Colonial North America: Countway Library of Medicine

190

Materia Medica

Tonics

much inspection to discover whether the hemorrhagy is of the active or passive kind, with Dr Martin I am of opinion it oftener originates from the same cause which produces our intermittants than is generally supposed.

Dropsy. This generally arises from fever or is connected with it, as in every paroxysm is succeeded by an increase of the swellings, by attention to the febrile type may be perceived. Dr Lind observed the tertian type through the whole course of the disease during apyrexia the bark may be administered with success.

Hydrocephalus. When incipient I believe bark would effect a cure, I believe 99 out of 100 are ushered in with symptoms of intermittants. I have 30 or 40 cases every one of which discovered those symptoms. I lost two negro girls which belonged to my brother, the symptoms were that of a tertian dropsy, after death we found on examination the disease to be hydrocephalus.

Gangrene. Hunter divides this into two kinds one accompanied or beginning with inflamation the other without, if inflamation exists so as to require bloodletting bark and wine will be improper, but if there is a loss of tone in the heart and arteries

198

Materia Medica

Tonics

this recent stage and while the contageon is still acting it is improper but maybe of use if the disease continues by force of habit, two cases that I have seen have taght [taught] me to be cautious of its use. The first, a boy for the want of sufficient depletion and by the use of the bark was carried of [off] with Hydrocephalus Internus, the second from the same cause was attaked with a dropsy and was with difficulty saved.

Asthma. This sometimes depends on a plethoric State of the lungs when the bark must be hurtfull, but there is another kind owing to what Dr Cullen calls the mobility of the system, and which by some is called the tristemic asthma, where it may be usefull combined with opium, it has been usefull in cases of Mania.

Angina Pectoris. This has seldom or never appeared in this City it is now common in London where it is treated with purging and bark. I know nothing from experience, but from my Idea of this disease. If not improper the bark would be of use, it should be given with much caution, upon dissection on subjects that died of this disease, the coronary arteries of the head have been found completely ossafy’d [ossified]

426

Materia Medica

Errhines

they are therefore often usefull in Rheumatic Affections of the neighboring muscles and in congestion of the head near the nose. Dr Cullen however thinks they may affect the whole head they are generally thought to act topically. I believe they sometimes produce sneezing, when taken into the stomach, Errhines have been employ’d in Hydrocephalus Internus. Dr Patterson thinks before exhibitting them some precautions should be taken. I have never employ’d it in this disease when it affected children but I have in the case of adults. I consider them safe and perhaps usefull. Errhines and particularly Mercurial ones might be employ’d in Epilepsy attended with congestion of the head without an affection of the mind. I used the Turpeth Mineral in one case in our Hospital with considerable success it produced a salivation, in some cases of deafness they might always be employ’d, I am not capable of pointing out the different species of deafness, it proceeds however from a variety of causes, one of which is an affection of the Eustachian tube, and generally arises from what is called catching cold which produces inflamation of the tube. this species is characterised by a noise which seems to be heard in the ears of the patient similar to the sound of boiling water, the roaring of wind, or distant thunder. I have always found this to

454

Materia Medica

Sialagogues

is considered by some physicians as an important mode of practice. Dr Clark of England found it verry usefull. I wish to impress on your minds one rule, Viz. If the mercury does not produce good effects in three or four days lay it asside as useless, or pernicious, for it will probably undermine the strength of the patient and upon the whole I think it a verry nice and difficult practice, and I hope you will never follow it upon my recommendation without recollecting the nicety and caution I have endeavored to impress. Since using the Ipecac in dysentary I have not employ’d the mercury so much as I formerly did, the calomel does not always save the patient, and has many inconveniences, there is one form of dysentary in which it is always combined with scurvey in this mercury is always improper. I have given mercury to the extent of 2 or 3 grs [grains] every 3 or 4 Hours, and always in combination with opium. This is in immitation of Dr Clarks practice, but I have gradually laid it aside. Mercury seems well adapted to some cases of diarrhea particularly the chronic kind.

Hydrocephalus Internus. May be owing to a rupture of the Lymphatics of the brain, it frequently commences with head ache, fever, and lassitude, sometimes with squinting, costiveness, and vomiting, and

486

Materia Medica

Emetics

to the exhibition of bark, in the intervals between the paroxysms has been a verry common practice and perhaps too much so, bark may generally be given without preparations of any kind, but when any evacuations are necessary purges are preferable to emetics, the latter are however sometimes necessary for the cure of fever, in some climates they may be given more freely than in some others, in hot more than in cold climates. The maxim of Hypocrates was emetics in Summer and cathartics in Winter, it is a disputable point among the Physicians whether emetics are proper when there is a determination of blood to the brain, Sydenham advises bleeding before emetics when this is the case, this even might be made a general rule. It is probably that emetics are not so dangerous when there is a determination of blood to the brain as has been supposed, the vomiting at sea never kills although it is generally verry violent. Some physicians disregard the opinion of Sydenham so much as to give emetics in Epilepsy just before the expected paroxysm. I have given them myself with great advantage. Dr Fothergill says the Epilepsy is symptomatic of the state of the stomach and therefore he considers emetic medicines proper on those occasions. Emetic medicines have been recommended in Hydrocephalic Fevers, and also in Cephalic Ones.