the same manner if you pour some drops of those forementioned volatil liquors into a small quantity of blood though crude and phlegmatick you will digest it into laudable blood and preserve it warm and slorid but upon dropping some oyl of Vitriol into it it turns immediately into a curd the serum or whey is depressed downwards and assumes a purple red colour Spirit of Nitre doth pervert the redness into a whitish or ash colour but doth not precipitate the whey suffering it to swim a top Upon the further pursuit of the matter I dropt a drop into a large proportion of blood almost coagulated whereby almost in a moment the tye of the coagulative particles was dissolved and indued with a shining lustre not at all inferiour to the best digested blood Neither doth it only from this external use deserve to be termed so admirable but that in a short time being used inwardly as I have oft made trial it hath singularly digested the crude blood of Asthmaticks Scorbuticks and of worfer habits A consistency between thick and thin signifies a vigour of concoction chiefly to be ascribed to the volatil salt living in the vital Bitumen The causes of the thinness or tenuity of urine in those that are sick of a Fevor are the scarcity of volatil and sixt salts not being separated from the torrent floating through the great vessels also the drying away of the mucilage of the blood through the heat or its dissipation through the pores The thickness of urine is occasioned by the whey or serum imbibing too great a quantity of salt and thick mucilage Touching the matter of the hypostasis or settlement of the urine there hath hitherto but little certainly been stated among Authors though most are of opinion it proceeds from the superfluous humour of the third concoction To me the sediment appears to be a mucilage partly imbibed by the serum or whey within the vessels partly deterged from the slimy substance of the intern tunick of the ureters and bladder wherewith they are liquored to prevent their most exquisite sense be not hurt by the urine that flows by This mucilage if you examine the Chamber-pot shall be found to be a glutinous thick and slippery slime moreover that it 's dissolvable by heat and apt to be thickned by cold like phlegm may be observed in turbid urines which as long as they continue warm after they are made are clear and perspicuous but a little after growing cold are turned into turbid and dark being deprived of the energy of the particles of hot volatil salts that dissolved the slime for if you do but hold the urinal a moment to the heat of the fire or hold it in warm water they will resume their former shape of clearness Bubbles that oft swim a top the surface I judge ought not to be imputed to a slatuous but lixivious constitution of urine for ashes soap and other lixivious things being dissolved in water render it subject to turn frothy and bubbly with the least stirring The colour consistency and contents are chief universals whence a Physician may extract what preternaturals lye hidden in the body The colour discovers the active qualities of the salts the consistency the state of the serum or whey and the contents the quantity of the foresaid salts and other excrements that had performed their office a further and particular explication of all these relating to the kinds of Fevors shall be reserved to the sequel of the book Lastly it is to be noted that in the contents are included the enaeorema and hypostasis CHAP. IV. Concerning the true and Spurious Essence of a Fevor IN the first Chapter we had hinted at the definition of a Fevor what concerns its explication we have partly referred hither That a Fevor is a derivative from the nature of fire is abundantly suggested from its destructive manner of acting most fierce heat the tongue and roof of the mouth being crusted with a black smoak likewise from other symptoms thence proceeding as thirst dryness and roughness of the skin and inflammation of several parts Here the Reader is to assume that the vital Bitumen of the heart and the whole body being kindled into a fire is the disease or Fevor or rather that the fiery distemper of the heart and the whole body or part is the disease but not the preternatural heat being that's rather to be counted a symptom immediately flowing from the disease in no wise differing from the manner the heat emanates from the fire Wherefore the definition which is extant among Academick Authors as Fernelius Sennertus and others ought justly to be rejected To wit A Fevor is a heat against nature kindled in the heart and from thence by means of the spirits and blood diffused throughout the whole body and doing hurt to all the natural actions The objections against this definition I offer you in these positions First I assert that the essence of a Fevor doth in no wise consist in an universal heat nor secondly that the heat which attends a Fevor doth not altogether arise from sparks glittering in the heart The argument that confirms the former is taken from the genus of a Fevor which is stated a disease but a disease is said to be the constitution of a part hurt or injured which kind of saying doth not at all agree with a preternatural heat that depends on the burning fixt Bitumen of a part or oft on miasms or steems blown from the heart the receptacle of the fire to all or most parts of the body but those torrid miasms are not to be taken for the disease but causes that in process of time through their heat may occasion a disease Here may be offered a probable objection that a Fevor is the kindling or heat of the influent spirits of each single or more parts whose hurt is to be imputed immediately to the heat of the spirits whence a Fevor may justly be judged a heat Hereunto must be replied that the name of a part of the body can in no wise be given to the spirits because they flow continually neither are they in any manner permanent but are assigned for the animation and nutrition of the parts and for that reason their distemper ought not to be taken for a disease if notwithstanding the subversion of the temperament of a part should flow from a tumult of the influent spirits and that thence they should be incapable of performing their offices nevertheless because it 's a mediate affection and to be derived from the burning of the spirits it 's not to be taken for a disease but a cause Secondly If from the general opinion you have a mind to instance that the putrid heat of all the parts of the body is a Fevor to wit a continual putrid one supposing likewise that the said heat is risen out of the blood only being through its means conveyed to the sanguin parts I answer it ought not be
as appears here and there by the writings of Galen and Avicen Notwithstanding I can scarce apprehend the foundation of these seats wherefore I desire to be satisfied in this doubt whether continual Fevors are said to bud forth in the veins because the blood that leaps out upon phlebotomy doth appear hot to the touch and shews deep red being mixt with a blew milky or yellowish whey But this blood is not different from any other that 's extracted in an intermittent Fevor or any other disease And whether the difference of seats is expounded to be such because the blood within the vessels having an immediate commerce with the heart is capable to foment a strong heat whereas entrails that are more remote from the heart do only by fits profuse those putrid and fevorish steems and under that shape do occasion an intermittent heat Certainly not Moreover the entrails being tyed to the vessels are not less commodiously situated by means of these small chanels that tend directly to the heart to foment a fevorish heat than if the cause were engendred within the foresaid vessels or whether because the vessels are of a just capacity wherein they may receive such a quantity of fevorish matter as may suffice to nourish a Fevor without intermission whereas the entrails are stated to be streight and not provided with a hollowness to retain matter enough On the other hand the entrails according to what the thing requires ought to ingurgitate a larger quantity of matter which might suffice to protract an intermittent Fevor to some months and years as doth oft happen But to touch the knot of the difficulty the cause of the continuation intermission remission and intention of Fevors is not to be imputed so much to the quantity as the quality of the fevorish matter as hereafter shall be treated more at large In the precited definition the heart is idly stated the part primarily affected for thence would follow that the greater part of Fevors should be mortal because the composure of its temperament being once subverted is not easily restored Secondly Suppose an inflammation of the Liver or other entrail attended with a Fevor which do you think the part primarily affected the Heart or Liver CHAP. V. Concerning the fopperies of Fermentation ALmost every Barber and Plaster-spreader have got the knack to buzze every patient in the ear the song of fermentation and know how to fit the tone of it to every disease but chiefly to a Fevor illustrating the exposition thereof with this commentary that the blood fermenteth and the humors are in a fermentation likewise the ferment of the Heart Spleen Liver and it may be of the Fundament too if they go not orderly to stool is depravated moreover if a Corn of the Toe doth but ake the distempered ferment is the cause of it Summarily fitting the word ferment to every disease cause and symptom they conceive the case to be very well handled and thence tell the Patient they will expel the disease by correcting the serment and so as if they had done their business mighty well they send the Patient home swelled with hopes Concerning this abstruse Philosophy borrowed from certain theorems of the Wine-press and chymical notions Anthonius Guntherus Theobaldius Hoghelandius Felicianus Betera Conringius Martinus Kirger and others have prosessedly treated whose Treatises if you peruse you will find the word fermentation to serve in divers significations the one in a large sense gives the description of it not at all different from Peripatetical mixtion excepting that this performs its task by qualities the other by action and reaction But fermentation in a narrower signification as it relates to fluids is stated an effervescency of any liquor tending to concoction At present we will examine whether a Fevor be a fermentation or effervescency of the blood To the resolving of this we must resume from what hath been said in the foregoing Chapter that a Fevor as it is a disease of the body doth necessarily inhere in a part as its subject and foundation but the blood cannot perform the office of a part therefore neither a Fevor or fermentation can be properly attributed to it Secondly Neither can the blood fermenting be probably conceived to be the continent cause of a Fevor because its fluid mixture is absorbed in a few days whereas a Fevor is protracted to some weeks Suppose a fevorish Patient to contain four and twenty pints of blood in his vessels whereof a quarter of a pint is consumed every day by abstinence and dissipated away through the pores into vapors and some days a whole pint or at least three quarters are drawn off by phlebotomy for it 's very familiar amongst the French the first and second opening of a vein to extract a whole pint of blood and every bleeding afterward which is commonly every other day to take away two Porringers containing three ounces a piece by this computation the whole mass should be drawn off in two weeks or less and consequently the fermentation must be quieted and stopt and the Fevor expelled But on the contrary if you should extract blood forty times as I have oft observed in France they have done the height of the heat will not be half a degree abated but rather augmented Who would then maintain the blood boiling through fermentation to be the cause of a Fevor However this experiment is observed to be true if you take off the third part of any liquor that is a fermenting whether of Wine Beer or any other mixture it will immediately be taken off from working but ofttimes the blood is tapt off to the half and sometimes to the last fourth part without the least quieting of the fermentation if I may call it so Possibly you reply that according as the vessels are emptied by bleeding sweating and other torments they swell up again by the food and drink that 's daily taken On the contrary there is a thin Diet ordered to such as are in a Fevor neither do most in the whole course of a Fevor allow their stomach so much as whereout the sanguifick faculty may engender a pound of blood add hereunto that their appetite for fourteen or twenty days is quite dejected But you reply that they take as much food as answers what is consumed to this I return that the blood which is daily ingendred and newly admitted into the vessels either it 's pure or stained if the former then it ought to dilute and temperate the fermenting mass which it doth in no manner do if the later it is not to be doubted but that it hath contracted its stain from the concocting and depurating entrails whence follows that the primar and principal cause is not to be attributed to the blood but the entrails Thirdly It 's confirmed by experience that fermentation doth happen to any mixt liquor and soft compositions as paste or dow electuaries and others which is observed to be a mild working of
inferred a disease since the blood also because it 's a fluent matter cannot justly deserve the name of a part but a cause of a disease or the vehicle of it Thirdly The bones cartilages and ligaments are not sensible of heat neither are they subject to receive any putrid heat because in a Fevor they are seldom or never observed to be taken with a putrefaction or rottenness how can then a Fevor be termed a preternatural heat of all the parts Likewise Fourthly Why ought the name of Fevor to be attributed to a fevorish heat more than to a shaking or fevorish coldness in the beginning of a paroxysm of a Fevor both the former and the later flowing equally as symptoms from a Fevor Fifthly An universal heat is erroneously ascribed to a Fevor for in a lipyrious Fevor a torrid heat doth torment the internal parts though the externals are cold moreover it oft happens that the hands and feet are stiff of cold and the entrails do in a manner glow with a burning heat Furthermore it may be observed that a Fevor doth sometimes only haunt one single part as the foot or hand Neither have I forgotten a certain Fevor whose heat extended no further than the head and face Hereunto add that those particular Fevors are not only inferred to be such because of the preternatural heat but also by reason of the preceeding cold shaking and ulcerous lassitude Sixthly those that swell so much with the Doctrine of Fermentation they do not altogether affirm that it is a preternatural heat that constitutes a Fevor since the forementioned heat doth take its rise from a heap of influent spirits striving to expel humours and such small bodies as are annoying which heat ought therefore rather to be judged natural than against nature In the second position we maintain that the heat that attends a Fevor is not always kindled in the heart as if the primar hearth were there which assertion is proved from the kinds of symptomatick Fevors for the Fevor that surprises a wounded patient or one that 's detained with an inflamation of an entrail as the Spleen Liver or Kidney certainly it 's not first kindled in the heart but in the part affected whence afterwards it 's dispersed throughout the whole structure Secondly If the heart were the only brand of fevorish heat the blood that passeth through its ventricles should retain a mark of being burnt and undergo some change of tincture when on the contrary thousands that have been bleeded in Fevors their blood that was extracted hath appeared to the eye to be of a pure scarlet and florid until the fourth and oft until the sixth and eighth day In the next paragraph I have thought fit to please my self with the examination of the vulgar opinion concerning the common seat of continual putrid Fevors intimating it to be the blood seething in the vessels and stained with putrefaction but how grosly this rabble of Physicians is mistaken may be extracted from what shall be proposed First If the sprout of a continual Fevor were ingraffed on the blood it would not be so refractory to cure but consisting of fluid and moveable elements by means of alteratives purgers diaphoreticks and emptying the vessels by opening a vein might in a short time be reduced to its former purity and temperament moreover through one nights seething of the blood nature doth oft expel those thin little bodies that float in it and the grosser it casts forth into pustules botches and other such tumors Secondly I cannot grant that what is stirred by motion and continual flowing as the blood is that it is easily taken with putrefaction for being full of vital spirits and living heat it 's held in a continual motion Thirdly Until the third fourth sixth eighth or tenth day computing from the beginning of the distemper according to the degree of the height of the Fevor the blood at the first phlebotomy is extracted pure and florid as I have observed in hundreds whence it 's evident that the primar matter of putrefaction and the seat thereof is erroneously placed in the blood though afterwards passing the entrails it be stained with a malignant quality loading it self thence with hot Miasms and Salts Fourthly pure phlegm or veiny gelly being watered with an immoderate quantity of a pale green and blew lymph or whey since it makes two thirds of the blood in the veins of those that are troubled with the Dropsie Green-sickness and other kinds of diseases why is not that blood which is so heterogeneous and so far remote from a temperature moisture abounding and the plurality of particles breeding putrefaction always forced into a fevorish heat And on the contrary why are hot and dry temperaments where choler is abounding constantly so inclinable to putrid Fevors whereas dryness doth so particularly resist putrefaction Summarily the blood according as I have asserted in the premises since upon no pretence it 's to be accounted among the parts of the body doth utterly exclude it self being capable to be a seat place or part affected If peradventure you doubt that I have hitherto receeded from the path of the received doctrine stating the heart or other entrail the seat in Fevors you have the liberty to take it from the fountain what is to be concluded concerning the matter Avicen fen 1. lib. 4. tract 2. cap. 43. dictates thus Dicamus quod Febris sanguinis est Febris putredinis Febris calefactionis ebullitionis that is Let us say that a Fevor of the blood is a Fevor of putrefaction and a Fevor of heat and ebullition Here is to be noted that the blood is inferred the subject matter and seat of a putrid Fevor Also Galen lib. 2. de Cris. cap. 12. Manentibus igitur in venis humoribus continuae ex ipsis Febres generantur that is The humors remaining in the veins continual Fevors are engendred out of them Likewise Aetius tetrab 2. Serm. 2. cap. 74. Putrescentes igitur humores aut intra vasa arctati continuas nunquam intermittentes usque ad perfectam morbi solutionem Febris efficiunt that is Wherefore humours putrefying or streightned within the vessels do cause continual Fevors and never intermitting until the perfect solution of the disease Here by the way observe though according to Galen Fevors are seated in the veins by their name Arteries are also described as lib. 1. de Crisib cap. 7. it 's by him more largely expressed Febres omnes sunt passiones venarum itaque in Febribus omnibus quoniam venosi sunt generis passiones nam arterias in hoc genere comprehendimus ad urinas praecipue attendere oportet the English is All Fevors are passions of the veins wherefore in all Fevors because they are passions of the veiny gender for we comprehend the arteries also in this gender we ought chiefly to heed the Urins On the other side they have destined the seat of intermittent Fevors to be without the vessels
bleeding and purging are by Galen stated great remedies on the use whereof life and death doth depend neither is the former to be less suspected than the latter wherefore that Aphorism 29. lib. 2. that was so prudently dictated doth relate to both viz. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is move at the beginning of diseases if any thing ought to be moved Diseases are said to begin as long as the symptoms of the first assault continue without alteration but as soon as they are sensibly intended provided there doth not follow a remission presently after then they exceed the limits of the beginning and arrive to the Augment or increase of the Disease Thence doth Galen also admonish us on the foresaid Aphorism 29. l. 2. Ut citius eveniant coctiones circa principia melius est evacuare per venae sectionem purgationem that is that the concoctions may sooner be performed it is best to evacuate by bleeding and purging at the beginning Avicen doth oft highly extol bleeding but at the beginning of a Fevor sen. 1. lib. 4. tract 1. Cap. 33. writing concerning the cure of a Fevor Cum causa est multitudo humorum atque repletio tum oportet in principio properes ad phlebotomiam that is when the cause is the abundance of humours and repletion then you ought to apply your self to bleeding and that in the beginning Likewise in another place he saith Evacuatio non est aliqua nisi sicut phlebotomia in quacunque hora accidat non expectatur crisis neque digestio that is There is no evacuation like bleeding at whatever hour it happens and that there be no expectation of a crisis or of digestion Galen lib. introduct cap. 3. discoursing of Fevors expresseth himself in this manner Curatur in principio venae sectione in statu tam frigidae tam aliorum quae refrigerandi vim obtinent potio confert idem enim semper remedium accipitur ut quocunque morbi initio sanguinis detractio in English thus it is cured in the beginning by bleeding at the state by drinking of cold water and other things that have a power of cooling the same remedy is always made use of as also is bleeding at the beginning of the disease and in another place he declares Quod in consilii inopiam deveniunt qui statim à principio non vaeuarunt sanguinem that those want advice who immediately at the beginning have not taken away some blood Alexander Trall lib. 12. c. 2. adviseth thus Continentes Febres solerte diligentia curari debent subitoque id faciendum quod internotitia dictaverit sive missionem sanguinis sive expurgationem requirat maximum enim incommodum est tum omnibus morbis tum in continentibus dilatio which is thus englished Continent Fevors are to be cured with a prudent diligence and that must be suddenly done which your knowledge doth dictate whether it require bleeding or purging for delay is the greatest disadvantage to all diseases and to Fevors What need is there of words we have abundantly made the case known by reasons authorities and experiments whence it 's evident how barbarously they act to the ruine of those sick people that are troubled with a continual putrid and malignant Fevor by taking blood away from them about the middle and end of the Augment and State It is a great truth I shall say that at the beginning it is life in the middle and end of the Augment and State it is death Against what hath been said an argument might be here taken from what the great master of Physick doth command Aphor. 8. lib. 1. viz. Quando morbus constiterit in suo vigore tunc victu tenuissimo utendum that is when the disease is in its vigour then you are to use a very thin diet that the mass of blood may not increase so much as to exceed the power of natures government wherefore for the same reason one may take away blood in the vigor that it may not too much oppress and burden the spirits The objection is easily refuted a very thin diet is commended that the spirits may not be drawn from the concoction whilst they are busied in subduing the Febril matter but not because of the too great increase of blood since the mouths of the vessels lye almost flat and there is rather a greater proportion of it required to supply thence a greater quantity of spirits It is not difficult to extract from the premises a reason for two bleedings in continual Fevors since it 's to be celebrated in the commencement of the Disease or the beginning of the augment though very seldom for if it be performed as oft as possible at the time of the beginning namely in the space of four or six dayes you ought not to open a vein beyond the second time for there ought to be at least two days between each bleeding to recover strength whence it 's apparent there is scarce occasion left for a third unless thereby you intend to annoy nature in the augment and to cut off from her strength But if a Fevor be attended with malignity bleeding ought not to be attempted or repeated without a great deal of caution What ought to be done in the beginning of a Fevor hath been hitherto discussed At present we must take into consideration the cure of the augment or increase of a Fevor First of all we must be resolved whether at the time of the growing of the Fevor the fermentation is to be promoted Physitians here are blinded in a mist being utterly ignorant of the stages of Fevors they follow a heedless and impious practice daily tainting their hands with the death of their Patients what compass do they steer by to arrive at the exact minute of opening a vein or giving a purge what mark do they aim at when they force pouders and cordials on their Patients and if there should a faculty of suppressing continual putrid and malignant Fevors be allowed them being ignorant of the manner and punctual time of giving them they are capable of doing as much mischief with them as a mad Barber with a Rasor Hippocrates being perswaded by this reason which is to be rightly noted doth take the beginning of his Aphorisms from an observation to be minded above all others in the art of Physick 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is life is short art is long time is swift experimenting is dangerous c. It is the third member of this precept that expresses what is to our purpose viz. Time is swift that is the exact opportunity and occasion is of great moment especially in acute diseases for the same medicine in respect of time doth both kill and cure That a Fevor doth make as it were four stages vulgar observation tells us It passeth the first whilst the fevorish matter lieth hidden about the subservient entrails the Stomach Pancreas Lungs the Gall-Bladder Glandules of the Mesentery one or all of them
puddle of salt and sharp water into great bubbles but those on whom the precited Vesicatories have been affixt where there hath been no concoction or separation before have had a small quantity of moisture extracted into low blains which for the most part is a mortal sign so that it doth appear thence that the cause of their cure and recovery is not to be ascribed to the Vesicatories but to the subduction and concoction of the malignant water and heterogeneous humours Secondly in Epispastick medicaments the Cantharides perform the chief work the relation of whose properties I judge may be advantageous They are of a most hot and burning nature they oft occasion Fevors great tortures and pains a disturbance of the humours in the vessels and a very sharp irritation which a dysury and bloody making of water do oft follow they are extreamly hurtful to the brain and sinews and suddenly destroy ones strength so that they are markt with a signature of the most malignant venom though only applied externally Wherefore if Epispastick plasters being thick spread with Cantharides are applied to a Patient that is ill of a malignant Fevor at the time of the vigour when his strength is decayed do they not increase the Fevor put the malignant humours into a rage heap up one malignity on another quite oppress the principal faculties destroy the forces and certainly deprive the Patient of his life Possibly here may be objected that though Vesicatories do occasion a great deal of hurt per se to a fevorish body yet per accidens they do abundance of good by exhausting the malignant serum and putting the external parts to pain whereby there is a revulsion made of hurtful humours and steems from the brain Hereunto is to be replied that in this case the blood is most frequently wanting of moisture whence the febril fire burneth the more violent so that it 's possible only to attract a very few drops whereby a heap of very great evils is brought upon the Patient Secondly since malign corpuscles are chiefly seated in fuliginous salts you cannot possibly by any device extract them for at the time of the state they are so very closely and intirely soldred to the humours that to draw them asunder is by no means feasible That these things are so is proved by this argument The Ichor or bloody moisture that by an Epispastick is attracted outward at the time of declination or concoction and separation doth swell out in a great quantity under the blains which when cut doth leap out being of a sharp tast fiery and salt because it 's laden with those foresaid fuliginous and malignant salts but being expelled at an unseasonable time appears limpid insipid and fresh Moreover I will now tell you what the vulgar will scarce give credit to namely that Vesicatories being applied at the declination to parts that are not so convenient have very suddenly snatcht sick Patiens away out of this sublunary orb A certain person that was ill of a burning and malignant Fevor aged thirty two after he had lain sick fourteen days not without some signs of perfect concoction and separation in manner that on the fifteenth he walkt several times up and down his room being attended with all characters of health to expel the latent malignity outwards had by the advice of two fermenting Physitians at the hour of Rest large Vesicatory Plaisters applied to the nape of the neck and the wrists The following morning the Fevor was bursted out again burning enough his speech was taken away and was grown light headed but that they might make an end of their task on the sixteenth they took the man out of the world Doubtless the malignant salts being attracted out of the whole body to the brain and nervous parts did very suddenly extinguish his forces and spirits Many other tragical cases I could produce for testimonials did not the purpose of a compendious tract disswade me wherefore take the precited in lieu of all It may be stated for a certain that at the beginning of a malignant Fevor especially when it hath attracted the seminary of malignity out of the air which seldom happens Epispasticks being applied to the remote parts the symptoms have been subdued immediately and the Fevor extinguisht but then they were applied within the third or fourth day Likewise being affixt to one that is taken with a pestilential infection they have been very advantageous In some cases they may also be applyed to convenient parts at the declination My business doth only permit me to premise these particulars in this first Section in the second section which will e're long follow I shall apply my self to give you a description of putrid continual and malignant Fevors likewise of the Small Pox and Meazels by their foundation subject and symptoms and likewise shall subjoin practical observations and the true method of cure and remedies In the third section shall discourse of the division of Fevors and in particular of intermittent Fevors Upon so important an affair as the Practical part of Malignant Fevors I ought not to make so sudden a recess as to leave those salutiserous maxims premised in this Tract only astipulated with reason but to recommend them to you confirmed by experience abstracted from those cures which for success and happy event are not to be conferred with the vuâ—gar methods Among the number of them I could here produce shall only insert some few of the last years date whence a proof sufficiently evident may easily be reduced The last preceding autumn I was called to one Mr. Van Mildert a Dutch Merchant of considerable note aged about twenty nine of temperament Pituitous and Melancholick not robust of constitution but of a rare texture of body On the Sunday he was surprised with drowsiness and heaviness of his head a Catarrhe in his throat an ulcerous lassitude a rigor or shivering and shaking a nauseousness or inclination to vomit and some other symptoms dependant on the former during the first four days he used the prescriptions of one of the elder City Physitians the chief whereof to the best of my memory directed some vulnerary vegetables for a decoction another was a decoction of Carduus B. in posset ale intended to move a gentle vomit and after that advised bleeding The fifth day I made my first visit and found the Patients sense of sight and hearing much diminisht his pulse extreamly languid inequal in motion and debility a little more frequent than in the state of health the urine thick turbid and a little high coloured the tongue scabrous red dry and fissured his thirst was so extream that no quantity of any former drink could in the least abate it By intervals his rational faculty was perverted with a Delirium that would continue several hours Touching his sleep some dayes and nights he was wholly restless other dayes soporous and comatick a case of greater difficulty I have not met with neither