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
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
Citron Pills Make an Electuary the Dose is the quantity of a Nutmeg in the Morning and at five in the Afternoon drinking after it of the following Julape three Ounces and walking upon it Take water of the Leaves of Wake Robin a pound of Pennyroyal and Hyssop of each four Ounces Sugar an Ounce Mix them make a Julape Take of the Tincture of Antimony an Ounce the Dose is from twenty to five and twenty drops twice a day with the said Julape Moreover amongst these we may place the Tincture of Steel and its Syrup also Elixir proprietatis with many others Secondly The panting of the Heart which is more frequent and much more violent happens through some fault in the Arteries belonging to the Heart which fault is either an Obstruction or a Convulsive affect The first default for the most part is continual and often incurable but especially if it arises from Consumptive Lungs or because the Roots of the Arteries are half stop'd or compress'd by reason of some Tuberculum or bony Excrescency in them And in this case all that can be done is to give some ease now and then by Hypnoticks Moreover it is not improbable that the Arteries sometimes are almost fill'd up with Polypous Concretions engendred in them and sometimes within the Cavities of the Heart it self and that thereby the free passage of the whole current of Blood is hindred but as it is diffcult to be satisfied when this is so so it is as rare to find a Cure for it When there is a suspicion of it Saline Medicines seem to be most proper and of those we must give such as have a Volatile or Acid Salt but we must not give them together but for a time those which failing of success try the others Take Spirit of Sal Armoniack Compound viz. distill'd with Millepedes or with other Anti-Asthmaticks three Drams the Dose is from fifteen drops to twenty thrice a day with the Julape or some proper distill'd water After the same manner you may try the Spirits of Hartshorn Soot Blood and of an old Scull Take Spirit of Sea Salt or of Vitriol distill'd and often Cohobated with the Spirit of Wine impregnated with Pneumonick Herbs three Drams the Dose is from fifteen drops to twenty after the same manner for these purposes the Spirits of Tartar Guaiacum and of Box are often us'd The panting of the Heart is very often a Convulsive affect and wont to be produc'd from the like Cause and manner of affecting as other Hypochondriack and Asthmatick affects and its Cure also ought to be attempted by Antispasmodick Remedies but a cholce of them must be made with some difference according as the Disease happens in a hot or cold temperament In respect of the former the following Medicines may be prescrib'd Take Spiritus succini Armoniaci three Ounces the Dose is from fifteen Drops to twenty twice a day with the Julape or some proper distill'd water After the same manner may be given interchangeably the Tincture of Tartar of Steel or of Antimony Of the trembling of the Heart and its Cure THe trembling of the Heart is an effect distinct from its panting or Palpitation and of a different nature from it for in that its carneous and moving Fibres seem affected by themselves nor does the Morbifick Cause as in the other affect seem to lie in the Blood or in the Arteries of the Heart The trembling of the Heart may be well describ'd to be a Spasmodick Convulsion or rather a trepidation of its flesh by which the moving Fibres hastily and only half contracted cause most swift turns of the Systoles and Diastoles but broken and as it were at halfs so that the Blood is brought into and carried forth of the Sinus 's of the Heart only in very small Portions As to the method of Cure to be us'd in the trembling of the Heart since this affect is meerly Convulsive therefore they are not Cordial Remedies but rather Cephalicks and Nervous Medicines that are Indicated which nevertheless according to the temperament and constitution of the Patient must be either more hot or moderate or now of this now of that nature To comprehend all in a few words since there are three sorts of Mecines that are wont to be mighty successful in this Distemper viz. testaceous Medicines Chalybeates and such as are endow'd with a volatile Salt I shall here briefly set down certain forms of each of these and their use Therefore in the first place a provision being made for the whole by evacuatives and a choice being made of that sort of Medicine which promises best you may prescribe as follows Take Coral prepar'd Pearl of each two Drams both Bezoars of each half a Dram white Amber two Scruples Amber-greece a Scruple Make a Powder the Dose is half a Dram twice or thrice a day with a distill'd water or some proper Julape Take Powder of Crabs Claws Compound two Drams Powder of Male Peony Roots and of Mans Scull prepar'd of each a Dram Flowers of Male Peony of Lillies of the Valley of each half a Dram Make a Powder to be taken after the same manner Take Ivory red Coral powdered of each three Drams Species Diambrae a Dram double refin'd Sugar dissolv'd in a sufficient quantity of water of Navews and boil'd to a consistency for Tablets seven Ounces Make Tablets according to Art weighing half a Dram let one or two be eaten often in a day as the person pleases Take Conserve of the Flowers of Lillies of the Valley six Ounces Powders of Coral prepar'd Pearl Ivory Crabs Eyes of each a Dram and a half Vitriol of Mars a Dram Syrup of Coral what suffices Make an Electuary the Dose is from a Dram to two Drams twice a day drinking after it a draught of the following Julape Take the water of Navews and of whole Citrons of each six Ounces of Orange Rines distill'd with Wine two Ounces Sugar half an Ounce Make a Julape Take of our Syrup of Steel six Ounces the Dose is a spoonful in the Morning and at five in the Afternoon with two Ounces of the Julape before written leaving out the Sugar or with distill'd water Take Powder of Ivory and of Coral of each two Drams and a half Species Diambrae a Dram Salt of Steel two Drams Sugar eight Ounces Amber-greece dissolv'd half a Scruple Make Tablets weithing half a Dram the Dose is three or four Drams twice a day Take fresh Strawberies eight pounds the outward Coats of twelve Oranges fresh Filings of Iron half a pound being bruis'd together pour to them eight pounds of Wine let them ferment in a Pot close cover'd for twenty four hours then distill it in common Organs Take Spirit of Hartshorn or of Blood or the like three Drams The Dose is twenty drops twice a day with a fit Vehicle Take Flowers of Sal Armoniack Coral prepar'd of each two Drams The Dose is a Scruple twice a day Take
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
requires the Judgment of a Physician or skilful Chirurgion For we must be very careful that a Cautery or Incision be not admitted over or too near the Tendons or greater Vessels Nor must an Issue be made in the very Body of a Muscle but in the Space or Interstice betwixt the Muscles where the hole must pass the whole Skin and so much farther till the little Membrane of the Muscle underneath be penetrated wherefore this operation is not to be committedindiscreetly to Quacks and others ignorant of Anatomy for upon an ill performance herein there ensues not only a Frustration of all good but often great prejudices thence arise nay sometimes eveâ— to the hazard of Life It 's needless for me here to describe the way of preparing and compounding a Cautery or the figure and uses of the Incision Instrument for making Issues for these are commonly known yet it will not be amiss to discourse somewhat here after what manner we must deal with the Symptoms which happen to those Emissaries after they are made and hinder or pervert their Energies There being many and sundry sorts of affects hapening to Issues a Cure is not requir'd for them all but only for those of greatest moment Therefore in the first place it is needed whenever an Inflammation happens to the part or place where it is Secondly if the Orifice voids more or less Ichor than it ought Thirdly if the Sore be apt to dry up of its own accord and now and then to be covered with a little Skin or to grow rank with a Spungy Flesh growing up in its Circumference As to the lesser defaults as when the Sore bleeds often or if changing its place it gets by little and little into a worse with many others in which it 's wont to prevaricate it will not be worth while to mind them here 1. An Inflammation sometimes happens to an Issue and that sometimes so great that it threatens a Spacelus or Mortification of the part nay and sometimes brings it Now such an affect comes either upon the fresh making of the Orifice or happens afterward by reason of the Blood and Humours being upon some occasion put in a Commotion and rushing in a throng to that place When an Issue is first made presently by reason of the Solution of continuity and consequently the Blood 's being somewhat letted in its Circulation in that part some Inflammation and Soreness happen to all persons But in some who have a very hot Blood and little diluted with Serum this proves much more violent there hapening sometimes a Mortification of the part inducing a Spacelus Or Secondly the Blood there stagnating is chang'd into a Pus to be evacuated by an Abscess Or Thirdly which more frequently happens and ought to be always procur'd in our case the Blood causing an Inflammation is return'd again into the Vessels and restord to its Circulation by other Ductus's into which it is forc'd But that it be convey'd back these two things are necessarily requir'd viz. First that it be much diluted with Serum there plentifully abounding or rather protruded into the part And then Secondly that the emptied Vessels behind the Tumour Drink up again the Blood diluted by the Serum and driven back For the Blood driven toward the Tumour when it can go no farther forward yet at least that upon lessening its Bulk it may go back discharges Serum plentifully from it self and drives it into the places obstructed which entring into the stagnating Blood dilutes it and getting into tis place drives it into the Ductus's of the Vessels and that Serum in the mean time passing forward exhales through the Pores and so the Blood which was extravasated being diluted and sent back by the Serum and the Serum it self evaporated the Tumour with the Inflammation vanish by degrees But in case as it often happens in hot Temperaments the Blood extravased and driven into the Pores be not diluted with a plentiful access of Serum it will not only stick there with obstinacy but will cause a violently Inflamed Tumour with a Fever and sometimes other dreadful Symptoms Not long since a great Divine whose Blood was thick and hot having an Issue made in the inside of his Legg though the Skin only was cut an Inflammation shortly followed which grew so violent within a few Days that it could scarce be hindred from turning to a Gangreen by the use of any Remedies whatsoever Wherefore when the Blood extravasated through a Solution of Unity and wanting an access of Serum for diluting it and carrying it back tends to a violent Inflammation Fomentations and Cataplasms of Emollient things outwardly apply'd often do much good because the moist and mild Parricles parting from them enter the stagnating Blood and dilute it and so giving it a gentle motion cause it to return more readily into its Vessels so that those moist applications outwardly us'd supply the defect of the inward Serum requir'd for diluting the Blood Nevertheless that the Blood so diluted and put in motion be restor'd to Circulation it 's farther necessary that the Vessels which are to receive it be fufficiently emptied for which end besides a slender Diet Bleeding and Purging are often of necessary use and indeed it is usual to Purge and often to Bleed Cacochymical and Plethorical persons a little before or after an Issue is made Nor are these Remedies only proper to prevent or remove an Inflammation in case of a fresh Issue but are likewise good whenever that affect happens to an Issue of a long standing For if at any time the Blood being very impure and withal Feverishly boiling enters upon an Excretory Turgescency it often falls out that it deposes its Excrements and Filthy Dreggs about the Issue being hardly to be Purg'd elsewhere and that it being there hindred from its Circulation upon their being heapt together is extravasated and so causes a violent Inflammation Such an affect lately hapening in an Ancient Nobleman and at first neglected soon turn'd to a Gangreen from which nevertheless by the help of proper Medicines carefully administred both inwardly and outwardly he escapt not without great danger of his Life 2. If at any time an Issue discharges too much Ichor which for the most part is thin and of a very ill Smell and sometimes discoloured so that such vast Spendings of Humour and withal it 's intolerable Stench requires a Cure In such case there are two chief Therapeutick intentions viz. First to strengthen the mixture of the Blood that its Texture be not too prone to a Dissolution and Fusion of Serum And Secondly to preserve the place Ulcerated by the Issue and to keep it free from any Coruptive Ferment so that no Noysome Filth there lodg'd may defile the Blood as it passes through in circulating whereby being infected it may presently run into parts and be forc't to depose the Serum there in such abundance The former scope of Curing orders scarce any thing
about the declining of the Disease viz. when the Confines of the Brain obtain'd a calm the Clouds as it were being discharg'd thence on the Brest a mighty Catarrh presently fell on the Lungs But in some especially who suffered little from the Disease in the Head presently from the beginning of the Fever a violent Cough and a Spitting of filthy Matter accompanied with a Consumptive Disposition as it were seiz'd them and precipitated them suddenly and unawares into a Consumption from which nevertheless by a seasonable use of Remedies they often unexpectedly recover'd I observ'd in some after a long failure of the sensitive faculty and an oppression of the Brain from the Morbifick Matter that at length Tumours ensued in the Glands about the Neck from which assoon as ripen'd and broken a thin and stinking Ichor flowed for a long time and gave ease I have seen also Watery Wheals sais'd in other parts of the Body which have past into bollow Ulcers with difficulty to be Cur'd Sometimes small Spots and as it were Flea-bites appear'd here and there Though I have not heard that broad and livid Spots ever were to be seen in Persons sick of this Disease However notwithstanding this Fever had not any very Malignant breakings forth yet it was not free from Contagion For in the same Family it seiz'd almost all the Children and younger People one after the other and often Persons stricken in years who attending the sick familiarly us'd about their Beds and Bed-cloaths were infected with the same Disease Yet I must say there was not so great a suspicion of infection that for that reason the Friends of the Sick should be wholly forbidden to visit them or converse with them Though all along the course of this Disease unless when the Brain was greatly assail'd it appern'd only mild and past without any dreadful Symptom nevertheless its Cure was always difficult and was not perform'd but after a long time For the Diseas'd seldom recover'd within three or four Weeks nay for the most part scarce within so many Months But if this Disease fell on Men of a decayed Age or Strength especially on such as were before subject to Cephalick Diseases as the Lethargy Apoplexy or Convulsions it often kill'd them in a shorter space Or if there were any hope of recovery it could be carryed on very slowly scarce any Remedies affording a sensible relief so that the Diseas'd were no sooner gotten without the Sphere of this Fever but they found themselves within the Confines of a Consumption If the formal reason and causes of the foresaid sickness be enquir'd into it plainly here appears that the Liquour which lies in the Brain and Genus Nervosum for the most part together with the Blood was in fault and was the immediate cause of the Symptoms that seem'd chiefly pressing viz. in as much as the Latex presently from the first invasion of the Disease was become more impoverisht than its wont and effaete as it were and therefore a Languor and Enervation with a Spontaneous Lassitude and a Disability to motion together with a sudden Consumption of the Body happen'd to the Diseas'd Though still the default of this Latex necessarily depends on the Dyscrasy of the Blood and of the ill Constiution of the Brain but here as in other places I refer you to Dr. Willis himself for a fall Aetrology of Symptoms I have often observ'd in this Fever after Oat Broath a Decoction of Barley and other thin Dyet that no less Ebullition of the Blood has been rais'd than by a full Meat Broath For indeed on one side as well as the other the Nutritive Juice sent from the Chyle into the Blood in regard it was not imploy'd in the work of Nutrition troubled the Blood as some Heterogeneous thing that would not duely mix with it And by reason of the Particles of this superfluous Juice sent off in a plentiful manner with the Serum the Urine was very thick and red and mightily fill'd with Contents And for this reason the Belly for the most part was loose in as much as the Blood being full of a Nutritious Juice suck't a less Portion of Chyle from the Lowels and discharg'd again into the Intestines a part of that which was brought into it moreover the Feverish Distemper stuck for so long time in the Blood because till upon the Restitution of the Animal Governance Nutrition was rightly perform'd that superfluous Matter was heap't together in the Mass of Blood I shall now give an instance or two of Persons affected with this Disease A Robust and Florid young Man about the beginning of the Spring An. 1661. falling sick without any evident cause soon became weak and as it were enervated with a loss of Appetite and a languishing of the Spirits Cathartick Remedies Antipyreticks Digestives nay and Antiscorbuticks and others of eivers kinds being given him according to the prescripts of famous Physicians did not the least good But the Diseas'd still continuing in a languishing condition lay by it for six weeks with a slow Fever of uncertain returns a quick and weak Pulse and a deep red Urine Moreover being mightily pined away he complain'd of a ringing in his Fars and an Undulation of sound as it were in his head Though he was affected with a great Stupor yet his Sleeps were very much troubled and interrupted with a talking Light-headed After forty days the Fever not yet declining it was thought good to draw about four or five Ounces of Blood from the Vessels of the Fundament by Leeches Hereupon presently the Fever began to be very much exasperated for the heat became more intense with a Thirst Watchings and an almost continual tossing of the Body the Tongue also growing dry and rough shortly after a troublesome Cough with much and discolour'd Spittle ensued There were carefully given him Almond and Barley Drinks with temperate things against the Cough boil'd in them Water of Milk distill'd with Snails and Herbs appropriated to the Thorax Powder of Shells Niter prepar'd and likewise Cordial Opiats which nevertheless scarce giving any relief the Diseas'd still became weaker And when after this manner having been sick above two Months the Feverish Distemper and the Cough also daily growing worse he seem'd to be at Death's Door at length a Sweat hapening of its own accord which sometimes came upon him every night sometimes every other night he grew better by degrees thereby and using afterwards the foresaid Medicines he became perfectly well within six weeks Whilst this Person lay ill I went to see another about Twelve years of Age affected after the like manner but this when I was first call'd having lain ill above a Month was reduc't to a Skeleton Moreover he was affected with a Giddiness a ringing in the Dars and a Deafness and likewise with a violent Cough thâ— accompanied with a yellow and as it were Consumptive Spittle His Pulse was quick and weak his Urine red and thick his
inconstancy of mind a disturb'd fancy a dread and suspicion of every thing an Imaginary being Affected with Diseases of which they are free and many other distractions of the Spirits nay sometimes Melancholy and a Mania accompany this Sickness Besides these interiour Regions of the Body being beset with this Disease wandring Pains also Cramps and Numbnesses with a sense of Formication seise likewise almost all the outward parts Night Sweats Flushings of Blood in the Face and Palms of the Hands Fevers of uncertain returns and many other Symptoms of an incertain Origine on all hands arise of which in regard it has not been easy to assign the Genuine causes and ways of their coming to pass Physicians have charg'd though unjustly all the blame on the Spleen In the mean while it is to be observ'd that the chief Symptoms of this distemper are convulsive and depend immediatly upon the Irregularities of the Animal Spirits and Nervous Juice rather than on the Dyscrasies of the Viscera that serve for Concoction As a great many have ascribed this valetudinary disposition to the only fault of the Spleen So others making all the confines of this Entral a party in the fault will have the Blood lying in any part soever of the Vessels of the Spleen and Epigastrick Region to give the Origine to this evil But the renowned Highmore has charg'd the chief cause of this Disease wholly on the faulty Constitution of the Stomach Concerning this opinion though I so far agree with this famous Author that I may grant the Ventricle to be often greatly distemper'd in this affect Yet I cannot be brought to think that all the Symptoms of the Hypochondriacal Disease depend only on the Ill constitution of the Ventricle for I have known many sorely afflicted with that Distemper whose Stomachs were well enough and I have known others who through an ill dyet have brought their Stomachs to be greatly Distempered yet as to the Precordia and Animal Faculties being sound enough they were not at all accounted Hypochondriacal As to what the Spleen contributes to this Disease Dr. Willis first curiously observing the use of this part to wit that from the Blood brought to it from the Arteries a certain Dreggy Portion viz. consisting of an Earthly matter and a Fixt Salt is depos'd in this Entral which being there exalted as it were by Digestion and rais'd to the nature of a Ferment is again committed to the Blood as it passes back by the Veins which inspires it with a certain Fermentation and performs the same thing as to its Pneumatosis as our common Leaven does when mixt in a Mass of Meal so that as the Leaven inables the sluggish parts in the Bread for Motion so the Ferment of this Entral raises the sluggish Particles of the Blood to a state of activity And secondly considering the intimate communication betwixt the Brain and the Slpeen by the means of the Nerves of which there are a world of Plexus's and Fibres arising from them in this part he says that the ways of affecting with which the Spleen being evil dispos'd produces or at leastwise contributes to the rise of the Symptoms of the Hypochondriacal Distemper are chiefly these following Viz. First it sometimes happens that the spongy substance of the Spleen is very much stuff't and obstructed by the Faeces of the Blood sticking too much in its Pores and there Stagnating so that afterward it does not admit into it the Dreggs of the Mass of Blood as much as it ought but the same being brought thither but not receiv'd Regurgitate into the neighbouring Branches of the Caeliack Artery whence presently they are convey'd into the Membranes of the Ventricle the Caul and Mesentery and other neighbouring parts and are wont to stick in them hence the Tone of those Viscera is so much perverted that they cannot rightly execue their due Functions in order to the Concoction of the Chyle and the Circumjacent Membranes being very much fill'd with Heterogeneous and Irritative Particles become mightily obnoxious to Convulsions arising here and there to running Pains Contractions Distentions and a multitude of Flatus's 2. Though the Slpeen should receive freely enough the Melancholy Juice brought by it from the Blood to the Arteries yet often it does not duly Concoct the same but the salt being very much exalted perverts it into a humour too Sharp or Austere or faulty some other way wherewith when the whole Mass of Blood and the stock of Nutritive Juice contained in it are infected the fruits of a Hypochondriacal seed display themselves throughout the whole body the Blood boiling more then it ought is driven violently into certain parts and at the same time in others it is apt to stagnate Hence some presently upon eating have Flushings in the Face the palms of their hands burn c. In some again running pains with a Pricking happen in many parts of the Body 3. From the Blood thus deprav'd through the fault of the Spleen a prejudice also is often brought on the Animal function the Heterogeneous and Convulsive particles being often discharged on the Brain and Genus Nervosum hence persons are troubled with fancies and thoughts with Giddiness Scotomia's Head-aches and often Paralitick affects Then as the Morbifick matter passes from the Brain into the Genus Nervosum Convulsive affects are raised in many parts of the Body but chiefly about the Precordia and Viscera of the Belly the Spirits that are in the Nerves which regard those parts being greatly troubled by the passions of the mind 4. It is also very probable that the Nervous Fibres whereof there are a world disperst through the Spleen sometimes receive into them its most Sharp Juice which creeping up the Passages of the Nerves often is the cause of Convulsive Motions And there being an intimate commerce betwixt the Spleen and the Brain we judge that besides the long way of the Blood they have a nearer way of communication by the Nerves of the Par Vagum and Intercostale by which they mutually affect each other so that sometimes the Melancholy being disturb'd in the Spleen conveys thence the passion to the Brain whence disorderly and Hypochondriacal fancies happen And on the contrary when a violent Passion of the mind occasionally rais'd within the Brain troubles the Spirits residing in it the impression given the fancy is convey'd to the spleen by the course and successive affect of the Spirits lying within the Nerves of the Per Vagum and Intercostale whence many disturbances are caused in that Entral and in the parts adjacent I shall now give an instance of a person troubled with the Hypochondriacal affect An honourable person of a Melancholick temperament and always accounted to be troubled with the Spleen complained very much of a Pain and Inflation of the left Hypochondre with a frequent Rumbling and a Sour Belching also a Trembling of the Heart a continual Giddiness a want of Sleep and a Troubled Fancy
beget Catarrhs the Dropsie the Jaundise Melancholy and many other Affects Now if that extraneous thing be seasonably removed the Blood even as the Wine being free from that Extraneous Mixture soon recovers its former Constitution But each of those Liquors being for some time infected with Heterogeneous Contents at length degenerates from its due Crasis and consequently is not easily restor'd Again both Wine and the Blood fall from their due Temper for many other causes 1. Concerning Wines we may observe that sometimes the same do not come to a ripeness but for want of a Pneumatosis because the Spirits and other active principles of Salt and Sulphur being involv'd in such as are more Gross cannot clear themselves remain wholly Crude Wherefore they do not become Spirituous but being of a Gross consistency and of an ingrateful savour degenerate into a Flat Wine without strength Even so the Blood sometimes the Spirit and Sulphur being deprest remains Crude and Watry also without vigour and unapt for a sprightly accension in the Heart such a disposition causes the longing Disease and an Hydropical Diathesis 2. The Sulphureous part of the Wine being exalted above the rest causes an Immoderate Effervescency or an ebullition in the Liquor we call it a Fretting of Wines In like manner the Sulphureous part of the Blood being too much exalted and consequently apt to Boyl and be kindled in the Heart too much brings a Feverish distemper and is really the cause of many continual Fevers 3. Often in Wine the Spirit becoming faint and the Sulphur being bound the Saline part is rais'd to a State of flowing and praedominates over the rest wherefore the Liquor passes into Vinegar from such an Acetous disposition of the Blood Melancholy is caus'd 4 It 's a vulgar observation in Wines that besides that they degenerate into a Flat Wine or into Vinegar the same sometimes upon the Spirits being deprest and the Salt and Sulphur's being together exalted become either Rank or Pendulous or Mucilaginous we call it Wines become over Fretted or become Ropy In both changes the Spirit being brought under the Sulphureous and Saline Particles are joyn'd together and are above the other Elements and bring the Crasis of the Liquor to their nature But the thing is not done in both wholly after the same manner for in the former dyscrasie of the Wine the Sulphur is a little above the Salt and in the latter the Salt is above the Sulphur Nay and either of them being in power and having thrown off the Dominion of the Spirit takes the other to it and raises it above its due state Now it 's probable that the Blood is altered after the like manner in the Scorbutick affect as Wines when upon being overheated become over Fretted or become Ropy and we may conclude the Dyscrasy of the Blood which is the Parent of the Scurvy to be two fold as that of Wine viz. Sulphureo-Saline and Salino-Sulphureous For there being a very great variety of affects which are accounted of as belonging to the Scurvy all of them may be aptly enough reduc't to these two as it were chief heads or as the two fountains of the evil viz. First that the Blood being touch't with a Scorbutick taint either is very hot as in which the Sulphur having gotten the Dominion takes the Salt to it wherefore being become rank it Boyls disorderly in the Vessels and discharges continually from it self adust Recrements viz. the concretions of the Salt and Sulphur and disperses them every way which being outwardly spread produce Spots Wheals Pushes or Ulcers But being inwardly depos'd cause Vomitings Cardialgias Diarrhaeas or Dysenteries and also violent pains In this kind of Scorbutick rankness of the Blood only temperate remedies and frequent Bleedings agree and not Scurvygrass horse Raddish and other things of a smart and instigating Nature After the same manner as overfretted Wines are Cur'd by Racking them from the Lees and likewise by pouring Milk Amylum Ichthiocolla and other Lenifying things to them Or Secondly in the Blood which Foments the Scurvy the Salt having got the Dominion takes to it self the Sulphur wherefore it is not so hot but like Ropy Wine becomes thick and Mucilaginous as it were is Circulated slowly in the Vessels and is apt to stuff the Vessels as it passes through them Furring them with a Muddy Filth Such as are so affected for the most part being without Pushes or Cutaneous Eruptions become Dull Pursy and enervated are troubled with a Spontaneous Lassitude a Straitness of the Breast nay and are found obnoxious to Passions of the heart Faintings of the Spirits to a Giddiness and Convulsions And in this kind of Scorbutick disposition Hot remedies and such as are endued with a Volatile Salt nay and Galybeates which Fuse and exagitate the Blood are wont to be most of use after the like manner as Ropy Wines are dealt with to wit they ought to be very much stirr'd and agitated and also quicklime burnt Allom Lime Plaister Sea Salt Calcin'd and other things of a very smart nature are put into them I shall now shew after what manner the seeds of that Disease are laid in the other general humour viz. the Nervous Juice About the beginnings of a Scurvy till the Crasis of the Blood and the Tone of the Brain are wholly vitiated that Subtle Liquor which passes in the Brain and Nerves and is distill'd from the Blood coming to the Brain both as the Matter and Vehicle of the Animal Spirits is yet Spirituous and Sweet and not very unapt for any offices it ought to perform but afterwards from the Mass of Blood become depauperated and very much Effaete a much thinner Latex and inclining to a Sourness is distill'd Moreover from the Dreggy and as it were Rank or Muddy Blood Heterogeneous Particles and such as are very injurious to the Animal Oeconomy are sent and are admitted without difficulty into the Brain which is become weak and thence are diffus'd into its appendix both Medullary and Nervous with the Juice which passes in them Hence follow the Fallings and Eclipses sometimes Distractions and Painful and Convulsive Explosions of the Animal Spirits that happen in each of the Regions Wherefore the Palsey Convulsions a Giddiness Pains Tremblings and other Praeternatural affects of the Brain and Genus Nervosum are wont to ensue upon a Scurvy when deeply rooted Mean while we may observe in general that the Scorbutick Taint fixt in the Nervous Juice Consists in these three things viz. In some one of them or in all of them together viz. that the Liquor lying in the Brain and Nerves becomes much more thin or poorer that it degenerates from its Spirituo-Saline Crasis towards a Sourness that it is stuff't with Heterogeneous and Morbifick Particles As to the Prognostick of the Scurvy let your judgment in this case be wary long suspended and not rash for many as it has occurr'd to our observation accounted for desperate have recovered
either proceeds from a serous filth discharged from the Blood on the Cortex of the Brain or from a stupefaction inflicted on the Spirits there residing and then this affect by how much less it is than the Lethargy by so much is it accounted less dangerous but more commonly this Disease ensues upon other Cronick or acute distempers viz. the Head-ach Convulsions and most frequently upon Fevers of an ill crisis especially in Children old and phlegmatick people Some years since in an Epidemick Fever hapning through the affect of the Nerves which we have elsewhere describ'd as I observed some to be Lethargical so many to be troubled with the Coma of whom a great many recover'd the morbifick matter being conveyed from the Head into the Breast Moreover in other cases this affect being of a doubtful event betwixt hope and fear requires the sedulous care of a prudent Physician In a Primary Coma the Therapeutick method suggests to us the like and in a manner the same intentions of healing as in the Lethargy As to the morbifick matter we must endeavour both that its new afflux to the Brain and that which is already sticking in it be discuss'd or drawn away Moreover the Animal Spirits ought to be raised up and all drowsiness or stupefaction ought to be shaken off from them For this end we must order Purging Blooding Cupping-glasses Vesicatories Revulsing and discussing Topicks give Cephalick Medicines and especially such as are endowed with a Volatile Salt and use many other ways of administrations before-mentioned But if this Disease ensuing upon other affects happens to any Person whose Body is much worn away the Blood vitiated or greatly depauperated we must seriously deliberate concerning letting Blood and Purging before we order them nay and for the most part we must abstain from them tho sometimes that the conjunct cause of the Disease or the matter sticking in the Brain may be put in motion it may be convenient to draw Blood in a small quantity from the Forehead or from the Temples by Leeches or from the Shoulder-blades by Cupping glasses with a Scarification Vesicatories have a chief place here not only to be applied to the Neck or Head but to the Legs and Arms and to other parts of the Body by turns Moreover let Spirit of Harts-horn of Soot or of Sal Armoniack impregnated with Amber Mans Scull Coral and other Cephalick things be frequently given with an appropriated Julep or other Liquor Forms of these and of other Medicines usual in these cases together with stories of sick Persons and examples of their Cures are to be found in the description of the foresaid sleepy Fever so that I need not here again inculcate the same or the like There remains yet another sleepy affect or kind of the Lethargy vulgarly called a Carus which being greater than the Lethargy and somewhat less than the Apoplexy is so allyed to this that it often passes into it but is wont to be distinguished from both for those that have the Carus for the most part breath well if at any time they are hard pinched they move their members sometimes raise up themselves open their Eyes and often speak which Apoplectical Persons do not do but the same tho stirred or roused up scarce understand or plainly discern any thing in which respect they are distinguished from those that have the Lethargy From what is said it seems to be manifest that the conjunct cause or morbifick matter of the Carus penetrates somewhat more deep toward the middle of the Brain and to have its seat at least in the outward border of the Corpus callosum and sometimes as that matter gradually advances from one part to another the Diseases before-mentioned successively arise and each last is only the encrease of the other But sometimes the morbifick cause without a gradual progress through those Parts at the first assault affects the middle part of the Brain and there as it sticks shallower or deeper causes a Carus or Apoplexy In which case it must not be thought that the whole circumference of the Corpus Callosum as also of the cortical part of the Brain is possest by the soporiferous matter for it suffices that rushing into any one place it has seized some part of the middle for thereupon presently in all that Region follows an eclipse or at least a prosternation of the Spirits The Prognostick of a Carus for the most part is ill especially if the Disease happens upon a malignant or long continued or a slow Fever not determined or on that which happens in Childbirth Nor is less danger threatned if it succeeds other Cephalick Diseases or is rais'd by reason of a wound in the Head though in these cases sometimes there is a Cure The event of this Disease either for death or recovery is wont to be various The Carus often passes into an Apoplexy which soon kills so that after the loss first of the animadversive faculty in a while a deprivation of sense and mortion and then by reason of the taint convey'd to the Cerebellum alterations of the Pulse and Respiration and in a short time Death it self follows But sometimes the morbifick matter sinking deeper and falling from the Corpus Callosum into the Corpus Striatum one or both together the Brain becomes a little clear so that the Diseas'd look about them speak and know things nevertheless in the whole Body besides the Palsey or Hemiplegia ensues Neither are thus things in safety as to Life for often when the Brain begins to be restor'd the Cerebellum is worse so that thereupon the Spirits which execute the offices of the Vital and meer Natural function being there ill affected either Convulsions in the Viscera and Praecordia or mortal lettings of the Pulse and respiration are caus'd tho sometimes when the morbifick matter is neither too redundant nor too malignant it is partly drank up again into the Blood and partly discuss'd so that the Diseased perfectly recover The Therapeutick method suggests the same intentions of Healing and indicates altogether the sanie Remedies which are wont to be used in the Apoplexy Wherefore it will not be needful to set down here Classes of Indications or to heap together a mighty mass of Medicines but that which seems more to the purpose I shall here propose a story or two of Persons diseased whereof I have a great many ready to relate A worthy man about forty years of age having lost his health through intemperance when he had begun to use I know not what Remedies prescribed by an Empirick fell into a Carus haply because the morbifick matter being stirr'd and agitated by the Medicine rush'd into the Brain Going to see him the second day I found him buried in a profound sleep and almost insensible for tho upon hard pinching or pricking he opened his Eyes and mov'd his Limbs yet presently falling asleep again he perceiv'd nothing at all of what he did or endur'd
to be within the same inward portion of the Brain viz. The Corpus Callosum as that of the Vertigo to wit in as much as in both affects the Imagination common Sense tho in a far differing degree are affected viz. in the former the irradiation of the Spirits is wont to be obscur'd in some places and to be inetrrupted with little Clouds as it were scattered here and there but in the latter the same is forthwith wholly darkned and undergoes a total Eclips The Apoplexy according to the import of the Word denotes a striking and by reason of the stupendous Nature of the affect as tho it contain'd somewhat Divine it is called a sideration for those that are seized with it as tho they were Planet-struck or smitten by an invisible Deity fall on the Ground on a sudden and being deprived of Sense and Motion and the whole animal function unless that they breath ceasing they lye dead as it were for some time and sometimes dye out-right and if they revive again they are oftentimes affected with a general Palsie or an Hemiplegia Tho it may seem a Paradox it is not disagreeing with Reason to say that the Apoplexy is two-fold and that one of them belongs to the Cerebellum and that the other has its seat in the midst of the Brain the former happens by reason of the animal Spirits design'd for the vital function being supprest in their very source viz. within the Cerebellum the motion of the Heart being often thereby letted or supprest as we have intimated before that this happens in some sort in the Incubus and doubtless to this cause ought to be attributed what I have observed in some that after a great heaviness in the Occiput a Swooning with a sudden privation of all the animal function ensues in which the diseased lye without Motion or Sense with a Pulse and Respiration greatly diminish'd and scarce perceivable and being all over cold for many Hours nay often a Day or two more resembling Persons dead than living We have sometimes known Persons so affected who have grown cold and stiff their Pulse and Respiration seeming wholly to be ceased and who have been really taken for dead and put in their Coffins yet after two or three dayes to have come to life again To enquire into the causes of the other and the wayes of its coming to pass we must first distinguish concerning the various Invasion of this Disease to wit how sometimes being raised from a sudden solemn and invincible cause without any previous Disposition or Procatarxis it is for the most part mortal against this no Procatarctick or preservatory Method can be ordered and the method of curing it which is ordinarily entred upon for the most part becomes ineffications or secondly an Apoplectick Fit having an antecedent Cause or a previous Procatarxis is brought into act through various Occasions or evident Causes As to the seisure of the former kind viz. being sudden and unawares its conjunct and immediate cause is either a great Solution of Continuity hapning some where within or near the middle of the Brain through which its Pores and Passages being obstructed or comprest all emanation of the Spirits is supprest or it is a great and sudden putting to flight or extinction of the Spirits residing in the Brain The things which are wont to cause a great solution of Continuity within the Brain are Blood extravasated an Abscess suppurated and broken and an inundation of a serous humour and tho this latter seldom or never happens of it self yet sometimes by reason of strong evident causes such a glut of serous filth rushes into the Brain that presently filling and stuffing all its medullary Pores it renders the Person speechless which I have known to have hapned to some upon sleeping presently after having drank too largely of small Wine and Spaw Waters I have observed the like affect upon a total and long continued suppression of Urine And in malignant Fevers the serous recrements by a critical Metastasis being conveyed to the Brain have often caused a loss of Speech with Death Of the evident Causes by which an extemporary Apoplexy is wont to be procured the other kind consists in a sudden profligation or extinction of the Spirits which strong Narcoticks and an immoderate drinking of hot-Waters often effect Thus much concerning the Causes of the accidental and extemporary Apoplexy which bring a fit of it on all Persons indifferently tho not predispos'd and wherefore there can be no Prophylaxis ordered and it is seldom that a Cure succeeds But we observe besides that this Disease sometimes is habitual viz. That there remains in certain men a constant Disposition by reason of which first slight Bickerings trouble them afterward by short intervals greater accesses come upon them of which for the most part they dye at last As to the conjunct cause of this Disease it consists in the sudden filling of the Pores of the Corpus Callosum and the destroying of the Spirits by the approach of a malignant matter It s procatarctick Causes are the like as in most other affects of the Brain viz. both the Blood is in fault that either engendring of it self or taking from elsewhere extraneous Particles and such as are very adverse to the texture or constitution of the animal Spirits and as it were extinctory of them it sends them to the Brain and moreover the fault of the Brain is that being weak in its Crasis and too lax and loosned in its Pores and Passages it always admits so easily and without resistance the morbifick matter obtruded from the Blood The Subject of this Disease being the Brain or the Cerebellum or both together the Brain is shewn to be most obnoxious to it by previous and frequent Scotomias and vertiginous Affects the Cerebellum is argued to be ill-disposed by a frequent Incubus an intermitting Pulse a Swooning and frequent Fainting The Prognostick of this Disease is never declar'd but fatal and dubious for an Apoplexy is never without danger either present or to come but the worst is in which besides all the spontaneous Functions being abolish'd the Pulse also and Respiration either fail or are carried on with much adoe and then for the most part it happens with a foaming at Mouth and a Swooning to which at length a sweat which most commonly is colliquative supervening foreshews that Death will happen very suddenly Those who being seized with the Apoplexy are deprived of Pulse and Respiration and a little after growing cold seem to be dead ought not presently to be taken forth of Bed or to be left without Physical Administrations moreover tho no hope of Life appears let them not be buried till after three or four dayes for such either of their own accord or by the use of Remedies sometimes revive which happens not by reason of the vital heat being raised up again in the Heart for it was not wholly destroyed here but for that the
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
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
vehemently by parts at length like Hay laid together wet after a long incalescence bursts forth all together into a flame through the violent boyling of the Blood at this time the Diseased complain of an intollerable thirst Moreover a head-ach obstinate watchings often also Deliriums a Phrensy and convulsive Motions molest them they loath all Food or cast it forth by Vomit or if happily it be retain'd being parcht by the too much heat it turns to a febrile matter there is also a bitterness in the Mouth an ungrateful savour a roughness of the Tongue a vehement and quick Pulse a Urine very ruddy for the most part troubled filled with contents without an Hypostasis or laudable sediment the Blood at this time being in a manner wholly kindled it engenders by its deflagration a mighty quantity of adust matter like the ashes remaining after a Fire whereby both the Serum being mightily fill'd yields a Urine that is thick and full of Contents and the Blood being loaded with it to a Turgescency is irritated into critical Motions wherewith that febrile mater if it may be being subdued and separated may be sent forth and this brings the height of the Fever in which judgment is given betwixt Nature and the Disease the contest being brought as it were to a tryal and therefore the evacuation which thereupon ensues is called a Crisis Therefore the height of a putrid Fever is that time of the Disease in which Nature attempts the expulsion of the adust matter remaining after the deflagration of the Blood to this are requir'd first that the Blood for the greatest part has past burning for in the midst of it Nature is not at leisure for a Crisis nor ever attempted it prosperously nor is it procur'd by Art with good success Secondly that the Spirit first in some manner subdue this adust matter of the Blood and separate it from that which is good and render it fit for expulsion Thirdly that this matter be heapt together in so great a plenty that by its Turgescency it irritates Nature to a critical Expulsion when either of those things is wanting the Crisis for the most part is of no effect and not to be relied on and seldom puts an end to the Disease A Crisis in a continual Fever is in a manner the same as the fit of intermittents for as in these when the mass of Blood is saturated to a fulness of Turgescency with the Particles of the nutritive Juice depraved and unfit for Maturation there happens a flowing secretion and expulsion of that matter so in a continual Fever after the deflagration of the Blood and nutritive Juice a great many Corpuseles of adust matter are heapt together with which the Blood being opprest when it is a little free from burning it subdues and separates them by degrees and then a flowing being raised endeavours to send them forth Wherefore as the fits of intermittents do not happen but at a set time and after so many hours so also critical Motions happen from the fourth day to the fourth or haply from the seventh to the seventh for in such a kind of space the Blood burns off and by its burning makes a heap of adust matter as it were of Ashes which being offensive to Nature causes critical Motions by its irritation Therefore as to what some say that the Crises depend altogether on the Influences of the Moon and Stars and that they follow their Quartile or opposite Aspects or their Conjunctions it is not true because critical Evacuations are determined only by the heaping together and Turgescency of the adust matter whose Particles if they can easily be separated from the Blood and the Pores of the Skin are open enough being involved in the Serum they are sent forth by sweat and this is the best way of a Crisis which if it succeeds well it often at one bout puts a perfect end to the Disease without fear of a relaps to this next succeeds that crisis which is attempted by an haemorrhagie for this matter as an Efflorescence arising with the Blood if by reason of an unfree perspiration it be not sent forth by sweat it is conveyed into some part remote from the Heart and is frequently sent into the Head by an impetuous sally of the Blood where if there be an open passage from the Sinus's spreading into the Nostrils the morbifick matter springs forth together with a portion of the Blood but otherwise often sticking in the Brain it brings a Delirium Frensy or other sore and lasting Diseases of the Head and it is to be observed that in almost any continual Fevers if at any time they come to an imperfect or difficult crisis so that the Blood is corrupted for a long time with a feverish matter or adust Recrements thereby the nervous Juyce as it seems comming to be tainted obstinate Affects viz. Watchings also Deliriums Tremblings Conlvulsive Motions and long sticking Weaknesses of the nervous Parts follow There are other wayes of Crisis's in which Nature endeavours to expell the febrile matter not at once and entirely but by little and little and by parts sometimes by Urine sometimes by Vomit or Seige sometimes by Pushes or Buboes which way soever it be done that it may be with good success it is requir'd that the deflagration of the Blood preceeds it and that the adust matter be concocted and rendred apt for separation Therefore the Height of the Disease is not one and simple nor always happens after the same manner but with a various diversity of Symptoms and with a tendency to events far differing now a prudent Physician must give his Prognostick in what space of time the Disease will come to its height and what event it will have If the Fever from the beginning be vehement and on a sudden pervades the whole mass of Blood with a burning if with the fierceness of Symptoms it presses in a constant and even manner without remission for the most part the Blood will so much burn off within four dayes that the adust matter which is to make a Crisis rises by that time to a plenitude of Turgescency but if the beginnings are slow and the accension of the Blood be often interrupted the Fever will come to its height about the seventh day if it begins yet more remisly the height of the Disease is wont to be protracted to the eleventh or fourteenth mean while it is to be noted that as the fits of intermittent Fevers return at set times so do critical Motions in such as are continual and for the most part they observe the fourth day for tho a perfect Crisis be prorogued to the fourteenth or seventeenth or haply to the twentieth day because all things requir'd to a full determination of the Disease do not concur yet in the middle space light motions happen with which the febrile matter rising by degrees to an increase is a little emptied and cut off as it were by parts till
mightily dread this Disease fall more readily into it for by Fear the Particles of the Miasm are convey'd from the Surface of the Body inward at the time that the Contagion is rife and the Small Pox is Epidemick all other Diseases in a manner degenerate into this 3. As to the Conjunct Cause of this Disease to wit what is the formal Reason of it or its way of coming to pass the thing seems a little more intricate It is vulgarly wont to be compared to the Effervescence of new Wine or of Ale when they are depurated in a Vessel being put in a Fermentation by the mixture of some heterogeneous Substance but if the thing be narrowly considered a great difference will here appear for the Miasm of the Small Pox is as a Ferment but corruptive and forces the Flood to ferment not towards a Perfection but a Depravation for when the venemous Particles of this Miasm light on a capable Subject they presently stir up Corpuscles like themselves and innate to us with which being joyn'd they pervade the whole Mass of Blood and make it grow mighty turgid and boyl and after some Effervescence to separate into Parts and to be coagulated to wit the dispers'd Seeds of the Venom dissolve the Mixture of the Blood presently subvert the more pure Spirits and afterward gather to themselves the more gross Particles of it and congeal them as it were by their Adhaesion The Portions so coagulated together with the Seeds of the Venom mingled with them being left by the rest of the Blood in its Circulation in the Extremities of the Vessels are fix'd on the Skin after which manner if Nature being strong enough sends off the whole Venom with the congeal'd Blood the rest of the Mass of the Blood tho depauperated is nevertheless good and capable of continuing Life but if the Blood being too much coagulated cannot be cleansed after this manner or if the Portions of the Blood closing with the Venom do not fully break forth they either restagnate inward again and wholly corrupt the Liquor of the Blood or fixing themselves on the Viscera and especially the Heart they destroy their Crasis and Strength The Portions of the Blood congeal'd with the Venom about the fourth day sometimes sooner sometimes later begin to break forth for the Coagulation is caused not presently but after some time that the Venom displays it self and by its Effervescence ferments the Blood first light Portions of the Blood being desil'd and those but few in number are fix'd in the Skin like Flea-bites soon after these more appear and those which brake forth first by the access of new matter and by the continual Appulse of the congealed Blood grow bigger and are rais'd into a Tumour afterward these Pushes which at first are red being encreased by degrees at length turn white to wit the Blood extravasated with the Venom by reason of the Heat and Stagnation is chang'd into a Pus About the seventh day after the Eruption the white Tumours turn to a dry Scab for the more subtle Part of the Matter being evaporated the rest grows hard which at length the Scarf Skin being eaten off and broken falls from the Skin When the Miasm of the Small Pox is once gotten into the Spirits and Mass of Blood it is very seldom that it can be destroy'd or clear'd off by Medicines or Bleeding but the latent Disposition will break forth into Act wherefore first it diffuses it self gently and inspires the Mass of Blood as it were with a Ferment hence an Ebullition and Effervescence are produced in the whole Body the Vessels are extended the Viscera are irritated the Membranes are twitch'd till the Seeds of the Contagion by fusing and coagulating the Blood at length being involv'd in its congeal'd Portions are thrust forth The Essence of this Disease will be the better known if I set down the Signs and and Symptoms which are observ'd in the whole Course of it and give you in order the Reasons of them and the Causes on which they depend Now these are either such as indicate the Disease present or such as fore-shew the height of it and its event As to the Diagnostick of this Affect whereby it may be known whether any one at first falling sick will have the Small Pox or not There must be considered at that time the force of the Contagion and the Concourse of the Symptoms first appearing for if by reason of the malignant Constitution of the Air this Disease generally reigns no one is then seised with a Fever without a suspicion of the Small Pox especially if the Person never had it before but if this Disease be more rare and there be no Fear of Contagion yet its unexpected Invasion in a short time discovers it self by these kinds of Signs and Symptoms 1. There is an inconstant Fever coming at random sometimes intense sometimes more remiss observing no set form of Increase or coming to a height so that the Diseas'd one while are mighty hot by and by without an evident Cause they are without any Fever the Cause of which is That the sermentative Seeds are not agitated with an even motion but like Fire half extinct one while they have an extraordinary Flash another while they lye quiet and dye as it were till the Burning spreading it self the Flame breaks forth every where 2. A Pain in the Head and Loins is so peculiar a sign in this Affect that it alone in a continual Fever signifies an imminent Small Pox the Cause of which is vulgarly imputed to the great Vessels being very much extended by the Effervescence of the Blood tho it does not appear why the same Pain should not be as well caused in other Parts by reason of the like Extension of the Vessels and why those kinds of Pains are rife in the Small Pox rather than in the Causon or other Fevers where the Blood boyls more Again you may observe that mighty Pains are pressing sometimes in the Head sometimes in the Brains when the Blood not being turgid the Vessels are not enlarg'd viz. in the beginning of the Disease when the Feverish Distemperature is not yet conspicuous while the Diseas'd are yet walking abroad and have a good Stomach the imminent Small Pox first discovers it self by these Pains wherefore it seems that the Cause of these kinds of Pains subsists rather in the Genus Nervosum to wit that those Pains arise in the Brain and spinal Marrow by reason of the Membranes and Nervous Parts being twitch'd by the Particles of the Venom for it is likely that the innate Seeds of the Small Pox are chiefly stored up in the Spermatick Parts and that the first Contagion of the Miasm for the most part seises the Animal Spirits hence the first Effervescence is raised in the Juice wherewith the Brain and nervous Parts but especially the spinal Marrow are irrigated and thence the taint is communicated to the Mass of Blood wherefore
began to nauseate him I prescrib'd after the following manner Take Powders of Tormentil Roots of Contrayerva Bole Armenick Alexiteriated of each a Dram Pearl Red Coral prepar'd White Amber of each half a Dram make a Powder the Dose is half a Dram in the following distill'd water Take Tops of Cypress and Myrtle of each four handfuls Leaves of Meadow-sweet Burnet St. Johns-wort Avens of each four handfuls Roots of Tormentil Bistort of each six Drams Red Rose-flowers four handfuls Kermes Berries four Ounces Cinnamon Mace of each one Ounce Being all slic'd and bruis'd together pour to them Red Florence Wine and Red Rose water of each four pounds distil all in a common Still let the whole Liquor be mingled and sweetned with Syrup of Coral He took also three or four times a day of the following decoction three or four Ounces Take Roots of Avens and Scorzonera of each an Ounce of Tormentil two Drams Hartshorn burnt and powdred six Drams shavings of Ivory and Hartshorn of each two Drams Tops of St. Johns-wort a handful Flowers of Red Roses and Balaustiae of each a pugil Boil all in three pounds of fountain water till it comes to two adding towards the end of the boiling of Red Lisbon wine four Ounces let it boil close cover'd for an hour then let it be strain'd through Hippocrates Sleeve Every night he took a Scruple of Liquid Laudanum in three Ounces of the Bloody Flux water ev'n now describ'd with three Drams of Syrup of Clove Gilly-flowers in it His common drink was a decoction of burnt Hartshorn with Barley a Crust of Bread Mace and Cinnamon to a Pint and a half of which a Pint of new Milk was added He took the Purging Infusion a second time by the use of which and the things before mentioned within ten days the Feaver left him and the Flux became much more gentle which though without Gripes or much Blood yet still continued with the little pieces of Flesh the fragments of Membranes and a bloody Phlegm or Gelly which daily came from him Therefore to strengthen and heat the intestines the following things were given Take Tops of St. Johns wort Leaves of Perwincle and Mousear of each a handful Red Rose Flowers two pugils Boil them in the Broath of a Sheeps Guts To a pound of the Liquor strain'd add Oyl of St. Johns-wort two Ounces Honey of Roses an Ounce and a half mingle them for two Glysters whereof one was given him in the Morning the other at five a Clock in the Afternoon He wore Emplast de minio Paracelsi upon him Belly He took moreover twice a day three Ounces of Juice of Plantain wrung forth with water of Scordium and Plague water He eat also every day a Quince made hollow and fill'd with the Powders of Olibanum Mastick and Balsam of Tolu and so rosted in the Embers By the constant use of these Remedies he grew perfectly well within a Month. About the same time another robust young man fell into a dreadful Bloody Flux from the first day he was seiz'd frequent stools and very bloody presently brake forth with violence being accompanied with a Pain and Gripes Moreover a strong Feaver with a cruel Vomiting Thirst and Wakings molested him These Symptoms being a little mitigated with Opiats a Delirium and a Vertigo with an intermittent Pulse and horrible extensions and contractions of his Limbs presently seiz'd him this hapning because the malignant matter which was inwardly restrain'd presently flow'd into the Brain and Nerves Nevertheless as often as the Looseness and Vomiting return'd these affects were presently appeas'd On the fifth day Vomiting up a bloody matter he complain'd of a great torture in his Stomach and of a Pain as though it were Ulcerated and in truth I suspected that there might be a beginning of some Inflam'd Blisters or Ulcers in it as it usually happens in the Intestines but by giving him Emollient Broths with Milk in them his Vomiting and the tortures of his Stomach soon ceased his Flux in the mean time encreasing He took that night of Diacodium an Ounce Cowslip water and small Cinnamon water of each an Ounce and a half by which Medicine he was so much reliev'd that in twenty four hours space his Vomiting and Pains left him and he was only troubled with a few Stools and having a good indifferent Pulse and frequent Sleeps he was pretty well yet the following night though he took again the same Opiate his Flux return'd and that with very frequent Stools and bloody as before The next day after he took an Infusion of Rhubarb with Mirobalans Red Saunders and Cinnamon He often voided Bilous and very sharp Excrements but without the least of Blood then in the Evening he took Liquid Laudanum Cydoniated twenty five Grains in a good spoonful of Cinnamon water hordeated he had moderate and quiet Sleeps Afterwards loathing any more Medicines he took only an Opiate every Evening sometimes of one sort and sometimes of another and in a short time grew very well CHAP. V. Instructions concerning Diuretick Medicines or such as work by Vrine with Diuretick Prescripts THe chief Scopes or ends of Diuretick Medicines are as follows First If at any time the Blood becomes so compact and tenacious from a fixt Salt Sulphur and Earth fermented together and mutually combin'd in it that the Watery Particles do not easily separate from the rest Diureticks fit to loosen its Texture and to fuse the Serum must be such as excel in a volatile or acid Salt for such Particles chiefly dissolve any coalitions caus'd by a fixt Salt But in regard this disposition is common both to a Feaver and the Scurvy in the former affect the most proper Diureticks are the temperate Acids of Vegetables also Sal Nitre the Spirits of Sea-Salt of Vitriol c. And likewise such as have a Volatile Salt as the Spirits of Hartshorn of Sal Armoniack Salt of Amber of Vipers and others of this kind which we have also rang'd amongst Diaphoreticks In a Scorbutick disposition when the Urine is but in a small quantity and thick the Juices of Herbs and preparations both of a sharp or tart and acid nature are of excellent use also Salt and Spirit of Vrine of Sal Armoniack of Tartar c. Secondly Sometimes the Blood does not retain the Serum long enough within its Body but either being obnoxious to Fluxions or rather Coagulations it deposes it here and there in a great abundance even more than enough whence it breeds Catarrhs or Tumours in many places Or the Blood being become of a weak habit and withal of a depraved constitution to wit inclining to a sourness its apt to coagulate as to its more gross Particles so that the more subtle Particles being every where thrown off in circulating and falling on the weaker parts cause sometimes distempers of the Head or Breast sometimes an Ascites or Anasarca And we shall hereafter shew how a Diabetes happens from
he fell at length into a confirm'd Diabetes as it seem'd and almost past hope of recovery For besides that in the space of twenty four hours he voided near a Gallon and a half of clear water and wonderfully sweet as though Honey were mixt in it He was moreover affected with a cruel Thirst and a Fever seemingly a Hectick with a mighty Languor of the Spirits a fall of strength and a Consumption of the whole Body I then prescrib'd him the following Remedies by the use of which he seem'd in a short time to recover Take Cypress Tops eight handfuls Whites of Eggs beaten two pounds Cinnamon half an Ounce being cut small pour to them of new Milk eight pounds distill it in an ordinary Still taking care of an Empyreuma Let him take six Ounces thrice a day Take Gum Arabick and Gum Tragacanth of each six Drams Penids an Ounce Make a Powder let him take about a Dram or a Dram and a half twice a day with three or four Ounces of the distill'd water Take Rhuba-b powdred fifteen Grains Cinnamon six Grains Make a Powder let him take it in the Morning and renow the Dose within six or seven days Take Cowslip water three Ounces Cinnamon water hordeated two Drams Syrup of Meconium half an Ounce Make a draught to be taken every Evening His Diet was only Milk which he took pretty often in a day sometimes crude or diluted with the distill'd water or with Barly water sowetimes boil'd with White-bread or with Barly Growing daily better by the use of these things within a Month he seem'd to be almost Cur'd As he began to grow a little well his Urine which was Insipid did not much exceed the quantity of Liquids he took and afterwards turning a little Salt it became less in quantity than what he drank and so by degrees recovering the wonted tone of his Spirits and a good strength he took to his former Diet. Nevertheless the disposition to this Disease did not so throughly cease but afterwards being apt frequently to Relapses upon disorders in Living and haply upon changes according to the seasons of the year he first made Water in a greater measure than ordinary which by degrees grew clear and sweetish a Thirst and Fever with a Languor of the Spirits accompanying it But by the use of the same Medicines he us'd in a short time to recover again Not long since after a large interval of health a little before he fell into a Flux of Urine he found great irregularities and failings in the Genus Nervosum viz. He was seiz'd with a dull numbness of his Brain and a Vertigo and was taken with sudden Cramps in his Limbs and felt little Leapings of the Tendons and various runnings about him as though it were of a wind creeping here and there And when by the use of fit Remedies the aforesaid Symptoms seem'd to be Cur'd the Diabetes after its wounted manner burst forth afresh viz. the matter flowing forth in abundance from the Fibres and solid parts into the Blood and thence to the Reins and the Urinary Passages In this Juncture the same Remedies were prescrib'd again by the use of which when within a few days he began to grow bettr he was ordered to take thrice a day Water of quick Lime to five or six Ounces Having continued this Remedy four days he made water in a moderate quantity well ting'd and somewhat salt and as to other things he seem'd well as he was before By the same method and chiefly with the Water of quick Lime I Cur'd another of a Diabetes who was look'd upon as past recovery The Kinds and Prescripts of Medicines that stop Vrine flowing in excess A Stringent Medicines properly so call'd to wit such as are austere acerb and stiptick do little or nothing in stopping a Diuresis for the vertue of those things has no effect on the Mass of Blood nor does it reach to the Reins and Bladder But the Remedies that chiefly do good in the Diabetes are of two kinds as we have hinted before viz. First those that hinder the combinations of the Salts and consequently the fusion of the Blood such as the Incrassatives before mentioned Secondly Those that dissolve the Concretions of the Salts and consequently restore the mixture of the Blood of which kind are Saline Remedies of a contrary nature which are apt to cleave to the Acid Salt and so withdraw it from the combinations it has entred into within the Blood as chiefly Medicines endow'd with a fixt volatile or alchalisate Salt Besides these two Primary kinds of Medicines that restrain Urine there rests a Secondary kind to wit Hypnoticks which putting some stop to the Animal Aeconomy cause the vital function to be perform'd with more calmness and consequently with less fusion of the Blood or precipitation of the serous and nutricious humours It remains now to set down some Select Forms of each kind of these Medicines I. The first Scope of Curing to wit by which we endeavour by thickning the Blood to prevent its fusion or to take it away is effected by the Medicines following Take Gumm Arabick and Tragacanth powder'd of each an Ounce Sugar Penids half an Ounce Make a Powder divide it into sixteen parts Take one part thrice a day dissolving it in the distill'd water or in the docoction of the Roots of Comphry in fountain water or Milk Take of the Resumptive Electuary three Ounces Species Diatragacanthi frigidi an Ounce Red Coral prepar'd two Drams Confection of Hyacinth a Dram and a half Gelly of the cast Skins of Vipers what will suffice Make an Electuary of which let the Patient take twice a day the quantity of a Wallnut Take white Amber Mastick Olibanum powdred of each an Ounce Pulvis Haly two Ounces Balsam of Tolu half an Ounce Make a Subtle Powder the Dose is half a Dram twice or thrice a day Take Roots of great Comphry and Water Lillies of each three Ounces Dates slic'd two Ounces Seeds of Maliows Cotton-plant Plantain Fleawort of each half an Ounce Boil them in four pounds of fountain water till half be consum'd to the straining add Syrup of Water Lillies two Ounces The Dose is four Ounces thrice a day Take of the decoction of Barly with Water Lilly-roots a pound and a half Sweet Almonds prepar'd an Ounce and a half Seeds of white Poppies Purslain Lettice of each half an Ounce Make an Emulsion according to art the Dose is four Ounces thrice a day Take Cypress Tops six handfuls Clary Leaves four handfuls Flowers of blind Nettles Comphry Water Lillies of each four handfuls Roots of Water Lillies and Comphry of each half a pound Mace an Ounce all being small slic'd together pour to them of new Milk eight pounds distil them in an ordinary Still The Dose is four Ounces thrice a day with the Powder of Electuary above written II. In the second place though Saline Medicines of every kind and condition are accounted Diuretick
and impurities by Sweat and Urine Respiration not only as it is urgent but moreover as the same is interrupted Convulsive or otherwise variously irregular often requires a Narcotick Medicine In a violent or very frequent Coughing always troubling us this uses to give relief before all other Remedies Again in fits of the Asthma when the Organs of Respiration are so laboriously exercis'd that the Person affected seems to be brought to the Agony of Death a Dose of some proper Opiat makes all things presently serene and calm Moreover in horrible Vomiting in excessive or violent Purging this usually gives great ease Fluxes can scarce be Cur'd without Opium not that this Medicine fixes the boiling and raging Juices and Humours but stops the Excretory Convulsions of the Fibres and that partly within the Cavities of the Viscera themselves it stupifying by its meer contact the Spirits there Implanted and partly by suppressing the Spirits within the Cerebellum which continually flow to those parts whereby the others being destitute of supplys from them readily remit of their Convulsive rage Fifthly In Catarrhs and Defluxions of all kinds we often fly to Opiats as to our last refuge they powerfully stay excretions of Blood and moderate and restrain serous Evacuations when at any time they are excessive and tend to a Colliquation They repress the Immoderate Ebullition of the Blood in a burning Feaver and lessen its excessive Accension Briefly they most readily appease all turbulent commotions in our Body from what cause soever they arise and let the Blood be never so much disturb'd they most commonly reduce it to a calm and quiet state Opiats where they agree most commonly fuse the Blood and after the manner of Alexipharmicks powerfully provoke Sweat and move Urine as Dr. Willis gives us here an Instance of a Person troubled with the Dropsy and severely tormented with Night-pains caus'd by the Pox who by the constant use of Laudanum fell at length into great Sweats and Evacuations of Urine every Night and so was Cured A Lady who for many years was subject at times to cruel pains of the Colick as often as she fell ill of that Disease and found the pains grow intolerable could get no ease from any Remedy but from Opium Wherefore she took a Dose of this each Night till the Morbifick matter being consum'd by degrees she became at length free from all grief and pain Of the evil Effects of Opium with cautions concerning its Vse WE have found by sad experience in many the Use of Opium to be sometime hurtful and destructive for that some presently after taking it have fallen into a perpetual sleep and others by taking a Dose of it too great or unseasonably have either shortn'd their Lives or by injuring their principal faculties have rendered it afterwards uneasie and burthensome I have known some who upon taking a Pill of Laudanum have fallen presently into so profound a sleep that they could never be rais'd from it they liv'd indeed for three or four days and as to their Pulse Respiration and Heat were pretty well but could never be brought again to sense and waking by any Remedies or tortures I have observ'd others who after taking Opium have slept but moderately nay sometimes little or scarce at all but as to their Pulse Respiration and Heat presently grew worse so that incontinently after the Medicine they began to have a failing of strength and then growing short and thick Breath'd to decay more and more nor could their vigour be renew'd by any Cordials but fainting by degrees they died I have elsewhere related a story of a robust man kill'd by Opium who had no sleep at all after it till his last and mortal sleep viz. Death it self following it this Man presently after he had taken the Medicine complained of a great heaviness upon his Stomack and of Cold then he was taken with a great Languor and a Consternation of all his Spirits with a coldness of his extream parts and within some hours complaining that his Eyes grew dim and at length that he was quite blind he died I shall now relate what evils from the improper or unseasonable use of Opium sometimes happen in the Head what in the Brest and what in the Belly As to the first it 's well known that the principal functions of the Soul viz. the Memory the Reason and the Acuteness of the understanding are very often extreamly injur'd by Narcoticks A frequent use of them weakens the Memory in many persons I knew a person who by taking a great Dose of it in a Feaver wholly lost the use of that faculty and after some weeks when the use of it began to return he remembred only things done within a peculiar tract of time and nothing of those that were done before or after I have known some that have grown dull and stupid by this Medicine and others that have grown mad And it 's observ'd that those Turks that eat much Opium though they seem to be well and not injur'd by it yet they are rendred more cold and their functions become worse they appear always as though they were drunk and besotted and are affected with a Coma or a continual inclination to sleep being stupid and unconstant sometimes affirming a thing and sometimes denying it so that they are unfit to deal or converse with men Secondly We find that Opiats are sometimes hurtful to the Precordia and Brest because they depress and lessen the Pulse and Breathing sometimes also as we have said before they make them faulter and by degrees wholly to cease Wherefore in Feavers when the Blood being mightily deprav'd seems to admit of no Crisis or not a good one and that at the same time it furnishes but very few and weak Spirits to the Animal Oeconomy Narcoticks are in a manner always destructive and as it were poysons For though in the Plague and Malign Feavers whilst the Pulse and Respiration are strong Treacle Mithridate and Diascordium nay and Laudanum are often given with good effect yet if at any time in those Diseases and in other Feavers that do not carry so much malignity the vital faculty languishes those famous Antidotes must be us'd but very sparingly and the stronger Opiats not at all Moreover in a violent Cough the Phthisick Plurisy Empyema and other Diseases of the Brest viz. in what ills soever nature is stirr'd up to discharge it self on a sudden of that which is offensive and oppresses the Brest and lifts at it with its greatest effort and at the same time the Organs of Respiration being destitute of a sufficient plenty of Spirits faulter and perform their work with great pain and difficulty we must in such a case forbear Opium no less than poyson for then Narcoticks increase and fix the weight to be remov'd and lessen the strength of the parts that labour to throw it off Thirdly As to the parts within the Belly we find that Narcoticks often taken
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
First of one troubled with a simple Cough which begins of it self and is free from the suspicion of a Phthisick Some years since I took care of the Health of a Student who from his Childhood had been subject to a Cough and was wont often to undergo severe fits of it and of long continuance he seem'd to be of a pretty strong Constitution only that his lungs being originally weak suffer'd much whenever his blood began to run into serosities in summer as long as a free perspiration lasted he was sound enough but spring and fall when the blood changing its temper either of its own accord or upon some slight occasion offer'd falls into serous fluxions he fell lightly into a Cough accompanied with abundance of thick spittle yet this affect very often vanisht by degrees within six or seven days without any great adoe with Medicines assoon as the mass of blood was purg'd by the lungs But if to the said slight occasion of this Disease other greater Causes were added as chiefly the stoppage of the Pores and errours in Diet sometimes a most violent and obstinate Cough came upon him not soon nor easily yielding to Remedies and threatning nothing less than a Phthisick Then growing ill indeed for the first days he had light shiverings in his whole Body and perceiv'd a Catarrh in his Larynx Afterwards he was troubled with a frequent Coughing accompanied with a thin spittle together with a giddiness deadness of the senses and a dropping at the Nose In this state his best Remedy and often try'd with good success was to drink Sack somewhat freely and as little of any other Liquor as might be for by this means the Acidity and flowing of his Blood being supprest and a more free perspiration rais'd he sound himself very much eas'd and sometimes in a very short space grew well Moreover going to Bed and first in the Morning he us'd to take seven or eight drops of Tincture of Sulphur in a spoonful of Syrup of Violets or of the Juice of ground Ivy Or Take Conserve of red Roses four Ounces Spirit of Turpentine two Drams Mix them the Dose is the quantity of a Chesnut Evenings and Mornings But if these Remedies together with the Canary Antidote and a thin Diet do not do the Disease not being Cur'd by such means runs then to a great length and following him sharply for some Weeks and sometimes Months brings the Diseas'd to a mighty leanness and even to the brink of the Grave For the Cough growing daily worse and very troublesome hinders sleep mightily and interrupts it his strength languishes his appetite is dejected heat and drought press hard upon him In the mean time the Spittle is daily increas'd and cast forth in a vast quantity so that afterwards not only the Serum and dreggy Excrements of the Blood but even the nutritive Juice and the wastings of the solid parts being continually pour'd on the Lungs turn into corruption which is Cough'd forth in abundance but respiration grows difficult the Limbs very weak and the Flesh consumes very much When our Patient was lately ill in this manner we prescrib'd the following Method and Remedies by the continued use of which he at length recovered In the first place a thin Diet being ordered him and Ale or Beer wholly forbidden he took of the following Apozeme about four Ounces twice a day warm and a little of it at other times cold to quench his thirst Take China Roots two Ounces Sarzaparilla three Ounces white and yellow Saunders of each an Ounce shavings of Ivory and Hartshorn of each three Drams Infuse them according to Art and let them boil in eight pounds of fountain water to half adding Raisins of the Sun three Ounces Licorice three Drams Strain it and let it be us'd for ordinary drink Take Tincture of Sulphur three Drams Let him take from seven drops to ten going to rest and early in the Morning in a spoonful of Syrup of Violets or of Syrup of the Juice of ground Ivy. When by a long use of this Medicine he began to loath it the following Eclegma was ordered in its stead Take Conserve of red Roses four Ounces Spirit of Turpentine two Ounces Mix them by bruising them together the Dose is about a Dram at the same hours Afterwards instead of this the following Powder was sometimes taken Take Powder of the Leaves of ground Ivy prepar'd in the Summer Sun three Ounces Sugar Candy half an Ounce Mix them the Dose is half a spoonful twice a day with three Ounces of the following distill'd water Take Leaves of ground Ivy six handfuls Hyssop white Hore-hound of each four handfuls the Lungs of a Lamb half boil'd and slic'd small pour to them of Posset-drink made with small Ale eight pounds distil it in common Organs Let the whole Liquor be mingled and when it is us'd sweeten it at pleasure with Sugar Candy or Syrup of Violets To appease the almost continual toyl of Coughing he swallowed now and then the following Troches or a little extract of Licorice Take Species Diatragacanthi frigidi three Drams Powder of the Seeds of Annise Caraway and sweet Fennel of each half a Dram Flowers of Sulphur two Scruples Flowers of Benzoin a Scruple extract of Licorice diluted with Hyssop water what suffices Make a Paste and form it into Troches Or Take Species Diaireos è Pulmone Vulpis of each two Drams Flowers of Sulphur Roots of Elecampane of each half a Dram Oyl of Anniseeds half a Scruple Sugar dissolv'd in a sufficient quantity of Pennyroyal water and boil'd to a consistency for Tablets six Ounces Make Tablets according to art weighing half a Dram let him take one as often as he pleases swallowing it by little and little In the midst of this Course though he had a weak Pulse and was of a cold temperament he was let Blood in the Arm Besides these Remedies a great benefit accrued to him from the fresh Air which he took daily either on Horseback or in a Chariot For by this he first began to recover his Appetite Digestion and Sleep which afterwards were followed by degrees with an abatement of the other Symptoms so that at length he perfectly recover'd He has us'd a method like to this and with the like success as often as till this time he has been troubled with a tedious and stubborn Cough and now though he be wholly free from that distemper yet he is forc'd carefully to avoid all occasions by which the Pores are stop'd or by which a Fusion or Precipitation of the Blood into Serosities is rais'd such are chiefly his going by Water on the Thames and his drinking Acid Liquors as Cider French or Rhenish Wines The foregoing Relation gives you a Type and way of Curing a Cough caus'd through the fault of the Blood and not reaching the limits of a Phthisick Now follows another which Illustrates the nature of the same affect when it proceeds chiefly from the
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
Prunella or Sal Armoniack from a Dram to a Dram and a half Make a Glister Take of the Vrine of a sound Man a pound Sal Prunella a Dram Venice Turpentine dissov'd with the Yolk of an Egg an Ounce and a half Make a Glister 2. Dinreticks If any other Remedies premise help in this Disease Take live Millepedes cleans'd three Ounces one Nutmeg slic'd being bruis'd together pour to them of the following Diuretick water a pound express it strongly The Dose is from three Ounces to four twice a day Take of the green Berries of Juniper and Elder of each six pounds Firr tops four pounds green Wallnuts two pounds Winters Bark four Ounces the outward Rinds of six Oranges and four Limons the Seeds of Ameos Rocket and Water-cresses of each an Ounce and a half Dill-seeds two Ounces being slic'd and bruis'd pour to them of Whey made with Whitewine eight pounds distil it with common Organs Let all the Liquor be mixt Take Crystal Mineral half an Ounce Volatile Salt of Amber two Drams Powder of wild Carrot-seeds a Dram Venice Turpentine what suffices Take small Pills take three at Night and in the Morning drinking after it of the foresaid water three Ounces Take sweet Spirit of Salt half an Ounce give from eight drops to twelve twice a day with a Draught of the same water adding Syrup of Violets a spoonfull Take Spirit of Salt of Tartar an Ounce give from a Scruple to half a Dram twice a day after the same manner So also Spirit of Nitre and Tincture of Salt of Tartar may be given Take Leaves of Plantain Chervil and Clivers of each four handfuls being bruis'd together pour to them of the former distill'd water a pound express it strongly The Dose is three Ounces twice or thrice a day with some other Medicine Take Grass Roots three Ounces Roots of Butchers-broom two Ounces Chervil and Candied Eringo's of each an Ounce shavings of Hartshorn and Ivory of each two Drams burnt Hartshorn two Drams and a half Burdock-seeds three Drams boil them in three pounds of fountain water to two pounds In the warm straining put Leaves of Clivers and Watercresses bruis'd of each a handful adding of Rhenish Wine six Ounces let there be a close and warm Infusion for two hours then strain it again and add of the Magisterial water of Earth-worms two Ounces Syrup of the five Roots an Ounce and a half make an Apozeme the Dose is four Ounces twice a day with some other Medicine Whilst these things are taken inwardly let Topicks also and outward applications be carefully Administred not such as are hot and discussing but such as are endow'd with Particles of a Volatile and Nitrous Salt which destroy the combinations of the other Salts and make void the efforts of the Spirits for which ends we propose the following things If Fomentations ought to be us'd at all let them not be apply'd too hot and let them not be prepar'd of the vulgarly call'd Carminatives but chiefly of Salts and Minerals Cabrotius quoted by Helmont says he Cur'd a Person eighty years of Age whose Belly he somented twice a day with a Lixivium in which he boil'd Salt Allum and Sulphur and after apply'd Cow-dung for a Cataplasm I use to prescribe as follows Take Flowers of Sal Armoniack an Ounce Crystal Mineral two Ounces small Spirit of Wine containing much Phlegm in it two pounds Mix them and dissolve them in a Glass Let a Woolen Cloath dipp'd in this warm be apply'd on the whole Abdomen and be chang'd now and then dipping it afresh Let it be done twice a day for half an hours space afterwards let there be apply'd either a Cataplasm of Cow-dung with the Powder of Dogs-turd or the Plaister following Take Emplastrum Diasaponis that is of Minium with Venice Soap what suffices Let it be thin spread on thin Leather and apply'd to the whole Belly renewing it within ten or twelve days The Second Indication requires chiefly altering Medicines viz. such as put a stop to the Fermentations of the humours in the Viscera of the Belly and to the wild Efforts and irregular excursions of the Spirits and which likewise procure the even mixtures and due motions of the Chyle and Nervous Juice For which ends Chalybeats are principally us'd and truly not only for this Disease but for many others belonging to the Viscera of the Belly it 's usual to have recourse to Steel Medicines though in the mean time many Empyricks confidently prescribing them do not consider after what manner such Medicines work or what alterations for the better may be expected from them And indeed it very often falls out that nature her self is destroyed and not the Disease when Chalybeats of which there is a great variety and of diversified Operations are given without any distinction or choice or without respect to the Temperament Constitution and state of the Disease in Patients We have treated elsewhere ex professo concerning Medicines prepar'd of Iron and Steel and of their vertues and manners of working so that it 's needless to repeat the same here As to this Disease if any of them are proper for it certainly they are not all For those in which the Sulphur still remains and being free predominates over the other principles after that the texture of the mixt Body is open'd must be wholly excluded from this number for by their powerful fermentation they greatly ferment the Juices of the Viscera and put the Blood and Spirits in such a Commotion that the whole Region of the Belly is puft up in a greater Bulk as though some Spirit rush'd violently into it Nor are those more proper here from which the Sulphureous Particles are wholly driven away with the Saline as in Crocus Martis prepar'd by a very strong and long Calcination for as this Medicine is good to stay all fluxions so it sixes more any Impactions of Spirits and humours and renders them more obstinate But there remains a Martial Remedy of a middle kind in which the Sulphur being wholly or for the greatest part expell'd the Vitriolick Salt remains and has for the greatest part the Predominancy as it has in a Solution of the Filings of Iron or in its Infusion either simple or in Mineral waters in Salt or Vitriol of Mars in our preparation of Steel with many others preparations and compositions of which have been often found by experience to have done great good in some cases for these destroy the Exotick and restore the Genuine Ferments of the Viscera open their Obstructions fix the Blood and keep its Texture from much dissolution Wherefore Chalybeate Medicines as also some other Alteratives have haply some effect against the Procatarctick and more remote Causes of a Tympany but do little or no good at all against its Conjunct Cause Take of our Steel ground very fine two Drams of the Distill'd water above written two Pounds Syrup of the five Roots two Ounces mix them in a Glass
succinated or of Soot from twenty to twenty five Drops Or Tincture of Salt of Tartar from half a Dram to a Dram. So much of Hydragogue Medicines to be taken inwardly which cause waters to be evacuated either by drawing them inwardly towards the Intestines or by driving them out to the Reins or to the Pores of the Skin Moreover there are certain outward Administrations us'd by which waters gather'd together within the habit of the Body are put in motion and so dispos'd either generally to pass off by Sweat or Urine or particularly are presently let forth a Vent being made in some peculiar places In the first rank we place Frictions Liniments Fomentations Baths both dry and moist And particular things to evacuate waters are Vesicatories Escharoticks and prickings by a Needle I shall speak of each of these or at least of the chief of them as far as they regard this Disease Frictions prove often of good effect in a Leucophlegmatia and an Anasarca For as the habit of the Body is not only so charg'd with a Glut of filthy waters there heapt together that nothing can breath through them but even the outward parts grow cold upon the Blood 's being hindred of an access to them frequent and strong Frictions give a motion to the stagnating waters and in some measure dissipate them from thence and by opening the passages call again the Blood into those parts whence it was banisht wherefore it is good not only to rubb the swollen Member but even the whole Body once or twice a Day with a course Cloath or with a little brush now commonly made for that purpose In rubbing or after it Liniments and Fomentations are somtimes proper They are prepar'd either of Salts and other Minerals dissolv'd or of hot and discussing Vegetables boil'd with Lees of Wine in water and being apply'd hot open the Pores give a farther motion to the accumulated Waters and discuss them and enlarge the compass of the Blood 's circuit the watery Mass being in some measure dissipated The Liniments consist of Sulphur and Salts of divers kinds or of Quick-lime and other Minerals which being powdred and mixt with the Mucilaginous extracts of Smart Herbs are made into an Ointment To which for their better consistency let a fit quantity of Oyl of Scorpions be added Nay this Oyl apply'd by it self so it be right gives often great relief I knew a Boy swollen very much with an Universal Anasarca who was Cur'd by this only Remedy For his Mother I know not how advis'd anointed his whole Body Mornings and Evenings with Oyl of Scorpions chafing well the parts with her warm hand Upon which within three Days he began to make a vast quantity of water and having continued to make water so for some Days the swelling vanishing by degrees he grew well Baths are scarce proper for any Dropsie but an Anasarca nor for this but in the first Disposition to it or as it goes off For since by the heat of Baths encompassing the whole Body the Blood being made very hot and instigated puts the waters every where in motion which were stagnating before and drinking them into it self conveys them sundry ways there is danger lest as it frequently happens receiving them from the habit of the Body into its Mass it presently deposes them in the Praecordia or the Brain for there is nothing more usual than that the affects of those parts viz. an Asthma or Apoplexy happen to Hydropical persons after bathing But when the conjunct cause of the Disease viz. the swelling is moderate or not very great a Bath of water impregnated with Salts and Sulphur or also a hot-house promoting a gentle Sweat are often us'd with good effect Instead of a hot-house it 's better that the Patients be plac't in some convenient Cells in a Salt-house near the Furnaces in which the Mineral water is boil'd into Salt which often proves of mighty benefit to them Vesicatories let forth the waters betwixt the Flesh and the Skin in a plentiful manner and somtimes too profusely these are to be apply'd to Hydropical persons with very great caution for such an Epispastick apply'd to swollen places makes a vent too wide upon the opening of which the water first breaking forth often draws after it from the whole Neighbourhood a great Glut of it whence presently follows a great Consternation of the Spirits Moreover somtimes the place so drain'd on a sudden being depriv'd of Heat and Spirits in a short time becomes mortifyed Wherefore this Medicine is seldom apply'd to the Leggs or Feet of hydropical persons where the neat is weak and the swelling very great but somtimes to the Thighs and Arms with security when need requires Escharoticks are apply'd somwhat more safely to the swollen Places than Vesicatories because the Flux of waters out of this Vent is not so violent and in such Abundance presently at first But beginning moderately it grows after by little and little to a great Current which nature after being accustom'd to it by degrees bears better Moreover there is less danger of a Gangrene after an Escharotick than after a Vesicatory because in that Application the part whose Union is dissolv'd is fortify'd by the Eschar against the loss of heat I knew an illiterate Empyrick who often by an Echarotick successfully evacuated the Members of Hydropical peasons though never so much swollen after the following manner viz. First he fomented their Leggs Morning and Evening with a Decoction of Dwarfe-elder Wormwood Camomill and other hot Herbs the Lees of Wine or Ale being added to them and betwixt the times of fomenting he apply'd a Cataplasm made of the Faeces of that Decoction with Bran After these things had been us'd three Days he covered both Leggs and Feet with a Plaister of Burgundy-Pitch leaving only a small hole on each Calf to the bigness of a small Nut in which places he put an Escharotick of the Ashes of Ashen Bark to the naked Skin which being remov'd after twelve hours a small Eschar was left out of whose Pores the Matter first Sweated gently then daily distill'd forth somwhat more freely and at length the Eschar falling off it flow'd forth in a plentifull Stream as from an open Source till it was drawn from the whose Legg both above and beneath There remains yet another way of drawing forth waters from betwixt the Flesh and the Skin not inferior to the former though less in use viz. by the pricking of a Needle Which also much be done very cautiously and by little and little lest a head-strong and excessive Flux of waters be rais'd by it Take an ordinary Needle such as Taylors use and prick the Skin over with it in the place most swell'd but let it not enter so far as to draw Blood and so make six or seven little holes at a time about an inch distant the one from the other The water will Issue by drops forth of each little hole
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
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
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
let the Patient keep himself quiet with his Head in an upright posture then let the Joynts of his Arms and Thighs many of them together but not all of them be bound with strait Ligatures which must now and then be loosn'd and remov'd to other parts for upon their being bound all at once and so continued a long time I have known that terrible Swoundings have happen'd by reason of the Bloods being detain'd in the outward parts and kept too much from the Heart Though otherwise this Remedy being prudently administred gives often relief For since by this means the Blood which passes into the Members by the Arteries is hindred from its quick return by the Veins its violent taking to the head is stay'd Moreover by the painful Ligatures of the Joynts the Muscular Fibres of the Carotide Arteries from whose Branches the Blood issues at the Nostrils are freed from the Convulsion which they often fall into 2. To withdraw the course of the Blood from the Nostrils sometimes it 's proper to open a Vein in the Arm or Foot for the more Blood is carried by the Arteries to the place where a Vein is open'd the less will flow to the Nostrils Yet this Administration does not always prove so successful but its contrary effect sometimes happens as we have observ'd before where we treat of Spitting Blood The reason whereof is that the Vessels being suddenly and not sufficinetly emptryed draw into them again the disagreeing Homours before ejected and stagnating within the Pores by which the Blood is presently stirr'd up again to a greater Turgescency for Eruption 3. Cold things apply'd to the Forehead and Temples also to the Nape of the Neck where the Vertebral Arteries ascend constringe the Vessels and somewhat repress or repel the Flux of Blood But it is ill done of some who advise topical coolers to be apply'd to the Jugular Veins for this retarding the course of the Blood in its return causes it to flow more plentifully out at the Nostrils Moreover as to the usual way of applying a Linnen-cloath or a Spunge dipt in Vinegar to the Share and Genitals it gives relief only as a Ligature of the Members viz. in as much as it hinders the return of the Blood of the Veins A sudden and unexpected Sprinkling of cold water on the Face by striking a Terrour often stops an Eruption of Blood 4. Cupping-glasses applyed to the Hypochondres Flanks inward parts of the Thighs and to the Soles of the Feet have been accounted both by Ancient and Modern Physicians a famous Remedy for withdrawing an Eruption of Blood from the Nostrils 5. Frictions of the extream parts are commended in this affect by some Practitioners which nevertheless we judge not so very good nay scarce safe For though they cause a greater confluence of Blood to the Hands and Feet yet they so accelerate its return that it endangers a more violent Sally of it to the Nostrils 6. Zacutus Lusitanus among Revulsory Remedies proposes an actual Cautery to be apply'd to the Soles of both Feet and Crato the bending of the little Finger of the same side which last you may do well to try in regard it is done easily Though I do not advise so of the other Remedy unless the Cure by it were more certain which might recompence the Pain and Lameness that will ensue 7. A Swounding by what means soever caus'd stops presently for the most part an Eruption of Blood be it never so refractory Wherefore when persons seiz'd with an Eruption of Blood and grown weak by it are pull'd out of Bed or if Blood be taken from them though in a small quantity by opening a Vein they apprehending a danger in it or if their Members are long bound or they are suddenly put in a fright with some feigned Rumour and upon any other occasion fall into a Swound or a Fainting Fit the Eruption of Blood from the Nostrills presently ceases The reason whereof it evident enough because as soon as the Motion of the Heart fails both the Blood and Spirits presently rush thither so that all outward Effusion is incontinently stopt and that which before was immoderate does not begin afresh 8. In the last place we must take a view of those Remedies for repressing an Eruption of Blood from the Nostrils which are said to work after an Occult manner and by Sympathy and Antipathy Of which kind chiefly are the Sympathetical Powder made of Roman Vitriol Calcin'd to whiteness by the Sun in the Summer Also a piece of the Wood of a Maiden or young Ash cut about the moment that the Sun enters Taurus The efficacy of which Remedy is attested by many credible witnesses to have been prov'd in stopping Eruptions of Blood in wounded Souldiers during the late Civil Wars So a dry'd Toad sewed up in a Silk Bag and worn on the Pit of the Stomack is said to stop any Flux of Blood and to prevent its return There are many other famous Medicines for stopping Blood whose operation is wont to be referr'd to Occult causes and to some secret Vertue As Neck-laces of the Blood-stone worn about the Neck also Vsnea or the moss of a Mans Skull carried in the hand Epithems of the Leaves of Netles stampe and apply'd to the Soles of the Feet and the Palms of the Hands which Empirical Administrations being to be try'd without trouble or charge we have no reason to reject them especially since in a dangerous case we ought to leave nothing unattempted and in regard that those applications may do good sometimes in this respect that they fortify the imagination of the Patient Whilst these outward Administrations are us'd for repelling or withdrawing the Flux of Blood from the Nostrils let Topicks also be put into the Nostrils to close the Gaping Mouths of the Vessels for which use Injections of Liquid things Pledgets Powders to be blown in and Fumes are wont to be prescrib'd which failing of effect we must come at last to Escharoticks 9. Amongst Liquids a Solution of Vitriol made in fountain water is accounted not only the chief but as good as all the rest Some boast of this as of a great secret and an infallible stopper of Blood Indeed the same apply'd to a fresh Wound for as much as by corrugating the extremities of the cut Vessels it closes them it keeps back the Flux of Blood and powerfully stops it But in regard in an Eruption of Blood from the Nostrils where the Blood is convey'd to the gaping Mouths of the Arteries and ought to be receiv'd by the Veins this application closes these as well or rather than those it does here little or no good at all as I have often known it try'd This Medicine is prepar'd of green Vitriol viz. the Hungarian or of that of our own Country also of the Factitious Vitriol of Mars dissolv'd in a sufficient quantity of fountain water I know some commend a Solution of Roman Vitriol which they
intimated before As to others that are not so weak we say thus those whose Blood has not an easy Transpiration by reason of the Constipation of the Pores and upon its being put in a stronger Motion by the heat of the Bed is dispos'd to greater Turgescencies and to Eruptions it will be good for them not only to stay out of Bed while Bleeding but likewise sometimes to be cool'd by outward Applications in the whole habit of the Body or at leastwise in most of its Members Wherefore Fabritius Hildanus relates how he presently Cur'd one of a violent Bleeding at Nose after many ordinary Remedies try'd in vain by putting him into a Vessel of cold water with the like success also Riverius having ordered another affected in like manner to be taken forth of his Bed and laid on a Woolen Rugg in the Floor fomented his whole Body with Linnen-cloaths wetted in an Oxicrate Yet this method is not generally proper for all Persons and at all times But on the contrary those whose Blood being of a free Transpirable disposition and enjoying open Pores readily evaporates and is wont upon any moderate ambient heat to be resolv'd into Sweat and consequently to become more calm it 's good for such to continue in Bed not only whilst Bleeding but as long as that Eruption is in danger of returning in a short time after For this reason it is that many Persons subject to violent Eruptions of Blood live free from that Distemper during the Summer whilst they have a free Transpiration but when the cold of the Winter presses them their Pores being stopt they undergo more frequent and dreadful Fits of it 3. The third Indication being for Preservation which regarding the removal of the cause of the Distemper either hinders the Eruptions of Blood or renders them less frequent or less considerable suggests to us these two chief intents of Curing viz. First that the Blood being restor'd to its due Temperament and Mixture be quietly circulated within its Vessels without Turgescencies and Eruptions And Secondly that the Blood Vessels be kept in their due State as to their Conformations of their little Months and the Tones of their Muscular Fibres so that those Vessels neither cause those disorderly Sallyes of the Blood to the Head or give way to its Eruption from the Nostrils For both these ends in the first placelet the Redundancy of the Blood and its great foulness be provided against by a seasonable Administration of Phlebotomy and Purgation and then forprocuring and preserving its right Temperament let the following Alteratives be given in fit seasons for Physick Take Conserve of red Roses and of the wild Rose of each three Ounces Powder of all the Saunders of each half a Dram of Coral prepar'd a Dram of the reddest Crocus of Mars two Drams Sal Prunella four Scruples With a sufficient quantity of Syrup of Coral make an Electuary take early in the Morning and going to Bed the quentity of a Chesnut either by it self or Drinking after it of the following distill'd water three Ounces Take of the tops of Cypress and Tamarisk of each eight handfuls tops of St. John ' s-wort and of Horse-tayl of each four handfuls all the Saunders bruis'd of each an Ounce Pith of White-bread two Pounds being slic't very small pour to them of New-milk eight Pounds distill it with common Organs Sweeten each Dose as you take it with a sufficient quantity of the Syrup of the Juice of Plantain Take Leaves of Plantain Brooklimes and stinging Nettles of each four handfuls being bruis'd pour to them of the foregoing water half a Pound small Cinnamon water two Ounces express it strongly the Dose is three or four Ounces in the Morning at nine of the clock and at five in the Afternoon Let Medicines of this kind be taken Spring and Fall for twenty or thirty Days giving sometimes a gentle Purge between whiles But in the Summer let Mineral Chalybeat waters be Drunk for a Month than which there is not a more excellent Remedy in this case I shall now give you an example of one Cured of an Eruption of Blood whose case was somewhat particular I was lately sent to for advice for a Gentleman living far off who had been troubled a good while with frequent and violent Eruptions of Blood sometimes from the Nostrils sometimes from the Heamorrhoids this person had been often let Blood by the advice of his friends but found no good thereby nay most commonly after opening a Vein falling into cold Sweats and Swounding Fits and still as liable to Eruptions of Blood he was wont to be much worse To this Person not having seen him I prescrib'd Julapes and cooling Decoctions and Anodyns also Juicy expressions of Herbs and other things to cool the Blood but these things also as though all yet were far from the makr had nothing a better success at length being call'd into the country to see him I found the affect with which he was seiz'd to be meerly or chiefly Convulsive for the Blood breaking forth daily his Pulse was weak his Extream parts cold and all the Vessels were fallen as though too much emptied Moreover the Patient was troubled with a continual Giddiness and a Trembling of the Heart and was taken now and then with Swounding Fits or with the apprehension of it Truly it was so far from it that the Blood should break forth of the Vessels by reason of any Redundancy or Turgescency that rather on the contrary its Current was so extreamly low and small that it seem'd scarce able to maintain the Stream of Circulation But the thing was that often in a Day he sensibly pervceiv'd somewhat on a sudden to pass privately sometimes up and sometimes down his Body like a wind and for the most part an Eruption of Blood from the Nostrils or Haemorrhoids followed the Tendency of that Motion So that it was easy hence to conclude that the moving Fibres of the Blood Vessels by which they are contracted being seiz'd with Convulsions drew suddenly every way in a disorderly manner the Stream of the Blood as small and low as it was and forc't it now and then to an Eruption Which also was the easier done because the Lax and Gaping Mouths of the Vessels permitted the Blood driven to them to flow forth without any due stay A Method of Cure ordered pursuant to this Aetiology confirm'd it by its good success For Bleeding and the use of Blood-stopping Medicines being thenceforwards omitted I prescrib'd the use of the following Powder whereof he took a Dose every sixth hour with a proper Julape Take Powder of the Roots of Male Peony red Coral and Pearl of each a Dram Ivory Crabbs Eyes Blood-stone of each half a Dram Sal Prunella a Dram make a Powder the Dose is half a Dram. Take black Cherry water eight Ounces Balm water and small Cinnamon water of each two Ounces Treacle water an Ounce Syrup of Coral an Ounce and
irritated a Watery Humour fill'd with Fiery Particles and therefore rejected both from the Blood and from the Nervous Juice is voided in a great abundance That Lympha because it cannot pass through the Scarf-skin separates it from the Skin and raises it into a Blister Hence it will be easy to understand after what manner Vesicatories perform their operation viz. Cantharides and so all other things of the same vertue being outwardly apply'd and coming to be made warm by the Effluviz's of the part they lie on and so stirr'd up to exert their force emit from them a great plenty of Smart and Fiery Particles as it were which penetrating the Scarf-skin without breaking it strongly fix themselves in the Skin Where sirst they act on the Spirits and then by their means on the Humours and Solid parts Those Particles very much irritate the Spirits and make them cause painful Convulsions of the Fibres and they fuse the Humours and make them separtate into parts so that the Watery part being mightily fill'd with those Smart and as it were Venemous Particles is thrown off on every side by the rest of the Latex And the extremities of the Vessels and Fibres being either in the mean time Eaten away by Burning or open'd and emulg'd as it were by Twitching that Ichor is voided in a plentiful measure from their little Mouths carrying with it the offensive Particles Which Ichor afterwards separates the Impervious Scarf-skin from the Skin and raises it into a little Blister And after this is broken and remov'd is plentifully voided for some time from the Ulcerated Skin But this is not only so done because the Serous Latex inbibing the Smart Particles of the Medicine and conveying them forth does not always carry them back all the same way that they came in but sometimes being imbued with those Particles it regurgitates into the Mass of Blood and afterwards being circulated with it and voided with its offensive Load by other Emunctories it offends in its passage or as it goes forth certain weak or tender Ductus's Hence many after the use of great or many Vesicatores having their Urinary passages thereby affected with an Acrimony or Erosion get a Strangurie which in some is most sharpe and intolerable Again in others troubled with the Stone that application sometimes causes Bloody Urine Hence also it may be suspected that tender Lungs or such as are inclin'd to a Consumption may be much endangered by the outward application of this Medicine Which nevertheless I have not hitherto known happen to any but rather on the contrary I can testifie by frequent trials that it rather proves to their advantage than to their prejucice For the smart Particles of the Catharides upon long application being sometimes plentifully imbib'd by the Blood infect its whole Serum which Latex nevertheless so aculeated as long as it is mixt with the Balsamick Blood offends no part but being separated from it by the Reins it sometimes hurts them and often not only twitches the Neck of the Bladder with its Acrimony but sometimes Corroding it fetches thence a Mucus and little Schims and even Blood it self But in the Mass of Blood those same sharpe Salino Volatile Particles often do great good because they destroy the fixt and acid Salts in it and likewise open the too close Texture of the Blood and so cause its Serous and other Morbifick Particles before fast bound in it to be separated from it and to be readily sent forth by Urine and Sweat hence in Fevers Vesicatories long apply'd cause a large Evacuation by Urine and a free Sweat Moreover the same open the Obstructed passages and stir up the Portions of the Blood and Serum stagnating in any place or extravased and restore them to Circulation Wherefore they are wont to do good not only in Distempers of the Serum but also of the Blood nay in the Pleurisie Peripneumonia and in any other Fevers whatsoever Hitherto having shewn after what manner Vesicatories work first on the Spirits and then on the Humours and Solid parts I must next set down their effects both good and evil also the manner of using them That they work first on the Spirits it is plain from hence that they exert no power on the Dead And it s an ill Omen in very weak persons when Vesicatories do not work because it 's a sign that the Animal Spirits are mightily dejected or lessen'd in their store Therefore to explain well the Energy or Vertue of this Medicine we must consider what Humours it evacuates or alters immediately or mediately And then in what Diseases and in Bodies how dispos'd it does good or hurt As to the first the Humours immediately let forth by a Vesicatory partly issue from the Pores and Glands of the Skin and partly from the Mouths of the little Arteries and partly from the extremities of the Nervous Fibres haply some little of the Juice fresh receiv'd may be cast back again from the little Mouths of the Veins though much of it cannot The Humours mediately voided by a Vesicatory are those which the foresaid parts being emptied receive from elswhere and convey forth 1. The Scarf-skin being remov'd by a Vesicatory from the Skin a Serous Humour is drawn from the Glands and Pores and this not only from the place Blistered but those Pores being pervious to others a Portion of Serum coming from other Pores sometimes succeeds in the Cells of the first drain'd and thence also distill forth wherefore in an Anasarca the little Ulcers rais'd by a Vesicatory empty waters on every side in great plenty and derive them from all the Neighbouring parts nay sometimes from those that are very remote 2. The Mouths of the Arteries do not only Spew forth the Portion of Serum brought to them according to common course but the Serous Latex being imbued with the irritative force of the Medicince in the whole Mass of Blood is thereby separated from the Blood in a more plentiful manner and carried forth by the said Mouths of the Arteries and with it other Excrements and sometime the Morbid matter it self in a large measure Hence in Malignant Fevers nay and in some Putrid Fevers of a difficult Crisis when the Refuse and Corruptions of the Blood unapt for separation threaten the Praecordia or Brain-vesicatories deriving it forth continually and by degrees often give great relief To which may be added that the same also as we have hinted before alter and restore the Blood degenerated or deprav'd as to its Salts and likewise by opening or rarifying its Texture dispose it to a Eucrasy Wherefore this kind of Remedy often agrees excellently well not only in a Feverish State of the Blood but likewise when it is otherwise vitiated or Cacochinical 3. Reason and Experience convince us that Vesicatories draw from the extremeties of the Nerves and Nervous Fibres the Latex contain'd within their Ductus's and free it from Stagnation and that they exagitate the
Heterogeneous Particles mixt with the Latex and deriving them from the Brain convey them forth whence they are found of excellent use in Convulsive affects From these things we may gather for the Cure of what Diseases this kind of Remedy is chiefly conducing for in order to an Evacuation from the Pores and Glands of the Skin as often as a Serous sharpe or otherwise offensive Humour is gathered together in or near them and being excluded from Circulating with the Blood obstinately sticks there certainly there is no readier or easier way of clearing the same forth than by applying a Vesicatory on or beneath the place affected wherefore it is not only indicated in an Anasarca and all Cutaneous foulnesses and breaking forth but a Vesicatory is likewise requir'd in Pains either of the Gout or Scurvy any where sixt in the outward habit of the Body or in some Member Secondly Vesicatories are always us'd in Malignant Fevers in respect of the Blood both to Purge it by degrees from all Heterogeneous and Morbifick matter and to alter it from its two Acid or Salt or otherwise vitiated Disposition into a due Temperament Nay they are of most excellent use in all Putrid Fevers threatning ill and of a difficult Determination Therefore also in the Scurvy Leucophlegmatia the Longing Disease of Maids and in any other Cacochimia that kind of Remedy does often great good Again Vesicatories are generally apply'd with good success not only for correcting the Blood it self but likewise as often as being deprav'd it pours its Corruptions on the other parts and so gives a beginning to Diseases and cause Fits of them in the Head Thorax Belly or Members Wherefore in Head-aches Vertigo's and Sleepy affects this is a known and vulgar Remedy and so in a Catharrh and any Defluxion either into the Eyes Nose Palate or Lungs every ordinary Man Prescribs Cantharides for a Revulsory without advising with a Physitian I must own that my self having been often seiz'd with a violent Cough accompanied with much and thick Spittle to which I am Originally inclin'd have not found more good from any Medicine than from Vesicatories therefore I am wont when that Distemper presses first to apply Blistering-plaisters on the Vertebrae of the Neck then those little Ulcers being heal'd I apply them behind the Ears and afterwards if need requires on the Shoulder-blades for so the Serous Filth breaking forth in abundance from the dissolv'd Texture of the Blood is deriv'd from the Lungs nay and the mixture of the Blood sooner recovers its Crasis its irregular Salts being by this means destroyed 3. In respect of the Humour to be evacuated or deriv'd from the Genus Nervosum and the Brain it self Epispasticks as they are of most common use in Sleepy Convulsive and Pain-causing affects so they often prove mighty beneficial Was ever any one seiz'd with a Lethargy Apoplexy or Falling-sickness but presently his Freinds or Attendants though never so ignorant flead his Skin with Cantharides In strange Convulsive Motions usually ascrib'd to no less than Witchcraft I have apply'd Vesicatories with great success to many parts of the Body together and by renewing them now and then in fresh places I have continued them above a Month Again fixt and cruelly tormenting Pains in the Membranous parts are seldom Cur'd without this AdminiAstration For sometimes Humours and Morbifick Particles which being throughly radicated yield not at all to Catharticks or Medicines working by Sweat or Urine seem to be utterly rooted out by Vesicatories laying hands as it were on the Disease Yet this Remedy though very general does not work so readily and successfully in some Diseases and Constitutions wherefore we must not use it inconsiderately or indifferently to all persons for those that have the Stone and are subject to frequent and great Fits of the Strangury scarce ever undergoe its application without prejudice Wherefore in persons so affected we must not use Vesicatories but in Malignant Fevers or in Acute Diseases of the Head to prevent a greater Mischeif As to the various Temperaments and Constitutions of Men in respect of which Vesicatories agree or dissagree more or less Concerning these things this threefold notable difference presents it self fiirst some in a manner always bear the use of this Medicine well and the little Sores made in the Skin by it distill forth the Excrementitious Humidities plentifully enough without any Disury or great Inflammation of the place Blistered and then heal of their own accord Which effect happens only in a Blood of a good Temperament where the Salt and Sulphur being in a moderate quantity and in a due state there is a good plenty of Serum whos 's Latex receding readily and in a copious manner from the rest of the Blood takes with it the smart Particles of the Medicine imbib'd and partly distills them forth by the place Blistered and partly conveys them out by the Urinary passages without offending them On this account also those good effects before mention'd are puoduc't in the Mass of Blood But Secondly this Medicine does neither agree nor work well with others for it makes the place on which it is apply'd mighty red or rather excoriats it with a violent Pain and a great Inflamation And yet the little Sores there made though they torment the Patient a good while cast forth but a very little Ichor or scarce any at all Moreover in those to whom Blistering always proves so torturing a cruel Stangury for the most part succeeds it This troublesome and withal unprofitable use of Vesicatories happens very frequently to Men of a hot and cholerick Temperament whose Blood contains Salt and Sulphur in a great plenty and but a little Serum which is wholly tainted with the others Wherefore when its Latex which ought to carry off the smart Particles of the Medicine does not part readily nor in a plentiful manner from the rest of the Blood to wà sh them away presently those Particles still sticking in the Skin Taint and Poyson as it were the Blood in its passage and being thereby hindred in its Circulation they cause it to gather together and stagnate within the extremities of the Vessels whereby they are inflam'd Moreover the Serous Latex at length separated by the Reins being but in a small quantity and sharpe of it self and made more sharpe by the Particles of the Medicine irritate the Neck of the Bladder and often corrode it with its Acrimony There remains a Third though more rare case of persons Blistered in whom the little Sores rais'd in the Skin presently pour forth the Serous Humour in such abundance that there is streight way need of repelling Medicines and such as close the Mouths of the Vessels otherwise upon the too great Efflux of waters a Dissolution of the strength and a failing of the Spirits are endanger'd to ensue I have known this to have happen'd so constantly in some that they were forc't for the time to come to abstain from
be hung about the Neck Moreover let Anticonvulsive Medicines be daily given the Nurse Let her take Morning and Evening a draught of Whey in which the Roots and Seeds of Male Peony and the Seeds of sweet Fennel are boil'd Take Conserve of the Flowers of Betony Male Peony and Rosemary of each two Ounes Powder of the Roots and Flowers of the Male Peony of each two Drams red Coral prepar'd white Amber of each a Dram Roots of Angelica Zedoary prepar'd of each half a Dram with a sufficient quantity of Syrup of Peony make an Electuary Let ber take the quantity of a Nutmegg Morning and Evening Take Powder of the Roots of Male Peony two Drams Seeds of the same a Dram make a Powder double refin'd Sugar dissolv'd in the water of Lime-tree Flowers and boil'd to a consistency for Tablets three Ounces Oyl of Amber a Scruple Let Tablets be made according to Art each Weighing half a Dram let her eat one every sixth hour and let her keep an exact Form of Diet. In case any Infant be actually affected with Convulsions because an Issue works but little and slowly it is proper to apply a Vesicatory to the Nucha and behind each Ear and unless a cold Temperament forbids it let Blood be drawn from the Jugular Veins by Leeches Let Liniments be applyed about the Temples Nostrils and Neck and Plaisters to the Soles of the Feet Let Clysters be daily injected which plentifully empty the Belly Moreover Let Specifick Remedies be taken inwardly often in a Day to wit every sixth or eighth hour Take Oleum Capivii and Oyl of Castoreum of each two Drams Oyl of Amber half a Dram make a Liniment Take of the Emplaster Oxycroceum two parts Galbanum dissolv'd one part Oyl of Amber a Scruple make a Plaister for the Soles of the Feet Let the Powder of Gutteta according to the description of Riverius be given twice or four times a day Take Mans Scull prepar'd Peony-seeds Elks-hoof Pearl prepar'd of each half a Dram Amber-greice six Grains make a Powder the Dose is six Grains in a Spoonful of the Liquour beneath written three or four times a day Or Take Mans Scull prepar'd Pearl of each half a Dram Salt of Amber a Scruple Sugar of Pearl a Dram the Dose is half a Scruple Or Take Spirit of Harts-horn three Drops let it be given every sixth or eight hour in a Spoonful of the Julape beneath prescrib'd To poor peoples Children let Powder of the Root of wild Valerian be given from half a Scruple to a Scruple let it be given twice a day in a Spoonful of Milk or of an Appropriated Liquour Vntzerus greatly commends the Gall of a Sucking Whelp viz. that all the Juice of the Gall-bladder be taken forth and given to the Child with a little Water of Lime-tree-flowers A Learned Physitian lately told me that he had known many Cur'd with this Remedy Moreover Empiricks after the Gall is drank are went also to give to greater Children to eat the Liver roasted Julapes distill'd Waters and other Appropriated Liquours may be prepar'd according to the Forma following Take black Cherry-water three Ounces Antiepileptical-water of Langius an Ounce Sugar of Pearl two Drams mix them Take fresh Roots of Male Peony cut into slices six Ounces Hungarian Vitriol eight Ounces Mans Scull two Ounces Antiepileptical Water of Langius half a Pound mix them and let them distill in a Glass Retort by a Sand heat The Dose is from a Spoonful to two Spoonfuls Take fresh Roots of Male Peony slic'd four Ounces being bruis'd in a Marble Mortar pour to them of Spanish Wine a Pound express it strongly add Manus Christi perlated half an Ounce let it be kept in a Glass close stopt the Dose is a Spoonful or two twice a day When Convulsions happen by reason of a difficult breeding of Teeth this Symptome is look't upon as secondary and not dangerous and therefore in the Method of Cure it is not always the first or chief thing which requires help but sometimes we are rather sollicitous of appeasing the pain and removing the feverish Distemper wherefore both the Patient and Nurse ought to use a thin and cooling Diet when the Teeth are upon eruption let the passage be made open for them either by a rubbing or Section of the Gums And also let Anodines be applyed to those parts when swollen and full of pain Clysters and Bleeding often have place here We must procure sleep and allay the fervour of the Blood Mean while let Anticonvulsive Remedies be us'd but of the more moderate kind and such as little trouble the Blood and Humours Vesicatories in regard they evacuate the Serum which is too apt to be discharg'd on the Head often give relief When Children are troubled with Convulsions and that neither presently upon their Birth nor by reason of an Eruption of Teeth but through other occasions and accidents the cause of such an affect for the most part lyes either in the head or somewhere about the Viscera of Concoction When there is a suspicion of the former as it is wont to appear by signs which shew that a Mass of Serous Filth is gathered together within the head the above-cited Remedies ought to be given in a little larger Dose moreover in those who bear Purging well sometimes a Vomit and a gentle Purge may be order'd them Wine and Oxymel of Squills also Mercurius Dulcis Rhubarb and Rosin of Jalap are of excellent use As often as the cause of the Convulsive Affect appears to be in the Bowels either Worms or sharp Humours causing Gripes in the Belly are found to be in the fault Against Worms a Purge of Rhubarb or of Mercurius Dulcis with the addition of Rosin of Jalap is ordered Formerly to a Child miserably troubled with Convulsions so that he seem'd even a Dying I gave a Dose of Mercurius Dulcis with Rosin of Jalap With his Stools whereof he had four he voided twelve Worms and presently grew well Take Roots of Virginia Serpentary powdred a Dram Coral caloin'd to a whiteness half a Dram make a Powder the Dose is from half a Scruple to a Scruple twice a day for three days one after the other drinking after it a Decoction of Grass Roots Take Species of Hiera a Dram and a half Venice-treacle two Drams make a Plaister for the Belly or let a Plaister of Galbanum be applyed to the Navel If the Convulsive motions are thought to proceed from the Irritation of the Ventricle and the Intestines caus'd by sharp Humours a gentle Purge either by Vomit or Seige or of both the one after the other ought to be ordered For this purpose let gentle Emeticks of Wine of Squills or of Salt of Vitriol be taken to wit if at any time the Diseas'd be of their own accord seis'd with a straining to Vomit but if the Evacuation seems rather fit to be attempted downwards an Infusion of Rhubarb or its Powder Syrup
Persons both Men and Women Diseas'd after this manner who being ill of a Head-ach an oppression of the hinder part of the Head or a Vertigo perceiv'd in their sleep presently Convulsive motions in the Praecordia or Bowels or in both of them together Which happens from the Salley of the tumultuary Spirits reflected from the Brain into the Origines of the Nerves And as an Opiate gave the Patient before mention'd a quiet sleep without the wonted Sequel of Convulsions so I have often successfully Cur'd terrible Convulsive Fits both Asthmatical and as it were Hysterical by giving Opiats 1. A Woman sixty seven years of Age having still a florid Countenance and being of a gross habit of Body and who first had liv'd long subject to a Swelling of the Face and great Fits of the Head-ach upon the Weathers growing very cold in the Winter fell into a very grievous Vertigo with a Trembling of the Heart a Fainting of the Spirits and a frequent striving to Vomit Being put to Bed if she open'd her Eyes or was turn'd from one side on the other she was presently seiz'd with a mighty Scotomia a danger of Swooning and moreover with a cruel Vomiting As I was to see her I did not doubt but the cause of the Disease was the Convulsive Matter convey'd from the outward Region of the Head to the inmost Recesses of the Brain by the ill Breath or Heterogeneous Combination of which the Animal Spirits being struck they rais'd the Vertiginous affects as they made their disorderly sallyes towards the Brain and when they tumultuarily rusht into the Roots of the Nerves they caus'd the Scotomia the disorders of the Praecordia and the striving to Vomit The Cure of this was perform'd within a few days by the application of large Vesicatories to the Nucha and behind the Ears the dayly injection of Clysters and by a frequent use of Spirit of Harts-horn and a Cephalick Julape Dr. Willis gives Instances of Persons in whom some portion of the Morbifick Matter which besets the Origine of the Nerves descending from the Head often enters deeper into the Ductus's of the Nerves and so about their middle and extream Processes and Plexus's makes a fomes of an explosive matter as it were of Gun-powder But for brevity sake I omit them It is observ'd that when a Convulsive Fit begins within the Brain at the Origine of the Nerves presently the remotest Spirits residing in the extremities of the Nerves as many as are predispos'd for that Symptom fall upon Explosions and so convey upwards the Convulsive affect there more strongly begun which happens for this reason that when some whole Series of Spirits is disturb'd those which are in the extream parts are first destitute of their Original Influx wherefore those before others begin to grow in a tumult and to be irregularly dispos'd as when a Nerve of the Arm or Thigh is constring'd by lying on it so that it is hindred of its wonted influence of the Spirits a stupor with a sense of pricking is first perceiv'd in the Fingers or Toes of the hands or Feet whence it creeps upwards by degrees towards the places affected And hence it is we find that if whilst the outmost Spirits are exploded a strong Ligature or Compression intercepts the succession of others into the same space or their progress towards the parts the Convulsion is usually hindred from ascending upward Wherefore as Physical Histories testify when a stupor beginning at the top of a Finger or Toe of a hand or Foot creeps to the upper parts with a sense of Formication or like a cold wind and at length taking to the Brain causes terrible Convulsions If presently at the first seizure the Arm or Leg be strongly bound about the Convulsion being not able to pass that place is hindred from getting to the Head Nay and it s an usual thing for Hysterick Women assoon as a Swelling of their Belly or an ascent of a heavy lump is first perceiv'd in their Abdomen to bind about hard the Trunk of their Body with Swathes and so commonly the Praecordia and the Region of the Head are kept from being affected with the Convulsive Fit It 's likewise observable that if Blood be let forth of a Vein in the midst of a Covulsive or Apoplectical Fit it presently seems to be congeal'd so that being receiv'd in a Bason it does not keep an even and plain Surface like Liquids but accumulating it self drop upon drop it rises in a heap like Tallow melted and distill'd into a cold Vessel Yet as to what some conclude hence viz. that Convulsions depend wholly on the thickness obstructed motion and stagnation of the Blood we must not allow of it For Blood drawn from Persons that are subject to Convulsions a little before the Fit is diluted with Serum and fluid enough Wherefore we may opine that that Congelation is caus'd by the Fit it self To wit because in Convulsive motions from the excessive Contractions of the Muscles and Viscera the Blood passing bet wixt them its Spirit and Serum exhaling is a little solv'd in its mixture and therefore is somewhat coagulated just as when Milk by reason of its too great agitation and Separation of parts one from another hardens into butlter wherefore this kind of Coagulation of the Blood seems rather to be the effect of Convulsions than their cause The Therapeutick Method AS to the Cure of these kinds of Convulsive affects which in Men or Women proceed from a Morbifick cause besetting the Origines of the Nerves The first Indication will be to withdraw the fuel of the Disease viz. to hinder the Blood from discharging on the Head the Heterogeneous Particles either engendred in it self or receiv'd from elsewhere from the Bowels For this purpose an Evacuation ordered both by Purging and Bleeding unless somewhat indicates the contrary is wont to be administred with good success Vomiting very often gives relief wherefore let Vomits of the Infusion of Crocus Metallorum or of Salt of Vitriol or of Wine of Squills be given in the first place Then in a few days let Blood be drawn either by opening a Vein in the Arm or by Leeches applyed to the haemorrhoid Veins then afterwards let a gentle Purge be ordered either of Pills or of a Purging Apozeme and let it be repeated in due and convenient time Take Crato's Pills of Amber or Bontius's Pills of Tartar two Drams Rosm of Jalap sixteen Grains Castoreum a Scruple Oyl of Rosemary or of Amber half a Scruple Gum Ammoniacum dissolo'd in a sufficient quantity of Hysterick-water make sixteen Pills let four be taken every sixth or seventh day Take Roots of Polypody of the Oak sharp pointed Dock prepar'd and of Chervil of each six Drams of Male Peony three Drams Leaves of Betony Germander Ground-pine Vervain Male Fluellin of each a handful Seeds of Carthamus and Burr-dock of each three Drams let them boil in four Pounds of Fountain-water
Conserve be made of the Leaves of the Tree of Life with an equal part of Sugar the Dose is from half a Dram to a Dram twice a day Take Powder of Millepedes prepar'd three Drams Ameos-seeds a Dram make a Powder divide it into ten parts let a Dose be taken twice a day Or twelve Millepedes being bruis'd with White-wine pour'd on them let the Juice be exprest make a draught let it be taken twice a day In the mean while that these Remedies are taken inwardly it is proper sometimes to raise Blisters by applying Vesicatories on the Nucha or behind the Ears for so the Serous and sharp Humours are very much deriv'd from the Head Moreover Sneezing-powders and Apophlegmatisms often give great relief The drawing of Blood from the Haemorrhoid Veins or from the Foot ought to be sometimes repeated And during the Fit Plaisters or Cataplasms are applyed to the Soles of the Feet with good effect It is good also to apply Epispasticks about the Legs and Thighs CHAP. IV. Of Convulsive motions whose cause lyes about the Extremities or within the Plexus's of the Nerves THat Convulsive affects sometimes without any fault in the Head arise from the Irritation and Explosion of the Spirits lying about the extremities of the Nerves it plainly appears even from this because when Medicines smartly twitch the Coats of the Stomack or Intestines or when Worms gnaw them Convulsions do not only follow in those parts but likewise Convulsive motions are sometimes retorted on the Members and outward Limbs For as we have shewn elsewhere when a sense of great pain torments any part and is communicated from that to the Primum Sensorium presently upon it the Spirits being there irritated an involuntary and irregular motion is wont to be thence reflected and that not only by those Nerves by which the sense of pain was brought but sometimes the Convulsion is reciprocated also by others either of the same pair or belonging to a pair wholly differing Thus a Stone fixt in the Ureter causes Convulsions not only in the Vessel affected but in a manner in all the Viscera of the Belly and cruel vomitings for the most part follow upon it Wherefore it is not to be doubted but Convulsive Diseases also and some such Symptoms are often caus'd by reason of some outward offence offer'd the extremities of the Nerves within the Membranes Muscles or Viscera Nay and if at any time in Hysterick Hypochondriack and certain other passions Convulsive motions are rais'd through the fault of the Womb Spleen or some other of the Viscera the Head being without hurt truly those arise and are propagated on every side into various Regions of the Body only this way viz. by the annoyances of the rest of the parts by the Way of the Nerves and not at all by vapours convey'd to the Head I shall now give you some instances and observations of Convulsions arising from the Extremities of the Nerves A delicate Virgin about the sixteenth year of her Age falling from a Horse and dashing her self against a rough Stone sorely hurt her left Brest whence a Swelling with a pain arose which Symptoms nevertheless at first seem'd to be mitigated by the use of Remedies and afterwards for a long time to pass indifferently well but after three years upon taking cold and having us'd a very ill Diet all things began to return a new the place hurt swelling up in a greater bull was affected with a most acute and almost continual pain so that the Diseased through the mighty torment passed many days and nights without sleep nor could she indure that the Glandules of her Brest then become more swollen shonld be toucht or handled nay nor any noise or concussion to be made in her Chamber When to this Tumour degenerating towards a Cancer Fomentations and Cataplasms of Hemlock and Man-drake and other stupifying things and Repercussives were apply'd the noble Lady began to undergo certain Convulsive affects which often molested her In the first place as often as a violent pain came in her Brest she felt there prickings and likewise Convulsions and Contractions shooting in and out Presently after the Ventricle and Hypochondres and after that the whole Abdomen were wont to be blown up and mightily distended with a rumbling and a straining to Vomit By and by the same affect being convey'd by degrees to the upper parts took away her Senses and shortly upon it so strong Convulsions followed in her whole Body that the Diseas'd could scarce be heal'd by three or four robust Men. These kinds of Fits at first came at random and were only rais'd occasionally viz. they ensued as often as the pain of the Brest was rendred more intense by some evident cause Afterward those Convulsions more frequently molested her and at length becoming periodical and habitual they return'd twice a day viz. constantly justsomany set hours after Meals And when Diseas'd had been miserably afflicted after this manner for six Months at length she began to be troubled with a certain Vertiginous affects which continually followed her For which evil when a Fomentation of Aromatick and Cephalick Herbs had been for some time applyed she grew better as to her Vertigo but from thenceforwards she was continually molested with a new and very wonderful Symptom viz. a violent dry Cough following her day and night unless when she was fallen asleep After this noble Virgin had tryed divers sorts of Remedies prescrib'd by several Physicians without much benesit at length vpon the use of the Baths of a moderate heat at Bathe she was reliev'd and being marryed presently upon it after conception and her being delivered of a Child she recovered by degrees As to the violent Cough above mention'd it seems that that Symptom depended on the Origine of the nerves being affected and not on any stuffing in the Lungs for she spit forth nothing with the Cough we say therefore that the Morbifick matter depor'd near the Origint of the Nerves being rarified and mov'd by the Fomentation entred deep in at the Mouths of the Nerves that go to the Lungs and stirr'd up perpetual Convulsions in the Fibres and Filaments thereof A noble Matron Fifty years of Age after that her Menses had ceas'd to flow for a year and a half first began to complain of a pricking pain in her left brest then afterward that affect ceasing she was taken ill about the Stomack To wit a hard and as it were schirrous Tumour arose there with an oppressing pain this was presently followed by an inflation of the Ventricle with a difficult Breathing a Nauseousness and frequent Vomiting Then the Disease growing worse and worse with a more acute pain and shooting in and out every way she fell into Conulsive affects of the Ventricle To wit the Convulsions shooting in that place several ways she was almost continually in such a torment as though the Stomack were torn in several pieces Moreover a continual Perturbation of mind
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
also Elixir Proprietatis sometimes also Spirit of Harts-horn for many days afterward at long run upon taking that Powder daily for some space she began to find help Inthe mean while that this Method of Cure was followed her Hair being Shav'd off her Head was cover'd only with a thin Dress she wore the Hysterick Plaister with a mixture of Galbanum on the Abdomen She drank for her ordinary drink a Boâ—het of Sarsa and China with the Roots of Male Peony and other appropriated things infus'd and boil'd in Fountain Water Within a Month the Fits remitted a little Afterward becoming more mild by degrees and lesser at length they ceas'd in a manner altogether unless that near the time of her Menses she was wont to be troubled with an assault or two of that disease Moreover she was troubled almost with a constant Giddiness and a loathing of Meat in the midst of Summer the drank Astrope Waters for six weeks and grew perfectly well As to the way of Cure to be us'd in general for such Marvellous Convulsions it is not an easie thing to assign Remedies equal to so Hereulean a Disease or a certain method of its Cure confirm'd by frequent experiments For besides that cases like those seldom occur we may likewise observe that the same Medicine which did good to this sick person at one time gave not the least relief to another person or the same when given at another time the reason of which seems to be that the cause of the Disease seems to consist in the Discrasy of the Nervous Juice Which liquor is not always perverted after one and the same manner But from the manifold combination of the Salts and Sulphurs gets a Morbid disosition of a various kind and condition and often changes it Wherefore in those difficult affects we must not prescribe vulgar Medicines taken from Apothecaries Shops but Magisterial ones as occasion requires according to the appearances of the Marvellous Symptoms A Gentle Vomit a Purge and Bleeding ought in the first place to be us'd and sometimes to be repeated as it shall seem convenient And as to Specifick Medicines and such are appropriated in those cases since the chief Indication will be to amend the Crasis of the Nervous Juice we may try a great many things and sift their vertues from the effect Therefore we may try what things endued with a Volatile or Armoniack Salt will do For this purpose let the Spirits and Salts of Harts-horn Blood Soot the Flowers and Spirits of Sal Armoniack be taken These giving no relief we must come to Chalybeats let the Tinctures and Solutions of Coral and Antimony be given which sort of Medicines must be given in such a Dose and form and for so many times that some alteration may be made by them in the Blood and Nervous Juice Again if these have not success we must proceed to Alexipharmicks which are good against Poyson and a Malignity gotten into the Humours viz. of these we must order Decoctions Destillations Powders Conserves and other Preparations of Vegetables and we must variously compound them the one with the other and administer them several ways It seems likely that those sorts of Medicines which being inwardly taken are wont to do good to such as are bit by a Viper or by a Mad Dog and likewise against Wolfs-bane and Napellus may also be of use in the above mentioned Convulsions We may here after the example of Gregor Horstius in his Tracts of the Malign Convulsive disease prescribe also Magisterial Remedies in form of a Purging Electuary also of a Powder and Convulsive Antidote for these Marvellous Convulsions and variously Compound the same of Simples partly Alexipharmical and partly Antiepileptical CHAP. VIII Of the Affects which are vulgarly call'd Hysterical IF at any time an unusual sort of Sickness or of a very Secret Origine occurs in the Body of a Woman so that its Cause lies hid and the Therapeutick Indication be wholly uncertain presently we accuse the evil influence of the Womb which for the most part is guiltless and in any unusual Symptom we cry out that there is somewhat Hysterical in it and consequently the Physical intentions and the uses of Remedies are directed for this end which often is only a starting hole for Ignorance The passions which are wont to be rank't in this number are found to be various andmanifold which seldom agree in divers Women or happen wholly after the same manner the most common of them and which are vulgarly said to Constitute the formalstate of an Hysterick affect are these viz. A Motion in the lower part of the Belly and an Ascent as it were of some round thing there then a Belching or Straining to Vomit a distention of the Hypochondres and a Rumbling with a Belching forth of Wind an uneven and for the most part a letted Respiration a Suffocation in the Throat a Giddiness an Inversion or Rotation of the Eyes often Laughing or Weeping a Talking Idly sometimes a Speechlesness and Immobility with an obscure or no Pulse and a Cadaverous aspect sometimes Convulsive Motions rais'd in the Face and Limbs and sometimes in the whole Body But universal Convulsions seldom happen and not unless the disease be raised to its worst state for the Tragedy of the Fit is acted through for the most part without any contraction of the Members only in the Belly Breast and Head viz. one of them or successively in all Women of all Ages and Conditions are obnoxious to these affects to wit Rich and Poor Virgins Wives and Widows I have observed those Symptoms in Girls before the time of Puberty and in old Women after their Menses ceast to Flow nay and men are sometimes troubled with such kind of Passions instances of which are not wanting The cause of these Symptoms must not be imputed to the Ascent of the Womb and to vapours rais'd from the same nor to the Impetuous rushing of the Blood into the Lungs as the Learned Highmore has Judg'd But we say that the affect call'd Hysterical chiefly and primarily is Convulsive and depends principally on the Brain and Genus Nervosum being affected and is produc't wholly by the exposions of the Animal Spirits as other Convulsive Motions And whatever disorder or irregularities happen else about the Motion of the Blood they are only secondary and depending on the Convulsions of the Viscera The way of the difference whereby the kinds of this disease both differ from each other and from the other Convulsive affects is taken from the various Origine and chiefly from the extension of the Morbisick Cause for the Origine of this as of many other Convulsive affects sometimes resides in the Head the Womb being wholly without fault Though sometimes this affect happens through the fault of the Womb and sometimes through that of other parts As to the extension of the Disease from whatever Origine it proceeds for the most part it chiefly affects the Interiour
Wherefore in Dropsies and Haemorrhagies Remedies endued with the Saline Particles of Iron are of notable use and efficacy for many Diseases proceed from this Cause That the little Mouths of the Arteries being too open and the Interstices of the Vessels being become too lax the Serum or bloody Latex breaks forth which kind of Affects are oftentimes cured by the Vitriolick Particles of Steel they constringing and corroborating the Blood-Vessels and the Nervous Fibres After this manner the Filing of Steel inwardly taken seems at the same time to put Spurs to and check the Blood but in regard that this Medicine is much more powerful in instigating than restraining therefore it ought to be given only to those whose Blood is very thick and cold as to Rusticks and very Robust persons It is not proper in a very hot and spirituous Blood and in hot Bowels Moreover in persons of a delicate and tender Constitution there is danger lest small Portions of Steel when they are not able to be dissolved are thrown on the Membranes of the Viscera and sticking pertinaciously to them cause Ulcers and mortal Gripes which I have really known to have sometimes happen'd 2. After the Filing of Iron the next way of preparing it is by Calcining it with Sulphur and reducing it to a Powder in which Preparation of it some of the Sulphureous Particles exhale In the mean time the Saline Particles seem to be encreased new ones accruing to them from the burning Sulphur so that the active Particles of both kinds viz. the Sulphureous and Saline come near to an Aequilibrium and since by this means this Medicine the Texture of the Metal being loosened may be brought to a very fine Powder it becomes of a much more excellent use than the Filing of Iron In many cases where Steel ought not to be given in substance as in a Cachexia the longing Disease and the like it is proper to use this Medicine 3. In the third place follows the Preparation of Steel with Vinegar sprinkling the Filings of Steel with Vinegar and drying it till it may be reduced into an impalpable Powder In this Preparation the greatest part of the Sulphureous Particles evaporate and the Saline are much encreased by reason of others accruing to them from the Vinegar This Powder does little in opening the Obstructions of the Viscera or in restoring the Ferment of the Blood nevertheless in a hot Constitution in Haemorrhagies and in the Hypochondriacal affect it is wont to be given with greater success than the foregoing Preparations 4. The rust of Iron follows in which there being but few Sulphury Particles it does not so powerfully Ferment the Blood or open the obstructions of the Viscera as Steel prepar'd with Sulphur nevertheless in Hot dyscrasies of the parts or humours it Egregiously performs the Intents required from a Chalybeate Medicine In this Classis our preparation of Steel is justly plac't in which all the Particles of the Metal being freed from the Bond of Mixture are contained together Which also the Concrete being first reduc't to a Powder are immediatly dissolv'd in any Latex or Menstruum This Powder inwardly taken excels in the same vertue as Steel Calcin'd with Sulphur But to the Menstruum or Liquor in which it is dissolv'd it Communicates chiefly and in a manner only the Saline or Vitriolick Particles the Sulphureous flying away and the Earthly Particles subsiding in the bottom I use to give common Water impregnated with this dissolution instead of Natural Spaw Waters in a great quantity And often with excellent Success Moreover I make Medicinal Wine Beer Cider Whey and other Liquours by dissolving this Powder in them and order them to be taken for various Physical intents So far of preparations of Iron in which the Elementary Particles of each kind though in a various proportion are comprehended There remain others in which the Particles in a manner only of one kind viz. the Saline or Earthy are left the rest for the greatest part being driven away of which kind chiefly are Vitriol of Mars Salt of Steel and Crocus Martis 5. Salt of Steel prepar'd as you may find here in Dr. Willis has a Sweetish Tast with somewhat of a Rough Stiptickness and so much partakes of a Vitriolick nature that it seems not much to differ from Green Copperas Taken inwardly as a Medicine it somewhat ferments the Humours and powerfully constringes the Nervous Fibres In Cold and Phlegmatick Cachexia's because no Particles of Sulphur are exerted this Medicine is not proper It is often given with success either by it self or mixt with other Medicines as a Spur in Hot Dyscrasies of the Viscera with a predominancy of adust Sulphur also in Flitting Scorbutical and Irregular Boylings of the Blood and Nervous Juice Notwithstanding in tender Constitutions there is danger lest through its acrimony and too great constriction the Tone of the Stomach and the Fibres be injur'd 6. In the last place comes the astringent Crocus Martis prepar'd by long Calcination in the Fire This Medicine is of egregious use in some cases and yields to none of the Chalybeats viz. in every Extravasating and too great Eruption of the Blood and Serum as in inward and outward Haemorrhagies in a Diarrhaea a Diabetes in a Vehement Catarrh also in an Ascites or a beginning Dropsie I have known nothing more excellent than this Medicine I have heard it lately mightily commended by a Famous and Expert Physician of our Country of which Medicine nevertheless in regard it is wholly destitute both of Saline and Sulphureous Particles and in a manner only consists of such as are Earthy and Fiery it is much in dispute with what Faculty it operates and produces so laudable an effect in humane body For it might seem that nothing should remain in this more than the Caput Mortuum or Terra Damnata of Vitriol and of other Minerals distill'd by a most intense Fire To give my opinion concerning these things it seems in the first place that a certain activity whereby it exerts it self and displays its virtues either by opening obstructions or by Astringing the Vessels and Nervous Fibres of the Viscera accrues to this preparation from the Fiery Particles being included in the most fixt Earth and from their breaking forth within the Body But the chief way of giving help consists in this that the Earthy Particles being wholly depriv'd of the Saline to which they were most closely bound most earnestly seek to be reunited to the same or the like Wherefore that Crocus Martis being Immerg'd in our Bodies suddenly catches to it self any sorts of Salts that come in its way and closely binds them to it and so whilst it drinks up like a Sponge a great many Saline Particles it takes away many Enormities chiefly arising from the Flowings of the Salts This way it is that Harts-horn burnt Spodium and Diaphoretick Antimony exert their vertues if at any time they give help CHAP. X. Of the
our Syrup of Diasulphur Lohoch de allio Pills of Elecampane Roots Milk of Sulphur Flowers of Benzoin made up with Tar or liquid Amber with many other things which it would be tedious here particularly to enumerate And now having given you the ways of curing the chief kinds of Convulsions it seems time to put an end to this Tract but since there remains another kind of Disease viz. the Scurvy which contains Passions of a mixt nature viz. partly Convulsive and partly arising immediately from the Dyscrasies of the Blood and Viscera I think it expedient to give you briefly the way of Curing that for both these Affects viz. the Scorbutick and Convulsive being placed together will mutually illustrate each other The Practice of PHYSICK Contained in Dr. WILLIS's TRACT OF THE SCURVY CHAP. I. THE Nature of the Scurvy being so diffused and extended to so various and such a multiplicity of Symptoms that it cannot be comprehended in one only Definition or scarce in one particular Description I think it fit in the first place to heap together all the Phaenomena of this Disease or to set forth in full all the chief accidents of it and then to accommodate some Hypothesis for duely Solving those appearances As to the former to consider the signs of the Scurvy from Head to Foot we shall begin with those in the highest part To this place belong violent and habitual Head-aches and those either happening at random or periodical sometimes a deadness and drowsiness of the Spirits sometimes obstinate Watchings frequent Giddinesses 's and Scotomia's Convulsions a Palsey much Spitting soreness of the Gums a looseness of the Teeth a stinking Breath 2. Meanwhile about the Region of the Breast Pains in various parts of the Membranes and especially in the Sternum which often being acute and pricking miserably torture the Diseased for many Days and Nights a frequent Asthma a difficult and uneven Breathing a Constriction and straitness of the Breast a husky Cough a disorderly Pulse a trembling of the Heart frequent Faintings of the Spirits a frequent Swooning and a continual being in danger of it 3. In the Region of the Belly this Disease establishing as it were its principal Seat produces Iliads of Evils For there are often a nauseousness a Vomiting a Rumbling a Cardialgia Inflations and Murmurings of the Hypochondres a frequent Colick and most troublesome Pains shooting every way an almost continual Diarrhaea sometimes a Dysentery or Tenesmus an Atrophia and sometimes an Ascites The Urine is commonly very ruddy and lixivial with a Scum swimming on it or sticking to the sides of the Glass tho' now and then at certain times the same being pale and Watry is voided in a great plenty 4. Besides these inward Affects in the outward Members nay in the whole Habit of the Body wandering Pains and often very violent and chiefly infesting by night are felt a spontaneous Lassitude a Consumption of the Flesh an Ach in the Loins and a weakness and enervation of the other Limbs Spots of various colours in the Skin Tumours Tubercles and often malignant Ulcers break forth about the Muscles a Stupor Formication and ascent as it were of a cold Wind also Contractions and Twitchings of the Tendons Moreover to Scorbutical Persons disorders of the Blood unconstant Boilings of it restless distemperatures Feavers without any constant Course and great Haemorrhagies generally happen Besides these common and very usual Symptoms of the Scurvy whereof sometimes more sometimes fewer and those one while of this kind and fashion another while of that infest the Diseased sometimes also unusual and prodigious Accidents ensue upon this Disease As to the evident Causes of the Scurvy though an ill Dyet a sedentary Life a disorder of the Spleen and Crudities heap't together in the first Passages are very much accus'd yet the unwholsomness of the Air and the Crasis of the Blood vitiated by former Distempers are wont to be much rather in the fault wherefore the Scurvy in Maritime and Marshy places is often endemious It frequently seizes suh as are long at Sea and use in the mean while Salt Meats and such as are dryed in the Smoak and also corrupted Water It every where succeeds long continued Feavers and other Chronical Diseases ill Cured also over great Haemorrhagies and other immoderate Excretions nay and the suppression of usual Evacuations as of the Menses and Haemorrhoids Moreover this Disease without any great procatarxis is often wont to be raised by Contagion and sometimes is hereditary The material cause of this Disease or the Scorbutick taint diffused through the whole Body is founded either in the Blood or in the nervous Juice or in both of them together That the Scorbutick Taint is fix't in the Blood it s disorderly Boilings the Eruptions of Spots and Pushes the ruddy and as it were lixiviated Urine plainly testifie which is also shewn by the diversified production of this Disease which for the most part succeeds the depravation of the mass of Blood That the Taint sticks also in the Nervous Liquor is shewn by the most troublesome Pains raised both inwardly in the Membranes and outwardly in the Genus Nervosum by the weaknesses or resolutions of the Members the Giddiness the Convulsions and frequent Failings of the Animal Spirits Since therefore both general Humors are in fault let us see which is first or chief in fault whence it drew its Taint and after what manner it is communicated to the other Humour and likewise to any other Parts that are wont to be affected As to the Blood in whose Mass the Scurvy seems chiefly to spread its Roots we have shewn elsewhere that in its Crasis it consists of the like kind of Particles and is temper'd almost after the like manner as Wines Moreover we have intimated that as Wine even so the Blood for two causes chiefly is ill disposed viz. either because some extraneous thing that will not duely mix with them is got into this or the other or because the Crasis or temper of the Liquor is perverted in as much as one Element or haply two to which the Dominion is due being supprest others which ought to be kept under are exalted Concerning the former we observe in Wine that when the Foeces first sever'd and thrown to the bottom being stirr'd again are rais'd or if any Heterogeneous thing as Sewet or an exotick Sulphur be cast into the Vessel a mighty working is thence caus'd which unless it be appeas'd in a short time the Crasis of the Wine is in danger of being subverted In like manner there are many immiscible things which coming into the Blood disturk its Motion and Circulation and hinder the course of its Oeconomy from being duely performed The Nutritive Liquor being filled with filthy Dreggs Ferments the Blood in a disorderly manner Nay and its Liquor being become degenerate causes Fits of intermittent Fevers The Vapoury Serous Bilous and Melancholy Recrements of the Blood retain'd within it
when green Herbs are scarce we may prescribe after this manner Take Leaves of Scurvy-grass four handfuls tops of Broom of the Pine-tree and of Juniper of each three handfuls the Middle-bark of Elder and Ash of each four Ounces Roots of Horse-raddish and of Polipody of the Oak of each three Ounces the Rinds of four Oranges and of as many Limons Winters-bark four Ounces being slic't and bruis'd pour to them of White-wine or of Cider or of Whey made with either of them eight Pounds let them be distil'd The simple Water of the Leaves of Aron distil'd in the Spring time is an efficacious Remedy against the Scurvy if three or four Ounces are given twice a day with another Medicine The simple Water of Scurvy-grass pour'd again on fresh Leaves bruis'd and distil'd and so iterated by frequent Cohobations becomes an efficacious Remedy Moreover a hot Spirit of Scurvy-grass is prepar'd after this manner Take Leaves of Scurvy-grass what suffices being bruis'd let it be made into Balls such as are made of Woad for Dying Then let those Balls be kept in a Glaz'd Pot for three or four days very close stopt in a cold place either Water of Scurvy-grass or Wine of the same being pour'd to them and covering them over above four fingers deep Then an Alembick being put on let the whole matter be distill'd Let the distill'd Water being put into a Cucurbit be rectified the hot Spirit will come off first whereof let fifteen or twenty drops be taken in a fit Vehicle 6. Antiscorbutick Wines and Beers I Use to prepare a simple Antiscorbutick Wine of excellent use after this manner In the Spring or Summer-season Take Leaves of Scurvy-Grass gathered in clear and dry Weather what you think good being bruised let the Juice be prest forth and let a Vessel containing three or four Gallons be fill'd a spoonful or two of Yest being put to it let it ferment for two Days then the Vessel being close stopt let it be plac't in a Wine-Cellar for six Months and then let the clear Liquor which will be of an Amber colour like Spanish Wine be drawn out into Bottles and be kept for use it continues good many years The Dose is three or four Ounces twice a Day Physick Wines whereof a Glass or two may be daily taken at Physical Hours or also at Dinner may be prepar'd after this manner Take Leaves of Scurvy-Grass four handfuls Raspings of Horse-radish four Ounces Winters-bark bruised half an Ounce the outward Coats of four Oranges and of so many Limons Let them be put in a Glass with twelve Pounds of White Wine or Rhenish or small Spanish Wine The Vessel being stopt let it be kept in a cold place Let the Wine be pour'd off clear as often as you use it It 's more usual to prescribe a Physick Ale or Beer to Scorbutical persons to be drank constantly for their ordinary Drink Let Beer be prepar'd to fill a Vessel of four Gallons instead of Hops let three Handfuls of Pine or Fir-tops be boiled in it After it has wrought in the Vessel put into it Leaves of Scurvy Grass three Handfuls Roots of sharp pointed Dock prepared four Ounces the Rinds of four Oranges After it has stood a Week to clear let it be expos'd to Drink These kinds of Physick Drinks with other Ingredients may be variously prepar'd according to the Temperament and Affect of the Patient by which kind of Remedy in regard the Physical Particles altering the Dyscrasy of the Blood are forthwith convey'd into its Mass together with those of the Food often much good is done in removing the Cause of the Scurvy But since we have shewn the cause of this as also the Nature of the Disease to be twofold and since the Medicines hitherto proposed regard in a manner only the Salino-sulphureous Distemper of the Blood we must next direct Medicines which are proper in the other viz. the Sulphureo-saline Dyscrasy of the Blood CHAP. III. Of Medicines of each kind of the foregoing forms which have regard to the Scurvy raised in a hot Constitution and in a Sulphureo-Saline Dyscrasy of the Blood IN certain Scorbutical persons the use of Scurvy-grass Horse-Radish Winters-bark and of other smart things and such as are greatly endow'd with a volatile Salt is found to be very offensive wherefore in those kinds of cases where the Morbifick Cause consists in a hot Dyscrasy of the Blood resembling over-fretted Wine temperate Medicines and such as do not exagitate the Particles of the Humours which are apt to boil too much of them selves are indicated Wherefore we shall set down Forms after the same order and running as it were parallel with those before and in the first place we shall give you solid Medicines Electuaries Take Conserve of Brooklimes and Cuckow-Flower made with an equal part of Sugar of each three Ounces Species Diatrion Santalon Diarrhodon Abbatis of each a Dram and a half Ivory powdered a Dram Pearl half a Dram Salt of Wormwood and of Tamarisk of each a Dram with a sufficient quantity of syrup of Coral make an Electuary Take Conserve of Wood-sorrel and of Hips of each three Ounces or Conserve of the Roots of sharp pointed Dock and of the Roots of Cichory of each three Ounces Troches of Rhubarb two Drams Species Diamargariti Frigidi a Dram and a half Bark of Tamerisk a Dram Sal Prunella a Dram and a half Myrobalanes condited in number two with a sufficient quantity of the syrup of the Confiture of Mirobalanes make an Electuary For poor people I use to prescribe this easy prepar'd Electuary Take Leaves of Brooklimes six Ounces of Wood-sorrel two Ounces double refined Sugar eight Ounces let them be pounded adding Powder of sweet Fennel-seeds half an Ounce Ivory powdered two Drams Sal Prunella a Dram and a half with a sufficient quantity of Syrup of the Juice of Brooklimes make an Electuary Confections TAke Powder of the Roots of China and of the Male Peony of each a Dram white and yellow Saunders of each three Drams Ivory a Dram and a half Pearl half a Dram Crabs-eyes a Dram Coral moistened with Juice of Oranges and ground on a Marble two Drams white Tartar a Dram and a half double refined Sugar dissolved in a sufficient quantity of compound Scordium Water six Ounces Make a Confection Take Roots of Eringo and Scorzonera preserv'd of each three Ounces Powder of Aron-roots compound half an Ounce Species Diatrion Santalon two Drams Sal Prunella a Dram and a half with a sufficient quantity of syrup of Clove-Gilli-flowers Make a Confection Powders TAke Powder of the Leaves of Ground-Pine of Aron-roots Compound of each an Ounce and a half Ivory powdered red Coral prepared with Juice of Oranges of each two Drams Tablets of Oranges two Ounces mix them Make a Powder The Dose is a Spoonful twice a day Pills TAke Species Diatrion Santalon and Diamargariti Frigidi of each two Drams Seeds of Citrons and of Carduus
and a half Confection of Alkermes a Dram mix them The Dose is three or four Spoonfuls Or Take Aqua Mirabilis six Ounces Water of Snails and of Wallnuts of each two Ounces Pearl powdred a Scruple Confection of Hyacinth a Dram Syrup of Clove-gilliflowers an Ounce mix them When Scorbutick Women are wont to be troubled with Hysterick Fits and Men with Convulsions Take Water of Bawm and Pennyroyal of each three Ounces compound Briony-water four Ounces Tincture of Castoremn half an Ounce Tincture of Saffron a Dram Syrup of Clove-gilliflowers a Dram and a half Castoreum tyed in a Nodulus and hung in the Glass a Dram. The Dose is three or four Spoonfuls For those who desire rather to have Cordial Medicines in a solid form let Electuaries or Tablets be prescrib'd Take Conserve of Clove-gilliflowers three Ounces Confection of Alkermes half an Ounce Pearl powdred a Dram with a sufficient quantity of Syrup of Coral make an Electuary Take Species Diamargariti Frigidi and Diarrhodon Abbatis of each a Dram and a half Pearl powdred a Dram double refin'd Sugar dissolv'd in Treacle-water and boil'd to a consistency for Tablets four Ounces Oyl of Cinnamon six drops make Tablets according to Art As to Opiats and Anodine Medicines in some certain affects of Scorbutick persons I had rather be without any kind of Medicine besides than the use of them For not only against obstinate Pains and Watchings but in Asthmatick Fits in Vomitings a Diarrhaea and also in a Vertigo and Convulsive Passions as often as nature being irritated above measure falls into extream irregularities I have found no Remedy more excellent than to procure sleep by giving a safe Narcotick Mean while there is need of a very great caution that they be not taken if at any time something in the Constitution of the Diseas'd or in the nature or time of the Disease forbids the giving of such a Medicine Besides the Hypnoticks usual in Apothecaries Shops viz. Laudanum Opiatum Nepenthe the Philonia Diacodium and Syrup of red Poppies two other preparations of Opium are known to me which I use to give in the form of a Tincture or of a liquid Extract from ten drops to twelve with some other appropriate Liquour The Diet or Form of Living to be observ'd in Scorbutical persons is of no small importance in the Method of Cure for that being neglected or ill ordered the other Prescripts of Physick do little or nothing towards Health The Rule of Diet being extended to various things is chiefly concerning the Air and Situation of the Habitation Meat and Drink and the motion or rest of the Body As to the first what kind of habitations and places of Residence in respect of the Heavens and the Earth cause the Scurvy and consequently ought to be shun'd it is sufficiently manifested by what we have said before Those that endeavour to prevent or cure this Disease ought to take care to choose an Air moderately hot and dry and which also is subtle and pure and sufficiently expos'd to the Winds Such Food only is proper which has a good Juice and is easie of Concoction let such as is gross viscous and dryed in the Smoak mouldy and rank also such as is unfermented or greatly compounded all manner of Pulse Milk-meats and unripe Fruits be shun'd I so much disapprove things preserv'd or very much season'd with Sugar that I judge the invention of it and its immoderate use to have very much contributed to the vast increase of the Scurvy in this late Age For that Concret consists of a very sharp and corrosive Salt though mitigated with a Sulphur as it plainly appears from its Chymical Analysis For Sugar distil'd by it self yields a Liquour scarce inferior to Aqua Stygia And if you distil it in a Vefica with a great deal of Fountain-water pour'd to it though the fixt Salt will not so ascend nevertheless a Liquour will come from it like the Hottest Aqua Vitae burning and very pungent when therefore Sugar mixt almost with any sorts of Food is taken by us in so great a plenty how probable is it that the Blood and Humours are rendred salt and sharp and consequently Scorbutical by its daily use A certain famous Author has laid the cause of the English Consumption on the immoderate use of Sugar amongst our Countrymen I know not whether the cause of the spreading Scurvy may not also be rather hence deriv'd Let the Drink be midling Ale mild and clear and also let it be altered with Antiscorbutick Ingredients without an ungrateful favour Let it not be thick and sweet nor also too old and turning sharp Let this be taken in a moderate quantity and in a manner only at the set hours of Dinner and Supper The custom which has prevail'd with many viz. that assoon as they are out of their Beds they presently indulge themselves to drink a large Mornings Draught as they call it seems very pernicious For by this means the Blood Vessels are too much fill'd a store of new Chyle being almost continually sent into them and Crudities and Filthy Morbifick Dregs are engendred in the Blood and the office of Sanguification is greatly debilitated Truly it is better for most Men unless it be those whose Ventricle as long as it is empty is wont to be plainfully contracted and corrugated to keep themselves fasting till Dinner time Nor is that vulgar custom less contrary to Health to swill themselves with much Drink presently after Meat Wines and Ciders so they are mellow pure and not adulterated being taken in a moderate quantity do not offend But the same being counterfeit musty austere or turning sharp there is nothing more hurtful or injurious to our Health Exercises and Labour are so notably conducing both to the cure and prevention of the Scurvy that many by this sole Remedy either preserve or recover an entire Health For the Blood and Nervous Liquour of persons that lead an idle and sedentary Life like Stagnating Waters contract a clamminess and mouldiness But upon the assiduous and much motion of the Body the Humours and Spirits become clear and get a vigour the Excrementitious and Heterogeneous Particles evaporate the stuffings of the Bowels are purg'd and their Tone is corroborated CHAP. VI. Some Stories and rare Cases of Persons troubled with the Scurvy A Woman of Renown tall and graceful about the twenty fifth year of her Age had contracted a Scorbutick Taint by reason of various errours committed in Diet. The signs of which were a Spontaneous Lassitude a difficult Breathing Pains and Spots in the Legs and her Gums likewise swoll'n and full of Blood in the Spring time after an Abortion falling into a Tertian Ague she soon became in a languishing and weak condition from which Disease nevertheless first being Methodically proceeded with in Physick she had soon recovered but that indulging her self to eat Flesh and other improper things she soon had a Relaps and then being a weary
the first scope of Curing which we must first and chiefly have respect to we say that the matter or Humours that are wont to be heap'd together about the parts of the Head predispos'd for a Head-ach and to raise the fits of the Disease are the Blood or its Serum or the nutritive or nervous juice Moreover with all these vapours and effluvia also excrements sometimes bilous sometimes melancholick sometimes acid salt sulphureous and others of various kinds being receiv'd into the Blood from the Viscera sometimes these sometimes others are convey'd along with it to the Head against the salleys and incursions of all which let Physical defensatives be ordered 1. And first if the Procatarxis or disposition for pains being plac'd about the Membranes of the Head the Blood as being hot and apt for turgescencies rushes now and then all of a sudden into the Membranes of the Head and upon it s not easily passing them stretches the Vessels above measure and severs from each other the nervous Fibres and so raises fits of this disease a sign of which are a sanguine temperament heat and a suffusion of redness in the Head about the Face also a high and vibrating Pulse with Veins stroutting with Blood we must presently endeavour both that the Blood being rendred more calm be not so readily put upon turgescencies and also that when stirr'd and boyling it be not carried with a greater salley to the Head than to other Parts nor be not forc'd there to stagnate by reason of the Sinus's of the Meninges being too much fill'd Wherefore if the fit continues long let the Person be blooded in the Arm or in the Jugular Vein out of the Fits it is sometimes proper to draw Blood from the Vessels of the Fundament by Leeches to wit that by this means the Blood haply boyling may be drawn downward towards that place whither it often tends of its own accord Let Oxyrhodinums or other Epithems be applied to the Head moreover let Juleps Emulsions or Decoctions which allay the fervour or fury of the Blood be taken Let the Belly be cooled and kept soluble by the use of Clysters Morever for prevention Whey or the use of Spaw-waters is convenient also drinking of Water a thin and cooling dyet do good You must order a forbearance of Wine Spices Bathing Venery any violent motion of the Body or Mind and all hot things Moreover for fixing the Blood and preventing its effervescencies let distilled Waters expressions of Heerbs or Decoctions Electuaries Powders and especially Crystal Mineral be frequently us'd It will not be needful to subjoyn here a method or particular forms of Medicines because in this case almost every Person that is ill being taught by frequent experience from things that do him good or hurt is wont to be his own Physician 2. It is seldom that the Blood is in the fault alone or only by it self Other Humours oftner being carried to the Head by the conveyance of the Blood and there depos'd cause the Evil If at any time therefore a filthy glut of Serum breaking forth in abundance from the Blood causes frequent Head-achs the signs whereof are Catarrhs at the same time infesting the other parts viz. the Nostrils Mouth or Trachaea then abstinence and rest being commanded and the Belly being emptied by a Clyster let the fluxion of the Serum be permitted to appease it self and the matter discharg'd on the Membranes of the Head to evaporate Which if they do not follow of their own accord and in a short time in a hot constitution Bleeding often is proper viz. inasmuch as the Vessels being emptied of Blood suck in again the extravasated Serum But in cold Persons Vesicatories applied to the Neck or behind the Ears are of excellent use Then after that the Belly is emptied by a Clyster let the fluxion be appeas'd by the use of an Anodyne or gentle Opiat and that being appeas'd it is proper to give a gentle Cathartick and then Medicines that operate by Urine or Sweat or together by both and so gently evacuate the superfluous Serosities Medicines fit for these ends are every where to be found in Books which nevertheless may not be us'd rashly and indifferently by Empiricks but they ought to be chosen compounded or altered nay and sometimes to be prepared Extempore as occasion requires according to the judgement and discretion of a prudent Physician respect being always had to the Constitution Temperament Idiocrasis and other accidents and circumstances of the Patient Wherefore in regard it would be superfluous to heap together here a great many Receipts I have rather thought fit to rpopose here only a form or two of the Medicines of each kind viz. of such as regard the chief Intents Take Pills of Amber half a dram Rosin of Jalap four grains Balsam of Peru what suffices make four Pills let three be taken going to Bed and the next morning if the former do not work enough Or Take Scammony sulphurated half a Scruple Ceruse of Antimony fifteen grains Cream of Tartar eight grains make a Powder let it be taken in a spoonful of Panada early in the morning Take Sulphur of Antimony four grains Rosin of Jalap five grains Cream of Tartar six grains let them be bruis'd together and with a sufficient quantity of Conserve of Violets make a Bolus to be taken early in the morning with Governance Take roots of Butchers-broom the great Bur-dock Chervill Avens of each an ounce preserv'd Eringo's an ounce and a half Florentine Orris three drachms the lesser Galingal a drachm and a half Bur-dock-seeds three drachms dryed leaves of Betony Sage Vervain Fluellin of each half a handful Raisins ston'd two ounces boyl them in four pounds of Fountain Water will a third part of it be consum'd then add of White-wine half a pound strain it let it be sweeten'd if need be with Syrup of the five roots two ounces let six ounces be taken warm twice or thrice a day a good while after meat For such as have a Cold and Flegmatick constitution let a Decoction be prepar'd of the Wood Guiacum Sassafras Sarzapar With the addition of the foresaid Ingredients make an Apozeme whereof let six or eight ounces be taken twice or thrice a day warm For Poor People and often to the Rich I use to prescribe with good Success a Decoction of the dryed Leaves sometimes of Sage sometimes of Betony Vervain or of Rosemary made in fountain Water and then impregnated with the Tincture of the Powder of Coffee-berries to be taken twice a day warm to six or eight Ounces 3. But if with the abounding Serum Particles also saline acid bilous or otherwise infesting are violently carried into the Membrances of the Head either wholly from the Mass of Blood or by the Mediation of this as receiv'd from the Viscera and there being fix'd cause more acute and lasting Pains then it will be proper sometimes to repeat a spare Bleeding and also a gentle
the excretory Vessels gape into the cavity of the mouth certainly by this way chiefly the envenom'd Latex of the Blood will find its passage forth which it cannot readily do elsewhere Wherefore upon a Salivation being rais'd the Blood long fermenting like Wine or Beer purging it self throws off by the Ductus Salivales and the innumerable Meatus every where gaping into the Mouth whatsoever extraneous and degenerate substance it may either contain within it self or can drink up or receive from elsewhere be it from the Viscera or solid Parts or from other humours Moreover it is likely that as the off-scowrings of the Blood so also those of the Liquor that irrigates the Brain and Nervous Appendix being stirr'd upon the entrance of the Mercury are voided forth also this way viz. by the Ductus Salvales Therefore a Salivation caus'd by Mercury if haply it succeeds well removes sometimes difficult and indeed Herculean distempers and such as will not be mastered by any other Remedies viz. forasmuch as this operation by a long expurgation throughly cleanses the Blood and nervous Juice and other humours destroys all exotick serments quells the enormities of Salts and Sulphurs and also exagitates the morbifick matter sticking any where or stagnating and often leads it forth Nevertheless this Medicine is not always free from danger viz. because the Mercury being become exorbitant and carrying with it a mighty store of most sharp and as it were envenom'd Serum and rushing violently into the noble Parts and especially the Brain with the appendixes both medullary and nervous or into the Lungs and Praecordia brings upon them an indelibel and sometimes a mortal prejudice Wherefore in an ancient and fore Head-ach there is danger lest the indispos'd Fibres be more irritated by the Mercury pervading them with much and Corrosive Serum and be put upon greater Convulsions and painful Corrugations And also lest upon the mighty recourse of Humours to the Head the Brain be invaded and consequently which happens too often lest the sleepy or Convulsive affects be caused I would have discoursed more concerning these things because it is of a great concern but that we daily expect an exact method of Salivation and a full account of it as to its ways and effects advantages or disadvantages to be set forth by the Leanred Physician Dr. Needham From Chirurgery there remains yet another famous remedy for curing inveterate Head-achs viz. the opening of an Artery Some of the moderns use this and very much extoll it it being greatly accounted of amongst the Ancients Nevertheless as far as it has appeared to our observation success has often been wanting to that so much cryed up operation Nor is it a wonder because that ground on which the Ancients relying blam'd the Arterious Blood as differing from that of the Veins and more exorbitant and therefore advised it to be let forth does not hold good Nor indeed is thereany other reason wherefore Blood drawn from an Artery rather than from a Vein near the place grieved should give ease but rather on the contrary we may expect a greater help from the opening of a Vein because an Artery being emptied receives and draws away nothing from the part affected but a Vein being opened in the place of the Blood issued forth draws from the whole Neighbourhood and often drinks in again and restores to circulation the Blood and other humours heaped together and Stagnating near the seat of the Disease However lest we recede too far from the practice of the Ancients attributing nothing to Arteriotomy we grant that sometimes haply it gives help tho not immediately and causally but only by way of consequent and per accidents viz. forasmuch as the ends of a cut Artery grow together so that the passage for the Blood that way is stopt for the time to come hence in regard somewhat a less store of Blood is brought towards the place by the Arteries and an equal quantity is still carried away by the Veins therefore it sometimes happens that the fuel of the morbifick matter is diminished and that its flock is consumed by degrees For this reason that administration has often succeeded well in distempers of the Eyes Moreover Farriers use a practice not unlike this for curing malignant tumours in Horses Legs to wit they take and bind the Artery by which the matter flows to the part affected mean while that which was there sticking partly evaporates and partly is drunk up again by the Vein I have heard that in a manner the same method was successfully tryed by our Harvey for curing strumous and schirrhous tumours also in the Body of man I might here set down many other kinds of Remedies and also Prescripts and forms of Medicines which are wont to be used both by Physicians and by Empiricks for curing Head-achet but the Books of Physicians abound too much with these I shall now give you some rare cases of Persons troubled with the Head-ach and first some examples of a most severe continual Head-ach which also the cause being invincible has often proved fatal A Woman fifty years of age after that she had been ill for about six months with a very great pain of her Head troubling her almost continually under the Sagittale Suture and yielding to no Method or Medicines fell at length into a Lethargy with a Partial resolution of her Limbs from which nevertheless being in a short time recovered by remedies seasonably administred she had again the violent pain in her Head as before and afterward within a fortnight or three weeks falling into a sleepy affect she departed this life The Scull being opened on the side of the third Sinus a schirrhous tumour three fingers broad grew to the Membranes by the mediation of which the Dura Menix also for some space grew to the Pla and the Blood Vessels which ought there to open into the cavity of the Sinus were stopt moreover both the outward Anfractus of the Brain and â—its inward cavity were filled with clear water From these observations the invincible and at length mortal cause of that Disease may plainly appear I remember formerly to have observed by Anatomy a case like to this in a certain other Person Moreover in regard I judge that in many Persons troubled with the Head-ach the Disease depends on such an invincible cause I shall here give you one instance that is quite fresh of that kind of affect Some few years since I was called to see a Lady of Quality troubled for above twenty years with a Head-ach which at first was intermittent but of lat eis almost continual She was endowed with admirable gifts both of body and mind so that she was excellently skilled in the Liberal Sciences and all Learning above the condition of her Sex but as tho Nature thought it too much for her to enjoy so great endowments without some affliction she has suffered very sorely from this disease Before she was eight years of
to set forth here cases of the Head-ach whose Fits being erring and uncertain proceed from the Blood or Serum rushing into the places affected in regard that these are very frequent and vulgarly known I shall now set before you certain choice Observations of this Disease being either periodical or seeming to arise from some one of the Viscera per Consensum As to the Former the periodâ—â—â— invasions of the Head-ach are produced either from the nutritive Humour or from the nervous Juice I shall now give you example of both A venerable Matron in the forty fifth year of her age being of a thin habit of Body and a bilous temperament after having liv'd for a long time obnoxious to Head-achs wont to be occasionally rais'd about the beginning of Autumn she began to be troubled with a periodical Head-ach This affect seizing her about four a clock in the Afternoon was wont to hold her almost till midnight till the diseased being tired with watchings and tortures was forced to fall asleep then after a pretty prosound sleep upon her awaking in the morning she was well The Diseased having undergone daily Fits of this Disease for three weeks after this manner delay'd the use of Physick which she very much abhorr'd but at length her appetite being dejected and her strength worn away she was forc'd to desire a method of Cure and after a gentle Purge and blooding she took twice a day for a week or a fortnight the quantity of a Chestnut of the following Electuary and grew perfectly well Take Conserve of the Flowers of Cichory and Fumitory of each three ounces compound powder of Aron Roots two drams and a half Ivory a dram and a half yellow Saunders Lignum aloes of each half a dram Salt of Wormwood a dram and a half Vitriol of Mars a dram Syrup of the five Roots what suffices make an Electuary The cause of this periodical Head-ach doubtless was that the assimilation of the Chyme or nutritive Humour into Blood was hindred For when its store received into the mass of Blood could not be overcome it was wont after a little stay to fall at odds and ferment with its particles Therefore presently the Blood falling into a turgescency that it might shake off that incongruous mixture depos'd its recrements as on other Parts so chiefly and with a greater sence of offence on the Fibres of the Meninges being before weak or injur'd in their conformation so that the pain lasted till the heterogeneous particles boyling by their mutual congress either were subdued or did exhale A handsome tall and slender Woman long and sorely obnoxious to cephalick affects was wont to be infested sometimes for many days nay weeks with a violent Head-ach which seiz'd her daily at her awake early in the morning and afflicted her for three or four hours In the mean space she was also affected with a heaviness of the whole Head a deadness of the Senses and a stupidity of Mind which affects vanishing together with the pain before Noon like Clouds disperst left all things calm and serene Till the next morning they possest again the Brain like a sogg and dark mist For curing these distempers I prescribed parging Pills a spare Bleeding Vesicatories also and the use of Spirit of Harts-horn or of Soot with Cephalick Juleps or Waters In this Gentlewoman the pains of the Head rather followed sleep than was cur'd by it because in this morning Head-ach the morbifick matter resided in the nervous Juice whose greatest curdity and aggravation about the Head happen presently after sleep but the other evening fit of this disease in regard it depended on the plenitude and turgescency of the nutritive liquor within the mass of Blood therefore hapned so many hours after dinner and was not mittigated but after sleep which appeases the disorders of the Blood Tho the Experience and Complaints of sick Persons manifestly shew that Fits of the Head-ach sometimes arise by consent from the other Parts viz. the Womb Spleen Stomach c. Nevertheless it as clearly appears from the accounts of them and the Phoenomena being duely considered that this is done by another means than by Vapours rais'd from the Viscera affected to the Head And first as to the pains of the Head seeming to be rais'd from a Womb nothing occurs more frequently than for violent Head-achs to ensue upon the suppression of the menses or lochia moreover tho the menses observe their due course yet some Women are wont to be afflicted with a violent pain of the Head just as they are coming others as soon as they are past But yet tho at the same time that the Head is affected the Womb is also yet it does not follow that the Injury is convey'd immediately from this to that but it is the Blood it self which fixes the morbifick matter on the Head viz. it sometimes perversly conveys it being engendred within its own bosom and design'd for the Womb into the Meninges of the Brain and sometimes withdrawing it from the Parts of the Womb it delivers it to the Head with a greater mischief This Aetiology agrees also with the Head-ach vulgarly imputed to the Stomach Spleen and other Parts A beautiful young Woman of a thin habit of Body and a hot Blood having been obnoxious to an hereditary Head-ach was wont to undergo frequent Fits of it and those coming at random to wit some happening on a light occasion and others arising of their own accord that is without any evident cause On the day before the spontaneous access of the Disease being very hungry in the Evening she greedily eat a plentiful Supper with a hunger-starv'd not to say Canine appetite most certainly fore-knowing by this sign that a pain of the Head would seize her next morning which sign never fail'd of Event for as soon as she awak'd being afflicted with a most cruel torture throughout the Sinciput she was affected likewise with a vomiting of a humour sometimes acid and as it were vitriolick sometimes bilous and extremely bitter it hence seeming to appear that that Head-ach had its rise from the fault of the Stomach To undertake to give the reason of this in the first place it is known that a vomiting ensues upon the Head's being injur'd viz. after a stroak Wound or a fall from an high place nevertheless a pain of the Head seldom or never follows a vomiting Cardialgia or the Stomachs being otherwise troubled unless an effervescency of the Blood happens Wherefore in the foresaid case of the Person diseas'd since it plainly appear'd that the Meninges of the Brain were predispos'd for Head-aches and that its Fits had raised an agitation of the Blood hence it will be obvious to conceive when the heterogeneous Particles by reason of the fault of Chylification were heap'd together in the mass of Blood to a fulness presently upon its beginning to flow in order to the expulsion of that which was offensive they being severed
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
of the Brain they raise a thousand and often horrible Fantasms with which Sleep is kept off or directing farther their Tendency into the Genus Nervosum they raise there great disorders which continually drive away and break off Sleep tho seeming never so much to be stealing on or to be at hand As for the former of these I have often observed some troubled with watching who dreaded to begin Sleep tho it came on according to desire for as soon as being about to sleep they closed their Eyes presently starting up again they cryed out that a confused multitude of Fantasms made them mad so that they found themselves necessitated to abstain from Sleep Secondly when the Spirits being become exhorbitant are called from the circumference of the Brain towards the inward parts in order to Sleep sometimes they convert their Sallies into the Genus Nervosum and then either rushing in a tumultuous manner into the Nerves that go to the Precordia or Viscera they cause disorders in the respective Parts hence to such as are so affected as often as closing their Eyes they invite Sleep either Tremblings Leapings and Constrictions of the Heart with Failings of the Spirits and a letted Respiration happen or inflations and Swellings of the Viscera a Sense of Suffocation and other Symptoms vulgarly accounted for hysterical or secondly the Spirits being called from their Watchings and converted to the Genus Nervosum sometimes transfer their Sallies into the spinal Marrow and thence into the Nerves that pass into all the outward Members wherefore to some when being a Bed they betake themselves to sleep presently in the Arms and Leggs Leapings and Contractions of the Tendons and so great a Restlessness and Tossings of their Members ensue that the diseased are no more able to sleep than if they were in a Place of the greatest Torture Sometime since I was advised with for a Lady of Quality who in the day time was wont to be afflicted with a Cardialgia and a Vomiting and in the Night was hindred from Sleep by reason of those spasmodick affects which came upon her as now and then she was upon the point of rest nor indeed was she able to sleep all Night unless she took first a pretty good dose of Laudanum Wherefore of this Medicine which at first was allowed her only twice a Week she took afterward daily for about three Months receiving no injury thereby either in the Brain or about any other function and when in the mean while by the use of other Remedies the discrasies of the Blood and Nervous Juice being corrected the animal Spirits became more benign and mild she afterward leaving off wholly the Opium was able to sleep indifferently well As to the cure of the VVatching-evil which we even now describ'd because it cannot be long endured therefore those things are chiefly to be given which give a present relief for this end those things are proper which sooth the Spirits and gently appease their Disorders as the vulgarly called Anodines viz. distilled waters Decoctons Syrups and Conserves of Flowers of Nymphea Cowslips Mallows Violets Knapweed the Leaves of Lettice Purslan the Willow also Emalsions or juicy Expressions And if the restles Spirits will not be mitigated by fair means we must force them to be quiet by imposing Fetters as it were and using Severity their stores ought to be diminish'd and withall the spaces in which they may freely and without tumult expand themselves ought to be dilated and cleared from the stuffings of other humours viz. of Blood and Serum for which ends opening a Vein sometimes is proper Vesicatories in a manner always have place moreover let Diacodium and Laudanum in case they agree well be frequently taken and mean while that the Opats give truce from the violence of the Disease let the cause of it be eradicated by the use of other Remedies as much as may be Wherefore day after day at Physical hours let things be given that take away the sharpness of the Blood and Nervous Juice and restore them to sweetness In which rank we account Testaceous Powders Apozemes and altering distilled Waters of temperate Antiscorbuticks gentle preparations of Steel spirit of Harts-horn of Soot and above all things tincture of Antimony There remains another kind of Watching-evil whose cause consists for some part if not mostly in the almost continual opening or too great gaping of the Pores or Passages in the cortical part of the Brain for besides that the animal Spirits being sharp and somewhat exhorbitant refuse to lye down of their own accord and to yeild to rest and that they are not kept down or subjugated by the Nervous Liquor entring the Pores of the Brain but being free and exempt from all imposed Burthen they are expanded also within the outward spaces of the Brain which are every where open for them for which cause those that have the watching evil perceive no drowsiness or heaviness of the Sinciput no appulse or desire of Sleep I have known some affected after this manner who when they had past many Nights one after the other wholly without Sleep yet being still chearful and brisk having a good Stomack and ready at business seemed not as yet to have wanted Sleep The cause of this doubtless is a burnt and melancholy Blood which supplies the outward part of the Brain with a Nervous Juice not mild and benign but too much scorcht and filled with adust Particles which consequently is neither apt to flay long within the Pores of the Brain nor kindly to receive and contain the Animal Spirits Moreover the Spirits themselves ingendred from it become too elastick and restless in their Nature so that they are neither easily appeased nor inclin'd for Sleep of their own accord Nevertheless being of a fixt Nature they do not readily fly away nor are soon tired so as to flag but last a long time and continue vigorous without any great refreshment Concerning this sleepless Disposition of the animal Spirits since it is the same as in Persons troubled with melancholy we shall have a fit place of speaking somewhat more largely of it in the sequele We may observe that Coffee also on the same account keeps Persons from Sleep for that Drink insinuates its adust Particles with which we find it to abound both by the tast and smell first into the Blood and then into the Nervous Juice which thereupon by their Agility and Restlessness both keep the Pores of the Brain still open and add spurs and a certain rage to the Spirits all other Combination and Stupefaction being deposed by which they are stirred up to a longer execution of their Functions Again as to what regards the prophylactick cure of this Watching-evil or the removal of the morbifick cause we shall give it you in the Sequel where we shall treat of Melancholy mean while for the immediate removal of that Symptome as often as it sorely presses we observe that Opiats will not do
somewhat waver so that the Diseased fall down and are often offuscated with Darkness In a fit of this it is to be observed that the Imagination and common Sense are in some sort deceived whilst they think the Objects that stand still do move but the rational judgment holds good for we know our Errour That the morbifick cause of the Vertigo and the preternatural way of its hapning may be known we must enquire after what manner the same affect how suddenly soever it comes upon us is wont to be raised by non-natural things for by a long turning round of the Body by looking from an high place passing over a Bridge by sailing in a Ship or going in a Coach by Drunkenness or taking Tobacco and certain other ways Persons every where become Vertiginous or contract a Giddiness which Affect those occasions produce in as much as the animal Spirits being greatly disturbed in their set Series and orders are both moved loosely and in a disorderly manner this way and that within the Passages of the Brain and break off certain Lines or Threads as it were of their wonted irradiation into the genus Nervosum for those two things being in a manner always reciprocal mutually succeed and depend on each other viz. the Perturbation of the Spirits within the middle of the Brain and their letted emanation into the genus Nervosum On whatever cause either affect is produc'd presently the other follows A turning round of the Body being carried in a Coach or Ship also Drunkenness an unusual taking of Tobacco force the Spirits to fluctuate or to reel disorderly in the Brain which thereupon are presently hindred from their due emanation into the Nerves so that the Persons affected are scarce able to stand or go In like manner a looking from an high place passing over a Bridge a Fainting or Swoon seizing us recall the Spirits from their wonted emanation into the genus Nervosum which therefore falling in a tumult or being disorderly mov'd within the Brain cause a Scotomia or a running round of Objects these things being thus premitted concerning the Vertigo rais'd by reason of some accident or by some evident solemn and non-natural cause we must now enquire how and after how many ways it is wont to be produc'd by an intrinsecal and preternatural cause Concerning this you may observe that the Vertigo is sometimes a symptom depending on some other affect seated sometimes within the Brain sometimes without it but that sometimes it is a Disease by it self which being raised within the middle of the Brain is very troublesome and often terrible and difficult to be cured As to the former many Diseases of the Head viz. an acute Pain the Lethargy Epilepsy Carus Apoplexy with many others have often a Vertigo joyned with them viz. inasmuch as an even expansion of the Spirits in the Brain and their irradication thence into the Genus Nervosum is lightly disturbed from those various morbifick causes Moreover this symptom is wont sometimes to be produced by reason of other affects seated far from the Brain and that chiefly after two manners For first it is usual for a Scotomia to arise by reason of the afflux of Blood call'd on a sudden from the Brain as in a swoon and great fainting in great hunger hard labour a very great hemorrhagy long fastings violent passions of fear or sadness nay through other occasions if at any time the motion of the Blood fails or faulters in the Heart so that the affected are ready to fall into a fainting of the Spirits presently because the supply of the Vital Liquor is withdrawn the Animal Spirits also failing in the Brain withdraw their irradiation from the Genus Nervosum For their Head-spring being cut off those that remain flying back from their emanation run to and fro confusedly in the Brain and raise vertiginous and often delirous affects Secondly a disorderly retreat of the Animal Spirits from some one of the Viscera or some outward member into the Brain often causes a Vertigo viz. inasmuch as the Spirits being troubled in a long series from the Part affected by the Ductus's of the Nerves at length trouble others inhabiting the middle part of the Brain and force them into the like disorders for this cause it is that sharp humours twitching the Fibres of the Stomach and that often an offensive and irritative matter stirr'd in the Spleen Pancreas or Intestines and an acute pain Ulcers c. in the Foot or Arm often cause light Scotomias in the Brain But the Vertigo is not only a symptom but sometimes is a disease primarily and of it self for the through understanding of the nature of which we must enquire into its subject formal state and causes The Immediate Subject of the Vertigo are doubtless the Animal Spirits which every person troubled with this affect perceives to be very much troubled and to move about in a confused manner but the mediate subject are those parts of the Brain in which Imagination and common sense reside and whence the next way leads into the Genus Nervosum Now these are the Corpora Callosa and Striata For the Animal Spirits love to expatiate themselves within these medullous Bodies and when they smoothly flow in one series from the two extremes attending the Corpus Callosum viz. from the Corpora Striata and Gyri of the Brain towards its middle part they represent pleasant imaginations and fancies and when in another series and haply by other Pores they flow from the midst of the Corpus Callosum into the Gyri of the Brain they carry thither the signatures of notions for the memory and when they direct themselves thence into the Corpora striata and origines of the Nerves they actuate all the moving parts and as often as there is occasion convey to them the Instincts of setting upon motions Now in a Vertigo those even emanations of the Spirits seem to be intercepted in various places and to be diversly perverted for some files of the Spirits are rendred obscure others are wrested another way and are driven this way and that into Gyri and Vortex's and often are forcibly drawn cross-wise wherefore by reason of the Spirits being so troubled in the Brain confus'd fancies erring and unconstant species of sensible things or turnings round of them are represented And then according as the Irradiation into the Genus Nervosum is lessen'd or stopt a Scotomia and sailings and faulterings of the locomotive function ensue It seems probable that such disorders of the Spirits depend on two causes viz first that some exorbitant and extraneous particles being entred the Brain deeply together with the Nervous Juice cleave to the Spirits and force them into irregular motions it being manifest to vulgar experience that this happens to some persons after immoderate drinking of Wine or Strong Waters unusual smoaking Tobacco the eating of certain Vegetables an anointing with Mercury c. Secondly we may imagine that sometimes
morbifick matter being discuss'd or evaporated from the Cerebellum the motion of the Heart is renewed as that of a Clock upon hanging on Weights In an Apoplectick Fit if after letting Blood relief follows some hope of well-doing appears but if after this and other Remedies the affect continues above four and twenty hours without remitting or grows worse all hope is over concerning the diseased If after the first seisure of a speechlesness being well over the diseased afterward becoming more drowsie and dull is affected with a Scotomia and a frequent Vertigo it is a sign that he will be obnoxious to other accesses of the Apoplexy for the foresaid affects proceed from the morbifick matter at that time deposed in the circumference of the Brain and there floating here and there and now and then descending by small parts only into the midst of it which matter whether it be Vitriolick or Narcotick after that it is gathered together to a fulness brings the Apoplexy The Therapeutick method either is curatory for removing the fit after it has seized or preservatory for preventing it from returning the former regards every Apoplexy the other only that which is habitual A fit of the Disease hapning if it does not proceed from an outward or violent hurt of the Head tho it be unknown whether it be raised by an invisible cause such as are an extravasating of the Blood in the Brain or an Abscess broken or not however we ought diligently to endeavour its cure And because the Blood being too turgid is wont to induce the morbifick cause or at leastwise to increase it and when it subsides and becomes more calm is wont sometimes to remove the same therefore in the first place we ought to deliberate concerning the moderating of its course And here a question arises concerning the site of the diseased viz. Whether he ought not presently to be put to bed or rather to be kept out of it for some time some religiously observe the latter nor is it without reason because in Bed there is a greater propension to sleep and the Blood boyling more and burning more freely by reason of the ambient hear of the Bed sends more of the recrementitious matter into the head affected on the contrary when the diseased being thinly cloathed is plac'd in a Chair the Blood flows more slowly and the subsiding Vessels seem more fit rather for drinking up humours sent from the Brain then for sending them thither Wherefore if the Patient be strong enough it may haply be better for him to stay out of Bed for six or eight Hours till the Fluxion of the morbifick Matter be past and the course of the Blood be made more calm by blooding and other Remedies carefully administred But let those that are weak and of a tender Constitution be put presently to Bed as soon as they are seiz'd Let the site of the diseased whether he be in Bed or out of it not be on his Back but the Head somewhat raised and learning sometimes to one side sometimes to the other Blooding being necessary almost in all Apoplectical Persons may not be delayed but a smart Clyster being injected let Blood be taken in a plentiful quantity In the Clyster let there be dissolved Species Hierae Diacolycinth and a thick infusion of Crocus Metallorum let a large Vesicatory be applyed to the Neck and others to the Leggs and drawing Cataplasmes to the feet let the Temples and Nostrils be anointed with appropriate Oyles and Balsoms and let painful Frictions be used to the Limbs nay to the whole Body meanwhile let those things be now and then given which raise up the animal Spirits and free them from their Fetters viz. Spirit of Harts-horn Soot and the like with a Cephalick Julep Afterward the diseased being put to Bed if he seems easie and able enough to bear a Vomit let a vomitory of Salt of Vitriol Oxymel of Squils or an infusion of Crocus Metallorum be given and now and then a Quill being thrust into his Throat let a vomiting be raised four or five times Posset-drink by intervals being poured into him The vomiting being over let comforting things as Quercitans Elixir of Life Spirit of Lavender or of Treacle camphorated Tincture of Peony or of Amber or Coral be given in a fit dose with Apoplectick and other appropriate Waters and as occasion requires let them be repeated On the second day the same Remedies being still continued let dry Cupping-glasses or with a scarification also be applyed about the Shoulder-blades or in the Neck or if more Blood ought to be drawn let the Jugular Vein be opened let the Clyster be repeated Let Spirit of Sal Armoniack or a steam of Galbanum boyled in sharp Vinegar be held to the Nostrils Moreover let Errhins and Apophlegmatisms be used afterward in the Evening let a purge of Pilulae Rudii or the Electuary of Roses solutive dissolved in some Liquour be given These things doing no good tho there be small or no hope let either a burning hot Iron or a large Vesicatory be applyed to the Crown of the Head shaved let the remaining part of it and chiefly the Forehead and Sinciput be somented with Bezoardick Vinegar Let Leeches be applyed to the Temples or behind the Ears Let Spirit of Harts-horn or of Soot be given him in a large dose and often we must insist on these and other ways of adminstrations till death seems to be at hand which as Celsus has it those kind of Remedies often only delay and in the mean while prove troublesome to life The Prophylactick Method regards both those who have been formerly set upon with one or more Invasions and those who seem prone to them as being born from Apoplectick Parents or being obnoxious to the Vertigo Incubus or frequent Faintings and such as have the Neck short and thick grown Spring and Fall let purging and blooding where it is proper be used as to the former let those that are easie to vomit take first a vomitory of the Infusion of Crocus Metallorum with Salt of Vitriol or of Sulphur of Antimony and then after three or four dayes let a dose of Pilulae Rudii or of Amber be given and afterward by due intervals let it is be repeated three or four times let two large Issues be raised near the Shoulder-blades or if those Places do not please some let them have one in the Arm and another in the opposite Leg. On other dayes free from purging let altering and cephalick Medicines be taken twice a day Take Conserve of the Flowers of Lillies of the valley or of male Peony six ounces powder of the roots of male Peony half an ounce mans skull prepar'd three drams seeds and flowers of male Peony powdered of each two drams red Coral prepar'd Pearl and white Amber of each a dram Salt of Coral four scruples syrup of the flowers of male Peony what suffices make an Electuary the dose is two drams
morning and evening drinking after it of the following water two or three ounces Take roots of male Peony Angelica Master-wort of each half a pound roots of Zedoary the lesser Galingal of each an ounce leaves of Mistletoe of Apple-trees Rue Sage Betony of each four handfuls the outward coats of ten Oranges and eight Lemmons Cardamums Cloves Nutmegs of each half an ounce all being slic'd and bruised pour to them of White-wine in which two pounds of Peacocks dung hath been infused for a day ten pounds let there be a close infusion for three dayes then distill it according to art let the whole Liquor be mixt Take species Diambroe two drams powder of the roots of male Peony choice Zedoary of each a dram and a half Pearl a dram Oyle of pure Amber half a dram double refined Sugar dissolved in Peony Water and boyled to a Consistency for Tablets six ounces make Tablets according to art weighing half a dram let the Patient eat one or two often in a day at pleasure Within fifteen or twenty dayes the Remedies that they may be less loathsome and more advantageous ought to be changed therefore instead of the Electuary give for a fortnight or three weeks sometimes Spirit of Sal Armoniack saccinated or coralliated or impregnated with Mans Scull or Castoreum sometimes the Elixir of Peony or the tincture of Amber or Coral or Quercitans Elixir of Life mixtura simplex Also instead of the compound Waters let them take either the Water of black Cherries or of Walnuts or of Rosemary or of Lavender simple sometimes a draught of Posset-drink with the Flowers of male Peony or of Lillies of the Vallies boyled in it or a draught of Tea or Coffee in the Morning those Ingredients being first boyled in the Water of which it is prepared or let a Confection of Chocolate be made after this manner Take powder of the Roots of male Peony mans Scull prepared of each half an ounce Species Diambrae two drams make a Powder to every paper of which add Cocao-nut-Kernels a pound Sugar what suffices make a Confection let half an ounce or six drams of this be taken every Morning in a draught of a decoction of Sage of Peony Flowers or the like Take Powder of the Roots of male Peony mans Scull prepared of each an ounce and a half Roots of choice Zedoary bastard Dittany Angelica Contrayerva of each two drams make a subtle Powder of all of them add the yellow Coats of Oranges and Limons preserv'd of each two ounces let them be bruised together to a Powder let about half a dram or a dram be taken an Hour before and after meals For ordinary Drink let a Vessel of four Gallons be filled with midling Ale in which boyle the Leaves of white sweet-smelling Hore-hound dryed six handfuls Anacardiums Cardamums of each an ounce and a half being slic'd and bruised make a Bag. But especially let an exact form of Dyet be observ'd Let a temperate dry and well ventilated Air be chosen let food only of an easie concoction and light be eaten let the Supper be spare or none at all let sleeping at noon drinkings and other ill accustomances about nonnatural things be shunned I might here instance several stories of Apoplectical persons viz. of some who tho seiz'd once or twice are still living and of others kill'd by the first or second or afterward at the third Invasion The Right Reverend Father in Christ Gilbert Lord Arch-bishop of Canterbury lives still who escap'd above six years since from a severe Apoplectick fit God to whom ever be praise giving success to Physical endeavours and from that time tho he has now and then undergone light touches of the Disease yet he has never been so prostrated by it as to become speechless or insensible But it 's to no purpose to dwell long in setting forth this and other examples in regard they contain nothing very rare whence the Aetiology of the Disease may be illustrated I have dissected some dead Bodies but they were in a manner only of such Persons as were seiz'd Apoplectical after the Head being greatly hurt as by a stroke or a fall in all which the Blood extravasated or an Abscess was the cause of Death As to the opening of Persons dead of an habitual Apoplexy we are most commonly hindred by Friends who expecting their revival both delay the Interrment and wholly forbid Anatomy But I shall give you here one notable Anatomical Observation made about five years since at Oxford An ancient Divine an honest and pious man of a gross Body and having a short and full grown Neck being long ill-dispos'd in his health and leading a sedentary life had contracted a very Scorbutick Cacochymia being affected with a difficult and pursy breathing and with an unwonted heaviness and drowsiness of his Head he was scarce able to perform any thing of labour or exercise but to go and come daily from his Chamber to the Chappel and Refectory On a certain morning entring the Chappel a little before Prayers as he set himself on his knees being struck on a sudden and presently becoming speechless and insensible he fell on the ground but being forthwith rais'd up and his Cloaths taken off he was put into a warm Bed My self and other Physicians being call'd and coming as quick as might be we found him not only without Sence Pulse and Respiration but cold and absolutely stift throughout his whole Body Nor could he be brought to life or to a heat by any Remedies or ways of administration tho applied with all diligence for some time Whence we imagin'd that from his first being struck the beat of the Heart was wholly stopp'd and its flame being extinct that presently all motion of the Blood was suppressed The next day after we opened the Body it appearing to be quite dead and stiff nothing doubting but very clear footstepts of an affect so suddenly mortal left within the Brain would shew themselves to the eye but neither there or in any other part was there remaining so much as any shadow of the Disease tho very violent the vessels irrigating the Meninges were indifferently fill'd with blood but without any inflammation or extravasation the Brain Cerebellum and medulla oblongata with all their processes and prominences appear'd every where firm and well-coloured throughout both within and without neither was there Serum nor extravasated Blood heapt together any where within their Pores and Passages nor also within the greater Ventricles nay and the plexus choroeides plac'd both within the Cavity of the Brain and behind the Cerebellum seemed free from all fault so that the morbifick matter being as fine and subtle as the Spirits which it affected remained wholly inconspicuous and we could only argue its presence there from the effect Nevertheless lest it should lye hid elsewhere without the Head after having accurately inspected all the Contents of the Brain we came to the Thorax where the Lungs
straitned than in the Corpus Striatum What before we said in the Apoplexy we affirm now in the Palsey that the morbid Particles are not only opilative but sometimes narcotick and extinguish the Spirits thus the steams of Antimony Mercury and Auripigment cause weaknesses tremblings and often resolutions of the Members to some using amongst furnaces of Metals In like manner we may imagine that in certain scorbutical and very cacochymical Persons heterogeneous Particles and seemingly of a vitriolick nature enter the Ductus's of the Nerves and subvert certain files of the Spirits or suppress their motion hence stupors or resolutions suddenly arise in the Members or Muscles sometimes in these and sometimes in those they often removing from place to place and sometimes a fixt Palsey is settled And in every Palsey caused by obstruction the morbifick matter is not a gross and viscous phlegm as Galen and many Physicians affirm for such does not pervade the Brain much less the Ductus's of the Nerves but seems to consist of subtle and very active particles tho injurious to the animal oeconomy for the Palsey happens to men as a blight or rust does to Plants for some Winds endued with Vapours more than cold viz. of a vitious or vitriolick Spirit when they blow upon young tender Plants presently cause them to wither viz. in as much as the tender stamina interwoven every where like Nerves in the Leaves and Branches are so throughly constring'd by the blast of the malignant Air that they no longer admit the Juice sent from the Trunk and Root through defect of which they wither after the like manner extraneous and as it were vitriolick Particles admitted within the Organs of Sense and Motion in as much as at the same time they stop the Pores and deject the animal Spirits or restrain them from Motion bring as it were a blast on the respective Parts As to the evident causes of an habitual Palsey viz. through what occasions those that are disposed to this Disease contract it sooner or being already seized with it are more severely troubled with it I say all such things make for this which add to the vitiating of the Blood also which fill the Brain and its nervous Appendix or raise suffusions of a morbifick matter in it those things likewise wich affect the Spirits with a Stupefaction or diminish their Stores in the number of these first occur disorders in the six non natural things an ill form of Dyer a drinking of strong Wines or hot Waters too much or unseasonable Sleep Idleness and a sedentary Life immoderate Venery too great losses of Blood a moist and marshy Air houses fresh plaistred metallick Fumes and Vapours frequent use of Narcoticks or Tobacco an excess of Cold Heat or Moisture vehement and long continued Passions of Sadness and Fear with many other things which I shall not here stand to relate There is another kind of this Disease depending on the scarcity and fewness of the Spirits in which tho motion fails wholly in no Part or Member yet it is performed but weakly only or depravedly by any to wit the affected tho not become without Motion yet they are not able to move their Members or to sustain any Burthen with strength moreover in any moving effort they are troubled with a trembling of the Limbs which is only the effect of Weakness or a broken strength in the moving Faculty Persons become subject to this affect by reason of an extream or valetudinary old age also through immoderate losses of Blood or Seed and likewise by reason of being very scorbutical or cacochymical and many recovering with difficulty and slowly from a chronick distemper are troubled with a languishing of the Limbs and a great resolution of the Members from their due Vigour and Strength so that tho their Stomack holds good and their Pulse and Urine be well disposed yet being enervated as it were and without Strength they scarce dare to set upon any local motion and if they begin it they cannot hold it long nay some without any considerable sickness keep their Beds for a long time as Persons ready to dye whilst they lye undisturbed they discourse with their Friends and are chearful but they neither will nor dare be raised up or walk about nay they abhor all motion as some dreadful thing Doubtless in these tho the animal spirits in some sort actuate and irradiate the whole Genus Nervosum yet their Stores are so slender and loosly set together that when many Spirits ought to be gathered together somewhere in it for motion there is great danger lest presently in the Neighbourhood their Continuity be broken off and consequently the tension in the Nervous Parts ber esolv'd Wherefore in regard the Spirits residing in the Brain are conscious of the Weakness of the others plac'd in the Members they refuse to impose local motion on their Companions as being a task too difficult for them for which cause the affected are scarce led by any perswasion to try whether they are able to go or not but those who being troubled with a scarcity of Spirits will force them as much as they may to local Motions are able at their first rising in the Morning to walk move their Arms this way and that or to lift up a weight with strength but before Noon the store of the Spirits which influenc'd the Muscles being almost spent they are scarce able to move Hand or Foot I have now a prudent and honest Woman in cure who for many years has been obnoxious to this kind of bastard Palsey not only in the Limbs but likewise in her Tongue This Person for some time speaks freely and readily enough but after long hasty or laborous speaking presently she becomes as mute as a fish and cannot bring forth a word nay and does not recover the use of her Voice till after an hour or two In a certain species of the Palsey the sensitive faculty is hurt by it self motion being still entire this is obvious enough concerning the Organs whose Nerves are only relating to Sense as of the Sight Hearing Tast and Smell and the Reason is plain enough But that in the uttermost habit of the Body or the Members sometimes the touch perishes the locomotive Power being without hurt as it is every where seen in Persons affected with the Leprosie Elephantiasis and in some troubled with the Mania who are wont to go naked and to lye on the Ground and who are become so insensible in the Skin and the Flesh of the Muscles that they do not feel the cuts of a Pen-knife or Needles any where thrust into them This I say is very difficult to be explained But concerning this it must be said that the same Nerves haply convey forward and backward the instincts of Motions and the Impressions of sensible things but that the same Fibres which are locomotive are not alway or chiefly sensible We have shewn elsewhere that the muscular and
Parts are so generally and vulgarly known that it would be superfluous to insist here in describing them at large First let Liniments of Oyles Unguents and Balsams more or less hot according to the temperament of the diseased be applied twice a day with Frictions Let Fomentations of a Decoction of Cephalick Herbs and Aromaticks in Fountain-water be sometimes us'd before these adding sometimes hot Waters Wine or Beer or their Lees moreover it is proper sometimes to apply Vesica ories Cupping-glasses a Pication or Urtication about the places affected Bags and Playsters oft do good Again if the case admits it it is profitable for the resolv'd Members to be put into Grains or the Dregs of Grapes remaining after pressing or to be thrust into the Belly or Thorax of a Beast fresh killed or also be bath'd in an artificial Bath or natural hot Baths and to be kept in any of these for a long time But if these things do no good we must come to the Universal or great Remedies such as chiefly are Diaphoreticks Mercurials raising a Salivation and strong Vomitories of each of which we shall speak in short There is no one of the Vulgar but every where observes that Diaphoreticks sometimes do great good in the cure of the Palsey and that sometimes they prove very prejudicial Wherefore it much concerns us that the reasons of so different an effect should be explicated to the end that Indications may be thence taken concerning the use or rejecting of them Therefore a copious sweating is wont sometimes to prove very advantageous to Paralyticks chiefly for two reasons to wit that it may plentifully drive forth the impurities of the Blood and nervous Juice which are apt to exhale so that the morbifick Matter may no longer flow to the Brain and the Parts affected and that that which has already flown to them may in part be conveyed forth And then secondly that the effluvia of heat passing from the boyling Blood very much open the Ductus's of the Nerves before obstructed as they pass through them in evaporating and open wayes for the Spirits Wherefore this Administration agrees chiefly and in a manner only with those whose Blood being not filled with a fixt Salt and Sulphur is diluted with a limpid and insipid Serum for on the contrary Paralyticks whose Blood and Humours are greatly stor'd with wild Exotick and fixt Particles of exorbitant Salts and Sulphurs and such as are unfit for exhaling often receive a great damage from a sweat violently raised of which effect we assign these two Causes to wit that the morbifick Particles being too much exalted by reason of their Agitation become more exorbitant and then secondly that being driven plentifully into the Brain and Genus Nervosum they often increase the ancient Obstructions and not unfrequently produce new For raising a plentiful and easy Sweat both inward Medicines and outward Administrations are wont to be used the former stir the Blood or Serum to effervescencies or stimulate the Heart to quicker Motions and thence whether one of them or both be performed when the Liquor of the Blood being rapidly circulated through the Heart and Vessels is put into a frothy Turgescency it cannot but discharge from it self a great many Effluvia which are the matter of Sweat for this end Medicines of various kinds are recommended to Paralyticks of which those of chief note are a decoction of Guaiacum Sarsaparilla c. Spirit and Oyl of Guaiacum mixtura simpelx Flowers and Spirit of Sal Armoniack Aurum Diaphoreticum Salt Powder and Wine of Vipers mineral solar Bezoar Tincture of Antimony c. Outward Administrations promote a Sweating for as much as they raise and keep a moderate heat in the whole circumference of the Body and then the Blood being heated is forc'd to move more swiftly and to evaporate more and withall the pores of the Skin being open'd more readily let forth all Particles apt to exhale for this end besides Bed-coverings which only keep the Effluvia of heat emitted from the Body in its circumference a Cradle likewise with Charcoal or Spirit of Wine kindled a Hot-house and Baths of various kinds and forms and natural Hot Baths are wont to be used but above all our Hot Baths at Bathe than which if they agree well with the temperament of the Patient no more excellent Remedy can be imagin'd which is sufficiently shewn by the Crutches of a great many Persons cur'd of resolved Members hung up as so many Trophies of the Conquest of this Disease Nevertheless as generous Medicines if they do not prove Alexipharmicks often pass into Poysons so the use of hot Baths when it has not cur'd some Paralyticks has rendred them much worse so that more Members and such as were before affected being more resolv'd there has been no other occasion for the Diseas'd for leaving their Crutches there but that being rendred more weak they could use them no longer we have hinted the cause of this before to wit that bathing exagitating the Blood and all the Humours exalts more all Morbifick and heterogeneous Particles and being rendred more exorbiant drives them from the Viscera into the Mass of Blood whence in regard they cannot easily evaporate entring the Brain and Genus Nervosum they increase the Paralytick affect and often bring a Convulsion with it for this reason Bathing sometimes first actuates a Nephritick and Gouty Disposition moreover it brings to many a Blood-spitting Asthma or Consumption where no Disposition was wherefore hot Baths ought not to be tryed without the advise of a Physician and being try'd if they seem not to agree they ought soon to be left I have it sufficiently confirmed both by my own Experience and that of some other Physicians that some Paralyticks are cured by a Salivation raised by Mercury but I judge that this kind of Remedy is to be us'd only in an habitual Palsey viz. which has a Procatarxis in the Blood and Brain readily enough to be moved and a conjunct Cause in the nervous Appendix which is not very fix'd but when that affect is caused by an outward and great hurt or happens upon a Carus Apoplexy or Convulsions Salivation is attempted in a manner always in vain and sometimes not without a mighty Prejudice and let not those who having a weak or over-lax Brain are frequently subject to a Vertigo drowsiness and convulsive Motions use Mercurial Medicines inconsiderately But sometimes a Salivation does mighty good in an habitual Palsey and which is not very fix'd for as much as by taking away the Impurities of the Blood it cuts off all the fuel of the Disease and in as much as some Mercurial Particles whilst having past the Brain they enter the Ductus's of the Nerves divide the Morbifick matter sticking in them and severing its parts one from another disperse them several ways some forward and some backward Whereas it is a common fault of other Medicines that often they press forward only the
must have regard both to the Fever and to the fury The feverish burning or immoderate effervescence of the Blood which for the most part is the antecedent cause of the other affect ought in the first place to be restrained and appeased and withall the Animal Spirits ought to be pacified and freed from any violent excandescence If a Frensy happens about the beginning or middle of a Fever in a manner the same remedies and method of Curing conduce for both ends But if that affect happens upon this whilst it is in its greatest force or height the ways of curing often are contrary to each other and there is need of great caution lest while we give help to one disease we increase the other in this case the vital indication concerning the preservation of the strength has the first place and let not Blooding or Purging be used rashly and in a large measure In the former case when the Fever and Frensy are almost of the same standing let Phlebotomy which is seldom or never to be omitted presently be used and if the strength bears it let it be sometimes repeated for nothing depresses and diminishes the immoderate flame of the Blood as much as this Remedy and nothing more removes or withdraws its burning flame from the Animal oeconomy Wherefore if the case requires it let a Vein be opened sometimes in the Arm or Hand sometimes in the Leg or Foot sometimes in the Neck or Forehead sometimes haply it may be expedient to open the Artery of the Temples and sometimes also to draw Blood from other places by Leeches or Cupping-glasses for this is the chiefest relief And according to Galen this being the first and greatest of all Remedies is wont to satisfie a great many indications in the Frensy Moreover to prevent the violent recourse of the febrile matter from the Viscera to the Head Clysters will be of chief use with which if need be let the Belly always be kept soluble Vemits and Purges unless only such as are lenitive have seldome place here Let Cataplasms of Rue Cammomil Vervain Briony Roots Red Poppy-flowers with Soap be applied all over the Feet or in their place let Pidgeons slit in two be applied whilst they are warm Mean while Juleps Apozemes Powders Confections by which both the boylings of the Blood and the excandescence of the Spirits are appeased ought to be prescribed according to occasion Take the waters of Apples Black Cherries Cowslips of each four ounces of whole Citrons two ounces Pearl powdred a dram Syrup of the juice of Citrons an ounce mix them make a Julep let three ounces be taken three or four times a day Take Roots of Grass Leaves of Wood-Sorrel Burnet of each a handful Barley half an ounce Apples slic'd Corinths or Strawberries or Rasberries a handful let them boyl in four pounds of Fountain-water to the consumption of a third part to the clear straining add Syrup of Violets an ounce Sal Prunella a dram and a half Take fresh and tender leaves of Borage four handfuls Wood-Sorrel two handfuls two Apples pounded to a mash Sal Prunella two drams the pulp of one Orange double refin'd Sugar an ounce being bruis'd together pour to them of Fountain-water two or three pounds make a strong expression keep it in a glass to be clarified by setling Let six or seven ounces be taken at pleasure often in a day For quenching thirst drink at pleasure the divine drink of Palmarius viz. Fountain Water with Sugar and the Juice of a Limon or Water or Whey with the leaves of Meadow-sweet or Burnet infus'd or boyl'd in them emulsions of a decoction of the roots and flowers of Nymphaea with the seeds of Melons or fountain or distill'd Water with the pulp of boyled Apples dissolved in them Hypnoticks are often necessary in this Disease but such as are strong are not proper presently at the beginning nor may they be frequently used because sleep caused by opiats brings the matter more to the Brain and fixes it there more deeply Take Water of Cowslip flowers four ounces Syrup of Maeconium half an ounce Pearl a scruple make a draught to be taken late at night Take white Poppy-seeds two drams Sugar-candy a dram and a half being bruis'd together pour to them of white Poppy-water six ounces wring it forth and take it after the same manner Let Narcoticks consisting of meer cold things be given with caution because they do not agree with some whose Stomachs have their fibres very tender and sensible I have often observ'd that these kinds of Hypnoticks have caus'd a great oppression in the Ventricle and that then presently its inflation and a little afterward distractions and disorderings of the Spirits in the Brain nay in the whole Body followed So that not only a frustration of sleep but a mighty restlesness was caus'd Let a dose of liuqid Laudanum prepared with Salt of Tartar or the Juice of Quinces be given in a convenient liquor Epithemes also which provoke Sleep are often applied to the Temples Forehead and Sinciput with success of which kind are Oxyrrhodinum an Embrocation of Water or Milk liniments of the Oyl of Nutmegs by expression and unguentum populneum to which sometimes let five or six grains of Opium be added or a cake of Roses or of Poppy-flowers with Vinegar and Nutmeg c. Again on this account rather than for removing the inflammation of the meninx the warm lungs of a Lamb or Weather also Pidgeons or Chickens cut in two often give an excellent relief For this use the great Burr-dock bruised and mixt with Womans Milk and applied to the Sinciput shaved is greatly commended Also Penotus's Epitheme of twelve grains of Musk half a scruple of Camphire and twenty ounces of Rose-water impregnated with the Tincture of Red Saunders is commended by some Moreover not only to the Head but likewise to the Heart Liver and other parts Epithemes are wont to be applied Let a Sacculus of fine Linnen with lays of cordial Species and Cotton stuck in it and irrigated with the distilled Water or Vinegar of Roses be applied to the Praecordia also let Linnen Cloaths dipt in Vinegar of Roses be laid on the Testles Let the Feet be bathed with a decoction of the leaves of Willow Lettice and the heads of the white Poppy But let these kinds of cooling and mitigating topicks be us'd only about the beginning of the Disease in its greatest height let Resolvents and Emollients as the flowers of Cammomil Melilot Elder c. also the leaves of Mallows Arach Marjoram Hyssop and the like be added In the declination of the Disease let Resolvents only and those sparingly be used In the mean while a very great regard ought to be had of the Strength for this being too much broken all hope of Cure is lost Now the strength is wont to be soon consumed by reason of great watchings perpetual agitations of the body and mind a thin dyet and Blooding
often drawn back become sad and timorous for since that Muscle is not actuated but by the influence of weak and irregular Spirits it is not able to perform its Contractions with Strength and Constancy enough whereby the Blood may be driven forward throughout the whole Body without stop or flying back Therefore the Blood and animal Spirits mutually affect each other with a reciprocal injury and bring dammage on each other the melancholy blood that is consisting of saline Particles exalted together with such as are sulphureous engenders animal Spirits of an acetous nature as we have shewn and these Spirits performing the vital Function amiss cause such a dyscrasy of the Blood to be encreas'd So far of Melancholy in genera viz. of its Essence conjunct Causes and chief Symptoms before we proceed to the kinds and differences of this Disease we ought to explicate from what causes both procatarctick and evident it is wont to arise and be fomented and first whence both parts of the Soul viz. both animal and vital acquire their morbid Dispositions Of these we have shewn the former to be acetous resembling Spirit of Vitriol or of Vinegar and the other to be Salino-Sulphureous or Atrabilarious moreover and that as they both soment each other so that they first engender each other for sometimes melancholy beginning from the animal Spirits being troubled and put in a certain confusion and persisting some time brings a melancholy habit to the Blood sometimes also the Blood contracting first that discrasy perverts the Nature of the Spirits That Melancholy oftentimes begins from the animal oeconomy it s easily seen in excessive Love extream Sadness pannick Terrours Envy Cares and immoderate Studies for on these occasions the animal Spirits being driven out of the wonted Paths of their Expansions and persisting in their errour through the assiduity of their Passion at length fall into devious Tracts which afterward keeping to they are with difficulty reduced into the ancient and right again Moreover since thereupon the Motion and Vigour of the Heart are diminish'd therefore the Blood falls from its due Crasis and Pneumatosis and thereby being rendred more fixt and salino-sulphureous furnishes only animal spirits degenerated to a sourness and so the Blood being depraved a posteriori gives a Fuel to the melancholy disposition begun by the Spirits Nor does it happen less frequently that the seeds of melancholy first laid in the Blood give at length that taint to the Spirits for this reason some hereditarily become obnoxious to that Disease Moreover a disorderly dyet the intermission of an exercise long us'd solemn Evacuations as of the Menses or Hemmorhoids also of the Seed or serous Ichor suddenly supprest and many other occasions easily defile the Blood and render it melancholick whose evil Disposition will afterward of necessity be communicated to the Spirits As to what a great many Physicians think that melancholy rises from a melancholick Humour engendred somewhere primarily and per se and assign particular Places for its Generation viz the Brain Spleen Womb and the whole Habit of the Body we do not easily grant all this for besides that no secret Stores of such a humour lying any where appear unless haply in the Spleen it is indeed the Blood it self which first conceives per se the melancholick Distemper or any other and afterward deposes recrements of that Nature in proper Emunctories or Receptacles nor would the yellow Choler be stor'd up in the Gall-Bladder or the black so call'd in the Spleen unless the mass of Blood first engendred those Humours If at any time these or other recrementitious humours some where depos'd be receiv'd by the mass of Blood they produce its effervescence but not presently or easily its distemperature 1. As to that therefore that the origine of Melancholy is sometimes ascrib'd to the Head and the distemperature of the Brain is accus'd by some as too hot and by others as cold I think we ought rather to say that the affect sometimes first begins from the Brain and from the Soul residing in it 2. As for the Origine of this affect being sometimes drawn from the Womb it must not be thought that the melancholy Humour is there first engendred but that the occasion of melancholy proceeds thence either because by reason of the Menses supprest the whole Blood being defil'd and become degenerate afterwards falls into a melancholy discrasy or for that by reason of the Stimuli of Venery restrain'd with a great reluctation of the corporeal Soul the animal Spirits being long contained and kept in at length become fixt and melancholick 3. That melancholy is sometimes either primarily raised or very much fomented by the Spleen being ill affected and thereupon by a peculiar word called Hypocondriacal it is both the common and our own Opinion but the Blood being first in the fault engendring in it self filthy melancholy Dregs at the beginning deposes them in the Spleen which afterward receiving again being exalted into the nature of an evil ferment it is vitiated more in its Crasis by their defilement 4. As to that that besides another species of melancholy distinct from the Hypocondriacal and the former is said to be engendred together in the whole Body it is nothing else than that the whole mass of Blood becoming degenerate from its right Nature by reason of errours in the six non-natural things and on many other occasions acquires a melancholick Discrasy that is where the Spirit being depress'd the sulphureous Particles together with the saline and some also that are terrene are exalted this melancholy disposition of the Blood being very much allyed to that sulphureo-saline Habit which we have shewn to be often prevalent in a certain kind of Scurvy The Prognostick of Melancholy tho as to Life or Death it be for the most part safe yet in reference to the event it is very uncertain for some recover soon others are not cur'd but after a long time and others not at all This affect rais'd on a sudden from some solemn evident cause as from a vehement passion is much safer than invading by degrees after a long Procatarixs for if the evident cause be presently remov'd that often ceases of its own accord or is cur'd with little ado but in this in regard both the mass of Blood and the whole troop of Animal Spirits have fallen from their due crasis and often the conformation of the Brain as to the tracts of the Spirits is altered a Cure does not happen but with great difficulty and not but after a long time Melancholy long protracted often passes into a Fatuity and sometimes also into a Mania or Madness Moreover sometimes it brings Convulsive affects or a Palsey or Apoplexy nay sometimes a violent Death There is little or no hope of a Cure if the affected being very stubborn and refractory refuse all Medicines and any method of management Moreover scarce any thing better may be expected from those who
being sick of Diseases in a manner only imaginary take any Remedies nad often require many and of divers kinds to be given them The Cure of Melancholy as it is always difficult and long so it is wont to be very intricate and perplex'd seeing that in respect of the causes of every kind evident procatarctick and conjunct also by reason of the symptoms daily energing it ought to be diversly taken in hand and often to be varied Nor must we only change the Remedies and method of Cure but variously intermix with them advices deceptions flatteries entreaties and punishments But in the first place let the evident cause of the Disease if any notable one has preceded be search'd out and if it may be let it either be presently remov'd or let the removal of it be some way counrais'd either be appeas'd or be subdued by others that are opposite Wherefore in an excessive passion of Love Indignation and Hatred come in as a relief to Sadness let baits of Pleasures Musick the desire of vain Glory be oppos'd or also a pannick terrour In like manner you may proceed with other Passions either for curbing or cluding them The Therapeutick Method fitted to the Cure of Melancholy suggests many other Indications Whereof the chief and to which the rest may be best reduc'd are those three so vulgarly known viz. the Curatory which regards immediately the disease and its Conjunct cause the Preservatory which regards the procatarctick and evident causes and the Vital which is occupied in preserving the strength As to the first Indication the Physical Intentions will be so far to raise volatize and corroborate the Animal Spirits being become fixt or dejected also and apt to act overthwartly or go astray that afterward being more freely expanded they may irradiate the whole Brain with a full and stedfast beam of Light for the acts of the Imagination Judgment and the other chief Faculties and may so vigorously actuate the Praecordia and make them vibrate so strongly that the Blood being plentifully kindled may thence spring forward without stop or restagnation throughout the whole Body Therefore for the cure of the Spirits let it be chiefly procur'd that the Soul be withdrawn from the troublesome and forc'd Passion viz. from excessive Love Jealousie Sadness Commiseration Hatred Fear and the like and be compos'd to a Cheerfulness and delight let a merry or jocose Discourse Singing Musick Painting Dancing Hunting Fishing and other pleasant Exercises be brought in ure those to whom Delights or Sports are not pleasing for these are always ungrateful to some melancholy Persons may be put upon some light Employs mathematical or chymical Studies sometimes also travelling does great good moreover it is often profitable to change the Places of their Habitation in their native Soyl. Those who must always stay at home should be advised to look after their houshold Affairs and govern their Families to cultivate and order their Houses Gardens Orchards and Fields for a Mind employed in necessary Cares and Offices more readily deposes vain or mad Thoughts and at length quits them Let melancholy Persons be seldom left alone for if at any time they are permitted to follow and dwell long on their Phantasms and aereal Speculations the Soul subsides within and leaving the Body and undergoing a certain Metamorphosis indues a new species and often contrary to the state of Man wherefore the affected ought to be continually disturbed by the discourses of their Friends and Acquaintance to wit that they animal Spirits being call'd outward from their bye wayes be brought again into their former and usual Tracts But if the diseased being seduc'd by fantastical Illusions imagine and firmly belived certain prodigious things of themselves the Mind is to be withdrawn from those things by artificial Inventions of which manner of Cures there are many Cases and Examples to be found in Books and a prudent Physician may invent the like as occasion requires Tho a melancholy new contracted is sometimes cur'd by a meer ordering and management of the Mind and the animal Spirits yet in a lopng continued to inveterate melancholy where the Spirits have contracted an acetous Disposition and the Blood an atrabilarious dyscrasy and that the Conformation of the Brain as to its Pores and Passages is injured and other indications called preservatory are required for removing the procatarctick Causes of the Disease Concerning this thing the Physical intentions must be in the first place to reduce the Blood to a better and genuine to wit a spirituo-saline Crasis and then to give a vigour to the Brain and its Pores being opened to render it clear and diaphanous and withall to strengthen the animal Spirits and to stir them up to a vigorous Emanation for which ends I propose the following Method which nevertheless ought to be varied according to the various Constitutions of the diseased Blood-letting has place in a manner in every melancholy and sometimes it is often to be repeated for the adust and effaete Blood being withdrawn at times a new and more sprituous Blood springs up in its place Concerning the Quantity Place and Wayes of administring this Remedy Authors are of various Opinions but the Motion and Affects of the Blood being duely weighed it may suffice first to draw an indifferent quantity of it from the Arm and afterward if need be a less either from thence or from the Vessels of the Fundament by Leeches how the opening of the Slavatella Vein should give so notable a releif as is said I confess is unknown to me if melancholy Persons are strongly perswaded that blooding there will cure them before any where else haply it may do them good a frequent opening of the Hemorrhoid Vessels afterward to endeavour that evacuation which spontaneously hapning as Hippocrates tells us often cures this disease Purging ought to be used from the beginning and to be repeated by intervals in regard it withdraws the fewel of the disease from the first Passages and removes the impediments of other Remedies as to what some judge that for the speedy eradicating of the Disease we must chiefly use Hellebore or the Spurges and quote Hippocrates their Author those things if the success be look'd upon are not found so generally to agree but that they often very much injure the Diseased for strong purgers do not take away the cause of the Disease to wit the dyscrasy of the Blood but rather encrease it moreover they farther weaken and prostrate the animal Spirits before dejected Hellebore is so frequently prescribed by Hippocrates because scarce any other Catharticks were then known at least wise they were not in common use but now it is far better to draw gently from the receptacles of the Humours by such as are mild and without roughness and to cleanse the Viscera and first Passages without troubling much the Blood and Spirits Vomitories as in most Cephalick Diseases free from a Fever are wont to give relief after a peculiar
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
let a gentle purge sometimes and letting blood in a small quantity if the strength will bear it frequently be used for the same pursose and likewise for deriving Faeculencies from the Brain Issues are proper in the Arm or in the Leg or together in both in gross Bodies and such as have a moist Brain it is good sometimes to cut two by the Shoulder blades Moreover it is on this account that some mightily extoll trepanning to wit whereby the Brain may transpire and evaporate the more freely let the diet belight and attenuating the Habitation in a free and dry Air the Sleep moderate After that these things have been used for some time and in a solemn manner if there be found no change it will be in vain to waste any more physical Oyle and Labour but if after the use of those things signs of benefit or some hope appear sometimes it seems proper to add altering Remedies to be taken daily at Physical hours for a long time Forms of these may be taken from our curatory part of Physick before delivered for removing the Procatarxes of most Cephalick Diseases Moreover I have thought good to add here besides some Magistral Receipts which particularly regard this case Take Spirit of Armoniack succinated six drams give from fifteen drops to twenty in the Evening and early in the Morning in three spoonfuls of the following distilled water drinking after it seven spoonfuls of the same Take fresh leaves of mistletoe growing on Apple-trees six handfuls Sage Rosemary Savory Wild-time Calamint Penny-royal Marjoyam the greater Rochet of each four handfuls roots of Angelica Master-wort of each six ounces Zedoary the lesser Galingal Calamus Aromaticus Winters bark of each two ounces Cloves Nutinegs Mace Cinnamon Ginger of each an ounce Cubebs Cardamums Grains of Paradise of each six drams all being slic'd small and bruised pour to them of the best Canary wine twelve pounds let them digest cold and in a close Vessel for three dayes then distill them according to Art let the whole Liquor be mixt and sweeten it with Sugar as you use it the Dose is two or three ounces After the use of Spirit of Armoniack for fifteen or twenty dayes let other Medicines have their turns for about the same space of time such as are the Spirits of Soot Harts-horn mans skull the tincture of Coral Antimony Castoreum Amber Quercitan's Elixir of Life Elixir Proprietatis Spirit of Lavender c. Or Take Conserve of the flowers of Lillies of the Valley six ounces roots of Aromatick-reed preserv'd six drams Ginger condited in the Indies Nutmegs condited of each half an ounce Species Diambrae two drams Lignum Aloes yellow Saunders roots of choice Zedoary Cubebs Jamaica Pepper of each a dram and half Coral prepar'd two drams Syrup of the Preserve of Ginger what suffices make an Electuary the Dose is two drams morning and evening drinking after it three ounces of the distill'd Water Let those whose Brains abound with too much moisture drink every morning a draught of Coffee with the leaves of Sage first boyled in it to those whose animal Spirits are effaete and depauperated the drink of Chocolate such as before describ'd seems profitable For ordinary drink prepare small Ale or Beer and in a Vessel of three or four Gallons let the following Bag be put after it has wrought Take leaves of Salvia acuta dried four handfuls Cubebs an ounce Cloves Nutmegs being slic'd and bruis'd mix them according to art Outward Applications have place here or which kind are a Cucupha or Cap Plaisters and Liniments and sometimes let these sometimes those or the others be us'd Take Flowers of Lillies of the Valley Rofemary and Staechas of each a handful Celtick spike two drams Roots of Cyperus the lesser Galingal Florentine orris of each three drams Labdanum Benzoin Balsam of Tolu Amber of each two drams Nutmegs Colves Mace Cinnamon of each a dram and a half make of all a jubtle powder and sew it into a cap interlacing it with Cotton Take of the Plaister call'd Flos Vnguentorum two ounces Tachamahacha Ceranna Balsam of Tolu of each three drams powder of Amber and Myrrhe of each two drams Cloves Nutmegs Mace of each a dram being melted together let them be made into a mass of which let a Plaister be made to be spread on Leather and to be apply'd to the Head shav'd Take Oyle of Palm half an ounce oleum Capivii three drams Balsam of Peru a dram oyl of Nutmegs by expression two drams oyl of Amber half a dram make a liniment for the Head I could add here many other Medicines and wayes of Administrations but let these suffice in a Case almost desperate where most commonly no Remedies do good and the Cure is never perfected CHAP. XIII Instructions and Prescripts for curing the Gout AMong the Diseases of the Head and Genus nervosum we justly rank also certain Affects which are wont chiefly to infest the Feet and Belly to wit the Gout and Colick For we may conclude from the primary symptom viz. Pain that the Seats of both are in the nervous parts I shall speak in the first place of the for mer. The Gout most commonly is wont to arise about the Internodia of the Bones of the Feet tho often it happens in the Joynts of the Hip Knee Elbow Shoulder Wrist Ancle and of other Parts The Fits of this Affect which in a manner is always intermittent either seize at random or periodically which ending sometimes sooner sometimes later good lucid Intervals ensue presently upon the first invasion Pains for the most part arise without any swelling tho afterward about the height of the Disease the Part affected often swells the Pains about the beinning scarce yield to any Remedies but are wont to be very much exasperated by Catharticks and not presently to be driven away or asswag'd by Topicks the Fits most commonly seize on a sudden and without a precious affect tho sometimes it has a fore-running effervescence in the Blood or a little Fever The Disposition to this Disease sometimes is Hereditary sometimes acquir'd through an ill Diet the Occasions or Causes which being wont to actuate the Disposition raise the Arthritick Pains are some violent alterations or Passions inflicted on the Humours and Spirits Hence Surfeiting immoderate drinking especially of acid and thin Wines Transpiration letted Anger immoderate Venery Sadness also the Revolutions and great changes of the Year and Air every where bring Fits of this Disease those that are obnoxious to this are also in danger of being sometimes troubled with the Stone or Gravel in the Kidneys and on the contrary moreover the Gout increasing gathers together every where about its chief Seats to wit the Joynts a calculous matter and there raises a tophous mass The Parts affected upon the twitching of whose Fibres the Pains are raised for the most part are the Periostia or the Membranes covering the heads of the Bones also the Tendons and
no exercise Secondly the Scorbutick affects which initate the Gout are a Rheumatism and the Arthritis vaga Scorbutica concerning which we have written in our Tract of the Scurvy The Gout has so near a Relation to the Stone in the Reyne that both affects as tho they were of the same Origine most commonly concur for scarce any Person is troubled with that Disease but he is found obnoxious to this Moreover an inveterate Gout is wont to cause strong concretions in the Joints such as the Nephritick Disease in the Reins hence I think it very likely that the ach in the Reins arrises from a like or wholly the same cause which we have assign'd for the Gout to wit that the Salino-fixt-matter depos'd by the Blood in the Reins ferments with the acid humour often sent thither by the Nervous Ductus's and that therefore Nephritick Pains are frequently caused and that afterward the Stone is form'd by both matters coagulated after fermenting As to the Prognostick of the Gout every man knows it to be a Disease that is safe enough but extreamly difficult to be cured 1. As to the former this Disease is not only void of danger as to it self but is a prevention against most other Diseases for gouty Persons by reason of a saline-fixt Discrasy of the Blood are not obnoxious to Fevers Moreover they live for the most part free from other affects of the Head or Viscera in as much as the Recrements both of the Blood and Nervous Juice are continually depos'd in the Joynts 2. But as to the way of its cure it is so diffcult that for the removal of the Procatarxis of the Disease there is requir'd both a most perfect amendment of the two Humours viz. of the Blood and Nervous Juice to wit that they engender not any Saline-fixt or acid Particles and likewise a Restitution of the weakned Joints neither of which can ever easily be done to which may be added that the conjunct cause of this Disease lies in parts very remote where the Vertues of no Medicine reach Sometimes it happens by reason of the fluxions of the Arthritick matter being supprest or struck back that one while gripes of the Belly or Viscera of the Abdomen another while a Dyspnaea Asthma or other affects of the Brest and sometimes also that the Apolexy and other sleepy or convulsive Diseases are raised from which things being observed it will be obvious to object that the Minera of the Gout is not such as we even now describedit because its saline part in regard it is the same which is appointed for the nourishment of the Joints cannot be driven thence or convey'd or depos'd elsewhere when as to the other part to wit the acid Seminium deposed in its usual place it seems that that cannot easily be driven back and being supprest by it self or in its Passage or convey'd elsewhere that it will not much hurt any part but it may easily be replyed to this that the acetous Portion of the Arthritick matter flowing in the Ductus's of the Nerves may be repelled or stopt and that being discharged on other parts it often causes very sore Diseases and indeed the nervous Liquour and its Recrements since they consist of Particles that are very subtle and active upon any small let or repulse are driven into divers sorts of sallies and fluxions Moreover when those grow turgid about the noble parts or within the Ductus's of the Nerves or meet with Particles of other Humours of another kind and ferment with them they cause various affects either inducing pain or convulsive and often in as much as Particles of a differing nature are coagulated together Tumours sometimes Strummous sometimes Cancrous or otherwise malignant arise Whilst I was writing these things I was called to a renowned Matron who formerly having been very obnoxious to the Gout after that she had been ill of late for about three Months of a very great weakness of the Stomack with an Anorexia a Nauseousness and almost a continual Vomiting at length I know not on what occasion falling into frequent Swoonings a little after she was often troubled with a Vertigo with a failing of Memory and sometimes with a slight Delirium and when she had continued so for many dayes and in the means while being free from the Gout and having a good Stomack she eat Broath twice or thrice and flesh once a day with an Appetite and disgested it without trouble this was a plain sign that the Recrements of the Nervous Humour which formerly were wont to fall by the spinal Nerves into the feet to the seat of the Gout afterward being deposed by the Nerves of the Par vagum and Intercostale in the Ventricle raised continual Troubles in it which at last partly restagnating in the Brain and partly being conveyed into the Nerves of the Heart were followed by those affects of the Leipothymia Vertigo and Delirium The Theraputick method suggests three primary Indications whereof the first being curatory is used only in the Fits for the appeasing or sooner putting an end to the Pains The second being preservatory and appointed for the intervals of the accesses endeavours to remove the Procatarxis of the Disease so that the invasions of the Pains may return but seldomj or more mildely or not at all The third being vital orders by what kind of dyet and with what Remedies the strength may be supported among the said Tortures and Life notwithstanding the frequent and almost continually troublesome oppressions of the Disease may be prolong'd and withall reinvigorated The first indication viz. the appeasing of the Pains contains these two cheif intents viz. That the Solution of Continuity be taken away and in the mean while that the irritation or excandescency of the Fibres or of the Spirits abounding in them be allayed 1. To take away the Solution of Continuity in the places affected both the fluxions of the Humours which are apt to tend thither ought to be stop'd and the Minera already there sticking ought to be discuss'd or dissipated and its Particles be restrained from their mutual Effervescencies For these ends evacuating and altering Remedies and both of them as well inward as outward are appointed we shall-set down certain select Forms and wayes of Administration of these in order Blooding in a new Gout or which is not very inveterate and especially in a hot constitution being used about the beginning of the Disease often gives relief but in an habitual Difease also in a cold temperament and in old Age it is wont to do more hurt than Good in as much as it depresses the vigour of the Blood and Spirits which are not too exorbitant without a diminution of the morbifick matter Concerning Purging about the beginning of the Disease the thing is very much controverted whilst some Physicians religiously abstain from all Purging before the declination or end of the Fit and others on the contrary constantly give strong Purges about the
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
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
to be a little chill'd and afterward plainly to have the cold fit and as it went off to sweat the reason of this was because by the hot summer the Constitution of the Blood was become sharp and very much burnt wherefore the Particles of the crude Juice mixt with it were presently scorcht and burnt that they did not wax cold first with a sourness like new beer and then afterward burn out but a Turgescency being raised the whole like dry Wood laid on the fire presently burnt out in a light flame but afterward the Liquour of the Blood after having burnt for some fits became less torrified that the depraved nutritive Juice was not presently scorcht but passed into a nitrous Matter and fermenting with a sourness which first growing turgid brought a sence of coldness on the whole Body There remains yet a great doubt concerning the distances of the returns which sometimes seem to be double in the same Fever that the first access answers to the third and both happily in the Morning and again the second to the fourth and both happen in the Evening and so on wherefore such a Fever is wont to be called a double tertian or quartan It seems to me that in this case sometimes it happens that the Fever is simple and of one kind and that the Types are a like and all agreeing with each other but that the errour chiefly arises because the intervals of the returns are not computed by hours but by dayes for since the intervals of the beginnings of the Fits are not distant from each twenty four hours exactly but either sixteen or thirty hours in a quotidian and in a tertian not forty eight hours but forty or fifty six more or less or thereabout it will come to pass that the alternate fits will happen before and the rest after noon to which also may be added that the uneven way of living which the diseased use may oftentimes produce great unevennesses of the returns that sometimes the fit comes twice a day as I have often observed in cachectical Persons and such as have used a disorderly dyet nevertheless it often happens that intermittent Fevers have returns of fits which neither observe the same distance nor keep wholly to the same sort of form I have frequently noted in a quartan Fever that besides the set accesses returning about the same hour the fourth day certain erring and uncertain fits troubled the Diseased that sometimes the day preceeding the wonted fit sometimes following it another fit also tho slight was raised anew carrying exactly the Type of an intermittent Fever with a shivering a heat and sweat and nevertheless the primary access returned at the usual time this for the most part is wont to happen either by a diet ill ordered especially by surfeiting and drinking of Wine or by the ill administration of Physick the reason of which I take it consists in this that by these errours in diet more matter is heapt together than can be clear'd off at one fit CHAP. IV. Of the kinds of intermittent Fevers and first of a Tertian WE call a Tertian Fever not that which happens at three days distance but inclusively from the day in which one fit begins on the third thence another returns mean while sometimes if the fits are long viz. protracted to twenty four hours and withall come before the usual time of their accesses the space of intermission is often less then twenty four hours The essence of a Tertian Fever consists in this that the Blood like Beer made of over-dryed Malt being too sharp and burnt does not soon subdue and ripen the nutritive Juice which is brought into it crude from things eaten but perverts a great deal of it into a Nitro-sulphureous matter wherewith when the mass of Blood is saturated to a Turgescency like new Beer put in Bottles it falls a fermenting from the flowing of that nitrous matter which obtunds the heat and vital Spirits and twitches the nervous Parts first a cold is caused with a shivering afterward the vital Spirit prevailing again this matter fermenting in the Blood begins to be mastered and to be kindled in the Heart by the burning of whilch an intense heat is diffus'd throughout the whole Body afterward its relicks being severed and mixing with the Serum are sent forth by sweat This burnt disposition of the Blood consists in this that it is impregnated more than it ought with Particles of Salt and Sulphur Wherefore the procatarctick Causes which dispose to this disease are a hot and bilous Temperament Youth a very hot Diet as an immoderate use of Wine and peppered meats but especially the Vernal and Autumnal Seasons of the Year tho most comonly some evident Cause besides is requir'd for putting this Disposition in act and we ascribe the origine of this Disease to some notable accident Wherefore a lying on the Ground or taking cold after sweating or transpiration any way hindred also surfeiting or a troubling of the Stomack by disorderly eating and whatsoever things cause an immoderate effervescence of the Blood bring into act the latent disposition of this Disease for on every such occasion the nutritive Juice heapt together in the Blood and somewhat deprav'd falls a flowing and separating from the rest of the Blood ferments it with a nitrous sourness afterward being kindled and exagitated with the vital Spirit and Heat it brings the fit with a very intense burning A Tertian Fever is wont to be most common in the Spring at which time the Blood is most vigorous and in best plight A Fever hapning if it continues not long is commonly said rather to be Physick than a Disease which in part is true because by this means the impurities of the Blood are consumed the obstructions of the Viscera are opened and indeed the whole body is ventilated so that it is wholly freed from any excrementitious matter and from the seminaries of growing Diseases but if this Disease be drawn out in length it is the cause of many Distempers and of a long sickness for hereby the mass of Blood is very much deprived of the vital Spirit and like Wine too much fermented in some manner looses its strength wherefore a Jaundise Scurvy or Cachexia follow upon this Fever when it is long a curing for by the frequent fits the vital spirit very much evaporates which in regard it is little restored by things eaten the Blood becomes thereby watery and almost without strength mean while the Particles of the Salt and Sulphur are raised and exalted more whence the Blood is made sharp and salt and so more unapt for Circulation and a Pneumatosis Moreover this Disease protracted in length often changes its form and from a Tertian becomes either a quotidian or sometiems a quartan and afterward sometimes it returns from both to a Tertian the reason of this is the various change of the Disposition of the Blood for when from being sharp and bilous as it
by a Diet and an exact form of Food which in this Disease ought to be thin and spare wherefore Hunger is commonly said to be the best Remedy of this Disease and we find by common Experience that by a spare feeding the feverish access is most commonly put off beyond it usual time There are two things chiefly to be observ'd concerning Dyet first that the Aliments be thin let nothing be given sulphureous or spirituous for so the conflagration of the Blood is lessened then secondly that when the Fit is a coming or has seized no Food be taken wherefore in fasting Persons the Fit is more mild and is sooner over What was propos'd in the third palce a stopping of the feverish access is undertaken by Remedies which stop the fermentation of the Blood and tho this Remedy be look'd upon by Physicians as Empyrical Immethodical and Deceitful yet I have found by experience that these Fevers have been oftentimes cured this way when Medicines did nothing at all tho you must observe that the use of these after bleeding and purging if there be need of them will do most good and unless these are duely premitted those others seldom stop the Fit and Vomiting Purging and Blooding unless they are used presently and at the beginning do little good nay are oftner wont to do hurt wherefore if the Choler about the beginning be plentifully cleansed forth or the Blood be ventilated by breathing a Vein it is reduced to its due Crasis but afterward in the progress of this Disease the Spirit being very much exhausted and the Salt and Sulphur being too much exalted if these evacuations are us'd they weaken the Crasis of the Blood more and therefore it is found by observation that a Tertian Fever is seldom or never cur'd and often passes into a Quotidian where these Medicines are us'd very late I have known my self in the Spring-time that certain Persons enjoying a good entire health have fallen presently into a Tertian Fever after having taken a Vomit for prevention-sake which caused a violent evacuation and that others who have been cur'd for some time of this Fever have presently undergone a relapse upon taking a strong Purge for carrying off the remainder of the febrile matter it may readily be said that the Minera of the Disease lying quiet before is rous'd up by this means by the Medicine and brought into act but if you consider this thing rightly it seems rather to be said that by a strong Purge the Crasis of the Blood is very much injur'd and whereas before it was prone to a bilous Discrasy so that it assimilated with difficulty the nutritive Juyce upon this evident cause it presently degenerates more and that it forthwith perverts the Nutriment into a fermentative matter and so incurrs the feverish disposition An Opinion has vulgarly prevail'd that a Tertian Fever can scarce be cured without a Vomit wherefore some Medicasters are wont under the pretext of necessity to give an Emetick Medicine to any Persons whatsoever troubled with this Disease tho weak and infirm not without great danger of Life and those whom they judge wholly unable to bear this Remedy they leave to Nature as not easily curable But as I am well satisfied by having often try'd the contrary that this kind of Practise is ill founded and I rather think that Vomits are seldom or never requir'd for the Cure of a Tertian Fever unless it be in a robust Body and readily inclin'd to vomit and when it happens that the Stomach is loaded with an excrementitious matter but instead of this that a gentle Purge may be more properly us'd for a Purge in this case does the same thing as a Vomit to wit it evacuates the Vessels containing the Choler that this being plentifully exhausted from the blood the feverish Dyscrasy may be corrected Now when the Humour of the Gall emptied in the Stomach is drawn forth upward a great offence is thereby brought on the Stomach and a mighty perturbation is raised in the whole body but if by a gentle Cathartick that Humour is allur'd downward it is sent forth without any trouble Moreover if to a gentle Purge repeated once or twice a very thin Diet and without any meat be added it will often answer the Preservatory indication that there will not be need of other Remedies for removing the cause of the Disease but these things being duely premitted let those things be used which either inwardly taken or outwardly applyed stop the access of the Fever By this plain and easie form of Physick viz. by purging with an infusion of Senna and Rhubarb a thin diet and a topical febrifuge applyed to the Brest or Wrists I have oftentimes known tertian Fevers cured in a short time without the use of any other offensive Medicine Nay a thin diet alone with Periapts seasonably applyed has cur'd very successfully a Woman with Child aged Persons and such as were very weak whose strength would not bear purging I have so frequently experienc'd the wished success of that method that I do not doubt but a tertian Fever if it be mannag'd this way from the beginning to wit before the temper of the Blood be more injured by an ill form of diet or by Physick ill administred it will be caured as easily as any other Disease for proof of this I shall give the following relation A certain noble Youth of a cholerick Temperament was seised with an intermittent tertian Fever as the fit came on him he vomited very much yellow and grenish Choler afterward for many hours he was sorely troubled with a most intense Heart-burning a heat and a drought The day of intermission on which it was my chance to be present eight ounces of Blood were drawn by my order from this Person and in the Afternoon an emollient Clyster was injected he used also a very thin diet viz. only of Barly Meats he took every Night going to rest this Opiate viz. Conserve of Roses vitriolated half a dram Diascordium a scruple and every Morning a Scruple of Salt of Worm-wood in a spoonful of the Juice of Oranges but these things not succeeding for the fit returned somewhat more remiss but with a violent vomiting as before and likewise in regard this sick Person greatly dreaded a Vomit because upon taking a very gentle Emetick not long before he had vomited about thirty times even till being seiz'd with a Cramp and Convulsions he was brought to a great failure of strength with danger of Life therefore the day following the said fit I gave him a potion of the infusion of Senna Rhubard and yellow Saunders with Salt of Wormwood in Fountain Water by which he purg'd ten times with relief the next Morning three hours before he expected the fit I applyed febrifuge Epithems to his Wrists and blooded him again to six onnces from which time he had no fit of his Fever and afterward being purg'd again after the same manner he grew
perfectly well But if a Tertian Fever by reason of the evil constitution of the diseased or by reason of errours committed in diet or Physick has laid its roots deep that after a long continued affect the fits still grow worse and worse and the diseased mightily languish their strength being dejected with a thirst and burning almost continual a loss of Appetite Watchins a weak Pulse a ruddy Urine and very full of contents somewhat a differing method of Cure ought to be ordered in this case first it must be endeavour'd that the Discrasy of the Blood be removed wherefore let the diseased feed only on thin diet as Barly or Oat Meats with the opening Roots boyled in them wholly forbearing Meat Broaths let the Belly be kept soluble if it be needful by the use of emollient Clysters Moreover Catharticks being omitted it seems that we ought only to insist on digestive Medicines which fuse the Blood and gently lead forth the serous Impurities by Urine and comforting Remedies which strengthen the Viscera and refresh the Spirits for this end apozemes of diuretick Herbs and Roots neatly prepared also Opiats of temperate Conserves with Sal Nitre or the fixt Salt of Herbs and with testateous Powders and Spirit of Vitriol mixt with them excellently conduce when the Crasis of the Blood is somewhat amended that the Urine is clearer and less colured also the sleep quieter with an abatement of Thirst and Heat then Remedies may be profitably given for stopping the fit of the Fever Wherefore let febrifuge Epithems be applyed to the Wirsts and to the Soles of the Feet also let the Powder of the Peruvian Bark or of its Succedaneum or also of the Bark of an Ash of Tamarisk or of Gentian be given in White-wine with the mixture of Salts After that the accesses are taken away and the diseased begin to gather Strength to have a Stomack and in some measure to concoct what they take gentle Purges will be of use but let the diseased still abstain from seeding on Flesh or rich fare and it is not to be doubted but he will soon recover his perfect Health without violent purging or blooding CHAP. V. Of the Intermittent Quotidian Fever or Ague NExt after a tertian Fever by reason of their Affinity and the likeness of the Fit follows a Quotidian viz. whose access is wont to return every day It is the Opinion of some that this Fever is only a double Tertian and that it arises from the matter being disperst and getting possession of a two-fold focus to which nevertheless I do not agree and I judge that its rise is to be attributed to a peculiar Discrasy of the Blood in this the symptoms of Heat and Cold are more remiss but the access holds longer and is often wont to continue eighteen or twenty hours this Fever for the most part follows upon a Tertian for when the vital Spirit is much spent by a frequent Deflagration of the Blood and the feverish Disposition still remaining the Blood is become weaker it less concocts or brings to perfection the nutritive Juice and perverts it in a manner wholly into a fermentative matter wherefore it is sooner brought to an increase and is heapt together to a plenitude of Turgescency in half the time as before but because the matter heapt together partakes as well of crudity as adustion therefore the heat of the fermentation is more remiss and more uneven and like green Wood laid on the fire it burns more flowly wherefore the fit is of a longer continuance Sometimes it happens that a Qutidian Fever arises first without a foregoing Tertian viz. when a feverish affect seises a Body that is cacochimical and filled with evil Juices for then the Blood being poor in Spirits perverts the nutritive Juice in a greater store and heaps it together in a shorter time to a plenitude of Turgescency and that which at first is a Quotidian often changes its Type and becomes a Tertian even as a Tertian often passes into a Quotidian there being a great vicinity betwixt these Fevers and their Causes and a little change of the Constitution of the Blood makes a transition of the one into the other An intermittent Quotidian Fever is not so easily cur'd as a Tertian for whether that comes first simply or follows upon another intermittent however it is raised drom a stronger cause and argues a greater Discrasy of the Blood which does not presently yield to Remedies Moreover this Fever if it be of Long eontinuance or comes upon another Cronick Disease besides the vice of the Blood it has most commonly joyned with it infirmities of the Viscera to wit the Blood being vitiated easily fastens its Impurities heapt together by degrees on the Viscera as it passes through their Involutions Hence in a quotidian Fever a loading of the Ventricle a tension of the Hypochondres obstructions or Tumours sometimes of the Liver sometimes of the Spleen or of the Mesentery are joyn'd tho these kinds of Affects are not the cause of the Fever as is vulgarly thought but only its products Wherefore in this Fever besides the simple Method of Cure which is indicated in a Tertian many other Intents or Coindicants come in consideration viz. We must use all our Endeavours that the Ventricle be purged of its load of Humours that the stuffings of the Viscera be clear'd that their Infirmities be strengthned and together with these that the Discrasy of the Blood be amended and the feverish accesses stopt so that by reason of these various kinds of Intentions we must proceed by a longer way to the Cure In this case Vomits if the Strength will bear them will be of use above the rest also Purges with which the assiduous increase of the excrementitious Matter may be sent forth must be often repeated besides these digestive Remedies and deobstruents which restore the Ferments of the Viscera and of the Blood and correct their Discrasies are frequently to be used Wherefore fixt Salts of Herbs their extracts the acid Spirits of Minerals and sometimes Preparations of Steel do excellently well Concerning these means there is a difficult task since because of the manifold evils many things are to be done together whereas by reason of the assiduity of the feverish fit the Diseased can use only a few In affects thus complicated tho the way of Method requires first a removal of Impediments and then to cure the Disease yet I have known this kind of Fever cured often without method and empirically in a cacochymical Body attended with many other affects to wit after a light provision for the whole febrifuge Remedies outwardly apply'd have first taken away the feverish access that afterward time and occasions of curing might be the better afforded for the other affects I lately went to see a Lady of Quality who having long had a cachectical habit of Body and being weak and feeble a month after Child-birth was seized with an intermittent Quotidian after fix
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
is brought as it were to flame and therefore from its likeness to humid things putrifying which contract a fervour this kind of ebullition of the Blood because it causes an immoderate Heat is called a Putrid Fever Which name it ought properly enough to retain because in this Fever the Composition of the Blood as it usually happens in Liquors putrifying is very much dissolv'd and so that its Principles are in a manner wholly severed from each other by the ferment of the Heart and the active Particles being loosened from the mixture break forth as it were into a flame Wherefore the Liquor of the Blood being after this manner rarified and as it were kindled in the Heart is carried thence with a most rapid motion through the Vessels and with its deflagration sends a great many effluvia's of heat from it hence the whole mass of Blood like water set on the fire continually boyling stretches the Vessels vellicates the Brain and nervous Parts raises Cramps and Pains in them very much consumes the Vital Spirits by its effervescency destroys the ferments of the Viscera hinders the functions of concoction and distribution often depraves the nutritive Juice sent into the Genus Nervosum that thereby very great disorders of the animal Spirits ensue nay it perverts in a manner the whole oeconomy of Nature The Procatarctick Causes which dispose to this Disease are a hot and moist temperament an Athletick habit of Body Youth the Spring or Summer season a plenteous and rich Feeding moreover an assiduous drinking of rich Wines a sedentary and idle Life a Body cacochymical and filled with evil Juyces but above the rest it is observed that a frequent letting blood renders men apt to a Fever wherefore it is commonly said that those who have been let blood once unless the same be done yearly are prone to a Fever The reason is that by a frequent letting blood the Sulphur is more copiously heapt together within the mass of Blood the Salt in the mean while which ought to moderate and keep it from growing exorbitant being by this means withdrawn The Evident Causes which draw the latent disposition of this Fever into act are of the same kind as those which bring an Ephemera Fever and a Synochus Simplex in this rank we place chiefly perspiration letted and surfeiting By reason of the effluvia being restrain'd the mass of Blood being increas'd in its bulk grows turgid and being inspir'd anew with a certain ferment as it were falls a burning and boyls violently thereupon presently the Pores are more obstructed by the stuffing of the effluvia and the texture of the Liquour being dissolved the particles of the abounding Sulphur in the Blood get free from the mixture and are inflam'd by the fermentation of the Heart as tho Fire were applied to them and so they kindle a very intense Fever And by surfeiting both an immoderate fermentation is caused in the Blood and also a nitro-sulphureous matter fit for burning and being enkindled is conveyed as a fuel into the inflam'd Blood In this Fever four states of time are to be observed by which as by so many Stages its course is performed and they are these the beginning the Increase the height and the declining state these are wont to be pass'd over in some sooner in some slower and in a longer time The beginning ought to be computed from the time that the Blood begins to grow hot and its Sulphur to fall a burning till the burning Heats and inflammations are diffus'd throughout the whole mass of Blood The increase is from the time that the Blood being heated and kindled throughout has burnt for some space and its mass is loaded with Recrements or adust Particles which also increase the Fermentation The height of the Disease is when after the Blood has burnt enough and its inflammation is remitted the long troubled Blood as a noble Champion its adversary somewhat giving ground recollecting all its Forces endeavours a subduing and separation of that adust matter wherewith it is saturated to a fulness and a driving of it forth a Crisis being attempted once or oftener The declining state follows after the Crisis in which the Blood the inflammation growing weak becomes less hot and either the vital Spirit still prevailing it subdues and purges forth by degrees what there is remaining of that adust and extraneous matter till it be restored to its ancient vigour or the same Spirit being too much deprest the Liquour of the Blood is still tainted with adust Recrements and therefore becomes troubled and depauperated that it neither assimilates the nutritive Juyce nor continues fit for Circulation nor for accension in the Heart for sustaining the lamp of Life When therefore any one is seized with a Putrid Fever for the most part a cold stiffness or a shivering accompanies the first invasion which is followed by a Heat which is unequal and not as yet intense because the Blood being yet full of crude Juyces is kindled only by parts and therefore it burns a little and then ceases and then begins again like a flame burning wet straw in this state the Disease continues for some dayes the Urine becomes more ruddy than usual by reason of the Salt and Sulphur more dissolved and incocted with the Serum it retains still its Hypostasis because the coction and assimilation are not altogether depraved it has a sediment greater than it ought which nevertheless is easily separated and subsides of its own accord at this time you may let Blood and give a Vomit or a Purge so it be done without any great Perturbation of the Blood It often happens upon the seasonable administrations of these kinds of Evacuations that the greater increases of the Disease are prevented and that the Fever is killed as it were in ovo the limits of this stage are variously determined according to the temperament of the Diseased and other accidents of the Disease Sometimes within a day or two the first Rudiments of this Disease are laid sometimes the beginning of the Disease is extended to more if it happens in a Body well in Flesh full of Spirit and of a hot Blood and Juyce in the time of Youth and in a very hot Season in case the Disposition to a Fever be great and a strong evident cause supervenes the severish Effervescence once begun soon pervades the whole Blood and on the second or third day the root being laid the Disease arises to its increase but if the feverish Indisposition begins in a body that is not hot a Phlegmatick or melancholy temperament in old age or in a cold Season it has a longer Proaemium and scarce passes the limits of this first stage before the sixth or seventh day The increase of this Disease is computed from the time that the burning of the Fever has got possession of the whole mass of Blood that is the Sulphur or the oily part of the Blood being long heated and boyling
thin juyce be administred whence the mass of Blood is refresh'd with a genuine Spirit and Sulphur 2. After an evil Crisis the thing is otherwise the Liquour of the Blood like Wine too much fermented wholly loses its strength its Spirit is greatly diminisht what there is remaining of it for the most part is involv'd and as it were overwhelm'd with Particles of adust matter whence a continual Effervescence remains still in the Blood tho without coction or assimilation of the nutritive Juyce or a separation of that which is useless from what is good the benign Sulphur and Food of the vital Flame is much consum'd so that the Blood is kindled in the Heart less than it ought mean while through adust Recrements and raised to too great a height with Salt and Earth it continually boyles in the Vessels with a Drought and a Heat and because it is daily depauperated upon the continual spending of the benign Spirit and Sulphur and is more tainted with the Salt and earthy Faeculencies too much exalted its Liquour in a short time grows vapid and becomes unfit for circulation and accension in the Heart for upholding the vital Fire wherefore Life must necessarily fail 3. After an imperfect and doubtful Crisis when the Diseased being broken by a long continued Weakness recover not but after a long time the case stands thus the Spirituous and Sulphureous parts of the Blood are very much consum'd by their long burning the remaining Liquour being not purg'd from the adust Recrements and Feculencies is rendred very impure and there remaining still somewhat of Oyle for the vital Flame and the Spirits not ceasing wholly from working upon the febrile Matter the Blood is still circulated and tho in a small measure is kindled in the Heart nay and the Spirits recover themselves by little and little and begin to set upon the matter remaining after the Fever and at length wholly subdue it and restore a sprightly Fermentation de Novo in the Heart CHAP. IX Of the most observable Symptoms and Signs in a Putrid Fever THE accidents which a Physician ought chiefly to consider in giving a true Diagnostick and Prognostick of this Disease may be reduced to three Classes as it were or common Places that is to say they have regard to the Viscera of Concoction viz. the Ventricle and Intestines with their Appendixes or secondly to the Humours flowing in the Vessels to wit the Blood in the Arteries and Veins and the thin Liquor in the nervous Parts together with the first sources of both viz. the Heart and Brain or lastly those Symptoms regard the habit of the Body with the various constitution of the Pores and the firmness or pining away of the solid Parts those who will exactly observe the course of the Disease and aptly draw the Curative Intentions must mind these three heads of Symptoms and diligently observe what alterations happen in these distinct Regions as it were according to the differing times of the Fever 1. Concerning the Ventricle and first Passages in the whole course of this Fever tedious affects and Disorders as a Nauseousness a Vomiting loss of Appetite Indegestion a Diarrhoea a roughness of the Tongue and Mouth a bitter savour are wont to molest them these things for the most part are attributed to the Humours first heap'd together in the Stomach and there putrifying but besides that the Recrements of the Chyle being burnt with too much heat degenerate into an offensive matter often those kinds of accidents happen because the off-scourings and filth of the Blood and nervous Juyce whilst they ferment are carried inwards and being depos'd within the Membranes of the Viscera cause Contractions and make a filthy heap of a vitious and very infesting Humour I have often observ'd that about the beginnings of Fevers the Blood vehemently boyling still depos'd its recrments in wardly to the benefit of the Diseas'd where tho some tedious affects hapned about the first Passages yet the effervescence was thereby more mild the Pulse moderate and the Urine laudable and after this manner those that were ill of a Fever with a thin Diet and the use of gentle carriers forth of Excrements recovered in a short time but if in this case I gave a violent Cathartick for extirpating the Humours that natural purging of the Blood being letted presently the Fever became intense with a ruddy and troubled Urine a high Pulse Watchings and other horrid Symptoms also often after the height of the Disease the adust and excrementitious matter is sever'd from the Blood by this kind of inward lustration hence sometimes a loosness sometimes crusty breakings forth of the Mouth and Throat happen wherefore concerning the accidents which happen in the first passages there is need of caution lest while we obviate those we pervert the Motion of Nature and lest whilst we fortifie these Parts against the incursion of the morbific Matter we perversly keep the same shut up in the mass of Blood The Symptoms chiefly to be considered in reference to the Mass of Blood are a heat diffus'd through the whole a great trouble of the Praecordia a ruddy Urine a spontaneous Lassitude a Swooning from which being duely considered these following things may become known viz. what the degree of heat is or according to what tenor the inflamed Blood burns what times of remission or exacerbation its effervescence observes whilst it burns whether it retains its Crasis or its mixture entire what strength of the Heart suffises and what space the Vessels afford for its burning and the circulation of it being kindled in what store the Blood whilst it boyles heaps together adust Recrements after what manner it subdues and severs them or at leastwise endeavours to sever them in fine what way of Crisis it endeavours and with what success The Accidents which regard the thin Liquour with the Brain and the nervous Appendix are disorders about Sleep and Watching a Weakness of the whole Body a Trembling a Tetanus Pains convulsive Motions Contractions of the Viscera a Stupor a Phrensy and the Observation of which will suggest to us what is the Temper and Constitution of that thin Liquour after what manner it irrigates and influences the Nervous parts and circulates through them how the animal Spirits perform the Functions of the Viscera what is the state of the Brain whether it continues free from the incursion of the feverish matter whether it be not in danger of being overwhelm'd by reason of its critical Metastasis Concerning the Habit of the Body we must consider the manner of its Perspiration and the degree of it whether it be only by vapory Effluvia or by Sweat or also by Pushes whether the flesh falls on a sudden from its wonted bulk or whether it retains it a long time what is the colour of the Face and the Vigour or dulness of the Eyes from these things being duly compared together we excellently measure the Course of the Fever at what
it 's probable that that matter by long Coction is so parch'd and grown thikc almost like Glew wherefore it is neither to be blown off by Sweat nor insensible Transpiration nor is fit to be separated by the urinary Passages but at length distills forth by degrees from the little Arteries and other Ductus's of the Saliva which open themselves into the Mouth as being the usual way of Excretion and presently by reason of its thickness it settles into that clammy Humour The same Reason holds concerning Infants whose Blood being rendred impure from the Filth contracted in the Womb presently by making an outward Efflorescence it endeavours to purge it self which if by reason of the Thickness of the Matter it does not succeed well presently the viscous Impurities are exterminated this way as the more open I knew a certain Person in the Declination of a Fever who had not only an Incrustation of this kind of a clammy Humour in the Parts of the Mouth but a copious Salivation as tho he had taken Mercury was raised in him for many Days with a stinking Breath and a swelling of the Tongue and Gums 7. A Head-ach is raised in Fevers by reason of the Meninges of the Brain being twitcht by Vapours and by a sharp and boyling Blood for the Blood being violently moved it is carryed in a greater Plenry to the Head by reason of the streight Direction of the great Artery than to the inferiour Parts to which it is carryed obliquely And sometimes Head-achs arise by reason of the nervous Juice which is supplyed from the boyling Blood being too sharp and pungent wherefore when the Membranes and nervous Parts are irrigated with the same being twitcht by its Acrimony they are cast into Pains and Contractions 8. In like manner also the other Affects of the Head as Watchings a Delirium a Frenzy Conyulsions c. sometime arise from the Blood making an Fffort and so raising disorderly Motions in the Brain sometimes also from the nervous Juice degenerated and therefore become disproportionate for the Governance of the animal Spirits but most commonly these kinds of Symptoms are rife in Fcvers by reason of a Metastasis of the febrile Matter from the stock of Blood into these Parts for the Blood being full of adust Recrements remaining after Deflagration endeavours like working Wine wholly to subdue them and to exclude them from its Society which when a flowing hapning it is not able to expell by Sweat Urine or an Hoemorrhagie it often conveys them into the substance of the Brain and there fixes them and hence chiefly the foresaid Affects when they are fixt and firmly rooted take their Rise but when they are light and easily moveable they often proceed from the Causes before mentioned 9. Convulsive Motions happen in Fevers for divers Causes sometimes by reason of a Matter heapt together in the first Passages which by reason of its mighty Pravity twitches there the membranous Parts and afterward by the Consent of the Genus nervosum presently a Convulsion is communicated to the Origine of the Nerves in the Brain and thence is retorted sometimes into these Parts sometimes into others after which manner Worms gnawing in the Entrails sharp Humours moved and venemous Medicines cause Convulsions or secondly when a Fever partakes of some Malignity so Convulsions srequently happen in the Small Pox Meazles or Plague to wit because the Blood is altered from its benign and natural temper to a venemous Nature whereby the Nerves and their Origines are put upon Motions and Contractions often also without a suspicion of Malignity in a Putrid Fever convulsive Motions are caused by reason of a Metastasis of the febrile Matter to the Brain as it was hinted even now so I have often observ'd when a Disease is not presently solv'd by a Crisis the Diseased lye ill of a long Sickness and become obnoxious to convulsive and trembling Motlons Thirdly for the most part in every Fever convulsive Motions are the sad Fore-warners of Death which I think to happen not only through the malignity of the matter whereby the Genus Nervosum is twitcht and troubled but because the Spirits being very much exhausted and weakned do not sufficiently influence and extend the Bodies of the Nerves wherefore being relaxt from their wonted Tension and tonick Motion through the weaker effort of the Spirits they are still put upon a disorderly motion 10. Swooning is wont to be caused many ways in Fevers but chiefly for three Causes viz. Either throught the Mouth of the Stomach being affected which part being interwoven with sundry Plexus's of Nerves is very sensible and because from the same branch of the sixth Pair branches of Nerves are derived to the Heart and Ventricle if the Orifice of the Ventricle so beset with Nerves be affected with great Pain the offence also is communicated to the heart and in this the Motion is either stopt or at leastwise a disorderly one is raised whereby the even afflux of the Blood and Spirits is interrupted for a time I knew a certain Person in an acute Fever seiz'd with a srequent swooning which Affect nevertheless wholly ceased after that he had cast up by Vomit a long and round Worm Secondly a swooning also is sometime caused because a venemous Matter is circulated culated with the Blood which fixes and extinguishes the vital Spirits on a sudden and congeals the Blood it self that it is apt to stagnate in the Heart as it is usual in the Plague Small Pox c. of which we shall speak particularly beneath Thirdly A Swooning is wont to happen by reason of the fine Texture of the Spirits which being very thin and subtle easily yield to a Fainting upon any immoderate Motion or Pain so I have known some who lying still in their bed were well enough but being moved to any side presently fainted 11. A Cardialgia happens in Fevers when the Ventricle and especially its Orifices being very sensible by reason of the manifold Insertions of Nerves are beset with a sharp and betterish or also with an acid and corrosive Humour for hence a Pain arises from the Acrimony of the Humour after the like manner as when the Sphincter of the Anus is affected with a tedious Pain in bilous Dejections 12. For the like Cause a Vomiting and a Nauseousness are wont to be raised to wit the Ventricle being beset and irritated to a Contraction by a matter which is extraneous and not agreeing with it self Such an excrementitious matter is heapt together in the Ventricle after three manners for either the Aliments partly through defect of an acid Ferment wherewith they ought to be duely concocted partly by reason of the burning Heat of the Ventricle are parcht into such a Mass of Corruption or secondly this kind of Matter is deposed into the cavity of the Ventricle from Arteries terminated in it as it usually happens in the Small Pox Plague and malignant Fevers or thirdly meer Choler
exprest from the Meatus Choledochus into the Intestinum jejunum by reason of an inverted and as it were convulsive Motion of the Intestine is cast up into the Stomach The loss of Appetite also happens by reason of the Ventricle being filled with vitious Juices and because the acid Ferment is wholly perverted by the scorching Heat These kinds of Affects of the Ventricle and Viscera sometimes arise from an excrementitious matter viz. the Alimentary degenerated whilst it was concocting heapt together in the first Passages a long time before the Fever which often is the occasional Cause of the Fever it self but sometimes the Nauseousness Loss of Appetite Vomiting Cardialgia c. are the immediate Products of the Fever for when the day before the falling sick the Affected had a Stomach good enough assoon as the immoderate Effervescence is brought on the Blood whilst that boyls above measure both the Effluvia and Recrements wont to be evaporated outwardly and the bilous Humour flowing from the Vasa Choledocha are pour'd into the Stomach with which its Crasis is perverted and the Relicks of the Chyle and other Contents in the Viscera are mightily depraved whence the foresaid Affects draw their Origine 13. Nor is a Loosness a less frequent symptom in Fevers which sometimes happens about the beginning of the Disease and arises for the most part either from the Choler flowing from the Vasa Choledoca into the Duodennm or from the Recrements of the Blood and Nervous Juyce pour'd from the Arteries and Ductus of the Pancreas into the Intestines Sometimes also about the height of the Disease and in its declining state a loosness is raised and so either Nature being conqueress the grosser off scourings of the Blood are this way Critically voided or the same being overcome the loosness is an effect and sign of the Viscera being wholly dissolv'd in their strength and firm tone Sometimes it happens in a Fever that the Belly is alwayes bound and unless irritated by a Medicine it discharges nothing and tho the Diseased have taken only liquid things for many dayes the stools are alwayes of a solid and hardish consistency and this seems for the most part to be done when the Blood burning greatly with a smart heat consumes the moisture lying in any part like Fire and by a copious emission of stems draws the watery matter from the Viscera into it self and presently causes it to evaporate outwardly wherefore the grosser part left in the Intestines is thickned by the parching heat as the Caput Mortuum remaining after distillation 14. The bloody Flux is an affect so frequent in continual Fevers that in certain years it becomes Epidemious and being as bad as a Plague it kills many the cause useally is not a humour produ'd inwardly in the Viscera which corrodes the Intestines with its Acrimony as some assert but some Miasm past into the Blood and so in wardly mixt with it that it cannot be forc'd from the Blood under the form of a Vapour or sincere Humour wherefore being driven toward the Intestines it opens the Mouths of the Arteries and causes little Ulcers and Distillations of Blood there as when from a feverish Blood taking toward the Skin Pushes and inflamed Swellings break forth outwardly and it is likely that those affects of the bloody Flux which accompany malignant or epidemious Fevers may airse from a certain coaulation of the Blood The pulse and Urine bring up the rear of the Symptoms and Signs in a putrid Fever which are chiefly to be minded for knowing both the state of the Disease and the strength of the Diseased for there being two things by which our Life is supported viz. Heat kindled in the heart and Coction to be perform'd in the Viscera and Vessels because the Pulse and Urine excellently shew the alterations caused in both by the Fever therefore hence a most certain Judgment is taken of the affect whether it will terminate in Death or a Recovery First we consult the Pulse as a Thermometer constituted by Nature for measuring the heat kindled in a Fever which if it be intense and raises a great ebullition of the Blood the Artery has a vehement and quick beat as long as the Spirits hold a good Vigour afterward the same being somewhat exhausted the strong Pulse remits which nevertheless is recompens'd by quickness and becomes quick and small If the Fever be mild and be attended by a less burning the Pulse also declines less from its natural state and in the whole course of the Disease the moderation of this denotes a truce of Nature nor does the Pulse only discover the strength of the Fever as it were of the Enemy but plainly shews also the sktrength of Nature and its ability of resisting as long as the Pulse is laudable things are in safety and it gives very good hope but from the evil state of this a very ill omen is given and a despair of doing well So that without a srequent and diligent examining of the Pulse the Physician can neither make a due prognostick nor safely order a Medicine 1. As to the first he ought to know as far as he may what sort of Pulse a Person has according to his natural Constitution for in some it is strong in others weak again in each change of Fevers he must weigh by what degrees it differs from its natural state for one while it is more vehement than it ought and argues the Fever to be intended another while it 's deprest lower than usual and denotes the Spirits and Strength to be dejected Those whose Artery has a weak and languid beat in their state of Health when they are taken with a Fever it is not so very ill with them to have a small and weak Pulse that we must presently despair of their well doing those who have naturally a strong and vehement Pulse if after the Crisis of the Disease it scarce holds a mean Vigour tho it be not altogether weak it argures the state of the diseased to be suspected and not safe If at the beginning of a Fever before the Blood has much burnt or if after a Crisis when part of the burthen is diminisht or if at another time the Pulse becomes weak without an evident cause it fore-bodes ill but if after long Watchings or after a great Evacuation the Pulse becomes somewhat weaker we may not therefore despair of a Recovery because Strength dejected or impair'd by these means may be again restor'd and the Spirits may be refresht When the Pulse on a sudden is altered for the worse tho the Diseased as to the rest of the Symptoms seems to himself to be better you may give a sad prognostick of Death and on the contary tho horrid Symptoms are pressing if notwithstanding the Pulse be laudable we may still hope for a Recovery If in a robust man being in a Fever the Pulse becomes very small and formicating Death is near at hand 2. In giving Medicines
we think somewhat otherwise to wit that in Truth there is no Putrid Fever which is merely symptomatical occasionally perchance it may arise from some other Affect but it is founded immediately in the sulphureous part of the Blood too much heated and as it were kindled for without a Procatarxis or precedent Indisposition of the Blood the foresaid Affects seldom or scarce at all bring a putrid Fever As to the Squinancy Plurisie and the like I say that those are Products of the Fever or Affects following it but not Causes of it for most commonly an evident Cause has preceeded which has produc'd the feverish Effervescence of the Blood as a taking of Cold an Evacuation restrain'd c. afterward tho the Diseas'd are not forthwith openly feverish nevertheless a greater Ebullition of the Blood than usual is raised as we may easily gather from the Urine Pulse and Restlesness of the whole Body After some Days sometimes sooner sometimes later an Inflammation is produced in this or that part whereof a probable Reason enough is thus assigned The Blood by reason of the Effluvia retained which are like a Ferment is increas'd in bulk and swells its Vessels more than usually and when through defect of Ventilation it is straitned in the space of its Circulation it readily finding a way springs forth of the Arteries and being extravasated upon the course of Circulation its being interruptted it is raised into a Tumour and because by that kind of Tumour a Heat and Pain in the Part are made more intense the Blood is more troubled in its motion and so the Fever first kindled is more aggravated Moreover in these kinds of Fevers we may observe a certain aptness of the Blood to coagulate whereby it becomes less fluxile and so apt to be congeal'd in the lesser Vessels even as we find in Milk when it begins to turn sour for then it cannot be boyl'd nor warm'd on the Fire without coagulating in like manner we have reason to suspect in the Blood also a certain Diposition to turn sharp by reason of which it is obnoxious to coagulation for it plain enough appears that in the Phrensy Peripneumonia Squinancy and the like Diseases an Inflammation or Extravasation of the Blood does not always depend on the exuberancy of the Blood and the plenitude of the Vessels for often with a weak Pulse and a subsiding of the Vessels the Blood is stopt in its Motion and being extravasated in the side or else where causes an acute pain It only remains for us to enquire whether the Fever which accompanies these affects be to be accounted of the number of those which are called putrid or not To this we reply that oftentimes they are simple Synochi in which only the subtle and more spirituous part of the Blood is inflamed and therefore if after a copious taking away of Blood or the Vessels being emptyed by sweat the extravasated Blood be restor'd to Circulation presently the Effervescence is restrain'd and the Fever in a short time is appeas'd Nevertheless sometimes when a Predisposition happens as in a Plethora or mighty Cacochymia a putrld Fever is kindled together with these kinds of affects wholly from the same occasion Among Symptomatick Fevers they place that which is vulgarly call'd Febris Lenta those that are troubled with this grow hotter than they ought especially after Meats or any Motion or Exercise the Urine for the most part is ruddly the Spirits are weak and the Strength dejected as to Appetite and Sleep they find themselves indifferently well they are without a Cough or much Spitting but daily like consumptive Persons they pine away and without any manifest cause the fault for the most part is ascribed to Obstructions in some one of the Viscera suppose the Liver Spleen or mesentery by whose default the Food is not well concocted nor duely dispen'd but it seems to me that this kind of affect is immediately founded in the evil Disposition of the Blood whereby it inclines to an over-salt and sharp Temper and therefore is rendred less apt for Nutrition and an even Circulation But the Fever which most deserves to be called Symptomatical is that which is raised in Ptysical Persons from an Ulcer or Consumption of the Lungs for the Blood whilst it wholly passes through the Lungs in its circulation often imprints on this entral the Ideas of many Diseases and on the contrary from the Lungs being ill affected it receives the same Whatsoever impure is contain'd in the Mass of Blood is cast forth of the extremities of the Arteries as the flowrings of new Wine Wherefore when Nature being become weak is not able to convey its Recrements to the superficies of the Body it deposes the same in the Lungs by a nearer way of purging it self Hence a mighty Cacochymia and many Cronick Diseases frequently end in a Ptysick In like manner when the flesh of the Lungs consumes or abounding with an ulcerous Ichor is become half rotten the blood passing through it is infected with the purulent matter or the consumptive filth and consequently is put upon a continual Effervescence by reason of that immiscible Substance being confounded with it wherefore it brings an assiduous Fever and wholly perverts the nutritive Juyce the like reason holds concerning Fevers caused from an Ulcer or Absess often hapning in other parts for those even as the consumptive Constitution of the Lungs often bring the Ptyfick or hectick Fever a full consideration of these things belongs not to this Place wherefore let us return to the putrid Fever properly so call'd or essential Fever The essential putrid Synochus is wont to be divided into the putrid such is above describ'd inot the Causus or most sharp burning Fever and moreover into the quotidian tertian and quartan The putrid Synochus even now describ'd ought to be the Rule or Square of the rest according to the Type of which for the most part Fevers which are of this kind are compounded as to the rest even now mentioned I shall briefly set them down according as they vary their Species A Causus or burning Fever is that which performs its course with a great burning an intollerable Thirst and other Symptoms shewing a mighty Inflammation of the Blood its formal Nature wherein it 's different from the rest consists in this that the temper of the Blood in those that are affected with it is hotter that is it more abounds with a combustible Sulphur therefore when it rages it is kindled in a greater plenty and by its burning diffuses Effluvia's of a most intense heat throughout the whole Body its Motion is acute and soon comes to its height it is attended with more horrible Symptoms than others it has a difficult Crisis and its event is very dangerous Now as to what regards those periods or paroxisms in which a putrid Fever now and then at a set time is wont to have a sharp fit and intermitting as it were sometimes every
abounding and thence is drawn into the solid Parts and fixes the Evil in them If this Contagion first seises the Animal Parts presently the Injury is communicated to the Brain and the Genus Nervosum and esecially to the Ventricle it forthwith poysons the Homour lodging in these dissolves its mixture perverts its regular Motion and renders it wholly disagreeing and offensive to the tender substance of the containing Parts thence forthwith Cramps and Convulsive Motions violent Vomitings a Cardialgia also a Frenzy Delirium or obstinate Watchings are raised about the first Invasion of the Disease whereas in the mean while the Taint being not yet disperst through the Blood the Diseased are not in a Fever nor infested with a disorderly Pulse or a Swooning or an appearance of Tokens which Symptoms nevertheless assoon as the Blood is infected shew themselves afterward If at any time the Spirits of the Blood are first seised with the venemous Miasm either breathed in with the Air or attracted by the Pores by and by its ferment is disperst throughout the whole mass of Blood the infected portions presently begin to be loosned from their even mixture to separate into parts and to be coagulated and the same being conveyed into the Sinus's of the Heart to stagnate there and to cause a Swooning Faintings and often a sudden Death also being carried outwardly and fixt about the Skin they are wont to cause Bubo's Pushes and the other marks of a Venenosity mean while the Diseased are present enough to themselves and are not assail'd with a Delirium or convulsive Motions but if from a stronger cause an Injury be inflicted on both Parts at once the course of the Disease is carried on with a more horrible appearance of Symptoms and with a Phrensy infesting together As to what regards its rise when the Plague first arises in any Region or Tract of the Earth whatsoevre others may think we place the first and chief natural Seminary of this Poyson in the Air for it seems consonant to reason that from the same Fountain from whence the Food of common Life is derived the beginnings also of Death which is no less diffused should be taken the same necessity lies upon us for breathing the Air as for Fish of living in the Waters wheresore as the common Destruction of Fish dying in Multitudes is ascribed to Waters being infected with Poyson so nothing but a Taint of the Air breathed by all can kill Men that dye without a manifest Cause by an epidemick Destruction For the Air which we necessarily breath in for the Support of Life consists of thick Steams and Vapours which continually are breathed from the Earth to which the exhalations of Salts and Sulphurs being mixed they make here a thick Fog as it were of Atomous Corpuscles The Motions of these being both very swift and restless are of a manifold and very differing Figure wherefore some of them continually encounter others and according to their various Configurations they close with these and are mutually combined and are driv'n and fly from others on this the Reasons of every Sympathy and Antipathy chiefly depend from the divers Agitations of these kinds of Atomes near the Surface of the Earth this or that Tract of the Air undergoes divers Alterations with which Bodies especially those that are living are variously affected for the inward Motion of the Particles of each Animal depends very much on the motion and temper of the Particles of the Air Since these continually exagitate those stir them up when they are drowsie repair the Losses of those that fly away exagitate the vital Flame with their Nitrosity and supply it with a nitro-sulphureous Food and eventilate it being kindled by the continual Courses of Accesses and Recesses as long as an apt Contemperation happens for the Motion and Configuration in both Animals enjoy a perfect Life and Health but if the Corpuscles flying in the Air are of such a kind of Figure and Power that they are manifestly contrary to the Spirits implanted in Animals they loosen the mixtures of these from the rest of the Elements with which they are bound and pervert their Motions hence the Crases of things are destroyed Life is overthrown and that being scarce extinct the Bodies incur Putrefaction hence the Tops of Trees or Corn being struck with a Blast wither on a sudden hence the Murrain oftentimes reigns amongst Cattel which kills whole Herds together For this kind of Cause the Seeds of the Pestilence first exert themelves and threaten a universal Slaughter of Mankind for even as venemous Corpuscles gathered together in the Bowels of the Earth or on its Surface produce Arsenical Mixts or venemous Herbs so these being resolved into a Vapour and gathered thick together in the Air create pernicious Blasts from which malignant and pestilential Diseases arise and it seems to me not improbable that the things which first give a seminary of the Pestilence to any peculiar Tract of the Air are the venemous Effluvia of Salts and Sulphurs grown exorbitant and breath'd forth of the Bowels of the Earth which sometimes being first long included in the Earth are exhal'd by degrees sometimes by reason of Tremblings of Openings of the Earth break forth together of which kind also there are generally breath'd from the Tents of Souldiers filled with Nastiness by reason of dead Carcasses lying unburied or from places fill'd with staguating and stinking Mud. And Corupscles exhaled after this manner by a long Putrefaction acquire to themselves wonderful Powers and Discongruencies that thereby they are disagreeing and heterogeneous to all others whatsoever and so being received into to the Air they ferment it like a mass of Liquor and pervert it from a'wholsome and benign into a pernicious and curst Nature Some Bodies easily receive the malignant Tincture of a pestilential Air others not so readily those who have a very great Cacochymia by reason of an ill Dyet and those who by reason of a Plethora have a Blood filled with an inflamable Sulphur a light Blast of a venemous Air fastens the pestilential Venom on them especially if they lye under a Fear and Sadness which convey inwardly the lightest Parts of Contagion as it were by a certain Infusion On the contrary those who have the Viscera clean and the Mass of Blood well tempered and those who carry a strong and undaunted Mind do not so eafily receive this Infection and sometimes being receiv'd they expell it again So far of the Pestilence and its Communication according to its first Being and the Source of the infected Air thence drawn it remains for us to speak of its Propagation by Contagion as it is often communicated from some Men to others as it were ex traduce By Contagion we understand that Force or Action whereby any Affect being in one Body stirs up the like to it in another but since this happens either immediately by Contact as if any one lying in the same Bed with
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
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
easie to judge which we must obviate first and chiefly take care off in respect of the Fever Purging Bleeding and cooling things chiefly conduce but whilst these things are used the Malignity for the most part is increased and they being neglected it diffuses it self farther Against the Malignity Alexipharmicks and Diaphoreticks are required but these greatly intend the Fever exagitate as by a blowing of Bellows the Blood and Spirits kindled before and put them in a manner all in a Flame wherefore there is need here of a great Quickness of Understanding that these things be duely compared betwixt each other and that the curative Intentions be there directed where most danger shews it self tho so that while one is taken care of the other be not neglected but in these Cases besides the private Judgment of each Physician Experience furnishes us with the chief method of healing for when these Fevers first grow rise almost every particular Person trys particular Remedies and from their Successes compar'd together it is easily learnt what kind of Method we must insist on till at last by a frequent Tryal as it were by the Foot-steps of Passengers a common and Road-way as it were is made to the Cure of these kinds of Affects being fortified with various Observations and Precepts Besides these kinds of Fevers which assail many together and by reason of their Contagion Mortality and conspicuous Marks of Virulency deserve to be called Pestilential or Malignant there are found some other Epidemick or Popular Fevers which almost every Year either Spring or Fall grow very rise in certain Countries of which a great many of the Inhabitants are wont to fall sick and not a few especially of the more elderly People to dye in which nevertheless no Signs of a pestilent or malignant Nature appear nor does the Disease seem so much by Contagion to pass from some incontinently to others as to seise many together by reason of a Predisposition communicated almost to all Now these kinds of Affects depend chiefly on a foregoing Constitution of the Year for if a Season very intemperate by reason of excesses of Cold or Heat Drought or Moisture has preceded and has so continued a long time it changes our Blood for the most part from its due Temper whereby it is apt afterward to fall into severish Effervescencies and hence a Fever sometimes of this sometimes of that Type and Idea is produced which presently becomes epidemical because it draws its Origine from a common Cause whereby the Bodies in a manner of all Men are affected together Now such Fevers in as much as they depend on the Blood getting a Disposition sometimes sharp sometimes austere or of another kind according to the Temper of the Year for the most part they are of the number of Intermittents tho they are wont to be mark'd with a peculiar Apparatus of Symptoms according to the peculiar Constitution of each Year We cannot comprehend these under a certain common Rule or formal Consideration which aptly answers to each of the Particulars of this Nature because they vary yearly according to a great many Accidents tho however of these kinds of Fevers reigning of late Years in this Country we shall give the Descriptions taken at that time and shall set them down as a Conclusion at the end of this Work It remains for us still to add to the number of Malignant Fevers certain other private Fevers partaking of no Contagion as are those especially which are wont to happen to Women in Child-bed by reason of their difficult Labour or for that the Lochia are detain'd for it is manifest enough by common Observation that these are very dangerous and often mortal for if the Parts of the Womb being injured or upon the admission of Cold or haply for some other Cause the Lochia are stopt and the Humour which ought to have been voided forth comes to be mingled with the Mass of Blood it fouly defiles it with a certain venemous mixture as it were that thereby presently a Fever is raised which for the most part is attended with an ill Company of Symptoms viz. a Heat and violent Drought a Vomiting a Cardialgia and Watchings and generally comes either to no Crisis or a very difficult one because unless the flowing of the Lochia after their wonted way be again restor'd after the Blood has undergone an Effervescence for some Days the Taint is wont to be communicated to the Brain and the Genus Nervosum whence presently a Delirium Frenzy Convulsions and other very ill Affects for the most part are caused which often terminate in Death But these kinds of Fevers deserve a peculiar Consideration which we resolve to have more fully beneath in a Discourse appropriated to this purpose mean while we must give some Instances or Examples of the Fevers above treated of viz. of the Pestilential and Malignant The pestilential Fever of late Years has reign'd more rarely in these Parts than the Plague it self I shall give you briefly the Description of the only one of this kind which has occur'd to our Observation Anno 1643. when in the beginning of the Spring the Earl of Essex besieg'd Reading kept by the King's Garrison in both Armies a very Epidemick Disease began to arise tho however he pursuing his work till the Besieged were forced to a Surrender The Affect so prevail'd that in a short while afterward there was a Cessation on both sides and thenceforward for many Months there was a Conflict not with the Enemy but with the Disease Essex withdrawing his Forces seated himself at and the adjacent Places where in a short time he lost a great Part of his Men and the King returned to Oxford where the Souldiers first keeping themselves in the open Field and afterward being disposed off in Towns and Villages he underwent a loss not much inferiour for his Foot whom it chiefly seised being lodg'd a great many of them together in streightned Lodgings when they had filled all Places with Nastiness and Filth and stinking Odours that they seem'd to have defil'd even the Air it self fell sick many of them together and as it were in Files at length the Fever reaching farther than the Souldiery assailed every where the weak Multitude to wit the Persons of the Houses where the Souldiers lodged and others tho many of them at first the Contagion being yet but mild upon them escaped yet lying a long time in a very languishing Condition About the Summer Solstice this Fever began to psread it self with a worse Attendance of Symptoms and to seise a great many Husband-men and others living in the Country and afterward it reigned in this our City and the whole Neighbourhood for at least ten Miles round about mean while those who liv'd in other Countries far from hence as tho they were beyond the Sphere of the Contagion continued free from harm But here that Disease grew so general that the greatest part of Mankind was
was present enough to himself and had a quick Sense and Understanding being asked concerning his Health he said he was pretty well the Urine which before was ruddy and troubled appeared then pale thin and with a laudable Hypostasis that the Diseased especially because free from Thirst and an immoderate Heat seemed to be come to a perfect Crisis and free from the Fever The Morning following the ninth day of the Fever he continued still dull but being stirred up he seemed without a Distemperature and to be chearful in a state of Convalescence only that he began a little to faulter in his Speech in the Evening when things were not suspected the Fever being kindled again he fell on a sudden into a Lethargy that he was scarce able to be awaked from his Sleep and being pull'd up hardly to know any one or to speak articulately Tho so great a loss of Blood had preceded his Pulse was again quick high and strong and his Urine was ruddy after deriving and revulsing Remedies used all that Night this noble Youth seemed somewhat in a better state so that the next Morning he kept himself longer from Sleep began to turn his Eyes this way and that and to raise himself a little tho without Speech or Knowledge of the Standers by before Noon his Eyes being clos'd again he wholly lost the use of every Animal Faculty and lay as it were Apoplectical for three Days with a high and vehement Pulse a Palpitation of the Heart and a short and broken Respiration the Pulse at length growing less by degrees he died on the tenth day of the Fever On the 18th of February his little Sister having a feverish Distemperature and a Thirst began to complain of a Pain and Gripes in the Belly a trembling in the Hands and a painful Tension in the Muscles of the Neck On the last day of February being more openly feverish she was not able to keep out of Bed moreover she was affected with a running Heat sometimes in the Hands sometimes about the lower Parts she became also drowsie and sleepy awaking from her Sleep she did not forthwith come to her self On the first of March she was gently Purged with an Expression of Rhubarb which gave her ease the Urine was thick and ruddy also red Spots like Flea-bites as in the rest were plain to be seen We gave her afterward frequently for four days to wit every six hours Ten Drops of Spirit of Harts-horn in a Spoonful of a Cordial Julep the foresaid Symptoms afterward remitted by degrees and this sick Person recovered her Health tho slowly without a manifest Crisis About the same time a Brother of these the youngest of all fell sick almost after the same manner who nevertheless through a Loosness naturally happening voiding bilous and green Excrements for many days more easily recovered Also in the same Family a great many other Domesticks and some Strangers who came there as Attendants fell ill of the same Disease the Taint as it were being propagated by Contagion all of which notwithstanding escaped at length with a difficult and long Convalescence without any Crisis regularly made That this Fever was malignant it seems to be manifest from the Contagion Mortality the appearance of Spots like Flea-bites and many other Tokens tho that infecting Miasm whereby it passed from one to another was torpid and less efficacious for betwixt the Sicknesses of each many Days and often Weeks interceded that the Infection of this Disease tho acute and its Propagation in many were scarce ended within four Months space in the same House the Fever about the first Beginnings seem'd mild and gentle not very terrible by its Burning but the Matter heap'd together after the Deflagration of the Blood presently became masterless and difficult to be exterminated also offensive to the Brain and Genus Nervosum wherefore in each the Beginnings of the Disease were known rather by a Drowsiness and a Sleepyness than by a Sweat and Burning also the Crisis tho attempted various ways to wit by a Sweat a Loosness and an Haemorrhagie did not succced well but for the most part the Blood growing turgid by a critical Motion was forc'd to transfer the febrile Matter from its own Precincts into the mansion Places of the Animal Spirits nor did it self notwithstanding become purified after this manner but about the height of the Fever both Humours to wit the Blood and the nervous Juice being vitiated together and sorely blasted with an impure Mixture made the Event of the Disease either fatal or very dangerous CHAP. XIV Of the Small-Pox and Measles IN the rank of pestilential and malignant Fevers we place next the Small Pox and the Measles which in Truth are mixt Affects both according to and against our Nature As to their Origine they have a seminary Connate to us but as to the Affects they produce praeternatural Symptoms and venemous as the Plague it self so that they constitute a certain peculiar sort of Fevers which belong to all Mankind and only to them and that but once If haply any one lives free from them all his Life or some one falls often into those Affects these are rare and unusual Events of Nature which do not derogate to common Observation but it may pass for a Truth that all and only Mankind are obnoxious to the Measles and Small Pox and that they are usually freed of them at one Bout We shall speak of the Measles by themselves 1. As to the Small Pox The natural Praedisposition which inclines Mankind to it seems to be a certain Taint or Impurity of the Blood conceiv'd in the Womb with the first Rudiments of the Foetus All Authors in a manner will have this ascrib'd to the menstruous Blood which Opinion does not seem altogether improbable because in the Womb of a Woman otherwise than in most other Animals a certain Ferment is engendred which being communicated to the Mass of Blood gives it a Vigour and Pneumatosis and afterward procures at set Periods of Times a Turgescency and an Excretion of the superfluous Blood and at the time of Conception when the Menses wholly cease a great deal of this Ferment is communicated to the Foetus and its Particles being heterogeneous to all the rest whatsoever are disorderly confounded with the Mass of Blood and Humours as some extraneous thing in which being involved and being separated from each other they lye hid a long time tho afterward at some time being stirr'd by an evident cause they ferment with the Blood and cause in it an Ebullition and afterward a Coagulation from which most of the Symptoms of this Disease arise 2. The Evident Cause which stirs these Fermentative Seeds and oftentimes brings them into Act is said to be threefold viz. Contagion receiv'd from elsewhere the Disposition of the Air and an immoderate Perturbation of the Blood and Humours Persons related soon infect each other also those that are fearful and
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
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
their Bodies which are very tender and by reason of the Labours of Child-birth and the Exclusion of the Foetus are all full of open Pores are too unwarily expos'd to the open Air for most being impatient of their Bed put on their Cloaths and rise from it within a day or two or sooner than they ought thereby presently the Pores of the Skin being presently stopt and the Air getting into the Uterine Parts tanspiration is check'd and often the Lochia are suddenly stop'd either of which suffices to raise a feverish effervescence The conjunct Cause or formal Reason of this Distemper comprehends chiefly these three things to wit there are present first a mighty Dyscrasie of the Blood that growing very hot from a Fever occasionally rais'd it does not burn evenly nor does is subdue by degreeds the adust Recrements and purge them forth critically moreover the boyling Blood is presently loos'ned in its Mixture and its Texture being loos'ned it declines toward Corruption hence when it has a little abated of its Heat the Spirits being cast from their Governance are driv'n into Confusion mean while the sulphureous Particles become masterless and exorbitant wherefore the Strength fails without a manifest Cause the Pulse becomes weak and disorderly Tho from the Deflagration of the Blood a great many adust Recrements are heap'd together yet nothing is duely concocted or separated but Nature being greatlyopprest altho the Diseased continually sweat they often receive no ease thereby but the Febrile Matter which ought to be purged forth being conveyed into the Head and Genus Nervosum causes there very sore Perturbations of the animal oeconomy Secondly The Tragedy of this Disease for a good part of it is ascribed to the nervous Juyce forthwith turning sharp and therefore rendred disproportionate to the Brain and its Appendix for this being defiled with a Taint contracted from the Blood does not gently irrigate and mildly inspire its Subjects but as when an Infusion of Vitriol is pour'd on a Worm mightily vellicates and irrtates into Contrqactions and as it were into Motions of Trepidatons and Leapings those tender Parts and sometimes wholly overthrows their Functions hence Contractions severe Convulsions a Delirium Watchings sometimes a Stupor and sleepy Affects happen to Women after Delivery Ihirdly whilst these things are done often a third Troop of Symptoms infest the Diseased to wit for that the Womb being some way hurt moves it self disorderly and is struck with a Contraction in these or those Parts thence presently by the Membranes nad nervous Ductus's convulsive Motions pervade the whole Region of the Abdomen wherefore the Viscera and Hypochondres are blowen up Belchings and violent Vomitings are raised afterward the Affect creeping upward and possessing the nervous Parts of the Thorax a difficult and uneven Breathing a Palpitation of the Heart a sense of Choaking in the Throat by reaon of the Muscles there drawn together and other Symptoms are raised throughout the whole upon the same Injuries being communicated to the Brain The Fevers of Women afte Delivery are scarce ever free from danger tho sometimes it happens for them to be cur'd about the first beginnings by a thin Diet and upon restoring the flowing of the Lochia but if the feverish Distemper has laid deep Roots that the Blood be wholly kindled and boyls immoderately we can give but an ill Prognostick and there will be a greater Cause of Danger if besides a Heat diffus'd through the whole the Diseased are seised with a frequent Shivering if they are affected with a great Restlessness and Watchings with sudden Concussions of their Bodies or Contractions of the Tendons if on the third or fourth Day they complain of a ringing of the Ears with a great Repletion of the Head you may presently gather that a great Evil is at hand to wit a Mertastasis of the febrile and offensive Matter into the Brain nor is less to be feared if there lyes an Oppression and Load on the Praecordia that the Diseased cannot freely breath nor draw their Breath deep nor form the bottom of the Thorax but only from the upper part of it and that short and with a Blowing so that in the mean while the Diseased are forc'd to fit upright and to move themselves this way and that after a restless manner for this argues the Blood to stagnate about the Heart and Lungs also that it is apt to grow clotty and to be coagulated and if worse yet Affects of the Brain and Genus Nervosum ensue and the Pulse becomes weak and uneven you may declare the Case to be desperate but if as if sometimes falls out tho rarely after a Fever is kindled and threatens severely either a flowing of the Lochia or a Diarrhoea happens with Relief some Hope may be admitted Concerning the Cures of these kinds of Fevers a Physician has a very hard Task because among the Vulgar all Medicines to Women in Child-bed are accounted not only useless but likewise very hurtful wherefore Physicians are selfom called but when there is no place left for Medicines and the occasion for a useful Assitstance is wholly past and if they are present about the first beginnings of the Disease it will not be an easie thing to procure Health to the Diseased by vulgar Remedies and whatsoever they try unless it gives Help is affirmed by old Women and those that are about them as pernicious and the only Cause of their Death that in reality there is wont to accrue to us about the Cure of no Disease less benefit and more Disgrace than of this Now the method of Cure even as in contagious Diseases is twofold to wit Prophylactick and Therapeutick the former of these delivers Precepts and Cautions with which Women in Child-bed are preserved from the Incursion of Fevers the other suggests curative Intentions with which the Diseased if it may be recover again their Health 1. Tho this Fever however malignant it be is not accus'd of Contagion and there be no fear in those that lye in of a venemous Miasm being received from without nevertheless all Women in Child-bed have an innate Minera of Virulency and ought to have a care of the mischief of this as a Fomes of a mighty Malignity wherefore they have need of an exact Governance that after Child-birth the Impurities of the Blood and Humours may be duely purg'd without the danger of a Fever and that the evil Affects of the Womb be healed and that the Strength broken and debilitated by Child-birth may be duely restored For these ends these three things are to be chiefly inculcated in the Praescripts of Physicians First I think it necessary that a most exact form of Diet be ordered Women in Child-bed to wit that at least for a Week they wholly feed on Oat Broths sometimes prepar'd with Ale sometimes of Water mixed with White-wine because they are much emptied therefore they may sup often of them but let nothing of a solid or strong Food
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
That the Air or Flatus's first heap'd together there are the Cause of the Distension In our Sick Person the Blood growing hot and soon being full of an adust and malignant matter presently it being incapable of being subdued and separated by Sweat endeavoured to fix it in the Brain the first discharge of that Matter on the Head by reason of the Animal Spirits being half overwhelmed brought the Sense of the Heads being very much increast in bulk which happens after the like manner as when the Foot being seised with a Stupor seems to be felt much greater than it self now that after some ease by slumbering and closing the Eyes the Affect return'd anew the Reason is because Watching and the stirring of the Senses in some sort shake off and remove from them the Matter besetting the Brain and Nerves which nevertheless being seated near and in a Readiness Sleep stealing on is as it were imbib'd by them and throughly enters their Bodies together with the nutritive Juice Now the Blood tho it had copiously discharged the Recrements on the Brain yet it became not free it self but being still full of an impure Load fell as it were upon a critical Efflorescence and with a Shivering followed by a Heat and a Sweat as is usual in a great Excretion it tryed again and again to shake off its Burthen tho all it could do by that Effort was that the Matter sticking to the Brain got deeper Root in it and fixing it self in certain Sprouts of the Nerves it took away Speech and Swallowing and then afterward Sensation and the Mass of the Blood being deprav'd more and more by degrees at length it became unable for supporting Life A Renowned Woman Married a little under Twenty being with Child and during the time of her Ingravidation having used but little Diet and almost no Exercise underwent in her Travail Pains and Throws but with Intermission and a frequent Respite for twelve Hours and brought forth a Son the Foetus came away with the Secundine and all things were well about the Womb. On the first and second days she was indifferently well but on the third after a light Shivering she began to complain of a Thirst and a Heat which a Loosness followed so that she had four Stools that day the Night passed in a manner without Sleep the feverish Distemper continued afterward for two days after the same manner she daily had three or four Stools the Lochia as yet flowing moderately On the sixth day when by the Perswasion of Women she had taken somewhat for moderating her Loosness the Purgings of the Womb were in a manner wholly stopt at which time the Fever became more intense and Symptoms resembling Hysterical arose for in the Praecordia she had great and frequent Oppressions and had a sense of Choaking in the Throat On the seventh day there was a more intense Heat and a difficult and more painful Breathing and then by a Physician 's Order at that time first call'd three ounces of Blood were drawn from the Foor after which for four Hours she was better for a quiet Sleep with a copious Sweat ensued the Lochia tho in a small quantity appear'd again in the Evening all things grew worse the Strength being very much resolv'd the Pulse became weaker and uneven she complain'd also of a Noise and a ringing of the Ears with a Plenitude of the Head moreover she had Leapings of the Tendons in her Wrists also sudden Convulsions of the whole Body and still the Loosness troubled her To this Person Cordials and other Remedies and kinds of Administrations diligently used by the Prescripts of many Physicians did not the least good the pulse growing weaker and the Strength decreasing by degrees on the ninth day after Delivery she died This Fever depended very much on the vicious Disposition of the Body as on the procatarctick Cause for I have often observed that it falls out ill with Women in Child-bed who when they are with Child unwholsomly seed on fruits and any sorts of food and living without Motion and Exercise indulge themselves only to Idleness and Rest the Blood by reason of the previous Cachexia without any evident Occasion fell a burning as it were of its own accord now whilst it boyled deposing its Recrements and Impurities still inward it brought the Loosness nor did its Mass become more pure from that almost continued Excretion but its Mixture or Crasis being still more depraved at length the Blood fell wholly from its genuine Nature and became uncapable of fermenting in the Heart the Loosness naturally hap'ning was ill stopt especially by the use of AsTringents for I have often observed that these things are not attempted without danger for a Loosness has cured some that were ill and in that Lady and in many others as we have sufficiently found by Experience tho it did not take away the Fever yet it freed them from the more severe Afects of the Brain and Genus Nervosum whence this Diseased was wholly without a Delirium nor was she seised with convulsive Motions till she was brought almost to the last A worthy Matron about thirty six Years of Age going with Child the seventeenth time was very sad and perplex'd with Thoughts that she should dye in Child-bed upon her Delivery but as it pleased God she was very well delivered of a Son and was chearful for three days after On the fourth day having eaten more of a Chicken than she ought a little before Night she fell into a feverish Distemper with a Vomiting and the Lochia were stop'd all the night she lay without Sleep and restless the next Morning within an Hours space she had four Stools and seem'd to be reliev'd about Noon at which time I came she complained again of a Heat and a Drought also of a Palpitation of the Heart and of the Ascent of a certain heavy thing in her Throat the Pulse was quick and small the Urine was ruddy the Lochia scarce appeared I ordered that Cordial Juleps and things moving a Uterine Purgation should be given to this Person moreover That Fomentations should be applyed to the lower part of the Belly also that the Legs and Feet should be often rubbed with warm Cloaths at the time for Sleep I gave her a Grain of Laudanum with half a Scruple of Saffron powdred in a Spoonful of Treacle Water She slept quietly and the Lochia flowed plentifully afterward using a thin Diet and things gently promoting a uterine Flux for a few days she perfectly recovered A Noble Woman Young and Handsome had a good easie Deliverance of a second Daughter and for six days being well as to the Lochia and other Accidents she was wholly free from the Suspicion of any Distemper she daily are Flesh and being taken forth of Bed she lived chearfully in her chamber On the seventh day without a manifest Cause she had a Shivering with a Fever and the Lochia were lessened tho not
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
extraneous Miasm the Corpuscles of which Miasm being inwardly admitted fermented with the Blood and Humours and so caused this Fever in a great many with the same Appearance of Symptoms But I do not think that this Fever arose from a certain Contagion communicated from the Air and immediately fixing the Taint in Men but rather from a certain febrile Diathesis or Predisposition communicated to our Bodies by degrees before through the Distemperature of the Year which at length having gotten a Maturity is brought into Act on a light occasion and it cannot be said so much to burst forth into this Fever as to grow into it For when about the Beginning of July the Air wax'd immoderately hot through a most intense Scorching for many days it easily altered our Blood towards a hot and bilous Distemperature to wit because as in Wine fermenting more than it ought the sweet and spirituous Part is very much spent mean while the saline and sulphureous is too much exalted that thereby the Liquor readily contracts a Mustiness or a Sharpness now we have seen elsewhere that this kind of Diathesis of the Blood whereby from a sweet and spirituous Temperament by reason of its too great Scorching it inclines to a bilous is very apt for Intermittent Fevers Hence the nutritive Juice which is continually conveyed into the Mass of Blood is not duely concocted nor assimilated into Blood but is perverted into an extraneous as it were and fermentative Matter which arising to a Fullness within the Blood and growing turgid at set Periods according to its Increases brings the Fits of an Intermittent Fever Since therefore from the scorching Heat of this Summer the Blood almost of all Men growing hotter than it ought was very much parch'd it 's no Wonder if thereby it contracted a very great Aptness to Intermittent Fevers but why this Disease grew not rife during the great Heat but rather afterward the Reason is because this Indisposition is not imprinted in our Blood at one bout but by degrees and not till after a long time and therefore the Fruit as it were of the Disease after the foregoing Heat of the Summer were chiefly brought to a Ripeness in Autumn All do not equally contract this Aptness or Disposition to a Fever those whose Blood being hot by Nature most abound with Sulphur and thereby is sooner parch'd and those who being given to Labours or staying much in the Sun endur'd most of the Summer Heat by reason of their Blood being more egregiously scorch'd easily fell into this Disease wherefore it first reigned among the Husbandmen and chiefly in the Country of those who had acquired an Aptness to this Fever from their Blood being scorched haply some fell into it naturally the feverish Diathesis being raised by degrees to a Maturity others by reason of a light Occasion or an evident Cause which is otherwise wont to raise a feverish Effervescence as upon taking Cold Surfeiting drinking Wine and the like and others fell sick by reason of a Contagion received from others for Effluvia constantly flow from the Sick which when they light on Bodies predisposed to the like Affect readily raise into Act the latent Powers That the Conjunct Cause of this Disease and its formal Reason may be known you must call to Mind what is said elsewhere concerning the Nature of Intermittent Fevers to wit we suppose that the Basis as it were of this Affect is a burnt and bilous Constitution of the Blood by reason of which the nutritive Juice daily supply'd as it were by Measure is not duely concocted but through its being scorch'd turns into a fermentative Matter and not miscible with the Blood When the Blood is saturated with this Matter to a Fullness which happens at set Intervals of Times because the nutritive Juice is supply'd in a set Measure as it were it naturally falls into a Turgescency and the Effervescency raised for the Expulsion of this Matter brings the feverish Fit which lasts so long till this febrile Matter kindled in the Heart and as it were burnt is wholly blown off with the Sweat From these things premitted it is plain that there are some things which in this Affect whereof we treat happen after a peculiar manner from the common kind of Intermittents and therefore it is not unfitly call'd by the Name of a new Fever such as are first that about the beginnings of the Disease the Fits begin without a Cold or a Shivering but long afflict the Diseased with a Vomiting a Thirst and a most intense Heat to which a Swear for the most part with difficulty and partial and often interrupted ensues whereby the Access is not ended but in a long time the reason of which eught to be solely plac'd in the very bilous and excessively parched Disposition of the Blood for this proceeding from the prevailing Sulphur wholly hinders the wonted Sourness of the Blood which follows its Turgescency and is wont to raise the Shivering or Cold and by reason of this kind of Temperature of the Blood scorching too much and as it were burning the nutritive Juice the Blood growing turgid together with that Juice and stirr'd to motion is kindled more than usually in the Heart and by its Deflagration it causes a most intense Heat with a Drought which are most tedious to the Diseas'd Bilous Vomitings happen not only at the Beginning but even in the middle of the Fit by reason of the Redundancy of the Choler wherewith the Vasa Coledocha being oftentimes too much fill'd they pour it into the Intestines which afterward a Contraction being raised in the Viscera is easily sent into the Stomach the Sweat follows with difficulty because the Choler abounds more than the Serum wherefore the burnt Febrile Matter is not easily separated by a Sweat but either being mixt with the Blood brings a long continued Effervescence or being convey'd towards the Intestines produces a Vomiting or a Loosness Secondly this Fever differs from a vulgar Intermittent because after a Fit ended there is not given a full Intermission so far as an Apyrexia but the Diseas'd continue still languid and dry being ill disposed as to their Appetite Sleep and other Accidents which really happens because by the intense Heat of the Fever more of the Blood and febrile Matter is kindled than that the Recrements remaining after its Deflagration can be soon blown oft especially because a Sweat by reason of the Drought of the Matter with great difficulty ensues nor is the febrile Matter to be voided forth sufficiently diluted with a Serous Latex wherefore the Blood being not perfectly freed from its Contagion at the time of the Fit ferments still nor the Access being ended has it a full Truce from the Disease Mean while that the Blood is press'd after this manner with an almost continual Effervescence it differs from a Synochus because in this the sulphureous Part of the Blood being too much exalted is inflam'd as it were and makes
the Fever by its Deflagration but the continual Ebullition which happens to this Intermittent Fever depends wholly on the Confusion of the Matter not miscible and the difficult Secretion of it from the Blood A Synochus happens as Wine naturally fermenting by reason of its Richness the other like the same Wine when it falls a working by reason of some haeterogeneous thing mixt with it wherefore we observe that when our Fever has pass'd into a continual yet it comes not to a Determination neither by a Sweat nor by a Loosness tho happening in a plentiful manner and frequently because depending on the Blood depauperated rather than being inflam'd it continues a very long time and disposes the Diseased towards a Cachexia The third way of difference wherein this Fever differs from the common Rank of Intermittents is plac'd in this that it is oftentimes readily propagated by Contagion into others the reason of which is because here a great many Bodies are predispos'd after the same manner to the same Affect which at another time does not happen wherefore the mere Effluvia from a morbid Body are able to stir up the like Affect in a Subject easily capable even as certain Rays of a Flame kindle a Flame in a Matter which is very combustible mean while all do not contract the taint of this Fever alike but some not prepar'd for it converse with the Diseas'd without hurt There is another Symptom which does not constantly attend this Fever but only happening in some Places which distinguishes it not only from a common Fever but changes its own proper Type to wit it sometimes happens that dyssenterick Affects accompany this Disease in some bilous Vomitings and Seiges are very troublesome as in the cholerick Disease and in others bloody Stools happen with a violent Pain and Gripes of the Belly I have often observ'd the former in this our Neighbourhood and the reason of it may be deduced from a mighty bilous Temperature for by reason of this the adust Matter not to be blown off by Sweat is copiously separated in the Liver afterward by reason of the Vasa Choledocha being over-fill'd it is sent to the Ventricle and Intestines the other Affect of the Dysentery is found only in some Places and there being sporadical rather than common it has seised only some sick Persons The Origine of it can be ascrib'd only to the peculiar Crasis or vicious Predispositions of some Bodies also to the Scituations of Places or the nature of the Air. Moreover it may be suspected that the Disease is now and then conveyed to others not without the Communication of a certain Miasm Concerning this Disease there ought to be a double Prognostick first of the Fever it self in general what kind of end it will have and when what it does threaten to our Land whether it be not a Fore-runner of the Plague or Pestilential Diseases as it is vulgarly feared Secondly We ought to give the Signs by which we are wont to presage a Well-doing or Danger in the various Cases of the Diseased As to the first because we have shewn that the Origine of this Affect is not to be taken from the Air infected with a Contagion or venemous Miasm nor from a malignant Seminium of Vapours diffus'd through the Air but only from a mighty bilous Temperature or Diathesis of our Bodies with a Blood which is adust and mightily scorch'd by reason of the Summer Heats I think there is no cause of Fear here whereby we may dread that this Fever being rais'd to a worse state through the fault of the Air may grow at length to be Malignant or Pestilential but rather what the Change of the Season of the Year and the Alteration of our Blood may make us expect we ought to fear lest this Fever which at first imitates the Type of a Tertian may pass into a Quartan which I observe has already happened to some and think it is greatly to be fear'd lest hereafter Autumn drawing to an end it may happen in many As to the particular Prognostick the Signs which happen in the course of this Fever most remarkable and which in some manner foretell its Issue and Event are these If the Disease happens in a sound Body well-temper'd and easily perspirable if a Vomiting with a well-bearing ensues and the Belly be loose if the Fit begins with a light Shivering and after a moderate Heat ends in a Sweat and the Interval of it be with an Apyrexia or a well-bearing if the Pulse be strong the Urine of a flame colour clear with a laudable Hypostasis we predict that the Disease will end in a short time without danger but if this Fever be raised in a fat Body and of a vicious Habit if with a troublesome Vomiting an exorbitant Heat and an intolerable Thirst long torment the Diseased if the Heat be succeeded by a difficult partial often interrupted Sweat and interlac'd with frequent Vomitings and does not end in an Apyrexia we declare this Disease to be long and liable to Danger but if the Diseased holds his Strength and the Urine shews signs of Concoction we do not despair of well-doing especially if after four or five Returns the Disease as it is usual remits of its wonted fierceness Thirdly we observe if this Disease happens in a Body which is cold or broken with other Diseases or weaken'd if besides horrible Vomitings and a violent Heat a frequent Fainting Swoonings Deliriums or Lethargick Affects happen if after many Accesses the Strength of the Diseas'd falling the Disease remits nothing but a continual Effervescence troubles the Blood and very much dissipates the vital Spirits if a dejected Appetite obstinate Watchings convulsive Motions with a weak Pulse a troubled or thick Urine happen we declare the Case to be full of Danger but it is protracted to a good length and it gives Time and Occasions for Nature to recollect her self and to the Physician for giving Remedies The Therapeutick Indications which have place in the Cure of this Fever are chiefly four First that the Blood being becom burnt and too bilous be reduc'd to its due temper Secondly that the depravation of the Nutritive Juyce and its alteration into a fermentative matter be stopt or at leastwise be lessen'd Thirdly that about the declination of the Disease the Blood being depauperated by a frequent Deflagration and rendred impure by the mixture of the morbifick or adust matter be restored and be rendred volatile as it ought Fourthly that we obviate with Remedies the Symptoms which are chiefly infesting in the Course of the Disease To answer these Intentions I advise the following Method to be used About the first beginnings of the Disease if a bilous Humour flowing from the Vasa Choledocha and sent into the Ventricle the Diseased be inclin'd to Vomit when the Fit is at hand let a plentiful Evacuation of the same be raised by a gentle Emetick Blooding and Purging ought not to be used
but during the Interval of Fits for while the Blood violently ferments or is resolved into a Sweat Nature ought not to be diverted from its Works begun nor its Attempts be disturbed by the Prescripts of Physicians wherefore after the Access is over and the Sweat entirely ended let a Purging be ordered by a gentle Cathartick and let the same afterward be sometimes repeated on the like occasion for by this Method not only the store of the excrementitious Matter is withdrawn from the first Passages but especially the Choler-Vessels being emptied the Bile is plentifully drawn from the Mass of Blood and thereby the Blood is restor'd toward its natural Crasis Let Blooding if it be indicated be put in Practise from the beginning for so its Liquor growing too turgid is eventilated whereby it both less perverts the nutritive Juice and when the Fit presses it burns with a more mild Blast together with the morbifick Matter but otherwise if after a long Sickness a Vein be opened when the Blood being depauperated and rendred watery has heaped together more of morbifick Matter and does not duely concoct it and purge it forth much is drawn from the Strength of Nature from the Power of the Disease nothing In the Interval of the Accesses when Blooding nor Purging may not be admitted let the Belly be kept soluble by a constant use of Clysters also let digestive Remedies of acetous or saline Liquors and Powders be giv'n such as Cream of Tartar the fixt Salts of Herbs Tartar Vitriolate burnt Harts-horn Spirit of Vitriol and of Salt c. for these restore the Ferments of the Viscera lost or grown sluggish depurate the Blood by fusing it also separate and as it were precipitate the morbifick Matter also at this time if obstinate Watchings chance to prove infesting and impair the Strength of the Diseased we may interlace Anodyne and gently Narcotick Remedies but by no means give them in the Access for then they greatly hinder the subduing and secretion of the febrile Matter and prolong the Fit which would sooner end So far concerning what is to be done in the Intervals of the Fits but in the Fit tho the Diseased then chiefly send for and call upon Physicians yet their Prescripts at this time are limited within a narrow Scope if a Vomiting tho an Emetick be giv'n before be still infesting let it be freely promoted by Posset-Drink either simple or with bitter Herbs boyled in it but let the chief way of the Cure be in qualifying the Heat and Drought which are wont to torture severely the Diseased in this Fever for whilst the Blood fermenting with the morbifick Matter and being kindled in the Heart springs into the Lungs it raises there a most violent Inflammation which requires a pouring on of cold Water as it were for extinguishing a Flame wherefore they desire to be pouring in Drink without measure without which the Diseased faint through the too much burning and in a manner all their Blood being rarefied as it were into a Flame and a Smoak does not easily continue the thread of Circulation wherefore Drink by all means ought to be granted to those that are in the Fever which nevertheless if it be pour'd in in too great a quantity first it exagitates more the boyling Blood and again brings a Confusion of the febrile Matter began to be separated that thereby the Work of subduing and Secretion is longer protracted and the Fit is made longer moreover a great pouring in of Drink proves offensive to the Stomach and by troubling it and often by raising a Vomit hinders Transpiration and calls in a Sweat breaking forth or haply already broken forth wherefore when the Heat of the Fever is first kindled let the Diseased tho very dry drink only by sipping and what they may let them refrain it afterward when the burnt and subdued Matter begins to be sent off by Sweat let them more freely gratifie themselves with it for so the Sweating is greatly promoted and the Fit is sooner over as to the nature of the Drink sometimes let Posset Drink sometimes small Ale or Barley Water be given sometimes Fountain Water either alone or sharpen'd a little with the Juice of Limons in this case the use of Sal Prunella is justly commended given in any Liquor for this by its Nitrosity wonderfully restrains the boyling Blood and powerfully moves Sweat I have often observ'd in the middle of the Fit that the Diseas'd have fall'n into a Fainting or a Swoon where the Cordials and hot Liquors which are wont presently to be pour'd in very much increase the Violence of the Fever and cause greater Troubles than usual that the Fit is more difficultly ended but these Swoonings for the most part happen either from the bilous Humour sent into the Ventricle or by reason of a Sweat broken off abruptly and against these I have always found the most present Remedy that either a Feather being put in the Throat a Vomit be promoted or that a thin Liquor being drank in a plentiful Measure the Sweat be again rais'd and in the whole Course of this Fever I am wont to give no Cordials or Alexipharmicks A Diet in this Fever only thin and not rich ought to be ordered let all Food prepar'd of the Flesh of Animals be wholly shunn'd for these abounding with Sulphur plentifully afford a Fuel to the boyling or kindled Blood as Oyl pour'd on a Flame moreover let nothing spirituous as hot Waters strong Ale or Wine be allowed but let Oat or Barley Decoctions or Broths altered with cooling Herbs be chiefly used also let Posset Drink small Ale or Whey be drank by the Diseased at Pleasure for since by this Means a very thin and watery nutritive Juyce is conveyed to the Mass of Blood the resolved Particles of the Sulphur are burnt off sooner and with less Tumult also the Recrements of the adust Matter are more readily sent forth from the Mass of Blood but if on the contrary a rich and plentiful Nourishment be used the Effervescence of the Blood is thereby much encreas'd and the Blood is more infected with the Mixture of an adust Matter When after frequent Fits the Blood being much burnt off and the Fever being in its declining State has remitted of its Fervour and Fierceness Care must be taken that the Diseased while upon their Recovery do not fall into a Cachexia or Scorbutick Affect for the Crasis of the Viscera being injured and the Blood being very much depauperated the nutritive Juice tho it be not scorch'd as before yet is not duely concocted and maturated into a perfect Blood but through defect of a Pneumatosis serous Excrements imbued with a fixt Salt are very much heap'd together and sometimes being fixt in the Viscera sometimes in the extream Parts bring forth various Affects Wherefore in a long continued languor of the Diseased or otherwise in order to a quicker Recovery let Remedies be given which volatize the Blood
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
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
when the Blood being rendred weak and withall impure is not able to expell forth the febrile Matter or the adust Recrements by a critical Motion it conveys the same to the Brain and therefore abut the increase of this Fever a Drowsiness and a Stupidity of the Spirits a Sleepiness a Vertigo a ringing of the Ears Tremblings and Convulsive Motions with a great Suppression of the whole animal Faculty are oftentimes caused Those who being of a cold Temperament or grown in Years are seized with this Disease tho they have not so acute a Fever yet are wont to lye in a greater danger of Life for in these besides the Disposition of the Blood not easily reducible also in the Fits what is heaped together extraneous and not miscible is hardly subdued and with difficulty separated from the mass of Bood wherefore both the Blood is still more notably depraved in its Crasis and in every of the Fits is more infected with an impure mixture Moreover the Nervous Liquour is greatly perverted from its due Temper and is exceedingly defiled with adust Recrements continually poured on the Brain when therefore old melancholy or otherwise unhealthy Persons fall into this Fever from the first Invasion they presently become torpid and for the most Part Vertiginous in the Fits tho the heat be not vehement and sharp yet they lye restless and tossing very much often talk absurdly and idlely after a long Incalescence either no Sweat or only a partial one and often interrupted ensues whereby the fit is not fully solved but all during the Intervals the Diseased being very dry continue to be ill disposed with a drought of the Mouth a roughness of the Tongue and an overspreading of a viscous Lee after some fits their Strength being mightily dejected either they are confined to their Bed altogether or rising a little in the day time they are scarce able to stand or to creep about from Place to Place mean while they are troubled with a Fainting a difficult Breathing a Deadness of the Senses and a great Weakness of the whole Genus Nervosum The Urine is intensly red in a great many of a more saturated Colour and a thicker Consistency than in a common Tertian the Pulse as long as the Strength is not wholly cast down for the most part is strong and even afterward when the Diseased grow very faint it is weak uneven and often intermittent to which also Contractions of the Tendons and convulsive Motions in the Wrists being iovn'd for the most part give an occasion for a Prognostick of Dearth Those who being weak'ned by degrees decline toward Death for some time before they dye lye for the most part without speech or the Knowledge of the Standers by as Persons stupid it seldom happens in this Fever that any one about to dye being of a good Memory and Understanding disposes things of his Family or bids his Friends farewell and those who happen to escape from a mighty Weakness and almost from a desperate Condition do not recover by a sudden and manifest Crisis but wavering a long time lye torpid and enervated that not without a doubrful and difficult Contest Nature at length with much adoe prevails over the Disease and then they recover their Strength by Degrees by a slow and long-continued Convalescence If the nature and formal reason of the Epidemick Fever even now described be inquired into we say that this as that of the foregoing Year is properly an Intermittent for that which generally reigns carries this kind of Type tho some continual Fevers here and there are scattered with them of which also we shall presently give a short Touch. It will not be needful for us to derive the Seminary of this from the Air infected with some Miasm but rather to fetch the antecedent Cause of it from the undue Constitution of the Year and the Indisposition of our Blood acquir'd thereby for Spring and Fall intermittent Fevers yearly reign to wit because our Blood as the Juyce of Vegetables is wont to be moved and to display it self at these times more sprightly than ordinary wherefore if the Mass of Blood by reason of the foregoing Season of the Winter or Summer be altered from its â—ue Temper and has contracted a sharp or atrabilarious Diathesis of another kind it s Dyscrasies began before are chiefly maturated about the Equinoxes to wit when the Blood more freely fermenting in case it falls from its natural Crasis does not so readily sanguifie but will be apt to pervert the nutritive Juyce mix'd with it into an extraneous and febrile Matter Since therefore this Year very much declined from its due Constitution that not only the preceding Dog days but the two Solstices and Equinoxes before were altogether intemperate is no Wonder if intermittent Fevers more frequent than usual and those attended with some unusual Symptoms reign in Autumn That therefore an Epidemick intermittent Fever reigns at this Time I think it ought not to be attributed to the Fault of the present Air but to the Irregularities of the foregoing Season but on what Causes and Occasions certain peculiar Symptoms and distinct from the common Rule of Intermittents arise in this Fever it is worthy to be inquired into I have said above that the Apparatus whereby this Fever became destructive to Mankind consisted chiefly in two things to wit the Temper of the Year one while mighty cold afterward happening to be very hot both variously perverted the Crasis of our Blood and affected the Pores of the Skin with an undue Constitution According to the Reasons taken from both I shall briefly explicate the Accidents of this Disease and assign the Causes of its Phoenomina 1. First we observe that the Type of this Fever was various to wit in some with a continual Effervescence in others with an Eruption of Spots but in most intermitting and like a Tertian and sometimes tho rarely like a Quotidian renewing its Fits either each or every other day we assign the Cause of this Diversity because in this Year the morbid Procatarxis was greater and stronger than only to produce an intermittent Fever generally usual in Autumn wherefore in some haply of a more deprav'd Habit of Body it raised Fevers somewhat malignant and in those to whom it brought Intermittents according to the wonted Custom of the Season it distinguished them by some peculiar Appearance of Symptoms 2. Persons after being seis'd with the Epidemick Fever at this time whether it be continual or intermittent forthwith undergo ill Affects of the Head to wit they are wont to be infested sometimes with a violent Head-ach sometimes with a Stupor or a too great Distraction of the Animal Spirits the Reason of this is that the nervous Juyce as well as the Blood through the Distemperature of the Year is very much altered from its due Crisis to wit from its sweet and spirituous Nature and has become sometimes dull and almost vapid sometimes too sharp and
and more and withall the Spirits being continually consum'd is become poor we may declare the Life of the Diseased to be in a dangerous Condition If besides these the nervous Juyce be faulty that being altered from its due Temper or being dull and vapid as it were it does not actuate the Brain and Genus Nervosum or being more sharp than it ought it continually irritates the same into Cramps and Distractions and if besides vapory Effluvia continually departing from the Blood or adust Recrements wont to be voided forth by a critical Sweat are convey'd to the Head and there cause Lethargical or Maniacal Affects the well-doing of the Diseas'd stands very ticklish and we may fear a very fatal Event Concerning the method of Cure of this Disease three chief curative Intents come under Consideration First A speedy Reducement of the Blood and nervous Juyce to their natural Crasis as much as may be or at leastwise a Prevention of a too great Depravation of them Secondly A due Management of the Diseased as to their Fits which ought to procure first that less of degenerate Juyce be heap'd together for a Matter of the Fit secondly that the store of that which is heap'd together be wholly blown off every Access that the Diseased may be better in the Intervals Thirdly That the Body being altered for the better the Fits be stopt with antifebrifuge Remedies the third Intent regards the Symptoms chiefly pressing which must be seasonably obviated whereby Nature being not hindred may reduce whatsoever intemperate is contain'd in the Viscera may subdue and clear forth what is extraneous and may soon recover its former Strength and Vigour First therefore for the Reducement and Correction of the Blood and nervous Juyce divers kinds of Evacuations about the beginning of the Sickness are wont to be us'd in this Disease with good Success It is maifest by modern Practise that Vomitories are very much more useful in this Affect than in a common Tertian wherefore in a robust Body and prone to Vomit about the beginning of the second or third Fit an Emetick Medicine is wont to be given The Operation of this seems to do more good in this Fever both in as much as it plentifully evacuates the filth from the Ventricle and the yellow Choler from the Vasa Choledocha and because it copiously expresses the Serous Latex from the Emunctories of the Genus Nervosum plac'd about the Pancras and Intestines and draws it forth by stirring them wherefore we observe after a Vomit given the Diseased are better as to the Affects of the Head Let Purging where Vomiting is not proper be ordered the day following the Fit as a Succedaneum to the other also tho a Vomit be premitted it may do well after a Fit or two but let it be perform'd only with a mild and gentle Medicine which does not trouble or exagitate the Blood It is usual with us in these Fevers all Aloetick or diagridiated Medicines laid aside to give only the Infusion or Powder of Sena Rhubarb and yellow Saunders with Tartar and Salt of Wormwood and to use this kind of Purging a little after the beginning the Disease but at other times to make the Belly soluble by a frequent use of Clysters That Blooding in this Disease is very good frequent Experience has sufficiently taught us for since by reason of the Pores being more clos'd than usual in all the Blood boyling in a Fever wants a Ventilation letting Blood supplies the Place of a more free Transpiration and prevents the Effluvia restrained from being so readily discharged on the Brain and Genus Nervosum But this Remedy is chiefly indicated by a very hot Blood and a hot Temperament nor ought it to be used indifferently by old Persons such as are flegmatick and others very weak unless haply it be in a small Quantity that the Mass of Blood may be somewhat eventilated and that the Translation of the febrile Matter into the Brain may be stopped If it be proper to open a Vein let it be done about the beginning of the Fever or at leastwise before the fourth or fifth Access to wit before the Blood be rendred very effaete by a frequent Deflagration and too impure by the Mixture of an adust Matter for if Blooding be used when the Blood is mightily vitiated the vital Spirits and the Strength of the Diseased are thereby more debillitated nor is there any thing withdrawn from the Power of the Disease or its Cause There remains another Evacuation famous in this Fever to wit by Blistering Plaisters applyed to many Parts of the Body these are so vulgarly observed to give Relief that such as are against them and have a great Aversion for such a Remedy being led by the Example of others growing better thereby easily admit of it After what manner they separate the skarfe Skin from the Skin and raise it as it were into a Bladder full of Water whether they fetch the watery and limpid Humour from the Arteries or out of the Nerves this is not the Place to enquire but that they are used with benefit in this Disease besides Experience this Reason seems somewhat to convince to wit because a large Discharge of this kind of serous Humour does in some sort recompence the Defect of a free Transpiration Moreover this kind of Remedy opens as it were the Doors and Gates at which the Blood and nervous Juice may presently void forth the extraneous Matter mixt with them by a nearer way of Purging wherefore in the Plague and malignant Affects Vesicatories are esteemed very profitable Also it is manifest by common Observation that in this and other Fevers hapning in the same Season they prevent the severe Affects of the Head and are wont to relieve them being caus'd before wherefore in Men that are flegmatick aged and of a cold Temperament Epispastic Plaisters may be apply'd about the first Invasion of this Disease for Preservation and in any others troubled with a Drowsiness a Vertigo or a violent Head-ach they are wont to be advantagiously used for the Cure of those Affects But in very hot Constitutions where with a Defect of Serum the Blood is too much burnt and if those that are in Fevers with an intollerable Burning are obnoxious to Watchings or a Frenzy Vesicatories do not seem fit to be used For correcting the Crasis of the Blood and the Tone of the Viscera qualifying and digestive Remedies have place in intermediate times when the Sick have rested a little from the Evacuations ev'n now mention'd being such as fuse the Liquor of the Blood and separate its Foeculencies and drive them towards the Emunctories as it were by precipitating them for those kinds of Intents are wont to be giv'n cooling Juleps and Decoctions acidulated with Spirit of Vitriol of Salt with Tamarinds the Juyce of Oranges or of Limons whereof neat Forms enough are vulgarly to be sound and for this end conduce acetous saline and testaceous Powders
Scurvy its Cure p. 355. Blistering Plaisters see Vesicatories Blood its Eruption from many Parts of the Body p. 188. It s Eruption from the Nostrils and the Cure of it applyable to all other Haemorrhagies p. 189. An Eruption of Blood from the Nostrils to be manag'd one way if without a Fever and a different way if joyn'd with it ib. How to be managed if hapning without a Fever ib. p. 190 191 192 193. How to be managed in a Fever p. 194. How to answer the second and vital Indication ib. p. 195. How to answer the third Indication being for Preservation and for removing the Cause of the Distemper ib. p. 196. An Instance of Eruptions of Blood cur'd ib. p. 197. Blood-letting see Phlebotomy Blood let forth in a Convulsive or Apoplectical fit why seeming congeal'd p. 260. Blood-spitting the indications for curing it p. 96. what to be done in reference to the first Indication ib. what to be done in reference to the second indication ib. p. 97. Select Forms of Medicines answering to the Therapeutick Indications ib. p. 98 99 100 101 102. An instance of a Person troubled with Blood-spitting and how managed ib. p. 103 104. The medicine which did him most good ib. p. 105. Blood of Man its Anatomy p. 519. its resolution into five Principles p. 520. its Spirits ib. its sulphureous saline earthy and watery Particles p. 521. its comparison with Wine p. 422. p. 328 329 330. its comparison with Milk p. 422. its natural Motion p. 423 424. its preternatural Motion ib. p. 425. Bloody Flux cur'd p. 356. see Purging Bones their crackling p. 367 368. Breathing difficult see Asthma Breathing difficult in the Scurvy its cure p. 353 354. C. CArus what Disease it is p. 399. where seated p. 400. its Prognosticks ib. its Method of cure ib. Instances of Persons seiz'd with the Carus and how proceeded with p. 401 402. Chalybeate Medicines see Steel Chin-Cough see convulsive Cough and Ptisick Coffee its effects p. 68 69. Colick its Description p. 507. the part primarily affected in it p. 508 509. It s Seminium or Minera ib. The Procatarctick Cause of it p. 510. The evident Causes ib. p. 511. The Prognostick of it ib. The Method of curing it ib. p. 512 513 514 515 516. The vital Indication to be minded ib. the preservatory Indication to be us'd out of the Fits ib. p. 517. Instances of Persons troubled with the Cholick ib. p. 518. Colick Scorbutick its Cure p. 355. Coma see Sleepy and Watching Consumption of the Lungs see Ptisick Consumption confirm'd see Ptisick Continual Fevers see Fevers Convulsions in Children p. 250. they are chiefly subject to them at two Times ib. What Parts of the Body they infest ib. How to prevent convulsive Fits in Children hereditarily obnoxious to them p. 251. the Therapeutick Method p. 252. how to provide against imminent Convulsions ib. what to be done when a Child is actually seis'd p. 253. for poor Peoples Children ib. what to be done when Convulsions happen upon breeding of Teeth p. 254. what when hapning on other occasions ib. p. 255. Convulsions in adult Persons hapning by reason of the Origine of the Nerves being chiefly affected p. 256 257. An Instance of a Lady troubled with Convulsions on this Account and how proceeded with ib. p. 258. a second Instance ib. why Blood let forth in a Convulsive Fit seems congeal'd p. 260. the method of curing these Fits ib. p. 261 262 263. Prescripts for poor People ib. Convulsion whose cause lies about the Extremities or within the Plexus's of the Nerves p. 264 An Instance of them and the method us'd ib. p. 265. a second Instance p. 266. Convulsions arising from the Liquor lying in the nervous Bodies and irritating all their Processes into Convulsions p. 267. such Convulsions produc'd by Poyson p. 268. by the Bite of the Tarantula ib. produc'd by Witchcraft p. 269. 270. Convulsions general wont to be rais'd in malignant ill determin'd and some Anomalous Fevers p. 271 272. after what manner rais'd p. 273 274. the formal Reason and Causes of such Fevers p. 275. Instances of such Fevers p. 276 277. The Method of curing them p. 278 279 280 281. Another Instance of a Convulsive Fever p. 282. Convulsions general wont to arise by reason of a scorbutick Disposition of the nervous Juice p. 283. two kinds of them ib. A strange Instance of the first kind p. 284 285. the reasons of it ib. p. 286. Instances of the second kind and the method us'd with them ib. p. 287. 288 289 290 291 292 293 294 295. The way of Cure to be used in general for such marvellous Convulsions ib. p. 296. Convulsive Cough and Asthma p. 320. the causes of it ib. p. 321 322. An Instance of a Person troubled with it ib. A second Instance with the way of managing it p. 323. The Remedies and Method of Cure to be used in this Disease p. 324 325. See Ptisick and Asthma Cordial Medicines improperly so called p. 48. Kinds of Cordial Medicines for promoting the Accension of the Blood p. 49. A Caution concerning the frequent use of such Cordials ib. Cordial Medicines for appeasing the too great boyling of the Blood ib. p. 50. Such Cordials for opening the Texture of the Blood and discharging its Superfluities ib. Cordials endowed with a volatile Salt giv'n in Fevers and Swoonings ib. Cordials endow'd with an Alchalisate Salt ib. p. 51. Cordials proper in a Pleurisie ib. Cordials whose Basis is a fluid or acid Salt given in Fevers ib. Cordial Medicines having a fix'd or lixivial Salt for their Basis p. 52. Cordials Alexipharmicks or Antidotes for Preservation ib. p. 53. Cordials Alexipharmicks or Antidotes for curing ib. p. 44. Cosmeticks p. 218 219 220. Cough see Ptisick Cutaneous Affects various p. 216 217. Summer Spots whence caus'd ib. Liver Marks whence caus'd ib. chiefly appearing in the Summer The Cure of Summer Spots Lentiginous Spots and Liver Marks p. 218 219 220. D. DElirium what it is p. 448 449. how caus'd ib. p. 450 451. the ways of Cure hinted ib. how to be cur'd when hap'ning upon continual and malignant Fevers p. 452. see Frenzy Diabetes or Pissing Evil the method of curing it p. 28 29. An Instance of a Person troubled with it and the Medicines used in curing him ib. Kinds and Prescripts of Medicines that stop Urine flowing in Excess p. 31 32 33 34. Diaphoretick Medicines or such as promote Sweat p. 34. What things requir'd for a free Eruption of Sweat ib. how Persons must be ordered for Sweating p. 35. Kinds and Prescripts of diaphoretick Medicines p. 36 37 38. a diaphoretick Diet-drink for curing the French Pox ib. Diaphoreticks to be prescrib'd in malignant Fevers p. 39. other Diaphoreticks ib. p. 40 41. Diaphoreticks in a cold Constitution p. 42. Diarrhoea see Purging Diuretick Medicines see Urine Dropsie of the Breast whence it arises p. 133. An Instance of a Person troubled with it and how proceeded with
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
scopes of curing it ib p. 372. Medicines for the Cure of it p. 373 374 375 376 377 378 379 380 381 382. Instances of Persons troubled with it and the Methods us'd with them p. 383 384 385 386. Instances of Periodical Head-aches ib. p. 387. an Instance of a Head-ach arising by Consent of other Parts p. 388. Heart its Passions p. 54. its Panting when happening through the fault of the Blood how cur'd ib. p. 55. the same cur'd when it happens through the Fault of the Arteries ib. p. 56. Trembling of the Heart its Description and Method of Cure ib. p. 57. the Cure of the intermitting Pulse p. 58. Medicines for the Heart see Cordials Hydragogue Medicines p. 151 152 153 154 155. Hypocondriacal Affects shewn to be for the most part convulsive and not caus'd by Vapours p. 307. the Symptoms belonging to this Disease p. 308. what the Ventricle and Spleen contribute to this Disease p. 309 310. An Instance of a Person troubled with this Distemper p. 311. the Method of Curing it p. 312 313 314 315. Hysterical Affects see Fits of the Mother I. JAundise three primary Indications in the Method of curing it p. 138. what Medicines are proper according to those Indications ib. p. 139. prescripts of Medicines for curing it ib. p. 140 141 142 143. Jesuits Powder its Nature and how it stops Fevers 545 546 547. Imposthume of the Lungs the morbifick matter of it p. 121. the three primary Indications in the method of Cure p. 122. Physical Prescripts pursuant to them ib. p. 123. Instances of Persons having the Imposthume of the Lungs and the Methods us'd with them p. 124 125. Incubus or Nightmare it 's an Affect of the Cerebellum p. 408. its Phoenomina ib. the Prognostick of it p. 409. the method of Cure ib. Infants often troubled with it and how to be proceeded with p. 410. Inflammation of the Lungs see Peripneumonia Intermitting Fevers see Fevers Issues what Humours chiefly they evacuate and whence they derive them p. 207. in what Diseases and Constitutions they agree better or worse p. 208 209. in what Parts and Places Issues ought to be made ib. p. 210 211. how we must deal with the Symptoms which happen upon Issues p. 212 213 214 215. Issues do not dispose to Barrenness ib. Itch a Disease of the Skin p. 221. its morbifick matter the lymphick Humour in the Glands ib. that Humour deprav'd three ways ib. p. 222. dangerous in Children and cachectical Persons ib. the Indications in order to its cure ib. p. 223. Purging necessary in curing it ib. Prescripts of Medicines for curing it ib. p. 224 225 226. L. LEprosie of the Greeks see Running Scab Lethargy where seated p. 389 two kinds of it ib. the conjunct Causes of the Lethargy so properly call'd p. 391. the chief Symptoms of it ib. the Prognostick of it ib. p. 292. the Method of curing it ib. when Vomits or Purges are proper p. 393. Instances of Persons seis'd with it and how proceeded with p. 394 395. a Lethargy hapning by the use of Opiates how to be dealt with ibid Liver its Distempers p. 146. Medicines against its over-growth p. 147. Remedies against other Diseases of the Liver coming from Obstructions ib. p. 148 149. Liver Marks see cutaneous Affects Loosness see Purging Lungs inflam'd see Peripneumonia Lungs their Imposthume see Imposthume Lungs their Consumption see Ptisick M. MAdness or the Mania allied to Melancholy p. 478. the Spirits chiefly in fault in it ib. three things to be observ'd in Persons seis'd with it ib. how happening upon a vehement Passion p. 479. often hereditary p. 480. why mad Persons are bold and very confident p. 481. its Prognostick ib. p. 482. the method of Cure to be us'd in a continual Madness ib. p. 483 484 485 486. what to be done in an intermittent Madness ib. Malignant Fevers see Fevers Mania see Madness Measles allied to the Small Pox p. 621. their Essence and Cure differ but as to more or less ibid. Melancholy its Definition p. 460. Universal Melancholy its Symptoms consisting chiefly in three things p. 461. the formal Nature and Causes of Melancholy p. 462. the evident and procatarctick Causes of universal Melancholy p. 464 465. the Prognostick of it ib. 466. the method of curing it ib. 467 468 469 470 471 472. Instances of Persons troubled with Melancholy and the ways of proceeding with them ib. p. 473 474. particular Melancholy p. 475. two chief Occasions of it ib. p. 476. Morphew see Scab Mouth its Distempers cur'd p. 359 360. N. NArcoticks see Opiates Nervous Liquor how tainted to cause Convulsions p. 267 268 269 270. Nightmare see Incubus Nitre its Nature and how it works its Effects p. 25. O. OBstructions of the Liver see Liver Opiates how they exert their Force and in what their narcotick Force consists p. 59. what they do in a small quantity and what in a great ib. the good Effects of Opiates p. 60. properly indicated in a want of Sleep in some delirous Affects in all sorts of Pains in an over-quick or vehement Pulse or Breathing also in a breathing interrupted convulsive or otherwise variously irregular in Fits of the Asthma in excessive Vomiting or Purging in Catarrhs and Defluxions of all kinds ib. p. 61. Instances of Persons cur'd by Opiates ib. of the evil Effects of Opium with Cautions concerning their use p. 62. the principal Functions of the the Soul often extreamly injur'd by Narcoticks ib. p. 63. sometimes hurtful to the Praecordia and Breast ib. sometimes very injurious to the Parts within the Belly ib. Precepts and Cautions concerning the right use of them p. 64 65 66. Kinds and Praescripts of Opiates ib. p. 67 68. P. PAins see Aches and Opiates Palsie its Description p. 428. divers Kinds of the Palsie p. 429. why Sense is not alway hindred as well as Motion in the Palsie p. 430. a dullness of Mind Forgetfulness and Stupidness often Fore-runners of the Palsie ib. the evident Causes of an habitual Palsie p. 431. a Palsie in which the sensitive Faculty is hurt Motion being entire p. 432. the Prognostick of the Palsie p. 433. three Methods or Ways of curing the Palsie ib. the method of Cure when caus'd by some Accident with a violent hurt ib. how to cure it when hapning upon a Fever Apoplexy Carus c. p. 434. how to be proceeded with when it depends of a Procatarxis p. 435 436. Praescrips of Medicines ib. p. 437 438 439 440. Hot Baths sometimes prejudicial in the Palsie 441. Salivation when to be us'd ib. Instances of Persons seis'd with the Palsie and the Methods us'd with them p. 442 443 444 445 446. Paraphrenitis not caus'd by the Inflammation of the Diaphragm p. 452 453. Passions of the Heart see Heart Peripneumonia its Description p. 105. the primary Indication in order to its Cure ib. the Intents of curing pursuant to it ib. p. 106 107. the secondary therapeutick Indication ib. Praescripts of
Medicines according to the various Intents ib. p. 108 109 110 111. Instances of Persons troubled with it and the method us'd with them ib. 112. Peruvian Bark see Jesuits Powder Pestilential Fever see Fever Pestilence see Plague Phlebetomy how many Ways and for what Causes and End an Eruption of Blood happens of its own Accord p. 177 178 179. how many Ways and for what Causes and Ends it is indicated by Physick ib. p. 180. the Uses and Affects both good and evil of Phlebetomy in Physick p. 181. certain Rules and Cautions to be observ'd in the due Administration of Phlebetomy p. 183 184 185 186 187 188. Ptisick and Consumption of the Lungs p. 71. the divers States of this Disease ib. p. 72. a threefold method of Cure ib. the method of curing a new Cough hapning upon taking Cold ib. p. 73 74. Praescripts of Medicines for it ib. p. 75 76 77 78 79. the Chin-Cough in Children its Cure ib. p. 80 81 82. the method of curing an inveterate Cough when it begins to degenerate into a Consumption ib. p. 83 84. Praescripts of Medicines for this inveterate Cough p. 85 86 87 88 89. the method to be us'd in a great confirm'd Ptisick which is commonly past Cure ib. p. 90. Praescripts of Medicines in it ib. An Instance of a Person troubled with a single Cough and free from the Suspicion of a Ptisick and the method us'd with him p. 91 92 93. An Instance of a Person troubled with a Cough proceeding chiefly from the nervous Liquor and the Method us'd ib. p. 94 95. Pissing Evil see Diabetes Plague it 's Description p. 592. Signs which foreshew that it will happen ib. Signs which shew its Presence in a Body diseas'd p. 593. Signs of Recovery or Death in it p. 595. Prophylactick Cautions against it p. 596 597. its Cure p 598 599 600. see Fever Pestilential Pleurisie its Description p. 113. the method of Cure ib. p. 114. Praescripts of Medicines adapted to the Indications p. 115 116 117. An Instance of a Person troubled with it and how proceeded with ib. p. 118. Poysons in general how they affect our Bodies p. 583 584 585 586 587. Poysons causing Convulsions p. 268. Pox see French Pox. Psora see Itch. Pulse intermitting see Heart Purging three Degrees of it 〈◊〉 All Purges not to be us'd inâ—â—â—â—rently ib. when improper ib. 〈◊〉 Praescripts of purging Potiâ—â—â— Pills Powders Bolus's Eleâ—â—â—ries some of each kind being 〈◊〉 gentle others of a mean and â—â—â—ers of a strong Operation toâ—â—â—her with some Purges of each â—â—â—d of an easie Preparation for 〈◊〉 Poor p. 9 10 11. purging â—â—â—blets Wines and Ales p. 12. 〈◊〉 prevent over-purging upon giâ—â—â—g a Medicine what to be conâ—â—â—ered ib. p. 13. how cur'd if â—â—â—ning ib. excessive Purging â—â—â—ning without giving a Mediâ—â—â—e for the most part symptoâ—â—tical ib. two kinds of Fluxes â—â—â—ning almost yearly in London â—â—â—ally call'd the Griping of the â—â—â—uts p. 14. the proper method of â—â—â—ire in that which happens withâ—â—â— Blood ib. p. 15. the method 〈◊〉 Cure in the other which is â—â—â—ody ib. p. 16. the therapeutick â—â—â—ications into which the said â—â—â—thod of curing the Bloody Flux â—â—â—y be resolved ib. Instances of â—â—â—sons cur'd in the Bloody Flux 〈◊〉 17 18 19. Q. QVartan Fever or Ague see Fever Quotidian Fever or Ague see Fever R. RAving see Delirium Rheumatism cur'd p. 367. Rickets Medicines for curing it p. 147. Ring-worm see Running Scab Running Scab or the Leprosie of the Greeks its Description as it is understood by us p. 227. its material Cause p. 228. whence this Disease takes its Rise ib. the method of Cure ib. 229. Praescripts of Medicines ib. p. 230 231. how to proceed with it when it arises from the Scurvy p. 232 233. how to proceed if it arises from the French Pox p. 234. topical Remedies to be apply'd outwardly ib. p. 235. An Instance of a Person troubled with the running Scab and how proceeded with ib. p. 236. another Instance p. 237. S. SCab see Itch and running Scab Scurvy the Signs of it in all the Parts of the Body p. 326 326. the evident Causes of it ib. p. 328. its material Cause p. 329. the Prognostick of it p. 331. Instructions in order to its Cure p. 332 333 334. Purgers to be us'd in a hot Scurvey or in a sulphureo-saline Dyscrasie of the Blood p. 335 336. Purgers to be used in a cold Scurvy or in a salino-sulphureous Disposition of the Blood ib. p. 337. Preservatory Medicines for rooting out the Cause of the Disease in a cold Scurvy or in a salino-sulphureous Dyscrasie of the Blood p. 338 339 340 341 342 343 344 345 346. Medicines for rooting out the Cause of the Disease in a hot Scurvy or in a sulphureo-saline Dyscrasie of the Blood p. 347 348 349 350 351 352. the Curatory Indication of the Scurvy whereby we obviate the Disease it self and the Symptoms that are chiefly pressing p. 353. the Cure of a difficult Breathing and Asthmatick Fits hapning in the Scurvy ib. p. 354. the cure of the ill Affects of the Ventricle hapning in the Scurvy ib. p. 355. the scorbutick Cholick cur'd ib. the Cure of the Diarrhoea and dysenterical Affects hapning in the Scurvy p. 356. the Cure of the Vertigo Swooning and other Affects usually joyn'd with them in the Scurvy p. 357. the Cure of Hoemorrhagies hapning in the Scurvy p. 358. the Cure of Distempers of the Mouth hapning in the Scurvy p. 359 360. the cure of night pains in the Legs and Limbs in the Scurvy p. 361. the Cure of the scorbutick Gout p. 362. the Cure of convulsive and paraltick Affects hapning in the Scurvy p. 363. the Cure of the scorbutick Atrophia and Fever ib. p. 364 365. the Cure of the Rheumatism in the Scurvy p. 365. the Cure of the Dropsie hapning in the Scurvy p. 366 367. the crackling of the Bones in the Scurvy p. 367 368. the vital Indication in the Scurvy where Cordials Opiates and a fit Diet are ordered p. 369 370 371 372. Instances of Persons troubled with the Scurvy and the Methods us'd with them p. â—â—â— 374 375 376 377. the Meâ—â—â— of Cure to be us'd in some 〈◊〉 of the Scurvy p. 379. Skin its Affects see cutanâ—â—â—â— Affects Sleep Medicines to procurâ—â—â— see Opiates Sleepiness continual the Seâ—â—â—â— this Disease and the Differâ—â—â— from the Coma and Lethâ—â—â— p. 396. its method of Curâ—â—â— p. 397. An Instance of a Pâ—â—â— troubled with it and the metâ—â—â— us'd ib. p. 398. Sleepy Coma wherein differâ—â—â— from the continual Sleepiness 〈◊〉 the Lethargy p. 398. the seâ—â—â—â— this Disease ib. sometimes bâ—â—â—ning of it self and sometimeâ—â—â—suing upon other Distemperâ—â—â—â— p. 399. the Method us'd in 〈◊〉 mary Coma ib. the method 〈◊〉 when hapning upon other â—â—fects ib. Sleep wanting see Watchâ—â—â— Evil. Small Pox whence Man 〈◊〉 â—â—clin'd to it p. 614. the eviâ—â—â— Causes of it ib. p. 615. the â—â—â—junct Cause of it ib. the Diaâ—â—â—