as it 's commonly described neither is there a rare pulse because there is no interval of rest between pulsation for conceiving that the pulse is like a reciprocal swelling and falling like the tide of the sea there can only be inferred a point of reflection namely as soon as it swells up the next moment it falls again and as soon as it 's fallen the next minute of time it swells again Moreover this rising or swelling is attended with an impulse from the heart by means of the constriction of its fibres whereby like waves besides the forementioned swelling or turgescency the blood is propelled through the pores of the body out of the arteries into the veins Wherefore that I might not beyond necessity burden my self in my practice with notions I scarce am used to take notice of any thing else in the motion of the pulse besides its swiftness and slowness neither do I stand much whether it be hard or hot or pricking since this rather relates to the altered qualities than the pulse Thirdly It is to be observed that those whose pulse being naturally full strikes quick their vital faculty is very weakly wherefore in women and children the arteries strike quick but full Fourthly In malignant Fevors the arteries do oft move slowly in such a manner that one might judge them free from all putrid heat but this doth not happen unless death be ready to follow within a day two or three The natural swiftness of pulsation not in sick people must be imputed partly to the abundance of volatil salt but such as is not close and compact for as soon as it arrives to the ventricles of the heart it 's apt to be flusht into too volatile particles and soon after the salt being so copious follows immediately from the other parts of the salt whence another pulse is ready at hand partly it 's to be imputed to a Bitumen that is easily inflamed which quickly kindles and is kindled whence happens the frequency of the pulse By the way a small question might here be moved whether the pulse beating quick in Fevors there passeth more blood through the heart than when one is in a state of health First It must be agreed upon whether in every dilatation the heart is filled full of blood and in every constriction it be quite emptied some defend the affirmative part which to me doth not at all seem plain for those whose pulse at one time beats full and at another empty it must necessarily be argued that at one time the pails of the heart must be swelled up with a greater quantity of blood and at another with a lesser and from the consequents it's evident that reciprocally in divers pulses there must be expelled a various proportion of humors Secondly Since it may be observed that a large diastole of the heart is sometimes the next moment followed by a short and weak systole as appears out of the swelled diastole of the arteries of the wrist or any other part there oft following a short and weak systole whence it 's deemed there is more received into the receptacle of the heart and less expelled so that oft a proportion that 's admitted by one diastole is expelled in three or four systoles To answer to the question we assert that the blood is not circulated nothing near so rapidly or quick in malignant Fevors as it is in the state of health because the pulsifick faculty of the heart is languishing neither is the systole of the arteries or heart made with so much force but in putrid Fevors the systole and diastole being violent the blood is transfused somewhat swifter than in a healthful state Here is to be observed by the way if a swift pulse be perceived to go slower a day before and the day after to grow swifter a malignity is to be suspected The third particular worthy of observation is the equality or inequality of the pulse in reference both to motion and strength Wherefore in respect hereof a pulse is said to be equal or inequal in motion to wit swiftness and slowness and in strength namely fortitude and weakness The equality which Authors are wont to apply to a thick and rare pulse likewise to the tone or musical rithme we pass by being rather apt to occasion confusion to the practising Physician To unequal in motion are accounted the dicrotus or anvile-pulse caprisant or goat-pulse intercedent and some others A strong pulsifick faculty and not depraved likewise a temperate mixture of the blood being well depurated from heterogeneous particles are both some causes of an equal pulsation On the contrary blood that 's unequally mixt with the vital Bitumen and several sorts of salts occasions an unequal pulse both in respect of motion and strength As for other differences proceeding from the force of passion and other procatarctick causes we refer to another place CHAP. III. Of what is generally to be observed in Urins SInce the Urine for a more certain presage must give place to the pulse we have thought fit to discourse of this after the other Through the abuse of pispot-gazers and some Physicians that imprudently pretend to tell wonders the doctrine of Urines among some is fallen into disgrace nevertheless since it makes an ample discovery of the diagnosticks and prognosticks of diseases it ought not to be dismembred from the art of Physick First we shall set down what Urine is afterwards what particulars are to be observed in it To me the Urine seems to be a liquor melted from the volatil and fixt salts likewise of some excrementitious phlegm dissolved in the serum or water of the blood which being throughly filled and impregnated with the foresaid contents through its weight tending downwards is posted to the kidneys thence as if it were distilled by descent it falls down by drops towards the bladder But that the nature of urine may be made more plain to you some particulars are to be taken from the constitution of the blood and proposed here Those volatil salts I conceive to be the principal efficient of concocting the blood adding to it a scarlet tincture sweetness homogeneity and fluidity in which shape the blood arriving to the pores of the parts that are to be nourisht doth desert the salts which return with the superfluous blood to the veins and lymphatick chanels that afterward disburden themselves into the emulgents That those salts do not only illustrate the blood with a tincture but likewise the urine shall be demonstrated by sight You shall find that spirit of sal armoniack scarce differing from spirit of Urine or spirit of Hartshorn or spirit of Soot a drop or two being dropt into whitish drabbish and undigested urine shall immediately concoct it into a golden or vitrinous colour and an excellent consistency But if you effuse an acid spirit that 's forced out of a fixed salt you shall see it turn more drabby more crude and of a heavier weight In
A THEORETICAL AND Chiefly Practical TREATISE OF FEVORS Wherein it 's made Evident that the Modern Practice of curing continual Fevors is dangerous and very unsuccessful Hereunto are added several Important Observations and Cures of Malignant Fevors not inserted in the former Impression Written in Latin by Gideon Harvey M. D. Physician in Ordinary to his Majesty Now rendered into English by I. T. and Surveyed by the Author LONDON Printed for William Thackeray at the Angel in Duck-Lane 1674. TO THE Physical Reader I Have long since observed that Physicians did not cure continual Fevors but rather did render them mortal Though if by good fortune any one hath been delivered of a Fevor it is only to be imputed to the strength of nature which if she had not been disturbed by improper means would have disintangled her self from the disease much sooner and with less danger The cause of this so unfortunate practice depends on a false supposition of fermentation whence since they desume erroneous indications the success must necessarily frustrate their expectation I confess I have made use of the term of fermentation in several Treatises and possibly in the illustration of Fevors but to this intent only that I might in some manner be complaisant to the received opinion of the times not in the least imagining the notion thereof necessary or contributing any whit to the knowledge or cure of Fevors Moreover the Reader is to take notice that at present I have not written or acted the part of a Professor in the Chair making a Methodical and Pedantick Lecture on the definition division next the causes then the Diagnostick and afterward the Prognostick signs of Fevors c. But it is my purpose to discourse succinctly of such things as are most necessary for a Practical Physician and of such other cases as I could call to mind since the time when I had seldom less in cure than two hundred Patients that lay sick of Fevors What concerns other theoretical notions and farther observations touching the several kinds of Fevors I shall hereafter propose them in distinct Sections in the mean time farewell Hatton Street near Holborn THE BOOK SELLER TO THE READER TAking my measures from the reception of the Latin Copies I judged I should do the publick service in causing this Treatise to be faithfully translated and that it might be attended with a greater welcom I have obtained the favor from the Author to make a superficial survey of the Translation and to insert the addition of very remarkable and important observations and cures which have rendred the Treatise at least a fourth part bigger than it was before in having procured this I doubt not but that you will easily believe I am your Friend and Servant W. T. A Theoretical and Practical TREATISE OF FEVORS CHAP. I. Of the Nature of Innate Heat IT is usual among Authors to derive the name they intend to impose upon the distempers of parts from the chiefest symptom whence the word Febris or Fevor being taken from fervor i. e. heat or from februa a sort of fiery sacrifices of the Antients or from the verb februo i. e. I cleanse likewise 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek a Fevor from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 a fire seem to be applied to this distemper The word Fevor in English is certainly derived from fervor heat only leaving out the r and therefore ought to be written Fevor and not Fever unless you derive it from the French word fievre by omitting the i. Wherefore what this fervor or heat or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 fire signifie will best appear by conferring with them the words Calor warmth and Calidum heat being their opposits from warmth Calor and heat Calidum we have our strength and live but through Fervor a destructive heat and fire we lose our strength and end our days It will much conduce to our purpose I judge to premise the difference of these words Calidum heat denotes a hot essence or substance but Calor warmth signifieth only a quality separable from its subject or hot nature by our thoughts or concept and not really though 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 calidum or heat and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Calor warmth are by Hippocrates used in the same sense Neither are you to imagine that in feeling of Pulses of such as are ill of a Fevor it is not the quality of heat but fiery steems bodies really physical do strike your hand and ends of your fingers 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 fire is by Hippocrates expounded the Innate Heat of man but among the Latines generally a Fevor whence a Fevor may be commodiously defined A fire kindled out of the Innate heat of the body chiefly of the heart but secundarily Wherefore that the heart and its constitutive principle is the part for the most times hurt is evident from the fevorish affection and life the proper action of the heart being immediately opprest from the inordinate pulse a sudden decay of strength and the actions of the whole oeconomy being very considerably and all at once depravated and diminisht The experience of those that have put their finger into the ventricles of the heart the breast being suddenly opened of malefactors who by sentence have had their head cut off and have extracted it again thence very hot doth confirm that the Calidum or heat of the heart is a substance really burning about its chambers and thence diffusing flames through the articles to the circumference If on the other side the destructive nature of a burning heat be objected it 's not material considering the burning or flaming of brimstone or spirit of wine whose purity of flame will not burn those bodies it touches especially when through graduation of the air it may be moderated to any tone of heat or warmth Furthermore I state the Calidum Cordis or heat of the heart to be a Bitumen really ethereal and vital most exactly defecated or refined dispersing every where its most subtile and pure flames and feeding on the most pure and flowring particles of the blood But since it 's difficult to gain an universal assent that the nature of blood excercising so slender a commerce with the air and limited within the narrow bounds of the heart and arteries should be convertible into a flame and a perpetual warmth it may be rendred obvious by this only instance Namely almost all subterraneous waters that partake of a continual heat as the water of Aix la Chapelle Bathe and of other hot Baths since they source out of the deepest and most remote bosoms of the earth just in the same manner doth the indesatigable soring of vegetative or living blood leap very hot out of the bosom of the heart into the arteries like rivulets and certainly that which by natural Philosophers is asserted to be the cause of heat in those waters may easily be imposed upon me to believe the same to be the cause of heat in the blood
knee the use hereof in eight and twenty days did restore her to her former senses and perfectly freed her from that distraction so that she hath never been troubled with it since The malignant Fevor I formerly cured Mrs. Lamot of whose Husband is a Merchant in Thames street near Fishmongers Hall and some weeks after a violent Rhumatism following which was removed by two bleedings and a dose or two of Hydrotick Pills is a farther confirmation to me of the preceding observation which to illustrate by a greater number of instances I judge is needless and therefore shall proceed to recommend to you a remark of use so important that it may gain the Physitian repute and save the lives of many Patients The observation is such that it gives me occasion to admire so many preceding ages have so grosly erred in their practice and doth likewise detect the cause why malignant and indeed most Synochical Fevors prove so oft mortal It is an universal theorem that in these Northern Climates Fevors are terminated not critically but slowly and gradually by sweat and urine per Diaphoresin Diuresin Through the former viz. sweat the salin volatil and fuliginous matter is expelled through the latter namely urine the fixt salin and lixiviated matter is excern'd To accomplish this usually as I said before are prescribed Diaphoreticks as Aqua Epidemica Theriacalis Scordii Composita c. of one or more of these the measure of an ounce or two is mixed with the same proportion of Alexiterial simple waters and hereof two or three spoonfuls is to be given every second third or fourth hour according to the Capricio of the Physitian undoubtedly the effect doth not answer his expectation and no sweat appears upon this it may be double the quantity is to be used and yet not a drop of sweat is forced out then apologizes your Doctor for himself and tells you if the Patient could but be brought to sweat he would soon mend and further prognosticates if he doth not fall into a a sweat by to morrow or it may be next day he is a dead man and so Buenas Noches Now I will render it as evident to you as the light of the Sun that Mr. Doctor is the cause of this mans death that is to be understood 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 There being nothing more familiar among the fermentators than to explain their notions by theorems taken from the Brewhouse and Kitchin I shall make use of arguments desumed from the same Categories There is possibly a piece of meat to be prepared for to be eaten which to maturate or take away the crudity of it to mollifie or render it tender to dissolve and to purge it from its filth and impurity is to be boiled if you put to it salt wine or other ingredients and there be not a sufficient proportion of water or that the water boileth away too much especially if the meat be left dry it will not only harden but be burned smell of adustion or empyreum and soot and be entirely corrupted and spoiled whereas if it had been supplied with water the meat would have been softned concocted and depurated from its recrements and impurities which it casts forth into a scum The case is not different in the blood that boyelth up in the veins and arteries of fevorish Patients which being full of salin adust and other heterogeneou particles is by ebullition to be depurated of the said impurities if then the blood wanteth water or serum to dissolve those salin particles it must necessarily grow dry coagulate and be burnt up and consequently death must be the unavoidable issue Now observe that a Patient that hath been broyling under a continual Fevor for eight or ten days or longer his entrails scorcht and parcht his blood dried up and affected with an empyreum how impossible it is he should be put into a sweat by hot cordials though diaphoretick as Aqua Epidemica Theriacal lap Contrajerv to be given every third or fourth hour by spoonfuls or scruples These certainly must render the blood hotter and dryer and totally absorb the remaining moisture The infallible way to prescribe a remedy to Patients of this nature is to observe that for to cast one into a sweat you are to consider the subject the matter of sweat the efficient of sweat the several causes that hinder c. but chiefly the matter of sweat and the efficient The matter is the superfluous serosity of the blood The efficient is the spirits that expel the foresaid serosity to the circumference These two are nearest causes without both which at the same time no sweat can be procured for if we have only abundance of spirits and no abounding moisture the spirits will be provoked into a greater rage and force and consequently if there be any moisture remaining they will absorb that and so quite exsiccate the body this is that end which the Fermentators and the Putrid Physitians attain by their Cochleatim cordials The indication drawn hence doth direct that to procure sweat which as I said before is a common terminator of malign Fevours is to moisten the body well with appropriate Juleps or Apozems Which done give but two drams of any alexipharmacal water or five or six drops of spirit of Hartshâ—rn rectified and you shall certainly cause an abundant sweat In the next place consider though there be moisture sufficient to subminister matter for sweat as sometimes there is in malign Fevors there either may be a defect of spirits or the spirits may be opprest by the malignity and in a manner rendred languid or drowned by moisture too much abounding then in this case Putrid Physitians do commit a killing error in forcing the Patient to swallow down their acid Juleps and Apozems The indication desumed hence doth direct so subtil cordials as through their penetrability may insinuate into the most intime effuges of the body and disintangle the spirits from those malign particles that oppress them which done they will soon expel their malign enemies through the pores by sweat But since nothing can illustrate this point more than experience I will give you a most convincing instance I was not long since called out out of my bed to see the child of Mr. Harvey in Fetter lane end next Holborn who I was told lay a dying The child was two years and an half old or almost three I found she fetcht her breath with great difficulty her Pulse did beat convulsive vibrating and extreamly frequent as in like cases it usually beateth some two or three hours before death She was delirious not knowing any that were used to be about her her eyes were very hollow dim and very slow in motion her face was pale and cadaverous I examined how she had been the day before I was told that she had a high colour had been very burning and was very droughty and drousie She had been ill some four or five days After I had examined her mouth and belly I soon understood what it was viz. a malignant Fevor occasioned by the Small Pox which nature could not cast forth for want of moisture for hot cordials she had taken in abundance almost every half hour and would undoubtedly have been dead in three hours more had they gone on in that method I prescribed four or five drops of rectified spirits of Hartshom with a grain two or three of Bezoard mineral and a dram of Aq. Scordii comp to be given in a large draught of pure posset drink in less than two hours the Small Pox appeared and she was put into a tolerable sweat then caused two Epispasticks to be applied to the Wrists which had singularly performed their operation by extracting a great proportion of malignant serosity By next morning her senses were returned her aspect appeared florid and vivid her Fevor very much abated and all her malignant symptoms vanisht insomuch that within two or three days she was perfectly recovered Some other observations I must refer to the next opportunity in the mean time I wish Physitians would prefer experience before their opiniater notions FINIS
inferred a disease since the blood also because it 's a fluent matter cannot justly deserve the name of a part but a cause of a disease or the vehicle of it Thirdly The bones cartilages and ligaments are not sensible of heat neither are they subject to receive any putrid heat because in a Fevor they are seldom or never observed to be taken with a putrefaction or rottenness how can then a Fevor be termed a preternatural heat of all the parts Likewise Fourthly Why ought the name of Fevor to be attributed to a fevorish heat more than to a shaking or fevorish coldness in the beginning of a paroxysm of a Fevor both the former and the later flowing equally as symptoms from a Fevor Fifthly An universal heat is erroneously ascribed to a Fevor for in a lipyrious Fevor a torrid heat doth torment the internal parts though the externals are cold moreover it oft happens that the hands and feet are stiff of cold and the entrails do in a manner glow with a burning heat Furthermore it may be observed that a Fevor doth sometimes only haunt one single part as the foot or hand Neither have I forgotten a certain Fevor whose heat extended no further than the head and face Hereunto add that those particular Fevors are not only inferred to be such because of the preternatural heat but also by reason of the preceeding cold shaking and ulcerous lassitude Sixthly those that swell so much with the Doctrine of Fermentation they do not altogether affirm that it is a preternatural heat that constitutes a Fevor since the forementioned heat doth take its rise from a heap of influent spirits striving to expel humours and such small bodies as are annoying which heat ought therefore rather to be judged natural than against nature In the second position we maintain that the heat that attends a Fevor is not always kindled in the heart as if the primar hearth were there which assertion is proved from the kinds of symptomatick Fevors for the Fevor that surprises a wounded patient or one that 's detained with an inflamation of an entrail as the Spleen Liver or Kidney certainly it 's not first kindled in the heart but in the part affected whence afterwards it 's dispersed throughout the whole structure Secondly If the heart were the only brand of fevorish heat the blood that passeth through its ventricles should retain a mark of being burnt and undergo some change of tincture when on the contrary thousands that have been bleeded in Fevors their blood that was extracted hath appeared to the eye to be of a pure scarlet and florid until the fourth and oft until the sixth and eighth day In the next paragraph I have thought fit to please my self with the examination of the vulgar opinion concerning the common seat of continual putrid Fevors intimating it to be the blood seething in the vessels and stained with putrefaction but how grosly this rabble of Physicians is mistaken may be extracted from what shall be proposed First If the sprout of a continual Fevor were ingraffed on the blood it would not be so refractory to cure but consisting of fluid and moveable elements by means of alteratives purgers diaphoreticks and emptying the vessels by opening a vein might in a short time be reduced to its former purity and temperament moreover through one nights seething of the blood nature doth oft expel those thin little bodies that float in it and the grosser it casts forth into pustules botches and other such tumors Secondly I cannot grant that what is stirred by motion and continual flowing as the blood is that it is easily taken with putrefaction for being full of vital spirits and living heat it 's held in a continual motion Thirdly Until the third fourth sixth eighth or tenth day computing from the beginning of the distemper according to the degree of the height of the Fevor the blood at the first phlebotomy is extracted pure and florid as I have observed in hundreds whence it 's evident that the primar matter of putrefaction and the seat thereof is erroneously placed in the blood though afterwards passing the entrails it be stained with a malignant quality loading it self thence with hot Miasms and Salts Fourthly pure phlegm or veiny gelly being watered with an immoderate quantity of a pale green and blew lymph or whey since it makes two thirds of the blood in the veins of those that are troubled with the Dropsie Green-sickness and other kinds of diseases why is not that blood which is so heterogeneous and so far remote from a temperature moisture abounding and the plurality of particles breeding putrefaction always forced into a fevorish heat And on the contrary why are hot and dry temperaments where choler is abounding constantly so inclinable to putrid Fevors whereas dryness doth so particularly resist putrefaction Summarily the blood according as I have asserted in the premises since upon no pretence it 's to be accounted among the parts of the body doth utterly exclude it self being capable to be a seat place or part affected If peradventure you doubt that I have hitherto receeded from the path of the received doctrine stating the heart or other entrail the seat in Fevors you have the liberty to take it from the fountain what is to be concluded concerning the matter Avicen fen 1. lib. 4. tract 2. cap. 43. dictates thus Dicamus quod Febris sanguinis est Febris putredinis Febris calefactionis ebullitionis that is Let us say that a Fevor of the blood is a Fevor of putrefaction and a Fevor of heat and ebullition Here is to be noted that the blood is inferred the subject matter and seat of a putrid Fevor Also Galen lib. 2. de Cris. cap. 12. Manentibus igitur in venis humoribus continuae ex ipsis Febres generantur that is The humors remaining in the veins continual Fevors are engendred out of them Likewise Aetius tetrab 2. Serm. 2. cap. 74. Putrescentes igitur humores aut intra vasa arctati continuas nunquam intermittentes usque ad perfectam morbi solutionem Febris efficiunt that is Wherefore humours putrefying or streightned within the vessels do cause continual Fevors and never intermitting until the perfect solution of the disease Here by the way observe though according to Galen Fevors are seated in the veins by their name Arteries are also described as lib. 1. de Crisib cap. 7. it 's by him more largely expressed Febres omnes sunt passiones venarum itaque in Febribus omnibus quoniam venosi sunt generis passiones nam arterias in hoc genere comprehendimus ad urinas praecipue attendere oportet the English is All Fevors are passions of the veins wherefore in all Fevors because they are passions of the veiny gender for we comprehend the arteries also in this gender we ought chiefly to heed the Urins On the other side they have destined the seat of intermittent Fevors to be without the vessels
the edge of them and freeth those Sulphurs not only of their stink but impure recrements Whereby it 's apparent how great an error they are in that under that pretence of quieting the fermentation rail against Treacle-water and Aqua Apotheriacalis because of the acid ingredients But setting aside these discourses though I do not contemn Treacle-water for the reasons newly quoted yet for other causes I look upon it as a medicine of no effect and vertue for the liquor that 's distilled off from the matter digested in the body of the Still doth appear to be nothing but a phlegm impregnated with a small proportion of the vertues of the ingredients and those obtused too by acids Secondly Acids indued with the salin parts of the ingredients it hath attracted being thence rendred more ponderous do not pass the helm or alembick but remain in the bottom so that the Fermenters need not to be stomacht so much at the hurt of these acids since they are left behind at the bottom Wherefore those with whom this reason doth take place make use of Vinegar impregnated only with the vertues of Alexipharms against pestilent and malignant Fevors setting aside the destilling of it they hold it to be strongest by digestion and filtration by means whereof the faculties of both are preserved intire Likewise those that labour to extract the volatil salts of Diaphoreticks and Alexipharmacals by destillation having ordered their infusion in spirit of wine they destil off the liquor by all means avoiding the pouring any acids to it hereof there is an example in the Aqua Theriacalis in the Augustan Dispensatory and in that Treacle-water which is ascribed to Paracelsus mentioned in the mixtura è tribus in peracutis According to this way of reasoning it is inserred that the Aqua Scordii composita described in the London Dispensatory is much weakned in its vertue because the acid juices of Sorrel and Citrons not mounting up to the Helm or Alembick detain the vertues of the other ingredients within them though notwithstanding many railing at Treacle-water because of the Vinegar make a great noise of the praises of Aqua Scordii as being composed of Acids that are not restringent These I would have to be answered out of solution of the Problem to wit whether Vinegar as it is added to Treacle-Water be restringent certainly not for in time its restrictive faculty doth languish away by being united with the alcalized and volatil salts of the rest of the ingredients until at length the nature of Vinegar being quite buried the medicine groweth ecphractick or opening in the same manner as Oyl of Vitriol exceeding all others in restriction and being obtused by the Alcali of Salt of Tartar is now arrived to be a very great opener Secondly That astringents are very active but it is per accidens in removing the obstructions of bodies especially of such as are inclined to Fevors is made evident by this experiment being confirmed by all mens judgements Salt of Steel bred out of the stem of Oyl of Vitriol is not at all different from vitriol it self since it is manifestly known that the foresaid salt is oyl of vitriol coagulated through the hungry matter of Iron and reduced to its old form and body of Vitriol but advanced to a higher degree of purity for Iron growing out of Vitriol condensed by being separated from its mercurial part now its late mercurial part namely Oyl of Vitriol being returned to it again is as it were through a new birth reduced to its primitive body of Vitriol but its impure recrements are rejected So that hence though the Salt of Steel is made visibly to be a most special medicine for astriction nevertheless it is prefer'd for a most potent medicine to remove the obstructions of the Spleen Liver and Womb. This effect it very successfully performs by causing a combate and effervescency in the vessels between the acid and fiery salin parts of the humors whereby the blood coagulated in the veins is at length dissolved and that which is thick is attenuated Steel prepared with Vinegar whereby its vitriolate astringent vertue is increased is esteemed famous against obstructions by all Physicians Hence you may learn that all chalybeate and purely vitriolate medicines are per se restringent and stopping but per accidens they dissolve and open wherefore they ought to be used with a great deal of caution by Dogmatick-spagirical Physicians according as it is illustrated in this following relation A fermentitious Physician of no mean rank having given Crocus Martis three times to one that was troubled with a bilious diarrhoea or looseness and though he had before prescribed him two infusions of Rhubarb and Miroâ—alans yet had occasioned such gripes in the Guts pain and inflammation of the bowels that increasing his stools as much more sent the Patient to Limbo On what this unfortunate practice is grounded you may judge from what hath been premised Now it 's time to look back to the place whence I digressed The opposition of the Fevor is not only committed to an antifebril Cordial medicine but another that 's purely Cordial is also joyned with it for assistance thereby to relieve the Heart and Arteries with a supplement of spirits in the form as followeth R. Aq. melis tot citr lujul. aur ceras nigr ana â„¥ j. Aq. mirabil Ê’ vj. tinct croc or according to others Spir. menth Ê’ ij succ kerm. Ê’ j. or Ê’j ss Syr. garyophyl others write Syr. è suc citr â„¥ j. m. f. Pot. Capiat cochl 1. or 2. altern hor. Hereunto some add Confect Alâ—herm or de Hyacinth Ê’j also spec è chel cancr comp ℈ ij or Ê’j But such as do not so well approve of these kind of prescriptions because those distilled waters are so faint and void of spirits offer their Patients burnt Claret spiced and mixt with cordial waters and syrups Also raw Rhenish Wine as appears by this following prescript R. Aq. Hord. depur lib. j. Aq. bor buglos viol ana â„¥ ij Vin. Rhenan elect â„¥ iij. Syr. è suc citr Garyophyl ana â„¥ j. ss m. f. Iulap E quo sumat Patiens â„¥ iij. tertia quaque hora. This is a Julep of 〈◊〉 his composing as may easily be conjectured by the Wine it contains for he doth not willingly leave it out of any thing either for himself or for another but I imagine he ought to be better versed in that ingredient since he hath for so many years made it his mothers milk than not to know what sort of Rhenish Wine ought to be put in whether Bachrach Rinckhower Hochmer besides a hundred sorts of Rhenish Wines differing infinitely in strength and quality from each other but that 's entrusted to his Apothecaries palate but as for the success hereof let that be buried with those that have made use of it Cooling Cordials according as they are called in the common phrase as the four Cordial-waters Aqua frigida Saxoniae
naturae quia aut curabit eam aut manifestabit eam that is when you do not know the disease leave it to nature because either she will cure it or discover it Also they would contribute far greater advantage to the ease of the sick by expecting with Hippocrates the crisis than by a thousand tricks to circumvent nature for if they can do no good let them do no harm at least But now it is I am at leisure particularly to set down the order of this lazy practice Those that reject glysters in the beginning of a Fevor because they should not blunt the edge of the ferment too much do not at all perform their duty in the right administring of things since the rubbish of the body that is lodged about the turnings and windings of the guts and the hidden places of the mesentery not being expelled doth either by profusing steems into the vessels very remarkably increase the heat or by putrid particles creeping into the blood is apt to kindle the Fevor This rubbish because it is incapable of being concocted and is lodged without the vessels does easily yield to a gentle laxative potion or purging glyster without any fear of increasing the heat But since people here are such immoderate devourers of flesh that the belly being the sink of the whole body must needs abound with sordid excrements is not a laxative purge or Cathartick glyster very necessary But it must be given in the first preceding days or afterwards the greatest part of that filth and dirt is carried away into the vessels by the rapid torrent of the blood and therefore all purging is to be set aside for hereby nature would else be drawn from its work with a great disturbance and that without the least benefit Neither is that I have proposed just now contrary to Hippocrates as you may observe Aphor. 10. â—â—b 4. In acutis passionibus eadem die si fiâ—i potest medicandum nam in his cunâ—ari malum est that is in all acute passions you must give physick the same day if possible for to tarry is hurtful also Aphor. 29. lib. 2. and in Aphor. 30. lib. 1. he gives the reason for it Circa initia omnia debiliora in statu omnia fortiora quae purgationem fieri impediunt that is about the beginning all things are at weakest and about the state at the strongest which hinder that a purge should be given Secondly all bodies that are inclinable to Fevors or are fevorish are for the most part in the beginning oppressed with a Plethora ad vires or a fulness of the vessels more than their strength can bear whereby the spirits are pincht and through too great a condensation grow vehemently hot the circulation grows slug and dull and is carried in a disorderly motion and the pores are stopt how urgent is the case then that some blood be taken away immediately thence the spirits will be able to bestir themselves the motion of the blood from irregular will become regular the passages of the skin will be more free and the heat will be moderated But since it is not seldom that a Fevor being subdued by the first bleeding though not to an absolute extinction of the fiery heat the sparks raising the flame again the blood doth swell up a new and run violently up and down reason doth like wise advise that the veins are 〈◊〉 be deplenisht the second time that we may arrive to the same effects But those that indeavour to venture the opening of a vein e third time do unpunisht make a playgame of a mans blood for there is not so great a benefit reaped this third bleeding as there was by the two former as I have found by a thousand trials but the spirits and forces of the sick are barbarously destroyed by taking away their due food and nourishment and quite ruining their base and foundation for they inhere in the blood as their foundation and subject and from it they draw life Moreover neither is the blood then so turgid and impetuous because besides the former substraction of blood the parts of the whole mass are attenuated melted and dispersed through a great many little caverns and holes that before were filled Likewise there is now a close engagement between the vital spirits and the febril corpuscles what these are shall be told you hereafter so that if either you disturb the spirits or exhaust and lessen them by bleeding the fevorish miasms must necessarily get the victory and produce death for their trophy Thousands are killed by the slaughter of the lancet That you may understand the case more plainly I will illustrate it to you by an example of one that lieth sick of a malignant Fevor whom should you bleed but a second time or sometimes but once you would certainly bring his life into danger for neither Pulse or Urin do signifie any great heat that should be the cause of the swelling of the blood neither are the pores stopt by an abundance of soot wherefore there must by no means any blood be taken away because it doth in no kind of manner nor through its abundance annoy the spirits If however against reason blood should be extracted the spirits will be so much wasted that they will be rendred too weak for the encounter Secondly since the vessels by opening of a vein are so swiftly deplenisht the malignant matter that stagnates in the capillar vessels or elsewhere lieth hidden in remote holes and secret places is thereby most impetuously drawn into the great vessels that lead to the principal parts where joyning with particles of their own nature do with a joint force fall upon the strong holds of life certainly this is a most clear demonstration We must here unty the knots of two particulars that were asserted above The first is the manner of computing the bleedings whence the first is to be counted whence the second and third The other is why there are but justly two bleedings set down At the first assault of symptoms that are derived from the spring of a Fevor that is not intermittent as Hippocrates here and there calls it by which name are meant both continual and continent Fevors the same day there ought some blood be taken away out of the right arm to quiet and suppress the febril matter that it may not be mixt with the mass flowing through the great vessels nor fiercely fall upon the spirits for as much as this should happen so much the quantity of the blood that is to be extracted ought to be moderated Moreover the measure of blood that is to be drawn away is to be taken from the degree of the swelling of the blood for if the degree of intumescence or swelling be at the degree of eight and if unto this degree doth answer the taking away of ten ounces of blood then if the intumescence be at the degree of four the substraction of five or six ounces will be
proportionable to allay it and according to this manner you must make your computation in the others But where the Orgasmus or turgid working of the febril matter is appeased and its malignant faculty suppressed you may safely next day or two days after by a cathartick potion expel the matter of a Fevor that is imprisoned in hidden places without the vessels and in the capillar vessels In the same manner is a malignant Fevor to be dealt withal at the first assault though otherwise it would certainly tend to the destruction of life yet by so managing your affairs the sick man will be released There ought a laxative or at least an emollient glyster to be administred before the bleeding Fevorish patients are oft in the beginning tortured with a violent shaking extream vomiting and frequent fainting in this case six or eight ounces of blood being extracted out of the veins the same day the swelling of the blood the plethory of the vessels and the violent working of the febril matter have been quite suppressed But possibly one may reply that if the blood should be preyed upon on every appearance of the foresaid accidents it would be oft lookt upon as a very careless and needless piece of work when ofttimes those symptoms do of their own accord the blood being appeased vanish away in six or eight hours as useth to happen in intermittent Tertians and some other kind of Fevors I answer that in such a case the overweight of blood is never lightned without great benefit by opening of a vein since the forementioned symptoms do issue from a plethory and a hot burning matter and granting that the violent working doth settle of its own accord it will return again upon the least occasion wherefore to relieve nature there must necessarily some part of the burden be taken off Secondly the nature of an Orgasmus or violent working is well known almost to every experienced Physitian whether it appears to be superficial and moveable or permanent and thence may easily conclude about the necessity of bleeding But since it often happens that sick people do not advise with a Physitian before the second third and fourth day or afterwards there first ought to be inquired whether the same or a greater or a lesser quantity of blood should be extracted than if a Physitian had had the occasion at the first assault to have given his advice Secondly whether nevertheless a Physitian coming the third or fourth day that substraction of blood ought to be accounted the first and whether the fifth sixth or eight morning after the opening of a vein ought to be repeated First there must be considered the degree of concoction and the ebb of the blood occasioned by fasting or thinness of diet must be taken notice of before any thing can be certainly concluded on Wherefore take it only for a supposition if hereafter you are not convinced of the absolute truth thereof that nature is imployed thirteen dayes and sometimes fifteen days in concocting the matter of acute Fevors and afterwards doth endeavour to separate and expel it the fourteenth or sixteenth day according to the course of the Moon wherefore Hippocrates pronouncing Aphor. 13. l. 2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is those whose crisis is growing on the night before the fit is very troublesom to them the concoction is brought to the height or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 on the thirteenth because that is accounted the day that immediately preceeds the fourteenth on which according to the dictate of the same Hippocrates Aphor. 22. lib. 2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is acute Fevors come to a crisis in fourteen days the crisis of acute Fevors are wont to happen Now since the night before the crisis all things are very troublesom it must be that nature is at that time most busied and is at the highest point of concoction which namely is the thirteenth day or night immediately preceeding the fourteenth day being the day of the crisis on which namely the fourteenth day as I hinted now nature doth gradually separate and expel the concocted febril matter by stool vomit through the pores of the skin or hemorrhage but most frequently by urine in the shape of a white and heavy sediment if the concoction be perfect or reddish if imperfect Here is to be noted that crises which happen to bodies in hot and thin climates and whose blood floating in the vessels is very thin and the veins free from obstructions are very rapid and swift expelling the concocted matter by stool or through the pores of the skin all at once as it were and with a violence but those that lie sick in a northern climate because their blood being thick muddy and ropy doth in all parts promote obstructions and their skin is hard and thick and the faculty of their guts is dull for the most part they are freed by having the febril matter gradually sent down to the Kidneys and Bladder In the mean time it 's not to be denied but that the word Crisis by its first imposition doth denote a sudden change with disturbance either to life or death wherefore though I said above that the matter was by a crisis gradually expelled it is to be understood in respect of a more rapid crisis that 's proper to hotter countries and in respect of the lingring solution of the disease by translation of the matter it doth justly merit the name of a Crisis for the whole matter is expelled in four or five days more or less This by the way If then the thirteenth day be the top of the concoction and that the symptoms are gradually intended from the minute of the augment or increase which usually happens to be in true acute Fevors about the fifth or seventh day according to the variation of the Moon it will not be safe to open a vein past the seventh day because then the spirits are endeavouring to concoct and the swelling of the blood is suppressed by fasting if bleeding was not premised and thinness of diet what is it then you will exhaust the veins for If notwithstanding in the beginning of an acute Fevor which is defined to be the first four or six days because during that time the first appearance of symptoms is scarce altered the fevorish Patient hath beyond reason and necessity gratified his stomach and appetite and that thence the turgency of the blood hath been fed it may be convenient to take away some blood though it be the eight day so that those things are to be defined according to the swelling of the blood and the decrease thereof by a thin diet for if so much be consumed by a thin diet in the beginning or the first four or six days as is proportionable to once bleeding it will be advantageous to bleed once besides within the seventh day but those things are to be left to the judgement of every experienced Physitian yet let him not be unmindful that
thence vomiting up into the blood certain tumultuous miasms that force it into a heat As soon as the foresaid matter is thronged out of its lurking places and forcibly rushed into the great vessels the symptoms thereupon raging in heat do forthwith shew a countenance of the augment or increase And when the whole mine of febril matter is quite floated into the channel of blood then the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or vigour is near at hand At that time there is a close ingagement with the febril enemy and its force being broke Nature by her victorious arms doth expel those rebellious intestine corpuscles and separated humours into several sinks of the body the disease in this manner declining the sick man doth arrive safe and well This expedition doth contain some particulars very worthy of note 1. At the first of the ingagement nature doth encounter with the Fevor at a distance some steems being only scattered abroad before the gross of the preternatural matter lodging in the deep places without the vessels nor at all mixt with the torrent of blood 2. The Fevor increasing the lesser part of the matter is confused with the blood that flows by but the greater part doth as yet remain still and quiet in the spring 3. At the vigour all preternatural bodies are closely intermixt and confused with the natural From hence doth shine a light whereby the bottom of the difficulty wound up in the foregoing discourse may be plainly known and discovered Wherefore since fermentation doth tend to the same end concoction doth namely of subduing the heterogeneous quality of the adventitious minims that are got into the blood and that whilst the disease is yet in the augment only part of the Febril matter is crept into the blood and not throughly insinuated into the depth of the forementioned scarlet juice it will prove a help no ways deceitful if the sick man doth take a Diaphoretick draught well impregnated with volatil salts whereby he may be put into a smart sweat certainly a very proper means through which the vital power may free it self from those hurtful corpuscles since as yet the spirits are numerous and vigorous and are not so much ingaged by the intestine enemy whence consequently they have still a power of expelling the fumes and soot have not yet filled up the passages of the body nor pores of the skin being left open for natures cutaneous evaporation a part only of the Febril matter is here and there loosly intermixt with the blood and may easily be forced out thence From all which it doth plainly appear and is inferred that fermentation fie upon the abuse of the word is in this case to be rendred easie the liquor of the veins being thereby attenuated occasion is given to the spirits to fly together to make an united force to grind off the sting of the Febril matter and thereupon to expel it But though the fermentation is to be rendred easie it is by no means to be increased and intended for that would put the Bitumen of the blood into too high a flame and through the crackling and vibration of the salts would occasion a very dangerous storm in the blood Of this nature are almost all the remedies that are proposed by the Fermenters namely Aqua Epidemica Spirits of Hartshorn and all the other fiery cordials as shall hereafter be resolved more at large Neither do I esteem those reasons I have now produced so much but that the many experiences whereby I have delivered some hundreds after the manner aforesaid of their continual Fevors without suffering them to come to the height do more clearly discover the matter According to the mark spoken of before let us enquire what harbour this Rhomb of giving hot cordials by spoonfuls will bring them to undoubtedly if the Fevor be any thing outragious there is danger of shipwrack For things that are taken by spoonfuls contribute matter to the inflammation and fire increase the matter of the soot and really stop the pores moreover do not concoct the least part of the febril matter neither do they separate or expel it being concocted Wherefore if a Fevor is of its own accord carried on to the height without doing any thing and the febril matter be more closely and intimately knitted with the blood and spirits and the whole mine be disturbed and profused into the great vessels certainly in doing ill they must speed much worse What they have acted in the increment hath just now been shewed at present pray give your judgement are your toothless wifes in the country more dextrous in curing a Fevor or Fermentitious Physitians Neither are the sick themselves so void of sense but that they are sensible they are precipitated by the burning cordials of Fermentators in the state of their disease into their too early Tombs The forementioned Cordials derive their burning nature from an impure Sulphur which doth not only plentifully abound in the spirits of wine the menstruum of all those compounded alexipharmacal liquors but the ingredients themselves especially the aromaticks contain excrementitious Sulphurs and impure salts whence it happens that those that have liberally taken of them arrive sooner to the end of their fatal journey Wherefore it 's plain enough that by these things the fermentation is intended the mass of blood is forced into a fiercer fire and burning and the whole sink of the Febril matter which only partly flows to the blood and partly remains in its hidden station is violently suckt up and drawn in by the circulating juices and is united with them in every particle so that to give the prefaced cordials which increase the fermentation and do not at all render it easie by a most subtil and diaphoretick vertue is with purpose to kindle the body into a flame and rob the sick of his life However that inquiry may not be pretermitted what admirable effects do issue from the fore instanced Aqua Epidemica we are to be resolved from the examination of the context of the simples Tormentil Root is in the front whose power doth reside in a ponderous fixt salt and for that reason no part of it doth ascend the Alembick Liquorish in this place is termed alexipharmacal which was never attributed to it by any Physitian nevertheless it was possibly added to abate the acrimony of the other ingredients but since it doth also obtuse the attractive vertue of the Menstruum and render it incapable of attracting the salts of the simples neither doth the least particle of it climb out of the body to the head of the Still certainly it ought justly to be rejected hence Moreover who but a mad man would commend Mugwort Agrimony Betony and other such like herbs against the Plague according as they are inserted by the former age in this composed medicine These though they use some small force against the venom of the air yet other Alexipharmacals as long as they are far more deservedly