The following Account of a remarkable Suppression of Urine I had in a Letter, dated the 25th of November 1757, from Mr. Pearson, one of the Surgeons to his Majesty's Military Hospitals, who then served as a Mate.

James Ruffendal, aged Twenty, of a delicate Habit, was, in the Middle of July last, seized with a violent Pain in both Kidneys, which extended along the Ureters to the Bladder, and remained in the same Situation for about three Weeks; during which Period his Urine began to decrease in Quantity, and the voiding of it was attended with acute Pain about the Neck of the Bladder. The Secretion then totally stopt; he remained for upwards of five Weeks in the Hospital at Dorchester, and made no Water; at the End of which Time I first visited him along with Mr. Adair. He complained then of a slight Pain in his Kidneys, and told us he had a tolerable Appetite, sweated little, and voided every Day four or five Liquid Stools. He was ordered Boluses of Camphor, and sal. vol. c. cervi, and every Night a Dose of tinctura cantharidum; which he continued to take for a Fortnight without receiving the least Benefit. I then blooded him to the Quantity of ten Ounces, and gave him an Emetic of six Drachms of the vinum ipecacoanhae, and two Ounces of the Oxymel of Squills, which operated very well; and afterwards ordered him to take one of the following Boluses every four Hours. Rx Sapon. dur. Hispan. drachm. i. Sal. Absynth. gr. vi. Calc. Viv. gr. x. Balsam. Peruv. q. s. ut fiat Bolus. These he continued to take for twelve Days. On the Morning of the 14th of October, he was suddenly seized with an acute Pain in both Kidneys, and about Noon voided upwards of Half a Pint of straw-coloured Urine, which let fall a clay-coloured Sediment. As he was feverish, I took away twelve Ounces of Blood, and ordered him Barley-Water with Nitre for Drink. He was easy in the Night, and made upwards of two Pints of Urine, which deposited a Sediment of a gelatinous Consistence. Next Morning the Pain increased, especially in his Right Side, and ten Ounces more of Blood was taken away. This lowered the Pulse, and considerably abated the Pain. Both this and the Blood taken away the Day before threw up an inflammatory Buff. He was ordered to continue the Use of the Barley Water with Nitre, and to take three Spoonfuls of a Mixture with spiritus mindereri every two Hours. He had an easy Night, and was next Day free from Fever; but complained of an Uneasiness in his Stomach and Nausea. He was ordered a Scruple of the Powder of Ipecacoanha, which vomited him, and procured him a Stool. He was easy in the Night; but in the Morning was hot, and complained of a Pain in his Right Kidney, and all over his Bones, as he expressed it. I then gave him a Mixture, with spiritus mindereri, and the pulvis contrayerva comp. of which I desired him to take some Spoonfuls frequently. This procured him a plentiful Sweat, which removed the Fever and Pain: these Symptoms returned next Day, but were removed by the same Means. I remained at Dorchester for a Week after, and he recovered his Strength and Appetite as much as could be expected in so short a Time; but he still complained of Pain in his Right Kidney, tho' he made Water freely. By a Letter I received from the Gentleman whose Care I left him under, I understood he had a Relapse, which he has since got the better of.

I forgot to inform you, that his Father died of the same Complaints, after being six Months without secreting a Drop of Urine; and his Brother died of the same in about ten Weeks.

Where it depended on Strictures of the Urethra, Bougies introduced into that Passage, and worn for some Time, were of great Service. The Patients were at the same time ordered to live on a cool Diet, and to drink the decoctum Arabicum, or an Infusion of Linseed, or such other mild mucilaginous Liquors; and to take oily Medicines and Opiates occasionally, and gentle Laxatives, to keep the Body open; which Method of Treatment generally gave Relief. Where the Patients were plethoric, or complained of Pain, or the Disorder was attended with a Fever, Bleeding was often necessary.

When the Stoppage of Urine seemed to arise from an Inflammation of the Kidneys or Bladder, or other Diseases of these Parts, we treated it accordingly; and where the Fever was considerable, we made Evacuations, and gave plenty of diluting Liquors, and the cooling saline Medicines, and afterwards those of the soft, mucilaginous, and oily Nature, and mild Diuretics and Opiates.

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



OF THE EPILEPSY.

The Epilepsy, or Falling Sickness, attacked a Number of Men, from the severe Duty of long Marches in hot Weather, and afterwards lying out on the cold Ground, exposed to the Damps of the Night[98].

[98] I saw above twenty Men, while I was in Germany, who attributed the Epileptic Fits they were attacked with to these Causes, and said they had never had the Epilepsy before; besides others, who had been formerly subject to these Fits, who declared, that the Disorder was brought back by the same Means.

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

[99] William Wilson, a Boy fourteen Years of Age, was admitted into St. George's Hospital, Sept. 20, 1758, for Epileptic Fits, which he had been subject to for some Time, and which generally seized him three or four Times a Week. He took Variety of Medicines without any Effect till the 6th of November, when I ordered him to take eight Grains of the pilulae foetidae Morning and Evening, and Physic twice a Week, and a Seton to be made in his Neck. After the Seton began to run, he had but three or four slight Fits in November, and none the following Month; and he was discharged the Hospital the 3d of January 1759, seemingly in good Health, with Directions to keep the Seton running at least for some Months after he went home, and to come again to the Hospital if he should have any Return of his Fits; but we never heard more of him.

Mary Hacket, a Girl of nineteen Years of Age, was admitted into St. George's Hospital the 14th of February 1759, for Fits. The Account she gave of her Case, was, that about five Years before she was seized with the first Fit, after a Fright; three Years afterwards she had a second Fit, and for some Time after had a Fit commonly once a Month, about the Time of the full Moon; and since had them more frequently; that the Fits began with a Trembling and Shaking of the right Foot, and she had frequent pricking Pains in the right Thigh, and what she called convulsive Tremors in the right Leg and Foot. She was regular in her menstrual Discharge. At the Time she came into the Hospital, she was feverish, and complained much of a sharp Pain in the right Thigh: She was blooded, and took some cooling Medicine, and had no Fit till the 9th of March: She then took the fetid Pills and camphorated Julep twice a Day; but still the Fits returned frequently. She then had the Bark, Valerian and Purging Doses successively, and used the warm Bath; but without any Effect. On the 7th of May a Blister was applied to her right Foot, which was intended to be kept open; but an Inflammation coming on that Leg and Foot, it was suffered to dry up, and an Issue made in the same Leg. From the Time the Blister was applied, she had no Fit while she remained in the Hospital. She was discharged the 15th of July, seemingly in good Health; though during that Period she had some little Tremors in her Foot, and was subject to be low and faintish, which was always relieved by cordial anodyne Medicines. After going out of the Hospital, she remained in good Health for seven or eight Months, when I was told her Disease had returned as violent as ever.

It is no Wonder that Soldiers, during the Time of Service, should seldom be cured of these Fits; for in Adults it is not often cured even in private Practice, with all the Conveniencies and Advantages to be wished for; and generally the few that do get well, require a considerable Length of Time to accomplish the Cure; and we find from daily Experience, as well as from examining the Records of Medicine, that the Cures that have been made, have mostly been performed either by a Change of Air, such as going from a cold to a hot Climate[100], by some remarkable Change of Life[101], or some accidental Disorder;[102] or by Issues or Drains[103]; or by the Removal of some acrid or irritating Substance, or such like[104]; or by preventing the Cause[105]; and that those Medicines called Specifics have in general had but little Share in the Cure.

[100] Hippocrates lays the chief Stress of the Cure upon Change of Air, Aphor. 4, 5, sect. ii. The Baron Van Swieten says, he has known a great Number cured by going to the East Indies; many of whom have remained well ever after, while others had a Return of the Disorder when they came back to Holland. Comment. vol. III. p. 436. sect. 1080.

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

[102] William Glen, a Patient in the Royal Infirmary at Edinburgh in September 1747, was freed from Epileptic Fits, which used to return ten or twelve Times a Day, for a Quarter of a Year, by a Diarrhoea coming on; but they afterwards returned.

A Man subject to the Epilepsy was cured of it by a Quartan Ague, and had afterwards no Return of the Disorder. Miscell. Curios. Dec. 3. Ann. 3. p. 34.

[103] There are numerous Instances of the good Effects of Issues and Drains in diverse Authors. Tulpius, Van Swieten, &c.

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

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



OF THE SMALL-POX.

The Small-Pox appeared at Paderborn in the Spring 1761, and five had the distinct Kind, who recovered. Six or seven had them at Osnabruck in May and June, and one Man and a Child died of the confluent Kind. Four had the distinct Kind at Munster in July and August who all did well. During the Winter, we had sixteen in the Hospital I attended at Bremen; ten had the distinct Kind, and all recovered; five had the confluent Kind, of whom two died; as did also one who was brought to the Hospital with all the Symptoms of the most malignant Kind. Two were sent to Natzungen in July, both ill of the confluent Kind; the one died two Hours after his Arrival; the other recovered: And we had only two in the Hospital at Osnabruck in Winter 1762-63, and both did well.

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

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

Luckily this Disorder never spread much in the Army, while I was in Germany.



OF ERISYPILATOUS SWELLINGS.

In January 1762, several Patients in the Hospitals I had the Care of at Bremen, had shining watery Swellings of the Face, or Extremities; which came suddenly, and were attended with a slight Degree of Inflammation, and watery Blisters rising above the Skin, and some Degree of Fever. The Blisters were not small, round, and angry, as in St. Antony's Fire; but larger, and of an irregular Figure, resembling those raised when People are scalded by boiling Water. The Swellings did not pit on being pressed, as the oedematous Swellings commonly do: They gave Pain when pressed, but the Inflammation was not in that high Degree as it is in the common Phlegmon: The Blood was sizy, and the Water of a high Colour. The Disorder seemed to be a Species of the Erisypelas.

Between the 9th and 12th of January, three Patients were seized with such Swellings.

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

The second was a Man of the Twentieth Regiment of Foot, who had been some Months in the Hospital for a hectic Complaint; he was taken ill, the same Night as the Dragoon, with a Swelling of his whole Face, particularly the Lips, which had a shining watery Appearance, and a slight Degree of Redness, attended with a strong Fever; and was cured by Bleeding, Purging, the Use of the saline Medicines, and the Application of a Blister.

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

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



OF THE SCURVY.

The true Scurvy, attended with spungy fetid Gums of a livid Colour, with livid Blotches, and Ulcers of the Legs, and other Symptoms, began to shew itself at Bremen in January 1762; tho' we had not the least Appearance of this Disorder in the Hospitals at any other Place, while I was with the Troops in Germany.

A great Variety of Disorders have been called by the Name of Scurvy: and the Disease has been divided into hot and cold; into the Acid, the Alcaline; and the Muriatic, according to the different Fancies of Authors, and the Causes they imagined it took its Rise from; but, from later and more accurate Observations, Dr. Lind has justly remarked, that the true Scurvy has been found to be the same in all the different Parts of the Globe, and to take its Rise from similar Causes; from Cold and Moisture, and living much upon salted Provisions, joined to a Want of fresh Vegetables, and of good generous fermented Liquors; and hence it is most frequent in low marshy Places in northern Climates, where there is a Scarcity of fresh Vegetables; and where the Inhabitants live much upon salted Provisions in Winter; and aboard of Ships in long Voyages or Cruizes, especially in the northern Seas; and hence this Disorder was so frequent at Quebec the first Winter it was in our Possession; and in some of the other Forts in North America, which were taken so late in the Year, that the Troops had not sufficient Time to lay in a Stock of Vegetables, and of fresh Meat to be preserved by the Frost[106]; but were obliged to live mostly on Ship Provisions.

[106] In Quebec, and other northern Parts of North America, as soon as the Frost sets in, they kill their Meat intended for their Winter Store, and hang it up: It soon freezes, and will keep in this Manner all through the Winter. They preserve Vegetables in the same Way; and when they intend to make Use of either, they put so much as they want into cold Water for some Time, which draws the Frost out of it; and then they boil or roast it, as they think proper.

It is observed, both at Sea and Land, that where the Scurvy rages, those People are least subject to it who are well cloathed; who live in dry Habitations, or lie in dry Births; who take proper Exercise, without being too much exposed to the Inclemency of the Weather; and who live well, and drink good Beer, Cyder, or Wine; as has been remarked by Dr. Pringle, Dr. Lind, and others.

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

The Cure of this Disorder requires—living in a dry comfortable Place—good Cloathing—light Food of easy Digestion, such as good Bread, Panado, Milk, Whey, Broths made of fresh Meats—white Meats, with Greens, or other Vegetable, &c.—the Use of Liquors of the acid or acescent Kind, or the moderate Use of Beer, Cyder, good Wine, or weak Punch[107]—And, by Way of Medicine, gentle Purges, mild Diaphoretics; the free Use of acid or acescent Fruits, Lemons, Oranges, Apples, Pears, Currans, Grapes, &c. and of the antiscorbutic Plants and their Juices, as Succory, Endive, Water-Cresses, Scurvy-Grass[108], &c. on which a great Part of the Cure principally depends; and the Use of some of the strengthening Bitters[109], of which the Bark is not the least efficacious.

[107] The free Use of raw Spirits is found to be very prejudicial; but a moderate Quantity of these Spirits, diluted with Water, and acidulated with Lemons or Oranges (or with Cream of Tartar, or Tamarinds, when the former cannot be got), and made into Punch, is found to be a good Antiscorbutic.

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

[109] Most of the common Bitters have been strongly recommended in this Disorder, Gentian, Trifoil, Wormwood, &c.—as likewise aromatic Bitters and Aromatics; such as calamus aromaticus, Carvi Seeds, Winters Bark, Cinnamon, and many others.

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

And where the Patient is strong, and there is no Danger of Haemorrhages, warm aromatic Baths have sometimes been found serviceable; but they are not to be used where the Patient is weak.

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

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

[110] Dr. Lind, who has wrote one of the best Treatises on this Disorder, and who had a great Deal of Practice himself, says, "When first the Patient complains of an Itching and a Spunginess of the Gums, with loose Teeth, either a Tincture of the Bark in Brandy, or aluminous Medicines, will be found serviceable in putting a Stop to the Beginning Laxity of these Parts." When the Putrefaction increases, he recommends the Use of some of the mineral Acids. See his Treatise on the Scurvy, part ii. chap. v. p. 201.—Van Swieten says, he never found any Thing answer better than a Gargle made of four Ounces of Elder or Rose Water, acidulated with a Drachm of the Spirit of Sea Salt; and where the Gums were very putrid and gangrened, he has been obliged to touch them slightly with the pure Acid Spirit, and some Hours after to have them washed with the Gargle just mentioned. Vide Comment. vol. III. p. 629, sect. 1163.

If the Spunginess of the Gums sprout out into a luxuriant Fungus, it is sometimes requisite to cut such Funguses away, and to wash the Sores frequently with gentle astringent or acid Liquors.

[111] Dr. Huxham observes, that, after the Disease has continued some Time, the Blood appears a mere Gore as it were, not separating into Serum and Crassamentum as usual, but remaining an uniform half-coagulated Mass, generally of a more livid or darker Colour than common; though sometimes it continues long very florid; but it always putrifies soon. See his Essay on Fevers, chap. v.

There is something very particular in the Nature of this Disorder, according to an Observation of Dr. Lind's; who says, "That the Scurvy is a Disease in its Nature very opposite to that of a Fever; insomuch, that even an Infection is long resisted by a scorbutic Habit; and those of a scorbutic Habit being seized with the Fever, was a Proof of its proceeding entirely from Infection." See his First Paper on Fevers, p. 4.

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

In February and March, seven or eight more scorbutic Patients were sent to the Hospital I attended, who were all treated in the same Manner; and all did well. About the Middle of February this Distemper began to shew itself in the other Hospital attended by Dr. Miller, who treated the Patients nearly in the same Way, and they all recovered.

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

[112] If the Swellings become large, stiff, and painful, Dr. Lind recommends that the Legs should be frequently bathed and fomented; or, what he has found preferable, to be exposed to their Steams, after being well covered with Blankets. After this Operation, he advises the Limb to be rubbed with some mild Oil, such as oleum palmae, or Salad Oil; and if the Swellings resist both the general Cure and these Applications, the Limbs to be sweated with Spirits. See his Treatise on the Scurvy, part ii, chap. v.

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

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

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



OF THE ITCH.

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

It has been found by Experience, that internal Medicines have little or no Effect in removing this Disorder; and that only external Remedies, which come immediately in contact with the Parts affected, are capable of making a Cure; which has been brought as a farther Proof, that the Itch is owing to Animalcules or Insects; as it is alledged, that no Remedies will cure the Distemper, but such as are capable of killing them.

The Medicines, which are most commonly used for the Cure, are Mercury, White Helebore, and Sulphur.

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

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

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

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

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

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

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

It is no uncommon Thing to see the Itch appear again, some Weeks after it has seemingly been cured by the Use of sulphureous Unctions; which most commonly happened to those who were in too great a Hurry to get well, and left off the Use of the Unctions too soon. Such Returns of the Itch were generally cured by the Repetition of the same Treatment as before.



TABLE of DIET.

The following is a Copy of the Table of Diet which was used in the Hospital all the Time I was with the Troops in Germany:

Breakfast. Dinner. Supper. One Pint of Rice Gruel; made with two Ounces of Rice, one Full Diet, Spoonful of fine One Pound of As Breakfast. Flower, a little Meat. common Salt, and fine Sugar. One Pint of Middle Diet, As above. Broth, Half a As above. Pound of Meat. One Pint of Broth; or Half As above, or a Pint of according to Panado, with two Low Diet, the Patient's Spoonfuls of As Breakfast. Stomach or Wine, and a Indisposition. Quarter of an Ounce of fine Sugar.

The daily Allowance of Bread was a Pound to those on full and middle Diet, and Half a Pound to those on low Diet, or a Pound, if so ordered by the Physician.

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

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

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



PHARMACOPOEIA IN USUM

Nosocomii Regii Militaris Britanici.

MDCCLXI.



PHARMACOPOEIA IN USUM

Nosocomii Regii Militaris.

Ann. MDCCLXI.

AQUAE SIMPLICES ET SPIRITUOSAE.

AQUA Alexeteria. —— Bacc. Juniperi. —— Cinnamomi. —— Menthae vulgaris. —— Menthae piperitidis. —— Nucis moschatae. —— Pulegii. —— Rutae.

Vel aliae aquae hujus generis praeparari possint, terendo in mortario vitreo elaeosacchara praeparata, cum oleis essentialibus, et sacchari albi 12la quantitate; et dein addendo aquae fontanae vel spiritus vini tenuis quantitatem sufficientem[114].

[114] Such Elaeosacchara (as they are called), made by rubbing the essential Oils with twelve Times the Quantity of Sugar, may at all Times be prepared at the fixed Hospital, and carried about with the flying Hospital, much more conveniently than the simple or compound Waters themselves.

Aqua calcis simp. Ph. Lond.

Dosis a lib. i. ad lib. ij. in die.

Aqua Hordeata. Ph. Lond.

Utenda pro potu.

BOLUS.

Bolus anodynus astringens.

Rx Theriacae andromachi, drachm. dimid. opii, gr. i. M. pro dosi semel vel bis die.

Bolus e rheo cum mercurio.

Rx Pulv. rhei, gr. xxv. calomel, gr. v. syrup sacchari, q. s.

Bolus e calomel.

Rx Calomel gr. v. conserv. rosar. scrup. i. M.

Bolus mercurialis.

Rx Argenti vivi, gr. x. extingue in balsam copaivi, q. s. et adde conserv. rosar. q. s.

Bolus e scordio cum rheo.

Rx Elect. e scordio, scrup. i. pulv. Rhei, gr. x. syrup, q. s. ut fiat bolus sumendus semel, bis, terve die.

COLLYRIA.

Collyrium saturninum.

Rx Sacchari saturni, salis ammoniaci crudi ana gr. vi. solve in aq. fontanae, unc. xij. adde pro re nata tinct. thebaicae, drachm. i.

Collyrium vitriolicum.

Rx Vitrioli albi, drachm. ss. solve in aq. fontanae, lib. i.

Confectio cardiaca. Ph. Lond.

Conserva cynosbat. Ph. Lond.

Conserva rosar. Ph. Lond.

DECOCTA.

Decoctum album. Ph. Lond. utendum pro potu.

Decoctum arabicum.

Rx Gum. arabici, unc. dimid. coque in aq. hordeatae bullientis, lib. ij. ad solutionem Gummi. utend. pro potu.—addi possit pro re nata spirit. nitri dulcis, drachm. ij.

Dococtum corticis Peruviani.

Rx Cort. Peruv. crass. pulv. unc. i. coque in aq. fontan. lib. iij. ad lib. ij. Colaturae adde tinct. cort. Peruv. unc. i. spirit vini Gallici sescunc. Dosis ab uncia i. ad unc. iv. bis ter. quaterve die.

Decoctum cort. cum serpentaria.

Fit addendo decocto cort. Peruv. sub sinem coctionis, rad. serpentariae virgin. contus. unc. dimid. Dosis ab unc. i. ad unc. iij. ter quaterve die.

Decoct. commun. pro clyster.

Rx Flor. vel herb. chamaemel. unc. i. coque in aq. fontan. lib. i.ss. ad lib. i. & cola.

Decoctum ligni guaiaci.

Rx Ligni guaiaci ras. lib. ss. aq. fontanae bullientis, cong. ij. macera per noctem; mane coque ad congium. i. & cola; Capiat a lib. ss. ad lib. ij. die.

Decoctum nitrosum.

Rx Coccinel. scrupul. i. coque in aq. fontan. lib. ijss. ad lib. ij. & dein adde salis nitri, unc. i. sacchar. albi sescunc. Colaturae addi possit pro re nata aq. alicujus spirit. unc. ij. Dosis ab unc. i. ad unc. iv. 4tis vel 6tis horis.

Decoctum pectorale.

Rx Fol. herb. malvae, unc. ij. feminum lini, unc. dimid. coque in aq. fontan. lib. ivss. ad lib. iv. addendo sub finem coctionis rad glycyrrhiz sescunc. vel mellis optimi, unc. i. Cola pro potu.—Adde pro re nata aceti, sescunc.

Decoctum rad. sarsaparillae.

Rx Rad. sarsaparillae, unc. iij. coque in aq. fontan. lib. iij. ad lib. ij. adde sub finem coctionis ligni sasafras, drachm. i. rad. glycyrrhizae, drachm. ij. Colaturae capiat a lib. i. ad lib. ij. in die.—Adde pro re nata vini antimonialis, drachm. ij.

ELECTARIA.

Elect. astringens balsamicum.

Rx Specier. e scordio, pulv. e tragacanth. comp. ana unc. i. tincturae thebaicae, drachm. ij. syrup sacchari, q. s. ut fiat elect. Dosis ad molem N. M. bis, ter. quaterve in die.

Elect. corticis Peruviani.

Rx Pulv. cort. Peruv. unc. iv. syrup sacchari, q. s. Dosis a scrup. i. ad drachm. unam, bis, ter, 4r. 6ties. vel decies die.

Elect. corticis anodynum.

Rx Elect. cort. Peruv. unc. 1nam. elect. e scordio unciam dimidiam, vel tinct. thebaicae scrup. ij.

Elect. corticis astringens.

Rx Elect. cort. Peruv. semunc. pulv. rad. tormentil, lapidis cancror. ppt. singulorum, drachm. i. syrup, q. s.

Elect. cort. cum serpentaria.

Rx Elect. cort. Peruv. unc. i. pulv. rad. serpentar. virgin. cort. canel. alb. ana, drachm ij. syrup. q. s.

Elect. cort. cum sale ammoniac.

Rx Elect. cort. Peruv. sescunciam. sal. ammon. crud. drachm. i.

Elect. e baccis lauri. Ph. Lond.

Elect. lenitiv. Ph. Lond.

Elect. lenitivum cum sulphure.

Rx Elect. lenitiv. lib. ss. flor. sulphuris, unc. ij. Dosis, moles, N. M. vel ad semunc. pro re nata.

Elect. lenitivum compositum.

Rx Elect. lenitiv. lib. i. pulv. jalap. unc. i. sal. nitri, drachm. ij. syrup. q. s. Dosis a drach. i. ad drach. iv. pro r. n.

Elect. lenitivum balsamicum.

Rx Elect. lenitiv. comp. unc. ij. bals. copaiv. unc. i. gum guaiac. unc. ss. M. Dosis, cochleare theae, h. s. vel mane & vesperi.

Electuar. e scordio vel diascordium. Ph. Lond.

Elect. e spermat. ceti.

Rx Balsam Peruv. unc. im. misce optime cum mucilag. gum arab. sescunciam & adde spermat. ceti, conserv. rosar. ana unc. xij. syrup sacchar. q. s. dosis, a dimidia drachma bis die ad drachm. im. quater vel sexties die.

Elect. stomachicum.

Rx Conserv. cynosbat. unc. iv. pulv. rad. zinziber. drachm. ij. canell. alb. unc. i. rubigin. martis, drachm. ij. syrup. q. s. dosis a scrup. i. bis terve die ad semidrach. 4tis horis.

Elect. e scammon. Ph. Lond.

ELIXIR.

Elix. aloes. Ph. Lond.

Elix. paregoricum. Ph. Lond.

Elix. vitrioli acid. Ph. Lond.

ENEMATA.

Enema commune laxativ.

Rx Aq. fontan. calid. unc. xij. elect. lenitiv. semunc. sal. cathartici amari, unc. i. M.

Enema commun. oleos.

Rx Aq. fontan. bullient. unc. x. mucilag. gum arabic. unc. im. olei olivar. unc. ij. adde pro re nata elect. e scord. drachm. ij. vel. tinct. thebaic. drachm. i.

Enema ex amylo.

Rx Aq. fontan. calid. unc. iv. gelatin. amyli, unc. v. elect. e scord. drachm. i. M.

Enema terebinth.

Rx Terebinth commun. drachm. vi. solve in vitello ovi & adde enemat. oleos. unc. x.

Emplastrum vesicatorium. Ph. Lond.

FOTUS.

Fotus communis.

Rx Fol. malv. flor. chamaemel. singulorum, m. i. coque in aq. fontan. q. s.

Fotus commun. spirit.

Rx Fotus commun. lib. ij. aceti, lib. i. spirit. vini tenuis, lib. ss. M. pro fotu.

Fotus cum sale ammoniac.

Rx Fotus commun. lib. ij. sal ammoniac crud. unc. i.

Fotus volatilis.

Rx Fotus commun. q. s. asperge panno statim ante applicationem spiritus sal. ammoniac, q. s.

GARGARISMATA.

Gargarisma commune.

Rx Aq. hordeat. unc. xij. sal. nitri, drachm. i. mellis semunc. M. adde pro re nata spirit. vin. unciam i.

Gargarisma acidum.

Rx Aq. hordeat. unc. xij. spirit. vini gallici, unc. i. aceti sescunc. tinct. myrrhae, drachm. ij. M.

Gargarisma volatile.

Rx Aq. hordeat. unc. xij. spirit. vin gallic. unc. ij. sal. vol. ammoniaci, drachm. i. M.

GUTTAE ANTIMONIALES ANODYNAE.

Rx Vini antimonialis, unc. im tinct. thebaic. drachm. ij. dosis a gutt. 30 ad 40 bis terve die, vel a gutt. 60 ad 140, h. s. in potu tepido.

HAUSTUS.

Haustus simplex.

Rx Aq. fontan. sescunc. spirit. vini gallici drachm. i. ss. sacchar alb. drachm. dimidiam M.—Haustus praeparari possit aqua aliqua simp. et spirit. loco aq fontan. & spirit. vini gallici pro re nata.

Haustus anodynus.

Rx Haust. simp. sescunc. tinct. thebaic. gutt. xx. M.

Haustus camphoratus.

Rx Camphorae, gr. iij. tere in mortario cum sacchar. alb. drach. dimid. & dein adde mucilag. gum arabici, drachm. ij. haust. simp. sescunciam. M. s. a. Dosis repetenda, 4ta vel 6ta. quaque hora.

Haust. emetic. antimonialis.

Rx Vini antimonialis semunciam. Dari possit ad drachm. x. pro r. n.

Haust. emeticus scilliticus.

Rx Oxymel. scillit. drachm. x. aq. fontan. semunc. pulv. rad. ipecacoan. gr. vi.

Haustus cardiacus.

Rx Haust. simp. sescunciam confect. cardiac. scrup. im. M. f. haustus repetendus 4tis. vel 6tis. horis—adde pro re nata sp. lavend. comp. dr. i.

Haustus cardiacus oleosus.

Rx Ol. essential. menth. gutt. ij. tere in mortario vitreo cum sacchar. alb. drachm. dimid. & adde haust. simplicis sescunc. tinct. stomachic. drachm. i. M.—adde pro re nata tinctur. thebaic. gutt. x.

Haustus lixiviosus anodynus.

Rx Haust. simp. sescunciam, lixivii tartari, drachmam dimidiam tincturae thebaicae, gutt. xx. cap. h. s. vel mane & vesperi.

Haustus e mithridatio.

Rx Haust. simp. sescunc. mithridat. scrup. i. aceti vin. drachm. iij. dosis repetenda 4tis. vel 6tis. horis.

Haustus oleosus communis.

Rx Mucilagin. gum arabici, drachm, iv. ol. olivar, drachm. v. misce s. a. & adde haust. simp. sescunciam. Repet. 4tis. vel 6tis. horis.

Haustus oleosus cum rheo.

Rx Haust. oleos. communis, unc. ij. tinct. rhei sescunc. vel pulv. rhei, gr. xxv. tinct. thebaic. gutt. xv. M. fiat haustus sumendus vel h. s. vel primo mane.

Haustus purgans.

Rx Infus. senae. unc. iij. sal. glauber. drachm. iij. spirit. vin. gallici, drachm. ij. sacchar. alb. drachm. dimid. capiat mane.

Haustus salinus communis.

Rx Aceti vinosi vel succ. limonum semunciam, sal. absynth. scrup. i. vel ad saturationem, haust. simp. sescunciam adde pro re nata pulv. contrayerv. comp. scrup. i. vel pulv. contrayerv. cum nitro, scrup. ij.—Haustus praeparari possit cum salis diuretici drachma dimid. loco acidi & salis absynthii. Dosis repetend. 3tiis. 4tis. vel 6tis. horis—Eodem modo sit haustus cum spirit. mindereri uncia dimidia.

Haust. salin. cum confect. cardiaca.

Rx Haust. salin. commun. unc. ij. confect. cardiac. scrup. i. M. repet. 4tis. vel 6tis. horis.

Haust. salin. cum mithridatio.

Rx Haust. salin. commun. unc. ij. mithridatii, scrup. i. M. sumend. 4tis. vel 6tis. horis.

Haustus salin. cum rheo.

Rx Haust. salin. com. uncias ij. pulv. rhei, gr. xxv. M. capiat mane.

Haustus salin. cum phu.

Rx Haust. salin. commun. unc. ij. pulv. rad. valerian. sylvestris, scrup. ij. Dosis repetend. 2dis. 4tis. vel 6tis. horis.

Haust. salinus succinatus.

Rx Haust. salin. commun. unc. ij. sal succini, pulv. castorei singulorum, gr. x. H. repetend. 4tis. vel 6tis. horis.

Haust. salinus purg. oleosus.

Rx Mannae opt. semunc. olei olivar. drachm. vi. vitelli ovi q. s. tere in mortario, addendo paulatim sal cathartici amari, unc. i. solutam in aq. fontan. calid. unc. iij. spirit. vini gallici vel aq. alicujus spirituosae, drachm. iij. M. s. a pro dosi matutino.

Haustus volatilis.

Rx Haust. simp. sescunciam sal. vol. c. cervi, gr. x. M. H. repet. 4tis. vel 6tis. horis.

INFUSA.

Infusum amarum. Ph. Lond. Addi possit pro re nata in praeparando spirit. vini tenuis, lib. ss. ad lib. ij. infusi. Dosis ab unc. ina. bis die ad unc. ij. ter. die.

Infusum raphani rusticani.

Rx Rad. raphani rusticani, unc. ij. baccar. juniper, unc. inam. cort. canell. alb. drachm. ij. aq. fontan. bullient, lib. iv. infunde per noctem leni calore. Colaturae adde spirit. vini gallici unc. iv. Dosis ab. unc. i. bis terve die ad unc. iv. 6tis. horis.

Infusum senae commun. Ph. Lond.

JULEPUM E MOSCHO.

Rx Mosch. drachmam im. tere optime in mortario cum sacchar. alb. drachm. iij. & adde mucilagin. gum arab. dr. iv. Haust. simp. unc. vi. Dosis unc. ij. 4tis. vel 6tis. horis.

LINCTUS.

Rx Conserv. cynosbat. unc. iv. ol. olivar. syrup. sacchari vel mellis ana unc. ij. adde pro re nata spirit. vitrioli tenuis, drachm. iv. Dosis cochleare theae urgente tussi.

LINIMENTA.

Liniment. saponaceum. Ph. Lond.

Linimentum camphoratum.

Rx Olei olivar. unc. ij. camphorae, drachm. ij. M.

Linimentum volatile. Ph. Lond.

Linimentum volatile commune.

Rx Olei olivar. unc. iij. spiritus salis ammoniaci, dr. vi. M.

MELLA.

Mel cum borace.

Rx Mellis optimi, unc. i. pulv. subtilissim. boracis, dr. i. M.

Mel AEgyptiacum. Ph. Lond.

Mel rosaceum. Ph. Lond.

MITHRIDATIUM. Ph. Lond.

MIXTURAE.

Mixtura acida communis.

Rx Haust. simp. unc: viij. spirit. vitrioli tenuis, scrup. ij. vel ad gratam aciditatem. Dosis ab. unc. ij. ad unc iv. 4tis. vel 6tis. horis.

Mixtura ammoniaca.

Rx Gum ammoniaci, drachm. i. solve in haust. simp. unc. vi. Dosis ab. unc. i. ad unc. ij. bis terve in die.

Mixtura ammon. cum oxymel.

Rx Mixt. ammoniac. unc. vi. oxymel scillit. drachm. vi. Dosis a cochlear. i. ad unc. ii. ter. 4rve. die.

Mixtura ammoniac. anodyna.

Rx Mixt. ammoniac. cum oxymel. unc. vi. tinct. thebaic. drachm. dimid. Dosis a cochlear. i. ad iv. 4tis. vel 6tis. horis.

Mixtura Campechensis.

Rx Extract. ligni Campechensis, drachm. iij. solve in haust. simplic. unc. vi. adde pro re nata tinct. thebaic. gutt. xxx. vel Philon. Londinen. drachm. i. Dosis ab. unc. i. ad unc. iij. bis, ter, 4rve. die.

Mixtura faetida.

Rx G. asafaetid. drachm. i. solve in haust. simp. unc. vi. Dosis ab. unc. i. ad unc. iij. 4r. die.

Mixtura faetida volatilis.

Rx Mixt. faetid. unc. vi. spirit. volat. sal. ammon. drachm. i. Dosis ab. unc. i. ad unc. ij. bis, ter, 4rve. die.

Mixtura fracastorii.

Rx Haust. simp. unc. viij. Elect. e scordio, drachm. iv. Dosis ab. unc. i. ad unc. ij. 4tis. vel 6tis. horis.

Mixtura japonica.

Rx Haust. simp. unc. vi. Tinct. japonic. unc. i. adde pro re nata tinct. thebaic. dr. i.

Mixtura laxativa.

Rx Elect. lenitiv. unc. i. Mannae semunc. coque in aq fontan. unc. xvi. ad unc. xij. Colaturae adde sal. cathartici amari. sescunciam. spirit. vini gallici, unc. i. Dosis ab. unc. ij. ad unc. xij.

Mixtura purg. antimonial.

Rx Elect. lenitiv. sescunc. mannae semunc. coque in aq. fontan. unc. xx. ad unc. xvi. & dein solve tartar. emetici, gr. x. Colaturae dosis ab. unc. i. ad unc. iv. omni hora vel omni 2da. vel 3tia. vel 4ta. hora, donec laxetur alvus.

Mixtura oleosa volatilis.

Rx Haust. simp. unc. vi. ol. olivar. unc. iij. spirit. volatil. salis ammoniaci drachmam inam. M. Dosis ab. unc. i. ad unc. iij. 3tiis. vel 4tis. horis.

Mixtura scillitica.

Rx Haust. simp. unc. vi. oxymel scillitic. drachm. vi. Dosis a drachm. iv. ad unc. ij. bis, ter, 4rve. die.

Mixtura e spermat. ceti.

Rx Spermat. ceti, drachm. ij. solve in vitello ovi & adde haust. simp. unc. vi. adde, pro re nata, tinct. thebaic. scrup. ij. Dosis ab. unc. i. ad unc. ij. 4tis. vel 6tis. horis.

Mixtura e spermat. ceti cum balsamo.

Rx Balsam. copaiv. drachm. ij. tere in mortario cum mucilag. gum arabici, drachm. iij. & dein adde mixtur. e spermat. ceti, unc. vi. Dosis ab. unc. i. ad unc. iij. 4tis. vel 6tis. horis.

MUCILAGO. G. ARABICI.

Rx G. arabici pulv. unc. iv. solve in aq. purae bullient. unc. x.

Oxymel scillit. Ph. Lond.

Philonium Londinen. Ph. Lond.

PILULAE.

Pilulae faetidae.

Rx Gum asafaetid. myrrh. ana drachm. i. sapon. alb. hispan. drachm. ij. Tinct. fuliginis q. s. Dosis a gr. x. ad drachm. dimid. bis terve die.

Pilulae guaiac.

Rx Sapon. albi hispanici semunc. gum guaiac, scrup. iv. syrup. q. s. Dosis a scrup. i. ad drachmam dimidiam bis terve die.

Pilulae gummosae. Ph. Lond.

Pilulae mercuriales.

Rx Argenti vivi semunc. extingue in balsam. copaiv. q. s. & adde pulv. glycyrrhiz. gum guaiac. singulorum, drachm. vi. syrup. q. s. ut fiat massa. Dosis a scrup. ss. ad drachmam dimidiam semel vel bis die.

Pilulae rufi. Ph. Lond.

Pilulae saponaceae. Ph. Lond.

Pilulae saponaceae cum rheo.

Rx Sapon. alb. hispanici, drachm. vi. pulv. rhei, drachm. ij. syrup. sacchari q. s. Dosis a scrup. i. ad scrup. ij. bis terve die.

Pilulae scilliticae.

Rx Pulv. glycyrhiz. rad. scill. exsiccat ana drachm. dimid. rad. zinziber. drachm. i. sapon. alb. hispan. drachm. ij. syrup. q. s. Dosis a gr. iv. ad. gr. xvi. bis terve die.

Pilulae stomachicae.

Rx Pulv. canell. alb. drachm. ij. extract. rad. gentian. dr. i. mucilag. gum arabici q. s. Dosis a scrup. i. ad drachmam dimid. bis die—adde pro re nata rubigin. martis drachmam dimid.

PULVERES.

Pulvis astringens.

Rx Pulv. canell. alb. rad. tormentill. singulorum, drachm. i. M. Dosis a scrup. i. ad drachm. i.

Pulvis aluminosus.

Rx Alumin. crud. terrae japonicae ana partes aequales dosis a gr. viij. ad drachmam dimidiam.

Pulv. anodynus Doveri.

Rx Sal. nitri, tartari vitriolati singulorum, unc. iv. in crucibulum candens injice, agitetur donec deflagratio & scintillatio desinat, & adde opii concisi, unc. i. & in pulverem redige addendo rad. glycyrrhiz. ipecacoanhae subtilissime pulver. ana, unc. i. & dein probe misceantur omnia. Dosis a gr. x. ad scrup. ij. vel ad drachmam 1nam.

Pulvis antimonialis.

Rx Pulv. e chel. cancror. drachm. x. tartari emetici, dr. i. M. fiat pulv. subtilissimus. Dosis a gr. iij. ad gr. x. 4ta. vel 6ta. quaque hora.

Pulvis cardiacus.

Rx Pulv. canell. alb. drachm. i. rad. zedoariae, drachm. ij. rad. serpentar. drachm. i. M. dosis a scrup. i. ad drachm. i. 4tis. vel 6tis. horis.

Pulvis chamaemelinus.

Rx Pulv. flor. chamaemel. drachm. iij. aluminis, g. myrrh. ana drachm. i. Dosis a scrup. i. ad scrup. ij.

Pulv. contrayerv. comp. Ph. Lond.

Pulv. contrayerv. cum nitro.

Rx Pulv. contrayerv. comp. unc. iv. salis nitri, drachm. i. M. Dosis a scrup. i. ad drachm. i. 4tis. vel 6tis. horis.

Pulvis emeticus.

Rx Pulv. ipecacoanhae, scrup. i. tartar emetici, gr. ij. Dosis a gr. xi. ad gr. xxii.

Hiera picra. Ph. Lond.

Pulv. Ipecacuanhae cum opio.

Rx Pulv. rad. ipecacoan. gr. x. opii, gr. ij. dosis a gr. iij. ad gr. xij.

Pulv. e jalapio.

Rx Pulv. rad. jalapii, drachm. vi. rad. zinzib. drachm. ij. Dosis a scrup. i. ad scrup. ij.

Pulv. jalapii cum nitro.

Rx Pulv. rad. jalap. drachm. iv. salis nitri drachm. im. Dosis a scrup. i. ad scrup. ij.

Magnesia alba.

Pulv. nitrosus.

Rx Pulv. e chel. cancror. drachm. iij. nitri, drachm. i. M. Dosis a scrup. i. ad scrup. ij. vel ad drachmam. i.

Pulv. nitrosus camphoratus.

Rx Pulv. nitros, scrup. ij. camphorae, gr. v. M. Dosis a scrup. i. ad scrup. ij.

Pulv. nitrosus cum gum guaiac.

Rx Sal. nitri, drachm. ij. gum guaiac. drachm. dimid. Dosis a gr. v. ad drachm. dimid.

Pulv. plummeri.

Rx Calomel, sulph. aurat antimonii ana dr. ij. tere in mortario ut fiat pulv. subtilissimus. Dosis a gr. ij. ad gr. x. vel ad scrup. im.

Pulvis stanni. Ph. Lond.

Pulv. e spermat. ceti cum nitro.

Rx Spermat. ceti, drachm. ij. sacchar. albi sal. nitri ana unc. im. Dosis a scrup. dimid. ad drachmam i.

Pulv. e tragacanth. Ph. Lond.

SALES ACIDI.

PRAEPARATIONES. Spir. vitrioli fortis Acida tenuis Spir. vitrioli dulcis mineralis Spiritus nitri Spir. nitri dulcis AEther. Spir. salis marini Spir. salis dulcis.

Varietat. acid. Acetum. vegit. Spiritus aceti vel acetum distillatum. Succus limonum. Chrystalli tartari.

Acid. anomal. Sal. succini. Sal. sedativus Hombergeri.

SALES ALCALINI.

Alcal. vegit. Sal. absynthii. Sal. tartari.

Alcal. min. Sal. alcali mineral. seu soda, seu natrum.

Alcal. vol. Sal. volatilis c. cervi. Sal. volatilis sal. ammoniaci.

SALES NEUTRI.

SALES NEUTRI, qui fiunt ex ALCALI et ACIDO.

Tartarus vitriol. vegetab. Sal. glauberi minerali vitrioli. Sal. am. vitrioli volatili

Sal. nit. com. vegetab. Nit. cubicum mineral. nitri. Sal. am. nitrosum volatili.

Sal. digest. sylvii vegetabil. marin. com. minerali Sal. marini. ammon. com. volatili

Varietates Sal. diureticus vegetab. aceti. salis Tartar. tartar. veget. chryst. tartar. neutri tartari comp. ex Sal. citratus com. veget. succ. limonum. Vegetabil. alcal. & absynth. acid. Sal. de seignette minerali chryst. tartar. vegitab. Spir. mindereri. volatili acet. distillat.

Hi omnes sales neutri praeparari possint pro usu medico admiscendo Alcali & acidum ad saturationem; alii vero in crystallos redacti, s. a. commodius circumferuntur pro usu militari; alii ut sal. citratus comm. et spiritus mindereri facilius praeparantur ad miscendo alcali & acidum ad saturationem pro re nata[115].

[115] This Table of neutral Salts is nearly the same as one I have seen, which was said to be a Copy of that given yearly by Dr. Cullen, Professor of Chymistry in the University of Edinburgh, to his Pupils; and as that published by Dr. Vogel, in his Institutiones Chymiae, sect. 629. These neutral Salts are likewise taken Notice of by Macquer, in his Elemens de Chymie, and other late chymical Authors.

Solutio mercurii corrosivi sublimati.

Rx Mercur. corrosiv. sublimat. gr. vi. spir. vini gallici, unc. xii. M. fiat solutio. Dosis a semunc ad unc. i. die.

Species aromaticae. Ph. Lond. —— e scordio. Ph. Lond.

Tartar. emetic. Ph. Lond.

Theriaca andromachi. Ph. Lond.

TINCTURAE.

Tinctura amara. —— corticis Puruv. —— martis in sp. sal. —— japonica. —— melampodii. Pharm. Lond. —— myrrhae. —— sacra. —— saturnina. —— serpentariae. —— thebaica.

Tinctura rhei.

Rx Pulv. rad. rhei, unc. ij. semin. cardamom minor. decortic. semunc. vini alb. hisp. lib. ij. sp. vini gallici, unc. viij. digere sine calore & cola. Dosis ab. unc. i. ad unc. iij.

Tinctura stomachica.

Rx Cort. canell. alb. semunc. cort. aurantior. unc. i. semin. cardam. minor. decort. drachm. ij. spirit. vini gallici lib. ij. digere sine calore & cola. Dosis a semunc ad unc. i. bis terve die.—Adde pro re nata vin alb. hisp. lib. i.

UNGUENTA.

Unguenta caerulea vel mercurial. Ph. Lond.

Unguentum sulphuratum. Ph. Lond.

VINA.

Vinum amarum. —— antimoniale. Pharm. Lond. —— chalybeatum.

VITRUM CERATUM ANTIMONII.



AN ESSAY ON THE MEANS of Preserving the Health of SOLDIERS on SERVICE. AND Conducting MILITARY HOSPITALS.



OF THE Means of Preserving the Health of Soldiers on Service.

The Life of British Soldiers on Service, in Time of War, is so very different from what they lead in Time of Peace, as to subject them to many Inconveniences and Diseases.

In Time of Peace, Soldiers are quartered either in Towns or Garrisons, where they are under the Eye of their Officers, who take Care that they keep themselves clean, and provided with Necessaries; they lie either in private Houses or in Barracks, where they have a good Bed, regular Meals of wholesome Provisions, and enjoy most of the other Necessaries of Life in common with the lower Class of People, their Duty is easy, they mount Guard but seldom, and in other Nights enjoy an undisturbed Rest.

Whereas, during the Time of an active Campaign, they are seldom in Houses; they lie in Tents upon the Ground, which is often bare, and at best covered only with Straw and a Blanket; and sometimes they are obliged, after fatiguing Marches in wet Weather, to lie on the bare Ground, without even a Tent to cover them; they must stand Centinel, and be upon Pikets and other Out-Posts in the Night, during all Kinds of Weather; besides performing long fatiguing Marches, and other military Duties; and when near an Enemy, they are perhaps on Duty every second or third Night, besides working Parties, and other Duties of Fatigue; and what Rest they have is interrupted by frequent Alarms. They have often but little Time or Convenience to make themselves clean. Provisions are sometimes scarce, and frequently on long Marches they have no Opportunity of dressing what they can get: Water is sometimes difficult to be come at, and what is to be got, is bad. And it frequently happens, that neither Beer, Wine, nor Spirits, can be purchased for Money. In fixed Camps, they are often exposed to the putrid Effluvia of dead Bodies, of dead Horses, and other Animals, and of the Privies and Dung of the Horses[116]; and, in some Encampments, likewise to the unwholesome Vapours of marshy Ground, and of corrupt stagnating Water: All which, joined to the other Hardships and Inconveniences unavoidably attending a military Life in Time of Service, often give Rise to numerous Diseases, which weaken an Army in a most surprising Manner; and therefore Commanders ought to use every Means in their Power, consistent with the necessary military Operations, to preserve the Health of the Soldiers.

[116] In the Year 1760, the Men, who remained in the fixed Camp about Warbourg, were very unhealthy; while the Regiments who were detached to the Lower Rhine, under the Command of the Hereditary Prince of Brunswick, enjoyed a much better State of Health; and notwithstanding their great Fatigues, and the Loss they sustained at the Affair of Kampen, were much stronger when they rejoined the Army to go upon the Winter Expedition into the Country of Hesse, than those Regiments which had remained in the fixed Camp.

Diseases are more or less frequent in Armies according as the Season is hot or cold, wet or dry; according to the Nature of the Climate, and the Time of the Year in which military Operations are carried on; the Nature of the Ground on which the Army is encamped, or the Situation of the Towns or Villages in which they are cantonned; the Cleanness, Neatness, and Dryness of the Camp, and of the Tents or Houses in which the Soldiers are lodged; according as the Men are supplied with Provisions, and good Water, good Beer, Wine, or other fermented Liquors; or are well cloathed, and well furnished with Straw and Blankets; in proportion as the Duty is more or less severe; and to the Care taken of such as are attacked with Sickness.

Soldiers generally enjoy good Health in cold dry Weather, even during the Time of severe Frost; if they be kept in Exercise, be well cloathed, and well supplied with Provisions and good Liquors, and with Wood; as the Troops, both in Germany and North America, experienced during the late War; but Cold joined to Moisture was observed always to be productive of Diseases.

Nor is mere Heat of itself such an Enemy to Health[117] as is generally apprehended; but when joined to Moisture, is observed to give Rise to the most fatal Disorders in the warm Climates.

[117] This Dr. Pringle takes Notice of; and Mr. Naesmith says, he observed it in Voyages to the East Indies, which afford the fairest Trials of this Kind. See Dr. Lind's Essay on the Means of Preserving the Health of Seamen, 2d edit. note to page 5.

In our northern Climates the Winters are cold, and the Weather variable; sometimes it is cold and rainy, at other Times thick and foggy; sometimes we have fair Weather and Sunshine, at other Times Frost and Snow; and sometimes it happens that we have all these different Sorts of Weather in the same Day. During this Season, Soldiers are subject to Coughs, Pleurisies, Peripneumonies, Rheumatisms, and other Disorders of the inflammatory Kind. And in very intense Frost, they are liable to have their Limbs benumbed with Cold, and their Extremities Frost bit (as it is called).

And where there is a Want of fresh Provisions, and they are obliged to live on salted Meat, and cannot have Greens, Pot Herbs, Roots, or other fresh Vegetables, nor be properly supplied with Beer, Cyder, Wine, or other generous fermented Liquors, they, as well as Sailors, are subject to the Scurvy[118]; especially if they be encamped or quartered in low damp Places.

[118] Dr. Joh. Valint. Willius, Army Physician to the King of Denmark, in his Treatise on Camp Diseases, says, you scarce find a Camp in these northern Countries in which the true Scurvy, attended with stinking Breath and eroded Gums, is not to be observed. Cap. iii. sect. iii.

The best Means of guarding against inflammatory Disorders, and other Mischiefs arising from Cold, whether in Camp or in Quarters, is, to take Care that the Soldiers be well cloathed; that they lie dry, and be well provided with Straw and Blankets, and with Wood; and to prevent, as much as possible, their exposing themselves to sudden changes from Heat to Cold.

In these northern Climates, it would be right to allow every Soldier on Service a Flannel Waistcoat, a Pair of worsted Gloves, and a warm woollen Stock, or a Neckcloth, to wear when on Duty in cold and wet Weather, as soon as the Winter begins to set in[119]. Dr. Pringle mentions the Advantage the Troops received from the Flannel Waistcoats supplied by the Quakers, in the Winter Campaign of 1745-6, in Britain; and those Regiments who had them for their Men towards the End of the Campaigns in Germany, found that they contributed greatly to keep the Men in Health. Officers ought to take particular Care that the Men be well provided with good strong Shoes and Stockings; and where the Troops remain late in the Field, if the Government allowed a Pair or two extraordinary of each to every Foot Soldier, it would be of great Use to the Service.

[119] A Flannel Waistcoat, worsted Gloves, and woollen Stock, or a Neckcloth, may be purchased for about Half a Crown per Man, and would contribute to preserve the Lives of many; the recruiting of others, to supply whose Places, if they die, will cost the Government a great deal more than the Price of the Articles mentioned; which for a Regiment of nine hundred Men, at the Rate of two Shillings and Six-Pence per Man, comes only to 112l. 10s. per Ann. Every Recruit sent from England to the Army in Germany, cost the Government at least twenty Guineas before he joined his Regiment; and every sick Man sent to the general Hospital, cost the Government at least sixteen Pence per Day, which is ten Pence above his Pay; so that, if we suppose the extraordinary Cloathing here mentioned would preserve only the Lives of nine Men to each Regiment yearly, and keep forty in Health who would otherwise be sick, we see what great Gainers the Government will be in Point of Money at the Year's End; besides preserving the Lives and Health of so many Men.

Blankets ought to be provided for each Tent, and those carried along with the Regiment, so as to be always ready for the Men when they come to their Ground. During the late War in Germany, a Couple of Blankets were allowed for each Tent of the British Troops, and each Company carried their Blankets covered with an Oil Cloth on a Horse; so that they were always up with the Regiments when they came to their Ground.

Each Regiment ought to be provided with a Number of Watch Coats sufficient to serve the Centinels who are to be on Camp Duty, or general Guards, in very cold and wet Weather. Some of the Regiments in Germany had such Coats, and found great Service from them.

In Winter Quarters, Soldiers are apt to make the Rooms in which they sit, and their Guard Rooms, as hot as possible; especially in Germany, where the Inhabitants use close Stoves, instead of open Fires; and continue in these warm Rooms till they are called out on Duty, when, by being exposed to sudden Cold, they are apt to be seized with Inflammations of the Breast; and therefore Officers ought to examine carefully the Quarters and Guard Rooms allotted for their Men, and chuse them dry and comfortable, if possible[120]; but never to allow the Men to keep them as hot as Ovens, by Means of close Stoves, or other such Contrivances; but to depend more on good warm Cloathing, and dry Quarters, for guarding against Diseases, than upon artificial Heat. Many of the Regiments in Germany made the People in whose Houses their Men were quartered, take down their Stoves, and use only open Fires; when there was no Danger of the Soldiers making their Quarters too warm, as Wood was difficult to be got.

[120] Dr. Pringle has very justly observed, that upper Stories are preferable to Ground Floors; and that all uninhabited large damp Houses ought to be rejected. Observat. on Diseases of the Army, part ii. chap. iii. sect. 2.

If Necessity obliges Officers to put up with such Places for their Men, Care ought to be taken to clean them well, and to air and dry them by Means of Fires, before the Soldiers go into them; and to supply well the Men who are to lodge in them with Straw and Blankets, and with Wood or Turf.

But although close Stoves are prejudicial in small Rooms, yet when a Town is much crowded, and Men are obliged to be lodged, in Winter, in large Barns or Churches, or other large open Places, the German Stoves may be used with great Advantage in airing and drying such Places, and keeping them of a moderate Heat; especially if there be a Place in them for an open Fire, or if they be of that Kind which the Germans call wynd Stoves, which have a Door opening into the Chamber where the People are lodged; or if there be broken Windows, or any other Opening by which a free Circulation of Air can be kept up in the Men's Apartments.

In Winter, when the Weather is very cold or wet, a Glass of Brandy, or of the spirituous Tincture of the Bark, given to the Men as they went upon Duty, especially in the Night, has been found to be of great Use[121]. Dr. Pringle has very justly observed, that the Times of standing Centinel, and being upon Out-posts, ought, if possible, to be shortened at such Seasons; and that Fires in the Rear of the Camp, for Men coming off Duty to warm and dry themselves at, were found to be of great Service.

[121] Dr. Pringle has taken Notice, that it would be a right Measure to make an Allowance of Spirits to the Infantry on Service; which certainly would be of great Use, and save many Mens Lives; and might be done at a small Expence to the Government, if properly managed; as it would only be requisite to make such an Allowance when the Troops are in the Field, and to such Men as mount Guard in cold wet Weather, or at Nights in Garrison Towns, during the Winter. If ever such an Allowance be made, what Spirits are given to the Men ought to be mixed with five or six Times the Quantity of Water; except when Men are to stand Centinels, or to be upon Out-Posts, in a frosty Season, or in cold wet Weather; at which Time a small Glass of pure Spirits may be given them in Presence of the Officer or Serjeant of the Guard.

In Spring, and the latter End of Autumn, the Days are sometimes extremely hot, and the Nights cold and damp, and the Men exposed to these sudden Changes; at such Times, the Men who go upon Duty in the Night, ought to put on their Flannel Waistcoats, and be warmer cloathed than in the Day; and use many of the Precautions practised in Winter for the Preservation of their Health.

In North America, when the Men were in the Field in very hard frosty Weather, Fires were lighted at the Ends of the Tents, and Centinels set over them to prevent their doing Mischief; and both in Germany and North America, when the Troops were in the Field without Tents, they cut down Wood and made large Fires, and the Soldiers lay down and slept round these Fires, with their Feet next to them; and Fires were lighted at all Out-posts, where it could be done with Safety.

In Germany, when the Weather set in rainy or cold towards the End of the Campaigns, and the Army was in a fixed Position, his Serene Highness Prince Ferdinand constantly ordered the Army to Hutt; which was done either by thatching their Tents, or building Hurdles, or digging Pitts, and covering and thatching them over. The Officers either built Hutts with Fire Places, or had Chimnies built to their Tents.

If, notwithstanding all Precautions, Men upon Out-posts should be benumbed with Cold, or Frost bit, as soon as they are brought into Camp or Quarters, their Extremities ought to be rubbed with Snow, or put into cold Water[122]; and afterwards well dried, and wrapt up in Blankets; and warm mild Liquors given them to drink, and afterwards Cordials; and, after some Time, they may be brought near the Fire, or put to Bed. Dr. Lind[123] mentions one Caution to be used when Men are found in this Condition; which is, not to give them immediately strong spirituous Liquors, for that those often prove instantaneously fatal; but to put them to Bed, and give warm Water Gruel, or some other mild diluting Liquor, to drink; after which, he says, a Glass of Spirits will prove less dangerous and more beneficial.

[122] Hildanus relates a very remarkable Instance of the good Effects of this Treatment. A Man was found quite stiff and frozen all over. He was put into cold Water, and immediately the icy Spicula were discharged from all Parts of his Body, so that he seemed covered with an icy Crust. He was then put into a warm Bed, and took a Cordial Draught, and a plentiful Sweat followed; after which he recovered with the Loss of the last Joints of his Fingers and Toes. De Gangraena, cap. xiii. People who are benumbed with Cold in frosty Weather ought never to be brought immediately near a Fire; for that has been found either to cause immediate Death or Gangrenes of the Extremities; and even Apples and other Fruits which have been frozen, if brought immediately near a Fire, turn soft and rot; but if put into cold Water, throw out the icy Spicula, and recover, so as to be almost as good as before they were frozen.

[123] Means of Preserving the Health of Seamen, 2d edition, page 19.

When Men are quartered or cantonned in Towns or Villages, whose Situation is low and damp, and where fresh Meat and Vegetables are scarce in Winter, and the Scurvy frequent among the lower Class of People; Commanding Officers, at the Approach of Winter, ought to use their Endeavours to provide a Store of Potatoes, Onions, Cabbages, sour Crout; of pickled Cabbages, and other pickled Vegetables; of Apples and other Fruits, preserved in different Forms, to be laid up, and sold out to the Men at a cheap Rate during the Winter. They should contract, if possible, with Butchers to furnish the Men with fresh Meat[124], and endeavour to procure good small Beer, or Cyder or Wine in the Wine or Cyder Countries; or Spirits to be mixed with Water, and a small Proportion of Cream of Tartar or Vinegar; or some other wholesome fermented Liquor for their Drink[125]; and to put their Men into as dry comfortable Quarters as possible.

[124] The Regiments in Germany who kept their Butchers in Winter, and made Stoppages of the Mens Pay, and obliged them to take a certain Quantity of Meat daily, were much more healthy than those who used no Precaution of this Kind.

[125] In Places where the Articles here mentioned are at too high a Price for a Soldier's Pay, a small Allowance, from the Government, of such Things would contribute much to the Preservation of the Mens Health in unwholesome Garrisons.

In Times of War, when Men are sent upon Expeditions into warm Climates, great Care ought to be taken to embark such only as are in good Health; particular Regard ought to be paid to those who are picked up in the Streets, or have been taken out of the Savoy, or other Jails. All dirty Rags from off such People ought to be thrown away or burnt; and the Men, after being well washed, and new cloathed, ought to be kept for a Fortnight or three Weeks in some Garrison Town, or with their Regiments, in open airy Places, that it may be ascertained that they have no infectious Disorder before they be put aboard the Transports.

All Ships allotted for Transports ought to be well aired and purified, and every Thing fitted up properly, before the Men are embarked. They ought to be provided with Ventilators, or Wind Sails, to make a free Circulation of Air through the Vessel[126]; and they ought never to be crowded; but full Room allowed for each Man, in Proportion to the Length of the Voyage[127].

[126] See Dr. Lind's Treatise on the Means of Preserving the Health of Seamen in the Royal Navy, where he takes Notice of most of the Articles here mentioned with regard to Transport Ships in treating of Ships of War.

[127] When Ships are too much crowded with Men, if they meet with a tedious Passage, and hot moist close Weather, they are often attacked with Diseases which prove very fatal. Dr. Lind, talking of Ships of War, says it is a Mistake destructive to the Men to crowd too many of them together in a southern Voyage, or in a hot Climate; as the Ship will be found, before the End of the Voyage, in more Distress for Want of Men, than she would have been, had she at first carried out only her proper Compliment. An additional Number is made, in order to supply an expected Mortality; but they generally increase that Mortality to double or triple their own Number. Ibid. note to p. 48.

In military Expeditions, Soldiers are put upon Ships Allowance; which, Dr. Lind very justly observes, ought not, in Voyages to the warm Climates, be made up so much of salted Beef and salted Pork (which always tend to the Putrescent), as is the common Practice of the Navy; but that a greater Share of Biscuit, Flour, Oatmeal, Goarts, Rice, and other Stores of that Kind, ought to be laid in; and a greater Proportion of them, and a Less of the salted Meat, distributed among the Men: And he is certainly in the Right, when he says, that a full Animal Diet, and tenacious Malt Liquors, are well adapted to the Constitution of our own, and of other northern Climates; and that Sailors who visit the Greenland Seas, and are remarkable for a voracious Appetite, and a strong Digestion of hard salted Meat, and the coarsest Fare, when sent to the West Indies, soon become sensible of a Decay of Appetite, and find a full gross salted Diet pernicious to Health. "Instinct (he says) has taught the Natives between the Tropics to live chiefly on a Vegetable Diet, of Grains, Roots, and subacid Fruits, with Plenty of diluting Liquors[128]."

[128] The following is the Diet established for the Seamen of his Majesty's Navy.

Every Man is allowed a Pound of Biscuit, Averdupoiz Weight, and a Gallon of Beer, Wine Measure, per Day.

On Sunday and Thursday, one Pound of Pork, and Half a Pint of Peas, Winchester Measure.

On Monday, Wednesday, and Friday, one Pint of Oatmeal, two Ounces of Butter, and four Ounces of Cheese.

On Tuesday and Saturday two Pounds of Beef.

It is left to the Commanders of Squadrons to shorten the aforesaid Allowance of Provisions according to the Exigence of the Service, taking Care that the Men be punctually paid for the same. As it is thought for the Benefit of the Service to alter some of the foregoing Particulars of Provisions in Ships employed on foreign Voyages, it is to be observed, that

A Pint of Wine, or Half a Pint of Rum, Arrack, or Brandy, hold Proportion to a Gallon of Beer.

Four Pounds of Flour, or three Pounds of the same with a Pound of Raisins, Half a Pound of Currans, or Half a Pound of Beef Suet pickled, are equal to a four Pound Piece of Beef, or two Pound Piece of Pork with Peas.

Half a Pound of Rice is equal to a Pint of Oatmeal.

A Pint of Olive Oil is equal to a Pound of Butter, or two Pounds of Cheshire Cheese.

And Two-thirds of a Pound of Cheshire Cheese is equal to a Pound of Suffolk.

If Soldiers are sent as Passengers on board of King's Ships, or on board of Transports, their Allowance is generally but Two-thirds of the above.

A Store of Vegetables, such as Mustard Seed, Garlick, Onions, Potatoes, pickled Cabbages and other pickled Vegetables, sour Crout and other Things of that Kind, which can be purchased at a cheap Rate, and preserved for some Months, ought to be laid in; which may be mixed with the Soops prepared for the Men, or given them to eat along with their salted Provisions.

A Quantity of Beer, Cyder, or Wine, ought to be put aboard, and a certain Allowance distributed to each Man daily. When, for Want of these, Men are reduced to an Allowance of Spirits, they ought to be mixed with seven or eight Times the Quantity of Water, or made into Punch, by the Mixture of Water and Molosses, and the Juice of Lemons, before they are given to the Men; and, if Lemons cannot be got, Cream of Tartar, or Vinegar, ought to supply their Place; and it ought to be a Duty of one of the military Officers on board to see the Punch made, and distributed among the Men daily.

It would be right, on all Expeditions into warm Climates, to send some Sloops of War, or other armed Vessels, before the grand Fleet, to take up a Quantity of Wine that will keep, either at the Madeira, or other Wine Countries; and afterwards to go to any of our Settlements that are nearest the Place of Destination, and to take in a Quantity of Limes, Lemons, Oranges, and other Fruits, and Vegetables which will keep for some little Time; and of Spirits, live Stock, and other Provisions proper for the Army; and then to meet the Fleet at the general Rendezvous. When once a Landing is made good, these Vessels, after having unloaded their Cargoes, may either be employed on other Services, or kept constantly going and coming for whatever Stores or Provisions are wanted for the Army or Fleet.

A sufficient Quantity of Vinegar ought to be put on board of each Transport, both for the Men to eat with their Victuals, and likewise for fumigating and washing between Decks occasionally. And a Quantity of Molosses, or coarse brown Sugar, and of Lemons, or their inspissated Juice, or Cream of Tartar, ought to be allowed for making the Punch, as well as for other Purposes.

If the Water become foetid, the Quantity to be used in the Day ought to be sweetened by Means of the Ventilator contrived by the ingenious Dr. Hales[129] for that Purpose.

[129] This Ventilator is no more than a long Tube, with a Tin Box, about six Inches wide and four high, with a Number of Holes at the Top, fixed at one End; and this Box is put down to the Bottom of the Water, and the Nose of a Pair of Bellows fixed to the other End of the Tube, which is above the Water; by working the Bellows, fresh Air is driven through the whole Body of Water, the putrid Effluvia are evaporated and dispersed, and the Water becomes sweet in a very short Time.

The Men ought to be brought upon Deck, and Roll called two or three Times a Day; they should be made to comb their Hair, and wash their Hands and Face every Day, and to shift themselves sometimes, if possible; and in every respect keep themselves as clean as the Nature of the Service will admit; and proper Exercises should be contrived, to keep them in Health.

All the Parts of the Ship ought to be kept very neat and clean; and the Hold, and all between Decks, ought to be scraped and swept daily; and every Morning, in fair Weather, ought likewise to be washed, and afterwards sprinkled or washed with warm Vinegar, while the Men are upon Deck[130].

[130] This ought always to be done in the Morning, that all the Parts of the Ship may have Time to dry before the Men go to rest in their Births at Night; but it ought never to be done after Sun-set.

When the Weather will permit, Fires of dried Wood may be lighted in Iron Kettles between Decks, and Centinels set over them, and the Fires sprinkled with Rosin or Bits of Rope dipt in Tar, or with some cheap Aromatic; and these Fires may be carried into all the Parts of the Ship that Safety will permit, in order to dry and purify the Air[131]. After this Operation all the Ports and Hatchways should be opened, and the Air in all the Parts of the Ship often renewed by working the Ventilators.

[131] It has been proposed, that the Air in Ships of War should be purified in this Way both by Dr. Lind and by Mons. de Hamel de Monceau.

The Mens Hammocks and Beds ought to be brought up upon Deck in fair Weather, and well aired, and afterwards put in their Places, and Fires lighted below Decks.

When Troops, sent on an Expedition into warm Climates, arrive at the Place of their Destination, particular Care should be taken to guard them against the Diseases peculiar to such Climates, which are different from those common to our more northern Latitudes.

Dr. Lind says, that People coming first from a cold into a hot Climate are apt to have plethoric Symptoms; a Pain of the Head, Giddiness, a Sense of Weight, and Fulness of the Breast, and a slight Inflammation of the tunica conjunctiva; and that some are apt to be seized with ardent Fevers and Diarrhoeas. And all Practitioners have observed, that New-Comers into warm Climates are at first liable to Fevers tending to the Ardent, and are very subject to Fevers of the remitting and intermitting Kind, which are the Endemics of all warm Countries at certain Seasons of the Year; and after some Time they are apt to fall into Fluxes, the Yellow Fever, and other Diseases depending on a putrescent State of the Juices. In military Expeditions these Disorders are liable to be complicated with Fevers of the Malignant or Hospital Kind, if Care is not taken to prevent it. And nothing has been found to be more productive of Diseases in those warm Climates, than indulging freely in the Use of Spirits and other strong fermented Liquors; exposing one's self to the Damps, especially lying on the Ground after the Dews fall; and working hard, or using violent Exercise in the Heat of the Day.

The best Preservatives against Diseases in warm Climates have been found to be,—1. Temperance; a Diet of light and easy Digestion, composed more of vegetable than of animal Food; such as a small Portion of fresh Meat, joined with a sufficient Quantity of Vegetables; Rice, Indian Corn, and other Grains, and Roots of various Kinds, prepared in different Forms; well baked Bread; the moderate Use of ripe Fruits; and the free Use of mild cooling subacid Liquors, joined with a small Proportion of vinous or spirituous Liquors; carefully avoiding the too liberal Use of Wine, Spirits, or other strong fermented Liquors.—2. Great Care not to expose one's self to the Damps of the Night, nor lie down to sleep on the Grass, or in woody moist Places, in the Day; and to avoid all violent Exercise in the Heat of the Sun.—3. Such Means as tend to support the Spirits; for Chearfulness has been observed to contribute as much to the Preservation of Health, as Fear and Dejection of Spirits to the Production of Diseases.—4. Keeping the Body clean, and bathing frequently in the Sea, or in a River, in the Morning.

And therefore, in warm Climates, Officers ought to be particularly careful to keep their Men sober and temperate; to procure them good Bread, and Plenty of Vegetables and fresh Meat, if possible; and where no other but salted Meat can be got, to make them boil a small Proportion of it in their Camp Kettles, along with Onions, Goarts, Rice, Carrots, Turnips, Greens, or any other wholesome Roots or Herbs which the Country affords, or they can get, and of these to prepare a good wholesome Soop for themselves; and where there is Plenty of the ripe acescent Fruits, which are reckoned wholesome, to distribute a moderate Quantity among the Soldiers daily, which will both help to preserve their Health, and prevent them from privately stealing and eating large Quantities to the Prejudice of their Health.—To encourage their Men, and keep up their Spirits.

They should also prevent, as much as possible, the too free Use of Wine, Spirits, or other strong fermented Liquors; and in Wine Countries give every Man a daily Allowance of Wine, to be mixed with Water for his common Drink; and in Countries where nothing but Spirits can be got, make the Spirit be mixed with Water, or made into a very weak Punch, before it is given to the Men, as Lemons, Oranges, Limes, and other Fruits proper for this Purpose, are generally to be had in most warm Countries.

They should be careful not to march their Men in the Heat of the Day, nor order them upon Duty where they must stand exposed to the Dews and Damps of the Night, unless where the military Operations absolutely require it.

They should endeavour to make the Bottom of the Tents be covered with Straw, or dried Leaves of Trees, or dried Reeds, and with Blankets[132], for the Men to lie upon.

[132] A sufficient Store of Blankets has often been neglected to be carried out in Expeditions into warm Climates; but Blankets are no-where more necessary, as it is very prejudicial to the Health of Soldiers to be obliged to lie down on the bare Ground; and Straw, dried Reeds, and other such Things, are often difficult to be got in the warm Climates.

The Time of standing Centinel, and being upon Out-posts, if possible, should be short, where Men are exposed to the scorching Heat of the Sun; and when Men are upon Out-posts in the Night, it should be recommended to them to lie down on the Ground as little as possible; and if they do it, to chuse a dry Place; and, where it can be done, to have it covered with Straw or a Blanket, and to have some light Covering to defend them from the Dews.

The Tents should be covered with Boughs of Trees, and the Men should be ordered sometimes to strike them in the Middle of the Day, and air well every Thing within them.

The Men should be obliged to keep themselves neat and clean; to comb their Hair, and change their Linen often; and if the Camp be near the Sea, or a large River, they ought to bathe early in the Morning as often as the Nature of the Service will permit. However the following Caution, mentioned by Dr. Lind, ought to be observed, which is, not to go into the cold Bath when overheated with Work or Liquor, or when the Stomach is full, or when a critical Eruption, called the prickly Heat, appears on the Skin[133].