Differences that the first Degree furnishes us with and general division of those that may be observed in the second 3. What may be understood by Particular Poxes 4. What the Vniversal Pox is 5. Explication of the differences that may be drawn from the third Degree 1. BEfore I come to speak of the Differences of the Pox it is good to acquaint you that I do not conceive any different Species of it nor own any Sanguine Cholerick Phlegmatick and Melancholick ones as some Men have inconsiderately done but on the contrary do always esteem it as the same in what degree and whatsoever subject it may be found since it is always produced by one and the same cause that always acts after the same manner and produces different Effects according to the various disposition of the parts that receive its action This being once presupposed you will easily grant that the differences of this disease can only be drawn from the diversity of its degrees that is to say from the time that its matter hath been received from the progress that it hath made and from the Accidents that it produces 2. Though I consider the time that the Venereal matter hath been received for one degree from whence some differences of the Pox may be drawn and that some Authors do think to ascertain the Prognostick of it by the consequences they thence draw yet it must be acknowledged that they are of no great consideration For though it may be said that this Disease is either New or Inveterate according to the more or less time it hath been contracted yet one cannot judge for all that of the easiness difficulty or impossibility of its Cure because this same matter is more or less active according to its quality or quantity or else according to the particular dispositions of the Bodies in which it enters For 't is certain as I have already observed that it becomes more Venemous consequently more penetrant subtile when it hath had duration in the change that may be made of it from different subjects and the great quantity of it doth very much advance the disorder it is able to make in every particular person To which may be added that it acts the more suddenly when it is excited by the heat that is found in the Temperaments of Cholerick or Sanguine Bodies which are so much the more disposed to suffer its insinuation as their pores and other passages are naturally more open but on the contrary it is sometimes so fixt and shut up in the cold or gross Humours of Phlegmatick or Melancholick persons that it can lye there a long time like fire under ashes and experience lets us see that it can lurk 10 or 12 years before any effects of its Motions will be felt whence it follows that the Judgment of the three Circumstances I related do chiefly depend on the examination that ought to be made on the progress it hath already made and the accidents it hath produced For by the consideration of the first circumstance the Particular or Universal Pox may be judged of and this distinction is of such importance to the right prognostick of the easiness or difficulty of its Cure that it lets us see in what degrees particular or common remedies may suffice or whether the stronger and more general are also necessary 3. Before we pass further it seems very proper to explicate what I mean by this Difference that I may let you see how it doth not serve only to distinguish the degrees of this Disease and that it is not any way contrary to what I said of it at the beginning of this Chapter I do call then a particular Pox when its matter doth continue fixt to some parts which suffer it to be dressed and cured with particular Remedies external or topical and for which those are employed chiefly that are called General or Internal as well as to hinder the progress it might make by the penetration of its Salts such are for example the Venereal Ulcers and Chancres or else Claps and Virulent Gonorrheas and which I call the Pox as well as the others named before because they are all of them productions of an impure Contact and of some Venereal matter received of which all the effects may be observed though it doth still adhere to some particular parts as well as when it is dispersed over all the Body for the coagulation and corruption that I have said doth happen by it in the liquid substances may be observed in the Seed that runs in Virulent Gonorrheas or else in the fixation of the Juyce that nourishes the parts in which the Venereal Ulcers are that do by this means degenerate into Chancres or Carnosities The pricking gnawing or drying up of the Flesh may be also observed in the beginning augmentation and changes of these same Ulcers in a word the elevation rottenness and corruption of solid parts are sometimes the consequents of these first Evils when they happen upon Bones or Cartilaginous parts in so much that you may hence see with how much reason I do reckon them for degrees of the Pox since it is commonly by then that it is found to begin and they are almost never seen to advance into a higher degree when they arâ— drest as they ought to be I do acknowledge nevertheless that this name of the Pox was at first given to this Disease only by reason of the resemblance that was thought to be between it and the Small Pox through their spots and pustules and it seems consequently that this Name should then only belong to it when it is in the degree that produces them But we must observe that it often passes from one degree to another almost insensibly so that sometimes it cannot properly deserve that Name if we stick close to this Circumstance besides it may be said that Names do not establish the essence of Diseases and it matters not how this Disease is called provided that it be considered as always of one Species according to my opinion 4. When the Venereal Salts are subtile enough to penetrate through the pores without staying in the places through which they pass as hath been seen in some persons or rather when they there stop and cause the particular Poxes of which I have spoken without the persons taking care notwithstanding to oppose its insinuation by the means of fit Remedies that drive or attract from within outwardly they then cause what I call the universal Pox by insinuating into the Vessels that contain the Blood and spreading universally over all the Body by the Circulation They who have read the Authors that write on this subject will wonder doubtless that I make the Venereal Salts pass from the superficial parts into the Veins and Arteries without speaking of that Species of the Pox they make consist only in subtile Vapours and Spirits but as I have already told you I cannot acknowledge any different Species of it and
for Coition the Nocturnal pollutions without pleasure the suppression of the Terms in Women or of the regulated Hemorrhoides in some men Lastly the mobile or fixt pains of the Head the Shoulders and Extremities The latter Signs are Gonorrheas Buboes or Poulains Ulcers and Chancres of the Yard and of the Privities of Women or else the hardness that remains after their Cicatrices the fall of Hair from Head and Beard the Wounds and Ulcers that cannot be cured with ordinary Remedies the Tetters Pustules and Warts lastly the Elevation Rotteness and corruption of Bones But we must be sure to observe that all or most of these Signs that I have named are but Accidents of the Pox it self that it produces not all of them at all times nor in all subjects and that they become different according to its divers degrees in so much that they do not happen always in a constant and assured Order For there have been some persons seen whose bones have rotted with the Pox before ever any of those Accidents Authors do call Antecedent have been at all felt which Accidents I had rather call Consequent because they do most commonly follow those that accompany the particular Poxes of which I have spoken Nevertheless as it is impossible to make a good Prognostick of this Disease without being able to distinguish all the degrees it can happen in it will be necessary to reflect on all that hath been already said to the end we may the better find how it passes out of one degree into another and why in each particular one it doth produce very different Symptomes 4. It may with Reason be said that the Ulcers which are caused by impure Contacts do constitute the first degree of the Pox because they are the effect of some matter that very superficially adheres they cannot be distinguished from ordinary Ulcers at their beginning but by the preceding Contact and the parts in which they happen and they may be cured in this condition with common and ordinary Desiccatives But when the Salts that caused them cannot be destroyed by these or other means they then penetrate into the Vessels that contain the blood or else mix with the Natural moisture that remains in the ulcer'd part and fix it in such manner that from Ulcers they degenerate into Chancres and then indeed they are much more dangerous and hard to cure but are known by the elevation of their white sides by their obscure colour and by their hardness You may easily judge that Claps or Virulent Gonorrheas are of a yet higher degree than the Ulcers I now spoke of because the matter that makes them is more deeply driven into the bodies of those who suffer them and the parts that are infected with them are such as are inward and concealed The Bladder for Example and the parts adjacent or dependent on it are the first that suffer the Inflammation which is sufficiently known by the heat and pains that are felt in urining and sometimes by an entire suppression of the Urine the seminal parts and the Seed it self are not more free from an Alteration since the loss thickness corruption of the Seed are undoubted marks of it Lastly the passages through which these Impurities are carried do not long remain free from their ill effects but become exulcerated by the sharp points of the Salts they contain and this exulceration doth cause them to suffer very grievous pains during the passage of their Urine While this particular Pox is but newly contracted it can be cured with a great deal of ease and safety by preventing that which we ought otherwise to fear and taking away whatsoever appears by the use and application of proper Remedies to this effect But when it hath had a considerable duration without necessary succour it must be then believed to be of a much more difficult and dangerous Cure because all its Accidents become greater and the further penetration if its matter that is the universal Pox may be then with just Reason suspected Therefore it must then be treated with more care and precaution and the Prognostick that is made of it must be more doubtful We may now observe that the Venereal Salts do often pass from the parts I spoke of into the orifices of the Veins and Arteries and do sometimes penetrate more directly by the subtilty keenness of their points Nevertheless what way soever they enter it is always true that they cause in some a great ebullition of their blood either by the particular dispositions they find in it or else by their own deleterious quality during which ebullition the Impurities do separate much after the same manner as Lees do in the fermentation of Wine and so are driven out after a while by the force of Nature or if you will so by the Faculty Expultrive into the Glandules of the Groins where it causes a Bubo or Botch that serves for a Crisis of the Pox if it be attracted and brought to perfect Suppuration It may be distinguished from other Tumours that sometimes happen in those parts by the impure Contact that preceeded it by the Claps Gonorrheas Ulcers and Chancres that often happen a little before its discovery but principally by its slow advancement its durity and large Basis But this penetration of the Venereal matter into the mass of the blood is not always attended with so happy success as the extrusion of such a Tumour the Venereal Salts do sometimes participate more of fixt than volatile and the blood is not equally hot and subtile in all sorts of men so that in some it presently coagulates by this means much after the same manner as some curious persons have experimented by syringing Acid Liquours into the Veins of Brutes and this coagulation is often the Cause of those suppressions I took notice of and of their loathing all Meat aâ—â— of their indifference as to Coition because whil'st it continues the Circulation grows very slow and consequently the Natural Functions that depend on it become interrupted Wherefore this time may be observed for another degree of the Pox that can nevertheless be clearly carried off by the inward Sudorisicks which do dissolve and attenuate the blood by new ebullitions provided that Nature be also assisted in her other evacuations At the time that this coagulation of the blood ceases by the separation of the different particles it then contains we may consider the beginning of its fermentation which is performed so much the more gently and by degrees as it met before with Obstacles to hinder it whence it comes to pass that this blood doth but only rise and boil by little and little though indeed this gentle ebullition fails not nevertheless to cause Symptomes very much different from those I have already spoken of and such as I shall remark hereafter For whil'st it lasts light vapours arise from it that are carried all over the body and do cause those inquietudes of mind and body
be desired to maintain my Opinion yet I do not pretend to make it pass for a thing altogether unquestionable both for that it is possible to be false and because there might have been some unknown Abuses under equal and as good appearances I therefore leave all curious persons the liberty of making what other Experiments they please and to every one in particular that of judging the other circumstances of this Opinion according to their own Ideas or particular Observations as things Problematical and no way absolutely necessary to the Art of curing the Pox. 4. After having sufficiently explicated what I mean by the Original Cause or Generative of the Pox it is now necessary to observe the several sorts of Contact that can conduce to its Communication which are here considered as Causes of this Disease because it is by them principally gained But we must not imagine that this second Cause is always found in Coition as the first it matters not after what manner the Contact is made provided that it permits an adhesion or entrance to some part of the Venereal matter it may be made either directly or indirectly and here 's an Example of it A Woman with Child who in the Company of one that hath the Pox shall attract into her Womb the corrupted Seed that shall be there ejaculated will catch the Pox immediatly by reason of the Coition and Contact that preceded and the Infant that shall be in her Womb will be also infected with it by reason of the same Coition but not by reason of the Contact because the remoteness of the Infant hinder'd the Infection from being direct in respect of it The same thing may be said of Infants that are engendered of divers like Seeds according to the ordinary course of Nature or by way of Superfetation Besides the Example that I just now gave many other sorts of Contacts may be found which are made by other ways and yet fail not to cause the Pox For Example if one should happen to drink after him that hath the Pox and by chance put the Lips to the same place of the Glass where some little Poison of the Ulcers of his mouth or else some of his spittle fill'd with Venereal Salts shall have stuck it often happens that this either causes other Ulcers by superficially adhering to the parts or else without delay the universal Pox when the Salt that they contain is volatil and penetrant enough to enter into the Veins and Arteries without leaving any marks of its passage for let ever so little of it be once mixt with the Blood it will work like Leaven in a great deal of Dough or rather it ferments and corrupts as other Poisons do which are always more pernicious by their quality than by their quantity Another Example of this nature may be drawn from those who are infected with this Disease for having unfortunately lain in the sheets wherein one in the Pox had sweated or in which there might remain some of the matter that run from his Ulcers Besides these sorts of Contact all others may be said to be immediate because they are made by the application of one part against another Among them all the most ordinary is Coition because this Disease doth for the most part begin in the parts that serve for Generation and its matter is not always dispersed universally through the Body In this action if a Man hath Venereal Ulcers on his Yard some part of the Poison that nourishes them and which is nothing else but a dissolution of the Salts that constitute the Pox doth almost always stick in some part of the Womb or else in the wrinkles of the neck of her Womb that he lies with wherein he often causes other Ulcers by adhering to the skin or pellicules that cover those parts on which matter it may be observed that I have just reason to add this last circumstance by reason that this matter doth not always necessarily adhere in Women either because the Membrane that covers the Vagina is very smooth polished and cover'd with a slimy Humour or because the Seed that is therein ejaculated doth often slide out at the same time and carries away with it this Virulent matter so much the more easily as it hath not had time to adhere and as the scituation and form of this part do much contribute to its easier sliding out it is also for this reason that common Strumpets do sometimes give hurt to others though they have none at all themselves because the approaching them a little after they have enjoyed the Company of other men that are impure doth give some part of the impurity they received though themselves may be exempt from any adhesion or effect of the remaining matter by the means that I have mentioned It is observable that a virulent Clap and the universal Pox are able equally to render the Seed impure in so much that if that of a Man who is infected with it be attracted and retained in the Womb of a Woman it may cause in her either a Virulent Clap by adhering particularly to the spermatick Vessels or else the universal Pox by passing through the Oririfices of the Arteries and Veins that terminate in this part In a word a Woman that shall suffer such Indispositions may in like manner communicate them to a sound Man that shall converse with her by the adhesion or entrance of the matter that can cause them It is also observeable that the Impurities of the Mouth of a little Infant that hath the Pox are able to infect the Nurse by adhering to her Teats or else the air of his Respiration that can easily penetrate them through the pores that give passage to the Milk In like manner an infected Nurse can impart her Disease to the little One by an adhesion of the matter of her Ulcers or by the use of the corrupted Milk that is suckt from her Teats To ly with one that hath the Pox and touch him naked while he sweats or when he hath Ulcers and Pustules on his skin is a thing that may well be believed very dangerous and chiefly for those that have their pores very open and therefore do easily receive the impression of any thing that touches them The custom of Kissing with open Mouth is another very dangerous business for the reasons I have spoken of Lastly there are so many different Contacts which are capable of giving the Pox to those who have it not that when you shall once know it assuredly by its Signs you need not trouble your self but little about the manner how it was communicated since you cannot always find it out and since it is often unknown even to the persons sick themselves CHAP. III. Of the Differences of the Pox which may serve to make a Prognostick 1. An Advertisement on this Subject and general Division of the Degrees from whence may be drawn some Differences 2. Explication of the
from its passage and this causes a Flux downwards which lasts indeed but a small time and requires no particular consideration It may be also observed in the increase of the Salivation that the Ulcers which I spoke of do enlarge in latitude and profundity by the action of the matter that runs out of them and that the motion of the Artery appears almost as strong and unequal as in burning Fevers because impurities cannot be thus seperated from the Blood without raising a great Ebullition in it by the motion of Mercury or strength of the natural heat But seeing these things do happen through an indispensible necessity and are not at all contrary to what may fairly be expected from the Action of Mercury you need not trouble your selves to think of preventing or curing them by contrary Remedies 7. Nevertheless you may mitigate the pains in the Belly when they become very hard to endure by the means of Anodyne and cooling Clysters or else diminish the corroding Acrimony which causes Ulcers in the Mouth with gentle affwaging Gargarisms such as are for example Cows Milk luke-warm or the Decoction of French-Barley Linseed and Fleawort-seed to which must be added that it is sometimes necessary to consume the corrupted flesh about them with Spirits of Wine Vitriol or Sulphur It should remain to say something of the Quantity of the Matter and time of its running but seeing these two Circumstances do absolutely depend on the Temperaments of persons and degrees of the Disease they cannot be precisely regulated but by the Judgment Application and Experience of him that treats them Wherefore I shall not detain you to no purpose on this Subject but believe it may suffice to say generally speaking that you ought not to begin counting the days of the Flux until it is able to furnish at least two pounds of Matter in four and twenty hours and that it ought to continue a fortnight at least and a month at most Nevertheless there are some Authors who pretend that the cessation of Accidents and especially of the Flux are undoubted marks of a complete and perfect Cure But you may easily perceive this Rule not to be infallible since I have proved in another place that the Cause of the Pox may still remain when the ordinary Accidents are vanished away and that there are other Accidents on the contrary which can never wholly disappear but by the application of particular Remedies either during or after the universal Purification of the Body for example the Rottenness of Bones which must be corrected by actual Cauteres the Consumption of Flesh or Skin made by Tetters or profound Ulcers which can never be regenerated but by mundifying Medicines lastly the Relaxation and weakness of the Spermatick Vessels which causes in some persons a continual Effluxion of the Seed until they be closed up again by styptick and astringent Remedies Besides you will find by experience that the Flux often ceases before the Disease and that it is sometimes necessary to renew it or at least to assist the former Evacuation with Remedies that purge through other passages especially when Nature is so inclined But you must not do like those who think they can never enough drain the Bodies that are thus infected who consume and exhaust the Radical Moisture it self which is the foundation of Life after having drawn away all the other Humours But remember rather that it is of as great importance to preserve what is natural to the Body as to destroy whatsoever is enemy to or against Nature And to the end you may the better avoid this Excess you must observe very exactly how far the Body is dried how the forces are spent and all the other Circumstances which I gave you before that so you may timely stop the Salivation after a sufficient continuance of it by change of Linnen Bed and sometimes Chamber too or by the Precipitation of Mercury which may be made with the Salt of Tartar taken alone in a Broth or mixed with the ordinary Purges and Diureticks CHAP. V. Of the Diet of such as are in the Artificial Crises of the Pox. 1. In what this Diet doth consist in general and why it is necessary to give particular examples of it 2. The manner of governing those who are of a good Complexion 3. Who are Hot and Dry 4. Who are Cold and Moist 5. General Observations for them all 1. THE Method of governing such as are in the Crises that are raised by Mercury doth in general consist in preserving them from the violence of ill Air and bad Weather in regulating the Quality and Quantity of Aliments and Medicaments and if you will also in a Moderation of the Passions of the Mind The means of answering the first point have been already given when I spoke of the proper seasons to treat the Pox and it seems that the prudence and discretion of the Physician ought to make Rules for the other two Nevertheless seing it is often impossible to correct perfectly in the Preparation all the preternatural Dispositions which proceed from the diverse Temperaments of persons and it is consequently necessary to persist until the end of the Cure in a regular use of things that are contrary to their pernicious Qualities it may be expedient to do as I have here done in delivering the Method of Preparing such as have this Disease that is to say of shewing here the proper management of Nourishment and Remedies for such as are of an even and good Temperament and for those that are removed from this good Mean by great Repletion and Inanition after which you will here find some general Circumstances it is convenient to observe in all those persons who are treated with Mercury 2. There are two Rules particularly important for the Diet of one of a middle Temper the first is Not to give him any more Aliments than will preserve his forces in good plight that Excrements and Superfluities may not too much abound and the second is That you give him light Remedies for to open the chief passages that Nature may not be diverted in her operations by contrary motions You will sufficiently answer the first Rule if you give him two new-laid Eggs at noon and a Broth every fourth hour all the rest of the day and night which you may make with a Leg of Beef Pullets and some Succory The Ptisanne which I have before described for preparation of Bodies of this consistence may also serve them very well during the Crisis to answer the second Rule I gave you because it is Sudorifick and Diuretick and may be also rendred proper for gently loosning the Body by making a cold Infusion of two Drachms of Senna four and twenty hours in a Quart of it which you may make him drink every second day at several draughts 3. When you shall come to treat a Body that is very Hot and Dry you must remember it would be a dangerous thing to nourish