374 PRACTICAL OBSERVATIONS ON THE 



With regard to bleeding, Dr Clauk tells me he lias now 

 and then had occasion to order it in full habits: he has re- 

 course to this, however, but seldom, and then very sparingly. 

 In Jamaica the lancet is now laid aside in the treatment of 

 this disease; as some young men, who were seized with the 

 yellow fever, and blooded on the day of the attack, died in a 

 few hours after. The American practice, therefore, will not 

 succeed in the West Indies. 



In cases where the strength of the patient is much reduced, 

 the strongest wines, or even brandy itself, must be freely used. 

 Dr Deummokd tells me, that in such dangerous stages of the 

 the disease, even when the black vomiting has come on, he 

 has given the pepper medicine* with success. The use of 

 this medicine is continued till a generous warmth takes place, 

 which must be kept up so long as the delity or the vomiting 

 last; but, in the mean time, the use of mercury must be 

 pushed vigorously, till the mouth is affected, and till there 

 are evident appearances of a resolution of the disorder, and 

 an abatement of the most violent symptoms. 



In such stages of typhus, where there were petechias, a 

 difficulty of swallowing, or a sense of choking; or where 

 aphthae were present, or there was a great irregularity of 

 pulse, I have found the use of ether -f- very beneficial. 



Hitherto the black vomiting has usually been considered 

 as a fatal symptom ; and a remedy to obviate it has long- 

 been a desideratum amongst physicians +. To whom the 

 happy discovery of such a remedy, in the capsicum, is owing 



" This is composed of three grains of powder of Cayenne pepper, made 

 into a pill with mucilage, and may be given every two or three hours ; 

 but unless the pill is well coated with dough, or while wafer, it will be 

 difficult to persuade the patient to swallow a second dose. 



t For an account of the efficacy of the spirit us vitrioli dulcis in fevers, 

 see a valuable paper, by Dr Smyth, in the Medical Communications, 

 vol. i. 



t Dr Bariiam of Jamaica, contemporary of Sir Hans Sloan. 



