Of incomparably greater consequence, and more widely extended influence, is the second division of this subject. It regards not merely the welfare of individuals, but the prosperity and security of nations. It is perhaps the most important branch of general police; for its influence is not confined to those whom accidental circumstances bring within its sphere, but extends over the whole population of the state. Many of its principles have been long acknowledged, and considered as necessary consequences of medical and political truths; and some few of them have acquired the authority of laws. But it was reserved for the philanthropic Frank, to collect the whole into one vast and beneficent system, and to separate it from juridical medicine; in the old systems of which, it was neglected, or mentioned only in a few short paragraphs. His enlarged mind perceived at once, and fully vindicated its importance. The very name of Medical Police, is now sufficient to attract the attention of legislators and of magistrates, and to make them desirous of becoming acquainted with its principles, and anxious to see them carried into execution. In fact, its influence is already visible in the countries where it is cultivated. If the principles of medical police were separated from the professional part of medicine, and communicated in a form generally intelligible, in what country have we reason to expect more beneficial effects from its influence than this? Where is the spirit of patriotism and benevolence so prevalent? What nation is more generous in its public institutions. Where does the individual sacrifice a part of his wealth so willingly for the benefit of the community? It seems only necessary to prove that an undertaking will be of advantage to the state, to have it carried into instant execution. But, can medical knowledge be more usefully employed than in pointing out the means of preserving or improving health; of supplying healthy nourishment to the poor, especially in times of scarcity; of opposing the introduction of contagious diseases, and of checking their progress; of securing to the indigent the advantages intended by their benefactors; of rearing the orphan to be the support of the nation which has adopted him; and of diminishing the horrors of confinement to the poor maniac and the criminal? These good effects are not to be promoted so much by rigid laws, as by recommendation and example. Nor can it be reasonably objected to a system of medical police, that it is a pleasing dream, which flatters the imagination, but the execution of which is in reality impracticable. As well might we entirely throw aside the rules of humanity, because no one is able to observe them all; or live without laws, because no existing code is unexceptionable.

Medical police may be defined.—The application of the principles deduced from the different branches of medical knowledge, for the promotion, preservation and restoration of general health.

The effects to be expected from it are the general welfare of the state, and increase of healthy population; and are to be attained by means of public institutions, express laws, and popular instruction. Instructing the people, and convincing them of the propriety of certain precautions and attentions, in regard to their own and the general state of health, are necessary to secure the good effects of our public institutions and regulations; to obtain respect and obedience in many things, to which no express law can be adapted; and, to induce them to forego what may be prejudicial to the safety of the community, and of themselves.

Public medical institutions and laws, must be adapted to the country for which they are intended. Many local circumstances, national character, habits of life, prevalent customs and professions, situation, climate, &c., make considerable varieties necessary. And many institutions, many a law which would be highly beneficial to the public health, in some circumstances, would be useless, impracticable, and even hurtful, in others. These causes and their effects, must, therefore, be particularly attended to.

The principal authors who have written on this subject, are Alberti, Heister, Flaz, Frank, Hussey, Metzger, and Hebrenstreit; to whom we may add Howard and Rumford.

The subjects which it comprehends, cannot be clas- sed very regularly or systematically. Its views will be different, according to occasional and temporary causes; and its interference may sometimes be advantageously extended beyond what may seem the strict limits of a branch of the medical profession.

**Medical Police relates to**

**The Situation of Places of Abode. Construction of houses.**

**Air. Means of counteracting its impurity—Its various impregnations.**

**Water. Its necessity and purity.**

**Food. Its various kinds—Comparative quantities of nourishment afforded by them—Cheaper kinds, which may be safely substituted in times of scarcity—Bread—Animal food—Butcher meat—Fish—Vegetables—Vessels—Cookery; Healthy; Economical.**

**Drink. Beer—Ale—Porter—Cyder—Spiritous liquors—Wine—Warm drinks—Adulterations of these liquors—Hurtful additions—Vessels.**

**Fire and Light.**

**Clothing.**

**Cleanliness.**

**Professions. Manufacturers—Mechanics—Soldiers—Sailors—Men of letters.**

**Healthy Propagation.**

**Pregnant and Puerperal Women.**

**New-Born Infants. Registers of birth.**

**Physical Education.**

**Prevention of Accidents. From poison—Hurtful Effluvia—Maniacs—Rabid animals.**

**Restoration of the Apparently Dead. Humane Societies—Care of the dying—Danger of too early—too late burial—Places of Interment—manner of conducting it—Bills of mortality.**

**Contagious and Epidemic Diseases. Plague—Putrid fever—Dysentery—Smallpox—Inoculation—Extirpation of them—Leprosy—Itch and pox—Precautions to be taken, to prevent their introduction, to diminish their violence, to destroy their cause, and to counteract their effects.**

**Management of Public Institutions in which many people are collected under the care of the public.**

**Hospitals for the Indigent:**

1. Lying-in Hospitals. 2. Foundling ditto. 3. Orphan ditto. 4. Hospitals for Education. 5. Aged Observations on the Means of preserving Health.

Having now treated of all the most important diseases to which the human body is subjected, we shall conclude the article Medicine, with a few observations on the means of preserving health, both for the general management of valetudinarians, and of those also who wish to obtain long life and good health by avoiding the causes of those diseases which the human species often bring upon themselves. On this subject much has been written at almost every period of medicine. And we may refer those readers who wish for a full and extensive view of this interesting subject to a very elaborate work lately published by Sir John Sinclair, Bart. entitled the Code of Health and Longevity. Here we cannot propose to give even an abridged view of this extensive inquiry; but must content ourselves with offering only a very few general observations.

I. Rules for the Management of Valetudinarians.

That part of the medical system which lays down rules for the preservation of health, and prevention of diseases, termed Hygiene, is not to be strictly understood as if it respected only those people who enjoy perfect health, and who are under no apprehensions of disease, for such seldom either desire or attend to medical advice; but is rather considered as relating to valetudinarians, or such as, though not actually sick, may yet have sufficient reason to fear that they will soon become so: hence it is that the rules must be applied to correct morbid dispositions, and to obviate various particulars which were shown to be the remote or possible causes of diseases.

From the way in which the several temperaments are commonly mentioned by systematic writers, it should seem as if they meant that every particular constitution might be referred to one or other of the four; but this is far from being the case, since by much the greater number of people have temperaments so indistinctly marked, that it is hard to say to which of the temperaments they belong.

When we actually meet with particular persons who have evidently either,

1. Too much strength and rigidity of fibre, and too much sensibility; 2. Too little strength, and yet too much sensibility; 3. Too much strength, and but little sensibility; 4. But little sensibility joined to weakness;

we should look on such persons as more or less in the valetudinary state, who require that these morbid dispositions be particularly watched, lest they fall into preserving those diseases which are connected with the different temperaments.

People of the first-mentioned temperament being liable to suffer from continued fevers, especially of the inflammatory species, their scheme of preserving health should consist in temperate living, with respect both to diet and exercise: they should studiously avoid immoderate drinking, and be remarkably cautious lest any of the natural discharges be checked. People of this habit bear evacuations well, especially bleeding: they ought not, however, to lose blood but when they really require to have the quantity lessened; because too much of this evacuation would be apt to reduce the constitution to the second-mentioned temperament, in which strength is deficient, but sensibility redundant.

Persons of the second temperament are remarkably prone to suffer from painful and spasmodic diseases, and are easily ruffled; and those of the softer sex who have this delicacy of habit, are very much disposed to hysterical complaints. The scheme here should be, to strengthen the solids by moderate exercise, cold bathing, cinchona, and chalybeate waters; particular attention should constantly be had to the state of the digestive organs, to prevent them from being overloaded with any species of saburra which might engender flatus, or irritate the sensible membranes of the stomach and intestines, from whence the disorder would soon be communicated to the whole nervous system. Persons of this constitution should never take any of the drastic purges, or strong emetics; neither should they lose blood but in cases of urgent necessity. But a principal share of management, in these extremely irritable constitutions, consists in avoiding all sudden changes of every sort, especially those with respect to diet and clothing, and in keeping the mind as much as possible in a state of tranquility: hence the great advantages which people of this frame derive from the use of medicinal waters drank on the spot, on account of that freedom from care and serious business of every kind, which generally obtains in all the places planned for the reception of valetudinarians.

The third-mentioned temperament, where there is an excess of strength and but little sensibility, does not seem remarkably prone to any distressing or dangerous species of disease; and therefore it can hardly be supposed that persons so circumstanced will either of themselves think of any particular scheme of management, or have recourse to the faculty for their instructions: such constitutions, however, we may observe, bear all kinds of evacuations well, and sometimes require them to prevent an over-fullness, which might end in an oppression of the brain or some other organ of importance.

But the fourth temperament, where we have weakness joined to want of sensibility, is exceedingly apt to fall into tedious and dangerous diseases, arising from a defect of absorbent power in the proper sets of vessels, and from languor of the circulation in general; whence corpulency, dropsy, jaundice, and different degrees of scorbutic affection. In order to prevent these, or any other species of accumulation and deprivation of the animal fluids, the people of this constitution should use a generous course of diet, with brisk exercise, Means of exercise, and be careful that none of the secretions be preserving interrupted, nor any of the natural discharges suppressed.

These constitutions bear purging well, and often require it; as also the use of emetics, which are frequently found necessary to supply the place of exercise, by agitating the abdominal viscera, and are of service to prevent the stagnation of bile, or the accumulation of nucous humours, which hinder digestion, and clog the first passages. The free use of mustard, horse-radish, and the like sort of stimulating dietetics, is serviceable in these torpid habits.

When the general mass of fluids is increased beyond what is conducive to the perfection of health, there arises what the writers term a plethora, which may prove the source of different diseases; and therefore, when this overfulness begins to produce languor and oppression, care should be taken in time to reduce the body to a proper standard, by abridging the food and increasing the natural discharges, using more exercise, and indulging less in sleep.

But in opposite circumstances, where the fluids have been exhausted, we are to attempt the prevention of further waste by the use of strengthening stomachics, nourishing diet, and indulgence from fatigue of body or mind.

Vitiated fluids are to be considered as tainted either with the different kinds of general acrimony, or as betraying signs of some of the species of morbid matter which give rise to particular diseases, such as calculus, scurvy, &c.

During the state of infancy, we may sometimes observe a remarkable acidity, which not only shows itself in the first passages, but also seems to contaminate the general mass of fluids. As it takes its rise, however, from weak bowels, our views, when we mean to prevent the ill consequences, must be chiefly directed to strengthen the digestive organs, as on their soundness the preparation of good chyle depends; and hence small doses of rhubarb and chalybeate (either the natural chalybeate waters mixed with milk, or the murias ammoniae et ferri) in doses of a few grains, according to the age of the child), are to be administered; and the diet is to be so regulated as not to add to this acid tendency: brisk exercise is likewise to be enjoined, with frictions on the stomach, belly, and lower extremities.

Where the fluids tend to the putrescent state, which shows itself by fetid breath, sponginess and bleeding of the gums, a bloated look and livid cast, the diet then should be chiefly of fresh vegetables and ripe fruits, with wine in moderation, due exercise, and strengthening bitters.

Where acrimony shows itself by itching eruptions, uncommon thirst, and flushing heats, nothing will answer better than such sulphureous waters as the Harrogate and Moffat, at the same time using a course of diet that shall be neither acrid nor heating.

So far with respect to those kinds of morbid matter, which do not invariably produce a particular species of disease; but there are others of a specific nature, some of which are generated in the body spontaneously, and seem to arise from errors in diet, or other circumstances of ill management with respect to the animal economy; and hence it is sometimes possible, to a certain degree if not altogether, to prevent the ill consequences. Thus, there are instances where returns of the gout have been prevented by adhering strictly to a preserving milk diet.

The rheumatism has also been sometimes ward off by wearing a flannel shirt, or by using the cold bath without interruption.

Calculus may be retarded in its progress, and prevented from creating much distress, by the internal use of soap and lime-water, by soap-leses taken in milk or in veal-broth, or by the use of aerated alkaline water, which may perhaps be considered as being both more safe and more efficacious, and at the same time more pleasant than any of the other practices.

The scurvy may be prevented by warm clothing and perseverance in brisk exercise, by drinking wine or cider, and eating freely of such vegetable substances as can be had in those situations where this disease is most apt to show itself.

In constitutions where there is an hereditary disposition to the scrophula, if early precautions be taken to strengthen the solids by cold bathing, a nourishing course of diet, and moderate use of wine, the constitution which gives rise to the disease will probably be prevented from producing any very bad effects.

The other kinds of morbid matter, which are of the specific nature, are received into the body by infection or contagion.

The infection of a putrid fever or dysentery is best prevented by immediately taking an emetic on the first attack of the sickness or shivering; and if that do not completely answer, let a large blister be applied between the shoulders: by this method the nurses and other attendants on the sick in the naval hospitals have often been preserved. As to other infectious morbid matter, we must refer to what has already been said when treating of hydrophobia, poisons, gonorrhoea, &c.

The ill effects which may arise from the different species of saburra, are to be obviated, in general, by the prudent administration of emetics, and carefully abstaining from such kinds of food as are known to cause the accumulation of noxious matters in the first passages.

Crude vegetables, milk, butter, and other oily substances, are to be avoided by persons troubled with a sourness in the stomach; brisk exercise, especially riding, is to be used, and they are to refrain from fermented liquors: the common drink should be pure water; or water with a very little of some ardent spirit, such as rum or brandy. Seltzer or Pyrmont waters are to be drunk medicinally; and aromatic bitters, infusions, or tinctures, acidulated with sulphuric acid, will be found serviceable, in order to strengthen the fibres of the stomach, and promote the expulsion of its contents, thereby preventing the too hasty fermentation of the alimentary mixture. In order to procure immediate relief, magnesia alba, or creta preparata, will seldom fail; the magnesia, as well as the chalk, may be made into lozenges, with a little sugar and mucilage; and in that form may be carried about and taken occasionally by people afflicted with the acid saburra.

In constitutions where there is an exuberance or stagnation of bile, and a troublesome bitterness in the mouth, it is necessary to keep the bowels always free, by taking occasionally small doses of pure aloes, oleum ricini, When there is a tendency to the empyreumatic and rancid saburra, people should carefully avoid all the various kinds of those oily and high-seasoned articles of diet generally termed made-dishes, and eat sparingly of plain meat, without rich sauces or much gravy; and in these cases the most proper drink is pure water.

II. Rules for those who enjoy perfect Health.

There can be no doubt, that, in general, temperance is the true foundation of health; and yet the ancient physicians, as we may see in the rules laid down by Celsus, did not scruple to recommend indulgence now and then, and allowed people to exceed both in eating and drinking; but it is safer to proceed to excess in drink than in meat; and if the debauch should create any extraordinary or distressing degree of pain or sickness, and a temporary fever should ensue, there are two ways of shaking it off, either to lie in bed and encourage perspiration, or to get on horseback, and by brisk exercise restore the body to its natural state. The choice of these two methods must always be determined by the peculiar circumstances of the parties concerned, and from the experience which they may before have had which agrees best with them.

If a person should commit excess in eating, especially of high-seasoned things, with rich sauces, a draught of cold water, acidulated with sulphuric acid, will take off the sense of weight at the stomach, and assist digestion by moderating and keeping within bounds the alimentary fermentation, and thus preventing the generation of too much flatus. The luxury of ices may be here of real service at the tables of the great, as producing similar effects with the cold water acidulated. Persons in these circumstances ought not to lay themselves down to sleep, but should keep up and use gentle exercise until they are sensible that the stomach is unloaded, and that they no longer feel any oppressive weight about the precordia.

If a man be obliged to fast, he ought, if possible, during that time, to avoid laborious work: after suffering severe hunger, people ought not at once to gorge and fill themselves; nor is it proper, after being overfilled, to enjoin an absolute fast: neither is it safe to indulge in a state of total rest immediately after excessive labour, nor suddenly fall hard to work after having been long without motion: in a word, all changes should be made by gentle degrees; for though the constitution of the human body be such that it can bear many alterations and irregularities without much danger; yet, when preserving the transitions are extremely sudden, there is a great risk of producing some degree of disorder.

It is also the advice of Celsus to vary the scenes of life, and not confine ourselves to any settled rules: but as inaction renders the body weak and listless, and exercise gives vigour and strength, people should never long omit riding, walking, or going abroad in a carriage. Fencing, playing at tennis, dancing, or other similar engagements, which afford both exercise and amusement, as each shall be found most agreeable or convenient, are to be used in turn, according to the circumstances and tendency to any particular species of disease. But when the weakness of old age shall have rendered the body incapable of all these, then dry frictions with the flesh-brush will be very requisite to preserve health, by accelerating the flow of humours through the smallest orders of vessels, and preventing the fluids from stagnating too long in the cellular interstices of the fleshy parts.

Sleep is the great restorer of strength; for, during this time, the nutritious particles appear to be chiefly applied to repair the waste, and replace those that have been abraded and washed off by the labour and exercise of the day; but too much indulgence in sleep has many inconveniences, both with respect to body and mind, as it blunts the senses, and encourages the fluids to stagnate in the cellular membrane; whence corpulency, and its necessary consequences languor and weakness.

The proper time for sleep is the night, when darkness and silence naturally bring it on: sleep in the daytime, from noise and other circumstances, is in general not so sound or refreshing; and to some people is really distressful, as creating an unusual giddiness and languor, especially in persons addicted to literary pursuits. Custom, however, frequently renders sleep in the day necessary; and in those constitutions where it is found to give real refreshment, the propensity to it ought to be indulged, particularly in very advanced age.

With regard to the general regimen of diet, it has always been held as a rule, that the softer and milder kinds of aliment are most proper for children and younger subjects: that grown persons should eat what is more substantial; and old people lessen their quantity of solid food, and increase that of their drink both of the diluent and cordial kind. For full information on the subject of Diet and Regimen, see the article Dietetics in the Supplement.

INDEX.

A.

IPSIA, Gen. 108. N° 376 AUSTIA, Gen. 99. 366 AUROSIS, Gen. 93. 360 NORRHOEA, Gen. 126. 402 ANTIA, Gen. 65. 326 PHRODISIA, Gen. 109. 377 PARCA, Gen. 75. 339 STHESIA, Gen. 100. 366

ANOREXIA, Gen. 107. N° 375 ANOSIMA, Gen. 98. 365 APHONIA, Gen. 110. 379 APHTHA, Gen. 35. 233 APOPLEXIA, Gen. 42. 255 ARTHROPOUSIS, Gen. 25. 216 ASCITES, Gen. 79. 343 ASTHMA, Gen. 55. 292 ATROPHIA, Gen. 70. 333

Abortus, Abscess of the lungs, Acute rheumatism, Acrimony of the blood, Adynamia, Egyptian physicians, Esculapius, Etius, Alexander,

N° 247 186 205 103 271 2 4 43 44 Amentia,