Medicines such as the Balsamick Syrup Leucatella's Balsam c. As for Example Let the Patient take every Night Leucatella's Balsam Conserve of red Roses of each half a Dram or two Scruples with three or four drops of Balsam of Peru. Or a spoonful of the Balsamick Syrup truly made twice or thrice a day either by it self or dissolv'd in a draught of Sarsa Drink Or half a Dram of Balsam of Tolu made up into Pills at Physical Hours drinking a draught of the Sarsa Drink after it Or if there be no Feverish Heat let him take twice a day eight or ten drops of Natural Balsam mixt with a little Sugar-candy But when the Ulcer comes to heal Care must be taken that a Consumption of the Lungs does not follow upon healing of the Vlcers there must be a great deal of care taken lest a true Consumption of the Lungs follows in the room of a common Consumption from the substraction and loss of the Chyle which indeed does very often happen For this passage by which the Nutritious Juice uses to run off being now stopt by the Surgeons and Physicians Art if the Blood still remains dispirited and does not recover its former Balsamick and Oily Nature it is wont to grow more hot and sharp and thereupon that sharp and hot Nutritious Juice which was used before to be thrown out by the Ulcer it usually comes now to cast off upon the substance of the Lungs as being spungy and apt to receive the Humours Whereupon follows not only a stuffing of the Lungs and upon that a difficulty of Breathing but also a considerable swelling of the Glands which do often enough happen in these parts and upon that a dry and troublesome Cough yea a Heat and Inflammation and thereupon a Fever not only a Hectical one but also a Putrid or rather Inflammatory Fever and at length an Apostem and Ulcers with a Thirst and want of Appetite all which do at last end in a fatal and confirm'd Consumption of the Lungs The Signs which threaten it must be attended to And therefore as soon as ever these external and remote Ulcers begin to heal the Physician ought to make what Observation he can to find whether the least degree of a difficulty of Breathing or any other sign of an Affection of the Lungs comes upon it Yea if the Appetite continues weak or if but the least degree of a Preternatural Heat in the Habit of the Body does appear If they appear what is to be done which may give us the least occasion to suspect a Consumption of the Lungs the first Attack and Progress of it ought to be prevented with all the Physician 's Power in the manner following Let several Issues be made the Head shaved the use of the Balsamick Remedies before mentioned and the Sarsa Drink with the aforesaid Vulnerary Herbs be continued or for the farther temperating and altering of the Blood let the Patient be put into a Milk Diet and kept strictly to it For the same reason the Chalybeate Mineral Waters are here also of great use Also the Physician must make all the hast he can and disburden the Lungs that are stufft by Pectoral and Pulmonary Apozems expectorating Linctuses and other Medicines of that Nature which we shall afterwards describe in the Book of a Consumption of the Lungs before the Tone of the Parts is injured and a Feverish heat is brought on by the continual stagnation of hot and sharp Juices Let the Patient also have a very great care to preserve himself from Passions of his Mind Passions of the Mind Cold and violent Excercise are to be avoided and Cold and use no violent Exercises let him also abstain from the use of Wine and Spirituous Liquors which may make the motion of the Blood to and through the Lungs quicker than it ought to be and kindle a Preternatural heat in the Blood But if there be no suspicion of the Lungs What is to be done after the Vlcers are healed when there is no suspicion of the Lungs when the Ulcer comes to be healed let the Patient be enjoyn'd to be chearful let him be plac'd in a benign and open Air and eat plentifully of such Food as affords a good Juice but yet is mild and free from a sharpness and lastly let him use moderate Exercise by the use of all which the Blood may as soon as is possible recover its former Balsamick Temperate and Oily Nature and the Appetite of the Stomack may be increased By which Method we may not only prevent a Consumption that is coming but also cure one that is begun when it proceeds from external Ulcers as I have before discours'd more largely in the former Chapters of other Original Consumptions caused by the loss and want of the Nutritious Juice An History Mr. Wheatley's Wife near St. Sepulchres in London about Fifty Years old having been tormented for the space of two Years with an intolerable pain of her Loins first from an Inflammation and then an Aposteme of the Muscles of the Loins following upon the Inflammation was in progress of time by the uninterrupted pain racking her both Night and Day and by the continual loss of the Nutritious Juice discharging it self daily and plentifully into this Common-shore put into a Fever and at length brought into a Consumption and that even to the degree of a Marasmus with an intolerable Thirst a continual Weakness want of Appetite and want of Rest yet without any sign of a Consumption of the Lungs so that the poor Woman being always confin'd to her Bed lingred a long time crying out dreadfully as if she were ready to expire presently By reason of her mean Circumstances she did not ask the Advice of a Physician but thinking her Distemper to be the Stone in the Kidneys she miserably tormented her self every day with I know not what Medicines to break and dissolve the Stone such as every sorry Woman that came to see her did with assurance warrant should do her good But I being at length desired by the most Ingenious Dr. Tyson to go and see her and together with him observing the parts of the Loins to be swell'd and to resist a Pressure and perceiving the fluctuation of purulent Matter under our fingers when we prest it though it lay somewhat deep by reason of the thickness of the Muscles and of the Skin with the consent of my most worthy Colleague I ordered that after the application of a Caustick the Tumour should be opened in a convenient place Which was no sooner done but a great quantity first of clear then purulent Matter and a great Number of little Bags filled with a very clear Water at least Five Hundred gusht out with a great force We brought away for three Weeks or more taking out the Tent every day a great deal of Matter and small Bags filled with Water From the first opening of the Apostem her pains were
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-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
the very beginning but also quick and very Acute so that it carries off the Patient within a few Months and it may be Weeks I shall add these few things concerning the variation of Cure in this kind of Consumption First Lubricating Medicines must be taken plentifully in the beginning of this Distemper yea and gentle Vomits by which means we may endeavour to bring away the Stone or any other things that have slipt down into the Lungs before they are quite fixt there by their lodging long in the part and before the Tone of the Lungs is much injured by them Secondly But if great and spasmodick pains are excited by the tearing of the Lungs caused from the motion of these sharp bodies we must expect a great spitting of Blood and therefore instead of Lubricating Medicines we must give Laudanum and that in good quantities and often whereby we may hinder the motion of the Stone for the present abate the pain and prevent the spitting of Blood For in this case letting of Blood outward Fomentations and Liniments do no good as they use to do in Pleuritick and Peripneumonick pains and this I found by Experience in one Mr. Foster and in many others 'T is true indeed that a lingring and slow Consumption attended with a difficulty of Breathing and other such-like Symptoms will follow from a Stone lying in this manner in the Lungs which I have often observed in my Practice But yet a lingring and uncertain Consumption is better than an Acute one accompanied with horrid pains that certainly and quickly terminates in Death For if this kind of Consumptive People take such care of their Health as to live always in an open and Country Air to keep from taking of Cold from Drinking and too much Exercise and any other thing that may disturb the Stones again that are fixt and lye quiet they may live to a great Age and do their Business well enough Sometimes the Bleeding must be permitted a while Thirdly But if there follows a spitting of Blood from the tearing of the Lungs it ought to be let alone for a while For in this Flux the Stones or any other things that have slipt down into the Lungs may be voided But if the Haemoptoë is great and dangerous we must open a Vein and if it be necessary repeat it and we must give not only Opiate Medicines but also Astringents in the form of Linctuses Juleps c. the Lapis Haematites the Royal Styptick Water we must use a Milk Diet and other things briefly mentioned before in the former Chapter which I shall hereafter give a larger Account of in another Book if I have an Opportunity to treat of an Haemoptoë Balsamicks must be plentifully used Fourthly But if the Lungs happen to be torn and to be ulcerated from the motion of the Stone whether it be voided or not we must make choice of Balsamick Medicines and give them plentifully of which I have given several forms in the General Method of Cure A Milk Diet is not convenient where there are Stones in the Lungs Fifthly we must not Order a Milk Diet in a Consumption proceeding from Stones in the Lungs unless there is a great necessity because it is apt to breed some new Chalky Stones Whereby it comes to pass that the Cure of one Consumption is wont to lay the Foundation of another The Chalybeate Waters must be drank in little quantities Sixthly Likewise the Chalybeate Waters though they may be good in this Consumption must be drank in a little quantity at a time for fear the Stone should be stir'd again by the too great distention of the Vessels of the Lungs Whereby it comes to pass that the return of the pain and of the spitting of Blood does often follow upon it Seventhly Sometimes there are several Stones Sometimes there are several of these Stones in the Lungs so that after one or two or it may be a third has been voided yet the Lungs are ulcerated by those which remain behind and from thence there follows a Consumption As I remember it happened to Mr. Plucknet and some others But a Consumption of the Lungs is wont to proceed not only from a Stone in the Lungs The Stone and Vlcers of the Kidneys and Bladder do often cause a Consumption and an Ulcer there following upon it but likewise very often from Ulcers and a Calculous disposition of the Kidneys and Bladder so that I have very often observed those that have had the Stone to dye of a Consumption But this Consumption is alwas lingring and Chronical and is to be cured in the same manner as an ordinary Consumption How this Consumption is to be cured only we must avoid those Medicines that irritate the pains of the Stone as my Balsamick Pills c. But the Chalybeate Waters which ease those pains must be often used For I am apt to think that those who have the Stone do not fall into a Consumption so often from the long and tormenting pain as from a want of the due secretion of the Serum and an alteration of the Ferment which separates it in the Kidneys following upon it And therefore in the Cure of this kind of Consumption we must have a regard not only to the Consumption by using the Pectoral Medicines I have before mentioned but also to the Disease which is the cause of this Consumption to wit the Stone of the Kidneys and Bladder by using such Medicines as may lubricate the Urinary Passages and expel the Stone or at least mitigate the pain History 1. Mr. Plucknet being Forty Years old or thereabouts a strong and lusty Man but one that had for many Years lived irregularly in almost all the six non-natural things yet found no other mischief from it besides a hesky and dry Cough which he had now been used to for a long time without any great trouble at length upon hard Riding and taking of Cold by being very wet with the Rain he fell into dreadful pains of his Breast that were like the pains in a Pleurisy upon which there came a great and long spitting of Blood with a Fever and a Cough almost continually troubling him I could do no good with External Liniments and Expectorating Medicines until I came at length to the use of Opiates With which though he got a little respite and a treacherous Truce yet he could get no perfect Cure For as his Cough so the Hectick Fever still continued with which he every day by degrees pined away and that notwithstanding the plentiful use of Balsamick and Pectoral Medicines of Asse's Milk c. till at last in the space of a Year he appeared in a deplorable Consumptive state with an universal Colliquation made by the Skin by Stool by his Lungs c. Which Consumption that in its own proper Nature was lingring and Chronical without doubt came to be so quick and hasty from a long predisposition of
and Chronical it may be because strictly speaking the Part affected or seat and source of both Distempers are not the same The beginning is known by a Cough different from an ordinary Cough For a Consumptive Cough proceeds from a Glandulous Swelling or Tubercle of the Lungs themselves and that with the sense as it were of some heavy weight in the Breast as also a difficulty of Breathing and other Symptoms of the same Nature which I shall by and by particularly though briefly run thorough But on the contrary a simple Catarrh owes its Original from a distillation of Rheum cast out as it were in continual drops by the Uvula and Almonds and the other Glands seated in the upper part of the Wind-pipe yea and by all the glandulous Coat of the Wind-pipe it self For the Wind-pipe by a certain Providence of Nature is covered on the inside with a Nervous Membrane that has a very exquisite sense which will by no means admit of any thing but the Air it self no not a drop of the clearest Water without grievous trouble and opposition and therefore when it is tickled by the going down but of the least disagreeable Particle it presently endeavours with all its might to throw it up again by Coughing And indeed Nature has made this Provision for very great Reasons For if a free and quiet passage were every day allowed but to the smallest Body or Particles that are heterogeneous how soon would there be an end of Man's Life by the stuffing of the small branches of the Wind-pipe which by reason of the straightness of the passages use sometimes to be stufft and Asthmatically stopt even by the Air it self when it is thicker than ordinary But how fierce soever and continual this Catarrhous Cough is as being provok'd by a tickling from a continual Excretion and Distillation of Rheum from the Glands in the Wind-pipe yet as it is always at the beginning moist and joyned with a great flux of Humours so likewise it is accompanied with no weight or oppression of the Lungs or shortness of Breath which for the most part are obvious to our Observation in a Consumptive Cough and that in the very beginning Therefore this I make to be the first distinguishing sign of a Consumptive Cough to wit This dry Cough from Tuberâ—lâ—s of the Lungs that it is dry at least in the beginning because it proceeds from a swelling of the Lungs rather than from any thin Rheum owzing out of the Internal Membrane of the Wind-pipe and the Glandules seated in the upper part of it Yet it cannot be denyed but these Patients in the beginning of this Distemper Yet these Patients spit a great deal of thin Rheum whenever the Lungs happen to be violently moved by an extream and deep Cough so as to make them Vomit either after eating or from any other Accident I say these Patients do throw out a great plenty of thin clear Spittle from the Salivatory Ducts and likewise hawk up from the Tonsils some Glutinous Phlegm that is sometimes salt sometimes insipid which may happen also to those that are well sometimes from the same cause to wit by reason the Salivatory Ducts and Glandulous Parts seated in the Throat are squeez'd and as it were milkt by this violent motion But yet it is a dry Cough But nevertheless this Cough is to be reckoned a dry one because there is no Rheum or Phlegm thrown out of the Wind-pipe or the branches of it And it is as true that this dry Cough uses sometimes to turn to a Catarrhous Cough and such as is attended with a flux of Rheum as the Wind-pipe and the branches of it supply a continual flux of Humour which is sometimes crude sometimes in the form of concocted Phlegm as it uses to be in a true and genuine Catarrh Which comes to pass from hence because the Glandulous Coat of the Wind-pipe it self and the branches of it being irritated by this long and violent motion of the Lungs in the Nature of a dry Cough caused by the Swellings dispersed here and there through their whole substance is continually emptied of its Liquor as if it were milkt and thereupon does throw out daily an abundance of Serum or Water almost in the same manner as Milk is fetcht out of the Breasts and Spittle from the Salivatory Ducts by drawing them in a manner continually or as an involuntary flux of the Seed in a simple Gonorrhoea proceeds from the Glandulous seminal Parts by frequent fribling How it may be distinguisht from a true Catarrh But yet this Consumptive Cough when it is attended with a Catarrh may be distinguisht from a genuine Catarrh especially two ways First in that a Consumptive Cough is from the very beginning dry for some Months and sometimes it may be for some Years whereas a simple Catarrh is at first humorose as I said before Secondly in that a simple Catarrh goes off in a few Days at most in a few Weeks to wit so soon as ever that accidental Feverish Ferment occasioned by taking of cold does by degrees once cease to put the Mass of Blood any longer into an extraordinary motion Which being once done the Glandulous Coat of the Wind-pipe does no more separate or spew out any Humour but what it does Naturally From whence it comes to pass that what remains of that Rheum which is separated by these Glands being no longer attenuated with a new flux of the Humours is by degrees concocted by the Natural heat of the parts into a Phlegm that resembles purulent Matter and is cough'd up in that form and thereupon the Serum or Humour being thrown out when it is first separated the Glandules quickly recover their Natural Tone without any hard Swelling or Tubercle remaining By which means it also comes to pass that the Cough together with the tickling wheesing shortness of Breath c. cease of their own accord But on the contrary in a Consumptive Cough as the lasting and inexhausted Fountain does supply a distempered Humour to the Glandulous Parts from the Mass of Blood predispos'd by a long abuse of those six things which we call not Natural and put continually into an inordinate motion by a Feverish Ferment habitually fixed in it So from the Swellings dispersed here and there through the substance of the Lungs and compressing the branches of the Wind-pipe not without some trouble the Wind-pipe it self is provok'd to cough by a certain continual tickling And this causes as continual a spewing out of a sharp and distemper'd Humour all along the inside of the Wind-pipe until at length those Tubercles growing very large begin to be inflam'd and to turn to Apostemes Whereupon as soon as any one of the Bags or Cavities which contain the Matter breaks there is plainly in coughing if there be a passage for it a true and stinking Corruption thrown out from these ulcerated Swellings mixt with some thin Humour or Phlegm
that is plentifully supplyed from the Glandulous Coat of the Wind-pipe Neither indeed can the Patient when the Distemper comes to be a Fatal Case be ever freed from this Cough by any Art till Death effectually stops it But let no one admire how those Tubercles or Swellings that are placed in the Lobes of the Lungs far from the top of the Wind-pipe can provoke this dry Cough together with a tickling in the upper part thereof when he may every day observe the same kind of Chronical dry Cough caused and continued a long time by chalky stones generated in the substance of the Lungs Yea and once I observed the same Symptom to happen from three Nails that slipt by chance as the Person was laughing through the Wind-pipe down into the Lungs and to continue for a whole Year the sick Person all that while being in other respects very well How the Tubercles which are remove from the top of the Wind-pipe do affect that part And indeed the thing it self shews it for the Wind-pipe is every where divided through all the Lobes of the Lungs into many branches which are a great way distant from one another so that the very fine and small Pipes of those branches are propagated to the very extremities of the Lungs by the continuity of those Membranes which had their Original from the beginning or upper part of the very Wind-pipe From whence it necessarily follows that as those Tubercles in what part soever of the substance of the Lungs they happen to be bred cannot but make a troublesome compression upon some of these small Pipes and straighten them So that troublesome sense by reason of the continuity of the Membranes does affect the upper extremity or beginning of the very Wind-pipe by a consent of parts as we commonly say whereby it provokes the Wind-pipe to cast out its Enemy by a vain and dry Cough Just as we see every day in a Strangury or difficulty in making Water from a stone pressing uneasily upon the Ureter yea if it be the very Kidney a great pain felt in the extremity of the Yard it self from the continuity of the Membrane For in Nature's endeavouring to expel the Stone there arises a Spasmodick Contraction of the whole Urinary passage from the very Kidneys which yet does very much affect the extremity of the Yard with a kind of heat of Urine The Nature of this Cough shews it to be from the Tubercles And even the Nature of this Consumptive Cough does likewise favour much this Opinion whilst it yet continues to be dry as being caused only by Tubercles and before a disposition to a Catarrh does in progress of time come upon it For as it is dry and without any expectoration so it is not great nor the Fits long and is rather made of its own accord to relieve the Oppression of the Lungs then excited by a violent tickling or accompanied with that great straining which usually accompanies a Catarrhous and fierce Cough that is caused by the continual excretion of a Waterish Humour by the Wind-pipe and the branches of it But if any one should be inquisitive about the Original of the Tubercles in the Lungs A general Account of the Original of the Tubercles in the Lungs which are the first occasion of this dry and truly Consumptive Cough I shall give this general Answer That the substance of the Lungs not only seems more obnoxious to a flux of Humours as the Ancients love to Phrase it than any other parts of the Body from the continual motion of these parts caused in respiration but also by reason of its spungy softness because it consists wholly of small Bladders and Vessels is wont to suck in and retain the Humours And therefore when all the internal and external Parts as well those that are Muscular as those that are Glandulous are very often affected with several sorts of such Swellings why should it be strange if they are frequently found here also as they are in other parts of the Body Yea when I consider with my self how often in one Year there is cause enough ministred for producing these Swellings even to those that are wont to observe the strictest Rules of Living I cannot sufficiently admire that any one at least after he comes to the Flower of his Youth can dye without a touch of a Consumption And without doubt the breeding of these Swellings is so frequent and common The breeding of these swellings is very common that a Consumption of the Lungs would necessarily be the common Plague of Mankind if those Swellings did not vanish or were not removed by Art as easily as they are bred at first And indeed I have been used to think not without Reason that as the more Benign Tubercles are wont to go off of their own accord and that quickly so none of them lay the Foundation of this great Disease And when they are Malignant they occasion a Consumption of which I am now treating but only those which are in some degree Malignant and ill-natur'd and that are wont to putrefie sooner or later from some peculiar quality in their Nature from what part soever of the Body they have their Original But that I may more particularly say something of the beginning and rise of these Tubercles A particular Account of the beginning of them As far as I have been able hitherto to learn either from the inspection of the dead Bodies of such as have had a Consumption or by Reasoning a crude Tubercle or Swelling is bred from the Obstruction of some Glandulous part of the Lungs to wit when a greater quantity of Serum or Water is separated from the Blood than is thrown out by the Duct of the Glandule From whence it comes to pass that as the Part affected being too much distended by the Humour that is imprisoned in it is deprived of its Natural Tone and thereupon is no longer able to spew or throw out the Serum or Water that flows into it or is separated so likewise the Humour that is so shut up not being any more renewed by an influx of fresh Humor does by degrees grow dry and hard from the Natural heat of the Part From whence arises a hardness that resists a pressure or a Tubercle of which we are now speaking which in progress of time after the Natural Tone of the Part is in this manner destroyed is wont to be inflam'd and to turn to an Apostem sooner or later according to the Nature of the Lympha or included Humor and of the Blood from which it is separated which indeed is the whole immediate cause of a Consumption of the Lungs and of the dry Cough which attends it The causes of that Obstruction which produces the Tubercles There remains yet some Enquiry to be made from what cause this Obstruction or Stagnation of the Humour in the Glandulous parts of the Lungs does proceed And this is
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-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-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
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-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-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-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
Acrimony being as it were coagulated and so unable perfectly to unite the new Chyle to it self and the solid parts is wont to throw it in a greater quantity than is convenient upon the Glandulous Parts where the small Vessels do not run in a right Line as in the Muscles but spirally from whence it comes to pass that the Blood is wont to make a longer stay and to stagnate longer in these than in other parts and so to make a more plentiful separation of the Nutritious Juice in them whereby it comes to pass that these parts are apt to swell more and to grow larger and harder than others And what happens in other Glandulous parts happens also in the Lungs themselves which are every where full of innumerable Glandules but of some more conspicuous ones upon the Wind-pipe and the branches of it though in their Natural state they are not so easily discerned So that 't is no wonder if those that have the Kings-Evil who are frequenlty subject to Glandulous Swellings in other parts are likewise many times affected with such kind of Tubercles even in the Lungs themselves the substance of which is Naturally spongy and apt to receive the Serous Particles of the Blood that are here plentifully separated by their continual agitation And indeed from these sixt Swellings in the Lungs this Scrophulous Consumption is wont to proceed The most certain Diagnostick Sign of which is to be taken from Glandulous Swellings in the External Habit of the Body accompanying of it The Diagnostick sign of it or at least preceding it as also from an Ophthalmy and Scab that often return and from other such-like Scrophulous Affections Though I think I must freely confess that sometimes it happens so that the Glandules of the Lungs only and no others are affected with this Humour In which case there is need of an Experienced and Judicious Physician to find out the peculiar Nature of this Consumption from what yet remains to be spoken under this Head Therefore here we must particularly observe The Tubercles here are either Phlegmatick That these Tubercles of the Lungs as Scrophulous Swellings in other parts are either crude and phlegmatick and so no ways disposed to an Inflammation and Maturation Or more hot Or else more hot which will be seized with an Inflammation sooner or later according to the present disposition of the Blood and the different Nature of the Matter that is contained in the Cystis For sometimes to wit when the Matter is concocted and hardned into a Chalky or Steatomatous Substance or into the substance of a Meliceris which it most commonly is the Inflammation and the Exulceration that proceeds from thence are not only some considerable time before they happen but likewise when they do they are very slow Chronical and almost insensible But whenever the Blood When the Matter is of a hot Nature the Swellings are apt to inflame and the Matter contained in the Cystis are of a Nature different from this which also sometimes though seldom happens the Swellings are very apt to be inflam'd so to suppurate and to turn to an Ulcer And from hence arises the difference in Scrophulous Consumptions For some to wit whenever the Swellings are crude and not apt to be inflam'd in a Consumptive state live though they are crazy and sickly from their Childhood till they are old with a Cough that is almost continual and troubles them both Night and Day Summer and Winter with a weight in their Breast with a difficult and somewhat Asthmatical Respiration but yet without any sensible Fever but upon the taking of the least Cold to which also they are more subject than other People they are wont to spit a great deal of Phlegmatick and Serous Matter These People may be preserved from any dangerous or fatal Effects of their Distemper even without Physick only by ordering themselves regularly in those Six Things which we call Non-natural And hence it comes to pass that they seldom desire the Help of a Physician in this sickly crazy state being better contented to live Miserably A Scrophulous Consumption is curable when the Tubercles are crude than Physically But for my part I do not question but by the frequent changing of Air and making choice of such as is thin and clear and by the long use of Balsamick and Mercurial Medicines of Wood-lice Chalybeates but especially the Mineral Waters and of other Antiscrophulous Remedies these Swellings may be wasted in the Lungs as well as in other parts and so the Patient may be freed from a Scrophulous and Consumptive state as I have often experienced In the Cure of this kind of Consumption A Milk Diet is not to be used in the Cure of it we must by no means put them upon the use of a Milk Diet because it is wont to promote and increase the Obstructions and Swellings that proceed from a Viscous Humour Likewise those Pectoral Medicines that are commonly called Expectoratives and Opiates do no great good in this case unless it be upon the taking of new Cold to mitigate the Symptoms that arise from it as a Cough Fever difficulty of Breathing want of Sleep and that only whilst all or some of these do yet remain in a great degree and violent But whenever these Tubercles are of a hotter Nature When the Tubercles are hot the Consumption is Acute and thereupon more subject to a quick Inflammation and Exulceration this Scrophulous Consumption is very Acute and terminates in a few Months and as to the manner of Cure differs but little from a common Consumption Neither are we to make any other Prognostick in this than in another Consumption to wit that it differs in the event according to the degree and progress of the Disease as I have said before I have many times observed this kind of Acute Consumption to proceed from the stopping and drying up of a Scrophulous Scab The Occasion of this Consumption as the other more Chronical Consumption is wont to seize upon those that have been subject to cold Swellings of the Glands What is to be done in the hot Swellings In the beginning of these more hot Swellings liberal and frequent Bleeding is for the most part more necessary than in other Consumptions by which means the Inflammation and Suppuration of the Tubercle may perhaps be prevented though the incipient Tumour that is begun to arise may neither be lessened nor perfectly wasted Here also it is convenient to add your Figwort Dropwort Wood-lice and other Antiscrophulous Ingredients to the Pulmonary Medicines Here likewise the Gums and Balsams are very serviceable As also my Balsamick Pills before mentioned by a long use of which I have done more towards the perfect Cure of very many of this kind of Consumptive Patients than by any other Pulmonary Medicines When they Apostemate Specificks do no good But if these hot Swellings begin once to turn to an
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-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
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-Baum-water black-cherry-Black-Cherry-water of each three Ounces of epidemick-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-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
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