Colonial North America: Countway Library of Medicine

72

Materia Medica

Astringents

again was too weak, it was a valuable remidy in this disease, when the piles are too high up a saturnine solution may be used, it is necessary to distinguish between the different kinds of piles, one arising from a torpid state of the alimentary canal occurring in the decline of life in sedentary and Hypochondric patients, here galls are proper, possably they may be given internally with advantage, but in the febrile state of the piles they are injurious and the depleting plan will be necessary, and infusion may be used with advantage as an injection in gleets, in the disease called gonorrhea many vegitable astringents have been used, and some have been used with the greatest advantage, such as rose leaves, and green tea &c, which have succeeded after all other remidies have failed. Balsam Copaiva blended intimately with calomel is an excellent remidy, where there is no inflamation. Dr Swedier recommends a solution of galls in gonorrhea and gleets as an injection, when the disease is local astringents may be serviceable in weak injections, and in such cases may be used in the first stage. My old preceptor Dr Shippen found Hernia Humoralis brought on more frequently from the use of the Sulp. of Copper than of any other article.

147

Diaphoretics

Chronic Dysentary. Charactarised by small and mucus like evacuations, great weakness, Indigestion, eyes week, complexion sallow, skin dry and cold, pulse feeble. I have succeeded in affecting a cure (after every thing else had fail'd even powerfull astringents) with Dovers Powders alone, the disease is often kept up by a vitiated secretion from the liver, here small doses of calomel should be combined, as in fact the secretion from the surface is always in an inverse proportion to that of the intestines, every complaint of this nature must be managed by due attention to the surface. Flannel worne next the skin, and Blisters apply'd over the abdomen will sometimes relieve them.

149

Diaphoretics

Phlegmasia. In this class of disease strict attention must be paid to the surface of the body regarding its temperature, if that be above the sweating point it must be reduced by bloodletting or any other depleting remidy, as cold.

Rheumatism. Here cold would be improper to the joint and their use should be supply'd by Saline effervescing draughts at which time Diaphoretics are highly usefull, a combination of Ipecacuanha, calomel, and cicuta are verry deservedly praised, the extract of cicuta in dose of 10 or 12 grains is verry usefull; In the confirmed cronic State, Stimulants are necessary, there are Guaicum, Mezereon, Vol. Alkali, Sarsaparilla and Savin, which last I particularly recommend from my own experience in the alms hous [house], here the pulse was verry feeble,

155

Diaphoretics

from the skin therby lessening the quantity of urine.

Dropsy. There use is well establish'd, particularly those kept up by visceral obstructions, attended with dry pale skin, vitiated apetite &c, they act here by restoring an equipoise to the system determining from the center to the surface. To effect this the best medicine I know is a combination of opium, Ipecacuanha, and calomel. Many other diseases might be added. Our class of medicines I have said are divided 1st Those making a direct impression on the exhalants, 2d Those relaxing the constricted surface, 3d Those which invigorate the circulation. The

170

Materia Medica

Tonics

or by its tonic power increase the symptom of fever. I have bled a patient eight times before I thought it proper to administer the bark and in billious fevers weeks have passed before the barks could be used, after it was the only remidy of efficacy. I think we should do well to precede the bark with some evacuant, but there is no need to excite the stomach actively by the use of Emetics, it is the activity of the stomach that prevents the use of many medicines. Emetics are improper when there is any disposition to vomit or where there is a determination of blood to the head, they often increase the irritability which is a verry difficult to manage. Since the fever of 1793 of this City Emetics have been given less frequently than before. Should any evacuants be thought necessary I should use cathartics, the following I have found most useful, Calomel either alone or combined with rhubarb, the root of May Apple the Padophyllum peltatum of Linneus is a verry gentle cathartic and may be advantageously combined with calomel, the dose of both is about ℈i [1 scruple]. Jallap is generally preferred, I seldom employ it as it is verry apt to excite nausea. I do not wish to exclude emetics entirely as a remedy in fevers they are sometimes verry serviceable. Evacuants have not only been of service in the commencement and