A TREATISE OF THE ASTHMA. Divided into Four Parts. In the First is given A History of the Fits, and the Symptoms preceding them. In the Second, The Cacochymia which disposes to the Fit, and the Rarefaction of the Spirits which produces it, are described. In the Third, The Accidental Causes of the Fit, and the Symptomatic Asthmas are observed. In the Fourth, The Cure of the Asthma Fit, and the Method of Preventing it is proposed. To which is annexed a Digression about the several Species of Acids distinguished by their Tastes. And 'tis observed how far they were thought Convenient or Injurious in general Practice by the Old Writers, and most particularly in relation to the Cure of the Asthma. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Galen. LONDON, Printed for Richard Wilkin, at the King's-Head in St. Paul's Churchyard. 1698. TO THE Learned and Judicious Physician, Dr. PHINEAS FOWKE, AT Wyrly in Staffordshire. SIR, I Have many Reasons for my Dedication of the following Treatise to yourself: The particular Favours you have showed me, have deserved a greater Acknowledgement, than this small Present I make you, as a Testimony of my Gratitude; but in this Undertaking I shall Appeal to you, who are well read both in the Ancient and Modern Authors, as the most Candid and Learned Judge, concerning their Old Notions, and Practice in the Asthma, which I shall here prefer, for their usefulness to all the Moderns that have Writ on that Subject. Sir, I think myself so much obliged to those Learned old Authors you lent me, from that Large and Curious Collection in your own Study, that I cannot but here own the Benefit I received by Reading of them, and following their Method of Practice on myself and others; I hope this will be a sufficient Excuse for my endeavouring to justify their Notions, and Explaining of them, and for the Recommendation I shall give of their Medicines. Sir, I here present you with your own old Authors, dressed up in the present new Philosophy, for that changes its Fashion in every Age; for it would not now appear Modish to express themselves in the Aristotelian way, but as to their sensible Observations, and useful Methods of Practice, they will last for ever, as being true Descriptions of Natural Things, and confirmed by frequent Observation and Experiments. My Design is not in this Dedication to Compliment your Philosophic way of Living, your Universal Learning, nor Greatness of Mind in retiring from all the Pleasures, and Impertinent Business of Life, that you might more freely converse with your Learned Authors; Thou these are sufficient Subjects for a large Encomium, I must confess myself unfit for well performing of it; neither would your great Humility admit of a just Praise of your Virtues. I know your Curious Genius requires some Variety of Thoughts to divert it, or some Philosophic Enquiry to entertain it, for which end I will here propose my following Observations, by which you will discern the design of this Treatise, and the good Performance of the Old, and the Faults of the New Writers, in treating of the Asthma. First, I shall observe that that is the most useful Notion of the Asthma, from whence we can take our Indications for Practice, and which is deduced from an exact and full sensible History of the Disease, its Subject, Causes, and Symptoms. I have assigned the immediate Cause of the Asthma, to the Sraitness, Compression, or Constriction of the Bronchia; and in the continued Asthma, the Causes must be constant, as Dropsy, Tuberculum, etc. but in the Periodic Asthma, the Returns must depend on the Defluxion of Humours on the Primae viae, where the Inflations begin, or on the Lungs and Nerves, if either were formerly weakened by other Diseases; these Hypochondriac, or Pneumonic, or Nervous Inflations, depend all on the same Defluxion of Serum; and they all frequently hap in old Asthmatics at the same time. This Defluxion of Serum evidently appears in lose Stools, fluxes of Urine, great Spitting, and the Drowsiness of the Head in the beginning of the Asthma Fit: This Defluxion depends on the Effervescence of Humours, because there is a feverish Heat at that time, which rarefies the Serum, and drives it through th● Glands'. I think it not probable that the Nerves could contain so much Serum, but rather that the slimy and flatulent Cacochymia irritates the Heart to stronger Pulsation, and Excretion of those Humours, as the bilious Contents do irritate the Guts. For when we found Excrementitious Humours evacuated, we may rationally suppose that their Vellication produced their Excretion, rather than any preternatural Faults of Spirits. The Cacochymia which irritates, we observe by the Windiness and Sliminess of Humours evacuated. This Inflation in the Stomach, the Effervescence in the Blood, and Inflation in the Pneumonic Membranes, comprehend the large Nature of this Disease; and contrary to these our Practical Notions must aim, by suppressing the Effervescence, which Cures the Defluxion at the same time; and than the flatulent and slimy Cacochymia must be Evacuated and Corrected. If the Asthma be but partially described, and a false Hypothesis built on that Description, the Practice answering that is very Impertinent, or injurious. Thou the old Notion of the Asthmas being a Defluxion of serous Humours, was certainly true, because evident to our Senses, by the Evacuation of Serosities; yet the Explication of that Defluxion, by comparing the Head to a Cupping-Glass, which draws up Humidities by its Heat, and causes them after to descend on the Lungs, was notoriously false, and contrary to the Structure of the solid Parts, and the Circulation of the Fluids. This fanciful Notion occasioned much impertinent Practice, by Fumes, Errhines, Apophlegmatisms, Plasters to the Head, and Issues, which have all fallen with the Hypothesis they risen from. These Old Writers neglected the Effervescence, and the Nervous Inflations I have mentioned. The Age succeeding observed a great Viscidity in the Humours of the Lungs, and to that alone, they impute this Stertorous Wheesing; these endeavoured to Cure this Viscidity and the Tubercula, by prodigious pectoral Antidotes, made for the Asthma, but still they neglected the Effervescence, and nervous Inflations, and therefore had no success. The Later Writers, as Van Helmont, and Dr. Willis, have most particularly described the nervous Symptoms of the Asthma, and built their Hypothesis on the supposition, that 'tis a Convulsion; and that what Cures that will relieve the Asthma: This false Hypothesis led them into an injurious Practice, by giving hot Tinctures, acrid Gums, and volatile Salts, and sulphur Medicines. Some Writers, as Silvius, and Etmuller, have observed the Hypochondriac Symptoms in the Stomach, and conclude the Asthma is a Hypochondriacal Flatus, and wants Digestives. By these Observations I design to prove, that all our Practical Notions and Indications aught to be taken from all the sensible Observations in a Disease, and than we shall avoid the several Errors into which many Learned Hypotheses lead us▪ and than our Practice will always be the same, though the general Philosophy, by which we explain our Notions, altars with the Age. The old sensible Cacochymias must still be allowed, and the Method of Curing them by contrary Tastes, because very rational; therefore though the Circulation of the Blood be lately discovered, and the Circulation of the Serum through the Lymphatic Vessels, yet these Discoveries have made but little Alterations in the Practice of Physic, but by that we can bette● explain the Motion of Humours, and the Translation of Diseases from one Part to another; therefore this Discovery has only helped us to solve some Difficulties we knew not before, and to give Reasons for them: Yet still this is the chief Scope of our Practice, to Evacuate the Quantity, and Correct the ill Quality of the Cacochymia's anciently described; and we must use the same Medicines as the old Writers advice. The Nervous Juice is still as much unknown as formerly, and therefore its Affections are inexplicable; and though it still be a Dispute whether the Motion of the Heart in a Fever be by an Irritation of the fermenting Blood, or the disordered Spirits, yet it will be the same thing as to Practise; for by which soever of them the Rarefaction happens in the Asthma, I must levelly my Method against the Effervescence, if I will cure the Fit or prevent it. If I compare our Bodies to a Watch, and the Spirits to the Spring of it, because on that all its Motions depend, as also on the Spirits in an Animal Body, as in the Watch: The reason of its going false, may be the fault of the Wheels, or many other Contrivances; and as it would be absurd, when the Watch is out of Order, to lay all the faults on the Spring, because on that depends all its false as well as regular Motion; so it is in our Bodies, tho' the Spirits produce all the regular and irregular Motions, yet, as in the Watch, the irregularity must depend on other Organs ill constituted, so in the Body the Lungs being oppressed, the regular Respiration becomes a Dyspnaea; if the Bronchia be constringed, an Asthma; if any extraordinary thing or Fume affect the Skin of the Eyes, Tears immediately flow, and the Saliva runs upon any Acrimony which irritates the Palate. The same Motions which are expected in the Nerves by external Objects, are produced by sharp Acrimony in the Humours, which, if bilious in the Stomach, excite Vomiting and Purging in the Cholera. If the Humours ferment in the Veins, they irritate the Heart to a violent Circulation, which raises the Fever, which lasts only till the Fermentation ceases; but in those Fevers which depend on the disordered Spirits, they are but of small continuance. And we must observe that the Animal Spirits rise from the Blood, and have both their Origine, and good or ill Temper thence; and tho' they move the Fluids, yet that external Motion only helps and promotes the intestine Motion of the Humours (as Beer and Wines are promoted in their depuration, by being carried on Shipboard.) If the Spirits should circulate Water through the Veins (and the Hydropical Serum is not much different) neither Blood nor a true natural Heat would arise in the Water by Ten thousand Circulations; by which we found we must look back to the old Cacochymias, to explain the Nature of Humours, and the Diseases, and in the Asthma we must retain the Flatulencies anciently observed, and the Defluxion of Serum both on the Guts, the Lungs and Brains. The Dulness and Drowsiness of the Head, is a sign of a Defluxion through the Nerves in Hysteric Cases, as well as the Flux of Urine in them; but for satisfying the Helmontians, I will confess the Hysteric Asthma has no Defluxion through the Glands' of the Lungs, till it is an old Disease; but the Serum in this only makes its Defluxion through the Glands' in the Stomach, and Guts, and Brain; there is the same Effervescencies, the same Flatulencies, and consequently the same Cacochymias in these, as in the Spitting Asthma. If I should describe only the Nature of Spirits in Wine, all Persons would believe I talked like a Philosopher, but not much to Edify any one, who only from the Taste of the Wine can best describe its Nature, whether sweet, rough, or sharp, or bitterish; and when it is vitiated, 'tis flat, or waterish, sour, roapy, windy, bitter, fetid, full of Leeses, and Ferments; these are all sensible Vices in Wines, and the same in Animal Humours we call our Cacochymias. And as the Vintners can Cure all their Wines by particular Tastes, without being versed in the Mechanic, Chemical, or Microscopical Observations about Wines; so may Physicians both understand, and cure Diseases by a rational Use of sensible Observations, and the old Galenical Practices built on them, may yet stand unmoved. It is a very short way of Explaining Diseases, to tell us, that the Spirits, or Archaeus, are either weak, or strong; in a fury, or stupid: This Philosophy is much admired, tho' not understood either by Plebeians, or Philosophers, who aught to admit nothing either in Diseases or Medicines, but sensible Observations, and those Notions which are immediately deduced from them. These we can be certain of, and on these the Galenists built their Practice, and these two sensible Observations will always stand good; 1. That the Asthma is a Defluxion. 2. That all Medicines in the Asthma aught to be inciding without Heat. The Invention of the Microscope has much discovered the sensible Mechanism of the solid Parts; but what Indication can I take from the Globuli of the Fluid? Thou they may help me better to Explain, yet I fear I shall not be enabled by their Discovery easily to cure any Disease. All the old Notions of the Asthma grounded on sensible Observations, on which a successful Practice depends, aught still to be retained, and if it be necessary they may be better explained. So in the Asthma, we observe there is a Defluxion of Serosities, and for this Vomits and Purgers were successfully used by the Ancients; therefore the new Writers unjustly explode that sensible Notion, because ill explained. In this case we must mend the Explication of a Defluxion, and not search for the Fountain of Rheum in the Head, but in the Blood, and allow the Nerves to be the Instruments of the Defluxion. If it were possible for us to discern all the Mechanical Structures of the solid Parts, and all the Motions and Figures of the Fluid, we might than that way explain all our Diseases; but since that will always be impossible to our dull Senses, 'tis not fair to trouble the Learned with fancied Figures and Motions, because possible: But by observing the sensible effects of Mechanic Motions, the Cacochymias, we do as much as is necessary. For from thence we take our Indications of those Remedies which will restore vitiated Humours to their natural State. The Chemists unjustly reject the Galenic Cacochymias, and explain as well as cure all Diseases by their Mineral Principles, which seems very absurd, since Minerals are of a very different Nature, and they are produced by different Digestions and Preparations. Animal Humours are made by particular Fermentations, Circulations, Secretions, in our Organised Bodies, from a pure Milk, but Minerals arise from sulphur Fumes, and stony Particles coagulated in the Earth. And all Chemical Product from them are the Effects of a violent Fire; so that by the mixtures of Chemical Medicines, we can guests but little at the diseased State of Animal Humours. I generally observe, that all pure Chemical Authors know little of Anatomy, and the Nature of Animal Humours; for Distillation altars the natural or diseased Constitutions, and therefore we cannot discover either by the Fire: The Chemists wholly depend on the extolled Virtue of their Medicine; if prepared from Antimony, or Quicksilver, it is a certain Panacea, given in all Diseases, without any Method; and the Chemists impute great Knowledge to their Medicine, in finding out the Disease, and making various Operations, or corroborating Nature, as Nature requires, all which are more absurd than any thing in the Galenic Hypothesis, and show the Ignorance of the Chemist in the nature of Medicines, and method of Practice. The Empyrical Doctors reject all our Cacochymias; they want general Philosophy, Anatomy, and Chemistry, and so cannot make any rational Notion of the Disease, from the Consideration of all its Symptoms; they know therefore nothing of any rational Method of Practice, but go on in the dull Road of Vomiting, Purging, the Cortex, Steel, Salivating, Medicinal Waters; whereas the true Rational Galenist, considers that Notion of the Disease which agrees with all the Symptoms, and prescribes such Tastes as will cure each Cacochymia; he considers the Constitution of the Patient, the Complication of Diseases, and can give a good Reason for altering the common Method, when necessary. He with his Vegetables more cures safely, than with Minerals; he makes no Preparations, but what Nature has prepared he gives, in Powder or Decoction, etc. He is Nature's Servant, and altars his Methods to serve her, and uses the only means we have to observe her, our Senses and Experience. I shall make this my last Observation, that the old Writers found out the most useful Medicines in the Asthma. There is a natural Instinct, by which all Animals found out their proper Food, and by the same Method they observe what Medicines are most suitable to their Diseases. The Stomach prepares all the Humours for the Veins, and in choosing of the Food, it naturally desires that which is like to our Humours, to nourish them; the Tongue is well pleased with those Tastes which agreed with the Stomach, because of the common Membrane which covers both. In a healthful State, the Tongue and Stomach delight in sweet Tastes, because the Blood and Saliva have that; but in a diseased State of Humours, those Tastes are most pleasant, which altar it; as when we are too hot, cool Tastes; when dry, the Humid; and e contra, Nature teaches us to Cure ourselves by contrary Tastes. And Reason and Experience tell us, that thin Humours require incrassing viscid Tastes; and the glutinous Humours, inciding Acrids; and the roughness of the solid Parts, Oily Lenients; and the flux of all Humours, Styptics. In Fevers we naturally desire Acids; and in ill Digestions, Bitters are grateful. 'Tis of no small moment in curing Diseases, that our Tastes can inform us what Medicines are agreeable to the Stomach and Humours; and our Smells inform us what Medicines are suitable to our Animal Spirits. And since the Objects of these two Senses differ only in the Tenuity of their Substances; for Bitters, Acerbs, Acrids, affect our Tastes in the form of a Liquor; but a Halitus from the same Medicines, affects our Smells; and because of this small difference, from the Virtues of the Tastes mentioned, we may easily guests at the Efficacy of those particular Smells. The old Writers observed, that the Cacochymia in the Asthma required Digestives, because of the Wind and Slime in the Stomach, and for this they used all the Wormwood Bitters, as Polium, Southernwood, Mugwort, and Wormwood itself; and all the bitter Gums, as Ammoniacum, Galbanum, etc. and Gentian, Aristolochia, Briony. The same Authors observed, that the Medicines in the Asthma must cool, as well as incide, they therefore used Vinegar, and mixed divers Bitters and Acrids with it, to make it more inciding, as Squills, Orris, Nettles; and they observed by their Tastes, that the Salso-acids, such as Niter, and Sal Armoniac, had both an inciding and cooling Quality. They observed the Flatulencies in the Asthma, and for that used the Carminatives steeped in Vinegar, and boiled many Aromatics, as Thyme, Hyssop, Calamint in Oxymels. They used Anticonvulsives, as Castor with Oxymels, and Rue mixed with Niter, in Diaspoliticum, and Briony ʒss. in a Cyathus of Vinegar. Neither did they omit the use of Opiates, but gave a Caution about them. Sir, I must have begged your Pardon for this long Letter, if I had not now presented myself as a Patient, who have the Privilege of telling the Injury received by the Modern Practisers, and of commending the best Doctors for the Asthma, Hypocrates and Galen, because I have received most Benefit by their Medicines; and I believe none is more able to defend those Fathers of our Faculty, and their rational Method of Practice, against Chemists, the Empirical, and the Mechanical Doctors, than yourself. I desire therefore, under your Patronage, to defend the old Truths and Fundamentals of our Faculty, A rational Practice, directed by sensible Notions, and confirmed by the Experience of former Ages. I am of Opinion, that most of the Diseases incurable by the Modern Practice, as the Gout, Dropsy, Epilepsy, Leprosy, were oftener cured by the old Methods, which have been disused, and neglected upon the account of pure Chemical Medicines, and new Hypotheses, recommended by great Authors; these aught to be considered, and revised by others, as I have done the Asthma. I know your great Candour will commend an Ingenious probable Hypothesis, but that your Zeal for the good of Mankind, cannot but regret the rejecting old approved and useful Notions, and experienced Medicines, because they will not agreed with a new Doctrine. I hope you will pardon my Faults, and accept this Performance with your usual Candour, and believe me, that I present it to you, as a demonstration of my being a sincere Admirer of your Judgement and Learning, and as an acknowledgement of your kind Respect to, Litchfield, May 25. 1698 Honoured Sir, Your most Obliged Humble Servant, John Floyer. TO THE READER. THE design of the following Treatise will be better understood, by giving a general Scheme of the several Causes and Species of the Asthma; but since that is a Depravation of Respiration, I think it necessary to treat first of Respiration, its natural Causes and Use, and the simple Species of it, when depraved. I shall first observe that Respiration depends on the Pulse of the Right Ventricle of the Heart, which naturally stimulates an Animal to the Reciprocal Motions of Inspiration and Expiration; for the Pulse incessantly injects Plenty of Blood through the Arteries of the Lungs, and that soon fills the Blood Vessels, and oppresses the Lungs, which pressure being felt by the Nervous Parts, and that Sense communicated to the Muscles serving Inspiration, they, by their Contraction, immediately enlarge the Cavity of the Breast, and than the Air by its Elasticity presses through the Trachea, and expands the Bladders of the Lungs. This Expansion of the Bladder does necessarily extend and stretch the Blood Vessels, which are spread upon the Convex Superficies of the Bladders, and that stretching consequently lessens their Cavities, which is also compressed by the intruding weight of the Air; therefore both by the Expansion of the Lungs, and the Compression of the Air, the Blood is driven out of the Pneumonic Vessels, and the free admittance of more Blood is hindered, during a continuance of a full Inspiration. This obliges the Animal after some Interval, by a feeling of a new Oppression from the Blood, and injected by the Pulse, and stopped in its Circulation during Inspiration, to use the Muscles designed for Expiration, which by their contraction pull down the Ribs and Sternum, and by forcing in the Belly, force the Diaphragme to go upwards into the Breast; and the Air which came into the Lungs in a state of Compression, is blown out intermixed with watery Vapours, and being much rarefied by the heat of the Blood there, it is not unlike the Artificial Wind produced in an Aeolopile half filled with Water, and heated by the Fire. This Rarefaction of the Air, makes its Efflation more easy, in Coughing, Sneezing, Speaking. If either Inspiration or Expiration be hindered, a Suffocation succeeds, which is a full stop in the Circulatien of the Blood. After Expiration the Vessels are shrunk as the Bladders be, and the Reticular Fibers of the Bladders, by closing them, express the Blood out of the Vessels; so that both a full Inspiration, and Expiration, force the Blood out of the Lungs, and during the Interval betwixt them, there is no Circulation through the Lungs, but a stop is for that short time given: And if we inject any Liquor through the Lungs of a dead Animal, it passes with difficulty; therefore the Circulation through the Lungs is more easily performed, whilst the Lungs are in continual motion of Expansion, and closing. I shall next observe, That neither Inspiration nor Expiration, are simply necessary of themselves, but the reciprocal Motion only, whereby the Bladders of the Lungs are distended, and afterwards contracted, is absolutely necessary for the prolongation of an Animal Life. If the Air were mixed with the Blood in Inspiration, that would easily appear by the Airs blowing up the Blood Vessels, as well as the Bladders, when we blow up the Lungs by a pair of Bellowss, but we found no Air to pass into the Blood Vessels; the Air therefore can only cool the Blood by its contact through the Membranes, as we feel it cools through the Skin; and for that end, when we are very hot, we desire to inspire cool Air; and it appears that Inspiration does not impress any new Matter on the Blood, because the Blood is driven out of the Lungs by Inspiration. Neither is Expiration absolutely necessary, because many Fumes expire with the Air; for those Vapours may be collected in Bartolet's Pneumatolabium; and though the quantity be considerable, yet if all that is expired in a quarter of an Hour, were retained in the Blood Vessels, the Animal could not thereby be killed, so soon as we see it dies, if the Windpipe be but accidentally stopped. Morever the Animal dies in Mr. boil's Vacuum, where there is room enough for the Expiration of Fumes. The third Observation I shall give, is, That the true Use of Respiration is for the preparing the Blood, and fresh Chyle injected into the Lungs, by the Heart, for a larger Circulation, by dividing it into smaller Parts, and Globuli, and by procuring them a more perfect mixture. The Circulation of Blood through the Lungs began after the Birth of the Foetus, when the Respiration also began, and the first was the occasion of the other. The joint Original of these Motions show, they were designed for the same end. If we consider the Blood that is injected from the Right Ventricle of the Heart, we may observe that it has a mixture of Chyle and Lympha with it; and that this reciprocal Motion of Respiration may help the mixture of these, appears, because the shaking of the Lungs, as well as the compression of the Pulse divides the Globuli of the Blood, which appears always black, before it has passed the Lungs; but it acquires a floridity afterwards, as Blood long stirred by a Stick does, by the separation of the Globuli. This change of its black colour into a florid, is all the sensible Alteration the Blood acquires by passing through the Lungs, which is best accounted for by the separation of the Globuli: For in the Feverish, the Hysterical and Maniac, the Blood is made, because of its violent Motion, very florid; but in the Melancholic, where the Globuli are coagulated together, and where the Motion is languid, the Blood appears black, as in the Veins, where the motion is slow, but 'tis florid in the Arteries. This mixture of Chyle and Blood in the Heart being imperfect, it would not be fit to be injected into the more solid Parts, and the Viscera, and to pass the Muscular Fibers, jest it should stick there. Therefore it was necessary, that this new Mass of Humours should have its first preparatory Circulation through a Part composed of Bladders and Air Vessels, which would easily yield to its Circulation. The Chylous Water being ill mixed, often sticks in the Lungs, and produces its Tubercula, and consequently Consumptions, by evacuating too much Chylous Matter. By the Blood's sudden Return to the Heart, 'tis evident, this short Circulation was only a Preparative for a larger, viz. by well mixing the new Chyle with the Blood, and by dividing both into Globuli more small, and fit for Circulation, by the compression of the Pulse, and the smallness of the Vessels it passes, and most particularly by the Compression of the Air, which forces the Blood forward in Inspiration, and the Reticular Muscles in Expiration; so that the most probable use of Respiration is, the preparing the new Blood and Chyle by a minute division, for the next Circulation through the Arteries. I will next consider the several Species of the depravations of our Respiration, and those Causes which they usually depend on. I. They depend on the preternatural State of the Blood, and immediately on the preternatural Pulsation of the Right Ventricle of the Heart. II. On the Obstruction of the Blood Vessels or Air Vessels; or else their Compression, or Constriction. III. On the Muscles designed in Respiration, to open and close the Breast; or else on the preternatural State of the Spirits, moving those Muscles. I. If the Blood be copious, fermenting, or much rarefied, the Pulse beats high, and full, and than the Lungs being much oppressed by Blood, that stimulates the Muscles by consent, to distend the Breast fully for a large Inspiration of Air to fill the Lungs, and compress the Blood Vessels, and promote the Circulation through them; and this is to be called a full, great, or long Respiration, and is a sign of hot Blood. When the quantity of Blood is small, or when its heat is moderate, the Pulse strikes low, the Lungs are not so much stimulated to a large Expansion, and therefore this Respiration is small; and as the Pulsation of the Heart declines in Vigour, so does the Respiration decrease in greatness. If the Pulse beaten quick, by the stimulation of hot fermenting Blood, than the Lungs are soon filled with Blood, and a dense or thick breathing is occasioned thereby, in which the Interval is short, and the Inspiration and Expiration follow one another quick. On the contrary, if the Pulse be slow, and the Blood be crude, the Lungs are not filled therewith of a long time, and than the Respiration is rare, and the Interval betwixt Inspiration and Expiration is long. If the Lungs be much oppressed, and stimulated by the Blood, the Respiration is performed in a short time, and that we call a quick Breath; but if the Lungs be not much oppressed, the Respiration is slow, that is, a long time in doing. Short breathing in English is used for divers of these Species, for a small Respiration, for the dense, for the quick; for all who have these may be called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Since the several Species of simple Respirations mentioned do depend on the Pulse, I may infer, that Respiration in its natural Constitution does so too; and as there is a great Analogy betwixt the Pulse and Respiration in their motion of Systole and Diastole, and the Intervals betwixt them, so they both agreed in their use; for as the Pulse, so does the Respiration help the Circulation through the Lungs, and the Separation of the Globuli, and the moulding of them to fit them for a large Circulation through the whole Habit of the Body. The Diseases of the Blood altar Respiration, by altering the Pulse, as Fevers, Inflammations, which make Respiration dense or great, because the Pulse beats high and quick, and soon fills the Lungs. II. Respiration is altered by Obstructions of the Blood Vessels in the Lungs, or else by those of the Air Vessels. An Inflammation, Tumour, Abscess, and all constant Obstructions of the Blood Vessels, give a stop to the motion of Blood through the Lungs, and make the Respiration dense and quick; the same is the Respiration in the Dyspnea from Tumours of the Belly, and in the Gibbous. When the Muscles labour much for Inspiration and Expiration, through some Obstruction, or Compression of the Bronchia, etc. we properly call this a Difficulty of Breath: But if this difficulty be by the Constriction of the Bronchia, 'tis properly the periodic Asthma: And if the Constriction be great, it is with Wheesing; but if lesle, the Wheesing is not so evident; the Pulse being stopped in the Asthma Fit, the Respiration is rare. The Vesiculae being straitened, or pursed up, the Inspiration is small; the labouring and straining of the Inspiratory Muscles, makes the Respiration high. The stop, or constriction, or compression, makes the Respiration slow. The Muscles of the Breast seem to feel the weight of the Atmosphere, and labour under its pressure, because the Air cannot be received into the Lungs, to help the enlarging of the Breast. This high and slow Respiration differs from the Delirious, because in the Asthma it is with labour and wheesing, tho' these Diseases agreed in the low Fever, and coldness of the Extremity. III. These alterations of Respiration depend on the Muscles and Spirits. Every Organ, when diseased, hinders the Action in that way or manner it helped it when well; and therefore if the Muscles produced the Asthma, they must be Convulsively affected, and than we should observe them to move with twitching, as in Hysteric Fits, and such stops in Breathing, are always a sign of Convulsions. If the Breathing be with trembling, 'tis a sign of Weakness, as in the Palsy. If the Breath be suddenly stopped, it is by the Convulsion of the Pneumonic Muscles, as in an Hysteric Apnea, when either the Muscles of the Belly pull down the Sternum, or else the Diaphragme convulsed, keeps the Breast dilated for some time. The old Writers thought the Animal Spirits diverted by odd Fancies in the Delirium, and that that hindered the Action of the Pneumonic Muscles; and therefore a great, and large, and rare Respiration happens, which was judged by them peculiar to the Delirious; and so in reality it is: For the greatness and freeness of the Inspiration distinguishes it from the Asthma; but the reason of the rareness is a stop on the Pulsation of the Heart, by the contraction on it in Deliriums; but if a high Fever be complicated with Deliriums, the Pulse and Respiration must be quick, small, and dense, as Galen has well observed in Deliriums. An Intermitting Pulse depends on the stop of the Circulation through the Lungs, because the Left Ventricle of the Heart, by that stop, wants sufficient Blood, to continued its constant Pulsation, (like a Mill which stands still for want of Water,) and this is plain in the Asthma, where the Pulse intermits, because of the Constriction, which stops the Circulation through the Lungs. 'Tis observed that the Asthmatic cannot Cough, Sneeze, nor Speak easily, because a sufficient quantity of Air cannot be drawn into the Lungs to produce those Actions, and the Expiration is difficult in them, as well as Inspiration. The Asthmatic cannot move strongly, because 'tis necessary to hold the Breath in all strong Motions. I was surprised to observe our Great Galen's Mistake, about the dense Respiration in the Asthma, but I perceive he describes only the continued Asthma; and his Mistake was also occasioned by the Observations he made upon Hippocrates' Cases of Asthmas complicated with Fevers; for in both the continued, and Asthma joined with Fevers, he observed 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, so Hypocrates describes the Daughter of Agisis, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, whilst her Tuberculum ripened, but after it broke she was Asthmatic. Hypocrates plainly describes the Asthma continuing after the Fever was over, and the Asthma complicated with Epidemical Fevers, and than the Asthmatic have a dense or a thick Respiration. If the Asthma be without a putrid Fever, Hypocrates calls it 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, but Galen mistakes that, and calls it 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, because the Breath goes no farther than to the top, and not to the bottom of the Lungs: But it is plain, that the high Breathing is so called from the lifting up the Shoulders, and the Respiratio Sublimis is a rare, slow, and laborious high Respiration, by which Hypocrates distinguishes the Asthma, from 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉; he mentions the Inflation of the Hypochondria, and therefore calls the Asthmatic 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Pain in the Respiratory Organs makes the Respiration small, because the Breast cannot be distended as in Pleurisies; 'tis also dense and quick, because of the Feverish Pulse. A Scheme of the several Species of the Asthmas. THE Asthma is a laborious Respiration, with lifting up the Shoulders, and Wheesing, from the Compression, Obstruction, or Coarctation of some Branches of the Bronchia, and some Lobes of the Bladders of the Lungs. The Asthma is either continued or Periodical. The continued Asthma depends on the Compression of the Veins, and Bronchia, and Bladders of the Lungs, or Nerves; 1. By a Dropsy in the Breast. 2. By an Empyema, Inflammatory Tumour, or Abscess, or large Tuberculum. 3. By a Polypus in the Pneumonic Vessels, or Coagulation of Blood in the Vessels, or the Varicoseness of the Vessels, or Plethora, by stop of the Hemorrhoides, and Menses, Issues, or Ulcers, or Itch. 4. By Stones bred in the Trachea. 5. The Lungs may be compressed by Fat, or a Tumour of the Thymus. 6. By Gibbosity, in which the Lungs are compressed by the Luxations of the Spina, and the sharpness of the Sternum: In these Hypocrates observes Tubercula in their Lungs, and that they are 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. 7. By the Adhesion of the Lungs to the Diaphragme, and Pleura, and Pericardium. 8. By straining the Lungs by Running, the Membranes or Fibers, which fill the Interstices betwixt the Lobes of the Bladders, and are designed to help the opening of the Bladders, may be injured; and than the Bladders remain contracted, by their reticular Muscles. 9 By the tumors of the Belly in the Ascites, Tympanites, Hydrops Vteri; by the tumors of the Liver, Spleen, Pancreas, Kidneys. 10. By the Inflation of the Colon, Stomach, the depression of the Diaphragme is hindered. 11. In Apoplectic Fits, Giddiness, Lethargy, some extravasate Serum oppresses the Nerves. 12. By a Windy Tumour of the Lungs, as it happens in Broken Wound Horses. The Periodic Asthma depends on the Constriction of the Bronchia, and Bladders of the Lungs, by windy Spirits, and succeeds these Diseases. 1. They succeed Fevers, Quartans, Smallpox, Inflammation of the Lungs, Intermitting Fevers. 2. A Catarrh. 3. Hysteric Fits. 4. Hypochondriac Fits. 4. An Ephemera, depending on the six Nonnaturals, especially the Air and Changes of Wether. 6. A flatulent Slimy Cacochymia, which is bred in the Stomach, and creates Inflations there, and gives an Effervescence in the Blood, and an Inflation in the Membranes of the Lungs; and this is the true Periodic flatulent Asthma. Note, That the Continued Asthmas have frequently Paroxysms, by any great Motion, or the accident of Diet, or else in the Night; but they are not regularly Periodic once in ten Days as the other be. My design in this Treatise is chief to describe the Periodic Asthma, to which I have been long subject, and that has given me many Opportunities of considering the History of that Disease more nicely than it was possible for Physicians, who have always an imperfect account of Chronical Cases from their Patients; and to that I must impute their ill Success in many Chronical Diseases. I hope this Treatise will excite those Physicians, who are subject to Chronical Diseases, to observe nicely the History of their Disease, and to describe all its sensible Phaenomena; to consider all the Ancients successfully used in those Chronical Distempers, and to give the Public a more exact Account from their own Experience and Observation of the History of their Chronical Distempers, which can only, by this means, be fully described; and never from the Relation of our Patients; and than any Ingenious Physician may from all the sensible Observations given, easily take his Practical Notions. And though there be many Hypotheses to explain the sensible Phaenomena, yet the Method of Practice being grounded on the Contrariety of the Remedies to some sensible Fault, in the solid or fluid Parts, the Candid and Rational Practisers cannot disagree in their Cure of Diseases, which in all Ages will be the same. Though a desire of Novelty altars the Philosophy, and sometimes the Medicines, to the great Prejudice of Physic, whose useful Observations are thereby discredited, and experienced Medicines disused. I shall not treat much of the Continued Asthmas, because they are depending on other Diseases, both in their Causes and Cures, which are well described by many Authors; as for Instance, the Dropsy of the Breast: And for that the common Method of Cure is used, Purging by Pills of Cambogia, and the Pil. Lunares, and Elaterium, Diuretics, Salts, and with these may be complicated the Anti-Asthmatics, upon the occasions of Fits; as the Oxymel, and Acetum Scylliticum, and Laudanum: But my chief Aim in these Symptomatic Asthmas, is the Curing the Original Disease, without which no Anti-Asthmatic can do any good. I have in the following Treatise recommended a Dispensatory-Medicine, Acetum Scylliticum, which is a bitter Acid; (and that I sometimes make more grateful by Aromatics, or turning it into a Syrup with Sugar for nice Palates,) this gave me an occasion of considering the whole Class of Acids, and to propose a farther Trial of other mixed Acids in the Asthma. The Acid Syrups and Oxymels I give in the Morning in a Glass of Water in the Summer, and the Aceta chief, if nauseous, at Night, for many Months. THE CONTENTS. CHAP. I COntaining a Description of the Symptoms preceding the Fits of the Flatulent Asthma, and of the Fits themselves, with the several Intervals betwixt them. Page 6 CHAP. II. Of the Preternatural State of the Chyle, and Blood, and Serum in the Asthma; and of the Rarefaction of the Animal Spirits, by an Effervescence in the Humours, which produces the Periodical Fits. 29 CHAP. III. Of the evident Causes of the Asthmatic Fit; as Air, Diet, Exercise, Passion, etc. and of those Diseases on which the Asthma depends as a Symptom. 63 CHAP. IV. Of the Cure of the Asthma, both in the Fit, and out of it. 1●4 An Appendix about the Weighing of an Asthmatic after Sanctorius' Manner: Also an Account of the Dissection of a Broken-Winded Mare. 201 ERRATA. IN the Ded. page 9 line 3. read irritated. In the Book p. 17. l. 21. r. arvis Temp. p. 18. l. 24. r. Gilead. p. 52. l. 29. r. cellulas. p. 59 l. 3. r. have some. p. 99 l. 12. r. bitter. p. 121. l. 23 and 26. f. add r. a. a. p. 145. l. 7. r. ℥ iv. p. 146. l. 27. r. Dose. p. 152. l. 8. r. any parts. p. 158. l 2. f. Dr. Waller r. Etmuller, l. 27. r. Constitution. p. 159. l. 10. r. Peru. p. 166. l. 14. r. acrid. p. 167. l. 26. deal dis. p. 169. l. 24. r. rectified. p. 170. l. 15. r. ʒiii. p. 177. l. 20. r. Polygomum. p. 178. l. 14. r. Rhus. p. 179. l. 8. r. to cool. p. 181. l. 20. r. Cyathis, l. 23. f. Arms r. Anus. p. 186. l. 22. r. doubted. p. 187. l. 4. deal ʒio. l. 8. r. ℥ iv. p. 188. l. 9 r. Macisʒss. & reservetur. p. 190. l. 27. r. Lumbric. l. 28. f. add r. cum. p. 191. l. 9 r. ℥ ss. l. 10. ss. gr. r. drops. l. 13. r. drops, p. 192. l. 3. r. ʒi. l. 9 r. ʒii. l. 17. f. ℥ ss. r. ʒss. l. 24. r. ʒx. l. 26. r. ℥ ss. p. 193. l. 24. r. Colour. p. 198. l. 11. r. condemns. p. 199. l. 5. r. Ariteus. p. 200. l. ult. r. give it with two Spoonfuls of hot Vinegar. p. 205. add The best Medicines of the Ancients, to the foreging Paragraph. p. 210. l. 2. r. Stolen. p. 214. l. 13. r. pursed. p. 220. l. 22. f. Smir. Wine r. Smalledge. p. 222. l. 14. r. Colaturae lb ii. p. 223. l. 12. f. advenae r. renes. p. 224. l. 14. r. takeʒss. withʒvi. of Oxymel. THE PREFACE TO THE TREATISE OF THE ASTHMA. SINCE the Cure of the Asthma is observed by all Physicians, who have attempted the Eradicating of that Chronical Distemper, to be very difficult, and frequently unsuccessful; I may thence infer, That either the true Nature of that Disease is not thoroughly understood by them, or they have not yet found out the Medicines by which the Cure may be effected. It is my Design in this Treatise, to Inquire more particularly into the Nature of this Disease; and, according to that Notion I can give of it, to propose those Methods and Medicines which appear to me most likely to effect its Cure, or, at lest, to palliate it. I have suffered under the Tyranny of the Asthma at lest Thirty Years, and therefore think myself to be fully informed in the History of that Disease: And since I have Practised Physic, I have made many trials for the Relieving and Preventing of the Fits, and out of Compassion to those Miserable Patients, I design to relate what I have found useful both to myself and others. The Method I shall take in this Discourse, is, First to describe the Symptoms preceding the Fit, and those which attend it, and the different Intervals of the Periodic Fit: And that this History of the Asthma may be more exact▪ I will give the History of my own Asthma, which I shall, for distinction sake, name the True Flatulent Asthma, and hereafter give my Reason for calcalling it so. I have for many Years kept a Diary of that Disease, out of which I can give a more true Account, than if I had now Recollected what has long since passed. I will afterwards give the History of the Asthma, which is commonly called Hysterical, from the Observations of an Ingenious Lady, who has suffered under that Disease Twenty Years, and gave me that Account, in Writing an Answer to many Queries I sent her about it. The Asthma is a long Disease, and it requires a long Observation to give a true Account of its Symptoms, Changes, and various Causes, which common Patients cannot nicely observe; and therefore I thought it very necessary in the First Chapter of this Treatise, to give a full History of the Asthmatic Fits. In the next Chapter I will describe the Viscous and Flatulent Cacochymia of the Chyle, Chylous Lympha, Serum, and that Rarefaction of the Animal Spirits which give the chief Disposition to the Fits of the true Asthma. In the Third Chapter I will describe the Accidental Fits of the Asthmas depending on the Air; and its Changes; and show that they are real Fits of an Ephemera Fever, such as a slimy flatulent Blood, and windy Spirits, are capable of. And I will enumerate all the other evident Causes, as Diet, Exercise, Passions, etc. And I will there observe the several Diseases on which the Asthma depends, as a Symptom, and give some Remarks for distinguishing the true Asthma from other Species of the Dyspnea. In the Fourth Chapter I will propose the several Indications necessary for the Cure of the Fits, and those which are to be pursued for the preventing their Returns; I will observe what I have found injurious to that Disease, and describe those Medicines I have found most Beneficial. I have frequently compared my Observations of my Asthma, with those of my Patients, and found them much alike: But some variety of Symptoms have appeared in all I have Discoursed. I have put my Notion of the Disease to some very intelligent Asthmatics; and they agreed with me that there is a slight Fever, and windy Rarefaction of Humours in the Fit, which I call an Effervescence; and this will be confirmed by the Medicines I use, which are of that Taste, which Experience has observed to succeed well in the Cure of the Flatulency of our Humours, and their Rarefactions, by an Effervescence. CHAP. I Containing a Description of the Symptoms preceding the Fits of the Flatulent Asthma, and of the Fits themselves, with the several Intervals betwixt them. IN the Afternoon which precedes the Fit of the Flatulent Asthma (which is commonly called the Humid, or Spitting Asthma) about two or three hours after Meat, most Asthmatics are sensible of a great straitness, or fullness about the Pit of the Stomach, which is than much oppressed with Wind, and an insipid Ructus rises from it; and this fullness of the Stomach is the first sign of the ensuing Fit; it appears before any Cough or Straitness happens in the Lungs. This Fullness at the Stomach seems to me to depend partly on the Windy Rarefaction of the Digesting Meat contained in its Cavity, and also on the Inflation of the Nervous Fibres of the Skins of the Stomach. An Effervescence in the Blood succeeds this Inflation of the Stomach; for these Asthmatics are obscurely hot in the Night, and cannot bear the heat of the Bed-Cloths on their Breasts; all hot things disorder them more, as sitting by the Fire, Wine, Tobacco, all cool Liqours, as Water, relieve the Fullness at Stomach; the Issues are generally inflamed before the Fits, and very sore and bleed: There appears a great Dulness and Fullness of the Head, with a slight Headache, and great Sleepiness towards the Evening before the Fit, and frequently great Retchings and Yawning many times, and towards Night a great quantity of pale Water is made, and the same pale Water all that Night, and also all the first day of the Fit; but though the Water be pale before, and in the beginnings of the Fits, yet it is as high coloured after it, and appears plainly to have a Feverish Colour and Sediment. After this obscure Effervescence in the Blood, succeeds a Rarefaction of the Spirits in the Nerves, and Membranes of the Lungs themselves, for they feel rigid, stiff, or inflated; there is a great Restlessness on the Spirits all the Day before the Fit; the Head seems filled with Fumes, or Serous Humours, with some pain; the Limbs appear heavy and unfit for motion, the Breast has the same weight and heaviness as appears in the Limbs, the Asthmatic seem to suck in their Breath, and wheeze a little towards Night: This Straitness of Breath seems to be for want of an easy Inspiration; the Diaphragme cannot Contract itself to move downwards, and that occasions a laborious Breathing to draw in Air; the Trachea, or its Bronchia, have their Membranous and Nervous Fibres Contracted, by which the Wheezing is made in Expiration. The Asthmatic seem to have a Convulsive Cough before the Fit, and sometimes a little slimy Phlegm is spit up, but both of them are very inconsiderable. The Lungs in the Humid Asthma do not always appear to be much oppressed with Phlegm before the Fit, and at the end of the Fit, the Straitness goes of before any considerable quantity of Phlegm is spit up, which would not hap if the Straitness depended on a great quantity of Phlegm. At first waking, about one or two of the Clock in the Night, the Fit of the Asthma more evidently gins, the Breath is very slow, but after a little time more straight, the Diaphragme seems stiff, and tied, or drawn up by the Mediastinum. It is not without much difficulty moved downwards, but for enlarging the Breast in Inspiration, the Intercostal Muscles which serve for the raising of the Ribs, and lifting up the Breast, strive and labour more vehemently, and the Scapular and Lumbar Muscles, which serve for strong Inspiration, join all their force, and strain themselves to lift up the Breast and Shoulders, for the enlarging the Cavity of the Breast, that the Lungs may have a place sufficient for their Expansion, and the Air may more plentifully inspire. The Asthmatic is immediately necessitated to rise out of his Bed, and sit in an erect Posture, that the weight of the Viscera may pull down the Diaphragme. The Muscles which serve for Expiration cannot easily perform the Contraction of the Thorax, being hindered in that by the Stiffness or Inflation of the Membranes in the Thorax; for though the Asthmatic expire more easily than they can draw in their Breath, yet the Expiration is very slow and leisurely, and Wheezing, and the Asthmatic can neither Cough, Sneeze, Spit, or Speak freely; and in the Asthmatic Fit the Muscular Fibres of the Bronchia and Vesiculae of the Lungs are Contracted, and that produces the Wheezing Noise, which is most observable in Expiration: But it is evident to me, that all the Lobes of the Lungs are not constringed alike. For in the Fit I could never breathe tolerably, if I lay or leaned on the Left side, which made me very sensible that all my Straitness lay on the Right side of my Lungs, and that inclined or naturally occasioned me to lie on that side during the Fit; but after the Fit was over, I always lie easiest on the Left side: I perceive the Right side to be most affected in my Case, and from the n●eall the Spit does plainly rise when the Fit goes of. After the Fit is begun, the Stomach suffers a great Inflation of its Muscular Membranes, and also a great Rarefaction of its Contents; and this Flatuosity opposes the descent of the Diaphragme, and straitens the Breath much more. If the Fits be Extreme, the Asthmatic often Vomits green or yellow Choler: Cold Liquors best agreed with the Stomach; and hot Liqours, whether Vinous or naturally hot, make the Flatuosity, very Vehement, and Suffocating. I must observe that the Fit of the Asthma happens often after Purging, Vomiting, or Fasting, when none or few Contents are in the Stomach, and than this Flatuosity must be a Nervous affection of the Membranes: But I cannot but confess, that if any Surfeit or Fullness be in the Stomach, when the Asthma Fit first seizes, the Danger of it is very great, and the Fit very Violent and longer, with much more Flatuosities. The Asthmatick is extremely hot, burning and inclined to Sweated, as in the Fit of a Fever, and his Pulse is quick, though unequal; and all the Feverish Symptoms continued during his keeping in Bed, which is not safe in a strong Fit, nor tolerable to the Asthmatic, who is necessitated to rise into the cool Air; and after he is risen out of Bed, a lose Stool frequently happens from the great working in the Belly, occasioned by the Fit: And I have often heard the Asthmatic complain, that the Fits of Inflation fall lower in their Bellies than ordinary, and than the Fits go of with lesle shortness of Breath, and a breaking Wind downwards, with some Stools. The Motion of the Muscles of the Heart is altered or stopped by the Fit; for the Pulse is weak and intermitting, and the Hands and Feet cold, for want of a free Circulation, and the Face often blackish by the Stagnation of the Blood in it, and for the same reason the Asthmatic are very much subject to Swooning, and Palpitation of the Heart, because the Blood Vessels are constringed, as well as the Bronchia, by the Inflation of the Nerves and Membranes; for the Par Vagum sends Branches both to the Heart and Lungs, and Orifice of the Stomach, where the first Nervous effects, or Inflations begin, and that by the same Nerves is communicated to the Heart and Lungs and Membranes of the Breast. The Intercostal Nerves are also affected; for that communicates with the Par Vagum Fibres, by which also the Nerves of the Guts are inflated in the Fit, and that sends Branches to the Gula, which can scarce swallow in the Fit, but it makes a Noise like breaking of Wind. From these Nerves come the Inflations in the Belly and Stomach and the frequent Eructations. The Lips seem to be drawn into a posture for Sucking, the Eyes seem to start, and shed Tears involuntarily, which frequently colour the Skin near the Eyes yellow, or blackish, the Face is pale or livid, the Muscles of the whole Body seem to subside, or loose their Plumpness, for want of the Circulation of Blood through them, and all Motion of the Limbs is languid. After some continuance of the Fits the Head often Aches much, and is very dull, and troubled with dreaming Fancies, and that this depends on the stopping the Circulation, may be proved, because Combing the Head backward very much relieves it, by promoting the Circulation that way; the Asthmatic during the Fit have a great dullness to sleep, but sleep little till the Fit has spent the Windy Spirits; and in the first day of the Fit they have often broken sleep sitting in a Chair, leaning on one side, or forward, but cannot lean backwards: A straight Room, and a fire in it, are extraordinary offensive, as well as any Dust, or ill Smell during the Fit; and all things heated by the fire, or of a vinous Nature; and all things which oppress or straiten the Breast, increase the Suffocation. If the Fit last but two or three hours after rising out of Bed, the straitness abates, and some raw Gelly-like Phlegm, like the White of an Egg, or the Solution of Gum Tragacanth, is spit up, both in the Humid and Old Hysteric Asthma, and that is streaked with black, like a Feather, or Spiders Web. When a short Fit happens, it is accompanied only with Wind, and Spitting, with a feverish quick Pulse, and a disposition to Sweated, and the Water is higher coloured in the Morning, no oppression at the Stomach precedes, nor no pale Water, and but a little sleepiness over Night: This I call a Spitting Fit; such as my Asthma was before it settled into Periods. And these Fits depended on Disorders in Diet, and Accidents of Wether; and appeared to me a Fit of an Ephemera Fever. If the Fits continued long, viz. two, three, or four days, the first two days none or little Phlegm is spit up, but on the third or fourth day it is Coughed up somewhat digested, and lesle viscid, of a white, greenish, or yellow Colour; and in old Asthmatics, sweet in Taste like Blood, or Liquorish, or else a little putrid, saltish, or acid; and the Spit of the Asthmatic is often streaked with Blood. The Fits usually go of in three, four or five Days clearly, so that little Phlegm is spit afterwards, till the next Fit. The occasion of settled Periodic Fits in myself, were an Intermitting Fever; of these I kept a Calandre for seven Years, that I might better observe their Intervals, and their respect to the Moon and Wether; and such Physic I used for them. The Observations I made thence are as follow. I observed that in the Winter were sixteen Fits, but in the Summer Months I had twenty Fits; and in the Summer the Fits were more sharp and longer, and that I spit more digested Phlegm than: In August I always had the severest Fits. The longer the Fits, the greater the Intervals; the long Fits lasted 3, 4, or 5 days; the shorter the Fits, the shorter were the Intervals. The short Intervals were 2, 3, 4, 5, 6, or 7 days; the longest Intervals 8, 9, 10, 11, 12, 13, 14, or 15 days. The Winter Months I reckon from September till March, and from thence to September the Summer Months. In Rainy Weather or towards Snow, and in the Foggy, I am frequently sensible of a great straitness at the Stomach, so that such Wether gives an Inclination to a Fit before either the Rain or Snow fall; but in all that kind of Wether I sometimes miss a Fit. The Fits usually returning once in a Fortnight, they frequently hap near the Change of the Moon; but I could not perceive they kept any certain times either before or after, but sometimes they happened near an equal distance from both the Changes; but, I believe, as the several Phases of the Moon altar the Wether, by that means it produces some Alterations on the Spirits of the Asthmatic. Helmont observes the Influence the Moon has on an Asthmatic; Exacerbatur Lunae stationibus, & aevi tempestatibus, quas ideo praesentit & praesagit. And I always upon unexpected Fits; found some great Change of Wether to succeed. Horstius mentions a Young Asthmatic, Qui crescente Luna afficitur anhelalatione crebra. A Change from a Frost to a Thaw frequently gave me a Fit, with a Rheumatic Pain in the Temples. A change of the Wind into the East often produced a Fit. In the Intervals of the Fits I unsuccessfully tried these Medicines. I drank many Pectoral Drinks, as Gill and Hyssop, and sometimes Rue in Diet-Drinks; the last was good for the Wind, but troubled my Spirits; I used Syrup of Garlic, Syrup of Sulphur, Tincture of Gum Ammoniacum in Elder-flower Water, Tincture of Lavender, Spirit of Hartshorn: Broom Beer agreed with me better than Gill, or its Juice. I tried Myrrh thus, ℞ Myrrhʒij. Mellis ℥ ij. Croci ℈ ss. Nucis moschatʒss. Misce. This is an Excellent Pectoral, but hot: I tried Saffron Lozenges thus; ℞ Crucipulv. ʒi. Sacch lb i. I tried Flores Sulphuris, and Flores Benzon▪ in Lozenges. I smoked Amber with my Tobacco, I used all kind of Balsams, Gilded Balls. Peruvianum; ʒi. Solut. in lb i. Syr. Balls. Balls. Sulph. Anisat, Succinat, Terebinthinat, Tinct. Sulph. with Syrup of Ground-Ivy. I tried Lime Water; Infusions of Millepedes, Decoction of Sarsae, Drinks with Horehound lbss. to six Gallons. I drank the Spa Waters to my Injury, the Stipticity of the Steel proved injurious. I tried Extracted Ecphracticum at Night, and at other times Vitriolum Martis dissolved in Milk Water; and a very severe Fit discouraged my farther use of Steel. I often Vomited, Bled, Purged in the Intervals, but found no Relief by any of these methods. None of the preceding Methods would succeed, but increased the severity of my Fits: At last I Vomited once in a Month, I took six Ounces of the Cortex infused in Wine, and after that three Ounces of Ammoniacum dissolved in Oxymels. This method relieved me for three or four months in the Winter, but at last proved unsuccessful, and the Fits returned as bad as ever. I drank Ass' Milk, which increased my Phlegm, and stopped up my Lungs. Next Summer I drank the Waters at Bath, where indeed I had no Fit; but they returned severely when I came Home. I found I had read most of the Modern Writers, and hitherto had tried their Methods, and hot Pectorals, and Cephalics in vain; I believed, by my ill success in their way, that they never understood this Disease; and therefore turned over some of the Old Writers, Galen, Aegineta, Aetius, etc. where I found more rational Notions, and was directed by them to the use of that Medicine which does very much relieve and prevent my Fits, of which I will hereafter give an account. I cannot remember the first Occasion of my Asthma, but have been told that it was a Cold when I first went to School: As my Asthma was not Hereditary from my Ancestors, so, I thank God, neither of my two Sons are inclined to it, who are now past the Age in which it seized me. I at first was only troubled with it at the great Changes of the Year, and preserved myself tolerably in Health for some Years, by taking Purging Pills frequently: I never had any considerable Fit in Oxford for Twelve Years that I lived there, which I imputed to the clearness of that Air, and the spare Diet there▪ but as often as I came into Staffordshire, into my Native Air, I was usually visited with a severe Fit or two: The Air of a Town makes the Fits more severe when they hap, but I do not think the Asthmatic so much exposed to the Accidents of the Wether in a City, as in the Country: The Asthma being a Fever Fit, all hot Regimens and hot Air, such as that of a City, may dispose some lean hot Bodies to Coughs, and consequently Fits; but I could never observe my Fits to come oftener in London than in the Country, only I found them more severe in a close Air, as they would be in a close hot Room, when they hap. I have met with some Asthmatics, who have been so for fifty Years, as they informed me, and yet in tolerable Health, without any considerable decay of their Lungs, or disability to perform their usual Employments, which I often reflect on to Encourage my Patients, and myself, who yet can Study, Walk, Ride, and follow my Employment, Eat and Drink and Sleep as well as ever I could; neither am I yet sensible of any Decay in my Lungs, though I believe all old Asthmatics have several Tubercula there, and the Glands' of the Trachea are much Relaxed by the frequent Defluxion of a Mucus through them; but the frequent Expectorations carry of the fullness of Humours, and I have observed very few to die of the Asthma Fit, but the frequency of that often occasions Consumptions in lean Habits, and Dropsies, Lethargies, or Inflammations of the Lungs in fatter Constitutions, which prove fatal. Inquiries sent to an Ingenious Lady troubled with an Hysteric Asthma, and her Answers to them. Quere 1. What was the first occasion of your Hysteric Asthma? Answer. The Affliction I had by the Loss of my Father threw me into a violent Fever, which happened in the Spring, I being than 14 Years old; and about that time Twelvemonth into Fits of the Mother, and those of several sorts, as Raving, Laughing, and Silent; and in one of these Fits Tobacco being blown on my face recovered me; but in other Fits this being repeated, I found my Breath become straight: This difficulty of breathing was much more uneasy to me than any of the Fits of the Mother. And after this I was troubled sometimes with the one, and sometimes with the other: But after I was married, which was about 22, I never had any Fits of the Mother, other than Shortness of Breath: Though the trouble I have mentioned produced these Fits, yet I cannot but acknowledge I might have some Disposition to the Asthma from my Father, who was also troubled with a Shortness of Breath. Quere 2. What Alteration has happened in the manner of your Fits? The first Fits I had generally lasted me 36 Hours, but I never had more than three or four Fits in one Year: But coming from London into the Country, I had them frequently; and in the beginning of July they seized me violently every morning at two a Clock, and held me in great Extremity five or six Hours, and went of generally at Noon; and after that, till the next Fit, I was tolerably well, but for seven week's time I never went into Bed till after my Fit was of. I slept in a Chair leaning on a Table, which I use to this day, and found it the easiest when my Breath is indisposed; for many times my Wheezing will leave me in sleeping thus; but if I lean back but a little in a Chair to sleep, or in my Bed raised with Pillows, I shall Wheeze the more. Quere 3. What Signs preceded your Fits, as Headache, pale Water; and in what manner did the Fits hold you, how many days, and what Spit after? My Straitness or Hardness of Breathing is betwixt the Breast and Pit of my Stomach; but indeed my Arms, Shoulders, and all my Upper Parts are generally uneasy. I never Spit in any Fit, or afterwards, unless my Fit comes upon catching Cold, than at the going of I spit white Phlegm, with black streaks like Feathers; but I am not now so subject to Cold as formerly. My Head is always well in the Fit, except in the long one I mentioned, when it was benumbed in the hind Part, and my Eyes dim when the Fit went of. If I be sleepy on a sudden, a Fit generally follows; I observed no quantity of Water before the Fits, but always a great quantity of pale Water in the Fit; but it is high coloured as the Fit goes of. Quere 4. What Medicines have relieved you most, and what did you found Injurious to you? At the first, Spirit of Castor in fair Water relieved me, and Hysterical mixture by Dr. Hewet of Lichfield, in the Year 76. Than Treacle Water; afterwards Prince Rupert's Drops; sometimes Spirit of Hartshorn did well; but in my long fit I mentioned above, it made me worse, and I fell into a sort of Convulsion with it, and never took it since. Dr. Hollins gave me all the Varieties of Hysterical Medicines, Juleps, foetid Pills, and Plasters, but none of them gave me the lest Relief; but I continued out of my Bed for seven Weeks; at last I took half a Dram of the Jesuits Powder in a Cordial Water, and that first Dose relieved me, so sensibly, that it seemed to press down the stoppage of my Breath, and by repeating that Morning and Evening, I perfectly Recovered, and since I found the same Medicine more beneficial to me than any other for preventing my Fits. Any thing of Strong Waters or that is hot, or any Stink much offend me in my Fits. Quere 5. What Feverishness attends your Fits? In my long fit I had no Fever; and in that fit Purging disturbed me extremely; in other fits my Hands are sometimes very hot, and at the going of, my Water is very high coloured, and breaks much. I have had a Fever four Years ago without any shortness of Breath, but as soon as that left me, the Asthma returned. Quere 6. What Accidents of Wether or Diet occasion your Fits? I have found London Air, and that of Holland, agreed best with me, and by going into a sharp Air I have immediately fallen into shortness of Breath, particularly in my going from London to Epsom; but upon my return next day to London I was very well. I have had severe fits in London, none in Holland, but a little Heaviness, which the Jesuits Powder put of immediately. Eating a Supper, or any thing in an Afternoon, occasions my fits; but in the beginning of my fits, Supper agreed well with me. POSTSCRIPT. My Fits have often returned, and the Jesuits Bark never failed Relieving me for ten Years; afterwards the Bark sometimes failed me, and than I bled often. About 15 Years ago Spring and Fall I took Steel for eight Weeks, and Purged once a Week in that course with Hierapicra; for all Potions were more apt to bring a fit. After some Years I took Steel without Purging, which made me worse, so that I than left it of; but when I took it with Purging I was better. Four Years ago after my Fever, I began to take strong Purgers of Sena and Buckthorn two days together; once in a Fortnight, and to Vomit with Carduus once in a Month., which with the often repeating of the Bark kept of my fit Nine Months together, but still in July and August I have some Return of my fits, but of no great continuance, and very seldom violent. About six or eight Years ago I spit in my fits, but since my Purging I spit no more than I did at first, twenty Years ago. I have omitted to mention this, that my fits never seize me but in the Night, and than awake me with a heaviness, and so grow worse and worse immediately. I am always most easy when I am Laced, and my fit goes frequently of on a sudden, so as to be perfectly well in half an hours time. I have lately had two easy fits, which I impute to Purging and Vomiting before they came. If I may give some Rationale on this Lady's Asthma, I believe the Intermitting Fever laid the Foundation of it, and the Relics of that by the trouble mentioned, was turned into the Nerves, and gave her Hysteric Fits; and those being disturbed by the smoke of Tobacco, which is yet extremely offensive to her if she smell it: Or else the Disposition from her Father, laid the Foundation of an Hysteric Asthma, which at present receives no Relief by Steel, or Hysteric Medicines, but by Vomits, strong Purges, and frequent Repetitions of the Cortex. CHAP. II. Of the Preternatural State of the Chyle, and Blood, and Serum in the Asthma; and of the Rarefaction of the Animal Spirits, by an Effervescence in the Humours, which produces the Periodical Fits. THAT the Preternatural State of the Chyle in the Asthma is a Flatulent Crudity, appears because all flatulent things, as new Beer, Turnips, Cabbage, and all Roots which have a Mucilage and Acrimony mixed, very much disagree with the Asthmatic, by irritating the Spirits, and creating a Windiness in the Stomach, and they also affect the Nerves. Frequent Eructations precede the Fits of the Asthma, and a Fullness is commonly complained of in the Stomach before the Fits. That the ill state of Chyle supplies the new Matter before the ●it of the Asthma appears, because the Oppression at the Stomach, and some small straitness of Breath happens within two or three hours after Dinner; and the Exacerbation of the fit happens in the Night, about two a Clock, when the Chyle is most plentiful in the Blood; and no other Humour is so capable of Fermentation and Flatuosity as the Chyle is: For if the Chyle be not perfectly digested by a thorough Fermentation, it resembles new Ale unripe, which is very Windy; and this causes the same Inflation that the other does in the Primaeviae. The Agitation of the Spirits, and their Expansion of the fermenting Mass, produces the fermentation and dissolution of the Meat in the Stomach; which being either deficient, or else stopped in their motion by a viscid Slime, the Spirits remain Inviscated in the roapy Liquor, and there raise Bubbles, which we call Wind. It is commonly observed, that fullness of Diet, and all Debauches, tender the Fits most severe, and a temperate Diet make the Fits more easy. I have heard some Objections against the Digestion of Meats by a fermentation in the Stomach, to which I will give the Solutions following. 'Tis objected that Fruit and new Wine are easily fermented, but not easily digested, which they aught to be if Digestion was made by a fermentation. To this I may answer, that that kind of Diet easily raises Windiness in the Stomach, and therefore some fermentation happens after eating thereof, which occasions the Ructus, and Swelling of the Stomach, and 'tis rather an excess of fermentation to which that kind of Diet is subject, which produces the Fevers, Vomitings, and Fluxes to those that use it, than a defect of the Digestion or Fermentation. And, as we observe, Wines may be under-fermented and crude, or else over-fermented or acid; so we must acknowledge two contrary faults in Digestion, the one when the Meat is crude, slimy, windy, acerb; or else when the Meat is over digested, and becomes acid, bitter, salt, putrid. 'Tis further objected, that Bones, Flesh, Fat, and putrid things are easily digested, and yet difficultly fermented. To this I may Answer, That Fat is of all things the most difficultly digested, and as difficultly fermented: I have observed Suet to lie in the Stomach of a Dog fed with it, twelve hours undigested, and very little altered as I found when I opened him. Fat Meats often go whole through the Body unaltered; and Butter is heavy or hard of Digestion to many Stomaches: As to Bones they lie long in the Stomach before their dissolution; 'tis their Jelly they are resolved into by digestion that is fermented in the Stomach, but the hard Parts go of undissolved in the Feceses. The New Digester dissolves them into Broth, by Heat, rarifying the Air included in their Pores, and in their Juices, and the gentle heat of the Stomach in a lower degree, and a longer time rarefies the Air in the Animal Juices contained in the Bones, which may occasion the solution of the solid parts of the Bones, and a full digestion of the Liquors issuing from them. Putrid things are easily digested, because half fermented, and therefore they are apt to ferment too much in our Stomaches, and occasion Surfeits. Flesh Meats are easily made putrid, and that is the highest degree of Fermentation. The external Heat of the Hen Colliquates the Humours contained in the Egg when 'tis hatching; and if the formation of the Foetus miscarries, nothing is more putrid; which is an evident proof of a Fermentation in Animal Humours: And if the Digestion of Flesh in the Stomach be observed, the Foetor and Acid smell from a Carnivorous Stomach may more plainly prove the dissolution of it, by a putrefactive Fermentation. The common Objection is, That the Contents of the Stomach, when distilled, yield no inflammable Spirit, and therefore are not fermented. To this I may answer, That no Aliments stay long enough in the Stomach to be perfectly fermented; and till Vegetables are perfectly fermented to a sharp Acidity, they do not yield their inflammable Spirits; but the Fermentation in the Stomach is continued but some few hours for the dissolution of the Meat, which is than carried out into the Guts, where the Choler and salt Lympha being mixed with the Chylous Mass, a stop may thereby be given to all farther Putrefaction of it. But that an inflammable Spirit may be distilled from Animal Humours fully prepared, appears by a remarkable Instance given in the Collectanea Chymica, in the Anatomy of the Bile, where the Author describes a volatile Spirit from Choler distilled in B. M. which is inflammable like Spirit of Wine. Not only the Chyle and Alimentary Mass in the Stomach and Intestines have their preternatural State, but the Lympha Lactea (which is a Chylous Humour separated from the Chyle by the Mucous Glands' in the Stomach and Lungs) is too crude, slimy and flatulent, and thereby lesle fit to promote the Fermentation of the Meat in the Stomach. This is evident and visible if a Vomit be given to an Asthmatic, a great quantity of this frothy, crude, or slimy Mucilage is evacuated; and this way a great ease is given to the Paroxysms, some Matter of the Disease being evacuated, which increased the Inflation of the Stomach; and this viscid Saburra in the Stomach is most observable in old Asthmatics, both in those that have the Spitting and Hysterical Asthma. In the Spitting Asthma this slimy Lympha is very evident, and gives the Matter of the viscid Phlegm usually spit up at the end of the Fit: It at first appears clear, like a Solution of Gum Tragacanth, but after some days like the viscid and digested Phlegm in a Cold. All kinds of viscid gummose Meats or Drinks stop and oppress the Stomach and Lungs of the Asthmatic, and occasion their Fits, which is by supplying a great quantity of viscid Chyle and Lympha, which will not easily circulate through the Lungs of the Asthmatic, which are frequently obstructed by crude Tubercula. The Serum is made of the Chyle, and therefore must have the same kind of Flatulency and Sliminess as the Chyle has. In the hot Scorbutical Temperaments 'tis deficient and viscid, which occasions either Tubercula or Inflammations in the Lungs; or else 'tis too waterish in the Hydropical, or very apt to Effervescences in the Hysterical and Hypochondriacal. The pale Water in the Fit is the thinner part of the Serum occasioned by some Constriction of the Lymphatics. For as in the Fits of the Stone, the Urine is pale, because of the Constriction of the Lymphatics, through which the remaining Serum aught to be carried of, upon the Secretion of part of it through the Kidneys; but the Pain causes that Constriction: And in the Asthma, the Inflations, by stopping the Circulation of the Serum through the Lymphatics, occasion this great Diabetes in the Asthma; as will hereafter be more fully explained. This defect of Digestion and Mucilaginous Slime in the Stomach, are very obvious, and observed by Writers, and were supposed the immediate cause of the Asthma; but their ill success with Pectorals and Digestives, occasions my doubt of that Assertion; especially since I can deduce the Asthma from a more probable Cause, and show that the mentioned Alterations of the Humours, are produced by the long continuance of it, and do not produce the Fits of the Asthma, but only make them worse, or dispose us to them. All Chronical Causes, as the Gout, Consumptions, etc. produce the same viscid Saburra, with Windiness in the Stomach, and yet are not usually attended with Asthmatic Fits, and the Inflammation of the Lungs, the Tubercula in Consumptions, the great clog of Phlegm in Catarrhs, stuff and oppress the Lungs, and occasion a Dyspnaea, but do not commonly give Asthma Fits; and therefore we must seek for some other Cause of them. The Blood of Asthmatics is very subject to Effervescences; and whatsoever produces that, occasions the Fits; as great Heats or Cold, violent Motions of the Body or Mind, any Excess in Eating and Drinking, or Venereal Pleasures; the Heat of the Bed, the Changes of the Wether to Rain, Snow, or from Frost to a Thaw; the Alteration of Clotheses, the Changes of the Air at Spring and Fall: All these are causes of the Fever we call an Ephemera, and they also produce the Fits of the Asthma; from whence I may infer, that the Nature of the Asthma consists in a slow Effervescence, or Ebullition of our Blood, on which the several Symptoms of that Disease depend. The common Ephemera happens in a healthful state of Blood, when 'tis not tinctured by any morbid Cacochymia; and that Ebullition is attended with the common Symptoms of Fevers; as Heat, Pains, quick and high Pulse, Thirst, and sometimes high-coloured Water: But in the Asthma, the Effervescence happens in a mucilaginous state of Humours, and therefore the Heat is sometimes obscure, the Urine pale, the Pulse quick but oppressed, some Pains in the Head, or Heaviness attends it; and if the Patient keep his Bed in the beginning of the Fit, they are very hot, and inclinable to Sweated; and at the latter end of the Fit, the Urine has evidently a feverish Sediment. The great Constriction of the Pulmonic Arteries, and the other Blood Vessels, as well as the Heart itself, in the Fit, stops the Pulse of Asthmatics, and that depresses the feverish Ebullition, and prevents the Heat, high Pulse, and high coloured Urine at first. The quick and strong motion of the Heart promotes the Ebullition in Fevers; and if by Opiates we can stop the violent Pulsation, the Efferverscence considerably subsides. That the Nerves may stop the Circulation very much in the Asthma, is evident by the frequent Circumvolutions they have about the Blood Vessels near the Lungs. And since the Nerves make an evident constriction on the Bronchia during the Fit, we may observe by the intermitting Pulse, that they make the same sort of Ligature upon the Arteries, and thereby check the high Effervescence of the Asthmatic Fever. The ferment of this Asthmatic Fever is the flatulent Succus Nutriticus, which by reason of some Crudity is not fully digested into Blood, but is thence easily precipitated by the changes of the Air, Diet, or other external Accidents; or else of itself, like as in other intermitting Fevers, once in 10 Days it separates from the Blood, and by making its Consistence turbid, it produces in it an obscure Effervescence, by which the several great Symptoms of the Asthma are produced. 1st. A great quantity of pale Urine is thrown of by that Effervescence. 2dly. A flatulent Lympha is evacuated into the Stomach and Guts, which raises the Alimentary Mass there into violent Flatulencies, like Wine over stummed. 3dly. The Glands' of the Trachea and Vesiculae of the Lungs receive part of the mucilaginous flatulent nutritious Juice separated from the Blood by the Effervescence: For the occasion of this Symptom in the Spitting Asthma, is the Weakness left in those Glands', which they contracted from that Inflammation of the Lungs, which produces the Spitting Asthma. 4thly. The more spirituous part of this slimy and flatulent nutritious Juice passes through the Nerves, being forced by the Effervescence, and there, because of the slimy Vehicle of the flatulent Spirits, difficulty circulates through the Nerves, but fills them, and causes an Inflation in the Membranes of the Breast, and Lungs, and Stomach. The Nerves of the Breast were formerly weakened by some Dyspnaea, occasioned by Inflammation of the Lungs, or some Hysterical Convulsion, and thereby lost their Tone, and became too open for the admitting of flatulent, unripe, or undigested Spirits from the Blood; and this predisposition determines the Flux of windy Spirits chief into the Pulmonic Nerves. When I have been in a Fit of the Asthma, I have seriously considered all the Symptoms described, and always believed from my sense and feeling of the Disease, that the Fit depended on an inward burning Heat which occasioned them, so that I am fully convinced that the Asthma Fit is a Fit of a Fever. Carolus Piso affirmed this long since; and S●nnertus could not believe the Asthma to be without a Fever: He says, Est blanda febris & halituosa, qualis etiam alios morbos à fervore & motu serosi humoris ortos, ut Arthritidem, Catarrhos, & hujusmodi fluxiones, alias comitatur. The Modern Physicians have observed many Intermitting Fevers to lurk under the Disguise of Chronical Diseases, as Coughs, colics, head-aches, Fits of the Mother, and Swooning Fits; and the severish Heat, quick Pulse, and high coloured Water disappears, till the Blood be raised to a higher Digestion, or Fermentation: The same is often the case of the Asthma; the Effervescence is in the Blood, decayed by some former Disease, which occasions the Water to be pale, and the Heat little. That the Asthma may be a Symptom of an intermitting Fever, is evident by the Description of some cases of that nature in some Modern Writers: And I remember an Apothecary who, after drinking largely, was seized with an Intermitting Fever, with an Inflammation of the Lungs, and every Night a fit of the Asthma accompanied a fit of the Fever, which after three Weeks was cured by frequent Bleeding, Vomiting, and at last Purging; but the Asthma long after continued, returning every Night with large Spitting. He used too little of the Cortex, and therefore suffered these Returns of the Asthma upon any Disorder, for half a Year, when the Fever evidently returning on the Change of the Year, seized his Head with a Delirium and Convulsions, and so killed him. In this case it appears to me, that the Asthma depended on the Fever whilst that was evident, and afterwards whensoever the Relics of that Fever were agitated by an Accident into an Effervescence, they produced only the Asthma Fit, without the usual Symptoms of the Fever. I will give another Instance of a Patient about 50 Years old, who after an ordinary Intermitting Fever, without any Symptoms of the Asthma, Relapsed after 14 Days into the same Fever, which returned every 12 Hours, and held him shivering and shaking, with a terrible fit of the Asthma, for about half an Hour, and that passed of without any considerable Sweat, or Heat, or Spitting: This Person was subject to a Paralytic shaking, and in the Fever had strong Convulsive motions: The Cortex would not stop any of the 〈◊〉, but Riverius Salt mixture did put of the fits for some time, but neither that nor Alexipharmics would cure him. By this Instance I observed, that an Intermitting Fever having its Matter transferred to the Nerves, produces the complicate Fevers described by the Ancient Writers; in which many Irregular Returns hap, and those great Shakes which denominate the Fever, Horrifica, etc. in which they observed Nervous Symptoms with pale Water. I was consulted for a Gentleman, who at the latter end of a Tertian, was taken with Swooning Fits at certain Hours every Night: He grew very cold, short Breathed, and than swooned, unless he used great quantities of Spirits and Cordials: This was certainly the Relics of his former Ague, and he was cured by Salt of Wormwood, and Elixir Proprietatis, given at convenient times. And the same swooning Fits I knew cured in another by the Cortex. In neither cases the Fever was discernible, either by Thirst, Heat, or Urine. I have mentioned these cases, to show that all Fevers are not regular in their Symptoms, and that the Asthma is one of those Irregulars, both as to any extreme Heat, Thirst, etc. and also in its Periods, because it returns every tenth Day in the Periodical fit, or else Spring and Fall, as intermitting Fevers; and it has this peculiarity of Anomalous Fevers, that its greatest Symptoms appear in the Nerves, viz. the Inflations, which I shall next describe. That old distinction of Natural, Vital, and Animal Spirits, must be still admitted, and approved by all Modern Physicians, and I will give my Explanation of it, being obliged to admit that there are Animal Spirits which produce the Inflations of the Membranes in the Asthma fit. If we consider the Generation of Vegetable Spirits, we may more easily apprehended the Rise and Constitution of the Animal. That all Vegetable Spirits are prepared from their Oil and Acid, appears by their Preparation; for if the Vegetables be fermented, a Spirit may be distilled from them; but if the Vegetables be distilled after a short Digestion, an Oil is distilled from the same. Fermentation dissolves the Tartar of Liquors, and makes it spirituous, by which it affects the Nose strongly. By Fermentation the Air is mixed or united with the most volatile Particles of the Oil and Acid, and that gives the Elasticity and briskness of motion to the Spirits of fermented Liquors; their Inflammability is from their Oil, and their sharp Pungency from the volatile Tartar: This volatile Oil and Tartar, if they swim in the Air, they are like the resinous Particles of Smells, affecting our Noses by their Spirituousness; but if contained in a Bubble of Water, they may be called the Spirit of that Liquor. Those volatile hot Parts, like fire, rarify the Air included in the Bubbles, and make it more Spirituous and Elastic; the Oil and Acid being of different natures in different Vegetables, they variously denominate and distinguish these several Spirits, and give different Rarefactions to the included Air in the Bubble constituting those Liquors. The first production of the Spirits in animal Humours is in the Stomach, when the Meat being dissolved by Fermentation, or Agitation of its aerial Particles, the volatilised oily Parts (which give the Foetor) and the volatile Acid, which smells sharp or sour, mixed with the aerial elastic Particles, and included in a Bubble of Water, compose the Spirits of animal Humours; the frothiness of the Contents of the Stomach shows the oily Viscidity of the Chyle, and that was necessary to constitute the Bubbles for containing the Spirits of animal Humours. These Bohnius describes in the Chyle, by the help of the Microscope, Chylus est fluidum ex globulis diaphanis, per liquorem crystallinum agitatis.— And pingues chyli particulae in bullulas sive vesiculas ab aeris A●omis reducuntur. If too much Slime abound in the Chyle, the most rarified Parts of the Air, and volatile Parts of Meat, are fully enclosed and retained, and created a very windy Liquor; such as is that of new Wine, or Beer, undepurated from its Slime, and windiness, or spirituous Air. It is in animal Humours as in all other fermented Liquors, the better it is fermented, the more quick and brisk are the Spirits; but if they be not sufficiently fermented, the Spirits are windy and flat; if over fermented, the Spirits are easily Evaporated, or else turned eager, or acid, or foetid: So all Aromatics, as Orange or Citron Pills, if fermented too long, they yield a foetid Oil and stink; if lesle fermented, they yield an Aromatic Oil. In the Chyle the Spirits are like that of new Beer, crude, raw, and not inflammable; but in the Blood they are more depurated by secretion of slimy Humours, such as the Lacteal Lympha, and by long and frequent Circulations, the oily, acid, aerial Spirits become more volatile, and are contained in the Bullulae which make the read particles of Blood: And these Bohnius thus describes; Rubicundam portionem autopsiae mobiliorem esse, hinc magis activam ratio suadet.— Sphaerulae illae agiles gelatinosa ramenta simul in motus perennes abripiunt, & mutua attritione deliquant, rubicundae vesiculae per Microscopium apparent per Crystallinam Lympham ferri, quae statim cum secum quietem componunt, motore vitali destitute, in grumum nigricantem facessunt. These large read Bullulae in the Blood contain the rarified Air, and volatile Particles; and because they do not readily mix with Water, they may have some Fatness or Oil in them. The use of these is to dissolve and make the mucilaginous Mass of Blood more fluid, which helps its Circulation and Secretion, Digestion and Assimulation of the new Chyle; and in this consists the use of the Vital Spirits. If these Globuli contain a very windy Spirit, that makes it subject to Effervescences, and Fevers, and Defluxions; for that forces the Serum that is Cacochymical, too much through the Cephalic, or other Glands', which aught naturally to be perspired, or go of by Respiration. If these windy Globuli fill the Respiratory Nerves, and Muscular Membranes, they produce that stiffness or rigidity observed in the Breast in the Asthma Fit. The Spirits we call Animal, are probably a Congeries of the Globuli observed in the Blood, and are separated from it by the Glands' of the Brain; and since the Animal Spirits pre-existed in the Blood, they must partake of the same preternatural Quality and State, as is observed in the Chyle and Blood, and be very windy, and easily rarified; and because of their mucilaginous Vehicle, unfit for a free Circulation through the Nervosum Genus, but apt, upon great Rarefactions, to stand inflated. There is a continual Flux of the Animal Spirits into the Pneumonic Nerves, for the necessary use of Respiration, and also into the Cardiac Nerves, to perpetuate the Circulation of the Blood, as also into the Par intercostale, to promote the constant Peristaltic motion of the Guts; and these Nerves are chief affected in the Asthma, and none of those which serve for voluntary Motion, and by reason of the continual Flux of Spirits through the mentioned Nerves, they must be more open, and apt to receive the windy Spirits from the Blood, by which the Asthmatic Inflation is made in the Breast and Primae Viae. The Nerves of the Lungs were also weakened by some precedent Inflammation in the Spitting Asthma, or else by Hysterical Dyspnaea's in the Hysteric Asthma; and that determines the motion of the windy Spirits very much that way. I have described the mucilaginous windy Temper of the Chyle, and Effervescence of the Blood, and windiness in the Animal Spirits, in a mucilaginous Slime, to whose Rarefaction the Stiffness and Rigidity and Contraction in the Membranes is to be imputed. If I had only described the Globuli, and imputed all Effects to mechanic Motion, I could not have taken any Indication thence useful in Practice, therefore 'tis necessary to describe the Cacochymia's, against which I must direct my Method and Medicines: And I must desire the Mechanic Writers to explain in what part of the Globuli the Oil, the Acid, and the Earth stands, and how Fermentation altars them, and how Medicines work any Alteration in them. The Chemical Principles are more useful in Practice than the Mechanic, but above all the old Galenic Cacochymia's: For tho' Nature be too fine for me to discern its Figures and Motions in Fermentations, yet 'tis easy for me to observe the Effects of that great Instrument of Natures, whereby she changes Liquors from one Cacochymia to another, and makes the preternatural State sensibly slimy, windy, acid, serous, or salt, viscid, acrid, bitter or putrid; this I can see, taste and understand; these were the true, sensible, ancient Galenic Notions useful in Practice. In his Method of curing Inflations, he describes the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Animal Bodies, which is raised by the natural Heat, and aught to perspire from our Humours, after a perfect Digestion; and when the innate Heat (by which is to be understood the Fermentation of Humours) is weak, or the Humours half digested, thick, glutinous, that impure Spirit cannot perspire, especially if the Pores be stopped. He observes farther, that sometimes the Heat being increased, the thick and glutinous Humours are resolved into thick Vapours. Galen describes the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, as the Matter of flatulent tumors, which he calls 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, not 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, nor 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉; and this he explains by a different Constitution of the Air in the South and Northwinds; a tempestuous Air full of Vapours is like the windy Spirits, but a clear sedate Air like the natural Aetherial well digested Spirit. This notion is easy, obvious, and true; for in fermenting Liquors there rises a spirituous Vapour from them, which bursts the Vessels if restrained, and this is the windy Spirit; but that which agitates the Globuli of perfectly Fermented and Depurated Liquors, that is more pure and lesle Elastic than those beforementioned. I will next describe those nervous Parts that are filled, inflated, and become tense or stiff by this immature or ill prepared Spirit. Galen observes, That the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 is contained sometimes under the Skin covering the Bones, sometimes under the Peritonaeum, sometimes in the Belly, sometimes under the Skins covering the Muscles, and sometimes in the membranous Tendons, and the Muscles are filled with that Spirit; by which we may observe, that he observed it was usual for that Spirit to affect the Membranes; but this it does not only externally by Inflating them, but enters into the hollow Tubes of the nervous Fibrillae, which constitute the Nerves and Membranes. The Membranes that are inflated, and thereby contracted in the Asthma; are, First, Those of the Lungs and Cavity of the Breast. Almost the whole Substance of the Lungs is Membranous, consisting of the Trachea, Bronchea, and Vesiculae; the exterior Membrane of the Trachea is described to have motritious Fibers, which go along the length of it, to abbreviate the Trachea, and circular Fibers to contract its Cavity. It has also an inward Membrane extremely sensible of Fume, Dust, or the lest Injury, and the Vesiculae of the Lungs constitute a great spongy Substance of it, and they are described to have muscular Fibers, for to contract them in Expiration. Pulmonibus musculum reticularem collulas eorum singulas ambientem, & comprimentem supersterni.— Et tracheae tunicam succingentem e rectis & circularibus staminibus Musculosis coagmentari, is observed by Anatomists; and these Muscular Stamina, like the Fibrae Nervosae, which move the Stomach and Guts, are inflated in the Asthma, as the others be in the Primae Viae. The whole Cavity of the Breast, the Intercostal Muscles, the Diaphragme and Sternum, are covered with the same Membranes, which are affected more or lesle with an Inflation in the Fit of the Asthma; and on this do the Symptoms, appearing in the Breast, depend. By this Inflation the Bronchia are contracted or straitened, and that produces the Wheezing noise in Expiration, and that this Symptom does not depend on Phlegm is plain, because the Hysteric, who have no Phlegm, Wheeze very much. The Lungs feel stiff, straight, and admit but little Air, because the Vesiculae are contracted, as well as the Bronchia; and some express their feeling, as if the Lungs risen and were drawn upwards, to choke them. This contraction of the Vesiculae is very probable, because the Bronchia are contracted, and the Vesiculae have the same Muscular Fibres to help Expiration, by which they may be drawn so up, as not to admit the Air. From this Contraction of the Vesiculae and Bronchia of the Lungs, it follows, if the Air cannot be admitted there, the Breast cannot be dilated duly, to make a true Inspiration. The motion of our Lungs is like a Pair of Bellowss, if they be opened by the force of our Hands, and the cavity will freely admit the Air, we can move them easily; but if the Nostrils and entrance of the Air be stopped, or suppose a Bladder tied within the Bellowss to the Nostrils, so to receive the Air, and suffer none to get into the cavity of the Bellowss, but what it contains; it will follow, that in a perfect stoppage of all the entrances of Air, the Bellowss could not be opened; and if no more entered than may be contained in the Bladder (supposed above) the Bellowss would be opened but a little way, and would inspire difficultly. So it apapears in the business of the Asthma, the Inspiration is difficult and laborious, because but little Air can be admitted into the contracted Bronchia, and the Vesiculae drawn up: This puts the Scapular and Intercostal Muscles and Diaphragme upon a violent endeavour to press in the Air, and open the Lungs, which nisus Authors have mistaken, and supposed the Pneumonic Muscles, especially the Diaphragme, to be convulsively affected; but it may be easily apprehended, that the Diaphragme cannot press the Viscera downwards to enlarge the Breast, if the Air cannot beadmitted into the Lungs to follow its depression, and fill the cavity of the Breast; for in that case the weight of the Atmosphere pressing on the Belly, would more than counterpoise its force. And this is the true reason why the Diaphragme cannot move in the Asthma Fit. Not only the Membranes immediately composing the Lungs are Inflated, and thereby the cavity is contracted in the Asthma, but also sometimes the Membranes of one or both of the Pleura's, and that draws the Asthmatic to lie and lean on that side during the Fit, and flying Pains are many times observed after the Fit. The Mediastinum is affected in others, who complain of straitness, weight, or pains towards the Sternum; and the Pericardium is also affected in those who are subject to Fainting Fits, or Palpitations, or I●●●mitting Pulses. The Membranes of the Muscles and Diaphragme being tense or stiff, may hinder the motion of the Pneumonic Muscles, because the Membranes being supposed to arise from the Tendons, and being continuations of them, they may divert the Spirits from the body of the Muscles, and by their straitness hinder both the flux of Spirits and Blood into the Muscles, by compressing the Arteries and Nerves. The slowness of Inspiration and Expiration in the Fit depends on the stiffness or straitness in the Lungs, and Parts inflated, which resists the Action of the pectoral Muscles; 'tis a long time before the Air can be drawn in, and almost as long before it can be forced out, because of the constriction of the Bronchia. The rareness, or stop, or interval betwixt Inspiration and Expiration, depends on the stop given the Pulse by the Asthma Fit, (and that stop is made either by the Constriction on the Pericardium, or the Membranes of the Arteries;) for the stronger and quicker the Pulse is, the more frequent are the Inspirations and Expirations The great labour for Inspiration, is, because the Diaphragme cannot move downward, by reason of the stop given in the Lungs to the Airs Inspiration; for the Diaphragme should depress the Belly, and thereby enlarge the cavity of the Breast for Inspiration: This defect obliges the Asthmatic to labour more with the Muscles of the Shoulders to lift up the Breast, and for the same reason the Asthmatic must sit up, that the weight of the Belly may a little weigh down the Diaphragme, and the Asthmatic finds ease in leaning forward, or being held up under the Arms to enlarge the cavity of the Breast for Air; and this sort of Breathing is called Sublimis and Magna, because the Breast is more enlarged upward in this Dyspnaea more than any other, and yet but little Air is drawn into the Lungs. Secondly, The Membranes of the Head are much affected in the Asthma with an Inflation, which makes the sense of numbness in some, in others fullness, or straitness, as if the Membranes were on all sides drawn downwards; and this straitness produces a stop in the Blood Vessels, from whence comes Pain, Dulness, Stupidity, and running irregular Fancies; but this usually remits before the Fit goes of, after the sleep of the first Night of the Asthma; and is much abated by Combing the Head backwards, and keeping it cool, and getting out of Bed in the beginning of the Fit. This stop on the Vessels does in old Asthmatics produce the Dropsy in the Head, of which they always die Lethargic. Thirdly, The Membranes of the Stomach and Guts are much affected by Inflations in the Fits: Hence come frequent Eructations, when the Stomach is empty, yet it feels full, distended, and the Guts are disturbed with continual Wind, which sometimes gripes them, or gives Inflations and Contractions; and sometimes the small Fits of the Asthma, which depend on Wether, are only in the Primae viae, where the nervous Fibres and Membranes suffer Inflations: The changes of Wether very much affect the Primae viae, by a flux of serous and flatulent Humours that way, by which the Contents are violently Rarified, and the Membranes irritated into Inflations, and also the windy Spirits raise some disturbance in the Membranes, and a distension which hinders the motion of the Diaphragme. The Incubus is very like the Asthma. It takes Persons therewith affected in their sleep; they have a difficulty of Breath, and they have the same difficulty in moving their Hands and Limbs, which is more than is in the Asthma; the Incubus lasts but a shorter time, depending on the crude Spirit, filling the Nerves from a full Stomach, which evaporate on waking, or else the Stagnation of Chyle in the Heart and Lungs, for I have observed their Pulse to Intermit. In the Palsy, where the Nerves are obstructed above, there is no Inflation of the Parts beneath, but they are rather weak and flaccid, but the Asthma Fit lasts but few hours, or some days; and if in the Asthma the Nerves were obstructed in the Plexus, how can that be so soon removed? or the Lungs appear stiff and inflated below? they would rather be relaxed below the Obstruction. The Irritation of the Nerves by the Serum extravasated in the Head is only in Cachectic Persons, and those who are Hydropical, and cannot ordinarily produce the Fits, but is the effect of a long Disease. The Asthma often ends in Tympanitical Inflations of the Belly, and that Distemper by Analogy may explain the preternatural State of the Spirits; for windy Inflations affect the Guts alike in both, and that makes the Parts stiff and rigid; all hot things increase the Inflations, and cool ones alloy them in both; so that the same is the preternatural state of the Spirits in both, they being crude and unripe, because contained in a mucilaginous Lympha; so that being Rarified on any occasion into large Bubbles or Froth, they produce that Inflation in the membranous Fibres, the which makes them stiff, and the Inflation contracts the cavities they constitute in the Lungs, etc. The windy tumors of the external Parts, which presently subside again, are not unlike the Asthmatic Inflations. In the Belly, those windy tumors depend on the Tumour of the Viscera, compressing the nervous Parts, and are therefore more lasting; but in the Asthma the Spirits are only Rarified, and 'cause their own Obstruction and Stagnation for a small time, till the windy Spirits are Evaporated, or again compressed and restored to their natural Consistence. I never could observe any Tumour, Pain or Stiffness, Fullness or Convulsion in any of the Expiratory or Inspiratory Muscles. If the Diaphragme was convulsed, that would help the Inspiration, by enlarging the Breast, as in its natural Motions; If the Muscles of the Belly, which help Expiration, were convulsed, that might easily be observed by their pressing in the Belly; and the same would be observed in the Triangular Muscle of the Sternum. I must confess I have observed a twitching sometimes, when the Breast is almost perfectly subsided, but that is not constant; so that I cannot think any Convulsion is commonly found in the Asthma Fit, but is sometimes a Symptom, upon Extremities of Labouring and Suffocation. No other Hypothesis seems to me fairly to explain this lasting Stiffness of the Lungs, but an Inflation in its Membranes, which hindering the entrance of Air, gives a Catalepsis, and Rigidity, or immobility to the Diaphragme, the Part most unjustly accused of this Tyrannic Oppression. I shall from the Discourse above about the antecedent 'Cause of the Asthma, and the parts affected by it, give the following Definition of this Disease. The Asthma is a high, slow, rare, and laborious Respiration, which depends immediately on the Inflation of the Membranes of the Lungs (which constringe the Bronchia, Bladders of the Lungs and Blood Vessels) by windy Spirits, rarified or propelled through the Glands' of the Brain, either by external Accidents, or a periodic Febrile Effervescence of the Blood. The Priapism is reckoned by old Writers amongst the windy Inflations; and it is truly so; for as the windy Spirits in the sleep inflate the Membranes of the Penis, and by stopping the Circulation of Humours make a Stiffness or Inflation; so it may be in the Nervous Fibres of the Lungs, there are no true Muscles in either part to make this Inflation, but only nervous Fibres, and in the muscular Membranes, the stiffness of these Parts is not a Convulsion, for that is transient, but a true Inflation, which may endure many days; and therefore Helmont was mistaken when he called the Asthma Pulmonis Caducum, which seems rather to be of the nature of a Catalepsis, in which all the Parts stand rigid, stiff and immovable. CHAP. III. Of the evident Causes of the Asthmatic Fit; as, the Air, Diet, Exercise, Passion, etc. and of those Diseases on which the Asthma depends as a Symptom. I Have described the Nature of the true Flatulent Asthma in the preceding Chapters, and in this design to describe the Accidental Fits of the Asthma, depending on the Six Nonnaturals, and also several kinds of the Symptomatic Asthmas. First, The Air. Not Changes or Alterations hap in the Air without causing some Alterations in Animal Humours and their Spirits, especially those of the Asthmatic, the Air being admitted into the Lungs, and every where compressing all the external Parts of the Animal, according to its several degrees of weight or pressure; it must affect the Spirits, which are also of an Elastic Quality, and expand themselves the more the external pressure of the Air is abated. This Mr. boil has sufficiently proved. For Animals are wonderfully inflated or blown up in his Vacuum; the Eyes start out, and they Vomit; but upon the readmission of Air, they subside into their former bigness; and in very high mountainous places, 'tis observed, by reason of a lesle pressure of the Atmosphere, that Vomiting, Choleras, Hemorrhages, and Dyspnaea's hap. The Respiration is most particularly affected by the Alteration of the pressure, because in Inspiration, the Air, by virtue of its Elasticity, expands the Vesiculae of the Lungs, and therefore that expansion must altar according to the different pressure and elasticity of the Air. For want of this due Expansion in the Vacuum, the Circulation of the Blood is stopped in the Lungs, and the Animal dies Convulsive: And that the pressure of the Air being weakened, occasions short breathing, is not only evident by those who have been on very high Mountains; But Helmont describes an Asthmatic, of whom he tells us, Montanis locis pejus se habet, ideoque Bruxellis vix pernoctare audet: And it will more fully appear, by comparing the Observations made of Wether by the Barometer, with the Changes in the Spirits of Asthmatic Persons, and their Fits, which succeed on the Changes of Wether. I will first prove that the Spirits of Animals be very Elastic, and those of Asthmatics much more so, because very windy. If the Experiments above mentioned are not sufficient to convince the Reader, let it be considered, that the Spirits of Vegetables are very Elastic, and force their Vessels in very high Fermentations, and in bottled Liquors; that the Changes of the Wether make Vegetable Liquors clear or turbid, and set them to Ferment again; upon the Changes of the Year, Wines Ferment: And the same Changes may be observed in Animal Humours, upon Changes of the Wether, and the Times of the Year, which shows the Similitude of their aerial Spirits, which keep the same Expansion and Pressure as the Air itself has, which is the great Instrument of the Agitation by which Fermentation is managed, and also the chief cause of fluidity in Liquors, as well as the clearness of their consistence. That the Animal Spirits are Elastic, appears by the Inflation of the Belly, and all the Habit of the Body in those who die Convulsive, their whole Body being excessively swelled; and in Poisoned Bodies the same happens when the Poison comes by those Medicines which act much on the Spirits. All Liquors, as Milk and Blood, are raised into Bubbles in Vacuo Boyliano, upon the Pumping of the Air, which is occasioned by the Rarefaction of the included Air and Spirits; and that Air is included in Animal Humours, is evident by the application of Cupping-Glasses, by which the pressure of the external Air being removed, the Internal Spirits and Air become rarefied by its Heat, and swell the solid Parts in which they are contained. I will next consider how the Spirits of the Asthmatics are affected in the different States of Air, and show that those Effects are produced in Animal Bodies, by the same cause as the Alterations are in a Weatherglass. In a dry state of Air, the Spirits of the Asthmatic are most lively, and they breath free, there being than no Vapours in it, or Fumes to weaken the pressure of the Air; for in Serene Wether the Mercury stands higher than in other states, because a larger Cylinder of Air unmixed, presses up the Mercury in the Barometer, and by this heavy pressure of the clear Air, the Spirits of the Asthmatic are kept from that Expansion, which ordinarily produces the Fit. 'Tis observed that the Intervals of the Fits are largest in dry settled Wether. When any Mist arises, the Asthmatic breaths difficultly, and finds an Oppression on his Spirits, especially a Straitness and Fullness at the Stomach, upon Changes of Wether, though the Fit does not always succeed that complaint. The Moisture of the Air is most prejudicial to the Asthmatic, whilst the watery Vapours retain the nature of Exhalations, because than they act most on the Spirits, and 'cause the Inflation at the Stomach. The Rain when it falls, does not much affect the Asthmatic, but the watery Vapours which precede it one, two, or three Days, because the Vapours weaken the pressures of the Air, as appears by the Barometer, which sinks sometimes before Rains, and great Storms, and the Asthma Fits hap two or three Days usually before such Changes; but I have observed the Animal Spirits to be more nice, and predict the Alteration before the Weatherglass. It is observed by Seamen, that if there be any bad Wether in a Month, it usually happens two or three Days before, or after the Full or Changes of the Moon, which is the reason why the Asthmatic Fits hap at those times. The pressure of the Air being weakened by the Vapours, the windy Asthmatic Spirits expand themselves, and inflate the Pneumonic Nerves and Membranes, and occasion the Asthmatic Fits before great Rains. All damp Houses and fenny Countries, and those Winds that bring fenny Vapours and Mists, by altering the pressure of the Air, very much affect the Spirits of the Asthmatics; and such the East Wind often brings, which at its first coming usually give, the Asthma Fits, upon very great Winds and Storms, though no Rain follows, the Mercury sinks lowest of all; for these drive away a great quantity of the usual Cylinder of Air, by which the pressure of the Air is altered; and before great Storms I have frequently observed great Asthma Fits. It was one of Van Helmont's Observations, Al●as observavi, quae spirante Boreâ statim vel in Hypocaustis Asthmate plecterentur insontes. The South Wind is also offensive by the moist Air it brings, but the West and North are least prejudicial here in England. From other Causes I have observed the Fits of the Asthma to hap, in all the various Points of the Winds, so that the Changes of the Air and Winds only dispose or incline the Asthmatic to their Fits, and often occasion them; but such accidental Fits are short, and I generally observe them to trouble the Stomach most, where a Windiness inflates it, and hinders the depression of the Diaphragme, but no great alteration happens in the Lungs; for the Fit goes of with Wind, and a little Spit, and lose Stools. In Summer the Asthmatic Fits are most frequent, and grievous; the Asthmatic are most impatient with Heat, especially that of the Fire, before which they do not willingly sit, but most of them, taught by long Experience, choose to sit on the side of it. The heat of the Fire rarefies the Air, or over-heats it, so that it expands the Animal Spirits in the Lungs, and disposes them to their Asthmatic Inflations. So we observe in Dogs, a great Dyspnea occasioned by lying too hot near the Fire. Van Helmont observes, Aestate saltem saepius & saeviùs infestat accessus, quam hyeme, which is generally true, though I have discoursed some who complain most of the Winter. These Winter Asthmatics have a Catarrh joined with their Asthma. I had once a Patient who was a fat Woman, who complained of her Winter Asthma; she Spit very much, and complained of frothy Urine, and Stools like Barm, who by a Diarrhaea was run very Consumptive, and during the continuance of that, she had none of the Asthma. That Vegetable Spirits are expanded by Heat, appears by the Thermometer, and the Animal are alike expanded by the Heat of the Sun, Fire, Clotheses, and the Bed, or a Crowd, or close Room, because of the hot Air in them are very offensive. All Heat weakens the pressure of the Air, as it appears in Cupping-Glasses, and that being weak, it cannot easily expand the Bladders of the Lungs; therefore Asthmatics seek a moderate cool and free Air, which makes a more vigorous pressure on their Lungs, and cools their expanded Spirits, which thereby does refresh them; they love the Windows open, and to be carried into the open Air in a Chalash, to avoid all hot Places, and Wether, which Suffocate them. The Fit of the Asthma is generally increased by the Heat of the Bed, and it usually seizes them there, and they are obliged to rise out of it, and they can bear a great degree of Cold, in sitting up all Night with the Windows open on them, because of the great Expansion of Animal Spirits by the Fit. I have often had great Fits when the Wether has continued very clear, and only very hot Wether has succeeded, to which I than imputed the Fits. In very cold Wether the Fits of the Asthma are lesle violent, because that compresses the Expansion of the Spirits; but before any great Snows, the Asthmatic usually have a Fit, and that a severe one; or, or lest, when the Fit does not succeed, they feel a Fullness at Stomach. The Quicksilver falls in the Glasses for want of pressure in that state of Air, and occasions or gives way to the Expansion of the Spirits; and before such Storms of Snow, the Spirits feel very uneasy and restless, and some Rheumatic Pains affect the Temples, or top of the Head, with a lightness in the Head, and other Pains are observed in the Limbs: Hence it appears that frozen Vapours have the same effect on the Barometer, and the Spirits, as the floating moist Vapours have, and the reason of both is a lesle pressure in the Air at such times. In calm frosty Wether the Mercury stands high, the cold Air being condensed weighs most; and in such Wether the Asthmatic is most free from Fits, for by compression of the Spirits the Asthma is hindered. The Mercury stands highest in the cold Easterly and Northerly Winds, because the cold condensed Air is driven hither by those Winds; and since that Air is heaviest, we must impute the Fits occasioned by them to a sudden check of Perspiration, which produces the Effervescence, on which the Asthmatic Inflation depends, and not only to the want of pressure in the Air. In extreme cold Wether the Circulation is more stopped in the External Parts by the compression of Air, and therefore than the serous Humours are carried inwardly towards the Belly, Lungs or Brain, where they pass those Glands', after the manner of a Defluxion. Any kind of Smoak offends the Spirits of the Asthmatic, and for that reason many of them cannot bear the Air of London, whose Smoke, like Fire itself, irritates their Spirits into an Expansion. I always observed the Smoke of Wood more Suffocating than that of Coal, and more apt to occasion a Cough. The fetid smell of a Candle put out, or the smell of melted Grease, will often occasion a Fit: And I remember an Asthmatic Lady had a severe Fit by the smell of an Ointment she boiled. Horstius has a Remarkable Story of a Woman who grew Asthmatic, by holding her Head over the smell of a Lixivium, for the making of Soap, of which she died after 7 Years; and in her Windpipe opened, black Glands' were observed, of the bigness of Peas or Beans, to which the Fit was imputed. A Lady informed me that she smoked Tobacco for an Hysterical Pain in her Stomach, by which she fell into the Asthma, for which Astrop-Waters gave her some Relief. During the Fit of the Asthma, the smoke of Tobacco is so offensive, that it very much straitens the Breath, if it be smoked the first Day of the Fit, and much endangers a Suffocation. There are many Asthmatics that cannot bear the smell of it, therefore its Foetor is injurious at any time, its Heat thickens the Phlegm, and rarefies their aerial Spirits, making them restless; all the good it can do, is, to discuss the Windiness after the Fit abates, and to help the Coughing up the Phlegm; but it generally over heats the Air in the Humours of Animals, and raises the Fermentation too much. There is a Remarkable Instance in Bonetus, of an Asthmatic who fell into a violent Fit, by going into a Wine-Cellar, where the Must was fermenting; and this shows how much the Spirits may be disturbed by Fumes, which are capable of Rarefying them, or else causing a Fermentation in the Humours, which will certainly 'cause their Expansion to produce an Asthma Fit. The Fumes of Metals dry the Lungs, and especially those of Quicksilver, which may corrode the Trachea, or at lest irritate the Spirits there, and determine their motion much towards the Lungs, where the Fumes are received. Fumus Mercurii (qui ut larvatus semper est tamen Mercurius) statim laringem praecludit, & constringit: Helmont gives us this Observation; from whence we may observe the Stipticity of Mercury, and that Stipicity was observed by Avicenna in Mercury, which Taste is always injurious to the Asthma: Those Fumes which Irritate, may vitiate the Trachea, and produce the Humid Asthma, as Helmont describes the Asthma from such Fumes. The Dust of other Metals fills the Lungs and irritates them, and the Fumes dry the Lungs like Flesh dried with Smoak, and this Asthma is to be cured by moistening them with Oil, and Milk-Diet, Mucilaginous Pectorals, and open Air. Mineral Poisons are best corrected by Mineral Medicines; Mercur. Dulcis with Lenitive Purges, Antimonium Diaphoreticum with Theriaca to Sweated, Sulphur Flowers unite with Mercury. There are some Instances of Shortness of Breath occasioned by Thunder, and helped by Sulphur Medicines, and Vomiting; to which those who are Thunderstruck, and recover, are inclined, as I have been told. Not only foetid offensive Smells occasion the Asthma Fits, but those also that are strong scented and sweet, and most Asthmatics are affected by Perfumed Waters and Medicines, as the Chemical Oils offend by their strong Odours. There is a Relation of a Monk, in Helmont, who when he eat Fish fried with Oil, Ruit extemplo anhelitu privatus, sicut vix praefocato distinguatur; and this Observation Helmont farther confirms, Vidi frequentes, quae suave olentium odore praeter cephalalgias, & syncopes, confestim in extremam respirandi difficultatem inciderent. Since I have given these Instances of the great Influence of Smells upon Animal Spirits, I will beg pardon to digress a little, to consider the nature of Smells, that by comparing what I shall say of them with my ●ormer Discourse of Animal Spirits, I may give a general account of these great Effects produced by Smells. I will describe the Matter of Smells, than their Differences and Manner how they variously affect the Animal Spirits. The●phrastus has observed that every thing that is unm●●'d is without smell, as well as taste, therefore all Simple Bodies are without smell, as Water, Air, and Fire are without smell; but that the Earth alone has a smell, because most mixed. Tastes and Odours are therefore chief to be observed in Juices of Plants or Animals, or Metals, and it is is a particular Texture in those Juices, which arises from the mixture of the Principles of things, (viz. the Oil, Acid, Earth, and Water) which strikes the Organ of Taste, with a particular taste, and the same specific texture and mixture was necessary to produce a particular smell, which every Plant and Animal has peculiar to itself; for what gives the taste in the form of a Liquor, if it be Rarified and ascends into the Air in Vapour, it strikes the Organ of Smelling with a particular Odour. Since there is no Odour without Taste, nor Taste without some Odour, and the Odour in Wines and Fruits are changed with their Tastes; the matter of both Tastes and Smells appears to be the same which gives such a vicinity and sociable accord to both those Senses, that Plants are said to taste as they smell, and è contra; and we use the names of Smells, as Foetid and Aromatic, to express our Tastes; and, I think, we aught also to use the Names of Taste, to express the great variety of our Smells, as I shall do hereafter. Odours are not sufficiently distinguished into their Species, which want Names, and they must be borrowed from the tastes of Plants. Odours are commonly distinguished into pleasant or grateful 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and ungrateful or ill smells 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉; but since all Animals have a great variety in their Food, and that was designed to be grateful to them both in Taste and Smell, the different Temperament of each Animals Humours and Spirits must make one Food grateful to some, which will prove very ungrateful to others: So it may be observed of Birds of Prey, as Kites, Crows, delight in putrid Flesh, which is to Mankind very ungrateful and unnatural; therefore the gratefulness or disagreeableness of a Taste or Smell consists in its suitable Nature to the Spirits of each particular Animal. Every Animal has his peculiar Odour, according to the particular Temperament of the Humours, which is pleasant and sincere in the Vigour of its Age, and in perfect Health; it is sweet in Youth, but strong, virose, at the Seasons for Coition, or when the Humours are changed by Age or Diseases, they smell ill, strong, rank, as in Rabbits, Goats, Deer. The Matter and vaporous Nature of Smells in Plants and Animals, does most immediately represent the Nature of the Spirits of Animals, and their various States. 1st. Odours are very volatile, lighter than the Air in which they swim, and such are the nature of Animal Spirits volatile, invisible, as Odours, and the effects of a thorough Digestion; for Plants have not their true Odour till they be full ripe, and in Flower; Wine smells more odoriferous than their unripe Must, and Plants in their native Soil are better ripened, and therefore more odoriferous than in the Garden Soil, where there is too much crude Juice: And in a Morning, after a perfect Digestion of Animal Humours, we are sensible that our Spirits are most pure, active, and lively. 2dly. The Matter of Smells in Plants, is chief an Oil, or Turpentine, or Rosin▪ in Animals a greasy or fat Substance▪ Wine and Oil does most easily imbibe and dissolve Odours, because of the similitude of oily Substance; and in Oil of Ben and Almonds we usually preserve Aromatics. In Animals the most odorous Juices are Oily, as Musk and Castor; nothing smells stronger than the Axungia's, and all these readily mix with Oil, by reason of their oily nature. Amongst Minerals the Bitumen, which are of a strong smell, have an evident Oiliness, as Ambergrease, and Petroleum, and Sulphur is ready mixed with Balsams. 3dly. All Aromatics give a briskness to the Spirits, and please them if smelled to, and supply a larger quantity, if deficient, and are therefore accounted Cordials; foetid Smells are accounted Hysteric Medicines, and enlarge the Expansion of Spirits; and since Smells act so immediately on the Spirits, there must be a great similitude betwixt their oily Substances. But these effects of Smells on the Spirits, must be more particularly considered, and for that end I will divide Smells into their several Species, and give the Names of Tastes to several of them, whose Effects being well known, it will be more easy to assign the true Effects of their Smells on Animal Spirits. I will give Avicenna's Opinion of Tastes, and their Virtues, Non est possibile ut sapores dulcis, & amarus, & acutus, & salsus sint nisi in substantià calida; neque ponticus, Stypticus, & acetosus, nisi in substantia frigida; & similiter odores acuti non sint nisi in substantia calida; odores quandoque significant sapores, sicut odor dulcis, & acetosus, & acris & amarus; sapores sunt octo dulcedo, amaritudo, & acuitas, & salsedo, acetositas, ponticitas, Stypticitas, unctuositas. I will reckon all the following Smells amongst the hot Smells, which affect the Head, and expand the Spirits, and give them a quicker Motion. 1st. Acrid Smells, which are pungent; and Authors call this 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, but these may be very much distinguished, according to the Degree of Acrimony; for a cress Acrid is milder, such as Mustard; than a corrosive Acrid, such as Garlic, or Squills; and Acrids may be distinguished by the Aromatic, or Bitterness, or Foetor joined with them. These kind of Smells are most specific to those indispositions of Spirits, which hap to arise from that state of Humours which requires a hot acrid Taste to correct them; in Hypochondriac cases we excite the Animal Spirits by volatile Salts, and we give the same inwardly: In Hysteric cases, we discuss the flatulent Vapours by foetid and acrid Gums, both outwardly and inwardly, so that it may be a Rule, where any Taste is necessary and useful inwardly, we aught to apply the same, if Odorous, outwardly, to rectify any Disorders of Spirits, that may hap in that case; and why may we not infer, that since any Medicine externally applied to the Smell, very much gratifies it, the same may be given inwardly to altar the Cacochymia, from whence the disordered Spirits are produced? This seems a piece of natural Reasoning, whereby Brutes discover their Medicines when they are Sick, and they eat what pleases their Smell; and if any Medicine or Meat pleases both Taste and Smell, we readily use it. If the piercing and volatile Nature of acrid Smells be considered, we shall never apply them to Hysterics, where the Spirits are over-volatile and fiery, which seem only proper for the stupid, dull, contracted State of Animal Spirits. 2dly. All Aromatic Smells, as well as Tastes, are hot, and they have either a great Acrimony, or a Bitterness joined with them; fresh Orris is bitter, and exulcerates the Skin, Myrrh, Costus, Cinnamon, Cassia, Juncus Odoratus, Cyperus, are described by Theophrastus to be hot, acrid and styptic, for which Tastes they are used as Medicines. The milder Aromatics have a sweetness, as Fennil, Aniseed; but all strong Aromatics a bitter Taste: These Smells are on the account of their Acrimony and Bitterness very hot; these Aromatic Smells we apply to fainting Persons, and the same are very useful inwardly in a languid state of Blood and Spirits. These volatile oily Salts or Balsams are easily infused in Vinous Spirits, and if they be put into Wine as the Ancients used, (viz. they commended Wines impregnate with Myrrh, Cedar, Rosin, etc.) they affect the Head much, and raise the Circulation of Blood, and Expansion of Spirits, and by similitude of oily Parts assimilate themselves with the Animal Spirits. These Aromatic Smells will not agreed with the choleric, hot, fiery Spirits, because the Aromatic inwardly in that state of Humours are too hot, burning and inflaming the Humours and Spirits. 'Tis this excessive Heat of odoriferous Medicines which gives a vertiginous Motion to the Spirits of hot Constitutions, and too much expands the windy Spirits, and thereby produces a Dyspnaea. 3dly. Foetid Smells, which the old Writers call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, Gravis Odour, this is offensive to the Spirits, as Aromatics are grateful; if they be Narcotic, they stupify the Spirits, and alloy Pains, Watch, stop Bleedings at Nose, and too great a volatility of Spirits, and their great expansion in Convulsions: And these Foetids, though very acrid in Taste, and very bitter, yet because of a peculiar texture 'cause a coolness of Spirits, and therefore may be reckoned amongst the cooling Smells; but all other Foetids, as Assafoetida, Castor, volatile Salts, Amber, Sulphur, and the fume of the Fat of a Sea-Calf, Horns and Hoofs are of very hot Parts, very volatile, they expand the Spirits more than Aromatics, but because they prevent their tumultuous Expansions by changing their motions or texture, they are useful to some Hysteric Women, but extremely offensive to others, who cannot bear the lest of those foetid Smells. And Pliny relates that the Ancients did by burning Bitumen, try whether their Slaves were Epileptic or not; Accenso lapide gagate explorabant Epilepsiam in servis venalibus; by which one might conclude, that Bitumen, and other Foetids, are injurious to Convulsive cases, especially when they come near to be Epileptic; in which cases I should doubt of Castor, Assafoetida, Powders of the Skull, Vipers, Toads, Worms, the Stones of Horses, or Secundine, all these being strong Foetids, rarefy tumultuous fiery Spirits into violent Fits, and drive more morbifie Matter into the Nerves of such Persons, which are too open to receive extraneous Matter. All poisonous Plants, whether Narcotic or Corrosive, are very Foetid; such as Napellus, their Foetor offends the Spirits, and their Burning or nauseous Taste, the palate, that thereby Animals might be naturally taught to avoid them. All putrid things are very Unwholesome in our Diet; and Theophrastus well observes, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, the Foetor gives us an aversion to it, therefore I should always avoid giving Mummy, or other putrid Parts of Animals, as Skulls, Rennet; to these who have a violent Aversion, especially if we smell their putrid or virose Odour. Foetid Smells outwardly, and Foetid Medicines inwardly, are useful always in the same case, viz. Lethargic and great Dulness of Spirits; the Ancients gave Castor from ℈ i to ʒss. and ʒi. for a Dose; for 5 days, they used the same quantity in Clysters, they mixed it in Sternutories, or used its Fumes, and they anointed it outwardly, and in very hot Bodies they contrived to temper its heat, by giving it in Oxymels, or Vinegar, and not in Brandy Spirits, as we improperly do. 'Tis plain to me, that Foetids do more good after their Acrimony is abated by Vinegar, than in a finer Solution: We therefore act very oddly, when we study more for a Menstruum, which shall curiously dissolve a Gum, but neglect an experienced Vehicle, which makes it better to agreed with our Constitutions. Vinegar does not dissolve Gums well, but coagulates them; but nothing corrects their corrosive Acrimony like it: Water is their most natural Menstruum, which turns them into their original Milk, and Brandy Spirits only dissolve the resinous Part, and not the whole Gum. The cool Smells are those which abate the Heat, Motion, and Expansion of our Animal Spirits. 1st. Crude Smells, such is that of fresh Plants which are set in Rooms to correct the heat of the Air, as Vines, Nymphea Leaves, Willows, and all Plants of a crude Juice, Meadow sweet, and fenny Plants. The smell of a green Turf is used to be held to the Noses of them that are struck with a Damp, to recollect and cool their Spirits, which are too much rarefied by the Sulphur Fumes. 2dly. Acid smells, such as is that of Vinegar: The Seamen use Vinegar much to correct the putrid Air of their Ships, by washing the Wood and Beams of their Cabins with it. This is therefore very agreeable to the Sick in many cases. The smell of Vinegar removes the nauseousness, and prevents Vomiting, and cools. Omnes odores ex quibus sentitur mordicatio sunt calidi, & bene redolentia, quapropter dolorem capitis pariunt, & illi ex quibus sentitur acetositas, omnes sunt frigidi. Avicenna. The smell of the Fumes of Vinegar is proper for many Hysterical Women, who cut Rue and Nutmeg, than sprinkle it with Vinegar, so they tie it in a Nodulus to smell to: This will most effectually compress the expanded Spirits, for Acids make the Blood black, which the curious Microscope impute to the Globuli crowded together, as they do the Floridness to the Division and Separation of the Globuli. Vinegar will cool the Elastic Particles, and abate their Expansion, for that corrects all volatile Salts, thickens Oils, coagulates milky Juices, cools Inflammations, stops Evacuations and Fermentations, and has all properties contrary to the action of Fire, and all hot Animal Principles, for they rarefy and expand the Spirits and Humours, and make them more agile, elastic, fermenting. Vinegar agrees with Fevers and all Inflammations, and Effervescences of Humours; therefore the smell of Vinegar is very suitable to all Nervous Effects depending on such Diseases, such is the Hysteric Fits and Inflations of Spirits I have described, and in all furious Dispositions of Spirits, where their motions are tumultuous, in Deliriums, Phrenetics. 3dly. The Narcotic Smells, such as Primrose, Poppies, give a Heaviness to the Spirits, and dispose them to a lesle Expansion; therefore we may add these to a Nodulus with Vinegar to compose the Spirits. Sweet Smells, such as the Writers call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, seem to be Cordials refreshing the Spirits, but neither so strong as to discompose them, but so warm as to continued the motion or expansion. A strong (〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉) Smell is when there is very much of a Smell in any thing which makes a violent impression on the Spirits. The heat of Fire, or of the Sun, or grinding, causes the Vapour in which the smell is, to rise plentifully into the Air, and act briskly on the Spirits: Strong Inspiration through the Nose, and snuffing up any Liquors, gives a more evident Impression on the Sense. A mild Smell, Mollis, or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, is a weaker Impression by a more languid Halitus, Quicquid tenue & molle in odoratu, infirmum est. The Sensibleness of the Trachea is very evident, because all Asthmatics are offended by the lest Dust made by sweeping of a Room, or making of a Bed. I knew one who was a Malster, who told me he could not bear the Dust of Corn whilst it was removed. And Helmont gives a remarkable Instance of a Monk employed in pulling down Buildings, who grew Asthmatic; and he says of him, Quoties deinceps locus aliquis vertitur, vel all as ventus pulverem excitat, mox concidit fere praefocatus, pene praecluso anhelitu ●acet moribundus. In this case the Dust irritates the Skin of the Trachea, and thereby occasions a tumultuous motion of Spirits, which of themselves are always disposed in Asthmatics to expand too much, and 'cause the Constriction in the muscular Fibers of the Bladders of the Lungs, and those of the Bronchia. Secondly, Of Diet, or Meats and Drinks agreeable or injurious to the Asthma. I shall next treat of such Meat and Drink which Experience shows us is agreeable to Asthmatics, and what is most disagreeable to them, by occasioning their Fits. All strong Liquors are very injurious to the Asthmatic, and this is confirmed by their constant Experience of shortness of Breathing upon any Debauch by them. Strong Wines inflame the Spirits, and all strong Malt Liquors increase the Fits of the Asthma, and shorten the Intervals by expanding and rarefying the Spirits, by raising a violent Fermentation in the Stomach, as also by breeding great quantity of viscid Phlegm, whereby the Lungs are oppressed and stopped: But Brandy above all Liquors is most pernicious to the Asthma, it rarefies the windy Spirits most of all, and certainly gives a violent Fit. And since Spirits are so evidently Suffocating to Asthmatics (for Punch will immediately give me a Dyspnaea) we may thence infer, That the Animal Spirits in the Asthma are too much rarefied or expanded, and that whatsoever is contrary to Brandy Spirits, as Watery and Acid Liquors, they will best agreed with Asthmatics: And since this is by my Experience found to be true, I may infer the same thing, à Nocentibus as well as Juvantibus, that the Spirits and Humours are too much rarefied in the Fits of an Asthma; this seems to me the true natural way of discovering the unknown state of Humours in occult Diseases, for that Diet is most agreeable in every Disease which is contrary to the state of Humours which produce it, a cooling Diet to rarefied hot Humours, and a hot aromatic acrid Diet to a crude mucilaginous serous State. If than I consider the Nature of any Diet, that sick Persons by Experience found most agreeable, I may by that be instructed, that the Nature of the Disease is contrary to it; and if I know what are the Tastes and Temper of a Diet which agrees with the Disease, I may choose the same Temper and Tastes somewhat stronger, but of the same kind in my Medicines, and those will prove most Specific to the Disease, and that particular Constitution which has experienced the Diet. As for Example; I have observed Sack, Sherry, Frontiniac, and all other rich Wines to be the occasion of Asthma Fits, by raising a Fermentation in the Stomach, and an Ebullition in the Blood, which ends in an Inflation of the Pneumonic Membranes and Fibres; but on the contrary I observe, that Mead, or Mulsum unfermented, Wine and Water are the most agreeable Liquors, because they are not apt to ●erment and raise Wind in the Stomach, and therefore do not agitate or rarefy the Humours and Spirits, neither do they thicken the Lympha Lactea, and occasion much Phlegm. By this certain Experience, and my Rationale on it, I learn to avoid all hot Diet, and consequently all hot Medicines in the Asthma, and I am taught to use all the cooling methods, which created no Wind, nor Phlegm, nor rarefie the Spirits, and it is of no small moment in the Asthma, and many other cases not to offend in our Liquors, as to the sort of it, or its quantity; for our Healths, in Chronical cases, much depends on our Liquors, which by raising accidental Ebullitions occasion our Fits. All fermenting Wines, or new Drinks have an intestine Agitation of aerial Spirits, which they communicate to the Spirits of Animals, such an effect in a high degree all bottled Liquors have, which, by reason of its Windiness is very disaagreeable to the Asthma. By this Observation 'tis plain, that all windy Liquors and Medicines are to be avoided by Asthmatics; therefore, if possible, they must abstain from fermented Liquors, which are more or lesle Windy, and they aught to live on Decoctions of Woods, or some other watery Decoctions of Herbs. I know an Asthmatic, who upon any tendency towards a Fit, drinks plentifully of Milk and Water, which presently allays the Inflation of his Stomach. Water with a burnt Toast is a good Liquor for young Stomaches, but the aged, whose Spirits are lesle hot, cannot bear such poor Liquors; and frequent Fits often make the Spirits languid, and than they require a moderate Spirituous Liquor, such is a small Ale of Six-strike in the Hogshead, which is the strongest Asthmatics aught to drink, with green Broom or Gill dried, putting lbss. of either to be hung in a Bag in six Gallons of this small Ale, for ordinary drink at Dinner. All drinking betwixt Meals is injurious, especially all morning or evening draughts of Wine or Malt Liquors, for that raises unnatural Windiness in the Stomach: My general Custom is to drink Toast and Water every morning half a pint, to drink about a quart of Broom small Beer at Dinner, and at night to take a Toast and Mead, or Hydromel for my Supper, or else Bread eat with a Glass or two of Wine and Water: And than in the Winter lbss. of Mum agrees well; all hot Liquors, as Coffees, Theas; of Cephalic Herbs, as Sage, etc. or Stomachic, as Buckbean, which is a Centaury I have tried, but found none so good as Toast and Water. No Distemper requires more orderly Diet than the Asthma, but especially a moderation in Drinking, that the Serum of the Blood may not abound too much, and a constant use of those Liquors that are moderate, neither too hot nor cool, but suited to the Constitutions and Age. I know a fat Asthmatic who was much relieved by drinking very little of any Liquor. From these Observations of the Nature of hot Diet, and its disagreement, I may argue, that all hot Tastes, as Aromatics, Acrids, Gums, Fetids, or Balsams, or Oils, or Resins, or Salts, by raising a Windiness and Rarefaction of Humours and Spirits, are likewise injurious to the Asthmatic. As to the Food of Asthmatics, I observe that all that which produces a viscid Chyle, thickens the Humours, creates Phlegm and Wind, and stops the Breathing, such is that of Pudding, Crust, and most Meal-meats, of Rice, Wheat, Peas, Beans; and Milk-meats, as Cream, Cheese, etc. and amongst Flesh-meats, those which abound with a Mucilage, as Fish, Eggs, young Creatures, young Pigs, and the Extremity of Animals, and Jelly-Broths, Oysters; all which breed a thick Chyle, which stops in the Lungs in the Spitting Asthma, and that oppresses them. From this Experience I may infer, that no mucilaginous Gums or Medicines, Syrup or Pectorals of that nature, can be convenient for the Asthmatic, but rather Medicines which attenuate without heat, and proper to dissolve a thick mucilaginous Chyle, without exciting an Effervescence, such as the following Vinegar. Galen makes Pythagoras the Author of Vinegar of Squills, which he began to use about the 50th▪ Year of his Age, and lived to 117. Galen's Prescript is the same as in the Dispensatory, which he highly commends against all Flatuosities: It makes the Senses quick, the Colour good, and the Respiration easy; it helps Digestion, it loosens the Belly, it provokes Urine, discusses Wind, and abates the Fullness of Flesh. He observed the Pthisical cured by this when desperate; it cures the Epilepsy, and prevents it; it helps the Gout, and Rheumatic Pains, and Hardness of Liver, and Spleen. The Wine of Squills is commended by Galen for the same Diseases: Galen uses lb xij. of Wine to one of Squills, but the Dispensatory but viij. and he mentions Honey two or three parts to be added to make it more acceptable; his Doses was ℥ i. (which is too much) before meat, and half an Ounce after it. This Digestive the Ancients constantly used as part of their Diet, and Emperors used it to prolong their Lives. The lesle the Asthmatic are nourished, the longer are the Intervals of the Fits, and the clearer is their Breathes; for if we eat moderately, we subtract the quantity of our Chyle, and we better Digest what we take; but any Excess raises a tumultuous Fermentation in the Stomach and Blood, which produces a Rarefaction in the Spirits. So true is Hypocrates Observation, If a man eats and drinks little, he shall have no Disease. Though we eat moderately, yet in 10 Days, or 14 at most, the Asthma Fit returns from a Fullness of flatulent Chyle, or nutri●ious Juices, which, like the morbific matter of an Ague, will not throughly assimilate with the Blood, but Ferments with it, and part of that is forced into the Nerves upon every Fit; but from such a flatulent Cacochymia windy Spirits are always prepared. The Asthmatics are best Fasting, and under a very frugal and simple Diet, which I shall here mention, because I have had so much occasion to touch on many other particulars of Diet. They may use Water-Gruel cool, not hot, for Breakfast, or Toast and Water, as I have mentioned; and the same may be their Supper, if agreeable, or else Small Beer, or Ale, with Bread: The Asthmatic must eat for Dinner of one or two Dishes at most, Beef, Mutton, roast Veal, Rabbits, Birds, Pork. All Waterfowl is heavy, slimy, having too much of the moorish crude Taste in it. All Pickles, Sauces, Oysters, Salt Meats are very injurious to the Asthmatic▪ and all smoked meats; for these raise a Fermentation too high in their Stomaches, and produce a great disturbance in the Blood and Spirits. Salads and Fruits are too cold, and crude, and windy, for most Asthmatics; Cabbage▪ Turnips, Colliflowers, all which are of the cress Taste, and are found very windy on the Stomach of Asthmatics. The Asthmatic must eat no Flesh Suppers, for if he do, it frequently proves fatal, or else very suffocating if a Fi● hap after it. By all the Reflections on our Diet for the Asthmatic, we learn, that the Medicine must be like the Diet, contrary to the Disease, that is, of a cooling, attenuating, carminative Temper, not spirituous, windy, viscid; and such is Galen's Medicine: The acid cools and discusses Wind, and the better attenuates the viscid Humours. Thirdly, Of Exercises▪ All violent Exercise makes the Asthmatic to breathe short, because their Lungs are frequently oppressed with Tubercula; and if the Exercise be continued it occasions a Fit, by putting the Spirits to a great Expansion. The most agreeable Exercise is Riding, the greatest are Sawing, Bowling, Ringing of a dumb Bell, Swinging, Dancing; Walking is more vehement than Riding, but not so great as the other; those Exercises that move the Arms, exercise the Lungs most. In a Fi● no motion is convenient till the Fit is going of; and I found Riding to help Expectoration; the rubbing of the Breast heats it, and occasions the Fit; and the rubbing the extreme Parts moves the Blood too much, though that is commended by Authors, and a Decoction of Guaicum to preserve Perspiration of Windy Spirits. They who use no Exercise in the Intervals of Fits, soon fall into Cachexies, Lethargies, Dropsies, through too much Serum, loss of Appetite, and Consumption, for want of Perspiration and Expectoration: But in the Fit all Exercise endangers Suffocation. Fourthly, Of the Passions. I will next describe the Effect of Passions in producing the Fit. A fatal Orthopnea is described by Forestus from a Fright. The Passion of Anger makes the Spirits restless, and apt to produce the Fit, and the Asthmatics observe in themselves great restlessness of Spirits the day preceding the Fit; and Hippocrates' Aphorism advises all Asthmatics to abstain from Anger and Shouting. Fear, Solicitude, and much Study, discomposes the Spirits, and produces a restlessness in them, which may occasion a Fit; the Asthmatics are commonly Hypochondriacal, which the frequent Fits produce, though that is supposed to depend on the other. Study inflames the Spirits, and too much rarefies them; and all violent motions of the Spirits quicken the Pulse, and thereby produce the Asthma and Ephemera. All the related occasions are observed by Helmont, who says, Denique & alias quae ex potu sacchari, vini hispanici, ex ira, tristi nuntio, vel etiam objurgatè luctuoso mox Asthmate corriperentur; and of these he gives Examples. And I have observed that Reading or Writing is very injurious in the Fits, and highly disorders the Asthmatic. Fifthly, Of Excretions, Natural, Physical, and Preternatural in the Asthmatic. The Asthmatic always makes a great quantity of pale Water in the Fit, the first day, but at the going of the Water is of a high Colour, with a thick feverish Sediment. I cannot perceive much dryness or faintness to attend the pale Water; and since that happens only in the beginning of the Fit, I cannot believe a true Diabetes occasions it, but rather an Effervescence of Humours, (which is at last evident by the high coloured Water) may at the beginning of the Fit throw of a good quantity of crude Serum, which may be the matter of the pale Water; but I am inclined to believe that the true cause of the pale Water is the Asthmatic straitness, which stops the Circulation of the Serum through the Lymphatics; for if the motion of the Lympha up the Thoracic ductus be forced by the compression of the Belly in Inspiration, in the Asthma, that being defective, and the motion of the Diaphragme being hindered, it must follow, that the Lympha must stagnate in the Lymphatics; and if that Serum which should return from the Kidneys through the Lymphatics be stopped in its Circulation, for want of the pressure of the Diaphragme, than all the Serum which comes in the Arteries into the Kidneys must pass into the Ureters, because it cannot circulate through the Lymphatics; and this happens till the Serum is very much abated. I remember an Ingenious Experiment of Mr. Nuycke, who teaches us to make Ligatures on the Veins and Lymphatics, whereby the Liquor injected through the Arteries is forced into the Ureters; and this seems to confirm my Conjecture about the pale Water. In the Fits of the Mother the pale Water flows in great quantity, because the motion of the Serum is stopped in the Lymphatics, by the convulsive Constrictions, or the stop put to the motion of the Diaphragme. A fat Woman, who lived long an Asthmatic, told me she found benefit by drinking her own Water, and that she observed that before the Fit● came it grew very salt. I have tasted my own pale Water, but never observed it either sweet or sour considerably, but rather very salt. Alum will not curdle it, as it does other nutritious Juices, which inclines me to believe that the pale Water is none of the nutritious Juices, but that this Serum aught to be carried of by the Fits, as appears by this, because when it is stopped a Dropsy usually succeeds. That the pale Urine is from the Serum is manifest, because it tastes as salt as any ordinary Urine. I evaporated it in a Spoon, and it left only a brown saltish Sediment; it smells as strong of Saltness as any ordinary Urine. The quantity of pale Urine made in one Night was about two Quarts, though I drank not half a Pint at Supper time. The Sediment left upon evaporation was not viscid, but sandy and gritty, and tasted very salt, and therefore had none of the Succus Nutritius in it. This pale Urine would not coagulate Milk though mixed with it, and therefore no great acid was in it. From the past Reflections I conclude the pale Water to be the thin part of the Serum of the Blood, with a great quantity of Salt in it. Helmont observed before the Fit, that the Saliva in an Asthma was salt; but this I was never sensible of in myself, but that it is usually viscid or mucilaginous the day before the Fit. As to Spitting and Coughing, that is common at the latter end of the Spitting Asthma, upon the going of of the Fit: The first and second day they spit little, but more the third, when the straitness goes of, and than the mucilaginous Phlegm digesting and putrifying, it loses its viscidity, and so comes up easier. The Phlegm indigested is like the White of an Egg, and the first Spits of the Asthma are streaked, or feathered, and like a Spider's Web, of a blackish colour, from Blood, or some acid Splenetic Juice, which probably being of a Salt nature, it shoots into Figures: This Phlegm comes from the Glandulous Coat of the Trachea, which by the constriction of the Bronchia is expressed from that Skin. This Spit Helmont calls Guttas caeruleas liquato tragacantho similes; it has the same Pellucid clearness as that Gum dissolved: And he farther observes, Ingravescente senio, graviores screatus, si quid forte sub finem exscreetur, tantillum id, non prioris & causae occasionalis rationem subire debet, sed potius producti vicem habet, ex magnâ coarctatione, & injuria pulmoni illata. He believed it to be the Succus Nutritius of the Membranes, which later Anatomists know to be a glandulous Lympha. Mr. Nuycke observes a Blackness in the excretory Vessels of the salivatory Glands', so that this black Humour is commonly mixed with the slimy Lympha. Not Pectoral can do any thing towards the curing or preventing of the Fit, whether oily or detersive, but at the latter end of the Fit, the oily and sweet Pectorals help the Expectoration of the viscid Phlegm, which gathers in the Bronchia during their constriction, and it is no occasion of the Fit, but the product of it; for if it were so, the Fit would not come so suddenly as it does; and before the Fit I never was sensible of an Oppression or Stuffing of Phlegm, though I spit much after a Fit. Vomiting very much relieves the Asthmatic by evacuating a great quantity of this Phlegm, or mucilaginous Slime from the Stomach and Lungs, which appears to me all of the same nature, but after some small time the Fits will return again. I have often vomited a Choleric Matter in the beginning of the Fit, which I imputed to the vehemence of the Fit, and some compression on the Guts, or the Gall Bladder, and to be purely accidental. I have discoursed an Asthmatic, who was extremely troubled with violent motions of Vomiting in the beginning of each Fit, and nothing composed it like drinking Water; this Gentleman told me that he received much benefit by drinking Bath Water, which cured him of his Asthma for some Years, but the Asthma returning, he came to Bathe the second time, where I met him; he was of a full Habit of Body, he drank the Waters, but durst not adventure to bathe; he lives near Northampton. The giving of a Vomit will put some Persons into Fits, tho' it generally relieves the straitness and oppression at Stomach in all Asthmatics, but that will soon return, and the Phlegm be again evacuated into the Stomach. The breeding of this great quantity of mucilaginous Slime both in the Stomach and Lungs, depends much on the frequent stop given to Circulation of Humours by the Asthma Fit; for 'tis the motion of Humours, and quick circulation that dissolves the mucilaginous Liquors of Animals; but if they once remit that motion, they naturally thicken like Jelly-broth as it cools. The want of the motion of the Diaphragme in the Asthma Fit, may occasion the stagnation of the Contents in the Guts, as well as the Chyle in the Lacteals, and also the Blood in the Mesentery; for these are all helped by its depression in Respiration: From this stagnation of Humours the Guts may be irritated into Inflations, which will hinder their natural Peristaltic Motion, and all the Humours stagnating will be much rarefied, become windy, and swell their Vessels, so that the Asthma has these degrees; First, there is a straitness in the Bronchia and Vesiculae, that hinders the descent of the Diaphragme, and the defect of that gives the pale Water and Inflations in the Belly. Bleeding, though never so often repeated, will not cure the Asthmatic, but a little for the present relieve the straitness and suffocation. It is agreeable to young Persons, but very prejudicial to old habituated Asthmas, who at present are not much relieved thereby, but after some time they become Cachectic. No Diuretic Balsam, or Turpentine, can prevent a Fit, nor cure it, but they rather make it worse, by rarefying and heating the Humours and Spirits. Some Persons during some critical Evacuations, as Dysuria, Looseness, or Ulcers, have no Fits of the Asthma; and I have heard some commend Issues on that account; and I have been informed that King William during the running of the Sore upon his Shoulder, made by the bruise of the Cannon-Bullet at the Battle of the Boyne in Ireland, was free from any trouble of his Asthma. I have observed the Asthma to be better in some after the Legs begin to swell, because than the Blood is not so much inclined to Ferment, nor the Spirits to be rarefied; I have known others much better by copious Urine which relieved them. A Gentlewoman about 60 Years old being always Asthmatic, fell into a Diarrhaea, by which she was freed from Stone, Cholic, and Asthma; but that being permitted too long, run her into a Consumptive state, and extremely wasted her fat Body, and disposed her to Surfeit upon every occasion: I cured her by Rhubarb Purges, Steel, and Bitters. This Diarrhaea is dangerous to thin Asthmatics, i● it be stopped it makes them worse; in this case we must neglect the original Disease▪ and cure it as an ordinary Scorbutic Diarrhaea, by S●yptics, Laudanum, and Digestives. As to Sweated in a severe Fit, 'tis very great sometimes, and in Bed very hot, and without any benefit to the Asthmatic, I have often taken Spirit of Hartshorn to produce Sweat▪ and to put by the Fit, but it had not that effect, but made the following Fit more violent. The sitting up all Night does make the Asthmatic subject to Rheumatic Pains, and Cachexies. As to Stools, the Asthmatic are seldom bound; and in the beginning of a● Fit, as soon as they rise out of Bed, they have a lose Stool, and most of them are easily Purged. I could not found that by Purging I could commonly prevent a Fit, but I observed that Purging did frequently occasion the Fit; and if a Purge be given in the Fit, it causes an extraordinary Tumult in the Spirits, and endangers a Suffocation, for which reason I doubt of the sincerity of those Authors, who prescribe it in a Fit: It gives the same Disorder as Purging in a Fever, but is more dangerous. I knew an Asthmatic who made a great quantity of pale Water, and had running Pains in his Limbs; the pale Water made him lean and sainty▪ though it tasted somewhat brackish, and not sweet, as he informed me; he had frequent Fits once in 14 days, he was often eased by Vomiting with Oxmel Scilliticum, and Oil; that which was peculiar in this case was, that, he was always very much bound, for which he used Clysters, Lenitive▪ Elect. Extract. Ecph. cum Aloe, and for his Diabetes, Aqu. calcis Composita: This Asthma was very grievous as often as the Body▪ was bound extraordinarily, and to that he always imputed his Fit: This Asthma▪ upon the stopping of the Diabetes, ended in a Dropsy with a Hectic Fever, with Hypochondriac Winds and Gripes, of which he died. What Salivation can do in the Asthma I know not; but since no Evacuation which I have mentioned, as Purging, Bleeding, Vomiting, Sweeting, Diuretics or Pectorals, can either cure▪ or prevent the Fits, as I have experienced, though they have sometimes relieved and palliated it, I must confess I cannot expect any benefit by Salivation (unless it can cure some of the Scrophilous' Tubercula of the Lungs) for Salivation is only the great Evacuation of the Serum of the Blood, it depresses the Fermentation of the Blood more than raises it, and the Blood● becomes more viscid after Salvation, which is injurious to the Asthmatic straitness: But that I might be better satisfied about the success of Salivation, I desired my Ingenious Friend Dr. Gibbons, that he would communicate the success of some Experiment he had made in the Asthma, of which he gave me the following Account, in his Letter to me on the 20th of September, 94. I have once or twice given Mercurial Medicines in an Asthma with success; but the Patients were Leprous likewise, which induced to me give them.— I have found Gas Sulphuris frequently given, very efficacious when other things have signified nothing.— And in Hysteric Asthmas, Laudanum seldom fails. Sixthly, Of Sleep, and Waking, how they affect the Asthmatic. I have observed the Fit always to hap after Sleep in the Night, when the Nerves are filled with windy Spirits, and the heat of the Bed has rarefied the Spirits and Humours, but the next day Sleep composes the disorder of the Spirits. The Night before the Fit the drowsiness and slight Headache are signs of the Matter entering into the Nerves, and it is like the Sleepiness in the beginning of the Fit of an Ague, from an Oppression upon the Spirits by serous Humours, which than occasion also a R●●tching and Yawning. I have found that by late sitting up, I have put by the Fit for a Night or two, and I have found it commonly necessary to rise out of Bed, especially in the Summer time, and to sleep in a Chair the first Night of the Fit; two Nights before the Fit Asthmatics want sleep frequently. Narcotics are accounted dangerous to Asthmatics by some Authors, because they apprehended that they make a greater stoppage in the Breath and Pulse, and thicken the viscid Humours of the Asthma, if given in any great Dose; but if in a moderate quantity, they are the fittest Medicines to compress the Inflations; and Riverius' Experience confirms it, and all our Moderns, as well as the Ancient Writers▪ used it in the Asthma. I wish we had in common use a Preparation of Opium with an acid, that I am certain would prove more agreeable to the Asthma, because the acid best corrects the Opium, and that makes all acrid and bitter Medicines more suitable to that Disease. The Ancient Writers often object against the knowing of the Nature of all Medicines by the Tastes; that Narcotics are hot by being bitter, acrid and foetid, and yet they cool the Humours and thicken them. To which I may Answer, that Narcotics by those Tastes produce hot Effects, as well as cool in our Humours; Narcotics are Diuretics, and evidently Diaphoretics, by their bitterness and acrimony, and they 'cause an itching in the Skin sometimes; many of them are also Vomitories, and Purgers, as Tobacco, which is a Solanum, and Solanum lignosum is Purging; all which Qualities depend on the Acrimony of them. But besides this Taste, there is an evident mucilage in Narcotics, as appears in Poppy-leaves, which always cools; but the chief Effects of Opium lies in the fetid Smell, which being destructive to the Spirits by a particular texture of its Principles, they being stupefied, evaporated, or made lesle elastic; the motion of the Heart and Circulation of Humours are stopped, on which the coolness and viscidity accidentally depends, that all these Effects are produced by the hot Tastes of the Narcotic is plain, because strong Spirits long used, and all hot Regimens, as hot Baths, hot Drinks, do accidentally i'll our Bodies, and evaporate our Spirits: Camphire cools by its discussing Quality, being a volatile acrid oilous Salt, it opens the Pores, and evaporates hot Humours. The Nature of other Poisons, as Vegetables, lies in their Foetor and Acrimony, as well as in Opium, which we can never Mechanically explain, because we never can know the Textures of the Vegetable Juices, nor the Nature of Animal Spirits; but we must be contented, that we can distinguish by our Tastes and Smells those Plants that are Narcotic and Poisonous from other Plants, by their offensive Foetors and Corrosiveness. I shall next describe those Diseases which produce the Asthma as a Symptom. 1st. The Suppression of the natural Evacuations of Blood by the Haemorrhoids or Menses, which being stopped, do occasion a great Oppression of the Lungs, by the Viscidity or Fullness of Blood stagnating in the Blood Vessels, which often makes them varicose, and not only hinders the Circulation there, but occasions a compression on the Bronchia and Vesiculae, for the Veins and Arteries accompany the several Branches of the Trachea, which keep the middle, and the Veins lie over them, and the Arteries underneath; and by this it appears, that the Stagnation of the Chyle or Blood in those Vessels, may compress the Bronchia, and by that produce a constant Wheezing in them; and this is to be cured by restoring the deficient Evacuations of Blood. This stoppage of the Haemorrhoids I have observed increase the Fits in many Asthmatics, who were troubled with them, and during their Flux the Asthma was very much relieved. This stop of the Haemorrhoids is an occasion of a Scorbutic Spitting of Blood in many Asthmatics; this Hawking up Blood returned every Afternoon in a particular Asthmatic towards four of the Clock, and I could not stop it by any Evacuations, or Styptics; but the Cortex immediately cured it. 2dly, By a great quantity of Blood Plethoric Persons have an Oppression in the Lungs, which gives them a Dyspnaea, till it be emptied by profuse Bleeding, and Purging, with a spare Diet. 3dly, A Polypus in the Heart and Lungs, upon any motion gives a Shortness of Breath, because the Blood cannot freely circulate through them, without oppressing the Bronchia; this gives also a Palpitation and intermitting Pulse, and upon violent motion they die suddenly; and this is incurable. 4thly, The Coagulation of the Chyle in the Lungs produces the Asthma, and of these Asthmas there are many Instances given in Authors: This arises from drinking cold Water, or washing in it whilst the Body is very hot, which by a sudden compression of rarefied Humours coagulates them, and from hence came the Catarrhus Suffocativus, which suddenly kills many Children, who drink cold Water being hot: This is without Intermission, and accompanied with a Fever. Upon this I believe the Pulmonic Asthma in broken Wound Horses, frequently depends; it is a continued Asthma upon any motion, they have a dry Cough at first, but after some time they vent some Slime by their Nostrils, and are easier whilst their Bodies are kept open by a moist Food; they have a dry Cough, which is a sign of some great Obstruction in the Lungs; they breathe thick and short, which differs from the Asthma, because that is a high Breathing, and the Inspirations are very high, and both Inspiration and Expiration very rare and slow, the Muscles in the Abdomen, which cause Expiration, labour as well as the Diaphragme, which helps Inspiration, as we may observe by the motion of the Flank out and inward: The Diaphragme, because the Air is not freely admitted into the Lungs, moves but little downward, as in ordinary Respiration, and the Expiration returns very quick, and causes a trembling motion in the Flank of the Horse thus affected. The Crock in a Hawk is usually imputed to some strain in the Membranes, which contains the Air in the Belly by hard Flying, and is never recovered. 5thly, The Viscid Serum in a Peripneumonia obstructs the Blood Vessels, and the Glandules of the Lungs with Viscid Phlegm, and the Dyspnaea produced by it is at first without Stertor, but that by long continuance strains the nervous Fibers and Membranes, and disposes them to Asthmatic Inflations. And from this cause the common Pneumonic Humid or Spitting Asthma takes its Original, which is attended with much Spit as the Fit goes of. It is observed that the inward Skin of the Trachaea is Glandulous, Vnctuoso humore perfunditur contra aeris asperitatem; and by the Constriction of the Bronchia a great quantity of this is expressed during the Fit; for the Circulation of the Blood and Chyle being retarded by the Fit, some of the Chylaceous Mass is obliged to pass the Glands' of the Membranes in the Trachaea. If a Liquor be injected into the Arterial Vein of the Lungs, some of it will pass into Trachaea, and this way the slimy Spit passes in the Asthma Fit; which by its colour and consistence appears of a Chylous Nature. These Pneumonic Spitting Asthmas have been observed upon Dissection to have Tubercula or Schirrosity in the Lungs, and they frequently turn to an Abscess, and that into an Empyema; but that small Tubercula alone will not produce the Asthma is plain, because all Consumptive People who have them are not Asthmatic. The Lungs usually in these Asthmas adhere to the Sides, which makes only short Breathed upon any motion, for which Inconvenience Authors commend the motion of the Arms and Breast, and Emollient Baths, and Milk; but all these Asthmatics usually die Consumptive. This Pulmonic Asthma depended originally on a Fever, and so does the several Fits of it, which force some Chylaceous Lympha through the Glandules of the Lungs, and that produces the Spitting Asthma. These Fits come suddenly, and with out any sense of Matter collected in the weakened Glands' before the Asthma Fit, but it flows through them in the Fit, so that an Inflammation of the Lungs does not produce the Asthma in all Persons, but only the Spitting Symptoms in those who have a Cacochymia, which disposes them to this Disease, or else it occasions large Tubercula. 6thly, The Stones in the Lungs produce an Asthma, which is continued, and not periodic: Of this Helmont gives a remarkable Instance, Invenitur sinistri la●eris lobus in dissecto corpore durus, & ● pumice lapidescens, pluresque ejusmodi lapillos sparsim per pulmonis regionem vidi. This was the case of a Presbyter who lived a sober Life, but of a sudden grew Hoarse, and afterwards Asthmatic; he lived a Year with this Disease. 7thly, In the Pica and other Cachexies, the viscid Chyle stagnates in the Lungs, and occasions a Dyspnaea; and the Cachectical Serum in the Hydropical fills the Lymphatics of the Lungs with Serum, and extends them into Hydatides, which oppresses the Lungs, and gives a Dyspnaea, and these frequently break and fill the cavity of the Breast with Water, and than the Legs swell, and they can never lie down without danger of Suffocation; there is a slow mild Fever, a dry Cough, great Thirst, an Ebullition or Fluctuation of Water, fainting Fits, a painful Anxiety about the Cartilago Ensiformis, a Blackness in the Face: In this case some Antihydropical Wine is necessary to Purge of the Serum. This is Horstius' Prescription: Take Roots of Enula, Campana, Orris, ad ℥ ss. Liquorish ʒii. Sena ʒx. Agaric. Trochse ℥ ss. Tops of Elder ʒiii. Leaves o● Carduus, Horehound, of each M. i Flowers of Elder, Cham. ad P. i Seeds of Fennil, Rue, etc. ʒi. Raisins ℥ i Ginger, Mace, Cinnamon, ad ʒss. Saffron ℈ ss. make an Infusion in lb ii. of White Wine, take a draught for four days. Vomiting relieves them, and strong Purging, with Diuretic Salts and bitter Vinegars. 8thly, A long Catarrh ends in an Asthma, for that enlarges the Passages of the Glands' into the Trachea, and disposes them to receive any flux of mucilaginous Slime, upon any Effervescence of Humours, and this usually happens in the great Changes of the Year, and gives an Anniversary Asthma, which a Catarrh precedes and accompanies, and that ends in much Spitting. It may be observed, if the Asthmatic catch Cold, and have a Rheum in the Teeth, Throat, or Head, within a Night or two the Fit will follow. In this case 'tis plain the Effervescence which usually attends all Catarrhs, bushes some slimy Lympha on the Lungs, which produces the Fit. As the Peripneumonia produces a Fit of the Asthma in those disposed to it, and cannot produce it in others not so prepared; so it is in Catarrhs, the Phlegm abounding in a Catarrh cannot produce the Asthma in those who are not disposed to it, but it lays the ground for the Spitting in the Asthma, and excites a disposition to that Disease, which was la●ent before; and whensoever the Chylaceous Matter gathers or flows into the Glands', it irritates the Bronchia, and gives the Constriction of the Blood and Air Vessels to produce another Fit. A young Boy had the Asthma almost from his Birth, upon catching Cold, which occasioned a great running at his Nose, and constant Wheezing; no Medicines relieved him, but he died suddenly, being one Year and half old. If a long Catarrh produces any Tubercula in the Lungs that are large, and they constantly oppress the Bronchia, by that means a constant Asthma may be produced which is truly Pulmonic, like that in Broken-winded Horses, which frequently comes after a long Cold, and they are Asthmatic upon any motion. The sign of the Breeding of a Tuberculum, is when any one in good Health gins to breathe short, and as that increases a Stertor is observed in Breathing. There is an Example in Hypocrates of the Daughter of Agasius, who being a Girl, breathed short from a crude Tuberculum, which did not easily digest, but when she was with Child it broke, and she became Asthmatic. By this we found that a Tuberculum may produce the Asthma, whose Fit will return as often as the Chylaceous Matter fills that Tumour, for than it must constringe the Bronchia, and that Asthma is truly Symptomatical, depending on that Tumour, and not the windy Cacochymia. The Itch repelled, or Ulcers stopped up, may occasion an Asthma, by filling the Blood with too much malignant Serosity, and that either flows through the Glandules of the Lungs or Brain, and excites an Effervescence in the Humours. If a flux of Serum falls on the Stomach, and Intestines, that occasions Gripes and Inflations there, and many lose Stools, and than the Asthma Fit appears very little in the Nerves, the Fits are very short, and little Spitting happens; these sort of Fits frequently hap from a Catarrh, as appears by a Looseness, but if any defluxion of Serum oppresses the Bronchia, it causes much Spit, and the straitness on the Bronchia, and the same Inflation there in its muscular Membranes, which hap in those in the Belly, when the Defluxion of Serum runs through those Glands', but if the Defluxion of Serum passes the Glands' of the Brain, the straitness is most with dulness in the Head, and the Fit is longer. 9thly, The Asthma depends on Fevers, the Small Pox often leaves viscid Matter in the Lungs, which upon any Effervescence of Blood stops that, and the Chyle, and that stoppage occasions an Inflation in the Lungs. I am certain the Small Pox increased the Asthma in myself, and others I have discoused with. Horstius gives an Example of an Asthmatic who died of an Imposthume in the Lungs in that Disease. A Young Gentleman about Twenty, was taken with an Asthma after a Pleurisy, which Spring and Fall gave him great trouble, but after he had had the Small Pox, his Asthma was very severe, and drew his Breath with more difficulty. He complained to me of straitness in the Sternum about the middle of it; he could lie on either side, and does not Wheeze: The straitness takes him in a Morning, and Spits more now than at first; he found some Benefit by this Method, by gentle Vomiting, and Purging with gentle Pills, and Castor Pills at Night. I anointed him with Anticonvulsives, and Emollients; he used an Antiscorbutic Diet-Drink, and an Anti-asthmatic Syrup; by these he continued well some time, but the Fits return sometimes; I gave him the Cortex, but it occasioned more straitness at the Stomach. Intermitting Fevers are often the occasions of the Asthma Fit, as appears by the Instances above mentioned, and than it cannot be cured without a plentiful Dose of the Cortex; but Bleeding, Vomiting, Clysters, and Blisters must precede, and in great Faintness Antispasmodics. About Eight Years since I had an Intermitting Fever, with Swooning Fits every Afternoon, to this I impute the settled Periods of my Asthma: In this I used great quantities of the Cortex, and ʒii. of Spirit of Hartshorn every Day, which than very much relieved me; but no Pectorals nor Balsams, or Purging, Vomiting, Bleeding, nor a long use of the Cortex would put any stop to the Periods of the Fits, till I used an Oxymel hereafter described, and bitter Thea of Buckbean, with an exact Diet. A Gentlewoman of a lean Habit of Body had been Asthmatic from her Youth, after she had had the Small Pox, to which she imputed it; but these Fits came seldom but upon taking Cold, or the turns of the Year; but after the Quartan Ague, which was cured by the Cortex, it came frequently towards Morning, and she had also a pain on the left Side. I gave her a Vomit of Oxymel Scilliticum, she Purged with Pill de Hieracum Agarico, de Succino, ad ℈ i. once in a week, afterwards she used a Decoction of the Cortex with an Hysteric Julep, and Hysteric Pills, with an Asthmatic Syrup, because she was very subject to Hysteric Fits, and did not Spit after her Fits; she drank an Antiscorbutic Diet Drink, and the Decoction of Bitters, without Sena, for a long time, by which she continued well for Twelve Months, but than the Ague returned again with the Asthma Fits, which were cured by the same method. And by this Instance, and the former I mentioned, I learn, that the Hysteric Asthma depended on an Intermitting Fever, as well as the Spitting Asthma, and that both of them have the same Periods, of which I must observe two sorts; for the one, in Pulmonic or Hysteric Asthmas, happens once in Ten Days, or Fourteen Days at farthest; and the other only upon Changes of the Year, when Intermitting Fevers return usually; therefore such Asthmatics aught to use the Cortex Spring and Fall, after Vomiting, Bleeding, and Purging. I knew a Divine, who after the Quartan Ague was every Spring seized with the Asthma, to whom I recommended the method mentioned. Every Fever will not occasion an Asthma Fit, neither had I any in the Small Pox; therefore where the Asthma is a Symptom, there seems to be a crude flatulent Cacochymia in the Blood before the Fever came, and a flatulency of Spirits, which being rarefied by the Fever, produces the Asthmatic Symptoms, with Windiness in the Stomach, much Spitting, Intermitting Pulse, Palpitation, Coldness, Fainting; which Symptoms often appear, attending an Astmatic Fever. If Tubercula in the Lungs stopped the Feverish Blood, and occasioned the Asthma, than that would hap in all Fevers to Asthmatics, which I am certain does not, but some Intermitting Fevers occasion it; and upon curing that, it goes into its old Periods again. Mr. B. of Warwickshire, was first seized by the Asthma in Spain, as he thought by eating of Fruits there; he was than Twentyfive Years old, and was forced to leave tha● Country, because when the Rains fell i● violently held him. His Grandfather had the Asthma▪ and died of it about the Fortieth Year of his Age; but his Father and Mother were very healthful, and never had any Asthma; but some of his Brothers and Sisters are subject to the same Disease so that it was a Disease in the Family, but yet miss one Generation. This Gentleman for the space of Ten Years was Asthmatic in a high degree▪ for which he often bled, which made him Consumptive; his Stomach was apt to Surfeit by Eggs, Salads, potted Meats, which gave severe Fits; he used Steel, and Gums, and volatile Salts, which did him great Injury. In London Air his Fits were much as in the Country; about the Thirty-fifth Year of his Age he had a Fever, and than his Fi●●s left him for Three Years, but he Spit and Coughed much more, and that way evacuated the Matter of the Asthma; 〈◊〉 last an Intermitting Fever returned on him, but the usual Method proved unsuccessful, and the Cortex oppressed his Stomach▪ Asses, Milk purged him, no Pectorals relieved him; he drank Sarsa Drinks▪ Emulsions, Pearl Juleps with Balls. Sulp. Anis in Syrup of Balsam, and other Balsams; he died Hectic in the Winter; I opened his Thorax, and found the Lungs to stick to the Pleura on both sides; there were many Tubercula in his Lungs, and some purulent Matter, and I found a small Schirrus on the Skin: This Consumption was introduced by the Intermitting Fever, and probably all the Tubercula were the Effects of it. Asthmatics have no short Cough betwixt the Fits, which makes me doubt whether they commonly have any Tubercula, especially when I observe they can use great Motion without Wheezing. 10thly, If a Vomica break in the Lungs, it by a sudden Inundation of Matter occasions a fatal Asthma. An Empyema oppresses the Lungs as the Dropsy does, and hinders their Expansion, and the Empyema has a great Fever in the beginning, which grows milder as soon as any Matter is concocted, and than it has all the Signs of a Consumption to accompany it. It usually succeeds the breach of a Vein, or Vomica Sanguinea, the Inflammation of the Lungs or Pleura, the Quinsey, Lethargy, Wound or Ulcer, Pthisic, or the ripening of a Tuberculum. 11thly, Every external Compression of the Lungs, may 'cause a Pulmonic Asthma, as too much Fat about the Heart, the growing of the Lungs to the Diaphragme, Pericardium. The Gibbous are Asthmatic, because of the contortion of the Spinal Marrow, the compression of the Nerves, or the ill shape of the Cavity of the Breast, which straitens the Lungs. The Asthma often causes a Gibbosity in young Persons, and that is observed to be fatal ante P●bertatem. I have described the several kinds of Compression of the Lungs, or Bronchia, by which Inspiration is hindered, as too much Blood, a Polypus, Coagulation of Chyle, Hydropical Serum, Tubercula, Empyema, and all external Accidents that compress the Lungs, but there remains one other, which is in the Cavity of the Belly, viz. 12thly, The tumors of the Viscera, which produce a spurious Asthma, as that of the Liver, Spleen, Kidneys, Pancreas, and all Hydropical tumors: I remember a Patient who had a great Tumour on the left side of his Belly, which gave a great Dyspnaea; I found in him upon Dissection, a Bladder filled with clear Salt Water, containing about a Gallon of it; this Bladder grew on the Spleen, and stuck to the Muscles of the Belly, so that if it had been tapped, it would have sunk; and the Water might have been evacuated; this Tumour by its greatness stopped the motion of the Diaphragme, and caused that Dyspnaea that killed him. I once observed a Diabetes to end in a Tumour amongst the Muscles of the Belly, which gave the Patiented a continual Cough, Rheum, and Shortness of Breath when he lay down, but he had no Cough all day, and this ended in a Consumption. Those who have a Dyspnaea from the tumors of the Belly, can sleep and breath easiest lying on their Belly. The Inflation in the Guts and Stomach which happens by a flux of Serum on them on great Changes of Wether, often gives a short Fit with Windiness, which hinders the descent of the Diaphragme, and that gives the difficulty of Inspiration. I shall next describe those Symptomatic Asthmas, which succeed Cephalic Diseases. 1st. I have observed an Asthma in very old Persons after a slight touch of an Apoplectic Fit, or Giddiness, which at first makes them to fall to the Ground; this Asthma lasts some weeks, and sometimes months, with loss of Appetite, and it ends in Oedematous tumors of the Legs, and there seems to me always in this case a Dropsy in the Breast: Vomits of Oxymel very much relieve these Patients: Bitters and Diuretics agreed, but Purging did never agreed with them: I have given some of them strong Purgers without much advantage. This Asthma in half a Years time proving fatal to these Patients, I have observed this to hap to fresh-coloured old Men, that have sipped much, though not very intemperately of strong Liquors, and every Night they have severe Fits, but in the day also a continued Dyspnaea. The Gout also often ends in a fatal Dyspnaea. A Gouty Lady who first had an Apoplectic Fit, by Medicines had her Head very much cleared of that, but a severe Asthma in a small time succeeded, neither Bleeding, Blisters, or any volatile Medicines gave the lest relief. Dr. Willis describes a Convulsive Asthma after Headache, Giddiness, and Lethargy. I have observed an Asthmatic Fit to seize Persons who were in an Intermitting Fever, with an Inflammation of the Lungs, and Delirium, and this proves always fatal, notwithstanding Bleeding, Blisters, etc. The Blood in these cases is very Rheumatic, and there is a great pain in the hinder part of the Head. 2dly, Hysterical Fits frequently occasion the Asthma, because the Convulsions often stop the motion of the Diaphragme, and binding and straightening the Bronchia and blood Vessels, by the Nerves, which encompass them, that disposes all the disordered or ill digested Spirits to move that way, to inflate and constringe the Lungs and Heart. Hypocrates imputes the hysterical Disease very much to Wind, because of the frequent eructations, and windiness of the Belly, or pains of Back or Loins: This windy Spirit in hysterical Fits is more furious, and inflates the Muscles, but in the Asthma the high flatulencies being evaporated, they only inflate the nervous Fibres of the Membranes of the Lungs: And we may observe the hysterical Fits to end in the Asthma, and for that reason it must be a lesle degree of expansion than the Spirits have in the hysteric Fits. Hysterical Women hold their breaths long through the Convulsion of the Muscles of the Belly during their Fit, and therefore may by stopping the motion of the breath, strain the Nerves and Membranes, and dispose them to receive windy Spirits, when admitted into the Nerves. The frequent Convulsions, by retarding the motion of Humours, may at last make them mucilaginous and slimy, by which they are better prepared to retain the Spirits in the form of Wind, and the frequent disorders of the Spirits spend much of the volatile Parts, so that the Spirits after long Fits, have neither a true volatility, or a thin Lympha to float in, and upon these accounts the Spirits become Asthmatic, and the solid Parts are disposed to the same, by the Convulsions and Straining mentioned. Helmont calls this hysterical Asthma, Caducum Pulmonis; and he affirms of it, Quicquid Epilepticum Adultum sanat, sanat etiam Asthmaticum. It will not be improper here to compare the Fits of the Spitting and Hysterical Asthma. In the Spitting Asthma there is no lesle Inflation of the Lungs, and the same rigidity in the Spitting Asthma, as in the Hysterical, which is commonly called a Convulsion, but is more like a continued Inflation, or Catalepsis. The Lungs in the Spitting Asthma are vitiated by tumors frequently, which stop the Circulation of the Blood, Spirits, and Chyle, and the filling the Lungs, may produce the Inflation, or Rigidity, and than this constriction may be called a Symptom of the Diseases of the Lungs; but in the Hysteric Asthma, the Disease first began in the Nerves, where a constriction is made on the blood Vessels, and Bronchia, and those Humours stagnating help the Inflation and Rigidity of the Lungs by their fullness. The Hysteric Asthma in time degenerates into the Spitting, after Humous have been often stopped on the Lungs by frequent Fits, and the Glandules there filled and become Schirrous Tubercula, they obstruct the Circulation of Chyle, causing it to pass in small quantities into the Bronchia, where it causes the Spit. Those who are most subject to the Spitting Asthma, who are of a lean Habit of Body, and are subject to Rheums, and glandulous Swell in their Youth, which are inclining to the Scrofulous Obstructions; these are most subject to the Tubercula of the Lungs, and much Spitting; they have too much Appetite, and are troubled with Hypochondriacal Flatuosities. I observed some fat Hysterical Women who have had the Hysterical Asthma, in which they Spit little after Twenty Years continuance, but have the same sort of Spit as the lean Asthmatic, clear and mucilaginous, streaked with black. Whatsoever Causes produce the Fit of the Hysterical Asthma, produce the same in the Spitting Asthma, as Changes of Wether, Heat and Cold, violent Motions, Passions, Wine, Surfeits; in neither kind of Asthma can they bear the heat of the Bed; since the same Causes produce the Fits in both sorts of Asthmatics, there is certainly the same Effervescence in both, which occasions the Fits, and that is plainly proved; for at the end of the hysteric Asthma Fit, the Water appears feverish, with a thick Sediment; and I observe that there is the same Interval betwixt the hysteric Asthma Fits, as there is in the spitting Asthma; and there is the same quantity of pale Water in both kinds of Asthma. Since therefore these two kinds agreed in the same sort of Constriction of the Bronchia, in the same Effervescence of Humours, occasioned by external Causes, all these two kinds differ in, is, the first occasion that produced them, and the Spitting attends the one and not the other, the reason of which I impute to Inflammation of the Lungs, or a Catarrh, and the other rises after Hysterical Fits, or a Fever. In both sorts there is the same flatulent and mucilaginous Cacochymia, which by the Effervescence is forced upon the Lungs in the one, and on the Nerves in the other. 3dly. Hypochondriac Fits occasion another sort of Asthma, without Wheezing; the Breath is short, the Sternum oppressed, flatulencies are in the Stomach, giddiness in the Head, with fear of Swooning; in these the Lungs are not much affected, but the Sternum, or Membranes of the Breast, as the Mediastinum, and this must be cured as the original Cause requires, by Vomiting, Purging, Chalybeats, and Cephalics. 4thly. When the Scurvy affects the Nerves with too much sharp Serum, it produces the Asthma Convulsivum, with straitness of the Breast. This is Dr. Willis's Opinion; and for that he uses volatile Spirits, Tincture of Antimony, Sulphur, Castor, Lavender, Flowers of Sal Armoniac, Benzoin, Elixir Proprietatis: He prescribes Sudorifics, sharp Clysters, Diuretics, for the evacuating of the Serum. Dr. Willis relates a History of a Convulsive Asthma, from the Serum in the hinder part of the Head, and violent Fits of the Asthma seizes them in lying down; and this succeeds other Diseases, or Cachexies, and is a deplorable state. Zecchius observes an Asthma without Stertor; when the Constriction or Angustia falls on the blood Vessels, more than on the Bronchia, he imputes the Cause of Asthma wholly to a Catarrh from the Head, and prescribes the usual methods for it to the Head, which is as absurd as the explication of a Catarrh descending thence; yet we must allow that in the Asthma there is a real flux of Serum, either through the Lungs or Nerves, and all defluxions like the Asthma are apt to return. Zecchius observes many other useful things relating to the Asthma, which I will mention. 1st. He observes that Asthmaties are hurt by hot Medicines, and that in cold Climates, if dry, they have best Health, and that the South Wind is injurious; for the heat of their Liver, that is, their Blood (of which the old Writers made the Liver the Fountain) he advises, the depurated Juice of Cichory, and Goats-whey; he observes also a Crudity in the Stomach. 2dly. He observes that the Asthma is Respiratio tarda, magna, rara; and to his Honour be it, that no other Authors, who generally call the Asthma Respiratio Densa, have given a true Description of it but he; and he observes the Cough the Asthmatics sometimes have in Expiration, which puts than to great pain, because their Lungs are not full enough of Air to 'cause a Cough; he observes also, that the Urine is thick and turbid in the Fit. 3dly. In the Fit he prescribes Medicines mixed with Acids, thus, Take simple Oxymel ℥ jss. Oxymel of Squills ℥ ss. Sal Armoniac ℈ i Saffron iij. gr. powdered, or Ammoniacum ℈ i Musk iij. gr. Saffron two. gr. with Oxymel of Squills; make Pills, take them in a Potch'd Egg. He commends this Cleanser for the Lungs, Turpentine washed ℥ i Sulph. ʒi. Ammoniacum dissolved ʒii. make Pills, and let the Patient dilute his Wine with the Decoction of Misletoes. He observes the Praeludia of the Fit to be a heaviness in the Head, and a Distillation, with a small Cough, to prevent which Zecchius well advises a Clyster, and a Blister, and a Narcotic at Night▪ and afterwards Ammoniacum dissolved in Oxymel, which cleanses and dilates the Lungs, and dries them, without any immoderate heat. CHAP. IU. Of the Cure of the Asthma, both in the Fit, and out of it. THE Cure of the Asthma Fits requires these following Intentions and Remedies: First, To abate the quantity of the windy Chyle in the Belly by Clysters, if the Asthmatic be bound, which carry of the flatulencies: In the Fit they have generally lose Stools; but in an extreme Fit I once took a Clyster of Posset-Drink, Chamomile-flowers and Sugar, which immediately eased me, after the Fit had continued many days before. Vomiting, if gentle, very much relieves the Fit, by evacuating a great quantity of fermenting Humours from the Stomach, and the straining to Vomit dissipates the Inflations both in the Lungs and Stomach, and some slimy Lympha is evacuated from both. I never could approve of a strong Vomit in the Fit, one ounce of Oxymel Scylliticum, and as much Oil of Sweet Almonds is sufficient, with Posset-drink or warm Water. Much straining to Vomit is suffocating, and it is impossible to drink much in the Fit for the use of a strong Vomit, therefore my custom is to sip about half an Ounce of Acetum Scylliticum without any mixture, which in a small time makes me sick, and by the help of a Feather and warm Water, I Vomit so much as to evacuate all the Contents of the Stomach, which very much relieves the straitness, though it does not always take of the Fit. Secondly, To relieve the straitness, or constriction in the Bronchia and Blood Vessels, which can no other way be suddenly done if the Fit be extreme, than by bleeding a sufficient quantity, for that helps the circulation through the Lungs, it empties the fullness of Humours; but this very little relieves the old Asthmatic, and aught not to be practised upon common Fits, but only in great Extremities. Thirdly, The Rarefaction of the windy Spirit, both in the Stomach, Blood and Nerves, must be compressed by cool Liquors, as Toast and Water with Gas Sulphuris, or Pectoral Ptysanes, but these by their sweetness are apt to ferment, and created Wind, as Mead does; I rather prefer fair Water with an acid Spirit, or Sal Prunel, Niter, Sal Armoniac unprepared, small cold Beer, and Wine and Water and distilled Milk are agreeable Liquors for acid Spirits or cool Salts; these compress the Inflations, check the Esservescence of Humours, and by their coolness much refresh the hot Spirits in the Fit: On the contrary, I have found by experience this very certain, that all hot Medicines, as volatile Salts, acrid, aromatic and Fetid Plants, all Chemical Sulphurs, Oils, and spirituous Waters, though never so carminative, endanger the suffocating of the Asthmatic in the Fit, and very much disagree with them out of it: Not solutions of Gum Ammoniacum, nor Castor Medicines, nor the Cortex aught to be given in the Fit; the shortness of breath can bear no Pills, nor Bolus, nor Electuaries. Salts, or acid Spirits, in a carminative Julep, or Ptysan, are the best Anti-Asthmatic in the Fit; the old Posca of Water and Vinegar, or Verjuice and Water, may do well in those who cannot purchase other Medicines. Take Sal Prunel, or Niter and Sal Armoniac, of each ℥ ss. Sugar Candy ℥ i mix them, give ʒi in Milk-water, or the following Julep or Decoction. Take Elder-flower Water, Rue, Black-Cherry, Chamomile-flower Water of each ʒiv. Syrup of read Poppies ℥ iss. mix them for a Julep. Take Eryngo Roots candied ʒiss. Liquorish ʒii. Barley ʒss, Raisins ℥ i boil them in three Pints to two for a Ptysan, add Syrup of Violets, or Syrup of Vinegar a. a. ℥ iii These cool Febrifuges are to be used two or three times in a day, till the heat and straitness is repressed, according as the Stomach can bear them. 4thly. The motion of the Spirits may be turned to the extreme Parts, by many Blisters applied to the Arms, and Legs, and Shoulders, which may discharge a Serum from the Nerves. 5thly. After all the Evacuations mentioned, if necessary at Night we aught to compose the Inflation of the muscular Membrane both of the Stomach and Lungs by gentle Opiates, at Bedtime thus; Take Diacodium and Oil of Sweet Almonds, mix equal parts of them with Sugar Candy; take a Spoonful or two at Bedtime, till sleep comes: Or 10 or 12 drops of Laudanum Liquidum may be given in an Hysterical Julep, which must be mild, and mixed with Gas Sulphuris. Dr. Willis says, Pro subitâ Dispnaeae mere spasmodicae sedatione, nullum praesentius remedium expertus sum laudani opiati tinctura nostra, quip somno ob repente spiritus inordinationes suas remittunt. I have often drank Poppy-water ℥ iii with Syrup of read Poppies ʒvi. and Sal Prunel ʒss. to my very great Advantage. If Castor, Amber, Assafoetida, volatile Salts, or Sulphurs' be taken inwardly, they rarefy the Spirits, raise the Effervescence, and drive the windy Spirits violently into the Nerves, whereby the Strangulation is increased, by which Experience I found, that the contrary are only proper for the Asthma, viz. cool, watery Liquors, acids, Spirit, or cooling Salso-acids, or some Carminatives tempered by Vinegar. The Ancient Physicians in a Fit gave ʒiiis. Aphronitri in lb ss. of Mulsum; some of them usually prescribe a Spoonful in a Day. Verum in his qui suffocantur Aphronitriʒiii. cum aquae Mulsae cyathis tribus praebe, & aliquando cum Cardamomo & statim auxiliatur Aegineta. Three Drams of Sal Armoniac may be mixed with lb iss. of Mulsum, or Honey boiled with Water, and given at many draughts in a day. As soon as the Asthmatic awakes, they aught to rise out of their Beds, though in the Night, which shortens the Fit, makes the straitness lesle, and by sitting up they breathe better; the next day, if the Room be not large, they must remove into an airy Place, where they may sit in an easy Chair all day without any motion, for that increases the straitness. During the Fit the Astmatic aught not to eat any thing, the first day of it, but Small Beer, and Toast and Butter, or Mead, or Wine and Water with a Toast, and this may be taken at Noon, but nothing in the Morning till than, but the coolest Juleps, and Salts; and the same again at Night, or else an Egg or two, with Vinegar in good quantity. If the Fits continued violently for two or three Days, continued the same Diet; for the thinner and smaller the Diet is, the lesle Chyle is bred to stop on the Lungs, and the sooner the Phlegm will digest and come up. Upon occasion of Faintness, I take a Glass of Sack and a Toast, but that occasions a greater Inflation, and straitness; A potched Egg or two at Dinner time, with a great quantity of Vinegar, is good Diet, but all Flesh-meats are very injurious in the Fit, and therefore touch none of it, for the first or second Day, till the Phlegm gins to expectorate: And that I may deter all Persons from Flesh-meats in the Fits, I must tell them, that by eating thereof many have been suffocated, and that causes the Fits to last four or five Days longer. Not Pectorals but Oil and Sugar do any service in the Fit, but that I use the second Day, to help the slipping up of the Phlegm, and I sometime use a Pectoral Ptysan of Figs and Liquorish made very thin in the Summer, and in the Winter time only common Oil and Sugar, to relax the straitness, and lubricate the Trachea, and I frequently Butter the Toast and dip it in Small Beer. I take all Medicines cold, for no hot Liquors agreed with the Asthmatic; the Fire offends, if very hot; the Bed increases the straitness; so much are the Spirits of the Asthmatic disturbed by every hot thing, that warm Beer, or hot Water-gruel is very injurious, and increases the straitness. I always order the Asthmatic to go to Bed the second Night, though the Fit continues, having first taken his Opiate, or some of this Linctus to compose his Breathing. ℞ Ol. Amygd. Dulc. Diacod. ad ℥ iss. Oxymel. Scyllitici ℥ ss. Sacch. Cand. ʒii. Misce cap. Coch. semel bis vel ter repetatur. The next Day as the Fit goes of, he may take a Spoonful of this Asthmatic Syrup Morning and Night; ℞ Syr. de Erysimo, Prassio, Balsamic A. ℥ two. Oxymel Scyllitici & aq. Bryon Composit. A. ℥ i Balls. de Peruʒss. signetur the Asthmatic Syrup. Since the Fit of the Asthma gins three Hours after Meat, a Clyster in the Afternoon is very convenient, before the Fit grows worse, and than Vomit also if necessary, and eat little or no Supper, but take an Opiate. I have tried Vomiting, Purging, Sweeting over Night, and the Cortex to prevent the Fit I apprehended was coming, but all in vain, for the Fit was frequently worse for it; but I found most benefit by drinking of Toast and Water very plentifully, and adding some Niter and Sal Armoniac to it; and at Bedtime I take ʒii. of Galen's bitter Acid, which generally puts by the Fit. I think I may appeal to the Cure of the Asthma Fit, to justify my Notion of it, that a Fit of the Asthma depends on an Ephemera, because whatsoever composes the inflamed, rarefied, or expanded Spirits in an Ephemera, as cool Liquors, Clysters, Opiates, acid Medicines, Quiet and Abstinence, that only agrees with the Asthmatic in the Fit, and all external Accidents that occasion the Ephemera, produce the Asthma, and those must be removed in both. The feverish Ferment in the Asthma is very volatile, and perspires insensibly, as it does in the Ephemera, without much Sweat, the most part goes of in Urine, or lose Stools, and the feverish Sediment in the Water appears but for one Night or two after the Fit. The Air of the Room must be kept cool in the Fit, because that has most weight to open the obstructed Lungs. All Fumes and Smells must be avoided, because they offend the Spirits of the Asthmatic, by rarefying them: A Fire of Wood is more suffocating than that of Coals, by the Fumes which smell and disperse more in a Room. The smell of Charcoal is most Suffocating. The Air of a City, by the plenty of Fires and Smoke is more hot and rarefied than that of the Country, which makes the Fits worse there; the Air of a Square has but little vent, and the Smoke stands more in them like Water in a Pool; but those Streets which are short, and that part of it where four Streets meet, have a more constant motion of Air, and therefore are more fit for Asthmatics, and especially that part of the City which stands highest is best: In the Air of a City the viscid Spit is tinged black with Smoak, which gives a blackish Spit every Morning, and may irritate the Fit. The Breast of the Asthmatic aught to be kept cool in the Fit, and not anointed with Oils that have any smell, because that offends much. All straight clothes, and the weight of Blankets hinder the Extension of the Breath, and raising the Shoulders for Inspiration; and the Asthmatics in Bed usually lie high, leave their Breast uncovered, and put one Arm out of Bed, leaning the Hand upon the Thigh, that the Shoulder may be raised high in Inspiration; and the Belly must not be compressed by any thing, that it may give way readily to the motion of the Diaphragme; any Plaster on the Breast hinders Respiration. Frictions of any Roots give great disturbance by promoting the Circulation of Humours. The Medicines of Castor, Saffron, and Musk seem most proper in fainting Fits, and in them I also use volatile Salts. Zecchius recommends Saffron 10 grains, Musk gr. i. in a draught of Aromatic Wine in extreme Fits. When the Asthma continues for some Months, it is a true Pulmonic Asthma, and depends on some Disease in the Breast, as Dropsy, Tubercule, Abscess, which compress the Bronchia, and till that evident cause be removed, 'tis impossible to Cure the Asthma Fits; for removing this Compression, Vomiting, Purging, Bleeding, and the strong Cleansing Pectorals are useful; but if that cannot be effected, 'tis best to palliate these Cases by cool methods, as cool Liquors, Acids, and Opiates, and a very spare Diet, and an open Air, which will not irritate any Cough, by the smoakiness of it; this Method prevents Inflammation, Inflations of the Membranes, and the increase of any straitness. This useful Observation the Ancient Physicians have left us, that Acids prevent all Imposthumations, and Inflammations; and for this end in the Pneumonic incurable Asthma, 'tis very useful to use the Vinegar Acids, to palliate it, and to abate the Suffocations which depend on the Paroxysms, which hap in the Night in continued Asthmas, as well as those which are Periodical. I have observed very little Spit in some of these continued Pulmonic Asthmas, except a small quantity of a slimy Mucilage, though the Disease had lasted some Years; and that no Balsams, as that of Sulphur with Turpentine did them any service. These Asthmatics breath thicker and shorter than those in the Periodic Asthma, who breath slowly and very rarely. Hypocrates observed in Agisis, that she was 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 before her Tuberculum ripened, and broke, and Asthmatic afterwards. I shall next describe that Method whereby the Return of the Asthma Fit may best be prevented, which is to be performed, 1st. By Evacuating the flatulent and windy Cacochymia. 2dly. By correcting of it by Digestives. 3dly. By preventing any Effervescence in our Humours, or Rarefactions of Spirits. 4. The Obstructions of the Glands' in the Lungs must be removed, if any be, and the Glands' of the Brain constringed or reduced to a better tone. If all these Intentions can be performed, we may prevent the breeding of any more Cacochymia, which when it is in any great plenty, produces a Periodic Effervescence. First, the viscid Lympha must be evacuated, 1. By a gentle Vomit both from the Stomach and Lungs; such is a Vomit with Carduus, or Radish-seeds boiled in Water, to which Oil and Oxymel Scylliticum, of each an ounce or two, may be added, and this Vomit may be repeated once in a Month in old Asthmatics, when the Fits return once in ten Days, or thereabouts; and in others where the Fits are Anniversary, once or twice in a Year, or quarterly; for there is always a Phlegmatic Saburra in the Lungs, and especially in the Stomach of the Asthmatic. To strong Bodies an Infusion of Crocus Metallorum, from ℥ ss. to ℥ i are convenient, or rather some of the Oxysacchara; but Sal Vitrioli is observed by Bartholet, to be injurious to Diseases of the Lungs by its Stypticity: He gives it in Oils. All Asthmatics aught to Vomit frequently, but it is to be managed warily, because of their aptness to Fits of the Mother in Hysterical Asthmas by strong Vomits; and I have observed a Fit of the Asthma to have been occasioned by them. I have given ℥ i of Acetum Scylliticum to Asthmatics to Vomit them, tho' they had formerly spit Blood, and that without any Injury. Without Vomiting sometimes no Asthmatic can be throughly relieved, and at Night after the Vomit, give an Opiate, to quiet the Disorder of Spirits. 2. Clysters once in a Week are much commended by some Persons, who have tried them with good success, to prevent the Fit. 3. By Purging once, or twice, or three times after the Vomiting, or once in fourteen days, if it be an Asthma returning in that time. Pills of Ammoniacum, Hiera cum Agarico, de Succino, Ruffi, are the best Purgers either single or mixed ℈ two. at Night. Pil. Coch. cum Castoreo, these are proper in cold Constitutions, in whom Hiera Picra may do well; but in the hot I only use Purging Salt ℥ i in White Wine Posset Drink, or the Purging Waters boiled very much: This Purge raises no Effervescencies in the Humours, which generally occasions an Asthma Fit. After ordinary Purges, Decoct. Senae, or the bitter Purging Decoction with Buckthorn agrees with others; a Diet Drink of Sena and Monk's Rhubarb agreed with some; but Sena ferments, because 'tis a Legumen, and that raises windiness injurious to the Asthma. The Decoction of a Cock in Broth, with Sena, and Pectorals, is much commended by many Authors. Purging often occasions Fits, by raising an Effervescence in the Humours, and therefore an Opiate is necessary after them, and sometimes the Cortex too, to prevent the feverish Returns, which hap after Purging, like those in the Ague. The Old Authors Purged with Elaterium, and Troches Alhandall; these may be proper in the Hydropical Cases, where watery Tumours are in the Limbs, as Pil. de Cambogia, but in the hot thin Tempers they are certainly mischievous, for the Serum is deficient in these, but Superabundant in the Hydropical; and where that overflows, Purging is absolutely necessary, and injurious if deficient. Aetius Purges with Savin Powder, the first day ʒi. the next day ʒii. the third ʒiii. the fourth ℥ ss. and this brings away Blood. 'Tis Aetius' saying, Maximum est remedium purgatio fortior, per Pharmaca fortiora. I found that ordinary Asthmatics are very fainty, languid, and hot after Purging, and they generally say Purging does them no good. But it was Bellonius' advice, In difficultate spirandi non est formidanda frequens & magna purgatio. I remember an Asthmatic who took some Quack Pills, by which he had 20 or 30 Stools, this very much relieved him, because he was subject to the Dropsy; so that strong Purgers in gross, fat, hydropical Persons may be proper, but not in the contrary Constitutions. Thus Dr. Waller prescribes; ℞ Pil. de Hiera cum agarico ℈ i Troch. Alkand. gr. two. Gum Ammoniacum ℈ ss. f. Pil. 4. Issues diminish the quantity of the Serum, but I never found any benefit by them, though made between the Shoulders, and on the Arms, nor found any injury by stopping of them up. I never tried any on the Breast, nor top of the Head, but cannot approve of either; nor those in the Back, because they require a Ligature which straitens the Breast. 5. Sudorifics are commended for Catarrhs, as the Decoction of Guaicum, China, Sarsa, and therefore may be useful where the Asthma happens after a Catarrh; and in the same case Venice Treacle may be given every Night, which by its bitter and acrid Taste helps the Digestion, and promotes the Circulation of the Serum through the Lymphatics, and opens the stopped Perspiration, and by its opiate Faculty it allays the Inflations of the Spirits; but we aught to take care that it be not too hot for the Consumption, and in such cases must be mixed with Acetum Theriacale, or its Extract. 6. Diuretics, as Millepedes, in the great quantity of Serum of the Blood are very useful, but the Asthmatic seems to make too much Water sometimes. The common Diuretics are Woodlice, Sassafrass, Pine-tops, Gill, Horehound, Enula Campana, Orris, Radish-roots, Juniper-berries. I have used Gilead Balsams, and Balsam of Tolu dissolved in Syrup of Balsam, and Balsam Sulphur, Anisat, without any advantage; but these aught to be used in a Diuretic Oxymel to temper their Heat. Secondly, The mucilaginous and flatulent Cacochymia must be corrected, 1. By diluting and cooling the viscid Humours, for which end we must drink much of Mead, and Milk-water, Sack and Water, Decoctions of Sarsa and China. Those Asthmatics whose Blood wants Serum, may bear Chalybeat Waters, but in those who have old habituated Asthmas, the Serum is too abundant, and in them the Chalybeat Waters affect the Nerves, and fill the Vessels with too much Serum; and in some they coagulate the Serum, and give Rheumatic Pains. Ass' Milk, and common Milk, make the Lymphas too viscid, and they cannot agreed with the Asthmatics: Though I know an Asthmatic, who commends Milk and Water, for allaying the Inflations at the beginning of a Fit. Drinking of Water agrees with the Young Asthmatic, but the old habituated Asthmatic must use it moderately, for fear of a Dropsy, and Pains of the Stomach and Spleen, of which I have heard old Persons complain who drink Water much; but I have observed that a Person who drank no Malt Liquor, but only Toast and Water, and rarely a Glass of Wine, lived free from the Asthma, which certainly returned if he changed his Liquor. The drinking Bath Waters is much commended for the Asthma, but the going into the Bath rarefies the Blood and Spirits, breeds more viscid Humours, and is very injurious to all Asthmatics, as all Authors affirm, and I found observed in Crato's Concilia. I discoursed an Asthmatic at Bath, who was extremely troubled with a violent motion to Vomit in the beginning of each Fit, and nothing composed that like drinking Water; This Person assured me, that he received much benefit by drinking Bath Water, which cured him for some Years, but the Asthma returning, he came than to Bathe a second time: He was of a full Habit of Body, and drank the Waters, but durst not adventure to bath. I drank the Bath Waters, whose heat seemed very disagreeable to me, since no actual hot Liquor can well agreed with me, but I liked these Waters best when I drank them no hotter than new Milk: They passed well, but I found no benefit by 'em. I went twice for trial into the Cross Bath, and that each time made my Breath straight, and Spirits and Stomach very languid, by which I learned the inconvenience of bathing in the Asthma. I met with other Asthmatics at Bath, who found benefit by drinking, but durst not bathe. I know the Hypochondriacal have received some Relief of their Pains on the Breast by Purging and Bathing, but none for the Asthma, as I could observe in a Person who was both Hypochondriacal and Asthmatic, neither drinking nor bathing did him any service. Thin Bodies can neither bear the heat, nor Purging of the Bath Waters; and all Sulphur Medicines are disagreeable to Asthmatics, the Tubercula in the Lungs, Impostumate by bathing; the Heat and Serosity of the Water, does more injury to such Constitutions, than the cleansing quality of the Niter or Sulphur can compensate: And I have heard an Ingenious Asthmatic complain, that her Asthma never was severe till she had drunk the Bath Waters. The opening the Pores, and rarefying the Humours, make the Asthmatics more subject to every nice Change of Air, than they were before; the drinking the Waters gives a strange Oppression and Stupor to the Spirits, with Sleepiness, and that must consequently affect the Nerves serving Respiration, and make them more open for receiving of flatulent Spirits. I do in short think the Bath Waters most agreeable to fat and cool Constitutions, who can well bear their Heat and Sulphur, and their cleansing Qualities. I remember they sunk the Habit of the Body too much in very lean dry Bodies. 2. We must avoid all occasions which make the Chyle viscid or windy, such is Milk, Cheese, Fish, Jelly Broths, strong Wines of a thick consistence, Malt-drink, baked Pies, and Cakes, and Puddings, all Flower Meats unfermented; for all these breed viscid Humours. All crude slimy flatulent Meats are to be avoided, as Herbs, Salads, Mushrooms, Peas, Beans. The most simple Diet is of Flesh-meat boiled or roasted, once in a day, with good Bread well fermented and well baked, and the Bran not too much dressed out; the Drink may be Toast and Water, for all young Asthmatics; Wine and Water for the declining Age, and good small Beer or Ale not bottled; and no Malt Liquor aught to be used but at Dinner by those who cannot leave it of. Extreme cold Air increases the viscidity, and is to be avoided by living in a Town; gentle Riding and Walking attenuate Humours, and discuss Flatulencies, which arise from ill Digestion; violent Exercise makes our Humours more viscid, as we observe in labouring People, and their Horses, whose Blood is made seizie by constant Sweeting, by which the Blood becomes inspissated like Serum heated by the Fire. Too many Clotheses heat and thicken the Blood, by evacuating the Serum, and this Practice makes them more subject to take Cold; for the more the Humours are rarefied, the quicker does the Air compress them, or rarefie them upon the alteration of Wether; they therefore catch lest Cold whose Spirits and Humours have the Air most compressed in them. Sadness stops the motion of Humours, and makes them more viscid. 'Tis observed that all Asthmatics being angry or sad, do fall into Fits oftener than when they are cheerful. The Belly must be preserved fluid, the Urine must flow in due quantity, and the Sweat must be moderately promoted by Exercise; for all these ways the viscid Humours may be evacuated, and the windy Spirits discussed. 3. We must correct the mucilaginous quality of the Chyle and Lymphas by Digestives. First, By Bitters. I have long used bitter Wines, but those inflame the Blood and Spirits. Dr. Lowers' bitter Tincture with Steel did me no service, but great injury. I have heard some Cachectical Persons commend Wormwood Beer and Wine, but they are generally too hot. I have used many Ounces of Elixir Proprietatis prepared with volatile Salts, and Hiera Picra infused in Sack, without any benefit, and that prepared with fixed Salt is as mischievous to the Asthmatic; but Elixir Proprietatis prepared with an Acid is lesle heating, and a truer digestive, and more convenient for Asthmatics against their Cachexies. I have used great quantity of Horehound in vain, as lbss. to six Gallons of very small Table-beer, it produces much Urine, and was pleasant enough, though a very strong Bitter, of the taste, nature, and quality of the Verbascum, to which class I therefore think it referrible; but a long use of this did me no service. But I very much relieved a Cachectical Asthma, by a long use of Syrup of Horehound in Hyssop-water, which was taken Morning and Night for three Months. I tried great quantity of dried Buckbean in Thea for my Breakfast, I drank half a pint of this with or without Sugar all Winter every Morning; this agreed with my Stomach, as Centaury Thea did, which I also have frequently used with Sugar; both these Theas agreed in Colour, Taste, and Virtue, for which reason I call Buckbean a Marsh Centaury. I tried the bitter of Broom, putting of green Broom lbss. to six Galons in a Bag; this agreed with my Stomach, and helped my Appetite, though it did the Asthma no good. I have known it to produce much Water in the Cachectical, and help the Hydropical Asthmatics: Neither boil the Broom nor dry it, for than it has a nasty smoky leguminous Taste; use equal quantity with Hops. Since Oxymels with bitter acid Cephalics, and Pectorals, are generally commended by Authors, I thence learned, that a bitter Acid was useful to Asthmatics, and I observed that they usually prescribed their bitter Gums, and acrid Medicines to be dissolved in Oxymels, or drank with a Posca. I was frequently relieved by the following Oxymel, and my Fits kept of many Months; I used the Prescriptions of Authors in vain, wherein they order the solution of Gum Ammoniacum, because they failed me in not prescribing a sufficient quantity of Gum Ammoniacum, as Physicians formerly did err in the small quantity of the Cortex: This dissolution seems to me convenient, and I use it till I have spent three Ounces of the Gum. ℞ rad Zedariae ℥ i Coq. in aqu. Font, lb ii. ad lb iss. Colaturae adde aceti ℥ iv. in quibus dissolvatur Ammoniaci ℥ i. Colaturae add Mellis ℥ iv. Coq. & dispumatur, & coletur, Capiat colatur. Cochl. 3. Mane & V●speri per menses aliquot. There is a very volatile Acrimony in Ammoniacum, which affects the Roof of the Mouth, besides the Bitterness, by which it sensibly opens the Passages of the Lungs, and enlarges the Breath; it helps the Digestion, and discusses Winds, it produces gentle Sweats, and sensibly invigorates the Nerves; but I found it necessary to follow the Ancients method, in correcting its bitterness and acrimony by Vinegar, and that makes it more cool; but sometimes I used it thus, ℞ Rad. Emul. candit. ℥ i Coq. in aq. lb ii. in Colaturâ calida; Dissolvatur Ammoniaci ℥ i & Mellis ℥ iv. This was without Vinegar; The Ammoniacum is best dissolved by Water, but it is no ways disagreeable to the Asthmatic, till Vinegar is added to abate the heat of its great acrimony and the bitterness, and by the Experience I had of this Medicine I learned, that no acrid nor bitter would agreed with the Asthmatic, unless they were corrected in their heat by an Acid; I therefore usually added Vinegar of Squills ℥ iii to the former Prescription. Dioscorides commends Aristolochia decocted in Water. I have used that and Gentian, of each ℥ i infused in lb i. of Vinegar; 'tis not disagreeable. Briony and Centaury are commended by the Ancients for the Asthma. All Acrids are forbidden by Galen in the Dyspnaea, because they rarefy the Humours, and dissipate the thinner part, by which Humours are made more thick. If Acrids be used, they must be used in small quantity, and well diluted by Liquids', or rather corrected by Acids. I like the drinking of Mum in an Evening, half, or a whole Pint, for that helps Digestion, and keeps the Body open, both which are useful to the Asthmatic; thin Constitutions may use this all Winter for Supper with Dutch Biscuit, and it will feed them. The Theriaca Diatessaron is a good, old and useful Medicine, if taken at a Night, and some Oxymel after it, to cool its heat. The bitter Decoction may be used for a Month every Morning, to help Digestion, with some drops of the Elixir Paracelsi in it. Centaury, Gentian, or Carduus, may be used in all our small Beers, ℥ i to each Gallon; or else Broom, Horehound, or Pinetops, Germander, Woodsage, or Gill lbss. in four Gallons for ordinary Drink; or use Thea of Centaury, Gentian, Buckbean. Secondly, By Salsoacid Digestives. Some Asthmatics have drank their own Urine every Morning, and found much advantage by it, which gave me a hint of using Sal Armoniac Preparations. The Acid Spirit of Sal Armoniac distilled from that and Sugar, and made into a Tincture; and ʒiii. to lb i. of a Tincture of Cordial Flowers, 'tis useful if given in Water, to a spoonful, or two, or three, in the Cholic, and Fits of the Mother; and the Flowers of that Salt, which are rarefied from the common Salt, are given in intermitting Fevers; or else the common Salt of Sal Armoniac may be given as a Digestive, or the volatile Salt fixed with Spirit of Vitriol gr. seven. Sal Succini is a Salsoacid Volatile, I used some Drams of it without any benefit. Aqua Calcis compound seems proper to correct the Phlegm, and cure the Diabetes attending all Asthmas, and to raise the Digestion; I tried it, but it heated the Blood extremely, dried the Mouth by its stypticity and saltness, and made the following Fits worse, neither would agreed with any other to whom I recommended it. Three Drams of common Sal Armoniac is prescribed in ʒi. Cyathis of Aqua Mulsa by the old Writers. Thus also they used Sal Armoniac in their Diet; Take Sal Arm. lb i. Pepper, common Salt, ad ℥ iii Seeds of Rocket, Ammeos, ad ʒii. Hyssop, Thyme, ad Mii Smallage, and Parsley-seeds, of each ℥ two. Origanum ℥ i pound and searse them for a Powder; half a Spoonful may be used in Diet; and 'tis much commended for Windiness and Diseases of Breast and Eyes. If the Niter of the Ancients was Urinous, we have nothing so like it as Shall Armoniac, but they prescribe them and describe them as different Medicines in the Asthma, but they used them both in it, for their cooling and attenuating Qualities. I have observed the Merchants to try the Salt Petre before they buy it, by throwing it into the Fire, to see whether it will crack, for than they reject it as full of common Salt. I think the best substitute of the Aphronitum may be Sal Prunel, and a volatile Salt, for they will have a lixivial Taste, and ferment with an Acid, and Nitrum regeneratum, and tart nitrated is of a like taste and quality. All volatile Salt exposed to the Air, has a cool taste like Niter, and may be mixed with Spirit of Niter. Thirdly, By Chalybeat, or Vitriolic, and Sulphurous Digestives. Extractum Ecphracticum cum Aloe, seems the best digestive for Asthmatics, for tho' the Steel by its stypticity stops the breath, yet Aloes helps the Steel of the Stomach. Most Asthmatics complain that Steel heats them, stops their Stomaches, and Breathes, and thickens the Phlegm, and at last produces a severe Effervescence which gives the Fit. Baccius assures us, that Steel-waters by their stypticity offend the Asthmatic, in them they occasion Rheums and Catarrhs and fill them full of Serum; the Steel affects the Head with a drowsiness and giddiness, as all Steel Wines do: Those I have recommended to the Steel Waters have much complained of them; and the Germane Spaw-waters did increase my Fits; but I will confess I have discoursed some Persons, who have been much better for those Waters, the quantity of cool Water doing more service than the Steel could do injury. I believe Vitriolum Martis inconvenient, because of its great stypticity; though it raises no Effervescence in the Blood, yet whatever gives a violent motion to the Humours produces the Asthma. All Steel Wines are mischievous, as well as all other Medicines infused in Wine. Lower's Infusion of Steel and bitter, swollen my Stomach, that I could not bear it, because of the strong Waters in it. The Effervescence of the Chyle we call a hot Flatulency, and that of the Blood an Ephemera Fever; both these aught to be stopped, and the occasions avoided, as Surfeits, much Drinking, stoppage of the Pores, violent Motions, Passions, Study, all these Causes rarefy the Air included in the Bubbles, which constitute the fluids in Animals, and thereby produce Flatulencies, Effervescencies, Heat, and Expansion of Spirits. For the suppression of all Effervescencies in our Humours, the Method prescribed in the Cure of Ephemeras, and the Asthma, must be used, but for preventing it nothing more likely than the use of the Cortex. Take ℥ i of it after your quarterly Vomits and Purges; I boil it in Pectoral Drinks, for in substance the stypticity of it oppresses the Stomach, and makes a greater straitness than usual. Though the Cortex cannot prevent the Fits in a Pneumonic Asthma depending on a great Tuberculum, nor in the flatulent Asthma, where there is a great Cacochymia, yet I perceive it greatly relieves the Sweats and Faintness attending the Fits, and head-aches, and makes the Intervals of the Fits longer, but it is no ways proper to give it in a Fit, for than it exceedingly huffs up the Stomach. It seems to me a rational design, to try more Antifebriles against the Asthma, after general Evacuations and Digestives are tried, of which kind this seems proper in the Summer time, and it is commended by Rulandus as very good in the Asthma. Take 20 or 30 Leaves of Houseleek, pound them, and express the Juice, putting to them first a little Water, and two drams of Sal Armoniac: This Houseleek and Salt are proper to prevent Effervescies in the Blood, for which reason also we may try Ribwort, Plantain; for Plantain is used against intermitting Fevers: Boil Mij. in Posset-drink one Pint. I drank the Water distilled from the Juice of Houseleek lb iv. with ℥ two. of Sal Armoniac in a Sand Furnace; this cools well, but a Syrup would have been much better. These are the best Febrifuges to be used in the Summer. 1. Watery cool Liquors, distilled Milk, Water drinking, Decoctions of Sarsa. 2. Acids▪ as the Tartar Acids and Acerbs, acrid Acids of Vinegar, Sulphur Acids, Salsoacid Spirits, vitriolic Acids, nitrous Acids. 3. Vitriolated Salts, or Salfoacids, Sal Armoniac, Niter, Sal Prunel, Sal Succini. In the Winter Bitters are the best Febrifuges, as Venice Treacle, bitter Decoction, Oxymel Scilliticum, and the Acetum, Elixir Proprietatis, with an Acid. The watery Toast and Water for ordinary Drink, or else lb i. in a Morning, after Dinner lbss. and as much at Night. Maxima continentium febrium remedia, haec duo sunt, venesectio & frigida potio. The old Practisers gave as much cold Water to drink, as the Patient could bear, lb iii. or iv. and they affirm, Ipsius febris qua febris aqua frigida est remedium. I am very well assured, that if an Asthmatic could drink no fermented Liquor, he would rarely have the Asthma Fits. I usually drank lb i. of Water heated with a Toast in the beginning of my Fits. The Decoction of the Woods is very useful Morning and Night. Take Liquorish bruised ℥ i steep it in fair Water all Night (about lb ii.) without heat, and drink every Morning a large draught, or else use it for ordinary Drink; others must use a fifth or sixth part of Sack or White Wine, with a large proportion of Water; others may use Waters boiled with Cinnamon, or Aniseed, and Raisims. I use this Hydromel, Take Honey lb i. boil it in one Gallon and a half of Water to one Gallon, scum it well, than add to it Ginger 3 races, Cloves 30, boil it and strain it, than when 'tis cold bottle it, and use it Night and Morning with a Toast and Butter, or else for ordinary Drink. Take boiling Water lb ii. Cinnamon ʒii. the crumb of white Bread a good quantity, Sugar ℥ iii steep them, and put them through Hypocrates Sleeve. 'Tis usual to add an Acid to the Water, and than lesle Water will do; thus, Take Water lb i. Spirit of Vitriol ℈ i This Water drinking is very agreeable to all Chronical Diseases, in which there is an Effervescence of Humours, as the Gout, from whence it is observed, Rarissimum exemplum ut quis Hydropota fiat Arthriticus. By Water drinking all Salt and other vicious Tastes of our Humours are diluted, and made more mild and lesle corrosive: Water drinking is proper for all Defluxions which depend on the Ephemera, as head-aches, the Hysterical, Falling Sickness, Tremble, dull Sight, the Melancholic, Bilious, Hemorragies, Putrefactions of the Mouth, Fluxes of Humours by Stool, Urine, the Womb, and is certainly very useful for all the hot Cacochymias, as well as all very hot burning Fevers. I have often put by my Fits, and cured the Inflation of the Stomach by the Hydroposia, for which reason I cannot but recommend this to other Persons. The next and most prevalent cooling Taste, is, of the Acid Febrifuges, which coagulate the consistence of Humours, gathers or compresses the Globuli of the Blood, and makes the Blood of a blacker colour; they cool the Spirits, and prevent their too great rarefactions: I will first consider the varieties of Acids, common Vegetables, and than those observable in Animals, and Minerals, and propose the best Forms of them that I could collect out of Authors, to be tried in the Asthma. 1. The styptic acerb Tastes, such is Plantain, Polygourd, spotted Aresmart, Sorrel, the Seda; amongst these the Sedum Majus has been tried, and recommended in the Asthma by Rulandus, as I mentioned above. Dr. Baynard tells me a Relation of a Woman relieved in the Asthma by Sorrel, a Posset-drink made with the Juices of the Seda, or Sorrel may be tried, or a Syrup made of the Juices, and dissolve it, an ounce of it in four ounces of the distilled Water of the same Plant, and use in with ʒss. of depurated Niter, or gr. 15. of Sal Armoniac. See the Serum de Sed● in Bates' Dispensatory. The Virtue of these Acerbs is to cool Inflammations, Fevers, and astringe all Fluxes of Humours: Their Tartareous Acidity makes them cooling and diuretio, and their Stipticity makes them proper for intermitting Fevers, and in these Cases these acerb Acids must be used. The most Physical Acerbity we observe in the Fruits of Trees, as in Meddlers, Services, Quinces, Granates, Rhue, Opsoniorum, Barberries, Grapes, Sloes, Bilberries, Cherries, Pears. The most acerb Tastes are too styptic for the asthmatic; but the fermented Acids are commended in the Asthma, as old Verjuice and Vinegar. The acerb Taste depends on the want of a due Fermentation in the Fruits, for in a farther and perfect Maturation, they become sweet and more acid, with a lesle Astringency: The crude acerb Juice of Grapes has no Acrimony, but Vinegar having undergone, first, a vinous or perfective Fermentation, and after that, a second putrefactive Fermentation, it becomes something acid, and is properly an Acid acrid: From Fruits fermented by Nature a pure Acid is produced, such is that of ripe Fruits, and I call it, 2. The tartareous Acid; such is the Juice of Lemons, Lime Juice; this may be called the sweet Acid; in these there is a Tartar too cool, but no Stypticity to bind; but these Acids purge most, and are used chief for Thirst and Fevers; but these ferment too much for the Asthma. Take Conserve of Wood Sorrel, Hips, Rob of Berberries; each ℥ i Crem. Tart. ʒiij. Syrup of Lemons; mix them. Drink Limonade, Limon Posset-drink, or Verjuice Posset-drink, Decoction of Pippins, sweetened with the Syrup of Lemons, Citron, adding Spirit of dulcified Salt, Niter or Vitriol. All Meats aught to be acidulated with Oranges, Lemons, Sorrel, and the Drinks too, as Barley Water, lb ij. Juices of Oranges or Lemons, ℥ iiij. Cinnamon Water, and Syrup of Raspberries, of each ℥ iij. sweet dulcified Spirit of Niter, ℈ ij. See Tabulae Tartareae, and Cicera Tartari in Bates, and Julapium Fragorum and Ideum, for proper Forms. Instead of common Salt use Tartar powdered with all your Meats, or Cream of Tartar, ℥ ij. with Juice of Oranges, ℥ ij. may be dissolved in lb ii. of Barley Broth to loosen the Belly; one Spoonful of crude Tartar may be used in Broth, to loosen in a Morning, or else Honey and Cream of Tarter mixed; take three Drams. Pulvis hepaticus rubeus is made of Cream of Tartar irrorated with Spirit of Vitriol: It cools and prevents Drunkenness. Take Cream of Tartar irrorated with Spirit of Vitriol, Crabs-Eyes prepared with Vinegar, of each ℥ i Oil of Cinnamon, Cloves, of each ʒss. Sugar, lbss. make a digestive Powder. 3. I will next consider the acid acrid, or Vinegar Acids, and give the Forms. The old Posca made of Vinegar ℥ i Water lb i. given ʒvi. three or four times in a Day: 'Tis good for the Cholera and Hemorrhages, and consequently for all other Effervescences: Rose Water, Vinegar distilled, and Sugar, of each ℥ i Pliny commends Vinegar Medicines as very useful, Vini Vitium transit in Remedia; it excites our Appetites, and recommends our Meats to our Palates: It may be mitigated with Water or a Toast, Wine, Pepper, Salt makes it hotter, otherwise Vinegar is of its self of a cooling; and no lesle discussing Quality; it ferments with the Earth, and breaks Stones, which Fire cannot; by which we observe that 'tis proper for Stones; if it be drank it takes of Nauseousness, Hickops, and sneezing by smelling to it: Vinegar is useful in Eye Medicines, and in Gargarisms for the scorbutic Putrefaction of the Mouth. Vinegar is proper for diary Fevers, from Heat of the Sun, and for Thirst; and for these the Ancients used the Aceta Theriacalia. Vinegar was used by the Ancients for leprous Scurfs, Ulcers, Bites of mad Dogs, or other venomous Stings; outwardly for Hemorrhages, 'tis applied with a Sponge, and two Cuatha may be taken inwardly to dissolve the Blood. Vinegar is applied to the Procidence of the Arms or Vulva; it helps the old Cough, Orthopnea, and Decays of the Teeth. Agrippa had his Legs immersed into hot Vinegar in a cruel Fit of the Gout; by this it appears, and many other Prescriptions, that Acids were used outwardly for the Gout, and Crato used Oil of Vitriol five Drops in Broth to prevent the Gout. The old Writers always used the Acid of Vinegar and Niter to cool the Humours, and to abate the Heat, Acrimony, and Bitterness of strong Medicines: I will give Pliny Commendation of the Acetum Scyllicitum, which all the old Writers commend in the Asthma. The old Vinegar of Squills is most approved of; it is profitable in the Acidity of Digestion, and to those who vomit fasting; it cures the Stench of the Mouth, Lungs, and Gums; confirms the Teeth, gives a healthfuller Colour to the Face, helps Deafness by gargarising, sharpens the Sight; 'tis proper for the Epilepsy, melancholic, vertiginous, hysterical, bruised, infirm Nerves and Faults of the Kidneys: Thus the Ancients used their medicated Vinegers instead of acid Spirits, and false acid chemical Salts, and they seem more natural to our Humours than the others: From the medicated Vinegers they order a Posset-drink thus, take two Spoonfuls of Vinegar, mix them with lb i. of Milk, to make a Posset-drink, and any specific Juice or Scurvygrass may be added. The Spirit of Vinegar is not so acid as the common Vinegar, and lesle to be valued, but the Dose is ʒij. to ℥ ss. in any Julap. Tincture of Steel with Spirit of Vinegar, Tincture of Opium with Vinegar, may be used in hot Cacochymias. Silvius preserved himself from the Plague by Vinegar, one Spoonful in the Morning. Vinegar is good in Surfeits, Vomiting, Hickops; and outwardly applied to the Stomach with Leaven and Mint. Vinegar corrects Opium, if a Draught be taken after it: I think we want an Opiate extracted with Vinegar and Canary for a Menstruum, or Vinegar Spirit alone; this is more proper for the Asthma and Fevers, than the Brandy Spirits: The Fumes of Vinegar excite the Lithargy, and those that faint by Dissipation of Spirits by bathing: Vinegar hinders Imposthumes, and inwardly and outwardly is used for the Erisipelas; it is proper for the Scab, Impetigo, Burning, it is proper for the Gout, with Sulphur in Embrocations, it stops Fluxes of Blood; the Vapour of Vinegar cures the Noise in Ears and Deafness, and the same Fume is good for the Dropsy: Vinegar is commended for an old Cough, and Dyspnea. Avicenna gives these Virtues of Vinegar. I will not only commend Vinegar with the Ancients, but also tell its Faults as they observed them. Vinegar is injurious to the Hypochondriacals, because they too much abound with an acid acrid Humour, but for some Diseases of the Spleen, as tumors, Inflammations, Galen commends it both outwardly and inwardly; Vinegar usually gripes the Hypochondrias. Vinegar does Injury to the Womb by stopping the Menstrua, which are produced by an Orgasmus, Effervescence, Ebullition, or Turgescence, which implies not only a quick Circulation of the Blood, but also an intestine or fermentative Motion before the Menstruum hap for two or three Days, which gives Pains in the Back and Loins, with a Lassitude, Pulsation and Heaviness in the Limbs, Pain in the Head, Inflation in the Hypochondria, and I hope by these Symptoms I may say that Women have than an Ephemera, which occasions the Flux of their Blood, which being rarified, stimulates the circulating Vessels for its Excretion: But Vinegar, if mixed with Bitters or Hony, does not suppress the Menstrua, but is proper to cool and cleanse the Womb. 4. Vinegar produces Sterility, by repressing the Flatulency of Spirits, and coagulating the Sperm, which it will do as it does coagulate Milk. 5. Vinegar is injurious to the Nerves and Nervous Parts when obstructed in a Palsy, but no way in those Diseases which depend on the hot Cacochymias, as Deliriums, Phrenities, Epilepsies, Convulsions, Asthmas, Fevers. 6. Vinegar corrodes the Parts ulcerated, as the Guts and Kidneys; it extenuates the Body, by evacuating the Succus Nutritius; it depresses the natural Fermentation of Humours, and breeds the Dropsy and Cachexy in cold Constitutions. Vinegar is made more acrid and acid by Distillation from Niter, Salt, and Sal armoniac; or if ℥ ss. of Sal armoniac be added to distilled Vinegar; by this it will dissolve Stones and Metals. The Ancients made purging Vinegar with Sena or Agaric, and an Elixir Salutis may be made with the same Ingredients as that in Bates' only; use Vinegar for the Menstruum, or else Vinegar with an equal Quantity of Spirit of Wine. Galen prescribes Aloes to be dissolved in Vinegar, or else Scammony, or ʒi. to lb i. Hiera Picra may be infused in it, as well as in Canary or Brandy; the Oxysacchary, made by the Infusion of Crocus Metallorum in Vinegar, are certainly more agreeable and most innocent: I have observed stomachic Vinegers with Quinces or Mint, diuretic Vinegers with Juniper Berries, cordial Vinegers with Cloves, styptic Vinegers with Roses, pectoral Vinegers with Squills, diuretic, antihydropical Vinegers with Elder Flowers, cephalic Vinegers with Rosmary Flowers, uterine Vinegers with Myrrh or Savine, Pennyroyal, Castor, Assa-foetida; Vinegar with Niter or Sal Armoniac for the Stone; Aromatics and Honey may be added to all the Vinegers, or Sugar to make them more agreeable: We prescribe ℥ iv. of Vinegar with Pepper for Obesity every Morning, I have often doubled. Whether ℥ iv. of the Cortex might not be infused in lb i. of Vinegar, to the great Advantage of hot Patients, who cannot well bear the bitter: A styptic Vinegar may be made with Sloes, lbss. in lb ii. of Vinegar, or else by the Infusion of Oak Bark; an alexipharmic Vinegar is best of Venice Treacle, Myrrh; of each ℥ i Saffron, Camphir; of each ʒi. Vinegar, lb ii. or prescribe thus, Syrup de Scordio, Aqua Epidemica, ʒio. Aceti Bezoardic, Does. Cochl. i. ad iii For pectoral Cases, ℞. Aceti Scyllitici, Syrup. de Prassio, Aqua Brion. composit. cum ʒiv. Does. Cochl. i. Infinite are the Prescriptions I have met with in the Ancients, made of Vinegar, with all Sorts of Specifics; but I shall reserve them for a Treatise of simple Medicines, digested under their several Tastes, but here design to add more about the Use of Oxymels, which were the pectoral Acids of the Ancients, but I must not omit that Bellis Minor is an Acid acrid, and may be properly infused in Vinegar; the Chemists use a Tincture of the Flowers with Spirit of Vitriol for the Asthma: Anagallis Flore Phaeniceo may be infused in any Liquor for Fevers, being an acrid Acid, and so is Vrsa Solis, in Aqua Theriacalis: All the Tythimals and Hellebores are corrected by Vinegar, which shows the Virtue of Vinegar to correct vicious Humours which are corrosive. The most acid Oxymel hath the fourth Part of Vinegar, in respect of the Honey, the most sweet, the eighth Part in viscous Humours the Acid is to be used, and in others the sweeter. Take of any pectoral Decoction, lb iiij. Acetum Scylliticum, lbss. Honey lb ij. boil it and scum it. I have made Oxymel Scylliticum thus; ℞. Aceti & Mellis cum lb ss. Aquae lb ss. coque cum Scyllae ℥ i & Macis, add cum lb i. & reservetur. The acid Spirit of Turpentine is the best Diuretic, and the Acid of Guaicum the best Acid diaphoretic amongst Vegetables. I think not fit to multiply any farther Receipts from vegetable Acids, but will pass to the Acids of Animals, where Buttermilk Posset-drink is the chief, and Buttermilk distilled with Sorrel or Lemons; and these I may call the Tartar Acids in the Chyle of Animals. The Salso-Acids from Urinal, or volatile Salts mixed with Acids, as Shall armoniac: Let the Patient drink six Ounces of his own Urine with Specifics: Take Niter and Sal armoniac, dissolve them in Vinegar, and crystallize them, or Sal Polychrest. lb i. Sal armoniac, ℥ i dissolve and crystallize them. Take the volatile Salt of Sal armoniac or Hartshorn, fix it with either Spirit of Sulphur, Niter, Vitriol, or Salt, putting as much as will dissolve it, than filter and crystallize it, or evaporate it to be a factitious Sal armoniac. Take Flowers of Sal armoniac, Grains xv. in Conserve of Hips for a Month, or the acid Spirit of Sal armoniac, mixing ʒiii. in a lb i. of the Tincture of Cordial Flowers, the Dose one Spoonful in fair Water Night and Morning. ℞. Flowers of Sal armoniac, ℈ i Aquae Angelicae, Cardui, aa. ℥ iss. Syrup. Citri, ℥ ss. mix for a Sudorific. ℞. Flowers of Sal Armoniac, Mortiat. ℈ i take it in a Spoonful of Wormwood Wine in the Dropsy. ℞. Take Sal Prunel. ʒiij. Volatile Salt of Hartshorn, ʒi. Flowers of Benjamin ʒss, mix them, Dose ℈ i add ʒss. ℞. Juice of House leek, lb iv. Sal Armoniniac, ℥ two. distil them, or else use them in a Syrup with Sugar for the Asthma. Sal armoniac may be used for common Salt. Amongst Minerals we have Sulphur Acids, which are to be used in Fevers. Ol. Sulph. ℈ ss. ad ℈ i in four Ounces of Purslane Water. Gas. Sulph. one, two, or three Spoonfuls in a Glass of Water, or any Julap or pectoral Ptysan. Take spring Water, lb iii. Spirit of Sulphur, Liquorice, Coriander Seeds; of each ℥ ss. boil them in a Glass Vessel: Briony Water, lbss. Ol. Sulph. ℥ ss. Does. Cochl. Take any Cordial or specific Water or Brandy ℥ iv. Ol. Sulph. per Campanam cinnam aa. ℥ ss. Digest them to a Tincture; the Dose is thirty Drops in Beer. Take any pectoral Syrup, lbss. Ol. Sulph, ʒi. the Dose is one Spoonful. All the Drink or Wine may be sulphurated; many heat their Drink with a sulphureous hot Coal, and light their Tobacco with a Match, and the Tobacco may be washed in sulphurated Water; the Water cleanses away much Filth, and the Sulphur Acid corrects the narcotic Quality of Tobacco. 2. The false acid Spirits, which are properly diuretic and stomachic. ℞. Aqua Feniculi, Flores Sambuci, ad lb i. Raphani composit Lucubric. Syr. de 5 Radicibus. add ʒiij. Sals. Absynthii ʒij. Spir. Salis ʒi. Does. Coch. 3. cum quolibet Liquore 〈◊〉 The sweet Spirit of Salt, twenty Drops in Beer. Sal▪ Gem. may be used as common Salt, or the Rock Salt found in Cheshire may be powdered and used as common Salt. 3. Vitriolic Acids, for the cooling the Blood, Oil of Vitriol, or Spirit, six Drops in Broth or Water, ℥ vi. Plantain Water, ℥ x. Spirit of Vitriol, ℥ ss. Ol. Vitriol. Grains four in Wine or Broth, twice in a Week: Crato gives it for the Gout, and he prescribes thus; Syrup of Betony ℥ iij. Oil of Vitriol, Grains nine. He first gives one, than two or three Spoonfuls to them fasting, and says it helps a pituitous and moist Stomach, for it vehemently dries, deterges, and astringes, and excites the Appetite; but by its Use the arthritic are made Cachectical, and it injures dry Bodies. The Tincture of Roses, with Spirit of Vitriol is useful in Effervescences, Fevers, Inflammations; in which Cases the Mineral Acids are most useful. Hartman used Oil of Vitriol with Man's Grease externally, for an Atrophy of any Part. Give volatile Spirit of Vitriol, twenty Drops in a cephalic Julap, for the Epilepsy. Elixir Vitriol is useful for the Appetite, ℈ i to ʒi. Mixtura Simplex ℈ i to ʒv. in Aqua Lactis is a Diaphoretic in Fevers. Spirit of Vitriol is mixed by Chemists, with Cream of Tartar, or Crystals of the Juice of Wood Sorrel. Take Hydromel, aromatized with Ginger lbss. Cream Tartar ℥ ij. or Tartar vitriolated ℈ ij. If Vitriolum Martis be convenient, give it with Oily Pectorals thus; Take Juice of Liq. or Balls. Lucutell. one Ounce, Tart. Vitriolate, and Vitriolis Martis, of each ʒi. mix them with Oil of sweet Almonds, or Syrup of Balsam: The Dose is ʒi. or ℥ ss. and drink the Antiscorbutic Milk Water after it. This Method may agreed with the Hypochondriac Asthmas, or else Extractum Ecphracticum, to an Ounce of which add Vitriolum Martisʒi. make it into Pills. 4. Nitrous Acids to cool in Fevers. ℞. Aqua Cardui lb ij. Rob. Ribi. aa. ℥ x. Sacchari ℥ ij. Nitri prep. ʒij. this cools. Barley Water lb iij. Niter ʒss. Syrup of Violets ℥ iij. take it with Rhenish Wine. Niter may be used instead of 〈◊〉▪ in Broth or with Meat. Sal Polychrestumʒi. take it in Water. ℞. Vitriolum Martis ʒi. Arcanum Dupli●● Sal Prunell. aa. ʒij. Dose ℈ i in long Fevers. Take Niter ●ii. Vinegar lb i. the Dose is one Spoonful in great Effervescences. The most powerful Cooler is made by Distillation of Spirit of Niter and Oil of Vitriol. Spirit of Niter is dulcified, and the Dose ℈ i two or three times in a Day, or in a pectoral Decoction, or else Spirit of Niter three Drops in a carminative Julap for Colic and Flatulency. Take Sal Prunellae, Cream of Tartar, and Powder of Liquorice, and Sugar Candy, of each ʒijs. Dose ʒi. Avicenna observes that Niter has no Stypticity, but cleanses much, and is given in a Decoction of Rue and Dill: It cures Leanness, but a great Use of it blackens the Choler. Bartolet commends a ●actitious Niter with Spirit of Niter, and Oil of Tartar to make the Diospoliticum, which because of the Niter is laxative, and good for Flatulencies. Take Diaspoliticum ℥ i Hony ℥ vi. Sal Armoniac ℥ ss. mix them: The Ancients gave Diaspoliticum before or after Meats; it may be given in Broth. If the Rue▪ Cummin, Pepper, and Niter be in equal Parts, it loosens the Belly; commonly the Niter is but half a Part. I would make a Diaspoliticum thus: Powder of Cinnamon▪ Nutmegs, of each ʒiis. Niter▪ ʒi. Sugar Candy ℥ ij. Mix them with Gum Dragon dissolved, Lozenges may be made, and ʒii. of Flower of Brimstone added. Or thus: Take Niter ℥ i Sugar ℥ two. Ol. Cinnam. or Nutmegs or Cloves ℈ ss. the Dose two Drams in Water. Salts vitriolated, Diagridium, Grains three or four, Tartar vitriolated ʒss. take it in Wormwood Wine, for Dropsies to purge. Take Tart. vitriol. Salt Prunell. Cream of Tart. aa. ℥ ss. Sugar. Candy ℥ i for twelve Doses, take one Morning and Night. Take Tartar, Vitriol, ℥ i Rhenish Wine, lb i. Decoction of Barley with Raisins lb i. Syrup of Violets and small Cinnamon Water, of each half a Pound, the Dose is ℥ iii twice in a Day; 'tis a Digestive and Febrifuge. Hartman order it thus. Tartar vitriolated ℥ i dissolve it in a Pint of Wine of Squills; add to it two Pints of a Decoction of Raisins, Cinnamon ℥ ss. boil them in three Pints of Water to lb ii. take a Draught thrice in a Day. ℞. Tartar prepared with Niter ℥ i Orange Pills ℥ ss. infuse them in a Pint of Parsly Water. Take Sal Prunell. ʒi. Spirit of Vitriol Grainsten, in a Decoction of Barley, and the Roots of Sorrel. ℞. Sal Armoniac▪ ʒi. Niter ℥ ss. Borax ʒss. Flowers of Sulphur ℈ i to the colliquated Niter in a Crucible add the rest. Arcanum Duplicatum ℈ i in Broth: The Ancients used ʒv. of common Salt to make Epythimum, purge and boiled them in Aqua Mulsa: Twelve Grains of Sal Succini may be given in a Julap, or the acid Spirit of Amber twelve Drops to thirty when an Acid is necessary for cephalic Cases. I could not omit the various Species of acid Medicines, because no Fit of the Asthma can be cured or prevented without an Acid. The Galenical Acids, for Flatulencies and Effervescencies, were Vinegar and Niter; the chemical are the acid Spirits, and mixed Salts: But because a long Use of Acids corrodes the Belly, sours Humours, dries the Succus Nutritius, suppresses the natural Rarefaction of Humours, and introduces a Cachexy instead of the Effervescence, the Ancients wisely mixed their hot Medicines, as Acrids, Aromatics, and Bitters, with their acid Medicines, and the bitter helps the Digestion of Humours, whilst the acid corrects their Effervescence, and both together keep the Body soluble, and drive out the Flatulencies. Trallian boils Marrubium in his Oxymel. All Authors agreed, that the asthmatic Medicines aught to be inciding without any vehement Heat, because by Heat the Humours become more viscid; therefore no hot Pectoral aught to be used, but in an Oxymel, nor no Sulphur without Niter, or acrid Gums without Vinegar▪ according to ancient Practice: From whence I learned Galen's bitter Acid, of which I take ʒij. or ℥ ss. every Night when I fear a Fit, and drink Toast and Water after it; this generally cures the Inflation at the Stomach, and puts of the Fit; At first it aught to be taken fourteen Nights together, but afterwards three Nights before and after the Change of the Moon, and upon Surfeits, and Changes of Wether, and ill Digestion, and when the Inflation affects the Pit of the Stomach. I will give some Remarks out of Galen, to show his Opinion, and Cure of the Asthma: He calls those asthmatic, who breath like one out of breath by running; and he observes they inspire too little, though their Breast is much dilated, because of a Straitness in their Lungs, caused by an empyematic Humour, or by an Inflammation, or by viscid Humours, or else a Tumour like an Abcess: He cures the viscous Humours by Evacuations, and the Use of attenuating and deterging Medicines; and the viscous Humours require much Drink to dilute and expectorate them: He observes that all Medicines for the Asthma, aught to attenuate without Heat, and for that purpose, Vinegar and Oxymel of Squills are useful; and since all thick Humours are made more viscid, by too much Heat, he doubts of the Use of Millepedes, which attenuate and discuss much. He observes those Medicines which cool too much; such as the Opiates, are injurious, by thickening the Humours; such are Poppy, Mandrake, Hemlock, Henbane, and Fleabane, Linseed, by their Mucilage. He commends all Astringents. He commends moistening, both in Diet and Medicine, for diluting thick Humours, and commends a thin Diet. 'Tis observable, that most of the hot Medicines he citys from Archigenes, are taken with Vinegar, or Niter, or Oxymel, or Water; of which I will give an Instance thus. Take Seeds of Rue ℥ ss. Aristolochia, Southernwood, Wormwood, Ammoniac, Sulphur, aa. ℥ ss. make Pills with Vinegar, give two with ℥ iiij. of Oxymel. He purged with Coloquintida, or Elaterium, and gave Niter or Salt in Aqua Mulsa after them. From Andromachus he had this Medicine; take Squills, Sulphur, Bitumen; ad Does. ʒss. cum Oxymilite. He mentions Eugenius, who mixed Opiates with Pectorals, for the Abfcess; the hot Pectoral, as Myrrh, Sulphur, Bitumen, Gums, are recommended. Avicen commends Niter with the Decoction of Hyssop, Oxymel with Iris and ●epper, and other Acrids, as Nettles, Leeks, Cabbage boiled in Vinegar, and puts to his Ptysans, of Hyssop, Thyme, Origanum, Niter instead of Salt; and orders the Breast to be covered with Oil, Niter, and Salt, soaked with Wool; the Chapter of the Cure of the Asthma is lost unhappily. Trallian approves of the mixing the hot Medicines with the cool, for viscous Humours in thin Bodies and Fevers, and says, that in such Cases all the Physicians used Mustard Seed, Niter, and Sulphur; but he treats not particularly of the Asthma. Aegineta vomits with Raphanus▪ and commends Niter thus; Verum in his qui suffocantur: ℞. Aphronitri ʒiij. capiat in Aqua Mulsata cyathis tribus, aliquando cum Cardiamomo, facit & ad coxendium Morbum: Or ℞. Aphronitr. ʒix. Sulph. ʒss. Piperis ʒi. dato▪ cochl. cum Aqua calida. Take Mustard Seed ʒi. Niter ʒss. Elateri●m ℈ ss. mix them and make eight Pastilli; the Dose is two; it vomits without Trouble. Oribasius commends the Vinegar of Squills, as well as all the former; he commends two Parts of Orris, with one of Niter, to rub the Breast; and mentions many bitter and acrid Medicines. Aesius perfectly transcribes all the former Authors; he says▪ in a crude Tuberculum there is neither great Weight, nor are they much asthmatic; but if it ripens, a Fever attends it, with putrid Spit afterwards. He commends Wormwood, Orris, Castor with Vinegar; he uses Coloquintida with Acetum Scylliticum, and Elaterium with Niter. Actuarius cures the Asthma as a Catarrh. Cornelius Celsus has all the hot Pectorals, but that which I like is datur utiliter aut Nitrum, aut Nasturtium. Nicolas Myrexsa has many Anticlotes for the Asthma, but his Diospoliticum, in which there is Niter, is the best. Marcellus commends Acetum Scylliticum, and prescribes Sulphur, Niter of each ʒi. Abrotan. p. 1. give two Spoonfuls, with hot Vinegar. Avicenna observed the Paroxysms of the Asthma to be like those of the Epilepsy and Convulsion, and prescribes the Medicines for a Catarrh, strong Vomits and Purgers: He uses Medicines mixed with Acids, Cummin Seeds, or Nettle Seeds, and Squills with Vinegar, and prescribes thus: Take Castor, Ammoniacum, Aristolochia rotunda, of each ʒi. mix them with the Rob of Grapes, and give the Quantity of a Bean with Oxymel. He commends Bitters, the Decoction of Centaury, or five Drams of Aristolochia rotunda every Day, in Water or Gentian constantly: He prescribes Arsnic or Sulphur, whose Fumes are acid. And Arsnic inwardly in Aqua Mellis; but all this seems hazardous, and 'tis better to use what he advises, attenuating Medicines, without any vehement Heat: He much extols Crocus, and a Decoction of Faenugreeck, with Figs and Hony. He cautions much against Baths and flatulent things; he prescribes Aphonitri ℥ ss. Seed of Nausturtion ʒij. in a Decoction of Hydromel. Avicenna de Juvamentis Syrupi acetosi, observes, that it incides, subtiliates, and opens without Heat, & hujusmodi via, est magni Juvamenti, multae Vtilitatis, & Sufficientiae in arte Medicinae: This extinguishes Fevers, and cools the Liver (that is, the Blood) and incides gross Humours, allays Thirst, in Inflammations; other acid Syrups have a Stypticity, as that of Apples, or too much Water, as the Syrup of Citrons; but the Syrup of Vinegar cools Choler, and excites Appetite, incides Phlegm, and 'tis proper for the Asthma, and the Squill Vinegar, he recommends in Epilepsies, if made into a Syrup, and than it does not injure the Nerves, but this Syrup is inconvenient in Excoriations, and the Cholic, and Pain of the Womb, and Palsies, Tremors, in which it injures the Nerves, and the Melancholic Influxes of Urine and the Spittle, and in Rheumatic Pains of the Back and Knees, and in the Cancer, and those who have a Sourness at the Stomach; it hinders Coition and Fertility, and it introduces the Dropsy in those who are not of a hot Constitution, and much Flesh. From these Observations we may learn the Benefit and Injury of all acid Medicines. Joh. Anglus Prescribes the Lungs of a Fox, two Drams, in Aqua Mellis, and says, it is Medicina Sublimis & experta in Asthmate. He recommends Ammoniacum in an Oxymel, or Nettleseeds, boiled with Figs in Barleywater: He advises the Juice of Fenil with Milk, to sucking Children: He prescribes Medicines too hot, supposing the Asthma to depend on viscid Humours, and a Catarrh. Horstius gives many Examples of the Asthma, and Cures them by Oxymel Cratonis, or Quercitan's Oxymel de Peto: He Purges the Hydropical with Pills of Hiera, with Agaricʒi. Diagr. gr. v. Oil Fenil, make Pills: He gives Balsam of Sulphur in a Diuretic Oxymel. Sennertus thinks the Asthma does not depend on a Catarrh from the Head, but the Arteries, and that what is imputed to a Flatus aught to be attributed to a rarefied fermenting Serum; and he believes Piso's Opinion, That this Disease depends on an Effervescence of the Serum. This is Crato's Oxymel▪ Take Hyssop, Veronica, Scabios. Horehound, Origanum, Penyrotal, Carduus, of each M. i Orris ʒvi. Ginger ʒiss. Agaric ℥ ss. infuse them three Days in a Glass-Vessel warm, in lb iss. of Vinegar, Speedwell and Carduus Water, of each lb ss. boil them; and to lb iss. add Honey lbss. The Dose is two or three Spoonfuls. Sennertus advises this, to show his Opinion of Acids, Take Pectoral Water ℥ vi. Syrup of whorehound ℥ iss. Spirit of Vitriol ℈ ss. mix them. Hartman commends Vomits of Aqua Benedicta, and this, Water from Bryony-roots lb ss. Spirit of Vitriol or Sulphur ℥ ss. Dose one Spoonful; and also Shall Armoniac rectified from decrepitated Salt in Wormwood Wine. Silvius imputes the Asthma to a Flatus, and partly to a Catarrh, and recommends a mixture of a volatile oily Salt, with a dulcified acid Spirit. Dr. Willis observes the Orgasmus, or Effervescence in the beginning of the Asthma Fit, and prescribes Sal Prunel in cool Juleps to check it; but I could never found any benefit by his hot Pectorals, and Antispasmodics, Tincture of Castor, of Sulphur, Spirit of Sal Armoniac, Syrup of Garlic, etc. All that I found useful in him was a Vomit, and Opiates; he takes too little notice of Niter, Oxymels, and common Sal Armoniac. The best Medicines of the Ancients, and the present Age, has too much followed his unsuccessful Practice by hot Medicines, no way suited to the Febrile Effervescence in the Asthma, which requires an Acid to abate the heat of all his Specifics. Sir Theodore Mayherne treats the Asthma as a Catarrh by too hot Pectorals Sulphur of Benjamin, Saffron, which are intolerable to the Asthmatic, if not given in cool Liquors, or with Acids. Etmuller observes, That there are more humid Asthmas, through the fault of the Stomach, than that of the Lungs, and that happens in the Hypochondriacal and Seorbutic: He recommends the following Digestives; Shall Armoniac ℈ ss. cum gr. xv. Tartar Vitriolat, Crem Tartar, and Salt of Tartar, Spirit of Salt or Niter dulcified, Arcanum Duplicatum, Elixir Proprietatis Paracel●i, Spiritus Carminativus secretus; and Prescribes thus, ℞ Hyssop-water ℥ iij. small Cinnamon-water, Oxymel S●ylliticum, Briony Compound water, of each ℥ i Come Ammoniacum dissolved in Vinegarʒii. Spir. salis ducls. For Flatulencies thus, 〈◊〉 the Carminative Seeds, and give them with Spirit of Niter▪ dulcfied, or Spirit of Niter, or Spirit of Aniseeds, and give it in a Decoction of Camomil-flowers, with Aniseeds and Caroways in Beer. He gives Spirit of Sulphur in distilled Water in the Fit, and commends the Asthmatic Spirit of Verdigrease, Sulphur, Ammoniacum, 20 or 30 drops in Briony-water. He says the Convulsion of the Diaphragme gives an Asthma without Stertor, or Cough, and he describes the Pneumonic Asthma from Mineral Fumes, Abscess, Vomica, Empyema, coagulated Blood, Serum, Cachexy, Terror, drinking cold Water when hot, crude Tuberculae, Grando Stones, Gibbosity. Helmont gives many Asthmatic Histories, and disproves the Opinion that it is from Phlegm, because it happens suddenly, and goes of without Spitting, and that the Spit is the product of the Fit, from the Injury done to the Lungs, and therefore he thinks Pectorals useless, and Medicines to the Head upon the account of Catarrhs; and confutes the Opinion, that the growing of the Lungs to the Sides is the occasion of the Asthma. Grembs is an Helmontian, and prescribes Cinnabar of Antimony; he uses Oxymels, and Syrup of Tobacco; he observes that a Cachexy or Hydrops at the beginning resembles the Asthma, and they are to be cured by Purging, and Digestives; but the Vis Crescitiva of the Viscera by Mercury. He observes some Asthmas to depend at last on a Vomica; condemns Purging in the Dropsy of the Breast, and only allows a Paracentesis. Riverius describes the Asthma as a Catarrh, and gives all the hot Pectorals; but prudently adds O! Sulphuris to his Oil of Sugar, and prescribes Spirit of Sulphur 4 or 5 drops in Broth, and prescribes his Gum Pills thus, ℞ Ammoniacum Bdellum dissolved in Vinegar of Squills, of each ℥ ss. Flowers of Sulphurʒiii. Oxymel of Squills q. s. make Pills, Dose 4. Lac Sulphuris is milder than the Flowers, and may be given in an oily Mixture: He commends the Oxymel with Agaric, and this is his best Medicine; Take Cinnanon-water ℥ two. Oxymel of Squills ℥ i take one spoonful often. I have mentioned all these Author's Practice, to show they always used the mixture of some Acid, with their Anti-Asthmatic; and I could not withstand the common Practice of hot Pectorals, and Anti-Convulsions, if I had not so much Authority as well as Success by the contrary Method I have proposed. I shall next add those Prognostics which the old Writers give, That young Men are difficultly cured; old Men, and the Hereditary Asthma is only palliated; Children are usually Suffocated by it: If a Peripneumonia hap with the Asthma, and Phrenitis, I generally observed it fatal. The Asthma usually ends in a Consumption in lean Bodies, and than Tubercula are bred in the Lungs, by the Humours frequently stopped on the Lungs, as I have observed in a Dissection of a Consumptive Asthmatic, for whom I am certain no hot Pectorals can be convenient. It seems to me much more convenient to keep the Tubercula from Imposthumating by Acids, and by a cool Regimen, than to endeavour to cure them by a hot one. The Polypus in the Heart often kills Asthmatics suddenly, and the Asthma frequently ends in Abscesses, tumors, Vomicas, Ulcers, Spitting of Blood. The Liver is stopped, and the Asthmatic are subject to the Jaundice, both in the spitting and dry Asthma. The Dropsy or Tympany succeeds the Asthma, either from too serous Constitutions, or the Rupture of the Lymphatics, by the Tumours of the Viscera, which compress them or the Constriction of the Blood Vessels. As to the Head, the Asthma very much affects that, with Pain, Fullness, Vertigo, Lethargy, Apoplexy, or Palsy. Dr. Willis gives a History of a Convulsive Asthma, after a Vertigo, Pain of the Head, with a fear of Swooning, which after a few Days became a Lethargy, and this settled into a Paroxysm of the Asthma; and this he cured by Vomiting with Sulphurs' of Antimony, Cream of Tartar, of each gr. vi. taken in the Pap of an Apple, and Purging with Resin Jalap gr. v. Merc. Dulcis gr. xii. Castor gr. iv. Ammoniac. solut. q. s. f. Pil. I remember an old Asthmatic, who was troubled with difficulty of swallowing, upon which his Asthma left him; he seemed to me to have some Tumour, or Palsy in the Oesophagus, but no Methods would relieve it; but since that he has continued seven or eight Years without the Asthma, who formerly had the Fits periodically for fourteen Years, and they were ocasioned, as he tells me, by drinking Small Beer: The Powder of Juniper-berries most relieves the Difficulty of his Swallowing. I have observed many Asthmatics, to have the Stone and Gravel, and to die of it, with a stoppage of Water. A Patient, who had a Convulsive Cough from his Father, was seized with the Asthma, and a sort of Diabetes, with frequent returns of an Intermitting Fever, with Lethargic Symptoms; he spit much, and had sharpness of Urine, and frequent Stools; but the Decoction of the Cortex, Vomiting, and Steel-waters cured him for a Twelve Month, when he relapsed into the same Symptoms: His Legs swelled, the Asthma returned by Fits; he was obscurely Feverish, and died full of Flesh. All these Symptoms depended on an Intermitting Fever originally. I have observed divers Asthmatics with Rheumatic Pains, and Looseness at last, and others consume by a Diabetes, and a great quantity of Water is made out of the Fits, as well as in them; and when this flux of Water stops, the Asthmatic become Hydropic, their Legs swell, and their Breasts are filled with Water. I shall add some particular Cases of Asthmas, communicated to me by my Ingenious Friend Dr. Fred. Slare. Mr. Orlibar of the Temple▪ having been some Years Asthmatic, died suddenly; in his Body opened, the Lungs were free from any Imposthumation, or other Cause of his Death; but the Ventricles of the Bram were full of Water, and on that depended his Drowsiness, 〈◊〉, and a constant Asthma upon motion long before his Death. Capt. Brent had the Asthma with swollen Legs, and could not he down in his Bed▪ he died suddenly, by stooping to take up an Orange; his Breast and Head were full of Water. He gave me also a farther account of a Child very Rickety with a swollen Head, who was for some Months Asthmatic, without any Injury appearing in the Lungs, by Dissection, but the Head was full of Water. Dr. Slare gave me a particular account o● Sir Patient Ward's Asthma, with an Haemoptoe, which lasted about a Year: He often hawked up Blood mixed with tough Phlegm; the Cortex did him no Service, after he became Hydropical, the Legs and Belly swelled; two spoonfuls of the Acetum Scylliticum vomited him, and made him to make much Water; than Steel and Diuretics relieved him for some time; and Laudanum helped his Dyspnea always. When he was opened, 4 or 5 Quarts of Water was found in his Belly, and two in his Breast, his Lungs were without Schirrous Matter, or Tubercula; the Lungs stuck to the Right Side: He believes this Asthma to have been Nervous, and the Dropsy to have happened at last: He observed the Left Kidney full of Water, and Hydatides encompass it without, from whose Rupture the Dropsy might come; the Cartilages of the Sternum were grown Osseous, the Gall in the Bladder was thick and muddy; there appeared not Vestigia of the Haemoptoe mentioned, upon his Lungs. The Inundation of the Brain, Breast, Abdomen, by an Hydropical Serum, is commonly the effect of an old Asthma, and the Anasarcous Tumours of the Body, depend all on the frequent Constriction of the circulating Vessels, by the Asthma Fits, by which they are weakened, obstructed, and broken, and the digestion of Humours decays; as the Circulation is depressed, a thin Serosity also gives matter to all the sorts of Dropsy, into which the Asthmatic fall, through too much Bleeding, or Haemorrhages, as it might be in the Case described. I shall next give a remarkable Case, communicated to me by the Ingenious and Learned Dr. Tyson, by which my Hypothesis will be plainly demonstrated, that the Asthma Fit may depend on the contraction of the Vesiculae, and Bronchia of the Lungs; and how far that may depend on the straining the Lungs by swift running, or the Causes the Dr. mentions I must leave the Reader to judge. A Case of an Asthma communicated by Dr. Tyson. When I was a Student formerly at Oxon, hearing of a Spanel Dog, that had been noted for his swiftness in Running; but of late, and on a sudden, had fallen into so great a shortness of Breath, that he could not run 15 or 20 Yards, but was forced to stand still and pant for a good while after, would breathe very short and quick, and with a great deal of Labour. I had a Curiosity of seeing him, and upon my own Observation found what was told me, to be exactly true. The Person that kept the Dog could give me no account how this happened to him▪ but being hereby▪ rendered altogether useless, for a small matter● I purchased the Dog, having a mind to see what occasioned this shortness of Breath upon so little motion. Upon Dissection in the Abdomen, there was nothing unusual or uncommon to be observed: But upon opening the Thora●, I found the Lungs to be very much pu●●'d up, or contracted, so that they did seem to fill but half that space which the Lungs of an other Dog of that size would occupy: However I did not found the Lungs in any other respect out of Order; there was no Discolouration, no Adhesion to the Pleura; and within no Tubercule or Glands, but the Substance of the Lungs, soft and spongy as usually. Upon blowing into the Windpipe the Lungs would be inflated somewhat, but not half so much as in an other Dog. And what hindered this Inflation ●arther, I could plainly perceive was the Contraction of the outward or common Membrane of the Lungs, which did seem upon this Contraction to be somewhat Incrassated, and its Colour a little Whiter. In the Cavity of the Thorax, I observed a small quantity of Water, and sometimes did suspect whether this Water (if of a Corrosive Nature) might not contribute to the Contraction of the Membrane. But this I did not think of, till▪ 'twas too late to make trial of the Nature of this Extravased Serum; it being fling away; nor upon the whole do I think it might be the cause of it. But here I rather suspect the Dog might have lighted upon some sort of Poison which might particularly affect that Membrane, and 'cause the Contraction. I will not trouble you with at present the Reasons I have for such a Conjecture; or if it was not from an outward Poison taken inward, it might otherwise hap from an Internal Cause. However this Observation plainly shows us the Reason why upon Motion this Dog proved Asthmatical, nor could he continued his Motion but for so short a Time; since by means of the Contraction of the outward Membrane, the Lungs could receive by Inspiration, not half the Quantity of Air at a time, as it could before or usually was want to do. I shall give some Observations which were Communicated to me by my worthy Friend Dr. Pierce of Bath, about four Years since, by which he assures me of the great benefit of the Bath-Water; which he tried on many Asthmatics both in the nervous and humorous Asthma, in which the Bath-Waters dilute the Viscidity of the Phlegm, and deterges it by helping its Expectoration. He first mentions the Benefit the Old Duchess of Ormond received, by drinking Bath-Waters, when she was sixty Years Old, which recovered her Appetite, helped her Expectoration so well, that she could lie down in her Bed, and walk about her Room before she went away; and on this good Success was encouraged to visit the Bath, and drink the Waters there some Years after. The second Case he gives me, is of one Mr. Coming, who came both Asthmatical, and Scorbutical, and Hydropical to Bath, where he drank the Waters, which passed well after Purging, Vomiting, and the use of Aqua Asthmatica Quercitani, and Aqua Raphani Composita; he recovered his Breath and Appetite, and bathed frequently▪ By all which, in two months' time, he perfectly recovered to a Miracle. The third Case is of the Lady Mary Kirke, who often drank the Bath-Waters for an Orthopnaea, with great Advantage; for thereby her Fits did Intermit▪ many Months. She bathed by the Lady Elizabeth Littleton's Persuasion, who says, she was cured of her Asthma chief by Bathing. The fourth Case is of Sir Edward Villers, who upon the Healing of an Ulcer in the Leg, was Asthmatic, for which he drank the Waters, and his Fits came not so often, and the Pain of the Ulcer was relieved by bathing the Leg. The fifth Case is of a Lady of Thirty or Forty, Hydropical and Asthmatic, who both drank the Waters and bathed for the Asthma. The sixth Case is of Mistress Whittacre, who had a great Cough and Palpitation of the Heart, with shortness of Breath, and she was always hot and feverish: She recovered by drinking Bath-Waters. The seventh Case is of Sir Robert Craven, who was Asthmatic, and in his fat Body the Thymus was observed to be enlarged to a great bulk, which upon any great commotion by Laughing, Talking earnestly, gave him severe Asthmatic Fits, with blackness in the Face. This Case shows us how readily the Asthma is produced by any external Compression of the Lungs, and these Fits did immediately go of again, on the alteration of the Pressure of this Glandulous Tumour. He died not of this Asthma, but of a Fever. The former Cases teach us to use the Bath-Waters for the viscid Humours of the Asthmatic; and two of the Cases show the benefit the Hydropical and Asthmatical have by drinking the Waters, and bathing, which is an extreme difficult Case to Cure; but these Cases being Matter of Fact, aught to be admitted; and I acknowledge myself obliged to Dr. Pierce for this Information he has given me in the particular Cases described. Botrys is a Lamium in Taste and Virtue, and like Ground-Ivy; I use it in Syrup, Decoction, or Thea, 'tis useful for Coughs. The Lungs must be cleansed in the Periodic Asthma after every Fit, and the obstructed Glands' opened by Pectorals in the Pulmonic Asthma. 1. By Bitters of the Deadnettle Class, Gill Beer, Gill Thea, sweetened with its own Syrup, or Powder of Motherwort mixed with Oxymel Scylliticum, Syrup of Horehound with Milk-water. 2. By the smoky Bitters, as the Thistle bitters, Syrup of Carduus, Seabiose mixed with Oxymel Scylliticum, and Oil of Sweet Almonds, or else some Pectoral Drink. 3. By the bitter Gums; I have used these, Myrrh, Olibanum, Castor, Nutmegs, of each ʒi. Syrup of Violets, and Oxymel Scylliticum, of each ℥ i make a Linctus. Take Pennyroial Water, Rhenish Wine, of each lb i. Ammoniac ℥ i dissolve them, add Syrup of Vinegar ℥ iv. or Tincture of Gum Ammoniac 20 drops in any Oxymel, Elixir Proprietatis Paracelsi ℈ i in small Beer every Morning. The Ancients mixed Honey, Turpentine, Galbanum, in an Electuary Hiera cum Colo●ynthid●. 4. Terebinthinate Bitters; Tar Pills, or Pills of Wood-Lice, Salt of Amber, Sal Prunel with Nutmegs and Turpentine. Balsam of Sulphur, or Gilead Balsam in an Oxymel, with Pectorals; Syrup of Enula Campana ℥ iv. Oil of Sulphur ʒi. mix for an E●legma. Agarl● which grows on Turpentine-tree, in an Oxymel. The Kernels of Pine in an Emulsion, with Almonds. Hiera cum Agarico. Savin powdered ʒi. Butter ℥ ss. Honey ℥ two. mix them; used for three days, and repeat it again after three days. Frankincense and Sugar Candy, in a roasted Apple: Or, The Roots of Valerian, Butterbur, boiled with Liquorish, Raisins, Aniseeds, or in an Oxymel. 5. The sweet smoky Bitters, as Bellis Major, in Decoction, or Syrup, or Thea. Coltsfoot Syrup, or Eyrngo●roots, Centaury the greater, and Erigerum. 6. By the sweet acrid Aromaticks; Seeds of Parsley, Anise, Cinnamon, Dill, Parsnep, Roots of Parsnep, Smirwine, Panax, Pimpinella, Saxifrago, Peucedamum, decocted Diacymenum, with Oil of Aniseeds in Tablets, Diaspoliticum ℥ i mixed with two or three parts of Honey. 7. Nauseous Bitters of the Lyrbanis Class, Gentian, Centaury, Trifol. Fibrinum, Saponaria, the bitter Decoction without Se●a for a Month▪ Th●r●aca, Diatesseron, cum opio, vel sine ill●. 8. Fetid Bitters nauseous and purgative; Aristolochia ʒi. with Honey, Juice of Briony, with Honey, Syrup of Tobacco, distilled Water of Tobacco with Syrup of Violets, Juice of Squills, with Honey, equal parts, boiled▪ the Dose is ℥ ss. before or after Meat. Take Vinegar, Honey, of each ℥ iv. Fountain-Water lb i. Rhue one handful, Cinnamon, Cloves, of each half a dram, boil them, and make an Oxymel; the Dose is one spoonful with a draught of Water. One Pound of Squills is used to be infused in lb xii. of Vinegar. Hypocrates is said to be Author of this Medicine. Galen prescribes it in a Morning, and the walking after it seven Stadia; but I found 'tis better to use it at Night▪ because it Vomits in the Morning; and I have found it necessary to add Aromatics to it▪ or strong Waters, or Sugar to make it a Syrup, or mix it with Syrup. 9 Caustic Acrids▪ Powder of Aron with Oxymel, or else let ℥ i be boiled in lb ii. of Oxymel. The Root of Dragon is of the same Virtue. This is Archig●nes's Medicine; The crude Juice of Squills, boil it with equal parts of Honey▪ the Dose is one or two spoonfuls before or after Mea●. Add ℥ ss. of Nettleseeds to a Pectoral Drink of lb ii. 〈◊〉 Aq●● Cinnam. Syr. Vol. 〈◊〉 Scyll●●●●a. a. ℥ ●. Preserved Garlic and its Syrup is commended, Lee● Pottage, Onions boiled and buttered, or roasted, and Honey mixed with them and Butter; 〈◊〉 boiled and dissolved in a Decoction of Enula condited ℥ i Tol. lb ii. add Syrup of Vinegar ℥ iii I was informed by a Lady, that Garlic applied to the Feet, cured her of the Fit of the Asthma; and I knew one who took an Infusion of Garlic in Cephalic Waters, with her Steel Medicines. Infuse one Head of Garlic in 12 Ounces of Cephalic Waters, Rosemary-Lilly, and Black-Cherry, a. a. ℥ iv. strain it. 10. Crest Acrids; Syrup of Erysimum, Mustard Seed with Honey, Juice of Horse Radish Roots, with Sugercandy, Decoction 〈◊〉, an Oxymel with Rue 〈…〉. of Rue in six Gallons of small 〈…〉 unpleasant, but a great Diuretic. Sal 〈…〉. Rocke● Seed with Honey ℥ iv. or the Powders in Mulsum. 11. Moss Acrids; used as Syrup, or boil it in Drink, and 〈◊〉 or one Handful boiled in lb ii. of Posset Drink with Figs and Liquorice. 12. Leguminous Acride; Seeds of Woodbine Berries, drank with Wine for forty Days, or the Conserve of the Flower▪ these are great Diuretics, as most Pectorals are: In Thoracis Morbis 〈◊〉 advenae respiciendum. 13. Laurel Acrids; Bay Berries with Honey, Decoction of Guaicum, or Misletoe with Pectorals, or sweetened with Hony. 14. Aromatic Acrids; Thyme, acacias, Hyssop, Decoction of Calaminth with Figs, Flowers of Rosemary boiled in Water with Hony, Pennyroyal, or Mint boiled in Oxymels, Decoction of China with Cephalies, and a Co●k. 15. Burning Aromatics; Orris Tincture in Aniseed Water, or the Roots decocted in an Oxymel, Species Dia●reon made into Ro●al●●, with Oil of sweet Aniseed and Sal Prunell▪ or else the Roots infused in small Ale, or candied. 16. All burghers and Vomitories are pectoral, as Briony, Tobacco, Squills, Agaric, Aloes: Take Syrup of Tobacco, Horehound, Oxymel Scilliticum▪ Aqua Brion. ad ℥ i. Misce Does. Cochi. 17. Hony, which is a sweet Gum of Plants, Sugar, and Mead, and all Oxymels with Orris, Ennula, Liquorice, Leaves of Scabius, Coltsfoot, Horehound, Figs, Dates, Hyssop in Barley Water with Hony. 18. Foetid Parts of Animals; the Lungs of a Fox, in the Decoction of a Cock, take ʒvi. with ʒss. of Oxymel. Infusion of Millepedes ℥ i in lb ii. of the Decoction of Woods. Fox Lungs powdered with Hony or Oxymel. Take Castorʒii. Gum Ammoniacum dissolved in Vinegar of Squills ℥ ss. make Pills: Aniseed and Sulphur may be added ad ʒii. I have prescribed thus: ℞. Castorei, Salis Succini aa. ʒii. Flores Benzo: Croci aa. ℈ i Ammoniac Acet. Solut. Grains v. Succi Licoritiae, ●●ant Pil. 19 Salts, Sp. Cervi Fuliginis, Cranii, add ℥ ss. of Spiritus Lavendulae to ℥ i of the volatile Spirit, the Dose is thirty Drops in pectoral Waters; these are fittest in Faintings. ℞. millipeds calcined to a Whiteness, mix them with Honey, the Dose is two Spoonfuls before and after Meat. 20. Sulphureous Medicines, as the Balsams and Tinctures of Sulphur and Antimony, Flowers of Sulphur ℈ i with Butter. I never found any Benefit by Sulphur Medicines in the Asthma. 21. Sneezing Powders help Expectoration, but Vomitories most. 22. Lubricating Mucilages and Oils, help up the Phlegm, as Hydromels' and Oxymels', and pectoral Decoctions, Oils, and Sugar: Sapo-Venetus, Sperma Cetiʒi. mixed with Oil of Almonds, and Syrup of Balsi, and Lucutellus Balsam, Butter and Hony mixed, or Honey boiled in Beer. I have mentioned all these Pectorals, that those may be chosen which are not too hot, but suitable to each Constitution, Av●●enna gives us this Direction from the Tastes of Medicines; Acutum est aliud, deinde▪ amarum, deinde salsum, quoniam acutum est fortius ad resolvendum, abstergendum, & incidendum quam amarum, deinde salsum; ponticum est frigidius, deinde stypticum, postea acetosum, quamvis vero acetosum sit nimis frigidum, tamen majoris infrigidationis, propter Penetrationem. The old Opinion was, that in turning Wine into Vinegar, the fiery and aerial Parts were evaporated by the Ferment, or the Heat of the Sun, as John Anglus describes it. I shall next give some Remarks on some Errors in Authors. 1. All very violent Purges and Vomits, used by them, commonly disagree with the Asthmatic, and give Fits. 2. Strong Expectorators, and all hot Medicines are injurious in the Beginning of Fits, as Balsams, Tinctures, Spirits, and strong Cordials, Wine, Brandy, Spirits, chemical Oils, and Gums. 3. Eating any solid thing the first Days of the Fit is dangerous. 4. All Fumes of Tobacco, Amber, or Arsenic, are suffocating. 5. All Ointments to the Breast heat it, and offend by their Smells, as Oil of Amber, and the Axungias, the rubbing of the Breast rarefies the Spirits too much: Fomentations to the Breast are likewise mischievous, and Plasters hinder Respiration. 6. All Motion makes the Fit worse; Fire, a close Room, all actually hot Diet, is intolerable. 7. Not Medicines for the Asthma must be infused in Wine or Brandy; no chemical Oils are useful. 8. Errhines, Apophegmatisms, quilted Caps, are Mistakes, and S●ernutories dangerous in the Fit; the burning an Issue on the coronal Sutures▪ Breast, signify nothing▪ Cupping-glasses, and Lotions of the Feet are mischievous; no Benefit is to be expected from Issues. 9 Frequent bleeding brings a Dropsy; bleed only twice in a Year, or upon extraordinary Fits. 10. Much Water drinking is in●urious to the old, and pure unmixed Acids▪ great Astringents stop the Breath; the mucilaginous Gums breed Phlegm, all very ho● Aromatics, and odorate things inflame too much. The Cure of the hysteric Asthma in the Fit is the same as that of the spitting Asthma, because there is the same Windiness in the Stomach, the same Effervescence of Humours, and Rarefaction of Spirits, as in the other Asthma; no hot hysteric Medicine is useful in the Fit, as volatile Spirits, or Gums, or Castor, but only Laudanum twelve Drops, or more in a mild hysteric Draught, the first and second Night if necessary, after a Glister or Vomit. For the preventing this Species of Asthma from its Returns, we must▪ 1. Use the same Vomits and Purgers which are recommended in the other Species of Asthmas: Purging Salt is most agreeable; and let the Vomits be with Carduus Water and Squills once a Month, and the Purge once in fourteen Days, till the Fits remit, and Laudanum after them. 2. The same Digestives are convenient, because there is the same flatulent and slimy Cacochymia in all Species, but in the hysteric Asthma, because it arose from those Fits; hysterical Medicines may be mixed with Digestives. 3. The Febrifuges must here be used against the Effervescencies, and Fever Fits, to prevent their Returns, as a Decoction of the Cortex; give two Ounces with an hysteric Julap, and repeat it till four Ounces are taken, or else two Ounces in an Electuary, and this aught to be repeated upon the Turns of the Year; this Medicine I have found most effectual in the hysteric Asthma, much more than in the spitting Asthma, for which reason I guests that the periodic hysteric Fits depended originally on a latent Fever, but in time they introduce a slimy flatulent Cacochymia, which requires due Evacuations and Digestives, and than the Repetition of the Cortex with mild Antihysterics. 4. After the general Methods proposed, some Antihysterics may be used, such as the Aromatic, or foetid Cephalics, to rectify the flatulent Spirits, and they must be suited both to the Constitution of the Patient, and the Nature of the Asthma, which will not admit of any inciding hot Medicines, without some Acid to abate them. Some Asthmatics have commended Spirit of Lavender, but I always observed it very injurious to me in my Fits, and it increases the Straitness, because of the Perfume: Pennyroyal, Sage, Clary, Rue, may be boiled in Oxymels; and I observe that the old Writers prescribe ʒss. of Castor in an Oxymel, or else in their Posca. Zedoary may be decocted in Oxymels, and its Powder given in Pills: I found these Prescriptions in Zecchius: Sal Armoniac ℈ i Musk two Grains, Crocus Grains three in Oxymel Scylliticum, make Pills. The Volatility of the Flowers of Benjamin, and their smoky Smell, is injurious to some Persons, and for that Reason Bartolet prepares them best by a Balneum and Distillation. Take Ammoniac dissolved by Vinegar, Juice of Licorice aa. ʒij. Flowers of Benjamin ʒss. Crocus ℈ i Mosch ℈ ss. with Oxymel, make Pills. In Extremities Crocus ℈ ss. Musch Grain one; take it in Oxymel. Salt of Amber, Sal Prunell. Crabs-Eyes, aa. ʒij. or Oil of Amber in Lozenges with Salt Prunell. and Cream of Tartar. This was used anciently, Castorʒi. Ammoniacum dissolved in Vinegar ʒij. make Pills; for two Doses ʒi. of Saffron may be infused in lb ij. of any Liquor; but the Saffron must be roasted in a Limon: I must confess I never found Benefit by Saffron. Seven Grains of Cinnabar of Antimony is commended by Grembs, to be taken for a Month in a Spoonful of Briony Water. I have been very much inclined to believe that those Acids which relieve Epileptic Fits, which are from a higher Degree of Flatulency in the Spirits, would relieve the hysteric Asthma, and I propose them to the Reader's Consideration. The volatile Spirit of Vitriol ten or twenty Drops, the phlegmatic Spirit ten Drops, or the Oil dulcified, or the common four Drops in an hysteric Julap. Spirit of Vitriol distilled with Urine according to Hartman, Clyssus Vitrioli. Spirit of Gum Ammoniacum, Sulphur, and Aes Viride in E●muller, which mix in equal Parts with Spirits of Aniseed. Spirit of Sculls, mixed with Spirit of Vitriol. Spiritus Vitrioli Philosophicus, Julapium Camphoratum with Sal Prunell. Spiritus Veneris, Guttae 6. ad 12. Take Sal Prunell. ʒiij. volatile Salt of Hartshorn or Vipers, or Flowers of Sal Armoniacʒi. Dose ℈ i add ʒss. Mixtura simplex ℈ i. ad ʒi. in Milk Water and Briony compound. Take Peony Water ℥ ij. Spirit of Blackberries ℥ i volatile Spirit of Hungarian Vitriol. Rue Water, Bryony Water, Vinegar of Rue or Squills, Syrup of Peony, of each one Ounce. Sweet Allom Water, Apoplectic Water, of each ℥ ij. add Phlegm of Vitriol. For an Opiate, torrified Opium ʒi. Bryony Water ℥ vi. Spirit of Vitriol ʒi. digest Nitrum Saturnisatum in Bates, or Spiritus Saturni ex Saccharo: The acid Spirit of Sal Armoniac. Spiritus Nitri dulcis ℈ i. ad ʒi. No Steel seems to agreed with the hysteric Asthma, but the Extractum Ecphracticum cum Aloe, or Steel Waters in young Asthmatics, because it stops in the Stomach, straitens the Breath, and raises an Effervescence in the Humours: The Roots and Seeds of Peony aught to be tried in Powders or Decoctions, continuing it for some Months. Not foetid Fumes of Amber, or Assafoetida can be proper in the hysteric Asthma, therefore all Fumes must be avoided; but the Smell of Vinegar is more agreeable if mixed with Rue, or without it. AN APPENDIX, Containing some Observations omitted, and one about Weighing of an Asthmatic after Sanctorius' Manner; with an Account of the Weight before, and in, and after the Fits. SOME Mornings the Asthmatic (who was betwixt 40 and 50 Years old) upon weighing fasting was 179, others 178, and 180, and 181. But the Day before the Fits in the Morning, May 2d. 1698, he was 180 Pound (including the weight of the Chair 33 Pound, and the clothes.) May 3d. the Morning weight was 178 Pound, after having passed by Urine a Pound and half, by Stool half a Pound. The Wether was very cold, and Wind N. E. and it Snowed in the Afternoon; the Asthmatic drank Ale, which with the change of Wether, gave a short Fit with very little Spit. The Observations I shall make are, 1. The Defluxion of Serum is very evident by the quantity of Urine unusual, and some Spit more than usual, and the Stools lose. 2. The change of the Air to Snow made the Air lighter, which lesle compressing the Blood disposed it to the Asthma Fit with the drinking of Ale, which occasioned an Effervescence. 3. The great coldness of the N. E. Wind affected the sense of the Skin, and that by its shivering Contraction compressed the Circulation of the rarefied Humours inwardly, and occasioned the flux of Serum by Urine and Stool. 4. There was no unusual weight observed in the Asthmatic the day before the Fit, therefore the Matter of the Asthma is not any great quantity of Serum, since it cannot be observed by weighing; but the cause of it must be an Effervescence of Humours, which are flatulent and serous. The Asthmatic took a spoonful of this Acid Syrup in lb ss. of Water, and repeated it three times before Dinner time: Take Vinegar lb ss. Aron Roots ℥ two. infuse them three Days, strain them, and add Sugar lb ss. make a Syrup. Orris, Enula Campane, or Horse Radish, or Fenil Roots may be infused in the same manner, or any Carminative Seed ℥ i in lb i. of Vinegar to make the like Syrup. These cool things, Toast and Water, with an acid Syrup abate the Windiness, and compress the rarefied Serum; for the Humours are rarefied by Heat into Bubbles, which we call Wind. We found in Vinegar a cool Taste from its acid, fit for the cooling of bilious or o●ly Humours; the Acrimony in it makes it biting, and, as the Ancients say, fit for Obstructions, from viscid Humours, where there is a Fever too because it cools and opens both. The Water drank in the Morning run of by Urinal before Dinner. The Diet of the Asthmatic on the Fit day was at Dinner two Eggs, Toast and Butter, Small Beer and Water after Dinner two Pound and a half in weight, the weight of Supper one Pound and quarter, Diet in all, three Pound three quarters. The weight lost on the Day of the Asthma, three Pound three quarters; by Urine, three Pound; Insensibly three quarters. By this 'tis evident, the Insensible is the fourth part of the whole weight lost on the day of the Fit; and it appears to me, that usually the Insensible Perspiration in April last, when it was cold Wether, amounted to but a third or fourth part of the weight lost. The day following the Asthmatic was the same weight as on the Morning of the Asthma 178, which is lighter than usually. May 6. the former Fit being only suppressed, the next change of Wether on this day towards Rain, the Wind West, and the Wether warm, raised a new Effervescence and gave a new Fit, rather worse than the former. May 4th the weight was 178. 5th the weight was 178 three quarters, the weight not considerably increased before the Fit. 6th in the Morning, lost than by a Stool and Water lb iiss. The weight was in this Morning 178 Pound, after the Evacuation mentioned. The whole weight lost the day before the Fits was thus; Breakfast lb i. 3 quarters. Lost before Dinner by Urine and Stool lb i. 3 qu. Dinner lb iiss. Lost before Supper by Urine lb i. By Perspiration lb ss. Supper lb i. 1 qu. Lost in the Night and next Morning, By Urine and Stool lb iiss. By Perspiration lb ss. Add the weight to the Diet which was lb vss. The Morning weight May 5th, 178 lb. 3 qu. both 184, 1 qu. Lost sensibly by Urine and Stool lb v. 1 qu. Insensibly lb i. Lost in all lb vi. 1 qu. The weight next day after the Asthma, by which we perceive the loss of weight in the Fit, 177 Pound, which is the lest weight, lesser than usually. Note, The Perspiration was the sixth part the day before the Fit. Therefore the sensible Evacuations are five times as much as the Perspiration the day before the Fit. I weighed a Boy of Fourteen, the weight lost in one day, May 2. was two Pound 3 qu. Diet in all lb ii. 3q. By Urine lb iss. By Stool 〈◊〉 3 qu. By Perspiration lb ss. which is about the 4th part of the sensible Evacutions, and of the whole weight lost the fifth. If we consider the different weight of our Air, and the grossness of our Diet, in respect of the Italian Air and Diet, we may well suppose a difference in England, where the sensible Evacuations are three or four times as much as the Insensible: But, by Sanctorius, in Italy the sensible Evacuations are exceeded by the insensible, and they amount to five Pound, if any one eats eight Pound every day; but much the contrary happens here, the sensible commonly exceed the insensible three or four times. The following Purge was communicated to me by a Spitting Periodic Asthmatic, by which he usually cured his Fits, and he takes it any time of the Night the Fits hap. Take Sal Prunel gr. x. Tartar Vitriolategr. vi. Diagryd gr. iv. Lenitive Electuaryʒii. make a Bolus. An Ingenious Physician in London, whose Name I have forgot, informed me that he gave ℈ i of Merc. Dulcis in a Fit, which by giving two or three lose Stools, i● soon relieved. If any Lenitive Purge may be admitted in a Fit, non● so convenient as Purging Salt ℥ ss. or ʒvi. and Laudanum at Night after. This following bitter Acid never fails to give a Stool next Day, if two Drams or half an Ounce be taken at Night with Toast and Water a draught. Take Squills dried ℥ two. one Orange Pill, steep them in Vinegar lb i. for a Week, and strain it out. It aught to be Sunned fourteen Days. Strong Purges I have observed both in the Fit and out of it, to be injurious to the thin Hysterical and Hypochondriacal Asthmatics. June the 4th, I Dissected a Broken Wound Mare, who was exceedingly troubled with that Disease, and sold for the Dog's Meat, being much Emaciated: I found all the Viscera in the Belly very sound, the Liver had very little of any Schirrosities dispirsed in it, the Spleen had none; there was no Water in the Belly nor Breast; the Diaphragme had no Injury, but was pressed by the Guts much up towards the Thorax: And the prove Posture of Horses makes the Guts more subject to press on the Diaphrag me, than it happens in Men, whose Belly hangs below the Diaphragme, and this occasions the Breathing very short in Horses, as soon as they have been Watered, or full ●ed. In the Thorax the Lungs appeared very much swelled or puffed up, and appea●'d much bigger in the Broken Wound than usual▪ the Outside of the Lungs seemed like Tubercula, but upon pressing I found those only Bladders very much distended with Air, as I found by cutting them. I blew up some Lobes of the Lungs, and found the Air would no● come out again, nor the Lungs subside of themselves; by which it was plain, that the Bladders of the Lungs had been extended or broken by some Strain in Running, and that the Air remaining either in the over-distended Bladders, or else passing through some Breach of them, betwixt the Fibrous Substance of the Lungs; that caused a continual Inflation of the whole Lungs, which compressing the Bronchia and Blood-Vessels, produces a continual Dyspnaea, in which the external Air cannot pass freely through the Trachea and its Branches in Inspiration or Expiration; and this difficulty occasions the great Labour and Nisus of the Respiratory Muscles. There was no Polypus in the Heart, or the Blood Vessels of the Lungs; no Adhesion of the Lungs to the Sides, nor any signs of any quantity of Phlegm in the Trachea and Bronchia, nor no Decay, Tumour, or Corruption or Obstruction in any Part of them, only the Bladders seemed to make the Superficies of the Skin of the Lungs unequal, and the whole spongy Substance of the Lungs seemed swelled with Wind; for no quantity of Humour appeared any where. This Mare had not been Broken Wound above one Year. By this Observation it appears, that the Broken Wind depends on an Injury done to the Membranes, rather than to the Humours of the Body. FINIS. POSTSCRIPT. Some Reflections on the Dissection of the Broken Wound Mare. THere are two sorts of windy Tumours in the external Membranes of the Body; the one from the admission of the external Air amongst the Membranes, as appears in a Wound of the Thorax, in which the Membranes are inflated if the Orifice be small: And another windy Tumour happens to the Membranes of the Knees, Feet, Hands, Eyes, Belly, by a rarified Serum filling the Canals of the Nervous Fibers, and this is properly a Nervous Inflation: For if this Tumour be opened, no Humour appears to come forth. I desire to apply this Distinction of flatulent Tumours, to the Inflations which produce the flatulent Asthma, and I shall reckon two Species of these Inflations; the first is, the Broken Wind, from the Rupture or Dilatation of the Bladders of the Lungs, by which the Air is too much retained in the Bladders, or their Interstices, and thereby produces a permanent flatulent Tumour in the whole Substance of the Lungs. 'Tis not easy to explain the Production of a permanent flatulent Tumour in the Lungs, by a Strain in Running; but by supposing the Bladders of the Trachea too much distended, and the muscular Fibers which constringe them in Expiration thereby overstretched, and made unfit to express the Air afterwards: So that these Bladders retaining more Air than is usual, the Substance of the Lungs must appear always Inflated. I could not found any other Disorder, but this flatulent Tumour of the Lungs, in this Mare I Dissected, therefore I shall impute all the Symptoms to this only Cause, though I have with the Vulgar conjectured, that the Disease depended on Polypous Concretions of Blood, or Tubercula, which are observed in some Horses; they are only the effects of a long Broken Windedness, by its long continuance. This windy Tumour, by compressing the Trachea, hinders the admission of the Air, and makes a laborious Respiration: The same Tumour hinders the Efflation of Air, which occasions the Muscles of the Belly to strain much, as appears by their Working in the Flank. The return of the Blood to the Heart▪ and the descent of the Chyle into the Guts, and its depuration, secretion, and distribution, do naturally depend on the Motion of the Diaphragme and Breast, and that being hindered, the Horse is languid, and fainty, for want of a free Circulation, which is also stopped on the Lungs, by the flatulent Tumour of them, and that much increases the Tumour and Angustia, Fullness and Straitness in the Breast. The Parts are Emaciated for want of a full Circulation of Humours into them; neither can the Chyle be well prepared or assimulated to the Blood, where the Circulation is weak and stopped; 'Tis only digested into a slimy Nutriment, which is the Matter of the slimy Phlegm, both in the Stomach and Lungs. A Windiness is always observed in the Belly of the broken Wound Horses, for want of a quick Distribution, or a thorough Preparation, or Fermentation of the Aliments, for which the slimy Ferment of the Stomach seems unfit. These Horses Wheeze much after filling their Stomaches, by Water, or Food, because that keeps up the Diaphragme, and that by reason of their prove Posture of Body presses much upon the Lungs, which by their Tumour take up too much room in the Breast. The other flatulent Tumour of the Lungs depending on a rarefied Serum in the Nerves and Fibers of the Membranes, is sufficiently described in this Treatise, as to its frequent Paroxysms and Causes. As it happens in external flatulent Tumours, they at first go of and return, but at last fix in permanent flatulent Tumours; so it is in the flatulent Asthma, the frequent nervous Inflations induce at last a constant windy Tumour, or Inflation; and it aught to be considered how far the holding the Breath in Hysteric Fits, or the violent Coughing in long Catarrhs, or the great Distension of the Lungs, by an Inflammation in the Peripneumonia, may strain the Bladders, and their Muscular Fibers, and thereby produce the same Rupture, or Dilatation, or Hernia, as happens in the broken Wound. This must be observed by the help of the Microscope; and if the Air blown into any Lobe will not be expelled thence, by the natural Tone or Muscle of the Bladders, that the Lobe may again subside of itself, 'tis certain, some Injury is done to the Ventiducts; the Bladders are either broken, and admit the Air into the Membranous Interstices, or else they are over-distended, like a Hernia in the Peritoneum; and this will produce an Inflation of the whole Substance of the Lungs, and that a continual compression of the Air and Blood-Vessels, which will produce a constant Asthma; But where the Fits are Periodic, 'tis certain there is no permanent inflated Tumour, but that depends on a flux of windy Serum into the Nerves, or on the preternatural Rarefaction of the Succus Nervosus, by external Accidents. This flatulent Tumour of the Lungs has been often observed in Asthmatics. Car. Piso observes a Dyspnaea in an Arthritic, à Pulmone tument. And De Graaf de Succ. Pancreatico, has this Observation, Saepius offendimus Pulmonum Parenchyma, atque vasa statu distenta. Rhodius observes, that the Lungs of an Asthmatic were Turgid with Wind: Other Authors have observed the extraordinary bigness of the Lungs, and that they could not be easily kept in the Thorax opened. The Cure of the broken Wind cannot easily be projected any other way, but by a Parasentesis in the Thorax; for if the external Air be admitted, it will compress the flatulent Tumour, and through the same hole a Styptic and Carminative Hydromel may be injected, to restore by its Stypticity the Tone of the Membranes, and discuss by its Aromatic Acrimony the windy Spirits, or Air retained in the Lungs. This may easily be tried in the broken Wound Horses, by injecting through a Hole made in the declining Part of the Breast. I perceive the Experiment of Dr. Lours, by which he produced the Asthma in a Dog, by cutting the Nerves of the Diaphragme, has occasioned some Moderns to impute the Asthma, as he doth, to some Strain, or loss of Tone in the Nerves of the Diaphragme. But this cutting of the Nerves, if nearly considered, doth only hinder the motion of the Diaphragme, and that being hindered, the Breast cannot be dilated fully by the Intercostal Muscles; the want of that Dilatation compresses the Lungs, and hinders their due Expansion, and this must occasion a Dyspnaea, as Gibbosity, or a Pleurisy doth, in which the Intercostal Muscles are hindered from dilating the Breast, for which they serve as well as the Diaphragme. It seems to me a mistake, to believe the Nerves of the Diaphragme can be injured by any Strain; for Strains only affect the Body of a Muscle, and not the Nerves inserted into it; and I could never perceive any Injury done to the Muscle or Tendon of the Diaphragme in the Asthma, but that as well as the Intercostal Muscles, strive with all their force to dilate the Breast, but all in vain, because the Bronchia are compressed or constringed by the Inflation of the Membrane: And if the Air cannot be admitted, the Breast cannot be dilated by its Muscles, as we plainly perceive when any External Body slips into the Windpipe, whereby the Air is excluded in some measure; this produces a violent Orthopnaea and Suffocation very suddenly. ADVERTISEMENT. REmarks upon some late Papers relating to the Universal Deluge, and to the Natural History of the Earth. By John Harris M. of A. and Fellow of the Royal Society. 8ᵒ FINIS.