94 PRACTICE OF PHYSIC. 



of curing this disease is, after some general bleedings for taking 

 off, or at least diminishing the phlogistic diathesis, to employ 

 sweating conducted by the rules laid down, CLXVIII. and 

 CLXIX. 



" Before the time of Sydenham, immediately preceded the 

 age of Alexipharmics and Sudorifics ; and there is no doubt that 

 sweating was then employed in rheumatism ; but since that pe- 

 riod it has been abstained from ; and only very lately Dr. Clerk 

 of Edinburgh imagined that rheumatism could be cured by 

 sweating ; but nobody ventured to imitate him in this practice, 

 till we learned of Dover's Powder, with which he was not ac- 

 quainted, and which has this advantage that we can produce 

 sweat by it with much less heat than is otherwise necessary. 

 Nothing is better known in the history of physic than that 

 opiates have been found the most effectual sudorifics ; and even in 

 theory this is sufficiently probable, as opium acts as a stimulant in 

 exciting the heart and arteries, yet is combined with a sedative 

 power, which relaxes the system, and operates more upon the 

 extreme vessels, whereby we practise sweating with more ease 

 and less impetus than would otherwise be necessary. To secure 

 the effects of opium in that way, we may find advantage from 

 combining it with neutral salts and emetics, both of which, we 

 know, act on the extreme vessels, and determine the operation 

 of the opium in that way." 



In this, Ipecacuanha has been constantly employed : it has 

 been supposed to have a specific power of diminishing the power 

 of opium, as in Dover's Powder larger doses of opium can be 

 employed than would be proper in the use of opium alone. This 

 opinion, however, we cannot admit of, as we suppose that the 

 large doses of opium which are given in Dover's Powder, be- 

 come safe only because by the other ingredients it is directed 

 to sweat. This we take to be the effect of the Ipecacuanha, 

 not by any specific, but by its emetic power, for we can obtain 

 the same effect by antimonial emetics. 



In what time of the disease may this remedy be administer- 

 ed ? May we set out with this practice from the beginning, be- 

 fore the general diathesis is in some measure overcome by ve- 

 nesection and the other remedies ? I am clearly of opinion 

 that this very effectual remedy cannot be prosecuted till the 



