changeth his Note of the great danger our little Patient was in and out of a Malignity to the other Physician Benigns the Disease That which is also the more ridiculous because this Gentleman in the immediately preceding Observation viz. the 14 th of his 2 d Book says thus of a Pleurisie in general 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Graecè a loco affecto nimirum Pleurâ Latinis morbus costalis seu lateralis dicitur estque inflammatio Membranae costas succingentis quae Pleura nominatur Haec inter morbos acutos lethales vel imprimis numeratur gravia Symptomata pericula secum adfert morbus est gravissimus A Pleurisie is called in Greek Pleuritis from the part affected to wit the Pleura or Side In Latin it 's called the Rib or Side-Disease and it is an Inflammation of the Membrane that covereth the Ribs within which is called Pleura Amongst acute and mortal Diseases a Pleurisie is especially reckoned it brings with it grievous and dangerous Symptoms and is a most grievous Disease A Pleurisie then is a most dangerous Disease when Mr. Loss cures it but when Alius Medicus cures it it 's a Benign Pleurisie The Nature of an Acute Disease consists in two things in its being a great Disease and in its moving nimbly with vehemency and danger Young Mrs. Moore 's Fever was peracute putrid continual worse every night it had joined with it an Inflammation of an internal Part next neighbour to the Heart It was occasioned by Choler in a Bilious thin Body it caused bad Symptoms and threatned death and if notwithstanding all this it must pass for one of Mr. Loss his Benign Pleurisies so let it Mr. Loss his Judgment of the Cause of this Patient's Pleurisie Examined THE Conjunct Cause of her Pleurisie was Inflamed Blood The antecedent-Antecedent-Causes were of two sorts some did cause the Blood to be inflamed as her Plethora quoad vires and her Cacochymia Some did cause her inflamed Blood to fall upon her left Side as the the weakness and debility thereof that Side being weakned first by an Issue and afterwards by an Afflux of Humors causing a soreness in her left Breast some years before her sickness The Procatarctick Causes were her being obnoxious to Catarrhs her Cholerick Constitution her over-heating her Blood by play and her drinking cold Beer whilst she was hot that which Sennertus takes especial notice of for a Cause of a Pleurisie But Mr. Loss mentions no other Cause but an External only her catching cold by walking forth late in the Evening in an Autumnal cold Season with her Breasts naked as is the manner of most Noble Virgins This is but a vulgar account any one that comes in to see such a sick Patient can readily suggest that She might get her sickness by taking some cold and being too late out in the Evening It is too general an account and although it gives sometimes very good satisfaction unto ordinary Persons that understand little of Physick or Philosophy yet how will any wise man acquiesce if asking after the Cause of a Particular Disease his Physician tells him he hath got cold which is in a manner a general Cause of all Diseases It is an illogical Inference She got cold therefore She got a Pleurisie for we may predicate of an Individual the Species and next Genus and so upwards For example Peter is a Man A Man is an Animal an Animal is a Corporeal Substance c. But we cannot invert this order and go downwards saying A Corporeal Substance is an Animal An Animal is a Man A Man is Peter Thus we may say That a Pleurisie may be caused by catching of cold but we cannot say catching of cold is the cause of a Pleurisie because a Genus cannot be confined to one Species and catching of cold might as well have caused other Diseases as a Pleurisie The Consideration of such a Cause is useless to a Physician he can make no benefit of it for Causa transiens non indicat because it is one of the conditions of an Indicans that it be Manens in corpore for how else can it indicate its ablation from thence What though this young Lady did catch cold that was past before Mr. Loss was sent for and the need a Patient hath of a Physician is to find out and remove the Cause that doth actually cause the sickness not to talk of that which is already gone If Mr. Loss had understood that the division of Causes of Diseases into External and Internal is an error among some Physicians because it may so fall out that against the Rules of Logick both Members of the division may be predicated of one and the same thing as when a Dagger is stuck into the flesh He would not have called the cold Air an External but a Procatarctick Cause of her Disease Besides all that hath been said this only account which Mr. Loss gives of this Patient's Sickness is also false either this young Lady was too hard for this old Gentleman by concealing her over-heating her self at play and then drinking cold Beer or else our trusty Observator according unto his manner of seeing and proving things in his Observations never troubles himself to examine the business but easily takes upon trust what as easily he puts forth in Print But suppose we that what he says were true let 's a little dive into his profound Philosophy I know this old Gentleman is no friend to the new Philosophers he had rather that those that went before him should be accounted wiser than any that come after him Antiquity he reverenceth but he doth not consider that the younger generation of Men is the older World and that as all things else here below so Knowledg and Learning cannot but grow and increase by time and the daily experiments and inventions by which it is improved and advanced or else for which I see no reason he must conclude that Learning is past its Zenith and upon the decline I shall not therefore trouble him with questioning whether Heat be an Accident or a Substance I mean that Heat which he saith so easily causeth a Pleurisie by melting the Humors but I ask him in what Subject it is It 's plain that he means by Cold the cold Air that which caused as he says this Gentlewoman's sickness and therefore I presume he means by Heat the hot Air. But how hot Air can insinuate it self into and single out the Pleura a membranous and colder part and yet there by melting the Humors easily cause a Pleurisie I cannot easily understand I acknowledg it may help to increase Choler in the Body which abounding may take fire and inflame the Blood and I can easily imagine that some of this inflamed Blood may strike to the Pleura and inflame that but then this is contrary to what Mr. Loss would have for thus the Fever must needs precede the Pleurisie whereas he says positively that the
according unto which the advice of the Physician ought to be directed For the concern is not what a Patient's Age is but what his strength is Therefore a strong Child is safely Cured Thus Avenzoar makes mention of his successful bleeding his own Son at three years old and we find by experience that Children of four or five years old do by bleeding most commonly escape dangerous Diseases The same Author likewise in his Praxis and Chapter of a Pleurisie says thus Adeo necessaria est Venaesectio in principiò ut nunquam omitti debeat nedum in sene puero gravidâ puerpera menstruas purgationes Patienti docuit ènim Experientia hisce omnibus utilissimam fuisse Venaesectionem presente hoc morbo So necessary is opening of a Vein in the beginning of a Pleurisie that it must never be omitted no not in an old Man or Child or Woman with Child or that hath her Terms for Experience doth teach us that in all these in this Disease opening of a Vein hath been most profitable By Experience It is not long since that I knew a Girle not five years old that fell into an Atrophy a meer wasting and pining away without any Symptoms of a Consumption or Phthisis she was too young forsooth to be bled and all other means were to no purpose for she died and upon the opening of her Body her Liver was found so largely grown as to out-weigh the Spleen seventeen times Now whether the Liver be the Fons Sanguinis or the Heart or neither but that every Bowel contributes its office towards the making of the Blood yet since the Liver by separating the Choler into the Gall sweetens the Blood much and that sweetness helps to increase both Liver and Blood as also doth the absence of the acid ferment from the Spleen and I am prone to think that the Helluo the Blood eat her up and caused such an over-fast growing of the Liver as starved the Spleen and other parts Should another such a Case offer it self of such a Plethora would any rational man forbid bleeding until the Child were fourteen years old of which there is no likelyhood it should live until seven I am sure I did not in a Brother to this Sister about seven years old that not long after was treading in her steps and making haste apace unto the same end but being forwarned I bled him and I never saw more advantage by bleeding befal a Man than hapned unto this Child his recovery was so speedy and his health so good ever since as those then about him can witness I might instance also in the two above-mentioned Experiences wherein Mr. Loss himself can bear me witness of successfulness of bleeding under fourteen years of Age. Yet by all this which I have said I do not mean that I would encourage any Physician to be rash and venturous one that should hand-over-head pell-mell bleed all younger Patients as readily as Men without due consideration of their tender Age but I only urge from what I have written That there may be a time wherein it may be necessary to bleed a Child by Lancet under fourteen years old 2. That this Gentlewoman young Mrs. Moore might be bled by Lancet Here were several Indications for Bleeding and Co-Indications and there were no Contraindicantia nor Correpugnantia The Indications Here was Plethora quoad vires such a fulness of Humors in the Mass of her Blood as Nature could not rule well or manage so as to preserve them in their due Temperament and Mixture from separating and corrupting and therefore to remove this Morbifick Cause and to disburden the Body of a good share of that load it was pressed under that so Nature might the better comport with the remainder and by degrees master and subdue the Disease opening of a Vein was requisite Here was also need of Revulsion from a weak Part and Revulsion did Indicate Bleeding for this Patient was represented to me when I first visited her as a Child always Sickly Splenetick and Scorbutick and having her left Side weak by being Splenetick and pained in her left Breast more or less for two years before she fell sick Formerly she was obnoxious to Catarrhs and now also there was a flux of Humors in the mass of Blood flowing to her left Side part of the inflamed Blood had already got thither and lodging it self within the Pleura and Vicine Muscles caused in her a Symptomatical Pleurisie and there was great fear lest that inflammation should increase farther and therefore as bleeding was principally Indicated by the Plethora so was it likewise accidentally Indicated by Revulsion Here was Heat likewise that did Indicate accidentally the opening of a Vein in order unto the cooling her whole Body which was in a flame she having a putrid Scorbutick Feaver for her principal Disease Now this Preternatural Heat and Fire was to be put out and bleeding would help upon two accounts 1. By it part of the Fire even part of the Inflamed Blood might be taken away 2. By it Insensible Transpiration whose Evacuation alone is greater far than all the sensible together as Sanctorius observs in his Medicina Statica might be promoted the Pores of the skin opened whereby the Heat might breath forth and perhaps the cold Air get some ways in These Pores were before as it were wedged up with the plenty of Humors as is sometimes a Church-door by a throng of People each hindering another from getting forth but bleeding might unwedg them by letting some out another way and giving Nature room to drive forth what was superfluous by an open and free Transpiration as was also effectually done in this Patient who not long after fell into a great universal Sweat which completed her Cure The Coindications Some were taken from her Naturals and some from her Non-Naturals To her Naturals did belong her 1. Strength This was good even Mr. Loss himself being Judg so good as nothing could hurt 2. Habit of Body For lean people are generally fuller of Blood and have larger vessels than those that are fat and gross their Blood also wants more sweetning and 3. Her Age Though it was not fourteen yet was it about four It seems noways unagreeable to Reason to assert that one and the same thing may both Contraindicate and Coindicate bleeding as it is diversly considered For example He that considers of age under fourteen years that it is tender and wasts very much by the pores or habit of Body may so far look upon it as a Contraindicans as not to bleed in such an age except there be great need and good strength for fear the Patient should not be able to bear two large Evacuations at once And thus Mr. Loss seems to have considered this Patient's Age but notwithstanding this if need requires and strength will bear bleeding in a Patient not fourteen years old this Age as it intimates predominancy of Blood it may coindicate bleeding and
seeing that in the Title he tells us that the Disease was Benign With a pricking pain in her Side It is no hard task for any Physician to reckon upon his fingers the five Pathognomonick signs of a Pleurisie but then the Spitting of Blood is none of them and why the Pulsus durus which is one of them should not be here mentioned Mr. Loss can tell We have seen something of the Narrative of the Case there is yet one thing more taken notice of by Mr. Loss but both mistaken and misplaced it appertains unto the Patient 's Non-naturals her Walking late in the Evening in a cold Time with naked Breasts This I conceive should have been mentioned in the Narrative and before he had come to pass his judgment of the Disease There were also other things belonging unto the Narrative which Mr. Loss hath not mentioned at all viz. That formerly she had an Issue in the left Arm to which humors flowed so fast that becoming troublesom by some advice or other it was shut up That not long after the shutting of it up she began to have a pain in the left side of her Breast which had continued more or less some two years time when she fell sick with such soreness as would not easily suffer an ordinary impression of ones hand That just before her sickness she over-heat her Blood at Play and then drank cold Beer Things as material I suppose as many of these which Mr. Loss hath mentioned 3. Mr. Loss his Judgment on the Case THis Judgment concerns the Disease or the Cause of it Touching the Disease his Judgment is double 1. That it was a Pleurisie 2. That it was a Benign Pleurisie Touching the External Cause of it That it was her taking cold in her Breast by walking forth late If I do not mistake all these three are false It seldom happens that any one falls sick so as to lie by it and to be in great danger but there is a complication of Diseases in the Case and then the Physician is not to rest satisfied with the naming of some Disease or other which may be in the Patient but his Art requires of him to find out that which is the Principal and upon which the other do depend and from it to name the Case Denominatio enim est a potiori otherwise he will shew himself an Emperick and must needs make mad work in his Method of Cure This Patient 's Principal Disease was not a Pleurisie IF her Side was neither the first part ill-affected nor the Principal part that suffered then a Pleurisie was not her Principal Disease I do not see any reason to go about to prove this major Proposition But her Side was neither the first part ill-affected nor the Principal Ergo. I prove the Minor in both its Parts 1. It was not the first part ill affected for upon her drinking cold Beer when she was hot the Stomach must first suffer before the Side but because this was not considered of nor perhaps known to Mr. Loss I add that her Heart and all its Vessels were first ill-affected with a Fever in her Mass of Blood before the pricking pain in her Side and other Symptoms of her Pleurisie and this is made out both by the reason of the thing and by a double authority 1. I prove it by Mr. Loss himself in this very Observation who says She was taken in a Fever with a pricking pain in her Side If he meant that the Pleurisie was her Principal Disease he should have said She was taken in a pricking pain in her Side with a Fever for a Fever that went before though but some few minutes could never be the effect and symptom of a Pleurisie that came after though Mr. Loss says afterwards that on the sixt day of the Disease the Fever and other Symptoms were gone as if the Fever were the Symptom of a Pleurisie which followed after it 2. I prove it by Sennertus who in his Chapter de Pleuritide observes That although the Ancients did call these Fevers that do accompany the Inflammations of the Internal parts Symptomatical yet of a Truth they are nothing so Si quis enim rem diligenter perpendat animadvertet non Febres ab hisce inflammationibus sed potius inflammationes istas a Febribus originem habere If any one saith he considers the matter well he shall find that these Fevers have not their Original from the Inflammations of the Internal parts but rather that those Inflammations have their rise from the Fevers And if so the Fevers are the Principal Diseases that which also the Method of Cure shows plainly and did shew in this particular Patient 2. It was not the Principal ill-affected Amongst other Rules which Physicians give to know what Part is principally affected these three are very considerable 1 That which suffers most grievous Symptoms is the part principally affected But it is plain that the Effects of this young LADY's putrid Fever were much more grievous in her Heart than these from the Pleurisie in her Side 2. That Part which is continually affected and never at ease is the part principally affected but her Side was much at ease and if you will believe Mr. Loss her Pleurisie was gone then when Alius Medicus was sent for and then when all the Family where She lay Sick despaired of her Life And her Heart was never at ease but still troubled more or less with a continual Fever until at length the Universal Sweat compleated the Cure and the Fever once gone there was no news of the Pleurisie 3. That Part which receives no benefit by these Remedies which do help another Part is the Part principally affected but her heart was but little benefited by all Mr. Loss his Emperical Cure of her Side Therefore This Patients Pleurisie was not Benign A Benign Disease is such an one as goes on in a gentle mild manner not much troublesom or offensive to Nature nor yet so dangerous as to hazard Life And I do admire that Mr. Loss should title this Disease Benign for I am sure that before I was sent for the good Lady the Patients Mother was sent unto that She might make haste to come twenty miles out of the Country to see her Daughter that lay very sick in Town so little belief was there then of the Benignity of the Disease and I am sure that when I propounded to purge her after She had been bled Madam Moore told Mr. Loss who was against it that She would try the Purge for my Child said She is a dead Child in your account But afterwards when Mr. Loss saw that the Patient was able to bear both Bleeding Purging and Sweating and in few days was strangely recovered to my credit and his no little disturbance being to write this Observation which I think he put forth on purpose to honour himself and shame me what he could in this particular Case the good Man
this Mr. Loss seems not to have considered of at all though it be evident that this Age is one sign of the Predominancy of Blood for Riverius in Cap. de Signis Sanguinis in Corpore Predominantis amongst the efficient Causes of it reckons this Age for one Aetatem a Pueritia usque ad pubertatem Now Childhood in a large sense is one of the four stages of the Life of Man Youth middle-Age and old-Age being the other three And this stage of Childhood is subdivided into four parts Infancy lasts till four years old some say until seven Pueritia or Boy-hood lasts from seven to fourteen Puberty from fourteen to eighteen and Adolescency from eighteen to twentyfive Pueritia therefore from seven to fourteen years old is an efficient Cause of the bloods Predominancy in the Body for the Temperament now is hot and moist and so is the Bloods Children also do eat much and being full of play and exercise they generally digest well and they have neither cares nor fears nor any inordinate passions to waste or drink up their Blood at least its Life and Spirits so that this Patient 's not being fourteen years old at which Mr. Loss hath ignorantly made all this stir did in truth more Coindicate than Contraindicate her bleeding 4. Her Part Affected which besides her Heart was her Pleura or Side which being a Membranous part in its Substance and Temperament Spermatick not Sanguifick having exquisite Sense and in its situation being neighbour unto the Heart a part that upon all these accounts was very unfit to have any Blood much less inflamed Blood poured out upon it did also Coindicate Bleeding partly that it might be relieved from what it already suffered by having strength to discuss or concoct it whilst it was not much partly that it might be delivered from the imminent danger of new hot Blood flowing unto it by a Revulsion of it with bleeding To her Non-Naturals did belong 1. The Air to which belongs the time of the year when she lay sick It was in the Spring a Season most seasonable for bleeding for like the Sap rising in the Trees our Blood also Ferments afresh the Time it self being hot and moist and the return of the Sun towards us gives us a sort of new Life and Spirits Besides The approaching Summer gives something of encouragement to venture bleeding because in it we may the better hope for a fit Time to recover in if we should lose a little strength by bleeding 2. Eating and Drinking This young Lady drank cold Beer when she was hot by which sudden alteration that motion which Nature was then in a centro ad Circumferentiam her Body being in a Sweat was inverted a Circumferentia ad Centrum the Spirits retiring upon this Alarm inwards whither also by this means were carried all or most of those Superfluities which before were reaking forth and passing per habitum Corporis hereupon she fell into a Fever and because her left Side was weak by default in her Spleen by Catarrhs falling on her left Breast and by use and Custom of Humors falling formerly to the Issue in her left Arm with the Fever she fell into a Pleurisie in that side which doth Coindicate bleeding as the Cure of it 3. Motion and Rest To her Motion did belong her over-heating of her Blood at play by too violent exercise This also as a cause of her Fever and Pleurisie did Coindicate the Remedie of them bleeding 4. Passions of the Mind Her being merry and cheerly and full of play did contribute also unto the increase of her Blood and in some small measure coindicate bleeding Contraindicantia here were none The Reader may please to take notice that Indicantia and Contraindicantia do belong to things Preternatural which can be none other than these three The Cause of the Disease the Disease and the Symptoms I have already above shewed that the Disease and the Cause of the Disease did Indicate bleeding by Lancet let Mr. Loss shew how either of them did Contraindicate bleeding by Lancet in this Patient What concerns the Symptoms they do never Indicate or Contraindicate as such indeed when they urge they are considered of as a Cause and so weak strength as a Cause of increasing the Disease doth many times Contraindicate bleeding but that cannot be pleaded here Coindicantia and Correpugnantia do belong to things Natural or Non-natural even unto all such as are either Causes or Signs of a Patient's Strength I have shewed above that there were Coindicantia of bleeding this Patient let Mr. Loss again produce the Correpugnantia Juvantia and Ledentia are very good Topicks by which may be proved in a good measure the agreeableness or unagreeableness of any Remedy made use of and the success in this Case is not to be disputed And by this time I hope I have sufficiently proved my second Proposition that this young Gentlewoman might be bled by Lancet 3. That Mr. Loss was to blame that she was not bled by Lancet before the sixth day To quit himself I think from this fault was I suppose the main reason he opposed my bleeding her The sooner one bleeds in a Disease that doth require it the better for why should a Disease be suffered to take rooting or to grow to an height and hazard a Patient's Life if it may be prevented But this Patient's Disease did require opening a Vein Therefore Mr. Loss was to blame it was not done before the sixth day I do not know that the Major needs any Proof The Minor hath been proved already And Mr. Loss doth confess that he did think of bleeding this Patient in the beginning if we may believe him for saith he Venaesectio summum in Pleuritide commodum afferre solet Bleeding in a Pleurisie useth to be very advantageous His only obstacle was that the Patient was not fourteen years old but that was in truth no obstacle as hath been proved In the beginning of this young Ladie 's sickness there was none other Physician but Mr. Loss there was then no animosity or prejudice against any other Physician for to his Cure alone her Life was recommended and no body disturbed or hindred him from doing what he thought best that he did not therefore bleed her by Lancet cannot be well attributed unto any thing else but to his ignorance he did not know that a Vein might be opened in a Child under fourteen years old or if he did he was yet more to blame And thus much for his Second Accusation To his Third Accusation That the bleeding of her by Leeches which had been appointed was of no moment WE have an English Proverb Better is half a Loaf than no Bread and it is true also if we cannot do as we would we must do as we can Where the Lancet may not be had I never said bleeding by Leeches was of no moment but I do say in this Case it was but of little moment For it
was this the sixth day of the Disease To his Fift Accusation That this Patient was not bled in the Right Place From the right Basilick Vein of the opposite side that which Fuchsius says is an Error THat I bled this Patient in the right Arm I do not deny nor yet that Mr. Loss opposed me in the Consultation I told him that to satisfy Revulsion meaning proper Revulsion not that which is a sort of derivation it ought to be in the contrary Arm but he told me that whether it were for Revulsion or Derivation it must be in the same Side where the Pleurisie is And because I was not of his opinion he urged against me the Authority of Sennertus at which I wondered and told him if I understood Latin Sennertus was against him and the next day Mr. Hern a Divine at whose House the Patient lay sick coming to my study to ask if she might drink Beer with a Toast after her Physick I then shewed him Sennertus and in him the Figure engraven on purpose to shew the difference of bleeding for Revulsion and for Derivation and we did both admire that he should so mistake an Author which himself quoted But it seems having since studied upon the point though he quoted Sennertus his meaning was the most Learned Fuchsius For my part I do not intend to trouble my self or the Reader with a dispute so well and so largely handled by Sennertus who hath taken the pains to relate the opinions of near thirty several Authors touching this point and amongst them Fuchsius is one and yet Sennertus holds for me I shall only tell the Reader what Reason I had to bleed this Patient in the contrary Arm. I took my Indication for bleeding her from the Putrid Fever which was her principal Disease and not principally from her Pleurisie which was Symptomatical Now the Putrid Fever did not Indicate bleeding either for Revulsion or Derivation but Evacuation only That part of the putrid and corrupt Blood might be carried off which did burden Nature and make her unable to manage the mass of Humors in the Vessels and this Evacuation might be performed as well in the right Arm as in the left But beside the Putrid Fever I had to consider of in this Patient a Symptomatical Pleurisie in her left Side and that which made Mr. Loss so fierce for bleeding on that Side was in my judgment a main reason for the contrary for seeing bleeding for the Fever might be indifferently done in either Arm who would have chosen to have done it in the left thereby drawing the Humors more to the weaker side weak formerly as hath been mentioned and now much more so by the inflammation of the Pleura on that Side and not rather in the right Arm by which at once Revulsion was made from the Pleura inflamed and Evacuation of the putrid and inflamed Blood fully as well if not better performed than in the left Side so that what Mr. Loss alledgeth as my fault that I bled her in the right Arm would have been my fault if following his counsel I had done it in the left I know well that bleeding in a Pleurisie is usually in the same Side and I have many times so Practised when I had no fear of any great Plethora or of the flowing of Humors to the part especially weak before and when the Pleurisie was more urgent than the Fever But at this time here was no Pleurisie at all if we may believe Mr. Loss and yet angry he is that I would not help to bring it again by drawing the Humors what I could to her weak Side I could fill up much Paper upon this subject but I am not willing to anticipate Mr. Loss his Reply he may perhaps pick much meat out of this Goose-Eye yet My comfort is that although I am for the opposite Side hitherto as luck would have it it hath been for the right To his Eighth Accusation That I Purged her He gave her powder of Sena by which she was six or seven times Purged THis is the first of those faults he finds concerning Purging of her That I did Purge her In the Consultation he would by no means give way that this Patient should be purged for fear a Diarrhaea should happen and he was so angry when the Purge was given that he went from Mrs. Moore and left her to her great discomfort There can be no greater reasons to be given that I know of why a Physician should purge his Patient than these Here were Indications Coindications and there were non-considerable Contraindicantia or Correpugnantia As Plethora quoad vires did indicate her bleeding so did Cacochymia her purging that the foulness of the first region and her abundance of Choler might not still add fuel to her inflamed Blood but be removed her strength and bilious Temperament did coindicate I need not be so punctual in this particular of her purging because I have been so above in that of her bleeding Mr. Loss seems to oppose two Contraindicantia unto this which I did Obj 1. The Disease it self inasmuch as he judged that it was a Pleurisie did forbid purging Resp I do readily acknowledg that a Pleurisie as such doth forbid purging for that is not the immediate way to remove the inflamed Blood from the Pleura nor yet any corruption that is there gathered The Conjunct Cause of a Pleurisie must be either evacuated by bleeding dispersed or expectorated and purging seems a contrary motion But yet I say That in the Cure of all Diseases the first Indication that is to be satisfied by them that understand the Art though sillily neglected here by Mr. Loss is the removing of the Antecedent Cause He spent all his shot at the conjunct cause the asswaging of the pain in her Side and the helping of her expectoration and was so far from bleeding her by Lancet and purging her that he did not only neglect them himself but was so ignorant as to find fault with another in print for doing them thereby discover his own want of skill Had he understood himself aright he would not have been so mad as to have hazarded his Patient's Life by acquiescing in his safe Medicines his Emollient and cooling Glyster Fomentation Cataplasm Linctus c. in the interim to suffer the opportunity of Cure and the strength of his Patient worn out by sickness to pass away But this is his safe way of Practice for which he hath been long famous storing his Patient with Juleps Almond-Milks Pearle-Water that is a little Cordial-water with a little Cinnamon-water sweetned with Manus Christi perlata and let these that thus admire him use him still But with what reason can any Physician approve his this way curing of a Pleurisie whilst the Fever was yet permitted to rage or who besides him could have been so confident of success in expectorating the Conjunct Matter whilst yet the Antecedent Cause was so
most predominant naturally in his Patient's Body and whether the present peccant humour and the disease be nearer or farther off from his natural constitution and what measure of health is to be aimed at in his recovery and what probability there is of it To his non-Naturals belong these queries 1. What is the Air he breaths in To this belongs the Country he dwels in the situation of his habitation the time and seasons of the year the wind and weather the influences of the Sun Moon and Stars and the neighbourhood of any thing that is contagious or noxious 2. What Dyet hath he kept To this belong the substance quantity quality manner of preparing order of using and the time of taking either his Meat or Drink But it is not convenient though the Patient should be a Drunkard or Glutton or great Tobacconist to follow this Gentleman's example and publish them for such in print 3. What Exercise doth he use To this belongs whether he useth any exercise or none what its kind is when the time before dinner or presently after and upon a full stomach as also how long it is continued whether only until the body begin to swell a little and grow florid or until it sweats and is weary 4. What hath been his sleeping and waking To this belongs the posture he sleeps in the time how long the time when he begins as also the benefit or hurt which is received thereby 5. What are his Excretions or Retentions To this belongs very many things even all the particular sensible evacuations of the Body or non-evacuations and above all the insensible transpiration which as Sanctorius observes in his Medicina Statica by many degrees exceeds all the sensible 6. What are the Passions of his Mind his Love or Joy or Grief c. To his former praeter-naturals belong an enquiry after such sicknesses as at any time heretofore he hath suffered in any remarkable manner what they were by what causes extraordinary they came about what symptoms did follow them and what did formerly do him either good or hurt For these things many times will much contribute to the understanding of the present case and its desired cure And thus much briefly of the first General Who the Patient is To the second What in the stating of cases already past of which Medicinal Observations are made do belong these two parts 1. What the Patients Complaints were 2. What the Physitian did fore-see or prognosticate what he did do and what was the effect of all To the first of these belong the Patient's praeter-naturals in the case proposed and they can be none other than either his disease or its causes or symptoms and because these are accidents quae adesse vel abesse possunt sine interitu subjecti but which cannot subsist without their subject therefore hereunto likewise belong the disquisition of the part or parts affected I shall not reckon up all diseases and what belong to them their causes or the parts affected that would be to transcribe Physick and Anatomy but forasmuch as the Patients complaints are generally symptoms and by symptoms principally are found out the disease the causes and the parts affected it will be no great digression to such as I write unto if I set them down here the heads of Symptoms All the Symptomatical complaints which any Patient can make they must belong to one of these three Heads To his injured Actions or Functions whether such as are diminished or depraved or totally abolished and whether again they be 1. Animal whether 1. Principal as Reason Imagination c. or 2. Less-Principal as Sense and Motion To Sense belong all a Patients Complaints of Pain whether heavy pricking shooting corroding beating c. To Motion belong all Gestures and Postures of the Body as also Tremblings Shiverings Convulsions c. 2. Vital whether belonging to his 1. Respiration be it weak or strong free or stopt short or long or 2. Pulse be it strong or weak quick or slow c. Upon the Respiration of the Pulse do depend the Circulation of the Blood 3. Natural whether belonging to 1. The Formation of the Faetus in the Womb done wonderfully and strangely when neither We nor our Parents think on 't a Meditation which alone methinks is enough to convince an Atheist 2. His Nutrition and Accretion subservient whereunto are vulgarly reputed Attraction Retention Concoction and Expulsion I am not ignorant of some men's finding fault with this ancient Division who do reduce it unto the Dichotomy of Animal and Vital because the Natural is supposed to be nothing else but involuntary Animal But as far as I can yet understand there seems then to me no necessity at all of any Division in us for all our Actions may be accounted Animal since I cannot conceive what Vital is if I abstract from it Sense and Motion which belong to Animal and if the Formation of us in the Womb be Involuntary Animal as also our Nutrition and Accretion why may not all our Actions be Animal Voluntary Involuntary or Mixt 2. To his Excretions or Retentions whether 1. Vniversal by the Pores of the skin or 2. Particular by the Eyes Ears Nose Mouth Bladder Belly Womb c. The things which belong to this Head are very large 3. To his Altered Qualities whether 1. Of the First Sort as Hot Cold Moist Dry and their Compounds or 2. Of the Second Sort as Hard Soft Rare Dense Light Weighty Subtile Crass Arid Slippery Friable Glutinous Rough Smooth c. 3. Of the Third Sort as belonging to Colour Smell Taste or Sound And thus much of the First Part of the Second General What. To the Second belong the Physician 's Judgment on the Case what is the Part affected what the Disease and what the Cause is of the Disease His Prognosticks touching the Event His Method of Cure and all his Instruments for the satisfying his Indications by a right use of Remedies Dietetick Chirurgick and Pharmaceutick These and all things belonging to these are the Limits and Boundaries of all such Medicinal things of which Medicinal Observations ought to consist A Catalogue of Mr. Loss his Impertinencies IF I should go about to mention all the particulars of his Non-Medicinals in his Book of Medicinal Observations I doubt whether I should not transcribe a great share of it I shall therefore content my self with mentioning some of the chief Heads to which they all seem reducible As 1. Divine or Moral Meditations are not Medicinal I do not say they are not good yea most willingly I do acknowledg that Divinity and Morality do treat of the most Excellent things such as so far exceed matters of Physick as the Soul is in worth above the Body And forasmuch as the World are generally apt to brand Physicians more than other Men with the abominable sin of Atheism I do heartily wish that every Physician would vindicate his Profession and himself as much as
one that knew he had the fall knew also that his Head was hurt And what more doth Mr. Loss mention yet of the Disease Yea so little did he think of the os occipitis that it was cleft that the second time though he had once diligently searched it before he directs his enquiry after the Disease in the os frontis But what need we any further proof of this point for after this second search likewise habemus confitentem reum and he says plainly neque quicquam animadvertere potuimus quanquam fracti cranei multa erat Conjectura so that the nearest that he came unto the Knowledg of his Patient's Disease before he was dead and his Skull opened was a general Conjecture only of a Fracture but no direct Knowledg of a Counter-cleft 2. That Mr. Loss might have understood his Patient's Disease before he was dead if he had been more an Artist FOrasmuch as this Proposition will be more doubted than the former and some may be apt to plead an invincible ignorance in vindication of this Gentleman I shall therefore take somewhat more pains to prove it than I did to prove the former and I shall do it gradually by these three Assertions 1. He might have absolutely concluded that this Carter had some Fracture or Fissure in his Skull at first I know of but three Fountains of signs from whence a Physician may have the knowledg of a Disease and they are its Essence Causes and Effects Diseases are sometimes so plain and evident of themselves that every one can tell them thus any one as well as Mr. Loss might have told that this old man had a Cleft in his Skull when they saw it but then is it that a Physician 's skill is seen when by its Causes and Effects he makes discovery of a Disease whose Essence by it self doth not appear Therefore 1. Here were the Causes of a Fracture or Fissure in the Skull as fully and clearly set down as if any one had made it his business to describe them viz. Here was a sudden violent blow upon the head with some hard thing Had this Carter walked only and tripping faln with his head upon a stone he might have broke his Skull much more then by a blow more violent at a greater distance from the ground and by a fall from a Horse his feet being wholly from the ground so that by them he was not able to help himself by stepping forward or otherwise bearing up part of his Body that it might not have faln with its whole weight in a lump His hands likewise whilst he was in the Air lesser time than to bethink himself where he should fall and whilst his eyes could not direct him nor but probably so providentially strecth't forth as toward the blow and keep off the violence of the stroke upon his Head Besides he was an old and therefore impotent man and being slung off with a force from a Cart-Horse he must needs fall heavy thus the blow was both sudden and violent and it was likewise upon his bare forehead for if he had an Hat on its probable that it fell off and lastly it was with an hard thing for he dash't his forehead against the stones 2. Here were also the Effects of a crack't Skull which I shall reduce to these two Heads Immediate and Subsequent 1. Here were the Immediate Effects which are wont presently or by and by to fall out after a Skull is crack't for presently upon the blow his eyes failed of their sight his speech was taken from him and if he had not faln before he must needs have faln upon the blow for he could not rise but was taken up by others half dead and so brought home By and by also he vomited up choler and his Nose fell a bleeding These Symptoms are of so great concern in this Disease that from them we may not only Conjecture that the Skull is Fractured but likewise absolutely conclude it And because this makes home to my purpose I shall back it with the authority of Celsus an Author not only generally approved of by Physicians but particularly quoted by Mr. Loss in this Observation and which is strange for why then did he not read or understand him in the same Chapter viz. the 4 th of the 8 th Book he writes thus Vbi calvaria percussa protinus requirendum est num bilem is homo vomuerit num oculi ejus obcaecati sint num obmutuerit num per nares auresve sanguis ei effluxerit num conciderit num sine sensu quasi dormiens jacuerit haec enim non nisi osse fracto eveniunt If the Skull be crack't you must forthwith make enquiry whether the Patient vomited whether his eyes failed of their sight whether he was dumb whether blood came from him at his nose or ears whether he fell with the blow and lay without sense as one asleep all which are plain and evident in this Carter's case for these things cannot be except the bone be broken An evident proof that Mr. Loss might at his first visiting this Patient have absolutely concluded that he had some Fracture in his Skull But 2. Here were the Subsequent Symptoms which are wont to follow a Fractured Skull some time after it 's done and which Authors do make mention of as a Feaver a Stupidness a Sleepiness and a Convulsion And thus much for my first Assertion That Mr. Loss might at first have absolutely concluded that this Carter had some Fracture in his Skull 2. If Mr. Loss had so far wisely understood the Case as at the first visit by the Immediate Effects to have absolutely concluded that somewhere there was a Fracture in the Skull he must of necessity have known before his Patient's death that the Disease was a Counter-cleft for although the word seems to intimate a Fracture in a part opposite to that which received the blow yet it is a Counter-cleft if it be in any place else besides there where the blow was given And Dr. Read in his Treatise of Wounds Lecture 22. writes thus A Resonitus or Contrafissura falls out when the Craneum is stricken upon one part and Fractured in another and this happens either in the same bone or in divers in the same bone either sideways on the right hand or on the left or perpendicularly from the upper to the lower part in divers bones as when the right side of the head is beaten and the left Fractured or when the left side is beaten and the right Fractured or as in the Case in hand when the forepart is stricken and the hinder part cleft But that there was no Fracture in this Carter's forehead the place where the blow was given Mr. Loss himself witnesseth after a double search had he therefore known there was a Fracture he must necessarily have known likewise that the Disease was a Counter-cleft I do not say it had been a very easie business to have
perstarent de venâ secandâ cogitavi ut quae summum in pleuritide commodum afferre soleat Cum vero venaesectionem Galenus in pueris ante decimumquartum annum vix suscipiendam suadeat praesertim in corpore molli raro atque ad dissolutionem prono quale erat hujus puellae siquidem internam habent copiosam perpetuam vacuationem ab actione sui innati coloris excitatam qui substantiam humidiorem facilè digerit absâ—mit unde timendum ne huic liberali vacuationi altera addita vires prosternat Itaq sanguinis uncias quinque sic jubente Doctissimo Sennerto hirudinibus ex internâ sinistrï cubiti vena emungendas curava praemisso enemate emolliente refrigerante Hoc facto dolorem lateris fotu unctione lenire studeo Fovebam autem malvarum florum Camomillae meliloti anethi seminum lini decocto admota insuper inunctione ex unguento dialtheae pectorali oleo amygdalarum dulcium superimposito cataplasmate dolorum lenitivó Recipe Malvae florum Camomillae ana M. 1. Meliloti Anethi Violariae ana M. s Floram Violarum P. 1. Seminum Foenugraeci Lini ana unc s Decoquantur in aqua contusis adde Olei Amygdalarum dulcium unc i. Pinguedinis Gallinae unc s farinae hordei fabar ana q. s Fiat Cataplasma quibus continuatis dolor plurimum alleviatus Hinc ad promovendum sputum conversus mane in jusculis exhibui Oleum Amygdalarum dulcium recenter sine igne extractum quo alvus quoque fluidior reddita subsequente promtâ facili anacatharsi interdiu verò utebatur linctu ex Syrupo Violaceo capillorum veneris diatragacantho frigido diaireos Saccharo Cando atque penidiis In principio morbi assumpsit tincturam florum papaveris erratici cum aqua cardui Mariae scabiosa cum spiritu sulphuris addito pugillo uno vel altero Florum Violarum extractam Postea etiam Decoctum pectorale officinarum hausit pro potu ordinario bibit decoctum hordei cum passulis liquoritia Seminibus Anisi His summâ diligentiâ administratis aspirante Gratiâ Divinâ Natura cooperatrice intra paucos dies puella haec a lateris dolore sputo cruento liberata ut e lecto surgeret remanente tussi non admodum molestâ cui removendae phthiseos vano metu visum est nobilissimae Matri instigatione avunculi Alium Medicum in Concilium adhibere Hic acta pro more multorum accusans maxime veró quod venaesectio neglecta quae sanguinis per hirudines detractio instituta fuisset nullius sit momenti venaesectionem instituit sexto morbi die cum febris reliqua symptomata cessassent detractis ne nihil fecisse videretur quatuor circiter unciis sanguinis ex basilicâ dextrâ oppositi scil lateris id quod inter errores Medicorum a doctissimo Fuchsio numeratur qua plures rationes in contrarium allegat Die septimo exhibet pulverem senae quo sexties vel septies fuit purgata Sub vesperam ejusdem diei incidit in sudorem spontaneum copiosissimum a quo omnino convaluit assumpto tamen aliquandiu Balsamo Peruviano Haec licet 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 sine ratione instituta nullo tamen aegrae damno quod vires ubi valentes sunt quales erant in hac Puellâ omnia contemnant tolerent ubi infirmae fuerint a quovis offendantur Observation the 15 th Book 2 d. A Benign Pleurisie resolved in a Week THE most Noble Damsel Elizabeth Eldest Daughter of the most Noble Gentleman Mr. Thomas Moore Esq aged more or less about ten years thin and cholerick and of a very rare Constitution boarding at Dorchester at a School-mistress's house for her better education subject to Rheums in Autumn when eventilation is less than at other times for which cause the Body is more prone to admit of the Internal inflammations of parts after a precedent rigour was taken in a Fever mild indeed but continual and worse every day towards evening with a pricking pain in the left side reaching to the Throat a difficulty of breathing a cough and spitting of blood Being called unto her and considering what has been said I judged that this noble Maid was sick of a Pleurisie whose external cause was by catching cold seeing that in a cold season late in the evening she had gone forth a walking with naked breasts as is the manner of Noble Virgins For as heat melting the humors easily causeth a Pleurisie so doth cold likewise by compacting them the Blood being gathered by reason of cold about the Intercostal Vessels and causing an Inflammation in the Membrane compassing the Ribs called the Pleura and the neighbouring internal Muscles Presently therefore for as much as her strength was yet pretty good I was thinking of opening a Vein as being that which uses to give great relief in a Pleurisie But because Galen adviseth hardly to admit of bleeding in Children not yet 14 years old especially in a body soft and spare and prone to dissolve such as this Damsels was for these bodies have a continual and plentiful internal evacuation caused by the action of their innate heat which easily digests and consumes their moist Substance so that there was reason to be afraid lest her strength should fail if to this liberal evacuation an other should be added Wherefore following therein the command of the most learned Sennertus I took care to evacuate by Leeches five ounces of Blood from the Internal Vein of the left Arm having first ordered an emollient and cooling Glyster Afterwards I made it my business by fomentation and unction to asswage the pain of her side My Fomentation was a Decoction of Mallows Chamomile-flowers Line-Seeds and Dill after which she was anointed with Althaea and pectoral Ointments and oil of sweet Almonds and this Cataplasm was applyed Take of Mallows Camomile-flowers of each one handful of Dill and Violet-Leaves of each half one handful of Violet-flowers a pugil of Faenugreek and Line-Seed of each half an ounce boil them in Water and when hey are bruised add to them one ounce of Oil of sweet Almonds half an ounce of Hens-grease and as much Meal of Barley and Beans as is enough Make a Pultess These things being continued the pain was much asswaged applying my self therefore to promote expectoration I gave her in the morning in her Broth oil of sweet Almonds fresh-drawn without fire by which She was also more soluble and a ready and easie expectoration followed But in the day She used a Linctus of Syrup of Violets Maiden-hair Diatragacanth frig Diaireos Sugar Candy and Penidice In the beginning of the Disease she took a Tincture of Wild Poppy-flowers extracted with Waters of Card. Marand Scabioso Spirit of Sulphur and a pugil or two of Violet-flowers Afterwards she drank the pectoral Decoction of the shops and for her ordinary drink a decoction of Barley with Raisins Loquorice and Aniseeds These
things being most diligently made use of by the blessing of God and cooperation of Nature within few days this Virgin was freed from the pain of her side and spitting of Blood so that she could rise out of her bed a Cough remaining but not very troublesom to remove which out of a vain fear of a Consumption it seemed good to the most noble Mother through the instigation of the Vncle to call into Counsel another Physician who after the manner of many others accusing what had been done and especially that a Vein had not been opened and that her having been bled by Leeches was of no moment orders on the sixth day of the Disease that a vein should be opened then when the Fever and other Symptoms were gone So taking away some four ounces of Blood that he might not seem to do nothing from the Basilick Vein of the opposite side that which by the most learned Fuchsius is accounted an error in Physicians who alledgeth many reasons to the contrary The seventh day he gives her Powder of Sena by which she was purged six or seven times About the Evening of the same day she fell into a plentiful voluntary Sweat by which she grew altogether well excepting that for some time afterwards she took Balsam of Peru. Though these things were ordered without method or reason yet they did the Patient no harm for strength when it is good as it was in this Virgin it contemns and tolerates all things but when it is weak every thing offends it I have already above mentioned what the Medicinal Materials are with which a Physician is to build any Medicinal work I shall now offer at the Method of ranging these into a Medicinal Observation which according to what I yet best understand ought to consist of these five Parts 1. A Title which is to invite the Reader to peruse it telling him what it is he may expect in the Observation and therefore it ought to contain either the sum of it or somthing very remarkable in it and commonly it speaks the Patients Disease 2. A Narrative of the Case containing its history or the matters of fact which the Physician met with in that Case such as are these three especially 1. His Natural viz. His Parentage Age Sex and Natural Constitution in which I include his Temperament Complexion Predominant Humor and his habit of Body 2. His Non-naturals which some thus in short express Aer Esca Quies Repletio Gaudia Somnus Haec moderata juvant immoderata nocent 3. His former Praeternaturals what Disease he hath formerly had from what Causes and with what Symptomes as likewise the Juvantia and Laedentia what did formerly do him good or hurt 3. The Judgment of the Physician founded upon this Narrative and this Judgment ought to be the delivery of his Opinion touching these three particulars especially 1. What the part Affected is and whether it be Primarily affected or by Sympathy 2. What the Disease is I mean the Principal Disease and that in regard of its Essence Accidents or Mutation 1. In respect of its Essence whether it be a Similar Disease a Distemper only or an Organical consisting in some default of 1. The Conformation of the Part Affected respecting its figure its roughness or smoothness or Cavity in its being Compressed Obstructed or Dilated 2. The Magnitude of it when the Part is either Bigger or Less than it should be 3. The Number when in a greater Organical part there are more or fewer lesser Organs 4. The Connexion when a Part doth not Cohere where it should or Cohere where it should not or is otherwise faulty in its site 2. In respect of its Accidents of which four are especially considerable As 1. It s Magnitude whether it be a great Disease such as being very intense afflicts the Body with a great force or a little Disease that receding but little from the natural constitution doth but little impair the strength 2. It s Motion in respect of its Quantity in its parts as being in its beginning increase state or decrease or in the whole whether it be an Acute Disease or a Chronical 3. It s Motion in respect of its Quality or Manner whether it be a Benign Disease or a Malign 4. It s Event whether it be likely to be Salutary or Mortal Besides these Accidents taken from the Properties that do accompany the Essence of a Disease there are also other accidental differences that a Physician may judg of As 1. Whether in respect of the subject or part affected the Disease be Idiopathick or Sympathick Protopathick or Deuteropathick If Sympathick whether Positive or Privative whether Sympathick by reason of Neighbourhood Society of the same kind Communion of Office Site or Connexion 2. Whether the efficient Cause of the Disease or peccant Humor be Legitimate or Bastard 3. Whether in respect of the Causa sine quâ non especially the Region or Place where the Patient lies sick the Disease be Endemick Epidemick or Sporadick 3. In respect of its Mutation whether it will change into another Disease or it self terminate either by 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Life or Death 4. The Practice of the Physician according unto his Judgment of the Case his Method of Cure and his Remedies made use of whether Dietetick Pharmaceutick or Chirurgick 5. The Event and Success of what was done I do not undertake to prescribe to any one this Method for his framing of any Medicinal Observation but because I think it doth contain whatsoever needs to be taken notice of by any Physician in any particular Patient's Case according to it I shall follow my Examination of the newly mentioned 15 th Observation of Mr. Loss his Second Book of Medicinal Observations supposing that my having premised it hath not been any fruitless digresson since by it the Reader may be informed unto what head each Particular that shall be spoken unto belongs and thereby himself become a more competent judg both of Mr. Loss his Observation and of my Examination This 15 th Observation is more than ordinary remarkable in that there is a double case to be taken notice of in it The First did belong to young Mrs. Bridget Moore the Sickness of her Body The Second doth belong unto my self her other Physician who was sent for to consult with Mr. Loss in her Sickness and it is the wounding of my Reputation by his private whispers and now publick slander The first of these Patients by the blessing of the Almighty grew well in a short time and she may now say to me Physician cure thy self To which my Answer shall be the very same that when she lay sick it was unto her honoured Mother upon somewhat the like question The Case is indeed very dangerous but I 'll do the best I can for the Cure And although it is not in my power to perswade any one contrary to what they themselves please yet
it shall be my fault if what I have writ and proved be not enough to vindicate me to any indifferent Reader And I hope that the Almighty who knows the wrongs and injuries which for several years last past I have suffered by this Gentleman's means will so far favour the innocency of the Cause now that it must needs become publick that he will prosper me in this Cure also In Mrs. Moore 's Case I shall Examine 1. The Title of the Observation 2. The Narrative of her Case 3. Mr. Loss his Judgment both of her Disease and of the Cause of it 4. His Method of Curing her 5. The Event of what he did which I shall refer unto the Second Case 1. In my own Case I shall insist on these particulars His Preface thereunto being a pompous but false Narrative of his wonderful success in the first Case and a plotted and studied piece of forgery to perswade the Reader by a plausible tale how it came about that notwithstanding his great Cure Alius Medicus was sent for Here likewise upon occasion of his naming me Alium Medicum what I could not put into the Preface of my Book for fear of swelling it too much I shall here insert viz. my Answer unto some Objections against it As 1. That it is not seemly for one Physician to write against another 2. That Wise Men love neither to be pattern nor patron of any Controversy 3. That Mr. Loss having not named me I needed not to have been concerned at his Book 4. Being his Book is in Latin my Answer ought to have been in Latin also 5. That writing in English I needed not to have spoke so plain 6. That after I have done all uncharitableness and envy will be the Censure of my undertaking and more strife and trouble the fruit of it 2. His Narrative of my Case containing all his charge of Accusations against me 3. His Judgment of my Disease that it was want of Method and Reason in my Practice and of its external and moving Cause I did what I did that I might not seem to Mrs. Moore or others to do nothing being sent for to the Patient It is not to be expected that I should here mention in the fourth place his Method of Cure for he did not wound me but on purpose that I might bleed 4. His Relation of the Event that by Accident I did the Patient no harm 5. Instead of his my Method of curing this Disease 1. By sufficient Witnesses proving matter of Fact 2. By Reason and Authority vindicating matters of Art and answering every particular Observation And because his first Accusation is That I Accused what he had done I shall there take occasion of aggravating that most unworthy Trick of some bad Physicians that make it their practice to backbite and slander others of the same Profession then I shall give instances of Mr. Loss his thus dealing with me and lastly a direct answer to this and every other Accusation against me as it lyes in order 1. Of the Title of the 15th Observation A Benign Pleurisie resolved within a Week THere is little in this Title remarkable that should invite the Reader to take the pains of perusing the Observation and when examined let any one judg if there be not as many errors in it as there are words For 1. This Patient's Disease to speak properly was not a Pleurisie but an acute Fever whereupon Symptomatically followed a Pleurisie 2. That Pleurisie that was was rather Malign than Benign These two Propositions I shall prove when I come to examine Mr. Loss his Judgment of the Disease 3. This Title doth not answer the Observation unto which it is prefixt for according unto that it should have been thus A Pleurisie and no Pleurisie cured before the sixt day and yet lasting until the seventh These pretty Contradictions of our off and-on in-and-out Gentleman would have made any Reader admire the Writer and above all his Book to have pitch't upon this Observation where to prove what I have said in his Judgment on the Disease he says Considering what hath been said I judged that this noble Maid was sick of a Pleurisie and his Method of Cure and Medicaments do all speak the same thing But in his Narrative of the Case he says After a precedent rigour she was taken with a Fever mild indeed but continual and worse every day towards Evening with a pricking pain in the Left side c. A plain demonstration that the Disease was not a Pleurisie with a Fever but a Fever with a Pleurisie And yet again on the sixth day of the Disease the Disease was no Pleurisie no nor Fever neither for before Alius Medicus was sent for Mr. Loss tells us These things being most diligently made use of by the blessing of God and Cooperation of Nature within few days this Virgin was freed from the pain of her Side and spitting of Blood so that she could rise out of her Bed a Cough only remaining but not very troublesome This Gentleman had cunningly packt away the Disease before I was sent for that I might have nothing to do and that if I did any thing he might say of me that I did it that I might not seem to do nothing not the Pleurisie only but the Fever also and other Symptoms for so he says Medicus Alius orders on the sixth day of the Disease that a Vein should be opened then when the Fever and other Symptoms were gone This augments the Contradiction and makes the Observation still more wonderful That there should be a Pleurisie and no Pleurisie a Fever and no Fever a Disease and no Disease for how could there be a sixth day of the Disease when the pain of her Side her spitting of Blood the Fever and other Symptoms were gone But our Observator is still more wonderful He says this Pleurisie was resolved within a Week if he means that it did not last a week but was gone before the sixth Day he contradicts himself in saying About the Evening of the Seventh day she fell into a plentiful voluntary Sweat by which she grew altogether well a proof that she was not well before If it be said that some remains only lasted until the seventh day at Night but the Pleurisie it self was gone before the sixth I deny this Assertion for the Pleurisie was not gone on the sixth day much less the Fever which was her principal Disease and whose conjunct Cause was not yet discussed until after the Sweat and whilst the Cause remained the Effect did also remain If he means that it did last a Week and no longer how doth he contradict himself in this again by saying he had cured this Pleurisie before the sixth day This Gentleman that hath been noted for one that almost perpetually contradicts what another Physician or his Patient offers to have done though many times soon after he prescribes the same thing himself and in so
Fever is a Symptom of the Pleurisie as appears by these words Sexto morbi die cum Febris reliqua Symptomata cessassent If the Humors be melted by the hot Air then they were not melted before and if not how were they fluid and Humors One would think that heat should rather dry up and consume moisture than make it more fluid and that if it did make humors more fluid they should therefore the rather pass more easily within their own Vessels than break forth into the Pleura why should hot Air cause a Pleurisie so easily and not as well a Phrensy or any other hot Disease If it causeth any other hot Disease as easily as a Pleurisie Mr. Loss is but a pittyful Philosopher that can or doth give none other but a general Cause for a particular Effect If he means by melting of the Humors nothing else but their rarefying by the ingress of hot Air whereby they cannot now be contained within their former bounds what directs them to break forth in the Pleura and what Philosophy calls the rarefaction of humors their Colliquation Frigus humores compingens Pleuritidem facilè introducere solet Cold saith he easily causeth a Pleurisie by compacting the Humors Who can imagine that the cold ambient Air can compact and congeal the Humors in a living Body especially in the Breast or Side parts so neighbouring unto the Heart Why did not the extreme parts grow rigid and stiff with cold at the same time how can the Humors be supposed to be an Ice and the solid parts yet be warm and move How can such a cold do less than quite stifle the insensible transpiration especially in the part most exposed thereunto and if so why did not her naked Breasts gangrene the natural heat being wholly suffocated And besides who can imagine that a freezing cold should cause a melting inflammation especially in a cold Membranous part His meaning sure was that the cold by constipation of the pores by accident caused heat But this falls out then only when the pores of the Skin are lessened but not quite shut with the cold but such a cold as can congeal the Humors within must needs quite shut the pores without and so stifle and put out the innate heat not raise it into a flame Lastly Who can understand the reason of this Antithesis As Heat says Mr. Loss makes the Humors get out of their Vessels into the Pleura by Colliquation and so inflames it so Cold makes them get thither also for so they must if they cause a Pleurisie by Congelation and also inflames it Mr. Loss his Method of Curing her IN the Cure of a Disease are two things Considerable 1. The Method 2. The Means or Instruments The Method is by attending unto the Indicantia to find out the Indicata what it is that must be intended or designed to be done The Means are all those Remedies which will help to bring these things to pass whether they belong to Dyet Chirurgery or Physick Mr. Loss seems to have been a meer Emperick in respect of the Method he made use of for this Patient's Cure as will appear in these three things 1. He did not concern himself what Part was principally affected or what was the principal Disease it was enough to him She had a Pleurisie 2. He did nothing material towards the removing of the antecedent Causes for he was wholly against bleeding of her by Lancet and Purging her 3. All his applications were to a Symptomatical Disease and without satisfying first the Indications from the Cause his first and whole business was after a few Leeches applied to the Arm which did not remove the Cause to cure the Disease by his Fomentation and Vnction of her Side his Cataplasm Linctus Tincture Barley-water Oil of Sweet-Almonds Pectoral Decoction c. of all which Medicines he hath given us not only a Narrative but their Recipes I do not blame his Medicines had they been with Art applied neither yet do I know any thing extraordinary in them for which they deserved to have been printed But I do blame his playing the Emperick and his labour in vain attempting to cure a Disease without first removing the Cause and I do say that for ought I know if no other Method had been made use of for her Cure this Patient must have perished The Event of what he did I shall refer unto the now following Preface of the Second Case The Preface Mr. Loss makes unto the Second Case THese things being most diligently administred by the blessing of God and the cooperation of Nature this Damsel was freed from the pain in her Side and spitting of Blood One would almost laugh at this Gentleman to see with how much gravity and formality he sets forth at large his doing of little or not much to the purpose for this his Patient But I dare not make sport of or laugh at his mockery in calling as it were God and Nature to witness an untruth that She was freed from the pain in her Side whereas Mrs. Moore says positively the pain in her Side continued very violent Some one may think perhaps that this untruth was some mistake or came some-ways inconsiderately from him but it would be strange that he should light by accident upon that than which nothing though designed and plotted could make more for his purpose for if She was freed from the pain in her Side the Reader takes it easily for granted that her Pleurisie her Disease was gone and then he easily consents that the sending for Alius Medicus might be upon such an account as Mr. Loss tells him and that Alius Medicus was guilty of the faults are laid to his charge and that he did nothing to the Cure for that was done before he was sent for and that what he did was without Method or Reason and done only because he would seem to do something Thus the Relation of the Event in the first Case is a very convenient Preface to the second for it argues the great Art and Skill made use of besides the blessing of God upon it to the honour of Mr. Loss who so speedily and safely had wroughte Cure and è contra the ignorance and madness of Alius Medicus that should bleed and purge a Patient that had no need of either but was recovered before The main business Mr. Loss had to do in this Preface was how he should so handsomly and conveniently bring Alius Medicus upon the stage as to rob him of the credit he had got of this Cure and to take it to himself and cast dirt upon him First therefore he gives the Reader a plausible story of what he had done and for the better credit of the business he tells him what intentions he followed to cure this Pleurisie and sets down also the Recipes of his Medicines both which an indifferent Physician might have easily translated from many Books that write the Praxis of
is like a Venice-Glass bright and clear but withal fragile and if once crackt though it may be sodred or plaistred and serve for some use yet it is despised undervalued and in a manner fit for nothing Credit to men in a Profession is like Virginity to Women it enhanseth their price and just esteem mightily but if it once be lost how shall it be retriev'd People are as ready to catch at slanders as slies are to light upon a gal'd place and they have their impudence to come again be they never so often beaten off When a Slander hath once taken Air 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 who is able to stop or stay its wild-fire from doing mischief It 's like a poisoned Arrow if it once fetcheth blood who can keep it from infecting or tainting the Heart A Man can never therefore be too careful of his credit he must keep it as the apple of his Eye many times guarding it when there is no hurt near but always defending it when it is in danger To the Slanderer for it 's fourty to one but sometime or other Murder will out and Slander also I cannot easily sit down and imagine with my self any Person so impregnable so next to impossible to be discovered and convicted as was Mr. Loss for being near fourty years a Practiser of Physick in one place he hath had the opportunity of doing Courtesies and Kindnesses to most about him and hath thereby gained their good will and being all along a great Professor of Religion amongst those that are perhaps really good and apt to think others so likewise he hath gained an easie belief that whatsoever he says is true And yet this Oracle of Physick this piece of starch't Honesty and Religion to speak against whom one told me was all one as to set my shoulders to heave an house-end will probably in any place besides Dorchester and possibly there also be reputed for another Person than he was taken for for if I mistake not his passions have so at length befool'd him that his 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 his meash of denying things being now stopt quia litera scripta manet what no man else possibly could have done he himself I think hath effected in the discovering of his own slanders not of me only but of many other Physicians also and Apothecaries Instances of Mr. Loss his Slandering of Alius Medicus Some six years since I was sent for to a Person of quality not far from Dorchester Mr. Loss his Patient who notwithstanding all that was done for her continued many days under the torturing pains of a Scorbutick Collick I then told him that in my opinion it was high time to give her some ease by an Opiate Medicin for which she was not yet too weak he opposed my advice for fear forsooth that any thing which had Opium in it should further impact the Morbifick Matter I argued that Symptoma urgens did indicate as a Cause impairing her strength which without ease given could not well hold out until the conjunct cause of the Disease should be removed and besides that whilst Nature was thus on the rack and in a rage no Physick that should remove the Peccant Humor could work or have its due operation for Nature must first work on it and she was at present otherwise employed but to take off all doubt I told him that my purpose was to have respect at once both to her strength the Morbifick matter for I purposed that she should take the Laudanum in a Purging Bolus with some reluctancy he at last consented the Event was that it calmed the enraged Archaeus as the Chymists love to speak and stopped the violent fermentation of the humors and having first given her great ease it afterwards gently carried off good part of the Morbifick Matter but not all for within a small time the remains and what was new generated began again to ferment afresh and her Torments did return insomuch that early in the morning whilst we were both of us in bed together she sent up her servant to acquaint us with the sadness of her condition Mr. Loss that had intimated unto me a little before that I need not be too diligent my pay would not be answerable speaking thus of a Family he hath got many a score Pounds by begins now to give me himself for an example of that Rule he would needs instruct mein let the Lady therefore toss tumble and cry out for pain I saw he could lie qâ—ietly and at his ease in bed and let me get up in a cold Winter-Morning though it was to mind our Patient's ease more than my own I found her very ill and by such means as were at hand in her Closet next her Chamber reposited there I suppose chiefly for charitable uses she her self by the blessing of God received such help and so great benefit in this her extremity as pleased her so well that she bade me write down her Name in my Book for the best Patient I ever had being a sort of promise that she would be so and some hours after when Mr. Loss was got up and come into her Chamber in my hearing she bade him get out of her sight she could not endure him If this Gentleman said she had not arose and come to me I might have perished for all you And this I think was the foundation and first beginning of his quarrelling with me For finding how things went and what an interest I had gained in this Patient he begins to think it high time to look about him and reflecting with himself that some of her nearest Relations were still his fast Friends as well as old Acquaintance for he had been about twenty years a Physician to the Family and I never there before he takes the opportunity of the next returning of her pains for neither yet was the Disease wholly extirpated and then when grief and sadness had again seized the Family whilst I was yet in the house behind my back he makes his complaint to the Husband and Mother-in-Law of my irrational proceedings insinuating as if what I had done that Morning when he kept his bed was the repeating of some Opiate which had impacted the Morbifick Matter and was the cause of these her returning torments adding more expresly words to this purpose that I had already done more than I could answer and that if they did not set a spy upon me I would kill her I was so venturous and accordingly forthwith a spy was set to see that I medled not or mixed any thing for the Patient No question but this good man saw in his Bed if not in his sleep what Medicines I took down in the Ladies Closet and how I ordered them or else the Nurse guessed at them and told him But a Gentleman of good Credit whom I can Name told me that he heard him speak to the Husband and Mother these things he said of me behind