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
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
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
the sulphurous and volatil-salin particles exerting a temperate heat that attenuates expands and dissolves the whole essence and separates the suliginous-salin parts from the homogeneous ones by subliming them into a sharp salin scum the tartarous and fixt salin particles it precipitates into a mucid and slimy mud This being observed to be the signification of fermentation according to the true intent and meaning of those that imposed it on things that were to be fermented it seemed indeed a very simple and idle assertion that whilst the blood doth seeth boyl hiss and burn the hand of him that toucheth it and occasion a black and sharp steem being an effect of fire on the mouth and tongue that all this should depend on a fermentation and mild heat of the blood Doth not fermentation always tend to concoction but a Fevor oft to corruption and death and that one and the same word shall signifie two contraries is it not an absurdity To express alteration mixtion generation corruption calefaction and what not by the word fermentation a word wondrous pregnant is to set limits to all physical re-searches and inquiries Neither do they detract less from the art of Physick who assert a vitiated ferment the cause of a Dropsie Phthisick Pleurisie and of the whole train of diseases on the correcting whereof to wit the serment every old Wife and Barber-surgeon shall say the stress of the cure doth lie and is it not then lawful for this Tribe to vye with fermentitious Physicians yes and exceed them How formally and cunningly at this rate is the disease cause and cure proposed by every Glisterpipe What is it at last come to What necessity is there to apply ones study to Anatomy Botanicks Physiology Pathology and a thousand other things O wonderful Head-pieces You will notwithstanding by the way admire if this notion of fermentation be only assumed as a phaenomenon or supposition for the thing it self is not yet agreed on by those that are something higher advanced in Learning to shew themselves more dextrous in illustrating the causes extracting of indications and in the method of curing yet it is not to be doubted but that they ship off a greater troop of sick in Charons Boat and deserve a greater fraight than the putrid Physicians But to the business let us now be at leasure to examine the manner and method that Fermenters undertake the cure of continual and intermittent putrid Fevors what indications they answer unto and wherein they receed from putrid Physicians The Indicantia and Indicata ought to be ranged in this order The blood too much inraged or too little moved by fermentation and a vitiated ferment are the chief Indicantia those things that promote or quicken the too slack fermentation and temperate it when too violent and reduce the ferment when receeded from its temperament are the Remedies Indicated The vital faculty languishing and deprived of its spirits doth indicate a cordial and restorative medicine The animal faculty being broken through want of many nights rest must be relieved with Opiats The Belly if forgetful of its office must be rowsed up with a stimulating suppository or laxative glyster neither are the urgent symptoms of a two swelling fermentation to be neglected A Phrensie that proceeds from sulphurous steems fuming up from the fermenting mass must be allayed by means that revell or draw back from the Brain Astringent medicines bridle a loosness and enormous vomiting Thus far in general concerning indications taken from their theorems nevertheless these being waved the Fermenters do follow the method of cure of the putrid Physicians in posting away their Patients to the place of their fore-fathers as shall be recited immediately That it may be physically illustrated we ought to premise their practice being fitted to a particular sick person whose age sexe temperament former custom of living season of the year tenor of their Pulse state of Urine urgent symptoms occasional and procatarctick causes and manner of the first assault of the Fevor what symptoms attended what symptoms arrived afterwards manner of breathing the habit of the Hypochonders Stomach and Belly the manner of the look of the sick man his manner of speech what habit of body what usual evacuations are suppressed whether the Fevor be essential or symptomatick whether first come or a relapse what disease he was troubled with last what remedies were applied before the Physicians coming and many other particulars that are to be distinctly proposed all which I say ought to be represented to the serious meditation of any Physician that is to undertake the cure of a Fevor But they receed so far from these necessary animadversions that being sent for to a Patient having only felt his Pulse they look upon the Urine and make some little inquiry concerning the state of his Belly whether loose or costive neglecting all other necessary informations and apply themselves immediately to prescribing and their first business is to put the Belly in order which they endeavour by this following form of a glyster but I am to advertize you before concerning the custom that young Physicians that are newly come from the University diligently repair to the Apothecaries shops for to inform themselves with the forms and receits of the Elder Physicians and being acquainted with them it happens thence that every Physician is furnished with the same examples or forms of remedies neither doth the one go an inch from the road of theo ther. Wherefore I shall collect you the most received forms throughout the whole course for to remove a fevor compiled by our modern ones afterwards how successfully our age makes use of them I shall particularly observe The presciption of a glyster according as it 's commonly found in the Shops is this R. Decoct commun pro clyst vel juxta alios R. Decoct Emoll com lib. j. Elect. lenit â„¥ j. Ol. com vel viol Mel. Mercur. vel Ros. ana â„¥ j. vel ij Sal. com q. s. m. f. Enem Some there are that instead of common Salt put in Salt-peter or Sal-prunellae from half a dram to a dram which for its detergent and cooling quality is far beyond the other and indeed Crystal mineral being added to any sort of glysters is far more beneficial because it agreeth so very well with the temperament of the Guts on the contrary Sea-salt being of a drying inflaming and irritating faculty is very offensive to the Guts For this reason the Antients made use of it as well inwardly in Pills thick Syrups Glysters as outwardly in Oyntments Some among the Fermenters do extreamly oppose the giving of purges or laxative glysters in Fevors because they provoke the corrupted excrementitious humours to ferment whose steems piercing into the vessels do disturb and augment the fermentation of the Fevor On the other side the putrid Physicians make this reply to them that glysters doing their work quick and without the Vessels cannot transmit the least breath of heat nor blow up