apply'd to his Belly and the Julep I just now mentioned in the last History which was made very strong of the Salt of Amber to be drank as often as he would take it What I have been telling of the former Patient the same thing did happily fall out here in this For the Boy refusing all other Liquors did covet the Julep Day and Night so that he drank almost four and twenty Ounces every day By which means it came to pass that in the space of a fortnight or less his Stools were brought to a Natural consistence colour and quantity His Urine also flow'd plentifully The swelling of his Belly went down to a Miracle Neither could I any more perceive any Swellings that lay conceal'd within it though I strictly examin'd with my fingers His Appetite and desire of Drink were Natural and as they ought to be His Flesh likewise seem'd gradually to increase every day And now his Melancholy and Weariness being overcome the Boy seems to recover not only the wonted vigour and activity of his Body but also a good Look and a fresh Colour in some measure so that I am not at all sollicitous about what remains to compleat the Cure A TREATISE OF Consumptions The Second BOOK Of an Original Consumption of the Lungs What a Consumption of the Lungs is A Consumption of the Lungs is a Consumption of the whole Body with a Fever proceeding first from an ill Affection and at length an Exulceration of the Lungs Which indeed is the most Famous Consumption and that which is called so by way of Eminence and of which Authors use to treat as if there were no other kind of Consumption and therefore I shall now speak more largely of it It is either Original or Symptomatical This Consumption of the Lungs is either Original which from the very beginning depends upon an ill disposition and an Exulceration of the Lungs Or Secundary and Symptomatical when ever the Lungs receive any great Injury from preceding Distempers But seeing that we ought always in the Cure of a Symptomatical Consumption of the Lungs to have a particular regard to the Primary Distemper from which this Consumption has its Origine and the Cure of it does require a variation in some things according to the Nature of that Distemper I shall make it my business in the last Book of this Treatise to treat of the Cure of this kind of Consumptions having first given in this Second Book so far as I have been able to observe a general Account of the Nature Causes Differences Diagnostick and Prognostick Signs Indications of Cure and the Method of Curing an Original Consumption of the Lungs CHAP. I. Of the Causes of an Original Consumption of the Lungs The general cause of a Consumption THE cause of a Consumption of the Lungs in general is a vitiated disposition of the Mass of Blood and of the Spirits in the Nerves contracted gradually from several Procatartick or predisposing causes in which the sharp or Malignant Serum or Water of the Blood being separated by the soft and Glandulous substance of the Lungs does stuff inflame and at length also exulcerate the Lungs themselves which is the immediate cause of this Distemper The Procatarctick causes of a Consumption First the stopping of Evacuations The Procatartick causes or those which give the first occasion to this Disease are First the stopping of some usual and necessary Evacuations as the Monthly Courses Child-bed Purgations Old Sores and especially Fistula's Issues Sweating in the soles of the Feet or any other parts of the Body a Gonorrhoea the Whites and other Evacuations of that kind when they are stopt without correcting or removing the causes upon which they depend From whence it comes to pass that even the Blood it self is polluted and distemper'd by those Humours which are condemned by Nature to be thrown off or banisht but by some Bars and Impediments lying in their way are stopt and retain'd in the Mass of Blood longer than is convenient 2. Passions of the Mind Secondly troublesome Passions of the Mind but especially Fear Grief Anger too much Thinking and Sollicitude as also unseasonable and too long Studies with other things of this Nature which contribute very much to this Distemper not only by vitiating the Animal Spirits and thereupon hindring the Natural Fermentation of the Blood but also by fixing almost a continual Spasmodick Contraction or Convulsion upon the soft substance of the Lungs Thirdly 3. Intemperance in eating and drinking a too plentiful and an unseasonable gorging of Meat and Drink and also an imprudent choice of such Meats and Liquors as abound with Excrementitious parts and are not very easie to be digested but especially the drinking too much Wine and Liquors that are very Spirituous Which when it is joyn'd with Cares and Grief and other such-like Passions of the Mind so far as I have been able to observe is commonly the cause of a Consumption of the Lungs For the Habit of the Body being from hence filled with a load of dispirited and unprofitable Humours as it is when it is Oedematous the whole Mass of Blood is polluted and rendred waterish and sharp and at length is disposed to a Hectical heat Fourthly the neglect of due Exercise 4. Want of due Exercise for want of which the Excrements which ought by the usual Law of Nature to be thrown out by the Skin being detained in the Blood are wont by degrees to destroy the Crosis or mixture of it For want of this the Humours also are wont to stagnate in the Habit of the Body and various Obstructions to arise here and there in the small Fibres themselves which contribute very much to the corrupting of the Blood and the weakning of the Spirits Fifthly Night-studies 5. Night Studies and long Watchings and long Watchings which not only weaken the Animal Spirits which are necessary for the Fermentation of the Blood but also keep within the Body those Excrementitious parts which are wont to be thrown out in the Bed by Sweat or Perspiration and who will think it strange that the whole Mass is by degrees vitiated by this means Sleeping in the day To this we may also add sleeping in the Day and sleeping much but especially presently after eating which as it dispirits the Mass of Blood and fills it with useless Chyle by hindring the Digestion of the Food from which cause frequent and troublesome Coughs are wont to proceed So by putting the Animal Spirits to sleep at an unseasonable time and thereupon hindring the Fermentation and Volatilization of the new Chyle it makes the whole Mass of Blood too waterish and sharp 6. An ill Air. Sixthly also a foggy and thick Air and that which is filled with the smoak of Coals does extreamly promote a Consumption by vitiating the Animal Spirits which are so necessary to the Natural Fermentation of the Blood and also by stuffing
and weakning the Lungs that serve for Respiration which are the Seat and Theatre of this Distemper 7. An Hereditary Disposition Seventhly An Hereditary Disposition from the Parents does very often bring a Consumption of the Lungs when every Body knows very well that those who come of Consumptive Parents are apt to fall into the same Distemper 8. An ill formation of the Breast Eighthly an ill formation of the Breast whether it be Natural or Accidental is another cause of this Disease I call that Natural where the Breast is narrow the Neck long and the Shoulder-blades stand out like Wings And that I call Accidental where there is a crookedness or distortion of the Breast whereby not only the parts of the Breast and especially the Lungs being once weakned in their Tone are rendred subject to the Flux of Rheumes but also the Lungs wanting their necessary expansion and being streightned do heap up in themselves and retain the vitiated Serum of the Blood from whence it comes to pass that at length they come to have Obstructions Ninthly 9. Infection This Disease is also propagated by Infection For this Distemper as I have observed by frequent Experience like a Contagious Fever does infect those that lye with the Sick Person with a certain taint Tenthly 10. Chalky stones and such like in the Lungs also Chalky Stones that are Preternaturally bred in the Lungs or Nails and other hard Bodies slipping down into the Lungs when Persons laugh are to be reckoned among the Causes of a Consumption of the Lungs By which not only a troublesome Cough provoking a Flux of the Humours is caused but also Apostemes and Ulcers where also for the most part a spitting of Blood preceding does dispose the Lungs to those Apostemes and Ulcers Of which I shall afterwards give some Histories Eleventhly 11. Some preceding Distemper Also some particular Diseases which corrupt and overthrow the Nature of the Blood and Spirits do occasion this Distemper From whence there follow a Symptomatical Consumption of which I shall make it my business to discourse in the end of this Treatise as the Scurvy Kings-Evil Convulsive and especially Hysterical Affections if they have been of a long continuance also Fevers and especially Intermitting and Scarlet Fevers and such as proceed from a Surfeit so the Small-Pox Measles Stone in the Kidneys the French Pox an Asthma spitting of Blood Inflammation of the Lungs Pleurisie and other Distempers of the Breast ill cured likewise the Green-sickness a sixt Melancholy Gout and Rheumatism The more immediate cause is taking of cold The Body being thus predispos'd to a Consumption by these and other such-like Procatarctick Causes the more immediate cause of this Distemper is for the most part the taking of Cold from whence it comes to pass that in the Body disposed in such a manner by a load of Humours or Water continually deriv'd from the distemper'd Habit of the Body into the Lungs a Cough is caused that is not easily shaken off as that is wont to be which happens from a meer accidental Cold where the Matter is concocted within a few days into a putrid Flegm and upon that is all perfectly thrown out by a Cough as I shall shew more largely in the Chapter of a Catarrh Moreover from a stock of very sharp and Malignant Humours which were gathered before in the Habit of the Body as there is a continual supply of new Matter from the Circulation of the Blood there is a continual and troublesome Cough produced and sticks upon the Patient to his dying day The Serum or Water of the Blood being separated as it were in a perpetual stream by the Glandulous parts of the Lungs and not admitting of any Concoction until the Lungs especially the Glandulous parts of them swell from their being stufft and grow hard and at length the Tone of the parts is quite destroyed and they are ulcerated by the sharpness of the Humour that is separated by these tender and soft ways Which indeed is the immediate Cause of a Consumption of the Lungs CHAP. II. Of the degrees of an Original Consumption of the Lungs and the Signs which give us warning of it together with the Preservatory Indications or what we are directed to do in order to prevent it THE degrees of this Distemper are these which follow to wit first The first degree is a stuffing of the Lungs 2. A Swelling a stuffing of the Lungs from the Serum or Water of the Blood that is plentifully separated in them Secondly a hard Swelling but more especially in the Glandulous parts of the Lungs arising from the same Serum distending those parts too much and not having a free passage out of them Which Tumour I take to be the crude Tubercle mentioned by Galen which Tubercles or crude and glandulous Swellings I have often found in the dead Bodies of Consumptive Persons when the other parts of the Lungs have been full of Apostemes and Ulcers Thirdly 3. An Inflammation an Inflammation of the Lungs arising from the heat and sharpness of this Serum And lastly 4. An Impostumation and Exulceration an Impostumation and Exulceration of these inflamed Parts when the Distemper comes once to its height and extremity The signs which respect a Consumption of the Lungs are either the Prognostick or Diagnostick and Pathognomonick signs Those of the first sort are these which follow First Prognostick Sign being born of Consumptive Parents First the being born of Consumptive Parents for this Distemper so far as I have been able to observe is more Hereditary and oftner propagated from the Parents than any other 2. An ill figure of the Breast 3. A shrill squeaking Voice Secondly an ill conformation and figure of the Breast whether it be Natural or Accidental Thirdly a Voice that is naturally small and squeaking or at least so by use and a habit as being that which proceeds either from a Natural weakness of the Lungs or from an Obstruction of the Glandulous Coat of the Wind-pipe and the branches of it caused by a glutinous and tough Phlegm But from which soever of these Causes that appearance arises still it threatens a Consumption of the Lungs which is afterwards like to follow 4. A white soft Skin 5. A blouted habit of the fleshy parts Fourthly a white and soft Skin together with a thin Habit of Body Fifthly a soft and blouted habit of the Muscular Parts proceeding from their being much stufft with old and dispirited Nutritious Juice 6. Melancholick Oppressions about the Breast Sixthly long Hypochondriacal Oppressions about the Region of the Breast that feel heavy like some troublesome weight as also Hysterical Choakings that are frequent of long continuance and unusual being in the same places 7. Thoughtfulness and some Passions of the Mind 8. The stopping of Customary Evacuations 9. Spitting of Blood 10. The hawking of black and tough Phlegm Seventhly Thoughtfulness
Whites that are of an ill Nature and Venereal when the Impurity proceeding from that Venom has once infected the Humors do often terminate in a Consumption of the Lungs unless they are timely and perfectly cur'd But of this kind of Consumption and of the Causes Degrees and Cure of it I shall Discourse more fully in its proper place to wit in the latter part of this Treatise when I shall professedly speak of a Symptomatical Consumption of the Lungs But for the present I do from a long Experience and Observation affirm that a Consumption does often arise from a simple or benign Gonorrhoea and Whites A Consumption sometimes proceed from a simple Gonorrhoea c. and therefore this sort arising from the continual substraction of the Nutritious Juice by the Seminal Glands must be reckoned under the Head of an Originary Consumption For in a Gonorrhoea and the Whites sometimes the Flux is so extraordinary and continues so long that the Mass is thereby plainly dispirited and rendred unfit for Nourishment whereupon the Blood being loaded with Heterogeneous and disagreeable Particles grows hot and at length a Hectick Disposition is by degrees brought upon the solid Parts and the Habit of the Body which is the same sort of Consumption that we are now treating of The presaging signs of this Consumption The Symptoms which presage this Consumption I have for the most part observed to be these to wit an Hypochondriacal Oppression Melancholy and too much Thoughtfulness with a decay of Strength and loss of Appetite in Men that are affected with a plentiful Running of the Reins but in Women that have been long afflicted with the Whites flowing in a great quantity a soft and blouted Habit of the Body a squalid and pale Countenance together with Hysterical Fits a remarkable Weariness and decay of Strength all which Symptoms proceed from the same cause to wit from the poor dispirited Nature of the Blood caused by a want of new Chyle whereby not only the Spirits are weakned and opprest but also the Habit of the Body is rendred Oedematous from the waterish disposition of the Blood as it is full of old and dispirited Chyle And therefore the Signs which presage this Consumption are as I said before Hypochondriacal Oppressions Hysterical Affections a decay and want of Strength a blouted habit of the Body and a want of Appetite Which Symptoms in progress of time that is when the Distemper comes to be confirm'd are followed also by some others as a Thirst a Hectical disposition Atrophy and wasting of the Flesh till at length the Body is plainly brought to the highest degree of a Consumption and that very often without any Cough or any other remarkable sign of a Consumption of the Lungs This Distemper is easily cured if the antecedent cause of it can be removed that is if the Gonorrhoea and Whites can be cured When confiâ—med it is incurable But when it comes once to be confirmed it is plainly incurable And therefore a Prudent and Honest Physician that is carefully concern'd for his own Reputation will not do well to undertake the Cure of it but ought rather to take his leave and walk off from such a Patient after he has made a Prognostick of his Death and so he will be just to his Art and may satisfie his Conscience though he loses some Fees and defrauds his own Pocket But if the Physician be sent for in time What a Physician is to do in the Cure of it when he is sent for in time he ought to do all he can by all proper means and a convenient Method to stop the Gonorrhoea or Whites which are the cause of this Consumption Which thing we shall speak of at some other time and shew how it is to be done in the Chapters of a Gonorrhoea and of the Whites This efflux of the Nutritious Juice being once stopt by Art we must endeavour with all our Power to replenish the dispirited and impoverisht Blood as soon as may be with new oily and benign Chyle And therefore as we hinted in the former Chapter such Food as is delicious and affords a good Juice and is most grateful to the Patient's Palate and Stomack must be given often in a day though in a little quantity at a time And that his Appetite may be the more excited let him be advised to be chearful For there is nothing that destroys the Appetite and confirms a Consumption more than Grief and Sadness Let him also enjoy the advantage of an open and benign Air which is very beneficial to the Nerves and consequently to the Appetite and Stomack Let him likewise use Exercise every day and rubbing of his Body even to the procuring of moderate Sweats if his strength will bear it that the load of old dispirited and unprofitable Chyle with which the Blood-Vessels and Habit of the Body are stufft may be sweated out to make more room for new and useful Chyle and consequently for the improvement of the Appetite in the Stomack But he must Religiously abstain from the liberal use of Wine Spirituous Liquors are to be avoided and Spirituous Liquors which are wont to put the Blood which is before become too hot No considerable Evacuations are to be made into a greater flame Let the Physician also take heed he does not prescribe any Purges or any Medicines whatsoever to procure any other considerable Evacuation which may create farther Expences to Nature when she is already weak But if a Hectical heat even in the least degree be kindled in the solid Parts he must presently endeavour with all his Industry to quench this flame by the use of Asses Milk a Milk Diet and of such Mineral Waters as are Chalybeate CHAP. V. Of a Consumption proceeding from Apostemes and large Vlcers I Have always observed that Apostemes Large Vlcers in any part may cause a Consumption and large Ulcers let them happen to any part whatsoever of the Body whether external or internal if they continue long and throw out much Serum or waterish Matter have at length rendred the Body of the Patient Consumptive and that even to the degree of a Fatal Consumption and I can say I have taken notice that these kind of Ulcers do bring on a Consumption as well when they are in the Muscles of the Back and in the Testicles yea in the Knee and the Foot as when they are in the Kidneys or Liver or in the Lungs themselves Besides that I have often observed that a Consumption of the Lungs has come upon these large and old Ulcers The cause of this Consumption without all question is the long and plentiful substraction of the Nutritious Juice continually flowing out of the Mass of Blood by the Ulcers The reason of this Consumption whereby the Blood which remains in the Vessels being deprived of its Oily Nutritious Juice does grow sour and contracts a Preternatural heat and is
by Spitting of Blood p. 225 Chap. 6. Of a Consumption caused by Stones bred in the Lungs and by things slipt down into them from without as also by the Stone in the Kidneys and Bladder p. 238 Chap. 7. Of a Consumption proceeding from the French-Pox p. 250 Chap 8. Of a Consumption proceeding from the Suppression of a virulent Gonorrhoea of the Running of Old Ulcers but especially Fistula's in the Fundament and Scrophulous Ulcers Issues and the Whites p. 254 Chap 9. Of a Consumption proceeding from the Green-Sickness and a Suppression of the Monthly Purgations in Women p 258 Chap. 10. Of a Consumption caused by a Peripneumony and a Picurisie p 263 Chap. 11. Of a Consumption proceeding from the Gout and from a Rheumatism p. 276 Chap. 12. Of a Consumption proceeding from Fevers especially such as are from Surfeits Scarlate and Intermitting Fevers as also from the Small-Pox and Measles p. 294 Chap. 13. Of an Icterical or Hepatick Consumption p. 307 Chap. 14. Of a Consumption of the Lungs proceeding from Internal Ulcers of the Viscera and Membranous Parts p. 340 A TREATISE OF Consumptions The First BOOK Of Consumptions in general and particularly of a Consumption proceeding from the whole Habit of the Body or an Atrophy both that which is Nervous and that which is caused by Evacuations THAT I may give such a Scheme of this whole Work as will lye under a single View and open a Prospect into my Design I shall here by way of Preface first give a Definition and make a Division of the Subject about which we are to treat whereby as by Ariadne's Thread we be easily and safely directed to and proceed through all the parts of the Work The Definition of a Consumption in general A Consumption in general is a wasting of the Muscular parts of the Body arising from the Substraction or Colliquation of the Humours and that either with or without a Fever and it is either Original or Symptomatical Of an Original Consumption An Original Consumption is that which arises purely from a Morbid Disposition of the Blood or Animal Spirits which reside in the System of the Nerves and Fibres and is not the effect of any other preceding Disease Of which there are two sorts to wit an Atrophy and a Consumption of the Lungs Of an Atrophy An Atrophy is an Universal Consumption proceeding from the whole Habit of the Body and not from any Distemper of the Lungs or of any other Entrail without any remarkable Fever and is either Nervous or the effect of Evacuations Of a Nervous Consumption A Nervous Atrophy or Consumption is that which ows its Original to an ill and morbid state of the Spirits and to the weakness or destruction of the Tone of the Nerves from whence as an imbecillity and an Universal Consumption in the whole Habit of the Body upon the want of a due assimulation of the Nutritious Juice do at length proceed so from the beginning of the Disease there is to be found a want of Appetite and a bad Digestion in the Stomack from an imperfect Fermentation and Volatilization of the Chyle Which sort of Atrophy may justly be reckoned one of the Fatal Symptoms of the Scurvy An Atrophy from Inanition or an Expense of the Humours Of an Atrophy from Evacuations is that which derives its Original from a preternatural Defect or Evacuation of the Nutritious Juice and that long and habitual which differs according to the variety of the passages formed in the Body either by Nature or Art by which this precious Liquor either has or may run off and be wasted A Consumption of the Lungs is an Universal wasting of the Parts of the Body Of an Original Consumption of the Lungs caused by some Distemper of the Lungs as a stuffing swellings inflammation and exulceration of them and thereupon it is attended with a Cough difficulty of Breathing and other Symptoms of the Breast and accompanied with a Fever which at first is slow and Hectical afterwards Inflammatory and at last Putrid and Intermitting A Symptomatical Consumption is that Of a Symptomatical Consumption which although it does immediately proceed from a Preternatural and ill state of the Blood and Spirits yet has a mediate dependance upon some other preceding Diseases which had given that ill Tincture to the Spirits and Humours And because it is necessary if we would be successful in the Cure of this kind of Consumption to have a respect to the Disease which the Patient first laboured under I shall in the end of this Treatise speak of all the several kinds of this Consumption which I have hitherto had an Opportunity to observe in my Practice but I shall begin and discourse first of an Original Consumption CHAP. I. Of a Nervous Consumption A Nervous Atrophy or Consumption is a wasting of the Body without any remarkable Fever Cough or shortness of Breath but it is attended with a want of Appetite and a bad Digestion upon which there follows a Languishing Weakness of Nature and a falling away of the Flesh every day more and more A Nervous Consumption that which Virginians are most incident to Which kind of Consumption I have sometimes observed in England but most frequently amongst those that have lived in Virginia after they have come over hither In the beginning of this Disease the state of the Body appears oedematous and blouted and as it were stufft with dispirited Chyle the Face is pale and squalid the Stomack loaths every thing but Liquids the strength of the Patient declines at that rate that before the fleshy Parts of the Body are evidently consum'd he is render'd plainly feeble and almost always confin'd to his Bed The Urine also keeps not constant to any colour though for the most part it be high-colour'd and but little in quantity Yet it is sometimes as it happens commonly to be in Nervous Distempers though seldom pale and plentiful But there is no considerable Fever to be discovered either by the Pulse or a Thirst or Heat how high-colour'd soever the Urine appears So that the Pathognomonick Signs or those which do evidently manifest the beginning of this Consumption are a decrease of the Patient's Strength and a loss of Appetite without any remarkable Fever Cough or shortness of Breath though in the Progress of the Distemper when a Consumption of the Flesh has gradually affected the whole Habit of the Body there is some difficulty and trouble in breathing to be observed as it uses to happen to all those who are under a great Weakness The immediate cause of this Distemper I apprehend to be in the System of the Nerves proceeding from a Preternatural state of the Animal Spirits The Causes and the destruction of the Tone of the Nerves whereupon I have used to call this a Consumption in the Habit of the Body For as the Appetite and Concoction are overthrown by the weak and infirm
Tone of the Stomack so also the Assimilation the Fermentation and Volatilization of the Nutritious Juice are hindred in the whole Habit of the Body from the distemper'd state of the Brain and Nerves The Causes which dispose the Patient to this Disease I have for the most part observed to be violent Passions of the Mind the intemperate drinking of Spirituous Liquors and an unwholsom Air by which it is no wonder if the Tone of the Nerves and the Temper of the Spirits are destroy'd This Distemper as most other Nervous Diseases is Chronical but very hard to be cured The Prognosticks unless a Physician be called at the beginning of it At first it flatters and deceives the Patient for which reason it happens for the most part that the Physician is consulted too late And at last it terminates in an Hydropical and Oedematous swelling of the Body especially of the lower and depending Parts in which case there remain no hopes of the Patient's Life neither is there any thing more to be done for his Cure than giving him some ease whereby his Miserable Life may be lengthened for some days The Cure The business of Cure if it be so that the help of our Art is called in in due time consists in the convenient use of Stomack-Medicines and such as comfort and strengthen the Nerves such are Chalybeates Antiscorbutick Cephalick and bitter Medicines of all sorts As for Example let the Patient if his Body be costive take every third or fourth Morning four Ounces of the bitter Decoction with Senna or every fourth Night two Ounces of the Sacred Tincture or of our Sacred Cephalick Tincture made with Hiera Picra infused in Rue-water Black Cherry-water and strong Piony-water For his common Drink let him use Ale in which a Bag of Cephalick and Antiscorbutick Ingredients has been hung An hour before Dinner let him take xxx drops of Elixir Proprietatis in a draught of Wormwood-White-wine To the Region of the Stomack let there be applyed the Magisterial Stomack-Plaister with some Drops of the Chymical Oyl of Cinnamon and Oyl of Wormwood Or let the Stomack be fomented every day with some Aromatick Bags made of the Leaves of Mint Wormwood Cinnamon Mace Zedoary Galingale Cyprus-roots Calamus Aromaticus boyl'd in Claret If it be in the Summer let him use the Chalybeate Waters But if it be the Winter time let him make use of a Chalybeate Syrup or our Chalybeate and Aromatick Wine made with the Filings of Steel quenched three or four times in strong White-Wine and with Zedoary-roots Galingale Nutmegs the best Cinnamon Mace Cubebs Cloves bruised and steeped in the same Wine But for Chalybeates I do prefer Mynsicht's Extract before any other which I order to be given for xx or xxx days in the form of a Bolus or Pills As for Example Take of Mynsicht's Extract half a Scruple Balm of Gilead which in this case is very proper and beneficial because it is not a little grateful to the Stomack and Nerves seven Drops Old Conserve of red Roses a Dram mix them and make them up into a Bolus to be repeated every day Or if the Patient chooses to take Pills let the Extract be made up into that form in the manner following Take of Mynsicht's Extract half a Scruple of Balm of Gielead seven Drops of Haly's Pouder six Grains of the compound Pouder of the Roots of Wake-Robin four Grains of Pouder of Liquorice so much as will make them into the due consistence of Pills and make the Mass into Pills of a middle size let them be gilded and repeated once every day Also Natural Balsam by it self as likewise Spirit of Hartshorn and Spirit of Sal Armoniack are of use in this case because they are good for the Nerves As for Example Let the Patient take viij or x. drops of Natural Balsam or Spirit of Hartshorn in a convenient quantity of Sugar-candy twice a day Rules for Exercise Diet c. Let the Patient endeavour to divert and make his Mind chearful by Exercise and the Conversation of his Friends For this Disease does almost always proceed from Sadness and anxious Cares Let him also enjoy the benefit of an open clear and very good Air which does very much relieve the Nerves and Spirits And because the Stomack in this Distemper is principally affected a delicious Diet will be convenient and the Stomack ought not to be too long accustomed to one sort of Food History 1. Mr. Duke's Daughter in St. Mary Axe in the Year 1684. and the Eighteenth Year of her Age in the Month of July fell into a total suppression of her Monthly Courses from a multitude of Cares and Passions of her Mind but without any Symptom of the Green-Sickness following upon it From which time her Appetite began to abate and her Digestion to be bad her Flesh also began to be flaccid and loose and her looks pale with other Symptoms usual in an Universal Consumption of the Habit of the Body and by the extream and memorable cold Weather which happened the Winter following this Consumption did seem to be not a little improved for that she was wont by her studying at Night and continual poring upon Books to expose her self both Day and Night to the injuries of the Air which was at that time extreamly cold not without some manifest Prejudice to the System of her Nerves The Spring following by the Prescription of some Emperick she took a Vomit and after that I know not what Steel Medicines but without any Advantage So from that time loathing all sorts of Medicaments she wholly neglected the care of her self for two full Years till at last being brought to the last degree of a Marasmus or Consumption and thereupon subject to frequent Fainting Fits she apply'd her self to me for Advice I do not remember that I did ever in all my Practice see one that was conversant with the Living so much wasted with the greatest degree of a Consumption like a Skeleton only clad with skin yet there was no Fever but on the contrary a coldness of the whole Body no Cough or difficulty of Breathing nor an appearance of any other Distemper of the Lungs or of any other Entrail No Loosness or any other sign of a Colliquation or Preternatural expence of the Nutritious Juices Only her Appetite was diminished and her Digestion uneasie with Fainting Fits which did frequently return upon her Which Symptoms I did endeavour to relieve by the outward application of Aromatick Bags made to the Region of the Stomack and by Stomack-Plaisters as also by the internal use of bitter Medicines Chalybeates and Juleps made of Cephalick and Antibysterick Waters sufficiently impregnated with Spirit of Salt Armoniack and Tincture of Castor and other things of that Nature Upon the use of which she seemed to be much better but being quickly tired with Medicines she beg'd that the whole Affair might be committed again to Nature whereupon consuming
every day more and more she was after three Months taken with a Fainting Fit and dyed History 2. The Son of the Reverend Minister Mr. Steele my very good Friend about the Sixteenth Year of his Age fell gradually into a total want of Appetite occasioned by his studying too hard and the Passions of his Mind and upon that into an Universal Atrophy pining away more and more for the space of two Years without any Cough Fever or any other Symptom of any Distemper of his Lungs or any other Entrail as also without a Looseness or Diabetes or any other sign of a Colliquation or Preternatural Evacuation And therefore I judg'd this Consumption to be Nervous and to have its seat in the whole Habit of the Body and to arise from the System of Nerves being distemper'd I began and first attempted his Cure with the use of Antiscorbutick Bitter and Chalybeate Medicines as well Natural as Artificial but without any benefit and therefore when I found that the former Method did not answer our Expectations I advis'd him to abandon his Studies to go into the Country Air and to use Riding and a Milk Diet and especially to drink Asses Milk for a long time By the use of which he recover'd his Health in a great measure though he is not yet perfectly freed from a Consumptive state and what will be the event of this Method does not yet plainly appear CHAP. II. Of a Consumption proceeding from some Evacuation TO this sort of Original Consumption from the whole Habit of the Body belongs also another kind of Consumption which I have often met with in my Practice arising from the empoverishment of the Blood The loss and want of Nutritious Juice empoverishes the Blood and causes a Consumption occasioned by the Preternatural substraction and loss of the Nutritious Juice Whereupon the whole Mass of Blood being deprived of the Nutritious and Oily Juice grows sour and too hot affording none or very little Nourishment to the Muscular Parts and thereupon there follows a Consumption of the whole Body and a Hectical heat fixed in the whole Habit of it without any considerable Cough or difficulty of Breathing or any other remarkable affection of the Lungs at least in the beginning of the Distemper But it must be confest that in the Progress of it the Lungs seem to be in some measure affected At length the Lungs seem affected in some measure especially where the Preternatural Evacuations which are the cause of the Distemper are stopt by Art without any correction or sweetning of the Mass of Blood by which means it might recover its Natural Oily Benign Nature and such as renders it fit for Nourishment In which case there is no reason to wonder if the hot and sharp Serum of the Blood continually passing after the other Sluices of Nature are stopt through the soft and glandulous substance of the Lungs does at length stuff inflame yea and at last exulcerate them too whereby it comes to pass that this Consumption which was Originally in the Habit of the Body does a little before Death end in a Consumption of the Lungs with a Cough difficulty of Breathing and other Pathognomonick Signs of that Distemper And therefore I have often observed that if the Appetite and Digestion are not restored by such Medicines as have a peculiar quality of altering the Blood and strengthening the Stomack so that the Mass of Blood may thereupon be supplyed and filled with a sweet and Oily Juice the Consumption is not cured This Distemper sometimes turns to a Consumption of the Lungs but at length is changed from a Consumption in the Habit of the Body to a Fatal Consumption of the Lungs This Consumption is akin to that which is Nervous And this Consumption is in truth a-kin to the Nervous Consumption which I have before mentioned For as in that which proceeds from a Preternatural state of the Nervous Juice and Spirits the Nutritious Chyle which is continually carryed into the Blood is rendred less fit for the Nourishment of the Parts and thereupon as the Mass of Blood is filled with stale and dispirited Chyle such as is unfit for Nourishment and not craving any new there follows a loss of Appetite and a sickness in the Stomack and consequently a Consumption of the whole Body and at length a fixed Hectical and Colliquative heat in the solid Parts from the heat of the Blood and Spirits So in this kind of Consumption the Nutritious Juice running off from the Mass of Blood with a full stream the Muscular Parts of the Body being thus deprived of their due Nourishment fall into an Atrophy whereupon likewise the Mass of Blood which remains for want of new Oily Chyle is not only dispirited and rendred unfit for Nourishment but a preternatural fixed and hectical heat is kindled not only in the Blood but also in the Spirits and all the solid Parts whereupon there follows a Drought and want of Appetite Which kind of Consumption is that which we are now in the first place professedly to treat of The Cure of this Consumption is to be altered according as the Evacuation varies But because the Cure of this kind of Consumption is to be altered according to the variety of the Evacuations which are the cause of it I shall add nothing concerning the general Cure of it but refer that to the several kinds of Evacuations which are the cause of this Distemper to be spoken of under their proper Heads Of which so far as I have had an Opportunity to make Observations I come now particularly to treat CHAP. III. Of a Consumption from Bleeding THat which here first offers it self is a Consumption from Bleeding whether it be at the Nose or from the Lungs by coughing from the Throat by hawking from the Stomack by vomiting from the Kidneys by the passages of Urine from the Haemorrhoids or Vessels of the Womb in the ordinary Monthly Purgations or difficult Labour or lastly from Wounds where there happens a plentiful and long flux of Blood from the opening of the large Blood-Vessels Moderate and frequent bleeding makes People grow fat For although frequent and moderate Blood-letting as every ignorant Fellow and Barber knows will make one grow fat forasmuch as the emptying the Vessels with a moderate hand does make room for a greater quantity of new Chyle whereupon the Mass of Blood growing richer is rendred more fit for Nourishment and consequently the Appetite is excited But an immoderate bleeding impoverishes the blood and causes a Consumption Yet every immoderate and long Bleeding impoverishes the Blood and creates a Hectical heat in the Spirits and solid Parts thereupon destroying the Appetite and bringing the whole Body into a Consumption and Leanness Here the bleeding must be stopt In this case the bleeding must be stopt as soon as may be and the return of it is to be prevented by Incrassating Opiate and
Anxiety Sadness and an unusual proneness to Anger especially if they be without any evident cause Eighthly the stopping of customary Evacuations by Issues or old Sores so likewise of Child-bed Purgations the Whites and all others of this Nature Ninthly spitting of Blood though it be accidental Tenthly the hawking of black and tough Phlegm constantly in a Morning for a long time For that it proceeds from those Glands being filled with a black Humour which are placed in the Lungs near the Wind-pipe Which Symptom as it is a common thing with those that have the Scurvy or Kings-Evil so it does in progress of time afford us a Prospect of an Asthmatical Consumption that is like to follow Eleventhly 11. A sharp and salt tast of the Phlegm a salt tast of the Phlegm that is hawk'd up which discovers a saltness and sharpness to be in all the Serum or Water of the Blood Which when a great deal of it passes through the soft substance of the Lungs and is separated there upon the getting of a great Cold is apt to inflame and ulcerate them in a strange manner Twelfthly 12. A proneness to spit much A proneness to have a great flux of Spittle by the glandulous Coat of the Tongue and by the Salivatory Ducts and Tonsils and that whether it be with or without any evident cause Which Symptom is a thing that is very common with those that have the Scurvy and such as are Hypochondriacal and shews a Colliquative disposition of the Blood That is that it cannot by reason of its too great and preternatural sharpness perfectly assimilate to it self the new Nutritious Juice nor make it duly mix with it self and therefore throws it off upon these Glandulous Parts and consequently does in progress of time oblige the soft substance of the Lungs to receive it from whence a Consumption commonly has its Original 13ly 13. A want of Appetite that lasts long A want of Appetite that continues long and still grows worse without any other Distemper accompanying of it so that the sick Person unless he uses much Exercise and abstains from eating a great while and pleases his own Fancy in the choice of such Food as is very grateful cannot make a full Meal as he used to do without the turning of his Stomack and making him sick Neither indeed can he digest or distribute the Food which he takes be sure if he eats much without an Oppression at his Stomack and a gravative weariness in his Limbs Which is the very Symptom that opens the way to a Consumption For it proceeds from too great a fulness of the Vessels and the whole Habit of the Body caused by stale and dispirited Nutritious Juice by which means there is not room to receive new Chyle and therefore Nature does not desire it Which want of Appetite does yet grow worse if it happens so that a flame is kindled in the whole Mass of Blood by the present Catarrh from the continual and violent motion of the Lungs and by reason of the serous and colliquative state of the Blood In which case as the Thirst increases so the desire of Food grows less Or else there follows an universal want of Appetite from too great a fulness of the Vessels so that the sick Person plainly refuses Drink as well as Food 14. A Chronical heat 14ly A troublesome and Chronical heat at least in the soles of the Feet and the palms of the Hands especially after eating together with a Pulse somewhat quicker than it ought to be For this Symptom shews an Inflammatory and Hectical state of the Spirits and consequently a sharp serous and colliquative disposition of the Blood from which causes a Consumption of the Lungs does commonly proceed 15. A streightness of the Breast and shortness of breath 15ly A straightness and oppression of the Breast with some difficulty and shortness of Breath almost always joyn'd therewith Which Symptome is very common not only with such as have the Kings-Evil by reason of the swelling of the Glands of the Lungs but also with those that are Scorbutical and Hypochondriacal by reason of the constriction of the Lungs the Diaphragm and other Muscles that serve for Breathing which is from a light degree of a Convulsive Affection of the Nerves that are assign'd for their motion 16ly 16. A disposition to Catarrhs A disposition to Catarrhs that is when the sick Person is frequently subject to a Cough even upon every little occasion yea and sometimes without any evident cause For this Symptom shews a sharpness and colliquative state of the Blood From whence it comes to pass that the sharp Serum or Water of the Blood supply'd from the load of Humours lurking in the Habit of the Body uses to be almost continually separated and thrown out by the glandulous Coat of the Wind-pipe and by the soft substance of the Lungs Which is a very evident sign that a Consumption of the Lungs is then just at hand which will most certainly seize the Patient whenever the serous part of the Blood has contracted so great a sharpness as is sufficient to inflame or exulcerate the Lungs either from the liberal drinking of Spirituous Liquors or from taking of great Cold or any other cause 17ly 17. Any of those Distempers preceding which are apt to dispose to it All those Distempers before mentioned as the Scurvy Kings-Evil a Chronical Green-sickness an Inflammation of the Lungs spitting of Blood Pleurisy Rheumatism Asthma c. which are wont to occasion a Consumption of the Lungs For the Body being in this manner as it were habitually predisposed a Consumption of the Lungs and that many times an incurable one does very frequently seize upon the Patient upon the next great Cold he gets And indeed almost every Catarrh when it afflicts the Patient does at the same time threaten a Consumption that is like to follow To prevent a Consumption the great business to be careful in the six non-natural things Therefore in the preventing of a Consumption which is much easier than the Cure of it the great business whilst the Patients remain in this sickly condition is to take all possible care that no Error be committed in those six things which we call not Natural For in this so slippery a state of Health they are wont upon every little occasion of this Nature to fall headlong into a Fatal Consumption As for Example First 1. In eating and drinking they ought to be Prudent in the choosing of their Meat and Drink that the Chylous Liquor may be made to abound with good Juice and that the Nourishment may create very little trouble to Nature in digesting and dispensing of it Let them also take heed they do not eat too much Food though it be such as affords a good Juice as also that they do not drink too much Wine and strong Liquors 2. Sleep Secondly let them sleep the fore-part of
that is plentifully supplyed from the Glandulous Coat of the Wind-pipe Neither indeed can the Patient when the Distemper comes to be a Fatal Case be ever freed from this Cough by any Art till Death effectually stops it But let no one admire how those Tubercles or Swellings that are placed in the Lobes of the Lungs far from the top of the Wind-pipe can provoke this dry Cough together with a tickling in the upper part thereof when he may every day observe the same kind of Chronical dry Cough caused and continued a long time by chalky stones generated in the substance of the Lungs Yea and once I observed the same Symptom to happen from three Nails that slipt by chance as the Person was laughing through the Wind-pipe down into the Lungs and to continue for a whole Year the sick Person all that while being in other respects very well How the Tubercles which are remove from the top of the Wind-pipe do affect that part And indeed the thing it self shews it for the Wind-pipe is every where divided through all the Lobes of the Lungs into many branches which are a great way distant from one another so that the very fine and small Pipes of those branches are propagated to the very extremities of the Lungs by the continuity of those Membranes which had their Original from the beginning or upper part of the very Wind-pipe From whence it necessarily follows that as those Tubercles in what part soever of the substance of the Lungs they happen to be bred cannot but make a troublesome compression upon some of these small Pipes and straighten them So that troublesome sense by reason of the continuity of the Membranes does affect the upper extremity or beginning of the very Wind-pipe by a consent of parts as we commonly say whereby it provokes the Wind-pipe to cast out its Enemy by a vain and dry Cough Just as we see every day in a Strangury or difficulty in making Water from a stone pressing uneasily upon the Ureter yea if it be the very Kidney a great pain felt in the extremity of the Yard it self from the continuity of the Membrane For in Nature's endeavouring to expel the Stone there arises a Spasmodick Contraction of the whole Urinary passage from the very Kidneys which yet does very much affect the extremity of the Yard with a kind of heat of Urine The Nature of this Cough shews it to be from the Tubercles And even the Nature of this Consumptive Cough does likewise favour much this Opinion whilst it yet continues to be dry as being caused only by Tubercles and before a disposition to a Catarrh does in progress of time come upon it For as it is dry and without any expectoration so it is not great nor the Fits long and is rather made of its own accord to relieve the Oppression of the Lungs then excited by a violent tickling or accompanied with that great straining which usually accompanies a Catarrhous and fierce Cough that is caused by the continual excretion of a Waterish Humour by the Wind-pipe and the branches of it But if any one should be inquisitive about the Original of the Tubercles in the Lungs A general Account of the Original of the Tubercles in the Lungs which are the first occasion of this dry and truly Consumptive Cough I shall give this general Answer That the substance of the Lungs not only seems more obnoxious to a flux of Humours as the Ancients love to Phrase it than any other parts of the Body from the continual motion of these parts caused in respiration but also by reason of its spungy softness because it consists wholly of small Bladders and Vessels is wont to suck in and retain the Humours And therefore when all the internal and external Parts as well those that are Muscular as those that are Glandulous are very often affected with several sorts of such Swellings why should it be strange if they are frequently found here also as they are in other parts of the Body Yea when I consider with my self how often in one Year there is cause enough ministred for producing these Swellings even to those that are wont to observe the strictest Rules of Living I cannot sufficiently admire that any one at least after he comes to the Flower of his Youth can dye without a touch of a Consumption And without doubt the breeding of these Swellings is so frequent and common The breeding of these swellings is very common that a Consumption of the Lungs would necessarily be the common Plague of Mankind if those Swellings did not vanish or were not removed by Art as easily as they are bred at first And indeed I have been used to think not without Reason that as the more Benign Tubercles are wont to go off of their own accord and that quickly so none of them lay the Foundation of this great Disease And when they are Malignant they occasion a Consumption of which I am now treating but only those which are in some degree Malignant and ill-natur'd and that are wont to putrefie sooner or later from some peculiar quality in their Nature from what part soever of the Body they have their Original But that I may more particularly say something of the beginning and rise of these Tubercles A particular Account of the beginning of them As far as I have been able hitherto to learn either from the inspection of the dead Bodies of such as have had a Consumption or by Reasoning a crude Tubercle or Swelling is bred from the Obstruction of some Glandulous part of the Lungs to wit when a greater quantity of Serum or Water is separated from the Blood than is thrown out by the Duct of the Glandule From whence it comes to pass that as the Part affected being too much distended by the Humour that is imprisoned in it is deprived of its Natural Tone and thereupon is no longer able to spew or throw out the Serum or Water that flows into it or is separated so likewise the Humour that is so shut up not being any more renewed by an influx of fresh Humor does by degrees grow dry and hard from the Natural heat of the Part From whence arises a hardness that resists a pressure or a Tubercle of which we are now speaking which in progress of time after the Natural Tone of the Part is in this manner destroyed is wont to be inflam'd and to turn to an Apostem sooner or later according to the Nature of the Lympha or included Humor and of the Blood from which it is separated which indeed is the whole immediate cause of a Consumption of the Lungs and of the dry Cough which attends it The causes of that Obstruction which produces the Tubercles There remains yet some Enquiry to be made from what cause this Obstruction or Stagnation of the Humour in the Glandulous parts of the Lungs does proceed And this is
Consumption who are always subject to Colliquations of the Serum by the Glands of the Guts and Salivatory Glands a Looseness is wont to arise and joyn it self to a Consumption not long before the Patient dyes For as it shews Nature to be in a very great flame so it strangely hastens and promotes its farther Destruction This Looseness is proportionate to the present state of the colliquated Blood This Looseness is sometimes moderate in as much as it is always proportionate to the present state of the colliquated Blood but in others it is violent and accompanied with racking pains which usually defies the power of Opiates and all manner of Astringent Medicines or at least returns upon taking of the least Cold or drinking a draught of Beer or omitting the use of Opiate Medicines And so long as the Looseness is stopt by the Narcotick Power of Medicines we usually have a difficulty of Breathing in which the Patient is almost choak'd or a Dropsie or some other Symptoms no less troublesome nor less dangerous arise For the Blood being once brought by degrees to an irreparable and incurable state of Colliquation the crude Nutritious Juice that is continually carried about in the Mass of Blood does when one Door is shut find some other and it may be one that is more prejudicial and troublesome to the Patient The colliquated Humours producing a Dropsie is another sign of a confirm'd Consumption Fourthly But when in this colliquative or melting state of the Blood the Nutritious Chyle that is quite dispirited does not find a convenient passage through the Glands of the Skin by reason they are stopt by the cold of the ambient Air or by the Glands of the Guts being shut up by the use of too many Opiates either a Dropsie of the Breast or else of the Belly and the lower Limbs does usually follow Yea a blouted swelling in the whole Habit of the Body if the passages into the aforesaid Cavities of the Body and the lower Limbs are either by Art or Accident stopt And in plain terms a Dropsie coming upon a Consumption of what kind soever it be And not only of a confirm'd but of a deplorable Consumption is to be reckoned amongst the signs not only of a confirm'd but likewise of a deplorable and incurable Consumption And that not only because it shews a very great flame in the Blood and that the state of it is extreamly colliquative but likewise because the Patient by reason of his too great weakness is not able to bear such an Evacuation of the extravasated Serous-water as is necessary by such Medicines as purge forth Water And for Diureticks they are plainly of no use in this case because even the strongest of them cannot promote a Flux of Urine but rather cause a greater Colliquation in the Blood by attenuating and heating of it more Whereupon there is caused a greater and quicker flux of the Water into the cavities of the Body and into the lower Limbs where it has a free passage so as to increase the Dropsie Fifthly and lastly At last the colliquated Humours are thrown out by the glands of the Throat In this universal Colliquation Nature sinking a little before the Person dyes makes it her business to throw out the Serum or Juice that is full of distempered and purulent Particles by the Tonsils and other Glands that are seated in the Throat as also by the Salivatory Ducts of the Mouth From whence arises 1. A heat in the Throat From whence there are wont to arise two new Symptoms and they very troublesome ones to wit a great heat about the Tonsils and the Parts that serve for swallowing Whereby it comes to pass that the Patient can scarce swallow any thing but with grievous pain Which Symptom is wont to proceed from a light Inflammation of these parts caused not only by the perpetual agitation of them by the Cough and external Cold but likewise by the separation and spewing out of the Feverish Serum and sharp Matter Secondly 2. A Thrush long and troublesome Thrushes disperst through the whole Mouth which arise from the distemper'd state of the Spittle But especially if the Looseness that they have been followed with has been violently stopt with Opiates and Astringent Medicines For hereupon Nature when the Door by which the Serum uses to pass is once stopt endeavours though in vain to force out her Enemy by the passages of the Spittle By which means it comes to pass that the parts of the Mouth being tinged with that sharp Humour happen to be inflam'd and ulcerated with the Acrimony of that distemper'd and feverish Serum which is separated and thrown out by the Glandulous Membrane of the Mouth Which indeed is the immediate cause of this Symptom which how troublesome soever it is does nevertheless plainly defie whatever either Art or Nature can do because the stock and fuel of it that is heaped up in the Mass of Blood This universal Colliquation quickly brings a Marasmus cannot be spent Thirdly this universal Colliquation through what Sluces soever of the Body it happens to be made uses very quickly to bring a Marasmus with a Hippocratick Face which is a total Consumption of the Muscular Flesh from the defect of the new Nutritious Juice which by adhering to the Solid Parts might repair the continual loss that they sustain And when the thing is at length come to this pass there are no hopes of the Patient's Life And therefore this Symptom has ever been reckoned by all Persons one of the most certain signs not only of a confirm'd but likewise of a deplorable Consumption Observations Besides these Diagnostick signs which I have already mentioned it may perhaps be beneficial to add likewise my Observations concerning the Pulse the Urine and the Matter which they bring up in their coughing in the several degrees of this grand and stubborn Distemper And first of the Pulse 1. Of the Pulse When there is only a Hectick Fever In the beginning of a Consumption whilst there is no other Fever but a Hectick as the preternatural heat is continual and moderate so likewise the Pulse is somewhat quicker than it ought to be according to the degree of the Fever yet for the most part it always observes the same strokes and is always alike but only that after eating as a feverish Heat so likewise a quickness of the Pulse may more easily be discerned And indeed some Persons in a Consumption that are more cold and Phlegmatick do use to perceive nothing amiss either in their Pulse or Temper at any time but only then When there is an Inflammatory Fever But as soon as ever the Peripneumonick Fever with an Inflammation of the Lungs seizes them the Pulse as it uses to happen in other Peripneumonies is not only quick but also hard and strong yea likewise rises up more in one place than in another so as to
at least by prudent Counsel if he cannot by Medicines Therefore first let the Patient be ordered to take though often but a very little quantity of Food at a time Secondly let him be indulg'd the use of Food that is most grateful to his Stomack so it be such as affords good Juice and is of easie digestion Thirdly let him as much as ever he can keep from Coughing and deep hawking up of Phlegm that lyes low and let him likewise forbear sleeping and lying down presently after he has eaten But Medicines can scarce do any good in this deplorable state Of relieving a Thrush a pain in the Throat and Hiccough in the end of a Consumption After the flame of the Putrid Fever is kindled but especially when the exclusion of the colliquated Matter by the Bowels and other Doors is hindred by Art it sometimes happens that Nature endeavours though in vain the extrusion of her Enemy by the Salivatory Ducts and Glandulous Membrane of the Mouth and Gullet From whence a continual troublesome spitting for many Weeks arises Secondly by reason of the sharpness of the Humour separated by these parts there follows an Inflammation of the Membrane not only of the Mouth but also of the Gullet and Stomack Thirdly from the Inflammation there follows an Exulceration and thereupon little Ulcers commonly call'd a Thrush attended with a very troublesome pain in the Throat as I observed in Mrs. Wells and some other Consumptive Persons who were wont to complain of this Symptom more than of the Original Distemper it self Fourthly and lastly a very troublesome Hiccough arising from the Inflammation and Exulceration of the Stomack And these Symptoms A Thrush and Hiccough are always fatal as they are wont to be very troublesome so sometimes also of a long continuance but always fatal and such as presage the Patient's Death neither indeed do they admit of any Cure For that the cause from which they proceed is incurable However that may be yet an honest Physician ought here also as much as it is in his power to give a helping hand with the use of Gargles to be squirted into the Mouth and Throat with a Syringe which must be made of Cleansing Soft Astringent and Mucilaginous Ingredients Such as we have often occasion to use in our Practice the forms of which we meet with every where in Authors under the Head of a Fever But yet for the easing of this kind of pain in the Throats of Consumptive Persons the keeping the backward Glands seated in the Throat continually Night and Day defended from the external Air with a covering of Flannel doubled does a great deal of good from whence there may be more relief expected than from Gargles or Mucilages A TREATISE OF Consumptions The Third BOOK Of a Symptomatical Consumption of the Lungs I Call that a Symptomatical Consumption of the Lungs which is caused by What a Symptomatical Consumption is and depends upon some other preceding Diseases For it often happens so that from Distempers and those not only Chronical but also Acute and that whether they are perfectly cured or not the Mass of Blood is so altered by the preternatural Ferment preceding that there remain and lurk in the Blood some indelible Impressions and the Seeds of a Consumption that will afterwards follow which by degrees shews it self by a Cough and other usual Signs until at length the miserable Patient being on every side environed with the Fatal Symptoms of the Disease is forced to submit to the stroke of Death Yea sometimes also it is not only the Distemper but likewise the Physician himself that uses to be the occasion of this Consumption to wit when being greedy of Gain and a little present Fame he does in a perfunctory manner and without a due Method and necessary Evacuations rather suppress than root out the Ferment of the preceding Disease whereupon the Patient not being so much cured as translated from one Distemper to another after some space of time spent in a sickly state falls into an Acute and Deplorable Consumption This is the most common Consumption And indeed this kind of Consumption as far as I have been able to observe is the most common of all others and where we see one Original Consumption of the Lungs which depends meerly upon an alteration of the Blood predisposing the Patient to it there are five and it may be ten to be found which proceed from Crapulous and Intermitting Fevers from the Small-Pox Measles Scarlet Fevers a Pleurisie Peripneumony Melancholy and Hysterick Affections from the Kings-Evil Scurvy Green-Sickness Asthma Spitting of Blood Stones in the Lungs and sometimes also in the Kidneys and Bladder from the French-Pox Gout stoppage of the Monthly Purgations of Issues a Gonorrhoea and of Old Ulcers especially such as are Fistulous and Scrophulous These Consumptions have a peculiar disposition Which Symptomatical Consumptions besides the general Nature of a Consumption use to have likewise a proper and peculiar Genius or Disposition of their own and thereupon they are to be distinguisht amongst themselves as by particular Marks and Pathognomonick Signs And there is some variation to be made in the Cure proportionate to the different Nature of the Distemper And a Physician can scarcely in the Cure of a Symptomatical Consumption of the Lungs rationally satisfie all the Indications of Cure by the general Method already described so as to obtain a happy and desired event of things Therefore in the Cure of them a respect must be had to the Original Distemper unless he has in the whole course of his Cure as well a peculiar respect to the Original Distemper by mixing Specificks with his other Medicines as to the Symptoms in the Lungs which are the effects of it by Medicines that are proper for a Consumption of the Lungs which we have already described Therefore taking it for granted that the Description and Cure of an Original Consumption the Lungs already delivered belong likewise to of these Consumptions that I may not draw out the Thread of this Discourse to too tedious a length by Tautologies I thought it worth my while briefly to add under their proper Heads those things which may shew the various Nature of these Consumptions their Causes Differences Pathognomonick Signs and Indications of Cure by which a Physician with his Judgment and Sagacity may alter the general Method of Cure so as to be able to accommodate his Remedies to the peculiar Nature of the Disease and to answer the Indications that arise from it CHAP. I. Of a Scrophulous Consumption This Consumption is very fr quent I Shall speak of this kind of Consumption in the first place because it occurs most frequently in our Practice For I remember more of this kind of Consumptive Patients that I have cured or at least have seen cured by others than of any other sort For in a Scrophulous Consumption the Blood by reason of its preternatural
to drink a Quart three Pints two Quarts five Pints three Quarts of the Waters in Bed and likewise for her present use a little warm'd because of the coldness of that time of the Year for it was past the middle of September and to persist in the use of them a Month if they did but pass well by Urine and not work or go off by Stool and that she should be of good Courage if her Appetite began to return and her Thirst with the other Symptoms of her Fever were abated upon the use of them but if it happened otherwise that she should let me know it that I might presently do what I could to help her But being hindred by a great deal of Business I heard no more of her till three Weeks after she and her Brother came to me as I was in my Study she being now plainly free from her Fever Cough and Weakness and perfectly recovered from her Consumption to a Miracle and making no more complaint but of too great a greediness of her Appetite which yet I promised to reduce to a moderation as soon as she had got up the Flesh which she had lost by the long use of good Nourishment the truth of which she found by Experience in a short time Neither did I prescribe any Medicine but only that she should use a Diet-drink made with Antiscorbutick and Pectoral Ingredients the space of a Month for her ordinary Drink With which she recovered her perfect Health and is yet alive and continues well at her Father Mr. Minakin's House at the Sign of the King's Head in St. Martins near Aldersgate I could give several such Instances of the extraordinary Efficacy of the Chalybeate Waters in Curing a Hectick Fever and an incipient Scorbutical Consumption of the Lungs but that I endeavour to be as brief as I can CHAP. III. Of an Asthmatical Consumption THough every Scorbutical Consumption is of an Asthmatical Nature yet by this I especially understand that which proceeds from a true Asthma as the preceding Cause and depends wholly upon it Every Asthma has a tendency to a Consumption For every Asthma but especially that which is Humerose has a tendency to a Consumption because in this Distemper not only the Lungs are very often straitned and drawn together in the Nature of Spasms whereby the Tone of them is wont to be injured and destroyed and a thick viscid Humour is wont to be prest out of their substance into the branches of the Wind-pipe by that frequent compression which sticking fast there causes a Cough Wheesing and difficulty of Breathing but likewise from the previous disposition of the Blood to be viscid and tenacious the Lungs are almost always knotted from the very beginning of this Distemper which Knots or Tubercles in progress of time are wont to be inflam'd and exulcerated from whence there follows a true and fatal Asthmatical Consumption How this Consumption is distinguisht from others But this Consumption is to be distinguished from others especially by this that it is accompanied through the whole course of the Disease with a Wheesing and extream difficulty of Breathing because the Humour that is continually prest out of the Tubercles and substance of the Lungs into the Wind-pipe and branches of it as I hinted before is always thick and viscid sticking tenaciously and troublesomly to the sides of the Wind-pipe and its branches like Glew and so hindring the free passage of the Air. But this Consumption This Consumption is very Chronical though it is usually Fatal and Incurable yet in its own Nature it is very Chronical so that I have seen some who though they have been in an Asthmatical Consumption yet have lived several Years with the help of a due Government and of a thin Air. The cause of which thing seems to me to be the toughness and viscidity of the Humour thrown out by the Lungs in this Consumption For this Humour by reason of the great quantity of Salt contained in it easily and quickly admitting some concoction though into a viscid Matter loses a great deal of its corrosive Acrimony and thereupon becomes more benign leaving a less impression behind it upon the Lungs than where it is sharp thin and perfectly crude and admits of no Concoction at all Old Age is such a Consumption And indeed Old Age seems to me to be this kind of Chronical and Incurable Consumption because all Old People that are not seized with some Acute Disease languishing in this manner with a Consumption do at length come to the period of their Lives but not without such fore-runners as a Chronical Cough a difficulty of Breathing a wasted lean Habit of Body and something of a Hectick Disposition And we need not wonder at it when the small Fibres of the Substance of the Lungs by reason of a great Age losing their tensness are wont to fall together from whence it comes to pass that the whole Substance of the Lungs grows slabby like a Quagmire from the Nutritious Juice being seperated and stagnating there and upon that there is that plenty of viscid Phlegm a Wheesing Asthmatical stuffing of the Lungs difficulty of Breathing an emaciation of the whole Body and a Hectical Disposition And why should I use many words wh n there follows plainly a Consumption of Old Age Neither is a Milk Diet nor Opiates convenient in this Consumption 1. A Milk Diet is seldom convenient in this Consumption much less Opium because by increasing the thickness of the Humours it promotes the difficulty of Breathing and all the other Symptoms of this Consumption so that I have sometimes in this case seen the Life of a Patient brought into sudden danger with but one Grain of Opium A thin Air is necessary in the Cure of it 2. A thin and open Air is more necessary in the Cure of this Consumption than in any others Neither indeed can this kind of Consumptive Persons live long with the use even of the most Generous Medicines in a foggy or smoaky Air. Inciding Medicines are the best sort of Pectorals 3. Amongst the Expectorating Medicines the best are such as are Cleansing and Inciding as Honey Mead Syrup of Hedg-Mustard of the five Opening Roots of Vinegar We must avoid at least we must be very cautious in giving Incrassating things Balsams Gums Wood-lice but especially my Balsamick Pills are here of great use As also Spirit of Harts-horn of Salt Armoniack c. whenever the Consumption depends upon a Convulsive Asthma What is to be done in violent Asthmatick Fits 4. This kind of Consumptive Patients are many times taken with Fits of an Asthma to a great Extremity In which case it is necessary to open a Vein though the Patient be never so much emaciated and it is as convenient to give Riverius's Emetick Mixture of equal parts of Oxymel of Squills and strong Cinnamon-water or something of that Nature and to repeat it
a Virgin that was Consumptive and as I remember dyed within a Year after she was married with an universal Colliquation and the other Symptoms of a fatal Consumption of the Lungs a few Months after her Death fell into a Consumption as I judg'd by Contagion To which fatal Disease an Haemoptoë prepared the way with which he was suddenly taken at Exeter and that in the Winter-time and he lost a great deal of Blood But as soon as his spitting of Blood was stopt by Phlebotomy a Milk Diet and Incrassating Medicines and he had recovered his strength in some measure being dismist by his Country Physician within a Fortnight which was much sooner than was fit he came back to London on Horse-back and presently sent for me But alas how much was he changed from what he was before I found the poor Patient very Feverish and always Coughing and extreamly wasted with a Colliquation that was now begun and troubled with a streightness and pains in his Breast I found it to be a mixt Fever partly Peripneumonick from a new Inflammation of some of the Tubercles partly Putrid from the purulency of other Glandules which had begun so soon to be ulcerated I judged the Distemper to be a very Acute Consumption of the Lungs from a spitting of Blood which as it was contracted by Infection so it was rendred more hasty and violent by his ill Government in his Journey and his return into our Air that is filled with the smoak of Coals The violence of the Pain and Fever requiting it I presently ordered a Vein to be opened but I took away but a little Blood because of the Consumption and Colliquation that was upon him Then I endeavoured at least to stave off this hasty Ruin for some time with temperate Juleps and Opiates and all sorts of convenient Pectoral Medicines Blisters and a due management in all things But all these things were to no purpose for within three or four Weeks he departed this Life with all the Symptoms of a very Acute Consumption of the Lungs CHAP. VI. Of a Consumption caused by Stones bred in the Lungs and by things slipt down into them from without as also by the Stone in the Kidneys and Bladder Chalky stones are often bred in the Lungs I Have often observed Chalky Stones bred in the Lungs which when they have been Angular and disturbed with the shaking of the Lungs are wont to tear the tender substance of those parts from whence have arisen a violent and dry Cough and a horrible pain in the Breast like that in a Pleurisy and Peripneumony sometimes also an Haemoptoë with a considerable Flux of Blood and from thence Ulcers with the usual Signs of a Consumption of the Lungs Therefore when these horrid Pains happen with an Haemoptoë about the beginning of a Consumption When we may judge a Consumption to be from them we may justly suspect it to be a Consumption from Stones in the Lungs Although we cannot pronounce any thing certain of this thing till a Stone or two have been cough'd up For it often happens that these Stones passing by degrees through the Lungs do at length get into the branches of the Wind-pipe by which they are cough'd up and that seldom without a great flux of Blood But if these Stones are smooth and not such as may break or tear the substance of the Lungs they do not dispose the Patient much to a Consumption at least an Acute one nor indeed do they occasion any great mischief more than a dry Cough that is somewhat troublesome and something of an oppressing weight in the Breast as I have observed in several long ago in whose Lungs after they have been dead I have found many of these smooth Chalky Stones and some of them pretty large without the least Tubercle or Ulcer occasioned by them Where these Stones are sharp they cause a Consumption But where these Stones have been Angular and sharp and apt to break and tear the Lungs they have caused a Pain a spitting of Blood Ulcers and a Consumption it self as I have already hinted In which case as a pain does precede to and accompany the spitting of Blood so a spitting of Blood goes before and accompanies the Ulcers and Consumption What I have now said of Stones The same is true of Nails c. is likewise true of Nails Pins and other things that slip down into the Lungs as People laugh For unless they are quickly cough'd up again they prick the Lungs and cause a lancinating pain from whence a spitting of Blood Ulcers and a Consumption are wont to proceed Of which I shall add a remarkable History presently at the end of this Chapter These Ulcers as also the Consumption The Vlcers they cause cannot be cured before they are brought away which is the effect of them which we may likewise observe of Ulcers in the Kidneys and Bladder can never be cured without fetching away the Stone or Nail or Pin or whatever else it is of that Nature that breeds the Ulcers But these things which causing a continual pricking in the ulcerated part did by that means render the Cure of it impossible before being once come away though it be as it usually is with a great Haemorrhage yet the Ulcer and Consumption of the Lungs that proceed from them do oftentimes admit of an easie and perfect Cure because they have not their Original so much from a predisposed Habit of the Body as from a meer accidental Distemper of one single part Of which I shall relate one or two remarkable Histories at the end of this Chapter The Cure of this Consumption In the Cure of this kind of Ulcers Opiate and Balsamick Medicines with a Milk Diet are of very great use Opiates to obtund the sense of the torn and stimulated parts and to keep them as quiet as is possible whilst the Balsamicks exert their Healing Power And with the continual use of Milk the Hectick heat of the Blood contracted in this Consumptive state is to be allayed But although these sharp Stones can neither be made to lye quiet in that part of the Lungs which they occupy with the plentiful use of Laudanum nor brought away with the use of Lubricating Medicines but cause an Incurable Consumption and spitting of Blood and that such a one as returns by uncertain Intervals with a lancinating pain Yet this Consumption is in its own Nature slow and very Chronical as a Consumption from the Stone in the Kidneys and Bladder uses to be and generally speaking every Consumption that depends meerly upon an indisposition or Ulcer of some particular part without an habitual disposition of the Blood contracted either by propagation from the Parents or a long abuse of the six things called non-natural But whenever a heap or stock of predisposed Humours does conspire with some such fatal Cause the Consumption which proceeds from thence is not only fatal from
beyond the Sphere of Surgery And not to be cured without healing the Original Vlcer And indeed to Cure this Consumption perfectly without healing of the Ulcers from from which it takes its Original is the same thing as to take away an Effect whilst the Cause of that Effect remains It is true indeed that so often as these Ulcers happen to be small and benign and are likewise placed in the Kidneys Bladder Testicles Ovaries the Vagina Uteri or in other Membranous Parts and Entrails that are more remote from the Heart as the Ulcers themselves which here assume the Nature of a Cause do sometimes admit of a perfect Cure so likewise the Pulmonary Consumption it self which depends upon them may as well be cured But this Consumption whether it be capable of a Cure or not does nevertheless almost always assume the Nature of a Chronical Disease in some measure And from hence I have found some of this sort of Patients for several Months When this Consumption is Chronical yea and sometimâ— several Years languishing with a Consumption pining away by degrees and dissolv'd by Colliquations but especially when the source of the Disease has been in one of the Kidneys the Bladder or Vagina Uteri that have been ulcerated A Consumption proceeding from an Ulcer of the Ovaries in Women or the Testicles in Men I have observed to have been of a middle Nature but for the most part to carry off the Patient within the space of a Year But that which arises from an Exulceration of the Womb it self When Acute the Stomack Liver or other Entrails or Membranous Parts of the greatest note I have observed to put an end to the Patient's Life in the space of a very few Months or even Weeks after the manner of a very Acute Consumption because it has been immediately attended first with an extraordinary Inflammatory Fever and after that with a Putrid Intermitting Fever and an universal Colliquation together with a want of Rest Light-headedness Spasms and other direful Symptoms of the Nerves But yet by reason of the sudden Destruction brought on from the Nature of the Original Disease I have found by inspecting into Bodies after they have been dead that the Lungs have not been so much affected as they used to be in other Consumptions that are more Chronical to wit where by reason that the Original Distemper has suffered the Patient to live long enough the Lungs have happen'd not only to be stufft but likewise to have Tubercles bred in them and those Tubercles at length have happen'd to turn to Apostems But generally speaking The more Acute it is the harder to Cure as every Consumption of this kind is very hard to Cure so it is so much the harder as it is more Acute because it has its Original from more considerable Ulcers Neither indeed does it ever admit of a perfect Cure without the healing of the Ulcers whatever they are and in whatsoever Entrail or Membranous Part those Ulcers are bred which gave the first occasion to this Disease From what I have now said it is plain enough even to Reason what are the Indications of Cure in this kind of Consumptions which likewise the happy Success of our Practice is wont daily to present to our very sight that is whenever the Distemper does in its own Nature admit of a Cure The Indications of Cure And they must respect the Original Disease as well as the Lungs themselves first by promoting as much as we can the healing of the Ulcers in what part soever of the Body they have been bred with the plentiful use of Balsamick and Vulnerary Medicines which indeed ought to be of the milder sort lest by increasing the Feverish Flame that is already kindled in the Blood they should do more hurt than good Secondly by taking timely care of the Lungs with the use of Pulmonary Remedies to wit Opiate and Expectorating Medicines given alternately by which the mischief which they have got may be taken off or at least as little as may be promoted by the Original Distemper Thirdly by mixing always with the Pectoral and Balsamick Medicines those things which may restore and confirm the Tone of the Part which was first of all affected and which have a particular respect to it as Uterines Hepaticks Diureticks and other such-like Medicines as the case may require Fourthly by tempering the Hectick heat which is already kindled in the Blood and Spirits with a strict Milk Diet the Chalybeate Mineral Waters Vulnerary Decoctions of Sarsa Lime-water and other things of the like Nature so far as the present state of the Patient can bear them as also by taking off the Putrid Intermitting Fever with the plentiful use of the Peruvian Bark and with repeating of it often enough at due intervals And lastly by relieving with the most diligent application the most urgent Symptoms and those which weaken the Patient most whether they arise from the Original Ulcer or from the Lungs As for Example The Method of Cure If the Original Ulcer is so benign and small that there appear any hopes of a perfect Cure and it has not continued so long that the Patient is brought very weak with it and if it is not seated in so Noble a Part as to make us fear the sudden destruction of the Person from an Acute Consumption it is plainly convenient in the very beginning of the Cure to endeavour the healing of the Original Ulcer by giving Calomelanos plentifully and that not only mixt with Purges and therefore at due intervals but likewise by it self in Doses repeated quickly one after the other with a design to raise a Salivation by which if the Patient has strength enough to bear so great an Evacuation and it be convenient in other respects we shall take much better Measures as for the healing of the Ulcer so likewise for the preventing of the Consumption which is like to follow than by any other Apparatus of Medicines But if that be contraindicated by the Patient's Weakness the intense degree of the Fever and the very Acute Nature of the Consumption at least as Antimonial so Mercurial Medicines may be so disposed at due intervals in the Method of Cure that they may successfully exert their extraordinary Healing Vertue without any expensive Evacuation excited thereby As for Example Let the Patient take every Night xv or xx Grains of Antimonium Diaphoreticum in a little bit of Old Conserve of Red Roses mixt with Leucatellus's Balsam And every third or fourth Morning a Scruple or half a Dram of Mercurius Dulcis in a spoonful of Milk Let him also drink a Vulnerary Decoction of Sarsa described in another place for his ordinary Drink adding always at the time when he takes it of the Balsamick Syrup so much as will serve to make a Draught of it grateful to the Patient's Palate My Balsamick Pills are likewise very good in this case being ordered so