MEDICAL ADVICE To the CONSUMPTIVE PEOPLE OF ENGLAND.

IF it ſhould be aſked, why I addreſs my⯑ſelf to the Patient, rather than to the Phyſician, I anſwer, that, having offended the Doctor in my title-page, I preſume he will give but little attention to my reaſon⯑ing; for we liſten very unfavourably to the advice of a man who begins by aſſerting, that we are fundamentally wrong. But with the Patient, the caſe is different: recollec⯑ting that conſumptions, in the preſent mode of practice, are very rarely cured, he al⯑moſt aſſents to the truth of my aſſertion, even before he has heard the arguments upon which it is founded. I ſpeak, there⯑fore, not immediately to the Phyſician, be⯑cauſe I do not like that a man ſhould turn his back on me when I am talking to him. If the Doctor chuſes, whilſt I am converſ⯑ing with my Patient, to look another way, yet ſquint an ear to my babbling, he is very welcome; provide he will not condemn my [4]practice, till he hath proved its futility by experience.

Now though I write not directly to Me⯑dical Gentlemen, I eſteem it nevertheleſs neceſſary to proceed methodically, and ac⯑cordingly ſhall premiſe as much of the ana⯑tomical and phyſiological deſcription of the lungs, as will be ſufficient to enable thoſe, who have not had a medical education, to comprehend my arguments. I ſhall then enquire into the prediſpoſing and immedi⯑ate cauſes of Conſumptions; ſhall indicate the ſymptoms by which the patient may be certain of his diſorder, and ſhall laſtly proceed to conſider the cure, upon rational principles.

The trunk of the human body is divided, by a membrane called the diaphragm, into two diſtinct cavities, the lower of which is called the abdomen, or belly, and the up⯑per, the thorax, or cheſt. The latter of theſe cavities contains the heart and the lungs. The lungs are divided into two principal lobes, which are incloſed in two diſtinct bags, formed by a membrane called the pleura; ſo that the right and left lobe of the lungs have not the leaſt communi⯑cation. The adheſion of theſe bags near the middle of the cheſt, forms a perpen⯑dicular membrane called the mediaſtinum; but receding from each other as they go lower down, they form a third bag, called [5]the pericardium, which contains the heart: ſo that the cheſt is divided into three ſepa⯑rate cavities.

The lungs are compoſed of blood veſſels, air veſſels, lymphatic or water veſſels, nerves and cellular membrane.

The blood veſſels are arteries and veins; but theſe are of two diſtinct kinds: the firſt receive and return the whole maſs of blood, which circulates thro' the lungs, before it is thrown into the other parts of the body, and the ſecond were intended only for the ſupport and nouriſhment of the lungs them⯑ſelves.

The air veſſels are infinitely ſmall branches continued from the wind-pipe, with which, in a ſound ſtate, they have a free commu⯑nication, ſo as at every inſpiration to be filled with air.

The lymphatic veſſels are diſtributed on the ſurface of the lungs, and convey the lymph, which they imbibe, to a certain duct, whence it is returned to the maſs of blood.

The nerves are exceeding ſmall branches, which proceed chiefly from what is called the eighth pair.

The cellular membrane, which fills the intermediate parts between the veſſels, is compoſed of fibres or lamina, which are neither vaſcular, nor endowed with ſenſi⯑bility.

The aſpera-arteria, or wind-pipe, is that tube which conveys the air paſſing thro' the mouth, or noſe, to and from the lungs. It is compoſed of alternate cartilaginous and fleſhy rings, behind which are an infi⯑nite number of ſmall glands, which ſup⯑ply the wind-pipe with a thin pellucid mu⯑cus lining its internal ſurface, which con⯑ſiſts of a membrane of exquiſite ſenſibility.

Thus much being premiſed, we ſhall now proceed to the office and utility of the lungs, which are neceſſary to be underſtood, be⯑fore we ſpeak of its diſeaſes.

The organs of reſpiration are ſo indiſ⯑penſably neceſſary to our exiſtence, it is no wonder that phyſiologiſts ſhould have taken uncommon pains to diſcover the real deſign of nature in their formation. Various have been the conjectures of authors on this ſub⯑ject. Some have ſuppoſed, that the blood in paſſing thro' the lungs acquires its red colour; others have been of opinion, that the intention of reſpiration is to receive a certain quantity of air, which they ima⯑gined neceſſary to be mixed with the vital fluid; with many other ſuppoſitions equal⯑ly without foundation. That nature, by firſt circulating the blood thro' the lungs, after the reception of freſh chyle, intend ſome neceſſary preparation may be con⯑cluded without farther examination; and that this preparation is effected by throw⯑ing [7]off a certain quantity of noxious mat⯑ter, imbibed by the air which is received by the lungs, ſeems evident from the ex⯑periments which prove, that air once ſatu⯑rated with this noxious matter, is unfit for reſpiration. The notion that animals, when confined to breathe the ſame air, die be⯑cauſe the elaſticity of the air is deſtroyed, is entirely without foundation; it being very eaſy to prove, that the elaſticity of the air is not in the leaſt diminiſhed. The uſe therefore of reſpiration, is to relieve the body from a certain matter, perſpirable on⯑ly from the lungs, which, if entirely re⯑tained, is incompatible with exiſtance, and, when retained in part, is productive of diſ⯑eaſe. It is ſeparated from the blood by means of ſmall ducts paſſing from the pul⯑monary arteries to the air veſſels, where it is diſſolved and carried off by the air. The exiſtence of theſe ducts is eaſily demonſtra⯑ted, by injecting almoſt any liquor into the pulmonary artery, which liquor may, with⯑out much difficulty, be made thus to fill the branches of the wind-pipe.

Suppoſing that we are now pretty well acquainted with the fabric and office of the lungs, we may, I think, with ſafety, pro⯑ceed to the more immediately object of our attempt.

The general prediſpoſing cauſes of a con⯑ſumption of the lungs are to be ſought for [8]in the original formation of the body, the acrimony of the juices, or the age of the patient. As to the firſt of theſe cauſes, without reaſoning about the matter, it is ſufficient for our purpoſe to obſerve, that people of a ſlender and delicate frame, whoſe ſkin appears remarkably tranſparent, whoſe cheſt is flat and narrow, and ſhoul⯑ders high, are in general more ſubject to this diſeaſe than people of a contrary make; becauſe, ſay the learned, the veſſels of the lungs are, in ſuch bodies, too fine and too weak, to reſiſt the impetus of the blood, flowing with great rapidity thro' the organ of reſpiration; a rupture of the veſſels, a ſpitting of blood, &c. are the conſequence. The ſame effects may be produced by an extraordinary acrimony in the fluids, which may corrode the veſſels; and as to the third cauſe, it is attributed to the fervor of the blood, which is ſuppoſed to be greateſt at the age when people are moſt liable to con⯑ſumptions. To a ſagacious reader, part of this reaſoning will appear plauſible, and part otherwiſe. But theſe are remote cauſes which are equally applicable to all coun⯑tries, and which do not in the leaſt aſſiſt us in accounting for the peculiar conſump⯑tive propenſity in the inhabitants of this iſland.

This propenſity muſt be accounted for, not by any prediſpoſition in the make of [9]our bodies, but by what is called a pro⯑catarctic or occaſional cauſe, namely, the inſtability of our climate, or rather its im⯑mediate effect, a Cold, to which, I am con⯑vinced, the frequency of Conſumptions, in this kingdom, is chiefly to be attributed.

What is a Cold, and what are its effects?

The queſtions are of importance; let us not, therefore, be too precipitate. Expe⯑rience, our beſt inſtructor, hath taught us, that nothing is ſo detrimental to the human body, as ſudden tranſitions from one ex⯑treme to another; but it is particularly true in regard to heat and cold. The natural effect of warm air is to relax the ſkin, con⯑ſequently to open our pores, and conſe⯑quently to increaſe our perſpiration; an effect which may reaſonably be ſuppoſed to take place equally in the lungs, as on the ſurface of the body. When the body, in this ſtate, is ſuddenly expoſed to a cold air, the conſequence is an immediate ſpaſm over its whole ſurface. The pores are obſtinately cloſed, and the perſpirable matter is gra⯑dually returned into the maſs of blood.

That this perſpirable matter is of an ex⯑ceeding acrid nature, is evident from its effects. By irritating the veſſels, it in⯑creaſes their oſcillations, which, increaſing the circulation, produces fever. Its acri⯑mony appears even in the very firſt ſymp⯑tom of a Cold. The pores of the head have [10]ſcarce been cloſed a moment, before the perſpirable matter, falling upon the mem⯑brane which lines the noſe, cauſes, by its irritation, that convulſive motion which we call Sneezing. It returns upon the glands about the wind-pipe, and iſſuing thence excites another convulſive motion, called a Cough; which are different efforts of na⯑ture to rid herſelf of the offending cauſe. In oozing down the wind-pipe, it deſtroys the mucus, therefore we are hoarſe; and by inflaming the membrane which lines the trachia, occaſions that ſenſation of ſoreneſs in the breaſt, which we feel in a few hours after taking cold. Thus continually deſ⯑cending, it enters the branches of air veſ⯑ſels, and diffuſing itſelf to every part of the lungs, occaſions the cough, which we ſo eaſily diſtinguiſh from that which proceeds from an irritation in the upper part of the wind-pipe, and which we call a tickling cough.

We are not however to imagine, that this acrid lymph, which falls from above, is the ſole cauſe of irritation in the lungs. On the contrary, it is more probable, that they are principally offended by the acri⯑mony of that which iſſues from their own peculiar glands; for in ſevere colds, that is, when the obſtruction of perſpiration is almoſt univerſal, for it is never entirely ſo; in ſuch caſes, I ſay, every humour in the [9]body is contaminated; and that very mucus which, in health, prevents irritation in the air veſſels of the lungs, is now the princi⯑pal cauſe.

Inflammation is the natural conſequence of this continued irritation, which as na⯑turally produces a ſuperabundant ſecretion of mucus, and which, if not conſtantly ſpit up, ſuffocates the patient. When theſe ſymptoms are violent, the diſeaſe is called a peripneumony. But if this inflamma⯑tion continues beyond a certain time, the veſſels are deſtroyed, and become diſſolved in a kind of matter-called pus.

Thus we are arrived at the immediate, or proximate, cauſe of a Conſumption of the ſubſtance of the lungs. But here it may naturally be aſked, how it happens, when a part of an organ, ſo indiſpenſibly neceſſary to life, is deſtroyed, that the pa⯑tient does not immediately die? I anſwer, that Nature, in this inſtance, has been par⯑ticularly kind to us; for the two lobes of the lungs having no communication, are not immediately affected by each other's diſ⯑eaſes; beſides, every minute branch of the ſame lobe is ſo contrived, as to perform its office independent of the reſt; therefore every ſingle veſſel continues to receive and return its portion of air, till it be actually deſtroyed. Hence it is, that in diſſecting of bodies which have died conſumptive, we [10]frequently find a conſiderable part of the lungs entirely deſtroyed. Indeed the ap⯑pearance of the lungs in thoſe who have died of this diſeaſe, is ſo various, that tho' it may be but of one genus, the number of ſpecies are extremely numerous, if we may conclude from the diverſity of phenomena upon diſſection. Sometimes we find the texture of a part of the lungs entirely de⯑ſtroyed, and nothing but a collection of purulent matter in its place, communicat⯑ing with the wind-pipe, ſo as to fill it on laying the head downward. At other times, we diſcover a quantity of matter incloſed in a kind of bag. Sometimes this matter is contained in a number of ſmall follicles, and at others, it may be ſqueezed from every part, and the texture of the lungs but little injured. In ſome caſes, we find a num⯑ber of ſmall hard lumps; in others, large indurations, and ſometimes tumours that are abſolutely cancerous. In ſhort, as I have before obſerved, the variety of ap⯑pearances is infinite, eſpecially if we in⯑clude colour.

However, notwithſtanding this great di⯑verſity, the proximate cauſe of that ſpecies of Conſumption which is ſo frequent, and ſo fatal, in this kingdom, is an ulcer in the lungs, in conſequence of inflammation, oc⯑caſioned by a cold, or, in other words, by a greater flux of acrid perſpirable matter to [11]the lungs, than can be abſorbed and car⯑ried off by the air. It is alſo poſſible, that a part of this matter may be confined near the extremities of the air veſſels, by a ſpaſ⯑modic conſtriction in the upper part, occa⯑ſioned by the ſudden admiſſion of cold air. When this is the caſe, an incloſed ulcer, or vomica, is the conſequence.

Having proceeded thus far in the conſi⯑deration of our ſubject, and, I think, with⯑out ſtraining our text, we are now naturally led from the cauſe, to the cure of our diſ⯑eaſe. And firſt it may not be amiſs to en⯑quire a little into the foundation of the ge⯑neral practice.

The firſt thought, which naturally oc⯑curs, is, that this general practice is gene⯑rally unſucceſsful; and we thence as natu⯑rally conclude, that it muſt be fundamen⯑tally wrong.

If the inflammation be violent, compar⯑ing it with inflammations in other parts of the body, and reaſoning from analogy, the firſt thing we do is to bleed, and ſo far we are right, as by leſſening the quantity of blood, we leſſen the impetus of the remain⯑ing part, and thereby retard the progreſs of the diſeaſe for a time; but alas! the time is very ſhort. The pulſe ſoon recovers its velocity and ſtrength. Well; but then we adminiſter a quantity of ſaccharine, oily and mucilaginous medicines, in the form [12]of an emulſion, or otherwiſe, intending, no doubt, thereby to ſheathe and obtund the acrimony which cauſes the irritation in the lungs. The intention is certainly lau⯑dable; but it happens unfortunately that theſe balſamics go down, not into the lungs, but into the ſtomach, where they imme⯑diately undergo ſuch a change, as to carry but little of their balſamic qualities even into the inteſtines, where they are ſtill far⯑ther mixed and adulterated, particularly by the addition of a certain quantity of bile, immediately on quitting the ſtomach.

But to proceed. Let us ſuppoſe theſe demulcents already in the inteſtines. What becomes of them? They muſt either be received by the lacteal veſſels, or paſs off per anum; the latter of which is the way choſen by the greateſt part of them, con⯑trary to the intention of the phyſician. Happily for mankind, theſe lacteal veſſels are endowed with a kind of mechanical ſagacity, which enables them to ſelect from that heterogeneous maſs of food and medi⯑cines, conſtantly preſented to them by the ſtomach, ſuch matter only, under the de⯑nomination of chyle, as is fit to be aſſimu⯑lated with the blood.

Here I ſhall be interrupted with an ob⯑jection, that the lacteals are capable of ad⯑mitting poiſonous matter, and conveying it to the heart, to the immediate deſtruction [13]of the body. To this objection (having firſt hinted, that moſt poiſons are deſtruc⯑tive from their immediate action on the nerves in the ſtomach) I anſwer, that Na⯑ture acts, not by partial, but by general laws. Thoſe who are incapable of apply⯑ing this argument, deſerve no other reply.

Let us now ſuppoſe, that a ſmall portion of our balſamics has gained admittance through the mouths of the lacteals. Thence it is conveyed into the glands of the me⯑ſentery, and having been ſecerned through ſeveral of theſe, it riſes into a certain re⯑ceptacle, whence it is conducted into a vein under the left arm, and thus mixes with the blood. It now ſoon reaches the heart, and from thence, thus mingled with blood, it paſſes thro' the lungs. I ſay through the lungs; becauſe it is immediately returned to the heart, thence to be diſtributed thro' the reſt of the body.

Now it muſt be remembered, that the ſeat of the diſorder which, by theſe heal⯑ing medicines, we are endeavouring to cure, is not in the blood veſſels, but in the air veſſels of the lungs; and that theſe air veſ⯑ſels have no communication with the arte⯑ries, except by means of tubes or pores ſo extremely ſmall, as not to admit the red globules of the blood; conſequently the conſtituent particles of our medicine muſt be ſmaller than theſe, otherwiſe no part of [14]it can poſſibly be thus applied to the part injured. But we have ſaid, that a liquor may, by injection through the pulmo⯑nary artery, be forced into the bronchia: true; but this liquor paſſes colourleſs, al⯑ways depoſiting in its paſſage the matter with which it was tinged.

Theſe things being properly conſidered, let me now ask the reader, whether he thinks it probable, that even the leaſt be⯑nefit can rationally be expected from ſac⯑charine, oily, mucilaginous, or balſamic medicines, thus applied?

What then is to be done? Has Nature been ſo unkind, particularly to the inhabi⯑tants of this iſland, as to afflict us with a diſeaſe for which there is no remedy? I verily believe ſhe has not been ſo unkind. The fault is not in Nature, but in ourſelves; or, perhaps, rather in the difficulty of the task: for we cannot ſuppoſe, in the preſent improved ſtate of chemiſtry and anatomy, that all thinking men are not perfectly ſen⯑ſible of the improbability, I had almoſt ſaid impoſſibility, of applying demulcents to the lungs through the alimentary canal: nor is it more reaſonable to ſuppoſe them forget⯑ful, that the only poſſible way of applying medicines directly to the lungs, is through the wind-pipe. But, as I have before ob⯑ſerved, they have been prevented from at⯑tempting [15]this obvious method, by the dif⯑ficulties which occurred in the execution.

To convey any palpable ſolid or liquid ſubſtance through the wind-pipe into the lungs, we know to be impoſſible; for that if the leaſt crumb of bread, or drop of any liquor, happens by accident to enter the glottis, a violent cough is immediately ex⯑cited, till the offending matter be rejected. But we alſo know, that impalpable volatile matter is inceſſantly carried to and from the lungs, along with the air; every ſubſtance therefore that can be volatilized, may be conveyed directly to the lungs. Aqueous liquors may be eaſily converted into vapour, and vapour may be impregnated with great variety of medicinal ſubſtances.

On theſe conſiderations, it ſhould now ſeem, that the whole myſtery is at once diſcovered, and that we have nothing more to do, than to convert our proper medicines into vapour, and ſo convey them directly to the diſeaſed part. Alas! there are many conſiderable obſtacles yet to ſurmount, as will appear from a chemical view of the medicines in queſtion.

Let us ſuppoſe, that our patient, having caught a ſevere cold, labours under an in⯑flammation of that membrane or skin which is continued from the mouth, down the wind-pipe, into the bronchia, and that this [16]inflammation is chiefly in the lungs. Or let us ſuppoſe, that the irritating matter is not ſufficiently acrid to produce much in⯑flammation; but only, a ſuperabundant ſe⯑cretion of acrid mucus. Or, let us farther ſuppoſe, that the lungs are actually ulce⯑rated. In theſe ſeveral ſtages, or degrees of the diſorder, what are the indications?

Our endeavours to reſtore the obſtructed perſpiration, is undoubtedly rational; but our medicines, given with this intention, commonly fail. They excite indeed a co⯑pious ſweat; but the fluid thus determined to the ſurface of the body, is totally dif⯑ferent from that volatile matter which, in a ſound ſtate, exhales particularly from the lungs, and to the diminution of which ex⯑halation, the diſeaſe in queſtion is ſolely to be attributed. But what is the preſent danger? It is, that the inflammation may end in ſuppuration; or that the acrid mat⯑ter may be obſtructed by mucus, or ſpaſm, and ſo corrode, indurate, or deſtroy the ſubſtance of the lungs. The immediate indication therefore is, if poſſible, to pre⯑vent theſe conſequences; which I preſume can only be effected, by the application of antiſeptic (that is medicines which reſiſt putrefaction) antiſpaſmodic, attenuating, and balſamic medicines, directly to the part affected.

With regard to the firſt, viz. antiſeptics, there is no difficulty, the moſt powerful of them (I ſpeak from experience) being in their nature volatile. Antiſpaſmodies and attenuants are equally eaſy of conveyance; ſo that the ſole difficulty lies in our balſa⯑mic medicines, which are very refractory, but of great importance.

Gums, mucilages, and expreſt oils, are, by no means, volatile: nor would I, in the preſent caſe, give one farthing to find them otherwiſe; as they would, at any rate, be totally unfit for our preſent purpoſe. Our whole attention therefore is fixed on the reſinous native balſams; but not indiſcri⯑minately. Thoſe who have beſtowed ſo much attention on them as myſelf, will find them extremely different in their che⯑mical properties and effects on the human body. Beſides, they are rarely to be met with genuine; and a thorough knowledge of them is only to be acquired by long ex⯑perience and frequent examination.

The chief of the liquid balſams are, Bal⯑ſam of Gilead, of Copaiba, of Peru, of To⯑lu, of Canada; and the dry balſams are Benjoine, Storax, Labdanum, Myrrh and Maſtich, and the Terpentines. But though theſe ſeveral ſubſtances are much alike in their chemical properties, yet they differ eſ⯑ſentially in their medical virtues, which is eaſily accounted for, from the difference in [20]quantity and quality of the etherial oil which they contain.

The chemical properties, as far as they are commonly known, of theſe fragrant reſins or balſams are, that they are inflam⯑mable, diſſoluble in rectified ſpirits, but not in water. Now, this being the caſe, ſuppoſing, even after a thouſand experi⯑ments, that we have fixed upon thoſe whoſe oils are leaſt acrid, and which, in every reſpect, are beſt fitted for our purpoſe, how ſhall we poſſibly contrive to convey them to the lungs in a proper vehicle? They will not diſſolve in water, and the vapour of ſpirit of wine is much too ardent and in⯑flammatory.

If indeed we had remained ſatisfied with theſe general properties, without farther enquiry, we ſhould ſtill have believed, with our neighbours, that the attempt was im⯑practicable; that it was impoſſible to apply an efficacious remedy directly to the lungs, and conſequently that conſumptions were incurable.

Ever ſince I was capable of enquiry, it hath been a conſtant maxim with me, to take nothing for granted, upon any autho⯑rity whatſoever. Upon this principal, I be⯑gan my experimental diſquiſitions relative to the ſubject in queſtion, being fully per⯑ſuaded, for reaſons which will hereafter appear, that if I could find means to con⯑vey [21]the beſt of theſe native fragrant bal⯑ſams to the lungs, in a mild and truely bal⯑ſamic ſtate, the conſumptive people of this iſland might expect conſiderable benefit from my ſucceſs.

Were I to relate the many fruitleſs ex⯑periments I have made, ſince I firſt en⯑gaged in this enquiry, the reader would be ſurprized at my patience and perſeve⯑rance; but it would anſwer no other pur⯑poſe. Let it ſuffice therefore to tell him, that I, at laſt, hit upon a certain chemi⯑cal liquor, which, to my great aſtoniſh⯑ment, diſſolved at leaſt double the quan⯑tity, of the balſamic reſins which I had ſe⯑lected, to any menſtruum which I had ever tried or heard of. The pleaſure I felt upon this diſcovery, can only be conceived by thoſe who have had the happineſs to extend, in any degree, the path of know⯑ledge. It immediately occurred to me, that the diſcovery of ſo powerful a men⯑ſtruum, would not only be a conſiderable ſtep in my preſent purſuit, but might pro⯑bably prove of ſingular advantage to me⯑dicine in general. But what added greatly to my expectations was, that this liquor happens to be of exceeding volatility, not at all inflammatory, and remarkably anti⯑ſeptic, and antiſpaſmodic.

Thus far, I had obtained every thing that I could wiſh. My ſolution, however, was too ſtrong for the purpoſe I intended. [22]I therefore, by way of experiment, drop⯑ped a few drops of it into boiling water, and found, beyond all poſſibility of a doubt, that the ſteam was richly impregnated, both with the antiſpaſmodic and antiſeptic qua⯑lities of the menſtruum, and alſo with the balſamic and ſalubrious principles of the fragrant reſins. This vapour I drew in with my breath, for a conſiderable time, and found it not in the leaſt irritating; but, on the contrary, extreamly mild and agreeable. Being now deſirous to aſcertain the quanti⯑ty of the diſſolved reſins, which thus roſe with the vapour, I poured half an ounce of my ſolution into a quantity of hot water, and after evaporating the whole, I found remaining in the veſſel a very ſmall propor⯑tion of the weight of balſam which had been diſſolved in that quantity, and conſe⯑quently by much the greateſt part had riſen with the vapour.

Let me now aſk the reader, whether he is not of opinion, that the happieſt effects may rationally be expected, from ſuch a medicine thus applied, by means of the ſteam of hot water, directly to the injured lungs? Whether he does not think it pro⯑bable, that the acrimony of the irritating fluid will be thus obtunded, either in a recent cold, or more advanced ſtate of the diſeaſe? Whether the ſpaſmodic conſtric⯑tion of the veſſels will not thus be relaxed, [23]and the conſequence of obſtructions pre⯑vented? Whether the progreſs of putri⯑faction may not thus be ſtopped, and whe⯑ther, in that caſe, even in the advanced ſtage of a conſumption, we may not hope for a cure?

When a conſiderable part of the ſubſtance of both lobes of the lungs is deſtroyed, the diſeaſe is doubtleſs incurable; but we know from diffection, that commonly one lobe only is principally affected. If there⯑fore we can thus ſtop the progreſs of pu⯑trifaction in the diſeaſed lobe, the other may continue to perform its office, and the patient ſuffer but little inconveniency.

THERE remains yet another argument in favour of this new method of applica⯑tion, which, I think, will appear to be a powerful one. We know that many peo⯑ple who have been far gone in a conſump⯑tion, have recovered by removing to hap⯑pier climates. We cannot rationally attri⯑bute their recovery to any other cauſe, than a difference in the air they breathe, which difference muſt ariſe from its being impregnated with certain ſalubrious, anti⯑ſeptic, or balſamic effluvia. Since there⯑fore this natural application of ſalutiferous air to the part affected, will produce that which medicines taken into the ſtomach had attempted in vain, are we not thereby naturally led to conclude, that the beſt way [24]of adminiſtering to the lungs, is by means of the air? It were ridiculous to attribute the recovery of conſumptive people on their migration to a milder climate, mere⯑ly to increaſe of heat, which might be in⯑creaſed to any degree in the patients cham⯑ber at home. On the contray, we know that heat remarkably accelerates putrifac⯑tion; ſo that in a putrid ſtate of the lungs, if it were not for ſome powerful counter⯑acting cauſe, the diſeaſe, by travelling ſouthward, muſt neceſſarily be increaſed.

With regard to the manner of applying this medicine it is extremely eaſy. I uſu⯑ally drop 20 drops into about half a pint of boiling water, immediately after it is taken from the fire, ordering the patient to hold his mouth over the veſſel ſo as to draw in with his breath, as much as poſſible of the vapour, continuing the operation as long as the ſteam will riſe. I then or⯑der him to drink the water as ſoon as it is cold enough for that purpoſe: for tho' I depend entirely on the vapour for the cure of the lungs, yet as all the juices in the body may be in ſome degree affected, by the matter abſorbed from the lungs, this balſamic water received into the ſtomach, will be of ſome advantage.

This ſimple method of application will be abundantly ſufficient in common colds, hoarſeneſs, &c. but when there is reaſon to [...] [27]and from its antiſeptic power, that it will prevent putrifaction, or ſtop its progreſs when begun, and thus preſerve the ſound part of the lungs, and give an opportunity to nature to regenerate the parts that were already deſtroyed.

What! ſays the ſagacious reader, do you imagine, if a part of the lungs be ac⯑tually deſtroyed, that it can ever be re⯑ſtored!—Sir, it is a maxim with me, ne⯑ver to affirm any thing which I cannot prove; but I know no reaſon why nature ſhould not as eaſily reſtore a part of the lungs, as a part of an external muſcle, or a part of the external ſkin, which is con⯑tinued into the lungs, and which is as vaſcular as the lungs themſelves.

I ſhall now beg leave to add a few words concerning the diet, &c. of conſumptive people; for, though our opinion of a me⯑dicine be ever ſo great, it were certainly imprudent to neglect ſuch other means as may contribute to its ſucceſs; and indeed, if the diſeaſe be far advanced, little is to be expected from any medicine whatſoever, unleſs the patient will adhere implicitly to the rules preſcribed by his phyſician, rela⯑tive to his diet and manner of living.

Firſt, with regard to exerciſe. Our im⯑mortal Sydenham was ſo ſtrongly prepoſ⯑ſeſſed in favour of riding on horſe-back, that he conſtantly recommended that exer⯑ciſe [28]in every ſtage of a conſumption. It is, however, with this, as with moſt effi⯑cacious medicines; if it does no good, it certainly does harm. The patient himſelf will be able to determine whether its ef⯑fects be ſalutary or otherwiſe, by obſerving the following directions. Firſt, unleſs the weather be hot, let his cloathing be ſome⯑what warmer than uſual, as he will other⯑wiſe grow chilly. Let him ride not more than an hour at a time, and that very gent⯑ly. If it be in ſpring or autumn, he muſt ride from eleven to twelve, or from twelve to one. If in the hotter months, let it be from nine to ten in the morning. But in moiſt or cold weather let him not ride at all. If after this gentle exerciſe, he finds himſelf in better ſpirits, his appetite in⯑creaſed, his breathing eaſy, and his ſkin cool and ſoft, he may certainly conclude that riding is of ſervice to him, and ought therefore to be continued as often as the weather will permit. If on the contrary, he finds himſelf fatigued, his breathing more frequent and more difficult, his ſkin parched and dry, the palms of his hands hot, his cheeks fluſhed, his tongue dry, and in himſelf an inclination to drink rather than eat, he may then conclude that rid⯑ing is improper in the preſent ſtate of his diſorder, and that taking the air in a car⯑riage will have better effects. If never⯑theleſs, [29]he finds no alteration for the bet⯑ter, I adviſe him, by all means, to have recourſe to a ſea voyage, from which, with the continuance of the medicine here re⯑commended, I venture to promiſe him every thing that human art can poſſibly ſup⯑ply. It may not be improper to obſerve, that though I have above, in ſpeaking of riding, limited the patient to an hour at a time, I mean that, in proportion to his in⯑creaſe of ſtrength, and benefit received, the time ſhould be prolonged, and the de⯑gree of exerciſe augmented.

We come now to aliment, which is of infinite importance. The firſt general rule which I give to my conſumptive patients is, that, regardleſs of all ſtated hours, he is to eat as often as he has an appetite, but never much at a time. If, when he riſes in a morning, he finds no appetite for his breakfaſt, let him walk a little into the air, and wait an hour or two before he takes any food. As to tea, I abſolutely forbid it, becauſe it is an enemy to weak nerves, but more eſpecially on account of the warm water, which greatly relaxes the ſtomach. A ſea biſcuit with a pint of cold almond milk, made with barley water or whey, is a good breakfaſt for a conſumptive perſon; or a few almonds blanched and ground in a mortar with a little cold water, and then mixed, by little at a time, with two [30]thirds of milk from the cow, is ſtill bet⯑ter, where more nouriſhment is required. This admixture of almonds renders the curd, which ſeparates in the ſtomach, much leſs tenacious, and eaſier of digeſtion. I mention cows milk, becauſe it is moſt ea⯑ſily obtained; otherwiſe, aſſes milk is cer⯑tainly preferable, becauſe it contains much leſs of curd, which is both difficult of di⯑geſtion, and putreſcent. Goat's milk con⯑tains even a greater proportion of curd than cows milk, and therefore highly improper, tho' frequently preſcribed.

Eggs are by no means to be allowed, on account of their putrifactive tendency. In ſhort, animal food is in general to be a⯑voided; though, if the patient be weak, I allow a little boiled white meat once or twice a week, and now and then a little veal or chicken broth with a ſmall quanti⯑ty of lemon juice ſqueezed into it. Po⯑tatoes, turnips, carrots, parſneps, beans, ſpinach, broccoli, ſallets, bread and rice, conſtitute our general bill of fare.

As to drink, if the patient has much hectic fever, I confine him entirely to al⯑mond milk, barley water, or milk and wa⯑ter; otherwiſe, beſides theſe, he is per⯑mitted to drink one or two glaſſes of mountain wine every day; or in caſe that cannot be afforded, now and then a draught of ale, porter, or table beer.

If the patient complains of a nauſia, weight, or uneaſineſs at his ſtomach, I or⯑der him ten grains of Ipecacoanha, with chamomile tea, to be repeated once in ten days, or a fortnight, if the ſymptoms re⯑turn.

With regard to bleeding, as I expect no⯑thing more from it than a little preſent relief, I never order it, unleſs when the fever runs too high, and then I ſeldom ex⯑ceed five ounces.

If the patient be coſtive, I order him a ſolution of manna, with a little ſoluble tartar; if the contrary, I give him occaſionally a few drops of the Thebaic tincture in a little ſimple cinnamon water.

If he ſweats towards morning, which is often the caſe, I order him to go to bed in good time, to riſe very early, and to re⯑poſe a little after dinner. If his ſweat ſtill continue, I give him 20 or 30 drops of the acid elixir of vitriol in a glaſs of cold water twice a day. As to the Peruvian bark on this occaſion, I believe it to be an excellent medicine; but I diſlike it in ſub⯑ſtance for many reaſons, and am no leſs diſſatisfied with all the known preparations of it. I have lately begun a courſe of te⯑dious experiments, with an intention to diſcover the parts in which its virtues actu⯑ally reſide, and to diveſt it of thoſe which are inert. If I am not much miſtaken in [32]my conjectures, it is poſſible to condence its active principles into a very ſmall compaſs, and thereby to render it a much more agreeable and efficacious medicine. If I ſucceed, poſſibly the publick may in ſome future time expect to be made acquainted with the reſult of my enquiries.

There remains yet one piece of advice, to which the patient, if he regards his own ſafety, will be particularly attentive. It concerns the poſition of his body. Con⯑ſumptive people, from an indolence pecu⯑liar to their diſorder, are very apt, whether ſitting, walking, or riding, to ſuffer the body to bend forward, for want of a pro⯑per exertion of thoſe muſcles by which it ſhould be kept erect. In this drooping poſition the cheſt is never ſufficiently en⯑larged, nor the lungs fully expanded. I, therefore, conſtantly adviſe my patients to keep themſelves upright, and, eſpecial⯑ly when in the open air, to endeavour to bring their breaſt as forward as poſſible. In this, my intention is, to expand the ſmall ramifications of the bronchus to their extre⯑mities, and to open a free paſſage for the blood from and to the heart; both which will aſſiſt our endeavours to remove ob⯑ſtructions, and prevent thoſe adheſions of the lungs to the pleura, which are general⯑ly found on diſſection of conſumptive bo⯑dies^*.

My aſthmatic patients, no doubt, begin to think me tedious, or rather imagine that I have quite forgot them. That, however, is not the caſe. By an aſthma we mean that diſorder, the chief ſymptom of which is a difficulty of breathing. It is either continued or by fits. Now, tho' the cauſe of this diſeaſe is frequently in the lungs, yet it is ſometimes owing to a morbid af⯑fection of ſome of the other organs of reſpiration, as the diaphragm, the inter⯑coſtal muſcles, or the wind-pipe, or ſome of the neighbouring viſcera. How it hap⯑pens that the balſmic medicines, which are recommended as a cure for conſump⯑tions, are at the ſame time recommended in aſthmatic complaints, is amazing, and muſt proceed either from conſummate ig⯑norance, or unpardonable diſhoneſty. If, as we have ſeen above, theſe balſamics, taken into the ſtomach, can do nothing towards the cure of a conſumption, how much leſs likely are they to relieve an aſth⯑matic patient? For if they could even be ap⯑plied immediately to the part affected, they poſſeſs no one virtue that might authorize ſuch expectation.

Hold! cries the reader, if that be the caſe, how comes it that you recommend your balſamic vapour for the cure of an aſthma? I anſwer, that unleſs the aſthma be a ſymptom of a conſumption, I expect [34]no advantage from the balſamic quality of this vapour. But when the cauſe of the aſthma is a ſpaſmodic contraction of the lungs, or wind-pipe, which is very fre⯑quently the caſe, eſpecially when the diſ⯑eaſe returns by fits, I then expect conſider⯑able advantage from the antiſpaſmodic pow⯑er of this vapour; and when in a continu⯑ed difficulty of breathing, the cauſe of the diſorder is an infarction of the lungs from viſcid mucus, my hopes are then built on the attenuating power of the vapour ex⯑hibited in the manner I recommend. Let thoſe who are capable of reaſoning judge, whether my expectations are well founded.

I have ſaid, that the peculiar conſump⯑tive diſpoſition obſervable in the people of this kingdom, is to be attributed to the inſtability of our climate, which renders us ſo frequently liable to take cold. Now as it is always better to prevent a diſorder, than to cure it, and as colds do no injury to the lungs, except in their remote effects, I thought it rational to ſuppoſe, if imme⯑diately after taking cold. I could dilute or obtund the acrimony of the humour which irritates and inflames the lungs, I ſhould probably prevent the bad conſequences of obſtructed perſpiration, at leaſt as far as it concerned the lungs. Having, myſelf late⯑ly taken a violent cold, I immediately be⯑gan to uſe the balſamic vapour, by hold⯑ing [35]my head over a common pint veſſel, keeping my mouth generally ſhut, that the ſteam might paſs thro' my noſe, and repeating the operation ſeveral times a day, for two or three days. The conſequence of this was, that I very ſoon got rid of my cold, without the leaſt cough or diffi⯑culty of breathing, which was really a re⯑markable circumſtance, becauſe my lungs are naturally ſo irritable, that I hardly re⯑member ever to have had the leaſt degree of cold which did not end in a cough. This, however, is but a ſingle experiment. But I have another of greater weight.

Having founded my expectations, in the cure of conſumptions, which are far ad⯑vanced, chiefly on the antiſeptic quality of this Aether, in order to try its power, I ſuſpended from two nails, at the diſtance of about four foot from each other, two pieces of freſh beef. Under one of theſe, I held a veſſel of hot water, into which fifteen drops of the medicine were drop⯑ped, repeating the operation three or four times every day, and continuing it about five minutes each time. To the other piece nothing was applied. I carefully ex⯑amined each piece every day, and was great⯑ly ſurprized to find, at the expiration of a month, that neither of them was, in the leaſt, tainted or diſcoloured. That the piece, to which the vapour was appli⯑ed, [36]continued ſweet, did not at all ſurprize me; but I own, I did not expect, that the antiſeptic power of this vapour was ſo great, as to prevent putrifaction in the other piece of beef, by only mixing with the air in the room. Indeed the room was ſmall. This unexpected event, however, gave me great pleaſure, as it immediately ſuggeſted to me the evident advantage that might be expected, in all putrid diſorders, from im⯑pregnating the air in the chamber with this vapour. For this purpoſe, it is my conſtant practice to order 30 or 40 drops to be dropped into a quart of boiling water, and the veſſel to be placed near the bed of the patient, to be repeated three or four times a day; or the water to be kept boiling over a lamp, in any part of the room, till it is entirely evaporated, if the diſorder be of a very putrid nature, and eſpecially in the ſmall pox. It were cer⯑tainly needleſs to mention the uſe of this vapour in ſore throats, whether inflam⯑matory or putrid.

The medicine is entitled, Dr. Stern's Bal⯑ſamic Aether, and may be had, for ſix ſhil⯑lings the bottle, of Mr. ALMON, in Picca⯑dilly, Mr. Cook, near the Royal Exchange, Mr. Bladon, in Pater-noſter Row, Meſſrs. Curtis, in Fleet-ſtreet, Mr. Woodfall, Char⯑ing Croſs, and Mr. White, Lincoln's Inn Fields, Bookſellers.

I ſhall now, by way of concluſion, beg leave to give a few general rules to the reader, which may enable him to judge properly of medicines which are expoſed to ſale. Theſe rules ſeem the more neceſ⯑ſary, in an age when almoſt every week produces a new medicine.

The firſt general rule is, never to pay the leaſt regard to the canting of thoſe who pretend, that the good of mankind is their ſole motive for offering their medi⯑cine to ſale.

Secondly, diſregard all aſſertions concern⯑ing the excellency of a medicine, which are mere aſſertions, without any founda⯑tion in reaſon and experiment.

Thirdly, conclude the advertizer to be either a knave or a fool, in phyſick, who pretends, that his medicine will cure ſeve⯑ral diſorders which have not the leaſt ana⯑logy to e [...] other.

Fouthly, give no credit to the recital of Caſes, as they are generally invented by the doctor.

And laſtly, when the doctor writes a pam⯑phlet, with an intention to recommend his medicine, if it betray a manifeſt ignorance of his ſubject, of ſtyle, and grammar; in ſhort, when his language is evidently that of a porter, conclude him to be ſome illi⯑terate, ignorant perſon, whoſe medicine and opinions deſerve no attention.

Concerning myſelf, and the medicine I recommend, I do not expect, that the reader ſhould have any dependance on what I may have aſſerted in the preceeding pages; becauſe, if he has any knowledge of man⯑kind, he has reaſon to ſuppoſe, that I have ſacrificed truth to intereſt and a fa⯑vourite hypotheſis. My aſſertions however are very few, except what relates to the experiment to prove the antiſeptic quality of this vapour; but as it is in every ones power to repeat the experiment, it will be an eaſy matter to convict me of falſehood, or confirm the truth. All I expect of the reader is, that he will impartially conſider the reaſons, upon which I have founded my expectations of curing diſorders of the lungs by means of this balſamic vapour. If he is of opinion, that I have reaſoned juſtly, he will certainly think it adviſeable for thoſe whoſe lungs are injure to try the experiment, eſpecially as it cannot poſſibly be attended with any danger; and as to the expence, it will certainly be thought moſt inconſiderable, when compared with the fees of a phyſician, and the bills of an apothecary.