The Common Evacuations | 18th Century Medicine

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    About the author

    Edward St. Germain.
    Edward St. Germain

    Edward A. St. Germain created AmericanRevolution.org in 1996. He was an avid historian with a keen interest in the Revolutionary War and American culture and society in the 18th century. On this website, he created and collated a huge collection of articles, images, and other media pertaining to the American Revolution. Edward was also a Vietnam veteran, and his investigative skills led to a career as a private detective in later life.

    Contents

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      Editor’s note
      The following is a chapter from the book “Domestic Medicine” written by Dr. William Buchanan in 1785. It provides a fascinating insight into medical knowledge of the time, including the often haphazard and sometimes dangerous techniques used to treat certain injuries and illnesses in the 1700s. We have not edited this book chapter, and as a result it may contain old English spellings of certain words.
      ”

      Chapters

      THE principal evacuations from the human body are those of stool, urine, and insensible perspiration. None of these can be long obstructed without impairing the health. When that which ought to be thrown out of the body is too long retained, it not only occasions a plethora, or too great fulness of the vessels, but acquires qualities which are hurtful to the health, as acrimony, putrescence, &c.

      Of the Evacuation by Stool

      FEW things conduce more to the health than keeping the body regular. When the faeces lie too long in the bowels, they vitiate the humours; and when they are too soon discharged, the body is not sufficiently nourished. A medium is therefore to be desired; which can only be obtained by regularity in diet, sleep, and exercise. Whenever the body is not regular, there is reason to suspect a fault in one or other of these.

      PERSONS who eat and drink at irregular hours, and who eat various kinds of food, and drink of several different liquors at every meal, have no reason to expect either that their digestion will be good, or their discharges regular. Irregularity in eating and drinking disturbs every part of the animal oeconomy, and never fails to occasion diseases. Either too much or too little food will have this effect. The former indeed generally occasions looseness, and the latter costiveness; but both have a tendency to hurt the health.

      IT would be difficult to ascertain the exact number of stools which may be consistent with health, as these differ in the different periods of life, in different constitutions, and even in the same constitution under a different regimen of diet, exercise, &c. It is however generally allowed, that one stool a-day is sufficient for an adult, and that less is hurtful. But this, like most general rules, admits of many exceptions. I have known persons in perfect health who did not go to stool above once a-week. Such a degree of costiveness however is not safe; though the person who labours under it may for some time enjoy tolerable health, yet at length it may occasion diseases.

      ONE method of procuring a stool every day is to rise betimes, and go abroad in the open air. Not only the posture in bed is unfavourable to regular stools, but also the warmth. This, by promoting the perspiration, lessens all the other discharges.

      THE method recommended for this purpose by Mr. Locke, is likewise very proper, viz. to solicit nature by going regularly to stool every morning whether one has a call or not. Habits of this kind may be acquired, which will in time become natural.

      PERSONS who have frequent recourse to medicines for preventing costiveness, seldom fail to ruin their constitution. Purging medicines frequently repeated weaken the bowels, hurt the digestion, and every dose makes way for another, till at length they become as necessary as daily bread. Those who are troubled with costiveness ought rather, if possible, to remove it by diet than drugs. They should likewise go thinly clothed, and avoid every thing of an astringent, or of an heating nature. The diet and other regimen necessary in this case will be found under the article Costiveness, where this state of the bowels is treated as a disease.

      SUCH persons as are troubled with a habitual looseness, ought likewise to suit their diet to the nature of their complaint. They should use food which braces and strengthens the bowels, and which is rather of an astringent quality, as wheat-bread made of the finest flour, cheese, eggs, rice boiled in milk, &c. Their drink should be red port, claret, brandy and water in which toasted bread has been boiled, and such like.

      As a habitual looseness is often owing to an obstructed perspiration, persons affected with it ought to keep their feet warm, to wear flannel next to their skin, and take every other method to promote the perspiration. Further directions with regard to the treatment of this complaint will be found under the article Looseness.

      Of Urine

      So many things tend to change both the quantity and appearances of the urine, that it is very difficult to lay down any determined rules for judging of either. It has long been an observation among physicians, that the appearances of the urine are very uncertain, and very little to be depended on. No one will be surprised at this who considers how many ways it may be affected, and consequently have its appearance altered. The passions, the state of the atmosphere, the quantity and quality of the food, the exercise, the clothing, the state of the other evacuations, and numberless other causes, are sufficient to induce a change either in the quantity or appearance of the urine. Any one who attends to this, will be astonished at the impudence of those daring quacks, who pretend to find out diseases, and prescribe to patients from the bare inspection of their urine. These impostors, however, are very common all over Britain, and by the amazing credulity of the populace, many of them amass considerable fortunes. Of all the medical prejudices which prevail in this country, that in favour of urine doctors is the strongest. The common people have still an unlimited faith in their skill, although it has been demonstrated that no one of them, unless he has been previously informed, is able to distinguish the urine of a horse from that of a man. Dr. Cheyne says, the urine ought to be equal to three-fourths of the liquid part of our aliment. But suppose any one were to take the trouble of measuring both, he would find that every thing which altered the degree of perspiration would alter this proportion, and likewise that different kinds of aliment would afford very different quantities of urine.

      THOUGH for these, and other reasons, no rule can be given for judging of the precise quantity of urine which ought to be discharged, yet a person of common sense will seldom be at a loss to know when it is in either extreme.

      AS a free discharge of urine not only prevents, but actually cures, many diseases, it ought by all means to be promoted; and every thing that may obstruct it should be carefully avoided. Both the secretion and discharge of urine are lessened by a sedentary life, sleeping on beds that are too soft and warm, food of a dry and heating quality, liquors which are astringent and heating, as red port, claret, and such like. Those who have reason to suspect that their urine is in too small quantity, or who have any symptoms of the gravel, ought not only to avoid these things, but whatever else they find has a tendency to lessen the quantity of their urine.

      WHEN the urine is too long retained, it is not only resorbed, or taken up again into the mass of fluids, but by stagnating in the bladder it becomes thicker, the more watery parts flying off first, and the more gross and earthly remaining behind. By the constant tendency which these have to concrete, the formation of stones and gravel in the bladder is promoted. Hence it comes to pass, that indolent and sedentary people are much more liable to these diseases, than persons of a more active life.

      MANY persons have lost their lives, and others have brought on very tedious, and even incurable disorders, by retaining their urine too long, from a false delicacy. When the bladder has been over-distended, it often loses its power of action altogether, or becomes paralytic, by which means it is rendered unable either to retain the urine, or expel it properly. The calls of Nature ought never to be postponed. Delicacy is doubtless a virtue; but that can never be reckoned true delicacy, which induces any one to risk his health, or hazard his life.

      BUT the urine may be in too great as well as too small a quantity. This may be occasioned by drinking large quantities of weak watery liquors, by the excessive use of alkaline salts, or any thing that stimulates the kidnies, dilutes the blood, &c. This disorder very soon weakens the body, and induces a consumption. It is difficult to cure, but may be mitigated by strengthening diet and astringent medicines, such as are recommended under the article Diabetes, or excessive discharge of urine.

      Of the Perspiration

      INSENSIBLE perspiration is generally reckoned the greatest of all the discharges from the human body. It is of so great importance to health, that few diseases attack us while it goes properly on; but when it is obstructed, the whole frame is soon disordered. This discharge however being less perceptible than any of the rest, is consequently less attended to. Hence it is, that acute fevers, rheumatisms, agues, &c. often proceed from obstructed perspiration before we are aware of its having taken place.

      ON examining patients, we find most of them impute their diseases either to violent colds which they had caught, or to slight ones which had been neglected. For this reason, instead of a critical inquiry into the nature of the perspiration, its difference in different seasons, climates, constitutions, &c. we shall endeavour to point out the causes which most commonly obstruct it, and to shew how far they may be either avoided, or have their influence counter-acted by timely care. The want of a due attention to these, costs Britain annually some thousands of useful lives.

      Changes in the Atmosphere

      ONE of the most common causes of obstructed perspiration, or catching cold, in this country, is the changeableness of the weather, or state of the atmosphere. There is no place where such changes happen more frequently than in Great Britain. With us the degrees of heat and cold are not only very different in the different seasons of the year, but often change almost from one extreme to another in a few days, and sometimes even in the course of one day. That such changes must effect the state of the perspiration is obvious to every one. I never knew a more remarkable instance of the uncertainty of the weather in this country, than happened while I was writing these notes. This morning, August 14, 1783, the thermometer in the shade was down at fifty-three degrees, and a very few days ago it stood above eighty. No one who reflects on such great and sudden changes in the atmosphere will be surprised to find colds, coughs, rheums, with other affections of the breast and bowels, so common in this country.

      THE best method of fortifying the body against the changes of the weather, is to be abroad every day. Those who keep most within doors are most liable to catch cold. Such persons generally render themselves so delicate as to feel even the slightest changes in the atmosphere, and by their pains, coughs, and oppressions of the breast, &c. they become a kind of living barometers.

      Wet Clothes

      WET clothes not only, by their coldness, obstruct the perspiration, but their moisture, by being absorbed, or taken up into the body, greatly increases the danger. The most robust constitution is not proof against the danger arising from wet clothes; they daily occasion fevers, rheumatisms, and other fatal disorders, even in the young and healthy.

      IT is impossible for people who go frequently abroad to avoid sometimes being wet. But the danger might generally be lessened, if not wholly prevented, by changing their clothes soon; when this cannot be done, they should keep in motion till they be dry. So far are many from taking this precaution, that they often sit or lie down in the fields with their clothes wet, and frequently sleep even whole nights in this condition. The frequent instances which we have of the fatal effects of this conduct ought certainly to deter others from being guilty of it.

      Wet Feet

      EVEN wet feet often occasion fatal diseases. The colic, inflammations of the breast and of the bowels, the iliac passion, cholera morbus, &c. are often occasioned by wet feet. Habit will, no doubt, render this less dangerous; but it ought, as far as possible, to be avoided. The delicate, and those who are not accustomed to have their clothes or feet wet, should be careful in this respect.

      Night Air

      THE perspiration is often obstructed by NIGHT AIR; even in summer, this ought to be avoided. The dews which fall plentifully after the hottest day, make the night more dangerous than when the weather is cool. Hence, in warm countries, the evening dews are more hurtful than where the climate is more temperate.

      IT is very agreeable after a warm day to be abroad in the cool evening; but this is a pleasure to be avoided by all who value their health. The effects of evening dews are gradual indeed, and almost imperceptible,

      but they are not the less to be dreaded: We would therefore advise travellers, labourers, and all who are much heated by day, carefuIly to avoid them. When the perspiration has been great, these become dangerous in proportion. By not attending to this, in flat, marshy countries, where the exhalations, and dews are copious, labourers are often seized with intermitting fevers, quinseys, and other dangerous diseases.

      Damp Beds

      BEDS become damp, either from their not being used, standing in damp houses, or in rooms without fire. Nothing is more to be dreaded by travellers than damp beds, which are very common in all places where fuel is scarce. When a traveller, cold and wet, arrives at an inn, he may by means of a good fire, warm diluting liquor, and a dry bed, have the perspiration restored; but if he be put into a cold room, and laid on a damp bed, it will be more obstructed, and the worst consequences will ensue. Travellers should avoid inns which are noted for damp beds, as they would a house infected with the plague, as no man, however robust, is proof against the danger arising from them.

      BUT inns are not the only places where damp beds are to be met with. Beds kept in private families for the reception of strangers are often equally dangerous. All kinds of linen and bedding, when not frequently used, become damp. How then is it possible that beds, which are not slept in above two or three times a-year, should be safe? Nothing is more common than to hear people complain of having caught cold by changing their bed. The reason is obvious: Were they careful never to sleep in a bed but what was frequently used, they would seldom find any ill consequences from a change.

      NOTHING is more to be dreaded by a delicate person when on a visit, than being laid in a bed which is kept on purpose for strangers. That ill-judged piece of complaisance becomes a real injury. All the bad consequences from this quarter might easily be prevented in private families, by causing their servants to sleep in the spare beds, and resign them to strangers when they come. In inns where the beds are used almost every night, nothing else is necessary than to keep the rooms well seasoned by frequent fires, and the linen dry.

      THAT baneful custom said to be practised in many inns, of damping sheets, and pressing them in order to save washing, and afterwards laying them on the beds, ought, when discovered, to be punished with the utmost severity. It is really a species of murder, and will often prove as fatal as poison or gun-shot. Indeed no linen, especially if it has been washed in winter, ought to be used till it has been exposed for some time to the fire; nor is this operation less necessary for linen washed in summer, provided it has lain by for any length of time. This caution is the more needful, as gentlemen are often exceedingly attentive to what they eat or drink at an inn, yet pay no regard to a circumstance of much more importance. If a person suspects that his bed is damp, the simple precaution of taking off the sheets and lying in the blankets, with all, or most of his clothes on, will prevent all the danger. I have practised this for many years, and never have been hurt by damp beds, though no constitution, without care, is proof against their baneful influence.

      Damp Houses

      DAMP houses frequently produce the like ill consequences; for this reason those who build should be careful to chuse a dry situation. A house which stands on a damp marshy soil or deep clay, will never be thoroughly dry. All houses, unless where the ground is exceeding dry, should have the first floor a little raised. Servants and others, who are obliged to live in cellars and sunk stories, seldom continue long in health: Masters ought surely to pay some regard to the health of their servants, as well as to their own.

      NOTHING is more common than for people, merely to avoid some trifling inconveniency, to hazard their lives, by inhabiting a house almost as soon as the masons, plasterers, &c. have done with it: Such houses are not only dangerous from their dampness, but likewise from the smell of lime, paint, &c. The asthmas, consumptions, and other diseases of the lungs, so incident to people who work in these articles, are sufficient proof of their being unwholesome.

      ROOMS are often rendered damp by an unseasonable piece of cleanliness; I mean the pernicious custom of washing them immediately before company is put into them. Most people catch cold, if they sit but a very short time in a room that has been lately washed; the delicate ought carefully to avoid such a situation, and even the robust are not proof against its influence. People imagine if a good fire is made in a room after it has been washed, that there is no danger from sitting in it; but they must give me leave to say that this increases the danger. The evaporation excited by the fire generates cold, and renders the damp more active.

      Sudden Transitions from Heat to Cold

      NOTHING so frequently obstructs the perspiration as SUDDEN TRANSITIONS from heat to cold. Colds are seldom caught, unless when people have been too much heated. Heat rarifies the blood, quickens the circulation, and increases the perspiration; but when these are suddenly checked, the consequences must be bad. It is indeed impossible for labourers not to be too hot upon some occasions; but it is generally in their power to let themselves cool gradually, to put on their clothes when they leave off work, to make choice of a dry place to rest themselves in, and to avoid sleeping in the open fields. These easy rules, if observed, would often prevent fevers and other fatal disorders

      NOTHING is more common than for people, when hot, to drink freely of cold water, or small liquors. This conduct is extremely dangerous. Thirst indeed is hard to bear, and the inclination to gratify that appetite frequently gets the better of reason, and makes us do what our judgment disapproves. Every peasant, however, knows, if his horse be permitted to drink his bellyful of cold water after violent exercise, and be immediately put into the stable, or suffered to remain at rest, that it will kill him. This they take the utmost care to prevent. It were well if they were equally attentive to their own safety.

      THIRST may be quenched many ways without swallowing large quantities of cold liquor. The fields afford variety of acid fruits and plants, the very chewing of which would abate thirst. Water kept in the mouth for some time, and spit out again, if frequently repeated, will have the same effect. If a bit of bread be eaten along with a few mouthfuls of water, it will both quench thirst effectually, and make the danger less. When a person is extremely hot, a mouthful of brandy, or other spirits, if it can be obtained, ought to be preferred to any thing else. But if any one has been so foolish, when hot, as to drink freely of cold liquor, he ought to continue his exercise at least, till what he drank be thoroughly warmed upon his stomach.

      IT would be tedious to enumerate all the bad effects which flow from drinking cold liquors when the body is hot. Sometimes this has occasioned immediate death. Hoarseness, quinseys, and fevers of various kinds, are its common consequences. Neither is it safe when warm to eat freely of raw fruits, salads, or the like. These indeed have not so sudden an effect on the body as cold liquors, but they are notwithstanding dangerous, and ought to be avoided.

      SITTING in a warm room, and drinking hot liquors till the pores are quite open, and immediately going into the cold air, is extremely dangerous., Colds, coughs, and inflammations of the breast, are the usual effects of this conduct. Yet nothing is more common than for people, after they have drank warm liquors for several hours, to walk or ride a number of miles in the coldest night, or to ramble about in the streets. The tap-rooms in London and other great towns, where such numbers of people spend their evenings, are highly pernicious. The breath of a number of people crowded into a low apartment, with the addition of fires, candles, the smoke of tobacco, and the fumes of hot liquor, &c, must not only render it hurtful to continue in such places, but dangerous to go out of them into a cold and chilly atmosphere.

      PEOPLE are very apt, when a room is hot, to throw open a window, and to sit near it. This is a most dangerous practice. Any person had better sit without doors than in such a situation, as the current of air is directed against one particular part of the body. Inflammatory fevers and consumptions have often been occasioned by sitting or standing thinly clothed near an open window. Nor is sleeping with open windows less to be dreaded. That ought never to be done, even in the hottest season, unless the window is at a distance. I have known mechanics frequently contract fatal diseases, by working stript at an open window, and would advise all of them to beware of such a practice.

      NOTHING exposes people more to catch cold than keeping their own houses too warm; such persons may be said to live in a sort of hot-house. They can hardly stir abroad to visit a neighbour, but at the hazard of their lives. Were there no other reason for keeping houses moderately cool, that alone is sufficient: But no house that is too hot can be wholesome; heat destroys the spring and elasticity of the air, and renders it less fit for expanding the lungs, and the other purposes of respiration. Hence it is, that consumptions and other diseases of the lungs prove so fatal to people who work in forges, glass houses, and the like.

      SOME are even so fool-hardy, as to plunge themselves when hot into cold water. Not only fevers, but madness itself, has frequently been the effect of this conduct. Indeed it looks too like the action of a madman to deserve a serious consideration.

      THE result of all these observations is, that every one ought to avoid, with the utmost attention, all sudden transitions from heat to cold, and to keep the body in as uniform a temperature as possible; or, where that cannot be done, to take care to let it cool gradually.

      PEOPLE may imagine that too strict an attention to these things would tend to render them delicate. So far however is this from being my design, that the very first rule proposed for preventing colds, is to harden the body, by enuring it daily to the open air.

      I SHALL put an end to what relates to this part of my subject, by giving an abstract of the justly celebrated advice of Celsus, with respect to the preservation of health. ” A man”‘ says he, who is blessed with good health, should confine himself to no particular rules, either with respect to regimen or medicine. He ought frequently to diversify his manner of living; to be sometimes in town, sometimes in the country; to hunt, sail, indulge himself in rest, but more frequently to use exercise. He ought to refuse no kind of food that is commonly used, but sometimes to eat more and sometimes less; sometimes to make one at an entertainment, and sometimes to forbear it; to make rather two meals a-day than one. and always to eat heartily, provided he can digest it. He ought neither too eagerly to pursue, nor too scrupulously to avoid, intercourse with the fair sex: Pleasures of this kind, rarely indulged, render the body alert and active, but when too frequently repeated, weak and languid. He should be careful in time of health not to destroy, by excesses of any kind, that vigour of constitution which should support him under sickness.”

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