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
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
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
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
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
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
Sleepy or Convnlsive affects ensue Moreover sometimes the Poyson of the Medicine produces within the Praecordia or Viscera horrible affects of the Asthma Leipothymia or Bloody-flux The vulgar Form of a Mercural Ointment for the Itch and very much in use is this Take Quick-silver reduc't into minute parts with an Acid and as they call it Killd an Ounce and a half Fresh Haggs â—ard six Ounces incorporate them well by stirring them a long 〈◊〉 in a Stone or Glass Mortar Nor only in the Form of a Liniment but many other ways the foresaid Medicines may be us'd For the Fume of Cinnaber which is prepar'd of Mercury with Sulphur cast on the Coals and taken in at the Mouth or breathing against the Superficies of the Body Cures the Itch The Mercurial Cosmetick water before written made about half weaker and apply'd to the Skin with a little Cloath in the Sorest places kills the Itch Yet the use of these is not so very safe as to be generally administred to all persons Of Sulphur and Vegetables either separately or conjunctly boil'd in water Baths are prepar'd which Cure this Distemper not by washing off only the Filth of the Skin as common Baths but likewise by destroying its ferment Besides these there is yet another easier and much more neat way of Curing the Itch viz. by boiling a Shift in fountain water with Powder of Brimstone and after it is dryed in the Sun or before the Fire to wear it four or five Days next the Skin For so that Disease is wont to be Cur'd without Bathing or the Nastiness or ill Odour of an Ointment Poor people usually Cure themselves of this Distemper only by taking the Powder of Brimstone in Milk inwardly and by anointing themselves with the said Powder mixt with Butter outwardly Sulphur seems to be so Specifick an Antidote against the Itch by reason of its Balsamick Vertue which destroys the Acidities and all Exotick and Corruptive Sharpnesses of the Blood and Humours and restores to each Latex a Benign that is a Mild and as it were Oyly Nature As to Mercury it 's no wonder if medicines made of it perfectly Cure any places of the Skin infested with the Itch where-ever they are apply'd For by the application hereof breakin gs forth and all Virulent Ulcers viz. any that are Venereal and Scorbutical are wholly conquered Moreover it seems not strange that this Medicine apply'd to some particular place should Cure an inveterate Itch in case it raises a Salivation but sometimes it Cures without any such thing as when a person wears a Girdle of it to this we say that the Particles of the Mercury pass then into the Venous Blood and after being diffus'd through its whole Mass are driven outward from all parts and depos'd in the Skin where they kill the Itch and when it happens that these Mercurial Particles are all again evaporated through the Skin after the Cure is performed then no Salivation or other inconvenience ensues CHAP. VII Instructions and Prescripts for the Cure of the running Scab or the Leaprosie of the Greeks AFter the Scab with the Itch it follows that we treat of another affect somewhat allyed to it in its breaking forth in Pushes which is commonly call'd the running Scab by some a Tetter or Ringworm or Morphew by others the Leaprosie of the Greeks but the Names of this affect being variously confounded and the Nature of it haply being differing in several Countries I shall describe it as it is now understood by us The running Scab begins and affects persons after this manner viz. First little red Wheals or Pushes sometimes single sometimes many of them joyn'd together arise in many parts of the Body but especially in the Arms or Leggs and grow at length in heaps or clusters the Surface of each Scab when grown in clusters appears rough and somewhat whitish and scaly so that upon scratching Scales fall away and a thin Ichor often issues forth though it s soon dryed again and hardens into another crusty Scale These clusters of Pushes at first are but small and few as in the Arm or Legg or some other particular Member haply three or four appear to the bigness of a peny or two pence Afterwards if the Disease be suffer'd to increase they break forth in many places and grow to a crowns breadth and at length if not stopt cover not only particular Members but the whole Body with a whitish Leaprosie which rais'd to this degree was judg'd for the most part incurable by the Ancients These breakings forth in some are only temporary as coming in the Winter and going away in the Summer in others on the contrary they come in the Summer and vanish in the Winter In many others this Distemper is continual having no time of remission or mean The running Scab differs from the Itch that in this the Pushes are generally single and separated from each other though but by small spaces but in the other they rise in clusters Again the Itch is extreamly infectious but the running Scab is not so This Disease is also distinguisht from the Leaprosie that this is likewise as infectious as the Itch and its breakings out are much more violent and terrible than in the running Scab wi viz. being crusty and scaly and diffus'd in a continued manner throughout the whole Body Hence it appears that the material cause of the running Scab is not a meer Cutaneous Humour depraved and degenerated from its Crasis by reason of some Corruptive Effluvia's receiv'd from without or upon other occasions because the infection is not easily communicated to others as in the Itch nor presently disperst through the whole Body but the Pushes first breaking forth about the beginning of the Disease seem to proceed from hence that some Acido-saline Concretions happen in the Mass of Blood like Tartar in Wine which seeing they can neither be subdued nor again dissolv'd are driven to the Skin as to the sides of the Vessel This Disease takes its rise for the most part on two chief occasions viz. First from an ill Diet as from frequent eating of Salt Meats Pork Shell-fish or others or Secondly from the corrupted Seminaries of other Diseases left in the Body as especially of the Scurvy and French-pox ill or not Cur'd For First those sorts of Food either because they are rank or otherwise disproportion'd convey Particles to our Blood that cannot enter a due mixture with it or are not easily mastered by it To which Heterogeneuos Particles gather'd together in great abundance by long continuance of such Diet Saline Particles of all kinds readily associate themselves and so make Tartarous Concretions which are driven to the Skin and are the Seminaries of the running Scab or Leaprous affects Secondly the Miasms of the Scurvy and French-pox lest left in the Body and at long run rais'd to the highest degree in Combinations of Exorbitant Salts and Sulphurs engender a most plentiful Seminary of this
yet known to me either from my own experience or that of others I shall try haply some time what our artificial Mineral waters viz. impregnated both with Iron and Antimony being taken for many Days in a great quantity will be able to effect towards the Cure of the Falling-sickness CHAP. II. Instructions and Prescripts for Curing the other kinds of Convulsions and in the first place of the Convulsive motions of Children IT happens that Infants and Children are so generally and frequently troubled with Convulsive affects that this may be accounted as the chief and almost only kind of Convulsions for those kinds of Symptoms in Adult persons are denoted by other Names and are wont to be refer'd to the Epilepsy Hysterick Hypochondriack or Colick passions or also to the Scurvy but in Children as it were by way of excellency they are call'd Convulsive motions Concerning these we may observe that Children are found to be very subject to Convulsions chiefly at two times viz. within the first Month after they are Born and about the time of the eruption of Teeth Though Fits of this Disease happen also often at other times and for certain other causes For in those in whom the Seeds of a Convulsive Disposition are rooted these Seeds sometimes display themselves and come to a Morbid Matureness either presently after the persons are Born as is said before or lying hid for a while sometimes precede in them the Eruption of Teeth sometimes follow it at a great distance of time after and at length in an uncertain course break forth in act for other evident causes viz. either inward or outward such as are an unhealthy or pregnant Nurse Milk coagulating in the Ventricle or degenerating into an acid or bitter Corruption a Feverish Distemper of the Head and Ulcers of other parts breakings forth suddenly disappearing changes of the Air Conjunctions or Opposite Aspects of the Sun and Moon and the like These Convulsions in Children are wont to infest three Regions of the Body viz. the parts of the Head and Face the Members and outward Limbs and the Praecordia and Viscera And we observe that sometimes these sometimes the others sometimes two of them or all the Regions together are troubled with the Morbifick cause according as the same is fixt either about the Origines or extremities of the Nerves And when the first of these happens according as the superiour middle or lower spinal part of the Medulla Oblongata to wit one of them alone or more of them together are set upon by the Morbifick cause In Children obnoxious to Convulsions hereditarily the Convulsive Fits are excellently provided against if presently after a Child is Born an Issue be made in the Nucha and Blood be drawn from the Jugular Veins by Leeches for by the former the Corruptions of the Nervous Juice are convey'd away and by the latter the impure Efflorescencies of the Blood are withdrawn from the Head A person whose Children dyed all of Convuisions within three Months time at length to prevent the like fatal Accident in a Child fresh Born sought for Remedies Being call'd after some Days after the Birth I advis'd that in the first place an Issue should be made in the Nucha and then the next Day after that a Leech being apply'd to the Jugular of both sides Blood should be drawn to the quantity of two Ounces moreover that near each of the Conjunctions and Opposite Aspects of the Sun and Moon about five Grains of the following Powder should be given in a spoonful of Julape for three Days Mornings and Evenings Take Mans Scull prepar'd Roots of Male Peony of each a Dram Pearl powdred half a Dram double refin'd Sugar a Dram mix them make a subtile Powder Take black Cherry water three Ounces Langius's Antiepileptical water an Ounce Syrup of the Flowers of Male Peony six Drams mix them I ordered also that the Nurse at the same Physical hours should take a draught of Whey in which Seeds and Roots of the Male Peony and Leaves of the Lilly of the valley were boil'd The Infant continued well for about four Months but then began to be troubled with Convulsive affects At which time the same Remedies were given in a greater Dose both to the Infant and to the Nurse Vesicatories were also applyed behind his Ears and Blood was drawn by Leeches from both Jugular Veins and within two or three Days the Child grew well afterward when within four or five Months the Convulsions return'd at times still by the use of the same Remedies he was Cur'd After a year and a half the Convulsive affects wholly ceast but about the lower part of the Back-bone a Tumour without Pain grew up whence some Crookedness of the Vertebrae and a weakness of the Leggs and at length a Palsy were caus'd It seems in this case that the Convulsive matter which was wont to assail the Origines of the Nerves at length entering the Spinal Marrow and being thrown down into its lower part wholly stopt the Mouths of the Arteries belonging to it to wit because to the explosive Particles other narcotick and grosser Particles had joyn'd themselves The Therapeutick Method against Convulsive affects in Children IN Infants and Children we must take care either to prevent imminent Convulsions or being already begun to Cure them For if former Children Born of the same Parent have been found obnoxious to Convulsions that evil ought to be prevented in the rest of the Children Born afterward by a seasonable use of Remedies For this end it is usual to pour into the Mouth of an Infant newly Born assoon as it begins to Breath some Anticonvulsive Medicine Hence some are wont to give it some drops of most pure Honey others a spoonful of Canary sweetn'd with Sugar and others Oyl of sweet Almonds fresh drawn By some persons a drop of Oyl of Amber or half a spoonful of Epileptical water is put into its Mouth Besides these first things given Children which truly seem to be of some moment certain other remedies and ways of Administration ought to be us'd viz. let a spoonful of a Liquour appropriated to this affect be drank twice a Day For Example Take water of black Cherries and of Rue of each an Ounce and a half the Antiepileptick water of Langius an Ounce Syrup of Corral six Drams Pearl prepar'd fifteen Grains mix them in a Glass On the third or fourth Day after it is Born let an Issue be made in the Nucha then if it has a Florid Countenance let a little Blood to an Ounce and a half or two Ounces be drawn from the Jugular Veins by Leeches care being taken lest he Bleed too much when he Sleeps Let the Temples and Neck be gently rub'd with such a Liniment Take Oyl of Nutmeggs by expression two Drams Oleum Capivii three Drams Oyl of Amber a Scruple let a Periapt of the Roots and Seeds of the greater Peony with a little addition of Elks-hoof
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
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
Belly with violence By and by respiration being stopt she became senceless with a Cadaverous aspect After that she had lain thus dead as it were for three or four minutes of an hour she was wont to start up on a sudden that she could scarce be kept down or held by persons present Then followed violent contractions and distortions in all the parts of the Mouth and Face and in all the Members of the Body These Symptoms were judg'd really Hysterical because the noble Lady had so lately Aborted But considering all these things I was at length of this opinion That the cause of both Fits viz. the Paining and Convulsive depended wholly on the evil affects of the Brain and Genus Nervosum without any fault in the Womb to wit that the sharp humour heapt together within the Brain descended thence by the passages of the Nerves into parts very remote and lying in the Membranes and Fibres and fermenting with the humour coming to it from the Mass of Blood irritated them very much and caus'd violent pains then afterwards when the heterogeneous and explosive Particles admitted into the Brain with that Humour and entring the Ductus's of the Nerves joyn'd with the Spirits thereupon the Convulsive disposition now and then breaking forth into violent Fits was caus'd as it will by and by appear more at large Directing my curative intents according to this Aetiology I ordered the sick Lady at the time she was extreamly ill that Blood should be drawn from the Saphaena Vein That a gentle Purge should be given her within two days and that it should be repeated once or twice a Week Also on other days I gave her Morning and Evening Spirit of Harts-horn and at other hours twice or thrice in a day Powder of Pearl and Crabs-eyes with a Dose of the following Julape Take Water of Snails Magisterial Water of Earth-Worms of each three Ounces Water of Saxifrage and of Black-Cherries of each four Ounces Hysterick Water an Ounce Syrup of Coral an Ounce and a half Tincture of Castoreum a Dram mix them She us'd frequently a Bath of fresh Herbs when necessity required it she took Opiats always with good success Vesicatories were applied to the inward part of each Thigh and to her Neck Moreover Fomentations Liniments Glysters Cupping-glasses Sneezing-powders and many other ways of Administration were prescrib'd according to the exigency of Symptoms After this method of Curing used about fourteen days the noble Lady being very much relieved was wholly without the Convulsive Fits nay and the pains of the Bowels and Members and other Symptoms being very much mitigated gave us a very fair hope of a speedy Recovery but after this partly by reason of an ill Dyet to which the Diseased upon never so little an amendment always indulg'd herself but especially by reason of a sudden passion of terriour or sadness which a severe accident happening within her own House had rais'd falling into a Relapse the Disease was presently brought to a much worse condition for both the Convulsions and Pains troubled her in a more violent manner nay and the Stomach being stirr'd up in a manner with a continual Vomiting neither admitted Food nor Medicines she took Asses Milk for some days with some Benefit yet in regard it turn'd to Choler in her Stomack and gave her some offence it was soon left off At length in despite of all Remedies prescrib'd with all diligence by the advice of many Physitians the noble Patient languish't daily more and more and by degrees drew near to Death Two days before her Decease the pains of her Belly and Loyns remitted very much and becoming more chearful than her wont she had some hope of her Recovery but in the mean while she complain'd of a pain and a mighty oppression of her Head and falling into a profound Sleep about the beginning of the Night upon her awaking she fell into a very horrible Convulsive Fit which presently past into a mortal Apoplexy for becoming insensible and speechless she departed this Life within twelve hours The Body of this person being open'd after her Decease the Womb was found wholly without fault tho' many of the Viscera were preternaturally dispos'd in the Mesentery about the midst of it where it is fixt to the Back and contains great Plexus's of the Nerves a lax substance and blown up as it were with many Bladders was seen it equalling a hands breadth in extent opening this place I found no Humour in it but only that the Membranes were separated from each other and that nothing was included in the spaces betwixt them but a Wind which Separations doubtless were caused by the Convulsions and Explosions of the Spirits sent from the Head into those Plexus's and as to those pains in the Belly and the ascent of the great heavy thing as it were and the Inflation of the Abdomen in the Convulsive Affects it is not to be doubted but the Seat of the morbifick Cause lay hid in that part of the Mesentery As to the method of Curing to be us'd in the Passions vulgarly call'd Hysterical since the greatest part of the Symptoms of this Disease are Convulsive it is thence plain that anticonvulsive Remedies such as above written are chiefly indicated Nevertheless since these Affects very often happen to the Female Sex in which the Menses and other accidents of the Womb are most commonly taken in as a part of the Morbifick Cause therefore Medicines having regard to various dispositions of the Womb ought to be added to the former and be sundry ways complicated with them The Therapeutick Indications are either Curatory to be us'd in the Fit or Preservatory which being prosecuted out of the Fit remove the cause of the Disease and prevent its Accesses As to the former if the Fit be but small let it pass off of its own accord without any farther perturbation of the Spirits but if it so forely presses that it is needful to give aid to Nature as being greatly opprest let this one thing be endeavoured That the Spirits being made free from the Embraces of their Heterogeneous Combination remit of their Disorders and Explosions For this end it is very usual in the first place to apply to the Nostrils stinking and strong-smelling things the effluvia's of which repress and reduce to order the Spirits which are grown too wild and apt to make exorbitant efforts nay and discuss their Heterogeneous Combination and often wholly exterminate it Assa Foetida Castoreum Galbanum tyed in a fine Linnen Cloth and held to the Nostrils are proper also the Feathers of Partridges or old Shoes burnt or Sulphur kindled moreover the Spirit and Oyl of Soot or of Harts-horn often give help tho' I have known that these kinds of Suffurnigations have prov'd very offensive to some Women and have encreas'd the Fit it 's probable that sometimes they irritate the Spirits too much and force them into greater disorders As stinking things held to
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
have judged the cause of the Disease to be seated wholly about the Stomach or Hypochondres Nevertheless Cathartick Medicines Emeticks Digestives Cephalicks Antiscorbuticks Chalybeats and others almost of every kind prescribed to this Person for two years by famous Physicians and also by Empiricks and Mountebanks have not effected a cure he lately tryed Astrop VVaters but finding himself the worse by them he presently left them off and is now advised to drink the Sulphureous VVaters at Knaresborough in York-shire But what success he finds in them I know not at present This case in regard by reason of the concourse of the various Symptoms it does not belong to any peculiar kind of Disease else is justly referred to the Scurvy As to the Method of Cure to be used in this and the like cases there are two Intentions on which we must chiefly insist viz. First we must cleanse the Mass of Blood and withdraw the offensive Ferments conveyed to it from the Stomach Spleen and haply other of the Viscera Secondly the Brain and Genus Nervosum ought to be strengthned lest they admit extraneous Particles and the nervous juice that lyes in those Parts degenerating from its due Crisis to a sharp and otherwise morbid Nature ought to be restor'd and rectified the first of these is perform'd by Catharticks Emeticks bleeding and especially specifick Medicines correcting or wholly taking away the scorbutick taint of the Blood Now that the Iron or vitriolick Spaws that famous cleanser of the Blood did rather injury than give help to this Person the reason seems to be both that the Brain being become weak by reason of Cephalick Affects with difficulty throws off the filthy glut of Waters sent into the Blood nay and is in danger of being overwhelmed by it as it violently makes to its confines and likewise because when the nervous Liquor degenerating from its Crasis inclines to a sharpish Nature it is wont to be more perverted by the fluid Salt of the Spaw Waters Wherefore we generally observe that in the Rheumatism and Gout the morbid Disposition is increast by the drinking of those Waters The second Intent is excellently performed by Cephalick Remedies and especially such as are endowed with a volatile Salt of which kind are Spirit and Salt of Blood of Soot of Harts-horn the roots and Seeds of Peony leaves of Mistletow of the Oak c. with which Antiscorbuticks are mixt The London Practice OF PHYSICK CONTAINED In Dr. Willis's Tract of the Diseases that regard the Corporeal Soul and its subjects viz. the Brain and Genus nervosum CHAP. I. Instructions and Prescripts for the Cure of the Head-ach SInce all Pain is an Action violated or an irksom Sensation depending on the contraction or corrugation of the Nervous Fibres the subject of the Head-ach must be the parts of the Head that are most nervous that is the Nerves themselves also the Fibres and Membranes whereof it has many plac'd both upon and under the Scull and those parts which are affected with pain are chiefly the two Meminges and their various Processes the Tunicles of the Nerves the Pericranium and other Periostia the Muscles the Panniculus carnosus and lastly the Skin it self As to the Brain and Cerebellum and their medullary appendixes we conclude that these Bodies in regard they want sensible Fibres apt to be corrugated and distended continue free from pain and so the same is also to be said of the Scull Now whenever a pain is rais'd any where about the nervous parts of the Head its formal cause consists in this that the animal Spirits being sever'd from each other and put to flight cause the Bodies that contain them to be withal convuls'd and corrigated and so raise that troublesome sensation And that which so distracts the Spirits that a troublesome sensation thence arises is somewhat disproportionate rushing against the Spirits themselves or the Bodies that contain them which entring the Pores or Interstices of the Fibres severs them from each other and withal forces the Spirits there residing to Irregularities As to the Prognostick of this Disease in case the morbid disposition be inveterate so that Fits for many years have often return'd of their own accord and likewise upon any slight occasion we predict that the diseas'd though not much in danger of life will not easily be cur'd Moreover that the Cure will be yet more difficult if hypochondriacal or hysterick affects often troubling them are wont at frequent times to raise the Head-ach or if the corrupted taint of an inveterate Venereal distemper be radicated in the Part affected And if the Head-ach be not only inveterate but almost continual that we may justly suspect it to arise from a phlegmonous or schirrous Tumour an Erysipela Abscesses or Worms there remains but small or no hope of Cure A Head-ach whether continual or periodical if it be violent and has a Vertigo Vomiting and other affects either convulsive or sleepy joyn'd with it gives suspicion of great danger forasmuch as it frequently passes into a mortal Apoplexy and often into an Epilepsy Palsey Blindness Deasness and other Diseases either very severe or incurable The Therapeutick method of the Head-ach comprehends many Indications and those of various kinds according to the manifold species causes and differences of this Disease which it will not be easie to digest and place all here in an exact order An accidental or occasional Head-ach viz. such as is wont to arise from an evident cause alone without any Procatarxis or previous disposition as when it happens upon drinking Wine Surfeiting being in the Sun or through a vehement exercise also in fits of Feavers this for the most part ceases of its own accord upon the removal of the evident cause and its consequences or at leastwise is taken away by bleeding rest and sweating In every habitual Head-ach whether continual or intermittent two chief scopes of curing occurr to which all the other Therapeutick intentions ought to level and with which provision is made against each cause of the morbid origine 1. viz. In the first place for the cutting off all the fewel of the Disease we must endeavour both that the matter flowing or oftentimes apt to flow to the affected or ill dispos'd places of the Head be either stopt or withdrawn thence to some other place and likewise that the Convulsions rais'd in other places and thence wont to be propagated to the Head be prevented 2. Then Secondly in order to the eradicating of the Disease it self or if it may be of its conjunct Cause we must endeavour that the places of the Head predispos'd for Aches whether only weak or injur'd in their conformation being fortified against the frequent incursions of the offensive matter recover their ancient state and vigour which Indication though it be seldom ever perform'd on a sudden or throughly yet sometimes by a long and diligent care the morbid root how fix'd and radicated soever it be it consum'd As to
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
through their own fault in as much as being spent or affected with a stupefactive force they are congeal'd as it were or because their Paths or tracts are obstructed in the outward part of the Brain and are possess'd by a strange guest so that they have not a space granted them fit for their expanson The chief Symptoms of this Disease are Sleep and Forgetfulness a cessation of every other knowing or spontaneous function an uneven and slow respiration a Fever and often the affect growing worse Cramps leapings of the Tendons and lastly universal and mortal Convulsions The prognostick of the Lethargy is included in very narrow bounds for the Fit of the Disease being for the most part acute is soon terminated in Death or a Recovery and most commonly is wont to give more cause of fear than hope If it happens upon a Fever that is malignant or of a difficult determinations or if upon other cephalick or convulsive Diseases as the Head-ach Frensy Mania Epilepsy or also if on a long continued or severe Cholick or Gout the Physician can prognostick nothing but ill nor is it less to be fear'd if it happens in a cacochymical Body or in one long subject to sickness and in old age In like manner it is an ill Omen if the Diseas'd being presently overwhelm'd with a great deadness and becoming almost Apoplectical cannot be awak'd if he breaths unevenly and flowly or with great snoarings Moreover if the Disease growing worse and worse the sick Person be affected with Tremblings Cramps leapings of the Tendons and lastly with convulsive motions he is to be look'd upon as in a desperate condition But if the affect without any great Procatarxis be rais'd by an evident Cause alone as from over-eating drunkenness the use of Narcoticks or from a stroak or wound of the Head that are not very dangerous we may expect a less fatal event Moreover if the affect arising on such an occasion happens to a Body which was sound and robust before if at the first invasion it does not wholly take away the Sense and Memory and after a little time the symptoms begin to remit we may not despair of such a sick Person In any Lethargy if the cause of the Disease seems somewhat to be shaken and mov'd so as plentiful and laudable evacuations by Sweat Urine or Seige happen by the help of Medicines or by the instinct of Nature and give ease if upon the application of Vesicatories a great glut of filthy Waters flows forth if inflamed swellings or great pushes arise behind the Ears or in the Neck if a great sneezing with a dropping at the Eyes or Nose shall happen we may thence conceive some hope of recovery And sometimes an Empyema hapning upon a Lethargy puts an end to it viz. inasmuch as the morbifick matter which was fix'd in the Head and first caus'd the Lethargy being afterward drank up again by the Blood and depos'd in the Breast produces the Empyema In the description of the Epidemical sleepy Fever which reign'd An. 1661. we have observed that this hapned to many Concerning the Cure of this Disease since it allows no truce we must not be long deliberating After the injection of a smart clyster presently let a Vein be open'd for the Vessels being emptied of Blood more readily drink up again the Serum or other humours depos'd in the Brain Moreover I advise in this case the Jugular Vein to be open'd rather than a Vein of the Arm because by this means the Blood very much heap'd together and haply stagnating within the Sinus's of the Head will be more easily reduc'd to an even circulation After Bleeding other Remedies of every kind are presently to be applied to use let large Visicatories be applied to the Neck and Legs the Faces and Temples are to be anointed with Oyl of Amber or Cephalick Balsams let Cataplasms of Rue Pepperwort or Crowfoot well pounded together with black Soap and Sea-Salt be applyed all over the Feet let smart frictions be us'd to the Limbs let Salt of Vrine or Spirit of Sal Armoniack be frequently held to the Nostrils In the mean while let Cephalick Remedies be now and then taken Take Water of Peony Flowers Black Cherries Rue Walnuts simple of each three ounces compound Peony Water two ounces Castoreum tyed in a Nodulus and hung in the Glass two drams Sugar three drams mix them make a Julep let four or five spoonfuls be taken every third or fourth hour moreover to each dose of this add from twelve to fifteen drops of Spirit of Harts-horn Amber or Sal Armoniack or a paper of the following Powder Take Powder of Male Peony Roots Mans Scull Roots of Virginia Serpentary Contrayerva of each a dram Bezoar Pearl of each half a dram Coral prepar'd a dram make a Powder divide it into twelve parts Moreover it is here to be considered whether a purging by Vomit or Seige ought not to be ordered just at the beginning I know that this is variously controverted amongst Authors and I have known it us'd in practice with a various success which being considered and compared betwixt themselves I shall briefly declare what is my opinion If a Lethargy has arose from a fresh over-eating or being drunk or if from taking improper and narcotick things presently let a vomit be raised Wherefore let Salt of Vitriol be given with Wine and oximel of Squils or in robust Persons an infusion of Crocus Methallorum or Mercurius Vitae with Black-Cherry Water and afterward unless it works of its own accord let a Vomit be provoked by thrusting a Quill into the Throat But if the invasion of the Disease happens upon a Feaver or other Cephalick affects or if it be raised primairly or per se by reason of a Procatarxis first laid in the Blood or in the Brain Vomits and Purges given presently at the beginning whilst the matter is flowing are wont oftner to do more hurt than good to wit inasmuch as whilst the humours are in motion those Medicines more exagitate them and since they are not yet able to subdue them and lead them forth they drive them into the part affected On the second day if the dead sleepiness be not yet remitted let bleeding in case the Pulse indicates it be repeated or in its stead let Blood be taken away in the Shoulder-blades by Cupping-glasses after Scarification Then a little afterward let an Emetick Medicine if nothing prohibits it or a Cathartick be given Take Sulphur of Antimony five grains Scammony sulphurated eight grains Cream of Tartar six grains mix them make a Powder let it be given in a spoonful of the Julep prescribed Or Take Scammony sulphurated twelve grains Cream of Tartar fifteen grains Castoreum three grains make a Powder give it after the same manner Mean while let the same or the like altering or deriving Remedies be still continued On the third day and afterward those things which at the beginning of the Disease were
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
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
being discoloured and stufft throughout with a frothy Ichor shew'd manifestly enough the cause of the difficult and pursy breathing but the Heart being sound and firm enough was wholly free from any obstructions or polipous concretions Moreover neither near it nor in other adjacent Viscera was any Abscess or Impostume found by whose contact or ill favour the Heart could so be opprest or the Vital Spirit in case this be possible on a sudden be suffocated Wherefore in this case we could imagine nothing else but that the Animal Spirits residing within the middle of the Brain were on a sudden put to flight and extinguished as it were by certain malignant or narcotick or otherwise infesting Particles so that the motion of the Heart as of the first mover in a machine failing on a sudden presently all the other Functions their impulses being taken away wholly ceas'd CHAP. VIII Instructions and Prescripts for curing the Palsey THE middle of the Brain or the Corpus callosum where we have assign'd the Seats of the Vertigo and Apoplexy seems also to be the place primarily affected in the Epilepsy but of this as also of convulsive Diseases we have treated elsewhere wherefore let us descend to other lower Regions of the Brain and its Appendix and next let us describe the affects that belong to the Corpora striata medalla oblongata and also to the nerves and nervous Fibres These Parts execute all the Functions that regard motion and sense wherefore the failings or enormities of these must be affects of those Bodies or of the Spirits residing in them now sense and motion are injur'd chiefly two ways for both are wont to be perverted or stopped when motion is perverted Cramps and Convulsions when Sense pains arise when either Function or both of them together are letted or abolish the Affect thence rais'd is call'd the Palsey of which we must treat at present The Palsey is described after this manner viz. That it is a Resolution or Relaxation of the Nervous parts from their due Tention by reason of which Motion and Sense to wit either one of them alone or both of them together cannot be exercised in the whole Body or in certain parts of it after a due manner The Nervous Parts are resolved because the animal Spirits doe not sufficiently irradiate raise and actuate them with vigour The cause of which defect is either an obstruction of the Ductus's whereby their passage or conveyance is hindred or an impotency of the Animal Spirits inasmuch as being affected with a stupefaction or being but few they do not display themselves vigorcusly enough By reason of these various ways of affecting divers kinds of the Palsey arise For first as to motion by it self this spontaneous faculty which chiefly and in a manner only is obnoxious to the Palsey sometimes in the whole Body or in certain parts is wholly abolish'd but sometimes it being only letted is diminish'd or deprav'd Secondly in like manner we observe as to Sense by it self that either one Sense or many together sometimes wholly are taken away and that sometimes they are very much diminished or vitiated Thirdly sometimes it happens that both powers are injur'd together we shall speak of each of these in order and in the first place of the Palsey in which spontaneous motion is abolished which we conclude to happen chiefly for two causes to wit by reason of the Ductus's being obstructed or of the Animal Spirits being struck with a stupefaction or as it were with a certain malignant blast As to the former the Interception of the Spirits from the Parts resolved by reason of the Pores being obstructed it being always above the Parts is wont to happen in various places and for divers causes but especially either in the primum sensorium viz. in the Corpora Striata or somewhere about the Caudices Medullares or lastly in the Nerves themselves and so lightly it happens either in their origines or in the middle of their Processes or in their extream parts viz. the Nervous Fibres When the Injury happens to the Corpora Striata or Medulla oblongata or Spinalis it either obstructs the whole running of the marrow of the Back-bone whence a universal Palsey arises beneath the place affected or one half of it whence a Hemiplegia or it affects the heads of some certain Nerves either in one side or in both together whence resolutions are caus'd in this or that member separately from the others There are many ways by which the passages of the Animal Spirits in the foresaid bodies are obstructed viz. either first their Ductus's are fill'd with an extraneous matter forc'd into them or secondly they are compress'd by extravasated Blood a glut of serous filth or some tumour lying on them or thirdly there is a solution of their continuity as by a wound stroak concussion also by an excess of heat or cold As often as a Vniversal Palsey or Hemiplegia as is usual ensues upon a Lethargy Carus or Apoplexy it is obvious to conceive that such a change of the Disease happens by reason of the removal of the matter viz. inasmuch as this passing at length from the pores and passages of the Corpus Callosum which if first possest and falling a little lower enters into the medullary tracts of one Corpus Striatum or haply of both If it be askt why Sense is not always hindred as well as Motion in the Palsey since both are performed by the same Nerves and Fibres and as it seems within the same medullary tracts so that one faculty is only the inversion of the other it seems here to be said that as Light passes through Glass where the Wind is excluded so also Sense continuing entire Motion often is abolisht Moreover Sense is only a Passion and sensible impression which is propagated by the continuity of the nervous process from the Organ to the sensorium commune without any effort or force of the Spirits which might be done tho the Sensorium Commune be somewhere obstructed and the Spirits residing in it are grown dull But Motion is a difficult and laborious Action to which it is required that the Spirits display themselves vigorously and make as it were explosive affects not only in the moving Organs but especially about the parts where the principle of Motion and its first Impetus is also in the whole passage through the Nervous parts Wherefore whereas a few Spirits and those disabled suffice for Sense many are required for Motion and those free and prompt as to their Expansions I have observed in many that when they were first affected with an Indisposition of the Brain a Dulness of the Mind and a Forgetfulness and afterward with a Stupidity and Dotishness they fell afterward as I was wont to predict into a Palsey viz. the morbifick matter being fallen by degrees and at length heap'd together to an opilative plenitude somewhere within the Caudex Medullaris where the medullary Tracts are more
damm that obstructs the ways of the Spirits and therefore if they do not force it asunder they drive it more firmly into the places obstructed And it is in some sort for this reason that Vomitories often do egregious service in Curing the Palsey to wit that they withdraw the fuel of the Conjunct Cause and do not drive only forward the matter sticking in the Nerves but revulse it mightily shake it and often break it into minute parts so that when the Continuity of the damm is broken the animal spirits themselves easily dissipate the Particles of the Morbifick matter sever'd from each other we have intimated before another reason concerning the relief of Emeticks in the sleepy affects which has also in some sort place in the Palsey So very many Examples and Instances of Paralyticks daily happen every where that the various Types and Histories of them if they were described would fill a mighty Volume wherefore I shall only set down here some of the more rare viz. one or two with which each chief species of that Disease may be illustrated and since it would be to little or no purpose to give a Relation of Resolutions of Members hapning by reason of some outward Accident as a fall from an high Place a Wound or a Stroke I shall insist only in describing those Cases where the Palsey arises either by it self after a previous Disposition or follows upon some other Disease Some time since a certain Gentleman Robust well in Flesh and above forty years of Age having been in a manner always in health at length giving himself to a sedentary Life and Idleness and afterward becoming more dull than usual refused any exercise and vigorous motion of the Body moreover being melancholy and sad on any light occasion nay sometimes without any manifest cause he was wont to break forth into a weeping and tears this Person a short while after which I have also observed of many others was affected with a Weakness and a Trembling of all the Members and afterward with a Resolution of the lower Parts by which Disease being melancholy and soon a weary of Physick yielding himself overcome and growing weaker by degrees he dyed within six months I remember many others but especially two committed to our care being as to the first part of their Life mighty Ingenious and well Learned who afterward in their declining Age partly by reason of a Cacochymia of the Body and partly through a trouble of mind growing dull and forgetful at length notwithstanding the use of Remedies in the beginning of the Disease became Paralytical A young man of a sanguine temperament clear spirited and for the most part Healthy sitting in a Chair after a plentiful Supper and an immoderate Drinking of Wine was so affected with a stupidity in his right Hand that his Glove which he happened to hold fell down against his will afterwards standing up and endeavouring to go he perceived a resolution in the Leg and Thigh of the same side falling a little afterward into a certain dulness of Mind and a stupidness tho without an Apoplexy for he was always present to himself answering aptly enough tho slowly and with some trouble to things asked and doing things that were commanded him a very skilful Physician being presently called Blooding Vomiting Purging were used in order Cupping-Glasses a Scarification Liniments Frictions and other fit Administrations were diligently applyed nevertheless the Palsey increas'd so that besides Motion almost taken away from the Members of the right side he lost also the sight of that Eye yet tho dull and sleepy being still Compos mentis he knew his Friends and being conscious of his Infirmity and sollicitous for the recovery of his Health he took all Remedies offered but notwithstanding this the animal functions daily fail'd more and more and through a consent with them at last the vital so that about the seventh or eighth day falling ever and anon sometimes into a Delirium sometimes into Convulsions and other distractions of the Spirits at length his strength being gone he yielded to Death A certain Noble-mans Bayliff about forty years of age having a sharp Blood and a bilous temperament and long obnoxious to a Vertigo as he rode through a certain Village in the Country being seiz'd on a sudden with a Scotomia fell head-long on the ground where being presently taken up by the Inhabitants and put to Bed he lay for many hours insensible and dead as it were but afterward awaking he found all the members of both sides resolv'd into a Vniversal Palsey going to see him the next day after I presently drew about twelve ounces of Blood and forthwith prescribed other Remedies both as to outward administrations and inward Medicines to be diligently us'd and indeed with good success for after five or six days he began to stretch forth or bend his feet nay to move them from their place this way and that tho slowly afterward by the constant use of Remedies he was able within two months to raise himself stand on his feet and go a little with Crutches then having us'd at his house an artificial Bath for some time he daily gain'd in the motion of his members and his strength at length assoon as the season of the year was fit going to Bathe and by the use of the hot Baths perfectly recovering within six weeks he returned sound leaving there his Crutches The following Relation will manifestly shew that the Palsey does not only follow upon Cephalick affects but also on the Colick and Scurvy A handsome Woman and young after Child-birth fell into a Tertian Ague this afterward becoming a Quotidian and the cure protracted brought a very violent Cholick and of long continuance Pains first raged only in the Abdomen with a vomiting and most bitter tortures being long tormented and almost worn away with these at length she began to be troubled with a stupor and a sense of pricking such as arises in members lain on Nor was it long after but a Palsey which that other affect very often fore-runs followed in the whole Body In this state being brought to Oxford she was committed to our care another famous Physician D. D. Lydall being called to joyn with me Not only all the greater Members of this Diseased but even the lesser of each Limb were so wholly resolved that she was not able to stir from its place either Hand or Foot or any finger of either hand Moreover she was so far affected with an Atrophia that the flesh being wholly vanished the Skin scarce stuck to the Bones yet she still had a good Pulse and vivid Aspect from which alone we gathered somewhat of hope After that we had given this Person for many Weeks the choicest Medicines both Antiparaliticks and Antiscorbuticks almost of every kind and according to various Methods without any success at length we proposed to her self and her Friends a Salivation as a Remedy more powerfull than any
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
haply the Ligaments there plac'd but since the Pain in those Parts depends wholly on the solution of continuity and this proceeds from a certain matter sticking in or lying on those Bodies we must enquire first of what kind that morbifick matter is secondly whence it is brought thither and thirdly after what manner by solving unity in them it causes such periodical Fits of the Gout As to the morbifick matter it seems in the first place that it is neither the Blood nor the nervous Juyce by themselves nor also one single Humour depos'd by either of them but that in the chief Seat of this Disease many fermentative Juyces and not easily miscible meet and then that from their contest and effervescency painful twitchings of the nervous Fibres arise Therefore a saline or tartarous matter depos'd from the arterious Blood about the spaces betwixt the Bowels is as it were the feminine Seed of this Disease which nevertheless tho heap'd together in a great plenty is wholly unfruitful of it self till the nervous Liquour growing turgid sends acetous Recrements falling from it to the seat of the former which as the masculine Seed presently renders the other prolifick for in as much as those two particles which are of a differing state and origine meet and mutually contest they twitch the Fibres of the Membranes and Tendons and so cause the Fit of the Gout the appeasing of which depends wholly on the mutuall subduing and dissipation of the sharp Particles of both kinds As to the evident causes for which the nutritive liquor brought from the Blood to the Joynts is too much stored with a fixt Salt and by reason of which these Parts become over-ready and easie to receive what is disproportion'd to them in regard they are various and manifold we shall here briefly touch the chief of them 1. And first an hereditary disposition is wont to produce both the failures for Gouty Persons for the most part engender Gouty Children and this Disease descending from Parents to Children is wont to have in both not only the like fruit and to be brought to a ripeness about the same terms of age but for the most part it fixes its first roots in the same members and every where observes the like progress 2. But nevertheless the Arthritical disposition without an original taint is often caused by reason of an ill dyet and errours in the six nonnatural things for those who being given to feasting and good fellowship delight themselves in eating and drinking much and disorderly and especially if they feed on salt and sumptuous provisions and drink Wine plentifully easily contract this Disease For by this means none but an indigested Chyle and such as is endowed with wild and unmeet Particles is prepared in the Viscera moreover after much drinking of Wine Salt dregs and heterogeneous filth which otherwise would stay in the first passages being too much exalted are conveyed into the Blood To which irregularities in Dyet if a sedentary Life Idleness and much sleeping are joyned so that neither the superfluities exhale nor the saline Impurities are blown off by exercise that they do not subside about the Joints certainly a great store of this Alchalisate seed will be sown for producing this Disease of the Joynts The weakness and Arthritick disposition of the Joints is not only hereditary but is frequently caused on several occasions the falling down of the morbifick matter often brings it for if by chance it happens that the firs fit of the Gout be in this or that Part the peccant humour will afterward more readily fall on that member and in a short time will make there as it were its nest where it will continually lodge its brood Moreover solution of Continuity also or an injury hapning to some Joint by cold or moisture a wound or luxation often cause a Gouty disposition The evident Causes which in respect of the Nervous Liquor cause Fits of the Gout either pervert the particles and Portions into an acetous nature or being before degenerated stir them to fluxious 1. Many acid Liquors and small Wines ought to be avoided and experience teaches us that Cyder and stale Beer ought of all things to be shunn'd by Arthritical persons for those kinds of drinks do not only bring into act the latent cause of the Disease but by filling the Brain and Nerves with a great many acetous particles they contribute to its fuel and encrease the morbifick matter 2. Immoderate or unseasonable exercise of the Body Violent passions immoderate Venery and a disorderly Diet and likewise whatsoever things greatly trouble or exagitate the Spirits and Humours and consequently raise fluxions of the nervous Juice or of its Recrements cause Arthritick pains 3. Solemn Evacuations supprest also an admittance of cold and moisture forasmuch as by this means the Blood and consequently the Nervous Liquor fall into effervescencies and fluxions bring fits of that Disease 4. For the same reason changes of the places of aboad also the revolutions of the year are wont to bring pains of the Gout that it is become a Proverb that Couty persons carry their Almanack in thier Bones and from their pains draw most certain prognosticks of the seasons for as often as a moist constitution of the year and South or North Winds or Snows are at hand they are wont to predict those things from the accesses of their pains Moreover at each quarter of the year especially Spring and Fall they are more sorely tormented wherefore the Aequinoxes are always religiously observ'd by them The reason of these things partly consists in this that insensible transpiration is variously altered by reason of the changes of the air and of the year for which reason the Effluvia which were wont to transpire being restrain'd ferment the Blood and Nervous humour and easily stir them to Arthritick flucions Moreover the humours of our Bodies as the Juices of Vegetables and other natural or artificial liquors diversly ferment according to the changes of the seasons and fall into various states sometimes of fixation sometimes of volatility sometimes of flowing The chief differences of this Disease are taken from the places affected and therefore they are made as it were the distinct species of the same viz. to wit the Hand Gout the Hip Gout the Knee Gout the Foot Gout Mean while pains usually rais'd in any other Members go by the common name of the Gout Whether the Tooth-ach the pain in the Loins and pains of other Parts ought to be referr'd to this I have not now leisure to enquire A long continued Gout very often joyns to it s Scurvy and some Scorbutick affects so plainly counterfeit the Gout that they cannot easily be distinguish'd The reason of the former is both a like Dyscrasy of the Blood in both affects depending on the fixt Salt and likewise that the Scorbutical disposition easily comes upon Gouty persons for that keeping long to their Bed or a Chair they use
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
or seven accesses of which her strength was so cast down that she was not able to rise from her bed or scarce to be rais'd up in it nor could she take ever so little food tho very thin but it caus'd great disturbances in her Stomach Moreover the Region of the Stomach and of the left hypochondre was all beset with a hard Tumour and violently paining By reason of the strength being extremely cast down there was no place here for evacuation besides the use of Clysters and the Stomach being mighty weak refus'd all other Remedies unless they were pleasing and in a small quantity In this difficult case and pent up within narrow limits of Curing I advis'd these few things viz. that she should take twice a day this mixture viz. Magistral water of Earth-worms two ounces Elixir Prprietatis six drops moreover I ordered a fomentation to be apply'd to the Stomach of the Leaves of Pontick Wormwood Centory Southernwood boyl'd in White-wine with the roots of Gentian the Vessel covered and that after the somentation a toast dipt in the same Liquor should be worn on the Stomach besides I had febrifuge Epithems bound to her Wrists and by these Remedies alone on the third day she mist her Fit and continued free from the same afterward and then by the use of Chalibeat Remedies she grew perfectly well within a short time CHAP. VI. Of the Quartan Fever or Ague IN a Quartan Fever the time for the return of the Fit is longer than in the rest it being extended to the fourth day inclusively and it 's wont to be of longer continuance and more difficultly cured for this Disease is protracted for many Months and often Years and seldom or searce at all yields to Medicines The Fit for the most part begins with cold and a shaking which are followed with a pretty troublesome heat but more remiss than in a Tertian Sweat for the most part concludes the access If the Disease sticks long it brings the Scorbutick or hypochondriack affect and involves men in an unhealthy habit of body The Causes which dispose to this Disesse are first the constitution of the Air and of the Season for the time of Autumn is always proper for this affect that you shall seldom observe a Quartan Fever to arise but about the Fall also in certain places especially about the Sea-coast this affect is wont to be endemious seizing any that live there or come thither as strangers for this also makes a declining age also a melancholy temperament and which by reason of an ill form of Diet is obnoxious to the hypochondriack affect moreover Fevers of another kind that are of a long continuance and Chronick Diseases often pass into a Quartan Fever These things being confidered it seems that it must be said that a Quartan Fever even as other Intermittents depends on the vitious disposition of the Blood for the nutritive Juyce conveyed by degrees into the Vessels is perverted into a fermentative Matter and the effervescency of this heapt together to a plenitude of turgescency makes the Fit of a Quartan Fever But since in this Fever there are some things peculiar from the rest we must enquire what sort of dyscrasie of the Blood there is in this Disease distinct from the rest and after what manner it raises the most observable Symptoms I say therefore that in this Disease the Liquor of the Blood has pass'd from its sweet spirituous and balsamick nature to be acid and somewhat austere like Wine turning sour That is to say there is a scarcity of Spirits and the earthly or tartarous part which consists chiefly of Earth and Salt is exalted too much and being raised to a flowing brings a sourness to the mass of Blood the Blood degenerated after this manner from its native Disposition does not duely concoct and assimilate to it self the nutritive Juice but perverts it into an extraneous matter wherewith when it is saturated to a sulness in the Vessels and the nervous parts are irrigated with the Juice thence arising there follows a flowing and as it were a spontaeous Esfervescence of this Matter whereby the feverish access is wont to be caused with a shaking and a heat as in a Tertian In a Quartan Fever the returns have longer Intervals because the Discrasy of the Blood being toward an acid and therefore less smart and hot it perverts the nutritive Juice without a contest and tumult wherefore somewhat of it is assimilated and the depravation of the rest does not recede so far from its natural state as in a Tertian and hence its heaping together to a plenitude is slower and it rises to a Turgesency in about as much time again and a half as in a Tertian The reason why this Disease is of so difficult a cure and so obstinately infests the Diseased is the melancholy Constitution of the Blood which is nor easily removed and yields scarce to any Medicines for there being in it a scarcity and defect of Spirits and the Salt and Tartar being too much exalted as when Wines turn sour it is extream hard to restore it and it is in a manner of the same labour and difficulty as to renew the vinous Spirit and Vigour in Vinegar because for restoring the Blood depraved after that manner there is need that its whole mass be volatiz'd and that it spiritualises as it were anew Wherefore in this case evacuatives do not the least good nay by depauperating the Blood more without remedying it they often impair the Strength but there is need of those things which may exalt and volatise that which is fixt and may promote a Pneumatosis in the whole mass of Blood thence it is that in this disease the change of the Air and of the Soil most commonly give relief before any other Remedies whatsoever For Quartan Fevers arising about Autumn are often cured by the following Spring which doubtless happens because the changed quality of the Air is wont to alter the evil habit of the Blood for the better and for the same reason the change also of the place of aboad most commonly cures this Affect when it will not yield to any Medicine The Autumnal Season is most proper to produce this severish habit of the Blood because when very much of Spirit and Sulphur has past away by the Summer heat and that which remains begins to be prest upon by the Cold the Liquor of the Blood as Wine turning sour after too much Effervesence easily degenerates into a pontick and sharpish Nature this also is provur'd by the Air of the Sea infecting the Blood with saline Vapours which fix the Spirits Moreover the affinity of this Disease which the Scurvy and the Hypochondrial affect plainly shews that the evil Disposition of the Blood is in fault whereby it is become salt and earthy with a defect of a Pneumatosis The last year towards the end of the Summer which had been very hot an Epidemick Fever arose then
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
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
another time are to be left wholly to Nature This in some may be obviated with asswaging and lenifying Remedies but in others with a rough and irritating Physick mean while it is a Precept to be stood to in all that we religiously follow the Footsteps of Nature which if it acts amiss its Disorder is to be reduced if rightly but too vehemently it is to be cheekt and if rightly but slower or weaker than it ought it must be our business to encourage and aid its Effort by physical means 5. In the declining state of a Fever when after a perfect Crisis Nature has gotten the upper-hand of the Disease things are in Safety nor is there much left for a Pyhsician to do it only remains to propose an exact form of Diet that the Diseased may soon recover their Strength without fear of a Relapse also it is good to clear the Remainder of the febrile matter by a gentle Purge Concerning the Diet Men very often incur a Relapse to wit by an over-hasty eating of Flesh or strong Food the Diseased fall back into the Fever for since the Viscera are weak and do not easily concoct Food unless it be very thin and since the Crasis of the Blood is so weak what it does not assimilate a strong nutritive Juice if any thing disproportionate be brought to either the oeconomy of Nature is again perverted and all things run amiss Wherefore let such as are upon Recovery frobear a long time from Flesh and let them not use it till their Urine is become like that of sound Persons and is no longer troubled by the Cold and indeed then it will be better to begin with diluted Broth of Flesh and afterward by Degrees to rise to stronger Aliments 6 When after an imperfect Crisits the thing hangs in doubt and is not yet come to a Determination then the Physician has a hard Task let a diligent Eye be had to the motion and strength of Nature whether it begins to prevail over the Disease or yields to the same if there are signs of Concoction and the Strength holds good a gentle Evacuation and only per Epicrasin is to be put in practise mean while let the chiefly pressing Symproms be obviated by fit Remedies let all Impediments be removed let the Strength be upheld as much as may-be by Cordials and a true method of Diet. 7. When after an evil or no Crisis all things grow worse and when the Physician in a manner despairs of the Cure of the Disease he may declare the event of it to be suspected and greatly to be feared nevertheless we must not so yield to a bare Prognostick that Fear shall put us by of all things else but still as much as lies in the Art of Physick let Care be taken for a Recovery tho the Case be desperate let Remedies be used to the Symptoms that are most dangerous let the Spirits of the Blood almost extinct be reinvigorated with Cordials When we despair of a Recovery let Life be drawn out in length as long as it may be at leastwise let an easie Death be procur'd I shall now briefly give you some few Examples having regard to each Species of the foresaid Fever A noble Matron about fifty Years of Age of a thin habit of Body a low Stature and a fresh coloured Countenance having cloathed her self thinner than usual on the fifteenth day of June by reason of the Summer-heat in the Evening was taken ill and upon it was seised with a Nauseousness and an Oppression of the Stomach she had wandring Pains troubling her sometimes in the Shoulder-blade sometimes in the Back being very thirsty tho without any immoderate Heat On the second and third day she found her self almost after the same manner On the fourth day after a Vomit given her viz. un ounce of the Infusion of Crocus Metallorum she vomited four times a yellow Choler and purging thrice by Stool she seemed to receive ease the following night she slept somewhat better but the next day the Fever being kindled throughout the Body she complain'd of a Thrist a burning of the Praecordia and of a Pain sometimes in the Side sometimes in the Back presently eight Ounces of Blood were taken from her her Urine was of a very saturated Redness opake and troubled without an Hypostasis or subsiding of the Contents the Pulse was uneven and often intermitting the following Night was without Rest On the sixth day of the Disease early in the Morning a small Sweat arose whereupon the Heat became somewhat more mild which grew more intense again in the Evening On the seventh day there was a very sharp Heat with a Thirst Burning a disorderly and intermittent Pulse also a mighty Restlessness of the whole Body On the eighth the Symptoms were somewhat more remiss also in the Urine there were some Tokens of an Hypostasis she took on that day Whey with the Leaves of Meadow-sweet boyl'd in it she sweated freely the Fever came to a Crisis All the time of her Sickness her Diet was only small Ale Whey Barley and Oat Broaths Clysters were frequently us'd Drink and cooling Juleps were given her at her Pleasure About the beginning of the Summer Anno 1656. a worthy Man of an athletick habit of Body without any manifest Cause unless that being very much addicted to Study he used no Exercise besides fell ill first he complain'd of a Nauseousness and a want of Appetite with a violent Head-ach On the second day he was affected with a cold Shivering sometimes with a heat coming upon him by Turns and likewise with a Thirst and burning of the Praecordia with a roughness of the Tongue and an ingrateful Savour on that Day he took ten Drams of an Emetick Liquor after which he vomited seven times and threw up a mighty quantity of yellow Choler and had four Stools the Night following was restleAss and in a manner without Sleep at which time the Diseased the heat being increast grew more intensly feverish On the third Day when the foresaid Symptoms increast ten ounces of Blood were taken from him his Urine was reddy and thick with a copious Sediment the Pulse was quick and vehement in the Night he sweated a little with a short but troubled Sleep the Morning following the seemed somewhat relieved but in the Evening all things grew worse again with Watchings and a most intense Heat and Drought On the fifth day after a light Sweat the burning somewhat remitted which nevertheless return'd again with its wonted Fierceness a little before the Evening the Night again was without Sleep with an almost continual tossing of the Body in the Morning upon a gentle Sweat he found a little Relief in the Evening again there was an Exacerbation of all things the night also was very restless About the beginning of the Day following a Sweat happened as before and somewhat more plentifully this day there was a manifest Change toward a Recovery the Heat
various Coagulations and Corruptions in which not only the Spirit and the Sulphur as in a Putrid Fever make an exorbitant Effort and force the Blood to boyl immoderately but withal the mixture of the Blood is forthwith dissolved and its Liquor runs into parts and so that horrible Symptoms with a manifest danger of Life are caused in this kind of Affect Under this Rank we comprehend Malignant and Pestilential Fevers the Plague the Small Pox and Measles concerning which it remains for us to treat at present By the unanimous Consent of all the Force and Power of these Diseases are plac'd in a venemous Matter because upon a Pestilential Affect even as upon drinking Poyson we find that the Strength is suddenly cast down and that Life is soon destroyed and therefore for explicating the nature of the Pestilence it will not be amiss first to enquire concerning Poyson in general and after what manner it affects our Bodies and then to shew what sort of Venom is disperst in the Plague and contagious Diseases which being premitted we shall speak in particular of the Affects even now mentioned We may justly give the name of Poyson to whatsoever sticking in our Body violently and after a secret manner injures the Temper and Actions of any part or of the whole destroys the Spirits or perverts their Motions dissolves the mixture of the Liquors causes Coagulations and Corruptions subverts the Ferments and Functions of the Viscera and so on a sudden and privily endanger Life There is a vast store of these in Nature which are often engendred within our Bodies and abundantly supply'd outwardly from the Earth Air and Water and from the distinct Families of Minerals Vegetables and Animals As there is a great variety of Poysons so there is no less a diversity of them as to the Subjects and the ways of their hurting for tho a great many poysonous things are said to be contrary to us as to the whole Substance so that they set upon any thing and like a Funeral Flame with a caustick Force reduce it as it were into Ashes yet some of these being endowed with a peculiar Force of offending rather hurt one Part or Substance than another The Subjects on which the Taint of the Venom fixes it self first of all and most immediately are two-fold to wit the Animal Spirits or the spirituous and subtle Liquor passiing in the Brain and ' Genus Nervosum and the Blood flowing in the Heart and Vessels When a disproportionate Object presents it self to one of them alone or to both together so that thereupon the Crasis of the Liquors or of the containing Parts is subverted whereby Functions necessary for performing the Offices of Life and Sense are letted and this is done after a secret manner and as it were on a sudden these kinds of Effects we ascribe to Poyson The nervous Bodies with the animal Spirit are not set upon wholly after the same manner by all sorts of Poysons for sometimes they are assail'd with a Stupor sometimes with Cramps and convulsive motions and those of divers Kinds and Conditions The Bite of the Tarantula causes a Dancing the force transmitted from a Tortoise by a Spear or the Cords of a Net stupifies the hand of the Fisher the Roots of Wild Parsnips or the Seeds of Dranel eaten make Men tun mad Opium Mandrake Henbane and the like cause a deep and sometimes a mortal Sleep These and a great many other things without any mighty Perturbation of the Blood or Injury brought on the Heart fast'n chiefly their Venom on the Animal Faculty or Spirit There are also some Poysons which chiefly insinuate their Malignity into the mass of Blood wherefore after using some Medicines a yellow or black Jaundice sometimes a Leprosie leprous Affects or Swellings of the whole Body are produc'd Vapours rising from subterraneous Vaults also from Charcoals newly kindled often suffocating the Vital Spirits congeal the Blood withall and stop its Motion so that the Flame of Life cannot be continued in the Heart Every Man may see how great a Corruption is communicated to the Mass of Blood from the pestilential Miasm by the Spots and Pushes which are the infamous Marks as it were of the blasted Blood If the Injury first inflicted on either viz. the ceconomy of the Heart or Brain be light for the most part it is brought to an end without any great Offence of either wherefore Convulsive Motions a Stupor Lethargy Melancholy Paralytick Affects often begin with a landable Pulse and without an immoderate Effervescence of the Blood and afterward if the Affect does not wax strong they come to an end and cease by little and little There are other Poysons which often deprave the Blood and corrupt its Mixture by dissolving it the animal Functions in the mean time continuing whole and sound but if the Ferment of the Poyson be stronger and lays deeper Roots presently the Venom is disperst from the one into the Province of the other for when the nervous Parts are fill'd with a virulent Juice a Portion of the Venom brought back with the nervous Latex by the lymphatick Vessels into the Veins is readily conveyed into the Mass of Blood and defiles it with the Corruption prevailing in it also from the Blood greatly infected with Venom the Juice wherewith the Nerves are irrigated in a short time becomes tained Hence Persons that are mad are feverish and such as are seiz'd with a pestilential Fever very often are assailed with a Delirium or Frenzy Concerning these things we must consider what kind of Alteration or Impression of Injury it is which is inflicted by Poyson on the Animal Spirits with the Brain and nervous Appendix also what on the Blood with the Heart and the Vessels annex'd to it As to the first we observe that that subtle Liquor or the Animal Spirits with which the nervous Bodies are influenced and by the Expansion of which Sense and Motion perform reciprocal Actions are easily perverted from their Continuity and even Expansion for the Nerves being of a sost Texture and the Spirits wherewith they are fill'd being of a very subtle Substance they are not able to endure any sorts of Objects that are strong or vehement wherefore when any violent or disproportionate Thing assails them by Surprise they are often forc'd from their Expansion and Excursion to a Flight and a Retreat and often into Irregularities of motions wherefore sudden Passions of the Mind distract them and stir them to Twitching and Convulsions when the nutritive Juice wherewith they are supply'd is sent to them too sharp acid or austere they undergo sometimes Resolutions sometimes Shrinkings and if some Object more contrary such as we affirm Poyson to be presents it self whose Particles are of such a fierce Nature or of such a Configuration that they violently ferment with the nervous Liquor they strongly drive the subtle or spirituous Part of it this way and that or wholly drive it away and either
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
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
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
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
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
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
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—
stick of this Affect p. 616 〈◊〉 the Prognostick of it ib. p. â—â—â— its Cure 619 620 621. Sâ—â—â—â—s of Persons distempered with 〈◊〉 and the method us'd with thâ—â—â— p. 622 623 624. Summer Spots see cutaneous â—â—fects Spitting Blood see Blood â—â—ting Spots in the Skin see cutaâ—â—â—â— Affects Steel Medicines or Chaâ—â—ates the several ways of â—â—â—â—ring them and their various Affects in the Body of Man p. 316 317 318 319. Stomach see Ventricle Stupidity or Folly whence it proceeds p. 489. the procatarctick and evident Causes of it p. 490. the difference betwixt Folly and Stupidity p. 491. many degrees of Stupidity ib. the Prognostick of it p. 492. the method of curing it ib. p. 493. Praescripts of Medicines ib. p. 494. Sudorificks see Diaphoreticks Sugar the Cause of the Scurvy and Consumption p. 372. Sweat Medicines to raise it see Diaphoreticks Excessive or depraved Sweating to cure p. 42. such Sweating sometimes the symptom of some other Disease then affecting the Person as of the Ptisick or Scurvy ib. its Cure then depends of the Cure of the Disease p. 43. excessive Sweating sometimes the Effect of some foregoing Disease which is brought to an end as of an Ague ib. the chief Cause of frequent and copious Sweats consists in the ill Habit and depraved Accension 〈◊〉 the Blood ib. the Method and prescripts for curing it ib. p. 44. a Distemper relating to Sweating or an excessive Perspiration whereby Persons become extreamly tender to take cold p. 45. whence this Tenderness proceeds ib. the Method and Praescripts for curing it p. 46 47. Swooning cur'd p. 357. Synochus see Fever T. TAlking light-headed see delirium Tarantula its bite causing Convulsions p. 286. Teeth when breeding to ease the pain p. 254. Tertian Fever see Fever Tetter see running Scab Trembling of the Heart see Heart Tympany its Description p. 160. the previous affects that dispose to it ib. the Method of curing it with Prescripts of Medicines ib. p. 161 162 163 164 165 166. V. VEntricle its various affects in the Scurvy cur'd p. 354 355. Vertigo its Description p. 411. how caus'd ib. p. 412. the immediate and mediate Subject of it ib. p. 413. the conjunct cause of it ib. p. 414. the Procatarctick cause of it ib. the prognostick of it ib. the Method of curing the Symptomatick accidental and the habitual Vertigo p. 415 416 417 418. Instances of Persons troubled with the Vertigo and the Methods us'd with them ib. p. 419 420. Vesicatories of what Substances and how made p. 198 199 200. after what manner they operate p. 200 201. their good and evil Effects and the manner of using them p. 202 203. for the Cure of what Diseases this Remedy chiefly conduces ib. p. 104 105 106. Vomiting what things foreshew the want of it what permit it and what prohibit it p. 1 2. Prescripts of Vomitories ib. p. 3. if a Vomit over-work what to be done ib. what to be done in critical Vomiting ib. p. 4. how to proceed when the Stomack is primarily affected ib. Prescripts of Medicines in a belching and an acid Vomiting p. 5. Prescrips of Medicines in a hot and tartish vomiting ib. p. 6. Prescripts of Medicines in a bilous or bitterish vomiting ib. what to be done in an habitual vomiting through the debility of the Stomack arising from the Fibres themselves ib. p. 7. what to be done in a debility of the Ventricle through the Fibres being obstructed ib. Vrine the chief scope of Medicines that purge by it p. 20 21. Kinds of Diureticks ib. p. 22. Prescripts of Diureticks which have an alchalisate Salt fot their Basis ib. Prescrips of Medicines which have a fixt Salt for their Basis p. 23. Prescripts of Medicines which have a volatile Salt for their Basis p. 24 25. Prescripts of Diureticks that have salt Nitre for their Basis p. 26. Prescripts of Diureticks which have an Alchalisate Salt for their Basis p. 27. Sulphureous Diureticks ib. 〈◊〉 cure too much purging by Urine see Diabetes W. WAshes for the Face p. 218 219. Water Medicines depurge it see hydragogue Medicines Waters Mineral prejudicial 〈◊〉 the Gout and Rheumatism p. 361. Watching Evil p. 402. on what preternatural Watching depends p. 403. the Method of curing it p. 404 405. an Instance of a Person troubled with it p. 406. Watching Coma what kind of affect it is p. 406 407. what 〈◊〉 be done in it ib. Witchcraft causing couvulsious p. 269 270. Womb its Diseases see Fits 〈◊〉 the Mother Women in Child-bed their â—â—vers see Fever Worms in Children to kill thâ—â—â— p. 255. Worms in the Face to kill them p. 220. FINIS ERRATA PAg. 1. l. 9. r. prescripts l. 14. for which r. what p. 4. l. 20. r. tone p. 7. l. 14. r. successfully p. 5. l. 25 26 29. r. Jalap p. 11. l. 31 37 42. r. Jalap p. 12. l. 3. r. Diâ—prunum p. 16. l. 33. c. r. viz. l. 37. after may be r. the first of these is perform'd with Diaphoreticks and the other with fit Alexipharmicks p. 39. l. 29. Saits r. saline things p. 46. l. 7. r. conformation p. 51. l. 41. cherbet call'd also r. call'd cherbet also p. 55. l. 16. the r. a. l. 34. r. these p. 56. l. 14. r. affect p. 81. l. 19. r. successfully p. 89. l. 24. r. Labdanum p. 109. l. 20. r. sweet spirit of Nitre p. 142. l. 3. blot out the. p. 144. l. 6. though r. and. p. 145. l. 3. r. water of Earth-worms p. 148. l. 26. r. ciches p. 156. l. 16. so r. too p. 163. l. 13. take small r. make p. 165. l. 31. r. a Decoction p. 177. l. 7. r. either happens p. 183. l. 28. blot out to it p. 185. l. 18. r. of p. 188. l. 4 r. orifice l. 6. r. orifice p. 190. l. 11. r. convulsions p. 181 l. 23. begin afresh r. again return p. 193. l. 7. r. moss growing p. 201. l. 42. r. skins p. 208. l. 41. r. in quality vitious p. 215. l. 18. extend r. spreads l. 40. r. dispose p. 216. l. 34. r. breakin gs p. 220. l. 24. Ointment r. Cosmetick p. 224. l. 23. r. bochet p. 227. l. 39. that this r. that the later p. 239. l. 17. r. Scotomia p. 242. l. 13. after Brain r. and stirring them up to praeternatural explosions l. 31 32 dissipating r. diffus'd p. 243. l. 5. r. of a Brewer p. 248. l. 5 6. r. Euphorbiâ—m p. 250. l. 28. r. or breakings forth p. 265. l. 20. r. held l. 28. r. the diseas'd l. 30. r. affect p. 268. l. 14. r. slight p. 275. l. 43. the r. that p. 280. l. 33. from r. p. 310. l. 18. r. to it from the blood by the. p. 316. l. 4. r. effects p. 3.7 l. 34. dele not p. 321. l. 27. every r. a very p. 327. l. 31. put a comma after distemperatures and blot out the comma after Fevers p. 328. l. 43. r. disturb p. 349. l. 32. four r. six p.