments when they
came to their Ground.</p>

<p>Each Regiment ought to be provided with a
Number of Watch Coats sufficient to serve the<span class='pagenum'><a name="Page_317" id="Page_317">[317]</a></span>
Centinels who are to be on Camp Duty, or
general Guards, in very cold and wet Weather.
Some of the Regiments in <i>Germany</i> had such
Coats, and found great Service from them.</p>

<p>In Winter Quarters, Soldiers are apt to make
the Rooms in which they sit, and their Guard
Rooms, as hot as possible; especially in <i>Germany</i>,
where the Inhabitants use close Stoves,
instead of open Fires; and continue in these
warm Rooms till they are called out on Duty,
when, by being exposed to sudden Cold, they
are apt to be seized with Inflammations of the
Breast; and therefore Officers ought to examine
carefully the Quarters and Guard Rooms
allotted for their Men, and chuse them dry and
comfortable, if possible<a name="FNanchor_120_120" id="FNanchor_120_120"></a><a href="#Footnote_120_120" class="fnanchor">[120]</a>; but never to allow
<span class='pagenum'><a name="Page_318" id="Page_318">[318]</a></span>the Men to keep them as hot as Ovens, by
Means of close Stoves, or other such Contrivances;
but to depend more on good warm
Cloathing, and dry Quarters, for guarding against
Diseases, than upon artificial Heat. Many
of the Regiments in <i>Germany</i> made the People
in whose Houses their Men were quartered,
take down their Stoves, and use only open
Fires; when there was no Danger of the Soldiers
making their Quarters too warm, as
Wood was difficult to be got.</p>

<p>But although close Stoves are prejudicial in
small Rooms, yet when a Town is much
crowded, and Men are obliged to be lodged, in
Winter, in large Barns or Churches, or other
large open Places, the <i>German</i> Stoves may be
used with great Advantage in airing and drying
such Places, and keeping them of a moderate
Heat; especially if there be a Place in
them for an open Fire, or if they be of that
Kind which the <i>Germans</i> call <i>wynd Stoves</i>,
which have a Door opening into the Chamber
where the People are lodged; or if there be
broken Windows, or any other Opening by<span class='pagenum'><a name="Page_319" id="Page_319">[319]</a></span>
which a free Circulation of Air can be kept up
in the Men&#8217;s Apartments.</p>

<p>In Winter, when the Weather is very cold
or wet, a Glass of Brandy, or of the spirituous
Tincture of the Bark, given to the Men as they
went upon Duty, especially in the Night, has
been found to be of great Use<a name="FNanchor_121_121" id="FNanchor_121_121"></a><a href="#Footnote_121_121" class="fnanchor">[121]</a>. Dr. <i>Pringle</i>
has very justly observed, that the Times of standing
Centinel, and being upon Out-posts, ought, if
possible, to be shortened at such Seasons; and
that Fires in the Rear of the Camp, for Men
coming off Duty to warm and dry themselves
at, were found to be of great Service.</p>
<p><span class='pagenum'><a name="Page_320" id="Page_320">[320]</a></span></p>
<p>In Spring, and the latter End of Autumn,
the Days are sometimes extremely hot, and the
Nights cold and damp, and the Men exposed
to these sudden Changes; at such Times, the
Men who go upon Duty in the Night, ought
to put on their Flannel Waistcoats, and be
warmer cloathed than in the Day; and use
many of the Precautions practised in Winter for
the Preservation of their Health.</p>

<p>In <i>North America</i>, when the Men were in
the Field in very hard frosty Weather, Fires
were lighted at the Ends of the Tents, and
Centinels set over them to prevent their doing
Mischief; and both in <i>Germany</i> and <i>North
America</i>, when the Troops were in the Field
without Tents, they cut down Wood and
made large Fires, and the Soldiers lay down
and slept round these Fires, with their Feet
next to them; and Fires were lighted at all
Out-posts, where it could be done with Safety.</p>

<p>In <i>Germany</i>, when the Weather set in rainy
or cold towards the End of the Campaigns, and
the Army was in a fixed Position, his Serene
Highness Prince <i>Ferdinand</i> constantly ordered<span class='pagenum'><a name="Page_321" id="Page_321">[321]</a></span>
the Army to Hutt; which was done either by
thatching their Tents, or building Hurdles, or
digging Pitts, and covering and thatching them
over. The Officers either built Hutts with Fire
Places, or had Chimnies built to their Tents.</p>

<p>If, notwithstanding all Precautions, Men
upon Out-posts should be benumbed with Cold,
or Frost bit, as soon as they are brought into
Camp or Quarters, their Extremities ought to
be rubbed with Snow, or put into cold Water<a name="FNanchor_122_122" id="FNanchor_122_122"></a><a href="#Footnote_122_122" class="fnanchor">[122]</a>;
and afterwards well dried, and wrapt
up in Blankets; and warm mild Liquors given
<span class='pagenum'><a name="Page_322" id="Page_322">[322]</a></span>them to drink, and afterwards Cordials; and,
after some Time, they may be brought near
the Fire, or put to Bed. Dr. <i>Lind</i><a name="FNanchor_123_123" id="FNanchor_123_123"></a><a href="#Footnote_123_123" class="fnanchor">[123]</a> mentions
one Caution to be used when Men are
found in this Condition; which is, not to give
them immediately strong spirituous Liquors, for
that those often prove instantaneously fatal; but
to put them to Bed, and give warm Water
Gruel, or some other mild diluting Liquor, to
drink; after which, he says, a Glass of Spirits
will prove less dangerous and more beneficial.</p>

<p>When Men are quartered or cantonned in
Towns or Villages, whose Situation is low and
damp, and where fresh Meat and Vegetables
are scarce in Winter, and the Scurvy frequent
among the lower Class of People; Commanding
Officers, at the Approach of Winter, ought
to use their Endeavours to provide a Store of
Potatoes, Onions, Cabbages, sour Crout; of
pickled Cabbages, and other pickled Vegetables;
of Apples and other Fruits, preserved in
different Forms, to be laid up, and sold out to
<span class='pagenum'><a name="Page_323" id="Page_323">[323]</a></span>the Men at a cheap Rate during the Winter.
They should contract, if possible, with Butchers
to furnish the Men with fresh Meat<a name="FNanchor_124_124" id="FNanchor_124_124"></a><a href="#Footnote_124_124" class="fnanchor">[124]</a>,
and endeavour to procure good small Beer, or
Cyder or Wine in the Wine or Cyder Countries;
or Spirits to be mixed with Water, and
a small Proportion of Cream of Tartar or Vinegar;
or some other wholesome fermented Liquor
for their Drink<a name="FNanchor_125_125" id="FNanchor_125_125"></a><a href="#Footnote_125_125" class="fnanchor">[125]</a>; and to put their
Men into as dry comfortable Quarters as possible.</p>

<p>In Times of War, when Men are sent upon
Expeditions into warm Climates, great Care
ought to be taken to embark such only as are
in good Health; particular Regard ought to be
paid to those who are picked up in the Streets,
or have been taken out of the <i>Savoy</i>, or other
<span class='pagenum'><a name="Page_324" id="Page_324">[324]</a></span>Jails. All dirty Rags from off such People
ought to be thrown away or burnt; and the
Men, after being well washed, and new cloathed,
ought to be kept for a Fortnight or three
Weeks in some Garrison Town, or with their
Regiments, in open airy Places, that it may be
ascertained that they have no infectious Disorder
before they be put aboard the Transports.</p>

<p>All Ships allotted for Transports ought to
be well aired and purified, and every Thing
fitted up properly, before the Men are embarked.
They ought to be provided with
Ventilators, or Wind Sails, to make a free Circulation
of Air through the Vessel<a name="FNanchor_126_126" id="FNanchor_126_126"></a><a href="#Footnote_126_126" class="fnanchor">[126]</a>; and
they ought never to be crowded; but full
Room allowed for each Man, in Proportion to
the Length of the Voyage<a name="FNanchor_127_127" id="FNanchor_127_127"></a><a href="#Footnote_127_127" class="fnanchor">[127]</a>.</p>

<p><span class='pagenum'><a name="Page_325" id="Page_325">[325]</a></span></p><p>In military Expeditions, Soldiers are put
upon Ships Allowance; which, Dr. <i>Lind</i> very
justly observes, ought not, in Voyages to the
warm Climates, be made up so much of salted
Beef and salted Pork (which always tend to the
Putrescent), as is the common Practice of the
Navy; but that a greater Share of Biscuit,
Flour, Oatmeal, Goarts, Rice, and other
Stores of that Kind, ought to be laid in; and
a greater Proportion of them, and a Less of the
salted Meat, distributed among the Men: And
he is certainly in the Right, when he says, that
a full Animal Diet, and tenacious Malt Liquors,
are well adapted to the Constitution of our
own, and of other northern Climates; and that
Sailors who visit the <i>Greenland</i> Seas, and are
<span class='pagenum'><a name="Page_326" id="Page_326">[326]</a></span>remarkable for a voracious Appetite, and a
strong Digestion of hard salted Meat, and the
coarsest Fare, when sent to the <i>West Indies</i>,
soon become sensible of a Decay of Appetite,
and find a full gross salted Diet pernicious to
Health. &#8220;Instinct (he says) has taught the
Natives between the Tropics to live chiefly
on a Vegetable Diet, of Grains, Roots,
and subacid Fruits, with Plenty of diluting
Liquors<a name="FNanchor_128_128" id="FNanchor_128_128"></a><a href="#Footnote_128_128" class="fnanchor">[128]</a>.&#8221;</p>

<p><span class='pagenum'><a name="Page_327" id="Page_327">[327]</a></span></p><p>A Store of Vegetables, such as Mustard
Seed, Garlick, Onions, Potatoes, pickled Cabbages
and other pickled Vegetables, sour Crout
and other Things of that Kind, which can be
purchased at a cheap Rate, and preserved for
some Months, ought to be laid in; which may
be mixed with the Soops prepared for the Men,
or given them to eat along with their salted
Provisions.</p>

<p>A Quantity of Beer, Cyder, or Wine, ought
to be put aboard, and a certain Allowance
distributed to each Man daily. When, for
Want of these, Men are reduced to an Allowance
of Spirits, they ought to be mixed with
seven or eight Times the Quantity of Water, or
<span class='pagenum'><a name="Page_328" id="Page_328">[328]</a></span>made into Punch, by the Mixture of Water and
Molosses, and the Juice of Lemons, before they
are given to the Men; and, if Lemons cannot
be got, Cream of Tartar, or Vinegar, ought to
supply their Place; and it ought to be a Duty of
one of the military Officers on board to see the
Punch made, and distributed among the Men daily.</p>

<p>It would be right, on all Expeditions into
warm Climates, to send some Sloops of War,
or other armed Vessels, before the grand Fleet,
to take up a Quantity of Wine that will keep,
either at the <i>Madeira</i>, or other Wine Countries;
and afterwards to go to any of our Settlements
that are nearest the Place of Destination,
and to take in a Quantity of Limes, Lemons,
Oranges, and other Fruits, and Vegetables
which will keep for some little Time; and of
Spirits, live Stock, and other Provisions proper
for the Army; and then to meet the Fleet
at the general Rendezvous. When once a
Landing is made good, these Vessels, after having
unloaded their Cargoes, may either be employed
on other Services, or kept constantly going
and coming for whatever Stores or Provisions
are wanted for the Army or Fleet.<span class='pagenum'><a name="Page_329" id="Page_329">[329]</a></span></p>

<p>A sufficient Quantity of Vinegar ought to be
put on board of each Transport, both for the
Men to eat with their Victuals, and likewise
for fumigating and washing between Decks occasionally.
And a Quantity of Molosses, or
coarse brown Sugar, and of Lemons, or their
inspissated Juice, or Cream of Tartar, ought to
be allowed for making the Punch, as well as
for other Purposes.</p>

<p>If the Water become f&#339;tid, the Quantity to
be used in the Day ought to be sweetened by
Means of the Ventilator contrived by the ingenious
Dr. <i>Hales</i><a name="FNanchor_129_129" id="FNanchor_129_129"></a><a href="#Footnote_129_129" class="fnanchor">[129]</a> for that Purpose.</p>

<p>The Men ought to be brought upon Deck,
and Roll called two or three Times a Day;
they should be made to comb their Hair, and
wash their Hands and Face every Day, and to
<span class='pagenum'><a name="Page_330" id="Page_330">[330]</a></span>shift themselves sometimes, if possible; and in
every respect keep themselves as clean as the Nature
of the Service will admit; and proper Exercises
should be contrived, to keep them in Health.</p>

<p>All the Parts of the Ship ought to be kept
very neat and clean; and the Hold, and all
between Decks, ought to be scraped and swept
daily; and every Morning, in fair Weather,
ought likewise to be washed, and afterwards
sprinkled or washed with warm Vinegar, while
the Men are upon Deck<a name="FNanchor_130_130" id="FNanchor_130_130"></a><a href="#Footnote_130_130" class="fnanchor">[130]</a>.</p>

<p>When the Weather will permit, Fires of
dried Wood may be lighted in Iron Kettles
between Decks, and Centinels set over them,
and the Fires sprinkled with Rosin or Bits of
Rope dipt in Tar, or with some cheap Aromatic;
and these Fires may be carried into all
the Parts of the Ship that Safety will permit,
in order to dry and purify the Air<a name="FNanchor_131_131" id="FNanchor_131_131"></a><a href="#Footnote_131_131" class="fnanchor">[131]</a>. After
<span class='pagenum'><a name="Page_331" id="Page_331">[331]</a></span>this Operation all the Ports and Hatchways
should be opened, and the Air in all the Parts
of the Ship often renewed by working the
Ventilators.</p>

<p>The Mens Hammocks and Beds ought to
be brought up upon Deck in fair Weather,
and well aired, and afterwards put in their
Places, and Fires lighted below Decks.</p>

<p>When Troops, sent on an Expedition into
warm Climates, arrive at the Place of their
Destination, particular Care should be taken to
guard them against the Diseases peculiar to such
Climates, which are different from those common
to our more northern Latitudes.</p>

<p>Dr. <i>Lind</i> says, that People coming first from
a cold into a hot Climate are apt to have plethoric
Symptoms; a Pain of the Head, Giddiness,
a Sense of Weight, and Fulness of the
Breast, and a slight Inflammation of the <i>tunica
conjunctiva</i>; and that some are apt to be seized
with ardent Fevers and Diarrh&#339;as. And all
Practitioners have observed, that New-Comers
<span class='pagenum'><a name="Page_332" id="Page_332">[332]</a></span>into warm Climates are at first liable to Fevers
tending to the Ardent, and are very subject to
Fevers of the remitting and intermitting Kind,
which are the Endemics of all warm Countries
at certain Seasons of the Year; and after
some Time they are apt to fall into Fluxes,
the Yellow Fever, and other Diseases depending
on a putrescent State of the Juices. In military
Expeditions these Disorders are liable to
be complicated with Fevers of the Malignant
or Hospital Kind, if Care is not taken to prevent
it. And nothing has been found to be
more productive of Diseases in those warm Climates,
than indulging freely in the Use of Spirits
and other strong fermented Liquors; exposing
one&#8217;s self to the Damps, especially lying on the
Ground after the Dews fall; and working hard,
or using violent Exercise in the Heat of the
Day.</p>

<p>The best Preservatives against Diseases in
warm Climates have been found to be,&mdash;1.
Temperance; a Diet of light and easy Digestion,
composed more of vegetable than of
animal Food; such as a small Portion of fresh<span class='pagenum'><a name="Page_333" id="Page_333">[333]</a></span>
Meat, joined with a sufficient Quantity of Vegetables;
Rice, <i>Indian</i> Corn, and other Grains,
and Roots of various Kinds, prepared in different
Forms; well baked Bread; the moderate
Use of ripe Fruits; and the free Use of mild
cooling subacid Liquors, joined with a small
Proportion of vinous or spirituous Liquors;
carefully avoiding the too liberal Use of Wine,
Spirits, or other strong fermented Liquors.&mdash;2. Great
Care not to expose one&#8217;s self to the
Damps of the Night, nor lie down to sleep on
the Grass, or in woody moist Places, in the
Day; and to avoid all violent Exercise in the
Heat of the Sun.&mdash;3. Such Means as tend to
support the Spirits; for Chearfulness has been
observed to contribute as much to the Preservation
of Health, as Fear and Dejection of Spirits
to the Production of Diseases.&mdash;4. Keeping
the Body clean, and bathing frequently in the
Sea, or in a River, in the Morning.</p>

<p>And therefore, in warm Climates, Officers
ought to be particularly careful to keep their
Men sober and temperate; to procure them
good Bread, and Plenty of Vegetables and fresh<span class='pagenum'><a name="Page_334" id="Page_334">[334]</a></span>
Meat, if possible; and where no other but
salted Meat can be got, to make them boil a
small Proportion of it in their Camp Kettles,
along with Onions, Goarts, Rice, Carrots, Turnips,
Greens, or any other wholesome Roots or
Herbs which the Country affords, or they can
get, and of these to prepare a good wholesome
Soop for themselves; and where there is Plenty
of the ripe acescent Fruits, which are reckoned
wholesome, to distribute a moderate Quantity
among the Soldiers daily, which will both help
to preserve their Health, and prevent them
from privately stealing and eating large Quantities
to the Prejudice of their Health.&mdash;To encourage
their Men, and keep up their Spirits.</p>

<p>They should also prevent, as much as possible,
the too free Use of Wine, Spirits, or other
strong fermented Liquors; and in Wine Countries
give every Man a daily Allowance of
Wine, to be mixed with Water for his common
Drink; and in Countries where nothing
but Spirits can be got, make the Spirit be mixed
with Water, or made into a very weak Punch,
before it is given to the Men, as Lemons, Oranges,<span class='pagenum'><a name="Page_335" id="Page_335">[335]</a></span>
Limes, and other Fruits proper for this Purpose,
are generally to be had in most warm Countries.</p>

<p>They should be careful not to march their
Men in the Heat of the Day, nor order them
upon Duty where they must stand exposed to
the Dews and Damps of the Night, unless
where the military Operations absolutely require
it.</p>

<p>They should endeavour to make the Bottom
of the Tents be covered with Straw, or dried
Leaves of Trees, or dried Reeds, and with Blankets<a name="FNanchor_132_132" id="FNanchor_132_132"></a><a href="#Footnote_132_132" class="fnanchor">[132]</a>,
for the Men to lie upon.</p>

<p>The Time of standing Centinel, and being
upon Out-posts, if possible, should be short,
where Men are exposed to the scorching Heat
of the Sun; and when Men are upon Out-posts
in the Night, it should be recommended to
them to lie down on the Ground as little as
possible; and if they do it, to chuse a dry
<span class='pagenum'><a name="Page_336" id="Page_336">[336]</a></span>Place; and, where it can be done, to have it
covered with Straw or a Blanket, and to have
some light Covering to defend them from the
Dews.</p>

<p>The Tents should be covered with Boughs
of Trees, and the Men should be ordered sometimes
to strike them in the Middle of the Day,
and air well every Thing within them.</p>

<p>The Men should be obliged to keep themselves
neat and clean; to comb their Hair, and
change their Linen often; and if the Camp be
near the Sea, or a large River, they ought to bathe
early in the Morning as often as the Nature of the Service
will permit. However the following Caution,
mentioned by Dr. <i>Lind</i>, ought to be observed,
which is, not to go into the cold Bath when
overheated with Work or Liquor, or when the
Stomach is full, or when a critical Eruption,
called the prickly Heat, appears on the
Skin<a name="FNanchor_133_133" id="FNanchor_133_133"></a><a href="#Footnote_133_133" class="fnanchor">[133]</a>.</p>
<p><span class='pagenum'><a name="Page_337" id="Page_337">[337]</a></span></p>
<p>When Men are seized with inflammatory
Symptoms on entering into warm Climates,
they may be blooded freely: Afterwards they
do not easily bear such copious Evacuations,
but rather require to have them made in
smaller Quantities, and very early and frequent,
as Inflammations make a rapid Progress
in warm Countries. Dr. <i>Lind</i> says, many
Practitioners disapprove of Blood-letting in
the Countries lying under the Torrid Zone,
on a Supposition that the Blood is too much
dissolved; but he thinks that this Rule will admit
of many Exceptions; and that Sailors (<i>and
consequently Soldiers</i>), being strong and robust,
and exposed to greater Vicissitudes of Heat and
Cold, and more Excesses, and other Accidents
in general, bear freer Bleeding than any other
Set of People.</p>

<p><span class='pagenum'><a name="Page_338" id="Page_338">[338]</a></span></p><p>After some Time, the Diseases in these warm
Climates tend to the putrid Kind, and must be
treated as such.</p>

<p>In all Countries, and in all Climates, great
Care ought to be taken in chusing the Ground
on which Men are to encamp. Dry high
Grounds, exposed to the Winds, where there
is a free Current of Air, and which lie at
a Distance from Marshes, stagnating Water,
and large Woods, are generally healthful in
very different Climates<a name="FNanchor_134_134" id="FNanchor_134_134"></a><a href="#Footnote_134_134" class="fnanchor">[134]</a>. But Places situated
low, where, on digging two or three Feet
below the Surface of the Earth, you come to
Water<a name="FNanchor_135_135" id="FNanchor_135_135"></a><a href="#Footnote_135_135" class="fnanchor">[135]</a>, and marshy Grounds, and Places
surrounded with corrupt stagnating Water, are
almost always the contrary, and very unhealthful;
<span class='pagenum'><a name="Page_339" id="Page_339">[339]</a></span>as are often those Grounds which are subject
to be overflowed by large Rivers, and low
Places covered with Wood, where there is no
free Circulation of Air. However, it ought
to be observed, that it is not the Neighbourhood
of Water alone which is prejudicial, but
the watery Vapours which keep the Air perpetually
moist, and the Exhalations of corrupt Effluvia,
which render such Places unwholesome;
for the Neighbourhood of Rivers, and of the
Sea, where the Tide ebbs and flows freely,
has no such Effect, where the Situation is dry
and airy; and those very unhealthy marshy
Grounds often continue healthy in cold Weather,
when their Waters are refreshed with
Rains<a name="FNanchor_136_136" id="FNanchor_136_136"></a><a href="#Footnote_136_136" class="fnanchor">[136]</a>, and little or no moist putrid Exhalations
rise from them; though, as Dr. <i>Pringle</i>
observes, in Summer and Autumn, when their
Waters begin to corrupt, and the Exhalation is
strong, they are always exposed to Diseases;
<span class='pagenum'><a name="Page_340" id="Page_340">[340]</a></span>and it is for this Reason that such Places are
always very unhealthy in warm Climates.</p>

<p>Hence, where the military Operations will
permit, Commanders, if possible, ought to
chuse a dry Ground, whose Situation is high,
and which admits a free Current of Air, such
as on the Banks of Rivers, where there is generally
a Stream of fresh Air, and Plenty of
fresh Water to supply the Camp<a name="FNanchor_137_137" id="FNanchor_137_137"></a><a href="#Footnote_137_137" class="fnanchor">[137]</a>; taking
Care to avoid the Neighbourhood of low marshy
Grounds, and corrupt stagnating Waters,
especially in Summer, and in hot Climates.</p>

<p>When Necessity obliges Commanders to take
Post, or encamp in a wet or marshy Ground,
they should endeavour to make it as dry as
possible, by ordering Trenches to be cut for
<span class='pagenum'><a name="Page_341" id="Page_341">[341]</a></span>Drains across the Field and round the Mens
Tents; to see that the Ground within the
Tents be well covered with Straw; to order
the Tents to be struck at Mid-Day, in dry
warm Weather, and the Men to dry and
air the Straw, and change it frequently; to
have a proper Supply of Blankets for the Men,
and to take Care that they be well cloathed,
especially those who go upon Duty in the
Nights; and, in the northern Climates, to have
Fires in proper Places for warming the Men
and drying their Cloaths, and for correcting the
Dampness of the Air<a name="FNanchor_138_138" id="FNanchor_138_138"></a><a href="#Footnote_138_138" class="fnanchor">[138]</a>.</p>

<p>In Countries lying under the Torrid Zone,
the Parts near the Sea Shore are often marshy,
<span class='pagenum'><a name="Page_342" id="Page_342">[342]</a></span>or close and covered with Wood, or have
swampy Beaches, and are very unwholesome;
and therefore where Soldiers aboard of Transports
keep their Health, Commanders ought to
be very careful not to allow them to land, till
they come to the Place of their Destination.
Dr. <i>Lind</i> observes, that Men commonly live
more healthy in warm Climates at Sea, where
the Air is dry and serene, and the Heat moderated
by refreshing Breezes, than when they
arrive in Harbours, or get within Reach of the
noxious Vapours which arise from many Parts
of the Land<a name="FNanchor_139_139" id="FNanchor_139_139"></a><a href="#Footnote_139_139" class="fnanchor">[139]</a>.</p>

<p>When Necessity requires Parties to be
landed for Wood or Water, or on other
Duties, they should always be obliged to
return and lie aboard at Night; and if that
cannot be done, they should be cautioned to
avoid lying down to sleep on the Grass, where
the Air is fresh, or they are exposed to the
Dews; and to pitch their Tents on a rising
<span class='pagenum'><a name="Page_343" id="Page_343">[343]</a></span>Ground, covered with Straw or dried Reeds,
and a Blanket; and to use the other Precautions
necessary for encamping in these warm Climates;
for where this Care has been neglected, the
Consequences have frequently proved fatal<a name="FNanchor_140_140" id="FNanchor_140_140"></a><a href="#Footnote_140_140" class="fnanchor">[140]</a>.</p>

<p>On unhealthful Coasts, the noxious Land
Vapours often affect the Crews of Ships that
run up into Rivers or Harbours, and cause
great Sickness; and therefore in such Places
Ships should anchor at as great a Distance from
the Shore as can well be done, that they may
be exposed to the Sea Breezes, and as much to
<span class='pagenum'><a name="Page_344" id="Page_344">[344]</a></span>the Windward of the Woods and Marshes as
possible; and if the Anchorage is safe, one
should prefer the open Sea to running up into
Rivers or Creeks<a name="FNanchor_141_141" id="FNanchor_141_141"></a><a href="#Footnote_141_141" class="fnanchor">[141]</a>.</p>

<p>Cleanness and Neatness in the Camp is another
Article that ought to be particularly regarded.
<i>Portius</i>, <i>Ramazini</i>, and most other
Authors who treat of Camp Diseases, attribute
those of the putrid Kind in a great Measure to
the Stench and putrid Effluvia arising from the
Excrements of Men and Beasts, and from the
dead Bodies of Men, Horses, and other Animals,
<span class='pagenum'><a name="Page_345" id="Page_345">[345]</a></span>lying unburied in the Neighbourhood of
Camps, and have in a particular Manner mentioned
the Necessity of burying such putrid Substances.
Dr. <i>Pringle</i> has very justly recommended
the Digging of Deep Pits for Privies
in Camp, and covering the Excrements with
Earth daily<a name="FNanchor_142_142" id="FNanchor_142_142"></a><a href="#Footnote_142_142" class="fnanchor">[142]</a> till the Pits are near full, and then
to fill them up with Earth, and dig new ones;
and to punish every Person who shall ease himself
any where in Camp but in the Privies:
And he remarks, that when the Camp begins
to turn unhealthy, that often the only Means
that will preserve the Health of the Men, is to
change the Ground, and to leave behind all the
Filth and Nastiness which gave Rise to those
putrid Disorders.</p>

<p>In fixed Camps, the striking the Tents at
<span class='pagenum'><a name="Page_346" id="Page_346">[346]</a></span>Mid-Day in fair Weather, and turning and
airing the Straw, and changing it often, as recommended
by Dr. <i>Pringle</i>, will contribute
much to preserve the Health of the Men; and
making the Men wash themselves daily, and
change their Linen often, and keep themselves
otherwise clean, ought never to be omitted by
the Officers.</p>

<p>All military Authors have recommended
to Commanders always to have Straw for their
Men when they come to their Ground, if
possible; and to have the Army well supplied
with Provisions; giving proper Encouragement
to the Country People, and to Suttlers
and Merchants of all Sorts, to bring in every
Kind of Provisions and other Necessaries to
Camp; and preventing, as much as possible,
the Soldiers from moroding. And the Commanders
of every Corps ought to take Care
that their Men form themselves into Messes,
and that Stoppages be made for buying them
Provisions.</p>

<p>In <i>Germany</i> every Regiment of the <i>British</i>
Troops contracted with a Butcher, who was
obliged to carry along with them, at all Times,<span class='pagenum'><a name="Page_347" id="Page_347">[347]</a></span>
a certain Number of live Sheep and Oxen to
kill when wanted, and to sell the Meat at a
fixed Price. Every Soldier was obliged to take
a certain Quantity, which was paid for by
Stoppages made in his Pay; and this Meat was
boiled in the Camp Kettles, with such Roots and
Greens as could be got; by which Means the
Men, whenever they could use their Kettles,
had always a good warm Soop, as well as Meat,
to refresh them after their Fatigues, which,
along with their Ammunition Bread, made a
good wholesome Food.</p>

<p>In Countries where Fruit is plentiful, a certain
Quantity of what is fully ripe, distributed
to the Men in warm Weather, and in hot Climates,
will contribute to preserve their Health,
though the Abuse of it will prove prejudicial;
but unripe and acrid Fruits are always hurtful<a name="FNanchor_143_143" id="FNanchor_143_143"></a><a href="#Footnote_143_143" class="fnanchor">[143]</a>.</p>
<p><span class='pagenum'><a name="Page_348" id="Page_348">[348]</a></span></p>
<p>Water is another Article which Commanders
endeavour to have their Camp well supplied
with, and therefore they generally encamp
near Rivers or Rivulets. Where the
Stream is small, Care ought to be taken that its
Course be not interrupted, and that no Filth or
Nastiness, or any Thing that will spoil or corrupt
the Water, be thrown into it.</p>

<p>When there are no Rivers or Rivulets near a
Camp, and the Men are supplied from Wells,
if the Water is not pure, very often the digging
of deep Pits, and covering the Bottom and Sides
with large Stones, and over these a Lay of
Sand, Gravel, or Chalk, will make the Water
pure in a few Hours.</p>

<p>In fixed Camps, where the Water is bad,
<i>Portius</i><a name="FNanchor_144_144" id="FNanchor_144_144"></a><a href="#Footnote_144_144" class="fnanchor">[144]</a> proposes straining it thro&#8217; Sand, and
has given Figures of Machines to be used for
that Purpose; but the Method proposed by
Dr. <i>Lind</i> is still more simple, which is, to get
<span class='pagenum'><a name="Page_349" id="Page_349">[349]</a></span>a broad Cask with one End struck out; then
put a longer Cask, with both Ends struck out,
in the Middle of it; fill the short Cask one-third
with Sand, and the inner longer Cask
above one-half; fill the Rest of the inner Cask
with the Water, which will filter through the
Sand, and rise above the Sand in the outer
Cask, where it may be allowed to run off into
Vessels placed to receive it, by Means of a Cock,
put into the Side of the outer Cask, fifteen or
twenty Inches above the Level of the Sand.</p>

<p>Where there are no such Conveniences for
purifying the Water, what is used for Drink
ought to be mixed with a small Proportion of
Spirits, or Wine, or with Vinegar, or Cream of
Tartar, when neither of the other two can
be got; and if the Water be previously boiled,
it will be so much the better.</p>

<p>In Expeditions into warm Countries, where
fresh Water is difficult to be had, a few Stills,
with a proper Apparatus, ought to be carried
out; and after a Landing is made, the Stills
ought to be set to work for distilling fresh
Water from Sea Water in the Manner mentioned<span class='pagenum'><a name="Page_350" id="Page_350">[350]</a></span>
by Dr. <i>Lind</i><a name="FNanchor_145_145" id="FNanchor_145_145"></a><a href="#Footnote_145_145" class="fnanchor">[145]</a>; and although a sufficient
Quantity cannot be distilled for serving
the whole Army, yet enough may be got in
this Way for the Use of the Sick.</p>

<p>When Men are very warm, after long
Marches, and other hard Duties, in Summer;
Officers should endeavour to prevent their
swallowing immediately great Quantities of
cold Water, and persuade them to wait a little
till they cool; and at such Times, if Spirits
can be got easily, to order a small Quantity to
be mixed with the Water in each Man&#8217;s Canteen.</p>

<p>Though the Abuse of vinous and spirituous
Liquors is very destructive to the Constitution,
yet these same Liquors, given in Moderation to
Soldiers on Service, during the Times of great
Fatigues, are some of the best Preservatives of
<span class='pagenum'><a name="Page_351" id="Page_351">[351]</a></span>Health. Spirits, for common Use, ought to
be mixed with Water; and in the hot Climates
made into Punch; though in very cold
and wet Weather, and in damp Nights, a Glass
of pure Spirits, given to the Men going on Duty,
is of great Service; for it is always observed,
that Men are much less apt to catch Diseases
from being wet when they are upon a
March, or at hard Work, than when they stand
Centinels, or are upon Out-Posts where they
move but little, or when they lie down in their
wet Cloaths; and that they are less liable to be
affected by the Weather after a hearty Meal,
or drinking a Glass of Spirits, or some generous
Liquor, than when their Stomachs are
empty.</p>

<p>An Infusion of Bark or other Bitters, and of
Garlick, in Spirits, has been found to encrease
their Efficacy as Preservatives both against the
Effects of Cold and malignant Distempers.
Dr. <i>Lind</i> has recommended an Infusion of
Garlick in Spirits as one of the best Stomachics
and Diaphoretics he knows in cold wet Weather.
And many have recommended a Tincture of the<span class='pagenum'><a name="Page_352" id="Page_352">[352]</a></span>
Bark<a name="FNanchor_146_146" id="FNanchor_146_146"></a><a href="#Footnote_146_146" class="fnanchor">[146]</a>: Towards the End of the Year
1743, Mr. <i>Tough</i>, one of the Apothecaries
to the <i>British</i> military Hospital in the late
War, then a Mate to a marching Regiment,
was ordered to go down the <i>Rhine</i>
with a Party of Sick, who had the Seeds
of the Hospital Fever among them, and were to go in Bilanders,
from <i>Germany</i> to <i>Flanders</i>. Having had
a Cask or two of Brandy put aboard as Part of
the Stores for the Sick, he was afraid lest the
Men should make too free with the Spirits; to
prevent which he threw in a Quantity of Bark
into each Cask, and gave the Men regularly,
Morning and Evening, a Glass of this bitter
Tincture. At the same Time, the Men were
kept extremely clean. By these Means most
<span class='pagenum'><a name="Page_353" id="Page_353">[353]</a></span>of the Sick mended upon the Passage, without
the Malignant Fever appearing
again amongst them; whereas, Dr. <i>Pringle</i>,
who takes Notice of the other Parties who
came from the same Hospitals in <i>Germany</i>, tells
us, that the Malignant Fever broke out in a violent
Degree, and Half the Number died by
the Way, and federal others soon after their
Arrival<a name="FNanchor_147_147" id="FNanchor_147_147"></a><a href="#Footnote_147_147" class="fnanchor">[147]</a>.</p>

<p>Commanding Officers ought always to endeavour
to proportion the Time the Men are
to be upon Duty to the Weather and the Nature
of the Climate. The Time of standing
Centinel in very hard Frost, and in cold wet
Weather, or in the Heat of the Day in Summer,
when the Weather is very warm, and in
hot Climates, ought to be shorter than when
the Weather is dry and more temperate.</p>

<p>The Marches of Troops ought, if possible,
during the Time of very hot Weather, to be
made either very early in the Morning, in the
Evening, or at Night; and Officers, during the
<span class='pagenum'><a name="Page_354" id="Page_354">[354]</a></span>Course of an active Campaign, ought to spare
their Men as much as possible.</p>

<p>And when they are in Quarters, and have
nothing to do, they should narrowly inspect
into their Manner of living; and have them
out daily, when the Weather will permit, and
exercise them, or march them two or three
<i>English</i> Miles a-Day, in order to prevent their
falling sick for want of Exercise; for Soldiers
left to themselves are very subject to Diseases
when they come into Quarters after an active
Campaign, by leading too indolent a Life, if
Officers do not take Care to prevent it. However,
at such Times, the Exercise ought to be
moderate, and the Men should not be brought
out in wet Weather.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_116_116" id="Footnote_116_116"></a><a href="#FNanchor_116_116"><span class="label">[116]</span></a> In the Year 1760, the Men, who remained in the fixed
Camp about <i>Warbourg</i>, were very unhealthy; while the Regiments
who were detached to the <i>Lower Rhine</i>, under the
Command of the Hereditary Prince of <i>Brunswick</i>, enjoyed a
much better State of Health; and notwithstanding their great
Fatigues, and the Loss they sustained at the Affair of <i>Kampen</i>,
were much stronger when they rejoined the Army to go upon
the Winter Expedition into the Country of <i>Hesse</i>, than those
Regiments which had remained in the fixed Camp.</p></div>

<div class="footnote"><p><a name="Footnote_117_117" id="Footnote_117_117"></a><a href="#FNanchor_117_117"><span class="label">[117]</span></a> This Dr. <i>Pringle</i> takes Notice of; and Mr. <i>Naesmith</i>
says, he observed it in Voyages to the <i>East Indies</i>, which afford
the fairest Trials of this Kind. See Dr. <i>Lind&#8217;s Essay on the
Means of Preserving the Health of Seamen</i>, 2d edit. note to
page 5.</p></div>

<div class="footnote"><p><a name="Footnote_118_118" id="Footnote_118_118"></a><a href="#FNanchor_118_118"><span class="label">[118]</span></a> Dr. <i>Joh. Valint. Willius</i>, Army Physician to the King of
<i>Denmark</i>, in his Treatise on Camp Diseases, says, you scarce
find a Camp in these northern Countries in which the true
Scurvy, attended with stinking Breath and eroded Gums, is
not to be observed. <i>Cap.</i> iii. <i>sect.</i> iii.</p></div>

<div class="footnote"><p><a name="Footnote_119_119" id="Footnote_119_119"></a><a href="#FNanchor_119_119"><span class="label">[119]</span></a> A Flannel Waistcoat, worsted Gloves, and woollen Stock,
or a Neckcloth, may be purchased for about Half a Crown
<i>per</i> Man, and would contribute to preserve the Lives of many;
the recruiting of others, to supply whose Places, if they
die, will cost the Government a great deal more than the
Price of the Articles mentioned; which for a Regiment of
nine hundred Men, at the Rate of two Shillings and Six-Pence
<i>per</i> Man, comes only to 112<i>l.</i> 10<i>s.</i> <i>per Ann.</i> Every Recruit sent
from <i>England</i> to the Army in <i>Germany</i>, cost the Government at
least twenty Guineas before he joined his Regiment; and every
sick Man sent to the general Hospital, cost the Government at
least sixteen Pence <i>per</i> Day, which is ten Pence above his Pay;
so that, if we suppose the extraordinary Cloathing here mentioned
would preserve only the Lives of nine Men to each Regiment
yearly, and keep forty in Health who would otherwise
be sick, we see what great Gainers the Government will be in
Point of Money at the Year&#8217;s End; besides preserving the Lives
and Health of so many Men.</p></div>

<div class="footnote"><p><a name="Footnote_120_120" id="Footnote_120_120"></a><a href="#FNanchor_120_120"><span class="label">[120]</span></a> Dr. <i>Pringle</i> has very justly observed, that upper Stories
are preferable to Ground Floors; and that all uninhabited large
damp Houses ought to be rejected. <i>Observat. on Diseases of the
Army</i>, part ii. chap. iii. sect. 2.
</p><p>
If Necessity obliges Officers to put up with such Places for
their Men, Care ought to be taken to clean them well, and to
air and dry them by Means of Fires, before the Soldiers go into
them; and to supply well the Men who are to lodge in them
with Straw and Blankets, and with Wood or Turf.</p></div>

<div class="footnote"><p><a name="Footnote_121_121" id="Footnote_121_121"></a><a href="#FNanchor_121_121"><span class="label">[121]</span></a> Dr. <i>Pringle</i> has taken Notice, that it would be a right
Measure to make an Allowance of Spirits to the Infantry on
Service; which certainly would be of great Use, and save
many Mens Lives; and might be done at a small Expence to
the Government, if properly managed; as it would only be
requisite to make such an Allowance when the Troops are in
the Field, and to such Men as mount Guard in cold wet Weather,
or at Nights in Garrison Towns, during the Winter. If
ever such an Allowance be made, what Spirits are given to the
Men ought to be mixed with five or six Times the Quantity of
Water; except when Men are to stand Centinels, or to be upon
Out-Posts, in a frosty Season, or in cold wet Weather; at which
Time a small Glass of pure Spirits may be given them in Presence
of the Officer or Serjeant of the Guard.</p></div>

<div class="footnote"><p><a name="Footnote_122_122" id="Footnote_122_122"></a><a href="#FNanchor_122_122"><span class="label">[122]</span></a> <i>Hildanus</i> relates a very remarkable Instance of the good
Effects of this Treatment. A Man was found quite stiff and
frozen all over. He was put into cold Water, and immediately
the icy Spicula were discharged from all Parts of his Body, so
that he seemed covered with an icy Crust. He was then put
into a warm Bed, and took a Cordial Draught, and a plentiful
Sweat followed; after which he recovered with the Loss of the
last Joints of his Fingers and Toes. <i>De Gangr&aelig;na</i>, cap. xiii.
People who are benumbed with Cold in frosty Weather ought
never to be brought immediately near a Fire; for that has been
found either to cause immediate Death or Gangrenes of the
Extremities; and even Apples and other Fruits which have been
frozen, if brought immediately near a Fire, turn soft and rot;
but if put into cold Water, throw out the icy Spicula, and recover,
so as to be almost as good as before they were frozen.</p></div>

<div class="footnote"><p><a name="Footnote_123_123" id="Footnote_123_123"></a><a href="#FNanchor_123_123"><span class="label">[123]</span></a> <i>Means of Preserving the Health of Seamen</i>, 2d edition,
page 19.</p></div>

<div class="footnote"><p><a name="Footnote_124_124" id="Footnote_124_124"></a><a href="#FNanchor_124_124"><span class="label">[124]</span></a> The Regiments in <i>Germany</i> who kept their Butchers in
Winter, and made Stoppages of the Mens Pay, and obliged
them to take a certain Quantity of Meat daily, were much
more healthy than those who used no Precaution of this Kind.</p></div>

<div class="footnote"><p><a name="Footnote_125_125" id="Footnote_125_125"></a><a href="#FNanchor_125_125"><span class="label">[125]</span></a> In Places where the Articles here mentioned are at too
high a Price for a Soldier&#8217;s Pay, a small Allowance, from the
Government, of such Things would contribute much to the
Preservation of the Mens Health in unwholesome Garrisons.</p></div>

<div class="footnote"><p><a name="Footnote_126_126" id="Footnote_126_126"></a><a href="#FNanchor_126_126"><span class="label">[126]</span></a> See Dr. <i>Lind&#8217;s Treatise on the Means of Preserving the
Health of Seamen in the Royal Navy</i>, where he takes Notice of
most of the Articles here mentioned with regard to Transport
Ships in treating of Ships of War.</p></div>

<div class="footnote"><p><a name="Footnote_127_127" id="Footnote_127_127"></a><a href="#FNanchor_127_127"><span class="label">[127]</span></a> When Ships are too much crowded with Men, if they
meet with a tedious Passage, and hot moist close Weather, they
are often attacked with Diseases which prove very fatal. Dr.
<i>Lind</i>, talking of Ships of War, says it is a Mistake destructive
to the Men to crowd too many of them together in a southern
Voyage, or in a hot Climate; as the Ship will be found, before
the End of the Voyage, in more Distress for Want of Men,
than she would have been, had she at first carried out only her
proper Compliment. An additional Number is made, in order
to supply an expected Mortality; but they generally increase
that Mortality to double or triple their own Number. <i>Ibid.
note to p. 48.</i></p></div>

<div class="footnote"><p><a name="Footnote_128_128" id="Footnote_128_128"></a><a href="#FNanchor_128_128"><span class="label">[128]</span></a> The following is the Diet established for the Seamen of
his Majesty&#8217;s Navy.
</p><p>
Every Man is allowed a Pound of Biscuit, <i>Averdupoiz
Weight</i>, and a Gallon of Beer, <i>Wine Measure</i>, <i>per</i> Day.
</p><p>
On <i>Sunday</i> and <i>Thursday</i>, one Pound of Pork, and Half a
Pint of Peas, <i>Winchester Measure</i>.
</p><p>
On <i>Monday</i>, <i>Wednesday</i>, and <i>Friday</i>, one Pint of Oatmeal,
two Ounces of Butter, and four Ounces of Cheese.
</p><p>
On <i>Tuesday</i> and <i>Saturday</i> two Pounds of Beef.
</p><p>
It is left to the Commanders of Squadrons to shorten the
aforesaid Allowance of Provisions according to the Exigence
of the Service, taking Care that the Men be punctually paid
for the same. As it is thought for the Benefit of the Service
to alter some of the foregoing Particulars of Provisions in Ships
employed on foreign Voyages, it is to be observed, that
</p><p>
A Pint of Wine, or Half a Pint of Rum, Arrack, or Brandy,
hold Proportion to a Gallon of Beer.
</p><p>
Four Pounds of Flour, or three Pounds of the same with
a Pound of Raisins, Half a Pound of Currans, or Half a
Pound of Beef Suet pickled, are equal to a four Pound Piece
of Beef, or two Pound Piece of Pork with Peas.
</p><p>
Half a Pound of Rice is equal to a Pint of Oatmeal.
</p><p>
A Pint of Olive Oil is equal to a Pound of Butter, or two
Pounds of <i>Cheshire</i> Cheese.
</p><p>
And Two-thirds of a Pound of <i>Cheshire</i> Cheese is equal to a
Pound of <i>Suffolk</i>.
</p><p>
If Soldiers are sent as Passengers on board of King&#8217;s Ships,
or on board of Transports, their Allowance is generally but
Two-thirds of the above.</p></div>

<div class="footnote"><p><a name="Footnote_129_129" id="Footnote_129_129"></a><a href="#FNanchor_129_129"><span class="label">[129]</span></a> This Ventilator is no more than a long Tube, with a Tin
Box, about six Inches wide and four high, with a Number of
Holes at the Top, fixed at one End; and this Box is put down
to the Bottom of the Water, and the Nose of a Pair of Bellows
fixed to the other End of the Tube, which is above the Water;
by working the Bellows, fresh Air is driven through the whole
Body of Water, the putrid Effluvia are evaporated and dispersed,
and the Water becomes sweet in a very short Time.</p></div>

<div class="footnote"><p><a name="Footnote_130_130" id="Footnote_130_130"></a><a href="#FNanchor_130_130"><span class="label">[130]</span></a> This ought always to be done in the Morning, that all
the Parts of the Ship may have Time to dry before the Men go
to rest in their Births at Night; but it ought never to be done
after Sun-set.</p></div>

<div class="footnote"><p><a name="Footnote_131_131" id="Footnote_131_131"></a><a href="#FNanchor_131_131"><span class="label">[131]</span></a> It has been proposed, that the Air in Ships of War should
be purified in this Way both by Dr. <i>Lind</i> and by Mons. <i>de Hamel
de Monceau</i>.</p></div>

<div class="footnote"><p><a name="Footnote_132_132" id="Footnote_132_132"></a><a href="#FNanchor_132_132"><span class="label">[132]</span></a> A sufficient Store of Blankets has often been neglected to
be carried out in Expeditions into warm Climates; but Blankets
are no-where more necessary, as it is very prejudicial to the
Health of Soldiers to be obliged to lie down on the bare
Ground; and Straw, dried Reeds, and other such Things, are
often difficult to be got in the warm Climates.</p></div>

<div class="footnote"><p><a name="Footnote_133_133" id="Footnote_133_133"></a><a href="#FNanchor_133_133"><span class="label">[133]</span></a> Dr. <i>Lind</i> says, the Use of the cold Bath, either in Tubs
under the Forecastle, or to dip in the Sea early in the Morning,
has been found extremely beneficial in warm Weather and hot
Countries; and that he can affirm, from his own Experience in
hot Climates, that many Diarrh&#339;as and other Complaints, the
pure and sole Effect of an unusual and great Heat (relaxing the
System of the Solids, and occasioning a Colliquation of the
Animal Juices), have not only been cured by cold Bathing;
but their Return, and even the Attack of such Diseases, effectually
prevented by it. <i>Ibid.</i> p. 44, &amp;c.</p></div>

<div class="footnote"><p><a name="Footnote_134_134" id="Footnote_134_134"></a><a href="#FNanchor_134_134"><span class="label">[134]</span></a> Mr. <i>du Hamel</i> says, that the Air of the Island of <i>St. Domingo</i>
is very fatal to <i>Europeans</i>; but it is observed that those
People who inhabit the rising Grounds are much less exposed
to Diseases than those who live in the Vallies. <i>Sur la sant&eacute; des
Equipages</i>, art. i. p. 16.</p></div>

<div class="footnote"><p><a name="Footnote_135_135" id="Footnote_135_135"></a><a href="#FNanchor_135_135"><span class="label">[135]</span></a> Ground may seem very dry and healthful, and yet be
quite the contrary, as Dr. <i>Pringle</i> remarks is the Case in the
Neighbourhood of <i>Bois le Duc</i>, in <i>Flanders</i>, where Water is
found every where at the Depth of two or three Feet from the
Surface.</p></div>

<div class="footnote"><p><a name="Footnote_136_136" id="Footnote_136_136"></a><a href="#FNanchor_136_136"><span class="label">[136]</span></a> Mr. <i>du Hamel</i> remarks, that Places which were formerly
very subject to Diseases have become healthful when the Water
which surrounded them was refreshed by opening a Communication
with the Sea. <i>Ibid.</i> art. i. p. 18.</p></div>

<div class="footnote"><p><a name="Footnote_137_137" id="Footnote_137_137"></a><a href="#FNanchor_137_137"><span class="label">[137]</span></a> Dr. <i>Pringle</i> observes, that where Grounds are equally
dry, that the Camps are always most healthful on the Banks of
large Rivers; because in the hot Season Situations of this Kind
have a Stream of fresh Air from the Water, tending to carry
off both the moist and putrid Exhalations.&mdash;And in Cantonments
we are not only to seek Villages removed from marshy
Grounds, but such as are least choaked with Plantations, and
stand highest above subterraneous Water. See his <i>Observat.
on Diseases of the Army</i>, 3d edit. p. 99.</p></div>

<div class="footnote"><p><a name="Footnote_138_138" id="Footnote_138_138"></a><a href="#FNanchor_138_138"><span class="label">[138]</span></a> The Negroes on the Coast of <i>Guinea</i>, and some of the
<i>Indians</i>, both of whom sleep on the Ground, have constantly a
Fire producing a little Smoak burning in the Hutts where they
sleep, which corrects the Moisture of the Night, and renders
the Damp of the Earth less noxious; and during the Time of
the very unwholesome Fogs on the Coast of <i>Guinea</i>, called Harmattans,
which lay waste whole Negroe Towns, the Smoak of
Wood, of pitched Staves, and such Things, are found to be
the best Correctors of this thick Air. See Dr. <i>Lind&#8217;s Means of
preserving the Health of Seamen</i>.</p></div>

<div class="footnote"><p><a name="Footnote_139_139" id="Footnote_139_139"></a><a href="#FNanchor_139_139"><span class="label">[139]</span></a> Dr. <i>Lind</i> says, that it is constantly observed in unhealthy
Harbours, that the Boats Crews employed in wooding and watering
the Ships, who are obliged to lie on Shore, suffer most.
<i>Ibid.</i> p. 72.</p></div>

<div class="footnote"><p><a name="Footnote_140_140" id="Footnote_140_140"></a><a href="#FNanchor_140_140"><span class="label">[140]</span></a> A very remarkable Instance of this we have related by
Dr. <i>Lind</i>. In the Year 1739, in <i>Mahon</i> Harbour, a Party of
Men were sent with the Coopers from Admiral <i>Haddock</i>&#8217;s Fleet
to refit and fill the Water Casks, who, finding an artificial Cave
dug out of a soft sandy Stone, put their bedding into it; every
one who slept in this damp Place was infected with the Tertian
Fever, then epidemic in <i>Minorca</i>, and not one in eight recovered.
At the same Time the Men aboard the Ships continued
healthy; and others, who were afterwards sent on the same
Duty, enjoyed perfect Health by being obliged to sleep in their
respective Ships. He says, he has known a whole Boat&#8217;s Crew
seized next Morning with bad Fevers by sleeping near the
Mangroves, with which the Sides of the Rivers are frequently
planted in the Torrid Zone. <i>Ibid.</i> p. 74, 75.</p></div>

<div class="footnote"><p><a name="Footnote_141_141" id="Footnote_141_141"></a><a href="#FNanchor_141_141"><span class="label">[141]</span></a> The higher that Ships sail up the Rivers upon the Coast
of <i>Guinea</i>, the more sickly they become: Such, however, as
keep at Sea beyond the Reach of the Land Breezes (that is, two
or three Leagues at Sea), are for the most part healthy. <i>Lind</i>,
<i>ibid.</i> p. 65. The Malignity of these Land Vapours often does
not extend itself to any considerable Distance, as we know by
manifold Experience. The Troops in <i>Zealand</i> were very unhealthy
when Admiral <i>Mitchel</i>&#8217;s Squadron, which lay but a little
Way from the Shore, enjoyed perfect Health.&mdash;Dr. <i>Pringle&#8217;s
Observat. on the Diseases of the Army</i>, p. 1. chap. vii.&mdash;In <i>July</i>
and <i>August</i> 1744, two Ships, belonging to Admiral <i>Long</i>&#8217;s
Squadron in the <i>Mediterranean</i>, lying near the Mouth of the
River <i>Tyber</i>, began to be affected, while others, though at a
very small Distance, but further out at Sea, had not a Man
sick. <i>Lind</i>, <i>ibid.</i> p. 66.</p></div>

<div class="footnote"><p><a name="Footnote_142_142" id="Footnote_142_142"></a><a href="#FNanchor_142_142"><span class="label">[142]</span></a> The divine Lawgiver <i>Moses</i> has enjoined Cleanliness in
the Camp to the <i>Jews</i> in a particular Manner, when he says,
</p><p>
&#8220;Thou shalt have a Place also without the Camp, whither
thou shalt go forth abroad; and thou shalt have a Paddle
upon thy Weapon, and it shall be when thou wilt ease thyself
abroad thou shalt dig therewith, and shalt turn back and
cover that which cometh from thee. For the Lord thy God
walketh in the Midst of thy Camp; therefore shall thy
Camp be holy, that he see no unclean Thing in thee, and
turn away from thee.&#8221; <i>Deuteronomy</i>, chap. xxiii. verses 12,
13, 14.</p></div>

<div class="footnote"><p><a name="Footnote_143_143" id="Footnote_143_143"></a><a href="#FNanchor_143_143"><span class="label">[143]</span></a> The <i>British</i> Soldiers in <i>Germany</i> used sometimes to hurt
their Health by eating great Quantities of raw unripe Apples,
Plumbs, and other unripe Fruits; but the foreign Troops had
a much better Method of using such Fruits: They commonly
boiled or stewed them, and eat them with Bread, or with their
Meat, which in a great Measure corrected their bad Qualities.
</p><p>
The Orders in the <i>French</i> Camp, prohibiting the Men from
eating unripe Fruit, were strictly complied with every-where in
<i>Germany</i> during the late War.</p></div>

<div class="footnote"><p><a name="Footnote_144_144" id="Footnote_144_144"></a><a href="#FNanchor_144_144"><span class="label">[144]</span></a> See the Treatise published by Dr. <i>Luc. Anton. Portius</i>
in 1686, <i>de Militis in castris sanitate tuenda</i>, <i>part.</i> ii. <i>cap.</i> vi.
In this Book we have many useful Things mentioned relative
to the Health of Soldiers.</p></div>

<div class="footnote"><p><a name="Footnote_145_145" id="Footnote_145_145"></a><a href="#FNanchor_145_145"><span class="label">[145]</span></a> Dr. <i>Lind</i> relates a Number of Experiments of his having
distilled Sea Water in different Manners, as recommended by
others; and concludes, that the best Way of getting fresh Water
from Salt, is to distil the Sea Water by itself, without any
Mixture; and he proposes having a Still Head to the Coppers
or Iron Pots in which the Meat is dressed aboard a Ship. <i>Ibid.
note to p. 84</i>, &amp;c.</p></div>

<div class="footnote"><p><a name="Footnote_146_146" id="Footnote_146_146"></a><a href="#FNanchor_146_146"><span class="label">[146]</span></a> During the Campaign in <i>Hungary</i>, in the Year 1717,
Count <i>Boneval</i> preserved both himself and Family from Disorders,
by taking himself, and making all his Domesticks take,
two or three Times a Day, a small Quantity of Brandy, in
which Bark had been infused, at a Time when all the Rest of
the Army were infected with malignant Disorders. A Regiment
in <i>Italy</i> continued healthy by the Use of the Bark, when
the Rest of the <i>Austrian</i> Army, who did not pursue the same
Method, were greatly annoyed with Sickness. See <i>Kramer.</i>
quoted by Dr. <i>Lind</i>.</p></div>

<div class="footnote"><p><a name="Footnote_147_147" id="Footnote_147_147"></a><a href="#FNanchor_147_147"><span class="label">[147]</span></a> <i>Observat.</i> part. i. chap. iii.</p></div>
</div>


<h2><a name="MILITARY_HOSPITALS" id="MILITARY_HOSPITALS"></a><small>OF</small><span class='pagenum'><a name="Page_355" id="Page_355">[355]</a></span><br />
<span class="smcap">Military Hospitals</span>.</h2>


<p class="newchapter"><span class="firstword"><span class="dropcap">W</span>henever</span> Men are seized with
Distempers, they ought immediately
to be separated from those in Health, and
either sent to the Regimental<a name="FNanchor_148_148" id="FNanchor_148_148"></a><a href="#Footnote_148_148" class="fnanchor">[148]</a> or General
Hospital.</p>

<p>There is no Part of the Service that requires
more to be regarded than the Choice of proper
<span class='pagenum'><a name="Page_356" id="Page_356">[356]</a></span>Places for Hospitals, and the right Management
of them, on which the Health and Strength of
an Army often depends; for in wet unwholesome
Seasons, if infectious Disorders get into
the Hospitals, which possibly might have been
prevented by proper Care, they often weaken
an Army in a very short Time far more than
the Sword of the Enemy.</p>

<p>We have no Account of the particular Manner
in which the Antients took Care of their
Sick and Wounded in Times of War; for although
we read in <i>Homer</i><a name="FNanchor_149_149" id="FNanchor_149_149"></a><a href="#Footnote_149_149" class="fnanchor">[149]</a> of Surgeons or
Physicians attending the <i>Grecian</i> Camp, and in
<i>Xenophon</i><a name="FNanchor_150_150" id="FNanchor_150_150"></a><a href="#Footnote_150_150" class="fnanchor">[150]</a> of <i>Cyrus</i>&#8217;s having appointed Physicians
to his Army; and we learn from <i>Tacitus</i><a name="FNanchor_151_151" id="FNanchor_151_151"></a><a href="#Footnote_151_151" class="fnanchor">[151]</a>
<span class='pagenum'><a name="Page_357" id="Page_357">[357]</a></span>and <i>Livy</i><a name="FNanchor_152_152" id="FNanchor_152_152"></a><a href="#Footnote_152_152" class="fnanchor">[152]</a>, that the wounded <i>Romans</i> were
received into the Houses of the Nobility, and
had Physicians to attend them, and were furnished
with Fomentations and other proper
Remedies; and from <i>Justin</i><a name="FNanchor_153_153" id="FNanchor_153_153"></a><a href="#Footnote_153_153" class="fnanchor">[153]</a>, that the <i>Lacedemonians</i>
followed the same Method: yet
these Authors make no Mention of the particular
Oeconomy or Manner in which these
Hospitals were conducted.</p>

<p>The Hospitals commonly wanted for an Army
acting on the Continent, are,</p>

<p>1. One in the Rear, to follow their Motions,
so as to be always ready to receive the Sick
from Camp, which is called the Moveable or
Flying Hospital. 2. One or more, at some
<span class='pagenum'><a name="Page_358" id="Page_358">[358]</a></span>Distance, in Towns, to receive such of the
Sick as can be moved from the Flying Hospital,
when they are obliged to go from one
Place to another; or when a greater Number
of Sick is sent to them than they can easily
take Care of<a name="FNanchor_154_154" id="FNanchor_154_154"></a><a href="#Footnote_154_154" class="fnanchor">[154]</a>.</p>

<p>Each of the Hospitals ought to be provided
with Physicians, Surgeons Mates, Purveyors,
or Commissaries, and others, to attend and take
Care of the Sick.</p>

<p>Besides the physical People who attend the
Hospital, one or two Physicians ought to go
along with the Army to attend the Commander
in Chief, and the General and Staff Officers,
in Case of Sickness; and an Apothecary,
provided with a small Chest of Medicines,
ought to attend at Head Quarters to make up
the Prescriptions of the Physicians.</p>
<p><span class='pagenum'><a name="Page_359" id="Page_359">[359]</a></span></p>
<p>A Number of Hospital Surgeons also, with
Mates, ought to attend the Army, to be ready
in Case of an Action. These ought to be attached
to the Suite of the Commanders of the
different Corps or Brigades, and to be quartered
or encamped with them. And each Surgeon
should be provided with a Waggon or some
Horses loaded with a proper chirurgical Apparatus,
as Instruments, Bandages, Lint, and
other Things necessary for taking Care of the
Wounded.</p>

<p>A small Quantity of Medicines, some Wine,
Rice, portable Soop, &amp;c. and Utensils for a
small Hospital, and two, three, or four hundred
Sets of Bedding, should be carried about
with the Army, in Case of an Action, for the
Use of the Wounded, till they have Time to
receive Assistance from the Flying Hospital.
Some of the Bedding ought to be carried on
Horseback, so as to be at Hand when any of
the Surgeons are sent with Detachments that are
going upon an Attack.</p>

<p>To prevent crowding the General Hospitals
in Winter Quarters, every Regiment ought to<span class='pagenum'><a name="Page_360" id="Page_360">[360]</a></span>
take Care of their own Sick, and to have proper
Hospitals fitted up for them.</p>

<p>Dr. <i>Pringle</i> has laid down some very good
Directions with regard to the Choice of Places
fit for Hospitals, and the Method of preventing
infectious Disorders in them; and we find
many excellent Hints of this Kind in Dr. <i>Lind</i>
and Mons. <i>du Hamel</i>&#8217;s Treatises on the Means
of Preserving the Health of Seamen, and some
likewise in Dr. <i>Brocklesby</i>&#8217;s late Treatise on military
Disorders.</p>

<p>In the Time of Service the Commander in
Chief generally orders the Hospitals to be established
in Towns or Villages that least interfere
with the military Operations, to which the
Sick and Wounded can most easily be conveyed;
and which he can best protect from the
Insults of the Enemy<a name="FNanchor_155_155" id="FNanchor_155_155"></a><a href="#Footnote_155_155" class="fnanchor">[155]</a>.</p>
<p><span class='pagenum'><a name="Page_361" id="Page_361">[361]</a></span></p>
<p>In Towns, the Places fittest for Hospitals are
public Buildings, which have large dry airy
Apartments, situated on a high Ground, where
there is a free Draught of Air, and a Command
of Water.</p>

<p>In Winter, those Houses, which have open
Fire Places in the Rooms, are always preferable
to such as have close Stoves, or no Fire
<span class='pagenum'><a name="Page_362" id="Page_362">[362]</a></span>Place at all; for an open Fire Place serves
to keep up a free Circulation of Air in a Room,
as well as to keep it warm. And for the same
Reason, where nothing but Stoves can be got
to warm the Wards, the Wynd Stoves, which
open into the Room or Ward, are vastly preferable
to the close ones.</p>

<p>Where there are no public Buildings, private
Houses answering nearest to the above Description
are most proper for Hospitals. In general,
Houses with small Rooms make but bad
Hospitals; and very Damp and close Places
ought by all Means to be avoided.</p>

<p>In Summer, when the Moveable or Flying
Hospital is ordered into Villages, large Barns,
and the largest airy Houses, are the best.</p>

<p>Churches, situated on a dry high Ground,
make good Summer Hospitals; and in Winter,
when Necessity obliged us sometimes to use
them in <i>Germany</i> for this Purpose, they were
found to answer very well, when we had
Bedsteads or Cradles for the Men to lie upon,
and the Wynd Stoves to keep them of a
moderate Heat.<span class='pagenum'><a name="Page_363" id="Page_363">[363]</a></span></p>

<p>In making Choice of Houses for Hospitals,
particular Regard ought to be had to the Privies
or Necessaries; because, where their Smell
is offensive, there is always Danger of infectious
Disorders. If, therefore, there be no
proper Conveniencies of this Kind about an
Hospital, such ought to be contrived so as to
prevent any Danger from their putrid Effluvia.
If there be a River near the Hospital, the Necessaries
may be made above it at a Place
where there is a rapid Stream below. In Villages
deep Pits may be dug in the Ground
behind the Hospital, and Seats made over
them, as in Camp; and a thick Lay of Earth
be thrown above the F&#339;ces every Morning,
till the Pits are near full, and then they must
be filled up, and others dug to supply their Place.</p>

<p>When once the Places are fixed upon for
Hospitals, every Ward ought to be made perfectly
sweet and clean; first, by scraping and
washing with Soap and Water, and afterwards
with warm Vinegar; and then they ought to
be fumigated with the Smoke of wetted Gunpowder
and of Aromatics, and afterwards well<span class='pagenum'><a name="Page_364" id="Page_364">[364]</a></span>
dried and aired by lighting Fires, and opening
the Windows, before any Sick are admitted.</p>

<p>After this the Beds ought to be laid; in doing
of which great Care should be taken not to
crowd the Wards too much, as nothing corrupts
the Air so much, or so soon brings on infectious
Disorders. Dr. <i>Pringle</i> says, the Beds
ought to be laid so thin, that a Person unacquainted
with the Danger of bad Air, might
imagine there was Room for double or triple
the Number. In high lofty Apartments, and
in Churches, and other large Places, the Beds
may be laid much closer together than in
Rooms with low Cielings. In Churches, or
such Places, thirty-six square Feet, or a Square
of six Feet by six, may be allowed for each
Man; but in common Wards we must allow
from forty-two square Feet, <i>i.&nbsp;e.</i> six by seven
Feet, to sixty-four square Feet, or eight by
eight, according to the Height of the Cieling,
the Airyness of the Place, and the Nature of
the Diseases of the Patients.</p>

<p>The Bedding most fit for Hospitals, is Palliasses
and Bolsters filled with Straw, Sheets,<span class='pagenum'><a name="Page_365" id="Page_365">[365]</a></span>
and Blankets, as they can easily be washed.
Feather Beds and Matrasses are apt to retain
Infection, and cannot be easily cleansed. In
the fixed Hospitals, Bedsteads or Cradles may
be set up for laying the Bedding on: But in
the Moveable or Flying Hospital the Bedding
must be, for the most part, laid on the Floor.</p>

<p>When once the Beds are laid, and the Sick
arrive, some of the Gentlemen belonging to the
physical Department ought to attend, to distribute
the Sick properly through the Hospitals.</p>

<p>All the Surgery Patients, such as have
Wounds, Ulcers, Sores, the Venereal Disease,
&amp;c. should be separated from the Rest, and put
either into particular Wards by themselves, or
into an Hospital fitted up for that Purpose under
the Direction of the Surgeons.</p>

<p>Those labouring under infectious Fevers and
Fluxes, should each of them be placed in good
airy Wards by themselves, where the Beds are
laid much thinner than in the other Wards of
the Hospital. If the Flux Wards have a Privy
near them, where the Men can ease themselves,<span class='pagenum'><a name="Page_366" id="Page_366">[366]</a></span>
without being offensive either to their
own Ward, or any other Part of the Hospital,
they are so much the fitter for such Patients.
In the Hospital I attended at <i>Bremen</i>, the Flux
Ward had a Necessary that opened into the
River <i>Weser</i>, and at <i>Natzungen</i> a deep Pit was
dug in the Field about twenty Yards from the
Barn where the Flux Men lay, which kept
these Wards always sweet.</p>

<p>Patients that have got the Itch, or any other
infectious Distemper, ought likewise to be put
into separate Wards by themselves; and at all
Times a Place should be set apart for those who
may be taken ill of the Measles or Small-Pox.
A House separated from the other Hospitals,
with a distinct Set of Nurses and other Attendants,
bids fairest to prevent the Infection from
spreading.</p>

<p>When once the Sick are properly ranged,
the next Care must be to prevent infectious
and malignant Disorders from being generated,
and from spreading amongst the Sick; which is
principally to be effected by keeping the Sick<span class='pagenum'><a name="Page_367" id="Page_367">[367]</a></span>
and the Hospital extremely clean and well-aired,
and the Wards as sweet, and free from
putrid and offensive Smells, as possible.</p>

<p>Every sick Man, as soon as he arrives at an
Hospital, should be washed with warm Water,
or if there is a warm Bath, or bathing Tub, to
be put into it; and afterwards be supplied with
a clean Shirt<a name="FNanchor_156_156" id="FNanchor_156_156"></a><a href="#Footnote_156_156" class="fnanchor">[156]</a> well-aired before he be put to
Bed; and his own dirty Linen should be immediately
carried to the Wash-House: And
every Morning each Nurse ought to carry a
Bucket full of warm Water, and a Piece of
Soap and a Towel, round to each of her
Patients, and make them wash their Hands
and Face, and their Feet, when dirty.</p>

<p>Every Morning all the Wards ought to be
scraped and swept, and afterwards sprinkled
with warm Vinegar; and when dirty, they
ought to be washed after the Fires are lighted.</p>
<p><span class='pagenum'><a name="Page_368" id="Page_368">[368]</a></span></p>
<p>Every Thing in the Wards, and about the
Sick, should be kept as clean as possible; the
Chamber-Pots and Close-Stools ought to be
carried away as soon as used, and immediately
emptied and washed before they be brought
back.</p>

<p>The Windows of the Wards ought to be
kept open to admit fresh Air Morning and
Evening, for a longer or shorter Time, according
as the Weather will permit.</p>

<p>If the Wards are close, and the Cieling too
low, Dr. <i>Pringle</i> advises to remove some Part
of them, and to open the Garret Story to the
Tiles<a name="FNanchor_157_157" id="FNanchor_157_157"></a><a href="#Footnote_157_157" class="fnanchor">[157]</a>; and if the Opening of the Windows
<span class='pagenum'><a name="Page_369" id="Page_369">[369]</a></span>is not sufficient to air the Wards, Ventilators of
different Kinds, such as those mentioned by Dr.
<i>Hales</i> and Dr. <i>Pringle</i>, may be used, especially
when the Weather is hot.</p>

<p>In Winter, Fires should be lighted in all
the Wards where it can be done.</p>

<p>In foreign Countries, when we meet with
Hospitals where there are no Places for open
Fires, but only close Stoves, different Contrivances
may be used to renew the Air. Ventilators
of different Kinds may be used, or Openings
made in the Doors and Windows. In
Winter 1761-62, some of the Wards in the
Hospital at <i>Bremen</i> which I attended had
such Stoves. In order to keep up a free Circulation
of Air in those Wards, I directed large
Holes to be cut in the lower Part of the Door
in each Ward, and two Grooves to be made on
the Outside of the Door, above and below the
Hole, parallel to each other, in which a Board
slided; by means of which, the Hole could be
either quite covered or only in Part, or left
entirely open; and I directed a Casement,<span class='pagenum'><a name="Page_370" id="Page_370">[370]</a></span>
about eight or nine Inches square, to be made
in the upper Corner of each Window. After
the Fires were lighted, upon removing the
Board which covered the Hole in the Door,
and opening the little square Windows, a Current
of fresh cool Air rushed into the Ward by
the Door, while the heated foul Air found an
Exit by the Windows. In very cold Weather,
the Opening of the small Windows was sufficient;
but in mild Weather, and in Summer,
it was necessary to keep both open.</p>

<p>The Wards should be daily fumigated by
Means of Aromatics, or wetted Gunpowder
thrown on burning Coals, put in an Iron Pot
or Chaffern, or with the Steams of warm Vinegar
placed in the Middle of the Ward. Dr.
<i>Lind</i> says, that although Cleanliness and a pure
Air contribute much to prevent infectious Disorders,
or to check them, yet that they of
themselves are not always sufficient; but that
he seldom or never knew a proper Application
of Fire and Smoke to be unsuccessful in producing
the happy Consequence of effectually<span class='pagenum'><a name="Page_371" id="Page_371">[371]</a></span>
purifying all tainted Places, Materials, and Substances<a name="FNanchor_158_158" id="FNanchor_158_158"></a><a href="#Footnote_158_158" class="fnanchor">[158]</a>.</p>

<p>In all Military Hospitals, at least in the fixed
ones, one Ward ought to be always kept
empty; and whenever a malignant Fever, or
any other infectious Disorder, breaks out in any
Ward, the Men ought to be removed into this
empty one; and the foul Ward purified, by
washing and cleaning it well with Soap and
Water, and then with warm Vinegar; and afterwards
purifying it with Smoke, in the same
Manner as is practised in his Majesty&#8217;s Ships of
War; and Fires should be lighted daily, and
the Windows kept open for some Time, before
any Sick be again admitted into it.</p>
<p><span class='pagenum'><a name="Page_372" id="Page_372">[372]</a></span></p>
<p>As soon as any Patient dies, the Body ought
to be removed to the Dead House; and the
Bedding he lay upon should be carried away
immediately, and not used again till it has been
smoked, well-aired, and washed.</p>

<p>All the Linen of Patients in Fevers, Fluxes,
and other infectious Disorders, ought to be
changed often; and all the foul Linen and foul
Bedding of the Hospital should be smoked
with the Fumes of Brimstone, or of wetted
Gunpowder, in a Place set apart for that Purpose;
and Dr. <i>Lind</i> advises to steep them first
in cold Water, or cold Soap Lees, before putting
them in warm Water; as it is dangerous
for any Person to receive the Steam that may
at first arise, where this Precaution is not
used.</p>

<p>All the Cloaths, of Soldiers who die in Hospitals,
ought to be sent to the Smoke House,
and be well fumigated, and afterwards aired,
before they are put up in the Store-House.</p>

<p>The next Thing to be considered about a
Military Hospital is the Diet of the Patients,
which should consist of good wholesome Provisions,<span class='pagenum'><a name="Page_373" id="Page_373">[373]</a></span>
that can be purchased easily, and at a
cheap Rate<a name="FNanchor_159_159" id="FNanchor_159_159"></a><a href="#Footnote_159_159" class="fnanchor">[159]</a>.</p>

<p>Good Bread<a name="FNanchor_160_160" id="FNanchor_160_160"></a><a href="#Footnote_160_160" class="fnanchor">[160]</a> is a standing Article of Provisions
for an Hospital in all Countries and in
all Climates; and a certain Quantity of it
ought to be distributed to each Man daily.</p>

<p>The Breakfast and Supper in most Military
Hospitals must be made of Water Gruel or
Rice Gruel; as either Rice or Oatmeal can be
got in most Places, and are very portable.&mdash;Water
Gruel is in general preferable to the
Rice Gruel, because most Patients nauseate the
Rice Gruel, after eating it for some Days, but
not the Water Gruel, as every Person, who has
attended the Military Hospitals, must have experienced.
<span class='pagenum'><a name="Page_374" id="Page_374">[374]</a></span>Where both Rice and Oatmeal can
be had, Rice Gruel may be used two or three
Times a Week by Way of Variety.</p>

<p>But although Rice Gruel is not so proper
for constant Use, yet Rice should always make
an Article among the Stores for an Hospital, as
it is useful for making Rice Water for Drink;
and it can be boiled or ground, and made into
a light Pudding, and in short may be used in a
Variety of Forms to make a good and wholesome
Food for the Sick.</p>

<p>Oatmeal is cheaper than Rice, and can be
procured almost every-where in <i>Europe</i>, where
Armies make Campaigns; as Oats make such
a great Article in the Forage for Horses. And
a sufficient Quantity can at any Time be ground
into Meal for the Use of the Sick, at the Mills
which are employed for making Flour for the
Bakery, if there be none nearer the Hospital.</p>

<p>In Countries where neither Oatmeal nor
Rice can be had, <i>Indian</i> or some other Corn,
which is known to be wholesome, and which
the Country affords, may be employed in their
Place.<span class='pagenum'><a name="Page_375" id="Page_375">[375]</a></span></p>

<p>When fresh Meat can be got, the Men who
are on full Diet, and the Nurses and other
Servants about the Hospital, should have Meat
for Dinner; and the Meat that is boiled for
them ought to make Broth for the Sick who
are kept on a low or middle Diet. Some Barley
or Rice should be added to the Broth; and
a small Quantity of Carrots, Turnips, or other
Vegetables, boiled along with them, will make
it more agreeable to the Taste.</p>

<p>On Expeditions where nothing but salted
Meat can be had, a Quantity of portable Soop
should always be carried out for the Use of the
Sick; which with Water and some Barley,
and fresh Vegetables, when they can be
got, will make a good Soop or Broth. On
such Occasions, the Dinner ought to consist of
Soop and Bread, or of light Puddings made of
Flour or of Rice, of boiled Rice or Barley, or
of Panado, &amp;c.</p>

<p>Nurses and recovered Men may be allowed
salted Meat twice or thrice a Week.</p>

<p>The common Drink of Military Hospitals
ought to be Rice and Barley Water, with a<span class='pagenum'><a name="Page_376" id="Page_376">[376]</a></span>
small Proportion of Spirits and Sugar. Small
Beer is a good Drink where it can be easily
procured; as is Wine and Water, or a very
small Negus, or very weak Punch in warm
Climates.</p>

<p>Besides this Diet, extraordinary Indulgences
may be occasionally allowed to particular Patients,
as Wine, Brandy, Sugar, Milk. And
the Physicians and Surgeons ought to have a
discretionary Power to order a Vegetable or
any other proper Diet for Patients in the Scurvy,
or any other particular Complaints.</p>


<p class="negative">The Established Diet of a Military Hospital<span class='pagenum'><a name="Page_377" id="Page_377">[377]</a></span>
may be,</p>

<table summary="diet" class="diet">
<tr><td>&nbsp;</td><td style="text-align: center"><i>Breakfast.</i></td><td style="text-align: center"><i>Dinner.</i></td><td style="text-align: center"><i>Supper.</i></td></tr>

<tr><td style="width: 14%; border-right: solid black 1px">Full Diet,</td>

<td style="width: 25%; border-right: solid black 1px"><span style="padding-left: 1em">One Pint of Water or Rice Gruel.</span><br />
<span style="padding-left: 1em">Water Gruel made with 3 or 4 Ounces of Oatmeal, a
little common Salt, and with or without a little Sweet Oil, and two Spoonfuls of Wine.</span><br />
<span style="padding-left: 1em">Rice Gruel made with two Ounces of Rice, one Spoonful of fine Flour, a little
common Salt and Sugar.</span></td>

<td style="width: 25%;  border-right: solid black 1px">One Pound of boiled fresh Meat.</td>

<td style="width: 25%">As Breakfast.</td></tr>

<tr><td colspan="4" style="line-height: 1%; border-bottom: solid black 1px">&nbsp;</td></tr>
<tr><td colspan="4" style="line-height: 1%">&nbsp;</td></tr>

<tr><td style="width: 14%; border-right: solid black 1px">Middle Diet,</td>

<td style="width: 25%; border-right: solid black 1px">Ditto.</td>

<td style="width: 25%;  border-right: solid black 1px">One Pint of Broth, half Pound of boiled Meat.</td>

<td style="width: 25%">Ditto.</td></tr>

<tr><td colspan="4" style="line-height: 1%; border-bottom: solid black 1px">&nbsp;</td></tr>
<tr><td colspan="4" style="line-height: 1%">&nbsp;</td></tr>

<tr><td style="width: 14%; border-right: solid black 1px">Low Diet,</td>

<td style="width: 25%; border-right: solid black 1px">Ditto, or according to the Patient&#8217;s Appetite.</td>

<td style="width: 25%;  border-right: solid black 1px">One Pint of Broth, or half a Pint of Panado, with two Spoonfulls of Wine,
and a Quarter of an Ounce of Sugar.</td>

<td style="width: 25%">Ditto.</td></tr>
</table>


<p>The daily Allowance of Bread to be one
Pound to each Man.<span class='pagenum'><a name="Page_378" id="Page_378">[378]</a></span></p>

<p>The common Drink for those on full and
middle Diet to be Rice or Barley Water, with
two Spoonfuls of Brandy to each Pint, and a
Quarter of an Ounce of Lump Sugar; small
Beer, or very weak Punch; or Wine and Water,
two Ounces of Wine to a Pint of Water,
and a Quarter of an Ounce of Sugar. The
Quantity not to exceed three Pints <i>per</i> Day.</p>

<p>Those on low Diet to have Rice or Barley
Water as above, with or without Wine or
Brandy.</p>


<p class="negative">The Diet Boards hung up in the Hospitals may
be made with the following Columns, nearly
as they were with us in <i>Germany</i>.</p>

<table class="boards" summary="Diet Boards">
<tr><td>Regiments.</td><td>Mens Names.</td><td colspan="3">Diet<br />F.<span style="padding-left: 1em; padding-right: 1em">M.</span>L.</td><td>Wine.<br />&frac12; Pints.</td>
<td>Brandy.<br />Ounces.</td><td>Milk.<br />&frac12; Pints.</td><td>Sugar.<br />Ounces.</td></tr>
<tr style="line-height: 1500%"><td>&nbsp;</td><td>&nbsp;</td><td style="width: 1%">&nbsp;</td><td style="width: 1%">&nbsp;</td><td style="width: 1%">&nbsp;</td><td>&nbsp;</td><td>&nbsp;</td>
<td>&nbsp;</td><td>&nbsp;</td></tr>
</table>

<p>When such Diet Boards are kept in an Hospital,<span class='pagenum'><a name="Page_379" id="Page_379">[379]</a></span>
and the Mens Names and Regiments are
once wrote down, the Patients may with very
little Trouble be put upon the full, middle, or
low Diet, with so much of the above-mentioned
Extraordinaries as may be judged proper.</p>

<p>If any Thing else be wanted for the Sick,
the Physician ought to give a particular Order
in Writing for it, the Columns here marked
being only for such Things as are most frequently
wanted.</p>

<p>It should be a general Rule in all Military
Hospitals, that, when a Party of Sick arrives,
every Man may have immediately a Mess of
Water Gruel given him, and afterwards be put
on low Diet till it is ordered otherwise by the
Physician or Surgeon who attends him.</p>

<p>It is not to be supposed that the Diet here
mentioned can be strictly kept to in all Parts of
the World; for it must often be varied according
to the Difference of the Climates, and to
the Provision of the Countries where the Scene
of War may be.<span class='pagenum'><a name="Page_380" id="Page_380">[380]</a></span></p>

<p>Whenever a Moveable or Flying Hospital is
to attend an Army, a Quantity of Bedding, and
of all Utensils for forming an Hospital, ought
to be put up in the Waggons, together with
Provisions of different Kinds, such as Oatmeal,
Rice, Sago, Brandy, Wine, Sugar, &amp;c. A Butcher
with a Stock of live Cattle, and a Baker
with a proper Quantity of Flour for making
Bread ought constantly to attend; and a Number
of empty Waggons should likewise be always
in Readiness, to transport the Sick when
the Hospital moves, or when a Party is to be
sent to the fixed Hospitals.</p>

<p>When Troops go upon an Expedition, besides
the common Hospital Ships, another Ship
ought to be properly fitted up for the Reception
of sick Officers<a name="FNanchor_161_161" id="FNanchor_161_161"></a><a href="#Footnote_161_161" class="fnanchor">[161]</a>; and every Hospital
Ship ought to be supplied with all Sorts of
<span class='pagenum'><a name="Page_381" id="Page_381">[381]</a></span>Provisions, and other Necessaries fit for forming
an Hospital, before they leave <i>England</i>.&mdash;And
one or more armed Vessels loaded with
Provisions, Wine, and all Sorts of Necessaries
for the Sick, ought to attend them; or if the
Expedition be intended for the warm Climates,
these Vessels ought to go before the Fleet to
take up Wine and Fruits, such as Lemons,
Oranges, &amp;c. Vegetables of different Kinds,
and a live Stock for the Use of the Sick.</p>

<p>All Hospitals attending Expeditions should
carry out among their Stores a Number of
large Tents for lodging the Sick and Wounded
immediately on making good their Landing.
Where a Siege is expected which will take up
Time, and where no Accommodations for the
Sick can be had till the Siege is over, a Ship or
two, with Boards, and other Necessaries for
building large Sheds, or temporary Hutts, for
the Sick, as proposed by Dr. <i>Brocklesby</i>, ought
to go along with the Fleet, or meet them at
the Place of their Destination. Such thatched
Sheds, or Hutts, are very necessary in the warm
Climates, as the perpendicular Rays of the Sun,<span class='pagenum'><a name="Page_382" id="Page_382">[382]</a></span>
beating upon Canvass, make Tents intolerably
hot. When any of our own Settlements
happen to be near the Place attacked, a fixed
Hospital may be established there; either in
Houses, if proper ones can be found; or in
temporary Sheds or Hutts erected for that Purpose;
and some Vessels, properly fitted up,
may be kept going with the Sick and Wounded,
and bringing back the recovered Men.</p>

<p>At every Military Hospital a Serjeant&#8217;s Guard
ought to mount; and Centinels be placed at
the Doors of the Hospital, 1. To prevent all
Visitors, who have not proper Leave, from
coming into the Hospitals; as such People oftentimes
crowd the Wards, disturb the Sick,
and are apt to catch infectious Distempers, and
to spread them among the Troops. 2. To
take Care the Patients do not go out of the
Hospital without having a Ticket<a name="FNanchor_162_162" id="FNanchor_162_162"></a><a href="#Footnote_162_162" class="fnanchor">[162]</a> of Leave
for that Purpose, signed by the Physician, Surgeon,
<span class='pagenum'><a name="Page_383" id="Page_383">[383]</a></span>or Apothecary, belonging to the Hospital.
3. To prevent spirituous Liquors, or other
Things of that Kind, being clandestinely carried
into the Hospital.</p>

<p>The Serjeant of the Guard, attended by the
Ward Master, ought, every Morning, to go
round the Wards to call a Roll, and see that
every Man is in his Ward; and to do the same
at Night before the Hospital Doors are shut,
and at this Time to order every Person out of
the Hospital who does not belong to it. And
the Serjeant, every Morning, ought to report
to the Physician, Surgeon, or Apothecary,
every Man&#8217;s Name who was found to be absent
at Roll-calling; and whether he found every
Thing regular and in good Order in going his
Rounds.</p>

<p>Every large Military Hospital ought to have
one Head Nurse, and a sufficient Number of
other Nurses, to attend and take Care of the
Sick.</p>

<p>Orders to the following Purport, hung up in
every Military Hospital, would serve to shew
the Nurses and Patients what their Duty is,<span class='pagenum'><a name="Page_384" id="Page_384">[384]</a></span>
and to maintain Regularity and good Order
through the whole Hospital.</p>


<h4><i>Matron, or Head Nurse.</i></h4>

<p>Every Matron, or Head Nurse, is to go
round all the Wards of the Hospital at least
twice a Day, Morning and Evening; to see
that the Nurses keep their Wards clean; that
they behave themselves soberly and regularly,
and give due Attendance to their Patients; and
to examine the Diet of the Patients, and see
that it is good and well dressed; and if she
finds any Thing amiss, to report the same to
the Physician, Surgeon, or Apothecary, of the
Hospital.</p>


<h4><i>Common Nurses.</i></h4>

<p>1. The Nurses are to give due Attendance
to their Patients; and to keep them always as
neat and clean, as the Nature of their Distempers
will admit of; to give them their Diet
regularly; to be particularly careful to see them
take the Medicines ordered by the Physicians,<span class='pagenum'><a name="Page_385" id="Page_385">[385]</a></span>
according to the Directions given; to report to
the Physician, Surgeon, or Apothecary, any Faults
or Irregularities which any of their Patients
may have committed; and to acquaint
the Ward Matter and Head Nurse of the Death
of any of their Patients as soon as it happens,
that proper Care may be taken of their Cloaths
and Effects.</p>

<p>2. They are to keep their Wards extremely
clean, to sprinkle them every Morning with
Vinegar, and to fumigate them with the Smoke
of wetted Gunpowder, or of Frankincense, or
any other Aromatics that may be thought proper;
in fair Weather to keep open the Windows
of their Wards, twice or thrice a Day;
for a longer or shorter Time, as the Weather
will permit; to attend at the Steward&#8217;s Room
for the Provisions of the Patients at the Hours
appointed for that Purpose; and to pay implicit
Obedience to the Matron, or Head Nurse,
in what relates to their Duty; and punctually
to obey all Orders they receive from the Physician,
Surgeon, or Apothecary, of the Hospital.<span class='pagenum'><a name="Page_386" id="Page_386">[386]</a></span></p>

<p>3. They are to keep themselves clean and
decently dressed, and to observe the strictest
Rules of Sobriety; remembering, that if any
one is found intoxicated with Liquor, that she
is immediately to be sent to the Guard, and
afterwards discharged.</p>

<p>4. They are not to absent themselves from
their Wards, unless when employed in the Discharge
of their Duty; nor to go out of the
Hospital to which they belong, without having
a Ticket of Leave signed by the Physician,
Surgeon, Apothecary, or Head Nurse, belonging
to the Hospital.</p>

<p>5. They are not to throw Nastiness of any
Kind out at the Windows, but to carry it to the
common Necessaries, and to empty the Chamber
Pots and Close-stools as soon as used, and
be careful to wash them before they bring
them back.</p>

<p>6. They are not, upon any Pretence whatever,
to alter the Diet ordered by the Physicians
or Surgeons to the Patients on the Diet
Boards; nor to suffer their Patients to use any
other Diet than what is allowed by the Hospital;<span class='pagenum'><a name="Page_387" id="Page_387">[387]</a></span>
nor are they to bring, or allow others to bring,
Meat, spirituous Liquors, or other Things of
that Kind, into their Wards, except what is allowed
by the Physicians or Surgeons. Whenever
any Thing of this Kind is found in any of
the Wards, it ought immediately to be thrown
into the common Necessary; and if it be
found in the Custody of a Nurse, she ought to
be confined in the Guard, or discharged.</p>

<p>7. Nurses guilty of great Neglect of Duty,
or of getting drunk and using their Patients ill,
or of stealing, or concealing or taking away the
Effects of Men who die in the Hospital, are to
be immediately sent to the Guard, and reported
to the Commanding Officer of the Place, that
they may be tried by a Court-Martial, and be
confined, whipped, or otherwise punished, as
the military Law directs; all Followers of Armies
on foreign Service being equally subject
to the military Law as the Soldiers themselves.</p>


<h4><i>Patients.</i></h4>

<p>1. All sick Soldiers, on their Arrival at a Military
Hospital, are to be washed all over with<span class='pagenum'><a name="Page_388" id="Page_388">[388]</a></span>
warm Water, or to go into a warm Bath;
and afterwards to wash their Face and
Hands every Morning, and their Feet occasionally,
with warm Water and Soap, brought
round every Morning by the Nurses for that
Purpose; and they ought to comb their Head
every Day. If they be too weak to wash and
comb themselves, it is to be done by their
Nurses.</p>

<p>2. Every Patient is to be shaved and have
clean Linen twice a Week, or oftener if requisite.</p>

<p>3. They are punctually to obey the Directions
given them, and to take the Medicines ordered
by the Physician; and none to be allowed
to go out of the Hospital without a Ticket
of Leave signed by the Physician, Surgeon, or
Apothecary, of the Hospital.</p>

<p>4. They must commit no Disorder or Riot,
but in all Respects behave themselves well.</p>

<p>5. If any Man disobeys the Orders he receives
from the Physicians or Surgeons, or is
irregular in Conduct, gets drunk, and commits
Riots in the Hospital, or is found guilty<span class='pagenum'><a name="Page_389" id="Page_389">[389]</a></span>
of Theft or other Crimes, the same is to be reported
to the Commanding Officer of the
Place, and he to be tried by a Court-Martial,
and punished as soon as his Strength will
permit.</p>

<p>In conducting the Military Hospitals, we
found that it was always right to discharge the
Patients from the sick Hospitals as soon as they
were recovered, and to send them either to
Billet, or to a convalescent Hospital; because
recovered Men are always the most riotous;
besides they crowded the Hospitals, and were
in Danger of catching fresh Disorders from
those who were sick; and therefore the recovering
Men in every Hospital ought to be reviewed
once or twice a Week by the Physician
or Surgeon, and the Names of such Men
as are well enough, to be marked; in order that
they may be sent the next Day to the convalescent
Hospital, or to Billet. A Return of
those marked for Billet ought immediately to
be sent to the Officers on convalescent Duty.</p>

<p>When a convalescent Hospital is established,
it ought to be put under proper Regulations;<span class='pagenum'><a name="Page_390" id="Page_390">[390]</a></span>
the following are those which I drew
up for that established at <i>Osnabruck</i> in <i>April</i>
1761, and which were found to answer the
Purpose intended.</p>


<h4><i>Regulations for a Convalescent Hospital.</i></h4>

<p>1. That this Hospital be entirely occupied
by such Men as are recovered from Diseases;
that no Men be sent there but those whose
Names are returned to the Purveyor&#8217;s Office by
the Physician or Surgeon of the Hospital.</p>

<p>2. That all the Patients shall be upon full
Diet, unless in particular Cases it be ordered
otherwise by the Physician or Surgeon.</p>

<p>3. That all the Patients shall breakfast, dine,
and sup, at regular stated Hours, in the Hall
appointed for that Purpose: Breakfast to be
ready at nine, Dinner at one, and Supper at
seven o&#8217;Clock in the Evening.</p>

<p>4. That no Patient shall carry up any Victuals
into the Wards appointed for sleeping in; and
if any Patient does not attend at the regular
Hours of Meals, no Allowance of Victuals<span class='pagenum'><a name="Page_391" id="Page_391">[391]</a></span>
shall be made him in the Place of such Meals,
unless he has been absent on Hospital Business,
or been confined to Bed by Sickness.</p>

<p>5. That as soon as the Men are come down
Stairs to Breakfast, the Wards in which they
sleep shall be cleaned out and sprinkled with
Vinegar, and the Windows opened to air
them.</p>

<p>6. That the Doors of this Hospital shall be
locked every Night at eight o&#8217;Clock, and no
Man be allowed to come in or go out after that
Time. The Doors to be opened again at seven
o&#8217;Clock in the Morning.</p>

<p>7. That the said Hospital is to be visited two
or three Times a Week by the Physician, Surgeon,
and Apothecary, who are to see that the
above Orders are complied with; to examine
the Diet, and take Care that every Thing is
carried on properly; and to prescribe for any
little Disorders the Men may be affected with.</p>

<p>8. That one of the Hospital Mates be appointed
to visit this Hospital daily, to administer
any Medicines which may have been prescribed<span class='pagenum'><a name="Page_392" id="Page_392">[392]</a></span>
by the Physician; to apply any Dressings
ordered by the Surgeon; and to acquaint
the Physician or Surgeon if any of the Men be
so bad as to require their Attendance, or to be
sent back again to the Sick Hospital.</p>

<p>9. That for the better executing these Regulations,
orderly Serjeants or Corporals be appointed
for the Care of the Men; who shall
mount a Guard of six or more of such of the
Patients of the said Hospital as are fit for this
Duty&mdash;That the Serjeants are to call a Roll of
all the Patients regularly three Times a Day,
before Breakfast, Dinner, and Supper; to see
that the Men behave themselves soberly and
decently; and that they keep themselves clean,
and commit no Riots; and to confine in the
Guard such as commit Riots and other Irregularities,
or whom they find drunk, or who stay
out all Night; and to report the same to the
Officer on Duty.</p>

<p>10. That an Officer on convalescent Duty do
visit the said Hospital daily at the Times of
Roll-calling, to see that every Thing be carried
on properly; and to receive the Reports from<span class='pagenum'><a name="Page_393" id="Page_393">[393]</a></span>
the Serjeants, and give what Orders he may
think proper for the better regulating the said
Hospital.</p>

<p>11. That if at any Time it should happen
that there are more Convalescents than the
Hospital can hold conveniently, a Review be
made of all the Patients, and the strongest and
most healthy be sent to Billet.</p>

<p>12. That a Review be always made, when
any Party is going to join the Army, to pick
out the Men who are fit to join their Regiments.</p>

<p>The Physical Officers employed in the Military
Hospitals, are Physicians, Surgeons, and
Apothecaries.</p>

<p>No Person ought to be appointed a Physician
to the Army, or Military Hospitals, without
previously undergoing the same Examination
at the College of Physicians, as those do who
enter Fellows and Licentiates of the College,
that none but proper Persons may be employed.
On such Examinations the Physician General
to the Army ought to be allowed to sit as one
of the Censors of the College.<span class='pagenum'><a name="Page_394" id="Page_394">[394]</a></span></p>

<p>The Surgeons are all obliged to pass an Examination
at Surgeons Hall before they are appointed,
and the Apothecaries ought in like
Manner to pass an Examination at Apothecaries
Hall.</p>

<p>The Mates employed in the Service ought,
previous to their Appointment, to be examined
both in Surgery and Pharmacy, as the Service
commonly requires their acting in both
Branches.</p>

<p>The Direction of all Military Hospitals
ought always to be committed to the Physicians,
who have the immediate Care of Hospitals.</p>

<p>When an Army is acting on a Continent,
and there is a Number of Hospitals in different
Places, the Physician who attends the Commander
in Chief ought to be made Physician
General and Director of the Hospitals, with
proper Appointments; and all Orders from
Head Quarters ought to go immediately thro&#8217;
this Channel.</p>

<p>Every other Physician at the different Hospitals
ought to direct every Thing about the<span class='pagenum'><a name="Page_395" id="Page_395">[395]</a></span>
Hospital which he attends, and his Orders
ought to be punctually obeyed; and he ought
to keep up a constant Correspondence with the
Physician General; acquainting him from Time
to Time with the State of the Hospital, and
what is wanted for it; and he ought punctually
to obey whatever Orders he receives from
the Physician General.</p>

<p>If there be separate Hospitals for the Surgery
Patients, the eldest Surgeon ought to direct
every Thing in the Hospital he attends; and
when any Thing is wanted for his Hospital,
to report the same to the Physician General.</p>

<p>The directing and purveying Branches ought
never to be entrusted to the same Person, as
the Temptation of accumulating Wealth has at
all Times, and in all Services, given Rise to the
grossest Abuses, which have been a great Detriment
to the Service, as well as to the poor
wounded and sick Soldiers, and has occasioned
the Loss of many Lives. And therefore neither
the Physician General, nor any of the Physicians
or Surgeons of the Army, or any other
Person concerned in the Direction of the Military<span class='pagenum'><a name="Page_396" id="Page_396">[396]</a></span>
Hospitals, ought ever to act as Purveyor
or Commissary; nor ought they ever to have
any Thing to do with the Accounts, Contracts,
or any other Money Affairs relating to
the Hospital; and if ever they be found to
intermeddle in these Affairs, they ought to be
immediately dismissed the Service.</p>

<p>The purveying or commissariate Branch
ought to be entirely distinct from the physical.
The Purveyors or Commissaries ought punctually
to obey whatever Orders they receive
from the Physicians or Surgeons; to provide
every Thing for the Hospital; to keep regular
Accounts of all the Men who come into, or
go out of the Hospitals; and from Time to
Time to make Returns to Head Quarters of
all the Men in Hospitals; and their Accounts
ought to be controuled by such Persons as the
Government may think proper.</p>

<p>Every Physician and Surgeon of a Military
Hospital ought to visit the Sick at regular stated
Hours, and the Mates to attend and go round
with them, and receive and execute their Orders.<span class='pagenum'><a name="Page_397" id="Page_397">[397]</a></span></p>

<p>Every Mate ought to have a certain Number
of Patients allotted him, for whom he is
to make up all Medicines, dress all Sores, and
execute whatever Orders he receives from the
Physician, Surgeon, or Apothecary. That the
Mates may know and execute their Duty,
proper Orders in Writing should be hung up
in the Apothecaries Shop for that Purpose.
The following are those which I gave out at
all the Hospitals I attended in <i>Germany</i>.</p>


<h4><i>Orders for the Mates.</i></h4>

<p>1. That all the Gentlemen do attend at the
Apothecaries Shop every Morning at eight
o&#8217;Clock, to assist in making up the common
Medicines of the Day, and afterwards to go
round the Hospitals with the Physicians and
Surgeons.</p>

<p>2. That every Mate have a Book for writing
the Prescriptions of the Physicians in,
which is to be kept in the following Order.&mdash;First,
to mark the Patient&#8217;s Name and Regiment;
then the Day of his Entry into the Hospital<span class='pagenum'><a name="Page_398" id="Page_398">[398]</a></span>
and his Disorder; then the Prescriptions
of the Physician; and after all the Day of his
Discharge, or of his Death. <i>Ex. gr.</i></p>

<div class="blockquot">
<p class="negative"><i>John Clarke</i>, 20th Regiment. <i>Jan.</i> 1. Fever.</p>

<p><i>Jan.</i> 1. V.&nbsp;S. unc. x.&mdash;H. salin. cum pulv.
contrayerv. 4<sup>r</sup>. die.&mdash;2. Emplast. vesicat. dorso,
&amp;c.</p>

<p style="padding-left: 2em">Discharged or dead <i>Jan.</i> 28.</p></div>

<p>3. That every Mate make up himself the
Physician&#8217;s Prescriptions for his own Patients,
and afterwards go round and administer them,
or give them to his Patients with proper Directions;
that he bleed his own Patients, and
dress any slight Sores they may have, which
do not require their being sent to the Surgery
Hospital.</p>

<p>4. That every Mate go round amongst his
Patients in the Evening, to see that every
Thing is well conducted, and to report to the
Physician or Apothecary if any Thing extraordinary
happens.<span class='pagenum'><a name="Page_399" id="Page_399">[399]</a></span></p>

<p>5. That two of the Mates attend all Day at
the Apothecary&#8217;s Shop to receive any Sick that
may arrive, and to place them properly; to
make up what Medicines they may immediately
want; to order each of them a Mess of
Water Gruel; and if any Thing extraordinary
occurs, to send an orderly Man to acquaint the
Physician or Apothecary with the same. The
orderly Mates to make up likewise for Officers,
or others, all Prescriptions sent to the Apothecary&#8217;s
Shop through the Day.</p>

<p>A Joint of Meat, roasted or boiled, for
Dinner, and a Bottle of Wine, was allowed to
the orderly Mates, by Lord <i>Granby</i>&#8217;s Order,
that they might not absent themselves from
their Duty.&mdash;Where there was Conveniency
for it, a Mate lodged in the Hospital.</p>

<p>The Apothecary ought to take Care of the
Medicines; to go round the Hospitals in the
Morning before the Time of the Physician&#8217;s
visiting; to see that the Wards are in proper
Order; that the Nurses and other Servants
have done their Duty; to examine into the
State of the Sick, and to see that the Provisions<span class='pagenum'><a name="Page_400" id="Page_400">[400]</a></span>
are good; and make a faithful Report of all
these Things to the Physician when he arrives.&mdash;To
take Care that the Mates prepare in the
Morning the Medicines that are commonly
wanted for the Day; and that they afterwards
make up faithfully the Prescriptions of the
Physician; to go round the Hospital again in
the Evening, to see that the Sick have got their
Medicines regularly; and to make the same
Enquiries as in the Morning.</p>

<p>The Apothecary should always be lodged
near the Hospital, to assist in Case of any Accidents
happening, or of Sick arriving at the
Hospital.</p>

<p>When there are any strong infectious Disorders
in Military Hospitals, the physical Gentlemen
may use the following Precautions to guard
themselves against Infection.</p>

<p>1. Never to visit the Sick with an empty
Stomach; but to eat Breakfast before they go
into the Hospital.</p>

<p>2. To have a Suit of Cloaths reserved for
visiting the Hospital, and a waxed Linen Coat
to wear above them in going round the Wards;<span class='pagenum'><a name="Page_401" id="Page_401">[401]</a></span>
and as soon as they have come out of the Hospital,
to wash and change their Linen and
Cloaths.</p>

<p>3. Before they go into the Wards, to order
that they be well cleaned out, and sprinkled
with Vinegar, and afterwards fumigated, and
aired by opening the Windows, or by Working
the Ventilators.</p>

<p>4. If the Infection be very strong, to take a
Glass of the spirituous Tincture of the Bark
just before they go into the Hospital.</p>

<p>5. To put small Rolls of Lint, dipped in
camphorated Spirits, up the Nostrils, and to
direct a Vessel, with warm camphorated Vinegar,
to be carried round, and held near the
Patients they are examining.</p>

<p>6. In examining Patients affected with the
Petechial Fever, or any other malignant Distempers,
to stand at some little Distance, and
ask what Questions they may think proper;
and when they come near, to feel the Pulse,
and examine the Skin, not to inspire while
their Head is near the Patient&#8217;s Body; but
after being fully satisfied in these Points, to retire<span class='pagenum'><a name="Page_402" id="Page_402">[402]</a></span>
a little, and ask what other Questions may
be necessary.</p>

<p>It would be right to establish some military
Rank for every commissioned Officer of the
Hospital on Service, and to settle the same Subordination
in the physical as in the military
Department. By these Means, the Service
would be carried on with greater Order, and
more Advantage to the Sick.</p>

<p>And it would be right, in Times of War,
to add a Clause in the Mutiny Bill to allow
any military Officer on convalescent Duty
to call in the commissioned physical Officers
to assist in making up a Court-Martial,
when there are not a sufficient Number of military
Officers in a Place, to try convalescent
Soldiers guilty of Crimes. For in Times of
Service, very often a sufficient Number of military
Officers cannot be spared to be on Duty
at the different Military Hospitals; and at all
such Places the Convalescents are generally
very disorderly, when they know that there is
not a sufficient Number of Officers to form a
Court-Martial for punishing them. Where-ever<span class='pagenum'><a name="Page_403" id="Page_403">[403]</a></span>
there are a sufficient Number of military
Officers, no physical Officer ought ever to be
called upon as a Member of a Court-Martial.</p>

<p>Men, in Time of Service, are often apt to
saunter in and about Hospitals, and there learn
all Manner of Debaucheries, and lose all Sense
of Discipline; and therefore, to keep up Order
and Decorum, there ought to be, at every
Fixed and every large Military Hospital, a military
Inspector or Commander, an Officer of
known Activity and Probity; and a Number
of Officers on convalescent Duty sufficient to
form a Court-Martial whenever required.</p>

<p>The Duty of the Military Inspector, or
Commander, should be, to take Care of all
Convalescents on Billet; to see that the Officers
under him do their Duty, and maintain the
same Regularity and Discipline among the
Men belonging to their respective Corps, as if
they were with their Regiments; and that the
Men attend the Parade and Roll-calling; and
that they always appear neat and clean.</p>

<p>He ought, from Time to Time, to visit the
Hospitals; to see if they are kept clean; to<span class='pagenum'><a name="Page_404" id="Page_404">[404]</a></span>
enquire if the Men behave well, if the Diet is
good, and the Officers, Nurses, and Servants,
do their Duty; and if he finds any Thing
amiss, to report the same to the Physicians and
Surgeons of the Hospital, or to the Purveyor or
Commissary, or others, under whose Department
it may be, that the same may be immediately
rectified; and if he finds that the superior
Officers of the Hospital overlook such Abuses,
notwithstanding his Representations, to report
the same immediately to the Head Quarters.</p>

<p>He ought to order one of the Officers on
convalescent Duty to visit the Hospitals daily,
to make the Enquiries above-mentioned, and
to give him a Report of the same in Writing.</p>

<p>The Purveyor or Commissary ought to
make a Return to him twice or thrice a Week
of every Man admitted into, or discharged
from, the Hospitals, or who dies in them;
marking in the Return the Name of every
Man, and the Company and Regiment he belongs
to; that he may report the same to the
Officers of the different Brigades or Regiments.<span class='pagenum'><a name="Page_405" id="Page_405">[405]</a></span></p>

<p>The Military Inspector ought to have the
Power of providing Billets for all Officers and
Soldiers about Hospitals; and the Names of
all Men to be discharged from Hospitals should
be sent to him the Day before they are discharged,
that he may provide Billets for them;
and next Day the Men ought to march from
the Hospitals to the Parade, to receive their
Billets, and the Orders of the Military Inspector,
and of the Officers of the Corps they belong to.</p>

<p>The Military Inspector ought to see that the
Arms of the sick Men, and the Arms and
Cloaths of those who die and are lodged in the
Magazines, be properly taken Care of; and
that the Stores of the different Regiments be
properly looked after.</p>

<p>As the Service often makes it necessary at
Military Hospitals, where the Number of Sick
is great, to employ the convalescent Soldiers<a name="FNanchor_163_163" id="FNanchor_163_163"></a><a href="#Footnote_163_163" class="fnanchor">[163]</a>
<span class='pagenum'><a name="Page_406" id="Page_406">[406]</a></span>as orderly Men and Servants about Hospitals,
all Men thus employed ought to have a special
Leave from the Military Inspector for so doing;
and no Man should be employed in any
Capacity as a Servant about an Hospital, who
at that Time is on the Books as a Patient.
And all Men employed about the Hospital
ought to be reviewed once a Week by the Military
Inspector, and likewise whenever a Party
of Convalescents is going to join the Army, or
their Regiments; that no Man may be allowed
to remain with the Hospital, after he is fit to
do Duty in his Regiment.</p>

<p>When the Military Inspector is absent, the
eldest Officer on convalescent Duty ought to
act in his Place.</p>

<p>Every Officer sent on convalescent Duty
ought, as soon as he arrives at the Place where
the Hospital is, to wait on the Commandant,
or Military Inspector; to acquaint him of his
Arrival, and to receive his Commands. He
ought then to go to the Purveyor or Commissary&#8217;s
Office, to get a List of all the Soldiers
who are in or about the Hospital, and belong to<span class='pagenum'><a name="Page_407" id="Page_407">[407]</a></span>
the Regiment or Brigade he is employed for,
wherein those on Billet are distinguished from
those in Hospitals. The next Day he ought
to parade all those marked on Billet, to see if
the Number of Men agrees with the List
given him, and to examine in what State each
Man is, and how he is employed; and then
he ought to go round the Hospitals, attended
by an orderly Serjeant, to see all the Men in
the Hospitals, and to know if the List given him
at the Purveyor&#8217;s Office was right; and afterwards
he ought to send every Day a Serjeant
or Corporal to see the Men in Hospitals, and
to report to him when any Men are discharged
or die.&mdash;And he ought to procure from the
Military Inspector a Return of all the Men of
his Corps, who are either admitted into, or discharged
from Hospitals, on the Days when
such Returns are made. He ought to make all
his Men on Billet appear regularly on the Parade
at Roll-calling, and to oblige them to
keep themselves clean and their Arms in good
Order, and to endeavour to preserve the same
Regularity and Discipline as when they are<span class='pagenum'><a name="Page_408" id="Page_408">[408]</a></span>
with their Regiments. And whenever a Party
is to be sent to join their Regiments, he ought
to have all his Men particularly examined;
and those Men who are found to be perfectly
recovered, should be sent to their Regiments.</p>

<p>If every Officer on convalescent Duty conform
to these Directions, no Man can ever be
detained without his Knowledge in or about
Hospitals, as he must always know where every
Man is, in what State of Health, and how he
is employed; and may at any Time be able to
make a Return to the Brigade or Regiment for
which he is employed, of every Man who is
admitted, discharged, or dies in the Hospital.</p>


<p class="center" style="letter-spacing: 0.25ex; padding-top: 2em; padding-bottom: 1em; font-size: 130%">FINIS.</p>

<div class="footnotes"><h3>FOOTNOTES:</h3>

<div class="footnote"><p><a name="Footnote_148_148" id="Footnote_148_148"></a><a href="#FNanchor_148_148"><span class="label">[148]</span></a> Some of the regimental Surgeons in <i>Germany</i>, when they
took the Field, had always some spare Tents carried along with
their Medicine Chests; and when any of their Men fell sick in
Camp, and they could get no House for a regimental Hospital
in Villages, they ordered these Tents to be pitched, and had
the Ground within well covered with Straw and Blankets, and
then put the Sick into them, and there took Care of them till
they found an Opportunity of sending them to the Flying Hospital.</p></div>

<div class="footnote"><p><a name="Footnote_149_149" id="Footnote_149_149"></a><a href="#FNanchor_149_149"><span class="label">[149]</span></a> <i>Homer</i> mentions <i>Podalirius</i> and <i>Machaon</i>, sons of <i>&AElig;sculapius</i>,
as two excellent Physicians or Surgeons in the <i>Grecian</i>
Army. Vid. <i>Iliad</i>, lib. ii. Physic and Surgery were antiently
exercised by the same Persons.</p></div>

<div class="footnote"><p><a name="Footnote_150_150" id="Footnote_150_150"></a><a href="#FNanchor_150_150"><span class="label">[150]</span></a> Vid. <i>Xenophon. de Institut. Cyri.</i> lib. i. et viii.</p></div>

<div class="footnote"><p><a name="Footnote_151_151" id="Footnote_151_151"></a><a href="#FNanchor_151_151"><span class="label">[151]</span></a> <i>Tacitus</i>, after giving an Account of 50,000 People being
killed by the Fall of an Amphitheatre at <i>Fidena</i>, during the
Time of a Shew of Gladiators, has these Words: &#8220;Ceterum
post recentem cladem, patuere procerum domus, fomenta &amp;
medici passim pr&aelig;biti; suit urbs per illos dies, quanquam
m&aelig;sta facie veterum institutis similis, qui magna post pr&aelig;lia
saucios largitione &amp; cura sustentabant.&#8221; <i>Vid. lib.</i> iv. <i>Annal.</i>
&sect; 63.</p></div>

<div class="footnote"><p><a name="Footnote_152_152" id="Footnote_152_152"></a><a href="#FNanchor_152_152"><span class="label">[152]</span></a> In <i>Livy</i> we find the following Passage: &#8220;Neque immemor
ejus quod initio consulatus imbiberat, conciliandi animos
plebis, saucios milites curandos dividit patribus. Fabiis
plurimi dati, nec alibi majore cura habiti.&#8221; <i>Vid. lib.</i> ii.
cap. xlvii.</p></div>

<div class="footnote"><p><a name="Footnote_153_153" id="Footnote_153_153"></a><a href="#FNanchor_153_153"><span class="label">[153]</span></a> <i>Justin</i> mentions the same Thing of the <i>Spartans</i> after
their Defeat at <i>Sellasia</i>&mdash;&#8220;Patentibus omnes domibus saucios
excipiebant, vulnera curabant, lapsos reficiebant.&#8221; <i>Vid.
lib.</i> xxviii. cap. iv.</p></div>

<div class="footnote"><p><a name="Footnote_154_154" id="Footnote_154_154"></a><a href="#FNanchor_154_154"><span class="label">[154]</span></a> When Parties of Sick or Wounded are to be sent from
Camp, or from one Hospital to another, Care ought to be
taken that they are placed properly in the Waggons; that
they have proper physical People, Nurses, &amp;c. to attend
them; as well as Provisions, and other Necessaries, so as to
be in no Danger of wanting any Thing while they are on their
Journey.</p></div>

<div class="footnote"><p><a name="Footnote_155_155" id="Footnote_155_155"></a><a href="#FNanchor_155_155"><span class="label">[155]</span></a> The <i>Roman</i> Generals seem to have sent their Sick and
Wounded into Towns, in the same Manner as is done by those
of the present Time. For we read in <i>C&aelig;sar&#8217;s Commentaries</i> of
this Method having been practised on more Occasions than
one. In the sixty-second Chapter of the third Book, <i>de Bello
Civili</i>, we have the following Passage: &#8220;Itaque nulla interposita
mora, sauciorum modo &amp; &aelig;grorum habita ratione, impedimenta
omnia silentio prima nocte ex castris <i>Apolloni&aelig;</i>
pr&aelig;misit, ac conquiescere ante iter confectum vetuit. His
una legio missa pr&aelig;sidio est.&#8221;&mdash;And immediately after, in
chap. lxv. &#8220;Itaque pr&aelig;missis nunciis ad Cn. Domitium C&aelig;sar
scripsit, &amp; quid fieri vellet ostendit: pr&aelig;sidioque <i>Apolloni&aelig;</i>
cohortibus iv. <i>Lissi</i> i. tres <i>Orici</i> relictis; quique erant ex
vulneribus &aelig;gri depositis; per Epirum atque Arcarniam iter
facere c&aelig;pit.&#8221;
</p><p>
And in the twentieth chapter, <i>de Bello Africano</i>, we read:
&#8220;<i>Labienus</i> saucios suos, quorum numerus maximus fuit, jubet
in plaustris deligatos <i>Adrumentum</i> deportari.&#8221;
</p><p>
It would be a right Measure, in the Beginning of every War,
to settle by a Cartel that military Hospitals on both Sides should
be considered as Sanctuaries for the Sick, and mutually protected;
as was agreed upon between the late Earl of <i>Stairs</i>,
who commanded the <i>British</i> Troops, and the Duke <i>de Noailles</i>,
who commanded the <i>French</i> in the Campaign in <i>Germany</i> in the
year 1743. See <i>Dr. Pringle&#8217;s Preface</i>.</p></div>

<div class="footnote"><p><a name="Footnote_156_156" id="Footnote_156_156"></a><a href="#FNanchor_156_156"><span class="label">[156]</span></a> Every military Hospital ought to have a Number of
Shirts belonging to it, for the Use of the Sick who arrive without
having clean Linen with them. As soon as their own
Shirts are washed and dried, or that new ones are provided by
their Regiments, the Hospital Shirts ought to be taken from
them.</p></div>

<div class="footnote"><p><a name="Footnote_157_157" id="Footnote_157_157"></a><a href="#FNanchor_157_157"><span class="label">[157]</span></a> In Wards which are too close, it has been found that one
or two square Holes (of about six or eight, or ten Inches diameter),
cut in the Cieling, and a Tube made of Wood fitted to
it, and carried up into the Chimney of the Ward above, so as to
enter above the Grate, is one of the best Contrivances for procuring
a free Circulation of Air; as the foul Air, which is
lightest, and occupies the highest Part of the Ward, finds a free
Exit by these Tubes: We have such Tubes now fixed in several
of the Wards in <i>St. George</i>&#8217;s Hospital. A Hole cut above
the Door of the Ward, or in the upper Part of the Windows,
and one of what are called the <i>Chamber Ventilators</i> fixed in it,
will answer, where Holes cannot be conveniently cut in the
Cieling.</p></div>

<div class="footnote"><p><a name="Footnote_158_158" id="Footnote_158_158"></a><a href="#FNanchor_158_158"><span class="label">[158]</span></a> Dr. <i>Lind</i> tells us, that the Ships of War in his Majesty&#8217;s
Service are purified by Fire and Smoke, and gives the Process
by which it is done; and he says, that he never heard of any
Ship, which, after being carefully and properly smoked, did
not immediately become healthy for the Men.&mdash;See <i>First Paper
on Fevers and Infection</i>.&mdash;And he observes, that these Steams
and Smoke, which are inoffensive to the Lungs, besides correcting
the bad Quality of the Air, produce another good Effect;
which is, to make both the Patients and Nurses desirous
of opening the Doors and Windows for the Admission of fresh
Air. <i>Ibid.</i> p. 51.</p></div>

<div class="footnote"><p><a name="Footnote_159_159" id="Footnote_159_159"></a><a href="#FNanchor_159_159"><span class="label">[159]</span></a> The <i>French</i>, and many other Nations, give their Patients
Meat Soops in acute Diseases, and after capital Operations;
and they allow them but little Bread or other Preparations
of Vegetable Substances: But these Meat Soops without
Bread do not nourish the Patient sufficiently, and tend too much
to the Putrescent; and this is one Reason why more Sick die
in the <i>French</i> than in the <i>British</i> Hospitals.</p></div>

<div class="footnote"><p><a name="Footnote_160_160" id="Footnote_160_160"></a><a href="#FNanchor_160_160"><span class="label">[160]</span></a> On Expeditions where a Siege is expected, a Quantity
of Flour ought to be carried out, and a Number of portable
Ovens for baking bread for the Sick, which may be put up
after the Troops have made good their Landing.</p></div>

<div class="footnote"><p><a name="Footnote_161_161" id="Footnote_161_161"></a><a href="#FNanchor_161_161"><span class="label">[161]</span></a> If there be no Ship fitted up for the Reception of sick
Officers, those who are taken ill on Expeditions must be in a
most miserable Situation; as there is no Place to receive them
in the common Hospital Ships, they must remain almost without
Assistance in a crowded Cabin amongst People in Health; as
was the Case in some of our Expeditions during the late War.</p></div>

<div class="footnote"><p><a name="Footnote_162_162" id="Footnote_162_162"></a><a href="#FNanchor_162_162"><span class="label">[162]</span></a> At every Hospital there ought to be a Number of printed
Tickets lying ready to be filled up and signed by the Physicians
and Surgeons, and no Man ought to be allowed to go out
without a Ticket so signed.</p></div>

<div class="footnote"><p><a name="Footnote_163_163" id="Footnote_163_163"></a><a href="#FNanchor_163_163"><span class="label">[163]</span></a> In the <i>French</i> Hospitals there are always a Number of
Men who attend their Sick who belong to the Hospital, so that
they have no Occasion to employ their Convalescents, as we
are often obliged to do, where the Sick are attended by Nurses,
who are commonly Soldiers Wives, and not so capable of doing
such laborious Work as the Men.</p></div>

</div>

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