easie to judge which we must obviate first and chiefly take care off in respect of the Fever Purging Bleeding and cooling things chiefly conduce but whilst these things are used the Malignity for the most part is increased and they being neglected it diffuses it self farther Against the Malignity Alexipharmicks and Diaphoreticks are required but these greatly intend the Fever exagitate as by a blowing of Bellows the Blood and Spirits kindled before and put them in a manner all in a Flame wherefore there is need here of a great Quickness of Understanding that these things be duely compared betwixt each other and that the curative Intentions be there directed where most danger shews it self tho so that while one is taken care of the other be not neglected but in these Cases besides the private Judgment of each Physician Experience furnishes us with the chief method of healing for when these Fevers first grow rise almost every particular Person trys particular Remedies and from their Successes compar'd together it is easily learnt what kind of Method we must insist on till at last by a frequent Tryal as it were by the Foot-steps of Passengers a common and Road-way as it were is made to the Cure of these kinds of Affects being fortified with various Observations and Precepts Besides these kinds of Fevers which assail many together and by reason of their Contagion Mortality and conspicuous Marks of Virulency deserve to be called Pestilential or Malignant there are found some other Epidemick or Popular Fevers which almost every Year either Spring or Fall grow very rise in certain Countries of which a great many of the Inhabitants are wont to fall sick and not a few especially of the more elderly People to dye in which nevertheless no Signs of a pestilent or malignant Nature appear nor does the Disease seem so much by Contagion to pass from some incontinently to others as to seise many together by reason of a Predisposition communicated almost to all Now these kinds of Affects depend chiefly on a foregoing Constitution of the Year for if a Season very intemperate by reason of excesses of Cold or Heat Drought or Moisture has preceded and has so continued a long time it changes our Blood for the most part from its due Temper whereby it is apt afterward to fall into severish Effervescencies and hence a Fever sometimes of this sometimes of that Type and Idea is produced which presently becomes epidemical because it draws its Origine from a common Cause whereby the Bodies in a manner of all Men are affected together Now such Fevers in as much as they depend on the Blood getting a Disposition sometimes sharp sometimes austere or of another kind according to the Temper of the Year for the most part they are of the number of Intermittents tho they are wont to be mark'd with a peculiar Apparatus of Symptoms according to the peculiar Constitution of each Year We cannot comprehend these under a certain common Rule or formal Consideration which aptly answers to each of the Particulars of this Nature because they vary yearly according to a great many Accidents tho however of these kinds of Fevers reigning of late Years in this Country we shall give the Descriptions taken at that time and shall set them down as a Conclusion at the end of this Work It remains for us still to add to the number of Malignant Fevers certain other private Fevers partaking of no Contagion as are those especially which are wont to happen to Women in Child-bed by reason of their difficult Labour or for that the Lochia are detain'd for it is manifest enough by common Observation that these are very dangerous and often mortal for if the Parts of the Womb being injured or upon the admission of Cold or haply for some other Cause the Lochia are stopt and the Humour which ought to have been voided forth comes to be mingled with the Mass of Blood it fouly defiles it with a certain venemous mixture as it were that thereby presently a Fever is raised which for the most part is attended with an ill Company of Symptoms viz. a Heat and violent Drought a Vomiting a Cardialgia and Watchings and generally comes either to no Crisis or a very difficult one because unless the flowing of the Lochia after their wonted way be again restor'd after the Blood has undergone an Effervescence for some Days the Taint is wont to be communicated to the Brain and the Genus Nervosum whence presently a Delirium Frenzy Convulsions and other very ill Affects for the most part are caused which often terminate in Death But these kinds of Fevers deserve a peculiar Consideration which we resolve to have more fully beneath in a Discourse appropriated to this purpose mean while we must give some Instances or Examples of the Fevers above treated of viz. of the Pestilential and Malignant The pestilential Fever of late Years has reign'd more rarely in these Parts than the Plague it self I shall give you briefly the Description of the only one of this kind which has occur'd to our Observation Anno 1643. when in the beginning of the Spring the Earl of Essex besieg'd Reading kept by the King's Garrison in both Armies a very Epidemick Disease began to arise tho however he pursuing his work till the Besieged were forced to a Surrender The Affect so prevail'd that in a short while afterward there was a Cessation on both sides and thenceforward for many Months there was a Conflict not with the Enemy but with the Disease Essex withdrawing his Forces seated himself at and the adjacent Places where in a short time he lost a great Part of his Men and the King returned to Oxford where the Souldiers first keeping themselves in the open Field and afterward being disposed off in Towns and Villages he underwent a loss not much inferiour for his Foot whom it chiefly seised being lodg'd a great many of them together in streightned Lodgings when they had filled all Places with Nastiness and Filth and stinking Odours that they seem'd to have defil'd even the Air it self fell sick many of them together and as it were in Files at length the Fever reaching farther than the Souldiery assailed every where the weak Multitude to wit the Persons of the Houses where the Souldiers lodged and others tho many of them at first the Contagion being yet but mild upon them escaped yet lying a long time in a very languishing Condition About the Summer Solstice this Fever began to psread it self with a worse Attendance of Symptoms and to seise a great many Husband-men and others living in the Country and afterward it reigned in this our City and the whole Neighbourhood for at least ten Miles round about mean while those who liv'd in other Countries far from hence as tho they were beyond the Sphere of the Contagion continued free from harm But here that Disease grew so general that the greatest part of Mankind was
of the Oak of each a handful Seeds of both the Wild Carrots of each three Drams Raisins a handful let them Boyl in four Pounds of Fountain Water till half be Consum'd add of Whitewine two Pound and a half Strain it Let it be kept in Vessels close stopt The Dose is three or four Ounces twice a day Take Seeds of Wild Carrots bruis'd two Ounces Castoreum an Ounce put them in a Glass with two Pounds of White-wine The Dose is two Ounces twice a day 3. As to the third intent which putting a stop to the disorders of the Womb advances the Cure of the Hysterick affect I say in the first place that what was formerly believ'd concerning the Cause of the Disease and the Scope of Curing it viz. That the Womb did Ascend and therefore that it ought to be restor'd to its due place is altogether Fictitious as we have shewn elsewhere The descent or falling forth of the Womb often happens but this seldom or never produces Hysterical affects Moreover a Dislocation of the Womb sometimes happens to Child-bearing Women presently after Child-birth viz. When the body of the Womb being enlarged and newly emptied does not settle in a right place within its Cavity but leans high sometimes to the right side of it sometimes to the left and there being Constring'd like a Purse is folded up in a great Lump which Lump lying a long time in the side of the Inguen is wont to Cause suspicion of another Foetus or of the after Birth being left behind or also of a Scirrhous Tumour there Growing but afterward when upon the Lochia's passing away freely the Womb is reduc't to its due magnitude that Tumour vanishes by degrees And whilst it continues there unless haply the Lochia are thereby stop't it does not cause Hysterick Passions For the quick reducing of this part to its due position Fomentations Liniments and Plaisters contribute much But very often that Symptom passes away of its own accord without any further offence We have shewn elsewhere ex professo to what affects else the Womb is obnoxious after Child-birth and with what methods of Physick we must obviate them As to the other Distempers of this part which happen to other Women viz. to such as do not Bear Children we observe those chiefly to be either a Disease of the Womb caus'd by a Solution of continuity which is either a Tumour or an Ulcer or to be a Stoppage of some usual Excretion viz. either of the Sanguis Menstruus or of the Fluor albus or of the Seminal Humour by reason of the Menses retain'd the Heterogeneous particles being often discharged on the Head Cause Convulsive Passions In like manner when the White Humour is stop't the Excrementitious Matter being drank in again by the Blood is delivered to the Brain and Genus Nervosum Moreover when a wonted evacuation of the Seed is stop't the superfluities of the Nervous Humour Regurgitate into the Brain and infect the Spirits in it with a Morbifick and Explosive Tincture It will not be necessary for us to discourse particularly and at large on these particular affects of the Womb but to Complicate Medicines and Physical Administrations appropriated to Womens Diseases with Anticonvulsive Remedies CHAP. IX Of Affects vulgarly call'd Hypochondriacal which are shewn to be for the greatest part Convulsive and by the by of Chalybeate Medicines AS we have shewn before that the Passions vulgarly call'd Hysterical do not always proceed from the Womb but oftner from the Head 's being affected So though it has been vulgarly held that the affects call'd Hypochondriacal are caus'd for the most part by Vapours arising from the Spleen and running hither and thither yet in truth those distempers are for the greatest part Convulsions and Contractions of the Nervous parts which may better appear after we have considered the Symptoms As to the affects therefore which are vulgarly call'd Hypochondriacal it is to be observed that they chiefly happen to persons of a Melancholick Constitution with a wan aspect and a thin habit of body It is seldom that Disease troubles persons who are well in flesh and have a florid or also an over Phlegmatick countenance About the time that persons come to a set age it discovers itself with manifest signs Men are found to be more frequently obnoxious to this than Women in both being become habitual it is cur'd with great difficulty or searce at all in Women by reason of their weaker Constitution it is attended with far more Convulsive affects Wherefore it is commonly said in this Sex that the Hysterick affect is joyn'd to the Hypochondriacal The Symptoms which are accounted as belonging to this Disease are commonly very many and of a differing Nature nor have they in all a like Origine or the same mutual dependance on each other For we see that in these the Viscera of the Belly in those the Praecordia in others the Confines of the Brain are most affected in a great many but not in all the Stomach much Labours as to appetite it has often too much of it but is presently opprest by what is taken into it and when the food through slowness of Concoction tarries a long time in it the Saline particles of it being rais'd to a state of flowing pervert the whole mass of the Chyle into a Pap sometimes Acid or Austere sometimes Salt or Tart Hence a Cardialgia a mighty store of Flatus's a Rumbling and a frequent Vomiting ensue and because through a defect of a Pneumatosis the Chyme is not volatilis'd throughout and carryed forth but a Mass of Viscous Matter sticking to the Coats of the Stomach is left behind an almost continual Spitting molests them a distention in the left Hypochondre and often there and under the Ventricle a violent beating is felt and there pains every where arise which shoot here and there at random and miserably torture the person with a certain pungent Pain for many hours Mean while from the Contractions of the Membranes and the Fluctuation of the Flatus's thence rais'd Croakings and Rumblings are produc't So in the Thorax there is often a great Straitness and Constriction so that the Breathing becomes difficult and painful upon any motion nay farther in some very terrible Astmatick Fits supervene Moreover the diseas'd are wont to complain of a Trembling and palpitation of the heart with a mighty oppression of the same also frequent Failings of the Spirits and danger of Swooning come upon them that the diseased always think Death at hand In this Region about the Membranes and especially the Mediastinum an acute Pain which one while is determin'd in one part another while is extended to the Shoulder is a familiar Symptom of this Disease But in the Head an Iliad of Evils for the most part troubles Hypochondriacal persons to wit most violent Pains Periodically returning arise also Scotomia's frequent Giddiness Obstinate Watchings a Fervency and a most troublesome Fluctuation of thoughts
of Cichory with Rhubarb or of Roses with Agarick ought to be given And I have often seen a Convulsive affect in Children Cur'd by these Remedies when seasonably administred moreover Clysters in this case are of frequent use But withal let not outward Medicaments be omitted viz. Fomentations Liniments and Plaisters to be applyed to the Belly Take Cammomil Leaves small slic't two handfuls let them be put into two bags made of fine Linnen or Silk which being dipt into warm Milk and wrung forth must be applyed successively to the Belly Take Tops or Flowers of Mallows slic't boil them in fresh Butter or Hogs Lard and let them be applyed to the Belly in the form of an Ointment or Cataplasm CHAP. III. Instructions and Prescripts for Curing Convulsive Diseases in Adult Persons hapning by reason of the Origine of the Nerves being chiefly affected THough Convulsive affects which happen to Adult Persons being denoted by other Names are also vulgarly accounted to have another Origine and are wont to be refer'd to those they call Hysterical Hypochondriacal or Colick passions or to the Scurvy nevertheless if the thing be a little more attentively considered it will easily appear that certain Convulsive Symptoms frequently happen both to Men and Women which properly and duly claim the name of a Convulsion Now these may be variously distinguisht according to the Manifold seat of the Morbifick cause but especially into these three kinds viz. into certain Convulsions caus'd by reason of the Origine of the Nerves being chiefly affected and into others which are caus'd by reason of the extremities of the Nerves being stopt with a Morbifick Matter and lastly into others whose Morbifick Matter descending from the Head gets possession of the whole or the greatest part of the Ductus's of some peculiar Nerves or of them altogether We shall treat of each of these kinds of Convulsions one after the other Therefore first of all as to Convulsions hapning by reason of the Origine of the Nerves being affected we must note first that the Morbifick Matter besetting the Origines of the Nerves sometimes passes chiefly into the foremost Pairs of Nerves viz. which attend the Muscles of the Eyes and Face and thence Contractions and tremblings sometimes of the Nose Cheeks or Lips sometimes of the Eyes or Mouth ensue Secondly sometimes the Par Vagum and Intercostal chiefly imbibe the Heterogeneous Particles and then Inflations or Contractions of the Abdomen and Hypochondres and also a Palpitation and Trembling of the Heart a difficult and interrupted Breathing an intermitting Pulse and other Symptoms of the middle or lower Region of the Belly chiefly molest us Thirdly but sometimes the Morbifick Cause lying behind chiefly affects the Spinal Marrow and therefore the outward Members and Limbs are rendred obnoxious to Twitchings and Contractions Moreover as we may conjecture from various Types of the Con\vulsive affect it seems that the Convulsive Matter going to these or those Nerves or to many of them together either lodges it self in a manner only about their Origines so that upon frequent Explosions of the Spirits there an almost continual and very troublesome Vertigo arises and so Tremblings and a short Fainting and danger of Swounding are perceiv'd about the Praecordia and often Twitchings and gentle Contractions in the Bowels or Muscles Or Secondly the explosive Particles convey'd to the Origine of the Nerves enter deeper into their Processes and often falling down into the Plexus's of the Nerves belonging to the Praecordia or Viscera of the Belly or also to the outward Members make there other seats as it were of Convulsive affects so that as often as the Spirits are forc't to Explosions about the Origine of the Nerves presently Fits as it were Hysterick Asthmatick or otherwise Convulsive arise in the Belly Thorax or outward Members I shall now give you some instances of Persons in whom the Morbifick Matter besetting the Origine of the Nerves and not yet fall'n deeper into their Processes caus'd frequent Vertigo's and only gentle Convulsions of the Viscera and Praecordia 1. A Lady of great Quality about Thirty years of Age of a tender Constitution and of a thin habit of Body was wont to be sorely afflicted every Winter with a Catarrh distilling on her Trachaea and Lungs with a Cough Hoarsness and great Spiting but the last year through a diligent care and caution us'd she escaped that evil But after the Winter solstice upon taking cold she was seis'd with a violent Head-ach a ringing in the Ears a Vertigo with a mighty Distillation of Rheum at the Eyes and Nose whence it easily appear'd that the filthy Mass of Serum which was wont before to distil on the Brest was then wholly depos'd within the Head and Brain The effect whereof moreover was that as often as she began to sleep she was very much troubled with a sort of Hysterick Fits to which she had never before been obnoxious For if at any time beginning to sleep she clos'd her Eyes presently it caus'd a rising of a heavy thing in her Belly a Suffocation in her Throat and Tremblings and Twitchings about the Praecordia Which affects nevertheless when she was perfectly awak't presently ceas't so that the Diseas'd was forc't to abstain in a manner wholly from sleep for many days and nights together Being call'd to this Lady after she was become very weak upon many days Sickness I was forc't to use only gentle Medicines Therefore I ordered four Ounces of Blood to be taken from her Foot and a Clyster of Milk with Sugar to be daily given her after which she was wont to have three or four Stools Moreover every eighth hour I gave her a Dose of Spirit of Harts-horn in a Spoonful of the following Julape Take Water of Penny-royal Wallnuts black Cherries of each three Ounces Hysterick Water two Ounces Syrup of Clovegilly-flowers an Ounce and a half Castoreum tyed in a Nodulus and hung in the Glass half a Dram Pearl powdred a Scruple mix them I applyed with good effect Vesicatories behind the Ears and Cataplasms of Leaves of Rue and Aron with Bryony Roots Sea Salt and black Soap to the Soles of the Feet Sometimes in the Evening I gave half an Ounce of Diacodium in a little Draught of the Julape before ordered which was followed by a moderate sleep without being attended according to wont with Convulsions Which kind of effect I have often experienced in such a case after Opiats given For quenching Thirst I gave a Ptisan with Diuretick Ingredients boil'd in it By the use of these things she was very much reliev'd within a short time But that which fell out much for her good was that an Abscess in the left Ear breaking of its own accord first discharg'd a yellow Gore and afterward for many days a vast quantity of thin Ichor After which Evacuation the Convulsions of the Bowels and Praecordia wholly ceasing the Disease was perfectly determin'd I have known many
Persons both Men and Women Diseas'd after this manner who being ill of a Head-ach an oppression of the hinder part of the Head or a Vertigo perceiv'd in their sleep presently Convulsive motions in the Praecordia or Bowels or in both of them together Which happens from the Salley of the tumultuary Spirits reflected from the Brain into the Origines of the Nerves And as an Opiate gave the Patient before mention'd a quiet sleep without the wonted Sequel of Convulsions so I have often successfully Cur'd terrible Convulsive Fits both Asthmatical and as it were Hysterical by giving Opiats 1. A Woman sixty seven years of Age having still a florid Countenance and being of a gross habit of Body and who first had liv'd long subject to a Swelling of the Face and great Fits of the Head-ach upon the Weathers growing very cold in the Winter fell into a very grievous Vertigo with a Trembling of the Heart a Fainting of the Spirits and a frequent striving to Vomit Being put to Bed if she open'd her Eyes or was turn'd from one side on the other she was presently seiz'd with a mighty Scotomia a danger of Swooning and moreover with a cruel Vomiting As I was to see her I did not doubt but the cause of the Disease was the Convulsive Matter convey'd from the outward Region of the Head to the inmost Recesses of the Brain by the ill Breath or Heterogeneous Combination of which the Animal Spirits being struck they rais'd the Vertiginous affects as they made their disorderly sallyes towards the Brain and when they tumultuarily rusht into the Roots of the Nerves they caus'd the Scotomia the disorders of the Praecordia and the striving to Vomit The Cure of this was perform'd within a few days by the application of large Vesicatories to the Nucha and behind the Ears the dayly injection of Clysters and by a frequent use of Spirit of Harts-horn and a Cephalick Julape Dr. Willis gives Instances of Persons in whom some portion of the Morbifick Matter which besets the Origine of the Nerves descending from the Head often enters deeper into the Ductus's of the Nerves and so about their middle and extream Processes and Plexus's makes a fomes of an explosive matter as it were of Gun-powder But for brevity sake I omit them It is observ'd that when a Convulsive Fit begins within the Brain at the Origine of the Nerves presently the remotest Spirits residing in the extremities of the Nerves as many as are predispos'd for that Symptom fall upon Explosions and so convey upwards the Convulsive affect there more strongly begun which happens for this reason that when some whole Series of Spirits is disturb'd those which are in the extream parts are first destitute of their Original Influx wherefore those before others begin to grow in a tumult and to be irregularly dispos'd as when a Nerve of the Arm or Thigh is constring'd by lying on it so that it is hindred of its wonted influence of the Spirits a stupor with a sense of pricking is first perceiv'd in the Fingers or Toes of the hands or Feet whence it creeps upwards by degrees towards the places affected And hence it is we find that if whilst the outmost Spirits are exploded a strong Ligature or Compression intercepts the succession of others into the same space or their progress towards the parts the Convulsion is usually hindred from ascending upward Wherefore as Physical Histories testify when a stupor beginning at the top of a Finger or Toe of a hand or Foot creeps to the upper parts with a sense of Formication or like a cold wind and at length taking to the Brain causes terrible Convulsions If presently at the first seizure the Arm or Leg be strongly bound about the Convulsion being not able to pass that place is hindred from getting to the Head Nay and it s an usual thing for Hysterick Women assoon as a Swelling of their Belly or an ascent of a heavy lump is first perceiv'd in their Abdomen to bind about hard the Trunk of their Body with Swathes and so commonly the Praecordia and the Region of the Head are kept from being affected with the Convulsive Fit It 's likewise observable that if Blood be let forth of a Vein in the midst of a Covulsive or Apoplectical Fit it presently seems to be congeal'd so that being receiv'd in a Bason it does not keep an even and plain Surface like Liquids but accumulating it self drop upon drop it rises in a heap like Tallow melted and distill'd into a cold Vessel Yet as to what some conclude hence viz. that Convulsions depend wholly on the thickness obstructed motion and stagnation of the Blood we must not allow of it For Blood drawn from Persons that are subject to Convulsions a little before the Fit is diluted with Serum and fluid enough Wherefore we may opine that that Congelation is caus'd by the Fit it self To wit because in Convulsive motions from the excessive Contractions of the Muscles and Viscera the Blood passing bet wixt them its Spirit and Serum exhaling is a little solv'd in its mixture and therefore is somewhat coagulated just as when Milk by reason of its too great agitation and Separation of parts one from another hardens into butlter wherefore this kind of Coagulation of the Blood seems rather to be the effect of Convulsions than their cause The Therapeutick Method AS to the Cure of these kinds of Convulsive affects which in Men or Women proceed from a Morbifick cause besetting the Origines of the Nerves The first Indication will be to withdraw the fuel of the Disease viz. to hinder the Blood from discharging on the Head the Heterogeneous Particles either engendred in it self or receiv'd from elsewhere from the Bowels For this purpose an Evacuation ordered both by Purging and Bleeding unless somewhat indicates the contrary is wont to be administred with good success Vomiting very often gives relief wherefore let Vomits of the Infusion of Crocus Metallorum or of Salt of Vitriol or of Wine of Squills be given in the first place Then in a few days let Blood be drawn either by opening a Vein in the Arm or by Leeches applyed to the haemorrhoid Veins then afterwards let a gentle Purge be ordered either of Pills or of a Purging Apozeme and let it be repeated in due and convenient time Take Crato's Pills of Amber or Bontius's Pills of Tartar two Drams Rosm of Jalap sixteen Grains Castoreum a Scruple Oyl of Rosemary or of Amber half a Scruple Gum Ammoniacum dissolo'd in a sufficient quantity of Hysterick-water make sixteen Pills let four be taken every sixth or seventh day Take Roots of Polypody of the Oak sharp pointed Dock prepar'd and of Chervil of each six Drams of Male Peony three Drams Leaves of Betony Germander Ground-pine Vervain Male Fluellin of each a handful Seeds of Carthamus and Burr-dock of each three Drams let them boil in four Pounds of Fountain-water
also Elixir Proprietatis sometimes also Spirit of Harts-horn for many days afterward at long run upon taking that Powder daily for some space she began to find help Inthe mean while that this Method of Cure was followed her Hair being Shav'd off her Head was cover'd only with a thin Dress she wore the Hysterick Plaister with a mixture of Galbanum on the Abdomen She drank for her ordinary drink a Boâ—het of Sarsa and China with the Roots of Male Peony and other appropriated things infus'd and boil'd in Fountain Water Within a Month the Fits remitted a little Afterward becoming more mild by degrees and lesser at length they ceas'd in a manner altogether unless that near the time of her Menses she was wont to be troubled with an assault or two of that disease Moreover she was troubled almost with a constant Giddiness and a loathing of Meat in the midst of Summer the drank Astrope Waters for six weeks and grew perfectly well As to the way of Cure to be us'd in general for such Marvellous Convulsions it is not an easie thing to assign Remedies equal to so Hereulean a Disease or a certain method of its Cure confirm'd by frequent experiments For besides that cases like those seldom occur we may likewise observe that the same Medicine which did good to this sick person at one time gave not the least relief to another person or the same when given at another time the reason of which seems to be that the cause of the Disease seems to consist in the Discrasy of the Nervous Juice Which liquor is not always perverted after one and the same manner But from the manifold combination of the Salts and Sulphurs gets a Morbid disosition of a various kind and condition and often changes it Wherefore in those difficult affects we must not prescribe vulgar Medicines taken from Apothecaries Shops but Magisterial ones as occasion requires according to the appearances of the Marvellous Symptoms A Gentle Vomit a Purge and Bleeding ought in the first place to be us'd and sometimes to be repeated as it shall seem convenient And as to Specifick Medicines and such are appropriated in those cases since the chief Indication will be to amend the Crasis of the Nervous Juice we may try a great many things and sift their vertues from the effect Therefore we may try what things endued with a Volatile or Armoniack Salt will do For this purpose let the Spirits and Salts of Harts-horn Blood Soot the Flowers and Spirits of Sal Armoniack be taken These giving no relief we must come to Chalybeats let the Tinctures and Solutions of Coral and Antimony be given which sort of Medicines must be given in such a Dose and form and for so many times that some alteration may be made by them in the Blood and Nervous Juice Again if these have not success we must proceed to Alexipharmicks which are good against Poyson and a Malignity gotten into the Humours viz. of these we must order Decoctions Destillations Powders Conserves and other Preparations of Vegetables and we must variously compound them the one with the other and administer them several ways It seems likely that those sorts of Medicines which being inwardly taken are wont to do good to such as are bit by a Viper or by a Mad Dog and likewise against Wolfs-bane and Napellus may also be of use in the above mentioned Convulsions We may here after the example of Gregor Horstius in his Tracts of the Malign Convulsive disease prescribe also Magisterial Remedies in form of a Purging Electuary also of a Powder and Convulsive Antidote for these Marvellous Convulsions and variously Compound the same of Simples partly Alexipharmical and partly Antiepileptical CHAP. VIII Of the Affects which are vulgarly call'd Hysterical IF at any time an unusual sort of Sickness or of a very Secret Origine occurs in the Body of a Woman so that its Cause lies hid and the Therapeutick Indication be wholly uncertain presently we accuse the evil influence of the Womb which for the most part is guiltless and in any unusual Symptom we cry out that there is somewhat Hysterical in it and consequently the Physical intentions and the uses of Remedies are directed for this end which often is only a starting hole for Ignorance The passions which are wont to be rank't in this number are found to be various andmanifold which seldom agree in divers Women or happen wholly after the same manner the most common of them and which are vulgarly said to Constitute the formalstate of an Hysterick affect are these viz. A Motion in the lower part of the Belly and an Ascent as it were of some round thing there then a Belching or Straining to Vomit a distention of the Hypochondres and a Rumbling with a Belching forth of Wind an uneven and for the most part a letted Respiration a Suffocation in the Throat a Giddiness an Inversion or Rotation of the Eyes often Laughing or Weeping a Talking Idly sometimes a Speechlesness and Immobility with an obscure or no Pulse and a Cadaverous aspect sometimes Convulsive Motions rais'd in the Face and Limbs and sometimes in the whole Body But universal Convulsions seldom happen and not unless the disease be raised to its worst state for the Tragedy of the Fit is acted through for the most part without any contraction of the Members only in the Belly Breast and Head viz. one of them or successively in all Women of all Ages and Conditions are obnoxious to these affects to wit Rich and Poor Virgins Wives and Widows I have observed those Symptoms in Girls before the time of Puberty and in old Women after their Menses ceast to Flow nay and men are sometimes troubled with such kind of Passions instances of which are not wanting The cause of these Symptoms must not be imputed to the Ascent of the Womb and to vapours rais'd from the same nor to the Impetuous rushing of the Blood into the Lungs as the Learned Highmore has Judg'd But we say that the affect call'd Hysterical chiefly and primarily is Convulsive and depends principally on the Brain and Genus Nervosum being affected and is produc't wholly by the exposions of the Animal Spirits as other Convulsive Motions And whatever disorder or irregularities happen else about the Motion of the Blood they are only secondary and depending on the Convulsions of the Viscera The way of the difference whereby the kinds of this disease both differ from each other and from the other Convulsive affects is taken from the various Origine and chiefly from the extension of the Morbisick Cause for the Origine of this as of many other Convulsive affects sometimes resides in the Head the Womb being wholly without fault Though sometimes this affect happens through the fault of the Womb and sometimes through that of other parts As to the extension of the Disease from whatever Origine it proceeds for the most part it chiefly affects the Interiour
Nerves to with those that particularly regard the Viscera and Precordia and their appendixes and chiefly troubles the Spirits lying in them Sometimes also though rarely the Spirits that presides in the Exteriour Nerves and likewise those in the Brain and Cerebellum are involv'd in the same affect As to the Morbifick Matter or Explosive Combination which accruing to the Spirits within the Brain and deriv'd with them into the Processes of the Nerves often is the cause of the affects which are vulgarly call'd Uterine or of the Mother We say this to be Heterogeneous Particles sent from the Blood as in other kinds of Convulsions and which are wont to be made to cleave to the Spirits that pass into the Origines of the Nerves on two chief occasions viz. either through the fault of the Spirits themselves or through the great force of the Matter instances of both kinds every where occur Through the fault of the Spirits themselves as when through a sudden Passion suppose of Fear Anger Sadness they are very much Troubled and forc't into Irregularities through the Exorbitant force of the Matter as in the evil Crises of Fevers also in any Malignant and Scorbutical and other Chronical affects of an ill Determination these causes are much upheld and promoted by an ill or weak Constitution of the Brain and Genus Nervosum whether it be hereditary or acquir'd by an ill dyet hence Women are more obnoxious to Convulsive affects than Men and those one more then another Tho' these they call Hysterical affects very often arise from the Brain yet sometimes they are rais'd by a cause beginning either in the Womb or in other of the Viscera and this either by reason of a solution of continuity through a Tumor or Ulcer or Stimulation of the part or by reason of the obstruction of the Nervous Juice in its Circulation thus when some accustomed evacuation whereby the superfluities of the Nervous Liquour were wont to be discharged is stop'd as upon the sudden stopping of Issues or drying up of old Ulcers without Purging many have fallen into Convulsive affects which sometimes also happen to Virgins and widows through a retention of the Semianl homour which ought to be Voided its proper way And sometimes the Nervous Juice regurgitates toward its Origine because its passage is somewhere stop't by a Cancrous or Scirrhous Tumour To illustrate our doctrine of the vulgarly call'd Passions of the Womb I shall now give an instance of a person troubled with them A Renowned Lady extreamly beautiful and endowed with an excellent temper of mind and manners lately lived in these parts who for many years was obnoxius to Convulsive affects she having contracted this valetudinary disposition fro her Birth or Hereditarily and having found in herself these fruits of the morbid root almost every fourth year of her Age but especially as often as she conceived with Child as she often had and undergone frequent Abortions she was wont to be extraordinarily troubled with Convulsive passions in a manner Hysterical For presently upon the stopping of the Menses the Heterogeneous Particles being convey'd to the Brain and Genus Nevosum brought violent Fits of the distemper After that she had last conceived in the first Months according to her ancient wont she was often troubled with Convulsive affects about the uinth week of her being with Child upon taking Cold she fell into a dangerous Fever in which very acute Pains sorely infesting her in the Loins and about the lower part of the Belly seem'd to threaten an Abortion But those Pains as it appear'd at last being rather to be judg'd of the Colick proceeded from a Sharp humor falling from the Brain into those parts by the Ductus's of the Nerves for about the declining of the Fever that matter being convey'd elsewhere a Diarrhaea Pains of the Feet and a Blistering as it were ensued As soon as this Lady grew well of her Fever and Pains the Convulsive affects returned for every morning as she awaked from her sleep she was wont to undergo violent Contractions and Convulsions about the parts of the Mouth and Face and also in the Arms and Legs which Syptoms doubtless arose from the Serous filth heap'd together in the Head about the Origines of the Nerves and deeply Imbib'd by them during the sleep together with the Juice that passes in them and when afterward the same matter was caryed again by the conveyance of the Interiour Nerves into the Plexus's of the Mesentery and the Loins most violent Pains of those parts and likewise Fits as it were Hysterical sorely infested her For those Convulsive Motions of the Face and Members ceast in a short time yet she continued still Weak and Infirm with a Pale Countenance Trembling as she went and having a mind to no Food but such as was improper and to hot Liquors about the end of the third Month at which time she used constantly to Abort her Menses broke forth which passing from her for two or three days together with pieces of broken Membranes she expected the Abortion But the Flu ceasing Pains like those of a person in Labour arose in the Abdomen and Loins as before and miserably tormented her day and night for a week At length having us'd a Bath of Emollient Herbs and then being put to bed to sweat she was delivered of the burthen of her Womb the Conception thus passing from her with a mighty torture was as a Pea-hens Egg in bigness and figure the outward coat of this was ragged and broken the inward coat remaining whole contained about half a pound of clear Water and nothing else And no rudiments of a Faetus that was form'd or about ot be form'd did appear Afterward for four or five days the Lochia flowed from her with some pieces of Membranes Mean while Pains troubled her with their wonted violence And in regard that after a week was past they did not cease of their own accord at length remedies were desir'd for appeasing them For this end in the first place Liniments Fomentations Baths and Glysters were freuently administred And Medicines cleansing the filth of the Womb on which the cause of the whole distemper was charg'd were inwardly taken Upon the use of the former short intermissions of the Pains followed But now and then the affect returned and was mighty tedious Nay and within three weeks the disease growing much worse brought many other horrible Symptoms along with it For besides the Pains in the Abdomen and Loins which grew daily more violent she was now troubled likewise with a great torture in her Back Neck Shoulder Blades also in the Arms and Leggs and that more severely as often as she grew warm in her Bed Moreover she was afflicted with a frequent Giddiness a Vomiting and Nauseousness and often in a day with vehement Convulsive Fits viz. First a great heavy thing seeming to Ascend in the lower parts of the Belly presently raised up the
have judged the cause of the Disease to be seated wholly about the Stomach or Hypochondres Nevertheless Cathartick Medicines Emeticks Digestives Cephalicks Antiscorbuticks Chalybeats and others almost of every kind prescribed to this Person for two years by famous Physicians and also by Empiricks and Mountebanks have not effected a cure he lately tryed Astrop VVaters but finding himself the worse by them he presently left them off and is now advised to drink the Sulphureous VVaters at Knaresborough in York-shire But what success he finds in them I know not at present This case in regard by reason of the concourse of the various Symptoms it does not belong to any peculiar kind of Disease else is justly referred to the Scurvy As to the Method of Cure to be used in this and the like cases there are two Intentions on which we must chiefly insist viz. First we must cleanse the Mass of Blood and withdraw the offensive Ferments conveyed to it from the Stomach Spleen and haply other of the Viscera Secondly the Brain and Genus Nervosum ought to be strengthned lest they admit extraneous Particles and the nervous juice that lyes in those Parts degenerating from its due Crisis to a sharp and otherwise morbid Nature ought to be restor'd and rectified the first of these is perform'd by Catharticks Emeticks bleeding and especially specifick Medicines correcting or wholly taking away the scorbutick taint of the Blood Now that the Iron or vitriolick Spaws that famous cleanser of the Blood did rather injury than give help to this Person the reason seems to be both that the Brain being become weak by reason of Cephalick Affects with difficulty throws off the filthy glut of Waters sent into the Blood nay and is in danger of being overwhelmed by it as it violently makes to its confines and likewise because when the nervous Liquor degenerating from its Crasis inclines to a sharpish Nature it is wont to be more perverted by the fluid Salt of the Spaw Waters Wherefore we generally observe that in the Rheumatism and Gout the morbid Disposition is increast by the drinking of those Waters The second Intent is excellently performed by Cephalick Remedies and especially such as are endowed with a volatile Salt of which kind are Spirit and Salt of Blood of Soot of Harts-horn the roots and Seeds of Peony leaves of Mistletow of the Oak c. with which Antiscorbuticks are mixt The London Practice OF PHYSICK CONTAINED In Dr. Willis's Tract of the Diseases that regard the Corporeal Soul and its subjects viz. the Brain and Genus nervosum CHAP. I. Instructions and Prescripts for the Cure of the Head-ach SInce all Pain is an Action violated or an irksom Sensation depending on the contraction or corrugation of the Nervous Fibres the subject of the Head-ach must be the parts of the Head that are most nervous that is the Nerves themselves also the Fibres and Membranes whereof it has many plac'd both upon and under the Scull and those parts which are affected with pain are chiefly the two Meminges and their various Processes the Tunicles of the Nerves the Pericranium and other Periostia the Muscles the Panniculus carnosus and lastly the Skin it self As to the Brain and Cerebellum and their medullary appendixes we conclude that these Bodies in regard they want sensible Fibres apt to be corrugated and distended continue free from pain and so the same is also to be said of the Scull Now whenever a pain is rais'd any where about the nervous parts of the Head its formal cause consists in this that the animal Spirits being sever'd from each other and put to flight cause the Bodies that contain them to be withal convuls'd and corrigated and so raise that troublesome sensation And that which so distracts the Spirits that a troublesome sensation thence arises is somewhat disproportionate rushing against the Spirits themselves or the Bodies that contain them which entring the Pores or Interstices of the Fibres severs them from each other and withal forces the Spirits there residing to Irregularities As to the Prognostick of this Disease in case the morbid disposition be inveterate so that Fits for many years have often return'd of their own accord and likewise upon any slight occasion we predict that the diseas'd though not much in danger of life will not easily be cur'd Moreover that the Cure will be yet more difficult if hypochondriacal or hysterick affects often troubling them are wont at frequent times to raise the Head-ach or if the corrupted taint of an inveterate Venereal distemper be radicated in the Part affected And if the Head-ach be not only inveterate but almost continual that we may justly suspect it to arise from a phlegmonous or schirrous Tumour an Erysipela Abscesses or Worms there remains but small or no hope of Cure A Head-ach whether continual or periodical if it be violent and has a Vertigo Vomiting and other affects either convulsive or sleepy joyn'd with it gives suspicion of great danger forasmuch as it frequently passes into a mortal Apoplexy and often into an Epilepsy Palsey Blindness Deasness and other Diseases either very severe or incurable The Therapeutick method of the Head-ach comprehends many Indications and those of various kinds according to the manifold species causes and differences of this Disease which it will not be easie to digest and place all here in an exact order An accidental or occasional Head-ach viz. such as is wont to arise from an evident cause alone without any Procatarxis or previous disposition as when it happens upon drinking Wine Surfeiting being in the Sun or through a vehement exercise also in fits of Feavers this for the most part ceases of its own accord upon the removal of the evident cause and its consequences or at leastwise is taken away by bleeding rest and sweating In every habitual Head-ach whether continual or intermittent two chief scopes of curing occurr to which all the other Therapeutick intentions ought to level and with which provision is made against each cause of the morbid origine 1. viz. In the first place for the cutting off all the fewel of the Disease we must endeavour both that the matter flowing or oftentimes apt to flow to the affected or ill dispos'd places of the Head be either stopt or withdrawn thence to some other place and likewise that the Convulsions rais'd in other places and thence wont to be propagated to the Head be prevented 2. Then Secondly in order to the eradicating of the Disease it self or if it may be of its conjunct Cause we must endeavour that the places of the Head predispos'd for Aches whether only weak or injur'd in their conformation being fortified against the frequent incursions of the offensive matter recover their ancient state and vigour which Indication though it be seldom ever perform'd on a sudden or throughly yet sometimes by a long and diligent care the morbid root how fix'd and radicated soever it be it consum'd As to
Purging to apply Anodyne and mitigating Epithemes to the Places affected and also often to give gentle Hypnoticks by frequent changes Apozemes also and Juices and Expressions of Herbs that allay the Fervour of the Choler and gently carry it off by Seige and Urine are of excellent use but in the mean time let smart or strong Medicines whether they operate by Seige Urine or Sweat in regard they too much fuse and exagitate the Blood and Humours be carefully avoided I have often observ'd in Persons troubled with an acute and obstinate Pain of the Head that the Serum swimming on the Blood when let forth have been ting'd with a Yellowness or with bilous excrements incocated in it and that also in this Case a spare and frequent Bleeding and afterward a free drinking of Whey and Spaw-Waters have given a notable Relief and beyond other Remedies 4. Moreover if the Parts of the Head suster through the Fault of some one of the Viscera as of the Stomach Liver Spleen Womb or any other by reason of the Transmission of the ill Ferment then in the Cure of the Disease let such Remedies as regard the Viscera be administred together with Cephalicks hence to certain Persons troubled with the Head-ach whose Stomach also is in a Fault Elixir Proprietatis Mynsichts Elixir of Vitrol Tinctura sacra Vitriolum martis the compound powder of Aron Roots and other things vulgarly accounted for Stomachals often do good to others whose Heads participate of the evils of the Spleen Chalybeats often give help Some Women sometime find ease of their Head-ach by hysterick Remedies in like manner when the Faults of other Parts contribute to the Head-ach let the coindicated things taken from those Parts be joyned with the first things indicated 5. Sometimes the nutritive Juice is the Cause of a periodical Head-ach viz. in as much as being mix'd with the Blood and not duely assimilated it causes a Turgescency in it by reason of its disagreeing Particles so that the Blood boyling to the Head throws off its Refuse in its Meninges or certain Parts of them predispos'd for it and so irritates the Fibres to painful Convulsions For this Reason I have known many to have been obnoxious to a daily Head-ach after the Measles Small-Pox and other Fevers or Sicknesses with which the Mass of Blood is wont to be vitiated viz. so many Hours after Meals sometimes sooner sometimes later first a flushing of Blood in the Face then a Plentiude and Pain in the Head infested them moreover after drinking of Wine or eating of turgid Food they were more severely punish'd The Access of the Distemper is wont to happen sooner or later after they have eat or drunk according as the Chyle begins to grow turgid either a little after its first entrance into the Blood or after it has stay'd some while in it This affect is free from Danger and for the most part is easily enough cur'd After a Provision being made for the whole a gentle Purge and sometimes blooding being ordered Remedies which restore the Crasis of the Blood such as are chiefly antiscorbuticks and Chalybeats prove mighty beneficial Take Conserve of Fumitory Tansey Wood Sorrel of each two Ounces compound Powder of Aron Roots three Drams Ivoy Crabs Eyes Coral prepar'd of each a Dram and a half powder of yellow Saunders Lignum Aloes of each half a Dram Vitriol of Mars a Dram salt of Wormwood a Dram and a half syrup of the five Roots what suffices make an Electuary let the Quantity of a Chesnut be taken in the Morning and at five a Clock in the Afternoon drinking after it three ounces of the following Liquor Take Water of the Leaves of Aron Vervain and of the Flowers of Elder of each six Ounces magistral Water of Snails and Earth-worms of each two Ounces Sugar on Ounce mix them Various Medicines wont to be us'd against the scorbutick Diseases of the Blood may be rang'd here and giv'n with good Success for Head-aches which are so familiar in the Scurvy oftentimes proceed from the Fault of the Blood perverting the nutritive Humour and discharging its Recrements in the Membranes of the Head wherefore the Remedies mention'd by me elsewhere against that affect claim a place also here 6. There remains yet another Humour to wit the nervous Liquor which being carried into the Fibres of the Meninges and other parts of the Head sometimes becomes disproportionate to the Fibres by its own disagreeing nature as it is sharp or otherwise degenerate sometimes twitches the containing Parts and irritates them into Convulsions or painful Distentions as it strongly ferments with some other humour viz. the nutritious or serous Humour flowing thither The nervous Humour where it is thus morbifick either being vitiated in its whole Mass brings a very great Injury on the Brain predispos'd for it or being faultless of it self is perverted within the Fibres affected and so becomes morbifick secondarily the Cure of which then depends on the Restitution of the containing Parts viz. If the Weaknesses of the Fibres or their injur'd Conformations be amended the Humour irrigating them will presently be free from Fault With what Remedies the Defaults of the Parts predisposed for Head-achs are remov'd we shall presently acquaint you Mean while if the nervous Humour being degenerate in its whole Mass causes a great Offence to the Head predispos'd for Pain let those kinds of Medicines and that method be us'd with which being reduc'd to its due Crasis and gently passing through those Fibres it may irritate them little or not at all for which end neither strong Purging nor large or frequent Blooding are proper in regard they exagitate the Blood and Humours and impair the Strength and consequently give a greater Acrimony and Rage to the nervous Humour which was faulty before But gentle Loosners and a spare Bleeding will now and then be of use whereby the Viscera may be cleans'd and the Mass of Blood be somewhat purg'd and a way be prepar'd for other Medicines which will succeed the better afterwards Now the Medicines that render the nervous Liquor more friendly and benign to the Membranes of the Head which are wont to be offended by it are those which are vulgarly call'd Cephalicks viz. whose Particles being active enough and withall fine and subtle pass the Blood without any Turgescency or Tumult and then insinuating themselves into the nervous Liquor gently actuate it and cause the Ductus's of the Nerves so to open themselves that thereby the animal Spirits more freely irradiate all Bodies both sensible and motive and inspire them without Swoonings Convulsions or anomalous Distentions These kinds of Remedies tho not always efficacious nevertheless often remove some Head-achs that are not very inveterate and in others tho never so obstinate they frequently do good moreover those things that are prescribed against Pains of the Head are also given against Affects of the Brain and Genus Nervosum and on the contrary the things
the excretory Vessels gape into the cavity of the mouth certainly by this way chiefly the envenom'd Latex of the Blood will find its passage forth which it cannot readily do elsewhere Wherefore upon a Salivation being rais'd the Blood long fermenting like Wine or Beer purging it self throws off by the Ductus Salivales and the innumerable Meatus every where gaping into the Mouth whatsoever extraneous and degenerate substance it may either contain within it self or can drink up or receive from elsewhere be it from the Viscera or solid Parts or from other humours Moreover it is likely that as the off-scowrings of the Blood so also those of the Liquor that irrigates the Brain and Nervous Appendix being stirr'd upon the entrance of the Mercury are voided forth also this way viz. by the Ductus Salvales Therefore a Salivation caus'd by Mercury if haply it succeeds well removes sometimes difficult and indeed Herculean distempers and such as will not be mastered by any other Remedies viz. forasmuch as this operation by a long expurgation throughly cleanses the Blood and nervous Juice and other humours destroys all exotick serments quells the enormities of Salts and Sulphurs and also exagitates the morbifick matter sticking any where or stagnating and often leads it forth Nevertheless this Medicine is not always free from danger viz. because the Mercury being become exorbitant and carrying with it a mighty store of most sharp and as it were envenom'd Serum and rushing violently into the noble Parts and especially the Brain with the appendixes both medullary and nervous or into the Lungs and Praecordia brings upon them an indelibel and sometimes a mortal prejudice Wherefore in an ancient and fore Head-ach there is danger lest the indispos'd Fibres be more irritated by the Mercury pervading them with much and Corrosive Serum and be put upon greater Convulsions and painful Corrugations And also lest upon the mighty recourse of Humours to the Head the Brain be invaded and consequently which happens too often lest the sleepy or Convulsive affects be caused I would have discoursed more concerning these things because it is of a great concern but that we daily expect an exact method of Salivation and a full account of it as to its ways and effects advantages or disadvantages to be set forth by the Leanred Physician Dr. Needham From Chirurgery there remains yet another famous remedy for curing inveterate Head-achs viz. the opening of an Artery Some of the moderns use this and very much extoll it it being greatly accounted of amongst the Ancients Nevertheless as far as it has appeared to our observation success has often been wanting to that so much cryed up operation Nor is it a wonder because that ground on which the Ancients relying blam'd the Arterious Blood as differing from that of the Veins and more exorbitant and therefore advised it to be let forth does not hold good Nor indeed is thereany other reason wherefore Blood drawn from an Artery rather than from a Vein near the place grieved should give ease but rather on the contrary we may expect a greater help from the opening of a Vein because an Artery being emptied receives and draws away nothing from the part affected but a Vein being opened in the place of the Blood issued forth draws from the whole Neighbourhood and often drinks in again and restores to circulation the Blood and other humours heaped together and Stagnating near the seat of the Disease However lest we recede too far from the practice of the Ancients attributing nothing to Arteriotomy we grant that sometimes haply it gives help tho not immediately and causally but only by way of consequent and per accidents viz. forasmuch as the ends of a cut Artery grow together so that the passage for the Blood that way is stopt for the time to come hence in regard somewhat a less store of Blood is brought towards the place by the Arteries and an equal quantity is still carried away by the Veins therefore it sometimes happens that the fuel of the morbifick matter is diminished and that its flock is consumed by degrees For this reason that administration has often succeeded well in distempers of the Eyes Moreover Farriers use a practice not unlike this for curing malignant tumours in Horses Legs to wit they take and bind the Artery by which the matter flows to the part affected mean while that which was there sticking partly evaporates and partly is drunk up again by the Vein I have heard that in a manner the same method was successfully tryed by our Harvey for curing strumous and schirrhous tumours also in the Body of man I might here set down many other kinds of Remedies and also Prescripts and forms of Medicines which are wont to be used both by Physicians and by Empiricks for curing Head-achet but the Books of Physicians abound too much with these I shall now give you some rare cases of Persons troubled with the Head-ach and first some examples of a most severe continual Head-ach which also the cause being invincible has often proved fatal A Woman fifty years of age after that she had been ill for about six months with a very great pain of her Head troubling her almost continually under the Sagittale Suture and yielding to no Method or Medicines fell at length into a Lethargy with a Partial resolution of her Limbs from which nevertheless being in a short time recovered by remedies seasonably administred she had again the violent pain in her Head as before and afterward within a fortnight or three weeks falling into a sleepy affect she departed this life The Scull being opened on the side of the third Sinus a schirrhous tumour three fingers broad grew to the Membranes by the mediation of which the Dura Menix also for some space grew to the Pla and the Blood Vessels which ought there to open into the cavity of the Sinus were stopt moreover both the outward Anfractus of the Brain and â—its inward cavity were filled with clear water From these observations the invincible and at length mortal cause of that Disease may plainly appear I remember formerly to have observed by Anatomy a case like to this in a certain other Person Moreover in regard I judge that in many Persons troubled with the Head-ach the Disease depends on such an invincible cause I shall here give you one instance that is quite fresh of that kind of affect Some few years since I was called to see a Lady of Quality troubled for above twenty years with a Head-ach which at first was intermittent but of lat eis almost continual She was endowed with admirable gifts both of body and mind so that she was excellently skilled in the Liberal Sciences and all Learning above the condition of her Sex but as tho Nature thought it too much for her to enjoy so great endowments without some affliction she has suffered very sorely from this disease Before she was eight years of
age upon her recovery from a dangerous Fever she became obnoxious to pains of her Head which were wont to arise sometimes of their own accord but oftner on some light occasion offered the disease being not limited to one place or part of the Head sometimes infested the right side sometimes the lest and often its whole circuit During the access which seldom ending within the space of twenty four hours often infested her for two three or four days she could not endure light speech sound or any motion but sitting upright in her Bed in a darkned room she was able to speak with none nor to take any rest or food at length as the Fit declined she used to fall into a deep and troubled sleep from which awaking she was wont to be better and then by degrees to recover and during the time of intermission to be indifferently well Formerly the Fit being raised only occasionally seldom returned within twenty days or a month and then afterwards much more frequently but of late she is seldom free from them Moreover through many occasions or rather evident causes such as are the changes of the Year and of the Air the great Aspects of the Sun and Moon violent passions and errours in diet she is sorely tormented with them Now tho this affect having sorely afflicted this noble Lady when I went to see her above twenty years and pitching its Camp near the Confines of the Brain had so long besieged its Royal Fort however it had not yet gotten possession of it But the diseased being free from a Vertigo Scotomia Convulsive affects and any sleepy symptom had still the chief Faculties of her Soul whole and sound In order to the obtaining or rather endeavouring a Cure throughout the whole progress of the Disease a great many Remedies prescribed by most skilful physicians as well of our Country as Foreigners were used without any success or ease She tryed all the Great Remedies of every kind and form but always in vain a great many years since she underwent a long-continued and most troublesome Salivation by a Mercury Ointment so that she incurred a great danger of Life Afterward a Cure was twice undertaken by a Flux tho to no effect by a Mercury Powder which the famous Empirick Charles Huis generally gave She tryed hot Baths and drank Spaw-waters almost of every Country and Nature with the like success as the rest She was frequently blooded and once in an Artery she went with many Issues made sometimes in the Sinciput sometimes in the hinder part of the Head She took the Air in divers Countreys viz. besides her Native that of Ireland and France She took Medicines of all kinds whatsoever to wit Cephalicks Antiscorbuticks Hystericks all famous Specificks nay and Empirical Remedies given both by the learned and unlearned by Mountebanks and old Women yet she declared that she had not received any where from any remedy or method of Cure the least help or relief But the refractory and obstinate Disease being deaf to all inchantments of Medicines would not be mastered Moreover having possessed so long the precincts of the Brain tho it could not enter its recesses yet when I went to see her extending its limits into certain other parts of the Genus Nervosum it began to raise violent pains in the Limbs also in the Loyns and Abdomen such as are usual in a Rheumatism and in a Scorbutick Cholick A worthy man about forty years of age robust and sound when upon riding a whole day in the rain he had gotten cold by reason of the hinder part of his Head being continually wet soon began to feel a pain in that Part which in a short time being very much encreased miserably afflicted the Diseased both day and night and kept him in a manner always without sleep Blooding Purging Clysters Vesicatories Hypnoticks nay and a great many Remedies of all kinds diligently administred by the joint advice of a great many Physicians did little or nothing towards the Cure of this affect When the Disease notwithstanding all these daily grew worse after six weeks Glands preternaturally swoln and painful arose all over the Neck the Hemicrania in the mean while abating nothing Moreover the Tendons of the Neck being very much distended and stiff proved very tedious to him to which in a short time Convulsive motions and leaping of the Tendons succeeded in various Parts with a Delirium and at length the Diseased being worn out with pains and watchings yielded to Death As in the foregoing cases the Head-aches proceeded from Nodes and tubercles of the Meninges so sometimes mortal and incurable Head-achs arise from a Phlegmon and Abscess A while since a University Scholar after he had complained for a fortnight of a very great Head-ach afflicting him almost constantly at length the Fever becoming stronger presently Watchings Convulsive motions and a talking light-headed ensued at which time a Physician being called Blooding Clysters Playsters Revulsives Vesicatories also inward Remedies for withdrawing the course of the Blood and Humours from the Head being carefully administred he could do no good but Death in a short time followed The Scull being opened the Vessels spread over the Meninges were filled with Blood and very much distended as tho the whole mass of Blood had flown thither so that the Sinus's being dissected and opened above half a pound of Blood flowed forth Moreover the Membranes themselves being affected throughout with a Phlegmonous tumour appeared discoloured These coverings being taken away all the Anfractus of the Brain and its Ventricles were full of clear water and its substance being too much irrigated was moist throughout and nothing firm For the Blood being there heaped together when it could not circulate threw off from it self a plentyof Serum by which the whole Head was soon floated so that the Disease curable haply at the beginning by Phlebotomy afterward became mortal I remember another University Scholar who after being constantly and very sorely afflicted with a Hemiâ—â—ania under the temporal Suture for three weeks fell at last into a fatal Apoplexy The Head being opened a Phlegmon had grown in the Meninges near the place paining from which at length suppurated and broken the Sanies falling on the Brain had affected its substance with a lividness and corruption But tho a continual Head-ach especially if it be drawn in length for many weeks without intermission be not without danger nevertheless we must not presently despair of its Cure because the cause of this how fixed and immovable soever it may seem is often cured by a long use of Remedies nay sometimes without them by Time and Nature tho in a case that is almost desperate there is need of some Physick lest the present affect pass into a worse viiz into a sleepy or Convulsive distemper So much of the continual Head-ach it now remains for us to propose some Examples and some rare Instances of an intermittent Head-ach Therefore not
to set forth here cases of the Head-ach whose Fits being erring and uncertain proceed from the Blood or Serum rushing into the places affected in regard that these are very frequent and vulgarly known I shall now set before you certain choice Observations of this Disease being either periodical or seeming to arise from some one of the Viscera per Consensum As to the Former the periodâ—â—â— invasions of the Head-ach are produced either from the nutritive Humour or from the nervous Juice I shall now give you example of both A venerable Matron in the forty fifth year of her age being of a thin habit of Body and a bilous temperament after having liv'd for a long time obnoxious to Head-achs wont to be occasionally rais'd about the beginning of Autumn she began to be troubled with a periodical Head-ach This affect seizing her about four a clock in the Afternoon was wont to hold her almost till midnight till the diseased being tired with watchings and tortures was forced to fall asleep then after a pretty prosound sleep upon her awaking in the morning she was well The Diseased having undergone daily Fits of this Disease for three weeks after this manner delay'd the use of Physick which she very much abhorr'd but at length her appetite being dejected and her strength worn away she was forc'd to desire a method of Cure and after a gentle Purge and blooding she took twice a day for a week or a fortnight the quantity of a Chestnut of the following Electuary and grew perfectly well Take Conserve of the Flowers of Cichory and Fumitory of each three ounces compound powder of Aron Roots two drams and a half Ivory a dram and a half yellow Saunders Lignum aloes of each half a dram Salt of Wormwood a dram and a half Vitriol of Mars a dram Syrup of the five Roots what suffices make an Electuary The cause of this periodical Head-ach doubtless was that the assimilation of the Chyme or nutritive Humour into Blood was hindred For when its store received into the mass of Blood could not be overcome it was wont after a little stay to fall at odds and ferment with its particles Therefore presently the Blood falling into a turgescency that it might shake off that incongruous mixture depos'd its recrements as on other Parts so chiefly and with a greater sence of offence on the Fibres of the Meninges being before weak or injur'd in their conformation so that the pain lasted till the heterogeneous particles boyling by their mutual congress either were subdued or did exhale A handsome tall and slender Woman long and sorely obnoxious to cephalick affects was wont to be infested sometimes for many days nay weeks with a violent Head-ach which seiz'd her daily at her awake early in the morning and afflicted her for three or four hours In the mean space she was also affected with a heaviness of the whole Head a deadness of the Senses and a stupidity of Mind which affects vanishing together with the pain before Noon like Clouds disperst left all things calm and serene Till the next morning they possest again the Brain like a sogg and dark mist For curing these distempers I prescribed parging Pills a spare Bleeding Vesicatories also and the use of Spirit of Harts-horn or of Soot with Cephalick Juleps or Waters In this Gentlewoman the pains of the Head rather followed sleep than was cur'd by it because in this morning Head-ach the morbifick matter resided in the nervous Juice whose greatest curdity and aggravation about the Head happen presently after sleep but the other evening fit of this disease in regard it depended on the plenitude and turgescency of the nutritive liquor within the mass of Blood therefore hapned so many hours after dinner and was not mittigated but after sleep which appeases the disorders of the Blood Tho the Experience and Complaints of sick Persons manifestly shew that Fits of the Head-ach sometimes arise by consent from the other Parts viz. the Womb Spleen Stomach c. Nevertheless it as clearly appears from the accounts of them and the Phoenomena being duely considered that this is done by another means than by Vapours rais'd from the Viscera affected to the Head And first as to the pains of the Head seeming to be rais'd from a Womb nothing occurs more frequently than for violent Head-achs to ensue upon the suppression of the menses or lochia moreover tho the menses observe their due course yet some Women are wont to be afflicted with a violent pain of the Head just as they are coming others as soon as they are past But yet tho at the same time that the Head is affected the Womb is also yet it does not follow that the Injury is convey'd immediately from this to that but it is the Blood it self which fixes the morbifick matter on the Head viz. it sometimes perversly conveys it being engendred within its own bosom and design'd for the Womb into the Meninges of the Brain and sometimes withdrawing it from the Parts of the Womb it delivers it to the Head with a greater mischief This Aetiology agrees also with the Head-ach vulgarly imputed to the Stomach Spleen and other Parts A beautiful young Woman of a thin habit of Body and a hot Blood having been obnoxious to an hereditary Head-ach was wont to undergo frequent Fits of it and those coming at random to wit some happening on a light occasion and others arising of their own accord that is without any evident cause On the day before the spontaneous access of the Disease being very hungry in the Evening she greedily eat a plentiful Supper with a hunger-starv'd not to say Canine appetite most certainly fore-knowing by this sign that a pain of the Head would seize her next morning which sign never fail'd of Event for as soon as she awak'd being afflicted with a most cruel torture throughout the Sinciput she was affected likewise with a vomiting of a humour sometimes acid and as it were vitriolick sometimes bilous and extremely bitter it hence seeming to appear that that Head-ach had its rise from the fault of the Stomach To undertake to give the reason of this in the first place it is known that a vomiting ensues upon the Head's being injur'd viz. after a stroak Wound or a fall from an high place nevertheless a pain of the Head seldom or never follows a vomiting Cardialgia or the Stomachs being otherwise troubled unless an effervescency of the Blood happens Wherefore in the foresaid case of the Person diseas'd since it plainly appear'd that the Meninges of the Brain were predispos'd for Head-aches and that its Fits had raised an agitation of the Blood hence it will be obvious to conceive when the heterogeneous Particles by reason of the fault of Chylification were heap'd together in the mass of Blood to a fulness presently upon its beginning to flow in order to the expulsion of that which was offensive they being severed
morning and evening drinking after it of the following water two or three ounces Take roots of male Peony Angelica Master-wort of each half a pound roots of Zedoary the lesser Galingal of each an ounce leaves of Mistletoe of Apple-trees Rue Sage Betony of each four handfuls the outward coats of ten Oranges and eight Lemmons Cardamums Cloves Nutmegs of each half an ounce all being slic'd and bruised pour to them of White-wine in which two pounds of Peacocks dung hath been infused for a day ten pounds let there be a close infusion for three dayes then distill it according to art let the whole Liquor be mixt Take species Diambroe two drams powder of the roots of male Peony choice Zedoary of each a dram and a half Pearl a dram Oyle of pure Amber half a dram double refined Sugar dissolved in Peony Water and boyled to a Consistency for Tablets six ounces make Tablets according to art weighing half a dram let the Patient eat one or two often in a day at pleasure Within fifteen or twenty dayes the Remedies that they may be less loathsome and more advantageous ought to be changed therefore instead of the Electuary give for a fortnight or three weeks sometimes Spirit of Sal Armoniack saccinated or coralliated or impregnated with Mans Scull or Castoreum sometimes the Elixir of Peony or the tincture of Amber or Coral or Quercitans Elixir of Life mixtura simplex Also instead of the compound Waters let them take either the Water of black Cherries or of Walnuts or of Rosemary or of Lavender simple sometimes a draught of Posset-drink with the Flowers of male Peony or of Lillies of the Vallies boyled in it or a draught of Tea or Coffee in the Morning those Ingredients being first boyled in the Water of which it is prepared or let a Confection of Chocolate be made after this manner Take powder of the Roots of male Peony mans Scull prepared of each half an ounce Species Diambrae two drams make a Powder to every paper of which add Cocao-nut-Kernels a pound Sugar what suffices make a Confection let half an ounce or six drams of this be taken every Morning in a draught of a decoction of Sage of Peony Flowers or the like Take Powder of the Roots of male Peony mans Scull prepared of each an ounce and a half Roots of choice Zedoary bastard Dittany Angelica Contrayerva of each two drams make a subtle Powder of all of them add the yellow Coats of Oranges and Limons preserv'd of each two ounces let them be bruised together to a Powder let about half a dram or a dram be taken an Hour before and after meals For ordinary Drink let a Vessel of four Gallons be filled with midling Ale in which boyle the Leaves of white sweet-smelling Hore-hound dryed six handfuls Anacardiums Cardamums of each an ounce and a half being slic'd and bruised make a Bag. But especially let an exact form of Dyet be observ'd Let a temperate dry and well ventilated Air be chosen let food only of an easie concoction and light be eaten let the Supper be spare or none at all let sleeping at noon drinkings and other ill accustomances about nonnatural things be shunned I might here instance several stories of Apoplectical persons viz. of some who tho seiz'd once or twice are still living and of others kill'd by the first or second or afterward at the third Invasion The Right Reverend Father in Christ Gilbert Lord Arch-bishop of Canterbury lives still who escap'd above six years since from a severe Apoplectick fit God to whom ever be praise giving success to Physical endeavours and from that time tho he has now and then undergone light touches of the Disease yet he has never been so prostrated by it as to become speechless or insensible But it 's to no purpose to dwell long in setting forth this and other examples in regard they contain nothing very rare whence the Aetiology of the Disease may be illustrated I have dissected some dead Bodies but they were in a manner only of such Persons as were seiz'd Apoplectical after the Head being greatly hurt as by a stroke or a fall in all which the Blood extravasated or an Abscess was the cause of Death As to the opening of Persons dead of an habitual Apoplexy we are most commonly hindred by Friends who expecting their revival both delay the Interrment and wholly forbid Anatomy But I shall give you here one notable Anatomical Observation made about five years since at Oxford An ancient Divine an honest and pious man of a gross Body and having a short and full grown Neck being long ill-dispos'd in his health and leading a sedentary life had contracted a very Scorbutick Cacochymia being affected with a difficult and pursy breathing and with an unwonted heaviness and drowsiness of his Head he was scarce able to perform any thing of labour or exercise but to go and come daily from his Chamber to the Chappel and Refectory On a certain morning entring the Chappel a little before Prayers as he set himself on his knees being struck on a sudden and presently becoming speechless and insensible he fell on the ground but being forthwith rais'd up and his Cloaths taken off he was put into a warm Bed My self and other Physicians being call'd and coming as quick as might be we found him not only without Sence Pulse and Respiration but cold and absolutely stift throughout his whole Body Nor could he be brought to life or to a heat by any Remedies or ways of administration tho applied with all diligence for some time Whence we imagin'd that from his first being struck the beat of the Heart was wholly stopp'd and its flame being extinct that presently all motion of the Blood was suppressed The next day after we opened the Body it appearing to be quite dead and stiff nothing doubting but very clear footstepts of an affect so suddenly mortal left within the Brain would shew themselves to the eye but neither there or in any other part was there remaining so much as any shadow of the Disease tho very violent the vessels irrigating the Meninges were indifferently fill'd with blood but without any inflammation or extravasation the Brain Cerebellum and medulla oblongata with all their processes and prominences appear'd every where firm and well-coloured throughout both within and without neither was there Serum nor extravasated Blood heapt together any where within their Pores and Passages nor also within the greater Ventricles nay and the plexus choroeides plac'd both within the Cavity of the Brain and behind the Cerebellum seemed free from all fault so that the morbifick matter being as fine and subtle as the Spirits which it affected remained wholly inconspicuous and we could only argue its presence there from the effect Nevertheless lest it should lye hid elsewhere without the Head after having accurately inspected all the Contents of the Brain we came to the Thorax where the Lungs
living Whereas we see in other Animals as in a good breed of Horses and Cocks that their young ones do certainly patrizare so that presently they are sold at a great rate their Vertues in regard they are not broken by a disorderly and preternatural way of living descending in a long series to their posterity Secondly there are many evident causes by which Stupidity is brought on such as are originally sound Some at first being witty and ingenious in their declining years grow dull and doltish on the contrary some at first being dull and incapable of Learning as they grow further in years become very witty Thirdly sometimes a great wound or concussion of the Head especially which happens by falling headlong from an high place brings a prejudice and weakness to the animal faculty dulling the understanding Fourthly frequent drunkenness and surfeiting especially if men sleep presently on eating and drinking very much weaken the understandings of some and impair the use of Reason as a frequent use of opiats has shrewdly blunted the edge of the understanding of others Fifthly violent and sudden Passions such chiefly as an exceeding great terrour coming unawares or an extream sadness have rendred some doltish Sixthly We may observe that some Men by reason of great Diseases of the Brain have turn'd Fools this frequently happens in a severe and long continued Epilepsie in as much as this affect possessing the Meditullia of the Brain perverts and so stuffs with Feculencies and fills all the Pores and Passages by reason of the Spirits there frequently and vehemently exploded that the Tracts of the Spirits being close shut the Acts of the inward Senses and Motions are hindred Moreover I have observed Stupidity to accompany and precede the Palsey in many to wit the same matter which in the Corpus Striatum brings a Resolution being gathered together in the Corpus Callosum if it does not bring an Apoplexy or Carus often causes Folly There are many differences of this Disease and first we use to destinguish betwixt Folly and Stupidity that those who are affected with the former apprehend simple things well and quick enough and keep them fast in Memory but for want of Judgment ill compound or divie Notions and far worse inferr one thing from another Moreover by fooling and doing and speaking a great many things unhappily or ridiculously they move Laughter in the Standers by on the contrary those that are stupid by reason of the defects of the Imagination Memory and Judgment neither apprehend well nor nimbly nor argue well moreover they do not behave themselves as the former in making Sports and Gestures but blockishly and unfeatly and as it were like Apes and consequently the simplicity of these is more who so carry their Disease in their Countenance and Gesture In Folly it seems that the animal Spirits being somewhat nimble but unstedfast and having only short and oblique Tracts do not pass the Brain with an even and constant irradiation but making excursions this way and that after a desultory manner kexercise only slight or ridiculous Acts of animal Functions but in Stupidity the Spirits of their own nature being dull and obtuse and residing in a gross and unpervious Brain are not able to exert themselves for duly performing the Offices of the animal oeconomy There are many degrees of stupidity for some Persons are accounted unfit as to the comprehension of all things others only as to some some being wholly unfit for Learning and the liberal Sciences are apt enough to mechanical Arts others tho incapable of both these yet readily comprehend Apriculture and Country Affairs others being incapable in a manner of all business can be taught only those things that regard eating and drinking and the common way of living others being meer Dolts scarce understand any thing as all or do any thing with Knowledge As to the Prognostick Stupidity contracted by birth or hereditary or hapning through some unknown causes if it continues to the time of Puberty is scarce ever cured tho sometimes it happens that little Children at first dull and almost senseless when the Crases of the Brain and Spirits come afterward to a maturation become ingenious and apt enough to Iearn The Disease raised through some sole evident Cause as by a hurt of the Head or a violent Passion also hapning upon an inveterate Epilepsy if it persevers some time is afterward incurable That which ensuing upon other sleepy Affects depends chiefly on the hurt of the Memory sometimes those affects being cured vanishes of its own accord if at any time therefore in these Cases the cure of Stupidity is ordered in a manner the same method of healing and Remedies which we have prescribed for the preservatory indication of the Lethargy will be proper here whereof the chief intents must be that the animal Spirits being free from any Deadness and Stupefaction make Pores and Passages within the translucid Brain and duely expand themselves in them Sometimes a Fever has cur'd some Fools and stupid Persons and has rendred them more acute Huartus relates that a certain Fool in the Court of Corduba being affected with a malignant Fever arriv'd in the height of the Disease to so great an acuteness of Judgment and Discretion that he put the whole Court in Admiration and for the whole remainder of his Life continued a very prudent Person and we have known a certain Person of a dull and indeed Boeotian Understanding who raving in a Fever was very quick at breaking smart Jests and season'd with much Salt the Reason of which things seems to be that the Febrile heat sometimes rarefies and disperses the mist investing the Brain Therefore as to the cure of this Disease Stupidity whether innate or acquir'd if it be not a plain senselesness and doltishness incapable of all Erudition tho it be not usually cur'd yet it is wont to be amended Wherefore the cares both of a Physician and Tutor must be us'd for polishing somewhat the Understanding of such as are so affected and that being brought to the use of at least some little Reason they may be exempted from the rank of Brutes For this end because Bards or such as are very blockish learn not the Notions of things more readily than Children their A. B. C. therefore they are to be instructed in all things by an assiduous and very diligent Master and the same things are to be incultated again and again For by this means the Spirits tho dull and torpid will in some measure be actuated by perpetual Exercise and being continually stirred up will make at length for their Expansion some Tracts or Passages tho imperfect in the Brain how gross soever For the better and more easie effecting of these things physical Remedies also ought to be given for purifying and volatizing the Blood and nervous Liquour together with the animal Spirits and also for clarifying the Brain and rendering it as it were diaphanous For purifying the Blood
let a gentle purge sometimes and letting blood in a small quantity if the strength will bear it frequently be used for the same pursose and likewise for deriving Faeculencies from the Brain Issues are proper in the Arm or in the Leg or together in both in gross Bodies and such as have a moist Brain it is good sometimes to cut two by the Shoulder blades Moreover it is on this account that some mightily extoll trepanning to wit whereby the Brain may transpire and evaporate the more freely let the diet belight and attenuating the Habitation in a free and dry Air the Sleep moderate After that these things have been used for some time and in a solemn manner if there be found no change it will be in vain to waste any more physical Oyle and Labour but if after the use of those things signs of benefit or some hope appear sometimes it seems proper to add altering Remedies to be taken daily at Physical hours for a long time Forms of these may be taken from our curatory part of Physick before delivered for removing the Procatarxes of most Cephalick Diseases Moreover I have thought good to add here besides some Magistral Receipts which particularly regard this case Take Spirit of Armoniack succinated six drams give from fifteen drops to twenty in the Evening and early in the Morning in three spoonfuls of the following distilled water drinking after it seven spoonfuls of the same Take fresh leaves of mistletoe growing on Apple-trees six handfuls Sage Rosemary Savory Wild-time Calamint Penny-royal Marjoyam the greater Rochet of each four handfuls roots of Angelica Master-wort of each six ounces Zedoary the lesser Galingal Calamus Aromaticus Winters bark of each two ounces Cloves Nutinegs Mace Cinnamon Ginger of each an ounce Cubebs Cardamums Grains of Paradise of each six drams all being slic'd small and bruised pour to them of the best Canary wine twelve pounds let them digest cold and in a close Vessel for three dayes then distill them according to Art let the whole Liquor be mixt and sweeten it with Sugar as you use it the Dose is two or three ounces After the use of Spirit of Armoniack for fifteen or twenty dayes let other Medicines have their turns for about the same space of time such as are the Spirits of Soot Harts-horn mans skull the tincture of Coral Antimony Castoreum Amber Quercitan's Elixir of Life Elixir Proprietatis Spirit of Lavender c. Or Take Conserve of the flowers of Lillies of the Valley six ounces roots of Aromatick-reed preserv'd six drams Ginger condited in the Indies Nutmegs condited of each half an ounce Species Diambrae two drams Lignum Aloes yellow Saunders roots of choice Zedoary Cubebs Jamaica Pepper of each a dram and half Coral prepar'd two drams Syrup of the Preserve of Ginger what suffices make an Electuary the Dose is two drams morning and evening drinking after it three ounces of the distill'd Water Let those whose Brains abound with too much moisture drink every morning a draught of Coffee with the leaves of Sage first boyled in it to those whose animal Spirits are effaete and depauperated the drink of Chocolate such as before describ'd seems profitable For ordinary drink prepare small Ale or Beer and in a Vessel of three or four Gallons let the following Bag be put after it has wrought Take leaves of Salvia acuta dried four handfuls Cubebs an ounce Cloves Nutmegs being slic'd and bruis'd mix them according to art Outward Applications have place here or which kind are a Cucupha or Cap Plaisters and Liniments and sometimes let these sometimes those or the others be us'd Take Flowers of Lillies of the Valley Rofemary and Staechas of each a handful Celtick spike two drams Roots of Cyperus the lesser Galingal Florentine orris of each three drams Labdanum Benzoin Balsam of Tolu Amber of each two drams Nutmegs Colves Mace Cinnamon of each a dram and a half make of all a jubtle powder and sew it into a cap interlacing it with Cotton Take of the Plaister call'd Flos Vnguentorum two ounces Tachamahacha Ceranna Balsam of Tolu of each three drams powder of Amber and Myrrhe of each two drams Cloves Nutmegs Mace of each a dram being melted together let them be made into a mass of which let a Plaister be made to be spread on Leather and to be apply'd to the Head shav'd Take Oyle of Palm half an ounce oleum Capivii three drams Balsam of Peru a dram oyl of Nutmegs by expression two drams oyl of Amber half a dram make a liniment for the Head I could add here many other Medicines and wayes of Administrations but let these suffice in a Case almost desperate where most commonly no Remedies do good and the Cure is never perfected CHAP. XIII Instructions and Prescripts for curing the Gout AMong the Diseases of the Head and Genus nervosum we justly rank also certain Affects which are wont chiefly to infest the Feet and Belly to wit the Gout and Colick For we may conclude from the primary symptom viz. Pain that the Seats of both are in the nervous parts I shall speak in the first place of the for mer. The Gout most commonly is wont to arise about the Internodia of the Bones of the Feet tho often it happens in the Joynts of the Hip Knee Elbow Shoulder Wrist Ancle and of other Parts The Fits of this Affect which in a manner is always intermittent either seize at random or periodically which ending sometimes sooner sometimes later good lucid Intervals ensue presently upon the first invasion Pains for the most part arise without any swelling tho afterward about the height of the Disease the Part affected often swells the Pains about the beinning scarce yield to any Remedies but are wont to be very much exasperated by Catharticks and not presently to be driven away or asswag'd by Topicks the Fits most commonly seize on a sudden and without a precious affect tho sometimes it has a fore-running effervescence in the Blood or a little Fever The Disposition to this Disease sometimes is Hereditary sometimes acquir'd through an ill Diet the Occasions or Causes which being wont to actuate the Disposition raise the Arthritick Pains are some violent alterations or Passions inflicted on the Humours and Spirits Hence Surfeiting immoderate drinking especially of acid and thin Wines Transpiration letted Anger immoderate Venery Sadness also the Revolutions and great changes of the Year and Air every where bring Fits of this Disease those that are obnoxious to this are also in danger of being sometimes troubled with the Stone or Gravel in the Kidneys and on the contrary moreover the Gout increasing gathers together every where about its chief Seats to wit the Joynts a calculous matter and there raises a tophous mass The Parts affected upon the twitching of whose Fibres the Pains are raised for the most part are the Periostia or the Membranes covering the heads of the Bones also the Tendons and
voided more sparingly besides in the Head vertiginous affects frequently preceed or follow the invasions of this Disease nay and the Colick encreasing and becoming inveterate often brings Pains in the outward Members and at last is terminated in a Palsey Since therefore many Parts are wont to be troubled by it we must enquire which is primarily affected and by the means of which the rest suffer and shew what is the conjunct Cause of this Disease in what place it subsists and whence it draws its Origine As to the Part primarily affected when the Disease presses the whole region of the Belly is wont to be troubled yet its primary seat ought to be plac'd where the pain infests chiefly and sticks most obstinately Now this is said by many Physicians to be somewhere in the Colon because we generally observe that the Intestines and chiefly the Colon being irritated by Flatus's by which choler and haply other humours contained within their cavities fall into pains and gripes but if the pains of the Cholick proceeded from the sharp and irritative contents of the Colon doubtless those things which loosen the Belly and copiously expell Flatus's and the Faeces would bring a most certain relief the contrary of which oftentimes happens viz. that after frequent or violent Purging that Disease becomes worse Wherefore that the seat and nature of this Disease may be duely known we must first distinguish here concerning the Gripes or Pains of the Belly vulgarly accounted as of the Colick For either being meerly occasional they arise from an evident cause alone and without a previous disposition in any Person indifferently thus alterations about the six non-natural things often raise mighty disturbances in the Viscera of the Belly with pains Which kind of affect never theless ought not to be lookt upon as a Disease but only as a symptom rais'd from a manifest cause But besides the Colick properly speaking does not only happen to any men indifferently being produc'd by an accidental cause but following some men predispos'd after a peculiar manner depends wholly on a procatarctick cause brought to a ripeness by degrees the greater fits of the Disease for the most part have their periods and observe the alterations of the Air and of the Year Moreover being rais'd they do not easily yield to Remedies nor soon pass off But notwithstanding the use of Epithems or the Belly 's being purg'd tho in a plentiful manner by Clysters or Catharticks they often continue many days and sometimes weeks with great violence the pains in every fit take always to the same Part and for the most part are attended with the like concourse of other symptoms Moreover Colick pains tho they have not the same seat in all but sometimes rage most about the Ventricle sometimes about the Navel or hypochondres sometimes in the hypogastrick Region or toward the Loins Yet as often as they return in the same Diseased they most commonly observe the same seat I say now that the Part primarily affected in the Colick is the Mesentery We have shewn elsewhere that the causes of certain convulsive motions which are vulgarly called hysterical oftentimes lye hid in the Plexus's of the Mesentery and then we asserted the pains of the Colick sometimes to have their seats in the same places and we made it plain enough from Anatomical observation But it is not the same but somewhat a differing matter which is wont to raise those so different affects under the same roof in the Passions called histerical we have set forth at large in the former Tract that the Animal Spirits being overcharg'd with an Elastick Combination burst from one another or are exploded as it were and consequently that they force in despite the containing Bodies into irregular or preternatural motions but in pains of the Colick the same Spirits being irritated by reason of a Matter annoying them and being disproportionate to them and thereupon being divided and severed from each other they force the sensible fibres to very troublesome corrugations after what manner this is done in the Colick and what is the Conjunct cause and Procatarxis of that Disease we shall now say somewhat more plainly Therefore for the Seminium or Minera of the Colick we suppose that certain recrements of the nervous humour falling from the Brain by the Nerves and passing into the Mesentery and other Plexus's of the Abdomen are there heap'd together Which if they are so gross and viscous that they cannot be receiv'd and sent away by the Lymphaeducts or distill forth into the cavities of the Intestines by the small branches of the Vessels then stagnating and being heaped together by degrees in those Parts they arise at length to an irritative plenitude Afterward that matter becoming more degenerate and more offensive by stagnation and growing turgid on some occasion or of its own accord or haply fermenting with the Saline-fixt humour sent thither from the Blood will torture with very troublesome and painful corrugations the branches of the Nerves and Nervous Fibres with innumerable of which the Mesentery is stor'd Which affect of them does not wholly cease till the fermenting matter either is discuss'd or express'd into the cavities of the Intestines or at length is subdued Again forasmuch as from the Mesentery and its Plexus's nervous branches and fibres are most thickly protended to the bottom of the Ventricle the Gall-Bladder the Ductus Choledochi all the Intestines and on every side almost into all the Viscera of the Abdomen therefore whilst the Colick matter fermenting in its Minera's causes there often most sharp gripes and tortures at the same time in most other membranous Parts Cramps and Convulsive or painful contractions will be every where raised Hence by reason of the Mesentery primarily affected under the Navel there is a cruel pain as tho a stake were stuck there or a piercer were making a hole moreover all about almost in the whole Abdomen by reason of the Intestines being variously drawn forward and backward at the same time in differing places erring pains shoot this way and that and by reason of the motions of the Fibres being distracted or inverted as well in those parts as in the primary Vessels the Belly is in a manner always bound and there ensues sometimes a suppression of Urine or very little is made Moreover the Duodenum the Gall-Bladder with its Ductus's and the bottom of the Stomack being affected with a cramp and their Fibres being drawn upward a frequent vomiting with a copious casting up of a yellow or greenish Choler often happens during the Fit In a Fit of the Colick to Pains of the Belly most violent Pains of the Loins raging in the lower part of the Back are oftentimes joyned which certainly can arise from the irritation of no Intestine but it will be easie to conceive that they are raised from a morbifick cause plac'd in the Mesentery viz. in as much as certain considerable Nerves of the Loins
to be a little chill'd and afterward plainly to have the cold fit and as it went off to sweat the reason of this was because by the hot summer the Constitution of the Blood was become sharp and very much burnt wherefore the Particles of the crude Juice mixt with it were presently scorcht and burnt that they did not wax cold first with a sourness like new beer and then afterward burn out but a Turgescency being raised the whole like dry Wood laid on the fire presently burnt out in a light flame but afterward the Liquour of the Blood after having burnt for some fits became less torrified that the depraved nutritive Juice was not presently scorcht but passed into a nitrous Matter and fermenting with a sourness which first growing turgid brought a sence of coldness on the whole Body There remains yet a great doubt concerning the distances of the returns which sometimes seem to be double in the same Fever that the first access answers to the third and both happily in the Morning and again the second to the fourth and both happen in the Evening and so on wherefore such a Fever is wont to be called a double tertian or quartan It seems to me that in this case sometimes it happens that the Fever is simple and of one kind and that the Types are a like and all agreeing with each other but that the errour chiefly arises because the intervals of the returns are not computed by hours but by dayes for since the intervals of the beginnings of the Fits are not distant from each twenty four hours exactly but either sixteen or thirty hours in a quotidian and in a tertian not forty eight hours but forty or fifty six more or less or thereabout it will come to pass that the alternate fits will happen before and the rest after noon to which also may be added that the uneven way of living which the diseased use may oftentimes produce great unevennesses of the returns that sometimes the fit comes twice a day as I have often observed in cachectical Persons and such as have used a disorderly dyet nevertheless it often happens that intermittent Fevers have returns of fits which neither observe the same distance nor keep wholly to the same sort of form I have frequently noted in a quartan Fever that besides the set accesses returning about the same hour the fourth day certain erring and uncertain fits troubled the Diseased that sometimes the day preceeding the wonted fit sometimes following it another fit also tho slight was raised anew carrying exactly the Type of an intermittent Fever with a shivering a heat and sweat and nevertheless the primary access returned at the usual time this for the most part is wont to happen either by a diet ill ordered especially by surfeiting and drinking of Wine or by the ill administration of Physick the reason of which I take it consists in this that by these errours in diet more matter is heapt together than can be clear'd off at one fit CHAP. IV. Of the kinds of intermittent Fevers and first of a Tertian WE call a Tertian Fever not that which happens at three days distance but inclusively from the day in which one fit begins on the third thence another returns mean while sometimes if the fits are long viz. protracted to twenty four hours and withall come before the usual time of their accesses the space of intermission is often less then twenty four hours The essence of a Tertian Fever consists in this that the Blood like Beer made of over-dryed Malt being too sharp and burnt does not soon subdue and ripen the nutritive Juice which is brought into it crude from things eaten but perverts a great deal of it into a Nitro-sulphureous matter wherewith when the mass of Blood is saturated to a Turgescency like new Beer put in Bottles it falls a fermenting from the flowing of that nitrous matter which obtunds the heat and vital Spirits and twitches the nervous Parts first a cold is caused with a shivering afterward the vital Spirit prevailing again this matter fermenting in the Blood begins to be mastered and to be kindled in the Heart by the burning of whilch an intense heat is diffus'd throughout the whole Body afterward its relicks being severed and mixing with the Serum are sent forth by sweat This burnt disposition of the Blood consists in this that it is impregnated more than it ought with Particles of Salt and Sulphur Wherefore the procatarctick Causes which dispose to this disease are a hot and bilous Temperament Youth a very hot Diet as an immoderate use of Wine and peppered meats but especially the Vernal and Autumnal Seasons of the Year tho most comonly some evident Cause besides is requir'd for putting this Disposition in act and we ascribe the origine of this Disease to some notable accident Wherefore a lying on the Ground or taking cold after sweating or transpiration any way hindred also surfeiting or a troubling of the Stomack by disorderly eating and whatsoever things cause an immoderate effervescence of the Blood bring into act the latent disposition of this Disease for on every such occasion the nutritive Juice heapt together in the Blood and somewhat deprav'd falls a flowing and separating from the rest of the Blood ferments it with a nitrous sourness afterward being kindled and exagitated with the vital Spirit and Heat it brings the fit with a very intense burning A Tertian Fever is wont to be most common in the Spring at which time the Blood is most vigorous and in best plight A Fever hapning if it continues not long is commonly said rather to be Physick than a Disease which in part is true because by this means the impurities of the Blood are consumed the obstructions of the Viscera are opened and indeed the whole body is ventilated so that it is wholly freed from any excrementitious matter and from the seminaries of growing Diseases but if this Disease be drawn out in length it is the cause of many Distempers and of a long sickness for hereby the mass of Blood is very much deprived of the vital Spirit and like Wine too much fermented in some manner looses its strength wherefore a Jaundise Scurvy or Cachexia follow upon this Fever when it is long a curing for by the frequent fits the vital spirit very much evaporates which in regard it is little restored by things eaten the Blood becomes thereby watery and almost without strength mean while the Particles of the Salt and Sulphur are raised and exalted more whence the Blood is made sharp and salt and so more unapt for Circulation and a Pneumatosis Moreover this Disease protracted in length often changes its form and from a Tertian becomes either a quotidian or sometiems a quartan and afterward sometimes it returns from both to a Tertian the reason of this is the various change of the Disposition of the Blood for when from being sharp and bilous as it
Motion of the Body or Perturbation of Mind from an ambient heat as that of the Sun or of a Stove by hot things inwardly taken as drinking of Wine eating of peppered Meats and the like for the Spirits of the Blood easily wax very hot of their own accord and being violently moved are not presently appeased but exagitate variously confound and force to a rapid and disorderly Motion other Particles of the Blood also by this Motion of the Spirits the Sulphur or the oily part of the Blood is more boyled a little more dissolved and somewhat more freely kindled in the Heart whence an intense heat is raised in the whole Body but for as much as the Sulphur is heated and inflamed only by minute Parts and not throughout the whole that fervour of the Spirits is soon allayed and ceases Wherefore the Fever which is raised after this manner is terminated for the most part within twenty four hours and therefore is called an Ephemera And if by reason of a greater heat of the spirituous Blood it be prorogued longer it seldom exceeds three dayes and it is called an Ephemera of many dayes or a Synochus not putrid but if it happens to be extended beyond this time this Fever readily passes into a putrid to wit from the long continued ebullition of the spirituous Blood at length the grosser Particles of the Sulphur fall a burning and involve the whole mass of Blood in this Effervescence An Ephemera Fever and a simple Synochus seldom begin without an evident Cause besides the things before-mentioned immoderate Labour Watchings a sudden Passion of the Mind a constriction of the Pores Surfeiting also a Bubo or Wound in Child-bearing Women an increase of milk are wont to bring these the procatarctick causes which dispose to them are a hot temper of Body an Athletick habit a Sedentary Life and a Disuse of Exercise The first beginnings of this Disease depend on the presence of an Evident Cause for either the Corpuscles of an extraneous heat mixt with Blood make it boyl like Water on the Fire or a Fever is brought by motion or by reason of Transpiration being letted even as when Wines being heated or stopt close in a Vessel are set in a strong working after what manner soever the inflammation be first rais'd presently the Spirits make an effort and moving hither and thither force the Blood to boyl and to inlarge it self in a greater space with a frothy rarefaction wherefore the Vessels are stretcht and the membranous Parts are vellicated hence a Pain especially in the Head and Loyns a spontaneous lassitude and an inflation as it were of the whole Body ensue But if with the Spirit of the Blood some sulphury Part withall be somewhat kindled a smart heat is diffus'd through the whole the Pulse becomes high and quick the Urine ruddy also Thirst Watchings and many other offensive Symptoms arise Concerning the Solution or Crisis of an Ephemera Fever and of a Synochus not putrid there are three things chiefly requisite viz. a removal of the evident Cause secondly a severing or difflation of the depraved or excrementitious matter from the Mass of Blood thirdly an appeasing of the parts of the Blood and their restitution to a natural and even motion and site According as these things happen sometimes sooner sometimes slower and with more difficulty this Disease is ended in a shorter or longer time 1. The Evident Cause which for the most part is extrinsecal is easily remov'd and Diseased Persons as soon as ever they perceive themselves injur'd by any thing are wont to avoid the presence of or continuance with that thing no Person being in a Fever upon drinking Wine continues still to drink it when any Person grows more hot than usual by the heat of a Bath or of the Sun it is irksome to him to continue in it longer 2. As to the excrementitious matter which ought to be separated and blown off from the Blood this is either brought from without as when by surfeiting drinking of Wine standing in the Sun or bathing in hot Water the Blood is infected with hot and fermentative effluvia's or Corpuscles or that matter is ingendred inwardly as when upon the deflagration of the Blood its Liquor is stuff't with adust Recrements or Particles both these Matters must be separated and blown off from the Blood and be sent forth either by Sweat or insensible Transpiration before the Fever is appeas'd wherefore when the Pores are clos'd and Transpiration is hindred the Ephemera Fever continues a longer time and passes from a simple Synochus into a putrid Fever 3. The Evident Cause being remov'd and this degenerated Matter blown off for a cessation of the burning heat there is required an appeasing of the Parts of the Blood and a reducement of them to order for a rapid and disorderly motion begun in the Blood is not presently stopt but ought to be allay'd by degrees also the divers Particles of the Blood disorder'd after this manner and being driven this way and that by reason of the feverish effervescence do not presently take to their former order of site and position but it is necessary that they be extricated by degrees and restored to their due mixture by little and little Tho this Disease after the removal of the Evident Cause ceases for the most part of its own accord yet some Physical Remedies are advantageously applied to Use especially where there is danger lest the Ephemera Fever passes into a putrid The chief Intentions must be to allay the fervour of the Blood and to procure a free Transpiration to which chiefly conduce blooding a very thin Diet or rather abstinence cooling Drinks a withdrawing the excrements of the Belly by Clysters but above the rest Sleep and Rest do most good which if wanting they must be seasonably procur'd by Opiats and Anodines A renowned young man about twenty years of age of an athletick habit of Body by an immoderate drinking of strong Wine fell into a feverish distemper with a drought heat and a mighty trouble of the Praecordia being blooded he drank a vast quantity of fountain-water and thereupon a copious sweat presently ensuing he soon recovered An ingenious young man of a sedentary Life and withall very much addicted to the study of Learning when of late he had exercis'd himself above measure in the Summer Sun began to complain of a Head-ach a want of Appetite a trouble of the Praecordia and a feverish distemperature over the whole Body To whom in regard he loathed all Physick I ordered a total Abstinence unless it were from small Beer and Barley-meats On the second day and again more on the third the Symptoms remitted by little and little at length on the fourth he became free from his Fever without any Medicine CHAP. IX Of the Putrid Fever A Putrid Fever is when the oily or sulphureous part of the Blood being too much heated grows turgid above measure and
infected with it whatsoever House it entred presently it set upon the whole that there were scarce enough remaining in Health to attend those that were ill such as came to them from elsewhere or Hirelings called to attend the Diseased were presently seised with the same Infection that at length for fear of the Contagion such as lay sick of this Fever were shunn'd by those that were in Health in a manner as Persons troubled with the Plague Nor did a small Mortality or Destruction of Mankind attend this Disease for a great many old Men Cachectical Ptysical or otherwise unhealthy Persons fell under this Fate also not a few Children Youths and such as were full grown I remember that in certain Villages all the elderly People in a manner were carried off this Year that there scarce remained alive any for unpholding the Customs and Priviledges of the Parish by the Traditions rcceiv'd from their Ancestors When this Fever first began it carried somewhat the Type of a putrid Synochus but it came with difficalty to a Crisis and when it seemed to be solv'd by a Swear or a Loosness it was wont presently to wax worse again but for the most part after a Deflagration of the Blood continued for six or seven days this remitting and instead of a Crisis the adust Matter being convey'd to the Brain the Diseased lying a long time sometimes raving mad oftner with a Drowsiness and a great Weakness and sometimes with convulsive Motions scarce escaped at length with Life About the middle of the Summer beside the Contagion and the frequent Mortality this Disease discovered its malignant and pestilential Force by open Signs viz. by the Eruption of Pushes and Spots for about this time without any great burning of a Fever the Pulse in many grew uneven weak and very disorderly also without a manifest spending of the Spirits the Strength presently became languid and very much dejected in others lying ill after the like manner Pimples sometimes small and red sometimes large and livid appear'd in many Buboes as in the Plgaue about the glandulous Parts some of these without any great Conflict of the Spirits or feverish Excandescence raised in the Blood died without noise and on a sudden mean while others growing presently raving mad as long as they continued in Life underwent horrible Distractions of the Animal Spirits Such as escap'd from this Disease recovered not but after a long time and that without a laudable Crisis unless by a Sweat procured by Art the Brain at length and the Genus Nervosum being affected and they being seized with a Dullness of the Senses Tremblings a Vertigo a Weakness of the Members and-convulsive motions During the Dog-days this Disease still infesting began to be handled not as a Fever but as a milder sort of Plague and to be overcome only by Alexipharmick Remedies Bleeding was always thought fatal to it Vomitories and Purges were used now and then tho not so frequently but the chiefest method of Cure was placed in Alexipharmicks and a Sweant seasonably procured For this purpose besides the Prescripts of Physicians taken from Apothecaries Shops certain Empirical Remedies deserv'd no small Praise then first in this Country the Countess of Kent 's Powder began to be of great Fame and another ash-coloured Powder was not of the least note which a certain Courtier coming by chance to this City gave to many with good Success and sold it others who approved of its use at a great rate The Diseased were wont upon drinking half a Dram of this in any Liquor to fall into a most copious Sweat and so to be freed from the Virulency of the Disease that Diaphortick the Preparation whereof I learnt afterward from the Authors Sisters Son was only the Powder of Toads cleansed with Salt and afterward washed with good Wine and lightly calcin'd in an earthen Pot. Autumn coming on this Disease remitted by Degrees of its wonted Fierceness that fewer fell sick and a great many of them recovered till upon the access of Winter a state of Health was again entirely setled in this City and in the adjacent Country Let us here consider the Rise Progress and lastly the End of this Fever which at first was only belonging to the Army and at length became pestilential and epidemick that the Disease first began in the Souldiers Camp it seems that it ought not only to be imputed to their Nastiness and stinking Smells but in some measure to the common Fault of the Air for since these Fevers do not happen yearly their Origine will be somewhat ascribed to the peculiar Constitution of the Year for a light Distemperature of the Air being thereby contracted tho it does not ill affect such as use a wholsome way of living yet in an Atmy where to the general Procatarxis evident Causes viz. a great many Errors in the six non-natural things are joyn'd those kinds of Sicknesses must of necessity be more easily rais'd Now the Vernal Constitution of this Year was very moist being almost continually attended with wet Showers to which afterward a hot Summer succeeding both rendred still more depraved the Miasms of the feverish Contagion reigning here before and more disposed all Bodies to receive them wherefore that this Distemper became in a manner peculiar to this Country and epidemick at this time it was long of its Seminary arising in the first place from the Army lying round about but in as much as becoming afterward pestilential and very epidemick it infected the greatest part of Mankind here living and killed not a few the cause was the ill Affect of the Air which being unwholsome through the Distemperature of the year became moreover so vicious at length by the continual breathing forth of stinking Vapors from the Souldiers Camps and the Cohabitation of the Diseased that the Miasms of this Fever disperst in it were greatly exalted and rise almost to the Virulency of a Pestilence Diemerbrochius relates That from such a kind of Camp-Fever rais'd in the Summer in the Town of Aquitane afterward another malignant and pestilential and at length the Plague it self grew and that this our Fever at last stood in competition with the Plague it self besides the great force of the Contagion and the great Mortality the very ill Affects of the Blood and nervous Liquor presently caused in all from the same did declare for the Strength dejected on a sudden the weak intermittent and formication Pulse the Eruption of Pushes and Buboes argued the Coagulation and corruptive Disposition of the Blood Moreover a Delirium Mania Frenzy Deadness Sleepyness Vertigo Tremblings convulsive Motions and other Affects of the Head of divers kinds shew'd a mighty Annoyance of the Head and Genus Nervosum For setting forth the Type or Idea of the Malignant Fever to the Life there are a great many Observations or Stories of Sick Persons ready at hand Of many Examples of this Disease I shall here insert only a few which some
their Bodies which are very tender and by reason of the Labours of Child-birth and the Exclusion of the Foetus are all full of open Pores are too unwarily expos'd to the open Air for most being impatient of their Bed put on their Cloaths and rise from it within a day or two or sooner than they ought thereby presently the Pores of the Skin being presently stopt and the Air getting into the Uterine Parts tanspiration is check'd and often the Lochia are suddenly stop'd either of which suffices to raise a feverish effervescence The conjunct Cause or formal Reason of this Distemper comprehends chiefly these three things to wit there are present first a mighty Dyscrasie of the Blood that growing very hot from a Fever occasionally rais'd it does not burn evenly nor does is subdue by degreeds the adust Recrements and purge them forth critically moreover the boyling Blood is presently loos'ned in its Mixture and its Texture being loos'ned it declines toward Corruption hence when it has a little abated of its Heat the Spirits being cast from their Governance are driv'n into Confusion mean while the sulphureous Particles become masterless and exorbitant wherefore the Strength fails without a manifest Cause the Pulse becomes weak and disorderly Tho from the Deflagration of the Blood a great many adust Recrements are heap'd together yet nothing is duely concocted or separated but Nature being greatlyopprest altho the Diseased continually sweat they often receive no ease thereby but the Febrile Matter which ought to be purged forth being conveyed into the Head and Genus Nervosum causes there very sore Perturbations of the animal oeconomy Secondly The Tragedy of this Disease for a good part of it is ascribed to the nervous Juyce forthwith turning sharp and therefore rendred disproportionate to the Brain and its Appendix for this being defiled with a Taint contracted from the Blood does not gently irrigate and mildly inspire its Subjects but as when an Infusion of Vitriol is pour'd on a Worm mightily vellicates and irrtates into Contrqactions and as it were into Motions of Trepidatons and Leapings those tender Parts and sometimes wholly overthrows their Functions hence Contractions severe Convulsions a Delirium Watchings sometimes a Stupor and sleepy Affects happen to Women after Delivery Ihirdly whilst these things are done often a third Troop of Symptoms infest the Diseased to wit for that the Womb being some way hurt moves it self disorderly and is struck with a Contraction in these or those Parts thence presently by the Membranes nad nervous Ductus's convulsive Motions pervade the whole Region of the Abdomen wherefore the Viscera and Hypochondres are blowen up Belchings and violent Vomitings are raised afterward the Affect creeping upward and possessing the nervous Parts of the Thorax a difficult and uneven Breathing a Palpitation of the Heart a sense of Choaking in the Throat by reaon of the Muscles there drawn together and other Symptoms are raised throughout the whole upon the same Injuries being communicated to the Brain The Fevers of Women afte Delivery are scarce ever free from danger tho sometimes it happens for them to be cur'd about the first beginnings by a thin Diet and upon restoring the flowing of the Lochia but if the feverish Distemper has laid deep Roots that the Blood be wholly kindled and boyls immoderately we can give but an ill Prognostick and there will be a greater Cause of Danger if besides a Heat diffus'd through the whole the Diseased are seised with a frequent Shivering if they are affected with a great Restlessness and Watchings with sudden Concussions of their Bodies or Contractions of the Tendons if on the third or fourth Day they complain of a ringing of the Ears with a great Repletion of the Head you may presently gather that a great Evil is at hand to wit a Mertastasis of the febrile and offensive Matter into the Brain nor is less to be feared if there lyes an Oppression and Load on the Praecordia that the Diseased cannot freely breath nor draw their Breath deep nor form the bottom of the Thorax but only from the upper part of it and that short and with a Blowing so that in the mean while the Diseased are forc'd to fit upright and to move themselves this way and that after a restless manner for this argues the Blood to stagnate about the Heart and Lungs also that it is apt to grow clotty and to be coagulated and if worse yet Affects of the Brain and Genus Nervosum ensue and the Pulse becomes weak and uneven you may declare the Case to be desperate but if as if sometimes falls out tho rarely after a Fever is kindled and threatens severely either a flowing of the Lochia or a Diarrhoea happens with Relief some Hope may be admitted Concerning the Cures of these kinds of Fevers a Physician has a very hard Task because among the Vulgar all Medicines to Women in Child-bed are accounted not only useless but likewise very hurtful wherefore Physicians are selfom called but when there is no place left for Medicines and the occasion for a useful Assitstance is wholly past and if they are present about the first beginnings of the Disease it will not be an easie thing to procure Health to the Diseased by vulgar Remedies and whatsoever they try unless it gives Help is affirmed by old Women and those that are about them as pernicious and the only Cause of their Death that in reality there is wont to accrue to us about the Cure of no Disease less benefit and more Disgrace than of this Now the method of Cure even as in contagious Diseases is twofold to wit Prophylactick and Therapeutick the former of these delivers Precepts and Cautions with which Women in Child-bed are preserved from the Incursion of Fevers the other suggests curative Intentions with which the Diseased if it may be recover again their Health 1. Tho this Fever however malignant it be is not accus'd of Contagion and there be no fear in those that lye in of a venemous Miasm being received from without nevertheless all Women in Child-bed have an innate Minera of Virulency and ought to have a care of the mischief of this as a Fomes of a mighty Malignity wherefore they have need of an exact Governance that after Child-birth the Impurities of the Blood and Humours may be duely purg'd without the danger of a Fever and that the evil Affects of the Womb be healed and that the Strength broken and debilitated by Child-birth may be duely restored For these ends these three things are to be chiefly inculcated in the Praescripts of Physicians First I think it necessary that a most exact form of Diet be ordered Women in Child-bed to wit that at least for a Week they wholly feed on Oat Broths sometimes prepar'd with Ale sometimes of Water mixed with White-wine because they are much emptied therefore they may sup often of them but let nothing of a solid or strong Food
Case somewhat of Hope has shewn it self the Pulse and other Symptoms promising a little better tho the Cure has seldom succeeded but when that use of Cordials was remitted the Diseased fell headlong into Death with a weak Pulse and a Loosness forthwith arising 3. When still the case of the Diseased grows worse and worse that the Fever being increased the Pulse is weak and uneven and frequent Shiverings and convulsive Motions infest the whose Body with a Delirium or a Stupor then let the Physician first giving a Prognostick of Death insist on fewer Remedies and those in a manner only Cardiack and let him wholly abstain from Blooding Scarifying Vesicatories or the use of Cupping Glasses for such Administrations bring only an ill-will and Disgrace that thereby we are accounted by Women hard-hearted and cruel The Symptomatick Fevers of Women in Child-bed THE acute Diseases of Women brought to bed do not only follow the Type of the foresaid Fever but are sometimes attended with some notable Symptom to wit the Quinsey Plurisie Peripneumonia Dysentery Small Pox or of some other kind and then they are call'd by the Names of those Affects It is not proper to repeat in this Place what belongs to the Natures and Essences of each of them at large but I shall briefly set down what those Diseases complicated with the Affects of Women in Child-bed have peculiar to them as to their Causes or Cures We judge that all those Symptoms proceed from a certain Coagulation of the Blood and afterward its Extravasation now while the Blood is extravasated in one part every natural nad critical Effiux of it is restrain'd in another wherefore there is danger lest while the Blood begins to be coagulated either in a particular and usual Focus of Congelation or universally in its whole Mass presently the flowing of the Lochia be stopt which in reality happens for the most part and therefore those Affects are most commonly mortal to Women in Child-bed nevertheless the Cause of their Death for the most part happens with some difference to wit in the Small Pox the flowing Lochia call inward the Malignity began to be sent forth outwardly and wholly poison with their Taint the Mass Blood and the Heart it self and therefore in the Small Pox those uterine Purgations ought to be stopt but in the Pleurisie Quinsey and the rest when the Stimulus of the Disease fix'd here or there in a particular Place calls to it self and wholly derives from the Womb the Impurities of the Blood which ought to be voided by the Lochia thereby it increases the Taint of the BLood the Lochia restrain'd in the Small Pox might be sent forth by a more general way of Excretion with the venemous Particles of the Disease with indeed does not succeed in the rest by reason of the small and more spare way of Excretion Among these the Quinsey Plurisie and Peripneumonia by reason both of the great likeness of their Cause and the Analogy of their Cure may be considered together When a Woman in Child-bed is affected with either of these it is to be judg'd that besides the Miasms heaped together during the time of Ingravidation there happens a certain acid disposition of the Blood by the means of with whilst it feverishly boyls certain Particles of it being imbued with a sharpness fall into a Congelation in this or that place like Milk turning sour and consequently coagulated the Blood letted there and hindred in its Circulation hinders the Passage of the rest now the Blood being obstructed in its Motion butts against its dam and so being heaped together round about and driven out of its Vessels grows into a Tumour thence presently whatsoever haeterogeneous and separable is contained in its Mass is deposed in the Part affected as in a Sink wherefore the Corruptions of the Blood which ought to be purg'd forth by the Womb are deriv'd thence toward the Seat of this Disease which since they cannot be purged forth sufficiently this way both the Liquor of the Blood is more notoriously corrupted and a Crisis of that particular Affect to wit of the Quinsey Plurisie or some other is rendred more difficult For the Cure of these kinds of complicated Diseases presently from the very first beginning it must be endeavoured that the Blood fixt any where and begun to be extravasated be restor'd to Circulation and do not make an Impostume because it is very rarely that Women in Child-bed seised with those symptomatick Fevers are cured by an Abscess or spitting forth of the Matter wherefore inward Remedies which fuse the Blood and free it from Coagulation are to be used of which kind are chiefly Diaphoreticks filled with a volatile Salt as Spirit of Harts-horn of Soot of Urine and the Salts themselves also testaceous and bezoartick Powders Sal Prunella Decoctions and Juleps of Vegetables promoting the menses or the Urine in all which those things ought to be mixt which by Experience are found to be appropriated to uterine Affects moreover discussing Remedies which drive away and expell the Matter stinking in the Part affected of which kind are Liniments Fomentations and Cataplasms are carefully to be applyed to it Mean while let the violent Motion and immoderate Effervescence of the Blood be removed far from thence and let its Excretions of Filth be conveyed still to the lower Parts by what ways we may for this end Frictions Ligatures Epispasticks and if need be cupping Glasses may be applyed to the Feet or Legs in case the Affect growing very much worse blooding be indicated unless there be a great Plethora in the whole Body and a very acute Inflammation in the Part affected it will be best to breath a Vein in the Foot or to open the haemorroid Vessels with Leeches but if necessity presses for it to be done in the Arm after Blooding there let another Bleeding if it may be admitted follow in the Leg nevertheless we must give a Hint that opening a Vein ought to be very cautiously ordered in these Cases for unless it gives Relief which I have seldom known to happen presently the Pulse being rendred more weak the State of the Diseased becomes worse A Dysentery takes its Rise in a manner from the like Cause as the foresaid Affects but because in this the extravasated Blood is presently poured forth nor being restrain'd in the Body creates a mischief there and is still more corrupted and since this way of Excretion is performed near the uterine Efflux and does not derive it afterward another way hence less danger is feared from this Disease than from the others before mentioned tho oftentimes this Affect is mortal to Women in Child-bed and that the rather because by a Dysentery things that qualifie and gently astringe the Blood are indicated and these are found too apt to stop the flowing of the Lochia wherefore in this case till Women delivered are in a manner purg'd enough by a long flowing let the Cure
but when the one prevailing the Assistance of Art was required it was necessary to check the Lochia and to put forward the Small Pox. CHAP. XVI Of Epidemick Fevers I Had design'd to have put an end here to our Dissertation concering Fevers it being my Intent rather to write a Commentary than an entire Tract but in regard certain Epidemick Fevers are often rise which observe no Laws nor can be reduced to a certain Rule of Doctrine but being wholly anomalous vary yearly and therefore as often as some one of them spreads it self presently it is called the New Disease therefore I have thought it necessary because general Precepts are not to be given concerning these Fevers to subjoyn particular Relations of some of this kind for from the various Apparatus of Symptoms whereby they are wont to be marked the Nature and the whole formal Reason of these kinds of Affects will somewhat appear Since therefore of late Years within a little Tract of Time three Popular Diseases have reigned in these Countries I shall give here as a conclusion to this Work the particular Descriptions of them made formerly in the Tiems that those Fevers reigned A Description of an Epidemick Fever Reigning in Autumn Anno 1657. made in the middle of September WE designing a Description of a Fever violently reigning at this time it is fit that being led by the Example of Hippocrates we first consider the foregoing Constitution of the Year and its Distemperatures and Excesses of the Qualities for the Cause of an Epidemick Disease raised generally among People must be common We must note what the State of the Year was and the Disposition of our Body thence contracted whereby many were affected together Now to take the thing stom its Origine The foregoing Spring and the Time thenceforward to the end of the Summer to wit all this half years space was mighty hot and dry but especially after the Summer Solstice the Heats were so intense for many Weeks together that Night and Day every one complained of the Heat of the Air and almost of a continual Sweat wherewith they were all bedewed and that they could not breath freely About the end of July this Fever being first sporadical began to break forth in certain Places that one haply or two in a Town or Village were seized with it in most it carried the Type of an intermittent Tertian to wit the Fits returned every other Day which nevertheless without any fore-running Cold or Shivering infested the Diseased with a most intense Heat Vomitings and bilous Stools happen'd plentifully in most a Sweat succeeding but difficult and often interrupted whereby the feverish Access seldom went off with an Apvrexia but all the time of Intermission the Diseased continued languid and weak with a Thirst and a Restlessness in some when they began to amend after three or four Fits a cold and a Shivering began the Access and the Fever became exactly an intermittent Tertian but in most the Disease still grew worse and presently became obstinate and of a difficult Solution with an ill Apparatus of Symptoms for the Diseased being mighty hot in their Fits and sweating with Difficulty Errors were wont to be committed which daily intended the Strength of the Disease for through the Impatience of the Diseased and the Unskilfullness of the Attendants the Sweat which ought to have ended the feverish Access being interrupted scarce one Fit was ended but another presently succeeded and thereby the Disease was wont to have erring and uncertain Periods without an Intercession of an Apyrexia and afterward it was wont to pass into a continual Fever as it were the State whereof was sometimes very dangerous with an ill Affect of the Brain and Genus Nervosum that not unfrequently a Lethargy or Delirium and often Cramps and convulsive Motions were raised In the Month of August this Fever began to reign far and near among the People that in every Part and Village many lay ill of it tho it was far more common in the country and little Villages than in the Confines of Cities and Towns It still carried the Type of an intermittent Fever only that through the Violence of Symptoms and the Shortness of Intermission it seemed more tedious than ordinary and therefore was generally call'd the New Disease Moreover it was censur'd of some Malignity and gave Proofs certain enough of its Contagion and Mortality in as much as it crept from House to House and infected many of the same Family with the same corrupted Taint and especially such as conversed familiarly with the Sick moreover in many Places it carried off old Persons and such as were come to a Ripeness in Years If you consider the Nature and Essence of the Affect this Fever must be placed properly in the number of Intermittents for the Fits return at set times also for the most part they begin with a Cold and a Shivering and very often with a Vomiting and presently going on with a most intense Heat at length they are ended in a Sweat The Urine in most appears of a Flame Colour clear in the Fit with some Hypostasis out of it thick with somewhat a ruddy Sediment the Disease comes not to a Crisis by a Sweat tho very plentiful and often repeated which might be expected in a continual Fever but the Affect holds on for many Days and sometimes Months to a very long time tho there happens a very great Evacuation by Vomiting and Sweating almost daily which we observe to fall out often in an Intermittent Fever seldom in a continual out of the Fit at any time of the Disease Purging is conveniently ordered which it were a Crime to attempt in a Synochus before the Signs of Concoction Moreover that this Fever is of the kind of Intermittents it hence appears because most recover of it that scarce the thousandth part of the Diseased dies which I think is scarce heard of an Epidemick Synochus About the first beginnings of this Disease it appears very like an Intermittent Tertian tho it may seem in some by reason of a vicious Predisposition of the Body and of Errors committed in Diet and Transpiration to have pass'd into a continual for in those in whom the Fits do not come to a due Determination nor end in an Apyrexia by reason of the morbifick Matter being not perfectly blown off in those the Blood continually boyls whence it comes to pass that the Accesses return quicker and infest longer till at length by reason of the store of the Matter and the languishing of Nature the Blood becoming weak is not able to grow turgid any longer and to separate the Febrile Matter at set Hours but endeavours to subdue it by little and little and by a continual Effervescence Some haply may wholly place the Cause of this so Popular a Disease in a malignant Constitution of the Air to wit that the Particles of the Air breath'd in were infected with a certain
the Fever by its Deflagration but the continual Ebullition which happens to this Intermittent Fever depends wholly on the Confusion of the Matter not miscible and the difficult Secretion of it from the Blood A Synochus happens as Wine naturally fermenting by reason of its Richness the other like the same Wine when it falls a working by reason of some haeterogeneous thing mixt with it wherefore we observe that when our Fever has pass'd into a continual yet it comes not to a Determination neither by a Sweat nor by a Loosness tho happening in a plentiful manner and frequently because depending on the Blood depauperated rather than being inflam'd it continues a very long time and disposes the Diseased towards a Cachexia The third way of difference wherein this Fever differs from the common Rank of Intermittents is plac'd in this that it is oftentimes readily propagated by Contagion into others the reason of which is because here a great many Bodies are predispos'd after the same manner to the same Affect which at another time does not happen wherefore the mere Effluvia from a morbid Body are able to stir up the like Affect in a Subject easily capable even as certain Rays of a Flame kindle a Flame in a Matter which is very combustible mean while all do not contract the taint of this Fever alike but some not prepar'd for it converse with the Diseas'd without hurt There is another Symptom which does not constantly attend this Fever but only happening in some Places which distinguishes it not only from a common Fever but changes its own proper Type to wit it sometimes happens that dyssenterick Affects accompany this Disease in some bilous Vomitings and Seiges are very troublesome as in the cholerick Disease and in others bloody Stools happen with a violent Pain and Gripes of the Belly I have often observ'd the former in this our Neighbourhood and the reason of it may be deduced from a mighty bilous Temperature for by reason of this the adust Matter not to be blown off by Sweat is copiously separated in the Liver afterward by reason of the Vasa Choledocha being over-fill'd it is sent to the Ventricle and Intestines the other Affect of the Dysentery is found only in some Places and there being sporadical rather than common it has seised only some sick Persons The Origine of it can be ascrib'd only to the peculiar Crasis or vicious Predispositions of some Bodies also to the Scituations of Places or the nature of the Air. Moreover it may be suspected that the Disease is now and then conveyed to others not without the Communication of a certain Miasm Concerning this Disease there ought to be a double Prognostick first of the Fever it self in general what kind of end it will have and when what it does threaten to our Land whether it be not a Fore-runner of the Plague or Pestilential Diseases as it is vulgarly feared Secondly We ought to give the Signs by which we are wont to presage a Well-doing or Danger in the various Cases of the Diseased As to the first because we have shewn that the Origine of this Affect is not to be taken from the Air infected with a Contagion or venemous Miasm nor from a malignant Seminium of Vapours diffus'd through the Air but only from a mighty bilous Temperature or Diathesis of our Bodies with a Blood which is adust and mightily scorch'd by reason of the Summer Heats I think there is no cause of Fear here whereby we may dread that this Fever being rais'd to a worse state through the fault of the Air may grow at length to be Malignant or Pestilential but rather what the Change of the Season of the Year and the Alteration of our Blood may make us expect we ought to fear lest this Fever which at first imitates the Type of a Tertian may pass into a Quartan which I observe has already happened to some and think it is greatly to be fear'd lest hereafter Autumn drawing to an end it may happen in many As to the particular Prognostick the Signs which happen in the course of this Fever most remarkable and which in some manner foretell its Issue and Event are these If the Disease happens in a sound Body well-temper'd and easily perspirable if a Vomiting with a well-bearing ensues and the Belly be loose if the Fit begins with a light Shivering and after a moderate Heat ends in a Sweat and the Interval of it be with an Apyrexia or a well-bearing if the Pulse be strong the Urine of a flame colour clear with a laudable Hypostasis we predict that the Disease will end in a short time without danger but if this Fever be raised in a fat Body and of a vicious Habit if with a troublesome Vomiting an exorbitant Heat and an intolerable Thirst long torment the Diseased if the Heat be succeeded by a difficult partial often interrupted Sweat and interlac'd with frequent Vomitings and does not end in an Apyrexia we declare this Disease to be long and liable to Danger but if the Diseased holds his Strength and the Urine shews signs of Concoction we do not despair of well-doing especially if after four or five Returns the Disease as it is usual remits of its wonted fierceness Thirdly we observe if this Disease happens in a Body which is cold or broken with other Diseases or weaken'd if besides horrible Vomitings and a violent Heat a frequent Fainting Swoonings Deliriums or Lethargick Affects happen if after many Accesses the Strength of the Diseas'd falling the Disease remits nothing but a continual Effervescence troubles the Blood and very much dissipates the vital Spirits if a dejected Appetite obstinate Watchings convulsive Motions with a weak Pulse a troubled or thick Urine happen we declare the Case to be full of Danger but it is protracted to a good length and it gives Time and Occasions for Nature to recollect her self and to the Physician for giving Remedies The Therapeutick Indications which have place in the Cure of this Fever are chiefly four First that the Blood being becom burnt and too bilous be reduc'd to its due temper Secondly that the depravation of the Nutritive Juyce and its alteration into a fermentative matter be stopt or at leastwise be lessen'd Thirdly that about the declination of the Disease the Blood being depauperated by a frequent Deflagration and rendred impure by the mixture of the morbifick or adust matter be restored and be rendred volatile as it ought Fourthly that we obviate with Remedies the Symptoms which are chiefly infesting in the Course of the Disease To answer these Intentions I advise the following Method to be used About the first beginnings of the Disease if a bilous Humour flowing from the Vasa Choledocha and sent into the Ventricle the Diseased be inclin'd to Vomit when the Fit is at hand let a plentiful Evacuation of the same be raised by a gentle Emetick Blooding and Purging ought not to be used
and either hinder the Stuffings of the Viscera or remove them being made and restore their Ferments being almost extinct for this Use chiefly conduce the Remedies and Preparations which are vulgarly call'd Digestives and Antiscorbuticks by which being seasonably administred I have known many weak pale and bloodless Persons as it were to have soon recover'd a sprightly Strength and Vigour A Description made the last Day of May of a Catarrhous Epidemick Fever happening in the middle of the Spring An. 1658. AN immoderate Heat of the Summer before was followed in the Winter with a Frost equally intense so that no Man living has scarce remembred a year like this for an Excess both of Heat and Cold. From the fifth of December almost to the Vernal Equinox the Earth was cover'd with Snow and from the North Winds continually blowing all things set in the open Air waxed stiff with Cold and afterward from the beginning of the Spring almost to the first day of June the same Wind still blowing the Season was more like Winter than Spring only that sometimes haply it was interlac'd with a day or two of hot Weather During the Winter amongst our People here save that the Quartan Ague contracted in the Autumn infested some the State was indifferently healthful free from any popular Disease In the beginning of the Spring an intermittent Tertian Fever as it 's usual in every other year seised some About the end of April on a sudden an Affect shew'd it self which being sent as it were by a certain Blast from the Stars seis'd a great many that in some certain Towns in a Weeks space above a thousand Men lay ill at once The Pathognomick Symptom of this Disease which first seised the Diseased was a troublesome Cough with a copious Spitting and a Catarrh falling on the Palate Throat and Nostrils there is also a feverish Distemperature which for the most part is joyn'd with a Heat and a Drought a want of Appetite a spontaneous Lassitude and a great Pain in the Back and Loins which Fever nevertheless in some was more remiss that they walk'd abroad and during all the time of their Sickness followed the usual Offices of Life complaining in the mean time of a want of Strength and a Weakness of a loathing of food of a Cough and a Catarrh Now in some a hot Distemperature very much reigned that being confined to their Bed they were troubled with a Burning and a mighty Drought with Watchings a Hoarseness and an almost continual Cough sometimes a Bleeding at Nose in some a Spitting Blood and often bloody Stools happened upon this Affect Those who being of an infirm Body and stricken in Years were seised with this Disease many of them died but in a manner all of those that were strong and of a sound Constitution recover'd those who yielding to this Disease perished they died for the most part by reason of their Strength being wasted by Degrees and a Mass of serous Filth being heaped together in the Breast with the Fevers being increased and a difficult Breathing like Persons troubled with a Hectick Fever Concerning this Disease we must enquire what kind of Procatarctick Cause it had that it should rise on a sudden in the Spring and that within a Months time almost the third Part of Mankind should be affected with it Afterward the Signs and Symptoms being diligently compared together the formal Reason of this Disease also the ways of its Crisis and Cure ought to be assigned That the North Wind is most apt for producing Catarrhs besides the Testimony of Historians common Experience makes good but why Catarrhs did not spread themselves so much sporadically during all the Tract of the Winter and Spring but that this Affect should reign epidemically only for the space of one Month and then joyn'd with a Fever the reason is not so plain I know that many draw the Cause from the uneven Distemperature of the Air for that Season which tho for the most part cold yet sometimes the Northwind remitting for a Day or two was very hot wherefore on this Occasion as upon taking Cold after being hot many Men might fall sick this kind of evident Cause might suffice haply for affecting some with this Sickness but for causing an Affect arising so on a sudden and generally reigning besides such an occasion a great Procatarxis or Predisposition was requir'd for it ought to be supposed that all Men in a manner were ready prepared for receiving this Disease otherwise no evident Cause would exercise its force so powerfully on a great many wherefore it is likely that this Disease drew its Origine from the Distemperature and very great Irregularity of the Year and as the intermittent Autumnal Fever above described was the Product of a preceeding immoderate Heat so this catarrhal Fever wholly depended on the Tract of the Year hapning to be too cold for the Blood being already burnt from the over-hot Summer and inclin'd to the Fever above described then Autumn coming on being made more sharp and apt to a Quartan Fever afterward by reason of the intense Cold of the Winter being little eventilated and hindred from its due Perspiration it held still a Dyscrasie and was ready to suffer by it as occasion might be given Wherefore in regard the Blood in the middle of the Spring as the Juyce of Vegetables being become more sprightly and having begun to spring and display it self by reason of its Thickness still continued was straitned in circulating it was prone to feverish Effervescencies and in regard the Serous Latex abounding in the Blood was not able to evaporate forth by reason of the Pores being still closed with the Cold restagnating inwardly and falling chiefly on the Lungs where somewhat succedaneous is performed to outward Perspiration it rais'd so frequent and troublesome a Cough Therefore the Rise and formal Reason of this Disease are chiefly founded in two things to wit that there happened together a greater Effervescence of the Blood than ordinary caused by the Spring Season and withall a Density or a great Constriction of the Pores caused by the preceeding Tract of Time which was too cold that thereby there was not a free space granted the Blood springing in the Vessels the Case was the same as if Wine beginning to ferment were put into Vessels close stopt for by this means both the Vessels and the Wine are in danger of being destroyed Wherefore to draw the thing in short that this Disease arising in the middle of the Spring presently spreading very far seiz'd a great many the cause was not a blast of a malignant Air whereby the Diseased were affected as tho struck by a Sideration as some will have it but that at this time the Blood being inspired by the Constitution of the Spring and so apt to display it self and ferment was straitned in its Motion and the Efluvia being inwardly restrained it could not be enough ventilated Every years tho
when the Blood being rendred weak and withall impure is not able to expell forth the febrile Matter or the adust Recrements by a critical Motion it conveys the same to the Brain and therefore abut the increase of this Fever a Drowsiness and a Stupidity of the Spirits a Sleepiness a Vertigo a ringing of the Ears Tremblings and Convulsive Motions with a great Suppression of the whole animal Faculty are oftentimes caused Those who being of a cold Temperament or grown in Years are seized with this Disease tho they have not so acute a Fever yet are wont to lye in a greater danger of Life for in these besides the Disposition of the Blood not easily reducible also in the Fits what is heaped together extraneous and not miscible is hardly subdued and with difficulty separated from the mass of Bood wherefore both the Blood is still more notably depraved in its Crasis and in every of the Fits is more infected with an impure mixture Moreover the Nervous Liquour is greatly perverted from its due Temper and is exceedingly defiled with adust Recrements continually poured on the Brain when therefore old melancholy or otherwise unhealthy Persons fall into this Fever from the first Invasion they presently become torpid and for the most Part Vertiginous in the Fits tho the heat be not vehement and sharp yet they lye restless and tossing very much often talk absurdly and idlely after a long Incalescence either no Sweat or only a partial one and often interrupted ensues whereby the fit is not fully solved but all during the Intervals the Diseased being very dry continue to be ill disposed with a drought of the Mouth a roughness of the Tongue and an overspreading of a viscous Lee after some fits their Strength being mightily dejected either they are confined to their Bed altogether or rising a little in the day time they are scarce able to stand or to creep about from Place to Place mean while they are troubled with a Fainting a difficult Breathing a Deadness of the Senses and a great Weakness of the whole Genus Nervosum The Urine is intensly red in a great many of a more saturated Colour and a thicker Consistency than in a common Tertian the Pulse as long as the Strength is not wholly cast down for the most part is strong and even afterward when the Diseased grow very faint it is weak uneven and often intermittent to which also Contractions of the Tendons and convulsive Motions in the Wrists being iovn'd for the most part give an occasion for a Prognostick of Dearth Those who being weak'ned by degrees decline toward Death for some time before they dye lye for the most part without speech or the Knowledge of the Standers by as Persons stupid it seldom happens in this Fever that any one about to dye being of a good Memory and Understanding disposes things of his Family or bids his Friends farewell and those who happen to escape from a mighty Weakness and almost from a desperate Condition do not recover by a sudden and manifest Crisis but wavering a long time lye torpid and enervated that not without a doubrful and difficult Contest Nature at length with much adoe prevails over the Disease and then they recover their Strength by Degrees by a slow and long-continued Convalescence If the nature and formal reason of the Epidemick Fever even now described be inquired into we say that this as that of the foregoing Year is properly an Intermittent for that which generally reigns carries this kind of Type tho some continual Fevers here and there are scattered with them of which also we shall presently give a short Touch. It will not be needful for us to derive the Seminary of this from the Air infected with some Miasm but rather to fetch the antecedent Cause of it from the undue Constitution of the Year and the Indisposition of our Blood acquir'd thereby for Spring and Fall intermittent Fevers yearly reign to wit because our Blood as the Juyce of Vegetables is wont to be moved and to display it self at these times more sprightly than ordinary wherefore if the Mass of Blood by reason of the foregoing Season of the Winter or Summer be altered from its â—ue Temper and has contracted a sharp or atrabilarious Diathesis of another kind it s Dyscrasies began before are chiefly maturated about the Equinoxes to wit when the Blood more freely fermenting in case it falls from its natural Crasis does not so readily sanguifie but will be apt to pervert the nutritive Juyce mix'd with it into an extraneous and febrile Matter Since therefore this Year very much declined from its due Constitution that not only the preceding Dog days but the two Solstices and Equinoxes before were altogether intemperate is no Wonder if intermittent Fevers more frequent than usual and those attended with some unusual Symptoms reign in Autumn That therefore an Epidemick intermittent Fever reigns at this Time I think it ought not to be attributed to the Fault of the present Air but to the Irregularities of the foregoing Season but on what Causes and Occasions certain peculiar Symptoms and distinct from the common Rule of Intermittents arise in this Fever it is worthy to be inquired into I have said above that the Apparatus whereby this Fever became destructive to Mankind consisted chiefly in two things to wit the Temper of the Year one while mighty cold afterward happening to be very hot both variously perverted the Crasis of our Blood and affected the Pores of the Skin with an undue Constitution According to the Reasons taken from both I shall briefly explicate the Accidents of this Disease and assign the Causes of its Phoenomina 1. First we observe that the Type of this Fever was various to wit in some with a continual Effervescence in others with an Eruption of Spots but in most intermitting and like a Tertian and sometimes tho rarely like a Quotidian renewing its Fits either each or every other day we assign the Cause of this Diversity because in this Year the morbid Procatarxis was greater and stronger than only to produce an intermittent Fever generally usual in Autumn wherefore in some haply of a more deprav'd Habit of Body it raised Fevers somewhat malignant and in those to whom it brought Intermittents according to the wonted Custom of the Season it distinguished them by some peculiar Appearance of Symptoms 2. Persons after being seis'd with the Epidemick Fever at this time whether it be continual or intermittent forthwith undergo ill Affects of the Head to wit they are wont to be infested sometimes with a violent Head-ach sometimes with a Stupor or a too great Distraction of the Animal Spirits the Reason of this is that the nervous Juyce as well as the Blood through the Distemperature of the Year is very much altered from its due Crisis to wit from its sweet and spirituous Nature and has become sometimes dull and almost vapid sometimes too sharp and
ib. p. 134 135. the Method of Cure ib. Prescripts of Medicines for it p. 136. An Instance of another Person troubled with it and how cur'd ib. p. 137. Dropsie call'd Anasarca see Anasarca Dropsie call'd Ascites see Ascites Dropsie call'd the Tympany see Tympany Dropsie hapning in the Scurvy its Cure p. 366 367. Dysentery see Purging E. EMetick Medicines see Vomiting Empyema what the Word imports p. 119. what to be considered in order to its cure ib. An Incision not to be attempted over hastily in it p. 120. Forms of Medicines requisite for curing an Empyema ib. A Julep against Faintings and Swoonings upon the Operation ib. Ephemera Fever see Fever Epilepsie seeing Falling Sickness F. FAlling Sickness its Description p. 138 139. Sometimes terminates of its own accord ib. The Method of proceeding with it p. 240. What Medicines us'd against the Fit ib. p. 241. The chiefest care in the Prophylactick part for removing the cause ib. What Medicines to be us'd for it ib. p. 242. An Instance of a Person troubled with the Falling-sickness and with what Medicines cur'd p. 243. The general Method of curing it with prescripts of Medicines ib. p. 244 245 246 247 248 249. Fever its Description p. 426. Intermitting Fevers whence caused ib. why a cold and a shivering precede the heat in them p. 427. whence their Intermission and set returns ib. p. 528. their Cure how undertaken ib. p. 529. Certain Irregularities of them p. 530. Fever tertian Instructions concerning it p. 531 532. Symptoms foreshewing its Remission ib. 533. It s Method of Cure p. 534 535 536 537. Fever quartan Instructions concerning it p. 540 541. Why so difficult to cure ib. curd by raising a gentle Salivation p. 542. Other Remedies for it p. 543 544 545. c. Fevers continual wherein differing from Intermittents p. 548. the kinds of them ib. Fever call'd Ephemera or simple Synochus holding one or many Daies Instructions concerning it p. 549 550. three things required to a Crisis or Solution of it ib. p. 551. its Cure ib. Fever putrid its Causes p. 552 553. the four observable times of it ib. p. 554 555 556 557. the most considerable Symptoms and Signs in it p. 560 561 562 563 564 565 566. the Pulse and Urine chiefly to be minded for knowing the State and Strength of the Diseased p. 567 568. 569 570. The kinds of the putrid Synochus p. 571 572 573. its Cure p. 574 575 576. Examples of Persons seised with it and the Method us'd with them p. 577 578 579 580 581 582. Fever Malignant or Pestilential in general wherein it consists p. 583. What parts of the Body their venom Affects p. 584 585. the Essence of a Pestilential Fever in what founded p. 587. whence it arises 588 what Bodies apt to receive it p. 590. how propagated by Contagion ib. p. 591. Fevers Pestilential and Malignant in Specie and other Epidemick Fevers p. 601. the distinctions betwixt a Plague a Pestilential and a Malignant Fever ib. p. 602. Pestilential and Malignant Fevers plac'd in the rank of Continual Fevers ib. Signs of Malignity in Fevers p. 604 605. what to be observed in the cure of Pestilential and Malignant Fevers ib. an Instance of a Pestilential Fever p. 606 607. its way of cure p. 608. Instances of the Malignant Fever p. 609 610 611 612 613. Fevers of Women in Child-bed Instructions concerning them p. 625 626 627 628 629. of the Lacteal Fever of Women after Child-birth p. 630. its cure p. 631. Putrid Fevers of Women in Child-bed ib. p. 632. their Procatarctick Causes p. 633. the Evident Causes ib. the Conjunct Cause p. 634. they are dangerous p. 635. the cure ib. p. 636 637 638. Fevers Symptomatick of Women in Child-bed what those Symptoms are p. 639. what must be done in order to their Cure p. 640. What must be done in the Small Pox when happening p. 641. Stories of Women in Child-bed troubled with Fevers ib. p. 642 643 644 645 646 647. Fevers Epidemick and Anomalous p. 648. A Description of one ib. p. 649. its Nature and Essence ib. p. 650 651. its conjunct Cause ib. what it has peculiar from common Intermittents and a Synochus p. 654 653. its general Prognostick p. 653. its particular Prognostick ib. its method of Cure p. 655 656 657. Fever Epidemick and Catarrhous described p. 657 658. the rise and formal reason of it p. 659. its Symptoms p. 660. its Prognostick ib. the method of Cure p. 661. Another Epidemick Fever described p. 662 663. its Nature p. 665. its Accidents p. 666 667. the Prognostick of it p. 668. the method of Cure p. 669 670 671 672. Fever Epidemick chiefly infesting the Brain and Genus Nervosum p. 271 272. its formal Reason and Causes 275. Instances of Persons seis'd with it p. 276 277 278. the method of Cure ib. p. 279 280 281. An Instance of a Fever chiefly radicated in the nervous Juice and its Cure 282 Fever Scorbutick its Cure 363. 364. Fits of the Mother p. 297. the various Passions vulgarly said to constitute an Hysterick fit or a fit of the Mother ib. those Fits are properly Convulsive p. 298. they arise chiefly from the Brain and genus Nervosum ib. sometimes from the Womb and others of the Viscera ib. p. 299. An Instance of a Person troubled with them and what done in order to the Cure ib. p. 300 301 302. The method of Cure to be us'd in the Passions vulgarly call'd Hysterical ib. p. 303 304 305 306. Flux See Purging Folly see Stupidity French-Pox safely cur'd with a Sweating Diet-Drink p. 38. Frensy its Definition p. 451. whence caused ib. the formal Nature of it wherein it consists p. 453. another Definition of it p. 454. the previous Dispositon of the Blood disposing to a Frensy ib. another Disposition to the Frensy ib. the evident Causes of it p 455. the Prognostick of it ib. p. 456. In the Cure of it regard must be had to two things ib. Prescripts of Medicines for it p. 457 458 459. an Instance of a Person Troubled with it and how cur'd ib. p. 460. G. GIddiness or running round of the Head see Vertigo Gout its Fits either seise at random or periodically p. 495. The Dispositions to this Disease and the Occasions or Causes which are wont to actuate them ib. the Morbifick Matter ib. the evident Causes of it p. 496 497. It 's near ally'd to the Stone in the Reins p. 498. The Prognostick of it ib. it often turnes to Gripes in the Belly to a difficulty of Breathing c. ib. p. 499. the Method of Cure with Prescripts of Medicines ib. p. 500 501 502 503 504 505. An Instance of a Person troubled with it ib. p. 506. Gout Scorbutick moving from one Place to another its Cure p. 362. Gumms sore their Cure p. 359. 360. H. Haemorrhagies see Blood Head-Ach its Subject p. 370. the formal Cause of it p. 371. the Prognostick of it ib. habitual Head-ach two