Item of the Day: Rush on Bloodletting (1789)

Full Title:

Medical Inquiries and Observations.  To which is added an Appendix, containing Observations on the Duties of a Physician, and the Methods of improving Medicine.  By Benjamin Ruch, M. D. Professor of Chemistry in the University of Pennsylvania.  The Second Edition.  Philadelphia, printed.  London, reprinted for C. Dilly, in the Poultry, MDCCLXXXIX.

An Account of the Effects of Blisters and Bleeding, In the Cure of Obstinate Intermitting Fevers.

The efficacy of these remedies will probably be disputed by every regular-bred physician, who has been a witness of their utility in the above disorder; but it becomes such physicians, before they decide upon this subject, to remember, that many things are true in medicine, as well as other branches of philosophy, which are very improbable. 

In all those cases of autumnal intermittents, whether quotidian, tertian, or quartan, in which the bark did not succeed after three or four days trial, I have seldom found it fail after the application of blisters to the wrists.

But in those cases where blisters had been neglected, or applied without effect, and where the disease had been protracted into the wintermonths, I have generally cured it by means of one or two moderate bleedings. 

The pulse in those cases is generally full, and sometimes a little hard, and the blood when drawn for the most part appears sizy. 

The bark is seldom necessary to prevent the return of the disorder.  It is always ineffectual, where bloodletting is indicated.  I have known several instances where pounds of this medicine have been taken without effect, in which the loss of ten or twelve ounces of blood has immediately cured the disorder.

How shall we reconcile the practice of bleeding in intermittents, with our modern theories of fever?

May not the long continuance of an intermittent, by debilitating the system, produce such an irritability in the arteries, as to dispose them to the species of inflammatory diathesis which is founded on indirect debility?  Or,

May not such congestions be formed in the viscera, as to produce the same species of inflammatory diathesis which occurs in several other inflammatory diseases?

Doctor Cullen has taught us, in his account of chronic hepatitis, that there may be topical affection and inflammatory diathesis, without much pain or fever; and had I not witnessed several cases of this kind, I should have been forced to have believed it possible, not only in this disorder, but in many others, from the facts which were communicated to me by Doctor Michaelis in his visit to Philadelphia in the year 1783.

I once intended to have added to this account of the efficacy of blisters and bleeding in curing obstinate intermittents, testimonies from a number of medical gentlemen, of the success with which they have used them; but these vouchers have become so numerous, that they would swell this essay far beyond the limits I wish to prescribe to it.   

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Item of the Day: Parkinson’s Medical Admonitions (1803)

Full Title:

Medical Admonitions to Families, Respecting the Preservation of Health, and the Treatment of the Sick.  Also, a Table of Symptoms, Serving to Point out the Degree of Danger, and, to Distinguish one Disease from Another.  With Observations on the Improper Indulgence of Children, &c.  By James Parkinson, M.D.  Hoxton.  First American, from the Fourth English Edition.  Portsmouth, New-Hampshire: Printed for Charles Peirce, by N. S. & W. Peirce.  1803.

Gout.

The paroxysms of this tormenting disease are most commonly preceded, by a general uneasiness; the feet and legs are afflicted with numbness and coldness, and frequently also with the sense of prickling; the veins on the surface are also said to become unusually turgid, and the muscles of the leg to be affected with the cramp.  But the circumstances which have been observed, most particularly to precede the attacks of this disease, are the changes which, for some little time before, take place in the stomach; this organ generally suffers a considerable derangement of its functions; the appetite being much impaired, and the stomach and bowels distended with wind, the consequence of digestion not being properly carried on; the appetite becoming, however more eager before the attack. 

According to the observations of the attentive Sydenham, the paroxysm generally begins about two o’clock in the morning.  The patient, having gone to bed free from pain, is waked about the time with pain possessing commonly some part of the foot.  Soon after this, comes on a coldness and shivering, which terminates in fever.  The pain increasing, sometimes resembles that which might by expected to be produced by the stretching and tearing of the ligaments, or the gnawing of a dog; at others, the parts seem to suffer the effects of a tight stricture, or considerable pressure, being so feelingly alive, as not only, not to bear the weight of bed-clothes, but not even the heavy tread of any one across the room.  In this miserable state the patient continues, tossing about the bed, in vain trying the effect of variety of posture to lessen his sufferings.  At about the same hour of the following morning, the patient, in general, experiences a sudden mitigation of the pain, which he commonly attributes to the last position in which the limb was placed.  Soon after this, a moderate sweat coming on, he falls asleep, and, upon waking, finds that the pain is considerably diminished; but that the part which suffers is affected with a red shining swelling.  The pain sometimes continues two or three days, increasing at night, and becoming more mild towards morning. 

If, after the disease has thus completed its course in one foot, it disappears entirely, the patient regains use of the foot, and experiences a most grateful change–strength and alacrity having taken the places of debility and languor.  But it often happens, that after the violence of the first attack has subsided, a second will be experienced in the other foot.  In more inveterate cases, both feet, sometimes, are affected at the same time; an repeated paroxysms sometimes extend the sufferings of the patient for six weeks or two months, or even longer.     

Item of the Day: Observations on the Construction of Hospitals (1793)

Full Title: Observations on the construction of Hospitals, by Mr. Le Roy, Member of the Royal Academy of Sciences — (Extracted from an Essay on the Subject, which, with several elegant plans, was transmitted by the author to the Society, but could not be inserted entire, as it contained many remarks of a local nature, respecting Paris —only.

 Found In: Transactions of the American Philosophical Society, held at Philadelphia, for promoting Useful Knowledge. Vol. III> Philadelphia: Printed and sold by Robert Aitken & Son, No. 22, Market Street, M.DCC.XCIII. [1793]

 [pp. 348-350]

THE construction of Hospitals is in general objectionable, either because many of the wards do not admit of perfect ventilation, or because the air passes from one patient over another, by which means contagious diseases are often spread.

To avoid these inconveniences, a large Hospital should consist of distinct and separate buildings, each forming one ward, erected upon arches or columns, at a considerable height from the ground, and ranged at a distance from each other, like the tents of an encampment.

The cieling [sic] or roof of each ward should be formed into a number of spherical arches according to  its size, the crown of each arch being in the middle of the breadth of the ward, and opening into a funnel like a common chimney, which should be supplied with a vane, (resembling that we call a cow) so that it may always open to leeward.

In each floor, midway as to breadth, should be a row of holes at suitable distances from each other, to admit air from below, so constructed that the quantitiy of it may be regulated at pleasure.

In consequence of this structure there must be a constant change of air, for that which is in the lower part of the ward, being warmed by the patients and nurses, and the necessary fires, will ascend, and in consequence of the spherical construction of the roof, will be directed to the openings in it, and flow through them, while the holes in the floor will afford a constant supply of fresh air, which will move rapidly as it enters the from so low.

A number of arches with openings is preferable to a single arch in the center, because the air is passing from the extremeities of the room to the center flows, from one patient over another–and a plan or flat cieling [sic], even with apertures, is improper, because the upper air at a distance from the apertures cannot move to them.

The rooms may be warmed by placing grates or stoves over these holes in the floor, and no bad effect can be produced by t he fire as the air and vapours will ascend from it and go off by the holes in the cieling — If it be necessary to quicken the circulation of air, either on account of the sluggishness of the atmosphere, or of the contagious nature of any diseases in the ward, small fires may be fixed ingrates or stoves near the openings in the cieling, to increase the motion of the air.

To prevent the spreading of contagion, as well as to keep the sick from beholding the sufferings of each other, a screenof suitable height should be placed between each bed.

For contagious disorders and surgical cases, there should be a number of wards, at a distance from the Hospital, and to leeward of it with respect to prevailing winds. . . .

Item of the Day: General Observations on the Philosophy of Medicine (1809)

Full Title: General Observations on the Philosophy of Medicine; with some Anticipations of its Future State, Arising Out of a Comparison of its Progress with that of the Sciences in General. By Joseph William Gullifer, Esq. Edinburgh: Printed by James Ballantyne and Co. for the Author, 1809.

SECTION FIRST.

WHEN the Statesman sits down to study the profound views of the science of legislation, and the Physician to investigate the various results arising from the complicated structure of the human body, the object which both propose to themselves, at the commencement of their labours, bears a manifest relation to the same end. viz. the bettering the condition of the human species. The errors for the practical Statesman, however, and the policy by which he is governed, are soon discovered, and soon pointed out, by the discerning eye of an enlightened public; but the Physician is able to veil his errors, and conceal the imperfections of his art, under the specious appearance of knowledge. This concealment of ignorance, on the part of the Physician, could not long pass unregarded, if there were any convincing test whereby to judge either of the depth or of the soundness of those principles whereupon he proceeds.

 

SECTION SECOND.

That we are very far from the knowledge of first principles in medicine, has been often allowed; and that no department of science can be expected to go on in any state of progressive improvement, until some data, some elements, are furnished to conduct the inquirer, is likewise a fact that cannot be denied. It is from the want of some materials of this kind, that the medical student finds himself so much at a loss; –he studies, and he may still continue to do so; collecting ideas ad infinitum, without reaping any real or solid advantage; –he cannot even indulge the fond hope, or the alluring prospect, of benefiting posterity by his labours; –he discovers, amdist the immense mass of materials presented to his view, such a multiplicity of heterogeneous opinions, as bewilder the attention, and distract the memory, and which he can refer to no general head whatever; –he finds himself entangled in the mazes of an unintellibible phraseology, that claims no title to use, much less to distinction, but that which the venerable sanction of time always secures to monuments of antiquity.

SECTION THREE.

Various as the divisions of mental inquiry are found to be, and difficult as it is to pursue them with precision, from the vagueness of language itself, yet in no circle of knowledge is this inconvenience more sensibly felt than in medicine. How various are the terms which Physicians daily employ, without annexing any correct or distinct idea to them? I feel persuaded, from the prodigious improvement that chemistry has lately undergone, partly owing to the philosophical nomenclature introduced by the French, and partly to the scientific arrangement observed in classing the differnt parts of its’ system, that, if a path somewhat similar to this, that is, a plan conducted upon principles nearly allied to it, were once opened, and steadily pursued, we should then gain a very important desideratum to guide the studes of medical men. When speaking upon the soruces of minunderstanding and fallacy arising from the abmiguity of language, it ought not to be forgotten, as the Abbe de Condillac has well remarked, that we think only through the medium of words; and that the first step towards the attainment of a philosophical system, is the acquirement of an accurate language for the ideas we express. It is not, however, the language of medicine itself that is so exceptionalbe–the doctrinal parts of it are no less so. Whilst the doctrines of Sympathy, of Spasm, of Irritability, follow each other with such a rapid succession at one time, and are found to approach and to receed from each other like the oscillations of a pendulum at another, what prospective advantages can the science of medicine be expected to hold out? That which is so fluctuating, so eccentric in its orbit, so totally void of any solid foundation for its support, which is made to appear as the standard of perfection to-day, and becomes obsolete on the morrow, may please for a while the speculative theoretician, but can never prove useful to the patient inquirer after the sublime operations of nature.

 

Item of the Day: Chesterfield to his Son (1774)

Full title: Letters Written by the Late Right Honourable Philip Dormer Stanhope, Earl of Chesterfield, to His Son, Philip Stanhope, Esq; Late Envoy Extraordinary at the Court of Dresden. Together with Several Other Pieces on Various subjects. Published by Mrs. Eugenia Stanhope, From the Originals Now in Her Possession. In Two Volumes. Vol. II. Dublin: Printed by G. Faulkner, in Parliament-street, M.DCC.LXXIV.

TO HIS SON.

LETTER LI.

London, February the 14th, O.S. 1752

My Dear Friend,

In a month’s time, I believe, I shall have the pleasure of sending you, and you will have the pleasure of reading, a work of Lord Bolingbroke, in two volumes octavo, upon the use of History; in several letters to Lord Hyde, then Lord Cornbury. It is now put into the press. It is hard to determine, whether this work will instruct or please most: the most material historical facts, from the great aera of the treaty of Munster, are touched upon, accompanied by the most solid reflections, and adorned by all that elegancy of style, which was peculiar to himself, and in which, if Cicero equals, he certainly does not exceed him; but every other writer falls short of him. I would advise you almost to get this book by heart. I think you have a turn to history; you love it, and have a memory to retain it; this book will teach you the proper use of it. Some people load their memories, indiscriminately, with historical facts, as others do their stomachs with food; and bring out the one, and bring up the other, entirely crude and undigested. You will find, in Lord Bolingbroke’s book, an infallible specific against that epidemical complaint*.

I remember a gentleman, who had read history in this thoughtless and undistinguishing manner, and who, having travelled, had gone through the Valteline. He told me that it was a miserable poor country, and therefore it was, surely, a great error in Cardinal Richelieu, to make such a rout, and put France to so much expence about it. Had my friend read history as he ought to have done, he would have known, that the great object of that Minister was to reduce the power of the house of Austria; and, in order to do that, to cut off, as much as he could, the communication between several parts of their then extensive dominions; which reflections would have justified the Cardinal to him, in the affairs of the Valteline. But it was easier to him to remember the facts, than to combine and reflect.

On observation, I hope, you will make in reading history; for it is an obvious and a true one. It is, that more people have made great fortunes in courts, by their exterior accomplishments, than by their interior qualifications. Their engaging address, the politeness of their manners, their air, their turn, hath almost always paved the way for their superior abilities, if they have such, to exert themselves. They have been Favourites, before they have been Ministers. In courts, an universal gentleness and douceur dans les maniéres is most absolutely necessary: an offended fool, or slighted valet de chambre, may, very possibly, do you more hurt at court, then ten men of merit can do you good. Fools, and low people, are always jealous of their dignity; and never forget nor forgive when they reckon a slight. On the other hand, they take civility, and a little attention, as a favor; remember, and acknowledge it: this, in my mind, is buying them cheap; and therefore they are worth buying. The Prince himself, who is rarely the shining genius of his court, esteems you only by hearsay, but likes you by his senses; that is from your air, your politeness, and your manner of addressing him; of which alone he is a judge. There is a court garment, as well as a wedding garment, without which you will not be received. That garment is the volto sciolto; an imposing air, an elegant politeness, easy and engaging manners, universal attention, an insinuating gentleness, and all those je ne sçais quoi that compose the Graces.

I am this moment disagreeably interrupted by a letter; not from you, as I expected, but from a friend of yours at Paris, who informs me, that you have a fever, which confines you at home. Since you have a fever, I am glad you have prudence enough, with it, to stay at home, and take care of yourself; a little more prudence might probably have prevented it. Your blood is young, and consequently hot; and you naturally make a great deal, by your good stomach, and good digestion; you should therefore, necessarily, attenuate and cool it, from time to time, by gentle purges, or by a very low diet, for two or three days together, if you would avoid fevers. Lord Bacon, who was a very great physician, in both senses of the word, hath this aphorism in his Essay upon Health, Nihil magis as sanitatem tribuit quam crebrae et domesticae purgationes. By domesticae, he means those simple uncompounding purgatives, which everybody can administer to themselves; such as senna-tea, stewed prunes and senna, chewing a little rhubarb, or dissolving an ounce and a half of manna in fair water, with the juice of half a lemon to make it palatable. Such gentle and unconfining evacuations would certainly prevent those feverish attacks, to which every body at your age is subject.

By the way, I do desire, and insist, that whenever, from any indisposition, you are not able to write to me upon the fixed days, that Christian shall; and give me a true account how you are. I do not expect from him the Ciceronian epistolary style; but I will content myself with the Swiss simplicity and truth.

I hope you extend your acquaintance at Paris, and frequent variety of companies; the only way of knowing the world: every set of company differs in some particulars from another, and a man of business must, in the course of his life, have to do with all sorts. It is a very great advantage to know the languages of the several countries one travels in; and different companies may, in some degree, be considered as different countries: each hath its distinctive language, customs, and manners: know them all, and you will wonder at none. Adieu, child. Take care of your health; there are no pleasures without it.

*We cannot but observe with pleasure, that at this time Lord Bolingbroke’s Philosophical works had not appeared; which accounts for Lord Chesterfield’s recommending to his son, in this as well as in some foregoing passages, the study of Lord Bolingbroke’s writings.

Item of the Day: The Works of John Fothergill (1784)

Full Title: The Works of John Fothergill, M.D.  . . . with some Account of his Life by John Coakley Lettsom. London: Printed for Charles Dilly, in the Puultry, M.DCC.LXXXIV. [1784] 

 

OF THE MANAGEMENT PROPER

AT THE

CESSATION OF THE MENSES

 

To the Medical Society in London.

Gentlemen,

THERE is a period in the life of Females to which, for the most part, they are taught to look with some degree of anxiety; as a period on which depends their enjoying a good or bad state of health during the residue of their lives.

The various and absurd opinions relative to the ceasing of the mentrual discharge, and its consequences, propagated through successive ages, have tended to embitter the hours of many a sensible women. Nor have these mistaken notions been confined to them only; they have occupied the minds of such who ought to have been better informed: some practitioners, in other respects able and judicious, if they have not favoured these erroneous and terrifying notions, seem not to have endeavoured to correct them, with the diligence and humanity which an object like this requires.

The design of this essay is to contribute my mite towards so necessary a purpose; to assist in removing these groundless apprehensions, and to substitute a reasonable confidence, that, with very little aid, Nature is sufficient to provide for her own security on this occasion.

You must forget for a moment that I am submitting these remarks to the judgment of a Society, every member of which, perhaps, is as capable of this work, and some much better than myself. I am writing to many sensible young men in the profession of physic, who, though they may have applied themselves to the general study and practice of our profession with diligence and success, may not yet, perhaps, know where to look for such information on this subject as may be sufficient to satisfy themselves and their patients, what managment is proper when the Menses are about to cease.

To propose a regimen that shall suit all the different cases that may occur, would require a volume. To give some general direction is all I intend, without entering into a minute description of the commencement, progress, and termination of the Menses. I must suppose every thing of this kind is already known, and that the single question is, What conduct, what management is necessary to be observed, when the Menses are about to cease, by the patient who consults her physician on the occasion? We are now sensible that the menstrual discharge is not, what it was too long and too generally believed be by many of the sex, an evacuation of peccant matter and morbid humour, sometimes acrimonious and malignant, whose retention, from its noxious qualities, never fails to be extremely injurious to the constitution. What opinion the ancients entertained concerning it, I need not repeat to you: that its malignancy was such as to affect even inanimate bodies. But these fables are wholly disbelieved, except by some of those who ought to be undeceived in a matter that so much concerns them.

It is now well known, and the sex cannot be too generally apprized of it, that the menstrual discharge possesses no such injurious or malignant properties; that it is solely a redundancy of that pure vital blood, which animates the whole frame of a healthy person; and that its retention is by no means attended, in general, with effects that are not as easily removed as any disorder to which they are subject.

That some acrimonious morbid humours may be discharged together with the Menses, when any such exist, is not improbable. So it happens likewise to men subject to piles, or other preternatural excretions.

Women who have unhappily imbibed that prejedice, are naturally alarmed at the consequences they apprehend must ensue from such a change in their constitution; and the more strongly they are preposessed with a belief, that by this channel has been regularly discharged whatever had a tendency to produce diseases, the more they are terrified with apprehensions of some of the worst complaints: and, indeed, it is not seldom that, by such anxiety, they bring on disorders that are not easily removed, attributing them to the cause we are speaking of, whilst they principally originate from anxiety.

 For the most part, the menstrual discharge, as has been mentioned, proceeds from a redundancy of good and healthy blood; this redundancy is formed for the most necessary purposes; continues whilst this necessity subsists; and ceases when, according to the constitution of the female frame, it is no longer required.

The powers communicated to the human system, generally expressed by the term Nature, are such as spontaneously bring about this cessation. The provision for the Mesnes ceases, and extra quantity of blood is not generated, and the vessels provided for its regular discharge by degrees collapse; and in general all this proceeds without any the least interruption to the health of the subject in which this alteration happens. Here it might not be improper to mention at what time this alteration first begins, and the general period of its cessation. These circumstances, however, may be found elsewhere so amply treated of, as to render it as unnecessary as it is foreign to my present design.

There are great numbers of women in whom the menstrual discharge ceases, without their perceiving any alteration in their usual health. There are some who, from being invalids during a part of the season which is appropriated to menstruation, find themselves by degrees recovering health and vigour, to which they have been strangers during that period, when this discharge leaves them entirely. Very tender, delicate, relaxed habits, subject to copious discharges, are often much benefited by the cessation. All, however, are not so fortunate. Some alterations frequently supervene, that render assistance necessary. . . .

 

Item of the Day: Hutchin’s Almanack (1773)

Full Title: Hutchin’s Improved Almanack and Ephemeris of the Motions of the Sun and Moon; the Ture Places and Aspects of the Planets; The Rising and Setting of the Sun; and the Rising, Setting, and Southing of the Moon, for the Year of our Lord, 1773: Being the first after Bissextile or Leap Year. Containing also, The Lunations, Conjuctions, Eclipses, Judgment of the Weather, Rising and Setting of the Planets, Length of Days and Nights, Courts, Roads, &c. Together with Useful Tables, chronological Observations, and entertaining Remarks. By John Nathan Hutchins. New-York: Printed and sold by Hugh Gaine, at the Bible and Crown, in Havover-Square, where may be had the New-York Pocket Almanack.

Precaution to preserve SIGHT; and a Remedy for Weakness in the Sight. By Dr. Hill.

FIRST, never sit in absolute Gloom, or in a Blaze of Light, much less go suddenly from one into the other: A House situated North and South, is therfore wrong for any who are tender in Sight. Secondly, To avoid small Print in Reading, and all Attention to minute Objects. It is in vain to think of assisting the sight by Glasses; they represent Objects plainer, but commit a Kind of Violence upon the Eye, and always hurt weak ones. Thirdly, Never read in the Dusk: and when the Eyes are at all disordered, not by Candle Light. Fourthly, Never look into a bright Fire. Fifthly, Avoid all glaring Objects, especially in the Morning at first waking; therfore a Bed-chamber should never be so situated, as for the Sun to shine into it at that Time; and there should be no Red, nor too much White in it; and the Degree of Light should be moderate. Those who have weak Eyes, will find great Advantage in green Furniture in their Rooms, and in admitting the Light gradually to their Eyes at the Time of waking: And it is thus Nature provides for all her Creatures; the Day Light comes by very slow Degrees, and the first Object is univeral Green.

For a Weakness in the Sight, take two Ounces of Leaves of Rosemary, and put them into a Pint of Brandy; let it stand three Days, then strain and filter it through Paper; mix a Tea Spooful with Four of Plantain Water; make it warm, and wash the Inside of the Eye every Night going to Bed, moving your Eye till some get between the Eye and the Lid. By Degrees put less and less Water, till at length a Tea Spoonful of each is mixed.

Item of the Day: Bell’s System of Operative Surgery (1816)

Full Title: A System of Operative Surgery, founded on the Basis of Anatomy. By Charles Bell. The Second American, from the last London Edition. Vol. I. Hartford: Printed by George Goodwin and Sons, 1816.

PREFACE.

WHEN a Surgeon first takes the knife in his hand, and is preparing, with oppressive feelings, to perform an operation which may termiante the life of his patient, he is not always aware of what is the most difficult to be accomplished. His ideas are vague; his mind not settled to what he is to expect; the circumstances which ought chiefly to engage him are not distinctly before him; and no man has ever performed this painful duty, without feeling that it is in the very course of the operation that he learns what it is most necessary for him to know and to practise. For myself, I confess, that it is only by reflecting on the doubts which have crossed my mind during the operation; by taking note of the ideas which crowd into my recollection when it is over: and by thus contemplating the subject in a light purely practical, that I have been encouraged in the hope of making this book useful to the profession, and that I have been able to compress it into so small a compass.

The reader will find that I have not attempted to impose upon him the notion, that this is a complete system by setting up in array a fair arrangement of Titles. This book is limited in its aim. I consider the student, while in the Lecture Room, in the Dissecting Room, and in the Hospital, as having attained a knowledge of Anatomy and of the Doctrines and Practice of Surgery. That is knowledge which cannot be compresed in two small volumes, nor explained in any books at all: it is to be acquired only by continual exercise, by daily and careful observation, by treasuring up the lessons which the passing occurrences of the Dissecting Room and Hospital suggest to his own mind, or draw from his teachers. But while I acknowledge this, and wish to inculcate it, I think that there ought to be a book in the hands of the pupil to direct him in his studies; to be associated with all he sees and hears; in which the lessons he has detailed to him at length by his teachers may be found more shortly expressed; to which, as a student, he can recur for a concise exposition of the points material in practice; to which, as a surgeon, he can turn for the detail of what is necessary to be done in preparing for an operation and in operating, unembarrassed by useless disquietudes.

Every surgeon on the eve of a great operation ought to bring his judgment maturely to bear on all the points of the case; the objects to be attained; the dangers to be expected; the resources which he ought to have in readiness against probable mischance. And he cannot do his duty to his patient or to his own reputation, without arranging the probable occurrences in his mind, that by anticipating he may avoid embarrassment, maintain his self-possession undisturbed, and save himself from the distraction of consultation and whispering during the crisis of his patient’s fate.

It is to aid the young surgeon in entering into this communing with himself that I have offered these volumes to the profession.

Tha a design so obviously useful has not before been executed is surprising. since the first appearance of this work several others have been announced, which had they preceded mine would have left me to follow other and more agreeable pursuits.

It is at all times a heavy task to compose a system, and the labour never yet was repaid by reputation, or otherwise. To those who know my situation and pursuits I shall not appear to arrogate much when I say, that I might have been more profitably employed; but I felt it to be a duty to my pupils to prepare them the present work, and I must not regret the time that has been employed on it.

London, 34, Soho-Square,

1st October, 1814.

 

Item of the Day: Transactions of the American Philosophical Society (1793)

Full Title:  Transactions of the American Philosophical Society, held at Philadelphia, for Promoting Useful Knowledge. Volume III.  Philadelphia: Printed by R. Aitken & Son, 1789-1786-1793.

INTRODUCTION

To Vol. the Third.

An Essay on those inquiries in Natural Philosophy, which at present are most beneficial to the United States of North America.  by DR. NICHOLAS COLLIN, Rector of the Swedish churches in Pennsylvania.

Read before the Society the 3rd of April, 1789.

Philosophers are citizens of the world; the fruits of their labours are freely distributed among all nations; what they sow is reaped by the antipodes, and blooms through future generations.  It is, however, their duty to cultivate with peculiar attention those parts of science, which are most beneficial to that country in which Providence has appointed their earthly stations.  Patriotic affections are in this, as in other instances, conducive to the general happiness of mankind, because we have the best means of investigating those objects, which are most interesting to us.  In the present circumstances of the United States some problems of natural philosophy are of peculiar importance; a survey of these may contribute to the most useful direction of our own inquiries, and those of our ingenious fellow citizens.  I submit, gentlemen, my reflections on this subject to your candid indulgence and enlightened judgement.

I.  ARTICLE, Medical Enquiries.

All countries have some peculiar diseases, arising from the climate, manner of living, occupations, predominant passions, and other causes, whose separate and combined influence is but imperfectly known.  In North America we may count five — nervous disorders, rheumatism, intermitting fevers, loss of teeth, and colds.  It is remarkable that nervous complaints are at present more frequent in Europe than they formerly were.  They spring in great measure from the indulgencies of a civilized life; but in America these fiends infest with less discrimination on the dwellings of industry and temperance.  Proteus-like they assume every shape, and often baffle the best physicians.  Their baneful effect on the mind requires the serious attention of legislators, divines, and moral philosophers:  I have myself often seen their amazing influence on religious sentiments.  when extreme, they derange the whole system; obscure the intellects, bewilder the imagination; prevent the natural order and operation of all the passions:  the soul vibrates between apathy and morbid sensibility:  she hates when she should love; and grieves when she ought to rejoice:  she resembles a disordered clock, that after a long silence chimes till you are tired, and often instead of one strikes twelve — These extremes are indeed rare; but the more general degrees are still analogous, and produce a great sum of evil.

Slight rheumatic pains are almost epidemic in some seasons of the year.  Yet, these are scarcely worth mentioning in comparison to the severe fits that afflict a great number of persons, even in the earlier parts of life, growing more frequent and violent with age; not seldom attended with lameness, and contraction of limbs.

Fever and ague is here, as in other countries, the plague of marshy and feeny situations, but what is singular, it also visits the borders of limpid streams.  The lesser degree of it generally called dumb ague, is not rare in the most salubrious places during the months of September and October.  Through all the low countries from north to south this diseases rages in a variety of hideous forms; and chiefly doth the surry quartan with livid hue, haggard looks, and trembling skeleton-limbs, embitter the life of multitudes:  I have known many to linger under it for years, and become so dispirited, as not even to seek any remedy.  It is a soul source of many other diseases often terminating in deadly dropsies and consumptions.

Premature loss of teeth is in many respects a severe misfortune.  By impairing mastication, and consequently digestion, it disposes for many disorders.  It injures the pronunciation; and is a particular disadvantage in a great republic, where so many citizens are public speakers. It exposes the mouth and throat to cold, and various accidents.  It diminishes the pleasure of eating, which is a real though no sublime, pleasure of life; and which I have heard some persons very emphatically regret. Finally, it is a mortifying stroke to beauty; and as such deeply felt by the fair sex!  Indeed that man must be a stoic, who can without pity behold a blooming maiden of eighteen afflicted by this infirmity of old age!  This consideration is the more important, as the amiable affections of the human soul are not less expressed by the traits and motions of the lips, than by the beaming eye. I have not mentioned the pains of tooth-ach, because they are not more common or violent in this country than in some others, where loss of teeth is rare; many persons here losing their teeth without much pain, as I have myself experienced.

The complaint of catching cold is heard almost every day, and in every company.  this extraordinary disorder, little known in some countries, is also very common in England.  An eminent physician of that country said that “colds kill more people than the plague”.  Indeed many severe disorders originate from it among us:  it is probably often the source of the before mentioned chronic diseases.  When it does not produce such funest effects, it is nevertheless a serious evil; being attended with loss of appetite, hoarseness, sore eyes, heach-ach, pains and swellings in the face, tooth and ear-ach, rheums, listless langour, and lowness of spirits:  wherefore Shenstone had some reason to call this uneasiness a checked perspiration.  Great numbers in the United States experience more or less these symptoms, are are in some degree valetudinarians for one third of the year. . . .

These distempers frequently co-exist in the most unhealthy parts of the country; and not seldom afflict individuals with united force.  Comparison for suffering fellow citizens ought in this case to animate our investigation of those general and complicated local causes.  The extreme variableness of the weather is universally deemed a principal and general cause of colds, and of the disorders by them produced; the fall and rise of the thermometer by 20 a 30 degrees within less than four and twenty hours, disturbing the strongest constitutions, and ruining the weak.  A most important desideratum is therefore the art of hardening the bodily system against these violent impressions; or, in other words, accommodating it to the climate.  The general stamina of strength support it under the excesses of both cold and heat.  The latter is, however, the most oppressive as we can less elude it by artificial conveniences.  We suffer especially during the summer four, til 6 a 8, critical extremes, when the thermometer after 86 a 92 degrees, falls suddenly to 60.  Could means be found to blunt these attacks on the human constitution, they would save multitudes from death and lingering diseases.  Sometimes this crisis happens as late as medium September, and is in a few days succeeded by the autumnal frosts:  in such case weak persons receive a shock, from which they cannot recover during the autumn, and will aggravate the maladies of the winter, especially when it is early and rigorous.

 Search for general causes of the mentioned distempers in the popular diet, we should examine the following circumstances — excessive use of animal food, especially pork:  the common drink of inferior spiritous liquors both foreign and home made; not tomention a too frequent intemperance even in the best kinds: the constant use of tea among the fair sex, drank generally hot and strong; and often by the poorer classes, of a bad quality.

In general modes of dress we plainly discern these defects: — the tight-bodied clothes, worn by both sexes, encrease the heat of a sultry summer; the close lacing and cumbersome head-dresses of the ladies are especially injurious to health.  The winter-cloathing is too think for the climate of the northern and middle states, which is for several months at times equally cold with the North of Europe.  Few persons preserve their feet from the baneful dampness of the slush occasioned by the frequent vicissitudes of hard frosts and heavy rains during the winter:  women generally wear stuff-shoes: the American leather, though otherwise good, is very spungy; a defect owing to the precipitate process of tanning.  Nor does either sex guard the head against the piercing north-west wind which is so general for five or six months: on journeys especially the men should exchange their hats for caps that cover the ears and cheeks.

In the modes of lodging these improprieties are observable: — the poorer, or more indolent people, especially in the less improved parts of the country, frequently dwell in houses that are open to the driving snow, and chilling blast:  good houses often want close doors; a chasm of six or eight inches near the floor admits a strong current of cold air, which sensibly affects the legs.  Such houses cannot be sufficiently warmed by the common fire-places; hence the frequent complaint, that the fore part of the body is almost roasted, while the back is freezing:  a situation very unnatural, productive of rheumatism and other distempers.  The larger towns of North-America have, with their spacious streets, a number of narrow alleys; which are peculiarly detrimental in a sultry climate, and in co-operation with the slovenly habits of their poorer inmates, are nurseries of disease.

Among the general customs which may influence health, the most striking is an excessive, and in some cases ill-judged cleanliness: the continual washing of houses, especially in the cold season, has, I am confident cost the lives of many estimable women, and entailed painful diseases on their families.

In the business of life we often remark a very irregular application: indolence succeeded by hurry and intense fatigue.  This must particularly inure our husbandmen, as the neglect of a day may damage a precious crop, if it is not compensated by exertions, which in the sultry heat of summer are very trying to the strongest constitution.

As to nervous disorders, philanthropy compells me to remark, that, besides their general connexion with a sickly constitution, they have in a great measure originated from two singular causes.  One is the convulsion of public affairs for a considerable time past, which occasioned many and great domestic distresses:  the natural events of the late war are universally known:  numbers of virtuous citizens have also felt the dire effects of the succeeding anarchy; especially the loss of property.  The operations of the cause are, however, continually lessened by time that cures our griefs, or buries them in the grave; and such evils will under Providence be for ever prevented by the new confederation of the United-States — The other cause is that gloomy superstition disseminated by ignorant illiberal preachers; the bane of social joy, or real virtue, and of manly spirit.  this phantom of darkness will be dispelled by the rays of science, and the bright charms of rising civilization.

Item of the Day: Webster’s History of Animals (1812)

Full Title:

History of Animals; Designed for the Instruction and Amusement of Persons of Both Sexes by Noah Webster, Jun. Esq. Printed in New-Haven by Walter & Steele, 1812.

Excerpt from “MAN”

16. Of the human race. Among the countless species of animals which inhabit the globe; Man holds the first rank. He is not indeed the largest or strongest animal; but he is of the most beautiful form, and indued with a superior degree of intellectual power, which enables him to subdue other animals, and make them subservient to his necessities, his convenience, or his luxury. But what especially distinguishes man from other animals, is his rational soul, which is capable of continual improvement and high intellectual enjoyment in this life, and is destined to survive the body, and enjoy immortality.

17. Infancy of man. Notwithstanding the dignity of man compared with other animals, he is, at his birth, the most helpless and dependent. When first born, the infant can only move its feeble limbs, and manifest its wants by the cries of distress. Unable to move its body, it depends on its nurse for support and protection; and its utmost efforts towards procuring food consist in swallowing the milk which is poured into its mouth, or in feebly drawing it with its lips from the breast.

18. Progress of infancy. For several month after its birth, the infant continues most of the time in sleep. When awake, its eyes are fixed, or moved without design; and they appear glossy or destitute of lustre. Light indeed atracts the eye of an infant, in a short time after its birth; but rarely does it exhibit a smile, or shed a tear, until after forty days. Its hands are moved, but without design, or direction to a particular object. Its bones are soft, and its joints feeble. In this manner the infant continues dependent on the fostering care of its mother and nurse, till the appearance of teeth indicates the time when it may quit the breast, and be fed with more substantial food.

19. Childhood. The teeth usually begin to appear between the ages of four and eight months. Strong, healthful children begin to walk at the age of nine or ten months; but more generally, children cannot walk till twelve or fourteen months old. From the time of weaning, till three years old, the child is exposed to many dangers from accidents, and especially from the diseases incident to dentition, or teething. Until this period, and for several years after, the child’s life is exposed to hazard from certain diseases which are epidemic, at irregular periods, in all countries; by which means one third of the children perish before they are three years old.

20. Propensity of children to action. No sooner is the child able to walk, than he manifests an inclination to be continually in motion. He walks from place to place to find objects of amusement; but soon dissatisfied with one toy, he throws it away, and seeks another. As he advances in strength, he begins to run and to play with more vigor, and to seek for companions as lively, as playful and noisy as himself. This propensity to action, however troublesome to his parents, is of immense consequence to the child; it is intended, in the wise economy of providence, to prompt the feeble child to exert his muscles and limbs, for the purpose of giving them strength and firmness; invigorating the body, and fitting it to sustain the necessary toils and labor of his future life.

21. Puberty. From infancy, the growth of the body is tolerably regular and uniform, till the age of thirteen or fourteen years. At this time, the child passes rapidly to a state of manhood; and often the size of his body is enlarged, in disproportion to its strength; and young persons of both sexes are peculiarly liable to disease, especially to affections of the lungs. By the age of twenty years, but sometimes a little earlier or later, the body has usually acquired its full size, proportion, strength and beauty. Females however generally arrive to their full size at an earlier age than males.

22. Progress of man to old age. After the body has arrived to its full size and strength, it continues many years without any great change, except that it sometimes gains an inconvenient load of fat. The state of full strength continues often to the age of forty or forty-five years; but, before this period, the body usually begins to lose in activity. At the age of fifty, or somewhat earlier, man begins to be sensible of a decay, not only of activity, but of strength; and about this period, his eye-sight begins to fail. The decay is gradual—the bones become hard; the cartilages (or gristle) become more rigid, rendering the motion of the joints more difficult; and other parts of the body undergo a similar alteration. The flesh falls away, and leaves the skin to contract into wrinkles; the hair often becomes white; all the functions of the body become more slow and languid; until the blood ceases to circulate, and man sinks into his native dust.