Manuale Medicum. OR A Small Treatise of the Art of PHYSIC in General. AND OF VOMITS AND THE JESVITS' POWDER in Particular. By Hugh Chamberlain. Physician in Ordinary to his late Majesty, and Fellow of the Royal Society. LONDON, Printed by J. Gain, for the Author, 1685. PREFACE. IT being my Misfortune to differ in Opinion from Eminent and Famous Physicians in two things of great moment to the Preservation of LIFE and HEALTH Viz. The great Contempt or Neglect of Vomits, which in the following Tract is presumed to conduce more to the Restoring of Health and Saving of Life than any other Remedy yet publicly discovered; and the Common Use of the Jesuits Powder, which plainly appears as Destructive. I have been often urged for the Reasons that prevail with me to be singular, and wanting leisure to satisfy by Discourse such of those Enquirers to whom I owed that respect I found myself under a necessity to Print a few of those Arguments which support my said Opinions, and which I had, Currente Calamo, written for the Use of a Son I sent to the East-Indies, where better Help may be wanting. I purposely avoid Tediousness, and pretend to no Florid Style, nor Elaborate Treatise, clogged with many Niceties not easily to be conceived; but waving those difficiles nugae, I hope I have stumbled upon certain plain and useful Truths, which my Reader may rely upon in time of Need, and with a small Understanding comprehend, if he will give himself a little thinking time. I know Men are under such invincible Prejudices by Education, Custom, and Interest, that whosoever hath the Confidence to oppose common received Opinions by broaching New, or reviving Old, runs a mighty hazard of his Reputation: Notwithstanding, I have adventured to cast in my Mite, and if either it proves serviceable for the Preservation or Recovery of Life or Health, or provokes some more Able, to perfect or disprove my Notions in this Essay, (the Defects whereof I am not ignorant of, but want both Time and Ability possibly to Correct) I have my Satisfaction. I do not here pretend to write any thing of which our Physicians are Ignorant, but what, for Reasons best known to themselves, they rarely put in practice: And therefore hope it may be no Crime unpardonable to refresh their Memories, as well as guide the Patient in some measure, to judge whether he is Skilfully and Candidly dealt with by his Physician: Which Use alone may be a small Recommendation of this Manual, for both physician's and Patient's Sake. It may upon due observation be strongly presumed, that near half that die yearly in London, and the Country, come within the Power of Nature and Art to be kept alive much longer, were but the Practice Reform, and Patients taught to be more prudent in making timely Application for H●lp, and being contented to be Governed until Health be perfectly Restored. The several particular Points herein asserted, may seem new Notions, yet are they all Founded upon Old Truths; which unless the Philosopher's Elixir comes to be discovered, and brought into Common Use, as some have vainly hoped, will never justly grow out of Date. This Short Account to my Reader may not be impertinent, since I seem Obliged to excuse my Appearing in Print: To which I was compelled having no other Means to Secure myself and others from the Abuse of a False Impression, which might Surreptitiously creep forth by Imperfect Copies, already given to some few Friends. PAge 1. line 3. r. Physical. p. 7. l. 6. r. critical. p. 8. l. 18. r. the Roots or Fountains of all Diseases. p. 13. l. 10. after or r. some. p. 14. l. 12. r. transmuted. p. 15. l. 1. r. Vomiting. and l. 13. r. as is confessed. p. 16. l. 10. r. Caution. l. 11. place a comma after Distempers. p. 17. l. 2. after and r. for. l. 10. deal most. p. 18. l. 26. r. who for he. p. 19 l. 22. r. Böetius with two tittles. l. 23. deal ● in fasting. p. 21. l. 9 r. deep rooted l. 11. r. Nerves. l. last add to the bottom of Berrnier's Relation this Observation of the late ●uke of Albemarl's ●n the last great Plague, Anno 1665, Viz. That all the Soldiers that took Vomits in the beginning of their being Infected, Recovered. Which by the way, ●s more than can be ●aid of any one Medicine besides. P. 33. l. 3. r. Laurinum. p. 36. l. 20. r. though many. l. 24. deal by. p. 41. beginning of the last lines. Manuale Medicum, OR, A short Physick-Essay, etc. THE Art of Healing can never be Successful, when neither the Theory is sufficiently understood, nor the Practice well managed, though for the Instructing therein multitudes of Books are extant, and daily new Hypotheses started; but as the former cause Confusion, so most of the latter have little besides their Novelty to recommend them. This Art is of absolute necessity, and great use to the well-being of Mankind; and yet it wants, as most other things, not only the Improvements might reasonably have been made, but even the benefit of many formerly in use, and still fit to be continued. Divers things have contributed to this Misfortune; amongst others, the causeless Fears and rash Censures of Patients; which have encouraged some disingenuous Physicians to take advantage of their Ignorance; most of them choosing rather to be decoyed into their Graves, than forced into their Health. Something not much unlike this humour was in Jeremiah's Time; Jer. 5.31. The Prophets prophesy falsely, and the Priests bear Rule by their Means, And my People love to have it so; and what will ye do in the end thereof?; And Amelot de la Houssaie, in his History of Venice, pag. 260, 261, and 262, observes, That ill Counsels (provided they are covered with plausible Appearances) are oftener followed than good. Which most commonly displease, either from the difficulty of the Execution; or, because the good or ill Consequences are not generally foreseen; for men do not discern what is true from what is false, nor what is convenient from what is destructive. But if Diseased Patients could be healed naturally, as once miraculously, by a Command to take up their Beds and walk, without a necessity of swallowing many loathsome Potions, and seemingly churlish Medicines, and always as well jucundè, as sometimes citò & ●u●ò be freed from their Diseases, than might Physicians boast of a Purge, or Vomit which should neither make sick, nor gripe; and of Specificks without any sensible Evacuation, wherewith to vanquish all Diseases: but these are Desiderata: for though a Disease be received with never so much delight into the Body, it shall cost some pain and trouble before it can be parted with: 'tis true, that pain and trouble, where Strength gives liberty and time, may be divided into smaller Portions, by protracting the Cure; and a Patient, who cannot suffer a removal of his Disease at once, may be healed by degrees, there being (besides the true and safe Method of helping with powerful Remedies) a slower and more uncertain, yet seemingly milder, for such as have patience, and will run the hazard. Diseases may of themselves for a time be quieted, and their Fermentation interrupted, and sometimes also by Art to good purpose; but never was any Cured without Evacuation, general or particular, natural or artificial, as by Vomiting, Siege, Urine, Sweat, Sneezing, Imposthumations, or other Eruptions, B●●oding, Fluxing, Blistering, or Cupping, with, or without Scarifications, according to the sound Judgement of a well experienced and honest Physician. And of this his late Majesty hath been a late famous Example, when attacked with that dreadful Fit, to the terror of the whole Nation, who was only relieved by speedy Evacuation of all sorts. Which fair way of Practice would not scare Patients with an Apothecary's Bill, amounting to 15 l. or 20 l. in an ordinary Case. It may boldly be affirmed, that Cordials commonly in Use, never Cured any Distemper which would not as certainly have been Cured without them. 'Tis confessed many Cordials, so called, tend towards Evacuation by Urine or Sweat, and some to Sweetening and Quieting; the former do very little, or nothing assist Nature, in comparison to larger Evacuation; and the latter only Palliate or Quiet for the present; and soon after, the Torrent, if not prevented by Evacuations, breaks forth again with greater Violence: the proper use of Cordials being with more speed to restore Spirits exhausted by Labour, violent Workings of Physic, or Diseases already in a great measure overcome; because, Potu citius quam Cibo reficimur: For otherwise, Impura Corpora, quo magis nutrieris, èo magis laeseris. And consequently, Cordials than hurt more than help. As for Example: Compare a Disease in the Body to a Parcel of Wood in a Chamber, which always incumbers, though sometimes without danger; and admit an unexpected Fire kindles that Wood; as an accident may rouse a latent Ferment in the Body; then the Room becomes in danger of burning, and the Patient of being destroyed by a Fever, or the like. The Question will be, What may best secure this Chamber and Patient? Whether with Water, to extinguish the Fire, and leave it smothering, and more apt to receive a new Inflammation? Or, suffer it to burn out, whereby the Chamber is also endangered? Or, cause it to be carried away by a brisk stout Fellow? So, whether to palliate the Patient's Disease with a quieting Medicine, to bridle the present Ferment, leaving still behind some uneasy Symptoms, the Relics of an Imperfect Cure, or Chronical Distemper instead of the Fever? Or, suffer the Fever to make its own way, and Nature to struggle for the Mastery, to the hazard of the Patient's Life? Or, by proper and powerful cathartics, or other Evacuants, carry off this Morbific Matter; this Foams, and cause of those Appearances, which by mistake, are called Diseases? For Instance; A Fever continual or intermitting, a Vomiting, or Looseness, a Colic or Convulsion, Jaundice or Dropsies, etc. are no more the Disease than a Cholera Morbus, Fever and Convulsion caused by the taking Poison, is then the Disease: Whether therefore at such a time a quieting astringent Opiate may more properly be administered for the Patient's Recovery, than a Cup of Sack for the Relief of a wearied Porter would be more acceptable than the taking the Burden off his Back. Sickness may be said to be the various Passions of the Body, which happen when Nature is attempting to free itself from whatever is troublesome or useless; or thus, every Humour received, bred, or so altered within the Body, as by reason of its quantity or quality, is unapt to be converted into the Use or Nourishment of the same; but, è contra, irritates, interrupts, or burdens either the Natural, Vital, or Animal Functions. Nature therefore for the most part, attempts to expel as a Disease whatever it cannot digest into Use by Fermentation, arising from a Confusion of the Homogeneous and Heterogeneous Matter or Humour, retaining the first for the Service of the Body, and expelling the last as Excrementitious: and possibly, most purging Medicines work no other way but as a Ferment cast in, to awaken Nature; by the help of which Fermentation, Diseases are often purged away by the strength of Nature through the common Vents or Emunctories, as by Siege, Urine, Sweat, Haemorrhages; or Nature otherwise throws off some, or all of the Morbific Matter upon the habit of the Body, or remote Parts, where it after becomes a Chronicle Disease or Tumour, as Gout, Scurvy, Bubo, etc. These Expulsions are either Critic or Symptomatical; Critical, when Nature dischargeth the Whole, or greater Part; and Symptomatical, when the Peccant Matter so abounds, as to destroy, or at least endanger or incommode the Patient, by attacking him in several Parts and different Manners, notwithstanding the Particular Evacuations. The true and only Causes of all Obstructions and Diseases are the Abuse of, or Errors in the six Nonnaturals: Solutio continui, Contusions, venomous Stinging, and Contagion, may also be reduced under the same Heads; which Errors altar and vitiate the Humours, and they the Solid Parts. Observe therefore, That Health is preserved by Good Air. Wholesome Meat and Drink. Moderate Excretion & Retention Regular Exercise and Rest. Fitting Sleep and Watching. Orderly Passions of the Mind. and lost by Bad, Air. Unwholesome Meat and Drink. Immoderate, Excretion & Retention Irregular, Exercise and Rest. Unfitting, Sleep and Watching. Disorderly, Passions of the Mind. Which six Particulars are both the Cause and Cure of Sickness and Health; Temperance therefore and Content goes a great way in its Preservation. In short, Repletion and Inanition, or if you please, Addition and Substraction, with the Passions, cause all Diseases; the first, by receiving what is unfit in Quantity or Quality for the Support of the Body, or retaining what ought to be discharged as Useless: the last, by not supplying what is necessary for the Support of the Body, or expelling too soon by Wound, Purge, or otherways, what is so supplied, and aught longer to have been retained. By these means the Blood is either coagulated, whence Stagnation and Suffocation; or rarified, so as the Spirits get lose and vanish, by both which Death only enters. Diseases produced by the forementioned six Nonnaturals are to be distinguished by their taste, colour, and consistence, as, Bitter and Yellow, Sour and Greenish. Salt and Glassy. Insipid and Viscous. And were anciently the four Simple Humours, called Excrementitious Choler and Phlegm, Whey and Melancholy (of which, only the two former are allowed by the Learned Lister) together with the various Compounds and Mixtures of these, which when they exceed their Limits, and predominate, bring forth divers Symptoms, or, as they are often called, Complicated Distempers, according to the several parts they possess, sprouting up like many Branches from one and the same Trunk. Thus Medicine over-dosed, and Food in an undue quantity, create dangerous Humours or Diseases; for a Scruple of Mercury precipitate, a Dram of Opium or Spirit of Vitriol, or a Quart of Brandy, will, by altering and moving the Humours irregularly, poison such as are not used to them; and yet in small quantities are both Food and Physic: for 1/1000 part of a Grain of the same Mercury, a Grain of Opium, ten Drops of Spirit of Vitriol, or one Ounce of Brandy, are both Food and Physic, and hurt not, according to the Proverb, Parum Veneni non nocet: For Poison in so small a Dose as Nature can overcome, may be Food or Physic; and Food and Physic in a larger quantity than can be subdued by Nature, is Poison; only those things have obtained the Name of Poison which are powerful in small Quantities, and without great exactness cannot safely be applied to the benefit of Mankind. Note, That the Humours may be said to offend in quantity, when any one part is overcharged with them, though there remain less than necessary in the rest. For the Signs of Diseases, see Riverius' Institutions, the 1st. Chap. of the 2d. Sect. of his Semeioticks, and so to the 5th. Chap. where he gives a large Account. But the most necessary and material Signs I have thence extracted and subjoined. And first, the Signs when Choler predominates, are A full, frequent, and hard Pulse. Want of Appetite, and loathing of Meat, great Thirst, a Burning Fever, a Tertian, Frenzy, Pleurisy, Vomiting of Choler, Looseness, Erisipilas, Tetter, etc. Pimples in the Face, bitterness in the Mouth, Stools very yellow, and sometimes white, when the Skin is yellow, Urine thin and high coloured, and sometimes thick and yellowish, red and intense, a dry burning of the Hands and Feet, a yellowish colour of the Face and Eyes, and sometimes of the whole Body, falling off the Hair, etc. Secondly, When Phlegm, expect, A small, slow, and soft Pulse. A bad Appetite, little or no Thirst, Catarrhs, Dropsies, Obstructions, Lethargies, Palsies, etc. a white, thick, insipid Humour from the Nose and Mouth, slimy Stools, a white and pale Urine, and thin when it proceeds from Obstructions, else thick, and troubled with a large Sediment; the Whites in Women, etc. Thirdly, When Blood, there is A large, full, and slow Pulse. An Indifferent Appetite, and moderate Thirst, Burning Fevers, Phlegmons, etc. frequent bleeding at Nose, Haemorrhoides, and Womb, a good Urine, reddish Stools, etc. Fourthly, When Melancholy, you find A slow and hard Pulse. Sometimes loss of Appetite, sour Belchings, Quartane Agues, Spleen, Leprosy, Scabs, Piles, Vomitings, much Spitting, Costive Body, and blackish Stools, thin Urine and pale, sometimes thick and lived. These are the most material Signs where the several Humours predominate. Diseases being reduced, as above, to a few Heads, according to the peccant Humours, their Method of Cure consequently may be much contracted, with respect to the Humours, the Part offended, and the manner, whether by Obstructions, Tumour, or otherwise. I shall here purposely omit treating on the Inconveniencies succeeding Inanition, being more Diaetetical than Pharmaceutical, a wholesome and moderate Diet proving sufficient, where 'tis Simple, without the Complication of Preternatural Humours, and then 'tis included in the following Methods. For Example, in a Bilious Colic, Tertian Ague, Jaundice, Erisipilas, one sort of Palsy, etc. Choler is the Disease, and these the several Appearances or Symptoms of the same, according to the Sedes, or pars recipiens, as amongst other Signs is manifest by their frequent Change from one to another. And thus also a Defluxion, or Catarrh, possibly caused by a total or partial Suppression of insensible Transpiration, when it falls upon the Eyes, Ears, Nose, sharp Arteries, Lungs, or Joints, is distinguished into several Diseases, yet materially is the same, only invading different parts, and in the main requiring the same Cure, and with equal facility oft times to be pursued. For the first, direct the most effectual Purgers of Choler, and the Application of suitable Strengtheners to the part affected, Inward or Outward. For the last, after general cathartics, nothing seems more proper than Diaphoreticks, and Sudorificks, to promote sensible or insensible Transpiration (due regard being had to the Part affected) Evacuation in general being the chief way to overcome Diseases: therefore a Fever, and all sorts of Fits caused by Nature for Consumption and Discharge of the Morbific Matter, are not to be hindered by the Jesuits Powder, or other Astringents, but treated by Sweeting, or other proper Evacuation, that so the Cause may be removed. Wherein the pretended Tenderness of some Physicians (allowing long Intervals betwixt cathartics, or never using them) is real Cruelty to their Patients, giving thereby time to the Disease to recover Strength, and oft times to the hazard of the Patient's Life; for either the Patient is Cured by the first, and needs no Repetition; or not recovered, and then endangered by such Delay. But a Physician hath done his Duty, when he hath committed nothing he ought not, nor seasonably omitted any thing he ought to have used, be the Success what it will; which notwithstanding always follows a due Course of right means, as wetting doth naturally the use of Water, and burning the application of Fire; and when success fails, 'tis either because the wrong means were relied on, or the right not seasonably exhibited in quantity, both for weight and time. And he certainly is the most ufeful and skilful Physician who can best discover a Disease, and the fittest Method to Cure it; and always in like number, and equally difficult Cases, hath the best Success. His principal Work therefore (taking it for granted, that Diseases must be expelled before the Part can be strengthened, as being impossible otherwise to be expiated or transmitted) is to make a wise choice of the forementioned ways of Evacuation, to answer the several Indications, it being very evident, that according to the occasion, one sort is not only more effectual, but also the other may be dangerous; as in the Smallpox Sudorificks are commonly most successful, Bleeding commonly mortal, except very early performed; therefore Nature being the best Guide, seldom or never leaves a curious Observer without some Circumstance to lead him into the ready way. And of all sorts of Evacuation, Vomits are found by long and daily Experience, the most successful, and yet by the ignorant, most opposed as dangerous and violent, when possibly it may not be so very difficult to prove, that Vomits are the real Cordials, which (by fortifying Nature) enables it to throw off the Disease by Vomit●●● or otherwise, and that 'tis no Malignity in the Vomit which causeth those Gripes and Sickness usually attending it, but the Motion of the Humours which Nature (being revived by the Medicine, improperly called a Vomit) is upon expelling. When Vomits are directed according to Art, with respect to the Patient's Strength, Indications for them, and no contraindications lying against their Use, 'tis one of the most effectual means for rooting out of Diseases, and is confessed by Quercetan, Fernelius, Riverius, Willis, and divers others. So ordered, they do not only empty (as the Vulgar imagine) the Stomach, from which all parts receive their Nourishment, and when foul, can never have good afforded, but both the neighbouring and remoter parts, as the same, and other Authors readily acknowledge. And (though of the six only Inlets of Diseases, the Errors of the Nonnaturals, Food is but one) yet shall the Stomach be affected, and sympathise with most, if not all the other parts, though the Disease be caused by any of the other five; for instance, tread upon a Man's Corn, and he shall immediately be sick at Stomach; bring him ill Tidings, and though never so sharp set before, his Appetite presently flags: and 〈◊〉 a Headache be caused by Wind or Sun, 〈◊〉 Stomach shall not escape. Vomits reach those Humours, no other sort of Evacuation can touch, at least 〈◊〉 so certainly, nor without more frequent Repetitions: And prepared accordingly, may be given to Old and Young, Men or Women, with Child, or not (but with great Cautiousness to the Female Sex) in most, if not all Distempers Beginning, Increase, State or Declination, at all hours Day and Night, the Stomach is principally, or by consent disordered, always discerned by loss of Appetite, Pain, Heaviness or Fullness at the Stomach, Vomiting, or Reaching to Vomit. Quercitan sp●●●ng of Vomits in the 17th. Chapter of his Pharmacopeia, declares, That Art must al●● follow Nature; which of its own 〈◊〉 endeavours all sorts of Evacuation, 〈◊〉 there enumerated, as Stool, Urine, S●●●t, and Vomit, for the General; and the Excrements of the Nose and Mouth by Salivation and Spitting, for Particulars; all w●●ch Ar● ●mnst●mitate. Vomits (〈◊〉 he) anciently were in great Estee● and much more in Use than now; for our late Physicians reject them, by reason they do (as they suppose, very much disturb the Body, introducing dangerous Symptoms, and that (our Climate being colder than Graece, where Hypocrates and other Grecians used them, and our Inhabitants more Phlegmatic) Vomits are not so needful: But these are generally granted to be idle Reasons, and therefore exploded; for on the contrary, Vomits are found to be very useful and necessary for rooting out the most desperate and most difficult Diseases no ways else to be effected; the mention of which alone affrights our Hen-hearted Physicians. But how can they then boast themselves Friends to Nature who (neglecting the most powerful Remedies, without daring so much as to make Trial) prove rather her Enemies and Flatterers, seeking to defend her with Helps too weak and inconsiderable, never thinking to attack her Foe with powerful Weapons, who in the mean time remains unhurt by their gentle Medicines, even despising the milder Vomits; after which, in vain applied, they dare not return the second time to the same Remedy. This Author enumerates some Cautions in giving Vomits, and afterwards declares what Spontaneous Vomiting is; and further adds, that the Ancients ordered Vomits more unsafe than those of late Days invented; making mention of divers extraordinary Cures of Rulandus, and afterwards citys two; in the first of which he relates the great Agony a Patient suffered by a Vomit, but yet was Cured, though forsaken by all the Doctors before. The last is more considerable, for the strange matter brought away, and the great success ensuing, so that he resolves to publish it to the World, to the end those Physicians (who through a worse Fear than that of a Hare, wickedly condemn this way of Purging) may see their great Error. Riverius in his Institutions acknowledgeth, That Humours contained in the Stomach and Neighbouring Parts, are easier Purged off by Vomit than Stool, it being the shortest way; and though Vomits are not much in use; yet 'tis very certain, that being discreetly appointed, they work admirable Effects; for many Intermitting Fevers remaining (notwithstanding other Medicines) , are by Vomits only eradicated, as appears by frequent Experiments; which he pursues with divers Instances; and for a further Confirmation, please to take notice of a late Instance of the King of France, the 1st. of July, 1658, who being taken with a Malignant Fever, removed to Calais, where his life being despaired of, the Physicians (finding his Strength daily decay, his Disease increase, and that the second bleeding in the Foot, on the 8th. of the said Month, gave no Relief) upon a full Consultation in the Presence of the Cardinal, resolved to give him an Antimonial Vomit, which the King took with great hopes of Relief; accordingly the Operation was so happy and speedy, that after emptying the Stomach and Bowels of a great deal of malignant and adust Matter, he found himself much eased the same Night, next Morning, being the 10th. he took the second Purge, which although more gentle, worked notwithstanding so well, that in five or six days he was perfectly recovered. If this Remedy had been delayed twenty four hours longer, or that it had not worked within twenty four hours, the King's Recovery had been absolutely desperate. This Relation was taken out of the History of the Treaty of Peace Concluded on the Frontiers of Spain and France, Anno 1659. Diseases, says Böetius, are Cured by the Egyptians, either with Fasting or Vomits every, or every third or fourth day; for say they, All Diseases proceed from Superfluity of Diet, therefore that is like to be the best restorer of Health which takes away the Principles of Diseases. Sydenham, quoted by Bonetus in the English Translation, fol. 159. Sect. 13, 14; intimates, That if he were permitted, he would give Vomits in the beginning of all Fevers and Dropsies. Vncerus in Answer to Objections, in Chap. 14. Book I. of the Stone, asserts, That Vomits do not weaken the Stomach, unless irregularly given; but on the contrary, strengthen it, by carrying off the Humours that infest it. That Vomits are given in Vomitings to root out Choler the sooner. That Vomitings in the Stone are not to be hindered, but furthered. That Vomits have been extremely helpful in the Stone. That whatsoever removes the Cause of Diseases, and cleanseth the Stomach of the tartarous Matter, is useful in the Stone; which Vomits do. That Vomits take off all Humours, prevent the Stone, and Cure it; and may as well be given for it as Purges; which none scruple. All which he strengthens by Quotations out of divers eminent Authors in the following 15th. Chap. To which again he briefly subjoins his own Opinion. Willis, pag. 26, & 27 of his Rational Pharmacy, saith, That as the Operation by Vomit is more violent than by Stool; so in most Distempers, where 'tis with Judgement directed, it doth more good than ten Purges. For by this the heavy Phlegm, untouched by Purges, is removed; besides, the Neighbouring Parts are cleansed: So that Obstructions there made, and Stagnation of Humours in the Blood, are easily helped, Preternatural Ferments, and deeply rooted Diseases can by no other means be removed; epecially of the Brain and Nervs. Then giving an Account how they work: He concludes, That most desperate Diseases are best Cured by Vomits, and hardly without them. Berniers, a French Author of the Memoirs of the Empire of Mogul, pag. 170, in his Voyage of Rachimire, speaks thus in commendation of Vomits: By opening of the Plague-Sore, I was myself soon Infected; so that had I not forthwith taken some Butter of Antimony, I might have been as well as others an Example of the little certainty there is of the Plague after the Dew: But this Emetic Medicine in the beginning of the Evil, did Wonders, and I kept but three or four days within doors. Hypocrates and Fernelius are both quoted to this purpose in the Pharmacopeia Augustana. Hypocrates in the 17, & 18 Aphorism of the fourth Book, directed a Vomit to all such as, having no Fever, complain of loss of Appetite, Gnawing at the Stomach, dark, melancholy Vertigoes or Fumes, or Bitterness in the Mouth: and also to Purge by Vomit, when ever Pains and Illness arise above the Diaphragma; and by Stool when below. And Fernelius in the 3d. Chap. of the 3d. Book of his Methodus Medendi, speaking of Vomits, says, That they are most effectual, and best of all Purges, where moderate and easy; for they draw forth, and empty the true hurtful Humours, and chief cleanse all the Filth which hangs in the Capacity and Tunicles of the Stomach, and expel out of the Membranes of the Praecordia, the hollow of the Spleen and Liver, and the Pancreas, the sincere superfluous Humour of all sorts, which for the most part, neither Hiera, nor any other strong Medicine, though often repeated, can move in the Belly; for the Passages are shorter & readier out of those parts into the Stomach than into the Belly; which makes Vomiting easy. And although at first it only dischargeth the Inward Parts, yet consequently it easeth the Head and the rest of the Body. Wherefore it helps all Diseases arising from the Impurity of the Praecordia, as, Languishing Appetite, Reaching to Vomit, Loathing of Food, Frequent Vomitings, Distension of the Stomach and Praecordia, Jaundice, and Green Sickness, Intermitting-Feavers, Headache, Vertigoes, Night-Mares, Falling-Sickness, Suffusion, and all Diseases of the Head, contracted by the Sympathy of the Praecordia, and brought forth by the Impurities of the same, thrown off upon the rest of the Body; in short therefore, in every Disease, where a languishing Appetite and desire of Vomiting, troubles the Patient, and Purges do not, Vomits must Cure; for what Purges cannot wash away, Vomits root out; and what descends not easily from those Parts into the Bowels, readily returns into the Stomach. I choose to make the Quotations entire, though they serve to confirm several of my Positions; which the Judicious Reader may easily apply. The Reasons therefore why Vomits are so much laid aside, are first, they Cure too soon for some Physician's Advantage, and by their seeming Violence in Operation disgust the Patients; who being for the most part short sighted, choose to avoid a present Trouble though to their future prejudice, rather than endure it for Recovery of Health, or saving Life, as the Author of the History of Venice formerly cited, takes notice, pag. 262, of the Feebleness and Ignorance of Mankind, who not regarding the Future, choose rather to lose all afterward than at present to part with any thing, though for the safety of the rest; like those obstinate Persons, who rather run the hazard of a Gangraene than endure the Pain of an inconsiderable Incision. 2dly. When they are given, and Patients die after, either by the Malignity of the Disease, or great Progress it had made, or the Patient's unwillingness to repeat them as oft as necessary for mastering any desperate Distemper, they usually have the ill luck to bear the blame; whereas the Disease is generally and truly accused, when insignificant and comfortable Cordials are given without them, though probably the Disease had not got the Victory, if Vomits had been duly prescribed; nor is it difficult to prove, that fewer die by some hundreds, if not thousands, after Vomits, than after those Comfortable Cordials. If that therefore were a good Exception, it lies stronger against Cordials. So that the Patient's Humour or Inclination concurs here with the physician's Interest, not to shorten the Cure by Vomits, but to multiply Fees by protracting it with Cordials: to the great discouragement of Honesty and Skill, which neither pleaseth the Patient, nor enriches the Possessor. Much to this purpose speaks the aforesaid Author of the Venetian History, pag. 263. That Ill Counsels are most acceptable, and Good not only rejected, but heard with Indignation. And Riverius also in the 9th. Obser. of the second Cent. complains, that Physicians are under a kind of Necessity to forbear doing their Patients good, to please them: in these words: The Malepertness of our Women imputing every unhappy Success to the Remedies, makes the more prudent Physicians, for fear of Calumny, to abstain from the Use of the best Medicine. Some offer a seeming great Objection, That Vomits are exceeding dangerous, because of their Violent Operation: Not considering they work the more upon the peccant Humour, nor remembering the ill Consequence of Delay. Where gentle means lead as certainly to the same end, violent are not pleaded for; but where violent will, and gentle will not, they ought to be preferred: for which is most eligible, to be one of the nineteen that escape of 20 that leap overboard when a Ship is on fire, or stay behind with five hundred that dread the present danger of Drowning, and are certainly in a few minutes after destroyed with the Ship by fire. But this Object. against Vomits may easily be removed; for the Violence of their Operation is but remotely the effect of the Medicine, it being the natural and immediate consequence of the Motion of the Morbific Matter, and aught as patiently to be born as Labour when a Women is with Child, the Periodick Vomiting Motions being no other than the Periodick Throws in Labour, for the Expulsion of what Nature desires to be freed from, the Reasons being the same, Viz. Irritation, from the uneasiness by the increase of new useless Matter: Time for Nature's recovery of strength between every Throw or Vomiting: and the trouble of compressing and squeezing out by the expulsive Faculty; and this is no new conceit, for Fernelius in the 3d. Chap. of his 3d. Book of his Rationes Medendi useth the same Comparison. Even as the Womb in Labour, with collected strength from all parts, contracts itself closely to the upper parts whereby it may bring forth the Birth: So also the Stomach tired with the Injury of things offensive, by compressing the bottom is by force wholly moved upwards, throwing out all that is offensive by Vomit. This is the most manifest of all natural Motions, by which the Stomach also springing from its proper place, puts a Force upon the neighbouring Parts to which 'tis fastened, whence ariseth the difficulty and violence in Vomiting, though to some more, some less. And it may further be observed, that Persons are as sick, when by a Surfeit, Great Belly, Giddiness, or Sea-Voyage they vomit bitter or sour Choler, melancholy or tough Phlegm, as when they take a Shop-Vomit, or drink large quantities of Lukewarm Water, or Posset-Drink, or (as they are called) the milder Vomits such as Groundsel, or Carduus, provided they eradicate the same Matter; and upon taking a Vomit, if that Matter be not brought up or stirred by reason of a Congeries of other more easily moved and in the way, or that there is but a small Quantity to be removed, the Patient shall be no more sick than when he drinks so much Wine or Water, which for illustration sake, may be plainly proved by the different Working of three of the very same Vomits for substance and measure in the same Person within a few days one after the other: For Instance; the first spending itself upon a large quantity of serous Matter, and some tough Phlegm, gripes but little, and causes no great Sickness. The 2d. penetrating deeper, and finding little or none of the first Humour to take off its edge, by pumping out the green and yellow Matter, causes Gripes, great Sickness, Faintness, cold Sweats, and almost Convulsions; which is no otherwise than when the same stuff is cast off by Nature without a Vomit. The 3d. Vomit again shall hardly work at all, most of both sorts of the Morbific Matter being removed by the two former, and consequently it causeth little or no Sickness. So that this violence only proceeds from removing the Disease (not to be avoided, if willing to be rid of the same) it not being the immediate effect of the Vomit, for than 'twould always accompany it; which by Experience is found otherwise. But in truth, a Vomit enables Nature to separate and squeeze out those Humours which are imcompatible with, and Preternatural to it, and that Expulsion being the Work of Nature, is the true Cause of that Pain and Sickness. And for that Reason there is no more danger in this Artificial than in a Preternatural or Spontaneous Vomiting, which, or some other effectual Evacuation, must either be endured together, or divided, or the Disease must continue, unless by a present quieting Medicine, a Foundation for future Chronical Distempers, be laid; for Preternatural Humours, once in the Body, if not ejected, will make their way to one part or other, especially to the weak, if any such, they being altogether incapable of ever after being made useful to the Body. A Second Objection often brought against their use is, That Nature never made the Stomach for Discharge of Excrements upwards. To which, an Answer may be given, not much unlike one more witty than true, of Sir Francis Pruiyan in another Case to a Gentleman reproaching him for using Foreign Drugs, when sufficient were produced at home, according to the common Saying, That every Country is furnished with necessary Medicines for the Diseases of the Place which he acknowledged: but withal told him, That if he went beyond Sea for Food, as Wine and Spice, he must do the like for Physic. And so in this Case the Fundament and other usual Vents are sufficient for discharge of Natural Excrements when the Party is in Health; but if by Plenty, Luxury, and Laziness Preternatural Excrementitious Humours are collected to disease Mankind, new ways for their Discharge must likewise be invented, and this Nature directs. Furthermore, divers Excrements are naturally voided upwards by Nose and Mouth, and these sort of Humours can seldom or never be carried away by Stool, nor are they the same that naturally pass that way; but I presume no Salivator will stiffly maintain this Objection. A Third Objection is, That granting Vomits to be more powerful than other Remedies, yet 'tis inexcusable to give them upon every slight occasion. Which truly seems plausible till 'tis considered, That Diseases are not always safely to be trusted, because divers at first have appeared mild, which too late have been discovered to be dangerous and malignant, and an opportunity lost may be a Life lost: but no other use of them is pleaded for, except where Nature directs; or when in all likelihood most safe, and where no other Inconvenience can thereby happen, but a speedier Cure. A short Appendix of PRACTICE. PReserve your Health by Temperance in Meat and Drink, Convenient Rest and Labour, Sleeping and Watching, Excretion and Retention, good Air, and moderate Passions, especially Grief, Anger, etc. But when, by the Abuse of any of these Nonnaturals, Health is impaired, Recover it by proper Evacuation, as before mentioned, and the occasional Use of Hypnoticks. Begin to apply your Remedies immediately after you find yourself disordered, for Delays breed danger, Quod hodie non fit, cras minus aptus erit; Principijs obsta, post est occasio calva. Therefore, as oft as ye are Bound, take a Lenient Clyster, or some gentle Purge, except there were any probable Appearance of Plague, Smallpox, or the like Pestilential Distempers, and then a Suppository, as a Violet Comfit, or Candles Ends may be best. At all times when your Appetite is lost or dulled, a Loathing, Vomiting, Sickness or Pain at your Stomach attends you, than Vomits are the best Remedies, though cathartics may sometimes recover you, when the Inconvenience is not great. And then take a Vomit, drinking Possit-Drink, thin Broth, or Lukewarm water during the Working, and repeat it two or three days together; if your Stomach continues disordered, the Fever Violent, or intermitting; giving it then just before the Fits. After the working of Vomits, or strong Purgers, and where Sleep is wanting, take a quieting Remedy for Sleep. In all Fevers, after convenient Purging and Vomiting; and wherever Sweeting is necessary to remove Pains, Soreness, or Weariness, take a Sweeting Remedy. Bleeding is good in all Fevers (Plague, Smallpox, Measles, Spotted, or Malignant Fevers excepted) in all Pains of the Head or Limbs, Pleurisy, Running Pains, in Fullness of Blood, in Youth, in all Coughs, and Inflammation of any Part; but 'tis not only more advantageous in one Part than another, but also more prejudicial when taken out of a wrong place. Whensoever you happen to have any Stoppage of Urine by Stone, Gravel, Colic, or otherwise, make use of Diuretics, Clysters, and the other Remedies, provided there be Indications. For the Itch, Purge, and wash the place with Tobacco Stalks boiled in Beer, or Urine: or anoint with Olium Laurium with Brimstone, or powdered Ginger. For Boils, Swell, or other Breaking's out, apply Poultices, or Drawing and Ripening Plasters to break or discuss them, or a Caustick; and, if they are not malignant, or that they are in a Part to which either you cannot at all, or not conveniently make an outward Application, then Purge or Flux. Never leave a Disease till the Disease quits the Patient, for that gives it but time to recover: The weaker the Patient, the stronger and speedier ought the Remedy to be, because there is no time to lose; and the stronger the Remedy, if not beyond Reason, the quicker will the Patient recover strength, and much sooner than no Remedy, or but a weak one. Here followeth a Short Direction, formerly designed for the English Army in Flanders. THe Poverty and Discontents of the ruined Inhabitants in Flanders. The Intemperance, and thence the frequent Indigences of the Soldiers, whence their Troubles of Mind. The Change of Air and Diet, the want of Shifts, and their uncleanliness. The straightness and illness of their Lodging. The want of due Exercise, most of them having been Labouring Men, Are sufficient Causes to produce Camp-Diseases, which the unseasonable heat of the Air actuates into Malignant, and then is easily communicated by Contagion to such as converss with them, whose Bodies are thereto predisposed. For which, the Remedies are, First, To Preserve the Sound, indicated by the Causes: And, Secondly, To Cure the Sick. To which purpose the Peccant Matter and Humours (being thus produced in the Body, and not possible to be reduced to their Pristine State) must therefore be carried off. To effect which, the usual and most approved ways are by Antidotes, and Alexipharmicks, which sometimes by Urine, and most by Sweat, discharge the Body of that Enemy; but because they may be slow and uncertain in their Operation, and that oft times there are other Indications; Therefore as soon as taken ill (after a Clyster is administered, if Costive) order a Vomit, which may the next day without danger be repeated, if there be Indications for it. The Night after the Vomit, an Alexipharmacal Medicine, mixed with Hypnoticks, will prevent all ill Symptoms. Afterwards Purge but if Matter be cast forth by the common Emunctories or Habit of the Body; then Drawing-Plasters to the Boils, and Sudorificks inwardly, with Blisters and Applications to the Feet, perform the whole Cure. Of the Jesuits Powder. ACcording to my promise in the Preface, I think myself obliged to offer some of my Exceptions against the present unreasonable, and too frequent use of the Cortex Patrum, or Peruviana, commonly called the Jesuits Powder, and therefore (without repeating the Description of the Plant, the Place whence 'twas brought, the time when first Imported into Europe, the manner how the Virtues thereof were first discovered, with other particulars relating to the same, which have been already at large treated upon by divers Authors; to which I refer my Reader) my Province shall be to take notice of some of the Reasons which have induced many Physicians to make it so general a Febrifuge, and now almost a Panpharmacon; and then modestly to propose to the consideration of the Impartial and Judicious Reader what makes me descent from the Practice of so many Learned and Eminent Professors. The principal Motives I presume, are the original Recommendations from abroad: Talbor's Blind and General Applicatlon; together with the sudden and surprising success they suppose immediately follows the Exhibition of the Cortex, whereby, the Fit is soon interrupted, and the Patient pleased with a seeming and sudden Recovery, whereby many to my knowledge are obliged to tedious Courses of the Cortex, even six times longer than was expected for the Cure, and; which often f●i●ing hath been at last effected by by quite other Methods; of which may be given divers Instances, but that every day will furnish faithful Inquirers with plenty of Examples. To proceed therefore, please to observe, That 'tis on all hands agreed, that the Essential and manifest Quality of the said Bark is Styptic or Astringent. Yet at the same time, such as do not rely upon any occult Quality, will have it endued with a Property to open, empty, and remove the morbific Cause by some unintelligible, invisible, and let me add, preposterous manner of working. That it hath the Binding Quality, besides the foresaid acknowledgements, is manifest by the Retention of the Morbific Matter in the Body, which appears to be so from its being let lose and returning to its old Course as soon as, or in a few days after a Purging Medicine operates upon the Patient, which (had it been evacuated, as those Gent. would have it) could not possibly be brought back again into the Body by a Purge or Vomit. His late Majesty, to justify the supposed Skill of the deceased, and according to the Proverb, fortunate Knight Sir R. T. was pleased to offer as a Trial of Skill to the Physicians, that Persons cured by the said Knt. with the Jesuits Powder, should by taking a Purge, be again reduced to their pristine state for the Physicians to employ their best Endeavours to help them if they could. This was a sufficient concession that the Foams still remained in the Body, and only by the quieting or styptic Quality of the Cortex was hindered from exerting (for the present) its peccant Motions. For what can else be the Cause of the almost certain Return of the Ague after three weeks or a Month, but that the force of the Medicine being spent, the Cause of the Ague will no longer obey, but attacques the Patient afresh. And if by chance the Ague appears not so soon nor in its proper Colours, yet what reason can be given, that at least two in three that have taken any quantity of it, after the Expiration of three or four Months, are infallibly troubled with a Shortness of Breath, loss of Appetite, a Hectic Rheumatisme, Colic, Jaundice, Scurvy, etc. or suffer a severe Augmentation of such Distempers, to which they were formerly subject, whereby it becomes almost Habitual, and oft times destructive to the Life of at least one in five that had the misfortune to be therewith treated. 'Tis confessed, that it often cheques the Fit of an Intermitting Fever, and that frequent Repetitions of the same may so disguise the Distemper as the Patient may believe himself Cured, when alas the best is but a truce, and though it may never return in the same shape, yet it seldom gives over haunting the Patient in different Manners, which occasions many to make most grievious Complaints of their want of Health, Suffocations, or other Maladies, as abovesaid, that infest them as bad, or worse than their Ague: So that it may be said, that the Jesuits Powder cures the Ague, but at the same time destroys the Patient. Which Dr. Willis seems to allow in an other Case, pag. 19 of the London Practice of Physic, where he concludes the Cause of divers ill Symptoms of the Brain and Nerves to proceed from the inward restraint of the malignant Matter driven thither by the means of Opium, or the like Astringent. Nevertheless as often as the Looseness and Vomiting returned, those affects were presently appeased. To prove this further, consider that 'tis generally owned, that the Cortex hath no Opening, but as already intimated, a Binding and Astringent Quality, now unless it had withal a Transmuting Quality, to change the Morbific Matter into Nutritive, I cannot see how possibly the Patient can be safe, and that there is no such Transmutation, appears by the frequent return of the Distemper after a few Weeks, especially upon the giving a Purge: whereby 'tis evident, that the Matter was not only damned up in the Mass of Blood, though the motion of it was suppressed by the Cortex, but that it still remained the same useless peccant Matter as before, why else should it many times return in the same shape; indeed if by frequent and continued repetition of the Cortex, the Disease happens to be a long time imprisoned in the Body, and that Nature wants power sufficient to expel it, 'tis possible by the acquisition of fresh Matter, or the tendency of it to another part, some new Phenomina may arise, very different f●om the old, but no less grievous; which therefore deludes the Patient out of a suspicion of its being a Brat of the former Ague. But let us now suppose that this Jesuits Powder should infallibly cure the Fit of an Ague in all Persons, as they say it doth in most, yet so long as it appears by experience that it only prevents the Accidents, leaving the Cause untouched, the Patient is certainly more endangered, for the Fits not being the Disease, but caused by the Motion of the Disease in order to a natural Discharge: wherein then lies the Excellency of this Medicine? The Author of Sir R. 't's. Wonderful Secret, or English Remedy, doth Learnedly Philosophise against all Sense and Reason, as in page 17, etc. where he will not allow that the Binding, Styptic Quality doth retain the Morbific Matter in the Body, but by riveting (as his words are) the Homogeneous parts of the Blood, separates them from the Heterogeneous, whereby it facilitates the Expulsion. Can this Chimara be granted, how comes an expelling Medicine to destroy the effect of the Cortex, which if so, would really help it? To what end doth his Medicine separate, if Nature cannot, Art must not discharge? Nay, in pag. 20. he asserts, that the principal action of the Cortex is directly opposite to that of Evacuations, and thereby endeavours to confute the Opinion of the Author of the Additions to Schroderus, who imagines that it operates by Precipitation: notwithstanding, quickly forgetting himself in finding fault with La Merry, he changeth his Opinion, pag. 26. and confesseth that the Febrifick Matter remains (after the proper parts of the Blood are reunited) confounded in the superfluous Serosity wherewith 'tis evacuated, either by Transpiration or Urine. Truly the Discoveries of the Properties of this Remedy would have been no great loss to the World, if they had still remained concealed under the occult Quality, for the Explanations seem to me Riddles and Paradoxes, it Opens and Binds, and Binds and Opens, and both, and neither, ignotum per ignotius. But 'tis no wonder it should be so, when Authors writ more to support Opinions and maintain indulged Notions than to discover Truth, and study more what will please, than what may guide and instruct. For certainly, if they would have had more Patience, instead of an Ambition to appear in Print, and had made some more diligent Observations upon the Exhibition of the Cortex, they could never have been guilty of so great a mischief, as blindly to recommend a Drugg so highly prejudicial and destructive to Life and Health as this hath since proved, whether by abuse of it or otherwise, I will not now dispute. If any curious Observer will but please to reflect a little on the Weekly Bills of Mortality, since the frequent use of the Cortex, he'll assuredly find not a single Corpse less in number than before, 'tis well if not many increased; for there are certainly more colics, Apoplexes, Suffocations; Rheumatismes in abundance, Hectics, etc. than formerly, which were impossible if it answered the commendation of some, and the expectation of others, for if we have no fewer People of the same number of Inhabitants die, but more painful and tormenting Diseases increase than before its use, what is the Benefit accrues thereby? The Observations other Physicians have met with, I hope will in time wean them from the use of this Drugg, for they may find the same as I do. If there be any true way to discover the Virtues and Usefulness of Remedies but by Experience, I must confess my Ignorance, for I know no other. Scarce a Patient comes to me that hath not just cause to complain of the Cortex by reason of some Chronical Distemper or other, which ever since the use of the Bark hath afflicted them. If what I have in the former part laid down as a certain Rule (that no Disease was ever cured without Evacuation) be true, than I think it cannot reasonably be long controverted whether a styptic Remedy is fit to be applied for the complete Cure of an Ague, which none will deny to proceed from Heterogeneous and preternatural Humours; and I believe few can prove those Humours ever after converted into Homogeneous and Natural; and if so, the natural Indication is Evacuation. Can this Powder be more effectual than the Method I have in general proposed, or indeed any other, or did it perform what they say it doth, leaving no deadly poison behind it, than would I as hearty embrace it; but since other Methods are experimentally seen to be more safe, certain and useful, it ought to be exploded as a common Enemy to Mankind; witness the untimely Death of divers of our Nobility, Gentry and Commonalty, so notorious, that I forbear to name them. I shall leave these my thoughts to the Scrutiny of any Candid Person, for my part I do not see how Practice can support it, or Theory encourage it. It may not be amiss here to insert an Observation of the Cortex, communicated by a Person of great Worth and Experience in Chemistry; That a convenient Quantity of the same being thrown into Wort after Yeast is added to cause it to work, or any other Liquor upon Fermenting, the Fermentation shall immediately be interrupted, and the Liquor rendered vapid, useless, and totally destroyed. POSTSCRIPT. AFter this Small Treatise was Finished and Composed by the Printer, there remained four blank Pages to complete the Sheet, which gave me opportunity to make some Amendments, and to fill up the rest with a few scattered Remarks and Observations. Wherefore the Reader may please to take notice that in Translating the Quotations out of the Latin, I followed as near as I could the Phrase and Style of my Authors, without endeavouring to mend it where it was significant. And further, that having had the good fortune, since the Printing the 21st. page, of Mr. Bernier's Acquaintance, whose Curiosity brought him to visit this Kingdom, and see the Coronation: I look upon myself obliged to acknowledge my Error in naming a Person of his great Merit and Reputation in Europe with no more Respect, besides the Honour he had in being Physician to the Great Mogul in the strange Revolution of that Rich and Mighty Empire. For Observations take this taste. A Hackney Coachman in Hedge-Lane having used the Cortex a whole Month in an Intermitting Fever upon a Promise of being by it recovered without Purge or Vomit in three or four days. And being in that time reduced to a very weak Condition, besides an Addition of dangerous Symptoms, was by a contrary Method in less than a Fortnight much relieved, and in a very short time after restored to perfect Health. A Young Gentlewoman having been six Month afflicted with a Quartane, notwithstanding the frequent Use of the Cortex, was in less than a Week perfectly Cured by a Purging Course. Many more to the same Purpose may be added, but that I am not willing to enlarge at present; but if this small Trifle comes hereafter to be Published, 'tis very possible it may receive an Augmentation by some Remarkable Observations in divers Diseases. ERRATA. PAge 8. l. 18. r. the Roots or Fountains of all Diseases. p. 16. l. 10. r. Caution. l. 11. place a comma after Distempers. p. 17. l. 2. after and r. for. l. 10. deal most. p. 18. l. 26. r. who for he. p. 19 l. 22. r. Böetius With two tittles. l. 23. deal s in fasting. p. 21. l. 9 r. deep rooted. l. 11. r. Nerves. FINIS.