Chapter IV: Of the Power of Celestial Bodies over Men and Women (1)

Having spoken thus largely of Physiognomy, and the judgments given thereby concerning the dispositions and inclinations of men and women, drawn by the said art, from every part of the bodies of men and women, it will be convenient here to show how all these things come to pass; and how it is that the secret inclinations and future fate of men and women may be known from the consideration of the several parts of the bodies. They arise from the power and dominion of superior powers over bodies inferior; by superior powers I understand the 12 Signs of the Zodiac, whose signs, characters, and significations are as follow.

_Aris_, the Ram, which governs the head and face.

_Taurus_, the Bull, which governs the neck.

_Gemini_, the Twins, governs the hands and arms.

_Cancer_, the Crab, governs the breast and stomach.

_Leo_, the Lion, governs the back and heart.

_Virgo_, the Virgin, governs the belly and bowels.

_Libra_, the Balances, governs the reins and loins.

_Scorpio_, the Scorpion, governs the secret parts.

_Sagittary_, the Centaur, governs the thighs.

_Capricorn_, the Goat, governs the knees.

_Aquarius_, the Water-Bearer, governs the legs and ancles.

_Pisces_, the Fish, governs the feet.

It is here furthermore necessary to let the reader know, that the ancients have divided the Celestial Sphere into twelve parts, according to the number of these signs, which are termed houses; and have placed the twelve signs in their houses, as in the first house Aries, in the second Taurus, in the third Gemini, &c. And besides their assigning the twelve signs to the twelves houses, they allot to each house its proper business.

To the first house they give the signification of life.

The second house has the signification of wealth, substance, or riches.

The third is the mansion of brethren.

The fourth is the house of parentage. _

The fifth is the house of children.

The sixth is the house of sickness or disease.

The seventh is the house of wedlock, and also of enemies, because oftentimes a wife or husband proves the worst enemy.

The eighth is the house of death.

The ninth is the house of religion.

The tenth is the signification of honour.

The eleventh of friendship.

The twelfth is the house of affliction and woe.

Now, astrologically speaking, a house is a certain space in the heaven or firmament, divided by certain degrees, through which the planets have their motion, and in which they have their residence, and are situated. And these houses are divided by thirty degrees, for every sign has so many degrees. And these signs or houses are called the houses of such and such planets as make their residence therein, and are such as delight in them, and as they are deposited in such and such houses are said to be either dignified or debilitated. For though the planets in their several revolutions go through all the houses, yet there are some houses which they are more properly said to delight in: As, for instance, Aries and Scorpio are the houses of Mars; Taurus and Libra, of Venus; Gemini and Virgo, of Mercury; Sagittarius and Pisces are the houses of Jupiter; Capricorn and Aquarius are the houses of Saturn; Leo is the house of the Sun; and Cancer is the house of the Moon.

Now to sum up the whole, and show how this concerns physiognomy, is thus: as the body of man, as we have shown, is not only governed by the signs and planets, but every part is appropriated to one or another of them, so according to the particular influence of each sign or planet, so governing, is the disposition, inclination, and nature of the person governed. For such and such tokens and marks do show a person to be born under such and such a planet; so according to the nature, power, and influences of the planets, is the judgment to be made of that person. By which the reader may see that the judgments drawn from physiognomy are grounded upon a certain veracity.

THE MIDWIFE’S VADE-MECUM;
CONTAINING
PARTICULAR DIRECTIONS FOR MIDWIVES, NURSES, &c.

Those that take upon them the office of midwives, ought to take care to fit themselves for that employment by the knowledge of those things that are necessary for the discharge thereof. And such persons ought to be of the middle age, neither too young nor too old; and of a good habit of body, not subject to disease, fears, or sudden frights. Nor are the qualifications assigned to a good surgeon improper for a midwife, viz, a lady’s hand, a hawk’s eye, a lion’s heart; to which may be added, activity of body, and a convenient strength, with caution and diligence; not subject to drowsiness or impatience. She ought also to be sober, affable, courteous, chaste, not coveteous, or subject to passion, but bountiful and compassionate; and, above all, she ought to be qualified as the Egyptian midwives of old, that is, to have the fear of God, which is the principal thing in every state and condition, and will furnish her, on all occasions, both with wisdom and discretion.

When the time of birth draws near and the good woman finds her travailing pains begin to come upon her, let her send for her midwife in time, better too soon than too late, and get those things ready which are necessary upon such occasions. When the midwife comes, let her first find whether the true time of the birth be come; for by not properly observing this, many a child hath been spoiled, and the life of the mother endangered; or at least given her double the pain needful. For unskilful midwives, not minding this, have given things to force down the child, and thereby disturb the course of her natural labour; whereas nature works best in her own time and way. I do confess, it is somewhat difficult to know the true time of a woman’s labour, they being troubled with pains long before their true labour comes, even some weeks before; the reason of which I conceive to be the heat of their reins; and this may be readily known by the swelling of their legs; and therefore, when women with child find their legs swell overmuch, they may be assured that their reins are too hot. For the cure whereof, let them cool the reins, before the time of their labour, with oil of poppies, and oil of violets, or water-lillies, by anointing the reins of their backs with them; for such women whose reins are very hot, have usually hard labours. But in this case, above all the remedies that I know, I prefer the decoction of them in water; and then having strained and clarified it with the white of an egg, boil it into a syrup with its equal weight of sugar, and keep it for use.

There are two skins that compass the child in the womb; the one is the _amnios_, and this is the inner skin; the other is the _allantois_, and this is the skin that holds the urine of the child during the time that it abides in the womb. Both these skins, by the violent stirring of the child near the time of its birth, are broken; and then the urine and sweat of the child contained in them fall down to the neck of the womb; and this is that which the midwives call _the waters_, and is an infallible sign that the birth is very near; for the child is no more able to subsist in the womb after those skins are broken, than a naked man is in the cold air. These waters, if the child come presently after them, facilitate the labour, by making the passage slippery; and therefore the midwife must have a care that she force not the waters away, for nature knows better the true time of the birth than she, and usually retains the waters till that time.

GENUINE RECIPES FOR CAUSING SPEEDY DELIVERY.

A loadstone held in the travailing woman’s hand. Take wild tansy, bruise and apply it to the woman’s nostrils. Take also date stones, and beat them to powder, and let her take a drachm of them in white wine at a time.

Take parsley, bruise it, and press out the juice, and put it up (being so dipped) into the mouth of the womb, and it will presently cause the child to come away, though it be dead, and the after-burden also; besides it cleanseth the womb, and also the child in the womb, of all gross humours.

Let no midwife ever force away a child, unless she is sure it is dead. I once was where a woman was in labour, which being very hard, her midwife sent for another midwife to assist her, which midwife sending the first down stairs, and designing to have the honour of delivering the woman herself, forced away the body of the child, and left the head behind; of which the woman was forced afterwards to be delivered by a man-midwife.

After the child is born, great care is to be taken by the midwife in cutting the navel-string, which, though by some is accounted but a trifle, yet it requires none of the least skill of a midwife, to do it with that prudence and judgment that are requisite. And that it may be done so, you must consider, as soon as the child is free from its mother, whether it is weak or strong; if the child be weak, put back gently part of the vital and natural blood in the body of the child by its navel (for both the vital and natural spirits are communicated by the mother to the child by its navel-string); for that doth much recruit a weak child; but if the child be strong, you may forbear.

As to the manner of cutting the child’s navel-string, let the ligature or binding be very strong; and be sure not to cut it off very near the binding, lest the binding unloose. You need not fear to bind the navel-string very hard, because it is void of sense; and that part of the navel-string which you leave on falls off of its own accord in a few days; the whole course of nature being now changed in the child, it having another way ordained to nourish it. It is no matter with what instrument you cut it off, so it be sharp and you do it cleverly. The piece of the navel-string that falls off, be sure you keep it from touching the ground; remember what I have before told you concerning this matter, and if you keep it by you it may be of use. The navel-string being cut off, put a little cotton or lint to the place, to keep it warm, lest the cold enter the body of the child, which it will be apt to do if it be not bound up hard enough.

The next thing to be done, is to bring away the after-birth, or secundine, else it will be very dangerous for the woman. But this must be done by gentle means, and without delay, for in this case especially delays are dangerous; and also in what I have set down before, as good to cause speedy delivery, and bring away the after-birth. And after the birth and after-birth are brought away, if the woman’s body be very weak, keep her not too warm; for extremity of heat doth weaken nature and dissolve the strength; but whether she be weak or strong, let no cold air come near her at first; for cold is an enemy to the spermatic parts. If cold goes into the womb, it increases the after-pains, causes swelling in the womb, and does great hurt to the nerves.

If what I have written be carefully observed by midwives, and such nurses as keep women in their lying-in, by God’s blessing, the child-bed woman may do very well, and both midwife and nurse gain credit and reputation. For though these directions may in some things thwart the common practice, yet they are grounded upon experience, and will infallibly answer the end.

But there are several accidents that lying-in women are subject unto which must be provided against; and these I will speak of next.

The first I shall mention are after-pains, about the cause of which, authors very much differ; some think they are caused by the thinness, some by the sliminess, and others by the sharpness of the blood; but my own opinion is, they proceed from cold and water. But whatever the cause may be, this I know, that if my foregoing directions be observed, they will be very much abated, if not quite taken away. But in case they do happen, boil an egg, and pour out the yoke of it, with which mix a spoonful of cinnamon-water, and let her drink of it; and if you mix it with two grains of ambergris, it will better.

The second accident lying-in women are subject to is excoriation in the lower part of the womb. To help this, use oil of sweet almonds, or rather oil of St. John’s wort, to anoint the part with.

Another accident is, that sometimes, through very hard labour, and the great straining to bring the child into the world, the lying-in woman comes to be troubled with the hemorrhoids or piles. To cure this, let her use polypodium bruised, and boiled in her meat and drink.

A fourth thing that often follows is, the retention of the menses; this is very dangerous, and, if not remedied, proves mortal. But for this, let her take such medicines as strongly provoke the terms; and such are peony roots, dittany, juniper-berries, betony, centaury, sage, savory, pennyroyal, feverfew.

The last thing I shall mention is, the overflowing of the menses. This happens not so often as the foregoing, but yet sometimes it does; and in such cases take shepherd’s purse, either boiled in any convenient liquor, or dried and beaten to powder, and you will find it very good to stop them.

Having thus finished the Vade-Mecum for Midwives, before I conclude I will add something of the choice and qualifications of good nurses; that those who have occasion for them, may know how to order themselves, for the good of the children whom they nurse.

1. Let her age be between 20 and 30, for then she is in her prime.

2. Let her be in health, for her sickness infects the milk, and the milk the child.

3. Let her be a prudent woman, for such a one will be careful of the child.

4. Let her be not too poor; for if she wants, the child must want too.

5. Let her be well bred; for ill bred nurses corrupt good nature.

6. If it be a boy that is to be nursed, let the nurse be such a one whose last child was a boy, and so it will be the more agreeable; but if it be a girl, let the nurse be one whose last child was a girl.

7. If the nurse has a husband, see that he be a good likely man, and not given to debauchery; for that may have an influence upon the child.

8. In the last place, let the nurse take care that she be not pregnant herself; for, if so, she must of necessity either spoil her own, or yours, or both.

To the nurse thus qualified, you may put your child without danger. And let such a nurse take the following directions, for the better governing and ordering herself in that station.

_Approved Directions to Nurses._

1. Let her use her body to exercise. If she hath nothing else to do, let her exercise herself by dancing the child; for moderate exercise causeth good digestion; and I am sure good blood must needs make good milk, and good milk cannot fail making a thriving child.

2. Let her live in good air; there is nothing more natural than this. It is the want of this makes so many children die in London; and even those few that live are not of the best constitutions, for gross and thick air makes unwieldy bodies and dull wits.

3. Let her be careful of her diet, and avoid all salt meats, garlics, leeks, onions, and mustard, excessive drinking wine, strong beer, or ale, for they trouble the child’s body with choler: cheese, both new and old, afflicts it with melancholy, and all fish with phlegm.

4. Let her never deny herself sleep when she is drowsy, for by that means she will be more wakeful when the child cries.

5. Let her avoid all disquiets of mind, anger, vexation, sorrow, and grief; for these things very much disorder a woman, and therefore must needs be hurtful to her milk.

6. If the nurse’s milk happen to be corrupted by an accident, as sometimes it may be, being either too hot or too cold, in such cases let her diet be good, and let her observe the cautions which have already been given her. And then, if her milk be too hot, let her cool it with endive, succory, lettuce, sorrel, purslain, and plantain; if it be too cold, let her use burorage, vervain, buglos, mother of thyme, and cinnamon; and let her observe this general rule, that whatsoever strengthens the child in the womb, the same attends the milk.

7. If the nurse wants milk, the thistle, commonly called the lady’s thistle, is an excellent thing for the breeding of milk, there being few things growing (if any) that breeds more and better milk than that doth; also the hoofs of the forefeet of the cow, dried and beaten to powder, and a drachm of the powder taken every morning in any convenient liquor, increases milk.

_Choice Remedies for increasing Milk._

If any nurse be given to much fretting, it makes her lean, and hinders digestion; and she can never have store of milk, nor what she hath be good. Bad meats and drinks also hinder the increase of milk, and therefore ought to be forborne. A woman that would increase her milk, should eat the best of food, (that is if she can get it,) and let her drink milk wherein fennel seeds have been steeped. Let her take barley-water, and burrage, and spinach; also goat’s milk, and lamb sodden with verjuice. Let her also comfort the stomach with confection of aniseed, carraway, and cummin seeds, and also use those seeds sodden in water; also take barley-water, and boil therein green fennel and dill, and sweeten it with sugar, and drink it at pleasure.

Hot fomentations open the breasts, and attract the blood, as decoction of fennel, smallage, or stamped mint applied. Or, take fennel and parsley, green, each a handful, boil and stamp them, and barley-meal half an ounce, with seed drachm, storax, calamint, two drachms, oil of lilies two ounces, and make a poultice.

Lastly, take half an ounce of deer’s suet, and as much parsley roots, an ounce and a half of barley-meal, three drachms of red storax, and three ounces of oil of sweet almonds; boil the roots well, and beat them to pap, then mingle the other amongst them, and put it warm to the nipples, and it will increase the milk.

And thus, courteous reader, I have at length finished what I have designed; and can truly affirm, that thou hast here those recipes, remedies, and directions given unto thee with respect to child-bearing women, midwives and nurses, that are worth their weight in gold, and will assuredly answer the end, whenever thou hast occasion to make use of them, they not being things taken on trust from tradition or hearsay, but the result and dictates of sound judgment and experience.

THE VENEREAL DISEASE.

In a former edition of this book the venereal disease was omitted. The reasons, however, which at that time induced me to leave it out, have, upon more mature consideration, vanished. Bad consequences, no doubt, may arise from ignorant persons tampering with medicine in this disorder; but the danger from that quarter seems to be more than balanced by the great and solid advantages which must arise to the patient from an early knowledge of his case, and an attention to a plan of regimen, which, if it does not cure the disease, will be sure to render it more mild, and less hurtful to the constitution.

It is peculiarly unfortunate for the unhappy person who contracts this disease, that it lies under a sort of disgrace. This renders disguise necessary, and makes the patient either conceal his disorder altogether, or apply to those who promise a sudden and secret cure; but who, in fact, only remove the symptoms for a time, while they fix the disease deeper in the habit. By this means a slight infection, which might have been easily removed, is often converted into an obstinate, and sometimes incurable malady.

Another unfavourable circumstance attending this disease is, that it assumes a variety of different shapes, and may with more propriety be called an assemblage of diseases, than a single one. No two diseases can require a more different mode of treatment than this does in its different stages. Hence the folly and danger of trusting to any particular nostrum for the cure of it. Such nostrums are, however, generally administered in the same manner to all who apply for them, without the least regard to the state of the disease, the constitution of the patient, the degree of infection, and a thousand other circumstances of the utmost importance.

Though the venereal disease is generally the fruit of unlawful embraces, yet it may be communicated to the innocent as well as the guilty. Infants, nurses, midwives, and married women whose husbands lead dissolute lives, are often affected with it, and frequently lose their lives by not being aware of their danger in due time. The unhappy condition of such persons will certainly plead our excuse, if any excuse be necessary, for endeavouring to point out the symptoms and cure of this too common disease.

To enumerate all its different symptoms, however, and to trace the disease minutely through its various stages, would require a much larger space than falls to this part of my subject; I shall therefore confine my observations chiefly to circumstances of importance, omitting such as are either trifling, or which occur but seldom. I shall likewise pass over the history of the disease, with the different methods of treatment which it has undergone, since it was first introduced into Europe, and many other circumstances of a similar nature; all of which, though they might tend to amuse the reader, yet could afford him little or no useful knowledge.

OF THE VIRULENT GONORRHŒA.

The Virulent Gonorrhœa is an involuntary discharge of infectious mucus from the parts of generation in either sex. It generally makes its appearance within eight or ten days after the infection has been received; sometimes it appears in two or three days, and at other times not before the end of four or five weeks. Previous to the discharge, the patient feels an itching, with a small degree of pain in the genitals. Afterwards a thin glary matter begins to distil from the urinary passage, which stains the linen, and occasions a small degree of titillation, particularly at the time of making water; this gradually increasing, arises at length to a degree of heat and pain, which are chiefly perceived about the extremity of the urinary passage, where a slight degree of redness and inflammation likewise begins to appear.

As the disorder advances, the pain, heat of the urine, and running, increase, while fresh symptoms daily ensue. In men the erections become painful and involuntary, and are more frequent and lasting than when natural. This symptom is most troublesome when the patient is warm in bed.

The pain which was at first only perceived towards the extremity, now begins to reach up all the urinary passage, and is more intense just after the patient has done making water. The running gradually recedes from the colour of semen, grows yellow, and at length puts on the appearance of mucus.

When the disorder has arrived at its height, all the symptoms are more intense; the heat of the urine is so great, that the patient dreads the making water; and though he feels a constant inclination this way, yet it is rendered with the greatest difficulty, and often only by drops; the involuntary erections now become extremely painful and frequent; there is also a pain, heat, and sense of fulness about the seat, and the running is plentiful and sharp, of a brown, greenish, and sometimes of a bloody colour.

By a proper treatment, the violence of the symptoms gradually abates; the heat and urine goes off, the involuntary and painful erections, and the heat and pain about the seat, become easier; and the running also gradually decreases, grows whiter and thicker, till at last it entirely disappears.

By attending to these symptoms, the gonorrhœa may be generally distinguished from any other disease. There are, however, some few disorders for which it may be mistaken, as an ulcer of the kidneys or bladder, the _fluor albus_, or whites in women, &c. But in the former of these, the matter comes away only with the urine, or when the sphincter of the bladder is open; whereas in a gonorrhœa the discharge is constant. The latter is more difficult to distinguish, and must be known chiefly from its effects; as pain, communicating the infection, &c.

REGIMEN.—When a person has reason to suspect that he has caught the venereal infection, he ought most strictly to observe a cooling regimen, to avoid everything of a heating nature, as wines, spiritous liquors, rich sauces, spices, salted, high seasoned, and smoke dried provisions, particularly salt itself in every shape; as also all aromatic and stimulating vegetables, as onions, garlic, shalot, nutmeg, mustard, cinnamon, mace, ginger, and such like. His food ought chiefly to consist of mild vegetables, milk, broths, light puddings, panado, gruels, &c. His drink may be barley-water, milk and water, decoctions of marshmallows and liquorice, linseed tea, or clear whey. Of these he ought to drink plentifully. Violent exercise of all kinds, especially riding on horseback, and venereal pleasures, are to be avoided. The patient must beware of cold, and when the inflammation is violent, he ought to keep his bed.

MEDICINE.—A virulent gonorrhœa can rarely be cured speedily and effectually at the same time. The patient ought, therefore, not to expect nor the physician to promise it. It will often continue for two or three weeks, and sometimes for five or six, even where the treatment has been very proper.

Sometimes, indeed, a slight infection may be carried off in a few days, by bathing the parts in warm milk and water, and injecting frequently up the urethra a little sweet oil, or linseed tea, about the warmth of new milk. Should these not succeed in carrying off the infection, they will at least have a tendency to lessen its virulence.

To effect a cure, however, astringent injections will generally be found necessary. There may be various ways prepared, but I think those made with the white vitriol are both more safe and efficacious. They can be made stronger or weaker as circumstances may require; but it is best to begin with the more gentle, and increase their power if necessary. I generally ordered a dram of white vitriol to be dissolved in eight or nine ounces of common or rose-water, and an ordinary syringe full of it to be thrown up three or four times a day. If this quantity does not perform a cure, it may be repeated, and the dose increased.

Whether injections be used or not, cooling purges are always proper in the gonorrhœa. They ought not, however, to be of the strong or drastic kind. Whatever raises a violent commotion in the body increases the danger, and tends to drive the disease deeper into the habit. Procuring two or three stools every second or third day for the first fortnight, and the same number every fourth or fifth day for the second, will generally be sufficient to remove the inflammatory symptoms, to diminish the running, and to change its colour and consistence. It gradually becomes more white and ropy as the virulence abates.[1]

Footnote 1:

If the patient can swallow a solution of salts and manna, he may take
six drams; or, if his constitution requires it, an ounce of the
former, with half an ounce of the latter. These may be dissolved in an
English pint of boiling water, whey, or thin water-gruel, and taken
early in the morning. If an infusion of senna and tamarinds be more
agreeable, two drams of the former, and an ounce of the latter, may be
infused all night in an English pint of boiling water. The infusion
may be strained next morning, and half an ounce of Glauber’s salts
dissolved in it. A tea-cupful of this infusion may be taken every half
hour till it operates. Should the patient prefer an electuary, the
following will be found to answer very well. Take of the lenitive
electuary, four ounces, cream of tartar two ounces, jalap in powder
two drams, rhubarb one dram, and as much of the syrup Of pale roses as
will serve to make up the whole into a soft electuary. Two or three
tea-spoonfuls of this may be taken over night, and about the same
quantity next morning, every day that the patient chooses to take a
purge. The doses of the above medicines may be increased or
diminished, according as the patient finds it necessary. We have
ordered the salts to be dissolved in a large quantity of water,
because, it renders their operation more mild.

When the inflammatory symptoms run high, bleeding is always necessary at the beginning. This operation, as in other topical inflammations, must be repeated according to the strength and constitution of the patient, and the vehemence and urgency of the symptoms.

Medicines which promote the secretion of urine are likewise proper in this stage of the disorder. For this purpose an ounce of nitre and two ounces of gum-arabic, pounded together, may be divided into twenty-four doses, one of which may be taken frequently in a cup of the patient’s drink. If these should make him pass his urine so often as to become troublesome to him, he may either take them less frequently, or leave out the nitre altogether, and take equal parts of gum-arabic and cream of tartar. These may be pounded together, and a tea-spoonful taken in a cup of the patient’s drink four or five times a day. I have generally found this answer extremely well, both as a diuretic, and for keeping the body gently open.

When the pain and inflammation are seated high, towards the neck of the bladder, it will be proper frequently to throw up an emollient clyster, which, besides the benefit of procuring stools will serve as a fomentation to the inflamed parts.

Soft poultices, when they can conveniently be applied to the parts, are of great service. They may be made of the flour of linseed, or of wheat-bread and milk softened with fresh butter or sweet oil. When poultices cannot be conveniently used, cloths wrung out of warm water, or bladders filled with warm milk and water, may be applied. I have often known the most excruciating pains, during the inflammatory state of the gonorrhœa, relieved by one of these applications.

Few things tend more to keep off inflammation in the spermatic vessels, than a proper suspensory for the scrotum. It ought to be so contrived as to support the testicles, and should be worn from the first appearance of the disease, till it has ceased some weeks.

The above treatment will sometimes remove the gonorrhœa so quickly, that the person will be in doubt whether he really laboured under that disease. This, however, is too favourable a turn to be often expected. It more frequently happens, that we are able to procure an abatement or remission of the inflammatory symptoms, so far as to make it safe to have recourse to the great antidote _mercury_.

Many people, on the first appearance of a gonorrhœa, fly to the use of mercury. This is a bad plan. Mercury is often not at all necessary in a gonorrhœa; and when taken too early, it does mischief. It may be necessary to complete the cure, but can never be proper at the commencement of it.

When bleeding, purging, fomentations, and the other things recommended above, have eased the pain, softened the pulse, relieved the heat of urine, and rendered the involuntary ejections less frequent, the patient may begin to use mercury in any form that is least disagreeable to him.

If he takes the common mercurial pill, two at night and one in the morning will be a sufficient dose at first. Should they affect the mouth too much, the dose must be lessened; if not at all, it may be increased to five or six pills in the day. If calomel be thought preferable, two or three grains of it, formed into a bolus, with a little of the conserve of hips, may be taken at bed-time, and the dose gradually increased to eight or ten grains. One of the most common preparations of mercury now in use is the corrosive sublimate. This may be taken in the manner afterwards recommended under the confirmed lues or pox. I have always found it one of the most safe and efficacious medicines when properly used.

The foregoing medicines may either be taken every day, or every other day, as the patient is able to bear them. They ought never to be taken in such quantity as to raise a salivation, unless in a very slight degree. This disease may be more safely, and as certainly, cured without a salivation as with it. When the mercury runs off by the mouth, it is not so successful in carrying off the disease, as when it continues longer in the body, and is discharged gradually.

Should the patient be purged or griped in the night by the mercury, he may take half a dram of the opiate confection dissolved in an ounce of cinnamon-water, to prevent bloody stools, which are apt to happen should the patient catch cold, or if the mercury has not been duly prepared. When the bowels are weak, and the mercury is apt to gripe or purge, these disagreeable consequences may be prevented by taking, with the foregoing pills or bolus, half a dram or two scruples of diascordium, or of the Japonic confection.

To prevent the disagreeable circumstance of the mercury’s affecting the mouth too much, or bringing on a salivation, it may be combined with purgatives. With this view the laxative mercurial pill has been contrived, the usual dose of which is half a dram, or three pills night and morning, to be repeated every other day; but the safer way is for the patient to begin with two, or even with one pill, gradually increasing the dose.

To such persons as can neither swallow a bolus nor a pill, mercury may be given in a liquid form, as it can be suspended even in a watery vehicle, by means of gum-arabic, which not only serves this purpose, but likewise prevents the mercury from affecting the mouth, and renders it in many respects a better medicine.[2]

Footnote 2:

Take quicksilver one dram, gum-arabic reduced to a mucilage two drams;
let the quicksilver be rubbed with the mucilage, in a marble mortar,
until the globules of mercury entirely disappear; afterwards and
gradually, still continuing the trituration, add half an ounce of
balsamic syrup, and eight ounces of simply cinnamon-water. Two
table-spoonfuls of this solution may be taken night and morning. Some
reckon this the best form in which quicksilver can be exhibited for
the cure of gonorrhœa.

It happens very fortunately for those who cannot be brought to take mercury inwardly, and likewise for persons whose bowels are too tender to bear it, that an external application of it will answer equally well, and in some respects better. It must be acknowledged, that mercury, taken inwardly for any length of time, greatly weakens and disorders the bowels; for which reason, when a plentiful use of it becomes necessary, we would prefer rubbing in to the mercurial pills. The common mercurial, or blue ointment, will answer very well. Of that which is made by rubbing together equal quantities of hogslard and quicksilver, about a dram may be used at a time. The best time for rubbing it in is at night, and the most proper place the inner side of the thighs. The patient should sit beside the fire when he rubs, and should wear flannel drawers next his skin at the time he is using the ointment. If ointment of a weaker or stronger kind be used, the quantity must be increased or diminished in proportion.

If, during the use of the ointment, the inflammation of the genital parts, together with the heat and feverishness, should return, or if the mouth should grow sore, the gums tender, and the breath becomes offensive, a dose or two of Glauber’s salts, or some other cooling purge, may be taken, and the rubbing intermitted for a few days. As soon, however, as the signs of spitting are gone off, if the virulency be not quite corrected, the ointment must be repeated, but in smaller quantities, and at longer intervals than before. Whatever way mercury is administered, its use must be persisted in as long as any virulency is suspected to remain.

During this, which may be called the second stage of the disorder, though so strict a regimen is not necessary as in the first or inflammatory state, yet intemperance of every kind ought to be avoided. The food must be light, plain, and of easy digestion; and the greatest indulgence that may be allowed, with respect to drink, is a little wine diluted with a sufficient quantity of water. Spiritous liquors are to be avoided in every shape. I have often known the inflammatory symptoms renewed and heightened, the running increased, and the cure rendered extremely difficult and tedious, by one fit of excessive drinking.

When the above treatment has removed the heat of urine, and soreness of the genital parts; when the quantity of running is lessened, without any pain or swelling in the groin or testicle supervening; when the patient is free from involuntary erections; and lastly, when the running becomes pale, whitish, void of ill smell, and tenacious or ropy; when all or most of these symptoms appear, the gonorrhœa is arrived at its last stage, and we may gradually proceed to treat it as a gleet with astringent and agglutinating medicines.

OF GLEETS.

A gonorrhœa frequently repeated, or improperly treated, often ends in a gleet, which may either proceed from a relaxation, or from some remains of the disease. It is, however, of the greatest importance in the cure of the gleet, to know from which of these causes it proceeds. When the discharge proves very obstinate, and receives little or no check from astringent remedies, there is ground to suspect that it is owing to the latter; but if the drain is constant, and is chiefly observable when the patient is stimulated by lascivious ideas, or upon straining to go to stool, we may reasonably conclude that it is chiefly owing to the former.

In the cure of a gleet proceeding from relaxation, the principal design is to brace and restore a proper degree of tension to the debilitated and relaxed vessels. For this purpose, besides the medicines recommended in the gonorrhœa, the patient may have recourse to stronger and more powerful astringents, as the Peruvian bark,[3] alum, vitriol, galls, tormentil, bistort, ballustines, tincture of gum kino, &c. The injections may be rendered more astringent by the addition of a few grains of alum, or increasing the quantity of vitriol as far as the parts are able to bear it.

Footnote 3:

The Peruvian bark may be combined with other astringents, and prepared
in the following manner:—Take of Peruvian bark bruised six drams, of
fresh galls bruised two drams, boil them in a pound and a half of
water to a pound; to the strained liquor add three ounces of the
simple tincture of the bark. A small tea-cupful of this may be taken
three times a day, adding to each cup fifteen or twenty drops of the
acid elixir of vitriol.

The last remedy which we shall mention, in this case, is the cold bath, than which there is not a more powerful bracer in the whole compass of medicine. It ought never to be omitted in this species of gleet, unless there be something in the constitution of the patient which renders the use of it unsafe. The chief objections to the use of the cold bath are a full habit, and an unsound state of the viscera. The danger of the former may always be lessened, if not removed, by purging and bleeding; but the latter is an insurmountable obstacle, as the pressure of the water, and the sudden contraction of the external vessels, by throwing the blood with too much force upon the internal parts are apt to occasion ruptures of the vessels, or a flux of humours upon the diseased organs. But where no objections of this kind prevail, the patient ought to plunge over head in water every morning fasting, for three or four weeks together. He should not, however, stay long in the water, and should take care to have his skin dried as soon as he comes out.

The regimen proper in this case is the same as was mentioned in the last stage of the gonorrhœa: the diet must be drying and astringent, and the drink Spa, Pyrmont, or Bristol waters with which a little claret or red wine may sometimes be mixed.

When the gleet does not in the smallest degree yield to these medicines, there is reason to suspect that it proceeds from ulcers. In this case recourse must be had to mercury, and such medicines as tend to correct any predominant acrimony with which the juices may be affected, as the decoction of China, sarsaparilla, sassafras, or the like.

Mr. Fordyce says, he has seen many obstinate gleets, of two, three, or four years standing, effectually cured by a mercurial inunction, when almost every other medicine has been tried in vain. Dr. Chapman seems to be of the same opinion; but says, he has always found the mercury succeed best in this case when joined with terebinthinate and other agglutinating medicines. For which reason the Doctor recommends pills made of calomel and Venice turpentine;[4] and desires that their use may be accompanied with a decoction of guaiacum or sarsaparilla.

Footnote 4:

Take Venice turpentine, boiled to a sufficient degree of hardness,
half an ounce, calomel half a dram. Let these be mixed and formed into
sixty pills, of which five or six may be taken night and morning. If,
during the use of these pills, the mouth should grow sore, or the
breath become offensive, they must be discontinued till these symptoms
disappear.

The last kind of remedy which we shall mention for the cure of ulcers in the urinary passage, are the supperating candles or bougies. As these are prepared various ways, and are generally to be bought ready made, it is needless to spend time in enumerating the different ingredients of which they are composed, or teaching the manner of preparing them. Before a bougie be introduced into the urethra, however, it should be smeared all over with sweet oil, to prevent it from stimulating too suddenly. It may be suffered to continue in from one to seven hours, according as the patient can bear it. Obstinate ulcers are not only often healed, but tumours or excrescences in the urinary passages taken away, and an obstruction of urine removed, by means of bougies. Obstinate gleets may be removed by the use of bougies.

OF THE SWELLED TESTICLE.

The swelled testicle may either proceed from infection lately contracted, or from the venereal poison lurking in the body; the latter indeed is not very common, but the former frequently happens both in the first and second stages of a gonorrhœa; particularly when the running is unseasonably checked, by cold, hard drinking, strong drastic purges, violent exercise, the too early use of astringent medicines, or the like.

In the inflammatory stage, bleeding is necessary, which must be repeated according to the urgency of the symptoms.[5] The food must be light, and the drink diluting. High-seasoned food, flesh, wines, and every thing of a heating nature, are to be avoided. Fomentations are of singular service. Poultices of bread and milk, softened with fresh butter or oil, are likewise very proper, and ought constantly to be applied when the patient is in bed; when he is up the testicles should be kept warm, and supported by a suspensory, which may easily be contrived in such a manner as to prevent the weight of the testicle from having any effect.

Footnote 5:

I have been accustomed for some time past to apply leeches to inflamed
testicles, which practice has always been followed with the most happy
effects.

If it should be found impracticable to clear the testicle by the cooling regimen now pointed out, and extended according to circumstances, it will be necessary to lead the patient through such a complete antivenereal course as shall ensure him against any future uneasiness. For this purpose, besides rubbing the mercurial ointment on the thighs as directed in the gonorrhœa, the patient must be confined to bed, if necessary, for five or six weeks, suspending the testicle, all the while, with a bag or truss, and plying him inwardly with strong decoctions of sarsaparilla.

When these means do not succeed, and there is reason to suspect a scrofulous or cancerous habit, either of which may support a schirrous induration, after a venereal poison is corrected, the parts should be fomented daily with a decoction of hemlock, the bruised leaves of which may likewise be added to the poultice, and the extract at the same time taken inwardly.[6] This practice is strongly recommended by Dr. Storck in schirrous and cancerous cases; and Mr. Fordyce assures us, that by this method he has cured diseased testicles of two or three years standing, even when ulcerated, and when the schirrous had begun to be affected with pricking and lancing pains.

Footnote 6:

The extract of hemlock may be made into pills, and taken in the manner
directed under the article Cancer.

OF BUBOES.

Venereal buboes are hard tumours seated in the groin, occasioned by the venereal poison lodged in this part. They are of two kinds, viz. such as proceed from a recent infection, and such as accompany a confirmed lues.

The cure of recent buboes, that is, such as appear soon after impure coition, may be first attempted by _dispersion_; and, if that should not succeed, by _suppuration_. To promote the dispersion of a buboe, the same regimen must be observed as was directed in the first stage of a gonorrhœa. The patient must likewise be bled, and take some cooling purges, as the decoction of tamarinds and senna, Glauber’s salts, and the like. If by this course the swelling and other inflammatory symptoms abate, we may safely proceed to use the mercury, which must be continued till the venereal virus is quite subdued.[7]

Footnote 7:

For the dispersion of a Bubo, a number of leeches applied to the part
affected will be found equally efficacious as in the inflamed
testicle.

But if the buboe should, from the beginning, be attended with great heat, pain, and pulsation, it will be proper to promote its suppuration. For this purpose the patient may be allowed to use his ordinary diet, and to take now and then a glass of wine. Emollient cataplasms, consisting of bread and milk softened with oil or fresh butter, may be applied to the part; and, in cold constitutions, where the tumour advances slowly, white lily roots boiled, or sliced onions raw, and a sufficient quantity of yellow basilicon, may be added to the poultice.

When the tumour is ripe, which may be known by its conical figure, the softness of the skin, and a fluctuation of the matter plainly to be felt under the finger, it may be opened either by a caustic or a lancet, and afterwards dressed with digestive ointment.

It sometimes, however, happens that buboes can neither be dispersed nor brought to a suppuration, but remain hard indolent tumours. In this case the indurated glands must be consumed by caustic; if they should become schirrous, they must be dissolved by the application of hemlock, both externally and internally, as directed in the schirrous testicle.

OF CHANCRES.

Chancres are superficial, callous, eating ulcers, which may happen either with or without gonorrhœa. They are commonly seated about the glands, and make their appearance in the following manner:—First a little red pimple arises, which soon becomes pointed at top, and is filled with a whitish matter inclining to yellow. This pimple is hot, and itches generally before it breaks; afterwards it degenerates into an obstinate ulcer, the bottom of which is usually covered with a viscid mucus, and whose edges gradually become hard and callous. Sometimes the first appearance resembles a simple excoriation of the cuticle; which, however, if the cause be venereal, soon becomes a true chancre.

A chancre is sometimes a primary affection, but it is much oftener symptomatic, and is the mark of a confirmed lues. Primary chancres discover themselves soon after the coition, and are generally seated in parts covered with a thin cuticle, as the lips, the nipples of women, the _glens penis_ of men, &c.[8]

Footnote 8:

When the venereal ulcers are seated in the lips, the infection may be
communicated by kissing. I have seen very obstinate venereal ulcers in
the lips, which I have all the reason in the world to believe were
communicated in this manner. Nurses ought to beware of suckling
infected children, or having their breasts drawn by persons tainted
with the venereal disease. This caution is peculiarly necessary for
nurses who reside in the neighbourhood of great towns.

When the chancre appears soon after impure coition, its treatment is nearly similar to that of the virulent gonorrhœa. The patient must observe the cooling regimen, lose a little blood, and take some gentle doses of salts and manna. The parts affected ought frequently to be bathed or rather soaked in warm milk and water, and if the inflammation be great, an emollient poultice or cataplasm may be applied to them. This course will, in most cases, be sufficient to abate the inflammation, and prepare the patient for the use of mercury.

Symptomatic chancres are commonly accompanied with ulcers in the throat, nocturnal pains, scabby eruptions about the roots of the hair, and other symptoms of a confirmed lues. Though they may be seated in any of the parts mentioned above, they commonly appear upon the private parts, or the inside of the thigh. They are less painful, but frequently much larger and harder than primary chancres. As their cure must depend upon that of the pox, of which they are only a symptom, we shall take no further notice of them till we come to treat of a confirmed lues.[9]

Footnote 9:

I have found it answer extremely well to sprinkle chancres twice a day
with calomel. This will often perform a cure without any other
application whatever. If the chancres are upon the _glans_, they may
be washed with milk and water a little warm, and afterwards the
calomel may be applied as above.

Thus we have related most of the symptoms which accompany or succeed a violent gonorrhœa, and have also given a short view of their proper treatment; there are, however, several others which sometimes attend this disease, as a _strangury_ or obstruction of urine, _a phymosis_, _paraphymosis_, &c.

A strangury may be occasioned either by a spasmodic constriction, or an inflammation of the urethra and parts about the neck of the bladder. In the former case the patient begins to void his urine with tolerable ease; but, as soon as it touches the galled or inflamed urethra, a sudden constriction takes place, and the urine is voided by spurts, sometimes by drops only. When the strangury is owing to an inflammation about the neck of the bladder, there is a constant heat and uneasiness of the part, a perpetual desire to make water, while the patient can only render a few drops, and a troublesome _tenesmus_, or constant inclination to go to stool.

When the strangury is owing to spasm, such medicines as tend to dilute and blunt the salts of the urine will be proper. For this purpose, besides the common diluting liquors, soft and cooling emulsions, sweetened with the syrup of poppies, may be used. Should these not have the desired effect, bleeding and emollient fomentations will be necessary.