skin, generally termed leprosy, the Discutient Plaster (B), page 130, spread on black silk, is a very efficacious remedy. (See OIL OF WALNUTS, p. 365; WALNUT OIL SOAP, p. 367; and a new remedy for LEPRA, &c. p. x. OF LUMBAGO. When rheumatism attacks the loins, it is thus denominated. In cases of continued violent pains in the loins, medical advice should always be taken; for should inflammation be here mistaken for rheumatism, and treated by stimulating medicines, the consequence might be a formation of matter, constituting the disease termed Lumbar abscess, which generally terminates fatally. Advertised medicines for lumbago have certainly been productive of much mischief in this respect. When the case is doubtful, the warm water or warm vapour bath, a blister over the part, and the Diaphoretic Draught, p. 106, may be safely employed. Luinbago requires the same general remedies and topical applications as recommended for rheumatism. -(See AMMONIATED TINCTURE OF COLCHICUM SEEDS, p. 148.) OF MEASLES. — This disease is highly infectious, and the constitution that has been once under its influence, is not liable to a second attack. - SYMPTOMS. It generally begins with shiverings, succeeded by heat; a severe head-ache in adults, and heaviness in children; a slight inflammation and considerable heat in the eyes, attended with swelling of the eyelids, a defluxion of acrid tears, an inability to bear the light, frequent sneezing, and discharge from the nostrils; sooner or later a fever comes on, with a cough, a sense of tightness across the chest, nausea, and vomiting. About the fourth, and sometimes the fifth day, red spots, resembling flea-bites, begin to appear on the forehead, and other parts of the face, and successively on the lower parts of the body, which increase, run together, and form large red spots of different figures. The spots on the face sometimes appear a little prominent to the touch; but on other parts, do not rise higher than the surface of the skin. On the third day of the eruption, the vivid redness is changed to a brownish red, and in a day or two more entirely disappears, and is succeeded by a mealy scaling of the scarf skin, and sometimes a difficulty of breathing, dry cough, pains in the chest, and fever; which, in scrofulous habits, often terminate in consumption. TREATMENT.If the inflammatory symptoms do not run high, the occasional use of the Purgative Mixture (A), p. 113, and fifteen or twenty drops of ipecacuan wine at bed-time, a low diet, and a warm room, will be sufficient. If the fever and affection of the lungs be considerable, the loss of blood, a blister over the breast-bone, and the Antitussic Mixture (A), p. 111, will likewise be absolutely necessary, and should not be delayed. The almond emulsion, linseed tea, or the compound barleywater, as directed page 146, should be taken freely. If, after these means, the cough, difficulty of breathing, and pain in the chest, should continue, it will be advisable to apply another blister between the shoulders, or two or three leeches to each side of the chest. If looseness supervene, it should not be checked, unless it be violent, and even in that case not suddenly. Five grains of rhubarb, with two of ipecacuan powder, will in general, for this purpose, be sufficient. After the spots have disappeared, the patient should not be too hastily exposed to a cold air. The diet should be low in proportion to the degree of fever. The Almond Emulsion, p. 145, or Compound Barley-water, page 145, and vegetable jellies, as arrow-root, tapioca, sago, &c. will, in general, be sufficient, till the feverish symptoms have nearly subsided. When the eruption recedes, blisters to the chest, the warm vapour bath or sudatory (p. 172), and a gentle emetic of ipecacuan powder, are the most powerful remedies that can be employed for its re-expulsion, and if this should not succeed, the Rubefacient Ointment, p. 128. should be extensively and freely used over the chest. - (See DERIVATIVES, p. 23.) —— Recession of the eruption is so serious an occurrence, that no time should be lost in calling in the aid of an experienced practitioner. - If much debility of the system should come on towards the end of the disease, and particularly if purple or black spots appear, the strength of the patient should be supported with cordials, beef tea, and animal jellies, in order to assist nature in effecting a favourable termination. With this view, the rhatany root or Peruvian bark will also be proper, which may be given in the following form: Take of Infusion of Rhatany Root, or the Decoction of Bark, Dilute Sulphuric Acid, 6 ounces. 1 drachm. 2 drachms. ounce. Compound Tincture of Rhatany Root, Mix.-From a dessert to two table-spoonsful to be taken three or four times a day, according to the age of the patient and urgency of symptoms. Yest, on account of the quantity of fixed air it contains, has been employed in this case, for the purpose of counteracting a supposed tendency to putrescence in the system. In some instances it has been administered with success, in the dose of a dessert or table-spoonful four times a day; but in the majority of cases I believe it has proved hurtful, by bringing on purging. If such an effect should follow its use, two or three drops of laudanum may be given with each dose. If the patient should be afflicted with violent purging, it should either be checked or moderated by the Astringent Mixture (B), p. 112. The propriety of restraining purging must, in a great measure, depend on the appearance of the fæces; for if they be dark and offensive, and the strength of the patient not reduced by the evacuations, they may be considered of a critical nature, and should rather be encouraged than diminished: but to determine a point on which the life of the patient probably depends, the opinion of an experienced practitioner should be resorted to. After the termination of the disease, there is frequently an inflammatory disposition remaining, which should be removed by gentle doses of the Basilic Powder, as directed, p. 85. If cough should, notwithstanding, come on, a blister to the chest, and the Antitussic Mixture (A), p. 111, will also be necessary. Attempts have been made to communicate the measles by inoculation; but I do not believe it ever succeeded. DISTINCTION. On the first attack of measles, it is often difficult to distinguish it from common catarrh; in a day or two, however, the violence of the symptoms evince the nature of the disease. It may be distinguished from other eruptions by the cough, watering of the eyes, sneezing, hoarseness, difficulty of breathing, and drowsiness, which precede the eruption. Practical Remarks. Measles is a disease produced by a specific contagion, and runs a certain course. The object of practice is, in the first instance, to reduce the system by purgatives; and if the system be plethoric, by bleeding; and to keep up perspiration. As the lungs generally suffer more than any part of the body in this disease, cough should be quieted by an anodyne mixture, and by a blister. In case of great debility, and symptoms of typhus fever coming on, the strength of the system should be supported; and if the eruption recede, the warm vapour or sudatory, blisters, and sudorific medicines, are necessary. After the termination of the disease, the use of a purgative medicine is necessary to take off the inflammatory state of the system which generally follows it, provided the strength of the patient will admit of it; and if the system be considerably reduced, a mild tonic medicine will be proper. OF MELANCHOLY.- Melancholy is a mild species of insanity, or rather incipient insanity, so nearly allied to hypochondriacism, as to require a similar mode of treatment. Indeed, it is very difficult in all cases to distinguish the hypochondriac affection from melancholy, the same temperament being common to both. Hypochondriacism is generally attended with symptoms of indigestion; and though there be at the same time an anxious melancholic fear arising from the feeling of these symptoms, yet while this fear is only a mistaken judgment, with respect to the state of the person's own health, and to the danger to be from thence apprehended, the disease may still be considered the hypochondriac affection, and distinct from melancholy; when an anxious fear and despondency arise from mistaken judgment, with respect to other circumstances than those of health, and more especially when the person is at the same time without any symptom of indigestion, it constitutes the disease strictly named melancholy; but as a melancholic temperament may induce a torpor and indolence in the action of the stomach, so it generally produces some symptoms of indigestion, and hence there may be some difficulty in distinguishing such a case from the hypochondriac affection. When the characters of the temperament are strongly marked, and more particularly when the false imagination turns upon other subjects than that of health, or when, though relative to the person's own body, it is of a groundless and absurd kind, then, notwithstanding the appearance of some symptoms of indigestion, the case is still to be considered as that of melancholy, rather than the hypochondriac affection: these distinctions, however, bear no reference to any difference of treatment. The distinguishing character of this disorder, is an attachment of the mind to one object, concerning which the reason is defective, and perfect with regard to other subjects. In its treatment, as in hypochondriacism, there is great scope for the management of the mind and passions. The chief point is to divert the mind from accustomed pursuits, and to introduce variety of matter, upon which it may exercise itself. This, however, requires the greatest caution and delicacy in the execution. Most melancholic persons are jealous of being esteemed as such, and have generally a great opinion of their own wisdom and sagacity, and, of course, are apt to hold very cheap the common amusements of life, especially those connected with social intercourse and company, being inclined to think themselves neglected and despised by the world. Melancholy is distinguished from mania by being confined to a few objects or trains of ideas, whereas in mania it is general. Some ancient writers employed the term melancholy to signify insanity accompanied with gloom or despondency, without any attention to its being partial or general. Dr. Good has noticed four varieties of melancholy, viz. gloom, restlessness, mischievousness, and self-complacency, all which are excited by the same causes, and owe their difference to peculiarity or even the natural dispositions of the mind. Fracastorio notices varieties from prevailing temperament. The phlegmatic, says he, are heavy; the sanguineous or plethoric, lively, cheerful, merry, but not witty: the choleric, are in rapid and perpetual motion, impatient of dwelling on any subject. An acuteness of wit belongs to most of the varieties, but not to all; and hence Diocles, in opposing Galen for holding, after Hippocrates, that 66 gloom and terror are distinguishing signs of melancholy, observes: Upon serious consideration, I find some patients have nothing of these qualities, and others that exhibit every diversity of feeling; for some are sad without being timid, others timid without being sad; some are neither, and some both. Spurzheim, the phrenologist, has noticed another curious variety, to show that the mental faculties are double, and that each side of the brain contains a distinct set. Tiedman," says he, "relates the example of one Moser, who was insane on one side of the brain, and who observed his insanity with the other."!!! Dr. Gall states, that he attended a minister who had a similar disease for three years, and that he heard constantly for that period, on his left side, reproaches, &c., and turned his head to that side in order to look at the persons. With his right side, says the Doctor, he commonly judged of the madness of his left side. Long after his left side was cured, if he happened to be angry, or if he had drank more than he was accustomed to do, he observed in his left side a tendency to his former alienation. According to this theory, if a man exercises only one side of his brain, he will probably in some respect act foolishly; and on reflection, i. e. on bringing both sides into consultation, or when the side which generally acts calls in the aid of the other side, he will discover his error. If this be really a fact, it satisfactorily accounts for the ideas some religiously insane people have had of being visited by a spirit, and of receiving communications from the Almighty. By this theory we may also account for dreams, in which the most ridiculous nonsense does not appear inconsistent or irrational, by the disordered side of the brain remaining awake whilst the healthy side sleeps !! The ancients considered all the varieties of melancholy to be more or less dependant on the prevalence of black bile in the intestinal canal; and they accordingly prescribed purgative medicines, which they supposed to possess some peculiar property of carrying it off, and of correcting the biliary secretion. Their favourite remedy, for these purposes, was the black hellebore root, the powder of which they administered in the dose of twenty to thirty grains, once or twice a week. It is worthy of notice, that this article, which, in some constitutions, acts powerfully as a purgative, and in others scarcely produces any effect, always occasions very dark motions, which are more or less followed in nervous subjects by serenity of mind. Dr. Mead, who gave the extract of it an extensive trial, speaks very highly of it as a tranquillising purgative, and a deobstruent. It is worthy of remark, that in most disorders or diseases of the brain of increased excitement, the fæces are more or less dark and offensive; and in cases of melancholy and mania, they are |