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PREFACE

      The fact that forty-seven editions of this work have passed through the press renders any apology for presenting a new edition to the public unnecessary. The work has undergone complete revision, and many sections have been entirely rewritten, so as to embody the new doctrines and methods of treatment up to the present day. It will be found a complete book of reference and instruction in the treatment of Medical and Surgical Diseases by those persons for whom it was originally written: there is scarcely a disease to which the human body is liable which is not described in it, and the treatment fully detailed, in the plainest language. It contains an account of the rules laid down by the highest authorities for Restoring Suspended Animation from Drowning; and, independent of the medical character of the work, it contains several useful Domestic Formulas and Receipts.

      The Book, as it now stands, is divided into Three Departments or divisions: First, a Pharmaceutical or Drug Department, in which is contained a full account of all the principal medicines in use, their properties, qualities, and doses

as administered in the cure of disease; Secondly, a Surgical Department, in which is given a concise description of all the more common dislocations and fractures incidental to persons employed in laborious occupations, together with their symptoms and treatment; and Thirdly, a Medical Department, which points out the best mode of treating successfully those bodily complaints to which children and grown persons are subject. The whole is written in an easy style, and free from all technicalities, so that he that runs may not only read but understand.

      As this work is consulted by Ship-Captains, Missionaries, Colonists, and others who are beyond the reach of medical and surgical aid, instructions are given as to the treatment of many diseases and surgical injuries, which should not be put in practice by those who have not been professionally educated, if it is possible to obtain skilled assistance.

      In the commencement of the work will be found a Scale of Doses, by which means the proper dose of any Medicine suited to different Ages will be seen at a glance, and an Alphabetical List of the Drugs spoken of; and at the end, a List of the Medical Terms used in the work, with their explanation in English, as well as a copious Index, by which any given subject may be immediately found without delay.

      London, January, 1887.

DOSES PROPER FOR DIFFERENT AGES.

      In the same manner for fluids, divide the quantity suited for an Adult by the above fractional parts. If for a child under one year, the dose will be one twelfth; under two years, one-eighth; under three years, one-sixth; and so on,

ARTICLES FOR THE MEDICINE CHEST.

A spatula for mixing ointment, pills, &c.
A tile, on which the preceding articles may be made or divided.
A glass funnel.
An enema syringe.
Graduated glasses for measuring fluids.
Lint.
Scales and weights.
Small glass mortar and pestle.

      The two-ounce measure has a scale graduated from half a drachm to two ounces or more. The first line marks half a drachm: the second, one drachm; the third, two drachms; the fourth, three drachms; the fifth, four drachms, (or half an ounce,) and so on.

      The minim measure contains one fluid drachm, or sixty minims, which is divided into twelve lines, each line making five minims; thus, the first line marks five minims, the second 10, the third 15, the fourth 20, the fifth 25, the sixth 30, or half a fluid drachm, and so to one drachm. A minim is considered equal to two drops.

      As these measures, as well as the weights, are marked with their proper characters, it will be proper to point them out, so as to render them intelligible. Thus:

Has been tong and well known for its powers as an universal stimulant and antispasmodic.^* It may be given safely in any painful complaint unattended with inflammation. †

      Spirit of aether,*‡ spirit of lavender, of each a teaspoonful, mixed with a wine-glassful of cold water, and taken immediately, is a good remedy in the hysterical and hypochondriacal lowness to which many persons, especially delicate females and sedentary men of weakly constitutions, are subject. A tea-spoonful of spirit of zether, in half a glassful of brandy, and twenty or twentyfive drops of laudanum, will often relieve the excruciating torments of the gout when it has fixed in the stomach; it is at the same time advisable to wrap the feet in flannel, which will conjoin in inviting back the gout to thcm, which appear to be its natural seat. Equal parts of spirits of wine and camphor (see Spirits of Wine), a:thcr, and laudanum, mixed in a phial, form an admir-

      First, those of full habit; second, those predisposed to apoplexy; and thirdly, where there is much constipation of bowels. In case of poisoning by this drug, the first thing to be done is to empty the stomach of its contents by the stomach pump, or emetics (see White Vitriol), then stimulants are to be employed; the most effectual are: the injection of cold water into the ears; cold affusion to the head and neck; warmth to the legs and feet, and the internal use of Sal Volatile. The same means are to be resorted to in alarming cases of drunkenness from spirits.

Is a useful and agreeable purgative in most cases, if taken to the amount of one or two table-spoonfuls. From its warm aromatic nature, it is particularly adapted to those constitutions where there is much flatulence, or wind, collected in the stomach or bowels. A small dessert-spoonful, with a tea-spoonful of spirit of lavender, taken in a glass of cold water, mid-time between breakfast and dinner, creates a good appetite, and, consequently, is very serviceable where there is a disposition to dyspeptic complaints, or a defective appetite.

      Aloetic wine is an extremely proper purgative where the monthly evacuations of women are stopped, but highly improper where this discharge is too profuse. — Two teaspoonfuls, taken twice a day, and continued for some time, will commonly succeed in restoring the monthly evacuations when stopped, especially if the feet be immersed in water, warm as can be borne, three or four times a week on going to bed (see Female Pills). — Aloetic wine forms a good purgative for children troubled with worms.

      None of the preparations of aloes should be administered in cases of pregnancy, or when the patient is suffering from piles. An excellent form to give aloes in is the following: — Take of compound decoction of aloes, three ounces; tincture of senna, two ounces; compound tincture of cardamoms, one ounce; mix. — Two table-spoonfuls three times a day. This is a useful warm aperient in the green sickness (chlorosis), suppressed flow of the monthly evacuations, and in a deranged state of the bowels in dyspepsia.

removed by rinsing the mouth frequently with a solution of alum in the proportions already mentioned. If it should make the mouth bleed, or smart much, it will require a little dilution. It is also very valuable as a garglc in relaxed uvula and most forms of sore throat. The soreness of the nipples, which often happens to women after delivery, so as to prevent the parent from nursing her child, is readily removed by frequent ablution of the parts with the solution of alum. If it create much smarting in the proportions mentioned, it will be proper to dilute it. The nipples should be well washed before the child is suffered to suck, otherwise the astringent taste of the alum will make it loathe the breast. — A scruple of alum, dissolved in a tea-cupful of water, makes a moderately strong solution, which, if a little is sniffed up the nose repeatedly, will often succeed in preventing bleeding from that part. — Alum is an approved remedy for bleedings in the internal parts; but these, when trifling, require no such aid; and, when excessive, require such discrimination as necessarily calls for the judgment of the profession. — One drachm of alum, dissolved in four ounces of vinegar, to which water and spirits of wine, of each two ounces, is addied, makes an excellent lotion for chilblains; cloths wet ted in it should bc kept constantly on the parts.

      In cases of flooding after delivery, or miscarriage, alum is a good remedy. The following is a good astringent mixture: — Take of alum, half a drachm; diluted^* sulphuric acid (oil of vitriol), one drachm; water, six ounces; mix. — The sixth part every three hours. Half an ounce of alum and the same quantity of white vitriol, in three pints of water, form an exccllent injection in the "whites," to which women are subject. In lead colic, from which painters suffer, alum has been found to be exceedingly efficacious.^† Alum whey, is made by boiling two drachms of powdered alum in a pint of milk, and then straining; the dose is a wine-glassful.

      From Dr. Pearson's analysis of James's Powder, it appears that the present article is of a similar nature to that famous and highly-respected remedy; an extensive experience has also left no room to doubt a coincidence in their effects.

      In a recent cold or a stuffing in the head, as it is called, three or four grains of this powder, taken in a large basin of whey, as warm as can be swallowed; and the same dose of powder being repeated, after an interval of three or four hours, with a little warm whey, seldom fails in removing it, provided the patient be kept warm in bed, from the time of his taking the first close till the perspirative effects are over. The same plan will often succeed in removing a violent head-ache, attended with a beating in the head, especially if the feet be kept twenty minutes in hot water, immediately before the patient goes to bed. Like James's Powder, it has no effect in preventing fevers; but in the dose of three or four grains, every three or four hours, it is a very appropriate remedy when a fever of any kind exists. The patient should drink freely of barley water whenever this medicine is taken.

      In all fevers, of whatever nature, thirty or forty drops of this wine, added to every quart of the patient's common drink, cannot fail to be serviceable; neither does it impart to the fluid any disagreeable taste, so that it may be done without the patient's knowledge. — Five or six drops, with two drops of laudanum, given three or four times daily, often removes that febrile state to which most children are subject during the time of teething. — Thirty or forty drops given at bed-time, in a basin of warm gruel, has a good effect in removing a cold, or in preventing it where a person has been much exposed to wet, if he be kept warm during the operation. — It is commonly recommended as an emetic; but as it often proves violent in its operation, and leaves an excessive lassitude and debility afterwards, it is properly superseded by safer and more convenient articles (see Itecacuanha and Emetic Tartar).

      The medical properties and uses of this drug, are, stimulant, antispasmodic, and expectorant; and is given with great benefit in hysterics, flatulent colic, and diseases of a nervous character. In combination with ipecacuanha and compound extract of colocynth, it forms an excellent aperient in dyspepsia, and when the stomach is filled with wind. The following is a good pill: — Take of asafoetida, t wo grains; compound colocyn th -pill, two grains; powdered ipecacuanha, half a grain; make a pill, to be taken three times a day. — A tea-spoonful of the tincture of asafoetida, and one of spirit of tether, in a wine-glassful of peppermint-water, is recommended in asthma. The dose may be given every two hours until relieved.

half of tartar emetic, may be well mixed and divided into two doses, of which one should be taken every quarter of an hour till it vomits; plenty of liquid being taken after the operation commences, which will contribute to promote the purging effect also. From ten to twenty years, a scruple of ipecacuanha, and a grain and a half of emetic tartar, is to bc taken at two doses, and managed in the same way. But in case these fail to purge, a dose of rhubarb may be given to occasion a stool or two.

      The method of exhibiting the bark must vary according to circumstances, which can only be specifj.ed where the case is present; but we shall endeavour to lay down such rules as will apply in the majority of cases and constitutions that occur.

      Some stomachs loathe the powder that will retain the decoction. The best form is that of mixture with port: — An ounce and a half of the powder, and two drachms of the ginger powder, may be added to a bottle of port; the dose should be an ounce at a time, and repeated as often as can be done in the intervals of the fits. This kind of mixture will mostly prevent sickness; and, if it purges, three drops of laudanum may be added to each dose.

      When bark is directed to be taken such a number of times in a day, without regard to any particular time, it sometimes fails to cure. In such cases, as much as possible should be got down immediately before the fit is expected as the stomach can possibly retain, and this will mostly succeed. If a dose of laudanum, proportioned to the age of the patient, be given half an hour after the commencement of the hot fit, it will abate its force, and remove more of the disease than an ounce of bark would do.

      When bark fails in curing agues, it is gencrally from one of these circumstances: either discontinuing it too soon, giving it too sparingly, or in an improper form.

      Bark contributcs much to the recovery of persons labouring under putrid or typhoid fevers; it has been known to preserve the patient even whcn the blood has become in such a state as partially to pass through the coats of the blood-vessels. In these cases it is doubly useful: to brace up the weakened fibres, and to correct putridity.

      Bark is a principal remedy in some cases of mortification,

in others it is exceedingly injurious. But, as more discrimination is required in these cases than usually falls to the share of those who are not professionally educated, we decline any further remarks upon it in this case.

      A scruple of bark taken thrice a day, in a little port, has succeeded in removing periodical head-ache (see Sulphate of Quinine).

      Bark is administered with advantage in hysteria, habitual cough, and discharges of blood depending on debility, in malignant sore throat, confluent small-pox, and in debility resulting from scarlet fever and measles. — Five grains of bark, twenty grains of soda, and one of colchicum, is of the greatest benefit in chronic rheumatism, relieving pain when all other remedies fail.

      Decoction of Bark Is made by boiling an ounce of yellow bark in a pint of water, for ten minutes, and when cold to be strained, adding sufficient water to make up the quantity to sixteen fluid ounces.

      One part of finely-powdered borax, to eight parts of clarified honey, is an excellent application, and much used to remedy that soreness of the mouth, called thrush, to which infants are very liable. A small quantity should be put into the child's mouth, which it will sufficiently disperse about by the motion of its tongue. Half an ounce of borax, dissolved in four ounces of boiling water, and sweetened with a little sugar, is an efficacious mixture for abating the febrile and restless state of children brought on during teething. — The dose may be two tea-spoonfuls every third hour.

      Calomel is justly considered one of the most efficient and valuable preparations of Mercury, but requires to be used with much caution and judgment. Some constitutions are too readilyand powerfully affected by it, and there are peculiar idiosyncrasies that forbid its employment

altogether: in some instances a few doses will produce nervous irritation, or a degree of salivation and other unpleasant effects. Nevertheless, in skilful hands, it is adapted to cure or relieve some of the most formidable diseases. In febrile affections it is often productive of great benefit; and it is singularly efficacious in subduing inflammatory action in general. In typhus, combined with antimonials, it often effects a surprising amelioration of the symptoms. Its action varies considerably according to the dose and mode of combination with other remedies. It increases the laxative qualities of other purgatives, as scammony, jalap, and rhubarb; with antimony and opium it opens the pores of the skin and induces perspiration; and with squills, digitalis, &c., it adds considerably to their diuretic effects. As a purgative it may be given in any case unattended with intestinal inflammation. It acts powerfully on the biliary secretion, — hence in those complaints usually denominated bilious, it is a valuable medicine. In such complaints, and in disordered states of the stomach and bowels generally, three or four grains with ten grains of rhubarb or jalap may be taken at night, and should be followed early the next morning by the common black draught (see page 17). Two or three doses are commonly sufficient to relieve the bowels of much offensive matter. Calomel is also used successfully in chronic inflammation and induration of the liver, in glandular obstructions, rheumatism, indolent tumours, and in certain cutaneous eruptions. In some of these disorders it must be continued in small doses until soreness of the gums is produced, but a medical man is the only safe judge in these matters. We shall not enter here upon the antisyphiliti c virtues of calomel.

      Calomel is a no less important remedy in the treatment of diseases of children; and they in general bear proportionally larger doses than adults. In disordered states of the stomach and bowels, from whatever cause, it is extremely efficacious. In cases of croup, when properly administered, it has saved the lives of numerous infants. Combined with jalap, scammony or santonin, it is an excellent remedy for worms, especially the thread worm. In convulsions, hydrocephalus, and other infantile diseases,

it constitutes a most valuable medicine; but we cannot too strongly protest against its indiscriminate employment in every ailment to which children are subject.

      The usual close as a purgative is from three to six grains, used as before mentioned. Two grains may be given to a child Linder twelve years old, and beyond that age from three to five grains, taking care whenever there is griping and frequent green mucous stools to suspend its use. It should be given in syrup, moist sugar, gum, or magnesia, avoiding saline and acid substances during its employment. As an alterative, the dose is from half a grain to two grains, taken occasionally.

      Camphor is a stimulant, narcotic, and a promoter of perspiration. The efficacy of this medicine has long been ascertained in many very formidable diseases; but of its influence over these it would be to no purpose to speak, as their management requires a degree of discernment of which everyone is not supposed to be possessed; we shall, therefore, confine the remarks to less desperate cases. It is administered in fever of a low character, in combination with ipecacuanha and opium; one grain of the latter, with five grains of camphor, made into a pill, will often promote sleep and free perspiration in this disease. The same form of pill is of the greatest service in quieting pain and irritability after delivery, and in chronic rheumatism. In violent sick head-ache, the saine preparation will afford great relief. Half an ounce, dissolved in nine ounces of spirits of wine, forms the spirit of camphor — a useful preparation in many respects. Two drachms of camphor, dissolved in an ounce and a half of olive oil, is an excellent liniment for sprains, bruises, stiff joints, and rheumatism. Camphor mixture or julep, is made by allowing a piece of camphor to dissolve slowly in a bottle of water.

      This is a preparation in high reputc for destroying all offensive and putrid effluvia; it prevents putrefaction, and corrects the impurities of the air in close apartments and in situations exposed to noxious vapours.

      It is sold both in powder and liquid state, but you may save considerable expense by purchasing the former, and dissolving it yourself in this manner: — " To a table-spoonful of the powder, add gradually one quart of water, or, to one pound of the powder, three gallons of water; break all the lumps, mix it well, and the clear liquor is then fit for use." In a sick-room the clear liquor is to be sprinkled about or kept in open dishes; in ordinary cases the latter may be preferred, as they can be removed if the smell of the liquid becomes too powerful; but in putrid disorders it may be used more plentifully, and a glassful, added to the water of the night-chair or bed-pan, will prevent effluvia. Where small-pox, measles, cholera, scarlet, typhus, and yellow fevers, or other infectious diseases prevail, in addition to the above precautions, the linen &c. taken from the

      If you employ the liquid as prepared by Chemists, you must add a wine-glassful to a quart of water.

      This valuable preparation, in addition to its use as a disinfectant, is applicable to the following beneficial purposes, under the direction of the medical attendant: as a LOTION, in the proportion of one to ten parts of water, in carbuncle, ill-conditioned and gangrenous sores of every description, all foetid discharges, scald head, &c.; as a GARGLE, in the proportion of one to twenty parts of water, in ulcerated sorc throats, ptyalism, or violent spitting of saliva, spongy gums, and carious teeth; INTERNALLY, in doses of five to forty drops, in a wineglassful of water, as a diuretic, and corrective of organic poisons. In the proportion of five to tcn drops in a wineglassful of water, the solution of chlorinated soda will be found an excellent wash for the mouth, correcting a tainted breath, and cleansing the tongue. One or two tablespoonfuls added to each linseed poultice is most useful in case of foul and sloughing ulcers.

      This is a most useful medicine, originally brought before the notice of the public as a secret remedy by the late Dr. Collis Browne. A similar preparation is now made by many chemists, such as Flinders, Freeman, Towle, and others. The active ingredients are morphia or opium, prussic acid and chloroform. — In doses of from ten to twenty drops it is useful in diarrhoea, colic, coughs, &c.

      Is well known as a remedy in all cases of emaciation. It is a harmless remedy and acts both as a medicine and as an article of diet. It is given beneficially to children of a scrofulous nature, and to those persons suffering from consumption, bronchitis, rheumatism, chronic skin diseases, &c. The pale Newfoundland cod liver oil appears to be the most suitable for invalids, as it is more easily and readily absorbed and is less nauseous than the ordinary brown cod liver oil, and consequently agrees better with persons whose stomachs are weak.

      The medicinal properties of the 'oil consist in the quantity of iodine, bromine, and phosphorus which the pure oil ought to contain, and upon which depends the quality of the oil. To procure pure cod liver oil in small quantities, it can be readily made in the following way: — Take the liver of a fresh cod fish, score it well with a sharp knife, and place it in an earthenware jar, let the jar containing the incised liver be put into warm water and allowed to simmer for a short time, then the oil will separate from the liver and will be ready for immediate use. Some persons whose stomachs reject the oil can derive the same benefit by frying the livers and eating them as food. Some children take the oil greedily.

Has been much used as a purgative and a diuretic in dropsy. When administered as a purgative, it must be given to the amount of half an ounce or six drachms, dissolved in water; when intended to promote a flow of

urine, two drachms are sufficient for a dose, which should be given in the morning, and much fluid of some kind, as barley water, must be given during the day, to forward its operation, and on the strict observance of this will its success chiefly depend. Cream of tartar forms a principal ingredient in the imperial water, which is as follows: — Take an ounce of cream of tartar, the peel of a lemon, a gallon of boiling water, and half a pound of lump sugar. This forms a cooling pleasant drink in fevers. The clear liquor may be poured into bottles, which, if well corked, and put in a cool place, will keep some time. — A tea-spoonful of an electuary, consisting of equal parts of cream of tartar, flowers of sulphur, and tamarinds, taken every night, is serviceable in the piles.

Is used for making the salinc draughts, when conjoined with bi-carbonate of potash (which article see).

      Take of prepared chalk, one ounce; powder of Peruvian bark, two drachms; powder of myrrh, one drachm; mix them well together.

      The method of using this powder is so familiar to all, as to preclude the necessity of any comments on that hcad; suffice it to say, it is a perfectly safe and agreeable, as well as an efficacious compound, free from those pernicious ingredients frequently recommended.

      This powder consists of one grain of opium, one grain of ipecacuanha, and eight grains of sulphate of potash. It is one of the most powerful and certain medicines for raising a perspiration, on which account it is frequently used, and with succcss, in rheumatism. It is not admissible in fcvcr, particularly where therc is a dry furred tongue, a dry skin, or whcrc thcre is any disturbance of the brain. This powder should never be given to infants

or children. — Five grains of DOVER'S POWDER and one of calomel, given every four hours until the pain is relieved, or the mouth affected, is of the greatest service in inflammation of the bowels, and those inflammations following delivery. In these cases, the effect is very much enhanced by the application of warm fomentations. It is useful in common colds when taken at bed-time, in which cases the patient should drink plentifully of warm slops, as they materially assist in promoting perspiration. It should never be given unless the tongue be moist, the skin, if not damp, at least soft, or where there is any determination of blood to the head. — Dose, from five to ten grains in some hot fluid.

Contributes much to the relief of coughs, but particularly the coughs to which many old people are subject. It is likewise an excellent remedy for putting off an asthmatic fit, when it is perceived to be coming on, especially if a tea-spoonful of spirit of sether be given along with it. The dose of parcgoric may be two tea-spoonfuls. Twelve or fourtecn drops, given at bed-time, procure sleep, and allay the cough which often harasses weakly children during the process of teething.

Is an agreeable acid, and is often used in the dose of fifteen or twenty drops, in a glass of spring water, twice or thrice a day, to promote the appetite when it is defective, as sometimes happens after a long illness. The same plan often succeeds in checking profuse perspiration, which reduces the strength of the body, as is commonly scen in some cases of consumption. It is commonly joined with bark, which it sometimes enables the stomach to retain, when it would otherwise reject it. — The following is a good mixture in consumption, when the cough is trouble some and the perspirations profuse: — Take of elixir of vitriol, one drachm; tincture of henbane, two drachms; syrup of poppies, four drachms; pure water, six ounces; naphtha, sixty drops; mix, and take two table-spoonfuls three times a day.

As a common purging medicine, are admirably well adapted to a great variety of complaints. An ounce dissolved in water, and taken early in the morning, is a common, and by no means a bad way of using them. It is better to take this medicine in the morning in preference to night, as it is often quick in its operation; and it may be observed with respect to all salts, that they act much better and with more ease to the patient, when dissolved in a considerable quantity of fluid, and taken in small doses, at short intervals, than when dissolved in as much water only as is sufficient for their solution, and swallowed all at one dose. It is on this principle that the Cheltenham waters are found so certain and efficacious in their operation. In these waters, a small quantity of aperient matter is dissolved in a large bulk of fluid, and these, from experience, are found to act best when taken in small doses and often. The method of using Epsom salts, agreeably to this plan, is to dissolve an ounce in a pint and a half of barley water, or common water, and to take three . table-spoonfuls every hour till it has the desired effect. Two grains of emetic tartar, added to half a pint of this solution, adds to its activity as a purgative, and thus renders it more effectual (see Tartar Emetic). Sulphate of magnesia is the active ingredient in all the various alkaline aperient waters sold at high prices under various foreign names. An ounce of salts, two drachms of scnna leaves, half an ounce of manna, and one scruple of ginger, infused three or four hours in a pint of boiling water, in a close vessel, forms an excellent preparation, commonly called a black draught, and one much used in any case where it is found necessary to open the bowels. This medicine is well adapted whcre there is any inflammation, as having a tendency to abate this, on account of the peculiar mode of its operation, for it is very cicar that all purges have not this power equally. It is highly proper where the body is bruised, or any way hurt from a fall or violent blow. — Thrce spoonfuls may be takcn every two or three hours till the bowels are sufficiently affected. In

hot weather, some persons are subject to a redundance of bile, causing sickness in the morning, and a bitter taste in the mouth. These disagreeable symptoms are readily removed by taking every morning, an hour before breakfast, a drachm and a half or two drachms of salts, dissolved in water, half a pint of water being taken immediately after; it dilutes the bile, promotes its expulsion from the body, and is a proper means (much more so than emetics) to secure the constitution against fevers when such diseases prevail.

      They are the best aperient that can be administered when sickness is present, as they are retained on the stomach when everything else is rejected. The following is a good fever mixture: — Take of Epsom salts, six drachms; antimonial wine, two drachms; mindererus spirit, one ounce; syrup of saffron, four drachms; camphor julep (see Camphor), five ounces; mix. — The fourth every four hours.

Is a good application to any cut or wound of small extent.

      Twelve grains of green vitriol, ninety-six grains of socotrine aloes, fifteen grains of powdered blistering fly, and twenty drops of the oil of caraway, to be well mixed and divided into forty pills.

      The convenience of these pills will be found very great when we consider that women frequently have an obstruction of that natural periodical evacuation, on the regularity of which their health so much depends. These pills are not intended to remedy every irregularity, but only to restore the proper discharge when it has ceased from other causes than pregnancy, as cold, weakness, &c. When it is stopped in a woman not pregnant, and occasions any inconvenience, if it arise from weakness' this will be denoted by the paleness of the face and body, lassitude and inaptitude to motion. In such a case, two of these pills, taken morning and night, will be found peculiarly useful. Moderate exercise, made to alternate with ease and rest, has frequently a good effect, whenever the patient

is unwilling to move about. The patient, therefore, should once a day, at least, recline on a bed, if she is so disposed. This plan, both with respect to medicine and exercise, will be equally proper, where the discharge has never commenced, and the patient is inconvenienced in consequence of the inability of nature to effect it. When the discharge, after having commenced, is stopped from cold, or any other morbid cause, there will be much pain in the loins and head, especially at the periods when it was accustomed to return; but there will not, in these cases, at least commonly, be that paleness of the body, as when it is attended with or proceeds from great weakness. The best practice here is to give two tea-spoonfuls of aloetic wine twice a day, and immerse the feet in warm water three times a week at bed-time.

Is an internal stimulant and stomachic. In enfeebled and relaxed habits, especially in old persons, and those afflicted with gout, it promotes digestion, relieves flatulency and spasm of the stomach and bowels. Five grains of ginger, five grains of rhubarb, and ten grains of bicarbonate of soda, is an excellent remedy in heartburn, indigestion, and colic arising from flatulence. It strengthens the stomach, promotes good secrctions, absorbs acidity, and increases the appetite. It is a convenient article in many respects, particularly for warming other medicines. A few grains of ginger, added to each dose of powder of bark, will often prevent the latter medicine from creating an uneasy sensation at the stomach. A drachm and a half of ginger, infused in a pint of boiling water, and taken during the day, particularly at meals, is a vcry serviceable beverage in the gout, especially if attended with an uneasy sensation in the stomach. A drachm of ginger, and three drachms of bruised dried Seville orange peel, infused and prepared in a manner similar to tea, has been used as a breakfast with great effect in restoring the appetite that has been impaired by excess in drinking or othcr causes. It likewise forms an excellent kind of breakfast for those who are troubled with the gout.

      Ginger Beer is a popular and an agreeable beverage. The following is an excellent formula for its preparation: — Take of white sugar, one pound; lemon juice, eighteen ounces; honey, one pound; ginger, bruised, twenty-two ounces; water, eighteen gallons. Boil the ginger in three gallons of water for half an hour, then add the sugar, the lemon juice and the honey with the remainder of the water, and strain through a cloth. When cold, add the white of one egg, and half an ounce of the essence of lemon. After standing for four days, bottle. This yields a very superior beverage and will keep many months. (Pereira's Materia Nedica.)

Is one of those medicines (even with the external application) of which it is better for those who are not familiarized to its effects, not to make too free. But, notwithstanding we deem it necessary to give this caution respecting it, yet several safe and valuable compounds into which it enters may be recommended. Goulard, spirit of wine, of each one drachm, and soft water a pint, forms the famous vegetomineral goulard, or while water, the utility of which is great as a cooling application to irritated or inflamed parts, and particularly to burns and scalds. As these accidents are commonly occurring, in situations where immediate assistance cannot always be procured, it may not be useless to lay down a few rules for the management of these accidents, although not immediately connected with our present plan, except so far as regards the application of goulard; this digression will be still more allowable when we consider that an early application to a burn is half its cure. Such burns or scalds as may be safely treated without the assistance of a surgeon are only those of moderate extent, where a blister is raised, or where it is not raised; for where there is an extensive destruction of skin it cannot be safely managed but by proper surgical aid. Whenever a burn or scald is received, the person should immediately immerse the injured parts in cold water, and keep them in this fluid at least an hour, if the part be in such a situation of the body as to admit of it.

Is a substance so generally useful that it will doubtless be found a convenient article in a medicine chest.

      This article of the Materia Medica is obtained from oil by adding an alkali; the acids of the oil combine with the alkali forming soap, and a clear liquid is left of a sweetish

taste, which is the essence of oil or glycerine. When pure it possesses extraordinary healing properties. It acts as a preventive from chaps, and when chaps have appeared it cures them with wonderful rapidity. Its application renders the skin soft, delicate, and white, and often removes pimples, freckles, and blotches from the skin. The common method of using glycerine is as an outward application in the form of a wash, consisting of one part of glycerine with two parts of rose water. A few drops dropped into the ear is beneficial in deafness. It is also a capital adjunct to a cough mixture.

      Ipecacuanha powder is either emetic, expectorant, or diaphoretic, according to the doses in which it is administered. In large doses, say 20 grains, it forms an easy emetic, and in doses of from half a grain to four, it promotes perspiration and expectoration. A scruple of this powder combined with one grain of tartar emetic is of the greatest service in the commencement of fever, ague, inflammatory sore throat, and inflammation of the windpipe. In doses just sufficient to produce nausea, it has an excellent effect in dysentery and obstinate bowel complaint. In consequence of its expectorant effects and its power in promoting perspiration, it forms a very useful remedy in colds and hoarseness.

      "When a child becomes hoarse, and begins to cough," says Dr. Cheyne, "let every kind of stimulating food be withdrawn, let him be confined to an apartment of equal warmth, have a tepid bath, and take a tea-spoonful of the following mixture every hour or every two hours: — Take of ipecacuanha wine, three drachms; syrup of tolu, five drachms; mucilage of gum, one ounce; and all danger will be probably avoided (Dr. Pereira)." Ipecacuanha is also useful as an emetic in hooping cough. — Persons subject to asthma should never expose themselves to the preparations of this drug, as it frequently induces a paroxysm of difficulty of breathing.

      Ipecacuanha powder is the emetic now in most common use, and the chief excellence of this root consists not only in its safety, but in its operating, generally speaking,

in a small dose. Six or seven grains will mostly vomit a person under ten years of age, provided it be assisted by taking some lukewarm liquid, as camomile tea; above ten years, from fifteen to twenty grains may be given and aided in the same way. Whatever may be the dose administered, if it does not operate in twenty minutes, a repetition of the dose will be very proper. Ipecacuanha may be concealed by mixing it in a teapot and pouring it out, with a mixture of sugar and milk, by which children may be deceived. When an emetic is given in the beginning of a fever, a mixture of this powder and tartar emetic is preferable to either of them alone (see Tartar Emetic).

Is used in the same cases, and for the same purpose, as the powder of the root. This wine can be taken with less disgust by some people than the powder; its dose may be from one ounce to an ounce and a half as an emetic; it is likewise serviceable in hard, dry coughs. — Dose, ten to twenty drops twice or thrice a day.

      This powder has long been esteemed for the certainty of its operation as a laxative, particularly in such as are of a dropsical habit. Its dose for an adult, is from fifteen to thirty grains, to which it is proper to add four or five grains of ginger, to prevent the griping which it would otherwise be apt to occasion. If one part of jalap is well mixed with two parts of cream of tartar, it forms an excellent purgative for administration towards the end of the acute stage of measles or small-pox. Its dose may be two or more scruples.

      The following is an excellent form of powder for evacuating the collection of water which takes place in dropsy: — Take of powdered jalap, two scruples; cream of tartar, two drachms; powdered ginger, half a drachm; mix, and divide into six papers. One to be taken three times a day.

      The administration of jalap is not admissible in inflammation of the stomach and bowels; in piles, or in descent

of the womb and bowel. Dose for an adult, ten to thirty grains; for children under twoyears, from two to five grains. In combination with a few grains of calomel, it is one of the best medicines that can bc given for the expulsion of worms; and in retention of the monthly evacuations of women, it acts most beneficially, from the extension of its stimulating effects to the vessels of the womb.

      The general utility of this medicine is too well known to require much description of its effects; WC shall, however, speak of its application in certain diseases in which its effects are not quite so familiar to the public, as well as mention the common mcthod of forming a night draught; as in many cases, both medical and surgical, a night draught is necessary for allaying pain and procuring sleep. The proper dose for an adult varies very much according to the constitution; but, as a general rule, we may say that twenty-five or thirty drops is a fair dose for an adult; this is formed into a night draught by the addition of a little loaf sugar and an ounce and a half of peppermint water. Two parts of laudanum and one of oil mixed together, so as to form a liniment, will, if well rubbed on the pit of the stomach, often allay a violent and distressing vomiting, when nothing can be rctained on the stomach for that purpose. Mixed with opodeldoc, it forms the anodyne balsam, which is an excellent remedy for sprains, rheumatic pains, &c. (see Opodeldoc). For the good effects of, and method of giving laudanum in agues, see Bark. Forty, fifty, or sixty drops in half a pint of gruel, will, when given as a glyster, allay that pain and fruitless desire to go to stool which is so harassing to the patient during the bloody flux. A few drops of laudanum dropped into the car will oftcn put a stop to the violent pain in this part, particularly if the steam of boiling water is previously allowed to pass through a funnel into the ear. This method of steaming the ear is also very useful where there is inflammation. After the ear has been steamed, it should be filled with cotton to prevent taking cold (see AEther). On the further application of this medicinc to dangerous

diseases we decline saying anything, as such cases are only to be treated successfully by those who have a proper insight into the laws of the animal economy.

      When a person takes an overdose of this drug, either intentionally or by accident, he falls in a short time into a state of insensibility to all external impressions; the breathing is slow, and, after a little time, becomes stertorous and laboured; the patient lies on his back with his eyes closed, and the whole expression of the countenance is that of natural sleep. As the influence of the poison advances, the face becomes flushed, there is profuse perspiration and profound lethargy. After this stage, the countenance becomes pale, cadaverous, and ghastly; the muscles relax, cold clammy sweats break out on the surface of the body, and the breathing grows more and more slow; at last death ensues in about twelve or fifteen hours. If the person survives beyond that time, there is a probable chance of his recovery. Remedies to be employed: — The stomach is to be emptied immediately, either by the stomach pump or by means of powerful emetics of sulphate of zinc (white vitriol). Half a drachm of this salt should be given every twenty minutes, until full vomiting is established; cold water is to be dashed on the head and neck; the patient should drink freely of strong coffee, and be kept walking up and down an indefinite time, so as to prevent him from going to sleep.

Is used alone as a laxative in doses of one or two drachms mixed with a little water, but is particularly adapted to such constitutions as are troubled with heartburn, which arises from the generation of a morbid acid in the stomach. Magnesia is a laxative in itself, but is much more so when it meets with this acid in the stomach, and on union with this its activity depends in a great measure. Mixed with an equal quantity of rhubarb, it is an excellent laxative for children at the breast. The dose may be from five to ten grains, according to the age and constitution of the child (see Oil of Aniseed).

      From the sweet taste of this drug, children will often be prevailed on to take it when every other medicine is refused. Two or three drachms will prove mildly purgative, and operate without griping even when the bowels are very sensitive (see Senna).

      This, although a neutral salt, is not used as a laxative; the quantity required to produce such effects would create great distress at the neck of the bladder, if not much diluted, and if much diluted would pass off by urine; it is therefore a good diuretic when accompanied by much drink. If nitre is not dissolved fresh every time it is taken, it loses part of its good effects; hence the impropriety of making a large quantity of any medicine at a time in which nitre is an ingredient — no more should be made than will be consumed in the day. Three drachms of nitre dissolved in a quart of barley water, and administered during the day at several draughts, is good in that species of rheumatism attended with much fever. — One drachm of nitre, half an ounce of vinegar, and eight ounces of water, is a good mixture in common fever. Three spoonfuls may be given to an adult every four hours. The same mixture is likewise a very useful gargle in common sore throat; also, a lump of nitre dissolved in the mouth, and the saliva slowly swallowed, is an excellent means of removing a simple sore throat.

      This is a very agreeable aromatic oil, and is a powerful and useful carminative. When four or five drops are given in a little milk, being previously rubbed down with a lump of sugar, it will generally be found an effectual means of expelling wind or flatulence from the stomach. It is recommended as a proper article for a medicine chcst, as forming an ingredient of a very useful composition for dissipating the windy colic with which many children are afflicted during the first two or thrce months after birth. The composition is as follows, of which a small dessertspoonful may be given whenever the child is troubled with wind: —

Take fifteen drops of oil of aniseed, which is to be dropped oit as much lump sugar as will absorb it; triturate this well in a mortar, with half a drachm of calcined magnesia, one drachm of stomachic tincture, and three ounces of milk. — Or the following may be used, which thcrc is reason to think resembles nearly, in its composition, " Dalby's Carminative," or, at least, is equally valuable for its benign influence on the constitutions of such children as are affected with flatulence or windy colic: —

      Take twenty drops of oil of aniseed; triturate it well with two or three lumps of sugar; add one drachm of calcined magnesia; syrup of saffron and foetid spirit of ammonia, of each a drachm and a half; or of water and emulsion of sweet almonds, three ounces and a half. A small dessert-spoonful taken occasionally will often remove a windy colic, or the fits which are commonly dependent on it.

      This is a good digestive application to wounds of almost any description; but where it is found too sharp or drawing, cerate may be used in its place (see Brown Ointment).

      Basilicon is particularly used for dressing blisters; and whcn it is used to keep them open, a daily dressing with an ointment of two drachms of blistering ointment and six of basilicon will effect this; in irritable habits, it may be advisable to dress with this ointment and basilicon alternately.

      This is made of a consistence proper for spreading, and may be extended over a piece of leather, a small margin free from the ointment being left all round.

      A blister applied behind the ear often relieves soreness and inflammation of the eyes, pain in the head, jaw, &c. Whcn applied to the nape of the neck, it is generally effectual in removing the distressing head-ache that ushers in low fevers. Blisters are likewise proper in all internal inflammations; they commonly succeed also in removing rheumatic pains. Blisters are sometimes found to create

rnueh uneasiness in the neck of the bladder; for the removal of which the patient may drink freely of barley water in which a little gum arabie is dissolved, and the blister itself should be well washed twice a day with warm milk and water, till the distress of the bladder ceases.

      This ointment, commonly called Turner's Cerate, is a much milder application for dressing blisters than basilicon; the latter sometimes creating pain and smarting in irritable habits. It is also a well-known remedy to old ulcers of the leg, which it frequently keeps clean and easy, if it does not dispose them to heal. It is likewise a mild and proper application to wounds of every description.

Is a good application to inflamed eyelids; it is much better than most ointments for dressing blisters. An ounce of spermaceti ointment rubbed with one draehm of camphor (which must be previously powdered with the addition of four or five drops of spirits of wine) is a good application to chapped hands or chilblains.

      Take of compound extract of eoloeynth, one draehm; oil of caraway or oil of aniseed, twelve drops; mix, and divide into twelve pills. One, two, or three may be taken at bed-time, when a costive state of the bowels requires it. Persons subject to piles should not use aloetie pills repeatedly, for they will do harm. A milder pill is made by mixing equal parts of compound extract of eoloeynth and compound rhubarb pill, and dividing into five-grain pills, of which one or two may be taken as required.

      I shall here remark, that such as are of a costive habit, may, by a little regulation, soon bring the bowels to a natural state, without the aid of medicine, which is always the best plan where it can be done; since most medicines, more or less, leave a disposition to costiveness after the purgative operation is over, and thus present inconvenience only is remedied. To establish a daily call, the patient

may take a little castor oil every night, but not in quantity sufficient to purge, soliciting nature by repeated efforts the succeeding morning. If the dose of oil bc taken for a few times, and the attempt be regularly persisted in every morning, a habit will shortly be acquired, and the disposition to costiveness removed.

      Opium is both a stimulant and a sedative, first producing its stimulating and then its sedative effects. It acts directly on the nervous system, and when taken into the stomach extends its influence over every part of the body, allaying pain, and producing comfort.

      The effects and application of this medicine in the cure of diseases, are of course nearly the same with those of laudanum; the latter being no more than a spirituous solution of the former. But there are many cases in which it is more useful in a solid than in a liquid state; and on the other hand, there are many instances in which the liquid is preferable to the solid opium, on account of its operation being quicker, as where the object is to allay violent pain. In cases of violent vomiting, a grain of opium is commonly given to check it, and this will often be retained when laudanum will be thrown up, merely on account of the bulk of the fluid in which it is taken, lIcnce it is better to give an opium pill in every case of this nature, but without any fluid, for the obvious reason just assigned. A grain of opium, with three of camphor, is a good remedy in sick head-ache, and is preferable to laudanum, as its cffects are more durable. A scruple of opium, dissolved in eight ounces of warm water, is a good wash for painful ulcers of the leg.

      In combination with cinchona bark and quinine, it is employed in the cure of ague (see Bark and Sulphate of Quinine). In combination with calomel and ipecacuanha, it is administered with great relief to pain in acute rheumatism. In combination with squills, it relieves those obstinate coughs to which old people are very subject. The following is a good mixture for old people: — Takc of paregoric elixir, four drachms; tincture of squills, twa

drachms; sweet spirit of nitre, three drachms; syrup of squills, one ounce; camphor mixture, five ounces; mix. — Two table-spoonfuls to be taken every four hours if the cough be troublesome. In conjunction with camphor it is of the greatest service in arresting pain arising from difficult menstruation; in this case the patient might take half a grain of opium and two grains of camphor every four hours, until relieved. In combination with chalk and aromatic confection, it arrests bowel complaint (see Prescriptions for Formula of Astringent Mixture, No. 10). Opium should never be administered in affections of the lungs when the cough is dry and hard, or the expectoration difficult and scanty; or in those cases where there is a liability to determination of blood to the head. — Dose, from one quarter of a grain to two grains, to adults. The tincture is the form in which it is given to children.

      The utility and mode of applying this preparation is so familiar with everyone as to supersede the necessity of comments or directions here; suffice it to say, it is a good remedy in sprains, bruises, and some rheumatic affections where there is no fever. One part of laudanum, combined with two or three parts of opodeldoc, forms another valuable composition called "Bates's Anodyne Balsam," applicable in the same cases as opodeldoc, but is more efficacious where the sprains, &c. are very painful.

      It also forms a good stimulating liniment in combination with tincture of cantharides and spirit of hartshorn; and is of essential service in chronic inflammation of joints, white swelling, and spinal affections. The following is a good liniment: — Take of opodeldoc, two ounces; spirit of hartshorn, half an ounce; tincture of cantharides, half an ounce; mix.

      As the essence occupies much less space than peppermint water, it was thought proper to give it the preference as an article in the chest, especially as peppermint water is readily made from it. The simple peppermint water

consists of three drachms of essence, well shaken in a large bottle with a quart of common water. The spirit of peppermint is macle by adding to half an ounce of spirit of wine, seven drops of the essence, and an ounce of water. This spirit is in common use for pains or windy collections in the stomaclr and bowels.

Is a convenient application to cuts and wounds. Whenever a wound is made in any part of the body of considerable magnitude, it will heal in half the usual time, if the edges of such wound be nicely adapted to each other, and retained in this situation by narrow slips of diachylon plaster, all extraneous substances being. previously picked or washed out if such should be in it. When the wound has been thus closed, a little lint spread with cerate should be laid over it, and a bandage over the whole. The time for dressing the wound will be pointed out by the uneasiness the patient experiences in the part. The diachylon plaster is a good application where the skin is abraded, on account of its mildness and incapability of irritating.

      This plaster, applied between the shoulder-blades, often relieves, in an effectual manner, the long-continued coughs to which some children are liable, and is a remedy particularly recommended by Buchan for this disease. It will frequently be found more efficacious than all the internal medicines that can be administered. Applied to the breast or pit of the stomach, it promotes expectoration in asthmatic complaints, and mitigates that chronic difficulty of breathing with which asthmatic patients are much troubled.

Is found to be a convenient purgative in most of the bowel complaints of children, especially when they are purged, as it has a disposition to leave costivencss, after its purgative operation. A child under six months may take as a dose, six grains; and above this, and under twelve months,

eight grains. The dose of an adult may be half a drachm or two scruples. — Equal parts of rhubarb and calcined magnesia arc a good laxative, where there is an acid in the stomach, or when a patient is much affected with heartburn. Rhubarb is one of the best purgatives in the bilious complaints which frequently happen in hot weather. Tincturc of rhubarb is a warm, comforting stomachic, and when given in half-ounce doses, in combination with peppermint water, is of great benefit in flatulency of stomach and relaxed bowels, from an excess of bile.

      The medical properties of this drug are purgative; it acts mildly, and in order to prevent its griping effects, it is generally combined with ginger or caraway seeds. It is generally given either in the form of infusion or tincture. Senna tea, sweetened with sugar, and coloured with milk, is a safe and good aperient for children troubled with worms. Senna tea is made in the following manner: — Take of senna leaves, one and a half ounce; ginger sliced, one drachm; boiling water, one pint; infuse for one hour and strain. — Two ounces of this infusion and three drachms of epsom salts, constitute the black draught. Tincture of senna is an excellent aperient in flatulent colic and gout, and is the most appropriate aperient for those whose bowels have been weakened by intemperance. — Dose, from two drachms to one ounce in peppermint water.

Is an excellent old-fashioned remedy for coughs and hoarseness, especially if given in conjunction with gum arabic, and a little paregoric elixir as in the following form: — Take of spermaceti powder, half an ounce; powdered gum arabic, half an ounce; elixir paregoric, three drachms; clarified honey, a table-spoonful; mix, and make an electuary, of which a tea-spoonful is to be dissolved in the mouth and swallowed slowly, whenever the cough is troublesome or the hoarseness great.

      This preparation is much used in the treatment of febrile states of the system, its action being diaphoretic and refrigerent. It also acts as a diuretic, increasing the flow of urine from the Kidneys. The dose is from two to six fluid drachms well diluted. If the strong or concentrated solution is used, only one-fifth of the above dose should be administered.

      A tea-spoonful of spirit of nitre, given twice a day in a little water, is an excellent diuretic, and is commonly found serviceable in gravelly complaints of long standing. Half an ounce, mixed with a pint and a half of spring water, and taken during the day, is an excellent and efficacious beverage in fevers of every description.

      In large doscs it acts as a gentle stimulant to the stomach, and relieves sickness and flatulence. In dropsy, it is given in combination with squills and digitalis, to determine to the kidneys and to increase the flow of urine; in fever, it is given with mindererus spirit and antimonial wine. The following is a good mixture in fever and common colds: — Take of sweet spirit of nitre, four drachms; antimonial wine, two drachms; powdered nitre, half a drachm; syrup of saffron, four drachms; camphor julep, six ounces; mix. Take a sixth part every four hours.

      This medicine is a convenient remedy for lowness of spirits, for which it may be taken in the dose of a teasp4onful in a glass of wine on an empty stomach. Twenty drops in a glass of wine thrice a day, commonly remove the heartburn; and thirty or forty drops in camphor water, frequently repeated, is very useful in fainting fits; also to counteract the depression which ensues after the bite of venomous reptiles. Applied locally, immediately after snake-bite or sting of a wasp, it gives instant relief. Six drops, twice a day, check the acidity of the stomach and bowels which, in infants, commonly bring on many violent convulsive and other complaints.

Is chiefly put into the chest as an ingredient entering into a great variety of compounds which have been directed to be made from the chest. A solution of camphor in spirits of wine, forms the spirit of camphor, an application of great utility in many cases (see Camphor). It is much used in the preparation of tinctures and liniments.

      Sulphate of quinine is too well known to require a minute description; it is in small silky crystals, bearing in appearance a resemblance to benzoic acid; it is intensely bitter, and very difficult of solution. It is presumed that in the preparations of quinine and einchonine we possess all the activity of the respective barks, unencumbered by inert matters, which nauseate the stomach and load the bowels, in eases where large and continuous doses arc requisite; and experience, as far as it has gone, seems to justify this opinion. They have been employed in almost every case for which the fine Peruvian barks have been so long celebrated; but the most severe tests of their virtue seem to be cases of intermittent fevers, and the most obstinate agues, which have been effectually treated by the sulphate of quinine. In very delicate constitutions, and in many of the diseases of children, these remedies also promise to be of essential service. Both quinine and cinchonine are likely to be useful in these eases, but the sulphate of the former will undoubtedly establish itself as the most serviceable and most elegant substitute for bark ever presented to the profession; indeed, it has already gained so fair a reputation, that everyone who has employed it, must acknowledge its utility and convenience.

      Sulphate of quinine has been exhibited in doses of from one to five grains, three or four times a day; though eight grains are by some regarded as an equivalent to an ounce of bark. Mr. BRANDE considers it wculd be more prudent to begin with small doses, and if they answer the intended purpose, not to increase them; if not, they may be augmented till the disease feels the influence of

the remedy; but in large doses, this salt will be found to nauseate, to create weight and pain in the stomach, attended by thirst, a white tongue, and a quickened and hardened pulse. In large doses it is a most valuable antipyretic, and is especially useful in puerperal fever; but in these cases should never be given except under the supervision of a medical man.

      This salt may be said to be a specific in ague, when given in large doses, say from two to five grains. It must be administered when the fits are over and during the intermissions. When there is a great degree of nervous excitement, it may be advantageously combined with opium. The following is a good mixture for ague: — Take of disulphate of quinine, nine grains; diluted sulphuric acid, half a drachm; tincture of opium, thirty drops; camphor mixture, six ounces; mix. The fourth part to be taken every six hours. Purchasers of quinine would do well to see that they are served with that of Howard's manufacture, as inferior quinine of foreign manufacture is often substituted.

Is an excellent medicine both for external and internal purposes; it is always mild in its operation, and can never do harm in any case. A scruple, or half a drachm, proves gently aperient, and is particularly adapted to those constitutions where the piles are troublesome. Half an ounce of sulphur, made into an electuary of moderate consistence with honey, is an excellent plan of removing spring and autumn colds; a tea-spoonful may be taken twice or thrice a day till the cold abates. Sulphur has long and justly been celebrated as a certain cure for the itch; and the most efficacious, though perhaps disagreeable, method of using it, is in the form of ointment, with which a part of the body only is to be rubbed at once, lest too many pores be closed by it at the same time. One-half of the body may be rubbed every night for four nights, and it will be proper to anoint the upper and lower parts alternately. The patient should keep on the same linen till the cure is complete.

      The ointment is made by mixing one ounce of sulphur ith two ounces of hog's-lard, and to this a little perfume of any kind may be added, for the sake of ameliorating the scent.

Are a gentle laxative, and may be given to children and delicate women with that intention. An ounce infused in a moderate quantity of boiling water, and allowed to become cold, forms an agreeable acid-drink in fevers, and will often be taken largely by children in such cases, with obvious advantage. Tamarinds are useful as a vehicle for othcr mcdicines, the taste of which they somewhat conceal, and thus render them less disgusting to the palate.

      The medical properties of this drug arc emetic, diaphoretic, expectorant and rubefacient. Two grains dissolved in four ounces of water may be given in table-spoonful doses every twenty minutes until vomiting is produced. In consequence of the uncertainty of its action, this medicine ought never to be given to infants or to young persons under fourteen years of age.

      When a fever is suspected to be lurking about the body, it is proper to compound the emetic to be given, of one grain of tartar emetic and twenty-five of ipecacuanha; these, when well triturated together, may bc divided into two doses if the person be an adult, and into four if he is not above ten years, one of which is to be taken and repeated after twenty minutes, if the first dose does not succeed.

      Two grains of tartar emetic, added to a half-pint mixture of purging salts, quickens the purgative operation, and renders the medicine much more beneficial.

      Tartar emetic, in combination with squills, ammoniacum, and camphor, forms a good medicine for promoting perspiration and expectoration. For doses of each drug, sec the articles on cach. It is of great service in inflammation of the lungs, when the patient is of a full habit of body and sanguinous temperament. It lowers the action

of the heart, determines to the skin, and empties the aircells and minute bronchial tubes of their accumulated phlegm. In combination with hog's-lard or spermaceti ointment, in the proportion of two drachms of the former to one ounce of the latter, it constitutes one of the most powerful counter-irritants with which we are acquainted, bringing mit on the parts to which it is applied a particular eruption, similar to small-pox; and is employed, with great success, in white swellings and deep-seated chronic inflammations. In cases of poisoning with this drug, which is recognised by violent vomiting, hiccough, a sensation of sinking at the pit of the stomach, colic, excessive purging, fainting and convulsions, oily liquids must first be administered, after which the decoction of yellow bark should be freely drank. Dose, from the one-sixteenth of a grain to two grains, every three or four hours.

Is a medicine the chief quality of which is its power of destroying acids. Hence its utility in removing heartburn, which depends generally on the presence of superabundant acid in the stomach. On this principle also, it often affords great relief to children who are troubled with purging and vomiting, when these complaints depend on acidity, which will be generally known to be the case by the sour smell of the contents of the stomach and intestines when evacuated. It is also largely given as a diuretic, especially in cases where the urine is excessively acid and causes a smarting sensation when passed. — Dose in adults, twelve grains twice or thrice a day; in children, three grains may be taken occasionally, dissolved in water. But the principle use of bicarbonate of potash is as an ingredient in the saline draughts; the method of preparing which is as follows: — Take one drachm of bicarbonate of potash, dissolve it in four ounces and a half of water; to this may be added forty-two grains of the crystallized lemon juice, previously dissolved in two ounces:_tf water. An effervescence takes place on the admixture.

      A method is here laid down for preparing the saline draught with the crystallized lemon juice, because the fresh

lemon juice is often difficult to procure; but where the latter can be made use of, it ought always to be preferred, as the uncertain strength of the former renders every rule for preparing the draught very incomplete. But in addition to what has been already said, it may be observed, that the object in mixing the ingredients is to neutralize them, and this is understood to be the case, when, on adding the acid, the mixture ceases to effervesce; this circumstance then, must be attended to in making the draughts.

      The method of preparing the saline draughts with the fresh lemon juice is, to dissolve one drachm of bicarbonate of potash in four ounces and a half of water, and to this must be added one ounce and a half of lemon juice strained; the mixture effervesces for some time, as in the former case. The dose of a saline draught is from one to two ounces, and they are chiefly used for abating fever, of whatever kind it may be.

Is an excellent medicine in every case where there is debility, particularly of the stomach, causing a bad, inefficient digestion. Two tea-spoonfuls in a glass of wine and water, on an empty stomach, or at a little distance from meal hours, will always be found beneficial in these cases. This plan is also an excellent means of recruiting the strength after a tedious illness, which often remains in an impaired state for a long time. Where infectious fevers are prevalent, two or three tea-spoonfuls in a little wine three or four times a day, may be taken to fortify the body against infection; and, to aid this intention, salts may be occasionally taken in the manner and form recommended under the article, "Epsom Salts." Equal parts of tincture of bark and cold water forms an excellent tincture for the teeth and gums.

      A tea-spoonful or two of this medicine, taken in a glass of port, with fifteen or twenty drops of spirit of sal volatile, is an excellent means of exhilarating the spirits, more especially if it be taken between breakfast and dinner, when the stomach is empty.

      This is a veryconvenient and agreeable bitter for creating appetite in those who have impaired the stomach by the pernicious habit of drinking spirits. A table-spoonful should first be taken in a tumbler of cold water twice a day; after a continuance of this for a few days, the quantity should be gradually lessened, by which progressive diminution of such unnatural stimulants, the stomach will at length recover its healthy state. It is to be understood in this case, that the custom of spirit drinking is left off entirely. Two or three tea-spoonfuls of the stomachic tincture, in half a wine-glass of sherry, is a good means of removing a morning head-ache and qualmish stomach, caused by excessive intemperance the preceding evening.

      Stomachic tincture is macle in the following manner: — Take of tincture of calumba, two ounces; compound tincture of cardamoms, six ounces; mix.

      If this be occasionally rubbed over the surface of those fungus excrescences called "proud flesh" it will soon destroy them, and is consequently much used by surgcons for that purpose. It will frequently, but not always, destroy those excrescences called warts; it is observed that it does not always succeed, for it is acknowledged, that in some cases no means can be devised for eradicating them. The following is a convenient process for endeavouring to remove warts: — Tie a fine silk thread, well waxed, tight round the base of the wart, where it can be done. This ligature is to be tightened a little every day, and the wart will soon fall off; when it is removed, take a small piece of diachylon plaster in the ccntre of which is a circular opening of a size just sufficient to expose the whole remaining surface of the wart. The plaster is to be applied. The blue vitriol is to be rubbed on the wart every day till its application gives pain, at which time it may be presumed the wart is destroyed. The precaution of the plaster is necessary, as it prevents injury to the contiguous

parts. Internally it acts as a speedy emetic in five-grain doses, and in quarter of a grain to one-grain dcses as an astringent in chronic diarrhoea, but in these cases should be given only under medical supervision.

      This substance is the kind of emetic chiefly used where poisons have been swallowed by mistake. It is given in the dose of twelve grains, or from this to twenty, to be repeated in twenty or thirty minutes if the dose should not succeed. Although considerable latitude is here given with respect to the dose, it may readily be judged how to adapt it to different ages, from what has already been said in the preface.

      Ten grains of white vitriol, dissolved in four ounces of rain water, is a good lotion for slight inflammations, either of the eyes or skin, or may, with equal propriety, be used as a wash to languid or glassy-looking ulcers. With alum it forms an excellent injection for "whites" (see Alum).

      White vitriol finely powdered, one scruple; hog's-lard, an ounce; mixed well, so as to form an ointment, is a useful application to the inflammation of the eyelids to which old people are subject; a small bit should be put in each eye every night at bed-time.

      Oxide of zinc or zinc powder is used at the present day only as an external application. It is an excellent absorbent, and is of great service in erysipelas, accompanied by blistering of the skin; it absorbs the fluid when the blisters break, and excites the skin to take on a healthy action. It is also used in the chafing which takes place in fat children in the groins and other places. An ointment composed of two parts of zinc powder and six of spermaceti ointment or lard, is an excellent application in those spongy pustular running eruptions which frequently take place on the skin.

      These two forms of injury require the application of the same principle of treatment, and may therefore be considered under the general term, burns, or injury done to the person by the application of heat, whether of hot water, metal, fire, or explosion of gunpowder.

      The injury done may vary greatly in degree, from the production of mere redness, without destruction of the outer skin, to the charring, and consequently the destruction of both the outer or false, and the inner or true skin, and even the soft parts beneath. The application of hot water, at or even below the b.oiling heat, will effect the first; the direct application of fire, or the explosion of gunpowder, will cause the second degree of injury. The symptoms of the slighter injury are redness of the skin, particularly about the margin of the scald or burn; the rising of the skin into blisters, sometimes of large size (called vesications), and acute pricking pain. This pain continues for many hours, perhaps from twelve to eighteen, without relief; at length it subsides, and the redness diminishes in the course of three or fourdays — the skin over the blisters dries, and comes off.

      Treatment. — In scalds of a trifling kind, the application of cold water, or goulard water, kept constantly applied, will be all that is necessary. Instant relief may be obtained in slight burns or scalds from the application of chalk and cold water mixed to form a thin paste. In those of a graver kind, the parts may be well dredged with flour, or wrapped up in wadding, and surrounded with a roller or bandage. The parts may be left undisturbed for threc or four days, if not very uncomfortable, or until the discharge floods off the application; they are thcn to be well cleansed in warm water, and done up as before. An excellent application is the following: — Take of lime water and of sweet oil, of each equal parts, make

a liniment; to be applied frequently to the scalded surface. Should there be much pain, twenty drops of tinctnre of opium in a little peppermint water may be given every four hours, until the pain ceases, to adults; from five to ten drops to children varying from five or six years to fifteen. This medicine must be given with caution and judgment, not continuously, but only occasionally when required, and never after the fourth dose, whether there be pain or not, unless under the directions of a medical man. The bowels are to be kept gently open, and proper diet administered. When the wounds begin to heal, they may be dressed with yellow basilicon or spermaceti ointment.

      A corn is that well-known troublesome thickening of the skin which occurs on the feet from the pressure and irritation of tight shoes. There is not only a thickened state of the external skin, but a kind of root extending more or less into the subjacent fat; a small cavity is also found between the cutis and cuticle, called bursa. Thcre are two kinds of corns, dry and horny, and soft and moist. The hard corn may occur on any part of the external surface, but generally over a projecting portion of bone; while the soft corn is formed between the toes, commonly between the little and fourth toe. The former, after being soaked in warm water and well rubbed with soap, may be removed by any fine sharp-cutting instrument, or rasp, care being taken to remove every portion and not to wound the part beneath; or they may be touched twice a day with strong acetic acid, or a solution of nitrate of silver (lunar caustic). The texture of the skin is thus destroyed, and after a few applications the corn readily peels off. Another simple and often effectual method is to spread a thin piece of linen or calico with diachylon or other simple ointment, and lay it on the part affected, and over this a piece of buckskin leather, with a hole made in it the size of the corn; thus the pressure of the shoe is taken off the corn and thrown on the surrounding parts. When an abscess forms under the bursa of a hard corn, the skin must be carefully pared off, and an opening made into the bursa

to allow the escape of the small quantity of matter which gives rise to the pain. The treatment of soft corns is much the same as the above, but caution must be used in applying strong acids or caustic, lest they penetrate to the parts beneath. A safe and efficient application to soft corns is the solution of caustic potash. If the toes are in any way displaced, they must be brought into their proper position, and the patient should be provided with a shoe of soft leather of a proper shape and width.

      A bunion is caused by an inflammation of the bursa mucosa at the inside of the ball of the great toe — the surrounding parts become thickened and indurated, the bones of the joint enlarge, and after a time suffer a kind of displacement. In the early stage the inflammation should be subdued by leeches, poultices, and fomentations, or goulard water may be constantly applied on linen rags. If an abscess form, it should be opened with a lancet; poultices should afterwards be applied, and then a dressing of brown or spermaceti ointment. Rest and the horizontal posture should be observed as much as possible, and wearing a piece of soft leather, with a hole corresponding to the size of the bunion, as recommended for corns, will afford comfort and relief to the patient.

      By this term we understand a displacement by violence of one part of a joint from its natural connection to the other. By a knowledge of the structure of the joint, we are enabled to lay down rules by which the displaced bone may be returned or reduced; the ligaments which have been torn asunder re-unite, and the joint regains its healthy structure. The sooncr this is done the better, and the easier will it be effected; but the attempt may be made even after the expiration of three or four weeks, if in the larger joints. After this period, the displaced bone adheres to the part it is in contact with, and the attempt should not be made but by an experienced surgeon. .After the reduction, inflammation of a mild charactei may follow. The joint may be bound up moderately tight with a wet band, and cold water or vinegar and water applied.

      Symptoms. — The mouth is fixed open, pain in front of the ear, and extending up to the temples. This state of the jaw occurs suddenly, while gaping, eating, or talking, while the jaw is in motion.

      Mode of Reduction. — Place the patient on a low seat, cover the two thumbs with a silk pocket handkerchief, pass the thumbs into the mouth, and press with force, slowly applied, on the last four lower teeth, and at the same time raise the chin, pushing the jaw backwards. Considerable pressure is required by the thumbs; two pieces of wood may be employed as a substitute for the thumbs.

      Either end of the collar-bone may be dislocated by a blow or a fall, indicated by a swelling over the joints, which the bone forms either with the breast-bone or shoulder-blade, and by the suddenness of its occurrence. The treatment is very much like that of fracture of the collar-bone, to which reference must be made. A pad of lint should be put on the swelling, and the arm raised high in a sling. This accident will require three weeks' rest.

      Symptoms. — Flatness of the shoulder, compared with the roundness of the sound side. Inability to move the arm; the elbow placed at from two to three inches from the side, the attempt to press it to the side occasioning pain in the shoulder. If the fingers be passed up under the arm to the arm-pit, the head of the bone will be felt out of the socket, and may be revolved to make it perceptible.

      Reduction. — A round or jack towel, through which the arm should be drawn; the towel carried up to the arm-pit and twisted over the shoulder, and the two ends thus twisted passed over the back of the neck, and fixed into a staple by a rope or otherwise. Wash-leather, or other soft material, to be wound around the arm, just above the

elbow; a close hitch-knot of good quarter-inch line made upon it. The patient to be placed in a chair and held firmly, or to lie down on a bed and fixed. The arm to be drawn slowly and steadily, at an angle half-way between horizontal and vertical, viz., about 45°, and the extension to be continued for ten minutes to a quarter of an hour, during which, frequently, the surgeon or superintendent should raise the arm near the upper or dislocated end upwards, with his two hands, with some force; the head will return into the socket with a sound and a slight shock. If the head of the bone be thrown forward on the chest, the extension to be carried a little backward; if backwards, a little forward. After reduction, a sling and three weeks to a month's rest.

      The reduction may also be effected by laying the patient on the ground on his back, while the operator, placing his right heel in the left arm-pit, if the dislocation occur on the left side, and his left heel in the right arm-pit, if it occur on the right side, makes powerful extension on the affected arm by both his hands.

      The elbow-joint consists of three bones; the bone of the arm spreading out across the joint: the radius outside and the ulna inside. The most common dislocation is when both radius and ulna are thrown backwards.

      Symptoms. — Joint motionless, a little bent; skin tight in front of the joint, a projection behind formed by the elbow, which, with its tendon, are pushed back. The joint can neither be bent nor straightened.

      Reduction. — Two men will suffice generally, unless the patient be very muscular. Extension to be made in a straight direction by both. The force required is not generally very great, and the reduction takes place commonly with a snap. Both bones may be forced forwards when this accident occurs — the elbow (olecranon) is broken. The imperfect line of the joint will be readily observed when a comparison is made with the opposite joint. Reduction. — Simple extension as before, and when reduced the joint should he placed straight and bound on to a splint. This accident will require from

five to six weeks; other accidents of this kind occur to the elbow-joint, but they may all be treated on the same principle, viz., forcing the bones back to their natural position, which may be ascertained on comparison with the opposite sound limb, or the limb of another person.

      The hand may be forced backwards or forwards, but this accident is very uncommon. The nature of the case will be apparent to the slightest observation.

      Reduction. — The hand should be grasped firmly by a powerful man, and drawn straight. If the hand slips, a bandage may be applied around it to aid the application of the extending force; but all that is required is full extension, by which the hand may be drawn straight.

      The same observations will apply to dislocation of the fingers.

      These dislocations are veryimportant andvery numerous, being not less than four in number. The hip-joint consists of the head of the thigh-bone and the socket formed by the pelvis, or continuation of the haunch-bone, towards the middle of the body. These accidents generally arise from a fall from a height, or a very severe blow, and are attended with severe injury to the structure of the joint and surrounding parts, although the consequences are not generally so severe as fracture of the neck of the thigh, detailed above. The head may be thrown from the socket in four directions — Ist, upwards and backwards; 2nd, backwards; 3rd, downwards and inwards; and 4th, upwards and inwards. The most frequent is the first, upwards and backwards.

      The Symptoms are, shortening of the leg to the extent of about two inches. The foot is turned in and lies over the opposite foot; the ball of the great toe towards the opposite instcp; the leg cannot be turned out, nor the attempt made without pain. On examining the side of the buttock where the head is thrown, it will be felt on the bone, with the great projection formed by the end of the shaft of the bone, placed in front of it. If the leg is

rotated, the head and the great process or prominence (trochanter) will be felt to revolve also. The line of the thigh is altogether too far outwards.

      Reduction. — A round or jack towel should be applied, as in the case of the dislocation of the shoulder, and drawn up around the thigh as high as possible, and twisted over the hip-bone somewhat tightly, and fixed behind into a staple. Wash-leather, or a soft towel, to be wound around the thigh, about the knee, and around this the cord or line with two clove hitches, one on each side of the thigh. The aid of six men will be required, who must draw very slowly and very cautiously. The patient should be placed nearly on the sound side, and the limb should be drawn a little across the other limb; and after it has begun to descend, yet a little more across the opposite leg. When the thigh is fully extended, it will generally reduce itself, and may be heard to return into the socket with a snap. Should it not do so, the superintendent should take the thigh high up towards the trunk in his hands, and raise it, and use a round towel, passed under the limb and over his neck, and raise it, twisting it outwards at the same time.

      The Symptoms are nearly the same, except that the shortening is less and the turning in of the foot less also; but both the symptoms exist in a degree. The head of the bone lies lower down, and is less apparent to the hand when pressing on it.

      The Reduction is effected by the application of nearly the same means. The limb should, however, be drawn rather more over the opposite limb. When fully extended, it should be turned outwards, when the head will slip into the socket.

      Dislocation Downwards and Inwards.

      SYMPTOMS. — The leg is a little lengthened, and is drawn forwards on the trunk; or if placed straight downwards on the ground, the trunk will be bent forwards as in a stooping posture; the toe points a little outwards.

The line of the thigh, when compared with its fellow, is directed too much inwards towards the middle of the body, and also too far backwards. The thigh should be moved in all directions, slightly, to ascertain that it is fixed in this position.

      Reduction. — Apparatus applied as before, patient lying on his back; extension to be made downwards and outwards, and when brought down, after some minutes' extension, the thigh should be forced in its upper end, outwards, by the hand, or the towel being placed between the thigh and drawn in the direction opposite to that of the dislocation, viz., upwards and outwards.

      This is the most formidable of all these dislocations.

      Symptoms. — The leg is shortened, and like the last dislocation, drawn forwards on the body, as though in the act of stepping to walk. Both these last symptoms are more strongly marked than in the former. A swelling, caused by the head of the bone, is apparent at the groin, and the bone is firmly fixed.

      Reduction. — The same means as before and nearly the same direction as the last accident, except that the limb should be drawn outwards and more backwards. These two last dislocations may be reduced in the sitting posture of the patient, and in that position drawn round a bed-post. A month's rest is required, or even more.

      The knee-pan (patella) may be forced off the end of the thigh-bone, cithcr outwards or inwards; but the latter is very rare. Displacement outwards is generally caused by sudden and violent action of the muscles of the thigh. The Symptoms are, the appearance of the bone on the outside of the knec-joint, instead of in front, attended with pain, stiffness of the knee, and inability to walk without much pain.

      Reduction. — The leg must be bent forwards on the trunk, and the knee straightened as much as possible; the bone is then to be forced bac: by the pressure of the hand.

      The foot may be forced inwards, outwards, forwards, and backwards. Of these, the second (outwards) is by far the most frequent. It is generally accompanied by fracture of the small or outer bone of the leg, about four inches above the ankle-joint. On comparing the dislocated with the opposite foot, the distortion will be apparent.

      Reduction. — The foot should be held firmly by a strong man, by the heel and by the front, and drawn steadily downwards, and forced back into its position. A little backward and forward movement of the foot, or the ankle, will facilitate its return.

      The other dislocations may be ascertained by comparison with the opposite foot, and should all be reduced on the same principle, and by the same means, as the dislocation outwards above described.

      Fractures of the various bones of the skeleton are among the frequent results of violent injuries, occurring at sea as well as on land. The consequence of a broken bone is the entire incapacity of the limb or the part to perform its functions in the economy, and of course the loss of the services of the affected person, until the bone is not only united, but so firmly knit as to render him fitted for a cautious return to his duties. A bone requires for this purpose a period proportionate to its size, bulk, &c., the extremes being from about three weeks to twelve, for what are termed simple fractures; but in compound fractures (viz., where the soft parts about the broken bone are largely torn, communicating with the external air by a wound of the integument) these periods must Be Greatly Extended. First, with respect to Fractures of the Skull, little can be said on this subject, inasmuch as the injury is essentially dangerous in its nature, and the aid from surgery comparatively less than in ordinary fractures.

If it be attended with deep sleep, snoring, and insensibility to pain, evidenced by pinching, Sze., it may be inferred that a portion of the bone is pressing on or into the brain.

      Whether the external skin be broken or not, an examination should be made, provided the situation of the blow be clearly indicated by the fracture being perceptible to the touch, or by blood being effused under the skin. A cut should be made of two or three inches in length down to the bone; if arteries bleed, they should be seized with a pair of forceps and tied with a piece of silk thread, the ends of which may be eut off. When the bone is exposed, by one or two incisions as may be required, the depressed bone should be raised by a chisel, or some similar instrument, to its natural level; any pieces of separated bone should be removed entirely, the surface sponged clean, and lastly, the skin or scalp brought together; the hair around having been shaved off, the wound is to be re-united by sticking plaster. From twelve to sixteen ounces of blood may be taken from the arm about twenty-four hours afterwards, when inflammation appears, supposing little blood to have escaped from the wound, either at the time of the accident or the operation, if the pulse beeonv full and the skin hot, and the brain excited.

      Fractured collar-bone is indicated after a fall or blow on or about the shoulder by irregularity of the line of the bone and inability to move the arm, attended by pain on pressure at the suspected part, where will be found, more or less prominent, a small swelling. This swelling or prominence is formed by one broken end of the bone projecting over the other. The opposite collar-bone should be carefully examined as a guide; if the two bones do not correspond, a fracture may be generally inferred. If the shoulders be drawn forcibly backwards by a person placing his knee against the back and his hands on the round of each shoulder, the prominence will be found to be diminished in the ease of fracture, and this is the treatment required for the purpose of setting the broken bone. The more fully the shoulders are drawn backwards, the better

will the bone be set; the only difficulty in the management of the case consisting in that of retaining them for some weeks in this position. To effect this, a flannel roller is to be employed, of about four inches in breadth, to be carried round the front of one shoulder, under the arm-pit, across the back over the opposite shoulder, under the arm-pit, and again across the back in the form of a figure of c. Pads of lint or tow may be put in each arm-pit, to prevent the cutting of the roller. About twelve or fourteen yards will be required for the application. It is indispensable that the roller should be applied while the shoulders are being drawn back by the assistant. The bone will unite in a fortnight, but not firmly within a month or five weeks.

      Fracture of the humerus or upper arm, is not a very frequent occurrence. Like most other fractures, it is difficult to assign to it its exact cause; but, doubtless, it arises from violence applied to some part of the arm. The muscles that surround the upper arm are very large, and it is only on the outer side that the bone can be clearly felt. When this accident is suspected, each end of the bone should be taken in the hand of the surgeon, and with a force sufficient to ascertain the fact, moved freely. If it be broken, in all probability grating (crepitus) will either be felt or heard. If fracture has occurred towards the middle of the bone, it may be treated successfully and without difficulty. If towards either extremity, the time required is longer and the union will probably be effected in a less perfect degree, as regards the restoration of the form and functions of the arm. Three splints should be used — one for the back of the arm, extending very high, on to the side of the blade-bone and down below the elbow; one on the inner side, pressed up into the arm-pit and down to the elbow; a third on the outcr side along the flat of the arm. These splints should consist of wood, glued on to kid leather and split longitudinally, that they may bend round the arm; thcy should be well padded with tow, wrapped up in linen, very thick,

and most especially so the pad that passes into the arm-pit.

      The head of the pads should exceed that of the splints, so as to prevent their pressure giving pain in any direction. When the pads are made, and all is prepared, the arm should be slowly drawn downwards to lengthen it; this should be done by a powerful man, but the force applied very slowly and carefully. A second assistant will be required to keep the body of the patient in its position, that it may not be drawn down by the person extending the arm; this is called counter-extension. The extending force should be applied until the arm has acquired its natural length; and when this is done, the pads, with the splints laid accurately over them, should be placed in their relation on the arm; and finally, the splints should be fixed to the arm by a roller or bandage, or by three leather straps or buckles, passing around the limb and fixing the splints in their position; they will require re-adjustment every two or three days. Tithe fracture be very high, or low, near the elbow-joint, the arm should be fixed straight, and the splints applied with especial care to include the part of the arm at which the fracture is felt; but the extension must be made thoroughly, to the end of bringing to their relative positions the broken ends of the bone. For the union, from about five to six weeks will be required, during which the splints may be removed three or four times, to ascertain that the skin is not abraded (rubbed), and that the fractured ends of the bone are in proper relation to each other.

      These two bones are very liable to be broken. The bone that extends along the inner side of the arm from the line of the root of the little finger is the ulna, and the other the radius. Either may be broken singly, or both. When both are broken, the difficulty of ascertaining the fact is not great; it is more so, generally, when either bone is broken singly. The same means should be resorted to as described in the preceding fracture; probably more or less swelling, and some grating, may sufficiently

prove its presence; whether one or both bones be fractured, the treatment of the case will be the same. Two flat splints will be required for the two flat surfaces of the arm. The extension required is greater in fracture of both bones than in the case of a single bone, because the muscles cannot retract the broken bone to any considerable degree where the other bone remains entire, the two bones being connected closely together. The arm should be placed in a sling, as likewise in the preceding form of fracture, and supported from the elbow to the wrist. It should be placed in the sling with the thumb-side of the hand uppermost, and allowed to remain in that position for a month on the average. The bone will have united, by soft matter, in about ten days to a fortnight; but the arm will not be fit for use under about five or six weeks.

      These fractures also require full extension and the application of two splints of wood, proportionate in size to that of the bone they are intended to support; they require from a fortnight to three weeks. Many weeks will elapse before the functions of the fingers are fully re-established after fracture of the bones of the hand or fingers.

      This is not an uncommon accident, generally arising from a blow or a violent fall. One rib may be broken, or two or more; they are more generally fractured behind than before, or at the side; but this will, in some measure, depend on the direction of the blow. It is followed by pain and difficulty of breathing. Pressure of the hand on the chest over the suspected part, during respiration, will generally detect fracture if it exist, especially if more than one rib be broken. The treatment consists in employing pressure, and this is effected by the use of a circular elastic roller, or bandage, either of flannel, or what is far better, of Indiarubber webbing, as used for braces, but broader. The patient should be desired to take as deep a breath as possible, and while holding in the air, the bandage should be applied around the chest — if flannel, six or eight times; if Indiarubber, about three times; it should not be

applied too tightly, but the person may be allowed to breathe with tolerable freedom, not, however, by the ribs, but by the belly. Inasmuch as this fracture is often attended by injury to the membrane lining of the chest (the pleura), inflammation of the membrane may follow the injury within forty-eight hours; and if his pulse be high, the difficulty and pain of breathing be great, and his skin be hot, an effervescing saline mixture with small doses of laudanum, five to ten drops, should be administered, and he should be kept on low diet for a weck or ten days, or even longer, and his bowels acted on with a purgative or two.

      These fractures are rare, and are generally dangeroti s; they are not very readily detected, and require a go od deal of management in the treatment. All that can be said of them in so limited a work is, that the whole peh 'is should he bound round tightly with a flannel or cali co roller, and fixed as firmly as possible, to keep the brok en surfaces together. This pressure should be continued I or six weeks or two months, and the most perfect r, .st ordered. Any attempt to move before the bones are fu lly united being attended with considerable danger.

      The thigh-bone is generally broken by a fall from a height or a severe blow, and in consequence of the size of the bone requires good management and a long time to unite. Like other bones it may be broken straight across, forming what is called a transverse fracture, or obliquely, along the bone. In the latter case, the pointed end of the bone may penetrate one of the larger muscles around it, and be held firmly by it. The thigh-bone may be broken also at either end: first, close to the hip-joint, and secondly, close to the knee. The first of these two latter will form a distinct subject, and no further reference need be made to it in this section. In the common fracture of the thigh-bone, a swelling or irregularity in the line of the bone will be met with; if the knee be raised off the bed with one hand, while the other is passed up along the

back of the thigh, and by grasping the limb here and there, the fracture will be ascertained without great difficulty. The broken limb will generally be somewhat shortened in its lengih. For this accident four splints are required: one in front extending from the groin to the knee-pan; one on the inner side from the upper end of the thigh to the inner side of the knee; a short one behind; and a long splint for the outer side, sometimes extending from the arm-pit down to the foot, but a splint of the entire length of the thigh from the hip to the outer side of the leg will suffice. These four splints should not be so broad as to touch each other when the straps or roller is applied around them, nor so narrow as to allow the roller, &c. to touch the skin. If they are too broad, they will ride over each other or overlap. The pads must be very thick and very large, and the upper end of the inner splint should be covered to protect the skin from its pressure. Sometimes the inner and back splint can be dispensed with, the long outer splint and one in front being sufficient to keep the bones in position.

      Treatment. — The patient being placed on his back, two strong men are to extend the thigh, one holding it below the groin, and grasping it firmly, the other drawing downwards from the knee. The extending force requires to bc applied for some minutes, and to be persisted in steadily. A slightly sideway motion will facilitate the adjustment of the bones, but the extension must be applied with great force if the limb be shortened, and continued until it has reached its natural length. The splints may thcn be applied. If the extension be discontinued even for a few minutes before their application, the shortening will reappear, and it must be renewed. The splints require a good deal of pressurc from the roller or straps, in consequence of the thick mass of muscles intervening between them and the bone. The patient should continue to lie on his back throughout. The bone will require from five to seven weeks for its union, during which the splints may be occasionally removed for readjustment. In fracture of the thigh-bone close to the knee, i.e. within two or three inches, a long splint shoUld be applied at the back of the thigh, extending down the

leg to below the calf, and the knee rendered firm and extended. This splint should be firmly rolled to the calf. In hospital practice fracture of the lower end of the shaft of the thigh-bone is often treated by using a back splint made in the form of a double-inclined plane so as to keep the thigh flexed on the body.

      After a fall the bone may be broken at its upper end close to the hip-joint. This part of the bone is called the neck, which is a short oblique portion between the hipjoint and the long straight part or shaft. Its length is about two inches.

      Fracture of the neck of this bone has the following symptoms: — The limb is shortened by about an inch, as may be seen by the position of the knee-pan. The foot is turned much outwards. It may be brought up straight, but it falls out again immediately if the hand be removed, and lies nearly flat on the bed. If the limb be extended to its natural length, a grating of the bone is generally, but not invariably, heard or felt. The limb is very flexible, and may be moved in any direction moderately, but not without pain. This form of fracture, although it generally occurs in old persons, occasionally happens in young, or indced at any age.

      The trcatment requires a very long splint, as described in common fracturc of the thigh, passing up into the armpit, bound round the chest, abdomen (belly), and thigh, down to the foot, to which it is also to be firmly applied, with a view to keep the leg as permanently extended as possible. Union of the fractured bones will require from two to three months, or more. Somewhat less time is necessary in the case of a patient of middle or youthful age.

      The knee-pan (patella) is most frequently broken transversely, but occasionally, in consequence of great violence, the fracture may be longitudinal. It is readily detected by the hand.

      The difficulty in the treatment of the transverse fracture consists in the tendency of the muscles of the front of

the thigh to draw up the upper end of the bone, thus leaving a space of one or more inches between the broken surfaces. To meet this liability, the leg must be raised on pillows, or on a wooden inclined frame placed underneath it to the height of about two feet at the foot, from the surface of the bed. This position will bend the thigh forwards on the trunk, and straighten the knee. The thigh should then be rolled from the groin downward to within about six inches from the knee, and cross-bandages carried around the thigh above the knee-pan, with a view to urge it gently downwards, the lower end being as gently forced in the opposite direction; this practice will require from three to five weeks, and great care will be required in bringing the limb into use.

      The leg is composed of two bones, an inner larger (the tibia), an outer smaller bone (the fibula). One or both may be broken. The tibia is more frequently broken about two-thirds of the way down. It is detected without much difficulty by passing the hand down the line of the shin, although the displacement may not be great. It is not easy to detect a fracture of the fibula, nor is it of great importance to do so. Extension must be macle as in the other fractures, and sufficiently so to bring the broken surfaces together. Two splints only will be required, and they should be applied at the sides of the limb and bandaged firmly; the leg may be placed either on the side or on the hack; the more comfortable position may be selected.^* Fractured leg, involving the tibia, will require from four to six weeks in splints, after which a "starch bandage" should be applied.

      The treatment corresponds with that of similar injuries to the hand.

      The term compound is applied to a fracture in which the skin is broken or torn, the wound of which communicates with the broken bone. This case is much more serious and much more tedious than that of common fractures, especially when the wound is large; but be it ever so small, it proves great violence and injury done to the soft parts, muscles, &c. Some weeks after the injury elapse before the bone begins to unite, in consequence of the large formation of matter that generally takes place, and the process of union of the bone does not begin until this action has ceased. During this stage the patient becomes often seriously ill, and his vital powers are exhausted by the large quantity of matter poured out around and among the injured parts. In young and healthy persons, in whom the injury to the muscles, &c. is not very great, these stages are not very strongly marked, and the cure proceeds more rapidly.

      Treatment. — The wound must be healed, if possible, the edges being brought together by adhesive plaster. The splints, whatever bone may be affected, should be applied as in simple fracture, care being taken, however, not to press on the wound if possible, and this may be avoided by dividing the pad that lies over the wound into two parts, leaving a space for the wound, which should be untouched; the pad should be very thick. A better method than this, however, is to divide the splint and to connect the two parts by means of an arch of iron, so that the wound may be dressed without difficulty. This is called an interrupted splint. If the wound do not heal at once, the plaster may be removed, and a linseed meal poultice substituted.

      During the stage of formation of matter (thc stage of suppuration) the patient will require tonic medicines, as bark, porter, &c., and small doses of opium at night, and nourishing diet, if his stomach will bear it; but this treatment should not be carried too far. Strong purgatives are injurious. The case will continue to progress very slowly for some weeks, abscesses may form, and should matter collect under the skin so as to be felt on

examination, or the skin become red and thin, the part should be punctured, and great relief will be afforded by its escape.

      The splints should be removed as often as the matter renders the pads foul, or the wound appears to suffer from their presence; perhaps this may be required every other day, or even oftener. When the suppurative stage has passed, which may occupy from one month to two, the wound will look florid and healthy; and as soon as it begins to heal (but not until then) the bone will begin to unite. A month or five weeks will still be required before the union is complete, and two or three weeks yet longer before the patient is enabled to use the limb. The above periods refer to compound fracture of the thigh-bone. Compound fractures of other bones pass through these stages more readily.

Are injuries done to the ligaments, tendons, and other structures surrounding the joints. They are produced by jumping, falling, or other causes which forcibly stretch or lacerate them. The joints most liable to sprains are the wrist and ankle-joints; the wrist-joint becomes sprained in consequence of the arms being naturally thrown out by persons in falling, to prevent their being seriously injured, by which means the whole weight of the body is thrown on the wrists, which not only sprains those joints but sometimes fractures them. The ankle-joint is frequently sprained by jumping from a considerable height, or by the foot turning under the weight of the body. Sprains are attended with great pain at the time of the accident, and also with considerable swelling and discoloration of the injured part; the swelling and discoloration arising from the effusion of blood into the surrounding structures. The joints at first can be easily moved, but as the swelling and inflammation increase, all motions become painful, and the patient is unable to use the injured limb under any circumstance whatever.

      In the treatment of sprains the injured limb must be kept in a perfect state of quietude, and in such a position as to relax the muscles in connexion with the affected

tendons, as well as to favour the return of the blood to the heart. He must be kept in the recumbent position; evaporating lotions should be kept constantly applied to the injured parts, by means of linen rags wctted in the following lotion, and which should be renewed as often as they become warm: — Take of goulard water, eight ounces; gin, four ounces; camphor mixture and mindererus spirit, of each two ounces; make a lotion, which should be kept in a cool situation until required for use.

      This practice should be continued for the first twentyfour or forty-eight hours; after which period, should the swelling or pain increase, leeches may be freely applied to the parts affected, and the bleeding freely encouraged by means of a sponge and warm water eonstantly applied to the leech bites. Hot fomcntations should afterwards be applied by means of flannels wrung out of a decoction of camomile flowers and poppy heads, and the bowels kept in a frce state by the following mixture: —

      Take of Epsom or Rochelle salts, one ounce; antimonial wine, half an ounce; mindererus spirit, one ounce; syrup, half an ounce; camphor mixture, three ounces; mix; two table-spoonfuls to be taken every three or four hours until the bowels arc freely acted on. By this treatment the disease will rapidly subside, and the parts will return to their usual healthy condition in persons of sound health. The patient should not be allowed to make use of his limb too soon, as the irritation and inflammation of the joint will be kept up, and thus he may suffer from it for months, or even years. When all signs of the disease have disappeared, the motions of the part may be promoted by gentle exercise, and the following liniment may be rubbed in night and morning: —

      Take of soap liniment, one ounce; olive oil, half an ounce; tincture of French flies, half an ounce; mix; the parts may be afterwards supported by a roller, or it may be found necessary to envelope them in straps of soap plaster, in addition to applying the bandage.

Are either incised, lacerated, contused, or punctured.

They are called incised wounds when they are made with a sharp-cutting instrument, as when a shoemaker cuts himself with his knife, or a carpenter with his chisel. They are called lacerated when the flesh is torn, either by machinery, hooks, or other blunt instruments. Wounds are said to be contused when there is an irregular breach of surface, accompanied by injury and a bruised condition of the surrounding parts. They are generally produced by falls or blows of blunt instruments. Punctured wounds are produced by the forcible entry of sharp instruments, such as bayonets, swords, scissors, hooks, or the pointed ends of broken bones.

      Treatment of Incised Wounds. — It has been observed before, that incised wounds consist of a mechanical division of parts by a cutting instrument; all, therefore, that is necessary to be done is to bring the edges of the wound nicely together, and maintain them in that position until union takes place. This is effected, if the wound be trifling, by means of straps of sticking plaster, which should be so applied as to preserve the edges of the wound in apposition. If the wound be of considerable extent, and bleeds freely, the first thing to be done will be to arrest the haimorrhage; this will be effected, if the bleeding vessels be small, by making pressure with a sponge for some considerable time; all extraneous matter should be cleared off, and the lips brought together; a piece of lint should then be dipped in the blood and placed over its edges; this is found to be au excellent application, as the blood in drying, in consequence of its adhesive qualities, seems to maintain the union of the edges of the wound. In the course of four or five days, the parts will be found to be united, unless some accidental circumstance, such as too great a degree of inflammation or an untimely meddling with the dressings, should occur. The strappings or dressings should on no account be disturbed before the fourth, fifth, or sixth clay, unless the parts should be in great pain or much swollen. If the incision takes place about the checks or lips, or other parts which are unsupported, and where sticking plaster could not be applied, it will be necessary to put in two or three sutures, or stitches, according to the extent of the wound.

Surgeons generally use silver wire for sutures, but white silk or horse-hair will answer just as well in most cases. Should the parts swell, a cooling lotion may be applied, such as goulard water, and the bowels should be kept in a free state. When the edges of the wound are to be maintained in apposition by means of suture, the sutures are to be inscrted in the following way: The needle which is used on the occasion, and which may be either curved or straight, being armed with a fine thread or a piece of silk, which is to be previously waxed with a piece of white wax, is to be passed through both edges of the wound and drawn forwards until one end of the suture passes through also; then both ends are to be tied, and afterwards cut off close to the parts.

      Treatment of Lacerated Wounds. — Lacerated wounds, in consequence of the great injury done to the parts, and from the fact of their not bleeding much, are very subject to active inflammation. If the wound be considerable and the parts much injured, the patient should enjoy perfect rcst, the parts should be covered with cooling lotions (see Prescription recommended in Sprains); all dirt and extraneous substances being previously washed off, the bowels should be opened by the common black draught (for Prescription, see Senna). If the inflammation run high, lecches should be applied and the bleeding encouraged by the application of hot water; the cold lotion should now give way to fomentations and poultices; the patient should live low. When the inflammation has subsided, the wound may be dressed with basilicon or Turner's cerate. Erysipelas frequently follows lacerated wounds of the scalp; in this case the parts should be freely fomented with hot water, and the patient should take a fever mixture (for Prescription, see Epsom Salts). Tetanus, lock-jaw, and spasm, often arise from lacerated wounds; in such eases, opium should be administered in doses suited to the age and circumstances of the patient. One grain might be given every three or four hours until relieved.

      Treatment of Contused Wounds. — Contused wounds will require the sante treatment as that already described. Cold applications in the first instance, and if

inflammation sets in, lecches and hot fomentations. They generally terminate in suppuration and sloughing, or mortification of the parts, according to the extent of the injury; in order to expedite these processes, poultices of bread and water or linseed meal should be applied three or four times a day, and when the abscess opens or the slough is thrown off, they are to be treated as common ulcers with basilicon, or some other stimulating ointment, for the purpose of promoting healthy granulations, and thus healing them. During the active stage of inflammation, the patient should live sparingly; but tonics, such as quinine (see Quinine), and a gencrous diet, should be allowed under the stage of suppuration or sloughing.

      TREATMENT OF PUNCTURED WOUNDS. — Punctured wounds are extremely dangerous, much more so than the others already described. A punctured wound from a nail, hook, or any other pointed instrument, gives rise to inflammation of the absorbents (a set of vessels running from the wound into the neighbouring glands), and is manifested by red lines taking the course of these vessels. Abscesses of the glands and of other parts of the body in their course frequently ensue; and if the matter be deepseated, such a degree of irritative fever is produced as to cause death.

      Lock-jaw (tetanus), and frightful convulsions, are often the result of tendons or sinews receiving punctured wounds. In the first instance, the puncture should be laid open with the lancet, cold lotions should then be applied, and if inflammation sets in, the parts should be covered with leeches according to the age and strength of the patient; the diet should be sparing, fomentations and poultices should be constantly applied, and the limb should be supported on an inclined plane, in order to favour the gravitation of the blood towards the body. All stimulating drink should be cut off. The bowels should be kept freely open, and the patient should observe perfect rest. As soon as matter has formed, it should be let out by free incisions with the lancet, after which the parts should bc poulticed three or four times a day. In order to allay irritation and pain, and to procure sleep, great

advantage will be derived from the administration of ten grains of Dover's powder at bedtime (see Dover's Powder).

      Symptoms. — Severe pain in the bitten part, considerable swelling, which is at first red, and after a short time becomes livid; the patient grows faint and sick; the pulse is small and intermitting, vomiting takes place, the skin becomes yellow, and death is frcquently the consequence. The same symptoms arise from the bite of the adder, and other venomous serpents, and of course the treatment will be similar.

      TREATMENT. — The treatment will be both local and general. The bitten part, if the poison be virulent, and communicated by a most venomous rcptile, should be cut clearly out; a ligature should be applied above it, and the cupping glasses placed over the wound in order to prevent absorption; after which, the surface of the wound should be destroyed by nitrate of silver, nitric acid, or the actual cautcry; a poultice should thcn be applied. Internally, the patient should take frequent doses of brandy and watcr, and ammonia. He may take five grains of ammonia, dissolved in a table-spoonful of brandy and two table-spoonfuls of water, every hour or two, while the faintness and sickness continue. The bowels should be kept in a gentle relaxed state.

      Treat the patient instantly, on the spot, in the open air, exposing the face and chest to the breeze (except in severe weather).

      1. To Clear the Throat. — Place the patient gently on the face, with one wrist under the forehead. If there be breathing — wait and watch; if not, or if it fail –

      2. To Excite Respiration — Turn the patient well and instantly on his side, and excite the nostrils, the throat and dash cold water on the face previously rubbed warm. If there be no success, lose not a moment, but instantly –

      3. To Imitate Respiration — Replace the patient on his face, raising and supporting the chest well on a folded coat or other article of dress; turn the body very gently on the side and a little beyond, and then briskly on the face, alternately — repeating these measures deliberately, efficiently, and perseveringly fifteen times in the minute, occasionally varying the side. When the prone position is resumed make equable but efficient pressure, with brisk movement, along the back of the chest, removing it immediately before rotation on the side.

      4. To Induce Circulation and Warmth — Meantime rub the limbs upwards, with firm grasping pressure, and with energy, using handkerchiefs, &c. Let the limbs be thus warmed and dried, and then clothed, each bystander supplying a coat, a waistcoat, &c. Avoid the continuous warm bath, and the position on or inclined to the back.

      1. Instantly turn patient downwards, with a large firm roll of clothing under stomach and chest. Place one of his arms under his forehead, so as to keep his mouth off the ground. Press with all your weight two or three times, for four or five seconds each time, upon patient's back, so that the water is pressed out of lungs and stomach, and drains freely out of mouth. Then:

      2. Quickly turn patient, face upwards, with roll of clothing under back, just below shoulder blades, and make the head hang back as low as possible. Place patient's hand above his head. Kneel with patient's hips between your knees, and fix your elbows firmly against your hips. Now — grasping lower part of patient's naked chest — squeeze his two sides together, pressing gradually forward with all your weight, for about three seconds, until your mouth is nearly over mouth of patient; then, with a push, suddenly jerk yourself back. Rest about three seconds; — then, begin again, repeating these bellows blowing movements with perfect regularity so that foul air may be pressed out, and pure air be drawn into lungs, about eight or ten times a minute, for at least one hour or until patient breathes naturally.

      Note. — The above directions must be used on the spot, the first instant the patient is taken from the water. A moment's delay — and success may be hopeless. Prevent crowding around patient; plenty of fresh air is important. Be careful not to interrupt the first short natural breaths. If they be long apart, carefully continue between them the bellows-blowing movements as before. After breathing is regular, let patient be rubbed dry: — wrapt in warm blankets — take hot spirits and water in small occasional doses, and then be left to rest and sleep.

      The object of clothing being to defend the infant from the inclemency of the weather, the system of swathing and bandaging cannot be too severely condemned, as it interferes with all the most important functions of the body, namely, respiration and the circulation of the blood. The infant should be warmly and comfortably clad, and at the same time plenty of room should be allowed for the free flexion and extension of the limbs. Too great attention cannot be paid to the way in which the pins are stuck in, as many infants have suffered severely from neglect on this point. To remedy this evil, and to secure the infant from being pricked, the clothes should be stitched on with a needle and thread. According to the old method of swathing and bandaging children, the circulation of the blood was interfered with, the respiration obstructed, and thus the foundation of fatal diseases was laid in early life, to be developed at some future time upon the occurrence of some exciting cause.

      The great art in dressing an infant lies in studying its ease, warmth, and comfort.

      There can be no doubt of the fact, that Providence intended the mother's milk should constitute the sole nourishment of her offspring during the early months of infancy. In order to meet this intention, he has caused milk to contain all the nutritious principles which constitute our food, and which may be divided into three great classes: namely, the Saccharine, Oleaginous, and Albuminous; or, in othcr words, those containing sugar, fats, and albumen. Now, thesc are the substances in thcir varied ramifications which contribute to the support of the body, and which arc cxtracted in the stomach and intestines out of the varieties of food which we live on. They arc all found in milk, in a simplc state, fitted for the stomach of the young of all animals. Albumen constitutes the most important part of the food of animals. It is found in a liquid state in eggs, and it forms the principle constituent of all kinds of flesh. This principle, in combination with sugar and butter, abounds in milk, and renders that fluid so very nutritious for the infant — nothing but dire necessity should dcprive it of that food which nature has so kindly provided for it.

      Now, it not unfrequently happens that some unfortunate circumstance arises which interferes with the regular course of things, and with the intentions of nature; such, for example, as the dangerous illncss of the mother, or even her death, great debility, sore nipples, or the absence of those useful appendages to the female breast, or some other cause, moral or prudential, which would interfere with the child being suckled. The question then arises, what is the most proper food — what is the best substitute for the mother's milk? Ass's milk comes nearer to that of the human female than that of any other animal, and is, consequently, the best fitted for the stomach of infants.

      The following is an analysis of the milk of the cow, ass, woman, and goat:

Taken from Chevallier's Journal of Pharmacy.

      From the foregoing analysis it will be seen that woman's milk contains about the same quantity of cheese and sugar that ass's milk does, which circumstance renders the one so good a substitute for the other. Cow's milk contains three times the quantity of cheese that woman's does, and consequently, when taken into the stomach, gives rise to the formation of a hard, cheesy curd, when acted on by the gastric juice, which is extremely indigestible by infants.

      The next best substitute for the mother's milk, is a mixture consisting of two parts of boiling water and one of cow's milk, sweetened with loaf sugar. Some prefer barley-water, or thin arrow-root, to mix with the milk in place of water.

      It frequently happens that infants are unable to retain cow's milk on the stomach, even when so largely diluted as to be of little value as a nutrient. In such cases it is often found that condensed milk or some form of prepared milk food can be taken with satisfactory results. Loeflund's "Kindermilch" or Infant's Milk is, for very young children, a most excellent substitute for the mother's milk, and being entirely free from starch and cane sugar is readily digested.

      As the child advances in age, and after it has cut some teeth, solid farinaceous food may be allowed. This may be either mixed with water or milk, and should it not agree with the stomach, mutton-broth, or beef-tea, may be substituted. All stimulating drinks should be avoided.

      Nothing can be morc conducive to a child's health than the use of the bath. It cleanscs the skin from all offensivc and injurious matter; promotes healthy perspiration, and produces a balance of the circulation, by which means all the internal organs are enabled to perform their functions in a healthy manner, thus rendering the body active and robust. While the child is in the bath, it should be rubbed down either with the hand or with a sponge, so as to wipe off all impuritics that may firmly adhere to the skin. The temperaturc of the bath should be bctween 86 and 90 degrees of Fahrenheit's thermometer, which may be still lowered as the child advances in life. During the first two months, it should only be allowed to remain in the bath a few minutes, and afterwards the time may be increased to ten or fifteen minutes. After removal from the bath, care should be taken to wipe the child quite dry, great attention being paid that the night clothes are perfectly aired. It should then be put to bcd, so as to avoid all chances of taking cold.

      Crusta Lactea, or Milk Crust. — This is a disease which attacks infants and young children. It commences as a pustular eruption, and generally arises in serofulous constitutions. When the pustules break they run into each other, and the scabs are so joined together as to cover the head and face like a mask. It is produced in two ways: in the first place, it is caused by the tears which flow from the eyes of children who are suffering from scrofulous inflammation of the eyes, which are of such an irritating nature as to produee excoriation and a pustular eruption of the cheeks as they flow down; in the second place, it depends on the breaking-up and scabbing of the pustules in a disease of the skin called impetigo.

      Symptoms. — The face and head become covered with large fissured scabs, discharging sometimes a thin and sometimes a thick matter; great itching, restlessness, and fever. The disease is recognized at first sight.

      Treatment. — To relieve the itching, bathe the parts with goulard water, or with a weak solution of salt in water, say a table-spoonful of salt to a pint of water, to be increased or diminished according to its effects on the patient. To purify the blood, and keep the bowels and stomach in order, give the following powder: —

Take of Mercury with chalk, 1 grain;
             Powdered rhubarb,   2 grains;
             Carbonate of soda,   2 grains.

      Mix, and make a powder, to be given three times a day.

      These proportions will be suitable for children from six months to two or three years, after which age, the doses

may be doubled. They should be given for a week at a time, and then discontinued for a week; an occasional dose of castor oil should also be given. To remove the scabs, and to cause a healthy action of the skin, the following ointment is invaluable: —

Take of Oxide of zinc, 1 drachm;
             Spirits of wine, 40 drops;
             Benzoated lard, 7 drachms.

      Make an ointment, to be applied freely on the parts affected three or four times a day. Proper attention must be paid to diet and cleanliness.

      Diarrhoea, or looseness of the bowels, is one of the most common and dangerous diseases incident to children; and as it arises from so many causes, no better plan than that adopted by Dr. DAVIS can be followed on this occasion, as each cause may be treated of under its proper head. According to Dr. DAVIS'S classification, the causes which produce diarrhoea are,

1st. Milk of a bad quality.
2nd. That natural and best food in excess; and,
3rd. Unusual supplies of it after long fasting.
4th. Improper food.
5th. Sudden changes of food.
6th. Injudicious attempts to wean delicate children.
7th. Irritation of the bowels from ill-digested food.
8th. Deficient or redundant secretion of bile.
9th. The irritation of dentition.

      When diarrhoea arises from the bad quality of the mother's milk, the treatment will consist in changing the nurse or feeding the child on ass's milk, or farinaceous food. If it arise from an excessive supply, the quantity of milk must be diminished. When from increased secretion of bile, which is known by the motions being of a healthy colour, but more liquid than natural, small doses of rhubarb will afford great relief.

      When it occurs in consequence of dentition, too much caution cannot be observed in stopping it too soon, as the sudden stoppage is often productive of disease of the brain, or some other internal organ. In this case, the gums

should be freely lanced, and a little mercury with chalk, and rhubarb — two grains of each — administered occasionally. When from any cause the stools become very frequent and slimy or tinged with blood, are expelled with much force, are acid, and emit a very offensive smell, the looseness must be immediately checked. The following is an excellent mixture in this disease: —

Take of Prepared chalk, 1-1/2 drachm;
             Compound tincture of cardamoms, 2 drachms;
             Tincture of opium, 8 drops;
             Aromatic confection, 1/2 drachm;
             Cinnamon water, 1-1/2 ounce; make a mixture.

A tea-spoonful to be given every two or three hours until the relaxation ceases.

      This dose will suit children from six to twelve months old; children from one year to three years old may take two tea-spoonfuls under the same direction.

      So called from the Greek word, Diphthera (leather), the secretion or exudation which is deposited on the throat and fauces, and which is the distinguishing characteristic of the disease, resembling leather of an ash or dirty-white colour. It is a most contagious disease, is most fatal in its attack, and frequently destroys life in a period ranging from four hours to four weeks. There can be no doubt but that occasional cases may have existed at all times, but it never was recognized as a distinct disease until described by a French physician in 1821; since that time it has appeared in all the countries of Europe and America, committing the most horrible ravages, and destroying the inhabitants by tens of thousands. In the year 1858, a practitioner in Dorsetshire lost thirty out of forty cases in Leeds, it cut off a whole family consisting of father and mother and four children; and since that time to the present, Diphtheria has decimated the people which it has visited, scarcely ever leaving a house without taking with it three or four victims: and what renders it more awful is, its taking them all at once — it being no uncommon occurrencc to find three children lying dead in the same house at the same time. It is a disease essentially

belonging to children, although no age is exempt from it. The mortality, however, is not so great in adults as in children.

      Causes of Origin. — Atmospherical conditions, such as produce scarlet-fever and other eruptive diseases; specific contagion, such as the transmission of the poison from body to body.

      The disease being so contagious, the question arises how far persons are justified in running into the jaws of danger. The best advice to the friends and connexions of the patient upon this point is — to do their duty fearlessly, to attend to every circumstance that may conduce to his comfort and safety, even at the risk of their lives, but not to unnecessarily expose themselves to danger by sitting by his bed-side, or by stopping too long in the sick room. The same law will apply to clergymen in their ministrations to the sick, in this as well as in other dangerous diseases. The predisposing causes are bad drainage, cesspools, badly-ventilated and badly-constructed cottages, and filth of any kind in a state of decomposition near to the dwellings of the poor, such as we see in great holes dug in the front or rear of houses in rural districts, in which are deposited decaying animal and vegetable matter, and which also serve as privies to those houses unprovided with such conveniences — a state of things which outrages decency and is a disgrace to civilization.

      Symptoms. — The general symptoms of this complaint are fever, sometimes trifling and sometimes severe, according to the form; extreme depression, loss of appetite, &c.; general redness of the inside of the mouth, extending from the roof over the soft palate, tonsils and gullet. The tonsils are sometimes very much enlarged and swollen, and at other times scarcely affected more than presenting an inflammatory blush. The characteristic exudation is at first sometimes deposited on the side of the tonsils which look inwards, it then creeps over the arches of the palate, and over the surfacc of the throat gcnerally — it presents the appearance of a white slough, but is in fact a false membrane, and can in some cases be scraped off; in other cases it appcars to corrode or cat

away the uvula and soft palate, and presents all the appearance of a disease of the skin called Nolo me tangere. The tongue is covered with a dirty-white fur or coating, but is more generally slate-coloured; strings or shreds of thick and tenacious slime sometimes hang from the roof of the mouth to the tongue. As the disease advances to an unfavourable end, there is great difficulty of breathing, the child or patient becomes lethargic or drowsy, and is roused with difficulty; he refuses all nourishment from the pain caused in swallowing; the external glands of the neck become very much enlarged; the saliva issues from the corners of the mouth, an excoriating fluid from the nose, vomiting comes on, and death closes the scene. Appearances in this disease are very deceptive — the child seems to have little or nothing the matter with him one day and is dead the next. Death under these circumstances is caused by the extension of the false membrane into the windpipe, thus offering a mechanical impediment to the ingress of air into the lungs. Not unfrequently it happens that patients who have recovered from an attack of diphtheria are attacked with paralysis of the ocular muscles causing squint; or of the muscles of the soft palate and pharnyx, causing a nasal tone of voice, difficulty of swallowing and regurgitation of fluids through the nostrils. Occasionally there is some loss of power of the limbs. These symptoms gradually get better under the influence of tonics, rest, and good diet.

      Treatment. — The treatment will consist of local and general means. The local applications are bran poultices externally, and gargling the throat internally with warm water, in which common salt has been dissolved in the proportion of a table-spoonful to the pint. This must be constantly persevered with. Many physicians object to poultices, but when properly applied they are comforting to the patient, although they cannot have much effect upon the course of the disease. The throat must also be frequently gargled with a gargle consisting of

Dilute nitric acid, 1 drachm;
Dilute muriatic acid, 1 drachm;
Water, 6 ounces.

      In cases where it can be borne, the acids may be increased considerably, and the parts mopped out with the tincture of perchloride of iron, by means of a piece of sponge tied on a pen-holder. Some persons are in the habit of freely applying the solid nitrate of silver, or solutions of that remedy, in the proportion of 16 grains to the ounce of distilled water, to the surface of the throat. Blisters and leeches are decidedly injurious. Great comfort is derived from sucking ice. As regards general treatment, the bowels should first be acted upon with a dose of calomel and jalap powder, after which tincture of perchloride of iron in doses of from five to twenty drops, according to the age of the patient, well diluted, should be administered every three or four hours. Chlorate of potash in five or ten-grain doses may be combined with the iron, and in cases where there is great prostration a grain or two of quinine should be added. Many other medicines have been recommended in diphtheria, but it is doubtful whether any other form of treatment is equal to the iron treatment as recommended above. Of more importance than medicines in the treatment of diphtheria is the systematic and liberal administration of liquid nourishment. Strong beef-tea, raw eggs and milk, milk and brandy, port wine or iced champagne are essential. It is astonishing how much stimulant can be taken with advantage in this disease. Cases have been recorded where patients have taken a bottle of wine in twenty-four hours. When the diphtheritic exudation so blocks the airpassages as to place the patient in danger of suffocation, the operation of tracheotomy should be performed if the services of a surgeon can be obtained.

      Young children are very subject to colic, or wind in the bowels and stomach. In this complaint the little patient starts suddenly, becomes very restless, twists and writhes its body, draws up its knees to its belly, strains forcibly, and is in constant pain, which is manifested by its continually crying. The causes which produce it are,

acidity of stomach, derangement of the bowels, sucking voraciously after long fasting, sucking while the mother or nurse is in a state of excitement, exposure to cold, improper feeding.

      The treatment consists in the administration of mild cordials, gentle laxatives, and the warm bath. If the bowels be confined, magnesia or small doses of calomel should be given; rhubarb irritates the bowels of young children too much; castor oil is also an excellent aperient in these cases. In flatulent colic, accompanied by a loose state of the bowels, the following is an excellent mixture; it soothes and comforts the infant, and is very efficacious in stopping spasm: —

Take of Magnesia, 10 grains;
             Tincture of opium, 4 drops;
             Aromatic confection, 1 scruple;
             Chloric ether, 20 drops;
             Dill %%rater, 1-1/2 ounce.

      Mix, and give a tea-spoonful when in pain, and repeat it every two hours until relieved. Age of child, from two months to 12 months.

      This is a very contagious disease, and although no age is exempt from its attacks, it generally happens to children and young persons. It takes from three weeks to three months or more to run its course, and is only palliated, but not cured, by medicine.

      Symptoms: – It is ushered in by all the symptoms of common cold or catarrh — there is running from the nose and eyes, and cough. The cough, which is at first simple, and undistinguishable from any other cough, in about eight or nine days from the commencement of the attack assumes its characteristic paroxysmal "whoop," which is so well known when heard, and which requires no further description. It comes on in fits, which are generally more frequent during the night than in the day. When simple, it is unaccompanied with fever, so that when the fit of coughing is over, the patient returns to his play and appears in his usual health. It is a spasmodic cough, and the peculiar "whoop " depends on spasm of the upper

part of the windpipe, which so contracts the opening as to admit air with difficulty. In the commencement of the attack, the fits of coughing are very frequent, and the phlegm or sputa brought up is glairy and stringy, like unboiled white of egg, and is coughed up with great difficulty; as the disease advances, the phlegm becomes thick and opaque, and is brought up easily, and consequently the severity of the cough is materially diminished.

      Treatment. — Administer an emetic every or every other morning, if there be much difficulty in bringing up the phlegm — 10 grains of ipecacuanha in warm water as a dose for children above eight years of age — and repeat in an hour if the first dose does not cause sickness; and to children under that age down to six months old, from five to six grains may be given in the same way. The following is a good mixture in this complaint: —

Take of Bromide of potassium, 1 drachm;
             Ipecacuanha wine, 2 drachms;
             Syrup of poppies, 4 drachms;
             Syrup of squills, 4 drachms;
             Juice of belladonna, 1 drachm;
             Common water, 8 ounces.

      A dessert-spoonful to children from eight years and upwards, every four hours, and one or two tea-spoonfuls to children below that age. The bowels are to be kept gently open by rhubarb and carbonate of soda; the patient is to be warmly clad in flannel if the weather be cold, to sleep in a room in which a fire has been kept all day, and to have light but nourishing diet.

      Liniments applied to the spine are said to be very useful in this complaint. The following will be a good application: —

Take of Strong solution of ammonia, 1/2 ounce;
             Opodeldoc, 1 ounce;
             Sweet oil, 3 ounces;
             Tincture of cantharides, 1/2 ounce;
             Camphorated oil, 3 ounces.

Mix, and make a liniment. To be rubbed along the back-bone night and morning.

      Hooping cough is sometimes accompanied with bronchitis, inflammation of the lungs, and water in the head,

in which cases it is attended with so much danger to life that the services of a medical man should be resorted to without delay.

      For other good remedies in this disease, see Prescriptions.

      Symptoms. — This disease is attended with fever of an inflammatory character; there is cough, sneezing, a watery state of the eyes and nose; shivering, succeeded by flushes of heat, lassitude, difficulty of breathing arising from inflammation of the air-tubes, and a determination of thin acrid matter to the surface, which manifests itself in red spots all over the body, more especially on the neck and arms. These spots disappear after a few days in a mealy scaling of the scarf-skin. The eruption generally commences on the third day of the fever, and terminates about the eighth or ninth. The fever does not subside on the appearance of the eruption as in small-pox, but continues unabated, with oppression and anxiety at the pit of the stomach, until about the sixth day, when it undergoes a material change for the better, attended with relaxation of the bowels.

      Distinguishing Characters. — It is distinguished from scarlet fever by the nature of the eruption, it being more elevated above the surface in measles than in scarlet fever, by its appearing in well-defined and crescentic patches — the eruption in scarlet-fever appearing in dotted points, or in one uniform redness over the whole body; by the watery and swelled condition of the eyes and nose, and by the absence of sore throat, which in 99 cases out of every 100 accompanies scarlatina or scarlet fever.

      Cause of its Origin. — Specific contagion, to which all persons are liable once in their lives. The disease itself is not to be so much dreaded as it after-consequences. These are, inflammation of the lungs, inflammatory sore throat, discharges from the nose and eyes, bowel complaint of a severe form, disease of the mesenteric glands, and even consumption. A child who is exposed to the contagion of measles cannot be pronounced out of danger of catching them for a period of fourteen days, the disease taking that time to fully develop itself.

      Treatment. — The patient should be kept in a moderately warm room, and in bed; he should he kept on a light food, such as barley water, weak beef-tea, mutton-broth, light puddings, such as rice and bread and butter puddings. All animal food, in a solid state, should be dispensed with, as well as stimulating and fermented liquors.

      In the commencement of the disease a brisk purge should be given if the bowels be at all confined, consisting of jalap and calomel (see those articles for doses), which should be taken in something thick, such as jam, sugar and water, or gruel. The stomach and bowels being by those means emptied of their contents, the patient may take the following fever mixture with advantage: —

                  Prescription No. 1.
Take of Mindererus spirit, 4 drachms;
             Sweet spirit of nitre, 2 drachms;
             Syrup of saffron, 4 drachms;
             Antimonial wine, 2 drachms;
             Camphor mixture, 4-1/2 ounces; mix.

      Two table-spoonfuls every four hours for persons above sixteen years; one table-spoonful every four hours for persons above ten years; and half a table-spoonful for children above five years; infants under five years may take a tea-spoonful every four hours.

      The cough and hoarseness will be relieved by the inhalation of the steam of warm water, by drinking barley water, in which may be dissolved some powdered gum arabic, or by thin arrow-root, to which may be added a little powdered nitre; and should the cough be troublesome, small doses of syrup of poppies, according to the age of the patient, may be given with advantage. The following will be a good cough mixture for persons above fifteen years of age: —

                  Prescription No. 2.
Take of Paregoric elixir, 4 drachms;
             Syrup of poppies, 4 drachms;
             Common nitre, 1 drachm;
             Camphor mixture, 5 ounces.

      Make a mixture; a table-spoonful or two, every four hours, if the cough be troublesome.

      Should the eruption retire suddenly, and be followed by convulsions, difficulty of breathing, sinking, or delirium, the patient should be immediately placed in the warm bath, blisters or mustard plasters applied to the chest, and warm diffusible stimulants given, such as brandy and water, wine and water; camphor and ammonia should be also administered with the view of bringing back the eruption to the surface. The following will be a good stimulating mixture in these cases: —

                  Prescription No.Prescription No. 3.
Take of Carbonate of ammonia, 10 grains;
             Compound tincture of cardamoms, 4 drachms;
             Sweet spirit of nitre, 1 drachm;
             Cinnamon water, 1-1/2 ounce.

      Make a mixture. Two tea-spoonfuls for children above three years old every two hours, and one tea-spoonful for children between twelve months and three years; for children under twelve months, half a tea-spoonful.

      In this disease, which is contagious, the glands in front of the ear on each side, as well as the glands under the jaw on each side, are swelled from inflammation. It is a complaint generally peculiar to children and young persons of both sexes, and as a rule unaccompanied with danger. It arises from cold or other atmospheric causes, and runs its course in about eight days. In receding from the glands, it occasionally attacks the testicles in the male, and the breasts or ovaries in the female.

      Treatment. — Warm applications to the throat, either by flannels wrung out of warm water, or a flannel bag half filled with bran wetted with hot water, or by bread

and water poultices, confinement to the house, the administration of a little medicine of a cooling nature, and an unstimulating diet. See Prescription Ara. i, Measles.

      Symptoms. — Like all other eruptive diseases, nettle rash is ushered in by general fever. It is accompanied by head-ache, weariness, and lassitude, shivering succeeded by heat, sickness, loss of appetite, and general indisposition. There is a burning and tingling sensation of the skin. The character of the eruption consists of an elevated bump with a white spot in the centre of an inflamed base. It disappears or becomes very pale when the patient is cold or in the air, and becomes again very red when hot or in bed. It is generally a disease unaccompanied with any danger to life. It is very frequently removed under proper treatment in the course of a week or ten days.

      Treatment. — Administer a full emetic in the commencement of the disease: 20 grains of ipecacuanha powder, and one of tartar emetic, will be a good form for an adult male, mixed up in a little water; for a female, the ipecacuanha will be sufficient; this should be followed up by a saline aperient mixture, such as is recommended at page 105, under the head of "Dysentery," two tablespoonfuls of which should be taken every four hours; the offending article of diet should be avoided, and the patient

should not he exposed to cold. The doses suited to patients of differcnt ages must be given according to the scale laid down in the beginning of the book.

      These names represent one and the same disease, and not two diseases differing in symptoms and characters, as is generally supposed to be the case amongst a great many people. It is a most contagious disease, infinitely more so than small-pox, and when it makes its appearance in a house or in a locality, no one can tell how long it may continue. When it assumes a severe form, it is the most destructive to life of any known disease. There are three varieties of it: first, simple Scarlatina, which is unaccompanied with sore throat, is very mild in its attack, is scarcely attended with any fever — at least, not sufficient to disturb the general functions of the patient, and runs its course in a few days; second, the Scarlatina which is accompanied with enlargement of the tonsils, sore throat, and inflammatory fever, resembling in many respects quinsy; and third, that form of it which is accompanied by typhus fever, ulceration, swelling, and sloughing of the throat, and which is of such a fatal and deadly character as to be styled Scarlatina maligna. These three forms are only modifications of the same disease, so that, that which was mild and simple at first, may, under unfavourable circumstances, become the most dangerous.

      Symptoms. — The general symptoms of this disease are chilliness, succeeded by heat of skin; head-ache, lassitude, weariness, pain in the limbs, delirium, nausea, and vomiting, sore throat; enlargement of tonsils, which are covered with a slimy secretion; and an eruption of a bright scarlet colour, resembling a boiled lobster, which, beginning on the face and neck, becomes diffused over the wholc body. The eruption generally makes its appearance from the second to the fourth day from the commencement of the attack, the pulse is rapid, and the tongue, which at first is covered with a white fur, as the disease advances becomes scarlet red, then glazed and

smooth, and in bad cases, brown, dry, ulcerated, and tremulous. For the means of distinguishing it from measles, see the article Measles. It is a disease of youth, although no age is exempt from its attack, and it seldom appears in the same subject twice. The cause of the eruption is the effort of nature to remove the poison by the skin; therefore, if the eruption be well developed, the danger is proportionally little; but when the skin fails in its efforts, then the throat becomes affected, inasmuch as it is called upon to discharge its duty. When the throat and skin fail, the poison attacks the lining membrane of stomach and bowels, and destroys life in twenty-four hours, or in some cases less.

      Cause of Origin. — Specific contagion, which is a mystery of nature not yet discovered. Like measles, the after-consequences are frequently worse than the disease: these are, discharge of matter from the eyes, nose, and ears; diarrhoea, dropsy of the belly, ulcerations of the skin or angry-looking sores, a puffy or doughy state of the skin, caused by inflammation and infiltration of the cellular tissue, dropsy of the chest, and an extreme degree of debility for weeks and months after the attack.

      Treatment. — In the simple form of the disease, nothing more need be done than confining the patient to the house, keeping the bowels open, and enjoining a light farinaceous diet. In the second form, the first thing to be done is to get the bowels acted upon by an aperient (see Prescription No. 2), after which the saline and fever mixture recommended in the article Measles (Prescription No. 1 in that article) is to be given according to the rules there laid down. After the rash has developed, should the throat symptoms be severe, tincture of iron may be administered instead of the saline mixture, in doses of from five to fifteen drops, well diluted. The throat is to be frequently gargled with salt and warm water internally, and bran poultices applied externally. One of the best forms of gargles in this complaint is the following: —

Take of Dilute muriatic acid, 1 drachm;
             Dilute nitric acid, 1 drachm;
             Syrup of red poppies, 4 drachms;
             Water, 6 ounces.

Make a gargle, to be used frequently; the strength may be increased or diminished according to the taste of the patient. In the commencement of the attack, slops, barley water, toast and water, and a light diet should be given, but as the complaint advances, and the strength becomes lowered and the fever removed, a more generous diet will be required, such as fish, meat, wine, Tonic medicines may now be given with advantage.

Take of Sulphate of quinine, 12 grains;
             Dilute sulphuric acid, 1/2 drachm;
             Compound tincture of cardamoms, 4 drachms;
             Syrup of orange peel, 1/2 ounce;
             Water, 6 ounces.

      Make a mixture; a sixth part to be taken three times a day. In the malignant form of the diseasc, which is accompanied by sloughing or mortification of the throat, feeble pulse, bloody discoloration of the skin, and general sinking of the vital powers, stimulants and tonics must be freely administered. Port wine may be given generously, in fact, as much as can be borne, even to a bottle or two a day, according to circumstances; strong beef-tea, brandy, ammonia, and sulphate of quinine. The following is a good stimulating draught: —

Take of Carbonate of ammonia, 4 grains;
             Simple syrup, 2 drachms;
             Camphor mixture, 1-1/2 ounces.

      Make a draught, to be taken three or four times a day. In the case of children under thirteen years of age, only one-half or a third of the above to be taken as a dose. The throat must be frequently gargled as directed, or mopped out by means of a sponge on a piece of stick, wetted with the gargle recommended, in a much stronger form. In cases of recovery from any of the forms of this disease, great care must be taken not to expose the patient to cold or to allow him to go out too soon. I have known two lamentable cases, specially called so as being the only and beloved children of their parents, in which death occurred in consequence of catching cold, although they were not taken out for four or five weeks after the disappearance of the eruption and all bad symptoms.

      The ShINGLES, so called from the Latin word cingulum, a belt, is a disease of the skin. It consists of a number of small vesicles or blisters situated on an inflamed surface, which passes round one-half of the body, commencing generally in the centre of the back on the right side, and sometimes on the left, and ending at the centre of the abdomen or belly in front. There is a tradition among the common people, that if it goes round the entire body the patient dies — a doctrine which appears to be without foundation. It arises from exposure to cold when the body is warm, from drinking cold fluids when in a state of perspiration, from irregularities of diet, and it is said to frequently attack those children who wet their beds at night.

      Treatment. — Clear out the bowels by some aperient powder, after which, a saline mixture, such as is recommended in measles or other eruptive diseases, may be given. The parts may be well dredged with flour, as is recommended in erysipelas, or covered with zinc ointment spread on lint. It runs its course in about ten days, and does not appear to be attended with any danger to life.

      Symptoms. — This disease is ushered in by lassitude, head-ache, pain at the pit of the stomach, sickness, pain in the back and loins, great heaviness and disposition to sleep, and sometimes by convulsions or epileptic fits. These symptoms are succeeded by a frequent pulse, hot and dry skin, diminished secretions, and great uneasiness until the time of the eruption, when they suffer considerable abatement.

      Species of Small-Pox. — There are three kinds or species of this disease: namely, the discrete, the confluent, and the malignant or haemorrhagic. The discretc is so called from the distinct character of the pustules; and the confluent, from the circumstance of the pustules running into each other. Malignant small-pox is happily very rare, but is extremely fatal, usually killing the person attacked in from twenty-four to seventy-two hours.

      The progress of the development of the fever of distinct small-pox, from day to day, is so well described in Dr. Hooper's book, that we cannot do better than transcribe it in his own words: —

      "Towards the end of the third day from the commencement of the attack, the eruption makes its appearance on the face and forehead in the form of small red points, not unlike flea-bites. During the fourth day, it extends itself successively to the sides of the nose, chin, and upper lip, to the neck and wrists, and at length to the trunk, thighs, and the whole body.

      "About the fifth, a little vesicle, appearing depressed in the middle, containing a colourless fluid and surrounded by an inflamed margin, perfectly circular, may be observed on the top of each point or pustule. The eruptive fever now disappears.

      "About the sixth, the saliva becomes increased in quantity, and viscid; at the same time there is a degree of swelling of the throat, difficulty of swallowing, and hoarseness.

      "On the eighth, the pustules are completely formed and prominent, and appear almost to terminate in a point — the contained matter has assumed the appearance of pus. The face swells, and the swelling extending to the eyelids, they become so enlarged as to close the eyes.

      "About the eleventh, the pustules have gained their full size, the matter has changed from a white to an opaque yellow, and a dark spot appears on each. At this time the tumefaction of the face subsides, and the hands and face begin to swell. The secondary form now makes its appearance.

      "After the eleventh day, the pustules, from being smooth become rough, break, and discharge their contents, which, dying on the surface, a small crust is formed over each of them; these in a short time fall off and leave the parts they covered of a dark brown colour, which they often remain for many days; and in cases where the pustules have been large, or late in becoming dry, deep indentations of the skin. The swelling of the hands and feet gradually subsides, and about the seventeenth day the secondary form disappears."

In the confluent form of small-pox, the fever is more severe, and increases from the appearance of the eruption to the maturation of the pustules. Delirium, and a disposition to deep sleep, accompanies the secondary fever, which is always of a more aggravated form in this than in the former species, and generally terminates in typhus. Severe diarrhoea and profuse salivation are frequent concomitants of this form of the disease, in consequence of inflammation of the mucous membranes. The eruption is irregular in its appearance, and in the succession of its stages. A dry appearance of the skin of the face generally precedes the coming out of the pustules, which are developed on the second day in the form of small red points; these run into each other, and form clusters which greatly resemble the measles. These pustules do not observe any defined form, but are of an irregular shape, often flattened, and appear like thin pellicles fixed on the skin, and containing instead of true matter, a thin brownish fluid. The swelling of the face rises to a much greater extent than in the distinct form; there is profuse salivation, and the fever, although it suffers some slight remission, does not cease on the appearance of the eruption. About the ninth day it increases to an alarming extent, and in some instances all the worst symptoms of typhus ensue; the eruption becomes of a dark livid colour, effusion of blood takes place into the cellular tissue under the skin, the patient is attacked with bloody urine, and dysentery; sordes, or a collection of black dirty secretion takes place on the teeth and lips, convulsions ensue, and the patient is frequently carried off on the eleventh day from the commencement of the attack. Should he happen to recover, the pits and scars will be much deeper than in the distinct form. The appearances which may be considered unfavourable, are a sudden striking in of the eruption, the pustules running into each other, subsidence of the swellings of the face and hands, deficiency of saliva, depression or flattening of the pustules, great depression of strength, oppression at the chest and fainting.

      Malignant small-pox is characterised by intense nervous depression, low muttering delirium, extreme prostration, and usually hamorrhages under the skin.

      Small-pox is communicated by contact with a person labouring under the disease, or by the inhalation or breathing of air impregnated with the effluvia, or by the clothes of the patient. Persons are rarely subject to it twice in their lives.

      Treatment. — The first thing to be done before the eruption makes its appearance will be to administer a brisk purge of calomel and jalap. Should the fever run high, the patient should be placed in a warm bath, great pains being taken that he does not take cold. He should remain in the bath for five minutes, after which he is to be wrapped in a warm blanket and put into bed: he is then to be dressed in his night things, after having remained in the blanket for an hour or two. Salines and antimonials are then to be given (for form of mixture, see Measles, Prescription No. 1). The diet should consist of light farinaceous food, such as arrow-root, sago, bread and butter puddings; no animal food in a solid shape should be allowed, but on the subsidence of the eruptive form, mutton-broth or beef-tea may be allowed. There should be good ventilation in the room in which the patient is lying; his feelings, however, are to be consulted, so that he neither feels too hot nor too cold. His drink should consist of cooling fluids, such as lemonade, imperial and saline draughts (for formula of beverage, see Cream of Tartar). After the eruption appears, the salines and antimonials should be continued, and the bowels kept in a loose state by a saline aperient mixture as follows: —

Take of Epsom salts, 4 drachms;
             Syrup of senna, 4 drachms;
             Cinnamon water, ri ounces.

From a dessert-spoonful to a table-spoonful to be taken every four hours, until the bowels are well relieved.

      If there be great restlessness and nervous irritation, the tincture of opium, given in doses according to the age of the patient, will be of the greatest service. The following is a good draught under these circumstances for persons between eight and fifteen years of age: —

Take of Bicarbonate of potash, I scruple;
             Camphor mixture, 10 drachms;
             Tincture of opium, 6 drops;
             Simple syrup, 1 drachm.

Make a draught, to be Laken every four hours in combination with a table-spoonful of lemon juice.

      The Laudanum should be discontinued as soon as its good effects are produced. If the throat be much affected, astringent gargles should be employed. The following will be a good gargle: —

Take of Muriatic acid, 30 drops;
             Honey, 1 ounce;
             Water, 5 ounces.

Make a gargle, to be used frequently.

      Disturbance of the brain, from a determination of blood to that organ, demands the use of blisters, mustard plasters to the feet or calves of the legs, and the foot-bath, and the usual medicinal remedies which are used in inflammation of any other part of the body. When the eyelids are much swollen, bathing them with warm water, or anointing them with cream, oil, or some cooling ointment, will afford great relief. The following is a nice application: —

Take of Cream of milk, 2 ounces;
             Extract of goulard, x drachm.

Mix, and make a liniment; to be smeared over the face by means of a feather several times a day. Tonics, such as quinine and calumba, are to be administered in the stage of debility (see articles Quinine and Calumba for doses.)

      Should the eruption suddenly go in, and the pock sink and become flat, and alarming symptoms, as convulsions and delirium, ensue, the patient must be placed in a warm bath while the head is exposed to the cold douche; that is, cold water should be poured over the head, blisters and mustard plasters should be applied to the chest and extremities, and warm diffusible stimulants administered, such as brandy and water, wine and water, until re-action takes place, when they must be withdrawn. For an appropriate mixture under such circumstances, see Measles, Prescription No. 3.

Are the only diseases which can be confounded with Small-pox; and as they are not dangerous to life, all they

require in their treatment is to keep the bowels open, by giving some cooling saline medicines (for formula, see Measles, Presciption No. 1).

      This disease consists of an eruption of very minute white pustules, which extend over the tongue, inside of the lips and cheeks, and in some very severe cases run through the whole length of the intestinal canal, even appearing at the anus or extremity of the bowel outside. On looking into the mouth, the whole surface appears as if covered with very minute pieces of curd. It arises from acidity in the stomach, and from improper food; it invariably takes place in those children who are brought up by hand. In the generality of cases, it is a disease of little importance and requires scarcely any medical treatment.

      The treatment consists in regulating the bowels, which may be done by giving two grains of rhubarb, with one of mercury with chalk, every night, or night and morning, according to the age of the patient. The following remedy may be applied to the mouth three times a day: —

Take of Borax, powdered, 1 drachm;
             Honey, 1 ounce; mix.

      This is sometimes a very dangerous condition in infants; sometimes causing fever, congestion of the brain, convulsions, and not unfrequently death.

      Treatment. — The warm bath, aperient medicines, light food, and lancing the gums freely; this may be done without fear, and the incision must be carried down to the crown of the tooth when it appears prominent, but when the gums are only round and swollen, and the teeth not prominent, scarification, so as to draw blood freely, will be sufficient. There is a great prejudice against the free lancing of the gums in teething amongst parents and the public generally, on the supposition that the scars or seams are more difficult to be cut through as the tooth pushes its way upwards. This doctrine, according to the

best authorities, is unfounded, inasmuch as the harder the parts are, and the less endowed with vitality they are, the more easily they are removed by absorption, which is a natural process, and because the tooth does not mechanically cut its way through the gum as it advances upwards, but is removed by the process already named.

      There are two forms of cerebral apoplexy: the simple, arising from congestion of the blood-vessels of the brain; and the hemorrhagic, arising from congestion with rupture of the blood-vessels and effusion of blood, either upon or into the substance of the brain.

      Symptoms. — Sudden loss of all voluntary power, accompanied by stertorous or loud breathing, as if a person were snoring; the face is flushed and swollen, the blood vessels appearing prominent on the face and head; the breathing is difficult and oppressed, the pulse is strong and full, there. is total unconsciousness to surrounding objects, there is grinding of the teeth, the pupil is dilated, sometimes there is sneezing, and the eyes are either shut or half opened. An attack of apoplexy is sometimes sudden, the patient falling down without any warning, sometimes it is preceded by the following premonitory symptoms: head-ache, giddiness, confusion of ideas, sense of constriction of the brain as if a cord were tightly bound around it, loss of memory, drowsiness, and numbness of the extremities. If the patient be attended to in this stage, an attack may be prevented by proper treatment.

      Treatment. — Place the patient in the recumbent position, let the head be raised higher than the rest of the body, and dash cold water constantly over it; apply mustard plasters to the legs, and administer from five to ten grains of calomel, or one or two drops of croton oil may be placed on the tongue, and repeated every three or four hours until it operates freely.

      These means will be sufficient in a case of simple apoplexy from fulness of the blood-vessels, and the patient

will generally recover without further trouble; but in thosc cases where blood is poured out into the substance of the brain, in addition to the above remedies, it will be necessary to apply leeches from time to time, blisters to the nape of the neck, and to follow up the calomel with saline apericnts, and a mixture containing iodide of potassium in five-grain doses. Thesc remedies will often succeed, in the coursc of three or four weeks, in producing absorption of the clot and removing the paralysis which always follows on effusion of blood in the brain, but if the quantity poured out be large, death quickly ensues. The treatment of the premonitory symptoms will consist in purging, the foot-bath, total abstinence, and a low diet. Formerly blood-letting in apoplexy was universally employed, but is now rarely resorted to, except in bad cases of the hemorrhagic variety.

      Blood-letting should never be performed except by a medical man, as the risks are considerable, and unless the case is clearly one calling for it, this treatment might do the paticnt much injury.

      This extraordinary and fatal disease is one of those of whose true cause and nature still remains one of the unsolved problems of medical science. It is undoubtedly an acute specific disease, the exciting cause of which is a specific poison, the active agent in which is believed to be a minute organism to which the name cholera bacillus has been given. This organism is found only in the intestines and evacuations. The real nature of the bacillus is at present undecided, but investigators in different countries are studying the question, and we may hope shortly that medical science will not only unravel the true nature of the disease, but discover a cure. The evidence is in favour of cholera being an infectious disease capable of being transmitted from one human being to another, but the chicf cause of its propagation is the contamination of water used for drinking purposes with the excreta of persons suffering from the complaint. The disease is said to have made its first appearance in India, on the banks of

the Ganges, in 1817. There it commenced its destructive career, and in the course of seventeen or eighteen years it appears to have passed round the globe, progressing mainly in a north-westerly direction, and reaching this country about 1832. As on the occurrence of every other similar terrible disaster, its nature and mode of propagation were either misunderstood or misstated; and the lamentable prejudices of the vulgar in too many instances added to the miseries inseparable from the visitation itself. In almost all the capitals of Europe, the populace appear to have imbibed the notion that the disease was purposely introduced, and the mortality wilfully caused either by the machinations of government, or the wicked designs of the medical profession, many of whose members unfortunately fell victims to the frenzied delusions of the multitude.

      Whether cholera is infectious or not, the safer plan is to consider it as suspicious, and to avoid unnecessary exposure to it; but, above all, should the localities in which it prevails be avoided, if possible.

      Symptoms. – At the time when malignant cholera may be prevalent, all unusual looseness of the bowels should be considered as a symptom of considerable importance, and should be carefully attended to; for, by simple attention to this precaution, many attacks of cholera, in its fully developed form, will be prevented.

      After a shorter or longer continuance of this diarrhoea, or even without its previous occurrence, the symptoms of the cold stage of the disease, and from which it derives its designation, commence. These are vomiting and purging of a peculiar fluid, resembling rice-water or thin gruel, very copious, and which restores the colour of reddened litmus paper; violent cramps very soon attend these evacuations, and affect, in severe cases, nearly all the muscles of the body, but especially those of the legs and belly. The secretion of urine ceases; the voice becomes faint, hoarse, and at last almost inaudible; the skin is cold, damp, and livid, as that of a corpse; the features sink, and an intolerable thirst torments the miserable sufferer. Cold as he appears, he complains of being burnt up with an inward fire, and his insatiable cravings for cold drinks, which serve but to supply the stomach

with fluid to be immediately rejected, mark the agony of this feeling. The pulse soon ceases to be perceptible at the wrist — the vital powers fail more or less rapidly — death, in severe cases, soon closes the scene, and sometimes in a very short time. The same symptoms, but in less urgent degree, mark the course of the disease in its milder form, and in which the powers of life may be able, eventually, to throw off their deadly foe. In these cases, after twenty-four to thirty hours of the stage of collapse, as it is termed, re-action sets in, and a febrile condition ensues, which is marked by some peculiarities, and attended by certain symptoms, which indicate an important point in the treatment of this stage of the disease This peculiarity consists in many cases in the continued suppression of the urinary secretion; and the symptoms caused by this are, at first excitement, and afterwards oppression of the functions of the brain. The skin is hot and dry, and the tongue dry, red, and glazed. This febrile stage does not always follow even severe cases of collapse, but does so frequently, and has often proved fatal, after all danger had apparently ceased.

      Treatment. — The medicinal treatment is not particularly satisfactory, the mortality being very high whatever method of treatment is adopted. This disease is one in which the old adage "Prevention is better than cure" essentially applies. The history of cholera epidemics shows that the disease most frequently fastens upon, and spreads among, the dwellers in the poorer quarters of large towns, where overcrowding exists, and where the inhabitants are ill-fed and dirty in their habits. Cholera rarely occurs, except in isolated cases, among those who are well fed, well housed, and study cleanliness. Hence cleanliness, pure air and food are of the first importance.

      In case of a person being attacked, the greatest attention should be paid to the choleraic discharges from the bowels, which should be immediately disinfected and emptied into the drain, or so disposed of that there shall be no danger of their contaminating drinking water. Great care should be exercised to see that water used for drinking, milk, and food are pure. The former should always be filtered during times of cholera epidemic.

      When a person is attacked with cholera, medicinal treatment should be prompt. Two opposite methods of treatment have been recommended, one commencing with the administration of an aperient, such as castor oil or tincture of rhubarb, with a view to assisting the elimination of the poison; the other method being the immediate administration of opium and astringents to check the evacuations. Recoveries have followed after both plans, but the best authorities appear to agree that the astringent method is the most satisfactory. The sooner the evacuations are stopped the better the chance the patient has of recovery. As soon as diarrhoea sets in, if medical aid is not at hand, a dose of the following mixture should be given every two or three hours: —

Mix. — Dose, 1 ounce.

      Brandy is a very useful adjunct, and in the collapse stage should be very freely administered. If the above mixture does not check the purging, acetate of lead may be given in three-grain doses, or tannic or gallic acid in ten or fifteen-grain doses, combined with twenty drops of laudanum. In India and tropical regions the preparation called Chlorodyne enjoys a very high reputation for checking cholera in the early stage, and in English cholera there is no doubt that it is a most valuable remedy in twenty to thirty-drop doses.

      In the stage of collapse opium should not be given. If there is still purging, astringents, tannic acid or acetate of lead, should be continued, and stimulants in full doses, of which brandy, sal volatile and spirit of camphor are the best. As regards diet, this must be sparingly administered when there is vomiting; a little chicken-broth or arrow-root and milk may be tried, but if the patient cannot retain anything on the stomach, nutrient enemata of peptonised milk and beef-tea should be given. When unable to take liquids, the patient should be allowed to

suck ice, if it can be obtained. In case of cramps, large mustard poultices, or flannels wrung out of hot water well sprinkled with turpentine or chloroform liniment, should be applied over the abdomen.

      Should nature or art bring the patient through the collapse stage, the secondary fever, if it should follow, requires attention, and every endeavour should be made to restore the secretion of the kidneys. This is to be effected by mustard plasters over their situation in the back, and by the moderate use of saline purgatives and diuretics, as nitre, and cream of tartar (see those Articles).

      Is constitutional in some persons, their natural habit being one or two motions in the course of the week without any inconvenience. It is also the result of inattention to the calls of nature, as occurs with persons employed in shops, or in other business callings, who have not the opportunity of going to stool when they feel the desire; women in the family-way suffer much from it, in consequence of the heavy womb pressing on the end of the bowel or gut; and it is too often the result of constantly taking aperient medicine, in the shape of quack pills, which are so unblushingly advertised, and sold for the cure of all diseases to which human nature is subject. To suppose that one kind of medicine can meet the exigencies of every case, and cure diseases of the most opposite natures, is a doctrine so repugnant to reason and common sense, that it is lamentable to find that even persons who appear to be well informed upon all other subjects, and are very discerning in most matters which affect their interests, seem totally blind and ignorant on this point.

      Treatment. – Always supposing that the natural standard is one motion a day, every endeavour should be made to bring the bowels into that condition. When the constipation is constitutional, and the patient suffers no ill effects in his health from the infrequency of going to stool, it would be wrong to administer opening medicine;

when it is induced in pregnant women, the administration of small doses of castor oil once or twice a week, the smaller the dose, provided it acts, the better (see Prescription No. 11); and when it is the result of inattention to the calls of nature, or arises from sluggishness of the bowels produced by constantly taking drastic medicines, the treatment will consist in observing regular periods to go to stool, in immediately repairing to the water-closet upon the slightest inclination, by living on a diet of a laxative description, such as vegetables, fruit, and the oatmeal porridge of the Scotch, or "stirabout" of the Irish, and by occasionally throwing about a pint of warm water into the rectum. A good plan for curing those persons whose health is injured by taking quack pills, and whose stomach and bowels are rendered sluggish by constantly taking opening medicine, is to recommend them to leave off such a bad habit, to take no medicine at all, but every morning to go to the water-closet immediately or shortly after breakfast, whether there be the desire or not, to sit there intent upon the purpose for which they went from fifteen to twenty minutes, and to employ gentle friction with their own hands along the spine. This method of proceeding, together with a laxative diet, succeeds, sooner or later, in establishing a regular and healthy state of the bowels. At the commencement of this plan, persons need not be alarmed at not having a motion for four or five days; at the end of this time, if there be wind or unpleasant feeling, a gentle pill (see Prescription No. 45) may be taken at bedtime, or two tea-spoonfuls of Epsom or Rochelle salts dissolved in a large tumbler of cold watcr, early in the morning, fasting — only as an occasional dose. Hundreds of cases have been cured by this plan. Costiveness can never be permanently cured by the constant use of aperient medicine.

      This is a species of apoplexy which frequently occurs in warm climates, where men are exposed to much fatigue, or get intoxicated, and carelessly expose themelves to the sun. It first begins with great head-ache, thirst, and sometimes difficult breathing, which are soon

suceeeded by vertigo and bilious vomiting. The patient then drops down breathless, turns comatose, and unless immediate assistance is given, the face swells and turns black; the pulse, at first full and quiek, soon sinks, and after a few faint struggles for breath, the unhappy victim expires.

      The means to be employed here require to be instantly had recourse to. The patient should be removed to a cool situation under a shade, and the air cooled by fanning it round the body; ice should be applied to the head constantly by means of the ice-cap; cold water, rendered even artificially so, should also be given to drink, and the face and hands bathed with it. A large blister should be applied betwixt the shoulders, and ten grains of calomel and fifteen of jalap should be given immediately.

      Spasm, or cramp of the stomach, is a symptom of, and is dependent on, dyspepsia, or indigestion. It is a very painful affection while it lasts, but fortunately is not attended with much danger to life.

      Symptoms, — A sense of weight, pain, and tightness in the region of the stomach, accompanied with belching or eruetation of wind, and sometimes of an acid or rancid fluid into the mouth, great restlessness, depression of spirits, and costiveness. Delicate females are very subject to this complaint, and such is the violence of the spasms in some eases, that it requires the care, watchfulness, and strength of several attendants to prevent them from injuring themselves during an attack.

      Treatment. — Emetics (see Prescription No. 1), purgatives (see Prescription No. 2), hot fomentations by means of a flannel petticoat, or bran bags wrung out of hot water and applied to the pit of the stomach, and hot brandy and water, if the bowels be open. The emetic which acts most quickly and energetically is white vitriol or the sulphate of zinc. The following is the form in which it may be administered: — Take of sulphate of zinc, one drachm; cold water, four ounces; mix — the third part to be given every hour until full vomiting is produced. If the attack comes on in the evening, half a grain of opium may be

administered after the sickness. The following mixture may be taken with advantage afterwards: —

Take of Carbonate of soda, i drachm;
             Infusion of calumba, 6 ounces;
             Compd. spirit of lavender, 3 drachms;
             Sweet spirit of nitre, 2 drachms;
             Chlorodyne, 1-1/2 drachm.

      Two table-spoonfuls three times a clay (see Infusions).

      Symptoms. — This disease consists in a copious and frequent discharge of feculent matter from the bowels, accompanied by griping; there is a sense of weight and fulness in the lower part of the stomach, attended with a murmuring noise, arising from the presence of a great collection of wind: this feeling is relieved after every evacuation which takes place, and is again renewed before a second ensues. In addition to these symptoms, the patient is troubled with nausea, sickness, and vomiting, and, if the purging be not quickly arrested, by great exhaustion and depression of the vital powers, accompanied by spasm and cramp.

      The causes which produce diarrhoea are, bad and indigestible food, or food taken in too great quantities; acid fruits, or oily and putrid substances taken into the stomach, the abuse of active purgative medicines, the application of cold to the body, the suppression of perspiration, long-continued heat of the atmosphere, a transfer of gout or rheumatism to the intestines, and depressing passions of the mind. lt is distinguished from dysentery by the absence of fever, inflammation, contagion, and straining at stool, and also by the absence of blood in the motions.

      The appearance of the motions in the commencement of the disease are sometimes thinner than natural, in consequence of a large quantity of fluid being poured out by the intestines. They are somctimes slimy and of a green colour, sometimes they are yellow, and sometimes of a dark brown, accompanied by a very fetid smell. As the disease advances the motions become very watery and similar to coffee grounds, the strength rapidly fails, the

countenance turns pale, the skin is dry and stiff, great emaciation takes place, and exhaustion.

      Treatment. — In the treatment of this disease, attention must be paid to the cause which produces it, and the remedies administered accordingly. If it arise from repletion of the stomach, or from indigestible food, a gentle emetic of ipecacuanha should be given (say twenty grains); this should be followed by an aperient, to clear out any offensive matter that may remain in the intestines. The following will be a good draught: —

Take of Powdered rhubarb, 1 scruple;
             Cinnamon water, 1-1/2 ounce;
             Compound spirit of lavender, 2 drachms.

      Make a draught, to be given at bedtime. Should the motions be scanty and frequent, and accompanied by some degree of bearing down, four or six drachms of castor oil, with five drops of tincture of opium, will afford great relief. This treatment will also suit in cases where oily and putrid substances have been taken into the stomach. If it arise from the abuse of purgative medicines, they must be discontinued, and the following mixture administered: —

Take of Tincture of rhubarb, 1 ounce;
             Tincture of opium, 30 drops;
             Spirit of lavender, 4 drachms;
             Cinnamon water, 5 ounces.

Make a mixture; two table-spoonfuls every four or six hours. If it has proceeded from the application of cold to the surface of the body, or the suppression of perspiration, every effort must be made to restore the secretion by the administration of medicines which determine to the skin: such as James's or Dover's Powder; five grains of the former, or ten of the latter, will be sufficient for a dose, which may be taken in a little gruel or arrow-root. The patient should immerse his feet in warm water every night, and should the looseness continue, he may take the following powder three times a day: — Take of Dover's Powder, three grains; of mercury, with chalk or grey powder, two grains; mix.

      When it arises from acidity in the stomach, which is known by frequent eructations of air, diffusing a hot and

disagreeable sensation in the mouth, griping pains in the belly, accompanied by motions of a clay colour, which produce a burning sensation at the rectum in passing through, absorbents with opium must be employed. The following will be a good form of mixture: —

Take of Prepared chalk, 3 drachms;
             Spirit of lavender, 2 drachms;
             Compound tincture of cardamoms, 2 drachms;
             Chlorodyne, 1 drachm;
             Cinnamon water, 6 ounces.

Make a mixture; take two table-spoonfuls every three or four hours until the relaxation ceases.

      Should it arise from a transfer of the gout or rheumatism, fomentations of hot water, mustard plasters or blisters should be applied over the bowels; the patient's feet should be immersed in hot water, and ten grains of Dover's Powder administered to produce perspiration; at the same time, he should drink plentifully of weak brandy and water, or wine whey.

      Should it arise from the presence of worms, which is recognised by the slimy motions, and the presence of the worms themselves, either in a living or dead state, the remedies recommended among the prescriptions for their expulsion should be had recourse to (see Prescription No. 24).

      When it arises from ulceration of the intestines, as oftens happens in consumption and other protracted diseases, the most effectual astringents, in addition to what has been already recommended, should be employed; such as catechu, kino, alum, logwood, tannin, white and blue vitriol. The following is a good mixture in these cases: —

Take of Chalk mixture, 5 ounces;
             Tincture of catechu, 4 drachms;
             –––——of kino, 3 drachms;
             Syrup of poppies, 2 drachms;
             Tincture of opium or chlorodyne, 1 drachm.

Make a mixture; two table-spoonfuls to be given three or four times a day.

      The diet in these cases should consist of sago, arrowroot, and rice puddings made with or without milk, or

they may be given in a liquid form; all solid food should for a time bc suspendcd. It will bc necessary for those persons who are subject to frequent attacks of this complaint, either from a peculiar weakness or irritability of the bowels, to live temperately, to avoid all acid fruits, most kinds of vegetables, unwholesome food, and meats of hard digestion.

      A disease accompanied by frequent and scanty motions and great bearing down of the rectum.

      Symptoms. — This disease is ushered in by all the concomitants of inflammatory fever; such as cold shivering succeeded by heat of skin, frequency of pulse, loss of appetite, sickness, and costiveness. This stage is quickly followed by severe griping pains, and pain on pressing the belly, frequent desire to go to stool, accompanied by great straining, and painful bearing down of the rectum; the evacuations consisting of a peculiarly foetid matter, without containing any particle of healthy motion. These evacuations frequently vary in their appearance, being sometimes pure mucus, or mucus streaked with blood, sometimes pure blood is passed, at other times pure matter, and it not unfrequently happens that pieces of membrane, arising from ulceration of the lining of the intestincs, are seen floating in the dejections. It is seldom that any natural faeces appear in the course of this disease, but when they do, they are passed in hard, small balls, accompanied by great relief of the griping and bearing down.

      Causes. — The causes which produce this diseasc are, a cold and moist state of the atmosphere, quickly succeeded by heat; the suppression of the perspiration, whereby the blood is thrown from the external upon the internal vessels, immoderate use of spirituous liquors, unwholesome food, exposure to noxious exhalations, or to the effluvia arising from the bodies of persons labouring under the disease.

      The season in which it usually prevails in these countries are the months of September, October, and

November; and in the East and West Indies it commences during the rainy season, and continues some time after it.

      Question of Contagion. – It is supposed that dysentery, when it proves infectious, is owing to the impure and vitiated condition of the atmosphere; hence it frequently appears in hospitals which are not properly ventilated, and other places where a number of sick persons are crowded together; while in situations where great attention is paid to ventilation and cleanliness, it seldom extends beyond the individual in whom it originates.

      Cause of the continuance of this disease: inflammation of the whole or part of the lining membrane of the intestines, and ulceration of the large intestines.

      Favourable Symptoms. – A gentle perspiration over the surface of the body, the stools improving in colour, and becoming less frequent, a sediment in the urine, and the strength little impaired.

      Unfavourable Symptoms. — The tenesmus or bearing down of the gut becoming very intense, the inclination to go to stool more frequent, the discharge from the bowels being very scanty and of an unnatural colour, much depression of the powers of life, a tense state of the belly, cold clammy perspirations, ulceration of the mouth and throat, a feeble pulse, and coldness of the surface of the body.

      Treatment. — If the fever be of an inflammatory character, accompanied with rigors and succeeded by heats and flushes, a saline aperient or a dose of castor oil should be given every second or third morning, so that evacuations of a natural character may be procured. The following is a good mixture for this purpose: —

Take of Epsom salts, 1 ounce;
             Best manna, 1/2 ounce;
             Peppermint water, 5 ounces;
             Tincture of rhubarb, 2 drachms.

Mix; four table-spoonfuls to be taken every second or third morning. Should there be much pain on pressing the belly, fomentations of the docoction of poppy-heads

and camomile flowers, or turpentine; the purgatives already recommended should be continued every second morning, and, in the interval, small doses of Dover's Powder and calomel may be given every four or six hours, care being taken not to cause salivation. Great relief will be also found from the application of soothing liniments over the abdomen, such as the following: —

Take of Camphorated oil, 1 ounce;
             Tincture of opium, 1 ounce; mix.

The belly to be rubbed with this oil several times a day. Camphorated oil is made by dissolving half an ounce of camphor in two ounces of sweet oil. In order to relieve the tenesmus, or bearing down, injections consisting of starch or mutton-broth, and tincture of opium, say half a drachm, or even a drachm, should be thrown into the rectum; or, should these not be retained or fail to afford relief, two grains of opium, made soft with a little oil or conserve of roses, introduced into the rectum, will be found very serviceable. In employing the injection, a small quantity of fluid should be used, say not more than two ounces, as a greater quantity will not be retained; and, in introducing the opium, care should be taken to put it beyond the sphincter muscle, at least two inches from the verge of the anus. The bowels should be kept open with castor oil, combined with small doses of laudanum, say half an ounce of the former, and ten drops of the latter. In the advanced stage of this disease, great benefit will be derived from the following mixture: —

Take of Diluted nitric acid, 2 drachms;
             Laudanum, 1-1/2 drachms;
             Distilled water, 14 drachms; mix.

      A tea-spoonful to be taken four times a day in a cup of barley-water. When there is acidity in the stomach, absorbents combined with opium will be required; such as chalk, kino, catechu, and logwood (for form of mixture, see Diarrhoea).

      The patient should at the same time drink port wine and water with his meals; as a common drink, equal parts of lime-water and milk have been highly recommended.

      In those cases where the motions are passed frequently, from a weakened state of the bowels, the greatest benefit will be derived from the sulphate of zinc, alum, sugar of lead, and blue vitriol, in combination with opium. For form of astringent mixture, see Alum, and for doses of each of the other substances, see their respective articles.

      In a more advanced state of the disease, vegetable tonics should be administered, for the purpose of giving tone to the muscular coat of the intestines, and of improving the health generally. The following is an excellent mixture for this purpose: —

Take of Infusion of cascarilla, 5 ounces;
             Tincture of calumba, i ounce;
              of catechu, 2 drachms;
             Diluted nitric acid, j drachm; mix.

Three table-spoonfuls three times a day.

      Dr. Maclean and other physicians who have had large experience of the disease in India, recommended powdered ipecacuanha in full doses as a specific. They begin by giving twenty-five to thirty grains in a small quantity of fluid, with a little syrup of orange peel; the patient to be kept quiet, and to take no food for three hours, but may suck a little ice. In eight to ten hours a smaller dose is given, and for a night or two ten or twelve grains are given at bedtime.

      Diet. — The patient should live at the commencement of the disease on preparations of barley, rice, sago, flour, tapioca, and Indian arrow-root boiled in milk, and broths occasionally should be allowed. He should avoid all spirituous and fermented liquors, and every description of food which has a tendency to putrefaction. During his convalcscence or recovery, meat of the lighter kinds may be used, and he should drink port wine and water, or brandy and water, at his meals.

      Precautions. — As dysentery is considered by some physicians to be contagious, the greatest care should be taken to procure good ventilation, particularly where persons are crowded together, as on board ship, or in hospitals. The sick should be immediately removed from the healthy, they should be placed in separate rooms if possible, their motions should be taken away

as soon as passed, the body-linen and sheets frequently changed, and the rooms fumigated with the solution of chloride of lime or boiling vinegar. The following is a cheap and easy method of fumigating, for the purpose of destroying contagion arising from dysentery, small-pox, typhus-fever, or any other infectious disease: —

Take of Peroxide of manganese, 2 parts;
             Common salt, 4 parts;
             Oil of vitriol, 3 parts;
             Water, 1 part.

      This mixture should be placed in an earthenware vessel, and allowed to remain in the room until all vapours cease to rise. A greater quantity of this vapour, which is chlorine gas, may be obtained by putting the same mixture in an oil flask and applying heat. Of course this method of fumigating cannot be resorted to until after the patients are removed from the rooms or places about to be fumigated, as the vapour cannot be breathed without producing great irritation of the lungs; and, when existing in any great quantity in the atmosphere, is fatal to life.

      Symptoms. — Trembling and shaking of the hands and of the whole body; total want of sleep; loss of power of the brain, producing delirium, in which the patient imagines that some great evil has befallen him — he is tormented with the most frightful visions, and is suspicious of every person about him, but most particularly of his friends; and usually, pain on pressure upon the pit of the stomach, and total loss of appetite. The tongue is moist, the face is pale generally, the skin cool and clammy, and the pulse small and quick. These are the usual distinguishing symptoms of this disease, but it is sometimes complicated with congestion of the brain, and in such cases the pulse will be full, frequent, and hard, the face flushed, and the skin hot and dry.

      Causes. — Immoderate use of ardent spirits, and the sudden total abstinence from intoxicating liquors after a long indulgence in their use.

      Treatment. – When it arises from suddenly leaving off drink, and is accompanied by pale countenance, small pulse, coldness of the head and skin, and loss of power, the preparations of opium must be freely administered, as well as the stimulants to which the patient was accustomed, whether gin, brandy, or wine. The patient may take the following draught every three or four hours until sleep is produced: —

Take of Tincture of opium, 40 drops;
             Compound tincture of cardamoms, 4 drachms;              Camphor mixture, 1-1/2, ounce; mix.

      Wine, brandy, and gin, should be also freely drank, and strong beef-tea, or other nutriment, should be given. In the other form of delirium, accompanied by congestion, leeches should be applied to the temples, and the head kept cool by means of a bladder filled with very cold water, or iced water, and saline purges administered (for form of mixture, see Epsom Salts).

      When the inflammatory stage is reduced and the delirium continues, the means already recommended will be necessary.

      This disease consists in a sudden loss of the senses, attended with violent convulsions of the whole body.

      Symptoms. — Sudden loss of power and motion, the patient falls down, and his whole muscular system is thrown into the most violent contortions. Convulsions of the muscles of the eyes and face take place; the mouth is drawn on one side, the eyes roll frightfully about, the teeth are clenched; there is great agitation of the legs and arms, the patient foams at the mouth, there is frequently a discharge of the urine and motions, and after the convulsions have ceased, a profound sleep ensues, at the expiration of which, the patient appears as well as if nothing had happened. It is distinguished from apoplexy, by the foaming at the mouth, and by the increase of motion of the muscular system, which is totally suspended in apoplexy; and from hysterics, by the foaming at the mouth, gnashing of the teeth, blackness of the countenance, and the convulsions terminating in profound sleep.

It more frequently takes place in young persons than in old. The causes which give rise to this disease are twofold, namely, those arising internal and those arising external to the head. The causes internal to the head are, tumours, polypi, concretions, deformity of the bones of the skull — in such cases a cure is hopeless. The causes external to the head are, affections of the spinal marrow, worms in the intestines, teething, the suppression of any long-accustomed discharge, great emptiness or repletion, or a poison received into the stomach. It may also arise from the following accidental causes, viz. blows, wounds, fractures, and other injuries done to the head by external violence; a determination of blood to the brain, violent affections of the nervous system, sudden fright, joy, or grief. This disease is frequently simulated by imposters, for the purpose of exciting charity and other bad motives. The best means of detecting the counterfeit will be to blow some Scotch snuff, through a quill, into the nose: in the true epileptic fit, it will be found to produce no effect whatever, whereas, in the counterfeit, it will produce violent sneezing. Other means, such as threatening to bleed, blister, or souse in cold water, may be tried with effect.

      Treatment. — During the continuance of a fit, little more can be done than preventing the patient from injuring himself, taking care that there is no pressure on the vessels of the neck. There should be a free current of air, and a piece of soft wood should be placed between the teeth, to prevent the tongue from being bitten. The bowels should be freely opened by means of castor oil, or jalap and calomel: twenty grains of the former and four grains of the latter will be a sufficient dose. In affections of the spinal marrow, tartar emetic ointment will afford great relief; it should be rubbed along the spinal column until it produces an eruption similar to small-pox (see Tartar Emetic). When it arises from worms, these vermin should be dislodged by proper remedies. The following is a good preparation: —

Take of Jalap powder, 10 grains;
             Scaminony, 2 grains;
             Calomel, 4 grains.

Make a powder, to be taken in something thick at bedtime. The doses should be proportioned to the age of the patient; for direction, see Scale of Doses.

      When it arises from teething, the gums should be freely lanced; and when from the suppression of any accustomed evacuation, the evacuation should be encouraged or discharges established by medicines, setons, or blisters. When the disease arises from debility, the patient should make use of a generous and nutritious diet — he should breathe good air, and take moderate exercise. The cold or shower bath will render great service, and anti-spasmodics and tonics should be administered in the interval. The following will be a good form of draught to prevent spasm: —

Take of Tincture of valerian, 1/2 drachm;
             ———–of castor, 1 drachm;
             Peppermint water, 1-1/2 ounce;
             Spirit of sulphuric aether, 30 drops.

      Make a draught — one three times a day; or the following:

Take of Infusion of calumba, 1-1/2 ounce;
             Ammoniated tincture of valerian, 20 drops;
             Tincture of calumba, 2 drachms;
             ———–of henbane, 15 drops.

Make a draught; to be taken three times a day. The best tonic in this disease is iron. It may be given in the following form: — Take of carbonate of iron, 1 drachm; which is to be taken in treacle three times a day; or it may be administered in the form of a mixture: —

Take of Copperas (sulphate of iron), 1 scruple;
             Powdered myrrh, 1 drachm;
             Spirit of nutmeg, 1/2 ounce;
             Sugar, 1 drachm;
             Rose water, 7-1/2 ounces; mix.

A sixth part three times a day.

      The diet in epilepsy should consist of such things as are light and easy of digestion. Animal food should be taken sparingly, and spirituous liquors, wine, porter, and ale, should be abstained from. The hair should be cut short, and cold applications made to the head, whenever the skin feels hot. The patient should keep himself as cheerful as possible in the intervals of the fits; and he

should guard against all violent emotions of the mind, and never place himself in a dangerous situation. Sexual intercourse should be only moderately indulged in.

      This disease, as its name implies, is a diffuse inflammation of the skin, that is to say, it may extend over a large tract of surface, getting well at one point, and getting bad at another. It belongs to the eruptive diseases, and is capable of being communicated from Person to person, in the same way as small-pox or measles. When it attacks the face and head, we speak of it as a distinctive or specific disease, and call it erysipelas, but every other part of the body is subject to erysipelatous inflammations, arising from various causes.

      Causes of Origin. — Contagion, exposure to cold, depressing and exciting passions, such as fear and anger, irregularity of diet, a morbid condition of the blood, and external injuries, such as scratches, wounds, stings of insects, and various other mechanical injuries acting on a diseased eonstitution.

      In this complaint, the inflammation may be so slight as merely to cause a redness on the skin, and to produce no constitutional disturbance; or it may extend from the skin to the parts beneath, producing boils, carbuncles, and the most violent fever and disturbance of the whole system. It is most dangerous when it attacks the head and face, causing great swelling of those parts, closing up the eyes for days, and often causing death, in consequence of pressure on the brain, from the effusion of water into that organ.

      Symptoms. — It is ushered in by the same symptoms as all the other eruptive diseases — rigors or shiverings, succeeded by heat, sore throat, weariness and lassitude, nausea, head-ache, languor and depression of spirits.

      Treatment. — Administer a brisk purge to clear out the bowels, consisting of jalap and calomel (see Prescription No. 2) or castor oil.

      To abate the fever, administer the following saline mixture (see Prescription No. 21). After the fever is

abated, fifteen drops of tincture of iron should be given three times a day. To abate the swelling and pain of the skin, the parts should be kept constantly wet with linen cloths saturated with goulard water; or they should be dusted with flour, which is one of the best applications, as it cools the surface, and absorbs the irritating fluid which escapes from the blistcrs that frequently form on the surface of the skin in this disease. If, under this treatment, everything progresses favourably, no more active measures should be employed. If the strength fails, and there be no bad symptoms, the constitution should be supported by wine and bark; the quantities will depend on the circumstances of the case — wine without bark will be preferred by the patients, which may be given according to its effects.

      When the symptoms assume an unfavourable aspect, that is to say, when the patient presents great debility, when his pulse is feeble, and there are tremors, and subsultus tendinum, or locking of the hands and legs, and when the tongue is dry and brown, wine in large quantities must be administered with beef-tea, and two table-spoonfuls of the following mixture must be given every three hours: —

Take of Carbonate of ammonia (smelling salts), 1/2 drachm;
             Sweet spirit of nitre, 2 drachms;
             Compound tincture of cardamoms, 4 drachms;
             Compound tincture of bark, 3 drachms;
             Camphor mixture, 6 ounces; mix.

      During convalescence, the paticnt must be supplied with a good and generous diet.

      There are several kinds of fevers, but those of which we shall treat in this volume will be Simple or continued Fever, Typhoid, Intermittent Fever or Ague, and Typhus Fever.

      General Symptoms of Simple Fever. — Chilliness and shivering, succeeded by increase of heat over the whole surface of the body; lassitude, and an aversion to

bodily or mental exertion; pulse strong, full and frequent; dull, aching pain in the back and loins; sensation of sickness and frequent vomiting; intolerance of light and sound; great head-ache, a bloodshot state of the eyes, irregular and oppressed breathing, great thirst, flushed state of the countenance, white tongue, bowels costive, urine scanty and high-coloured, loss of sleep, great anxiety of mind, diminution of strength, loss of appetite, voice husky or hoarse, slight soreness in the throat, and sense of weight at the chest.

      These are the symptoms which usually present themselves in the commencement of all fevers; but they will vary in individual cases, according to the description of the fever, the circumstances under which the patient is placed, and the stage or continuance of the disease.

      Causes which oroduce Fever. — Exposure to cold and damp, prolonged exposure to the sun, irregularity of diet, intemperance, cooling suddenly after violent exercise, suppression of some accustomed discharge exposure to foul and impure air, low living, privation of the common necessaries of life, or specific contagion.

      Treatment. — The patient should be kept in bed, the room in which he lies should be well ventilated, the surface of the body should be sponged three or four times a day with vinegar and cold water. His diet should consist of the lightest food, such as sago, arrowroot, barley-water, chicken-broth, and beef-tea; and his drink, of toast and water, lemonade, cold tea, cream of tartar water (see Cream of Tartar), thin gruel, or cold water. Everything offensive should be removed, and his motions carefully taken away as soon as passed — the light of the room should be partially excluded, he should lie on a mattress instead of a feather bed, and his pillow should consist of some hard material, such as a hair pillow instead of feathers, in order that the head may be kept as cool as possible. If the fever does not give way to these means after a couple of days, and the head-ache and intolerance of light still continue, a bladder of cold or iced water may be kept on the head, the hair having been previously shaved, and the following mixture administered

Take of Epsom salts, 3 drachms;
             Solution of acetate of ammonia, 1 ounce;
             Syrup of saffron, 2 drachms;
             Sweet spirit of nitre, 2 drachms;
             Camphor mixture, 5 ounces; mix.

Two table-spoonfuls every three or four hours.

      Want of sleep being a prominent feature in this disease, great benefit will be derived from a dose of Dover's Powder at bedtime, say ten grains, but it should never be given while there is a great degree of head-ache, a dry or furred tongue, and when there is great heat of skin. (For precautions in the administration of Dover's Powder, see that article in the Pharmaceutical department of the work.) When the active stage of the fever is reduced, and the patient suffers from debility, a more generous diet and light bitters may be allowed (see Calumba Root).

      Typhoid, enteric, or gastric fever, as it is sometimes called, is now believed to be an originate from a specific poison, and is transmitted from one to another through the final discharges. There is very little risk of infection from coming into contact with a person suffering from the disease; the fact that nurses or doctors attending on patients rarely take it favours the supposition that it cannot be transmitted from simple contact. If the excreta are left lying about or thrown on the ground, emanations from them may impregnate the atmosphere, and so propagate the disease; but the usual medium of conveying the contagion is by water. The excreta being thrown into cesspools, or on the ground, soaks through the soil, and the poison ultimately finds its way into wells, the water of which is used for drinking purposes, and in this way it sometimes happens that a whole village is infected.

      Typhoid fever is most common during youth and adolescence. It is rare in infants and in persons over forty-five or fifty years of age. In England it is most common in the autumn after a hot and dry summer. It attacks persons in all classes of society, and is by no means confined to the poor or ill-fed, as is demonstrated

by the numerous cases of this disease in the royal and noble families during reccnt years.

      The Symptoms of the fever in the early stage are similiar to those of simple fever, with the addition of a very tender condition of the abdomen, with pain, which is increased on pressure. In many cases when the right side of the abdomen is pressed with the fingers a gurgling sound is produced, caused by the movement of fluid and gas in the large intestine. Often there is diarrhoea, the stools being of a "pea-soup" character and very offensive, and sometimes there is intestinal haemorrhage. Occasionally the bowels are constipated throughout the attack. The skin is hot and dry; the temperature, as indicated by the clinical thermometer, ranging from 101 to 105 degrees, or even more in severe attacks. A characteristic feature is that the evening temperature is generally one or two degrees higher than the morning temperature. The force of the fever seems to spend itself chiefly in the intestinal tract. The mucous membrane throughout is inflamed and irritable, and often there is great irritability of the stomach. But the most charactcristic feature of the disease is that it attacks the glandular structures of the small intestines, causing ulceration, which may end in perforation of the bowel, collapse, and speedy death. The duration of the fever is generally about three weeks, but at times it goes on for four weeks. About the second week of the fever in many cases, although not invariably, a peculiar eruption of small, round or oval patches, about the size of a split pea, appears on the abdomen and chest. They come out in successive crops, each lasting from two to five days and may continue until the end of the third or fourth week. In number they vary greatly, sometimes only two or three can be detected, in other cases there may be twenty, but rarely more. The spots disappear completely on pressure, returning on the pressure being removed. In severe cases there is delirium, at first only at night, gradually becoming more persistent. Sometimes the patient is very noisy and talkative, at others very quiet and drowsy, lying in an apathetic state with the eyes only partially closed.

      Treatment. — In mild cases medicinal treatment is not much called for, small doses of dilute hydrochloric acid and quinine, about fifteen minims of the former and one grain of the latter, being all that is necessary. The diet, however, requires all attention; milk should be the chief food, with beef-tea or chicken-broth, or custards occasionally. The drink should be barley-water, toast-water, or milk and soda water. Ice may be sucked to relieve heat and thirst. Stimulants are not often necessary, and should not be given unless there are signs of flagging heart. Complications must be treated as they arise. Abdominal pain and flatulent distension call for hot poultices and fomentations, and sometimes opium or morphia in small doses. Diarrhoea, if excessive, should be checked by giving mixture No. 10, or a powder containing five grains of Dover's Powder and ten grains of carbonate of bismuth, every four hours. If there is hemorrhage from the bowels, tannic acid should be given in the form of mixture, combined with opium, thus: —

Take of Tannic acid, 1 drachm;
             Tincture of opium, 1 drachm;
             Mucilage of acacia, 1 ounce;
             Water to 6 ounces.

Dose. — One ounce every two hours.

      During convalescence bitter tonics, calumba or quinine, and wine is often of great service. The patient must be cautioned against indulging in solid food for at least a week after the fever has subsided.

      Symptoms. — This disease was formerly confounded with Typhoid, but it is now known to be perfectly distinct. The symptoms are languor and lassitude, lowness of spirits; rigors succeeded by heat, obscure head-ache, giddiness and noise in the ears; and, as the disease advances, more or less delirium, usually low and

muttering; listlessness and indifference to surrounding objects; pulse small, weak and intermitting; respiration hurried; tongue at first moist, and covered with a slime, and afterwards becoming brown and dry, and, as the disease advances, black and cracked; the teeth and lips are covered with a black secretion (sordes). There is little thirst; the urine is pale and watery. About the fifth or sixth day a mottled kind of eruption under the skin appears over the abdomen, borders of the armpits, and backs of the wrist, followed usually by a characteristic rash, slightly elevated in colour, resembling the stains of mulberry juice. When this rash appears there can be no doubt as to the nature of the disease. The temperature ranges from 104 to 106 degrees, and in fatal cases may reach 108 or 109 degrees.

      During the eruption stage all the symptoms tend to get worse. There is extreme prostration, followed by stupor, which often settles down to complete coma. There are also muscular twitchings and convulsions. In some cases the patient picks the bed-clothes, in others he lies perfectly still, with his eyes wide open, staring vacantly into space. This condition is called coma-vigil. If the patient recovers, the improvement takes place from the thirteenth to the seventeenth day, and is preceded by a long, deep, quiet sleep. The mortality is said to be one in five.

      Causes. — This disease is caused principally by infection, being highly contagious, but this occurs with rare exceptions only, under circumstances of bad ventilation, bad living, and the crowding of many cases together. It appears also to rise spontaneously in poor districts, and in badly-drained and ill-ventilated localities. It may be considered as the disease of poverty, overcrowding, dirt, and improvidence.

      Treatment. — An emetic may be given in the beginning of the attack; cold to the head by the means recommended in simple fever; blisters on the back of the neck; free ventilation, and light food; the bowels should be kept open by saline aperients, or what is better, by castor oil (see Prescripion above, or Epsom salts); and sponging frequently with vinegar and water;

at the close of the disease stimulants, tonics, and a nourishing diet may be allowed. The following will be a good tonic in this disease: —

Take of Dilute sulphuric acid, 1-1/2 drachms;
             Infusion of calumba, 5 ounces;
             Compound tincture of cardamoms, 4 drachms;
             ————————of bark, 4 drachms; mix.

A sixth part to be taken three times a day. As regards diet, hygienic measures, &c., those laid down for Typhoid apply equally to this disease.

      Symptoms. — This disease occurs in distinct paroxysms, or fits, which return at regular intervals of 24, 48, or 72 hours, and the ague is termed quotidian, tertian, or quartan, accordingly. Each fit or paroxysm consists of three stages, viz., the cold stage, the hot stage, and the sweating stage.

      The Cold Stage is ushered in by a sense of languor and listlessness; the patient begins to yawn and stretch, the face is sunk and hollow; the skin is constricted as if cold were applied to it, is corrugated and rough, and its appearance has given rise to the term cutis anserinuts, or goose skin; this stage is followed by a universal feeling of coldness, commencing in the back, and diffusing itself over the whole body; after which, rigors ensue, which terminate in universal and convulsive shaking.

      The Hot Stage. — After a shorter or longer continuance of the cold stage, the sensibility of the body, which was impaired, returns, and is increased; the skin, which was before pale and shrunken, becomes full, tense, swollen, and red; the circulation becomes hurried and excited, and a universal glow of heat diffuses itself over the whole body; there is sharp, throbbing head-ache and hurried breathing; the pulse is strong, hard, and frequent; the tongue is brown and dry, the urine is scanty and high-coloured, and there is great thirst.

      The Sweating Stage. — After a shorter or longer continuance of the hot stage, a moisture breaks out on the face and neck, which, after a time, diffuses itself over the whole body, and becomes a universal perspiration;

the heat of the body is reduced to the natural standard, the pulse is diminished in frequency and becomes full and free; the bowels are no longer constipated, the urine deposits a sediment, and all the functions return to their natural healthy condition.

      Treatment. — The treatment will consist in cutting the cold stage short, by inducing the hot; and in cutting the hot stage short, by inducing the sweating.

      During the cold stage, the patient should be covered heavily with blankets, his feet should be immersed as far as the calves of the legs in warm water; an emetic of ipecacuanha should be given, its operation being assisted by copious draughts of warm water, after which he should take a draught consisting of thirty drops of laudanum, a tea-spoonful of sulphuric rether, and two tea-spoonfuls of sweet spirit of nitre, in a wine-glassful of camphor julep.

      During the hot stage, cool drinks should be administered, and he should be exposed to a free current of air; his body should he sponged with cold water and vinegar, and saline effervescing draughts administered.

      During the sweating stage, the patient should be wiped dry, his linen changed, and he should go to bed and take a sleeping draught (for formula, see Laudanum). In the intervals or during the periods between the attacks, the bowels should be kept open, and tonics administered, such as quinine and arsenic. The following will be a good mixture: —

Take of Sulphate of quinine, 18 grains;
             Diluted sulphuric acid, 1/2 drachm;
             Tincture of ginger, 1 drachm;
             Water, 6 ounces; mix.

A sixth part to be taken three times a day. Or the quinine may more often be advantageously exhibited in much larger doses at once, in which way the disease will in general yield to a smaller quantity of the drug than when it is given in smaller doses and frequently repeated. A large dose or two, say of ten or fifteen grains, to a grown person, given in some aromatic water, three or four, hours before an expected attack, will usually put an end to the disease economically and safely. The bowels should be well cleared out before the administration of

the quinine, and it should not be given in these large doses if there is any distinctly-marked local affection present.

      For a further account, see Disulphate of Quinine.

      Inflammation of the lungs is rather an indefinite term, therefore, for the sake of clearness, we will divide it in to —

• 1st. — Pneumonia, or inflammation of the substance of the lung.

• 2nd. — Bronchitis, or inflammation of the bronchial or air tubes.

• 3rd. — Pleurisy, or inflammation of the covering of the lungs, called the pleura.

      Pneumonia, commonly called inflammation of the lungs, has the following symptoms: short cough, thirst, dry tongue, pain in the chest, delirium, hurried and oppressed breathing, flushed countenance, frequent beat of heart, quick pulse, the expectoration scanty and rust-coloured. An experienced person, on placing his ear to the chest at this stage, would hear a sound with the breathing like the rubbing of a lock of hair between the fingers (called minute crepitation). Should the patient not have relief, the lung becomes solid, and finally undergoes gangrene, which may be known by the breath becoming horribly offensive. Typhoid symptoms set in, with a dry brown tongue and great prostration; the patient becomes comatose, picks at clothes, lies on his back, sinks towards the foot of the bed, and finally dies. In strong plethoric persons, leeches applied to the affected side of the chest give great relief to the pain and difficulty of breathing. The following mixture may be taken: —

Take of Aromatic spirit of ammonia, 3 fluid drachms;
             Nitrate of potash, 1/2 drachm;
             Chloric ether, 1 drachm;
             Water, to 6 ounces.

A sixth part every three or four hours. Should the cough be very troublesome, the following might be taken: —

Paregoric elixir, 1/2 ounce; or chlorodyne, 1-1/2 drachm;
Oxymel squills, 3 drachms;
Syrup of tolu, 2 drachms;
Water, 6 ounces.

A sixth part for a dose, occasionally, every three or four hours. Blisters, or turpentine stupes, i.e. flannel wrung out of hot water and dipped in turpentine, may be applied to the chest. Should the patient appear to be sinking, and the tongue become dry and brown, with sordes or filth about the teeth, brandy must be given with beef-tea, or eggs beaten up with sherry; and this mixture: —

Take of Carbonate of ammonia, 1/2 drachm;
             Chloric zether, 1-1/2 drachm;
             Tincture of bark, 3 drachms;
             Water, to 6 ounces.

A sixth part every two or three hours, as required.

      The diet must be nutritious in quality, and easy of digestion, such as beef-tea, mutton-broth, arrow-root made with milk, or gruel; and acidulated drinks, as lemonade, may be given to allay thirst.

      Bronchitis, or inflammation of the air tubes.

      Symptoms. — A loud and prolonged cough, sometimes terminating in vomiting, short and quick breathing, profuse expectoration, inability to lie down, thirst, wheezing, pain in the chest, and fever. In very young and old persons this disease is particularly unfavourable, and has received the name of suffocative catarrh, owing to their being suffocated by the accumulation of mucus in the air passages.

      Treatment. — The cough should not be interfered with, as that is nature's safety-valve, for without coughing the mucus collects, the patient becomes weaker and weaker, and finally dies, suffocated. Stimulating expectorants may be given, as the following: —

Take of Carbonate of ammonia, 1/2 drachm;
             Tincture of squills, 2 drachms;
             Syrup of tolu, 3 drachms;
             Paregoric elixir, 2-1/2 drachms;
             Cinnamon water, to 6 ounces.

A table-spoonful to be taken every four hours. Blisters

and mustard poultices are necessary to be applied to the chest. The diet should be nutritious and most easy of digestion; the room should be kept of a uniform temperature. In children and old people it is proper to give wine and other stimulants. If the bronchial tubes appear to be choked with mucus, an emetic generally gives great relief.

      Pleurisy.

      A disease of an inflammatory character. It occurs more frequently in young and robust persons, from exposure to cold. It commences with rigors and shivering, and is followed by the usual symptoms of inflammatory fcver. There is a sharp stabbing pain in the region of the lungs, on one or both sides, which is greatly augmented on taking a deep breath. In the most severe cases it terminates in the formation of pus in the cavity of the lining membrane of the lungs. The treatment in this inflammation is, to apply leeches, blisters, or sinapisms to the chest, over the seat of the pain. The bowels should be freely purged with the following: —

Take of Calomel, 4 grains;
             Compound colocynth pill, 6 grains;

Make two pills, to be taken immediately, followed three hours afterwards by the ordinary senna draught (see Senna). After the bowels have been relieved, a mixturc of ammonia similiar to that ordered for inflammation of the lungs should be given. If there is a large accumulation of fluid in the chcst, this can be best relieved by tapping with the aspirator, which must be done by a medical man.

      This is an inflammation of a very severe character, and requires prompt treatment, or mortification is liable to ensue, which is soon followed by death.

      It commences with the usual symptoms of fever (see Fever), and with nausea or obstinate vomiting; the bowels are generally constipated; there is, in the first instance, great pain in one definite part of the abdomen, which is greatly increased on pressure, and, as the inflammation

increases, the pain and tenderness gradually extend over the whole abdomen; then the patient is unable to bear the weight of the bed-clothes, and consequently draws up his knees to support them. Should the inflammation not yield to treatment, the abdomen becomes much swollen, the pain ceases, hiccup sets in; therc is coldness of the surface of the body, and of the extremities; the vital powers are prostrated, and death soon puts an end to the sufferings of the patient. This inflammation is likely to be confounded with colic (see Colic, page 76); but may be distinguished from it, by noticing that in inflammation of the bowels the pain is continual and is increased on pressure, whereas in colic the pain is relieved by pressure, and is not constant. Inflammation of the bowels is accompanied with fever; colic is not.

      Treatment. — The abdomen is to be fomented, or covered with hot linseed-meal or bran poultices, which are to be frequently changed. If these do not relieve, leeches — about ten or a dozen — may be applied. Medicinally, opium is the remedy from which most benefit may be expected. It should be given in doses varying from half-a-grain to two grains, every two or three hours, according to circumstances, until the pain is relieved. After the pain is relieved, enemata of soap and warm water should be administered. Calomel is often necessary, but should be given only under medical supervision.

      Inflammation of the bowels arises from many causes, amongst which may be stated cold, irritation caused by indigestible food accumulating in the intestines, colic, or any obstruction in the intestines.

      This is an acute disease, and is ushered in with the usual symptoms of inflammatory fever, accompanied with great pain in the loins, in the situation of the kidneys, extending through the abdomen, and down the inner side of the thigh; there is nausea and sickness. It usually arises from cold, from external injuries, and from the injudicious use of medicines — turpentine, cantharides, nitre, &c. — which act too violently on the kidneys.

      Treatment. – Apply mustard poultices or leeches to the loins. The bowels should be freely acted upon. The warm bath is highly useful, and saline draughts should be given, as Mixture No. 21.

      Active congestion of the liver, ushered in with symptoms of feverishness and a feeling of tension, fulness and weight over the right side. The urine is generally high-coloured and scanty, the motions clay-coloured (from the absence of bile); the patient lies on his right side, as he is then more free from pain. Jaundice frequently accompanies this complaint.

      Treatment. — Hot fomentatrons over the liver should first be tried, and if this does not relieve, a blister or leeches may be applied over the seat of the pain, and the following pill taken: —

Take of Calomel, 4 grains;
             Powdered opium, 1/4 grain;
             Conserve of roses, sufficient to make two pills.

To be taken at bedtime, and followed up by an aperient draught (No. 15) in the morning. A saline mixture, combined with calumba, will also be found beneficial.

      In the chronic form there are many of the symptoms of the acute stage, but in a modified state; the pain in the right side is dull and obtuse, extending to the right shoulder, and occasionally felt between the shoulders. Fever is not always present, but may come on at times. There is nausea, the skin is sallow, the whites of the eycs are tinged with yellow, the patient is much depressed in spirits, the liver is felt hard and large beneath the ribs on the right side, and is tender to the touch. The treatment of the chronic form is to give small doses of calomel, to administer gentle purgatives, and the system should be supported with medicines of a tonic nature.

      The drunkard's, or "hob-nail" liver, is a chronic interstitial inflammation of the liver. It does not admit of cure, but may be relieved under the treatment recommended for chronic congestion of liver. It arises, as its name implies, from abuse in the use of intoxicating drinks, especially spirituous drinks.

      At 3

      Acute inflammation of the liver is rarely met with in this country, being a disease of tropical climates, except as a result of accident, pyaemia or direct irritation in the substance of the liver, such as gallstones or hydatid cysts.

      These organs are subject to inflammation of different kinds; they may be superficially inflamed, or the deep-seated structures may be affected. The symptoms in the former case are redness, pain, a watery condition of the eye or eyes, the feeling as if sand were under the eyelids, and intolerance of light; in this state, the blood-vessels are seen running in a tortuous or zigzag course from the circumference to the centre. The symptoms in the latter case are the same as in the former, only they are much aggravated; there is deep-seated pain in the body of the eye, and in the brow, and a considerable degree of fever; in this state the blood-vessels are much enlarged, and run in a direet line from the circumference to the centre. The tint or appearance of the eye in the former case is as red as scarlet cloth, while in the latter it is blue or violet coloured.

      Treatment. — In the superficial cases of inflammation, particularly if it arises in scrofulous children, little can be done in an active way. Confinement to a darkened room, fomenting the eyes with warm water, clearing out the bowels with jalap and calomel, and bathing the eyes several times a day with the following lotion: —

Take of Sugar of lead, 4 grains;
             White vitriol (sulphate of zinc), 4 grains;
             Weak rose water, 6 ounces; mix.

Make a lotion; a little of it may be allowed to get into the eye while bathing with it. In the deep-seated inflammations, bleeding either by the lancet or by leeches; hot fomentatiOns or cold lotions, according to the feelings of the patient; purging, blisters behind the ears; calomel and opium, say one grain of the former to one quarter of the latter, every four hours until the gums are tender, or a coppery taste is felt in the mouth, when it must be suspended. When the active stage of the inflammation

has passed, lotions of nitrate of silver will be of the greatest service. The following is a good form: —

Take of Nitrate of silver (lunar caustic), 4 grains;
             Distilled water, 1 ounce; mix.

A drop to be put into the eye by means of a camel's-hair brush two or three times a day. In cases of purulent inflammation, that is, when thick matter flows from the eye, and which frequently arises from the application of gonorrhoeal matter in the adult, and in infants from the vaginal discharges of the mother, an excellent application when the acute inflammatory stage has passed will be an ointment consisting of —

Red precipitate, 5 grains;
Ung. Hyd. Nit. (Citrine ointment), 2 drachms;
Lard, 3-1/2 drachms; mix.

A small quantity to be put into the eye every night; the edges of the lids may be smeared with it also.

      A disease of an epidemic character, highly contagious, and extremely violent in its nature. It has the same symptoms as a common cold, but in a much more severe form. It sets in mostly with rigors and fits of shivering, head-ache, frequent sneezing, with increased secretion of mucus from nostrils, watery state of the eyes, cough, hawking of glutinous or glairy mucus from the throat, and a peculiar eruption about the lips; great prostration, loss of strength, and extreme languor are marked features in this disorder, and which are sometimes the first symptoms that present themselves. This epidemic made its first appearance in this country in the 16th century, and has been very fatal in every visitation.

      Influenza may be known from a common cold by the greater severity of the attack, by the extreme weakness which accompanies it, and by its being epidemic.

      Treatment. — In the severe form, where it is accompanied with great debility, it will be necessary to soothe the system with an anodyne, and support the strength of the patient with stimulants and tonics. The following mixture will be found useful in this case, for an adult: —

Take of Solution of acetate of ammonia, 1-1/2 ounce;
             Sesquicarbonatc of ammonia, 1/2 drachm;
             Tincture of henbane, 1-1/2 drachm;
             Spirit of tether, 2 drachms;              Cinnamon water, 4 ounces; mix.

Two table-spoonfuls to be taken three times a day. The patient will require liberal diet, and white or red wine (port).

      In the mild form of this disease the patient will get well without medicinal treatment, if he takes the precaution necessary in a common cold.

      Should the disease be complicated with inflammation of the lungs, bronchitis, consumption, &c., the treatment must be directed to the complication.

      A good saline mixture to be given in cases of fever, inflammation, &c. —

Take of Sweet spirit of nitre, 2 drachms;
             Solution of acetate of ammonia, 2 ounces;
             Ipecacuanha wine, 2 drachms;
             Camphor water, 6 ounces; mix.

Dose. — For an adult, two table-spoonfuls every four hours; children, from onc tea-spoonful upwards, according to age.

Commences in the first place with shivering or rigors. compared to cold water running down the back; there is sore throat with great difficulty of swallowing, more especially when the saliva is swallowed, which, in these cases, is much increased in quantity, so that the patient is constantly expectorating. On examining the throat, the tonsils, which may be seen on either side, will be found red and swollen, and almost filling it; this causes also, at times, great difficulty of breathing; the patient is flushed, has pains in the neck, head, and back; there is thirst, deafness, and the mouth cannot be opened. In severe cases, suppuration takes place, that is, matter forms in the tonsil or tonsils, which either burst or require to be opened by the lancet. In milder cases, after a few

days' febrile excitement, the disease terminates by resolution. Gangrene of the tonsils may occur in very severe cases.

      Treatment. — In mild cases, or at the commencement, mustard poultices may be applied; the throat is to be gargled with warm water, or steamed, that is, by inhaling steam from the spout of a tea-pot, or by placing a funnel over a pewter pot filled with boiling water, and thcn drawing the steam in by the mouth. A brisk purge may be given, for example, half a drachm of the compound jalap powder, with two grains of calomel, to be followed by a black draught (see Black Draught) four hours after. Should the disease continue, it will be necessary to apply leeches to the throat, and to give the following mixture: —

Take of Solution of the acetate of ammonia, 2 ounces;
             Nitric aether, 2 drachms;
             Camphor mixture, to make 6 ounces.

A fourth part to be taken every two or three hours. (These prescriptions are for adults, but the quantities must be regulated according to age and sex.) Warm poultices, made of bran or chamomile flowers with poppyheads bruised and put into a flannel bag, may be placed round the throat. Emetics are very beneficial when there is difficulty of breathing, or suppuration has taken place; in the latter case, the act of vomiting frequently bursts the abscess, when the patient obtains immediate relief (see Emetics).

Are swellings or enlargements about the verge or circumference of the lower end of the bowel. They generally consist of dilated veins, or blood-vessels in a state of inflammation; they may be internal or external, bleeding or otherwise, and they generally depend on some obstruction to the return of the blood to those parts, such as occurs in disease of the liver or lungs, or other organs of the body.

      Treatment. — When thcy are full and throbbing, and attended with great pain, the application of leeches will be found to afford great relief; after which the parts

should be fomented with hot water, and warm poultices of bread and water applied several times a day. The bowels should be kept gently open with castor oil, or by the medicine (Prescription No. 11). When the acute stage is passed, astringent applications and lotions may be constantly applied (see the article Alum). A good ointment, under such circumstances, is the following: — .

      Take of Acetate or sugar of lead, 20 grains;
             Powder of nutgalls, 30 grains;
             Lard, 1 ounce;

mix, and make an ointment, to be applied several times a day. The patient may sit on a hard, twisted towel, or wear the metallic plug, which will afford him great relief.

May result from a variety of causes. It depends on stricture of the urethra or passage from the bladder, as occurs in gonorrhoea or clap; this may be either spasmodic or temporary, or permanent, and is brought on by the follies of youth. In this case, the warm bath is of the greatest service, hot fomentations to the region of the bladder, keeping the bowels open with castor oil, and a table-spoonful of the following mixture every four hours: —

Take of Sweet spirit of nitre, 3 drachms;
             Powdered nitre, 2 drachms;
             Solution of acetate of ammonia, 1 ounce;
             Laudanum, 30 drops;
             Mucilage (gum dissolved in water), 6 ounces.

Make a mixture. It also depends on paralysis, or loss of power of the muscles of the bladder, as occurs in old men and in women after severe labour. In men advanced in years, retention of urine is often due to mechanical obstruction at the neck of the bladder, caused by enlargement of the prostate gland. In these cases, the catheter, to draw off the urine, should be used first, and afterwards the following mixture, a table-spoonful of which may be taken every four hours: —

Take of Tincture of the perchloride of iron, 1 drachm;
             Sweet spirit of nitre, 2 drachms;              Water, 6 ounces. Make a mixture.

      The bowels are to be kept open, and gin and water allowed for drink instead of malt liquors.

Appears to be a disease of a nervous character, and occurs most frequently in females. The amount of danger entirely depends upon the number of muscles implicated. It most often commences as an involuntary twitching of the muscles of the face, and gradually extends to the extremities, and is very seldom if ever seen to affect both sides of the body at one time. All the movements and actions of the sufferer are ludicrous to the beholder. There is a loss of control over the voluntary muscles, so that, if they attempt to do anything, they make many ineffectual efforts before they are capable of accomplishing their wish, and it is in these fruitless endeavours that the ludicrous actions arise. The convulsive movements of the muscles of the face cause the patient to put on a very grotesque appearance, and it is by these ludicrous and grotesque movements or actions that the skilful physician is capable of distinguishing this disease from other diseases in which the brain and spinal marrow are seriously involved.

      It arises from many causes, as fright, worms, constipated bowels, nervous affections, uterine, intestinal, or spinal irritations, &c.

      In its mild form, it admits of cure; when more severe, it admits, if not of cure, of relief; and but little can be done when it is in its most severe form, as it is generally complicated with derangement of the intellect.

      Treatment. — The treatment to be adopted in the first instance is free purging, to rid the system of all crude and indigestible substances; and afterwards, give tonics, as the preparations of iron, zinc, &c., with the occasional use of the shower bath, friction and exercise. A good prescription to be administered in this disease is the following: —

Take of Sulphate of zinc (white vitriol), 1/2 drachm;              Tincture of muriate of iron, 1 drachm;              Simple syrup, 1 ounce;              Water, 5 ounces. Make a mixture.

A dessert-spoonful to be given three times a day, between the ages of five and ten years.

      The severer forms of the disorder require more powerful remedies, which ought to be administered only under the guidance of the family physician.

Is a very painful affection; it either depends on inflammation of the gum or on exposure of the pulp of the tooth to the air in consequence of destruction of its crown. When the nerve is exposed to the air, pain in the tooth is the consequence, which may extend from the tooth along one side of the face and head, even to the side of the neck, in which case it is called "Tic-doloreux." When the pain depends on inflammation of the gum, free lancing will be of the greatest service, accompanied with fomentations of warm water, and aperient medicine. When it results from exposure of the nerve, great relief is obtained from a mixture of equal parts of chloroform and kreosote, a few drops of which are to be put into the hollow of the tooth on a piece of cotton wool, taking care not to swallow the saliva. When these means fail, the tooth ought to be stopped or extracted.

      This complaint generally depends on dyspepsia or indigestion, although it is said sometimes to be unconnected with that disease. It consists in the vomiting, or, rather, eructation of a watery, insipid, tasteless, glairy fluid, arising from the stomach and salivary glands. It attacks all ranks of society and all ages, but is more generally found among the poor and young persons than amongst the aged and rich. It is said to depend on a vegetable or farinaceous diet, and is, therefore, more common in Scotland and Ireland than in England.

      Symptoms. — Pain in the region of the stomach, which feels to the patient as if it were drawn up and bound to the back; this is followed by a rigor, and the eructation of the peculiar fluid from which it derives its name. It is uncertain or irregular in its attacks, is likely to come

on at any time and on all occasions, whether the patient be at his meals or not.

      Treatment. — When the ejected secretion is alkaline, that is to say, when it contains soda or potash in excess, which may be easily ascertained by its turning a piece of litmus paper blue which has been previously reddened in an aeid, say vinegar, or by the taste of the patient, the administration of acids will be the proper treatment, say, from twenty to thirty drops of the diluted sulphuric acid in a wine-glassful of water, or infusion of quassia or gentian, three times a day; when the secretion is acid, which is of course known to the patient by its taste, then you will administer alkalies, say twenty or thirty grains of bicarbonate of soda or bicarbonate of potash in the same infusions three times a day. The bowels must be kept open by rhubarb and calomel, and a mixed diet of meat and vegetables allowed. The pain may be materially relieved by adding to each draught from ten to fifteen drops of the tincture of opium, according to age, always omitting it when the pain ceases. When there is no organic disease, one of the best medicines to give is the compound powder of kino. Dose for an adult, from ten to twenty grains.

      The human body, both internally and externally, is infested with a variety of animals, called worms. These worms, or parasites, are found in the brain, in the eye, the head, the liver, the bladder, and in the stomach, bowels, or alimentary canal. As it is the inhabitants of those latter districts which most particularly concern us, we shall confine our attention entirely to their description.

      Description. — The alimentary canal, or in other words, the stomach and bowels, is infested with three kinds of worms, namely: 1st. The round worm, ascaris lumbricoides; 2nd. The thread worm, ascaris vermicularis; 3rd. The tape worm, of which two varieties are met with in this country, viz., the taenia soluim, or narrow variety, and the taenia media-canellata, a broader variety. In Eastern Europe, a third variety is met with, the Bothriocephalus latus.

      The round worm in shape resembles the garden worm; it varies from six inches to a foot in length, is pointed at both ends, and is of a dirty-white colour. They are male and female, and are very prolific breeders. When very numerous, they creep from the small intestincs, which is thcir peculiar place of residence, through the stomach and into the mouth, and are rejected therefrom by vomiting.

      Thread worms are so called from resemblance to the cut ends of thread; they inhabit the rectum, or lowest part of the intestine, and are more common to children than to adults; they are male and female, highly prolific — thousands upon thousands of eggs being deposited in a very short period of time. When recently passed they arce full of life, and may be seen moving most actively in the liquid motions of children after aperient medicines. When very numerous, they creep out of the rectum on to the child's night clothes in males, and in females they creep into the vagina (private parts) causing the most intolerable itching.

      The tape worm, so called from its resemblance to a piece of tape, is a very long flat worm, of a dirty-whitc colour, and consists of innumerable joints or segments of a square form. This worm is an hermaphrodite, that is to say, it contains in its own body male and female organs of generation, so that it is capable of impregnating itself. It is of immense length, sometimes extending the whole length of the intestines, from the stomach to the rectum (the end of the bowel), and is capable of motion, so as to be felt by the patients who are infested with it.

      General Symptoms. — Pain about the navel, swelling of the belly, wasting of the legs, variable appetite (sometimes bad, sometimes voracious), grinding of the teeth, picking of the nose, itching of the anus, foul breath, troublesome cough, vomiting, and sometimes convulsions.

      Treatment. — The plan to be adopted in the removal of the round worm, will consist in the administration of brisk purgatives and bitters. The purgatives should consist of jalap and calomel, say for an adult, of thirty grains of the former and four of the latter, taken in something thick at bedtime once a week, and a wine-glassful of the following mixture night and morning: —

Take of Infusion of quassia, 8 ounces;
             Tincture of perchloride of iron, 3 drs.; mix.

      For making the infusion, see Prescription No. 38. The doses for persons of different ages must be regulated according to the scale laid down in the book. For children, santonine, given in doses of two to four grains, is very effective for the round worm.

      the plan for the removal of the thread worm will consist in the administration of an occasional purge of jalap and calomel, according to the age of the little patient; but the most effectual plan will be to inject, from an India-rubber bag into the rectum about a quarter of a pint of infusion of quassia, or about two drachms of spirit of turpentine in a quarter of a pint of gruel, or to introduce the finger, covered with a piece of linen, into the rectum, and to scoop them out, in the performance of which no danger need be apprehended, so that the person operating may effectually perform his task without paying any attention to the crying of the patient.

      The plan for the removal of the tape worm will consist in the administration of large doses of turpentine and castor oil (Prescription No. 12), and of an Abyssinian plant, called Kousso.

      The collateral or auxiliary treatment will consist in the administration of good diet. Pork, to persons suffering from tape worm, ought to be forbidden, for measly pork has been proved to generate tape worm; the worm constituting the condition called measles, being the embryo or germ of tape worm in the human subject. No stagnant water ought to be drank, inasmuch as it may contain the germs of animals which, when taken into the human stomach, become developed into beings of a different form. The eating of raw vegetables should be avoided.

      If a person has exposed his hands and feet to a very severe cold, the excitability of these parts will be so much accumulated, that, if they are brought suddenly near a fire, a violent inflammation and even a mortification may take place, which has, indeed, oftcn happened; or, at any rate, that inflammation called chilblain will be

produced, from the violent action of heat upon those parts. But if a person so circumstanced put his hands and feet into cold water, very little warmer than the atmosphere to which he has been exposed, or rub them with snow, which is not often colder than 33 degrees, the morbid excitability will be exhausted gradually, and no bad consequences will ensue. When the hands, feet, nose, or any other part of the body have, therefore, been exposed to violent cold, so as to be frost-bitten, they ought at first either to be well rubbed with snow, or be put into cold water, and afterwards be subjected to warmth in the most gentle and gradual manner. — Dr. Thomas's Practice of Physic.

      The means resorted to for this troublesome and distressing affection are the following: —

      Perfect rest in the recumbent position, exposure of the body to the cool and fresh air on deck, instead of going into the cabin or between the decks, draughts of weak spirit and water, or taking a little wine, or eating two or three raw apples; but the best remedy is a teaspoonful of sulphuric aether in a glass of sherry wine (see AEther).

      Strong impressions made on the mind, such as an alarm of fire on board, or danger of shipwreck, are capable of arresting the progress of this complaint.

      Two centuries ago scurvy was a common disease throughout all the northern countries of Europe. The writers from whom we have derived accounts of it agree in stating that it generally showed itself towards the end of winter, or in the early part of spring, and that it uniformly disappeared during the summer and autumn; but that it was at the close of long and severe winters, or when the country had been laid waste by war, and during long sieges, that its ravages were principally felt.

      As agriculture and gardening improved, scurvy became gradually less frequent, and we have witnessed its almost

complete extinction on land, as the influence of these arts has extended to the most remote parts of Europe, and to the humblest classes. But even in recent times, there are instances in which, under the peculiar circumstances I have specified, it has produced disastrous effects on shore.

      In the spring of 1795 it was very general among the French soldiers in the army of the Alps; and in 1801, during the siege of Alexandria, it prevailed among the inhabitants and garrison to a most frightful extent. During the siege, which was commenced by the English in May, and which lasted only till the end of August, 3,500 scorbutic patients were received into the military hospitals which the French had established in that city. But it is not only in armies and during sieges that we meet with even modern instances of scurvy arising on land. In the reports of the inspectors of prisons for the years 1836-7-8, there is frequent mention of its occurrence in our gaols and prisons.

      These examples are sufficient to show that scurvy is not peculiar to seafaring men; but it is, unquestionably, during long voyages that its fatal effects have been most felt, and its existence, as a prevalent disease, maintained.

      The narratives of all our early navigators abound with descriptions of the frightful ravages of scurvy. Vasco de Gama, who first discovered a passage to the East Indies by the Cape of Good Hope, in 1497, lost a hundred of his men, out of a hundred and sixty, by this distemper.

      Scurvy continued to prevail in all the fleets of this country until the year 1795, when an Admiralty-order was first given for furnishing the navy with a regular supply of lemon-juice, which had been long known to be a remedy for scurvy, and which some recent experiment had proved to be equally efficacious in preventing it. From this time we may date the extinction of scurvy in the British Navy. It has, indeed, shown itself on several occasions since, especially in some of the expeditions for the discovery of a north-west passage; but it has prevailed only in a slight degree, and has almost always been suppressed by an additional allowance of lemon-juice.

      The gums soon become sore, and bleed on the slightest touch. On examination, they are found to be swelled and spongy, and of a dark red colour, especially at their edges, where they are in contact with the teeth.

      Purple spots appear on the skin, particularly of the legs and thighs; but often, also, on the arms and trunk. These spots, which are sometimes very numerous, are generally small and circular, rcsembling flea-bites; but frequently, especially when the disease is a little advanced, we meet with other spots as large as the palm of the hand, sometimes much larger, in which the skin is of a variegated violet and green tint, and which resemble in every respcct the marks produced by a severe bruise. These bruise-like marks occur without the infliction of any blow, or at least of one sufficient to attract particular attention, and often surround an old scar, or appear on a part which a long time previous has been the seat of some injury.

      In advanced stages of the disease the complexion has a more dingy and somcwhat brownish huc; the gums are more swelled and more livid, forming in some cases a black spongy mass, which completely covers the teeth; the teeth themselves become loose, and frequcntly drop out; and the debility is such, that the slightest exertion, even the erect posture, causes breathlessness and palpitation, and not unfrequently an alarming faintness.

      Treatment. — The essential point is to give, in sufficient quantity, those articles of vegetable food which have been distinguished for their anti-scorbutic qualities. Oranges, lemons, or fruits of that class, if they can be procurcd, should be preferred. The salutary effect of them is extraordinary, and such as would scarcely be imagined by persons who have not witnessed it.

      If the state of the gums be such as to prevent the patient from masticating, he should be kept, for two or three days, on milk diet or on soups, in addition to the anti-scorbutics; at the end of this time, or at the commencement, if the case be less severe, his diet should consist of fresh animal food and vegetables, especially in the form of salads; and, as long as he continues very feeble, wine, porter, or ale should be given.

      This is all the treatment required for the cure of scurvy.

      Bleeding should never be had recourse to, although feverishness or severe pain may seem to render it advisable; it always produces ill-effects, and, in advanced stages of the disease, persons do not survive it.

      Blisters are apt in scorbutic persons to produce mortification, and for this reason we should abstain from their employment.

      Mercury, in every form, should be scrupulously avoided; in every instance it aggravates the disease, and very small quantities have been known to produce a dangerous salivation.

      As, in a subject like the present, particular examples are more impressive than general statements, I have subjoined the details of a case which occurred a few years ago. This case is certainly the worst I have ever met with; but I have chosen it, not on this account, but from its being well adapted to show the circumstances which have the chief influence in producing scurvy.

      A vessel sailed from England on the 26th of August, and arrived at the Mauritius on the 1st of December; she again set sail for England on the 17th of January following, and entered the port of London on the 1st of June. The crew were healthy when they left the Mauritius, and consisted of sixteen persons, of whom eight were before the mast, and formed one mess; the cook, carpenter, second mate, and boatswain, another mess; the captain, the first mate, the owner's nephew (a boy), and the steward, formed the remainder of the crew. Of the eight men before the mast, four died during the passage home, one, near St. Helena, of dysentery, and three, after passing the line, before their arrival in this country,

of scurvy. Of the remaining four, three were brought to the Dreadnought (Hospital Ship) soon after they arrived in port, the fourth was taken to his friends; all these were in a dreadful condition from scurvy, but they all recovered, with the exception of one who died soon after he was brought to the Dreadnought. Of the four who formed the second mess, one was brought to the Dreadnought, and others went to their homes; all werc in a very bad condition. Scurvy showed itself in these men about six or seven weeks after they left the Mauritius, and all of them, except two, had been confined to their hammocks since the latter part of April: of these two, one had been confined to his hammock only ten days; the othcr, though incapable of doing duty, continued to crawl about until they arrived in port. For ten days before their arrival the vessel was worked entirely by the captain, steward, first mate, and boy, who messed together in the captain's cabin, and continued free from scurvy. The weather, during the voyage homeward, was fine; the vessel, a good one; and the work of the men before they became affected with scurvy was not severe. Their diet, after they left the Mauritius, consisted of salt beef or pork, with biscuit and tea, for breakfast; beef two days, and pork one day, alternately, with biscuit for dinner; and, during the first half of the voyage, flour, in puddings, twice a week, and pea-soup twice a week. One glass of grog was given daily to each man nearly all the passage. They had no vinegar, lemon or lime-juice. The salt provisions were of bad quality, but not of the worst; and the diet was as good in every rcspcct in coming home as in going out, yet none of the crew showed any symptoms of scurvy in their passage outward. While in the Mauritius, each man had two pounds of fresh beef daily; but no fruits or vegetables of any description.

      I have since met with an instance in which the crew of a vessel, likewise from the Mauritius, were reduced by scurvy to a condition almost as bad as in the case of which I have given the details. In both instances the disease was owing, in part, to the want of lemon or lime-juice during the voyage; in part, to the circumstance

that, while they remained at the Mauritius, they were unprovided with fresh vegetables or fruits.

      The points which I have endeavoured to establish in the preceding pages are —

      1st. That scurvy, which for a long time has been almost unknown in the navy, is still very common in the merchant ships of this country, especially in those trading with the Mauritius, Australia, China, and the different ports of India.

      2nd. That the symptoms by which this disease may be recognised, are — a pale, sallow, dusky complexion; a listless, desponding manner; swelled and spongy gums, of a dark red colour, and apt to bleed on the slightest touch; purple spots and bruise-like marks, particularly on the legs; and swelling and hardness of the calf or ham, with stiffness and contraction of the knee-joint.

      3rd. That scurvy is not attributable to the use of salt meat, to sea air, or to any marine agency, but that it is occasioned by prolonged abstinence from succulent vegetables or fruits, or their preserved juices, as an article of food; and that by the use of these it may be prevented or cured.

      4th. That probably all succulent vegetables and fruits, which are wholesome, are more or less anti-scorbutic; and that generally those which are the most succulent are the most efficacious.

      5th. That the anti-scorbutic property resides in the juices of the plant, and that it is in some degree impaired by the action of a strong heat; and, therefore, the juices of fruits, as lemons, limes, apples, for sea use, should be kept good by the addition of a certain proportion of spirit, without the aid of heat. That vegetables, for the same purpose, should be preserved in the form of pickles, as in the preparation of sour-krout.

      6th. That no vessel should be sent on a voyage of several months' duration, without a supply of lemon or lime-juice: and that, on the arrival of a vessel in port after a long voyage, the captain should, if possible, provide his men with fresh succulent vegetables or fruits.

      In addition to what has been already said on the treatment of scurvy, we subjoin Dr. Beaumont's table of the mean time of the digestion of different kinds of meat.

      [The extent of this little work precludes the possibility of our inserting the whole of Dr. Budd's admirable Treatise on Scurvy; but we hare selected (with his permission) for insertion, the Symptoms and Treatment of that disease.]

      In presenting the following treatise to my readers, it is my intention merely to give a brief outline of the causes of the premature decay of the teeth, and to endeavour to give, as far as possible, recommendations for the prevention of the same.

      In infancy, the first teeth make their appearance about the sixth month, and a child is supposed to have his complete set of temporary or milk teeth by the time he has attained the age of two years; the number of the temporary teeth being twenty. About the sixth year the child begins to shed his first or temporary teeth, and the permanent teeth now make their appearance, and go on appearing until nearly the twentieth year, when he is then supposed to have completed his set; the number of the permanent teeth being thirty-two.

      It will be observed, therefore, that man has two sets of teeth: firstly, the temporary or milk teeth; and secondly, those which are to last him the remainder of his days, or permanent teeth.

      The use of the teeth consists in the preparation of the food (by trituratiOn and mastication) for its reception into the stomach, and unless the food is properly and thoroughly masticated or chewed, it passes into the stomach in large pieces, producing pain and many other symptoms of indigestion. It is this which overworks the stomach, and lays the foundation of disease, and, therefore, on this account alone, we should be careful in the preservation of the teeth.

      In a person of healthy constitution, the teeth are generally found sound, and if any attention has been paid to them, of a pearly whiteness; whereas, in persons of an enfeebled and debilitated constitution, although cleanliness has been strictly adhered to, we find the teeth suffering from decay.

      Neglect in cleanliness, abuse in the use of many substances or articles of diet, as sugar, vinegar — especially white vinegar — smoking short pipes, chewing tobacco, and the long-continued use of mercury, induce decay of the

teeth. A spongy state of the gums, arising from scurvy or any other cause, and salivation, cause the teeth to become loose and to fall out.

      Having given you a short account of the important position the teeth hold to health and beauty, I shall now proceed to lay down a few rules for the care and preservation of them, and, at the same time, shall give you several recipes which will be found beneficial in carrying out those recommendations.

      Regularity and evenness of the teeth will depend entirely upon their management in early life. In the commencement of this treatise, I mentioned that man is endowed, during life, with two sets of teeth — the temporary and the permanent teeth. During the time the temporary teeth are being shed and the permanent teeth are making their appearance, great attention should be bestowed on the child. The permanent tooth generally, as it rises out of the gum, pushes the temporary tooth before it; but if, from some cause or other, the temporary tooth should be immovably fixed, it compels the permanent tooth to make its exit in a contrary direction, and irregularity is the result. In this case, extraction of the temporary tooth is the only remedy.

      After the permanent teeth have made their appearance, the first and most important consideration is constant attention to the state of the bowels and digestive organs; and the next, is to keep the teeth constantly clean, and to prevent the accumulation or collection of tartar, which is highly injurious to the enamel of the tooth. For this purpose, the teeth should be washed with water after dinner and before retiring to rest at night. In the morning the teeth should be cleaned with tooth powder.

      Care should be taken in the selection of a tooth-brush suited for the purpose. A hard brush is injurious to the gums; a very soft one is most adapted for gently washing the teeth, and a moderately hard one for cleaning them.

      In cases where the gums recede from the teeth or become spongy, the following recipe will be found useful: —

Take of Tincture of Peruvian bark, 2 ounces;
             Tincture of myrrh, 1 ounce;
             Eau de Cologne, 4 ounces; mix.

One tea-spoonful in a glass of water can be used after dinner and before retiring to rest.

      The following is an agreeable and efficacious tooth powder: —

Take of Powdered myrrh, 2 drachms;
             Powdered Peruvian bark, 3 drachms;
             Powdered cassia, 3 drachms;
             Powdered cuttlefish, 3 drachms;
             Powdered orris root, 4 drachms;
             Precipitated chalk, 1 ounce; mix well together.

      The occasional use of very fine powdered charcoal renders the teeth white, and acts as a disinfectant to the breath. The constant use of camphorated chalk renders the teeth yellow.

      In cases of toothache, a mixture of equal parts of laudanum and chloroform is exceedingly beneficial.

      A decayed tooth should be immediately stopped.

      Treatment of Apparent Death from Cold. Let the body of the person be rubbed with snow, ice, or cold water, and after a time let heat be applied in the most gentle manner; then, if necessary, the means recommended for restoring suspended animation from drowning may be resorted to. Nothing can be morc pernicious than applying heat, either internally or externally, in the first stage.

      Treatment of Apparent Death from Hanging or Strangling. — Remove the necktie from the neck, place the body in the open air, expose the chest, and open a vein in the arm as soon as possible. If necessary, resort to the means recommended in restoring suspended animation from drowning.

      Treatment of Apparent Death from Suffocation by Foul Air. — Let the body be placed in the open air, dash cold water over the face, head, neck, and breast, frequently, and let warmth be gradually applied. If necessary, let the lungs bc inflated according to the directions laid down in the article on Drowning.

      In all cases of suspended animation, as soon as the patient is sufficiently recovercd, and the power of swallowing is restored, a tea-spoonful or two of warm brandy and water, or wine and water, or sal volatile and water, should be frequently given. He should be kept perfectly quiet, and in bed, and a disposition to sleep encouraged, unless in cases of recovery from poisoning by narcotics, such as opium, henbane, &c.

      Whenever infectious disease of any kind makes its appearance, a careful survey should be made of the premises where it exists; enquiry should be made as to the ventilation, drainage, milk, and water supply, and care should be taken to ascertain that the last mentioned is not contaminated by infiltrations from water-closets, dust-bins, manure-heaps, &c. Information should also be obtained as to the number of persons occupying each room, and the means taken for separating the healthy from the sick. If there is insufficient accommodation for the sick, they should be removed to a hospital in one of the public conveyances which are kept especially for the purpose, and the house and all things in it should undergo a thorough cleansing and disinfecting. The Sanitary Act of 1866 provides, amongst other things, for the prosecution of those who –

      1. Use public conveyances while suffering under contagious or infectious disorders.

      2. Knowingly convey such people in any public conveyance.

      3. Wilfully expose themselves in any street, &c.

      4. Knowingly let a house or part in which any person has been suffering from any contagious or infectious disorder, without having had it and all the articles in it thoroughly disinfected.

      5. Knowingly and without notice send out of the house articles of clothing to be washed.

      6. Knowingly mix or wash infected articles of clothing with those belonging to healthy persons.

      In order to prevent the spread of zymotic disease from house to house, it is necessary in all cases to provide for –

      1. Complete separation of the sick and those in attendance from those who are in health.

      2. Disinfection of the sickroom and all articles in it, both during its occupation and after the removal of the patient.

      3. Disinfection of the secretions.

      4. Thorough ventilation.

      In the first place, then, the patient should be moved into a separate apartment near the top of the house, with the nurse who is to be in attendance. All curtains, bed furniture, carpets, &c. should be removed prior to its occupation, and no person should be allowed to enter the room except the medical attendant. Outside the door a sheet should be hung, thoroughly soaked with a solution of carbolic acid, and the nurse should never pass this under any circumstances whatever. All articles of food should be placed under the sheet, and not taken in by the nurse till the servant has gone away. Inside the apartment, disinfection should be carried out by means of sprinkling sulphur on a live coal two or three times a day, and wafting the fumes all around, till sneezing and a feeling of suffocation are produced. By the bedside a basin should be placed for the patient to spit into, containing a solution of carbolic acid. Rags should be used for wiping the nose, &c., and should be burnt immediately afterwards. All soiled bed-linen should be placed in a solution of the acid as it is removed. Discharges from the bowels and kidneys should be disinfected by the same means; and all plates, dishes, glasses, &c. should be washed in boiling water, and thoroughly cleansed with Condy's fluid or chloralum before leaving the room. As soon as the patient is perfectly recovered, he should wash the body thoroughly over with carbolic acid soap. He should then pass out of the door quite naked, and wrap himself in a fresh blanket, which has been left on the outside. In this way he may pass into another room and dress, and then he may safely mix with the other members of the household. The nurse should act in the same way; but before leaving the room she should see that all the linen articles are placed in a solution of carbolic acid, and that the other things are hung upon lines, in order that

they may undergo a thorough fumigation. She should next place an old saucepan, containing some hot coals and sulphur, in the middle of the room, and then make her exit, taking care to close the door after her. At the expiration of twenty-four or forty-eight hours, the windows should be thrown open, and disinfection may be said then to be complete.

      These rules should be carried out in the case of all infectious diseases; but certain other precautions are necessary to be adopted peculiar to the particular disease we are called upon to treat. For instance, in the case of scarlet-fever, as soon as the eruption begins to fade, or as soon as there is the slightest appearance of peeling, the patient should be thoroughly oiled with carbolised oil all over, night and morning, for three days. He should then have a warm bath on going to bed, and the same process should be repeated at the same interval of time till all signs of peeling have disappeared. When the skin is perfectly clear, he may, after taking a bath, pass, in the manner directed, into another room and dress, and then mix with the other members of the household.

      The chief thing to fear in these cases is the thin skin which peels off from the various parts of the body, and floats about imperceptibly in the air. The oiling process and disinfection, if strictly attended to, entirely prevent the spread of the disease.

      In order to prevent the spread of small-pox, it is necessary, on its very first appearance, to vaccinate all in the same house, and, if other cases occur, all in the neighbourhood. The patient should not be allowed to leave his room till all appearance of suppuration has passed away. All articles of bed furniture and clothes that have been worn should be burnt as soon as the case is well. Keeping the apartment dark is of great use in lessening the formation of matter, and so the spread of the disease. Ventilate freely.

      In enteric fever, the chief thing one has to do is to see that the secretions are thoroughly disinfected, for it is by this means chiefly that the disease propagates itself. Care must be also taken whenever there is the slightest tendency to a relapse.

      In cholera, it is the breath, vomit, and stools that are so particularly infectious; but the disease spreads mostly by the drinking of contaminated water. The stools, therefore, should be thoroughly disinfected, and care should be taken that they are not thrown into any place where they are likely to come in contact with the drinking water.

      Acids. — Exhibit freely alkalies, as magnesia or its carbonate, in milk or water, lime water, chalk, or, in their absence, whiting, scrapings from walls, &c. Oil or soap and water are useful.

      Aconite. — See Tobacco. Belladonna and subcutaneous injection of atropine strongly recommended.

      Alcohol. — Use the stomach pump and emetics; afterwards apply cold affusion to the face and neck, with warmth to the extremities. The internal use of ammonia, as also artificial respiration or galvanism, may afterwards be required.

      Alkalies. — Use diluted acids, as vinegar or lemonjuice. Give oil and milk.

      Ammonia. — See Alkalies.

      Amyl., Vapour of Nitrate of. — Give plenty of fresh air at once, unloosen the clothes at the neck, maintain the recumbent position, and give tea or coffee. In extreme cases use artificial respiration.

      Aniline. — See Nitra-Benzole.

      Antimony and its Salts. — In poisoning by Tartar Emetic, promote vomiting at once by demulcents and frequent draughts of warm water or milk. Afterwards give infusion of tea, nut-galls, cinchona, or tannin. Opium is required to check diarrhoea. If poisoning occurs from sesquichloride of antimony, at first proceed as in cases of poisoning by the mineral acids and afterwards give tannin as above.

      Arsenic and its Compounds. — Use the stomach pump at once, and excite vomiting by the usual means. Exhibit magnesia, charcoal, in half-ounce doses, or the hydrated sesquioxide of iron.

      Atropia. — See Belladonna.

      Barium and its Salts. — Use the stomach pump and give the sulphate of magnesia or soda.

      Belladonna. — Use emetics and the stomach pump. Exhibit alkalies, as magnesia or lime water, or charcoal. Stimulants and cold affusion may be required. Ammonia may be breathed by the lungs. In very extreme cascs the extract of Physostigma. (Calabar bean) may be subcutaneously injected in doses of 1/4 grain, but this remedy should be used with caution. Pilocarpine is preferable and antagonistic.

      Benzole. — See Nitro-Benzole.

      Bichromate of Potassa. — Same treatment as for Acids.

      Bismuth and its Salts. — Use the stomach pump, and exhibit emollient drinks.

      Bromine. — See Iodine.

      Cannabis indica. — See Morphia.

      Cantharides. — Excite vomiting at once; give freely linseed tea, albumen of egg and demulcents generally. The use of oil is doubtful.

      Carbonic Acid, and Noxious Gases generally. — Remove the patient quickly into pure air; place him on his back with his head slightly raised; dash cold and hot water alternately on the face and neck, and, if necessary, use artificial respiration. As the patient recovers, use mild stimulants in small quantitics by the mouth.

      Carbolic Acid. — Exhibit freely olive oil, saccharated lime water or plain lime water, and, in absence of these, magnesia or its carbonate. Subcutaneous injection of apomorphia (gr. 1/20.) recommended.

      Chloral. — Empty the stomach by the use of emetics or the stomach pump and proceed as in poisoning by opium. Strychnia (one or two minims of the officinal solution), and physostigma (1/4 grain of the extract dissolved in a little water), are recommended to be subcutaneously injected in severe cases as antidotes.

      Chloroform. — Use the stomach pump. Apply cold affusion, artificial respiration and galvanism to the spine. Let the patient inhale two or three drops of nitrite of amyl. In case of poisoning by vapour expose the patient freely to a current of fresh air. Flip the cheeks, chest, abdomen, and limbs with a wet towel, and use vigorously artificial respiration. If collapse does not yield, an ounce of brandy may be injected into the rectum. Apply ammonia to the nostrils if there be the slightest sign of inspiration. In case of collapse continuing, air may be introduced directly into the lungs by the use of a large catheter passed into the larynx.

      Note. — Artificial respiration should be continued for at least an hour.

      Chlorine, Vapour of, and Chlorides. — Exhibit albumen of eggs, flour and water or oil. Use the stomach pump, and in case of vapour remove into fresh air.

      Chlorodyne. — See Morphia.

      Colchicum. — See Veratrum.

      Conium. — Excite vomiting. Exhibit infusion of galls, tea, &c. Strychnia may be an antidote.

      Copper and its Salts. — Give freely albumen of eggs, milk, wheaten flour mixed with water, as also magnesia or iron filings. Ferrocyanide of potassium in one drachm doses and turpentine have been recommended.

      Corrosive Sublimate. — Exhibit freely and quickly albumen of eggs, milk, alkalies and charcoal; also use gluten or flour of wheat mixed with water.

      Creasote. — Use ammonia and other stimulants, and give oleaginous and mucilaginous fluids and saccharated lime water. If necessary use artificial respiration.

      Cyanide of Potassium. — See Hydrocyanic Acid.

      Croton Oil. — Evacuate the stomach. Use demulcent drinks. Give opium to control the purging and ammonia to support the circulation. Use also in extreme cases warm baths.

      Curare. — Use ligature above wound and suction. Artificial respiration may be required.

      Digitalis. — Use the stomach pump and emetics; also stimulants and vegetable astringent infusions, as tea, &c. Be careful to keep the patient strictly in the recumbent position.

      Elaterium. — See Croton Oil.

      Ergotine. — See Secale.

      Fungi, Poisonous — Give emetics and aperients. Subsequent treatment to be determined by symptoms.

      — Emetics, stimulants, and artificial respiration are to be employed according to symptoms. Atropine is antagonistic.

      Hellebore. — See Croton Oil.

      Hydrocyanic Acid. — Cold affusion over the face and chest should be used at once, and artificial respiration commenced. Give ammonia if the patient can swallow, or apply ammonia to the nostrils. Chlorine water, or, in its absence, weak solution of chloride of sodium or lime, are recommended, and, in absence of either, diluted hydrochloric acid. Atropia may be useful injected subcutaneously.

      Hyoscyamus. — Use emetics and follow with brisk administration of stimulants and purgatives.

      Iodine. — Use the stomach pump, and promote vomiting by use of demulcents containing starchy matter, as arrowroot. If not at hand, substitute albumen of egg or magnesia, lime water or milk. Sulphate of soda has been recommended.

      Lead and its Salts. — Use the sulphates of soda, magnesia, potassa, or alum in solution. Excite vomiting by tickling the fauces or by the use of the sulphate of zinc.

      Lobelia. — See Tobacco.

      Mercury and its Salts. — Proceed as under head of corrosive sublimate; but in cases of poisoning by bicyanide of mercury, the use of albumen is valueless. Irritation and pain may require opium.

      Morphia and Opium. — Use the stomach pump, excite vomiting by tickling the fauces or use of emetics. Exhibit ammonia, magnesia, or charcoal. Dr. Ringer recommends bromide of potassium. Apply the cold douche over the face and chest, and galvanism from the spine through the chest. Rouse the patient by tickling him, flapping the soles and hands with a wet towel, and by walking him about. Exhibit strong tea or coffee, and, in an extreme case, the injection of ten drops of liquor ammonia into the veins has been attended with success. Artificial respiration may be necessary.

      Nitro-Benzole (Essence of Myrbane). — Evacuate the stomach, and proceed as in poisoning by hydrocyanic acid and opium.

      Nitro-Glycerine. — Cold to the head. Ergotine and atropine subcutaneously are to be used, as also cold affusion and artificial respiration.

      Nux Vomica. — See Strychnia.

      Opium and its preparations. — See Morphia.

      Oxalic Acid. — Exhibit by mouth salts of lime or lime water, magnesia, and, in their absence, albumen of eggs, milk, and demulcents of all kinds.

      Phosphorus and its Compounds. — Use freely demulcent fluids, magnesia and emetics, sulphate of copper and turpentine. Oil must be avoided.

      Physostigma (Calabar Bean). — The antidotes to this poison are chloral and atropia subcutaneously injected. Use artificial respiration.

      Picrotoxine (Cocculus Indicus). — Chloral is recommended as the antidote.

      Pilocarpine. — Inject subcutaneously atropine.

      Rabies. — Use a ligature above the lesion, and suction of the wound. Apply lunar caustic, nitric acid, or actual cautery.

      Sav1n. — Use emetics and demulcent drinks, as milk, linseed tea, &c. Opium and warm bath may be required.

      Secale. — Empty the stomach by the stomach purmp and emetics. Use purgatives. Chlorine gas (and in its absence diluted hydrochloric acid) is stated to decompose ergotine. Give stimulants and tannin.

      Silver and its Compounds. — Exhibit chloride of sodium (common salt) or alkalies, and use the stomach pump.

      Snake-Bite. — As in Rabies, administer ammonia.

      Stramonium. — See Belladonna.

      Strychnia. — Evacuate quickly the contents of the stomach. Benefit might be obtained from the use of astringents as tea, coffee, or infusion of galls. Alkaline bicarbonates, conia, ether, and turpentine may be used. Inhalation of the nitrite of amyl or its subcutaneous injection are useful. Narcotics and chloral are required to check the spasms. Calabar bean in state of extract (1/4 grain dissolved in small quantity of water) subcutaneously injected is recommended.

      Tobacco. — Use the stomach pump and warmth. Exhibit vegetable astringents, vegetable acids, and stimulants. Apply artificial respiration if necessary.

      Turpentine. — Use demulcents and sulphate of magnesia.

      Veratrum. — Use the stomach pump, and exhibit freely tannin and astringent drinks, as hot tea and coffee, with demulcents and stimulants. Maintain recumbent posture.

      Zinc, Chloride of. — In case of poisoning by the chloride (Burnett's solution) use demulcents as linseed tea, milk, &c. Give also emetics. Vegetable astringents are recommended, and opium may be required to allay pain.

PRESCRIPTIONS.

      In addition to the numerous Prescriptions already contained in the body of the book, we here subjoin a few others, which may be always consulted with advantage, as well as several formulae or modes of preparing the various remedies, recommended in the foregoing pages for the cure of disease.

      No. 1. Form of a good Emetic Powder: –

Take of Ipecacuanha powder, 1 scruple;
             Tartar emetic, 1 grain; mix.

This may be taken in a little water.

      No. 2. Form of a good Cathartic Powder: –

Take of Calomel, 4 grains;
             Compound powder of jalap, 1/2 drachms; mix.

This is an excellent purgative in bilious affections and confined bowels. It should be taken in something thick.

      No. 3. Form of a good Astringent Gargle, for spongy gums and ulcers in the mouth, and adapted for those suffering from scurvy: –

Take of Muriatic acid, 1/2 drachms;
             Barley water, 7 ounces;
             Honey of roses, 1 ounce.

Make a gargle, to be used frequently.

      No. 4.

Take of Alum powder, 2 drachms;
             Common salt, 2 drachms;
             Diluted sulphuric acid, 30 drops;
             Common water, 8 ounces; mix.

To be used frequently.

      No. 5. The following is a good application for Chapped Nipples, to which women are very subject in child-bed: –

      Take of tincture of catechu, 1 ounce. The nipple is to be painted over with this remedy by means of a camel's-hairbrush, after each time of the child's sucking, the nipple being previously dried.

      No. 6. Mode of making a Carrot Poultice: –

      Take of carrot roots, any quantity, boil them in water until quite soft, strain off the water, and mash them up into a pulp, and add a little oil to prevent the poultice getting hard. This is a good application to malignant and offensive sores.

      No. 7. Mode of making a Mustard Poultice: –

      Mix together equal parts of mustard and linseed meal, then add a sufficient quantity of vinegar to it to make it a proper consistence, and spread it on linen to the depth of half an inch. This poultice is an excellent application to the feet, or calves of the legs, in low fevers, in the stupor which takes place after large doses of opium, in apoplexy, or in any case where a stimulating effect on the body is required to be produced.

      No. 8. Form of a good Tooth Powder for scurvy and sponginess of the gums, and ulceration of the mouth: –

Take of Powdered catechu, 1 part;
             Finely powdered charcoal, 6 parts.

Make a tooth powder.

      No. 9. Form of a good Mixture to allay Sickness in Pregnancy: –

Take of Infusion of calumba, 5 ounces;
             Compound tincture of cardamoms, 4 drachms;
             Tincture of cinnamon, 2 drachms;
             Syrup of orange peel, 2 drachms;

make a mixture. Two table-spoonfuls to be taken every four hours.

      No. 10. Form of a good Astringent Mixture in Bowel Complaint:

Take of Prepared chalk, 3 drachms;
             Aromatic confection, 1 drachms;
             Tincture of opium, or chlorodyne, 1 drachms;
             Tincture of catechu, 3 drachms;
             Tincture of cardamoms, 4 drachms;
             Peppermint water, 6 ounces; mix.

Two table-spoonfuls to be taken every three hours until the relaxation ceases.

      No. 11. Form of a gentle Aperient Mixture for pregnant females, and sufferers from Piles: –

Take of Rochelle salts, i ounce;
             Manna, 6 drachms;
             Compound tincture of lavender, 1/2 ounce;
             Cinnamon water, 6 ounces; mix.

Three table-spoonfuls to be taken occasionally in the morning.

      No. 12. Form of a good Draught for expelling Tape Worm: –

Take of Castor oil, it ounce;
             Spirit of turpentine, 1/2 ounce; mix.
             This draught to be taken occasionally in the morning; Or,
             Liquid extract of male fern, 1 drachms;
             Mucilage of acacia, 1 ounce.

To be taken early in the morning, a dose of castor oil having been taken the previous night.

      No. 13. Form of a good Night Draught to be takcn at bedtime, always premising that the bowels are open: –

Take of Tincture of opium, 25 drops;
             Sweet spirit of nitre, 1-1/2 drachms;
             Syrup of saffron, 2 drachms;
             Camphor julep, 1-1/2 ounce; mix.

      No. 14. Form of a good Emetic Draught for ordinary occasions: –

Take of Antimonial wine, 2 drachms;
             Powdered ipecacuanha, 1 scruple;
             Water, 1-1/2 ounce;

Make a draught. After taking an Emetic the patient should drink warm water freely until sickness is induced.

      No. 15. Form of a good Aperient Draught: –

Take of Senna tea, 1-1/2 ounce;
             Epsom salts, 3 drachms;
             Tincture of senna, 2 drachins; mix.

This draught to be taken in the morning.

      No. 16. Mode of making Solution of Acetate of Ammonia: –

Take of Carbonate of ammonia, 2 ounces;
             Distilled vinegar, 4 pints.

Dissolve the ammonia in the vinegar, and when the effervescence ceases, put the stopper in the bottle. May be bought of all chemists ready prepared.

      No. 17. Form of a good Draught in Retention of Urine: –

Take of the Tincture of perchloride of iron, 12 minims;
             Tincture of henbane, 20 drops;
             Common water, 1-1/2 ounce.

Make a draught, to be taken every quarter of an hour until the water flows freely.

      No. 18. Form of a Diuretic and Purgative Powder, which is very serviceable in dropsy: –

Take of Powdered jalap, 1/2 drachms;
             Powdered squills, 6 grains;
             Foxglove powder, 6 grains;
             Ginger, 1 scruple;

mix, and divide into ten powders; one to be taken night and morning.

No. 19. Take ofCream of tartar, 1 drachms;
             Powdered squills, 2 grains;
             Powdered ginger, 4 grains;

Make a powder, to be taken every eight hours.

      No. 20. Form of a Pill to be given in Discharge of Blood, arising from consumption or other causes: –

Take of Acetate of lead, 10 grains;
             Powder of foxglove, 10 grains;
             Opium, 3 grains;
             Mucilage of gum, as much as will be sufficient;

mix, and divide into ten pills; one to be taken every six hours while the bleeding continues.

      No. 21. A Fever and Opening Mixture:

Take of Epsom salts, 1 ounce;
             Antimonial wine, 2 drachms;
             Solution of acetate of ammonia, 6 drachms;
             Sweet spirit of nitre, 2 drachms;
             Camphor mixture, 5 ounces; mix.

Two table-spoonfuls every four hours.

      No. 22. External Application: –

Take of Camphor, 1 scruple;
             Strong mercurial ointment, ounce; mix.

A good application in liver complaint and other diseases in which mercury is employed. About the size of a small nut to be rubbed on the part affected night and morning.

      No. 23. Tartar Emetic Ointment: –

Take of Tartar emetic, 1/2 drachms;
             Hog's lard, 3-1/2 drachms;
make an ointment.

An excellent application in all cases where a counterirritant is required.

      No. 24. Form of a good Powder for expelling Thread Worm: –

Take of Jalap, in powder, 5 grains;
             Powdered scammony, 5 grains;
             Calomel, 2 grains;
             Powdered ginger, 4 grains; mix.

This powder to be taken in honey or jam; age of patient from 8 to 12 years. The doses may be increased or diminished according to the age of the patient.

      No. 25. Black Wash: –

Take of Calomel, 1 scruple;
             Lime water, 1 ounce; mix.

      No. 26. A useful Wash for Weak Eyes:--

Take of Sulphate of zinc (white vitriol), 1 scruple;              Pure water, 8 ounces; mix.

      No. 27. Sir William Watson's prescription for Hooping-cough: –

Take of Tartarized antimony, 1 grain;
             Laudanum, 20 drops;
             Water, 1 ounce.

A tea-spoonful, or a dessert-spoonful, according to age, to be given every or every other evening.

      No. 28. Form of a good Gargle in Quinsy, and other sore throats: –

Take of Diluted muriatic acid, } of each 1 drachms;
             Diluted nitric acid, }
             Syrup of red poppies, 4 drachms;
             Water, 6 ounces; make a gargle.

      No. 29. An excellent remedy in simple cases of Deafness, arising from hardened wax in the ear, in consequence of cold, or from a thickened state of the lining membrane of the ear, in consequence of scarlet-fever or erysipelas, is the following: –

Take of Sulphuric aether, 1 drachms;
             Olive oil, 3 drachms;
mix.

Drop a few drops into the ear affected three or four times a day, afterwards filling the ear lightly with cotton wool.

      No. 30. An excellent Cough Mixture in cases of simple bronchitis, where there is not much fever or acute inflammation: –

Take of Syrup of poppies } of each 1/2 ounce;
             Syrup of squills,}
             Ipecacuanha wine, 2 drachms;
             Nitrate of potash, 1 drachms;
             Tincture of opium, 30 drops;
             Mucilage (solution of gum arabic in water), 6 ounces; mix.

A table-spoonful every four hours if the cough is troublesome.

      No. 31. Infusion of Calumba: –

Take of Calumba root sliced, 1 drachms;
             Boiling water, 1/2 pint;

let it stand two hours, and strain.

      No. 32. Infusion of Gentian: –

Take of Gentian root sliced, 1 drachms;
             Orange peel dried, 1 drachms;
             Fresh lemon peel, 2 drachms;
             Boiling water, 1 pint;

let them stand two hours, and strain.

      No. 33. Liniment of Iodine: –

Take of Iodine, 40 grains;
             Iodide of Potassium, 20 grains;
             Spirit of Wine, 1 fluid ounce; mix.

      No. 34. Iodine Ointment: –

Take of Iodine, 40 grains;
             Lard, I ounce; mix.

These two preparations are the best applications for the removal of goitre or Derbyshire neck.

      No. 35. Diluted Muriatic Acid: –

Take of Muriatic acid (spirit of salts), 8 parts by measure;
             Water, 18-1/2 parts; mix.

      No. 36. Diluted Nitric Acid: –

Take of Nitric acid (aquafortis), 2 fluid ounces;
             Water, 9 fluid ounces; mix.

      No. 37. Diluted Sulphuric Acid: –

Take of Sulphuric acid (oil of vitriol), 2 drachms;
             Water, 22 drachms; mix.

      No. 38. Infusion of Quassia: –

Take of Quassia chips, rasped, 1/2 drachms;
             Boiling water, 8 ounces.

Pour the water boiling on the quassia into a jug which has been previously heated, and allow it to stand for two or three hours, and strain.

      No. 39. Quinine Wine: –

Take of Sulphate of quinine, 12 grains;
             Sherry-wine, 1 bottle.

Dose. – Two table-spoonfuls twice or three times a day. Aperient medicine should be takcn frequently during the time quinine is taken.

      No. 40. A useful Ointment for Broken Chilblains, &c.; –

Take of Yellow wax, 7-1/2 ounces;
             Olive oil, 1 pint; melt together, and while cooling stir in
             Prepared calamine, 71 ounces.

      No. 41. Spermaceti Ointment, a nice cooling ointment for simple dressing: –

Take of Spermaceti, 5 ounces;
             White wax 14 drachms;
             Olive oil, 1 pint;

melt together, and when the wax and spermaceti are dissolved, stir briskly until cold.

      No. 42. Antibilious Pills; –

Take of Powdered socotrine aloes, 2 drachms;
             Powdered jalap, 1-1/2 drachms;
             Calomel, 1 drachms;
             Tartar emetic, 8 grains;
             Powdered ginger, 1/2 drachms;
             Oil of cloves, 10 drops;
             Treacle, sufficient quantity to make four dozen pills.

Dose. – Two at bedtime occasionally.

      No. 43. Female Pills: –

Take of Sulphate of iron, 10 grains;
             Socotrine aloes, 1-1/2 drachms;
             Powdered myrrh, 2 scruples;
             Essence of pennyroyal, 10 drops;
             Treacle, a sufficient quantity to make 50 pills.

Dose. – Two, twice or thrice a day.

      No. 44. Compound Rhubarb Pill for Indigestion, &c.: –

Take of Powdered rhubarb, 2 drachms;
             Powdered socotrine aloes, 1-1/2 drachms;
             Powdered myrrh, 1 drachms;
             Soft soap (white), 1/2 drachms;
             Oil of caraway seed, 10 drops
             Treacle, a sufficient quantity to make 60 pills.

      No. 45. Stomachic Mixture, useful as a "Pick-me-up": –

Take of Aromatic spirit of ammonia, 1/2 ounce;
             Tincture of orange peel, 6 drachms;
             Spirit of chloroform, 3 drachms;
             Tincture of nux vomica, 2 drachms;
             Water to 6 ounces.

      No. 46. Gregory's Powder, for Indigestion, &c.: –

Take of Calcined magnesia, 3 ounces;
             Powdered rhubarb, 1 ounce;
             Powdered chamomiles, 1/2 ounce;
             Powdered ginger, 1/2 ounce; mix.

One tea-spoonful for a dose, one hour before a meal.

      No. 47. Compound Decoction of Aloes: –

Take of Extract of liquorice, 7 drachms;
             Carbonate of potash, 1 drachms;
             Extract of aloes, }
             Bruised myrrh, }of each 1-1/2 drachms;
             Saffron, Water, 1-1/2 pint;

boil all together down to a pint, and strain, then add 7 ounces of tincture of cardamoms. Dose. – One or two table-spoonfuls.

      No. 48. Mixture for Dyspepsia, Acidity, and Debility, useful in convalescence after fevers, &c.: –

Take of Carbonate of ammonia, 1 drachms;
             Bicarbonate of potash, 2 drachms;
             Infusion of calumba, 8 ounces; mix.

One table-spoonful in a little water before each meal.

      No. 49. Dr. Fuller's Mixture for Hooping-cough: –

Take of Sulphate of zinc, 8 grains;
             Extract of belladonna, 7 grains;
             Water, 4 ounces; mix.

A tea-spoonful every four or six hours.

      No. 50. Bismuth Mixture, useful in diarrhoea, especially in consumptive persons: –

Take of Subnitrate of bismuth, 1-1/2 drachms;
             Chlorodyne, 3 drachms;
             Mucilage of acacia, to 8 ounces.

A table-spoonful with or without water every three or four hours.

      No. 51. A good Diuretic Mixture: –

Take of Acetate of potash, 4 drachms;
             Acetate of squills, 3 drachms;
             Spirit of nitre, 3 drachms;
             Tincture of digitalis, 1 drachm             Decoction of broom tops, 1/2 pint.

Take half a wine-glassful three times a day.

      No. 52. Borax and Glycerine for Ulcers of the Mouth and Gums.

Take of Borax in powder, 1 drachms;
             Glycerine, 2 ounces; mix.

Apply to the ulcers occasionally.

      No. 53. White Precipitate Ointment: –

Take of White precipitate, drachms;
             Vaseline, 2 ounces; mix.

Very serviceable for destroying lice in the head, and for eczema of the head.

      No. 54. "Fever Drink": –

Take of Powdered chlorate of potash, 1 drachms;
             Water, 1 pint; dissolve.

An excellent cooling drink in scarlet and other fevers.

      No. 55. Hemlock Bath for allaying irritation of the skin: –

      No. 56. Mustard Bath: –

INDEX.

      Cox's Companion to the Family Medicine Chest and Compendium of Domestic Medicine; Particularly Adapted for Heads of Families, Ship-Captains, Missionaries, and Colonists, With Plain Rules for Taking the Medicines, to which are Added a Plain Description of the Treatment of Fractures and Dislocations, and a Concise Account of Asiatic or Spasmodic Cholera.
  Revised, and Considerably Enlarged, by a Member of the Royal College of Surgeons.
Forty-Eighth Edition.
London: Simpkin, Marshall & Co., 1887.

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