enlightens each part of the Soul and disperses all the Clouds of every function But on the contrary those who being thin and of a Bilious or Melancholick temperament have a sharp or burnt Blood a hot Brain and the Animal Spirits too much stirr'd and restless ought to forbear this Drink altogether as being apt to pervert both the Spirits and humours in a greater measure and to render them wholly unfit and unable to perform any functions For I have observ'd many not having a sufficient plenty of Spirits and being also subject to the Head-ach Vertigo Palpitation of the Heart and a trembling or numbness of the Limbs who presently after drinking Coffee became worse as to those Affects and suddenly found an unusual Languor in their whole Body THE LONDON PRACTICE OF PHYSICK Contained in the Second Part of the Pharmaceutice Rationalis of Dr. WILLIS THis Second Part of the Pharmaceutice Rationalis is divided into three Sections whereof the First treats of Medicines that regard the Thorax the Second of Medicines that regard the Viscera of the Belly the third of outward Medicines viz. Phlebotomy Vesicatories Issues Cutaneous Affects c. SECT I. Of Medicines that regard the Thorax CHAP. I. Instructions and Prescripts for the Cure of the Phthisick and Consumption of the Lungs WE must observe the divers states of this Disease or the distinctive Marks which belong to it As First when it is meerly a Cough Secondly when it begins to degenerate into a Phthisick or Consumption Thirdly when the Phthisick is consummated or past recovery 1. And First as to a new Cough from what Cause soever it arises it is never free from suspicion of danger if it happens in a Body predispos'd to a Phthisick though in other robust Persons it be not presently to be fear'd For if at any time it be rais'd from some great evident cause and being without a Fever and an indisposition of the whole Body it proves not very troublesome then it is said to be only a cold taken and is either wholly neglected or soon Cur'd without much ado Again if it be accompanied with a small Feaver Thirst and loss of Appetite there is hope that the Blood being restor'd to its due temper the Cough will also cease of its own accord but if drawing in length and not easily submitting to vulgar Remedies it produces much Spitting and that discoloured it ought no longer to be neglected but must be dealt withal with a method of Cure and fit Remedies and an exact Form of Diet For then it may be suspected that the Lungs having receiv'd some prejudice in their Conformation do not transmit the Blood entirely but with a deposition of the Serum or Lympha and often the nutritive Juice and likewise that those humours there deposed do putrify and consequently that by a reciprocal injury they taint the Blood whereby it still offends the Lungs the more 2. But if to a Cough daily growing worse and worse with much and thick Spitting there be added a Languor and falling away of the whole Body a loss of Appetite difficult breathing thirst and a boiling of the Blood there is great cause to suspect that a Phthisick is at least begun if not well advanced Wherefore we must then use all our endeavours both to free the Lungs from the offensive load of matter already gather'd together in them and to fortifie them against the continual Incursion of the same and at the same time to cleanse the Mass of Blood of its dregs and to restore it to a good Crasis whereby it may duly contain its Serosities and other humours within its own texture or convey them to some other place than the Lungs 3. But if beyond the state ev'n now describ'd of this Disease the Spittle daily increases and becomes more discolour'd and all other things still growing worse and worse there be join'd to it a total decay of strength and a Hectick Feaver with a continual thirst Night Sweats a dying Countenance with a falling away of flesh ev'n to the drought of a Skeleton then there is no room left for Physick but only for a sad Prognostick or at least all hope of Cure being laid aside we have nothing left to insist on but Anodines which may help towards an easie death Wherefore according to the said three states of this Disease its method of Cure must be in a threefold manner viz. First we must prescribe what is to be done for Curing a Cough whilst being not entred the limits of a Phthisick it has only the name of a Cold taken Secondly what is proper in a beginning Phthisick Thirdly what is to be done when it is consummated and desperate 1. Men of a tender constitution or such as are inclin'd to a Consumption from their birth or have sometimes formerly been us'd to be endanger'd by a Cough ought immediately as soon as they find it coming to stand on their guard and betake themselves to the Rules of Physick according to which to proceed methodically in a way of Cure the Therapeutick Indications must chiefly be these three 1. To appease or take away the disorder of the Blood whence the Fluxions of the Serum proceed 2. To derive from the Lungs to the Pores of the Skin or Urinary passages and other Emunctories the dreggy Excrements of the Blood and all superfluities apt to depart from it 3. To corroborate the Lungs themselves against the reception of the Serum and other humours and likewise to fortify them against the invasion of outward Cold from which they are wont to receive a farther prejudice We shall speak of each of these a little more at large 1. The first Indication regards both the Effervescency of the Blood in that it grows over hot and boils in its Vessels by reason of the Effluvia's being restrain'd within it as also its dissolution in that being loosen'd in its Texture it lets fall too much the Serum and other Humours from its embraces to remove both a thin form of Dyet must be ordered and the person being careful to avoid all injury from outward Cold a pretty free transpiration must be procur'd or at least the wonted transpiration must be restor'd For these ends let the Patient presently be thicker cloath'd and let him keep himself in Bed or within his Chamber at least let him not go forth of Doors Evenings and Mornings let a gentle Sweat be rais'd by giving him Posset-drink with Rosemary or Sage boil'd in it If notwithstanding the Cough grows worse Bleeding proves often of good effect so his strength and constitution bear it after which Hypnoticks generally do well inasmuch as they retard the motion of the Heart and consequently the overhasty Course of the Blood Moreover they cause it to pass the Vessels of the Lungs gently and with moderation without casting off any great quantity of Serosities and to send forth what is superfluous either by Sweat or by Urine For this purpose also Pectoral Decoctions must be given
of Physick she took only Empirical Remedies with which sometimes the Fits of the Ague were driven away but often presently return'd mean while the Diseas'd being pale unable for motion and wanting Breath continued swol'n and blown up about the Ventricle and Hypochondres About the third Month of her being sick she began to have Gripes and bitter Tortures in her Belly with which shooting sometimes to the Back sometimes to the Stomach she was afflicted almost continually day and night Moreover she was affected with a frequent Vertigo and sometimes with Fits as it were Hysterical Also being troubled with a frequent Vomiting she daily threw up a viscous and froathy Phlegm Within a Months space this Disease passing to its highest pitch rais'd pains in the Back and Loins and so afterward in all the parts of the Body Besides at this time she complain'd of a mighty straitness of her Brest and a great contraction of the Viscera Mean while the habit of the Body fell away to a mighty Leanness so that the Bones being destitute of Flesh scarce stuck to the Skin the Urine was little and very ruddy on the surface of which grew a little thin Film garnish'd with various colours like the Tail of a Peacock A short while after this a Numness and Formication was perceiv'd sometimes in the Belly sometimes in the Limbs and afterward the Gripes and Pains began to remit nevertheless in their stead a Palsey succeeded which within a weeks space so pervaded all the Members of the whole Body that she was not able to bend or any way to stir from its place either Hand or Foot or any other part It is obvious that those severe Symptoms proceeded from a Scorbutick Root for by reason of the taint principally fixt on the Blood the Spontaneous Latssiude the difficult Breathing nay and the intermitting Fever hapning at random and often returning and the Bickerings of other Symptoms previous as it were and light were caus'd Again the Lixivial Urine and that diversified colour of it plainly shew'd the Blood to be seis'd with a Sulphureo-saline Discrasie which kind of Urine I have observ'd to be so mark't in many others affected with the like Disease Moreover when in this sick Lady the Morbid Seminal Root being increast in its store and flowing into the Mass of Blood came to spread it self on the Confines of the Brain and Genus Nervosum the other more violent affects arose This Lady living far hence by the advice of a Neighbouring Physitian took Medicines usual against the Collick which doing no good and the Disease growing worse the Patient being brought to Oxford tryed a great many Remedies both Antiscorbutick and Antiparalyticks almost of every kind and form though without any benefit Since therefore any ordinary Method of healing seem'd not sufficient for this Disease it was thought good to proceed to great Remedies and truly such as were not wholly void of danger Wherefore we gave this sick person as weak and worn away as she was a Mercurial Medicine for raising a Salivation which effect ensued according to our desire for a Flux arising within two days and gently continuing for many days without any ill Symptom gave a very great relief to the noble Lady For the Pains being mitigated she began in some measure to move her Limbs to have a better Stomach and to digest here Food better and to enjoy a quiet Sleep The Salivation being over she took a Decoction of Sarza and China with Antiparalytick Ingredients for a few days Afterward being carried to Bathe and having there us'd the temperate hot Baths for some time she recover'd an indifferent state of Health The whole Winter she constantly took Medicines against the Scurvy and the Palsey And upon her renewing the use of the hot Baths the year following she grew perfectly well and since is become the joyful Mother of many Children A Man forty years of Age of a Melancholick Temperament troubled with the Scurvy for many years is wont to find at various times of the year manifold and diversified Symptoms of it About his Legs spots and large black marks like those caus'd by a stroke appear Belly-achs and a Looseness frequently trouble him his Urine for the most part appears Lixivial a Spontaneous Lassitude a languishing of the Strength a want of Appetite almost constantly attend him besides these ordinary as it were accustomed evils he lives moreover obnoxious to violent Fits of sickness and those of various kinds Above two years since when I first went to see him he sorely complain'd of a difficult Breathing as though he were in danger of being choak't with a Trembling of the Heart failings of the Spirits and a frequent danger of Swooning Moreover of any thing of these passions in the Praecordia a little remitted for the most part he was assail'd with a cruel Scotomia and a Vertigo he seem'd to have perfectly recover'd of these affects after that he had taken for sometime Anticonvulsive Remedies complicated with Antiscorbuticks Butafterwrad within a few weeks he was affected with a Nauseousness and a Heart-burning and with an Inflation of the Hypochondres His Urine was little and very lixivial his Belly swel'd in a short time moreover his Feet and Legs growing mighty oedematous shew'd the marks of an invading Dropsie Afterward the like kind of Tumour seis'd the Thighs also the Flesh of the Back and Arms which affect nevertheless though it seem'd without hope was easily cur'd with Antiscorbutick Remedies Catharticks and Diureticks being join'd with them Notwithstanding this worthy Man though restor'd to his Health did not continue so long For half a year being scarce over he began to complain of a violent Head-ach with a Vertigo and an obstinate Watching afterward without any evident cause he was seis'd with a horrible Vomiting In a short time after the Asthmatick Fits return'd with a trembling of the Heart and failings of the Spirits At this time also when he seem'd almost past hope he recover'd again in a short while by the use of Antiscorbutick Remedies From this case it clearly appears how great evils the Scorbutick Miasm lying hid like a ferment both in the Blood and in the Nervous Juice and displaying its Venom according to occasion may cause Which kinds of affects nevertheless how dreadful and terrible soever they seem so they depend only of the Humours being vitiated in their Crasis and not on the Viscera injur'd in the whole or in their conformation for the most part they are wont to be Cur'd with little ado viz. by an Antiscorbutick Method aptly ordered according to the condition of the Patient as well as of the Disease A Renowned Lady about Twenty five years of Age of a Sanguine Temperament and a thin habit of Body fresh colour'd and handsome had been ill of a Scorbutick Affect of a long time For besides broad Spots and red Pushes breaking forth in divers parts of the Body she had been wont to undergo for a long time
Convulsive Inflation of the Membranous Parts and Viscera by reason of the Animal Spirits being driven into those Fibres in too great a plenty and there hindred from a Recess through the fault of the Nervous Juice obstructing it To which affect a gathering of Winds in the empty places is consequently added for compleating it That we may have timely notice of its beginning we must understand that there are some previous affects which dispose to it as especially a Hypochondriack Colick Hysterick and sometimes an Asthmatick disposition And if after frequent returns of Fits in any of these Distempers a tumour of the Abdomen follows though never so small at first a Tympany is presently to be fear'd A Tympany seldom kills of it self but after it has continued a long time to make more sure work it joyns to it self at length an Ascites as a forerunner of death In order to the Cure of a Tympany as in most other Diseases there are three primary Indications whereof the first and always the most pressing being Curatory endeavours to remove the tumour of the Abdomen by recalling the Animal Spirits from that Convulsive extention and reducing them to order The Second being preservatory keeps those Spirits or others from inordinate excursions into the Nervous Fibres of the Belly and at the same time corrects the faults of the Nervous Liquor accompanying them as to its Crasis or Motion The Third is Vital and by removing the Symptoms that are most pressing relives and upholds as much as may be all the functions that are opprest or weakned The First Indication is always of chiefest moment the whole stress of the Cure consisting in it but it s very difficult to be perform'd For it does not readily occur to us with what remedies or ways of Administration it ought to be attempted Bleeding has no place here but in a manner always is shun'd as hurtful also Catharticks for as much as they irritate the affected Fibres and trouble the Spirits and drive them more violently into those Fibres do rather increase than diminish or Cure the tumour of the Belly So likewise Diaphoreticks force the Spirits together with the Morbifick Particles deeper into those Fibres from which they ought to be summon'd forth and withdrawn The chief means of Cure seems to be plac'd in the use of Diureticks and Glisters and great things are likewise expected from Topicks because they are apply'd more immediately and by contact to the Disease it self and because we see they excellently dissolve or discuss tumours in other places but all dissolvents are not proper here even though in other tumours they are very Medicinable For those that are hot being accounted discussors most commonly rather do hurt than good in a Tympany whether they are us'd as a Fomentation or Liniment or apply'd in the Form of a Cataplasme or Plaister For they both open and dilate the Ductus's of the Fibres so that they lye more open to the Inroads of the Spirits and at the same time rarify the Particles sticking in them so that they coming to occupy a greater space the Inflation and Swelling of the Belly is augmented Lastly as to Alteratives even of those which do good against other affects of the Genus Nervosum only some few are proper in a Tympany for where the Morbifick matter sticking within the strait Ductus's cannot be driven forwards or quite through Elastick Medicines by fastning the matter deeper render the obstruction still greater or more fixt Wherefore the Spirits of Harts-horn Soot Sal Armoniack and so Tinctures Elixirs and other Medicines endowed with a Volatile Salt or Particles otherwise active do not only cause a very troublesome heat and drought in persons troubled with a Tympany but also make the Abdomen swell more because they trouble the Spirits and fuse the Blood and Nervous Juice so that the Particles deposed by each of these are forc'd into the parts affected Nowwithstanding Physick can do so little against this Disease we must not cease to move every stone in order to Cure or give ease to the Patient Therefore in the First place because it is the Custom to begin with Evacuatives though strong Catharticks always do hurt and the more gentle are scarce ever able to carry off the Conjunct Cause yet these latter for as much as they withdraw somewhat of that which feeds the Disease and prepare the way for other Medicines to exert their Energies more freely ought to have their turns in the Practice of Physick viz. once in six or seven days and at other times let Glisters the use of which is much better he frequently Administred Hydroticks being forbidden let moderate Diureticks be diligently plyed to which at the same time let such things be joyn'd which regard the altering and reducing of the Spirits and Humours which truly make up the chiefest part of Pharmacy for a Tympany Moreover in the mean time let not the use of Topicks be neglected We shall set down certain Select Forms of Medicines appropriated to each of these ends For a Medicine gently loosening use the Laxative Wine prescrib'd for a Tympany by the famous Greg. Horstius in the Fourth Book of his Observations Chap. 30. or instread of it let the following be prescrib'd in a shorter Form Take Flowers of Peaches and of Damask Roses of each two Pugils of Broom Elder and the lesser Centory of each a Pugil Leaves of Agrimony and Sea Wormwood of each a handful of the best Sena an Ounce Rhubarb six Drams Carthamus-seeds half an Ounce of Dwarf-elder two Drams yellow Saunders three Drams Galingal Roots two Drams being slic'd and bruis'd sew them up in a Silken Bag and put it in a Glass with two pounds of Whitewine Saxifrage water a pound Salt of Tartar a Dram and a half let them stand for forty eight hours then let the Patient begin to drink it taking about four or six Ounces every third or fourth day In a hotter constitution let the following Form be given which I have sometimes try'd with good success Take of Purging Mineral waters eight pounds Salt of Wormwood two Drams let it evaporate with a gentle Bath-heat to two pounds To this I use to add of water distill'd from Purgers with Wine four Ounces The Dose is from four Ounces to six Or to that Liquor evaporated to two pounds add of the Roots of Mechoacan and Turbith of each half an Ounce Rhubarb six Drams yellow Saunders two Drams Cloves a Dram Let there be a close and warm digestion for two hours filter it warm through lawn paper the Dose is three or four Ounces Glisters are of frequent use in this Disease because they loosen the Belly without any great irritation of the Fibres Take water of the Infusion of Stone-Horse-dung with Cammomile Flowers a pound Honey of Herb Mercury two Ounces After the same manner also let Decoctions or Infusions be prepar'd of Dogs-turd with Carminatives Take of the Emollient Decoction a pound Sal
told him that unless he would abstain from Drink he must die in a short time upon which he promis'd so I could save his Life that he would Drink no more in a Weeks time and was as good as his word for though very Thirsty he scarce took any Liquid thing into him but Physick for six or seven Days And during that time by carefully taking Hydragogue Catharticks and Diureticks and all other things Prescirb'd he grew much better and afterwards a Method as above Prescrib'd being somtime followed he was restor'd to his perfect Health and now lives a sound Man after five years past There remains certain other affects of the Viscera of the Belly of the Remedies of which according to a due Method I should have treated here but I have already perform'd this Task for the greatest part elsewhere for we have deliver'd most of the Medicines that concern the Reins amongst Diureticks and those that concern the Stomach and Intestines among the number of Emeticks and Purgers As for what respect the Spleen and the Womb we have fully set them forth in our Hypochondriack and Histerick Pathology As for what regards the Genital parts and their Diseases and Cure we have thought fit to reserve it for another time and place It concerns us next after having treated hitherto of inward Pharmacy to discourse somwhat of outward Medicines which we shall do in the next Section beginning with the great Remedy Phlebotomy SECT 3. Of Outward Medicines CHAP. I. Of Phlebotomy TO Discourse Methodically of this great Remedy we must first consider how many ways and for what causes and ends an Emission of Blood happens either of its own accord or is indicated by Physick Then Secondly we shall acquaint you with the good and ill effects or with the Advantages and Prejudices of this Evacuation and shall give you likewise certain rules and cautions to be observ'd in the due Administration of Phlebotomy As to the first Spontaneous Eruptions of Blood being manifold and of divers kinds are usually reduc't to these two heads or orders viz. either they are Critical nature endeavouring somthing good and for the Advantage of Health or Symptomatical which happen for the most part when she is put by of her Government and all things are in Confusion The Eruptions of Blood of the first kind are again distinguisht that either they come without a Fever and are either Periodical which often happen at set times as the Menses of Women and in some the Flux of the Haemorrhoides and in others yearly Bleedings at the Nose or otherwise customary which commonly happen upon the great changes of the year or of the Air Or they are erring and uncertain as when the Blood breaks forth for our good from those places and from many others somtimes in this part of the Body somtimes in that Moreover Excretions of Blood somtimes happen in a Fever and often determine it In all these cases the Blood breaks forth because growing Turgid within its Vessels and being very much rarifled it requires a larger space Now the Blood grows thus Turgid on two accounts viz. both as its Liquor is Inflammable and as it is Fermentative 1. As to the First that the Blood may have a due Accension for the preservation of Life and the due performance of its Functions its Innate Sulphureous Particles must be proportion'd to the Nitrous Particles coming to it from the Air Therefore as often as the Blood growing very hot and being highly rarified is much open'd and loosen'd in its Texture so that the Sulphur being at freedom is kindled more than ordinary a quick and toylsome Breathing follows to draw the Nitre also in a fuller measure than usually Now if the abounding Sulphur cannot spend it self after this manner by burning briskly nor the vital flame be thus regulated presently the next course for lessning the fuel of the Sulphur is that some part of the rarified Blood breaks violently forth Hence not only in Fevers but after Drinking Wine Bathing being in the Sun and other Accidents upon which the Blood grows very Turgid either Eruptions of Blood happen of their own accord or it 's often necessary to supply the defect of such Spontancous Evacuation by opening a Vein Secondly the Blood also as it is a Fermentative Liquor is apt to break forth of its Vessels for if at any time some Heterogeneous thing which will not mix with it comes into its Latex it strongly Ferments as Wine in a Hogs-head and boyls in its Vessels to expell that disagreeing substance which seeing it can neither conquer nor send forth by Sweat Urine or other ways the Blood it self throws off some portion of its own substance as a Vehicle to carry forth that matter with it hence divers Eruptions of Blood variously happen both in Fevers and without them which are all rais'd by nature for some good intent though it often happens otherwise through various Accidents and Circumstances but for the most part there is a failing in Spontaneous Haemorrhagies critically intended either First because the Blood in boyling knows no measure in flowing forth or Secondly because the mouths of the Vessels being once open'd do not presently close or cannot presently be shut or Thirdly because nature endeavouring an Excretion of Blood does it by places which are most open though often improper as when it happens by the Lungs Reins Intestines and other Viscera which therefore from being critical becomes Symptomatical and often Malignant Nor only these ways but likewise for many other Failures or Impediments of nature Symptomaticall Haemorrhagies happen in all which either the Blood it self or the Vessels containing or both of them together are alwarys chiefly in the fault First the Blood besides the ways above mention'd is apt to extravasate when its Latex being some way corrupted is not able to retain its due mixture but being apt to coagulate or putrifie runs Into parts whereof some break forth into Wheals or Pushes or shew themselves in Spots others plainly make Bloody Eruptions where they can first find a Vent as it 's generally seen in the Plague Small-pox Meazles and in Malignant Fevers and in some measure in Scorbutick Affects Secondly The Vessels conveying the Blood are many ways the cause of its Symptomatical Eruption as first if some of them are in any place obstructed as often as the Blood is put in a Rapid Motion it 's forc't to burst forth either there or near the place and somtimes also in parts far distant from it hence upon a suppression of the Menses or Haemorrhoides a Bleeding at the Nose often follows Secondly the little Mouths of the Vessels have somtimes al ill Conformation for that the fleshy Fibres with which they are guarded are grown Lax or resolv'd so that when the ends of the Arteries gape too much the Mouths of the Veins close by reason of this affect Scorbuticall and Cachectical persons are very subject to Eruptions of Blood Thirdly It oftens
Praecordia threatens a sudden Destruction the best way not only of a general Evacuation but likewise for a Revulsion is to let forth the Blood in a full current by opening a Vein in the Arm with a large Incision But if without any great Plethora the Blood be to be Evacuated from the whole Body and to be withdrawn from the Superiour Region of the Body to the Inferiour as in suppressions of the Menses or Haemorrhoids it 's more propper to draw Blood from the Foot or from the Haemorhoid Veins by Leeches And if after an Evacuation of Blood from the whole it must also be deriv'd from some particular place where it is gathered together let it be taken near the place affected Hence in Cephalick Diseases we open the Vein of the Forehead Temples or Thorat To Cure Tumors and Pains hapning in the Joynts we either open a Vein beneath or near them or draw froth the Blood by applying Cupping-glasses or Leeches there And so in affects of the Thorax and of the Belly either Cupping-glasses are apply'd to the Region Distempered or Leeches to the Vessells of the Fundament As to what is said that some Vessels have a peculiar respect to some of the Viscera in particular as the outward Vein of the Arm to the Head the inward to the Liver c. All this is a meer vnlgar errour grounded on no reason or Anatomical observation Therefore assoon as it is agreed on for opening a Vein and of the place make choice of some large Vessel and very fair to the sight that it may be more easily open'd and let it not have any Artery Nerve and Tendon near it that it may be Lanced more securely Wherefore the middle Vein of the Arm is most commonly made choice of though the Exteriour call'd the Cephalick be more safe being less crowded with other Vessels The Jugular Vein so generally open'd in Beasts is most safely and easily lanc't and is as proper as any other what soever for a general Evacuation of Blood from the whole Body besides its excellent Derivation from the Head If you open the Vein above or near the Ancle you must take a mighty care lest you hurt the Tendon which sometimes happens through the unskillfulness or rashness or Chirurgeons to the great prejudice of the Patient Moreover you must take care of opening a Vein near its Anastomosis with an Artery For if this be done the Blood springs forth violently all of a Scarlet colour and its stream is not easily stopt nor the Orifice of the Vessel soon clos'd As to the ways or Instruments with which Blood is drawn forth it 's done either by opening a Vein with a Lancet or by Suction with Leeches or by Cupping-glasses after Scarification It 's known by sad experience that in Lancing a Vein sometimes an Artery is prickt whence either Death or a cutting off of the Member sometimes follows the reason is that an Artery ought incessantly to vibrate and beat in like manner as the Heart it self its Fibres iterating the perpetual charges of Systole's and Diastole's wherefore a hole made in its Ductus becomes as it were incurable by reason of the continual Motion of the Vessel and the Efflux of Blood It is far otherwise in a Vein whose Aperture presently closes again of its own accord there being little stress of contraction lay'd on its Tunicles and indeed only so that its Fibres being a little dilated on occasion the Blood flowing back may be gently driven forwards If at any time a Physician of Patient are fearful of opening a Vein an Extraction of Blood by Leeches or Cupping-glasses with Scarification will aptly enough supply its defect and often with the like Advantage nay these Administrations for removing the Conjunct cause of a Disease where there is need rather of a Partial Derivation or Evacuation than a general one are often preferr'd to Phlebotomy The due season for letting Blood is often of so great moment that whereas this Evacuation does good at one time at another it proves mighty prejudicial There are various respects of times to be considered concerning Bleeding but chiefly these four viz. the time of the Disease Age Year and Day the First of these chiefly concerns the Cure of the Patient and the rest his Preservation First therefore if we ought to let Blood in any Disease the fittest time for it will be about the beginning of it or in its encrease but not at all or very cautiously in its height or Declination For in the former whilst nature endeavouring a Crisis is extreamly busied so that the Spirits labour mightily and the Blood ferments very much that its last effort ought not to be disturb'd and when a Disease is upon remitting either nature being conqueress does not stand in need of that Aid or belng conquered will not bear such Evacuation Secondly if at any time we deliberate of Bleeding for prevention Infants Children and aged Persons are exempted from it by the general Practice of all Nations This Evacuation also heretofore was forbidden to Women with Cnild but now it 's very ordinarily prescrib'd Men of a strong Constitution and of a middle Age herr Bleeding well encugh and want it very often but ought not to admit it the first and second time without great occasion for once begun and then repeated it soon passes into an Inevitable custom Hence those who use to Bleed Spring and Fall cannot afterwards omit this Evacuation without danger But those for whom it is good or necessary to be let Blood once or twice a Year the most seasonable times for it will be about the beginning of the Spring and Autumn when the Blood being apt to Ferment anew is in danger of changing its Crasts Bleeding in season prevents the exaltation of the Sulphur and Salts and consequently keeps the Blood from any Feverish Scorbutick or otherwise vitious Distemper And likewise from susing it self and pouring its Serous and other dreggy Excrements on the Brain Lungs or Viscera of the Belly About the Solstices when our Bodies are very cold or hot the Blood â—as also the Juices of all Vegetables being in a fixt State and unapt for any Turgid Motion ought not to be let forth unless some urgent cause requires it 3. Whereas some religiously or rather ridiculously observe in Bleeding the Position of the Heavens and the Aspects of the Moon and Stars it 's altogether Frivolous 4. As to the time of the Day in Acute Diseaes when immediate Bleeding is indicated a Physician being call'd after the Body is prepar'd may order that operation at any hour of the Day or Night But if there be room for delay then it 's more proper to Bleed rather in a Morning when the Stomack is fasting and the Vessels are emptyed by the Night Perspiration so that the current of the Blood is then in a very great Calm and free from Serous Excrements Nay though necessicy presses let it be delay'd a little till the fresh
from the blood as disagreeing with it and partly being sent from the Arteries into the Ventricle stirr'd up its ferment and so produc'd hunger and partly rush'd into the predispos'd Meninges of the Brain and there depos'd the fuel or rather incentive of the Head-ach which was presently to ensue This Patient loathing all Medicines and refusing undergo any method of Cure became at length also obnoxious to paralitical and convulsive affects From what is said it will be easie to give the Aetiology of any other Head-ach viz. hypochondriacal hepatical or otherwise sympithical so that it will not be needful to add here more Hystories or Observations CHAP. II. Instructions and Prescripts for curing the Lethargy HItherto we have described with what Disease chiefly and how diversly the precincts of the Head or the Coverings of the Brain are wont to be affected Now descending to its inward Parts and to its cortical Substance which immediately lyes under those Coverings let us see to what affects chiefly this Part is found to be obnoxious We have shewn elsewhere that the Cortex of the Brain is the Seat of Memory and the Entry of Sleep wherefore we justly ascribe to the cortical part of the Brain that Disease which is wont to cause an excess of Sleep and a defect or eclipse of the Memory to wit the Lethargy The word Lethargy is wont to signifie two kinds of affects which are only the act and disposition of this Disease for those that are said to be troubled with a Lethargy either altogether keeping their Beds through a very great Invasion of it are so far overwhelm'd with Sleep that they are scarce able to be rais'd by any impression of a sensible Object nay and if hapy they open their Eyes or raise their Limbs upon pricking or a smart stroak presently becoming insensible again they sink down and often when they are left to themselves falling into a perpetual Sleep they dye out right which kind of Fit has very often a Fever joyn'd with it though when the diseased awake and come perfectly to themselves for the most part it ceases of its own accord Or secondly those are accounted for Lethargical who being opprest with an immoderate deadness of the Senses are in a manner always prone to sleep so that in walking nay whilst they are eating or doing any other thing they now and then fall into a dead Sleep and since there are divers degrees of this Sleepiness and various manners of affecting hence also there are made many Species of the Lethargick Disposition at present we shall speak of the former Lethargy and so properly called and afterward of the continual Sleepiness also of the Coma Carus and other sleepy affects allyed to them and likewise of continual Watching Mean while you may observe that almost in every kind of Lethargy a Drowsiness or Sleepiness and Forgetfulness are always present as Pathognomick Signs and equally attend it Wherefore that the formal Nature and Causes of the Lethargy may the better be known We must first enquire here concerning Sleep and Oblivion what they are and for what causes they are rais'd The Essence of Sleep consists in this that the corporeal Soul withdrawing it self a little and contracting the Sphere of its Irradiation in the first place renders destitute the outward part of the Brain or its Cortex and then all the outward Organs of Sense and Motion of the Emanation of the Spirits and closes the Doors as it were so that they being called in for refreshment sake lye down and indulge themselves to rest mean while the pores and passages of the outward part of the Brain being free and void of the Excursions of the Spirits afford a passage to the Nervous Liquor distilled from the Blood for new Stores of Spirits In natural and usuall Sleep these two concauses conspire and happen together as it were by some mutual compact of Nature viz. at the same time the Spirits recede and that nervous Humour enters but in nonnatural or extraordinary Sleep sometimes this cause sometimes that is first for either the Spirits being weary or called away withdraw themselves first and afford an entrance to the Nervous humour heaped together in a readiness for it or a plenty of Nervous humour coming to those Places and making a way by force as it were repells the Spirits and entring their Passages floats them as it were Concerning Oblivion or the Eclips or defect of Memory the cause of this is wholly the same as of immoderate Sleep viz. an Exclusion of the animal Spirits from the passages of the outward part of the Brain which are filled with some Humour and their return prohibited for a time Preternatural Sleep or insatiable Sleepiness which is the chief Symptom in the Lethargy and in the sleepy Effects seems to arise wholly from the same causes as non-natural Sleep rais'd to a greater Energy viz. either the animal Spirits being first affected leave the outward part of the Brain and yeild an entrance not only to the Nervous but likewise to the Serous or otherwise vitious Humour or the serous and excrementitious Humours together with the Nervous force open the cortical Gates of the Brain and floating as it were its Pores and Passages repell and drive away the Spirits thence sometimes this Cause sometimes that is the first and chief and sometimes both happen together Therefore the conjunct Causes of the Lethargy are 1. a heaping together of a redundant or incongruous Humour within the Pores of the cortical part of the Brain which depends on other both procatarctick and evident causes As to the former both the Blood uses to be in fault in that it sends morbifick matter to the Part affected and the Brain it self in that it admits it too easily The evident causes which joyn with these are chiefly Over-eating Drunkenness and especially immoderate drinking of Wine and hot Waters then upon such an Excess to sit up all night or to sleep in the open Air Moreover a long suppression of an usual evacuation of Serum by other ways Also if Spaw-waters drank in a large quantity are not presently discharg'd again by Urine they threaten a Lethargy the same also is caused by the recrements of other Diseases coming to an ill or no Crisis convey'd to the Head so that a Lethargy happens upon acute or long continued Fevers and other Cronick Diseases and very often upon a Head-ach Frensie Empyema and Cholick 2. In regard as non-natural so sometimes preternatural sleep begins from the Spirits being first dejected therefore the other Conjunct cause of the Lethargy consists in a stupefaction inflicted on the Spirits which proceeds either from Opiats taken inwardly or from narcotick particles engendred in the Body The sum of what is said concerning the Lethargy is this that the animal Spirits residing in the outward part of the Brain being stop'd from their wonted motion and emanation yield to a profound and insatiable Sleep Now they are stop'd either
frequent access of it often begets a disposition to a Carus Apoplexy or Palsey This affect as often as it seems safe does not require a Cure for the Fit soon and easily passes off but because some whose Brain is weak and lax and whose animal Spirits being too dissipable are apt to a flight and confusion being troubled on any light occasion are wont presently to act or speak delirously therefore there is need of Physick for these tho not of Hellebore but of Cephalick Remedies for corroborating the Brain and fortifying it against the incursions of the morbifick Matter also for strengthning the animal Spirits and rendring them more fixt and stronger to resist We have given the Forms and wayes of Administration of these Medicines before they being profitable for removing the Procatarxis of any other Cephalick Disease A Delirium hapning upon continual and malignant Fevers requires a peculiar way of cure for it particularly indicates that the morbifick matter dangerously convey'd toward the Head ought to be revuls'd thence some way or other for which end let Vesicatories be applied to the Neck Plaisters or Cataplasms or the Flesh or warm Viscera of Animals to the Feet Inwardly let Temperate Cephalicks be given as Powders of Coral and Pearl the Waters of Black Cherries of the flowers of Cowslips and Poppies and other things refreshing and soothing the Spirits These things being thus premitted concerning the first and lightest manner of Raving let us ascend to a higher degree of it viz. the Frenzy which is far greater and more durable than the former affect In a Delirium the perturbation rais'd in the Spirits residing in the Brain seems like an undulation of Waters in a River upon throwing in a stone but in a Phrensy their commotion seems as the troublous motion of the Sea-waves raging upon a tempest The Phrensy is defin'd That it is a continual raving or a depravation of the chief faculties of the Brain arising from an inflammation of the Meninges with a continual Fever With this Disease another allied to it is rank'd viz. the Paraphrenesis and its cause is said to be not the Inflammation of the Membranes that cover the Brain but of the Diaphragm moreover in both affects the Fever as tho it were only symptomatical is said as also in the Pleurisie tho falsely to arise from the same Conjunct Cause viz. a Phlegmon of some Part but that the Phrensy rather succeeds the Fever both Hippocrates heretofore and now every Vulgar Person observes and that it is produc'd because the boyling Blood conveys its adust recrements to the Head viz. forasmuch as the Urine of a Feverish Person being changed from being troubled and thick to be thin and watery indicates an imminent Phrensy of which affect therefore the cause is gathered to be the removal of the febrile matter into the Brain But as to the Conjunct Causes of the Phrensy and Paraphrenitis it will be easie to shew that the former does not alwayes proceed from the inflammation of the Meninges and the latter never from that of the Septum in Anatomical Diffections I have commonly seen the Meninges nay sometimes also the outward circumference of the Brain beset with a Phlegmonous tumour but the diseas'd being not affected with a Phrensy but on the contrary with a drowsiness dyed of a Carus or other sleepy diseases And indeed Reason plainly dictates the thing to be thus for inflam'd Meninges and much more swollen greatly compress the Brain and stop the passages of the Spirits which causes a Lethargy whereas in a Phrensy the Spirits are dilated above measure the Pores of the Brain being all open'd tho it may happen by a long continuance of that Disease that the Blood being heaped together too much within the Veslels of the Meninges and there stagnating at length begets a Phlegmon in them but then we suspect for that cause by reason it frequently falls out so that the Phrensy passes into a Carus or Lethargy of which such as have the Phrensy often dye Nor do we less reject the inflammation of the Diaphragm which Galen with others have assign'd for the cause of the Paraphrenitis Anatomical observations plainly make out the contrary some time since opening the Body of a Girl dying of a sudden Leipothymia we found in the fleshy part of the Diaphragm a great Abscess with a bagg full of a gore and little bladders of Water yet she was never wont to be troubled with a delirium or phrensy And heretofore when we dissected the Body of a Renowned Person of the University who dyed of a bastard and long continued Pleurisie it manifestly appear'd that a great Abscess in the Pleura and intercostal Muscles being suppurated and broken inwardly had pour'd a mighty quantity of Pus into the cavity of the Thorax which corroding the subjacent Diaphragm had made a mighty hole in it and yet this Person in all his sickness had neither the Phrensy nor was delirous wherefore I judge that this affect is scarce ever produced by such a Cause but that opinion seems to have risen thence that oftentimes in a true Phrensy together with a continual Raving the motion of the Diaphragm is wont to be hindred or perverted as may be gathered from the uneven and difficult Respiration viz. sometimes being painful and suspended as it were sometimes thick and swiftly repeated with an Inspiration sometimes doubled which kind of symptoms and withall the alienation of the mind are said to proceed from the Septum being inflamed and therefore convuls'd wherefore the Ancients called the Diaphragm Phrenas tho they need not have done it if they had considered that all the action of the Diaphragm depends on the efflux of the animal Spirits from the Cerebellum and therefore if when the Phrenetick matter invades the Brain some part of it withall rushes into the Cerebellum besides the raving the motion also of the Septum tho in it self being without fault will be altered Therefore the formal nature of the Phrensy seems to consist in this that the animal Spirits being very much irritated chiefly in the whole brain are driven into disorderly very confused and withall impetuous Motions so that the acts of every animal Function are depraved and variously perverted the Ideas of things are confounded c. Moreover the Spirits not only in the Brain but likewise in the Cerebellum and every where in the Genus Nervosum being struck as it were with a rage fall in a tumult wherefore such as have the Phrensy do not only speak ravingly but breath unevenly cry out beat their Fists throw their Hands and Feet and exert all their Members with a mighty strength and force that really the whole Soul seems furiously to fret and rage in the whole Body or rather being set on fire as it were to be all in a flame and indeed the Phrensy cannot be more aptly defin'd than that it is a Phlogosis or inflammation of the whole sensitive Soul or of the animal
with the Juice irrigating the Brain is wont to arise after various manners and for divers causes but for the most part that affect as we have observed in Melancholy begins either from the Spirits themselves or from the Blood 1. A madness beginning from the Spirits sometimes arises from a solemn evident cause as from a violent Passion sometimes also it proceeds from a Procatarxis laid in the Brain as when it happens upon Melancholy or a Frensy Let us confer a little the Cases Reasons and the various wayes of the coming to pass of both 1. As to the former when a vehement Passion turns any one from his right mind that so happens to be done either because the Animal Spirits are too much cast down and driven into confusion or because they are raised above measure and endeavour to expand themselves beyond their Sphere 1. The Spirits are wont to be cast down by a violent and terrible Passion so it many times happens that some upon areal or imaginary seeing of a Ghost presently being struch with a pannick terour fall into a perpetual madness Moreover some by reason of some great disgrace or reproach others by reason of the hope of an excessive Love being frustrated on a sudden and unexpectedly and others by reason of Vows rashly broken and their Conscience being violated first being mightily disturbed in Mind become shortly after mad the reason whereof is that the animal spirits being driven out of their ranks and usual Passages and put in a Confusion frame new and bye wayes for themselves which entring they presently form delirous Phantasms mean while the sline Partcles of the nervous Juice fall from their volatility the spirituous being depress'd and coming to flow take to them the sulphureous Corpuscles sent from the Blood into the Brain being then weak and open whence this Liquour presently becomes most sharp like Aqua fortis and the animal Spirits exorbitant and very much troubled Secondly the animal Spirits sometimes whilst they are raised too much almost after the like manner bring both to themselves and the nervous Juice a Disposition to Madness hence Ambition Pride and Emulation have made some run and the reason whereof is that whilst the coproreal Soul swelling through the Opinion and Pride of its own excellency raises and endeavours to expand it self every way as far as may be beyond the limits of the Body the animal Spirits tumultuarily call'd into the Brian are not able to be contain'd within their wonted Treacts but being there refracted and diversly reflected by reason of their too great exertion are forc'd into new and wholly devious Tracts wherefore both themselves being disturbed from the course of their proper Emanation and the nervous Liquour soon acquire a sharp and irritating disposition and consequently a madness ensues So far of Madness raised by reason of a solemn evident cause alone but this disease also arises often by reason of a Procatarxis praeexisting in the Brain and chiefly by reason of a preceding Melancholy or Phrensy in that the animal Spirits being exalted a little too much with the nervous Juice and in this being a little too much depress'd acquire the Disposition to madness 2. The Disposition to madness no less frequently has its roots in the mass of Blood and at length is produc'd into act to wit when the Blood being mightily depraved and nitrosulphureous either perverts the nervous Liquour together with the animal Spirits or furnishes such as are evil which kind of taint of the Blood is eiter hereditary or acquir'd First it s a common observation that men born of Parents that are sometimes wont to be mad will be obnoxious to the same disease and tho often they have lived prudently and soberly above thirty or forty years yet afterward without any occasion or evident cause will fall mad The reason whereof is that the Blood at that time being fallen from its due crasis by degrees to be nitrosulphureous furnishes the Brain with animal Spirits and a nervous Juice of a most sharp Nature We heave formerly shewn that the Elementary Particles in our Body persist during Life separately from those that are scondary supplyed by Nutrition and that they have times of their Crudity Maturity and Decay wherefore we judge also that the morbid Seminia come to a ripeness also according to the periods of ages Moreover we observe that often these mobid Fruits being ripend continue a good while or during Life and that sometimes they wither away again as it were of their own accord and then that afterward after some tract of time new Fruits spring forth again from the miasm left behind and rises by degrees to their height wherefore an hereditary Madness sometimes is continual sometimes interrmittent and its Fits sometimes are wont to return after shorter intervals sometimes after longer 2. As the Procatarxis of the Mania sticking in the Blood is often innate or originally in it so the same sometimes is engendred by degrees either by an ill form of dyet or by a suppression of solemn Evacuations by reason of a precedent Feaver or for other causes and at length being brought to a maturity breaks forth into a madness It 's usual in a great dearth for certain poor People who are forc'd to love only on disagreeing Food or such as is of an ill digestion at first to become sad with a staring and wan aspect and in a short time after to turn mad the Flux of the Hemorrhoids or Menses being restrained or malignant Ulcers supprest dispose towards this Disease Moreover those who originally or acquiredly are of an eager Temperament an extravagant Behaviour and an earnest Countenance because of being nigh to a nitrosulphureous Disposition of the Blood are in danger of falling mad upon some strong evident cause 3. Venemous Ferments insinuated into the Blood and nervous Juice as especially from the biting of Animals that are mad or by the taking of some venemous things are wont to cause Madness Concerning the reason of the former we have elsewhere proposed our Conjectures Of late a noble Lady and worthy of Credit related to me of her own Knowledge that a certain Gentleman after having eaten at Dinner the tender Leaves of Wolf-bane in a Sallet with other Herbs found himself ill in the Evening and complaining of a great agitation and restlessness of his Blood and Spirits entreated his Friends that a Chirurgeon might be called to open a Vein and said that otherwise he should presently run mad which indeed happned as he said for before he could be let blood falling mad he dyed within the space of twenty four hours which deadly affect hapned so on a sudden in as much as the Poyson did not only pervert both the Blood and animal Spirits as to their Crasis but by its malign Ferment presently subverted them utterly The reason why mad Persons are bold and very confident so that they flye no dangers and set upon the most difficult of things is that
the animal Spirits being very exorbitant and vehemently moved both fortifie the Imagination that no Object seems greater or more terrible to it than usual and actuate the Praecordia with Vigour so that they strongly and swiftly convery the Blood and briskly drive it into the outmost bounds of the Body In this affect the Soul strives to outgoe and to springit self as it were beyond the circumference of the Body and so making an effort every way it bears it self undaunted against any incursions of exteriour things 2. The Reason why mad Persons are strong to a miracle is that Particles as it were nitrosulphureous or otherwise very sharp or as it were Stygian ar contained in their Blood and nervous Juice whence the animal Spirits excell in a stupendous and incredible elastick or explosive force far above the natural 3. It is to be observed that mad Persons are hardly ever wearied for tho by raging and striving they strongly exercise their Limbs for many dayes and Nights and in the mean while live without eating and sleeping they scarce at all faulter nor desist from their strugling through a failure of Strength which doubless so happens for as much as the animal Spirits tho very movable and elastick yet are not volatile and easily dissipable but by reason of the saline Particles depress'd from their volatility into a flowing state and being combin'd with the sulphureous ones become firm and fixt and therefore hold out veryling in their Activity 4. Almost for the same reason many Persons how much soever they suffer or are afflicted are not hurt but endure Cold Heat Watchings Fastings Stripes and Wounds without any sensible dammage because the Spirits being strong and fixt do not faulter nor flye away Moreover the Blood having got a nitrosulphureous dyscrasy is incapable of any other change wherefore tho insensible transpiration be stopt and other solemn evacuations are supprest or supplyes of te nutritive Juice are deny'd neither a Catarrh nor Feaver nor an Atrophia or Cacochymia lightly ensue upon Madness for in this affect tho the Particles of the Blood are grown very turgid yet by reason of the store of Salt they do not take to a feverish Flame As to the prognostick of Madness since the affected are never obnoxious to a Fever nor to oter Diseases besides nor are easily hurt by outward Accidents it is not a mortal Disease of it self but is very of Cure because a great alteration is to be made in the Blood and Spirits and the Diseased are refractory to any method of Cure being Enemies both to the Physicians and themselves If the Madness be inveterate or hereditary or be caus'd by the bite of a mad Dog it admits of a perfect Cure with difficulty or not at all that which is rais'd through some occasion whether it be from an evident cause alone or comes upon a Fever also on which the Itch Small Pox Hemorrhoids or Varix's happen is more easily Cured Those that are obnoxious to this Disease at times are very much in danger about the Summer Solstice or in the Dog days also in great changes of the Air as when long colds or heats are changed into opposite constitutions of the Heavens Since there are two kinds of Madness to with a continual and intermittent one the method of Curing also ought to be twofold 1. The Therapeutick method to be used in a continual Mania suggests to us the three primary Indications so vulgarly known viz. the first Curatory which regarding the Disease if self endeavours to correct or appease the furies and exorbitancies of the Aniaml Spirits The second preservatory which levelling at the causes of the Disease undertakes to remove or amend the sharp and nitrosulphureous Dyserasies of the Blood and the Nervous juice and the Stygian disposition as it were of the Spirit The third Vital which directs such a way of Dyet and resumptive nourishment that both the nutritive and vital functions may be able to be carried on and maintain'd as is barely necessary in this Disease The first Indication viz. Curatory requires Discipline viz. threats bindings or stripes as well as Physick and therefore the mad Person being put into a House fit for that purpose let him be so managed both by the Physician and prudent attendants that he be kept in a manner always in his due behaviour and in meet gestures and motions either by advice chiding or by punishments now and then inflicted on him and indeed there is nothing more efficacious or necessary for curing mad Persons than that they always dread and stand in awe of certain Tortures as it were for by this means the Corporeal Soul being somewhat deprest and restrained is forced to remit of its haughtiness and exorbitancy and therefore afterward grows mild by degrees and is reduced to order Wherefore mad men are sometimes sooner and more certainly cured by punishments and tortures in a pent up room than by Physick or Medicines But withal such a course of Physick also ought to be us'd which may restrain and bring down the haughtiness of the Corporeal Soul Wherefore in this Disease Blooding Vomitories and Catharticks how strong soever they are and given at rovers and boldly very often do good Which indeed manisestly apperars because Empyricks only with this kind of Physick together with governanace and a severe discipline often successfully cure Mad-men Tho this rough way of handling does not so well agree with all mad persons but chiefly with such as are raving mad oters being more remissly mad are often cured by fair usage and gentle Medicines But in most mad persons it is both the common voice and general practice to bleed plentifully about the beginning of the Disease and indeed it will be good now and then to repeat it as far as the strength will bear and sometimes to perform the operation in the Arm sometimes in the Jugular Vein Forehead or Foot and sometimes to open the Hemorrhoid Vessels by Leeches For these evacuations being seasonably made both the exorbitancies of the Spirits and te haughtiness of the Soul are excellently supprest and likewise the Dyscrasies of the Blood are corrected in regard that a new and more mild springs up in the place of that which was taken away being sharp and corrosive That Vomits also do great good in curing mad persons it is past even into a Proverb so that all Hellebore nay all Anticyra is assign'd to them After what manner Emeticks often do good in Cephalick Diseases we have shewn before Quacks in this case giving a large dose of Stibium tho it be rashly and dangerously yet have often success In truth Chymical things best agree here both because they move more powerfull and because the Disased may be deceived more easily by them Take sulphur of Antimony from eight grains to ten Cream of Tartar half a scruple mix them by grinding them together make a Powder let it be given in a spoonful of Panada or if it must be
or seven accesses of which her strength was so cast down that she was not able to rise from her bed or scarce to be rais'd up in it nor could she take ever so little food tho very thin but it caus'd great disturbances in her Stomach Moreover the Region of the Stomach and of the left hypochondre was all beset with a hard Tumour and violently paining By reason of the strength being extremely cast down there was no place here for evacuation besides the use of Clysters and the Stomach being mighty weak refus'd all other Remedies unless they were pleasing and in a small quantity In this difficult case and pent up within narrow limits of Curing I advis'd these few things viz. that she should take twice a day this mixture viz. Magistral water of Earth-worms two ounces Elixir Prprietatis six drops moreover I ordered a fomentation to be apply'd to the Stomach of the Leaves of Pontick Wormwood Centory Southernwood boyl'd in White-wine with the roots of Gentian the Vessel covered and that after the somentation a toast dipt in the same Liquor should be worn on the Stomach besides I had febrifuge Epithems bound to her Wrists and by these Remedies alone on the third day she mist her Fit and continued free from the same afterward and then by the use of Chalibeat Remedies she grew perfectly well within a short time CHAP. VI. Of the Quartan Fever or Ague IN a Quartan Fever the time for the return of the Fit is longer than in the rest it being extended to the fourth day inclusively and it 's wont to be of longer continuance and more difficultly cured for this Disease is protracted for many Months and often Years and seldom or searce at all yields to Medicines The Fit for the most part begins with cold and a shaking which are followed with a pretty troublesome heat but more remiss than in a Tertian Sweat for the most part concludes the access If the Disease sticks long it brings the Scorbutick or hypochondriack affect and involves men in an unhealthy habit of body The Causes which dispose to this Disesse are first the constitution of the Air and of the Season for the time of Autumn is always proper for this affect that you shall seldom observe a Quartan Fever to arise but about the Fall also in certain places especially about the Sea-coast this affect is wont to be endemious seizing any that live there or come thither as strangers for this also makes a declining age also a melancholy temperament and which by reason of an ill form of Diet is obnoxious to the hypochondriack affect moreover Fevers of another kind that are of a long continuance and Chronick Diseases often pass into a Quartan Fever These things being confidered it seems that it must be said that a Quartan Fever even as other Intermittents depends on the vitious disposition of the Blood for the nutritive Juyce conveyed by degrees into the Vessels is perverted into a fermentative Matter and the effervescency of this heapt together to a plenitude of turgescency makes the Fit of a Quartan Fever But since in this Fever there are some things peculiar from the rest we must enquire what sort of dyscrasie of the Blood there is in this Disease distinct from the rest and after what manner it raises the most observable Symptoms I say therefore that in this Disease the Liquor of the Blood has pass'd from its sweet spirituous and balsamick nature to be acid and somewhat austere like Wine turning sour That is to say there is a scarcity of Spirits and the earthly or tartarous part which consists chiefly of Earth and Salt is exalted too much and being raised to a flowing brings a sourness to the mass of Blood the Blood degenerated after this manner from its native Disposition does not duely concoct and assimilate to it self the nutritive Juice but perverts it into an extraneous matter wherewith when it is saturated to a sulness in the Vessels and the nervous parts are irrigated with the Juice thence arising there follows a flowing and as it were a spontaeous Esfervescence of this Matter whereby the feverish access is wont to be caused with a shaking and a heat as in a Tertian In a Quartan Fever the returns have longer Intervals because the Discrasy of the Blood being toward an acid and therefore less smart and hot it perverts the nutritive Juice without a contest and tumult wherefore somewhat of it is assimilated and the depravation of the rest does not recede so far from its natural state as in a Tertian and hence its heaping together to a plenitude is slower and it rises to a Turgesency in about as much time again and a half as in a Tertian The reason why this Disease is of so difficult a cure and so obstinately infests the Diseased is the melancholy Constitution of the Blood which is nor easily removed and yields scarce to any Medicines for there being in it a scarcity and defect of Spirits and the Salt and Tartar being too much exalted as when Wines turn sour it is extream hard to restore it and it is in a manner of the same labour and difficulty as to renew the vinous Spirit and Vigour in Vinegar because for restoring the Blood depraved after that manner there is need that its whole mass be volatiz'd and that it spiritualises as it were anew Wherefore in this case evacuatives do not the least good nay by depauperating the Blood more without remedying it they often impair the Strength but there is need of those things which may exalt and volatise that which is fixt and may promote a Pneumatosis in the whole mass of Blood thence it is that in this disease the change of the Air and of the Soil most commonly give relief before any other Remedies whatsoever For Quartan Fevers arising about Autumn are often cured by the following Spring which doubtless happens because the changed quality of the Air is wont to alter the evil habit of the Blood for the better and for the same reason the change also of the place of aboad most commonly cures this Affect when it will not yield to any Medicine The Autumnal Season is most proper to produce this severish habit of the Blood because when very much of Spirit and Sulphur has past away by the Summer heat and that which remains begins to be prest upon by the Cold the Liquor of the Blood as Wine turning sour after too much Effervesence easily degenerates into a pontick and sharpish Nature this also is provur'd by the Air of the Sea infecting the Blood with saline Vapours which fix the Spirits Moreover the affinity of this Disease which the Scurvy and the Hypochondrial affect plainly shews that the evil Disposition of the Blood is in fault whereby it is become salt and earthy with a defect of a Pneumatosis The last year towards the end of the Summer which had been very hot an Epidemick Fever arose then
look upon Simple Sinochi as free yet we assert them to be seldom touch'd with this Taint but most commonly the Fever which gives marks of a pestilent Nature or Malignity is such as imitates the Type of that we call a Putrid Fever for since in these Fevers besides the Phoenomena of a Virulency we observe a continued Effervescence of the Blood which as in Putrids passes through the Stages of a Beginning Increase Height and Declination we justly conclude that the sulphureous part of the Blood here is heated and kindled and by its burning brings the Fever wherefore in these kinds of Fevers two things are chiefly to be noted to wit the Effervescence of the Blood and a Malignity joyn'd with it of which sometimes this sometimes that excells and in both there is a great Latitude and there are many Degrees of Intension according as the Fever becomes more or less acute or malignant The Effervescence happens after the same manner as it is said before of putrid Fevers to wit the sulphureous part of the Blood growing hot above measure by its fervour takes to a Flame as it were whilst it burns it heaps together a vast Store of adust Matter in the Blood on the subduing and exclusion of which after the wonted manner of Fevers the height and Crisis depend but besides the Blood being infected with a certain venemous Miasm begins in burning by reason of the malignant Ferment to be coagulated and to putrifie by Parts wherefore besides the usual Symptoms of a vulgar Fever by Reason of certain Portions of the Blood being congealed or mortified a Fainting and Dejection of the Spirits also Appearances of Spots and Marks ensue Moreover the Venemous Effluvia which part from the Diseas'd by the force of the Contagion are able to stir up the like Affect in others wherefore by reason of the Destruction and Contagion and the various Degrees of the same it is call'd a Pestilential or Malignant Fever When the Blood boyling over vehemently is infected also with a malignant and venemous Ferment not only Coagulations of its own Mass with a Disposition to a Putrefaction are caus'd but the nervous Liquor also readily contracts this Taint whence being rendred disproportionate to the Brain and for the oeconomy of the animal Spirits it stirs up great Irregularities in them wherefore not only Spots and Pushes but oftentimes a Delirium Frenzy drowsie Affects Tremblings of the Limbs Cramps and convulsive Motions happen upon these Fevers We often observe that in certain Years malignant Fevers are rife which without an appearance of Marks shew their Virulency chiefly about the Genus Nervosum for in some presently from the Beginning a Sleepiness with a mighty Drowsiness of the Head in others obstinate Watchings a Disturbance of Mind with a Trembling and convulsive Motions but in most either no Crisis or a deceitful one and instead of it a Translation of the sebrile matter to the Brain has followed It has been farther observ'd that these Fevers have past by Contagion into others and that many have died of them so that they deserve to be call'd Malignant Now these kinds of Fevers sometimes are first begun by a venemous Miasm and the Blood being blasted with the Particles of the Poyson naturally falls into an over-vehement boyling and is inflamed as when any one by a Contagion or by breathing a malignant Air falls into a malignant Fever without an evident Cause or Praedisposition and sometimes a feverish Distemper arises from its own cause and afterward the Seeds of the Malignity either lying hid within the Body exert themselves in the Blood boyling over vehemently or come from elsewhere from a contaminated Air as a Fewel to a Flame first kindled for it is manifest by frequent Observation that during the time an Epidemick Fever reigns others after what manner soever they arise pass into it Malignant Fevers as also Pestilential for the most part are Popular and seise many together but sometimes they are peculiar and sporadical that haply they seise only one or two in a whole Country In such a case we may imagine that they proceed not from an Infected Air or Epidemick Cause but from a morbid Disposition of the Body for I have often observ'd that when Spring or Fall a pretty common Fever has reign'd in some City or Village of which a great many Sick escap'd haply some one on whom an evil Praedisposition and a strong evident Cause brought the Fever lay seis'd with more dreadful Symytoms and great Notes of Malignity in which Case that Malignity is not to be said a common Fever but only a sporadical and accidental one Tho the greatest Difference whereby these kinds of Fevers are distinguished betwixt themselves and from others consists in their Mortality and Contagion yet sometimes they are mark'd by some peculiar Symptom from which both the note of Malignity and the name they are called by are taken for that time hence in some Years an epidemick Fever reighs which causes in most that are affected with it a Quinsey at another time a Peripneumonia Plurisie Dysentery or some other Affect and that often dangerous and contagious so that not only the Seeds of Diseases deriv'd from Parents ex traduce disclose their Fruits by a certain Destiny as it were in the same Part or Member but also such as are received from a venemous Miasm generally reigning produce in all Persons Affects of the same manner and form which nevertheless I judge to happen not because the Seeds of the venemous Miasm regard this or that Region of the Body by some peculiar Vertue but they affect thus the Mass of Blood after the same manner in all forasmuch as for washing off that taint a Crisis must of necessity be attempted after the same manner in all for when without Malignity the Blood is apt to be extravasated by reason of Coagulation or haply for other Causes the usual Places in which the Portions of the same extravagated are wont to be fix'd are the Throat Pleura Lungs and Intestines wherefore it 's no Wonder when a Congelation and therefore an Extravasation of the Blood is procur'd from a malignant Cause if the Disease lodges it self in the usual seat of Nature As to the Signs of these kinds of Fevers besides by the Contagion and Mortality the Malignity of the Fever is shewn by a sudden Dejection of the Strength a weak and uneven Pulse an evil Affect of the Brain and nervous Parts caus'd on a sudden violent Vomitings a blackness of the Tongue an over-spreding of Blackness over the whole Body but especially by an appearance of Spots Buboes and other Marks For the Cure of Fevers both Pestilential and Malignant there is need of a greater Judgment and Circumspection than in any others whatsoever for there being two primary Indicants to wit the Malignity and the Feverish Distemperature and since we can scarce provide for the one without the Detriment of the other it will not be
years since happened in the House of a Venerable Person after a manner to be lamented and not without some Admiration About the Winter Solstice Anno 1655. a Boy about seven years of Age being ill without a manifest cause was affected with a great Pain in his Head a Sleepyness and a mighty Heaviness there was withall a Fever tho not intense with an indifferent Burning which nevertheless by unconstant Fits had its time of being intended sometimes once sometimes twice within the space of twenty four Hours Presently from the Beginning of the Disease he slept almost continually he was wont also to cry out in his Sleep to talk idly and oftentimes to leap out of Bed being stirred up and sometimes awaking of his own accord he was straitway present to himself and always desired Drink his Urine was ruddy and fill'd with Contents the Pulse was uneven and strong enough the Contractions of the Tendons in the Wrists were light in the Neck and other Parts of the Body certain red Spots like Flea-bites appeared On the first days a gentle Purge was ordered and a frequent easing of the Belly by the use of Clysters Cordial Juleps with Alexipharmicks were daily taken Vesicatories were applyed to the Neck and other Plaisters to the Soles of the Feet On the sixth day a little Blood dropt from the Nose On the seventh the Fever very much remitted without a manifest Crisis the Heat being only mild was perceivable by the Touch and the Urine was pale and thin without any Sediment nevertheless a Sleepyness and Heaviness of the Head prest far more severely so that the Urine and Excrements of the Belly flowed from him insensibly however being call'd upon by Name he knew the Standers by and answered to things asked Those Affects notwithstanding Remedies daily grew worse and worse About the fourteenth Day the Diseased became so stupid that he could neither understand nor speak yet he still swallowed down things put into his Mouth tho unminded by him and his Pulse was laudable enough about this time he had a Looseness naturally happening to him for four Days which at length ceasing a whitish and chalky Crust as it were began to cover the whole Cavity of his Mouth and Throat which being cleansed off often in a Day presently a new one arose When he had been troubled after this manner for four Days he was better as to his Understanding and Sensation so that he could know Friends give a Nod to what was said and do some things he was ordered but as the sensitive Faculty began to be restored so the Evil increased as to the Organs of the Speech and Swallowing doubtless the Matter being fallen from the Brain into the Beginnings and Ductus's of the Nerves The Heaviness and Stupidity were followed by a Palsie in the Tongue and Throat which Affect grew so much in a short space that afterward the Diseased was not able to swallow at all but things put into his Mouth presently came forth again nor did any thing descend into his Stomach when besides the Violence of the Disease there was danger lest he should dye through Hunger an Instrument was made of a flexible Whale-bone and a Lawn Button fix'd to the end of it and this being thrust into the Throat opened for a time its Closure that a Passage was made for Food giv'n after the use of this a Day or two he could swallow again and afterward take in Food enough and within a few days he began to speak to discern every thing and growing wonderfully hungry to desire all day long Food of all kinds and most greedily to devour all things giv'n him mean while through his long-continued Sickness and the nervous Parts being sorely injur'd he grew so lean that at length the Skin scarce sticking to the Bones he exactly resembled a living Skeleton tho afterward by the diligent indefatigable and prudent Care of his Mother as to his Dyet he recovered a perfect Health and continues still well At the Time that this Boy was about the height of his Sickness his Brother about two years elder fell sick almost after the same manner on the first day of January First he was affected with a Dullness and a heaviness of the Head On the third day growing feverish he had a Sleepiness and Stupidity he began in his Sleep to talk light-headed and upon his Awake scarce to be present to himself After four or five Days these Symptoms increased he could understand little nor speak without tripping of his Tongue and scarce arciculately his Urine was thick and opake without an Hypostasis or subsiding of the Contents red and small Spots like Flea-bites appear'd as in his Brother the Excrements as well of the Belly as of the Bladder pass'd from him insensibly but the Pulse held still strong and even the Hypochondres were extended and blown up with a Swelling of the Abdomen About the eighth day a little Blood dropt from his Nose On the eleventh day of the Sickness he fell into a Looseness whereby he had seven Stools of a bilous thin and very stinking matter within five Hours whence there was some hope that the Condition of the Diseas'd would change for the better tho the next day after the Loosness ceasing a Pain and Gripes violently tormented him in his Belly that crying and howling he complain'd most sorely Day and Night the Hypochondres and Abdomen were swollen and very much distended like a Drum Not receiving any thing of ease by any Remedies tryed by the most exquisite Endeavours of many Physicians he died on the fourteenth day convulst in these Tortures A little after the Death of this viz. on the 15th of January his Eldest Brother about eleven years of Age a very hopeful Lad began to be feverish being affected with a Dullness and a Heaviness of the Head as the former tho less intense but in his Blood which was of a hot Temperament a greater Effervescence and trouble appear'd that on the first six days besides a Heat and Thirst he was molested with a continual Effort of Excretion sometimes by Sweat sometimes by a Loosness his Urine was ruddy and troubled certain red Spots as in the others brake forth On the seventh day an Haemorrhagie happened to five ounces which ceasing a mighty Dullness followed that for all that day and the following Night he was scarce able to open his Eyes On the eighth day a very copious Haemorrhagie of the Nostrils happened again that there was danger of pouring forth his Soul together with the Blood the Blood sprang forth so copiously from the left-Nostril that being received into a Bason it made vast Bubbles by its fall when he had lost above two Pounds of Blood and being all in a cold Sweat began to lose his Strength Remedies being at length applyed the Flux was stop'd with great difficulty the Haemorrhagie being appeased the Lad slept a sound Sleep and became sleepy all that Night tho often waking he
ensued The next Morning the Small Pox brake forth which tho the Diseassed had very thick yet without any dangerous Illness or fear of Abortion she recover'd and perfectly compleated her Child bearing In the last Autumn a robust Man of an Athletick Habit of Body tho of a pale Countenance and a cold Temperament fell into a Fever On the second day he was tormented with a Heat and a Drought and a most violent Pain in the Loins when it was ordered that he should be let Blood in a small Quantity a Quack Chirurgion being called he took from him almost a pound and a half a little after the Diseased began to fall all into a cold Sweat and his Strength failing on a sudden to be seised with a Shivering a weak and uneven Pulse and a frequent Fainting being called at this time I ordered him temperate Cordials to be taken frequently then upon the restoring of his Pulse and Spirits the Fever was renewed which afterward held the Diseased for many Days nay Weeks after a very irregular manner for he was wont for three or four days to be very hot also to be infested with Thirst Watchings a Head-ach and other Symptoms afterward to fall into a copious and as it were critical Sweat all over his whole Body by which indeed in half a days time he found himself better tho afterward the Fever renewing again frequently heaped together a new Matter still to be blown off by a second and afterward by a third Crisis After that he had lay'n thus irregularly feverish for at least twenty days at length the Small Pox broke forth here and there in each part of the Body and then the Fever first began wholly to remit tho within a few days by reason of Errors committed in Diet a great many Pushes subsided again a few only being brought to a Ripeness however in the place of the subsiding Small Pox a mighty Bubo grew behind the right Ear which being suppurated and broken within a short time a great store of Pus flowed forth for many days and so at length the Taints of the Blood hardly to be blown off other ways were sent forth by degrees and the Diseased perfectly recovered his Health CHAP. XV. Of Fevers of Women in Child-bed VUlgar Experience abundantly testifies that the Fevers of Women in Child-bed are very dangerous above the Nature of our common Fevers also it clearly appears from the Signs and Symptoms of them duely considered that the same very much differ as to their Essences from a Synochus both simple and putrid wherefore I have thought it not amiss after malignant Fevers to treat of the acute Diseases of Women in Child-bed as being very much allied to them by reason of their Mortality But before I shall set upon the Explication of the Affects themselves we must consider their Subjects to wit the Bodies of Women that bring forth Children after what manner they are predisposed and with what Apparatus they become obnoxious to those kinds of Diseases Concerning this it first occurs That to undergo a Flux of menstruous Blood belongs to Humane Kind and that alway to Women concerning the Nature and Origine of which it does not concern us here to enquire but it may suffice to note that in them the Particles of the Blood to be voided periodically are very fermentative which if they are retain'd in the Body beyond the usual Custom of Nature they oftentimes become the Cause of many Sicknesses still excepting if the Woman has conceived with Child for all the time of Child-bearing the Menses stop without any great damage and mean while for the Nourishment of the Foetus Milk or a nourishable Humour is deposed in a great Plenty about the Placenta of the Womb but after Delivery that long Suppression of the Menses is recompenc'd by a copious flowing of the Lochia and the Milk within three days space leaving wholly the Womb flies plentifully into the Breasts at which time Child-bearing Women are wont to be set upon by a small Fever and if the Milk be driven from the Breasts it restagnates again towards the Womb and is voided forth together with the Lochia under the form of a whitish Humour Mean while after Delivery the Womb it self undergoes various Affects for often its Tone is injur'd its Unity is dissolv'd and a great many other Accidents are caused which render Women in Child-bed subject to a dangerous Condition wherefore that their acute Diseases may be duely explicated we must chiefly consider these three things to wit first concerning the Nourishment of the Foetus or of the Generation of Milk both in the Womb and in the Breast and of its Metastasis from either of them into the other Secondly of the Purgation of the Maternal Blood or of the flowing of the Lochia after the Menses being long supprest Thridly or the State of the Womb after Delivery and of its Influence on other parts of the Body And these things being premitted we shall speak of the Fevers of Women in Child-bed to wit both the Lacteal and that called Putrid which by reason of its Mortality deserves to be call'd Malignant First the Milk and nutritive Humour heap'd together in the Uterine Parts for the Nourishment of the Foetus are by Nature alike tho they differ somewhat in Consistency the Milk indeed is the thicker because being to be received in the Mouth it ought to be digested in the Stomach and afterwards it s more tender Portion to be convey'd into the Mass of Blood The other nourishable Humour is more thin and like to distill'd Water of Milk because it 's immediately infused into the Blood of the Embryo by the umbelical Vessels without a previous Digestion Both Juyces are thought to consist of the Chyle fresh made in the Mothers Stomach that which is deposed in the Breast is grosser and whiter by reason of the course Strainer and its Coction in the greater Glands it happens on the contrary in the Womb where the straining is closer and the Glands are very small Now it is greatly disputed among Authors by what Ductus's that Humour is conveyed both into the Breast and into the Placenta of the Womb. Some say that the Milk is engendred only from the Blood freely concocted in the Glands which nevertheless does not seem probable by reason of the immense Spendings of Milk which does not consist with the Blood Others affirm That the Chyle or Lacteal Humour is conveyed immediately into both Receptacles from the Viscera of Concoction through occult Passages without any Alteration But till those Ductus's appear it seems more likely to me that from the Food taken into the Mothers Stomach a Portion of the Chyle thence made is presently absorbed into the Veins which having gotten the Vehicle of the Blood and being brought by the Arteries into the Glands destinated here and there for receiving it before it is assimilated and being separated is depos'd again from the Mass of Blood
Case somewhat of Hope has shewn it self the Pulse and other Symptoms promising a little better tho the Cure has seldom succeeded but when that use of Cordials was remitted the Diseased fell headlong into Death with a weak Pulse and a Loosness forthwith arising 3. When still the case of the Diseased grows worse and worse that the Fever being increased the Pulse is weak and uneven and frequent Shiverings and convulsive Motions infest the whose Body with a Delirium or a Stupor then let the Physician first giving a Prognostick of Death insist on fewer Remedies and those in a manner only Cardiack and let him wholly abstain from Blooding Scarifying Vesicatories or the use of Cupping Glasses for such Administrations bring only an ill-will and Disgrace that thereby we are accounted by Women hard-hearted and cruel The Symptomatick Fevers of Women in Child-bed THE acute Diseases of Women brought to bed do not only follow the Type of the foresaid Fever but are sometimes attended with some notable Symptom to wit the Quinsey Plurisie Peripneumonia Dysentery Small Pox or of some other kind and then they are call'd by the Names of those Affects It is not proper to repeat in this Place what belongs to the Natures and Essences of each of them at large but I shall briefly set down what those Diseases complicated with the Affects of Women in Child-bed have peculiar to them as to their Causes or Cures We judge that all those Symptoms proceed from a certain Coagulation of the Blood and afterward its Extravasation now while the Blood is extravasated in one part every natural nad critical Effiux of it is restrain'd in another wherefore there is danger lest while the Blood begins to be coagulated either in a particular and usual Focus of Congelation or universally in its whole Mass presently the flowing of the Lochia be stopt which in reality happens for the most part and therefore those Affects are most commonly mortal to Women in Child-bed nevertheless the Cause of their Death for the most part happens with some difference to wit in the Small Pox the flowing Lochia call inward the Malignity began to be sent forth outwardly and wholly poison with their Taint the Mass Blood and the Heart it self and therefore in the Small Pox those uterine Purgations ought to be stopt but in the Pleurisie Quinsey and the rest when the Stimulus of the Disease fix'd here or there in a particular Place calls to it self and wholly derives from the Womb the Impurities of the Blood which ought to be voided by the Lochia thereby it increases the Taint of the BLood the Lochia restrain'd in the Small Pox might be sent forth by a more general way of Excretion with the venemous Particles of the Disease with indeed does not succeed in the rest by reason of the small and more spare way of Excretion Among these the Quinsey Plurisie and Peripneumonia by reason both of the great likeness of their Cause and the Analogy of their Cure may be considered together When a Woman in Child-bed is affected with either of these it is to be judg'd that besides the Miasms heaped together during the time of Ingravidation there happens a certain acid disposition of the Blood by the means of with whilst it feverishly boyls certain Particles of it being imbued with a sharpness fall into a Congelation in this or that place like Milk turning sour and consequently coagulated the Blood letted there and hindred in its Circulation hinders the Passage of the rest now the Blood being obstructed in its Motion butts against its dam and so being heaped together round about and driven out of its Vessels grows into a Tumour thence presently whatsoever haeterogeneous and separable is contained in its Mass is deposed in the Part affected as in a Sink wherefore the Corruptions of the Blood which ought to be purg'd forth by the Womb are deriv'd thence toward the Seat of this Disease which since they cannot be purged forth sufficiently this way both the Liquor of the Blood is more notoriously corrupted and a Crisis of that particular Affect to wit of the Quinsey Plurisie or some other is rendred more difficult For the Cure of these kinds of complicated Diseases presently from the very first beginning it must be endeavoured that the Blood fixt any where and begun to be extravasated be restor'd to Circulation and do not make an Impostume because it is very rarely that Women in Child-bed seised with those symptomatick Fevers are cured by an Abscess or spitting forth of the Matter wherefore inward Remedies which fuse the Blood and free it from Coagulation are to be used of which kind are chiefly Diaphoreticks filled with a volatile Salt as Spirit of Harts-horn of Soot of Urine and the Salts themselves also testaceous and bezoartick Powders Sal Prunella Decoctions and Juleps of Vegetables promoting the menses or the Urine in all which those things ought to be mixt which by Experience are found to be appropriated to uterine Affects moreover discussing Remedies which drive away and expell the Matter stinking in the Part affected of which kind are Liniments Fomentations and Cataplasms are carefully to be applyed to it Mean while let the violent Motion and immoderate Effervescence of the Blood be removed far from thence and let its Excretions of Filth be conveyed still to the lower Parts by what ways we may for this end Frictions Ligatures Epispasticks and if need be cupping Glasses may be applyed to the Feet or Legs in case the Affect growing very much worse blooding be indicated unless there be a great Plethora in the whole Body and a very acute Inflammation in the Part affected it will be best to breath a Vein in the Foot or to open the haemorroid Vessels with Leeches but if necessity presses for it to be done in the Arm after Blooding there let another Bleeding if it may be admitted follow in the Leg nevertheless we must give a Hint that opening a Vein ought to be very cautiously ordered in these Cases for unless it gives Relief which I have seldom known to happen presently the Pulse being rendred more weak the State of the Diseased becomes worse A Dysentery takes its Rise in a manner from the like Cause as the foresaid Affects but because in this the extravasated Blood is presently poured forth nor being restrain'd in the Body creates a mischief there and is still more corrupted and since this way of Excretion is performed near the uterine Efflux and does not derive it afterward another way hence less danger is feared from this Disease than from the others before mentioned tho oftentimes this Affect is mortal to Women in Child-bed and that the rather because by a Dysentery things that qualifie and gently astringe the Blood are indicated and these are found too apt to stop the flowing of the Lochia wherefore in this case till Women delivered are in a manner purg'd enough by a long flowing let the Cure
temperate it is usual in the Spring and Fall for certain Diseases to reign epidemically to wit because at this time the blood being renewed displays it self as it were anew and therefore intermittent Fevers and sometimes the Small Pox grow every where rife at this time wherefore it is no wonder after a very uneven Constitution of the Year and differing from the natural when in this Spring the Blood boiling strongly within the Vessels by reason of a letted Transpiration was not able to be circulated freely and to be enough eventilated if thence great Diforders follow and a very epidemick Affect be raised from this very general Cause As to the Symptoms joyned to this Disease the feverish distemperature and the things depending of it the burning of the Praecordia the Thirst spontaneous Lassitude the great pain in the Head Loyns or Limbs were caused by the Bloods boiling too much and not being enough eventilated Hence in many the thinner part of the Blood being heated and the remaining Liquour being only troubled a Synochus simple or of many dayes was caused but in some having a vitious Diathesis of the Blood or an ill habit of the Body this kind of Fever being arisen through the same cause soon passed into a very dangerous and often mortal putrid The Cough accompanying this Fever with the Catarrh draws its origine from the serous humour heapt together along time in the Blood by reason of Transpiration being letted and afterward an effervescence arrising distilling in a great plenty from the little Arteries gaping inwardly for when the Pores are constringed the superfluous Serosities in the Blood wont to evaporate outwardly are poured on the Lungs by a nearer way of purifying the Blood Wherefore upon taking cold as it s vulgarly said that is upon Transpiration being outwardly letted a Cough for the most part is raised and in the Procatarxis for this affect a redundancy of Serum in the Mass of Blood had almost the first Place for from the long continued cold stopping the burning of the Blood or the encrease of Cholor and hindring the Transpiration of the watery Latex of necessity a great deal of serous Humour was heapt together in the Blood wherefore when the Blood displaying it self in the Spring fell into an Effervescence the overflowing of the Serum and its discharge on the inward Parts was wont to bring first a Cough as a proper Symptom of this Disease and in whom the Blood being much diluted by the mixture of Serum were very obnoxious to the Cough and rheumatick affect those came more lightly off with the Feverish Distemper The Prognostick of this affect as to private Persons for the most part is easy that presently from its first invasion it discovers the event For if this Sickness be raised in a robust Body and sound before and the feverish Distemperature be moderate and without any severe and dreadful Symptom the Case is free from Danger and the affect is reputed of so light Moment that commonly it is only called a Cold taken and for the most part neither a Physician nor Remedies are sought after unless some that are very common and of an easy Preparation are used But if this Affect happens in a weak and unhealthy Body with an ill Apparatus and either the Fever be raised to a putrid or the Cough growing strong causes a difficult Breathing and a kind of consumptive Constitution the event of the Disease is very much suspected and often is terminated in Death The common Prognostick which is taken hence concerning the future state of the Year contains nothing very much to be feared or threatens mighty ill by reason of the uneven Intemperies of the Year as great excesses of Heat and afterward the Cold we may fear Diseases arising from the discrasy of the Blood but from the present state we neither suspect the Air mightily depraved nor infected with venemous Breaths that we may hence ground a Judgment of a Plague or malignant intermittent Disease As to the Method of Cure when this Disease seises lightly its cure for the most part is left to Nature for this Fever being only a simple Synochus is wont to be determined within a few dayes by a Sweat Wherefore after a copious Sweat for the most part about the third or fourth day the heat and Drought the lassitude and great Pains are appeased then the Cough protracted longer afterward remits by little and little and at length the Diseased recover by degrees If at any time this Disease has taken deeper root there is need of fit Remedies and an exact Method of Cure let the Fever growing strong be cured according to the Rules to be observed in a putrid tho with this difference that because a letted Transpiration and the discharge of the serous Humour on the Lungs are chiefly in the fault therefore let Diaphoreticks and the Remedies called Thoraciks be of frequent use for these restrain the great flowing of the Serum from the Vessels inward and either by opening the Pores convey it outward or by precipitating it from the Mass of Blood send it away by the urinary Passages therefore let the Method of cure for this Disease raised to a worse state regard both the feverish Distemperature for curing which you may direct according to the Intentions used in a putrid Fever and the Rheumatick Affect Which nevertheless must be the second Indicant and does not admit any evaporating Remedies indifferently or such as are usual against a Cough but only of that kind which does not intend the Fever Let the Forms of these and the fit times of healing be taken from the Precepts every where delivered for the cure of the putrid Fever and of the Cough the Aides which now by a frequent Experience are vulgarly said to have given a chief relief in this Disease are a Diaphoresis or a procuring of a Sweat and a letting Blood for the Vessels being emptied this or that way both the immoderate Effervescence of the Blood and the redundancy of it are moderated A Description made the first day of September of an Epidemick Fever arising about the beginning of Autumn An. 1658. THE Vernal Fever even now described scarce lasted above six Weeks that it plainly seemed only a light Effervescence of the Blood which growing turgid in the Spring and withall being straitned in its room for want of Ventilation boiled violently like new Wine stopt in Bottles and afterward ceased of its own accord but thenceforward as the Year did not recover its due Temper so neither did our Blood and so a second fewel was soon heaped together for a new Fever for after the Summer Solstice the North-wind still blowing the Season continued cold a long time so that the Husbandman feared that the Fruits and standing Corn would scarce be brought to a Maturiy this Year but after this a little before the beginning of August a most intense heat followed for many dayes and in the Dog Dayes the Air was mighty
Nervous Liquor A Boy about ten years of Age subject from his Infancy to be often troubled with a Cough has undergone of late years some great and tedious fits of that Distemper that is to say he is wont at times to fall ill of a hollow and shrill sounding Cough without Spitting which almost continually toyls him Day and Night and so tormenting him for many Days nay and Weeks it brings him to a very great weakness Afterwards the Course of the Disease being pass'd over which happens not till the store of Morbid matter be consum'd in a short time he becomes well enough again and as free as may be from any Distemper of the Thorax till the Morbifick matter as it seems being heap'd together again to a fullness without any evident cause the same affect returns and acts over its Tragedy again with its wonted severity About the time it first seizes the Cough usually troubles him only Mornings and Evenings afterwards the Distemper growing worse by degrees he often Coughs whole Days and Nights almost without ceasing and if at any time Sleep either happening of it self or being procur'd by Anodines gives some truce presently upon his waking a more violent fit of Coughing comes upon him After this manner Coughing very frequently and most vehemently without Spitting he continues ill for three Weeks or a Month till he be brought to a mighty leanness and an extream weakness and then the Distemper remits by degrees so that he Coughs somewhat more seldom and Sleeps indifferently shortly afterwards growing very hungry he soon becomes full of Flesh and vigorous and recovers in a short time his former Health These fits seldom trouble him in the Summer but in the rest of the year they return sometimes three or four times and put the Patient in great danger of his Life The cause of this Distemper is not the same as of a vulgar Cough in which a Serous humour distilling either slowly or in a plentiful manner from the Vessels of the Trachaea or of the Lungs into the Vesiculae or little Pipes of the Trachea induce the Symptoms that attend that affect for it plainly appears that in this the Ductus's of the Aspera Arteria are wholly free from any Serum or thick humour because the Cough which is always deep and sonorous throws forth nothing Nor does this Cough arise from the Blood forc'd into the Membranes of the Lungs because in this there is no Feaver Thirst nor Pain as in a Peripneumonia neither does its Morbifick matter seem to stick to the Nerves or Muscles ordain'd for breathing because then besides the Cough Asthmatick or Convulsive fits with a sense of choaking would sometimes follow which do not happen to our Patient I guess therefore that a certain Serous and sharp matter full of a Scorbutick taint falling from the Head by the conveyance of the Nerves enters the Nervous Fibres and Membranes of the Lungs or of the Trachaea and throughly cleaving to them increases by degrees to a fulness and at length growing angry and turgid through its perpetual irritation creates so troublesome a Cough When this affect once seizes it is wont to hold on its Course for a very long time in despite of all Remedies Pectoral Medicines commonly so called as Syrups Linctus's Eclegma's did little or nothing towards the Cure of this Disease though sometimes I have thought good to use them for making the Lungs slippery and to moisten them lest hap'ly they should be endangered to be torn asunder by the violence of the Cough and their Vessels to be broken for sometimes in a violent fit our Patient used to Cough forth a little Blood though no thick Spittle A gentle Purge in the beginning of this Disease has often done good as also in its declination Opening and Diuretick Medicines always work a good effect of both which he uses what suffices throughout the whole Course of his Distemper for his ordinary drink Evenings and Mornings he takes some drops of the Tincture of Sulphur with the Water of Snails lacteated I was forc'd sometimes to give late at Night a Dose of the mixture of Diacodium or of Liquid Laudanum In two of his fits he was Blooded from which he receiv'd no good In the last fit which beginning about the Autumnal Equinox pass'd over somewhat more lightly and gently the following method of Cure was observ'd First of all this Cathartick was given him and repeated after four days Take Calamelanos half a Scruple Rosin of Jalup four Grains Mix them make a Powder let it be taken in a spoonful of Syrup of Violets Take China Roots slic'd a Dram Grass Roots three Ounces Chervil Roots an Ounce Candied Eringo's six Drams shavings of Ivory and Hartshorn of each three Drams Raisins of the Sun ston'd three Ounces Boil it in three pounds of fountain water to two pounds strain it and let it be us'd for ordinary drink Take Syrup of Jujubes two Ounces Diacodium an Ounce Spirit of Sal Armoniack with Gum Ammoniacum a Dram Mix them the Dose is a spoonful going to Bed and early in the Morning He was much reliev'd by this Remedy though he took it only every other or every third day and sometimes in its stead a Dose of the Tincture of Sulphur with Syrup of Violets was given him The Disease declining he was purg'd twice and afterwards recovering by degrees he grew well enough within a fortnight But finding him subject not only to frequent relapses of Coughing but that each fit when it came upon him was irresistible and that its stay notwithstanding any use of Remedies was of long continuance and threatned nothing less than a Consumption I advis'd him that as well for preservation and in case the affect return'd as for Curing it he should Travel to a Region hotter than ours He took my advice and about the beginning of November went to Montpellier where passing half a year he had only two slight touches of illness Since being return'd to England he enjoys thanks be to God a perfect Health quite free from his Cough CHAP. II. Instructions and Prescripts for the Cure of Spitting Blood THe Indications for Curing a Spitting Blood are chiefly these two viz. First presently to moderate and stay the Flux of Blood And then in the Second place to heal the dissolution of Unity without leaving a Consumptive Putrefaction in the Lungs In reference to the First These two things are chiefly to be procur'd First That the Blood do not flow to the part affected Secondly That withal the Aperture of the Vessel be some way clos'd 1. To keep the Blood from flowing to the part affected many intentions of Curing must be set upon together viz. We must lessen the quantity of Blood moderate its fervent boiling alter its ill temper retard its motion or divert it another way For which ends Blooding Ligatures and Frictions most commonly do well Moreover Julapes Decoctions Emulsions and Juicy expressions of Herbs ought to be given
Poppy water three Ounces Syrup of the same an Ounce Mix them give a spoonful of it every other while Take Spirit of Sal Armoniack distill'd with Olibanum three Drams the Dose is from twelve drops to fifteen or twenty three or four times a day in a fit Vehicle After the same manner you may give Spirit of Vrine of Soot or of Hartshorn Take Spirit of Tartar three Drams The Dose is a Scruple in a fit Vehicle Take Mixtura Simplex three Drams The Dose is from a Scruple to half a Dram. 3. As to the Third Indication besides a thin Diet Cordial Remedies and Anodines are prescrib'd Forms of the former kind may be supply'd by the Julapes and Apozemes prescrib'd for the first Indication and by the Spirits and Powders for the Second Inward Anodines to be given in Watchings and in a very Intense pain are prescrib'd according to the Forms following Take red Poppy water two Ounces Syrup of the same six Drams Spirit of Hartshorn twelve drops Make a draught to be taken going to Bed If we must go higher Take Carduus water two Ounces Diacodium from three Drams to half an Ounce or six Drams Spirit of Sal Armoniack with Frankincense half a Scruple Make a draught Sometimes though rarely its necessary to rise to Laudanum's which being seasonably given have a mighty good effect inasmuch as they procure Sleep and move Sweat and Vrine Take water of Cowslip Flowers two Ounces Laudanum Tartariz'd from sixteen drops to twenty Spirit of Blood half a Scruple Syrup of Violets two Drams Mingle them make a draught Outward Anodines are usually prescrib'd in the Form of an Oyntment Fomentation and Cataplasm Take Oyntment of Marsh-Mallows two Ounces Oyl of sweet Almonds an Ounce Album Graecum two Drams Mix them by braying them together Take of the Emplaister of Mucilages two Ounces and a half Malax it with Oyl of Linseed and let it be apply'd upon Lawn Paper Take the tops of Both Malbows Leaves of Mercury and Beets of each three handfuls Boil them in a sufficient quantity of fountain water let the straining be us'd for a Fomentation Take the remaining faeces of the Herbs after the Liquor is wrung forth and being bruis'd add to it of Oat-meal six Drams Linseed Fenugreek-seeds of each two Ounces Oyntment of Marsh-Mallows two Ounces Make a Cataplasm I need not go far for Stories and Instances of persons troubled with the Pleurisie for I have a notable Example of this Disease now under Cure viz. a very fine young Woman subject most frequently and as it were habitually to that affect is committed to our care This Virgin who is very fair of a Sanguine Complexion but of a weakly Constitution has been wont for many years past upon every slight occasion viz. upon taking Cold or by errours in any of the six nonnatural things nay sometimes upon the meer change of the Season or of the Air to fall into a Feaver presently accompanied with pains of the Pleura a Cough and a difficulty of Breathing and for the most part horrible Convulsions following them She has been taken so very ill formerly of this Distemper that she has been often forc'd to keep her Chamber six Months or more every year but of late though she be not freed from this affliction yet she is seldomer tormented with it The last year she was pretty well all the Summer and well near all the Autumn about the beginning of Winter she fell sick of that Disease and now towards the end of it is fallen ill again The Pleuritick pain constantly possesses the right side where the Blood sticking and being extravasated in its passage about the Intercostal Muscles the Irritated Fibres commence a most tormenting pain together with a Convulsive motion of Coughing which they reiterate almost perpetually In the mean time the Lungs being found enough and open in their passages readily convey the Blood as clammy as it is without any lett or stay which often is the cause of a Peripneumonia No Remedies are wont to do good to this person without Bleeding which is always so particularly necessary that every time she is ill we are forc'd even whether we will or no to repeat it two or three times nay sometimes oftner The Blood emitted has constantly a Viscous and whitish Film on its surface This Disease was always a simple Pleurisie without any Peripneumonia and for its Cure she constantly us'd the following method with success Take Spirit of Sal Armoniack with Gum Ammoniacum three Drams give from fifteen drops to twenty thrice a day with the following Julape Take Carduus water Black-Cherry water of each six Ounces Hysterick water a Dram Sugar six Drams Betwixt whiles she took a Dose of Powder with three Ounces of an Apozeme Take the Powders of Crabs Eyes of a Bores Tusk of Sal Prunella of each a Dram Make a Powder divide it into six parts Take Grass Roots three Ounces Candied Eringo's an Ounce shavings of Ivory and Hartshorn of each two Drams parings of Apples a handful Raisins of the Sun an Ounce Boil them in three pounds of fountain water to two pounds add to the straining Syrup of Violets an Ounce Sal Prunella a Dram Mix them make an Apozeme Glisters of Milk with Syrup of Violets were administred sometimes every day and sometimes every other day if at any time Opïats though never so gentle were given her to allay pain commonly afterwards an aking and heaviness of the Head and Convulsive Affects most sorely tormented her CHAP. V. Instructions and Prescripts for the Cure of an Empyema BY the word Empyema according to its usual acceptation is denoted a Collection of Pus or corrupted matter within the Cavity of the Thorax by which the Organs of Respiration are opprest That Pus commonly flowing thither either from a Pleurisie or a Peripneumonia and sometimes haply from a Squinancy suppurated and broken As to the Cure of an Empyema we must in the First place consider whether the signs of this Disease as to the reality of its present Being be certain or doubtful if certain there will not be much need of Physick but only the Body being prepar'd you may presently proceed to open the side Therefore if after a Pleurisie or Peripneumonia not rightly Cur'd or after an inward effusion of Blood occasion'd by a stroak fall or wound there be perceiv'd a floating of Pus or of corrupted or bloody matter within the Cavity of the Thorax and this with little or no Spitting we need no longer think of Maturating or Expectorating Medicines but the Belly being loosen'd and the Blood and humours duly qualified by Julapes Apozemes and Anodines either order a bare Incision or in tender and timorous persons First let a Cautery be apply'd betwixt the sixth and seventh Vertebrae and after the Eschar being rais'd let the Incision Knife be entred obliquely towards the hinder and upper parts and that leisurely and by little and little till it penetrate
to ensue undertakes the purifying of the Blood and the strengthening of the Lungs for which eads Purges Vulnerary Decoctions distill'd Waters and Physick Drinks are proper Take Gereon's Decoction of Sena with Agarick a Dram and a half three Ounces and a half Purging Syrup of Apples an Ounce Aqua Mirabilis two Drams Make a Potion to be taken once a week with governance Let the Form of the vulnerary Decoction be the same which is prescrib'd for the Empyema after the Incision or because there is no Feaver you may give that Decoction of the shops to four or six Ounces thrice a day Take Fir tops six handfuls fresh Leaves of ground Ivy Hyssop Savory Rocket Hedge-mustard Winter Cress of each four handfuls Sun-flower Seeds six Ounces sweet Fennel-seeds two Ounces Roots of Elecampane and Florentine Orris of each three Ounces being slic'd and bruis'd pour to them of Brunswick or Spruce Beer eight pounds distil it with common Organs Let the Liquor be all mixt and when it s us'd let it be sweeten'd at pleasure with Syrup of the Juice of ground Ivy The Dose is three or four Ounces thrice a day Take Roots of Sarzaparilla six Ounces China Roots two Ounces all the Saunders of each six Drams shavings of Ivory and Hartshorn of each half an Ounce Mastick-wood an Ounce being slic'd and bruis'd let them Infuse according to art and boil in twelve pounds of fountain water till half be consum'd adding of Licorice an Ounce Raisins of the Sun four Ounces let the straining be us'd for ordinary drink The Third and Vital Indication prescribes Cordial and Anodine Remedies and a fit Diet The same Forms of Medicines in a manner that are prescrib'd for an Empyema after Incision are proper here Also the same Diet which is ordered in a beginning Consumption and Asses Milk often does good in this case Concerning the Cure of this Disease I have obferv'd that an Issue made in the side has often a very good effect A Gentleman of a middle Age having been always strong and healthy found himself ill without any manifest cause and in a short time fell into a languishing condition losing his appetite sleeping with difficulty was thirsty and had a heat about his Praecordia He was a long time under the hands of some Physicians for the Scurvy and of others as Hectical and after various methods of Cure had been try'd in vain the Disease at length openly discover'd it self For whilst one Night being more restless than usual he toss'd himself very much in his Bed the Impostume within his Lungs breaking on a sudden he threw up by Coughing a vast quantity of Pus which stunk most horribly so that within four or five hours he had thrown up about two pounds Moreover the Cough continuing for above two Months afterwards he daily voided by Spittle of that Purulent thick and mighty stinking matter till his Flesh being consum'd and his strength wholly spent he was decay'd and fallen away to nothing After the Impostume was thus broken we carefully gave him Medicines to cleanse and heal the place where it gather'd and to mundify the Blood and the Lungs and free them from the imminent Consumption Our Tincture and Syrup of Diasulphur together with Pectoral and Vulnerary Decoctions and Distillations also Linctus's and Balsamick Pills were taken day after day in a constant method With these Glisters also gentle Catharticks and Diureticks were interchangeably given Vaporations first then Suffumigations both Sulphureous and Arsenical were also us'd Mornings and Evenings After these things had been carefully followed a long time without any good we concluded to open his Thorax and were soon directed to a place proper for it for on the left side of his Sternum betwixt the fifth and sixth Vertebrae a tumour appear'd Instead of a Cautery I apply'd thereto a Suppurating Plaister and within three days the top of that Swelling became red and soft out of which being open'd the next day after first issued a thin Ichor and a little after a yellow and well concocted Pus and afterwards it continued daily to run in a more plentiful manner and then the stinking Spittle began to abate and within a Fortnight wholly ceas'd the Morbisick matter finding both an easie and more apt passage through that Orifice which at length was chang'd into an Issue and a Pea or a Pill of Wood being daily put into it there came forth continually for a year and a half a plentiful Ichor and in the mean time the Gentleman having wholly got rid of any corruption in his Brest and recovering his strong and fleshy habit of Body became sound in all respects Lastly That Issue being remoy'd to the Arm he has nothing of that Distemper about his Brest nor minds longer any fence against it Shortly after this Cure I was call'd to a Lady of Quality who having been troubled with a Cough and a heat of the Praecordia for many years on a certain day sensibly perceiv'd somewhat broken in her Lungs whilst she was Coughing and presently voided by Spittle a great quantity of meer and stinking Pus after that that Spittle with the Cough notwithstanding any use of Remedies continuing for a Week seem'd rather increas'd than diminish'd I advised that she would permit an Issue to be cut in her side near the place whence she perceiv'd the Pus to arise which she readily giving way to within three days meer Pus such as she Spit forth by her Cough began to run from the open Orifice and afterwards the Morbifick matter finding a sufficient vent by that passage both the Cough and the Spitting of Pus entirely ceas'd and within six Weeks the Patient grew perfectly well After this I was call'd to a robust man a great Drinker who being also affected with an Impostume of the Lungs did Spit forth a great quantity of mighty stinking Pus He would not permit any Issue to be made in his side yet being very free to take all sorts of Medicines he got free at length of that Disease by a long use of them The Medicines which chiefly did him good were preparations of Sulphur wherefore our Syrup and Tincture were given him often every day To these we gave for Vehicles sometimes a Pectoral Decoction sometimes a Pectoral Hydromel sometimes Lime water with the Infusion of Pectoral and Vulnerary Ingredients Moreover Fumigations especially of Sulphureous and Arsenical things gave great Relief CHAP. VII Instructions and Prescripts for the Cure of the Asthma AN Asthma is a difficult short thick and pursy Breathing with a great Agitation of the Brest and for the most part without a Feaver And it s either meerly Pneumonick proceeding from some stoppage in the Vessels that convey the Air or meerly Convulsive arising from some fault in the Organs of motion or mixt when both parts are joyntly faulty As to its Cure there are two Primary Indications or rather so many distinct methods of proceeding viz. the one Curatory the other
happens that the Vessells having this ill Conformation are likewise affected with Convulsions so that the Muscular Fibres of the Vessels being disorderly contracted cause sudden and violent Sallyes of the Blood somtimes upwards and somtimes downwards and consequently Eruptions For I have observ'd in some when the Current of the Blood has been slender enough with a low and weak Pulse that the Convulsions of the Vessells beginning in some place and carried forward as a Wind running here and there in the Body have driven the Blood vehemently though never so low of it self and forc't it into violent Eruptions And in these cases when opening a Vein and Medicines cooling and qualifying the Blood have done no good we have found the greatest relief from Narcotick's Anticonvulsives and Ligatures To speak now of Bleeding by Art we generally observe that Physick in some cases imitates nature in others exceeds it and often regulates it and reduces it when it acts amiss though there are some cases in which nature far exceeds the efficacy of Art in Excretions of Blood I shall speak briefly of each of these First therefore in whatever affects Spontaneous Eruptions of Blood use to do good if at any time these fail Physick the Handmaid of nature aptly suplys its place by Phlebotomy therefore if haply the Blood by reason of its Sulphur being too much at liberty and exalted is kindled too much upon opening a Vein the superfluity of that Inflammable fuel will issue forth So likewise immoderate Turgescencies of the Blood by Reason of some unsubduable substance gotten into it are allay'd by this means Wherefore Bleeding is presently ordered both against continual Fevers which proceed from the former cause and against such as intermit whose fits are from the latter And so as often as an accustomed Evacuation at set times which is stopt or a humour struck back from the outward parts or a sudden stoppage of the Pores or if a Surfeit Drinking of Wine and other Accidents of this nature by crowding the Blood with Heterogeneous Particles cause a Turgescency in it Phlebotomy is usually a most present Remedy Secondly Physick does not only imitate nature in letting forth of Blood but often exceeds it nay and frequently aids it and reduces it when it labours and acts amiss For if at any time the Blood taking a Head rushes in a Body to one part and there either presently breaks forth in a disorderly manner or being gather'd together in a large quantity causes an Inflammation a Vein being open'd in some remote part stops that Praeternatural Salley of the Blood and often puts an end to the Eruption or Inflammation Wherefore in the Plurisie Sqinancy Perpneumonia in Spitting or Vomiting Blood when nature either yields it self overcome or bing sturck as it were wiht a Rage seems to lay violent hands on it self Chirurgery withdrawing the Blood to some other place and letting it forth restores all things when almost in a loft Condition Moreover Physick often moderates or reduces nature when too profuse or extravagant in the Effusion of Blood for in Truth all immoderate Eruptions of Blood must be stay'd rather than promoted Again in regard in the Plague Small-Pox and Meazles broken forth and in Malignant Fevers a Spontaneous Eruption of Blood always foreboads ill Therefore in those affects Stiptick Medicines restraining the Eruption of Blood are more proper than breathing a Vein Nevertheless there are some cases of an Effusion of Blood by nature which Physick can no way imitate nor supply by Phlebotomy if haply they fail In Fevers about the Crisis of the Disease viz. after the Digestion of the matter that is its preparation for Separation a Spontaneous Eruption of Blood in regard it comes in a due nick of time is far better than any Bleeding by Art the due season for which is unknown And so a flowing of the Menses and Haemorrhoides hapening by the Instinct of nature is much more Advantageous than if Blood be caus'd to flow thence by Art There is this notable difference betwixt Blceding by opening a Vein and a Spontaneous Eruption of Blood that in this the Blood flows in a manner wholly out of the Arteries and in the other Evacuation it 's drawn only out of the Veins So far of Phlebotomy compar'd with a Spontaneous Eruption of Blood I shall now shew its use and effects both good and evil in the Practice of Physick Therefore in the first place let us shew in general what sort of alteration this Evacuation causes in the Mass of Blood and then to what Diseases either of the whole Body or of particular parts it most immediately has respect to Concerning the first it 's obvious that the Blood after Breathing a Vein is altered both as to its quantity and as to its Temper and Crafis and as to its Motion The first and most common Indication for Breathing a Vein is that by this Administration the Mass of the Blood be lessen'd Hence even the vulgar growing to an overful habit of Body cause themselves to be let Blood to remove that Plethorick Disposition but though the evils of that affect are remov'd or prevented by nothing better yet the necessity or this Evacuation ought to be avoided as much as may be Because the Blood is rendred by it more Sulphureous and less Salt and consequently it disposes Men to a Feverish habit and to grow Fat Moreover the great Remedy Bleeding if made common on every slight occasion will become of no effect in grand Distempers when it is needed To which we may add that according to the observation of the vulgar the more familiarly any one uses Bleeding the oftner he will want it For the Blood being let forth to avoid an overgreat fullness the rest of the Mass soon rises again to a Plenitude though it 's worse in its Crasis For by this means being much berest of its Balsamick Salt which preserves it from Putrefaction Instead of it it 's more fill'd with a Fatning and Inflammable Sulphur 2. Phlebotomy amends the Mixture and Temperament of the Blood in sundry respects First if any Heterogeneous thing be gotten into its Mass which can neither be mastered nor easily separated and sent forth upon opening a Vein the Blood flowing forth carries with it often a great Portion of that matter So again the Blood declining from its Temperament is often restor'd by Phlebotomy for when its Mass upon the exaltation of the Sulphur or fixt Salt of both of them together is degenerated into a sharp Salt or Salino-Sulpureous nature a Portion of the Blood being drawn out presently it ferments anew and often there is such a change made of all those kinds of Particles that thence forwards the Spirits with the Volatile Salt begin to rise again and recover their Dominion keeping he Sulphur and fixt Salt under as they ought to be Hence Bleeding gives often great relief not only in Fevers but likewise in the Scurvy Jaundise and even in a beginning
Juice of things taken into the Body be past into the Blood for the Vessels being emptyed will draw hastily into them the Chymus not only crude but often disagreeing with or disproportionate to the Blood whence not only its Motion is disturb'd but also the Vital flame is sometimes in danger of being overwhelm'd I have known some who upon Bleeding shortly after large Drinking or pouring in of Vinous Liquors have fell into dreadful swounding Fits which continued a very long time till the Vital Spirit half overwhelm'd happen'd at length to recover 5. As to the quantity of Blood to be taken besrdes the manifest errour of those who are sparing or profuse of it in the greatest extreams there is likewise an errour of no small moment committed within the moderate Limits whilst in some cases the Blood is taken too sparingly and in others in a greater quantity than is fitting In a burning Fever the Pleurisie Peripueumonia Squinancy Frenzy Apoplexy and other great Diseases rising from the Turgescency or Inflammatory Incursion of the Blood a spare Bleeding always does more hurt than good For besides that it does not remove the Antecedent cause of the Disease viz. the Plethora it moreover encreases its Conjunct causes viz. the Inflammation or Irruption of the Blood For it 's a constant observation that after a spare Emission of Blood it s whole Mass presently boyls in a high measure and makes new Sallyes into the part affected The reason of which is that in a great Plethora many Portions both of the Blood and Serum being driven into strait and by receptacles are forc't to reside there which upon the Vessels being a little emptied rush back hastily into the Mass of Blood and trouble it mightily driving it here and there in a violent manner As a spare Bleeding in some cases is not only useless but hurtful so in others a too large Effusion of Blood is seldom without danger and sometimes proves mighty prejudicial to Health For if at any time there be a failing of strength or the Body labours under a great Cachexia we must be spare of Bleeding and it is either forbidden or being indicated by reason of some accident it must be allow'd but in a small quantity Wherefore in Men of a tender weak or cold Constitution and in Consumptive Persons and such as are affected with a long or Malignant Fever also in those that the Hydropical or very Cacochymical we must not lightly open a Vein at least being open'd we must not let forth much Blood The quntity of Blood to be drawn being agreed upon the next care must be that a large Orifices being made it flows forth equally mixt in as short a space as may be For otherwise if it issue forth at a slender Orifices either by Drops or in a small stream the Mass of Blood fermenting will separate into parts and what is most Subtle and Spirituous will spring forth the thicker and more dreggy Portion remaining behind Hence it is to be observ'd that if at any time the Blood being let out of a large Orifice with a full stream be stopt a little by putting the Finger on it and in a short while after be let run again the Blood issuing forth the Second time will be much purer and brighter than the former because in the interval of its running the more subtle Particles having got free of the thicker and gatered themselves together in a Body prepar'd themselves for flying forth CHAP. II. Instructions and Prescripts for stopping an Eruption of Blood There being various and manifold kinds of Haemorrhagies or Eruptions of Blood Physick is not needful to all of them If a great Effusion of Blood happens through a Wound c. Chirurgery undertakes to stop it Moreover an Eruption of Blood if it be Critical ought not to be disturb'd by any Medicine but to be left wholly to the governance of nature so she be free and enjoys her power nay in Symptomatick Bleeding so long as it is but small or not very prejudicial Physick is not required But then chiefly and in a manner only it is needsul if at any time the Flux of Blood be either immoderate or breaks forth in improper places Bloody Eruptions of the latter kind require help chiefly if haply the Blood be cast forth upwards by coughing or vomiting or be voided downwards by the Fundament or the Urinary passages for in these cases though the quantity of Blood voided be not commonly much fear'd yet because a dangerous or pernicious Ulcer often follows the Solution of Unity so made in the Lungs or in the Stomack or Intestines or in a Vein therefore we must diligently take care of those Haemorrhagies from their very first appearance and therefore such Bloody Excretions are ranged amongst the Diseases of those parts and we have already delivered elsewhere the Theories and Cures of Blood-spitting and the Bloody Flux so that there is no need for us to repeat them here no more than that of Pissing Blood which belongs to the Pathology of Nephritick affects wherefore I shall pass to those Passions in which there being an immoderete Fffulx of Blood there is a particular necessity for Medicines to stop it The chiefest kinds of those sorts of affects are these three viz. an Eruption of Blood from the Nostrils and of the Menses and immoderate Fluxes of the Haemorrhoides The Cure of this latter belongs rather to Chirurgery than Physick and we have thought fitting to refer the consideration of the other to the Pathology of the Womb An Effusion of Blood by the Nostrills is the most general kind of those sorts of Passions and what I shall here deliver for the Cure of this Eruprion of Blood may be apply'd to all other Haemorrhagies whatsoever Therefore concerning the Cure of an excessive Bleeding at the Nose there are three primary Indications viz. Curatory Vital and Preservatory The two former have regard to the immediate sptopping of the Symptom as often as it presses and the later undertakes to remove the cause of the Disease that the returns of the Eruption of Blood may abate of their violence or wholly cease Again this Eruption of Blood must be manag'd one way if without a Fever and somewhat after a different manner if joyn'd with it If at any time therefore without a Fever much Blood flows from the Nostrils presently as there will be need of Remedies to stop the Blood there will be three chief intents of Curing all of them to be put in Practice together viz. the Turgescency of the Blood must be so allay'd that it be not prone to make disorderly Sallyes We must farther take care that its Fluxion being withdrawn from the Nostrils be diverted eisewhere and that the gaping Mouths of the Vessels within the Nostrils be clos'd For which ends a great many Remedies both External and Interna and of divers kinds are wont to be administred we shall speak of the former in order and briefly First therefore
Disease For the corrupted Taints of the Blood after that upon long continuance they are become wholly Heterogeneous and unsubdueable gather to themselves at length the Saline Particles with which growing together in that Tartarous Concretion and driven to the Skin they produce Eruptions of the running Scab Concerning the Crue of the running Scab there are two primary Indications viz. the Preservatory which regards the cause of the Disease and the Curatory which has regard to the Symptom viz. the breaking forth of Pushes The Vital has seldom place in this case unless grown altogether desperate where there is a deficiency of Sleep and Strength The Method of Cure ought always to begin with the Preservatory Indication which removes the causes of the Disease by inward Remedies for otherwise outward things are scarce ever administred to any purpose as in the Itch but the roots of the Disease being cut off within the Blood the Cutaneous Pushes soon dye away Though for removing them we must proceed one way when the running Scab begins of it self and somewhat a differing way when it comes after an inveterate Scurvy or the French-pox ill or not Cur'd We shall consider each of these cases severally and distinctly by themselves When therefore this Disease is simple and primary and fresh coming let the evident and external cuases be remov'd let the ill Diet and the Unwholesomeness of the Air be corrected therefore let persons who have been long and too much us'd to feed on Salt Meats Pork or Fish betake themselves to a Diet of good Juice and easy of Concoction Moreover if they live by the Sea side or in Marshy places let them remove to a more dry and clear Air and withal let them be as careful of their Drink avoiding thick and dreggy Beer and thin and acid Wines which are too much fill'd with Tartar Finally let them take care that their Drink or Food be not prepar'd of Mineral waters apt to petrify 2. In respect of the Conjunct and Procatarctick cause viz. a Saturation of the Blod with Saline Particles of a differing Disposition and Nature there are two chief intents of Curing to wit that the Blood and Humours be forthwith cleans'd of their impurities and that the Acido-saline Discrasies of the Blood and Nervous Liquour be altered for the better to keep them from engendring a Tartarous matter For which ends both evacuating Remedies of divers kinds and altertives are wont to be prescrib'd Nevertheless because not all but in a manner only great Remedies are here proper therefore those that are chiefly in use and found to do most good are Catharticks Bleeding Whey Mineral waters coming from Iron Juicy expressions of Herbs Decoctions of Woods Chalybeat Medicines and Salivation We shall set down certain Forms of each of these and the manners of ussing them In the Frist place therefore a general Purge and Bleeding as in the Cure of the Itch being premitted let the following Cathartick Infusion or Tincture be prescrib'd whose Dose is from six Ounces to eight to be repeated whithin six or seven Days Take Roots of sharp pointed Dock dryed of Polypody of the Oak of each half an Ounce Sena ten Drams Epithymum six Drams Rhubaru Mechoacan of each half an Ounce yellow Saunders two Drams Celtick Spike half a Dram Salt of Tartar a Dram and a half put them in a Glass with three Pounds of White-wine and a Pound of Elder-flower water let them stand close covered in a cold place for three Days then use it pouring forth daily a sufficient quantity of the clear Liquour Secondly to sweeten the Blood and cleanse ti from its Salts drink every Morning to two or three Pounds of Whey by it self or with Fumitory preparations of Cichory and with sharp pointed Dock infus'd in it and let this Drink be continued for twenty or thirty Days if it agrees with the Stomack and withal in the Evening and early in the Morning let a Dose or the following Electuary be taken Take Conserve of the Roots of sharp pointed Dock six Ounces Crabbs Eyes Coral prepard of each two Drams Ivory a Dram Powder of Lignum Aloes yellow Saunders of each a Dram and a half Sal Prunella two Drams Vitriol of Mars a Dram and a half Syrup of the Juice of Wood-sorrel what suffices make an Electurary the Dose if two Drams Thirdly for the same reason as Whey also Mineral waters coming from Iron are prescrib'd against this Disease and often do great good For when all other Medicines have prov'd of no effect I have sometimes Cur'd a great and almost Leaprous running Scab with this alone Moreover to add to their efficacy we may fitly joyn the use of Sal Prunella or of Vitriol of Mars or of the Electuary before written Fourthly in some persons having much Serun and a Watery Constitution where drinking of Whey or Mineral waters is not proper it is good for them to take constantly a Decoction of Woods at Physical hours and likewise for their ordinary Drink Take Raspings of Willow-wood half a Pound Roots of Sarsaparilla eight Ounces white Saunders Wood of the Mastick-tree of each two Ounces Shavings of Ivory and Harts-horn of each six Drams Shavings of Tin crude Antimony of each four Ounces both tyed in a Rag Licorice an Ounce let them infuse according to Art and boil in sixteen Pounds of fountain water of half keep the straining for use Fisthly Chalybeat Medicines because generally accounted of among the more excellent Remedies are seldom omitted in this Disease though they as seldom prove successful For a gret many preparatious of Iron in which the Sulphurous Particles predo minate for as much as they ferment the Blood and put it upon Excretory Effervescencies encrease rather than diminish the Eruptions of the running Scab Nevertheless Vitriolick Salts Syrups Tinctures and Infusions in regard they fix the Blood and somewhat restrain the Exorbitant excesses of the Salts answer aptly enough to the intention of Curing now propos'd but being too weak cnnot master so Herculean a Disease Wherefore Sixthly these and a great many other Remedies doing no good many reommend Salivation as the stoutest Champion and only fit to contend with so potent an Enemy Yet the event does not always answer this mighty expectation for I must own to have try'd this Remedy my self in four persons afflicted with a greivous running Scab not yielding to other Medicines but without any benefit some of these were put in a very high Salivation by a Mercury Unction others by Pills of the Solar Praecipitate which Salivation they lay under for about twenty Days after which time all the Scaly breakings forth and clusters of Pushes vanisht Nevertheless for perfecting the Cure a Diet Drinkd ordered of the Decoction of Sarza with frequent Sweating under a Cradle and deu Puring betwixt while was continued for a Month Yet this course being ended when no footsteps of the running Scab seem'd to be left behind within the second Month a
new stock of the same Disease biginning to spring forth grew up in a short time to its wonted Maturity Moreover when one of these persons would repeat this Medicine and another after two returns of the Di2ease would try it a third time both of them at length despair'd of Cure after they had underwent so much Misery Whence it appears that the French-pox though Malignant in the highest Nature and causing most Filthy and Virulent Ulcers consuming the Flesh and Bones may much more easily and ceratinly be Cur'd than the running Scab The reason of ti is that the cause of the Pox consists in a Malignant and altogether Heterogeneous Miasin defiling and as ti were Poysoning the Blood and Nervous Liquor for some time though not wholly subverting their Crasis or utterly depraving them for the future Wherefore that Cure is perform'd by Salivation or a Sweating Diet extirpating all that Venom the Genuine Disposition of the Blood and Humours then remaining But in a deep sort of running Scab the Elementary and Originally composong Particles of the Blood are corrupted so that unless the Crasis and due Disposition of these be restor'd all sorts of Evacuations and Purgings of the Malignant and Venemous matter though never so fll and eradicative will effect little or nothing Wherefore it is not without ground that many famous Physitians formerly have judg'd this Disease when coufirm'd and drawing near to a Leaprosie to be hardly or never Cur'd 2. No better event attends this Disease when if succeeds an inveterate Scurvy Haply the intentions of Curing are somewhat more certainly pitcht upon when this effect is suppos'd to be the basis or root of that viz. the Terapeutick intention being thence taken we insist chiefly on Antiscorbutick Remedies but yet the more smart and hotter things of this kind as Scurvy-grass Cresses Horse-raddish Pepperwort and other things irritating the Blood too much in regard they more dissolve its Crasis and drive the Tartarous Concretions more plentifully to the Skin are always found rather prejudicial than advantageous And for this reason the use of hot Baths or Bathing in hot waters which in regard it evacuates the Humours of the whole Body by a most plentiful Sweat and cleanses the Pores of the Skin and mightily purges them amy seem to be very available in this Disease most commonly is so far from doing good that the Eruptions are wont thence to be mightily encreast and exasperated For I have known many persons not very much over-gone with the running Scab who going to our Bath to bathe themselves in the hot waters have return'd thence perfectly Leaprous Wherefore when this affect is a Symptom arising from the Scurvy all Smart and Elastick things being avoided let only the more temperate and such as are endow'd with a Nitrous Vitriolick or Volatile Salt be administred We shall give you some kinds and froms of each of these sorts In the First p ace things chiefly excelling in a Nitrous Sal are Chrystal Mineral the Juices or Decoctions of certain Herbs and some Purging Mineral waters Take Chrystal Mineral or Nitre purified to the highest degree an Ounce Flowers of Sal Armoniack a Dram bruise them together in a Glass Mortar give to a Dram thrice or four times in the space of twenty four hours Take Leaves of the great House-leek two handfuls being bruis'd boil them in two Pounds and a half of fresh Milk till it turn to Whey and Curd being strain'd let the clear Liquour be taken to a Pound twice a Day Take Leaves of Dandelyon six handfuls being bruis'd put them in a Glaz'd Earthen Pot with a cover which put in an Oven after the Bread is draum and let it stand for six or eight hours then the Mass being put in a strainer let the clear Liquour run out the Dose of which is from four Ounces to six thrice or oftner in a Day Cucumbers being endow'd with a Nitrous quality are found by experience to be good against this Disease wherefore let store of them be often eaten as a Sallet Moreover let three or four of them being cut into slices be infus'd and close stopt in three Pounds of fountain water all Night to the clear Liquour pour'd off add of Sal Prunella two or three Drams the Dose is half a Pound thrice or oftener in a Day for the same purpose also Decoctions of the Leaves together with the Fruit made in fountain water are proper Some Mineral Purging waters as especially those of North-hal being resolv'd by Evaporation mainifestly shew the Nitrous Salt wherewith they are imbued And I have sometimes found by expericence that dayly drinking about two quarts of them for many Days Cures a small running Scab 2. But as I have hinted before Mineral waters endow'd with a Vitriolick Salt as those of the Spaw and ours of Tunbridge and Astrope far exceed those Nitrous waters nay and all other Medicines and are of greater efficacy in the Cure of the running Scab To those who have not the conveniency of using these waters I ordinarily give with good success against this Disease common waters impregnated with our Steel and so most exactly resembling those Mineral waters It happens that Tin and Antimony by reason of their Mineral Salts or at leastwise by reason of the Mercurial Particles in them are extol'd by many for curing the running Scab and are wont to be prescrib'd with other Medicines Let Shavings of Tin and Powder of Antimony be infus'd in Beer for ordinary Drink they enter also the Decoctions of Sarza with Woods which are ordered against this affect The use of the Viper and preparations of it sufficiently recommend the excellent Vertue of Volatile Salt for the Cure of the deep sort of running Scab nay of the Leaprosie it self For it being manifest by frequent observations that Remedies prepar'd of Vipers do good in the running Scab and Leaporfie certainly the reason of the help it affords ought to be ascrib'd to the Volatile Salt with a great plenty of which this Animal is endowed For the Particles of this destroy the fixt and acid Salts predominating in the Blood of the Diseas'd and dissolve their Combinations Nevertheless the Salt Spirit and Oyl of Vipers Chymically extracted by reason of their Empyreumatick and mighty Elastick Particles which they draw from the Fire are not proper in this Disease so neither the Spirit or Volatile Salt of Harts-born Soot or Blood and other such like Armoniacks because by exagitating the Blood and Humours above measure they cause their Crasis to be more dissolv'd and their Corruptions to be driven forth more plentifully to the Skin Wherefore the more simple preparations of Vipers as Broaths of their Flesh boil'd in water Drinks impregnated with Infusions or Incoctions of the same and Powders made of the same dryed and beaten are rpescrib'd with more success against this Disease Moreover not only the Flesh of Vipers but of other kinds of Oviaprous Snakes being boil'd and eaten for ordinary Food
Medicines it either terminates immediately in Death or is chang'd into some other Disease viz. a Palsy Stupidity or Melancholy for the most part incurable Concerning the Cure of the Falling-sickness the Indications as vulgarly set forth are either Curatory having regard to the Fit and either keep it off as it is coming or soon force it off when it has seiz'd Or they are Prophylactick and regard the cause of the Disease which if they remove its accesses will be kept off for the future As to the first intention general Evacuatives have scarce place nor ought a Vomit or Purge and very seldom Bleeding to be us'd in a Fit if the person continues depriv'd of Sense a long time Clysters are sometimes wont to be administred but the chief thing to be done is to fix the Animal Spirits which are too Exorbitant and Volatile and to suppress their beginning Explosions For which ends two kinds of Remedies chiefly conduce viz. First Such as repress the Animal Spirits apt to rise to an Exorbitancy and to shoot and repel them by a certain Fumigation as it were ungrateful to them and force them into their due course Which Medicines endow'd with a Volatile and Armoniack Salt or also with a Vitriolick Sulphur will effect Of which kind are Salt and Oyl of Amber Spirit of Blood of Harts-horn of Soot Tincture of Castoreum and the like For these being inwardly taken or held to the Nostrils often give relief nay and are thought to drive away the evil Spirits of this Disease even as in Tobit the Fume of the Gall of a Fish burnt did the Devil Secondly the Animal Spirits are diverted or hindred from entring upon Explosions when they are allur'd to and kept imploy'd in some work that is usual to them wherefore in the Fit Frictions us'd over the whole Body and continued for some time often do good But as to raising up persons seiz'd and wholly restraining the Arms and Leggs from the Convulsive motion or binding them in this or that Posture as some people use to do and so as to blowing Sneezing-powder into their Nostrils and pouring strong Cordials into their Mouths or applying Cupping-glasses and Scarifications and dealing roughly with the Diseas'd by other ways of Administration thus disturbing the course of the Fit I say this sort of practice is very often ill taken in hand because by this means Nature is doubly toil'd viz. both by the Disease and no less by standers by and Servants whereas it were much better to let the Fit pass according to its course that so the Diseas'd might escape with one affliction Truly the greatest care of a Physician and efficacy of Remedies is in the Prophylactick part of this Disease that its cause being taken away or its root cut off all the Fruit may wither The Medicines requir'd for this Indication have regard to many intents which nevertheless may be reduc't to these two chief heads viz. First that the fuel of the Disease supplyed immediately from the vitious Blood and Nervous Juice and more mediately from the Viscera and first passages be cut off And then Secondly that the evil Disposition of the Brain and Spirits in it which is peculiar to the Epilepsy be remov'd As to the first thing indicated here Vomits and Purges and other both Evacuatives and Alteratives nay and Bleeding and Cauteries have place for as much as by these means and ways the Impurities both of the Viscera and Humours are drawn away and their Discrasy is corrected For though these Medicines and Physical Administrations seldom or never Cure the Epilepsy alone yet they remove Impediments raise up Nature and stir her up to set upon her Enemy They also prepare the passages that thereby Specifick Remedies may more certainly and efficaciously exert their Vertues Wherefore when the Cure of this Disease is attempted Spring and Fall and at other fit seasons by Secrets and Arcana's it's usual to use betwixt whiles those sorts of Medicines As to Specifick Remedies which are affirm'd even alone though not always to reach the cause of the Epilepsy and to overcome it of which kind are the Male Peony Mistletow of the Oak Rue Castoreum Elks-hoof preparations of Mans Scull Amber Coral with many others In regard these things are taken without any sensible Evacuation or even Disturbance following in the Viscera or Humours it seems strange by what formal way or Vertue of working they are wont ever to do good in this Disease If there be any room for conjecture in this intricate and obscure thing in regard the Procatarctick cause of the Epilepsy consists in the Heterogeneous Combination hapning to the Spirits in the Brain it follows that those things which overcome and remove such a cause are of such a Nature that by strengthening the Brain and constringing its Pores they keep off that Combination and so fix and as it were constipate the Spirits that abound in the middle of the Brain leaving their Combination that they are no longer apt and prone to irregular Explosions After the like manner haply as when the Powder of Aurum Fulminans ground with Sulphur and sprinkled with Spirit of Vitriol loses its fulminating Vertue And in truth we may conjecture nay in some measure discover that these kinds of properties to wit one or both of them together are in many Antiepileptick Remedies for the Peony Mistletow of the Oak Rue Lillies of the valley with many others excel in a manifest sort of Astriction whence it is very likely that their Particles inwardly taken and so by the Vehicle of the Blood or Nervous Juice convey'd to the Brain so constringe and close its over Lax and Gaping Pores that they no longer lie open for the entrance of the Morbifick matter Moreover because these concrets breath forth an Armoniack as it were and dissipating vapour therefore the same are said to purify the Animal Spirits and to fix and corroborate them having left their Heterogeneous Combination This Vertue of purifying the Spirits proceeding from the Armoniack Salt shews it self most in Remedies taken from Minerals and Animals such as are the preparations of Mans Scull Blood Amber and Coral as the other Astringent Vertue appears most in the parts and preparations of Vegetables There is no need for us here to set forth a compleat Method of Curing the Epilepsy with exact Forms of Prescripts because general Precepts and excellent Remedies are every where to be had amongst Authors and a prudent Physician will easily accommodate both the Indications and that plentiful Apparatus of Physick to particular cases of sick persons But because we give a clearly new Theory of this Disease a Therapeutick Method also adapted to the same ought to be here given Which we shall presently fully delineate after I have given you a story of a person troubled with the Epilepsy The Daughter of an Alehouse-keeper at Oxford had been very subject from her Infancy to a Catarrh falling on her Eyes being otherwise strong and
and frequent Fainting Fits leading even to Death's door accompanied with a Thirst and Watchings pursued the sick Lady all which Symptoms she plainly perceiv'd always to arise from that Tumour of the Ventricle to wit its sharp and heterogeneous Particles continually entring the Extremities of the surrounding Fibres and Nerves To this Person all Vomitory Cathartick Antiscorbutick and Hysterick Medicines without giving any ease seem'd rather to have prov'd offensive and prejudicial After Bleeding by Leeches and the use of Asses Milk she receiv'd some benefit and afterward by long drinking Mineral Waters she was very much reliev'd What has been said here of Convulsions from a Morbifick cause besetting each end of the Systema Nervosum will be made more clear when hereafter we shall treat particularly of the chief kinds of Convulsions viz. of Hysterick Hypochondriack and other Passions In the mean while it will not be necessary to add a Therapeutick method to this Hypothesis of Convulsions hapning by reason of the Extremities of the Nerves being affected because the ways of Curing this affect may better be accommodated to those that we shall hereafter deliver in particular I have found also by ocular evidence that there are Convulsive affects whose cause or Morbifick matter lyes within the Plexus's of the Nerves For opening the Body of a noble Lady who had been horribly troubled with those affects they call Hysterical a little before her decease I found the Womb wholly without fault but along the Nervous Plexus's of the Mesentery which as it seem'd had been wont to swell and rise up in a bulk I found the Membranes of that Entral loosen'd and severed from each other so that they appear'd every where swoll'n and lax as if blown up in little bubbles or bladders Nor is it less probable that the pains of the Colick often proceed from a sharp and irritating matter contain'd in those same Plexus's Moreover such a kind of matter within the Pexus's of the Heart seems to cause there horrible Tremblings and Passions and within the Plexus's of the Lungs or Neck terrible Fits of the Asthma CHAP. V. Of Convulsive motions arising from the Liquour lying in the Nervous Bodys and irritating all their Processes into Convulsions IT is obvious almost to daily experience that Convulsive affects ren through the whole Genus Nervosum and infest sometimes these parts sometimes others sometimes many together For in some we may observe that the Tendons of the Muscles every where leap and are drawn with Convulsions in others that all the outward Members are in many places bent or extended this way and that with various flexions and contorsions We see some forc't by a masterless and ungovern'd impetus of the Spirits sometimes being struck as it were with a rage to run or leap sometimes strongly to belabour the earth or any thing that comes in their way with their Fists which unless they did they would fall presently into Swoonings and horrible Fainting Fits It would be too tedious to enumerate all cases of those general Convulsions passing through the whole Genus Nervosum But such like Symptoms though various and manifold may in some sort be reduc't to three chief heads viz. as they chiefly depend on three sorts of causes For since in these Convulfions passing from place to place we ought to suppose the whole Nervous Liquour to be vitiated and the Animal Spirits every where abounding in it to be adulterated and consequently to be almost continually exploded We may observe that that taint for the most part is communicated both to the Nervous Juice and the Spirits every where accompanying it by one or the other of these three ways viz. First Either from Poyson or Witchcraft Secondly from a malignant or ill-determin'd Fever viz. in which the Morbifick matter is discharg'd on the Brain or Genus Nervosum Or Thirdly When the Nervous Liquour in long process of time by reason of a Scorbutick or otherwise vitiated affect degenerates from its due Crasis into a sharp acid or otherwise Preternatural and Convulsive Liquour We shall here consider of each of these cases and first of Convulsive Fits which are product from Poyson or Witchcraft First therefore That some Poysons act on the Nervous Liquour rather than on the Blood and depraving it cause chiefly Convulsive affects it plainly appears from eating of Cicutaria Apium risus deadly Nightshade the wild Carrot and other offensive Herbs which is wont to be followed in a short time after with horrible Contractions of the Stomack a Numness Delirium and Twitchings and Convulsions in the whole Body of the tendons Moreover those kinds of Convulsive affects ensue in such as are bitten by a mad Dog and other Venemous wild Beasts when the Virulent Miasm receiv'd by the Nervous Juice having lay n hid in it a long time at length exerts it self and infects and poysons with its ferment the whole Mass of the Liquour in which it is involv'd And this is more clearly manifested by the wonderful Symptoms viz. the painful Convulsions and continual Dancing which are affirm'd by Authors of Credit to ensue upon the bite of a Tarantula Which doubtless happen because upon the bite of that Animal some Venemous Miasms are convey'd into the Body of Man which nevertheless being little injurious to the Blood and vital Spirit assoon as they have past from it into the Nervous Liquour presently spread themselves like a Ferment through its whole Mass and infect the Animal Spirits every where abounding in it so that they being forc't apart from one another and driven hither and thither in a disorderly manner cause Convulsive affects which sometimes are accompanyed with a Contraction of the containing parts sometimes with a languor and resolution of them If it be asked why the painful Convulsions which are rais'd by the bite of a Tarantula being presently appeas'd by Musick are wont to be chang'd into a Dancing I answer that the Venom communicated to the Nervous Juice by the bite of a Tarantula is more mild than to be able wholly to extinguish the Animal Spirits or altogether to dissipate and force them to very violent explosions being driven into divers parts but can only put them to flight and being driven hither and thither egg them to slght and in a manner only pain-causing Convulsions Now Musick by its gently soothing Nature readily gathers together in one and mutually associates the Spirits so dissipated Wherefore when the said Spirits by reason of Virulent Miasms sticking to them are continually prone to Involuntary and Convulsive motions the Melody disposes and directs them being allur'd together into such Convulsions that entring the Bodys of the Nerves in a certain feries and order they are carryed in certain limited I racts as it were till at length the Particles of the Venom being wholly evaporated and the fury and impetus of the Spirits wearyed they have wholly shaken off that rage And indeed Musick readily forces sound and sober Men even against
kind of Method she observed with so great advantage to her that she has enjoy'd her health for many years and enjoys it still Among many remedies which she took against that Sharpness and Ulcerous disposition as it were of the Palate and Aesophagus I ordered that she should Drink every Morning her own Urine fresh made This for the most part being very Salt was wont to give a mighty relief but at certain times the Urine that came from her was thin and in a great plenty which nevertheless was not Salt but manifestly Acid like Vinegar after the Drinking of which she found little or no benefit The reason of the good effect of the one and not of the other is this In as much as Saline Particles of a differing state and not those that are of the same mutually act on each other and weaken their strength therefore the Salt Urine and not that which was Sharp of sour Cur'd the Sharpness of the Throat And it appear'd from hence that the Humour distilling on the parts of this Ladies Mouth and Throat was Acid and drew near to the nature of a Vitriolick Vinegar because the smoke of Tobacco receiv'd in the Mouth of the Diseas'd seem'd wonderfully Sweet as it uses ot do in any that tast Vitirol before Ten years since I went to see the daughter of a certain Nobleman troubled with Convulsive Motions after such a manner that some thought her obsess't with an evil Spirit This Virgin being about sixteen years of Age Fair and well in flesh but begotten of a Father troubled with the Palsey about the winter Solstice began to be ill without any evident cause First for some days she was affected with a Head-ach and a Giddiness though in no severe manner afterward she perceiv'd a Trembling and sudden Contraction in one Arm and presently in the other which kind of Convulsions returning often that day scarce lasted a moments space The next day after sitting by her Sister in a Chair on a sudden she started up and made a leap or two and many others successively to many feets distance with a wonderful Agility Then when she was come to the end of the Room she stood for some while leaping up in the same place and every time to a wonderful height when her legs were able to hold Leaping no longer she fell on the ground and presently threw her Head several ways as though she would have thrown it off her Neck assoon as she ceast from this Motion through her being tired presently the same fury seiz'd her Hands and Feet that she was forc't to keep these members a going in a violent manner striking them against the Walls and Doors or stamping on the Floor When through Modesty or Reverence due to Friends or Persons present she kept her self from these Motions by main force for she was always present to her self and spake with sobriety presently the affect being convey'd inward she was very much infested with mighty oppression of the Heart a Sighing and very loud Sobbing then when she gave way to her self presently the Rage being convey'd to the Muscles of the outward Limbs she was forc't either to Leap or to throw her Head or Arms this way and that in a violent manner or also to run swiftly up down the Chamber or to stamp on the Ground with her Feet Thus these kinds of violent Commotions of the Limbs or Viscera mutually succeeded each other the Tragedy of the distemper returning as it were in a Circle Coming the fifth day after this Lady had been ill I gave her a Vomit of the Infusion of Crocus Metallorum Wine of Squills and Salt of Vitriol after which she Vomited a great store of Aeruginous Choler with a mixture of a most Sharp and as it were Vitriolick Humour The next day after I drew ten Ounces of Blood from the Saphaena Vein Moreover she took twice a day Antidotes of the Powders of Precious Stones Mans Scull and the Male Peony by the use of these things seeming to be recover'd she liv'd for many days after free from the foresaid affects but after a fortnight the full Moon coming she fell into a relaps of the same disease more violent than before for besides the wonderful Leaps the violent Contorsions and Convolutions of the Head and Members she was also forc't to Run up down in a Vehement manner in her Bed Chamber She took at this time by the Praescripts of others Antihysterick Remedies and Purges at some set intervals of time but without any relief Being call'd again in regard thatshe was of a Robust habit of Body and seem'd affected with a mighty raging of the Spirits I gave her a strong Vomit after which she Vomited ten times a Choler as green as Verdâ—grease with a Flegm as Sharp as Aqua Stygia and was suddenly reliev'd I gave her afterward every morning a draught of White-wine Diluted with Black Cherry Water pour'd on Millepedes bruis'd and strongly exprest By the use of these things seeming to be Cur'd she was perfectly well for a Month and more and when afterward she at any time perceiv'd any forerunning signs of a return of the affect presently by the use of a Vomit and the same expression of Millepedes she kept off the Fit Within three Months she so recover'd her former Health that she has now lived many years wholly free from such Convulsive affects But from the time that the Convulsive Passions wholly ceast she was sometimes troubled about the parts of the Mouth and Throat with a Defluxion of a most Acid Humour like the distill'd Liquor of Vitriol Moreover she has sometimes been obnoxious to the longing disease of Maids sometimes also to a Cough with a discolour'd Spittle threatning a Ptizick which nevertheless were easily Cur'd by remedies usual in the like cases Whilst I was writing these things I went to see a Noble Virgin who was troubled with Convulsive affects of another kind and those Universal and no less Admirable This about the eighteenth year of her Age being of a fresh Colour Handsome and before sound enough now happening unawares to incur the danger of being infected with the Plague it being rife hereabouts fell into a Panick Fear with frequent Swooning Fits the night following the underwent such Failings and Disorders of the Spirits that she seem'd even ready to Dye But having past that evil with much ado she had afterward every day Convulsive Fits though returning first at uncertain hours and in several forms But within a short time the accesses of the disease becoming regular they return'd constantly twice a day viz. at eleven of the Clock in the forenoon and at five in the afternoon that no intermitting Fever keeps its periods more exactly nay and all the circumstances of the Fit happen'd daily after the same manner When she had been thus ill three weeks I was call'd on a certain day that I might observe all the Symptoms and the whole form of the disease
White-wine half an Ounce let them boil in two Pounds and a half of Fountain-water till a half be wasted add of Rhenish-Wine a Pound and strain it presently into which put of the best Sena half an Ounce Rhubarb six Drams Leaves of black Hellebore half an Ounce the yellow Coats of Oranges two Drams make a close and warm Infusion for twelve hours let the Straining be kept in a stopt Glass the Dose is from five Drams to six It were easie to set down here many other forms of Catharticks but there is no great variety requir'd in these But of the foregoing let these or the others be given as they best agree and now and then let them be repeated within five or six days as occasion requires An over frequent and violent Purging casts down the powers of the Body greatly impairs the strength of the Viscera and in the mean time does not take away the Disease After a Purge or two if Bleeding be indicated let Blood be drawn from the Arm or from the Vessels of the Fundament by Leeches It matters not much which Vein be open'd nor is the opening of the Salvatella Vein of as much moment as it is said As to the large Discourses made by Authors concerning the opening of the Liver or Cephalick Veins rather than any others in the Scurvy since the Circulation of the Blood has been known it comes to nothing Phlebotomy is indicated by a plenty and vitiousness of the Blood which it is better to let forth at several times in a small quantity than at once in a great For when the Liquour of the Blood is become very impure it is corrected by no kind of Remedy more certainly than by a frequent and spare letting of it forth for the old corrupted Blood as often as it is drawn forth is succeeded by a better and clearer fresh Blood mean while there is need of caution that it be not drawn away at once in too great a quantity for its store being much drain'd together Sanguification fails so that a Dropsy or Cachexia ensues Besides Purging and if need be opening a Vein many Remedies of another kind no less necessary are requir'd in the Scurvy And that they may be prescrib'd in order we must forthwith consider whether only Preservatory Indications have place here and whether certain Curatory Indications viz. such as have regard to some severely pressing Symptoms ought not to be interchangeably pursued with them And if you are to imploy the whole work of the Cure against the cause of the Discase you may proceed after the following method We shall shew you hereafter what sort of Cure is to be apply'd to Symptoms if haply occasion requires it Therefore if nothing hinders but you are to imploy the chiefest stress of Physick in rooting out the cause of the Disease principally and by it self for this purpose let Digestives likewise and Specificks or Antiscorbuticks as we hinted before be us'd at all times unless on the days of Purging To which sometimes if it be needful let Diaphoreticks or Diureticks be added Manifold forms and prescripts of Medicines and of various kinds for performing these intents are every where to be found amongst Authors I shall here set down some of the more choice of them which I here thought good to distribute into two ranks according to the twofold nature of the Scorbutick Cause viz. the Sulphureo-saline and Salino-sulphureous Dyscrasies of the Blood And first I shall deliver such as are proper in this latter kind of affect viz. where there is need of Medicines endow'd with a certain instigating vertue and such as are very much fill'd with a Volatile Salt Let Digestive Medicines that restore the Ferment of the Stomach and help the Functions of that and of other of the Viscera which serve for Chylification and Anti-Scorbuticks or Specificks which take away the Dyscrasy of the Blood either be joined in the same Composition or at leastwise let them be taken the same day one after the other Among digestive Remedies are justly counted the Cream Crystals Salt and Tincture of Tartar Tartar Vitriolated and Chalybeated Elixir Proprietatis the simple mixture The use of each of these given twice a day oftentimes does good Moreover you may easily make Magistral Tinctures and Elixirs of various kinds both digestive and appropriated to the Scurvy with the two following Menstruums Take rectified Spirit of Vitriol Six Ounces Spirit of Wine Alcholized sixteen Ounces mix them and Distill them in a Glass retort with three Cohobations keep it for use in a Glass well stopt Elixir Proprietatis is more easily and better prepar'd with this Compound Menstruum than the vulgar way Take Winters-bark Lignum Aloes Roots of the lesser Galingal of each two Drams Cinnamon Cloves Cubebs of each a Dram Seeds of Bishops-weed and Watercresses of each half a Dram being bruised pour to them of the foresaid Menstruum enough to cover them three Fingers over let them digest in a Matrace in a Sand Furnace for six days let the straining be kept in a Glass close stopt The Dose is twenty Drops more or less in a Spoonfull of Canary or of an appropriated Liquor Let it be given twice a day Take white Amber Gum of Ivy Caranna Tacamahaca of each a Dram Saffron half a Dram Cloves Nutmegs of each two Scruples being bruised pour to them the aforesaid Menstruum and let a Tincture be extracted according to Art The Dose is twenty Drops as above Take blew Salt of Tartar four Ounces let it digest in a Matrace with a Pound of Spirit of Wine Alcholized till a Tincture be extracted Let this be another Menstruum with which you may prepare Elixirs out of Gums Spices c. after the same manner as with the former Menstruum While these kinds of Medicines are given in a small Dose in the Evening and early in the Morning at Physical hours viz. at eight a Clock in the Forenoon and at four in the Afternoon let the Antiscorbutick Medicines of the other kind be taken which for the most part we are wont to prescribe in a twofold form viz. in a solid form and a liquid to be taken all under one so that the solid Medicine being taken first the liquid is drank after it there are various kinds and ways of Composition of both viz. in a solid form Electuaries Confections Powders Pills and Tablets in a liquid form are Decoctions Infusions Expressions Distill'd Waters Physick Wines and Ales. We shall give you some of the more select Medicines of each of these kinds Electuaries TAke Conserve of Scurvy-grass Roman Wormwood Fumitory of each two Ounces Powder of Winters-bark Roots of Angelica and Aron of each two Drams Species Diatrion Santalon a Dram and a half Powder of Crabs-eyes a Dram Salt of Wormwood two Drams with a sufficient quantity of Syrup of the Juice of Citrons make an Electuary Take Conserve of the Leaves of Scurvy-grass and Brooklimes made with an equal quantity of
Flowers of Tamarisk also shavings of Harts-horn or of Ivory which sweeten the Liquour and preserve it from turning four viz. in as much as the Particles of the fluid Salt which abound in the Cider and are apt to make it sharp are taken up in dissolving the foresaid Ingredients Temperate Physick Drinks may be prescrib'd after this manner viz. let a small Ale be prepar'd to fill a Vessel of five or six Gallons into which instead of Hops let tops of the Pine-tree of Firr or Tamarisk or the Raspings of either of their Woods be put them after it has wrought let the Roots of sharp pointed Dock dryed be put into the Vessel than which certainly there is no Remedy more excellent in the Scurvy To these sometimes let the Leaves of Brook-limes Water-cresses Winter-cresses c. be added Also Pomecitrons or Oranges cut in slices Leaves of Harts-tongue put into a little Vessel of midling Ale after it has wrought gives it a grateful savour and odour CHAP. IV. Of the Curatory Indication of the Scurvy whereby we obviate the Disease it self and the Symptoms that are most pressing HItherto we have shewn concerning the Cure of the Scurvy what regards the Preservatory Indication to wit the removal of the Morbifick Cause viz. both the intentions of Curing and the Remedies indicated Which kind of method being seasonably begun and duly prosecuted often does the whole work viz. in as much as the Cause of the Disease or the Root of it being cut off the affects depending of it dye of their own accord Nevertheless we must not go on with this course of Physick always directly but turning aside several ways For sometimes severe Accidents and Symptoms happen which require a peculiar and as it were extraordinary Physical help to which we must Immediately attend and often interrupting the general Cure Concerning these we must observe that as affects which happen upon the Scurvy require Appropriated Remedies according to the Nature of each of them and to the disposition of the Patient yet Antiscorbuticks ought always to be mixt with them I will not be needful to order a Method of Cure against all diseases and affects with which the Scurvy is wont to be attended for so the whole Practice of Pyhsick would be here transcrib'd but we shall have regard only to the Symptoms that are chiefly pressing by which either the life of the Patient is endanger'd or the principal Cure Obstructed after what manner and by what Medicines such are Cur'd I shall now shew Of Curing a difficult Breathing and Asthmatick Fits A Difficult Breathing with a straitness of the Brest and Asthmatick Fits ought presently to be removed by appropriated Remedies to be prescrib'd besides the general Method for other wise the diseased is soon brought in danger of life Since these sorts of evils arise in Scorbutical persons for the most part either through the fault of the Blood stagnating in the Heart or by reason of the Nerves of the Lungs being hindred in their Function therefore they are Gur'd either by Cordial or Anticonvulsive Medicines Spirit of Harts-horn of Soot of Blood of Mans Scull also the Tincture of Castoreum of Antimony or of Sulphur Flowers of Sal Armoniack Flowers of Benzoin also Elixir Proprietatis are often of excellent use in these Cases which kind of Medicines may be frequently given with a Dose of some Antiscorbutick Liquors appropriated also against the foresaid afects For the appeasing of a sudden difficulty of Breathing which is meerly Convulsive if at any time it very sorely presses I have found no more present remedy then our Tincture of Laudanum with Opium given to ten or twelve drops in a convenient Liquour For Sleep Stealing on the Spirits remit of their disorders and in the mean while being refresh't they resume afterwards their accustom'd offices after a due manner Take Roots of the great Bur Dock of Butter-Burr and Chervil of each an Ounce Leaves of Maiden-hair and Germander of each a handful Seeds of the Great Bur Dock of Bastard Saffron of each three Drams Raisins two Ounces being slic't and bruis'd let them Boyl in three pounds of Fountain water till the third part be Consum'd add of White-wine four Ounces strain it into a Flagon into which put leaves of Scurvy-grass slic't a handful Roots of Elecampane preserv'd and small slic't half an Ounce make a close and warm Infusion for three hours the Dose is six Ounces twice or thrice a day Of Affects of the Stomach which are wont to happen in the Scurvy SCorbutical persons are wont sometimes to be troubled with a great Oppletion and Pain of the Stomach also with a Nauseousness and Belching and sometimes also with a frequent and violent Vomiting which kind of distempers sometimes arise from the Chyle there degenerated into a Mass of Corruption but oftner from the Morbifick Matter brought thither either by the conveyance of the Blood or also of the nervous Juice and either depos'd within the Cavity of the Stomach or fixt in the Plexus's of the Nerves and in the Membranes In these kinds of Cases if a Viscous Stinking or otherwise Offensive Matter be cast up by Vomit and there be a suspicion that the cause lyes within the Cavity of the Stomach its proper to give a gentle Vomit of Wine of Squills or of Salt of Vitriol Or let the offending Humours be Purg'd off by Stool either by Extract of Rhubarb or by its infusion with the addition of Salt or Cream of Tartar But if the Matter sticks deeply within the Membranes or the Plexus's of the Nerves Diaphoreticks or things that moderate the effervescencies of the Salts do better Let Elixir Proprietatis or Flowers of Sal Armoniack or Spirit of Soot be frequently taken with Raddish Water Compound water of Earthworms or some other Antiscorbutick Liquour Mean while once or twice a day let Fomentations of Wormwood Centory Flowers of Cammomil Roots of Gentian and other things Boyl'd in White-wine be applyed to the Region of the Stomach with Wollen Cloths dip't into it warm and wrung forth The use of Glysters is proper and Opiats often give great help Of the Belly Ach and the Scorbutick Collick SCarce any affect requires a more speedy Physical help than the Colick and gripes in the Belly which frequently happen in the Scurvy Against these evils Glysters of various kinds Fomentations Liniments and Cataplasms are administred The use of Opiates is found to be very necessary here Certainly in this Case that Praescript of Riverius chiefly has place viz. that Purging Pills be given with Landanum mixt with them for a plentiful Evacuation by seige and Sleep being caus'd the Fit often is taken away Moreover Powders of Shells by which the sharp Salts are Imbib'd or fixt conduce very much to the removal of the Morbifick cause for example Take Crabs Eyes and Egge Shells of each a Dram and a half Pearl a Dram make a Powder divide it into twelve Doses whereof let one be taken
age upon her recovery from a dangerous Fever she became obnoxious to pains of her Head which were wont to arise sometimes of their own accord but oftner on some light occasion offered the disease being not limited to one place or part of the Head sometimes infested the right side sometimes the lest and often its whole circuit During the access which seldom ending within the space of twenty four hours often infested her for two three or four days she could not endure light speech sound or any motion but sitting upright in her Bed in a darkned room she was able to speak with none nor to take any rest or food at length as the Fit declined she used to fall into a deep and troubled sleep from which awaking she was wont to be better and then by degrees to recover and during the time of intermission to be indifferently well Formerly the Fit being raised only occasionally seldom returned within twenty days or a month and then afterwards much more frequently but of late she is seldom free from them Moreover through many occasions or rather evident causes such as are the changes of the Year and of the Air the great Aspects of the Sun and Moon violent passions and errours in diet she is sorely tormented with them Now tho this affect having sorely afflicted this noble Lady when I went to see her above twenty years and pitching its Camp near the Confines of the Brain had so long besieged its Royal Fort however it had not yet gotten possession of it But the diseased being free from a Vertigo Scotomia Convulsive affects and any sleepy symptom had still the chief Faculties of her Soul whole and sound In order to the obtaining or rather endeavouring a Cure throughout the whole progress of the Disease a great many Remedies prescribed by most skilful physicians as well of our Country as Foreigners were used without any success or ease She tryed all the Great Remedies of every kind and form but always in vain a great many years since she underwent a long-continued and most troublesome Salivation by a Mercury Ointment so that she incurred a great danger of Life Afterward a Cure was twice undertaken by a Flux tho to no effect by a Mercury Powder which the famous Empirick Charles Huis generally gave She tryed hot Baths and drank Spaw-waters almost of every Country and Nature with the like success as the rest She was frequently blooded and once in an Artery she went with many Issues made sometimes in the Sinciput sometimes in the hinder part of the Head She took the Air in divers Countreys viz. besides her Native that of Ireland and France She took Medicines of all kinds whatsoever to wit Cephalicks Antiscorbuticks Hystericks all famous Specificks nay and Empirical Remedies given both by the learned and unlearned by Mountebanks and old Women yet she declared that she had not received any where from any remedy or method of Cure the least help or relief But the refractory and obstinate Disease being deaf to all inchantments of Medicines would not be mastered Moreover having possessed so long the precincts of the Brain tho it could not enter its recesses yet when I went to see her extending its limits into certain other parts of the Genus Nervosum it began to raise violent pains in the Limbs also in the Loyns and Abdomen such as are usual in a Rheumatism and in a Scorbutick Cholick A worthy man about forty years of age robust and sound when upon riding a whole day in the rain he had gotten cold by reason of the hinder part of his Head being continually wet soon began to feel a pain in that Part which in a short time being very much encreased miserably afflicted the Diseased both day and night and kept him in a manner always without sleep Blooding Purging Clysters Vesicatories Hypnoticks nay and a great many Remedies of all kinds diligently administred by the joint advice of a great many Physicians did little or nothing towards the Cure of this affect When the Disease notwithstanding all these daily grew worse after six weeks Glands preternaturally swoln and painful arose all over the Neck the Hemicrania in the mean while abating nothing Moreover the Tendons of the Neck being very much distended and stiff proved very tedious to him to which in a short time Convulsive motions and leaping of the Tendons succeeded in various Parts with a Delirium and at length the Diseased being worn out with pains and watchings yielded to Death As in the foregoing cases the Head-aches proceeded from Nodes and tubercles of the Meninges so sometimes mortal and incurable Head-achs arise from a Phlegmon and Abscess A while since a University Scholar after he had complained for a fortnight of a very great Head-ach afflicting him almost constantly at length the Fever becoming stronger presently Watchings Convulsive motions and a talking light-headed ensued at which time a Physician being called Blooding Clysters Playsters Revulsives Vesicatories also inward Remedies for withdrawing the course of the Blood and Humours from the Head being carefully administred he could do no good but Death in a short time followed The Scull being opened the Vessels spread over the Meninges were filled with Blood and very much distended as tho the whole mass of Blood had flown thither so that the Sinus's being dissected and opened above half a pound of Blood flowed forth Moreover the Membranes themselves being affected throughout with a Phlegmonous tumour appeared discoloured These coverings being taken away all the Anfractus of the Brain and its Ventricles were full of clear water and its substance being too much irrigated was moist throughout and nothing firm For the Blood being there heaped together when it could not circulate threw off from it self a plentyof Serum by which the whole Head was soon floated so that the Disease curable haply at the beginning by Phlebotomy afterward became mortal I remember another University Scholar who after being constantly and very sorely afflicted with a Hemiâ—â—ania under the temporal Suture for three weeks fell at last into a fatal Apoplexy The Head being opened a Phlegmon had grown in the Meninges near the place paining from which at length suppurated and broken the Sanies falling on the Brain had affected its substance with a lividness and corruption But tho a continual Head-ach especially if it be drawn in length for many weeks without intermission be not without danger nevertheless we must not presently despair of its Cure because the cause of this how fixed and immovable soever it may seem is often cured by a long use of Remedies nay sometimes without them by Time and Nature tho in a case that is almost desperate there is need of some Physick lest the present affect pass into a worse viiz into a sleepy or Convulsive distemper So much of the continual Head-ach it now remains for us to propose some Examples and some rare Instances of an intermittent Head-ach Therefore not
through their own fault in as much as being spent or affected with a stupefactive force they are congeal'd as it were or because their Paths or tracts are obstructed in the outward part of the Brain and are possess'd by a strange guest so that they have not a space granted them fit for their expanson The chief Symptoms of this Disease are Sleep and Forgetfulness a cessation of every other knowing or spontaneous function an uneven and slow respiration a Fever and often the affect growing worse Cramps leapings of the Tendons and lastly universal and mortal Convulsions The prognostick of the Lethargy is included in very narrow bounds for the Fit of the Disease being for the most part acute is soon terminated in Death or a Recovery and most commonly is wont to give more cause of fear than hope If it happens upon a Fever that is malignant or of a difficult determinations or if upon other cephalick or convulsive Diseases as the Head-ach Frensy Mania Epilepsy or also if on a long continued or severe Cholick or Gout the Physician can prognostick nothing but ill nor is it less to be fear'd if it happens in a cacochymical Body or in one long subject to sickness and in old age In like manner it is an ill Omen if the Diseas'd being presently overwhelm'd with a great deadness and becoming almost Apoplectical cannot be awak'd if he breaths unevenly and flowly or with great snoarings Moreover if the Disease growing worse and worse the sick Person be affected with Tremblings Cramps leapings of the Tendons and lastly with convulsive motions he is to be look'd upon as in a desperate condition But if the affect without any great Procatarxis be rais'd by an evident Cause alone as from over-eating drunkenness the use of Narcoticks or from a stroak or wound of the Head that are not very dangerous we may expect a less fatal event Moreover if the affect arising on such an occasion happens to a Body which was sound and robust before if at the first invasion it does not wholly take away the Sense and Memory and after a little time the symptoms begin to remit we may not despair of such a sick Person In any Lethargy if the cause of the Disease seems somewhat to be shaken and mov'd so as plentiful and laudable evacuations by Sweat Urine or Seige happen by the help of Medicines or by the instinct of Nature and give ease if upon the application of Vesicatories a great glut of filthy Waters flows forth if inflamed swellings or great pushes arise behind the Ears or in the Neck if a great sneezing with a dropping at the Eyes or Nose shall happen we may thence conceive some hope of recovery And sometimes an Empyema hapning upon a Lethargy puts an end to it viz. inasmuch as the morbifick matter which was fix'd in the Head and first caus'd the Lethargy being afterward drank up again by the Blood and depos'd in the Breast produces the Empyema In the description of the Epidemical sleepy Fever which reign'd An. 1661. we have observed that this hapned to many Concerning the Cure of this Disease since it allows no truce we must not be long deliberating After the injection of a smart clyster presently let a Vein be open'd for the Vessels being emptied of Blood more readily drink up again the Serum or other humours depos'd in the Brain Moreover I advise in this case the Jugular Vein to be open'd rather than a Vein of the Arm because by this means the Blood very much heap'd together and haply stagnating within the Sinus's of the Head will be more easily reduc'd to an even circulation After Bleeding other Remedies of every kind are presently to be applied to use let large Visicatories be applied to the Neck and Legs the Faces and Temples are to be anointed with Oyl of Amber or Cephalick Balsams let Cataplasms of Rue Pepperwort or Crowfoot well pounded together with black Soap and Sea-Salt be applyed all over the Feet let smart frictions be us'd to the Limbs let Salt of Vrine or Spirit of Sal Armoniack be frequently held to the Nostrils In the mean while let Cephalick Remedies be now and then taken Take Water of Peony Flowers Black Cherries Rue Walnuts simple of each three ounces compound Peony Water two ounces Castoreum tyed in a Nodulus and hung in the Glass two drams Sugar three drams mix them make a Julep let four or five spoonfuls be taken every third or fourth hour moreover to each dose of this add from twelve to fifteen drops of Spirit of Harts-horn Amber or Sal Armoniack or a paper of the following Powder Take Powder of Male Peony Roots Mans Scull Roots of Virginia Serpentary Contrayerva of each a dram Bezoar Pearl of each half a dram Coral prepar'd a dram make a Powder divide it into twelve parts Moreover it is here to be considered whether a purging by Vomit or Seige ought not to be ordered just at the beginning I know that this is variously controverted amongst Authors and I have known it us'd in practice with a various success which being considered and compared betwixt themselves I shall briefly declare what is my opinion If a Lethargy has arose from a fresh over-eating or being drunk or if from taking improper and narcotick things presently let a vomit be raised Wherefore let Salt of Vitriol be given with Wine and oximel of Squils or in robust Persons an infusion of Crocus Methallorum or Mercurius Vitae with Black-Cherry Water and afterward unless it works of its own accord let a Vomit be provoked by thrusting a Quill into the Throat But if the invasion of the Disease happens upon a Feaver or other Cephalick affects or if it be raised primairly or per se by reason of a Procatarxis first laid in the Blood or in the Brain Vomits and Purges given presently at the beginning whilst the matter is flowing are wont oftner to do more hurt than good to wit inasmuch as whilst the humours are in motion those Medicines more exagitate them and since they are not yet able to subdue them and lead them forth they drive them into the part affected On the second day if the dead sleepiness be not yet remitted let bleeding in case the Pulse indicates it be repeated or in its stead let Blood be taken away in the Shoulder-blades by Cupping-glasses after Scarification Then a little afterward let an Emetick Medicine if nothing prohibits it or a Cathartick be given Take Sulphur of Antimony five grains Scammony sulphurated eight grains Cream of Tartar six grains mix them make a Powder let it be given in a spoonful of the Julep prescribed Or Take Scammony sulphurated twelve grains Cream of Tartar fifteen grains Castoreum three grains make a Powder give it after the same manner Mean while let the same or the like altering or deriving Remedies be still continued On the third day and afterward those things which at the beginning of the Disease were
others but withall dangerous not deliberating long concerning this they resolve rather to try a doubtful Medicine than none or which is the same one wholly ineffectual Therefore we gave her Precipitatum ex Mercurio cum sole in a small Dose and repeated it the next day after on the third day an easy and gentle Salivation beginning went on fairly for a Week without any malign Symptome but then the Diseased complaining of a great Head-ach and Vertigo begun to be affected with Convulsive Motions so that we were forced presently to let fall the Salivation and to break off this Course as soon as we could withdrawing the fluxion of the serous latex from the head towards the other parts which frequent Clysters Epispastick and Revulsive Plaisters applyed in various places together with Cordials and Opiats inwardly given soon effected and presently upon it the noble Lady being somewhat better begun to stretch forth and bend the Joints of her Hands and Feet and to move sometimes those members or these from their place the Spitting ceasing being gently purged she took for many days a decoction of China Sarsa red Sannders Ivory c. with the addition of the dryed leaves of Sage Betony Speedwell c. with which she was wont to interlace the use of Spirit of Harts-horn or of Soot of a Cephalick and Cordiack confection also of an appropriate Powder and Julep within a Months space she was able to stand on her Feet and to walk a little in her Chamber being supported by Servants moreover getting Sleep and taking Food indifferently the bulk of her Flesh and her strength daily increas'd and at length using the temperate hot Baths at Bath she grew well But that hot Baths do not do good to all Paralyticks nay as we have intimated before that they do great hurt to some the following relation will plainly shew A London Merchant after a Luxation of a Joynt of the Foot became lame in that part being otherwise sound enough and robust when Topick Remedies of various kinds tryed for some time did not do at length by the advice of a Physician going to Bathe he began to try the temperate hot Baths from the farther use of which becoming forthwith worse upon it the Palsey presently beginning in other Members he had abstained but the Physician being then present assuring him that he would be better afterward advised him to persist wherefore he took the hot Baths again for about thirty dayes till all the lower Members to wit from the Os sacrum to the Feet being wholly resolv'd were withered and that in the Thorax a very great and as it were Asthmatical dyspnaea was raised for the Muscles imployed in Respiration being as it seem'd affected also with the Palsey the brest was not able to be dilated for drawing the Breath deep enough wherefore being always out of Breath he labour'd under continual affects of those Parts and an Agitation of the whole Thorax In this state departing from Bathe he is commanded by his Physician to abstain for a whole Month from any Remedies taken from Pharmacy which when he had religiously observed through hope as it were of a Resurrection that time being past all deliberation was now late concerning the use of Medicines for besides the Paralytick and withered Members his Belly swelled his Respiration was yet more difficult and letted that the diseased was scarce able to draw his Breath his Pulse being very weak with frequent Swoonings and Faintings hapning upon any Motion of his Body so that hereby scarce any place at all being left for Catharticks he must insist only on Cardiack and Paralytick Remedies notwithstanding the use of which the diseased within six weeks labouring under a very great dyspnaea for many hours at length dyed the immediate cause of whose decease I conceive to be Polypous Concretions of Blood in the Heart for in regard the Motion of the Praecordia was greatly letted for a long time nothing seems more probable than that those kinds of carneous lumps as it were were concreted within the Ventricles of the Heart For illustrating a little farther the Theories of the Palsey and also of the Lethargy and Carus I shall here give you another Example with Anatomical Observations which hapned whilst the precedent things were printing A child little more than three years of Age of a moist Brain as it appear'd by sore Inflammations of his Eyes and watery pushes of his Face to which he had been sometimes obnoxious at the beginning of Autumn being ill with a slow Fever and a dejected Appetite became very drowsie and sleepy so that he slept almost continually day and night but being awak'd he knew the standers by and answer'd aptly enough to things ask'd meet Remedies viz. Clysters Vesicatories Catharticks also Juleps Spirit of Harts-horn Powders with many other things usual in this case being forthwith and carefully given him did so much good that within six or seven dayes the diseased being free from his Feaver waking sufficiently and desiring Food seem'd to recover and scarce to have any more need of Physical help But in a short while after I know not on what occasion undergoing a relaps and being drowsie again he was presently affected with a great Stupefaction so that being with difficulty to be awak'd he scarce knew any thing or did any thing with Knowledge the next day after being utterly stupid tho being pinch'd hard he would open his Eyes and roul them this way and that he saw nothing and within a day or two a Palsey of the whole right side followed The former Remedies repeated to him and likewise Sneezers Apophlegmatisms drawing of Blood Cataplasms to be applyed to the Feet and Epispasticks to the whole Head shaved with other Medicines and wayes of Administrations prescribed in order did nothing but the diseased after he had lai so for three or four dayes insensible the Pulse and Respiration at length failing he dyed The Scull being opened the formost Region of the Brain almost as far as the Insertion of the fourth Sinus was swollen being covered with a limpid Water shining through the Membranes which upon the dissection of the Meninges presently flowed forth Moreover at that place the portions of the Brain cut off by piece-meal appear'd too moist and almost without red or bloody specks but in the hindmost part of the Brain the Vessels were red with Blood and the cortical Substance appeared more low and firm without a Tumour or being floated with Water from these things as we have concluded before it will manifestly appear that the Cause of the Lethargy depends on a watery glut of filth in the outward part of the Brain The Brain being cut off piece-meal and a hole being made into the foremost cavity strouting with a lympha the limped water sprung forth as tho it had been pent up in too narrow a space before whose mighty store had filled all the Ventricles to the top and as it seem'd by compressing the
whence all things seem to run round sometimes to be raised on high sometimes to be depress'd low so that nothing is seen fix'd and settl'd in its due site and position In a Brain rightly disposed the motion of the Animal Spirits is perform'd in certain numbers and measures as it were in a Dance while certain Spirits are moved in these tracts others lye still in those afterward these maintain those with a supply in motion and the several Acts of each Faculty become as so many distinct undulations of Waters in a River but in a Delirium all the Spirits skip about together and meeting each other in a tumultuous manner or taking several ways dance about like People distracted Moreover even as these being struck with such a Rage within the frame of the Brain raise manifold and very troubled thoughts so while they are carried beyond the confines of it into the Nervous Origine they produce an Idle talking absur'd Gestures of the Body and Members and often Convulsive motions yet since such a wild motion of the Spirits otherwise than in the Frensy or Mania soon ceases and after that that tumult is over no deviating tracts are made in the Brain the Delirium soon passes off and the affected in a little time come to themselves again no foot-steps of the distraction remaining If it be ask'd whence this short Fury is given the Spirits residing in the Brain that shaking off the Reins of the Mind they are so all in confusion in their Oeconomy we say that they enter upon this disorder for a double reason viz. this Rage is either immediately communicated to them from the Blood irrigating the compages of the Brain or certain animal Spirits residing in some outward part within the Genus Nervosum first begin a certain disorderly Motion and afterward the same disorder being communicated to the Brain by the Nervous Ductus's and affecting in like manner the Spirits there residing causes the Delirium There are various kinds and causes of both these wherefore we shall here briefly touch the cheif and first it shall be shewn how and on what occasions the Blood either swelling with too great an effervescency or being full of a venemous matter becomes the Parent of the Delirium in as much as it insinuates into the Pores and Passages of the Brain either exorbitant and masterless Particles or such as are malignant and subverting the animal oeconomy 1. As to the former in the Fits of intermittent Fevers and the height of such as are continual the Blood being troubled with an immoderate burning sometimes raises a Delirium by the meer Impetus of its Ebullition viz. in as much as being very turgid while it passes the small Branches of the Arteries spread all over the outward circumference of the Brain it greatly puffs them up and stretches them and therefore compressing the substance of the Brain it drives the Spirits several wayes and forces them into very confused crowds as it were Moreover from the Blood 's growing thus turpid through a frothy Rarefaction Effluvia of heat and Heterogeneous Particles with them entring the Pores and Passages of the Brain exagitate the Spirits and carry them violently hither and thither in a tumultuous manner 2. For a like reason in a manner to this Drunkenness causes a deep Sleep or a Delirium viz. In as much as the mass of Blood insinuates into the Pores and Passages of the Brain the spirituous Particles of the Wine which causes it to boyl and by which the Spirits residing in them are either overwhelmed or put into disorderly or confused Motions 3. Nor does the Blood only ministring febrile and turgid or vinous and masterless Particles but sometimes such as are malign and venemous as it were cause a Delirium with or without a Fever As to the former in the Plague small-Pox malignant Fevers tho the heat be moderate the malignant matter conveyed to the Head produces abrupt incoherent and at length distracted Notions in as much as it dissipates the stores of the Spirits rather than by driving them into a tumult 4. For a like reason to this some Poysons and venemous things inwardly taken and as some say outwardly applyed soon bring a Delirium this is vulgarly said of Solunum furiosum Mandrake and certain other Plants the thing is most notorious concerning the Roots of the wild Parsnip An intimate Friend of mine and a Man worthy of credit and also very learned told me once that he went into the House of a certain Gentleman where the Lady her Daughters and all the maid Servants one only excepted being all delirous at the same time ran about the House leaping and talking incongruous and absurd things he thinking them plainly distracted was given to understand by the Maid who was well in her Wits that all this hapned from eating Parsnip Roots which she alone had not touched and the event also confirmed it for after being tired they had slept all of them awak'd sober 5. But moreover we observe that a Delirium is sometimes raised by a scarcity of the animal Spirits and their great dissipation for when their Orders are broken and discomposed they minister confused and incongruous Notions as well as when tumultuarily hudled together Hence we observe that some have grown delirous after great Hemorrhagies or long Watchings and a long Fasting for this Reason many dying Persons speak light-headed and incongruously There remains the other kind of Delirium in which the Blood being without fault the animal Spirits residing somewhere in the Genus Nervosum first begin to fall in disorder and afterward the same affect creeping to the Brain by the Ductus's of the Nerves moves the Spirits residing in its Meditullium to a Delirium this is obvious in the Passions called Hysterical to wit that after a rising of the Belly and an Oppression of the Heart at length sometimes a privation of Sense sometimes a talking idly with a Weeping and a Laughter ensues In like manner I have observed in a violent Colick that sometimes extream Tortures about the Viscera or Loins have presently past into a Delirium then a little after this ceasing that the Tortures returned I knew a Girl who after taking an Emetick Medicine was wont constantly to be delirous till it wrought for this also makes what I often observe that a Delirium is raised by a Gangreen beginning in some outward Member and this is generally accounted for a mortal sign in a Wound or Vlcer because it denotes the animal Spirits to be generally a killing in the part affected Nor does that Symptom afford a better Prognostick to such as have been long valetudinary and are almost worn away in the Fits of intermittent Fevers it s in a manner alwayes safe but in continual Fevers it 's of a doubtful and somewhat a suspected event in malignant Fevers it commonly threatens ill in Convulsive Diseases the first invasions of a Delirium for the most part are without danger but a
appropriate Electuary such as above-described with a Cephalick Julep Within two months he was m uch better and afterward came to himself by degrees Whilst I was writing these things a young man of Quality lately returned from travelling beyond the Seas and being become sickly committed himself to our care This Person being formerly of a sanguine and chearful temperament of a gay behaviour also of an acute wit and a clear disposition as he travelled through Foreign Countries and being in a certain Summer in Spain he felt in himself a great alteration from the intense heats of that place For first he became obnoxious to frequent effervescencies of the Blood with sudden flushings of heat in the palms of his Hands and the soles of his Feet and to prickings often wont to arise in his whole Body and presently to go away again Afterward finding himself worse as to his Appetite and Sleep and likewise growing dull and somewhat sad he began to affect less and sometimes to shun any business or delights nay and conversation with his friends At length this indisposition daily growing worse without any manifest cause or real trouble of mind he became Melancholick so that always being thoughtful fearful and sad he took delight in nothing For Studies Exercises Travelling Conversation with learned men and all other things which before he delighted in were then wont to be a trouble or terrour to him Being affected after this manner for two years he was so much changed from himself as tho he were another man In order to a Cure he consulted the most skilful Physicians of Spain France Holland and of late in England and tryed various methods of Curing tho scarce with any benefit To wit that melancholy Discrasy of the Blood first contracted by the distemper of the Air continuing still caused Spirits of an acetous nature as it were to be supplied to the Animal oeconomy In the first place I thought good to commend to this Person the following Remedies Take Gerion's decoction of Senna with Tamarinds half an ounce four ounces Purging Syrup of Apples an ounce Aqua mirabilis two drams mix them let him take it with governance repeating it within nine days afer Purging let Bood be drawn with Leeches to three ounces Take of our Syrup of Steel six ounces let a Spoonfull be taken in the morning and atfive of the Clock in three ounces of the following Liquor walking upon it for an hour or two Take leaves of Baum Borrage Buglosse Burnet Meadow-sweet Harts-tongue Water-cresses of each four handfuls roots of Borrage half a pound Clove-gilliflowers Marygold flowers of each three handfuls the outward rinds of eight Oranges and four Lemmons Mace half an ounce being sliced and bruis'd pour to them of Whey made with Cyder eight pounds distill it with common Organs Take Conserve of Clove-gilliflowers the flowers of Betony and Borrage of each one ounce and half Pearl powdred two drams red Coral prepared a dram and a half Species of the Confection of Hyacinth two drams Syrup of Coral and red Poppyes of each what suffizes make an opiat let the quantity of a Chesnut be taken every Evening drinking after it two or three ounces of the water of Cowslip flowers After sixteen or twenty dayes the method of alteratives being changed instead of these let him take the following Take powder of Ivory Pearl red Coral prepared of each two drams Roots of male Peony a dram and a half Lignum Aloes half a dram Orange Tablets four ounces a solution of Tragacanth made in Baum-water what suffises make Tablets weighing half a dram let four be eaten in the Morning and at five of the Clock drinking after it a draught of Tea Take of the same Powder without Tablets half an ounce Flowers of Sal Armoniack Salt of Coral of each a dram with Chios Turpentine six drams make amass let half a dram be taken Morning and Evening drinking after it three ounces of the distilled Water Let him feed only on Food of a good Juice and of an easie Concoction let him drink small Ale with the Leaves of Harts-tongue infused in it he may sip a little now and then of Wine with Water in it or of Cyder Let him lead his Life continually occupied sometimes in easie Employs sometimes in moderate Exercises or Recreations of various kinds So far of universal Melancholy in which the diseased are in a manner indifferently affected by any Object so that in every place by any Accidents and Circumstances they are continually perplext with a multitude of Thoughts with a Raving Fear and Sadness A Melancholy is said to be Special when the diseased have regard to some particular thing or to some certain kind of things of which they in a manner alwayes think and by reason of all the Powers of the Soul being continually spent in this one thing they live always pensive and sad Moreover they have absurd and incongruous Notions not only concerning that Object but also concerning many other Accidents and Subjects In this affect the corporeal soul being altered from its proper Species assumes a certain new one and being not conformable to the rational Soul or to the Body or to it self it undergoes a certain Metamorphosis There are two kinds of occasions from which a particular Melancholy chiefly and most frequently arises viz. first if at any time some severe pressure of an Evil present or at hand whether it be true or imaginary lyes upon the Soul or secondly if the privation of a good before obtained or the despair of that which is desired happen In these opposite Cases the corporeal Soul either being allur'd outwardly omits all domestick care of it self or of the Body or of the rational Soul or being inwardly compress'd it leaves or perverts the offices both of the Reason and of the Vital and Animal Function It were a thing of an immense Labour to enumerate the various Cases and wayes of affecting in both kinds among the mighty store of them those which being of greatest moment seem chiefly to require a physical help are a furious Love Jealousie Superstition despair of eternal Salvation the imaginary Metamorphosis of the Body or of its Parts or the fantastical Goods or Evils of Fortune we shall speak briefly of each of these It is a vulgar and most common observation that if any one once being taken with the Aspect and Conversation of a Woman begins inwardly to be love-sick for her and to desire her earnestly and for his most devoted affection gets nothing but denials and Contempt unless he be upheld by a very strong Reason or being seized by other affections be turned another way as it were there is great danger lest he fall into a Love-melancholy with which Passion if he happen to be affected presently he seems transformed from himself into a living Statue as it were he thinks or speaks of nothing but his Mistris he seeks to put himself upon any of the greatest dangers of Life and Fortune
living Whereas we see in other Animals as in a good breed of Horses and Cocks that their young ones do certainly patrizare so that presently they are sold at a great rate their Vertues in regard they are not broken by a disorderly and preternatural way of living descending in a long series to their posterity Secondly there are many evident causes by which Stupidity is brought on such as are originally sound Some at first being witty and ingenious in their declining years grow dull and doltish on the contrary some at first being dull and incapable of Learning as they grow further in years become very witty Thirdly sometimes a great wound or concussion of the Head especially which happens by falling headlong from an high place brings a prejudice and weakness to the animal faculty dulling the understanding Fourthly frequent drunkenness and surfeiting especially if men sleep presently on eating and drinking very much weaken the understandings of some and impair the use of Reason as a frequent use of opiats has shrewdly blunted the edge of the understanding of others Fifthly violent and sudden Passions such chiefly as an exceeding great terrour coming unawares or an extream sadness have rendred some doltish Sixthly We may observe that some Men by reason of great Diseases of the Brain have turn'd Fools this frequently happens in a severe and long continued Epilepsie in as much as this affect possessing the Meditullia of the Brain perverts and so stuffs with Feculencies and fills all the Pores and Passages by reason of the Spirits there frequently and vehemently exploded that the Tracts of the Spirits being close shut the Acts of the inward Senses and Motions are hindred Moreover I have observed Stupidity to accompany and precede the Palsey in many to wit the same matter which in the Corpus Striatum brings a Resolution being gathered together in the Corpus Callosum if it does not bring an Apoplexy or Carus often causes Folly There are many differences of this Disease and first we use to destinguish betwixt Folly and Stupidity that those who are affected with the former apprehend simple things well and quick enough and keep them fast in Memory but for want of Judgment ill compound or divie Notions and far worse inferr one thing from another Moreover by fooling and doing and speaking a great many things unhappily or ridiculously they move Laughter in the Standers by on the contrary those that are stupid by reason of the defects of the Imagination Memory and Judgment neither apprehend well nor nimbly nor argue well moreover they do not behave themselves as the former in making Sports and Gestures but blockishly and unfeatly and as it were like Apes and consequently the simplicity of these is more who so carry their Disease in their Countenance and Gesture In Folly it seems that the animal Spirits being somewhat nimble but unstedfast and having only short and oblique Tracts do not pass the Brain with an even and constant irradiation but making excursions this way and that after a desultory manner kexercise only slight or ridiculous Acts of animal Functions but in Stupidity the Spirits of their own nature being dull and obtuse and residing in a gross and unpervious Brain are not able to exert themselves for duly performing the Offices of the animal oeconomy There are many degrees of stupidity for some Persons are accounted unfit as to the comprehension of all things others only as to some some being wholly unfit for Learning and the liberal Sciences are apt enough to mechanical Arts others tho incapable of both these yet readily comprehend Apriculture and Country Affairs others being incapable in a manner of all business can be taught only those things that regard eating and drinking and the common way of living others being meer Dolts scarce understand any thing as all or do any thing with Knowledge As to the Prognostick Stupidity contracted by birth or hereditary or hapning through some unknown causes if it continues to the time of Puberty is scarce ever cured tho sometimes it happens that little Children at first dull and almost senseless when the Crases of the Brain and Spirits come afterward to a maturation become ingenious and apt enough to Iearn The Disease raised through some sole evident Cause as by a hurt of the Head or a violent Passion also hapning upon an inveterate Epilepsy if it persevers some time is afterward incurable That which ensuing upon other sleepy Affects depends chiefly on the hurt of the Memory sometimes those affects being cured vanishes of its own accord if at any time therefore in these Cases the cure of Stupidity is ordered in a manner the same method of healing and Remedies which we have prescribed for the preservatory indication of the Lethargy will be proper here whereof the chief intents must be that the animal Spirits being free from any Deadness and Stupefaction make Pores and Passages within the translucid Brain and duely expand themselves in them Sometimes a Fever has cur'd some Fools and stupid Persons and has rendred them more acute Huartus relates that a certain Fool in the Court of Corduba being affected with a malignant Fever arriv'd in the height of the Disease to so great an acuteness of Judgment and Discretion that he put the whole Court in Admiration and for the whole remainder of his Life continued a very prudent Person and we have known a certain Person of a dull and indeed Boeotian Understanding who raving in a Fever was very quick at breaking smart Jests and season'd with much Salt the Reason of which things seems to be that the Febrile heat sometimes rarefies and disperses the mist investing the Brain Therefore as to the cure of this Disease Stupidity whether innate or acquir'd if it be not a plain senselesness and doltishness incapable of all Erudition tho it be not usually cur'd yet it is wont to be amended Wherefore the cares both of a Physician and Tutor must be us'd for polishing somewhat the Understanding of such as are so affected and that being brought to the use of at least some little Reason they may be exempted from the rank of Brutes For this end because Bards or such as are very blockish learn not the Notions of things more readily than Children their A. B. C. therefore they are to be instructed in all things by an assiduous and very diligent Master and the same things are to be incultated again and again For by this means the Spirits tho dull and torpid will in some measure be actuated by perpetual Exercise and being continually stirred up will make at length for their Expansion some Tracts or Passages tho imperfect in the Brain how gross soever For the better and more easie effecting of these things physical Remedies also ought to be given for purifying and volatizing the Blood and nervous Liquour together with the animal Spirits and also for clarifying the Brain and rendering it as it were diaphanous For purifying the Blood
voided more sparingly besides in the Head vertiginous affects frequently preceed or follow the invasions of this Disease nay and the Colick encreasing and becoming inveterate often brings Pains in the outward Members and at last is terminated in a Palsey Since therefore many Parts are wont to be troubled by it we must enquire which is primarily affected and by the means of which the rest suffer and shew what is the conjunct Cause of this Disease in what place it subsists and whence it draws its Origine As to the Part primarily affected when the Disease presses the whole region of the Belly is wont to be troubled yet its primary seat ought to be plac'd where the pain infests chiefly and sticks most obstinately Now this is said by many Physicians to be somewhere in the Colon because we generally observe that the Intestines and chiefly the Colon being irritated by Flatus's by which choler and haply other humours contained within their cavities fall into pains and gripes but if the pains of the Cholick proceeded from the sharp and irritative contents of the Colon doubtless those things which loosen the Belly and copiously expell Flatus's and the Faeces would bring a most certain relief the contrary of which oftentimes happens viz. that after frequent or violent Purging that Disease becomes worse Wherefore that the seat and nature of this Disease may be duely known we must first distinguish here concerning the Gripes or Pains of the Belly vulgarly accounted as of the Colick For either being meerly occasional they arise from an evident cause alone and without a previous disposition in any Person indifferently thus alterations about the six non-natural things often raise mighty disturbances in the Viscera of the Belly with pains Which kind of affect never theless ought not to be lookt upon as a Disease but only as a symptom rais'd from a manifest cause But besides the Colick properly speaking does not only happen to any men indifferently being produc'd by an accidental cause but following some men predispos'd after a peculiar manner depends wholly on a procatarctick cause brought to a ripeness by degrees the greater fits of the Disease for the most part have their periods and observe the alterations of the Air and of the Year Moreover being rais'd they do not easily yield to Remedies nor soon pass off But notwithstanding the use of Epithems or the Belly 's being purg'd tho in a plentiful manner by Clysters or Catharticks they often continue many days and sometimes weeks with great violence the pains in every fit take always to the same Part and for the most part are attended with the like concourse of other symptoms Moreover Colick pains tho they have not the same seat in all but sometimes rage most about the Ventricle sometimes about the Navel or hypochondres sometimes in the hypogastrick Region or toward the Loins Yet as often as they return in the same Diseased they most commonly observe the same seat I say now that the Part primarily affected in the Colick is the Mesentery We have shewn elsewhere that the causes of certain convulsive motions which are vulgarly called hysterical oftentimes lye hid in the Plexus's of the Mesentery and then we asserted the pains of the Colick sometimes to have their seats in the same places and we made it plain enough from Anatomical observation But it is not the same but somewhat a differing matter which is wont to raise those so different affects under the same roof in the Passions called histerical we have set forth at large in the former Tract that the Animal Spirits being overcharg'd with an Elastick Combination burst from one another or are exploded as it were and consequently that they force in despite the containing Bodies into irregular or preternatural motions but in pains of the Colick the same Spirits being irritated by reason of a Matter annoying them and being disproportionate to them and thereupon being divided and severed from each other they force the sensible fibres to very troublesome corrugations after what manner this is done in the Colick and what is the Conjunct cause and Procatarxis of that Disease we shall now say somewhat more plainly Therefore for the Seminium or Minera of the Colick we suppose that certain recrements of the nervous humour falling from the Brain by the Nerves and passing into the Mesentery and other Plexus's of the Abdomen are there heap'd together Which if they are so gross and viscous that they cannot be receiv'd and sent away by the Lymphaeducts or distill forth into the cavities of the Intestines by the small branches of the Vessels then stagnating and being heaped together by degrees in those Parts they arise at length to an irritative plenitude Afterward that matter becoming more degenerate and more offensive by stagnation and growing turgid on some occasion or of its own accord or haply fermenting with the Saline-fixt humour sent thither from the Blood will torture with very troublesome and painful corrugations the branches of the Nerves and Nervous Fibres with innumerable of which the Mesentery is stor'd Which affect of them does not wholly cease till the fermenting matter either is discuss'd or express'd into the cavities of the Intestines or at length is subdued Again forasmuch as from the Mesentery and its Plexus's nervous branches and fibres are most thickly protended to the bottom of the Ventricle the Gall-Bladder the Ductus Choledochi all the Intestines and on every side almost into all the Viscera of the Abdomen therefore whilst the Colick matter fermenting in its Minera's causes there often most sharp gripes and tortures at the same time in most other membranous Parts Cramps and Convulsive or painful contractions will be every where raised Hence by reason of the Mesentery primarily affected under the Navel there is a cruel pain as tho a stake were stuck there or a piercer were making a hole moreover all about almost in the whole Abdomen by reason of the Intestines being variously drawn forward and backward at the same time in differing places erring pains shoot this way and that and by reason of the motions of the Fibres being distracted or inverted as well in those parts as in the primary Vessels the Belly is in a manner always bound and there ensues sometimes a suppression of Urine or very little is made Moreover the Duodenum the Gall-Bladder with its Ductus's and the bottom of the Stomack being affected with a cramp and their Fibres being drawn upward a frequent vomiting with a copious casting up of a yellow or greenish Choler often happens during the Fit In a Fit of the Colick to Pains of the Belly most violent Pains of the Loins raging in the lower part of the Back are oftentimes joyned which certainly can arise from the irritation of no Intestine but it will be easie to conceive that they are raised from a morbifick cause plac'd in the Mesentery viz. in as much as certain considerable Nerves of the Loins
sometimes they are troubled more than usually of their own accord for when by a long digestion the sulphureous part of the Wine is exalted too much it falls into an effervescence greater than it ought and unless it be presently appeas'd it perverts the crasis of the Liquour by its Turgescency the same thing altogether seems to be in the feverish Effervescence rais'd in the Blood which is wont to be introduc'd for those kinds of causes The third observation or comparison of the Blood with Wine is this Wines as many other Liquours have their times of Crudity Maturation and decay the same thing being to be observ'd in the Blood concerning which sec Dr. Willis as large So far of the comparison of the Blood with wine what follows its similitude with Milk consists in the diversity of its parts and their parting from each other which is chiefly seen in it when it is let out of the Veins and grows cold in a Vessel For when the heat and vital Spirit which preserve all in a mixture are fled away the remaining parts depart from each other and there is made a separation of the thin from the thick of the Serum from the fibrous Blood c. After having considered the Blood we may observe that the nutritive Juice supply'd from the Blood and sever'd from its mass for the nutrition of the solid parts sometimes by reason of its depravation and irregular motion causes many symptoms in Fevers This nutritive Juice which is supply'd from the mass of Blood by a certain circulation after it has past the nervous parts what remains of it being effaete and Poor as it were is sent again by the Lymphick Vessels to the Blood CHAP. II. Of the Motion and Effervescencies of the Blood WE must next enquire concerning the Bloods motion both natural viz. by the help of what ferments and by what fort of turgescency of the parts it is circulated in a continual motion through the Vessels and preternatural viz. for what causes and by the efforts of what parts sometimes it boyles above measure in its Vessels and falls into feverish Effervescencies Concerning the natural Motion of the Blood we do not here enquire concerning its circulation viz. by what knid of structure of the Heart and Vessels as it were in a Water Engine it is carried round in a constant course but concerning its Fermentation viz. by what kind of mixture of the Parts and their mutual Action on each other like Wine fermenting in a Vessel it continually boyles and this kind of motion depends both on the Heterogeneity of the parts of the Blood it self and on the various ferments which are inspir'd into the mass of Blood from the Viscera As to the first those things which have altogether the like Particles do not ferment wherefore neither distill'd Waters chymical Oyles Spirits of Wine or other simple Liquours are stir'd at all but the Blood consisting of various Elements of a contrary nature and working on each other continually ferments and his all its Particles in a perpetual Motion It is an Argument that Ferments are requir'd for Sanguification because when they fail by nature they are supply'd by Art with good success for fixt Salts Alchalies Extracts Digestives and especially Chalybeat Remedies give help only in this respect that they restore a new the ebullition of the Blood either weak or almost extinct As to what concerns natural Ferments certainly many may be form'd and stor'd up in divers Parts or Viscera for any Humour in which the Particles of Salt Sulphur or Spirit being very much exalted are contain'd indues the nature of a Ferment After that manner Yest and Leaven come to be such with which new Beer and a mass of Bread are excellently fermented In like manner an acetous Humour in the Stomack participating of an exalted Salt helps there Concoction and in the Spleen the Dreggs of the Blood by reason of the Salt and Earth exalted in them turn to a ferment How great a Vigour comes to the Blood from the Womb and genital Parts appears hence because from the Privation or Discrasie of these in Virgins a Green-sickness in Men a want of Beard a weak Voice and an amission of Virility follow but the cheif ferment which ferves for Sanguification is lodged in the Heart for here is the greatest scat of heat in which the more crude Particles of the Chyme are kindled as it were and acquire a volatility Therefore the Motion and heat in the Blood depend chiefly on two things viz. partly on its proper Crasis and Constitution whereby being plentifully compos'd of the active Principles of Spirit Salt and Sulphur it grows turgid of its own accord in its Vessels as Wine in a Hogs-head and partly on the ferment implanted in the Heart which very much rarifles the Liquour passing through its Sinus's and forces it to spring forth with a frothy Effervescency Let thus much suffize concerning the natural Motion Heat and Fermentation of the Blood in the even tenour of which the state of our Health consists to speak now of its preternatural or over great Effervescency on which the Types and Fits of Fevers depend I call an over-great or preternatural Fermentation when the Blood like a Pot boyling over the Fire boyles above measure and being rarified with a frothy Turgescency swells the Vessels raises a quick Pulse and like a sulphureous Liquour taking fire diffuses on all sides a burning heat This kind of Motion or Fermentation of the Blood is excellently illustrated by the example of fermenting Wines for Wines besides the gentle and even fermentation whereby they are first depurated at certain times boyl so mightily that they work over the Vessels and if they are close stopt they make them flye in pieces after this manner being put upon an effort as it were unless they are presently drawn off from the Tartar or their Lees into another vessel they cease not to boyl till the Spirit being very much spent and the Sulphur or Salt too much exalted they either become over-fretted or degenerate into Vinegar Such an Effervescency is wont to be raised chiefly for two Causes first when any thing extraneous and immiscible is put into the Vessel so some drops of Tallow or of Fat dropt into the vessel produce this Motion or secondly when Wines having too much Lees or Tartar by reason of the sulphureous parts exalted above measure fall into an Effervescence of their own accord and boyl vehemently for in whatsoever substance Sulphur abounds and its Particles being loosned from their mixture joyn with one another and are kept close together there such immoderate Effervescencies are procur'd After the like tho not wholly the same manner as Wines ferment the Ebullition of the Blood is caused viz. either some extraneous and heterogeneous thing is mixt with the Blood which in regard it is not assimilated is wont to cause a perturbation and Effervescence till the heterogeneous thing be either subdued or
sent forth and the confused and troubled Particles of the Blood are clear'd again and take to their former position and site in mixture Or secondly the Blood is troubled above measure because some Principle or Element which composesit viz. the Spirit or Sulphur is rais'd beyond the natural Temper and becomes exorbitant whereby the Particles of this or that not agreeing with the rest are loosned from their mixture being loos'd make an effort more then they ought exagitate the Liquour of the Blood and cause an effervescence which is not appeas'd till the Blood being inflam'd as it were has burnt a long time with a feverish blast But there is this difference betwixt these two boylings of the Blood that the Effervescence which depends on the mixture of an extraneous thing with the Blood is for the most part short or comming by Fits which when the heterogeneous thing is separated or subdued ceases of its own accord and the troubled and disordered parts of the Blood readily return to their natural Site or Crasis but the Ebullition which arises from the disordering of the exorbitant Spirit or Sulphur is continual to wit here the whole mass of Blood is so open'd and loosn'd from the strict bond of mixture that taking a fire like an oily Lpquour it does not cease to rage and flame till the Particles of the Spirit or Sulphur or of the combustible matter are for the greatest part consum'd There remains yet a third preternatural way of effervescency in which the Blood undergoes an alteration which does not happen to Wine but very frequently to Milk viz. sometimes a coagulation of that liquor is induc'd by a morbifick cause so that it substance is sus'd and separates into parts and there is a secretion made of that which is thick and earthy from the thin by reason of which the Blood is not meetly circulated in the Vessels but its congeal'd portions being apt to be fix'd in the extreme Parts or to stagnate in the Heart interrupt its even motion and greatly hinder it For restoring of which effervescencies greater than usual are rais'd in the Blood to wit such as every where occur in the Pleurisie Plague Small Pox and malignant Diseases CHAP. III. Of Intermitting Fevers AFever may be describ'd after this manner That it is a disorderly motion of the Blood and it s over great boyling with a heat and thirst and other symptoms besides with which the natural oeconomy is variously troubled As we observ'd before concerning the effervescence of the Blood so we may now concerning the Fever that its access is either short and coming by sits which therefore is called intermittent or great and drawn in length which is call'd a continual Fever We shall speak first of the intermittent Concerning this Fever we shall first enquire in general what kind of effervescence of the Blood it is which causes its Fit and whence it is rais'd Secondly Wherefore the Fit consists of a coldness with a shivering and a sweat ensuing Thirdly What is the cause of the intermission and of the set times of return Fourthly and lastly we shall subjoyn certain irregularities of Intermittent Fevers As to the first We must suppose that for an Intermittent Fever some heterogeneous thing is mix'd with the Blood whose Particles in regard they are not assimilated make so long an ebullition of the same till either being subdued they are rendred miscible or being subtilis'd they are sent forth wherefore such matter being subdued or sent forth the fit ceases and when this matter springs a fresh it causes a new Ebullition and consequently a new Fit happens Now that which causes an exactly periodical Effervescence of the Blood must of necessity be some thing which against each of the set returns or accesses of the Fever is engendred in our Body in a set measure and alwayes in an even proportion and is communicated to the mass of Blood wherewith when the Blood is saturated to a fulness presently it grows turgid and falls into an Effervescence now whatsoever others may think I judge this thing to be the nutritive Juice supplyed from the matter of things eaten and convey'd to the Blood in weight and measure which in regard it is not assimilated through defect of Sanguification being heap'd together to a fulness in the Vessels it causes a Turgescency in the Blood for its expulsion I have observed before a three-fold State concerning the Particles of the Blood viz. of Crudity Maturity and Decay that is to say the nutritive Juice supplyed from the daily Food comes crude being mixt with the Blood and circulated for some time it is assimilated and maturated into a perfect humour afterward waxing stale it runs into parts and is separated while the Blood is continually renewed after this even manner and its losses are repair'd it ferments quietly and is circulated within the Vessels without tumult or immoderate Effervescence but if the supply of the nutritive Juice be not maturated as before nor turns into Blood by a perfect digestion its Particles mixt with the Blood continue in its mass as some heterogeneous thing and not exactly agreeing with which when it is saturated to a fulness presently the Blood grows turgid and falls into a feverish Effervescence whereby the fresh supply of this depraved Juice is either subdued or sent forth If it be askt for what cause the nutritive Juice being mixt with the Blood is not assimilated but degenerates into a heterogeneous and fermentative matter I judge that this is done for the most part not through the fault of the Aliments or of the Viscera but of the Blood it self For the Blood even as Wines sometimes falls from its native and genuine Disposition into a sharp acid or austere nature and because the Blood sanguifies it happens that when that is fallen from its due temper it easily perverts the store of nutritive Juice wherewith it ought to be repaired Secondly as to the shivering and cold preceding the heat in this affect doubtless the true and genuine cause of those is the flowing and turgescencie of the nervous Juice degenerated into a nitrous Matter wherewith the Spirits and heat being charged are obunded and the nervous Bodies being irritated are put into a Trembling but afterward when these nitrous Particles being in part protruded to the Superficies of the Body the Blood is somewhat freed from their cumbrance and oppression the animal spirits recollect and begin to display themselves and then a most intense heat ensues because both the mass of Blood being opened by reason of its Effervescence with the febrile matter and its mixture being loosned the sulphureous Particles are freely kindled in the Heart and because the Pores of the Skin being possest by the same matter protruded toward the circumference of the Body the vapory Effluvia are inwardly restrained which much exagitate and heat the Blood and which heat continues still in it till the fermentative Matter being wholly burnt and fully
subdued and subtiliz'd together with the adust Recrements remaining after the Deflagration and joyning with the Serum they evaporate by Sweat or insensible Transpiration Thirdly from what is said it will be easy to shew the Causes of the Intermission and of the Set Returns viz. the Intermission follows because the Morbifick Matter is all clear'd at one fit and so till a new be brought in place an intermission follows of necessity Now a new matter begins to be engendred from the time that the last Fit ceas'd and when the Blood is filled again to a Turgescency it boyles and comes to a flowing As to the Set Returns of the Fits these happen because for the most part the nutritive Juice is supplied from the Viscera to the Blood passing in the Veins in an even measure and quantity tho sometimes if the Persons who have intermittent Fevers gorge themselves too much or are very abstemious the Fits happen sooner or later than usual If it be ask'd wherefore the Set Returns of Fevers are not of one kind and of the same distance but that some come every day some every third or fourth day the cause is the different constitution of the Blood whereby it is perverted from its due temper into a sharp sometimes an acid or austere disposition According to this differing Dyscrasy the nutritive Juice fresh brought falls more or less from its maturation and is perverted into a matter sooner or later apt to Ferment The Procatarctick Causes of this Disease plainly shew its Origine from the temper of the Blood being chang'd For intermitting Fevers are chiefly rife in that Season and those places in which the Blood receives the greatest alteration from the Air. The same thing is made out by the Cure of intermittent Fevers whether it be natural and critical or artificial and be perform'd by the help of Medicines As to the first Intermittent Fevers are wont to be terminated after a two-fold manner the first is when the temper of the Blood is altered by the Fits themselves and it is brought to its natural state the other way is when the change of the Air or Place of abode brings a mighty alteration of the Blood for so Fevers begun about the Equinoxes are terminated about the Solstices also the Diseas'd travelling into another Country often recover As to the Cure to be perform'd with Medicines it is undertaken either Empirically or Dogmatically and in this Disease Empyrical Remedies taken from Mountebanks or old Women are more esteem'd and often effect more than the Prescripts of Physicians given according to an exact method of Curing The Empyrical Remedies which are said to cure intermittent Fevers are such as without any evacuation keep off the invading Fit and are either taken inwardly or are outwardly apply'd where the Pulses chiefly beat viz. they are bound for the most part to the Region of the Heart or to the Hand-wrists or to the Soles of the Feet now it is worthy to be enquired into after what manner these work and by what means they stop the feverish accesses It is manifest in the first place that the vertue and action of these things which are outwardly applyed are communicated to the Blood and Spirits immediately and in regard they drive off the Fit by way of prevention without the evacuation of any humour or matter of necessity the reason of this effect must consist only in this that by the use of these kinds of Medicines the Turgescency and Fermentation of the Blood with the Febrile matter are stopt that is to say from the Medicine bound about the Vessels certain Corpuscles or Effluvia are communicated to the Blood which greatly fix and constringe its Particles or also by fusing and exagitating precipitate them as it were after both wayes the spontaneous Effervescence of the Blood is hindred like as when cold Water is put into a boyling Pot or as when Vinegar or Allum is put into new and working Beer presently the fermentation ceases and the Liquour acquires a new tast and consistency and is as fit for drinking as if it had been ripened a long time Now that these Febrifuges operate after this manner it seems plain enough because those that are of chiefest note excell in a styptick and astringent or also in a precipitating Virtue hence Sea-salt Nitre Sal Gemm the Juice of Plantain Shepherds pouch all astringent Herbs bruised with Vinegar and the like things bound to the Wrists the roots of Yarrow Tormentill also Camphire hung about the Neck are said to remove this Disease Moreover the things that are taken inwardly are of the like sort the Juice of Plantain red Rose-water Allum in as much as they fix and constringe the Blood a Decoction of Pepper Sal Armoniack or of Wormwood Spirit of Vitriol also a sudden Passion of Anger or Fear in as much as by fusing and exagitating the Blood they precipitate it often hinder the feverish access like as a concussion and exagitation of any Liquour or an infusion of astringent things in it hinder a spontaneous Effervescence or Effort It is usual with some Empiricks for the cure of intermittent Fevers to make a hard Ball of Flax or Paper rowled up and to bind it so colse to the Wrist where the Pulses beat that the circulation of the Blood in that place is in some manner stopt and by this means the invading fit of the Fever is driven away I have certainly known many cured after this manner of a long continued Disease the reason of which seems to be that whilst the Blood is stayed in its Motion in any part it stirrs more violently in the rest and so from that trouble raised in the whole Blood the spontaneous Effervescence of its Liquour which was to follow a while after is stopt and upon the Fits being put off twice or thrice Nature takes to the digestion of the matter and to its ancient regularity The dogmatical cure for the most part is undertaken by Vomits and Catharticks also by letting Blood with which the Diseased are miserably tormented and the Disease is seldom brought to an end tho sometimes Tertian Fevers are taken away by a Vomit given a little before the Fit which happens because by this means the Blood is pretty fully cleansed of its bilous Humour tho its worthy observation that Vomits do no good in a Quartan Ague and seldom in a Tertian unless they are given presently at the beginning when the febrile Disposition is yet light and not fully confirmed Concerning intermitting Fevers in general there remain yet to be explained certain irregularities of them in which they alter from the common way first therefore the fits are wont sometimes to be without cold or shivering an intermittent Fever was rise this Autumn whose accesses troubled the diseased only with heat and that very intense in many there was a violent vomiting but no cold or sweat after four or five returns had hapned as the fit invaded the diseased were wont
Autumn coming on when that Disease ceased a Quartan Fever began to be very rife so that in many places well near the fourth part of man-kind was seis'd with the same and those of all Ages and Temperaments which plainly shew'd that this affect did not take its rise from a melancholy Humour heapt together through the fault of the Spleen as some have thought but from the Discrasy of the Blood caused through the distemperature of the Year Tho many Physical Apparatus's were ordered against this evil yet very few were cured within the compass of the Autumn In some about the first beginnings of their Sickness before the Disease had taken root Vomits gave relief tho in most Medicines purging any ways tho repeated a hundred times did not the least good at all those in whom the evil was deeply rooted received not any relief from the most exactly devised Remedies used throughout the whole Autumn when at this time I saw the vulgar Methods of Physick put in practise in vain To a certain noble Virgin who desired a sudden Cure to be performed by any manner of means I propos'd that if she would undergo a Salivation for some dayes by a mineral Medicine she might thence hope a speedy conquest of her Disease she readily agreeing to this I gave her a gentle and very safe Medicine by which only a gentle spitting was raised and that ended within twelve dayes from the time the salivation began she presently mist her fits but at the times they were wont to come she found a disturbance in her whole Body with an oppression of the Heart and a danger of Fainting but afterward the spitting being ended she seem'd throughly recovered and when after two Months time she had again certain slight accesses of this Disease an Emetick Powder being given her twice or thrice she was perfectly cured without a relapse After the Winter Solstice this Disease was not so violent but began to grow mild in some of its own own accord and to be more easily overcome in most others by the use of Medicines for at this time the discrasy of the Blood contracted by the Summer heat is wont to be removed by degrees by the cold of Winter and the inveterascent mass of the Blood to depose its old taint and to return towards its natural state but those who were of a melancholy Temperament or had the Viscera and especially the Spleen ill affected or those that used an ill form of diet received no change from this Tropick but held their Disease to the next period of the Year to wit to the Vernal Equinox and then in a great many this affect was seen to be overcome the Blood either being renewed of it self or its Distemperature being more easily amended by the use of Medicines but in the mean time many aged cachochymical and otherwise weakly Persons died every where of this Disease in this whole tract of time and some there were who having past the Summer Solstice had not yet shaken it off now tho many were troubled with this as it were Epidemious Fever almost for a whole Year yet none that I knew of contracted it first in the Spring and very few recovered of it during the Autumn that I cannot doubt but the Discrasy of the Blood was really the cause of it and that its cure consisted in its change The Remedies which oftentimes gave relief at least as far as it agreed with our observation were such as stopt the fit of the Fever for the evil habit of the Blood being somewhat amended upon the change of the Season of the Year in case the habitual usance of the fits be broken off Nature recollects her self and easily recovers her ancient state of Health by her own endeavour And this kind of intent viz. the stopping of the Fits tho it be sometimes performed by Vomits given a little before the access for these often stop the feverish Motion of the Blood by raising another contrary to it yet this indication is far more certainly and indeed more successfully performed by the use of those kinds of Medicines which do not at all evacuate from the Viscera but cause in the Blood a certain fixation or precipitation of the feverish Matter for a time Wherefore those whom I undertook to cure as the Spring came on and thence forwards I managed with this Method and in many with good success a provision being made for the whole by a Medicine sometimes Vomiting sometimes Purging three hours before the fit I was wont to order Epithemes to be applyed to the Wrists and withal a febrifuge Powder to be taken in Sack and the diseased to be kept in Bed in a gentle sweat It seldom happen'd but at the first or second time the access of the Fever was stopt after this manner and afterward the same Remedy being sometimes repeated at length the Disease wholly ceased this kind of Practise besides what I have found by experience seems to be made good by the use of the Powder of a certain Bark lately brought from the Indies which is said most certainly to cure this Disease whereas the Virtue or operation of this without any Evacuation consists only in this that it stops the invading fits of Fevers Concerning that Peruvian Bark because of late it begins to be in daily use these few things which occur to common observation are to be said the vulgar way of giving it is to infuse two drams of this being made into a Powder in White-wine or Sack for two Hours the Vessel being close covered and then as the fit approaches to let the Diseased lying in Bed drink the Liquour with the Powder This Drink often removes the imminent access tho many times that coming after its usual manner it prevents the next ensuing howsoever whether the fit be stopt at the first or at the second or third time of return and the Disease seem to be cured yet it oftentimes it wont to return within twenty or thirty dayes and then this Powder being given again the Invasion of the Disease is again put off for the space of about the same time and after this manner I have known many troubled with a Quartan to have undergone only a few accesses of it during the whole Autumn and Winter and so to have held the Enemy foreguarded till the Spring coming on by the help of the Season of the Year and of other Medicines the Disposition of the Blood was altered for the better and so that affect vanisht by degrees those who by this means procured frequent times of truce of the Quartan being cheerful and sprightly liv'd prompt for all business whereas otherwise being enervated and pale they were brought to a Languour and a vitious habit of Body scarce one of a hundred tryed this Remedy without effect nay if it be taken in a half quantity or less viz. to the weight of half a dram or a dram it oftentimes takes away the accesses and suspends the
Motion of the Body or Perturbation of Mind from an ambient heat as that of the Sun or of a Stove by hot things inwardly taken as drinking of Wine eating of peppered Meats and the like for the Spirits of the Blood easily wax very hot of their own accord and being violently moved are not presently appeased but exagitate variously confound and force to a rapid and disorderly Motion other Particles of the Blood also by this Motion of the Spirits the Sulphur or the oily part of the Blood is more boyled a little more dissolved and somewhat more freely kindled in the Heart whence an intense heat is raised in the whole Body but for as much as the Sulphur is heated and inflamed only by minute Parts and not throughout the whole that fervour of the Spirits is soon allayed and ceases Wherefore the Fever which is raised after this manner is terminated for the most part within twenty four hours and therefore is called an Ephemera And if by reason of a greater heat of the spirituous Blood it be prorogued longer it seldom exceeds three dayes and it is called an Ephemera of many dayes or a Synochus not putrid but if it happens to be extended beyond this time this Fever readily passes into a putrid to wit from the long continued ebullition of the spirituous Blood at length the grosser Particles of the Sulphur fall a burning and involve the whole mass of Blood in this Effervescence An Ephemera Fever and a simple Synochus seldom begin without an evident Cause besides the things before-mentioned immoderate Labour Watchings a sudden Passion of the Mind a constriction of the Pores Surfeiting also a Bubo or Wound in Child-bearing Women an increase of milk are wont to bring these the procatarctick causes which dispose to them are a hot temper of Body an Athletick habit a Sedentary Life and a Disuse of Exercise The first beginnings of this Disease depend on the presence of an Evident Cause for either the Corpuscles of an extraneous heat mixt with Blood make it boyl like Water on the Fire or a Fever is brought by motion or by reason of Transpiration being letted even as when Wines being heated or stopt close in a Vessel are set in a strong working after what manner soever the inflammation be first rais'd presently the Spirits make an effort and moving hither and thither force the Blood to boyl and to inlarge it self in a greater space with a frothy rarefaction wherefore the Vessels are stretcht and the membranous Parts are vellicated hence a Pain especially in the Head and Loyns a spontaneous lassitude and an inflation as it were of the whole Body ensue But if with the Spirit of the Blood some sulphury Part withall be somewhat kindled a smart heat is diffus'd through the whole the Pulse becomes high and quick the Urine ruddy also Thirst Watchings and many other offensive Symptoms arise Concerning the Solution or Crisis of an Ephemera Fever and of a Synochus not putrid there are three things chiefly requisite viz. a removal of the evident Cause secondly a severing or difflation of the depraved or excrementitious matter from the Mass of Blood thirdly an appeasing of the parts of the Blood and their restitution to a natural and even motion and site According as these things happen sometimes sooner sometimes slower and with more difficulty this Disease is ended in a shorter or longer time 1. The Evident Cause which for the most part is extrinsecal is easily remov'd and Diseased Persons as soon as ever they perceive themselves injur'd by any thing are wont to avoid the presence of or continuance with that thing no Person being in a Fever upon drinking Wine continues still to drink it when any Person grows more hot than usual by the heat of a Bath or of the Sun it is irksome to him to continue in it longer 2. As to the excrementitious matter which ought to be separated and blown off from the Blood this is either brought from without as when by surfeiting drinking of Wine standing in the Sun or bathing in hot Water the Blood is infected with hot and fermentative effluvia's or Corpuscles or that matter is ingendred inwardly as when upon the deflagration of the Blood its Liquor is stuff't with adust Recrements or Particles both these Matters must be separated and blown off from the Blood and be sent forth either by Sweat or insensible Transpiration before the Fever is appeas'd wherefore when the Pores are clos'd and Transpiration is hindred the Ephemera Fever continues a longer time and passes from a simple Synochus into a putrid Fever 3. The Evident Cause being remov'd and this degenerated Matter blown off for a cessation of the burning heat there is required an appeasing of the Parts of the Blood and a reducement of them to order for a rapid and disorderly motion begun in the Blood is not presently stopt but ought to be allay'd by degrees also the divers Particles of the Blood disorder'd after this manner and being driven this way and that by reason of the feverish effervescence do not presently take to their former order of site and position but it is necessary that they be extricated by degrees and restored to their due mixture by little and little Tho this Disease after the removal of the Evident Cause ceases for the most part of its own accord yet some Physical Remedies are advantageously applied to Use especially where there is danger lest the Ephemera Fever passes into a putrid The chief Intentions must be to allay the fervour of the Blood and to procure a free Transpiration to which chiefly conduce blooding a very thin Diet or rather abstinence cooling Drinks a withdrawing the excrements of the Belly by Clysters but above the rest Sleep and Rest do most good which if wanting they must be seasonably procur'd by Opiats and Anodines A renowned young man about twenty years of age of an athletick habit of Body by an immoderate drinking of strong Wine fell into a feverish distemper with a drought heat and a mighty trouble of the Praecordia being blooded he drank a vast quantity of fountain-water and thereupon a copious sweat presently ensuing he soon recovered An ingenious young man of a sedentary Life and withall very much addicted to the study of Learning when of late he had exercis'd himself above measure in the Summer Sun began to complain of a Head-ach a want of Appetite a trouble of the Praecordia and a feverish distemperature over the whole Body To whom in regard he loathed all Physick I ordered a total Abstinence unless it were from small Beer and Barley-meats On the second day and again more on the third the Symptoms remitted by little and little at length on the fourth he became free from his Fever without any Medicine CHAP. IX Of the Putrid Fever A Putrid Fever is when the oily or sulphureous part of the Blood being too much heated grows turgid above measure and
another Man seiz'd with the Plague gets the same Disease or mediately and at a distance as if it happens that the Contagion be convey'd from one House to others at a distance and so if the Plague assails any Person handling a Garment or Houshold-stuff of an infected House after some Days or Months or haply Years tgherefore that the nature of a Contagion and the divers manners of it may be plainly known let us examine first What that things is which flows from an infected Body secondly How it is fisposed in the medium through which it passes thirdly After what manner it engenders an Affect like it self in another Body 1. That from every Body though of a fixt Nature Effluvia's of Atoms constantly flow which make as it were a mist or cloudy Circle about them and invest them as it were like the Down of a Peach it is so receiv'd a thing among the soundest Philosophers that there is nothing more and the more active Particles any thing consists of by so much it sends from it Corpuscles of a more notable Vertue and Energy hence the Effluvia which part from Electrick Bodies are albe to move other Bodies from their Places from Sulphurs Emanations pass which fill the whole Neighbourhood with Odours since therefore the pestilential Venom as is said before tho in a small Bulk is of a mighty Efficacy and Operation wheresoever it is fixt certain Emanations necessarily proceed from the Bodies imbued with it which carry the nature of the same Poyson and Malignity and diffuse it on every side according to its Sphere of Activity but since these Corpuscles which retain the Contagion of the Pestilence when they flow from one body are not presently received by another let us inquire how they are disposed in respect of their passing through the Medium Where presently occurrs the difference of them from most others in regard that the Effluvia which generally evaporate do not long retain the Nature of the body whence they flow but either vanish in the tenuated Air or closing with other bodies are assimilated with them but those Particles which part from a pestilential Miasm are not easily absorb'd by the Air or other Body so that they wholly perish but among various Consusions of Atomes and Dashings against other bodies they preserve themselves entire for this Poyson being ina manner masterless and insuperable by others continues still the same and tho it consists of a very small heap of Atomes it does not presently vanish but taints with its Ferment the next Corpuscles to it and so acquires to it self new Stores and gets Strength as it goes whence it lies long hid in every Fomes and after a long time when it has lighted on a fit Subject it exerts it self and communicating the Infection of its Venom to the other it resuscitates a-new the Disease of the Plague which before seemed to be driv'n away and tho from a very small Seminary it disperses its mortal Povson far and near For the Plague discloses such most certain Signs of its Contagion that some Authors affirm it to subsist among Mortals only by this means and that it not where arises a-new but is preserv'd only by a Fomes and that it is now and then conveyed from one Region into another Histories tell us that the Seeds of it have lain dormant for many Years in a Garment or Bed-Cloaths that upon the same afterward being stirr'd they have shewn themselves and have brought the Disease of the Pestilence arising a-fresh with a mighty Destruction of Mankind when by reason of a Fomes the Pestilence is propagated to a distance after this manner the venemous Corpuscles which remain in the Miasm being stirred presently spring forth and display their Venom on every side as it were by a certain Irradiation if they any where light on a humane Body they presently seise the Spirits and are conveyed inward by their Vehicle and then easily enough infect the Blood and all other Homours flowing in the Vessels with their Ferment and in a short time cause Coagulations and a Putrefaction in them And after this manner by most subtle Effiuvia there is made a certain Transmigration as it were of the pestilential Disease ev'n as when a graft cut from some Tree and laid aside for some time and afterward inserted in another Trunk is able though from a very small Bud to produce a Tree of the same Kind and Nature CHAP. XII Of the Plague THE Plague may be described after this manner That it is an Epidemious Disease contagious very destructive to Mankind taking its Rise from a venemous Miasm first received by the Air afterward propagated by Contagion which setting upon Men after a hidden and secret manner causes Extinctions of the Spirits Coagulations of the Blood Syderations and Mortifications of it and of the solid Parts and brings the Diseased in danger of Life with an Appearance of Pushes Bubo's or Carbuncles and with the addition of other horrible Symptoms There are a great many Signs occurring to us which fore-shew that the Pestilence will happen in a short time to wit if the Year does not keep its Temperament but has immoderate and very unseasonable excesses of Heat or Cold Drought or Moisture if the Measles or Small Pox are every where very rise if Phlegmons or Bubo's accompany reigning Fevers from a preceeding Famines a most certain Presage is taken of an ensuing Plague for the like Constitution of the Year which for the most part brings a Dearth of Provisions by reason of the Corn being blighted is apt also to produce a Plague also the evil sort of Dyet which such as are prest with Hunger make use of eating all kinds of unwholsome things without choice disposes their Bodies more readily to receive the Contagion Moreover Earth-quakes and fresh-opened Grotto's and Caverns upon the cleaving of the Earth by reason of the Eruptions of a malignant and venemous Air have often given Beginnings to Plagues Again as there is need of great Diligence in taking a fore-view as it were from a Watch-Tower of an imminent Plague so we ought to be no less sagacious in observing the same as if first arises and cast its first Darts for often being too sollicitous we dread even vulgar Fevers if haply they end in Death for this Contagion and sometimes being too secure contemning the Pestilence by reason of its Symptoms resembling those of a common Fever we find our Dangers but too late wherefore for the fuller knowledge of this Disease we shall set down its Signs and Symptoms both common and pathognomick Besides the Signs above delivered which by a certain Demonstration a Priori give a Suspicion of an ensuing Plague there are others whose concurrence with it plainly shew its Presence in a Body diseas'd of these some are common to a Plague with a putrid Fever some are more proper to this Affect for the Impression of the Plague oftentimes stirs up an Effervescence of the Blood and
Secondly as to what regards the Menses supprest during the time of being with Child and the Lochia plentifully flowing after Child-birth we say That after the Foetus is conceived the Menses are stopt by Divine Appointment because their flowing often brings Abortion and in regard the Vessels are emptied by a continual Exsudation of the nutritive Juyce into the Parts of the Womb the Mass of Blood does not easily arise into Turgescencies to be appeased by a monthly flowing For the same reason the Menses for the most part are stop'd as long as Women give suck to Infants in some happily endowed with a hot Blood the Menses flow both in the Time of their being with Child and giving Suck but that is wont to happen but rarely and not without damage tho in the mean time the Menses stopt while Women are with Child because far less of the nutritive Humour at that Time is imployed for Milk deprave the Blood much more than the same are wont when restrained during the Time of gving Suck nay from those being long supprest in the first State a venemous Taint as it were is communicated to the Mass of Blood which unless it be purg'd off presently after Child-birth by a long flowing of the Lochia it produces sore and very malignant Affects wherefore to give my Opinion of the flowing Lochia I say that that Haemorrhagie immediately proceeds from those Vessels being broken by which the Placenta sticks to the Womb and that by this way the Blood and excrementitious Humours partly heap'd together about the Womb during the Time of being with Child and partly flowing from the whole Mass of Blood are evacuated to wit whilst the Womb first swoll'n in a Bulk falls presently after Delivery and is contracted into a less space the Blood is copiously express'd from the Vessels that are open in it And moreover in as much as during the Suppression of the Menses the Mass of Blood is imbued with very fermentative Particles assoon as after Child-birth the Mouths of the Vessels are open presently as tho a large flowing of the Menses were at hand the whole Blood ferments even as new Wine in a Bottle opened and endeavours to purge from it self the extream fermentative Particles by a flowing of the Lochia as it were by an Efflorescence and therefore besides the Blood which in the first days by reason of the Vessels being newly opened often flows forth pure afterwards very discoloured Ichors to wit livid or green and those very stinking are voided forth This kind of flowing is wont to continue for fourteen days at least nay in some for a month and if by reason of any Errors it be stopt before the Mass of Blood be cleansed enough by such an Efflorescence presently a very dangerous Fever with a horrible Apparatus of Symptoms is wont to be caused The third Consideration previous to the Doctrine of the Fevers of Women in Child-bed chiefly concerns the Womb it self to wit how it 's affected after child-birth and what kind of Influence it has over other Parts of the Body As to the first there are two Accidents chiefly on which the acute Diseases of Women in Child-bed much depend first the setling of the Womb or the Reducement of it to its natural Site and Magnitude from the Bulk of Ingravidation secondly A Solution of its Unity within its Cavity by reason of the Connexion of the Placenta being broken When the Foetus is deposed with its Envellopings presently the sides of the Womb it self before greatly inlarged fall together and contract themselves by degrees into a narrower space by the help of the Fibres By reason of this kind of Contraction the Blood and Ichors are copiously exprest from the Vessels and Pores of the Womb and are voided forth with the Lochia but sometimes it happens by reason of preternatural things contain'd in the Womb as are a part of the Secondine a Mola Clots of Blood c. even tho after a laborious Delivery a Contusion or great Dilaseration happen that the Womb does not duely contract it self but the Motion of the Fibres being inverted ascends upwards and is raised into a Lump also the Membranes being affected with a Twitching it is still assail'd with Tortures as tho the Throws of Child-birth were in being which kind of Affects if they continue for some time by reason of the Orifice of the Womb being constringed with a Convulsive Motion the Lochia also are often stop'd hence severe Symptoms ensue and oftentimes it happens that a Fever either thereby is first raised or being induc'd by some other cause is rendred far more dangerous Secondly as to the Unity dissolv'd by the Placenta being broken it happens either at the due Time of Delivery or when it is precipitated and over-hasty and then the Secondine is thrown out entire or being broken part of it being left behind it comes away as it were at halfs If a Child-birth happens at the just time and the Foetus falls away entire and without Violence from the Cavity of the Womb with its Envellopings as ripe fruit from a Tree the Mouths of the Vessels are somewhat opened that the Lochia flow moderately and hence no severe Symptom is feared But if the Foetus not yet ripe for Delivery be torn away as it were by force tho the Placenta with the Membrances are torn away entirely yet the Vessels being broken a great Haemorrhagie and at length the Mouths of the Vessels gleeting forth a stinking Ichor an ulcerous Disposition ensues And if part of the Secundine or the whole sticks to the sides of the Womb after Delivery and there putrifies they gleet forth very stinking Ichors and cause mischievous Affects oftentimes the Orifice of the Womb is shut and retains within Clots of Blood and pieces of Membranes or Flesh which putrifying through Hear Poyson the Blood and Humours flowing thither by Circulation from the whole Body and by a'troublesome Irritation stir the Parts of the Womb which are very sensible into Contractions Since therefore after Child-birth an Injury is brought on the Womb after the foresaid Manners the same is soon communicated to the other Parts not without a Disturbance to the whole Body which is usually done in a double Respect for first this happens because the Lochia hindred from being voided forth presently restagnate into the Mass of Blood and defile it with a sort of virulent Miasm Moreover from the Contents putrifying in the Womb either the Substance it self of the Ichor or the Particles departing from the cadaverous thing are mix'd with the Blood and nervons Juice passing through them and in a short time infect their whole Liquours Secondly Histerick affects are extended far and near by reason of the mighty accord there is betwixt the Womb and the Brain with the Fibres and Membranes of the whole Body by the means of the Conveyance of the Nerves for when the extremities of the Nerves plac'd about the Uterine Parts are
wholly excluded or be driven away from the breasts too much in a croud presently restagnating into the Blood it causes a disorder of the same as a forerunner of a putrid or malignant Fever of which we must speak next The Putrid Fevers of Women in Child-bed WOmen in Child-bed throught the taint of their ill affected Body as tho they were struck with the Contagion of a pestilential Air are found to be extreamly obnoxious to a putrid or rather malignant Fever tho all do not equally receive tha taint of this Disease for poor Women Hirelings Rusticks and others us'd to hard Labours also Viragoes and Whores who are clandestinely delivered bring forth without great difficulty and in a short time after rising from their Bed return to their wonted Labours but Women that are rich tender and beautiful and many living a sedentary Life asa tho they partak'd of the Divine Curse after a more severe manner bring forth in Pain and presently after their delivery lye in an uneasie and dangerous condition the reason of which seems to lye in this that those that use much exercise continually exagitate and eventilate the Blood and therefore after the Menses are stopt heap together fewer Miasms for the matter of the Disease Moreover labouring and active Women having the nervous Parts more firm are less subject to convulsive Mothions and the affects vulgarly called hysterical on the contrary in nice Women and such as live idly during the time of their being with Child the mass of Blood becomes impure and fermentative moreover because they have the Brain and the System of the Nerves thender and weak upon any light occasion they undergoe Distractions of the animal Spirits and disorderly Motions of the nervous Parts and here it is to be noted by the by that Women before Men and some of that Sex before others are troubled with the Affects called hysterical not so much by reason of the fault of the Womb it self but by reason of the weaker Constitutions of the Brain and Genus Nervosum for in Perons so affected Passions of Anger Fear Sadnes also all vehement or strong Objects easily pervert the Crases or Functions of those parts which when they have been once injur'd day afterward in a manner always accustom them selves to the same Irregularities But to return whence we made a digression the Fever even now mentioned is wont to infest Women in Child-bed at various thimes and for diver Occasions sometimes it arises presently after delivery especially if it has been difficult and laborious sometimes the second third or fourth Week tho the later it begins the safer it it is wont to be the Type of that effect passes after this manner after a previous indisposition an open feverishness for the most part with a cold and a shivering makes the first invasion which presently is followed by a heat afterward a sweat ensues for a day haply or two there are various reciprocations of Fits of heat and cold afterward the Blood being kindled throughtout the Lochia unlefs supprest before either flow a little or wholly stop If the Disease be acute and of a quick motion on the third or fouth day it comes to its height then there is an intense heat with a very troublesome drought a vehement and quick Pulse there are obstinate Watchings a great restlessness of the whole Body so that the Diseased continually toss themselves this way and that in their Bed the Urine is thick and ruddy and other severe symptoms are rife whilst the Fever is thus in its height a Crisis is not to be expected for I have never seen this Disease resoled by a critical sweat nay the case is very dangerous so that after the Blood has boyl'd for some time the adust matter presently being convey'd into the Brain dangerous and very sore Irregularities of it and of the Genus Nervosum straitway ensue for convulsive Motions of the Tendons wonderful distentions about the Viscera and puffings up resembling hysterick Passions oftentimes are raised Moreover sometimes a Phrensy a Delirium often a Stupor and a Speechlessness also follow almost in all the strength is suddenly cast down without a manifest Cause tyhe Pusse becomes weak and uneven and the Diseased are often precipitated into Death if any haply escape either the flowing of the Lochia being restor'd or a Diarrhoea superventing they recover with much adoe after a long lying ill I have known purple Spots to have appear'd in some indeed in most the symptoms which regard either the Blood or the nervous Juyce argue no small malignity The Procatarctick Causes of this Fever on which the malignity and mighty danger of this Disease depend are chiefly two viz. first an evil dispostion of the Blood after a long suppression of the Menses secondly after delivery the evil affects of the Womb from the dangerous labours of Women which make out the Divine malediction after the Menses being long supprest the Blood does not only grow turgid and its sulphureous parts being rais'd too much are rendred more apt for Inflammation but moreover the mass of Blood is imbued with very fermentaive Particles so that as is hinted before being struck as it were with a venemous Miasm as it ferments it forthwith is dispos'd toward a putrefaction and corruptive irregularities and besides it may presently poyson the nervous Liquour and render it offensive to the Brain and the whole Genus Nervosum this kind of taint communicated to the blood ought to be purg'd forth by a copious flowing of the Lochia but if after delivery the Womb be out of order their is not only a stoppage of the Lochia and so the Reparation of the whole blood is hindred but besides stinking Ichors are thence transmitted to the blood and greatly infect it Also by reason of convulfive motions begun about the Womb and thence continued to the other Parts Irregularities are rais'd in the Blood and Juyces whcih often conspire to the production or exasperation of a Fever The evident Causes which either cause an actual effervescence in the Blood having gotten a Dyscrasy or trouble the whole Body with the Distempers of the Womb are divers for these make a painful delivery a solution of unity about the Womb a contusion a retention of preternatural things an ulcerous disposition and a great many other Accidents which are caus'd throught some necessity but the occasions in the power of Patients and easie to be avoided which are wont to raise this Fever are chiefly two viz. an ill form of Dyet and a taking Cold. It 's a usual thing to give to weak Women after Child-birth on the first and second day the Flesh of Animals or their Gelly-broths and other Food very disproportionate to their Constitutions whence presently an indigestion and great disquietings arise in the Viscera and feverish turgescencies in the Blood by reason of a nutritive Juyced richer than it ought Befides Errours committed in Dyet often an Injury is Caus'd for that
supprest To the tenth day after her Delivery being only gently feverish and the Purgings of the Womb still flowing she liv'd free from any severe Symptom but then tho very feverish she seemed more chearful than usual and more confident of her doing well in the night she slept little or scarce at all the morning following at which time I first visited her she was manifestly delirous the Lochia were stopt and the whole Body was in a Shivering the Tendons in the Wrists were convulsed so that her Pulse was scarce to be distinguished which in the mean while was weak uneven and very quick I declar'd That this Person unless the Hand of God unexpectedly delivered her must dye in a short time however six Grains of Oriental Bezoar being given in a Spoonful of a Cordial Julep and causing a copious Sweat with a better Pulse and afterward other Cordials given at due Intervals gave some hope of doing well tho doubtful and not to be relyed on After four Hours after I came being in a languishing Condition she had a very large Stool then presently her Strength wholly fell and within an hour and a half she died A Woman of Quality scarce exceeding twenty Years of Age of a florid Countenance and a thin Body the Lochia flowing immoderately after Child-birth used certain astringent Remedies by the Advice of the Attendants whereby they were wholly stopt but a Loosness followed which increasing for three days the Women gave her other Remedies to stop the Loosness nor were they frustrated of Success mean while they brought a dangerous Fever and Affects as it were hysterical in the place of the former for the unfortunate Woman in Child-bed was affected with a Thirst and a Heat with Watchings afterward with a frequent Swooning and cold Sweats Being called at this time I ordered Cordial Remedies and things to promote uterine Purgations to be drank and likewise a Clyster to be injected the Loosness of the Belly being again procur'd the Lochia also came down and the Diseas'd being freed from the foresaid Symptoms and the more severe Disease viz. the Nurses Remedies soon recovered from her Fever Here let it be observed by the By that it 's very dangerous either to stop or to alter or to thwart any Motion raised by Nature tho anomalous A Woman of Note about twenty years of Age of a full and well-flesh'd Habit of Body aborted twice within a Years space when afterward she had conceived with Child by her Physician 's Order once a Month drinking plentifully of Whey she raised a Vomiting whereby she was wont to cast up a great deal of thick and clammy Flegm also during the time of her being with Child she was let Bood five times The time of Child-bearing being over she brought forth a Boy with great Difficulty the Secundine came away entirely and she purged egregiously On the second day as she raised her self on her Feet in her Bed that the Cloaths might be put in order she took Cold and thenceforward the bloody Lochia were wholly stopt and only a little serous Water flowed forth On the third day she began to complain of an acute Pain in the right-side the Women present applyed to it Bags of Camomile made warm with Bricks nevertheless the Affect was very much increast with a bloody Spittle On the fourth day after Delivery a most acute Pain with a most difficult and very painful Breathing seised her By the Order of a Physician then coming from the Neighbourhood six ounces of Blood were drawn from the Basilica and she suddenly found Relief and was better for ten Hours At Midnight a pricking Pain returned with the wonted fierceness at other Physicians being called to consult they all concluded that it was necessary to bleed again in the Arm of the Side affected Blood being drawn to four ounces the Pain remitted and the Diseased breathed better afterward Diaphoreticks being giv'n she fell into a copious Sweat with a quiet Sleep but the Pulse became more quick and weaker also Contractions of the Tendons appear'd in the Wrists Presently afterward she talked light-headed and within twenty four Hours after Blood was drawn the last time she died That this Lady upon the Lochia being supprest together with a Fever fell into a pleurisie the Cause in some measure seems to be the Bleeding so often used during the time of her going with Child for by this means the Blood accustomed to be breathed by the Arm afterward fermenting leaving the Womb ran towards the wonted way of being let forth where not finding a Passage it fixed it self in the neighbouring side as in the next seat of Extravasation Moreover besides the usual state of a Pleurisie no small Malignity was added to this Disease for the Blood being freed from Extravasation presently began to be corrupted in its Crasis and on the third Day of the Fever was so far deprav'd that it was not able to ferment longer in the Heart and so to continue Life Not long since the Wife of a certain Smith was brought to Bed at the time that her Children were sick of the Small Pox in the same House and her self as it seems took the Contagion of the Disease for on the second day after Delivery Pushes began to break forth with a feverish Incalescence and a Pain in the Loins which for three days the Lochia flowing moderately rise up as they ought to good Wheals and tho a uterine Purgation happened copiously at this time she had the Small Pox very thick in her whole Body nor were they only on the Surface of the Skin but they likewise so filled the Cavity of the Mouth and Throat that she was scarce able to speak or to swallow On the sixth day after being delivered the Lochia flow'd immoderately whereby presently the Small Pox falling a Swooning frequent Convulsions and other Symptoms of an ill nature assail'd the Diseased which threatned Death in a short time Being called I prescribed half a dram of this Powder to be taken constantly every three Hours in a Spoonful of the following Julep viz. Take Roots of Tormentil powdred two drams the best Bole-armoniack one dram Species of Hyacynth half a dram make a Powder Take Water of Scordium compound of Dragonwort of Meadow sweet of each three ounces Acetum Theriacale an ounce Syrup of Corals two ounces burnt Harts-horn half a dram make a Julep Moreover I ordered that in her Broth and in all things she drank the Roots of Tormentil should be boyled by these Remedies the uterine Purgation was wholly stopt and the Small Pox without any severe Symptom being ripened by degrees fell away This Case was really difficult and was managed with a great deal of Danger viz It was dangerous either for the Lochia or Small Pox to be kept in and nevertheless the full Eruption of either hindred the Motion of the other as long as both proceeded moderately the Busmess being left to the Guidance of Nature went on indifferently well
but when the one prevailing the Assistance of Art was required it was necessary to check the Lochia and to put forward the Small Pox. CHAP. XVI Of Epidemick Fevers I Had design'd to have put an end here to our Dissertation concering Fevers it being my Intent rather to write a Commentary than an entire Tract but in regard certain Epidemick Fevers are often rise which observe no Laws nor can be reduced to a certain Rule of Doctrine but being wholly anomalous vary yearly and therefore as often as some one of them spreads it self presently it is called the New Disease therefore I have thought it necessary because general Precepts are not to be given concerning these Fevers to subjoyn particular Relations of some of this kind for from the various Apparatus of Symptoms whereby they are wont to be marked the Nature and the whole formal Reason of these kinds of Affects will somewhat appear Since therefore of late Years within a little Tract of Time three Popular Diseases have reigned in these Countries I shall give here as a conclusion to this Work the particular Descriptions of them made formerly in the Tiems that those Fevers reigned A Description of an Epidemick Fever Reigning in Autumn Anno 1657. made in the middle of September WE designing a Description of a Fever violently reigning at this time it is fit that being led by the Example of Hippocrates we first consider the foregoing Constitution of the Year and its Distemperatures and Excesses of the Qualities for the Cause of an Epidemick Disease raised generally among People must be common We must note what the State of the Year was and the Disposition of our Body thence contracted whereby many were affected together Now to take the thing stom its Origine The foregoing Spring and the Time thenceforward to the end of the Summer to wit all this half years space was mighty hot and dry but especially after the Summer Solstice the Heats were so intense for many Weeks together that Night and Day every one complained of the Heat of the Air and almost of a continual Sweat wherewith they were all bedewed and that they could not breath freely About the end of July this Fever being first sporadical began to break forth in certain Places that one haply or two in a Town or Village were seized with it in most it carried the Type of an intermittent Tertian to wit the Fits returned every other Day which nevertheless without any fore-running Cold or Shivering infested the Diseased with a most intense Heat Vomitings and bilous Stools happen'd plentifully in most a Sweat succeeding but difficult and often interrupted whereby the feverish Access seldom went off with an Apvrexia but all the time of Intermission the Diseased continued languid and weak with a Thirst and a Restlessness in some when they began to amend after three or four Fits a cold and a Shivering began the Access and the Fever became exactly an intermittent Tertian but in most the Disease still grew worse and presently became obstinate and of a difficult Solution with an ill Apparatus of Symptoms for the Diseased being mighty hot in their Fits and sweating with Difficulty Errors were wont to be committed which daily intended the Strength of the Disease for through the Impatience of the Diseased and the Unskilfullness of the Attendants the Sweat which ought to have ended the feverish Access being interrupted scarce one Fit was ended but another presently succeeded and thereby the Disease was wont to have erring and uncertain Periods without an Intercession of an Apyrexia and afterward it was wont to pass into a continual Fever as it were the State whereof was sometimes very dangerous with an ill Affect of the Brain and Genus Nervosum that not unfrequently a Lethargy or Delirium and often Cramps and convulsive Motions were raised In the Month of August this Fever began to reign far and near among the People that in every Part and Village many lay ill of it tho it was far more common in the country and little Villages than in the Confines of Cities and Towns It still carried the Type of an intermittent Fever only that through the Violence of Symptoms and the Shortness of Intermission it seemed more tedious than ordinary and therefore was generally call'd the New Disease Moreover it was censur'd of some Malignity and gave Proofs certain enough of its Contagion and Mortality in as much as it crept from House to House and infected many of the same Family with the same corrupted Taint and especially such as conversed familiarly with the Sick moreover in many Places it carried off old Persons and such as were come to a Ripeness in Years If you consider the Nature and Essence of the Affect this Fever must be placed properly in the number of Intermittents for the Fits return at set times also for the most part they begin with a Cold and a Shivering and very often with a Vomiting and presently going on with a most intense Heat at length they are ended in a Sweat The Urine in most appears of a Flame Colour clear in the Fit with some Hypostasis out of it thick with somewhat a ruddy Sediment the Disease comes not to a Crisis by a Sweat tho very plentiful and often repeated which might be expected in a continual Fever but the Affect holds on for many Days and sometimes Months to a very long time tho there happens a very great Evacuation by Vomiting and Sweating almost daily which we observe to fall out often in an Intermittent Fever seldom in a continual out of the Fit at any time of the Disease Purging is conveniently ordered which it were a Crime to attempt in a Synochus before the Signs of Concoction Moreover that this Fever is of the kind of Intermittents it hence appears because most recover of it that scarce the thousandth part of the Diseased dies which I think is scarce heard of an Epidemick Synochus About the first beginnings of this Disease it appears very like an Intermittent Tertian tho it may seem in some by reason of a vicious Predisposition of the Body and of Errors committed in Diet and Transpiration to have pass'd into a continual for in those in whom the Fits do not come to a due Determination nor end in an Apyrexia by reason of the morbifick Matter being not perfectly blown off in those the Blood continually boyls whence it comes to pass that the Accesses return quicker and infest longer till at length by reason of the store of the Matter and the languishing of Nature the Blood becoming weak is not able to grow turgid any longer and to separate the Febrile Matter at set Hours but endeavours to subdue it by little and little and by a continual Effervescence Some haply may wholly place the Cause of this so Popular a Disease in a malignant Constitution of the Air to wit that the Particles of the Air breath'd in were infected with a certain
and either hinder the Stuffings of the Viscera or remove them being made and restore their Ferments being almost extinct for this Use chiefly conduce the Remedies and Preparations which are vulgarly call'd Digestives and Antiscorbuticks by which being seasonably administred I have known many weak pale and bloodless Persons as it were to have soon recover'd a sprightly Strength and Vigour A Description made the last Day of May of a Catarrhous Epidemick Fever happening in the middle of the Spring An. 1658. AN immoderate Heat of the Summer before was followed in the Winter with a Frost equally intense so that no Man living has scarce remembred a year like this for an Excess both of Heat and Cold. From the fifth of December almost to the Vernal Equinox the Earth was cover'd with Snow and from the North Winds continually blowing all things set in the open Air waxed stiff with Cold and afterward from the beginning of the Spring almost to the first day of June the same Wind still blowing the Season was more like Winter than Spring only that sometimes haply it was interlac'd with a day or two of hot Weather During the Winter amongst our People here save that the Quartan Ague contracted in the Autumn infested some the State was indifferently healthful free from any popular Disease In the beginning of the Spring an intermittent Tertian Fever as it 's usual in every other year seised some About the end of April on a sudden an Affect shew'd it self which being sent as it were by a certain Blast from the Stars seis'd a great many that in some certain Towns in a Weeks space above a thousand Men lay ill at once The Pathognomick Symptom of this Disease which first seised the Diseased was a troublesome Cough with a copious Spitting and a Catarrh falling on the Palate Throat and Nostrils there is also a feverish Distemperature which for the most part is joyn'd with a Heat and a Drought a want of Appetite a spontaneous Lassitude and a great Pain in the Back and Loins which Fever nevertheless in some was more remiss that they walk'd abroad and during all the time of their Sickness followed the usual Offices of Life complaining in the mean time of a want of Strength and a Weakness of a loathing of food of a Cough and a Catarrh Now in some a hot Distemperature very much reigned that being confined to their Bed they were troubled with a Burning and a mighty Drought with Watchings a Hoarseness and an almost continual Cough sometimes a Bleeding at Nose in some a Spitting Blood and often bloody Stools happened upon this Affect Those who being of an infirm Body and stricken in Years were seised with this Disease many of them died but in a manner all of those that were strong and of a sound Constitution recover'd those who yielding to this Disease perished they died for the most part by reason of their Strength being wasted by Degrees and a Mass of serous Filth being heaped together in the Breast with the Fevers being increased and a difficult Breathing like Persons troubled with a Hectick Fever Concerning this Disease we must enquire what kind of Procatarctick Cause it had that it should rise on a sudden in the Spring and that within a Months time almost the third Part of Mankind should be affected with it Afterward the Signs and Symptoms being diligently compared together the formal Reason of this Disease also the ways of its Crisis and Cure ought to be assigned That the North Wind is most apt for producing Catarrhs besides the Testimony of Historians common Experience makes good but why Catarrhs did not spread themselves so much sporadically during all the Tract of the Winter and Spring but that this Affect should reign epidemically only for the space of one Month and then joyn'd with a Fever the reason is not so plain I know that many draw the Cause from the uneven Distemperature of the Air for that Season which tho for the most part cold yet sometimes the Northwind remitting for a Day or two was very hot wherefore on this Occasion as upon taking Cold after being hot many Men might fall sick this kind of evident Cause might suffice haply for affecting some with this Sickness but for causing an Affect arising so on a sudden and generally reigning besides such an occasion a great Procatarxis or Predisposition was requir'd for it ought to be supposed that all Men in a manner were ready prepared for receiving this Disease otherwise no evident Cause would exercise its force so powerfully on a great many wherefore it is likely that this Disease drew its Origine from the Distemperature and very great Irregularity of the Year and as the intermittent Autumnal Fever above described was the Product of a preceeding immoderate Heat so this catarrhal Fever wholly depended on the Tract of the Year hapning to be too cold for the Blood being already burnt from the over-hot Summer and inclin'd to the Fever above described then Autumn coming on being made more sharp and apt to a Quartan Fever afterward by reason of the intense Cold of the Winter being little eventilated and hindred from its due Perspiration it held still a Dyscrasie and was ready to suffer by it as occasion might be given Wherefore in regard the Blood in the middle of the Spring as the Juyce of Vegetables being become more sprightly and having begun to spring and display it self by reason of its Thickness still continued was straitned in circulating it was prone to feverish Effervescencies and in regard the Serous Latex abounding in the Blood was not able to evaporate forth by reason of the Pores being still closed with the Cold restagnating inwardly and falling chiefly on the Lungs where somewhat succedaneous is performed to outward Perspiration it rais'd so frequent and troublesome a Cough Therefore the Rise and formal Reason of this Disease are chiefly founded in two things to wit that there happened together a greater Effervescence of the Blood than ordinary caused by the Spring Season and withall a Density or a great Constriction of the Pores caused by the preceeding Tract of Time which was too cold that thereby there was not a free space granted the Blood springing in the Vessels the Case was the same as if Wine beginning to ferment were put into Vessels close stopt for by this means both the Vessels and the Wine are in danger of being destroyed Wherefore to draw the thing in short that this Disease arising in the middle of the Spring presently spreading very far seiz'd a great many the cause was not a blast of a malignant Air whereby the Diseased were affected as tho struck by a Sideration as some will have it but that at this time the Blood being inspired by the Constitution of the Spring and so apt to display it self and ferment was straitned in its Motion and the Efluvia being inwardly restrained it could not be enough ventilated Every years tho
pungitive Moreover the Mass of Blood also has greatly contributed to this Evil for whilst it ferments the vapory Effluvia which ought to be blown away outwardly by reason of the Pores being constring'd are sent to the Membranes of the Head and the Brain and by reason of this closing of the Pores communicated almost to all a Sweat happens with Difficulty and that but partial and often interrupted in the Fits Hence also in the height of the Disease a perfect Crisis or a spontaneous Solution of it seldom or scarce at all happens but instead of it if the thing be committed to Nature an adust Matter or Recrements heap'd together in the Blood are conveyed to the Brain and there raise Affects sometimes of the Coma sometimes of the Frenzy and those lasting and obstinate 3. That the Fits sometimes begin without a Cold or a Shivering and are protracted in length with a troublesome Heat and a difficult partial and often-interrupted Sweating afterward that the same being ended the Diseased grow hot again so that the Accesses are not ended but after a long Evaporation of a dry Breath the Cause is the too sharp and bilous Disposition of the Blood whereby being fill'd with a burnt Salt and Sulphur rather than with a Serous Latex when it grows turgid it presently takes to a light Flame without a previous flowing of the nitrous Matter and therefore by reason of its want of Serum and the Pores being shut its Deflagration is continued a long time in a manner only with a dry Exhalation and scarce ends at length in an Apyrexia and therefore the Intervals of the Fits are very troublesome with a Heat and Drought a Head-ach a Vertigo and other Affects to wit because the febrile Matter heap'd together in the Blood is not wholly discussed every Fit but part of it being left after the Access as extraneous and not miscible brings almost a continual Effervescence 4. It is to be observ'd that those that are affected with this Fever presently fall from their Strength and the wonted firm State of their Bodies that after a Fit or two being out of Breath and very weak they are scarce able to stand or walk without a Staff whereas it is usual for such as are seised with a common intermittent Fever to be sprightly and chearful enough during the Intervals of the Accesses The Reason of the Difference is because in this Fever both the Mass of Blood is more depraved with the impure Mixture of a degenerate Juice and especially because the same is more perverted from its natural Crasis and therefore when out of the Fits it does not boyl yet it does not ferment duely and evenly in the Sinus's of the Heart wherefore when by a quick Motion or any Agitation of the Body the Blood is vehemently pressed forward into the Sinus's of the Heart because it is not all presently kindled there and springs forth by its Stagnation it brings an oppression of the Heart and great Faintings of the animal Spirits By reason of this kind of Dyscrasie of the Blood to wit whereby it is unfit for Fermentation or a due Accension in the Heart some Cattel also and especially Horses in the Spring of Fall become short-winded and very unfit for a swift Motion 5. It remains for us to enquire lastly concerning this Fever wherefore it reigns chiefly in Parishes little Villages and in the Country when Cities and great Towns have little of it It might seem that this Affect might be raised from marshy and other noxious Vapours plentifully heap'd together in this or that Tract of the Air but it is more rational to say That the Inhabitants of those Kinds of Places having been more exposed to the Winter Colds and Summer Heats contracted a greater Dyscrasie of the Blood and so a more apt Disposition to this Fever for those that live in the Country scarce go out of their Houses but are exposed to the Rays of the Sun or to the Fervour of the heated Air. Moreover Husband-men and those in the Country being used to hard Labours among whom this Fever chiefly reign'd through their Toyls and immoderate Exercises in the Fields and withall using an ill and course Dyet sooner acquire an adust and burnt Disposition of the Blood and therefore more apt to this Disease than Citizens and Towns-men who enjoying Rest and a wholsome Dyet most commonly live in Houses together or in Streets cooled by the shadow of Houses The truth of this Assertion is confirm'd for that not only the Epidemick Fever now reigning but the other also of the Autumn before rais'd through a Dyscrasie of the Blood was chiefly rife among Husbandmen and the Inhabitants of the Country but that popular Fever which arose in the middle of the Spring depending chiefly on a letted Transpiration infested most Citizens and Towns-people mean while those in the Country usually procuring a more free Transpiration by Exercise and Labours liv'd more free from it The general Prognostick of this Disease only seems to threaten that in a manner the like ill consequence will attend it as followed the Epidemick Fever of the foregoing Year to wit by a Guess taken from the Distemperature of the Blood rather than from the Taint of the Air we may dread an imminent Quartan Fever again but not a Plague As to the particular Observations in it to give you in short the Signs which promise Death or Well-doing they chiefly regard the Temerature and Governance either of the Blood with the vital Spirit or also of the nervous Juice with the Animal Spirit If from the Pulse Urine Actions not injur'd and the Appearance of other Symptoms it be plainly indicated that the Blood as to its feverish Disposition be not greatly perverted from its natural Crasis that in the Fits it burns only moderately and that in every Conflict it easily subdues the load of the febrile Matter and wholly shakes it off from its Fellowship that after some Accesses the Mass of the same Blood is somewhat restor'd toward its due Temper that it less perverts the nutritive Juyce and sends forth that which is extraneous and not miscible with a more mild Turgescency and in the mean while if the other spirituous Liquor duely influences and irrigates the Brain and nervous Bodies that Sleep Watchings Sensation and Motion are perform'd well or at leastwise indifferently we may hope all good things of the Diseased But if it shall appear from the same kinds of Signs that the Blood in this Fever has gotten a Crasis far remote from the natural if it perverts much of the nutritive Juyce and afterward from its extraneous and incongruous mixture the Liquor of the Blood be greatly troubled and the Spirits are driven into Confusion if in the Fits the Blood burns too intensly and for a long time and does not duely subdue the febrile Matter or send it wholly forth but its impure Mixture is still more infected and in every feverish Access more
ib. p. 134 135. the Method of Cure ib. Prescripts of Medicines for it p. 136. An Instance of another Person troubled with it and how cur'd ib. p. 137. Dropsie call'd Anasarca see Anasarca Dropsie call'd Ascites see Ascites Dropsie call'd the Tympany see Tympany Dropsie hapning in the Scurvy its Cure p. 366 367. Dysentery see Purging E. EMetick Medicines see Vomiting Empyema what the Word imports p. 119. what to be considered in order to its cure ib. An Incision not to be attempted over hastily in it p. 120. Forms of Medicines requisite for curing an Empyema ib. A Julep against Faintings and Swoonings upon the Operation ib. Ephemera Fever see Fever Epilepsie seeing Falling Sickness F. FAlling Sickness its Description p. 138 139. Sometimes terminates of its own accord ib. The Method of proceeding with it p. 240. What Medicines us'd against the Fit ib. p. 241. The chiefest care in the Prophylactick part for removing the cause ib. What Medicines to be us'd for it ib. p. 242. An Instance of a Person troubled with the Falling-sickness and with what Medicines cur'd p. 243. The general Method of curing it with prescripts of Medicines ib. p. 244 245 246 247 248 249. Fever its Description p. 426. Intermitting Fevers whence caused ib. why a cold and a shivering precede the heat in them p. 427. whence their Intermission and set returns ib. p. 528. their Cure how undertaken ib. p. 529. Certain Irregularities of them p. 530. Fever tertian Instructions concerning it p. 531 532. Symptoms foreshewing its Remission ib. 533. It s Method of Cure p. 534 535 536 537. Fever quartan Instructions concerning it p. 540 541. Why so difficult to cure ib. curd by raising a gentle Salivation p. 542. Other Remedies for it p. 543 544 545. c. Fevers continual wherein differing from Intermittents p. 548. the kinds of them ib. Fever call'd Ephemera or simple Synochus holding one or many Daies Instructions concerning it p. 549 550. three things required to a Crisis or Solution of it ib. p. 551. its Cure ib. Fever putrid its Causes p. 552 553. the four observable times of it ib. p. 554 555 556 557. the most considerable Symptoms and Signs in it p. 560 561 562 563 564 565 566. the Pulse and Urine chiefly to be minded for knowing the State and Strength of the Diseased p. 567 568. 569 570. The kinds of the putrid Synochus p. 571 572 573. its Cure p. 574 575 576. Examples of Persons seised with it and the Method us'd with them p. 577 578 579 580 581 582. Fever Malignant or Pestilential in general wherein it consists p. 583. What parts of the Body their venom Affects p. 584 585. the Essence of a Pestilential Fever in what founded p. 587. whence it arises 588 what Bodies apt to receive it p. 590. how propagated by Contagion ib. p. 591. Fevers Pestilential and Malignant in Specie and other Epidemick Fevers p. 601. the distinctions betwixt a Plague a Pestilential and a Malignant Fever ib. p. 602. Pestilential and Malignant Fevers plac'd in the rank of Continual Fevers ib. Signs of Malignity in Fevers p. 604 605. what to be observed in the cure of Pestilential and Malignant Fevers ib. an Instance of a Pestilential Fever p. 606 607. its way of cure p. 608. Instances of the Malignant Fever p. 609 610 611 612 613. Fevers of Women in Child-bed Instructions concerning them p. 625 626 627 628 629. of the Lacteal Fever of Women after Child-birth p. 630. its cure p. 631. Putrid Fevers of Women in Child-bed ib. p. 632. their Procatarctick Causes p. 633. the Evident Causes ib. the Conjunct Cause p. 634. they are dangerous p. 635. the cure ib. p. 636 637 638. Fevers Symptomatick of Women in Child-bed what those Symptoms are p. 639. what must be done in order to their Cure p. 640. What must be done in the Small Pox when happening p. 641. Stories of Women in Child-bed troubled with Fevers ib. p. 642 643 644 645 646 647. Fevers Epidemick and Anomalous p. 648. A Description of one ib. p. 649. its Nature and Essence ib. p. 650 651. its conjunct Cause ib. what it has peculiar from common Intermittents and a Synochus p. 654 653. its general Prognostick p. 653. its particular Prognostick ib. its method of Cure p. 655 656 657. Fever Epidemick and Catarrhous described p. 657 658. the rise and formal reason of it p. 659. its Symptoms p. 660. its Prognostick ib. the method of Cure p. 661. Another Epidemick Fever described p. 662 663. its Nature p. 665. its Accidents p. 666 667. the Prognostick of it p. 668. the method of Cure p. 669 670 671 672. Fever Epidemick chiefly infesting the Brain and Genus Nervosum p. 271 272. its formal Reason and Causes 275. Instances of Persons seis'd with it p. 276 277 278. the method of Cure ib. p. 279 280 281. An Instance of a Fever chiefly radicated in the nervous Juice and its Cure 282 Fever Scorbutick its Cure 363. 364. Fits of the Mother p. 297. the various Passions vulgarly said to constitute an Hysterick fit or a fit of the Mother ib. those Fits are properly Convulsive p. 298. they arise chiefly from the Brain and genus Nervosum ib. sometimes from the Womb and others of the Viscera ib. p. 299. An Instance of a Person troubled with them and what done in order to the Cure ib. p. 300 301 302. The method of Cure to be us'd in the Passions vulgarly call'd Hysterical ib. p. 303 304 305 306. Flux See Purging Folly see Stupidity French-Pox safely cur'd with a Sweating Diet-Drink p. 38. Frensy its Definition p. 451. whence caused ib. the formal Nature of it wherein it consists p. 453. another Definition of it p. 454. the previous Dispositon of the Blood disposing to a Frensy ib. another Disposition to the Frensy ib. the evident Causes of it p 455. the Prognostick of it ib. p. 456. In the Cure of it regard must be had to two things ib. Prescripts of Medicines for it p. 457 458 459. an Instance of a Person Troubled with it and how cur'd ib. p. 460. G. GIddiness or running round of the Head see Vertigo Gout its Fits either seise at random or periodically p. 495. The Dispositions to this Disease and the Occasions or Causes which are wont to actuate them ib. the Morbifick Matter ib. the evident Causes of it p. 496 497. It 's near ally'd to the Stone in the Reins p. 498. The Prognostick of it ib. it often turnes to Gripes in the Belly to a difficulty of Breathing c. ib. p. 499. the Method of Cure with Prescripts of Medicines ib. p. 500 501 502 503 504 505. An Instance of a Person troubled with it ib. p. 506. Gout Scorbutick moving from one Place to another its Cure p. 362. Gumms sore their Cure p. 359. 360. H. Haemorrhagies see Blood Head-Ach its Subject p. 370. the formal Cause of it p. 371. the Prognostick of it ib. habitual Head-ach two
meet the Acido-Saline Particles of the humours and are combin'd with them they loosen the Texture of the Blood and at the same strongly agitate its Mass by reason of their Heterogenous mixture Hence for a ready separation and driving forth of the Serosities through the Pores of the Skin those things are prescrib'd in the form of a Powder Bolus and Liquor Take Flowers of Sal Armoniack half a Scruple Cristal Mineral fifteen Grains Bezoartick Powder a Scruple mix them Let it be given in a spoonful of Sudorifick water Take Salt of Tartar a Scruple Ceruse of Antimony twenty five Grains Make a Powder let it be given after the same manner Take Powder of Bezoartick Mineral from a Scruple to half a Dram Gascoins Powder a Scruple Make a Powder let it he given in like manner Take Ceruse of Antimony from a Scruple to half a Dram Flowers of Sal Armoniack half a Scruple Make a Powder 2. Those things may be given in the form of a Bolus by mixing the aforesaid Doses with Treacle Mithridate or Diascordium or with the extract of Carduus Gentian or the like Take Bezoartick Mineral a Scruple Flowers of Sal Armonicak six Grains Mithridate half a Dram Make a Bolus Take Salt of Hartshorn eight Grains Bezoartick Powder fifteen Grains Extractum Theriacale a Scruple Make a Bolus or three Pills If a Liquid Form be more proper Take Spirit of Hartshorn or of Soot or of Sal Armoniack from fifteen Grains to twently Sudorifick water from an Ounce to three Ounces Make a draught let it be taken with governance Take Flowers of Sal Armoniack half a Scruple Salt of Tartar fifteen Grains Sudorifick water three Ounces Mix them make a draught 3. Diaphoreticks which have a Nitrous Salt for their Basis are wont to give relief generally in the same cases as those above made of a fixt and a volatile Salt because they destroy the predominancy of the Acid Salt and dispose the mixture of the Blood after such a manner that as it boils its Serum and Recrements are readily separated and discharged from it Take Cristal Mineral three Drams Salt of Hartshorn or of Soot or of Vipers a Dram Mix them the Dose is from a Scruple to half a Dram in a fit Vehicle Take Sal Prunella two Drams Bezoartick Mineral or Ceruse of Antimony a Dram Make a Powder the Dose is from two Scruples to a Dram. 4. Diaphoreticks whose ground is an Acid Salt have a peculiar efficacy against the predominancy of a fixt Salt and Sulphur viz. if at any time the Mass of Blood by reason of Salino-fixt Particles combin'd with Sulphureous or Terrene Particles in it comes to be too much lock'd up and close bound that it does not easily let go its Serosities to be expell'd by Sweat as it sometimes happens in continual Fevers and in Scorbutick affects the Acid Salt after the Medicine is given meeting the fixt Salt in the Body and laying fast hold on it makes void its undue combinations and so opens the boiling Blood and disposes it for a Sweat Take Spirit of Tartar from half a Dram to a Dram Sudorifick water three Ounces Flowers of Sal Armoniack half a Scruple Mix them Take of the simple mixture from half a Dram to two Scruples Give it in a spoonful of Treacle water or Bezoartick water Take Bezoartick Vinegar from half an Ounce to an Ounce Carduus water two Ounces Plague water six Drams Mix them make a draught Take Spirit of Guaiacum a Dram Sudorifick water three Ounces Mix them make a draught Some things meerly or for the greatest part Sulphureous are commonly plac'd in the rank of Diaphoreticks As for instance some Natural and other Artificial Balsams also Chymical Oyls as chiefly of Guaiacum Box Camphire Hartshorn and Soot So likewise the Resinous Extracts of Ponderous Woods with many others which though by themselves they do little for raising Sweat yet being join'd with the other Saline Medicines I do not think them altogether unprofitable because in a cold and Over-phlegmatick Constitution Sulphureo-Saline Medicines Rarify the Blood which is then become too watry and dispose it to a free evaporation no less than such as are Spirituous Take of Opobalsamum from Six Drops to twelve Water of Baum or of Ground Ivy three Ounces Sudorifick water half an Ounce Let it be taken every Morning to provoke Sweat for many days together It is proper for Phthisical Persons and such as have Vlcers in the Reins And so but in a greater Dose may be given the Balsam of Peru also the Tincture of the Balsam of Tolu and likewise compounded Balsams gotten by distillation Take Rosin of Guaiacum powdred two Drams Chymical Oyl of the same a Scruple Bezoartick Mineral Gumm Guaiacum of each a Dram and a half Balsam of Peru what suffices Make a Mass for Pills the Dose is from half a Dram to two Scruples drinking after it a Dose of the Sudorifick water or of the Decoction of Woods CHAP. VIII Instructions and Prescripts for Curing an Excessive or Depraved Sweating FRequent and immoderate Sweating is sometimes the Symptom of some other Disease then affecting the Person for in the Phthisick and Scurvy this is a common thing The reason of it is that the Blood tainted with some filthy infection or become of an ill habit is not able duly to concoct and assimilate the nutritive Juice still passing into its Mass and therefore always degenerating and coming now and then to be full charg'd by the addition of other Excrements it separates them and expells them by Sweat The Cure of this Sweating depends wholly on the Cure of the Diseass whose Symptom it is In the mean time those copious Night-sweats happening in those Diseases plainly shew that the Persons Diet ought to be altogether of light food viz. Milk Grnel Cream of Barly and the like whose gentle and mild Particles the Blood can bear and not of Flesh or strong substances Sometimes an excessive Sweating is the effect of some foregoing Disease which is brought to an end and this is so common a thing after long Agues that scarce any recover of them but this Indisposition still sticks upon them more or less I knew a young man who as he grew well of a Quartan Ague which had held him ten Months and began to lose its fits daily melted into such profuse Sweats that he was fain to change his Shift and Sheets thrice a Night being as wet as though they had been dipt in water This Evacuation continuing so for many Weeks his Flesh so fell away and his strength was so exhausted that he look'd like a Skeleton This Person when he had us'd many Medicines a long time without much benefit at length by drinking Asses Milk Mornings and Evenings and his other Diet being ordered of Cows Milk he grew very well in a short time The chief cause of frequent and copious Sweats seems to consist in the ill habit and weakness of the Blood in that it
is apt continually to be fus'd and precipitated into Serosities The Pores of the Body in the mean time being open and free for an Evacuation by Sweat Now the Blood is so apt to fusions and flowings for the most part from a predominancy of a Fluid or Acid Salt in it and sometimes the Nervous Juice growing sharp empties its Acid superfluities into the Blood and so precipitates its Mass into Serosities This excessive Sweating does not only arise from the vitiated Crasis and Fermentation of the Blood but sometimes from its depraved Accension and through an excess of Sulphur in it as sometimes through a deficiency of it In order to the Cure of this Over-Sweating the Therapeutick intentions must be chiefly these three First To take away or correct the ill habit or weakness of the humours Secondly gently to close the Pores of the Skin which are too open Thirdly To derive the Serum of the Blood and the watry superfluities to the Reins 1. The first of these is perform'd by those Remedies which destroy the predominancy of the Acid Salt in the Blood or Nervous Juice and which promote the Exaltation of the Sulphur if haply it grows weak for which ends Anti-scorbuticks Chalybeats Also medicines endow'd with a Volatile Nitrous or Alchalisate Salt most commonly prove effectual I shall set down certain forms of each of these Take Conserve of the Flowers of Cichory and Fumitory of each two Ounces Powder of Ivory Hartshorn Coral prepar'd of each a Dram Pearl half a Dram Species of Diarrhodon Abbatis a Dram Lignum Aloes Saunders both red and yellow of each half a Dram Sal Prunella four Scruples with a sufficient quantity of Syrup of Fumitory make an Electuary Give the quantity of a Wallnut in the Evening and the next Morning drinking after it either of the following Julap or distill'd water three Ounces Take the Waters of Fumitory and Wallnuts simple of each six Ounces the Waters of Snails and Earth-worms of each an Ounce Sugar six Drams Mix them make a Julap Take tops of Firr Tamarisk Cypres of each four handfuls of Myrtle two handfuls Leaves of Watercresses Brooklimes Agrimony St. Johnswort Harts-Tongue Fluellen or Speedwel of each three handfuls the outward Coats of twelve Oranges Being slic'd and bruis'd pour to them of Brumswick Beer eight pounds distill it in common Organs Let the whole Liquor be mixt and sweeten it at pleasure the Dose three Ounces twice a day Take Leaves of Dandelion Watercresses Plantain Brooklimes of each three handfuls being bruis'd pour to them of the distill'd water above written a pound wring it forth hard The Dose is from three to four Ounces in the Morning at Nine of the Clock and at Five in the Afternoon According to this method I use to prescribe in a failing of strength and Night-sweats after long Agues and if these remedies do no good we must come to Chalybeates Take Syrup of Steel six Ounces let a spoonful be taken in the Morning and at five in the Afternoon with three Ounces of the Water above prescrib'd Take Powder of Ivory of Coral prepar'd of each two Drams Crocus Martis Salt of Steel of each a Dram and a half Make a Powder the Dose is half a Dram twice a day with three Ounces of the same distill'd water Take Tincture of Salt of Tartar an Ounce The Dose is from twenty to thirty Drops twice a day with the distill'd water After the same manner may be given the Tincture of Coral and Tinctures prepar'd out of Gums and Balsams Moreover in these cases the Spirits of Hartshorn Vrine and Se et are given given with success The second intention for the Cure of excessive Sweating consisting in a due state of the Pores is perform'd in a manner only by outward Administrations For which end let the whole Body be anointed with Oyl of Date-kernels with an Oyntment of Orange Flowers and the like and let Linnen done over a little with the same be worn sometimes Bathing in cold Water or in a River sometimes change of Air may do well It seems here proper to speak a little of a certain troublesome Distemper relating to Sweating or at least to an excessive perspiration I often observe that some Persons have their Bodies so disposed that if upon any occasion the least Breath of Wind or Air comes upon them their Spirits are presently in a mighty trouble all their Powers are in a Consternation and their whole Body is discompos'd This extream tenderness in some Persons more than in others to take cold or to be offended with it happens either through the fault of the Animal Spirits or of the Blood or of the Pores of the Body to wit of one of them or of more of them together 1. First The Animal Spirits are sometimes in fault because being very weak they are not able to endure any thing harsh or rough outwardly pressing upon them but presently upon the appulse of the bare Air are put to flights and distractions And sometimes this Indisposition happens through their fault for that being degenerated and become of an eager restless and uneasie disposition they are put into disorder upon every such pressure of Air. Wherefore those who by reason of the Spirits so dispos'd become Hypochondriacal being also subject to the Affect before mention'd on every little occasion are troubled with Cold. 2. The Blood disposes to a habit of depraved Perspiration in a two-fold manner viz. both in respect of its temperament and of its mixture As to this latter oftentimes the Texture of the Blood is so loose and open that upon every light accident and espccially upon the appulse of a cold moist Air it 's presently stirr'd to fluxions and precipitations of Serosities insomuch that Persons who have such Blood dare not step forth of doors nay scarce look forth Again the Mass of Blood being often hot in its temper and very full of vapours Breaths forth Effluvia's very sharp and penetrative by which the Pores of the Skin being too much loosned and laid wide open the Spirits and the Vital Flame are expos'd to the injuries of the naked Air and the Winds more than they ought 3. The ill constitution of the Pores gotten either by sickness or other ways or being natural from our Birth very much inclines to that habit of depraved Sweating For in regard those passages being too wide do always in a manner gape the Blood and Spirits in the whole Body or in certain parts of it are not sufficiently guarded against the encounter of the outward Air. The Intentions for Curing this Distemper are chiefly these three ' viz. first to help the weaknesses or dejections or depauperations of the Blood and Spirits Secondly To take away their Dyscrasies if they have any Thirdly To procure a due Confirmation of the Pores The chief stress of this business consists in the first intention which regards the strengthning of the Animal Spirits and the inlargement of the whole sensitive Soul for