the swelling of the belly is somewhat diminished we are not to despair of the Cure but if Purgers bring out little or nothing of the Serum or Lympha and thence by reason of the Nervous fibres being irritated and driven into extensions or inflations of the bowels and membranes as it uses frequently to be the belly swells the more and grows like a Drum we may expect only a fatal event of the Disease About the curing of the Dropsie called Ascites it behoves us chiefly to consider by what ways the waters heaped within the abdomen The Cure of an Ascites may be thence brought out and evacuated for such an evacuation ought to be attempted only by possible ways And here presently is to be observ'd that the remedies used for Hydragogues according to the ordinary practice of Medicine intend to accomplish that end by purging by Urine By what and how many remedies the eduction of the water is to be endeavoured by Sweating and by insensible transpiration In some cases of the Sick you ought to proceed by this way and in other cases rather by that way or another and if none of these seem feasible or succeed well let mature consultation be had for a Paracentesis It will be worth our labour to weigh every of these kinds of Medicines and the reasons of every one and the manner of their operations and with how much vertue Hydragogues are endowed First First by purging therefore as to what relates to purging we have in another place shewed that from the irritation of the Physick made in the belly and guts as well the Contents and winde of these bowels as moreover the humours driven into their Coats and Glandules and which are heaped up in the Vessels and Pipes of the neighbouring parts are disquieted and partly streined into the passages of the guts and partly returned into the mass of blood insomuch that the tumour of the abdomen arising from the stoppage and as it were a waterish affection of those kind of Parts is often abated by Purgatives seasonably administred and sometimes wholly removed but it doth not so succeed when it proceeds from a Lympha fluctuating within the cavity of the abdomen or from an inflammation of the membranes or from a tympanitic extension because Hydragogues do little or nothing bring out those waters and if they be of the stronger sot they encrease this passion and exasperate it by inflaming the part Catharticks used for Hydragogues Catharticks are either Vomits or Purges are either Vomits or Purges they exert their power in the stomace and these rather in the Intestines insomuch that they powerfully provoke and twitch the Nervous fibres and together pour forth the blood and nervous liquor by a certain septick force and do cause the serous humours wherever impacted to be stirr'd and do cause them plentifully to be sent away by the passage granted Either are reckon'd of a various kinde viz. either simple or compound gentle or strong by the Ancients as well as by the Moderns some of which that are most chielfy noted we will here briefly observe 1. Emetick Hydragogues chiefly famous are Gambugia Esula Spurge and their several Preparations as also the Hercules of Bovim and the Pilulae Lunares 2. The chief medicines of either kinde Purgers are Elder and Dwarf-Elder Soldanella Gratiola or Hedge-hyssop the Juice of Orris and Elaterium We will briefly prescribe some methods either of preparing or compounding or administring each of these 1. 1. Gummi guttae Gambugia first an Indian Medicine being from thence brought by our Countrey-men from the Painters Shops coming to the Apothecaryes began to be in use and is much magnified for purging out serous humours But sorasmuch as taken by it slef it vehemently disturbs the Stomach and often weakens it therefore that its outragious and violent vomiting force may be somewhat abated there are divers ways of its Preparation invented but truly it is best corrected with an acid Spirit or with an alcalizate Salt or by throughly mixing and correcting it with aromaticks Adrian à Mynsicht It s various Preparations extolls the magistery thereof which is made by a dissolution in Spirit of Wine and after drawing it off and precipitating it with Spring-water also dissolving it with Spirit of Wine vitriolated and with Tincture of Roses and red Sanders and after by evaporating it others prepare it with the fume of Sulphur after the manner of Scammonie sulphurated others grinde it on a Marble moistening it with Oyl of Cinnamon or Cloves or other chymical Aromaticks I use most the Solution thereof made with a tincture of Salt of Tartar the dose from 15 drops to 20 or 30. Take of Gum-gutta gr 6. Mercurius dulcis gr xv Conserve of Violets The forms of Hydragogues prepared thereof a dram and a half make a Bolus Take of Gambugia twelve grains Salt of Wormwood fifteen grains Oyl of Mace one drop Conserve of Damask Roses one dram make a Bolus and it is wont to be given with Tartar vitriolate or Cream of Tartar and powder of Rhubarb Take of Gum-gutta sulphurated or vitriolated fifteen grains Cream of Tartar half a scruple Extract of Rhubarb one scruple Oyl of Cinnamon gut 2. make 4 Pills Lately a woman afflicted with a most painfull Ascites and most desperate as it seemed to me the ensuing Medicine being taken for 6 days successively she began to be much better and in a short time afterwards recovered her health entirely Take of powder of Gum-gutta twelve grains Oyl of Cinnamon one drop with syrup of Buck-thorn make a Bolus the dose daily to be augmented ascending from twelve grains to twenty Take of our Tincture of Gum-gutta one scruple water of Earth worms one ounce Syrup of Rhubarb half an ounce mix them and let it be taken with government 2. Whereas there are several species of Spurge or Tithymalus 2. Spurge The Preparations thereof and all of them work more violently either by Vomit or Stool by reason of the notable provocation they make in the bowels and for that cause do abundantly bring out serous humours yet by reason of the too outragious force of many of them the lesser Spurge for the most part only is now in use and the preparations thereof most of all magnified are the powder of the bark of the Roots and the Extract and we think fit to adde the tincture inferiour to none of the rest Take of Spurge with the Roots cleansed four handfuls Lignum-Aloes and Cloves of each one dram bruise them and boyl them in four pound of Spring-water to half the strained Liquor clarifie by separation or settling in a long glass afterwards evaporate the clear liquor in a Bath heat to the consistence of an Extract the dose one scruple Take of this Extract half an ounce Forms pour upon it into a matrass of the Tincture of Salt of Tartar 6 ounces digest them in a Sand-hath to the Extraction
while a great Mill is driven about with a screeking noise and a dreadful aspect of the wheels the distempered be put into the Trough or Receiver of the Grain or Corn and from thence the sudden cure of this disease sometimes happens The reason whereof without doubt consists in this that the Animal spirits being put to flight and forced into fresh distractions they relinquish their former disorders moreover the convulsive matter is either dissipated by that disturbance or is forced into other nerves where it is less troublesome The Empirical cure of this disease being described after this manner The rational cure together with the remedies vulgarly used and the rendring a reason of the cause at least probably unfolded from hence it will be lawfull to design a rational method of curing and perhaps more efficacious against childrens Coughs of this kind Wherefore in such a case sometimes successefully enough I have prescribed according to the following forms And seeing we ought to begin with purging Take of the syrup of Peach flowers one spoonfull of Aqua Hysterica one scruple mix it Purging and let it be taken with government Or take of Mercurius dulcis 6 grains Scammony prepared with Sulphur Resine of Jalap of each three grains make a powder give it in a little Pulp of a preserv'd Cherry to a lad six years old and let the dose be encreased or lessened according to the age let the Purge be repeated in 6 or 7 days If the Patient as it often happens be prone to vomit Take of Oxymel of Squils 6 drams Salt of Vitriol 4 grains mix it for a child of six years old and according to this proportion let the dose be accommodated to others I have known a Vomit of this kind taken every morning for four or five dayes together with good success Vesicatories or Medicines drawing blisters are in daily use Vesicatories and are applyed sometimes to the Nucha or nape of the neck another while behind the ears then to the inside of the arms near the arm pits and as soon as these sores begin to heal in these places let others be raised in other places Instead of Beer let the following Decoction be used for ordinary drink Take China-roots an ounce and half of all the Sanders of each half an ounce the shavings of Ivory and Harts-horn of each three drams let them be infused and boiled in six pints of spring water to the consumption of half adding Raisins stoned an ounce and half Liquorish three drams Take of Spirit of Gum Ammoniac with Salt Armoniac a dram Mixtures Syrup of Chin-moss three ounces Aq. hysterica an ounce the dose is a small spoonful in the evening and morning fasting Or Take of tincture of Sulphur two drams dose three drops in the evening and first in the morning in a spoonful of the Syrup of Cup-moss To some endued with a hot constitution and while they cough their countenance is spread with redness or rather blackness I have prescribed Phlebotomy or drawing of blood with Leeches to two or three ounces with good success Take Hog-lice living and cleansed two ounces powder of Aniseed a dram Nutmeg half a dram fine Sugar an ounce bruise them together and pour upon them six ounces of Hysop-water of Magistral Snail-water two ounces stir them together a little and press them out hard the dose two or three spoonfuls twice a day Hitherto of a Cough and its Remedy while it is only an entrance to a Consumption now it remains to treat throughly of the distemper it self having passed the limits of this dangerous disease and to design a method of curing and the forms of romedies which are proper to heal an inveterate Cough when either being neglected or not easily giving place to remedies it begins to degenerate into a Phthisis namely when it arrives to that state that the blood being dissolved in its consistence doth not only pour out the superfluous Sorum but also the nutritive Juice and perhaps the nervous the Lympha and other its superfluities on the Lungs and lodges them within its passages Of what sort the beginning of a consumptive Cough it and in the mean time the corruption of the Lungs is so much increased that the little Bladders being distended or many of them broke into one so that a solution of continuity or an Ulcer being caused a greater plenty of corruption is daily heaped in and moreover the matter in that place gathered together because it is suffered to abide there long putrifies and for that reason doth still more corrupt the Lungs themselves and defile the blood flowing through In this case the Therapeutical indications shall be chiefly these three Three indications concerning its cure 1. To stop the dissolution of the blood 2. To draw out the filth from the Lungs 3. To heal the Lungs hurt viz. in the first place to stop the dissolution of the blood which is the root of all this evil and to make provision that it pour not out the matter any longer in such abundance upon the Lungs Secondly by expectorating the purulent matter heaped up within the Lungs and to evacuate it quickly and sufficiently Thirdly to strengthen and dry the Lungs loosned from their unity or being too loose or moist or otherwise infirm lest they be daily more and more corrupted and give more reception to the morbific matter Every of these indications suggests various intentions of healing and requires remedies of divers kinds and many ways of administrations The chief of which we shall here briefly treat of 1. The first indication suggests three intentions of healing Therefore what the first indication suggests that the dissolution of blood may be prohibited these three things as much as may be ought to be procured viz. First that the mass of blood may contain and assimilate whatsoever of nutritive juice it may be furnished with and that it be so proportioned that it neither offend in quality nor in quantity Secondly that the acidities either generated in the blood or poured into it from some other place may be so destroyed that the blood retaining as yet its mixture or temperament may not be prone to flowings and pourings out Thirdly and lastly that all the excrements produced in the blood may be derived from the Lungs to other Emunctories and places of Evacuations 1. The first intention that the nutritive juice may be proportioned to the blood and assimilated by it As to the first intention of healing viz. that the nutritive Juice may be proportioned to the blood let it be advised before all things that they who cough and are phthisical abstain chiefly from drink and that they take liquid things in a very small quantity for that the blood being infirm in its temperament so long as it is not too much imbued with fresh juice may be able to digest small portions and retain it within its own consistence Moreover let that fresh juice consist
and vigorous he recovered his former health in a short time Fits of this kind more seldom infested him in Summer-season but in the restof the year repeated three or four turns and brought the sick even into great hazard of life If disquisition be made of the nature causes and formal reason of this unwonted and as it were irregular kind of Coung it is manifest it proceeds like all other from the provocation of the Lungs nevertheless as to the matter exciting its seat and manner of affecting it is doubted because neither thick spittle nor plentiful thin as is usual in other distempers is here cast out neither doth the Patient complain of feeling a Catarrh nor of any weight of the Lungs Wherefore not as in a common Cough does the serous humour either slowly or plentifully sweating out of the Trachea or pneumonic vessels into the little bladders or pipes of the Trachea induce the afore mentioned symptoms But it is plain from thence that the passages of the aspera Arteria are wholly empty of the serous or thick humour because the deep and sounding Cough throws off nothing Moreover neither from the blood impacted in the Membranes of the Lungs doth this Cough take its origine because neither feaver nor thirst nor pain are present here as in a Peripneumonie Besides neither doth the morbific matter seem to adhere to the nerves or muscles appointed to the function of breathing because then besides a Cough Asthmatical or otherwise convulsive fits would sometimes urge with a sense of strangling which notwithstanding did not happen to our patient Having frequently and seriously meditated about the aetiologies of this very difficult case I am at length induced to think that a certain serous and sharp matter as being loaded with a scorbutical taint falling from the head by the passage of the nerves doth enter into the nervous fibres and Membranes of the lungs or Trachea which cleaving throughly to them is by degrees encreased to a fulness The conjuct cause of the disease and at length being chaf'd and grown turgid with a perpetual provocation creates so troublesom a Cough We have in another place declared the matter of this kind impacted in the Coats of the guts and the neighbouring parts about them not rarely to excite a scorbutical Colick for many days yea sometimes weeks infesting them with vo miting and a most sharp torment and what else is this Coungh but a certain convulsive distemper of the lungs whose taint notwithstanding according to the capacity of the part labouring is imprest rather and more on the motive than on the sensitive Power For the lungs however twicht adn hurt do suffer small pain or scarce any at all notwithstanding from any light occasion they are invaded by storms and fits of coughing Indeed we compare this distemper of coughing so much the rather to the Colick because the subjects of either of them that is to say the Trachea and the guts as to their coats vessels little fibres and glandules are after the same manner fashioned The chief cause of the Cough now deseribed depends upon the morbific matter heaped together within the little fibres of the rough arteries to a provoking fulness wherewith when they are loaded first a quick and painfull breathing infests onely with amornings Cough because from the beginning onely some small portion of that matter being disquieted provoke the part afterwards when the whole mass thereof growing turgid almost perpetually twitches the fibres there follows a most troublesom cough which also being often repeated endures a long season because the morbifick mass impacted in the parts affected is neither presently cast off by the strength of nature nor easily gives place to any remedies For in all the fits of this disease I have made tryal of various methods of curing and of medicines of divers kinds though with little success That distemper beginning at any time is wont to make a long period maugre all remedies The medicines commonly called pectoral as Syrups Lohochs Eclegma's or Lambitives have conferred little benefit to its cure not withstanding sometimes it hath seemed good to admit of them into use for this purpose that they might make slippery and moisten the Lungs lest they run the hazard of being rent by a violent Cough and their vessels burst asunder for sometimes a more fierce fit troubling our sick Patient he hath been wont to cough out a little blood though no thick spittle A gentle Purge both in the beginning and declination of this distemper hath succeeded well Opening and diuretical Apozemes are ever administred with success both which he used enough through his whole course instead of ordinary drink Evening and morning he took some drops of the Tincture of Sulphut with the Milk-water of Snails late at night I was sometimes constrained to administer a Dose of Diacodion or of liquid Laudanum his belly for the most part loose enough that it seldom required Clysters in two of his fits he breathed a vein whereby nothing of success ensued In the last fit The usual method of curing beinning about the Autumnal Equinoctial which passed away a little more lightly and gently this following method of healing was observed First of all this Purge was given A Purge and after four days repeated Take of Mercurius dulcis ten grains Resine of Jallop four grains mix and make a powder to be taken in a spoonful of Syrup of Violets Take China-roots sliced a dram A Drink Grass-roots three ounces Chervil an ounce candid Eringoes six drams shavings of Ivory Harts-horn each three drams Raisins of the Sun stoned three ounces boil these in three pints of Spring-water to two pints strain it and use it for ofdinary drink Take syrup of Jujubes two ounces A Mixture Diacodion an ounce spirit of Salt Armoniac with Gum Ammoniac a dram mix them the dose a spoonful at night and early in the morning He was mauch relieved with this medicine notwithstanding he took it only every other or third day and for change sometimes a dose of the tincture of Sulphur with syrup of Violets The disease declining a Purge was twice repeated and afterwards recovering his health by degrees within two weeks he became healthy enough But when I beheld him not only obnoxious to frequent relapses of coughing but every fit to be irresistible when it assaulted him and its stay very long notwithstanding the use of remedies and all this threatning no less than a Phthisis at length I advised that as well for his preservation as for the more easie cure of the distemper if it should return he should travel into a hotter Region Hereupon he did not much delay but sails into France about the beginning of November and from thence by a straight journey to Montpelier where abiding half a year he was sick only twice and both tiems lightly afterwards returning into England quite free from a Cough praise be to God he enjoys his perfect health
from 15 drops to 20. with the distilled water prescribed above In this Class of Medicines by which the icterical distempers of the blood are to be corrected Steel remedies of several kinds steel'd remedies do also challenge their place by right for these afford notable help not so much by unlocking the obstructions of the bowels as by depressing the rage of the Sulphur and fixt Salt and by volatilizing the blood in the Jaundies no less than in other cachectical distempers Wherefore to the Decoction or Tincture or Infusion above prescribed is properly added the filings of Iron or the prepared powder thereof its mineral consistence being some wayes opened or the vitriolic Salt extracted from hence it is that Medicinal waters heal even to a miracle those sick of the Jaundies that had been despaired of although these drunk in a very large quantity inasmuch as they pass through all the vessels do also open the passages of the Liver however shut up Therefore also even Preparations of Steel are added to the Electuary Pills and Powders above recited one while this another while that in due proportion Moreover the Syrup thereof given twice a day to one spoonfull in three ounces of Apozeme or water against the Jaundies also tincture of Steel to twelve or fifteen drops may be administred in the same manner In the last place we may annex to this classis of altering Medicines those things which not taken inwardly Outward and Sympathetick remedies against the Jaundies but outwardly applyed and by contact used to the very urine of the Patient are held to cure this disease As to the former a remedy often tryed by the vulgar is a living Tench-fish whose Scales and outer superficies do resemble a yellow colour applyed to the right Hypochondria or Stomach according to some to the soles of the feet according to others whence a sudden flight of this disease is expected hence although many promise themselves a sure cure it hath often deceived me Another cure of the Jaundies at a distance is said to be done by I know not what sympathy or secret manner of working Take the fresh Vrine of the Patient made at one time of the ashes of the Ash-tree searced as much as suffices to reduce it into Paste which may be formed into three equal balls to be placed in a place shut near the hearth or Stove as these dry and harden the Jaundies will vanish after this course I have known this inveter ate disease happily cured although resisting many other remedies the practice thereof is very familiar with the Vulgar If of a certain it could be made manifest that this effect doth for the most part happen The reasons of some of them and the reason of it be inquired into in the first place we ought to suppose a consent or sympathy of the spirits and other particles in the animated blood with other symbols inmates of the fresh urine and that they immediately are affected in the like manner with these Notwithstanding it is evident enough that a lixivial Salt mingled with urine doth presently set free the volatile salt formerly subdued or enwrapt in other particles as is plainly seen in distillation of Urine which if you urge by it self with a sand-heat nothing but phlegm will arise but adde the calx of Tartar or Ashes immediately the Spirit and volatile Salt will come forth wherefore that Empirical administration being administred at the same time both in the Icterical urine and also in the blood of the Patient the volatile Salt escapes out of the power of the fixt Salt and the Sulphur and for that cause the icterical distemper of the Blood is put to flight Also upon the same reason is built another sympathetical cure of the Jaundies whereof Phil. Grulingius and Felix Platerus do make mention viz. the sick party pissing upon Horse-dung while it is hot hath cured many of the Jaundies inasmuch as the fixt Salt of the Urine and thereby the fixt Salt of the icterical blood of the patient is altered by the volatile Salt of the fresh dung and reduced into its due temperature 3. The third Curatory indication vital institutes a convenient course of Diet The Third Indication vital and moreover Cordials and Anodynes of both which there is frequent need As to what relates to the former Food in this disease more than in any other ought to be medicinal For Vegetables and their parts styled commonly Hepatick remedies are boyled in the broths of these Patients And these also are wont to be made instead of other flesh of Worms or Snails which are accounted Antidotes against the Jaundies Moreover Ale and other ordinary drinks are impregnated with infusion of Medicaments Take of the roots of stinging Nettles of Strawberries of each an ounce and half Eriygo-roots candied one ounce Ivory and Harts-horn of each two drams Earthworms cleansed twenty a Crust of White-bread Mace two drams boyled in two pound of water to one pound strain it through Hippocrates sleeve to which adde Diasantalon half a dram make broath whereof take from four ounces to six twice in a day for ordinary drink fill a Tub of four Gallons with Beer after it hath wrought put in the following Bag. Take the tops of Roman Wormwood white Horehound dryed of each two handfuls the roots of sharp pointed Docks six ounces of the Bark of Ash of Barberries of each 3 ounces the outer Rinds of eight Oranges and of four Limons being sliced and bruised let them be prepared according to Art Since many sick of the Jaundies are usually affected with a great languishing Forms of Cordials and frequent faintings of the Spirits they have also need of cordial Remedies Take of small Aqua Mirabilis eight ounces water of Earth-worms four ounces Syrup of Orange-peels two ounces mingle them the dose two or three ounces Moreover they who are troubled with this disease do very much suffer with pain sometimes very troublesome in the night and are often obnoxious to waking wherefore also Anodynes come into use for administration Take of Aqua Mirabilis water of Earth-worms of each one ounce Diacodium six drams Tincture of Saffron half an ounce the dose one or two spoonfuls late at night if sleep be wanting Take of Laudanum tartarizated two drams Aqua Mirabilis two ounces Syrup of Clove-gilly-flowers one ounce mix them the dose is one spoonfull after the same manner SECT II. CHAP. II. Of other Hepatick Remedies THe Liver is seldom or never found obnoxious to an Atrophie or extenuation since truly it performs the office of a strainer and according to some of a mingling bowel but on the contrary by reason of many causes and occasions it runs the hazard of being encreased as to its bulk and to be stufft and swell'd with divers things gathered therein and with concretions Hence no small account of health consists in this that the Liver having right conformation may freely convey the blood every
boyled Salt Alum and Sulphur and after applyed Cow-dung for a Cataplasm I use to prescribe these ensuing Take of flowers of Sal Armoniack one ounce Crystal mineral two ounces A somentation Spirit Wine small and imbued with much Phlegme two pound mixe and dissolve them in a glass Let a woollen Cloth dipt into this warm be applyed upon the whole Abdomen and then let it be changed wetting it again let it be done for the space of half an hour twice a day afterwards let there be applyed a Cataplasm of Cow-dung with the powder of Dogs turd or the following Plaister Take Empl. Diasaponis that is de Minio with Venice Soap A Plaister let it be spread thin upon limber Leather and applyed to the whole Belly to be renewed once in ten or twelve dayes II. The second Indication requires mostly alterative Remedies to wit The second Indication those which stop the fermentations of the humours in the bowels of the nether Belly and the Orgasms and irregular excursions of the Spirits also those which procure equal mixtions and due motions of the Chyle and nervous Juice Of Chalybeate Medicines for which end Chalybeates are chiefly in use And truly it is wont not only in this but in many other splanchnical Diseases to have resort to the Medicines of Iron as if from thence to fetch the sharpest weapons whenas many Empiricks and Quacks who prescribe these things confidently and dogmatically observe not by what way such a Medicine doth operate or what alterations for the better may be lawfully expected from thence wherefore while Iron changed into Medicine although the Sword of Goliah is snatcht and brandisht by a blind man it is no marvel if it prove in vain or if in the stead of the disease which is an Enemy Nature it self is sometimes hurt and truly frequently it happens so when Chalybeats of which there is great variety and diversity of operations are administred without any choice or difference either of the temperament or constitution in the Patient and respect to the state of the Disease Of Medicines prepared of Iron or Steel and of their vertues and manner of working What preparations of Iron are not convenient we have in another place treated and there is no need here to repeat the same things For this disease if any of them not all of them are fit for those in which the frame of the mixture being opened the Sulphur remains still and being loosened predominates over the rest they are altogether to be excluded from this number for they do much ferment the Juices of the bowels with their notable fermentation and do so exagitate the Blood and Spirits that the whole Region of the nether Belly is lifted up into a greater bulk as if by a certain Spirit thronging violently into it Neither here are they fit from which the sulphureous particles together with the saline are chased away as in Crocus Martis prepared by long and strong Calcination For this Medicine as it is conducing to stop all fluxes rather fixes any impaction of Humours and Spirits and renders them more obstinate But there remains a Martial Remedy of a middle kind What sort may be admitted wherein the Sulphur being wholly or for the most part expell'd a vitriolic Salt remains and predominates as indeed it is in the solution of the filings of Iron or in a simple Infusion or in Mineral water in the Salt or Vitriol of Mars in our preparation of Steel with many others out of which medicines being prepared or compounded we find by often Experience that in some cases they contribute notable help For these destroy the exotick ferments of the bowels and restore the native ferments they open their obstructions they fix the blood and restrain its consistence from too much dissolution wherefore Chalybeate remedies after the same manner as certain other alteratives do perhaps something profit against the procatarctick and more remote causes of a Tympany but as to the conjunct cause they contribute little or no succour Take of our Steel finely prepared two drams Forms of Chalybeates the distilled water above prescribed two pound Syrup of the five Roots two ounces mix it in a glass let it clarifie by settling the dose three or four ounces in the morning and at five afternoon Take of the Powder of Aron-roots Crabs-eyes of each three drams Crystal Mineral two drams Vitriol of Mars a dram and a half Sugar of Rosemary-flowers two drams mix them the dose half a dram twice in a day with a convenient vehicle Hartman doth wonderfully magnifie the liquor of the flowers of Tapsus Barbatus or Mullein A liquor of the flowers of Tapsus Barbatus as a specifick remedy in this disease by putting the fresh flowers into a Vessel being strongly press'd and put into an Oven with bread being close stopt afterwards the Liquor being strained let it be distill'd in Balneo the dose one Scruple in the Decoction of Fennel-seeds and Roots Surely this Medicine if it doth effect any thing ought to be given in a larger dose Johannes Anglus commends an Electuary of Rosata Novella with Diatrion Santalon and Egges of Ants which remedy seems to promise something probable enough In imitation of this I here propound this ensuing Take Conserve of Chichory flowers An Electuary of Indian Cresses of each three drams powder of Aron-roots Lignum Aloes yellow Sanders of each one dram Crabs-eyes one dram and a half Salt of Wormwood one ounce Ants Egges one ounce the liquor of Tapsus Barbatus half a dram with a sufficient quantity of Syrup of Citron-rinds make an Electuary the dose two drams twice in a day drinking after it of the former distilled water or of the following Julep three ounces Take the water of the leaves of Aron A Julep of the Juice of Elder-berries of the water of Juniper and Elder-flowers of each six ounces the magistral water of Snails and of Earth worms of each two ounces Syrup of the Juice of Elder-berries two ounces mix and make a Julep III. Third Indication The third Indication Vital prescribes Remedies against fainting of Spirits and difficult breathing and against Watching and Thirst We will briefly annex certain forms of either kind 1. Cardiacks Take of the water of Napha Cordials Marygolds Camomile of each three ounces of Dr. Stephan's water two ounces Tincture of Saffron two drams Sugar one ounce Pearls one dram make a Julep the dose four or five spoonfuls three times a day or oftner in faintings Take Conserve of Marygolds two ounces Confection of Alchermes and de Hyacintho of each two drams prepared Pearl one ounce Syrup of the juice of Citrons enough to make a Confection take the quantity of a Nutmeg evening and morning drinking after it a draught of the Julep 2. Hypnoticks Take of Aqua Hysterica six drams Hypnoticks Syrup de Meconio half an ounce mix them and take late at night Or Take
vital flame is continued and all the particles of Blood having as it were passed the fire become more purified and more agreeable among themselves moreover they are so disposed of whilest they are kindling that while some go into Nourishment of the Spirits of the Nervous Juice and the folid parts and others less useful depart into the ferments or recrements of the bowels mean while others being more fixt abide longer in the mass of blood and sustain its consistence and by fermenting the Nutritious Juice still engender new Blood untill themselves being impoverished are at length discarded and give place to others that are fresh and Iustie Having shewed after this manner by what course Sanguification ought to be finished An Hydropick temper of the blood springs from a double respect as well by fermentation as accension of the Blood it will be easie to conceive wherein the fault confists producing an Hydropick dispdsition To wit this usually assumes its rise whensoever either or both those Conditions requisite to Sanguification ether fail or are perverted First therefore this bappens more frequently and rather Viz. First from the desect or fault of its Fermentation for that the blood being depraved in its temperature doth not rightly ferment the Nutritious Juice poured into it that so it might be changed into laudable blood For when the watery particles predominate with the earthy in the mass of Blood the Salt and Sulphur being depressed with the Spirit as all the functions both Vital and Animal from thence languish and waver so especially Sanguification it self fails and is perverted For the Juice of the Chyle commixt with the Blood when it cannot be dissolved and fermented with the particles thereof after the fashion of other liquors as often as being mixt they want ferment it degenerates perhaps into a watery acid or ropy or otherwise faulty humour which being afterwards daily encreased and at length rising to its fulness lyes heavy on the blood and oft-times almost stifles its heat from whence there is a necessity that it be forthwith discharged by some means and wheresoever it can get vent but afterwards for that the offices of separation fail in their sunctions the stock of the animal Spirits Languishng by reason of the diminished provision from the influxe of Blood the abounding Serum is deposited every where into the pores and next vacuities whether greater or lesser out of the little moughts of the Arteries from whose daily and great encrease after all the pores are filled arises that as it were fenny habit call'd Anasarca of the whole body outwardly or of some of its members Secondly not only the defect or fault of Fermentation Secondly from defect of Accension but also of the accension of the Blood induces sometimes an Hydropical disposition on the mass thereof which is clearly discern'd inasmuch as some persons inhabiting Maritime or moorish places fall into the Dropsie without any other cause or occasion than that they draw a thicker air endowed with heterogeneous vapours by which the Nitre is either driven away or obscured Therefore the blood becoming degenerate and vitiated as to its temperature because it is not duely kindled nor perfected by efflagration within the precordia doth not rightly dissolve and assimilate the Juice of the Chyle but suffers it to be perverted into a watery liquor But although in the first place the blood being depraved for this reason sometimes loses its fermenting vertue and therefore the rather and more immediately procures a Dropsie notwithstanding it is manifest the first fault thereof assumes its origine from unwholsom air suckt in and not duely enkindling the Blood because such Hydropicks removing their residence into Sunny and Mountainous places recover their health without any other Medicines Hitherto of the nearest Causes of an Anasarca and which are conjoyned to the Disease it self which namely are the depravation or defect of the mass of blood chiefly as to its fermentation and in some measure as to the enkindling thereof which latter is scarce wont to be effective but when if follows the former But what remains as to the more remote and procuring causes of this Disease to wit from which the defermentative affection arises that I may say no more of the defect or depravation of its enkindling I say that these appear so diverse and many that I judge it hardly possible to recite them all particularly notwithstanding very many or at least the chief may be reduced to these three heads to wit Reduced to three heads For that the watery distemperament of the blood doth arise inasmuch as its active Principles viz. Spirit Salt and Sulphur are not invested with their fermenting and sanguifying force or vertue I account this to come to pass either First because those particles are too much wasted by their great expences or Secondly because they are not repaired by convenient and proportionate Refections or Thirdly for that they are overwhelmed or obscured by some other duller or heterogeneous Particles being too much accumulated in the mass of Blood We will a little weigh the Reasons and ways of each of these their coming to passe In the first place the former of these is evidently discerned in frequent and inordinate Haemorrhages whereby many men although strong and formerly healthy First because the active particles of the blood are too much consumed are immediately enclined to a Dropsie more than from any other accident or occasion the reason whereof is that the blood is so impoverished through its more noble Particles issuing out in great abundance that afterwards it can neither duely ferment nor enkindle the Juice of the Chyle brought into it Moreover sometimes the same effect fucceeds although in a more slow degree from Feavers and other long maladies and languishings to wit inasmuch as the blood suffering under a long depression is so extenuated and robb'd that at length it becomes watery and defermentative Secondly the Blood sometimes deferting its genuine disposition Secondly because they are not enough repaired declines into an Hydropical one for that the nourishment being more slender than it was wont or ought to be bestowed upon it its active and sanguifying Particles are not enough repaired within its masse for so we have observed that some who have used themselves to Wine and stronger Drink after they have been reduced to homely Diet and smaller drink of water of small beer suddenly have become Hydropick It is a common observation and frequently true although of ill omen that Drunkards and darly drinkers if that wild Custom be left at length becoming sober and abstemious are much in hazard lest by reason of the usual fermentation of the blood being denressed they become obnoxious unto that Disease I knew a notable Drunkard who declared that a Priest very learned and Pious was guilty of his death because he gave him admonition to Temperance and to leave his Drunkenness Thirdly because they are buryed in duller
do want Bridles not Spurs But in the Plague Small-pox and Measles broke out and in malignant Feavers sometimes the blood spontaneously flowing out portends for the most part evil therefore in those affects styptic Remedies or things stopping the eruption of blood are more convenient than breathing of a Vein Thirdly 3. Or Art out-done by Nature Notwithstanding on the contrary there are cases of shedding blood by Nature which Physick can no way imitate neither if they chance to fail can be supplyed by Phlebotomy In Feavers about the Crisis of the Disease to wit after the digestion of the matter that is to say the preparation for Excretion spontaneous Haemorrhagies if coming in time do far excell any Phlebotomie which none knows the best season of Moreover the Fluxes of the Terms and Haemorrhoids happening by Natures instinct are more advantageous than the mission of blood provok'd by Art in any of those places Between Phlebotomie and spontaneous Haemorrhagies Phlebotomy and spontaneous Hemorrhagies differ as to the subject and matter there is yet a notable difference although not of great moment in Physical practice viz. both as to the Subject and Matter of either of them for in this the blood being florid and throughly Scarlet doth for the most part only flow out of the Arteries but in the other Evacuation the Blood being of a black purple with a Scarlet Cream is only drawn out of the vein Whence the stream of Blood which is one within all the vessels and throughout continuous acquires such a diverse kind of appearance seeing we have shewed in another place it is not our present purpose to make any surther search into this Aetiologie because it concerns not much to the curing any distemper out of what vessel the blood be let provided it flow out largely But that the ancients do in some cases commend Arteriotomie and prefer it to an incision of a vein the Circulation of Blood not being then known we have elsewhere discoursed how well it may be done Hitherto of Phlebotomie compared with a spontaneous Haemorrhage The use and effects of Phlebotomy now our next business is to describe the use and effects thereof as well good as bad in Physical practice Wherefore we will first shew in general what alteration of the mass of Blood this Evacuation bring then what diseases it more immediately respects either of the whole body or its particular parts About the former How it affects and alters the Blood it is obvious enough that the blood is altered by breathing a vein both as to its quantity and temperament and as to its disposition and motion The first and most common Indication of Phlebotomie is 1. Diminishes its quantity that the plenty of blood be diminished by this Administration And truly this is a vulgar Remedy to remove or provide against a Plethora Any one though of the vulgar sort growing to a full habit of body le ts blood without the advice of a Physitian Moreover Rusticks and Countrey-men for healths sake Emission of the Blood is not to be either too prodigally or too slenderly made once or twice in a year cause blood to be drawn from themselves and their Beasts But although this custom is grown so much in use with some prodigal of their blood that they breathe a Vein on the smallest occasion and sometimes without any manifest cause notwithstanding we may find many others no less obstinate against this custome insomuch that for no cause will they lose any blood unless the greatest necessities be urgent Upon this matter whereas Arguments are alleadged on either part The reasons of the former hinted at that I may in few words determine what seems fit to be ordained in the first place it is requisite we grant that letting blood is convenient against a Plethora either made or beginning for by no other Remedy are the evils of that Affection wont to be better removed or provided against Notwithstanding the necessity of this evacuation ought to be declined as much as may be because from thence as we have intimated elsewhere the blood becomes more sulphureous and less salt and for that reason it most commonly disposes all men to be feaverish and to be fat Moreover the Great Remedy Blood-letting if it be prostituted to every little occasion becomes less efficacious to any grand affections when need requires To which we may adde that according to the vulgar observation by how much the more familiarly any one uses Phlebotomy he will the more frequently stand in need of it for blood being emitted to avoid a Plethora the rest of the mass will the sooner rise to a Plethora far otherwise than is the opinion of some who dread lest the store of blood be consumed by frequent Phlebotomie for that on the contrary by this means the quantity is more encreased although the Crasis be the worser for so the blood having lost much of its balsamick Salt and preservative against putrefaction instead thereof is filled with a pinguifying and more fiery Sulphur Secondly 2. Phlebotomie amends the mixture of the Blood Phlebotomie doth frequently correct the mixture and temperament of the blood in a manifold respect For in the first place if any thing heterogeneous be confounded with its mass which cannot be rightly digested nor easily excerned and sent away a Vein being opened the blood flowing out conveyes frequently much of the portion of that matter forth with it insomuch that the rest may be either subdued or expell'd For the orifice of a vessel being opened presently the blood fermenting gathers together the extraneous particles as much as possible and excludes that portion of it self wherein many of them are heaped up From hence we may observe the blood flowing out first and last to be well enough It restores its temper when that emitted between appears corrupt Also secondly the blood declining from its temperament is frequently restored by Phlebotomie For when the mass thereof by the Sulphur or fixt Salt or both together being exalted shall degenerate into sharp salt or saline-sulphureousness a portion of the blood being withdrawn immediately a new fermentation thereof arises and very often there is a transposition made of all the particles of that sort that afterwards the Spirits may a little emerge with the volatile Salt and recover their dominion the Sulphur and fixt Salt as is fitting being subdued For this reason it is that letting Blood doth not only confer great help in Feavers but also in the Scurvy Jaundies and beginning Consumption for the blood after the vessels are emptyed like the Stomach disburden'd doth better digest and assimilate any humoursingested and the more easily throws off and separates whatever is heterogeneous But if the mixture of Blood begins to be much loosned and become very bad Some distempers of the blood admit not Phlebotomy as in the Plague and malignat Feavers we must altogether abstain from Phlebotomie for the blood
being withdrawn the store of Spirits whose only part it is to vindicate the mass of blood from putrefaction and corruption is diminished so that immediately all things tend to a deadly dissolution Moreover if the Dyscrasie of the blood shall be of that manner that the more noble Principles to wit the Spirit the volatile Salt and Sulphur being depressed or cnsumed the watery and earthy particles predominate the blood ought not to be sent out but preserved even as the treasure of life for when the abundance of Spirits are so small any loss of them doth cause all the functions to stagger and gives way to the disease wherefore in a Dropsie Cachexia Consumption and other Distempers where the active Principles are greatly depressed the opening a vein is almost the same thing as cutting the mans throat In the before mentioned cases In some eases about Phlebotomy it is very doubtfull where the temperament of blood is respected it is easie to determine whether Phlebotomie be convenient or not but in some others as in a putrid continual feaver when upon this hinge Life and Death are turned there is need of the greatest deliberation and so much the rather because the event of the Disease and the success of all the accidents in its whole course whether good or bad is usually imputed to Blood-letting or its omission and from hence it is that Physitians being solicitous to preserve their own repute do chiesly raise doubts in their consultations of this matter And chiefly in a continual putrid Feaver But truly in this difficult knot that we may not be led by the rumour of the vulgar as it chances to happen one while approving another whise condemning Phlebotomie but with more certain advice we must consider the state of the Blood the tendency of the morbific matter and the strength of Nature First as to the former if in a putrid Feaver the blood very much growing hot shall raise a great heat with thirst watchings and burning of the Jaws and no eruption of abundant sweat nor pushes appear or is suddenly expected opening of a vein is so clearly demonstrated How the doubt is to be determined that it is a wickedness to omit it but on the contrary if in a languid body a slow and remiss Feaver but continual arises with a weak Pulse let Blood-letting be spared and the cleansing thereof be procured by breathing Sweats Urine and blistering Notwithstanding in a middle state of Blood and of a Feaver Phlebotomy almost indifferent in it self is determined by other things Therefore secondly we must weigh the tendency or flux of the morbific matter which if it remain dull in the mass of blood and unfit to be separated and so as it is frequently wont to be instead of a Crisis a translation towards the head be made and threaten the brain and nervous stock the cutting of a vein ought seasonably to be administred whereby these evils may be provided against Notwithstanding if that this matter being soon raised into a rage and either rushing inwardly to the bowels of the nether Belly provokes a huge Vomiting or Dysenterical affections or being driven outwardly seems to be about to bring the Small-pox Measles and other pushes every such force of Nature if good ought not to be disturbed if evil not to be made worse by Phlebotomie for in these cases it is not only dangerous to let blood but also very scandalous Thirdly about Phlebotomy to be administred in a doubtful case we are to take heed to the strength of the Patient for in a healthful Constitution a vigorous Age the commencing of a Disease and the functions both vital and animal being yet in a florid or indifferent estate we may confidently prescribe letting of blood unless something indicates the contrary Notwithstanding when it is otherwise as to those conditions we may not rashly proceed to that Evacuation Thirdly Thirdly Phlebotomy corrects or stays the inordinate motions of the Blood the inordinate motions of the Blood when being very much moved as it were with fury it either rushes impetuously one while into these parts another while into those or transferres the noxious matter are best restrained or reduced by Phlebotomy wherefore in great Cephalalgies in all soporiferous or convulsive invasions for Catarrhs Ophthalmia's and a Cough Asthma fits of the Gout and Stone or Phlegmons Erysipelas's also for many other Distempers raised by the flowings of the Blood or Serum an incision of the vein is commonly prescribed and indeed for the most part as with good success so also upon right Reason for the Vessels being emptyed the blood having obtained a more free space is circulated pleasantly and undisturbedly besides whatever is extravasated of the Blood or Serum is wont to be suckt up again and reduced into its course The Effects as well good as bad being thus shewn What Diseases and of what parts Blood-letting chiefly respects which happen to the blood in the manifold state thereof by Phlebotomie we will next make strict examination what Diseases chiefly either of the whole body or of any private Region that kind of Remedy doth more immediately regard And first as to what relates to general Distempers it is commonly enough known that letting blood is indicated bu a hot and dry temperament and interdicted by a moist and cold It is usually propounded in every Feaver but never in a Dropsie Moreover if we consider particular Diseases there is no region or part of the Body but as they rejoyce in the influence of vital as well as nutritious blood as long as it is well so as often as it is disturbed in any place or reaches out any disagreeable or provocative thing in place of benign Juice it requires avocation and a letting out thereof If I should take notice of every single case of this Indication we should here rehearse almost the whole Pathologie of the humane body An aking Head a Brain oppress'd with blood or overflowed with Serum whence spring a world of evils burning of the eyes inflammation of the face mouth and throat all the diseases of the Breast and Praecordia inasmuch as the disorder of Blood affords a rise or fuel to each of these likewise obstructions or inflammatory affections of the Liver Spleen and other Bowels moreover as a Plethora and Athletick habit of the whole body so also the tumours of each member painful and convulsive passions seem to accuse the blood as Author of all the evil and require its sending out as a certain kind of revenge In these and very many other distempers if at any time Bleeding be clearly indicated After Phlebotomy being indicated these four things following ought to be considered before it be performed four things ought to be considered viz. In what place by what manner and instrument at what season and in what quantity the Blood ought to be taken away First as to the former although according to the Laws of the
the Heart either grow weary or are forced into convulsive disorders for that cause the Heart beating in disorder drives out before it the blood either infirmly or irregularly But that the blood issuing out of the Heart doth not always with expedition pass through the Pneumonic Arteries 2. Sometimes by the fault of the blood 3. Sometimes by reason of passages obstructed that sometimes happens from its own proper fault and also sometimes from the passages obstructed and also by reason of other causes The blood it self in a double respect hinders its own passage through the Lungs viz. either offending as to its kindling or as to its temperature There are sundry accidents of either of these For first even as the blood is more or less kindled than is convenient it is hindred or obstructed in the pulmonary circuit if at any time the watry earthy or fixt saline parts are predominant in the blood the spirit and sulphur being consumed or brought low by reason hereof its liquor being not well or less kindled by the nitrous air is not easily rarified in the pulmonary passage and scarce passes through them like a flame of its own accord but it sticks still in its passages heavy and muddy and creates much trouble and labour to the Heart wheresoever it is circulated Hence as often as the blood is a little more plentifully forced into the Pracordia by the quicker motion of the whole body or of its parts the Heart and Lungs labour hard for its driving about and that with the utmost endeavours And in this case it is probable The blood hindred in the Lungs sometimes because not kindled enough that the blood carried more rapidly into the right Ventricle of the Heart doth somewhat stagnate because it cannot presently be carried into the passages obstructed before it Moreover from this cause those grumous or fleshy concretions called the Polypi of the Heart sometimes seem to arise Hence both in the Pica Leucophlegmatie Dropsie and inveterate Scurvy from the quicker motion of the body arises difficult and painful breathing 2. Sometimes the blood is too much kindled and breaking out almost into a flame Sometimes too much and being above measure expanded it can scarce be contained in the pulmonary passages which it very much blows up and extends but endangers them to be inflamed or kindled wherefore lest it should tarry longer in them the Pracordia beat with most frequent and strong endeavours that the blood so over-much kindled might be ventilated and circulated for otherwise it being carried within the Lungs and inflaming them all over would quickly destroy the vital function Besides these things which concern the kindling of the blood It is also stopt through its temperament being vitiated there are other faults as to its temperament or mixture by reason of which it less freely or expeditely is conveyed through the pneumonic passages For when its consistence is either too laxe or too close it will not easily pass through the small passages of the Lungs but oftentimes is in hazard to stick and stagnate in them and also run out and be extravasated The blood being in a diverse manner made loose in its consistence either deposites its Serum or its dregs or its putrefaction in the Lungs which being lodged in the recesses of the Vessels or affixed unto their sides do variously stop or pervert the course of the blood 1. The dissolution of blood which is most commonly injurious to the Lungs When the blood is too much loosened in its consistence although not very dangerously is wont to happen for as much as the serosities being unapt to be contained within the mass thereof and when they are not presently sent away by sweating or urine they separate from the blood within the Lungs and so boiling up and breaking out from their proper vessels do as well disturb and stop the passage of air as that of blood so that for the sake of expelling those serosities and continuation of the circulation of blood the Lungs are provoked into a frequent and very troublesom Cough What the formal reason of this Cough is and the manner of its being brought about we shall declare hereafter Though there are many causes and occasions by which the serous liquor Why it lodges the Serum in the Lungs departing from the loosned consistence of the blood flows out abundantly into the Lungs yet for the most part it happens from one of these three viz. first and most frequently because the Pores outwardly bound up by cold cast back the serosities which were wont to be sent away by perspiration into the mass of blood which compel it presently to boil up and cast off the serous superfluities in the Lungs The various causes and ways of doing it From this kind of cause Catarrhs and Coughs frequently arise insomuch that the beginning of every cough by the vulgar is always imputed to such an occasion to wit catching cold 2. The drinking of sharp and thin liquors as Cider Rhenish Wine white Wine Paris Claret commonly causes to some a Cough or catarrhal distemper the reason whereof is for that the blood weak in temperament is presently dissolved and precipitated into serosities like milk by sowre things cast into it which flow plentifully from the mouths of the inward Arteries I have experimented this upon my self yearly when in the Summer season when the blood abounds with sulphur I have drank Cider and tartish Wines safely yea frequently to advantage the same in winter when the blood is prone to sowreness but moderately tasted of do presently provoke a Cough 3. There is another cause of this serous inundation flowing out upon the Lungs viz. when the Lympha watering the nervous and solid parts doth suddenly suffer a flux and for that cause it streams back into the blood out of the Fibres and Glandules and other passages and receptacles whose liquor it presently dissolves and precipitates into serosities which often infests the Lungs For this reason a sudden and troublesom Cough frequently accompanies convulsive distempers which being commonly called a vaporous Cough is ascribed unto vapours Moreover in great alterations of air especially when the season varies from dry into moist and the volatile and fixed salts do thereby melt the Cough and Catarrhs increase very much Neither doth the serous liquor only but also many other humors or recrements of the blood lodged in the Lungs frequently stuff up their passages so that by obstructing both the passages of air and of blood they cause difficult breathing or a cough This is every where perceived in ill-habited bodies also in Gluttons and Drunkards and others leading an inordinate and slothful life Wherefore Foot-men use a thin and spare diet that they may have their Lungs free from the filth and recrements of the blood I have observed some melancholy persons the adust faces abounding in the pulmonary passages to have voided blackih spittle like ink also others
that a very small chink remains for the blood to pass Not long since we dissected a young man who died by reason of an ill formation of the pneumonic Vein Sometimes wax hard in whom the trunk of this vessel growing stony near the juncture to the heart did stick so close that the blood did drop into the heart only by drops or by a very little stream 2. That the passages bringing blood are often filled and stopt insomuch that the stream of blood is obstructed or straitned many anatomical instances and observations manifestly declare From thence it appears The vessels are stuffed with concretions resembling the Polypus that grumous or as it were carnous concretions of the blood do frequently so stop the ventricles of the heart and the roots of its larger vessels that the course of the stream of blood is almost entirely stopt Moreover reason perswades and experience concludes this more frequently to happen in the lesser vessels for seeing as we have even now intimated the blood emitted by Phlebotomy in Rheumatisms Peripneumonies and Pleurisies when it is cold is covered all over with a thin skin altogether of the like substance with those concreted Polypus's it plainly appears that it passes with difficulty through the passages of the lesser vessels by reason of those viscous excrements wherefore that it may pass by some means it distends them very much and sometimes breaks quite through them also it frequently unlocks their mouths and opens gaps into the Trachea insomuch that portions of the extravasated blood are by coughing frequently ejected We have known some to have died Asthmatic or short-winded whose Lungs being free from an Ulcer or any more grievous wound have swelled so much that they wanted room for their motion within the cavity of the Chest the reason whereof doubtless was that the thicker and more feculent blood for that cause not easily passing through those vessels every where extended the Arteries and Veins and caused it to stagnate in the lesser Pipes Moreover the feculencies of blood one while salt of different kinds another while sulphureous or earthly being combined with them and thrust into the small passages of the vessels and fixed there do altogether obstruct them insomuch that the pneumonic circulation of the blood is contracted into a shorter space and consequently the function of breathing is straitned in the compressed Pipes or little Cells There are many kinds and sundry ways of such an obstruction which if all or the chief should be enumerated such a Pathology would swell into a too great bulk 3. The pneumonic passage of blood is not only hindred by reason of the passages shut and obstructed but sometimes also being burst asunder For those vessels being small The blood is also hindred because the passages are burst asunder as in spitting blood or tender or very loose in some persons are frequently opened by the force or acrimony of blood so that the blood either bursting into the Trachea is ejected by spitting or heaped up in the interspaces of the passages causes a Peripneumony or falling down into the cavity of the Chest produces an Empyema Of all these we shall treat singly in the Chapter of spitting of blood 3. One impediment of the blood is want or default of air There remains as yet a third impediment of blood in the pneumonic passages which happens for the want or fault of Air. If at any time the Blood is not kindled after a due manner within the passages of the Lungs from air breathed in by the Trachea for that cause as presently its flame is irregular so likewise its motion is variously stopt or perverted for although the blood is forced through the lungs by the meer impulse of the heart notwithstanding the pulse hereof is proportioned according to the tenour of its being kindled by the air wherefore when the flame of blood is diminished or supprest for want or through the fault of the air presently the pulse proves languid or unequal and by reason of the bloods course being troubled or stopt presently a paleness and coldness succeeds wholly intercepted or frustrated because the nitrous particules are wanting presently the pulse ceases and anon life is lost The reason of all which is both because the blood being much impeded in its accension or extinct like Must given over working presently subsides and is unapt for any motion and chiefly because the flame of the blood failing and being substracted from the brain presently the Hypostasis of the animal spirits as it were light streaming from thence immediately fails and together with it the exercise or actions of all faculties do cease But if the blood is too much kindled the Sulphur of the Blood and the Nitre of the Air running together more than it ought for that cause presently that this too much burning may be eventilated enough the pulse of the heart is increased to its utmost We might adde many instances of this kind but truely this consideration of the blood leads us to the second thing proposed of Respiration hurt namely that we may duely weigh what sort of failings or defects do happen about the inspiration as well as expiration of the Nitrous air requisite for the preserving the nitral flame of blood that is to say from what causes they proceed and also what effects they are wont to produce in which search we will first treat of Inspiration hurt SECT I. CHAP. III. Of Inspiration hurt BReathing is accounted hurt Breathing hurt by the vicious qualities or defect of air when its use is frustrated or any ways hindred which most frequently happens by reason of the fault or defect of the Air drawn in As to the former if the Air chance to be depraved it neither duely kindles nor eventilates the blood yea it sometimes overthrows the temperament thereof or infects it as is every where seen in a Constitution of Air very malignant That we may touch on the chief reasons of these distempers The faults of the air we are to observe That as the Nitrous particles of Air are chiefly necessary as is manifest by manifold experiment for the preservation of life so frequently it happens that Nitre of the Air either to sail or be wholly wanting or by particles of another kind to be so much muffled or bound up that they cannot enough exercise their vital power or lastly malignant or fatal Corupscles to be adjoyned thereunto First the nitrous particles of Air are deficient if when it stagnating or growing hot the Nitre is chased thence or not stirr'd into action Wherefore in a low-roost Chamber or too close and in other places crouded with assemblies of men or made hot with the ardor of the Sun we difficultly or weakly breathe The same comes to pass in places of great height on the tops of those mountains exceeding the top of the Atmosphere wherein breath is faintly drawn for want of Nitre neither can we live long there
Greeks by little and little revived Various opinions are recited so that some did dare to make incision on the same side yet always one side judged the others of the opposite perswasion as it were guilty of murder as often as any unlucky event did happen So that while among Physicians about phlebotomy there was no less a contention than among the Jews and Samaritans about the Sacred place of Worship at length the Doctrine of the Circulation of the Blood held out like a new Light by the most renowned Harvey discuss'd all the clouds of this Controversie so that immediately it clearly appeared to be almost the same thing whether incision be made in the Vein on the affected or opposite side of a patient sick of a pleurisie although in our Age Custom hath prevailed first and rather to open the Vein of the affected side Notwithstanding a Vein being opened in either Arm draws nothing at all immediately from the vertebral Arterie or from the pleura they are only the branches of the Azygos or of the vertebral vein that receive the blood out of the place affected but that they may accomplish this they are not unloaded in any other manner but that the quantity of the whole blood be abated by phlebotomie wheresoever made Onely this may be affirmed for opening rather the vein of the affected side that the Basilick vein being unloaded the Arteries of the Arm receive the more ample provision of blood from hence the bloody stream of the vein Aorta runs down more swistly from that side towards the branches of the Arm and perhaps in the interim of its quick passage it infuses less blood into the vertebral Arteries for the nourishment of the disease As to that opinion that the blood is sometimes more plentifully carryed from place to place that from hence the right Lung or Liver being beset with an inflammation or obstruction the right part of the head is in pain and of the face grows more red I say this sometimes is brought to pass because the patients do constantly lie in their bed on the side affected wherefore the Vessels being compress'd the blood stays longer in other parts of the same side while it is circulating But of these things we will make a more diligent search when we shall render the History and Aetiologie of phlebotomy But if phlebotomy by reason of a weak pulse Cupping-glasses with Scarification supply the place of blood-letting and fainting of the animal function neither ought to be at first administred nor repeated though the pain be most urging Cupping-glasses with Scarification do well supply the turn hereof being applyed to the place pained Riverius and Zacutus Lusitanus have cited notable Examples of cures effected by this remedy And surely this practice seems to lean upon a reason strong enough for the blood being drawn away from the side affected that which is lodged in the neighbouring vessels being the conjunct cause of this disease is moved with it and partly drawn away and partly turned to its Circulation Moreover to remove an inflammation of the Pleura besides withdrawing blood by a free Phlebotomy or Scarification also the serous and other excrementitious humours ought to be gently solicited and excerned as well out of the mass thereof as out of the bowels by Stool Urine and Sweat The more strong purgatives are deservedly prohibited because they disquiet the blood and constrain it to be impacted more deep into the places affected And that certain renowned Chymists viz. Angelus Sala Hartman M. Rulandus with many others do audaciously exhibit Vomits of Stybium to any afflicted with a Pleurisie and magnifie it for the best remedy seems to me neither safe nor congruous to reason Whether Purges and Vomits are to be taken in a Pleurisie the only reason of helping as I think and that very uncertain and full of danger may be viz. that the medicine operating more vehemently while the patients suffer exolution of spirits or swoonings all the vigour and turgescence of the blood abates and for that cause the nervous Fibres remit their wrinklings or painfull contractions and the Vessels carrying blood being much emptyed do suck up the morbifick matter In the mean time there is danger lest the humours being violently disturbed rush more impetuously to the part affected at least lest the Spirits being too much dejected and the work of Nature disquieted about the digesting or separation of the morbific mater strength should utterly fail before the disease be cured Yet in the mean time Clysters are of frequent or daily use yea sometimes more benigne solutive purgatives are allowed provided that the Feaver be not very intense Julips and temperating Decoctions and things gently moving Sweat and Urine What other kind of Remedies are convenient in this disease as we have prescribed before for a Peripneumonie are also here convenient but let all hot and sharp things whether aromatick or endowed with a vinous spirit be carefully declined II. The second Indication preservatory The second Indication preservatory designed against the clamminess and boyling up of the blood prescribes Medicines of that sort which consisting of a volatile or alcalizated Salt do destroy the combinations entered into of the acid and fixed or otherwise distempered Salts with the other more thick particles For which intent the eyes or claws of Crabs the tooth of a Boar the Stone of Carps the jaw of a Pike Fish the Bone in the heart of a Stag the Priapus of a Hart Sal Prunella Salt of Coral Salt of Urine or volatile salt of Harts-horn powder of Goats-blood infusion of Horse-dung Spirit of Harts-horn of salt Armoniack Spirit of Tartar the simple mixture mineral Bezoar Diaphoretick Antimony flowers of salt Armoniack are very famous Remedies in a Pleurisie III. The third Indication vital The third Indication vital which provides that the strength and vital heat be preserved during the course of the Disease in due tune and state gives in precept first an apt kind of food and moreover Cardiac and Anodyne remedies and those which seasonably occur to other symptomes if perhaps they arise First in a true Pleurisie a most thin Diet ought to be appointed viz. of meer Oatmeal and Barley and for ordinary drink a Ptisan or Posset-drink rather than Beer alone is convenient although in an outragious thirst this also is to be allowed of in a moderate quantity Moreover for quenching thirst Juleps Apozemes and Emulsions are taken by turns to all which adde Sal Prunella Secondly Cardiacks let only the temperate Cordials be administred which mildly do recreate the animal spirits and not at all intend the kindling of the blood burning out of its due proportion For these intentions the water of Carduus Mariae Carduus Benedictus of Balm Borage Cowslips Black-cherries are usually given with success whereto let the powder of Pearls and Coral be added Thirdly It behoveth to administer Anodynes both inwardly to provoke sleep in
after it is maturated and broken pours out the contained homour and is soon and easily healed The difference of Pus and a purulent matter But an Imposthume affording a purulent matter forms its nest not so bound up and encompass'd with walls but for the most part unequal and crooked and being broken rather pours out filthy blood or gore than matter or Pus and then by reason of the successive source of excrementitious homour it is very difficultly healed Moreover we are to consider that each humour as well Pus as purulent matter doth sometimes stink notably and is also sometimes very free from any bad savour Some maturated and broken Imposthumes pour out fetid matter others matters without any smell I have often observ'd Imposthumes of the Lungs as well as Phlegmons of other parts to have this several distinction Purulent matter from any Ulcers stinks ill Why both sometimes with and sometimes without stench the Spittle of consumptive persons which is esteemed to be very dangerous for the most part is without any scent It is usual where the side is opened by reason of an Empyema that at first the matter flows out not unsweet but after two or three days the air having more frequently enter'd into the orifice it stinks most horribly which stench notwithstanding after an injection of some aromatical or vinous Spirit vanishes again in a short space But it would be a thing of much tediousness to denote the particular reasons of each of these accidents and alterations for that never so little alteration of the Pus or purulent matter both causes and removes the stench from them When the sulphureous particles are equally digested and being subjugated to the salts are contained in a mixture there is no stench but as soon as they being loosed begin to fly away and carry the salt particles with them whereby they are sharpened they disperse a very bad stench round about But whereas an Injection or Lotion with vinous and aromatical liquors being sometimes administred to a putrid Ulcer or nest of an Empyema frequently removes all stench the reason is becase the sides of an Ulcer no otherwise than as a stinking pot infect the contained liquor as with a certain ferment and so impresse a stink but when that ferment of the vessel or bowel is washed or overcome by a well-tempered and strong liquor then that propagation of a stench ceaseth From hence follows not always an ill sign nor is it so very good if the Spittle of consumptive persons and the Imposthumes of such as are Empyematical are excerned either with or without stench for that I have known it to have been to some healthful and to others deadly in either case Moreover a more certain Judgment is not to be taken from thence that the spittle of some consumptive persons floats upon the water and that of others sincks But although we do not much disapprove of that distinction of Pus and purulent matter Neither the cause of an Empyema notwithstanding we adjudge neither only this nor always that to be a conjunct cause of an Empyema Whenas this disease succeeding a simple Pleurisie arises from an Imposthume being suppurated and broken in the side it is most commonly pure and meer Pus which falling into the cavity of the breast engenders that disease But if an Empyema be an Offspring of a Peripneumonie unless an Imposthume of the Lungs intervene the ichorous matter being accumulated about the place of the phlegmon and after thickening by meer concoction it wounds the Lungs and at length making a hole through the membrane encompassing it and flowing out into the Thorax produces an Empyema That matter is rather to be accounted purulent than meer Pus The signs of an Empyema either prognosticate it while it is in fieri The Signs of an Empyema whilst beginning or indicate it plainly done Some foregoing diseases are esteemed of the former sort whose issue this uses to be of which sort are the Pleurisie Peripneumonie and Squinancy also sometimes a stroke or wound of the breast and sometimes other distempers thereof not well cured nor discharged out of which the suspicion will be greater of an Empyema to ensue if after one or two weeks without abundant Spittle the shivering of an Ague and fainting of the Spirits overtakes one Then after fourteen or twenty days there will be signs of an Empyema fully made as difficult breathing When perfect a heaviness of the breast a swimming to and fro of the matter and a sense of pain from the position of the body chang'd thirst and a small feaver almost continual redness of the cheeks disquietness of the whole body and watching An Empyema is distinguished many ways viz. First according to the distemper going before whose Offspring it is also according to its seat one while in the right side of the breast another while in the left and another while in the whole capacity thereof and lastly as to the morbific matter which is either meer and laudable pus or purulent matter and this one while gentle and benigne and another while sharp and stinking Prognosticks of this disease begin as well before as after incision Prognosticks of this disease the former determins whether the side ought to be opened or not also it presages of what sort the event will be either with or without opening If an Empyema succeeds more slow after the first distemper to wit not before the thirtieth or fortieth day whenas the strength is very much worn and the Lungs are vitiated and their structure hurt and also if a feaver remain as it were hectick the breathing short and painful the Pulse weak and quick with cold sweat and with a Diarrhea or wasting loosness and frequent faintings of the Spirits then the state of such a person being evidently desperate doth not admit of any opening let a Physician suffer him to dye without bleeding lest he seem to murder him But if on the contrary after manifest signs of an Empyema more maturely perfected the painfulness of the Lungs or side as also the feaver and other symptomes abate and the Pulse and strength of the Spirits are in vigour it will be lawfull safely to advance to cutting and thereby to hope a happy success Incision being made if white Pus duly concocted or otherwise laudable skip out with ease and thence the heaviness of the breast and difficult breathing abate and the patient is better as to the other passions there will not the least doubt remain of his cure but if no Pus or that which is bad if thin something bloody or stinking flow from the side being opened we can conceive thereby but small hope of recovery Hippocrates among the presaging signs of a mortal Empyema What it signifies when the Probe is guilded by the Empyematical matter recounts that of the Probes being coloured by the Pus as by fire or what we often observe and sometimes without any
breathing be procured as well upon the account of air as of the Lungs at least so far as may suffice to support life and secondly that the organs of breathing may be withdrawn and restrain'd as soon as may be from the Convulsions begun and usually obstinately continuing 1. As to what respects the former 1 Intention to facilitate breathing let the Patient be placed in an upright position of body in a more open place and pretty airy free from Smoak and breath of by-standers then let it be indeavoured that the Lungs being made free from all obstruction and inward oppression and also external compression may be able to draw and change the breath more easily For these purposes lest the bulk of the nether bowels compress or straiten the precordia the belly is to be loosen'd by a Clyster the apparel and what ever binds about the Breast to be loosened also when in this case either from the blood swelling up inordinately within the Pneumonic vessels or from the Serum distilling out of the Arteries and Glandules into the tracheal passages they are wont to be oppressed the impetuosity and instigations of either humour ought to be restraind and appeased insomuch that if strength endure and the pulse be strong enough Phlebotomy is oftentimes convenient Moreover those things are carefully to be administred which dispatch away the Serum and superfluities of the boiling blood by urine as well as sweatings to which intention Juleps Apozemes commonly call'd Pectorals do notably conduce yea powders of shells millepedes prepared Spirits and volatile salts are successfully used In the mean time besides let there be administred whatsoever opens and makes slippery the passages of the Trachea and moves expectoration and whatsoever if need be gives stop to a Catarrh distilling upon the fame for which purposes Lambitives Lohochs pectoral Decoctions and suffumigations are good 2. As to the other intention of curing in these Convulsive fits 2 Intention to free from Convulsions the moving parts Remedies which dissipate the spirits profit for this end viz. that the organs of breathing may be restrained from the Convulsions begun and may quietly return to their ordinary task unless this succeeds of its own accord after the boiling of the blood and Serum in the Lungs be appeased we must use Antispasmaticks or remedies against Convulsions and Anodynes for medicines which are used to be administred in hysterical passions do conduce in a convulsive Asthma Spirit of Harts-horn of soot and especially of fal Armoniac distill'd with gum Ammoniacum also the tinctures of gum Ammoniacum of Sulphur of Castor of Asa fetida Syrups of Ammoniacum Sulphur Oxymel of squils and such like which because they are of an ingrateful tast or smell as it were dissipate the spirits and withdraw them from tumults do sometimes help notably But if the spirits being outragious cannot by this means be appeased we must assay Narcotics Or do bring them asleep that some of them being subdued the others may be reduced to order for surely unless a stuffing up of the Lungs with a great oppression of the Precordia do hinder Opiates do sometimes greatly profit In the dreadful fits of this disease when other medicines had effected less I have often administred successfully Diacodium as also Laudanum Tartariz'd But these may not be exhibited without great circumspection because whereas more or less they hinder breathing which already is difficult and too much hindred they frequently bring the Patient into danger of life Besides this that the Pneumonic spirits may be diverted from their Convulsions it is many times expedient to molest the spirits in other places for some of the spirits being in other places afflicted most commonly the residue as well as those that are smitten do dismiss their irregularities Wherefore Vesicatories Cupping-glasses ligatures and painful frictions bring help also for this reason vomits are successfully taken in the midst of a fit The scope of healing being now design'd after what manner the patients in an urging fit of an Asthma ought to be handled it yet remains for us to propound some more select forms of Remedies appropriated to the same ends In the first place therefore to give a stop to the flux of blood and serum Forms of Remedies and to dismiss their superfluities deriv'd from the Lungs by sweat and urine these ensuing are prescrib'd Take the water of ground-Ivy eight ounces of Rue Pennyroyal Dragons of each two ounces of sal prunella one dram and a half Syrup Byzantinus red Poppies of each one ounce make a Julep take it three or more times in a day the dose three or four ounces Take grass roots three ounces An Apozeme roots of Kneeholm two ounces candi'd Enula campane one ounce and a half barly half an ounce Raisons of the Sun one ounce boyle them in three pound of water to two pound adding to your strain'd liquor sal prunella one dram and a half sweeten it if there be occasion with Syrup Byzantinus or of Violets Take tincture of Sulphur three drams A Tincture the Dose six drops to ten evening and morning in a spoonful of Syrup of the juice of ground-Ivy or Violets Take of faecula of Aron and Briony of each one dram and a half flower of Sulphur one dram flowers of Benzoin half a dram Suger-candy half an ounce Liquorish two drams make a powder to be taken to half a dram or two scruples twice in a day with the former Julep or Apozeme or Take of the powder prescribed two ounces A Powder hony or Oxymel what will suffice make a Linctus take about half a spoonful evening and morning and at other times lick it with a stick of Liquorish Take Syrup of Horehound of Garlick of each one ounce and a half tincture of Saffron Castor of each two drams mix them take a small spoonful in the fits Take of spirit of sal Armoniack with gum Ammoniacum three drams Mixtures of snail water and of Earth-worms of each three ounces Syrup of Horehound two ounces mingle them take by a spoonful once in four or five hours Take of the powder of Hedge mustard or of ground Ivy gather'd in the heat of the Sun one ounce of Oxymel simple enough to make a Linctus 2. 2. The Indication preservatory proposes what is to be done out of the fit So much concerning the method and medicines requisite in the fit of an Asthma The other indication preservatory designing the taking away of the whole procuring causes and the morbific matter contains two parts or distinct scopes of cure both which for the most part are wont in the practice to be complicated and administred together One of these endeavours to amend the conformation of the Lungs if it be any way hurt or faulty Suggests two Intentions of healing and the other to take off the irregularities of the moving parts and spirits appointed for them We shall best answer both these intentions if