obnoxious to depravation than this Pneumonic machine of the breast The organs of breathing being hurt the breathing is hurt also through which by sucking in air we preserve the vital flame of the blood with its motion and heat For whereas the vessels of the lungs belong to the function of breathing viz. the Trachea with the Bronchii and little bladders also the heart with arteries and veins besides which there are nerves with fibres as well musculous as nervous Lympheducts and Glandules also the contents of these Vessels viz. Air the old and fresh blood with its Serum the Lympha and the animal Spirits any fault happening in any of these doth oftentimes discompose the whole Pneumonic function Nor less also the moving Organs of the breast viz. the muscles with the Diaphragma and the nerves appointed to their use And likewise sometimes the animal spirits before they enter into those nerves being ill disposed often cause great disorders in breathing When the chief function and uses of the Lungs have been to convey the blood and air through the whole frames of the parts and their inmost recesses The uses and ends of breathing which use to be hurt and every their smallest passages and every where to mingle them namely for that purpose that the venal blood returning from its circuit and diluted with fresh juice and thereby crude and as it were half extinct may as well be more perfectly mix'd and wrought together as more effectually kindled afresh in all its parts by the nitrous air from hence the chief faults about this business or function of the Lungs do most of all consist in these two things First that the blood hath not due passage through the Sinus of the heart and the pneumonic vessels And secondly because the Air is not drawn in and breathed out in a due manner into the Trachea and its passages The defects and failings of the Lung in its office There are two parts of either of these For first as to the passage of the blood sometimes the fault is caus'd within the right Sinus of the heart or the pneumonic Arteries and also sometimes caused within the pulmonary veins or the left Ventricle of the heart Secondly as to the Air the failure is chiefly in inspiring and exspiring although each function offends sometimes equally There are divers accidents of each and many causes and ways of its being done whereof we will here briefly touch upon the chief Therefore first First in respect of the blood when the blood doth not duly pass through the right Ventricle of the Heart and the Pneumonic Arteries either it happens by its own fault or by the fault of those passages and sometimes by the fault of further passages For sometimes the stream of blood stops in the nether region of the Pracordia by reason of obstruction in the other moreover sometimes the defect or fault of the air breathed in stops the free passage of the blood What relates to that fault of the blood The opinion of the famous Sylvius concerning the blood fermenting in the Lungs when it passes not quick enough through the right Sinus of the Heart and Pneumonic Arteries the opinion of the Renowned Sylvius should here be discoursed but that it would be too tedious and from our purpose For he supposes The descending branch of the venal blood moistned with chyme together with the lymphatic humour returning from the whole body hath the nature of an acid-sweet spirit and in the mean time its branch ascending impregnated with choler from the bladder of the gaul mixt into the mass of blood does participate of an oily volatile salt and so by the meeting together of these something contrary to themselves a gentle and friendly contention or boiling is stirred up in the right ventricle of the heart in which and for which the fiery parts lurking and being shut up in each being freed and set at liberty do rarifie the chyle and blood and so change and alter them that they exercise the function of life and heat as well as motion and nourishment through the whole body Which seems not likely to be true There are many reasons why I assent not to this ingenious and neatly-framed Hypothesis For besides that many do far otherwise determine about the origine and dispensation of Choler and so not without strong reasons and experiments are thorowly perswaded by eye-sight that there is not any such boiling up of the blood of a different quality and striving or contending in the right ventricle of the Heart Our opinion hereof Our judgment continues still as it hath been that both streams of blood washed thorowly with the fresh chyme do consist altogether of one kind and for that cause the milky Vessels of the Chest carry about part of the Chyle so long a journey which they pour into the descending trunk of the Vena cava just as the meseraick Veins pour the other part into its ascending trunk also that the lymphatic humor together with the Chyle is poured into the subclavian Vessels so that it may very commodiously be reduced into blood neither truly doth there seem need of other or more passages Moreover we determine that that humor rightly constituted doth agree with and is easily assimilated to the mass of blood as well as the Chyle it self made sweet without any contention raised in the heart But if the lymphatic humor returning from the Brain and nervous kind as well as from the Glandules degenerate from its due temperature and contract a sowreness as it often comes to pass then being re-infused into the venal blood it overcomes it and it precipitates it into serosities and from thence great streamings of urine do ensue Moreover we have shewed elsewhere that the Diabetes is provoked from such a cause But such a flux of the lymphatic humor is so far from exciting a greater boiling up of the blood in the right ventricle of the Heart that rather on the contrary from thence often chilness of the whole or stiffness with a weak Pulse and sometimes swoonings or convulsive fits are provoked accompanied with a plentiful and pale urine The reason whereof without doubt is that then the clear humor flowing from the brain and nervous parts turns the blood into serosities and cools it by too much diluting and for that cause the animal spirits being destitute of their vehicle either faint or run into irregular motions But truly as we altogether deny an Elastic effervescence of the blood in the right Ventricle of the Heart from contention of dissimilar parts The pneumonic circulation of the blood is stopt sometimes by the fault of the heart it self so as often as from thence the blood is not cast out into the Lungs after a due manner we determine it to happen not so much from the proper fault and defect of the blood it self as from the animal faculty For if the spirits actuating the moving Fibres of
cholerick and inclining to the Jaundice to void yellow and sometimes very bitter as if it had been meet choler 3. The blood dissolved also lodges in the Lungs infections that cause corruption Moreover many instances manifestly declare that sometimes the Lungs are tainted by the corruption and putrefaction of the blood For the blood toucht with an infection or a pestilent or venemous contagion begins to be corrupted and withdraw into clotted and corrupted portions from thence the Lungs undergo the chief taint from whence the greatest danger of life is threatned This is too well known in the Measles small Pox Plague and malignant Feavers for me now to undertake to explicate it by which maladies as often as the sick die it seems to come to pass either because the blood clodding in the vessels of the Heart or Lungs obstructs the way of its proper course so that presently its influx into the Brain is hindred or because the corruption of the blood affixt to the sides of the pulmonary passages causes a Phlegmon as it were and therefore provokes a most troublesom cough or difficult breathing and frequently bloody spittle So much for the impediments of the circulation of the blood which happen in the Lungs by reason of the mass of blood too much dissolved The blood is hindred in the Lungs by reason of the too thick consistence of the blood and apt to depart into parts and portions which being there left obstruct their passages There remain other no less prejudices to the Pracordia which proceed from the consistence of the blood too much bound up together and sending nothing from it self by which a burning Feaver Pleurisie or Peripneumony arise In the former distemper the blood being more sulphureous than it ought and therewithal being thick As is perceived in a Feaver is not diluted enough with its Serum and those particles of it contained within it self it puts away with great difficulty wherefore it is more plentifully kindled in the Lungs and when it passes through the passages hereof with more difficulty by reason of its greater boiling and of its thickness the Heart beating quick and most vehemently endeavours its circumpulsion with all its might notwithstanding from its greater flame growing hot within the Pracordia heat and a most troublesom thirst with roughness and as it were a certain parching of the tongue arises In the other kind of distemper In a Pleurisie and Peripneumony viz. a Pleurifie and Peripneumony the blood is alike thick but less sulphureous and inflammable wherefore it doth not participate of such a burning yet by reason of its thickness it doth not so easily and quickly pass through the Chest or Lungs is frequently extravasated and sticking to the interspaces or sides of the passages causes obstructions and soon after an inflammation to which pain often succeeds with bloody or discoloured spittle We may observe in blood-letting in these kinds of distempers that after it hath setled its superficies is covered with a little whitish skin or otherwise discoloured but always with a thick and viscous the reason whereof is that the blood when it doth not send away in the circulation its old particles nor doth admit enough of new it is thickned with a continual boiling and like boiled flesh changed from a bloody colour into a whitish in which state passing with difficulty through the small passages of the vessels it is in danger to be extravasated and easily provokes a Pleurisie or Peripneumony Besides these stoppages of the blood The blood is hindred in the Lungs by the fault of the heart caused by its own fault while it passes through the Praecordium there are also other impediments which happen either by the defect of the Heart or its passages or by the fault of the air inspired By what means and for what cause the Heart offending in its motion forces the blood from its right ventricle through the Lungs into the left irregularly we have clearly shewn in our late Tract of Cardiac Distempers to wit that muscle sometimes labouring for want of spirits doth not vigorously and strongly enough perform its beatings 1. When the spirits thereof are wanting For when in corporal exercise the blood more plentifully than usual is forced from the Vena cava into the ventricle of the Heart if this cannot firmly contract it self labouring according to its strength it causes frequent and weak Pulses moreover to help this as well the Pneumonic Arteries as others in fundry parts of the body which drive about the blood every way do cause frequent and inordinate contraction Thus I have observed in Virgins afflicted with the Green-sickness and in other cachectical bodies from a quick motion of the body not only a palpitation of the Heart but in the neck temples and other places the Arteries to have beaten irregularly Neither is it the want of spirits only 2. Because moved inordinately but their disorder is sometimes the cause that the Praecordium doth with less strength convey the blood for sometimes the spirits the inmates of the Cardiacal nerves being stirred up by an incongruous conjunction and affected convulsively do impress their irregular contractions upon the Heart or Arteries whereby the progress of the blood is several ways perverted or hindred as it often happens in Palpitation of the Heart Trembling intermitting Pulse and other the like passions 3. The pneumonic process of blood is variously stopt 3. The blood is hindred from obstruction of the passages Which are shut up divers ways For divers causes here rehearsed because the passages are not open enough which impediments happen as often as the Pores or those passages are either stopt or broken Of the former there are two reasons viz. sometimes the ways are shut for as much as the passages of the vessels contracted by the carneous fibres are brought nearer one another as we have elsewhere shewed doth sometimes happen in Palpitation of the Heart and a convulsive Asthma The affects of which sort by reason of the stream of blood shut within the Praecordia difficult or hard breathing a small Pulse and chilness of the whole body are wont to accompany Moreover sometimes the course of the blood is shut up because the passages of the vessels are pressed together by a body or by some humor from without wherefore when the little Cells or bronchial Pipes as is usual are filled with a viscous flegm purulent matter or blood extravasated as the free passage of the air is hindred in them so also the passage of blood is stopt in the vessels adjoining On the same account come tumors little swellings worms also stony sandy and curdly concretions and others of another kind are in diverse manners excited the chief whereof we shall touch on hereafter The bronchial Pipes are filled Moreover we sometimes see the canals as well of an Artery as of the pneumonic Vein made very bony in some part and their sides so compressed
of a defect of fault in the motive organs or mixt when either parts conspire in the fault which origine every great and inveterate Asthma is wont to have of each of these we will treat in order 1. The ancient Physicians The Ancients allowed the cause of it only from the Bronchia obstructed and for the most part hitherto the Moderns have only acknowledged the first kind of Asthma judging the next cause and almost the only cause of this Disease to be the straitness of the Bronchis viz. inasmuch as the spaces of those passages being either straitned together by obstruction or compression as often as the use of breathing is required do not admit of plenty enough of Aire wherefore for the more free inspiration of aire as shall be needfull the organs of breathing do most difficultly labour with throes most frequently repeated But that some are found obnoxious to fits of an Asthma Or vapours from the Spleen or Womb but erroneously without manifest taint of the Lungs it was wont to be ascribed to vapours from the Spleen Womb Mesentery or some other bowel undeservedly enough but surely that passion without the straitness of the Bronchia or fault of those bowels we have in another place sufficiently evidenced to arise from Cramps of the moving parts and shall be presently clearly made out But in the mean time by what means it may arise also from the passages of the Trachea obstructed or compressed it lyes upon me to declare The straitness of the Bronchia After what manner the straitness of the Bronchis arises inducing the first kind of an Asthma is supposed to come to pass by an obstruction as often as either thick humours and viscous or purulent matter or blood extravasated are forced in upon them or that little swellings or Schirrus's or little Stones stop up their passages or finally that a Catarrh of a serous humour suddenly distills upon them Moreover the same distemper is thought to be raised by compression as often as matter of that kind and of every kind of them shall cleave to the passages of the pneumonic Arterie or vein Surely an asthmatical disposition depends upon these various causes and manners of disturbance but all invasions of the disease or at least the greater fits are usually provoked by reason of some accidents or occasions For while the stream of blood sliding and running down gently can be content with a small breathing it passes through the precordia without great labour either of Lungs or Breast But being boyling and passing through the Lungs more impetuously it requires a more full inspiration of aire for the freer admittance of this through strait passages presently all the breathing organs are alarmed into most frequent throes Whatever causes an effervescence of the blood is the evident cause of an Asthma Whatsoever therefore makes the blood to boyl or raises it into an effervescence as violent motion of the body or minde excess of extern cold or heat the drinking of Wine Venery yea sometimes mere heat of the Bed doth cause asthmatical assaults to such as are predisposed It is usual that those who are obnoxious to this disease oftentimes dare not enter into a Bed only sleep in a Chair or on a bed being covered with garments The reason whereof is Why Asthmatical Persons are worse in bed that the body covered and heated with bed-cloaths the blood being a little raised into a more quick motion and grown hot requires a more plentifull sucking in of air than may be supplyed from the passages of the Trachea being straitned for the more blood passes the Lungs each Systole and Diastole by so much for the enkindling and eventilation thereof the air ought to be more plentifully and quickly brought in and sent forth to which task when by reason of impediments it is not easily dispatched yet in some manner to be performed the ultimate endeavors of all the parts appointed for breathing are made use of with a great contention of the whole breast Moreover the blood being stirr'd is not only an occasion but also in some part a cause in those that are asthmatically predisposed for the vessels bringing blood being thereby more fill'd and distended within the lungs compress the Tracheal passages being already very strait and render them much more close II. A convulsive Asthma which we judged to be the second kind of this disease A convulsive Asthma and to be raised without any great obstruction or compression of the Bronchia from the mere Cramps of the moving fibres is not limited to one place or to any peculiar organ but being of a diffused energy it is extended to almost all the parts employed in breathing whereof one while this another while that or some other is in fault It s Seat manifold and diffused For a convulsive affection inciting an Asthmatical invasion hath regard to the moving fibres of the vessels of the Lungs to the Diaphragma to the muscles of the breast to the Nerves which belong unto the Breast or Lungs nay to the origine of those Nerves planted within the Brain and whilest the morbisic matter dwells in every of these places hindering or perverting the work or breathing it brings on the fits of this Disease as in another Tract we have somewhile since plainly demonstrated For the animal Spirits destin'd to the function of breathing if at any time they are very much molested and constrained into irregular motions enter inordinately into the fibres as well nervous as moving of the organs of breathing and make them for that cause one while to be contracted another while to be distended irregularly as also their solemn and equal turns of Systole and Diastole to be variously disturbed or hindered The morbific cause or matter provlking the Spirits prepared for the pneumonic work as in divers places so chiefly in these three The morbific matter consists in several places is wont to advance its force or power viz. 1. Either in the muscular fibres themselves or 2. In the branches or nervous slips or lastly within the Brain by the origine of the Nerves 1. As to the former 1. In the muscular fibres the heterogene matter being inimical to the Spirits is sometimes shaken off from the Brain into the trunks of the Nerves and from thence by their passages and slips if perhaps it shall be in very little quantity without very great or sensible hurt slides down to their lower ends And when it falls in the nervous fibres and being heaped up daily shall at length sensibly increase unto a great quantity it begins to trouble the inmate Spirits and to provoke them into asthmatical Convulsions which forthwith infest and are encreased by reason of evident causes neither do they utterly cease untill the stock of matter so accumulated be wholly dispers'd and consumed afterwards when it being renewed arises to a fulness the fits of that disease return and are for that cause
to wit Curatory Vital and Preservatory the two former respect immediately the symptom to be stopt as often as it shall be urgent and the last is busie about removing the Cause of the Disease that so the assaults of the Hemorrnage may be small or not at all Besides an Hemorrhage ought to be handled one way without a Feaver and after a different manner if pressed with a Feaver Therefore whensoever without a feaver much blood shall flow out of the Nose The Curatory Indication suggests three intentions of healing presently as there shall be need of stopping Remedies there will be three chief intentions of Curing all being together assumed into practice viz. Let the turgescency of blood be bridled that it may be less disposed into inordinate tendencies Moreover in like manner let it be endeavoured that as well its fluxion being withdrawn from the Nostrils may be diverted to another place as that the mouths of the Vessels gaping within the Nostrils be shut for which purpose Remedies as well external as internal very many and of diverse kinds are wont to be exhibited of the former we will entreat in order briefly First therefore let the Patient be quiet plac'd with his head upright Outward remedies to stop the flux of blood then let many of the Joints of his Arms and Thighs but not all be bound with strait Ligatures which ought now and then to be loosened and removed to other parts for all being bound together and long by reason of the blood being held in the outward parts 1. Ligatures and too much detained from the heart hath caused most dreadful swoundings but otherwise this Remedy being prudently administred frequently helps For when the blood by this means running into the members by the Arteries is stopt that it presently returns not by the veins it s more impetuous spreading it self into the head is impeded Moreover by the painfull Ligatures of the Joints the muscular Fibres of the Carotides Arteries are preserved from Cramps which oftentimes come upon them Secondly For diverting the tendency of blood from the Nostrils 2. Bleeding it is sometimes expedient to breath a Vein in the Arm or in the Foot For by how much more blood is carryed by the Arteries to the vein cut by so much less will the afflux be towards the Nostrils Yet this administration does not always so help but sometimes a contrary effect thereof happens as we have already observed in spitting blood The reason whereof is that the vessels being suddenly and not sufficiently emptyed suck up again the disagreeable humours formerly ejected and stagnating within the pores whereby the blood incontinently is stirred up into a greater eruptive turgescency Thirdly Cold things applyed to the Forehead and Temples 3. Application of cold things also to the Nape of the Neck where the vertebral Arteries ascend cause the vessels to be bound together and the flux of blood to be somewhat stopt or repelled Notwithstanding it is ill which some advise that cooling Topicks be applyed to the Jugular Veins for so the blood being retarded in its recourse flows the more plentifully out of the Nostrils Moreover what is usual to apply linty Cloaths or a Spunge moistened with Vinegar to the Pubes and Testicles helps by no other means than the ligature of the members to wit inasmuch as the flowing back of the venous Blood is impeded A sudden and unexpected sprinkling of cold water on the face frequently stops an Haemorrhage inasmuch as it gives an impression of terror Fourthly Cupping-glasses applyed upon the Hypochondres Flanches 4. Cupping-glasses inner part of the Thighs and the soles of the feet are accounted a famous remedy as well with the ancient as with modern Physitians for diverting a tendency of the blood from the Nostrils And the reason is plain viz. because a Cupping-glass being put on the impulse of air being prohibited by the space of the orifice and encreased every where about presently the blood and humours yea and vapours and solid parts being call'd from any other tendency are driven towards the empty space of the Glass Fifthly 5. Frictions Rubbing of the extream parts are commended in this distemper by some Practitioners which we judge not always useful nay scarce safe because although they solicit a greater appulse of the blood to the feet or hands yet they so hasten the return thereof that the whole mass of blood being raised into an effervescence it hazards a more violent tendency towards the Nostrils Sixthly Zacutus Lusitanus among his revulsory Remedies 6. Cauteries propounds an actual Cautery to be applyed to the sole of either foot and Crato the bending the little finger of the same side which because done with no trouble we may try but we advise not so of the former unless the way of helping were more certain which might compensate the pain and lameness that would ensue thereon Seventhly Swounding raised by any means presently stops an Haemorrhage 7. Faintings however contumacious it be wherefore when such bleeding persons are taken out of their beds or when they do timorously admit of Phlebotomie though but sparingly or have their members bound for a longer time or are suddenly affrighted with some feigned rumour or by some other occasion fall into a swouning or fainting of the spirits the flux of blood ceases thereon presently The reason whereof is evident enough for that as soon as the motion of the heart fails presently the blood and spirits rush thither and so every outward flux is stopt on a sudden and what was immoderate before doth not again return Eighthly Remedies by Sympathy and Antipathy In the last place for repressing the flux of blood from the Nostrils Remedies ought to be recited which are said to operate after an occult manner by Sympathy or Antipathy 1. Sympathetick powder 2. Young Ashwood of which sort first is the sympathetick powder made of Roman Vitriol calcin'd to a whiteness by the Summer Sun also a piece of wood cut from a young Ash first sprouting about the time the Sun enters Taurus the efficacy of which remedy in the late Civil Wars many worthy of credit attest to have been approved for stopping the Hemorrhages of wounded Souldiers Yea some still with much confidence prescribe it in all eruptions of blood I confess the reasons of effects of this kind are concealed from me if so be they happen often Besides it seems not a less Empirical and irrational Remedy that a silk Bag with a dry Toad in it 3. A dry Toad worn on the pit of the Stomach stops any kind of Hemorrhage and prevents its return unless according to the Aetiology of Helmontius that the application terrifying the Archaus compells the blood being astonish'd either to go back or desist from its inordinate excursion There remain very many famous Medicines whose Operations are wont to be referred to hidden Causes and secret vertue 4. A Blood-stone 5. Mosse as
hath been very necessary to the uses of the Lungs for seeing the air ought only to enter the Lungs for that end The use of the aforesaid frame that it might pour out to the blood nitrous particles for its flame and vitality or life and presently return back and seeing the blood doth pass through the Lungs for that cause that it might meet the air suckt in according to all its parts therefore it behoves that both these viz. the air and the blood be divided into small portions and with these make every where distinct and short meetings The manner of this is most elegantly perceived in the gills of fishes for seeing the Bronchia are as so many greater Lobes every one of these is divided into many rundles furnished with a complication of every kind of Vessels as if it were into so many Lobes in every one of which the blood is drawn out by minute portions as it were little rivulets that it might throughly meet with the nitrous particles and afterwards return into its chanel The Bronchial Pipes lead into the utter cavities The uses of the little bladdery Cells viz. into the numerous little Bladders discovered by Malpighius which truly are certain continued parts of the Aspera Arteria but distinct from the former because the Grisles are wholly wanting to them and which supply the turn of these are distant one from another in larger spaces for all the Bronchial branches send forth lesser slips from themselves every way whose passages although void of Grisles notwithstanding are straitned as it were with certain ligaments at certain intervals and the spaces between these being filled with air suckt in do make partly those small bladdery little Cells In truth those passages may not unaptly be compared to the Gut Colon of a Mouse whose continued hollowness in as much as it is girt about in divers places seems to be divided as it were into many little purses Moreover those bladdery passages being shorter on either side the Sinus or hollowness have as it were particular little Bladders growing thick to them and therefore the heap of all the Cells seems not much unlike to a bunch of Grapes The Figures of these as much as may be are exactly represented in the third Table Those little bladdery Cells that they may put forth their contracting endeavours for breathing have muscular Fibres as is plainly seen by the Microscope For as much as great plenty of air ought to be drawn within the Lungs and reserved in part lest it fail at any time therefore besides those upper passages which are as it were the threshold and dens moreover more inner chambers and capacious are required in which the air may be treasured up and from thence be dispensed upon occasion For it sometimes happens the external is too sharp or otherwise disagreeable to the Lungs so that as it was greatly necessary that it should be suckt in more sparingly and its vehemence presently be attempered and rebated by the air treasured within Moreover it cannot be drawn in or inspired otherwhile in quantity great enough as in running singing or much speaking also in some crazy dispositions and in that case the inward air being rarified supplies in a manner the defect of the outward Therefore seeing those bladdery little Cells receive a greater stock of air than that they can be bound presently to return it all by every turn of expiration Endued only with Muscular Fibres therefore the grisly twigs are wanting to them and their hollownesses are more large of themselves that they may be more largely distended but that they may puff out a greater quantity of air upon occasion or throw out matter to be coughed out being endued with muscular Fibres they contract themselves more narrowly and throw out what is contained within them thoroughly For the ordinary Systole's of the Breast which the relaxation of the Muscles do partly effect cast out perhaps at every turn the whole air from the Trachea and Bronchus but not from the little Bladders for the emptying of these as often as need shall be both the cavity of the whole Breast is very much straitned and the small bladdery Cells themselves are straitned from their proper Fibres being drawn together 2. The description and use of the Pneumonic Artery The next Vessel is the Pneumonic Artery of whose most thick branches extended every where to and fro and with other branches twisted and complicated together the frame of the Lungs consists This Artery issuing from the right Sinus of the Heart and inclining towards the Trachea is parted into a right and left branch which applying themselves to the like parallel branches of the Trachea do accompany them every where or rather are set under them for they are planted beneath and are first carried into the greater lobes of the Lungs and afterwards into all the lesser lobes in every of which the little branch of the Artery stretched out sends out on either side more slips from it self which presently are associated by other bronchial and venal slips and are several ways complicated and where the outmost sprigs of the Aspera Arteria depart into circular little Cells the Arteries being complicated with the Veins as is discovered by the Microscope do girt about those little Bladders with their thick branching and enwrap them like Ivy from whence we may conjecture that it is not for nothing that the Blood-vessels that are any where in the Lungs do curiously wait upon those of the air and every where insinuate and intimately mingle themselves Surely whatsoever hath been supposed by others I shall not easily believe that this is done for the more exact mingling of the Blood and its parts be they never so unlike For to do that what need would there be of so full an access of air which in rightly making other mixtures the more perfect whereof are called Digestions we seek as much as we can to keep out For if the air might freely come and go the Particles that should be mixed would most of them flye away And as to that which is affirmed That the Blood in the Lungs is carried through those small winding and extreme narrow passages only that it may be the better mixed I say that its being so carried is quite contrary to such an intention for the best mixture of any liquor as also of the Blood it self is made by fermentation and the liquour to be so mixed or fermented like Wine in a Hogshead requires a free and spacious room but it s going through these small and narrow passages like so many strainers serves rather for the separation than the mixture of its parts wherefore unless the Blood be exactly mixed in the greater Vessels and be there rightly fermented it does while it passes through the Lungs leave there the dregs and whatsoever parts are not rightly mixt and so does stuff up and very much obstruct their passages as we may see in persons
affected with the Green-sickness Cachexy and that sort of Dropsie called Leucophlegmatia who all have a difficulty of breathing by reason of dregs of the ill-mixt Blood that are left there Wherefore the use of the Lungs seems to be this That the Blood through the lesser Vessels as so many rivulets may as to all its parts lie open to and meet with the nitrous Particles of the Air and be by them enlivened and accended The Pneumonic Artery as also the Aorta and Wind-pipe hath a muscular Coat furnished with two ranks of Fibres namely straight and circular which doubtless when they are contracted do make the Pneumonic Arteries to beat and the Blood to be urged and driven still more and more forward A great many Glandules with a Net of Vessels lie on this musculous Coat The frame and branching of the Pnenmonic Artery in some one Lobe of the Lungs are expressed in the second Table All the Coats of this Vessel are drawn distinct and apart from one another in the sixth Table and first Figure and also in the fourth Table and second Figure The Pneumonic Vein having its rise in the left Ventricle of the Heart The description and use of the Pneumonic Vein and being divided and variously subdivided first into greater branches and then according to the greater and lesser Lobes of the Lungs into lesser and lastly into the least of all is carried above the Weazand and as it goes on does exactly answer to the branching both of the Pneumonic Artery and the Weazand and goes every where with them as it were cheek by joll and where the Weazand ends into the little Bladders the Veins being twisted with the Arteries as was said before do make as it were a little Net wherein those little Bladders are encompassed The Anatome of the Pneumonic Vein differs little or nothing from that of the Vena cava and its branches All the Vessels of this kind have four Coats distinct from one another 1. The outmost of these Coats consists of Fibres that seem to be nervous which perhaps are after a sort muscular and are extended straight long-wise though in no very regular order This Coat of the pulmonary Vein is very laxe and loose from the rest of the Vessel insomuch that it may all of it be blown up and very much extended as if it were a distinct Vessel Whence one might suspect that this were a peculiar passage to carry back Lympha or Serum separated from the Blood but it seems to be more probable that this outmost Coat is therefore made so loose that the passages might be much distended and widened for the return of the Blood now hot and boiling 2. 3. Two other Coats common both to a Vein and Artery viz. the vasculous The use of the venous and vasculous Coat and the glandulous lie under this the office of the vasculous is to bring nourishment to the part and of the glandulous to receive and send away the superfluous serosities 4. The fourth and inmost Coat is plainly muscular having Ring sibres The muscular Coat as the like Coat of an Artery hath which certainly being successively contracted after the stream of Blood do cause its return to be hastened and on occasion to be shortned But here arises a doubt wherefore Why there is no Pulse in the Veins seeing the Veins as well as Arteries have contracting muscular Fibres which in the latter are pulfifick and seeing both are alike joined to the Heart that beats continually the Veins as well as the Arteries should not statedly beat according to the constant turns of the Systole's and Diastole's in the Heart It may easily be answered to this first that the Arteries have a great deal more of the moving Fibres than the Veins have and therefore whereas those being strongly contracted successively do force the Blood along as if driven with a wedge for these it sufficeth that whilst they are gently contracted behind the stream of Blood they calmly and equally drive it forward flowing back again of its own accord and as it were down-hill But besides the reason hereof seems to depend somewhat on the unlike or rather inverted conformation of the Vessels for the Blood conveighed by the Arteries is driven still from wider to narrower spaces and therefore going along it every where violently distends them and lifting up the sides of the Vessels raises the Pulfe because whiles that part of the Artery that is behind the Blood is contracted by its muscular Fibres that part which is before it must needs beat being filled with the stream of blood gushing in but on the contrary the blood in the Veins returning to the Heart runs out of less into greater spaces or out of rivulets into a more capacious and deep chanel and therefore glides along silently and without the fluctuating of a Pulse The blood in the pulmonary Veins seems as much The disposition of the blood in the Pneumonic Veins or more than that within the Arteries to be animated or inflamed anew by the air insinuating it self every where from the Pipes or little Bladders of the Trachea because in those Veins 't is first changed from a black-purple to a scarlet the reason whereof is because the blood at the extremities of the Vessels namely as it passes out of the Arteries into the Veins does every where and most of all meet with the particles of the air And for that reason it is that if any liquour be squirted into the Pneumonic Artery it will not so readily and quickly pass through the Lungs and return by the Vein as it will do if you make the same experiment in any member or part of the body besides yea part of the liquor so injected will sweat through into the Pipes of the Trachea or the spaces between the little Lobes and another part being turned into a froth will return very slowly by the Veins which is a certain proof that while it passes through the Lungs it makes a stay in the mouths of the Vessels and is mingled with the airy particles The Circulation of the blood through the Lungs hath something diverse from or rather contrary to that which is made through the rest of the body seeing the Pneumonic Arteries contain a black-purple blood and the Veins a scarlet whereas in all the body besides the branches of the Aorta carry a scarlet blood and those of the Vena cava a black-purple Besides we may observe of the pulmonary Vein that it does every where in its whole length want valves except where 't is fastned to the Heart Which appears by this that when any liquor is injected into its trunk just as it is in the Artery it presently passes through all its branches without lett Which ought to be so to this end that the blood may always because of the violence of the passions freely every way fluctuate and regurgitate in and about the Heart Besides that the left Ventricle
of the Heart might never be overcharged with the blood impetuously rushing into it by the instinct of Nature the Fibres at the root of the Vein being contracted its course might be inverted and flow back The description of the Pneumonic Vein as to its utmost branching is in the fourth Table and third Figure To these three sorts of Vessels The Lymphaeducts added to the aforesaid Vessels wherein the air and the blood are conveighed the Lymphaeducts that carry forth a water are joined A power of these dispersed through the Lungs wait on the Arteries and Veins All the branches tending from the surface of the Lung towards its original unite into some greater trunks which being inserted into the Wind-pipe discharge thereinto the Lympha that is superfluous from the blood and nervous humour Indeed there is need of a great many of this sort of Vessels in the Lungs because seeing the blood is hottest of all here is hastily circulated and yet can exhale nothing to without by transpiration the Veins can hardly receive all the whole mass of blood from the Arteries and the Glandules contain not long what is deposited in them therefore there as need of Lymphaeducts as so many chanels whereby the superfluous humour might continually be sent off If these at any time happen to be obstructed or broken there often follows a Dropsie of the Lungs or Breast and sometimes Coughs and Phthisicks These lymphatick Vessels of the Lungs may very well be seen if in dissecting a live Dog you press the top of the Thoracick duct that nothing may be poured into the subclavian Vein for then the Lymphaeducts of the Lungs because they cannot discharge themselves into the common Receptacle now stopt and filled swell much and are very apparent If such a stoppage be made for some time in a Dog that hath eat and drunk largely a milky liquor will sweat into the Lungs out of the Thoracick duct the Valves being unlocked yea and the same liquor will pass through the Lymphaeducts placed far beneath the Reins and will render them strutted with that homour as if abounding with milk The rough delineation of the Lymphaeducts spreading themselves in the superficies of the lobe of a Lung is represented in the first Table 5. The last kind of Vessels belonging to the Lungs are the Nerves and their branches The nervous slips dispersed throughout the Lungs whereof there are many as we elsewhere intimated dispersed every where through the Lungs Heretofore doubting about the office of these we were induced to think the first force or at least instinct of breathing depended on these Nerves because otherwise we can hardly conceive after what manner the motion of the Lungs in breathing coughing laughing and other their actions should be always so exactly proportioned according to the several exigences of Nature For even as the blood doth more intensly or remisly heat and boil up within the Praecordia and as certain contents of the Trachea provoke the nervous Fibres we breathe either quicker or slower and oft-times though unwillingly we cough But besides there doth occur another and more necessary use of these Nerves for since it is manifest that the Coats of those Veins and of the Trachea are every where endued with muscular or moving Fibres by which they are contracted it is plain that the Pneumonic Nerves do convey as well plenty of spirits as inclinations of contraction to those Fibres And it is very probable from those Nerves convulsively distempered that the Palpitation of the Heart is often excited as also the Asthma and Chin cough We have some time since delivered the Anatomy or description of the Pneumonic Nerves in our Treatise of Nerves viz. pag. 311. so that there is here no need to repeat or inlarge The fivefold Vessels forementioned being mutual and many ways accompanied in their distribution as if divided into secret Groves with small bladders as in Trenches every where interwoven when they are complicated and variously woven together do constitute a fleshy web which is the very structure of the Lungs which moreover appears like a more solid Parenchyma in as much the Arteries and Veins being filled with blood are stufft up and the Vessels of the Trachea and Lymphaeducts being emptied of the air as well as water do fall together and seem to close We shall the less admire the fleshy fabrick of this Lung wove together out of meer Vessels and little Bladders if we consider the frame of the seminal Testicles to be nothing else than a heap composed of hollow filaments or spermatic Pipes woven together The description of the Nerves of the Lung and what relates to the bundle of Fibres whereof it is compact and to the spreading of its branches are described in the fifth Table The web of the Lung as above-said The Coats of the lungs whereof one is smooth and the other rough being weaved together of Vessels and little Bladders and divided according to their greater and lesser branchings into lobes and little lobes a Membrane wraps them about as a common covering Of this there are two Coats viz. one outer and fine which appears like a certain subtle texture or weaving together of nervous filaments as is apparent in most other Bowels the other more inward which is both rough and somewhat thick and consisting almost of meer ends of Vessels and little Bladders and by reason of the hollownesses every where caused from these its inward superficies resembles a Hive of Bees the forms of these are aptly enough described in the eighth Table This Membrane of two Coats blown up hath very many and large Pores insomuch that if Quick-silver be poured into the Trachial branch of one of the lesser lobes almost filling within the whole Membrane it will every where burst out from the Pores Both the arterial blood and the air beating in this Membrane as against a bank are reflected the former is brought back by the Veins into the left Venter of the Heart a certain watry part being sent away through the Lymphaeducts In the mean while the air is returned back by the same passages of the Trachea by which it flowed in For continually fresh air ought to be suckt in that it might supply nitrous Particles to the Blood to make room for which the other old air being now weak and useless must be first breathed out Because therefore both functions are to be performed within the same passages it is to be done by alternate turns first the one then the other While the air is drawn in the Lungs are blown up as if wind were forced into them and whilst the same is breathed out they fall down and are narrowly squeezed together for the benefit of excluding it and so after the manner of Bellows discharge constant changes of the Systole and Diastole Yet by what impulse and Organs it is accomplished is worth our labour here to consider Therefore upon the whole matter it is manifest by common
the Heart either grow weary or are forced into convulsive disorders for that cause the Heart beating in disorder drives out before it the blood either infirmly or irregularly But that the blood issuing out of the Heart doth not always with expedition pass through the Pneumonic Arteries 2. Sometimes by the fault of the blood 3. Sometimes by reason of passages obstructed that sometimes happens from its own proper fault and also sometimes from the passages obstructed and also by reason of other causes The blood it self in a double respect hinders its own passage through the Lungs viz. either offending as to its kindling or as to its temperature There are sundry accidents of either of these For first even as the blood is more or less kindled than is convenient it is hindred or obstructed in the pulmonary circuit if at any time the watry earthy or fixt saline parts are predominant in the blood the spirit and sulphur being consumed or brought low by reason hereof its liquor being not well or less kindled by the nitrous air is not easily rarified in the pulmonary passage and scarce passes through them like a flame of its own accord but it sticks still in its passages heavy and muddy and creates much trouble and labour to the Heart wheresoever it is circulated Hence as often as the blood is a little more plentifully forced into the Pracordia by the quicker motion of the whole body or of its parts the Heart and Lungs labour hard for its driving about and that with the utmost endeavours And in this case it is probable The blood hindred in the Lungs sometimes because not kindled enough that the blood carried more rapidly into the right Ventricle of the Heart doth somewhat stagnate because it cannot presently be carried into the passages obstructed before it Moreover from this cause those grumous or fleshy concretions called the Polypi of the Heart sometimes seem to arise Hence both in the Pica Leucophlegmatie Dropsie and inveterate Scurvy from the quicker motion of the body arises difficult and painful breathing 2. Sometimes the blood is too much kindled and breaking out almost into a flame Sometimes too much and being above measure expanded it can scarce be contained in the pulmonary passages which it very much blows up and extends but endangers them to be inflamed or kindled wherefore lest it should tarry longer in them the Pracordia beat with most frequent and strong endeavours that the blood so over-much kindled might be ventilated and circulated for otherwise it being carried within the Lungs and inflaming them all over would quickly destroy the vital function Besides these things which concern the kindling of the blood It is also stopt through its temperament being vitiated there are other faults as to its temperament or mixture by reason of which it less freely or expeditely is conveyed through the pneumonic passages For when its consistence is either too laxe or too close it will not easily pass through the small passages of the Lungs but oftentimes is in hazard to stick and stagnate in them and also run out and be extravasated The blood being in a diverse manner made loose in its consistence either deposites its Serum or its dregs or its putrefaction in the Lungs which being lodged in the recesses of the Vessels or affixed unto their sides do variously stop or pervert the course of the blood 1. The dissolution of blood which is most commonly injurious to the Lungs When the blood is too much loosened in its consistence although not very dangerously is wont to happen for as much as the serosities being unapt to be contained within the mass thereof and when they are not presently sent away by sweating or urine they separate from the blood within the Lungs and so boiling up and breaking out from their proper vessels do as well disturb and stop the passage of air as that of blood so that for the sake of expelling those serosities and continuation of the circulation of blood the Lungs are provoked into a frequent and very troublesom Cough What the formal reason of this Cough is and the manner of its being brought about we shall declare hereafter Though there are many causes and occasions by which the serous liquor Why it lodges the Serum in the Lungs departing from the loosned consistence of the blood flows out abundantly into the Lungs yet for the most part it happens from one of these three viz. first and most frequently because the Pores outwardly bound up by cold cast back the serosities which were wont to be sent away by perspiration into the mass of blood which compel it presently to boil up and cast off the serous superfluities in the Lungs The various causes and ways of doing it From this kind of cause Catarrhs and Coughs frequently arise insomuch that the beginning of every cough by the vulgar is always imputed to such an occasion to wit catching cold 2. The drinking of sharp and thin liquors as Cider Rhenish Wine white Wine Paris Claret commonly causes to some a Cough or catarrhal distemper the reason whereof is for that the blood weak in temperament is presently dissolved and precipitated into serosities like milk by sowre things cast into it which flow plentifully from the mouths of the inward Arteries I have experimented this upon my self yearly when in the Summer season when the blood abounds with sulphur I have drank Cider and tartish Wines safely yea frequently to advantage the same in winter when the blood is prone to sowreness but moderately tasted of do presently provoke a Cough 3. There is another cause of this serous inundation flowing out upon the Lungs viz. when the Lympha watering the nervous and solid parts doth suddenly suffer a flux and for that cause it streams back into the blood out of the Fibres and Glandules and other passages and receptacles whose liquor it presently dissolves and precipitates into serosities which often infests the Lungs For this reason a sudden and troublesom Cough frequently accompanies convulsive distempers which being commonly called a vaporous Cough is ascribed unto vapours Moreover in great alterations of air especially when the season varies from dry into moist and the volatile and fixed salts do thereby melt the Cough and Catarrhs increase very much Neither doth the serous liquor only but also many other humors or recrements of the blood lodged in the Lungs frequently stuff up their passages so that by obstructing both the passages of air and of blood they cause difficult breathing or a cough This is every where perceived in ill-habited bodies also in Gluttons and Drunkards and others leading an inordinate and slothful life Wherefore Foot-men use a thin and spare diet that they may have their Lungs free from the filth and recrements of the blood I have observed some melancholy persons the adust faces abounding in the pulmonary passages to have voided blackih spittle like ink also others
that a very small chink remains for the blood to pass Not long since we dissected a young man who died by reason of an ill formation of the pneumonic Vein Sometimes wax hard in whom the trunk of this vessel growing stony near the juncture to the heart did stick so close that the blood did drop into the heart only by drops or by a very little stream 2. That the passages bringing blood are often filled and stopt insomuch that the stream of blood is obstructed or straitned many anatomical instances and observations manifestly declare From thence it appears The vessels are stuffed with concretions resembling the Polypus that grumous or as it were carnous concretions of the blood do frequently so stop the ventricles of the heart and the roots of its larger vessels that the course of the stream of blood is almost entirely stopt Moreover reason perswades and experience concludes this more frequently to happen in the lesser vessels for seeing as we have even now intimated the blood emitted by Phlebotomy in Rheumatisms Peripneumonies and Pleurisies when it is cold is covered all over with a thin skin altogether of the like substance with those concreted Polypus's it plainly appears that it passes with difficulty through the passages of the lesser vessels by reason of those viscous excrements wherefore that it may pass by some means it distends them very much and sometimes breaks quite through them also it frequently unlocks their mouths and opens gaps into the Trachea insomuch that portions of the extravasated blood are by coughing frequently ejected We have known some to have died Asthmatic or short-winded whose Lungs being free from an Ulcer or any more grievous wound have swelled so much that they wanted room for their motion within the cavity of the Chest the reason whereof doubtless was that the thicker and more feculent blood for that cause not easily passing through those vessels every where extended the Arteries and Veins and caused it to stagnate in the lesser Pipes Moreover the feculencies of blood one while salt of different kinds another while sulphureous or earthly being combined with them and thrust into the small passages of the vessels and fixed there do altogether obstruct them insomuch that the pneumonic circulation of the blood is contracted into a shorter space and consequently the function of breathing is straitned in the compressed Pipes or little Cells There are many kinds and sundry ways of such an obstruction which if all or the chief should be enumerated such a Pathology would swell into a too great bulk 3. The pneumonic passage of blood is not only hindred by reason of the passages shut and obstructed but sometimes also being burst asunder For those vessels being small The blood is also hindred because the passages are burst asunder as in spitting blood or tender or very loose in some persons are frequently opened by the force or acrimony of blood so that the blood either bursting into the Trachea is ejected by spitting or heaped up in the interspaces of the passages causes a Peripneumony or falling down into the cavity of the Chest produces an Empyema Of all these we shall treat singly in the Chapter of spitting of blood 3. One impediment of the blood is want or default of air There remains as yet a third impediment of blood in the pneumonic passages which happens for the want or fault of Air. If at any time the Blood is not kindled after a due manner within the passages of the Lungs from air breathed in by the Trachea for that cause as presently its flame is irregular so likewise its motion is variously stopt or perverted for although the blood is forced through the lungs by the meer impulse of the heart notwithstanding the pulse hereof is proportioned according to the tenour of its being kindled by the air wherefore when the flame of blood is diminished or supprest for want or through the fault of the air presently the pulse proves languid or unequal and by reason of the bloods course being troubled or stopt presently a paleness and coldness succeeds wholly intercepted or frustrated because the nitrous particules are wanting presently the pulse ceases and anon life is lost The reason of all which is both because the blood being much impeded in its accension or extinct like Must given over working presently subsides and is unapt for any motion and chiefly because the flame of the blood failing and being substracted from the brain presently the Hypostasis of the animal spirits as it were light streaming from thence immediately fails and together with it the exercise or actions of all faculties do cease But if the blood is too much kindled the Sulphur of the Blood and the Nitre of the Air running together more than it ought for that cause presently that this too much burning may be eventilated enough the pulse of the heart is increased to its utmost We might adde many instances of this kind but truely this consideration of the blood leads us to the second thing proposed of Respiration hurt namely that we may duely weigh what sort of failings or defects do happen about the inspiration as well as expiration of the Nitrous air requisite for the preserving the nitral flame of blood that is to say from what causes they proceed and also what effects they are wont to produce in which search we will first treat of Inspiration hurt SECT I. CHAP. III. Of Inspiration hurt BReathing is accounted hurt Breathing hurt by the vicious qualities or defect of air when its use is frustrated or any ways hindred which most frequently happens by reason of the fault or defect of the Air drawn in As to the former if the Air chance to be depraved it neither duely kindles nor eventilates the blood yea it sometimes overthrows the temperament thereof or infects it as is every where seen in a Constitution of Air very malignant That we may touch on the chief reasons of these distempers The faults of the air we are to observe That as the Nitrous particles of Air are chiefly necessary as is manifest by manifold experiment for the preservation of life so frequently it happens that Nitre of the Air either to sail or be wholly wanting or by particles of another kind to be so much muffled or bound up that they cannot enough exercise their vital power or lastly malignant or fatal Corupscles to be adjoyned thereunto First the nitrous particles of Air are deficient if when it stagnating or growing hot the Nitre is chased thence or not stirr'd into action Wherefore in a low-roost Chamber or too close and in other places crouded with assemblies of men or made hot with the ardor of the Sun we difficultly or weakly breathe The same comes to pass in places of great height on the tops of those mountains exceeding the top of the Atmosphere wherein breath is faintly drawn for want of Nitre neither can we live long there
the Lungs were free from any Ulcer yet they were set about with little swellings or stones or sandy matter throughout the whole for from thence the blood because it could neither be freely circulated in the Praecordium nor animated enough by the nitrous air and when in the mean time it is perpetually polluted by its proper dregs deposited in the Lungs is frequently vitiated and made incapable of nourishing thereby wherefore a Phthisis is better defined that it is a withering away of the whole body arising from an ill fromation of the Lungs The Ancients following Hippocrates The cause assigned by the Ancients for the most part have assigned only two causes of this disease viz. a Catarrh and the breaking of a Vein to which some have added an Empyema and others exclude a Catarrh from this number for what is vulgarly affirmed that flegm falling from the Head into the Lungs and abiding there putrifies is most commonly the cause of a Phthisis or is often brought by it we have formerly intimated to be altogether erroneous and shall presently shew it more clearly In the mean time to shew what the matter is that generates a Consumption as often as it arises without an Empyema or Haemoptoe going before What the consumptive matter is it must be considered after how may manners and by what ways any thing disagreeable or heterogene can enter into the Lungs which diligent search being made it will easily appear that any thing that is an enemy to the Lungs creeps in and is admitted chiefly either by the Trachea or by the pneumonic Arteries By what ways it enters the Lungs yea and sometimes haply by the Nerves but nothing by the Veins or Lymphaeducts whose function is only to carry back or away the blood or Lympha and to leave there nothing at all As to the Trachea it is manifest it is ordained for this end that by its passages or pipes the air might be conveyed in or presently carried back by a constant recourse from whence it comes Sometimes by the Trachea yet not destilling from the head moreover whether any matter being hurtful or mortal to the Praecordia may be admitted the same way shall be now our present disquisition And that the Lungs frequently incur a pernicious pollution by this entrance is clear from hence because the moist air of some regions repleat with fumes or abounding with malignant vapours doth frequently induce the consumptive inclination nevertheless the affection thereof is wont to be communicated only by aerial minute particles whereby either the temperament of the blood or the conformation of the Lungs or both are prejudiced But whether besides this a serous matter or some humor corrupting the Lungs doth enter them through this passage is not without reason doubted although many do determine a Catarrh or a destillation of the Serum from the Brain into the Lungs by the passages of the Trachea the principal cause of a Phthisis Which opinion being erroneously delivered by the Ancients I admire any either of our modern Physicians or Philosophers have admitted thereof for it is manifest by anatomical observations that nothing from the Brain by the Glandula pituitaria which seems the only passage from thence falls down into the Palate or Breast but that the Serum there deposited is conveyed by appropriate passages to the jugular Veins and is remanded to the blood Moreover it is manifest to sight that whatsoever relique of Serum is laid aside in the Glandules of the Ears Mouth Nose or Face is conveyed from them all by peculiar passages insomuch that no humor whatsoever destils from the Brain or the Palate into the Lungs But although matter exciting a Congh doth not destil from the Head by the Trachea into the Lungs yet sometimes falling down from the sides of the Trachea into their cavities But sweating out of the sides of the Trachea it produces that disease commonly called a Catarrh For the Aspera Arteria like the Arteries beinging blood are endued with a nervous and musculous Coat and so do occasionally enjoy sense and motion having also a glandulous Coat and full of little vessels to sustain the vital heat and nourishment These last Coats make those interspaces and as it were cover the Cartilages Moreover the superfluous serosities proceeding from the blood watering the Trachea are deposited into this glandulous Coat which for the most part presently sweating into the cavities of the Trachea serves chiefly to make them slippery and most but if the mass of blood be poured out too much and precipitated into serosities as it frequently happens a cold being taken or the swallowing down of acid things and on many other occasions for this cause a great plenty of watry matter sweats out of the Glandules of the Trachea and mouths of the little Arteries into its cavities which soon doth cause a most troublesom Cough and often much spittle which afterwards comes to be consumptive But surely this cause of Spittle and as it were a Catarrhal Cough very rarely comes alone The consumptive matter brought into the Lungs rather by the pneumonic Arteries because while the blood watering the Trachea having suffered solution throws in its serosities into the Glandules whence presently they sweat into its cavities and also the remaining blood being in like sort dissolved it insinuates its Serum set apart within the pneumonic arteries partly into the tracheal hollownesses and partly into the Lympheducts by the overflowing whereof the Lungs are as it were overwhelmed and much incited for the most part provok'd to Cough and continual spitting A Cough and spitting of this kind as long as moderate A Cough and spitting sometimes healthful only throwing off the serosities of the blood rather are beneficial than prejudicial because the mass of blood and the very lungs being throughly purged after this sort those symptoms for the most part spontaneously abate and from thence ensues a more perfect health But if they be protracted a long time the serous humour being on both sides laid aside into the tracheal passages and from thence more plentifully daily heapt up at length it will change into corruption because as well the free enjoyment of air is impeded as also the motion of the blood and its temperature wholly perverted from hence a Cough becomes more fierce and breathing more difficult nay rather the whole mass of blood in as much as it is defiled by the foul blood which the Veins receive from the Lungs degenerating by degrees from its benign properties and being depraved it not only continually pours forth the super fluous Serum but also the nutritive Juice which it cannot assimilate out of the pneumonic Arteries into the tracheal passages Yet often being too much is dangerous and so this mass of consumptive matter is daily increased till the Lungs being more and more obstructed and filled and the blood being defiled and rendred unfit to perform any of its functions the Cough
Very many of these being endued with a narrow breast and a neck somewhat long and of a constitution very tender contract a Cough from the least occasion neither can they endure a cold or moist air To some of these a mansion in a City is very prejudicial where the air is breathed in thick and smoaky on the contrary to others prone unto the same disposition it is very friendly the reason whereof we shall diligently inquire hereafter To all of them a North-wind is for the most part an enemy considering that it usually irritates a Cough also a Spitting of blood a Pleuisie or Peripneumony viz. the pneumonic or the thoracical Vessels being thereby stufft and in the mean time the blood being rendred more rurgid and sharp by reason of transpiration hindred and the effluvia's restrained within the mass thereof For an hereditary disposition to a Phthisis doth chiefly consist in these two things In what it consists viz. 1. In regard the Patients being endued with a more sharp and elastic blood do require a more plentiful transpiration which perhaps if it be less granted the matter that was wont to evaporate redounds upon the infirm Lungs 2. If the pneumonic Vessels be too loose and tender they do not duly contain the Serum and other recrements of blood within the dissolved mass thereof but they sometimes suffer both them and a certain portion of the blood it self to break out into the Tracheal passages whose moving Fibres when they are infirm do not presently turn forth what is poured out into the cavities but they suffer it to abide and putrifie in the same place and at length to degenerate into black filthy gore corruptive both of the Lungs and blood 3. What the consumptive diseases of the breast are A Phthisis is sometimes the product or consequent of some other previous distempers of the Breast Those consumptive passions chiefly are Empyema's Pleurisies a Peripneumony and Imposthume of the Lungs and sometimes the small Pox Measles also irregular Feavers ill or slightly judged do cause the same effect The chief of these distempers or at least those which are proper to the Thorax together with the rendring the reason of the causes and how they dispose to a Consumption shall be declared hereafter with the reasons and manner of procedure in the mean time we are to take notice that this kind of fault is common to them all that is to say they dissolve the unity and weaken the tone of the Lungs and pervert the temperature of the blood whence whatsoever incongruous or distempered thing is poured out upon them from its depraved mass they do easily admit thereof and difficultly or not at all drive it back 4. The influence of the air for exciting a Consumption The procatarctic causes of a Phthisis being now explained viz. those which consist as well from the blood as the Lungs there is another common to them both which may be justly added and although altogether extrinsec hath great affinity with them both viz. the condition or temper or the air breathed in For such is the influence hereof to some consumptive persons that the cause of the disease is sometimes wholly ascribed to the incongruity of the air wherein they dwell and for a cure the alteration of air or soil is preferred to all other remedies whatsover Hence many of our Country troubled with a Cough or being in a Consumption flock to the Southern parts of France and others in the mean time who cannot go beyond Sea or will not presently hasten to remove out of the City-smoke into the Country as to a most undoubted refuge wherefore all our Villages near London which injoy a clear and open air are esteemed as so many Spittles for consumptive persons Notwithstanding all do not alike receive help from such a change of places for many either passing to France or to Country Villages do in those places rather find their graves than health And therefore London is not presently to be forsaken by all phthisical persons for I have known may obnoxious to a Cough or Consumption to have enjoyed their health much better in this smoaky air than in the Country So that for cure of the same disease while some avoid this City as Hell others flye to it as to an Asylum The reason of these things do clearly appear out of the Doctrine of Breathing before handled The grosser and city-City-air to some consumptive persons healthful to others hurtful for we do demonstrate the blood passing through the Lungs both as to its kindling or vitality and as to its motion doth chiefly depend on nitrous air suckt in whence it is a consequence that the tenor of this ought to be so proportioned to the temperament of that that the blood being moderately kindled within the Pracordia may burn out clearly and vigorously The reason whereof is inquired as well without smoak and sootiness as without too intense a flame and that it may pass the pneumonic Vessels freely and without any hindrance or leaving of recrements Wherefore a moist and close air as it is healthful to none so to them that cough it is especially hurtful on the contrary a serene and mild air moderately injoying the Sun and wind as it is healthful to all persons so it is friendly to all consumptive persons As to other conditions of the air some escape a Cough or lose it living in mountainous places exposed to the Sun where the impendent Atmosphere being free from all thick smoaky and feculent vapous whatsoever abounds with nitrous particles for those whose thick and feculent blood abounds with an impure Sulphur to kindle this duly and to waste the dregginess there is need of a very thin and nitrous air If the Lungs be not too tender but firm and strong they endure the more fierce assaults of its particles on the other side they who have a thin and subtil blood easily dissolvable and endued with a more pure but very little Sulphur and having tender and soft lungs very sensible and of a finer texture these persons being impatient of a nitrous and sharper air are most at ease and best in a thick and more sulphureous one Wherefore it conduces to these persons that they breathe the gross and more fat air of a smoaky City which to an impoverished and more thin blood doth afford Sulphur which fails sometimes and also Nitre and doth something thicken and fix its subtile consistence moreover it dulls the substance or texture of a Lung too much sensible and more thin and is a defence against the invasions of a more sharp and improportionate Air. A sulphureous air healthful to some consumptives It is manifest by frequent experience that a thicker Air provided it be sulphureous proves very benign to some phthisical persons that I do not say to all It is a common observation that a Consumption seldom infests those Regions either in England or Holland where fires
are nourished by turffe and do breathe a very sulphureous odour yea rather those places are chiefly wholesom and frequently sanative to persons obnoxious to a Phthisis or labouring under it To which we may add that a suffumigation of Sulphur and Arsenic which is filled with much Sulphur is reputed for the curing of almost incurable Ulcers of the Lungs although the last yet the most efficacious remedy Sulphureous Medicines chiefly agreeing Moreover add to this that pectoral Medicines prepared of Sulphur are far to be preferred to any other so that Sulphur is justly reported by Chymists to be the Balsam of the Lungs By what order and by what means these Medicines do work and so notably help in diseases of the Thorax we shall hereafter make diligent search into in the mean time that sulphureous Air is found helpful to certain phthisical persons the reason consists in these two things viz. in the first place as we now intimated from such an Air suckt in there is help brought to the jejune and depauperated blood and to the tender Lungs Secondly that the sulphureous Particles being suckt in with the nitrous do provide against The reason thereof discoursed or take away the acidities of any of the humours by which their flowings and extravasations into the Lungs do chiefly arife And for this reason it is that sulphureous Medicines being also taken inwardly do confer so excellent a help to them that cough or are phthisical therefore Sulphur as I now hinted hath the report of being the Balsam of the Lungs For as balsamic things applied to an Ulcer or Wound extinguish the acidity of the Ichor there sweating out and corrupting and paining the little Fibres soon ease the pain and afterwards heal the wound so also the sulphureous Particles passed into the Lungs either with the air or with the blood in as much as they provide against or abolish the acidities of all humors i.e. the blood the Serum the Lympha the nervous or nutritive Juice they conduce to the prevention or cure of a Consumption We shall in what follows more at large declare the cause when sulphureous Medicines shall be particularly treated of The conjunct and procatarctic causes of a Phthisis being thus handled it will not be necessary to discourse much touching the evident causes For in what manner a closing of the Pores by cold a surfeit or tipling and other errours of several sorts in the six non-naturals dispose to those distempers and sometimes presently do bring them The three times or distinct states of a Cough is so clear that it needs no explaining Neither is there any reason we should be long delayed about the Semiotical part of this disease nevertheless it is fit we observe the divers states or distinctive signs which certainly belong unto it 1. When it is meerly a Cough 2. When it begins to degenerate into a Phthisis 3. When it is a perfect and almost desperate Phthisis From which things duly designed the Prognostic of the above-mentioned affections will be very apparent 1. And in the first place what belongs to a new Cough and as yet alone When new there is no suspicion of a Consumption this taking its rise from any cause whatsoever in bodies predisposed to a Phthisis will scarce ever be free from the suspicion of danger but in a strong man and one who hath often before endured a Cough Scot-free it will not be immediately to be feared for when being stirred up from a more forcible evident cause without Feaver or indisosition of the whole body it shall not be very troublesom then it meerly passes for a cold being taken and is altogether neglected or in a short time is wont to be finished without many or very considerable Remedies Moreover if a small Feaver with thirst and want of appetite accompany this there is hope that the blood being restored to its due temperament the Cough then will cease of its own accord but if it be protracted longer and not easily yield to vulgar Remedies and produces much spitting and that discoloured it must not be any longer neglected but be provided against by a method of healing and by fit remedies and an exact course of diet For then it may well be suspected that the Lungs being prejudiced in their structure do not circulate the blood entirely but let fall the Serum and Lympha and frequently the nutritive Juice and moreover those humors so laid aside do putrifie and from thence the blood is defiled which by a reciprocal hurt prejudices again the Lungs 2. When it begins to induce a Consumption But if to a Cough growing daily worse and worse with plentiful and thick spittle a languishing and pining of the whole body loss of appetite difficult breathing thirst and fervent heat of the blood be added there is great cause of suspicion that it is come at least to the first limits of a Phthisis if not further Wherefore it will behove us to use all means whereby the Lungs may be freed from the great quantity of matter heaped up together and be defended from its continual assault or invasion and also that the mass of blood may be cleansed from all dregs and restored to its due temperament whereby it may rightly contain its serosities and other humors within it self or transfer them to some other place than to the Lungs 3. When it becomes a confirmed Consumption But if beyond the state of this distemper now described plenty of spittle and that discoloured shall be daily increased and all other things growing worse and worse a dejection of the whole strength and a hectic Feaver with a continual thirst night Sweats an Hippocratical face an utter decay of the flesh almost to the driness of a Skeleton happen upon all these then for the most part no place is left for Medicine but only a dreadful prognostic at least all hope of Cure being waved we must insist upon Anodynes whereby an easie death may be procured What therefore belongs to the cure of a Cough in general The curing method and first against a beginning Cough according to the three above-mentioned states of this disease a threefold method of healing ought to be appointed viz. that bounds as it were being set we may more distinctly prescribe what is to be done for the cure of a Cough whilst being on this side the limits of a Phthisis it passes only for a cold catched 2. What manner of healing to a beginning Phthisis 3. What to a Phthisis consummated or desperate 1. Although against a new Cough for the most part there are used only Remedies Empirical and scarce any of the common people but are furnished with many and divers of this sort which every where without the advice of a Physician very many confidently take and without method and give them to others yet men of a delicate constitution or inclining to a Consumption hereditarily or sometimes formerly
in hazard from a Cough ought immediately to provide against the first assaults thereof and readily betake themselves to the Precepts of Physick according to which that the method of healing may be duly instituted the curatory indications shall be chiefly these three Three indications viz. 1. To appease or take off the disorder of the blood from whence the fluxes of the Serum do proceed 2. To derive the excrements of the blood and all exuviae apt to separate from it from the Lungs to the Pores of the skin or to the urinary passages and into the other Emunctories 3. To strengthen the Lungs themselves against the reception of the Serum and other humors and also to defend them against the invasion of outward cold whereby they are wont to receive further hurt Upon each of these we shall treat a little more plainly 1. The first respects the effervescence of the blood The first indication respects as well the boiling up of the blood wherein by reason of the effluvia's restrained it grows too fervently hot and boils in the vessels as its dissolution whereby being solved in its consistence it lets go too much Serum and other humors from its embraces For the taking away of both a thin diet must be appointed and the injury from outward cold carefully declined a little more sweating ought to be procured or at least the accustomed restored To this end let the Patient put on thick garments and let him keep his bed or chamber at least let him hardly go out of his house evening and morning let a small breathing Sweat be provoked by Posset-drink boiled with Rosemary or Sage If notwithstanding all this the Cough increases Phlebotomy if the strength and constitution will bear it is often used with success after which Hypnoticks for the most part help in as much as they retard the motion of the heart and consequently the too precipitate course of blood moreover they cause it to circulate in the pneumonic Vessels gently and mildly without any great throwing out its serosities and to send away what is superfluous either by Sweat or Urine To this purpose pectoral Decoctions are also to be administred in as much as they destroy the acidity of humors and hinder the dissolution of the blood and its melting into serosities By the like reason and manner Medicines prepared of Sulphur do so signally help against a Cough The second respects the derivation of the Serum and other excrements from the Lungs The second indication viz. that the Serum and other recrements of the blood derived from the Lungs may be evacuated by other ways is performed by Diaphoretics Diuretics and mild Purgers which ought to be mixed with other Remedies or now and then used alone Wherefore after Phlebotomy we use to prescribe a gentle Purge and sometimes to repeat it Among the Ingredients of the pectoral Decoction let the Root of Chervile Butchers-broom Elicampane and other things that provoke Sweat and Urine be put Hog-lice volatile Salt of Amber and other fixed Salts and Powders of Shells made into Pills with Turpentine are often given with success The third indication The third intends the suppressing the Catarrh and strengthing the Lungs that the Lungs and their passages might be desended against the flowing of humors the encountring of cold and the suppression of the Catarrh as they commonly call it is performed by Linctus's Lohochs and other private Remedies and chiefly respects two things viz. that the mouths of the Vessels and Glandules opening into the Trachea be shut with moderate Astringents lest they should too much east out the serosities into it and secondly that the sides of the Tracheal passages may be made smooth and glib that neither from the pouring out of the sharp Serum nor invasion of any outward cold they may be offended and continally provoked into a troublesome Cough and moreover when those passages are made slippery enough the spittle sometimes obstinately cleaving to their sides might be the more easily coughed out For the first intention it is that Conserve of red Roses Olibanum Mastich Lohoch of Pine-tree Syrup of Jujubes of dried Roses of Cup-moss and other Astringents are often put into the forms of Pectoral Prescriptions For the second intention Liquorish with the divers preparations thereof is reputed a famous Remedy against any Cough for this purpose Syrups and Lohochs and all other sweet Pectorals seem to be ordained To which is added Oyl of sweet Almonds either administred by it self or brought with pectoral Syrups after a long stirring of them together into a milk form liquor These are the chief Therapeutic indications together with the apt intentions of healing which seem chiefly to be of use for a new Cough while as yet we have no suspicion of a Phthisis or at least that it subsists without the manifest limits thereof it now remains after this general method briefly shadowed out that we subjoin certain choice forms of Medicines appropriated to every intention These though they are manifold and of divers preparations yet those which are of chiefest note and most in use Forms of Medicines which are most in use are Mixtures Linctus's Lohochs Tinctures Balsams Troches Lozenges Powders Pills Decoctions and distilled Waters Of each of these we shall set down some choice Receipts 1. Mixtures Take of Syrup de Maconio of Jujubes of each an ounce and half of powder of Olibanum a dram the water of Earth-worms or of aq Hysterica or Peony compound a dram mingle them The Dose is one spoonful at bed time and after midnight Take of the water of Snails of Earth-worms of each an ounce and half of the liquid Laudanum Tartarizated two drams Syrup of Violets an ounce The Dose is one spoonful at bed-time Take of Snail-water â„¥ vj. Syrup of the juice of ground-Ivy â„¥ iij. Flower of Brimstone Ê’ss mix them The dose is one spoonfull at bed-time and soon in the morning Take of our syrup of Sulphur 4 ounces Water of Earth-worms 1 ounce Dose 1 spoonfull after the same manner 2. Linctus ' s. Take of syrup of Jujubes Maiden-hair of each one â„¥ and half syrup of red Poppys 1 ounce mix them to be lick'd with a Liquorish Stick Take Oyl of Sweet-Almonds fresh drawn Syrup of Maidenhair of each 1 ounce and half white Sugar-candy 2 drachms mix them by beating in a Glass-morter or shaking them in a Glass Vial till it wax white 3. Lohochs Take Conserve of red Roses 2 ounces and half Lohoch Sanum 1 ounce and half Spec. Diatragacanth frig 1 dram and half flowers of Brimstone half a dram Syrup of Violets or red Poppyes as much as sufficeth let it be made a sost Lohoch Dose 1 dram and half at night and early in the morning at other times to be licked with a Liquorish stick Take of the powder of the leaves of Hedge-mustard or Rockets 1 ounce and half clarified Honey 4 ounces mix them for a Lohoch let it be administred after
dram to be strewed upon burning coals Take Gum of Ivie Of the more strong Frankincense of each two drams Flower of Brimstone one dram and half Mastich one dram with a dissolution of gum Tragacanth form Troches Take of white Amber Arsenicals Olibanum of each two drams prepared Orpiment half an Ounce Styrax Labdanum of each one dram and half with solution of Gum tragacanth make Troches for fumigation Mountebanks do ordinarily prescribe the smoak of Arsnick to be suckt into the mouth Smoak of Auripigment like Tobacco kindled in a Pipe and sometimes with good success Moreover it is in practice with the Vulgar to burn like Tobacco in a Pipe little bits of cloth stained with Arsenick such as wherewith the walls of Taverns are hung and so suck the smoak into the consumptive Lungs for cure 3. Of a confirm'd Consumption These things being thus unfolded concerning a Cough and a Phthisis beginning both as to what belongs to the Pathologie and cure it remains now lastly to discourse of a more painfull Phthisis confirm'd and almost desperate and to consult what is to be perform'd when the lungs being very much vitiated and affected with one or more filthy ulcers neither the air nor the blood do rightly pass through them but choak or corrupt the mass thereof by continually suggesting filthy corruption insomuch that a hectick feaver and an Atrophie by reason of nourishment being frustrated infest the diseased with the loss of all their faculties and by daily weakening their strength precipitate them to the grave The most certain sign of this disease growing desperate uses to be accounted a pain very troublesome with an inflammation of the throat for this symptom argues a great putrefaction of the lungs from whence the putrid effluvia's exhaling are thrown about in the narrow passage of the throat The formal reason thereof which wound and grievously irritate those tender fibres there In this case the cleansing of the lungs as also the drying up of the Ulcer are in vain designed for all hotter Medicines ordain'd for those purposes and fit enough in the beginning of a Phthisis are not to be endured in a confirmed one inasmuch as augmenting the inflammation of the lungs they procure a hectick feaver thirst wathings and other more painfull symptomes or call them back afresh For truly in such a state of this disease where onely the prolongation of life is proposed with a light toleration and an easie death those remedies help chiefly which bridle the fervour of the blood allay the heat in the Praecordia and restore the sprits and gently cherish them Hence for food Asses Milk also Water-gruel Barly-broths Cream of Barly and for drink Ptisan Emulsions water of milk distilled with Snails and temperate pectoral herbs are usually of greatest success Forms of remedies in a desperate Consumption Syrups and Linctus's which appease the inflammation of the throat and Lungs and facilitate expectoration but chiefly the more mild Hypnoticks whereby moderate rest may be procured may be frequently or daily taken The forms of these are common enough but however according to our method we will annex some of the more select of each kind Take of Barly half an ounce Decoctions candied Eringo roots 6 drams parings of Apples one handfull Raisins stoned two ounces Liquorish three drams boyl them in three pints of spring-water to two make a Ptisan to restrain thirst take it 3 or 4 times a day also in the room of ordinary drink if it agree Take the tayls of twenty Crevises candied Eringo roots one ounce a crust of white-bread Raisins stoned two ounces Liquorish 3 drams boyl them in 3 pints of Spring-water to two strain it and take 3 or 4 ounces three times a day After the same manner is prepared the Decoction of Snails Take of Snails half-boyled and cut three pound Distilled waters ground-Ivy 6 handfulls Nutmegs sliced numb 6. crum of white-bread two pound fresh milk 8 pounds distill it in a Pewter Still The same way is distilled the water of Crevise-tayls The dose 3 or 4 ounces three times a day Hypnoticks sweetned with pearl'd Sugar or Sugar of Roses Take ears of greeen Wheat as many as convenient distill them in a common still drink three or four ounces three times a day sweeten'd with pearl'd Sugar Take syrup de Meconio three ounces water of green Wheat 6 ounces mix them Hypnoticks drink two or three spoonfulls at bed-time every or every other night Take Conserve of Mallow-flowers wild or garden three ounces Lohoch de pino two ounces Eclegma's Syrup of Jujubes two ounces make a Lohoch of which take often a dram and half or two drams What hitherto we have discoursed of concerning a Cough of every kind whether it be solitary and simple or the forerunner and companion of a Phthisis also what is to be prescrib'd in every case touching the method of healing it would be easily illustrated by the history of Cures or by the Anatomical observations on those that have dyed by that disease For instances of this sort and very many examples are every where had and happen daily it pleases us here to annex a few of the more select out of the large choice of these accommodated to the chief kinds of a Cough and Phthisis And first I will endeavour to illustrate the type of a simple Cough by one history or two and which takes its rise of it self and is altogether void of the suspicion of a Phthisis It is now many years since I took care of the health of a certain Student The History of a Cough threatening a Consumption obnoxious to a Cough from his tender years and who was wont frequently to undergo the more painfull affections of it and those of long continuance This person seemed of a melancholick temper of a sharp wit of an indefatigable spirit of a constitution indifferently strong but that his Lungs originally being infirm did suffer when the blood dissolv'd into serosities In Summer as long as he transpired freely he lived healthily enough but in the Spring and Autumn when the blood changing its temperament those serous fluxes came upon him either of their own accord or from any sleight occasion he fell easily into a Cough with abundant and thick spittle notwithstanding this distemper frequently within six or seven dayes as soon as the mass of blood was purged throughly by the Lungs vanished leisurely without any great use of remedies But if to the aforesaid occasions of this disease were added some stronger causes as chiefly the obstruction of the pores and errors touching his diet sometimes a more prodigious and stubborn cough neither presently nor easily yielding to remedies and threatning nothing less than a Phthisis did come upon him then manifestly the patient for the first days suffered light shiverings in his whole body and the sense of a Catarrh in his Larynx afterwards by frequent
SECT I. CHAP. VII Of Spitting Blood HItherto of a Cough and Phthisis as well in its beginning as confirmation which are the most common affects of the Lungs and most especially dangerous Besides which there are many other diseases of those parts that do occur which when they are not at all or not seasonably enough cured for the most part degenerate into a Phthisis These passions or at least the chief of them as we have before hinted are spitting of blood an Imposthume or Ulcer of the Lungs a Peripneumony Empyema a Pleurisie a Tumor of the Lungs and obstructions by reason of things divers ways concreted viz. sometimes little Pustles and Scirrhus's another while gravel and little stones and sometimes other preternatural matter and lastly hitherto belong an Asthma and convulsive distempers of the Breast Of these we shall treat in order and first of Spitting blood The spitting of blood out of the Lungs and the ejection thereof by Cough sometimes less and almost none Spitting blood a distemper very frequent another while more violent is a distemper frequent enough and truly an admiration it is that it happens not more frequently For whereas the vessels bringing blood are divided into twigs and innumerable slips and those very small and whereas the blood even siercely boiling is violently conveyed through them all complicated after divers manners and variously intorted we can hardly conceive how the circulation thereof being so perplexed and intricate and also so impetuous should be performed without some impediment and interruption And truly we conclude it to be very difficult in living bodies because it hardly succeeds by injection in the dead for as much as liquor sent therough the entrance of the pneumonic Artery will not readily and easily return by the Veins but sticking longer in the passage and skipping over the usual passages variously runs out into the little bladders and other canals of the Trachea and into the interspaces and other various gaps of the little Lobes Concerning an Haemoptosis or spitting blood we are to consider Three things to be considered concerning it first out of what vessells and by what distemper the blood bursts out secondly in what places most frequently laid up thirdly by what means it is wont either to be ejected or brought upward that it may be discharged by the mouth As to the first we are to suppose by the Law of Circulation that the blood of it self bursting out doth altogether proceed from the Arteries for the Veins as long as they remain whole do reduce it towards the Heart and not at all pour it out although we deny not that sometimes they being hurt by a wound fall bruise or some violent accident so as to be loosned from their unity do let go the blood out of their cavities Out of what vessels the blood bursts out Nevertheless the blood most commonly causing an Haemoptoe or blood-spitting proceeds from the little mouths of the Arteries being open or torn and then the fault is wont to be either in the ill temperament of the blood or ill framing of the vessels Of either of these there are variousw kinds and differences By what sault both of the vessels and of the blood it happens which also concur after a diverse manner to provoke the spitting of blood For the blood being sometimes more thin and also sharp it unlocks or corrodes the mouths of the little Arteries and sometimes again being more thick and prone to coagulate when it cannot readily enough be received by the Veins it is extravasated By reason of these faults in the blood they who labour with the Scurvy or with a pestilent Feaver as also those who have drunk some sort of poison do srequently fall into a spitting of blood Neither is this distemper less wont to arise from the fault of the vessels in as much as those being too tender or too thin many times are burst by a violent motion as by coughing hollowing leaping or other vehement exercises or for that being too loose and moist their mouths open and suffer the blood to break out of its circulation moreover sometimes for that the Veins being contracted and wrinkled by cold do not readily pass away the blood but the same restagnating distends the little Arteries and bursts out of their mouths As to the Arteries out of which the blood breadks causing a spitting of blood What Arteries chiefly and where placed do void blood it concerns much of what sort they are and where they are placed for besides that there arise notable differences of bloody spittle according as the blood breaks out from a smaller or a greater vessel and if either of them be placed in the top of the Lungs near the Larynx or in the middle region thereof among the greater branches of the vessels or lastly in the lower region among the orbicular little bladders moreover we observe that the Arteries which use to void blood are either of the number of them Both the pneumonic and tracheal are in fault which arising out of the pulmonary Trunk do every where accompany the branches of the Trachea or of those which owning their origine to the Aorts do cover the coat of the Trachea with a thick branching For it is apparent as we have declared before from the mouths of these as also of the Glandules and unctuous humor sweats out to make the inner superficies of the Trachea slippery Spitting blood from the tracheal Arteries moreover in as much as a serous houmor distils abundantly on t of the same into the cavity of the rough Artery a Catarrh arises Wherefore we doubt not at all to affirm that even fro the mouths of these being open meer blood sometimes soaking into the Tracheal passages does propagate a bloody spittle though in quantity very small I have observed many who without a Cough or any indisposition of the Lungs have once or twice a day voided one or two bloody spittles which as often as it came upon them the Patients perceived either in the bottom of the throat or on the top of the breast a kind of distillation whence immediately by the meer contraction of the Tracheal Fibres with a Snail-like motion a little of the fluid blood being mixed throughly with flegm and not at all frothy is voided and when sometimes that distemper had lasted for many months no prejudice ensued from thence which might bring or threaten a Phthisis which would not have come to pass if any of the pneumonic Vessels had been opened 2. So much concerning Vessels voiding blood and of their divers affections 2. In what places the blood is deposited What belongs to the places wherein the extravasated blood is deposited these chiefly and almost only arew the rough Artery and the inward cavity of the parts thereof For into this as into a Jakes all the filth or superfluities of all the rest of the passages are derived by the utmost endeavours of
Nature as far as is possible to be presently sent out of doors But if the extravasated blood be thrown into the interspaces of the little Lobes or soaking out of the outer Membrane fall into the cavity of the Thorax it doth propagate an Empyema and frequently an Imposthume in that place But for the most part the blood subject to fall from the pulmonary course produces various kinds of bloody spittle Either in the Larynx or in the middle of the Bronchii or in the orbicular little bladders according as it makes its nest either upwards within the cavity of the Larynx or a little beneath about the intermedial passages of the Trachea or lastly further within the orbicular little bladders The first distemper proceeds alone from the mouths of some Artery being opened which covers the trunk of the Trachea the next sometimes perhaps from this cause yet more often from the pneumonic Arteries themselves being open or burst asunder which vessels as they are greater pour out often a dreadful quantity of blood the spitting out whereof proves plentiful and violent in regard that the muscles of the whole breast together with the fibres of the Trachea are much provoked and greatly contracted But if the spring of bloody spittle consists in the lowermost little bladders the blood is thrown out more sparingly but with a profound frequent and very troublesom Cough 3. And from hence which was in the third place purposed the differences of bloody excretion out of the Lungs and the manifold modes and courses of bloody spittle are made known For the blood soaking into the Larynx after a small tickling in the throat without coughing or hawking doth easily and almost insensibly ascend into the mouth and if an extravasation of this kind of blood happens in sleep it presently flows out of the mouth upon wakening they being scarce sensible of it in as much as the moving fibres of the Trachea being contracted while one sleeps have then emptied the blood fresh distilled into the mouth But if from a greater vessel gaping or burst about the middle of the Lungs the blood which is ever frothy does break out abundantly into the Tracheal passages this by an outragious Cough raised thereby is forthwith cast upwards with violence and in great plenty insomuch that the sick seem rather to vomit than cough out blood And finally if the blood breaking out of the foldings of the vessels wherewith the orbicular little bladders are incompassed falls down into those little cells from thence it is discharged by turns in lesser quantity and not unless by a strong and very frequent Cough So much concerning the formal reason The procatarctic and evident causes thereof the conjunct causes and differences of an Haemoptoe as to what belongs to the primary and evident causes either of them are manifold and various In the former number are reckoned first an hereditary indisposition of the Lungs whenas they have originally been weak and soft with a straitness of the breast Moreover their ill temper from a Cough Empyema or Pleurisie going before and especially an obstruction or ill conformation do very much dispose to spitting blood and so much the rather if in such a habit an acrimony or Dyscrasie of the blood shall accrue from an ill course of Diet unwholesom Air or by any other means The suppression of the Menstrua the Haemorrhoids or blood flowing from the Nostrils incline most to a spitting blood Secondly among the evident causes ought to be reckoned primarily the excess either of heat or cold for when the blood grows above measure hot or the transpiration thereof through the Pores of the skin is hindred thereupon swelling after a huge manner it frequently bursts out of the pneumonic Vessels From hence Hippocrates long ago observed and as yet it is a vulgar observation That spitting blood most frequently happens in the winter when the North-wind blows Neither less seldom hath the use of bathing brought this evil upon many before the use whereof they were healthful enough Moreover many contract this from drinking of wine and strong waters from a blow a fall hollowing vomiting coughing or any other violent stirring of the whole body or of the Lungs Also certain poisons and according to Hournius the Lunar beams the reason whereof doth not easily appear neither doth there remain any credit thereto are reported to provoke this distemper The Prognostics of this disease are enough known to the vulgar The Prognistics of this disease whereas there is not any one of them who doth not suspect the spitting of blood as very dangerous Nevertheless whereas the kinds hereof are various one is found more or less dangerous than another The blood soaking out of the vessels of the Trachea is often free from any evil moreover when breaking out from the lowest and lesser pulmonar Vessels it often admits of Cure at least it is much safer than a plentiful spitting of blood happening from the great branches of the Artery being opened into the Trachea But the predisposition of the Patient makes a great difference in the Prognosticks of this disease for if blood-spitting be provoked by reason of a solitary evident cause and shall happen to a body formerly sound and well set there appears far greater hope of help than if the distemper arising of its own accord shall happen to a cachectical phthisical scorbutic or otherwise sickly body However 't is a common observation that this disease is dangerous and always difficult to cure the reason whereof is also clearly manifest for as much as the function of the Lungs consisting in a perpetual motion is altogether contrary to the method of healing a wound whereto primarily ease and rest are required In like manner this happens to be a greater hindrance to its Cure in as much as the frame of the Lungs is not a Parenchyma as was thought but a texture or very subtile web of innumerable vessels the unity whereof if once dissolved it will be altogether impossible for the ends of the disjoined vessels to meet again together or the space to be filled up with flesh or callous as in other parts But there is this only to be hoped that while the ends of the vessels grow together incongruously and always imperforated the circulation of the blood ceasing in the part distempered may be supplied by another neighbouring part which indeed rarely succeeds without hurt or prejudice of the whole Lungs As to what appertains to the Method of healing the Haemoptoe or spitting blood The Cure thereof the curative indications shall be chiefly these two viz. to stay presently and restrain the flux of blood then secondly to heal the dissolution of unity without any relicts of a Consumption in the Lungs I. As to the former these two things are chiefly to be procured 1. Indication viz. first that blood flow not to the part distempered and secondly that in the mean time the opening of the vessel
appropriate for that use which likewise is more frequently taken by such who nauseate and loathe Apozemes Take the tops of Cypresse A distilled water leaves of Ground-Ivy of each 6 handfulls of Snails half boyled one pound and half of all the Sanders bruised of each one ounce being cut and bruised infuse them in 8 pound of fresh Milk distill it in common Organs the Dose 3 or 4 ounces with a spoonfull of Syrup of Ground-Ivy to be taken twice in a day 2. The second intention respects the Lungs In respect of the Lungs viz. that without obstruction or opening of the vessels the Union of parts and due conformation of the whole may be preserved temperate balsamicks chiefly conduce To this intent Leucatello's Balsam is commonly prescribed to be taken daily and for a long season Chymists and certain Noble women do cry up with great praise a balsamick Oyl drawn by distillation called by them the Mother of Balsam It would be easie here to reckon up very many other remedies against spitting blood very much celebrated by the ancient as well as by modern Writers notwithstanding the harvest of these already gathered together doth at present seem rich enough But it remains that I illustrate as well the Theory of this disease as the curatory method above delivered by a History or two of sick Patients A noble young man The first History when after a scorbutical Cachexia he was affected with a Palsie and for curing this disease remedies not only great but improportionate to the blood and spirits were experimented by him viz. Salivation and the use of Baths he contracted a spitting of blood whose fits of all I ever knew not presently mortal were most fierce Presently on the first appearance of this disease spitting blood followed the Operation of Hues's powder from which having for some time suffered a flowing of the Mouth without his Palsie being cured he was reduced to great weakness Then being afflicted with a Catarrh and a Cough very troublesome he began to discharge a discolour'd Spittle sometimes stained and sometimes sprinkled with blood but this disease being mild from the beginning did suddenly vanish away by the use of remedies and after going into the Countrey and sucking in a more pure air he became better and after a while feeming healthful enough in his breast he went to the Bath for the benefit of his Palsie where daily bathing for a fortnight in those hot waters he again contracted a Cough and a little after an horrid Haemoptoe or a spitting of blood so that in the space of 24 hours coughing often and plentifully he poured out blood in a vast quantity I first visiting him in this condition provision being made for the whole I prescribed presently Phlebotomy for revulsions sake notwithstanding after this administration both then and ever after he either repeated the bloody spittle or grew worse Moreover I exhibited Juleps Lohochs Decoctions and also Hypnoticks which helping little or nothing ligatures made about his arms and thighs did first of all restrain the tyranny of this disease And when afterwards the Evil broke out again I perswaded him at length his drink of Beer being left that he should constantly drink the decoction of China and Sarsa with the Pectorals By the continual use hereof observing moreover an exact course of diet and altogether abstaining from wine more hot aliments and Salt and Sugar for above two years he was well in health But afterwards when by being crouded in a Court of Judicature he grew mighty hot he relapsed back again into a terrible spitting of blood A Physitian being sent for he was presently let blood in the arm whence his spitting of blood became more sharp and when afterwards letting blood was repeated the second and third day and the evil grew worse every time at length Ligatures as at first being administred and the pectoral drink and a Linctus being often taken the disease presently remitted and in a short space wholly ceased notwithstanding he continued the use of his pectoral decoction and slender diet viz. no flesh-meat for a fortnight and from thence he obtained truce from his enemy for three years and when afterwards at any time the blood sweeling by drinking of wine or taking more dainty food began to break out from the Lungs presently by ligatures and the use of the Decoction and Lohoch and a thin diet its assault was wont to be repulsed But he did not so safely escape but that it was necessary for him for the most part to keep perpetual watch against that enemy always lurking for not long since by reason of the intemperature of the year he contracted a troublesom Catarrh with a Cough a plentifull spittle and sometimes bloody and then the former medicines effected less wherefore he betook himself by his own advice to new things and in the first place took evening and morning a spoonfull of Syrup of Ground-Ivy and thereby ensued a notable help but when that Syrup became quickly loathsome by reason of the Sugar he took the powder of that herb well prepared to half a dram or one dram twice a day in a spoonfull of some liquor by the long use of which Medicine he was much better as to his Catarrh and Cough But when the spitting of blood now and then broke out though in little quantity he chang'd again his Medicine and took twice in a day the powder of the tops and chiefly of the hairy excrescences of Cynorrhodon or Dog-bryer which only medicine a certain Physician renowned for merly for the cure of spitting blood used with great success Neither did our Patient receive a less happy effect from that medicine for presently after he escaped altogether free from a Cough a Catarrh and bloody Spittle and so remained for a long while untill at length believing this disease of the Breast to be wholly subdued and therefore slighting it he assumed weapons against the other more ancient enemy the Palsie Wherefore while his Haemoptosis or Spitting of Blood was neglected he daily took a large dose of hot Medicines to conquer that other distemper viz. magistral waters distilled with Wine spirit of Harts-horn of Sa't Armoniack and Aromatick Powders and Confections Besides whilst he indulg'd himself in a more plentiful diet with a moderate drinking of Ale and Wine the roaring Lion that at first seem'd to sleep was again stirr'd up viz. he had not long continued in that antiparalytical Method but the Spitting of blood returned with its greatest fierceness so that in the space of a day and a night he coughed out above three pints of spumous blood But afterwards a Physician being sent for who presently prescribed Phlebotomy the spitting of blood began to cease upon bleeding as formerly it was always wont to do but then fell into sharp fits again which however by the use of Ligatures and a Lonoch and pectoral Decoction daily taken was presently asswaged and a while after wholly ceased And when
less prejudiced and as it shall be more intense or remiss this disease also is denominated either more or less acute As to the Prognostics of this disease Prognostics common experience doth attest that it is a very dangerous disease because many Patients either die of it or very difficultly recover health No less may we conclude this from the reason or Etiology of it for a wound with much extravasation of blood or a stagnation caused in the Lungs is most difficultly cured and the affected place is never restored unto its former conformation The prognostic signs which are of greatest note are taken from the appearance of Symptoms and nature of things thrown out and the state of strength 1. 1. From the appearance of Symptoms A Peripneumony coming upon a Pleurisie or Quinzy for the most part is worse than arising of it self or succeeding either of them but if upon this disease after what manner soever begun an acute Feaver follows with great thirst watchings and not breathing unless set upright it is ill and yet much worse if upon it a Delirium a Fenzy convulsive motions or a Palsie on one side ensue Moreover the Patient is not in less danger if he be very pursie if troubled with vomiting or frequent swounding away a weak Pulse and a cold Sweat For while these Symptoms are instant upon him the obstruction of the blood in the Lungs is not removed nothing is digested or ejected by spittle but the circulation of the blood being more and more hindred and its kindling by breathing stopt the animal spirits are throughly disordered and at length faint until together with a prostration of the whole strength the vital flame is extinguished 2. 2. From what is excreted As to Prognostics from things excerned we observe a Peripneumony to be dangerous wherein nothing is thrown out by spittle next to this then the spittle is thin and crude mixed with blood it is far better when the spitting is yellow and thick streaked with a little blood The Urine being yellow from the beginning and of a good consistency with a cloud in the midst shews that almost all the recrements of the blood are lodged in the place affected when from that state it is changed into a thick and turbid Urine it shews the morbific matter to be swallowed up again from that part into the blood but if such kind of Urine be suddenly changed into a thin one then a Delirium or death it self is impendent Much Sweat and plenty of Urine a Diarrhoea bleeding at Nose flowing of the Menstrua's or the Haemorrhoids do frequently promise good in this distemper yea any of these Evacuations happening seasonably doth frequently discharge the disease 3. 3. From the state of strength The condition of strength is ever of great moment in forming a due Prognostic in this disease for oftentimes when horrid Symptoms as an intense Feaver a Breathing very painful with a Cough watchings and other ominous signs shall be pressing if the Pulse be as yet strong and the animal spirits persist in their vigor there is better hope of the Patient than if these things being more quiet there were a weak Pulse and the Spirits should become drowsie and oppressed The first indication about the curatory Method in a Peripneumony is The Cure hath two chief indications that the blood being impacted in the pneumonic Vessels and causing a phlegmonous obstruction may be from thence discussed and restored to its pristine circulation Which if not to be procured the second indication will be that that matter be duly digested or brought to suppuration and with all expedition voided by spittle While the former indication prevails the intentions of healing will be these ensuing The first indication suggests four intentions of curing First that the more plentiful afflux of blood to the part affected be prevented or pro hibited by some means Secondly we must endeavour that the matter stagnated or extravasated in the Lungs be swallowed again by the Veins into the rest of the mass and caused to circulate Which that it may be the better procured thirdly the hoold ought to be freed from its clammy viscousness whereby its fluidity is impeded Fourthly that we apply to the Symptoms most urgent viz. a Feaver cough Watchings and difficult Breathing fit Remedies But if notwithstanding all these another indication shall come into use it will be requisite to prescribe maturating and expectorating Medicines vulgarly so called together with these 1. That we may satisfie the first and second intention together 1. The first intention that the afflux of blood may be cut off 2. That the extravasated be reduced to oirculation Phlebotomy is for the most part requisite in every Peripneumony yea sometimes it ought to be more frequontly repeated for the vessels being emptied of blood do not only withdraw the nourishment of the disease but do also sup up the matter impacted in the place affected Wherefore if strength remain and the Pulse be strong enough a more free breathing of a Vein is convenient at the very beginning but otherwise let it be used in a little quantity which however may be repeated as occasion offers it self We intimated above that blood drawn in a Peripneumony and also in a Pleurisie after it is cold contains in its superficies a small viscous and discoloured film moreover we may observe one while the blood entirely another while only a portion thereof is subject to this change For when the blood is received into three or four dishes sometimes in all but oftener in the second and third dish it is apparently bad and in the first and last laudable enough wherefore they commonly give it in precept that blood is always so long to be emitted till that which is so depraved begins to come forth and if strength remain the bleeding should continue till the good blood flows out again Truly as common experience doth approve of this practice even so doth reason it self for in this disease Rules concerning Phlebotomy because the whole mass of blood doth not presently acquire that clamminess the depraved portions are chiefly accumulated about the place of obstruction and adhere on every side in the lesser vessels Wherefore the blood first issuing by Phlebotomy is often void of any fault afterwards the vessels being emptied receive the other morbific matter at first stagnated and restore it to its circulation and when the portions thereof being placed near are carried as it were in a joint troop they flow out together at the orifice of the opened Vein and after that entire mass of bad blood hath flowed out the residue being more pure doth succeed Wherefore in this case ever let incision be made with a large orifice and let the blood be drawn out not only with a more plentiful spouting but also with a continued for otherwise if in the midst of Phlebotomy the bad blood issuing out the orifice as the manner of some
most frequently periodieal as is manifest to common observation According to this account we do deservedly suspect the cause of a convulsive asthma sometimes to lurk in the muscular coats of the pneumonick vessels also sometimes in the fibres of the Diaphragma or the Processes thereof towards the loyns It is not very probable that the nest of this disease consists within the fibres of this or that pectoral muscle although in Scorbutical persons from these also possessed with a convulsive matter we have known pains to have risen with breathing being hurt 2. But truly even as in another place we have not only demonstrated by reason 2. Within the Nerves and their ensoldings but by the observations and Histories of the sick a convulsive asthma is often incurred as often as the morbific matter sliding down into the pneumonic Nerves sticks in some place within their passages and especially about their foldings whence as often as it is accumulated to a plenitude it begins to be mov'd and shaken wherefore the spirits lying lurking and flowing into the ongans of breathing disturbed are forced into irregularity and those spirits presently affect other inmates of the fibres of the Lungs and breast and provoke them into unequal and asthmatical convulsions For this cause and the reason of the disturbance we have declared that not only invasions of this disease but also the precordia being disturb'd thereby the Cardiack passions do arise 3. 3. Near the Origines of the Nerves We have clearly unfolded by anatomical observations that the cause of a convulsive Asthma sometimes consists in the hinder part of the head near the origines of the nerves Surely I have observ'd some patients who when lying sick of other desperate diseases they were also asthmatick found it necessary to be whether in bed or chair with their head always erect or looking down but lying on their back or leaning backwards incontinently they gaped for breath as if they were dying and hardly breathed the cause whereof as appear'd by dissection after they were dead was only a huge collection of sharp Serum which was gather'd within the cavities of the brain which if by reason of the head inclining back wards it fell into the origine of the Nerves of the eighth pair presently the precordia and chiefly the breathing organs were affected with horrid cramps Moreover sometimes for this very reason it seems that Orthopnoick persons cannot lie down in their bed without danger of choaking but are constrain'd to sit up with an erect body III. 3. A mixt Asthma or partly Pneumonic and partly Convulsive Although an Asthma is sometimes simple from the beginning viz. either merely pneumonical or convulsive notwithstanding after either disease hath for some time encreafed for the most part it gains the other to it self hence it may be concluded every inveterate Asthma to be a mixt affection stirr'd up by the default partly of the Lungs ill fram'd and partly by default of the Nerves and nervous fibres appertaining to the breathing parts For when the pneumonic passages being straitned or obstructed from some cause do not admit of a free sucking in and breathing out of the air for that cause also the blood yea and nervous humour being hindred in their courses and compell'd to proceed slowly and to stagnate do fasten their feculency and dregs upon the nervous parts whence the passages of the spirits are obstructed or perverted and at length a convulsive taint accrues to them Moreover the blood being not duly inspir'd and eventilated within the precordia at length being vitiated in its temperament supplies the brain and nervous stock but with a depraved juice whose faults do chiefly punish the organs of respiration before hurt and debilitated In like manner also the evil is reciprocrated on the contrary part as oft as this disease begins by fault of the nervous stock for as much as the motion of the Lungs is often stopt or hindered by reason of Convulsions in the muscular fibres both the blood and the nervous juice being restrain'd from their usual motions do heap up dregs and filths fastening them to the parts containing them by which not only viscous humours and obstructing of the passages but even Tumours and other more solid concretes vitiating the structure of the Lungs are produced Therefore if when an Asthma being for some time confirmed and become habitual The causes of an Asthma recited shall attain to frequent fits and those emergent upon every occasion the conjunct cause thereof and also the procuring cause is placed as well inwardly in the lung it self as outwardly in the Fibres and Nerves and in the spirits imploy'd for the function of breathing Neither will it be difficult by seeking diligently each of these things to find in any case of the patient as well the chief nests as nourishment of this morbifick matter But as to the evident causes they are very many and also of diverse sorts For hitherto ought to be referred whatsoever move either the blood and the other humours or trouble the animal spirits and force them into irregularities Asthmatical persons can indure nothing violent or unaccustomed from excess of cold or heat from any vehement motion of body or mind by any great change of air or of the year or from the slightest errors about the things not natural yea from a thousand other occasions they fall into fits of difficult breathing As to the prognostick part The Prognosticks of the Disease an inveterate Asthma is difficulty or scarce ever cured notwithstanding the medicines and method of healing being rightly ordered oftentimes great succour is afforded viz. the fierceness of the fits is diminish'd longer respites are procured yea even the dangers of life it self seeming frequently to be imminent are removed This disease growing worse either threatens a Consumption or a Dropsie or some drowzy or convulsive affect accordingly as the Serum by reason of perspiration being hindred being more abundantly accumulated because the sick cannot sleep enough in their beds it is either fixed in the lungs or transfer'd into the habit of the body or into the brain it self For this very reason the diseased do find themselves better in Summer when they breath more freely than in Winter likewise better in hot countries than in cold the South or West wind blowing than the North or East Of the curatory method of an Asthma there will be two chief indications Two chief Indications or rather so many distinct methods of healing viz. Curatory and preservatory The first instructs what is to be perform'd in the fit it self that the Patient may be delivered from present danger the other by what out of the fit we ought to endeavour the taking away the morbifick cause lest that distemper be repeated more often or more heavily 1. Therefore a fit urging there will be two chief intentions of curing viz. first What is to be done in the fit that a more free
of small Cinnamon-water one ounce Diacodium three ounces Tincture of Saffron two drams Mix them and take one spoonfull at night if sleep be wanting Or Take Syrup of Cowslip-flowers three spoonfuls compound Poeony-water one spoonful Laudanum tartarized one dram take one spoonful if Watchings require it 3. Extinguishers of Thirst in this Disease being very thirsty Things mitigating Thirst ought frequently and in small quantities to be administred that that troublesom symptom may be restrained without much drink which is perpetually pernicious For which purpose Take of Conserve of Wood-sorrel passed through a Sieve three ounces Pulp of Tamarinds two ounces Sal Prunella one dram with a sufficient quantity of Syrup of the juice of Wood sorrel make a Lohoch of which let him lick often SECT II. CHAP. V. Of an Anasarca NOw two kinds of Dropsies viz. Ascites and Tympanie according to common reckoning being finisht although the third to wit an Anasarca for that it is an affection rather of the whole body than of the nether Belly appertains not properly to this place notwithstanding the Pathologie thereof having some affiance with the former we think sit to deliver here also its Cure in short The description of an Anasarca An Anasarca is described after this manner That it is a white soft Tumour of the whole outward Body or of some of its parts yielding to the touch and leaving a dent upon compression proceeding from a watery humour extravasated and accumulated as well within the interspaces of the Muscles as within the pores of the flesh and skin yea of the Glandules and Membranes It differs from an Ascites as to its outward form and appearance How it differs from an Ascites yet not as to its morbific matter which being the same in both distempers as it is heaped within the greater or lesser hollownesses it gains divers Appellations of the Disease The watery humour procuring an Anasarca The Original from the blood doth proceed altogether or for the most part from the blood for it being continually produced within the mass of blood by the fault and defect of sanguification it is poured out in greater abundance from the extremities of the Arteries than can be received or brought back by the Veins or the Lymphaducts or can be discharged by the Reins or pores of the skin and other vents of the serous Juice From these it follows that the material cause of this Disease is a watery humour The material and efficient cause and the efficient is blood which engenders waters and deposits them in the places affected We will exactly weigh the reasons of either of them and the manner of becoming and effecting it and first we will treat of the efficient Cause of an Anasarca 1. The affection of the Blood or rather the Hydropical brood The Blood its efficient cause in a double respect consists in these two things to wit First by reason of a failure or fault of sanguification it doth not rightly assimilate the nutritious Juice perpetually infused into its mass but suffers it to degenerate into a watery humour Then secondly by reason of the too loose mixture thereof it doth not retain that humour so degenerated so long within its consistence untill it might be discharg'd through fit Emunctories or Emissaries but lets it out every where near to the ends of the Arteries into the inter-spaces of the Vessels and there leaves it Either of these vices of the Blood we will consider a little more In the first place as to the former for the most part it is confessed by all First that it doth not rightly sanguifie that the Blood it self and not the Heart or Liver sanguifies by what of late is plainly understood concerning the functions of these parts yet by what means the Blood assimilates Chyle infused to it self and converts it into fresh blood to be bestowed to so many and diverse sorts of uses doth not easily lie manifest to us But what some affirm that it is made only by the exact comminution and commixtion of particles and for that cause the particles of either kinde being confused together they think that within the straiter passages of the Liver and Lungs they are kneaded and wrought together as it were with little pestils seems little probable to me but on the contrary I think these bowels as I have shewed already are constituted the Organs rather of separation than of mixture The reason whereof enquired into but the reason of sanguification altogether consists in this that the active particles of the old blood to wit the saline and sulphureous being placed in vigour with the spirituous immediately act upon the like particles of the infused Chyle as yet existing in an inferiour state and do so stir them up and ferment them that thereupon being extricated from the coverings of the thicker parts they are carryed into a like degree of exaltation or perfection with the former and being at length associated with them and made also homogeneous they put on the same nature of Blood the more thick and heterogeneous particles being removed thence to another place from those which they had deserted and gone away from For truly Sanguification is altogether finisht by Fermentation even as the maturation of the Must into Wine or Ale but the reason of the difference is that Wine being shut up in the Tub still remaining entirely in the same Mass is flowly fermented as to its whole consistence and is not accomplished but in a long space of time but the Blood constituted in a perpetual flux by the loss of some parts and the reparation of others is fermented by the parts still received fresh and is generated anew The old Blood for the most part affords the same thing towards the fresh Chyle The reason and manner of sanguification explained as Ferment from the flower or faeces of old Ale being put into new Ale notwithstanding as it were by a contrary manner because the huge mass of blood being formerly fermented doth suddenly ferment and alter the small portions of the Chyle continually brought in but the fermenting liquor in Ale in a very little quantity is put to the great mass of the other liquor to be fermented which it brings not to maturity under a long space of time After the rudiments of blood are so cast by fermentation the conclusion and perfect assimilation into blood is acquired by accension for surely that it is so enkindled as I think I have formerly shewed by demonstration which arguments chiefly taken from its proper passion although many have cavil'd at none have been yet able to overthrow Wherefore while the whole mass of blood consists of Blood and Chyle confusedly mixt together it is fermented while it is circulating andbeing divided into most minute portions is spread through the whole Lungs that it might be kindled successively according to all its parts by the nitrous air suckt in for by that means both the
vital flame is continued and all the particles of Blood having as it were passed the fire become more purified and more agreeable among themselves moreover they are so disposed of whilest they are kindling that while some go into Nourishment of the Spirits of the Nervous Juice and the folid parts and others less useful depart into the ferments or recrements of the bowels mean while others being more fixt abide longer in the mass of blood and sustain its consistence and by fermenting the Nutritious Juice still engender new Blood untill themselves being impoverished are at length discarded and give place to others that are fresh and Iustie Having shewed after this manner by what course Sanguification ought to be finished An Hydropick temper of the blood springs from a double respect as well by fermentation as accension of the Blood it will be easie to conceive wherein the fault confists producing an Hydropick dispdsition To wit this usually assumes its rise whensoever either or both those Conditions requisite to Sanguification ether fail or are perverted First therefore this bappens more frequently and rather Viz. First from the desect or fault of its Fermentation for that the blood being depraved in its temperature doth not rightly ferment the Nutritious Juice poured into it that so it might be changed into laudable blood For when the watery particles predominate with the earthy in the mass of Blood the Salt and Sulphur being depressed with the Spirit as all the functions both Vital and Animal from thence languish and waver so especially Sanguification it self fails and is perverted For the Juice of the Chyle commixt with the Blood when it cannot be dissolved and fermented with the particles thereof after the fashion of other liquors as often as being mixt they want ferment it degenerates perhaps into a watery acid or ropy or otherwise faulty humour which being afterwards daily encreased and at length rising to its fulness lyes heavy on the blood and oft-times almost stifles its heat from whence there is a necessity that it be forthwith discharged by some means and wheresoever it can get vent but afterwards for that the offices of separation fail in their sunctions the stock of the animal Spirits Languishng by reason of the diminished provision from the influxe of Blood the abounding Serum is deposited every where into the pores and next vacuities whether greater or lesser out of the little moughts of the Arteries from whose daily and great encrease after all the pores are filled arises that as it were fenny habit call'd Anasarca of the whole body outwardly or of some of its members Secondly not only the defect or fault of Fermentation Secondly from defect of Accension but also of the accension of the Blood induces sometimes an Hydropical disposition on the mass thereof which is clearly discern'd inasmuch as some persons inhabiting Maritime or moorish places fall into the Dropsie without any other cause or occasion than that they draw a thicker air endowed with heterogeneous vapours by which the Nitre is either driven away or obscured Therefore the blood becoming degenerate and vitiated as to its temperature because it is not duely kindled nor perfected by efflagration within the precordia doth not rightly dissolve and assimilate the Juice of the Chyle but suffers it to be perverted into a watery liquor But although in the first place the blood being depraved for this reason sometimes loses its fermenting vertue and therefore the rather and more immediately procures a Dropsie notwithstanding it is manifest the first fault thereof assumes its origine from unwholsom air suckt in and not duely enkindling the Blood because such Hydropicks removing their residence into Sunny and Mountainous places recover their health without any other Medicines Hitherto of the nearest Causes of an Anasarca and which are conjoyned to the Disease it self which namely are the depravation or defect of the mass of blood chiefly as to its fermentation and in some measure as to the enkindling thereof which latter is scarce wont to be effective but when if follows the former But what remains as to the more remote and procuring causes of this Disease to wit from which the defermentative affection arises that I may say no more of the defect or depravation of its enkindling I say that these appear so diverse and many that I judge it hardly possible to recite them all particularly notwithstanding very many or at least the chief may be reduced to these three heads to wit Reduced to three heads For that the watery distemperament of the blood doth arise inasmuch as its active Principles viz. Spirit Salt and Sulphur are not invested with their fermenting and sanguifying force or vertue I account this to come to pass either First because those particles are too much wasted by their great expences or Secondly because they are not repaired by convenient and proportionate Refections or Thirdly for that they are overwhelmed or obscured by some other duller or heterogeneous Particles being too much accumulated in the mass of Blood We will a little weigh the Reasons and ways of each of these their coming to passe In the first place the former of these is evidently discerned in frequent and inordinate Haemorrhages whereby many men although strong and formerly healthy First because the active particles of the blood are too much consumed are immediately enclined to a Dropsie more than from any other accident or occasion the reason whereof is that the blood is so impoverished through its more noble Particles issuing out in great abundance that afterwards it can neither duely ferment nor enkindle the Juice of the Chyle brought into it Moreover sometimes the same effect fucceeds although in a more slow degree from Feavers and other long maladies and languishings to wit inasmuch as the blood suffering under a long depression is so extenuated and robb'd that at length it becomes watery and defermentative Secondly the Blood sometimes deferting its genuine disposition Secondly because they are not enough repaired declines into an Hydropical one for that the nourishment being more slender than it was wont or ought to be bestowed upon it its active and sanguifying Particles are not enough repaired within its masse for so we have observed that some who have used themselves to Wine and stronger Drink after they have been reduced to homely Diet and smaller drink of water of small beer suddenly have become Hydropick It is a common observation and frequently true although of ill omen that Drunkards and darly drinkers if that wild Custom be left at length becoming sober and abstemious are much in hazard lest by reason of the usual fermentation of the blood being denressed they become obnoxious unto that Disease I knew a notable Drunkard who declared that a Priest very learned and Pious was guilty of his death because he gave him admonition to Temperance and to leave his Drunkenness Thirdly because they are buryed in duller
being administred he was restored to his entire health and even now though five years since lives and continues sound There remain certain other splanchnical Affections The 〈◊〉 of 〈◊〉 〈◊〉 touching the Remedies whereof according to the ensuing method we should here have treated notwithstanding I have performed this task already for the most part under other titles for as is above intimated Remedies which concern the Kidnies we have for the most part unfolded under the rank of Diureticks and those which concern the Stomach and Guts under that of Vomits and Purges what relates to the Spleen we have finished in the Hypochondriac Pathologie and what to the Womb in the Hysterical As to what appertains to the Genital parts and their Diseases and help I reserve for another time and place it behoves me now next of all after treating hitherto of the inward Pharmacie to discourse something of the outward and of the Reason or Aetiologie of the administrations thereof which shall be done inthe next Section beginning with Phlebotomie that great Remedy SECT III. CHAP. I. Of Phlebotomie AMong the universal Documents of Philosophie Phlebotomie a very general and ancient medicine or aids of Physick none either in Theory or Practice hath been more ancient or general than the speculation of the Blood and letting it out by opening a Vein As to the former we have in other places often explicated the nature and constitutive parts of the Blood we have unfolded the Virtures and Energy of the same and have demonstrated that it is in truth enkindled and that from the burning there of the flame of animal life as of a Lamp doth begin and receives continuation But as to what relates to Phlebotomie all Authors of every age have made mention thereof Moreover the same was ever in Medicinal use with all Nations howsoever barbarous or rude Neither is it a wonder for truely Nature it self in the first place hath taught the necessity and way of that part of Chirurgery Even the Divine Law commanding the Rite of Circumcision as a Symbol thereof seems to intimate that the innate impurities of Humane Nature ought to be purged in some manner by letting out the blood That we may methodically discourse of this great Remedie Nature shews it by Haemorrhagies we ought first to consider by what means also for what causes and ends the letting of blood either happens spontaneously to Nature or is indicated by the Physitian then secondly we will annex the chief effects of this Evacuation as well good as bad whether advantageous or disadvantageous and together propound certain Rules and Cautions to be observed about due administration of Phlebotomie As to the former spontaneous Haemorrhagies which suggest the use of Phlebotomy whereas they are manifold and of diverse kinds they are usually reduced to these two heads or ranks to wit they are denominated either critical Nature endeavouring something good and wholsome or symptomatical which for the most part happen she being dejected from her government and being altogether out of order Critical either with or without a feaver The bloody eruptions of the former kind are again distinguished that they are either raised without a Feaver and are either perodical which happen often at set seasons as the Flowers in Women and the Hemorrhoids in some and in others the solemn or otherwise accustomed opening of the Nostrils which very often succeed according to the great changes of the Year or alterations of the Air or they are fleeting and uncertain as when blood doth advantageously break out of those places and of many others one while in this part another while in that part of the body Moreover bloody Crises do sometimes happen in a Feaver and do often put an end to it as Hippocrates long ago observed and is now manifest by very common observation The blood breaks out in all these cases inasmuch as being turgid and above measure rarified within the vessels it desires a larger space wherefore unless some portion thereof give way the whole mass rund the hazard of being constipated and as well the motion thereof to be hindered as the enkindling to be suffocated and the temperature to be perverted For there are two chief Reasons or Causes The causes thereof proceed either wherefore such turgescencies of the Blood do arise inasmuch as its liquor is as well inflammable as fermentative 1. As to the former of these that the Blood may be duely enkindled for the supporiting Life 1. From the kindling of the blood and the due exercise of the functions thereof it behoves that the innate sulphureous particles of it be proportion'd unto the Nitrous adventitious ones from the Air. Therefore as often as the Blood being very boyling and rarified is much opened and loosened in its own consistence so that the Sulphur being dissolved is kindled in greater plenty there is a most frequent and painfull breathing instituted for the drawing in of a more plentifull Nitre Now if the Sulphur abounding in this manner cannot be wasted by burning nor the vital flame regulated the next course immediately to diminish the sulphureous suel is that a certain portion of the rarified Blood have vent From hence not only in Feavers but after drinking Wine Bathings being in the Sun and other accidents by which the Blood grows very turgent either an Haemorrhagia of its own accord succeeds or there is often need to supply the defect of such a spontaneous evacuation by Phlebotomie But that such kind of effusions of Blood whether made by Nature or Chirurgery are commonly reported to bridle its heat or raging really they do this only inasmuch as they diminish the kindling of the blood by withdrawing part of the sulphureous fuel as Oyl from a Lamp 2. But moreover in the second place the Blood 2. From its Fermentation inasmuch as it is a fermentative liquor it is apt also to be extravasated Namely if at any time any heterogeneous thing and not miscible be confounded with its liquor it grows hot very much like Wine in a Vessel and boyls up in the Vessels to exclude that disagreeable thing which if it can neither subdue nor turn off by Sweat Urine or otherwise the Blood it self excludes part of it self as a Vehicle for carrying that matter forth wheresoever a vent is to be found For this reason viz. that any disagreeable or indomitable thing may be turn'd out of the mass of blood divers sorts of Hemorrhagies happen as well in Feavers as without them all which are excited by Nature for an intention of good as also those by which the too much enkindling of the Blood is depressed But that frequently it happens otherwise ought to be imputed to divers accidents and circumstances But for the most part the sailure about the spontaneous Hemorrhagies critically instituted 1. Criticall Hemorrhagies sometimes turn into symptormatical is either in the first place because the blood while it is boyling knows
through the whole substance of the Lungs by a certain knitting and alike branching This is plainly perceived by a pleasant sight in a lobe of the Lungs being emptied and turgid Quick-silver being cast into some of the Vessels and others filled with a coloured liquor But in dissecting the living another sort of Vessels viz. Lymphaeducts are manifest to the eye to be spread through the whole Lungs The Lymphaeducts and nervous slips and we have in another place clearly enough shewn both very many Nerves and nervous slips every where to be distributed through them Besides these parts and the primary or chief vessels of a Lung some others and those as it were secondary are to be observed For the Pneumonic Veins and Arteries are endued with other sanguiferous Vessels springing from the Aorta moreover with Glandules and likewise with Fibres as well nervous as moving and the Wind-pipe is endowed with every one of these and cartilaginous ones besides Whence we may infer that the entire frame of a Lung is meerly fistulous The Vessels of a Lung and compacted of Pipes of several kinds and magnitude and variously and most intricately disposed which although they may appear wonderfully complicated and many ways twisted and wreathed are yet every where continuous and being stretched out with a mutual respect to one another do hither and thither in good order and regularly convey and dispose the air the blood the Lympha and animal Spirits for some accessary uses To describe as it were with a Pencil this bulk of a Lung together with the branchings separatings and mutual complications of all its Vessels would be no less difficult a task than to trace the several threads of a harl of silk and their respect one to another Nevertheless that both the Pathology of the Thorax and the cure may be duly known according to our design it seems to be material to recite here all the Vessels of the Lungs one after another and to deliver as well their descriptions as their preternatural uses and diseases to which at length the Therapeutic Method shall be subjoyned And these are the Vessels of which the entire fabrick of the Lungs consists the Wind-pipe with the Bronchia and little Bladders Arteries Veins Lymphaeducts and Nerves to which may the parts and appendices of those Vessels be added viz. the Coats of the greater Vessels which are endued with other sanguiferous Vessels and Glandules and also with nervous Muscles and Fibres Therefore as to the chief Vessels of the Lungs although all these by reason of their mutual offices communicate among themselves with a wonderful affinity yet the Arteries and Pneumonic Veins attend on the Trachea and its partitions the most exactly Wait on the Trachea for the branches and sprigs of every one of these springing alike from their respective stocks and stretcht out to and fro go on every where with like pace so that the Trachea and its branches are always in the middle above that the Vein and beneath the Pneumonic Artery are carried and all are distributed with an equal and sociable branching and the sprigs and branches sent from each of them are presently applied to their like and are interwoven like wonderful Nets of which the texture of the Lungs is almost totally constituted It will be impossible to describe the spreadings out and various complications among themselves of all these going on together as to the lesser sprigs and slips yet if you will cast into every vessel apart Quick-silver hot and flowing Gypsum Wax mingled and made liquid with Oyl of Turpentine or some such matter which will extend all or the chief passages and continue them stufft then you may exactly enough represent the figure and after that manner the frame or texture of the whole Lung may be conceived each being described by it self and apart Wherefore upon these and all other Vessels and parts of the Lungs we will treat in order and first of the Trachea or Wind-pipe The Wind-pipe or Aspera Arteria is a Pipe somewhat long The description of the Trachea consisting of Grisles and Membranes which beginning from the Throat or lowest part of the Jaws and leaning on the Gullet and descending into the Lungs is dispersed by manifold little branchings through their whole frame It is divided into two parts by the Ancients viz. the upper which is called the Larynx and the nether commonly called Bronchus to which a third or lowest is added by Malpighius called Vesicularis or the bladdery one The former of these which is the beginning of the Aspera Arteria The description of the Larynx doth chiefly serve for vociferation or loud noise formed of many and various Grisles to which also are adjoyned proper Muscles the description and use of all which are so exactly delivered by Anatomists that there is no need of dwelling longer on the description we only advertise for methods sake and by way of abridgment that the Larynx contains some greater Cartilages of divers forms and some uniform the former by reason of resemblance bear the denomination of Epiglottis the Buckler-like Cartilage the Ring Grisle and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 To this last doth succeed a continual rank or row of Cartilages fashioned altogether after the same figure and manner every one of which whereas they resemble a circle but not compleat are disposed after such a sort as if one so compose many wooden Rings that there should grow up from the sides of them by laying a good many one upon another a certain Pipe as it were with Ribs These circular Cartilages are equally distant one from another in their whole passage and are knit together by the benefit of an inner Membrane which fills up the spaces between like the Periostium as with a ligament But the hinder part of every Ring-like Grisle where it lies upon the Gullet that it may serve better to the swallowing of meats turns into a Membrance which altogether is the same and binding together those cartilaginous rings and covering the whole hollowness of the Larynx is always moist with an unctuous homour by which it may as well be defended against the sucking in of sharper air as breathing out more acrimonious vapours Besides this inner Membrane Membranes encompassing the wind-pipe also another outward though thinner encompasses the whole Wind-pipe by the aid whereof both the Cartilages are more firmly knit among themselves and the whole Pipe bound to its neighbouring parts and descends more safely and strongly into the Breast Besides we judge there are some other uses and offices of either Membrane than that it only serve to fashion or defend the sides of the Wind-pipe for as much as we do here manisestly observe many Nerves and nervous strings every where inserted and also the more inward Coat of the Aspera Arteria to be endued with Fibres as well nervous as fleshy or musculous from whence we may conclude the Wind-pipe to injoy both a certain sense
while these muscles are contracted for inspiration and another while for expiration in the mean while the opposite muscles have a pause and are moved by turns that they mutually give place to themselves successively From all this in the first place it is clear which likewise in another place we have abundantly declared that the animal Spirits for the exercising the contractive motion of the muscles leap from the Tendons into the fleshy Fibres and afterwards for their relaxation they recede out of these into those Moreover whereas the mutual function is twofold viz. spontaneous and meerly natural In the animal function we have before shewed in the former that the Spirits are brought from the Tendons into the fleshy Fibres by approaches according to the command of appetite and to remain within during the action till they are dismissed by its will and afterwards return into the Tendons till they are again commanded forth insomuch that the times of their motion and rest are unequal and uncertain and variously determined at our pleasure But it is far otherwise in the natural function And natural because the animal Spirits are carried out from the Tendons into the flesh by perpetual turns or constant reciprocation and a short contraction being made presently leap back from the flesh into the Tendons and so alternately after which manner the Heart it self the Organs of the Trachea and breathing also the fleshy Fibres of the Stomach and Guts unless they are otherwise limited by reason of their objects are drove on by their constant Systole and Diastole It will be needless to repeat here what we have already observed in another place touching these two kinds of motions The motion of the former sort ariseth from the brain the other from the Cerebellum viz. that the animal spirits of the spontaneous moving function are altogether or chiefly dispensed from the brain and the others causers of the meerly natural function are dispensed from the Cerebellum moreover also as the plenty of both sorts of spirits so the very instincts of beginning those actions have their conveyance through the Nerves Notwithstanding here ariseth a doubt to what kind of moving function It is a quaere of what kind the actions of breathing are viz. whether spontaneous or meerly natural the actions of breathing ought to be referred also of what original viz. whether of the Brain or Cerebellum the animal spirits appointed to that employment are It is manifest enough that this function is in a sort partaker of a spontaneous motion because it is in our power one while to shorten its exercises at other times to prolong and otherwise diversly to alter them yea sometimes a little to restrain them Moreover the nerves belonging to its chief moving Organs viz. the Diaphragma and Muscles of the breast springing from the nerves of the Arms and Loyns do owe their descent to the Brain and do plainly acknowledge the spirits they contain are chiefly ordained for voluntary motions but moreover on the contrary this function is so far natural that its organs do reciprocate the constant changes of Systole and Diastole in sleep without our notice and while we wake we not perceiving it Moreover although we can for some little time stop its exercise or at our pleasure vary it yet we deny it to be altogether or long suspended besides although the nerves appointed to the muscles of the breast and Diaphragma proceed from the spinal nerves yet these latter coming from the branches belonging to the arm communicate in their progress with the slips of the intercostal nerves moreover all the other nerves which belong to the Cerebellum arise from these which are spread about through the Trachea and Lungs From these it plainly follows It is concluded to be a mixt act that the power of breathing is as it were a mixt action and doth participate of either moving function viz. as well of the spontaneous as natural and that the spirits and nerves of either Province are imployed in this duty which proceed as well from the brain as from the Cerebellum and truely so it ought to come to pass according to the animal government for although some actions of breathing necessary for the preserving life ought to be constant and perpetual there are yet many other motions of the breast and lungs onely occasional and to be perform'd at our pleasure as may be discerned in laughing crying singing hollowing whistling and other singular offices of the lungs and wind-pipe in which works that they may be done strongly the muscles conspire together and endeavour joyntly As in violent labours and exercises of the whole body by which the blood being stirred up doth want the greater ventilution the arms being vehemently moved also do force the muscles of the breast and other pneumonic organs into more speedy motions for a more frequent breathing And truly for joint labour of this sort of the Arms and Diaphragma the nerves serving this motion proceed from the nervous branches of them Moreover it is provided for this purpose lest the exercises of the body might enfeeble at any time the strength of the lungs or exceed the order of breathing for when its organs labour more difficultly or begin to be weary the nerves of the Diaphragma do warn the other nerves of the arms plucking them and as it were admonishing of their duty to desist from an over intense motion For whereas the function of breathing is ordained for many uses The nerves of the lungs some rulers of the natural motion and others of the voluntary whereof some are merely natural and others spontaneous or violent therefore the spirits and the nerves which proceed and have their government as well from the brain as from the Cerebellum ought to be joyned together and to afford their social endeavours yet on that condition and as it were by mutual agreement that one give place to the other by turns for the discharging all works chiefly necessary or convenient and do mutually obey From the pneumonic nerves the instinct of ordinary breathing or meerly vital beginneth and is presently communicated to the nerves of the Diaphragma and from thence to all of the Thorax Both do alternately obey one the other and agree in their office so that presently all the moving parts agree together in the action and cause the Systole and Diastole of the breast in such sort as are required to the present state of the blood notwithstanding on the contrary as to other actions of breathing whether spontaneous or violent it seems to have them also viz. the instinct or first force of these beginning one while from these muscles another while from them is presently communicated to all the other Organs so that it is called upon by a working consort of all together sooner than the twinkling of the eye for the performing the designed acts of breathing What we have hitherto declared about the Organs of Breathing
Secondly the Nitrous particles of Air are wont to be obscured or blunted by other accessories also sometimes they are too much sharpened For as often as the South-wind blows the Air is too moist and thick inasmuch as the Nitrous particles are seiz'd upon by the watry and sulphureous and are much blunted so that while it is drawn in the blood is not vigorously kindled but like green wood put into fire it rather smokes than burns bright wherefore during such a state of Air we become stupid and dull and unapt for motion but on the contrary the North-wind blowing the cooling sharp and most nipping particles are adjoined to the Nitrous and the blood is enough kindled and we breathe freely yet the Vital flame is every where restrain'd by intense frost disproportion'd thereunto and unless refresh'd by motion and heat it is frequently entirely extinguished 2. Besides these faults of the Air whereby breathing is wont to be hurt The defect of air hurting breathing proceeds from the pneumonic Organs moreover this evill sometimes proceeds from its defect inasmuch as it cannot be drawn in in plenty enough Of which effects though there are many and divers causes yet for the most part it happens in respect of the organs of breathing either hindred as to their motion or their passages obstructed 1. The Organs of breathing are either meerly passive viz. which are moved as the Lungs or are Active and move themselves and those together as the muscles of the Chest and Diaphragma In every of these the impediments of the motion by which breathing is hurt happen variously And first what respects the Lungs we mentioned before that they sometimes very much swell by reason of the vessels being much distended and fill'd with blood insomuch as being stiffe and inflexible they obey not the turns of the Systple and Diastole of the Chest Moreover it happens sometimes through a phlegmon little swellings and other concretions of divers forms that a like stiffeness is caused in them Secondly the active organs of breathing or the moving parts viz. the muscles of the Chest and Diaphragma are wont to be perverted or stopt from their moving function by divers causes A solution of continuity made in any part of these either by clotting of blood or by falling down of the Serum and other homors as in the Pleurisie and Scurvy or in those that are wounded or bruised doth every where cause pain in the place affected with impotency of motion and difficult breathing Moreover sometimes without pain or any evident cause those parts being hindned from their motion do produce a most heavy pursiness As is frequently seen in an Asthma Suffocation of the womb and in certain other convulsive or hypochondriac distempers The reason of which passion without doubt consists in this for that the animal spirits appointed to the moving function of those parts are disturbed about their Origine or hindered in the passages of the Nerves and are turned aside from their due influx into the moving fibres Insomuch as many who are sound enough as to their Lungs and only obnoxious to affects of the Brain and Nerves are frequently surprized with horrid fits of an Asthma as we have at large declared in another place 2. The stopping of air hindering breathing whereby it less freely enters the Lungs frequently happens by reason of the Conveyances viz. the passages of the Trachea being shut or not enough open For indeed those passages are wont to be stopt as we have formerly observed touching the Vessels bringing Blood and prohibit the full entrance of air when they are either obstructed or compressed or more narrowly contracted The various ways of Obstructions Though there are many causes and wayes whereby the passages of the Trachea are wont to be obstructed yet chiefly and most often a Catarrhal distillation of the Serum while it departs from the blood and flows out of the vessels bringing blood into these parts which being first thin and sharp produces a troublesome Cough afterwards thickening by digestion and cleaving to the sides of the Trachea exceedinly straitens the ways of inspiration A Catarrb and shortens them by quite stuffing up their extremities In like manner the sweating out of extravasated blood as also of Pus or ichorous matter out of the Lympheducts or Veins into the tracheal little bladders doth frequently produce an Asthma and often a Consumption the reason of which sort of distempers shall be more largely explained hereafter Secondly it is manifest enough by common observation that the Tracheal passages as well the last as the intermedial often-times are straitened or shut The swelling of blood by which the passages are press'd together by compression For after a plentiful meal or abundant drinking of Wine or strong Ale inasmuch as the pneumonic vessels are very much distended by reason of the turgency of blood and the sides of the Trachea being press'd together do not admit of a free and usual entrance of air men otherwise healthful enough do breathe difficultly and painfully Which truely we esteem to happen from the lungs being filled and extended rather than from a cram'd stomach hindering the Systole of the Diaphragma Moreover for this reason even in the very paroxysmes of feavers a frequent and painfull breathing is manifest Neither onely from the turgency of blood but also from the same stagnating or extravasated and also from stony concretions and divers other manners the vessels of the Trachea being pressed together cannotdischarge a free breathing 3. The passages of the Trachea being sometimes more nearly contracted and closed from their fibres convulsively disposed deny a passage to the Air for due breathing The Cramps of the tracheal passages From hence when there is no obstruction or ill conformation in the lungs as also no consumptive disposition yet from those fibres preternaturally convulsed and drawa together dreadful fits of an Asthma frequently arise Whereas we have in another place discoursed of these passions it will not be requisite here again to repeat that discoure Resides these accidents of breathing hurt there are certain others which are stirr'd up by reason of the Air prohibited in its frist entrance viz. in the Nostrils the throat the Larynx from a tumour or ill conformation For the Polypus in the Nose the Quinzy in the Throat or inflammation of the Tonsils do render a difficult breathing in the same manner as a heap of sand about a Haven obstructs the ingress and regress of Ships But truly since the reasons of those passions and their manner of being made are exposed to sense it seems superfluous here to deliver their causes SECT I. CHAP. IV. Of Expiration hurt AS Expiration is much easier The act of expiration is easier than of inspiration and with lesser trouble performed than Inspiraration so it is less endangered to be stopt or perverted as to its function for in truth the contractive endeavours of fewer muscles are required to perform that
the places from whence the humour to be coughed out proceeds For sometimes cleaving to the sides of the Larynx or sweating from them the moving fibres being shaken by a gentle little Cough it is easily and by a short passage cast forth into the mouth sometimes the matter to be excerned being impacted a little deeper in the pipes of the Bronchii is not shook out but by large expirations and often repeated and lastly it sometimes happens that the excrements to be cast out are deposited within the farthest little bladdeers of the Trachea out of which it is not brought forth without a vehement labour of coughing and that frequently repeated and at last driven forth by a long journey through the whole lungs Concerning the Cough of a nutritious humour as also of a bloody and purulent hereafter it shall be discoursed when we treat of a Consumption and its remedy A dry Cough as often as it is the proper passion of the Lungs A dry Cough is excited after many manners and by sundry causes for an obstruction of any of the pneumonic passages whether it be by compression or oppletion or contraction doth necessarily induce this Wherefore an inflammation a tumour a little swelling a stagnation of the blood either through plenty or scarcity also gravelly stony or polypose Concretions worms and many other preternatural things inasmuch as they almost perpetually provoke the nervous fibres do induce a dry vain Cough but troublesome But a dry Cough sometimes is stirr'd up by the instinct of Nature as in place of a Pump to wit that the blood either by reason of its proper ill temperament or by reason of the pneumonic Vessels not being open enough not passing well through the lungs may be promoted by the shaking of these parts and forced into a more rapid motion What belongs unto the other acts of expiration hurt as when in sneezing hiccough laughing crying and in other affects its natural and even function is troubled or perverted seeing the rendrings of the causes of these which also in another place we have in part designed do not properly appertain to our purpose omitting them here we will pass to the thing chiefly designed viz. to the diseases of the breast and their remedies and to the reasons of curing them SECT I. CHAP. V. Of a Phthisis or Consumption in general WHereas we have hitherto viewed the fabrick of the Lungs accurately delineated and the motion thereof together with that of the whole Breast and the ways and passages of the air and of the blood and of other humors through them and have also observed their various impediments their remora's or diversions according to which it happens the act of the pneumonic function is after a diverse manner hurt or perverted in inspiration and expiration now in the next place we are to descend to the Pathology of this region so travelled over and which was our design from the beginning to treat of Medicines belonging to the Thorax or Remedies appropriated to heal the distempers of the Breast and the manner of their operation Of all the diseases of the Breast a Phthisis A Phthisis accounted chief among the diseases of the breast or Consumption by right claims the first place for there is none more frequent or difficult to cure Moreover all the other affects of the Thorax being ill or not at all cured do lead into this as lesser streams into a greater Lake and so ending in Phthisis lose both their natures and ancient names But truly these terms of Phthisis and Tabes in their proper signification denote an Atrophy The various acceptation of Phthisis or a withering away of the solid parts with debility of strength the distempers of which sort frequently proceed from a wound or Ulcer of the Lungs notwithstanding sometimes without any fault of these the extenuation or pining away of the whole body takes its rise from the meer fault of the blood or chiefly from the nervous juice It denotes any Atrophy Therefore before we handle a private pulmonary Phthisis seems to our purpose to explain the general reasons of this sickness and to declare how many ways and from when causes the ill temperaments of the humors are wont to induce a privation of nourishment of the whole body as it were consumptive For truly the Consumption of the Lungs it self doth not next and immediately proceed from an Ulcer or corruption of that bowel but it arises for as much as the blood from them contracting a corruption and highly defiled for that very cause loses altogether its nutritive virtue Moreover as well this as the nervous liquor acquires such an indisposition Of which in general we will now inquire And first what relates to the Blood An Atrophy first depends on the blood made unfit to nourish we may often take notice that some pine away without a Cough or without any apparent fault either in the Lungs or Breast in the mean time as to appetite digestion sleep and almost the oeconomy of the whole natural and animal function do carry themselves indifferent notwithstanding as if nourishment should be poured into a Receptable bored through they are not nourished but pine away sensibly maugre all Dietetical Rules The formal or conjunct reason of which kind of affect frequently consists only in this that the blood being notably depraved cannot assimilate the nourshing juice continually mixt with it wherefore it doth not only forthwith send it away but also takes away some particles of the solid parts which snatching to it self it presently throws out or casts it into some place or other or consumes it by evaporation The depravations or degenerate states of the blood that are wont to induce an Atrophy either consist in its proper distemper or themselves are communicated from some other place and indeed chiefly from the bowels or from the nervous liquor being also degenerate The proper Dyscrasie of the blood it self is twofold according to which it happens The consumptive Dyscrasit of the blood either from it self or communicated from other parts that the saline-acid particles or the sulphureous and most sharp are exalted above measure and predominate over the rest For sometimes the blood withdraws it self from its genuine disposition viz. a sweet and volatile into an acid as is always found in scorbutical melancholy or cachectical persons Wherefore the nutritious juice being ever mingled with the bloody mass seeing it cannot for that reason be assimilated and affixed to the solid parts is released again in a short time and is either forthwith sent away by urine sweat or a Diarrhoea or being pen'd up within the flesh or cavities of the bowels brings a Dropsie of which sort of distempers being led forth into an evil state 1. The kinds of the former are reckoned up the ordinary effect is wont to be that when some parts do swell very much other parts are very much extenuated Here it would
the entire body succeeds Surely when the nervous liquor and animal spirits pass not fully and freely out of the Dorsal Spine into the whole body from thence oftentimes a pining doth arise hence Imposchumes and Ulcers arise about the Loins or the Os sacrum which in as much as they consume or pour forth the nervous liquor too much cause an Atrophy in the whole or at least in the lower parts 2. From the expense of the humour through the genital parts That humour is first either seed a too great expence whereof induces an Atrophy Another kind of Tabes Dorsalis far more frequent is also twofold viz. it either ariseth from the great or too-often loss of the genital humor or from a continual corrupt flux from the genital parts 1. As to the first it is manifest by vulgar observation that the immoderate use of Venery yea involuntary efflux of the seed if it be either great or continual produce a faintness in the whole body and at length a pining away The reason of this as we have intimated in another place is not that the seed according to the opinion of some descends from the Brain through the Nerves into the spermatic bodies and from thence by reason of a great loss thereof first the Brain and then the parts all depending on the influence of the Spirits springing from thence become infirm and pine away But seeing we have sufficiently evinced that the seminal matter is immediately supplied out of the mass of blood into the genital parts and that it is altogether the same with that out of which the animal Spirits instilled into the Brain are proceated it will necessarily follow by now much the greater portion is got to the Testicles for repairing the loss of seed by so much is the Brain defrauded of its due share and therefore at length the sunction in the whole body as well motive as nutritive doth waver and diminish Our furious Whoremongers are sensible of a great debility about their Loins and the parts placed below them to wit the Thighs and Legs do chiefly wither away the reason is because as well the provision of the animal Spirits in its first spring viz. in the Brain failing the outmost chanels viz. the ends of the spinal marrow and the Nerves springing from it do suffer first and chiefly for this defect and moreover because near the Loins the arterious blood gives out to the Testicles more excellent particles and chiefly restaurative being destined to nourish the Back and in the mean time the venous blood being for that cause decayed or consumed is enfeebled and steals from the Loins as much as possibly may be The loss of the seed causing a Consumption is sometimes voluntary The losses whereof are voluntary or involuntary of which sort the salacious and prone to Venery do suffer sometimes involuntary of which affects there are divers kinds For in some it only happens by dreams or obscene phantasms but in others besides those occasions every endeavour of the Back whether through bearing a weight or excretion of Urine or the faeces of the Belly causes the genital humor to be thrust out the cause whereof is both because the seed is watry and thin and at once sharp and provocative also because the parts are weak and not able duly to digest or retain it In the other Tabes Dorsalis above-mentioned not the seed it self 2. Or Ichor flowing into those parts from solution of continuity but an ichor or a certain putrilage is cast out abundantly from the genital parts the efflux whereof if it the great and continual doth frequently impair the strength of the whole body and by withdrawing and prodigally removing the nutritive matter it induces an Atrophy or consumption For near the spermatic Vessels or in passage from them as well in men as women there are certain Emunctories placed whose faculty is to receive the superfluous humour from the seed formed and when it abounds to send it abroad through the genital parts For this cause that those passages in either Sex may be made slippery and moist lest they grow dry The formal reason of a virulent Gonorrhea and become less sensible the Prostates in men and the Glandules about the horns of the womb in women are constituted out of both which always in the act of coition and sometimes without when the spermatic bodies abound with too much moisture a certain serous liquor sweats out and in women whose bodies are more moist and in whom nature hath made these ways for their menstrual excretion this doth oftner and more plentifully happen than to men But if these Emunctories be affected with a great debility or a certain virulency so that they corrupt this liquor sent or do not retain it enough it is not only sent away incessantly and flows out plentifully through the Pudendum but also other superfluous humours or recrements of the whole body flowing together to those weak parts are thrown forth together Also the nutritious Juice destined to the neighbouring parts flows thither and presently goes out together so that at length by reason of the loss of the nutritious Juice which flowing to the same place is corrupted and continually sent away not only pains of the neighbouring parts but of the whole body and a pining doth succeed These things are commonly known in a Gonorrhoea also in fluore muliebri or those affects from an impure bed or immoderate Venery or are caused by a blow a bruise violent exercise or any other hurt inflicted upon the Loins It is not proper to this place to deliver particularly the true rendring of the cause and curatory method of healing of this sort of passions we shall proceed to treat of a Phthisis or Tabes properly so called viz. which arises from the only or chief fault of the Lungs which was the business of our design SECT I. CHAP. VI. Of a Phthisis properly so called or of a Consumption arising by fault of the Lungs A Consumption doth so frequently and usually proceed from the Lungs being depraved that some have termed it the peculiar Disease of this Bowel and that it very often so comes to pass the reason is because as we have shewed before the pining of the body doth for the most part more immediately proceed from the blood depraved and unapt for nourishment it is manifest that as its perfection is acquired in the Lungs so from these being ill-affected the same is most of all vitiated and degenerates into a languishing and corruptible state For in the Lungs rather than in the Heart or Brain the threads of life are spun and there they are oftnest defiled or broken A Phthisis is usually defined to be A pining away of the whole body The definition of a Phthisis taking its rise from an Ulcer in the Lungs But less true because I have opened the dead bodies of many that have died of this disease in whom
and Spittle become worse and worse and presently become dangerous Moreover breathing being hurt the faintness and pining away of the whole body the debility of all the functionx and at length a hectick feaver and a hasty declination to death follows When by the long continuance of a Cough and Spitting leasurely encreasing Why the Consumptive matter affects and by degrees hurts the lungs the humour is more plentifully deposited out of the mass of blood into the lungs it first of all enters into the tracheal little bladders and at length fills them and somewhat distends them from which while every morning by expectoration then more copiously performed it is almost entirely cast out from them thence the Thorax is exempt for a short space from the burden and respiration seems more free yet a little afterwards the blood being stuff'd again with Serum or nutritive juice it pours down new matter into the lungs and from thence again after meat or sleep the little bladders are fill'd and the humours by the afflux daily encreased are more distended and enlarged and at length the sides of two or more of the little bladders being burst many little bladders are here and there framed as it were into one lake within which the consumptive matter being more abundantly collected there it putrifies for it is not entirely prefently cast out and from thence it corrupts the substance of the lungs to which it is joined and imparts a putrid defilement to the blood passing through it This breach thus made in the lungs is daily encreased and frequently more are at the same time formed in divers places and by reason of the great plenty of humours heaped up and putrified in them a heaviness of the breast is felt like a weighty burden upon them the breathing is more hindrd moreover from the tabid blood being more plentifully intermix'd with the mass of blood frequent effervescences of it destruction of the nutritive juice also thirst heat loss of appetite nightly sweats and a pining of the whole body do arise How an Vlcer of the Lungs is made But the blood being polluted from the lungs causes them to be punished with a reciprocal affection that is to say from its peculiar pollution because the blood in the veins receiving this purulent matter in every circuit it immediately delivers it into the arterial from whence whereas it cannot be sent enough away by sweat or by Urine it is brought back by the pneumonic arteries to the lungs where again being separated from the blood it is every where conveyed as well into the little bladders of the Trachea as into the lesser passages insomuch that at length the whole frame of the lungs being filled clefts or ulcers are formed consequently in many places and all the other hollownesses are stufft with frothy quitter But sometimes it happens that there is one Ulcer or hole or happily two formed in the Lungs and the sides grow callous round about so that the matter being there gathered together is not conveyed into the mass of blood but is daily expectorated though in a vast plenty They that are so affected as if they had but an issue in the lungs An ulcer of the lungs covered with a callus less prejudicial although they cast up much Spittle and thick and yellow matter every morning and a little sometimes all day yet otherwise they live well enough in health they breathe eat and sleep well are well in flesh or at least remain in an indifferent habit of body and frequently arrive to old age insomuch that some are said to have been consumptive thirty or forty years and to have prolonged the disease even unto the term of their life for that cause not being shortened And in the mean time others who cough or spit less within a few months fall into a hectick feaver and in a short while are hurried into their grave Hitherto touching the conjunct cause and formal reason of a Phthisis or pulmonary Consumption The evident causes of a consumption what belongs to the other causes that is to say procatarctic and evident ones they truly are various and manifold inasmuch namely as they are more near or more remote inward or outward and lastly connatural or adventitious That I may undertake to design the powers operations and modes of effecting of all these in producing a Phthisis primarily it is requisite that I shew by how many modes and by reason of what occasions the serous humour of as folks commonly say the Catarrhal is laid apart out of the mass of blood into the little bladders of the lungs and into other passages of the Trachea The primary causes of a Consumption some from the blood others in part from the lungs Upon diligent search of this it is obvious to any one to percieve the morbific cause consists of two parts and that the fault is in the ill temper of the blood sending an offending matter to the Thorax and also the weakness or ill tone of the lungs easily receiving it As to the former it is manifest enough by common observation that the mass of blood being stuft with incongruous particles viz. it s proper ones degenerated or with others from other places intermingled The ill temper of the blood disposes to it doth boyl up for the expurging of them and what is to be separated when it is not easily sent away by any other ways it is spread abroad into the lungs if they are of a weaker constitution and cleaves to them There are many dyscracies of the blood and those of divers kinds and affections by by which its liquor being dissolv'd in its consistence and as it were curdled doth not rightly contain the serous and nutritive juice within it self moreover sending away these and other excrementitions humours uncessantly from it self as sometimes it deposits them among other parts so more often into the lungs 1. The blood sometimes like Milk grown sour of it self is depraved by little and little and at length departing from its genuine faculty into a sourness and being dissolv'd in its existence doth cast abroad its serosities too easily prone to separate themselves out of the Pneumonic and also Tracheal Arteries into the tracheal passages Thus to some it is ordinary once or twice in a year without any manifest cause to be afflicted with a grievous and troublesome Cough with copious spitting which in a certain process of time after the blood purged from its dregs and excrements recovers its temperature doth spontaneously abate and after doth succeed a more firm and durable health By reason of such a Cough serving for a purge to the blood I have known some often in a day and especially every morning who were wont to spit out spittle like black Ink with a small endeavour of the Trachea which distemper when for many months they had constantly labour'd under after a greater Cough occasionally contracted with much and yellow spittle they
have afterwards escaped altogether free from that former black spittle the reason whereof it that a heavier Cough abiding with plentiful spitting for several days altogether purges away those melancholy foeculencies from the blood and moreover it alters the temperament of the blood or rather takes away the ill temperament thereof 2. And sometimes it receives a consumptive taint from the nervous juice The nervous juice being frequently degenerated and with an abundant lympha returning back out of the fibres and nervous parts into the blood as it produces ill affects of the bowels and of the reins whereof in another place we have hinted so sometimes it causes a fierce and very troublesome Cough This kind of Cough one while is Catarrhal inasmuch as the Lympha having pass'd through the mass of blood is deposited in the Lungs by the arteries another while it is convulsive inasmuch as the Nerves and fibres constituted to move the breast are possest by that liquor and are provok'd into convulsive motions from either cause either conjunct or separately it comes to pass that more grievous passions of the brain and nervous kind frequently call on a troublesom Cough or are wholly changed into it 3. And sometimes by reason of a fault communicated from the Lympheducts Besides the faults of the blood and nervous juice frequently exciting a Cough it is probable that it sometimes arises from the Lympheducts being obstructed which belong unto the Lungs for whereas very many Vessels of this kind are spread abroad through the Lungs whose function it is to receive whatsoever is superfluous of the Lympha that is carryed through the Arteries into the Praecordia and not immediately brought back by the veins and to convey it to the trunk of the passage of the Thorax if by chance it happens that these passages are stopt or obstructed by viscous matter or compress'd or thickned by cold should not well discharge their duty it must needs be that those watery excrements shut out from their wonted sluces or whirling back into the blood do incite its fierce boyling up or being poured into the passages of the Trachea do stir up a Cough 4. Neither do the humors above-mentioned only The fourth reason is usual evacuations suppressed in as much as they either pervert or hinder the crasis or motion of the blood induce a Cough which frequently is the beginning of a Phthisis but moreover any usual or wonted Evacuations suppressed or let do usually impress a fault upon the Lungs The menstruous flux or the Haemorrhoids obstructed often bleeding at the Nose it by chance it ceases Issues closed up Pustles Scabs and Wheals driven back do frequently affix a taint in the Thorax If a plentiful spitting from the Glandules of the Mouth stops of its own accord or be cured by Medicine afterwards sometimes a consumptive Cough succeeds wherefore the same is vulgarly called a Rheum which had lately fallen from the Head into the Jaws and Throat and thence destilled deeper into the Lungs when indeed it is nothing else but a certain superfluous serosity of blood that being used to be put aside by the cephalic Arteries into the Glandules of the Mouth now being excluded thence is hurried through the preumonic Arteries into the Lungs Besides these private and periodical or extraordinary Evacuations By reason of transpiration hindred whose suppressions incline to a Cough and Phthisis there occurs another general and constant Evacuation viz. insensible transpiration which being either stopt or suppressed is oftner the occasion or parent of that evil than all the rest For the steams that usually evaporate by the Pores of the skin being restrained within ferment the blood and soon pervert it and cause it to be precipated into serosities which with other excrements of the mass of blood being immediately laid aside in the Lungs do stir up a troublesom Cough and often a consumptive one Hence it is a common observatioin that the catching of a cold by which the Pores are stopt whether it be by the blowing of cold air or being wet by rain or leaving off cloaths or by what other means it may come to pass disposes very many to distempers of the Thorax Wherefore in our Idiom the cause being put for the effect a Cough is called Catching of cold These are the chief causes and occasions which occur from the blood any ways depraved Partly from the Lungs and therefore depositing a peccant matter into the Lungs There follow other causes in regard of the Lung it self viz. those which dispose this Bowel more readily to a Cough or a Phthisis of which there are three sorts 1. An ill frame of the Breast From the breast ill formed From the hereditary disposition From foregoing distempers of the breast From incongruity of the air 2. An innate weakness of the Lungs or hereditary disposition to a Consumption 3. Preceding diseases of the Thorax as a Wound a Blow a Pleurisie a Peripneumony Empyema Spitting of blood the small Pox and Measles c. 4. The incongruity of air which is inspired as deserving a place among the procatarctic causes By reason of any one of these causes and sometimes of many together the matter provoking a Cough proving often after consumptive doth easily assault the Lungs and enters them and frequently imprints a deadly hurt On each of these we shall insist a little First therefore as to the frame of the Breast the case stands thus viz. that the Lungs being still whole and sound and free from any phthisical impression may be kept for a long time in their office it will behove that they sitll be exercised with a motion that is vigorous and with stretched our sails as it were to discharge the strong interchanges of the Systole and Diastole to that end that the air being plentifully suckt in The reason of the former exposed may be admitted to their inmost apartments and from thence immediately be cast back for the most part together with all the effluvia and sooty vapours at every change of breath Wherefore since the action of the Lungs doth depend much on the frame of the Thorax as being the moving Engine it must needs be that by reason of its ill fashioning the function of breathing becomes defective in many things There are two special kinds of a Breast ill framed viz. crookedness and shoulders like wings for which reason many are found prone to a Phthisis the reason of which is that in any such figure of the breast being either depressed or made long the Lungs do neither injoy a space so free and ample nor can the moving Muscles be so strongly contracted as in a square breast 2. What an hereditary disposition is The innate debility or hereditary disposition of the Lungs to a Consumption is so frequent and vulgarly known that when any is found inclining to a Consumption he is presently questioned whether his parents were not obnoxious to this distemper
of such kind of particles which being mild and thin may be tamed by the blood and assimilated without any effervescence or heat Wherefore Asses milk also sometimes Cows or Goats milk also Water-gruel Cream of Barley Ptisan Almond-milks and other simple nourishments will better agree and nourish more than Flesh Eggs and Gelly-broaths strong Ale Wine or any other kind of richer fare Secondly 2. That the acidities of the blood and other humours be taken away that the blood retaining its own temperament be not easily dissolved into serosities injurious to the Lungs it behoves that as well the acidities of it self as of other humors mixt therewith and chiefly the nervous and limpid ones be destroyed which intention Medicines prepared with Brimstone will best accomplish which for that cause in this case provided a hectic Feaver be not present may be more frequently and in abundance taken Wherefore the Tincture the Balsam the Syrup the Flowers and Milk of Sulphur in somewhat a large Dose may be exhibited twice or thrice a day For the same reason traumatic or vulnerary Decoctions also Decoctions of the pectoral Herbs commonly so called also of the Woods are to be taken instead of ordinary drink Moreover the Powder of Crabs eyes Hog-lice and other things endued with an Alcali or volatile Salt are often administred with great success 3. That the excrements of the blood be drawn off from the Lungs The third intention of healing respecting the first indication viz. that the superfluous dregs of the depraved blood if they shall be very much predominant being commanded out from the Lungs may be discharged by other Emunctories suggests very many ways to be used for their dispatch For besides Phlebotomy Diuresie and sometimes a gentle Purgation which take place in all Coughs yea in the beginning of a consumptive Cough or Phthisis hither also ought to be referred Baths taking in a more warm air whereby they may more freely transpire also Frictions of the extreme parts Dropaces Issues Blisterings or Depilatories Errhines Gargles and other private or public sluices either of humors or vapors The second indication in the beginning of a Phthisis viz. that the consumptive matter laid aside within the Lungs may be easily and daily evacuated Second indication requires expectorating Medicines is performed by expectorating Medicines These are said to operate after a twofold matter according to which their virtue is conveyed two ways to the Lungs For of those being taken by the mouth some immediately dismiss their active particles into the Trachea which partly by making the way slippery and loosning the matter impacted and partly by provoking the excretory Fibres into Convulsions do procure expectoration in which number are chiefly accounted Linctus's and Fumigations The expectorating Remedies of another kind which deservedly are accounted more available do exercise their energie by the passage of the blood For whereas they consist of such kind of particles which cannot be digested and assimilated by the mass of blood being spread through the blood because they cannot be mixt with it they are presently again exterminated and so penetrate from the pneumonic Arteries into the tracheal passages where lighting on the matter they divide and attenuate and so disturb it that the little fibres being irritated from thence and successively contracted while they cough the contents of the Trachea and of its little bladders are ejected upwards into the mouth Medicines proper for this use besides Sulphur and the preparations of it are artificial Balsams distilled with Oil of Turpentine Tinctures and Syrups of Gum Ammoniac Galbanum Asa foetida Garlick Leeks and such like yielding a strong scent from which also Lohochs and Eclegma's are prepared And these work both ways partly by slipping into the Trachea and partly by entring the Lungs by the circulation of the blood and assault the morbific matter both before and behind and so exclude it with the greater force 3. What belongs to the third indication viz. that the frame of the Lungs being hurt or their constitution vitiated may be either restored or amended Third indication is performed by Balsamicks and vulneraries such things are of use as resisting putrefaction do cleanse heal dry and strengthen to which intent also Remedies prepared of Sulphur Balsamics and Vulneraries do agree Hence some Empirics do not only successfully prescribe the smoak of Sulphur vivum but also of Auripigmentum to be suckt through a Pipe or Funnel into the Lungs Moreover it is for this reason that change of air and soil viz. from Cities to the Country or sulphureous air or the passage from one Region into another that is hotter is of such a signal advantage Hitherto of the Method of Healing which seems to be of use against the more painful Cough or Phthisis beginning now it remains according to all those curatory indications to subjoin certain select forms of Medicines which also according to the way of healing described above in a slight Cough which is short of a Phthisis Forms of remedies for a consumption we shall distinguish into certain ranks viz. which are Mixtures Linctus's Lohochs Tinctures Balsams Troches Lozenges Powders Pills Decoctions and distilled Waters We shall set down some Examples of each of these whereto also may be referred some of the forms of Medicines before described for a beginning Cough and not as yet consumptive 1. Magisterial Medicines and Syrups Take of our Syrup of Sulphur three ounces Mixtures water of Earth-worms an ounce tincture of Saffron two drams mingle them Take one spoonful at night and first in the morning Take of Syrup of the juyce of Ground-Ivy three ounces Snail-water an ounce flour of Brimstone a dram mix them by shaking The Dose one spoonful at night and morning Take of tincture of Sulphur two drams Laudanum tartarizated a dram Syrup of the juice of Ground-ivy two ounces Cinamon-water two drams the dose one spoonful at bed-time and if sleep be wanting towards morning Syrupus Diasulphuris Take of Sulphur prepared after our manner half an ounce Syrups best Canary wine two pints let them be digested 28 hours in a water or sand Bath which being done take of the finest Sugar two pounds dissolved in Elder-flower-water and boil to a height to make tablets afterwards pour to it by little and little Wine coloured with Sulphur and warm let it boil a little on the fire strain it through woolen You will have a most delicate Syrup of a gold colour and for coughs and other distempers of the lungs where a hectic Feaver and heat of the Praecordium is absent most profitable the dose a spoonful morning and evening by it self or with other Pectorals Syrup of Garlick Take ten or twelve cloves of Garlick stript from the little skins and cut into slices Aniseeds bruised half an ounce Elicampane sliced three drams Liquorish two drams let them digest for two or three days in a pint and half of spirit of Wine close and
Emulsions Take the leaves of Blood-wort Apozems Periwincle Mouse-ear Plantane Wood-sorrel both sorts of Daisies of each one handfull red Rose leaves half a handfull Barly half an ounce Raisins two ounces boyl them in three pints of Smith-forge water filtred or water wherein hot Iron hath been often quencht to two pints To the strain'd liquor add two ounces of the syrup of the Juice of St. John's-wort or of Mouse-ear make an Apozeme dose from four ounces to six three times in a day Take the leaves of St. John's Wort roots and leaves of Tormentil of the greater Burnet Meadow-sweet of each one handfull of the seeds of Purslain Plantane Sorrel of each one dram Conserve of red Roses half a pound Spring-water eight pound boyl them for 12 hours in Balneo Mariae to it being strained adde half a scruple of the spirit of Vitriol of Mars to be taken as the former Take of Barly-water with Madder-roots boyled in it a pound and half Tinctures infuse in it being warm a handfull of red Rose-leaves adding one scruple of spirit of Vitriol after three hours strain it adding Syrup of the Juice of St. John's wort one ounce and half take three or four ounces three or four times a day Take of the decoction of the roots of fresh Nettles a pound and a half Emulsions white Poppy and Henbane-seeds of each two drams Melon-seeds 6 drams make an Emulsion sweeten it with Sugar penids the dose is three ounces three or four times in a day 3. Juices of Herbs and juicy Expressions Take of the Juice of Plantane half a pound Juyces of Herbs take two or three drams three times a day in 3 ounces of the distilled water prescribed before sweeten it to please Take of fresh Nettles Plantane the smaller Daisies of each 3 handfulls bruise them and pour upon them of Purslain-water 6 drams make an expression take it as the former 4. Powders and Pills Take of the powder of Blood-stone Dragons-blood ground with Rose-water on a Marble Powders Pearles of each one dram Bole Armenick and Earth of Lemnos of each half a dram Troches of Winter-cherries two drams make a powder divide it into twelve parts one part to be taken three times a day in the former distill'd water Take of Henbane white Poppy-seeds of each 10 drams sealed Earth red Coral of each 5 drams Sugar of Roses three ounces make a powder the dose one dram morning and evening this composition made up with a fit Syrup into a soft consistence was anciently call'd and renowned in Germany by the name of Helidaeus Electuary The aforesaid Powders with the addition of Gum Tragacanth dissolv'd or some fit syrup Pills may be reduced into Pills or Lozenges The spongious excrescence usually growing to the fruit of Hipps or Dog-bryar reduced into powder half a dram taken twice a day is a very profitable remedy in spitting blood Take of Yarrow bruised and dryed in the Summer-Sun as much as you please reduce it into powder to be kept in a Glass the dose from half a dram to a dram twice a day in any convenient liquor Julius Caesar Scaliger's Powder or rather that of Serapion is mightily commended Dose four drams twice or thrice a day 5. Lohochs and Electuaries Take conserve of red Roses of Dog-rose of each two ounces Electuaries powder of white Poppy and Henbane seeds of each two drams species Diatragacanth frig one dram and half of Blood-stone dragons-Dragons-blood prepared of each half a dram Syrup of red Poppyes what will suffice to make an Electuary Take the quantity of a Chesnut evening and morning at other times let him lick with a liquorish stick Take conserve of the greater Comfry flowers of Water-lillies Lohochs of each an ounce and half Troches of Winter-cherries of Diatragacanth frig of each a dram and a half syrup of Jujubes what will suffice to make a soft Electuary of which lick often Take of the white of an Egge well beaten two drams Sugar of Roses one dram of white Starch three drams make a Lohoch to be taken often with a spoon Take of Conserve of red Roses 3 ounces Leucatella 's Balsam half an ounce Troches of Winter-cherries two drams Syrup of red Poppies what suffices to make a soft Lohoch the dose is the quantity of a Chesnut night and morning II. The second Indication The second preservatory Indication exhibits such remedies which by containing the blood in its right temper and the Lungs in their due frame do provide against a relapse of spitting blood and the following of a Phthisis Such things which respect the blood The first intention in respect of the blood either are mild evacuators by Stool Urine or Sweat or are meerly Alteratives Every of these are usually prescrib'd either in form of Potion Powder Electuary or Pills We will here shew you the most select patterns of the chief of them 1. A Purge As to Evacuators a gentle Purgative is sometimes appointed after this manner Take of the best Senna three drams Cassia fistula bruised one ounce Tamarinds three drams Coriander-seeds a dram and a half boyl them in Spring-water to 6 ounces to it strain'd add syrup of Chichory with Rhubarb one ounce clarifie it with the white of an Egge Or Take 4 ounces of Gereons decoction of Senna Syrup of Apples purging one ounce mingle them and make a potion 2. Alteratives That the good temper of the blood may be preserved and the superfluities drained from the Lungs may be continually discharged by Sweat and Urine these following Alteratives or some of them are for the most part receiv'd in constant use which also being endued with a healing power do succour the weak Lungs or those whose Unity is dissolv'd For ordinary drink let simple water especially in a hot constituion or being colour'd with a little Claret-wine be drunk Those with whom this doth not agree a Bochet of China Sarsa with shavings of Ivory Harts-horn with white Sanders or small Beer or small Ale with the leaves of Harts-tongue Oak of Jerusalem and the like infused are frequently used with good success Pectoral Decoctions or Hydromels with temperate Vulneraries are taken twice or thrice a day to 6 or 7 ounces Take of fresh Nettles Decoctions Chervil of each one ounce Harts-tongue Speedwell Mouse-ear Ground-Ivy St. Johns wort of each a hand-full boyl them in three pints of Spring-water to two points adding Raisins stoned an ounce and half Liquorish two drams to it strain'd add Syrup Byzantine two ounces clarifie it with the white of an Egge make an Apozeme to be taken from 4. ounces to 6 twice or thrice in a day for a month In a more cold or phlegmatick constitution let the Liquorish and Raisins with the Syrup be omitted adde at last of Hony well clarified two ounces strain it and keep it for use The Dose is the same The use of these is sometimes intermingled with a distilled water
afterwards he used the pectoral Decoction three months and a very slender Diet viz. without any flesh only of Herbs Barley c. and Milk-meats in a short time he recovered his former health and now lives in that state so triumphing over that cruel disease that many Haemoptotic persons consult him as their Oracle and for a Cure do propound a method of this kind of living to be followed before the Physicians advice What is most wonderful in this case is The reason of the case that after so many breaches so often happening in the Lungs this famous Person was not in the intervals affected with a Cough neither fell afterwards into a Consumption whereas most after any of the smallest vessels being open in the Pracordia for some time after labour with a Cough with plentiful and thick spittle and at length frequently become consumptive And that it happened otherwise to our Patient I chiefly attribute to the balsamic constitution of his blood viz. in the mass whereof the serous recrements are either less collected or so strictly mingled that they cannot be easily separated thence wherefore after the vessels were broken or their unity dissolved a plentiful I chor or sharp humor being wont to generate a Cough and Spittle did not sweat out as in many others Moreover what he himself observed contrary to many others that his spitting blood happened never in winter but in Summer came also so to pass by the same reason because when the blood did less abound with vaporous recrements the opening or obstruction of the Pores were neither an advantage nor prejudice to it nevertheless the blood growing hotter than it ought to be seeing it exhaled not there was a necessity it should break out of the vessels and when again diminished in quantity sending away little or no serous Ichor out of the orifices of the Vessels the spitting of blood ceased without a remaining Cough The same reason holds of many that spit blood wherefore some are found much inclinable others not prone to a Consumption This Gentleman ever found the use of the pectoral Decoction advantageous to him wherefore when he often varied other Medicines he always retained the same Decoction moreover he hath commended it to many others spitting blood with success The form of the Prescription was this Take of all the Sanders of each six drams A Drink infuse them for twelve hours in seven pints of Spring-water then hoil them to a confumjption of a third part after add leaves of Colis-foot Maidenhair Mouse-ear Speedwel flowers of St. Johns-wort each two handfuls sweet Fennel-seeds six drams Liquorish half an ounce Raisins stoned half a pound boil them to four pints afterward strain it and keep it for ordinary drink Moreover the spitting blood threatning and pressing upon him he took thrice or oftener a day the quantity of a Nutmeg of the following Electuary drinking after it seven spoonfuls of a Julep Take conserve of red Roses three ounces The Electuary conserve of Hips Comfry each an ounce and half Dragons blood a dram species of Hyacinth two scruples red Coral a dram with a sufficient quantity of syrup of red Poppies mix them and make a soft Electuary let him take hereof evening and morning a dram and half drinking after a draught of the following Julep At other times let him lick it with a Liquorish-stick Take Plantane and Spawn-Frog water each six drams The Julep syrup of Coral dried Roses each an ounce Dragons blood two scruples mix them and make a Julep Among the examples of them that spit blood the case of that Reverend person Dr. Berwick S.T.P. and lately Dean of St. Pauls Church ought not to be omitted which some while since I learned partly from the Patient himself and partly was communicated to me from his Brother that most skilful Physician Dr. Berwick my most dear Friend That most renowned Divine fifteen years before he died laboured with a most obstinate Cough The second History and sometimes with a bloody and falt spittle with a grievous breath stinking like Heel by which being made lean by a pining away of the body he wanted but little of being almost extinguished by a Consumption As often as his spitting blood intermitted the rankness of breath and spittle ceased also afterwards the return hereof declared constantly that other affect to be presently attendant In this languishing condition when this Renowned man was discovered to favour the Kings Party at that time oppressed with a grievous Tyranny and being cast into a strait Prison did drink meer water instead of ordinary drink he recovered his health beyond the hope and expectation of all persons and so remained indifferently healthful for above ten years space Nevertheless afterwards I know not by what occasion unless by the hardship of a cold winter not only the aforesaid evils viz. a Cough with bloody and salt stinking spittle did become fierce upon him but also over and above a debility of stomach want of appetite and a nightly Feaver did accrue But not long after these Symptoms a little remitting fair weather again seemed to shine out until on a certain day the air being suddenly changed into an intense cold towards night he was assaulted with great straitness of breast and difficult breathing with a quick and weak pulse and fainting of all his spirits as if he had been expiring Nevertheless from his danger he suddenly escaped by the interposition of a Crisis viz. by a plentiful spitting of blood and after by a breathing Sweat but from that time his spittle remitted much of the usual stench and something of its saltness and when in a short time afterwards the last and most painful invasion of spitting blood threatned him that usual presage from stench of breath was wanting but the subsequent spitting of blood being very plentiful did so dcebilitate his strength that from that time declining sensibly he expired within a month and when a little before his decease by reason of a sharp pain in his side a Vein was breathed his blood seemed to fail so that almost none streamed out Moreover in his body dissected after death very little quantity of blood was found nor could they find any footsteps of the other most notable Symptoms viz. spitting of blood and of the stinking breath and spittle for there was no collection of any filth or stinking and putrid matter nor any cavity in the Lungs made by an Ulcer or Wound but only one lobe of this bowel or rather the whole left side was so hardned from a scirrhous Tumor that the blood could not easily or but very little pass through the frame being so obstructed and as it were stony wherefore it is no marvel if the blood that should have passed most swiftly through the Lungs did now and then burst out in some place from the vessels which were joined together or suffered not a circulation by reason of the Schirrosity Notwithstanding here a greater
difficulty ariseth The reasons of the case viz. whereas his Lungs were found altogether free from any Ulcer or notable wound whence that most dire stench of spittle and breath always a forerunner and companion of the bloody spittle the last invasion of this disease only excepted proceeded We have in another place given remarks upon all these things as that Ulcers of the Lungs and the purulent spittle of consumptive persons seldom or never stink but the matter cast out of an Imposthume of the Lungs doth frequently stink but that in the sick Doctor the Lungs being free from either affect breathed out so horrible a breath the reason will best of all appear if we inquire of the manner and cause of a stench in general For we observe this to be excited when the impure Sulphur is dissolved either by a lixivial or an acid Salt and is precipitated by the other Let common Sulphur or Sulphur of Antimony be dissolved by Oil of Tartar or Stygian water afterwards if you pour on this solution a dissolution of fixed Salt and upon that Vinegar a most hideous stench will arise In like manner we may conceive in the case proposed that the sulphureous particles of the blood being very impure were corroded by the fixt Salt with which its juice abounded very much afterwards when the acid humor having endured a flux reflows from the nervous parts into the mass of blood it precipitates the dissolved Sulphur and so causes that stench to be exhaled from the Lungs and whilst it forces the blood into a turgency a little after it compels to a spitting of blood I have known some endued with a breast firm enough and free from all Coughs and consumptive disposition who have for the most part breathed out a most hideous stench which could proceed from no other cause besides what even now we have observed The impure blood abounding with Sulphur dissolved with Salts if perhaps while it is rarified within the Lungs and loosned in its frame it meets with an acid humor it will exhale in breathing putrid and horrid effluvia's It happens by the like reason of the blood otherwise disposed that as the breath of some persons is very stinking so of others very sweet And indeed the breath or air reciprocated through Respiration for that it carries out with it the effluvia's of blood highly rarified within the Pracordia one while disperses a grateful vapor another while a most unpleasant SECT I. CHAP. VIII Of a Peripneumony or Inflammation of the Lungs APeripneumony is usually defined to be The description of a Peripneumony an inflammation of the Lungs with an acute Feaver a Cough and difficult breathing They who labour with this distemper are greatly sensible of a notable inflammation in their breast with a swelling of the Lungs and sometiems a pricking pain they draw a painful and short breath or as Hippocrates affirms a deep breath the Feaver presses with great thirst watching and painful Cough whereto also bloody spittle or streakt with blood succeeds By which Symptoms it clearly appears that this disease arises in as much as the blood boiling feaverishly doth not easily pass through the lesser pneumonic Vessels but sticking in their passages begets first an obstruction afterwards being more heaped and extravasated propagates a Phlegmon or inflammation with heat a Cough and discoloured spittle Moreover in as much as the blood so accumulated and stagnating puffs up these passages of the Lungs and compresses them a difficulty of breathing is caused and in as much as it pulls or distends the nervous Fibres a pain frequently arises But if it be asked After what manner a Phlegmor is bred in the Lungs how a Phlegmon should grow together in the frame of a Lung meerly bladdery and excarnous and after what manner it is distinguished from that distemper which is wont to be stirred up in musculous flesh or the substance of a bowel We must answer although the above-mentioned parts vary as to the texture notwithstanding the reason of the affect is altogether the same in each of them For the small sanguiferous vessels do every where alike embrace bind and variously gird about both all the Tracheal passages in the Lungs and also the fleshy fibres in the Muscles and lastly the little fibres and nervous threds with the thickest foldings like clusters of the Parenchyma But that which produces a Phlegmon is the blood it self which while it grows very hot and is hindred in its passage every where and especially in the Lungs whose vessels branch into very small foldings doth first beget an obstruction and then an inflammation Wherefore the formal reason and conjunct cause of a Peripneumony consists in these two things The conjunct cause of a Peripneumony consists in two things 1. That the blood boils 2. That it sticks in the passages Sometimes this disposition sometimes that is first viz. that the blood boils feaverishly and sticking also within the more narrow passages of the Lungs engenders there an obstruction causing inflammation Unless these two things concur there is an exemption from this disease for in many other Feavers especially in a burning Ague though the blood most intensly heated and inflaming all the Praecordia as also in the longing of women the Green-sickness and the Dropsie of the breast is very clammy yet though sticking very much in the passages of the Lungs it does not stir up a Peripneumony to produce which both distempers must concur and join their strength Nevertheless when there is an indisposition of both these one while this another while that is first in act and after a sort one is the cause or at least the occasion of the other For sometimes the blood irritated into a Feaver causes an obstruction of the Lungs and the blood also sometimes finding a remora in the Lungs receives a feaverish boiling from its proper obstruction Notwithstanding for the constituting the procatarctic cause of this disease the blood ought to be fitted as well for the boiling as for the obstructing the vessels of the Lungs Though it will not be easie to shew what this disposition of the bloody liquor is inclining to a Peripneumony What that is Phlebotomy discovers yet the reason thereof doth something appear by Phlebotomy always made use of in this disease with the best success For the blood being drawn from any labouring with this disease as also from those in a Pleurisie after it grows cold in its superficies instead of a Scarlet cream it hath a little film somewhat white or otherwise discoloured growing on it which also is very tough and viscous whence we may conjecture that the mass of blood being too strait in its frame whilst that in the circulation it doth not discharge its recrements grows too thick and as it were clammy and for that cause becomes too prone as well to boil as to stick within the narrow passages and especially of the Lungs But if farther inquisition be
made What affection of the blood produces it from whence this disposition of blood proceeds by which it becomes clammy and viscous like ropy wine the general reason hereof is this viz. that the more thick parts of blood are not made thin enough by the more subtile so that all of them being equally mixed and mutually incorporated at length the good humors separate themselves into their appropriate functions and the superfluous are perpetually discharged by their proper Emunctories But on the other side in as much as the sulphureous particles of the blood being combined together with the saline and earthy too much exalted ensnare and entangle all the rest for that cause its liquor containing within it self all its recrements and impurities grows clammy as glue and in that regard contracts an inflammable disposition For it is obvious to every person that the blood that grows clammy in this manner is rendred prone to obstruct the narrow passages of the vessels which surely are very small in the Lungs moreover for the same reason they are disposed to become fearish viz. because retaining obstinately within its own bosom all the feculencies and ecrements from the same presently gathered into a heap it is constrained into a great turgescence or swelling whereby of necessity an inflaming obstruction of the Lungs takes either its origine or augmentation Moreover as to the procatarctic cause of this disease The fault of the Lungs produces it very frequently the faultiness of the Lungs is joined herewith and determines that general intemperament of blood to affect this part in such a sort For as the clammy blood grows hot the more strong and sound Praecordia do frequently discharge the designed mischief from themselves and the taint being fixed to the Pleura or about the habit of the body a Pleurisie or Rheumatism is rather caused than a Peripneumony Nevertheless the tender Lungs being bnoxious to a Cough or formerly prejudiced in their frame either by spitting blood or other distempers of the breast from the blood boiling up while it is too much bound nd clammy in its own consistence they easily engender an obstructing Phlegmon Hitherto of the conjunct and procatarctic causes of a Peripneumony The evident causes of a Peripneumony as for what regards the evident causes whatsoever suddenly perverts the temperament of the blood or restrains its free transpiration ought to be referred hither as chiefly are excesses of heat and cold or the inordinate drinking of Wine or strong Waters any veement exercise and the drinking of some waters and those especially icy Besides sometimes a malignant distemperature of Air doth engender this disease in many and akes it Epidemical Authors in Physick do every where observe and it is also a vulgar observation a Peripneumony frequently succeeds or comes upon a Pleurisie It often succeeds or follows after a Pleurisie but nothing is more usual than in a Pleurisie a bloody and thick spittle and as it were purulent to be voided Hence a regat disquisition arises by what passage or ways the matter by spittle cast out can be conveyed from the Pleura to the Tracheal passages Some think that this being fallen into the cavity of Thorax is sucked into the Lungs as with a Sponge and others suppose that it is transferred thither by the Membranes adhering thereto by which the Lungs often stick unto the Pleura But truly either way seems improbable if not impossible For first that the Lungs do not suck in the contents of the hollowness of the Chest is manifest from hence because in a Dropsie or wound of the breast when they happen the Lungs being unhurt neither water nor blood is at all discharged by coughing though frequently great plenty of this or that humor be there which presently flows out of its own accord from the Thorax incision being made But that Sometimes the Membranes growing from the Lungs knit themselves tot he Pleura is clearly manifest by Anatomical observation yea and by this way of return I have sometimes known the purulent matter translated into the side and there by an Issue made by Art or Nature to have been evacuated with a heathful Crisis nevertheless such Membranes of the Lungs joined to the Pleura do seldom pre-exist and in a Pleurisie which is a very acute disease they cannot like a Mushroom be the issue of one or two days moreover though sometimes those obscure passages may be ready at hand which perhaps by some admirable instinct of Nature discharge something out of the Lungs towards the precincts of the Thorax yet it seems against the Oeconomy of Nature that they can derive any corruption outwardly engendered to this most noble part within which surely is the fountain both of life and heat As to this if it may be lawful to propound our Judgment The reason of this is inquired into I am induced to think that a Peripneumony and Pleurisie are one while singular and separate affects and another while bred together and coexisting from the first and another while are by course one after another or succedaneous For the procuring cause being stirred up into act so that the blood growing clammy and boiling together obstructs in some places the lesser vessels the nest of the disease sometimes is fastned on the Pleura or separately in the Lungs sometimes in each of them together and sometimes first in one and then in t'other but for the most part the Pleura being first healed presently the same morbific cause invades also the pneumonic Vessels Moreover we have known a various shifting of this affect viz. that it has first troubled the right or left side presently that being deserted to have occupied the Lungs and afterwards both being deserted to affect the Brain and frequently to transfer its seat from thence into the above-mentioned places But for the reason aforesaid a Peripneumony not only succeeds a Pleurisie but frequently a Squinancy and sometimes other distempers for while the blood growing clammy and boiling together continues a Feaver in the whole it transfers the obstruction causing a Phlegmon variously hither and thither And from hence the solution of that observation is clearly manifest which has so much puzled Interpreters viz. that a Palsie or dead Palsie of one side doth sometimes succeed a Peripneumony because the blood that being clammy had lately obstructed the pneumonic Vessels afterwards stuffing certain foldings of the vessels of the Carotides prohibits the engendring of animal spirits in this or that part of the head and so restrains their influence into the respective nervous parts The differences of this disease From what hath been said the chief differences of a Peripneumony are made plain namely that it is either a simple distemper or joined together with a Pleurisie Squinancy or some other and then it is either primary or secondary Moreover it is usually distinguished as to the Feaver and state of breathing to wit according as this is more or
is lest the spirits should saint be closed with the finger when again it is opened the blood pure enough will issue next but the bad sliding by if there be any remaining will not return presently to that orifice Besides Phlebotomy many other remedies viz. whatsoever do repress the trugency of blood and empty the passages thereof whereby the morbific matter may be suckt up are here to be used Wherefore a very thin diet is prescribed for the most part meerly of Barley and Oats and if Cathartics are altogether prohibited because they disquiet the blood and hurry it more impetuously into the part affected notwithstanding Clysters which gently loosen the Belly and draw the recrements of the blood towards the Belly ought to be daily used Moreover Juleps and temperating Apozemes which bridle the fervor of the blood and draw out the superfluous serositles thereof and which also do gently open the passages of the Breast are taken with success 3. The third intention of healing The third intention of healing is that the clamminess or viscosity of the blood may be taken away which respects the withdrawing of the clamminess or obstructing viscosity of the blood is altogether to be performed by remedies which unloose the frame thereof being too much bound and dissolve the coupling together of its salts And truly the remedies of this kind which in this respect reason and analogy would dictate are now received into use by long experience For Powders of Shell-fish the Tooth of a Boar and the Jaws of a Pike and other things endued with an Alkali Salt also Sal Prunellae for the most part are prescribed by all Practitioners as well modern as ancient I have more frequently known the Spirit of Salt Armoniac and of Harts-horn to have yielded notable relief in this disease and for the same reason it is viz. because the volatile Salt is useful that the infusion of Horse-dung though a common remedy affords oftentimes singular help 4. As to the Symptoms and their Cure 4. That the most urging Symptoms may be helpt very many remedies appropriated to these fall in together with the former for against the Feaver the same Juleps and Apozems which appease the heat of blood and withal recreate the animal spirits are of most common use to which besides in respect of the Cough and difficult breathing temperate pectoral Remedies are added The great difficulty is what ought to be exhibited against want of sleep when it shall grievously oppress for Opiates because they do further prejudice the breathing which in this disease is already hindred are scarce safely administred nay sometimes become mortal Wherefore Laudanum and the strong Preparations of Opium are to be shun'd in a Peripneumony worse than a Dog or a Snake nevertheless Anodynes sometimes and mild Hypnotics as water and Syrup of red Poppies are not only allowed but accounted specific remedies in this disease and in a Pleurisie but sometimes it will be expedient to use Diacodiates as long as strength endures and as long as the Pulse is strong and good enough For the pain of the breast if at any time it be troublesom it is expedient sometimes to apply Liniments Fomentations and Cataplasms The second curative inoication The second indication respects the maturation and expectoration of the morbific matter whose intentions are to digest the matter impacted in the Lungs if it cannot be discussed or suckt up and to throw it out by spittle requires ordinary maturating and expectorating Medicines both which notwithstanding ought to be temperate that is to say such as asswage thirst and appease the feaverish heat rather than exasperate it We have above recited in the Chapter of a Cough the kinds of these sorts of Remedies properly called Pectorals the more select Receipts and chiefly accommodated to this affect shall be annexed here beneath The Forms of Remedies 1 2. The Medicines conducing to the first and second intention are prescribed according to the following Forms Take the water of Carduus Mariae ten ounces Juleps red Poppies three ounces Syrup of the same an ounce Pearls prepared a dram make a Julep the dose six spoonfuls every fourth hour Take water of black Cherries Carduus benedictus Balm each four ounces powder of a Boars tooth a dram Syrup of Violets ten drams make it into a Julep to be taken after the same manner Take Grass roots three ounces Apozemes shavings of Ivory and Harts-horn each three drams Raisins stoned an ounce and half Liquorish two drams boil them in Spring water from three pints to two to the strained iquor add Syrup of Violets an ounce Sal prunella a dram make an Apozem to be taken thrice a day about three or four ounces For the same intention Purgation viz. that the Vessels being emptied may withdraw the nourishment from the disease or sup up the morbific matter a Purge is prescribed by many In the Practice of the Ancients against this disease even as against many others after Phlebotomy Preparatives and Purgatives were usually appointed in a constant course and of late the Chymists with greater boldness do recommend Vomits and in a Peripneumony prefer it to all other remedies Yea Phlebotomy being omitted or countermanded they place the chief Cure in stibiate Vomits than which rash advice of theirs I know not any thing may be thought of more pernicious Indeed in rustic and robust bodies sometimes this Cure has been effected without danger notwithstanding for the most part no less unsuccessful but in tender constitutions it ought to be reckoned little inferior to poyson But for what respects Purgation although it may not be presently convenient from the beginning because it is then for the most part prejudicial nevertheless the flowing of the morbific matter being finished and the effervescency of blood being appeased we may safely and gently evacuate the body with a loosning Purge Take of the decoction of Senna of Gereon four ounces Purges syrup of Roses solutive an ounce mix them for a Potion Or Take the best Senna three drams Cassia and Tamarinds each half an ounce Coriander-seed two drams boil them in a sufficient quantity of Spring-water to six ounces to which strained add syrup of Violets an ounce clarified with the white of an Egg and let it be given Purgatives are not always to be exhibited nor ever unadvisedly in this disease but frequent Clysters and almost daily are in use but let them be gentle and emollient only which easily loosen the belly without any great agitation of humours or blood For this purpose Milk or the Whey thereof is often convenient with red Sugar or syrup of Violets Or Take the leaves of either sort of Mallowes of Melilote of Mercury of each one handfull Linseed and sweet Fennel-seeds of each half an ounce sweet Prunes Clysters numb vi boyl them in a sufficient quantity of Spring-water to a pinte to which adde syrup of Violets one ounce Sugar ten drams sal
after I repeated Phlebotomy and after continuing the same Remedies in four or five dayes he intirely recovered his health The blood we took from him was alwayes in the Superficies viscous and discoloured A certain Gentleman of a sanguine Complexion and a strong habit of body The second History after an immoderate drinking of Wine contracted a Feaver with a most painful Peripneumonie insomuch that thirst and heat mightily pressing him sitting always upright in his bed or Chair and breathing short and very frequent he could scarcely yea almost not at all suck in air enough to sustain the vital flame Because he could not undergoe a large Phlebotomy I drew blood twice or thrice day after day frequent Clysters were administred Moreover Apozemes Juleps also Spirit of Armoniack and powders of Fish-shells were administred by turns Within four or five dayes the Feaver somewhat abated also he began to breathe better and sometimes to take short sleeps yet he did always complain of a notable heaviness of his breast and intolerable oppression of the Lungs wherefore when Phlebotomy was no longer safe I applyed very large Vesicatories to his Arms and Thighs the blisters in his arms dry'd up in a short space but those on his legs did not only remain open but after five or six days did run hugely and afterwards almost for a month daily discharged great plenty of a most sharp ichor in the mean time his lungs sensibly amended and at length were delivered from all their burden lastly the little sores raised by the Vesicatories very painfully and not without frequent Medicines could be cured SECT I. CHAP. IX Of a Pleurisie HOw great affinity there is between a Pleurisie and Peripneumonie The diseases of a Pleurisie and Peripneumonie are akin we have hinted before viz. although either distemper is sometimes solitary and exists separately from the other yet they often happen together or one while this another while that come one upon the other or succeeds it The foregoing cause is the same of both viz. a disposition of the blood to be clammy and boyl up withall also the conjunct cause is the same viz. an obstructing Phlegmon in some part of the lesser Vessels by reason of such a disposition of blood Moreover the same method of Cure is prescribed by most modern Physicians for either disease The chief reason of the difference whereby they are distinguished one from the other is taken from the places affected which their Names denote How they differ betwixt themselves For the blood predisposed to the enkindling in some place an enflaming obstruction therefore often plants the nest of the disease in the breast because here it burns out more hideously by reason of the Hearth of vital fire and also is not freed from the vaporous Effluviums and other Recrements which hinder Circulation To all which there ensues that in this Region the mass of blood being shut up and not able to pass through the more strait Conveyances is not as in the bowels of the lower Belly opened with any ferment or new washt with any watery juice wherefore if perhaps the blood carried through the vertebral Arteries into the membrane encompassing the ribs shall stick in its passage about the narrowness of the Vessels or inter-spaces the Distemper of which we now treat succeeds In like manner if an obstruction happen within the passages of the Lungs a Peripneumonie will ensue as we have declared before Wherefore according to the Pathologie of this disease before delivered those things which belong to the Theory of a Pleurisie as well as the Curatory method may with small labour be designed Both the sense of pain The seat of a Pleurisie as well as Anatomical Observations taken from the Patients dead of a Pleurisie do plainly attest the feat of this Disease as often as it exists primarily and solitarily consists in the Pleura or Membrane environing the inside of the ribs And a true and singular Pleurisie is an inflammation of the Pleura it self from the abundant flowing in of inflamed blood growing clammy withall taking its motion through the vertebral Arteries with a continual and acute Feaver a pricking pain of the side a Cough and difficulty of breathing The next Cause is the blood obstructed by reason of its clamminess in the lesser vessels and interspaces of that membrane in like manner as it is in a Peripneumonie or being extravasated being heaped in the same place more plentifully The next cause of it by reason of the swelling up for that cause exciting an inflammation An acute pain ariseth upon this by a wound in a part highly sensible also there ariseth a Cough by reason of a provocation giving impression to the intercostal muscles moreover a difficult breathing by reason of the muscular fibres being hurt as to their action which because they cannot perform long and strong contractions they are constrained to undergoe weak although more frequent Contractions otherwise than in a Peripneumonie in which that symptome ariseth from a Lung too much fill'd and stuffed The Feaver is caus'd from effervescence of blood and is for the most part rather the associate than the effect of a Pleurisie For the blood from what cause soever driven into a feaverish turgescency if it be bound up together in its mass will be apt to grow clammy which together with the Feaver most often induces a Pleurisie or a Peripneumonie or both of them From hence we may observe this disease doth frequently vary its kind and change its place viz. from a Pleurisie into a Peripneumonie and on the contrary afterwards it passes from both or either into a Frenzy or a Squinancy for that the blood while it is boyling throws off its viscous recrements one while in this part another while in that another while in more together and lastly it reassumes them again and variously transferrs them The more remote causes of a Pleurisie are the same as of a Peripneumonie viz. whatsoever stirs up the blood The more remote causes of this Disease predisposed to grow clammy and also to boyl up and provokes a feaverish turgescency Hither appertains excess of heat and cold a sudden constipation of the pores surfeit drinking of Wines or Strong-waters immoderate exercise sometimes the malignant constitution of the Air brings this disease almost on every body and renders it Epidemical whereto may be added that this disease is very familiar to some from their constitution or custome so that a distemperature of blood induced almost by any occasion immediately passes into a Pleurisie From what we have already said the signs of this disease do appear manifest enough by which it is well known as to its Essence and is distinguished from other diseases and especially from a Bastard Pleurisie and a Peripneumonie But it is to be observed that a pain in the side arises sometimes very troublesome which while it counterfeits a Pleurisie is sometimes taken for it although falsly For in
some persons obnoxious to the Scurvy and the affects of the nervous kinde sometimes it happens that a sharp humour and very painful descends into the Pleura or intercostal Muscles and being fixt there produces most fierce tortures which distemper is yet discriminated from the Pleurisie inasmuch as it is void both of Feaver and Thirst the Pulse always abides moderate and laudable frequently the appetite and strength endure moreover the pain is not long fixed or limited to one place but sensibly creeps hither and thither into the neighbouring parts as the matter slides down through the passages of the fibres out of one place into another We meet not with many differences of this disease The differences of it notwithstanding it is used to be distinguished viz. to be either true and exquisite even as we have now described or spurious which having its seat in the intercostal muscles or their interspaces proceeds from winde or a serous and sharp humour heaped up in the same place and raises a pain less sharp without so much as an inflammation or feaver And whereas the grief is planted externally the Patient for the most part lyes better on the opposite side otherwise than in a true Pleurisie Secondly a Pleurisie is either single or complicated with a Peripneumonie or some other distemper and so it is either primary or secondary or join'd with some other affection As to the Prognosticks of this disease The Prognosticks Hippocrates hath observed many certain tokens whereby a good or evil event is signified to patients sick of the Pleurisie To run through each of these and to unfold them with Commentaries added to them we have neither leisure nor doth it seem worth our endeavours The chief thing of all in a Pleurisie is that the disease be presently dispatch'd partly with a free and frequent bleeding and partly by a Critical Sweat arising about the fourth day or before the eighth or these things not duely succeeding it will be prolonged and then most frequently a Peripneumonie or Empyema or a collection of corrupt matter between the Breast and Lungs or both distempers do arise upon this disease from which there follows a solution of the disease but slow and incertain and most frequently full of dangerous chances A Peripneumonie coming upon a Pleurisie not presently cured as it is often wont to be all our hope is placed in digesting maturely the Spittle and quick Expectoration thereof for if this be laudable and plentiful and easily and hastily thrown off it doth often finish both diseases intirely Notwithstanding it is not therefore a consequent that the matter of a Pleurisie is derived from the side into the Lungs by I know not what blinde passages or that the same being sweat out of the Pleura into the cavity of the breast is imbibed by the Lungs and at length drawn upwards through the passages and excern'd forth But when a Peripneumonie arises on a Pleurisie and the matter impacted in the Lungs begins to be evacuated by Spittle so that the affected places of the Lungs are continually emptyed the blood resumes the other matter fixed in the Pleura and carryes it to the Lungs where the places of conveyance are open to be ejected by Spitting But if the Pleurisie be cured neither by it self nor associating with a Peripneumonie then at length either by an Imposthume made in the Pleura or in the Lungs an Empyema or corruption between the Breast and Lungs succeeds or all the matter being brought into the Lungs and there putrified loosning the unity of the Viscera it propagates a mortal or scarce curable Consumption As to the cure of a Pleurisie forasmuch as the state of this Disease The Cure thereof the Crisis and tendencies are manifold divers curatory Indications offer themselves according to their various regards and as occasion serves according to the advice of a prudent Physician they ought to be appointed in the beginning and sometimes altered or continued For surely one Method is convenient for a solitary and simple Pleurisie and another if it be complicated with a Peripneumonie Besides it behoveth to ordain another and another if perhaps a Crisis be expected by Spitting or matters growing worse the disease is either passing into an Empyema or tends to a Consumption As to the three later cases that is to say when a Pleurisie commencing passes into a Peripneumonie or Empyema or lastly into a consumptive disposition there is designed an appropriate way of curing in the pathologies of each of these diseases particularly delivered But as to what appertains to our present purpose three Indications offer themselves for a primary and simple Pleurisie and they are curatory preservatory and vital I. The first Indication takes care that the Inflammation or obstruction of blood in the Lungs by all manner of means with all expedition be removed The first Indication for which intent phlebotomie in every Age by all physicians excepting some Fanatick or false Chymists is wont to be prescribed as a principal remedie Phlebotomie necessary almost in all Pleurisies The reason of which is altogether the same as in a Peripneumonie and many other distempers caused by reason of a stop of blood in some place and so an accumulation Because that the vessels bringing blood being much emptyed do not only rescind the nourishment of the disease but drink up the matter which is the conjunct cause thereof and convey it to another place Wherefore blood is to be freely drawn away in a Pleurisie if the strength endure it and the Pulse be strong And surely it is far better that the first time and every time after as often as there is need to repeat it blood be more largely emitted than to do it more often and more sparingly For very many portions of the blood growing clammy and degenerating into viscousness are heaped up about the place affected which unless they are call'd away from thence by emptying the Vessels through large phlebotomie and in a great part let forth the letting of blood will be frustrated of its desired effect Wherefore that Physicians prescribe blood in a Pleurisie to be drawn out even to swooning seems not incongruous to reason although that practice is not rashly to be attempted for that every evacuation ought to be proportioned to the tenour and tolerance of the strength which rule such a phlebotomy doth exceed But though there is almost a general consent of all Physicians to breath a vein in a Pleurisie notwithstanding there was ever an earnest contention about the place What Vein is to be opened in a Pleurisie what Vein ought to be opened Hippocrates and Galen opened a Vein on the same side of the patient afterwards the Arabians and their followers the Italians and French did either open the Saphene or the Basilica of the opposite side damning the phlebotomy of the same side by Bell Book and Candle Yet in the later generation the practice of the Ancient
three dayes it flowed out without any stench but afterwards as often as the Orifice was opened a most horrid smell came forth exceeding the stench of any Jakes though ne're so stinking and infected the whole Chamber with the ill scent Moreover it remain'd so for many days untill by injections made of Myrrh and bitter herbs boyl'd in Water and Wine and very often administred every day at length it was extinguished by the daily use of which the morbific matter and at length all the fordidness being washed away all flowing out ceased and last of all the Orifice being closed the patient recovered his entire health I dissected the dead bodies of those who dyed when by no perswasion of Physician or Friends they would admit of the opening of their side One I have spoke of otherwhere The History of one who dyed because he was not cut the result whereof was the Pus streaming from the Imposthume raised in the Pleura and in the intercostal Muscles and broken internally had wasted part of the affected place and of the contiguous Lung with a Sphacelus or Gangrene and so corroding the Diaphragma and a hole being made on the right side thereof it had descended into the Viscera or bowels of the lower belly and there in the whole passage of the Ventricle and Intestines the outer Coats on which the purulent matter had fallen appeared eaten and discoloured and at length the purulent matter corroding and boring through the intestinum rectum it came forth through the fundament together with his excrement The sick man being strong and impatient of any medicine endured the tyranny hereof for about two months but in the mean while he lived miserably afflicted with a light Feaver thirst inquietude pain of the stomack and frequent tumbling up and down and almost with continual watchings His body being opened after his decease a most horrid stench exceeding any Jakes diffused it self throughout the whole Chamber The Anatomy of another who dyed by an Empyema A fourth History like the former afforded not so vast an effusion of purulent matter This indeed had its nest in his side from whence falling into the cavity of the Thorax and there accumulated in a vast heap and continually defiling his Lungs drenched therein it caused a slow and as it were a hectick Feaver whereby the patient being very old dyed SECT I. CHAP. XI Of an Imposthume of the Lungs A Vomica of the Lungs is something a-kin to Empyema or Peripneumonie Vomica Pulmonis a disease seldom observ'd considering that the morbific matter is always meer Pus which notwithstanding is generated in the Lungs without a Feaver and Phlegmon yea without any great Cough or Spittle as it were silently and without noise and frequently this evil doth not discover it self before it kills the patient Galen makes mention of this in lib. 1. de locis affectis but among Authors who have written Systemes and the Practical parts of Physick mention thereof is seldom of scarce to be met with Tulpius in lib. 2. chap. 10. describes this distemper after this sort This evil meaning an Imposthume of the Lungs lurks in the beginning so secretly that it scarce discovers any signs of it self besides in the first place a little dry Cough and presently moist which continuing for some time the breath is drawn with difficulty the spirit fails and the body withers by degrees although in the mean time the Spittle makes no shew either of pus or blood and if the Imposthume break by way of surprisal the man is kill'd immediately It is wont sometimes so to happen but I have known many who in an Imposthume rising insensibly being maturated and at length breaking have spit up gâ—â—t plenty of fetid corruption and though with voiding daily such a Spittle for many weeks nay months they became very weak and as it were consumptive yet at length by the help of Medicines after the Ulcer hath been mundified and dryed they have recovered their health entirely This disease The formal reason and conjunct cause thereof if we search into the formal reason and conjunct cause thereof is in truth a concourse of ill humours gathered in some part of the Lungs whose matter although it be heterogene and an enemy to nature notwithstanding from the beginning appears not sharp or irritative For when at first being separated from the blood it is deposited in some hollow place of the Lungs perhaps in some bladdery cell it doth neither raise a Cough nor produce a Feaver but after wards when sensibly encreased it compresses the neighbouring Vessels bringing blood and moreover insinuates into the very blood passing by incongruous Effluviums from thence a small Feaver succeeds with a certain disquietude and feebleness and at length being accumulated to its fulness and maturated by a long digestion into mere pus breaking its nest very much distended before it flows out every where all about But if the ways are not open for the issuing of the pus it incontinently mingles it self with the blood and either empoysons it or impedes it from Circulation or rushing by heaps into the Tracheal passages it doth fill most of them at once and so stuffs them that a sufficient entrance is denyed to air to kindle the blood and presently the viatl flame expires but if this matter find passage and flow by degrees into the Trachea from whence again it may be presently carryed away and spit out there will be then some truce of life with hope and opportunity of cure And indeed I have known may cur'd of this disease The usual matter of an Imposthume of the Lungs is meer Pus The morbifick matter which often stinks notably and by that differs from the Spittle which is ejected in a Peripneumonie or a Consumption of the Lungs But whence that matter proceeds in the beginning thereof and of what disposition it was before it was ripened into pus I cannot so easily determine because the seeds of this disease being privily sow'd and growing up secretly spring wholly from an occult original wherefore its procatarctick or more remote causes lye conceal'd yea while it begins and increases can neither be discovered by any pathognomical Signs nor can any prognostick be devised before it discovers it self with a mortal stroak but the whole procedure thereof is treacherous Now if after the Imposthume is broke and the spitting up of pus with an easie discharge being begun with a constancy of strength there be means offer'd for some method of cure the chief Indications according to the common custom in most diseases will be these viz. Curatory preservatory and vital The first commands the matter of the Imposthume speedily to be discharg'd by Spittle and that the sides thereof should be cleansed and healed as much as is possible The second Indication provides against the conflux of new matter to that nest or other adjoyning places of the Lungs whence a Consumption may be engendred The
in the underlying waters they sometimes imbibe them being turn'd into vapour and so dispatch them to the blood or continually exhale them with aire coming out at the mouth That an effect of this sort may more easily happen to cure this disease medicinal aids are taken For that intention therefore the passages of blood aire and humours ought to be emptyed as much as may be and to be kept so empty For this purpose Purges Diureticks and more mild Diaphoreticks are methodically and alternately exhibited also remedies for the breast and expectorating challenge here their place let the Diet be slender and warming and a government appointed as to all other things of that nature that the blood may be made to exhale the more and all the superfluous humours to evaporate I think good to annex some forms of Medicines accommodated to these uses Take of Chervil-roots Knee-holme Polypodie of the Oak of each an ounce Agrimony A Purging Hydromel white Maidenhaire Oak of Jerusalem Ground Ivy of each one handful Carthamus-seeds one ounce Florence Orris half an ounce seeds of Danewort 5 drams Calamus Aromaticus half an ounce boyl them in four pound of Spring-water to the consumption of a third part adde to it being strained Senna one ounce and a half Agarick tow drams Mechoacan and Turbith of each half an ounce yellow Sanders a dram and a half Galangal the less one dram boyl them two hours gently and close covered afterwards strain it and adde of Honey two ounces clarifie it with the white of an Egge make a purging Hydromel The Dose is from six ounces to eight in the morning twice or thrice in a week Or Take Mercurius Dulcis one scruple Resine of Jallap half a scruple Balsam of Peruwhat suffices to make four Pills to be taken in the morning and to be repeated within five or six dayes Take Tincture of Sulphur three drams take from seven drops to ten Tinctures at night and in the morning in a spoonfull of the following mixture drinking after it three spoonfulls Take of the water of Snails Earth worms and compound rhadish water Julep of each four ounces water of Elder-berries fermented one pound Syrup of Juice of Ground-Ivy two ounces mix them for a Julep Or Take of Tincture of Ammoniacum or Galbanum take twenty drops evening and morning in the same mixture Or Take of Hog-lice prepared two drams flower of Sulphur two scruples Pills flower of Benzoin one scruple powder of wild Carrot and Burdock-seeds of each half a dram Turpentine of Venice enough to make a mass Make small Pills Take four evening and morning drinking after them a small draught of the Julep At Nine a Clock in the Morning and Five in the Afternoon A Lime-water let him take four onces of the Compound Lime-water by it self or with any other proper remedy For ordinary drink take the following Bochete Take Sarsaperilla six ounces China two ounces white and yellow Sanders A Bochet of each six drams shavings of Ivory and Hartshorn of each three drams Calamus Aromaticus half an ounce Raisins half a pound Liquorish three drams boyl and infuse them in twelve pound of Spring-water to six pound strain it Formerly about twenty five years since when I resided at Oxford A History of a Patient I was sent for to a young Scholar who suffered for three weeks space under a pain of the Thorax and a most grievous Dyspnoea constantly troubling him in the evening moreover from a more quick motion of body or going more hastily than usually up any steep place he laboured extreamly he could not ly down long on either side but was necessitated to lye in his bed supone and his head erect if perhaps he attempted to lye on either side immediately pain followed that position of body and if perhaps he roll'd himself from one side to another the pain being also presently translated he felt as it were water to wave from place to place Hence I had a just suspicion of a Dropsie of the Breast whereof that I might be more assured I order'd that lying upon his back on his bed he would suffer his head to bend backward from the bed-side to the floor immediately he had a plain perception of water running towards the Clavicles together with a change of the pain thither Moreover if at any time he grew more hot than usual from motion or in his bed or by the fire he presently felt sensibly in his breast as it were water boyling over the fire and also complained of a Vertigo and a small decay of Spirits Wherefore when we might lawfully collect out of these things rightly considered that he was affected with a dropsie of the breast I prescribed the following method and medicines with success Take of Mercurius Dulcis fifteen grains The Cure of him Resine of Jallap half a scruple Syrup of Roses solutive what suffices make three Pills He took them early in the morning and had twelve stools with great ease afterwards on the third day by the same Medicine he had but four but with greater benefit he took afterwards for many dayes six ounces of the Pectoral and Diuretick Apozeme twice in a day and lastly repeating the Purge he perfectly recovered SECT II. Of Splanchnick remedies or those which respect the bowels of the lower Belly CHAP. I. Of the Jaundies and the remedies thereof and the manner and reason of their operations HItherto we have largely enough unfolded the Pathologie and curatory method of the Thorax now it follows next to finish our task in like manner about the lower Belly But we have in our former tract for the most part described already the medicines belonging to this region and the manner and reasons of their working together with the Anatomy of the Stomach and Intestines we have treated of remedies stomachical dysenterical and others belonging to the intestines as also diureticks together with the reasons of them Moreover we have sussicently elsewhere handled the aetioligie of Hypochondriack and Hysterical remedies What therefore remains of Hepatical distempers as well proper as of those vulgarly ascrib'd thereunto and of their remedies we will discourse in this Section notwithstanding in each of these we will bestow more labour about the curatory than pathological part The chief diseases by which the Liver and the appendix thereof Diseases of the Liver are wont to be incumbred are the Jaundies and a Tumour and under this latter many other affects viz. obstruction inflammation induration and schirrus are numbred to all which are vulgarly appointed remedies commonly called Hepaticks and which make up a great part of the Dispensatory The Jaundies is either a disease by it self primarily beginning which is here properly treated of or it is an effect or product of another disease as when it arises upon an intermitting Feaver which oftentimes it puts an end to of which also we will presently treat by the by An Icterical distemper
by the common consent of most is judged to arise in as much as the yellow choler not at all or not enough received The Jaundies from the ends of vena porta into the passages of the cholerick pore overflows into the mass of blood and pollutes it with its greenness whereby also the very skin is discolour'd That obstruction is wont to happen after many manners and in various places The cause of it For sometimes it happens near the extream ends of either kind of vessels viz. the end of the vena porta and the porus bilarius the interspaces whereof happen frequently to be compressed and stopt by reason of the Parenchyma of the Liver being tumefied or otherwise vitiated wherefore the humour of the gall not being transferred out of the separating vessels of the porta into the other receiving vessels turns back upon the blood Secondly the passage of the humour of the gall is sometimes intercepted in the middle passages of the cholerick pore for that the cavities of these are filled either with a viscous or sandy and sometimes with a stony matter as is plainly discerned in the Livers of beasts in the winter senson while they are fed with hay and straw Thirdly it is also manifest by Anatomical observation sometimes an obstruction in the very bladder or the gall or in the cystic passage is the cause of the Jaundies for if at any time it being filled with stones receive not the choler or being here shut up or grown together it restrains the descent of the choler towards the guts that humour although well separated from the blood is constrained to flow black into the mass thereof and so propagates the Jundies Against this most received opinion by which it is judged The opinion of Sylvius of the cause of the Jaundies that the cause of the Jaundies for the most part consists on this side the vesica fellis or about it towards the Liver the most Renowned Sylvius altogether places it without this viz. in the Cystic or common passage For supposing the choler not to be separated from the blood within the passages of the Liver but in the very bladder of the Gall to be propagated of a humour brought thither by the Arteries He judged the greatest part being carried upwards by the passage of the pori bilarii to be poured into the blood for some notable uses and also another part to descend beneath to the Intestines also for necessary uses wherefore if this latter sluce be shut all the choler is carried upwards into the blood and filling it too much with this humour perverts it from its genuine temper into an Icterical But truly lest the stopping of the passage of the bladder or of the common passage neither of which easily happens or from any light occasion may seem less efficacious to excite any Jaundies therefore whether such an obstruction hath place or no the most Renowned man ingeniously supposes besides The choler while it is generated in the bladder does undergo sometimes a notable change by which it is moved and is born about more plentifully and impetuously towards the blood with which yet it is less mingled than is was wont to be but only confounded together with it and so more easily departs from it and infects and tinges the solid parts with its colour But that the choler in the Jaundies may be rendred unfit a mix with the other humours or to be nearly united he determines it to be done by a spirit too valatile mixed plentifully with it and so making it more spirituous and immiscible with others He confirms this assertion by two instances viz. in as much as the most spirituous poison from the biting of a Viper and the too much use of the more generous drinks viz. Wine and Strong-waters causes sometimes the Jaundies Moreover he endeavours to procure credit to this Hypothesis for that this disease is wont to be cured not only by medicines opening obstructioins but by them which blunt the force of a raging volatile salt of which sort are the decoction of Hemp-seeds also Venice soape with many other things of the same sort It belongs not to this place neither is it to our purpose to descend to end this contention nor dare I now rashly determine it since it hath tired so many Renowned Wits of the Moderns whether really the choler be made in the bladder of the Gall or whether it be only separated from the blood in the Liver the great organ of separation I confess this latter opinion best pleases me The Authors opinion And weighing these things seriously I am induced to think the cause of the Jaundies to consist chiefly in this that the choler being sever'd in the Liver is not by reason of the ways being obstructed at all or not enough conveyed to the bladder of the Gall but that it must of necessity regurgitate into the mass of blood notwithstanding in the mean while we deny not but this affect may sometime arise although more rarely from the Cystic passage or common pipe being obstructed But also we think the fault of the blood to preceed in part and perhaps sometimes wholly for the morbific cause when to wit from its sulphurous and fixt Saline Particles above measure exalted the choler is more plentifully or quicklier generated in the mass of blood than can be separated or discharged forth by the ordinary ways wherefore this separating every where from the blood with the Serum The cause of this disease sometimes in the blood is affixed to the solid parts and impresses its tincture upon them And without doubt it is for this reason that some poisons and chiefly the biting of Vipers and the dayly use of more generous drinks induces the Jaundies in bodies before sound for whose cure sometime Phlebotomie and medicines reducing the blood to a right temper are wont to profit more than those opening obstructions Moreover it seems for this reason that a tertian intermiting Feaver so frequently terminates in the Jaundies for we may not suspect the passages of the Liver can be by any means obstucted since in all fits so great an agitation of the blood and humours by cold and heat and such an-evacuation of them happens either by vomit or sweat and truly even as feaverish fits are caused inasmuch as the sulphurous part of the blood being too much advanced in the first place perverts the nutritious juice into a morbific matter and afterwards being inflam'd consumes and exterminates it so when the fixt salt is at last exalted together with the sulphur in the blood and for that cause meer choler is abundantly engendered the feaversh enkindling of the blood ceases by reason of the restrictive force of the fixt salt and in place thereof the distemper of the Jaundies doth succeed But as the blood being too much advanced to a sulphureo-saline distemperature causes the Jaundies in any though least predispos'd to it so in others
taken Tincture of Antimony or of Salt of Tartar and the simple mixture in a greater Dose for vehicles Apozemes distilled Waters and Juleps for this Intention of curing are convenient Take of the roots of Celandine the greater Apozems stinging Nettles Madder of each one ounce tops of Roman Wormwood white Horehound Agrimony Germander of each one handfull Worm-seeds two drams Shavings of Ivory and Harts-horn of each two drams yellow Sanders a dram and a half Coriander-seeds two drams boyl them in three pound of Spring-water to two pound adding of White-wine four ounces strain it and adde Syrup of Chichory with Rhubarb two ounces water of Earth-worms an ounce and a half make an Apozeme the Dose four or six ounces twice in a day Take of white Horehound dryed Centaury of each one handful Gentian and Turmerick-roots of each three drams Cinamon one dram Saffron half a dram being sliced put them into a Glass with two pound of White-wine or Rhenish-wine make an infusion the dose three ounces To this we will adde Gesners famous Antictericum Take of the roots of stinging Nettles a pound Saffron one scruple bruise them well and draw off the tincture with White-wine the dose three ounces 4 or 5 dayes Like to the former is that of Fr. Joel Take the Roots of Celandine the greater Empirick Remedies two handfuls Juniper-berries a handfull bruise them and pour on them a pound of Rhenish-wine and draw out the juice the dose sour ounces twice a day The juice of white Horehound is mightily commended by Dioscorides and the Syrup of the same by Forestus for curing the yellow Jaundice In lieu of an Elixir and other chymical liquors which to avoid nauseousness are to be taken in very small quantity to others endued with a stronger Constitution Electuaries Powder and Pills may be administred with better success Take of Conserve of Roman Wormwood of the yellow Rinds of Oranges and Limons An Electuary of each two ounces Species Diacurcumae one dram and half powder of Ivory yellow Saunders of Lignum-Aloes of each half a dram Troches of Capers one dram of Rhubarb half a dram Salt of Wormwood two drams with Syrup of Cichory with Rhubarb make an Electuary the dose the quantity of a Chesnut twice a day drinking after it three ounces of the following Julep Take of the greater Celandine-water Fumitory Wormwood Distilled Waters Elder-flowers of each five ounces Snail-water water of Earth worms compound of each two ounces Sugar half an ounce mingle them and make a Julep Or Take of the roots of stinging Nettles Angelica Gentian of each four ounces the greater Celandine leaves and roots six handfuls Wormwood Tansie Southern-wood of each four handfuls the outer rinds of twelve Oranges and four Limons prepared Worms and Snails of each one pound Cloves bruised two ounces being all cut and bruised pour upon them eight pound of White-wine let them be distill'd in a cold still and the whole water mixt Or Take of filings of Steel one pound fresh Strawberries six pound put them into a glazed pot stirring them together and let them stand a day afterwards adde of English Rhubarb sliced one pound the rinds of four Oranges sliced pour upon them of White wine six pound and distill them according to Art let all the liquor be mixt together The dose of this and of the former is three ounces twice in a day after the Electuary or any other medicine Take of Turmerick-roots Rhubarb of each one dram and a half the Bark of Caper-roots of Asarum-roots of each half a dram Extract of Gentian and Centaury of each one dram and a half Salt of Wormwood four scruples Water-cress-seeds half a dram of Rocket half a scruple Elixir Proprietatis one dram gum Ammoniacum dissolved in the water of Earth-worms what will suffice to make a mass form it into small Pills the dose is half a dram evening and morning drinking after it three ounces of the distilled water Sylvius doth much magnifie for cure of the Jaundies Sylvius his Empirical Remedies the Decoction of Hemp-seed in milk and the solution of Sope and from thence endeavours to establish his own Hypothesis as we have above intimated whereby he endeavours to deduce the Aetiologie of the Jaundies rather from an alienation of the choler than from the obstruction of its passages 2. The Second Indication respecting the altering or tempering of the blood The second Indication Remedies against the Jaundies endowed with an animal volatile Salt by which it may breed but moderately and duly separate the choler requires Medicines of that sort which depress the Sulphur and fixt salt too much advanced For these ends I know not by what chance or conduct Medicines endowed with a volatile salt as Worms Snails Millepedes yea Lice Dungs of fourfooted Beasts and Fowl are brought into practice for curing the Jaundies and not only prescribed by Empiricks but the more famous Physicians These sometimes by themselves but oftener joyn'd with Purgers and Deoppilatives become the chief Ingredients in Compositions against the Jaundies Fonseca prescribes Goose-dung gathered in the Spring-time and dryed as also the white excrement of Pullets of both which let the Powder be given in a convenient vehicle from half a dram to a whole one Take powder of Earth-worms prepared of Goose-dung of each three drams Ivory Varlous forms of them yellow Sanders of each half a dram Saffron one scruple make a powder divide it into six parts One to be taken every morning with some appropriate liquor To the Apozeme or Anticterical Tincture prescribed above Earth-worms Goose-dung and also Sheeps-dung are profitably added Take Millepedes fresh and alive from 50 to 100. Saffron half a Scruple Nutmeg a scruple bruise them together and infuse them in Water of Celandine four ounces of Earth worms two ounces express them strongly and drink it after this manner take it first once then twice in a day for a week The vulgar and Empirical remedy with us is that Nine quick Lice be taken in a morning for five or six dayes by which remedy they report to me many to be cured whenas other remedies effected little which truly can help by no other means than by restoring the volatile Salt depressed in the blood Upon the same account of succour even in this disease the flowers of Sal Armoniac Also such as are endued with a mineral volatile Salt the volatile Salts of Amber Harts-horn Soot in like manner their Spirits are frequently administred with great success Take powder of Earth-worms prepared two drams Species Diacurcumae one dram flower of Sal Armoniac half a dram Salt of Amber a scruple Extract of Gentian one dram Saffron one scruple Gum Ammoniacum dissolved in water of Earth-worms what suffices make a mass and form it into small Pills the Dose is three or four morning and evening drinking after it three ounces of the Julep before prescribed Take Spirit of Harts-horn tinctured with Saffron three drams Dose
many senses together viz. it is a Tumour of the Abdomen First in respect of blood from a waterish tumour contained within the cavity thereof The water making this tumour sometimes encreases to a huge inundation and scarce credible quantity I have once seen a Tub would hold 15 gallons filled with water taken out of the Abdomen of a woman dead of a Dropsie But whence that humour proceeds also by what manner and from what causes it gathers together in the belly first and afterwards is sensibly augmented and lastly by what passages and by what vertue and operations of Hydragogue Remedies it may again be taken from thence and evacuated seems most difficult to be unfolded As to the former viz. the encrease of water It doth not always proceed from the Liver Spleen some have thought it to descend from the Liver and others from the Spleen distempered into the cavity of the Abdomen and so this bowel or that being vitiated always to be the cause of an Ascites But that this is otherwise Anatomies of many dead of this disease do manifestly declare when after the inundation of the belly the Liver and Spleen and found often without fault And truly these bowels do not seem the Springs of any such illuvies being endowed with no cavityes wherein waters might be accumulated together wherefore the origine of an Ascites as of a standing Pool or Lake is to be derived from a River or at least a glutt or inundation of some Humour The humours that flow within the passages or Vessels as Brooks The humours by which it is produced are are chiefly these three viz. the Blood the milkie Humour and the Lympha The showering or distilling of water may come to pass from the nervous Liquor which sometimes slowly and insensiby sweats out of the fibres and membranes and from vapours condensed within the hollowness or some Cavity of the Body Whether by these wayes an Ascites doth rather and oftener proceed we will now search And in the first place as to what relates to the blood it is without doubt First the Blood the Serum falling from the masse thereof too much dissolved as it doth excite Fluxions and Catarrhs of various kindes so it sometimes stirs up the greater illuvies of waters viz. Dropsical wherefore when an Anasarca proceeds altogether from this cause and when oftentimes an Ascites comes upon that disease not immediately heald we may well enough inferr that either distemper is induced from a watery humour every where poured out from the little mouths of the Arteries Moreover it is not much improbable that the Serum of the dissolved Blood is first and solitarily poured out of some end of the Coeliac and Mesenteric Arterie being open into the Cavity of the Abdomen and so brings on an Ascites without an Anasarca going before and so especially if perhaps it happen that scirrhous Tumours Ganglion's little swellings or preternatural Concretions of another manner are first raised about the Mesentery the Spleen the Liver the Womb or any of the other bowels of the nether belly for because the Circulation of the blood is hindred in those places that the blood being carryed through the arteries may be some way brought back the serous part being thrust out from its company falls into the cavity For truly it is most evidently manifested that it so comes to pass by this Experiment mentioned by us in another place viz. If in a living animal the jugular veins being taken up and bound with a thred the reduction of the blood be stopt the whole Region of the head swells in a short space with a water between the skin and clearly hydropical And truly I have more frequently observed that an Ascites hath followed upon secret tumours gathered and raised in some place in the lower belly which certainly happens for the reason above recited When the course of blood being obstructed the watery part is extravasated in a short space that humour is not meerly serous but besides the nutritious Liquor ordained to nourish all the solid parts is emptyed into the belly wherefore while this Region swells up the members are extenuated and the Lympha taken out from an Ascites with heat thickens and grows white like the white of an Egge It is also very probable 2 3. The milkie and watery humour that the milkie Vessels being burst asunder pour out their humour into the cavity of the abdomen Truly the most renowned Sylvius thought this disease most frequently engendred from such a cause And truly as out of the milkie or watery Vessels viz. one of them or both together being divided or opened we may well suspect the illuvies of water or chyle sometimes to overflow the bowels of the nether belly so the following observation seems to confirm the same thing Of late one that had been long sick of the Jaundies and in the mean time temperate and abstemious of drink to which he was not prompted by thirst contracted an Ascites increased in a short time hugely After that medicines were administred in vain a Paracantesis is attempted according to the manner of Sylvius with a hollow Needle out of the orifice not icterical water but limpid and thin flowed out abundantly from whence we may inferre that hydropic humour flowed not out of the mass of blood for then it had been coloured but distill'd out of the lymphic or milkie vessels into the cavity of the abdomen We have joyn'd together as akin the ways of the milkie and lymphic Vessels in propagating an Ascites because both vessels do convey the chyle or what is analogous to it to the common Receptacle and many branches or leading Pipes of either kind are distributed about the bowels of the nether belly in the mean time it is not improbable but that a solitary fault of either vessel may sometimes produce an Ascites As to the other wamys of generating an Ascites proposed in the beginning I am scarce induced to think such an inundation of the belly can easily arise from the distilling of a nervous humour or by reason of vapours there condensed although perhaps in a Tympany where the cavity of the abdomen is enlarged and transpiration hindred the effluvia that were wont to exhale being forced inwards are changed into Lympha or water wherefore for the most part an Ascites is ever conjoyn'd with that disease The immediate or conjunct causes of an Ascites being design'd after this manner An Ascites often the product of the Jaundies which indeed seem to be either a watery humour poured out of the Vessels bringing Blood or Lympha or Chyle poured out of the proper passages of them both not we must in the next place inquire about the more remote causes of this disease viz. for what occasions and after what manner the vessels affected of either sort deposite their burdens into the cavity of the belly First therefore The kinds of a Dropsie that the watery part of
purging Hydragogues 2. Diuretick Hydragogues but Catharticks do not always cure an Ascites yea often-times exasperate it and if they be long continued render it incurable hence it is necessary to have recourse to other Remedyes for the Cure of this disease Wherefore let us next enquire whether Diureticks do here profit or not And truly any one may easily think that Remedies moving Urine conduce very much for draining waters out of every place or cavity of the body In truth it is manifest by frequent experience these do often cure an Anasarca before any other Remedy let us see what they may effect for the emptying the Cavity of the Abdomen As to this it first appears What Profit they bring in an Ascites that there is no passage immediately open from an Ascitick pool to the Reins although contiguous but that whatsoever waters are transferred from hence thither must of necessity first be drunk up into the mass of blood and from thence be poured out of its bosom into the sink of Urine and truly it is but a little which the gaping little mouths of the veins about the superficies of the bowels can receive if perhaps they are open at all and Diureticks can but effect this one thing that by pouring forth the blood and forcing its serosities more plentifully to the Kidnies they cause the waters fluctuating in the belly to be allured to it being so emptyed in the mean time there is no less danger lest Diureticks being unseasonably administred while they dissolve the blood too much they constrain the serum to depart into the seat of the Ascites more than into the Reins and so rather augment than remove the inundation of the belly For that it sometimes so happens I have often found by experience wherefore when Diureticks are prescurbed to cure an Ascites we must chielfy provide against such a contrary effect For this reason indeed Astringents and Corroboratives are always mixt in Remedies for the Dropsie founded on experience and the Authority and Practice of the Ancients not that such as is commonly said do confirm the Tone of the Liver but conserve the temperature and mixture of the blood lest it be wholly dissolved by too great a fusion Wherefore in an Ascites which chiefly or in part happens by reason of the frame of the bowels and vessels and chiefly the Coats Glandules and their little strings and their interspaces being stuffed by a serous humour and therefore very much swell'd up as Catharticks so also Diureticks profit and are frequently taken with success forasmuch as by the use of these the masse of blood being emptyed the serum being more plentifully derived to the kidneys doth easily reveive unto it self those waters every where stagnating about their little mouths and conveys it towards the urinary sink but on the contrary in a meer Ascites where the heap of waters do overflow the Cavity of the Belly the Textures of the bowels being free from the serous stuffing Diureticks are given in vain or incommodiously inasmuch as they express nothing from this Lake of the belly and most frequently by dissolving the blood more impetuously drive together the waters apt to be instill'd there Not all Diureticks of every kinde are equally convenient in an Ascites With what choice and difference they ought to be administred neither ought they indifferently to be administred for we must observe the affected in this disease for the most part make a little reddish Urine and as it were lixivial which truly is an indication that the temperature of he blood is too much bound in them by reason of the fixt and sulphureous Salt exalted and combined together and therefore that the Serum is not duely separated within the reins which notwithstanding is shook off about the windings of the obstructed bowels and so is depisited in the Cavity of the Belly Wherefore in this Case it will be convenient to drink only those things to excite Urine which so restore and amend the Constitution of the blood that the enormities of the fixed Salt and Sulphur being taken away the serous part might be separated within the reins and more plentifully discharged for which purpose not acid or lixivial things but those endowed with a volatile Salt are appointed For I have often observed in Patients of that kind when the Spirit of Salt and other acid drops of Minerals and when the dissolutions and Deliquiums of Salt of Tartar Broom and other things have done more hurt than good that the Juice of Plantane Brooklime and other Herbs abounding with a volatile Salt have much helped as also the expressions of Millepedes for the same reason Salt of Nitre throughly purified or Crystal Mineral doth often profit Forms of Medicines more accommodate for this use are extant in our former Treatise where viz. examples of Diureticks are described in which both volatile and nitrous Salts are the Basis Moreover hither ought to be referred the notable experiment by which Joannes Anglus affirms himself often to have cured the Ascites from a hot cause John English his Empyrical remedy which Medicine also that expert Physitian Dr. Theodore Mayern was wont to magnifie and prescribe in the like case Take of the juice of Plantane and Liverwort and fill an Earthen pot to the top which being stopt close put in a hot Oven after the Bread is drawn and make a little fire on the sides of the pot to continue the heat of the Oven after it is so boyl'd strain it and being sweetened with Sugar drink of it Morning and Evening and it cures In imitation of this I have often with success prescribed as followeth Take of green Plantane-leaves four handfuls Liverwort Brooklime of each two handfuls bruise them together and pour upon them half a pound of small compound Radish-water or other appropriate Aagistral express it strongly the dose three ounces three times in a day Although Diaphoreticks are most efficacious in an Anasarca How beneficial Diaphoreticks are in an Ascites yet in an Ascites they are rarely or not at all used for being unseasonably offered they impress oft-times great hurt on the Patient without any avail forasmuch indeed as by heating the blood they cause the fluctuating waters to grow hot and as it were to boyl in the hollowness of the belly so that the spirits and humours are disturbed by vapours raised from thence and so a disorder of all the functions follows and the very bowels being as it were boyled are much prejuciced Moreover from sweating unadvisedly instituted the blood being forced into a fusion and precipitation of the Serum throws it off the more into the nest of the Ascites Wherefore when some prescribe fomentations and liniments adn bathing to be applyed to the swelling Paunch of the Belly for the most part it turns to the worse in such Patients for besides a little Feaver a Vertigoe fainting of the spirits and other ill symptomes of the brain and heart being most
boyled Salt Alum and Sulphur and after applyed Cow-dung for a Cataplasm I use to prescribe these ensuing Take of flowers of Sal Armoniack one ounce Crystal mineral two ounces A somentation Spirit Wine small and imbued with much Phlegme two pound mixe and dissolve them in a glass Let a woollen Cloth dipt into this warm be applyed upon the whole Abdomen and then let it be changed wetting it again let it be done for the space of half an hour twice a day afterwards let there be applyed a Cataplasm of Cow-dung with the powder of Dogs turd or the following Plaister Take Empl. Diasaponis that is de Minio with Venice Soap A Plaister let it be spread thin upon limber Leather and applyed to the whole Belly to be renewed once in ten or twelve dayes II. The second Indication requires mostly alterative Remedies to wit The second Indication those which stop the fermentations of the humours in the bowels of the nether Belly and the Orgasms and irregular excursions of the Spirits also those which procure equal mixtions and due motions of the Chyle and nervous Juice Of Chalybeate Medicines for which end Chalybeates are chiefly in use And truly it is wont not only in this but in many other splanchnical Diseases to have resort to the Medicines of Iron as if from thence to fetch the sharpest weapons whenas many Empiricks and Quacks who prescribe these things confidently and dogmatically observe not by what way such a Medicine doth operate or what alterations for the better may be lawfully expected from thence wherefore while Iron changed into Medicine although the Sword of Goliah is snatcht and brandisht by a blind man it is no marvel if it prove in vain or if in the stead of the disease which is an Enemy Nature it self is sometimes hurt and truly frequently it happens so when Chalybeats of which there is great variety and diversity of operations are administred without any choice or difference either of the temperament or constitution in the Patient and respect to the state of the Disease Of Medicines prepared of Iron or Steel and of their vertues and manner of working What preparations of Iron are not convenient we have in another place treated and there is no need here to repeat the same things For this disease if any of them not all of them are fit for those in which the frame of the mixture being opened the Sulphur remains still and being loosened predominates over the rest they are altogether to be excluded from this number for they do much ferment the Juices of the bowels with their notable fermentation and do so exagitate the Blood and Spirits that the whole Region of the nether Belly is lifted up into a greater bulk as if by a certain Spirit thronging violently into it Neither here are they fit from which the sulphureous particles together with the saline are chased away as in Crocus Martis prepared by long and strong Calcination For this Medicine as it is conducing to stop all fluxes rather fixes any impaction of Humours and Spirits and renders them more obstinate But there remains a Martial Remedy of a middle kind What sort may be admitted wherein the Sulphur being wholly or for the most part expell'd a vitriolic Salt remains and predominates as indeed it is in the solution of the filings of Iron or in a simple Infusion or in Mineral water in the Salt or Vitriol of Mars in our preparation of Steel with many others out of which medicines being prepared or compounded we find by often Experience that in some cases they contribute notable help For these destroy the exotick ferments of the bowels and restore the native ferments they open their obstructions they fix the blood and restrain its consistence from too much dissolution wherefore Chalybeate remedies after the same manner as certain other alteratives do perhaps something profit against the procatarctick and more remote causes of a Tympany but as to the conjunct cause they contribute little or no succour Take of our Steel finely prepared two drams Forms of Chalybeates the distilled water above prescribed two pound Syrup of the five Roots two ounces mix it in a glass let it clarifie by settling the dose three or four ounces in the morning and at five afternoon Take of the Powder of Aron-roots Crabs-eyes of each three drams Crystal Mineral two drams Vitriol of Mars a dram and a half Sugar of Rosemary-flowers two drams mix them the dose half a dram twice in a day with a convenient vehicle Hartman doth wonderfully magnifie the liquor of the flowers of Tapsus Barbatus or Mullein A liquor of the flowers of Tapsus Barbatus as a specifick remedy in this disease by putting the fresh flowers into a Vessel being strongly press'd and put into an Oven with bread being close stopt afterwards the Liquor being strained let it be distill'd in Balneo the dose one Scruple in the Decoction of Fennel-seeds and Roots Surely this Medicine if it doth effect any thing ought to be given in a larger dose Johannes Anglus commends an Electuary of Rosata Novella with Diatrion Santalon and Egges of Ants which remedy seems to promise something probable enough In imitation of this I here propound this ensuing Take Conserve of Chichory flowers An Electuary of Indian Cresses of each three drams powder of Aron-roots Lignum Aloes yellow Sanders of each one dram Crabs-eyes one dram and a half Salt of Wormwood one ounce Ants Egges one ounce the liquor of Tapsus Barbatus half a dram with a sufficient quantity of Syrup of Citron-rinds make an Electuary the dose two drams twice in a day drinking after it of the former distilled water or of the following Julep three ounces Take the water of the leaves of Aron A Julep of the Juice of Elder-berries of the water of Juniper and Elder-flowers of each six ounces the magistral water of Snails and of Earth worms of each two ounces Syrup of the Juice of Elder-berries two ounces mix and make a Julep III. Third Indication The third Indication Vital prescribes Remedies against fainting of Spirits and difficult breathing and against Watching and Thirst We will briefly annex certain forms of either kind 1. Cardiacks Take of the water of Napha Cordials Marygolds Camomile of each three ounces of Dr. Stephan's water two ounces Tincture of Saffron two drams Sugar one ounce Pearls one dram make a Julep the dose four or five spoonfuls three times a day or oftner in faintings Take Conserve of Marygolds two ounces Confection of Alchermes and de Hyacintho of each two drams prepared Pearl one ounce Syrup of the juice of Citrons enough to make a Confection take the quantity of a Nutmeg evening and morning drinking after it a draught of the Julep 2. Hypnoticks Take of Aqua Hysterica six drams Hypnoticks Syrup de Meconio half an ounce mix them and take late at night Or Take
no measure of flowing out and therefore being stirr'd into violence it flows out too much or secondly because the mouths of the vessels once opened do not presently close again nor are able to be shut or Thirdly because Nature endeavouring an excretion of blood doth it by places more open but often inconvenient as when an Hemorrhage happens through the Lungs the Kidneys Guts or other Bowels which therefore pass from a Critical into a Symptomical and often into a malignant Haemorrhage Neither only by these means but by many other failings of Nature or impediments 2. Symptomatical Hemorrhagies arise either do Symptomatical Haemorrhagies happen in all which either the Blood it self or the Vessels containing it or both of them together are wont to be chiefly in fault 1. In the first place the Blood besides the reasons above mentioned First by the fault of the blood to wit forasmuch as it becomes inflammable or fermentable above measure is apt also to be extravasated because either its liquor being empoisoned or otherwise corrupted cannot retain its due mixture but being apt to coagulate or putrifie divides it self into parts and whilst some of them being here and there planted sending forth spots wheals and other brands of Malignity do discolour the Flesh and the Skin and obstruct the proper passages others otherwise running out an breaking forth wheresoever there is a vent found do produce bloody Excretions in divers places as is commonly discerned in the Plague Small-pox Measles and malignant Feavers yea perhaps this in some measure is the reason why in scorbutick Distempers as spots and marks so also Haemorrhagies are so familiar 2. Secondly The vessels bringing Blood being faulty many and divers ways Secondly The fault of the Vessels for that they are ill formed but chiefly in these three do appear the cause of a symptomatical Haemorrhage viz. In the first place if perhaps any where some of them are obstructed as often as the blood assumes a more rapid motion either in the same place or in the contiguous parts and also sometimes in remote parts it is constrained to burst out Frequently from such a cause an Haemoptoe proceeds moreover Spitting of blood and the Haemorrhage of the Nostrils do often follow the suppression of the Terms and Hemorrhoids Secondly the little mouths of the vessels by reason of the fleshy Fibres being loosened or resolved by which they are clos'd sometimes are ill formed so that when the ends of the Arteries do gape too much the little mouths of the veips do close By reason of this affection Scorbutical and Cachectical persons are found obnoxious to Haemorrhagies as we have remarkt in another place But Thirdly Thirdly Forasmuch as they are convulsively affected it frequently comes to pass that the Vessels being so evilly formed are also convulsively affected and so the morbific cause being as it were doubled this evil is much encreased insomuch that the muscular fibres of the Vessels being inordinately contracted cause sudden and violent fluxes of the blood one while towards the upper parts anotehr while to wards the lower and so their little mouths being open in the mean time they provoke prodigious Haemorrhagies For I have observed in some persons when the current of blood was small enough with a small and weak pulse the Convulsions of the Vessels generated in some place and propagated under the likeness of wind running to and fro in the body to drive more impetuously the blood however slow of it self and to constrain it into violent eruptions and in cases of this sort when Phlebotomies and Medicines refrigerating and tempering the blood have not at all profited the greatest relief hath been found from Narcoticks Antispasmodicks and Ligatures 3. 3. From the blood and vessels being both in sault Thirdly If perhaps it shall happen that these faults of the Blood and Vessels are complicated and put forth their mischiefs joyntly at once from thence it will be of necessity that this evil will be more intense and more frequent and prodigious Haemorrhagies will be raised the reasons of which as they appear plain enough by what goes before it will be neither necessary nor seasonable here longer to dwell upon explicating of them but rather whereas we have designed hitherto the acts of Nature about spontaneous effusion of Blood and its courses both rightly instituted and also wrongfully and evilly constrained now it behoves us next to declare how far Art for the most part the Ape of Nature and sometimes Mistris or Moderatrix thereof can act likewise well or better about letting of blood and how sometimes it is wont to succeed worse We advertise of these things in general Emission of the Blood procured by art that a Physitian imitates Nature in some cases of letting blood exceeds her in other cases and frequently regulates and reduces her when acting amiss Moreover ther are some cases wherein Nature excells far the efficacy or Art concerning bloody excretions briefly of each of these Therefore in the first place 1. It either imitates Nature in whatever affects spontaneous Haemorrhagies are wont to bring help when these are wanting Physick the Handmaid of Nature rightly substitutes Phlebotomie Therefore if perchance the Blood be immoderately kindled by reason of its Sulphur being too much loosened and advanc'd by breathing a vein what is superfluous of that inflammable fuel will flow out as also the immoderate turgescency of Blood by reason of somewhat untamable being mixed with it will be allay'd by this course Wherefore letting of blood is advantageously administred as well against continual Feavers which proceed from the former cause as intermittent Feavers whose fits proceed from the latter cause Also in like manner as often as an accustomed evacuation being suppressed or a humour driven back from the ourward parts or a sudden stoppage of the pores or if a Surfeit drinking of Wine or other accidents of this nature cause a turgescency of blood inasmuch as they dash heterogeneous particles against it Phlebotomie is usually the most ready Remedy Secondly 2. Or excells and regulates it Physick in Blood-letting not only imitates Nature but often excells it and also succours her being weakened and reduces her often erring For if at any time the blood struck with violence rushes in a heap against any part and either presently breaks out in the same place or abundantly gathered together engenders an Inflammation a vein being pierced in a remote place stops that preternatural tendency of the blood and frequently carryes away the bleeding or inflammation Wherefore in a Pleurise a Squinancy a Peripneumonia in spitting or vomiting of blood when Nature is vanquished or being outragious seems to cast violent hands upon her self Chirurgery recalling the blood to another part and sending it out restores the matter that was almost desperate Moreover Physick frequently restrains or reduces Nature when too prodigal or prevaricating in pouring out of the blood for in truth all immoderate Haemorrhagies
do want Bridles not Spurs But in the Plague Small-pox and Measles broke out and in malignant Feavers sometimes the blood spontaneously flowing out portends for the most part evil therefore in those affects styptic Remedies or things stopping the eruption of blood are more convenient than breathing of a Vein Thirdly 3. Or Art out-done by Nature Notwithstanding on the contrary there are cases of shedding blood by Nature which Physick can no way imitate neither if they chance to fail can be supplyed by Phlebotomy In Feavers about the Crisis of the Disease to wit after the digestion of the matter that is to say the preparation for Excretion spontaneous Haemorrhagies if coming in time do far excell any Phlebotomie which none knows the best season of Moreover the Fluxes of the Terms and Haemorrhoids happening by Natures instinct are more advantageous than the mission of blood provok'd by Art in any of those places Between Phlebotomie and spontaneous Haemorrhagies Phlebotomy and spontaneous Hemorrhagies differ as to the subject and matter there is yet a notable difference although not of great moment in Physical practice viz. both as to the Subject and Matter of either of them for in this the blood being florid and throughly Scarlet doth for the most part only flow out of the Arteries but in the other Evacuation the Blood being of a black purple with a Scarlet Cream is only drawn out of the vein Whence the stream of Blood which is one within all the vessels and throughout continuous acquires such a diverse kind of appearance seeing we have shewed in another place it is not our present purpose to make any surther search into this Aetiologie because it concerns not much to the curing any distemper out of what vessel the blood be let provided it flow out largely But that the ancients do in some cases commend Arteriotomie and prefer it to an incision of a vein the Circulation of Blood not being then known we have elsewhere discoursed how well it may be done Hitherto of Phlebotomie compared with a spontaneous Haemorrhage The use and effects of Phlebotomy now our next business is to describe the use and effects thereof as well good as bad in Physical practice Wherefore we will first shew in general what alteration of the mass of Blood this Evacuation bring then what diseases it more immediately respects either of the whole body or its particular parts About the former How it affects and alters the Blood it is obvious enough that the blood is altered by breathing a vein both as to its quantity and temperament and as to its disposition and motion The first and most common Indication of Phlebotomie is 1. Diminishes its quantity that the plenty of blood be diminished by this Administration And truly this is a vulgar Remedy to remove or provide against a Plethora Any one though of the vulgar sort growing to a full habit of body le ts blood without the advice of a Physitian Moreover Rusticks and Countrey-men for healths sake Emission of the Blood is not to be either too prodigally or too slenderly made once or twice in a year cause blood to be drawn from themselves and their Beasts But although this custom is grown so much in use with some prodigal of their blood that they breathe a Vein on the smallest occasion and sometimes without any manifest cause notwithstanding we may find many others no less obstinate against this custome insomuch that for no cause will they lose any blood unless the greatest necessities be urgent Upon this matter whereas Arguments are alleadged on either part The reasons of the former hinted at that I may in few words determine what seems fit to be ordained in the first place it is requisite we grant that letting blood is convenient against a Plethora either made or beginning for by no other Remedy are the evils of that Affection wont to be better removed or provided against Notwithstanding the necessity of this evacuation ought to be declined as much as may be because from thence as we have intimated elsewhere the blood becomes more sulphureous and less salt and for that reason it most commonly disposes all men to be feaverish and to be fat Moreover the Great Remedy Blood-letting if it be prostituted to every little occasion becomes less efficacious to any grand affections when need requires To which we may adde that according to the vulgar observation by how much the more familiarly any one uses Phlebotomy he will the more frequently stand in need of it for blood being emitted to avoid a Plethora the rest of the mass will the sooner rise to a Plethora far otherwise than is the opinion of some who dread lest the store of blood be consumed by frequent Phlebotomie for that on the contrary by this means the quantity is more encreased although the Crasis be the worser for so the blood having lost much of its balsamick Salt and preservative against putrefaction instead thereof is filled with a pinguifying and more fiery Sulphur Secondly 2. Phlebotomie amends the mixture of the Blood Phlebotomie doth frequently correct the mixture and temperament of the blood in a manifold respect For in the first place if any thing heterogeneous be confounded with its mass which cannot be rightly digested nor easily excerned and sent away a Vein being opened the blood flowing out conveyes frequently much of the portion of that matter forth with it insomuch that the rest may be either subdued or expell'd For the orifice of a vessel being opened presently the blood fermenting gathers together the extraneous particles as much as possible and excludes that portion of it self wherein many of them are heaped up From hence we may observe the blood flowing out first and last to be well enough It restores its temper when that emitted between appears corrupt Also secondly the blood declining from its temperament is frequently restored by Phlebotomie For when the mass thereof by the Sulphur or fixt Salt or both together being exalted shall degenerate into sharp salt or saline-sulphureousness a portion of the blood being withdrawn immediately a new fermentation thereof arises and very often there is a transposition made of all the particles of that sort that afterwards the Spirits may a little emerge with the volatile Salt and recover their dominion the Sulphur and fixt Salt as is fitting being subdued For this reason it is that letting Blood doth not only confer great help in Feavers but also in the Scurvy Jaundies and beginning Consumption for the blood after the vessels are emptyed like the Stomach disburden'd doth better digest and assimilate any humoursingested and the more easily throws off and separates whatever is heterogeneous But if the mixture of Blood begins to be much loosned and become very bad Some distempers of the blood admit not Phlebotomy as in the Plague and malignat Feavers we must altogether abstain from Phlebotomie for the blood
being withdrawn the store of Spirits whose only part it is to vindicate the mass of blood from putrefaction and corruption is diminished so that immediately all things tend to a deadly dissolution Moreover if the Dyscrasie of the blood shall be of that manner that the more noble Principles to wit the Spirit the volatile Salt and Sulphur being depressed or cnsumed the watery and earthy particles predominate the blood ought not to be sent out but preserved even as the treasure of life for when the abundance of Spirits are so small any loss of them doth cause all the functions to stagger and gives way to the disease wherefore in a Dropsie Cachexia Consumption and other Distempers where the active Principles are greatly depressed the opening a vein is almost the same thing as cutting the mans throat In the before mentioned cases In some eases about Phlebotomy it is very doubtfull where the temperament of blood is respected it is easie to determine whether Phlebotomie be convenient or not but in some others as in a putrid continual feaver when upon this hinge Life and Death are turned there is need of the greatest deliberation and so much the rather because the event of the Disease and the success of all the accidents in its whole course whether good or bad is usually imputed to Blood-letting or its omission and from hence it is that Physitians being solicitous to preserve their own repute do chiesly raise doubts in their consultations of this matter And chiefly in a continual putrid Feaver But truly in this difficult knot that we may not be led by the rumour of the vulgar as it chances to happen one while approving another whise condemning Phlebotomie but with more certain advice we must consider the state of the Blood the tendency of the morbific matter and the strength of Nature First as to the former if in a putrid Feaver the blood very much growing hot shall raise a great heat with thirst watchings and burning of the Jaws and no eruption of abundant sweat nor pushes appear or is suddenly expected opening of a vein is so clearly demonstrated How the doubt is to be determined that it is a wickedness to omit it but on the contrary if in a languid body a slow and remiss Feaver but continual arises with a weak Pulse let Blood-letting be spared and the cleansing thereof be procured by breathing Sweats Urine and blistering Notwithstanding in a middle state of Blood and of a Feaver Phlebotomy almost indifferent in it self is determined by other things Therefore secondly we must weigh the tendency or flux of the morbific matter which if it remain dull in the mass of blood and unfit to be separated and so as it is frequently wont to be instead of a Crisis a translation towards the head be made and threaten the brain and nervous stock the cutting of a vein ought seasonably to be administred whereby these evils may be provided against Notwithstanding if that this matter being soon raised into a rage and either rushing inwardly to the bowels of the nether Belly provokes a huge Vomiting or Dysenterical affections or being driven outwardly seems to be about to bring the Small-pox Measles and other pushes every such force of Nature if good ought not to be disturbed if evil not to be made worse by Phlebotomie for in these cases it is not only dangerous to let blood but also very scandalous Thirdly about Phlebotomy to be administred in a doubtful case we are to take heed to the strength of the Patient for in a healthful Constitution a vigorous Age the commencing of a Disease and the functions both vital and animal being yet in a florid or indifferent estate we may confidently prescribe letting of blood unless something indicates the contrary Notwithstanding when it is otherwise as to those conditions we may not rashly proceed to that Evacuation Thirdly Thirdly Phlebotomy corrects or stays the inordinate motions of the Blood the inordinate motions of the Blood when being very much moved as it were with fury it either rushes impetuously one while into these parts another while into those or transferres the noxious matter are best restrained or reduced by Phlebotomy wherefore in great Cephalalgies in all soporiferous or convulsive invasions for Catarrhs Ophthalmia's and a Cough Asthma fits of the Gout and Stone or Phlegmons Erysipelas's also for many other Distempers raised by the flowings of the Blood or Serum an incision of the vein is commonly prescribed and indeed for the most part as with good success so also upon right Reason for the Vessels being emptyed the blood having obtained a more free space is circulated pleasantly and undisturbedly besides whatever is extravasated of the Blood or Serum is wont to be suckt up again and reduced into its course The Effects as well good as bad being thus shewn What Diseases and of what parts Blood-letting chiefly respects which happen to the blood in the manifold state thereof by Phlebotomie we will next make strict examination what Diseases chiefly either of the whole body or of any private Region that kind of Remedy doth more immediately regard And first as to what relates to general Distempers it is commonly enough known that letting blood is indicated bu a hot and dry temperament and interdicted by a moist and cold It is usually propounded in every Feaver but never in a Dropsie Moreover if we consider particular Diseases there is no region or part of the Body but as they rejoyce in the influence of vital as well as nutritious blood as long as it is well so as often as it is disturbed in any place or reaches out any disagreeable or provocative thing in place of benign Juice it requires avocation and a letting out thereof If I should take notice of every single case of this Indication we should here rehearse almost the whole Pathologie of the humane body An aking Head a Brain oppress'd with blood or overflowed with Serum whence spring a world of evils burning of the eyes inflammation of the face mouth and throat all the diseases of the Breast and Praecordia inasmuch as the disorder of Blood affords a rise or fuel to each of these likewise obstructions or inflammatory affections of the Liver Spleen and other Bowels moreover as a Plethora and Athletick habit of the whole body so also the tumours of each member painful and convulsive passions seem to accuse the blood as Author of all the evil and require its sending out as a certain kind of revenge In these and very many other distempers if at any time Bleeding be clearly indicated After Phlebotomy being indicated these four things following ought to be considered before it be performed four things ought to be considered viz. In what place by what manner and instrument at what season and in what quantity the Blood ought to be taken away First as to the former although according to the Laws of the
Circulation of the Blood as oft as the mass should be diminished First the place from whence Blood is to be taken it differs little from what vessel a part thereof be taken provided it be large enough notwithstanding for that besides a general evacuation of the blood sometimes a particular one properly called Derivation as when the blood is to be brought out of a private place where it is accumulated and moreover a Revulsion when it is to be called into this or that part are intended for that reason in a humane Body there are appointed as it were various Boundaries out of which now by this now by that or by another vein the blood may be emitted as occasion is given and for the uses chiefly requisite If therefore at any time an univeral Evacuation of the blood be indicated the median vein of the Arm is best to be opened for this is easily opened being large enough and whereas it equally flows from the whole body to the orifice thereof being open enough by whose more free efflux nt only a Plethora is taken away but the greater vessels being every where emptyed after this manner the blood stagnating in any place is brought into motion and being extravasated is again swallowed up into the veins wherefore in great distempers when the blood being heaped in the Brain In some cases from the Arm. or Praecordia does threaten sudden destruction the best way not only of general Evacuation but of a Revulsion is to send the blood by a full current out of the vein of the Arm being largely open'd But if without any great Plethora the blood ought to be evacuated from the whole and pulled back from the upper part of the body towards the inferiour as in the suppression of the menstrual flux or Hemorrhoids it will be rather fit to bleed in the Foot or sedentary vessels by Leeches In others from the vein of the Forehead Temples or Throat But if after the blood being evacuated from the whole it be also to be derived from any private part where it is accumulated let its drawing off be near the place affected Hence in Cephalick Diseases we open the vein of the Forehead of the Temples or of the Throat To cure Tumours or pains raised in the Joynts we cut a vessel either beneath or near them or draw out the blood by Cupping-glasses or Leeches In like manner in distempers of the Thorax and nether Belly either Cupping-glasses are applyed to the region suffering The Cophalic Vein of the Arm the Liver Vein or the Salvatella erroneoufly so called or Leeches to the sedentary vessels But that some Vessels are reported to bear a peculiar respect to certain Bowels and that they ought to be lanced in their distempers viz. such are the outward brachial vein which is said to respect the head and the inward the Liver also the outer vein of the Hand tending to the Ring-finger which is said to respect th Spleen and for that cause this is called the Salvatella and the former of them the Cephalick and the other the Jecorary all this is meerly a vulgar error which being propt by no reason or Anatomical observation I am ignorant whence it took its origine Therefore as soon as it is agreed on to cut a vein and its place let a large Vessel be chosen and very conspicuous that it may the more easily be opened and being remote from an Arterie Nerve and Tendon may be the more securely lanced wherefore in the Arm the median vein is commonly chosen although the Cephalick being less environed with other Vessels is the more safely opened The Jugular Vein is almost always opened as often as blood is let in Beasts The jugular Veln is most safely opened it is a wonder it hath not obtained the same Custom in Man when the large and eminent Pipe hereof may most easily and safely here be cut because it neither hath an Arterie for its companion and lies a great way from any Nerve Moreover from this vessel as from any other whatsoever opened an universal evacuation of blood is made from the whole body and together the best derivation thereof from the head so that all the stagnations or aggestions of the Blood and Serum are discharged thence Concerning Vessels in the soot or the hand there is no great reason of choice Of Veins in the band or feet but take the vein which chiefly swells it matters little concerning the Place unless that if incision be made above or near the Ankle there is great care to be taken lest a Tendon be hurt which sometimes by unskilful or rash Chirurgeons happens to the damage of the Patient Moreover let care be taken lest a vein be cut near its Anastomosis with an Artery for if this be committed the blood being entirely Scarlet will impetuously skip out and the flux thereof is not easily stayed nor the orifice of the vessel soon stopt The chief places being thus designed of letting forth the blood we ought to consider by what menns or by what instrument the Blood ought to be drawn forth and the choice of the vessels being shewed we ought next to treat of the Manner or Instruments by which blood is drawn out which is used to be done either by a Lancet in cutting the vein or by suction by Leeches or by Cupping-glasses after Scarification But there is no need of discoursing these because each of these parts of Chirurgerie are every where in familiar use by Quacks Barbers and Women and all things relating to them so commonly known as a man his own house wherefore we will speak but one word Helmont of late and still certain followers of him Some of the Ancients as well as Modern have ridiculously exclaimed against letting of Blood Pseudochymists and Fanaticks have ejected Bleeding out of all Physick because they think this evacuation to be a great injury to Nature which being aided either by her own strength or by their Panacea's they will have to overcome every offensive thing of her self Surely this is no less ridiculous a thing than that long since Chrysippus Apaemantes Strato and some others as Galen reports damn'd this remedy because a vein is difficultly known from an Artery Truly it is manifest enough by sad experience that in cutting a vein sometimes an Artery hath been pierced whence either death or loss of the member sometimes ensues the reason whereof is not as is commonly alleadged that the coats of an Artery being more nervous or membranous than the coats of a Vein can scarcely or not at all be healed when in truth that Vessel is endowed with more and thicker fleshy fibres Wherefore in opening a Vein the pricking of an Artery is so dangerous but the cause is that an Artery like the Heart it self ought incessantly to shake and beat the fibres thereof repeating perpetual turns of Systole and Diastole wherefore a little hole being made in its Pipe for
the most part remains uncurable by reason of the continual motion of the Vessel and the efflux of blood It is otherwise in a Vein whose opening is immediately stopt of its own accord for but little of contractive work lies in its Coats yea this only that its fibres being lightly opened as occasion serves the blood flowing back of its own accord is gently moved forwards and after Phlebotomy the vessel being empty they are permitted to be quiet so that in the mean time the little hole made by incision is easily glewed together Whenever Physitian or Patient do dread the opening of a vein to be administred drawing of blood by Leeches or Cupping-glasses will aptly enough and with like advantage supply the defect hereof Moreover these administractions to remove the conjunct cause of a disease where there is need rather of partial than general Evacuation or Derivation are frequently preferr'd to Blood-letting it self There is no need to dwell longer on explicating the manner and reafon of the effects of either of these operations commonly enough known but proceeding to other things we will next throughly weigh the Time and Quantity of letting Blood The opportunity of letting blood is often of so great moment Thirdly The Time of letting Blood comes into consideration that whereas this Evacuation succeeds well at one time at another it highly prejudices But there are diverse respects of time to be considered about the due performance of Blood-letting but chiefly these four The Time of the Disease the Age the Year and Day The first concerns chiefly the Cure of the Patient the others the Preservation of him First therefore if blood ought to be let in any Disease 1. In respect of the disease it will be chiefly sesonably about the beginning or encrease thereof but not at all or very cautiously in the state or declination For at that time whilst Nature is busied endeavouring a Crisis so that the Spirits are in great labour and the blood ferments very much that great endeavour of it ought not to be disturbed and in the height of the disease either Nature being Conqueress doth not want such a relief or being subdued will not endure such an Evacuation Secondly If at any time for preservation it be deliberated touching letting blood 2. In respect of age Infants Boys and Old men by the Custon of all Nations obtain an exemption also this evacuation was wont to be interdicted to pregnant Women but now most commonly prescribed Men of a vigorous Constitution and middle Age do well enough endure Phlebotomy and often times want it Notwithstanding the first and second time it ought not to be done without great occasion for that being once begun and afterwards repeated it will soon proceed into an inevitable Custom Thirdly Hence they who used to let blood Spring and Autumn 3. In respect of the Tear and its parts afterwards cannot omit this evacuation without hazard But to whom it will be either profltable or necessary to breath a Vein once or twice a year the chief seasonable times will be in the beginning of Spring and Autumn viz. when the Blood being prone to ferment anew is in danger to change its Crasis Phlebotomy seasonably administred provides lest the Sulphur and Salts being exalted it should contract a feaverish scorbutical or other peccant distemper likewise lest suffering a flux it should pour forth the serous Recrements and other Feculencies upon the Brain the Lungs or Bowels of the nether belly About the Solstices when our bodies are very cold or hot the blood as the juice of all Vegetables consisting in a more fixt state and unapt to sweel up ought not to be let out unless upon some urgent cause But whereas some precisely or rather ridiculously observe about Phlebotomy The Aspect of the Moon and Stars are here of no moment even as the Countrey-men about Gelding Cattle the position of the Heavens and the Aspects of Moon and Stars it appears altogether frivolous and for that chiefly is this Custom condemned inasmuch as counterfeit Astrologers have a Figure in their Almanacks wherein every sign of the Zodiack is allotted to every particular member of our bodies and for that cause under what sign the Moon is conversant they forbid blood to be drawn from the respective part of man They who observe without reason the Heavens do erre as the saying is the whole compass of the Heavens Moreover this vulgar error is not only absurd but frequently malevolent inasmuch as many of the common people will abstain from Phlebotomy whatever indication makes for the same if as they say the Sign be in the place of letting blood Fourthly As to what relates to the time of the Day in acute Disease 4. The time of the day about letting of Blood when a Physitian is sent for and there be indication for Phlebotomy immediately to be performed after the body is prepared he may prescribe that operation any hour in day or night but otherwise if any interval may be allowed then breathing a Vein rather is to be celebrated in a morning when the Stomach is fasting the vessels emptyed by sweat in the night the stream of blood being quietest and appearing free from any â—â—ous filth Yea although necessity urge it may be deferr'd a little untill the new Juice of things eaten be pass'd into the blood for the vessels being emptryed-will not only snatch the crude Chyle into themselves but frequently what is disagreeable or unproportionate unto the blood whence not only its motion is difordered but also the vital flame runs the hazard of being extinct I have known some by Phlebotomy administred presently after plentiful Drinking or pouring in of vinous liquors to have fallen into dreadfull swoundings away which have lasted very long untill the vital spirit being almost overwhelmed recovered it self again Moreover in the fifth place the opening the vein being indicated 5. The Quantity of the Blood to be taken away ought to be considered and its time appointed there remains still no little consideration to be had what Quantity of blood is to be let out in which point there is most commonly a fault committed while some being too audacious and others no less timerous they affix those bounds on this or that side of which for the most part consists the Right For that I may omit those who scarcely or not at all admit of Phlebotomy as I have before hinted so I cannot easily assent to their practice who fear not to draw blood to swounings Too much Phlebotomy to be avoided Besides an error of no light moment is committed within the moderate bounds while in some cases blood is drawn by too sparing a hand and in others with too free In a burning Feaver But a more spare Bleeding often hurts and fixes a feavour Pleurisie Peripneumonia Squinancy Frenzie Apoplexie and other great diseases that have their origine from a turgescency or phlegmonic incursion of
the blood a sparing Phlebotomy doth always more prejudice than advantage For besides that it doth not remove the antecedent cause of the disease to wit the Plethora it further causes the conjunct cause viz. the inflammation and bursting out of the blood to be angmented For truly it is a constant observation that upon blood too sparingly drawn the whole mass doth boyl up more notably and doth acquire a new flux into the part affected the reason of which is that in a great Plethora many portions both of the Blood and Serum being thrust forward into recesses and strait places are there constrained to abide which after the Vessels being a very little emptyed The Reason of which is declared do impetuously regurgitate into the mass of blood and do much disturb it and force it more impetuously to and fro Wherefore also in this respect the vessels ought to be very much empted viz. that besides freeing the former Juice from straitness also space may be given to the Juice reduced from exile which otherwise being not congruous coming upon the blood troubles it and provokes it into effervescencies and eruptions From hence we may observe that almost all men grow more hot presently after Phlebotomy and yet the blood being sufficiently evacuated a little after they enjoy a more temperate condition But as a slender withdrawing of blood in some cases is only vain but is performed with prejudice so in other cases too much effusion is rarely committed scot-free and sometimes brings notable detriment of health For when either strength languishes or the body labours under a notorious Cachexia we must spare Blood-letting and its taking away is either prohibited or being indicated by some accident is allowed but in a small quantity Wherefore in men endowed with a weak tender and cold Constitution and in consumptive persons those affected with a long or malignant Feaver In some eases the mission of Blood must be altogether avoided also in Hydropicks or Cacochymicks a vein is not rashly to be breathed at least if it be much blood is not suffered to be taken away It will be an impossible thing to prescribe general Rules according to the particular cases of every individual person whereby the quentity of letting Blood may be exactly proportion'd according to the strength of the Disease and the ability of the Patient but let this be left to the judgment of the prudent Physitian present and let his Commands be ever exacutly observed And let not as it every where is such leave be given to Quacks Empiricks and Barbers to play with humane life who every where rashly and wickedly use Phlebotomy and if the blood spring more sreely and appear discolour'd therefore bragging of the vessel being well pierc'd they say it must be let out more plentifully because it appears bad when oftentimes on the contrary it ought to be spared As soon as the Quantity of Blood to be taken away is determined Phlebotomy ought ever to be done with a large orifice our next care ought to be that a more large orifice being made the blood equally mixt may flow out as soon as may be for otherwise if it go out from a small hole or drop by drop or with a little stream the mass of blood fermenting will separate into parts and what is more subtile and spirituous will burst out the thicker and feculent remaining behind Hence it is to be observed that the blood being let out of a large orifice with a more full stream if it be a little stopt with the finger clapt on it and a little after suffered to flow out the blood going out the second time becomes much purer and brighter than the former because in the interval of flowing the more subtile particles being unfolded from the thicker and accumulated together have prepared themselves to fly away Wherefore if Hippocrates's Precept shall be observed ' viz. to let it run to the change of its Colour it behoves us to procure that it spring out quickly with a full a not interrupted stream Besides all this as to what appertains to the alteration of the blood let out and cold and to the inspection and the judgment thereof for that we have often discoursed it in other places we now pass it by hastening to other things and now the thread of Method leads us to entreat of Remedies opposite to Blood-letting to wit Ischaemones that is those which are convenient to stop immoderate Haemorrhagies whether engenderd by Nature or by accident SECT III. CHAP. II. Of Remedies restraining or stopping of Blood EVen as Art imitates Nature in letting forth the blood by Phlebotomy offending in plenty or temperament or in its motion Every Hemorrhage is not to be stopt so it succours her being diseased or working wrong by stopping the flux of blood whensoever it is immoderate or hurtfull Whereas there are various and many species of an Hemorrhage there is no need of Physick for them all If perhaps a great effusion of blood happens by a solution of unity excited by an outward accident as a wound or stroke Chirurgery suggests the manner of Administrations whereby it should be restrained Moreover an Hemorrhage as long as it shall be Critical ought to be disturbed by no Medicine but left to the meer government of Nature as long as she does aright use her power and as to the Symptomatic whilest it is little or not much troublesome there is required no Physick notwithstanding there is great need of it if at any time the Flux of blood be either immoderate or flow out by unapt places Eruptions of blood of this last kind chiefly challenge a Cure But only the immoderate and inconvenient if perhaps the blood be cast upward by Coughing or Vomit or downwards by seige or thrown off through the Ureters For in these cases though the quantity of the Blood excreted be not much to be dreaded notwithstanding because often a dangerous or mortal Ulcer ensues the solution of the Unity so made in the Lungs or in the Stomach Guts or in a Vein therefore we must industriously rancounter those Hemorrhagies from their first appearance Therefore among the Diseases of those parts The chief Cases of the latter are reckoned such bloody excretions are accounted but we have already in another place delivered the Theories of Spitting Blood and of the affection Dysenterical and the reasons of healing them so that there is no need to repeat them here neither also to propound here a remedy for bloody Urine for that it belongs to the Nephritic Pathology wherefore we will pass to those Passions for which by reason of an immoderate efflux of blood there is great need of restraining Medicines The kinds of these Affections are chiefly three viz. Haemorrhage of the Nostrils And also of the former of the Flowers and the immoderate Flux of the Hemorrhoids The Cure of which last doth belong more to Chirurgery than Physick and I think it
best to referre the other to the hysterical Pathologie Here properly belongs to this place the blood flowing out of the Nostrile being the most general kind of passions of the sort For the present the Cure of the Hemorrhage of the Nostrils is only propounded and common to every Age Sex and Temperament so that from the Diagnostick and Therapeutick of it duely assign'd the uses and efficacies of Medicines stopping blood will best appear for what we proffer for the unfolding the Causes and Cure of this bloody eruption may be accommodated unto all other dreadful Hemorrhagies It is observable enough that the Flux of blood from the Nostrils doth happen to most men from extraordinary occasions for as oft as the blood about to break out through its own turgescency or through laxity of the vessels is apt in some place to make or find its way it is by a certain instinct of Nature very often directed to the Nostrils as to the part most easily opened A description of the Vessels from which Blood flowes The vessels from whence it flows in that place are slips of the arterial Branch going from the Carotides after having pass'd the Cranium it comes to the basis of the Cerebrum for this proceeding near to the mammillary Processes sends very many twigs from it self every where about of which some eminent ones passing the hole of the Sieve-like Bone with the smelling Nerves are distributed through the glandulous membrane investing the windings of the top of the Nose These nasal Arteries departing first from the Trunk of the Carotides within the skull anticipate part of the blood chiefly serous from the brain and lay aside the Serum it self and other watery recrements into the glandules of the Nostrils as into the proper Emunctories of that Region whence they distill into the cavity thereof Wherefore if the mouths of those little Arteries do alwayes gape somewhat by reason of the sweating out of the Serum it is no marvel if the blood it self being made more turgid opening them a little more which often are too loose of themselves bursts forth of dores Indeed this Emissary both of the Serum and of the Blood being apt ordinarily to open or on any occasion prevents or cures great incommodities of the brain or of the Praecordia yea and sometimes of the whole body For in the first place They are the same by which the Serum distills to the Nostrils this way the Serum as I said is derived from the head and when the mouths of those Vessels are vellicated or provoked by any sneezing Medicine put into the Nostrils the Serum is from thence more abundantly drawn out which yet doth not descend from the Brain as is commonly thought but is anticipated by these nasal arteries lest it should go to it from which when it is more plentifully drained and brought forth by the use of Errhines for that cause the Brain becomes more serene and exempt from vapours Then secondly lest the Brain should be overwhelmed at any time by blood more impetuously overflowing a portion hereof passing through these vessels and breaking out easily prevents it But sometimes it happens that an Haemorrhage of this kind The Blood flowing forth in too great plenty from these Vessels is very hurtfull rather becomes a Disease than a Remedy for whensoever the blood flows out more often and more abundantly than is fit from the Nostril if life be not immediately hazarded by reason of too great loss yet the remaining mass of the blood being impoverished thereby and losing its temper acquires a cachectick and frequently an hydropick disposition even as we have clearly intimated before where we also have shewn the Aetiologie of this distemper in common with other too great Hemorrhagies either to consist in the fault of the blood or of the vessels or of both together First The causes of such an immoderate flux the blood bringing an Hemorrhage of it self offends either in Quantity or Quality and therefore while occasionally it boyls up it cannot be contained within the vessels but either opening their mouths by distending them or unlocking them by its acrimony 1. From the fault of the Blood it skips out To which happens that the blood being sometimes dissolved in its consistence and as it were infected becomes unfit to continue the course of Circulation inasmuch as portions thereof separating from one another are partly fixed in the flesh or skin having suffer'd death and partly breaking out stirre up frequently dreadful and sometimes mortal Haemorrhagies as every where is discovered in malignant Feavers and sometimes in the Scurvy Notwithstanding the blood offending by meer Quantity or Acrimony unless the fault of the Vessels happening thereon provoke the flux thereof or too easily permit it seldom breaks out into a great Hemorrhage Therefore secondly 2. From the fault of the Vessels the vessels bringing blood as often as they conspire to produce that affection are usually in the fault either first inasmuch as their small mouths gaping by reason of the fibres being too loose and weak do not readily enough transvasate the blood out of the Arteries into the Veins which fault happens to scorbutick and cachectical persons or secondly inasmuch as by reason of the same moving fibres being affected with the Cramp and Convulsion the blood being snatcht impetuously to and fro and chiefly towards the Head is constrained to break out to continue the thread of circulation even as it will plainly appear in the case of a Patient which shall be shewn below 1. Prognosticks As to the Prognosticks although an immoderate flux of Blood in the Small-Pox Measles malignant Feavers and in the Plague doth ever presage evil and is expedient to be stopt notwithstanding it ought to be restrained not by meer cooling or revulsory things but to be chang'd by temperate Hydroticks into sweating 2. An Haemorrhage of the Nostrils though not great is more dangerous in Cachecticks with a weak Pulse and a cold sweat than a plentifull Hemorrhage in men endued with a Pulse strong enough and blood very fervent 3. They who are obnoxious to this Disease by reason of a Dyscrasie of blood and loosness of the vessels if there come upon both these a convulsive disposition of the fibres of the little Arteries they receive a far more difficult Cure and frequently are reduced to extream languishings by reason of the great losses of blood 4. From those who are feaverish when much blood shall flow out of the Nostrils and does not terminate the disease often-times in the place of a Crisis a delirous or a soporiferous affection succeeds There are many other prognosticks about a Hemorrhage accurately remarkt by Hippocrates which notwithstanding properly belonging to the discourse of a Feaver we omit in this place for truly the Cure in general of this Distemper is here almost only intended About which there will be three primary Indications Three primary Indications of Cure
being raised the flux of Blood often ceases if it be not very dangerous Take water of Meadow sweet Tormentil of each four ounces Remedies Saxons cool Cordial two ounces Treacle water an ounce and a half Acetum Bozoardicum three drams Syrup of Croal an ounce and a half Confection of Hyacinths two drams make a Julep the dose six spoonfuls every third hour Take of the Powder of Toads prepared half a dram Camphire two grains take it every sixth hour with the forementioned Julep Or Take Powder of Scarlet-cloth from half a dram to two Scruples as before Take Consection of Hyacinths three drams Powder of Scarlet-cloth on edram Syrup of Corals enough to make a Confection the dose the quantity of a Nutmeg every other hour Take of Bistort and Tormentil-roots of each one ounce the leaves of Meadowsweet Pimpernel Wood-sorrel of each one handful burnt Harts-horn two drams Shavings of Ivory and Hart horn of each two drams boyl them in Spring-water from three pound to two adding about the end Conserve of red Roses three ounces the dose three ounces being strained often in a day 2. Second Indication vital Hitherto of the first Indication Curatory together with the scopes of healing and forms of Remedies appointed for a Haemorrhage of the Nose happening with or without a feaver The second Indication Vital only prescribes a slender Diet temperate Cordial The Position of the Sick and a fit handling of the Patient The Provision of the first is so small and easie that there seems no need to appoint a Measure and Rules for it particularly About the latter the chief question is whether we ought to retain them within or out of their beds Without doubt the languishing and those obnoxious to often swounings are not to be roused up unless as we have already hinted it be for a Curatory attempt as to others less weak it seems so to be determijned Those whose Blood does not easily transpire by reason of the constipation of the pores Sometimes in bed and sometimes out and is incited into a greater turgescence from the heat of the bed and proner to break out it will be expedient they not only remain out of bed while bleeding but also sometimes through extern applications to be cooled in the whole habit of their body or at least in most of their members Wherefore Fabritius Hildanus relates he suddenly cured one of a great Hemorrhage of the Nostrils after many things tryed in vain by putting him into a vessel of cold water Also with like success Riverius cured another affected in like manner being taken out of his bed and laid on a woollen Matte on the Pavement he bathed his whole body with Linnen dipt in Oxycrate Yet this method is not alike convenient for all persons or at all seasons but on the contrary those whose blood is halituous and enjoying more open pores doth evaporate easily mnad being wont to be dissolved by a more moderate heat encompassing them into sweat and from thence find themselves more quiet it is more convenient that they remain within the bed not only while the blood breaks out but as long as there is danger of its return For this reason it is that many obnoxious to dreadful Hemorrhagies during the Summer when they transpire more freely live exempt from that disease but the Winter cold pressing them by reason of their pores being bound up they suffer under more frequent and dreadful Invasions 3. Third Indication Preservatory hath two intentions of healing The third Indication Preservatory which regarding the removing the Cause of that disease either stops the eruptions of blood or renders the same more rare or less and suggests these two Intentions of healing viz. 1. That the blood being restored to its due temperament and mixture may quietly circulate within the vessels without turgescency and breaking out 2. That the Vessels carrying Blood as to the structure of their little mouths and the tenours of the muscular fibres may be contained in their due state so that they neither cause those inordinate tendencies of blood towards the Head nor suffer effluxes out of the nose For both these ends too great plenty and impurity of the Blood are carefully to be provided against by Phlebotomy and Purgation seasonably used afterwards for procuring and conserving its good temperature the following Alteratives may be given at fit seasons of healing Take of Conserve of red Roses Forms of Remedies of Hipps an three ounce powder of all the Sanders an half a dram Coral prepared one dram of the reddest Crocus Martis two drams Sal Prunella four Scruples with Syrup of Coral make an Electuary take the quantity of a Chesnut early in the morning and at night by it self or drinking after it three ounces of the following water Take the tops of Cypresse Tamaris an eight handfuls St. Johns-wort Tamarisk Horsetail an four handfuls of all the Sanders bruised an one ounce of the Crum of Whitebread two pound slice them small and pour on them of new milk eight pound distill in a cold Still sweeten each dose when taken with Syrup of the juice of Plantane Take leaves of Plantane Brooklime stinging Nettles of each four handfuls to them bruised pour half a pound of the foregoing water of small Cinnamon-water two ounces press them strong the dose three ounces to four at Nine in the Morning and at Five in the Afternoon Madicines of this sort are taken in Spring and Autumn for twenty or thirty dayes with sometimes a gently Purge coming between In Summer let them drink Mineral Steel-waters for a Month than which in this case there is not a better Remedy Out of many Examples of persons labouring with an Hemorrhage we only propose this one singular case I was lately consulted at a distance for a certain Gentleman that had suffered frequent and great eruptions of blood one while at the Nostrils An Example of a rare Hemorrhage anotehr while at the Hemorrhoid Vessels He had frequently used Phlebotomy by perswasion of his friends without benefit yea frequently falling into cold Sweats and Swounings after breathing a vein and notwithstanding obnoxious to eruptions of blood he was wont to be much worse I prescribed Juleps having not yet seen him and cooling Decoctions and Anodyhnes also the juicy expressions of herbs and other things cooling the blood but even from these as if all still far enough from the scope he was nothing the better At length being sent for into the Countrey to visit him I found the affection under which he suffered to be meerly or chiefly convulsive for whereas he daily bled his Pulse was weak the extreme parts cold and all his Vessels as being too much emptyed fell flat It s Aetiologie also the patient was affected with a continual Vertigo and trembling of heart and by and by with a swouning or fear of it Really the blood was so far from breaking out by reason of turgescentce that
administer both a Dropace and Vesicatory Also by applying still the same Plaister the Scarf-skin being blister'd and taken off and the place being red and ulcerated and only wiping it once or twice in a day and putting it on again they cause the little Ulcer raised by the Vesicatory to flow at pleasure yea sometimes above a month and to throw off a plentiful Ichor Others inclose Cantharides bruised and sprinkled with Vinegar in Silk and apply to the place Some Empiricks use in the room of Cantharides a mass of the leaves of Crow-foot or flamula Jovis bruised on the place by which the Scarf-skin being blistered or rather eaten the skin it self as if toucht with an actual fire is much inflam'd and deeply ulcerated whence not only a profusion of Ichor but an inflammation of the whole member and a feaverish disposition sometimes follow wherefore these things are not to be used rashly 2. 2. How they operate If it be enquired of the manner and reason how these and other Vesicatories operate in the first place we ought to shew by what manner actual Fires and things endued with particles proceeding from Fire do raise a blister then by an easie Analogy the force and manner of working of those sorts of remedies will be known which are reported to be endowed with a potential fire Wherefore we observe of the former that the fiery particles not being too vehemently applyed penetrating the Scarf-skin without dissolution of unity enter under the skin it self Shewed by the example of Fire where the extremities of the vessels bringing blood of the Nerves and of the nervons Fibres are terminated and there do variously twist together these altering them from their position and pervert the structure of the whole texture of the skin insomuch that from all the vessels being made angry in a high degree the watery humour being imbued with igneous particles and therefore rejected as well by the blood as by the nervous Juice is spued out in great abundance This Lympha because it cannot pass through the Scarf-skin separates it from the skin and raises it into a bladdery bulk from which at length being broke of its own accord or occasionally it flows out Moreover as long as the igneous particles adhere to the skin and the mouths of the Vessels being covered with an Eschar are not closed up these being continually twitched by them do continue to spue out the Ichor This kind of ichorous flux will the sooner cease if immediately upon the hurt inflicted the fiery particles be drawn out by the application of some proper Antipyretick as Fire it self Nitre Soap Onions and the like Moreover it runs the longer if omitting an Antipyretick medicines hindering the generation of a Cicatrice or of the outer-skin and unlocking the mouths of the vessels be worn upon the place affected By these it is easie to understand by what manner Vesicatories perform their operation How Cantharides excite Blisters and draw forth water viz. Cantharides as likewise any other of the same vertue being outwardly applyed and being heated by Effluvia's of the parts subjected and so being provok'd to exert their power do plentifully dispatch sharp and as it were fiery particles from themselves which penetrating the Scarf-skin without any tearing it they are dashed against the Cutis or other skin where first they act upon the Spirits and then by the affecting these upon the Humours and solid parts They very much provoke the Spirits and drive them into painful Convulsions of the fibres dissolve the Humours and constrain them to separate into parts so that the watery part being very much embued with those sharp and as it were venemous particles is rejected every where by the other Juice and when in the mean time the ends of the Vessels and Fibres are either eaten by the burning or opened by twitching and as it were drained that Ichor conveying the hurtful particles is plentifully spued out of their little mouths which then separateds the impervious Cuticula or the Scarf-skin from the other skin or Cutis is self and raises it into a little bladder and after this being beoken and taken away it is for some time poured out by the ulcerated shin as we shewed it to come to pass by reason of the particles of fire But this is not only done because the serous Juice imbibing the sharp parts of the Medicine and conveying them out doth not always bear them all back the same way by which they entred but sometimes this being endued with these stings regurgitates into the mass of Bloodl and afterwards being circulated with it and ejected with its infestous burden through other Emunctories Why they bring a fervent Dysurie offends some weak or tenderer Channels in its passage or going forth from whence very many contract a Strangury from great or many Vesicatories by reason of the urinary passages being affected for that cause with Acrimony or Erosion which in some becomes most sharp and intolerable Also that application sometimes brings bloody Urines to others afflicted with the Stone hence a suspicion also arises that those who have tender Lungs or who are subject to a Consumption are much endagered by this Medicine outwardly applyed which notwithstanding I have not known happen to any but can reather attest by frequent experience on the other side that it redounds to advantage rather than hurt For the more sharp particles of Cantharides if they be long applyed being sometimes imbibed more plentifully by the blood infect its whole Serum which Juice so sharpened as long as it is confounded with the Balsamick blood hurts no part but being separated from it by the Kidneys it sometimes brings hurt to them and frequently not only twitches the neck of the Bladder by its Acrimony but sometimes corroding it causes filth and little skins nay and blood to come away but in the mass of blood the same more sharp saline-volatile particles do often most notably help inasmuch as they destroy the fixt or acid Salts in it and unlock the consistence of the blood too much bound up and so do cause the serous and other morbific recrements before wrapt up with it to be separated from it and to be more easily dispatched by Urine and Sweat Vesicatories move Sweat and Vrine hence Vesicatories being applyed long in Feavers do call forth plentifull Urine and a more easie Sweat Also they open the obstructed wayes and move together the portions of Blood or Serum stagnating or being extravasated in any place and restore them to their Circulation Wherefore they are not used only to help in serous maladies but also in those of the blood yea in a Pleurisie Peripneumonia and in any other Feavers Having hitherto shewed after what manner Vesicatories operate first on the Spirits and then on the Humours and solid parts it is now our business in the next place to shew both the good and evil effectgs of them as also the manners of
using them But that they in the first place operate on the Spirits is manifest from hence that they exert no power on the deceased and it is an ill Omen in those that are languishing when Vesicatories have no operation because it is an Indication that the Animal Spirits are much dejected or abundantly diminished Thereofre The effects of Vesicatories it behoves to consider about the due unfolding the energy force or virtue of this remedy what humours it either immediately or mediately evacuates or alters and afterwards in what Diseases and bodies how disposed it either profits or hurts First 1. As to humours of the Skin As to the former the humours that are immediately sent out by a Vesicatory drop forth partly from the pores and glandules of the Skin and partly out of the mouths of the little Arteries and partly out of the extremities of the Nervous fibres perhaps some little of the Juice newly received out of the mouths of the veins though not much seems to be carryed back The humours mediately drawn out by a Vesicatory are those which the aforesaid parts being emptyed receive elsewhere and derive them forth 1. The Skin is a thick Memgbrane consisting of a double Coat very porous also thick set about with most numerous galndules with fat as also the ends of the Vessels and fibres being terminated therein and thickly woven one within another Wherefore while a portion of it is made bare the Scars-skin being taken off with a Vesicatory and the nervous sibres being twitched do bind together and wreath the glandules and pores the serous humour contained in both is most plentifully squeezed out And whereas some pores are pervious into others the Serum doth not only flow out of the place blister'd but sometimes into the little holes first so emptyed a portion of the Serum coming from the neighbouring pores succeeds and thence by and by sweats out wherefore in Patients affected with an Anasarca the little ulcers raised by a Vesicatory exhaust the waters every where in great plenty and draw them out of the neighbourhood yea and sometimes at a great distance 2. 2. In respect of the blood The little mouths of the Arteries being uncovered and twitched about the blistered place do not only vomit out a portion of the Serum brought to them by ordinary custom but the serous liquor being imbued with the Stimula of the medicine in the whole mass of blood immediately is separated more plentifully from the blood and at every turn of Circulation a greater plenty thereof is thrown out by the same mouths of the Arteries continually irritated Which they purge and alter Moreover together with the Serum as it were so stagnating and therefore removed from the whole blood into the little ulcers of the skin other recrements and sometimes the morbific matter it self depart in plenty and are dispatched forth by the same Emissaries and for this reason in malignant feavers yea in some putrid that are difficult to be judged of when the recrements and corruptions of the blood unapt to be thrown off do threaten the Praecordia or Brain Vesicatories continually and leisurely draining it do frequently yield notable relief whereunto we may adde that they do also alter and restore as we before mentined the blood degenerate or depraved as to its Salts and also by opening or subtiliing its consistence dispose it towards an Eucrasie wherefore not only in a seaverish state of Blood but also in a state otherwise peccant or of ill Juice this kind of remedy is often extreamly convenient 3. 3. In respect of the Nerves and of the humours abounding in them and in the nervous parts Both reason and experience have enough proved that Vesicatories evacuate a certain humour from the Nerves and nervous Fibres and for that cause profit very much in convulsive distempers For surely we have in another place clearly enouth demonstrated that the watery liquor of the Brain and Nervous sytem doth sometimes abound with heterogeneous Particles Also it is manifest by frequent and familiar observation that the impurities and recrements of that liquor together with the watery Juice do spontaneously sweat out from the Nerves and nervous Fibres when the fluor is raised and either restagnating within the mass of blood are carryed off by Urine or by Sweats or being deposited within the Cavities of the bowels are dispatched by Vomit or Stool Wherefore when a Vesicatory is applyed the extremities of the Nerves and nervous Fibres being made bare and very much angred immediately a humour abounding near their ends is voided and also the whole Juice planted within their passages by a long succession is chafed and delivered from stagnation and the heterogeneous particles mixt with that nervous Juice being every where agitated and derived from the Brain slide towards their newly opened Emissary by degrees and at length are removed wholly forth From these things we may collect For the curing of what Diseases Vesicatories are convenient for the Cure of what Diseases this kind of remedy doth chiefly conduce for by reason of its evacuation out of the pores and glandules of the skin as often as any serous salt sharp or otherwise hurtful humour is collected in those parts or their neighbourhood and being excluded from the Circulation of blood shall obstinately stick in that place surely there is no more ready or easie way afforded for drawintg it forth than by applying a Vesicatory 1. In all cutaneous Distempers upon or below the place affected Wherefore it is not only indicated by an Anasarca or by any foulness or eruptions of the Skin but moreover a Vesicatory is required for pains either arthritical or scorbutical fixt any where in the extern habit of the body or in any certain member Secondly In respect of the Blood Vesictatories are always used in malignant Feavers 2. They take away the impurities and ill temperament of the blood as well to purge out leisurely any heterogeneous or morbific matter as to change it from a disposition either too acid or salt or otherwise peccant into a right temperament yea they are of most excellent use in all putrid feavers of ill habit and hard to be judged of Also for that cause in the Scurvy Leucophlegmatia This Remedy is profitable in those Diseases which the blood produces in other parts Pica Virginum or Green Sickness also in any other ill habit of body this kind of remedy affords frequently notable help Moreover not only for the sake of correcting the blood it self but besides as often as it being depraved spreads its corruption on other parts and so doth first beget diseases in the Head the Chest the nether Belly or Members and then excites their Fits Vesicatories are usually exhibited with success Wherefore it is a common remedy in Head-aches a Vertigo and soporiferous affections no less than in a Catarrh or any defluxion either into the Eyes Nose Palate or Lungs in which
every one without consulting a Physician will prescribe to themselves Cantharides for Revulsion I confess when I have often been surprized with a great Cough with abundant and thick Spittle whereot I am originally obnoxious I have received relief from no other Remedies more than from Vesicatories wherefore I am wont while that distemper doth urge to apply Medicines drawing blisters first upon the Vertebra's of the Neck then those little Ulcers being hcaled beneath the Ears and afterwards if need require it upon the Scapula's for so the serous filth loosened from the consistence of the blood sweating forth is derived from the Lungs and also the mixture of the blood sonner recovers its temper inasinuch as after this manner its enormous salts are destroyed Thirdly 3. Also in all Distempers of the Brain and of the nervous Stock In respect of the Humour Epispasticks as they are of most common use so they are wont to confer great help in soporiferous convulsive and painful distempers for deriving and evacuating it out of the nervous stock and the brain it self Was ever any surprized with a Lethargy Apoplexie or Epilepsie but that immediately Friends and Attendants however unexpert have tormented his Hide with the application of Cantharides In stupendious convulsie motions ascribed usually to nothing less than Witchcraft I have applyed Vesicatories with great benefit in many parts of the body at once and I have continued them above a Month presently renewing them in fresh places And also pains that are fixt and most fiercely tormenting in the membranous parts are seldom cured without this administration For sometimes morbific humours and Particles which being deeply radicated yield nothing at all to Purgers or sweating Medicines or Diureticks yet have seemed to have been pulled up by the roots by Vesicatories as it were remedies laying violent hands on the disease But this Remedy although most general is not used to operate so easily and happily in some Diseases and Constitutions For what Distases Vesicatories are intended wherefore we may not rashly or indifferently use it towards all persons For those who are Nephritick and obnoxious to a frequent and painfull Strangury scarce ever endure the application scot-free wherefore on those that are so affected we must not use Vesicatories unless in malignant Feavers or acute Cephalick Disea2es for avoiding the greater Evil. As to what relates to the various Temperaments and Constitutions of men in respect of which Vesicatories are used to be more or less convenient or advantageous In what Constitutions they agree best Concerning these this threefold notable difference occurs In the first place some persons for the most part endure well the use of this Medicine and the little Ulcers raised thereby in the skin sweat out an Ichor sufficiently plentfull witout any Dysurie or great Inflammation of the place blistered and then heal of their own accord which effect succeeds only in blood of a good temperament where to wit the Salt and Sulphur being moderately and rightly constituted there is present an abundant plenty of Serum whose Juice easily and more largely separating from the rest of the blood carryes away the sharper particles of the Medicine imbibed with it self and partly sweats them out through the placd blister'd and partly conveys them out without prejudice by the Urinary passages therefore also the advantagious effects now recited are produced in the mass of blood 2. Also in whom not But secondly this remedy with some doth nither well agree nor operate profitably because it rubifies the place very much to which it is applyed or rather excoriates it with most fierce pain and great inflammation notwithstanding the little ulcers made in the ssme place although they do for some time torment the patient yet pour out very small or scarce any Ichor Also to these always blister'd with torment for the most part a violent Strangury happens The use of these Vesicatories being troublesome and unsuccessefull doth frequently to men of a cholerick and hotter temperament In men of a more hot temperament they torment the part and do not draw forth the water whose blood is endowed with a plentiful Salt and Sulphur and a small quantity of Serum being more throughly concocted with the rest Wherefore when the Juice that ought to carry away the more sharp particles of the Medicine doth neither easily nor plentifully pass from the rest of the blood that it may speedily wash them out those particles sticking still in the skin do as it were infect and impoyson the blood it self passing through and for that cause beingimpeded from its circuit they cause it to stagnate and to be gathered together about the extremities of the Vessels whence they are inflamed Moreover the serous Juice being separated by the Kidneys when of it self it is little and sharp and besides becomes stinging from the particles of the Medicine it irritated the Neck of the Bladder and frequently corrodes it by its acrimony In others inasmuch as they draw forth too much Ichor they are not profitable 3. There remains a third Case although more rare relating to blistering to wit in whom little Ulcers beling raised in the skin presently pour out the serous humour in so great abundance that in a little time it will be necessary to give repelling Medicines and that shut the mouths of the Vessels otherwise from too much flowing out of waters a dissolution of strength and a fainting of the Spirits are in danger to ensu This I have known so constantly happen to some Patients that afterwards I was fain to restrain their use of Cantharides although there was need of them the reason whereof seems to be that the blood being endowed with a salt Serum and more sharp than it ought to be hath a consistence too easily dissolved wherefore that serous juice being sharp and fretting of it self as soon as it is provok'd by the particles of the Medicine loosening the consistence of the Blood too easily dissolved immediately breaking out with violence from the mass of blood wheresoever there is a passage afforded it flows out with a full torrent through the mouths of the vessels gaping in the blistered place Besides this too much flowing out of the Serum The Vlcers of Vesicatories do sometimes plentifully flow in Feavers and give Judgment of the Disease raised from the first application of the Vesicatory sometimes happening late in malignant Feavers and in others ill or not at all judged and remaining a good while wholly consumes the morbific matter and delivers the Patient from the jaws of Death In such a Case after the little Ulcers for the first days have poured out little or a very small quantity of Ichor at length Nature attempting a Crisis by this way a vast Illuvies of Serum flows out from the same and so sometimes for many dayes nay weeks continues to flow out untill the Patient before accounted desperate recovers his entire Health Little Ulcers so abundantly flowing
Sciatica For surely the glandulous Emunctories settled in that place do imbibe very many recrements of the blood and nervous Juice which if they be throughly and continually discharg'd from them by a fit vent it will much conduce to exempt the contiguous parts from any morbifick Mine The Thigh being a member soft and large in bulk In the Thigh seems apt enough for enduring many and great Issues to wit those which may purge away plentiful humours from the whole body Yet it doth not succeed so with many patients partly because of its figure too much declining like a Cone invers'd the Ligature containing the Pease in the orifice is not easily kept on and partly because a solution of the Unity being made among the concourse of so many Tendons it frequently becomes inflamed and painfull insomuch that fometimes it hath been necessary that it should immediately be stopt up to withdraw the trouble of pain and of lameness Notwithstanding it succeeds better in some Patients for that an inflammation doth not always ensue upon the place where the incision was made and that the Ligature has remained immovable to those that tye their hose above the knee Moreover A fit place in the member to be chosen that it may be made far from Vessels and Tendons as concerning Issues it is requisite to choose a convenient place not only in the body but also in the very member where incision is made which chiefly calls for the judgement of an expert Physician or Chirurgeon for carefull provision must be made lest a Cautery or incision be made upon or too near the Tendons or greater Vessels but let the Fontinel be made not in the very body of the muscle but in the interspace or distance between the muscles where the orifice as John Heurnius learnedly observes ought to pass through the whole skin so far untill the little membrane of the muscle underneath be penetrated Wherefore this part of Chirurgery is not rashly to be allowed to Quacks and others ignorant of Anatomy for that from this being ill done not only a frustration of the benefit but from thence frequently great mischief happens and sometimes to the hazard of life It is not needfull to describe the figure and use of the cutting Instrument Symptoms accidental to Issues how to be cured together with the manner of preparing and compounding Causticks for making Issues inasmuch as it is notorious to the common people yet it behoves us to handle in what manner the symptomes which happen to these Emissaries after they are made may be cured and it will not be besides the matter to discourse what do either impede or pervert their powers Whereas many and several distempers happen to Issues help is not required for them all but only for such as are of greatest moment Wherefore there will be need of help 1. Wheresoever an inflammation ensues upon the part or place where it is What chiefly require help 2. If the Orifice vent more or less Ichor than it ought 3. If the Ulcer shall be apt spontaneously to be dryed up and cover'd over with a skin or if it be prone to abound with spongious flesh growing about the sides As to lesser faults as when the Ulcer shall break forth into frequent Haemorrhagies or change its place creeping into another less convenient with many other ways by which it prevaricates it will not be worth our labour to discourse here 1. 1. Inflammation An inflammation frequently happens to an issue and that so painfull sometimes that it threatens a Sphacela yea and sometimes causes one But such an affection ensues either upon the orifice new made or happens after wards by reason of the blood and humours occasionally agitated and rushing frequently and in heaps to that part When a Fontinel is made Which happens to a new Issue the Reason of it and Cure proposed immediately by reason of solution of the Unity and consequently by reason of the circuit of blood somewhat hindred in that place a certain inflammation and ulcerous pain happens to some patients but in some endued with a fervent blood and whose Serum is less diluted this ensues much fiercer For the blood being brought thither by the Arteries the ends of the Vessels being cut off and obstructed it can neither go out nor be returned immediately by the Veins but sticking there in the passage it is accumulated more and more and being at length extravasated and filling and stopping all the pores of the contiguous skin and flesh it raises a tumour with redness and heat most intense which coming to pass either the blood so heaped up and extravasated An Inflammation hath three manner of Crisis's in a snort space of time becomes immovable by reason of constipation and for that cause being as it were divided from the rest of the mass it is extinguished and suffering death produces a Sphacela upon the part or secondly the blood so stagnating is after a sort agitated as to its particles and enjoying alwayes a vital flame and made more intense by the same it is as it were boyled throughly and so is changed into a Pus to be evacuated by an abscesse Or thirdly which happens more frequently and ought always to be procured in our case the blood provoking an inflammation is reduced into the Vessels and restored to Circulation by other passages whereinto it is constrained But that it may be reduced these two things will be necessarily requisite First The ordinary and best these is that the extravasated blood may be reduced That it be much diluted with the Serum flowing thither abundantly or rather thrust forward into the part Then secondly that the Vessels behind the Tumour being emptyed may swallow up the blood diluted and driven back by the Serum for the blood being forced towards the Tumour whenas it cannot advance forward yet its bulk being diminished that it may be able to return back it dischages the Serum plentifully from it self and drives it for wards into the places obstructed which entring under the stagnating blood dilutes it and succeeding into its places forces it back into the passages of the Vessels and in the mean while that Serum tending for ward exhales by the pores insomuch that the blood which was extravasated being diluted and forced back by the Serum and the Serum it self evaporated How it is done the swelling with the Inflammation vanishes leisurely away But if as in more hot temperaments it comes often to pass the blood being extravasated and impacted in the pores be not diluted by the Serum brought to it in great plenty it will not only stick there pertinaciously but it will irritate a fiercer Phlogosie with a Feaver and sometimes other dreadful symptomes So not long agoe when a renowned Divine endowed with a thicker and hot blood had an Issue cut in the inside of his Leg although the skin only was cut an inflammation followed presently which within
This excrescency is easily enough cured by sprinkling thereon Escharotick powders of burnt Alum Colcothar or Mercury precipitate for remedies of this kind do eat away the flesh so luxuriating by their acrimony as well as stiptickness repel the nutritious humour The reason thereof delivered and lock up the mouths of the Vessels As often as that superfluous flesh encreases about the sides of the Issue it is a sign that the nutritious humour flows thither more plentifully than the excrementitious and for that cause in Patients so affected that vent proves not always so benign Wherefore under pretext of this reason many are averse to that remedy though surely it is harmless to most although not alike usefull and advantageous to all We have before considered the chief disadvantages thereof as likewise the scandals objected thereunto yet there remains another thing according to the opinion or rather error of the Vulgar a notable objection against Issues which we will here discuss for a Conclusion With many in England a contumacious opinion is grown up I know not whether it be so in other Countreys That one or more Fontinels dispose to barrenness The common error is that Issues dispose to barrenness Wherefore this kind of remedy however otherwise conducible to health is scrupulously forbidden to all marryed Women that desire Children of which Prohibition there is no reason as yet made out but only Stories related of certain Women that have been barren having Issues when it were as easie to enumerate more barren women without Issues and many others that have been fruitfull with them and truly I use to retort whenas there is no need of any other refuting this as a chief Argument against that opinion SECT III. CHAP. V. Of the Diseases of the Skin and of their Remedies AFter Attractive Remedies of the Cuticula and Skin namely Issues and blistering Medicines delivered before by a certain Law of Method we are induced to handle Diseases of those parts and other kinds of Remedies of divers sorts the true Aetiology of which will afford matter of most pleasant as well as profitable speculation As for the fabrick and uses of those parts A Description of the Cuticula it needs not that I should here repeat all things already accurately described and well known in Books of Anatomy It may suffice us to note concerning the Cuticula that this outward skin is thin and dense without blood and without sense as destitute of Vessels and Fibres which cleaving to the inward skin coners and defends it from outward injuries This is every where full of pores into whose orifices the Vessels discharging sweat do open which Malpighius viewing more accurately with a Microscope a little before their gaping or opening affirms to be endued with little Valves for the retaining or free breating forth of sweat but I consess they lye hid to me The Cuticula being taken away by Fire or Phaenigmons the skin appears naked Of the Skin and looks red by reason of the sanguiferous vessels But this is a thicker membrane as to its greatest parts formed of filaments of Vessels bringing blood of Nerves and of nervous Fibres variously interwoven and complicated among themselves among which numerous Glandules and Lymphaducts or Vessels discharging Sweat and Vapours are thickly interposed The substance hereof is related to be double by most Anatomists the outer is nervous the inner fleshy or rather glandulous for an example of which the Rind of an Orange is brought If the skin be viewed naked by a Microscope by the renowned Malpighius's observations The pyramidal Papillae the Organ of feeling First there presents it self a body in form of a Net in whose thick holes are contained not only passages of Sweat but also very many Teats in form of a Pyramid rising out of the skin in parallel ranks and passing into the Cuticula where being stretcht out in length they are divided as it were into many little Fibres which the same Author hath determin'd to be the sense of touching Besides these the substance of the skin contains very many Glandules by which means the Lympha or watery matter is carryed by the Lymphaducts or excretory Vessels out of the Arteries to the Pores The Pores and Glandules of the Skin For indeed the most accurate Stenon hath observed that its Glandules lye under every pore which become either greater or lesser according to the use of sweating the sweat or vapours continually streaming out of these by the excretory vessels avoiding the excrements do moisten the nervous Teats in their passages lest perchance they should grow dry As to the pores or passages of Sweat The Pores twofold greater and lesser they are discovered by a Microscope to be of two kinds viz. The greater in most of which the roots of the hairs are implanted and by interspaces on both sides of each wrinkle of the skin are disposed in a parallel rank Or secondly they are the lesser Pores which being numberless do fill up all the spaces between the former in most thick Punctums or pricks For indeed the whole skin with its wrinkles appears like a Field furrowed by a Plow and after wards harrowed with the ranks turned or rather oblique so that its ground being eminent above the surrows of either kind there remain in its plain Figures very much of a Rhomboidal or a Diamond-fashion The wrinkles and furrows of the Skin and accordingly as those furrows with their banks or flattes are either shorter and less or deeper and greater the texture of the skin appears either delicate and thin or thick and course This kind of Constitution although it be most owing to ones birth and to the primogenial growing together of the humours is however manifoldly altered by reason of the various accidents of the ensuing life A more gross Diet difficult labour injury of Air From whence the Roughness or Fineness of the skin and chiefly excess either of heat or cold render a skin more rough also contrariwise a nice and delicate education renders its tone more fine and soft That the skin may become more neat smoothe and equal it avails much that all its pores be filled with a benign mild and unctuous humour for so whilest all its pores become full Depends much on the Humours filling the pores and extended the level of the whole skin appears more smooth Notwithstanding if a vicious humour furnish those pores or the benign humour that was in them be too much exhausted for that cause the skin will become rough and full of wrinkles Wherefore if any endowed with a most soft and even skin shall wet their hands in a Soap Lather Lie or Lime-water or also for some time in warm Blood presently the furrows and wrinkles will grow greater and deeper the saline humour being drawn out by the other Salts out of the pores wherefore more delicate women scrupulously decline washing with Soap or any other things that
or blow inflicted upon the body The Solution of the Vnity always the cause of it for the same thing is used to be induced from cold heat wind from the extravasating of the blood and of other humours or their being heaped up together in several places oftentimes the fashioning of the member remaining as yet entire in which cases although the continued parts and chiefly the fibres and filaments are not at all cut off notwithstanding they are in every Affection of grief pulled from their usual position either by the oppression of the object or by strange particles forced like wedges and are compelled into too much tension or distorsion or divulsion and for that cause the inmate spirits being pulled from their mutual embraces and dissipated are ill at case and incur the passion of pain or grief Pleasure is opposed to Pain What Pleasure is and is a manner of Feeling clearly contrary thereunto which takes its origine inasmuch as a pleasant stroaking being made upon the organ of Sense the spirits flock thither and presently being thickly gathered together and overspread with a certain delight they do as it were exult and rejoyce together in the organ afterwards inasmuch as the spirits enter into the like triumph or rejoycing within the Corpus striatum a perception of pleasure is stirred up The greatest pleasure which is offered to the Touch It s formal Reason consists in this that the cause of Pain being removed the parts formerly affected by it may recover their wonted temper and frame for so the animal spirits being before put to flight and dispersed from one another It chiefly consists in removing of Pain they recollect themselves and rushing into the places from which they were banished with reinforced strength they prepare themselves to rejoyce From hence the Peripateticks placed the formal reason of Pleasure only in the removal of something that was troublesome as when the excesse of cold or heat is received by an opposite and more agreeable state Indeed the tangible object because it is alwayes thick and dull doth scarce any way else excepting Venery allure the animal spirits into heaps to the organ of Sense unless for that it removes their former confusion From these things so described concerning those passions What the Itch is it is easily manifest that the Itch according to the formal account thereof is neither perfectly nor fully either Pain or Pleasure but imperfectly and as beginning partakes of both For really the scabby matter being heaped up within the pores of the skin and making the solutin of Unity in many places enclines towards pain yet as it is volatile moving and hastens towards vent How the Spirits are moved in it for that cause the Animal spirits are not put to flight from the Fibres although pulled asunder neither are they driven back with sense of pain but the contrary as if being stronger than the humour infesting they were able to cast it forth they being wrapp'd up more thick but irregularly within the cutaneous fibres do twitch them together variously and draw them on that they may the sooner discharge the morbific matter and expell it forth Wherefore inasmuch as the Animal spirits being neither put to flight nor repulsed but flowing together in crouds into the organs of Touching they manage themselves there tumultuously and disorderly and as it were by tickling the sensible fibres do provoke them into small Convulsions no pleasure but a troublesom feeling nor also is it Pain but a Passion clearly diverse arises from it But as soon as by rubbing or scratching the plenty of Spirits assembled about the organ of Sense begin to be better disposed and as it were reduced into order from thence a thorough feeling of Pleasure is introduced Wherefore the Itching seems to be a middle-state between the betginning of Pain and Pleasure A certain medium between Pain and Pleasure or a passage of the Spirits from the rudiments of that towards the full compleating of this But from this Physical discourse by the by let us return to our Pathologie or discourse of the distemper From what is above said it is easie to collect the differences of this disease In the first place therefore the Psora as to its origine either is got by Contagion The difference of the Psora as to its origine or by reason of an ill Course of Diet the fierceness and supply thereof is communicated by the Chyle and Blood being vitiated or it is generated in the skin it self by reason of filth and the defect of Transpiration Whereto we may adde that sometimes Infants acquire this taint hereditarit contracted from their Parents Secondly These cutaneous Eruptions as to their form 2. As to its form vary according to the diverse Constitutions of the persons affected for in some persons of a cholerick dryer Temperament or Melancholy only a dry Scab is stirred up and inasmuch as it evaporates lessby reason of the defect of the Serum with an stching not altogether so troublesome but in others of a moister Temperament and of more unclean blood very many wheals and pustules imbued with schor and most of all itching do very much provoke to scratching and by reason of the Ulcers stirred up therewith the Itch is immediately altered into pain As to the Prognosticks although this Disease is never of it self mortal or very dangerous and always easie of Cure yet frequently it contains an evil event The Prognosticks of it inasmuch as being long continued it utterly depraves the blood and nervous Juice and from it hastily cured by reason of the matter received within while it is discuss'd from the Pores a pernicious taint is brought upon the Praecordia and Brain and other noble parts The greatest hazard from a Scab threatens Children and Cachectick persons Most dangerous to Children and ill juiced or cachictick persons as in both of which the taint is more easily impressed from this Cutaneous humour upon the nobler parts which afterwards when the outward malady is removed remaining within cannot be vanquished entirely but by a very long Course of Physick of which neither is capable nor patient wherefore such persons It s Cure all care and diligence being administred ought to be preserved from the infection of the Scab as from the Plague Coucerning the Cure of a Scab or Psora two chief Indications present themselves The first Indication curatory and each of them two-fold viz. The first intention Curatory respects these two things First that the glandulous Humour its corruptive ferment being wholly extinct may be reduced to a due temper Secondly afterwards that the Pores and passages of the skin being freed from those schorous congealings may recover their pristine frame or good temper The Second Indication Freservatory takes care to prevent these two things The second Indication preservatory viz. First lest the impurity of the Psora or corrupting Miasma's of the skin being discuss'd
words the reason hereof I am apt to think whether that food is rancid or otherwise improportionate that it conveys particles not rightly mixed nor easily to be subdued to our blood which being so heterogeneous and largely heapt up by a long use of such Diet the saline particles of which kinde do easily associate themselves and so do constitute Tartarous Coagulations to be exterminated in the skin and the seeds of the Leprosie or of the Impetiginous Evil. But yet a plentiful Crop is begot from the taint of the Scurvy and Pox left in the body It often follows the Pox and Scurvy and afterwards by the combination of Salts and Sulphur exalted to extremity We have elsewhere discovered the reasons of the former disease and especially of the foresaid symptome coming after it which being accommodated to our present Hypothesis do make it more clear And it so often happens that pustulous eruptions of this sort do follow an inveterate Pox although it seem to be cured that none distempered almost with these wants the suspicion of that shamefull Disease so that the first Question of a Physician in such a case being consulted is Whether the Patient have not at some time formerly contracted that Distemper For surely the Corruptions of the blood after they are by a long stay become altogether heterogeneous and indomitable at length acquire to themselves salt Particles wherewith growing into such like Tartarous Concretes and being thrust forth into the skin produce those Impetiginous Pustules As to the Prognostick part of this Disease Its Prognosticks although it seldom threatens death or imminent danger yet after it hath taken deep root the Cure is very difficult if at all The Impetigo first beginning and exciting a few Pustules and knots of them perhaps in one or two members sometimes admits of Cure but hardly without a most efficacious remedy But if the Disease proceed so far that the frequent and broad clusters of wheals appear dispers'd throughout the body then small remedies effect nothing and the great ones howsoever diligently observed will not easily perform a Cure But if the Disease maugre all remedies advance daily and encrease at length into a Leprosie Celsius judges it impossible to be cured and therefore we must wholly abstain form it There are two chief Indications concerning the Cure of an Impetigo The Cure viz. Preservatory which respects the cause of the Disease and the Curatory which relates to the symptomes Two chief Indications viz. the pustulous Eruptions The vital Indication hath seldom place here unless in a desperate condition where sleep and strength fail The Method of Curing ought to begin with the Preservatory Indication which takes away the Causes of the Disease by inward remedies for otherwise external as in the Psora are never administred with success but the roots of the disease in the blood being cut off the cutaneous sproutings quickly consume away for the taking them away we must proceed in one manner when the Impetigo begins by it self and in somewhat a different manner when it follows an inveterate Scurvy or Pox being ill or not at all cured We will consider each case throughly by it self and distinctly Therefore whensoever this Disease is simple How to be cured the Disease beginning of it self and primarie and being yet New let the evident and extern Causes be removed let the manner of Diet and unwholsomness of Air be corrected therefore those that have been lately too much accustomed to salt Diet and the flesh of Pork and Fish let them change to Diet of good Juice and easie of digestion The evident causes to be first removed They that inhabit the Sea-coast or Fenny places let them remove to a dry and clear Air in the mean while let no less care be had to their Drink by declining thick and foggy Ale and small and acid Wines too much abounding with Tartar at length let care be taken lest their Drink or Food be dressed with any mineral waters that are apt to petrisie Secondly The conjunct Causes how taken away In respect of the conjunct and procuring Cause there are two chief Intentions of Cure viz. that the impurities of the bowels and humours be quickly purged out also that the acid faline distemperatures of the blood and nervous Juice be altered whereby the Tartarous matter may be the less engendred in them for these purposes Medicines both evacuating and altering are prescribed of several kinds Notwithstanding because not all but the greatest remedies are here convenient those which are most chiefly of use and available are Catharticks Phlebotomy Whey Chalybeate Waters The chief Remedies made known Juicy expressions of Herbs Decoctions of Woods steel'd Medicines and Salivation Some certain Models of each of these and the manner of using them we will annex Wherefore in the first place 1. A Purge universal purging and bleeding being celebrated as in the Cure of the Psora we appoint the following Tincture or purging Infusion whose dose is from six to eight ounces to be repeated in six or seven days Take of the roots of sharp-pointed Docks dryed Polyodie of the Oak A purging Infusion of each half an ounce Senna ten drams Epithymum six drams Rhubarb Mechoacan of each half an ounce yellow Sanders two drams Celtick Nard half a dram Salt of Tartar one dram and a half put them in a glass with three pints of White-wine water of Elder-flowers one pound let them stand stopt in a cold place three dayes pour off daily as much of the clear liquor as is sufficient Secondly For sweetning of the Blood and washing of the Salts thereof 2. Whey let simple Whey two or three pints or with the infusion of Fumitory Chicory and sharp-pointed Docks be drunk every morning for twenty or thirty dayes if the Stomach will bear it and likewise evening and early in the morning let a dose of the ensuing Electuary be swallowed Take Conserve of the roots of sharp-pointed Docks six ounces Crabs-eyes Coral prepared An Electuary of each two drams Ivory one dram Powder of Lignum Aloes yellow Sanders of each a dram and a half Sal Prunella two drams Vitriol of Mars a dram and a half Syrup of juice of Wood-sorrel what suffices to make an Electuary the dose two drams Thirdly For the same reason that Whey 3. Steel'd Waters your Iron Mineral waters are prescribed bed for this Disease and do oft notably help for when all the other remedies have been in vain I have with those alone cured a painfull and almost leprous Impetigo Moreover for more efficacy sake let the use of Sal Prunella or Vitriol of Mars or of the Electuary but now mentioned be dexterously adjoyned Fourthly In some endued with too much Serum and a watery Constitution 4. Decoctions of Woods where the drinking Whey or Mineral waters are less requisite it is sometimes expedient that a Decoction of the Woods be assumed at