THERAPEUTICA GENERALIS,

SI V E

METHODUS MEDENDI.

HEADS

O F

LECTURES

O N

THERAPEUTICS.

DELIVERED AT THE

UNIVERSITY OF EDINBURGH,

ANDREW DUNCAN, ikf. fcf P.

EDINBURGH;

PRINTED FOR P. HILL.

M.DCC.XCIV.

PREFACE.

Upwards of twenty years have now elapfedfince 1 firfl prefented to the Public a fliortx /

treatife under the title of Elements of Thera-peutics, or Firfl; Principles of the Pradice ofMedicine. Thefe Elements were chiefly in-tended as a text-book for ray ledures on thatbranch of medical fcience. It is perhaps un-neceflary to obferve, that the prefent publica-tion is meant with the fame intention. In-deed, although it appear under a differenttitle, yet it may in reality be confidered onlyas a different edition of my former work; andalthough it be now publifhed in an abridged,yet I hope it is not in an unimproved ftate.

It is true, that notwithstanding the fluc-tuation of medical theories, the influence ofemetics, cathartics, and other medicines, onthe animal frame, continues to be the fameas it was, not only twenty years ago, but fromthe very commencement of the practice ofphyfic ; and it will always continue to be thefame. No one, however, will deny, that ma-ny errors have prevailed refpeding the opera-

tion of medicines. It has therefore been myaim, by attempting to afeertain their real ope-rative efFeds, from thence to deduce the moftimportant principles, both with refped to theufe and abufe of them. And although, wTithregard to thefe fubjeds much room for cor-redion ftill remains, yet I truft that my en-deavours' have not been altogether unfuccefs-ful.

The intelligent reader mull foon perceive,that the following pages will be chiefly ufefulto thofe who may hereafter attend my Lec-tures, where Therapeutics are treated of as abranch of the inftitutions of medicine. AndI truft that to attentive ftudents they may beof fome ufe, by enabling them to underftandwhat may be delivered, with more prompti-tude, and to recoiled it with more precifion.They may, however, alfo perhaps lead otherpraditioners, into whofe hands they may fall,to mark with greater accuracy the operativeefFeds of medicines, and the circumftancesindicating or forbidding their employment.If they be produdive of this confequence,,fome benefit may arife from having prefentedthem to the Public as well as to my Pupils.

Edinburgh,September I. 1794.

Preface.

CONTENTS.

Page

Introduction, - i

I. Emetics, 311. Cathartics, - 6

\

111. Diaphoretics, - - 10

IV. Epifpaltics, - - 13V. Diuretics, 17VI. Expectorants, - 20

VII. Errhines, ~ - 23VIII. Sialagogues, 27IX. Blood-letting, - 30X. Emrnenagogues, - 33XI. Anthelmintics, - 37XII. Lithontriptics, - 38XIII. Antacids, - 40XIV. Antalkalines, - 42XV. Attenuants, - - 43

PageXVI. Infpiflants, - 45XVII. Antifeptics, - - 46XVIII. Aflringents, - 48XIX. Emollients, - - 51XX. Corrofives, - 53XXI. Demulcents, -

- 55XXII. Stimulants, - 57XXIII. Sedatives, - 60XXIV. Antlfpafmodics, - 63

CONTENTS.

HEADS

O F

LECTURES

O N

THERA P EUTIC S.

INTRODUCTION.

Definition of this branch of the in-ftitutions of medicine—its connexionwith pathological phyfiology withthe pradice of phyfic ftridly fo called—with the materia medica—Circum-fiances in which it differs from thefe.

View of indications in the cure ofdifeafes to be afforded by therapeutics—Obfervations on the nature of indi-cations Explanation of the termsindicans, indicatio, and indicatum—Obfervations on the kinds of indica-

2 THERAPEUTICS.

tions mentioned by medical writers—*confervatory— prefervatory— curative—palliative—Rules in forming indi-cations—regard to the method of na-ture—to age, fex, temperament, andidiofyncrafy—to times and circumftan-ces of difeafes—to what experiencehas fhewn to be healthful or hurtful.

Obfervations on the different plans-followed in confidering the methodusmedendi—Objections to a general fy-flematic arrangement—illuflrations ofthefe objections from Dr Cullen’s ar-rangement, according to curative indi-cations—Advantage of arranging thearticles of the methodus medendi un-der natural aflbciations or independentdalles—multiplicity of dalles of thiskind from the earliefl periods of me-dicine^—reafons for rejecting many ofthefe—for felecting twenty four clafles,afterwards to be conlidered.

Plan to be followed in treating ofeach clafs—-Obfervations on the natureof the clafs a definition of it—itsprimary or direct effects—the changes

THERAPEUTICS. 3

'induced from thefe, or its feconclary ef-fects —the different orders into whichit may be divided—Obfervations onthe rife of the clafs— indications ofcure deduced from its nature —circum-ftances influencing the choice of or-ders —Cautions to be attended to inthe employment of the clafs—contra-indications to its ufe.

I. EMETICS.

General properties characterizingthe articles referred to this affocia-tion—Primary effeCls refilling fromtheir employment —they excite naufea—they produce the aClion of vomiting—they occafion hidden and oppofitechanges in the circulation—they in-creafe the fecretion or difcharge of fe-creted matter, from the various glandsand other fecretory organs which pre-pare fluids to be depohted in the upperpart of the alimentary canal—Changesin the fyftem from the primary effeds

4 THERAPEUTICS.

of emetics—the evacuation of the fto-mach, and in fome degree of the up-per part of the inteftinal canal—freecirculation through the ftomach, inte-ftines and glands conneded with thefeorgans—general agitation of the body

commotion of the nervous fyftem—a particular affedion of the furface.

Different orders of emetics—Emeti-ca irritantia—E. calefacientia—E, tiaufe-ofa—E, narcotica.

Indications in the cure of dlfeafeswhich emetics are fitted to fulfil.

i. From the general agitation of thefyftem which they produce,

To reftore uniform circulation,To promote dimimflied lymphatic

abforption,To remove obftrudions in the fan-

guiferous fyftem.

2. From the evacuation which theypccafion by vomiting,

To difcharge noxious matter takenin by the mouth,

THERAPEUTICS. 5

To difcharge morbid accumulationsof fecreted matter lodged in theftomach,

To evacuate ferous accumulations.

3. From the adedion of the nervousfyflem which they occadon,

To reftore excitement to the ner-vous power,

To obviate inordinate affedions ofthe nervous energy.

Illuftrations of thefe indicationsfrom remarks on the ufe of emetics inparticular difeafes fever— dyfentery—phthilis—jaundice—dropfy—poifons—Circumftances to be attended to re-fpeding the choice of particular ordersfor fulfilling particular indications.

Circumftances fuggefling caution inthe employment of emetics deducedfrom the nature of the clafs—agitationof the fyftem—increafed celerity ofthe pulfe—Conditions of the fyftemfuggefling caution in their employ-

6 THERAPEUTICS.

ment infancy—old age—pregnancy—delicacy of habit —a plethoric flate

Cautions with refpedl to regimenduring the adminiflration of emetics—The flate of the flomach when theemetic is exhibited—The means of fa-cilitating the operation of the emetic—The time of exhibition—The tempe-rature in which the patient ought tobe kept after the operation of the e-metic is finifhed.

Circumflances contra-indicating theemployment of emetics—rupture orrelaxation of containing veflels—topi-cal inflammation of yifcera—a highdegree of debility in internal parts—«

fixed obftrudlions to the circulation.

il. CATHARTICS.

General charaderiflics of the ar-ticles referred to this affociationPrimary effeds refulting from the em-

THERAPEUTICS. 7ployment of them—they ftimulate theinteftinal canal—they increafe the pe-riftaltic motion of the inteftines—-they promote the fecretion of thofefluids which, for the purpofes of theoeconomy, are requifite in the intefti-nal canal—they produce more frequentand loofer ftools.

Changes in the fyftem from the pri-mary effects of cathartics —the evacu -

ation of the contents of the inteftinesdiminution of the quantity of cir-

culating fluids, and in a particularmanner of the ferofity—a change inthe balance of circulation—a diminu-tion of perforation—higher excite-ment in the fyftem in general, butmore efpecialiy in the inteftinal canal.

Different orders of cathartics—Ca-thartica Jiimidantia— C. refrigerantia—

C, adjiringentia— C, emollientia —C. nar-cotica.

Indications in the cure of difeafeswhich cathartics are capable of fulfil-ling.

THERAPEUTICS.

1. From the evacuation which theyproduce,

To obviate morbid retention of thecontents of the inteftines,

To diminifti the quantity of circu-lating fluids, when too great forthe ftate of the fyftem at thetime,

To evacuate morbid accumulationsof ferum.

2. From altering the balance of cir-culation,

To promote free circulation throughthe inteftines in thefe cafes whereit is morbidly impeded,

To diminifh the impetus of bloodagainft parts morbidly affedted.

3. From the affection of the nervousfyftem which they occafion,

To remove a ftate of torpor in themufcular fibres of the inteftines,

To reftrain inordinate motions ofthe mufcular fibres there.

therapeutics. 9Illustration of thefe indications from

remarks on the ufe of cathartics inparticular difeafes—dyfenteria—vario-la—hydrops—amenorrhoea—diarrhoea.

Circumstances to be attended to re-fpeding the choice of orders for ful-filling particular indications.

Circumstances Suggesting cautions inthe employment of cathartics, derivedfrom the nature of the clafs—The de-gree of evacuation which they produce—the topical irritation which they oc-casion to the inteStines themfelves—Conditions of the fyftem Suggestingcaution in the employment of them—-childhood—female habits—hystericalconstitutions—high degrees of irrita-bility and torpor—remarkable delica-cy of the Stomach—peculiar antipa-thies.

Cautions with reSpedt to regimen du-ring the administration of cathartics—-the mode of exhibiting the catharticthe temperature in which the patientis to be kept during its operation—the

THERAPEUTICS.10

diet to be employed —the degree ofexercife to be ufed.

Circumftances contra-indicating theemployment of particular orders ofcathartics—general inanition—a highdegree of irritability in the inteftines—circulation morbidly accelerated—-circulation uncommonly languid—ha-bitual coftivenefs —uncommon relaxa-tion of the inteftines.

111. DIAPHORETICS.

General properties characterizingdiaphoretics—Primary effects refultingfrom the employment of them—theyaccelerate the motion of the blood—-they produce free circulation through,the veftels on the furface—they excitea difcharge of fweat.

Changes in the fyftem from the pri-mary effeCls of diaphoretics—analtera-tion in the balance of circulation—a di-minution of the quantity of circulating

THERAPEUTICS.

fluids—a diminution more particular-ly of the ferofity.

Different orders of diaphoretics—Diaphoretica calefacientia—D. pungentia—D. Jiimulantia-D. antifpafmodicaD, diluentia.

Indications in the cure of difeafeswhich diaphoretics are capable of ful-filling.

i. From changing the mode of cir-culation,

To obviate morbid determinationtaking place to different vifcera,

To remove various caufes obftrud-ing or impeding circulation onthe furface.

To reflore the natural difchargewhich fhould take place by thefurface.

2. From producing evacuation,To diminifh the quantity of circu-

lating fluids, when too great forthe flate of the fyflem at thetime,

THERAPEUTICS.12

To reftore lymphatic abforptionwhen morbidly diminifhed,

To difcharge morbid accumulationsof ferum.

Illuftration of thefe indications fromremarks on the ufe of diaphoretics inparticular difeafes—fever—rheumatifm—dropfy, and herpetic affections.

Circumftances claiming attention inthe choice of orders for fulfilling par-ticular indications.

Circumftances fuggefting caution inthe employment of diaphoretics, deri-ved from the nature of the clafs—Thedetermination which they produce tothe furface—the acceleration of themotion of the blood which they occa-fion—the debility which is the confe-quence of a profufe difcharge of fweat—the effeds produced on the veffels ofthe furface by the free paffage of bloodthrough them.

Conditions of the fyftem fuggeftingcautions in the employment of diapho-retics— infancy—lax and debilitated

THERAPEUTICS. 13

habits —Conftitutions liable to coftive-nefs—Conftitutions not eafily adted up-on by diaphoretics.

Cautions with refpedt to regimenduring the adminiftration of diaphore-tics—the ufe of liquids—the tempera-ture in which the patient is to be kept—The means of promoting fweatingadapted to particular conftitutions.

Circumftances contra-indicating theemployment of diaphoretics—a mor-bid increafe of determination to thefurface—uncommon relaxation of thefyftem—a high degree of inanition—a

morbid diminution of the impetus ofthe blood at the brain.

IV. EPISPASTICS.

General properties characterizingthe articles to be confidered underthis title Primary effedls refultingfrom the employment of epifpaf-tics they excite pain they in-creafe the quantity of fluids, circula-

14 THERAPEUTICS.

ting through the part to which theyare applied—they produce a difchargeunder the form of ferofity—they pro-duce a difcharge of pus.

Changes in the fyflem from the pri-mary effedfs of epifpafHcs—Attentionto the fenfation of pain excited—anincreafe of excitement in the nervousenergy through the fyflem in generalan uncommon determination of bloodto the part adted upon—a diminutionof the quantityof blood palling throughthe blood-veflels in the neighbourhoodof thofe in which the flow is increafed•—a permanent change in the mode ofcirculation—a diminution of the quan-tity of circulating fluids—a diminu-tion more particularly of the ferouspart of the blood.

Different orders of epifpafHcs—Epi-fpajiica ruhefacientia — E. veficantia—E.fuppurantia.

Indications in the cure of difeafeswhich epifpaflics are fitted to fulfil.

THERAPEUTICS. 15

I. From their aflion on the nervousfyftem,

To diminifli violent pain,To take off the eflfedls of uncom-

mon fenflbility.To remove torpor.

2. From the alteration which theyproduce in the balance of circulation,

To diminifli the impetus of theblood againft parts morbidly af-fedled,

To diminifli a morbid increafe ofaction in veflels in the neighbour-hood of thofe to which they areapplied.

3. From the evacuation which theyproduce,

To diminifli the quantity of circularting fluids, when too great for the.ftate of the fyftem at the time,

To evacuate morbid accumulationsof ferum.

16 THERAPEUTICS.

Illuftrations of thefe indications fromremarks on the ufe of epifpaftics inparticular difeafes —-odontalgia—hae-morrhagia—apoplexia—hepatitis—hy-drocephalus.

Circumflances claiming attention inthe choice of orders for fulfilling par-ticular indications.

Circumflances fuggefting caution inthe employment of epifpaftics fromthe nature of the clafs—the pain whichis occaftoned by their aftion—the in-flammation they excite in the part to

which they have been applied theftrangury, which is a frequent attend-ant of their operation.

Conditions of the fyftem fuggeftingcaution in the employment of epifpaf-tics—the female habit during the men-ftrual flux—lax and debilitated habits*

Cautions with refpecft to regimenduring the admin iftration of epifpaf-tics— the accommodation of diet andtemperature to the difeafe of the pa-tient—the ufe of demulcents and di-luents—the length of time for whichthe epifpaflica yeficantia fhould be ap-

THERAPEUTICS.

plied—the treatment of the part aftertheir removal —the continuance of theepifpaflica fuppurantia.

Circumflances contra-indicating theemployment of epifpaftics—a high de-gree of irritability in the fyftem ingeneral—morbid fpillitude of the blood—a flate of general inanition.

V. DIURETICS.

General properties characterizingthe articles referred to this affociation—Primary effects refulting from theemployment of them—they promotethe fecretion of urine—they promotethe excretion of urine.

Changes in the fyftem from the pri-mary effects of diuretics—a change inthe balance of circulation—a diminu-tion of the quantity of circulatingfluids, but efpecially of ferofity andfaline matter—an increafe of abforp-tion by the lymphatics—a diminution

THERAPEUTICS.

of perfpiration—an increafed flow ofliquid through the urinary paflages.

Different orders of diuretics—Din-retie a Jiimulantia— D. refrigerantia—D.dibientia—D. nareotica.

Indications in the cure of difeafeswhich diuretics are fitted to fulfil.

i. From the evacuation which theyproduce,

To remove fuperabundant feroiityfrom the blood,

To evacuate morbid accumulationsof ferum, -

To remove morbid acrimony fromthe blood,

To diminifh the quantity of circu-lating fluids, when too great forthe flate of the fyflem at thetime.

2. From the alteration which theyoccahon in the balance of circulation,

To reftore the natural fecretion ofurine when morbidly diminiflied,

THERAPEUTICS.

To diminifh other fecretions whenmorbidly augmented.

3, From augmentation of the flowof liquid through the urinary paffages,

To remove obftrudtions in the uri-nary paflages,

To wafli out acrimony from the uri-nary paflages.

Illuflrations of thefe indications fromremarks on the ufe of diuretics in par-ticular difeafes —afcites—idterus—ne-phritis.

Circumftances to be attended to re-fpedting the choice of orders for ful-filling particular Indications.

Circumftances from the nature of theclafs fuggefting caution in the employ-ment of diuretics —-hidden evacuation—changes in the fecretion by the kid-ney—flow of liquid through the uri-nary paflages.

Conditions of the fyftem fuggeftingcaution in the employment of diure-tics —the ftate of the difcharge by u-

20 THERAPEUTICS.

rine previous to the ufe of them—pe-culiarities in the habit affedling theiroperation.

Cautions refpefling regimen duringthe operation of diuretics—ufe of li-quids—temperature—diet.

Circumflances contra-indicating theemployment of certain diuretics ahigh degree of morbid fenfibility inthe kidney—a mordid increafe of thefecretion of urine—fixed obflrudionsin the urinary paffages—deficiency offerofity in the blood —redundance offerofity in the blood.

VI. EXPECTORANTS.

General properties characterizingexpectorants—Primary effeCls refultingfrom the employment of expectorants—they ftimulate the lungs—they aug-ment the fecretion taking place by themucous glands of the lungs—they in-

THERAPEUTICS. 21

creafe the excretion of mucus fromthe lungs.

Changes in the fyflem from the pri-mary effects of expectorants— an altera-tion in the flate of the mucus excreted—an increafe of the fenfibility of thelungs free circulation through theblood-veffels of the fecreting organs—evacuation of thofe cavities in thelungs in which mucus is depofited.

Different orders of expectorants —

Expedorantia naufeofa—E. Jiimulantia—

E. antifpafmodica —E. irritantia.

Indications in the cure of difeafeswhich expedorants arc fitted to fulfil.

i. From affeding the fecretion ofmucus,

To promote the fecretion by thelungs when morbidly diminifhedthere,

To render the mucus thinner whenmorbidly thick and vifcid.

22 THERAPEUTICS.

2. From affeCting the excretion ofmucus,

To evacuate morbid accumulationsof mucus taking place in thelungs,

To fupply irritation to the lungswhen it is morbidly deficient.

3. From affeCting the flate of thelungs themfelves,

To remove morbid infenfibility inthe lungs,

To promote free circulation throughthe lungs when morbidly impededthere.

Illuflration of thefe indications fromremarks on the ufe of expectorants inparticular difeafes—catarrh—peripneu-mony.

Circumftances claiming attention inthe choice of different orders of expec-torants for fulfilling particular indica-tions.

Circumftances fuggeiling cautions inthe employment of expectorants de-

THERAPEUTICS. 23

rived from the nature of the clafs—-the naufea they excite—their effeCt inaccelerating circulation their in-fluence as irritating the lungs.

Conditions of the fyltem fuggeftingcautions in the employment of expec-torants —the ftate of irritability in thelungs—the period of life.

Cautions with refpeCt to regimenduring the ufe of expectorants theemployment of diet favouring expec-toration—exercife —dry and pure air.

Circumftances contra-indicating theemployment of expectorants—a highdegree of increafed fenlibility in thelungs—uncommonly quick expectora-tion of mucus from the lungs.

VII. ERRHINES.

General properties characterizingerrhines Primary effeCts refultingfrom the employment of them—they

THERAPEUTICS.24

produce a fenfe of titillation in thenofe—they excite the adion of freez-ing—they occafion the expulfion of fe-creted mucus from different cavitiesinto which it is depofited—they aug-ment the fecretion of mucus from theglands, feparating it in the cavity ofthe nofe.

Changes refuiting from the primaryeffeds of errhines—violent agitationof the body in general commotionof the nervous fyllem—hidden changesin the circulation—a diminution ofthe quantity of circulating fluidsmore free circulation through the mu-cous glands on which the flernutatoryads —a change in the balance of cir-culation between the nofe and neigh-bouring parts.

Different orders of errhines—Errhi-na Jiernutatoria—E. evacuantia.

Indications in the cure of difeafeswhich errhines are fitted to fulfil.

THERAPEUTICS. 25

I. From the agitation of the fyflemwhich they produce,

To difcharge morbid accumulationsof mucus from the cavities fur-rounding the nofe,

To remove a ftate of torpor in thenervous fyllem,

To obviate nervous affedlions of theconvulfve and fpafmodic kind.

2. From the determination whichthey produce to the nofe,

To promote the fecretion of mucusin the nofe, when morbidly dimi-nifhed,

To occalion derivation from partsmorbidly affefled in the neigh-bourhood of the nofe.

Illuftration of thefe indications fromremarks on the rife of errhines in par-ticular difeafes palfy headach—-ophthalmia.

Circumftances to be attended to inthe choice of orders.

26 THERAPEUTICS.

Circumflances fuggefting caution inthe employment of errhines, derivedfrom the nature of the clafs—the agi-tation of the fyftem which they pro-duce the change in determinationwhich they occaflon.

Conditions of the fyftem fuggeftingcaution in the employment of errhines—old age—irritability of habit—dif-pofltion to haemorrhage—a torpid ftate—former habits.

Cautions with refpefl to regimenduring the administration of errhines—means of obviating inflammationwhen excited —• influence of hiddenexpolure to cold.

Circumflances contra-indicating theemployment of errhines—a high de-gree of plethora —uncommon fenfibili-ty of the nofe—preternatural determi-nation to the nofe—ulceration of thenofe, or neighbouring parts.

THERAPEUTICS. 27

VIII. SIALAGOGUES.

Definition—Primary efieds— theyflimulate the falivary glands or theirexcretories, and increafe the adion ofthe veflels fecreting faliva—they acce-lerate circulation through the falivaryglands, and through blood-veflels inthe neighbourhood of thefe—they pro-duce a preternatural difcharge of fali-va.

Changes refulting from the primaryefleds of fialagogues—an alteration ofthe diftribution of fluids circulatingthrough the veflels to which the adionof the fialagogue extends, and throughthe veflels in the neighbourhood ofthefe—a diminution of the quantity ofcirculating fluids a change in thenature of the remaining mafs, inde-pendently of the diminution of quan-tity.

28 THERAPEUTICS.

Different orders of fialagogues—Sia-lagoga topica—S\ interna.

Indications in the cure of difeafeswhich halagogues are fitted to fulfil.

i. From the alteration which theyinduce in the balance of circulation,

To diminifh the impetus of the bloodagainft parts morbidly affefled inthe neighbourhood of the falivaryglands,

To diminifh morbidly increafed ac-tion in thefe neighbouring vellels.

To promote free circulation throughthe falivary glands when morbid-ly obftruded.

2. From the evacuation which theyoccafion,

To difcharge morbid accumulationsof ferum,

To produce a thorough change inthe fluids when morbidly vitia-ted.

THERAPEUTICS.

Illullration of thefe indications fromremarks on the ufe of lialagogues inparticular difeafes—toothach—cynan-che dropfy;—fyphilis.

Circumllances influencing the choiceof different orders of lialagogues forfulfilling particular indications.

Circumllances fuggefting caution inthe employment of lialagogues, dedu-ced from the nature of the clafs—theirinfluence in llimulating the falivaryglands and neighbouring parts thetime required for their addon—the in-fluence of their adion on other parts—the debility which they induce.

Conditions of the fyllem fuggeflingcaution in the employment of them—-old age conftitutions habituated totopical lialagogues —• peculiarities inconllitution determining the operationof internal lialagogues to other parrs—-the mentlrual difcharge—pregnancy.

Cautions with refped to regimen du-ring the ufe of lialagogues -the pre-fervation of moderate temperature—

mild diet—the free uie of diluents—-

THERAPEUTICS.

the ufe of different gargarifms theufe of moderate exercife.

Circumflances contra-indicating theemployment of halagogues—uncom-mon determination to the falivaryglands preternatural fenfibility ofthefe glands—deficiency of ferofity inthe circulating fluids—a high degreeof inanition—general debility of thefyftem.

IX. BLOOD-LETTING.

Modes of cure to be comprehendedtinder the title of blood-letting—Pri-mary effedts arifing from thefe —theyremove part of the circulating fluids—they produce a temporary increafeof the celerity of the pulfe—they di-mi nifh animal heat—they change thediftribution of blood in the fyftem.

Changes in the fyftem from the pri-mary effedts of blood-letting —a dimi-nution of the quantity of the blood,

THERAPEUTICS. 31

and of the tenflon of the blood veflels—a diminution of the celerity andimpetus of the blood through the fy-flem in general —a diminution moreparticularly of impetus in parts in theneighbourhood of thofe from whichthe difcharge is made—a diminutionof the quantity of fluids feparated bydifferent fecretory organs.

Diviflon of the different modes ofblood-letting—General— TopicaL

Indications in the cure of difeafeswhich blood-letting is fitted to fulfil.

I. From the abftradlion of blood,To diminifh the quantity of circu-

lating fluids, when too great forthe flate of the fyflem at thetime,

To take off morbid tenfion in thefanguiferous fyflem.

2. From altering the fiate of motion’in the blood,

32 THERAPEUTICS.

To leften the impetus of circulationwhen morbidly afleded,

To moderate morbid heat.

3. From altering the courfe of theblood,

To diminish adion morbidly in-creafed in particular veftels,

To leften the impetus of the bloodagainft parts morbidly affeded.

jHluftrationof thefe indications fromthe ufe of blood-letting in particulardifeafes.

Circumftances to be attended to re-fpeding the choice of different modesof blood-letting, as accommodated toparticular indications.

Circumftances from the nature ofblood-letting fuggelling cautions in theemployment of it— the Hate of thepulfe during the difcharge—the quan-tity of blood difcharged—the appear-ance of the blood when difcharged—-the effed of the difcharge as inducingdeliquium.

THERAPEUTICS. 33

Conditions of the fyftem fuggeftingcautions in the employment of blood-letting—certain periods of life—par-ticular urgent fymptoms where blood-letting is adverle to the nature of thedifeafe—the time of critical difcharges—high degrees of irritability and tor-por.

Cautions regarding regimen whereblood-letting is employed—diet—timeof performing the- operation—mode of

xiifcharge.Circumflances contra - indicating

blood-letting general inanition ofthe fyftem—the circulation remark-ably weak and languid—a high degreeof debility.

X. EMMENAGOGUES.

Modes of cure to be conftdered un-der the title of emmenagogues—Pri-»mary eftebls refulting from them—theyftimulate the circulating fyftem—they

THERAPEUTICS.

more particularly ftimulate the veffelsin the neighbourhood of the uterus, anelfed in fome degree communicated tothe velfels of the uterus themfelves—-they occafion a particular alfedion ofthe nervous fyftem.

Changes in the fyftem from the pri-mary effects of emmenagogues—an in-creafe of the momentum of the bloodthrough the uterus and neighbouringparts —an augmentation of the quanti-ty of blood determined to the uterus—

a change in the tonic power of thevellels of the uterus.

Different orders of emmenagogues—Emmenagoga Jlimulantia—E. irritantiaE. tonica—E. antifpofmodica.

Indications deduced from the natureof the clafs, by operating in fulfillingwhich they remove amenorrhoea.

i. From changing the mode of cir-culation,

To promote free circulation in theneighbourhood of the uterus, whenmorbidly obflrubled there,

THERAPEUTICS. 35

To promote that accumulation ofblood in the uterine veftels whichis neceflary for the menftrual dif-charge,

To remove morbid obftrudtion tothe paflage of blood into the ca-vity of the uterus.

2. From their influence as adting onthe flate of the animated folid,

To increafe the tonic power of thefyflem when morbidly diminifh-ed.

To increafe tonic power in the vef-fels of the uterus in particular,when morbidly deficient there,

To remove fpafmodic ftridture ta-king place on the veffels of theuterus.

Circumftances to be attended to re-fpedting the choice of orders for fulfil-ling particular indications.

Circumftances fuggefting caution inthe employment of emmenagogues, de-duced from the nature of the clafs—-

36 THERAPEUTICS.

the confequences of refloration ifpulhed too far—the irritation occafton-ed to the inteftmes—the ftimulus tothe fyftem in general.

Conditions of the fyftem fuggeftingcaution in the employment of emme-nagogues—the age of the patient—-former complaints to which the mayhave been liable—the duration of thsprefent complaints.

Cautions with refpeCt to regimenduring the ufe of emmenagogues—tem-perature—exercife—diet.

Contra-indications to emmenagoguesConditions contra-indicating the

whole clafs—a high degree of inani-tion —particular topical affections ofthe uterus —a particular period of life—morbid conditions contra-indicatingparticular orders.

THERAPEUTICS. 37

XI. ANTHELMINTICS.

General properties characterizingthis aflbciation —EffeCts refulting fromtheir ufe, particularly thofe exerted onthe worms themfelves they killworms to which they come to be ap-plied in the body—they expel wormsfrom the body—they prevent the gene-ration of worms in the body—Changesrefulting from thefe effeCls.

Different orders of anthelmintics—Anthelmintica venenofa—A. luhricantia—

A. tonica—A. cathartics.

Indications in the cure of difeafeswhich anthelmintics are fitted to ful-fil.

i. From acting on the worms them-felves,

To kill worms lodged in differentparts of the human body.

THERAPEUTICS,

2. From their adlion on the fyftefnin which the worms are lodged,

To promote the expulfion of wormsfrom the body, whether dead oralive,

To prevent the generation of worms-in the body.

Circumftances to be attended to re-ceding the choice of orders for ful-filing particular indications.

Circumftances fuggefting caution inthe employment of anthelmintics—ef-fects independent of their adlion asanthelmintics infancy —diet— exer-cife.

Circumftances contra-indicating theemployment of particular orders ofanthelmintics.

XII. LITHONTRIPTICS.

General properties characterizingthe articles to be treated off under the

THERAPEUTICS,

title of lithontriptics—Primary effedsof thefe articles—they deflroy acidcontained in the flomach—they bracethe mufcular fibres of the primse vise—-they produce an analogous effed onother moving folids.

Changes rebuking from thefe effects—an alteration in the flate of the cir-culating fluids, as a pabulum for thefecretion of urine—an alteration onthe flate of fecretion at the kidney.

Different orders of lithontriptics—Lithontriptica antacida—L. adftringentia.

Indications which lithontriptics arefitted to fulfil.

I. From altering the fiate of thefolids,

To obviate particular morbid laxityin the flomach,

To obviate particular morbid laxityin the kidney.

2. From altering the flate of thefluids,

THERAPEUTICS.40

To corredl a peculiar morbid flatein the pabulum furnifhed for thefecretion of urine.

Circumflances to be attended to re-fpedling the choice of orders for ful-filling particular indications.

Circumflances fuggefling caution inthe employment of lithontriptics.

Circumflances contra-indicating theemployment of particular lithontrip-tics—influence of alkali in its canflicflate on the fyflem confequenceswhen the operation of lithotomy isperformed after the long continuedufe of it.

XIII. ANTACIDS.

General properties characterizingantacids—Effects in deftroying acidin the alimentary canal—confluen-ces refitting from thence.

THERAPEUTICS,

Different orders of antacids—Anta~■cida eccoprotica—A, rejiringentia.

Indications which they are fitted tofulfil, as deftroying acid in the primaeviae.

To remove a fenfation of fournefs inthe ftomach,

To rellore the natural appetite whenmorbidly vitiated by acid in thejftomach.

Illuflration of thefe indications fromtheir ufe in different difeafes.

Circumftances luggefting cautions inthe employment of antacids.

Circumftances contra-indicating theemployment of antacids—alkalefcencyin the primae vise—a tendency to pu-trefcency in the fyflem.

42 THERAPEUTICS.

XIV. ANTALKALINES.

General properties characterizingantalkalines —EffeCt of neutralizing al-kali in the fyflem—changes refultingfrom thence.

Different orders of antalkalines—Antalkalina vegetabilia—A. falina.

Indications which they are fitted tofulfil, as deftroying alkali.

To remove unealinefs from alkalef-cency in the primae viae,

To reftore the natural difpofition toacidity in the ftomach,

To corred preternatural putrefcen-cy in the alimentary canal.

Illuftration of thefe indications fronttheir ufe in different difeafes.

Circumftances fuggefting caution inthe employment of antalkalines.

THERAPEUTICS, 43

Circumftatices contra - indicatingtheir employment a conllitutionaldifpofition to cardialgia on the life ofacids —circulation uncommonly' flowand languid uncommon diminutionof animal heat.

XV. ATTENUANTS.

Definition of attenuants —Primaryeffects of articles referred to this clafs—they dilute the contents of the pri-mse viae —they add an uncommon quan-tity of ferous matter to the blood—-they increafe the folvent power of theferofity—they render the confidenceof*the general mafs more fluid fhan itwas previous to their ufe.

Changes arifing from the primaryeffects of attenuants —free circulationthrough the fmalier blood-veffels—anincreafe of various ferous fecretions—

an increafe of effuilon into various ca-vities.

THERAPEUTICS.44

Different orders of attenuants—At-tenuantia diluentia—A, folventia.

Indications in the cure of difeafeswhich attenuants are fitted to fulfil.

i. From altering the flate of thehlood itfelf,

To counteract morbid vifeidity inthe circulating mafs,

To reftore free circulation whenmorbidly obftruded in the ex-treme yefiels.

2. From affecting the fecretions,To increafe the quantity of the fe~

rous fecretions when morbidly de-ficient,

To render the ferous fecretions morefluid when morbidly vifeid.

Circumftances to be attended to re-fpeding the choice of orders of atte-nuants.

Circum(lances fuggefting caution intheir life..

THERAPEUTICS. 45

Circumftances contra - indicatingtheir employment preternatural te-nuity of the general mafs of circula-ting fluids—a tendency to morbid ac-cumulations of ferofity in the fyftem—a remarkable increafe of ferous fe-cretions.

XVI. INSPISSANTS.

Definition of infpiflants—Eflecfts inthe fyftem Different orders intowhich they may be divided—lnfpijfan-tia farinofa—/. viucilaginofa—Influenceof the difcharge of ferofity as produ-cing infpiflation.

Indications in the cure of difeafeswhich infpiflants are fitted to fulfil.

i. From their influence on the ftateof the blood itfelf,

To remove morbid tenuity from thecommon mafs of circulating fluids,

46 THERAPEUTICS.

To prevent the tranfmiflion of redblood through veffels not natural-ly fitted to receive it.

2. From their influence on the flateof the fecretions,

To diminifh the quantity of ferousfecretions when morbidly aug-mented,

To render thofe fecretions more vif-cid when morbidly thin and acri-monious.

Circumfiances contra-indicating th6employment of infpifiants morbidvifcidity of the blood —preternaturaldiminution of ferous fecretions—pe-culiar debility in the organs of dbgefiion.

XVII. ANTISEPTICS.

General properties characterizingantifeptics—EfieCls refulting from the

THERAPEUTICS. 47employment of them they changethe appearance of putrefcent parts inthe living animal body—they renderthe texture of the part more firm andcompad—they alter the matter dif-charged to a more thick confidenceand whiter colour they remove aflrong fetid fmell ariling from thepart before their ufe.

Different orders of antifeptics—An-tifeptica tonka—A. refrigeraniia—A, fti~mulantia—A. antifpafmodica.

Indications in the cure of difeafeswhich antifeptics are fitted to fulfil.

i. From their influence as prevent*ing putrefadion,

To fupply an antifeptic power whenmorbidly deficient in the fyftem,

To obviate the alfimulating qualityof any putrefcent ferment whenintroduced into the body.

2. From their influence as obviatingputrefadion when already begun,

THERAPEUTICS.

To correct a putrid diathefis in thefluids of the living animal body,

To prevent the farther progrefs ofputrefaction when taking place inthe folids,

To reflore to a found ftate parts al-ready morbidly putrid.

Illuftration of thefe indications fromthe ufe of antifeptics in particular dif-eafes—gangrene— fcorbutus, and ty-phus.

Circumflances to be attended to re-fpecting the choice of orders for fulfillling particular indications.

Cautions to be obferved in the em-ployment of antifeptics.

Circumflances contra-indicating theemployment of them.

XVIII. ASTRINGENTS.

General properties characterizingaftringents—Primary effects refulting

THERAPEUTICS. 49

from the employment of them—theyexcite a peculiar fenfation referred tothe parts on which they more imme-diately ad —they produce a remark-able corrugation of thefe parts—theyproduce an affedion through the reftof the fyftem in fome degree limilarto that in the part to which they areapplied—they produce a condenfationof the dead animal fibre.

Changes in the fyftem from the pri-mary effeds of aftringents —an in-creafe of cohefion in various parts—

an increafe of tonic power—a diminu-tion of the capacity of containingveffels—a diminution of the irritabi-lity, and in fome degree alfo of thefenfibility of the parts on which theyad.

Different orders of aftrlngents—Ad-Jiringentia Jlyptica — A. corrugantia —A,tonica.

Indications in the cure of difeafeswhich aftringents are fitted to fulfil.

THERAPEUTICS.

i. From altering the condition ofthe moving folids,

To obviate original delicacy,To reftore natural compadnefs to

parts morbidly relaxed,To reftore diminifhed tonic power,To diminifh irritability when mor-

bidly increafed.

2. From altering the flate of con-taining veflels,

To diminifh Accretions when mor-bidly augmented,

To increafe the power of the fphinc-ters as retaining excrementitiousmatters,

To produce a conflridion of theorifices of ruptured veflels.

Circumflances claiming attention inthe choice of orders for fulfilling par-ticular indications Circumflancesfuggefling cautions in the employmentof aflringents —Circumflances contra-indicating the ufe of them —a high de-gree of rigidity—remarkable infenfibi-

THERAPEUTICS. 51

lity in the moving fibres—morbid di-minution of excretions.

XIX. EMOLLIENTS.

General properties characterizingemollients—Primary effects refultingfrom the employment of them—theyrender the part to which they are ap-plied more foft and flexible than be-fore—they excite a peculiar fenfationindiflinCtly referred to the part towhich they are applied —they producein fome degree the fame effect throughthe reft of the fyftem as takes place inthe part on which they immediatelyaCt.

Changes in the fyftem from the pri-mary effects of emollients—a diminutionof the power of cohefion in various partsof the animal body —a diminution oftonic power in the fyftem—an increafeof the capacity of yeffels in the partmore particularly aCted upon, and in

THERAPEUTICS.52

fome degree in the fyftem in general—*

an increafe of irritability and fenflbi-lity through the fyftem.

Different orders pf emollients—Emo~lientia humeclantia —E. laxantia—E. lubri-cantia—E. atonica.

Indications in the cure of difeafeswhich emollients are fitted to fulfil.

i. From their influence in produ-cing a change on the folids, connectedwith voluntary motion,

To reflore the natural flexibility toparts morbidly rigid,

To diminifli a morbid increafe oftonic power.

2. From their influence in produ-cing a change in containing veftels,

To obviate the effects of a morbidtenfion of parts,

To remove morbid obftrudion, par-ticularly in the fmall vclfels ofthe fanguiferous fyftem.

THERAPEUTICS.

Circumftances claiming attention re-fpecfting the choice of orders for ful-filling particular indications.

Circumftances fuggefting caution inthe employment of emollients.

Circumftances contra-indicating theemployment of emollients—a high de-gree of morbid laxity in the veftels—-a peculiar fenfibility in the moving fi-bres.

XX. CORROSIVES.

General properties characterizingcorrofives— Primary effects refultingfrom the employment of corrofives—-they excite a fenfation of pain refer-red to the part acted upon —they de-ftroy the texture of parts, and occafiona reparation of the difeafed from thefound part they lay open veftelswhich formerly pafted into the partdeftroyed.

THERAPEUTICS.54

Changes in the fyftem from the pri-mary effeds of corrofives—a ftate ofinfenfibility in the part aded upon—adiminution of particular folids onwhich they more efpecially ad—a dif-charge, particularly of purulent mat-ter from the veffels laid open.

Different orders of corrofives—Cor-rojiva erodentia— C, caujiica.

Indications in the cure of difeafeswhich corrolives are fitted to fulfil.

i. From inducing a ftate of infenfi-bility in the parts to which they areapplied,

To remove morbid fenfibility in thenerves of particular parts.

To facilitate and render effedualopenings into particular lodg-ments of matter.

2. From producing a diminution ordeftrudion of parts,

To remove morbid excrefcences orindurations.

THERAPEUTICS. 55

3. From producing a difcharge ofpus,

To facilitate the healing of ulcers.To begin and facilitate the adion

of the epiipaftica fuppurantia.

Circumftances contra-indicating theufe of corrofives—a peculiar Hate ofirritability in the fyflem—a high de-gree of putrefcent tendency—a can-cerous difpofition in the parts to beaded upon.

XXL DEMULCENTS.

General.properties charaderizing

demulcents—Primary efFeds refultingfrom the employment of demulcents—-they lubricate and fheathe thefe partsto which they are topically applied inthe animal body—they exert, after en-tering the circulation, the fame effedat different excretories at which theyare colleded—they diminifh the adi-

56 THERAPEUTICS.

vity of different ftimuli with whichthey happen to be conjoined in thebody.

Changes in the fyflem from the pri-mary effeds of demulcents—a dimi-nution of the facility of adion on fen-fible parts of the body—a diminutionof the force of the ading power bywhich thefe parts may be affeded.

Different orders of demulcents —De-mulcent ia lenientia—D. diluentia.

Indications in the cure of difeafeswhich demulcents are fitted to fulfil.

I. From their addon on fenfible fo-lids,

To diminifh the adion of ordinaryftimuli upon parts affeded with amorbid degree of fenfibility,

To obviate a morbid deficiency inthe natural coverings of parts,

To prevent the addon of morbid fti-muli.

THERAPEUTICS.

2. From their adion on ftimulatingfluids,

To diminifh morbid acrimony inthe fyftem in general,

To render more mild, fecretions ina morbidly acrid ftate.

Circumflances contra-indicating theemployment of demulcents—preterna-tural deficiency of acrimony in thefecreted fluids—a high degree of mor-bid vifcidity in the coverings of fenfi-ble parts—an uncommon want of fen-fibility in excretory organs.

XXII. STIMULANTS.

General properties characterizingftimulants —• Latitude in which theterm has been taken by medical wri-ters —neceflity of limitation for form-ing a natural aflbciation.

Primary effects refulting from theemployment of ftimulants—they pro-

58 THERAPEUTICS.

duce a particular fenfation in the partaded upon—they increafe the actionof the mufcular fibres in the part, ef-pecially in its veffels—they increafethe energy of the fenforium—they in-creafe nervous energy in the movingfibres through the fyftem in general.

Changes in the fyftem from the pri-mary effeds of ftimulants—accelera-tion of the motion of the blood in thepart to which they are immediatelyapplied —an increafe of the impetus ofcirculation through the fyftem in ge-neral—a higher degree of excitementin the powers of fenfation—augmen-tation of mobility and vigour in themufcular fibres through the fyftem ingeneral.

Different orders of ftimulants—Sti-mulant ia topica —S. diffufibilia— S. car-diaca—S, calefacientia—S. tonica—S, car-minativa.

Indications in the cure of difeafes-which llimulants are fitted to fulfil.

therapeutics. 59I. From affeding the circulation,To facilitate the paffage of blood

through parts in which it is mor-bidly obftruded,

To augment the force and celerityof circulation, when morbidlyflow and weak.

2. From affeding the powers of fen-fation,

To quicken the external fenfes whenmorbidly dull,

To roufe the mental faculties whenin a lethargic date,

To exhilarate a defpondent condi-tion.

3. From affeding the moving fibres,To reftore the power of motion

when morbidly deficient,To increafe the drength of motion

when morbidly weak.

Circumftances to be attended to re-fpeding the choice of orders for fulfil-ling thefe indications—Circumftances

THERAPEUTICS.

fuggefting cautions in the employmentof ftimulants.

Circumftances contra-indicating theemployment of certain flimulants —ahigh degree of morbid irritability—-the circulation uncommonly accelera-ted—an uncommon difpofition to he-morrhagy.

XXIII. SEDATIVES.

General properties characterizingfedative medicines—Primary effeds offedatives—they diminifh the fenfibili-ty of the part on which they imme-diately ad;—they diminifh the forceof adion and tonic power in the muf-cular fibres of the part aded upon—-they produce a peculiar fenfation inthe fyftem in general—they diminifhthe energy of the fenforium.

Changes taking place in the fyftemfrom the primary effeds of fedatives—retardation of the motion of the

61THERAPEUTICS.

blood in the part immediately adtedupon —diminution of the momentumof the blood in the fyftem in general

diminution of quicknefs in thepowers of fenfation, judgement, me-mory, and other intelledtual faculties—a diminution of vigour and of cor-redlnefs in the adlion of voluntary muf-cles through the fyftem in general.

Different orders of fedatives—Seda-tiva Joporifica—S. refrigerantia —S. nar-cotica.

Indications in the cure of difeafeswhich fedatives are fitted to fulfil.

i. From affedting the condition ofcirculation,

To diminifh the force and celerityof the blood’s motion, when mor-bidly augmented,

To diminifh the impetus of the bloodagainfl parts morbidly affedted,whether the impetus be morbidlyaugmented or not.

62 THERAPEUTICS.

2. From affeding the powers of fen-fation,

To abate violent pain,To procure deep in cafes of preter-

natural watchfulnefs.

3. From affecting the mufcular fibresfubfervient to voluntary motion,

To reftrain inordinate motions,To moderate exceflive evacuations.

Circumfiances claiming attentionwith refped to the choice of ordersfor fulfilling particular indications—Circumfiances fuggefting caution inthe employment of different fedatives—Circumfiances contra-indicating theemployment of certain fedatives—cir-culation particularly languid— a re-markably lethargic difpofition—a highdegree of torpor in the fyfiem.

"THERAPEUTICS.

XXIV. ANTISPASMODICS.

General properties characterizingthe clafs of antifpafmodics—Principleson which they feem to operate as allay-ing inordinate action.

Different orders of antifpafmodics—Antifpafmodica Jiimulantia— A,fedativa—

A. tonica.

Indications in the cure of difeafeswhich antifpafmodics are fitted to ful-fil.

To remove fixed fpafmodic contrac-tion in different mufcles,

To allay convulfive agitations,To prevent the return of fuch mor-

bid dates when the fyftem is ha-bitually liable to them.

THERAPEUTICS.

Circumftances claiming attention inthe choice of different orders of anti-fpafmodics for fulfilling particular in-dications Circumftances fuggeftingcautions in the employment of anti-fpafmodics— Circumftances contra-in-dicating the employment of particularantifpafmodics.