A DISSERTATION ON THE MEANS OF PRESERVING HEALTH IN CHARLESTON, AND THE ADJACENT LOW COUNTRY.

THE object of the medical profession is not only to heal diseases, but to prevent them. As it is my turn this evening to furnish a subject of conversation for the society, I shall, with great de­ference, submit to their consideration some practical observations on the means of preventing those dis­eases which are most common in Charleston and the vicinity. This I do the more readily as, having enjoyed almost uninterrupted health during a residence of sixteen years in this climate, I hope that I may be allowed to have some experimental knowledge of the subject

The foundation of good health through life, should be laid in a proper treatment of infants. Their limbs should be unconfined, and frequently rubbed. Their food ought to be plain and simple. They should be kept constantly clean, and never suffered to remain wet for any length of time. Caps should be laid aside after the third or fourth month in winter, and much sooner in sum­mer. Shoes and stockings may well be dispensed with through the whole period of infancy. Every prudent exertion should be early made for harden­ing the constitution against sudden changes of the atmosphere. To this end exercise should be freely and daily taken in the open air. When the weather turns suddenly cold, some additional cloathing may be proper; but it is often more for the interest of children, to habituate them to all the varieties [Page 4]of our weather, and even to expose them to occa­sional colds, than by an excess of care and tender­ness to induce a delicacy of habit.

In nursing cradles are hurtful. They add much to the heat of the infants who are confined between their narrow sides. A hard matrass is much cooler and on many accounts preferable. The youths who are accustomed to sleep on the floor with bare blankets, will pass through life with more independence and with greater advantanges than they who are accustomed to the relaxing indulgen­cies of soft beds.

On the propriety of using young children in this country to the cold bath, well informed physicians hold different opinions In some habits it certainly does good by bracing the tender limbs and fortifying the body against sudden changes of the air, while in others the shock is too great. In general it may nevertheless be safely affirmed that a great majority of our children would have a better chance for escaping the diseases of infancy, if they were from an early period of life habituated to the frequent use of the cold bath; and that very few cases occur in which the daily washing of them in cold water would not be of advantage.

Providence has kindly furnished us with an efficacious remedy for worms. Pink root is one of the best vermifuges in the world, and the seasonable administration of it to our children, would save them from what often proves a source of disease and death.

[Page 5]The months of April and May have been found by long experience to be unfriendly to children in Charleston. Parents should, there­fore, make arrangements for keeping them out of the city during these two months. Coun­try air is of singular utility not only for pre­venting but curing that vomiting and purging which attacks children on the approach of warm weather. Where a retreat to the country is not practicable, the next best preventive of this dan­gerous complaint is cold bathing.

The stomachs and intestines of infants should be well cleansed soon after they are born. That mothers should rest for several hours after their delivery is ad­visable. While they are recruited by repose after the sufferings of parturition, their offspring may be pre­pared for sucking with safety. This can only be done by thoroughly emptying their stomachs and intestines.

On this occasion give me leave to observe, that the writings of physicians who have practised in colder climates are not applicable to this country. They represent the first milk of mothers as sufficient to carry off the meconium of new born infants, but the contrary is known among us to every practitioner of physic. Milk either has not the same qualities, or does not produce the same effects in warm as in cold countries. In this climate it not only often fails in carrying off from new-born infants those crudities the retention of which gives rise to many diseases, but instead thereof, by mingling with them, produces such disturbances in the alimentary canal, as frequently issue in imme­diate [Page 6]death. Much of the mortality among chil­dren, especially on plantations, is owing to this cause Overlaying, which is commonly said to be the occasion of their death, takes place much seldomer than has been supposed. The locked jaw of infants frequently arises from the irritation excited by the mixture of milk with meconium. If there is any one direction of primary consequence for preserving the health, and even the lives of infants, it is to empty their stomachs and bowels well before they are suffered to suck plentifully. A due attention to this matter would annually save many lives.

For the preservation of health and prevention of diseases among adults, much is to be avoided and much is to be done. In the former class several particulars are to be reckoned. The first I shall mention is lying long in bed in the morning.

The coolest period of the day is a little before sun rising. This naturally proves a temptation to spend those precious moments in sleep. If this is indulged, the body lies immersed in the air which has been fouled by its perspiration through the night, and in a situation which tends to relax it nearly as much as if it was in a vapor bath. By proper improvement of the morning, new life, vigor and spirits are imparted for bearing the noon­tide heat; but by continuing to sleep, or even to loll, this opportunity of recruiting is lost—the languor and debility which resulted from the pre­ceding day continues to increase, till a change of season brings relief. The cool morning air acts like the cold bath in invigorating the body, and [Page 7]has an advantage over it by being inhaled and applied to the vitals. In another view of this subject, it may be added, that a man who rises early will comparatively add seven years of the best time for study and business to a life of sixty-five. Tho' early rising is very wholsome, yet going abroad in the morning in the country, while the grass is covered with dew, frequently produces fevers. To obtain the good, unmixed with the evil, the most should be made of the cool morning air, but without wetting our feet with damp grass, or other­wise exposing ourselves to an undue absorption of that moisture which abounds for some time after the rising of the sun. As a further precaution against the chills of the morning, it would be pru­dent never to go abroad with an empty stomach. A glass of cold water, or slice of bread, or a draught of some bitter tea, taken immediately after rising, would be beneficial.

The above cautions of avoiding the morning dew may safely be dispensed with in many cases. A man who washes his feet in cold water every day will hardly ever suffer from walking abroad in the morning. Nor will he who changes his shoes, and wipes his feet soon after they are wet from dewy grass. It may farther be added, that if chil­dren were educated as they ought to be, when grown up they would have little to fear from wet feet or morning dews.

Immoderate drinking should be avoided in this climate. To add the stimulus of large quantities of spirituous liquors to the heat occasioned by a warm atmosphere, is to add fuel to fire. Every [Page 8]evil that naturally results from an excess of heat, is aggravated by a plentiful use of ardent spirits. These tend to inflame the blood, and concur with a warm sun in wearing out the vitals, hasten­ing on a premature old age and an untimely death. How far it would be for the benefit of our country to exterminate the use of distilled spirits, I will not undertake to determine, but have no hesitation in pronouncing, that the sum of evil resulting from their abuse infinitely outweighs all the good that flows from them.

The habit of immoderate drinking when once begun [...] on its unhappy votaries almost irresistibly. In the intervals of sobriety, they feel a faintness and oppression which is intolerably dis­tressing. For this they find no relief but in a second intoxication. As the liquor loses its sti­mulus, the dose must be increased so as to procure an abatement of painful sensations. The remedy proves worse than the disease, and both continue to increase in a fatal progression from bad to worse, from ordinary grog to undiluted Jamaica spirits: even the latter becomes insufficient to warm the stomach, and instances sometimes occur where the hottest peppers have been added to the warmest spirits to take off their fancied coldness. To enumerate all the diseases which are brought on in this warm climate, by the abuse of ardent spirits, would far exceed the limits to which I must confine myself. Suffice it to observe, that among them is the destruction of the digestive powers, obstructions of the abdominal viscera, dropsies and madness. Nothing can more powerfully illustrate the per­nicious [Page 9]effects of rum than the havoc it makes among the Indians, who, from a robust and hardy race, by the free use of that pernicious liquid, be­come mad, waste away and die. They who wish to preserve health, should summon up all their re­solution to prevent the blandishments of company, or the seductions of appetite, from inducing them to deviate into the paths of intemperance; for, when once they have entered on that course, their return to the practice of that moderation and sobriety which health requires, is always difficult and often impossible.

Of the many forms in which ardent spirits are taken to the prejudice of health, none is more in­jurious than drams. Under the insidious shew of fortifying the body against foggy and damp wea­ther, the practice of daily drinking drams has slain its thousands. It gives a temporary stimulus to the system, but this is soon followed with increased debility. It creates a false appetite, and tempts to the eating of more solid food than either nature craves or the stomach can digest. These are its first effects. In process of time consequences of an opposite nature are produced. A loss of appe­tite, at least for breakfast, is a common complaint among those who have long been in the habit of drinking drams. To the evils resulting from this source physicians have sometimes incautiously con­tributed by recommending the use of bitters. Though the bitters taken in substance, or in water, may be useful, the spirits in which they are mostly prepared insensibly lead to the practice of dram-drinking. [Page 10]Huxham's tincture of the bark is, on these principles, the occasion of much mischief. It would be for the interest of patients that physi­cians should never prescribe the internal use of any medicines prepared in spirits, except such as are taken in small doses. They pay too dearly for being cured of fevers or bad appetites, who, by taking spirituous tinctures for that purpose, contract a fondness for drams. On this subject, it is worthy of remark, that health is often much injured by those who are at all hours of the day sipping spi­rituous liquors, though they are never intoxicated. It is a good general rule never to drink any thing stronger than water, except at our meals.

An intemperate use of animal food should be avoided in this climate, especially in summer. Excess in eating is as bad as excess in drinking. It excites a greater oppression, and requires a greater exertion of the digestive organs. The warmer the weather, the greater is the tendency to putrefaction. It cannot be expected, that meat which becomes tainted in a few hours in market, can be much longer otherwise when it is taken immoderately into the stomach. As often as an undue proportion of meat is taken at a meal, nature is not only oppressed, but a foundation is laid for putrid diseases. Perhaps in this view of the mat­ter, a small proportion of salted meat, as being less disposed to putrefaction than fresh, would be more suitable aliment in summer than has ge­nerally been supposed.

[Page 11]Inactivity is another of the evils against which the votaries of health should fix their most deter­mined opposition Many of our summer diseases arise from suppressed perspiration. From whatever cause this proceeds, languor and lassitude are the immediate consequences. These unpleasant sen­sations ought to be instantly removed; but to accomplish that desirable object, recourse should immediately be had to such active exertions as are calculated to restore an equable and free perspi­ration. Our feelings on these occasions deceive us. They persuade us to indulge in rest, but a regard to health leads to activity. The sense of weariness, which arises from suppressed perspira­tion, is more easily overcome by resisting than yielding. The person who sits or lies down will find his lassitude to continue and increase; but he, who in opposition to his own feelings, makes a proper exertion of his active powers, will soon be relieved from it.

The effects of exercise in promoting digestion, and all the regular functions of animal life, are too well known to need illustration. Suffice it to ob­serve, by way of applying the general observation to our local situation, that from the great moisture of our atmosphere, impediments to a free perspi­ration frequently occur. These should be coun­teracted by such constant, equable activity as, without heating the body, will keep all the se­cretions in their due order and proportion.

Among the evils resulting from indolence, a sondness for drinking ardent spirits is not the [Page 12]least. Human nature is so constituted that it requires something to agitate it. Where the mind and body are both unemployed, the stimulus of strong liquor becomes desirable, as a means of exciting sensations, and of obviating the irksome­ness of having nothing to do.

Inactivity is thus doubly destructive to health. First, by its own primary effects; and, secondly, by leading to intemperance.

Long sittings at meals should be avoided in this climate. All the evils resulting from the sources which have been already mentioned, are increased by the fashionable custom of spending three or four hours at the dinner table, for it leads to them all. The use of segars has the same ten­dency. They occasion a waste of the saliva, and of course injure the digestion of our food. They produce artificial thirst, and consequently lead to tipling. By taking off that sense of uneasiness which results from having nothing to do, they de­stroy one of the most powerful incentives to action, and lead to habits of indolence. The smoke of the segars tends to correct the moisture of the atmosphere, and the use of them in some consti­tutions may advantageously evacuate redundant phlegm; but the small advantages procured in this way are outweighed by many greater evils which flow fom their daily use.

Sudden changes from hot to cold air, violent exertions, depressing passions, hard rides, long walks, great fatigue, and excesses of all kinds, should be guarded against by those who are [Page 13]anxious for the preservation of health. These cautions are particularly necessary in the interval between June and October; for, during that time, there is such a morbid irritability of the whole system, that irregularities, which in other months of the year might be harmless, seldom fail of im­mediately drawing after them serious consequences.

Hunting clubs should be wholly discontinued through the summer. They begin with violent exercise, and this is followed by plentiful eating and drinking. After excessive perspiration has been excited by these means, a ride late in the even­ing closes the scene. Few situations occur in which there is so dangerous a combination of the causes of our fevers as takes place on these occa­sions. For similar reasons the game of fives, cricket, and in short every species of diversion or exercise that requires violent exertions should be abandoned in warm weather.

The time of exposure to the sun should be shortened as much as possible. While we are ne­cessarily exposed to it, we should abstain from ardent spirits, and should avoid standing still. It would also be proper to protect our heads from the effects of heat, by wearing white hats. These will be much the better for deep crowns of such a con­struction as leaves a vacancy between the head and the hat. Fashion, which seldoms consults either health or convenience, has lately deviated into what is salutary by introducing the use of flapped hats on the above construction. Long may this [Page 14]fashion continue, or rather may it never cease to be the fashion in Carolina.

We should be careful of lying in damp rooms, or in linen not sufficiently dry; and we should always put on dry cloaths, as soon as possible, after being wet. Chilling easterly winds, night air, and the evening dews should be avoided. The latter are more pernicious than a thorough wetting from rain. Dew in this climate is of such a pene­trating nature, that no ordinary covering can be depended on for excluding it. It insinuates itself through our cloaths, and coming in contact with the skin, checks those discharges which health requires. They who indulge themselves in spend­ing their evenings in open balconies, often pay dear for the hazardous gratification. The ground on which Charleston stands was probably gained from the ocean, and is but a little higher than the ordi­nary level of the sea. By digging eight or ten feet, we every where find water. From this cir­cumstance, together with the lowness of the ground, and the abundance of swamps and marshes, we breathe an air abounding with moisture. The heat of the sun so commonly but unjustly com­plained of, is beneficial by correcting this moisture; but when his chearful influence is withdrawn, the natural dampness of the air becomes eminently pernicious. Sleeping with open windows is, for these reasons, very injurious, especially if great changes of the atmosphere take place in the time of sleep. Habit has so far inured several persons to this practice, that they suffer nothing from it. [Page 15]It must also be acknowledged, that the confined air of a small close room soon becomes unfit for respiration. In estimating matters of this kind, the advantages and disadvantages should be weighed against each other. An opinion formed in this way would, as a general rule, be in favor of sleeping with shut windows, especially such as are near our beds. Perhaps the plan most consist­ent with health and comfort would be, to sleep in a room altogether close, except a door which opened into an adjoining one, into which there was a free admission of the external air. In every case we should so arrange ourselves as to be secure, that wind may not blow directly on us when we are at rest, and especially when we are composed for sleep. The body of a man asleep is in itself considerably cooler than when he is awake. There is, therefore, great danger from that undesigned sleep which often steals upon us in consequence of those lollings in which, when the weather is hot, we are prone to indulge ourselves. They who wish to preserve health should resist all temptations to sleep, except in circumstances where proper precautions are taken for defending the body from that abatement of animal heat which results from sleep itself, and still more from changes of the atmosphere.

The greatest care should be taken for the preservation of cleanliness in our persons, houses, kitchens, yards, stables, pumps and streets. The drains should be kept constantly free from obstruc­tions; but if this cannot be done, the grates over [Page 16]them should be covered to keep down the effluvia that would otherwise issue from them to the great danger of the inhabitants. The low grounds of this city, in which water usually stagnates, should be filled up^*.

All offensive and putrifying substances should be burnt up, or at least removed, so as to prevent their poisoning the air we breathe. The number of dead animals, and the quantity of putrid vege­tables in our streets, is a nuisance of the most dangerous kind. The expence of keeping the city clean would be much less than what is ex­pended in curing the diseases that are fostered by the filth of our streets. The weeds which surround the planters houses in the country should, for the same reason, be burned in that season of the year when they begin to rot.

Costiveness ought to be particularly avoided in this climate. Regularity in the alvine discharges is of the last consequence. Their retention, by disturbing the whole animal oeconomy, proves a source of many evils. Whenever these discharges do not return at their proper period, efficacious methods should be immediately adopted to aid the languid bowels in the discharge of their necessary functions. Rising early is one of the best means of obviating costiveness. The cool morning air [Page 17]tends to throw the excrementitious humors on the bowels, and to hasten their discharge. The re­verse is the case with such persons as spend an undue proportion of their time in a recumbent posture, and particularly those who lie in bed after sunrise. Attention to the state of the bowels is particularly indispensible in the summer and first months of the autumn. In most of the diseases between June and November, the bile is more or less injuriously predominant, and should be daily discharged. In the beforementioned period every article of meat or drink, known by experience to generate a surplusage of bile, should be either wholly laid aside, or sparingly used; and costiveness should be obviated by the use of laxative food. Perhaps no simple in the power of every person is more efficacious, in preventing bilious complaints, than raw eggs beat up into an agreeable mixture and taken every morning.

If notwithstanding all our precautions to the contrary, a fever is beginning to form, instead of indulging the vain hope, that it will go off itself, we should instantly retreat to our chambers, and take something, that by restoring an equable per­spiration will turn the current of humors from within outwardly. Nothing does this so effectually as a vomit. A proper medicine of that kind taken in time, when the introductory symptoms forebode a fever, will often destroy it in embryo, prevent a fit of sickness, and the necessity of taking a variety of other medicines.

[Page 18]In enumerating what ought to be done to pre­serve health, the advantages of temperance and exercise are obvious; but instead of dilating on principles suited to every situation, it will be more proper to dwell on such as especially apply to our own. For eight months of the year, South-Caro­lina is as healthy as any part of the globe. Our winters are delightful, and our greatest summer heats are far from being intolerably distressing. The mercury in the thermometer rises every year as high in Boston, New-York and Philadelphia, as in Charleston. I have lived in both of the latter cities, and can with truth declare, that I have suf­fered more from heat, in each of them, than I ever did in Charleston. If our summers are longer, and render us less able to bear continued fatigue, this is amply compensated by the superior mildness of our winters and the superior fertility of our soil, which requires less labor for procuring subsistence. The inhabitants of this state are in general, at all times, less liable to rheumatisms, coughs, colds, and in­flammatory disorders, than those who live in colder climates. Consumptions, except a few from ca­tarrh, are seldom seen amongst our own citizens. Gravel and stone are comparatively rare in this country. But to fevers of the low kind, we are particularly exposed, especially in the interval between June and November. As these may be considered to be the endemic of the country, I beg leave to offer some practical observations on the means of preventing them. Our summer and autumnal fevers, as far as they depend on local [Page 19]situation, chiefly arise from the separate or combined influence of heat, moisture, and marsh miasmata. To secure the body against the effects of these enemies to health, is, or ought to be, an object of general attention. With this view, I would re­commend the wearing of flannel next the skin. It has already been observed, that in summer per­spiration is great. Perhaps it is fortunate for us that it is so, for as many of our humors are by heat rendered morbid, the seasonable discharge of them is highly beneficial. Where a person is immedi­ately covered with linen, the perspirable matter, as fast as thrown off, is collected and kept in contact with the ducts from which it exuded. On the other hand, flannel, by absorbing the same, removes much of it from the skin. As the discharge of this excrementitious matter is beneficial, the reten­tion of it must be injurious. The gentle friction of flannel, which soon ceases to be disagreeable, acts like a flesh brush, and promotes an agreeable regular perspiration, than which nothing is more conducive to health. Where the trunk of the body is immediately covered with woollen of any kind, the chance of suffering from sudden changes of the atmosphere is greatly lessened. Summer colds are infinitely more dangerous than those which take place in winter. To these we are particularly ex­posed in the latter end of the warm weather, when the nights begin to grow cool. They who consult only present gratification, are apt to disencumber themselves from the bed cloaths, and in that situ­ation they go to sleep. This, though harmless in [Page 20]the first part of the night, often becomes injurious before day, either from sudden changes of the at­mosphere, or from that gradual cooling of it which takes place towards autumn. He who sleeps in flannel has a constant defence against those changes, and is thereby fortified against a common exciting cause of the disorders of the season. Such as can­not reconcile themselves to the wearing of flannel constantly, should at least put it on when they are particularly exposed. The inhabitants of Charles­ton going to the country when fevers are rise, would do well to observe this precaution, while they are out of the city, especially if their business leads them to be much in rice fields, or in the vicinity of stagnant waters.

Cold bathing, under proper regulations, is an excellent preventive of the diseases of this country. As heat relaxes, it is obvious that cold must brace. Once in twenty-four hours, to immerse the body in cold water, most powerfully strengthens the whole system. Perspiration, though for a mo­ment checked, increases with the returning glow, which immediately follows when the bathed person is wiped dry and begins to take exercise. If this is done in the evening, it seldom fails of procuring a good night's rest: if in the morning, it fortifies the body for bearing the heat of the following day. By bracing the whole system, it destroys that pre­disposition to diseases, which is brought on by the relaxing qualities of heat and moisture. It is farther serviceable by keeping the skin constantly clean. Such is the excessive perspiration in this [Page 21]country, in the summer, that frequent washings are indispensably necessary to preserve cleanliness. This precaution is too often neglected where peri­odical bathings are disused. The advantages from even a partial use of the cold bath are great. Colds in the head are very uncommon when it is daily washed in cold water. The eyes of a person who frequently plunges them, wide open, into cold water, will seldom be either weak or inflamed. Diseases of the throat rarely attack those who daily wash their necks with cold water. Frequent washings of the mouth prevent much of the tooth­ache. It has already been observed, that the person who daily washes his feet in cold water, will hardly ever suffer from exposing himself to the dews of the morning. So many diseases might be pre­vented, and so much good might be done by a judicious use of bathing, that every gentleman ought to have an apparatus in his house for that purpose. Sometimes cold water, and sometimes tepid, ought to be used. In other cases washing would be preferable to bathing. To adjust these, and several other particulars, and to prevent the mischiefs that might arise from indiscreet bathing, the advice of a physician is often necessary.

The aliment used in summer should be anti­septic and generous. The influence of what we eat and drink is very great. Butter and fat meats tend evidently to clog the stomach and vitiate the bile, and therefore should be laid aside, or sparingly used in hot weather. A due proportion of meat and vegetables is proper. Pepper, and the other [Page 22]warm condiments, which are used in seasoning, though in theory they seem to be improper, in a country where heat abounds, are found by expe­rience to be wholesome. They are for the most part the productions of warm climates, and we find that the productions of all countries suit best with their inhabitants. As no dish is more com­mon among negroes than pepperpot, so none is more wholesome. Dr. Lind observes, that "the negroes in the torrid zone commonly mix the most stimulating, poignant sauces with their ordi­nary light food, and this is experimentally found suitable to their constitutions." In using fruit the following cautions should be observed. It should be thoroughly ripe, and taken only in moderation, and baked or stewed rather than raw. A total abstinence, for some time after recovering from fevers, would be best for convalescents. Watermelons are not only innocent but useful. They may safely be taken in many fevers, and under qualified circumstances, tend to prevent the diseases usually prevalent when they are in season. Water is Nature's diluent. It is the only drink that can be safely taken at all times and by all persons; but, nevertheless, men in every age and country, and in every state of society, have sought for something that was more stimulant. Of all the additions made to water for that purpose, rum is the most pernicious. It contains no nourish­ment, but like a slow poison insensibly undermines the springs of life. As mankind will not content themselves with nature's beverage, it is the duty [Page 23]of physicians to direct them to such subtitutes as bring the greatest benefits with the least injury. Of this class are liquors which are prepared by fermentation, and also those which are expressed from vegetables. Of the drinks used among us, none are equal to porter and wine for preventing fevers. The former, by its bitterness, strengthens the stomach, while it proves highly nutritious, and at the same time moderately evacuant. Obstinate vomitings are sometimes cured by it, more effectu­ally than by the most celebrated officinal compo­sitions. Within ten years past, in which the inha­bitants of this city have generally exchanged punch for porter, they have grown much more healthy. Complaints of the bowels have sensibly lessened. Physicians are not now called upon to attend one patient with the dry belly-ache for every ten they formerly visited. Punch, when weak and taken in moderation, and no oftener than occasionally, is salutary and refreshing, but by no means suits for common drink. The same observation holds good with respect to cyder. Mineral acids, diluted with water, correct bile, and resist our summer diseases; but this cannot be affirmed of drinks prepared with limes and such like vegetable acids when freely and frequently taken. These re­marks, though generally well founded, admit of exceptions.

The temperate use of good sound wine is one of the most effectual, as well as one of the pleasantest, antidotes to fevers. It is highly antiseptic, and both prevents and cures putrid diseases. It is [Page 24]much more worthy of the appellation of a cordial, than any of the boasted officinal compositions, which are called by that name. Different consti­tutions require different wines, but in general old Madeira agrees best with the inhabitants of Caro­lina. All physicians know, that in low fevers a liberal use of wine is an essential part of the cure. In order to get the full benefit of this most desi­rable preventive of our summer diseases, it should not be drank every day. If it was laid aside in the winter and spring, and resumed on the approach of summer, and continued in daily use, only for three or four months, its efficacy in preventing summer and autumnal diseases would be greatly increased. The person who, with the above limi­tations, drinks from half a pint to a pint of wine every twenty-four hours cannot, in this climate, be justly deemed intemperate.

The daily use of strong warm teas is pernicious. Many respectable medical authorities might be produced, which concur in representing East-India tea as unfriendly to the nerves. Be this as it may, all must acknowledge, that the warm water, which is used as its vehicle, must be unsuitable to this climate.

Cheerfulness is of particular service in preserving health. Many of our diseases flow from bile, and fretfulness never fails to cause an increased flux of that acrid humor into the stomach. Those who watch their own feelings may observe, that when any wayward event breaks in on the peace of their minds, a bitter taste is immediately felt. This [Page 25]proceeds from an overflowing of bile. Bilious persons are for the most part peevish, and peevish persons are for the most part bilious. Bile and fretfulness seem to be reciprocally cause and effect, and both predispose to dangerous disorders. The eyes are sometimes observed to turn suddenly yel­low, in a gust of passion. They who are blessed with a constant, equable flow of cheerful spirits, are exempted from one of the occasional causes of fevers: On the other hand, such as give way to peevishness, or to the depressing passions, are par­ticularly exposed to the diseases, which a low, moist country is apt to produce.

In particular habits, the daily use of jesuit's bark, from July till October, is adviseable. Three doses of it, combined with a little rhubarb if necessary, taken in substance, every day or every other day, where ordinary precautions are taken, may in ge­neral be relied upon as an effectual antidote to the summer and autumnal fevers of this country.

Throughout the summer and the first month of the autumn, fires are more useful in damp days, than in the dry cold weather of winter. They correct the excessive moisture of the atmosphere, and counteract the exciting causes of the complaints most usual in the before mentioned seasons.

In the construction of our houses, we sacrifice health to profit and convenience, by digging cellars underneath them. The walls at their sides, and covers to their bottoms, lessen the evils that might otherwise result from them, but it would be better if there was not a cellar in the city. The [Page 26]evils arising from this source are of such a magni­tude, as to need the interposition of the city coun­cil. A law to compel all the inhabitants to pump the water out of their cellars, as soon as it begins to stagnate, would be salutary. It must have frequently occurred to every attentive observer, that, in wet seasons, the cellars in the low part of this city emit such putrid exhalations, as are sensibly offensive even to passengers. They who live over such cellars, or in the vicinity of them, must, therefore, be particularly exposed to diseases, and when sick, are with difficulty cured, unless they remove to a purer atmosphere.

The practice of planting trees before the doors of dwelling houses, is recommended by sound medical reasoning It has been demonstrated, that trees absorb unhealthy air, and discharge it in a highly purified state, in the form of what modern chymists call dephlogisticated air. It is only to be lamented, that the custom is not universal, and that some uniformity is not observed in the disposition of these beneficial ornaments. Should the present city council make effectual arrangements for plant­ing magnolias, or such like trees, every twelve or fifteen feet, on each side of our streets, through their whole length, they would merit the thanks of the rising generation.

Whether paving the streets of Charleston would conduce to the health of the inhabitants, has been doubted by many. It might add to the heat of the air, but would lessen its morbid qualities, by repressing exhalations. As dry heat alone is a [Page 27]much less evil than heat, moisture and miasmata combined, it is probable, that the inhabitants would be gainers, on balancing the advantages against the disadvantages that would result from paving the streets of this city.

In constructing our city houses, we should en­deavor to make them, especially on their north, south and west sides, as open as possible to favor the circulation of fresh air. A man in health pol­lutes a gallon of air in a minute, to such a degree, as to render it unfit for the purposes of life. The danger of breathing confined, unventilated air, must be therefore self-evident. On these principles, the use of curtains, other than those for excluding musquitoes, may be advantageously dispensed with. They seldom or never do any good, and by con­fining and heating the air often do harm.

The late practice of adding an attic story to low houses, is not only ornamental but beneficial. It increases the chances for health The higher we ascend into the atmosphere, the cooler it is, and the farther are we removed from those poisonous exha­lations which, though they rise from the earth and stagnant waters, seldom or never ascend to any considerable height. It is on these accounts pru­dent to sleep in the highest apartments of our houses, unless where their low pitch and converging sides make them warmer than those which are on the lower floors.

Wooden houses are most suitable to this cli­mate. They are much drier, and consequently healthier, than those which are built with brick. [Page 28]The latter absorb and retain, for a long time, much of that moisture with which our atmosphere abounds. The speedy rotting of paper on back walls proves their dampness. This is particularly the case, when some of their sides are inaccessible to the sun. In such situations they are seldom, for any considerable length of time, thoroughly dry. On this account, such of the inhabitants of this city as are troubled with rheumatic pains, coughs and complaints of the breast, should not live on that part of the Bay which is between its southern extremity and Broad street. The houses there are mostly built with brick, and are so closely con­nected together, that two, and often three of their sides are, for the greatest part of the day, sheltered from the direct rays of the sun Moisture there predominates, and, in conjunction with easterly winds, is very unfavorable to children and such as have weak lungs. Brick houses would be much drier than they usually are, if a vacancy was left between the walls and the plastering on their in­sides. This might easily be done by means of studs projecting but a few inches from the walls.

The position of our country houses, with respect to swamps, ought to be attended to; for the sum­mer winds, sweeping along their surface, waft destruction to the inhabitants. In general, the planters would do well to encourage the growing of trees, between their houses and the neighboring swamps; and to construct their houses so as to have neither-doors nor windows fronting on marshy ground; but as this cannot always be done, they [Page 29]should build on the south sides of their rice fields and other waters. The winds in the summer months are for the most part southerly. To be under a necessity of breathing air, saturated with the noxious effluvia acquired in passing over stag­nant waters, must be highly injurious. Indeed if health was, as it ought to be, preferred to riches, the planters would build their dwelling houses at a distance from the rivers. The inhabitants of a house in the pine barren has a much better chance for health, than he whose mansion is erected in the neighbourhood of any body of water, either stag­nant or running. Health and wealth seem to be at variance. The same qualities of the soil which make it fruitful, make it also unwholsome, while the dry surface of pine barren presents compara­tively a pure and wholsome air. Besides, the resin of the pine trees in itself contributes to the salubrity of the atmosphere. It is an old and well authen­ticated observation, that persons whether white or black, employed in burning tar-kilns, are always healthy. The method practised by Indians and negroes of living in smoke, is conducive to health; but the inconvenience of such a situation will for­ever operate against its being introduced into common use among our citizens; but, nevertheless, some considerable analogous benefit, with little expence or inconvenience, might be procured to those who reside in the country, from fires kindled round or near their houses. These will be more necessary when the wind is easterly, and more beneficial if made with resinous pine-wood.

[Page 30]On these principles, there is no difficulty in ac­counting why Charleston is more healthy than the neighboring parishes. It has long been observed in low countries, that they who reside in towns, are more healthy than those who live dispersed in the country, and that the inhabitants of the central parts of towns are healthier than those who live in their extremities. The fire and smoke from several hundred contiguous kitchens cannot fail of dimi­nishing the moistness of the atmosphere. The frequent ringing of bells, the flowing of the tides, the motion of carriages and of persons, occasions a brisker circulation of air in this city, than in the adjacent country. The policy of removing, on the approach of summer, from the country to Charleston, is therefore wise. The proper time for making this change varies in different years. In general it may be observed, that it should be early, if a wet spring is followed by a dry summer. While successive rains keep the waters in motion, the danger is little; but when warm and dry wea­ther continues for some time after heavy rains have fallen, fevers will probably soon begin to rage.

Strangers who propose to reside in this country, and our own citizens who have been long absent, when intending to return, should make a point of arriving here about the month of November. They would then have at least half a year to be assimi­lated to the climate, before their health would be endangered by any thing peculiar to it. The sudden deaths among us of persons disused to our country, are to be referred to an injudicious choice [Page 31]of time for coming to it, and still more to their own imprudence, combined with the hospitality of the inhabitants. To be invited almost daily to the plentiful tables of their friends and acquaint­ances, is the misfortune of such persons A fever, rapid in its progress, and fatal in its issue, is fre­quently the consequence. Strangers coming into this country should be doubly on their guard, but instead thereof they too often suffer themselves to be feasted into fevers, and not unfrequently out of their lives.

On a review of the whole subject, it may be observed, that instead of saying, "this capital is more sickly than the other maritime towns of the United States," it ought only to be said, "that more care is necessary on the part of its inhabitants for the preservation of their health." By proper attention to our children, and espe­cially by steady, discreet management of mo­thers, much of the mortality of infants might be prevented, and a new generation be reared, which would be much hardier and better adapted to the climate than many of the present. In fami­lies where children have been properly brought up, many of both sexes have as good constitutions as are enjoyed by those who live in more northern latitudes. The honors of old age are often attained by our citizens. Indeed the chance of life to a person who is above sixty years old, is considerably in favor of the inhabitants of warm countries. It must be acknowledged, that the variableneness and sudden changes of our atmosphere make caution [Page 32]indispensable; but this as enforcing the necessity of a sober, orderly life, ought to be esteemed an advantage. None of the blessings of this world can be attained without care. It is, therefore, unreasonable to look for health on easier terms. Much attention is necessary to preserve, even a good estate, from running to waste. The same is requisite for guarding a sound constitution against diseases. As well may the planter, who rarely visits his plantation, expect a good crop, as the man who lives at random, look for the continued en­joyment of health Such as are for a short life and a merry one, must abide by the consequences of their choice. But they who conduct with prudence, and have self-denial to abstain from such practices as experience may have proved to be hurtful, and steadiness to follow what by the same unerring rule they have found to be salutary, may live as health­ily, and as long in this city, as in any part of the world.