INDIANA MEDICAL HISTORY ", r QUARTERLY THE FAMILY PHYSICIAN; oa, Domestic Medical Friend: CONTA.ININO PLAIN AND PRACTICAL INSTRUCTIONS ~OILTH!! PREVENTION AND CURE OF DISEASE:l, WITH A SERIES OF CHAPTERS ON COLLATERAL SUBJECTS; C:O)IPJlllllfG ZV&aY THING llZLATIV& TO 'Ib• 'Ibtory a11d Principlu of tbt Mrdical Art, )JEC&SSA.&Y TO B& X.lfOWN .y THE PRIVATE PRACTITIONER.. TJIE WHOLE ADAPT&Z. TO THI USE OP THOSE HEADS OF FAYILW WHO HAVE NOT HAD A CLASSICAL OR MEDICAL EDUCATION'. BY ALEXANDER THOMSON, M. D. AGTH()R OF A TREATISE ON NEI.VOUS DISORDERS; OFDlALOOU£5 IN A Ulk.Ut' AND OTHER PRODUCTIONS. PnJNTED BY }AWES ORAM1 AT HIS PRINTtNC·OFFICE.J NO. 1()2, WATER•STRE£T. 1802, INDIANA HISTORICAL SOCIETY Volume V Number 1 March, 1979 R131 Al_IS_VS_NOl 001 IN THIS ISSUE This issue of the Quarterly consists of a partial reprint of an early nineteenth century home remedy book. Printed in 1802 and tucked away with the precious few belongings of the westward migrating pioneer, this book was intended not only as a text for the private practitioner but also for "the use of those heads of families who have not had a classical or medical education." The title of the book is The Family Physician or Domestic Medical Friend, by Alexander Thomson, M.D. It was pub­ lished in New York City by James Oram. New York's population at this time was about 18,000. Some aspects of health have not changed a great deal since the book was printed, for example: "The cancer has hitherto baffled all the efforts of medicine ... " In other areas however, the reader will not only be impressed with medical progress, he will also be impressed (and grateful) for progress in social customs and behavior; e.g. Dr. Thomson's comments on oral hygiene and care of the teeth: "We are doubtless far too inattentive with respect to the preservation of the teeth, considering of what importance they are in the chewing of food, which, without their previous exertion, would render it difficult for all the concoctive powers of the stomach to digest the aliment sufficiently. We do not often enough wash thera; we injure them, as has been already observed, by too free an [sic} use of sugar, or acids, which gradually corrodes their enamel; we wantonly contribute to destroy them by cracking nuts, or otherwise exposing them to violence; and instead of picking them with care, we employ a pick-tooth rather as a weapon of hostility than defence to the teeth .... (p. 214) " ... the care of (the teeth) ... is, in general, far from being sufficiently culti- vated. I believe that very few persons comparatively, wash their mouth in the morning; which ought always to be done. Indeed, though the operation seems not the most delicate to spectators at the table, this ought to be practiced at the con­ clusion of every meal where either animal food or vegetables are eaten: for the former is apt to leave behind it a rancid acrimony, and the latter an acidity, both of them hurtful to the teeth. Washing the mouth frequently with cold water is not only serviceable in keeping the teeth clean, but in strengthening the gums, the firm adhesion of which to the teeth is of great importance in preserving them sound and secure. "Picking teeth properly is also greatly conducive to their preservation; but the usual manner of doing this is by no means favourable to the purpose. A pick-tooth, with most people, is used in the manner of a tobacco-pipe ... "Many persons, while lauch•bly attentive to preserve their teeth, do them hurt by too much officiousness. They daily apply to them some dentifrice powder, which they rub so hard as not only to injure the enamel by excessive friction, but to hurt the gums even more by the abuse of the pick-tooth .... The quality of some of the dentifrice powders advertised in the news-papers is extremely suspicious; and there is reason to think they are not altogether free of a corrosive ingredient.... " (351-52) Dr. Thomson's comments on personal cleanliness remind us that although the wash basin was a common household item, the bath tub was not: "Personal clean­ liness is not only an amiable virtue but a source of comfort to the individual. For example after washing our feet we feel ourselves considerably refreshed; and this sensation would be still more perceptible, if the wholesome custom were intro­ duced of washing the whole body." The reader can form his own judgment in the following pages as to whether the average head of the family could benefit from the information they contain. The letter "s" adds to the interest of the book and is the reason for this form of repro­ duction. R131 Al ---15 VS NOl 002 CHAP. XLIII. Surgery. IT would be inconfifl:ent with the plan of a work of this nature to defcribe the various operations of furgery. All that is required i~ to give a concife and clear account of the proper treatment of fuch cafes as may be managed without profeffional education for the purpofe, and which may occur where the affiftance of a furgeon cannot readily be obtained. Bletding. The mofl: common operation of furgery is that of bleeding; the knowledge of rightly performing which, is only to be acquired by example. Were we to judge of this operation by the frequency and facility with which it is praCl:ifed, we ihould be apt to con­ clude that it was a matter of very little importance; whereas, in fact, there is none that more affcCl:s the confl:itution, and even life itfelf, according as it is either negleCl:ed on one hand, or car­ ried to excefs on the other. This operation is proper at the beginning of all inflammatory fevers, fuch as pleurifies, peripnuemonies, &c. It is alfo proper in all topical inflamm:\tions of internal parts, fuch as thofe of the ftomach, inteftines, &c. and likewife in the apoplexy, afthma, rheumatifms, coughs, violent head-a.chs, and other diforders, pro­ ceeding either from too great a quantity of blood, or an impedi­ ment to its circulation. Bleeding is no lefs neceffary after falls~ blows, bruifes, or any violent hurt received, externally or inter­ nally; as it is likewife .in cafes of fuffocation from foul air, ftran­ gulation, &c. But in all diforders proceeding from a relaxed h.abit of body, and a vitiated fiate of the fluids, bleeding is inju.. no us. In t0pical inflammations bleeding ought to be performed ai near the part affeCl:ed as poffible; and, in general. the heft method of doing it is by a lancet: but where a vein cannvt be found, recourfe muft be had to the application of leeches, or cupping. Leechu. Previous to the :tpplication of leeches, the fk.in fhould be ca.re· fully cleanfed from any foulnefs, and moiftened 'Nith a little m1lk, 3 R131_A1_15_VS_N01_003 4 INDIANA MEDICAL HISTORY QUARTERLY Cupping. by which means they fafien more readily, and this farther promo. ted by allo~ing them to creep upon a dry cloth, or a dry board, for a few mmutes before application. The moft effectual method to make them fix upon a particular fpot, is to confine them to the part by means of a fmall wine glafs. As foon as the leeches have ~eparated, the ufual method of promoting the difcharge of blood ts, to cover the parts with fine linen cloths wet in warm water. But if the blood fhould continue to flow from the orifice made by a Ieee~, longer than is defired, as has happened, in fame inftances, to ch1ldren, who have been nearly loft by the inability of the attendants to ftop the difcharge; after carefully wafhing off the blood,. the point of the finger fhould be preffed moderately upon the onfice, and afterwards a comprefs be kept upon it for a little time. Cupping. When, either from the feverity of a local fixed pain, or from any other caufe, it is judged proper to evacuate blood directly from the fmall ve!fels of the part affected, infl:ead of opening any of the larger :;trteries or veins, it is ufual~ befides leeches, to employ fcarification and cupping. Slight fcarifications may be made with the fhoulder or edge of a lancet; or by means of an infl:rument termed afcarijicator; in which fixteen or twenty lancets are com­ monly placed, in fuch a manner that, when the inftruments is ap­ plied to the part affetl:ed, the whole number of lancets contained in it arc, by means of a firong fpring, pufhed fuddenly into it, to the depth at which the infl:rument has been previoufly regulated. This being done, as the fmaller blood-veffels only, by this opera­ tion, are intended to be cut, and as .thefe -do not commonly dif­ charge fr'-ely, fome mea· .., or other becomes neceffary for promo­ ting the evacuation. V ario•1s methods have been propofed for this purpofe; glafles fitted to the form of the affected parts, with a fmall hole in the bottom of each, were long fince contrived; and thefe being placed upon the fcarified pa'rts, a degree of futl:ion was produced by a perfon's mouth fufficient for nearly exhaufl:ing the air contained in the glafs. This method accordingly increafed the evacuation of blood to a certain extent; bt t as it was attended with a good deal of trouble, and did not always prove effectual, an exhaufting fyringe was at lafl: adapted tu the glafs, by means ~f which the contained air was extracted.