Casus Medico-Chirurgicus: OR, A most Memorable CASE OF A NOBLEMAN, Deceased. Wherein is showed, His Lordship's Wound, the various Diseases survening, how his Physicians and Surgeons treated him, how treated by the Author after my Lord was given over by all his Physicians, with all their Opinions and Remedies. Moreover, The Art of Curing the most dangerous of Wounds, by the first intention; with the Description of the REMEDIES. By GIDEON HARVEY, M. D. Physician in Ordinary to his Majesty. LONDON: Printed for M. Rooks, and are to be sold by the Booksellers of London. 1678. THE EPISTLE TO THE Reader. READER, HIs Lordship's Aunt having acquainted me, that it was his Majesty's Command, I should writ my Lord's Case, the humble obedience I owed to so great and high Authority, hath obliged me to describe the said Case in all its circumstances; not doubting but that it may prove as useful in its kind, especially if it shall meet with an Answer, as any Physical Consultation that ever was yet printed. For, first, it contains the best Cordial Method, and Practice of the chiefest, Experienced, Learnedest Physicians. 2. Their best Methods and Remedies for curing all the sorts of Colicks. 3. Their best Methods and Remedies for curing the Scurvy. 4. Their best Methods and Remedies for curing the Stone and Gravel in the Kidneys. 5. Their best Methods and Remedies for transferring a total suppression of Urine. 6. Their best Method and Remedies to cure a Diabetes. 7. Their best Method and Remedies for curing a Fever, Acute Pains, Vomitings, Gripes, and many other Diseases. 8. After all this, a clear Demonstration, that his Lordship was troubled with no other Disease, than what was occasioned by the puncture of a Nerve, or procured by Art. But what I chief pretend unto in this Tract, is to inform you how to cure the most dangerous of Wounds by the first Intention, that is, in lesser hours than most simple fleshy Wounds are days or weeks in curing; which certainly will prove of great advantage to you, whether you be a Physician, Surgeon, Apothecary, or neither; for it is the Public good I aim at in this Treatise, and in that called The Family-Physician, and the House-Apothecary: For which, in recompense, some Apothecaries, some Physicians, and some near Neighbours, did very lately combine into a Conspiracy against my Life and Estate; but if that should miss, they were resolved not to miss their stroke in stabbing my Reputation: And what defence is there against a premeditated Stab? So, courteous Reader, I bid you Farewell. THE Medical & Chirurgical CASE OF A NOBLEMAN. § 1. FRom the esteem of those numerous observations in Physic communicated to the World, is greatly detracted by the Romancing vein of their Authors, or by being so common and vulgar, that they seem no novelty to every Nurse: So that they are only very few that recompense Physicians for their pains in reading of them; and among those few, the Case I am now describing, may merit a remark for rarity and variety of Symptoms, equal to any ever published; assuring you, there shall be nothing inserted here, what is not respondent to the truth in the lest particular; though nothing is more to be regretted, than that an accident so unfortunate in all its circumstances, both of the Wound, Cure, and Mistakes, should befall a person, whose Magnanimity, Valour, ancient Descent, and other singular Endowments, did tender him a true English Nobleman, and Peer of the Realm. § 2. His Lordship received a Wound in the right Hypocondre, the Sword entering about an Inch more or lesle (by conjecture) below the short Ribs, almost perpendicular to the right Pap, and passing thwart down through the Abdomen, seemed to stop on the Os coxendix (or hip bone) somewhat above the Acetabulum. The Sword felt very cold as it passed, and on this side the termination near the Groin, made a prick or puncture so smart, that it caused his Lordship to fall down; which also occasioned a great Bruise or Contusion on the Hip; that is, a contusion of the Musculi glutaei, and the Cutis above them. His Lordship got up again, and walked to some considerable distance, until he arrived at a person of Quality's house in, etc. § 3. My Lord's constitution of Body was strong and vigorous; his Temperament Hot and Humid, that is, Sanguine; his Habit replete, fleshy, and well-coloured: he was 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, that is, of good and sound Bowels; aged near eight and twenty; his 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 was only observable in this, that his Nature could in no manner bear strong Catharticks; whereas on the other hand, the gentlest Lenitives or Laxatives, and Eccoproticks, in a very moderate Dose, would ever operate plentifully with him, and that upon occasion cum 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. My Lord's 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 (if I may so term it) was a most passionate aversion from the Roman-Catholick Religion, and a great inclination to Learning and Languages; wherein he was so far advanced, as to be noted to be an universal Scholar; an expert Linguist, and an excellent Mathematician. His Candour and Affability rendered him beloved of all persons of whatsoever degree, that had the honour of knowing him. He was undaunted in the greatest of dangers, as appeared in the late Sea-fights, in which he served his Majesty as a Volunteer. He was entirely just in his actions, and free of all manner of Debaucheries of the Times. § 4. After a short repose at the place abovementioned, his Lordship was advised to sand for a Surgeon nearest at hand, who proved to be a French man: He not sooner came, but immediately probed the Wound, which finding to penetrate into the hollow of the Belly, crammed in a Tent, armed I suppose with some Stegnotick, though without any great occasion, in regard the Wound did issue forth but a small proportion of Blood. This done, he took away some eight or nine ounces of blood out of the right Arm. § 5. Whether the foresaid Frenchmam was a Barber, a Blood-letter, or Surgeon, I know not, being wholly unacquainted with his education, by which at Paris one is obliged to be Apprentice four years to a Master-surgeon of Paris, and afterwards examined: or if he hath attained to his profession with some Master abroad, he is to serve three years in one of the Hospitals of Paris before he can be admitted Master-surgeon of Paris. Neither is this French man, according to my information, received among the Company of Surgeons at London as a foreign Brother: So that if he was not a Master-surgeon of Paris, or other great City, nor yet a foreign Brother in England, I judge it was a great presumption in him to offer to dress so great a person as his Lordship. § 6. However, he hath the rereputation of a Surgeon here, which any French Lackey, having only served a Barber ten or twelve months, and coming into England provided with a Pot of Turpentine, a Lancet, and a stock of impudence, shall never miss of, viz. of the repute of a famous Surgeon lately come out of France. By the first ingredient he is to cure you of the Chaude Piss; by the second, of the Fever; and by the third ingredient it is he makes you believe he is as great a Physician as he is a Surgeon; whereas in effect, he is only a Surgeon of the three Ingredients. § 7. The first Physician sent for, was myself, having served his Lordship in that capacity seven or eight years; but not being in Town, Dr. Polyphemus his assistance was desired, who immediately prescribed Clysters, Ointments, Fomentations, Cordials, and what not, to fill up the Sheet, in order to remove, or at lest to appease the violent pain of the left side in the lower part of the Belly, among Physicians termed the Hypogastrick region. What the Prescriptions contained, the Doctor's own Apothecary knows best; neither can I speak further of them, than that in the time of four and twenty hours, or somewhat longer, the Bill amounted to three pounds odd shillings. § 8. Dr. Polyphemus observing the storm of Symptoms to increase upon him, in point of prudence did not judge it convenient to see himself sole Pilot in a Sea where so many Sands and Rocks might possibly environ him, and he not perceive 'em; he therefore pressed that some more able Headpieces might be joined to his, by which means, if a Shipwreck should hap, they could readily excuse one another; it being customary to many Physicians, first to consult their own reputation and profit, and next to that, the welfare of their Patients. To answer that indication, Dr. Timon and the Ephesian Doctor were called in. The first thing in debate was, what parts were hurt; for the discovery of which, they commanded their French Surgeon to make his soundings, which he performed not by the Probe, but by his Fingers, screwing one or two of them into the Wound, and turning them round: upon the forcing them out again certified his Principals, that the Peritonaeum was divided, his Finger having grated quite round and round the Perforation, and so conseqvently the Sword must have passed through the hollow of the Belly. Whereupon the eloquent Dr. Polyph. according to the usual custom of his Polyglot, did discharge himself in a most elegant Harangue, (which some in Burlesque term, prating, a quality more becoming the Stage, than a Patient's Bedside.) The substance was, That Wounds are more or lesle dangerous according to the parts that are hurt; therefore it were highly incumbent upon them in this conjuncture to make use of their best Anatomical craft; in which particular the learned Dr. Timon, by his industrious and most minute dissections of Animals and their parts, as Heads, Plucks, Dogs, Cats, at Oxford (human Carcases being very rare there) hath acquired so great a share (as appears in his egregious piece de C.) that he might with right challenge the dignity of Speaker in that little Council, whose determination than was: First, That the Liver was not hurt. Second, That the Sword slid over the Guts (being slippery) under the Peritonaeum. Further this Deponent saith not. § 9 Next Dr. Polyphemus fling in his Anatomical Talon, implying the external coat of the Colon to be razed by the Point of the Sword. Moreover, That the Sword did not pass under the bowels, (a sort of expression I never expected from any Physician) and consequently that the Mesentery escaped being pierced. § 10. The Doctor of Ephesus, than not a Fellow, nor indeed so much as a Candidate, spoke last, and lest, and closed with them both in a concedo totum. Should I pass by this last Doctor's care, I should eclipse his merit: For though every night either one of the Surgeons, Apothecary, or their men, were pressing to watch with his Lordship, yet the Doctor's passionate care did often exclude them, to prefer himself to sit up all night; for which service he was ever saluted next Morning with three Guinies, besides Pipes, Tobacco, Wine, Ale, and paying the Apothecary for the Opium, which was usually given when the Doctor watched. § 11. The French-Surgeon (who hath the honour of being called Dr. Polyph. his Surgeon, whether from following his Coach, or from being his Tributary, I know not) had the boldness to say, in the presence of two Noblemen, and before the Physicians faces, The Doctor be all mistaken, it be neider de Liver, neider the Gut, neider the Bladder; but it be de Kiddenay be hurt; and did undertake to prove it mathematically, viz. The Sword entered just under the short Ribs on the right side, which is one Angle; thence passed thwart over to the Kidde●●y, which makes another Angle; whence again the Point might easily be retorted to the Groin, which completes the third Angle: so that here you have a Wound made in a Triangle; adding, that if the Point of the Sword should not have reached the Groin, by consent of parts the pain might very well have been communicated from the Kidney thither. I confess had he not smiled when he delivered this impertinency, I could not have inferred him a rational Animal from his discourse, but only from his Risibility; and for that reason have not thought it seemly to insert the lest Letter of his Name among those so eminently learned men, as are mentioned, and to be mentioned in this Narrative. § 12. Still more Eyes were required; and to that end Dr. W. was invited into their Conclave; of whose sharp-sighted ingeny nothing was lesle doubted than a clear discovery of the seat and cause of those pains that continually tortured this Noble person. Anatomy had often showed him that the left ureter commonly took its way not far of from that region, within whose circumference the forementioned pains were limited; the difficulty of Urine thereunto being added, whereby his Lordship was at intervals much incommoded, were Arguments sufficient enough to induce him to believe the left ureter to be pierced through. § 13. Affairs daily appearing in a worse dress than other, it was prudently resolved among the forementioned experienced and learned Doctors, that since in all appearance a fatal determination would suddenly (in their opinions) hap, that to tender their frustraneous consultations more authentic, it was highly necessary to admit into the Cabal Mr. Pres. the Fountain of Physic, and Father to the Family of Physicians; likewise Dr. Nemo, their elder Brother and Elect, whose deep learning is so universally noted, that his abode cannot be unknown to any that shall but cast an eye upon the Frontispiece of that elaborate Dispensatory of the last Edition. By these, whatever had been done by the others before, was ratified and confirmed; and whatever hereafter should be acted, done, or performed, should also be approved and corroborated by them. So that it might seem not a little strange to hear people talk of miscarriages, errors, and I know not what other discourses concerning the preceding Physicians, here being the greatest and undeniable Authority to bear them out; therefore this may be an Item to all persons, that if any of their Relations, as Father, or Wife, should happily die under the care of such or such a Physician, not to mutter or mumble that they miscarried, or might have been recovered, or the like; because the Physician (if legal, as they call it) acteth cum privilegio; and it shall be ratified at any time that they died learnedly; and this in Law is adjudged to be a competent satisfaction. § 14. Though several parts were respectively by these great men in their scrutiny proposed to be affected, as you have read; yet in the whole their counsel cannot be deemed to be divided, not more than when any thing is supposed to be lost, it is determined by the seekers to look for it in places (though never so distant and absurd) as well where it is not, as where it is: and so it was in this case, especially, when his Lordship's Relation, out of curiosity hiding herself behind the Curtains in the Room where the Consultation was held, heard them conclude thus: Let the pain be in this part, that, or the other part, let us order a Clyster, for that can do no hurt: and so it was unanimously carried; and for this advice several guineas were distributed, which however can hardly be said that it was respondent to the new Motto, Come, let us prescribe for our Fees. § 15. In the next grand meeting, according to the account I had from the same person of Honour, it was held necessary to advice Barleywater for the Patient's ordinary drink; for which care the like number of guineas was presented: and for a third Consultation, where Milk and Water was agreed on, they were rewarded with such another sum. So you may observe with what care and mature deliberation Medicines were particularly advised one by one, and not thronged in by numbers; yet alas! Saepè etenim docta plus valet arte malum. § 16. But Reader, be not transported in your amazement at the extraordinary industry of these Physicians, in pitching upon such simple (that is, single) Medicines, as were just before mentioned to you, when two other Physicians of the Cabal did by far outvie them in their care, in prescribing a Pippin roasted to their Patient for his every night's supper; and to show of what importance the preparation of it is, they fell into a serious debate, whether it aught to be roasted in a brown Paper, or a Vine-leaf. The Contest grew high, though at last agreed upon the Vine-leaf, as being more medicinal. Likewise in the case of my Lord, about a month before his decease, it was thought necessary to call in two of the learnedest Physicians of London, who having taken an exact inspection of the Disease, and particulaly examined all my Prescriptions, did positively aver, that the Disease and Causes could be no other than what I had discovered them to be, and the applications expressed in the Bills to be very proper: Furthermore they desired me to retire with them into the next Room to consult; which I excused, alleging, that it would be more convenient for them both only to consult together, to have their free scope, and prescribe what they thought fit, that his Lordship's Relations and others might see what they could advice, whether it should be the same, or different, or something more than what was in use than, which on purpose I kept concealed from them. They wrote down, 1. An Hypnotick (or sleeping) Potion. 2. A Paregorick Lineament. 3. An Anodyne and Traumatick clyster. 4. A Vulnerary Decoction. This done, his Lordship's Relation demanded the Resolves of their Consult; which being expressed to her, she was pleased to tender this Answer: As for the Hypnotick, that in the opinion of all people hath been adjudged to be the principal cause of my Lord's ruin. Touching the Ointment, there is one made use of now, which is seldom applied without success. A Vulnerary Drink also is daily taken, by virtue of which my Lord was (not long since) so well recovered, as to enable him to go forth two months together. A clyster is given every afternoon, or at lest every other day, the effect of which hath been sufficiently approved. Wherhfore if you have thought upon nothing else, I conceive that the Medicines that are at present made use of, aught rather to be continued, than to run the risk of others, though of the same kind; and so I thank you for your pains and trouble. But that for which I produced this instance, was once more to offer to your view the great caution that's ever concomitant to the Learned in their joint advises: for upon my return into the Consult-room, I found the two Doctors at some variance; the one preferring brown Sugar to be dissolved in the clyster last spoken of, and the other striving hard for Sugar-candy. § 17. Before I arrive to the recital of the practical attempts of these grand Physicians, let's pause a while upon the variety of their Sentiments touching the parts hurt. The Anatomical Physician in his Essay, declares with a pensive gravity, that the Liver was not hurt; which, considering only the passage of the Sword, and the posture his Lordship stood in when the Wound was given, (a circumstance necessarily to be considered) was easily determined. My Lord's Adversary standing upon a high guard, with his Sword-arm strait extended, his Lordship made a Pass upon the Seconde (being the only thrust the other lay open to) with a full allonge; upon which his Adversary took time, by dropping his Point, and pursuing it with a thrust on the tiers, by which the Sword happened to enter a little below the short Ribs on the right side, and passed thwart downwards to the inside of the left Hip; so that he holding up his Wrist, and turning the Point of his Sword down, and thereupon making a Pass with an allonge upon his Lordship, standing in the posture aforesaid, must necessarily have missed the Liver, and passed through the Mesentery between the small Guts downwards; whereas if one standing on his guard in somewhat a higher posture, had received a quart thrust made strait, and the Sword had entered a little below the short Ribs on the right side, and had passed directly thwart over, than the Liver could not have escaped being wounded; and in all probability the Colon and the Spleen also would have been hurt (supposing the Sword had passed quite through) or if it had descended only a little downwards, than the Kidney indeed might have been hurt, as the Frenchman inconsiderately asserted. So that you may observe how requisite it is to take notice of the circumstances. In fine, I conceive that that learned Dr. was too short (I crave his excuse for the expression) in his discovery, there being other parts hurt than not thought on. § 18. He that suspected the Colon to be touched, must also have inferred, that a Wound in that part, though in the external Tunick, turning into an Ulcer, would soon have perforated the other Coats of that Gut; and consequently Blood and Matter issuing out at the stool, would have been evident signs of it; besides, the Excrements every time passing by, whether naturally, or by clyster, must also have occasioned inflammations and smart pains, and probably some part of the Excrements would now and than have been thrown into the capacity of the Abdomen. If according to the opinion of the other Physician, one of the ureters had been divided, there must soon have ensued a Dropsy upon it. § 19 The Chirurgical part was performed by two Frenchmen, whose devoires were to heal the Wound of the right Hypochondre by several intentions, viz. by stopping the bleeding, digesting, deterging, incarning, and cicatrizing; whereby on purpose it was kept open for many days, though against the rules of the most experienced Surgery; there happening, as commonly doth, 1. Choleric Vomitings. 2. Smart gripes of the Guts. 3. A Wound-feaver; and all this, besides other Symptoms, by keeping the Wound open, through which the crude nitro-salin air entering into the Body, causes such an impression and alteration on the Guts and Bowels, as produceth those mischiefs aforesaid. Moreover, if the Remedies to remove such ill attendants be not properly applied, than there is an addition of new concomitants, whereby at last the Patient is obliged to yield to his unfortunate Period, and this by the first mistake of curing a Wound: so that it is in Chirurgical practice, as it is in the way of reasoning, Admisso uno absurdo, conceduntur mille. § 20. Wounds are kept open either for to give passage in extracting some extraneous Body, as a Bullet, Splinter, a piece of a Sword, or Lance; or to purge extravasate Blood, or other Juices, that Nature may convert into an Ichor, Sanies, Pus, or other matter at the Orifice of the Wound. Now in this case of his Lordship, whatever Blood, or other matter should be supposed to have been extravased or issued out of the Vessels, disseminated through those parts that were hurt, it must necessarily through its natural propensity of weight have descended down into the Pelvis, or bottom of the Abdomen, granting the Peritonaeum to be divided: if so, how could it rationally be expected, that the foresaid matter lodging in the bottom of the Belly, should be evacuated at the upper part, unless the Patient were hung every day by the Heels with his Head downward? neither than would it be feasible, in regard that the Epiploon and the Guts would by such a counternatural position cram and fill up the Orifice of the Wound, by which the forementioned matter would be intercepted. Another inconvenience that is consequent to penetrating Wounds of the upper part of the Belly, is the Epiploon, or the Guts, or both, do ever after upon Coughing, or by lying on that side, or otherways, make such a Protuberance there, as is observed to hap upon ruptures, or Hernia's; which also upon this way of cure befell his Lordship, being thereby rendered subject upon the lest Cough, or lying on his right side, to be extremely incommoded with a Protuberance of the bigness of a Fist, more or lesle; for which we advised a Truss, such as I had seen another wear before, being wounded in the Belly, and ill cured. § 21. The last, and for what I know, the greatest mischief, whereof this way of cure was the occasional cause (a term best understood by the three first named Physicians) was, that nature was diverted from her work, namely of protruding the extravase Blood, that might be suspected to be fallen down into the Cavity of the Abdomen, towards the Groin, or other external part, to be converted into an Imposthume, as on the like occasion hath been often observed. 2. Of discussing through the Pores, or carrying of the Gleet (which otherwise soon turns into a Virus) by Urine, as daily remarks on such cases do sufficiently evince. 3. Of thickening and concocting the nervous juice (that by a Wound or puncture of a Nerve is rendered thin and acrimonious) by Nature's Balsamic virtue, whereby a puncture is soudered and consolidated. Of all these three intentions, I say, Nature was diverted, by keeping the Wound open; which occasioned unsufferable Gripes, Vomitings, and a Wound-feaver; by which means the spirits were put into a tumult and outrage, dispersed into several parts, which otherwise would in three or four days have easily healed both the Puncture and external Wound. § 22. I am not only to tell you how this accident aught not to be cured, but also am obliged to express the manner how his Lordship in probability might have been recovered in lesser hours than he survived Weeks. The external Wound, for the reasons alleged before, aught to have been cured by the first intention only, which is Agglutination or Consolidation, whereunto a Wound is easily promoted, by applying the lips together, and retaining them so, either by Bandage, Suture-plaster, or Suture, according to the position of the part, and circumstances of the discontinuity; supposing there was no extraordinary Hemorrhage, or expectation of extraneous Bodies to be extracted, or matter to be repurged, Tendons and Nerves to be recently hurt, so as to have received no prejudice from the ambient Air, or its own Gleet, which immediately turns into a Virus, and the whole Wound fresh, to which its own Blood often serves for the best Gluten and Balsam. But if by long retardation the extravase Blood should have been coagulated, than it must be washed of with a little warmed read Wine, and immediately upon it the Lips are to be closed. § 23. In case of a Haemorrhage in a fresh Wound, happening upon the division of some of the capillar or greater Arteries or Veins, make use only of this styptic Liquor, viz. Put three parts of Colcothar, one part of common Allom, and one of Sal Prunellae, powdered and mixed together, into a Bolts-head, affusing on them as much Spirit of Wine not rectified, as may swim atop two Inches; digest them in Ashes eight and forty hours, or longer, than decant the Liquor; with this wet some dry Lint, form into a lose Pledget, and apply it to the Wound so, that each particle thereof may assuge some part of the evaporation of the Liquor: this being continued until the Haemorrhage be sufficiently checked; than close the Lips, applying the same Pledget atop, newly wetted again, and put a Compress on each side of the Lips, about one Inch more or lesle distant from them; and over that make a Bandage according to the structure of the part and figure of the Wound. § 24. Possibly what concerns simple fleshy Wounds, their cure by the first intention may universally be approved to be the best and speediest, barring the exceptions hinted to before, and some few others; but it is much scrupled where Nerves or Tendons are punctured or divided, where Gleet, if imprisoned by a sudden consolidation of the circumjacent wounded fleshy parts, doth cause most exquisite Pains, Inflammations, Imposthumes, Convulsions, and sometimes Syncopees, and upon their continuation, Death. § 25. Surgery is in no part lesle improved than in this particular, which though punctures of Nerves or Tendons daily hap upon unskilful bleedings, yet allowing, they dilate the cuticular Orifice to give vent to the Gleet, sanies, or other matter that may be engendered, and so endeavour to cure the Wound by several intentions, notwithstanding it's frequently remarqued, that few escape without great tortures, large tumors, lameness, or the loss of the whole Limb, and sometimes of Life; and all this by reason the Gleet is not suddenly stopped, the Puncture healed, and the Air kept out, by a speedy consolidation of the supercubant wounded sanguine parts. § 26. Now to prevent all these mischiefs, and to answer those various indications by one single intention, I will do the Public that service, to impart a Medicine so penetrable as to reach a wounded Nerve, Tendon, or any nervous parts, though in the remotest recess of the Body, and so conglutinative and balsamic, that it will stop the Gleet, and consolidate the divided Nerve, and other wounded parts, in an interval of time so short, that only your trial of it can induce you to believe. The Medicine is the following Balsam. Take Oil of Therebinthin what proportion you please, which by gentle evaporation in Sand reduce to a Balsam; add to it as much Colchotar of Vitriol as will serve to impastate it into the consistence of an Electuary; hereon pour as much Spirit of Wine, once rectified, as will swim atop five or six Finger's breadth; digest it in Sand, until the Spirit of Wine be sufficiently impregnated or clogged with the Balsam; than decant it, pour on the remaining Balsam the same measure of Spirit of Wine, which being sufficiently digested, decant it. Pour the decantations into a Glass-body, fasten the Head to it, and abstract the Spirit of Wine in Balneo M. until what remains in the Glass-body be of the consistency of a Balsam or thick O●l. You may observe, if you make use of compound Balsam of Sulphur, instead of the Balsam of Therebinthin, impastate it with the Colchotar, and extract it as aforesaid, it may be preferred in some cases. The Application is in manner following: The discontinuity of the Nerve, or nervous part, not being very remote from the surface of the Body, you are to drop a few drops warmed into the Orifice of the Wound, having first, by washing with warmed read Wine, or gentle compression, removed the coagulated Blood out of the Wound, that may intercept the penetration of the Balsam to the parts intended; afterwards uniting the Lips, impose upon them a Pledget armed with a few drops of the Balsam; and with, or without Compresses, according to the condition of the Wound make your Bandage. But if a nervous part be supposed injured in a more retired situation of the Body, a proportionable number of drops of the same Balsam is to be instilled into a small quantity of white Sugar, and than dissolved in a draught of read Wine, or vulnerary sanative Decoction, which taken inwardly twice or thrice a day, will soon reduce the Patient to a perfect recovery. What I have here proposed, is to be apprehended only to relate to the manner of cure, by the first intention; in the mean while, if the Patient be plethoric, costive, or attended with particular Symptoms; bleedings, evacuations, and other means, are left to the discretion of the Physician, or Surgeon, to be administered according to the emergency of the occasion. Though among Vulnerary Medicines these beforementioned are the best I know, yet the many experiments of his Majesty's Vulnerary Drops on Wounds, and some penetrating also, (which in point of danger might seem to exceed that of his Lordships in the beginning) so speedily and safely cured by them, is an evident demonstration, that it is the most excelling of Medicines that ever was invented, considering how pleasant it is, and amicable to all the Spirits, and yet so extraordinary penetrating and sanative. These Royal Vulnerary Drops were procured by the Right Honourable my Lord H. and sent from him to his Lordship by Monsieur, etc. Which being signified to the Physicians, after they had sufficiently abused the said Monsieur, etc. for his pains, they declared it was a Medicine they did not understand; they knew not what it was, and therefore would not give their consent it should be used; adding withal this ●die sort of menace, That if his Lordship did take it, they would come at him not more (Would to God they had not) provided my Lord had only made use of the foresaid Vulnerary Drops. I am assured, by all what I understand of the circumstances of that Wound, and the manner how it aught to have been cured, (which I have already expressed to you) it was very possible he might have been living at this hour, and have given his Gracious Majesty thanks for saving his life, by the service that a Nobleman of his vigorous years, and extraordinary qualifications might enable him to. But than we should have lost our Fees and Reputation, for not performing the Cure. This puts me in mind of a French Surgeon at the Hague, (a sort of people to be found almost in all places, where the price of bleeding exceeds two pence half penny) who being met by a friend in the street, was inquired of whither he was going in so great haste; t'other replied, To get a brave Gelding, or a fat Ox, out of a Gentleman's Leg; Which being but superficially hurt, he to accomplish his design, did by sharp gnawing Ointments and Plasters, purposely widen the Wound, until at length by his tampering a Gangrene happened, and thereupon his Leg was taken of below the Knee, which soon after put a period to his life. Now had this Wound been cured by the first intention, in two or three days, than the Monsieur would have been disappointed of his fat Ox; or had he suffered another Surgeon more knowing and expert than himself to be called in to his assistance, which by the rules of honesty and conscience he aught to have done, when he found himself in an error, and the Patient in apparent danger; but, thought he, than his male practice, his ignorance, and want of skill would be detected, especially should one be called in that was not of his College at Paris, and possibly one that might have known the Constitution of this Patient's Body for several years. Not, saith the Frenchman, it's better for my Reputation that this man, and a hundred more, die under my hands, than that I suffer one to go from me not cured, to be recovered by another; for the Grave hides a multitude. But would the Patient's Relations have had five or six of his College at Paris sent for, these he would gladly consult with, (for many Shoulders can easier carry a Corpse to the Churchyard than one) and the method is usually thus. Brother (saith he in ordinary) I holp you out t'other day at a dead lift, and you, and you, and you; here is a Patient whose Leg is gangrened, he will die; I have made such and such applications: Than they conclude one and all, this Gangrene was occasioned by the Patient's ill diet and disorders. Yes, Brother, saith another Coxcomb, this Gangrene is Hereditary, his Father died of a Gangrene in the Kidneys; you have done what man could do, he is a dead man; but continued still the same applications, until he is certainly dead, jest another should come in and set him up again; for that would prove a great scandal to our whole Society. Before I recede from my Narrative, give me leave to prevent your suspecting it fabulous, by making appear, that it's very possible for a Frenchman, though only a Corn-cutter, a Shaver, or Blood-letter, to pass for an excellent Surgeon. First he shall show you a rare show of glittering Instruments; than charm your Ears with prating of hard words; by flaying of a Dog or Cat before two or three Novices as Witnesses, declares himself an Anatomist: If he mangles a Muscul into two parts, he triumphs in the Character of being the greatest Anatomist in the world, in regard he hath first discovered all Musculs to have two Bellies; whereas, poor fellow, besides a false experiment or two upon the ductus Chyliferus, or transfusing of Blood, is utterly ignorant of the whole System of Anatomy: and lastly, with a Stentorophonia, howls it out, he is one of the College of Paris, which engrosses all; and therefore needs to give no other account, though he be never so great a Quidam. The same arrogance is assumed by the Physicians of the faculty of Paris, which is the College also, who therefore suffer none to mount on Asses, or rather Mules, to visit Patients in the City, but themselves; whereas those other Physicians that are graduated at Monpellier, or other famous Universities, have only the liberty of practising in the Suburbs; so that if a person of Quality should hap to fall sick in the City of Paris, he is obliged to live and die under one of the Physicians of the faculty; and if by Prognostic he is sentenced to die by one of them, if he sends for twenty more, he will get no reprieve. For this reason, many Gentlemen, whose sickness will permit them to remove, make choice of the Fauxbourgs, where they may advice with what Physicians they please, whose Learning and Experience doth not consist in a mere formality of being of the College of Paris, but it's derived from their close studies, and industry in attaining to every Branch of the Art of Physic, as Anatomy, pathology, Chirurgery, Botanics, Pharmacy, Chemistry, travelling to most of the renowned Universities of Europe; visiting the Hospitals in all places, and observing cases, and fishing out of Professors what it's possible for them to learn. So that it hath been often observed, that those that could not be cured in the City, were easily recovered in the Suburbs. This being represented to his Majesty of France, it was judged very injust, that a Company of formal Fops should, by their invincible By-laws, exclude so many Learned men, and by that disable them for practising; and therefore, whoever he be that lieth sick in Paris, must either be killed or cured by one of them, and be mulcted according to his discretion. To remedy this, though his said Majesty would not deprive them of their ancient Privileges, because conferred on them by his Ancestors, yet thought it expedient to erect a foreign College, into which all Physicians that were graduated as Doctors in other Universities, were incorporated, and privileged to practise in the City, as well as Suburbs; which seemed to be a Balance to the faculty of Paris; by which means if male practice was committed by one of the latter, it was immediately taken notice of by some or other of the former, and complaint made to a superior power; and thus vouching for one another, and killing cum previlegio, was at an end. Another benefit that redounded from instituting a foreign College, was, that they were ever outvying one another in Learning, Experience, Cures: In fine, they were a diametrical control to one another; a sick man might be sure he should not be slattered, deceived, or imposed upon in his Distemper, or Purse, because there were their opposites (I mean in emulation) ready at hand to be called in upon them. This new Constitution was likewise very pleasing to many Gentlemen, that had three or four Sons; the Eldest claiming the Lands jure Haereditario, one of the rest possibly might be intended for Physic, on whose education in Learning, Travelling, and taking his Degrees, there must be a good sum of money expended, and probably all his Portion; now that this Physician so honourably educated, should have the privilege denied him of practising in the capital City of his Country, by a Society of avaricious Monopolising Physicians, because he will not repeat or take his degrees over again among them, pay 3 or 4 thousand Liures, stoop to the meanest of them, though his Juniors, and cohere with them in all their diabolical vouching, errors, and ill practices, was one of the severest things, and worst of customs imaginable. Neither was this all; but whoever was admitted among them, was to swear, that he would with all artifices, interest, and power, declaim all other Physicians, though duly educated and graduated, especially those that by their Industry, Studies, Travels, and Experience, equalled the best of their College, he was obliged to Mountebank, and call them Quacks, Ignorants, or any other vile name, that might tender them contemptible to the people, to prevent them in their Bud for ever coming to any considerable employment in Physic. The people at length grew incensed, and made it a grievance of the Nation, that a Colledge-physician should, beyond their Prince, have a power of life and death over them, without being liable to an account for it: Neither did their solicitude rest here, but would often surmise, what if a brave spirited Nobleman, or the Prince himself, should be taken ill, his life and their welfare must depend upon the conjectural opinions of three or four of these fellows; whereof if one by a hired wilful mistake, error, or ignorance, doth act perniciously, the rest will readily comply with their Leader, unless controlled and balanced by others of a more sincere and judicious temper. No wonder than, that these men had contracted the Character of Physicians of the three S. viz. Son, meaning thereby a clyster: Seigneé, Bleeding: and Sena, intimating Purging; expressing, as if they could do nothing else, but blow Wind in their Guts, bleed, and scour them. It was not keeping a Coach, and living in Grandeur, that would longer persuade people, they knew a whit the more for that; comparing them to some Merchants, who by living splendid and high, had procured a great credit, though looking into their bottom, they found them not worth a Sous marc. Therefore it is easily believed, that the erecting a foreign College was a great satisfaction to the Subject. But it's time I should have done describing those Colledge-fripons, * Fripnode College, a proverb, vid. Cotgrave's Dictionary. and pass over to the remainder of my task, where now I am arrived, to record the Prescriptions of the learnedst Physicians of the Universe, and chief Members of another sort of a College famous and renowned for every thing, that is, for aliquid in omnibus. I have already told you, that from the seventeenth of November in the Evening, to the nineteenth in the Morning, there were ordered Fomentations, Liniments, Cordials, etc. to be prepared by Dr. Polyph. his own Apothecary. November 19 ℞ Decoct. enem. prescript. addend. theriac. Andr. zij. injiciatur statim. ℞ Rad. lilior. alb. ℥ j sol. malu. parietar. Mercur. althaeae, flor. melilot. hyper. chamaemel. an. Mj. sum. centaur. absynth. M. ss. bac. laur. juniper. sem. lini, saenugr. an. ℥ ss. coq. in Aq. common. q. s. ad lb j addendo circa sinem coct. vin. alb. lb ss. Coletur pro fotu. Ingredientia pro fotu (expresso liquore) contusa, in sacculis laneis applicentur inguini dolenti, illinendo prius sacculum unguento nervino. Persistat in usu julap. Cordialis & decoction. ℞ Decocti pro sotu ℥ xij. mellis mercurialis, & rosacei, an ℥ j ol. hyperici ℥ j Theriac. Londinensis ℥ ss. sacchar. unlgaris ℥ ij. T. C. W. C. R. L. Me. What this last Prescription was intended for, they forgot to set down; whether for a clyster, (which is most likely) or a Fomentation, I know not; but this being their Morning's exercise, I presume they were in haste. Note, That all these following Prescripts are transcribed exactly from the autography of their Bills, both in respect of their Latinisms and Pointing. November 19 ℞ Aq. ceras. nigror. ℥ viij. aq. epidemic. ℥ ij. aq. poeoniae compos. ℥ i Syr. Caryophill. & de succo citri an. ʒuj. m. f. julap. Cardiac. ℞ Decoct. pro syrupo althaeae lb ij. syr. e 5 radic. ℥ iij. m. capiat tepid. saepius. T. C. W C R L In the Evening they marked down these following: ℞ Aq. cerasorum nigrorum ℥ ij ss. Aq. Epidemicae ℥ ss. syr. de meconio ʒuj. m. cap. hor. somni tepid. Repetatur idem haust. post 6 horas, omisso syr. de Meconio, & ejus loco substituend. syrup. Caryophil. & de succo citri an. ʒiij. ℞ Aq. ceras nigror. ℥ viij. Aq. Epidemic. ℥ iij. pulv. perlar. ʒj ss. sach. crystallin. ʒuj. m. f. julap. de quo cap. cochl. v. vel vj. 3tiâ quoque horâ & deinceps ad libitum. T. C. WCRL Me. I perceive they begin to be puzzled, in regard they fly so early to their Hypnotic or Sleeping Drink; they cannot conjecture what that pain in the Groin means. Novem. 20. ℞ Mann. oped. ℥ iij. Sal prunell. ʒj. dissolvantur in lb i ss. liquoris poscetici. Colaturae addendo olei Amygdalarum dulc. recentis ℥ iiij. capiat ℥ iiij. per vicem secunda quaque hora donec operetur. Pergat in usu julapii, fotus & sacculorum. T. C, GC. RL. Me. Repetatur haustus hypnoticus H. S. cum Syr. de Meconio. Another sleeping Potion. Praesto sint enemata duo injicienda, si opus fuerit. Permittantur reliqua judicio Medici praesentis. Novem. 21. Repetat. enema hor. 3tia pomeridiana. Persistat in usu julap. Cordialis perlat. T. C. WCRL Novem. 21. ℞ Vng. Nervin. ℥ vj. Spir. Lavendul. compos. zj. M. probe agitent. in mortar. marmoreo, & redigant. in Linimentum, quo inung. pars femoris interior. & inguinis. Sint in promptu julap perlat Sint in promptu cras mane Mann. & ol. Amygd. an ʒij. seorsum. Sal Prunel. & Crem. Tart. an. ʒj. seorsum Sumat haust hypnotic heri parat hora somni hac nocte. Repetat. enem. T. C. WCRL Me. Novemb. 22. ℞ Aq. ceras. nigror. menth. an. ℥ j diascord. ʒj. pulv. è chel. compos. ℈ j malaxentur in mortar. & add aq. Epidemic. cinam. hordeat. an. ʒj. sir flor. paralies. ℥ ss. m. f. haust. sumend. calidiuscule hac nocte. Praesto sint 2 enemata injiciend prout opus suerit. T. C. W. CRL Novem. 23. Sint in promptu enemata injicienda semel aut bis in die, prout opus sure it, persistat in usu julap. perlat. Cap. haust. hypnot. cum diacod. alternis noct. si opus fuerit. T. C. WCRL Novem. 24. ℞ Pil. Russi ʒss. Sal succini gr uj Elix proprietat Paracels. q. s. f pill. iiij sumend hac nocte sub somnum. ℞ Mann. Calabrin. ℥ j Crem. tartar. ʒss. dissolute in haust posset sumat quam primum evigilaverit. W. CRL Decem. 1. ℞ Limacum hortens. mundat. lb i. ss. salsaeparillae medullos ℥ vj. folior. beccabungae, agrimoniae, Taraxaci anam. j flor. cichorei, borragin. genistae anam j cortic. duorum Limonum, totidemque Aurantior. recens decisor. C. C. eborisque raspat. ana ℥ iij. santali albi & citrini ana ʒuj. Glycyrrhiz. ℥ ij. Incisis & contusis affunde Lactis vaccini recens emulcti lb ix. & vini Malagani veri lb ij. sact aque uj horarum maceratione, destillentur usque ad siccitatem. Liquor moderate dulcoretur, bibaturque ad ℥ iv. ter in die. G▪ C. Decemb. 2. Mittat. sanguis è brachio ad ℥ viij statim; but out of which arm, was forgotten. ℞ fotus prius prescript. lb iiij. ut atur ut prius. Applic. hypogastric & perinaeo ante & post clysterem. ℞ fotus prescript ℥ x ol. lini ℥ ij. ol. hyper. ℥ j Syrup. Althaeae ℥ ij. vitell. ovi unius M. injiciatur a misso sanguine. ℞ Aq. ceras. nigror. ℥ ij ss. Sir Althaeae mecon an. ʒ vj. Aq Cinam hordeat ʒ ij. m cap hor somni. T. C. W. C R L. Postscript. ℞ Aq. ceras nigror. ℥ viij. aq. Epidemic. Cinam hordeat an. ℥ ij. Syr. Caryophil. & de succo citri a ℥ j f julap. cap. cochl. vj. ad libitum ℞ Hordei integr ℥ j liquirit ℥ ss. coq. in aq. font lb ij ad lb i ss f Colatur. cui add. syr. Althaeae & de Nymphaea an ℥ i bibat ut libet. Decemb. 3. ℞ Ol. amygd. d. ℥ ij. syr. althaeae & de 5 radicib. an ℥ j sach. crystalini ʒ ss. m f linctus perfectisme mixtus. sumat cochl ij. in haust liquor. posset calidi 3tia vel 4ta quaque hora. Injiciatur quamprimum enema. & praesto sint 2 alia in noctem. Persistat in usu fotus cum sacculo applicand. fiat post fotum applic ung ex ung. nervin & sp. lavendul compos. Which will make a Lineament, but not an Unguent. T. C. W. C R L, Decemb. 4. Sumat statim part 4 tam man & ol. Amygd. d. solut. in decoct. pectoral praescripto Sumat. part. 2 post horam & sic. deinceps singulis horis interea urgente dolore colico repetat enem. & sacculi. Excellent Grammatical Latin! T. C. W C R L They returned at night, and prescribed in form following: Repet at hypnoticum hac nocte. ℞ Aq. fl. Camemel. Epidemic. an. ℥ iiij. Syrup. de corticib. Citri. ℥ i ss. M. f julap. cap. cochl. iiij. alternis horis. T. C. W. C R L. Decemb. 5. ℞ Fl. Camemel melilot. sambuc hyperic. an pug ij. semin lini. aneth. ʒ ij. coq. in aq. common. q. s. add ℥ xij. colato liquori add tincture. castorei ℥ j Theriac. Androm. ʒ iij. Ol. rutac. camemel. an ℥ j m. f. enema. injiciend. hor. 2da post meridiem. ℞ Theriac. Londinens. ℥ ij. Theriac. Androm. ℥ j m f Empl. add ol. Camemel. chym. gt xx. applicetur Abdomini inferiori sinistro. T. C. W C R L Decemb. 5. ℞ Aq. flor. camemeli, Ceras. nigr. an. ℥ j Aq. Steph. ʒ ij. Syr. de mecon. ℥ ss. Laud. liquid gut. 12 m▪ capiat hac nocte hora somni. ℞ Syr. nostr. Balsamic. ℥ vj. capiat bis, ter, quaterve in die aq. lact is praescr. ℥ iij ss. sir Bals. c. 1. Decemb. 7. Repetat. hac nocte haustus Cardiac. heri praescr. Sit semper in promtu enema. & fotus. Pergat in usu Apozematis. Repetatur linctus ex ol. Amyg. etc. Decem. 9 ℞ Pulu. sen. comp. mayor. ʒ ss. rhab. pulv. salis prunel. Cryst. tart. an. ℈ j ol. ch. nuc. mose. gut. ij. Syr. de althaea s. q. f. Elect. molle. capiat statim, & superbibat jusculi momentum. Repet. linctus. Sat in promptu Enema. Decemb. 9 ℞ Decoct. Emol. lb j Mell. Merc. sacch. vulg. ana ℥ ij. Elect. lenitiv. ℥ j Terebinth. vitell. ovi solut. z ss. f. enema. Sat in promptu injiciend. vesperi si opus fuerit. Decemb. 11. ℞ Milleped. recent. no. 50. Terantur in mortario marm. sensim affundendo Apozematis praes. ℥ 4. f. expressio. Capiat cras mane, & repet. hora quinta pomerid. calidiuscule, & sic ad quatriduum. Et post duas horas ℞ Opobalsami veri ʒ ss. capi. die craft. in ℥ 4. Aquae prescript. cum Syr. balsamic. Cochl. i & sic bis in die ad quatriduum. In reliquis ut ante▪ Propinetur opobalsamum horis circiter duabus post haustum ex millepedibus. Decemb. 12. ℞ Magmatis residui ex decocto pro fotu praescr. Contund. in mort. marmor. & add ol. è pedibus † bovinis ℥ 4. pro lb i magmatis cum vitellis quatuor ovorum▪ f. Cataplasma applic. parti affectae loco cataplasmatis ex Theriac. Lond. etc. Repetatur fotus quotidie ad horae spatium: & post fotum applic. statim Catapl. calide & sic quotidie. Sint in promptu enemata, & pergat in praescriptis. In the Margin was written Neats-foot-oyl with this character †. Decemb. 15. ℞ Labdani, Tacamahac. an. ℥ ss. empl. è mucilagini●us, & empl. è bacc●lauri an. ℥ i ss. Picis Burg▪ ℥ j Styracis liq. ʒ ij. dissolve. simul. Extend. super Alut. applic partibus affectis. ℞ Pulu. bezoardic magistral. ℈ j Capiat hac nocte hora somnie C. 1. julap Cardiac. & superbib ejusdem Cochl. 4. aut 6. Et sic ad quatuor noctes. Decemb. 15. ℞ Rad. Chin▪ Sarsaeparil. lig. lentisc. incis & contus, an. ℥ 4 ras. c c. eboris an. ℥ i ligni nephrit. ℥ ij. incid & contund. dein add. Aq. font▪ lb 12. coq. (post debitam in B. M. infusionem) ad lb viij. Colaturae calidae infund. ad▪ duas horas liquerit. Santal. alb. & rub. an. ℥ j Cinam. confract. ℥ j dein denuò coletur ad usum. Sumat. ℥ 4, aut 6. alternis horis calide edulcorando tempore usus seq. syrupi cochleari uno aut altero. ℞ Syr. Peruvian. ℥ viij. Decemb. 17. ℞ Ol. Amygd. dulc. recens expressi ℥ iiij. Aqu. Stephan. & Syr. de Meconio ana ℥ j m. in haustum mox ab enemate rejecto propinandum. ℞ Decoct. carmin. ℥ ix. Balsam Lucatelli ℥ 4. M. in Enema quamprimum infundendum. Perseveret in usu tum destillati antiscorbutici cum Syrupo Balsamico, tum Ol. Amygdal. & ejusdem Syrupi. There T G G C. Decemb. 18. ℞ Ol. Amygd. dulc. ℥ ij ss. Syr. de Althaea & de 5 radicibus ana ℥ ss. Aqu. Stephani ʒ ij. M. Sumat quamprimum. ℞ Pulver. Nephrit. magistral. ℈ 4. diluatur vini Rhenani cyatho, i.e. cochlearibus 4 vel 5 circatertiam pomeridianam. T C, G C. ℞ Pulu. nephrit. ante prescript. ʒ iij. dividatur in duas partes aequales, sumat. unam quam quamprimum in haust. vini Rhenani, alteram partem quando opus fuerit, id est, post horas 12 vel hora somni. ℞ Ol. Amygdal. dulc. rec. expressi ʒ ij. Aqu. Stephani ʒ ij. m. capiat hora 1 post pulverem cum vini Rhenani pauxillo, vel sine pro libitu. T C. G C. G M. Decemb. 20. ℞ Decoct. Emol. & carm. lb j Ole. Hyperic. Rut. an. ʒ vj. Elect. è bacc. Laur. Terebinth. Ven. vitello ovi solut. ana ʒ iij. f. enema injiciend. hora tertia vel quarta pomerid. Repetat. pulv. prescript. sexta quaque hora alternatim. Sint in promptu Ol. Amygd. & Clyster. Balsam. & Syr. Balsamic. & Opobalsamum, (I think, they embalmed his Lordship before he was dead, for here it's all Balsam and Balsamic) usurpanda urgente occasione methodo ante praescr. Decemb. 22. ℞ Spir. Terebinth. rectific. gut. xx. Syr. de alth. de 5 rad. ana ℥ ss. m. & quamprimum in posseti haustu propina; superbibendo Vini Rhenani haustum: & post sex hor. repetat. T. C. G. C. Decemb. 24. ℞ Aqu. Ceras. nigr. ℥ vj. cinam. hoard. & epidem. ana ℥ ij. Mar. pp ʒ ij. Sach. & Syr. Cardiac. ana ℥ ss. m. in julap. unde singulis horis propinentur ℥ ij. G. C. ℞ Infus. Emetic. ʒ ij. propinetur extemplo, superbibendo post horulam Oxymell. Scyllit. Posseto diluti q. opus fuerit. T. C. G. C. Decemb. 25. ℞ Decoct. traumat. & pro Syrup. de Alth. ana lb j m. & ter in die propinentur ℥ vj. vel seven. ℞ Pulu. Holland. ʒ ss. Syr. Alth. q. s. ut fiat mixtura mollis, gut. uj vel seven Balsam. Capiebae condienda, & singulis auroris exhibenda, superbibendo haustum decocti supra descripti. Perseveret in usu enematum quoties opus fuerit. Mi. T. C. D. W. G. C. Decemb. 27. ℞ Aqu. Epidem. ℥ 4. aqu. flor. Aurant. aqu. Cinam. hoard. ana ℥ ij, Syr. Caryoph. & è succ. Citr. ana ʒ vj. M. sumat. ℥ ij. ad libitum in languoribus. Decemb. 28. ℞ Pulu. Senn. comp. mayor. ℈ ij. Salis Absynth. gr. vj. Bals. de Capiva s. q. f▪ Bolus mollis sumend. statim. ℞ Aqu. Epidem. ℥ vj. Aqu. Cin. hoard▪ ana ℥ ij. Syr. Caryoph. & è succ. Citr. ana ʒ vj. m. f. julep. Capiat ℥ ij ad libitum in languoribus. Man. Xsti perlat. lb ss. the Cordail Julep prescribed to day. The ass by 7 to morrow morn. GC. Decemb. 28. ℞ Conf. Alkerm. c. m. ℥ ij. Theriac. Androm. ℥ ss. Pulu. Gascon. ℈ ij. Ol. Cinam. gut. j Syr. Caryoph. s. q. f. Electuarium molle cum fo. auri no xij. sumat. q. nuc. moschat. quarta quaque hora & ad libitum▪ in languoribus. T C. Decemb. 29. ℞ Candit Ros. rub. Consosruct. Cynorrhod. Syr. Berberor. M. f. Elect. molle, cui adde Margarit. pull. ʒ iij. Confect. Alcherm. ʒ vj. M. f. Elect. capiat quantitat. jugland. min. superbib. co. iiij vel v sequentis julepi repetendo tertia quaque hora. ℞ Aqu. Cerasor. nigror. citri ana ℥ iiij. Epidem. ℥ iij. Cinnamom. hoard. Rosar. rub. ana ℥ j Syr. Caryophil. ℥ i ss. m. f. julepus. ℞ Rad. Symphyti ℥ j Ras. c. c. & eboris, ana ʒ iij. fol. millefol. m i ss. coq. in Aqu. fontis lb ij. Colatura reponetur ad usum, cujus sumat haustum cum part. equal. lactis recentis permixtum, ter vel quater in die. T C G C T W Decemb. 30 in the morning. ℞ Gummi Arabic. Tragacanth. ana ʒ iij. Sacchari penidior. ℥ ss. f. pulvis in uj parts aequales dividendus, quarum detur una mane, & altera sub vesperam quotidie in tantillo lactis hordeat. ℞ Summit Cupressi M. iv. albumin. ovor. conquassator. lb ss. Cinnamomi crassiuscule triturati ʒ ij. minutim concisis affunde lactis vaccini recentis lb iv. & destillentur organis vulgaribus ad siccitatem. Destillati capiat uncias circiter uj statim post unamquamque pulveris supra praescripti dosin. T C G C Decemb. 30. at Noon. ℞ Rhab. pulv. gr. 24. Gum. trag. Arab. Rad. Symphyt. pulv. ana gr. iij. Syr. e ros. sic. s. q. M. f. mixtura mollis sumend. hac nocte. T. C▪ Decemb. 30. at Night. ℞ Sem. melon. pepon. papav. alb. ana ℥ ss. Amygd. decorticat. & incis. no. 12. Sacchari Cryst. ℥ j Aqu. Ros. rub. ℥ ij. aqu. hoard. integr. depurat. lb j f. s. a. Emulsio. Capiat ℥ 4 aut 5 tepidè tertia quaque hora, vel insuper ad libitum. T. C. Decemb. 31. Morning. ℞ Vnguenti Comitissae ℥ iiij. Vngr. parts Lumobales. T C G C Decemb. 31 at Night. ℞ Sem. Melon. Pepon. ana ℥ ss. sem. plantag. portulac acetos ana ʒ ij. sem. papar. alb. ʒ vj. Sacch. albiss. ℥ j Aq. Panis & aq. papav. Rhaead. ana lb j f. s. a. Emulsio qua utatur ut priori usus est. ℞ Rad. Symphyt. sicc. ℥ j Gum. Arab. ℥ ss. Sacch. albiss. ℥ vj. m. f. Pulu. subtilissimus. Sumat cochl. unum ex haustu lactis Avenacei prescript. T. C G C. Jan. 4. ℞ Aqu. meliss. Cerasor. nigr. Epidem. ana ℥ iij. aqu. mirab. ℥ j Croc. ℈ j Glycyrrhiz. ℥ j Infund. statim in frigido, & post horam unam f. Colatura, cui add. Syr. Meliss. Caryoph. ana ℥ j Sumat ℥ ij ss. singulis horis. ℞ Spir. CC. rectificat. ʒ ij. capiat gut. 15 (quoties urget virium languor) ex ℥ ij ss. julapii. T C. § 60. Observe, that about every four hours, or a little more, there are four Ounces of hot W●ters to be swallowed down, viz▪ A●ua mirabilis and Epidemica, besides 15 drops of burning Spirit of Hartshorn, almost in every Dose, which in 24 hours will amount to a Pint and half; and an half Ounce or more of Spirit of Hartshorn; on some occasions, enough to precipitate a well man into a Fever, and subvert his Senses, but much more a person so much macerated as this Noble Patient was. Probably the Doctor had amplified his experience by his Travels in Poland or Russia, where far larger Doses of Brandy, and other sublimed Spirits, acuated with a Spoonful of powdered Ginger, or half that quantity of Pepper, are given. § 61. But what need I, to justify the foremeant Doctor, fetch a precedent so far of, when there is one nearer, in a notable instance (if true) of a Physician, a degree higher elevated in fame than he? This Doctor was called in (as they term it) upon another Physician, not of the College, to cure a Patient; he not sooner saw him, but cries out, This is a sort of Asthma, which myself and Dr. Willis first found out, and named it Asthma Convulsivum: But it's I only have appropriated a Remedy to it. What is't, demanded t'other Gentleman? It is, quoth he, Spirit of Sal Armoniac, exhibited in the measure of a Spoonful without any vehicle. The other replied, I dare not consent to it, without a good proportion of liquor to dilute it. You are over-cautious, quoth the Sal Armoniac Doctor, leave it to me, and behold the Miracle. Nolens volens, given it was, but the Patient freely expiring that day (which is more than he had done many days before, his Lungs being obstructed) prevented the Medicine of performing its effect, and the Doctor of seeing the Miracle. Had the Patient been dissected, without doubt, they would have observed another occasional cause, namely a very sharp cutting Armoniac Rheum, that had inflamed, corroded, and excoriated the Oesophagus and Stomach, and convelled the great stomachic Nerves, whence derived this convulsive Asthma, the nerves of the Diaphragm being likewise convelled by consent: excuse the expression of attributing the word Convulsion to the Nerves, it being usually applied to Muscles. Now it's apparent enough, that this Medicine did exceed the former in heat; but by the way remember, that exhibiting it in that manner, was Authoritas Medica, not to be imitated by every Physician, nor indeed by any, unless of very great repute, not more than Steteruntque comae, by every Poetical Pedagogue. The relation of this forementioned consultation was given me in the company and hearing of twenty Physicians more, by the same Physician, whom the other was called in upon; from whose reputation the credit of this instance is to take its measure. But enough of this, intending to be more at large upon Miracles of this kind performed at Paris, in a Treatise, entitled, The Conclave of Physicians, where the subtle and polite Government of the Physical Pope and his Cardinals, is discoursed of. § 62. On the 27th and 28th of Decemb. if you look back on the Recipees, you will find the Cordial Juleps strained to a higher pitch of heat, and throngs of Spirits; whereas in the preceding treatment of his Lordship, especially towards the beginning, the Cordials were prescribed more moderate in heat, being diluted with Simple Waters; which as the Patient's Symptoms increased, were also thought fit to be stimulated, and made quicker, to keep pace with the Distemper, until at last both had carreered into an high Fever, as hereafter shall be remarqued. § 63. What ever Curatory Indications are desumed, I have ever observed, that some grand Physicians of, etc. never are forgetful of the Indicatio Vitalis; whereon they lay so great a stress, that they seem to prefer it before the Cure of the Malady, and the removing of the Cause: Insomuch, that wherever they come, the Scene is a Cordial prescribed at the head of the Scroll, especially where the Disease doth not manifest itself so plainly to their apprehension; and particularly in the Diseases of Children and big-bellied Women. This sort of Cordial Practice sounding so safe among the Vulgar, imposes a necessity upon the minor Physicians to move in the same Zodiac: For should a Friend or Relation of a Patient come to visit him, and not see the small Vials on the Table, with the Silken Stoppers, he would rail the poor minor Prophet out of doors, and cry out, He killed the sick man for want of a Cordial. So that it's easily believed, that the greatest estates are gotten by prescribing of Cordials, and not by curing Diseases. However, take my meaning right, I do not hence infer this Cordial Practice to be an Imposture in those eminent Doctors, but rather some Ruins of Paracelsus in their Pericranium; whence you may justly term them Chemists: for by their Cordials they intent to fortify the general Archaeus in the Stomach, or at lest to make an impression or idea upon it (or to use Helmont's phrase, a reflection like upon a looking-glass) which being successively continuated or propagated (like streams in a water) unto every particular Archaeus, that commands over every part, a Disease, and its occasional Cause, are expelled in a moment; provided that their Cordials are virtuated with those Qualifications Helmont designed for his Drif. But these are only Deliramenta Catarrhi, and so is often this Cordial Practice, unless when put into use, it hath a power adjoined to oppose and remove the Cause of the Disease. This premised, let's make enquiry whether this Cordial Practice used from the beginning upon my Lord, might be accounted proper. Secondly, Whether prescribing gentle and moderate Cordials in the beginning, and very strong and smart ones towards the latter end, was not much more improper. § 63. The Indication for Cordials is taken from the defect of the vital and animal Spirits, occasioned by the loss of laudable Blood, or a vitiated and diminuted Chymosis, whence Blood is not sufficiently engendered for matter to be converted into Spirits and the Succus nutritius, or by the loss of Spirits dispersed and consumed by great Pains and Tortures, or what other Cause, by the Phaenomenon they than conceived, they please to assign. The loss of Blood was insignificant here; but the insufferable pains in the lower part of the Belly were great, through which Sleep was interdicted, the Spirits extremely depauperated, and the Concoctions of the body subverted, so that a proportionable measure of Blood could not be generated. To answer the Indication surmised in this latter notion, they prescribed the common Cordials usual among them almost in all Distempers; viz. Black-Cherry-water, Plague-water, Cinamon-water, and Aqua mirabilis; sometime the one, and sometimes the other. But what could these effect? You may believe, they could not supply the twentieth part of Spirits that were daily exhausted. Furthermore, it may be offered to consideration, whether the foresaid Cordials did not sharpen and fret the Blood and Spirits, whereby the pains might be rendered more intense, and their causes augmented; which Method being continued, what could the issue of it be, but that which followed? § 64. To illustrate this to you in a more familiar instance; Suppose a man loaden with a burden on his shoulders so weighty, as to make his Joints shake and tremble under him; if you give him a Dram of the Bottle, he may support a little the longer: though soon after, his Joints fall on shaking much more, and than you relieve him with a glass of Canary; which perceiving to effect lesle than his first Cordial, in regard the burden on his shoulders hath dispersed more Spirits, and weakened him much more than the first Cordial restored, or corroborated, you make a third essay (imagining the former Cordials too weak) and offer him a large dose of Aqua mirabilis, upon which suddenly comes tumbling down to the ground, both man and burden. § 65. My observation upon this is; 1. That the direct way to assist this man, is to take of his burden from his shoulders, either all at once, or by degrees; which will prove the best Strengthner and Cordial, especially if supplying him with proportionable Corroboratives. 2. That the weaker a man groweth, his Cordials aught to be lesle spirituous, and more temperate; for else it will drown and overwhelm his Spirits on a sudden. But in these preceding Prescripts, I find the weakest Cordials exhibited in the beginning, and the strongest towards the end. However, since it was concluded by such great Physicians, that the administration of Cordials in that form and proportion was necessary, good manners prompt me to declare, It was well done, they did what men could do, and they aught to have been sure to continued it, until the Patient had certainly, etc. § 66. For to appease and lay the pains, Hypnoticks were frequently given: These by stupefying and condensing the Spirits, gave his Lordship some intermission of his tortures, during their operation; which not sooner was expired, but they returned into their accustomed fury. What followed? My Lord was several times surprised with a total suppression of Urine, a Symptom very dreadful: But the Ephesian happily thought on a small Wax-candle, which being forced into the Vrethra (or passage of the Yard) not so far as the Sphincter, did by stimulation excite the facultas excretrix of the Bladder, by which means his Lordship immediately discharged his Urine. Now let's examine the Cause of this Suppression: It was not occasioned by the Stone; for the Wax-candle did not penetrate so far, as to be supposed to reach it, and thrust it back; neither was it any grumous Blood, Slime, or Gravel, for the same reason. Than, I hope, I may without offence, put the question, Whether it was not the too often repeated Hypnoticks and Opiates, that had stupefied the Bladder, its Sphincter, and those branches of Nerves that defer the animal Faculty to both, and consequently the animal Spirits being rendered torpid, had not force sufficient to evacuate the Urine, whence happened that suppression. That Opiates and Narcoticks are not seldom attended with so ill a Symptom, as the suppression of Urine, needs no other proof, than daily Experience; and that his Lordship's suppression depended on such like cause, the argument à juvante seems evidently to infer, which was a Wax-candle; that by stimulating and exciting the soporous faculty of the Bladder, procured an excretion of Urine. But Modesty obliges me to say, This was very well done, in regard such great Masters of Medicine cannot do amiss. § 67. All this while the Physicians were only vagrant in latitude, receding from one Remedy to another, and not gaining the lest way in longitude, but rather losing ground; which made them come so often to an anchor, by giving of Opium. However, since they could not always act Lulla by, nor the Patient constantly be detained in sleep, there was a necessity of launching out, and steering all manner of Courses, to get into Port. First than, his Lordship's pains were judged to proceed from a Colica Biliosa, (or a hot Colic) which they endeavoured to purge of by their Laxative, prescribed on the 20th of November: What success had this? By night they were forced to summon in their whole Posse Comitatus, viz. Cordial Juleps, Fomentations, Bags, Hypnotic Potion, two Anodyne Glisters, as appears in their Prescriptions: the next day the repetition of the Purge was approved of, but Glisters, Anodyne Liniments, Pearl Cordial, and the Hypnotic, were to be in readiness. The 22th and 23th the Hypnotic (their Anchora salutis) and Cordials were repeated. On the 24th of Decemb. they were resolved to try their fortune once more, by purging of Phlegm out of the Stomach; by which they seemed to intimate another opinion, viz. That his Lordship's Pains issued from a Wind-Colick, the Wind being occasioned by the attenuation of the Phlegm in the Stomach, and posted thence into the great Guts; whence it was to be carried of by Pil. Ruffi, etc. § 68 Seeing the Pains proved too obstinate to be longer suspected for any, or all the sorts of Colic, they would now tentatiuè (a term too much in use among them) suppose these torments to be Scorbutic, and the pain that often excurred as far as the Loins, to be a Lumbago Scorbutica. About ship again, steer large; orders were immediately given to distil an Antiscorbutic Water or Spirit (or what you please to term it) prescribed on the 1 of Decemb. consisting of Snails, Brooklime, Dandalyon, Oranges, and Lemons, Broom flowers, etc. And that you may the better understand, that they had treated his Lordship severally and jointly as a Scorbutic Patient, you may peruse their joint-Prescription of the seventeenth of Decemb. where it is determined, that the Patient shall persevere in the use of the Destillatum Antiscorbuticum, which is the proper name they imposed upon their Prescription of the first of Decemb. Moreover you may observe, that I have not suggested these Diseases from the virtues or intention of their Bills, but from their expressed words; as for further instance, in their Record of the fourth of December you read, they term my Lord's pains a Colic pain. Where they seem for a while to leave of their Scorbutic method, and convert their whole efforts against the Colic on fresh: Here Oil of sweet Almonds, Syrup of Marshmallows, and Chamomil-water, are esteemed as great Specificks: Their Auxiliaries are Carminative Glisters, Fomentations, Bags, Cordials, Balsamics, and Hypnotics, their old friend. But Omnia incassum, still worse and worse. § 65. Once more, and that for the last, they are resolved to make a bolt or a shot of it: They remembered, that My Lord had been taken more than once with a suppression of Urine, a Symptom that often attends the Stone in the Bladder, and that which proved an Ignis fatuus to seduce our Physicians into a strange mistake: For unto the foresaid Symptom of Suppression, they added an intercurrent pain of the Loins, Vomitings, (now deemed a Symptom of the Stone-Colick) pains above the Groin, interpreted to be Vellications of the Ureter by Gravel, or small angular Stones: And lastly, his Lordship's Father dying of the Stone in the Kidneys, was an Herculean Argument, that those great Tortures were Nephritic Pains, and the Disease no other than the Stone in the Kidneys. This they confidently asserted to all my Lord's Relations and Visiters; and they made no doubt, but there were Engines, Pickaxes, and Shovels, that they could command out of their Apothecary's Shop, whereby they should easily dig the Stone out of the Mine of the Kidneys. To work they go with their edged tools, and make their first attaque with a Nephritic Purge, marked down on the 8th of Decemb. this to be seconded with a strong Laxative and Diuretic clyster; the next day the assault to be renewed twice with a Diuretic Apozem, virtuated with the expression of fifty Hog-lice, and within two hours to be reinforced with the exhibition of Opobalsamum, commonly called, The Balm of Gilead, or the best sort of a well-concocted Therebinthin, exactly imitating the virtues of the Rosin of Venice: In summa, an Imposture put upon the European Christians, by Armenians and Persian Mahometans. But by the way consider, the vast Dose of Hog-lice, the Opobalsam, or Armenian Therebinthin upon that, and Therebinthin Glisters upon that again; whereof some days four or five of them were administered successively one after another, each clyster containing four Ounces of Lucatellus' Balsam dissolved in it; so that in twenty four hours there were twenty or five and twenty Ounces, that is, above a Pound and an half of Lucatellus' Balsam forced into the Patient's Belly: How large the proportion of Therebinthine must be to make such a huge mass of Balsam, is easily computed. Besides all this, in the intervals were exhibited Doses of Oil of sweet Almonds, Syrup of Marshmallows, Balsamic Syrups, and a Decoction of Lignum Nephriticum and Mastic-wood, Chips so highly decanted for the Cure of the Stone. All these I accounted only the Shovels; but the great Pickax was their Pulvis Nephriticus Magistralis, a Nostrum prepared by their Privy Apothecary, and to be purchased of him at his own rate by the Apothecary in ordinary. And forasmuch as collaterally was intimated to me, this famed Pulvis Nephrit▪ derived its virtues chief from Hog-lice, Eggshells calcined, Crabs eyes prepared with Oil of Tartar, etc. But whether Cantharideses, or Spanish-flies, did constitute any part of the basis of this mighty Powder, I could yet never learn; a particularity worthy to be enquired into. A Dram and half of this Pulvis was ordered for a Dose on the 19th of December, as you may read before among the Prescripts, and to be swallowed down once or twice a day in Rhenish Wine. And because the passages, through which the Stone was to come, should be made big enough, wide enough, and slippery enough, a Draught writ down on the 17th of December, of Oil of sweet Almonds, Syrup of Marshmallows, and of the five opening Roots, was to be given a little before; besides, jest the Stone should stick in the way, a Therebinthin clyster was to bring up the rear, to force it on. During all this bustle, his Lordship's Urine came tumbling down in Cataracts, but no Stone. At length the Doctors begin to discover read Gravel, of which they reported, they had saved near upon one Spoonful and an half; but in regard it so exactly resembled that sort of read Sand, which is contained in the Germane Hour-glasses, scarce any body could look upon it without smiling. The Gravel descending was interpreted by them to be the Prodromus of the Stone, which now they expected every minute, with as much Faith, as the jews do their Messiah, after a great Storm. And what is more, one of them like a Bigot Midwife, sat up a Night or two, to assist at this Rocky birth. § 64. They push on still, and add new forces to their Stone-breakers, and Piss-driving Medicines, by ordering twenty drops of Spirit of Therebinthin (a strong Piss-driver) to be mixed with the Syrups forementioned, and washed down with a draught of Rhenish-Wine, this to be repeated after six hours: no Stone yet, but Urine in abundance; whence they surmised, that since the passages were so well lubricated, the Stone must stick fast in the Pelvis of the Kidneys; to loosen which, a Vomit was commanded to be used on the 24th of Decemb. as their Bill expresseth; and on the 25th and 28th, a Purge. From the concussion of the Vomit in its operation, and the compression of the Musculs of the Belly upon going to Stool, it was expected the Stone would be shaken, and tumbled down. But in fine, they were greatly mistaken in their measures; instead of the Stone, there was a flood of Urine (improperly so called) came down so impetuously, that this Patient, or Physicians Martyr (as his Lordship was often pleased to term himself) in twenty four hours made six times more water than he drank, according as myself, and Chirurgeon several times found upon an exact computation by measure: For in a Night's time twelve, and sometimes thirteen Pints of water, were discharged by the Bladder; which I cannot denominate Urine, as not having the Colour, Scent, or Taste of such; but on the contrary, looked like rock-water, transparent, and clear, without sediment, scented like Beef-broath, and tasted sweetish like Honey. Here, from making little or no Urine, observe well, sourced a most plentiful spring or fountain of clear water. Now all hands at work, if you are men, Luff, no near. To stopping the leak they go; and in order to that, on the 29th of December appoint an Adstringent stopping Electuary; likewise a potent binding Decoction of Comfrey, Yarrow, etc. On the 30th a thickening Powder of gum-arabic, and Gum-Dragant, with a Distillation of Cypress-tops, Whites of Eggs, Cinnamon and Milk: Upon this a mixture of Rhubarb, Gum Arabic, Dragant and Confrey-roots, an unpleasant sort of Tansey. Moore yet, there must be also plentifully drunk Almond-Milk with Poppey-seeds in it, and Cordials, and all this in one day. On the 31th in the morning they made their Visit, and spoke to the woman attending; Well, what cheer, Nurse? O, Mr. Doctor, abundance of Urine this night! Pain and tortures so insufferably violent, that his Lordship fling himself twice out of Bed, as if he had Convulsions! His burning Heat so great, that all night long my Lord held his hands on bottles of cold water! Fainted several times, that I thought he would not have seen the Morning! Vomited and strained very often, as if his eyestrings would have broke! My Lord drew his breath so extremely short and thick, that I verily believed, he would have been stifled; for his Lordship would not suffer any Curtain to be drawn, or any body stand near the bedside, jest he should hinder the air from him! Now, Mr. Doctor, Quomodo pulvis? No doubt, but the Nephritic Pulvis was a most excellent Powder; never did Medicine answer expectation better; for perfectly did it remove the suppression of Urine, and if Stone or Gravel had been in the way, it could never have resisted the force of it. Therefore, Let's conclude, one and all, They did what men could do! Here was no want, but abundance of Remedies, and it was ten to one, if one of them did not hit. He that throws with ten Dices, cannot easily miss quater trey, unless he be cursedly unfortunate; and Seamen in a Storm do often hoist up all their Sails, though they bring the Mainmast by the board. § 69. Well, Contra vim mortis non est Medicamen in hortis. After the Consult-Masse was ended, my Lord's Relation asked them, What think ye of my Lord? what hopes have ye? they replied (as I am informed) one and all, We have no manner of hopes, he is a dead man; we will do what we can to give him ease. They all gave him over; and to all those Noblemen that were Visiters, they declared positively, that his Lordship could not live; and some went so far, that they expressed it was impossible, he should outlive seven days. This desperate Decree of the Doctors was soon conveyed to my Lord's ears by a messenger, that seldom tarried long by the way to carry news of this nature to him. § 70. His Lordship no whit dismayed at the ill-tidings, about the second or third of january desired I should attend him. My Lord was than pleased to signify, that my absence from the Town on the day he received his Wounds, had occasioned him to make use of several vogued Physicians, whose greatness of fame since he perceived to be a vulgar opinion, by the success that attended their experiments upon him, he frequently pressed them to consult with me, as having had a greater experience of his Constitution upon various occasions, that did not only require competent Learning and Judgement, but a careful attendance. The inflammation this sort of discourse raised on their Dura Mater, caused them to burst into this peremptory answer, that they would not consult with me, let the event be what it would, because I was not of the College, and if his Lordship persisted in those demands, they would certainly desert him. This reply being thoroughly perused, my Lord was obliged to surrender himself to their discretion, partly through the necessity of pleasing▪ some of his Relations, and partly through the new assurances they confidently gave him of a speedy and perfect Recovery. Since therefore now he found their hopes turned into despair, he had easily obtained from them, what by no manner of arguments he could dispose them to before; and in consequence of that, did appoint me to give them a Consult-meeting on the morning following. In order hereunto, I examined the Symptoms preceding, and those present, which chief were insufferable Pains and Tortures on the left side of the lower part of the Belly, too horrible for any man of ordinary strength to endure. 2. A scorching Hectic Fever, that had so macerated his Body, that it was a perfect representative of a Skeleton, covered over with a skin. 3. A Diabetes, in the dialect of some boorish Physicians called a Pisspot-dropsie, a Symptom so rare, that among ten millions of sick persons, scarce one is observed to be afflicted with: For it is seldom in the power of the worst of Morbific Causes to produce it, unless assisted with the Pickaxes and Shovels of the Art of Physic. 4. Syncopees, or long deep Swoonings, several in a day, and frequent Lipothymies, or faintings. 5. A suffocative Respiration, or stifling breathing; as for want of sleep, a very low ebb of Strength, Vomitings, a dejected Appetite, and worse Concoction, etc. I accounted as nothing, in comparison of these five. § 70. Death usually being the termination of each of these Symptoms, even when singly afflicting the Body, moved this Query in me, Which of all these five mortal Enemies would in the most appearance kill his Lordship first? Upon some discussion, my opinion inferred, that the Diabetes would absolve its fatal course the soon, probably in eleven days; but than that each of the other four Symptoms might very well pretend to one days mischief, seemed conjectural enough, which substracted from the foresaid eleven, inferred a consequence, that his Lordship would not outlive seven days, as some of the Doctors had prognosticated. How little such a Tragic Scene of Morbisic Attendants could encourage a person to act jointly with those, that after so many brutal calumnies and affronts, now seemed only to admit of a Consultation to make use of me, like the Fox of the Cat's foot, was evident; however, the obligation I owed to my Lord, and some of his Lordships own Relations, engaged me to contribute the utmost of my endeavours, especially upon the general noise of their Conclamatum of his Life, and the observation of many particulars, wherein I apprehended they had egregiously erred. By appearing somewhat later than the hour appointed, it was supposed my stomach was taken of by the reflections the Doctors had made the night before, (for I was not yet of the College) who therefore knowing where I was that Morning, now pressed earnestly I should be sent for; not so much to consult, as to hale me in to bear part of the burden. Being come to the famous Consult-room, I found two men, one much of the Mien of some Renegado-Divine, or Schoolmaster turned to Physic, vested and tunickt with black; the other Campagne Tunickt with grey, smoking a Pipe of Tobacco al' Indiano. Whatever they seemed to me in the external, the Physical Eloquence of the former, expressed by a tongue so nimble, that my ears could hardly keep pace with him, and the solid judgement of the latter, did demonstrate them most excellent Physicians in the general; and in particular, the one hath merited, among the Vulgar, the fame of a good Childrens Doctor, and the other of a Woman's Doctor. The Prologue of these Physicians was, that they were come thither to hear, what Proposal I had to offer, in order to my Lord's Recovery. A greater impertinency I have not heard; implying, as if they had looked upon themselves to be appointed Commissioners to receive Proposals from me, touching some kind of improbable work, as the draining of a River, or the like; and to be Judges of Oyer and Terminer of the feasibility of the Project. Thus we see how arrogant some sort of men are, when finding themselves buoyed up by common fame, Coach and Horses, and Propped with the dubious interpretation of a Law, studying Omnibus viis & modis to oppress their equals. § 71. The Replication I made 'em was, that according to the form of Consultations, I expected an account of what course and method had been used, what Remedies, and against what Diseases, Causes, or Symptoms; which done, I should show▪ myself ready in declaring my Sentiment. Upon this, the well-spoken Gentleman related the nature of the Wound, and by what means cured; withal, that there were other Distempers survened upon that, viz. Colic, Scorbutic pains, Stone and Gravel; the latter of which he offered to prove, by having caused the discharge of a great heap of Gravel, through the force of those Stone-breaking and Piss-driving Medicines that were exhibited, adding the hereditary property of the Stone, whereof his Lordship's Father died. The other Physician was upon the carping auscultation, to which his continuando of the Virginian smoke contributed, by its Henbane quality of condensing of his animal Spirits. § 72. By passing over all what they had acted, and the reflections thereon, I endeavoured to avoid Disputes and Provocations, and thought to have contracted an amity and well understanding among them, which is very necessary to tender Consultations successful; and therefore immediately expressed my sense, That in all Wounds, the termination of the Cause wounding, be it Sword, Lance, etc. aught to be particularly observed; and for that reason, the Sword wherewith his Lordship was wounded, was to be exactly traced in its passage; which considering the prick, that my Lord very sensibly perceived a little above the left Groin, and caused him to fall down, was an argument the Sword terminated or stopped upon the Os Coxendix or Ischion, a little above the Acetabulum; if so, than probably the Sword must have passed the Mesentery, part of the Psoas, and the Musculus Iliacus internus. The ausculting Physician interrupted me, in saying, that there was no such Muscul as the Musculus Iliacus belonging to the frame of Man's Body; and that I was under a great mistake, it was an error; and farther, it was ignorance in me; and therefore I aught to consider well of what I said before such men as they were. At that time having no Anatomical Picture-Book by me, nor the occasion of showing them the Muscul in a dead Body, I swallowed the affront, for the reason expressed in the beginning of this Paragraph, and proceeded, intimating that here might very rationally be suspected, that there was some small proportion of purulent matter collected in the hollow of the Abdomen, converted into such, out of Blood leaking through some small Vessels, that were hurt by the passing of the Sword. But this did not seem a cause sufficiently adequated to produce those acute Pains above the Groin, which therefore I positively asserted, could be occasioned by no other than the Puncture of one of those great Nerves, that are originated from the Medulla Spinalis about the Lumbi, whence issuing a Gleet, which by Stagnation is soon converted into a Virus, or Venom, the property whereof is not only to 'cause horrible pains of the Nerves and Nervous Parts, but Syncopees, Lipothymies, Vomitings, short oppressed breathe, Convulsions, Fevers; but never a suppression of Urine, nor Diabetes: Whence these two latter are to be derived, ask the Doctors, and consult their Prescriptions. To prove that those forementioned Symptoms did only issue from the puncture of a Nerve, I instanced the concomitants and accidents, that usually attend and follow a puncture of a Tendon, or which is much worse, of a Nerve in the Arm, upon unskilful Bleedings; viz. extreme Pains, Imposthumations, Syncopees, and the rest. The Indications are two. 1. To stop the Gleet of the Nerve. 2. To remove the virulent humour, or liquor, that's already gleeted. By answering the first indication readily and in due time, the latter is prevented. But in his Lordship's case there were more Indications to be desumed from Diseases, that were constituted, per Deuteropathiam, per errorem externum, and by occasional causes. I cannot here omit, once more to declare the excellency of our Balsam, described before, how speedily it would have performed in the beginning, what both the Indications point at; and in many other Distempers its effects are not lesle admirable. But nothing is more to be regretted, than the omission of the Royal Vulnerary Drops, especially being offered so seasonably; which as far as I can understand, were never yet taken for the cure of the most dangerous of Wounds, without having certainly performed the effect, that was expected from them. Moreover, I do believe, that far meaner Medicines might have stopped the Gleet, as Spirit of Vitriol dulcified, Spirit of Sulphur, or Vitriolum Martis, or what is more ordinary, common Vitriol tied up in a rag, and applied externally, near the place where the puncture was, or further of; so diffusive and penetrative is the nature of Vitriol. It was not in the beginning, but at the latter end, that I was consulted; and therefore besides the former, other Indications are to be taken, as well from the Diseases the Sword had occasioned, as those which Art had procured, viz. Diabetes, Fever, etc. I soon perceived, that nothing but a Mercurial Remedy would answer all Indications; but jest the well-spoken Doctor should thence take an occasion to bespatter me, and cry out aloud, I offered to give his Lordship Mercury, (a word that sounds barbarous among the ignorant.) I apprehended it prudence to defer it, until another might be called in, or that I had prepared his Lordship, or some of his Relations for it. In the mean time I proposed this following, as answering most of the Indications, as affairs stood than. Januar. 5. ℞ Cerus. Antimon. ℈ j Troch. Viperin. ʒ ss. Croci Angl. pulv. gr. i ss. Syr. Cort. Citr. q. s. m. f. mixed. moll. Sumend. horâ nonâ vespertin. superbibendo haust. decoct. sudorif. Signed by Dr. etc. and myself. You may remember, I mentioned two Physicians that were to be consulted that Morning, before this was prescribed; but one of them being thrown out for a wrangler, I was yoked to the other; who did as readily reform, and conform, or indeed take up any form, as any man I ever met with; though at the same time he did also expect to be indulged in several of his own Enthusiasms, which resting too much upon the basis of some of his preceding Opinions, caused frequent dissensions and jarrings among us. And it is a very common Observation, that where some great Physicians have taken up a sentiment, and declared it, they will not recede from it, though they are convinced they are in the wrong, and that it will tend to a certain prejudice of the Patient; because they will seem to be more than men, in the impossibility of erring; but I have more charity, than to believe this worthy Physician was polluted with any such Principle; or at lest I hope he was not. I have somewhat abruptly given you an account of our first Consultation, which now I shall set down in the total. After I found that whatever I proposed, was not only rejected, but rendered in Ridicule, and that at so unfit a season, where a Person of Honour's Life lay at stake; I asked one of them in Latin, discoursing of the Diabetes, Exhibuisti ne bolum armenum contra hunc affectum? He replied, Non novi bolum armenum, sed novi quidem bolum armenam. Here I perceived he rather acted the part of a Schoolmaster, as he had done that of the Iliac Anatomist, than of a Physician; which made me conclude, they designed lesle what might be advantageous to the Patient, than carping, and derision. Upon that I took my leave, refusing my Fee, because I had done nothing for it; which notwithstanding they greedily accepted, as if they had laboured hard in prescribing never a Bill; and so we left the Patient in a great deal of Pain and Misery. At Night I was sent for again, where I met one of them alone, who singly agreed to all what I offered, but for formality desired, to defer prescribing until the other Iliac Physician should be present, which would not be until the next morning; and so we left the Patient again as we found him. But it happened before I went away, that a very eminent English Surgeon came thither, to give his opinion touching his Lordship's condition, which imported, that either some Tendon, Nerve, or Membrane was hurt on that side, where the pain was. This agreeing very near with what I declared to his Lordship before, we were appointed to meet the other Doctors next morning. Myself and the forementioned Chirurgeon, as we returned home, agreed, that in this case, Rebus sic stantibus, nothing could be more proper, than a Mercurial Medicine, viz. Mercurius dulcis, a preparation so safe, that it is as commonly given to Children against the Worms, as Aloes, or Wormseed. But I desired him to propose it, in regard the Physicians would rather take it from a Chirurgeon, than a Physician; such is the cursed emulation of mankind! On the Morning we met; it being my turn to speak first, the resentment I had of their false reflections touching the internal Iliac Muscul, and Bolus Armenus, obliged me to declare, that before I went on further, I would make it appear, who was in the error; and to that purpose, here was now brought an authentic Anatomy-Book, and a Pharmacopoea; in the latter they might see Bolus Armenus, and in the former the Musculus Iliacus internus. This was no sooner expressed, but one of the Physicians burst out into very scurrilous language, which without any further ceremony caused me to leave the Room, and the Consultation. Before I was gone passed half the length of the street, I was called back again; and he that was the most mutinous dismissed, though much against my desire. § 73. During the calm, the use of Mercuri. Dulcis was not sooner proposed, but agreed to, prescribed and signed by the other Doctor and myself, in form following. Januar. 3. ℞ Calomelan. ℈ j Cort. Citr. humid. conduit. contus. & per setac. traject. ʒ j Syr. ejusd. q. s. M. f. Mixtur. moll. sumenda quam primum. ℞ Rad. Sarsaeparil. ℥ iiij. Rad. Chin. non carios. ℥ ij. rasur. Ebor. corn. cerv. ana ʒ vj. Lign. sassafr. cinnamon. ana ʒ ij. Lign. Santal. rubr. ℥ ss. post digest. coq. in aq. font. lb viij. ad consumpt. medietat. coletr. & reponatr. in ampul. vitr. de q. capiat lb ss. quater ad minimum quotidie. ℞ Erinac. calc. & subtle. pulv. ʒ ss. sumat. in cochl. j Syr. Balsamrubr. horis duodecim post bolum prescript. § We had some controversy about this Hedgehog powder, the Doctor pretending he had done Miracles with it in the like case of a Diabetes; which assertion I much suspected, in regard such a Distemper, under those circumstances, was not easily paralleled. Besides, all the Authors that I ever read, and in particular Fran. joel. lib. 6. sect. 2. q. 8. recommends it as a singular Diuretic, against a total suppression of Urine, and seems to intimate, as if it were more forcible than Hog-lice. Likewise Forestus l. 21. 15. extols it for moving of Urine and Stool. How could this than be proper to put a stop to a Pissing Disease, that so potently moved Urine? However he would have it used, because his experience had supplied him with notable Examples. Neither could we well accord upon his Syrupus Balsamicus ruber, which according to my information was a dissolution of Gummi Guaiaci in Spirit of Wine, and sweetened into a Syrup with white Sugar. This Medicine I objected against, as being a violent Purgative, and Diuretic, and a great fretter of the Blood. The argument he valued little, but preferred his own experience; so that I was forced through importunity to yield to it. Though in the whole I found this was grounded upon the remains of his former opinion of his Lordship's being troubled with the Stone and Scurvey. So opiniatre are some men, when they fasten to a Disease. § 75. It was his Lordsh. commands, that since he had taken a new Medicine, prescribed him on Indications different from those of his former Physicians, I should watch with him; by which means I had occasion more particularly to observe the manner of his Pains, making of Urine, Vomiting, Breathing, and Fainting. About eleven of the Clock at Night his Symptoms grew very violent, insomuch that he called very earnestly for his Hypnotic, or sleeping Potion. I told his Lordship, I could by no means consent to it, in regard it would six those virulent humours, weaken his Brain and Nerves, and that it was wholly disagreeing with the Medicine he had taken in the Morning. A day or two after, My Lord related to me, that his other Physicians had given it him two and thirty Nights together, and therefore wondered I scrupled so much at it. You are to observe, that this ordinary Hypnotic was seldom prescribed, but ordered by word of mouth; For it's very rare, that Opiates are given in that proportion, and for so long a continuance; so that it was not convenient to have those Bills filled in an Apothecary's shop, in perpetuam rei memoriam. According to my information, this following was the usual Hypnotic. ℞ Aqu. Ceras. nigr. Paralies. Papav. Rh. ana ℥ j Aqu. Epidem. ℥ ss. Syr. de mecon. ʒ vj. Laudani Opiati gr. iij. m. f. Pot. sumend. hora somni. § 76. On the Morning following the Night I sat up, I gave his Lordship assurance of removing his pains very suddenly, by Remedies, that night's observation had indicated; but desired the application might be deferred, for an hour or two, until the English Surgeon (a person of great Knowledge and Experience, whose judgement I esteemed far beyond any of the Physicians) and the Doctor appeared, to whom I offered the use of Ventoses, or Copping-glasses, to be applied on the part affected, to the intent those virulent humours that occasioned these torments, should be attracted externally, and so discussed. The Surgeon well understanding the effects of Ventoses, and the nature of the Distemper, agreed immediately they should be applied, not in the lest doubting a good success; but the Doctor stumbled at it extremely, and objected eloquently against it: I suppose, because it was proposed by me, and so well approved by the Surgeon. At length our arguments prevailed for the Ventoses: Upon the application of the first Copping-glass, his Lordship's Pains abated, and upon the renewing it the second and third time, his Pains were vanished and clearly removed, without the lest return for two Months together. § 77. On the fourth of january in the Morning we met again, and prescribed as followeth. ℞ Aqu. Ceras. nigr. Epidem. ana ℥ iv. Syr. Garyophil. de suc. Citr. ana ʒ vj. Aqu. mirabil. ℥ ss. m. f. julap. de q. capiat cochl. iv. ad libit. in languoribus. § 78. This hot Cordial was pressed upon me, and to avoid debates, yielded to; but advised his Lordship privately to use it very moderately, a spoonful or two once in five or six hours. Renovetur Emplastr. parti affectae applicand. ℞ jugland. conduit. Not iij. Sumat hora somni. Cras mane diluculo repetatur Bol. è Calomelan. post cujus usum se alvus non respondeat intra spatium duar. horar. sumat Syr. è flor. persic. ℥ jss. ex haustu allae coct. In reliquis pergat ut ante. ℞ Aq. papav. Rh. ℥ ij. Syr. flor. paralies. ℥ j tinct. Castor. gut. x. m. f. haust. sumend. hora una aut altera a sumptis jugland. § 79. At Night the other Doctor sited alone by himself, and prescribed this Cordial. ℞ Aqu. Melis. Ceras. nigror. Epidem. ana ℥ iij. Aqu. mirab. ℥ j Croci ℈ j Glycyrrhiz. ℥ j infund. statim in frigido, & post horam unam f. Colatura, cui add. Syr. Meliss. Caryoph. ana ℥ j Sumat ℥ ijss. singulis horis. ℞ Spir. C. C. rectificat. ʒ ij. Capiat. gut. 15. (quoties urget virium languor) ex ℥ ijss. julapii. Januar. the 5th we prescribed, ℞ Cerus. Antimonii ℈ i Trochise. viperin. ʒss. Croc. Angl. pulv. gr. jss. Syr. court. Citr. q. s. m. f. mixed. moll. Sumenda hora nona vespert. superbibendo haust. decoct. sudorif. calidè hora tertia pomeridiana. Sumat bolum è pulv. Erinacei calcinati. § 80. Upon the going of of my Lords pains, his Urine came in lesser quantities and better coloured, for a day or two; than the other Doctor would needs crowd in his Hedgehog powder again, which procured the return of the Diabetes in the same degree as before: this being plainly observed by myself and the Surgeon, we positively told him, if he would not desist from giving this flying Hedgehog, we would consult with him not more; so that afterwards it was wholly left of. ℞ Spir. Salis Armoniac. succin. ℥ ss. Sumat gut. xij. in cochl. vj. cujuscunque liquoris, urgente lipothymia. At Night the Doctor prescribed alone by himself thus; Bolus è Cerussa Antimonii & Troch. Viperin. hac nocte hora nona. Haustus hypnotic. Vin. Ceras. ℥ ijss. vel iij. per intervalla. Cras mane pulv. Erinac. In reliquis ut ante. § 81. When I saw this Bill, I would neither allow of the Hypnotic, black Cherry-wine, nor Hedgehog. I confess it moved a strange jealousy in me; concerning the Doctor, prescribing now afresh a Hypnotic Hedgehog, and adding black Cherry-wine. § 82. january the 7th these following Prescriptions were signed by us both. ℞ Theriac. Andr, Diascord. ana ℈ ij. Spec. è chel. Cancr. comp. ℈ j Ol. cinam. gut. ss. Syr. Coral. q. s. M. f. mixed. moll. deaur. sumend. hora somni. superbibendo seq. julap. cochl. iij. The way to divide the single drop of Oil of Cinnamon into two parts, was by dropping it into a little powder, which being mixed together, might easily be separated into two parts. ℞ Aqu. Epidem ℥ vj. Aqu. Cinam. hoard. ℥ ij. Diascord. ʒ ijss. conterantur in mort. marm. addendo Syr. Garyophyl. de rub. id. court. Citr. ana ℥ ss. m. f. julap. Sumat cochl. ij. alternis horis vel ad libit. § 83. About this time his Lordship was on a sudden surprised with a Diarrhaea, or Looseness, so violent, that it put us out of our road for▪ a while; but the occasional cause of it was controverted between us, the one Doctor asserting it was the operation of the two doses of Calomelon. though it had been given some days before, and was wrought of by five or six motions on the same day. But beyond all perad-venture it was to be imputed to the daily use of the Balsamic Syrup of Gum Guaiaoi, that is so potently purging, and fretting; therefore without any more ado, myself and the Surgeon desired, that both the Glasses of the balsamic Syrups of the other Doctors might be taken away out of the Room, and be seen there not more. Moreover, we judged it highly necessary, to be more than ordinarily careful, that nothing should be imposed upon us, whereby so fair an appearance of a Cure might be subverted. Besides this Diarrhaea, my Lord was every moment heaving to vomit. On the 8th of january we agreed to these Prescripts; ℞ Mass. Empl. stomach. Magistr. part. ij. Gum. Tacamahac. part. j Ol. Cinam. gut. j M. f. Empl. scutiform. Extend. super alut. & applic. Ventriculo. ℞ Rhab. pulv. ℈ ss. Diascord. ʒ j Ol. Cin. gut. ss. Syr. de ros. sic. q. s. M. f. mixed. moll. deaur. Capiat hora somni haec nocte. ℞ Corn. Ceru. Calc. ℥ j coq. in aq. font. lb iiij. ad consuumpt. medietat. dein calidè affunde super cinnamon. crass. confrit ʒ ij. Sacchar. alb. ℥ j post horam decantetur sine colatura. Bibat ℥ iiij. ad libit. per se, vel cum aequali proport. lact is coct. Sat in promptu bolus suprascript. sitque in promptu idem bolus sine Rhabarb. addendo pulv. è chel. Cancr. comp. ℈ j bol. armen. ver. ℈ ss. Horis duabus a sumpto bolo sumat. haust. hypn. usual. Here there was a necessity to allow half an ounce of Diacod. dissolved in simple Waters for an Hypnotic. January 9 ℞ C. C. C. ℥ j coq. in aq. font lb iij. ad lb ij. colato liquori adde aq. cinam. hoard. sacchar. crystal. ana ℥ j m. Capiat ℥ iiij. 4ta quavis hora. ℞ Aq. Cerasar. nigr. ℥ seven. Aq. Epidem. ℥ jss. Syr. Caryophil. Syr. è suc. Citr. ana ʒ vj. m. f. julap. sumat cochl. v. ad libitum in languoribus. Januar. 10. Repetatur bolus hac nocte, & cras manè hora sexta. Repetatur julap. cord. & Decoct. corn. Ceru. calc. ℞ Marg. praep. ʒ ij. dividantur in part. sex, & capiat part. sexta quarta quavis hora in cochl. j jul. cord. superbibendo ejusdem julap. cochl. iiij. § 84. The effect of these Medicines having reduced the retentive faculty of the Guts to their former duty, I judged it expedient to lose not more time, but to proceed towards a Cure; and in regard it was not improbable, that in a short interval the Gleet of the Nerve would by stagnation reassume its preceding virus, and that the superfluous Humours of the body would by nature be thrown to that part, as being the weakest, I proposed, that a large Caustick should be applied on the region of the left Ilia, by which means the channel of the foresaid Humours would not only be diverted outwards, but there would be a vent given to those virulent evaporations, though their fountain was so deeply remote. For it's consonant to Experience, that an Empyema consisting of matter more gross, hath been rarified, extracted, and dried up, by several Caustics applied to the Breast. This being new to the other Physic jan, and because it was recommended by me, he would by no means assent to it, and therefore pressed, that another Physician of the Cabal should be called, in which particular he was indulged by my Lords Relations. He misunderstanding, that it was the other Doctor advised the Caustick, therefore immediately approved of it; but the next Morning perceiving his mistake, did as obstinately oppose the application of a Caustick on the inside of the Thigh a little below the Groin, as he had easily yielded to the former. The Surgeon, whose Experience and Judgement I esteemed beyond twenty of them, gave me his opinion, that the application could not be used without success; and therefore after they were withdrawn to their several occupations, we caused the foresaid Caustick to be applied, and three or four days after we judged it convenient to apply another on the inside of the Thigh, a little above the Knee; the Escar being cast of, we keep them open for a long time, by putting in several Ivy-pease with a piece of flatted lead over them, to 'cause them to make a deeper impression. § 85. The Prescriptions they forced in upon me than were these, being two to one; the mayor part according to the mode of consultations ever prevailing. ℞ Decoct. Traumat. ℥ x. ol. hyper. mel. ros. ana ℥ j ss. Balsam. Lucatel. ℥ j Vitel. ovi unius. M. f. Enem. Injiciatur quamprimum. ℞ Lap. Bezoar. or. pulv. ℈ j Capiat hora una post rejectum Clyst. è cochl. j julap. cardiac. superbibendo cochl. vj. julap. ejusdem. ℞ Conserv. rosar. rub. vet. ℥ iij. Balsam Lucatel. ℥ j m. f. Elect. Signetur Electuar. Vulnerarium. ℞ Balsam. Sulphur. Therebinthin. ℥ ss. capiat gut. x in cochl. j Syr. Balsam. rubr. superbibendo decoct. Chin. prescript. I was extremely dissatisfied at these Prescripts, and did vehemently suspect their effect; but their grandeur influenced his Lordship to use them. On the 12th of Januar. ℞ Diascord. fr. ʒ j sp. è chel. cancr. comp. ℈ j Lap. Bezoar. or. ℈ ss. syr. Garyophil. q. s. M. f. Elect. Moll. Capiat octava quavis hora, superbibendo julap. card. cochl. iiij. ℞ Balsam. Sulphur. rectif. ʒ ij. Capiat gut. vj. octava quavis hora, in haust. decoct. Chin. Repetatur Enem. prescript. What happened? The next day we had the Diabetes, a Diarrhaea, Faintings, Syncopees, Vomitings, and Gripes. The Balsam of Sulphur was a Remedy offered by me; but in regard the ordinary Chemical Balsam, that was brought thither, was a Medicine fit for a horse (though purchased with all the care imaginable by the Apothecary from the Chemist) I prevented his Lordship from using it, promising to bring some of my own preparation, but did not suffer my Lord to take it, until several days after. The other Doctors returning, I told them, it was their old Medicines had put us back again; and once for all declared, they should never be exhibited again, as long as I was concerned. They replied, it was the Balsam of Sulphur; upon which I drew a small thumbglass of my own Balsam of Sulphur out of my pocket, and shown it them full, telling them, though I had carried it about me several days, my Lord had not yet taken a drop of it; which his Lordship, and the others that attended, likewise attested: neither should it be used, before I saw what the effect of their Medicines would amount unto. § 78. Being transported into passion, they retired to their several occasions; one of them repeated his Visit next Morning, very early, leaving these subsequent directions. Januar. 15. ℞ Troch. Viperin. ʒ j Pulu. Comitiss. Lap. Bez. orient. ana ℈ j Succ. Kerm. s. q. f. Bolus exhibend. sexta quaque hora, loco prius prescript. ℞ Aqu. Epidem. aq. Ceras. nigr. ana ℥ iv. Croc. ℈ j Infund. in frigido ad horae spatium, dein coletur & add. Aqu. Steph. & Aqu. mirab. ana ʒ vj. Syr. Caryoph. & è succ. Citr. ana ℥ j M. sumat in onini languore, & alternis horis, vel tertia quaque hora. Pergat in usu margarit. Add enemati theriac. Androm. ʒ iij. These to me seemed Bills written upon the fret, and therefore I ordered the Apothecary to exhibit only half the forementioned Bolus, and that only once every twelve hours. The Cordial pleased me as little. At night he prescribed this costly Electuary, which was not used. Januar. 15. ℞ Confect. Alkermes ℥ ij. Theriac. Androm. ℥ ss. Pulu. Comitiss. ʒ ij. Confect. de Hyacintho ʒ ij. Lap. Bez. orient. ʒ j Ol. Cinam. gut. j Syr. Caryoph. s. q. f. Elect. cum fol. xij auri. Capiat ʒ i vel ij pro libitu in languoribus. On the 16th of january in the morning, this Physician finding his Lordship encompassed with Symptoms so dangerous, that in his opinion he seemed to have computed the Hours and Minutes, beyond which he could not survive, and therefore peremptorily declared, that if another Physician of the Cabal was not called in, he would come not more; an expedient that was made use of by him, to draw his neck out of the collar. I told him, as he went down the stairs, he acted not only very ungratefully, having received so many Fees; but uncharitably and inhumanely, in leaving a Person of Honour in that condition, who now once in six hours was assailed with a Syncope, that sometimes for the space of half an hour rendered him in appearance little different from dead. Conceiving these Convulsions, and other Symptoms, to be occasioned by those venomous steams, attacking the Brain, and the whole genus nervosum, and consequently the Heart, through that nervous branch of the Sixth pair that is distributed to it, to which the English Surgeon did not only assent, but likewise offered such demonstrative Arguments, that I should not have expected from any of the Physicians, moved me to give his Lordship six, and sometimes eight drops of my own Balsam of Sulphur, (prepared after a mode not common in the lest) in an ounce of a Cordial prescribed by me: for now being left at my own liberty, I directed such Medicines as I thought proper to answer the present Indications. At the second exhibition the Syncope and Convulsions ceased. His Vomiting, which was caused by consent of the great Stomachick Nerves, and his difficulty of Respiration depending on the affection (by consent) of the Nerves, that are disseminated through the Diaphragma, were also very considerably abated. Notwithstanding the other Physician judged it prudence to change his resolution, and make officious Visits to his deserted Patient, to observe the event; and perceiving that the Symptoms went of so strangely beyond his expectation, on the third morning after he had left us, came into the Consult-chamber again among us, with much affability and Eloquence, intending to enter into consultation with me; but we immediately gave him the whole Room to walk in by himself. My Lord enquired the reason of our leaving the Doctor; answer was made, that he had a mind to come in upon the review, and it was thought sit, that since he left his Lordship in extremity, we aught to leave the Doctor, now the distemper had a better aspect: But however as for my own particular, if his Lordship was pleased to command me, or if his Honour's Relation would needs have it so, I was very willing to advice with so learned and eminent a Physician. My Lord waved it, and left himself wholly to our care. By the way, this is a plain instance of the result of Consultations, and the difference of a Physicians acting singly and freely without that disturbance, employing the utmost of his care and endeavours to the advantage of his Patient: Whereas in Consultations, especially grand ones, it matters not what the event is, there being a great many vouchers and shoulders, to bear the corpse upon; besides, ofttimes he that prates most, leads the rest by the nose. And to what purpose should any of them take much pains? For if the Patiented lives, the reputation of his Cure is equal to them all, as well to the Fool as the Knave; their Fee is likewise equal, he that saith little, hath as much as he that speaks all: Moreover, if any of them should prove refractory, or somewhat mutinous, be sure the rest would never consult with him again; which must necessarily prove a great loss to him. For there is abundantly more money got by Consultations, than single Practice: Neither Mayern, Prudgeon, nor Willis could have got a quarter of the estate they left, barring Consultations; moreover, it is a safe practice, and no hazard of a man's Reputation. Every Physician expects no lesle than a double Fee, and for that each of them will foist in his medicine, which too often proves to be such a hodgpot, that it sends the Patient in a little time to his Ancestors. Fernelius, Hollerius, Duretus, and Cardan, men in their time of far greater fame than any of my Lords Physicians, chanced to be called in Consultation; the one advised Bleeding, the other a Julep, the third a Decoction, the fourth a Cordial Bolus, besides many other Medicines, all to be used in one day: a great charge this must amount to! The Patient was a Youth troubled with a Headache, Drought, Gripes and Fever. The Physicians were no sooner gone, but there comes an Old-woman, recommended by a Jesuit, who without much consultation anoints his Belly, especially about the Navel, with a Lineament of Ox-gall, Colocynthis, and Aloës, which in lesle than an hour moved a Stool or two, and brought away five or six Worms: Upon this the Lad was immediately restored to his health. The Physicians returning next morning to see the Patient, who was abroad at play, were very ill-received by the Mother of the Boy, who called them Rogues, that would have killed her Child by bleeding; and Cheats, for taking her Money without deserving it. Some days before this Doctor left us, there happened a long dispute between me and two of the former Physicians, who baited me for three hours together in a Consultation, concerning a purulent evacuation, which I had observed his Lordship made by Stool. Here they cavilled, in objecting, they saw no passage by which matter could be transmitted into the Guts. I told them the passages were not different from those, through which Nature in a Dropsy, being stimulated by a Purge, doth throw of water, that is collected in the capacity of the Abdomen. Let them read Hippocr. Aphor. 14. Sect. 6. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Likewise it hath been many times observed, that in an Empyema the purulent collection hath been discharged sometimes by Stool, but more commonly by Urine, by the matter being admitted into the Vessels, and so by Circulation posted down. Read Scultetus in Armament. Chir. Observe. Lively item Obseru. 46. Felix Wurts in his Surgery, in the Chapt. Of Wounds in the Breast. Also Fabrit. Hildan. in his Obseru. and Skenkius, besides many others. In Impostnumes of the Liver and of the Mesentery, the matter is commonly evacuated by Stool, by means of the Vessels, or sometimes by perforation of the pus through the Guts. It was much about this time, since affairs went on so successfully, the Physicians of the Brotherhood made it their business to disperse themselves into most of the great Coffeehouses of the Town, where they sometimes reported, I was a Mountebank, sometimes a Surgeon, and othertimes an Apothecary, or a Chemist; for what I had done was merely by chance. I much wonder, how many such Mountebanks they can show me, that are of their combination. As for my Education, I question whether I have not had far better than any of them. The Latin and Greek Tongues I attained in the Low-countrieses; than was placed in Exeter-College in Oxford, Doctor Conant being at that time Rector, where I studied Philosophy several years; than went to Leyden, where I had one Collegium Theoreticum, and two Collegia Practica under Professor vander Linden, two Collegia Anatomica under Professor van Horn, and one Colleg. Botanicum under Professor Vorstius. I went twice a week to the Hospital with the foresaid Professor vander Linden, to learn to know Diseases, when they came before me, and how to cure them. I was also instructed there in the Chemical Art by a Germane. My Lodging was at a Surgeon's house, on purpose to learn the practical part of Surgery; once a day I went to an Apothecary's shop, kept by a Relation of my Landlord, where I was taught the trade of an Apothecary. After this I passed into France, to improve myself by visiting the Sick of the Charité-Hospital every day, for some Months together; and twice a week I went to l'Hostel Dieu, made what Observations I could, and committed them to Paper. Thence I made the petit tour, and in my way I took my Degrees in Physic, both of Bachelor and Doctor. Upon my return to Paris, I made an agreement with Monsieur jannot to dress and assist at the greater Operations in Surgery, at the forementioned Charité-Hospital: in the intervals of my Studies I was present at Monsieur Gayen his Anatomies, as many as happened to be during my abode there. I passed also a course of Chemistry with Monsieur Barlet. Hence I returned into Holland, where I was admitted Fellow of the College of Physicians at the Hague, as appears by their Dispensatory in print. After some months I returned to London, whence I was sent to Flanders, to be Physician (or Doctor-General, as they commonly phrase it) to the Army, where I continued till I was tired of the employment, and than took my course for Italy through Germany; passed away some time at Milan, Bolonia, and Rome; and having seen the other chief Cities, came back through Switzerland, and so down the Rhine to Collen, thence into Holland, and soon after into England, where I have continued ever since, and followed my Practice. Now how these Gentlemen can make a Mountebank, Surgeon, Apothecary, or Chemist of me, without touching their own Copyhold, I cannot tell: Sure I am, I was never a Renegado Divine, a Schoolmaster, or Trooper turned to Physic, or ever put the dice upon them by a forged Diplome from Oxford; neither am I a mere Velvetier, that hath nothing but the Plush-jacket on his Back, to show what Trade he is of; neither was I ever Member of a Society that harboured such, but scorn to be of it. I never gave Mercurius Dulcis to a Lady against Fits, that served me such a jades trick as to Salivate her, and put her in danger of her Life. I never advised a young Lady very lately to lose twenty or thirty Ounces of Blood, upon a spotted Fever, which killed her. I have at no time administered Laudanum Opiatum so unskilfully, that Patients never awakened again. I never gave Vomit or Purge, that killed the Patient in the operation. I have not prescribed a Purge very lately to a young Gentleman, whose small Pox appearing, was mistaken by the Physician for Heat; which the next day, when the Purge should have been taken, were plainly risen all over the body, and caused the Doctor to go to Prayers with the Lady his Mother and the Family, to give God thanks the Purge was not taken, and made his confession, that it would have killed him, had he swallowed it, standing ready upon the Table for him. Thus you see Physicians sometimes tie a Sword over your head by a hair. Was it not the Town-Idol, that by his Anatomical Craft directed the place of Incision in a Child, whose Anus was imperforated, upon the Sphincter Muscul, whereof the Infant soon died, he having wholly miss the Venthole? Did he not a considerable time treat a Lady out of Town, for a a Rhumatisme of the Shoulder, which proved a large Imposthumation ready to be opened, and upon apertion discharged above a Pint of purulent matter, and so was suddenly recovered; who otherwise by this Rhumatic course might have lost the use of her Arm, and possibly of her Life? But enough of this at present; Only jest they should run into an inconvenience by a mistake of the name, I will give them this Advertisement, That there is one Harvy, whom the courtesy of England gives the title of Doctor, he lives somewhere near Suffolk-str. learned his Trade of john ●ontaeus, and doth cell Medicines up and down the Country, though whether he keeps the Stage, I cannot inform them. Thus much for my own vindication. The Vulnerary Decoction and Bags derived their Virtues chief from Traumatic Herbs (viz. Pyrola Virga aurea, Sanicula, and some others) that were gathered on the Alps of Switzerland, and carefully dried, in energy and goodness far exceeding ours, which were presented to me by the Right Honourable my Lord Holles. The form of my Prescriptions of the Vulneraries, Cordials, and other Medicines, may be seen on the Apothecary's file, the transcription whereof I have omitted, not only because it would swell this Treatise into too great a mole, but chief by reason those, that shall think fit to answer this Tract, should have some matter to work on; So that I hope they will as faithfully transcribe my Bills, as I have done theirs: For I should take it very ill, if they should traduce me in that particular. A third Reason you shall also know in my Reply. My Lord's Diet was chief upon Broth made of Mutton, Veal, and Poultry; sometimes with Vulnerary Herbs in it, other times without. I allowed him no Flesh for a month or six weeks. From Glisters I disused his Body gradually; directing at first but one in two days, than one in a week, at length wholly omitted them for a long interval: They were either of Mutton-broath alone, or of Milk and Sugar, according as I judged requisite. My Balsam of Sulphur was continued; I directed also a Vulnerary Decoction; afterwards Vulnerary Bags to be infused in Eight-shilling Beer, and to be drunk in his usual Drink; likewise Cordials, and sometimes Cordials and Antepileptics mixed together. The effect of these Medicines were such, that in a short space his Urine appeared in moderate proportions, of a good laudable consistence and colour, and a healthy hypostasis. Than I thought seasonable, to add Comfry-roots and Milfoil to his other Vulneraries, to heal and consolidate the punctured Nerve. After this his Lordship went abroad for two Months, fling of his Medicines too soon, against my advice; only once in a fortnight I prevailed with him to take a Laxative of Manna and Syrup of Roses, dissolved in Broth. In the interim my Lord kept a very ill Diet, sometimes did eat Coleworts, powdered Beef, fresh Cod, Salmon, Tarts, and the like; dined often abroad, where he scarce refused any thing, that was brought to the Table: Drank all sorts of Wine, though moderately; and once beyond other times drank sharp Rhenish-wine upon a plentiful Dinner of fresh Cod, which occasioned a smart ebullition of his Humours, bursted open again the Puncture, that was so lately healed, and procured a fresh Gleet, so violent, that his Lordship relapsed into Pains as great as ever. There was no way to stop the impetuous current of this Gleet, and consequently to remove his Pains, but by giving a lift to his humours, and turn the stream upwards; which I performed by raising a Salivation so gentle, that his Mouth was scarce sore, or his Face swelled: his Lordship did not salivate above a Pint and an half in 24 hours, neither was it continued beyond seven or eight days. The Salivation was no sooner raised, but his Pains vanished immediately, and in the time of the Flux recovered his Appetite and Strength; an observation contrary to what it useth to effect in others. However, this was a Demonstrative Argument à juvante, that his Lordship's pains were occasioned, by a venomous Gleet from a punctured Nerve. Upon this I caused my Lord to take two or three Sweats, upon a draught of a Decoction of Sarsa with Vulnenaries, in a chair, to sweated out the remains of the Mineral, and dry up the superfluities of the Succus Nervosus, and other humours: Afterwards continued the same Decoction for some time, though not so long as I did advice. In every draught of the Decoction were used ten or twelve Drops of my Tincture of Antimony, which put his Lordship into a condition to be abroad again for several Weeks; but returning to an irregular Diet, fell into a plain Rhumatism, viz. smart Pains in his Breast, which after a short continuance would remove to his Shoulders, thence to his Neck and Elbows, and sometimes to his Back; for this I advised his Lordship to be blooded a moderate quantity, twice in eight days, or thereabouts, by which means this foresaid Rhumatism went very well of. Than I used all the persuasive Arguments, not forgetting that of the Pitcher going so often to the Well, to observe Rules strictly, and particularly those relating to his Diet, which my Lord thought a Penance so great (as indeed it would have been to any man, that had been so long in a course) that he soon shaken of all directions, and was again as irregular in his Diet, or rather more than before. The effect of this proved likewise worse than formerly; for besides Pains, I began now to observe matter (pus) in my Lord's Urine, about the quantity of a dram, which by degrees increased to the measure of a spoonful or two, and that of an ill colour: For deterging, I gave his Lordship some of my Balsam of Sulphur, likewise another Tincture of Antimony, with directions how to use it in a Vulnerary Decoction that was prepared, sometimes with vulnerary Herbs, boiled in a small Aqua Calcis, and sometimes in water and a little French-wine. The matter by these means soon grew of a better colour, and well-digested into a white pus, than gradually diminished, until it came to that pass, which required consolidation and healing: To which intent I gave a Tincture of Mars of my own preparation, which being all used, as much as I had of it ready prepared, I was forced to advice Tunbridge-waters, having a Virtue not only to cleanse, and consolidate, (witness many that have been cured both of internal and external Ulcers) but to discharge the malignant Gleet of the Nerve, to which I ever had a particular regard, as being the cause of all. These Mineral-waters were drunk with so great success in Town, that I was encouraged to persuade his Lordship to go to the Wells, where the waters, by the observation of all people, are found much more effectual: But it happened, that the rockiness of the ways thither had so disturbed those tender parts (which might have been prevented by a Litter; but that my Lord would by no arguments yield unto) that it threw him into his pains, which so put us out of our course, that it was not in the power of Art to recover our point again; neither did his Lordship drink the Waters more than once; which he should not have done, had I been present. Being returned to Town, the Ulcer recruded again, and discharged matter, sometimes for eight or ten days, until what was engendered was quite drained; than there was an intermission of the discharge, until there was a sufficient quantity regendred, which would than again be cast of by Urine. At length there was so great a Debilitation of the Nerves and Brain, occasioned by the frequent return of the Pains, and regurgitation of the venomous Gleet, that it ofttimes cast the Patient into Cataleptic Fits, which by internal Medicines, the application of Ventoses and Epispastics, I did more than once bring his Lordship of, beyond the expectation of all persons. His Body being daily more and more macerated, his Spirits diminishing, and Strength extremely impairing, God Almighty was pleased to deliver him of all his miseries, on Michaelmass-day in the morning, about seven of the Clock. His Lordship's Body was opened two days after by command of the Coroners Jury, who aught to have understood, it was my business (who had attended this Noble Patient three quarters of a year, and in all probability knew best, where to discover the Cause (the occasional of his Death) by directing the Surgeon, Monsieur &c. (a Master-Surgeon of Paris, and of the Hall in London, that likewise attended last) in the Dissection: But it was so managed, that the other Physicians and Surgeons had designedly so pallisadoed themselves about the table, that I had only room to peep through, to observe the hand of the dissecting Surgeon, that he might not drop in a Pibble into the hollow of the Kidney, to palliate the reputation of his Masters. After they had left the Room, I returned to make a narrower search than they had done, there being also present two Doctors of Physic, not of the College, who were both very expert Anatomists. Here I found all his Entrails sound, not the lest Stone or Gravel in the Kidneys; but the Psoas Muscul, on the left side, was gangrened, and part of the Colon, both being turned black, though not sphacelated: for in a Sphacelus, which is a perfect Mortification, the part is so rotten, that it will scarce hung together, and is usually attended with a stink; whereas a Gangrene is only a tendency to, or the beginning of a Sphacelus. I likewise observed, that the foresaid Muscul, comparing it with the Muscul of the other side, was diminished one third part, being corroded away, and turned into matter, that was engendered through the Ebullition, or in their sense Fermentation of the malign Gleet and the Blood, which being received into the Veins, was by Circulation carried to the Emulgents and Kidneys, and thence with the Urine to the Bladder, in the same manner as I have already mentioned before. So that here in this part was the Ulcer, where no matter was found at that time; because it had been drained and carried of before, his Lordship not having discharged any matter five or six days before his Death. Moreover, pressing hard with my Fingers upon the said Psoas Muscul, that was so extremely wasted, I felt those great branches of Nerves of the first and third Lumbal Conjugations (whose anterior branches are disseminated through its body) like a cord, rigidly contracted, and knotted throughout, a true sign the Puncture was in one of those Nerves, neither was any other accident capable to produce all these and the other Symptoms; so that it was no wonder, if upon contraction of the Nerves, his Lordship's left Leg was contracted shorter than the right. His difficulty of breathing was beyond all dispute occasioned by consent of a branch of the first Lumbal pair of Nerves, that is distributed through the carnous part of the Diaphragm; likewise his Gripes by consent of those other branches of Nerves, that excur to the Guts. The pretended tumour on the left Ilia was only a tension of the Membranes. In Conclusion, I will presume to offer these Queries. 1. Whether I ever receded from the opinion I first stated, or from the Indications I first desumed. 2. Whether it be not probable, had I acted as variably as others have done, these great Physicians would have judged Oribasius de Laqueis a fit author for me to read than Hypocrates. 3. Whether a good old Surgeress in the Country might not in the beginning have been more successful with a Poultess of a few green Herbs on the Common, and the good Allom Posset. 4. If the method that was followed by me, had been used at the time, when they began to give his Lordship Opium, and before they had made use of their Pickaxes and Shovels, whether in all probability the success would not have been different. 5. Whether it was not as ridiculous as malicious, in some of these Physicians, to report, that two or three small Doses of Mercurius Dulcis, (whereof Children of three or four years old have taken six or seven Doses with great success against the Worms) and those consented unto by the chief of 'em, as appears by his Mark set to the Prescription, should have done his Lordship the lest injury, having been given at lest Six or Seven Months before. I have no more to say at present, but, From grand Consultations in Physic, Liberae nos Domine. Amen▪ FINIS.