by it. For supper he may take a little broth, or light bread pudding; and if malt liquor be necessary to quiet the system, or dispose it to sleep, he may take with it an anchovy with some bread.

Generally speaking, three meals a day are sufficient for the nourishment or support of the body; but, in nervous subjects, there is often such peculiarities of stomachs, that it is common for local nervous excitement to take place either in the head, heart, or bowels, when the stomach is not engaged, or when it is distended with gas. The determination of blood to the stomach, and increased energy of its nerves, which take place during digestion, often relieve violent nervous head-ache and other local nervous affections; and for this purpose, it is common for nervous subjects to have recourse to frequent meals; and when they evidently quiet the system, allay local excessive action, and do not fatigue or oppress the stomach, they should be allowed. With respect to the frequency, quantity, and even quality of meals, a nervous patient should be as competent to judge as the most experienced physician.

A little exercise is necessary to keep up the functions of the viscera, and such should be preferred which pleasantly engages the mind, as travelling in countries which afford a variety of scenery and different states of society; avoiding marshy parts, -the vapour of which is very apt to disturb the nervous system, particularly of gouty, rheumatic, and asthmatic subjects. Sometimes local irritation runs so high as to render the use of an article of the class of remedies termed sedatives necessary. (See effects of different SEDATIVES on the Nervous System, p. 41, and INDIGESTION, p. 403.)

OF NETTLE RASH. — This eruption is so named from its resemblance to that produced by the stinging of the nettle. It is a very mild disease, and seldom requires the use of medicine. When it is attended with fever, the Aperient Mixture, p. 111, with twenty drops of the tartarised antimonial wine, at bed-time, and a low diet, will be sufficient. If it be of a chronic nature, six drops of the dilute sulphuric acid may be taken three times a day (in a wine-glassful of cold camomile-tea). The sulphureous Purgative Salt, p. 152, is also a valuable remedy.

OF NIGHT-MARE. This complaint comes on with an oppressive sense of weight on the chest, and great horror and agitation of mind: sometimes the patient imagines he sees spectres of various shapes, which seem to oppress and threaten him with suffocation: he attempts to cry out, but often without effect; sometimes the uneasiness continues after he awakes, so as to prevent his turning or moving in bed. The studious, and

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what are termed nervous people, and those who indulge in full meals, particularly supper, are most subject to it.

CAUSES. - The most common cause of this malady, is the mechanical action of a distended stomach either by food or gas, when the body is in a position (as lying on the back) which favours the pressure of the stomach on the diaphragm, in consequence of which the powers of respiration are diminished, and even the heart itself oppressed. In some nervous subjects it is occasioned by indigestible food, as toasted cheese, or whatever disturbs the brain or nervous system by disordering the stomach. TREATMENT. — If the patient be of a plethoric habit, the loss of blood will be proper. The use of the Aperient Mixture (A), p. 111, a spare diet, exercise without fatigue during the day, a light supper, keeping the feet warm by wearing flannel socks, and obviating costiveness, by the occasional use of the Aperient Pill, p. 117, will in general be sufficient.

If the patient be what is generally termed nervous, the Nervous Mixture (A, B, C, or D), p. 113, taken as there directed, will prove very beneficial by strengthening the nervous system, and improving the general health.

When it arises from indigestion or flatulence, thirty drops of spirit of sal volatile, or Hofliman's anodyne liquor, taken at night in water, will prevent its recurrence. (See INDIGESTION.)

OF PAIN IN THE EAR, OR EAR-ACHE.- Acute pain in the ear, to which children are chiefly subject, most frequently arises from inflammation. It is accompanied by a sense of throbbing pain, and noise in the car; sometimes deafness, and general symptoms of fever. In every affection of this kind, dispersion of the inflammation is to be attempted, by applying a few leeches within the external ear, by administering the Basilic Powder, p. 85, or Purgative Mixture, p. 113, by dropping a little laudanum into the passage, and by the application of a blister behind the ear, which should be kept open till the symptoms are considerably abated.

In all cases of a slight nature, this treatment will be found to succeed; but in more violent affections suppuration is often unavoidable: the tendency to which is marked by an increase of pain in the organ, and by a more general affection of the head. The only treatment then left is to endeavour to promote suppuration by fomentation, or by injecting warm water into the ear by means of a syringe. A poultice has also been advised; but the situation will not admit of its being properly applied to the seat of the disease.

When the abscess breaks, the matter should be removed by injecting warm water into the ear. Should the discharge be too profuse, mild astringent injections will be necessary, consisting

of five grains of acetate of lead, or sulphate of zinc, in eight ounces of rose-water.

Sometimes the disease extends to the bone, in which case, before a cure can be effected, exfoliation will take place.

As deafness is sometimes the consequence of this complaint, the advice of an experienced aurist, (Mr. Wright of PrincesStreet,) should be taken in the first instance. If the patient be of a plethoric habit, general bleeding will be necessary.

OF PALPITATION OF THE HEART. This affection arises from morbid irritability of the heart. The beating is frequently so violent as to be heard at a considerable distance, and sometimes the effects of the increased action of the heart may be seen on the outside of the clothes.

TREATMENT. The treatment of this disease, like most others, must depend on the state of the system; for the morbid irritation may be the effect of increased vitality, or fulness, or of debility and relaxation, or, in other words, the inordinate action of the heart may be the consequence of nervousness from plethora or simple irritation unconnected with the state of the bloodvessels. If the system be in a plethoric state, the loss of blood and the use of the Aperient Mixture, p. 111, will be necessary. In case of general nervousness or debility, the Nervous Mixture (C), p. 113, is an excellent remedy. (See NERVINES, p. 37.) When it arises from malformation or disease of the heart, or of the large vessels, relief may be obtained by avoiding plethora, much bodily exertion, full meals, and excesses of every kind, with the use of the Nervous Mixture (A), p. 113.

If the action of the heart be very violent, a blister may be applied to the left side. If its violence should not abate after the use of these remedies for two or three days, two grains of hemlock powder may likewise be taken every six or eight hours, with fifteen or twenty drops of the tincture of foxglove; or if the patient be gouty, the same quantity of the ammoniated tincture of colchicum seeds.

This affection is sometimes occasioned by effusion of serum within the pericardium, which chiefly occurs in aged people; when small doses of calomel (about one or two grains) taken every night for a fortnight, or till the mouth is rendered tender by it, and twenty drops of muriated tincture of steel, in a glass of water, three times a day, with the jolting of a carriage once a day, will prove beneficial.

This disease is sometimes the consequence of the communication between the auricles of the heart, which exists during the fœtal state, remaining unclosed: such a case will only admit of the palliative means of avoiding plethora, violent exercise, and emotions of the mind.

When the head is affected, the application of cold water every morning has proved very serviceable.

OF PALSY.-Cullen defines palsy to be a partial impairment of the voluntary motions, often accompanied with sleep or drowsiness. In paralytic limbs it does not appear that the irritability (a property residing in muscles, noticed under the heads of Sedatives, p. 41, and Tonics, p. 48,) is diminished, the patient only losing the power of exercising the mind on the muscles, in consequence of the nerves being paralysed, which connect them with the sensorium: for when the fibres are brought into action by the stimulus of the electric or galvanic fluid, or by a mechanical irritant, after removing the integuments, they exhibit the same degree of contractile power as the muscles of the corresponding healthy limb.

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Four primary paralytic affections are noticed by authors:

1st.-Partial palsy (confined to certain nerves).

2d.-Hemiplegic (of one side of the body). Of this species there are two varieties. First, in plethoric habits—a sequel of apoplexy; secondly, in leucophlegmatic habits, from effusion of serum within the cavity of the skull.

3d.-Paraplegic palsy (of the lower extremities).

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4th.- Palsy from poison- externally or internally applied. Partial palsy is produced by some local cause, as a tumour compressing the trunk or a branch of a nerve, or by a morbid change in its structure. When it is the consequence chanical pressure, it is obvious that little benefit can arise from application to the nerve, or from internal remedies, till the cause is diminished or removed. When the nerve is diseased, all that art can do is, to improve the general health, and to stimulate the benumbed nerve by shampooing, the electric fluid, and some other stimulating means. The fact of the nerves of the upper extremities often becoming paralysed during what is termed the dry belly-ache, and continuing in that state for many months, and sometimes years, after the removal of the internal affection, strongly points out the necessity of attending to the state of the intestinal canal (with which a most important part of the nervous system is very closely connected, viz. the ganglionic) in all cases of palsy, and, indeed, from these circumstances, in all nervous affections. When palsy is the sequel of apoplexy, or occasioned by over-distention of the venous sinuses of the brain (See APOPLEXY, p. 273), it is of great importance to guard against every thing that is likely to compress the vessels of the belly, as tight waistbands, bandages, &c., and to promote the circulation in the viscera by stimulating purgatives. But we are not to depend even on powerful purgative medicines to unload the

sanguiferous system in cases of vascular plenitude; for frequent copious alvine evacuations seem to have very little, if any, effect on general plethora. Abstraction of blood will, therefore, be necessary in a case of general plenitude, and indeed in local congestion of the vessels of the brain, or in a case of palsy from apoplexy; after which an aromatic aperient medicine, by preventing distention of the bowels by an accumulation of fæces, or flatus, and by promoting the circulation in the viscera, will prevent a recurrence of apoplexy. It is common for physicians to condemn the use of aromatic or stimulating purgatives, under the idea that they increase the determination of blood to the head; but the fact is, by promoting the circulation in the bowels, they produce a derivation in favour of the head, whilst the cooling aperient salts, as the Epsom or Glauber's salt, and the saline aperient waters of Cheltenham, as I have observed, p. 58, by diminishing the visceral circulation, occasion an increased afflux of blood to the head; of which apoplexy is a common consequence. The stimulating effects of spirituous articles being extended to the brain, either from absorption or some peculiar action on the nerves, are unquestionably improper.-(See CATHARTICS, p. 19.)

The directions I have already given for regulating the bowels in cases of costiveness of people predisposed to apoplexy, p. 276, are applicable to palsy, from compression of the brain. Dry friction, the warm vapour-bath, dry cupping, shampooing, the stimulus of nettles, the liquor of ammonia, and cajeput opodeldoc, are good topical applications; but electricity, galvanism, and the warm-bath, so frequently recommended to stimulate the paralysed nerves, often prove injurious by increasing the determination of blood to the head. I have known fatal apoplexy immediately to follow the application of electricity.

In cases of palsy of the lower extremities, it is assuredly of great importance to keep up a regular state of the bowels by a stimulating aperient; but the disease being generally occasioned by some affection of the spinal column, or marrow, a local treatment will be necessary, as a perpetual blister, seton, friction, and stimulating embrocations. Friction with the galvanic brush, electricity, and shampooing, have also been found very beneficial when there is not a preternatural determination of blood to the brain.

The pressure of the water, during immersion in a warm bath, on the trunk of the body, together with the action of heat on the heart and arteries, certainly occasions a preternatural afflux of blood to the brain; whereas by the vapour bath, the circulation is increased in the skin and extremities, in consequence of the body being surrounded by rarefied air. (See THOMPSON'S VAPOUR BATH, p. 227.)