REMARKS ON THE SCURVY, &c. &c.

THE Sea Seurvy has been ſo often and ſo well treated upon, by various eminent authors, that any additional remarks may ſeem almoſt ſuperfluous. But as it has been my hap to ob⯑ſerve a few facts that may perhaps have been unnoticed by others in ſimilar ſituations, it ap⯑peared to me an indiſpenſible duty to commit them to paper, in hopes that they may furniſh ſome uſeful hints to my fellow-labourers in the medical art.

The deſcription of this diſeaſe, either with reſpect to its ſymptoms, riſe, or progreſs, is too well known to need repetition; I ſhall, there⯑fore, content myſelf with remarking, that, among the Engliſh priſoners in France, there was ſcarcely any malady whoſe appearance it did not put on, though a few days always cleared up the deception.

That the ſcurvy ſhould lurk under the maſk of rheumatiſm or aſthma was, indeed, nowiſe [2]ſurpriſing; but it ſomewhat aſtoniſhed me to meet with it under the complete reſemblance of pleuriſy; particularly in the months of June and July. I knew too much of this inſidious enemy, to ſuffer myſelf to be deceived by a full, or even pretty hard pulſe; but I once had the curioſity to draw about four ounces of blood from an otherwiſe healthy and robuſt young man, to ſatisfy myſelf as to the preſence of the inflammatory cruſt. The event, however, ſhewed the great propriety of abſtaining from phlebotomy, even in thoſe eaſes that ſeem moſt to demand it; for the blood, during its flowing, exhibited a very remarkable broken ſparkling, and, as it were, ſandy aſpect; nor did it, on ſtanding, ſeparate into ſerum and eraſſamen⯑tum, as uſual, but remained in a maſs of various hues, and poſſeſſing but little firmneſs.

Though the ſcurvy often borrowed theſe forms, it moſt frequently aſſumed its ordinary ſymptoms:—theſe were ſtinking breath, ſwelled, ſpongy, and bloody gums, tumours, ſtiffneſs of the joints (particularly of the knees), black, brown, purple, or livid ſpots, ſome no larger than a flea-bite, others very large, reſembling bruiſes, accompanied by great debility and dejection of ſpirits.

The ſcurvy has formerly been erroneouſly repreſented by ſome as a new diſeaſe,^* and the almoſt peculiar progeny of cold climates, but experience has ſufficiently demonſtrated that it is no ſtranger even to the warmeſt. Cold, eſpe⯑cially when joined with moiſture, has, however, [3]ſuch manifeſt influence in its production, when ſuperadded to ſalt, and otherwiſe bad diet, that a ſlight ſketch of the weather, and treatment we experienced in France may not be amiſs.

The latter part of the year 1794, and the be⯑ginning of 1795, were perhaps as cold as any in the memory of man; nor was the cold confined to one country only; but very ſeverely felt al⯑moſt through Europe. About the middle of February the weather grew warmer (in France at leaſt); but early in March it again became cold and rainy, nor did it remarkably change for the better until the beginning of May, when there were a few fine warm days. At this time cold, chilling, eaſterly winds began again to ſet in, accompanied for the moſt part by rain and remarkably damp weather. Notwithſtanding the wind ſometimes ſhifted to the oppoſite points ſtill the ſame cold, damp, and unſeaſonable tem⯑perature of the air continued; nor did it become more pleaſant and ſeaſonable till towards the end of July: after that it continued mild and pleaſant till we left France.

During the colds of the early part of ſpring, miſerable indeed was the ſtate of too many of our captive countrymen. Several, particularly ſoldiers belonging to the Loyal Clare regiment had neither beds nor a change of linen; the conſequence of which, joined to natural indo⯑lence and habits of dirt, rendered them the firſt victims of diſeaſe. Nor were even ſome maſters of merchantmen in a much better ſituation; for, having been captured by, or put on board thoſe French men of war that were loſt in the ſtorms of the month of January, they were barely able to preſerve their lives with the loſs of every article of their wearing apparel.

The caſtle of Breſt being full of priſoners, many (to the amount of 1200) were forced to be put on board ſome old Indiamen, which lay in the harbour, and ſerved as temporary priſon ſhips; here they were crouded without diſ⯑tinction into confined and dirty apartments, and underwent unſpeakable hardſhips.

It was my lot, on my arrival there, Feb. 23, to be put on board the Elizabeth, which though reputed the moſt tolerable of the whole, was horrid beyond deſcription!

We had no place to ſit down in, even to eat, but the open deck; our diet conſiſted of rice ſoup, or, more properly ſpeaking, rice water, qualified with a little rancid, ſtinking oil; about ſix ounces of bad, courſe, ſalt beef; and every third day our rice was alternated with a meſs of horſe beans, and our beef with ſalt fiſh, or half rotten dried pilchards. We had, how⯑ever, plenty of good bread, and three half pints of poor ſmall adulterated wine, but no vegetables whatever, and the wine it ſeems was withheld from ſeveral of the other ſhips. The water allotted us was foul and putrid, though there was plenty of good water on board, nor was any allowed for the purpoſes of cleanlineſs. Such were the miſeries of the day; but thoſe of the night far exceeded them, nor were perhaps ever outdone, unleſs by the horrors of the black hole of Calcutta!

The place allotted for us to ſleep in was a part of the ſhip's hold, whither we were thruſt down at ſun-ſet, and which afforded no more than four inches in breadth to ſix feet in length for each man. Our number was about 240; many, therefore, were obliged to ſleep upon the floor, notwithſtanding two, and in ſome [5]parts three tiers of hammoes had been hung one under the other. After having been in⯑cloſed in this den of miſery for about an hour the heat grew intolerable, and the odour ariſing from the effluvia of our bodies horribly offen⯑ſive. Thoſe on the floor were incommoded by the ſaliva and urine of thoſe above, who were often ſo faint with the heat and ſtench of thoſe that lay below, that they could not move even for the homelieſt occaſions; and, to add to theſe troubles,^* the Iriſh ſoldiers gave themſelves up to dirt and idleneſs in ſuch a manner, that as it was totally impoſſible to crawl in or out of our dungeon without touching ſome of their hammoes with our backs, we were ſure to find vermin upon our clothes on coming upon deck in the morning.

As the heat and ſtench increaſed, many fainted, ſome broke out into raving madneſs, uttering the moſt incoherent and horrid impre⯑cations; and we had the affliction, more than once, to ſee an unfortunate fellow-ſufferer, on the firſt moment of his expoſure to the cold air of the morning, drop down on the deck to riſe no more.

It was in vain that the captain of the ſhip, a humane and good man, endeavoured to re⯑lieve our ſufferings and check abuſes. He gave orders that the hatches ſhould be left open at nights, and that his ſurgeon ſhould look after the ſick; but as he had little compulſive power, no ſooner was he gone to bed than ſome one or other, in ſpite, as they ſaid, to [6]George and Pitt^*, laid the hatches down; the ſurgeon of the ſhip too was ſo ignorant, that after one of the ſick had applied to be ſent to the hoſpital, he confidently aſſerted, that nothing ailed him; in leſs than an hour, how⯑ever, this poor fellow contradicted his aſſertion by dying upon deck.

On the 2d and 3d of March, we were re⯑moved from this diſmal place and put on board ſome Engliſh cartels that had arrived from the Weſt India Iſlands with priſoners, and had been detained ſince the preceding ſummer in Lan⯑derneau road.

Here our condition was much mended; but ſeveral met with a great mortification, for they now perceived that their trunks, &c. had been privately broke open during their abode in the diſmal manſions of the Elizabeth, and many articles of value ſtolen out; among the reſt, I thinking, upon my arrival on board one of theſe cartels, to regale myſelf with a clean ſhirt, diſ⯑covered on looking that it was out of my power, they having been all ſtolen.

Our allowance of proviſions ſtill continued the ſame, but thoſe who fortunately had ſaved a little money, or goods that were ſaleable, had an opportunity of purchaſing proviſions of all kinds, which the French ſoldiers brought, partly by ſtealth, from Breſt and Landerneau. After we had been here about a month, freſh beef was [7]ſerved out to the priſoners; but, from what cauſe I know not, this allowance was ſoon diſ⯑continued; and, to our mortification, bread likewiſe became ſo ſcarce and bad, that ſick⯑neſs and famine ſeemed to unite for the deſ⯑truction of thoſe who were obliged to live upon ſuch miſerable fare.

The poor fellows, who were our guards, were, however, in the ſame condition, nor had either more or better proviſions than the priſoners; and the paper-money was ſo depreciated, that a merry old Frenchman ſwore heartily to me that his pay would not find in him ſnuff; yet the laugh and the dance, and the ſong, conti⯑nued their uſual round among theſe inflexible republicans.

As the freſh beef could be no longer procured the commandant, Captain Forterie, uſed to ſend his boat every Saturday to Landerneau, to pur⯑chaſe proviſions for ſuch as could pay the market price for them; this (which the butcher's bill regularly brought with them, always made known) was eight livres ten ſous a pound for mutton, and ſix livres ten ſous for veal; but if we recollect, that from one thouſand to one thouſand four hundred livres were then the price of the louis d'or, or guinea, we muſt re⯑duce the pound of mutton to two pence, and that of veal to one penny halfpenny.

It was on our arrival in Landerneau river that my attendance on the ſick commenced; a very laborious taſk, and replete with inceſſant vexation. We had no medicines but ſuch as had been put on board the ſhips before their leaving England, for the uſe of their reſpective crews. Theſe, originally of an inferior quality, and many of them compounded without ſkill, [8]had been much damaged by length of time: nor was there a poſſibility of procuring proper diet for the ſick. The commandant's ſurgeon uſed, indeed, to come pretty often to ſend ſuch as he thought fit to the hoſpitals; but theſe were ſo crouded that none could poſſibly be ad⯑mitted except they were very ill,^* and ſo very few returned of thoſe that went that others were unwilling to go; not to mention that ſeveral muſt have periſhed unleſs aſſiſtance could be procured more ſpeedily than their turn of ad⯑mittance came on.

During the firſt part of the ſpring the diſeaſes moſt common were fevers, in which there was little remarkable, except the early attack of de⯑lirium; which in ſome caſes preceded every other ſymptom. The patients complained of pains in the head and back, ſickneſs and vomit⯑ing; moſt commonly of diarrhoea, but ſome⯑times obſtinate coſtiveneſs, with which they had for the moſt part been troubled ſome days previous to the coming on of more urgent ſymptoms. The pulſe was low and generally about 110, but ſometimes during the firſt day or two very little accelerated or different from the healthy ſtate; the tongue was uſually white and foul, but ſometimes very clean, and the patients generally complained of a bitter taſte in the mouth, together with vertiginous affec⯑tions of the head.

The plan of cure was obvious; for, after clearing the ſtomach by a gentle emetic, the ſtimulant plan, with acidulated drinks, com⯑pleted the cure, without failing even in one [9]inſtance. Bliſters however availed nothing in removing the delirium, which yielded only to free doſes of opium.

About the middle of April the ſcurvy made its appearance, and ſoon ſpread to an alarming de⯑gree, without any poſſibility of ſtopping its pro⯑greſs. The ſhips were, indeed, ſmoaked with gunpowder and vinegar, cleanlineſs was endea⯑voured to be enforced, and vinegar was ſerved out to ſuch as choſe to apply for it; but all in vain.

The ſeverely cold and damp weather chilled and benumbed a number of poor wretches, half⯑naked and half-ſtarved, who, to avoid its incle⯑mency, could neither be prevailed upon to come upon deck, nor waſh their apartments. Nor was this all, for the crowd and dirt cauſed them to be overrun with vermin, in ſuch a manner that it was a moſt diſagreeable buſineſs to go among them, even for the few moments neceſ⯑ſary to render them what little aſſiſtance lay in my power.

The ſcurvy, in the mean time, was daily extending its ravages: ſcarce a day occurred but one or more were added to the number of the ſick; nor did a week paſs in which ten at leaſt were not ſent to the hoſpitals of Breſt or Landerneau; inſomuch, that by the middle of May, not more than one-third of the original complement remained.

It was perhaps unfortunate that moſt of the ſhips, being lately arrived from the Weſt India Iſlands, had rum on board, The ſeveral captains were willing to accommodate the priſoners with this, which indeed was a great refreſhment when temperately uſed; but ſome ſailors, having got [10]themſelves intoxicated, broke open the holds of the ſhips and plundered every thing they choſe.

This buſineſs was carried on with ſurpriſing regularity, being put in practice on board all the ſhips at the ſame hour; and, ſhame to tell! was encouraged by ſome whoſe ſituations ought to have induced them to ſet a far different exam⯑ple. This increaſed the ſickneſs, and ſome were even ſaid to have died under intoxication.

On the 1ſt of May I was removed, by the commandant's order, at the deſire of the three captains below, from the ſhip in which I originally was, to the Humphreys, as a mark of reſpect, that being the pleaſanteſt ſituation; and as from that time ſome degree of intimacy commenced between the commandant and myſelf, it then lay in my power to render more ſervice than for⯑merly; I therefore declined the offer of going upon parole, reſolving to abide by my country⯑men in their diſtreſſes, in preference to conſulting my own eaſe or pleaſure.

It is with infinite pleaſure I write the names of Captain Anthony Collins, of the Humphreys; Captain Wm. Yellowley, of the Reſolution; and Captain Rob. Alexander, of the Berwick, three men to whom the thanks of their country are juſtly due, for the preſervation of many valuable lives. The three ſhips to which they belonged were moved cloſe together in one tier, and as the greateſt harmony and friendſhip ſubſiſted among them, they united their endeavours to relieve the ſufferings of thoſe on board their veſſels. With this view they diſtributed among the pri⯑ſoners, at their own riſque, ſuch ſtores as were on board of bread, peas, oatmeal, beef, &c. in a regular manner. To the ſick they gave tea, [11]ſugar, and other accommodations, bought at their own expence; and thoſe maſters of ſhips and paſſengers, with whom they had any ac⯑quaintance, or who ſeemed to poſſeſs any merit, they entertained at their own tables. Theſe laſt amounted to ten in number, and we contrived to make our ſituation at leaſt tolerable. The ſtock of medicines was now made common, and the direction of it was my province.

The work of humanity went on from this time more cheerfully: the ſcorbutic was ſent off more frequently to the hoſpitals; for our three marine philanthropiſts were ſo much reſpected by the French, as well as the Engliſh, that whatever they requeſted was immediately granted.

Thoſe that were ſick of other diſeaſes generally remained with us, except they were deſtitute of clothing, in which caſe they were recommended immediately, on the attack of any ſerious illneſs whatever, to go to the hoſpitals. Though the French^* medical practice is certainly much in⯑ferior to the Britiſh, the advantages of proper diet, comfortable accommodations, and clean clothes (all which they had at the hoſpitals), perhaps more than counterbalanced that infe⯑riority: at all events it was next to impoſſible to effect a cure where all theſe were wanting.

But though this imperfect practice promiſed not much to other patients, the ſcorbutic very conſtantly found relief from the diet; and thoſe from Landerneau pretty generally returned to [12]us; thoſe ſent to Breſt frequently were put into the caſtle there; but theſe in either hoſpital ſeldom were in any hurry to return.

About the beginning of June the fevers began to aſſume a different and more dangerous form. The ſickneſs and vomiting no longer yielded to emetics; the tongue was foul, blackiſh, or a deep yellow; the pulſe generally, as in the former fevers, only lower; but the delirium was, if poſſible, more early in its attack, and remarkably obſtinate. On the third, fourth, or fifth day, a conſiderable degree of icterus came on, often followed by a diarrhoea, which removed the other ſymptoms. This was the mildeſt and moſt favourable form; for many times the vo⯑miting would only ſtop with the eruption of ſweat; profuſe haemorrhages exhauſted the pa⯑tient's ſtrength, without in the leaſt relieving any of the ſymptoms; the icteric ſymptoms came on with much pain in the region of the liver; and, the flux, by its profuſion and obſti⯑nacy, threatened the worſt conſequences.

It was here evident that the former plan of cure muſt be changed, in part at leaſt. The vomiting and ſickneſs could only proceed from one of two cauſes, BILE, or that general dia⯑theſis which frequently prevails in contagious and peſtilential diſeaſes, and which only ceaſes with the appearance of ſweat, ſome puſtular eruption, or glandular ſwelling; for putrid ſor⯑des, though frequently the occaſion of very troubleſome ſymptoms in the more advanced ſtate of thoſe diſeaſes, rarely, if ever, exiſt at their commencement.

When, therefore bile was ſuſpected for the cauſe, the vitriolic acid was naturally pointed out as the obvious remedy; otherwiſe a combi⯑nation [13]of opium and antimonials, or opium alone, was uſed to promote a free diaphoreſis.

When the vomiting was checked, if the pulſe was tolerably ſtrong, and not much delirium preſent, as was uſually the caſe when bile abounded, a gentle purgative was next admi⯑niſtered, which frequently completed the cure without needing a repetition.

In the other caſes, after ſweat has been ex⯑cited, the icteric ſymptoms coming gently on, were, for the moſt part, a ſign that the worſt was over: and if the diarrhoea came on with moderation, I uſually ſuffered it to proceed. Many caſes however occurred which required the utmoſt attention and exertion.

Delirium and haemorrhage were the moſt troubleſome ſymptoms I had to encounter. The cortex^* peruvianus availed nothing, nor were bliſters of the ſmalleſt ſervice; but, happily, the opium anſwered both theſe ends. If liberally given it procured ſleep, and removed the deli⯑rium: and in caſe of ſudden haemorrhage (no unfrequent occurrence) it was my cuſtom to give Tinct. opii gtts L. or gr. iij of the Extract, which uſually ſtopped the bleeding in a few minutes.

Very troubleſome fluxes were ſometimes the conſequence of the ſpontaneous diarrhoea, or even of a ſingle doſe of rhubarb, given during the icteric ſtage; but theſe were when neceſſary checked with great certainty and ſaſety by the opiate.

By theſe means, aided by the generous and humane exertions of Captains Collins, Alexander and Yellowley, I was fortunate enough to loſe [14]only one patient in, I may ſafely ſay, near an hundred; whereas of thoſe that went for theſe complaints to the hoſpitals, where they were treated on a very oppoſite plan of cure, not one tenth returned.

I had never, during all this time, attempted even to palliate a ſcorbutic complaint, conſcious that nothing effectual could be done without ſuch a change of diet as was impoſſible for the ſick to procure. But, about the middle of July, we were flattered with the hopes of a ſpeedy exchange, and our numbers were then reduced by death and ſickneſs (notwithſtanding two drafts from the caſtle at Breſt) to little more than three hundred. It then became impoſſible to reſiſt the entreaties of a number of miſerable men, all anxious to reviſit their native ſoil. Terrified at the idea of being left behind in an hoſpital, from whence but few had returned, they were deſirous, however ſick, to undergo every hardſhip rather than remain longer where they were; I therefore began, though with little hopes of ſucceſs, to conſider of the means probable to relieve thoſe whom I was convinced it was impoſſible to cure.

In the courſe of my reflections on this ſubject, I found reaſon to diſſent from many received opinions; and, by comparing what I had read with what I then ſaw, endeavoured to acquire more juſt ideas on the ſubject.

The ſcurvy has generally been repreſented as the offspring of cold, of ſalt proviſions, and of dirt; it has even been repreſented as infec⯑tious, and capable of being communicated like common contagious complaints, by a ſhort abode among the ſick. But though the circumſtances [15]of cold, ſalt proviſions, and diet, certainly con⯑tribute much to its formation, they are, in my opinion, by no means its principal cauſe, nor could I trace, in any inſtance, the ſmalleſt ſymp⯑toms of infection.

That ſalt proviſions are by no means its ſole cauſe, is plain from the hiſtory given us by Dr. Milmann of two women who had contracted the ſcurvy in a very ſevere degree, though their diet conſiſted entirely of bread and tea; nor was dirt (in that caſe) the cauſe, for theſe two poor women were remarkably cleanly.

The man, whoſe caſe is deſcribed by Dr. Huxham as having taken the horrid reſolution of ſtarving himſelf, died with as many ſcorbutic ſymptoms upon him as ſo ſhort a time could be ſuppoſed to produce. The other perſon men⯑tioned by him, as having deſtroyed his health by eating immenſe quantities of concrete vola⯑tile alkali, comes nearer to the ſuppoſition of its being produced by ſalt. But here it muſt be remarked, that a total loſs of appetite accom⯑panied the whole diſeaſe, from whence we are fairly entitled to draw the ſame concluſion, as well as from the following facts.

Perſons who, by habits of intemperance, have loſt their appetites, often exhibit appearances exactly reſembling the ſea-ſcurvy. Every per⯑ſon in the leaſt converſant with the diſeaſe, muſt have ſeen it frequently attack thoſe in a conva⯑leſcent ſtate from other complaints; and we know the African ſlaves are extremely liable to it, though their diet is almoſt entirely vegetable.

In the caſes of the two women, there was cer⯑tainly no cauſe but defect of nutriment; the ſame was alſo evidently true of the man that [16]ſtarved himſelf; and as we know that vegetable diet will but poorly ſupport thoſe accuſtomed to animal food, the ſame reaſoning may probably apply to the negroes. It may, however, be ob⯑jected, that the labourers in many places live chiefly on meal, and that they exhibit no ſcor⯑butic complaints; but it ſhould be remembered, that they make up by quantity for the defect of the quality. Thoſe who by intemperance loſe their appetites, and conſequently impair the digeſtive powers, certainly muſt be in the ſame predicament of defective nutrition; nor is the ſcurvy often found even among thoſe obliged to live on ſalt proviſions, unleſs they are deficient in quantity.

Thoſe who, upon their recovery from other diſeaſes, are attacked by the ſcurvy, do not im⯑mediately, on the turn of their former maladies, perceive its approach. For a few days their convaleſcence goes on as uſual; but, in a week's time, or perhaps near a fortnight, they begin to complain of pains in the limbs, and other ſcor⯑butic ſymptoms. This, as well as the other caſes, ſeems plainly to refer to the head of inanition; for we all know that convaleſcents require not only more but better nutriment than thoſe who have not been ſick.

It was before obſerved, that nothing occurred that could countenance the idea of infection, nor can I by any means ſubſcribe to that opinion, however reſpectable the authority of its main⯑tainers. If by an infectious diſeaſe, we mean one capable of being communicated by contact, of an infected perſon or thing, or a ſhort abode among the ſick, or in infected places, ſcurvy can hardly be referred in the claſs of infectious [17]diſeaſes. This opinion has, if I miſtake not, been chiefly founded on obſervations made upon the coaſt of Africa, where it was frequently found that the ſlaves were ſeized with ſcurvy in a few days after they arrived on board the ſhips. I have, however, been informed by ſe⯑veral gentlemen, who, though not of the faculty, are every way qualified for making obſervations, that thoſe who are ſo early attacked are ſuch as have been previouſly debilitated by diſeaſe or hunger; for the men, or rather brutes, that bring theſe miſerable creatures to the ſhips, are often under the neceſſity of marching them through the woods for many hundred miles, by which means they frequently catch violent fluxes, and are always liable to great fatigue and hunger.

If, indeed, the ſcurvy were at all infectious, the marine hoſpitals would be continually full of ſcorbutic patients, and thoſe that went thither to be cured of any other ſlight diſeaſe, would be almoſt ſure of contracting a worſe. But we find the caſe very different; nor do the healthy ex⯑perience the ſmalleſt detriment from admitting the ſcorbutic among them. We need not how⯑ever much wonder that the ſcurvy has been ſtyled infectious, when the gout itſelf has more than once undergone the ſame ſlander.

That the ſcurvy is neither the peculiar pro⯑duction of heat nor cold is plain, from its being alike to be found in the hotteſt and coldeſt re⯑gions; but there can be no doubt that either, if carried to a debilitating degree, will aſſiſt much in its formation.

It does not then appear that there is any one circumſtance in which all the caſes of ſcurvy agree, except that ſingle one of defective nutri⯑tion, [18]which we may therefore lay down as the remote cauſe of the whole diſeaſe; though other adventitious circumſtances certainly tend very much to influence its particular forms. I can⯑not think with Dr. Trotter, that the cauſe of ſcurvy lies in any peculiar ſtate of the blood; for though ſuch a ſtate accompanies it, I ſee no reaſon for ſuppoſing it to be the cauſe, as it may equally well be the effect.

It may be objected, that it has been known to appear contrary to my ſuppoſition among thoſe who had plenty, and who might have at leaſt eaten as much as they pleaſed. I muſt own I doubt the fact: but grant it true, it muſt be conſidered, on the other hand, that ſalt provi⯑ſions are by no means ſo nutritive as a much leſs quantity of freſh. If eaten without ſteeping the exceſſive ſaltneſs renders them almoſt into⯑lerable, and if too long ſteeped (as is generally the caſe) they become almoſt a mere caput mortuum.

Thus the very pains which are taken to ren⯑der the proviſions freſh, ſerve perhaps more than any indigeſtible property of the food itſelf to prejudice the health. This I very ſenſibly felt; for, being obliged to live for ſeveral days on proviſions ſo treated, I found them deprived of all their juices, and reduced by a very moderate boiling, to an almoſt inſipid bouillé, which retain⯑ed ſearcely any taſte except a faint ruſty one. The older the proviſions are, the more readily they thus part with their moſt nutritive parts; which may be another reaſon why ſcurvy more frequently appears on board merchant ſhips, whoſe proviſions are often old, than ſhips of war.

There is, beſides, a certain natural propenſity in the human frame to a variety of food: any [19]one kind ſoon cloys; and if once the quality becomes thoroughly diſagreeable, the ſtomach will not, without loathing, receive it in any conſiderable quantity. Vegetables, either freſh or dried, as they require ſalt to render them palatable, very much diſpoſe the ſtomach to receive ſalted food; and though they afford but little nutriment themſelves, yet by qualify⯑ing the diſagreeable flavour of that which is more nutritious, render eſſential ſervice.

How much difference the quantity as well as the quality of the food makes, was fully demon⯑ſtrated to me, by the ſtriking example before my eyes; for the ſailors belonging to the cartels, who had plenty of ſalt proviſions (with now and then a meal of freſh) were very little ſubject to the ſcurvy, unleſs debilitated by previous diſeaſe; whereas the priſoners, whoſe food was as miſer⯑ably deficient in quantity as in every other reſpect, were daily falling victims to it.

From theſe premiſes it was reaſonable for me to conclude, that the only radical cure for the ſcurvy was to be obtained not from medicine but from change of diet; yet that ſome pallia⯑tion might be expected from thoſe means that could be uſed to increaſe the appetite, joined with ſuch as give what may be called artificial ſtrength. Such are the ſeveral acids, bark, opium, wine, and ſtrong liquors, taken in mo⯑deration; but none of theſe could be ſuppoſed to do more than relieve for a few days.

Before I had perfectly ſatisfied my own mind on the ſubject, an event, leſs the effect of deſign than of accident, convinced me that I was not totally wrong. An old man having ſuffered in⯑tolerable pain, and loſt the uſe of his legs by the [20]ſcurvy, took at night a pill of extract. opii, to alleviate his torment. He was ſo much relieved in his complaints, by this ſingle doſe, that I gave him a few ſmall pills, with directions to take one three or four times a day: to my great, and very pleaſing ſurprize, not only his pains leſt him, but the ſtiffneſs of his joints likewiſe; the blackneſs which had almoſt completely ſurround⯑ed the knee, in a great meaſure diſappeared; nor did I find any difficulty in keeping him ſuf⯑ficiently well, to remain on board, till we ſailed for England.

Encouraged by this unexpected ſucceſs, I pro⯑ceeded to extend the ſame practice to others in different ſtates of the diſeaſe, till I aſcertained the important fact, that opium, prudently admini⯑ſtered, is capable of palliating, for many days, the moſt urgent ſymptoms of ſea ſcurvy, at leaſt in its incipient ſtate; and thus enabling the poor ſuf⯑ferers to hold out till perhaps ſome hoſpitable ſhore may afford the only radical cure—dry air, moderate exerciſe, and plentiful diet.

It now remains for me to lay down a few prac⯑tical rules for the general management of ſcor⯑butic complaints, as well in the curative as pre⯑ventive intention; as likewiſe ſome hints that may facilitate the adminiſtration of opium in thoſe caſes where its effects are deficient or exceſſive.

The prevention of ſcurvy is not attended with any remarkable difficulty. Every obſtacle has been nearly removed by the illuſtrious Captain Cook, whoſe plans are now pretty exactly fol⯑lowed in the Britiſh navy.

Nearly the ſame method might be adopted on board every ſhip bound on a long voyage, were not obſtinate bigotry to old cuſtoms a too [21]prominent feature in the character of moſt na⯑vigators. Captain Cook's firſt improvement was to divide his ſhip's company into three watches inſtead of two, a practice which might be more frequently imitated than it is. It does not very often happen that the whole watch (when the crew is formed into two watches only) is wanted on deck at the ſame time; it would certainly then be better to leſſen their fatigue, by dividing them into three, ſo as to allow one-third to have eight hours uninterrupt⯑ed reſt each night. This would allow ſufficient time to wear off the effects of bad and rainy weather, and to refreſh completely thoſe that have been haraſſed with labour. Two-thirds might often ſerve, when, according to the pre⯑ſent cuſtom, all hands are called; and when that is practicable, the advantage of having a reinforce⯑ment of freſh hands every eighth hour is too obvious to be overlooked.

Next to providing againſt over-fatigue, dry and ſufficient clothing ſhould be attended to. This, though effectually done on board ſhips of war, is too little attended to on board merchant ſhips. The ſailors themſelves are certainly of all men the leaſt proper to be truſted with lay⯑ing in their own neceſſaries. Few of them have the fortitude to reſiſt the temptations of a glaſs of gin or a ſtrumpet; and, to indulge themſelves in thoſe pleaſures, they will, without ſcruple, expend their laſt farthing, and go to ſea in the moſt deplorable condition.

The maſter, therefore, who wiſhes to conduct his ſhip through a long voyage in ſafety, will always take care to have on board a ſufficient ſtock of neceſſary clothing, to ſupply thoſe who [22]are to make the voyage, and may have come out in want. It would not, for obvious reaſons, be prudent for him to advance too much before their leaving port, but at ſea a mutual power ought to exiſt for him to be enabled to compel the men to have neceſſary clothes, and for them to demand to be ſo ſupplied by him, to be ac⯑counted for out of their wages, at a fair price.

The article of proviſions is of the greateſt im⯑portance; but in this little choice can be had after the freſh ſtock has been expended. Some means may perhaps be diſcovered of preſerving animal ſubſtances at a moderate expence, without ſalt, or at leaſt with a ſmaller quantity than is commonly employed for that purpoſe: at all events, a diſcovery ſo very important and ſalutary, is highly worthy the labours of the philoſopher, and ought, in a commercial coun⯑try, to be encouraged by a moſt ample reward.

However, as this deſirable diſcovery has not yet been made, all that can now be done is to modify and correct the ordinary ſalt proviſions, as to render them as little noxious as poſſible. Too much ſteeping, as was before obſerved, ex⯑hauſts the nutritious parts of the ſalted beef or pork, which ſeems to be chemically combined with the ſalt. Moderate waſhing is quite ne⯑ceſſary to remove that ſuperfluity of ſalt which would otherwiſe render the meat too acrid to be eaten; but beyond certain limits it is certainly detrimental. If peaſe, beans, callivances, or other farinacea, are eaten along with the ſalt proviſion, thus treated they will not only render it much more palatable, but (as they themſelves contain no very deſpicable ſhare of nutriment) contribute much to the preſervation of health. [23]This can however only be ſaid of them in a ſound and perfect ſtate; for, when ſpoiled with long keeping, or full of vermin, they become totally uſeleſs and diſagreeable.

Biſcuit for long voyages cannot be kept too cloſely headed up in caſks. Many perſons are of opinion, that it requires now and then to be opened and aired; but experience, as well as rea⯑ſon, prove the contrary; for I have ſeen biſcuit which has been kept, with no other precaution than that of being put into a tight caſk, more than three years, perfectly freſh and pleaſant to the taſte.

Vegetables are, doubtleſs, of conſiderable uſe in combination with other food, and in the inten⯑tion of rendering it more palatable may be uſed freſh or pickled; but if uſed alone they are neither able to check nor prevent the ſcurvy. I have ever ſeen them hurtful when eaten too freely or raw. It has been lately imagined by ſome of our navigators, that potatoes eaten raw are a ſpecific in this diſeaſe; but ocular demonſtration has convinced me that this nauſeous doſe pro⯑duces little or no effect. The ſame I can affirm of cabbages, with this addition, that ſeveral were taken ill in conſequence of not being able to digeſt theſe vegetables when too plentifully uſed.

The juices of aceſcent vegetables, infuſions of malt, vinegar, &c. poſſeſs in themſelves no antiſcorbutic powers; but by whetting the ap⯑petite and aſſuaging thirſt, they facilitate the reception and digeſtion of ſalt food. Were it otherwiſe, we ſhould find that a little vinegar or lemon juice would cure the diſeaſe at ſea; but the miracles ſaid to be wrought by vege⯑tables [24]have in general been performed on ſhore, where freſh meat is likewiſe to be had, with tho additional luxury of a pure and dry air.

It has often been matter of ſurprize to me, that dried and ſmoked meats ſo ſeldom enter into the lift of ſhips' proviſions. Prepared in this manner, though they are much inferior in nutrition and ſalubrity to freſh, they are much ſuperior in both theſe reſpects to the ordinary ſalt beef and pork. It ſeems, indeed, notwith⯑ſtanding this inferiority, if we may truſt to the numerous inſtances of the inhabitants of the north, whoſe diet is almoſt ſolely compoſed of theſe dried meats and oatmeal, that, aided by the ordinary ſtores of meal, peaſe, &c. they would hardly, if at all, produce the ſcurvy among ſailors. The great difference between dried and pickled meat is farther obvious, if we reflect, that in the one the nutritious juices are but lightly impregnated with ſalt, and dried, as it were, into a ſirm glutinous maſs of eaſy ſolu⯑tion; but, in the other, they are in one of two ſtates, either kept conſtantly in a ſtate of ſolu⯑tion by the ſurrounding pickle, or elſe ſo ſixed by the ſait as not to yield to an aqueous menſtruum. But the exceſſive inſipidity of pickled beef, freſh⯑ened by long ſteeping, plainly ſhews that the juices are by no means fixed: on the contrary, they are diſpoſed to eaſy ſolution, and ready to be waſhed away along with the ſalt that preſerves them from putrefaction.

The catching of fiſh is always encouraged, as it furniſhes many a freſh meal when no other can be had. The larger and ſtronger taſted ought to be boiled rather than fried, and always uſed when quite freſh; fortunately when fiſh can [25]be caught, there are few ſorts which a little oil and lemon juice, or vinegar, will not render very tolerable.

While the beer laſts, not only the ſcurvy, but other diſeaſes are generally very rare; but when that is conſumed the men often begin to grow ſickly. The water ſoon becoming putrid and diſguſting, the ſailors abſtain as much as poſſible from it, nor will they, unleſs compelled, mix their allowance of wine or ſpirits with it, but prefer drinking each ſeparate. In proportion to their ſtomachs becoming palled with their pro⯑viſions, their appetites and digeſtions fail, and the obvious conſequence, inanition, takes place. They are directed, by a kind of inſtinct, to ſup⯑port a ſort of artificial ſtrength with their allow⯑ance of wine and ſpirits; theſe produce that effect for a ſhort time, but loſe their efficacy by degrees, till at laſt the unhappy mariner falls a victim to the flow, but mercileſs diſeaſe.

Nothing contributes more than a cheerful mind and moderate bodily exertion to prevent at⯑tacks of the ſcurvy, of which I ſaw ſome ſtriking inſtances in France. One in particular, a little, lively fellow, who though his fare was no better than his fellow-ſufferers, eſcaped every ſcorbutic taint, which I could attribute to nothing but his activity and good ſpirits. It has indeed long been remarked, that the ſkulkers are the firſt ſuf⯑ferers: every means therefore ſhould be uſed to promote cheerfulneſs and gentle exerciſe, which laſt is the more neceſſary, as the life of a failor is either that of the ſevereſt drudgery or downright indolence.

Waſhing the mouth well in a morning with ſalt water and vinegar, may, as tending to clean⯑lineſs, [26]be productive of ſome good; but from this I can entertain little higher expectations than from moſt other popular noſtrums. If foulneſs of the ſtomach, or obſtinate coſtiveneſs, create uneaſineſs, they muſt be immediately remedied; evacuations of all ſorts muſt however be cauti⯑ouſly employed, and phlebotomy, after men have been ſome time at ſea, ſhould never be performed without the moſt urgent neceſſity.

The whole of the prophylactic plan may be ſummed up in a very few GENERAL RULES, of which the preceding remarks may ſerve for an explanation.

• 1. Uſe the moſt nutritive and palatable diet that can be procured;
• 2. Vary the food as much as poſſible, that it may not nauſeate by conſtant repetition;
• 3. Uſe wine or ſpirits in moderation;
• 4. Let dry clothes be put on when thoſe worn have got wet;
• 5. Let cleanlineſs be as ſtrictly obſerved as poſſible;
• 6. Let no unneceſſary watching be required;
• 7. Let idleneſs and deſpondency be avoided.

The cure of ſcurvy at ſea is certainly next to impoſſible, nor does the palliation of its moſt troubleſome ſymptoms appear to me to admit of great variation in the practice. The excellent effects of opium have already been mentioned, but I ſhall here ſomewhat enlarge upon that as well as a few other uſeful articles of the materiae medica.

The acids and their effects have been already examined, nor does it ſeem neceſſary to add any thing farther on them, except that as condiments [27]they are both uſeful and agreeable. The Peru⯑vian bark I had but little opportunity to try, nor indeed would any trials made by me have been in the leaſt deciſive; as all the bark we had was not only ſpoiled by long keeping, but originally of the worſt quality.

Of all the medicines propoſed for the eure of this complaint, I can find none that has produced any remarkable effects except opium; but as ex⯑periments of its utility are (ſo far as I know) in their infancy, I ſhall content myſelf with ſubjoin⯑ing a few hints on its more general uſe, ſincerely wiſhing, that others whoſe opportunities of ren⯑dering ſervice to mankind exceed mine, may find it as ſucceſsful as I have done.

Among the various officinal forms of this in⯑comparable article the ſolid, unprepared, or, as commonly called, crude opium, ſeems the beſt cal⯑culated for uſe in ſcorbutic caſes; the tincture, and even the ſofter extract, being too ſudden, violent, and tranſitory in their effects. The ſolid will indeed agree with many perſons who cannot take it in any other form, though ſome are ſaid to be incapable of bearing it in any form whatever. This however (though certain idioſyncraſies are beyond explanation) ſeems in general an ill-founded opinion; and that either the opium has been adminiſtered when not wanted, or without attending to the ſtate of the primae viae.

On this account we muſt conſider what are the ſtates in which the firſt paſſages are found, and what are the means indicated by reaſon, and confirmed by experience, for the remedying ſuch as are morbid.

The ſtomach in a healthy ſtate neither abounds [28]in acid, bile, phlegm, nor putrid ſordes, but per⯑forms its offices readily, and with eaſe; yet it is liable, more or leſs readily, to contract any of the above morbid ſtates.

Theſe ſtates are commonly the concomitants of certain habits of living. The ſtomach generally abounds in acidities in the fat and indolent; in bile, in perſons whoſe exceſſes in drinking deprive them of appetite, in thoſe expoſed to hot climates and ſeaſons, and in thoſe who have endured long anxiety of mind, and in both acid and bilious ſtate it is likewiſe apt to be ſtuffed with phlegm. All theſe conditions of the primae viae may, accord⯑ing to circumſtances, be either the cauſe or conſe⯑quences of various diſeaſes; but the putrid, when not owing to putrid ingeſta, is, I believe, the ſole production of diſeaſe continued for a length of time. Noſologiſts have indeed talked of an al⯑kaline ſtate, and have adapted a ſet of medicines to it under the barbarous name of Antalkalina; but ſuch a ſtate is not, I believe, very commonly found, at leaſt no inſtance of it has ever come to my knowledge.

In the firſt (the acid) the reſins and gum reſins are nearly inſoluble; purgatives of that claſs operate ſlowly, and with griping; and opium, though given in very large doſes, produces but little effect. The corrector for this is obvious, and was proved even to demonſtration in the epidemic diarrhoea of 1789, which prevailed almoſt all through England. Rhubarb even increaſed the diſeaſe, and opium alone produced little effect, but conjoined with either the fixed, or volatile alkali, magneſia, or even common chalk, operated in the happieſt manner.

We may take, as a farther inſtance, a diſeaſe [29]chiefly incident ſo old men, which I have twice met with. It is ſo far, as I know, a nondeſcript, and perhaps miſtaken for a ſpurious apoplexy; but the perfect ſimilarity of the two caſes, as well as their cure, ſhew that neither was ſin⯑gular.

"I was ſent for to an old farmer, who was ſaid to have been ſeized with a fit, and found him lying in a profound ſleep, with a full ſlow pulſe, deep ſnorting, and ſubſultus tendinum: he had been attempted in vain to be let blood in both arms, nor did I entertain the leaſt doubt of his caſe being apoplectic.

"In about a quarter of an hour he came ſome⯑what to his ſenſes, and vomited a ſmall quantity of phlegm, but preſently his eyes were diſtorted, his head drawn aſide, he uttered a piercing cry, and inſtantly relapſed into the ſame ſtate in which I had found him.

"On inquiry, I found he had complained of pain at the ſtomach before his fits; and as there was ſome mint water at hand, I gave him, as foon as he was able to take it, a ſmall tea-cup full, with a few drops of tinct. opii. This how⯑ever he ſoon rejected, and relapſed in the ſame manner as before.

"Suppoſing that his complaint might proceed from ſome putrid ſubſtance lodged in the ſto⯑mach, I ordered him a draught containing gr. x. of kali ppt. with gtts. xxx. tinct. opii, to be immediately followed by ſuce. limon ℥ſs. In the hurry of giving it to him the lemon juice was ſpilt, and before any more could be pro⯑cured the patient found himſelf ſo much better that he poſitively refuſed to take it. Next morning I found him almoſt well, his chief com⯑plaint [30]being of the ſoreneſs of his mouth and throat, which were almoſt excoriated by the ex⯑ceſſive acidity of what he had vomited: he ſaid his whole complaint had lain in his ſtomach, and that he had found immediate relief upon taking the (alkaline) draught.

"He has ſeveral times ſince been threatened with ſimilar attacks, but always repels them by means of a mixture, containing a conſiderable portion of the confectio aromatica & magneſia, which he keeps conſtantly by him."

The other caſe was ſo ſtrictly ſimilar, that nothing more need be ſaid, but that I removed the whole diſeaſe at once with the following draught:

• ℞ Aq. menth. ℥iſs.
• Sp. nuc. moſch. ʒiij.
• Tinct. opii gtt. xxx.
• Magneſs. Alb. ʒſs.
• Syr. zinzib. ʒij. M.

The next ſtate of the ſtomach to be conſidered is the BILIOUS, in which all the reſinous ſub⯑ſtances operate with remarkable force. The purgatives of this claſs act briſkly and quickly; and opium very often occaſions delirium.

Here the vitriolic acid is indicated both by reaſon and experience, for the purpoſe of de⯑compoſing the bile, and removing its hurtful effects. Emetics have, it is true, been the con⯑ſtant reſource of phyſicians, ever ſince the days of Hippocrates; and where the ſtomach is known to abound in phlegm are certainly proper. But this mode of practice ought to be cautiouſly pur⯑ſued, unleſs there is great reaſon to ſuſpect ſomething more than bilious ſordes in the ſto⯑mach. [31]In many robuſt conſtitutions uneaſineſs in the ſtomach, vertigo, and bitter, diſagreeable taſte in the mouth are removed with great cer⯑tainty by an emetic; but in tender and weakly perſons the ſame ſymptoms often require a very different method of cure. After theſe feeble patients have taken an emetic, they ſeem, per⯑haps for a day or two, to be relieved by it, but are ſometimes about that time attacked by a cholera morbus, which proves remarkably ſevere.

When, therefore, the want of ſtrength gives the leaſt ground for ſuſpicion, and there is no reaſon to believe that the complaint originates from any other cauſe than redundant bile, the vitriolic acid taken in ſmall doſes, as occaſion may require, will be ſufficient.

In the autumn of 1790, there appeared a bilious diarrhoea, which if not prudently treated, was very apt to run into cholera morbus in a very ſhort time.

The ordinary aſtringents excited vomiting, in proportion as they checked the flux; purga⯑tives, however gentle, brought on the cholera, and opium cauſed delirium; but by premiſing a few drops of acid. vitriol. dilut. any of theſe might be adminiſtered with ſafety.

Where the primae viae are clogged with phlegm, there is perhaps no way of removing it but by evacuation; nor muſt we be diſcou⯑raged if a doſe of extraordinary magnitude ſhould be required. This tenacious ſubſtance lines the ſtomach and alimentary tube in ſuch a manner as to render them incapable of being acted upon by ordinary doſes; at the ſame time it obſtructs the orifices of the lacteals; and until [32]it is cleared away the patient ſinks under a train of ſymptoms, often ſuppoſed to proceed from other cauſes. This is no where more ſtrongly exemplified than in the chronie colic; deſcribed by Aretaeus. Here it ſhould ſeem very briſk purgatives are quite neceſſary, as is made to appear by the caſe (the only one I believe on record) publiſhed by me in the New London Medical Journal, vol. I. part II.

The putrid ſtate of the ſtomach, or lower in⯑teſtines, is eaſily known, and can only be reme⯑died by the carbonic acid, whether it proceeds from putrid ſubſtances taken in by the mouth, or from previous general diſeaſe. Riverius was, I believe, the firſt that applied this acid, in the form of the fermenting mixture, in the putrid vomiting, which takes place in ſome fevers; but ſince his time, other phyſicians have conſider⯑ably extended its uſe, upon rational grounds, with the greateſt ſucceſs. When troubleſome ſymptoms are excited by putrid ſubſtances re⯑ceived by the mouth, it is equally efficacious; an inſtance of which may be found in the Medical Journal above-mentioned.

Many other medicines have been mentioned as poſſeſſing high antiſeptic. powers, but their effects ſeem very inconſiderable; nor, ſince we are provided with one of ſuch approved efficacy, is it of much conſequence whether we have any more.

I have been inſenſibly tempted into a long, and, perhaps, unneceſſary digreſſion; but as the correction of medicines once was a favourite theme in phyſic, and has of late been much ne⯑glected, I could not forbear giving my ſenti⯑ments on a ſubject, which, when rationally [33]attempted, is of more importance than feems at this time commonly imagined. Nor did I think it ſuperfluous to facilitate as much as lay in my power the uſe of one of the moſt active and excel⯑lent articles of the materia medica.

When indeed I firſt undertook the profeſſion of phyſic ſome rules, beyond what are commonly taught, ſeemed neceſſary for extemporaneous pre⯑ſcription. The uſe of articles confeſſedly inert ſtruck me as a criminal ſpecies of trifling; following implicitly the formulae of others ſeemed to be treat⯑ed mildly, by being only called ſervile indolence; nor did the uſe of diſputed medicines, or the ran⯑dom application of the more active, appear at all warrantable. Beſides, it has frequently happened that one phyſician, guided by experience, has ex⯑tolled to the ſkies an article which another, on the very ſame ground, has pronounced totally inert. No other reaſon could be aſſigned for this, (if one or both have not been deceived by uſing it in com⯑bination with other drugs, on which its power ſolely depended), but that ſome local circumſtance has been overlooked. On this account it was obviouſly neceſſary to inquire into thoſe ſtates of the living ſyſtem which could produce any remark⯑able difference in the power of medicines, and the above is ſome part of the reſult of that inquiry.

But to return to our ſubject. Having corrected the ſtate of the primae viae, we may generally pro⯑ceed to adminiſter the opium to our ſcorbutic pa⯑tients. Sometimes, however obſtinate coſtiveneſs renders its immediate uſe improper, and this muſt be removed by the uſe of gentle cathartics, given in ſuch doſes as are juſt ſufficient to produce their proper effects. But though this practice in general is neceſſary, it is not always ſo; for ſometimes [34]the opium, ſtrange as it may ſeem, produces an evacuation, even when ſmall doſes of carthartics fail; an effect only to be accounted for on the ſuppoſition that the faeces are retained, becauſe the inteſtinal tube is too much debilitated to expel them.

The patients muſt be kept dry and warm, but not too hot; nor ſhould any ſpecies of cleanlineſs be omitted. If they can move themſelves, they ſhould be as much as poſſible in the open air, when the weather is fine: gentle exertions ſhould be encouraged; and even thoſe who are themſelves incapable of motion, will find much refreſhment on being carried in their hammocs, or otherwiſe, upon deck. All ſurprizes, and ſudden emotions and exertions, ought to be carefully avoided, cheer⯑ful ideas ſhould be impreſſed, but even theſe ſhould be of the ſteady kind; amuſements ſhould be encouraged, but not laborious ones; and the pleaſing hope of reaching land in a few days ſhould be conſtantly inſtilled into the mind. Even when that deſirable event takes place, it ought to be gradually ſignified to theſe miſerable objects. The exertions of the mind have much effect on the body nor can I attribute the ſudden deaths of ſcorbutic patients, on their arrival in port, to any other cauſe than exceſs of joy. When the body is much de⯑bilitated, any ſlight exertion, or paſſion, produces very great effects; nor perhaps is a ſtate of greater debility any where to be found than in this diſeaſe; for here we often find perſons who the moment before were ſpeaking cheerfully, ſuddenly expire on attempting to riſe from their beds.

Scorbutic ulcers muſt be kept clean; but whether the practice of dreſſing them with vegetable acids is of much avail, experience can alone determine. [35]In general the fewer applications are made to wounds and ulcers the better; if the dreſſings be ſoft, and ſufficient to keep out dirt and cold, little more is required.

The earth-bath has been much commended, both as a topical and general application in ſcorbutic complaints. It is ſaid to occaſion great pain on being firſt uſed, but in a few repetitions the pains wear off, and the whole habit quickly amends. How far this is the caſe I am unable to determine; but as the earth-bath can only be practiſed on ſhore, the change of diet which may be ſuppoſed to obtain at that that time may perhaps effect the cure. The application of the freſh earth may perhaps palliate the ſymptoms, but it muſt ſtrike every one as a manifeſt abſurdity, to imagine that the morbid effects can permanently ceaſe whilſt their cauſe (bad and inſufficient food) remains.

If it is neceſſary to attempt the palliation of ſcorbutic complaints at ſea, the antiſcorbutic diet, particularly ſo far as relates to nutriment, muſt be adopted. If ſuch food cannot be procured, the addition of a little wine to the ſalt beef, when ſtewed, will render it more palatable, without de⯑ſtroying its nutritive powers. The portable ſoups are highly proper, and may be rendered ſtill more ſo, by being united with peaſe, as it appears from experiment, that fluid food is not ſo readily acted upon by the ſtomach as that which poſſeſſes ſome degree of ſolidity.

For drink the liquors muſt be ſuited to the climate. But in all caſes, as the creating of arti⯑ficial ſtrength is the principal object, wine, punch, or beer, may be taken, as appears moſt ſuitable. No liquor, perhaps in point of coolneſs and briſk⯑neſs, exceeds ſpruce-beer, and as the eſſence of ſpruce is perfectly portable, it becomes within the reach of every navigator.

Theſe rules are likewiſe proper to be obſerved by thoſe in a ſtate of convaleſcence from other diſeaſes; for ſuch are (as was before obſerved) very liable to attacks of the ſcurvy, every ſymptom of which however after diſappears as they regain their ſtrength.

For the uſe of ſuch as are much reduced by acute diſeaſes, an emulſion may be made as fol⯑lows; which, if well prepared, can hardly be diſ⯑tinguiſhed from cow's milk, and ſerves for tea or coffee equally as well:

Grind together in a marble mortar about a drachm of fine loaf sugar, half a drachm of gum-arabic, and half a teaspoonful of common salt: when well powdered and mixed, add from twenty to thirty blanched sweet al⯑monds; bruise the whole well together, and form them into a paste; to which add by degrees a pint of boiled water. The slower the water is added, and more pains is taken with rubbing them, the better will be the liquor; and when all the water is added, strain through a fine linen cloth.

Upon ſtanding, it throws up a fine rich cream, which may be collected in ſuch quantity, if we uſe enough of the emulſion, as to become a moſt delicate article of luxury.

If to half a pint of this liquor a little spirits and sugar be added, it forms a grateful and refreshing draught in any climate, hot or cold; nor can it perhaps be paral⯑leled unless by the luxurious milk of the cocoa nut.

In the mean time small doses of opium; for inſtance, pills of grj. Each must be administered at short in⯑tervals.

A ſoon as ever the ſcurvy makes its appearance on board a ſhip, the firſt conſideration ought to be the poſſibility of making land in a ſhort time. It is in vain to flatter ourſelves that the diſeaſe may not ſpread, becauſe perhaps only one man is ſick.

The ſeeds of this cruel malady once ſown, they [37]only wait for a favourable opportunity to pro⯑duce their horrid fruit. Every little fatigue will be ſeverely felt, and a few, a very few days of bad weather may reduce a numerous crew to the moſt helpleſs ſtate; incapable alike to improve a favour⯑able gale, or to guard againſt the perils of a ſtorm. To veſſels in this ſituation no ſuch thing ſhould exiſt as an enemy's port. The animoſities of am⯑bition ſhould be obliterated by the tears of huma⯑nity. This has more than once been the caſe, when ſhips in diſtreſs have put into the ports of their enemies; they have been relieved and ſet at liberty, and would always be ſo was man per⯑mitted to act for himſelf. In few caſes, indeed, will he, if left to his own feelings, do wrong. The ſacred voice of miſery will ever be heard with attention; nay, ſometimes the hand of wretchedneſs, impelled by want, has been held privileged even in violating the firſt rules of mora⯑lity. The natural diſpoſition of man is to good⯑neſs; his heart yearns with benevolence towards his fellow-creatures. Cruelty conſtitutes no part of his native character; but cuſtom and education often ſorely warp the naturally ſtraight wand. Born with feelings tremblingly alive to every re⯑preſentation of woe, vicious habits rooted by time too often render him inſenſible to the miſeries of others; he can ſee them without pity, he can inflict them without remorſe: but, permitted to obey the dictates of his own heart, without any vicious precedent to pervert his actions, they are for the moſt part generous, great, and good.