to be Acute for this Reason because it proceeds from a Colliquation of the Humours in an Acute Fit of a Humorose Rheumatism And therefore because it partakes of the Nature of an ordinary Consumption And must be treated with the general Method it ought to be treated wholly in the General Method that is with the use of Lubricating Incrassating Opiate and other Pectoral Medicines And indeed it has been my Practice and that with very good Success to prescribe in every Rheumatick Fit the plentiful use of Pectoral Lubricating and Incrassating Apozemes and Linctuses though there be no urgent Cough nor difficulty of Breathing not only to temper and soften the Blood but likewise to prevent a Consumption which uses often to be the effect of a Rheumatism But whenever this Consumption proceeds from an old Gout or a Rheumatism When it comes from an old Gout c. 't is Chronical that has returned frequently it is plainly Chronical and does gradually in several Years create trouble to the Lungs and the Parts that serve for Respiration And indeed it is of an Asthmatick kind And of an Asthmatick kind attended rather with a difficulty of Breathing from the toughness of the Phlegm than a pertinacious Cough Because it seems to arise rather from a Stupor of the Nerves than from a Colliquation of the Humours But yet this Asthmatical Consumption to me seems to be of a peculiar Nature But of a peculiar Nature because it is not at all relieved by the choice of a good Air. For I have observed that this kind of Consumptive Persons though they be likewise Asthmatical breath as well in a foggy and smoaky Air as in that which is thin and open And from thence also it comes to pass that Lubricating and Expectorating Medicines do no good in this case though Incrassating and Opiate Medicines are fatally Mischievous But there is more Relief to be expected from the frequent and plentiful giving of Spirit of Hartshorn of Salt Armoniack and Chymical Oyl of Juniper and other things of that Nature that excite the Spirits and comfort the Nerves than from any Opiates or Pectoral Medicines As the Consumption proceeds the Pains abate The more this Asthmatical Consumption grows upon the Patient the more the Rheumatick Pains and Swellings are wont to abate And a true and genuine Humorose Rheumatism long before it becomes Mortal degenerates into a Nervous Rheumatism attended with pains running up and down but with no evident Swelling When a Rheumatick Consumption is incurable This Rheumatick Consumption proceeding from a Chronical Rheumatism and happening to those that are Old so far as I understand is plainly incurable For it is a sign that Nature absolutely sinks and is now overcome in the last Scene of a Rheumatism Gentle Vomits are good Gentle Vomits repeated at due intervals especially if the Patient bears them well and they are not given when 't is too late do much towards the promoting of the Cure of this Consumption because they open the Obstructions of the Brain and Nerves and abate the Rheumatick pains by taking off the stiffness and Stupor of the Nervous parts from whence it comes to pass that a great part of the Procatartick Cause or that which feeds the Distemper is taken away Bleeding does good in the beginning Likewise Bleeding in the beginning of this Consumption before the Habit of the Body is too much extenuated does a great deal of good not only by abating the Hectick heat and the Rheumatick pains but also by relieving the difficulty of Breathing When the Distemper is improved it is hurtful But in the progress of the Distemper when a great Emaciation has before seized the whole Habit of the Body as I have often observed Nature to be more weakned so their Respiration to be rendred more difficult with Bleeding And indeed I do not at all doubt but this Asthmatical Consumption does often proceed from Bleeding profusely and the often repeating of it in the Fits of a Rheumatism the Crasis of the Blood being thereby destroy'd and the whole Mass of it impoverisht as it uses to happen in all immoderate Haemorrhages I have likewise very often by Experience found the extraordinary Vertue of the Peruvian Bark in extinguishing the Colliquative Hectick Flame which has been kindled in the Blood The Peruvian Bark does well and is left there by its Rheumatick state which Flame unless it is taken away either by some Art or by Nature does most certainly prepare the way to this Pulmonary Consumption I have observed likewise that Chalybeate Medicines do for the same Reason conduce very much in the beginning of this Distemper So Chalybeate Medicines at least to the gaining of some respite if not to a perfect Cure but especially the Chalybeate Waters if it be not too late when they are drank if they pass plentifully enough by Urine The use also of Natural and Artificial Baths And Baths if they are used before the Habit of the Body is too much extenuated is wont to promote the Cure of this Consumption very much at the beginning by opening the Obstructions of the Nervous parts every where A Milk Diet is likewise very beneficial at the first Invasion of this Distemper And a Milk Diet at the beginning by lessening the flame that is kindled in the Blood and correcting the preternatural Acrimony of it Though it must be confest it does not so well agree with these Patients in the progress of the Distemper when once there comes to be a difficulty of Breathing because it uses to cause a greater toughness of the Phlegm that is lodged in the branches of the Wind-pipe And it may be this Conjecture is grounded upon very good Reason to wit that the using of Milk too much in a Rheumatism does very much dispose the Patient to this Asthmatical Consumption History 1. Mrs. Laurence about the Five and Thirtieth Year of her Age at which time too she was big with Child fell into an Universal Rheumatism and committed her self to the care of a certain Apothecary for several Months till at length with a Cough difficulty of Breathing Hectick Fever Emaciation and other Symptoms of this kind which she then had upon her it was uncertain whether she would dye of a Rheumatism or of a Consumption the Rheumatism which before was a genuine one being degenerated into a Nervous Rheumatism attended with a rigidity and a wandring pain in the Limbs but with no Swelling At which time being the 25th of October 1686. I being sent for ordered an Electuary with the following Julep to temper the Rheumatick and Hectick heat of the Blood and Spirits and to allay the Hysterical Affections arising from thence Take the Old Conserve of Red Roses of Hipps strained through a Sieve of each an Ounce Lavender-flowers pouder'd Magistery of Coral of each a Dram of Syrup of Corals a sufficient quantity Mix them and make an Electuary
very much abated and by the moderate use of Syrup of Meconium she got convenient Rest and by the help of Surgery outwardly administred and the continual use of a Decoction of Sarsa given inwardly for her ordinary Drink the Ulcer within the space of a Year and half which we did designedly keep open so long with a Silver Tent that was hollow quite thorough was at length perfectly healed her Hectick Fever and Thirst went off her Strength increased her Appetite returned and she was plainly freed from the state of a Marasmus and being sent into the Country Air such as was open and benign and put into a Milk Diet she grew fleshy within six Weeks and recovered without any sign of a Consumption and being yet alive after Eight Years which are since past enjoys her Health very well Several Histories of this Nature I do designedly omit for Brevity's sake CHAP. VI. Of a Consumption happening to Nurses from the giving of Suck beyond what their Strength will allow What the Milk is MILK is nothing but the Nutritious Juice continually separated from the Mass of Blood by the Glandules of the Breasts And therefore if by reason of the want of an Appetite there be more Nutritious Juice suckt out of the Blood through the Breasts for a long time than is supplyed to the Mass of Blood by the new Chyle from the Lacteal Vessels When and how the giving of Suck does cause a Consumption it is in possible but an impoverishment of the Blood should follow and thereupon an Atrophy of the Body seeing it is depriv'd of due Nourishment and consequently an Hectical heat in the Blood Spirits and Habit of the Body which is another kind of Original Consumption proceeding from the substraction of the Nutritious Juice of which we shall now treat Yet a Consumptive disposition is sometimes cured by giving of Suck Yet I must ingeniously declare that I have sometimes observed a Consumptive Disposition cured by giving of Suck and that not only in my most dear Wife but also in very many other Women As for Example My Neighbour Mrs. Wilson who at other times is Consumptive and goes up and down like a Ghost does always grow fat all the time she gives Suck Yea Mrs. Thompson upon Snow-Hill did manifestly fall into a fatal Consumption in the Habit of her Body and upon that into a Consumption of her Lungs from the sudden weaning of her Child But at the same time it is as obvious to our Observation that all such Nurses as grow fat in this manner from giving of Suck But such Nurses have always a good Stomack have a good Stomack yea that during the time of their giving of Suck their Appetite is very much increased and from thence it is very easie to give an Account for this appearance to wit that the Appetite being increased by the continual drawing off of the Nutritious Juice by the Child's Sucking there is room made for a greater quantity of new and oily Chyle by which the Blood is every day enrich'd which does conduce more to the Cure of a Consumptive Disposition than all the Medicines in the World But if the Appetite during the time of giving Suck grows languid and thereupon by reason of the little Food that is taken in a less quantity of new Juice is supplyed to the Blood than is carried off by the Breasts a Hectical Disposition in the Blood and Spirits must inevitably follow and an Atrophy or Consumption in the Habit of the Body and that for the Reasons which we have just now given The first thing that presages the coming of this Consumption is a want of Appetite The presaging signs of this Consumption and therefore I give this Caution to all Nurses that when they find their Appetite to abate for some time they forthwith wean their Children The second sign is a weakness and faintness of the Spirits proceeding from a dispirited and impoverisht state of the Blood A third sign is an Hypochondriacal Oppression and frequent Fits of the Mother and Choakings Which appearance does not proceed from the sucking of the Child drawing the Vapours upward as is commonly thought but a too plentiful substraction and too great an expence of the Nutritious Juice By which means the Spirits themselves become in the same manner as the Blood poor and windy by reason they have lost their Natural and Original Vigour whereupon there follows an Obstruction and this inordinate and ungovernable motion of the Spirits in the Nerves and Fibres of the Muscles and upon that Oppressions and Suffocative and Convulsive Contractions of some Parts commonly called Hypochendriacal and Hysterical This Consumption often terminates in a Consumptions of the Lungs These presaging Symptoms in the Progress of the Distemper have an Atrophy and a Hectical heat following them which is not strange and do often terminate in a Consumption of the Lungs together with a Cough shortness of Breath c. Nevertheless this Consumption is Originally in the Habit of the Body and that from too great an expence of the Nutritious Juice And is then fatal This Consumption when it once comes to the degree of a Marasmus and to terminate in a Consumption of the Lungs proves plainly fatal and incurable The Method of Cure But in the beginning it is easily cured first by the speedy weaning of the Child whereby the cause which dispos'd the Person to it is removed Secondly by giving the Patient plentiful Nourishment of such Food as affords a good Juice Thirdly by exciting and restoring the Appetite by chearfulness of Mind the enjoyment of a benign and open Air by moderate Exercise c. Yea and lastly if her Hectical Disposition requires it the Sick Woman must be put upon the use of a Milk Diet A Caution or of the Chalybeate Waters But let her abstain from Wine and all Evacuations but what are necessary as we have already hinted in the Cure of a Consumption proceeding from other Evacuations A History The Wife of Mr. Bird my very good Friend who lives in Fetter-Lane being about three and thirty Years old gave Suck to a lusty Boy for the space of a Year or more But after she had given Suck for four Months she lost her Stomack and took very little Nourishment at any time and thereupon her Strength declin'd and she was troubled with Choakings or Hysterical Passions but without an Atrophy or Cough or any other Distemper Being sufficiently directed by these things I going at that time by chance to see her advised her to wean her Child without any delay lest she should fall into a Consumption But she however persisting in the giving of her Child Suck when she had lost her Stomack did at length fall into a Consumption or Atrophy of her Body but without a Cough or any remarkable Fever But yet she very much and almost continually complain'd of a dryness and very troublesom heat about the
very troublesome one of thin Rheum from the Glandules of the Wind-pipe and Lungs like the sucking of a Pump In the second degree of a Consumption the Indications are almost the some as those above mentioned In the Second degree of this Distemper that is when the Tubercles are first bred in the Lungs with a dry and troublesome Cough and so long as they remain crude without any great Inflammation and Exulceration the Indications are almost the same as before excepting that they must insist more diligently upon a very plentiful use of altering Medicines according as the degree of the Hectick heat is increased but according as their Weakness and the Colliquation of the Humours are greater all manner of Evacuations must be made more cautiously and sparingly but especially we must endeavour all we can to dissolve those Swellings with the use of Balsamicks Chalybeates Antiscorbutick Medicines of Wood-lice and other things of that kind But in the last degree of a Consumption there are new Indications But as soon as the Distemper comes by the Inflammation and ripening of the Tubercles at length to the last and for the most part fatal degree of a confirm'd Consumption which commonly shews it self not only by the vast increase of the Colliquation and the accession of a new Fever not only an Inflammatory or Peripneumonick but likewise a Putrid Intermitting Fever there presently arise new Indications of Cure 1. For when the Lungs are affected with an Inflammation of the Tubercles in the manner of a Peripneumony as there is an Indication of timely Bleeding and of Temperate and Cordial Juleps to soften the Blood and to keep up their Strength so also of a very thin Diet and a plentiful use of Pectoral Medicines but especially such as are Oily and Mucilaginous to take off the Convulsive contraction of the Lungs by their Anodyne Power and to facilitate and promote the bringing up or expectoration of the Phlegm out of the stufft Pipes But as soon as the Peripneumonick Fever happens to be succeeded by a Putrid Intermitting In the Putrid Intermitting Fever all Evacuations are to be avoided and extream Colliquative Fever together with a sudden decay of Strength after the Inflammation of the Tubercles turns once to an Exulceration as all Evacuations are contradicted by that Weakness so there is an Indication for the use of Temperate Pectoral Cordials Pectorals Opiates Slippery and Cleansing Medicines We must likewise endeavour to root out the Putrid Fever which although some deceitful Truce may be gained with the use of the Peruvian Bark The Peruvian Bark must be given yet does never admit of a perfect Cure without the Ulcers are healed which when they are small and benign is not altogether impossible with the help of a convenient Diet and good Air and the use of Balsamick Medicines But however that may be we may endeavour to give some check to the Colliquation by mitigating the Fever Fit and to alleviate the fatal Symptoms which arise on every hand from the Colliquation Of which I shall speak more largely by and by in the Method of Cure The Medicines that are proper in this Disease What Purging Medicines are convenient in a Consumption are First Purging Medicines which ought always to be mild and benign as Manna Lenitive Electuary the greater Compound Pouder of Senna Aloes prepared with the Juice of Roses Mastick Pills Pills of Amber Alaephangine Pills Stomack-Pills with Gums my Magisterial Stomack-Pills by the Prudent use of which at due distances my most dear Father who was himself a very Skilful Physician for the space of Thirty Years lived till he was an Old Man though in a Consumptive and Sickly state the description of which I am willing to publish out of his own Manuscript for the Publick Good Take of the finest Aloes an Ounce the best Myrrh Mastick of each half an Ounce Cinnamon Saffron of each two Drams Cloves Roman Wormwood Red Roses Nutmeg Mace Calamus Aromaticus of each a Dram of the best Rhubarb two Drams Galingale Schaenanthus Yellow Saunders Wood of Aloes the lesser Cardamoms of each half a Dram of Oriental Musk four Grains with a sufficient quanty of Syrup of Wormwood Make them up into a Mass for Pills according to Art Likewise the Purging Mineral Waters and in general all gentle Purgers that are grateful to the Stomack and Nerves and which cause as little heat as may be in the Blood and Spirits are of use here What Vomits may be given To this Head we must also refer Vomits as Honey of Squills and in the beginning of a Consumption especially when it is from a Surfeit the Infusion of Crocus Metallorum What Diuretick Medicines are proper Secondly Diureticks as the Mineral Waters both Chalybeate and Purging Wood-lice both crude and prepared the four greater cold Seeds common Turpentine Natural Balsam Balsam of Tolu of Peru and Compound Medicines made of these as Balsam of Sulphur made with Oyl of Turpentine and with Oyl of Aniseeds Dr. Goddard's Balsamick Syrup both the Simple and the Anodyne the Roots of Fennel Parsley Eringo and those either raw or candied of Elecampane the Seeds of Mallows of Marsh-mallows Plantain-leaves Juniper-berries Elder-berries simple Honey Honey of Violets Craw-fish Syrup of Marsh-mallows Sweet Almonds c. Thirdly Diaphoreticks The Diapheretick Medicines that proper As Sarsaparilla-roots and China in decoctions Venice-Treacle Laudanum both liquid and solid Mithridate Confection of Alkermes Saffron Sassafras-wood Lignum Vitae Saunders yellow or red Fourthly Pectorals The several sorts of Pectoral Medicines As those that are soft to which Head I use to refer First all Simple and Compound Medicines which by taking off the Acrimony of the Humours do abate the Colliquative state of the Blood whereby it comes to pass that the Rheum is not separated so plentifully by the Wind-pipe and Glands of the Lungs As for Example Coltsfoot Maiden-hair Alehoof Brook-lime Water-Cresses Pine-tops Scabious spotted Lungwort the Flowers of the great Daisie of Rosemary Betony Sage Violets of Borrage Bugloss Lilly of the Vallies the Roots of Polypody the Leaves of Yarrow Mouse-ear Burnet Dandelion Plantain Self-heal Sanicle Fluellin and such mild Plants abounding with a Volatile Salt with Syrups and other Compound Medicines made of those Simples the Leaves of the Oak of Jerusalem of Sun-dew Golden Maiden-hair and other Herbs commonly called Vulnerary which by altering the Mass of Blood do very much help the Concoction of the Humours that are lodged in the Lungs Likewise the Balsam of Tolu of Peru Natural Balsam Storax Benjamin Gum Elemi Balsam Capivi with other Gums and Balsams Brimstone and the several Preparations of it Crabs-eys Egg-shells Chalk Coral Pearl Wood-lice the four greater cold Seeds the Seeds of Mallows Marsh-mallows and Lettuce the Roots of China Sarsaparilla the shavings of Hartshorn and Ivory with the Compound Medicines made of them such as Haly's Pouder the Analeptick or Restorative Antidote the
to great Sweating and to make much Urine so likewise to a continual spitting by the Salivatory Ducts to a hawking up of tough Phlegm from the Tonsils and to a frequent Cough proceeding from a continual spewing out of a Serous Liquor by the Glandulous Coat of the Wind-pipe But this Scorbutical Lympha that is excern'd by the Tonsils and the other Glands though it admits of some Concoction yet as it abounds with a fixt Salt and is in its own proper Nature glutinous it has always some toughness The Cough in a Scorbutical Consumption is not violent and hereupon the Cough of this kind of Consumptive Persons though it be continual yet is not so violent and dry as it uses to be in others where the Serum that is thrown out by the Glandules is thinner whereupon there arises a fierce and troublesome Cough from the continual spewing out of that Serum by the Wind-pipe or at least a perpetual tickling molests them from the swelling of its Glandulous Coat whenever the Lympha does not find a convenient passage out of the Glandules and from hence for the most part there arises a violent and dry Cough From whence it comes to pass that in a Scorbutical Consumption by reason of the viscousness of the Matter that is separated by which the Coat of the Wind-pipe and of the branches of it is rather troublesomly besmeared than irritated the Patient is not so much provoked to Cough as he makes a Cough of his own accord to bring up the Phlegm that sticks and is troublesome to him But Asthmatical and hereupon this kind of Cough comes near to the Nature of an Asthmatical Cough and is attended with a greater Wheesing difficulty of Breathing Constriction and weight of the Lungs than we use to observe in other Consumptions This Consumption is very Chronical And from hence also a Scorbutical Consumption proves very Chronical and never threatens a sudden Fatality without a spitting of Blood or some other great Symptom coming upon it This kind of Consumptive Patients Every little Error makes these Patients Feverish though they spin out their Life to some length without any Medicines only by a due government and care in those six things called non-natural yet they live sickly and upon committing the least Error in their Diet or taking of Cold they are wont to be Feverish and to lose their Stomack The Signs that presage this Consumption The signs of this Consumption are especially two to wit a frequent eruption of Spots scattered up and down upon the whole Skin like the Miliary Shingles and a perpetual hawking up but especially in a Morning of Phlegm that is salt and troublesome thrown out by the Tonsils which is many times accompanied with an Exulceration and wasting of the Gums The manner how it is to be cured But in what manner the Cure of this Consumption is to be altered from the General Method I have already described I shall here briefly observe to wit Opium is hurtful First Opium is always mischievous unless it be upon the taking of new cold and then only it must be given to mitigate the Symptoms that arise from it because it makes the Phlegm more tough and hard to be expectorated Inciding Medicines are besâ— of Pectoraâ—s in this case Secondly Amongst the Pectoral Medicines those that are cutting and cleansing are alway to be preferred for helping and making the Expectoration easie or at least they must be mixt with others as Honey Mead Oxymel Gums and Balsams Wood-lice Syrup of Hedg-Mustard of the five Opening Roots the Balsamick Syrup But above all I commend my Balsamick Pills which I have already described the Use and Efficacy of which in a Scorbutical Consumption I have often had Experience of Antiscorbuticks must be mixt with the Pectoral Medicines Thirdly Antiscorbuticks must always be mixt with the Pectoral Medicines that at the same time when the flux of colliquated Matter is expectorated with the help of the Pectoral Medicines the Ferment that causes this Colliquation may be destroyed or at least abated by the Vertue of Antiscorbuticks Otherwise so long as the Cause is not taken away the Distemper it self cannot admit of a perfect Cure But we must make choice of the milder sort of Antiscorbuticks such as may cause the least heat and disorder in the Blood as Water-cresses Brook-lime Pine-tops the Leaves of Tun-hoof red Dock-roots Male Piony-roots c. of which a Bag may be made to be hung in Ale for ordinary Drink By which means the Volatile Salt of the Simples in which the Energy of the Medicine consists is better preserved than in Apozemes and so the Vertue of the Medicine is more freely communicated to the Blood and the Appetite is less injured by them Fourthly Steel is useful Also Steel is very useful in the Cure of this Consumption unless it runs hastily on to its Fatal Period If it be an Acid Scurvy then Salt of Steel will be proper a Grain or two of which may be mixt with every Dose of the Balsamick Pills If it be a Salt Scurvy Mynsicht's Extract which we have already taught how to give in the form of Pills Especially the Chalybeate Mineral Waters But in all Scorbutical Consumptions the Chalybeate Mineral Waters are to be preferred before any Artificial Preparation of Steel in the Summer-time if it be so the Consumption has not reached to the third degree because they are endued with an extraordinary power not only to open the Obstructions of the Nerves and to penetrate and dissolve the Tubercles but likewise to temper the Hectical Heat in the Blood and Spirits to quench the Drought restore the Appetite and to procure a Briskness and Chearfulness of Mind the Efficacy of which in curing this kind of Consumptions above any other Method of using Pectoral Medicines I have very often experienced with great Success And therefore I shall add at the end of this Chapter a History or two of their extraordinary Vertue in the curing of a Scorbutical Consumption But the use of them ought to be repeated every Year because this Chronical Distemper does not use to be overcome with one blow Fifthly If the Patient is costive What is to be done if the Patient is Costive the Purging Mineral Waters are here also very useful as also any Stomack-Pills before described by the help of which being repeated once or twice a Month my dear Father did happily prolong his Life in a Scorbutical Consumption for many Years Diversion and Chearfulness necessary for these Patients Sixthly The Patient must recreate his Mind and all Lawful means must be used to make him chearful For as this Distemper for the most part takes its Original so likewise its fatal Increase from Grief and disturbance of the Mind A Milk Diet seldom agrees with them Seventhly A Milk Diet seldom â—…ees with this kind of Consumptive Persons by â—eason of the Acid or
often because it takes off the Spasmodick contraction of the Lungs by its Carminative Power and by its Abstersive Faculty it cuts and brings up the Phlegm But yet we must bleed them sparingly according to the Patient's strength and we must not give that Mixture of Riverius unless there is an absolute Necessity A History Mrs. Sherwin a Virgin that had been for many Years past troubled with an Asthma especially in the Winter and when she lived in London with the help of a due Government of the Country Air c. she seemed to do her Business well enough till she was Forty Years old or there-abouts From which time she began to be somewhat Consumptive with an increase of her Cough and her difficulty of Breathing growing worse and worse every day her Appetite likewise being spoiled from her Feverish Hectick Heat which then began to seize her But with using the Chalybeate Waters my Stomack-Pills my Balsamick Pills and other Pectoral Medicines the Country Air likewise contributing very much for two or three Years she seemed much relieved and almost perfectly recovered But at length upon a Peripneumony arising from an Inflammation of the Tubercles of the Lungs she fell into a Colliquative Fever together with a Looseness Dropsie Vomiting profuse Sweats and the other Symptoms of a Fatal Consumption and dyed almost in the Flower of her Age of this Consumption which I call a Consumption of Old Age and if you had seen her before she dyed you would have taken her for an Old Woman When the Body was opened we found the Lungs every where knotted and in many places inflamed yea maturated and ulcerated The same I observed in Mr. Baxter an eminent Citizen of London who from a Chronical Asthma fell at last into a fatal Consumption of which he was much and a long time relieved with the use of Spirit of Salt Armoniack and Pectoral Medicines but especially Balsamicks but after a Year or two his difficulty of Breathing being very much increased and having a Looseness come upon it together with the Gripes a Dropsie and other Symptoms of a fatal Consumption he was carried off But the Asthmatick Fits which used to return often I always took off with the use of Riverius's Mixture when he once grew too weak to bleed with very good Success and with great Relief to the Patient even to his dying day Mr. Rand a noted Apothecary of London rub'd on many Years in the state of an Asthmatick Consumption though he was emaciated and weak with the plentiful use of Spirit of Harts-horn of Pectoral Chalybeate and Balsamick Medicines and a due management of himself in those six things which we call not Natural And although he was often in a Year subject to a light Peripneumonical Fever from a new Inflammation of the Tubercles of his Lungs yet with Bleeding and a due management and the use of Pectoral Medicines he as easily escaped But the extraordinary benefit of Emetick Medicines I often found in him whenever he seemed to be in very great danger from the increase of his Asthma and from his loss of Appetite and great Weakness following upon it CHAP. IV. Of a Consumption proceeding from Melancholy as also from an Hysterical and Hypochondriacal Affection ANY one that has been but a little concerned in the Practice of Physick Hypochondriacal and Hysterical Persons are often Consumptive for a long time and at last dye of it The Reason why it is so may easily observe that those that are Hypochondriacal and Hysterical do often live a long time in a Consumptive state and at length being seized with those Symptoms of a Consumption of the Lungs that accompany the last and fatal degree of it they dye The reason of which thing may be easily gathered from the Principles which I have already mentioned For in an Hypochondriacal and Hysterical Affection the Brain and the whole System of the Nerves are always distempered and thereupon not only the Animal Spirits do degenerate into a Windy and unquiet Nature but also the whole Mass of Blood which ought to be duly actuated and invigorated by those Spirits is turned into a crude and cachectical load And indeed we have reason to wonder that a Consumption does not always follow where there is such a destruction of the Tone of the Nerves and from such a disposition of the Spirits and Blood Moreover every one knows that some troublesome Passions of the Mind do for the most part precede or at least accompany an Hysterical and an Hypochondriacal Affection From which as I have already observed in the beginning of this Discourse a Consumption is wont oftner to take its Original than from Cold or any other Occasion Besides those that are Hysterical and Hypochondriacal from Fear and Anxious Thoughts are very often subject to continual Suffocations and Oppressions of their Breast which are nothing but Spasmodick contractions of the Muscles of the Breast and Larynx and of the tender Substance of the Lungs whereupon their Tone being once weakned and destroyed no Body can think it strange if there often follows a Consumption This Consumption is for the most part Chronical yet fatal But this Consumption for the most part is Chronical because it depends upon a morbid disposition of the Spirits and Humours contracted by degrees But yet for the most part it is Mortal not only because they are seldom frighted at it by reason of the insensible Progress of it until the Patient that had been a long time sickly falls at last into a deep Consumption but also because the stock of Humours upon which this kind of Consumption depends is plainly not to be exhausted How it is distinguisht from other Consumptions This Consumption may be distinguisht from other Consumptions especially by an Oppression of the Breast and an unusual Sadness of the Mind as also by frequent Hysterical Choakings Faintings and other Nervous Symptoms The Cure is almost the same as the general Method But the Volatile Spirits and Cephalicks must be given more plentifully in this Consumption The Cure is not to be altered much from the General Method Yet I will subjoyn some Observations concerning it First In this Consumption because the great Weakness and Obstruction of the Nerves require it we must allow if not even enjoyn a more liberal use of Spirit of Harts-horn Spirit of Salt Armoniack Tincture of Castor Hysterical Water and Compound Piony-water and other things of that Nature than we use to do in other Consumptions the extraordinary Efficacy of which in relieving the Symptoms of this kind of Consumptive Persons I have very often found by Experience and indeed without these neither their Faintness nor Choakings which are Symptoms that are wont very frequently to affect these Patients nor indeed the Cough it self which in this Consumption does for the most part proceed from the Genus Nervosum can be mitigated Secondly The Chalybeate Waters are very useful Likewise the Mineral Waters
Tone of the Stomack so also the Assimilation the Fermentation and Volatilization of the Nutritious Juice are hindred in the whole Habit of the Body from the distemper'd state of the Brain and Nerves The Causes which dispose the Patient to this Disease I have for the most part observed to be violent Passions of the Mind the intemperate drinking of Spirituous Liquors and an unwholsom Air by which it is no wonder if the Tone of the Nerves and the Temper of the Spirits are destroy'd This Distemper as most other Nervous Diseases is Chronical but very hard to be cured The Prognosticks unless a Physician be called at the beginning of it At first it flatters and deceives the Patient for which reason it happens for the most part that the Physician is consulted too late And at last it terminates in an Hydropical and Oedematous swelling of the Body especially of the lower and depending Parts in which case there remain no hopes of the Patient's Life neither is there any thing more to be done for his Cure than giving him some ease whereby his Miserable Life may be lengthened for some days The Cure The business of Cure if it be so that the help of our Art is called in in due time consists in the convenient use of Stomack-Medicines and such as comfort and strengthen the Nerves such are Chalybeates Antiscorbutick Cephalick and bitter Medicines of all sorts As for Example let the Patient if his Body be costive take every third or fourth Morning four Ounces of the bitter Decoction with Senna or every fourth Night two Ounces of the Sacred Tincture or of our Sacred Cephalick Tincture made with Hiera Picra infused in Rue-water Black Cherry-water and strong Piony-water For his common Drink let him use Ale in which a Bag of Cephalick and Antiscorbutick Ingredients has been hung An hour before Dinner let him take xxx drops of Elixir Proprietatis in a draught of Wormwood-White-wine To the Region of the Stomack let there be applyed the Magisterial Stomack-Plaister with some Drops of the Chymical Oyl of Cinnamon and Oyl of Wormwood Or let the Stomack be fomented every day with some Aromatick Bags made of the Leaves of Mint Wormwood Cinnamon Mace Zedoary Galingale Cyprus-roots Calamus Aromaticus boyl'd in Claret If it be in the Summer let him use the Chalybeate Waters But if it be the Winter time let him make use of a Chalybeate Syrup or our Chalybeate and Aromatick Wine made with the Filings of Steel quenched three or four times in strong White-Wine and with Zedoary-roots Galingale Nutmegs the best Cinnamon Mace Cubebs Cloves bruised and steeped in the same Wine But for Chalybeates I do prefer Mynsicht's Extract before any other which I order to be given for xx or xxx days in the form of a Bolus or Pills As for Example Take of Mynsicht's Extract half a Scruple Balm of Gilead which in this case is very proper and beneficial because it is not a little grateful to the Stomack and Nerves seven Drops Old Conserve of red Roses a Dram mix them and make them up into a Bolus to be repeated every day Or if the Patient chooses to take Pills let the Extract be made up into that form in the manner following Take of Mynsicht's Extract half a Scruple of Balm of Gielead seven Drops of Haly's Pouder six Grains of the compound Pouder of the Roots of Wake-Robin four Grains of Pouder of Liquorice so much as will make them into the due consistence of Pills and make the Mass into Pills of a middle size let them be gilded and repeated once every day Also Natural Balsam by it self as likewise Spirit of Hartshorn and Spirit of Sal Armoniack are of use in this case because they are good for the Nerves As for Example Let the Patient take viij or x. drops of Natural Balsam or Spirit of Hartshorn in a convenient quantity of Sugar-candy twice a day Rules for Exercise Diet c. Let the Patient endeavour to divert and make his Mind chearful by Exercise and the Conversation of his Friends For this Disease does almost always proceed from Sadness and anxious Cares Let him also enjoy the benefit of an open clear and very good Air which does very much relieve the Nerves and Spirits And because the Stomack in this Distemper is principally affected a delicious Diet will be convenient and the Stomack ought not to be too long accustomed to one sort of Food History 1. Mr. Duke's Daughter in St. Mary Axe in the Year 1684. and the Eighteenth Year of her Age in the Month of July fell into a total suppression of her Monthly Courses from a multitude of Cares and Passions of her Mind but without any Symptom of the Green-Sickness following upon it From which time her Appetite began to abate and her Digestion to be bad her Flesh also began to be flaccid and loose and her looks pale with other Symptoms usual in an Universal Consumption of the Habit of the Body and by the extream and memorable cold Weather which happened the Winter following this Consumption did seem to be not a little improved for that she was wont by her studying at Night and continual poring upon Books to expose her self both Day and Night to the injuries of the Air which was at that time extreamly cold not without some manifest Prejudice to the System of her Nerves The Spring following by the Prescription of some Emperick she took a Vomit and after that I know not what Steel Medicines but without any Advantage So from that time loathing all sorts of Medicaments she wholly neglected the care of her self for two full Years till at last being brought to the last degree of a Marasmus or Consumption and thereupon subject to frequent Fainting Fits she apply'd her self to me for Advice I do not remember that I did ever in all my Practice see one that was conversant with the Living so much wasted with the greatest degree of a Consumption like a Skeleton only clad with skin yet there was no Fever but on the contrary a coldness of the whole Body no Cough or difficulty of Breathing nor an appearance of any other Distemper of the Lungs or of any other Entrail No Loosness or any other sign of a Colliquation or Preternatural expence of the Nutritious Juices Only her Appetite was diminished and her Digestion uneasie with Fainting Fits which did frequently return upon her Which Symptoms I did endeavour to relieve by the outward application of Aromatick Bags made to the Region of the Stomack and by Stomack-Plaisters as also by the internal use of bitter Medicines Chalybeates and Juleps made of Cephalick and Antibysterick Waters sufficiently impregnated with Spirit of Salt Armoniack and Tincture of Castor and other things of that Nature Upon the use of which she seemed to be much better but being quickly tired with Medicines she beg'd that the whole Affair might be committed again to Nature whereupon consuming
every day more and more she was after three Months taken with a Fainting Fit and dyed History 2. The Son of the Reverend Minister Mr. Steele my very good Friend about the Sixteenth Year of his Age fell gradually into a total want of Appetite occasioned by his studying too hard and the Passions of his Mind and upon that into an Universal Atrophy pining away more and more for the space of two Years without any Cough Fever or any other Symptom of any Distemper of his Lungs or any other Entrail as also without a Looseness or Diabetes or any other sign of a Colliquation or Preternatural Evacuation And therefore I judg'd this Consumption to be Nervous and to have its seat in the whole Habit of the Body and to arise from the System of Nerves being distemper'd I began and first attempted his Cure with the use of Antiscorbutick Bitter and Chalybeate Medicines as well Natural as Artificial but without any benefit and therefore when I found that the former Method did not answer our Expectations I advis'd him to abandon his Studies to go into the Country Air and to use Riding and a Milk Diet and especially to drink Asses Milk for a long time By the use of which he recover'd his Health in a great measure though he is not yet perfectly freed from a Consumptive state and what will be the event of this Method does not yet plainly appear CHAP. II. Of a Consumption proceeding from some Evacuation TO this sort of Original Consumption from the whole Habit of the Body belongs also another kind of Consumption which I have often met with in my Practice arising from the empoverishment of the Blood The loss and want of Nutritious Juice empoverishes the Blood and causes a Consumption occasioned by the Preternatural substraction and loss of the Nutritious Juice Whereupon the whole Mass of Blood being deprived of the Nutritious and Oily Juice grows sour and too hot affording none or very little Nourishment to the Muscular Parts and thereupon there follows a Consumption of the whole Body and a Hectical heat fixed in the whole Habit of it without any considerable Cough or difficulty of Breathing or any other remarkable affection of the Lungs at least in the beginning of the Distemper But it must be confest that in the Progress of it the Lungs seem to be in some measure affected At length the Lungs seem affected in some measure especially where the Preternatural Evacuations which are the cause of the Distemper are stopt by Art without any correction or sweetning of the Mass of Blood by which means it might recover its Natural Oily Benign Nature and such as renders it fit for Nourishment In which case there is no reason to wonder if the hot and sharp Serum of the Blood continually passing after the other Sluices of Nature are stopt through the soft and glandulous substance of the Lungs does at length stuff inflame yea and at last exulcerate them too whereby it comes to pass that this Consumption which was Originally in the Habit of the Body does a little before Death end in a Consumption of the Lungs with a Cough difficulty of Breathing and other Pathognomonick Signs of that Distemper And therefore I have often observed that if the Appetite and Digestion are not restored by such Medicines as have a peculiar quality of altering the Blood and strengthening the Stomack so that the Mass of Blood may thereupon be supplyed and filled with a sweet and Oily Juice the Consumption is not cured This Distemper sometimes turns to a Consumption of the Lungs but at length is changed from a Consumption in the Habit of the Body to a Fatal Consumption of the Lungs This Consumption is akin to that which is Nervous And this Consumption is in truth a-kin to the Nervous Consumption which I have before mentioned For as in that which proceeds from a Preternatural state of the Nervous Juice and Spirits the Nutritious Chyle which is continually carryed into the Blood is rendred less fit for the Nourishment of the Parts and thereupon as the Mass of Blood is filled with stale and dispirited Chyle such as is unfit for Nourishment and not craving any new there follows a loss of Appetite and a sickness in the Stomack and consequently a Consumption of the whole Body and at length a fixed Hectical and Colliquative heat in the solid Parts from the heat of the Blood and Spirits So in this kind of Consumption the Nutritious Juice running off from the Mass of Blood with a full stream the Muscular Parts of the Body being thus deprived of their due Nourishment fall into an Atrophy whereupon likewise the Mass of Blood which remains for want of new Oily Chyle is not only dispirited and rendred unfit for Nourishment but a preternatural fixed and hectical heat is kindled not only in the Blood but also in the Spirits and all the solid Parts whereupon there follows a Drought and want of Appetite Which kind of Consumption is that which we are now in the first place professedly to treat of The Cure of this Consumption is to be altered according as the Evacuation varies But because the Cure of this kind of Consumption is to be altered according to the variety of the Evacuations which are the cause of it I shall add nothing concerning the general Cure of it but refer that to the several kinds of Evacuations which are the cause of this Distemper to be spoken of under their proper Heads Of which so far as I have had an Opportunity to make Observations I come now particularly to treat CHAP. III. Of a Consumption from Bleeding THat which here first offers it self is a Consumption from Bleeding whether it be at the Nose or from the Lungs by coughing from the Throat by hawking from the Stomack by vomiting from the Kidneys by the passages of Urine from the Haemorrhoids or Vessels of the Womb in the ordinary Monthly Purgations or difficult Labour or lastly from Wounds where there happens a plentiful and long flux of Blood from the opening of the large Blood-Vessels Moderate and frequent bleeding makes People grow fat For although frequent and moderate Blood-letting as every ignorant Fellow and Barber knows will make one grow fat forasmuch as the emptying the Vessels with a moderate hand does make room for a greater quantity of new Chyle whereupon the Mass of Blood growing richer is rendred more fit for Nourishment and consequently the Appetite is excited But an immoderate bleeding impoverishes the blood and causes a Consumption Yet every immoderate and long Bleeding impoverishes the Blood and creates a Hectical heat in the Spirits and solid Parts thereupon destroying the Appetite and bringing the whole Body into a Consumption and Leanness Here the bleeding must be stopt In this case the bleeding must be stopt as soon as may be and the return of it is to be prevented by Incrassating Opiate and
the Night But let them avoid sleeping in the day-time yea and sleeping too long in the Morning because such sleep is wont to retain and heap up a great load of Humours in the Habit of the Body 3. Exercise Thirdly let them every day use moderate Exercise and rubbing for a good while together to fetch out the dispirited Humours from the Habit of the Body by the pores of the Skin 4. Evacuations Fourthly let them strictly avoid all strong Purges forasmuch as they not only weaken Nature but also by putting the Blood into too great a motion with their sharp Particles they make it grow acrious and hot and bring it into a more Serous and Colliquative state upon which a Catarrh and a Consumption of the Lungs are wont to follow Fifthly 5. Passions of the Mind let the Patient by all Lawful ways industriously lay aside Care Melancholy and all poring of his Thoughts as much as ever he can and endeavour to be chearful For I have very often observed that a Consumption of the Lungs has had its Origine from long and grievous Passions of the Mind Sixthly 6. The Air. let the Patient enjoy an open fresh kindly Air and such as is free from the smoak of Coals which may not only cherish the Animal Spirits and comfort the Nervous Parts and consequently restore the weak Appetite but likewise procure quiet at least in some measure to the Lungs But there must be great care taken that he does not get new cold For the Body being in such a manner filled with a load of Humours every new Catarrh or Cold tends to a Consumption and from hence come all our Sorrows And here I shall earnestly beg Pardon for being too quick with my Pen if any one can resent it as preposterous whilst I offer something more in this Chapter though briefly concerning the Indications for preventing this Distemper and that before the Methodical Thread of my Discourse brings me to the more copious subject of the Indications of Cure The general Indications for preventing a Consumption in this sickly state are chiefly three The Indications of Cure The carrying off by some way of Evacuation the dispirited Chyle that lurks in the Habit of the Body The tempering of the Preternatural and Hectical heat in the Blood and Spirits newly caused by the stagnation of the Humours And lastly the strengthening of the Tone of the Parts and consequently freeing them from their Obstructions which being neglected there is all the reason to fear an ill Habit of Body and a return of the Preternatural Heat Gentle Purges to evacuate the Humors For this end though strong Purges as I have before hinted are in this case to be condemned yet it is very convenient to carry off the load of Humours by Stool gently and by degrees with kindly and Stomatick Purges until the Body is freed from its bloutiness and Obstructions and reduc'd to its first and Natural state The Purges of this Nature are the Stomack Pills with Gums Aloephangin Pills Aloes prepared with juice of Roses Mastick Pills Pill Ruffi the bitter Draught with Senna c. But I prefer the Tinctura Sacra and the Purging Mineral Waters before any other sort of Purge which as they carry off the vappid Humours by little and little with ease and without putting them into too great a motion so they also rather temper the Heat than kindle a new flame in the Spirits and Blood which is often the effect of other Purges and strengthen the Tone of the Stomack which in this case is weak and relaxt and withal increase the Appetite Diureticks and Diaphoreticks for the same end For the same purpose likewise such Medicines as provoke Urine and Sweat are of great use in order to the more effectual carrying off of the nasty Serum of the Blood But a Physician must be very prudent in the choice of these Medicines But in choosing of these Medicines a Physician ought always to be very cautious and prudent preferring those which communicate the least heat and sharpness to the Blood before others For Diureticks I prefer before any others Wood-Lice raw or prepar'd Turpentine Leucatellus Balsam Balsam of Sulphur and other Preparations made of Turpentine but especially the Chalybeate Mineral Waters Amongst the Diureticks the Chalybeate Waters are the best and amongst them Sadler's Waters at Islington the Vertue of which I have had the Experience of now for five Years not only in many others but also in my self with very good Success because that they are impregnated with more of a Mineral Spirit than any others that I have ever yet try'd in several Parts of England by which they penetrating like Lightning the farthest corners of the Body open Obstructions and provoke Urine very plentifully and yet they do not affect those that drink them so as to make them giddy and as it were fuddled to oppress the Stomack or to cause a great heat in the Hands and Feet at the end of their passing off so much as other Chalybeate Waters use to do Among those Medicines that are Diaphoretick a Decoction of Sarsa deserves the preference Amongst the Diaphoreticks a Decoction of Sarsa which not only causes a gentle breathing by the pores of the Skin but also tempers and softens the Mass of Blood As also Ceruss of Antimony Diaphoretick Antimony c. which Antimonial Medicines provoke Urine as well as sweat If the Blood seems but in the least degree to grow preternaturally hot If the Blood be at all preternaturally hot some must be taken away it is convenient in the very beginning to take away a moderate quantity of it in order to cool it and to abate the fulness of the Vessels For although Bleeding is condemn'd in a Consumption when it is once confirm'd because the use of it at that time not only affords no benefit but also procures the sudden destruction of Nature Yet nothing does conduce more to the preventing or extinguishing of that Hectical Flame which is in the Blood if it be administred time enough By which means other necessary Medicines being also given in a due Method the Inflammation and Swelling and consequently the Exulceration of the Lungs themselves yea and the Consumption it self together with a Cough difficulty of Breathing and the rest of the train of direful Symptoms may be happily prevented And indeed from what I have learnt by a great deal of Experience I do not doubt but many fall into fatal Consumptions from an Inflammation of the Lungs Many fall into Consumptions for want of due Bleeding a Pleurisie ordinary Catarrhs and other Distempers of that kind because through the carelessness of the Physician or the Patient's fear and the timorousness of his Friends that are about him there was not Blood taken away in due time or so often as there should be or in a sufficient quantity by opening a Vein From whence it comes
to pass that the Blood retaining a Hectical heat the Lungs for a long time remain hotter than they ought to be and upon that there is a conflux of the Humours flowing into the Part affected or rather a plentiful separation of the new Chyle by the Glands of the Lungs From which there follow violent and dry Coughs Inflammations and at length when the Consumption comes to its height Exulcerations And therefore I never do take away so great a quantity of Blood from other Persons that have a Fever as from these sickly Consumptive People whenever they happen to be Feverish and this I have done with very good Success so that I do not remember that I ever yet repented of doing it If there be any Hectick heat with a Catarrh an Opiate must be given If the Catarrh has but the least degree of a Hectical heat joyn'd with it and the other Circumstances of the Patient allow it the frequent use of an Opiate is also very necessary in this case and that not only to quiet the Lungs which at this time are heated by the continual and violent motion of the Cough but also to temper and calm the whole Mass of Blood So that it is plainly convenient every Night or every other Night to give a Grain and half of London Laudanum in a little Conserve of Red Roses or an Ounce of the Syrup of Meconium with three Ounces of Milk-water and three Drams of old Epidomick Water or twenty Drops of Helmont's Liquid Laudanum in a spoonful of the Balsamick Syrup which I shall afterwards describe or half a Scruple of Hounds-tongue Pill or the Pill of Styrax Yea And in this case every Purge excepting the Mineral Waters should have an Opiate mixt with it and in this case no Purge except the Purging Mineral Waters ought to be prescrib'd without mixing an Opiate with it lest the Cough and Heat should happen to be increased by too great a Commotion of the Humours As for Example Take a Scruple or half a Dram of Aloes rosate half a Scruple or twelve Grains of Hounds-tongue Pill mix them and make them up into four Pills to be gilded and taken when the Patient is to go to sleep Or Take two Ounces and a half or three Ounces of the Sacred Tincture fifteen or twenty Drops of Helmont's Liquid Laudanum This kind of Purges may be ordered every third or fourth Night and two Quarts of the Purging Waters the following Mornings either cold or boyl'd according to the Season of the Year Those days the Patient does not Purge When the Patient does not Purge Diureticks and Diaphoreticks are to be taken the Physician must go another way to work and endeavour to carry off the Humours gently by the Pores of the Skin and by the Kidneys and do it with the use of such Diuretick and Diaphoretick Medicines as may rather abate than increase the Preternatural heat of the Blood For Example Let the Patient take three times a day Fifty Wood-lice bruised in small draught of Milk-water Parsley or Fennel-water sweetned to the Palate with the Syrup of the five opening Roots Or Take two Drams of Wood-lice prepar'd a Dram of Ceruss of Antimony so much Turpentine washt in Plantain-water as will make them into Pills mix them and make them into Pills of a middle size to be put up in Pouder of Liquorice of which let him take three three times a day at Medicinal hours and drink after them half a pint of the Decoction of Sarsa and China keeping himself from the open Air. The Chalybeate Waters are excellent in this case But for this purpose I generally prefer the Chalybeate Mineral Waters before all others it being what I have learnt from long Experience for that they are found by precipitating the serous Liquor out of the whole Habit of the Body by the Kidneys in a great quantity and tempering the Hectical heat of the Blood and Spirits likewise by opening Obstructions and restoring the due Tone of the Parts to perform every thing that is requisite to a preventive Cure even Reason it self being Judge Which I have also found by much Experience ever since this kind of Waters here near us that is at Islington have first come into Publick use with the Approbation of our Famous Colledge Many preserv'd and cured by them And by the help of these I have seen a great many preserved and indeed others miraclulously recover'd from a Consumption such as I had plainly thought could never be cured no not with all that vast stock of Medicines which are Sold either in the Apothecary's or Chymists Shops and the most approved Method of giving them at least that I knew unless I had had those Waters or at least some others like them ready for my purpose I shall afterwards at the end of this Treatise give a short Account of some few Histories out of many that are pertinent to this business Here also Issues made in the Arms Issues or between â—he Shoulders are serviceable for abating the â—uantity of the Serous Liquor of the Blood and â—onsequently for comforting the Brain and Nerves and tempering the Animal Spirits which doubtless contribute very much to the exâ—inguishing of the Hectical Flame and to the â—revention of a Consumption Shaving of the Head And perhaps â—ut little less benefit may be expected from the â—â—equent shaving of the Head When by this the â—assage of the Humours through that very thick â—kin of the Head is rendred more free the use â—f which thing in relieving obstinate Catarrhs 〈◊〉 approved almost by universal Experience But alas Physicians seldom consulted for the preventing of a Consumption Physicians have very seldom an ocâ—asion to give their Advice about preventing this Distemper when in the beginning perhaps it â—ay be cured as well as other Diseases although â—or the most part by neglect it proves fatal â—e sick Persons seldom imploring Aesculapius â—elp before the Distemper has run on so far as 〈◊〉 be a fatal case and then they in vain expect Miracles from the Art of Physick when it is â—ore convenient for them to have the good Counsel of a Minister about the future Salvaâ—â—on of their Souls and the Advice of a Lawyer â—bout making their last Will. Wherefore I â—â—all spare that labour which will be to so little â—urpose and without any farther delay proceed 〈◊〉 the Diagnostick and Pathognomonick Signs â—f this Distemper CHAP. III. Of the Diagnostick and Pathognomonick Signs of the beginning of a Pulmonary Consumption THE Diagnostick and Pathognomonick signs of a present Consumption The signs either shew the beginning or confirmation of a Consumption are either such as discover it when it is but begun or when it is once confirm'd and deplorable The Pathognomonick signs of the beginning of a Consumption of the Lungs are First a Cough which one may and that by very certain signs distinguish from a simple Catarrh how violent soever
Accident and many times the Original Distemper from which it takes its beginning is easily cured Though I must confess that whenever a Consumption happens to arise from a Peripneumony or any other Distemper of the Breast ill cured from the drying up of old external â—ores or the running of internal Ulcers it is a very hard thing to cure it Every Consumption when 't is cured is opt to return Eleventhly Every Consumption though it be cured is apt to return and he that has once been in a Consumption unless he governs himself very regularly falls back into the same condition even upon the least occasion For not only the Lungs being already impaired by a former Attack from the Distemper are the more apt to receive a new impression but there is likewise found a greater inclination and disposition to this Distemper from the Habit of the Body it self in these than in other Persons Yea moreover even after the most perfect Cure of a Consumption there is reason to suspect that there are some crude Tubercles yet remaining which at length may by often meeting with an occasion be inflamed and ripen into Apostemes and so at last become Ulcers The sooner the Cure of a Consumption is begun the easier it is Twelfthly The sooner the cure of a Consumption is begun the better it usually succeeds and from hence this Distemper especially proves fatal because the Physician is consulted when 't is too late it being a common thing for Patients to neglect our Advice so long till they are not capable of any of those Evacuations and several other Medicines that are very necessary to this Cure CHAP. VII Of the Indications of Cure in an Original Consumption of the Lungs IN the beginning of this Distemper to wit whilst the Lungs are only stufft and being filled with dispirited Chyle and obstructed with the Habit of the whole Body at the same pass they have a Hectical Heat and spew out a great quantity of Serum which does often happen in a Consumption proceeding from a Catarrh and taking of Cold that is where the Body has been so predisposed and indeed continues a long time before the Tubercles and the dry Cough that proceeds from them are produced I say at this time the Indications are plainly these First The first Indication is to temper the heat of the Spirits c. This is to be done by alterative Medicines To temper the heated disposition of the Spirits by procuring a quiet and chearful Mind and to mend the Mass of Blood that has been by degrees reduced to a sharp and hectical state by the plentiful use of alterative Medicines And such we must reckon not only a Milk Diet the Chalybeate Mineral Waters and those Medicines that are commonly called Pectoral as being soft and mucilaginous and so obtunding the sharpness of the Humours but also Balsamicks and Specificks which have a respect to the proper Constitution of the Patient But the Remedies of this Nature must be taken plentifully and so must be given as much as can be in the manner of a Diet and they must persist in the use of them for a long time For the sharp and distempered state of the Humours which has been contracted by little and little is not corrected without a long and plentiful use of proper Medicines The second Indication is to carry off the ill Humours by Evacuations Secondly Gently to carry off the load of the dispirited and diseased Humours lodged in the Habit of the Body with convenient Medicines as Vomits Purges Diuretick and Sweating Medicines Which must be always gentle But all manner of care must be taken in the choice of these kind of Remedies to wit that they be very gentle and benign left that by heating the Blood and putting it into too great a commotion and by that means bringing it farther into a colliquative and waterish state they should by Accident increase the Distemper The third Indication is to open Obstructions c. Thirdly To remove Obstructions and to strengthen the Tone of the Parts especially of the Lungs that are weakned by the Humours they have imbibed and disposed to a Convulsive Contraction by the use of Steel prepared either by Art or Nature of Balsamick Medicines of good and agreeable Air of Volatile Salts and other things of this kind The fourth is to correct the Colliquative state of the blood Fourthly To prevent the Hectick and Colliquative Heat or Catarrhous state of the Blood or at least to lessen it by timely and plentiful Bleeding which although it may do mischief sometimes in a confirm'd Consumption yet in the beginning of one it is very beneficial And I do not at all doubt but the Tubercles for the most part are occasioned by the neglect of it or for want of Bleeding to a sufficient quantity in the beginning of the Distemper whereby the Consumption uses to run presently into the second and more fatal degree The fifth is to concoct and thicken the Rheume in the Lungs Fifthly To take all the care that we possibly can of the Part affected to wit the Lungs by hastening as much as may be the concoction of the thin Rheum that flows continually into them whereby the troublesome Cough it self together with the cause of it may be wholly removed What Medicines are convenient for this purpose Which is done not only by alterative and mucilaginous Medicines commonly called Pectorals which being taken plentifully do by taking off the sharp disposition of the Blood and Humours hinder any farther colliquation and heat in them by which means the new influx of them being once rendred less the Humours that are already sticking in the Lungs may be more easily and sooner concocted by the Natural heat of the Part But likewise by gentle evacuating Medicines which by diverting the Humours from the Lungs do for the Reason already mentioned conduce very much to the more speedy concoction of those which had been before collected But above all by the prudent and alternate use of cleansing and inciding Medicines as there shall be occasion For as Incrassating and Opiate Medicines prudently given do much promote the concoction of the Humour that is already fixt in the Lungs by stopping the influx of fresh Humours into them at least for a time so likewise by that respite which they procure to the Lungs from coughing the Lungs themselves not being for that time so much distended beyond their Tone and recovering their Natural strength are very much comforted But by the use of Oily and Lubricating Medicines the Humours that are lodged in the Lungs and concocted are more easily brought up by Expectoration And if in their concoction they happen to grow more hard and tough than they should be they may with the help of cutting and cleansing Medicines be brought up without violent straining or force of their Cough which if it happens may raise a new Flux and that a
Salt Ferment of their Stomacks and generally speaking is wont to disagree as well with Scorbutical as Hypochondriacal Persons The use of Tobacco is to be much suspected Eighthly The taking of much Tobacco is likewise to be much suspected in this Consumption because not only it increases the Ill and Salt Ferment of the Stomack by reason of the abundance of Salt that is contained in it whereby the Colliquation that is caused by a Saltness is increased but also because that Saline Smoak by irritating the Salivatory Ducts does promote a more plentiful excretion of the Spittle and that not only by the Glandulous Coat of the Mouth but also by the Tonsils and the whole Trunk of the Wind-pipe even to the very Lungs from whence it comes to pass that as the troublesome hawking up of Phlegm from the Tonsils so also the Cough of the Lungs is wont to be promoted Finally the shaving of the Head and many Issues are here very advantageous because they conduce very much to the lessening of the quantity of the Serous Liquor that abounds in this Distemper the one by promoting a Perspiration the other by deriving that Liquor to themselves A History Mr. Hunt a Citizen of London that had been a Scorbutical and Hypochondriacal Man lived almost from his Youth to the Seventieth Year of his Age in a Consumptive state doing his Business well enough by taking care and rightly managing himself without the help of Physick till he was above Sixty Years old from which time being very much emaciated he was very often subject to a Catarrhous Cough that was also something Asthmatical to a want of Appetite especially in the Winter and likewise to a light Peripneumonical Fever from a slow Inflammation of the Tubercles of his Lungs From which he was easily freed by the Advice of a Physician He also had three Sons all which though they were Scorbutical and Hypochondriacal by Inheritance yet they seemed strong and lusty even to the Thirtieth Year of their Age. About which time they were all one after another seized by the same Right of Inheritance with a Consumption occasioned by Passions of the Mind and the drinking of Spirituous Liquors from whence it came to pass that by reason of their neglect of a due Government this Distemper which was so Chronical in the Father was Acute enough in his Sons and if I well remember carried them all off before the emaciated Old Man dyed One of these Sons to wit the Eldest after he had continued his Hectical Heat for some Years by Cares and Drinking falling into a want of Appetite Thirstiness a dry Cough and heavy Oppression in his Breast committed himself to my care After Bleeding gentle Purges and the plentiful use of Pectoral and Balsamick Medicines he seemed to be something better But yet his Hectical Heat Cough and weakness of Appetite still continuing I sent him to drink Tunbridge Waters in the open Country Air the time of the Year favouring that Advice I expected more from the due use of the Waters than from the most pompous Apparatus of Medicines For although he did not stay so long as he ought to drink the Waters nor fortified himself by a due Government yet he came back after a Month recovered in his Flesh his Looks and Appetite and almost perfectly freed from his Cough and Hectical Heat too till the next Winter entangling himself with Cares and much Business and falling to his usual drinking of Wine he felt a return of all the former Symptoms of which he could not be relieved by any Prescriptions of the most able Physicians and so about the next June he dyed at Ebisham where he had lived for some time for the benefit of the Air. His Widdow as well from her grief for the Death of her Husband as from other causes as from taking of Cold in often Watching with him and perhaps by Infection too because she lay with him to his dying day but especially because she seemed predisposed to a Consumption from a Salt and Scorbutical Habit of Body after a Month began to have a dry Cough a very great Hectical Heat an extream Thirst and almost a total want of Appetite together with a squalid Look an emaciated Habit of Body a continual Oppression of her Lungs a Weakness and all the Symptoms of a very Acute Consumption So that if I must speak ingenuously I did expect that she would within a Month or two follow the lamentable Fate of her Husband let her be never so diligent in the use of the best Medicines of the Shops that I had any knowledge of unless the extraordinary heat of the Blood and Lungs could be extinguisht by a great plenty of some diluting and temperating Liquor which would obtund the sharp Salts of her Blood and open the Obstructions of the Nerves at the same time And therefore after a light Ventilation by taking away a little Blood I ordered her because her Body had been costive Ebisham Waters made into Posset-drink by way of Preparative and afterwards that she should drink Sadler's Waters at Islington the extraordinary Vertue of which to extinguish a Hectical Heat I had that very Year with great Success found in my self as well as in several others I ordered likewise a Pearl Julep her Faintness and the heat of her Blood and Spirits requiring it But by reason of the sickness and weakness of her Stomack she could not take any Linctuses or Pectoral Apozemes much less Balsamick Medicines And because of her great difficulty of Breathing I was very doubtful of the use of Opiates And thus for the present I left her The Purging Mineral Waters she took once or twice which put her into a Looseness that held her for three Weeks and I knew nothing of it her Fever still flaming and her Thirst Cough difficulty of Breathing Consumption Atrophy Weakness and other Symptoms increasing But she wholly abstain'd from and was plainly afraid of using the Islington Waters because that was the first Year they were found out and there were a great many Reports spread abroad of their Mischievous Nature But one time when I was not sent for going to visit her in her Chamber to know certainly what Effects the Chalybeate Waters had had because I had heard nothing either from her or from her Brother the Apothecary I found her in a worse condition than ever before and her Fever Cough and Atrophy with all the other ill Symptoms before mentioned so much increased by a Looseness that was come upon her and had now continued so long that she could hardly rise out of her Bed But at last being prevailed upon by the Reasons and the Experience that I urged I had lately had of them she consented to try the Vertue of Islington Waters And in order thereunto I ordered a Dose of my Astringent and Opiate Electuary to be given every Night for her present Looseness when it was necessary and the next Morning always
Glutinous Medicines of which we are to speak more fully in the Chapter of Spitting of Blood As for Example The manner how this is to be done Let strong Ligatures be made upon the Arms and Thighs yea if it be necessary and the strength of the Patient will bear it let a Vein be opened with a Lancet and Blood taken away frequently but in a small quantity to divert the present Flux of Blood and to prevent the return of it If the Part where the Blood breaks out will admit of it let Galen's Styptick Plaister the Royal Styptick cold Oxycrate Ink the ashes of Humane Hair lightly burnt in a Retort and made into the form of a Pultise with Vinegar true Bole Dragon's Blood and other things of that Nature be in a convenient manner presently applyed and often renewed Inwardly let the Patient take three or four times a day xx or xxx drops or more of the Royal Styptick in a draught of Milk-water Also v. or vj. spoonfuls of the clarified Juices of Plantain and Nettles or let him frequently take the following Linctus out of a Spoon Take of Syrup of Purslane three Ounces true Bole Dragons-Blood Troches of burnt Ivory sealed Earth of each two Scruples Japan Earth a Dram of Gum Tragacanth dissolved in Plantain-water a sufficient quantity mix them up into a Linctus Or let him take the quantity of a Nutmeg of the following Electuary Take of the Conserve of red Roses an Ounce Troches of Amber three Drams true Bole Dragons-blood of each half a Dram Syrup of Myrtles a sufficient quantity mix them up into an Electuary Let him likewise take every Night v. or vj. Spoonfuls of the following Julep shaking the Bottle Take of Plantain-water six Ounces small Cinnamon-water three Ounces distill'd Vinegar half an Ounce true Bole Dragons-blood of each half a Dram London Laudanum three Grains Syrup of Myrtles an Ounce and half mingle them and make a Julep After the bleeding is stopt the blood must be supplyed with new Chyle The Flux of Blood being thus sufficiently stopt and cur'd we are to use our most diligent Endeavours that the Blood may be quickly replenished with such new Chyle as abounds with sweet and Nutritious Juice and that the Feverish heat if there be any may be extinguisht to prevent a Consumption And therefore the Patient is to be nourished with the frequent taking of Jelly-Broaths poached Eggs and variety of Food that affords good Juices and is both easie to be digested and most grateful to the Stomack Nevertheless he is to abstain from Wine and from things that are salt or have Spice in them lest they increase the heat of the Blood which was before too hot from the defect of its Nutritious Juice And because this sort of Patients as all that are upon the Confines of a Consumption are subject to Anger to Sadness Hypochondriacal Oppressions Hysterick Fits and to a want of Appetite whereupon they can neither take nor digest much Food and consequently uncapable of making up the loss of that Blood which has been spent therefore the sick Person ought to be diverted and humour'd by his Friends and to be sent as soon as may be into an open and wholesome Air The Patient must be diverâ—ed and sent into the Country Air. which in truth I have being taught from a great deal of Experience observed to conduce more than any thing of Medicines to the comforting and fortifying of the Nerves and Spirits to the recovery of an Appetite and a chearful Mind and consequently to the preventing of an approaching Consumption But if the Patient seems either through his own neglect When there is a Hectical heat it must be taken off with the Bark or the sudden advances of the Distemper to be affected with a Hectical Heat and some degree of a Consumption from his bleeding then let the Physician make it his whole business perfectly to put out this flame as soon as ever he can with the help of the Peruvian Bark given in a large quantity the efficacy of which I have often found to be wonderful in this case Afterwards What is afterwards to be done if it be necessary let the Patient be put into a Milk Diet or upon the use of the Chalybeat Waters But he must forbear the use of all Purging Medicines And some benefit may be reasonably expected from the giving of Crabs-Eyes Coral Pearl and other such kind of altering and sweetning Medicines A History Mr. Hotchkins a Merchant of London a Man that was Scorbutical and Hypochondriacal was subject to a frequent bleeding at the Nose from the twentieth almost to the thirtieth Year of his Age so that he sustain'd a great loss of Blood from the heat of his Feverish Blood at least once or twice a Month though it did not observe any certain periods till at length the Blood that was let out with a Lancet or that which he bled at his Nose did appear just like the Water that Flesh has been wash'd in From the return of which bleeding I could not then free that Excellent Person and my very worthy Friend either with Phlebotomy or the temperating Juices Opiate and Incrassating Medicines a Milk Diet Antiscorbutick and Chalybeate Remedies or any other manner of Medicines From which he first fell into the state of an Atrophy and at length into a true Consumption of the Lungs together with a very great difficulty of Breathing and thereupon falling into an universal colliquative state he suffered a little before he dyed an exulceration of the Salivatory Glands after an extraordinary swelling of them By the opening of which on the out-side there flow'd out so great and such a continual stream of the Salivatory Juice as very much hastened the Death of that worthy Man that was before brought almost to the state of a Marasmus by the Consumption of his Lungs which was caused by his Bleeding But I was extreamly troubled that I did not at that time know the Efficacy of the Peruvian Bark in suppressing this effervessence of the Blood upon which that Bleeding which return'd frequently did certainly depend for from the use of this Medicine we may justly expect more Service in the preventing of a Haemorrhage proceeding from the effervessence of the Blood than from a Milk Diet or any other manner of Medicines CHAP. IV. Of a Consumption from a Gonorrhoea and the Whites THIS Consumption seems to have been known even to the Ancients This Consumption was not unknown to the Ancients under the name of a Consumption of the Back when it proceeds from a Gonorrhoea Galen also notes the Story of the Wife of Boethius a certain Nobleman of Rome who fell into a Consumptive Dropsie from the Empirical suppression of the Whites that had flow'd in too great a quantity and a long time 'T is very true indeed that a Gonorrhoea A Venereal Gonorrhoea and Whites often end in a Consumption of the Lungs and the