The Poor Man's Relief. HAving sent abroad a Paper, signifying, That I desire the Poor as well as the Rich might have the benefit of that Talon which God had given me: which was the scope of that Message to the Parishes of this County binding myself by Public Engagement, to acquit the sincerity of my proposal herein, by registering all the undertake which providence in this nature should send unto me. I found presently those different effects this general prescript wrought upon men's humours, many approving it, by attestation of subscription: Others approving the thing, but doubting of the probability of having it effected. For removing of improbabilities (as well as I am able) is the sum of this Relation. In a public work all the Instruments must be answerable to their parts, or otherwise the design will fail in the doing. 1. The Ability, Honesty, and Faithfulness of the Physician. 2. The liberal and willing Contribution of the Benefactors. 3. The Care and Diligence of the Chirurgeon and Apothecary. These are the parts, if any of them fail, the work is impaired. 1. To the first, I shall acquaint you with the Objections of mine own Heart; when I discovered, that Providence did require I should put forward the motion for supply of the Poor, and settling (if it were possible) an honourable Maintenance for Physicians. The first Objection was, That I could not speak herein, but 'twould savour of Self-love, and Covetousness, which I had most cause to abhor of any thing. This was removed, by freely acquainting a Christian Magistrate, how God had dealt with me in cure of this Gangoreen, which corrupts the welfare of common good. The next Objection, was the sad reflection of my distemper and weakness of bodily and Spiritual strength, that 'twas not probable I should manage such public affairs answerable to my promise and expectation of the County. To this, I thus concluded, That having learned by experience, how much discouragement had wronged the free mercy of God, who delights to make his power known by effecting great works with most despicable and improbable Agents, I durst not give way to such thoughts, but to prosecute it so far, as I found his assistance therein: And if it please him to enable me so long, as that I may moddell this undertaking in such a method, that an other may as well execute it as myself; When so much is done, then shall my Conscience in discharge of my duty, be at quiet. Wherefore I declare, That this proposal is presented upon no other resolution than this, namely, if God please to continue my life and understanding but one Year or two, I hope, through his blessing, to acquit men's expectations of the good that will accrue by it; and to let them see, by Publishing my prescripts, and annexing the observations, what effect they have had over men's infirmities and bodily distempers, and rating every such Prescript as equally to their cost of making, as may be: That then I desire to cease and execute it no further, having work enough at home. But only to recommend your charitable Contributions to Dr. Edward Wilson, and Mr. William Tonstall, to whom God hath given gifts of mind, and health of body proportionable for so great a work. 2. To the second, 'Tis in your hands to look to it, you may find some motives following, that will let you see (besides what your own Consciences will dictate when you are upon your sick Beds, and feel the comfort or want of Physicians help) That 'tis God's will, You love your Neighbour as yourselves. 3. To the third, For the care and diligence of the Chirurgeon, by nominating the man we shall employ (his demeanour hath been such already) that I hope 'tis enough to satisfy you herein, Mr. Thomas Cooper the younger. For the care of the other, I shall undertake for them, so long as I meddle in this business; And then, experience of their accounts will confirm your approbation of them. These things premised, you may see likelihood enough for a constant settlement of your Charity: and that the work is distributed amongst five persons, two Physicians to give advice, the other three to attend and administer it, which they may mutually prosecute without distinction of Surgery, or servant Apothecary; for as our Surgeon with assistant advice, may knowingly and safely give such Physic as we shall direct; so the other two, having seen the experience of our practice, may be useful to help (following the direction of the Surgeon and Physician) the poor people in any bodily infirmity. This, I hope, may serve to assure you, That (if plentiful contribution be not wanting) there is probable means enough to do the Country, both poor and rich, much good. And that you may know how little my hand is in this design, I shall relate to you, how I neither begun, nor prosecuted it otherwise, than providence directed, my Conscience urging me thereunto. It was my occasional Discourse to a Magistrate of this County, touching the benefits of having an honourable standing maintenance for approved Physicians in this County, and the many sad evils which was daily contracted by the neglect hereof, and at how easy a charge it may be accomplished. plished. To instance the benefits. First, The succour of the Poor, whose cries were loud, that there was none to help them, but they must live miserably, or die desperately, in adventring their bodies into the bands of such as had no promise of God's assistance and blessing to practise Physic, being un-called and unfit thereunto. And though this evil hath troubled the Commonwealth, as appears by the Laws made against it, yet could it never be prevented otherwise, then thus, by propounding to them, how they may have advise of Physicians and Physic for nothing. Secondly, The good and safety of all; For, whereas it is generally believed, after once any hath made use of a Physician, and God hath blessed the means with Success; that Party may with more security, rely upon the same Physicians advise, then upon a strangers, who knows not by experience the disposition of the party to Physic, but only by probable arguments. Now supposing the Country Physicians, which had most of the practice, were obliged to Register all men's cases as they were presented to them, freely writing the particulars of their Medicines, then may both Patient and Physician that comes after him, know better how to proceed, when next occasion is offered. Thirdly, The advance of Knowledge, he being engaged within the limit of the first three Years, to Write a Book of the Body of Physic, which may be supposed the Sum of all his Reading and Study, which being still kept, might further his Successors. And if in his practice, he meet with any particular secret, he likewise should note that for the same end. Fourthly, The Glory of God. We say, take away the Cause, and the Effect ceaseth; this is an undeniable Principle, yet ordinarily it is contradicted in the Physicians and Patient's practice: For the Cause, Principal, Antecedant, Concomitant, and sine qua non, is Sin, and that in every Disease, this therefore in right Method should first be removed, but it is last thought upon. How would God bless the precedings of the Physician, and Sanctify the sickness of the Patient, if that order were made, That none (if necessity did none prohibit) should expect a Physician's assistance, before the Minister have Visited him, except the sick party he a Recusant? To sum up all, Whatsoever evil were desired to be removed, or good done that laid in the power of the Physician, he being the Country's Servant, might have such Rules prescribed by the ablest of the Benefactors, that he should not transgress to the prejudice of either soul or body. And although all this were approved of, yet little hopes appeared, that these wasting times should make up so considerable a sum, as this business required: Therefore I presented to the Justices (whom I took to be the Physicians, depured of God for relief of the poor) motives of consideration in behalse of the indigent people, that they would but consider how many sad events in one Year happens, for want of those remedies which were (by God's Ordinance) as necessary to preserve life in time of infirmity, as Meat and Drink in time of health. This motion (though approved) yet could not be granted, because the Law allowed of no Assessment for relief of this nature. Failing here, I resolved to try the Friends God had given me, and see if they would make contribution, which might be in answer hereunto. And from all that I mentioned it unto, I received such encouragement through their Liberality, that I was induced to move it to the rest of the Country, that all might have notice, and no man might be excluded that desired to join assistance to this work of Charity. Wherefore I judge it my part to propound these two Cases. 1 I wish (unless they resolve to settle a maintenance standing for County Physicians) that I may have the liberty (without the ill will or censure of any man) to signify to those my Relations, who have no jealousy of my proposal, That I may have what contribution they please for the poor Yearly, and I shall faithfully disburse it upon those whom they please to recommend to my care, in cases of Physic and Chirurgery: And they will see Yearly what account I shall be able to give them, wishing from my heart, that all other Physicians would do the like to their Relations, that so the work may be better distributed amongst us. 2. If they do resolve to settle a standing allowance as is expressed, I shall give them my best furtherance and assistance in it, Thus; First, I consider the charge of Money, That it will be necessary to indent with one Chirurgeon at the least, binding ourselves to pay him twenty pounds per Annum, during the time of this Contribution, for his care and pains in cases of Chirurgery, which we shall recommend to him, giving him our assistance and advice herein; and defraying all his charge that is expended about it. In like manner it is necossary, That we indent with an Apothecary, allowing him accordingly for making up our prescriptions, and distributing them without payment. It is also necessary, That an other be indented with for attending those preparations which are done by the Art of Chemistry; and least people may conceive this to be needless: I desire to let them know, that it is absolutely necessary and convenient, because none ever practised Physic, but he found continual use of such Medicines, though he thought it a point of discretion to cover his practising of them from the know ledge of the Patient, which is generally affrighted with the name of a Mineral, because the unskilful practice of many, hath occasioned this misprision of Chemistry. If I be not believed herein, let any Graduate Artist charge me with a Lye. Besides (to those that know me, I speak) unless the Lord had signally instructed me in some thing of this Art, and witnessed his approbation therein, with concurrences of his blessing, I should (since the time I knew myself) never have dared to harbour one hours' study in these matters, wherein I had failed so much in expense of time and money formerly: I will not say more herein, then may be satisfactory to the Contributors, that the hopeful improvement of those scraps, which I have gathered hic & ubique, I shall bequeath into good hands for their use. Again, 'tis necessary that so much be allotted for provisions of Diet and Lodging, during the Cure of such, whose Maladies require daily attendance here in Town. It is convenient, that there be a Library of Physic Books, and a small Annual sum for enlarging the same. These are the Charges, as appurtenances to the main Disbursements of Medicines and, Maintenance of Physicians. The Account which we have engaged to Register consists of two parts. First, The Account of the Money Received, and how it is Expended: it is done in this Form. Contribution of each Parish. The whole sum of Contribution. The Disbursements. For Medicines, as appears by the Apothecary's Bills To such a sick person. Paid for Lodging and Diet of such a sick person for _____ Days Paid for Surgeons, and Messengers, for Charges of Houses and themselves in their Visits. Paid for Printing, Writing, and sending Letters, and for the Collection. Remaining in our hands for our pains and advice to be lessened, or augmented, as the Contributors every Year shall think fit— For this is our desire mainly, that moneys be not wanting for necessary charges of Physic, and attending it. And for our advice, we refer it to the County, when they see what we have done, which will deserve more one Year, than another. The second Part is the Account of God's blessing on our Endeavours towards the Poor. If this Account be without fraud made legible to all men's capacities; then the mouths of false fears and jealousies are stopped: which that they may be, I desire the Information in the behalf of any poor creature, be in this Form. A. B. Inhabitant of C. about the Age of _____ Years; such a Day was in this manner afflicted, contracted as is supposed, by occasion of _____, or not: who was formerly of sound Health, or otherwise inclineable to such a Distemper. It continued after such manner, till this time _____ This is the Water, we refer him to your Care under God, and we promise for him you shall have an Account what Effect those Means shall produce, which you direct. This I judge requisite, left the Country fashion be observed, in sending their Urine without further Information; supposing we shall know enough thereby, how, safely to Administer Advice in all Cases. After the Information is Registated, the Advice of the Physician I promise to Register. It is judged, That the Information Signed by A. B doth manifest a putrid Fevor, wherefore let there be Administered after Bleeding, First, A preparitory Potion; A Vomit the next Day; And then a Cordial sweat, as they are known by their Names in the Pharmacopaea Dunelmensis. The Effects whereof, as it hath pleased God to dispose, may be Read in the Catalogue of the returns sent from the poor Patients, to be Collected together in one Book. So when the Information is Viewed, the Judgement and Advice upon it; the Prescriptions to the Apothecary, how they answer the Advice, and the Returns what Effect such advice hath produced, I hope I have acquitted the Engagement. For the Remote Parts, as Darneton Ward, lest distance of Place make this Proposal less Effectual in their behalf; I do promise to leave a Chest of Medicines, and employ one thereabout, who shall carefully prosecute the intent of our Design, with less trouble than coming to Durham, except in cases of difficulty. This also I wish may be known, That two Months about Midsummer, being a Season, but in extreme cases, unfit to move the humours in the Body, I shall attend my Duty at the Well on Gaterly Moor, adjacent to this County. This Water is of the Nature of Sweet Spas, which partakes of Vitriol; the Spa at Knaisborough a little exceeds it in this property, and therefore is more effectual for Gravel in the Kidneys: but for Diseases of the Female Sex, proceeding from the Spleen and Matrix; as also for Worms, and all other Diseases, none excepted (with due care of Physic taken.) This Water hath the pre-eminence, (to my judgement and experience) of others in the North Parts; the Reason from hence is, That it partakes of the Tin and Lead: the former Mettle is approved to be of use in men's Bodies next to Gold; from the latter, it hath properties which are known to Physicians, and therefore is not safe for Women Conceived to meddle with it. I wish this necessary Caveat be not abused to sin I hope the Country may be now satisfied, That if there be no want on their Parts of Charity, the Poor shall not suffer in loss of Health or Life, so fare as my Care and Endeavour can prevent. And seeing the only ground and bothome of this undertaking (next to the approbation of God) is the good will and opinion of the Contributors, having no fear at all, that they by exceeding their Contribution with Messages of Patients, have purpose to impoverish me in my Actings for the Poor: Wherefore as I hope to be Instrumentally helpful to them, let no Man forbear to send to us in their behalf when there shall be need. These things premised, I desire it may be Published as followeth. THese are to signify, That George Tonstall, and William Tonstall Residing in Durham, have undertaken to supply any Poor Person, being an Inhabitant of this County, that shall be any way infirm, with Advice and Physic according to their best Skill, in all Cases wherein Physic or Chirurgery is required (except in the case of common Plague) without any charge to them, from the first of April 1655. And they desire, that such Gentlemen, Freeholders', and others, who think sit to Contribute in this Charitable Proposal, towards the Discharge of the Physic, and necessary Charge hereof, to subscribe their Names, and the Sum they will freely Yearly give, to be returned to us. And that they will Yearly Pay such Sums to the respective Ministers of the several Parishes, for our Use: the one moiety on the first of May; and the other moiety on the five and twentieth of December: And they do Engage to Register their proceed, to that end the said Contributers may receive Account Yearly how they discharge their Trust herein. Provided such Poor Person Inhabitant as aforesaid, that shall apply themselves unto the said George and William Tonstall, do procure and send a Note or Certificate from any * It is denied when conveniency will permit, that one of them be a Minister. three of the said Contributers, that they are of such as are intended within this Charitable Proposal. The only design next, in prosecution hereof is, to frame a Dispensatory in such a Method, that if any Person can but have true advice what kind of Remedies is needful for them to use, then shall it be sufficient direction to mine Apothecary what to give him, without prescribing such and such things in particular. And this, I hope, will be a beneficial work, because men prophessing Physic, seldom differ in Judgement concerning what is to be done, and after what manner. The Logical rules of Art lead men together thus fare: but with what shall our intentions be performed, here lies the Dispute? For it is natural, that he that hath made his practice with such Receipts, will not yield to alter them upon another's commending his. This knot will be loosed, when the Dispensatory is Viewed, with Observations how they took effect; Physicians than may judge of them. I wish them so much comfort, as a willing heart, to adjoin their Receips hereto: And when all is approved on, none need differ in using them. An Abstract of the Poor Man's Panacaea, or Pharmacopaea Dunelmensis. The Rational Method of Cure, is performed by Indication. And the subject of Indidication, is either 1. Causa Materialis. Antecedent. Continent. 2. Pars affecta. 3. Symptomata. 1. The Material Cause being praeternatural, hath for its Indication Evacuation, which is either of 1. Blood. 2. Humours. 3. Worms. 4. Stone and Gravel, 5. Wind. 6. Malign Vapours. Externall accidents Thorns. Splinters. Dirt and gravel, etc. 1. Blood hath its Evacuation by Lances, Leeches, etc. 2. Humours are divided ordinarily into Choler. Phlegm. Melancholy. Water. These have their proper Evacuatories Evacuatories in General are Vomits. Purges. Salivation. Sweats. Diuretics. Blistering. Fomentation. which are either Internal Drink. Cordial Electuries. and Powders. Externall Bath. Fuming. in Particular, Errhina. Apophlegmatismi. Tussilagogs', &c. Evacuatories by Stool are either in form of Pills. Electuaries. Potions. Powders. As Reason sees cause to vary. 2. The part affected: This hath for its Indication, Corroboration, which is performed by opposition of helps homogenial to the temperament, and Humidum radical. This Humidum radical, consists in the influential heat of the Heart (which communicates its life and vigour to the whole Body) and the innate heat of every Part or Member. These helps are Aliments. Medicaments. Medicaments are such as we call, Cephalicks, pectorals, Cordials, Stomachicks, Spleniticks, hepatics, Renall, and Matricall; these are peculiar to the noble parts of the Body, which respect the innate heat of each particular part, with a sweet spirit agreeable to the Vitals: The variation of this Indication is only in respect of the temperament in hot Distempers. cold Distempers. 3. Symptoms. These are such Effects as follow the Disease, and have for their Indication their contraries. The common Symptom, is pain; its contrary is Anodine. The other Symptoms are divided, in respect of Spitits. Blood and Humours. 1. Spirits, as Want of Sense. Want of Motion. Watchfulness. Drowsiness. 2. Blood, and Humours. These are divided in respect of their Qualities First. Second. Motion. 1. First Qualities are Heat. Cold. Moisture. Dryness. 2. Second Qualities are Thinness. clamminess. Grossness. Motion, proceeding from the Head. the Stomach. the Belly. the Liver. the Kidneys. the Matrix. Thus the material Cause, which is the main opponent, is discovered; the part affected strengthened, and the Symptoms removed; which comprehend the whole Method of Cure belonging to the Physician. Now followeth Chirurgery, which is a Method performed by manual operation upon the Body. The parts whereof are either Similare. Organical. 1. Similare are Bones. Nerves. Veins and Arteries. Membrans. Flesh. 2. Organical are Head. Palate. Ears. Eyes. Nose, etc. Infirmities belonging to these Parts, are either Tumours. Ulcers. Wounds. Imposthumes. Contusions. Gangrenes. 1. Tumours are Phlegmon. Erisipilas. Oedema. Schirrus. Flatulent. Scrophular. Wens. 2. Ulcers are Simple. These require only Consolidation. Compound. These are Mild, these are Plain. sinnuous are Callons, as the Fistula without callosity Malignant, and corroding, these are Herpes. Phagedaina. Noema. Cancer. Leprosy. 3. Wounds. 4. Imposthums. 5. Contusions. 6. Gangrenes, vary according to the division of the Parts. The Remedies answerable to all Indications in Physic and Chirurgery, shall (God willing) be fitly Composed and Annexed to every branch of Indication, expressed in this Abstract. Therefore when the Pharmacopaea Dunelmensis is Compiled, you may see our business is little more, then to give advice. This Commodity also will arise, That if the Contribution will amount to no more than will find the Poor with all Medicines necessary for Physic or Chirurgery; then may they have Advice gratis from any Artist, having such Remedies for their use in all Cases, as shall be Published. FINIS.