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A29736
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The epilogue to the five papers lately past betwixt the two physicians Dr. O. and Dr. E. containing some remarks, pleasant and profitable, concerning that debate, and the usefulness of vomiting and purging in fevers / by And. Brown, M.D.
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Brown, Andrew, M.D.
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1699
(1699)
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Wing B5007; ESTC R33269
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14,511
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41
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THE EPILOGUE TO The Five Papers Lately past betwixt the Two PHYSICIANS Dr. O. and Dr. E. Containing some Remarks Pleasant and Profitable concerning that Debate And the Usefulness of VOMITING and PURGING in FEVERS By AND. BROWN M. D. Victrix causa Diis placuit sed victa Catoni EDINBURGH Printed by John Reid Anno DOM. 1699 THE EPILOGUE c. OR Some Remarks on the late Debate about the Usefulness of VOMITING in FEVERS c. THO I have been much solicited to shew my Opinion about the Debate betwixt the two Physicians concerning Vomiting in Fevers in regard of its Affinity with the Practise of Purging in Fevers which was mantain'd by me some years agoe and violently oppos'd by a certain Club of Physicians I yet delay'd to give my Sentiments therein until I should see whether the Learn'd Colledge of Physicians would interpose therein and what would be their Decision and Suffrage For the Eyes of all Men were upon them expecting that they would do something in it whose Province it is either to compesce or determine such Differences among their own Members that the World might receive Satisfaction in these Controversies which concern our Lives and Health But whether they consider not that it belongs to them or that they know not what to do therein I am ignorant For there is neither any thing done that way nor intended so far as I can learn Thus in the great Concern of Life and Health every one is left to his own Capricious Opinion at Hap-hazard to take up with what he pleases without being beholden to them for Light and Diâ—ection in such important and intricat Concerns what to sollow or what not As whether or not a Patient that has been made Vomit only with Whey may be said to have been vomited by a Physician and the Direction ought to be found upon the Apothecarie's File and whether a Vomiter being given by a Physician in a Fever and the Apothecarie's File refer'd to One would think it had rather been an Antimonial Vomit than a Vomit of Whey And whether after twice Vomiting of a Patient with Whey and purging him with two lenient Potions and two Clysters may one Ounce of Vomiting Wine with three drams of Syrup of Buckthorn be given the 9 th day of a Fever Or whether there be alwayes as much hazard in Plentiful Purging as Bystanders apprehend who never were acquainted with the Purging Method in Fevers And whether or not by the vain Fears of Friends and By-standers a Faithful and Expert Physician may be blunder'd and a good Method disgrac'd And whether dallying and triffling with a Fever tho less exceptionable be not more dangerous and often of more fatal consequence than Plentiful Purging And whither upon any extravagant Purging the Quieting Medicine being a ready Remedy since in the controverted Case it was not given till the Ordinary's return to the Patient May it be thought there was no need of it before that time These I take to be the most material Points in this Debate which seems to be handled with a little more Heat and Humour than is consistent either with the Import of the Matter or Dignity of the Members of so Judicious a Society who would be expected to treat all their Matters and seek to advance the Improvement of Medicine in Candor Amity and Peace Now if I may lawfully interpose my Sentiments in these Matters since the same has such Relation to the Debate about Purging in Fevers wherein the rest of the Physicians being concerned either as immediat Actors Inciters or Connivers so exercised me that there passed betwixt us no fewer than eight Pieces in Print Which terminat in another Sub-division of the Colledge it self whereby they are now split into two halfs and parties into Guelphs and Gibellins which Rent still continuing has of late broken out into this new Debate whereupon there has passed five Peeces However others may think of all this my humble Opinion in the first place is That this last Contest has made so plain profitable and pleasant a Discovery that it may attone for the Scandal of all the former Divisions Animosities and Ruptures O blessed Breach and happy and fortunat Rent that has brought forth so much Light to Medicine that does so far approve of the Usefulness of Purging in Fevers as to allow of Vomiting therein also as may be seen in the Papers on both sides And as ex malis moribus oriuntur bonae leges Ill manners beget good Laws So we may see Debates Divisions and Differences may bring profitable Things to Light which would have been otherwise hid As Sampson kill'd more Philistines at his Death than in all his Life So it may be hop'd that this Division and Debate may occasion the killing of more Fevers than their Concord either ever did or in appearance would have done And as the best Antidote for the Venom of the Viper is the Viper's flesh so it is hop'd this wound may prove the true Cure of the virulent opposition this way of treating of Fevers has formerly met with And who would not rejoice to see such clear Light arise in Our Horizon of Medicine as to behold the Credit and Authority of the Sagacious Dr Sydenham avouched and mantained and his Judgement and Candor in his Writtings fully asserted by both Parties And especially his method of Treating Fevers by purging which had been too long and too much opposed by many in this place to the unspeakable loss of Medicine and Detriment of Mankind And tho Dr. Sydenham in his last work his Schedula monitoria only appoints purging in Fevers and does not go the length of Vomiting Those disputants seem so far to approve thereof that both of them allow of giving Vomits in some cases also for which the Authority's brought by the One seem to be needless since it is not denied by the other party But since these Authorities may make the Reader apprehend that the Purging in Fevers is no new Method and Practice and that it was in use before Dr. Sydenhams time It is to be remarked that Purging and Vomiting in Fevers were used only now then before his time and as some Indications did Require but were not used generally or in great and dangerous Fevers because the Commotion oft times raised by the Operation of the Purgative or Vomitive did frequently Exasperat the Fever which made the Physician often times Repent his use thereof And so Purging and Vomiting was wholly laid aside with us and the Cure Commited to Cooling ptisans Emulsions Clysters Cordial Iuleps c. And that oft times with as litle Reason as Success For the Disease going to a Crisis the Patients Life was alwayes in hazard because in every Crisis Nature stands as it were Hovering and In suspense as it were with an equal Ballance indifferent to Life or Death which may be casten as with a grain and he that suffers the Disease to go to a Crisis does just as if
he would throw the Dice upon his Patients Life Whereas Dr Sydenham considered that the Evacuation of the Morbifick Matter did profitably intercept the Crisis and was the thing indicated and required in the Cure of Fevers and that it could be done by Purging that any Commotion raised by the Operation of the Purge might be Commodiously allayed by giving the Paregorick Pacisick or Quieting Medicine and thus the Morbifique matter might be Evacuated and a Hazardous Crisis profitably prevented without any Superveeuing Commotion or the Exasperating the Fever whereby the Patient had the direct Benefit of the Purging without the accidental and Noxious effect thereof And as there are two wayes of these Fevers so there are two several wayes of practising of this Method for sometime these Fevers are more Slow Long and Chronical in their Motion and progress And sometimes they are more Rapid quick and Peracute and come quickly to an end either to Health or Death In the Slow and Long Fever Gentle Purges Repeated at intervals are most Convenient and there the quieting Medicine is Scarce needed but in the quick and Peracute Fevers sharpe Purges and Vomiters which work speedily must without delay be given For the Slow and Lenitive Method in a Peracute and quick Fever never stops its Course nor obviats its Carrier And as this seems most reasonable and suitable to Experience so it is very conform to the Practise of an Eminent Author Dr. Panthot President of the Colledge at Lions who in a Book lately emitted by him shews that as the frequent use of Cordials in Fevers is very hurtful because moving the Humours with a fretful Agitation they Drive them to the head So he used only Bleeding and frequent Purgatives with a Laxative Ptisan taken several times a day without delaying Purging as Hippocrates teaches to the end of the Fever And if Dosings Ravings Convulsions or any other Frightful Symptoms did arise then instantly and without Hesitation he appoints Emetique Wine to be given than which he knows not a better Remedy And there is an Abstract of his Book to be seen in the Miscellany Letters of the works of the Learned Emitted at London May 1695. Now as to the controverted case betwixt the two Disputants If Dr O when he came to the Patient who was treated before only with gentle Purgatives and found him under any pressing Symptoms and the Fever growing I humbly suppose he did not amiss to give Emetique Wine and in such a dose as the Patient cou'd bear And to say the truth the doses of Emetique Wine are very various according to the Disposition of Patients and their Easiness to be moved some taking two ounces for a dose and other only two drams And considering that upon any exorbitant effect of the Purgative or Vomitive the Pacifique or Quieting Medicine is instantly to be given and in regard in this case it was not given till the Ordinaries return we may construct in Charity that there was no need there obefore and the Bystanders and Friends their apprehensions and fears about the patient might be groundless they never having seen any in a Fever treated so for the Purging method in Fevers had always been Disguised and couched by Physicians and the Bystanders keept always in ignorance about it As witness somes calling the effect of a Purgative quietly given a Natural looseness which would carry off the Disease if these Fears were improven by any upon sinistrous designs they could not do a more wicked thing that being the way to fright timorous People from the use of this profitable practise of purging in Fevers And both Reason and Experience will shew to these that are acquainted with this way of Cure that there 's more Danger oft times in the neglect of plentiful Evacuations than by the use of them But as 't is not good to overact a Cure so it is not safe to Dally and triffle away time which is sometimes very Precious Occasio praeceps Oportunity Slips and Medio Tutissimus ibis the midle way is the Safest But in my humble opinion a Patient that survived so great and so Plentiful Evacuations would not probably have been cured without pretty considerable ones and some more they Dalling and Triffling or Couching and Dissembling the method But since our Disputants seem to be agreed about the substantials of this way of treating Fevers by Purging and Vomiting Pray let them not squable about the Circumstantials and let them strive to out do on another in Effectual and Speedy Curing without either over-acting the Method or shooting short of it And I can tell them from Experience that its hard to be believed how great Evacuations in many cases are not only tolerable but also required in the Cure of Fevers which we may the more freely venture upon having the Quieting Medicine alwayes at hand to check any Exorbitancy that way But by the by it may be observed how pretty Divertising it is notwithstanding the great Opposition made to this way of curing Fevers to behold the Reception it now has and to see persons at such Variance yet substantially agree in this Practice which is indeed no small Argument for it like the Iews and Christians who both agree to the Authority of the Old Testament And if we narrowly observe several Physicians Practice we will see some may be catched stealing into this Practise and some too Cavalierly marching into it some like Firrets and Moles working under Ground and some frolicking and vapouring it As it has been the Fate of all new discoveries and Discoverers to meet with opposition and Contradiction witness the opposition made to the Circulation of the Blood and the Cure of Agues by the Iesuits Bark no wonder this improvement of thus treating Fevers should meet with the same Lot especially when it Receded so much from the common Road which treated them only with Cooling Ptisans Emulsions Clysters Cordial Iuleps c. But when ever such improvments come to take place Physicians either Jugle or Labour to Disguise them or with more Resolution than Reason strives who shall be fore-most therein and extend them farthest as was done with the Iesuits Bark which was not only rashly used in all continual Fevers but by some most Proposterously to the Cure of most Diseases I hope then it will not be unpleasing that I offer my humble Sentiments in Relation to the Solution of this Moral Phaenomenon these strange appearances of the Actions of Men in their Opposing Shifting or Streaching things at this Rate to the great Detriment of Medicine in particular and of Mankind in general In regard new Discoveries in Medicine appear not at first to every one so plain and clear as to silence Contradiction they are sure to meet with opposition from the weak and less Perspicacious and with Quible and Cavil from a Spirit of Detraction in Elder Physicians who are Jealous that new improvment Derogate from them or their Experience or that they are