378 PRACTICAL OBSERVATIONS ON THE 



the fever and pain continue, I prescribe small doses of anti- 

 monial powder or antimonial wine, to bring on a gentle per- 

 spiration ; should this, however, be not speedily brought 

 about, I lose no time in exhibiting mercury internally and 

 externally, till the disease is conquered ; and this I have 

 done with uniform success for twenty-seven years ; whereas 

 acute hepatitis, treated by frequent and copious bleeding, too 

 often terminates in phthisis pulmonalis, or some other fatal 

 disorder. 



The chronic hepatitis is very common in Great Britain, and 

 is often mistaken for dyspepsia. Small doses of calomel, (as 

 a grain at bed-time every night for a fortnight) are in general 

 sufficient to remove it. 



Pleurisies and acute peripneumonies are common and fatal 

 diseases in all tropical countries, especially amongst the Ne- 

 groes who live upon estates in the hilly and mountainous 

 parts of Jamaica. 



In the cure of pleurisies, bloodletting is at first requisite ; 

 but a repetition of it requires much caution. Profuse and 

 repeated evacuations of this sort weaken the system ; and I 

 have seen many instances, where an improper use of the lan- 

 cet in such cases has been succeeded by general debility, pul- 

 monary consumption, and dropsy. In these diseases, after 

 one, or at most two moderate bleedings, I direct the belly to 

 be opened by clysters, or some gentle laxative ; give nitre 

 dissolved in the patient's common drink, and advise a thin 

 spare diet. A blister applied to the side affected generally 

 gives great relief. But if the fever is considerable, and the 

 pain acute, I order from three to six grains of antimonial 

 powder every two hours, till a plentiful sweat takes place, 

 which I encourage by a liberal use of warm tea, or water- 

 gruel. If small doses of the antimonial powder have not the 

 desired effect, I give ten, fifteen, or twenty grains for a dose ; 

 nor am I afraid of exciting full vomiting, either in pleurisy or 



