THE FAMILY MEDICAL GUIDE.

Under this head directions will be given for the domestic management of some of the more frequent ailments to which families are subject. Book-doctoring is a very doubtful economy, except where it is made the means of enabling the nurse or the mother to co-operate intelligently with the medical adviser. But there are cases, as among emigrants, or persons residing in remote places in the country, in which medical aid cannot readily be obtained. In such cases, the following papers will be found of great value. A number of specific remedies for various minor ailments will be found appended to the Medical Articles.

HOOPING-COUGH.

Hooping-cough is thought to have been introduced into Europe from Africa, and, like most other complaints, varies much in intensity. It is a highly infectious disease, and grown persons are liable to its influence; but it commonly takes place between the ages of four months and twelve years. It usually begins as a common cough, and is attended with the general symptoms of having taken cold; but in its progress, soon becomes more severe; though, the longer it is discoverable by the hoop, the more favourable it is likely to be. A frequent discharge from the mouth, nose, and eyes, food often rejected, together with large quantities of phlegm, after which the child generally appears pretty well, and eats his food heartily—these are the most common symptoms. When the disease is violent, they become greatly aggravated, especially during the night, and the child will appear almost strangled, becoming livid, and blood often starting from the nose and eyes.

The following is a favourite prescription of the late Mr. Tuckwell, of Oxford, who, for skill in his profession, courtesy of manners, and kindness of heart, has had few equals, and who has left in that University an almost imperishable memory:—

Dissolve one scruple of salt of tartar, in a quarter of a pint of soft water: add to it ten grains of cochineal finely powdered, and sweeten it with lump sugar.

This medicine is also highly recommended in the Lancet. The dose for an infant is a tea-spoonful four times a day; from five years old upwards, a table-spoonful may be taken: but as the paroxysms of this complaint are much aggravated by the resistance of the child to swallow medicine, it is very desirable to abstain, if possible, from giving any internal remedy.

The following embrocation was prescribed by a gentleman, one of the leading practitioners in Oxford; and for spasmodic coughs of all kinds, as well as for inflammatory croup, it is invaluable:—

Two drachms of Tincture of Opium.

Two ounces of Camphor Liniment.

A tea-spoonful to be rubbed in over the throat and chest every night and morning, and cover the parts immediately with flannel. If the chest is loaded with phlegm, an emetic must be given once, twice, or three times a week, as required. Ipecacuanha wine is most suitable, and the dose for a child of four or five years is 2½ or 3 drachms.

During the first stages of this disorder, the patient should breathe an equal temperature, as nearly as it can be managed, not too warm and close, but equal; and when the virulence of the disorder has passed away, the open air (if the weather be mild) may be frequently resorted to; and a change of air, where it is practicable, will often remove at once all remains of the complaint.

The only thing that remains to be mentioned, is the proper diet, which is, indeed, of paramount importance; and for children of even six and seven years of age, ought to be little more than milk and broths. These are nourishing, and more readily digested than meats or puddings. One prevalent error is, that milk engenders phlegm; but this is a mistake. Should the milk be found to curdle on the stomach, a little common salt must be added; or, better still, use asses’ milk, if it is attainable. These light nutriments quickly pass out of the stomach, or if brought out by coughing twenty times during the day (which is sometimes the case), the child will immediately take more with avidity.

If thirst prevails, a little toast-and-water may be given. When taken in time, and treated properly, hooping-cough is scarcely ever fatal, indeed never, as long as the patient is free from fever, or other disease. If the attack, from its length and severity, should cause a loss of strength, health will soon be recruited by a cold infusion of bark, gentle exercise, and pure uninfected air, and dieted with a nourishing broth, made as follows:—

Take three-quarters of a pound of veal, the same quantity of beef, chopped very fine, and simmered for three hours in about two quarts of water. Strain it, and let the invalid drink the clear liquid, hot or cold, as may be most agreeable.

Mixture for Hooping-Cough.

Ipecacuanha Wine 2 drachms.

Carbonate of Soda ½ drachm.

Paregoric Elixir 2 drachms.

Water 1 ounce.

A tea-spoonful or two (according to the age of the patient) may be given three times a day.

TEETHING.

This natural process in a child’s development, usually commences about the third month, though it is seldom till the fifth or sixth that the teeth make their appearance through the gums. The period when the teeth may be expected is indicated by an increased irritability of the infant, the gums become tense, shiny, and swollen; while the excited glands in the neighbourhood pour out so large a quantity of saliva, that it overflows the mouth, causing the infant to drivel, as the nurses call this natural salivation. At the same time the child, as if to relieve the heat and irritation it feels, thrusts its hands into its mouth in the attempt to do what the watchful mother will do for it—scratch the top of the gum with her nail, or, making a rasp of a rough crust, or a proper gum-ring, rub it freely along the top ridge, that, by abrading it of the binding cuticle, the imprisoned gum may have the power to expand. As the only benefit that can accrue from rubbing the child’s gum is the tearing or relaxing this fine but tenacious cuticle, all smooth surfaces, such as coral or ivory rings, are perfectly useless; such instruments to be of any service, should be cut into small diamonds like a fine file, and used frequently by the parent, exactly in that manner. The crust, though serviceable from its roughness, is dangerous from the chance of crumbs breaking off and getting into the infant’s throat. After the irritation and drivelling have continued for some weeks, a white line or a round spot appears on the top of the gum of the lower jaw, and ultimately of the upper; through these white spots the teeth finally burst their way in the following order: the two incisors of the lower jaw are the first to make their appearance, though frequently several weeks elapse between the advent of the first and second; the next cut are the four incisors of the upper, then the remaining two incisors of the lower jaw, one on each side, but not joining. There is now a pause for a short time in the process. The next in succession are the four eye teeth in either jaw, thus completing the infantine set of sixteen teeth. Another pause, usually of some months, succeeds before nature resumes her active operations; when she does, it is to place one double tooth on each side of both jaws, thus perfecting the child’s complement of twenty teeth. When these are shed, and nature completes her office, instead of the first ten she places sixteen teeth in each jaw, thus doubling her first complement, and making the adult set thirty-two. Each tooth as it is formed makes half a circle on its axis, and rising sideways, pierces the gum with the extreme point of its edge, revolving as it rises to the perpendicular.

The diseases that teething gives rise to in infants are very numerous, and the consequences of so natural a process are some of the most remarkable facts connected with the development of the human economy. The disorders excited by difficult dentition are, diarrhœa, convulsions, mesenteric disease, water on the brain, rickets, and remittent fever—all of them to the infant fearfully mortal diseases. Each of these affections, though so different in its locality, and so opposite in its symptoms, is induced by the same cause—long-continued irritation in the gums reacting on the delicate organization of the brain and nervous system. And, as this irritation is caused by the difficulty the imprisoned tooth finds in escaping from the fibrous membrane in which it is enveloped, and making its way through the tightly bound gum, it becomes the duty of the medical man or parent, as soon as the first constitutional disturbance manifests itself, to assist the efforts of nature to effect the escape of the tooth, by dividing the gum and leaving an aperture through which the new-formed tooth may reach its destination. But, as lancing the gums, as the process is called, will be worse than useless unless effectually done, the gums should never be cut unless the tooth can be plainly felt below, and, to be of service, the incision must be carried down to the tooth, or else the unyielding membrane in which it is encased will be undivided, and the child put to the inconvenience of lancing without effecting the slightest benefit. As, however, the irritation commences from the first entrance of the tooth into the gum on emerging from its bony socket, and long before the actual pressure of the tooth can cause the graver mischief, or simply from the increased amount of blood circulating in the parts, it is evident that lancing the gums in so early a stage of formation is not only impolitic, but hurtful.

Another mode of relief, both for the diarrhœa and convulsions that so frequently occur in weakly infants at this period, must be looked for; and that means, in all stages of dentition, from the first to the last, will be found either a source of instant relief or of certain recovery; that remedy is the hot bath, which, in all cases of infantine suffering, is the mother’s best hope, and should be her unshaken reliance. The time a child should be kept in a hot bath should seldom exceed two minutes; and, as the object is to unload some congested organ, or to relieve certain parts of their excess of blood by causing a rapid determination to the skin, the water should be hot enough to produce this effect as instantaneously as possible. When diarrhœa continues in despite of the hot bath, a little magnesia or a few grains of prepared chalk may be given two or three times a day until the excessive action is checked; or if unabated by these means, a few drops of tincture of kino is to be administered, as prescribed for diarrhœa.

SCARLET FEVER, OR SCARLATINA.

When scarlet fever becomes epidemic among adults, children rarely fail of being attacked by it in great numbers, and very frequently sink under it. It is, indeed, rather a child’s disease, and is very contagious amongst children; but is not often communicated from them to adults. This disease begins with the common symptoms of fever, often with languor and disposition to fainting, shivering, sickness, a quick pulse, and pain in the head; there is frequently, very early in the disorder, a stiffness in the muscles of the neck, which is soon followed by some difficulty in swallowing. This affection of the neck should be carefully inquired into, especially in young children; the soreness of the throat being sometimes not complained of in the most severe attacks of the disease, until but little hope remains of any mode of treatment being attended with success.

The fever generally increases in the evening, and is often accompanied with delirium; but some remission takes place towards morning, and perspirations come on. There is no complaint in which delirium is of so little consequence as in scarlatina. On the second or third day the efflorescence (or redness) appears on the skin, and generally first on the face, neck, and breast. Up to this period the disorder is sometimes supposed to be measles, as many of the premonitory symptoms are similar; but scarlatina is readily distinguished by the absence of that hoarse cough, frequent sneezing, and watery discharge from the nose and eyes, which are the constant attendants on the early stages of measles: in this latter complaint also, the skin is covered with a distinct eruption, raised above the skin, leaving it clear and well-defined between the marks,—while in scarlatina, the redness is on the skin, and its appearance seldom produces any remission of fever.

When the complaint is to terminate in health, the fiery redness abates gradually, and is succeeded by a brown colour, when the skin, becoming rough, peels off in small scales, and health is generally restored.

On the contrary, when it is to terminate fatally, the febrile symptoms run very high from the first attack, the skin is intensely hot and dry, the pulse is very frequent but small, great thirst prevails, the redness appears on the second day or earlier, and about the third or fourth is often interspersed with large livid spots, and the patient is cut off about the sixth or eighth day. Sometimes a severe purging comes on, which never fails to prove fatal. No complaint is more arbitrary in its attacks, and none on which, humanly speaking, you can reckon with so little certainty.

To determine to the surface of the body, it will be right to give the simple saline, made as follows:—

Take of

Citric Acid 1½ drachm.

Bi-carbonate of Potash 2 drachms.

Water 7½ ounces.

Simple Syrup ½ ounce.

Spirits of Nitre 2 drachms.

Mix, and take a sixth part every four hours. If the child is very young, give half the dose.

On the first appearance of this disorder, it will be proper to administer an emetic of ipecacuanha powder; and for children of four years of age, seven grains will be a sufficient quantity, and even a repetition of it may be the means of preventing any disposition to diarrhœa (purging). Throughout the whole of this disease it will be advisable to make frequent use of some detergent (cleansing) gargle, which in young children must be thrown into the throat with a syringe.

Detergent Gargle.

Take of

Purified Alum 1 drachm.

Barley Water 8 ounces (half a pint).

Honey of Roses 1 ounce.

Mix, and gargle the throat frequently.

Camphor is a medicine much employed in scarlatina, and with good effect; but more particularly where the pulse is very low, and the redness disappears suddenly from off the skin. In these cases volatiles, the aromatic confection, and wine will be proper remedies—this latter to be given in moderate quantity, according to the age and other circumstances of the patient, and it should be given in the food, which must consist of thin, nutritious aliments, such as sago, arrow-root, barley water with milk, &c., &c., and thin warm barley water, without milk, should be often drunk, in order to induce moderate perspiration.

In a general way, a cordial plan is required throughout the disease; and where the throat is much affected, either with sloughs (discharges of matter), or total blackness, bark is indispensably necessary, however thick and florid the rash, however hot and dry the skin. Bark, in moderate doses (for children of four years of age, six grains of Peruvian bark may be given four times a day), reduces the fever in the milder species of scarlatina, above every other remedy; and in the more malignant scarlet fever, it supports the system until the regular stages of the fever are accomplished, and a perfect crisis is formed. Should it be disposed to act too freely on the child’s bowels, one drop of opium may be added.

An unpleasant turn in the complaint sometimes takes place in a secondary fever, and is often the consequence of administering bark and wine too early, or too liberally, in the milder scarlatina.

As parents and nurses are naturally much alarmed at delirium, it may be well to assure them that there is no disease in which delirium is of so little consequence as in the one before us. In other fevers it seldom comes on until they have arrived at a dangerous height, but it sometimes accompanies scarlatina from the very first day, and many of the patients never fail to be delirious every night, though, excepting this, there exists no other unfavourable symptom from the beginning, and during the illness.

THRUSH, OR APHTHÆ.

This is a disease of the mucous membrane of the mouth, stomach, and bowels; and when severe, may be traced throughout the whole alimentary canal. Though thrush may attack persons at any stage of life, still it is regarded as a disease more peculiarly incident to childhood and infancy; and is generally induced by an abrupt change of diet, or some cause impairing the nutritive quality of the mother’s milk, which produces this eruptive fever in the infant’s digestive organs. The symptoms of thrush are heat, pain, and restlessness, followed by a series of small, raised, white spots, scattered over the mouth, tongue, and lips; sometimes there are but few, at others the whole mouth is studded with them. After a day or two, they enlarge and become distended with a white puriform fluid; the eruption looking like a cross of minute beads: this completes the suppurating or second stage; after which, the vesicles proceed to ulceration, when they burst, discharge their fluid, and degenerate into small flat ulcers, causing throughout, but especially in this the last stage, considerable irritation and pain.

Treatment.—Having, if possible found the immediate cause of the disease, and if an improper food, removed it, the child must be carefully fed on a diet that in no way can irritate the tender and inflamed lining membrane; and, if necessary, a few spoonfuls of beef tea are to be given occasionally as a gentle stimulant. The medical treatment consists in the exhibition of the subjoined powders and mixture, and the employment, each evening, of the warm bath as a sedative to the restless child.

Take of

Grey Powder 8 grains.

Scammony 6 grains.

Rhubarb 3 grains.

Mix and divide into nine powders for an infant from six to twelve months, giving one powder twice a day; into six powders for an infant from one to two years old, one twice a day; and into four powders for a child of three years, to be given in the same manner.

Take of

Mucilage ½ ounce.

Castor Oil 2 drachms.

Syrup 2 drachms.

Mix well in a mortar, and add

Dill Water ½ ounce.

Mix, and give a small tea-spoonful twice a day to an infant from six to twelve months; three times a day to one of from one to two years; and every six hours to a child of three years old. Should the thrush have proceeded to ulceration, the mouth of the infant or child should be washed out by a lotion, made by dissolving a small quantity of alum or borax in water well sweetened with honey; and then, by tying a fold of lint to a piece of stick, and using it as a mop, to cleanse the mouth, having first well wetted it in the lotion.

ITCH.

This cutaneous disease, the result of dirt and insufficient food, is communicated by the merest contact; and as this is a misfortune that any person may be exposed to, by touching in a cursory manner the person of an affected individual, it is necessary to show the means by which, with a day or two’s seclusion, it may be effectually eradicated. The intolerable itching that so remarkably distinguishes this disease, is the consequence of a very minute microscopic insect which burrows under the scarf skin of the hands and body; and all that is necessary to destroy the life of this insect, and of course cure the disease, is to block up the pores of the skin, by rubbing in some stiff simple ointment upon going to bed; use a hot bath in the morning to cleanse the body of the grease, and repeat the ointment again; and so continue the one at night, and the other in the morning till the cure is effected. For long standing cases sulphur or creosote is necessary, but for trifling cases, spermaceti ointment is quite sufficient, the hands being kept greased and gloved both day and night.

ERYSIPELAS.

This disease is an inflammatory affection principally of the skin, when it makes its appearance externally; it is most frequent in its attacks on women and children, and on those of an irritable habit, rather than of a full robust constitution. Erysipelas will sometimes return periodically, attacking the patient once or twice in the year, or even once in the month; and then, by its repeated attacks, it often gradually exhausts the strength, especially if the sufferer be aged, or of a bad habit of body.

This disease is brought on by all the causes that are apt to excite inflammation, such as injuries of all kinds, the external application of stimulants, exposure to cold, and obstructed perspiration; and it may likewise be occasioned by humours generated within the body, and thrown out on its surface. In slight cases where it attacks the extremities, it makes its appearance with a sensation of heat, accompanied by roughness, pain, and redness of the skin, which becomes pale when the finger is pressed upon it, and again returns to its fiery hue when the pressure is withdrawn. There prevails some fever, and the patient is hot, thirsty, and restless. If the attack is mild, these symptoms will continue only for a few days, the surface of the part affected will become dry and yellow, and the scarf skin (or outer skin) will fall off in scales; but this complaint appears more frequently in the form of small vesicles, or blisters, containing a thin fluid. In some instances the fluid is of a different consistency, and instead of escaping when the blister is broken, it adheres to, and dries upon the skin. In unfavourable cases, these blisters sometimes degenerate into very obstinate ulcers, which now and then become gangrenous. This, however, does not frequently happen, for although it is not uncommon for the surface of the skin and the blistered places to appear livid, or even blackish, yet this usually disappears with the other symptoms of the disorder. No remission of fever takes place on the appearance of the vesicles; and when the complaint is not of a dangerous tendency, the inflammation and fever cease gradually without any evident crisis. During these symptoms (fever and inflammation) it will be proper to administer aperient medicines, and nothing, perhaps, suits the purpose better than the old-fashioned black draught. The external application of Goulard’s Lotion will allay heat and irritation very successfully.

As erysipelatous fevers often terminate when profuse perspiration can be induced, the patient must drink freely of tea, bran tea, or warm barley water: and this is a necessary part of the treatment, which must never be neglected. The vesicles must be kept lightly covered with pure, unadulterated wheat flour; where the inflammatory symptoms run high, the diet must consist of light nourishing food, such as sago, arrow-root, bread pudding, and such like things; but in those cases where symptoms of irritation prevail, a more generous diet, such as animal broths, ought to be allowed.

When the attack is mild, the patient must be kept in the house, but need not be confined to bed. Very earnestly impress on the minds of your patients the baneful effects of opening the little watery blisters. An instance of this kind occurred in the writer’s vicinity, followed by the most lamentable and fatal results. The victim was a married woman, about 33 years of age; the blister appeared on the upper lip, and she, not knowing its nature, punctured it; inflammation, delirium, and death quickly succeeded each other, and baffled the skill of two medical men of long experience.

There is another species of erysipelatous inflammation, which usually attacks the trunk of the body, and is vulgarly known as “Shingles.” It consists of a number of blisters extending round the waist. Little or no danger ever attends this species of erysipelas, but much pain is felt darting through the body; and these pains will continue to annoy the patient at times for some weeks after the eruption has disappeared.

SMALL-POX.

This, the most serious of all eruptive diseases, though having many symptoms in common with other affections of this inflammatory class, has some peculiar to itself, and which, carefully observed, will always accurately define the disease, and point out small-pox from every other analogous affection. These distinctive features are the greater heat of the skin, the nausea and sickness that from the first attend it, and the fact that the rash appears on the fourth day of the illness, and not on the third, as in other eruptive diseases. Small-pox usually commences with shivering, pains in the back and head, heat, thirst, nausea, often sickness, a general feeling of languor and debility, quick full pulse, great heat and dryness of the skin, and a white furred tongue. This state continues with the usual febrile symptoms and nightly paroxysms till the fourth day, when a fine papillary rash, like grains of millet seed, breaks out on the face, neck, arms, and breast; in a few hours more extending over the rest of the body. On the fifth day the rash has become more distinct, each papilla has become larger and filled with a transparent fluid, changing its form into that of a vesicle, which, as the disease advances, enlarges with a flat head and depressed centre, the fluid passing from a transparent lymph into a yellowish matter. While this change is taking place, the extremities and the head swell, the head and face often becoming immensely distended, closing the eyes, and giving to the countenance a deformed and unnatural appearance. About the eighth day the maturation of the pustules is completed, and from thence to the eleventh day the declension of the eruption takes place, the pustules burst, the matter is effused, scabs are formed, and the dead cuticle begins, from the twelfth day, to peel off or disquamate, leaving pits in the skin, the consequence of the suppuration having destroyed the fatty matter beneath the cuticle.

As the different stages of the disease are advancing, corresponding changes are taking place in the constitution of the patient; the heat and thirst increase, the pain, restlessness, and anxiety are augmented; the inflammatory and febrile actions keep advancing, rendering the slightest noise intolerable, and causing delirium and a chain of the most dangerous symptoms.

Treatment.—The inflammatory nature of small-pox renders what is called the cooling mode of treatment, in all its details, a duty of imperative importance. For this purpose, the room in which the patient is placed should during the disease be kept dark and cool, and at least once a day thoroughly ventilated by means of a fire in the grate, for a short time night and morning, but especially at the latter period. The room, also, should be frequently purified by sprinkling the floor with chloride of lime, or by the burning of vinegar on a heated shovel. As the stomach is the first organ sensibly affected, and continues more or less disturbed during the whole disease, the treatment should begin by giving the patient an emetic, composed, if an adult, of twenty grains of ipecacuanha and one grain of tartar emetic; and as soon as that operation has ceased, the following powders and saline purgatives are to be employed, giving the mixture every two, and the powders every four hours.

Take of

Epsom Salts 1 ounce.

Mint Water 8 ounces.

Antimonial Wine 3 drachms.

Spirits of Nitre 2 drachms.

Syrup of Saffron 2 drachms.

Mix, and give to an adult two table-spoonfuls for a dose, and to children, according to their age, from a dessert-spoonful upwards. Take of

Calomel 3 grains.

Powdered Antimony 2 grains.

Rhubarb 3 grains.

Jalap 10 grains.

Mix, and make a powder. Give one of such a strength, every four hours to an adult till the bowels are well acted on, when they are to be discontinued; but the mixture is to be persisted in, though less frequently, or in half the dose. For a child from nine to twelve years of age, half of one of the above powders is to be given every four hours, till the same result is effected; and for younger children, each powder of the above strength is to be divided into three parts, and administered as the others. For an ordinary drink, in which the patient should on no account be stinted, lemonade, thin gruel, or cold tea is to be used; all solid food or nutritious aliment must be withheld, the patient kept low, his head cool, and the feet hot.

When the fever runs high, and the head symptoms are severe, it may be necessary to bleed, but if not, a blister is to be laid on the nape of the neck, and perhaps two small ones behind the ears, to relieve the tumefaction of the eyes, and where the want of sleep demands it, a draught at bed-time, composed of fifteen grains of nitre dissolved in two ounces of water, with twenty-five drops of laudanum; or to children, from three to ten drops in a little gruel, according to their ages. Such, in mild or distinct small-pox, is generally all the treatment needed; and even in the aggravated confluent, till the time of disquamation often no other means are necessary.

In cases, however, where the rash, after showing favourably, suddenly recedes from the skin, or only partly comes out, the patient must be put into a warm, or rather hot bath for three or four minutes; and when the pulse falls, and becomes small and feeble, as it becomes absolutely necessary to bring back the rash to the skin, hot wine and water must be given, together with soups, tonics, and stimulants, till the invigorated constitution has power to re-act. Should this not have been called for, a system of careful feeding, aided with wine and bark, must be commenced at the period when nature begins to throw off the dead eruption.

The great object to be observed in the treatment of small-pox, is to keep the patient cool, and on the lowest regimen, till the disquamation begins to act freely on the bowels, and to allay fever by cooling drinks. As soon as the patient is convalescent, the diet should be light, and composed chiefly of farinaceous foods, puddings, custards, &c. The body should be bathed once a week, and the cuticle excited by dry rubbing with a towel, and especial care taken for some weeks to keep children from the contact of the patient, who should for that time take an aperient every three days.

To prevent the face and neck from being pitted, each pock in that neighbourhood should be lightly wetted with a weak solution of lunar caustic, at the period when the pustules are filled with a transparent fluid, while they are yet round, and before suppuration has set in or the tops of the vesicles grown flat—or in other words, at the end of the second stage.

MEASLES.

This is a disease characterized by a species of inflammatory fever, attended with all the symptoms of a severe cold, running at the nose and eyes, sneezing, cough, cold chills, tightness at the chest, languor, lassitude, pain in the back and head, and, in fact, by all the indications of constitutional disturbance and fever; though the sign by which it may be most readily known and determined, is the running of humour from the eyes, and constriction of the chest, with a short dry cough. The great secret in the treatment of measles to be borne in mind, is not to discontinue the treatment with the subsidence of the symptoms, for no disease leaves behind it so many and hurtful consequences; therefore, to purify the system, and save the body of the child from mumps, dropsy, tumours, bad eyes, and many other distressing affections, it is necessary to keep up for some weeks, after the disease is cured, a mild but steady action on the body; give the child change of air, plenty of exercise, and a nutritive but light and stimulating diet.

The symptoms of measles commence with cold chills and flushes, lassitude, heaviness, pain in the head, and drowsiness, cough, hoarseness, and extreme difficulty of breathing, frequent sneezing, defluction or running at the eyes and nose, nausea, sometimes vomiting, thirst, a furred tongue; the pulse throughout is quick, and sometimes full and soft, at others hard and small, with other indications of an inflammatory nature. On the third day, small red spots make their appearance, first on the face and neck, gradually extending over the upper and lower part of the body.

On the fifth day the vivid red of the eruption changes into a brownish hue, and in two or three days more the rash entirely disappears, leaving a loose powdery disquamation on the skin, which rubs off like dandriff. At this stage of the disease, a diarrhœa frequently comes on, and being what is called “critical” should never be checked unless seriously severe. Measles sometimes assumes a typhoid or malignant character, in which form the symptoms are all greatly exaggerated, and the case from the first becomes doubtful and dangerous. In this condition the eruption comes out sooner, and only in patches, and often, after showing for a few hours, suddenly recedes, presenting instead of the usual florid red, a dark purple or blackish hue, a dark brown fur forms on the gums and mouth, the breathing becomes laborious, delirium supervenes, and if unrelieved, is followed by coma; a fœtid diarrhœa takes place, and the patient sinks under the congested state of the lungs and the opposed functions of the brain. The unfavourable symptoms in measles are a high state of fever, excessive heat and dryness of the skin, hurried and short breathing, and a particularly hard pulse. The ordinary after-consequences of measles are, croup, bronchitis, mesenteric disease, abscesses behind the ear, ophthalmia, and glandular swellings in other parts of the body.

Treatment.—In the first place the patient should be kept in a cool room, the temperature of which must be regulated to suit the child’s feelings of comfort, and the diet adapted to the strictest principles of abstinence. When the inflammatory symptoms are severe, bleeding in some form is often necessary, though, when adopted, it must be in the first stage of the disease; and if the lungs are the apprehended seat of the inflammation, two or more leeches, according to the age and strength of the patient, must be applied to the upper part of the chest, followed by a small blister; or the blister may be substituted for the leeches, the attendant bearing in mind that the benefit effected by the blister can always be considerably augmented by plunging the feet into very hot water, about a couple of hours after applying the blister, and keeping them in the water for about two minutes. The first internal remedies should commence with a series of aperient powders, and a saline mixture, as prescribed in the following formularies; at the same time as a beverage to quench the thirst, let a quantity of barley water be made, slightly acidulated by the juice of an orange, and partly sweetened by some sugar-candy, and of which, when properly made and cold, let the patient drink as often as thirst or the dryness of the mouth renders necessary.

Aperient Powders.—Take of scammony and jalap, each twenty-four grains; gray powder and antimonial powder, of each eighteen grains. Mix and divide into twelve powders, if for a child between two and four years of age; into eight powders, if for a child between four and eight years; and into six powders for between eight and twelve years of age. One powder to be given, in a little jelly or sugar and water, every three or four hours, according to the severity of the symptoms.

Saline Mixture.—Take of mint water, six ounces; powdered nitre, twenty grains; antimonial wine, three drachms; spirits of nitre, two drachms; syrup of saffron, two drachms. Mix. To children under three years, give a tea-spoonful every two hours; from that age to six a dessert-spoonful at the same intervals; and to children between six and twelve, a table-spoonful every three or four hours. The object of these aperient powders is to keep up a steady but gentle action on the bowels; but whenever it seems necessary to administer a stronger dose, and effect a brisk action on the digestive organs—a course particularly imperative towards the close of the disease—two of these powders given at once, according to the age, will be found to produce that effect. Thus, two of the twelve for a child under four years; and two of the eight, and two of the six, according to the age of the patient. When the difficulty of breathing becomes oppressive, as it generally does towards night, a hot bran poultice laid on the chest will be always found beneficial. The diet throughout must be light, and consist of farinaceous food, such as rice and sago puddings, with beef tea and toast; and not till convalescence sets in, should hard or animal food be given. When measles assumes the malignant form, the advice just given must be broken through; food of a nutritious and stimulating character should be at once substituted and administered in conjunction with wine, and even spirits, and the disease regarded and treated as a case of typhus. But as this form of measles is not frequent, and, if occurring, hardly likely to be treated without assistance, it is unnecessary to enter on the minutiæ of its practice here. What we have prescribed in almost all cases will be found sufficient to meet every emergency without resorting to a multiplicity of agents. The great point to remember in measles is not to give up the treatment with the apparent subsidence of the disease, as the after-consequences of measles are too often more serious and more to be dreaded than the measles themselves. To guard against this danger, and thoroughly purify the system after the subsidence of all the symptoms of the disease, a corrective course of medicine, and a regimen of exercise should be adopted for some weeks, according to the cure of the disease.

CHICKEN-POX.

This disease, like the Small-Pox, seems to depend on specific contagion, and seldom affects a person but once in his life. The eruption is often succeeded by chilliness, succeeded by flushings, pains in the head and back, thirst, restlessness, and a quick pulse; but at other times, none of these premonitory symptoms are observable. Pustules soon appear, and about the second or third day are filled with a watery fluid, which is never converted into yellow matter, as in the small-pox (to which it bears great affinity); and about the fifth day they usually dry away, and are formed into hard crusts or scabs. No danger attends chicken-pox, but often a good deal of suffering. The small-pox and chicken-pox differ: the eruption of the former is preceded by a fever of a certain duration, while that of the latter is either preceded by none, or by one of uncertain duration; also in the pustules and succeeding scabs appearing much earlier in the chicken-pox than in the small-pox; and in the fluid of the pustules never acquiring the thick purulent appearance, which it always does in distinct small-pox.

Let the patient partake freely of water or cooling drinks, as thirst is always an attendant on the disease, and gentle laxatives should be occasionally given—a tea-spoonful of lenitive electuary, with a little milk of sulphur in it, is all that is generally required; but should febrile symptoms run high, it may be advisable to take two or three saline draughts during the day. The following is a recipe for an excellent saline, to be drunk while effervescing:—Twenty grains of carbonate of soda dissolved in a tumbler containing two table-spoonfuls of water; add two tea-spoonfuls of lump sugar rolled; then put a dessert-spoonful of lemon into a wine-glass (or fifteen grains of citric acid dissolved in one table-spoonful of water). Pour it into the tumbler, and drink it while the effervescence is taking place.

The benefit of this draught cannot be too highly estimated where the stomach is deranged, and there is nausea and faintness, or in cases of fever and thirst.

CROUP.

The Croup is a complaint somewhat similar to the hooping-cough, and to which children only are subject. There are two species of it, the one acute, the other chronic: neither of them often attack children so late as ten or twelve years of age; while they may seize infants newly weaned, and are then the most severe. The cause of this disease is a morbid secretion of thick mucus in the trachea (windpipe), adhering so firmly to its sides as to impede respiration. The quantity and thickness of mucus increasing, gradually lessens the diameter of the part, and if it effects this to a considerable degree, the disease must of necessity prove fatal. The symptoms by which croup is manifested, even to the most uninitiated in the duties of the sick-room, is the peculiar croaking noise made in respiration (from whence it takes its name); and when the disorder is light, there is but little apparent indisposition between the paroxysms, save a certain dulness, and a sense of fear in children of an age to express it.

The fits frequently terminate by sneezing, coughing, or vomiting, and return without any regularity. It is attended with a sharp and shrill voice, and a flushed countenance, which grows livid during the paroxysms. A warm bath should immediately be administered, and an emetic given as soon as possible; say, ten drops of antimonial wine for a child three years of age, and repeated every quarter of an hour until effectual, and according to the age and strength of the patient; a blister should be applied across the throat, the sufferer being made to inhale the vapour of warm water with vinegar in it, and kept nearly upright in bed. A doctor should be procured as soon as possible; and, until his arrival, the foregoing directions may, in most cases, materially influence the physician’s proceedings, and often save life.

Children liable to this disease should be warmly clad, wearing flannel next the skin, and an emetic given upon the earliest appearance of the attack; for remember, this disease requires prompt attention to save life. With care, children usually grow out of it; that is, the constitution will repel the attacks after the tenth or twelfth year.

NETTLE RASH.

This disease takes its name from its being attended by an eruption similar to what is produced by the stinging of nettles. The causes of this complaint are by no means obvious; but it seems to proceed either from the perspiration being checked, or from some irritating matter in the stomach. In all cases, there prevails considerable itching and some heat in the parts affected; and, in some constitutions, a slight degree of fever either precedes or attends the eruption. Its duration seldom exceeds three or four days.

In some cases, Nettle Rash is accompanied with large wheals or bumps, which appear of a solid nature, without any cavity or head, containing either water or other fluid.

Half a tea-spoonful of magnesia, and the same quantity of cream of tartar, mixed in half a tea-cupful of milk, an hour before breakfast, and repeated as required, will be found very efficacious.

Some practitioners have entertained the idea that the humours of the body are never vitiated to such a degree by the nettle rash as to require the use of internal remedies, and that if the irritation could be certainly allayed by external applications, there would be no necessity for any other mode of cure.

As this disorder is very frequent in spring, when a hot sun, with cold winds, prevail, the visitor will hear of a variety of herbs as “never-failing cures” of nettle rash. Among these the nettle itself is the Abernethy of the party, concocted into a sort of tea with a proportion of one-third of ground-ivy infused in it. Although in a chronic form, it is often of rheumatic origin. Nettle rash is never a dangerous malady; but care should be taken to avoid currents of air, for, if it recedes, or, as is the common expression, “driven in,” it produces sickness, and other harassing symptoms.

We have always found, in such cases as these—and, indeed, at most times—that simple remedies, easily accessible, are the most efficacious.

CONSUMPTION.

The persons most prone to consumption, are those of a sanguine or phlegmatic temperament, with long neck, sharp shoulders, narrow chest, slender fingers, clear skin, fair hair, and rosy complexion. The disease usually begins with a short dry cough, followed, after a certain length of time by a gradual loss of strength, lassitude, and great fatigue upon small exertions; the pulse is quick and small, while the cough, at first confined to the day, begins to extend into and through the night; the breathing is hurried, with a sense of tightness at the chest, accompanied with shooting pains; the expectoration at first frothy, becomes viscid, opaque, often tinged with blood; and very copious in the morning. As the disease advances, emaciation takes place, the cough, pain, and difficulty of breathing increase, the face is flushed, the soles of the feet and palms of the hands are affected with a dry burning heat, the tongue, formerly white, now becomes clean and red, the pulse is smaller and quicker, and hectic fever sets in, attended with profuse perspiration; generally occurring twice a day, and, as the symptoms grow more formidable, the appetite usually increases, filling the patient with delusive hopes of recovery. The final symptoms, and those that indicate approaching dissolution, are the setting in of diarrhœa, night sweats, prominent cheek bones, hollow and cadaverous countenance, swollen legs, great emaciation, and curved finger-nails. The expectoration has at the same time altered its character with each stage of the disease; at first scanty and frothy, it becomes opaque and presents a mixture of mucus and pus, occasionally streaked with blood, and finally becomes all purulent, sinking in water, and often combined with irregular pieces of green or yellow substances.

Treatment.—There are three objects to be aimed at in the treatment of consumption; first, to promote the absorption of the diseased matter; second, to subdue inflammation; and, third, to improve the general health. For the first effect, it is the general practice to slightly salivate the system by small doses of calomel and kino, followed by a course of iodine, either in the form of burnt sponge, hydriodate of potass, or tincture of iodine. Inflammation is subdued by small bleedings, two or three times repeated, leeches on the chest, blisters, or the counter-irritation of the tartar emetic ointment. The general health is to be improved by exercise, cold ablutions, and friction every morning, by a light and generous diet, and tonics with the mineral acids. In confirmed consumption, and where all the worst symptoms are in operation, the treatment must depend greatly on the actual state of the patient, though the most ordinary course is comprised in the following means and remedies: counter-irritation over the chest, by the tartar emetic ointment; an opiate at bed-time; and two table-spoonfuls of such a mixture as the following, every four or six hours.

Take of

Tartar Emetic 20 grains.

Infusion of Gentian 6 ounces.

Powdered Nitre ½ drachm.

Mix. Where the sweatings are excessive, or there is spitting of blood with the cough, from fifteen to thirty drops of the elixir of vitriol in a wine-glass of water, is to be sucked through a quill every three or four hours.

No practice is so fatal as the sending a confirmed consumptive patient to a warm climate, or even to remove him to a warmer residence in his own country, as the increased temperature only developes the worst symptoms more rapidly. To a patient only predisposed to consumption, change of scene and climate is highly beneficial; but with the disease on him, it is suicidal. The modern practice of deluging the stomach with rancid fish oil, is a very questionable procedure, as any good that can result from its use must depend upon the amount of iodine or nitrogen the cod liver oil may possess; remedies that can be given in greater quantities, in a much less objectionable way.

In every stage of consumption, but especially in the early part of the disease, the patient should exercise the lungs as much as possible, by drawing deep inspirations of air, and inflating the organ to its fullest extent, and then slowly expiring what he has imbibed, repeating the process for ten minutes at a time, and resuming it four or five times a day. For this purpose he can either stand at a window, on a hill, or wherever the air is pure; when the atmosphere is damp, the air must be drawn through a veil, folded three or four times. This makes an infinitely better respirator than the metallic ones sold in the shops. As the natural stimulant of the lungs is air, no means are so likely to excite absorption of the tuberculous matter, as that which expands every air cell of its structure, and while healthily exercising the organ, stimulates it to increased action. That consumption is curable, is a theory now rapidly gaining ground; but this can only be effected by converting the acute into a chronic disease, and in that form following the admonitions of nature as a guide to the practice; and the most important of these is exercising the lungs themselves.

SCROFULA.

A peculiar condition of the body, in which the healthy vital energy is in a measure in abeyance, where the system is less strong, the body less perfect, the organization less harmonious, and the living power to resist accidents less perfect and capable of resisting those influences of time, air, contagion, and accident, ever at war on the frame of man, and which robust health may rebut and for a time defy, but before which the less perfect organization of scrofula ultimately succumbs. It is to this unnatural weakness of the constitution that we owe many of those diseases and ills that like a scourge afflict mortality; such as consumption, mesenteric disease of the bowels in children, rickets, goître, cretinism, hare-lip, white swellings, and many other local and constitutional maladies; all deriving their origin from this physical and specific weakness of the whole or a part of the human body. Any chronic swelling of the absorbent glands is denominated scrofula, as shown both by the wen in the throat and the white, shiny, and insidious swellings in the knee; yet neither of them is, correctly speaking, scrofula, but merely the local evidence of something we feel and know, but cannot define in the system, couched in the blood, reflected in the want of general nervous energy, and manifesting itself in some local character, to which science gives a name and unprofessional wisdom assigns the disease. The chief characters by which a scrofulous diathesis is known or may be suspected, are a want of perfect bodily symmetry, small, thin, or crooked limbs, a round or pigeon-breast, excessive enlargement of certain organs, broad jaws, low forehead, long neck, and large occiput, great transparency of the skin, with a rosy tint of the cheeks; when the complexion is dark, it is of a dirty, viscid appearance, when fair, unnaturally clear; a bluish ring round the eyes, which though large, clear, and sometimes black, are more generally light blue, with swollen or puffed eyelids, long lashes, upper lips thick and projecting, and the general expression of the countenance voluptuous case, with want of decision and energy; the first teeth are small, subject to decay, and the second white, liable to split, and often become prematurely decayed.

COUGH.

A cough is an effort of nature to relieve the lungs and air passages from any obstruction of mucus, phlegm, pus, or other sources of irritation in the parts. There are, consequently, many varieties of cough, according to the nature and situation of the disease or affection that excites it: as the cough in consumption, that from bronchitis, the stomach cough of children, hooping-cough, &c., beside which there is the common cough of an ordinary cold, which this article especially refers to. The ordinary cough is, in the first instance, generally hard and dry, becoming, after a day or two, more relaxed and attended with free expectoration, which, after passing through some changes of character, as regards quantity, colour, and substance, usually cures itself. When the febrile symptoms that attend a cold and cough are too slight to demand treatment, the best cough mixture that can be taken is one composed of equal parts of the syrup of squills, syrup of tolu, paregoric, and ipecacuanha wine, of which a dessert-spoonful may be given every four hours. When the cough is attended with great difficulty and tightness, a “warming plaster” should be applied to the chest, and the following expectorant mixture, employed to promote relaxation of the parts:—

Take of

Milk of Ammoniacum 6 ounces.

Dover’s Powder ½ drachm.

Mix in a mortar, and add

Oxymel of Squills 1 ounce.

Spirits of Sweet Nitre ½ ounce.

Syrup of Tolu 1 ounce.

Mix. One table-spoonful to be given three times a day, and two on going to bed.

ASTHMA.

Is a functional affection of the respiratory organs, frequently depending on constitutional causes, and seldom the result of organic disease. Asthma generally attacks persons of advanced years, and of a weak and lax system; it is, when not hereditary, often the result of sudden changes of temperature, disorder of the digestive organs, or of mental anxiety. An attack of asthma is usually indicated by a sense of constriction or tightness round the chest, a fulness of the stomach, lassitude, drowsiness, and headache. All these symptoms become more urgent towards evening, accompanied with laborious breathing and difficult expiration, attended at the same time with a wheezing noise in the chest and windpipe at every inspiration. As night approaches a hard dry cough succeeds to these symptoms, while the oppressed breathing and sense of suffocation become so acute, as the paroxysm reaches its climax, that the patient is compelled to spring up in bed, or rush to the open window, from fear of instant suffocation. Asthma generally attacks the patient in the night, and most frequently the severity of the fit endures for three or four hours, usually terminating about two in the morning, when, after a free expectoration of frothy mucus, the symptoms gradually subside, and the patient, after much anxiety and suffering, falls asleep. A succession of such paroxysms occur for several consecutive nights, before the symptoms give way and allow the exhausted patient time to recover his strength and tone.

Treatment.—The first endeavour must be directed to shorten the fit and to relieve the most distressing symptoms: the next, to remove the exciting and predisposing causes. Where the patient is strong and not far advanced in life, an emetic, composed of ten grains of ipecacuanha and one grain of tartar emetic, mixed in a cup of warm water, should be given in the first stage of the attack; followed up for some hours by nauseating doses of antimony and squills, as in the following mixture:—Antimonial wine, one ounce; water, four ounces and a half; tincture of squills, three drachms. Mix; and take a table-spoonful every hour so long as the urgency of the symptoms continues. When the attack is slight, and devoid of the marked features of a paroxysm, and the difficulty of breathing and sense of tightness in the chest are the chief symptoms, much benefit will be derived from taking from five to ten drops of hydrocyanic acid in a table-spoonful of water every two hours, for three or four times.

The asthma of old age, however, must be treated very differently: here, instead of debilitating, it becomes necessary to support and stimulate the patient under the exhaustion of the paroxysms. For this purpose, warmth should be early applied to the body and extremities, by the hot bath or bottles of hot water. The chest and pit of the stomach should be rubbed for a few minutes with hartshorn and oil; hot coffee, or small doses of brandy-and-water, administered occasionally; and the following mixture, according to the age and sex, given in doses of one or two table-spoonfuls every two or four hours, as the state of the patient may demand:—Carbonate of ammonia, one scruple; Dover’s powder, half a drachm; peppermint water, six ounces; mix, and add tincture of squills, spirits of lavender, and sulphuric ether, of each one drachm. When asthma has been induced by a derangement of the digestive organs, it will be necessary to give a dose of castor oil or an alterative pill; while for the shortness of breath and difficulty of breathing that often precedes and follows the full paroxysm, a poultice, composed of equal parts of mustard and flour, and applied warm to the chest for ten or fifteen minutes, will yield considerable relief. As an aperient, two compound assafœtida pills will be found of the utmost benefit, especially to those advanced in life.

BRONCHITIS.

Is now much milder in its attacks, and seldomer met with than formerly, though it still remains a disease of both severity and danger. Acute bronchitis is characterised by general fever, heat of the skin, difficulty of breathing, with hurried and sometimes laborious respiration; a peculiar sense of fulness and roughness of the windpipe, followed by hoarseness, oppression, or pain over the region of the heart, accompanied by a short dry cough. After from six to twelve hours, a secretion of mucus takes place in the trachea and bronchial tubes, producing a wheezing rattling noise as the patient respires; and in consequence of the blood not being freely exposed to oxygen in its passage through the lungs, the lips and cheeks assume an ashy or dusky hue. The pulse at the first is quick and hard, but after a time, becomes full and what is called, soft; but so compressible, that a little extra pressure of the finger will apparently extinguish it. There is at the same time great prostration of strength, considerable anxiety and alarm, with pain in the head, giddiness, and when the symptoms are severe, even delirium.

Bronchitis arises in general from exposure to cold and humid atmosphere; taking cold after violent exertion, or from any of the ordinary causes of cold or sore throat. The hoarseness and dry full sense, experienced in the nose and windpipe, is often felt extending far down the chest, attended with considerable sneezing; and the efforts of a dry hard cough, causing pain both in the chest and shoulders.

Chronic Bronchitis, when arising as a primary disease, presents some or all of the previous symptoms, but in a considerably modified form; the fulness in the windpipe, oppressed and laborious breathing, hoarseness and cough, are, however, the most general symptoms of chronic bronchitis; the expectoration, though after a time becoming more free, is far from being copious, and consists of a discoloured mucus; sometimes of a purulent appearance, at others stained with blood, or streaked with a brick-coloured fibrinous matter. The symptoms are generally exaggerated towards night, when they are attended with increased fever and night sweats.

Treatment of Acute Bronchitis.—In full-bodied constitutions, if the disease be taken in its first stage, bleeding to the extent of eight or ten ounces may be very safely and beneficially employed; but as the debility that attends bronchitis is both great and sudden, unless adopted in the earliest stage, the practice would be highly culpable, as all the physical stamina is required to throw off the collected mucus from the bronchial passages so bleeding; therefore, unless employed early, it can never properly be practised. When necessary, an emetic must be immediately given, consisting of antimonial and ipecacuanha wines, of each half an ounce, or the following powder:—Ipecacuanha 15 grains, tartar emetic 1 grain, mix; to be dissolved in a little warm water and drunk directly, following it up by frequent draughts of warm water. If the first emetic does not operate freely, repeat the same dose within the hour, assisting the action, if necessary, by tickling the throat with a feather. As soon as the vomiting has subsided, apply a blister three inches wide by six inches long, down the centre of the chest, and give a table-spoonful of the mixture below every two hours.

Take of

Distilled Water 6 ounces.

Tartar Emetic 6 grains.

Powdered Nitre 1 scruple.

Dissolve, and add tincture of colomba, 2 drachms—mix. At the same time, between the doses, let the patient inhale the steam of hot vinegar and water, and wear a veil over the face, so as always to breathe through a medium. When the blister has risen and the plaster has been removed, apply a hot bread poultice, which repeat every hour, for two or three times; and finally, dress with violet powder.

When the expectoration changes its character and becomes thick, greenish and ropy, it will be necessary to give stimulating expectorants, to facilitate the discharge; for that purpose, the annexed mixture, in doses of a table-spoonful every three or four hours, is to be employed.

Expectorant Mixture.

Gum Ammoniacum 2 drachms.

Carbonate of Ammonia 1 drachm.

Rub into a powder, then add a tea-spoonful of water; triturate till the whole is rubbed into a smooth creamy paste, when add, by degrees, six ounces of water.

Syrup of Squills 1 ounce.

Tincture of Tolu 2 drachms.

Spirits of Sweet Nitre 2 drachms.

Paregoric ½ ounce.

Should there be much restlessness or want of sleep, 30 drops of laudanum may be taken at bed-time in a little gruel, or added to a dose of the expectorant mixture. Or when the mixture is not necessary, from 10 to 15 grains of Dover’s powder, according to the age and strength of the patient, should be taken an hour before bed-time. It is also necessary to take an occasional aperient, which should consist of two assafœtida pills at night, and a black draught the following morning; or five grains of blue pill, and a dose of Epsom salts, three hours afterwards. The patient should be kept as much as possible in one temperature during the attack; and all lengthened conversation and fatigue strictly avoided. The diet should be light, low, and farinaceous, and consist of eggs, milk, custards, and sago, and tapioca puddings; and only when the expectorant or stimulating stage has been reached, should the drink be anything stronger than gruel. But when the expectorants are indicated, it becomes necessary to give wine, or other stimulants, and support the patient’s strength by a more generous diet.

Treatment of Chronic Bronchitis.—Where the symptoms are severe, the treatment may begin by placing a blister on the throat, and giving the expectorant mixture already prescribed. But in ordinary cases, it will be sufficient to place a large hot bran poultice on the throat and chest, renewing it every three or four hours; and twice a day rubbing the chest and throat with the following embrocation:—

Dissolve, by heat, two drachms of camphor in two ounces of olive oil, and add spirits of sal volatile half an ounce, and at the same time give the expectorant mixture in table-spoonfuls every two hours.

Where there is much loss of rest, and much anxiety, the annexed mixture to be substituted for the expectorant, and taken in doses of two table-spoonfuls every four hours.

Dover’s Powder 1 drachm.

Carbonate of Ammonia 2 scruples.

Camphor Water 8 ounces.

Sulphuric Ether 1 drachm.

At the same time, the steam of hot vinegar and water is to be inhaled, and the patient’s strength supported by a proper and efficient dietary; with all the precautions advised in acute, observed in the management of chronic bronchitis.

INFLUENZA.

A disease which, though unquestionably common to this country from remote time, has only within the last thirty years obtained a distinctive name and character. What the peculiar state of the atmosphere is, that induces or predisposes to this disease, science has not yet discovered, though the external causes, as far as appreciation enables us to form an opinion, appear to be, a long-continued state of humidity, succeeded by sudden heats, or seasons of alternate hot and wet weather, or a long humid autumn followed by a cold and boisterous winter. In these conditions of the climate the disease often becomes epidemic and puts on a protean shape, and, though twenty persons in the same tenement are attacked with it, not two perhaps present the same chain of symptoms, or have been seized in the same way. The first sign of illness in one is a sudden coma, that deprives the patient for some minutes of all consciousness; another falls in a fit, a third is seized with an intense pain on the top of the head, others by fits of sudden heat or cold, by coughing, or pains in the back, chest, or throat; but however varied the commencement may be, or different the general run of symptoms, there are three signs that, taken together, always characterize influenza, and by which it may in every case be at once identified; these are—severe and splitting pain on the top of the head, great and sudden loss of strength, and a rough excoriated sensation in the chest behind the breast-bone, as if the lining membrane in that part was raw.

When influenza comes on gradually, the disease generally puts on the following succession of Symptoms: a sense of cold, lassitude, weariness, cold chills, pains in the back, head, and loins; these symptoms are followed by flushings, weight on the head and a great oppression on the chest, sneezing, the eyes become bloodshot, a thin acrid discharge from the nostrils occurs, with inflamed fauces and throat, followed by a short cough with a thick viscid expectoration, which soon becomes thin, discoloured mucus, mixed with purulent discharge. With these symptoms there is extreme prostration of strength, loss of energy, and great depression of spirits, the pain on the head continuing with unabated violence. The pulse, which at the beginning was quick and small, becomes, as the disease progresses, sharp, weak, and irregular. From the first the appetite has failed, the tongue furred, and the stomach in a state of nausea and often irritated to vomiting. The discrepancy in the state of the pulse in influenza generally renders it an insecure guide to a knowledge of the heart’s action by the number or the frequency of the beats; the only true test of the vital strength of the patient is, the amount of pressure by the finger the pulse will bear. Influenza, if not speedily cured, is very prone to degenerate into bronchitis, pneumonia, pleurisy, or some chronic thickening of the mucous membrane of the throat, or enlarged tonsils.

Treatment.—The foremost point to be remembered in the treatment of this disease is, that the great debility is real, not a prostration dependent on nervous pressure, but a bonâ fide loss of vital power; consequently, bleeding, strong relaxing medicines, or blisters, are, except in very rare cases, highly injurious, and more likely to kill than cure the patient; the treatment therefore required is more a course of judicious dietary than one of physic. The medicinal means must consist of the following mixture and pills, keeping the feet hot by hot bricks, or bottles of water, and a hot bran poultice applied frequently to the neck and chest.

Take of

Powder of Compound Tragacanth 2 drachms.

Hot Water ½ pint.

Lump Sugar 2 drachms.

Mix in a mortar, adding the water slowly till a smooth thin mucilage is made of the whole; then add—

Tincture of Tolu 1 drachm.

Ipecacuanha Wine ½ oz.

Spirit of Nitre 6 drachms.

Shake well together, and lastly, add solution of acetate of ammonia, 1½ ounce. Mix, and make a 12 ounce mixture: of which let the patient take two large table-spoonfuls every four hours.

Take of

Compound Rhubarb Pill ½ drachm.

Extract of Henbane ½ drachm.

Mix, and divide into 12 pills, two to be taken at bed-time every other day.

To support the strength, the food must be of the lightest and most nutritious kind, such as boiled mutton, custards, and sago puddings; and as frequent stimulants are indispensable, claret glasses of warm egg-flip, either made in the usual way with the addition of a little rum or brandy, or egg-sherry must be given, with toast, every two hours. By these means, and the addition of twenty drops of laudanum, at bed-time, to a dose of the mixture, all ordinary cases of influenza may be safely and expeditiously treated to recovery.

BILIOUS COMPLAINTS.

Persons are said to be bilious, when bile finds its way from the small intestines into the stomach, and there, mixing with the digesting food and irritating the coats of the stomach, becomes absorbed into the blood, on which it acts like, a species of poison, producing a constitutional disturbance of more or less severity. The symptoms that prognosticate this kind of malady are intense pains in the head, weight and tenderness of the stomach, nausea and sickness, fœtid breath, a bitter or coppery taste in the mouth and throat, a coated tongue, and a quick sharp pulse. The skin is dry, there is considerable thirst, and also occasional shiverings.

Treatment.—The effect of bile on the stomach should be considered in the light of a chain of symptoms excited by the presence of some foreign or unhealthy substance; and the rational view of the treatment of such symptoms consists in expelling the intruding mischief as quickly as possible; and, as it is always better to make the bile take its natural course of exit—downwards—than urge it out of the system in an opposite direction, the treatment should commence by taking such aperients as will excite the whole alimentary canal, and carry it out of the stomach through the bowels: at the same time avoiding by every means its expulsion by vomiting. To carry off the bile by aperients, and allay the sickness, is in fact, all that has to be done, for when these objects are achieved, every other symptom will, as a natural consequence, subside. As the nausea and headache are the most urgent and distressing symptoms, they are the first to demand relief. A small blister, the size of the round of a wine-glass, should be laid on the pit of the stomach, and a dose of the subjoined effervescing mixture given every half hour; taking advantage of the first lull in the retching to give two of the aperient pills, which are to be repeated every six hours, till their action on the bowels shows that the object for which they were taken has been obtained. For females and persons of delicate constitution, one pill instead of two should be taken as a dose. If the patient is in bed, bottles of hot water should be kept at the feet; and as an after-corrective, the tonic mixture prescribed below, is to be taken twice a day for about a week; at the same time the convalescence will be facilitated, and the tone of the stomach improved, if a little toasted bacon is eaten for breakfast, and a dry biscuit and a glass of stout taken for lunch.

JAUNDICE.

Is the name given to the effect produced on certain parts and secretions of the system by a diseased state of the liver, or whatever cause prevents the bile from finding its natural outlet; and by confining it to the gall-bladder, or the secreting vessels of the liver, causes it to be absorbed into the blood, and, passing into the circulation, gives rise to those symptoms, which constitute what is called jaundice. The word “jaundice” signifies yellow, and is used to designate that impaired state of the liver known by the external signs of a yellow skin, a yellow tinge of the white coat of the eye, and a deep saffron colour imparted to the secretion from the kidneys, while the other alimentary discharges are almost white; these characteristics of jaundice are attended with languor, loss of appetite, sometimes amounting to a loathing of food, disturbed sleep, great avidity both of stomach and bowels, nausea, and often sickness; a heavy bitter taste, that no cleanliness can eradicate, pervades the mouth and fauces, while a dull heavy pain takes possession of the right side, just over the liver, greatly increased by pressure, but which no change of position abates. Attending these symptoms there is always more or less of what is understood as fever: when the disease is protracted, and the bile remains long unremoved from the blood, the skin and eyes darken in their colour, and assume a green aspect, and when still more obstinate of cure, that green becomes of a deep purple or blackish hue, when the disease is called black jaundice.

Jaundice is a very common disease in hot climates, especially to Europeans newly arrived, and, indeed, is by no means rare in this country and the sister island; and though, as we have already said, it may proceed from any diseased condition of the liver, there are many other causes that may induce it, such as pressure on the liver by the formation of tumours, pregnancy, and the presence of gall-stones, though in this latter case the cause is generally easily discovered by the severity, sharpness, and continuance of the pain. Though the remedies employed for jaundice are under all circumstances nearly alike, it is both satisfactory and useful to discover as early as possible what is the immediate cause that, obstructing the bile, has led to its absorption by the blood; as on this knowledge much time may be saved in the treatment, which is remarkably simple, and may be undertaken with the greatest confidence without consulting any medical opinion. In all cases of jaundice, especially when attended with pain, the warm bath is of the utmost importance, as it will afford instant relief; and if the pain and disease proceeds from a gall-stone, the heat of the bath, by expanding the duct in which it is impacted, will almost immediately facilitate its passage, and thus by removing the obstruction, at once remove the cause of the disease.

As remedial means, the adult patient should take one of the following pills three times a day, or one every eight hours, and every second morning two tea-spoonfuls of Epsom salts dissolved in a tumblerful of cold water, with a wine-glassful of dandelion-tea every four or five hours, and continued as long as it is necessary to take the pills.

Pills.

Take of

Camphor 2 grains.

Powdered Opium 2 grains.

Blue Pill 20 grains.

Mix and divide into six pills.

Take of

Dandelion Roots, washed and cut small 2 ounces.

Liquorice Root and Sassafras, of each 2 drachms.

Boiling Water 1½ pint.

Simmer slowly for twenty minutes; strain, and, when cold, give a wine-glassful every four or five hours.

When the obstruction has been removed, and the cure has been effected—as the restoration of the skin and eyes to their natural colour will indicate—it is sometimes necessary to take a tonic for a few days, to restore the tone of the stomach; this will be best effected by taking a table-spoonful of the following mixture an hour before each meal for four or five days:—Infuse 2 drachms of gentian, 2 drachms of carbonate of soda, and 1 drachm of ginger for six hours in a pint of boiling water; and, when cold, giving it in the above doses. To those subject to jaundice, exercise and sea bathing should be vigorously adopted after each recovery, so as to work the system into an energetic and self-supporting condition; for if not excited out of its torpidity, the body is very prone to relapse into its previous torpidity.

BOWEL COMPLAINTS.

These ailments are in all cases symptoms of the effect of other causes, and never occur spontaneously, but are the result of indigestive food or excessive acidity of the stomach, the presence of a large quantity of bile in the small intestines, acrid and misacting medicines, wet feet or exposure to cold; the result of disease in the mucous or muscular coats of the bowels, exposure to miasmata or infectious air, and the inhalation of noxious gases.

1. Bowel Complaint, attended with Sickness and Vomiting.

The vomiting should be first allayed by small effervescing draughts, or wine-glasses of soda-water, with a tea-spoonful of brandy, given every half hour, and a blister the size of a crown piece laid on the pit of the stomach: while for the relief of the bowels the following mixture is to be given in doses of two table-spoonfuls every hour till the relaxation is checked.

Prepared Chalk 1 ounce.

Aromatic Powder 2 drachms.

Sugar 1 drachm.

Peppermint Water 8 ounces.

Mix well in a mortar, and add

Tincture of Kino 3 drachms.

When the bowel complaint is attended with pain or griping in the stomach, 1 drachm of the tincture of assafœtida, and 40 drops of laudanum are to be further added to the mixture, which is still to be taken in the same quantity, and, if necessary, repeated as frequently.

2. Bowel Complaint, the result of Improper or Undigested Food.

Prepared Chalk 1 ounce.

Carbonate of Magnesia 2 drachms.

Carbonate of Soda 1 drachm.

Carbonate of Ammonia 2 scruples.

Camphor Water 8 ounces.

Mix well in a mortar, and add

Tincture of Kino 2 drachms.

Mix and take two table-spoonfuls directly, and one every hour afterwards.

3. Bowel Complaint from Exposure to Cold or Wet.

Infusion of Red Roses 8 ounces.

Epsom Salts ½ ounce.

Dissolve, and add

Diluted Sulphuric Acid 30 drops.

Mix, and take two table-spoonfuls every three hours, and one of the following pills every four hours. Should the skin be dry and hot, give ten grains of Dover’s powder, at bed-time, in a little gruel.

Compound Rhubarb Pill,

Extract of Henbane,

of each one scruple. Mix, and divide into eight pills.

4. Bowel Complaint, attended with Cramps and Spasms.

Apply hot mustard poultices, made with equal parts of mustard and flour, over the bowels, and to the inside of each thigh, and give the following mixture and pills every hour till relief is afforded.

Prepared Chalk 1 ounce.

Aromatic Powder 2 drachms.

Carbonate of Ammonia 1 drachm.

Mint Water 8 ounces.

Mix well, and add

Tincture of Kino 3 drachms.

Sulphuric Ether 1 drachm.

Mix; two table-spoonfuls with one pill every hour.

Camphor 6 grains.

Powdered Opium 4 grains.

Calomel 9 grains.

Extract of Hemlock, enough to make into a mass, which is to be divided into six pills.

5. For the Bowel Complaints of Young Children, the most efficacious and convenient remedy is the tincture of kino, given in doses of 20 to 60 drops, in a little sugar and water, and repeated every hour or two till the relaxation is stopped. When the bowels are disordered from teething, it is best to give an alterative powder every four hours, for two or three times, such as the following for an infant of nine months, increasing the strength according to the age.

Grey Powder 6 grains.

Rhubarb 2 grains.

Scammony 9 grains.

Mix well, and divide into three powders.

When the relaxation has been stopped, it is always advisable to take an aperient pill, in a day or two after, to restore the bowels to a healthy condition. In many simple cases of bowel complaint, a dose of castor oil is the only remedy required, and where resulting from improper food, by its aperient action it both removes the cause and the effect with it. The bowel complaint, or diarrhœa, that occurs as a critical symptom in fever, is on no account to be hastily or injudiciously checked; but when calling for treatment, the mixture No. 4 is the most advisable one to employ for that purpose.

FLATULENCE.

Unless in exceptional cases, such as from ill-cooked food, an excess of vegetable diet, &c., flatulence is always an indication of impaired functional action of the stomach, either proceeding from a disease of that organ or through sympathy with some other part; but by far the greater number of those who suffer from flatulence owe it to a weakened state of the stomach itself, often hereditary, frequently the result of an erroneous dietary, and sometimes from the injudicious habit of over-stimulating; besides these cases, it frequently proceeds from mental anxiety, imperfect mastication of the food, and a close sedentary habit.

Flatulence is often completely cured by strict attention to dietetic rules, such as avoiding for a time all vegetables and fruits, making the breakfast and tea on hard crusts, biscuits, or dry toast, and chewing these for a considerable time before permitting the food to pass into the stomach; at the same time taking as small a quantity of fluid in the way of tea, coffee, or cocoa, as possible, and only sufficient to facilitate the descent of the solid food; meat and bread for dinner, with a sparing draught of cold gin and water, should constitute the meal. The tea should be a repetition of the breakfast, and a supper of biscuit and cheese with a small tumbler of cold spirits and water, the same as that for dinner; a system like this, with exercise, repose on a sofa for half an hour after each meal, and using the flesh-brush night and morning over the chest and shoulders, and especially across the stomach, so as to excite the organ to increased action, will be found to yield the fullest advantage, and in many cases will supersede the necessity of any medicine whatever. When, however, there is much acidity in the stomach, it should be neutralized by a tea-spoonful of magnesia, or half a drachm of carbonate of soda, a short time before any one of the meals, and, when the bowels require it, a compound assafœtida pill at bed-time; the same regimen as to diet being persevered in, as that above. Where the stomach has become seriously enfeebled by a long-continued state of flatulence, it will be necessary, in addition to either of the former plans, to give the organ tone and strength, by employing one or other of the subjoined pills, adopting them in the order in which they stand.

Take of

Sulphate of Zinc 10 grains—powder.

Rhubarb, Powdered 20 grains.

Extract of Gentian, sufficient to make a mass, which divide into thirty pills, one to be taken three times a day.

Take of

Nitrate of Silver (Lunar Caustic) 3 grains—powder.

Quinine 4 grains.

Ginger 6 grains.

Mix well, and add extract of camomile sufficient to make a mass, which divide into twenty-four pills, one to be taken three times a day. When flatulence is attended with a sense of coldness in the stomach, a tea-spoonful of Gregory’s powder, with ten grains of soda, may be taken in a little aromatic water before breakfast each morning.

DYSPEPSIA,

Or indigestion, is that impaired condition of the stomach when the food is only half or imperfectly digested; producing want of appetite, a sense of distension, debility, headache, languor, want of sleep, and all those constitutional symptoms that usually attend an overtaxed and weakened stomach.

Treatment.—To effect a perfect restoration in the tone of the stomach, an entire change in the mode of diet is absolutely necessary, also in the habits and pursuits of the patient: the stomach must first be emptied and slightly stimulated by an emetic, or by a few alterative doses of blue pill and rhubarb, and the system submitted to a regular course of such tonics as infusion of camomile with carbonate of soda, gentian with potass, and, after a time, infusion of quassia with a few drops of muriatic acid. The food should be at first light and simple, and comprise the most solid aliments, and such as will compel a long mastication before swallowing; all drinks or stimulants with the meal being strictly prohibited till the salivary glands yield of themselves enough saliva to macerate the food; and this can only be effected by a long and perfect mastication.

DYSENTERY.

This is a disease more common in hot climates than cold ones, and both in its type and character approaches much more nearly than any other disease, to cholera. Dysentery is either the result of a congestive state of the bowels, or it proceeds from a chronic inflammation of the lining membrane of the colon.

Symptoms.—Dysentery commences with shivering, a griping flatulent state of the bowels, frequent discharges of mucus, or blood and mucus, and often blood alone; with loss of appetite, sickness, fever, and great debility.

Treatment.—When depending on inflammatory action, it is necessary to bleed and give cooling drinks with an emetic. In ordinary cases, the treatment should begin with the warm bath or fomentations, with three grains of calomel, one grain of opium, and three grains of assafœtida pill; the whole made and divided into two pills, which are to be taken every six hours, and a starch injection with assafœtida tincture twice a day. As the symptoms improve, tonics are to be given, at first mild, and gradually increased in strength, and combined with wine and a soft unexciting diet.

DIARRHŒA.

A relaxation or looseness of the bowels, consequent upon a certain condition of the mucous membrane of the alimentary canal; that is, either a state of congestion, or stagnant state of the blood in the membrane; or else from an inflammatory condition of the same tissue; or it may proceed from ulceration of the bowels, the presence of indigestible food, or acrid substances in the stomach; it may also occur as a crisis of fever, and without any direct cause of irritation. The causes that produce diarrhœa are very numerous, and often of the most opposite nature; though the chief are, sudden cold applied to the body, checked perspiration, powerful stimulants, the inhalation of noxious gases, &c.

Symptoms.—Nausea, sickness, and vomiting, thirst, dry state of the mouth and skin, frequent and copious evacuations, and a furred or red condition of the tongue.

Treatment.—The first step in the treatment of diarrhœa is to check the vomiting; to effect this, the feet are to be plunged into hot water and kept constantly warm, and a small blister or one or two leeches applied to the pit of the stomach. The state of the tongue must decide the nature of the subsequent treatment. When this organ is coated either with a white or brownish fur, it indicates a congested state of the membrane of the stomach, and must be treated by the exhibition of an emulsive mixture of chalk, and when the symptoms are attended with pain, by an opiate pill, as in the following prescription.

Prepared Chalk 1 ounce.

Honey ½ ounce.

Peppermint Water 6 ounces.

Mix into a smooth mass, of which give a table-spoonful every hour, and a one-grain powdered opium pill every four or six hours, till the pain is subdued. When, however, the tongue is red both on its surface and sides, it indicates inflammatory action, and must be treated by an opposite mode of practice, and the following mixture administered; the opium, however, being employed when pain is present, in the same form and frequency as in the former state of the bowels.

Infusion of Rose Leaves 8 ounces.

Epsom Salts ½ ounce.

Dissolve, and add diluted sulphuric acid, half a drachm; mix, and take a table-spoonful every hour. In all forms of diarrhœa, the feet should be kept warm, and a hot bath, if procurable, will, in every instance, be found beneficial. The diet should always be soft and nutritious, but not liquid; the best dietary consists of thick arrow-root, made with milk, blanc mange, tapioca, sago, and semolina puddings, made with eggs, and eaten moderately cool; and when animal food is given, it should consist in the first instance of boiled meats, and the stomach very cautiously brought back to digest roast or hard substances.

CHOLERA.

Although Cholera has, by the interposition of Providence, decreased in virulence, and the cases that occur are comparatively few, it is well to incorporate in our medical directions the circular issued by the Royal College of Physicians relative to the treatment of this fatal disease. In any case of sudden emergency, where medical attendance cannot be immediately procured, these instructions will be of the greatest use.

“1. No degree of looseness of the bowels should be neglected for a single hour. Medical advice should be at once sought when the looseness begins; and, previous to the arrival of a medical attendant, some of the medicines at other times used for checking diarrhœa should be taken:—for example, the chalk mixture; the compound cinnamon powder; or the compound chalk powder with opium, in doses from 20 to 40 grains for an adult.

“2. No saline aperients or drastic purgatives should be taken without the advice of a medical man.

“3. Intemperance in eating or drinking is highly dangerous; but the moderate use of vegetable as well as animal food may be recommended, and, in general, such a plan of diet as each individual has found, by experience, to be most conducive to his health; for any considerable change in the diet to which a person has been accustomed, is seldom advisable during the prevalence of an epidemic.

“4. Debility, exhaustion, and exposure to damp, render the poor especially subject to the violence of the disease. The committee urge upon the rich the necessity of supplying those in need with food, fuel, and clothing.

“5. The extreme importance of removing or counteracting all impurities, whether in the air, water, or soil—as by ventilation, cleanliness, and the free use of the chloride of lime or chloride of zinc—cannot be too strongly insisted upon.

“Lastly, since the reports made to the College of Physicians show that of the persons who were engaged about the sick in the last epidemic, the number of those who were attacked by the disease was, in proportion, exceedingly small, the fear of infection may be practically disregarded.”

Nearly every chemist keeps an “anti-cholera mixture” in a state of preparation, during the cholera season. And as these mixtures are prepared from recipes issued by the Board of Health, or by medical men skilled in the treatment of cholera, they may generally be depended upon. The great thing to be borne in mind is to take medicines to check looseness of the bowels before the system becomes exhausted.

FEVER.

Fever is the result of a diseased or impaired action of the system, and though sometimes attending or following certain diseases as a symptom or consequence, most frequently falls on the constitution as a substantive disease, either developing its characteristic symptoms, as the disease advances, or following the slow maturity of a chain of morbid actions. Fevers may, in the first instance, be divided into those which proceed from some indirect or secondary cause, and those that arise from contagion, or causes the direct precursors of fever, having a definite rise, an understood progress, and a well ascertained termination. In the first named class of fevers, are comprised those febrile symptoms that appear during or after some organic disease, accidents, surgical operations, or other causes of physical suffering.

The second, or spontaneous class, is divided into two chief heads—nervous and inflammatory fevers: under nervous fevers are classed typhus, intermittent, continued, and remittent fevers; and under that of inflammatory fevers, first, all eruptive fevers, as scarlet fever, small-pox; and, secondly, the fevers attending all inflammatory actions of organs or viscera, such as inflammation of the liver and bowels.

The general characteristics of fever are cold chills, lassitude, headache, loss of appetite, thirst and nausea, with a moist furred tongue, or else a tongue dry and coated, pain in the back and loins, succeeded by cold shiverings, which gradually give place to heat, diffusing itself over the body and becoming permanent; ringing in the ears, intolerance of light, and cold extremities; the pulse is either small and quick, or full and hard. Special fevers, and constitutional temperament, very much magnify, or even mitigate these symptoms; still those given are the ordinary characteristics, and sufficient to indicate the presence of fever to the least accustomed eye.

The treatment, on the same broad principle, resolves itself into relieving the congested organs, breaking the chain of morbid actions on which fever depends, equalizing the circulation, and lastly, by the adoption of a course of medicinal agents, correcting the vitiated state of the secretions, and restoring the functions to a healthy performance of their several duties. To effect the first it is often found necessary to bleed, or else by leeches, cupping, or blisters, relieve the overloaded organs; the second object is generally effected by an emetic, which in some instances it becomes necessary to repeat. The warm, the hot, or the shower bath, or aspersions of cold vinegar and water, are the means employed to effect an equalization of the circulation, and restore blood and warmth to the surface. The therapeutic means to be employed during the career of a fever, must depend entirely upon the character of the disease to be treated, and will be entered upon more particularly under their several heads.

A remarkable peculiarity belonging to all fevers, is a periodicity of the disease, or a property that all fevers have of arranging their effects into periods of regular sections; as, first, into fits and paroxysms, then into remissions, and finally into critical days. Most fevers have three stages, called the cold, hot, and sweating; in some, these divisions are perfect and distinct, in others, broken and imperfect; these fits following in regular order, comprise a paroxysm, which may return at certain hours or only at irregular periods.

The critical days are regarded as the 3, 5, 7, 9, 11, 14, 17, and 20; and the non-critical days are the intervening ones.

The ages at which persons are most liable to fever, are from 20 to 30, and in the following order, gradually declining from 30 to 40, 40 to 50, and 50 to 60. As respects sex, females are more subject to fever than males, but only in a small degree. All fevers are not infectious, but those that are so are communicated by contact, exposure to the atmosphere surrounding a fever patient, and whatever depresses the mind or weakens the body, predisposes the system to infection. The best preventive against the worst form of fever, is cleanliness, a cheerful disposition, and an active body.

BRAIN FEVER.

Brain Fever is characterized by two distinct epochs or stages—excitement and collapse; and though often distinct and well-defined, it occasionally happens that the one stage is so blended with the other as not to be appreciable, till the graver consequences of the second period evince themselves. The symptoms of the first stage are deep and intense pain in the head, tightness across the forehead, throbbing of the temporal arteries, ringing in the ears, flushed face, bloodshot eyes, and a wild and glistening stare; the pupils are contracted, and particularly sensitive to light, while the ears are impatient and irritable to the sense of noise: violent delirium, want of sleep, convulsive paroxysms, attended with a hot dry skin, hard quick pulse, a white coated tongue, great thirst, nausea and vomiting, and a confined state of the bowels. Sometimes delirium is the first symptom, or the disease may progress to a culminating point in a more insidious manner, often commencing with an apparent attack of biliary vomiting. This formidable disease usually proves fatal in a few days, sometimes in twelve hours.