the Lungs were free from any Ulcer yet they were set about with little swellings or stones or sandy matter throughout the whole for from thence the blood because it could neither be freely circulated in the Praecordium nor animated enough by the nitrous air and when in the mean time it is perpetually polluted by its proper dregs deposited in the Lungs is frequently vitiated and made incapable of nourishing thereby wherefore a Phthisis is better defined that it is a withering away of the whole body arising from an ill fromation of the Lungs The Ancients following Hippocrates The cause assigned by the Ancients for the most part have assigned only two causes of this disease viz. a Catarrh and the breaking of a Vein to which some have added an Empyema and others exclude a Catarrh from this number for what is vulgarly affirmed that flegm falling from the Head into the Lungs and abiding there putrifies is most commonly the cause of a Phthisis or is often brought by it we have formerly intimated to be altogether erroneous and shall presently shew it more clearly In the mean time to shew what the matter is that generates a Consumption as often as it arises without an Empyema or Haemoptoe going before What the consumptive matter is it must be considered after how may manners and by what ways any thing disagreeable or heterogene can enter into the Lungs which diligent search being made it will easily appear that any thing that is an enemy to the Lungs creeps in and is admitted chiefly either by the Trachea or by the pneumonic Arteries By what ways it enters the Lungs yea and sometimes haply by the Nerves but nothing by the Veins or Lymphaeducts whose function is only to carry back or away the blood or Lympha and to leave there nothing at all As to the Trachea it is manifest it is ordained for this end that by its passages or pipes the air might be conveyed in or presently carried back by a constant recourse from whence it comes Sometimes by the Trachea yet not destilling from the head moreover whether any matter being hurtful or mortal to the Praecordia may be admitted the same way shall be now our present disquisition And that the Lungs frequently incur a pernicious pollution by this entrance is clear from hence because the moist air of some regions repleat with fumes or abounding with malignant vapours doth frequently induce the consumptive inclination nevertheless the affection thereof is wont to be communicated only by aerial minute particles whereby either the temperament of the blood or the conformation of the Lungs or both are prejudiced But whether besides this a serous matter or some humor corrupting the Lungs doth enter them through this passage is not without reason doubted although many do determine a Catarrh or a destillation of the Serum from the Brain into the Lungs by the passages of the Trachea the principal cause of a Phthisis Which opinion being erroneously delivered by the Ancients I admire any either of our modern Physicians or Philosophers have admitted thereof for it is manifest by anatomical observations that nothing from the Brain by the Glandula pituitaria which seems the only passage from thence falls down into the Palate or Breast but that the Serum there deposited is conveyed by appropriate passages to the jugular Veins and is remanded to the blood Moreover it is manifest to sight that whatsoever relique of Serum is laid aside in the Glandules of the Ears Mouth Nose or Face is conveyed from them all by peculiar passages insomuch that no humor whatsoever destils from the Brain or the Palate into the Lungs But although matter exciting a Congh doth not destil from the Head by the Trachea into the Lungs yet sometimes falling down from the sides of the Trachea into their cavities But sweating out of the sides of the Trachea it produces that disease commonly called a Catarrh For the Aspera Arteria like the Arteries beinging blood are endued with a nervous and musculous Coat and so do occasionally enjoy sense and motion having also a glandulous Coat and full of little vessels to sustain the vital heat and nourishment These last Coats make those interspaces and as it were cover the Cartilages Moreover the superfluous serosities proceeding from the blood watering the Trachea are deposited into this glandulous Coat which for the most part presently sweating into the cavities of the Trachea serves chiefly to make them slippery and most but if the mass of blood be poured out too much and precipitated into serosities as it frequently happens a cold being taken or the swallowing down of acid things and on many other occasions for this cause a great plenty of watry matter sweats out of the Glandules of the Trachea and mouths of the little Arteries into its cavities which soon doth cause a most troublesom Cough and often much spittle which afterwards comes to be consumptive But surely this cause of Spittle and as it were a Catarrhal Cough very rarely comes alone The consumptive matter brought into the Lungs rather by the pneumonic Arteries because while the blood watering the Trachea having suffered solution throws in its serosities into the Glandules whence presently they sweat into its cavities and also the remaining blood being in like sort dissolved it insinuates its Serum set apart within the pneumonic arteries partly into the tracheal hollownesses and partly into the Lympheducts by the overflowing whereof the Lungs are as it were overwhelmed and much incited for the most part provok'd to Cough and continual spitting A Cough and spitting of this kind as long as moderate A Cough and spitting sometimes healthful only throwing off the serosities of the blood rather are beneficial than prejudicial because the mass of blood and the very lungs being throughly purged after this sort those symptoms for the most part spontaneously abate and from thence ensues a more perfect health But if they be protracted a long time the serous humour being on both sides laid aside into the tracheal passages and from thence more plentifully daily heapt up at length it will change into corruption because as well the free enjoyment of air is impeded as also the motion of the blood and its temperature wholly perverted from hence a Cough becomes more fierce and breathing more difficult nay rather the whole mass of blood in as much as it is defiled by the foul blood which the Veins receive from the Lungs degenerating by degrees from its benign properties and being depraved it not only continually pours forth the super fluous Serum but also the nutritive Juice which it cannot assimilate out of the pneumonic Arteries into the tracheal passages Yet often being too much is dangerous and so this mass of consumptive matter is daily increased till the Lungs being more and more obstructed and filled and the blood being defiled and rendred unfit to perform any of its functions the Cough
coughing with thin spittle together with a giddiness he was afflicted with numness of his senses and a dropping at his nostrils In this state his best remedy was wont to be and frequently tryed with success to drink a little more freely generous Wine and any other liquor very sparingly for so the acidity and fluor of the blood being suppressed and transpiration procured more freely he was much eased and sometimes recovered health in a short time Moreover at night and early in the morning he was used to take seven or eight drops of the tincture of Sulphur in a spoonfull of Syrup of Violets or of the Juice of Ground Ivy or Take Conserve of red Roses three ounces spirit of Turpentine two drams mingled the dose the quantity of a chesnut evening and morning If that these remedies together with the Canary Antidote and thin diet effected little the disease not being so cured spinning out into a long period and pressing him sharply for many weeks yea sometimes months it reduced the sick to a remarkable leanness and to the very brink of the Grave For then the Cough daily encreasing and being very troublesome did very much impede and break his sleep his strength languished his appetite was dejected heat and thirst molested him in the mean time spittle every day encreased and was cast forth in great plenty so that not onely the Serum of the blood and the recrements but also the nutritive Juice and the drainings of the solid parts being continually poured out upon the lungs turn'd into corruption which was abundantly cough'd out moreover his breath was difficult his joints very infirm and his flesh very much consumed When of late our patient laboured after this manner we prescribed the following method and remedies by the continued use whereof at length he recovered his health First of all a thinner diet being appointed him and for the most part Ale being forbidden altogether he took twice in the day of the following Apozeme about six ounces warm and a little at other times cold to restrain his thirst Take of the roots of China two ounces Sarsaparilla three ounces white and yellow Sanders of each one ounce Ivory and Harts-horn of each three drams infuse and boyl them in 8 pints of water to half adding Raisins of the Sun 3 ounces Liquorish 3 drams strein it and keep it for ordinary drink Take tincture of Sulphur three drams take from seven drops to ten at night and in the morning in a spoonfull of syrup of Violets or of syrup of the juice of Ground-Ivy When he began by continual use to nauseate this Medicine in its place the following Eclegma was appointed Take conserve of red Roses three ounces spirit of Turpentine two drams mix them the dose is one dram at the same hours Afterwards instead hereof the following Powder was sometimes taken Take of the powder of the leaves of ground-Ivy dryed in the Summer Sun three ounces Sugar-candy half an ounce mix them the dose half a spoonfull twice in a day with three ounces of the following water Take Ground-Ivy 6 handfulls Hyssop white Hore-hound of each 4 handfulls Lambs-lungs half-boyl'd and cut small pour upon them eight pound of Posset-drink made with small ale distill it in common Organs the liquor being mixed let it be sweetned to the taste as it is used with Sugar-candy or syrup of Violets To appease his almost continually troublesome Cough Troches he swallowed the following Troches and sometimes a little of the extract of Liquorish Take of the species of Diatragacanth frig 3 drams Annise Carue sweet Fennel-seeds of each half a dram flower of Brimstone two scruples flowers of Benzoin one scruple extract of Liquorish dissolv'd in Hyssop-water make a paste which form into Troches Or Take of Species Diaireos è pulm Vulpis of each two drams flower of Sulphur of Elecampane of each half a dram Oyl of Anniseeds ℈ ss Sugar dissolv'd in a sufficient quantity of Penniroyal-water and boyl'd to a body ℥ vj. form Lozenges of half a dram weight let him eat one swallowing it by degrees as oft as he will In the midst of this course although he was endowed with a weak pulse and more cold temperature we breath'd a vein in his arm moreover with these remedies the chiefest help accrued to him from the open air which for the most part he daily enjoyed either by riding on Horse-back or in a Coach for from hence he first began to recover his appetite his digestion and sleep whereto afterwards a relaxation of the other symptoms did sensibly follow till at length he recovered his entire health As often as he was afflicted since then with a stubborn and tedious Cough he used a method like this and with the like success and now although he lives altogether exempt from that distemper notwithstanding he is constrained to decline carefully all occasions or causes whereby either the pores might be shut or the flux of blood or its precipitation into serosities might be provok'd which were chiefly his going by water on the Thames at London and drinking of acid liquors as Cider French or Rhenish wine From the above-mentined history you may easily conceive both the means and the reason of healing of the Cough which caused by the fault of the blood is without the limits of a Phthisis The other follows which illustrates the nature of the same distemper when it chiefly proceeds from the nervous juice A Boy about ten years of age The second remarkable History of a hot temper and fresh countenance from his infancy obnoxious to a frequent Cough in his succeeding years sustained more grievous and lasting fits and assaults of this distemper and by turns was used to labour with a strong and shrill Cough A hooping Cough without spitting which almost continually afflicted him day and night and so infesting him many days yea weeks brought the sick to utter weakness Afterwards the period of his disease being come which happened not but by consuming the store of th morbific matter he again in a short time became healthy enough and very free from any sickness of the Thorax till the morbific matter as it seems being heaped again to great abundance without any evident cause the same distemper returned and performed its Tragedy with its wonted fierceness About its first beginning the Cough was troublesom only morning and evening after wards the evilby little and little increasing he almost continually coughed whole days and nights and if at any time sleep happening of it self or by the use of Anodynes afforded any truce a more outragious fit of couhing succeeded his wakening After this manner most frequently and fiercely coughing without any spittle he laboured for three or four weeks till he was brought to an extreme leanness and weakness and then the sickness leisurely remitted so that he coughed somewhat seldomer and enjoyed moderate sleeps afterwards in few days growing very hungry being quickly made full of flesh
and soon passing over at length grows to be a fixt and permanent disease Wherefore it seems material in this Case to accommodate th Aetiologie of those passions delivered by us in another place to unfold the Nature and Causes of this present maladie Which truly will not be of any great business or difficulty An Affection of what sort a Tympany is For supposing what we have in another place more largely set down the extensions and inflations of the membranes and hollow bowels take their origine from the impetuous invasions of the Spirits into the nervous fibres of which they are interwoven it will be obvious enough to conceive cven a Tympaine to be produeed from such a cause but being more sixt and longer or uncessantly in the act into the reason of which difference we will by and by inquire In the mean time I am induced to believe a Tympanie not the be stirred up from winds shut up within or without the Cavity of the guts It s cause and formal reason explicated for such an accumulation of winds in those places is an effect but not a cause of this disease but that it does arise inasmuch as the animal Spirits in the bottom of the belly belonging to the membranous bowels being forced into disorder by something incongruous do tumultuously rush every where into the nervous fibres and puffe them up neither do they immediately recede back from them from hence the Peritonaeum swells and the guts being blown up and enlarged they are as it were inflated the Mesentery and other membranous bowels being turgid with an impetuous Spirit are as it were raised up into a bulk moreover while these come thus to pass that the vacuities caused from the swelling of hollow bowels might be filled a portion presently of every humour within contained being rarified into vapours forthwith turns into wind wandring about those empty spaces Truly And proved by arguments and instances we have clearly enough shewn by reasons and instances in our Pathologie of Convulsions that the animal spirits puff up the membranous parts by their irregularity and so produce as it were this windie Distemper Moreover the fame is demonstrated by Anatomical observation made in dissecting a living Creature viz. inasmuch as the Trunk of the eighth pair of Nerves descending on each side by the Neck if it be taken out and bound with a thred forthwith all the stomach swells up as if it were puffed with winde An universal Tympanie which certainly can proceed from no other cause than that the animal Spirits of the fibres of that bowel and others flowing through the nervous passages inasmuch as they being cut off from their origine are driven into confusion do tumultuously enter those part and puss them up Besides these for the further illustrating of this Hypothesis I will relate a History cited by the most renowned Smetius of an universal Tympany as he calls it in a certain young man of Liege Who when he had received in a conflict under his right arm-pit a wound made by a prick penetrating into the Cavity of his breast next day and night being past he appeared in the morning after swell'd throughout his whole body not only in his breast but also in his back belly loins and in the cods besides both in his arms shoulders neck and face that he could not open his eye-lids also on the crown of his head the skin being every where swolne and tumefied the tumour was every where extended with great pain The Author calls this wonderful affection an Universal Tympanie The most renowned Sennertus relates a Case like this from his own knowledge Moreover I remember I have heard or read of the like from a wound of the breast being reveived near the arm-pit Notwithstanding The Cause of an universal Tympanie enquired into the reason of this Symptom deliver'd by Smetius and approved by Sennertus doth not at all please me for they ascribe the cause of the general Tympanie to the puffing up of the breast by the axillary wound made all that night under the skin as we see a new and moist bladder to be blown up by boyes with a quill which truly doth not only seem improbable but also we think scarce possible that the wind to be blown out of a wound of the Thorax by reason of the hole one might stopt can enter the skin and from thence passing through the whole body should make it become every where Tympanitical For besides that the wind cannot so suddenly pass from thence into all parts although it should be blown with a quill from the mouth under the skin besides while the orifice of the wound is stopt no wind can altogether be blown out from the Cavith of the breast because none in the mean time enters But assuredly the cause of that wonderful affection is this whence also the formal reason of a Tympanie is illustrated In the Breast near the Arm-pits The true cause assigned are many and eminent folding of Nerves as we have described in our Treatise of Nerves by which the nerves of the whole body communicate among themselves viz. the Trunk of the eighth pair unites with the intercostal Nerve and both with the nerves of the Spina Dorsi by branches and sprigs sent here and there Wherefore this nervous folding perchance being pierced by the point of the Sword first of all the spirits residing in that place being provok'd run into disorders afterwards a consent being immediately made thorow so many notable Nerves and transmitted to and fro every where other Spirits and then again others are sensible of the like irregularities and puffing up the membranous and nervous Fibres which every where they enter tumultuously they induce as it were a tympanitical affection throug the whole body By reason of the like fury or virulent madness imposed upon the Spirits in any place and from thence immediately diffused far and wide certain Poysons being fdrunk the strokes of weapons or of wild Beasts or a venemous bite do frequently induce a swelling together of many parts or of the whole body which swelling distemper of the Spirits is styl'd by Helmont to be Indignatio Archaas There are many other Cases and Instances by which it is most clearly evinced that the Animal Spirits being provok'd and driven into angry inclinations inasmuch as they do more impetuously enter into the nervous Fibres are wont first to swell the membranous parts and to excite many passions out of those which are vulgarly but falsely ascribed to windes so that in truth no other cause of a Tympanie can be assigned more like truth If it objected Why the belly swells in the dead that the Paunches of the defunct after some time are raised by winde into a bulk and swell like as in a Tympany I pronounce this to proceed from the putrefaction of humours and the extream dissolution of the mixture wherein all the active particles depart being freed one
affected with the Green-sickness Cachexy and that sort of Dropsie called Leucophlegmatia who all have a difficulty of breathing by reason of dregs of the ill-mixt Blood that are left there Wherefore the use of the Lungs seems to be this That the Blood through the lesser Vessels as so many rivulets may as to all its parts lie open to and meet with the nitrous Particles of the Air and be by them enlivened and accended The Pneumonic Artery as also the Aorta and Wind-pipe hath a muscular Coat furnished with two ranks of Fibres namely straight and circular which doubtless when they are contracted do make the Pneumonic Arteries to beat and the Blood to be urged and driven still more and more forward A great many Glandules with a Net of Vessels lie on this musculous Coat The frame and branching of the Pnenmonic Artery in some one Lobe of the Lungs are expressed in the second Table All the Coats of this Vessel are drawn distinct and apart from one another in the sixth Table and first Figure and also in the fourth Table and second Figure The Pneumonic Vein having its rise in the left Ventricle of the Heart The description and use of the Pneumonic Vein and being divided and variously subdivided first into greater branches and then according to the greater and lesser Lobes of the Lungs into lesser and lastly into the least of all is carried above the Weazand and as it goes on does exactly answer to the branching both of the Pneumonic Artery and the Weazand and goes every where with them as it were cheek by joll and where the Weazand ends into the little Bladders the Veins being twisted with the Arteries as was said before do make as it were a little Net wherein those little Bladders are encompassed The Anatome of the Pneumonic Vein differs little or nothing from that of the Vena cava and its branches All the Vessels of this kind have four Coats distinct from one another 1. The outmost of these Coats consists of Fibres that seem to be nervous which perhaps are after a sort muscular and are extended straight long-wise though in no very regular order This Coat of the pulmonary Vein is very laxe and loose from the rest of the Vessel insomuch that it may all of it be blown up and very much extended as if it were a distinct Vessel Whence one might suspect that this were a peculiar passage to carry back Lympha or Serum separated from the Blood but it seems to be more probable that this outmost Coat is therefore made so loose that the passages might be much distended and widened for the return of the Blood now hot and boiling 2. 3. Two other Coats common both to a Vein and Artery viz. the vasculous The use of the venous and vasculous Coat and the glandulous lie under this the office of the vasculous is to bring nourishment to the part and of the glandulous to receive and send away the superfluous serosities 4. The fourth and inmost Coat is plainly muscular having Ring sibres The muscular Coat as the like Coat of an Artery hath which certainly being successively contracted after the stream of Blood do cause its return to be hastened and on occasion to be shortned But here arises a doubt wherefore Why there is no Pulse in the Veins seeing the Veins as well as Arteries have contracting muscular Fibres which in the latter are pulfifick and seeing both are alike joined to the Heart that beats continually the Veins as well as the Arteries should not statedly beat according to the constant turns of the Systole's and Diastole's in the Heart It may easily be answered to this first that the Arteries have a great deal more of the moving Fibres than the Veins have and therefore whereas those being strongly contracted successively do force the Blood along as if driven with a wedge for these it sufficeth that whilst they are gently contracted behind the stream of Blood they calmly and equally drive it forward flowing back again of its own accord and as it were down-hill But besides the reason hereof seems to depend somewhat on the unlike or rather inverted conformation of the Vessels for the Blood conveighed by the Arteries is driven still from wider to narrower spaces and therefore going along it every where violently distends them and lifting up the sides of the Vessels raises the Pulfe because whiles that part of the Artery that is behind the Blood is contracted by its muscular Fibres that part which is before it must needs beat being filled with the stream of blood gushing in but on the contrary the blood in the Veins returning to the Heart runs out of less into greater spaces or out of rivulets into a more capacious and deep chanel and therefore glides along silently and without the fluctuating of a Pulse The blood in the pulmonary Veins seems as much The disposition of the blood in the Pneumonic Veins or more than that within the Arteries to be animated or inflamed anew by the air insinuating it self every where from the Pipes or little Bladders of the Trachea because in those Veins 't is first changed from a black-purple to a scarlet the reason whereof is because the blood at the extremities of the Vessels namely as it passes out of the Arteries into the Veins does every where and most of all meet with the particles of the air And for that reason it is that if any liquour be squirted into the Pneumonic Artery it will not so readily and quickly pass through the Lungs and return by the Vein as it will do if you make the same experiment in any member or part of the body besides yea part of the liquor so injected will sweat through into the Pipes of the Trachea or the spaces between the little Lobes and another part being turned into a froth will return very slowly by the Veins which is a certain proof that while it passes through the Lungs it makes a stay in the mouths of the Vessels and is mingled with the airy particles The Circulation of the blood through the Lungs hath something diverse from or rather contrary to that which is made through the rest of the body seeing the Pneumonic Arteries contain a black-purple blood and the Veins a scarlet whereas in all the body besides the branches of the Aorta carry a scarlet blood and those of the Vena cava a black-purple Besides we may observe of the pulmonary Vein that it does every where in its whole length want valves except where 't is fastned to the Heart Which appears by this that when any liquor is injected into its trunk just as it is in the Artery it presently passes through all its branches without lett Which ought to be so to this end that the blood may always because of the violence of the passions freely every way fluctuate and regurgitate in and about the Heart Besides that the left Ventricle
expiration should be excited by the meer rest and ceasing of the aforesaid muscles but from the motion of others opposed to them Moreover the Muscles now cited and opposite and straitning the breast seem to be required not only by reason of their violent exspiration but for their ordinary and constant service at least for the poising the function of respiration for otherwise those other whose office it is to enlarge the cavity of the Thorax being sometimes unmindfull of their task do it either stronger or longer than is convenient wherefore it is necessary they be forthwith admonished by others viz. their Antagonists subservient to Expiration and to be restrained in their duty But the muscles appointed for the straitning the breast are the Sacrolumbus the Triangular and inward Intercostals and some muscles of the Abdomen the use and descriptions of all which are delivered by many Anatomists and most accurtely by Fallopius The inner intercostal muscles as they obtain a contrary scituation so a contrary function to the outer intercostals which namely is to depress the ribs and to straiten the cavity of the breast by forcing it into the Rhomboidal Figure For we are to observe that the carneous and thicker basis of each of these is implanted in the lowest part of the nether ribs and the moving fibres ascending from thence obliquely and forward and dividing cross-wise the rest of the outward intercostals with their smaller and Tendony end are engrafted in the bottom of the upper-rib hence none need doubt but that these inner muscles do depress all the ribs or bring them downward but whilst these ribs are so depress'd that the trunk of the breast is rendred more strait these inward muscles otherwise than the outer do not only incline the ribs downward but also their gristly or cartilaginous processes For Fallopius hath acutely described this That the outward intercostal muscles do onely fill up the inter-spaces of the ribs and not of the gristles but the inward fill up both spaces The reason whereof seems to be after this manner affording a most delightfull speculation of the Divine Architect viz. while the ribs are brought upwards to the exercise of fetching in breath and are withall drawn back towards the Spine that motion commencing backward is performed by the ribs themselves which being first moved together the cartilages easily discharge their function as cords fitted to that purpose wherefore there seems little need of the muscular aid to place these in their order but to put the ribs in action not onely the intercostal muscles afore mentioned but the four other greater ones do continually endeavour it but on the contrary that the ribs may be depress'd and brought forwards together the force taking its rise before is performed by the cartilages as so many leading cords most easily bending the ribs downwards as far as need requires Moreover to this end that the cartilaginous appendices of the ribs may be drawn down and nearer one the other for the exercise of expiration not onely the inward intercostal muscles fill as well the intervals of the cartilages as of the ribs but moreover an entire triangular muscle is allotted for this function for this springing beneath from the bone of the Sternon and ascending upwards obliquely is inserted into to the lower Cartilages which it constrains towards its head and bends the Thorax nearer on the other side That is worthy of consideration which Fallopius hath remarked touching this muscle viz. whereas it is so little and minute in a man that it may hardly be allowed for a Muscle it is stretched out in a Dog along the whole bone of the Breast and reaches to all the Cartilages even those inosculated into the Sternon of the true Ribs Wherefore the triangular Muscle being small in a man is stretched out through the whole bone of the breast in a Dog The Diaphragma follows the motion of the Abdomen The reason of which difference clearly points at the Divine Providence touching the Fabrick of Animals For whereas this Animal is born to most swift and long running that the blood while it is more vehemently agitated may duly be kindled and fan'd as it ought swiftly and strongly to draw in the air even so to expire it for that fresh air may be more freely suckt in it behoves that all the old be strongly cast out and exploded therefore for the stronger discharge of this exercise of the which little use in a man this Muscle of a Dog is allotted a great bulk proportionable to such a work Hitherto of the Muscles that straiten the Trunk of the Breast by whose provision it is manifest enough that the relaxation of the opposite muscles are not sufficient to this function But that while the breast is constrained the Diaphragma ascending upwards may shorten its hollowness it is not enough that it is released from its contraction but it is also necessary that as soon as this ceases the muscles of the Abdomen being contracted squeez together the Bowels and press them upwards by which the Diaphragma being relaxed is lifted up and driven higher into the Trunk of the Thorax From the supposed reasons of these things we may infer The labour of Muscles the same in exspiration as in inspiration no less endeavours of the muscles are imployed in the exercise of expiration than in inspiration nay rather we may affirm them greater after this is added that the Pipes of the Trachea and Bronchii are endowed with muscular Fibres as we have shewed which being only contracted while we expire do cause the air contained within to be cast out with the greater force And truly so it ought to come to pass because the air prevailing with an elastic force doth of its own accord readily enter the pulmonary passages as often as they are suffered to be open but from thence that again it may presently and thorowly be excluded there needs a certain force and compression of the parts to thrust out For although the inspiration precede in course yet it is necessary that expiration follow immediately after and be proportioned according to the fashion thereof for that it may be great the turns or changes of this being greater are requisite Wherefore in vehement exercise of the whole body or of the Lungs alone that the fresh air may more plentifully be drawn in all the old air must be moved not only out of the Trachea and Bronchii but also out of the farthest little Bladders every turn or change of breathing out and expulsed most of it whereas while we draw in the breath only the muscles of the Breast are imployed the Lungs having respite in strong breathing out both the opposite Muscles and the Lungs themselves labour Having thus explained the Organs of Breathing The causes of the above-mentioned motions it remains yet to be inquired into by what instinct being stirred up to motion they so repeat perpetual changes of Systole and Diastole that one
and their functions and uses that they may more clearly be manifest it seems to be material to expose to your view the forms of some of their chiefest parts described to the life together with the explication of their Figures yet it seems proper first to insert a few things concerning the Lymphaeducts and interspaces of the Lobes omitted in the former Discourse The most renowned Malpighius first discovered these little Lobes of the Lungs and their interspaces but to what uses they serve he hath not clearly enough shewed Haply it may seem that these little places and empty spaces within the Lungs are certain receptacles of the air that there may be a larger store of it Notwithstanding it is evidently manifest upon experiment frequently made that the air pufft into the Pipe of the Trachea which is the only entrance into the Lung doth not enter or blow up these interspaces of the little Lobes The interspaces of the little Lobes have passage one into the other and from thence into the Lymphaeducts notwithstanding if you blow into the hole of any of these interspaces immediately all these spaces pufft up do swell in the whole lobe of the Lungs so that all the little lobes distinct by great interspaces will appear with a pleasant prospect as is expressed in the second Figure of the third Table Moreover the Lymphaeducts creeping through the superficies of the Lungs seem to be every where included in little Membranes covering those interspaces and to end in them But as the lymphatic Vessels are all furnished with little valves so those which appertain to the Lungs are furnished with almost infinite as is to be seen in the warm large lobe of an Ox and expressed to the life in Tab. 1. d d d d. That I may dare to conjecture concerning the use of these things Which therefore is done that the vaporous steaming of the blood being received by the interspaces and condensed into water in the Lymphaeducts may be conveyed out it is probable that those cavities intercepting each little lobe do receive the vapors flowing copiously every where from the blood being kindled when they cannot any where else be better thrust down or separated which sweat through their slender Coats into these cavities out of the ends of those Vessels and thence being forced further they are condensed into water to be carried out of the Lungs through those appropriate Vessels moreover lest the Lympha's caused from vapors within those passages and so being made thick should whirle again back into the Lungs which would bring great prejudice to them the thickest obstacles of the valves do hinder For I have frequently admired what becomes of the vaporous steams which incessantly flow in great plenty and sometimes most impetuously out of the blood burning ardently in the Praecordia For although very many of them flye away through the passages of the Trachea together with the air while we breathe notwithstanding one only way of passage or particular sluice doth not suffice to them from every place breaking forth wherefore these little places or empty spaces are every where placed that they may receive those vapors shut up in the Lungs and may drop out the same immediately condensed through the Lymphaeducts as if through so many noses of an Alembick The lymphic Vessels having their passage out of the Lungs incline towards the passages of the Thorax with their numerous branches The progress and distribution of the pulmonary Lymphaeducts and are for the most part mingled with them but they climb upon the Oesophagus in their way as also the trunks of the Trachea and the Aorta and do lose many slips in them by a various insertion likely for this cause that some of the lymphatic humor may be bestowed for making slippery the sides of those Vessels The Explication of the Figures THE first Table shews one entire lobe of the Lungs upon whose superficies the Lymphaeducts are seen spread through every where A. The Orifice of the Trachea being cut lying in the midst of the Vessels B. The Orifice of the Pneumonic Artery lying under C. The Orifice of the Pneumonic Vein placed above it d d d d. The outer Lymphaeducts spread abroad through the superficies of the Lobe e e e e. More Lymphaeducts meeting on the back of this Lobe from whence they pass into the Thoracick ducts The second Table shews one lobe of a Sheeps Lung cut in the midst that the upper part wherein is the trunk of the Vein being removed and the trunk of the Aspera Arteria laid by it self the branching of the Pneumonic Artery is shewn throughout its whole frame viz. through the small and least little Lobes All the passages of this viz. the slips and twigs how small soever being filled and coloured by any liquid thing cast into them are drawn to the life A A A A. The nether half of the Lobe divided containing the branching of the Pneumonic Artery B B B. The Trunk of the Pneumonic Artery belonging to this Lobe C. A hole from whence it s other branch was cut off and removed D D D D. The Trunks from which its other branches because they could not be expressed in this Table were cut off E E E E. The arterious stems thereof stretcht forward into length the side-branches on both parts stretcht out into the right and left side F F F F. The twigs and lesser slips which are every where intermingled with the like from the Veins and Bronchials and at last woven together with the Veins every where encompass the orbicular little Bladders and bind them as it were in clusters G G G G. The Bronchial branches which being cut from the stem of the Trachea laid aside and entring secretly into this lobe of the Lungs are accompanied with branches that bear blood H H. The stem of the Trachea appertaining to this Lobe which lay upon the Pneumonic Artery cut and laid aside f f f f. The stems of the Bronchial branches which are immersed partly in this portion of Lobe described G G G G and are partly distributed in the other half cut off The first Figure of the third Table expresses one lobe of the Lungs according to the branchings of the Aspera Arteria divided into lesser and less lobes the twigs and slips of which Vessel being filled by a liquid first injected and afterwards separated from among themselves towards the little lobes are also drawn to the life A. The Trunk of the Aspera Arteria being cut from the rest of his body B B B. The inner part being cut open that as well the holes leading into all its branches as it s straight muscular Fibres are viewed together a a a. The abve-mentioned holes leading into the every where stretched out branches b b b. The straight muscular Fibres upon which the other circular do lye C C. The upper part of this Tracheal stem being whole or shut that the Ring-like Grisles might appear D D D
obnoxious to depravation than this Pneumonic machine of the breast The organs of breathing being hurt the breathing is hurt also through which by sucking in air we preserve the vital flame of the blood with its motion and heat For whereas the vessels of the lungs belong to the function of breathing viz. the Trachea with the Bronchii and little bladders also the heart with arteries and veins besides which there are nerves with fibres as well musculous as nervous Lympheducts and Glandules also the contents of these Vessels viz. Air the old and fresh blood with its Serum the Lympha and the animal Spirits any fault happening in any of these doth oftentimes discompose the whole Pneumonic function Nor less also the moving Organs of the breast viz. the muscles with the Diaphragma and the nerves appointed to their use And likewise sometimes the animal spirits before they enter into those nerves being ill disposed often cause great disorders in breathing When the chief function and uses of the Lungs have been to convey the blood and air through the whole frames of the parts and their inmost recesses The uses and ends of breathing which use to be hurt and every their smallest passages and every where to mingle them namely for that purpose that the venal blood returning from its circuit and diluted with fresh juice and thereby crude and as it were half extinct may as well be more perfectly mix'd and wrought together as more effectually kindled afresh in all its parts by the nitrous air from hence the chief faults about this business or function of the Lungs do most of all consist in these two things First that the blood hath not due passage through the Sinus of the heart and the pneumonic vessels And secondly because the Air is not drawn in and breathed out in a due manner into the Trachea and its passages The defects and failings of the Lung in its office There are two parts of either of these For first as to the passage of the blood sometimes the fault is caus'd within the right Sinus of the heart or the pneumonic Arteries and also sometimes caused within the pulmonary veins or the left Ventricle of the heart Secondly as to the Air the failure is chiefly in inspiring and exspiring although each function offends sometimes equally There are divers accidents of each and many causes and ways of its being done whereof we will here briefly touch upon the chief Therefore first First in respect of the blood when the blood doth not duly pass through the right Ventricle of the Heart and the Pneumonic Arteries either it happens by its own fault or by the fault of those passages and sometimes by the fault of further passages For sometimes the stream of blood stops in the nether region of the Pracordia by reason of obstruction in the other moreover sometimes the defect or fault of the air breathed in stops the free passage of the blood What relates to that fault of the blood The opinion of the famous Sylvius concerning the blood fermenting in the Lungs when it passes not quick enough through the right Sinus of the Heart and Pneumonic Arteries the opinion of the Renowned Sylvius should here be discoursed but that it would be too tedious and from our purpose For he supposes The descending branch of the venal blood moistned with chyme together with the lymphatic humour returning from the whole body hath the nature of an acid-sweet spirit and in the mean time its branch ascending impregnated with choler from the bladder of the gaul mixt into the mass of blood does participate of an oily volatile salt and so by the meeting together of these something contrary to themselves a gentle and friendly contention or boiling is stirred up in the right ventricle of the heart in which and for which the fiery parts lurking and being shut up in each being freed and set at liberty do rarifie the chyle and blood and so change and alter them that they exercise the function of life and heat as well as motion and nourishment through the whole body Which seems not likely to be true There are many reasons why I assent not to this ingenious and neatly-framed Hypothesis For besides that many do far otherwise determine about the origine and dispensation of Choler and so not without strong reasons and experiments are thorowly perswaded by eye-sight that there is not any such boiling up of the blood of a different quality and striving or contending in the right ventricle of the Heart Our opinion hereof Our judgment continues still as it hath been that both streams of blood washed thorowly with the fresh chyme do consist altogether of one kind and for that cause the milky Vessels of the Chest carry about part of the Chyle so long a journey which they pour into the descending trunk of the Vena cava just as the meseraick Veins pour the other part into its ascending trunk also that the lymphatic humor together with the Chyle is poured into the subclavian Vessels so that it may very commodiously be reduced into blood neither truly doth there seem need of other or more passages Moreover we determine that that humor rightly constituted doth agree with and is easily assimilated to the mass of blood as well as the Chyle it self made sweet without any contention raised in the heart But if the lymphatic humor returning from the Brain and nervous kind as well as from the Glandules degenerate from its due temperature and contract a sowreness as it often comes to pass then being re-infused into the venal blood it overcomes it and it precipitates it into serosities and from thence great streamings of urine do ensue Moreover we have shewed elsewhere that the Diabetes is provoked from such a cause But such a flux of the lymphatic humor is so far from exciting a greater boiling up of the blood in the right ventricle of the Heart that rather on the contrary from thence often chilness of the whole or stiffness with a weak Pulse and sometimes swoonings or convulsive fits are provoked accompanied with a plentiful and pale urine The reason whereof without doubt is that then the clear humor flowing from the brain and nervous parts turns the blood into serosities and cools it by too much diluting and for that cause the animal spirits being destitute of their vehicle either faint or run into irregular motions But truly as we altogether deny an Elastic effervescence of the blood in the right Ventricle of the Heart from contention of dissimilar parts The pneumonic circulation of the blood is stopt sometimes by the fault of the heart it self so as often as from thence the blood is not cast out into the Lungs after a due manner we determine it to happen not so much from the proper fault and defect of the blood it self as from the animal faculty For if the spirits actuating the moving Fibres of
Secondly the Nitrous particles of Air are wont to be obscured or blunted by other accessories also sometimes they are too much sharpened For as often as the South-wind blows the Air is too moist and thick inasmuch as the Nitrous particles are seiz'd upon by the watry and sulphureous and are much blunted so that while it is drawn in the blood is not vigorously kindled but like green wood put into fire it rather smokes than burns bright wherefore during such a state of Air we become stupid and dull and unapt for motion but on the contrary the North-wind blowing the cooling sharp and most nipping particles are adjoined to the Nitrous and the blood is enough kindled and we breathe freely yet the Vital flame is every where restrain'd by intense frost disproportion'd thereunto and unless refresh'd by motion and heat it is frequently entirely extinguished 2. Besides these faults of the Air whereby breathing is wont to be hurt The defect of air hurting breathing proceeds from the pneumonic Organs moreover this evill sometimes proceeds from its defect inasmuch as it cannot be drawn in in plenty enough Of which effects though there are many and divers causes yet for the most part it happens in respect of the organs of breathing either hindred as to their motion or their passages obstructed 1. The Organs of breathing are either meerly passive viz. which are moved as the Lungs or are Active and move themselves and those together as the muscles of the Chest and Diaphragma In every of these the impediments of the motion by which breathing is hurt happen variously And first what respects the Lungs we mentioned before that they sometimes very much swell by reason of the vessels being much distended and fill'd with blood insomuch as being stiffe and inflexible they obey not the turns of the Systple and Diastole of the Chest Moreover it happens sometimes through a phlegmon little swellings and other concretions of divers forms that a like stiffeness is caused in them Secondly the active organs of breathing or the moving parts viz. the muscles of the Chest and Diaphragma are wont to be perverted or stopt from their moving function by divers causes A solution of continuity made in any part of these either by clotting of blood or by falling down of the Serum and other homors as in the Pleurisie and Scurvy or in those that are wounded or bruised doth every where cause pain in the place affected with impotency of motion and difficult breathing Moreover sometimes without pain or any evident cause those parts being hindned from their motion do produce a most heavy pursiness As is frequently seen in an Asthma Suffocation of the womb and in certain other convulsive or hypochondriac distempers The reason of which passion without doubt consists in this for that the animal spirits appointed to the moving function of those parts are disturbed about their Origine or hindered in the passages of the Nerves and are turned aside from their due influx into the moving fibres Insomuch as many who are sound enough as to their Lungs and only obnoxious to affects of the Brain and Nerves are frequently surprized with horrid fits of an Asthma as we have at large declared in another place 2. The stopping of air hindering breathing whereby it less freely enters the Lungs frequently happens by reason of the Conveyances viz. the passages of the Trachea being shut or not enough open For indeed those passages are wont to be stopt as we have formerly observed touching the Vessels bringing Blood and prohibit the full entrance of air when they are either obstructed or compressed or more narrowly contracted The various ways of Obstructions Though there are many causes and wayes whereby the passages of the Trachea are wont to be obstructed yet chiefly and most often a Catarrhal distillation of the Serum while it departs from the blood and flows out of the vessels bringing blood into these parts which being first thin and sharp produces a troublesome Cough afterwards thickening by digestion and cleaving to the sides of the Trachea exceedinly straitens the ways of inspiration A Catarrb and shortens them by quite stuffing up their extremities In like manner the sweating out of extravasated blood as also of Pus or ichorous matter out of the Lympheducts or Veins into the tracheal little bladders doth frequently produce an Asthma and often a Consumption the reason of which sort of distempers shall be more largely explained hereafter Secondly it is manifest enough by common observation that the Tracheal passages as well the last as the intermedial often-times are straitened or shut The swelling of blood by which the passages are press'd together by compression For after a plentiful meal or abundant drinking of Wine or strong Ale inasmuch as the pneumonic vessels are very much distended by reason of the turgency of blood and the sides of the Trachea being press'd together do not admit of a free and usual entrance of air men otherwise healthful enough do breathe difficultly and painfully Which truely we esteem to happen from the lungs being filled and extended rather than from a cram'd stomach hindering the Systole of the Diaphragma Moreover for this reason even in the very paroxysmes of feavers a frequent and painfull breathing is manifest Neither onely from the turgency of blood but also from the same stagnating or extravasated and also from stony concretions and divers other manners the vessels of the Trachea being pressed together cannotdischarge a free breathing 3. The passages of the Trachea being sometimes more nearly contracted and closed from their fibres convulsively disposed deny a passage to the Air for due breathing The Cramps of the tracheal passages From hence when there is no obstruction or ill conformation in the lungs as also no consumptive disposition yet from those fibres preternaturally convulsed and drawa together dreadful fits of an Asthma frequently arise Whereas we have in another place discoursed of these passions it will not be requisite here again to repeat that discoure Resides these accidents of breathing hurt there are certain others which are stirr'd up by reason of the Air prohibited in its frist entrance viz. in the Nostrils the throat the Larynx from a tumour or ill conformation For the Polypus in the Nose the Quinzy in the Throat or inflammation of the Tonsils do render a difficult breathing in the same manner as a heap of sand about a Haven obstructs the ingress and regress of Ships But truly since the reasons of those passions and their manner of being made are exposed to sense it seems superfluous here to deliver their causes SECT I. CHAP. IV. Of Expiration hurt AS Expiration is much easier The act of expiration is easier than of inspiration and with lesser trouble performed than Inspiraration so it is less endangered to be stopt or perverted as to its function for in truth the contractive endeavours of fewer muscles are required to perform that
insomuch as some do affirm that the meer relaxations of the moving parts whereby the dilatation of the breast in discharged doth suffice for its constriction Hence when in the agony of death the ultimate labour is to open the breast and fetch breath by which the flame of life may be continued as soon as that endeavour is become frustrate the animal exspires and is readily extinct But truly we have already clearly enough evinced that the tasks of breathing out no less than those of breathing in are performed by the help of peculiar muscles Wherefore when it happens that the Organs of Expriation are either hurt of prejudiced there must needs follow difficulty or depravation of that function The moving parts which bind together the breast and straiten the cavity thereof are especially the inward muscles of the breast some belonging to the Loyns and others to the Abdomen as also the muscular fibres of the Larynx and Trachea by reason of some faults occupying sometimes these anon them either single or many together exspiration is wont to be stopt or perverted after a diverse manner Expiration hurt sometimes proceeds from the fault of inspiration Although the hurt of this function frequently depends upon inspiration being prejudiced notwithstanding it sometimes happens alone so that when we suck in Air easily and duely enough we return it disturbed or perversly which truely is wont to come to pass through divers causes and after many manners the chief of which we shall here briefly touch upon 1. Sometimes being alone depends on various causes For first when a wound or convulsive or paralytical distemper happens in one muscle which causes exspiration or in more for that cause the cavity of the Thorax cannot be so freely drawn together and compress'd for the more full breathing out air or breath 1. On the wound of a part moving Hence not only such as labour in a Pleurisie but in a tumour or wound in the intercostal muscles or the Abdomen cannot easily couth or sing or perform other acts of stronger expiration Neither is the due drawing together of the Thorax less stopt by reason of the moving fibres of those parts affected either by a resolution or a cramp 2. 2. In a Cough The act of expiration whereas it is variously perverted or disturbed so it chiefly happens in a cough in sneezing in laughing in crying and in Hiccough into the reason and manner whereof we will briefly enquire And first we shall speak of a Cough A Cough may be described The description of a Cough that it is a vehement more frequent unequal and loud expiration stirred up either for the quieting of some troublesome and provoking thing or for expelling of it out of the Lungs through the passage of the Trachea For air being violently excluded and dash'd in the way on the sides of the Tracheal passages whatsoever is in any place impacted in them if it be easily moved it discusses and wipes it away and frequently sends it out of doors For the exciting of a Cough It s formal reason and the manner of its being done both the muscles contracting the Thorax and also the moving fibres of the Bronchii do concur in motion with a joynt force together For while the muscles straiten the cavity of the breast and every where squeeze the whole lungs these fibres one while contracting these tracheal passages another while them closing behind the air while it is driven forwards do endeavour its expulsion more quick and vehement A more intense sudden inspiration precedes every act of a Cough to wit that the air being admitted in greater plenty may presently be more violently driven out with noise in which endeavour not onely the new that is fresh breathed in but also the old being heaped up before in the tracheal little bladders is driven forth together with a noise for the encrease of breath blown out and when what is troublesome is not settled nor removed at the first assault the vehement exspiration of this kind is repeated by a frequent course even to the great wearying of Nature The first cause of every Cough is an irritation of the nerves or sibres belonging to the lungs concerning the nerves we are to observe It s primary cause that not onely the branches and their slips inserted into the Lungs but others from which they do arise or with which they do intimately communicate being provok'd in places far distant from the breast immediately cause a cough for which cause oftentimes a sharp humour being lodged within the Brain and from thence falling down into the little head of the pectoral nerves is wont to produce a most troublesome Cough or Asthmatick distempers as not long since we have declared by notable instances For the same reason a pain inflicted on the nostrils palate or Gula provokes a Cough or rather a vain attempt of coughing Moreover a little Serum distilling from the Arteries into the upper parts of the Gula or Larynx produces a frequent and very troublesome Cough without any notable prejudice of the Lungs But truly this provocation inflicted on the nerves and fibres distributed in the Lung it self more frequently and truly more violently provokes an endeavour of Coughing which is repeated by courses till what is troublesome be turned forth or the provocation restrained Of this kind of Cough from the nerves a notable Example shall be after set before you The provoking causes producing a Cough are manifold The evident causes thereof and make their stay in several places for besides that the nerves as we but now intimated and also the membranes with which there is an intimate communication with the Lungs being provoked in the open Nostril give an impression of that passion at a distance to the Lungs most frequently that irregular exspiration is stirr'd up by reason some incongruous or in some measure unproportion'd thing is cast into the Lungs For in the first place that this troublesome thing may be removed the nerves and the nervous fibres dispersed about the Lungs are irritated afterwards by the consent of these the muscles of the breast that draw it together and the moving fibres of the Trachea at once are forced into vehement and often repeated contractions Every Cough is either moist or dry The kinds thereof in the former a certain humour being deposited in some place within the tracheal passages is shaked by coughing and being to be thrown out upwards is cast into the mouth That humour whereas it is manifold and after divers sorts for the most part it is either call'd serous or nutritious or purulent or bloody Of the former there are many kinds and differences namely as to its consistence it is either thin or thick or crude or digested as to its colour it is either white or yellow or somewhat greenish also sometimes it is blewish or black Moreover A moist Cough a moist Cough is variously distinguished as to
Very many of these being endued with a narrow breast and a neck somewhat long and of a constitution very tender contract a Cough from the least occasion neither can they endure a cold or moist air To some of these a mansion in a City is very prejudicial where the air is breathed in thick and smoaky on the contrary to others prone unto the same disposition it is very friendly the reason whereof we shall diligently inquire hereafter To all of them a North-wind is for the most part an enemy considering that it usually irritates a Cough also a Spitting of blood a Pleuisie or Peripneumony viz. the pneumonic or the thoracical Vessels being thereby stufft and in the mean time the blood being rendred more rurgid and sharp by reason of transpiration hindred and the effluvia's restrained within the mass thereof For an hereditary disposition to a Phthisis doth chiefly consist in these two things In what it consists viz. 1. In regard the Patients being endued with a more sharp and elastic blood do require a more plentiful transpiration which perhaps if it be less granted the matter that was wont to evaporate redounds upon the infirm Lungs 2. If the pneumonic Vessels be too loose and tender they do not duly contain the Serum and other recrements of blood within the dissolved mass thereof but they sometimes suffer both them and a certain portion of the blood it self to break out into the Tracheal passages whose moving Fibres when they are infirm do not presently turn forth what is poured out into the cavities but they suffer it to abide and putrifie in the same place and at length to degenerate into black filthy gore corruptive both of the Lungs and blood 3. What the consumptive diseases of the breast are A Phthisis is sometimes the product or consequent of some other previous distempers of the Breast Those consumptive passions chiefly are Empyema's Pleurisies a Peripneumony and Imposthume of the Lungs and sometimes the small Pox Measles also irregular Feavers ill or slightly judged do cause the same effect The chief of these distempers or at least those which are proper to the Thorax together with the rendring the reason of the causes and how they dispose to a Consumption shall be declared hereafter with the reasons and manner of procedure in the mean time we are to take notice that this kind of fault is common to them all that is to say they dissolve the unity and weaken the tone of the Lungs and pervert the temperature of the blood whence whatsoever incongruous or distempered thing is poured out upon them from its depraved mass they do easily admit thereof and difficultly or not at all drive it back 4. The influence of the air for exciting a Consumption The procatarctic causes of a Phthisis being now explained viz. those which consist as well from the blood as the Lungs there is another common to them both which may be justly added and although altogether extrinsec hath great affinity with them both viz. the condition or temper or the air breathed in For such is the influence hereof to some consumptive persons that the cause of the disease is sometimes wholly ascribed to the incongruity of the air wherein they dwell and for a cure the alteration of air or soil is preferred to all other remedies whatsover Hence many of our Country troubled with a Cough or being in a Consumption flock to the Southern parts of France and others in the mean time who cannot go beyond Sea or will not presently hasten to remove out of the City-smoke into the Country as to a most undoubted refuge wherefore all our Villages near London which injoy a clear and open air are esteemed as so many Spittles for consumptive persons Notwithstanding all do not alike receive help from such a change of places for many either passing to France or to Country Villages do in those places rather find their graves than health And therefore London is not presently to be forsaken by all phthisical persons for I have known may obnoxious to a Cough or Consumption to have enjoyed their health much better in this smoaky air than in the Country So that for cure of the same disease while some avoid this City as Hell others flye to it as to an Asylum The reason of these things do clearly appear out of the Doctrine of Breathing before handled The grosser and City-air to some consumptive persons healthful to others hurtful for we do demonstrate the blood passing through the Lungs both as to its kindling or vitality and as to its motion doth chiefly depend on nitrous air suckt in whence it is a consequence that the tenor of this ought to be so proportioned to the temperament of that that the blood being moderately kindled within the Pracordia may burn out clearly and vigorously The reason whereof is inquired as well without smoak and sootiness as without too intense a flame and that it may pass the pneumonic Vessels freely and without any hindrance or leaving of recrements Wherefore a moist and close air as it is healthful to none so to them that cough it is especially hurtful on the contrary a serene and mild air moderately injoying the Sun and wind as it is healthful to all persons so it is friendly to all consumptive persons As to other conditions of the air some escape a Cough or lose it living in mountainous places exposed to the Sun where the impendent Atmosphere being free from all thick smoaky and feculent vapous whatsoever abounds with nitrous particles for those whose thick and feculent blood abounds with an impure Sulphur to kindle this duly and to waste the dregginess there is need of a very thin and nitrous air If the Lungs be not too tender but firm and strong they endure the more fierce assaults of its particles on the other side they who have a thin and subtil blood easily dissolvable and endued with a more pure but very little Sulphur and having tender and soft lungs very sensible and of a finer texture these persons being impatient of a nitrous and sharper air are most at ease and best in a thick and more sulphureous one Wherefore it conduces to these persons that they breathe the gross and more fat air of a smoaky City which to an impoverished and more thin blood doth afford Sulphur which fails sometimes and also Nitre and doth something thicken and fix its subtile consistence moreover it dulls the substance or texture of a Lung too much sensible and more thin and is a defence against the invasions of a more sharp and improportionate Air. A sulphureous air healthful to some consumptives It is manifest by frequent experience that a thicker Air provided it be sulphureous proves very benign to some phthisical persons that I do not say to all It is a common observation that a Consumption seldom infests those Regions either in England or Holland where fires
are nourished by turffe and do breathe a very sulphureous odour yea rather those places are chiefly wholesom and frequently sanative to persons obnoxious to a Phthisis or labouring under it To which we may add that a suffumigation of Sulphur and Arsenic which is filled with much Sulphur is reputed for the curing of almost incurable Ulcers of the Lungs although the last yet the most efficacious remedy Sulphureous Medicines chiefly agreeing Moreover add to this that pectoral Medicines prepared of Sulphur are far to be preferred to any other so that Sulphur is justly reported by Chymists to be the Balsam of the Lungs By what order and by what means these Medicines do work and so notably help in diseases of the Thorax we shall hereafter make diligent search into in the mean time that sulphureous Air is found helpful to certain phthisical persons the reason consists in these two things viz. in the first place as we now intimated from such an Air suckt in there is help brought to the jejune and depauperated blood and to the tender Lungs Secondly that the sulphureous Particles being suckt in with the nitrous do provide against The reason thereof discoursed or take away the acidities of any of the humours by which their flowings and extravasations into the Lungs do chiefly arife And for this reason it is that sulphureous Medicines being also taken inwardly do confer so excellent a help to them that cough or are phthisical therefore Sulphur as I now hinted hath the report of being the Balsam of the Lungs For as balsamic things applied to an Ulcer or Wound extinguish the acidity of the Ichor there sweating out and corrupting and paining the little Fibres soon ease the pain and afterwards heal the wound so also the sulphureous Particles passed into the Lungs either with the air or with the blood in as much as they provide against or abolish the acidities of all humors i.e. the blood the Serum the Lympha the nervous or nutritive Juice they conduce to the prevention or cure of a Consumption We shall in what follows more at large declare the cause when sulphureous Medicines shall be particularly treated of The conjunct and procatarctic causes of a Phthisis being thus handled it will not be necessary to discourse much touching the evident causes For in what manner a closing of the Pores by cold a surfeit or tipling and other errours of several sorts in the six non-naturals dispose to those distempers and sometimes presently do bring them The three times or distinct states of a Cough is so clear that it needs no explaining Neither is there any reason we should be long delayed about the Semiotical part of this disease nevertheless it is fit we observe the divers states or distinctive signs which certainly belong unto it 1. When it is meerly a Cough 2. When it begins to degenerate into a Phthisis 3. When it is a perfect and almost desperate Phthisis From which things duly designed the Prognostic of the above-mentioned affections will be very apparent 1. And in the first place what belongs to a new Cough and as yet alone When new there is no suspicion of a Consumption this taking its rise from any cause whatsoever in bodies predisposed to a Phthisis will scarce ever be free from the suspicion of danger but in a strong man and one who hath often before endured a Cough Scot-free it will not be immediately to be feared for when being stirred up from a more forcible evident cause without Feaver or indisosition of the whole body it shall not be very troublesom then it meerly passes for a cold being taken and is altogether neglected or in a short time is wont to be finished without many or very considerable Remedies Moreover if a small Feaver with thirst and want of appetite accompany this there is hope that the blood being restored to its due temperament the Cough then will cease of its own accord but if it be protracted longer and not easily yield to vulgar Remedies and produces much spitting and that discoloured it must not be any longer neglected but be provided against by a method of healing and by fit remedies and an exact course of diet For then it may well be suspected that the Lungs being prejudiced in their structure do not circulate the blood entirely but let fall the Serum and Lympha and frequently the nutritive Juice and moreover those humors so laid aside do putrifie and from thence the blood is defiled which by a reciprocal hurt prejudices again the Lungs 2. When it begins to induce a Consumption But if to a Cough growing daily worse and worse with plentiful and thick spittle a languishing and pining of the whole body loss of appetite difficult breathing thirst and fervent heat of the blood be added there is great cause of suspicion that it is come at least to the first limits of a Phthisis if not further Wherefore it will behove us to use all means whereby the Lungs may be freed from the great quantity of matter heaped up together and be defended from its continual assault or invasion and also that the mass of blood may be cleansed from all dregs and restored to its due temperament whereby it may rightly contain its serosities and other humors within it self or transfer them to some other place than to the Lungs 3. When it becomes a confirmed Consumption But if beyond the state of this distemper now described plenty of spittle and that discoloured shall be daily increased and all other things growing worse and worse a dejection of the whole strength and a hectic Feaver with a continual thirst night Sweats an Hippocratical face an utter decay of the flesh almost to the driness of a Skeleton happen upon all these then for the most part no place is left for Medicine but only a dreadful prognostic at least all hope of Cure being waved we must insist upon Anodynes whereby an easie death may be procured What therefore belongs to the cure of a Cough in general The curing method and first against a beginning Cough according to the three above-mentioned states of this disease a threefold method of healing ought to be appointed viz. that bounds as it were being set we may more distinctly prescribe what is to be done for the cure of a Cough whilst being on this side the limits of a Phthisis it passes only for a cold catched 2. What manner of healing to a beginning Phthisis 3. What to a Phthisis consummated or desperate 1. Although against a new Cough for the most part there are used only Remedies Empirical and scarce any of the common people but are furnished with many and divers of this sort which every where without the advice of a Physician very many confidently take and without method and give them to others yet men of a delicate constitution or inclining to a Consumption hereditarily or sometimes formerly
while a great Mill is driven about with a screeking noise and a dreadful aspect of the wheels the distempered be put into the Trough or Receiver of the Grain or Corn and from thence the sudden cure of this disease sometimes happens The reason whereof without doubt consists in this that the Animal spirits being put to flight and forced into fresh distractions they relinquish their former disorders moreover the convulsive matter is either dissipated by that disturbance or is forced into other nerves where it is less troublesome The Empirical cure of this disease being described after this manner The rational cure together with the remedies vulgarly used and the rendring a reason of the cause at least probably unfolded from hence it will be lawfull to design a rational method of curing and perhaps more efficacious against childrens Coughs of this kind Wherefore in such a case sometimes successefully enough I have prescribed according to the following forms And seeing we ought to begin with purging Take of the syrup of Peach flowers one spoonfull of Aqua Hysterica one scruple mix it Purging and let it be taken with government Or take of Mercurius dulcis 6 grains Scammony prepared with Sulphur Resine of Jalap of each three grains make a powder give it in a little Pulp of a preserv'd Cherry to a lad six years old and let the dose be encreased or lessened according to the age let the Purge be repeated in 6 or 7 days If the Patient as it often happens be prone to vomit Take of Oxymel of Squils 6 drams Salt of Vitriol 4 grains mix it for a child of six years old and according to this proportion let the dose be accommodated to others I have known a Vomit of this kind taken every morning for four or five dayes together with good success Vesicatories or Medicines drawing blisters are in daily use Vesicatories and are applyed sometimes to the Nucha or nape of the neck another while behind the ears then to the inside of the arms near the arm pits and as soon as these sores begin to heal in these places let others be raised in other places Instead of Beer let the following Decoction be used for ordinary drink Take China-roots an ounce and half of all the Sanders of each half an ounce the shavings of Ivory and Harts-horn of each three drams let them be infused and boiled in six pints of spring water to the consumption of half adding Raisins stoned an ounce and half Liquorish three drams Take of Spirit of Gum Ammoniac with Salt Armoniac a dram Mixtures Syrup of Chin-moss three ounces Aq. hysterica an ounce the dose is a small spoonful in the evening and morning fasting Or Take of tincture of Sulphur two drams dose three drops in the evening and first in the morning in a spoonful of the Syrup of Cup-moss To some endued with a hot constitution and while they cough their countenance is spread with redness or rather blackness I have prescribed Phlebotomy or drawing of blood with Leeches to two or three ounces with good success Take Hog-lice living and cleansed two ounces powder of Aniseed a dram Nutmeg half a dram fine Sugar an ounce bruise them together and pour upon them six ounces of Hysop-water of Magistral Snail-water two ounces stir them together a little and press them out hard the dose two or three spoonfuls twice a day Hitherto of a Cough and its Remedy while it is only an entrance to a Consumption now it remains to treat throughly of the distemper it self having passed the limits of this dangerous disease and to design a method of curing and the forms of romedies which are proper to heal an inveterate Cough when either being neglected or not easily giving place to remedies it begins to degenerate into a Phthisis namely when it arrives to that state that the blood being dissolved in its consistence doth not only pour out the superfluous Sorum but also the nutritive Juice and perhaps the nervous the Lympha and other its superfluities on the Lungs and lodges them within its passages Of what sort the beginning of a consumptive Cough it and in the mean time the corruption of the Lungs is so much increased that the little Bladders being distended or many of them broke into one so that a solution of continuity or an Ulcer being caused a greater plenty of corruption is daily heaped in and moreover the matter in that place gathered together because it is suffered to abide there long putrifies and for that reason doth still more corrupt the Lungs themselves and defile the blood flowing through In this case the Therapeutical indications shall be chiefly these three Three indications concerning its cure 1. To stop the dissolution of the blood 2. To draw out the filth from the Lungs 3. To heal the Lungs hurt viz. in the first place to stop the dissolution of the blood which is the root of all this evil and to make provision that it pour not out the matter any longer in such abundance upon the Lungs Secondly by expectorating the purulent matter heaped up within the Lungs and to evacuate it quickly and sufficiently Thirdly to strengthen and dry the Lungs loosned from their unity or being too loose or moist or otherwise infirm lest they be daily more and more corrupted and give more reception to the morbific matter Every of these indications suggests various intentions of healing and requires remedies of divers kinds and many ways of administrations The chief of which we shall here briefly treat of 1. The first indication suggests three intentions of healing Therefore what the first indication suggests that the dissolution of blood may be prohibited these three things as much as may be ought to be procured viz. First that the mass of blood may contain and assimilate whatsoever of nutritive juice it may be furnished with and that it be so proportioned that it neither offend in quality nor in quantity Secondly that the acidities either generated in the blood or poured into it from some other place may be so destroyed that the blood retaining as yet its mixture or temperament may not be prone to flowings and pourings out Thirdly and lastly that all the excrements produced in the blood may be derived from the Lungs to other Emunctories and places of Evacuations 1. The first intention that the nutritive juice may be proportioned to the blood and assimilated by it As to the first intention of healing viz. that the nutritive Juice may be proportioned to the blood let it be advised before all things that they who cough and are phthisical abstain chiefly from drink and that they take liquid things in a very small quantity for that the blood being infirm in its temperament so long as it is not too much imbued with fresh juice may be able to digest small portions and retain it within its own consistence Moreover let that fresh juice consist
dram to be strewed upon burning coals Take Gum of Ivie Of the more strong Frankincense of each two drams Flower of Brimstone one dram and half Mastich one dram with a dissolution of gum Tragacanth form Troches Take of white Amber Arsenicals Olibanum of each two drams prepared Orpiment half an Ounce Styrax Labdanum of each one dram and half with solution of Gum tragacanth make Troches for fumigation Mountebanks do ordinarily prescribe the smoak of Arsnick to be suckt into the mouth Smoak of Auripigment like Tobacco kindled in a Pipe and sometimes with good success Moreover it is in practice with the Vulgar to burn like Tobacco in a Pipe little bits of cloth stained with Arsenick such as wherewith the walls of Taverns are hung and so suck the smoak into the consumptive Lungs for cure 3. Of a confirm'd Consumption These things being thus unfolded concerning a Cough and a Phthisis beginning both as to what belongs to the Pathologie and cure it remains now lastly to discourse of a more painfull Phthisis confirm'd and almost desperate and to consult what is to be perform'd when the lungs being very much vitiated and affected with one or more filthy ulcers neither the air nor the blood do rightly pass through them but choak or corrupt the mass thereof by continually suggesting filthy corruption insomuch that a hectick feaver and an Atrophie by reason of nourishment being frustrated infest the diseased with the loss of all their faculties and by daily weakening their strength precipitate them to the grave The most certain sign of this disease growing desperate uses to be accounted a pain very troublesome with an inflammation of the throat for this symptom argues a great putrefaction of the lungs from whence the putrid effluvia's exhaling are thrown about in the narrow passage of the throat The formal reason thereof which wound and grievously irritate those tender fibres there In this case the cleansing of the lungs as also the drying up of the Ulcer are in vain designed for all hotter Medicines ordain'd for those purposes and fit enough in the beginning of a Phthisis are not to be endured in a confirmed one inasmuch as augmenting the inflammation of the lungs they procure a hectick feaver thirst wathings and other more painfull symptomes or call them back afresh For truly in such a state of this disease where onely the prolongation of life is proposed with a light toleration and an easie death those remedies help chiefly which bridle the fervour of the blood allay the heat in the Praecordia and restore the sprits and gently cherish them Hence for food Asses Milk also Water-gruel Barly-broths Cream of Barly and for drink Ptisan Emulsions water of milk distilled with Snails and temperate pectoral herbs are usually of greatest success Forms of remedies in a desperate Consumption Syrups and Linctus's which appease the inflammation of the throat and Lungs and facilitate expectoration but chiefly the more mild Hypnoticks whereby moderate rest may be procured may be frequently or daily taken The forms of these are common enough but however according to our method we will annex some of the more select of each kind Take of Barly half an ounce Decoctions candied Eringo roots 6 drams parings of Apples one handfull Raisins stoned two ounces Liquorish three drams boyl them in three pints of spring-water to two make a Ptisan to restrain thirst take it 3 or 4 times a day also in the room of ordinary drink if it agree Take the tayls of twenty Crevises candied Eringo roots one ounce a crust of white-bread Raisins stoned two ounces Liquorish 3 drams boyl them in 3 pints of Spring-water to two strain it and take 3 or 4 ounces three times a day After the same manner is prepared the Decoction of Snails Take of Snails half-boyled and cut three pound Distilled waters ground-Ivy 6 handfulls Nutmegs sliced numb 6. crum of white-bread two pound fresh milk 8 pounds distill it in a Pewter Still The same way is distilled the water of Crevise-tayls The dose 3 or 4 ounces three times a day Hypnoticks sweetned with pearl'd Sugar or Sugar of Roses Take ears of greeen Wheat as many as convenient distill them in a common still drink three or four ounces three times a day sweeten'd with pearl'd Sugar Take syrup de Meconio three ounces water of green Wheat 6 ounces mix them Hypnoticks drink two or three spoonfulls at bed-time every or every other night Take Conserve of Mallow-flowers wild or garden three ounces Lohoch de pino two ounces Eclegma's Syrup of Jujubes two ounces make a Lohoch of which take often a dram and half or two drams What hitherto we have discoursed of concerning a Cough of every kind whether it be solitary and simple or the forerunner and companion of a Phthisis also what is to be prescrib'd in every case touching the method of healing it would be easily illustrated by the history of Cures or by the Anatomical observations on those that have dyed by that disease For instances of this sort and very many examples are every where had and happen daily it pleases us here to annex a few of the more select out of the large choice of these accommodated to the chief kinds of a Cough and Phthisis And first I will endeavour to illustrate the type of a simple Cough by one history or two and which takes its rise of it self and is altogether void of the suspicion of a Phthisis It is now many years since I took care of the health of a certain Student The History of a Cough threatening a Consumption obnoxious to a Cough from his tender years and who was wont frequently to undergo the more painfull affections of it and those of long continuance This person seemed of a melancholick temper of a sharp wit of an indefatigable spirit of a constitution indifferently strong but that his Lungs originally being infirm did suffer when the blood dissolv'd into serosities In Summer as long as he transpired freely he lived healthily enough but in the Spring and Autumn when the blood changing its temperament those serous fluxes came upon him either of their own accord or from any sleight occasion he fell easily into a Cough with abundant and thick spittle notwithstanding this distemper frequently within six or seven dayes as soon as the mass of blood was purged throughly by the Lungs vanished leisurely without any great use of remedies But if to the aforesaid occasions of this disease were added some stronger causes as chiefly the obstruction of the pores and errors touching his diet sometimes a more prodigious and stubborn cough neither presently nor easily yielding to remedies and threatning nothing less than a Phthisis did come upon him then manifestly the patient for the first days suffered light shiverings in his whole body and the sense of a Catarrh in his Larynx afterwards by frequent
and vigorous he recovered his former health in a short time Fits of this kind more seldom infested him in Summer-season but in the restof the year repeated three or four turns and brought the sick even into great hazard of life If disquisition be made of the nature causes and formal reason of this unwonted and as it were irregular kind of Coung it is manifest it proceeds like all other from the provocation of the Lungs nevertheless as to the matter exciting its seat and manner of affecting it is doubted because neither thick spittle nor plentiful thin as is usual in other distempers is here cast out neither doth the Patient complain of feeling a Catarrh nor of any weight of the Lungs Wherefore not as in a common Cough does the serous humour either slowly or plentifully sweating out of the Trachea or pneumonic vessels into the little bladders or pipes of the Trachea induce the afore mentioned symptoms But it is plain from thence that the passages of the aspera Arteria are wholly empty of the serous or thick humour because the deep and sounding Cough throws off nothing Moreover neither from the blood impacted in the Membranes of the Lungs doth this Cough take its origine because neither feaver nor thirst nor pain are present here as in a Peripneumonie Besides neither doth the morbific matter seem to adhere to the nerves or muscles appointed to the function of breathing because then besides a Cough Asthmatical or otherwise convulsive fits would sometimes urge with a sense of strangling which notwithstanding did not happen to our patient Having frequently and seriously meditated about the aetiologies of this very difficult case I am at length induced to think that a certain serous and sharp matter as being loaded with a scorbutical taint falling from the head by the passage of the nerves doth enter into the nervous fibres and Membranes of the lungs or Trachea which cleaving throughly to them is by degrees encreased to a fulness The conjuct cause of the disease and at length being chaf'd and grown turgid with a perpetual provocation creates so troublesom a Cough We have in another place declared the matter of this kind impacted in the Coats of the guts and the neighbouring parts about them not rarely to excite a scorbutical Colick for many days yea sometimes weeks infesting them with vo miting and a most sharp torment and what else is this Coungh but a certain convulsive distemper of the lungs whose taint notwithstanding according to the capacity of the part labouring is imprest rather and more on the motive than on the sensitive Power For the lungs however twicht adn hurt do suffer small pain or scarce any at all notwithstanding from any light occasion they are invaded by storms and fits of coughing Indeed we compare this distemper of coughing so much the rather to the Colick because the subjects of either of them that is to say the Trachea and the guts as to their coats vessels little fibres and glandules are after the same manner fashioned The chief cause of the Cough now deseribed depends upon the morbific matter heaped together within the little fibres of the rough arteries to a provoking fulness wherewith when they are loaded first a quick and painfull breathing infests onely with amornings Cough because from the beginning onely some small portion of that matter being disquieted provoke the part afterwards when the whole mass thereof growing turgid almost perpetually twitches the fibres there follows a most troublesom cough which also being often repeated endures a long season because the morbifick mass impacted in the parts affected is neither presently cast off by the strength of nature nor easily gives place to any remedies For in all the fits of this disease I have made tryal of various methods of curing and of medicines of divers kinds though with little success That distemper beginning at any time is wont to make a long period maugre all remedies The medicines commonly called pectoral as Syrups Lohochs Eclegma's or Lambitives have conferred little benefit to its cure not withstanding sometimes it hath seemed good to admit of them into use for this purpose that they might make slippery and moisten the Lungs lest they run the hazard of being rent by a violent Cough and their vessels burst asunder for sometimes a more fierce fit troubling our sick Patient he hath been wont to cough out a little blood though no thick spittle A gentle Purge both in the beginning and declination of this distemper hath succeeded well Opening and diuretical Apozemes are ever administred with success both which he used enough through his whole course instead of ordinary drink Evening and morning he took some drops of the Tincture of Sulphut with the Milk-water of Snails late at night I was sometimes constrained to administer a Dose of Diacodion or of liquid Laudanum his belly for the most part loose enough that it seldom required Clysters in two of his fits he breathed a vein whereby nothing of success ensued In the last fit The usual method of curing beinning about the Autumnal Equinoctial which passed away a little more lightly and gently this following method of healing was observed First of all this Purge was given A Purge and after four days repeated Take of Mercurius dulcis ten grains Resine of Jallop four grains mix and make a powder to be taken in a spoonful of Syrup of Violets Take China-roots sliced a dram A Drink Grass-roots three ounces Chervil an ounce candid Eringoes six drams shavings of Ivory Harts-horn each three drams Raisins of the Sun stoned three ounces boil these in three pints of Spring-water to two pints strain it and use it for ofdinary drink Take syrup of Jujubes two ounces A Mixture Diacodion an ounce spirit of Salt Armoniac with Gum Ammoniac a dram mix them the dose a spoonful at night and early in the morning He was mauch relieved with this medicine notwithstanding he took it only every other or third day and for change sometimes a dose of the tincture of Sulphur with syrup of Violets The disease declining a Purge was twice repeated and afterwards recovering his health by degrees within two weeks he became healthy enough But when I beheld him not only obnoxious to frequent relapses of coughing but every fit to be irresistible when it assaulted him and its stay very long notwithstanding the use of remedies and all this threatning no less than a Phthisis at length I advised that as well for his preservation as for the more easie cure of the distemper if it should return he should travel into a hotter Region Hereupon he did not much delay but sails into France about the beginning of November and from thence by a straight journey to Montpelier where abiding half a year he was sick only twice and both tiems lightly afterwards returning into England quite free from a Cough praise be to God he enjoys his perfect health
Nature as far as is possible to be presently sent out of doors But if the extravasated blood be thrown into the interspaces of the little Lobes or soaking out of the outer Membrane fall into the cavity of the Thorax it doth propagate an Empyema and frequently an Imposthume in that place But for the most part the blood subject to fall from the pulmonary course produces various kinds of bloody spittle Either in the Larynx or in the middle of the Bronchii or in the orbicular little bladders according as it makes its nest either upwards within the cavity of the Larynx or a little beneath about the intermedial passages of the Trachea or lastly further within the orbicular little bladders The first distemper proceeds alone from the mouths of some Artery being opened which covers the trunk of the Trachea the next sometimes perhaps from this cause yet more often from the pneumonic Arteries themselves being open or burst asunder which vessels as they are greater pour out often a dreadful quantity of blood the spitting out whereof proves plentiful and violent in regard that the muscles of the whole breast together with the fibres of the Trachea are much provoked and greatly contracted But if the spring of bloody spittle consists in the lowermost little bladders the blood is thrown out more sparingly but with a profound frequent and very troublesom Cough 3. And from hence which was in the third place purposed the differences of bloody excretion out of the Lungs and the manifold modes and courses of bloody spittle are made known For the blood soaking into the Larynx after a small tickling in the throat without coughing or hawking doth easily and almost insensibly ascend into the mouth and if an extravasation of this kind of blood happens in sleep it presently flows out of the mouth upon wakening they being scarce sensible of it in as much as the moving fibres of the Trachea being contracted while one sleeps have then emptied the blood fresh distilled into the mouth But if from a greater vessel gaping or burst about the middle of the Lungs the blood which is ever frothy does break out abundantly into the Tracheal passages this by an outragious Cough raised thereby is forthwith cast upwards with violence and in great plenty insomuch that the sick seem rather to vomit than cough out blood And finally if the blood breaking out of the foldings of the vessels wherewith the orbicular little bladders are incompassed falls down into those little cells from thence it is discharged by turns in lesser quantity and not unless by a strong and very frequent Cough So much concerning the formal reason The procatarctic and evident causes thereof the conjunct causes and differences of an Haemoptoe as to what belongs to the primary and evident causes either of them are manifold and various In the former number are reckoned first an hereditary indisposition of the Lungs whenas they have originally been weak and soft with a straitness of the breast Moreover their ill temper from a Cough Empyema or Pleurisie going before and especially an obstruction or ill conformation do very much dispose to spitting blood and so much the rather if in such a habit an acrimony or Dyscrasie of the blood shall accrue from an ill course of Diet unwholesom Air or by any other means The suppression of the Menstrua the Haemorrhoids or blood flowing from the Nostrils incline most to a spitting blood Secondly among the evident causes ought to be reckoned primarily the excess either of heat or cold for when the blood grows above measure hot or the transpiration thereof through the Pores of the skin is hindred thereupon swelling after a huge manner it frequently bursts out of the pneumonic Vessels From hence Hippocrates long ago observed and as yet it is a vulgar observation That spitting blood most frequently happens in the winter when the North-wind blows Neither less seldom hath the use of bathing brought this evil upon many before the use whereof they were healthful enough Moreover many contract this from drinking of wine and strong waters from a blow a fall hollowing vomiting coughing or any other violent stirring of the whole body or of the Lungs Also certain poisons and according to Hournius the Lunar beams the reason whereof doth not easily appear neither doth there remain any credit thereto are reported to provoke this distemper The Prognostics of this disease are enough known to the vulgar The Prognistics of this disease whereas there is not any one of them who doth not suspect the spitting of blood as very dangerous Nevertheless whereas the kinds hereof are various one is found more or less dangerous than another The blood soaking out of the vessels of the Trachea is often free from any evil moreover when breaking out from the lowest and lesser pulmonar Vessels it often admits of Cure at least it is much safer than a plentiful spitting of blood happening from the great branches of the Artery being opened into the Trachea But the predisposition of the Patient makes a great difference in the Prognosticks of this disease for if blood-spitting be provoked by reason of a solitary evident cause and shall happen to a body formerly sound and well set there appears far greater hope of help than if the distemper arising of its own accord shall happen to a cachectical phthisical scorbutic or otherwise sickly body However 't is a common observation that this disease is dangerous and always difficult to cure the reason whereof is also clearly manifest for as much as the function of the Lungs consisting in a perpetual motion is altogether contrary to the method of healing a wound whereto primarily ease and rest are required In like manner this happens to be a greater hindrance to its Cure in as much as the frame of the Lungs is not a Parenchyma as was thought but a texture or very subtile web of innumerable vessels the unity whereof if once dissolved it will be altogether impossible for the ends of the disjoined vessels to meet again together or the space to be filled up with flesh or callous as in other parts But there is this only to be hoped that while the ends of the vessels grow together incongruously and always imperforated the circulation of the blood ceasing in the part distempered may be supplied by another neighbouring part which indeed rarely succeeds without hurt or prejudice of the whole Lungs As to what appertains to the Method of healing the Haemoptoe or spitting blood The Cure thereof the curative indications shall be chiefly these two viz. to stay presently and restrain the flux of blood then secondly to heal the dissolution of unity without any relicts of a Consumption in the Lungs I. As to the former these two things are chiefly to be procured 1. Indication viz. first that blood flow not to the part distempered and secondly that in the mean time the opening of the vessel
made What affection of the blood produces it from whence this disposition of blood proceeds by which it becomes clammy and viscous like ropy wine the general reason hereof is this viz. that the more thick parts of blood are not made thin enough by the more subtile so that all of them being equally mixed and mutually incorporated at length the good humors separate themselves into their appropriate functions and the superfluous are perpetually discharged by their proper Emunctories But on the other side in as much as the sulphureous particles of the blood being combined together with the saline and earthy too much exalted ensnare and entangle all the rest for that cause its liquor containing within it self all its recrements and impurities grows clammy as glue and in that regard contracts an inflammable disposition For it is obvious to every person that the blood that grows clammy in this manner is rendred prone to obstruct the narrow passages of the vessels which surely are very small in the Lungs moreover for the same reason they are disposed to become fearish viz. because retaining obstinately within its own bosom all the feculencies and ecrements from the same presently gathered into a heap it is constrained into a great turgescence or swelling whereby of necessity an inflaming obstruction of the Lungs takes either its origine or augmentation Moreover as to the procatarctic cause of this disease The fault of the Lungs produces it very frequently the faultiness of the Lungs is joined herewith and determines that general intemperament of blood to affect this part in such a sort For as the clammy blood grows hot the more strong and sound Praecordia do frequently discharge the designed mischief from themselves and the taint being fixed to the Pleura or about the habit of the body a Pleurisie or Rheumatism is rather caused than a Peripneumony Nevertheless the tender Lungs being bnoxious to a Cough or formerly prejudiced in their frame either by spitting blood or other distempers of the breast from the blood boiling up while it is too much bound nd clammy in its own consistence they easily engender an obstructing Phlegmon Hitherto of the conjunct and procatarctic causes of a Peripneumony The evident causes of a Peripneumony as for what regards the evident causes whatsoever suddenly perverts the temperament of the blood or restrains its free transpiration ought to be referred hither as chiefly are excesses of heat and cold or the inordinate drinking of Wine or strong Waters any veement exercise and the drinking of some waters and those especially icy Besides sometimes a malignant distemperature of Air doth engender this disease in many and akes it Epidemical Authors in Physick do every where observe and it is also a vulgar observation a Peripneumony frequently succeeds or comes upon a Pleurisie It often succeeds or follows after a Pleurisie but nothing is more usual than in a Pleurisie a bloody and thick spittle and as it were purulent to be voided Hence a regat disquisition arises by what passage or ways the matter by spittle cast out can be conveyed from the Pleura to the Tracheal passages Some think that this being fallen into the cavity of Thorax is sucked into the Lungs as with a Sponge and others suppose that it is transferred thither by the Membranes adhering thereto by which the Lungs often stick unto the Pleura But truly either way seems improbable if not impossible For first that the Lungs do not suck in the contents of the hollowness of the Chest is manifest from hence because in a Dropsie or wound of the breast when they happen the Lungs being unhurt neither water nor blood is at all discharged by coughing though frequently great plenty of this or that humor be there which presently flows out of its own accord from the Thorax incision being made But that Sometimes the Membranes growing from the Lungs knit themselves tot he Pleura is clearly manifest by Anatomical observation yea and by this way of return I have sometimes known the purulent matter translated into the side and there by an Issue made by Art or Nature to have been evacuated with a heathful Crisis nevertheless such Membranes of the Lungs joined to the Pleura do seldom pre-exist and in a Pleurisie which is a very acute disease they cannot like a Mushroom be the issue of one or two days moreover though sometimes those obscure passages may be ready at hand which perhaps by some admirable instinct of Nature discharge something out of the Lungs towards the precincts of the Thorax yet it seems against the Oeconomy of Nature that they can derive any corruption outwardly engendered to this most noble part within which surely is the fountain both of life and heat As to this if it may be lawful to propound our Judgment The reason of this is inquired into I am induced to think that a Peripneumony and Pleurisie are one while singular and separate affects and another while bred together and coexisting from the first and another while are by course one after another or succedaneous For the procuring cause being stirred up into act so that the blood growing clammy and boiling together obstructs in some places the lesser vessels the nest of the disease sometimes is fastned on the Pleura or separately in the Lungs sometimes in each of them together and sometimes first in one and then in t'other but for the most part the Pleura being first healed presently the same morbific cause invades also the pneumonic Vessels Moreover we have known a various shifting of this affect viz. that it has first troubled the right or left side presently that being deserted to have occupied the Lungs and afterwards both being deserted to affect the Brain and frequently to transfer its seat from thence into the above-mentioned places But for the reason aforesaid a Peripneumony not only succeeds a Pleurisie but frequently a Squinancy and sometimes other distempers for while the blood growing clammy and boiling together continues a Feaver in the whole it transfers the obstruction causing a Phlegmon variously hither and thither And from hence the solution of that observation is clearly manifest which has so much puzled Interpreters viz. that a Palsie or dead Palsie of one side doth sometimes succeed a Peripneumony because the blood that being clammy had lately obstructed the pneumonic Vessels afterwards stuffing certain foldings of the vessels of the Carotides prohibits the engendring of animal spirits in this or that part of the head and so restrains their influence into the respective nervous parts The differences of this disease From what hath been said the chief differences of a Peripneumony are made plain namely that it is either a simple distemper or joined together with a Pleurisie Squinancy or some other and then it is either primary or secondary Moreover it is usually distinguished as to the Feaver and state of breathing to wit according as this is more or
out by Cough so that in four or five hours he threw off about two pints Moreover after his Cough continuing about two months he daily spit out purulent matter thick and very stinking untill his flesh being consumed and he wholly spent was reduced to languishing and a notable Consumption From the stench of his Spittle and breath the whole Chamber was so filled that his Servants or those attending him could not endure the ill scent thereof After the Imposthume was thus broken I and two other well-known Physicians being advised with with all circumspection we prescribed Medicines to absterge and heal the Imposthume and to cleanse the Blood and Lungs and to redeem him from an imminent Consumption A Tincture and syrup of Sulphur together with Pectoral and Vulnerary Decoctions and Distillations were taken also Lohochs and balsamick Pills day after day in a constant course with Clysters gentle Purgatives and Diureticks were taken between whiles then these Vaporations and Fumigations as well sulphureous as arsenical were used morning and evening After these things being long and carefully used did help nothing I often propounded the opening of the Thorax but the sick man obstinately rejecting this operation said he would rather dye than be murdered yet at length when I assured him that this remedy or none was further to be attempted he began to deliberate with himself and immediately baring his breast he suffered me to search a place where I might apply a Cauterie the business was presently put out of doubt for a Tumour appeared on the left side of the Sternon between the 5th and 6th Vertebra Instead of a Cautery I applyed thereto a suppurating Plaister and within three dayes the top of that swelling became red and soft out of which being the next day opened first a thin ichor and a little after a yellow and concocted pus flowed out and afterwards it continued daily to stream out more plentifully from that time his stinking Spittle began to abate and within fourteen days it ceased quite the morbific matter obtaining through that orifice both an easie and more convenient issue Although by the effect it was manifest that the passage of that orifice lay open into the breast and perhaps into the middle of the Lungs yet no liquor cast in by a Syringe could either penetrate or be forced in thither so secret and intricate are the conveyances which Nature forms for her last aids that by the same paslage by which the morbific matter is exterminated nothing more hurtful can enter This opening of the side was at length chang'd into an Issue and a Pease or a wooden pill being put in there came forth daily for half a year together plentifull ichor and in the mean time this well-known person all corruption of the breast being shook off and the fleshy habit of his body being recovered became healthful in all respects and lastly that issue being removed to his arm he bears no sign of that nor any other disease in his breast After this Cure so by chance accomplished it hapned I performed another like it on purpose not less successefully for shortly I was sent for to a noble Lady which had been for many years obnoxious to the heat of the precordia with a Cough One day when she coughed she was throughly sensible of something broke in her Lungs and presently she voided abundance of meer pus and that stinking after that this kind of Spittle continuing with a Cough for a week notwithstanding the use of remedies seemed rather augmented than diminished I advised to have an Issue cut in her side near the very place whence she perceived the pus to ascend which she readily granted Within three days from the orifice being opened meer pus began to flow out like that she discharged by Cough Then after the morbific matter had issued out by that Fontinel both the Cough and the spitting of pus wholly ceased and within a Fortnight the patient recovered her firm health After this I was sent for to another viz. strong man and as strong a drinker who being affected with an Imposthume of the Lungs also spit up an abundance of pus and very stinking matter This Patient by a certain rude contumacy abhorr'd any issue wherefore he would not suffer any to be made in his side notwithstanding he took any Medicines offered to him by a long use of which Remedies he escaped free from that disease the Medicines whereby he chiefly received help were prepared of Sulphur as our Syrup and Tincture taken daily and very frequently To these for Vehicles were added one while a Decoction another while a pectoral Hydromel another while Lime-water with an infusion of pectoral as well as vulnerary Ingredients Moreover Fumigations and Smokes especially of sulphureous and arsenical Ingredients did contribute very notable help SECT I. CHAP. XII Of an Asthma AMong the Diseases whereby the Region of the breast is wont to be infested An Asthma a most terrible disease if you regard their tyranny and cruelty an Asthma which sometimes by reason of a peculiar symptome is denominated likewise an Orthopnoea doth not deserve the last place for there is scarce any thing more sharp and terrible than the fits hereof the organs of breathing and the precordia themselves which are the foundations and Pillars of Life are shaken by this disease as by an Earthquake and so totter that nothing less than the ruine of the whole animal Fabrick seems to be threatned for breathing whereby we chiefly live is very much hindred by the assault of this disease and is in danger or runs the risque of being quite taken away An Asthma is denominated from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which is to breath pursie or difficultly and may have this description that it is a difficult frequent and pursie breathing with a great shaking of the breast and for the most part without any Feaver The act of breathing depends as well on moving the Lungs The causes of respiration hurt the Structure whereof ought to be of that fort that its passages and all the pores may perpetually be open for the free sucking in and letting out air as from the parts or organs moving them which by alternate turns of Systole and Diastole do cause the hollowness of the breast and consequently the Lungs themselves to be dilated and contracted whereas therefore there are many and divers reasons of disturbance whereby respiration is prejudiced for the most part they may all be reduced to these two heads viz. that there is a fault either in moving the Lungs or in the parts or instruments that ought to move them and from hence the differences and kinds of this disease are best of all design'd for according to the various nature and position of the morbific cause it is called an Asthma either meerly pneumonick proceeding altogether from the passages bringing in aire being obstructed or not enough open or it is meerly convulsive which only arises by reason
of a defect of fault in the motive organs or mixt when either parts conspire in the fault which origine every great and inveterate Asthma is wont to have of each of these we will treat in order 1. The ancient Physicians The Ancients allowed the cause of it only from the Bronchia obstructed and for the most part hitherto the Moderns have only acknowledged the first kind of Asthma judging the next cause and almost the only cause of this Disease to be the straitness of the Bronchis viz. inasmuch as the spaces of those passages being either straitned together by obstruction or compression as often as the use of breathing is required do not admit of plenty enough of Aire wherefore for the more free inspiration of aire as shall be needfull the organs of breathing do most difficultly labour with throes most frequently repeated But that some are found obnoxious to fits of an Asthma Or vapours from the Spleen or Womb but erroneously without manifest taint of the Lungs it was wont to be ascribed to vapours from the Spleen Womb Mesentery or some other bowel undeservedly enough but surely that passion without the straitness of the Bronchia or fault of those bowels we have in another place sufficiently evidenced to arise from Cramps of the moving parts and shall be presently clearly made out But in the mean time by what means it may arise also from the passages of the Trachea obstructed or compressed it lyes upon me to declare The straitness of the Bronchia After what manner the straitness of the Bronchis arises inducing the first kind of an Asthma is supposed to come to pass by an obstruction as often as either thick humours and viscous or purulent matter or blood extravasated are forced in upon them or that little swellings or Schirrus's or little Stones stop up their passages or finally that a Catarrh of a serous humour suddenly distills upon them Moreover the same distemper is thought to be raised by compression as often as matter of that kind and of every kind of them shall cleave to the passages of the pneumonic Arterie or vein Surely an asthmatical disposition depends upon these various causes and manners of disturbance but all invasions of the disease or at least the greater fits are usually provoked by reason of some accidents or occasions For while the stream of blood sliding and running down gently can be content with a small breathing it passes through the precordia without great labour either of Lungs or Breast But being boyling and passing through the Lungs more impetuously it requires a more full inspiration of aire for the freer admittance of this through strait passages presently all the breathing organs are alarmed into most frequent throes Whatever causes an effervescence of the blood is the evident cause of an Asthma Whatsoever therefore makes the blood to boyl or raises it into an effervescence as violent motion of the body or minde excess of extern cold or heat the drinking of Wine Venery yea sometimes mere heat of the Bed doth cause asthmatical assaults to such as are predisposed It is usual that those who are obnoxious to this disease oftentimes dare not enter into a Bed only sleep in a Chair or on a bed being covered with garments The reason whereof is Why Asthmatical Persons are worse in bed that the body covered and heated with bed-cloaths the blood being a little raised into a more quick motion and grown hot requires a more plentifull sucking in of air than may be supplyed from the passages of the Trachea being straitned for the more blood passes the Lungs each Systole and Diastole by so much for the enkindling and eventilation thereof the air ought to be more plentifully and quickly brought in and sent forth to which task when by reason of impediments it is not easily dispatched yet in some manner to be performed the ultimate endeavors of all the parts appointed for breathing are made use of with a great contention of the whole breast Moreover the blood being stirr'd is not only an occasion but also in some part a cause in those that are asthmatically predisposed for the vessels bringing blood being thereby more fill'd and distended within the lungs compress the Tracheal passages being already very strait and render them much more close II. A convulsive Asthma which we judged to be the second kind of this disease A convulsive Asthma and to be raised without any great obstruction or compression of the Bronchia from the mere Cramps of the moving fibres is not limited to one place or to any peculiar organ but being of a diffused energy it is extended to almost all the parts employed in breathing whereof one while this another while that or some other is in fault It s Seat manifold and diffused For a convulsive affection inciting an Asthmatical invasion hath regard to the moving fibres of the vessels of the Lungs to the Diaphragma to the muscles of the breast to the Nerves which belong unto the Breast or Lungs nay to the origine of those Nerves planted within the Brain and whilest the morbisic matter dwells in every of these places hindering or perverting the work or breathing it brings on the fits of this Disease as in another Tract we have somewhile since plainly demonstrated For the animal Spirits destin'd to the function of breathing if at any time they are very much molested and constrained into irregular motions enter inordinately into the fibres as well nervous as moving of the organs of breathing and make them for that cause one while to be contracted another while to be distended irregularly as also their solemn and equal turns of Systole and Diastole to be variously disturbed or hindered The morbific cause or matter provlking the Spirits prepared for the pneumonic work as in divers places so chiefly in these three The morbific matter consists in several places is wont to advance its force or power viz. 1. Either in the muscular fibres themselves or 2. In the branches or nervous slips or lastly within the Brain by the origine of the Nerves 1. As to the former 1. In the muscular fibres the heterogene matter being inimical to the Spirits is sometimes shaken off from the Brain into the trunks of the Nerves and from thence by their passages and slips if perhaps it shall be in very little quantity without very great or sensible hurt slides down to their lower ends And when it falls in the nervous fibres and being heaped up daily shall at length sensibly increase unto a great quantity it begins to trouble the inmate Spirits and to provoke them into asthmatical Convulsions which forthwith infest and are encreased by reason of evident causes neither do they utterly cease untill the stock of matter so accumulated be wholly dispers'd and consumed afterwards when it being renewed arises to a fulness the fits of that disease return and are for that cause
by the common consent of most is judged to arise in as much as the yellow choler not at all or not enough received The Jaundies from the ends of vena porta into the passages of the cholerick pore overflows into the mass of blood and pollutes it with its greenness whereby also the very skin is discolour'd That obstruction is wont to happen after many manners and in various places The cause of it For sometimes it happens near the extream ends of either kind of vessels viz. the end of the vena porta and the porus bilarius the interspaces whereof happen frequently to be compressed and stopt by reason of the Parenchyma of the Liver being tumefied or otherwise vitiated wherefore the humour of the gall not being transferred out of the separating vessels of the porta into the other receiving vessels turns back upon the blood Secondly the passage of the humour of the gall is sometimes intercepted in the middle passages of the cholerick pore for that the cavities of these are filled either with a viscous or sandy and sometimes with a stony matter as is plainly discerned in the Livers of beasts in the winter senson while they are fed with hay and straw Thirdly it is also manifest by Anatomical observation sometimes an obstruction in the very bladder or the gall or in the cystic passage is the cause of the Jaundies for if at any time it being filled with stones receive not the choler or being here shut up or grown together it restrains the descent of the choler towards the guts that humour although well separated from the blood is constrained to flow black into the mass thereof and so propagates the Jundies Against this most received opinion by which it is judged The opinion of Sylvius of the cause of the Jaundies that the cause of the Jaundies for the most part consists on this side the vesica fellis or about it towards the Liver the most Renowned Sylvius altogether places it without this viz. in the Cystic or common passage For supposing the choler not to be separated from the blood within the passages of the Liver but in the very bladder of the Gall to be propagated of a humour brought thither by the Arteries He judged the greatest part being carried upwards by the passage of the pori bilarii to be poured into the blood for some notable uses and also another part to descend beneath to the Intestines also for necessary uses wherefore if this latter sluce be shut all the choler is carried upwards into the blood and filling it too much with this humour perverts it from its genuine temper into an Icterical But truly lest the stopping of the passage of the bladder or of the common passage neither of which easily happens or from any light occasion may seem less efficacious to excite any Jaundies therefore whether such an obstruction hath place or no the most Renowned man ingeniously supposes besides The choler while it is generated in the bladder does undergo sometimes a notable change by which it is moved and is born about more plentifully and impetuously towards the blood with which yet it is less mingled than is was wont to be but only confounded together with it and so more easily departs from it and infects and tinges the solid parts with its colour But that the choler in the Jaundies may be rendred unfit a mix with the other humours or to be nearly united he determines it to be done by a spirit too valatile mixed plentifully with it and so making it more spirituous and immiscible with others He confirms this assertion by two instances viz. in as much as the most spirituous poison from the biting of a Viper and the too much use of the more generous drinks viz. Wine and Strong-waters causes sometimes the Jaundies Moreover he endeavours to procure credit to this Hypothesis for that this disease is wont to be cured not only by medicines opening obstructioins but by them which blunt the force of a raging volatile salt of which sort are the decoction of Hemp-seeds also Venice soape with many other things of the same sort It belongs not to this place neither is it to our purpose to descend to end this contention nor dare I now rashly determine it since it hath tired so many Renowned Wits of the Moderns whether really the choler be made in the bladder of the Gall or whether it be only separated from the blood in the Liver the great organ of separation I confess this latter opinion best pleases me The Authors opinion And weighing these things seriously I am induced to think the cause of the Jaundies to consist chiefly in this that the choler being sever'd in the Liver is not by reason of the ways being obstructed at all or not enough conveyed to the bladder of the Gall but that it must of necessity regurgitate into the mass of blood notwithstanding in the mean while we deny not but this affect may sometime arise although more rarely from the Cystic passage or common pipe being obstructed But also we think the fault of the blood to preceed in part and perhaps sometimes wholly for the morbific cause when to wit from its sulphurous and fixt Saline Particles above measure exalted the choler is more plentifully or quicklier generated in the mass of blood than can be separated or discharged forth by the ordinary ways wherefore this separating every where from the blood with the Serum The cause of this disease sometimes in the blood is affixed to the solid parts and impresses its tincture upon them And without doubt it is for this reason that some poisons and chiefly the biting of Vipers and the dayly use of more generous drinks induces the Jaundies in bodies before sound for whose cure sometime Phlebotomie and medicines reducing the blood to a right temper are wont to profit more than those opening obstructions Moreover it seems for this reason that a tertian intermiting Feaver so frequently terminates in the Jaundies for we may not suspect the passages of the Liver can be by any means obstucted since in all fits so great an agitation of the blood and humours by cold and heat and such an-evacuation of them happens either by vomit or sweat and truly even as feaverish fits are caused inasmuch as the sulphurous part of the blood being too much advanced in the first place perverts the nutritious juice into a morbific matter and afterwards being inflam'd consumes and exterminates it so when the fixt salt is at last exalted together with the sulphur in the blood and for that cause meer choler is abundantly engendered the feaversh enkindling of the blood ceases by reason of the restrictive force of the fixt salt and in place thereof the distemper of the Jaundies doth succeed But as the blood being too much advanced to a sulphureo-saline distemperature causes the Jaundies in any though least predispos'd to it so in others
many senses together viz. it is a Tumour of the Abdomen First in respect of blood from a waterish tumour contained within the cavity thereof The water making this tumour sometimes encreases to a huge inundation and scarce credible quantity I have once seen a Tub would hold 15 gallons filled with water taken out of the Abdomen of a woman dead of a Dropsie But whence that humour proceeds also by what manner and from what causes it gathers together in the belly first and afterwards is sensibly augmented and lastly by what passages and by what vertue and operations of Hydragogue Remedies it may again be taken from thence and evacuated seems most difficult to be unfolded As to the former viz. the encrease of water It doth not always proceed from the Liver Spleen some have thought it to descend from the Liver and others from the Spleen distempered into the cavity of the Abdomen and so this bowel or that being vitiated always to be the cause of an Ascites But that this is otherwise Anatomies of many dead of this disease do manifestly declare when after the inundation of the belly the Liver and Spleen and found often without fault And truly these bowels do not seem the Springs of any such illuvies being endowed with no cavityes wherein waters might be accumulated together wherefore the origine of an Ascites as of a standing Pool or Lake is to be derived from a River or at least a glutt or inundation of some Humour The humours that flow within the passages or Vessels as Brooks The humours by which it is produced are are chiefly these three viz. the Blood the milkie Humour and the Lympha The showering or distilling of water may come to pass from the nervous Liquor which sometimes slowly and insensiby sweats out of the fibres and membranes and from vapours condensed within the hollowness or some Cavity of the Body Whether by these wayes an Ascites doth rather and oftener proceed we will now search And in the first place as to what relates to the blood it is without doubt First the Blood the Serum falling from the masse thereof too much dissolved as it doth excite Fluxions and Catarrhs of various kindes so it sometimes stirs up the greater illuvies of waters viz. Dropsical wherefore when an Anasarca proceeds altogether from this cause and when oftentimes an Ascites comes upon that disease not immediately heald we may well enough inferr that either distemper is induced from a watery humour every where poured out from the little mouths of the Arteries Moreover it is not much improbable that the Serum of the dissolved Blood is first and solitarily poured out of some end of the Coeliac and Mesenteric Arterie being open into the Cavity of the Abdomen and so brings on an Ascites without an Anasarca going before and so especially if perhaps it happen that scirrhous Tumours Ganglion's little swellings or preternatural Concretions of another manner are first raised about the Mesentery the Spleen the Liver the Womb or any of the other bowels of the nether belly for because the Circulation of the blood is hindred in those places that the blood being carryed through the arteries may be some way brought back the serous part being thrust out from its company falls into the cavity For truly it is most evidently manifested that it so comes to pass by this Experiment mentioned by us in another place viz. If in a living animal the jugular veins being taken up and bound with a thred the reduction of the blood be stopt the whole Region of the head swells in a short space with a water between the skin and clearly hydropical And truly I have more frequently observed that an Ascites hath followed upon secret tumours gathered and raised in some place in the lower belly which certainly happens for the reason above recited When the course of blood being obstructed the watery part is extravasated in a short space that humour is not meerly serous but besides the nutritious Liquor ordained to nourish all the solid parts is emptyed into the belly wherefore while this Region swells up the members are extenuated and the Lympha taken out from an Ascites with heat thickens and grows white like the white of an Egge It is also very probable 2 3. The milkie and watery humour that the milkie Vessels being burst asunder pour out their humour into the cavity of the abdomen Truly the most renowned Sylvius thought this disease most frequently engendred from such a cause And truly as out of the milkie or watery Vessels viz. one of them or both together being divided or opened we may well suspect the illuvies of water or chyle sometimes to overflow the bowels of the nether belly so the following observation seems to confirm the same thing Of late one that had been long sick of the Jaundies and in the mean time temperate and abstemious of drink to which he was not prompted by thirst contracted an Ascites increased in a short time hugely After that medicines were administred in vain a Paracantesis is attempted according to the manner of Sylvius with a hollow Needle out of the orifice not icterical water but limpid and thin flowed out abundantly from whence we may inferre that hydropic humour flowed not out of the mass of blood for then it had been coloured but distill'd out of the lymphic or milkie vessels into the cavity of the abdomen We have joyn'd together as akin the ways of the milkie and lymphic Vessels in propagating an Ascites because both vessels do convey the chyle or what is analogous to it to the common Receptacle and many branches or leading Pipes of either kind are distributed about the bowels of the nether belly in the mean time it is not improbable but that a solitary fault of either vessel may sometimes produce an Ascites As to the other wamys of generating an Ascites proposed in the beginning I am scarce induced to think such an inundation of the belly can easily arise from the distilling of a nervous humour or by reason of vapours there condensed although perhaps in a Tympany where the cavity of the abdomen is enlarged and transpiration hindred the effluvia that were wont to exhale being forced inwards are changed into Lympha or water wherefore for the most part an Ascites is ever conjoyn'd with that disease The immediate or conjunct causes of an Ascites being design'd after this manner An Ascites often the product of the Jaundies which indeed seem to be either a watery humour poured out of the Vessels bringing Blood or Lympha or Chyle poured out of the proper passages of them both not we must in the next place inquire about the more remote causes of this disease viz. for what occasions and after what manner the vessels affected of either sort deposite their burdens into the cavity of the belly First therefore The kinds of a Dropsie that the watery part of
frequently so raised even the belly also doth from thenc swell the more forasmuch as the Blood being agitated and poured out deposits in that place more largely the Serum and for that cause the mouths of the Vessels are more loosened and opened so that they may more readily let fall water prone to depart from the mass of blood But the Remedies which are chiefly wont to be administred with success near the places affected when a Cure is intended without a Paracentesis are Clysters and Plaisters The former draw the Serum out of the Vessels and Glandules of the Guts and Mesentery without fusion of the whole mass of blood Glysters and Plaisters which the stronger purging Medicines do excite which being so emptyed do imbibe a little the extravasated Lympha For this purpose the ensuing Clyster wont to be prescribed by us in this case is most fit in regard it contracts the intestinal fibres together and draws the Serum imbibed by the blood or contained formerly therein towards the Reins Take a pint of Vrine of a sound man that drinks Wine Forms thereof Venice Turpentine dissolved with the Yolk of an Egge an ounce and a half Sal Prunella one dram and a half make a Clyster which repeat daily Sometimes Plaisters yield help in an Ascites yet let them be such as by a certain restringent and comfortable virtue strengthen the bowels and bind together the moughs of the Vessels lest they too much spue out their serosities for this purpose I use to apply the Plaister Diasaponis with successe Or Take of the Plaister of Minium Paracelsus Plaister of each what suffices make a Plaister to be applyed to the Abdomen If this disease is accompanyed with a Tympanie Epithemes of another manner are fit as we shall hereafter declare The great and most present remedy of an Ascites is that the waters may be drawn out by a Paracentesis being made which administration however doth not oftner cure the disease than kill the Patient wherefore there is need of exact caution to whom and at what time of the disease it ought to be administred to persons of an ill habit who have been long ill in whom the conformation and temper of the bowels is wholly depraved it will be in vain to have the Lympha drawn out by the Paunch being pierced for thereupon immediately the Spirits faint and the strength is dissoved and after a while a new illuvies of the morbific humour succeeds When and to whom a Paracentesis is convenient in an Ascites But those who being formerly of sound bowels and healthful enough as to other parts when they fell into an Ascites from some great and evident cause as we are not at first presently to make a Paracentesis so neither if it be needfull ought we to deferre it too long for an incorrigible depravity of the Bowels is contracted by a longer delay while they remain a long while drowned and as it were boyled in water It is beside our purpose to describe here the administration of a Paracentesis whether it be done after the ordinary manner or by a hollow Needle according to Sylvius this part of Chirurgery as dangerous when Physitians seldom prescribe yet Quacks and Empiricks rashly and unluckily essay it Artists not being consulted we will relate here for conclusion the History of a true and huge Ascites lately cured without and Paracentesis A young Woman wise to a Merchant being slender and proper A history of a cure while she gave suck to her Child to encrease her milk day and night did immoderately guzzle one while plain Ale another while Posset-drink After having used this kind of dyet for a fortnight she contracted a vast Ascites in a short time the beginning whereof she was not in the least sensible of for her Abdomen being great with water fluctuating within did much swell up and its bulk when she turned from one side to the other fell without the Ileon and borders of the rest of the body when in the mean while the flesh of all her Members was very much consumed that she seemed no less in a consumption than a Dropsie The Child being weaned and a better course of Diet being appointed she betook her self to Medicines and took in the first place the more mild Hydragogues as well purgative as diuretical but without any advantage also she was worse after every purge but being committed to our care and almost desperate I handled her after the ensuing method I prescribed these Medicines for the most part forbidding Ale and any potulent liquor medicined excepted Take of the leaves of Plantane Brooklime Clivers of each 4 handfuls bruised and pour upon them of water of Earth-worms and Rhadish compound of each three ounces press them take it twice a day viz. at Eight in the Morning and at Five in the Afternoon She continued long in the use of this Medicine but did sometimes vary the Composition sometimes changing the herbs sometimes the Liquor poured on them Take of the reddest Tincture of Salt of Tartar an ounce and a half she took 20 drops at night and early in the morning in two spoonfuls of the following Julep drinking seven spoonfuls after it Take water of Elder-flowers Saxifrage of each six ounces water of Snails Earth-worms and Rhadish-compound of each two ounces She wore a Plaister of Minium and Oxycroceum upon her Belly The following Clyster was given first daily afterwards every two or three days Take Vrine of a healthy man one pound Turpentine dissolved with the Yolk of an Egg an ounce and a half Sugar an ounce Sal Prunella one dram make a Clyster By the constant use of these things her Belly asswaged within a fortnight but her flesh daily wasting a Consumption was threatned Wherefore going into the Countrey to avoid this she drank Asses milk by the benefit of which Nutriment and of purer Air continually taking the above-mentioned Medicines she recovered her entire health within three or four weeks and lives yet in health SECT II. CHAP. IV. Of a Tympanie ATypany vulgarly A Tympany not properly a kind of Dropsie although not properly is esteemed a kind of Dropsie from which rank Prosper Martianus alleading the testimony of Hippocrates rejects as well this Disease as an Anasarca But the former infessting the region of the Abdomen and raising it up into a bulk now comes under consideration next after an Ascites to which it is something a-kin where first of all it is obvious that this Disease as it is most difficult to cure so also to be known for although its outward form viz. a somewhat hard swelling of the belly very stiffe and yielding a sound like a Drum upon touching it is evidently perceived by many senses together notwithstanding what may be the morbifick matter inducing that Tumour or after what manner it is generated in the belly or from what place it comes thither is altogether unknown therefore those who have a Tympanie as though
from the other and flying about seek vent in every place and distend greatly all obstacles and chiefly the sides of the Cavities which doth not at all happen in living bodies wherefore as all Carkases do not putrifie alike so their bellies swell sooner or later more or less But while life endures no rottenness or dissolution of particles is made in an animated body that can bring about a splanchnick fermentation or swelling In the mean while we deny not that winds are generated within the offices of concoction fanguification and separation yea within all the particular cells and recesses of our whole body notwithstanding from them all unto the winds wheresoever engendred whilest the Spirits have their due influence and actuate the nervous as well as moving fibres that the sides of the howels be not kept distended and rigid and easie vent does every where lye open And the truth is in a Tympany we allow the wind to fill up the empty spaces but the spirits inasmuch as they extend the bowels by their irregularity do first cause those vacuities wherein the winds secondarily and consequently are engendreed and they inasmuch as the same bowels are still kept strutted and distended do hinder those winds from being removed And now I judge it is plain enough by what we have said The Animal Spirits and not winde the cause of the Tympanie that the animal spirits rather than the wind do raise swellings of the belly in that fort at least such short and transitory ones as happen in Hysterical and Colick fits Notwithstanding there yet remains a great difficulty after what manner the Tympanitical swelling of the Abdomen which is fixt and permanent yea for the most part immpovable can proceed from any such cause especially because the Animal Spirits being of their own nature active and very apt to motion do for the most part so affect removal that unless they be wearyed or become defunct they scarce ever lie still That I may loosen this knot by reasoning it becomes us to consider the Nervous Juice together with the substance of the Animal Spirits which is every where a vehicle to them and also a bridle for the Spirits enjoying the most subtile stream thereof do freely expatiate and lest being dissipated from one another they might fly away they are contained in and entire series When therefore theat Juice is faulty as to its temper or motion immediately the animal spirits become diversly delinquent or are perverted in the exercises of their functions as we have at large expounded in our Treatise of Paslions And lest by repeating them now I should make long Preambles I will contract into a few words what belongs to the present purpose Wherefore in the first place it is to be observed This happens by the fault of the Nervous juice that the contents of the nether belly excepting only the Liver Spleen and Kidneys are furnished with many membranous bowels which the nervous fibres for the most part weave together whence it follows that the nervous Juice whose journey is longer and the passages straiter in these parts doth find here many remora's which also may be proved from the effect forasmuch as the convulsive invasions every where stirr'd up in the Hypochondriack Colick Nephritical and Hysterical Passions do so grievously infest the Abdomen When therefore that Juice watering the nervous fibres of these parts shall be either viscid or tenacious of it self or fill them with very many feculencies for that cause it will come to pass that all the animal spirits will not easily return from thence as oft as they are hurl'd into these fibres in some part obstructed and when in this manner there is a full incursion and a small return of them at length it will happen that great abundance of the spirits remain in these fibres every day more and more impacted and hold them always distended and very much pufft up and at length by reason of the ways of their ingress and regress in those fibres being obstructed they become immovable in that place and keep the affected parts always extended and stiffe in the mean time because these Spirits there impacted within the nervous passages By the obstruction whereof the Spirits whthin the fibres are detained and made immovable and cramm'd thick have commerce whit others that flow to them in their dens therefore the affected part although it be stiffe and almost immovable yet however enjoys sense This Pathologie although it may seem to some a Paradox and uncouth I doubt not but it will deserve assent from many if it be throughly weighed that those who have been a long time obnoxious to Hypochondriack Colick and other convulsive distempers of the nether Belly do at length become sick of a Tympany The formal reason and conjunct cause of a Tympanie being delineated after this manner before we proceed to trace out diligently the more remote causes thereof it may be lawfull for us from what we have said to deliver a definition of at least a certain description of this disease viz. That it is a fixt and constant Tumour of the Abdomen equal A description of the disease hard stiff and yielding a noise upon striking taking its origine from a convulsive inflation of the parts and membranous bowels by reason of the Animal Spirits being driven into those fibres in too great abundance and through the fault of the nervous juice obstructing being hindred from their return back to which disease consequently an accumulation of winds in the empty places accrues as a complement As to what appertains to the procuring and evident causes of this disease it very seldom happeneth that they are altogether observed It s procuring causes but that insinuating it self by silent beginnings it frequently is finished or becomes deplorable before it is perceived insomuch that against this disease scarce any antidote can be appointed for while the ordinary functions are not much prejudiced the swelling of the belly is presumed only to have its origine from winde and while it is expected to vanish spontaneously it often grows into a Tympanie Wherefore that we may have timely notice of its beginning we may take notice that some previous affects dispose to it Other previous convulsive affections of this sort is first an Hypochondriack Colical and Hysterical disposition yea and sometimes an Asthmatical whose fits when they are used to be frequently raised if at length a tumour of the Abdomen follow it though it be small in the beginning a Tympany forthwith may be feared Of the former of these affects cases every where are to be met with and stand fair to common observation of the later Scherichius reports The case of an Asthma ending in a Tympanie That a man of Sixty years of age was infested with this symptome some months before his Belly was swell'd into any manifest tumour that as often as he sate at meat beginning to eat also when
of small Cinnamon-water one ounce Diacodium three ounces Tincture of Saffron two drams Mix them and take one spoonfull at night if sleep be wanting Or Take Syrup of Cowslip-flowers three spoonfuls compound Poeony-water one spoonful Laudanum tartarized one dram take one spoonful if Watchings require it 3. Extinguishers of Thirst in this Disease being very thirsty Things mitigating Thirst ought frequently and in small quantities to be administred that that troublesom symptom may be restrained without much drink which is perpetually pernicious For which purpose Take of Conserve of Wood-sorrel passed through a Sieve three ounces Pulp of Tamarinds two ounces Sal Prunella one dram with a sufficient quantity of Syrup of the juice of Wood sorrel make a Lohoch of which let him lick often SECT II. CHAP. V. Of an Anasarca NOw two kinds of Dropsies viz. Ascites and Tympanie according to common reckoning being finisht although the third to wit an Anasarca for that it is an affection rather of the whole body than of the nether Belly appertains not properly to this place notwithstanding the Pathologie thereof having some affiance with the former we think sit to deliver here also its Cure in short The description of an Anasarca An Anasarca is described after this manner That it is a white soft Tumour of the whole outward Body or of some of its parts yielding to the touch and leaving a dent upon compression proceeding from a watery humour extravasated and accumulated as well within the interspaces of the Muscles as within the pores of the flesh and skin yea of the Glandules and Membranes It differs from an Ascites as to its outward form and appearance How it differs from an Ascites yet not as to its morbific matter which being the same in both distempers as it is heaped within the greater or lesser hollownesses it gains divers Appellations of the Disease The watery humour procuring an Anasarca The Original from the blood doth proceed altogether or for the most part from the blood for it being continually produced within the mass of blood by the fault and defect of sanguification it is poured out in greater abundance from the extremities of the Arteries than can be received or brought back by the Veins or the Lymphaducts or can be discharged by the Reins or pores of the skin and other vents of the serous Juice From these it follows that the material cause of this Disease is a watery humour The material and efficient cause and the efficient is blood which engenders waters and deposits them in the places affected We will exactly weigh the reasons of either of them and the manner of becoming and effecting it and first we will treat of the efficient Cause of an Anasarca 1. The affection of the Blood or rather the Hydropical brood The Blood its efficient cause in a double respect consists in these two things to wit First by reason of a failure or fault of sanguification it doth not rightly assimilate the nutritious Juice perpetually infused into its mass but suffers it to degenerate into a watery humour Then secondly by reason of the too loose mixture thereof it doth not retain that humour so degenerated so long within its consistence untill it might be discharg'd through fit Emunctories or Emissaries but lets it out every where near to the ends of the Arteries into the inter-spaces of the Vessels and there leaves it Either of these vices of the Blood we will consider a little more In the first place as to the former for the most part it is confessed by all First that it doth not rightly sanguifie that the Blood it self and not the Heart or Liver sanguifies by what of late is plainly understood concerning the functions of these parts yet by what means the Blood assimilates Chyle infused to it self and converts it into fresh blood to be bestowed to so many and diverse sorts of uses doth not easily lie manifest to us But what some affirm that it is made only by the exact comminution and commixtion of particles and for that cause the particles of either kinde being confused together they think that within the straiter passages of the Liver and Lungs they are kneaded and wrought together as it were with little pestils seems little probable to me but on the contrary I think these bowels as I have shewed already are constituted the Organs rather of separation than of mixture The reason whereof enquired into but the reason of sanguification altogether consists in this that the active particles of the old blood to wit the saline and sulphureous being placed in vigour with the spirituous immediately act upon the like particles of the infused Chyle as yet existing in an inferiour state and do so stir them up and ferment them that thereupon being extricated from the coverings of the thicker parts they are carryed into a like degree of exaltation or perfection with the former and being at length associated with them and made also homogeneous they put on the same nature of Blood the more thick and heterogeneous particles being removed thence to another place from those which they had deserted and gone away from For truly Sanguification is altogether finisht by Fermentation even as the maturation of the Must into Wine or Ale but the reason of the difference is that Wine being shut up in the Tub still remaining entirely in the same Mass is flowly fermented as to its whole consistence and is not accomplished but in a long space of time but the Blood constituted in a perpetual flux by the loss of some parts and the reparation of others is fermented by the parts still received fresh and is generated anew The old Blood for the most part affords the same thing towards the fresh Chyle The reason and manner of sanguification explained as Ferment from the flower or faeces of old Ale being put into new Ale notwithstanding as it were by a contrary manner because the huge mass of blood being formerly fermented doth suddenly ferment and alter the small portions of the Chyle continually brought in but the fermenting liquor in Ale in a very little quantity is put to the great mass of the other liquor to be fermented which it brings not to maturity under a long space of time After the rudiments of blood are so cast by fermentation the conclusion and perfect assimilation into blood is acquired by accension for surely that it is so enkindled as I think I have formerly shewed by demonstration which arguments chiefly taken from its proper passion although many have cavil'd at none have been yet able to overthrow Wherefore while the whole mass of blood consists of Blood and Chyle confusedly mixt together it is fermented while it is circulating andbeing divided into most minute portions is spread through the whole Lungs that it might be kindled successively according to all its parts by the nitrous air suckt in for by that means both the
being administred he was restored to his entire health and even now though five years since lives and continues sound There remain certain other splanchnical Affections The 〈◊〉 of 〈◊〉 〈◊〉 touching the Remedies whereof according to the ensuing method we should here have treated notwithstanding I have performed this task already for the most part under other titles for as is above intimated Remedies which concern the Kidnies we have for the most part unfolded under the rank of Diureticks and those which concern the Stomach and Guts under that of Vomits and Purges what relates to the Spleen we have finished in the Hypochondriac Pathologie and what to the Womb in the Hysterical As to what appertains to the Genital parts and their Diseases and help I reserve for another time and place it behoves me now next of all after treating hitherto of the inward Pharmacie to discourse something of the outward and of the Reason or Aetiologie of the administrations thereof which shall be done inthe next Section beginning with Phlebotomie that great Remedy SECT III. CHAP. I. Of Phlebotomie AMong the universal Documents of Philosophie Phlebotomie a very general and ancient medicine or aids of Physick none either in Theory or Practice hath been more ancient or general than the speculation of the Blood and letting it out by opening a Vein As to the former we have in other places often explicated the nature and constitutive parts of the Blood we have unfolded the Virtures and Energy of the same and have demonstrated that it is in truth enkindled and that from the burning there of the flame of animal life as of a Lamp doth begin and receives continuation But as to what relates to Phlebotomie all Authors of every age have made mention thereof Moreover the same was ever in Medicinal use with all Nations howsoever barbarous or rude Neither is it a wonder for truely Nature it self in the first place hath taught the necessity and way of that part of Chirurgery Even the Divine Law commanding the Rite of Circumcision as a Symbol thereof seems to intimate that the innate impurities of Humane Nature ought to be purged in some manner by letting out the blood That we may methodically discourse of this great Remedie Nature shews it by Haemorrhagies we ought first to consider by what means also for what causes and ends the letting of blood either happens spontaneously to Nature or is indicated by the Physitian then secondly we will annex the chief effects of this Evacuation as well good as bad whether advantageous or disadvantageous and together propound certain Rules and Cautions to be observed about due administration of Phlebotomie As to the former spontaneous Haemorrhagies which suggest the use of Phlebotomy whereas they are manifold and of diverse kinds they are usually reduced to these two heads or ranks to wit they are denominated either critical Nature endeavouring something good and wholsome or symptomatical which for the most part happen she being dejected from her government and being altogether out of order Critical either with or without a feaver The bloody eruptions of the former kind are again distinguished that they are either raised without a Feaver and are either perodical which happen often at set seasons as the Flowers in Women and the Hemorrhoids in some and in others the solemn or otherwise accustomed opening of the Nostrils which very often succeed according to the great changes of the Year or alterations of the Air or they are fleeting and uncertain as when blood doth advantageously break out of those places and of many others one while in this part another while in that part of the body Moreover bloody Crises do sometimes happen in a Feaver and do often put an end to it as Hippocrates long ago observed and is now manifest by very common observation The blood breaks out in all these cases inasmuch as being turgid and above measure rarified within the vessels it desires a larger space wherefore unless some portion thereof give way the whole mass rund the hazard of being constipated and as well the motion thereof to be hindered as the enkindling to be suffocated and the temperature to be perverted For there are two chief Reasons or Causes The causes thereof proceed either wherefore such turgescencies of the Blood do arise inasmuch as its liquor is as well inflammable as fermentative 1. As to the former of these that the Blood may be duely enkindled for the supporiting Life 1. From the kindling of the blood and the due exercise of the functions thereof it behoves that the innate sulphureous particles of it be proportion'd unto the Nitrous adventitious ones from the Air. Therefore as often as the Blood being very boyling and rarified is much opened and loosened in its own consistence so that the Sulphur being dissolved is kindled in greater plenty there is a most frequent and painfull breathing instituted for the drawing in of a more plentifull Nitre Now if the Sulphur abounding in this manner cannot be wasted by burning nor the vital flame regulated the next course immediately to diminish the sulphureous suel is that a certain portion of the rarified Blood have vent From hence not only in Feavers but after drinking Wine Bathings being in the Sun and other accidents by which the Blood grows very turgent either an Haemorrhagia of its own accord succeeds or there is often need to supply the defect of such a spontaneous evacuation by Phlebotomie But that such kind of effusions of Blood whether made by Nature or Chirurgery are commonly reported to bridle its heat or raging really they do this only inasmuch as they diminish the kindling of the blood by withdrawing part of the sulphureous fuel as Oyl from a Lamp 2. But moreover in the second place the Blood 2. From its Fermentation inasmuch as it is a fermentative liquor it is apt also to be extravasated Namely if at any time any heterogeneous thing and not miscible be confounded with its liquor it grows hot very much like Wine in a Vessel and boyls up in the Vessels to exclude that disagreeable thing which if it can neither subdue nor turn off by Sweat Urine or otherwise the Blood it self excludes part of it self as a Vehicle for carrying that matter forth wheresoever a vent is to be found For this reason viz. that any disagreeable or indomitable thing may be turn'd out of the mass of blood divers sorts of Hemorrhagies happen as well in Feavers as without them all which are excited by Nature for an intention of good as also those by which the too much enkindling of the Blood is depressed But that frequently it happens otherwise ought to be imputed to divers accidents and circumstances But for the most part the sailure about the spontaneous Hemorrhagies critically instituted 1. Criticall Hemorrhagies sometimes turn into symptormatical is either in the first place because the blood while it is boyling knows
best to referre the other to the hysterical Pathologie Here properly belongs to this place the blood flowing out of the Nostrile being the most general kind of passions of the sort For the present the Cure of the Hemorrhage of the Nostrils is only propounded and common to every Age Sex and Temperament so that from the Diagnostick and Therapeutick of it duely assign'd the uses and efficacies of Medicines stopping blood will best appear for what we proffer for the unfolding the Causes and Cure of this bloody eruption may be accommodated unto all other dreadful Hemorrhagies It is observable enough that the Flux of blood from the Nostrils doth happen to most men from extraordinary occasions for as oft as the blood about to break out through its own turgescency or through laxity of the vessels is apt in some place to make or find its way it is by a certain instinct of Nature very often directed to the Nostrils as to the part most easily opened A description of the Vessels from which Blood flowes The vessels from whence it flows in that place are slips of the arterial Branch going from the Carotides after having pass'd the Cranium it comes to the basis of the Cerebrum for this proceeding near to the mammillary Processes sends very many twigs from it self every where about of which some eminent ones passing the hole of the Sieve-like Bone with the smelling Nerves are distributed through the glandulous membrane investing the windings of the top of the Nose These nasal Arteries departing first from the Trunk of the Carotides within the skull anticipate part of the blood chiefly serous from the brain and lay aside the Serum it self and other watery recrements into the glandules of the Nostrils as into the proper Emunctories of that Region whence they distill into the cavity thereof Wherefore if the mouths of those little Arteries do alwayes gape somewhat by reason of the sweating out of the Serum it is no marvel if the blood it self being made more turgid opening them a little more which often are too loose of themselves bursts forth of dores Indeed this Emissary both of the Serum and of the Blood being apt ordinarily to open or on any occasion prevents or cures great incommodities of the brain or of the Praecordia yea and sometimes of the whole body For in the first place They are the same by which the Serum distills to the Nostrils this way the Serum as I said is derived from the head and when the mouths of those Vessels are vellicated or provoked by any sneezing Medicine put into the Nostrils the Serum is from thence more abundantly drawn out which yet doth not descend from the Brain as is commonly thought but is anticipated by these nasal arteries lest it should go to it from which when it is more plentifully drained and brought forth by the use of Errhines for that cause the Brain becomes more serene and exempt from vapours Then secondly lest the Brain should be overwhelmed at any time by blood more impetuously overflowing a portion hereof passing through these vessels and breaking out easily prevents it But sometimes it happens that an Haemorrhage of this kind The Blood flowing forth in too great plenty from these Vessels is very hurtfull rather becomes a Disease than a Remedy for whensoever the blood flows out more often and more abundantly than is fit from the Nostril if life be not immediately hazarded by reason of too great loss yet the remaining mass of the blood being impoverished thereby and losing its temper acquires a cachectick and frequently an hydropick disposition even as we have clearly intimated before where we also have shewn the Aetiologie of this distemper in common with other too great Hemorrhagies either to consist in the fault of the blood or of the vessels or of both together First The causes of such an immoderate flux the blood bringing an Hemorrhage of it self offends either in Quantity or Quality and therefore while occasionally it boyls up it cannot be contained within the vessels but either opening their mouths by distending them or unlocking them by its acrimony 1. From the fault of the Blood it skips out To which happens that the blood being sometimes dissolved in its consistence and as it were infected becomes unfit to continue the course of Circulation inasmuch as portions thereof separating from one another are partly fixed in the flesh or skin having suffer'd death and partly breaking out stirre up frequently dreadful and sometimes mortal Haemorrhagies as every where is discovered in malignant Feavers and sometimes in the Scurvy Notwithstanding the blood offending by meer Quantity or Acrimony unless the fault of the Vessels happening thereon provoke the flux thereof or too easily permit it seldom breaks out into a great Hemorrhage Therefore secondly 2. From the fault of the Vessels the vessels bringing blood as often as they conspire to produce that affection are usually in the fault either first inasmuch as their small mouths gaping by reason of the fibres being too loose and weak do not readily enough transvasate the blood out of the Arteries into the Veins which fault happens to scorbutick and cachectical persons or secondly inasmuch as by reason of the same moving fibres being affected with the Cramp and Convulsion the blood being snatcht impetuously to and fro and chiefly towards the Head is constrained to break out to continue the thread of circulation even as it will plainly appear in the case of a Patient which shall be shewn below 1. Prognosticks As to the Prognosticks although an immoderate flux of Blood in the Small-Pox Measles malignant Feavers and in the Plague doth ever presage evil and is expedient to be stopt notwithstanding it ought to be restrained not by meer cooling or revulsory things but to be chang'd by temperate Hydroticks into sweating 2. An Haemorrhage of the Nostrils though not great is more dangerous in Cachecticks with a weak Pulse and a cold sweat than a plentifull Hemorrhage in men endued with a Pulse strong enough and blood very fervent 3. They who are obnoxious to this Disease by reason of a Dyscrasie of blood and loosness of the vessels if there come upon both these a convulsive disposition of the fibres of the little Arteries they receive a far more difficult Cure and frequently are reduced to extream languishings by reason of the great losses of blood 4. From those who are feaverish when much blood shall flow out of the Nostrils and does not terminate the disease often-times in the place of a Crisis a delirous or a soporiferous affection succeeds There are many other prognosticks about a Hemorrhage accurately remarkt by Hippocrates which notwithstanding properly belonging to the discourse of a Feaver we omit in this place for truly the Cure in general of this Distemper is here almost only intended About which there will be three primary Indications Three primary Indications of Cure
administer both a Dropace and Vesicatory Also by applying still the same Plaister the Scarf-skin being blister'd and taken off and the place being red and ulcerated and only wiping it once or twice in a day and putting it on again they cause the little Ulcer raised by the Vesicatory to flow at pleasure yea sometimes above a month and to throw off a plentiful Ichor Others inclose Cantharides bruised and sprinkled with Vinegar in Silk and apply to the place Some Empiricks use in the room of Cantharides a mass of the leaves of Crow-foot or flamula Jovis bruised on the place by which the Scarf-skin being blistered or rather eaten the skin it self as if toucht with an actual fire is much inflam'd and deeply ulcerated whence not only a profusion of Ichor but an inflammation of the whole member and a feaverish disposition sometimes follow wherefore these things are not to be used rashly 2. 2. How they operate If it be enquired of the manner and reason how these and other Vesicatories operate in the first place we ought to shew by what manner actual Fires and things endued with particles proceeding from Fire do raise a blister then by an easie Analogy the force and manner of working of those sorts of remedies will be known which are reported to be endowed with a potential fire Wherefore we observe of the former that the fiery particles not being too vehemently applyed penetrating the Scarf-skin without dissolution of unity enter under the skin it self Shewed by the example of Fire where the extremities of the vessels bringing blood of the Nerves and of the nervons Fibres are terminated and there do variously twist together these altering them from their position and pervert the structure of the whole texture of the skin insomuch that from all the vessels being made angry in a high degree the watery humour being imbued with igneous particles and therefore rejected as well by the blood as by the nervous Juice is spued out in great abundance This Lympha because it cannot pass through the Scarf-skin separates it from the skin and raises it into a bladdery bulk from which at length being broke of its own accord or occasionally it flows out Moreover as long as the igneous particles adhere to the skin and the mouths of the Vessels being covered with an Eschar are not closed up these being continually twitched by them do continue to spue out the Ichor This kind of ichorous flux will the sooner cease if immediately upon the hurt inflicted the fiery particles be drawn out by the application of some proper Antipyretick as Fire it self Nitre Soap Onions and the like Moreover it runs the longer if omitting an Antipyretick medicines hindering the generation of a Cicatrice or of the outer-skin and unlocking the mouths of the vessels be worn upon the place affected By these it is easie to understand by what manner Vesicatories perform their operation How Cantharides excite Blisters and draw forth water viz. Cantharides as likewise any other of the same vertue being outwardly applyed and being heated by Effluvia's of the parts subjected and so being provok'd to exert their power do plentifully dispatch sharp and as it were fiery particles from themselves which penetrating the Scarf-skin without any tearing it they are dashed against the Cutis or other skin where first they act upon the Spirits and then by the affecting these upon the Humours and solid parts They very much provoke the Spirits and drive them into painful Convulsions of the fibres dissolve the Humours and constrain them to separate into parts so that the watery part being very much embued with those sharp and as it were venemous particles is rejected every where by the other Juice and when in the mean time the ends of the Vessels and Fibres are either eaten by the burning or opened by twitching and as it were drained that Ichor conveying the hurtful particles is plentifully spued out of their little mouths which then separateds the impervious Cuticula or the Scarf-skin from the other skin or Cutis is self and raises it into a little bladder and after this being beoken and taken away it is for some time poured out by the ulcerated shin as we shewed it to come to pass by reason of the particles of fire But this is not only done because the serous Juice imbibing the sharp parts of the Medicine and conveying them out doth not always bear them all back the same way by which they entred but sometimes this being endued with these stings regurgitates into the mass of Bloodl and afterwards being circulated with it and ejected with its infestous burden through other Emunctories Why they bring a fervent Dysurie offends some weak or tenderer Channels in its passage or going forth from whence very many contract a Strangury from great or many Vesicatories by reason of the urinary passages being affected for that cause with Acrimony or Erosion which in some becomes most sharp and intolerable Also that application sometimes brings bloody Urines to others afflicted with the Stone hence a suspicion also arises that those who have tender Lungs or who are subject to a Consumption are much endagered by this Medicine outwardly applyed which notwithstanding I have not known happen to any but can reather attest by frequent experience on the other side that it redounds to advantage rather than hurt For the more sharp particles of Cantharides if they be long applyed being sometimes imbibed more plentifully by the blood infect its whole Serum which Juice so sharpened as long as it is confounded with the Balsamick blood hurts no part but being separated from it by the Kidneys it sometimes brings hurt to them and frequently not only twitches the neck of the Bladder by its Acrimony but sometimes corroding it causes filth and little skins nay and blood to come away but in the mass of blood the same more sharp saline-volatile particles do often most notably help inasmuch as they destroy the fixt or acid Salts in it and unlock the consistence of the blood too much bound up and so do cause the serous and other morbific recrements before wrapt up with it to be separated from it and to be more easily dispatched by Urine and Sweat Vesicatories move Sweat and Vrine hence Vesicatories being applyed long in Feavers do call forth plentifull Urine and a more easie Sweat Also they open the obstructed wayes and move together the portions of Blood or Serum stagnating or being extravasated in any place and restore them to their Circulation Wherefore they are not used only to help in serous maladies but also in those of the blood yea in a Pleurisie Peripneumonia and in any other Feavers Having hitherto shewed after what manner Vesicatories operate first on the Spirits and then on the Humours and solid parts it is now our business in the next place to shew both the good and evil effectgs of them as also the manners of
or blow inflicted upon the body The Solution of the Vnity always the cause of it for the same thing is used to be induced from cold heat wind from the extravasating of the blood and of other humours or their being heaped up together in several places oftentimes the fashioning of the member remaining as yet entire in which cases although the continued parts and chiefly the fibres and filaments are not at all cut off notwithstanding they are in every Affection of grief pulled from their usual position either by the oppression of the object or by strange particles forced like wedges and are compelled into too much tension or distorsion or divulsion and for that cause the inmate spirits being pulled from their mutual embraces and dissipated are ill at case and incur the passion of pain or grief Pleasure is opposed to Pain What Pleasure is and is a manner of Feeling clearly contrary thereunto which takes its origine inasmuch as a pleasant stroaking being made upon the organ of Sense the spirits flock thither and presently being thickly gathered together and overspread with a certain delight they do as it were exult and rejoyce together in the organ afterwards inasmuch as the spirits enter into the like triumph or rejoycing within the Corpus striatum a perception of pleasure is stirred up The greatest pleasure which is offered to the Touch It s formal Reason consists in this that the cause of Pain being removed the parts formerly affected by it may recover their wonted temper and frame for so the animal spirits being before put to flight and dispersed from one another It chiefly consists in removing of Pain they recollect themselves and rushing into the places from which they were banished with reinforced strength they prepare themselves to rejoyce From hence the Peripateticks placed the formal reason of Pleasure only in the removal of something that was troublesome as when the excesse of cold or heat is received by an opposite and more agreeable state Indeed the tangible object because it is alwayes thick and dull doth scarce any way else excepting Venery allure the animal spirits into heaps to the organ of Sense unless for that it removes their former confusion From these things so described concerning those passions What the Itch is it is easily manifest that the Itch according to the formal account thereof is neither perfectly nor fully either Pain or Pleasure but imperfectly and as beginning partakes of both For really the scabby matter being heaped up within the pores of the skin and making the solutin of Unity in many places enclines towards pain yet as it is volatile moving and hastens towards vent How the Spirits are moved in it for that cause the Animal spirits are not put to flight from the Fibres although pulled asunder neither are they driven back with sense of pain but the contrary as if being stronger than the humour infesting they were able to cast it forth they being wrapp'd up more thick but irregularly within the cutaneous fibres do twitch them together variously and draw them on that they may the sooner discharge the morbific matter and expell it forth Wherefore inasmuch as the Animal spirits being neither put to flight nor repulsed but flowing together in crouds into the organs of Touching they manage themselves there tumultuously and disorderly and as it were by tickling the sensible fibres do provoke them into small Convulsions no pleasure but a troublesom feeling nor also is it Pain but a Passion clearly diverse arises from it But as soon as by rubbing or scratching the plenty of Spirits assembled about the organ of Sense begin to be better disposed and as it were reduced into order from thence a thorough feeling of Pleasure is introduced Wherefore the Itching seems to be a middle-state between the betginning of Pain and Pleasure A certain medium between Pain and Pleasure or a passage of the Spirits from the rudiments of that towards the full compleating of this But from this Physical discourse by the by let us return to our Pathologie or discourse of the distemper From what is above said it is easie to collect the differences of this disease In the first place therefore the Psora as to its origine either is got by Contagion The difference of the Psora as to its origine or by reason of an ill Course of Diet the fierceness and supply thereof is communicated by the Chyle and Blood being vitiated or it is generated in the skin it self by reason of filth and the defect of Transpiration Whereto we may adde that sometimes Infants acquire this taint hereditarit contracted from their Parents Secondly These cutaneous Eruptions as to their form 2. As to its form vary according to the diverse Constitutions of the persons affected for in some persons of a cholerick dryer Temperament or Melancholy only a dry Scab is stirred up and inasmuch as it evaporates lessby reason of the defect of the Serum with an stching not altogether so troublesome but in others of a moister Temperament and of more unclean blood very many wheals and pustules imbued with schor and most of all itching do very much provoke to scratching and by reason of the Ulcers stirred up therewith the Itch is immediately altered into pain As to the Prognosticks although this Disease is never of it self mortal or very dangerous and always easie of Cure yet frequently it contains an evil event The Prognosticks of it inasmuch as being long continued it utterly depraves the blood and nervous Juice and from it hastily cured by reason of the matter received within while it is discuss'd from the Pores a pernicious taint is brought upon the Praecordia and Brain and other noble parts The greatest hazard from a Scab threatens Children and Cachectick persons Most dangerous to Children and ill juiced or cachictick persons as in both of which the taint is more easily impressed from this Cutaneous humour upon the nobler parts which afterwards when the outward malady is removed remaining within cannot be vanquished entirely but by a very long Course of Physick of which neither is capable nor patient wherefore such persons It s Cure all care and diligence being administred ought to be preserved from the infection of the Scab as from the Plague Coucerning the Cure of a Scab or Psora two chief Indications present themselves The first Indication curatory and each of them two-fold viz. The first intention Curatory respects these two things First that the glandulous Humour its corruptive ferment being wholly extinct may be reduced to a due temper Secondly afterwards that the Pores and passages of the skin being freed from those schorous congealings may recover their pristine frame or good temper The Second Indication Freservatory takes care to prevent these two things The second Indication preservatory viz. First lest the impurity of the Psora or corrupting Miasma's of the skin being discuss'd
the most part remains uncurable by reason of the continual motion of the Vessel and the efflux of blood It is otherwise in a Vein whose opening is immediately stopt of its own accord for but little of contractive work lies in its Coats yea this only that its fibres being lightly opened as occasion serves the blood flowing back of its own accord is gently moved forwards and after Phlebotomy the vessel being empty they are permitted to be quiet so that in the mean time the little hole made by incision is easily glewed together Whenever Physitian or Patient do dread the opening of a vein to be administred drawing of blood by Leeches or Cupping-glasses will aptly enough and with like advantage supply the defect hereof Moreover these administractions to remove the conjunct cause of a disease where there is need rather of partial than general Evacuation or Derivation are frequently preferr'd to Blood-letting it self There is no need to dwell longer on explicating the manner and reafon of the effects of either of these operations commonly enough known but proceeding to other things we will next throughly weigh the Time and Quantity of letting Blood The opportunity of letting blood is often of so great moment Thirdly The Time of letting Blood comes into consideration that whereas this Evacuation succeeds well at one time at another it highly prejudices But there are diverse respects of time to be considered about the due performance of Blood-letting but chiefly these four The Time of the Disease the Age the Year and Day The first concerns chiefly the Cure of the Patient the others the Preservation of him First therefore if blood ought to be let in any Disease 1. In respect of the disease it will be chiefly sesonably about the beginning or encrease thereof but not at all or very cautiously in the state or declination For at that time whilst Nature is busied endeavouring a Crisis so that the Spirits are in great labour and the blood ferments very much that great endeavour of it ought not to be disturbed and in the height of the disease either Nature being Conqueress doth not want such a relief or being subdued will not endure such an Evacuation Secondly If at any time for preservation it be deliberated touching letting blood 2. In respect of age Infants Boys and Old men by the Custon of all Nations obtain an exemption also this evacuation was wont to be interdicted to pregnant Women but now most commonly prescribed Men of a vigorous Constitution and middle Age do well enough endure Phlebotomy and often times want it Notwithstanding the first and second time it ought not to be done without great occasion for that being once begun and afterwards repeated it will soon proceed into an inevitable Custom Thirdly Hence they who used to let blood Spring and Autumn 3. In respect of the Tear and its parts afterwards cannot omit this evacuation without hazard But to whom it will be either profltable or necessary to breath a Vein once or twice a year the chief seasonable times will be in the beginning of Spring and Autumn viz. when the Blood being prone to ferment anew is in danger to change its Crasis Phlebotomy seasonably administred provides lest the Sulphur and Salts being exalted it should contract a feaverish scorbutical or other peccant distemper likewise lest suffering a flux it should pour forth the serous Recrements and other Feculencies upon the Brain the Lungs or Bowels of the nether belly About the Solstices when our bodies are very cold or hot the blood as the juice of all Vegetables consisting in a more fixt state and unapt to sweel up ought not to be let out unless upon some urgent cause But whereas some precisely or rather ridiculously observe about Phlebotomy The Aspect of the Moon and Stars are here of no moment even as the Countrey-men about Gelding Cattle the position of the Heavens and the Aspects of Moon and Stars it appears altogether frivolous and for that chiefly is this Custom condemned inasmuch as counterfeit Astrologers have a Figure in their Almanacks wherein every sign of the Zodiack is allotted to every particular member of our bodies and for that cause under what sign the Moon is conversant they forbid blood to be drawn from the respective part of man They who observe without reason the Heavens do erre as the saying is the whole compass of the Heavens Moreover this vulgar error is not only absurd but frequently malevolent inasmuch as many of the common people will abstain from Phlebotomy whatever indication makes for the same if as they say the Sign be in the place of letting blood Fourthly As to what relates to the time of the Day in acute Disease 4. The time of the day about letting of Blood when a Physitian is sent for and there be indication for Phlebotomy immediately to be performed after the body is prepared he may prescribe that operation any hour in day or night but otherwise if any interval may be allowed then breathing a Vein rather is to be celebrated in a morning when the Stomach is fasting the vessels emptyed by sweat in the night the stream of blood being quietest and appearing free from any â—â—ous filth Yea although necessity urge it may be deferr'd a little untill the new Juice of things eaten be pass'd into the blood for the vessels being emptryed-will not only snatch the crude Chyle into themselves but frequently what is disagreeable or unproportionate unto the blood whence not only its motion is difordered but also the vital flame runs the hazard of being extinct I have known some by Phlebotomy administred presently after plentiful Drinking or pouring in of vinous liquors to have fallen into dreadfull swoundings away which have lasted very long untill the vital spirit being almost overwhelmed recovered it self again Moreover in the fifth place the opening the vein being indicated 5. The Quantity of the Blood to be taken away ought to be considered and its time appointed there remains still no little consideration to be had what Quantity of blood is to be let out in which point there is most commonly a fault committed while some being too audacious and others no less timerous they affix those bounds on this or that side of which for the most part consists the Right For that I may omit those who scarcely or not at all admit of Phlebotomy as I have before hinted so I cannot easily assent to their practice who fear not to draw blood to swounings Too much Phlebotomy to be avoided Besides an error of no light moment is committed within the moderate bounds while in some cases blood is drawn by too sparing a hand and in others with too free In a burning Feaver But a more spare Bleeding often hurts and fixes a feavour Pleurisie Peripneumonia Squinancy Frenzie Apoplexie and other great diseases that have their origine from a turgescency or phlegmonic incursion of
the blood a sparing Phlebotomy doth always more prejudice than advantage For besides that it doth not remove the antecedent cause of the disease to wit the Plethora it further causes the conjunct cause viz. the inflammation and bursting out of the blood to be angmented For truly it is a constant observation that upon blood too sparingly drawn the whole mass doth boyl up more notably and doth acquire a new flux into the part affected the reason of which is that in a great Plethora many portions both of the Blood and Serum being thrust forward into recesses and strait places are there constrained to abide which after the Vessels being a very little emptyed The Reason of which is declared do impetuously regurgitate into the mass of blood and do much disturb it and force it more impetuously to and fro Wherefore also in this respect the vessels ought to be very much empted viz. that besides freeing the former Juice from straitness also space may be given to the Juice reduced from exile which otherwise being not congruous coming upon the blood troubles it and provokes it into effervescencies and eruptions From hence we may observe that almost all men grow more hot presently after Phlebotomy and yet the blood being sufficiently evacuated a little after they enjoy a more temperate condition But as a slender withdrawing of blood in some cases is only vain but is performed with prejudice so in other cases too much effusion is rarely committed scot-free and sometimes brings notable detriment of health For when either strength languishes or the body labours under a notorious Cachexia we must spare Blood-letting and its taking away is either prohibited or being indicated by some accident is allowed but in a small quantity Wherefore in men endowed with a weak tender and cold Constitution and in consumptive persons those affected with a long or malignant Feaver In some eases the mission of Blood must be altogether avoided also in Hydropicks or Cacochymicks a vein is not rashly to be breathed at least if it be much blood is not suffered to be taken away It will be an impossible thing to prescribe general Rules according to the particular cases of every individual person whereby the quentity of letting Blood may be exactly proportion'd according to the strength of the Disease and the ability of the Patient but let this be left to the judgment of the prudent Physitian present and let his Commands be ever exacutly observed And let not as it every where is such leave be given to Quacks Empiricks and Barbers to play with humane life who every where rashly and wickedly use Phlebotomy and if the blood spring more sreely and appear discolour'd therefore bragging of the vessel being well pierc'd they say it must be let out more plentifully because it appears bad when oftentimes on the contrary it ought to be spared As soon as the Quantity of Blood to be taken away is determined Phlebotomy ought ever to be done with a large orifice our next care ought to be that a more large orifice being made the blood equally mixt may flow out as soon as may be for otherwise if it go out from a small hole or drop by drop or with a little stream the mass of blood fermenting will separate into parts and what is more subtile and spirituous will burst out the thicker and feculent remaining behind Hence it is to be observed that the blood being let out of a large orifice with a more full stream if it be a little stopt with the finger clapt on it and a little after suffered to flow out the blood going out the second time becomes much purer and brighter than the former because in the interval of flowing the more subtile particles being unfolded from the thicker and accumulated together have prepared themselves to fly away Wherefore if Hippocrates's Precept shall be observed ' viz. to let it run to the change of its Colour it behoves us to procure that it spring out quickly with a full a not interrupted stream Besides all this as to what appertains to the alteration of the blood let out and cold and to the inspection and the judgment thereof for that we have often discoursed it in other places we now pass it by hastening to other things and now the thread of Method leads us to entreat of Remedies opposite to Blood-letting to wit Ischaemones that is those which are convenient to stop immoderate Haemorrhagies whether engenderd by Nature or by accident SECT III. CHAP. II. Of Remedies restraining or stopping of Blood EVen as Art imitates Nature in letting forth the blood by Phlebotomy offending in plenty or temperament or in its motion Every Hemorrhage is not to be stopt so it succours her being diseased or working wrong by stopping the flux of blood whensoever it is immoderate or hurtfull Whereas there are various and many species of an Hemorrhage there is no need of Physick for them all If perhaps a great effusion of blood happens by a solution of unity excited by an outward accident as a wound or stroke Chirurgery suggests the manner of Administrations whereby it should be restrained Moreover an Hemorrhage as long as it shall be Critical ought to be disturbed by no Medicine but left to the meer government of Nature as long as she does aright use her power and as to the Symptomatic whilest it is little or not much troublesome there is required no Physick notwithstanding there is great need of it if at any time the Flux of blood be either immoderate or flow out by unapt places Eruptions of blood of this last kind chiefly challenge a Cure But only the immoderate and inconvenient if perhaps the blood be cast upward by Coughing or Vomit or downwards by seige or thrown off through the Ureters For in these cases though the quantity of the Blood excreted be not much to be dreaded notwithstanding because often a dangerous or mortal Ulcer ensues the solution of the Unity so made in the Lungs or in the Stomach Guts or in a Vein therefore we must industriously rancounter those Hemorrhagies from their first appearance Therefore among the Diseases of those parts The chief Cases of the latter are reckoned such bloody excretions are accounted but we have already in another place delivered the Theories of Spitting Blood and of the affection Dysenterical and the reasons of healing them so that there is no need to repeat them here neither also to propound here a remedy for bloody Urine for that it belongs to the Nephritic Pathology wherefore we will pass to those Passions for which by reason of an immoderate efflux of blood there is great need of restraining Medicines The kinds of these Affections are chiefly three viz. Haemorrhage of the Nostrils And also of the former of the Flowers and the immoderate Flux of the Hemorrhoids The Cure of which last doth belong more to Chirurgery than Physick and I think it