thereupon rendred unfit for the Nourishment of the Body whereupon a Feverish and Hectical heat not only is kindled in the Blood and Spirits but also remains fixed in the Habit of the Body and the solid Parts together with a Thirst a decay of Strength want of Appetite sickness of the Stomack an Atrophy of the Parts and at length a want of Sleep Light-headedness and the other signs of a Fever until the sick Person being brought into the state of a Marasmus or consummate Consumption does miserably end his days though for the most part without a difficulty of Breathing Cough or any other Pathognomonick sign of a Consumption of the Lungs This Consumption may be costly cur'd if the Vlcers are heal'd in time This Consumption as we have observed of that in the foregoing Chapter does easily admit of a Cure if it be so that the Ulcers which are the cause of it can be timely cured by the internal help of Physick and the external Applications of Surgery that is before the Patient is fallen into any degree of a Marasmus But alas the Patient too often in this case being deceived by the fair Promises and Encouragement of some ill Surgeons does not send for the Physician till such time as it is more proper to have the good Counsel of some Divine about the future state of his Soul or the Advice of a Lawyer about making his Will Where the Patient is too far gone the Physician should not undertake the Cure In which case it is convenient for a Prudent Physician after he has foretold the Fatal Event of it rather to take his leave of the Sick Person than to deceive him when he despairs of his Recovery with the hopes of an impossible Cure What is to be done when the Physician is sent for in time But if the Physician be sent for in time before the Patient be too far gone in a Consumption and Hectical the Cure of the Ulcers is to be endeavoured as soon as may be and to be pusht on with all speed by the internal help of the Physical Art To which end a plentiful use of the Decoction of Sarsa c. is of great use not only to give a softness to the Blood that the Blood being freed from its sharpness and preternatural Heat may be able more easily to assimilate to it self the fresh Chyle and to change it into its own Nature and that the efflux and loss of the Chyle by the Ulcers may be moderated which does much promote the Cure of the Ulcers for which reason without doubt these Decoctions are commonly called drying but also to carry off that load of dispirited and unprofitable Juices which lurk in the Habit of the Body and in the Vessels by the pores of the Skin in sweats and insensible Breathings It has been my Practice to use the following Decoction Take of the best Sarsaparilla sliced six Ounces A Diet-drink to be used in this cose China-roots two Ounces Sassafras Chips red Saunders shavings of Hartshorn of Ivory of each half an Ounce Raisins of the Sun stoned a quarter of a Pound Liquorice slic'd an Ounce one Nutmeg slic'd After they have been steep'd a convenient time in six quarts of Spring-water boyl it with the Ingredients to three quarts adding at the end of the Decoction if there be the least suspicion of any Mischief in the Lungs from a Cough or difficulty of Breathing the Leaves of Coltsfoot Maidenhair spotted Lungwort Tunhoof Fluellin Flowers of great Daisies of each a handful then strain it and let the Patient drink plentifully of this Decoction for his ordinary Drink Yea if the Ulcers are old If the Vlcers are stubborn Lime-water must be us'd and hard to be cured let the Sick Person also drink at Physical Hours six or eight Ounces of Lime-water by the excellent Salt of which the sharp and acid Particles of the Blood being precipitated the whole Mass becomes more mild and thereupon does more easily embrace the new Chyle and change it into its own Nature whereby the Flux of the Chyle to the ulcerated parts is rendred less and consequently the Cure of the Ulcers by the Surgeon's Art is more quickly perform'd For which reason this Drink is also thought to be drying And here I shall add the Prescription for that Lime-water which I commonly use A Prescription for the making of a Lime-water Take of the best Sarsaparilla slic'd six Ounces Currans half a pound after they have been steep'd for a convenient time in six quarts of spring-Spring-water boyl them till the Liquor comes to three quarts then strain it Then in this Decoction quench half a pound of Quick-Lime and after it is clear'd by setling and impregnated with the salt of the Lime let it be poured off clear and kept in Glass Bottles for use Such Purges as are pretty strong must be given every fourth or fifth Night unless there be a manifest Hectick heat Yea if there be not a manifest Hectical Disposition let the Patient during the use of these Decoctions be Purged every fourth or fifth day and that not only with gentle Medicines as a Decoction of Senna with Manna c. but also with such as are stronger as with half a Dram of Extractum Rudii or a Dram of the lesser Pil. Cochiae Yea if the Patient bears Purging well and it be necessary he may ascend to the use of Scammony and of Rosin of Jalapp it self to which it is always convenient to add a Dose of Calomelanos Which Medicine by correcting and altering the disposition of the Blood is in an extraordinary manner serviceable to the Cure of Ulcers I have in my Practice used the following Prescription In the form of a Bolus Take of Diagrydium or Rosin of Jalapp sixteen Grains Calomelanos five and twenty Grains or half a Dram Conserve of Damask-Roses or Syrup of Buckthorn-berries a sufficient quantity Mix them up into a Bolus Or let the Patient take a Mercurial Purge in the form of a Pouder in a Spoonful of Milk Or of a Pouder observing the Rules which are common in a Purge By which Medicine the load of dispirited and unprofitable Chyle which was retain'd in the Blood and Habit of the Body is in an extraordinary manner discharg'd by Stool and thereupon the Cure of the Ulcers is hastened Yea if the strength of the Patient be firm If the strength and temper of the Patient allows it Salivation and no degree of a Hectical disposition has yet seized him a Mercurial Salivation must be raised by the help not only of Calomelanos but also if it be necessary of Turbith Mineral it self Which in truth is the last Refuge Which is the last and most powerful Remedy and a Powerful Remedy and is also safe enough if it be cautiously given in the Cure of old and obstinate Ulcers Here also internal Balsamick Medicines may be prescrib'd with advantage Balsamick
and Herbs with which the Beasts are fed are fresh Thirdly If common Milk will not agree we must use only Asse's Milk But if there be too Acid a Ferment in the Stomack that turns common Milk into a hard Curd and makes it uncapable of being concocted as it sometimes happens from whence their commonly follow Vomitings Gripes and a Looseness it is better to abstain from the use of common Milk and to endeavour to temper the Blood with Asse's Milk concerning the use of which these following things are also to be observed First The Rules to be observed in the use of Asse's Milk That the most convenient time to give the Asse's Milk is early â—n the Morning so that the Patient may sleep in his Bed afterwards and then again at five a Clock â—n the Afternoon Secondly That nothing else of a different Nature is to be taken into the Stomack either in the form of Food or of Medicine before the Milk is concocted Thirdly The Quantity or Dose of Milk for one time is from half a Pint to a Pint or there-abouts For â—he Stomack can neither receive nor digest a great quantity of this as neither of common Milk but uses presently to cast it out either by Vomiting or Stool and that to the great Prejudice of the Patient And therefore it is Prudently advised by Physicians that the Stomack be by little and little accustomed to this kind of Nourishment beginning at half a Pint and increasing the quantity every day till they rise to a Pint. Fourthly If the Patient by reason of the Acid Ferment of his Stomack be subject to a Looseness from the use of Asse's Milk which often happens the Milk must be sweetned with Sugar of Roses and milkt upon a sprig or two of Mint Yea if it be necessary and nothing contraindicates let the Patient every Night take a Grain of London Laudanum or a Dose of the Astringent Electuary which I have already mentioned Fifthly This Milk ought always to be given in its own Natural Heat as it comes from the Ass For if it has been once cold and is warmed again it is not only made less grateful to the taste and to the Stomack but also by losing its Spirituous part it loses some of its Vertue Sixthly During the use of the Asse's Milk they must abstain from all other Medicines which is a Rule ought to be prescrib'd as well in every Milk Diet excepting Opiates and Astringents if they should be necessary to prevent a Looseness or to quiet the violent Cough in the Night-time Seventhly But if a Looseness that is caused by the Milk should not be stopt with the use of Laudanum and Astringent Medicines or if a Vomiting or at least a continual Sickness and gravative Oppression of the Stomack succeed to the stopping of the Looseness which are certain signs that the milk curdles in the Stomack Or lastly if there are signs of a Schirrous and very obstructed Liver which is no rare thing in Scorbutical and Hypochondriacal Persons in a Chronical Consumption then they must carefully abstain from all sorts of milk For the use of milk is wont by increasing the Obstructions of the Liver to bring the Jaundice and a Dropsie upon the Consumption whereby the Original Distemper becomes plainly deplorable Fourthly If Asse's Milk disagrees with them too then we must use Shell-fish Testaceous Medicines c. Therefore in these cases it is better to alter the Blood and to correct the Acrimony of it with the plentiful use of Shell-fish and of Testaceous Medicines as also with Jelly Broths made of the Feet of Animals and drinking a good quantity of Compound Waters made with Milk of a Capon a Pig Snails and other things of that Nature The Phlegmatick Waters of Snails c. must not be used where there is an Obstruction of the Liver Although what I have already hinted concerning the use of milk is also true of these Phlegmatick Waters to wit that as often as the Liver happens to be before obstructed a Jaundies and Dropsie are wont to follow upon the plentiful drinking of them Therefore in this kind of Icterical and Hydropical Persons it is more convenient to endeavour to sweeten the Blood in the manner following Let them feed plentifully upon River and Sea Craw-fish Lobsters and in general all sorts of Shell-fish Which sort of Food being taken plentifully does very much temper the four state of the Blood and correct the Acid Ferment of the Stomack And of these Shell-fish may be made by Art very pleasant Broths which must be given in good quantities Take of Craw-fish an Hundred Prescripts for making of Broths beat them to pieces alive and then boyl them in two Quarts of spring-Spring-water adding when they are almost boyled enough two or three blades of Mace one Nutmeg sliced and half a pint of Malaga Wine Let the Broth be strained for use Amongst these may be reckoned Jellies and High Broths As for Example Take shavings of Harts-horn of Ivory of each four Ounces two blades of Mace the candied peel of an Orange sliced boyl them in two Quarts of spring-Spring-water to a Quart or a Pint and half Strain it and let the Patient when he pleases take three or four spoonfuls by it self or with warm'd Broths These kind of Jellies may be made grateful to the Patient's Palate by adding at the time when they take it a little Syrup of Baum of Cloves of Rasberries Acids do not well agree with Jellies Oranges or Lemons Though it must be confest that Acid Syrups do not so well agree with Jellies because they do in some measure spoil their Vertue For an Example of a Jelly Broth take this which follows Take one Capon drawn and cut to pieces two pair of Sheeps-feet two pair of Calves-feet shavings of Ivory of Harts-horn of each half an Ounce two blades of Mace one Nutmeg sliced of yellow Saunders three Drams or half an Ounce Boyl them all gently in a Gallon of spring-Spring-water to two Quarts adding when they are almost boyled enough of right Malaga Wine a pint the Flowers of great Daisies Colts-foot Maiden-hair spotted Lungwort of each a handful of fat Dates eight pair of Jujubes twelve pair of Sebestens ten pair of Raisins of the Sun stoned three Ounces Strain it and let the Patient take a large Draught of this Broth two or three times a day For the farther tempering of the sharpness of the Blood it is also very good for this sort of Consumptive Persons that are troubled with Obstructions to use prepared Coral Wood-lice Pearl Crabs-eyes prepared the simple Pouder of Crabs-claws and other such-like Testaceous Medicines which must be taken in a good quantity and often in a day As for Example Take of the Cordial Milk-water Carduus-water or Black-Cherry-water a pint of small Cinnamon-water half a pint of prepared Pearl half an Ounce of Loaf-Sugar two Ounces mix them and make a Julep of which let
all over them and the very Membrane which covers the outside of the Lungs corroded by the sharpness of the Matter whereupon there came to be a continual dropping or distillation of the purulent Phlegm into the cavity of the Breast out of which to the best of my remembrance I took out at least six-Pints of this purulent Liquor Which when I saw I no longer wondred at the obstinateness of the Pain and the difficulty of his Expectoration which accompanyed that Peripneumony Nor did it seem strange that a Peripneumony caused in this manner should terminate in a Fatal and such an Acute Consumption CHAP. VII Of a Consumption proceeding from the French Pox. The French Disease often brings on Atrophy 'T IS certain every French Pox if it be Chronical accompanyed with a virulent Gonorrhoea or many and large Ulcers is always apt to bring the Patient by degrees into a Consumptive state by the continual substraction of the Nutritious Juice from the Habit of the Body of which sort of Consumption I have before discoursed in the First Book And likewise a Consumption of the Lungs It is also as true and I have often observed in my Practice that a true Consumption of the Lungs has had its Original meerly from the alteration of the Blood and Humours caused by the French Pox. And it is no wonder when the whole Mass of Humours is so manifestly altered and brought into a colliquative state by the Ferment of this Distemper which is evident enough from the Malignant Swellings Gonorrhoea's and Ulcers that commonly accompany this Disease if these kind of Venereal Swellings and Ulcers happen sometimes also in the spongy and soft Substance of the Lungs whereupon a true Pulmonary Consumption must necessarily follow Indeed I have rather wondred that we ever meet with the French Disease especially if it has been of a long standing or ill cured without an Ulcer in the Lungs and a Consumption proceeding from it But to speak the truth I very seldom if ever observed a Consumption of the Lungs from the French Pox Which is rare unless the Lungs were obstructed before or from ill management unless it has been where the Lungs were obstructed and disposed to a Consumption before or at least where there has been a bad management and ill-natur'd Medicines have been given by some Quacks and the often taking of Cold in a Sweating Course or in a Salivation has been joyn'd with the French Pox. This Consumption if it be treated in due time and in a due manner is as easily cured as any other This Consumption is of an Asthmatick Nature For as far as I have observed it is of an Asthmatick Nature and is wont to be attended with tough Phlegm and a difficulty of Breathing rather than a violent Cough and therefore it is Chronical and ascends slowly and by degrees to its highest degree from whence it comes to pass that I have sometimes observed some of these kind of Patients to live several Years in a Sickly and Consumptive state Which perhaps may be partly from the continual use of the Decoction of Sarsa and other things of that Nature by which the Malignant Venom of the Humour though it is not perfectly eradicated is in some measure obtunded For I do not doubt but the peculiar Nature of the French Pox is so Venomous that unless the Malignity of the Humour happened to be corrected by the use of Calomelanos a Decoction of the Woods and other Medicines prepared by Art or Nature every Consumption from a French Pox in its own proper Nature would be Acute From a frequent Experience I do affirm This Consumption is not to be cured without Antivenereal Medicines mixt with the Pectoral that all Pectoral and Pulmonary Medicines that are meerly such without mixing Antivenereal Medicines with them will do nothing towards the perfect Cure of this Consumption And therefore there is no better Method can be thought of than to endeavour the healing of the Ulcers of the Lungs and the restoring of the Crasis of the Blood The best thing is a Salivation which has been destroyed by the Venereal Ferment by a Mercurial Salivation before the Patient has been weakned by a long protraction of the Distemper and so is unable to bear such a continual and profuse Evacuation What is to be done if the Patient cannot bear that But if the Patient by reason of the extenuated Habit of his Body does not seem to have strength enough for this Method of Cure all the hope that remains must be from the use of a Restorative Milk Diet and then from a strict and long use of a Decoction of Sarsa and of my Balsamick Pills giving likewise Purges with a moderate Dose of Calomelanos mixt with them Of a Cure of this Nature I shall not think much here to give an extraordinary Instance A History A Young Girle about Twelve Years old was perswaded by the Enticements of a Lascivious and Wicked Dancing Master that was infected with the French Pox to let him lye with her Whereupon she likewise by Contagion was so pepper'd with the Venereal Venom that notwithstanding one or two Salivations which had been raised by some Empericks and other Methods of Cure that had been tryed in the space of four Years after her Uvula was eaten away and after other marks of the French Pox yet remaining she fell into a Consumption of her Lungs with a Hectick Fever an Emaciation of her whole Body a continual Cough and a very great shortness of Breath by reason of the toughness of the Phlegm stuffing her Pipes Being called to her by Mr. Simons a skilful and noted Surgeon of London I ordered a Dose of Calomelanos with Diagrydium to be repeated once a Week and on those days she did not Purge to have three of my Balsamick Pills given her three times a day and the following Decoction for her ordinary Drink With the use of which continued for the space of six or eight Weeks in the Spring-time she was perfectly and without any relapse freed from her Consumption as well as from the Relicks of the Pox. Take of the best Sarsaparilla six Ounces of China-Roots two Ounces Sassafras-Chips red Saunders shavings of Harts-horn of Ivory of each half an Ounce of Raisins of the Sun stoned two Ounces Jujubes Sebestens of each an Ounce and half of Liquorice sliced half an Ounce After a due Infusion boyl them in six Quarts of spring-Spring-water to three Quarts adding when they are almost boyled enough Colts-foot Maiden-hair spotted Lungwort Sanicle Ladies-Mantle the Flowers of the great Daisie of each two handfuls then strain out the Liquor and add three Ounces of the Balsamick Syrup Mingle them and make an Apozeme CHAP. VIII Of a Consumption proceeding from the Suppression of a virulent Gonorrhoea of the Running of Old Vlcers but especially Fistula's in the Fundament and Scrophulous Vlcers Issues and the Whites How this Consump ion
short time provoked to Vomit he brought up not only crude Chyle out of his Stomack but also near a Pint of Pus plainly fetid out of his Lungs and thereupon with the use of a Cordial Julep both his Spasms and his Strangulation went off the heat of the Extream Parts too and his Pulse came again and at length after three hours he began to mutter some incoherent words and after some quiet sleeps he came to himself And so within 24 hours he was hungry and asked for something to eat to the great Amazement of his Friends and those that were about him But nevertheless he was not only weak and confined to his Bed but also emaciated and Hectical and lay continually Coughing and fetching his Breath very short from the weight of that Matter in the Cavity of his Breast which prest upon his Diaphragm as if he would in a short time dye of a Consumption By reason of the Acute Consumption which was upon him and his Weakness I dare not try to evacuate the Matter by Catharticks nor to let it out by a Paracentesis because as they that were about him were against it so indeed there appeared no protuberance in the Hypochondres to shew the right place where the aperture should be made And therefore for the present I resolved to bring the business about by a long and slow Method by ordering a Milk Diet to temper his Blood and the frequent use of the following Apozeme partly Pectoral and partly Diuretick with which if it were possible I might bring away the Matter by the Urinary passages without any loss of his strength The form of the Apozeme was this which follows Take the Seeds of Mallows of Marsh-mallows of each three Drams the four greater cold Seeds of each a Dram of red Cicers an Ounce of Winter-Cherries two Drams the Leaves of Colts-foot Maiden-hair of each a handful seven Figgs fifteen Sebestens Liquorice sliced an Ounce boyl them in two Quarts of spring-Spring-water to a Quart To the Liquor when it is strained add of Syrup of Marsh-mallows an Ounce Mingle them and make an Apozeme With this Management and the addition of a Pearl Julep and a Pectoral Linctus his strength seemed to be much mended But upon that there arose an Universal Dropsie which increased so much that the poor Patient seemed every day ready to dye for want of Breath But with the plentiful use of Salt of Amber gentle Purges and Chalybeate Electuaries Balsamick and Pectoral Medicines being always mixt with them he grew perfectly well of his Consumption and Dropsie both with the help of the Spring and Country Air and is yet living in health strong and lusty following his Business of Merchandize History 2. Mr. Gifford's Daughter in Fleet-Lane about the Eighth Year of her Age was taken with an Inflammatory Fever a Pain in her Side and a troublesome and dry Cough I being called after the Second or Third day of the Disease judging by the Diagnostick Signs that the Patient had a Pleurisy ordered a Vein to be opened once and again Liniments and Fomentations to be applyed externally and likewise Expectorating Medicines to be given her plentifully which she took too sparingly I ordered likewise Blisters as it was necessary upon the account of her Fever and the Affection of her Nerves and Pearl Juleps made of Cephalick and Cordial Waters After the use of these things the Inflammatory Fever turned to a Hectick and the Convulsive Pain of her Side into a Gravative Pain and thereupon all the Symptoms appeared more mild But because no Phlegm could by any Art be brought out of the Lungs by Coughing I did much suspect that the Putrid Phlegm which had been concocted in the Lungs had found some other way through the very substance of them into the Cavity of the Breast and that my poor Patient would at last dye of an Empyical Consumption caused by the Pleurisy for want of Expectoration And indeed I was not much out in my Conjecture For after the poor Girle had lain languishing for Twenty days after the end of the true Pleurisy every day pining away with a continual Hectick Fever a redness in her Cheeks often returning the palms of her Hands very dry with a dry and troublesome Cough pertinacious Watchings shortness of Breath and other expensive Symptoms at last she began to complain of a gravative pain of her Side about the left Hypochondre which increased so one day after another that at last she could not be moved nor set upright without crying out But after the Thirtieth day of the Disease looking upon the Part affected I found it swelled and rising a little with a point But yet I stay'd till the fortieth day and then Mr. Hollier a very Skilful Surgeon being called in we took out by degrees the putrid Phlegm by a Paracentesis made a little above the Diaphragm in the space of a Month For by reason of the emaciated state of her Body she could not bear the taking away of much at a time But for a Year or two the Wound was designedly kept open in the same part like as an Issue In the mean time making use of a Milk Diet Balsamick Medicines Wood-lice and drinking freely and a long time a Vulnerary Decoction of Sarsa c. with the help of the Country Air interposing likewise at due intervals and according to the strength of the Patient Purges made of Calomelanos and Diagrydium at length she recovered out of her Consumptive state having got a good Colour and Flesh and so she continued for several Years without the least Symptom of her former Distemper but only that she was somewhat drawn in with a crookedness on the Side that had been affected to her dying day when she was taken off by a Malignant Fever CHAP. XI Of a Consumption proceeding from the Gout and from a Rheumatism There is a Colliquation in a Gout and Rheumatism IN a Gout and Rheumatism especially that which is true and Humorose which is caused by a sharp Ferment supplyed from the Nerves there is such an evident Colliquation in the whole Mass of Blood that no Body can reasonably think it strange that a Consumption should arise from these Distempers but especially when they are stubborn and Chronical and return often And hereupon it is an easie matter to observe that a Rheumatick Pain In Rheumatick Pains there is a Cough coming from the taking of Cold seldom if ever is wont to seize upon the Joynts without a Pulmonary Cough And as I have seen that great Man the Lord Bridgman Mr. Philips and Mr. Tibs and many others after frequent and long Fits of the Gout and Rheumatism dye at last of a Consumption or Asthma so I have likewise observed that sometimes an Acute and Fatal Consumption has followed upon the first Fit of a Rheumatism This Consumption it sometimes Acute This Consumption when it seizes them from the first Invasion of a Rheumatism happens sometimes
of which let her take the quantity of a Nutmeg every six hours Take the Waters of Rue Black-Cherries of each four Ounces of Barley Cinnamon-water three Ounces the Compound Waters of Piony of Briony of each an Ounce and half of prepared Pearl a Dram and half of fine Sugar a sufficient quantity to sweeten them Mingle them and make a Julep of which let her take four or five Spoonfuls after every Dose of the Electuary and likewise at other times when she has a mind to it To help the pains and stiffness of her Joynts I ordered that same Night Blistering-Plaisters to be applyed to the inside of her Arms near the Arm-pits and I tryed a gentle Evacuation by Stool with two Ounces of Tinctura Sacra which she bore well I ordered the following Paregorick Draught to be taken when she was to go to Rest Take of Red Poppy-water three Ounces Barley-Cinnamon-water an Ounce of Compound Piony-water two Drams Salt of Wormwood six Grains Syrup of Meconium six Drams Mix them and make a Draught October 28. I gave her the following Vomit Take of the Infusion of Crocus Metallorum an Ounce Syrup of Violets two Drams Mix them and let them be given for a Vomit about five a Clock in the Afternoon with due care and management and if it be necessary let her take between her Vomiting a Scruple of Salt of Vitriol twice or thrice in a Draught of warm Posset-Ale I ordered also the following Paregorick Draught to be taken when the Vomit had done working Take of Mint-water half an Ounce Dr. Stephen's Water three Drams Barley-Cinnamon-water the Cordial Milk-water of each an Ounce of Meconium six Drams Mix them and make a Draught From the Vomit she found an Universal Relief and that not only from the Symptoms of her Consumption but also of her Rheumatism And therefore after three days I ordered the repetition of the Vomit and then I endeavoured to extinguish the Hectick flame which had been kindled in the Blood by the Rheumatism and thereby to take care of her Lungs which had been injured by it in the manner following Take a sufficient quantity of the Ingredients of the Pectoral Decoction of the Peruvian Bark an Ounce Balsam of Tolu a Dram boyl them in a sufficient quantity of spring-Spring-water to a pint and half to the Liquor when it is strained add distilled treacle-Treacle-water the Balsamick Syrup of each an Ounce and half Mix them and make an Apozem of which let her take four Ounces three times a day for six days together taking always in the Night-draught fifteen drops of Helmont's Liquid Laudanum if any Gripes or Looseness or want of Rest should trouble her When she had done using the Apozeme I ordered the Emetick Potion to be repeated and afterwards sc Novemb. 13. I prescribed the following Pills Take of the Peruvian Bark finely pouder'd an Ounce Mucilage of Gum Tragacanth a sufficient quantity Mix them and make them into Pills of a middle size to be gilt of which let her take six Morning and Evening from day to day With the use of which she grew perfectly well being plainly freed not only from the pains and stiffness of her Limbs but likewise from her Cough difficulty of Breathing Oppression Fever and all the other Symptoms of a Pulmonary Consumption Her Appetite also returned and at length she likewise recovered her Strength and her Flesh and still enjoys very good Health without any return of her Rheumatism or Consumption History 2. Mrs. Covert a Virgin about the Eighteenth Year of her Age fell into a Continual Fever which at length was followed by another that was Intermittent which continued for the space of Eleven or Twelve Months But this went away of its own accord only a Humorose Rheumatism succeeded to it But the Fever and Rheumatism in process of time being I know not by what means in some measure overcome yet the poor Virgin remained continually Hectical Coughing Short breath'd very much Emaciated and pale as if she had no Blood in her presenting in a manner an Hippocratical Face Moreover the Tendons of her Muscles were almost universally stiff by reason of a preternatural thickness and hardness in them the Trophies of her former Rheumatism so that all her Joynts not only the lesser ones of her Feet and Hands but also the larger being plainly unable to do their Office or at least doing it with a great deal of difficulty and pain she continued almost always fixt to her Chair or Bed like an Image She was likewise many times seized with wandring and shifting spasmodick and dreadful pains up and down all about her Breast and troubled with Hysterical Faintings and Fits of a Fever often returning at uncertain times To all these Symptoms there were joyned a continual languishing Weakness a want of Appetite and a suppression of her Courses The universal Habit of her Body too seemed to me to be very Scorbutical A case verily if any is so very deplorable which yet with the Blessing of God I did help by our Art in the following manner Going to see this poor Virgin on the Thirtieth day of May 1683. to temper the Scorbutical sharpness of her Blood and to ease in some measure her wandring Pains which as they had continued a long time so they did not a little wear out oppressed Nature I ordered Calomelanos Diagrydium of each fourteen Grains Syrup of Succory with Rhubarb a sufficient quantity Mix them and make a Bolus to be taken in the Morning with due care I likewise ordered two Scruples of Wood-lice prepared and Crabs-eyes prepared mixt together to be given three times a day at Physical hours in a spoonful of the following Julep drinking three or four spoonfuls of it after them Take the Waters of Baum Black-Cherries the Cordial Milk-water of each four Ounces Barley Cinnamon-water Epidemick-water of each three Ounces of Sugar of Pearl six Drams Mix them and make a Julep I also ordered the following Bag to be hung in three Gallons of midling Ale for her ordinary Drink Take the Roots of sharp pointed Dock of Male-Piony of each two Ounces Garden and Sea Scurvy-grass of each three handfuls Brook-lime Water-cresses Tun-hoof Pine-tops of each two handfuls of Aniseeds an Ounce Mix them and make a Bag. On the Second of June because the form of a Pouder was not so grateful to her and that I might promote the opening of Obstructions instead of the Pouder I substituted the following Electuary Take the Conserves of Hipps and Red Roses of each half an Ounce of Wood-lice prepared a Dram and half Crabs-eyes prepared two Scruples Salt of Steel twelve Grains Syrup of Steel a sufficient quantity Mix them and make an Electuary of which let her take the quantity of a Nutmeg every six hours drinking a Draught of the Julep after it I ordered likewise a Scruple of the Stomack-Pills with Gums to be taken the Night following June 5th because the form of an Electuary did not
Medicines which by removing the Obstructions of the Liver and consequently by taking away the Procatartick cause of the Disease do likewise sufficiently provide for the Lungs which have not yet received so much Mischief but it may go off and vanish of its own accord after there is no more Fuel supplyed from a distempered Liver But this Consumption is never cured with Pectoral Medicines alone We must abstain from Incrassating Medicines Yet I never saw this kind of Consumption cured by Pulmonary Medicines alone but I have always observed that it has been very much and quickly confirmed even to a fatal degree with the plentiful use of Incrassating Medicines and of all those things which increase the Obstructions of the Liver And therefore as common Milk and all things made of it yea and Asse's Milk it self much more a strict Milk Diet is not convenient in the Cure of this Consumption So likewise for the same Reason it is best to abstain from all use of Laudanum and any sort of Opiates unless there is a great necessity to give them How the Patient is to govern himself The Patient must carefully avoid Sadness which does always promote the constriction of the parts of the Liver He must likewise live in a thin and open Air and there use moderate Exercise every day all which do very much help to remove the Obstructions of the Liver But above all things the long use of bitter and Chalybeate Medicines does promote this Cure and especially the Chalybeate Waters if the Obstructions are not come to that height as to hinder the passing off of the Waters by Urine But if it be so we must Religiously abstain from the use of them lest the Distemper be quickly rendred incurable by bringing a Dropsie sooner than it would otherwise have happened History 1. Mr. Dell about the Twentieth Year of his Age when he had for several Years before been troubled with a difficulty of Breathing an Asthmatick Cough together with other signs of a Chronical Consumption of the Lungs and had been affected with somewhat a yellowish Tincture in his Skin and had his Urine of the same colour with other signs of an obstructed Liver fell at length into an Inflammatory Fever accompanyed with dreadful pains of his Breast a Thirst want of Rest and likewise a little Tincture of Blood in what he spit and other signs of the Inflammation of the Tubercles of the Lungs and he desired my help Presently by looking on his Urine which was of a very red yellowish colour and likewise full of Contents like Mum as also from a light yellowness of his Skin though I had never seen the Young Man before this that I know of I rightly guest that the Peripneumonick Fever came by some Accident upon the Patient that was before in the state of an Icteritious or Hepatick Consumption And therefore the first day which was the 9th of Nov. 1688. I ordered Ten Ounces of Blood to be presently taken away from the right Arm and four Ounces of the following Apozeme to be given with a Spoonful of a Linctus very often Take Oyl of sweet Almonds Syrup of Hedge-Mustard of each two Ounces of white Sugar-candy two Drams mix them exactly and make a Linctus Take of the Pectoral Decoction depurated a Quart Ticture of Saffron the Syrup of the five opening Roots of each an Ounce and half mingle them and make an Apozeme To ease the pain of his Breast and Side I ordered the following Fomentation to be applyed hot to the Parts affected when the Pain was great being first put into an Oxe's Bladder so that the Bladder should be but half full Take Parsley-Roots Fennel-Roots Linseed Fenugreek-seeds of each two Ounces the Flowers of Camomile of Melilote of each two handfuls boyl them in a sufficient quantity of Spring-water for a Fomentation I took care that when the Bladder was removed a Flannel should be rub'd warm with the following Liniment and put upon the Parts affected Take of the Oyntment of Marsh-mallows half an Ounce Oyl of white Lillies Oyl of Bricks of each three Drams mix them and make a Liniment To comfort his Spirits I ordered the following Cordial Julep to be taken by Spoonfuls at any time Take Baum-water Black-Cherry-water of each three Ounces of Epidemick-water two Ounces of Syrup of Clove-gillyflowers ten Drams mix them and make a Julep Nov. 10. His Fever being yet very high and his Pain very violent I again ordered Eight Ounces of Blood to be taken from the same Arm at which he had been bled before and because of his great Thirst fifteen Grains of the finest Salt of Nitre and half a Dram of white Sugar mixt together to be dissolved in every draught of Beer that he took likewise a Clyster of Milk and Sugar with Camomile-flowers boyled in the Milk to be given if he had not a Stool of his own accord and if the Pain required it a Plaister of equal quantities of Paracelsus and De Minio Plaisters to be spread upon Leather and to be applyed to the Parts affected likewise when he was to go to Rest if his Pain were still very great fifteen Drops of Helmont's Liquid Laudanum to be given in a little Draught of the Julep and an Ounce of Stone-Horse dung to be infused cold in the Pectoral Apozeme With the use of which things he seemed to be something better his Fever being now very much abated but then having made a diligent inspection of his Urine Skin and Stools I was more certain of the Obstruction of his Liver And therefore in the stead of the former Apozeme I ordered that which follows with a Linctus to be taken to the quantity of four Ounces every four hours Take a sufficient quantity of the Ingredients of the Pectoral Decoction the Roots of Parsley Fennel Succory Grass of each two Ounces the Roots of Turmerick the inner Bark of the Barberry-tree of each an Ounce the shavings of Harts-horn of Ivory of each half an Ounce of Currans two Ounces of Saffron tyed up in a Cloth half a Dram boyl them in a sufficient quantity of spring-Spring-water to a Quart adding when they have done boyling half a Pint of the best White-wine To the Liquor when it is strained add of the Magisterial Water of Earth-worms three Ounces the Syrup of the five Opening Roots the Traumatick Decoction of each two Ounces mix them and make an Apozem I likewise ordered two Ounces and a half of Tinctura Sacra to be given when he went to Rest with which he had two Stools the next Morning with relief And therefore Nov. 11th I ordered the use of the Apozem to be continued the Tincture to be repeated when he went to Rest and two Quarts of the Purging Mineral Waters boyled to three Pints and turned with half a Pint of Milk to be given to drink the next Morning and in the room of the former Julep I substituted the following to be drank plentifully Take
colour of his Skin I understood well enough that the first Original of all this mischief was not in the Kidneys but had layn in his obstructed Liver and that neither the progress of his Consumption could be prevented nor that horrid Pain that moved up and down between his Back Sides and Belly could be removed unless we had a due respect first to this part And I did not make any matter that the pain was felt in the lower parts of the Belly just by the Region of the Kidneys and Bladder and a great way below the seat of the Liver because I had often observed this same thing before in those that had the Jaundies whom I had often heard complaining and crying out by reason of the violent pain which they felt in the lower parts of the Belly when in truth the cause was remote in the right Hypochondre Which appearance it is no hard matter to Account for to wit that as the substance of the Liver according to my Hypothesis and Observation by reason of its preternatural closeness and density is almost deprived of Sense so likewise for the same reason it affords a very difficult passage to the Blood Lympha and other Juices that passed through it so that the Vessels which tend hither from the lower parts of the Belly must necessarily be distended beyond their Natural Tone and be rendred varicous and thereupon suffer a great deal till at length with the use of Hepatick and Deobstruent Medicines the Substance of the Liver had recovered its loose and Natural Tone From this Hypothesis for three weeks I ordered two Ounces and a half of Tinctura Sacra to be given every Night when he went to Rest to which being forced I allowed Thirty Forty and at length Fifty Drops of Liquid Laudanum to be always added by reason of the violence of the pain I likewise ordered the Purging Apozem with the addition of an Ounce and half of Syrup of Buckthorn to be repeated every fourth Morning and four Ounces of the following Diuretick Apozem to be given every four hours on the days between Take the Roots of Succory Grass Parsley Fennel of each two Ounces the Roots of Turmerick the inner Bark of the Barbery-tree of each an Ounce shavings of Hartshorn of Ivory of each half an Ounce of Currans two Ounces of Saffron tyed up in a Linnen Cloth and often squeezed half a Scruple of Aniseeds half a Dram boyl them in a sufficient quantity of spring-Spring-water to a Quart adding when they are almost boyled enough half a Pint of White-wine Add to the Liquor when 't is strained of the Magisterial Water of Earth-worms three Ounces the Juice of two Lemons of the Syrup of the five opening Roots three Ounces Mix them and make an Apozem I advised him likewise to take an Ounce and half of the Steel Wine sweetned with a little brown Sugar every Morning After Eight or Ten days were now past as his Pain began to abate so he likewise began to go to Stool more easily And therefore first I left out the Syrup of Buckthorn from the Purging Apozem And at length Aug. 30. in the room of the Purging Apozem I substituted six Pints of the Purging Waters crude with which he now went to Stool well enough and therefore I took care they should be repeated every third Morning Sept. 6. Because of his Faintness caused by his frequent Purging from that time he began to have so many Stools I ordered the omission of the Purging Waters for the future and prescribed the following Cordial Julep to be given often Take of Dr. Stephens 's Water two Ounces of the Epidemick-water an Ounce of Black-Cherry-water four Ounces of Syrup of Clove-gillyslowers ten Drams Mix them and make a Julep Sept. 12. When now at length my Patient began plainly to loath the Tinctura Sacra by reason of the long use of it instead of that and the Laudanum mixt with it I substituted the Stomack-Pills with Gums Cynogloss-Pill of each twelve Grains to be made into three Pills which I ordered to be repeated every Night And because I now perceived by the plenty and less high colour of his Urine that the Obstructions of his Liver were in some measure opened I ordered four of the following Pills to be taken every Morning for the farther promoting of Urine Take of the Pouder of Wood-lice half a Dram of Salt of Amber very well cleared from the Oyl fifteen Grains of Syrup of Marsh-mallows a sufficient quantity mix them and make them into Pills of a middle size to be gilt Sept. 18. When by the Tincture of his Urine being brought almost to its Natural colour I rightly conjectured that the Liver was in a manner restored to its Natural Tone I advised my Patient that he should try to open the Obstructions that remained and to precipitate the Reliques of the Morbifick Matter by Urine with the use of Sadler's Chalybeate Waters at Islington But when after the tryal of a day or two I was well enough satisfied that the obstructed parts were not yet opened so much as to give the Waters liberty to pass freely by the Kidneys because the Serum of the Blood being held by the bilious Particles and too much saturated with them and as it were coagulated by reason of the preternatural viscousness contracted thereupon could not yet be readily strained through the Pores of the Glandules of the Kidneys I altered my mind and instead of the Waters I prescribed the following Julep to be drank often and plentifully and two Drams of the following Chalybeate Electuary to be given every Morning expecting from the former of them a more plentiful flux of Urine and from the latter a farther opening of the Obstructions whilst at the same time I persisted to make the Tone of his Stomack more firm and his Body more soluble by repeating the Tinctura Sacra every third Night Neither did the Event deceive my Expectation The Julep was this Take Parsley water Fennel-water of each a Pint the Magisterial Water of Earth-worms the Syrup of the five opening Roots of each six Ounces Mix them The Electuary was this Take of the filings of Steel prepared two Drams Saffron Mace of each a Scruple Conserve of Hipps of the Flowers of Succory of each an Ounce and half of Syrup of Citron-peel a sufficient quantity Mix them and make an Electuary With the use of these things my Patient plainly recovered being freed not only from his Pains and his disposition to Vomit but likewise from the stuffing of his Lungs which he used to have from his Cough and difficulty of Breathing as also from the yellowish Tincture of his Skin and from all the other signs both of the Obstructions of his Liver and the Distemper of his Lungs For he got a very good Appetite again with which he soon was freed from his Consumptive as well as his Jaundies state and continues hitherto well and strong However when I dismist him
strained add the Magisterial Water of Earth-worms Syrup of Hedg-Mustard of each three Ounces the Juice of one Lemon Mix them and make an Apozeme Take parsley-Parsley-water fennel-Fennel-water of each four Ounces the Magisterial Water of Earth-worms strong Piony-water of each an Ounce of the Syrup of the five Opening Roots an Ounce and half Mix them and make a Julep of which let her take four or five spoonfuls when she is faint With the long use of which the Country Air likewise contributing something she became plainly freed not only from her Jaundies but also from her Consumption and the Morbid Symptoms of her Lungs and that without one Grain of Pectoral Medicines and now at length having recovered her wonted Temper and Appetite she is very well CHAP. XIV Of a Consumption of the Lungs proceeding from Internal Vlcers of the Viscera and Membranous Parts I Have as well from Reason as Experience proved in the First Book that there is a Flame kindled in the solid Parts from the long and plentiful substraction of the Nutritious Juice caused by old and large Ulcers which are wont to discharge continually a great quantity of gleety Matter in what part soever of the Body they happen to be seated whether inward or outward and thereupon the Patient is rendred Tabid I have likewise sufficiently shewn in the 8th Chapter of this Book that a Consumption of the Lungs is very often occasioned from the healing of this kind of Ulcers but especially if they have been customary and of a long continuance or else Malignant or Fistulous A true Consumption of the Lungs often proceede from Internal Vlcers But because I have observed not only that Patients being brought into the state of an Universal Atrophy have at length been rendred Tabid but have likewise many times from thence been affected with a Consumption of the Lungs from the beginning by a long continuance of Ulcers bred in the Viscera and Internal Membranous Parts but especially in those that are reckoned the more Noble and of greater use such as the Liver Kidneys Testicles Ovaries the Womb and the Vagina Uteri the Urinary Bladder Stomack Intestines c. from long substraction of the Nutritious Juice as frequently as from the healing of them I shall think fit in this place to add also though briefly the Observations which my Practice has offered to me concerning the peculiar Nature of this kind of Consumption Neither has any one reason to think it strange This is not strange upon several Considerations that this kind of Ulcers especially if they have been Chronical can occasion a true Consumption of the Lungs I say no one has reason to think it strange that seriously considers with himself how great and continual an expence there is of the Nutritious Juice that is wont to be discharg'd by this kind of Ulcers and how great an impoverishment of the whole Mass of Blood together with an Acrimony following upon it from this substraction of the Chyle that is designed for the reparation of it and how great a wasting or Atrophy of the Parts proceeding from thence thereupon how great an excandescence or intestine motion of the Blood and Spirits and finally how great a Flame there is with a fixt heat in the whole Habit of the Body together with an Universal Colliquation of the Nutritious Juice from the Mass of Blood to which by reason of its preternatural Heat and Acrimony it could not be perfectly united made by every Avenue where it has the liberty of passing But to be Ingenious and to speak the whole truth I have been ready to wonder rather that in this Universal Flame and Colliquation the Lungs whose Substance is Naturally so Tender Vesiculous and Spongy and thereupon as it is apt to be very soon affected with a Hectical Heat so it is also ready to be as soon corrupted by the purulent Particles which are translated thither by the Circulation of the Blood and in every considerable Colliquation more susceptive of the Humours than any other part can ever be long free from a touch of a Consumption A Consumption from Vlcers in parts remote from the heart ends in an Vlcer of the Lungs And indeed to speak the truth of this case whenever these Ulcers happen to be bred in the Bladder Womb Vagina Uteri the Ovaries or Kidneys or other Entrails or Membranous Parts that are remote from the Heart and so of less note as I have always observed the Consumption that is caused by them to be more Chronical so I have observed that a little before Death it certainly terminates in a true Consumption of the Lungs proceeding by degrees from a stuffing of the Lungs to Tubercles and those such as at length become ripe and ulcerate together with a troublesom Cough a shortness of Breath an universal Colliquation and the other signs of this Fatal Disease In a Consumption from Vlcers in the Liver c. Death prevents this But yet in a more Acute and hasty Consumption proceeding from an Exulceration of the Liver Stomack and other Entrails or Membranous Parts seated nearer to the Heart it self I have found in the Bodies of such Persons that have been opened when they have been dead the Lungs not so much exulcerated as discolour'd stufft and sticking to the sides of the Cavity of the Breast and at length that is when they have been very ill affected full of crude Tubercles Because by reason they dyed quickly there was not time enough for the Lungs to receive any deep impressions from this Phthisical Malignity the Patient being taken off by a quick Death from the Original Consumption before the Tubercles of the Lungs could be ripen'd or the Consumption of the Lungs could be advanced beyond its first or second degree But in this very Acute Consumption I have found plainly the same if not more violent Symptoms than in a true Pulmonary Consumption that has been Mortal the same fierce and troublesome Cough the same difficulty of Breathing though they proceeded meerly from a stuffing of the Lungs and crude Tubercles bred in them but first an Inflammatory Fever and afterwards a Putrid and Intermitting Fever attended with an Universal Colliquation Light-headedness and other more direful and fatal Symptoms than in an Original Consumption of the Lungs I speak of those which arise from an Inflammation and Exulceration of the Viscera or Membranous Parts that are very Noble So that it is a very hard matter to distinguish this Consumption from an Original Consumption of the Lungs unless it be by the more intense degree of the Symptoms and by some Pathognomonick signs which discover the Part that is primarily affected Every Pulmonary Consumption of this sort is very hard to Cure These Consumptions are very hard to Cure because it springs from a certain Fountain that is for ever running For the Internal Ulcers which gave the first Occasion to this Consumption can very seldom be perfectly cured as lying
And indeed I do not at all doubt but Catarrhs For want of this ordinary Coughs sometimes turn to a Consumption and ordinary Coughs do very often turn to a Consumption of the Lungs for want of due Bleeding and fanning of the Blood in the beginning of this Distemper And moreover we have reason to suspect that the Concretion or hard knots in the Glandulous parts of the Lungs and the Hectick Heat proceed from thence Secondly After Bleeding it is very necessary After bleeding a Vomit is necessary especially if the Distemper had its beginning from a Surfeit or if there be a nauseating and disposition to Vomit joyned with it to prescribe a gentle Vomit of Honey of Squills or Oxymel of Squills yea and sometimes of the Infusion of Crocus Metallorum to be taken in a moderate quantity By which Vomiting not only the Stomack that was opprest with a load of Humours may be eased and the sickness of the Stomack arising from thence may be removed and the Digestion restored all which are to be highly valued but likewise the heap of Humours which were before lodged in the Lungs uses by the exagitation or shaking of these parts in Vomiting to be expectorated very considerably not without a remarkable easing of that heavy weight which was caused by that load And I have not only seen several Empericks boast and that not without good Success that they could cure any incipient Consumption this way but likewise I my self by the Direction of Reason and the Encouragement of Experience have many times in the same manner stopt the Progress of a Consumption in the beginning of it in a very short time And is sometimes to be repeated This Vomiting especially if the Patient bears it well and finds Relief by it and if it be necessary may be repeated every third or fourth day for three or four times The most convenient time to give a Vomit The most convenient time to give a Vomit in this case is a little before the Evening but they ought to bleed first the day before for fear the Blood should be heated by the violent agitation of the Parts and by that means a Fever should be brought on or increased if there was one before And likewise to prevent a spitting of Blood which is wont to arise from the more vehement straining of the parts of the Breast caused at this time by Vomiting before the Blood-Vessels have been emptied It is also very convenient when the Vomit has done working When the Vomit has done working we must give an Opiate to Order some Opiate not only to temper the heat of the Blood excited by the straining and agitation but likewise to hinder a new influx of Rheum into the Lungs which uses to arise from this violent agitation of the parts The forms of the Vomits and Opiates which I commonly use in this case are these which follow Take of Honey of Squills half an Ounce let it be given in a Draught of Posset-drink and repeated twice or thrice in an hour if the Patient does not Vomit sufficiently Which is a Vomit mighty proper for Children and Young People being gentle and very grateful Or Take Oxymel of Squills Oyl of sweet Almonds of each an Ounce Mix them Let the Patient take it dissolved in a large draught of Posset-drink and repeat it twice or thrice in an hour if it be necessary to promote his Vomiting Or Take of the Infusion of Crocus Metallorum seven Drams Syrup of Violets two Drams mix them for a Vomit And in the time of its working if it be needful give Oyl of sweet Almonds and Oxymel of Squills of each half an Ounce in a draught of Posset-drink once or twice Salt of Vitriol is not so convenient because it continually twitches and irritates with its stypticity the Glandulous parts about the Throat and so uses to cause a greater flux of Rheum and so a troublesom and long Cough after the Vomiting is over The forms of the Opiates to be given after Vomiting are these which follow Take Cordial Milk-water Carduus-water of each an Ounce of Barley Cinnamon-water half an Ounce Syrup of white Poppies six Drams Mix them for a Draught Or Take of the clear Pectoral Decoction four Ounces of Tincture of Saffron two Drams of Helmont's Liquid Laudanum fifteen drops of Syrup of Violets two Drams Mix them for a Draught Or Take of Coltsfoot-water two Ounces Oyl of sweet Almonds fresh drawn Syrup of white Poppies of each an Ounce Mix them Or if the Patient likes the form of a Bolus better Take old Conserve of Red Roses Mithridate or Venice-Treacle Conserve of Wood-Sorrel of each half a Dram of London Laudanum half a Grain Mix them into the form of a Bolus Or let him take in the form of Pills half a Scruple of the Cyncgloss Pill or as much of the Storax Pill Gentle Purges are convenient Thirdly it is convenient also gently to carry down the load of Humours by Stool and Stomack-Purges and others of that Nature such as may cause but a very little Effervescence and Colliquation of the Blood As for Example Take the best Manna Oyl of sweet Almonds of each an Ounce and half or two Ounces dissolve them in a Pint of hot Ptisane Let the Patient drink half of it in his Bed the other half half an hour after rising out of his Bed Or Take of the best Senna two Drams Cassia broken with the Canes Tamarinds of each half an Ounce of Coriander-seed prepared half a Dram boyl them in a sufficient quantity of spring-Spring-water or Barnet or any other Purging Water to half a pint Dissolve in the Liquor strained an Ounce of the best Manna half a Dram of Salt of Prunella Mix them Let the Patient take half of this Potion in the Morning and the rest half an hour after with due care After the working of a Purge we must give an Opiate that Night But whenever he takes a Purge that Night after it has done working there must be an Opiate given as after the Vomits to calm the Commotions in the Blood and to give the Lungs some quiet for fear there should arise a new influx of Humours into the Lungs from the agitation of the Blood by the Purges And for the same Reason it is convenient to mix some Opiate with Stomachick Purges to be taken just before they go to sleep As for Example Take of Rose-Aloes a Scruple or five and twenty Grains of Hounds-Tongue Pill half a Scruple Mix them and make them into four Pills to be gilt which must be repeated every other Night after the Patient has been duly blooded This Pill commonly goes by the Name of the Catarrh Pill amongst Apothecaries because it not only carries the Humours down by stool but also hinders a new influx of them into the Lungs Or Take of the Stomack-Pill with Gums Aloephangine Mastick Pill or Pills of Amber half a dram or
the Patient take a quarter of a Pint shaking the Bottle first three or four times a day adding if his Stomack should require it an Ounce or two of epidemick-Epidemick-water Aqua Mirabilis Dr. Stephens's or some other Spirituous Water Or Take Wood-lice prepared Crabs-eyes prepared the simple Pouder of Crabs-claws red Coral of each a Dram of the Pouder of white Amber half a Dram. Mix them and divide them into nine Papers of which let him take one three times a day in a Spoonful of the Pearl Julep just now described or of some other such-like Julep drinking a Draught after it Fifthly If the Patient should seem to be plainly free from Obstructions of his Liver and so be neither in an Hydropical nor an Icterical state but yet the Milk Diet before described should not be very convenient by reason of a Looseness and the Acid Ferment of the Stomack besides the altering Medicines before described for the farther tempering of the sharpness of the Humours the plentiful use of a Compound distilled Milk-water Capon-water Snail-water Pig-water c. may be enjoyned with Advantage of which I shall in the next place give some Prescriptions A Milk-Water Take the Leaves of Maiden-hair Colts-foot spotted Lungwort Fluellin of each three handfuls Hyssop Goats-rue Minth Wormwood of each two handfuls Flowers of St. John's wort Scabious of each two handfuls of English Saffron a Dram three Nutmegs sliced Dates fat Figs of each a pound of Raisins of the Sun stoned a pound let them be all cut and steep'd in three Gallons of new Cow's-milk and three Quarts of Malaga Wine and distil them in an ordinary Still so that half of the Liquor may come over And let all that is distilled be mingled and reserved for Use If it be a Scorbutical Consumption let Pine-tops Brook-lime Water-Cresses Tun-hoof with others of the milder sort of Antiscorbuticks be added in the Distillation and instead of Malaga Wine put in Brunswick Mum. But if it be a Scrophulous Consumption put in three Pints of Wood-lice bruised with the Herbs and likewise other Ingredients that are proper for the Kings-Evil If you would make this Water not only Alterative such as may alter the Blood but likewise Restaurative you may add a Capon or a Pig in a second Distillation As for Example Take a Capon drawn or a Pig with the Bowels taken out and cut it to pieces of the milk-Milk-water above described a Gallon and distill them so that three parts of the Liquor may come over A Snail-Water Take Three Hundred Garden Snails cleansed with Salt of common Milk or rather of the Milk-water before described three Gallons distil them in an ordinary Still with a gentle fire until an Acid Liquor begins to come off I think the following Magisterial Water of Snails likewise also which I use to make is not to be despised because it may be kept for Use a long time Take of New-Milk two Gallons distil it with Mint Roman Wormwood of each two handfuls to a Gallon Then Take of Garden Snails washed first in common Water and then in Small-beer half a Peck of Earth-Worms slit and wash'd a pint of Angelica a handful and half Agrimony Betony Rue of each a handful Put the Herbs in the bottom upon these lay the Snails and Earth-Worms and upon the top of all lay of shavings of Hartshorn half a pound of Cloves an Ounce of Saffron three Drams Infuse them in two Quarts of Syder and a Quart of the best Malaga Sack and then distil them in an ordinary Still These Liquors must be drank plentifully The Water of Snails c. where it is used must be drank freely and that even for ordinary Drink mixt with an equal quantity of Milk if the Stomack will bear it and it will quench the Patient's Thirst enough If you like the form of a Julep best it may be given in the following manner Take of the Pig-water or Capon-water before described a pint of Loaf-Sugar a sufficient quantity Boyl them up into the form of a Syrup Take of the Milk-water or Snail-water a pint and half of the Magisterial Syrup just now described four Ounces Mingle them and make a Julep of which let the Patient drink freely whenever he pleases Or Take of the Milk-water or Magisterial Snail-water a Quart of Sugar of Pearl ten Drams or an Ounce and half Mix them and make a Julep of which let him drink plentifully and frequently If there be a difficulty of Breathing rather than a Hectical Heat we must use a Pectoral Mead. But if it be not so much a Hectical Heat as a difficulty of Breathing that troubles the Patient as it often happens in those that have a Scorbutical Consumption a Pectoral Mead is more convenient for his ordinary Drink than distilled Waters that have a great deal of Phlegm Of which we have an Excellent Recept in Riverius in his Chapter of a Consumption and every where else amongst Authors And therefore I shall add no other Description of it in this place CHAP. X. Of the Cure of an Original Consumption of the Lungs in the third degree of it to wit when the Patient is reduc'd by the Inflammation the Apostemes and Exulceration of the Glandulous parts of the Lungs to the state of a Marasmus together with an extraordinary Weakness a Consumption of his Flesh an increase of his Hectick Fever and likewise the Addition of a Peripneumonick and Putrid Fever and the other direful Symptoms which are wont to accompany the fatal state of a Consumption WHEN he comes once to this Third Degree of a Consumption A Consumption in the third degree is very seldom cured the Patient unless the Ulcers are very small and benign very seldom is cured or lives long And therefore though a Prudent and Honest Physician when he is called to Consumptive Patients in this degree of the Distemper ought as much as it is in his Power to mitigate and relieve the Symptoms that afflict such poor Wretches and should make it his business likewise to prescribe such Antiphthisical Medicines as may best answer the present Indications and be most agreeable to the present state of the Patient yet he ought by no means Therefore a Physician must be very careful how he promises a Cure though there should be some hopes from the abatement of the Symptoms to flatter him to injure the Reputation of Physick and his own too by promising a Recovery of his Health to the Patient or to his Friends too confidently But what good soever he should with the greatest Commiseration and Diligence do the Patient yet he must always pronounce a Fatal Prognostick of his Life and not suffer himself to be deceived with the vain hopes of his Friends and those that are about him And by this means he will secure as well the Art of Physick as himself from Reflexions The Intentions of Cure The Intentions of Cure in this degree of the Distemper are these four
follows upon it And likewise after the use of an Opiate Medicine we must give them Expectorating and Lubricating things more plentifully lest the Matter which has been some time fixt by it in the Lungs be too hard for the Patient to bring up Secondly How to abate the continual Cough and to help the Patient against pertinacious Watchings As a Looseness and sometimes also an implacable Bloody-flux together with dreadful Tortures do often come upon a Consumption from the Colliquation of the distemper'd and sharp Lympha made by the Bowels which are wont to scour in Consumptive Persons that have a Scorbutical disposition by reason of the peculiar Tone of their Guts more than in others As I have observed in very many who have been taken away in the very Flower of their Age by a Scorbutical Consumption attended with those Racking Symptoms So likewise many times in this state of the Disease The Cause of the Cough c. others use to be sufficiently troubled with an extraordinary Colliquation by the Wind-pipe and the branches of it caused by this Putrid Fever whereupon the Cough that was before dry and moderate now becomes violent and continually troublesome with a plentiful spitting sometimes of a thin Rheum sometimes of a discolour'd glutinous and purulent Phlegm so that the Patient by reason of his Cough troubling him both Day and Night is wont to be afflicted with almost continual Watchings till he is light-headed These Symptoms too are not to be relieved without the use of Opium These Symptoms require Opium Yet it must be cautiously given But in this extream degree of Weakness it must be allowed with a great deal of Caution but sparingly and not without manifest Necessity because from the stuffing of the Lungs caused by it there is wont to follow a very great difficulty of Breathing a weak Pulse and a faultering of the Senses together with a coldness of the extream parts so that the Patient to the disgrace of the Physician and his Art does not seem so much to dye as to be kill'd Therefore in this case I commonly use the following Linctus or some one of the same Nature Take Syrup of Marsh-mallows of Purslane of each an Ounce and half Species Diatragacanth frigidae Haly's Pouder of each two Scruples Syrup of Meconium an Ounce and half Mix them and make a Linctus to be taken out of a Spoon or with a Liquorice-stick when the Cough is troubelsome swallowing of it gently Likewise Aqua Mirabilis because it is Aromatick and Carminative being mixt with Pectoral Syrups and taken down gently is proper to quiet the Cough Or Take of the Balsamick Syrup two Ounces of Helmont's Liquid Laudanum two Scruples mix them and let the Patient take one Spoonful every hour or every two hours In this state of the Disease the Patient must seldom ascend so high as to half a Scruple or twelve Grains of the Cynogloss-Pill Here likewise the Trochisci bechici or Cough-Lozenges both the white and black or any others of that kind are good being to be dissolved gently in the mouth and swallowed down when the Cough is troublesome Of moderating the vast Colliquative Sweats From the first of the Putrid Fever there are Sweats These Sweats are wont to accompany a Consumption after the Putrid Fever arises through the whole course of the Disease and as I hinted before do very much relieve the Cough Watchings and other troublesome Symptoms and therefore so long as they are moderate Whilst they are moderate they must not be stopt they are by no means to be stopt by Art for fear a Looseness or some other more troublesome and fatal business arise upon the taking away of this Symptom But sometimes when the Consumption once comes near to its fatal Period because the colliquative state of the Blood is at this time so much increased that scarce any new Nourishment is united to the Solid parts or retained in the Mass of Blood it happens that these Sweats become so profuse that the Patient when-ever he falls into a sleep does not only seem to lye as it were in a Flood of Water which he finds very troublesome but likewise from a great sinking of his Spirits caused by those vast Sweats as soon as he awakes he is taken with some degree of Swooning In which case his sleeps must be short In this case their sleeps must be shorâ— and if there be occasion he must be awak'd out of his sleep before his Spirits are too languid with long Sweating Also temperate Pearl Cordials must be given often and in a large quantity to which it is convenient to add Chalk Coral Dragons-blood and other Temperating Astringent and Emplastick Ingredients which may in some measure lock up and mitigate the fluid state of the Blood As for Example Take the Waters of Tormentil Plantain Oak-buds of each three Ounces of small cinnamon-Cinnamon-water four Ounces of Aqua Mirabilis an Ounce Pearl and Coral prepared Chalk of each two Scruples true Bole Dragons-blood of each half a Dram of Japan-Earth a Scruple of distilled Vinegar or Spirit of Vitriol a sufficient quantity to give a grateful sharpness of Syrup of Myrtils an Ounce and half mix them and make a Julep of which let the Patient take two or three Ounces every third or fourth hour shaking the Bottle Some of the Bed-cloaths also must be taken off and let the Patient be removed into a thin open and fresh Air let him always sleep in a large Chamber and as soon as he begins to be faint let the Sweat be presently wiped off with dry Linnen Cloaths and the Patient be removed into another part of the Bed The pores of the Skin being in this manner once stopt though Nature should make it her business to throw out some part of the colliquated Humour by the Bowels or any other passage and thereupon new Symptoms should arise yet it is better for the Patient to labour under several moderate than one very extream Symptom Of extream Vomiting in the latter end of a Consumption Consumptive Persons are all along subject to Vomiting Persons in a Consumption are in some measure subject to this Symptom through the whole course of the Disease from the morbid state of the Blood and from the Tone and Ferment of the Stomack being thereupon perfectly destroy'd as also from the stuffing of the Lungs and the motion of the Stomack being inverted by the Cough and hawking up of the Phlegm that sticks in the Lungs as I have shewed before But about the end of a Consumption this Symptom is sometimes so much increased Which increases towards the end of the Consumption that scarce any Nutriment can be retained in the Stomack but the Food as soon as it is taken down is apt to be thrown up again by the Stomack Though there is not much to be done by Art in the extremity of this Symptom yet a Physician ought to give his helping Hand
please her I substituted a Chalybeate Syrup in the room of it for the same intention And because she was not easie to work upon I ordered instead of the former the following Pills to be made up For the Syrup Take of the Chalybeate Wine a Quart Tincture of Saffron of Castor of each an Ounce of fine Sugar a sufficient quantity Boyl them to the consistence of a Syrup Let her take two spoonfuls of it in the Morning and at five a Clock in the Afternoon on those days she does not Purge by it self or diluted with Carduus-water For the Pills Take the Stomack-Pills with Gums Aloes Rosate of each fifteen Grains of Salt of Wormwood four Grains Elixir Proprietatis a sufficient quantity Mix them and make them into four Pills to be taken on the Morrow Night without any strict Confinement I likewise ordered the Tendons that were indurated and contracted by reason of their thickness so as to be painful to be anointed twice a day with Oyl of Amber and Compound Spirit of Lavender oâ— each equal quantities before a good Fire and to put a Flannel upon them Though the swelling of the Tendons seemed to be lessened and her stiff Joynts to be rendred something more fit for motion with the use of these things yet the System of the Nerves seemed now and then to be grievously affected from her Hysterical Fainting Fits often returning And therefore on the Ninth of June I ordered four or five Spoonfuls of the following Julep to be given her when she was faint Take the Waters of Bawm Black-Cherries of each three Ounces the Compound Waters of Bryony and Piony of each an Ounce of Tincture of Caster a Dram Spirit of Salt Armoniack half a Dram Compound Syrup of Piony ten Drams Mix them and make a Julep I repeated the Bag of Antiscorbutick Ingredients and ordered the Purging Pills to be taken every fourth Night The Nerves having been relieved three or four times with the use of the Julep that had been prescribed I observed besides her continual Hectick Heat sometimes also a Fit of a true Intermitting Fever seizing her first with a chilness and going off with profuse Sweats though 't was by uncertain intervals And thereupon I did not without reason suspect that her loss of Appetite her continual Hectick Fever and Universal Weakness did proceed from this Feverish Ferment lurking within which had never yet been thrown out of the Mass of Blood and which hitherto had so like a Proteus in various shapes deceived my sight And therefore now I go and encounter this Enemy with all the Power of the Peruvian Bark For I promised my self and my hopes were not frustrated as the Event did afterwards prove that when this Enemy was vanquisht the state of her Health would be very much restored upon it however Baths Fomentations and other things of that kind would be of great use to extirpate fully the Trophies of the Gout which were left in her knotted and weakned Joynts And therefore June 13. I ordered the following Draught to be given and to be repeated every four hours for seven or eight times Take Baum-water Black-Cherry-water of each an Ounce Epidemick-water Syrup of Clove-Gilly-flowers of each two Drams of the Peruvian Bark finely pouder'd a Dram mix them and make a Draught I ordered likewise the following Julep to be taken by spoonfuls when she was faint Take of Carduus-water six Ounces Barley-Cinnamon-water four Ounces strong Piony-water two Ounces prepared Pearl a Dram and half white Sugar five Drams Mix them and make a Julep June 15. Take of the Peruvian Bark finely pouder'd five Drams the Mucilage of Gum Tragacanth a sufficient quantity Make them up into Pills of a middle size to be gilt of which let her take six at four a Clock in the Afternoon and when she goes to Rest from day to day taking every Morning the Chalybeate Syrup before ordered Let the Bag of Antiscorbutick Ingredients be likewise renewed But though the Patient was perfectly freed from the Fever Fits yet still her sickness at her Stomack and want of Appetite continued together with her Weakness and the other Trophies of her inveterate Enemy And therefore though I changed the form of the Medicine yet I still pursued the Enemy that was now plainly upon its flight with the Bark in the manner following Take of the Ingredients of the Purging bitter Decoction a sufficient quantity Salt of Wormwood half a Dram the Peruvian Bark pouder'd half an Ounce Infuse them in a due manner and boyl them in a sufficient quantity of Spring-water to twelve Ounces Let her take four Ounces of the Liquor prest out hard from the Ingredients every Morning and repeat it for three days together continuing the use of the Chalybeate Syrup at Four a Clock in the Afternoon June 27. I ordered the following Bolus to be taken every six hours with four Ounces of the following Apozem for three days together Take of the Peruvian Bark finely pouder'd half a Dram Syrup of Mugwort a sufficient quantity mix them and make a Bolus Take of the Peruvian Bark pouder'd half an Ounce infuse and boyl it in carduus-Carduus-water and White-Wine of each a sufficient quantity to twelve Ounces Strain it out for use July 6. Because the Nervous Parts seemed still to be somewhat affected I ordered her three of the following Pills to be taken three times a day at Physical hours and to drink four Ounces of the Tincture of the Bark just before prescribed Take of the Pouder of the Peruvian Bark two Drams Troches of Myrrh a Dram Castor Ens Veneris of each two Scruples the Mucilage of Gum Tragacanth a sufficient quantity Mix them and make them into Pills of a middle size to be guilt With this plentiful use of the Bark though it was given in several forms my Patient was in a wonderful manner recover'd to a state of Health so as to be every way well and was perfectly freed from all the Symptoms of her Consumption and Rheumatism but only that the Tendons and Joynts especially those of her Hands continued stiff and likewise something swell'd and she did not yet gather Flesh enough And therefore when I had by way of Preparation taken care to Purge her with fifteen Grains of Extractum Rudii and a Scruple of the Fetid Pill I sent her down to the Bath to use those Waters both outwardly by bathing and inwardly by drinking them for six Weeks ordering the Tendons and Joynts that were swell'd at the end of every bathing to be embrocated for a good while and freely with the Waters of the King's Bath and the same Parts when she was laid in her Bed and disposed to sweat to be a good while anointed with the following Liniment Take Oyntment of Marsh-mallows Nerve Oyntment of each an Ounce Oyl of Scorpions of white Lillies of each half an Ounce of Chymical Oyl of Aniseeds three Drams Mix them and make a Liniment And for fear she should be
Parsley-water Fennel-water of each four Ounces the Magisterial Water of Earth-worms Syrup of the five Opening Roots of each two Ounces Mix them and make a Julep Nov. 13. With this Method all the Symptoms began to be abated and he did not make such a Jaundies Urine as he did before And thereupon I ordered a continuation of the Apozeme Linctus and Julep which were last prescribed and the repetition of the Tinctura Sacra when he went to Rest and likewise for the farther opening of the Obstructions of the Liver three of the following Pills to be given every four hours in a Spoonful of the Linctus with a Draught of the Apozeme Take the Pouder of Wood-lice prepared Goose-dung of each a Dram of Saffron half a Scruple of the Syrup of the five Opening Roots a sufficient quantity Mix them and make them into Pills of a moderate size to be gilt Nov. 14. After I had taken this care for the relief of his obstructed Liver with good Success I began as the thing required to take more particular care of his Lungs which had suffered very much from the defect of this Entrail because his Chronical Cough as also his difficulty of Breathing proceeding from the toughness of the Phlegm with which the branches of the Wind-pipe were stufft did continually put me in mind of this part of my business but especially when both were now not a little increased by a Peripneumonick Affection he had so lately had And therefore besides the continuing of the use of the Abstersive Linctus and the Apozeme made of Pectorals Hepaticks and Diureticks and likewise of the Julep and the repeating of the Tinctura Sacra when he went to Rest I ordered three of the following Pills to be taken in a Spoonful of the Linctus three times a day with a Draught of the Apozeme Take of Wood-lice prepared three Drams of Gum Ammoniack depurated a Dram and half Flowers of Benjamin a Dram Extract of Saffron Balsam of Peru of each half a Scruple of Balsam of Sulphur Terebinthinate a sufficient quantity mix them and make them into Pills of a middle size to be gilt Nov. 15. I ordered him to insist upon the same things and after Midnight to repeat the Tinctura Sacra and the Purging Waters next Morning In which manner he proceeded by my Order to the Nineteeth day but only in the stead of the Tincture I substituted half a Dram of the Stomack-Pills with Gums because of the loathing of that Medicine which he began now to have from the long use of it Nov. 19. I ordered the repeating of the Stomack-Pills and the Purging Waters every third day for three times and that he should persist in the use of the Linctus Apozeme and Balsamick Pills for eight days Decemb. 10. He came to me into my Study strong fresh-colour'd and lusty and much more free from the unhealthful Symptoms of his Lungs and Liver than he had been for many Years past But that this Chronical Mischief might be perfectly eradicated I ordered a Pint of the Tinctura Sacra that he might take six or seven Spoonfuls every fourth Night and that he should take during the use of that four Ounces of the Pectoral and Hepatick Apozeme before described three times a day at Physical hours on the intermediate days Moreover I seriously advised him to use a Diet-drink made of Antiscorbutick Hepatick and Pectoral Ingredients steep'd in Beer and Sadler's Chalybeate Waters at Islington the Spring and Summer following History 2. Mr. Maddox a Man at least Fifty Years old Gouty and Hypochondriacal from long Cares and troublesome Passions of his Mind and from the hard drinking of Spirituous Liquors which he had used himself to fell by degrees into a want of Appetite a disposition to Vomiting a stuffing of his Lungs together with a Cough and likewise an Obstruction of his Liver and a Consumption of his whole Body But I being called on the third day of August in the Year 1688. found him labouring under a Costiveness of his Belly and a Spasmodick and very dreadful pain of his Back and Side for several days not without the manifest signs of a Fever and a Languor upon him which now were come to that height that they plainly despaired even of his very Life At first I thought the pain arose from a Stone-Colick and thereupon I ordered Ten Ounces of Blood to be taken from his Arm being induced to do it not only by the present Fever but likewise for fear of an Inflammation of the Intestines that might follow by reason of the violent pain I ordered the Parts affected to be anoynted warm with the Oyntment of Marsh-mallows Oyl of white Lillies and Oyl of Bricks mixt together and Pills of half a Dram of Extractum Rudii and a Grain and half of London Laudanum to be given him in his Bed that he might get some sleep likewise a temperate Cordial Julep to be given him often to drink to comfort him And I ordered that if there were occasion a Stool should be procured after eight hours with a Clyster of Milk and Sugar with Camomile-flowers boyled in the Milk but when the Purge had once done working they were to give him Twenty Drops of Liquid Laudanum in a small Draught of the Cordial at the time he should go to Rest But these things having no effect either to give him any Stools or the easing of his Pain on the 6th of August I prescribed a Mucilaginous and Lubricating Apozeme to be drank often and for three Nights together half a Dram of the Stomack-Pills with Gums and a Grain and a half of London Laudanum and the next Mornings two Quarts of the Purging Mineral Waters Aug. 17. I ordered the repetition of the Pills when he went to Rest and likewise of the Waters the next Morning and that he should drink the Waters boyled dissolving an Ounce and half of the choicest Manna in the last Draught But for all this the Spasmodick pain of his Back and his Costiveness continued And thereupon Aug. 18. I ordered four Spoonfuls of Elixir Salutis and Thirty Drops of Liquid Laudanum to be given when he went to Rest and that he should take three Ounces of the following Apozeme warm every three hours until he had had some good large Stools Take of Senna half an Ounce Coriander-seed prepared Salt of Tartar of each two Scruples boyl them in a Pint and half of the Purging Mineral Waters to a Pint dissolving in them when they are strained two Ounces of the best Manna With the use of which he at length began to have too many Stools that is more than he could bear but without any relief of his Pain which was so violent that it could hardly be quieted even with the use of Laudanum it self though by degrees I went as high as Forty Fifty Sixty Drops which yet I was forced to repeat every Night Aug. 21. Being called a second time to go see him by the little yellowish
use of the Parts affirms have no sense if they are cut or burnt or tyed hard with strings To which Opinion I very readily assent as being perswaded of the truth of it from the frequent Observation of Varices which I remember to have often happened in Cancrous Breasts and in the Legs of Women with Child All which seemed to be affected with a very obtuse or no pain from these Varices though they were grown never so big which pain too always seemed to me to proceed rather from a preternatural distention of the external Skin and a pressing upon the Muscular flesh under them caused by the larger Varices than from the sense of the Vessels themselves that were so varicous And it may be that dreadful pain in the lower part of the Belly which is wont to accompany an Icterical Consumption of which we are now speaking may be thought to be caused in the same manner For as soon as the substance of the Liver happens to be so constringed and thickned that being now deprived of its Natural laxity it does very difficultly if at all admit the passage of the Blood through it the Vena Portae and the branches of it which bring the Blood back to this part must necessarily at length be much swelled and rendred varicous by the continual drift of fresh Blood by reason of the stop that is here put to it Which being so though the Veins themselves according to Galen's Opinion are not affected with any dolorifick sense yet none ought to think it strange that from a distention and a Solutio continui made in the Membranes through which these varicous Vessels creep there proceeds this dreadful and spasmodick pain which can be removed only with the use of Chalybeate and Diuretick Medicines endued with subtle and penetrating parts and that a long and constant use of them which may be sufficient to open the Obstructions of the Liver Which Obstructions being once removed and thereupon the Varices going down of their own accord the Membranes through which they creep may by knitting together again be quickly freed from this Spasmodick Pain And in vain even for the abating of the pain are outward and warm applications made to wit of Fomentations and Anodyne Liniments which are wont to be of very great use in Pleuritick Colick and other Spasmodick Pains because the Blood contained in the Varices is more agitated and heated by external warmth whereupon a greater varication or preternatural distention of the Vessels with an increase of the pain must necessarily follow But I have observed that Oxycrate the Cerote of Saunders Oyntment of Roses and other such-like Styptick and cooling things and those applyed cold have much better answered the end But above all things Opium given inwardly as it is the last so it is likewise the only at least the greatest Relief and Refuge for this pain This too is given in vain if it be in a little quantity For no Dose will truly answer our end unless it be so great as may be able to cause some kind of numbness or insensibility in the distended Membranes as well as in the other parts of the Body Which I have often found in Mr. Maddox and other Patients in the like case whose Pains I could not so much as abate even with Laudanum it self till I began to prescribe three or four Grains every time 'T is true indeed the Original Disease and these Symptomatical Pains proceeding from it do afford different Indications For as much as these Pains are abated by Opiates so much the Obstruction or Constriction of the Substance of the Liver which gave the first occasion of the pain is increased and confirmed And indeed what is done by Chalybeates in the Day-time is in some measure undone by Opiates in the Night However forasmuch as the Vital Indication requires it oppressed and languishing Nature must be supported with necessary Opiates For they being now almost ready to expire with the continual Fatigue of these Spasms there cannot be room to use either Chalybeates or any other kind of convenient Medicines And therefore in this case though the use of Opium which is very necessary and which ought to be compensated with the more diligent and longer use of Deobstruent and Attenuating Medicines may be permitted at due intervals by a Prudent Physician yet we must not give even the least Grain of Laudanum without urgent necessity because the Original Distemper does plainly contraindicate the use of it History 4. The Wife of Mr. Prestbury that lived in Black-Fryars who was now some Months gone with Child really an honest Woman but somewhat anxious and thoughtful at length from Cares and various Passions of her Mind fell into the Jaundies from a deficient secretion of the Bile caused by as it were a kind of Schirrous hardness and closeness of the Substance of the Liver it self But from the long neglecting of her Jaundies she became not only tabid and emaciated by the long substraction of the Nutritious Juice but likewise began to want an Appetite to have a Thirst and something of a Hectick heat to be troubled with a difficulty of Breathing a Cough and other signs of an incipient Consumption of the Lungs insomuch that even I my self thought she would in a short time dye of a Consumption unless there could be some help given her to open the Obstructions of her Liver time enough And therefore when for fear of a Miscarriage I dare order neither Tinctura Sacra nor the Purging Mineral Waters nor any other Purging Medicine on the third day of May this present Year I ordered four Ounces of the Aperitive Apozem already described to be given her every sixth hour for ten days together adding likewise twice a day an Ounce of the Chalyheate Wine to the Draught But when by reason of some Natural Antipathy which she had against Saffron she could neither bear that not Turmerick-Roots nor it may be some other things that were Ingredients in these Medicines but as soon as they were taken she threw them up again and that not without signs of a sudden Miscarriage May 25. I set my self to answer the former Indications by some new Prescript made for the same intentions in the manner following Take the Pouder of Wood-lice Goose-dung of each two Drams of Salt of Steel a Scruple Syrup of the five Opening Roots a sufficient quantity Mix them and make them into Pills of a middle size to be gilt of which let her take three thrice a day at Physical hours and drink four Ounces of the following Apozeme after every Dose Take the Roots of Succory Grass Parsley Fennel Asparagus of each two Ounces of the inner Bark of the Barberry-tree an Ounce shavings of Hartshorn Ivory of each half an Ounce of Currans two Ounces boyl them in a sufficient quantity of spring-Spring-water to a Pint and half adding when they are almost boyled half a Pint of White-wine To the Liquor when it is
are commonly called Pectorals and Expectorating the more neat forms of which I shall very willingly subjoyn Take Oyl of Sweet Almonds Syrup of Maiden-hair Jujubes Violets or of Marsh-mallows of each an Ounce and half of white Sugar-candy a Dram and half mix them very well for a Linctus of which let the Patient take a Spoonful every four hours and drink four Ounces of the following Apozeme warm after it Take of the Pectoral Decoction when 't is clear a pint and half Tincture of Saffron extracted with Treacle-water Syrup of Maiden-hair Scabious or Jujubes of each an Ounce mix them and make an Apozeme If you have a mind to incrassate more Take Oyl of sweet Almonds fresh drawn Syrup of Comfrey red Poppies or of dryed Roses of each an Ounce and half of Syrup of Meconium half an Ounce of Sugar of Roses a Dram and half mix them and make a Linctus But if you have a mind to lubricate more Take Linseed-Oyl fresh drawn without fire Syrup of Liquorice or Honey of Violets of each an Ounce and half of white Sugar-candy a Dram and half mix them exactly for a Linctus to be taken either by it self or dissolved in a Draught of the Apozeme above-mentioned If a Feverish Heat should forbid the use of Hyssop or of the Tincture of Saffron If there is a feverish heat hot things must be omitted let them be omitted in the Apozeme If there be a Looseness such things as will make them laxative must be omitted If a Looseness or any other Symptom forbid their use let the Pectoral Fruits be left out of the Apozeme and the Oyl out of the Linctus's or else instead of the Medicines just now mentioned let these be substituted which follow Take the Lohoch of Poppies Sanans of each an Ounce and half Syrup of Purslane of dryed Roses of each an Ounce the cold species of Gum Tragacanth Haly's Pouder of each a Dram Saccharum Penidiatum or Sugar of Roses three Drams Mix them and make a Linctus to be taken in a Spoon or with a Liquorice-stick every four hours or oftner if the Cough requires it swallowing it gently and drinking after it a quarter of a pint of the following Emulsion warm Take the four greater cold Seeds of each a Dram white Poppy-seeds Lettuce-seeds of each two Drams Pine-Kernels Fistick-Nuts of each three Drams with a pint of the Water of Red Poppies Red Rose-water Barley Cinnamon-water of each three Ounces Make an Emulsion according to Art to be sweetned with Saccharum Penidiatum Or Take the Lohochs of Foxes Lungs of Colts-foot of Purslane of each an Ounce the Syrups of Jujubes Maiden-hair of each an Ounce and half of Flower of Brimstone two Drams of the Tincture of Saffron half an Ounce the cold species of Tragacanth the could species of Pearl Haly's Pouder of each a Dram Saccharum Penidiatum half an Ounce Mix them and make a Linctus to be taken as before Take Tacamabac Balsam of Tolu of each a Dram a sufficient quantity of the Ingredients of the Pectoral Drink boyl them in a sufficient quantity of spring-Spring-water to a pint and half with the Liquor strained and a Dram of each of the four greater cold Seeds two Drams of white Poppy seeds and as much Henbane seed seven sweet Almonds blanch'd Make an Emulsion according to Art to be sweetned to the Palate with Saccharum Penidiatum But if there be a greater difficulty of Breathing than ordinary from the toughness of the Phlegm let the following Linctus be prescribed Take the Lohochs of Raisins of Squills of each an Ounce and half the Syrups of Hedg-Mustard of Hyssop of Hore-hound of each an Ounce and half the species of Orrice of Calamint Flower of Brimstone of each a Dram and half of the Tincture of Saffron half an Ounce of white Sugar-candy six Drams Mix them and make a Linctus to be taken as before Yea if this Symptom be very urgent there may be added a Dram of Gum Ammoniack depurated and a Dram and a half of Flowers of Benjamin to the Linctus These Intentions to wit the speedy Concoction of that Mass which is lodg'd in the Lungs and the preventing of a new influx of it are likewise satisfied by Compositions made of Balsamick and Agglutinating Medicines As for Example Take the Pulp of Conserve of Red Roses of Wood-Sorrel of each an Ounce and half of Olibanum three Drams of Natural Balsam two Scruples mix them and make an Electuary of which let the Patient take the quantity of a Wallnut three times a day at Physical hours and drink after it a quarter of a Pint of the following Apozeme warm Take the Leaves of Yarrow Mouse-ear Burnet Dandelion spotted Lung-wort Jerusalem Oak Scabious of each a handful Flowers of St. John's wort Violets great Daisies red Poppies of each half a handful Jujubes Dates of each six pair of Saffron tyed up in a Cloath half a dram Anise-seeds Juniper-berries of each three drams steep them in a due manner and boyl them in a sufficient quantity of spring-Spring-water to three pints In the Liquor when it is strained dissolve a quarter of a pound of the Conserve of Red Roses which being in this manner added to the Apozeme gives it a Balsamick and very grateful taste strain it again and then add Syrup of Corals of Jerusalem Oak of Maiden-hair of each an Ounce mix them and make an Apozeme for use Or instead of the former Electuary let this be prescribed which follows Take of the Pulp of the Conserve of Red Roses strained through a sieve two Ounces of the Conserve of the Fruit of the Dog-Rose an Ounce of Haly's Pouder a Dram of Leucatellus Balsam half an Ounce a sufficient quantity of the Balsamick Syrup mix them and make an Electuary to be taken as before Let the Patient likewise take often in a day a Spoonful or two of the Balsamick Syrup which is very grateful to the Stomack and a Scruple of Balsam of Tolu made up into little Pills with every Dose of the Syrup Every Night an Opiate must be given Also every Night when there are not some other Medicines to be taken if nothing forbids it it is convenient to give xv or xx Drops of Helmont's Liquid Laudanum in a Spoonful of the Balsamick Syrup For this end likewise 't will be well to prescribe a Dram of the Flower of Brimstone in a potch'd Egg or a sufficient quantity of Honey of Rosemary-flowers If a tickling Cough by reason of the Acrimony and thinness of the Humour separated by the Wind-pipe and the branches of it be very troublesome to the Patient so that 't is to be feared the Catarrhous Cough being irritated after the manner of Suction or drawing the Humour more into those parts will be increased let the following Lozenges be always at hand to be taken at pleasure and swallowed gently to quiet the Cough Take of the Pulp of Marsh-mallow-Roots prest through a sieve an Ounce
the first declension of the Fever let it be of Chicken-Broth potch'd Eggs c. He must likewise if there is occasion presently have a Stool procured with a Clyster made of Milk in which Camomile-flowers have been boyled sweetned with brown Sugar which as often as it shall be necessary must be repeated Then let Eight or Ten Ounces of Blood be taken from the Arm of that side where the pain is which Bleeding must be boldly repeated every day or every other day according to the Effervescence of the Blood and the violence of the pain in the Side and the difficulty of Breathing so far as the strength of the Patient will bear it that the progress of the Inflammation to a ripening and an Aposteme if it be possible may be prevented In the mean time all along the course of the Disease let a Spoonful of the following Linctus be given dissolved in four Ounces of the Pectoral Decoction warm'd every third All the time of this Fever we must use Pectoral Medicines or at least every fourth hour Take Oyl of sweet Almonds new drawn Syrup of Maiden-hair of each an Ounce and half of white Sugar-candy a Dram and half Mix them very well and make a Linctus Yea if the toughness of the Phlegm the difficulty of Breathing and the increase of the Pain arising thereupon require it and there be no Looseness to forbid it let new Linseed-Oyl fresh drawn without any Fire be put in the stead of the Oyl of sweet Almonds and Syrup of Hedg-Mustard or of the five opening Roots in the room of the Syrup of Maiden-hair Moreover let two or three Ounces of Linseed-Oyl be likewise ordered to be taken by itself every four hours because it is wonderfully endowed not only with a Lubricating but likewise an Anodyne Quality Take of the clear Pectoral Drink a Pint and half Tincture of Saffron made with Treacle-water and Syrup of Maiden-hair of each an Ounce Mix them and make an Apozeme for the Use before mentioned For refreshing their Spirits Something must be done to comfort them and tempering the heat of the Blood let four or five Spoonfuls of the following Julep be ordered to be taken Take of the Cordial Milk-water eight Ounces Barley Cinnamon-water Epidemick Water of each two Ounces of Pearl prepared a Dram and half of Loaf-Sugar six Drams mix them for a Julep At the time they should go to Rest let the following Anodyne and Diaphoretick Bolus be ordered to be taken with a draught of the Pearl Julep but especially if their Body be too loose which often happens in this state of the Distemper Take of Venice-Treacle half a Dram of Gascoin Pouder a Scruple of Syrup of Clove-gilly-flowers a sufficient quantity mix them and make a Bolus Something to preserve the Brain For the security of the Brain and the System of the Nerves presently after Bleeding let Blistering-Plaisters be applyed to the hinder part of the Neck to the inside of the Arms and Legs and the Cephalick Plaister with Euphorbium to the soles of the Feet What is to be done when there is a pain in the Side For the relieving of the pain in the side caused by the Spasms of the Muscles and Membranes of the Breast let the following Fomentation and Liniment be alternately applyed to the Parts affected Take the Roots of Parsley of Fennel Linseed Foenugreek-seed of each two Ounces Camomile flowers Melilot-flowers of each two handfuls mix them together and boyl them in a sufficient quantity of spring-Spring-water let the Liquor being strained be put into a new Ox's Bladder till it is half full and let it be applyed hot to the Parts affected when the pain is violent When the Bladder is removed lay on a warm Flannel with some of the following Liniment Take of the Oyntment of Marsh-mallows half an Ounce Oyl of white Lillies Oyl of Bricks of each three Drams mix them and make a Liniment for use For the farther tempering of the Effervescence of the Blood and the heat of the Lungs the following Pouder may be ordered with Advantage Take of the finest Salt-Petre two Drams of white Sugar-candy half an Ounce mix them and then divide them into Eight Papers and let one of them be dissolved in every draught of Beer the Patient drinks As for the other things they must be left to the Judgment of the Physician that is with him to be prescribed as there shall be occasion As for what concerns the Putrid Fever of Consumptive Patients we must take notice A Description of the Putrid Fever that although they being treated in the foregoing Method do not dye of a Peripneumony yet the Inflammation of the Tubercles of the Lungs at this time turning to an Ulcer which very often happens at the end of the Inflammatory Fever there presently arises a Putrid Intermitting Fever which returns at certain periods every day or every other day with a Chilness a hot Fit and then Sweats succeeding one another for the Blood in its Circulation passing now through these purulent Parts is filled and opprest with Heterogeneous and disagreeable Particles by which Nature being irritated is rouzed and forms a Feverish Fit every day or every other day to expel her Enemy Vnless we can heal the Vlcers Pectoral Medicines will not Cure this Fever The Peruvian Bark will many times do great Service Which Fever so far as I understand it is impossible perfectly to eradicate with the help of Pectoral and Balsamick Medicines without healing as often as they are small and benign the Ulcers from which that Fever proceeds Yet I have very often found with very good Success the efficacy of the Peruvian Bark in taking off these Fever Fits at least for a time being frequently repeated and at due intervals So that I have seen the Lives of some Consumptive Persons that have been lookt upon as deplorable by the frequent use of it prolonged not only some months but likewise some years who though they were never perfectly recovered from a sickly state yet being once freed from their Fever by the use of the Bark could do their ordinary business well enough Wherefore I look upon this as the only Febrifuge in this case that has hitherto been found out For although by this means there is only a Treacherous and uncertain Truce obtained because the Fever is wont to return of its own accord or upon the least occasion yet by this temporary suppression of the Fever the Patient is not only immediately freed from many troublesome and grievous Symptoms for a time but likewise recovers his lost Strength in some measure and moreover gains some Opportunity for the use of Balsamick and Pectoral Medicines which by healing the ulcerated Tubercles may work a perfect and eradicative Cure of the Fever We must mix Balsami ke with the Bark And therefore it is very convenient not only to insist diligently upon the use of this kind of Balsamick Medicines at
faint in the use of the Bath she had the following Cordial in readiness to be taken by spoonfuls at any time when she pleased Take the Epidemick-Water Dr. Stephens 's Water of each half a Pint of Syrup of Clove-Gillyflowers two Ounces Mix them and make a Cordial Julep In the Month of September my Patient returned from the use of the Bath having found a great deal of Benefit But especially her Tendons and Joynts that were affected were very much restored by it to promote the Cure of which yet farther I advised her to use one of our Bagnio's here at London twice or thrice a Week together with the following Medicines Sept. 4. 1683. Take of the best Sarsaparilla four Ounces China-Roots an Ounce and half shavings of Ivory of Hartshorn of each three Drams of Raisins of the Sun stoned two Ounces Liquorice sliced half an Ounce after a due Infusion boyl them in four quarts of spring-Spring-water to two quarts Let her take half a Pint of the Liquor strained thrice a day at Physical hours Take Ceruss of Antimony Wood-lice prepared of each a Dram and half Mix them together for six Papers of which let her take one three times a day with every Draught of the Decoction before prescribed but especially when she goes into the Bagnio As soon as she had made an end of using the Bagnio I endeavoured to promote a gentle Diaphoresis every Night with the use of the following Draught Sept. 12. 1683. Take Carduus-water distilled Treacle-water of each an Ounce of Ceruss of Antimony a Scruple Syrup of Violets two Drams Mix them and make a Draught to be repeated for Ten Nights together With the use of which her Joynts and Tendons received a great deal of benefit But at length for fear the Patient's relapse into an Intermitting Fever at the end of the Year of which I had a great and reasonable Suspicion should frustrate the perfecting of her Cure I advised her to repeat the use of the Peruvian Bark for several days to be taken every fourth or fifth hour in the form of the following Apozem Sept. 20. 1683. Take of the Peruvian Bark pouder'd an Ounce boyl it in Carduus-water and White-wine of each an equal quantity to a pint and half and then let it be prest out very hard Lastly For the getting of her Flesh again and the farther tempering of her Hectick heat I advised her to go into a strict Milk Diet to be used for six Weeks in the Country Air. With the use of which she grew plump and recovered her perfect Health her Monthly Purgations then at length returning with a florid colour which before this had been quite stopt for four Years by reason of the emaciated and thin Habit of her Body But the next Year which was 1684 in the Month of June because of some stiffness which remained in the Tendons of her Wrists and of one Foot she went again to the Bath and afterwards repeated the Milk Diet. From which time to this present she has enjoyed perfect Health and likewise having been married has had Children With almost the same Method I happily cured Mr. Overton living without Newgate beyond the Expectation of all his Friends who with a long Rheumatism was at length brought plainly into a Tabid state with a difficulty of Breathing a violent and perpetual Cough a continual Hectick Fever a spitting of Matter like Pus and the other signs of a Fatal Consumption of the Lungs Whose Case I here forbear to recite for Brevity's sake History 3. Mrs. Lane a Barber's Wife whose Husband lived in Cow-Lane being about Five and Thirty Years old when she had lived in a Consumptive state Emaciated and Coughing for several Years past fell in the Month of April 1684. into a true Rheumatism with violent Pains and inflam'd Swellings which yet were moving suddenly from one Joynt to another with a Fever likewise that was evidently of a remitting kind accompanying of it which had the Type of a Tertian which I have very often observed to be the Nature especially peculiar to a Rheumatick Fever In which case whenever a new Fever-Fit seizes the Patient the Rheumatick Pain and Swelling which before were almost quieted are wont to be renewed in the Parts that were before affected or else by a Metastasis of the Matter as the Ancients love to speak to be translated to some other Joynts But the Fits were very long lasting for the space of Twelve or Sixteen hours and attended with a want of sleep light-headedness great tumbling and tossing heat and a very Feverish Pulse All which Symptoms used to be followed and go off with great Sweats But at the beginning of every Fit I observed that her Rheumatick Pains always grew more sharp in the Joynts affected or else seized some other Joynts that were free before So that a new Rheumatism seemed to come with every Fever-Fit Being called in the time of her Fit I endeavoured to satisfie the present Indications with Bleeding Blisters an Anodyne Draught Tincture of Roses a Pectoral Linctus and a Pearl Julep And indeed all the Symptoms going off at the end of the Fit when I came to see my Patient the next day I reckon'd the Distemper was overcome and removed with those things I had ordered till at length by the return of the Fever and Rheumatick Fit the next Night I plainly understood how vainly I had hitherto flattered my self And therefore according to the urgency of the Symptoms that indicated it I bled her again ordering the repetition of the Hypnotick Draught and likewise the application of an Anodyne Cataplasm to the Joynts that were affected with extream pain from the Rheumatism But after I found the Type of the Fever and Rheumatism for two or three times to be plainly a Tertian and that notwithstanding the Method I had before prescribed all things continually grew worse the very System of the Nerves being now at length seized with Spasms but especially in the time of the Fit and her Mouth being likewise ulcerated with a Thrush being led by a happy Conjecture I betook my self in this deplorable case to the use of the Peruvian Bark prescribing a Dram to be given every third or fourth hour when her Fit was off With the use of which in the space of Twenty Four hours she was freed both from her Rheumatism and Fever without any other Remedy and was well after her manner that is Consumptively but yet she was less opprest in her Lungs than she had been before she fell sick But as soon as she got rid of her Pain and Fever she wholly neglected her Chronical Consumption which likewise seemed to be helpt with the Bleedings the use of the Bark and the other Medicines before prescribed refusing all sorts of Medicines and thereupon after a Year or two she dyed of that Chronical Consumption of the Lungs CHAP. XII Of a Consumption proceeding from Fevers especially such as are from Surfeits Scarlate and Intermitting