Nov. 1762.

A dropfical cafe, ble as to his diet. However, I got him gain to make a trial of the feneka-decoc ion; which produced a watery ftool, ometimes two in a day. But, in a thort ime, it began to lote its effects.

His diftemper now increafing, I was inder the neceflity of having recourfe to nore powerful evacuants: but the choice vas difficult, as his ftrength was very nuch exhausted. Having many times ta ten notice of the eafy operation of the itr. antimon, ceratum on people much pent with the dyfentery, I refolved to ry its effects, and gave him three grains; which, in two hours, vomited him two or three times, and procured two very coious tools of almoft pure water. As he ore this well, and feemed rather to get pirits, than be depreffed, after the opeation, I two days after repeated the fame medicine, and increased the dole to fix grains. This did not give him the leaft naufea, but operated fo powerfully and eafily downwards, without gripes, that at three or four motions he filled a large clofe-ftool pan almost full of dirty water, without any excrementitious mixture after the firft. He had a plentiful diaphorefis, and his belly decreased in measure above two inches.

Encouraged by this trial, and finding the anafarcous Iwellings of the fuperior parts giving way, I continued the ufe of this medicine twice a-week for fome time, and ordered him fome good claret between the dofes, as a cordial and corroborant. (for drink of some fort he would have), and to be carried out every fair day in a chaile; and, that nothing might be omitted, I ordered the rubbing the abdomen with oil, according to Dr Oliver's method. In this way he pafled the winter 1756, until the month of February 1757, that I was again called to fee him, (for I lived a great diftance from him), and found his buik, both in the belly, thighs, and legs, greatly increafed, from the month of November when I left him; but the anafarcous fwellings of the head and face, back and arms, had totally fubfided. Now the navel was diftended to the fize of a fheep's bladder fully blown, and extremely painful, from a puncture with a lancet having been made in it fome time before.

Fordveral nights before this, he had not gone to bed, was obliged to fleep in his chair, his breathing greatly oppressed, and indeed was univerfally diftrelled; and, to all appearance, could not hold out many days,irithout fome relief. This,

joined to his own urgent defire, made me refolve on tapping him; and, on the 23d of this month of February, I drew off fortyeight English pints of dirty yellowish wa ter, which were measured, beides fome fpilt in the operation; fo that, in all, there could not be less than fifty.

Though greatly relieved by this vaft load being taken off, vet he quickly began to fill again; iniomuch that, by the 19th of April, I was again obliged to have recourse to the trocar, and drew off the fame quantity of water.

But by the 14th of June he was again to appearance full, when I tapped him for the third time, and drew off thirtytwo pints of water. At every tapping (if I may use the expreffion) I pumped him dry. And here I must remark, that whenever I perform this operation, which I frequently have been obliged to do from the want of a furgeon, I do not confine myfelf to the commonly directed number of inches or fingers breadth obliquely below the navel; I always pierce as low, and as far forward, as with fafety I can, the patient fitting in a chair, and move the trocar fometimes in one direction, and sometimes in another; fometimes drawing it a little outwards, fometimes moving it inwards. By this method, the water is more completely difcharged than by keeping the trocar fixed. Befides, as in the fimpleft afcites there is often more or less of a fubcutaneous collection of water, by gradually withdrawing the trocar, this is ditcharged; and the preffure neceflary in the operation, naturally determines the water to the place where the opening is made. The lets hurry in this operation, as indeed in all others, the lefs danger; for if the patient complains of being lick, or fatigued, ftop the trocar, continue the neceflary compretlion, which I always found best from the hands of sensible afliftants, give the patient a little warm wine, and he will foon recover his ftrength fufficiently to undergo the remainder of the operation. But this is only by way of digreflion from the hiftory of my patient; who, after this laft tapping, appeared rather more chearful and fout than after any of the former, till the third day in the morning, when he began to complain of griping pains about the navel, which wore eff, and he pafled the forenoon with few complaints, eat for dinner, rather more iparingly than ordinary, of reafted veal, and drank fome claret and water. But in the afternoon he complained much of griping

590 A dropfical cafe, pains in his bowels, and particularly all around the navel, and could not fit up. About five in the evening, he was very fick at stomach, made frequent efforts to ftool, but voided nothing; and, about fix o'clock, vomited haftily, and with ease, about fix pints of dirty water, loaded with thick roapy phlegm, as if he had taken a ftrong vomit. He immediately found himself eafier, and I made him drink fome warm water, which he easily threw up again, and feemed quite relieved for two hours; when his complaints of grinding pains returned with double violence: he vomited often to an incredible quanti ty, began to be parchingly hot, reftlefs, and thirsty. I immediately ordered a cly. fler, which came away as clear as given: his griping pains and vomiting ftill continued. I began now to fufpect an iliac paffion, therefore I ordered a fecond clyfter more ftimulating than the former, which came away as the other: in an hour after, a third, to as little purpose. Still the pain and vomiting continued, and next day rather increased; in the evening of which, being Saturday, what he brought up became extremely offenfive, and loaded with excrements. Clyfters were repeated; externally anodynes and aromatics were applied to the ftomach and belly his drink was chicken-broth, which feldom ftaid a minute on his ftomach. Sunday his ftrength failed much, his pulfe intermitted, his countenance was very ghaftly, and he had frequent fits of the hiccup. I ordered a decoction of fix drachms of fenna, with an ounce of cream of tartar, to be got ready, and given by degrees, and in very fmall quantities, with fifteen grains of Pill. Math. in the first potion, which he luckily kept, and two or three tea-cups full more of the decoction. In two hours he began to be quieter, and fome time after to flumber, and continued fo for fome hours. When he awaked thoroughly, his decoction began to operate; his ftools, which were very frequent, were alto as liquid as his vomits, after the first motion; but he vomited no more: and it is very remarkable, that, during the whole continuance of this terrible attack, his bowels made a noife like the hafty emptying of a narrow-mouthed large bottle, or a fmall cafk emptying by the bung: and it is inconceivable, what vaft explosions of wind, both downwards and upwards, he paffed during the operation of the purgative, and for twenty-four hours afterwards;

scarce a minute, either afleep or awake, fe in all that time, without an explosion. But what gave me the greatest furprise was, that, from the beginning of his voll miting, his legs and thighs began to fubte fide; and, by the time it was over, necut degree of fwelling remained, the k hanging loofe, though before the vomit ing his legs were as hard as pofts, and almost as big as a man's body. The Fe quantity of water he vomited, exclufit of his drink, was not less than fifty o pints. With great care, an uninterrupt ed ufe of corroborating medicines, ne rifhing diet, daily exercife, the flesh bruh, and bathing in fea-water, he recovered his priftine health and strength, the mufcles plumped up to their natural ful nefs, loft all appearance of dropfy; and he died fifteen months after of a frenzy, brought on by an immoderate fit of pal fion, and a small contufion of the head Mill Mount, ALEX. MACKENZIE. June 9. 1760.

On

the fevers and coughs of men and women.

Mr URBAN,

Have confidered the fevers and coughs of infants and children [302], and fhall now communicate my fentiments, on these diseases in adult perfons; that the poorer fort of people, who cannot be at the expence of employing a phyfician, may know my opinion, and have my a vice for the management of the fick, and for making fome proper and cheap medi cines for their recovery; medicines which, in my experience, have been very effec tual in refloring them to health.

There are two principal fources of fe vers. One comprehends the causes which render the blood, and other fluids of the body, too thick; the other includes thot which make them too thin; and I fhall thew how common people may diftin guifh one fort of them from the other. It fhould be obferved, that, in all fevers of every kind, there is a morbid quality w troduced, and fubfifting in the blood, a the productive caufe; and the proper means for curing them are fuch methods, and medicines as by experience have been found effectual for removing the morbid quality, and recovering the fick in the fhortest time.

In fome perfons, when there is tou much blood, fuch bleeding may be advi fed as will draw off the excels; except in peftilential diftempers, in which blood-letting has proved almost always mortal, e

in the bodies fulleft of blood. This ecuation may be moderately used in pleues, when the extremity of pain, and e difficulty of breathing fhall require it. That the common people (who genely know when perfons have fevers) may ve a little more knowledge of thefe ate difeafes, and how to distinguish one nd of them from another, the perfon o is to direct for the fick fhould care ly inquire into the ftate of his body. • fhould examine the pulfe. Let him :1 the pulse of two or three who are in alth, and his own pulfe, and then comre them with the pulfe of the patient; d thereby he will come nearly to know w much it differs from the healthful ndard, as to quickness or flowness, and to its ftrength or weakness, and be le to deduce fome conclufions which y guide his conduct. Then let him rn the degree of febrile heat; and one y to do this may be, by feeling the e of the neck below the ears (through ich the large blood veffels pafs to and om the brain), and thus the degree of e heat of the blood may be known; and e other fymptoms of the patient fhould particularly inquired into.

If the heat of the body is exceffive, the le quick and strong, and the flesh is ry dry, and the pores of the skin very fe, and the thirft very great, it may be ncluded that the caule which produced at fever has rendered the blood too thick. If the pulfe is too quick, and not strong, d the heat of the body not great; if e tongue is very black, or dry, and the irft is great; or if the patient voids ood by urine, or spitting, or at his nofe, by ftool; or if he has flat pots on his in, black or redifh in colour; or if he is a great loofenefs, with watery or thin pols; or if he has profufe fweats, with fenfible finking of his fpirits, and decafe of strength, it may be inferred, le fever is of a putrid kind, or that the ufe of it has introduced a quality into he animal fluids diffolvent of their natural onfiftence, and relaxing the mufcular bres, weakening the action of the heart, nd arteries, and leading on to a putreaction of the various parts of the body, hich will foon end in death, if God is ot pleafed to direct and blefs proper rededies to free the blood from its morbid Iiffolvent quality.

1

I will only add, at prefent, that as all evers are produced by, and are dependng on fome morbid quality of the blood,

WI

1 % {

fo I apprehend that the proper remedies are fuitable alterative medicines; and according to these fentiments has been my practice for more than fifty years with a most happy series of fucceffes.

I never expected that leffening the quantity of the animal fluid would obtain a fpeedy recovery of patients whose diseafes did arife from a wrong quality and this obfervation I have made, as to my own patients, that thofe of them who had been treated with evacuants before they had my advice, if they recovered, they recovered their strength more flowly; but that my patients without evacuating remedies recovered from their fevers in a fhorter time, and were sooner in poffeffion of their former ftrength.

The practical part of what I have to offer for the cure of fuch difeafes in adult perfons I defer to the next opportunity. Oct. 23. 1762. THEOPHILUS LOBB,

Mr URBAN, Birmingham, O&. 5. Though the use of the bark in furgery is well known, yet as it cannot be too much recommended, I fend you the - I am, &c. following useful cafe.

W. OAKELEY.

A young fellow, a carpenter, received a wound with an adz upon the infide of his left leg, near three inches above the internal ankle. About fix or feven days after the accident, I was defired to fee him. The wound was about two inches long, but very narrow, looked ill, and the discharge very thin; the whole leg was fo much fwelled as to threaten an immediate mortification; my patient was hardly fenfible in the day-time, but much worfe in the night; his pulfe quick and low. Bleeding and purging had been made ufe of before I faw him. I directed the leg to be fomented with the common fomentation, the wound to be dressed with warm digeftives, and covered with a bread and milk poultice; and I ordered half a dram of bark, in powder, to be taken every three or four hours in a difh of mint-tea. Upon visiting him next day, I found his fenfes better, and his leg lefs fwelled: the day afterwards his head was quite clear, and his leg much mended; about four or five days afterwards, I difcovered a finall abfcefs about two inches above the wound, which I opened by incifion, and difcharged afmall quantity of good matter. The bark was now taken three times aday, and foon after twice a day only; and the cure was completed in three weeks..

T Heles volumes were first published by Mr George Faulkner in Dublin, They contain, Four fermons; Remarks up on Tindal's rights of the Chriftian church; The Craft(man of Dec. 2. 1730, cenfuring the licence given by his then M jelty to the King of France, to inlift Roman Catholics in Ireland to recruit his forces; An antwer to this Craftfiman, in which Swift, in a strain of humour peculiar to himself, farther fhews the pernicious confequence of fuch a licence, under the appearance of an advocate for it; Memoirs of Capt. John Creichton, first printed in 1731.

Creichton was a cavalier in the reigns of Charles II. James II. and William III. who made himself remarkable by his zeal and courage during those reigns, but was neglected by the government. When the Dean was at Sir Arthur Achefon's at Market-hill in Armagh, Creichton was recommended to him; and being then poor, Swift made him a handfome prefent, and propofed publishing memoirs of his life by fubfcription, as a farther means of fupport. Creichton accordingly brought the Dean his own original memorandums, and related his adventures to him, from which the Dean made a fmall book under the above title, and the fubfcription pro"duced Creichton above 200 1.

clans, returning from the mountains, fet took Mackintosh himfelf prifoner. Cap. upon their enemies, killed feveral, and pagh had given ftrict orders to his men, not to kill any of the army; but Capt, Mackenzie, who commanded against him, making a troke at one of his men, the man thot the captain, who died foon after of the wound. Soon after the govern ment ordered Creighton to detach 60 dragoons, with a lieutenant, cornet, and standard, and to march with Capt. Streighton, and 200 of the foot-guards, against Cappagh's clan, which was very nume rous, and to destroy MAN, WO TAN, and Cai D, pertaining to Cappagh, and to burn his houses and corn. Upon the approach of our party," fays Creichton, "Cappagh, difiitling his prifoners, retired farther into the mountains, whereupon we who were fent against him, continued to deftroy all the houfes and corn from Lammas to the 10th of September.”

An order from the King to get poffeffion of a contested estate by force, and a grant of a military power to effect it, was illegal, arbitrary, and tyrannical, totally inconfiftent with the liberty of the people, and the coronation oath of the king: but to give orders to venge an oppofition, by the murder, not only of the men, but of all the women and children belonging to the injured party, was an inftance of cruelty that disgraced hu man nature, and would have been a crime of the deepest dye, if there had been no pofitive inftitution, and neither law nor compact exifting upon earth. [The fevere order against the Glencomen in 1692 [xx. 131.] was executed with greater rigour.]

name.

Thomas Dalziel, among many o

by a party of the to

he