cacuanha is to be given, which commonly relieves the ftomach from a load of acid, poraceous, bilious impurities:-but our great expectation from vomiting is, that its action on the mufcular fibres of the ftomach, forces open the extreme arterial capillaries, forwards the circulation to the furface of the body, and induces to fweat.-An opiate after its operation is neceffary.

After the vomit and opiate, it is proper to empty the bowels; but with caution, in cafe the patient is weak; and in fuch a manner as not to increafe the deter mination of the blood there, and divert it from the furface; for then we fhould lofe the ground gained by the vomit, and counteract our principal defign.-An antimonial that acts much upon the skin, and purges at the fame time, is what I always use.

The prime via being cleanfed, and the revulsion begun, it must be completed by fudorifics, that the disease may be thrown off by fweat. This will be effected by uniting an opiate with a diaphoretic, and adminiftering it as occafion requires. Laudanum and antimonial wine combined, is a medicine that caufes little or no irritation, and is a pleafant and certain diaphoretic it is always neceffary in the flux, when a fweat is intended by antimonial or other emetic medicines in small dofes, to add laudanum, to take off their irritation; by which means, their dofes and effects may be greatly extended. ·

James's powder is admirably well calculated to answer the first intentions in this difeafe; it pof felles this great advantage, that

though it fhall effectually cleanfe the prima viæ properly given, it never fails to excite a plentiful fweat, and terminates on the skin. -This double operation (if I may fo call it) perhaps has made it fo decifive in obftinate fevers.

When the diaphorefis is begun, I cover my patient with his blan ket (which no foldier fhould be without), and take care that the wind is not admitted directly upon him. I do not fuffer him to un cover himself, but order whatever he wants to be brought to him, and fupply him copioufly with warm mint, fage, balm, or oatmeal tea; and now and then give him a bafon of gruel, or thin flour pap, with a spoonful or two of good found white wine, as free as poffible from acidity.

When the fudorific procefs has been fuccefsfully continued, all the symptoms grow milder; and if the patient breaks out in a raslı, or efflorefcent eruptions, or boils, the disease will foon vanish.

In cafe the flux continues obftinate, and the fweats do not go on kindly, it will not only be requifite to carry off the morbific humours, by a dose of the antimonial purgative, but repeated vomits of ipecacuanha are to be given.-In this cafe, the circulation has not been enough di verted from the inteftines, to produce a full and fufficient diaphorefis; it is therefore necessary to give a fresh impulfe to the fibres, by the action of vomiting, for in vomiting, the action of the ftomach, and the contraction of the abdominal vifcera, forces the blood to the fùrface, and upper parts of the body.

Another caufe of obftinacy in

the

the flux, is indurated fæces lodged in the intefines;-and though the patient fhall have been repeatedly purged, and taken nothing but fluids during his illness, it is amazing what lumps of excrement will fometimes be brought away by a repetition of the antimonial purgative, after an interval of feveral days ;-for which reason, when the fweats have been plentiful, the pulfe moderate, and the flux ftill continues obftinate, we may fufpect this to be the cafe. The extraordinary appearance these balls of excrement fometimes acquire, from a long retention amongst difeafed fecretions, have induced fome to whimfical fuppofitions concerning their caufe, and component principles. I purfue this method, regulating it as occafion may require, or particul aroccurrences fuggeft, un til the patient is in a condition for bark, and other tonics and corroborants.

The flux will continue troublefome in fome fubjects, from mere weakness and relaxation of the vessels, without any material gripings or feverish fymptoms:here I never hesitate to give bark with fnake-root and wine.

In all complaints of the bowels, particularly in the dyfentery, the bark fhould never be given in substance; it caufes irritation, and gripings; and either brings back the disease, or fills the patient with obftructions:-a ftrong decoction therefore is ever to be preferred.

As the flux is always increased at the approach of night; fo, for fome time after, it has abated, the pulfe quickens, and the patient grows feverish in the evening.--

This is an admonition, that we fhould defift from the bark, and give a gentle diaphoretic at night. The remaining acrimony, which fometimes keeps up a fmall irritation after every other fymptom is removed, may be corrected with abforbents, and carried off before the ufe of the bark; or at any fubfequent period, if it fhould recur, with rhubarb and magnefiá, or any mild cathartic.

During the convalefcent state. of those who have been much reduced, and to prevent a relapfe, a flannel shirt or jacket, worn next the fkin, is of fingular benefit. When the bowels have fuffered confiderably by the flux, and cannot recover their tone, but from weaknefs are fubject to returns of that complaint, or to diarrhoea or tenefmus, on the leaft expofition to cold; a flannel jacket worn next the fkin will be found almoft a certain remedy, and preventive. Such occafional cloathing is very useful to officers and foldiers on fervice in hot climates, expofed to rains, dews, or night air; or to put on after having been wet, fatigued, or heated, that perfpiration may not be fuddenly checked, and that the body may cool gradually.

It is to be obferved, when the attack is fudden and violent, it will be neceffary to overtake the difeafe with opiates and cordials, before any recourfe to its principles can be adopted; otherwife the patient may be exhausted and funk beyond the recovery of me dicine.

Here I cannot help expreffing my concern, that the aggravated fymptoms which return in the morning, have not put an end to

the

the cuftom of giving pills of opium at night. When opium is given alone, and continued for any time, after its cordial effects are over, it weakens the veffels, injures the nerves, caufes a firangury, and lowers the powers of life: the humours, inftead of being diffipated, accumulate in the difeafed parts, that when the conftipation is off, the blood rushes forth with increated violence, and accelerates the patient's end.

In the far advanced state of the difcafe, we find the mefenteric veffels and glands enlarged, and obftructed; the glandulæ peyerianæ of the int fines thickened their coats tunsified, relaxed, abraded, and haftening into a state of fphacelation: opium in this fituation must increase and multiply every evil.

The real ufe of opium is, to arreft the hurry of the disease; to procure time to put fome rational means of cure into execution; to give other medicines their intended effet, and to eafe thofe to mina which fometimes are intolerable. Here the matchlefs power of opium raifes our admiration.

In he preceding hiftory it will appear, that the flux is not confied to particular feafons and fituations; that, what have been commonly confidered as univerfal remote caufes, only give the type to the difeafe; -- and that its ge. neral caufe, producible various ways, is obftructed perspiration.

The flux that prevailed last autumn, was attended with many of thofe caufes that are called remote: Auguff,, September, October, and the beginning of November, were remarkably clofe,

and fultry, with frequent rains;

the great discharge of perfpira tion, from the rarefaction of the blood, in such a season, relaxes the extremities of the perfpirable veffels, and fubjects them to fudden fpafm, and collapfion.

The camp dyfentery, in low, damp, marthy, countries, in the autumnal feafon, has all the concoinitants and type of a flux in hot climates after heavy rains; there will be lefs difpofition to inflammation, and the fluids will tend more to a state of diffolution-yet it is a fever turned upon the inteftines, for want of a free and regular perfpiration, from the thicknefs and moisture of the atmo sphere.

The irritation thus produced on the bowels, foon caufes a violent determination of blood there; and as the circulation is diminished in the veffels of the furface of the body, it is increased in thofe of the intestines.

By this increafed action of the arteries, the progrefs of the blood is impeded, in the minute rami fications of the veffels-hence hæmorrhage, and extravafation:-an immediate revulfion is therefore neceffary:-it must be exten five, but fuitable, that there may, be no mifchief done by increafing the debility incident to the dif ease.

Bleeding cannot be performed in every fubject, nor in every ftage or condition of a flux;-cathartics only cleanfe the affected parts; emetics are limited to answer certain purposes; diaphoretics have never been used, in a manner nor extent fufficient to produce an ef fect; and the cuftom of expofing

patients

or let down lower, to fink or raise the plough), and had another made to extend about a foot or rather more beyond the outfides of the ftandards, and from each end of the chain, made to let out or take up at pleasure, to each end of the pillar; this kept the rake even and fteady. To my great fatisfaction, I found it fucceed even beyond my expectation; for by means of this breaft-work, it could, like the Norfolk plough, be inftantly fet up or let down to the greatest degree of nicety; fo that any ftubble, whether cut high or low, whether very full of grafs or clover, or quite clean, might be raked by it with equal facility; for the teeth being made very much curved, the lower part of the back of the teeth refts upon the ground, and the points ftand out of it. The weight of the rake preffes the teeth close to the ground, and the corn is gathered into the throat of the rake, without digging up the weeds or the foil. The teeth are made fufficiently strong to prevent their bending. I have found a rake of the length above-mentioned very manageable; whether it would do better if made longer must be left to future experiments. I was determined to this length by the breadth of our gate-ways, being just enough to admit it through them without taking it to pieces.

For perfons who want to remove it to a diftant part, two fmall wheels might be added, to put on occafionally at the ends, to raise the teeth from the ground as it is drawn along the road.

I am fenfible, that if a low wheel were fixed at each end, even when in its work, it would greatly lef

fen the friction, and the horfe would draw it the eafier; but it would render it more complex and, perhaps, occafion it not to turn fo eafily at the ends of the land. I have, however, had it in idea, to fix fome kind of ftandard on the head of the rake for a line, like the Norfolk plough. lines, to come back to, that the man might guide the horfe himfelf, and fave the expence of a boy to lead him; but to this there feem to arise some objections.

One horfe, and a boy to lead him, with a man to clear the rake, will eafily rake twelve acres of ftubble in a day; and if two horfes are taken into the field, or be ufed alternately, twenty acres might be raked in the fame time; but this would be hard work for the man.

The manner of using it is as fol~

lows:

The rake being put on the breaft-work of the Norfolk plough in the fame manner as the ploughs are, the horse draws it with the fame traces, &c. (only in the plough two horfes are ufed, and here but one) and being fet into its work to a proper height, according as the ftubble is long or fhort, the boy leads the horse across the ridges, the corn being previously put in cocks by the forkers; the man follows the rake, and when it is filled, he speaks to the boy who ftops the horse, and puts him back a ftep or two. This is done that the man, by drawing the rake back a little, may the more eafily and speedily free it from the corn; then lifting it up, and the horse instantly going on,

he