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A29738 A vindicatory schedule concerning the cure of fevers containing a disquisition theoretical and practical, of the new and most effectual method of curing continual fevers, first invented and delivered by the sagacious Dr. Tho. Sydenham : also shewing by way of preliminary, the indispensible charge lying on physicians to improve themselves and the art ... : with an appendix of Sanctorius his Medicina statica ... / by Andrew Broun, M.D. Brown, Andrew. 1691 (1691) Wing B5012; ESTC R38643 101,066 263

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of the Bal●om and Mercury of life and that of Helmont making it an Imparity of one part of the Archeus that thereby is affected with Wrath and Indignation Because they seem altogether enigmatical vain bring more obscurity then light to this dark Subject therefore we leave them both Next follows the Opinion of that Hero in Medicine Sylvius who has placed the Pathognomick signe of a Fever in the Pulse preternaturaly frequent having conjoyned therewith Trouble Pain or the blemish of any function requisite for the felicity and ease of Life The cause whereof which makes to him the Essence of Fevers is either first a too great and Permanent Rarefaction of the Blood made by a violent Heat breaking out of the Effervescence of the Blood Or secondly any Acrimonius Acide Lixivial or Muriatique salt carried thorow the Veins together with the Blood and gnawing the Parenchyma of the Heart or thirdly any flatulent halitous Matter brought with the Blood to the Heart and augmenting the expansion thereof Fourthly any sharp or hard thing in the Pericardium or other wayes externally grating upon the Heart This Great-Man to whom Medicine this day is much indebted as being the first that clearly discovered the Errors and Dilusions of the Schools has also found out a more efficatious and sure practice in many Diseases Yet he there being none able for all things has fallen into some Errors of Theory about his triumvirat Humor and the effervescence of these Humors in the Intestines and Heart and about the motion of the Bile towards the Heart All which subsequent and more acurate anatomical Inspection having found to be otherwayes his Hypothesis of Fevers being established upon these must necessarly fall Yet these that reject this his Theory do imbrace his Practice in the Cure of Fevers In the last place follows the Opinion of Barbet placing a Fever in the circulation of the Blood increased which Opinion since it seems directly contrary to what we think most probable with the confirmation then thereof it will necessarly of it self evanish SECT VII Containing a New and Mechanical Hypothesis of the Essence of Fevers with the cause efficient and occasional of the frequency of the Pulse and that matterial or occasional cause also farther Mechanically traced IT seems very probable that all the Physicians holding the former Opinions have Erred and the Fountain of all their mistakes appears to be that fundamental error as the acurate Bontikoe observes that they took the immediate efficient cause of the motion of the heart to be the blood and that the frequent motion thereof and the Arteries did alwayes depend upon some alteration of that blood but that this must be otherwayes seems plain because the Heart of some Animals being cut out when they are alive and holden in the hand will beat a long time without a drop of Blood So the motion of the Heart seems not to depend on the Blood but on some other cause perhaps on the influx of the animal Spirits proceeding from the Brain by the remainder whereof inviscate in the Heart the motion seems to be continued after the separation thereof from the Body The next fundamental Error and observed likewayes by the same Author seems to be that they esteemed the intension of Heat alwayes to depend on the rapide efflux or circulation of the Blood and that it was both a sign and effect thereof The contracy of which appears by an Inflamation or Tumour where the Member affected is vexed with a great Heat and kind of Fever which is oft times communicate to the whole Body and here it is clear that the Blood is rather stagnant then swiftly moved and the Fever that is communicate from the Inflamation certainly shewing a near resemblance betwixt them perswades that a certain degree of Incrassation from this Fountain of Co-agulation And accompanied also with a frequent Pulse does affect the Blood as the Ignorance then of the concurring occasional cause of that frequency of the Pulse gave rise to all the Errors about this subject so the bringing to Light the true cause thereof will make all these Errors evanish For clearing then of this it is to be considered that the Body of Man being a curious Machine the motion wherewith it is en●ue● like other Machines as it has an efficient cause so it has a final cause thereof And in respect the final cause is alwayes the reason of placing the efficient cause and that the Idea thereof is still in the mind of the Architeck before the Idea of the efficient This makes the Idea of the efficient to be alwayes shaped subservient to the Idea of the final Cause And must also make the structure of the efficient in the Fabrick of the machine to be moulded to that final Cause likewise instructed qualified Suitable to attain the end of the motion that is to say that it may have a faculty of Intension and Remission to be regulate and moderate according to the exigence and necessity of the final to be productive of the end of its being put there At least in so far as the Contrivance of a Mechanism will go As in a Watch whose Spring is so contrived that it may be Bended or Slackned for attaining the end of its motion And it seems also probable that in every motion in Nature it s only the end that both puts the Efficient and sets it a going and therefore it must be still by that end that the motion must be regulate Hightned or diminished As it is seen when Mariners do exercise the Pump of the Ship it s alwayes with respect to the breaking in of Water at the Leaks Which being in great quantity does excite to frequent and vigorous Pumping to save the Ship Much after the same manner it seemes probable that this motion of the Heart which is nothing but a Pump designed to lay in the alimentitious Juice and so has for its end a proportionable proportional reparation of the functions and parts suitable to their Consumptsion and Waste And that by the sending to them throw the Channels of the Arteries the arterial Blood which is to be dispersed in such quantity and time as may answer to the reparation of their Consumptsion and Waste The Body consisting which seemes to deny it all consistance in a continual Flux and succession of new parts coming in place of the old that are wasted like a River which has nothing Identitious but the Channel And so this final cause would seem to require an efficient whither that be the first Impellent the Archeus or Spirits indued with a capacity and aptitude not only to continue but also to incite and quicken this motion according to the exigence of the final as when the Intervention of any stops or Impediments of the motions of the Blood does Interveen to overcome which its necessarie that the efficient of the motion be bended to Superate these stops and gain t is
the small channels and conduites betwixt the Arteries veins In which passage for the most part it depositates its nutritious parts or particles So it is very probable that slowness of the bloods motion to overcome which the heart excites frequent pulses doth for the most part proceed either from the number or magnitude of these Globules augmented or some vi●iation of their spherical figure as their scabricity and the like Or further thorow the viscidity of the serum into which as a vehicle they swim and are carried And thô from any of these alone this slowness of the blood may clearly proceed yet it is certain that the ingemination and complication of these causes rendring the groseness of the Blood more intense may also render the slowness of its motion more contumacious To conclude then as by this scheme here laid down seemes indeed may be given pretty clearly both a rational discovery a Mechanical solution of the nature phenomena of Fevers so it appears that former explications thereof having raised so many fumy efferveseences and turbid fermentations concerning them could never yet bring the matter to a digested pellucide and defecat conclusion but having clouded the eyes with the mist of ●iry phantasmes still left the mind boiling and working in the tumult of commotion doubt and difficulty SECT VIII Shewing that the Heat in Fevers is the ●ffect of the slow Motion of the Blood And how Heat is made may be consistent with that slowness SInce by what is said the rapid Circulation of the Blood in Fevers seems to be overturned And that the rapid motion thereof was the only adequate Reason commonly given to solve the Phaenomenon of Heat in Fevers Because swift and violent motions used often times to produce Heat in Bodies althô we perceive motion to produce Heat in no bodys but where it is acompanied with grating and grinding of hard solid parts on upon another but never in fluids and so we find the violent motion of the Body produces Heat therein by the at●rition which the Museules make on themselves and the adjacent parts Which also produces a thickness of the Blood and in consequence slackens its motion It remains to inquire to what parent this off spring of Intenss and Feverish Heat can be most properly legitimate The inquiry into this Phaenomenon may not only discover how Heat is made but will perhaps also further establish the Hipothesis of Fevers already laid down For if we take a view and find that all these things which as external causes bring Imoderate Heat that the same do bring on a pace with them thickness and crassness of the Blood Which is necessarly followed with the slowness of its motion And so to supply the parts with proportionable reparation suitable to the waste that is made the Acceleration is stimulated and frequent pulses are excited in proportion to that thickness and slowness of the Blood as it falls out in vehement motions of Body and Minde Great and long heat of the Sun and fire the excessive abuse of strong Liquors and in perspiration impeded c. In the vehement motion of the Body beside the above mentioned grateing of the muscles upon one another and upon the parts adjacent exciting heat there is also such a waste of spirits and particles of the Blood and humours which in motion do exhale that to make proportionable supply and refocillation with the arterial blood the heart is made to mend its pace As also that copious eruption of exhalations which sometimes comes to the degree of sweat leaving the Blood and Humors more gross and thickned must necessarily also increase the slowness of its motion which therefore crave greater and repeated force to squeeze it forward into these narrow Channels And so from all these circumstances in violent motion there is raised a paroxisme as to Heat and Pulse altogether resembling a Fever Which is mu●h after the same manner also produced by all the rest of external causes exciting Heat but with this difference that the Heat coming from the abuse of spirituous Liquors as apears by the Spirit of Wine which being poured upon Blood doth immediately co-agulate the same comes from their immediate incrassating and coagulating effect upon the Blood Which Incrassation has likewayes and for the same cause that stimulating effect upon the Heart And how stopt perspiration produces Heat shall be in its due place shown Whence we may conclude that all Intense Heat grivous to the Body is the genuin effect of the grosness of the Blood as it is clear by the contemplation of the Community of the Causes and the Community of the Phoenomena Natural and Practical belonging to both and shall afterward more fully be shown Having thus far premised It remains to clear how this Thickness and Grossness of the Blood produces also intense Heat And that the same Heat does not establish but rather evert both the Effervessence of the Blood and the swiftness of that motion thereof by some called the circulation and by others the circuit of the Blood In prosecution whereof it is to be noticed that in the natural state of Health the Heat is more strong and veget then in the valetudinary state where it is fretting and with trouble felt For in the state of Health the Rayes of Heat now whither or not these be thickly compacted together troops of Spirits it seems not worth the while to contend these Rayes I say do chearfully and pleasantly glide with the arterial Blood throw the Channels of the Arteries in a fluid sequacious and yeilding enough and by passages open sufficiently toward all the Bowels Organs and Habit of the Body for their refoccilation in which for the most part they are consumed And so from the continual efflux of these Rayes chearfully accomplshed does result the faelicity and ease of Life and integrity of the functions of the Oeconomy But in the state of sickness and cheifly in the heat of Fevers these rayes or Companies of Spirits flowing throw a viseuous crass-medium such as the arterial Blood then is and also approaching the narrow Channels of the arteries partly obstructed and partly beset with scabricity by means of this viscous Blood these rayes I say must undoubtedly in there passage throw that viscid and unequal Medium suffer refraction And in their approach to the extremities of the arteries thus obstructed or vitiated they must suffer Reflection or Collision Such modifications then of the rayes of heat seeme likely to produce the same effect on the sense that the like modifications of the rayes of Light and of Sight do It being known that the diversity or inequality of the medium throw which these pass and by which they are refracted Or the variety of the superficial textures on which these inciding are therefrom also reflected doth occasion Impressions on the organe of Sight whereby the object is represented either some way depraved or greater or more multiplied then it
is the defect of the watering these places with the Lymph and Spittle because the Lymphal and Salival Glandes being in like manner affected with the same Obstruction from the crasness of the Humors either do not secerne their proper liquor from the Blood or do not excerne and squeeze it out on these parts The Phaenomena of Paines of all sorts inquietudes and anxieties may also be resolved in that same fountain of obstructions For the rayes of Heat or Spirits not being able to run their course and carreer by reason of the gross Medium and obstructions do therefore resile and recoile on all hands and by their brisk twitches on the membranous parts endued with exquisite sense they raise paines and uneasiness and acting their scenes in every organ they do excite S●mptomes Competent thereunto And in the Brain Delirium or Raving seems to be raised much after the same manner for it appears only to be the Direct and Regular motion of the Spirits by Refraction and Collision perverted imprnting a Troubled Chattered and False Imagination Much after the same manner as there is a deception Imprinted in the Fancie when an Oare appears broken the one half thereof ●eing only in the Water And that because of the Refraction or Distortion of the visible rayes coming to the Eye So then it is very probable the Spirits within the Brain at the least the nervous juice their vehicle or medium being generate of that crass and unequal Blood the parent of these Refractions and Perversions acted in the Mass of Blood that thereof also may be generated such nervous juice as will make the Spirits obnoxious likewayes by Refractions and Depravations of their motion to produce all these Phaenomena competent to the region of the Brain Nerves And that by reason of the Obscurities or Inequalities of their medium that is the nervous juice throw which these Spirits do pass And that these Delusions are raised much after this manner is farther clear by pondering that familiar deception of the Touch which is made and exercised by crossing the Formost finger with the Mid-finger of the same Hand above it and with the points of the two fingers thus placed if ye shall touch any little Ball you will not only think but swear it to be two neither will you any wayes be delivered from this error but by the Eyes The true reason of this delusion seems to be from the distortion of the nerves which necessarly induce a depravation of the Impressions made and conveighed by the nerves unto the Brain And as this distortion in its manner effect resembles very much the refraction of the visive rayes misrepresenting the object in the Organe so it bespeaks a delirium or depraved Imagination to come from some refraction of the spirits within the Brain As concerning the eruption of spots in Fevers there seems nothing more perswasive to confirm the Hypothesis For these altogether resemble the markes made by stroaks on the Skine And these markes are also made by the stagnation coagulation of the Blood in the small Channells bruised and distorted which remain until new Blood superveening both cleanse and repair these Channels and restore to the skine its usual colour which is soon done when the Mass of Blood is intire and not infected with an obstructing Grossness After the same manner these Spots in Fevers happen but with this difference that they come not from the bruising of the Channels but from the thick and gross Blood stoping and coagulating in these Channels and tinging the Skine with blewness or redness And in Fevers the difference betwixt red and purple Spots as to the cause is the same that is betwixt these from an external cause Blew Spots being from a greater stroak and contusion beget a more intense Coagulation of the Blood and the red from a less produce a lesser effect for every Light external cause is apt to make the Skin red as the bits of the Fleas often do And so a lesser coagulation in Fevers begets red spots and a greater makes purple Spots SECT XI That the Phaenomena of Helpers and Hurters in Fevers confirm this Hypothesis And first how Bleeding a Helper confirmes the same And several other Phaenomena concerning Bleeding ●leared according to this Hypothesis THE nixt point both bringing light to the Theorie and fruit to the Practise of the Cure of Fevers is the exact consideration of the Practical Phaenomena the Helpers and Hurters in Fevers And how they do the same And the first is Bleeding which by the consent of almost all is granted to be very beneficial but if by this Theory is be cleared how it is so it may perhaps have its effect further improven also thereby Now it s certain that for the most part Bleeding Cooles the Body Calmes and slackens the Pulse and allays almost all violent Symptomes In so much that being celebrate to one in the Fury and Fever of a Drunkenness it allays that also But how it does this is to be inquired It s certain that the immediat effect of Blooding is the Emptying or depletion of the vein that 's cut and the nixt effect to this must be that the Blood that 's poured forth of the Vein that 's cut not going back to the Vena Cava or great Vein must be in consequence a proportionable Depletion of that Vein also Because the usual accession of Blood from that Vein cut is intercepted Now this Ebb made in that great Vein must certainly make the rest of the Veins that feed it flow with greater Force and Quantity thereunto likewayes Because the moment of Resistance in the great Vein thereby being less then it was is also less then the Pressure of the Veins feeding it which must make them empty themselves therein with greater freedom and force then they did before And this in consequence diminishing the pressure of the Blood in the whole Veins which lay against the Arterial Blood must make the arterial Blood from all the Arteries go into all the Veines with more freedom also When before the whole Veins being choak full by the resistance contranitence of the venal against the arterial Blood the arteries emptyed themselves with dificulty into the veins any obstructions betwixt the Arteries Veines could not easily yield to the Pressure of the Arterial Blood Because the Venal Blood being throng and Regurgitating its Resistance was equivalent to the Pressure of the Arterial Blood And so little or no advance being made in the motion of the Arterial Blood toward the Veins it could not sweep and clear these passages betwixt them the Veins Not very unlike as when a Mill-Wheell stands still and has its motion stoped by back Water there being an equivalent weight with that which should force it about hinging on the other side of it But when the back Water is removed off or falls low then the motion goes on as before even so it is here that any
the Vein being opened such Blood as is nearest the Superfice of the Vessell comes first out which diminishing the Pressure of the venal Blood on the borders of the Arteries adjacent the Arteriall Blood rushing into the veins Imbraces and caries along with it the opime Particles of the Blood unto the heart leaving these behind that are unapt or incongrous to the genius motion Imbraces of the Spirits Whence it happens that more of these vitiat Particles are heaped up together toward the side of the Channel For such by their congruity and similitude involved in mutual Imbraces sticke closs by others And so this stream of labefacted Particles coming first out at the orifice of the Vein does not only close it to the opimer Blood but they following close stick to one another make like a Thread Spun out at the Orifice And it is known with how much the greater Stream the Blood springs forth of the Vein cut by so much the more it appears Labefacted and the Patient has also more ease thereby Because the Blood stagnating turgent in the Veines the Labefacted part thereof no wayes obeying the motion of the Spirits of the Opime Blood but deviating into corners is easily thrust out at Chinks and Holes In so far as Concerns the first and last coming out of this vitiated Blood and the appearing thereof also thus different in the measures receiving it It would seem when it comes first out that these Particles either lay most in the Veins or that the Contranitencie of the venal Blood against the Arteries being lesser such Particles are also soon casten off from the Arterial Blood coming into the Veines But on the other hand when these Particles ly deeper in the Arteries or Capillary vessells Or where the Stagnation or Cantranitence of the venal Blood being more yields only to a greater effusion of Blood the segregation and expulsion of these Particles is slower the labefaction apears most in the last measures For which reason and also in the case where the Patient can more easily bear the same quantity of Blood to be evacuat by degrees rather then all at once it would not be impertinent alwayes to make some stops of the Orifice till the Blood being cooled give the marks of its temper whence may be made a computation of the due measure and quantity of the present Evacuation From all these things thus transacted it is evident that the integrity of the Functions and the serenity of Health does depend on this motion and circuit of the Blood duly performed except it be in the affects of the Brain and Nerves the Foundation w●ereof is also laid by some latent vice of this motion of the Blood And farther that this course may throwly proceed and that the reflux of the Venal Blood may not only furnish matter to the efflux of the Arterial Blood but also that the Venal by its stagnating may not overballance it or with its weight hinder the arterial Blood to squeeze out any obstacles of its motion sticking into the Channels of the Veins such is the wonderful providence of nature I say to dispatc● the incumbrance of this Motion epecially from the weight of the venal Blood pressing against the Arteries that sick People without considering so much are put at once under the Remedies and effects of their evils by their lying down upon the approach of any fitt of Sickness For as the Famous D. Lower has observed in Tractatu de Corde the native Gravity of the venal Blood below the Heart augments its pressure against the arteries more when the Body is upright than when that situation is changed into a plain level posture by lying down for then the venal Blood flowing like a River in a l●vel Channel and so being more easily carried back to the Heart both takes off the contranitencie from the Arterial Blood does at the same time supply the Heart with Matter for new Arterial Blood and also hands about the motion of the Arterial Blood into the veins and thus the Symptoms impendent are warded off And much for the same reason it is as is observed to good purpose by several Practitioners that sick People can with more safety ease endure Phlebotomy lying on a Bed then sitting upright because in that situation the Pressure of the venal Blood against the Arterial being less is not only with less quantity of Blood let out taken off but also the intercepted course of the venal Blood to the Heart in that posture is sooner redintegrated If there shall yet remain any doubt of the Verity or Probability of the Hypothesis of the slowness of the Blood in Fevers from the viscosity crassness and the obstruction of the Channels thereby because the blood drawn off feverish persons oftimes remains without any solid coagulation from which many Authours have deduced the tenuity of the Blood But the more closs consideration of this Phaenomenon will shew it far otherwayes for it is certain that Blood drawn does coagulate the crass and heavie Particles subsiding and the thinn and watry Parts sweeming above upon this very reason that the serosity is endued with suteable Levity and Tenuity and the clotty parts have their due ponderosity and crasness with such dimension in respect of the tenuity of the serosity as may make the separation So that by the Levity and Tenuity of the Serum the grumous parts fall to the bottom and on the other hand by the gravity and proportionable dimension of grumosity the serosity sweems on the top But if after refrigeration the Blood remain without distinct serosity and grumosity it truely denotes either the tenuity of the serum to be vitiated and its viscosity augmented Or the gr●vity at least the dimensions of the solid Particles in respect of the serosity to be altered And so the Solid Parts and Globuls of the Blood are kept in the Embraces of the serosity Each balancing another so equally that no Percipitation or Secretion of the Crass from the thinner parts is made SECT XII Purging in Fevers considered from Reason and Authority THE next practical Phaenomenon to be considered with its use and utility in Fevers and how it clears the supposed Hypothesis is Purging as coming in the Method of our Author immediatly after Phlebotomy And is only required when there is plenty of Fewel to nourish the Disease lodged in the first wayes the Stomack Intestines Mesentere Which by its emitting of Crudities into the Region of the Blood introduces new Obstructions the former being scarce well subjugat and subdued and causes the continuance of the former Scenes in a Theater very much disposed thereto And that by joyning forces with the Perspirable matter retained scarce yet eliminated whose choke Nature severally and separate would be able to sustain but being altogether unequal to their joint assault without fresh supplies she must thereto yeild and succumb Then is most welcome the aproach
of the Cathartick with its force power as only sufficient to intercept and divert the Enemies Provision and Forrage from this Coast. But farther to evince the security utility yea necessity of this Auxiliarie of Nature in this Intestine War it 's to be considered that this Method of our Author is not only exactly adapted to the Concatenation and Complication of causes making and ●omenting this War but thereby all the Auxiliaries are drawn up and planted in that Order and Battalion Form that each of them does both back and make good each others assault And bridle and restrain their Depradation Ravageries and Exorbitancies For the Cathartick and Paregorick Forces charging the Enemie severally and alone instead of Auxiliaries often prove Depredatory So then in the first place comes Phlebotomy whereof the proper direct effect is not more to be considered then the Respective preparative relation it has to the cathartick often times to be given on the back of it comes to be remarked Which in that order administred as it operats gently and without tumult So does it more efficaciously then being administrat otherwayes And this as it is observed by the most famous Silvius is comunicat as a remarke very useful in Practise And thô there can be no such p●rswasive Arguments for this as experience Yet for satisfaction of the curious inquirer of the reason thereof that they may have an adequat idea of the Phenomenon perhaps also bringing light as well in other cases as this I shal make this essay to give a reason therefore It seemes probable that all tumult and commotion in the Body with anxieties and trouble accompanying it has its rise from the complication of thir causes and according to their Intension or remission is more or less viz. From the energie of the Impellent faculty or explosion of the Spirits exciting frustraneous Essayes to pass themselves throw their Medium or to carry matter throw proper passages destinate for that end and these Essayes are frustraneous either because of indisposition and inaptitude of the matter throw viscosity or grosness Or because of the closness or Scabricity of the passages And so these explosive motions of the Spirits terminate in collisions repercussions irksome touches of themselves Or of that moveable matter upon the Walls and Fibres of the Vessels and Bowels inducing therein Irritations spasms anxieties and troublesome sense some being affected principally some by consent in which tumultuating state the Functions deprived of their due Incomes and Recruites do also languish and consequently become lank in their office So then on the approach of the Adventitious irritating and stimulating force of the Cathartick either under a present Orgasme thorow the foresaid cause or under a Disposition or Proclivity thereunto there must necessarly a Tumult arise or one already begun be heightned there being so much of an additional cause put as the Commotion of the remainder of the crude humors stirred up by the Purgative which being thereby somewhat atenuate are easily carried into the Blood and do by their viscosity and gros●ness which makes their unaptitude to go throw the small Channels and Vessels stop and close these Channels But by Venesection the Obstructions as was shown being much resolved and the course of the Blood in a manner restored these Spirits incitat and irritate by the Purgative enjoying a free course throw a pure medium do excite no tumults also these particles of commoved matter meeting with a brisk motion of the Blood patent channels are soon dissipate scattered and expelled by perspiration insensible And the Benefit of Connecting immediatly toge●her Phlebotomie and Catharticks in Fevers has been the succesful Practise of many famous antient Authors yet none thereof adverted the beneficial use of the Paregorick after the Cathartick as Riverius in his Practise of medicine Lib xvi Of the pestilent Fever chap 1. In that most cruel Fever that raged at Montpelier which took away the half of these that were infected therewith althô the sick People had the eruption of parotides were brought to extreme weakness yet he induced with the unsuccesfulne●s of all other Methods Cured them with Bleeding and Purging So that none that were so treated by him died And Sylvius Delaboe that deservedly to this day famous professor Practitioner of Medicine at Leyden does in the first Book of his practise Chap 29. Institute his Cure yea of Burning Fevers with Blooding and purging the purge to be given even within an hour after the Blooding And he appoints both to be reiterated till the Fever become much thereby subdued And Donckers that Famous Practitioner in Cologne in his treatise of the Petechial Fever which is the same with a Malignant Fever does follow much the same Method begining with Purging Bleeding in that Fever and gives with all this Practical Caution in the use of Purgatives that especialy to these whose Constitutions and Strength are not known they be administred not in one whole Dose but in partited Doses For a larger quantity that way given will have a more mild and a far more effectual operation then a less quantity by the third given at one Dose will have But above all which I have yet observed to contribute to the secure effectual present operation of Catharticks in Fevers there is nothing to be compared to volatile Salts with which the Doses given to Febricitants being well imbued The anxieties tumults and faintings Using to arise during the time of the operation are extraordinatly checked and supressed But yet if by the present disposition of the Body there be such a proclivity to Orgasmes and Anxieties in the time of the operation That these volatiles given in this manner are not sufficient to Bridle them It may be surely as I have frequently observed and to great surprize as it were like an Inchantment done by the reiterated administration of these volatiles at that time in a convenient vehicle Which has seldome or never been observed to faill of the designed effect And makes the purgative absolve its operation without any troublesome or hurtful symptome And the reason of thir effects seemes to be by the intimately commixing the Volatile Salt with the Cathartiek or the Superadding it so that wherever the Cathartick coming exerts its stimulating force and operation with uneasieness it is attended also with the opening and atenuating efficacie of the volatile making its operation easie SECT XIII The benefit and season of using Paregoricques in Fevers and there Diaphoretique vertue comended and the danger of other Diaphoretiques with a doubt from the Author Sydenham's Constitutions of years answered and this Method shown to be common to all Constitutions BUT at length when the Fewel or matter being the antecedent cause of the disease is so plentifull and Contumacious that being only raked up troubled by the Purgative it therefore does send into the Blood more crudities and viscosities then the Motion
Crisis he levelled in these Constitutions as the genius of that Intention would permit So it was only the difference of the Cures by way of a Crisis that did with him intitle different Constitutions of these Years But in the last Constitution of which he treats in his Schedula most happily falling on a method that did sure with that constituon and expending it further he did find it a method that did quite alter all the former measures and conduct of the cure of Fevers and consequently his constitutions and that it was a method which made the practice of the cure to run in an other channel and which did take up different indications passed over the needless dangerous conduct of Nature throw the maze of a crise As that this method did save the strength of Nature from a laborious prodigal and uncertain profusion and was a method that profitably and securely anticipated the crise he did therefore most reasonably judge it as I received it from his own mouth that it would agree with all manner of continual Fevers neither can there be yet any solide experience brought into the field that will weaken this Conclusion while the daily practice of sundry Physicians offers it self to all that will notice it clearly establishing the efficacie of this method SECT XIV The further Helpers in Fevers considered and how they work and confirm the Hypothesis such as fixed and volatile Salts Alcaline and Testaceous Concrets and also Cuppings Leeches and Frictions Wherealso some Phoenomena of Hurters are considered as the continual Sweats in Fevers And the continual lying in bed And lying with the head much Depressed For all which Reasons are given confirming the Hypothesis IT remains in the next place to enquire into other Helpers and Hurters in Fevers how they Operate and if the explication of such Phoenomena can bring any light to the foresaid Hypothesis And first as for helpers volatile and fixed salts are by the consent of all granted to be very effectual which altho in the case of a copious fomes they seem not to be ●afe yet the clearing how they work may shew as that they are effectual so when they are fit then to answer this it would be noticed that as the state or crasis of the blood may be vitiate two wayes so there may be so many wayes stops and bolts put so the motion thereof inducing its slowness and making it need more frequent or greater pulses to drive it on to distribution And first when the serosity of the Blood endued with due tenuity serves for a fit vehicle for the globuls but these globuls are vitiated either by their bulk number or in their figure that is by scabricity all which vi●es severally much more when they are complicate makes these globuls stick and stop in the small passages and channels of the vessels and so baricade up the course of the Blood that there are raised frequent and violent pulses of the heart and arteries to remove them and carry on the blood The next fault in the crase of the Blood is when the due proportion in the number bulk and figure of these globuls is kept yet the tenuity of the serum is vitiated by viscidity and this fault also makes the Blood slow in its passage throw the small vessels to overcome which the heart does excite great and frequent pulses likewise In the first case where the globuls are only vitiated and the serum intire the sick are infested and weakened with sweats Because the frequent pulses drive away the serosity of the Blood out at the pores which is called the dissolution of the crase of the blood leaving the globuls cruded up together in the small vessels And in this case fixed and Alcaline salts testaceous and marine concrets made in subtile powder seem much to help because all these concrets consisting as is known of particles very rough scabrous and rigide the minutest particles whereof where ever they go carrying that Figure with them so then such being mixed with the blood and carryed along with it must necessarly impinging on the obstructions and scabricities in the small channels not only scoure and clear them but likewise by their continual Attrition of the Globuls of the Blood they must polish and grind these globuls and make them fit for passage thorow these channels As to the other state and crase of the Blood where the Serosity being viscide makes the slowness of the Bloods motion here as there are no sweats so it 's difficult to raise dangerous to attempt them Before any remedie can be justly levelled for the removal of this fault of the Blood it must be first inquired in what this viscosity does consist it seemes then that viscosity being a degree of Solidity and Firmness and the first step from Fluidity thereunto and that Fluidity consisting in the actual and due Motion of minutest parts of the Liquors viscidity then must Import some abatement and diminution as of their due Fluidity so of their Motion And that either from the weakness of the Principle of that Motion or the unaptitude of the matter to receive and obey Impressions of that Principle As having some glewy viscous matter mixed therewith But whatever it proceids from it is certain that the outward or sensible Rest in Liquores that naturally ought to be moved is a concurring Cause to there viscosity so the agitation of Liquors does altogether take off there viscosity As may be seen in the example of Ale which being ropie and viscuous is by tossing and agitating th●reof in a Bottle closs stoped soon brought to leave its viscosity So then the viscosity of the serum of the Blood seemes to be the effect of its want of due motion And is further a cause to hinder that due motion of the efflux and reflux And as this visco●ity seems originaly to depend upon the serum not being duely Impregnat and Irradiat by the Spirits which do make it diaphanous and subtile so the want of this irradiation may depend upon its viscosity hindering that irradiation and so as these causes may hinder its due motion that want of due motion also does exceedingly contribute to its viscosity and check the influx of the Spirits And thus every one of these are mutually causes and effects to one another Yet unto these Ef●ects from whatsomever of these causes they be produced seem much conducible all such things which give copious Matter to the generation of Spirits and also which give them being generated also Spurrs such as are all volatile Salts which for this reason are known to break and attenuate all viscosity But these are indeed to be used with moderation and warriness in Fevers least we should spurr faster than we open and clear the way and so these Spirits too much incited should waken up or exasperat all these Scenes of Confusions and Tumults to which the Blood is very prone under this state It is certain that long experience
has found the use of Cuppings Leitches and Frictions to be very beneficial in these Fevers The cause wherereof being enquired into will also confirm this Hypothesis For these being used in several places of the Body as they alwayes are when beneficial by their raising the Flesh and Skin they do shake and loose throw all the circumambient parts that congealed and clotted Blood obstructing the capillary Veins which does fac●litate the arterial Blood to run more easily throw them and that by clearing these Passages of Obstruction And for Frication and Rubbing of the Skin that makes such Impressions on the capillary Vessels by pressing them hither and thither that it must necessarly force the obstructing Matter into motion again And moreover the benefit that even in Fevers has redounded to some by riding yea when the Patient was necessitate to be held on Horse-back for a while can be no other wayes accountable but by the Impressions that the jogging of the Body makes on the fixed and coagulated Humores to set them again a going Now as to these Phaenomena which are hurtful in Fevers it is no less certain that these being duely pondered will also confirm this Hypothesis for it is clear that in many Fevers the sick are poured forth all in Sweats And that without any ease thereby but rather with great hurt and weakening Therefore as our experimented Author observes these ought not to be indulged but rather checked Now this Phaenomenon may be easily solved by considering that the serosity of the Blood is in this case by the frequent Pulses squeezed out from the Globuls whereby the Blood being much thickned the obstructions are increassed while Sweats called criticall and giving ease which rarely fall out in long and great Fevers Because these are nourished of a copious and viscide fewel in the first wayes fall out in diseases only caused by perspirable matter first attenuat and comminuted and nixt expelled by Sweat and as this evacuation is altogether the effect of Nature so it rarely succeeds happily by stimulating Medicines Which after its wisely argued is most reasonbly concluded by Sydenham in his Schedula Monitoria And further as our Author observes and dayly experience also confirmes it is very much Hurtful to Persons in Fevers to ly continually in the naked Bed For the continual Heat of the Bed doth exceedingly lash enervat and relax the tone and firmness of the pores and fibers Whereby they shrinke and creep in And so retain the perspirable matter which ought to be evacuate throw them and this matter retained recoiling on the Blood does much increase all the tumult and disorders there But by exposing of the Body to a moderat refrigeration by putting on the Cloathes some Hours in the day the Natural Heat is both Concentrate to expel that perspirable Matter and the Tone and Firmness of the Pores and Fibres are restored to give a free passage to it And this is very suitable to the Experimental doctrine of Sanctorius who finds and Declares reasonably that the inward heat being by the external heat too much diffused is not sufficiently Concentrate bended to expel the perspirable matter as it happens in Aestival heat that is very troublesome to the Body not so much because of any vehement Impressions it makes thereon For every part of the Body is hotter of it self then the external heat affecting it But because of the detension of the Perspirable matter through the defect of sufficient Concentration of the Internal heat to expell it And indeed this state of the internal heat does also render i● subject to several indirect and refractive Motions instead of the direct motion by which the perspirable matter should be sweeped ●orward and expelled so the lesion of perspiration upon these reasons seemes in this case to be amended by the Patients keeping out of the naked Bed several hours of the day and lying on the top of the Bed with their Cloaths on And in that Situation rather than the upright posture of the Body the vacillant reflux of the Blood unto the heart is also promoved as was shown And also as our Author observes it is hurtful in Fevers and several other Diseases to ly with the Head much depressed it being more conducible to ly with it raised somewhat because in that posture the lighter finner Particles of the Blood as Des Cartes thinks are sublimed up to the brain for the generation of nervous Liquor and Spirits and the grosser and heavier parts are carried by a descent downward And so in that posture only there is an ascent of the Blood throw the Arteries unto the Head in so much that the subtilest Particles thereof prove alone obsequious to the Impulse And if it chance that any grosser parts mixed therewith do endeavour likewayes to ascend they secede and turn off at the axillarie Branches So that nothing but the most sublime parts of the Blood in this posture does ascend like the subtile Spirits of Wine which are only carried so high as is fit to separate them from the Phlegm But when the head lyes level with the Body and that especially in Sickness and when the Blood is vitiated in its Particles and Motion because then and in that posture there is no ascent to the Head nor descent to the rest of the Body the grosser parts of the Blood being carried indifferently to the Head do there generate Obstructions Which must certainly produce all such Phoenomena as are competent to the Brain and Nerves being affected SECT XV. Some Difficulties concerning the Hypothesis Answered IF perhaps there remain any difficulty in the mind concerning this Scheme because it may be thought that the Blood being alwayes first strained throw the narrow Vessels of the Lungs before it come to have difficult passage in the small Vessels betwixt the Arteries and the Veins that it should leave or Imprint some marks of its grosness in the Lungs To Answer this difficulty it is fit to premise something concerning the progress and pedigree of Sanguification And therefore it may be reasonably thought very likely that the Lungs are not only the Colatory for and Test of the Bloods sufficient Attrition and Comminution but also they by their Braying and Levigating thereof give the same the outmost Perfection and Complement which they do by their continual motion and agitation For their contraction and dilatation meeting with the Pulse of the Blood coming from the Heart into the Lungs must necessarly make such impressions on the Particles of the Blood going throw the Arteries of the Lungs as will attenuate smooth and polish them and thereafter the Lungs sends them thus levigated and intimately mixed with the Air back again and that under the notion and name of Arterial Blood unto the Heart to be dispersed by it as a Pump throw the whole Body And indeed that the Blood receives its outmost perfection in the Lungs and not in the Heart As is commonly
to them produce therein the like effect And so forth until the compression spend its Impression force Now in this case these Tumors being made of the Blood and Humors That should slip throw the Channels when they do stop coagulate there the humors are again set a going by the use of these things that add Spurrs to the Spirits and attenuate viscosity such as volatile Salts and also by such things as grate and grind gross Humors such as fixed salts c. which internally used are all dissolvers of tumours And farther as we find that the impurities which do cleave to garments worn called sweatiness and which being bred of the perspirable matter sticking there do yield to nothing but smegmatique mixtures so the coagulations therefrom within the body may yeild to such internally used And indeed it seems that there is as much forcein the grosness viscosity of the humors obstruction depending thereupon as will produce not only Fevers but the most of all chronick Diseases also But that the various faces with which Diseases appear proceeds as from the Deg●ee of grosness and obstruction and from the nature of the place or organe aff●cted therewith so from the impression that is thereby made on the impellent or the disposition of the Body exciting either resentment and irritation or only grief and languishing And altho in Fevers from the present disposition the impellent is for the most part irritated and strives to shake off the cause of the malady yet in chronick Distempers from another disposition it is less commoved and rather groans under then resents the invasion and oppression And these d●fferent effects from the like occasional cause in the natural body are paralelled by the like different consequences springing from the same occasional causes in the body politick For Tyrrany and Arbitrary Government exercised upon a Heroick and Generous spirited People uses to beget War but all the impression it makes on a servile and despirited Nation resolves only in languishing and depopulation And the parallel may be yet carried farther for as tyrrany oppression of a People is often shaken off by civil Wars and they thereby brought into a vegete and flourishing state so Chronick distempers in the natural body are often loosed by a superveening Fever and the body thereby is brought into a sound and healthy condition An APPENDIX concerning The Statical Doctrine of Sanctorius NOw in regard the due comprehension both of this Hypothesis and of the Practice of the Cure of Fevers and also of almost the whole Theory of Medicine seems to depend upon the right and full understanding of the Doctrine of insensible Perspiration the whole fundamental conclusions whereof are demonstrable to the Eye by the Ball●nce Also the due observation and regulation The Weighting Chaire of that Evacuation and Indications taken therefrom contributing more to the preservation of Health and Cure of Diseases than all other indications or means whatsomever it will be then not thought superfluous to insert here the description and use of Sanctorius's Weighting Chair and also some select Theorems taken out of his Staticks whereby the Reader having got a Tincture of that Doctrine may be fully cleared of its use and fruitfulness The Description and Vse of the WEIGHING CHAIR THe Chair is hung about two inches from the Floor upon the short end of the Ballance and the Weight on the long end of it being removeable hither and thither serves for two uses first having placed our selves therein we find out the daily insensible Perspiration of the Body and next seating our selves likewise in this Chair during the time of our Repast and placing the Weight in such a place of the Ballance as answers to the quantity of Aliment we intend to take we perceive by the Chairs coming to the ground when we have taken the due proportion of Mear and Drink beyond which and short of which we are alwayes prejudiced Now the Ballance may be fastned to a Beam in the Room above that where you take Refection For it may be thought unseemly in the same Room especially by reason of the Unlearned to whom all things unusual seem ridiculous SECT I. Of the Weight Measure and Nature of Insensible Perspiration Aphorism First IF the addition of these things that are deficient and the substraction of those that are exuberant be daily made as to Quantity and Quality such as it ought to be lost Health would be recovered and the present preserved II. If the Physician be only capable of judging the sensible Addition and Evacuation and knows not to regulate the insensible Perspiration he does not Cure but deceives his Patients III. If the Aliment taken in one day amounts to eight pound weight the insensible Perspiration amounts to five pound or thereabout yet there is some variety therein according to the diversity of Natures Climats Seasons Age Aliment c. IV. And this may be easily computed having weighed the Aliments taken in by sitting in the Chair having duly placed the Weight then weighing the Body the nixt morning before and after sensible Excretion The weight of the sensible being only found to come to three pound or thereby the rest being five must of necessity go by insensible Perspiration V. This insensible Perspiration is made throw the Pores of the Body which are transpirable in all its parts Or by respiration performed by the Mouth coming out with the breath which commonly amounts to half a pound a day VI. What quantity of perspiration is convenient for every One in order to continue his Health may be found out thus observing in the Morning after a somewhat plentiful Supper over Night what the Perspiration in the space of twelve hours comes to suppose it comes to 50 Ounces then another Morning after Fasting over Night but with this condition that thou didst not exceed at Dinner the day before make the same observation as suppose the Perspiration to have amounted to 20 Ounces So having made these observations pitch upon that proportion of Meat and other Non-natural causes which may reduce the perspiration to the mean betwixt 50 and 20 Ounces and that will be 35 ounces thus mayest thou live a long and healthful life and happily an hundred years VII The weight of the body being augmented without increasing the aliment or the retention of the sensible excrements is a sign of wanting perspiration VIII If the body be brought to the same weight that it was formerly by more copious urine or stools then the ordinary it begins to decline from health IX Plenty of perspiration and much sensible evacuations are inconsistent together and copious sensible evacuations with perspiration deficient are evil X. That weight of the Body is the standard of health when one can ascend a steep place with ease XI The weight of the Body is diminished by the evacuation either of sensible or insensible crude matter or by sensible or insensible concocted Matter The latter conduces to