THE LONDON PRACTICE OF PHYSIC: Or the whole Practical Part of Physic Contained in the Works of Dr. WILLIS. Faithfully made English, and Printed together for the Public Good. LONDON, Printed for Thomas Basset, at the George in Fleetstreet, and William Crook, at the Green-Dragon without Temple-Bar. 1685. THE PREFACE. THere are many Persons to whom the Voluminous Theory of Dr. Willis, might prove tedious, who would be desirous of having the Practical part in his Works entire by itself; and all 〈◊〉 will find themselves here gratified; and doubtless there are many Perusers of his Theory, who will not be without his whole Works; and 〈◊〉 will be equally desirous to have this Practical part by itself, as a Portative Manual to direct them in Practice on all occasions. The parts 〈◊〉 Dr. Willis's Works which contain Practice in them are these, 1. His First and Second Parts of his Pharmaceutice Rationalis. 2. His Tract of Convulsive Diseases. 3. His Tract of the Scurvy. 4. His Tract of the Diseases of the Brain and Genus Nervosum. 5. His Tract of Fevers. As for his Tracts, 1. of Fermentation, 2. Of the Anatomy of the Brain, 3. Of the Accension of the Blood, 4. Of Muscular Motion, 5. Of the Soul of Brutes, etc. they are all Theory, and contain nothing of Practice in them. That which you have in this Volume, is, all the Practice of Physic contained in those first five Tracts; I say all the Practice of Physic there contained, because there is not a great deal of Theory even in those which is not here inserted: For instance, Dr. Willis, in the First Part of his Pharmaceutice, is very large in giving the Anatomy of the Stomach or Ventricle, and of the Guts, being the parts which he calls the first passages, and he gives many Figures for the Illustrating what he there says concerning them. In the second Part of his Pharmaceutice, he 〈◊〉 large in like manner in giving the Anatomy of the Lungs, etc. Now these things are here omitted as being besides the design of this Work: Again, Dr. Willis, in many parts of his Practical Works, is very large in the Pathology of Diseases, and in the Aetiology of Symptoms; as to these also, I have been wholly arbitrary in them, often omitting what was conceived too Prolix, and setting down barely what was judged necessary for Illustrating the Nature of Diseases. To obviate therefore all Cavillations, which any Man shall pretend to make against this Work, as imperfect; on the account that all that Dr. Willis has written in his Books of Practice, 〈◊〉 not here contained, I shall give you 〈◊〉 short what you may here expect. First, You will here find all the Definitions or Descriptions which Dr. Willis gives of Diseases and Symptoms, together with as much of the Aetiology and Pathology as was conceived necessary or would be desired in a work of this Nature. Secondly, You have always here 〈◊〉 Method of Curing in any Disease, containing all his Physical Indications and Intents of Curing, none being omitted throughout his whole Works. Thirdly, There is not a Recipe 〈◊〉 order to the Cure of any Disease in a●● of his Tracts, but it is here inserted I have been induced to believe on several Grounds that the Practical pa●● of Dr. Willis's Works, set forth after this manner, would be acceptable 〈◊〉 many. For, in truth, besides the cheapness and portableness of the Volume, 〈◊〉 any Persons unacquainted with the 〈◊〉 Tongue buy Dr. Willis, it cannot be thought that they will have the patience to peruse a deal of Theory, consisting of large Anatomical and Physiological Discourses, and the like, which though never so clearly delivered in English, cannot be comprehended by them under some years study: And again, those who understand the Latin Tongue, will certainly be better pleased to read the Theory at large in the Original, than in the English, and having this ●●anual of Practice by them, they will and Dr. Willis's Theory of Diseases so ●●irly hinted in the Indications of them here given, that if at any time they have forgotten it, they will easily call it to mind again, having once read it before. The order observed here in placing the Books of Practice of Dr. Willis in this Volume, is not according as he writ them one after the other, neither is it conceived that if he were now to publish his Works together himself, he work 〈◊〉 so place them. Wherefore tho' his Pharmaceutice was the last Book he 〈◊〉 yet it is placed here in the first place, in regard that the first part of it contains the ●●nerals of Physic; it treating of Vomit 〈◊〉 Purging, Sweeting, etc. Which Generally ought to precede what he writes on particular Diseases. After the two parts of 〈◊〉 Pharmaceutice, we set his Tracts of Convulsive Diseases, and of the Scurvy, which 〈◊〉 designed as Praevious and Introductory 〈◊〉 his Tract of the Diseases of the Brain 〈◊〉 Genus Nervosum; which follows next; 〈◊〉 in the last place we put his Tract of Fev●●●●. As for the Head Title prefixed to this Volume 〈◊〉 where it's called the London Practice 〈◊〉 Physic; no man haply may wonder at 〈◊〉 if he considers, that whatever Medicine 〈◊〉 Dr. Willis, with his great Diligence 〈◊〉 most accurate Judgement, both in Consumptions, Practice, and on other occasions, 〈◊〉 served to be most in use here, and most rationally prescribed, he always carefully recorded them, and everywhere throughout his Books, here Printed, set down the most select forms of them, as he often declares himself: Some parts of his Works indeed were written at Oxford, as his Tracts of Fevers, of the Scurvy, and of Convulsive Diseases; but in regard the chiefest parts were written here, I mean his two parts of his Pharmaceutice, whereof the first contains the Generals of Physic; and his Tract of the Diseases of the Brain and Genus Nervosum; I think the Title may bear for the reason before given. I well know that Dr. Willis's Works are set forth together in Folio in the English Tongue. But as this Book is of a different Nature, it containing only a Synopsis of his Practical part, the large Theory being omitted, so it has its peculiar use: As for the way of Translation used in this Work, any Man who pleases to compare a Leaf of what is here done with a Leaf of the former Translation, will easily find that this is no Transcript; the way of expression being very differing; and we often disagreeing as to the sense of Dr. Willis; in which others will judge who has done him most right: and as I do not doubt but now and then therè may be found a more apt expression than what I have used, so I conceive there is no very material error in what I have written; and without Animadversion, or Insisting on particulars, I shall take freedom to say that I believe what I have here Translated will be judged by all Men to be more easy, correct and clear, than what has been done before. Eugenius 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. THE LONDON PRACTICE OF PHYSIC, Contained in the First Part of the Pharmaceutice Rationalis of Dr. WILLIS. CHAP. I. Instructions concerning Vomiting, with Precepts of Vomits. THat a Vomitory Medicine may be duly Administered; We ought to consider what are the Indications or Signs which foreshow the want of it, what things permit it, and which prohibit it. It is a sign that a Vomit is needed, when a bilous and bitterish humour floats in the Ventricle, so that from thence a nauseousness, an ungrateful savour, or a Headache is caused: Also if the Stomach be burdened with a viscous Phlegm, as in the longing disease of Maids, and in Men after Surfeiting, and disorderly eating or drinking. In most cases when with a difficulty of breathing, the loaded Ventricle is affected with a loathing of meat or nauseousness, upward Purging is a common Remedy. Moreover, when the Stomach is beset with some Exotic ferment, so that it presently casts up whatsoever is taken into it, even though the cause of it proceeds from some remote parts; Vomiting is often advised with good success: for by this means, the Vessels that contain the Gall being very much drained, the Choler is emptied from the Blood in a more plentiful manner, and its Feverish distempers are taken away. Again, forasmuch as the Superfluities or Stagnations of the Nervous humour are most easily Cured by this means of Evacuation; the use of Emetics contributes not a little toward a Cure in the Gout, Asthma, Epilepsy, Madness, and very many other Diseases which are accounted great, and most difficult to be conquered. Secondly, As to things that permit this Remedy, it may be given where there is a strength of the Viscera, and a firm constitution of Body, and especially to those whose Neck and Breast are but short, so that there is a nearer passage from the Stomach to the Mouth: We are encouraged also to give a Vomit to such as Vomit easily, and bear it well, and when the matter to be expelled is lax, and comes away readily; also when we find Nature in a calm, and as it were at leisure for such an undertaking. Thirdly, The use of Emetics seems to be prohibited, where there is a difficulty of Vomiting, or an unaptness to it found by former experience, where there is a tender and weakly Constitution, a tall and slender Stature, infirm Inwards, and especially if there be a Consumptive Disposition, with an Ulcer of the Lungs, or Spitting Blood; also where there is a too great Cachexia, in which there is danger, lest the humours should be forced from the whole Body all on a sudden into the Ventricle: Moreover an unusual effervescence of the Blood, the fits of Fevers, and an expectation of a Crisis, do wholly exclude this sort of Medicine. Prescripts of Vomits. TAke Oxymel of Squils' an Ounce and a half, Wine of Squils' two Ounces; mingle them and make a Vomitory. Take from Six to Nine fresh Leaves of Asarabacca; bruise them, and put them into three Ounces of Whitewine; squeeze them forth, and let it be taken cum Regimine. Take Powder of the Roots of Asarabacca, from a Dram to four Scruples; Oxymel of Squills an Ounce and a half; mingle them, and let it be taken in a draught of Posset-drink. Take Salt of Vitriol, from a Scruple to two Scruples, or a Dram; let it be taken in a draught of Posset-drink. Take the Infusion of Crocus Metallorum, from half an Ounce to an Ounce, or an Ounce and a half; let it be taken in a draught of Posset-drink cum Regimine. Take the Infusion of Crocus Metallorum six Drams, Wine of Squils' an Ounce and a half, Syrup of Vinegar simple half an ounce, mingle them and make a Vomitory. Take Sulphur of Antimony from six Grains to eight, Cream of Tartar a Scruple, mix them and let it be given in the Pap of an Apple, or in a Stewed Prune, or in a spoonful of Panada. Take Mercurius Vitae from three Grains to six, let it be taken after the same manner; after the like manner may be taken the Flowers of Antimony, Aurum Vitae, or the Solar Praecipitate, and Turbith Mineral. CHAP. II. A Cure for over-working of Vomits; and Anti-Emetick Medicines, or such as stop Vomiting, with Instructions. IF a Vomit over-works, let the Patient presently be put to Bed, and let him make use of both External and Internal Remedies; and first of all to appease the disorders in the Stomach, let there be outwardly administered to it, either a warm-Fomentation of the decoction of Sea-Wormwood, Mints and Spices in Red-Wine, or let a slice of the Pith of Bread be Toasted, and dipped in Claret-Wine warmed and applied thereto: Let there be a Glister given of Milk, with Treacle dissolved in it. Let also warm frictions of the Members be used, and strong Ligatures above the Knees to keep Convulsions from those parts; let the Stomach in the mean time be kept empty, unless an inclination to faint, or swooning otherwise requires, but as soon as it is able to receive any thing of Food, or Medicine, give some Cordial Water or m●●●● Burnt-Wine: In case the Affect be very violent, and the Pulse admit it, Venice Treacle or Diascordium, sometimes also a Solution of Laudanum or an Opiatick Tincture do well. Preternatural Vomiting stirred up from other causes, is either Critical or Symptomatical: In the former nothing must be done too much in haste or unadvisedly; that excretion so there be a sufficiency of strength ought not to be stayed, but the discharge of the matter to be expelled, is either to be facilitated or hastened, or it is to be converted some other way; hence when a person is urged by a nauseousness, or striving to Vomit, you may properly give either plain Posset-drink, or with the Leaves of Carduus boiled in it; also sometimes Oxymel or Wine of Squills, or Antimonial Wine; sometimes it may be good to use Glisters, sometimes also a gentle Purge carries away the matter offending the Stomach, by a more easy way of Evacuation through the Intestines. Symptomatick Vomiting proceeds from a conjunct cause, either subsisting in the Ventricle, which produces that Idiopathick Affect, or fixed in other parts, which stirs up their Convulsions, and consequently Vomitive Convulsions of the Ventricle, by a communication of the Nerves; the Cure of which Sympathick Vomiting depends on the Cure of the Primary Disease. When the Stomach is Primarily Affected, it is because its Fibres are irritated to an Excretion by some matter which it cannot duly digest or overcome, or press forwards into the the Intestines, which matter becomes so disagreeing or refractory, either by its own offensive quality or quantity, or through the fault of the Stomach itself, its Tome being become lax, and its Fibres so weak, that they are not able to brook or endure the Chyle itself, much less the Excrementitious humours, but cast all forth by Vomiting: There being various cases and manners of affecting of both these, we shall here briefly set down some of the chief of them together with the Remedies. The Emetic matter subsisting in the Ventricle, is either brought into it from elsewhere, or what for want of digestion, or because it is vitiated, is engendered there; in either respect, the present offensive load is first of all to be carried off, and then care must be taken to prevent any farther supply of it. To cleanse the filthy Mass of viscous matter forth of the Stomach, prescribe a gentle Vomit of Carduus Posset-drink; or of Oxymel, or Wine of Squills, or of a Decoction of the Flowers of Chamomil, or of the Roots of Eupatorium, or give a Solution of the Salt of Vitriol, or such like; then let the remainder be gently carried off by Glisters, or by a Purge of Pilulae Mastichin: or Pil. Stomach. cum Gummis, Tinctura Sacra, or an Infusion of Rhubarb. Moreover, when an impure or rank Blood, conveying ever and anon new Stores of offensive matter to the Stomach, either by the Arteries, or by the Gall-Vessels which often overflow, causes a disposition to Vomit, Bleeding frequently affords relief, and therefore Women with Child troubled with Vomiting, are often Cured by this means; those things also do good which so temper the Blood, that they keep it free from breeding adust Excrements: Hence Whey, Mineral Waters, Juices of Herbs, Sal Prunella, and such like, for as much as they fuse the Blood, and convey its dreggy Particles some other way, often remove Vomiting dispositions. These sorts of Remedies may also be used in case a frequent and daily Vomiting proceeds (as some think it may) from the meetings and contest of the Bilous and Pancreatic humours, and from their regurgitation into the Ventricle. The more frequent Vomiting, and harder to be Cured, is that which proceeds from a disagreeing matter, and consequently Emetic engendered within the Ventricle, to wit, by reason of the vitiated ferment of the Stomach, whatsoever is taken into it degenerates into an irritating Mass of Corruption; wherefore in this case, after that the filth of the Stomach is cleansed forth by gentle Evacuatives, Remedies commonly called Digestives are generally used; which according as the fermenting Juice of the Stomach (being for the most part of a Saline Nature, and sometimes of a Sulphurous) is in a various state of fixtness, flowing, or adustion, are variously prescribed, and sometimes these, sometimes the others do most good. In Belching and Acid Vomiting, these following Medicines may be tried, and you may fix upon your method of Cure according to what you find agrees best. Take Powder of Aron Compound an Ounce and a half, Salt of Wormwood two Drams, Sugar of Roses three Drams, make a Powder: give a Dram of it in the Morning, and at five a Clock in the Afternoon, in a little draught of Beer boiled with Mace and a Crust of Bread, or give it in the distilled Water, or Tincture of Roman Wormwood. Take the Powders of Ivory, Crabs Eyes, and red Coral, of each two Drams, Calcind Coral one Dram, red Saunders, Cinnamon of each half a Dram, make a Powder: the Dose is half a Dram after the same manner. Take the Powders of Lignum Aloes, yellow Saunders, Winter's Bark, of each two Drams, of white Chalk six Drams, Sugar-Candy half an Ounce, with the Solution of Tragacanth in Mint Water as much as suffices, make a Past, and let it be formed into Troches, weighing half a Dram; let the Patient take three or four of these thrice, or oftener in a day. Take Tincture of Salt of Tartar an Ounce, the Dose is from a Scruple to half a Dram twice a day in some proper distilled Water. In hot and sharp or tartish Vomiting, Medicines endowed with a sharp or tartish and vitriolate Salt are more proper. The famous Medicine of Riverius in this case does well. Take Salt of Wormwood a Scruple, give it in a spoonful of Juice of Limmons. Take prepared Coral two Drams, Salt of Wormwood a Dram and a half, Juice of Limmons four Ounces, let all stand in a large Glass; add to it of strong Cinnamon-water two Ounces, give a spoonful or two twice a day, first shaking the Glass. Take Powders of Ivory and Coral of each two Drams, Vitriol of Steel a Dram, Sugar-Candy a Dram, mix them, then divide the whole into six or eight parts, of which take one part twice a day in some convenient Vehicle. In this case, Purging Mineral Waters which have much Nitre in them, also Waters that come from an Iron Mineral, and likewise our Artificial Chalybeate Waters prove of notable effect. When at any time the Stomach perverts the most part of what comes into it, into a bilous and bitterish Mass of filthy corruption (as it often uses to do) and for that reason is prone to frequent Vomitings, than both acid and bitter things are proper. Take Elixir Proprietatis an Ounce, the Dose is a Scruple twice a day in some fit Vehicle. Take Rhubarb Powdered twenty five Grains, Salt of Wormwood a Scruple, Cinnamon-water half an Ounce, Juice of Limmons an Ounce, let it be taken alone, or with some other Liquor. Take Powder of Aron Compound an Ounce and a half, white Crystals of Tartar three Drams, Vitriol of Steel a Dram, Sugar half an Ounce, make a Powder: the Dose is half a Dram, or two Scruples every Morning, drinking after it a draught of the Tincture of Roman Wormwood, or some Coffee. Take Powder of Crabs Eyes half an Ounce, Chalybeat Tartar two Drams, Sugar-Candy a Dram, make a Powder: the Dose is half a Dram, with a fit Vehicle twice a day. Oftentimes the cause of a frequent and habitual Vomiting, is not so much the matter irritating the Ventricle, as the extreme debility of its Nervous Fibres, which are neither able to Concoct what is taken into the Stomach, nor to endure the weight or burden of it, but are presently irritated by any thing lying upon them, and stir up the Carnous Fibres to Excretory Convulsions. There are two principal causes of this sort of Affect, viz. either the debility of the Stomach arising from the Fibres themselves, is gotten by disorder in eating and drinking, so that those Fibres, for as much as they are beyond measure extended or overheated, and as it were scorched, are not capable of admitting or containing a sufficient plenty of Animal Spirits: Or Secondly, These Fibres though they may be well enough disposed of themselves, yet for that the Nerves are in some other place obstructed, they are destitute of a due Afflux of Spirits, whence becoming languid and flaxid, they cannot bear what is taken in, but presently finding themselves overcharged, throw all forth by Vomiting. In the former Affect, those Remedies are indicated, which by their Styptic force cause the too much distended and tenuated Fibres to corrugate and contract themselves into a shorter space; also such as by their most grateful refreshment enliven their languishing Spirits, and allure others more plenteously to them. Take Mynsicht 's Elixir of Vitriol an Ounce, give from ten Grains to fifteen twice or thrice a day in a spoonful of the following distilled Water, drinking seven or eight spoonfuls of the same after it. Take Cypress Tops six handfuls, Clary Leaves four handfuls, the outward Coats of twelve Oranges, Cinnamon, Mace, of each an Ounce, the Roots of Cyperus and the lesser Galingal of each half an Ounce, being sliced and bruised, let them be put into eight pounds of Brunswich Beer, and distilled in an ordinary Still. Take Tincture of the Balsam of Tolu, extracted with the Tincture of Salt of Tartar an Ounce: the Dose is twenty Grains with the same Vehicle: the Tincture of Wormwood prepared with the same Menstruum may also be tried. Take Powder of the Leaves of Wormwood and Myrtle dried in the Sun in the Summer time, of each two Drams, Cinnamon, Flowers of red Roses of each a Dram, Cubebs, Roots of the lesser Galingal of each half a Dram, red Coral prepared a Dram; make of all a subtle Powder, then with six Ounces of double refined Sugar dissolved in Cinnamon-water, and boiled up to a consistency, make it up in little Cakes, weighing half a Dram, let one or two of these be eaten often in a day, as the person pleases. Take Conserve of red Roses vitriolated four Ounces, Myrobalans condited six Drams, Ginger condited in the Indies half an Ounce, Species of Hyacinth two Drams, the reddest Crocus Martis one Dram, Syrup of Corals what will suffice, make of all an Electuary, the Dose is a Dram twice a day, drinking after it a little draught of the distilled water. In the debility or resolution of the Ventricle, by reason of the Nerves being somewhere else abstructed, Paralytic Remedies joined with Stomachicks must chief be insisted on. Take Elixir Proprietatis Tartarized an Ounce, the Dose is a Scruple twice a day, with the water above prescribed. The Tinctures of Salt of Tartar, of Coral, of Antimony may be used after the same manner. In this case also the sweet spirit of Salt, spirit of Sal Armoniac, or its Flowers are of great effect: Moreover Vomits, Purges, and even Diaphoreticks are often successively administered, I have known this Distemter sometimes happily Cured by Bathing in our hot Baths at . CHAP. III. Instructions concerning Purging, with prescripts of Purges. AS Nature often Purges itself according to three Degrees, so there are three Degrees of Purging by Medicine. The first is soft and easy, gently expelling any lose matter contained in the Ventricle and the Intestines. The second reaches not only that, but Purges likewise other humours from the Bilous and Pancreatic Passages, and from the Mouths of the Vessels. The third performs all this, and that in a more full manner, and going yet farther, strongly Purges from the Blood, and consequently from the Nervous Juice and other parts, an Excrementitious matter which is brought by the Arteries into the Intestines. As for what concerns the choice to be used in Purging Medicines, though we do not approve of those cried up Classes of Medicines appropriated to this or that Juice or Humour; yet we do not think that all Purges are indifferently to be used in all cases, but that there is need of a strong Judgement, and a wary circumspection in a Physician, that according to the strength of his Patients, their temperament, the state and ability of the Viscera, their bearing, custom, and fancy, and so according to the nature, of the Disease, its time and quality, he prescribe a Purge more gentle or strong; and that of hot things, or temperate, gentle or more smart, and in a solid substance or a liquid, or something of some other certain kind and form, as he shall see good. A Purge therefore being not convenient at all times, nor in every state of Body; to proceed as we ought, we must take a fit season, and use a certain preparation, and both these have regard to the first passages, and to the Mass of Blood. As to the first, if at any time the Stomach be loaded with a Mass of viscous Phlegm, or troubled with the boiling of Turgid Choler, a Purge most commonly either becomes of no effect or does hurt, unless those contents are first of all cleansed forth by a Vomit, or unless their oppression and effervescency be corrected by digestives. As to what regards the Blood, a Purge is often unseasonable, sometimes also inconvenient, and in neither of these cases Preparatives commonly so called, but only Alteratives are proper, for the business is not to dispose those imaginary humours for evacution, but the Blood itself ought to be reduced from its troubled and confused state to a calm condition, or from its debility and fallen Crasis to its vigour and even temperament. Whilst the Blood Feaverishly boiling is disturbed in its mixture, Purging is always found hurtful; and so whilst its Mass being become languid and weak, does not arise to its due fermentation, that sort of Evacuation is no less forbidden. Moreover, when the Blood is too bilous or watery, or too much inclined to Coagulations or Fusions, Purges for the most part do not take away those its defaults or depravations, but most commonly increase them: Wherefore in those cases altering Remedies are rather Indicated which may destroy the undue Separations and Combinations of the Salts, Sulphur and Serum, and take away other their enormities. Of these Digestives and Alteratives which supply the place of common Preparatives, we shall speak particularly hereafter. The chiefest Compositions of Purging Medicines being Potions, Powders, Bolus', Electuaries, Morsels or Tablets, and Physick-Ales or Wines, we shall here set down certain of the more Select Forms of each of them, and those of a threefold kind, according as the operation of the Medicine ought to be gentle, mean, or strong; to which in the fourth place we shall add Prescripts of easily prepared Purges for poor People. 1. Gentle Potions. Take Rhubarb sliced three Drams, yellow Saunders half a Dram, Salt of Tartar a Scruple, make a cold Infusion all Night in Cichory water and White-wine, of each two Ounces and a half, to three Ounces of Clear straining, add Syrup of Cichory with Rhubarb half an Ounce, Cinnamon water two Drams, make a Potion. 2. Mean Potions. Take of the best Senna three Drams, Rhubarb, Troches of Agarick of each a Dram and a half, yellow Saunders two Scruples, Salt of Tartar half a Dram, Corianderseeds a Dram; let them have a close Infusion all Night in Spring-water and White-wine made warm, of each three Ounces; to four Ounces of it strained, add of the Purging Syrup of Apples an Ounce, Aqua Mirabilis two Drams, make a Potion: Or, Take the decoction of Senna Gerionis four Ounces, Syrup of Roses Solutive an Ounce, Cream of Tartar half a Dram, Cinnamon water two Drams, make a Potion. Take the best Senna, Cassia Fistula, Tamarinds, of each half an Ounce, Corianderseeds two Drams, boil all in ten Ounces of Spring-water, till a third part be consumed, strain it, and Clarify it with the White of an Egg, add to it the Syrup of Apples an Ounce, make a Potion. 3. Strong Potions. Take of the decoction of Sena Gerionis (with the addition of the strings of black Hellebore and Agarick, of each a Dram and a half) six Ounces, Syrup of Roses Solutive, or of the flowers of Peaches an Ounce, Aqua Mirabilis two Drams: Or, Take of the best Sena half an Ounce, strings of black Hellebore, Turbith, of each two Drams, yellow Saunders a Dram, Corianderseeds a Dram and a half, Salt of Tartar half a Dram; let it infuse close all Night in eight Ounces of White-wine made warm, to five Ounces of the Clear straining, add of the Electuary of the Juice of Roses three Drams, Syrup of Buck-thorn six Drams, Cinnamon water two Drams, make a Potion. Potions of easy preparation for the Poor. Take of Flaxweed a handful, sweet Fennel-seeds two Drams, boil them in a sufficient quantity of Spring-water till it comes to six Ounces, add to it of White-wine two Ounces, make a Potion. After the same manner you may make a Purging Potion of the Flowers of Damask Roses; also of Peach Leaves, and so of the Roots of Eupatorium Avicennae. PILLS. First of a gentle Operation. Take of Stomach Pills with Gums, from a Scruple to half a Dram, Tartar vitriolated two Grains, Balsam of Peru what will suffice, make thereof three or four Pills. After the same manner may be made Pills of the mass of Pilul. Ruffi, of Pilul. Mastichin: of Pilul. de Succino, and of our extract Solutive, the description of which you may find in our Tract of the Scurvy. 2. Mean Pills. Take of Stomach Pills with Gums half a Dram, Rosin of Julap from four Grains to ten, Tartar vitriolated six Grains, Ammoniacum dissolved, as much as will suffice, make four Pills. After the same manner may be made Pills of the mass of Pilulae de Succino, Tartari Quercitani: Also instead of Rosin of Jluap, you may put Scammony Sulphurated, from six Grains to twelve, or Rosin of Scammony from eight Grains to fourteen. Or, Take Stomach Pills with Gums a Scruple, Rosin of Julap from six Grains to twelve, Balsam of Peru as much as will suffice, make four Pills. 3. Strong Pills. Take Pilulae Rudii half a Dram, Rosin of Julap from eight Grains to twelve, Balsam of Peru what will suffice, make four Pills to be taken cum Regimine. After the like manner Pills may be made of the mass of Pilulae Cochiae, de Sagapeno. Take of Pilulae ex duobus from a Scruple to half a Dram, Calamelanos a Scruple, make four Pills to be taken Cum Regimine. 4. Pills easily prepared, and cheaper. Take Powder of the best Jalap two Drams, Diagridium a Dram, Cloves, Ginger, of each a Scruple, Ammoniacum dissolved, as much as will suffice, make a mass, the Dose is half a Dram. Take of Pilulae Cochiae, from half a Dram to two Scruples, let four Pills be made. POWDERS. First, such as are gentle. Take of Rhubarb Powdered half a Dram, Salt of Wormwood half a Scruple, Cloves two Grains, make a Powder, give it in a spoonful of small Cinnamon-water, or in a little Broth. Take of the greater Compound Powder of Sena, from half a Dram to a Dram, in a little draught of Posset-drink. Take Powder of the Leaves of Sena a Scruple, Calamelanos seventeen Grains, yellow Saunders half a Scruple, make a Powder, give it in a spoonful of Panada. 2. Mean Powders. Take Powder of Diasena a Dram, Cream of Tartar a Scruple, make a Powder, give it in a little draught of Broth. Take Rosin of Jalap ten Grains, Calamelanos a Scruple, Cloves six Grains, make a Powder, and take it after the same manner. Take Species of Diaturbith with Rhubarb, from half a Dram to a Dram, Cream of Tartar from a Scruple to half a Dram. 3. Strong Powders. Take Turbith, Hermodacts of each three Drams, Diagridium a Dram, Ginger a Scruple, make a Powder, the Dose is from half a Dram to a Dram. Take Pulvis Cornachini a Dram; after the same manner may be given the Compound Powder of Hermodacts; also the Hydrotick Powder of Riverius. 4. Cheap Powders and easy to be got. Take Powder of the Roots of the best Jalap a Dram, Ginger a Scruple, give it in a little draught of White-wine; so you may give Powder of the Roots of Mechoachan, also of the Leaves of Sena in any Liquor. Bolus' and ELECTUARIES. First, such as work gently. Take of the Lenitive Electuary half an Ounce, Cream of Tartar half a Dram, Syrup of Roses what suffices, make a Bolus. Take fresh Cassia half an Ounce, Powder of Rhubarb half a Dram, Cream of Tartar a Scruple, Syrup of Roses as much as suffices, make a Bolus. 2. Mean. Take of the Lenitive Electuary half an Ounce, Cream of Tartar half a Dram, Rosin of Julap six Grains, Syrup of Roses what suffices, make a Bolus. Take of the Electuary Diaphaenicon half an Ounce, of the Compound Powder of Hermodacts half a Dram, Syrup of Elder what suffices, make a Bolus. 3. Strong Workers. Take of the Electuary of the Juice of Roses half an Ounce, Rosin of Julap ten Grains, Cream of Tartar half a Dram, Syrup of Elder what suffices, make a Bolus. Electuaries are Compounded of the same things made up in a greater quantity, by adding Conserves of Damask Roses, or of the Flowers of Peaches; the Dose is the quantity of a Chestnut to be taken betimes every Morning, or twice or thrice a Week. 4. Bolus' and Electuaries easily prepared. Take Powder of the Roots of Julap an Ounce, of Mechoachan half an Ounce, of Ginger two Drams, of Cloves a Dram, Cream of Tartar three Drams, Salt of Wormwood a Dram, Sugar two Ounces, Syrup of Roses Solutive what suffices, make an Electuary, the Dose is the quantity of a Walnut. Confectio Solutiva, & Passulae Laxantes, the Diapranum of Silvius in the 30. Page of his Practice of Physic. 5. Morsels or Tablets of a mean operation. Take Powder of Mechoacan, Gummous Turbith of each half an Ounce, Scammony sulphurated two Drams, Rosin of Jalap a Dram, yellow Saunders a Dram, Cream of Tartar two Drams, Conserve of Violets an Ounce, Sugar dissolved in Rose-water, and boiled up to a fit consistency a Pound. Make Tablets according to Art, each weighing a Dram, the Dose is one or two. The Purging Tablets of Silvius, Page the 28. of his Practice of Physic. 6. Physical or Purging Wines and Alice of a mean operation. Take Leaves of Sena an Ounce and a half, Turbith, Mechoacan of each six Drams, strings of black Hellebore three Drams, Cubebs, Galingal Roots, choice Cinnamon of each two Drams: Put all in a large Glass, with four Pounds of Rhenish-wine, adding to it Salt of Tartar a Dram and a half, let it stand cold and close covered for six days, add to it Sugar-Candy three Ounces, strain it through Hypocrates Sleeve, the Dose is three or four Ounces. Take Leaves of Sena three Ounces, Roots of Polypody of the Oak, and of sharp Pointed Dock prepared, of each two Ounces, Turbith, Mechoacan, of each an Ounce and a half, Epithymum, yellow Saunders of each an Ounce, Corianderseeds an Ounce and a half; let them be sliced and bruised, and put in a Bag according to Art, for four Gallons of Ale. the Dose is from twelve Ounces to a Pound, either every Morning, or twice or thrice a Week. CHAP. IU. A Cure for Over-purging, or of Medicines that stay too much Purging, or a Looseness: Also the Cure of the London-Flux; with Instructions in each Case. TO prevent over-purging upon giving any Purging Medicine, we must proceed thus: Before we give a Purge, we must first consider well the Constitution, Strength and Custom of the Body to be Purged; as also the Nature, Dose, manner of Working, and ordinary effects of the Medicine to be given, and then by comparing the one with the other, we must proportionate the virtue of the Agent according to the bearing of the Patient. Secondly, whilst the Medicine is working, let the Viscera where digestion is performed, the Blood, and the Animal Spirits be kept free from any other perturbation: Wherefore during that time, let not the Patient eat gross or viscous food, or too great a plenty of any food, which may offend the Stomach, let him carefully avoid the admittance of any outward cold, by which the Pores of the Body are shut up, also let the mind be kept calm and undisturbed, free from all Cares and toilsome Studies. Thirdly, The Operation of the Medicine being ended, we must appease the angry rage of the Animal Spirits, and allay the effervescence of the Blood and Humours; for which ends let an Anodine Medicine, or a gentle Hypnotick be given according to the following forms. Take Water of Cowslip Flowers two Ounces, Cinnamon-water hordeated, Syrup of Maeconium, of each half an Ounce, Pearls half a Scruple, make a draught to be taken going to rest: Or, Take Conserve of red Roses vitriolated two Scruples, Diascordium half a Dram, Pearls half a Scruple, Diacodium what suffices, make a Bolus to be taken going to sleep. In case this Provision be either omitted, or does not hinder a Purging Medicine from working to excess, let the Patient presently be put into a warm Bed, and be ordered as follows. First, Let either a Plaster of Mithridate be applied to his Stomach, and to the whole upper Region of the Belly; or let those parts be fomented with warm Linen , dipped in a decoction of Wormwood, Mints, and Spïces in red Wine, and so wiung forth; presently upon it let him take inwardly either a Bolus of Venice Treacle, or a Solution of it in Cinnamon-water. Moreover, let him drink every now and then a spoonful or two of Burnt-wine, diluted with a little Mint-water; if he be troubled with Gripes, give him a Glister of warm Milk with Treacle dissolved in it, and warm frictions must be used to the remote parts, and sometimes Ligatures to draw the Blood outwards, and so keep it from too great a Colliquation, and from discharging itself into the Cavities of the Viscera; then in the Evening if there be strength, and a pretty good Pulse, let him take a Dose either of Diacodium, or of Liquid Laudanum with some fit Vehicle. As to other kinds of excessive Purging, which are wont to happen without the Administration of a Purging Medicine, for the most part they are merely Symptomatical, depending on other Diseases, and their method of Cure is wholly the same as of those Diseases, whose offspring they are: Nevertheless sometimes a Looseness, or Flux seems to be a Disease of itself, and because this kind of Distemper Raging almost yearly in the City of London, is commonly accounted Endemious, or a Disease peculiarly attending Inhabitants, I shall here set down its method of Cure. I have often and long observed that there are two, and that very different kinds of that Flux (usually called the Griping of the Guts) which happens here almost yearly about Autumn: In one of them the Stools are watery, and in a manner clear, with a sudden failing of the strength; in the other they are bloody, but tolerable withal. In the Year 1670. about the Autumnal Equinox, a World of People here were seized with a most dangerous Flux (though without Blood) and joined with a cruel Vomiting, which presently caused great faintings, and a total decay of strength. For the Cure of this Disease no Evacuation did good, nay Bleeding, Vomiting, and Purging always did hurt; only Cordials, and those of the hottest nature, to wit, such as abounded with Spirit and Sulphur, or a Volatile Salt proved commonly of good effect; insomuch that Brandy burned a little with Sugar was a Popular, and as it were Epidemic Remedy, and in that sort of Flux was seldom given without success, though in the other sort of Flux which carried Blood with it, having been used without due regard, it has often been found to be hurtful: The method of Cure which I then took successfully enough with many, and am wont still to take in the like case, is after the following manner. Take Venice Treacle from a Dram to a Dram and a half; let the Patient take it in Bed, and drink after it seven or eight spoonfuls of the following Julap, and let him repeat this Dose every third, fourth, or fifth hour. Take Mint-water, Cinnamon-water hordeated, of each three Ounces, strong Cinnamon-water, Plague-water, Treacle-water, of each two Ounces, Powder of Pearls a Dram, Sacchari Crystalin half an Ounce, mingle them and make a Julap: At the same time take a piece of Bread, spread some Treacle on it, and dip it in Sack or Red-wine warmed, and let it be applied to the Stomach as hot as it may be suffered, and change it every now and then. In the Evening, if the Pulse and Breathing seem strong enough to bear it, let the Patient take of Liquid Laudanum Cydoniated twenty Grains in a draught of Plague-water. Take Diascordium a Dram, Liquid Laudanum half a Scruple, Compound Powder of Crabs Claws a Scruple, Cinnamon-water what suffices, make a Bolus to be taken going to sleep. To those to whom Treacle or Mithridate prove nauseous or disagreeing, give a Dose of the following Powder, or Spirit of Treacle every third hour, with the Julap. Take Compound Powder of Crabs Claws, Roots of Contrayerva, or Serpentaria Virgin, of each a Dram, Cinnamon, Roots of Tormentil, of each half a Dram, Saffron, Cochinele of each a Scruple, make a Powder, the Dose is from half a Dram to two Scruples. Take Spiritus Theriacalis Armoniacus three Drams, the Dose is a Scruple, with the Julap every fourth hour, or give that, and the Doses of the Powder interchangeably, one, one time, and the other, the other: After the same manner the Spirits of Hartshorn. or of Soot may be given; let the persons Drink be Ale or Beer with a Crust of Bread, Mace, add Cinnamon boiled in it and sweetened; or let it be Burnt-wine diluted with Mint-water; let his Food be Chicken-broth, Gruel or Panada, with the shave of Ivory, Hartshorn, and the Roots of Scorzonera, etc. boiled in it. About the Autumnal Equinox, in the Year 1671. a desperate Bloody Flux seized on many persons in this City; from the first seizing they voided Blood by siege in abundance, and that frequently, and for the most part it was attended with a Belly-ach, and Gripes, continual watch also with a Fever, and a mighty thirst usually troubled them; nevertheless their strength held commonly pretty well for some considerable time, and if the Flux were stopped sooner than it ought, it rendered the Patient's conditions worse. The method of Cure, with the Remedies which I found to give Relief in many persons, was according to the following manner. Take Venice-Treacle a Dram, Liquid Laudanum Cydoniated twenty Grains, make a Bolus to be taken going to rest. Take Conserve of red Roses vitriolated two Ounces, Venice-Treacle an Ounce, Powders of the Roots of Tormentil, Contrayerva, Pearl, Coral prepared, of each a Dram, Syrup of dried Roses what suffices, make an Electuary to be taken every fourth or fifth hour, and let the person drink after it of the following Julap three Ounces. Take the Waters of Mint, Baum, Cinnamon hordeated, of each four Ounces, Treacle-water, Plague-water, of each two Ounces, Pearl a Dram, Sugar an Ounce, mingle them and make a Julap. After a day or two give a Purging Potion, which leaves an Astringency. Take Rhubarb sliced two Drams, yellow Mirobalans sliced a Dram and a half, red Saunders, Cinnamon of each a Scruple; let them infuse all Night in the Waters of Plantain and Cinnamon hordeated, of each two Ounces and a half, wring it forth hard, then add of strong Cinnamon-water a Dram and a half, make a Draught. Every Evening, and also in certain cases in the Daytime, I was wont to give a pretty large Dose of Laudanum; nor have I ever known this Medicine to have done any prejudice to a person troubled with the Flux, which happens either because the Narcotick force of the Medicine is subdued, or made more gentle by the Acid Juice of the Stomach, or rather that its Particles which are transmitted to the Blood, are thence presently cast forth again with the Bloody Stools, so that they do not affect the Brain. If the abovementioned Electuary be found nauseous to any person, or disagrees with him, the following Powder may be given in its stead. Take Pulvis Pannonici Rubri a Dram, Roots of Contrayerva half a Dram, make a Powder, divide it into three parts, and give one part in any Liquor. Take Bole Armenick alexiteriated (that is, impregnated with the Juices of the Leaves of Tormentil, Bistort, red Roses, etc. and dried in the Sun) Roots of Contrayerva, of each a Dram, Pearl, red Coral, white amber, of each half a Dram, make a Powder: the Dose is from two Scruples to a Dram. Take the Roots of Avens and Scorzonera, of each an Ounce, of Tormentil, Bistort and Contrayerva, of each two Drams and a half, Hartshorn three Drams, shave of Ivory and Hartshorn, of each two Drams, Cochinele half a Dram, red Rose-leaves two Drams, boil all in a sufficient quantity of Spring Water, till it comes to two Pounds, towards the end of the boiling add conserve of red Roses three Ounces, to the Clear straining add Plague-water four Ounces: the Dose is three Ounces. To appease the Gripes and fretting of the Bowels, Glisters are commonly prescribed. Take the decoction of the Tops of St. John's-wort, in which Sheep's Trotters or their Mesentery has boiled eight or twelve Ounces, Venice-Treacle two Drams, Oil of St. John's-wort an Ounce and a half, make a Glister. The Therapeutic Indications into which the method before expressed of curing the Bloody Flux may be resolved, are chief four, etc. two regard the Blood, and as many the Viscera. First, as to the Blood, it's recrementitious and depraved dregs which tend inwards, must be driven forth into the habit of the body, that they may exhale by perspiration, and its coagulations must be dissolved, and its Crasis restored, as soon as may be. Secondly, as to what regards the Viscera, the irksome sensation of the Nervous Fibres, and the irritation of the Carnous Fibres to excretory Convulsions must be appeased, and the Mouths of the Vessels must be shut, to keep them from discharging the blood and humours into the Intestines. The first of these is usually performed with Opiates, and the other with Styptic or Astringent Remedies: Besides these we must have regard to urging Symptoms, and ill affects usually attending this Disease, the chief of which are a Fever, with a Thirst and Wake, Gripe of the Guts, and sometimes their fretting, Inflammation, and Ulcers. We must not proceed upon those four chief Indications severally and successively, but we must take them altogether, and set upon them at once; wherefore the Prescripts ought to comprehend Remedies of divers kinds, to wit, Alexipharmicks, styptics, Diaphoreticks and Opiates: And because it is not an easy thing to put these into a set method, and under set Rules, which may be generally applied; I have rather chosen to give you here some Examples of Cures performed by me in the Bloody Flux in the year 1671. To a Gentleman 25 years of Age, to whom I was called the third day after he was seized. I prescribed the following Bolus. Take Venice Treacle a Dram, Liquid Laudanum Cydoniated a Scruple, mix them, let him drink after it a little draught of the following Julap. Take waters of Tormentil, Mints, and Cinnamon hordeated, of each four Ounces, Treacle water and Plague water of each two Ounces, Pearl a Dram, Sugar an Ounce, make a Julap. He took besides of the following Electuary about a Dram and a half every third hour, with the said Julap. Take Conserve of Red Roses two Ounces, Venice Treacle an Ounce, Powder of the Roots of Tormentil, Contrayerva, Pearl, Coral prepared of each half a Dram, Syrup of Red Poppies what suffices. By the use of these Remedies the rigour of the Disease soon abated, so that he had not above six or seven stools in the space of twenty four hours, and those also were not very Bloody as before, but appeared full of little flakes of Flesh, and of fragments, as it were of Membranes: Every Evening he took an Opiate with Laudanum. The Fifth day of his illness he took the following Potion. Take Rhubarb sliced two Drams, yellow Mirobalanes a Dram and a half, yellow Saunders half a Dram, Powder of Cinnamon a Scruple; Salt of Wormwood half a Scruple; let them infuse all night in the waters of Plantain and Cinnamon hordeated, of each two Ounces and a half, to the straining add strong Cinnamon water two Drams It purged him three or four times, and gave him ease, and the next day the Fever being abated, he was better; so that seeming to grow well, he eat flesh. But shortly upon it fell into a Relapse, so that the Flux returning with the Fever, it presently became more violent than it was at first: Then because the former Medicines began to nauseate him, I prescribed after the following manner. Take Powders of Tormentil Roots, of Contrayerva, Bole Armenick Alexiteriated, of each a Dram, Pearl, Red Coral prepared, White Amber, of each half a Dram, make a Powder, the Dose is half a Dram in the following distilled water. Take Tops of Cypress and Myrtle, of each four handfuls, Leaves of Meadow-sweet, Burnet, St. Johns-wort, Avens, of each four handfuls, Roots of Tormentil, Bistort, of each six Drams, Red Rose-flowers four handfuls, Kermes Berries four Ounces, Cinnamon, Mace, of each one Ounce. Being all sliced and bruised together, pour to them Red Florence Wine, and Red Rose water of each four pounds; distil all in a common Still; let the whole Liquor be mingled and sweetened with Syrup of Coral. He took also three or four times a day of the following decoction three or four Ounces. Take Roots of Avens and Scorzonera, of each an Ounce, of Tormentil two Drams, Hartshorn burnt and powdered six Drams, shave of Ivory and Hartshorn, of each two Drams, Tops of St. Johns-wort a handful, Flowers of Red Roses and Balaustiae, of each a pugil. Boil all in three pounds of fountain water, till it comes to two, adding towards the end of the boiling, of Red Lisbon wine four Ounces; let it boil close covered for an hour, then let it be strained through Hypocrates Sleeve. Every night he took a Scruple of Liquid Laudanum in three Ounces of the Bloody Flux water even now described, with three Drams of Syrup of Clove Gillyflowers in it. His common drink was a decoction of Hartshorn with Barley, a Crust of Bread, Mace and Cinnamon; to a Pint and a half of which, a Pint of new Milk was added. He took the Purging Infusion a second time, by the use of which, and the things before mentioned, within ten days the Fever left him, and the Flux became much more gentle, which though without Gripes or much Blood, yet still continued with the little pieces of Flesh, the fragments of Membranes, and a bloody Phlegm or Jelly, which daily came from him. Therefore to strengthen and heat the intestines, the following things were given. Take Tops of St. John's wort, Leaves of Perwincle and Mousear, of each a handful, Red Rose Flowers two pugils: Boil them in the Broth of a Sheep's Guts: To a pound of the Liquor strained, add Oil of St. Johns-wort two Ounces, Honey of Roses an Ounce and a half: mingle them for two Glisters, whereof one was given him in the Morning, the other at five a Clock in the Afternoon. He wore Emplast. de minio & Paracelsi upon him Belly. He took moreover twice a day three Ounces of Juice of Plantain wrung forth with water of Scordium and Plague water. He eat also every day a Quince made hollow, and filled with the Powders of Olibanum, Mastic, and Balsam of Tolu, and so roasted in the Embers. By the constant use of these Remedies, he grew perfectly well within a Month. About the same time another robust young man, fell into a dreadful Bloody Flux; from the first day he was seized, frequent stools and very bloody, presently broke forth with violence, being accompanied with a Pain and Gripes: Moreover a strong Fever, with a cruel Vomiting, Thirst and Wake molested him. These Symptoms being a little mitigated with Opiates, a Delirium and a Vertigo, with an intermittent Pulse, and horrible extensions and contractions of his Limbs presently seized him; this happening because the malignant matter which was inwardly restrained, presently flowed into the Brain and Nerves: Nevertheless as often as the Looseness and Vomiting returned, these affects were presently appeased. On the fifth day Vomiting up a bloody matter, he complained of a great torture in his Stomach, and of a Pain, as though it were Ulcerated, and in truth I suspected that there might be a beginning of some Inflamed Blisters, or Ulcers in it, as it usually happens in the Intestines; but by giving him Emollient Broths with Milk in them, his Vomiting and the tortures of his Stomach soon ceased, his Flux in the mean time increasing. He took that night of Diacodium an Ounce, Cowslip water and small Cinnamon water, of each an Ounce and a half; by which Medicine he was so much relieved, that in twenty four hours space his Vomiting and Pains left him, and he was only troubled with a few Stools, and having a good indifferent Pulse, and frequent Sleeps, he was pretty well; yet the following night, though he took again the same Opiate, his Flux returned, and that with very frequent Stools, and bloody as before. The next day after, he took an Infusion of Rhubarb with Mirobalans, Red Saunders and Cinnamon: He often voided Bilous and very sharp Excrements, but without the least of Blood; then in the Evening he took Liquid Laudanum Cydoniated twenty five Grains in a good spoonful of Cinnamon water hordeated; he had moderate and quiet Sleeps. Afterwards loathing any more Medicines, he took only an Opiate every Evening, sometimes of one sort, and sometimes of another, and in a short time grew very well. CHAP. V Instructions concerning Diuretic Medicines, or such as work by Urine, with Diuretic Prescripts. THe chief Scopes, or ends of Diuretic Medicines, are as follows. First, If at any time the Blood becomes so compact and tenacious from a fixed Salt, Sulphur, and Earth fermented together, and mutually combined in it, that the Watery Particles do not easily separate from the rest, Diuretics fit to loosen its Texture, and to fuse the Serum, must be such as excel in a volatile or acid Salt; for such Particles chief dissolve any coalitions caused by a fixed Salt. But in regard this disposition is common both to a Fever and the Scurvy, in the former affect, the most proper Diuretics are the temperate Acids of Vegetables; also Shall Nitre, the Spirits of Sea-Salt, of Vitriol, etc. And likewise such as have a Volatile Salt, as the Spirits of Hartshorn, of Sal Armoniac, Salt of Amber, of Vipers, and others of this kind which we have also ranged amongst Diaphoreticks. In a Scorbutic disposition when the Urine is but in a small quantity and thick, the Juices of Herbs, and preparations both of a sharp, or tart and acid nature are of excellent use; also Salt and Spirit of Urine, of Sal Armoniac, of Tartar, etc. Secondly, Sometimes the Blood does not retain the Serum long enough within its Body, but either being obnoxious to Fluxions, or rather Coagulations, it deposes it here and there in a great abundance, even more than enough; whence it breeds Catarrhs, or tumors in many places: Or, the Blood being become of a weak habit, and withal of a depraved constitution, to wit, inclining to a sourness its apt to coagulate, as to its more gross Particles, so that the more subtle Particles being every where thrown off in circulating, and falling on the weaker parts, cause sometimes distempers of the Head or Breast, sometimes an Ascites, or Anasarca: And we shall hereafter show how a Diabetes happens from the like cause: And in truth many difficult Diseases which are falsely imputed to the ill constitution of the Viscera, arise from hence, viz. that the Blood being distempered and obnoxious to coagulations, when it cannot continue its full course of circulation, deposes the Serum in many places, this being too apt of itself to recede from it. The Diuretics to be given in these cases, are such as do not fuse the Blood, but make void its coagulations; of this kind are those things that are endowed with a fixed Volatile, and likewise Alkalisate Salt; and they must be such as restore and strengthen the Ferment of the Reins, which is done by certain Sulphureous and Spirituous things. For these ends are given Sulphureous and mixed Diuretics, Lixivial Salts of Herbs, Powders of shells, Salt and Spirit of Urine, etc. Millepedes, Horse-Raddish, Parsly-seed, Nutmegs, Turpentine, and preparations made of it, Spirit of Wine: The virtues of all which are not to fuse the Blood, and to precipitate serosities from its Mass (these things are chief done by Acids, and in those cases do commonly hinder any Purging by Urine) but to dissolve the coagulations of the Blood; so that its Body recovering a perfect mixture, and being more readily circulated through the Vessels, drinks up the Serum every where extravasated or deposed, and finally delivers it to the Reins to send it forth. Now we shall show after what manner according to both these, as it were opposite, ends of Curing, Diuretics of all kinds operate, and in what forms they are chief prescribed. The Kind's and Prescripts of Diuretic Medicines. FIrst then, as to Saline Diuretics, we say that any Salts whatsoever of a differing nature being put together, lay hold of each other, and are presently joined in one, and that whilst they are so combined, other Particles freed from the mixture, separate from each other, or fly away. This is plainly seen when a fluid or Acid Salt is put to a fixed, or Alkalisate Salt; and so when a fluid or fixed Salt is put to a Volatile, or a sharp Salt; and indeed on this only disposition of Salts, depends the whole business of Solutions and precipitations of what kind soever: Wherefore since the Blood and humours of our Body very much abound with Salt, which Salt is also wont to be variously changed from one state to another, and so to cause a Morbid disposition; and likewise since Saline Diuretics are of divers kinds, to wit, consisting of fixed, fluid, nitrous, volatile, or Alkalisate Salts, it will always require a great discretion and judgement in a Physician to see that the Saline Particles in the Medicine differ from those in our Body: We shall show after what manner this aught to be done, by running through each Species of Diuretic Salts. Amongst Diuretics containing an Acid Salt, Spirit of Salt, or of Nitre; also Juice of Limmons, of Sorrel, Whitewine, Rhenish and Cider, are of chiefest note amongst the vulgar, and pretty often perform that intent, for these things without the help of others fuse the Blood, and precipitate it into serosities, as when an Acid is dropped into boiling Milk; but this does not happen equally to all persons, nor to every one alike. In a sound constitution, or not very far from it, the Salt of the Blood is partly fixed, partly nitrous, and partly volatile; also in some Scorbutical and Hydropical persons, it becomes for the most part fixed: In every of these cases Diuretics containing an Acid Salt are given with success; but in Catarrhous affects, and in some Hydropical and Scorbutical distempers, when the Salino-fixt Particles of the Blood are exalted to a state of flowing, and the volatile are depressed, (as it often happens) Medicines of an Acid nature commonly rather do hurt than good; insomuch as they more pervert the Blood already degenerated from its Crasis, and Medicines containing a fixed or volatile Salt, are more proper to be used by such persons. Prescripts of Diuretics that have an Acid Salt for their Basis. TAke choice white Tartar powdered, Crystal Mineral of each a Dram and a half, Powder of Crabs Eyes a Dram: Make a Powder, the Dose is from half a Dram to two Scruples in a fit Vehicle, repeating it every sixth or eighth hour. Take Tartar vitriolated or nitrated two Drams, Powder of Eggshells a Dram and a half, Seeds of Parsley, or of wild Carrots half a Dram: Make a Powder, the Dose is half a Dram, after the same manner. Take of the best Spirit of Salt two Drams, Hartshorn burnt and powdered, what will suffice to imbibe it: Make a Powder, the Dose is from a Scruple to half a Dram. Take Juice of Limmons two Ounces, Radish water Compound, an Ounce and a half, Syrup of the five Roots three Drams: Make a Potion. Take Juice of Sorrel two Ounces, Whitewine six Ounces: Mingle them for a Potion. Take Radish water Compound two Ounces, Water of Pellitory of the Wall four Ounces, Spirit of Salt a Scruple, twenty five drops, Salt of Tartar fifteen Grains, Syrup of Violets half an Ounce: Make a Potion. That Medicines containing a fixed or Lixivial Salt move Urine, it plainly enough appears from the Vulgar and Empyrical Practice of Physic, which commonly gives them for Curing Hydropical persons: For it's a usual thing in an Anasarca, and sometimes in an Ascites, when the Viscera, or Fleshy parts are very much swollen by a loading of Waters: To give a Lixivium made of the Ashes of Wormwood, or of Broom, or of Bean-stalks with Whitewine, whence it frequently happens that a very plentiful evacuation by Urine follows, and that the Disease is taken away. Nevertheless I have observed that this Medicine has not proved Diuretic to some persons, and rather to have increased the Hydropical disposition, than to have cured it. The reason of which if we inquire into, we shall find by what is said before, that Lixivial Salts neither fuse Milk, nor Blood, or precipitate them, and therefore that they are not Diuretic in their own nature, though that effect sometimes follows; because that a fixed Salt taken in a good plenty, destroys the Energy of the Acid, and coagulative Salt predominating in the Blood; so that the said Blood, which before being too apt to fusion, and unable to contain its Serum, did cast it off from itself in divers places, now by the intercession of the fixed Salt, recovers its due Crasis, and therefore drinking up again its extravasated Serum, and constantly carrying it to the Reins, causes a large Evacuation by Urine. Prescripts of Diuretics, which have a fixed Salt for their Basis. TAke Salt of Tartar, or of Wormwood two Drams, Coral calcined to a whiteness, a Dram and a half, Nutmegs half a Dram: Make a Powder, the Dose is from half a Dram to two Scruples. Take Tincture of Salt of Tartar, from a Dram, to a Dram and a half, Radish water Compound, an Ounce and a half: Mingle them, give it in a draught of Posset drink which has had the Roots and Seeds of the great Bur-dock boiled in it. Take the Deliquium of Salt of Tartar which (whilst the Tincture is extracted) floats under, and is impregnated with the Sulphur of the Wine, from two Scruples to a Dram and a half, Whitewine from four Ounces to six, Syrup of the five Roots half an Ounce: Mingle them, and make a draught to be repeated twice or thrice a day. Take Ashes made of the Prune of the white Vine half a pound, Nutmegs two Drams, pour to them of White or Rhenish wine two pounds and a half; let it stand a day in a moderate heat, and close covered, then keep the straining for use: The Dose is four Ounces twice or thrice a day. Let Flints be made red hot in the Fire, and be quenched in White wine, or stolen March Beer: Give of the Liquor from six Ounces to eight twice a day. Take Water of quick Lime, from four Ounces to six, Tincture of Salt of Tartar, from a Dram to a Dram and a half: Make a draught to be taken twice or thrice a day. For the same reason as fixed Salts, sometimes also volatile Salts are given with good success to move Urine in a sourish distemper of the Blood, to wit, forasmuch as its Particles when admitted into the Blood destroy the predominancy of the fluid Salt in it; so that the Blood recovering its due mixture, and being freed from coagulations and fluxions, drinks up again what Serum is extravasated, and conveys what is superfluous, to the Reins to be sent forth by the Ureters. But we may note withal, that Medicines prepared of a volatile Salt, having particles somewhat fierce in operation and instigating, when they correct the Crasis of the Blood, dispose what there is superfluous of Serum to be discharged, sometimes by Sweat as much as by Urine. In this order of Diuretics, not only the bare volatile Salt drawn forth of Animals and Minerals ought to be numbered; but likewise the integral parts of Animals and Vegetables, such as are the Powders and Extracts of Infects and Vegetables of a smart nature. Prescripts of Medicines that have a volatile Salt for their Basis. TAke Salt of Amber, Pure Sal Nitre, of each two Drams: make a Powder, the Dose is from a Scruple to half a Dram, in a fit Vehicle. Take Flowers of Sal Armoniac, Crystal Mineral, of each two Drams: Make a Powder, the Dose is from a Scruple to half a Dram, in a good spoonful of Radish water compound. Salt of Urine may be given after the same manner. Take Powder of Bees a Scruple, Lovage-seed a Scruple: Make a Powder, give it in a spoonful of distilled water. Take Spirit of Urine, from a Scruple to half a Dram, Radish water compound, from an Ounce to an Ounce and a half, Juniper water three Ounces, mingle them, make a draught. Spirit of Tartar may be given after the same manner in a double quantity. Take Millepedes prepared two Drams, Flowers of Sal Armoniac half a Dram, Nutmegs powdered half a Dram, Venice Turpentine what suffices: Make Pills, let four be taken twice a day. Take Powder of Burdock-seeds two Drams, Wild Carrot-seed a Dram, Salt of Amber a Dram, Oil of Nutmegs half a Scruple, Balsamum Capivii what suffices: Make a Mass, form it into little Pills; of which let four be taken in the Evening, and as many the next Morning. Take Roots of Chervil, Stone Parsly, Fennel, Eringo, Cammock or Restharrow, of each an Ounce, Leaves of Saxifrage, Clivers or Goosegrass, of each a handful, Seeds of Gromwel, Hartwort, of each half a handful, Juniper Berrys six Drams, boil all in four pounds of fountain water till half be consumed; then add Rhenish Wine a pound, fine Honey two Ounces: Make an Apozem, the Dose is six Ounces twice a day. Take fresh millipeds two pounds, Leaves of Clivers, Chervil, Saxifrage and Golden Rod, of each two handfuls, Roots of Horse Radish six Ounces, Nutmegs an Ounce, Juniper Berrys, Wild Carrot-seeds, of each two Ounces; being sliced and bruised, pour to them of White-wine Posset-drink eight pounds, distil it in a common Still: Let the whole Liquor be mixed, the Dose is four Ounces twice or thrice a day. Take fresh Millepedes washed, from forty to sixty, Nutmegs half a Scruple; being bruised together, put to them distilled Water of Saxifrage three Ounces, wring it forth hard and drink it. Take Leaves of Chervil, Macedonian Stone Parsley, of each three handfuls, being bruised together, pour to them of Whitewine a pound and a half, wring it forth hard and keep it in a Glass; the Dose is three Ounces twice a day. Prepare a Tincture of Millepides, Bees, Grasshoppers or of Cantharideses dried with the Tincture of Salt of Tartar; give it from fifteen to twenty or thirty drops in a fit vehicle. Nitre is a sort of Salt, but differing from any other Salt, or from the nature of Saline Particles, being neither Acid, fixed or volatile, but holds the mean state as it were betwixt those three. And in truth Nitre is the thing by which all Plants have their vegetation, all Animals live and breath, and every Sublunary Flame or Fire is kindled and maintained. But as to our present purpose, it's well enough known that Sal Nitre cools the Blood, and powerfully provokes Urine, though it seems somewhat strange how this, which is of so fiery a nature should so qualify the Blood, and run it into Aquosities to move Urine. I conceive that Nitre works those effects in a twofold respect, to wit, as it is a Salt, allied both to a fixed Salt and a volatile, and as it carries a living Root of Fire in it. As to the first, we observe that Nitre (even as fixed and volatile Salts) being put into Milk, hinders or takes away its coagulation; so likewise Blood whilst warm, being poured to this, is preserved from coagulation, and from being discoloured not less than if put to those. Wherefore since Particles of Nitre inwardly taken preserve the mixture of the Blood entire, or restore it, it follows that they prevent or take away the fusions or coagulations of the same, from which heats, and a suppression of Urine, very often arise. So again, Nitre in regard it carries in it a living Root of Fire, when inwardly taken, cools the inflamed Blood, and moves Urine, because (according to what is hinted before) it adds a vigour to the flame of the Blood, which before was troubled and full of fumes, and so renders it more clear and pure, and consequently more mild; since therefore the Blood burning clearer by the access of Nitre becomes of a more lose consistency, the serous Particles easily get clear of the more gross, and pass away in a more plentiful manner. Prescripts of Diuretics that have Sal Nitre for their Basis. TAke Nitre prepared, two Drams, Barley water with Grass Roots, and Candied Eringo Roots boiled in it two pounds, Syrup of Violets two Ounces: Mix them, the Dose is four Ounces twice a day. Take Sal Prunella two Drams, Sugar-Candy a Dram, make a Powder to be divided into six parts: Let one be taken in a convenient Liquor thrice a day. Take Sal Prunella two Drams, Salt of Amber a Dram: Make a Powder, the Dose is half a Dram thrice a day. Take Sal Prunella, Crabs Eyes, Salt of Wormwood, of each two Drams: Mix them, the Dose is half a Dram thrice a day. It's also well known that Powders of Shells, and of certain Stones, containing an Alchalisate, or Petrifying Salt sometimes promote an evacuation by Urine. For Powders of Eggshells, of the Claws and Eyes of Crabs have been to some a present Remedy in great suppressions of Urine; and if we inquire into their manner and way of working, we shall soon find that these Medicines do not fuse the Blood, nor sensibly precipitate it; wherefore it must be said that these things in a fourish Dicrasie of the Blood and Humours, sometimes prove Diuretic, inasmuch as closing with the Acid Salts, they bind them and keep them under; so that the Blood being free from fluxions and coagulations, drinks up again the extravasated Serum, and conveys it to the Reins. Prescripts of Diuretics that have an Alchalisate Salt for their Basis. TAke Powder of Eggshells, from half a Dram to a Dram: Give it in a draught of Whitewine, or of Posset drink, or of a Diuretic decoction twice a day. Take Powder of Crabs Claws, or of Crabs Eyes two Drams, Salt of Amber, Sal Nitre, of each a Dram, Nutmegs half a Dram: Make a Powder, the Dose is from half a Dram to two Scruples in a fit Vehicle. Or let the said Powder be mixed with as much Venice Turpentine as will suffice, and make it into small Pills. The Dose is three or four Evening and Morning. Not only Saline, but likewise some Sulphureous and Spirituous substances justly take place amongst Diuretics, these often producing the like effect. Many substances of the Larix Tree, as chief Turpentine, and things prepared from them; the Oils drawn by distillation from Juniper, Nutmegs, Wax, and other Pinguous substances, taken inwardly, move in many persons a large Evacuation by Urine, and this carrying a smell like Violets. I have known that in some Hydropical and Scorbutical Persons, Brandy and Strong waters; nay, and strong Wine freely drank have caused a Purging by Urine. The reason of all which is, that when the Blood being weak, or turning sour, or what for want of fermentation, or through the predominancy of an Acid and Coagulative Salt in it, has not so sprightly and continued a Circulation, that it can contain the superfluous Serum within itself, till it delivers it to the Reins: The afovesaid Remedies forasmuch as they preserve the mixture of the Blood entire, or restore it when faltering, conduce to the promoting of that evacuation by Urine. Take Ivy Berrys, Juniper Berrys, Laurel Berrys fresh gathered, of each half a pound, wild Carrot-seeds four Ounces, Nutmegs two Ounces, all of them being bruised together, put to them in a Glass Retort of Venice Turpentine one pound, Rectified spirit of Wine four pounds, distil all in a sand Furnace, with a moderate heat till it grows dry, carefully avoiding an Epyreuma, and you will have a spirit, and a yellow Oil, both of them egregiously Diuretic. The Dose of the Spirit is from a Dram to two or three Drams, of the Oil from half a Scruple to a Scruple in a fit Vehicle. To the remaining faeces in the Retort, pour Tincture of Salt of Tartar one pound; let them digest for many days close luted in the sand Furnace, that a red Tincture may be drawn from it: The Dose of which is from a Scruple to two Scruples or a Dram in a fit Vehicle. Take Millepedes prepared three Drams, Nutmegs one Dram: being bruised, pour to them the purest Spirit of Turpentine, and Tincture of Salt of Tartar, of each six Ounces, distil it with a gentle Bath heat, and you will have a Spirit, Oil, and deliquium of Salt of Tartar, each of them notably endowed with a Diuretic force. CHAP. VI Instructions and Prescripts for Curing too much Purging by Urine, and particularly the Diabetes or Pissing Evil. IN a Diabetes, as in most other affects there are three Primary Therapeutic Indications, viz. Curatory, Preservatory and Vital. The first of these regarding the Disease, and attempting to stay the too great Effusion of Urine cannot be accomplished without the second, which aiming at the cause of the Disease, endeavours to preserve and restore the mixture and due Crasis of the Blood: Wherefore as to the Cure of this Disease, the chief intentions of healing must be to keep the Blood from fusion, and in case that happens to take it away. First the fusion of the Blood is prevented, so its gross and aqueous parts reciprocally contain each other, and do not readily and abruptly sever themselves, which thing is effected by Incrassatives (commonly so called) whose viscous and glutinous Corpuscles being admitted into the Mass of Blood, strongly adhere to its Active Particles, and so part them from each other, and hinder them from mutually combining betwixt themselves, or with Saline Particles coming from elsewhere, as might otherwise happen through fluxions. In this respect, Rice, Amylum, Mucilaginous Vegetables, also Gums and some Rosins are wont to give relief in this Disease. Secondly, To restore the Blood after fusion, those sorts of Remedies are indicated which dissolve the concretions of Salts, so that all the Elementary Particles in it coming again to be at liberty, recover their former places, and so restore the Crasis of the Blood to its first vigour. Now it's well known that this effect is produced in coagulated Milk by the addition of a fixed, volatile, or a nitrous Salt to it; also by the infusion of Spirit of Hartshorn, of Sal Armoniac and the like. The reason of which doubtless is, that whilst the Salino-fixt, volatile or nitrous Particles, being in a sufficient quantity put into the Milk, meet with the Acid or Precipitatory Particles, and are combined with them; the other Saline Particles which before were bound, being now freed, and diffused through the Mass of the Liquor, loosen the Sulphureous and Earthy Parts combined betwixt themselves, and disperse them every way, so that all the Particles being again equally mixed, mutually contain themselves, and are contained; yet because Saline Medicaments are accounted by many to be always Diuretic: We do not give them lightly, or without consideration for the Cure of a Diabetes, though in this Disease I have prescribed the Tincture of Antimony with good success. And a water of the Solution of quick Lime with the Rasping of Sassafras, Aniseeds, Raisins and Liquorish, according to the vulgar Receipt, is highly commended by some. The Vital Indication is made good in this Distemper by a thickening and gently cooling Diet, and by temperate Cordials, and chief by apposite and seasonable Hypnoticks. A Nobleman in the vigour of his Age, became very prone to an excess of Pissing, and when for many Months he had been used at times to undergo this great Flux of Urine, he fell at length into a confirmed Diabetes as it seemed, and almost past hope of recovery: For besides that, in the space of twenty four hours, he voided near a Gallon and a half of clear water, and wonderfully sweet, as though Honey were mixed in it: He was moreover affected with a cruel Thirst and a Fever, seemingly a Hectic, with a mighty Languor of the Spirits, a fall of strength, and a Consumption of the whole Body. I then prescribed him the following Remedies, by the use of which he seemed in a short time to recover. Take Cypress Tops, eight handfuls, Whites of Eggs beaten two pounds, Cinnamon half an Ounce, being cut small, pour to them of new Milk eight pounds, distil it in an ordinary Still, taking care of an Empyreuma. Let him take six Ounces thrice a day. Take Gum Arabic, and Gum Tragacanth, of each six Drams, Penids an Ounce: Make a Powder, let him take about a Dram, or a Dram and a half twice a day, with three or four Ounces of the distilled water. Take Rhuba-b powdered fifteen Grains, Cinnamon six Grains: Make a Powder, let him take it in the Morning, and renow the Dose within six or seven days. Take Cowslip water three Ounces, Cinnamon water hordeated two Drams, Syrup of Meconium half an Ounce: Make a draught to be taken every Evening. His Diet was only Milk, which he took pretty often in a day, sometimes crude or diluted with the distilled water, or with Barley water; sowetimes boiled with White-bread, or with Barley: Growing daily better by the use of these things, within a Month he seemed to be almost Cured: As he began to grow a little well, his Urine which was Insipid, did not much exceed the quantity of Liquids he took, and afterwards turning a little Salt, it became less in quantity than what he drank, and so by degrees recovering the wont tone of his Spirits and a good strength, he took to his former Diet. Nevertheless the disposition to this Disease did not so throughly cease, but afterwards being apt frequently to Relapses upon disorders in Living, and haply upon changes according to the seasons of the year; he first made Water in a greater measure than ordinary, which by degrees grew clear and sweetish, a Thirst and Fever, with a Languor of the Spirits accompanying it: But by the use of the same Medicines he used in a short time to recover again: Not long since after a large interval of health, a little before he fell into a Flux of Urine, he found great irregularities and failings in the Genus Nervosum; viz. He was seized with a dull numbness of his Brain, and a Vertigo, and was taken with sudden Cramps in his Limbs, and felt little Leaping of the Tendons, and various run about him, as though it were of a wind creeping here and there. And when by the use of fit Remedies, the aforesaid Symptoms seemed to be Cured; the Diabetes after its wonted manner burst forth afresh; viz. the matter flowing forth in abundance from the Fibres and solid parts into the Blood, and thence to the Reins and the Urinary Passages. In this Juncture the same Remedies were prescribed again, by the use of which, when within a few days he began to grow better, he was ordered to take thrice a day Water of quick Lime to five or six Ounces: Having continued this Remedy four days, he made water in a moderate quantity well tinged, and somewhat salt, and as to other things he seemed well as he was before. By the same method, and chief with the Water of quick Lime, I Cured another of a Diabetes, who was looked upon as past recovery. The Kind's and Prescripts of Medicines that stop Urine flowing in excess. A Stringent Medicines properly so called, to wit, such as are austere, acerb, and styptic, do little or nothing in stopping a Diuresis; for the virtue of those things has no effect on the Mass of Blood, nor does it reach to the Reins and Bladder: But the Remedies that chief do good in the Diabetes are of two kinds, as we have hinted before: viz. First, those that hinder the combinations of the Salts, and consequently the fusion of the Blood, such as the Incrassatives before mentioned. Secondly, Those that dissolve the Concretions of the Salts, and consequently restore the mixture of the Blood, of which kind are Saline Remedies of a contrary nature, which are apt to cleave to the Acid Salt, and so withdraw it from the combinations it has entered into within the Blood, as chief Medicines endowed with a fixed, volatile or alchalisate Salt. Besides these two Primary kinds of Medicines that restrain Urine, there rests a Secondary kind, to wit, Hypnoticks, which putting some stop to the Animal Aeconomy, cause the vital function to be performed with more calmness, and consequently with less fusion of the Blood, or precipitation of the serous and nutricious humours. It remains now to set down some Select Forms of each kind of these Medicines. I. The first Scope of Curing, to wit, by which we endeavour by thickening the Blood to prevent its fusion, or to take it away, is effected by the Medicines following. Take Gumm Arabic, and Tragacanth powdered, of each an Ounce, Sugar Penids half an Ounce: Make a Powder, divide it into sixteen parts. Take one part thrice a day, dissolving it in the distilled water, or in the docoction of the Roots of Comphry in fountain water or Milk. Take of the Resumptive Electuary three Ounces, Species Diatragacanthi frigidi an Ounce, Red Coral prepared two Drams, Confection of Hyacinth a Dram and a half, Jelly of the cast Skins of Vipers what will suffice: Make an Electuary, of which let the Patient take twice a day the quantity of a Walnut. Take white Amber, Mastic, Olibanum powdered, of each an Ounce, Pulvis Haly two Ounces, Balsam of Tolu half an Ounce: Make a Subtle Powder, the Dose is half a Dram twice or thrice a day. Take Roots of great Comphry, and Water Lilies, of each three Ounces, Dates sliced two Ounces, Seeds of Maliows, Cotton-plant, Plantain, Fleawort, of each half an Ounce, Boil them in four pounds of fountain water till half be consumed, to the straining add Syrup of Water Lilies two Ounces: The Dose is four Ounces thrice a day. Take of the decoction of Barley with Water Lilly-roots a pound and a half, Sweet Almonds prepared an Ounce and a half, Seeds of white Poppies, Purslain, Lettuce, of each half an Ounce: Make an Emulsion according to art, the Dose is four Ounces thrice a day. Take Cypress Tops six handfuls, Clary Leaves four handfuls, Flowers of blind Nettles, Comphry, Water Lilies, of each four handfuls, Roots of Water Lilies and Comphry, of each half a pound, Mace an Ounce, all being small sliced together, pour to them of new Milk eight pounds, distil them in an ordinary Still: The Dose is four Ounces thrice a day, with the Powder of Electuary above written. II. In the second place, though Saline Medicines of every kind and condition are accounted Diuretic, and every of them in certain cases, inasmuch as they fuse the Blood, and cause a copious separation of its Serosities, are in some sort Diuretic. Nevertheless for the reason abovementioned, to wit, for that meeting with the Acid Salt, when it is predominant in the Blood, they prevent and take away its fusion and dissolution. I do not doubt but sometimes they may be given with good success to stop Fluxes of Urine. And I have heard for certain, that one was Cured of a Diabetes by an Infusion of quick Lime. Now in regard the Saline Medicaments (which we suppose to take away the predominancy of the Acid Salt, and to fetter it, as it were) contain either a fixed, volatile or Alchalisate Salt: I shall give you some Forms of Diuretics, which have each of these for their foundation. 1. First then when a fixed Salt by itself, or joined with Sulphur is required for a Basis. Take Tincture of Salt of Tartar, or its Deliquium what suffices: Give it thrice a day in a draught of the decoction or distilled water before described. Take Tincture of Antimony, let it be taken after the same manner thrice a day: I have found by frequent experience the use of this to be very profitable in this Disease. Take Tincture of Salt of Coral a Scruple, let it be taken after the same manner. Take of the Infusion of quick Lime a pound: The Dose is three or four Ounces thrice a day, giving before a Dose of the Electuary, or Powder above prescribed. Take Conserves of the Flowers of blind Nettles, and of the great Comphry, of each four Ounces, of the reddest Crocus of steel half an Ounce, Coral calcined to a whiteness two Drams, Syrup of Comphry what suffices. Make an Electuary, the Dose is two Drams thrice a day. Take Lapis Specularis calcined an Ounce: The Dose is from half a Dram to a Dram twice or thrice a day. Country People with this Medicine successfully Cure their Cattle that piss bloody water. Take Coral calcined to a whiteness and powdered three Drams, Powder of Gumm Arabic and Tragacanth, of each a Dram: Make Powder, divide it into ten parts, let one part be taken thrice a day with a fit Vehicle, to wit, with the decoction or the distilled water. Take the reddest Crocus Martis six Drams, Gumm Lac powdered half an Ounce, red Saunders a Dram: Make a Powder, divide it into twenty parts, whereof let one be taken thrice a day. Take Hartshorn burnt and powdered half an Ounce, boil it in four pounds of the water of a Smith's forge till half be consumed, adding towards the end a Crust of Bread, Roots of great Comphry, and water Lilies dried, of each an Ounce and a half, Sacchari Perlati two Ounces, let him take four Ounces thrice a day. 2. Medicines containing an Alchalisate Salt, such as Coral, Pearl, Cuttlebone, Hartshorn, Ivory, Powders of Shells and the like, as they are commonly used against Rheumatic affects, so likewise for a Diabetes: And inasmuch as they imbibe the Acid Salt abounding in the Blood, and so free the Mass of Blood from fusion, we may justly expect a benefit from them. Take red Coral ground to a great subtlety, Cuttlebone, of each half an Ounce, Hartshorn Philosophically calcined three Drams, Pearl, Ivory, Crabs Eyes, of each a Dram: Mix them, make a Powder, the Dose is half a Dram thrice a day, with a fit Vehicle. Take of the said Powder three Ounces, Species Diatragacanth frigid two Ounces, Sugar Candy two Ounces: Make a Powder, and with a sufficient quantity of the Solution of Gumm Arabic make a Paste; and let it be formed into Troches weighing half a Dram, let three or four be taken thrice or oftener in a day. Take of the said Powder two Ounces, of the Resumptive Electuary four Ounces, Conserve of the Flowers of water Lilies three Ounces, Syrup of the same what suffices: Make an Electuary, let him take the quantity of a Chestnut thrice a day, drinking after it a draught of the Apozeme, or of the distilled water above prescribed. 3. For the same reason as Medicines endued with a fixed and Alchalisate Salt seem proper in Curing the Diabetes; for the same reason do such as have a volatile Salt. For these as well as those lay hold on, and draw of the Acid Salt, (by which the Blood is fused and dissolved into Serosities) so that its Liquor recovers its due Crasis. Take the Solar Tincture prepared (as I readily do it) with Sal Armoniac an Ounce, The Dose is twenty Drops thrice a day. The Spirits of Blood, Soot and Hartshorn, may also be tried in this Disease. Take Salt of Amber a Dram, the reddest Crocus Martis two Drams: Mix them, divide it into twelve parts, the Dose is one part thrice a day. III. As to the third kind of Remedies in the Diabetes, to wit, Hypnoticks, which by putting a stay to the Animal Spirits, retard the course of the Blood, and so hinder in some measure its effervescency and fusion. I use to prescribe to some persons Diascordium to be taken every Evening, and when that does not do, I give sometimes every Night, and sometimes every other Night Liquid Laudanum Cydoniated or Tartarized, and that with good success. Take the decoction of Barley, with the dried Roots of Comphry six Ounces, white Poppy-seeds two Drams, sweet Almonds prepared in number six: Make an Emulsion according to art, let it be taken every Night going to sleep. Take of the Magistral distilled water above prescribed four Ounces, Solution of Tragacanth two Drams, Diascordium from half an Ounce to six Drams. Give it going to sleep. Take Conserve of the flowers of water Lilies two Drams, Laudanum Tartarized or Cydoniated a Scruple, Tincture of Saffron six Grains: Make a Bolus to be taken going to sleep. CHAP. VII. Instructions concerning Sweeting and Diaphoreticks, or Medicines causing Sweat, with Prescripts of them. FOr a ready and plentiful eruption of Sweat, these three things are required. First that the Blood boiling more than its wont, circulates with a more rapid motion. Secondly, That its Latex abounds with many watery Particles, and those lose, that is, apt to be separated from the rest of the Liquor, and to be resolved into Vapours; for if there be a deficiency of Serum, or if it be not easily separable from the Blood through its too great compactness, or incrassation by reason of Faeculencies strongly mixed in it; scarce any sweat at all will follow, though the intense heat of a burning Fever presses for it, and most powerful Diaphoreticks are given at the same time. Thirdly, The Pores of the whole Body must be set wide open for a free passage of the Sweat. Therefore Sweeting Medicines to be taken inwardly must be such as make the Blood boil more than ordinarily, and consequently cause it to evaporate: Also such as somewhat loosen and fuse its often too compact and incrassated Mass, that its Serosities may more readily departed from it and be separated, and they must be such as at the same time dispose them so separated, rather to pass forth by Sweat, than by Urine or Siege. As to the third thing required, to wit, the opening of the Pores, this is done in a manner wholly by outward Administrations. Now because the same Saline preparations which are given to procure Sweat, are often given to move Urine, and sometimes also for Cordials; we must show by what preparation, and other requisites, Sweeting is to be promoted alone without the other intents. And we observe that Sudorificks inwardly taken, seldom or never work of their own accord, as Emetics, cathartics, or Diuretics; but always need some Governance to actuate the Medicine, and to determine it to that Energy: Wherefore a Diaphoretick being given, the Patient must presently be so ordered that the Pores of his Body may be opened, and the beat of his Heart very much heightened. For these ends, either let him be kept in a Bed, Bath, or Hothouse, or let him exercise his Body with some quick or laborious motion; and that these things may succeed the better in promoting Sweat; when it is in our power, let us make choice of a fit time and subject for it, viz. when the Blood enjoying a laudable, or not very evil Crasis, both sufficiently abounds with a Serous humour, and has not its Particles in too great a confusion or perturbation, but is in a disposition readily to be loosened, and to separate itself, and run into parts. For in a Bilous temperament, in a thin and dry constitution, and in the mindst of a burning Fever, when all things are in a trouble and undigested: Diaphoreticks commonly prove of no effect or do hurt. Moreover when Diaphoreticks are judged proper, we must not give all sorts of them indifferently, but peculiar Medicines must be chosen according to the various disposition of the Blood, and the different predominancies of the Element in it, sometimes of this, sometimes of that, and according to the states of the Salts. The Kind's and Prescripts of Diaphoretick Medicines. Sudorific Medicines being manifold, and of divers kinds, and being wont in a various respect to be ranged in order, and reduced to Classes. In the first place I have thought fit here to distinguish them, and set them down, both as to their form and manner of Composition, and as to the matter out of which they are made. Their most usual forms are 1. a Powder. 2. Chemical Liquors. 3. A Potion. 4. A Bolus. 5. A Diet. The matter of each of these are either the integral parts of the whole mixed Body, or certain Elementary parts of some mixed, resolved by Chemistry, and those are either simple, viz. either Spirituous or Saline: The latter of which also are either volatile or fixed, Acid or nitrous. Or lastly the Sudorific Particles so divided and separated by Chemistry, are Elementary parts compounded betwixt themselves, viz. Spirituo-Saline, and Salino-Sulphureous. As we run through each of these Species in order, we shall adapt to each matter the more Select forms of Prescripts. Diaphoreticks which have the integral parts of a mixed for their foundation, in which also a smart or volatile Salt is predominant, in this respect often conduce to provoke Sweat, that their Particles being admitted into the Blood, and being immiscible with it, and not to be subdued, exagitate its Mass, greatly divide it, and draw it asunder as it were into most Minute parts; so that at length the texture of the Blood being very much loosened, and set a boiling, the superfluous Serosites, Recrements, and taints of the Blood are cast forth together with the Particles of the Medicine, which are expelled by reason of their Heterogeneity. Those that are of this rank are usually given in the form of a Powder, Bolus, Potion and Diet, according to the following forms of Prescripts. Take Roots of Contrayerva, Serpentaria Virginiana, Butterburr, of each a Dram, Cochinele, Saffron, of each half a Dram: Make a Powder, the Dose is half a Dram, with a fit Vehicle. Take Powder of Vipers a Dram, give it in some convenient Liquor. Take Powder of Toads prepared, from half a Dram to a Dram. When Diaphoreticks ought to predominate in Sal Alchali alone, or mixed with the former. Take Oriental Bezoar, from a Scruple to half a Dram, give it in a spoonful of distilled water, or some other Vehicle. Take Powder of Crabs Claws Compound, from a Scruple to half a Dram, give it after the same manner. The Bezoartick Powder is made after this manner. Take Powder of the Roots of Contrayerva, of Crabs Claws simple, of each two Ounces, Pearl, both sorts of Coral, white Amber, Crabs Eyes, Hartshorn, Crystal prepared. of each an Ounce, Occidental Bezoar, Lemnian Earth, of each half an Ounce, Ceruse of Antimony two Ounces, Cochenele half an Ounce, Ambergris a Dram and a half, Musk half a Dram: Make a subtle Powder, and let it be formed into little round Balls with the Jelly of the Skins of Vipers, the Dose it from a Scruple to a Dram. Take of this Bezoartick Powder a Scruple, Powder of Toads prepared six Grains: Make a Powder, give it in a spoonful of Treacle water. 2. Bolus' which have for their Basis the integral parts of some mixed, made in the form of an Electuary, Extract, or Conserve. Take of Mithridate, from half a Dram to a Dram, of the Bezoartick Powder, from a Scruple to half a Dram, Syrup of the Juice of Citrons what will suffice; make a Bolus. Instead of Mithridate you may put Treacle, or Diascordium, or Confectio Liberantis, de Hyacintho: So likewise Bezoar powdered, or the Roots of Contrayerva, and the Powders of the like things may supply the place of the Bezoartick Powder. Take of the Extract of Treacle, from half a Dram to a Dram, of the Bezoartick Powder a Scruple: Make a Bolus. Take of the Extract of Carduus half a Dram, Bezoartick Powder a Scruple. Salt of Wormwood fifteen Grains, with a sufficient quantity of the Syrup of the Juice of Citrons: Make a Bolus. 3. Potious which have for their Basis common decoctions of Vegetables, or Infusions and Tinctures. Take Roots of Butterburr an Ounce, Seeds of the same two Drams, Eringo Roots Condited six Drams, Carduus Seeds two Drams, boil all in a pound of fountain water, till half be consumed: In the clear straining dissolve of Mithridate half a Dram or two Scruples: Let it be taken warm in Bed. After the like manner the Leaves of Carduus, the Flowers of Marigolds or Cammomile may be boiled in a sufficient quantity of Posset-drink, of which six or eight Ounces may be given warm either alone, or with some Powder, Electuary, or other Diaphoretic added to it. 4. Diaphoretick Infusions and Tinctures of divers kinds may be prepared by extracting the virtues of simple Vegetables, and Confections with Wine, Vinegar, or distilled water, which afterwards being strained and clarified by settling are often given with success: To this place ought to be referred the Bezoartick waters, Wines and Vinegars prepared by Infusion, the forms of which are every where to be found amongst Authors. Moreover Tinctures of Vegetables which are of very great effect in a small Dose, are made after this manner. Take Roots of Contrayerva a pound, being bruised and put into a Matrass, pour to them Spirit of Wine three Pounds: Let them digest to draw forth a Tincture; then strain it, and draw it off in Balneo to the consistency of Honey: Keep the Spirit first drawn off apart from the rest, pour it again to what stays behind, and draw the Tincture again: The Dose of which is from half a Dram to a Dram, in a fit Vehicle. 5. Diets, whose foundations are decoctions of Woods designed for the Cure of the French Pox, and other Cronick Affects deeply rooted in the Blood and humours. For indeed a very intense and frequent Sweeting, viz. continued for a long time, day by day is required for the Cure of some Diseases, to wit, that not only the Impurities and Corruptions of the Viscera and humours, may be purged forth, but even the Morbific Taints, deeply Imprinted in them may be wholly abolished, or as it were eradicated: To effect this it will not be enough to give a Sudorific Powder or Bolus now and then at times; but an entire Diet must be ordered for this purpose. Wherefore let all the drink the Person takes be a Diaphoretick Decoction, after a Dose of which taken each Morning, let a copious Sweat be promoted, by adding to it the heat of a Bath, or of a Hothouse; and after that by this means the Pores of the Skin are opened, and Nature is inclined to Seeat, let the Recrements of the Blood and Nervous Juice for that whole day evaporate by perspiration, which must be still maintained by the use of the said Drink: By this method not only the French Pox is most safely, and for the most part, most certainly Cured, but also some other most difficult Diseases are sometimes easily overcome. Take the Rasping of Guaiacum four Ounces, Sarsaparilla six Ounces, Chinna two Ounces, all the Saunders, of each an Ounce, Shave of Ivory and Hartshorn, of each half an Ounnce, Antimony powdered and tied in a rag six Ounces: Let them Infuse and Boil according to Art in sixteen pounds of founntain water, till half be consumed, and strain it; to the remaining Magma, add the like quantity of water, let them infuse and boil till a third part be consumed, adding to it Raisins a pound, Licorice an Ounce: Let the straining be kept for a common drink. In case of a Bilous Temperament, and a sharp and hot Blood, leave out the Guaiacum, and augment the quanntities of the China and Sarsa. Diaphoreticks which consist of the Integral parts of the whole mixed, and are easy to be gotten for poor people, may be prescribed according to the following forms. In Malignant Fevers. Take Conserve of Wood Sorrel a Dram, Mithridate two Scruples and a half, mix them: Let it be taken, drinking after it a draught of Posset-drink, that has the Leaves of Carduus, Scordium, or of Camomile Flowers, or Marigolds boiled in it. Take Powder of the Roots of Virginia Serpentary, from half a Dram to a Dram: Give it with a fit Vehicle, or give Powder of the Root of Butterburr a Dram after the same manner. In ordinary cases give the Decoction of Gromwel, of the Roots of Butterburr, or Virginia Serpentary, or of the Roots and Seeds of the great Burrdock: In the French Pox a Decoction of Soap-wort, or of the Rasping of Box, and the like may supply the place of the Decoction of Woods, which are of greater price. 2. Sweeting Medicines prepared from the Elementary parts of a mixed, have for their Basis either a Spirit, or a Salt, sometimes simple, sometimes combined with another Salt, or with Sulphur. Let Spirituous things be prescribed according to the following forms. 1. Let the Spirit of Treacle Camphorated be given, from half a Dram to a Dram, or a Dram and a half in a fit Vehicle. After the same manner many other Spirits distilled from the Juices of Vegetables, maturated by fermentation, and appropriated to certain Distempers, may be given to provoke Sweat, when it is Indicated: Of which kind are the Spirits of Black-cherries, of the Berries of Elder, Ivy and Juniper, with many others; the Spirits of Hartshorn, Soot, Blood and the like, ought rather to be numbered in the rank of Salts. 2. Diaphoreticks, whose Basis are Spirits, with other Elementary Particles combined, may be prescribed after this manner. Take of the simple mixture a Dram, give it in a convenient Vehicle. To this place also may be referred those things that consist of a Spirit, fixed Salt, or a Sulphur combined: Of which kind are the Tincture of Salt of Tartar and Antimony: The Dose of which are from a Scruple to two Scruples in some other Liquor. Moreover distilled waters in which the Spirituous Particles are diluted with watery ones, are often given to provoke Sweat with good success. Take Roots of Butterburr and Valerian, of each two Ounces, of Zedoary, Contrayerva, Virginia Serpentary, of each an Ounce and a half, Flowers of Butterburr four handfuls, Saffron two Drams, being sliced and bruised, pour to them four pounds of Sherry Sack, distil it according to Art: Let the whole Liquor be mixed, the Dose is from two Ounces and a half to three Ounces. Or take Roots of Angelica, and Master-wort, of each four Ounces, of Zedoary, Ele-Campane, Swallow-wort, low-wort, Gentian, the lesser Galingal, of each an Ounce, Tops of Carduus, Rue, Angelica, of each three handfuls, the middle Bark of the Ash six Ounces; being sliced and bruised, add Mithridate, Venice Treacle, of each two Ounces: Mix them, and pour to them of Canary six pounds, distilled Vinegar two pounds, distil it according to Art: The Dose is three Ounces. The Doses of the aforesaid Waters may be actuated by the addition of Chemical Liquors or Salts. These sorts of Medicines endowed with a Vinous Spirit are proper chief, and in a manner only for old people, and such as are of a cold temperament, and are subject to the Plasy and Dropsy: But in a hot constitution, and when there is a fervent heat of the Bowels, and a Feverish boiling of the Blood, by scorching those, and enflaming this too much, they usually rather do hurt than good. Diaphoreticks, whose Basis is Saline, as they are of a various nature, viz. according as the Salt is volatile, fixed, Acid or Nitrous, so they are of a different use and operation, and hence in certain cases these, and in others those and those are most to be given, as we have before observed in Diuretics. 1. Fixed and volatile Salt is most for those whose Blood very much abounds with a serous humour. Moreover, when at any time the Juice which Irrigates the Viscera, and the Genus Nervosum gins to turn sharp, as it usually happens in Hydropical and Cacochymical persons, and in such as are subject to Convulsive Distempers, those Medicines are most effectually give to cause a Sweat; because that whilst they meet the Acido-Saline Particles of the humours, and are combined with them, they loosen the Texture of the Blood, and at the same strongly agitate its Mass by reason of their Heterogenous mixture: Hence for a ready separation and driving forth of the Serosities through the Pores of the Skin, those things are prescribed in the form of a Powder, Bolus and Liquor. Take Flowers of Sal Armoniac half a Scruple, Crystal Mineral fifteen Grains, Bezoartick Powder a Scruple, mix them: Let it be given in a spoonful of Sudorific water. Take Salt of Tartar a Scruple, Ceruse of Antimony twenty five Grains: Make a Powder, let it be given after the same manner. Take Powder of Bezoartick Mineral, from a Scruple to half a Dram, Gascons Powder a Scruple: Make a Powder, let it he given in like manner. Take Ceruse of Antimony, from a Scruple to half a Dram, Flowers of Sal Armoniac half a Scruple: Make a Powder. 2. Those things may be given in the form of a Bolus, by mixing the aforesaid Doses with Treacle, Mithridate or Diascordium, or with the extract of Carduus, Gentian, or the like. Take Bezoartick Mineral a Scruple, Flowers of Sal Armonicak six Grains, Mithridate half a Dram: Make a Bolus. Take Salt of Hartshorn eight Grains, Bezoartick Powder fifteen Grains, Extractum Theriacale a Scruple: Make a Bolus, or three Pills. If a Liquid Form be more proper, Take Spirit of Hartshorn, or of Soot, or of Sal Armoniac, from fifteen Grains to twently, Sudorific water, from an Ounce to three Ounces: Make a draught, let it be taken with governance. Take Flowers of Sal Armoniac half a Scruple, Salt of Tartar fifteen Grains, Sudorific water three Ounces: Mix them, make a draught. 3. Diaphoreticks, which have a Nitrous Salt for their Basis, are wont to give relief generally in the same cases, as those above, made of a fixed and a volatile Salt; because they destroy the predominancy of the Acid Salt, and dispose the mixture of the Blood after such a manner, that as it boils, its Serum and Recrements are readily separated and discharged from it. Take Crystal Mineral three Drams, Salt of Hartshorn, or of Soot, or of Vipers a Dram: Mix them; the Dose is from a Scruple to half a Dram in a fit Vehicle. Take Sal Prunella two Drams, Bezoartick Mineral; or Ceruse of Antimony a Dram: Make a Powder, the Dose is from two Scruples to a Dram. 4. Diaphoreticks, whose ground is an Acid Salt, have a peculiar efficacy against the predominancy of a fixed Salt, and Sulphur, viz. if at any time the Mass of Blood by reason of Salino-fixt Particles combined with Sulphureous or Terrene Particles in it, comes to be too much locked up and close bound, that it does not easily let go its Serosities to be expelled by Sweat (as it sometimes happens in continual Fevers, and in Scorbutic affects) the Acid Salt, after the Medicine is given, meeting the fixed Salt in the Body, and laying fast hold on it, makes void its undue combinations, and so opens the boiling Blood, and disposes it for a Sweat. Take Spirit of Tartar, from half a Dram to a Dram, Sudorific water three Ounces, Flowers of Sal Armoniac half a Scruple: Mix them. Take of the simple mixture, from half a Dram to two Scruples, Give it in a spoonful of Treacle water, or Bezoartick water. Take Bezoartick Vinegar, from half an Ounce to an Ounce, Carduus water two Ounces, Plague water six Drams: Mix them, make a draught. Take Spirit of Guaiacum a Dram, Sudorific water three Ounces: Mix them, make a draught. Some things merely, or for the greatest part Sulphureous are commonly placed in the rank of Diaphoreticks: As for instance some Natural, and other Artificial Balsams, also Chemical Oils, as chief of Guaiacum, Box, Camphire, Hartshorn and Soot: So likewise the Resinous Extracts of Ponderous Woods, with many others, which though by themselves they do little for raising Sweat; yet being joined with the other Saline Medicines, I do not think them altogether unprofitable, because in a cold and Over-phlegmatick Constitution, Sulphureo-Saline Medicines Rarify the Blood which is then become too watery, and dispose it to a free evaporation, no less than such as are Spirituous. Take of Opobalsamum, from Six Drops to twelve, Water of Baum, or of Ground Ivy three Ounces, Sudorific water half an Ounce: Let it be taken every Morning to provoke Sweat for many days together. It is proper for Phthisical Persons, and such as have Ulcers in the Reins. And so, but in a greater Doses, may be given the Balsam of Peru; also the Tincture of the Balsam of Tolu, and likewise compounded Balsams gotten by distillation. Take Rosin of Guaiacum powdered too Drams, Chemical Oil of the same a Scruple, Bezoartick Mineral, Gumm Guaiacum, of each a Dram and a half, Balsam of Peru what suffices: Make a Mass for Pills, the Dose is from half a Dram to two Scruples, drinking after it a Dose of the Sudorific water, or of the Decoction of Woods. CHAP. VIII. Instructions and Prescripts for Curing an Excessive, or Depraved Sweeting. FRequent and immoderate Sweeting, is sometimes the Symptom of some other Disease then affecting the Person; for in the Physic and Scurvy this is a common thing: The reason of it is, that the Blood tainted with some filthy infection, or become of an ill habit, is not able duly to concoct and assimilate the nutritive Juice still passing into its Mass, and therefore always degenerating, and coming now and then to be full charged by the addition of other Excrements, it separates them, and expels them by Sweat. The Cure of this Sweeting depends wholly on the Cure of the Diseass whose Symptom it is: In the mean time those copious Night-sweats happening in those Diseases, plainly show that the Persons Diet aught to be altogether of light food; viz. Milk, Grnel, Cream of Barley and the like, whose gentle and mild Particles the Blood can bear, and not of Flesh, or strong substances. Sometimes an excessive Sweeting is the effect of some foregoing Disease which is brought to an end, and this is so common a thing after long Agues, that scarce any recover of them; but this Indisposition still sticks upon them more or less. I knew a young man, who as he grew well of a Quartan Ague, which had held him ten Months, and began to lose its fits, daily melted into such profuse Sweats, that he was fain to change his Shift and Sheets thrice a Night, being as wet as though they had been dipped in water: This Evacuation continuing so for many Weeks, his Flesh so fell away, and his strength was so exhausted, that he looked like a Skeleton. This Person when he had used many Medicines a long time without much benefit; at length by drinking Asses Milk Mornings and Evenings, and his other Diet being ordered of Cow's Milk, he grew very well in a short time. The chief cause of frequent and copious Sweats seems to consist in the ill habit and weakness of the Blood, in that it is apt continually to be fused and precipitated into Serosities: The Pores of the Body in the mean time being open and free for an Evacuation by Sweat. Now the Blood is so apt to fusions and flow for the most part from a predominancy of a Fluid or Acid Salt in it, and sometimes the Nervous Juice growing sharp, empties its Acid superfluities into the Blood, and so precipitates its Mass into Serosities. This excessive Sweeting does not only arise from the vitiated Crasis and Fermentation of the Blood, but sometimes from its depraved Accension, and through an excess of Sulphur in it, as sometimes through a deficiency of it. In order to the Cure of this Over-Sweating, the Therapeutic intentions must be chief these three. First, To take away or correct the ill habit or weakness of the humours. Secondly, gently to close the Pores of the Skin which are too open. Thirdly, To derive the Serum of the Blood, and the watery superfluities to the Reins. 1. The first of these is performed by those Remedies which destroy the predominancy of the Acid Salt in the Blood, or Nervous Juice; and which promote the Exaltation of the Sulphur (if haply it grows weak) for which ends Antiscorbutics, Chalybeats: Also medicines endowed with a Volatile, Nitrous or Alchalisate Salt most commonly prove effectual. I shall set down certain forms of each of these. Take Conserve of the Flowers of Cichory and Fumitory, of each two Ounces, Powder of Ivory, Hartshorn, Coral prepared, of each a Dram, Pearl half a Dram, Species of Diarrhodon Abbatis a Dram, Lignum Aloes, Saunders both red and yellow, of each half a Dram, Sal Prunella four Scruples, with a sufficient quantity of Syrup of Fumitory, make an Electuary: Give the quantity of a Walnut in the Evening, and the next Morning, drinking after it either of the following Julap or distilled water, three Ounces. Take the Waters of Fumitory and walnuts simple, of each six Ounces, the Waters of Snails and Earthworms, of each an Ounce, Sugar six Drams: Mix them, make a Julap. Take tops of Fir, Tamarisk, Cypress, of each four handfuls, of Myrtle two handfuls, Leaves of Watercresses, Brooklimes, Agrimony, St. Johnswort, Harts-Tongue Fluellen or Speedwell, of each three handfuls, the outward Coats of twelve Oranges: Being sliced and bruised, pour to them of Brumswick Beer eight pounds, distil it in common Organs: Let the whole Liquor be mixed, and sweeten it at pleasure, the Dose three Ounces twice a day. Take Leaves of Dandelion, Watercresses, Plantain, Brooklimes, of each three handfuls, being bruised, pour to them of the distilled water above written a pound, wring it forth hard: The Dose is from three to four Ounces in the Morning at Nine of the Clock, and at Five in the Afternoon. According to this method, I use to prescribe in a failing of strength and Night-sweats after long Agues, and if these remedies do no good, we must come to Chalybeates. Take Syrup of Steel six Ounces; let a spoonful be taken in the Morning, and at five in the Afternoon, with three Ounces of the Water above prescribed. Take Powder of Ivory, of Coral prepared, of each two Drams, Crocus Martis, Salt of Steel, of each a Dram and a half: Make a Powder, the Dose is half a Dram twice a day, with three Ounces of the same distilled water. Take Tincture of Salt of Tartar an Ounce: The Dose is from twenty to thirty Drops twice a day with the distilled water. After the same manner may be given the Tincture of Coral, and Tinctures prepared out of Gums and Balsams. Moreover in these cases the Spirits of Hartshorn, Urine and See't are given given with success. The second intention for the Cure of excessive Sweeting, consisting in a due state of the Pores, is performed in a manner only by outward Administrations: For which end let the whole Body be anointed with Oil of Datekernels, with an Ointment of Orange Flowers and the like, and let Linen done over a little with the same be worn; sometimes Bathing in cold Water, or in a River, sometimes change of Air may do well. It seems here proper to speak a little of a certain troublesome Distemper, relating to Sweeting, or at least to an excessive perspiration. I often observe that some Persons have their Bodies so disposed, that if upon any occasion the least Breath of Wind or Air comes upon them, their Spirits are presently in a mighty trouble, all their Powers are in a Consternation, and their whole Body is discomposed. This extreme tenderness in some Persons more than in others to take cold, or to be offended with it, happens either through the fault of the Animal Spirits, or of the Blood, or of the Pores of the Body, to wit, of one of them, or of more of them together. 1. First, The Animal Spirits are sometimes in fault, because being very weak, they are not able to endure any thing harsh, or rough outwardly pressing upon them; but presently upon the appulse of the bare Air, are put to flights and distractions. And sometimes this Indisposition happens through their fault, for that being degenerated, and become of an eager, restless and uneasy disposition, they are put into disorder upon every such pressure of Air. Wherefore those who by reason of the Spirits so disposed become Hypochondriacal, being also subject to the Affect before mentioned, on every little occasion are troubled with Cold. 2. The Blood disposes to a habit of depraved Perspiration in a twofold manner, viz. both in respect of its temperament, and of its mixture: As to this latter oftentimes the Texture of the Blood is so lose and open, that upon every light accident, and espccially upon the appulse of a cold moist Air, it's presently stirred to fluxions and precipitations of Serosities; insomuch that Persons who have such Blood, dare not step forth of doors, nay scarce look forth. Again, the Mass of Blood being often hot in its temper, and very full of vapours, Breathes forth Effluvia's very sharp and penetrative, by which the Pores of the Skin being too much loosened and laid wide open, the Spirits and the Vital Flame are exposed to the injuries of the naked Air, and the Winds more than they ought. 3. The ill constitution of the Pores, gotten either by sickness, or other ways, or being natural from our Birth, very much inclines to that habit of depraved Sweeting. For in regard those passages being too wide, do always in a manner gape, the Blood and Spirits in the whole Body, or in certain parts of it are not sufficiently guarded against the encounter of the outward Air. The Intentions for Curing this Distemper are chief these three ' viz. first to help the weaknesses, or dejections, or depauperations of the Blood and Spirits. Secondly, To take away their Dyscrasies' if they have any. Thirdly, To procure a due Confirmation of the Pores. The chief stress of this business consists in the first intention, which regards the strengthening of the Animal Spirits, and the enlargement of the whole sensitive Soul; for unless the Patients resolve to take courage, so as to attempt to go abroad, to set forth their strength to their utmost, and accustom nature daily to inure itself to hardship, all medicines prove useless: Wherefore a plentiful and cheerful way of living are no less necessary than Physic, that thereby the stock of Animal Spirits may be daily renewed and increased, and so confirmed in strength by greater practices now and then insisted on; for which ends strong Wines with good Dishes of meat are very proper. Moreover all Studies and Cares, (with which the Soul is depressed) being laid aside, let the time be passed in idleness and recreatious, or in moderare exercises. As by such a kind of living duly ordered, the Animal Spirits are greatly refreshed, so it repairs the decay and depauperations of the Blood. For the same ends also the following Medicines may be given with good effect. Take Spirit of Amber Armonicacated what suffices; fifteen or twenty drops be taken in the Evening, and the next Morning in aspoonful of the following distil a water, drinking after it nine spoonfuls of the same. Take Leaves of Sage, Rosemary, Time, Savory, Margerum, Costmary, of each four handfuls, Roots of Angelica and Master-wort, of each six Ounces, of Zedoary, the lesser Galingal, Calamus Aromaticus, Florence Orris, of each an Ounce and a half, Cubebs anOunce and a half, Nutmegs, Cloves, Cinnamon, of each an Ounce, the outward Coats of twelve Oranges, and of six Limmons; being sliced and bruised, pour to them of Whitewine and Canary of each four pounds: Distil it in common Organs, let the whole liquor be mixed and sweetened with Sugar perlated. In the distilling hang in the head of the Alembick a Nodulus, with a Scruple of Ambergris in it, and half a Scruple of Musk. Take Tincture of Antimony, or of the Balsam of Tolu an Ounce; let fifteen or twenty drops be taken in the Morning at Nine a Clock, and at Five in the Afternoon, in a spoonful of the water before prescribed, drinking after it three Ounces of the same; or rather in the Morning drink after it a Dish of Tea, or Cofee, or Chocholate prepared of a Decoction of Sage. A little before Dinner drink a Glass of Sherry, Sack. When these things have been used some time, and you think good to intermit them, take the following things in their place. Instead of the Spirit, take a Dose of the following Electuary in the Evening, and early in the Morning with the distilled water, or Viper Wine. Take of wet preserved Citron Pills, an Ounce and a half, Mirobalans Condited an Ounce, Nutmegs, Ginger Candied, of each half an Ounce, Confection of Hyacinth, Alchermes, of each three Drams, Pearl prepared, red Coral prepared, of each a Dram and a half, with the Syrup of the Juice of Kermes make an Electuary. Let the ordinary drink be a Physic Ale made after the following manner, viz. into a vessel of four Gallons put the following bag. Take an Old Cock half boiled and mashed, Leaves of Sage and Harts-Tongue dried, of each two handfuls, six Dates sliced, Rasping of Sassafras two Ounces; being sliced and bruised, mix them, put them in a little bag, and hang it in a Vessel after it had done working. The second intention which undertakes to correct the Dyscrasies', or depraved dispositions of the Blood and Spirits, is performed by the same Remedies, as in the Hypochondriacal distemper and Melancholy: Wherefore the prescripts which I formerly gave for the Cure of those affects may serve here. As to the third intention, which for keeping the Pores in a due State, ordains a meet way of Government as to clothing, the Air, the Fire, etc. there is little left for a Physician to do; for commonly every Patient will be his own Counsellor as to these things: There is only one kind of advice which they are apt to receive, and is wont to do them good, viz. that they change their habitation, by which often the Mind is also changed; for those that are never so much addicted to keep themselves penned up in a Chamber, or in Bed, when they travel into foreign Countries, where they breathe a warmer and more serene Air: It's almost incredible in how short a time they recover. So much concerning this depraved Perspiration which has not been touched by others. There remains yet a third kind of this immoderate Sweeting which is not as the first, the Symptom or effect of another present or past Disease; but itself first beginning, is either a Disease of itself, or the parent of some Morbid affect: To the first sort chief belongs the Pestilential Sweat, which was heretofore called Sudor Anglicus: But I shall not now, go about to prescribe Medicines for a Disease which I hope will never return. CHAP. IX. Instructions concerning Cordial Medicines, and Alexipharmicks, or Preservatives against Venom, with Prescripts of them. IF the thing be duly considered, the notion of Cordial Medicines was not well introduced, but is a mere vulgar error; for since it is not the Heart which is the Subject of Life, but chief, and in a manner only the Blood, and in regard the Soul itself (on whose existence and act in the Body Life depends) is founded partly in the Blood, and partly in the united stock of Animal Spirits, it plainly sollows that Medicines which preserve Life entire, or restore it when in danger, do rather and more immediately regard these parts of the Soul, to wit, the Blood, and Animal Spirits than the Heart, which is a mere Muscle, serving for the Circulation of the Blood, and as often as it slackens in performing this duty, or gives it off: This does not happen through its own fault, but through that of the Blood and Animal Spirits, by which it is actuated. Therefore to know the ways and manners of working of those Medicines which are called Cordials, we must consider these two things, viz. First, how many, and particularly what ways the Blood being ill disposed, and often endangered, either as to its accension, or mixture, requires Physical helps, which may preserve or correct it. Secondly after what manner by reason of a defect or delinquency in the Animal Oeconomy the Heart is hindered, or perverted from its due motion, so that Medicines are Indicated, which increase the stores of the Spirits, and better compose them. [To be well instructed concerning these things, read Dr. Willis at large.] The Kind's and Prescripts of Cordials. A Ccording to what is said before, we distinguish Cordial Medicines (commonly so called) into two kinds; some of them chief and more immediately affect the Blood, others the Animal Spirits. In the first rank of those that are designed for regulating the accension of the Blood, we place those which by increasing, or exalting its Sulphureous Particles cause its over-cold and slow moving Liquor to boil more, to be more freely kindled, and to burn with more life; of which kind are good Wines, Compound Strong-waters distilled, the Spirit and Tincture of Saffron, Quercitans' Elixir of Life: the Tincture of Salt of Tartar, of Steel, and other things that chief abound with Spirit, and haud a plenty of Sulphur; of which sometimes these, sometimes those may be taken as every patiented lists. When by reason of the Bloods being not kindled, and consequently of its too greatcorwding and stagnation, as it were, within the Praecordia, a languishing and failing of the Spirits, with a great oppression of the Heart happens, then Aqua Mirabilis, the waters of Cinnamon, Cloves, Wormwood Compound, also of the Rines of Oranges distilled with Wine are proper; to which sometimes a Dose of some Spirit, Elixir or Tincture may be added. But here great caution is needful, that a person do not indulge himself too much to these kind of Cordials, for many by often sipping of them, get an ill habit, continuing their daily use, and increasing the Doses, which at length proves fatal to them; for the Liver chief, and other entrails are so dried and scorched thereby, that the stock of Blood being diminished, and its Crasis perverted, an unhealthy Cacochymia follows, or an abbreviation of Life. In the second Rank of Cordials, we put those Medicines which somewhat appease the too great boiling of the Blood, and put a little stop to, and allay its immoderate deflagration, of this kind are distilled Waters, Acids, and Nitrous things. Take the waters of Woodsorrel, of whole Citrons, of Strawberrys, of each four Ounces, Syrup of the Juice of Citrons an Ounce, Pearl Powdered a Dram: Make a Julape; the Dose is two Ounces three or four times a day. Take the waters of Pippins, or Garden Apples, of Rasberrys, of each four Ounces, Syrup of Violets an Ounce, Spirit of Vitriol twelve Drops: Make a Julape. Take fountain water a Pound and a half, Juice of Limmons two Ounces, Sugar an Ounce and a half: Make a drink, of which let three Ounces be taken at pleasure. Take Grass Roots three Ounces, Candied Eringoes six Ounces, two Apples sliced (or Corinth's two Ounces) Shave of Ivory, and of Hartshorn, of each two Drams, Leaves of Woodsorrel a handful, boil them in three pounds of fountain water to two pounds; to the clear straining, add of Sal Prunella a Dram and a half, Syrup of Violets an Ounce and a half, Make an Apozem, the Dose is three or four Ounces thrice a day. Take Conserve of red Roses vitriolated four Ounces, fountain water two pounds, dissolve it close covered and warm, then strain it; the Dose is three Ounces at pleasure. Take Conserve of Barberrys, Rob of Rasberrys, of each an Ounce and a half, Pearl prepared half a Dram, Confection of Hyacinth a Dram, Syrup of the Juice of Citrons what suffices: Make a Confection; the Dose is half a Dram thrice a day. The third rank of Cordials furnishes those sorts of Medicines, which being destinated against the exorbitancies of the boiling Blood, loosen and open its close texture, for the separation and discharge of its drossy superfluities. These being chief, and in a manner only of a saline nature, are also of divers kinds according to the manifold state of the saline Particles of which they consist; but for the most part their Basis is either a Volatile, Alchalisate, Acid, Fixed, or Nitrous Salt, we shall set down certain forms of each of these. In the First place Cordials endowed with a volatile Salt, are wont to be given with good effect according to the following prescripts, both in Fevers, in respect of the Blood, and also in swoonings, and sudden faintings in respect of the Animal Spirits. Take Spirit of Hartshorn, from fifteen Grains to twenty, Treacle water two Drams, give it with a spoon, drinking after it a draught of some appropriated Liquor. After the same manner may be given the Spirits of Blood, of Man's Scull, of Soot, of Sal Armoniac Compound. Take Salt of Vipers a Dram, Sal Prunella two Drams, Powder of Crabs Claws Compound a Dram and a half: Mix them, make a Powder; the Dose is from half a Dram to two Scruples, in a spoonful of Cordial Julape, drinking after it a little draught of the same. Take Flowers of Sal Armoniac half a Scruple, Bezoartick Mineral a Scruple: Make a Powder, give it in a spoonful of some proper Liquor. Secondly, Those are chief called by the name of Cordials by the Vulgar, whose Basis is an Alchalisate, or Petrifying Salt, as particularly Oriental Bezoar, Pearl, Coral, and other Powders of Shells and Stones. Take Gascons Powder, or Powder of Crabs Claws Compound, from a Scruple to half a Dram; give it in a spoonful of Cordial Julape, drinking after it two Ounces of the same. Take Oriental Bezoar, from six Grains to twenty; give it after the same manner. Take Powders of Crabs Claws, and Crabs Eyes of each a Dram, Pearl, both sorts of Coral prepared, of each four Scruples, both sorts of Bezoar half a Dram, the best , Aurum Diaphoreticum, of each two Scruples, Bezoartick Mineral a Dram: Mix them, make a Cordial Powder; the Dose is from a Scruple to two Scruples, or a Dram, with a fit Vehicle. In Persons seized with a Pleurisy, the following things are accounted the most proper Cordials, for as much as by destroying the predominancy of the acid Salt, they take away, or prevent the Coagulations and Extravasating of the Blood. Take the Powder of a Wild Boar's Tusk, from half a Dram to a Dram, Crystal Mineral a Scruple, Powder, of red Poppy Flowers half a Scruple: Make a Powder to be taken in any Liquor. After the same manner may be given the Powders of Crabs Eyes, and of the Jawbone of the Pike-fish. To this place belong also preparations of Nitre, which are often given with good effect in Fevers, according to the following Forms. Take Crystal Mineral a Scruple, Volatile Salt of Hartshorn, from three Grains to six, mix them: Make a Powder, give it in a spoonful of Cordial Julape. Take Crystal Mineral, Antimony Diaphoretic, of each a Scruple, Bezoartick Powder half a Scruple: Make a Powder, give it after the same manner. Medicines whose Basis is a fluid, or acid Salt, are prescribed in Fevers after the following Forms, to loosen the Texture of the Blood. Take Spirit of Vitriol, from four Drops to six, Carduus water three Ounces, Treacle water two Drams, Syrup of the Juice of Citrons three Drams, Pearl half a Scruple: Make a draught to be taken twice or thrice a day. Spirit of Salt, or of Nitre may be taken after the same manner: For the same the drink Cherbet, called also the Divine drink of Palmarius are proper. Take Powder of Hartshorn Calcined, or of Antimony Diaphoretic three Drams, Spirit of Vitriol, or of Salt a Dram; bray them together in a Glass Mortar, and let them dry: The Dose is from a Scruple to half a Dram, in a spoonful of Cordial Julape. Fixed or lixivial Salts of Herbs often enter the Compositions of Alexipharmicks: Moreover, Medicines which have these for their Basis, as they are accounted very famous Febrifuges, so they ought to be numbered amongst Cordials; for instance we propose that known Medicine. Take Salt of Wormwood a Scruple, Carduus water three Ounces, Spirit of Vitriol, or Oil of Sulphur a Scruple, Syrup of Violets three Drams: Make a draught to be taken three or four hours before the Fit. Take the waters of whole Citrons, and of Wood Sorrel, of each half a pound, Salt of Tartar a Dram and a half, Juice of Limmons two Drams, Sugar half an Ounce, mix them, make a Julape; the use of it is in Anomalous Fevers, which though always burning, have daily returns of sharp fits: The Dose is three Ounces twice a day. The last rank of Cordials, and truly in some respect the chiefest, is of Alexipharmicks, because these are more vital than the rest. But Alexipharmicks being either for preservation, or for Curing: In the first place, we shall set down Select Medicines to be given to persons, whilst yet in a state of health, against the Infection of the Plague, or any Malignity whatsoever; omitting in the mean time what is usually ordered concerning the alteration and rectifying of the Ambient Air: And then in the second place we shall give you Select Forms of Prescripts to be used after the Contagion is taken. 1. Antidotes for Preservation. TAke Conserve of the Leaves of Rue four Ounces, Mithridate, and Confectio liberantis, of each an Ounce, Confection of Hyacinth two Drams, Salt of Wormwood two Drams and a half, Pulvis pannonici rubri half an Ounce, Bezoartick Vinegar what suffices: Make an Electuary; the Dose is the quantity of a Chestnut thrice a day. Take Powder of the Roots of Virginia Serpentary, Contrayerva, Zedoary, Species liberantis, of each two Drams, Camphire two Scruples, Sugar dissolved in Bezoartick Vinegar, and boiled to a consistency for Tablets six Ounces: Make Tablets according to art, each weighing half a Dram; let one or two be eaten often in a day. Take Roots of Virginia Serpentary three Ounces, boil them in three pounds of fountain water till half be consumed, to the straining add of the best Honey two Ounces, Venice Treacle an Ounce, dissolve it warm and close covered, and strain it: The Dose is two or three spoonfuls three or four times a day. Take Flowers of Sulphur four Ounces, melt them in a Crucible, then put into it by spoonfuls one after another, Salt of Wormwood four Ounces, stirring them together till the whole Mass grows red: then add the Powders of Aloes, Myrrh, Olibanum, of each a Dram, Saffron half a Dram; stir them again for a quarter of an hour, till they are incorporated; the Mass being cooled, and put on a glass plate; let it stand till it dissolves into an Oil, like a most beautiful Ruby: The Dose is from ten drops to twenty in an Ounce and a half, or two Ounces of the Bezoartick water twice a day. Or pour to the said Powder some spirit of Wine rectified on the Roots of Contrayerva and Virginia Serpentary, till it cover them three fingers over; draw forth a Tincture: The Dose is from twenty drops to thirty in a fit Vehicle. Or, Take of the same Powder half an Ounce, pour to it of the best Canary two pounds, let it dissolve close covered and warm: The Dose is a spoonful twice or thrice a day. After the Contagion is received, and the Crasis of the Blood is vitiated, and gins to corrupt, the same Medicines are still proper to be taken, but in a greater Doses, and oftener. Moreover the Vinegars, and fixed Salts of Herbs, are very often added with good success to Alexipharmicks, because by them the Coagulations of the Blood are resolved, and then all Heterogeneous Particles evaporating, and the other being brought into a due mixture, its liquor at length recovers its former state, and keeps it. There being innumerable Medicines in the Books of Physicians for this end; I shall here only set down a few. Antidotes for Curing. TAke of the Bezoartick water two Ounces and a half, Bezoartick Vinegar half an Ounce, Venice Treacle a Dram, mix them, by shaking them in a Glass: Make a draught, let the person take it, and sweat upon it. Take Gascons Powder, Roots of Contrayerva, and Virginia Serpentary, of each from a Scruple to twenty five Grains: Make a Powder, give it in a spoonful of Treacle water, drink after it a little draught of the same, or of a Cordial Julape. Take Powder of Teads prepared, Powder of Crabs Claws Compound, of each half a Dram: Make a Powder, give it after the same manner. Take Bezoartick Mineral half a Dram, Venice Treacle a Dram, Camphire six Grains, Bezoartick Vinegar what suffices: Make a Bolus to be taken after the same manner. Take the waters of Wood Sorrel and Dragon-wort, of each four Ounces, Water of Scordium Compound two Ounces, Treacle water and Bezoartick water of each an Ounce, Powder of Pearl a Dram, Syrup of Clove-Gillyflowers (or of the Juice of Citrons) two Ounces, spirit of Vitriol twelve drops: Make a Julape; the Dose is three Ounces often in a day, sometimes by itself, sometimes with other Medicines. CHAP. X. Of the Passions of the Heart, and their Remedies. AFter Cordial Medicines, vulgarly, though improperly, so called, it now follows for us to treat of the Passion of the Heart, in which the Heart is really ill affected, and therefore requires true Cordial Medicines: Under that name two affects, somewhat differing betwixt themselves are commonly denoted, to wit, The trembling of the Heart, and its panting: In both affects the motion or beat of the Heart seems to be disorderly, and in a manner Convulsive; but the irregularity of the first consists in the frequency of its Vibrations, and of the other in their vehemency. As to the Cure of the panting of the Heart, since its Causes are various and manifold, its Cure also must be various; for what some affirm, that those sorts of Remedies vulgarly called Cordials, which are reputed to revive the Heart, and to relieve it when ill affected, are proper in any of all these Cases, it is contrary both to reason and common experience. We say then that the palpitation, or panting of the Heart, proceeds either from the fault of the Blood, or of the Arteries belonging to the Heart: If it happens through the fault of the Blood, the chief intent of Curing must be to raise the Blood to a better Crasis, it being then become too watery and unmeet for accension and fermenting, and to exalt or increase its active principles which are then depressed or diminished; for which end spirituous Medicines, also saline Medicines of all kinds, Sulphureous and especially Chalybeates conduce: And to this place may be referred those things which are wont to be prescribed in the Pica or longing Disease, in the Leucophlegmatia, and in the cold Scurvy. Take Conserve of Sea Wormwood, the outward yellow Coats of Oranges and Limmons, of each two Ounces, Powder of Winter's Bark two Drams, Species of Diacurcuma a Dram, Steel prepared with Sulphur three Drams, Salt of Wormwood a Dram and a half, with a sufficient quantity of Syrup of Citron Pills: Make an Electuary, the Dose is the quantity of a Nutmeg in the Morning, and at five in the Afternoon, drinking after it of the following Julape three Ounces, and walking upon it. Take water of the Leaves of Wake Robin a pound, of Pennyroyal and Hyssop, of each four Ounces, Sugar an Ounce: Mix them, make a Julape. Take of the Tincture of Antimony an Ounce; the Dose is from twenty to five and twenty drops twice a day, with the said Julape. Moreover, amongst these we may place the Tincture of Steel, and its Syrup, also Elixir proprietatis, with many others. Secondly, The panting of the Heart, which is more frequent, and much more violent, happens through some fault in the Arteries belonging to the Heart, which fault is either an Obstruction, or a Convulsive affect. The first default for the most part is continual, and often incurable, but especially if it arises from Consumptive Lungs, or because the Roots of the Arteries are half stopped, or compressed, by reason of some Tuberculum, or bony Excrescency in them: And in this case all that can be done, is to give some ease now and then by Hypnoticks. Moreover, it is not improbable that the Arteries sometimes are almost filled up with Polypous Concretions engendered in them, and sometimes within the Cavities of the Heart itself, and that thereby the free passage of the whole current of Blood is hindered; but as it is diffcult to be satisfied when this is so, so it is as rare to find a Cure for it. When there is a suspicion of it, Saline Medicines seem to be most proper, and of those we must give such as have a Volatile, or Acid Salt; but we must not give them together, but for a time those (which failing of success) try the others. Take Spirit of Sal Armoniac Compound, viz. distilled with Millepedes, or with other Anti-Asthmaticks three Drams, the Dose is from fifteen drops to twenty thrice a day, with the Julape, or some proper distilled water: After the same manner you may try the Spirits of Hartshorn, Soot, Blood, and of an old Scull. Take Spirit of Sea Salt, or of Vitriol distilled, and often Cohobated with the Spirit of Wine, impregnated with Pneumonick Herbs three Drams; the Dose is from fifteen drops to twenty after the same manner; for these purposes the Spirits of Tartar, Guaiacum, and of Box are often used. The panting of the Heart is very often a Convulsive affect, and wont to be produced from the like Cause, and manner of affecting, as other Hypochondriack and Asthmatick affects; and its Cure also aught to be attempted by Antispasmodick Remedies; but a cholce of them must be made with some difference, according as the Disease happens in a hot or cold temperament. In respect of the former, the following Medicines may be prescribed. Take Spiritus succini Armoniaci three Ounces; the Dose is from fifteen Drops to twenty twice a day, with the Julape, or some proper distilled water. After the same manner may be given interchangeably the Tincture of Tartar, of Steel, or of Antimony. Of the trembling of the Heart, and its Cure. THe trembling of the Heart is an effect distinct from its panting or Palpitation, and of a different nature from it, for in that its carneous and moving Fibres seem affected by themselves, nor does the Morbific Cause, as in the other affect seem to lie in the Blood; or in the Arteries of the Heart. The trembling of the Heart may be well described to be a Spasmodick Convulsion, or rather a trepidation of its flesh, by which the moving Fibres hastily, and only half contracted cause most swift turns of the Systoles and Diastoles, but broken, and as it were at halfs; so that the Blood is brought into, and carried forth of the Sinus 's of the Heart, only in very small Portions. As to the method of Cure to be used in the trembling of the Heart, since this affect is merely Convulsive; therefore they are not Cordial Remedies, but rather Cephalicks, and Nervous Medicines that are Indicated; which nevertheless according to the temperament and constitution of the Patient, must be either more hot or moderate, or, now of this, now of that nature. To comprehend all in a few words, since there are three sorts of Mecines, that are wont to be mighty successful in this Distemper, viz. testaceous Medicines, Chalybeates, and such as are endowed with a volatile Salt: I shall here briefly set down certain forms of each of these and their use. Therefore in the first place a provision being made for the whole by evacuatives, and a choice being made of that sort of Medicine which promises best, you may prescribe as follows. Take Coral prepared, Pearl, of each two Drams, both Bezoars, of each half a Dram, white Amber two Scruples, Ambergris a Scruple: Make a Powder, the Dose is half a Dram twice or thrice a day, with a distilled water, or some proper Julape. Take Powder of Crabs Claws Compound too Drams, Powder of Male Peony Roots, and of Man's Scull prepared, of each a Dram, Flowers of Male Peony, of Lilies of the Valley, of each half a Dram: Make a Powder to be taken after the same manner. Take Ivory, red Coral powdered, of each three Drams, Species Diambrae a Dram, double refined Sugar, dissolved in a sufficient quantity of water of Navews, and boiled to a consistency for Tablets seven Ounces: Make Tablets according to Art, weighing half a Dram; let one or two be eaten often in a day, as the person pleases. Take Conserve of the Flowers of Lilies of the Valley six Ounces, Powders of Coral prepared, Pearl, Ivory, Crabs Eyes, of each a Dram and a half, Vitriol of Mars a Dram, Syrup of Coral what suffices: Make an Electuary; the Dose is from a Dram to two Drams twice a day, drinking after it a draught of the following Julape. Take the water of Navews, and of whole Citrons, of each six Ounces, of Orange, Rines distilled with Wine two Ounces, Sugar half an Ounce: Make a Julape. Take of our Syrup of Steel six Ounces, the Dose is a spoonful in the Morning, and at five in the Afternoon, with two Ounces of the Julape before written, leaving out the Sugar, or with distilled water. Take Powder of Ivory, and of Coral, of each two Drams and a half, Species Diambrae a Dram, Salt of Steel two Drams, Sugar eight Ounces, Ambergris dissolved half a Scruple: Make Tablets weithing half a Dram, the Dose is three or four Drams twice a day. Take fresh Strawberries eight pounds, the outward Coats of twelve Oranges, fresh Filings of Iron half a pound, being bruised together, pour to them eight pounds of Wine; let them ferment in a Pot close covered for twenty four hours, then distil it in common Organs. Take Spirit of Hartshorn, or of Blood, or the like, three Drams: The Dose is twenty drops twice a day, with a fit Vehicle. Take Flowers of Sal Armoniac, Coral prepared, of each two Drams: The Dose is a Scruple twice a day. Take Crystal Mineral two Drams, Salt of Amber a Dram, Salt of Hartshorn a Scruple: Mix them, the Dose is from fifteen Grains to twenty twice a day, with the distilled water. Of the intermitting Pulse, and its Cure. AMong the Passions of the Heart, the intermitting Pulse may justly be numbered, because in this affect, or at least in some kind of it the Heart itself labours, though in somewhat a different manner than in its panting, or trembling; for in these it is ill disposed, and irregular as to its motion, but in that, as to its rest, this being sometimes twice longer than it uses to be in its ordinary course. This intermitting Pulse, or overlong Cessation of Motion in the Heart does not proceed from the mixture or Crasis of the Blood, but only from the irregular dispensation of the Animal Spirits, from the Cerebellum into the Nerves that pass to the Heart, and thence into its Tendons, which irregularity happens, because those Nerves are somewhat obstructed. Although this Affect being very often without present hurt or danger, does not require an overhasty Cure; yet for preservation sake, lest some great Diseases follow it, Remedies and a method of Cure ought to be used; at least for the whole remainder of the Persons Life, let him keep to a Diet well ordered in all respects. Moreover, let some gentle Course of Physic be prescribed him to be constantly observed Spring and Fall; viz. That all the Seminal Roots of Diseases founded in the Brain, or apt to be there engendered, may be taken away, as much as may be; for this end we here direct you to the Prophylactick method, with the Medicines prescribed by us elsewhere, against the Fits of the Apoplexy. CHAP. XI. Instructions concerning Opiates, or Medicines that cause Sleep, with their good and ill Effects; together with Prescripts of them. Opiates exert their Force not by raising vapours to the Head, nor by opening the Pores of the Brain, for any vapours or other Soporiferous matter to be admitted into it, but only by destroying some of the Animal Spirits, so that the residue being in a consternation, or forced inward, or at least called back from their wont Emanation into the nervous parts, quit their office, or in some measure remit of it. The Narcotick force of Opiates consists in this, that as the Animal Spirits are most subtle Corpuscles, composed of Spirit and a volatile Salt united together, and exalted to a very high pitch; so Opiates on the contrary consist of a fetid Sulphur, that is, of a Sulphur, together combined with a fixed Salt, and an Earthy matter, and carried up to a most high degree in like manner: Which sort of Concrets are well known to be so contrary to the subtle Texture of the Animal Spirits, that sometimes they put them to flights, or subvert them at a distance by mere Effluvia's, which are very hardly, or indeed not at all perceivable by the smell. Opiates given in a small quantity chief and in a manner only regard those Spirits to which the particular charge of natural and ordinary sleep is committed, the rest being either untouched, or little letted by them: Wherefore after a Dose of Laudanum is taken, both the inward and outward senses are bound, but the Pulse, Respiration, also the functions of Concoction and Separation are continued after their usual manner, and after some time the Spirits of the first employ return to their wont Post. But if an Opiate be stronger than it ought, it extends its Force father into the Province of the Animal government, so that an overgreat Dose of it being taken, the Appetite for the most part is dulled, Respiration is much straightened, and rendered not only difficult, but likewise uneven or interrupted, and sometimes also the motion of the Heart is so far debilitated, that the Pulse presently grows weaker, with a cold Sweat, a deadness, and an Eclipse as it were, of all the faculties, so that a perpetual sleep sometimes follows this Medicine. The good Effects of Opiates. FIrst then, Opiates are most properly and necessarily Indicated, in case of want of sleep, for then being seasonably and duly Administered, they give a refreshing repose. Secondly, In Delirious affects Opiates are given with good effect, (though sometimes they rather do hurt than good, as we shall show hereafter) because the Spirits being then moved with too much eagerness within the Brain, and as it were struck with a rage, and passing their wont bounds, the Opiates repress them, and make them quietly retreat into their former stations. Thirdly, Opium is accounted of most excellent use for appeasing all sorts of Pains: For since Pain cannot be caused or continued, but a great plenty of Spirits must always abound in the part affected, in case the Nerves are so closed, that the passing of the Spirits to the place grieved be hindered, or much diminished, (which Opium effects) it follows of necessity that the Pain must cease: For the Particles of this Medicine besetting the extreme parts of the Brain, do not only quell the forlorn Spirits in its outmost part, but likewise strongly suppress them in their Original source within the Brain, and in the midst of the Cerebellum, and consequently hinder their Emanations from thence into the Genus Nervosum; so that during the Energy of the Opium, they are sent more sparingly and thinly into the Precordia and Viscera, nay, and into all other parts. Hence the Pulse and Breathing remit of their vehemency and frequency; many times also all the Members and Limbs are seized with a Languor and Lassitude. Moreover, hence the Viscera before irritated into Convulsions, either tending to Excretions, as by Vomit, or siege, or causing Pain, as in the Colic or Stone, depose their disorders. Again, the good effect of Narcoticks is notoriously known in the Cure of the Scorbutic Colic: In Pains of the Gout they also do excellently well, and so in the Pain of the Stone in the Bladder, which Disease, when it cruelly torments Old Men, and cannot be Cured by Cutting, admits no ease from any other Remedy, but from Narcoticks: Wherefore in this case I have advised some to the constant and daily use of Laudanum and Diacodium, which they have put in practice, to the great comfort of their life, receiving no hurt thereby, though sometimes augmenting its Doses, they have taken to a great quantity. Fourthly, Opiates are seasonably given, if at any time the Pulse or Breathing are more quick or vehement than they ought; for when in Fevers the Motion of the Heart and Lungs being made more intense, give a most rapid Circulation to the Blood, so that it is greatly perverted, both as to its Accension, and as to its Crasis, and is not able to separate its drossy Excrements, which are so throughly mixed with it: After a Narcotick is given, presently the Impetus of those parts is somewhat broken, so that the Blood coming then to a gentle and moderate Circulation, diffuses a less intense heat, and being loosened in its Texture, it purges its Serum and impurities by Sweat and Urine. Respiration not only as it is urgent, but moreover as the same is interrupted, Convulsive, or otherwise variously irregular, often requires a Narcotick Medicine: In a violent or very frequent Coughing always troubling us, this uses to give relief before all other Remedies. Again, in fits of the Asthma, when the Organs of Respiration are so laboriously exercised, that the Person affected seems to be brought to the Agony of Death, a Dose of some proper Opiate, makes all things presently serene and calm. Moreover in horrible Vomiting, in excessive or violent Purging, this usually gives great ease. Fluxes can scarce be Cured without Opium, not that this Medicine fixes the boiling and raging Juices and Humours, but stops the Excretory Convulsions of the Fibres, and that partly within the Cavities of the Viscera themselves, it stupifying by its mere contact the Spirits there Implanted, and partly by suppressing the Spirits within the Cerebellum, which continually flow to those parts, whereby the others being destitute of supplies from them readily remit of their Convulsive rage. Fifthly, In Catarrhs and Defluxions of all kinds, we often fly to Opiates, as to our last refuge, they powerfully stay excretions of Blood, and moderate and restrain serous Evacuations, when at any time they are excessive, and tend to a Colliquation. They repress the Immoderate Ebullition of the Blood in a burning Fever, and lessen its excessive Accension. Briefly they most readily appease all turbulent commotions in our Body from what cause soever they arise, and let the Blood be never so much disturbed, they most commonly reduce it to a calm and quiet state. Opiates, where they agree, most commonly fuse the Blood, and after the manner of Alexipharmicks powerfully provoke Sweat, and move Urine, as Dr. Willis gives us here an Instance of a Person troubled with the Dropsy, and severely tormented with Night-pains caused by the Pox, who by the constant use of Laudanum, fell at length into great Sweats and Evacuations of Urine every Night, and so was Cured. A Lady, who for many years was subject at times to cruel pains of the Colic, as often as she fell ill of that Disease, and found the pains grow intolerable, could get no ease from any Remedy but from Opium: Wherefore she took a Dose of this each Night, till the Morbific matter being consumed by degrees, she became at length free from all grief and pain. Of the evil Effects of Opium, with cautions concerning its Use. WE have found, by sad experience in many, the Use of Opium to be sometime hurtful and destructive; for that some presently after taking it, have fallen into a perpetual sleep, and others by taking a Dose of it too great, or unseasonably, have either shortened their Lives, or by injuring their principal faculties, have rendered it afterwards uneasy and burdensome. I have known some, who upon taking a Pill of Laudanum, have fallen presently into so profound a sleep, that they could never be raised from it, they lived indeed for three or four days, and as to their Pulse, Respiration, and Heat were pretty well, but could never be brought again to sense, and waking, by any Remedies or tortures. I have observed others, who after taking Opium, have slept but moderately, nay sometimes little or scarce at all; but as to their Pulse, Respiration, and Heat presently grew worse; so that incontinently after the Medicine, they began to have a failing of strength, and then, growing short and thick Breathed, to decay more and more, nor could their vigour be renewed by any Cordials, but fainting by degrees they died. I have elsewhere related a story of a robust man killed by Opium, who had no sleep at all after it, till his last and mortal sleep, viz. Death itself following it; this Man presently after he had taken the Medicine, complained of a great heaviness upon his Stomach, and of Cold, than he was taken with a great Languor, and a Consternation of all his Spirits, with a coldness of his extreme parts, and within some hours complaining that his Eyes grew dim, and at length that he was quite blind, he died. I shall now relate what evils from the improper, or unseasonable use of Opium, sometimes happen in the Head, what in the Breast, and what in the Belly. As to the first, it's well known that the principal functions of the Soul, viz. the Memory, the Reason, and the Acuteness of the understanding are very often extremely injured by Narcoticks. A frequent use of them weakens the Memory in many persons; I knew a person, who by taking a great Dose of it in a Fever, wholly lost the use of that faculty, and after some weeks, when the use of it began to return, he remembered only things done within a peculiar tract of time, and nothing of those that were done before or after. I have known some that have grown dull and stupid by this Medicine, and others that have grown mad. And it's observed, that those Turks that eat much Opium, though they seem to be well, and not injured by it, yet they are rendered more cold, and their functions become worse; they appear always as though they were drunk and besotted, and are affected with a Coma, or a continual inclination to sleep, being stupid and unconstant, sometimes affirming a thing, and sometimes denying it, so that they are unfit to deal or converse with men. Secondly, We find that Opiates are sometimes hurtful to the Precordia and Breast, because they depress and lessen the Pulse and Breathing, sometimes also (as we have said before) they make them falter, and by degrees wholly to cease: Wherefore in Fevers, when the Blood being mightily depraved, seems to admit of no Crisis, or not a good one, and that at the same time it furnishes but very few and weak Spirits to the Animal Oeconomy. Narcoticks are in a manner always destructive, and as it were poisons: For though in the Plague and Malign Fevers, whilst the Pulse and Respiration are strong, Treacle, Mithridate, and Diascordium, nay and Laudanum are often given with good effect, yet if at any time in those Diseases, and in other Fevers that do not carry so much malignity, the vital faculty languishes, those famous Antidotes must be used but very sparingly, and the stronger Opiates not at all. Moreover in a violent Cough, the Physic, Pleurisy, Empyema, and other Diseases of the Breast, viz. in what ills soever nature is stirred up to discharge itself on a sudden of that which is offensive, and oppresses the Breast, and lifts at it with its greatest effort, and at the same time the Organs of Respiration being destitute of a sufficient plenty of Spirits, falter and perform their work with great pain and difficulty; we must in such a case forbear Opium no less than poison, for than Narcoticks increase and fix the weight to be removed, and lessen the strength of the parts that labour to throw it off. Thirdly, As to the parts within the Belly, we find that Narcoticks often taken, proved sometimes very injurious to the principal faculty, viz. the appetite of food (on which all nutrition, and the Root of Life depends) because they very much blunt it, and often wholly destroy it: For when the Spirits residing in the interior Coat of the Ventricle are stupefied, or destroyed by the Particles of the Opiate; so that those Nervous Fibres though emptied, no longer are corrugated, than all hunger ceases, and there is no appetite to food, nay the same being then offered to the Stomach, proving rather troublesome than delightful to it, is presently thrown up again. Moreover, for the same reason the concoctive force of the Ventricle is weakened, and the excretory motions as well of this, as of the Intestines grow tardy; for it's a common observation, that a slowness of concoction, and a tardiness of going to stool, are the familiar effects of an Opiatick Medicine. From what is said, it will not be difficult to draw Physical Precepts and cautions concerning the right use of Opiates, which we may do by observing the four following things, viz. before a Narcotick Medicine be given, we must consider, First, What kind of constitution the Patient is of. Secondly, What kind of Disease it is he labours under. Thirdly, In what state the Animal Spirits are, in respect both of the Animal and Vital functions. Fourthly, In what condition the Blood and other humours are. 1. As to the first, when a Hypnotick is indicated, see that the temperament, habit of Body, or Indisposition, Custom, or manner of Life of the Patient do not indicate the contrary. For example, those that are of a mean stature, have a strong, well-set, and square Body, with a hot Blood, and a lively or quick aspect are wont to bear this Medicine best, and most commonly receive benefit thereby; which also they may much more securely adventure upon, if they have been used to it before; on the contrary it does not agree with, nay sometimes it proves very prejudicial to those who are too corpulent or very thin; also to those who being of a subtle texture of Body, have their Spirits easily dissipable, or being of a cold temperament, have their Flesh soft and flaggy, and being of a sluggish and intractable Nature, are of themselves dull and sleepy; to which this thing may be added, and it augments the weight of the rest, if they never made a Trial of that Medicine before. The nature of the Disease is sometimes of great moment for, or against the use of Opiates. None but flattering Physicians will make use of them in slight affects. Moreover in some great Distempers they are either forbidden, or their use is much suspected: In the Palsy, Vertigo, Incubus, Apoplexy, Orthopnaea, the Dropsy of the Breast, or of the Abdomen in the numbness and trembling of the Limbs, in very malign Fevers, and in the fits of intermitting Fevers, or in the Crisis of others, Narcoticks are most commonly forbidden. Again, in a Cough with much and thick Spittle, the Asthma, and in any other affects of the Breast, with an oppression of the Lungs, and in Hysterick and other Convulsive Passions, they are to be given but rarely, and not without caution, and the advice of some prudent Physician: But in a violent Headache, Catarrhs, the Colic, Pleurisy, ordinary Fevers, in Vomiting, the Bloody Flux, in Nephritick Fits, or fits of the Gout, and in any pains whatsoever, Opiates are not only allowed, but we have recourse to them as to a Divine Panacaea. 3. But as often as an Opiate is proposed, or comes to be deliberated on, we must farther consider in what state the Animal Spirits presiding in each faculty are, for if they are but few, or being oppressed, flag already, and do not sufficiently display themselves, certainly they must by no means be farther lessened, or put in a consternation by a Medicine: Wherefore whilst the Animal faculties do not appear quick, nor with sufficient vigour exert themselves as to sense or reason; or when the Pulse and Respiration have the courses of their Reciprocations but weak, also more quick or slow than usually, or disturbed, and inequal: And lastly, if a stupor and enervation with an unwonted Languor has seized the Members and Parts for Motion, we must wholly forbear Hypnotick Medicines; but we may be free to use the same, if at any time they are Indicated by reason of some great affects, and that the Animal Spirits at the same time are strong enough, according to these and the other respects, or also if they are too much expanded, or grown too raging and unruly. 4. In the mean time the state of the Blood and humours is not to be neglected, for sometimes the uneven, or ill condition of these wholly forbids Opiates, or permits them to be taken but sparingly, and with some restriction. The Blood indicateth against their use when it is amiss either in its quantity, or in its quality, or Crasis: As to the former, the bloody Latex either abounds, or is deficient, and in both respects it excludes Narcotick Medicines. For first, if at any time the Blood grown turgid through its plenty, and withal boiling in a Fever, so exceedingly extends the Vessels as to make them strut forth; and therefore the precordia mightily labour to circulate it as quick as possible, by most swiftly repeated turns of the Systoles, lest it somewhere stagnates or overflows; then certainly to give a Narcotick, whereby that labour and last effort of the Heart, so necessary for preserving Life, would be hindered, were rather the Office of a Poisoner, than of a Physician. Wherefore in an over fullness of Blood, Phlebotomy ought always to precede the use of Opiates. Secondly, No less damage is threatened from Narcoticks, if given when there is a want or scarcity of Blood, as after great Hemorrhages, long Fast, or long sicknesses: For when the current of the Blood is very slender, and by reason of its smallness scarcely continued, the Heart being moved with as quick a beat as may be, endeavours (as it were with redoubled efforts) to give it a most quick Circulation, lest its course be interrupted, and consequently ceases: Hence it is obvious to conceive how greatly prejudicial Opiates are, which put a stay, or let to this endeavour of the Heart, so very necessary in such a juncture. And indeed it seems to be for this reason, that we forbidden sleep to Women presently after Childbirth, when the Lochia flow in abundance, and to all others when a considerable quantity of Blood has been taken from them, and in great Hemorrhagies, to wit, lest the Heart be deserted by the Spirits during sleep, with which it swiftly circulates the lessened current of the Blood. Moreover sometimes the Blood being faulty in its quality, or (to speak more properly) in its Crasis, indicateth against the use of Opiates; for when in a Cacochymia, or Fever, the Blood being mightily filled with drossy Excrements, aught to be agitated with a greater effort of the Heart, and be more swiftly circulated, to wit, that the Heterogeneous Particles may be subdued, and soon evaporate; the Operation of a Narcotick intervening, puts a stop to these endeavours of the Praecordia, and consequently retards the Purification of the Blood, and sometimes disappoints it. As to other Excrementitious humours usually heaped together in the Ventricle, or the Intestines, these also must be purged forth by Vomit or Siege before an Opiate be given: For otherwise being there fixed, they will stick more pertinaciously: For the Fibres of those parts being stupefied by the Medicine, are not irritated as before; nor do they readily set upon excretory Convulsions for expelling those drossy superfluities, or perform it with any vigour. Wherefore according to the ancient Precept; If any thing be to be Evacuated, let it be done before a Narcotick be given. The Kind's and Prescripts of Opiates. THe safest Narcotick, and which is generally approved of by long experience is the Poppy and preparations of it: Wherefore as often as we endeavour effectually and safely to provoke sleep, the whole stress of the Medicine is Placed in Opium or Diacodium. As to the Heads of white Poppies, with the Seeds out of which Diacodium, also Decoctions, Emulsions, and other Hypnotick Confections are made; it plainly appears that these have much less of a Narcotick Sulphur in them, than the concreted Juice of Opium; and what they have of it, is much more pure and innocent: Wherefore we give oftener, and with more safety Medicines made of these, nor ought we to use Laudanum, but when through the violence of Symptoms, Diacodiats will not serve: Again since these have in them less of virulency, they do not want much preparation, but either a simple Decoction, or Infusion, or Expression being made of them, they may be applied to Physical use. Now Opium is seldom prescribed simply, and by itself, but is wont to be corrected and compounded after a various and diversified manner of preparation, that it may become a safe Anodine. The wild Poppy has a certain Hypnotick virtue, but much more mild and gentle than that other; wherefore in certain cases it agrees excellently well, and we may be more secure as to its use. Of this a Syrup and a distilled water is always ready prepared in Apothecaries Shops, which in many continual Fevers are often given with good success, and they are judged to have a certain specifical virtue in Curing the Pelurisy, because they take away pains, and by putting some stay to the Pulse, abate the Feverish boiling of the Blood. Moreover a Tincture is made of its Flowers Infused in Brandy, which is a famous Medicine amongst Empirics and good Women, and is averred to be good against Surfeits. The reason of which effect seems to be, that the Spirit of Wine frees the Contents of the Stomach from putrefaction, and the Narcotick force of the Flowers prevents the Invasion of the Fever. I shall now set down certain Select Forms of Narcoticks; which I shall also digest into certain Classes, according as the Opiates have for their Basis, either the Syrup or distilled water of the wild Poppy, or Diacodium, or Laudanum Extractum, or Liquidum, or Pilul. de Styrace, or de Cynoglosso, or lastly, Philonium. Take the water of wild Poppies, and Cowslip water, of each six Ounces, Syrup of red Poppies two Ounces, Sal Prunella half a Dram, mix them: Make a Julape, the Dose is three or four Ounces thrice a day in the Pleurisy, Pains, watching without a Fever, or any manifest Cause. Take of Poppy water, from four Ounces to six: Let it be taken now and then by itself twice or thrice a day for the same intent. Take Diacodium, from half an Ounce to an Ounce, Cowslip water three Ounces, Treacle water three Ounces: Make a Potion. Take Carduus water three Ounces, Diacodium half an Ounce, Spirit of Hartshorn, from half a Scruple, to a Scruple: Make a draught for procuring sleep and sweat. Take Diascordium half a Dram, Gascons Powder a Scruple, Diacodium two Drams, mix them: Let it be taken in a spoon. Take Diacodium three Ounces, Snail water an Ounce, mix them: It's proper in the Cough and Physic: The Dose is a spoonful going to Rest, and if need be, take it again after Midnight. Take London Laudanum a Grain, Powder of Claws Compound from half a Scruple, to a Scruple, with a sufficient quantity of Syrup of Clove-Gillyflowers: Make three Pills to be taken going to Rest. Take Laudanum a Grain, Stomach Pills with Gums half a Dram: Make four Pills to be taken going to rest, in the Colic. Take Laudanum, from a Grain, to a Grain and a half, Diascordium a Scruple: Make a Bolus, instead of Diascordium, you may put the Confection of Alkermes, or of Hyacinth. Take Laudanum a Grain, dissolve it in a spoonful of Treacle water, add of Cowslip water two Ounces: Make a draught. Take of our Liquid Laudanum tartarized twenty Drops, give it in a spoonful of Aqua Mirabilis, or of Cinnamon water, or of any other fit Vehicle: It's proper in Colic, Nephritick, or Gouty pains. Take Species of Hiera half a Dram, of the foresaid Laudanum twenty drops: Make four Pills, let them be taken going to rest, for Purging, and easing pains of the Colic at the same time. Take Liquid Laudanum Cydoniated, from fifteen Drops to twenty: Give it in a spoonful of small Cinnamon water for the Flux. Take Conserve of red Roses an Ounce, Venice Treacle, Confection of Hyacinth, of each two Drams, Pulvis Pannonici Rubri a Dram, Laudanum Cydoniated two Drams, Syrup of Coral what suffices: Make an Electuary, the Dose is a Dram every fourth or fifth hour, in a violent Bloody Flux with Gripes. Take Pilul. de Styrace, from five Grains to six, Lac Sulphuris half a Scruple, Oil of Anniseeds a Drop, Balsam of Peru what suffices: Make three Pills to be taken in the Cough, Asthma, etc. Take Pilul. de Cynoglosso, from six Grains to eight: Make two Pills to be taken going to rest for the same intents. Take Philonium Romanum, from one Scruple to two, Conserve of Clove-Gillyflowers half a Dram, mix them: Make a Bolus to be taken going to rest. It's proper for the Colic in a cold temperament. I shall now say something concerning the Effects of the great Anti-Hypnotick Coffee. Coffee, though in some cases it be very profitable and Physical, in others it is hurtful and unwholesome; for we see that great Coffee-drinkers become lean, and are very often subject to be Paralytic, and grow impotent for generation. Yet as to Affects of the Brain, and the Genus Nervosum, I very often prescribe this Drink for them. For indeed in very many Cephalick Diseases and Infirmities, viz. in headaches, Giddiness, the Lethargy, Catarrhs, and the like, where with a full habit of Body, and a cold temperament, or one that is not hot, and a watery Blood, there is a moist Brain with a sluggishness and dullness of the Animal Spirits, Coffee has often a very good effect, for being daily drank, it wonderfully clears and enlightens each part of the Soul, and disperses all the Clouds of every function. But on the contrary, those who being thin, and of a Bilious, or Melancholic temperament, have a sharp, or burnt Blood, a hot Brain, and the Animal Spirits too much stirred and restless, aught to forbear this Drink altogether, as being apt to pervert both the Spirits and humours in a greater measure, and to render them wholly unfit, and unable to perform any functions: For I have observed many, not having a sufficient plenty of Spirits, and being also subject to the Headache, Vertigo, Palpitation of the Heart, and a trembling or numbness of the Limbs, who presently after drinking Coffee became worse as to those Affects, and suddenly found an unusual Languor in their whole Body. THE LONDON PRACTICE, OF PHYSIC, Contained in the Second Part of the Pharmaceutice Rationalis of Dr. WILLIS. THis Second Part of the Pharmaceutice Rationalis, is divided into three Sections, whereof the First treats of Medicines that regard the Thorax, the Second of Medicines that regard the Viscera of the Belly; the third of outward Medicines, viz. Phlebotomy, Vesicatories, Issues, Cutaneous Affects, etc. SECT. I. Of Medicines that regard the Thorax. CHAP. I. Instructions and Prescripts for the Cure of the Physic, and Consumption of the Lungs. WE must observe the divers states of this Disease, or the distinctive Marks which belong to it: As First, when it is merely a Cough: Secondly, when it gins to degenerate into a Physic or Consumption: Thirdly, when the Physic is consummated, or past recovery. 1. And First, as to a new Cough from what Cause soever it arises, it is never free from suspicion of danger, if it happens in a Body predisposed to a Physic; though in other robust Persons it be not presently to be feared: For if at any time it be raised from some great evident cause, and being without a Fever, and an indisposition of the whole Body, it proves not very troublesome, than it is said to be only a cold taken, and is either wholly neglected, or soon Cured without much ado. Again, if it be accompanied with a small Fever, Thirst, and loss of Appetite, there is hope that the Blood being restored to its due temper, the Cough will also cease of its own accord; but if drawing in length, and not easily submitting to vulgar Remedies, it produces much Spitting, and that discoloured, it ought no longer to be neglected, but must be dealt withal with a method of Cure, and fit Remedies, and an exact Form of Diet: For than it may be suspected that the Lungs having received some prejudice in their Conformation do not transmit the Blood entirely, but with a deposition of the Serum, or Lympha, and often the nutritive Juice; and likewise that those humours there deposed do putrify, and consequently that by a reciprocal injury they taint the Blood, whereby it still offends the Lungs the more. 2. But if to a Cough daily growing worse and worse, with much and thick Spitting there be added a Languor, and falling away of the whole Body, a loss of Appetite, difficult breathing, thirst, and a boiling of the Blood; there is great cause to suspect that a Physic is at least begun, if not well advanced: Wherefore we must then use all our endeavours both to free the Lungs from the offensive load of matter already gathered together in them, and to fortify them against the continual Incursion of the same; and at the same time to cleanse the Mass of Blood of its dregs, and to restore it to a good Crasis, whereby it may duly contain its Serosities, and other humours within its own texture, or convey them to some other place than the Lungs. 3. But if beyond the state even now described of this Disease, the Spittle daily increases, and becomes more discoloured, and all other things still growing worse and worse, there be joined to it a total decay of strength, and a Hectic Fever, with a continual thirst, Night Sweats, a dying Countenance, with a falling away of flesh even to the drought of a Skeleton; then there is no room left for Physic, but only for a sad Prognostic, or at least all hope of Cure being laid aside, we have nothing left to insist on but anodynes, which may help towards an easy death. Wherefore according to the said three states of this Disease, its method of Cure must be in a threefold manner: viz. First we must prescribe what is to be done for Curing a Cough, whilst being not entered the limits of a Physic, it has only the name of a Cold taken. Secondly, what is proper in a beginning Physic. Thirdly, what is to be done when it is consummated and desperate. 1. Men of a tender constitution, or such as are inclined to a Consumption from their birth, or have sometimes formerly been used to be endangered by a Cough, ought immediately as soon as they find it coming to stand on their guard, and betake themselves to the Rules of Physic, according to which, to proceed methodically in a way of Cure, the Therapeutic Indications must chief be these three. 1. To appease or take away the disorder of the Blood, whence the Fluxions of the Serum proceed. 2. To derive from the Lungs to the Pores of the Skin, or Urinary passages, and other Emunctories, the dreggy Excrements of the Blood, and all superfluities apt to departed from it. 3. To corroborate the Lungs themselves against the reception of the Serum, and other humours; and likewise to fortify them against the invasion of outward Cold, from which they are wont to receive a farther prejudice. We shall speak of each of these a little more at large. 1. The first Indication regards both the Effervescency of the Blood, in that it grows over hot, and boils in its Vessels, by reason of the Effluvia's being restrained within it; as also its dissolution, in that being loosened in its Texture, it lets fall too much the Serum and other Humours from its embraces, to remove both a thin form of Diet must be ordered, and the person being careful to avoid all injury from outward Cold, a pretty free transpiration must be procured, or at least the wont transpiration must be restored: For these ends let the Patient presently be thicker clothed, and let him keep himself in Bed, or within his Chamber; at least let him not go forth of Doors: Evenings and Mornings let a gentle Sweat be raised by giving him Posset-drink with Rosemary, or Sage boiled in it: If notwithstanding the Cough grows worse, Bleeding proves often of good effect, so his strength and constitution bear it; after which Hypnoticks generally do well, inasmuch as they retard the motion of the Heart, and consequently the overhasty Course of the Blood. Moreover, they cause it to pass the Vessels of the Lungs gently, and with moderation, without casting off any great quantity of Serosities; and to send forth what is superfluous either by Sweat, or by Urine: For this purpose also Pectoral Decoctions must be given, because they destroy the Acidities of the humours, and hinder, and put a stop to the dissolution of the Blood, and its fusion into Serosities. For the like reason and manner of Operating, Medicines prepared of Sulphur are of such egregious use against the Cough. 2. The Second Indication, viz. the derivation of the Serum, and other dreggy Excrements of the Blood from the Lungs, and their Evacuation by other ways, is performed by Diaphoretick Medicines, Diuretics, and gentle Purgers; which must go along with other Medicines, or be now and then interchangeably used with them. Therefore after Bleeding, we usually give a gentle Purge, and sometimes repeat it. In the Pectoral Decoctions, let the Roots of Chervil, Butchers-broom, Elecampane, and other things moving Sweat and Urine be of the Ingredients: Millepedes, Volatile Salt of Amber, and other fixed Salts, and Powders of Shells, made into Pills with Turpentine, are often given with good effect. 3. The Third Indication, viz. the fortifying of the Lungs, and its Ductus' against the Fluxions of the humours and the assaults of the Cold, and the suppression of the Catarrh, vulgarly so called, is performed by Linctus', Eclegmas, and other particular Remedies, and has chief a regard to two things, viz. gently to close the Mouths of the Vessels and Glands that gape into the Trachea with Astringents, lest they cast forth the Serosities too much into it: And Secondly, To make smooth and glib the sides of the Ductus' of the Trachea, that they be not offended, and thence continually stirred up to a troublesome Cough, either by the sharp Serum coming upon them, or by the assault of any outward Cold; and moreover, that those Ductus' being made slippery enough, the Spittle sticking sometimes very fast to the sides of them, may be more easily gotten off and Coughed up: For the First intent it is, that Conserve of red Roses, Olibanum, Mastic, Lohoch de Pino, Syrup of Jujubes, of dried Roses, of Cupmoss, and other Astringents are so often ingredients in pectoral prescriptions. On the account of the second intent Licorice, with its various preparations is accounted so famous a remedy against any Cough whatsoever. For this end Syrups, Eclegmas, and all other sweet Pectorals seem to be ordered; to which is added Oil of sweet Almonds, either given by itself, or reduced into the Form of some Milky pap by long stirring it with some Pectoral Syrup. These are the chief Therapeutic Indications, together with the apt intentions of Curing, which seem to be of most considerable use for a new Cough, whilst it is yet free from the suspicion of a Physic, or at least not yet entered its manifest limits: It now remains after this general method briefly given unto you, to set down some Select Forms of Medicines appropriated to each Intention: These, though they are manifold, and diversely prepared, yet those that are of chiefest note, and most in use are Mixtures, Linctus', Eclegmas, Tinctures, Balsams, Troches, Tablets, Powders, Pills, Decoctions and distilled Waters: We shall give you some of the most Elegant Receipts of each. 1. Mixtures. TAke Syrup of Meconium, and of Jujubes, of each an Ounce and a half, Olibanum powdered a Dram, Water of Earthworms, or Hysterick Water, or Water of Peony Compound a Dram: Mix them, the Dose is one spoonful going to Bed, and after Midnight. Take Water of Snails, and of Earthworms, of each an Ounce and a half, Liquid Laudanum Tartarized two Drams, Syrup of Violets an Ounce: The Dose is one spoonful going to Bed. Take Water of Snails six Ounces, Syrup of the Juice of ground Ivy three Ounces, Flowers of Sulphur half a Dram: Mix them, the Dose is a spoonful going to Bed, and early in the Morning. Take of our Syrup of Diasulphur four Ounces, Water of Earthworms an Ounce: The Dose is one spoonful after the same manner. 2. Linctus'. TAke Syrup of Jujubes, and Maidenhair, of each an Ounce and a half, Syrup of red Poppies an Ounce: Mix them, let it be taken with a stick of Licorice. Take Oil of sweet Almonds fresh drawn, Syrup of Maidenhair, of each an Ounce and a half, Sugar Candy two Drams: Mix them by bruising them in a Glass Mortar, or shaking them in a Glass Vial till they grow white. 3. Eclegmas. TAke Conserve of red Roses, two Ounces and a half, Lohoch Sanum an Ounce and a half, Species Diatragacanthi frigidi a Dram and a half, Flowers of Sulphur half a Dram, Syrup of Violets, or of red Poppies what suffices: Make a soft Lohoch; the Dose is a Dram and a half in the Evening, and early in the Morning; at other times let it be taken with a stick of Licorice. Take Powder of the Leaves of Hedge-mustard, or of Rockets an Ounce and a half, Clarified Honey four Ounces: Mix them, make a Lohoch, give it after the same manner; it is proper in a cold Constitution. 4. Tinctures. TAke Tincture of Sulphur free from any Empyreuma three Drams: The Dose is from six drops to ten at Night, and early in the Morning in a spoonful of Syrup of Violets, or of the Juice of ground Ivy. I know not a more excellent Remedy in any Cough, so there be no Fever. Take Tincture of Sulphur of Antimony two Drams: The Dose is twenty drops Evenings and Mornings in a spoonful of Pectoral Syrup. Take Tincture of Gumm Ammoniacum prepared with the Tincture of Salt of Tartar an Ounce: The Dose is from fifteen drops to twenty. Tinctures of Galbanum, of Assafaetida, of the Gum of Ivy, prepared after the same manner, are likewise proper in a cold Constitution. 5. Balsams. TAke Opobalsamum two Drams: The Dose is from six Drops to ten, in a spoonful of the Water of Hyssop, or Pennyroyal, or of any other Pectoral Water. Take Artificial distilled Balsam, commonly called Mother of Balsam two Drams: The Dose is from six Drops to ten, in a spoonful of Syrup of Violets, or of Canary Wine at Night, and in the Morning. Take Balsam of Sulphur two Drams: The Dose is from five drops to ten after the same manner. Take Balsam of Peru a Dram: The Dose is from two drops to four, or six, in Conserve of Violets. 6. Troches. TAke Species Diatragacanthi frigidi, half an Ounce, Licorice a Dram, Flowers of Sulphur two Scruples, Flowers of Benzoin a Scruple, Sugar Penids three Ounces, Solution of Tragacanth made in Hyssop water what suffices: Make a Paste, form it into Troches, weighing half a Dram; let one of them be taken pretty often in the Day or Night. Take Seeds of white Poppies six Drams, Powder of red Poppy Flowers a Dram, Extract of Licorice two Drams, Lac Sulphuris half a Dram, Sugar Penids two Ounces, Mucilage of the Seeds of Quinces what suffices: Make a Paste, and form it into Troches. Take Species Diaireos, and of Fox Lungs, of each half an Ounce, Sugar Penids two Ounces, Solution of Tragacanth, what suffices: Make a Mass to be formed into Troches. Take Powders of Elecampane Roots, Anniseeds and Licorice, of each two Drams, Flowers of Sulphur a Dram, Tablet Sugar an Ounce and a half, Juice of Licorice diluted and strained, what suffices: Make a Mass for Troches. 7. Tablets. TAke Species Diatragacanthi frigidi three Drams, Powder of red Poppy Flowers, Lac Sulphuris, of each half a Dram, Sugar dissolved in Poppy water, and boiled to a consistency for Tablets four Ounces: Make Tablets weighing half a Dram. Take Species Diaireos, and of Fox Lungs, of each three Drams, Flowers of Sulphur, Elecampane Roots, of each half a Dram, White Benzoin a Dram: Make a fine Powder, and Oil of Anniseeds a Scruple, Sugar dissolved, and boiled to a consistency for Tablets eight Ounces: Make Tablets weighing half a Dram. 8. Powders. THese, though seldom, yet sometimes are given in a Cough and affects of the Lungs with good success. Take of the Reddish tops of ground Ivy what suffices, being bruised let them be made into a Cake, and presently dried in the Sun, then reduce it into a fine Powder, and keep it in a Glass; this Plant retains its virtue, with its smell and colour excellently well for a long time, beyond all Conserves and Syrups, and is of wonderful efficacy in a great and obstinate Cough: Give from half a Dram, to a Dram twice a day, with a distilled water, or Pectoral Decoction. After the same manner, Powders are prepared of other Pectoral Plants, and are given with good success. Take Cupmoss three Drams, Lac Sulphuris a Dram, Sugar-candy half a Dram: Make a Powder, the Dose is from a Scruple to half a Dram twice a day. This Powder is proper for those that are troubled with a Convulsive or Chincough. Take Flowers of Sulphur, Olibanum, Ceruse of Antimony, of each two Drams, divide it into twelve parts: Give one Mornings and Evenings in a spoonful of some fit Vehicle. 9 Pills. TAke Aloes Rosat. or rather Pilul. Ruffi, Flowers of Sulphur, of each a Dram and a half, Flowers of Benzoin a Scruple, Juice of Licorice diluted with water of Snails what suffices: Make a Mass, form it into little Pills; let four of them be taken at Night, repeating the Dose every Night, or every other Night. Take Powder of Elecampane Roots, Licorice, and Flowers of Sulphur, of each a Dram, Flowers of Benzoin half a Dram, Tar what suffices: Make a Mass, and form it into small Pills; the Dose is three or four at Night, and early in the Morning. Take Millipedes prepared two Drams, Powder of the Seeds of Nettles and Burdock-seeds, of each half a Dram, Oil of Nutmegs drawn by distillation a Scruple, Salt of Amber half a Dram, Juice of Licorice what suffices: Make small Pills, let three of them be taken at Night, and in the Morning. 10. Decoctions. THese are taken either by themselves, or with Milk added to them: Among those of the first kind, the Pectoral Decoction according to the London Dispensatory, first presents itself; which is to be taken twice a day, from four Ounces to six or eight. Take Leaves of ground Ivy, Maidenhair, Harts-Tongue, Coltsfoot, Agrimony, of each a handful, Roots of Chervil, Butchers-broom, of each an Ounce, Seeds of Carthamus and sweet Fennel, of each half an Ounce, boil them in six Pounds of fountain water, till half be consumed, adding towards the end either of Licorice three Drams, Raisins stoned two Ounces, and six Jujubes, or of the best Honey three Ounces: Make an Apozeme, Scumming off the Froth, and Clarifying it with the white of an Egg. The Dose is six Ounces warm twice or thrice a day. Decoctions to be taken with Milk are used Mornings and Evenings instead of a Breakfast and a Supper, according to the manner following. Take great Daisy Flowers a handful, Snails cleansed, in number three, Candied Eringo Roots half an Ounce, Barley three Drams, boil them in a Pound and a half of fountain water to a Pound: Take from six Ounces to eight warm, adding as much of Milk, and afterwards let the quantity of this be increased by degrees. After the same manner, let Cupmoss, also the Leaves of ground Ivy, St. John's-wort, and of other Pectorals be boiled, and taken with Milk. Decoctions of Woods frequently conduce very much to the Cure of an obstinate Cough, especially being taken constantly for some time instead of Beer, as an ordinary Drink. Take Roots of Sarzaparilla four Ounces, of China two Ounces, red and white Saunders of each half an Ounce, shave of Ivory and Hartshorn, of each three Drams: Let them infuse according to Art, and boil in eight Pounds of fountain water to four Pounds, adding to it of Licorice six Drams, Raisins stoned an Ounce and a half: In a Phlegmatic or cold Constitution, add Rasping of Guaiacum. 11. Distilled Waters. EVery Man may make many and different Forms of these, as occasion requires, and according to the Constitution of the Patient they may choose sometimes Milk alone, sometimes Milk with some part of Wine, sometimes Ale, or Brunswick Beer: I shall give you a Specimen of these as follows. Take Leaves of ground Ivy, Hyssop, Pennyroyal, of each four handfuls, Snails half boiled in their shells two Pounds, Nutmegs sliced, in number six. All of them being small shred together, pour to them of new Milk eight Pounds: Distil them in common Organs, the Dose is three Ounces twice or thrice a day by itself, or with some other Medicine: When it's taken, let each Dose be sweetened with Sugar-Candy, or with Syrup of the Juice of ground Ivy. In a Constitution that is not hot, especially if there be no fervent heat of the Blood or Praecordia, to six or seven Pounds of Milk add of Canary Wine a Pound or two, and in a Phlegmatic or Aged Body, instead of Milk, let the Menstruum be Ale or Brunswick Beer. Moreover, in the Winter when Snails are not easily, or scarce at all to be gotten, the Lungs of a Lamb, or of a Wether may properly enough supply their place, and sometimes also those of a Calf half boiled and sliced very small; and let them be distilled with the foresaid Ingredients, and added to a fit Menstruum in common Organs, or a Rose-still. In this Classis, where it's treated of a Cough not yet arrived to a Physic; we may aptly range the Convulsive, or suffocating Cough of Children, commonly called the Chincough. This Disease chief assaults Children and Infants, and at certain times, viz. in the Spring especially and Fall, it's usually Epidemical. The Diseased have frequent and very cruel fits of Coughing, in which the Organs of Respiration do not only greatly labour, but likewise being affected with Convulsions, variously interrupt, suspend, or pervert their Actions: But for the most part the Diaphragm being seized with Convulsions by itself, or by the impuise of other parts, obstinately so continues for a very long space sometimes its Contraction, and sometimes its Dilatation, that Inspiration or Expiration being hindered for a time, the Vital Breath can scarce be drawn at all; so that the Coughers cry out as though they were strangled, and their Countenance turns black through the Stagnation of the Blood: If haply those Organs being not so much seized with Convulsions, they can Cough out freely, nevertheless they are still forced to Cough with violence, and so long till theia strength fails them. Though this Cough seldom kills, or proves very dangerous, yet it is very difficult to be Cured, and oftener ceases of itself as the year changes, than it is conquered by Medicines. The reason is, that we must not only in this, as in an ordinary Cough, altar the Blood, and derive its drossy Excrements from the Lungs to the habit of the Body, to be sent forth by transpiration, but we must likewise take care to correct the Nervous Juice, which in this case is vitiated with a Heterogeneous and Elastic matter which causes the Convulsive motions. As to the Cure of this Disease, the method of Curing used in other Coughs seldom proves successful in this; whererore only Empirical Remedies are commonly Administered. Amongst many Remedies of this kind, the two following are usually preferred before all others whatsoever, and are chief in use, viz. to give inwardly Cupmoss, and various preparations and compositions of it, and if there be need of and further Cure, the Child is to be put into some sudden fright. And if these things work not the desired effect, Ptisans, Syrups, Julapes, or Decoctions and other Pectorals are laid aside, and commonly all other Medicines are thrown by, expecting till the Disease either ends of itself in process of time, or be Cured by the succeeding change of the year. Cupmoss, so commonly used amongst us against Coughs of Children, has an Astringent virtue, (as we find by its taste) and contains Particles of a smart nature, which denote a plenty of Volatile Spirits, whence we guess its use to be to fix the Blood, and to moderate the Fluxions of the Serum, and likewise by Volatilising the Nervous Juice, to take away its Convulsive disposition: It's usually given in the form of a Powder, Decoction, and Syrup according to the following Forms. Take Cupmoss Powdered a Dram, Sugar-Candy a Scruple: Mix them, divide it into three or four parts, take a Dose Evenings and Mornings, with a fit Vehicle. Take of the said Moss two Drams, Lae Sulphuris two Scruples, Powder of Anniseeds a Scruple: Divide it into six parts, give them after the same manner. Take of the said Moss Dram, boil it in a quantity of Milk sufficient for one Dose; let the straining be taken Evening and Morning: For those with whom Milk does not agree, or to whom it does no good; let a decoction of it be prepared in fountain water, or Hyssop water, or any other Pectoral water, and let it be given to two or three Ounces twice a day, sweetening it with Sugar, or some proper Syrup. Take of this Moss an Ounce, boil it in two Pounds of some Pectoral Water, till half be consumed: To the straining, add of Sugar-Candy a Pound, and let it evaporate in a gentle Bath heat, to the consistency of a Syrup. The other remedy commonly in use for the Cough of Children, is to put them into some sudden fright, as by setting them in a Binn when a Mill goes, etc. which sometimes Cures the Disense on a sudden; the reason of which doubtless consists in this, that the Animal Spirits being put to flights, and driven into new distractions, quit their former disorders, and likewise that the Convulsive matter is either dissipated by that perturbation, or driven into other Nerves, where it proves less offensive. The Empirical Cure of this Disease being thus set forth, together with the Remedies vulgarly used, and their Aetiologies at least probably explicated: I shall now set down a certain rational method of Curing, and haply more efficacious against these sorts of Coughs of Children: Therefore in such a case, I usually prescribe according to the Forms following, and sometimes successively enough: And First, since we must begin with a Purge; Take Syrup of Peach Flowers a spoonful, Hysterick water a Scruple: Mix them, let it be taken Cum Regimine. Or, Take Calamelanos six Grains, Scammony sulphurated, Rosin of Jalup, of each three Grains: Make a Powder, give it in a little pulp of preserved Cherries to a Boy of six Years Old; and let the Dose be increased, or lessened according to the Age: Let the Purge be repeated in six or seven days. If the Patient (as it often happens) be prone to Vomit, take Oxymel of Squills six Drams, Salt of Vitriol four Grains: Mix them, give it to a Child six Years Old, and according to this proportion, let a Dose be accommodated to others: I have known this kind of Vomit given every Morning for four or five days successively to have done well. Blistering Plasters are much used, and let them be applied sometimes to the Nape of the Neck, sometimes behind the Ears, sometimes to the Insides of the Arms near the Armpits, and as soon as the Sores in those places begin to heal, let others be raised elsewhere. Instead of Beer, let the following Decoction be his ordinary drink. Take China Roots and Ounce and a half, all the Saunders of each half an Ounce; shave of Ivory and Hartshorn, of each three Drams: Let them infuse according to Art, and boil them in six Pounds of fountain water till half be consumed, adding of Raisins stoned an Ounce and a half, Licorice three Drams. Take Spirit of Gum Guaiacum with Sal Armoniac a Dram, Syrup of Cupmoss three Ounces, Hysterick water an Ounce: The Dose is a little spoonful at Night, and Early in the Morning. Or, Take Tincture of Sulphur two Drams: The Dose is three drops at Night, and early in the Morning in a spoonful of Syrup of Cupmoss. To some persons of a hot Constitution, and turning of a deep red, or rather black colour with Coughing, I have sometimes successfully ordered a Vein to be opened, or that two or three Ounces of Blood should be drawn from them by Leeches. Take live Millepedes cleansed two Ounces, Powder of Anniseeds a Dram, Nutmegs haif a Dram, double refined Sugar an Ounce: Being bruised together, pour to them of Hyssop water six Ounces, Magistral Snail water two Ounces: Stir them together a little with a Pestle, and express it storngly; the Dose is two or three spoonfuls twice a day. Thus far of the Cough and its Cure, whilst it is only an entrance to a Consumption; now we must treat of this affect, having passed the frontiers of this dangerous Disease, and set down a method of Cure, and forms of Medicines proper for Curing an Inveterate Cough, viz. when either neglected, or not easily yielding to Medicines, it gins to degenerate into a Physic, that is to say, when it is come to that pass; that the Blood being loosened in its Texture, does not only pour the superfluous Serum, but even the Nutritive, and haply the Nervous Juice, the Lympha, and other its dreggy Excrements on the Lungs, and deposes them within its Ductus'; and withal, that the depravation of the Lungs is by so much augmented, that its Vesiculae being distended, or many of them broken into one, and so a Solution of Continuity, or an Ulcer being caused, a greater Mass of Matter for the Consumption is daily heaped together: Moreover, and that the matter, in regard it is permitted to continue long there, Putrisies, and so still corrupts the Lungs more, and taints the Blood passing through them. In this case the Therapeutic Indieations are chief these three, viz. First of all to stop the dissolution or the Blood, which is the Root of all the mischief, and to prevent it from pouring always matter in so great a plenty on the Lungs. Secondly, To evacuate by Expectoration the corruption gather d together within the Lungs, and that sufficiently in some short time. Thirdly, To corroborate and dry the Lungs being dissolved as to their unity, or become too lax and moist, or otherwise weak, lest they are daily more corrupted, and receive the Morbific matter always more and more. Each of these Indications prompts us various intentions of Curing, and requires divers sorts of Remedies, and many ways of Administration; of which I shall here briefly touch the chief. Therefore what the first Indication suggests, to wit, to stop the dissolution of the Blood, these three things (as much as may be) must be procured, viz. First, that the Mass of Blood may contain within it, and assimilate whatever Nutritive Juice it is supplied with, and be so proportioned with it, that it be not faulty either in quantity or quality. Secondly, That the Acidities engendered either in the Blood, or conveyed to it from elsewhere be so destroyed, that the Blood retaining always its Mixture or Crasis, be not so subject to Fluxions or Fusions. Thirdly, That all dreggy Excrements in the Blood be derived from the Lungs to other Emunctories, and places of Evacuation. As to the first of these intentions of Curing, that the Nutritive Juice be proportioned to the Blood, before all things it must be ordered that Persons troubled with a Cough and Physic, abstain as much as may be from Drink, and take liquid things but in a very small quantity, so that the Blood being weak in its Crasis, may be able more easily to subdue the minute Portions of fresh Juice, as long as it is not too much cloyed with it, and to retain it within its Texture. Again, let that fresh Juice consist of such Particles as are subtle and gentle, that they may be mastered by the Blood, and be assimilated without any eager heat of contest: Wherefore Asses milk, sometimes also Cows Mild, or Goat's Milk; also Water-gruel, Cream of Barley, Ptisan, Almond Milks, and other simple sorts of food agree better, and nourish more than Flesh, Eggs, or Gelly-broaths, strong Ale, Wine, or any other kind of richer Fare. Secondly, That the Blood retaining its temperament, be not easily dissolved into Serosities offending the Lungs; as well it's own Acidities, as those of the other humours that are mixed with it, and especially of the Nervous and Lymphick humours must be destroyed: Which intention is excellently performed by Medicines prepared of Sulphur, which therefore in this case (so there be not a Hectic Fever) are frequently given, and in a large Proportion. Wherefore let the Tincture, Balsam, Syrup, Flowers, and Milk of Sulphur be given twice or thrice a day in a good large Dose; for the same purpose Traumatick or Vulnerary Decoctions, also Decoctions of Pectoral Herbs (commonly so called) and Roots are to be taken instead of ordinary drink: Moreover, Powder of Crabs Eyes, of Millepedes, and of other things containing an Alkalisate or Volatile Salt, are often given with good success. The Third intention of Curing, referring to the First Indication, viz. That the dreggy Excrements of the depraved Blood, (in case they much abound) be withdrawn from the Lungs, and Voided by other Emunctories, suggests to us many ways to be put in practice for withdrawing them; For besides Bleeding, Evacuation by Urine, and now and then a gentle Purge (which have place in all Coughs, even in a beginning Physic) we ought also to range here Baths, Breathing in a warm Air to promote perspiration, also frictions of the extreme parts, Dropax's, Issues, Vesicatories, shaving the Head, Errhin's, Apophlegmatisms, and all other general or particular ways of Evacuating humours or vapours. The Seeond Indication in a beginning Physic, viz. that the corrupted matter deposed within the Lungs, be every day readily and clearly discharged, is performed with expectorating Medicines: These are said to operate in a twofold manner, according as their virtue is conveyed to the Lungs two ways. For some of them taken by the mouth, immediately send their active Particles into the Trachea, which partly by making the passages slippery, and by loosening at the same time the matter there sticking, and partly by irritating the Excretory Fibres into Convulsions, cause an Expectoration: In which number Linctus' and Fumigations are esteemed the chief. Expectorating Remedies of the other kind, which are justly esteemed the best, exert their Energy by the conveyance of the Blood, for consistion of such Particles which cannot be subdued and assimilated by the Mass of Blood, when they enter it, being immiscible with it, they are presently cast forth again, and penetrate from the Arteries of the Lungs into the Ductus' of the Trachea, where cleaving to the matter, they divide, attenuate, and so exagitate it, that the Fibres being thereby irritated, and successively contracted in Coughing, the Contents of the Trachea, and of its Vesiculae are thrown up into the mouth. Medicines proper for this use besides Sulphur and preparations of it, are Artificial Balsams distilled with Oil of Turpentine, Tinctures and Syrups of Gumm Ammoniacum, Galbanum, Assafaetida, Garlic, Leeks, and the like strong smelling things; of which also Lohoch's and Eclegmas are prepared, and these indeed work both ways, so that partly by slipping down into the Trachea, and partly by entering the Lungs by the Circuit of the Blood, they set upon the Morbific matter both before and behind, and so throw it forth with the greater force. As to the Third Indication, viz. That the injured Conformation, or vitiated constitution of the Lungs may be restored or amended; such things must be used which resisting putrefaction, mundify, consolidate, dry and corroborate; for which ends also Medicines prepared of Sulphur, balsamics, and Traumaticks are proper: Hence some Empirics successfully prescribe not only the fume of Sulphur, but likewise of Arsenic to be drawn through a Pipe or Funnel into the Lungs, Moreover for this reason it is, that the change of Habitation, as from Cities to a Country or Sulphureous Air, or travelling from one Country into another hotter, proves so notably beneficial. So far of the method of Cure which seems to be proper for a deeper Cough, or a beginning Physic: Now we must set down some Select Forms of Medicines according to each of those Therapeutic Indications, which also according to the way used in a gentle Cough, free from a Physic, we shall distribute into certain Classes, and those are Mixtures, Linctus', Lohoch's, Tinctures, Balsams, Troches, Lozenges, Powders, Pills, Decoctions, and distilled Waters: We shall set before you some Examples of each of these, to which also may be added some of the forms of the Medicines prescribed before for a beginning Cough, and not yet arrived to a Physic. 1. Magistral Mixtures and Syrups. TAke of our Syrup of Diasulphur three Ounces, Water of Earthworms an Ounce, Tincture of Saffron two Drams: Mix them, take a spoonful going to Bed, and early in the Mornign. Take Syrup of the Juice of Ivy three Ounces, Snail water an Ounce, Flowers of Suslphur a Dram: Mix them by shaking them together, the Dose is a spoonful Evenings and Mornings. Take Tincture of Sulphur two Drams, Laudanum Tartarized a Dram, Syrup of the Juice of Ivy two Ounces, Cinnamon water two Drams: The Dose is a spoonful at Bed time, and if the Person does not sleep, towards Morning. The Syrup of Diasulphur. TAke Sulphur prepared after our manner, half an Ounce, the best Canary Wine two pounds: Make a close digestion in B. M. or in Sand for twenty eight hours: Which being done, take double refined Sugar two pounds, dissolve it and boil it to a consistency for Tablets in a little Water of Elder Flowers; then pour to this by little and little the Wine tinged with the Sulphur whilst warm; let it boil a little on the fire, scumming it, and strain it through Woollen. You will have a most delicate Syrup of a Gold colour, and of great efficacy against the Cough and other affects of the Lungs (so there be no bayling heat of the Praecordia, nor Hectic Fever) the Dose is a spoonful Evenings and Mornings by itself, or with other Pectorals. Syrup of Garlic. TAke Cloves of Garlic Peeled, and out in slices, in number ten or twelve, Anniseeds bruised, half an Ounce, Elecampane Roots sliced three Drams, Licorice two Drams; let them have a close and warm digestion, for two or three days in a pound and a half of spirit of Wine, put the clear and warm straining into a silver-dish; add of double refined Sugar a Pound and a half; the Dish being put on hot Coals, let the liquor be set on fire, and whilst it burns stir it; sirain it through Woollen, and keep it for use. Syrup of Turnips. TAke Turnips sliced, and double refined Sugar, of each half a pound; put them in a glaz d Pot, a lay of Turnips, and a lay of Sugar till it be full: Let the Pot, being covered with Paper, be put into an Oven to Bake with Bread; when it is taken out, press forth the Liquor, and keep it for use: The Dose is a spoonful Mornings and Evenings. Syrup of Snails. TAke fresh Snails with their shells, in number Forty; cleanse them with a Linen Cloth, than each of them being run through with a Bodkin; let the Apertures of the shells be fill d with Powder of Sugar Candy, and being put in a Linen Bag, let them be hung up in a Cellar, and let a Glass Vessel be set under them to receive the Syrup which will drop from them: The Dose of this is a spoonful twice or thrice a day in a fit Vehicle, viz. Aqua lactis, or some Pectoral Decoction. 2.3. Linctus' and Eclegmas. TAke Conserve of red Roses three Ounces, Tincture of our Sulphur two Drams: Mix them by stirring them in a Glass Mortar; the Dose is the quanticy of a Nutmeg at Night, and early in the Morning: Sometimes to allay a troublesome Cough, you may add to this of Olibanum half a Dram, or a Dram. Take Conserve of red Roses four Ounces, Flowers of Sulphur four Scruples, fine Oil of Turpentine a Dram, Species of Fox Lungs three Drans, Syrup of the Juice of ground Ivy what suffices: Make a soft Lohoch to be taken after the same manner, viz. Mornings and Evenings; also to be sucked at other times with a stick of Licorice. Take Powder of Sugar Candy four Drams, Tincture of Sulphur two Drams: Mix them by stirring them in a Glass Mortar; let it be taken after the same manner. Instead of the Tincture of Sulphur, you may put other Balsamic Tinctures, as of Balsam of Peru, of Opobalsamum, of the Gum of Ivy, Guaiacum, Amber, with many others, which may be mixed either in Conserve of red Roses, or with Conserve of the Flowers of Colts-foot, or with Sugar Candy. 4.5. Tinctures and Balsams of the same nature and composition as we have prescrib'd before in a beginning Cough, are proper in a Physic, only the Dose must be a little larger. Take of Tar an Ounce, Water of quick Lime thrice Cohobated, two pounds, distil them in Balneo to half: Then let the filtrated Liquor be drawn off in Balneo to the consistency of honey; to which pour Tincture of Salt of Tartar half a pound: Let it digest in a close Glass to extract the Tincture: The Dose is from twenty drops to thirty, with a proper Vehicle. After the like manner a Tincture in gotten out of the black Oil of Soot, Liquid Amber, Liquid Storax, and many other things. Take of our Sulphur prepared with the addition of Myrrh, Aloes, and Olibanum in a subtriple quantity an Ounce: Let a Tincture be drawn off with Oil of Turpentine, also with Rectified Spirit of Wine: The Dose of this is from fifteen drops to twenty. 6.7.8. Troches, Tablets, and Powders, because chief directed for the Cough, are in a manner of the same Nature and Composition with those before prescribed for that affect, when new taken; only that for drying and consolidating the Lungs Sulphureous and Traumatick ingredients are required in a greater proportion. Take Powder of the Leaves of ground Ivy a Dram, Flowers of Sulphur two Drams, Sugar Penids a Dram and a half, Juice of Licorice diluted with Hyssop-water, what suffices: Make Troches weighing half a Dram. Take Powder of Yarrow bruised, and dried in the hot Sun, half a Dram, Flowers of Sulphur, Olibanum powdered, of each a Dram, Powder of red Roses dried, half a Dram, Sugar dissolved, and boiled to a consistency for Tablets six Drams, Oil of Anniseeds a Scruple: Make Tablets weighing half a Dram. Take one thrice, or oftener in a day, and especially at night, and early in the morning. 9 Pills. TAke Juice of ground Ivy Clarified in the Sun a pound, Flowers of Colts-foot dried, tops of Hyssop, Sage, , of each a handful, Anniseeds, Carrawayseeds, sweet Fennel-seeds bruised, of each half an Ounce; distil them in Balneo Mariae to half, then strain it, and distil the straining to the consistency of Pills, adding Juice of Licorice half a Dram, Powder of Elecampane Roots, Flowers of Sulphur, of each three Drams, Flowers of Benzoin a Dram, Balsam of Peru, half a Dram, Tincture of Sulphur three Drams, Laudanum Tartarized two Drams: Make a Mass, form it into small Pills, and take three or four at night, and early in the Morning. 10. Decoctions, such as we have before prescribed for an obstinate Cough, may be also properly taken in a beginning Physic. In desperate Cases I have sometimes very successfully prescribed the following Decoction to be taken twice or thrice a day, and also instead of ordinary drink. Take Guaiacum four Ounces, China, Sassafras, of each two Ounces, all the Saunders, of each an Ounce, shave of Ivory and Hartshorn, of each three Drams: Let them infuse, and boil them in twelve pounds of fountain water to half, adding Licorice an Ounce, Raisins stoned four Ounces; strain it. 11. Distilled Waters such as before prescribed, are also proper here, to which may be added the Water of Solenander drawn from Hog's Blood with Turpentine; also Balsamic Waters distilled from Turpentine with Pectoral Ingredients. Take Leaves of ground Ivy, white Horehound, Hyssop and , of each three handfuls, Roots of Elecampane and Florentine Orice, of each two Ounces, Turpentine dissolved with Oil of Tartar four Ounces, Hyssop-water four pounds, Malaga-wine two pounds, distil them in Sand; let all the Liquor be mixed, the Oil being separated: The Dose is two or three spoonfuls twice a day, with a spoonful of the Syrup of the Juice of Ivy. 12. In the last place, We must here prescribe Forms of Vapours and Fumes, the use of which sometimes does more good in a Physic, not past recovery than any other Remedies; and this because they go to the Lungs itself, and so by an immediate operation, Purge it, dry it, free it from Putrefaction, strengthen it, and open its Ductus'. First, Therefore let a moist steam be made after this manner. Take Leaves of Hyssop, ground Ivy, whit horehound, of each two handfuls, Elecampane Roots two Ounces, Calamus Aromaticus, half an Ounce, Anniseeds, Caraway-seeds, of each an Ounce, being sliced and bruis d, boil them in a sufficient quantity of fountain water: Let the Vapour of the hot strained Liquor be drawn into the Lungs through the hole of a Paper roul'd up Conically, or in the Jhape of a Funnel, use it Mornings and Evenings for a quarter of an hour. 2. A fumigation or dry Vapour is usually made one while more gentle of mere Balsamicks, another while more strong of Sulphureous, and sometimes Arsenical substances. Take Olibanum, white Amber, Benzoin of each two Drams, Gum Guaiacum, Balsam of Tolu, of each a Dram and a half, Powder of red Roses, red Saunders, of each a Dram: Make a Powder to be strewed on burning Coals. Take Gum of Ivy, Frankincense, of each two Drams, Flowers of Sulphur a Dram and a half, Mastic a Dram; with a Solution of Gum Tragacanth, make Troths. Take white Amber, Olibanum, of each two Drams, Auripigment prepared, half an Ounce, Storax Calamita, Laudanum of each a Dram and a half, with a sufficient quantity of the Solution of Gum Tragacanth: Make Troches for fumigation. Empirics ordinarily prescribe the smoke of Auripigment to be taken in a Pipe lighted, like Tobacco, and that sometimes with good success. Moreover it's a practice with the vulgar to take bits of Cloth Painted with Auripigment (such as serves for Hang in Taverns) and shredding them very small to kindle them in a Pipe like Tobacco, and so to draw the smoke into the Consumptive Lungs for a Cure. Now in the last place it remains for us to speak of the great confirmed Physic which is commonly past Cure, and to advise what is to be done when the Lungs being very much vitiated and affected with one or more filthy Ulcers do not convey the Air and Blood according to their due Course, but defile, or corrupt the Mass of the latter, by Ministering to it continually a stook of Putrified matter, so that a Hectic Fever, and an Atrophia through want of nourishment seize the Diseased with a great decay of all their faculties, and daily impairing their strength, precipitate them to the Grave: The most certain sign generally acknowledged of this Disease growing so desperate, is a very troublesome pain, with an Inflammation in the Throat, for this affect argues a great Putrefaction of the Lungs, whence the corrupted Effluvia's exhaling, stick against the narrow passage of the Throat and there pierce, and vehemently irritate the tender Fibres in that part: In this case its in vain to attempt to Mundify the Lungs, and to cleanse the Ulcer, and dry it; for all hot Medicines designed for those ends, and proper enough in a beginning Physic, are not to be endured when it's confirmed; because augmenting the Inflammation of the Lungs they increase the Hectic Fever, the Thirst, Watch, and other very troublesome Symptoms, or stir them up a fresh: And indeed in such a state of this Disease, when we only propose to ourselves to protract Life by helping towards a well-bearing of the Distemper, and to an easy death, those Remedies are of chiefest use that moderate the fervour of the Blood, alloy the heat of the Praecordia, restore the Spirits, and gently cherish them: Hence for Food, Ass' Milk, also Water-gruel, Barly-Broaths, Cream of Barley; and for Drink, Ptisans, Emulsions, Milk, Water distilled with Snails and temperate Pectorals are usually of greatest success. Let Syrups and Linctus' which lenify the Inflammation of the Throat and Lungs, and facilitate expectoration, be often or daily given, but especially gentle Hypnoticks to procure a moderate rest: I shall now give you some of the more Select Forms of each kind. Take Barley half an Ounce, Candied Eringo Roots six Drams, parings of Apples a handful, Raisins stoned two Ounces, Licorice three Drams, boil them in three Pounds of fountain water or two: Make a Ptisan to quench thirst; let it be taken three or four times a day, and if it agrees, let it be used instead of ordinary drink. Take twenty Caudae Gammorum, Candied Eringo Roots an Ounce, a Crust of White-bread, Raisins stoned two Ounces, Licorice three Drams; boil them in three pounds of running Water, to two pounds: Strain it, take three or four Ounces thrice a day; after the same manner you may make a Decoction of Snails. Take Snails half boiled and sliced three pounds, Leaves of ground Ivy six handfuls, Nutmegs sliced, in number six, Pith of White-bread two pounds, Milk from the Cow eight pounds, distil it in an ordinary still. After the same manner you may distil a Water è Caudis Gammorum: The Dose is three or four Ounces thrice a day, sweetening it with Saccharum Perlatum, or Sugar of Roses. Take Ears of green Wheat what suffices, distil them in a Rose Still: Let the Person drink three or four Ounces thrice a day, sweetening it, with Saccharum Perlatum. Take Syrup of Meconium three Ounces, Water of green Wheat six Ounces: Mix them, let two or three spoonfuls be taken going to Bed every Night, or every other Night. Take Conserve of the Flowers of Wild or Garden Mallows three Ounces, Lohoch de Pino two Ounces, Syrup of Jujubes' two Ounces: Make a Lohoch, of which let a Dram and a half, or two Drams be often taken. I shall now give Instances of some Patients which I have had in Cure in the foregoing Distempers: And First, of one troubled with a simple Cough, which gins of itself, and is free from the suspicion of a Physic. Some years since I took care of the Health of a Student, who from his Childhood had been subject to a Cough, and was wont often to undergo severe fits of it, and of long continuance; he seemed to be of a pretty strong Constitution, only that his lungs, being originally weak, suffered much whenever his blood began to run into serosities; in summer, as long as a free perspiration lasted he was sound enough, but spring and fall, when the blood changing its temper, either of its own accord or upon some slight occasion offered falls into serous fluxions, he fell lightly into a Cough accompanied with abundance of thick spittle; yet this affect very often vanished by degrees within six or seven days, without any great ado with Medicines, assoon as the mass of blood was purged by the lungs: But if to the said slight occasion of this Disease other greater Causes were added, as chief the stoppage of the Pores, and errors in Diet, sometimes a most violent and obstinate Cough came upon him, not soon, nor easily yielding to Remedies, and threatening nothing less than a Physic: Then growing ill indeed, for the first days he had light shiverings in his whole Body, and perceived a Catarrh in his Larynx: Afterwards he was troubled with a frequent Coughing, accompanied with a thin spittle, together with a giddiness, deadness of the senses, and a dropping at the Nose. In this state his best Remedy, and often tried with good success was to drink Sack somewhat freely, and as little of any other Liquor as might be; for by this means the Acidity and flowing of his Blood being suppressed, and a more free perspiration raised, he sound himself very much eased, and sometimes in a very short space grew well: Moreover going to Bed, and first in the Morning he used to take seven or eight drops of Tincture of Sulphur in a spoonful of Syrup of Violets, or of the Juice of ground Ivy, Or, Take Conserve of red Roses four Ounces, Spirit of Turpentine two Drams: Mix them, the Dose is the quantity of a Chestnut Evenings and Mornings. But if these Remedies, together with the Canary Antidote, and a thin Diet do not do, the Disease not being Cured by such means, runs then to a great length, and following him sharply for some Weeks, and sometimes Months, brings the Diseased to a mighty leanness, and even to the brink of the Grave: For the Cough growing daily worse and very troublesome, hinders sleep mightily, and interrupts it, his strength languishes, his appetite is dejected, heat and drought press hard upon him: In the mean time the Spittle is daily increased, and cast forth in a vast quantity; so that afterwards not only the Serum and dreggy Excrements of the Blood, but even the nutritive Juice, and the wastings of the solid parts being continually poured on the Lungs, turn into corruption, which is Coughed forth in abundance; but respiration grows difficult, the Limbs very weak, and the Flesh consumes very much. When our Patient was lately ill in this manner, we prescribed the following Method and Remedies, by the continued use of which he at length recovered: In the first place a thin Diet being ordered him, and Ale or Beer wholly forbidden, he took of the following Apozeme about four Ounces twice a day warm, and a little of it at other times cold, to quench his thirst. Take China Roots two Ounces, Sarzaparilla three Ounces, white and yellow Saunders, of each an Ounce, shave of Ivory and Hartshorn, of each three Drams: Infuse them according to Art, and let them boil in eight pounds of fountain water to half, adding Raisins of the Sun three Ounces, Licorice three Drams: Strain it, and let it be used for ordinary drink. Take Tincture of Sulphur three Drams: Let him take from seven drops to ten going to rest, and early in the Morning in a spoonful of Syrup of Violets, or of Syrup of the Juice of ground Ivy. When by a long use of this Medicine he began to loathe it, the following Eclegma was ordered in its stead. Take Conserve of red Roses four Ounces, Spirit of Turpentine two Ounces: Mix them by bruising them together, the Dose is about a Dram at the same hours. Afterwards instead of this, the following Powder was sometimes taken. Take Powder of the Leaves of ground Ivy prepared in the Summer Sun three Ounces, Sugar Candy half an Ounce: Mix them, the Dose is half a spoonful twice a day, with three Ounces of the following distilled water. Take Leaves of ground Ivy six handfuls, Hyssop, white horehound, of each four handfuls, the Lungs of a Lamb half boiled and sliced small; pour to them of Posset-drink made with small Ale eight pounds, distil it in common Organs: Let the whole Liquor be mingled, and when it is used, sweeten it at pleasure with Sugar Candy, or Syrup of Violets. To appease the almost continual toil of Coughing, he swallowed now and then the following Troches, or a little extract of Licorice. Take Species Diatragacanthi frigidi three Drams, Powder of the Seeds of anise, Caraway, and sweet Fennel, of each half a Dram, Flowers of Sulphur two Scruples, Flowers of Benzoin a Scruple, extract of Licorice diluted with Hyssop water what suffices: Make a Paste, and form it into Troches. Or, Take Species Diaireos, è Pulmone Vulpis, of each two Drams, Flowers of Sulphur, Roots of Elecampane, of each half a Dram, Oil of Anniseeds half a Scruple, Sugar dissolved in a sufficient quantity of Pennyroyal water, and boiled to a consistency for Tablets six Ounces: Make Tablets according to art, weighing half a Dram; let him take one as often as he pleases, swallowing it by little and little. In the midst of this Course, though he had a weak Pulse, and was of a cold temperament, he was let Blood in the Arm: Besides these Remedies, a great benefit accrued to him from the fresh Air, which he took daily either on Horseback, or in a Chariot. For by this, he first began to recover his Appetite, Digestion, and Sleep, which afterwards were followed by degrees with an abatement of the other Symptoms, so that at length he perfectly recovered: He has used a method like to this, and with the like success, as often as till this time he has been troubled with a tedious and stubborn Cough; and now though he be wholly free from that distemper, yet he is forced carefully to avoid all occasions by which the Pores are stopped; or, by which a Fusion or Precipitation of the Blood into Serosities is raised, such are chief his going by Water on the Thames, and his drinking Acid Liquors, as Cider, French, or Rhenish Wines. The foregoing Relation gives you a Type, and way of Curing a Cough, caused through the fault of the Blood, and not reaching the limits of a Physic: Now follows another which Illustrates the nature of the same affect, when it proceeds chief from the Nervous Liquor. A Boy about ten years of Age, subject from his Infancy to be often troubled with a Cough, has undergone of late years some great and tedious fits of that Distemper, that is to say, he is wont at times to fall ill of a hollow and shrill sounding Cough without Spitting, which almost continually toils him Day and Night, and so tormenting him for many Days, nay and Weeks, it brings him to a very great weakness: Afterwards the Course of the Disease being passed over, (which happens not till the store of Morbid matter be consumed) in a short time he becomes well enough again, and as free as may be from any Distemper of the Thorax, till the Morbific matter (as it seems) being heaped together again to a fullness, without any evident cause the same affect returns, and acts over its Tragedy again with its wont severity: About the time it first seizes, the Cough usually troubles him only Mornings and Evenings; afterwards the Distemper growing worse by degrees, he often Coughs whole Days and Nights almost without ceasing, and if at any time Sleep either happening of itself, or being procured by anodynes, gives some truce, presently upon his waking, a more violent fit of Coughing comes upon him: After this manner Coughing very frequently and most vehemently without Spitting he continues ill for three Weeks or a Month, till he be brought to a mighty leanness, and an extreme weakness; and then the Distemper remits by degrees, so that he Coughs somewhat more seldom, and Sleeps indifferently, shortly afterwards growing very hungry, he soon becomes full of Flesh, and vigorous, and recovers in a short time his former Health. These fits seldom trouble him in the Summer, but in the rest of the year they return sometimes three or four times, and put the Patient in great danger of his Life. The cause of this Distemper is not the same as of a vulgar Cough, in which a Serous humour distilling either slowly, or in a plentiful manner from the Vessels of the Trachaea, or of the Lungs into the Vesiculae or little Pipes of the Trachea induce the Symptoms that attend that affect; for it plainly appears that in this the Ductus' of the Aspera Arteria are wholly free from any Serum or thick humour, because the Cough which is always deep and sonorous, throws forth nothing: Nor does this Cough arise from the Blood forced into the Membranes of the Lungs, because in this there is no Fever, Thirst, nor Pain, as in a Peripneumonia; neither does its Morbific matter seem to stick to the Nerves or Muscles ordained for breathing, because then besides the Cough, Asthmatick or Convulsive fits, with a sense of choking would sometimes follow, which do not happen to our Patient. I guess therefore that a certain Serous and sharp matter, full of a Scorbutic taint, falling from the Head by the conveyance of the Nerves, enters the Nervous Fibres and Membranes of the Lungs, or of the Trachaea, and throughly cleaving to them, increases by degrees to a fullness, and at length growing angry and turgid, through its perpetual irritation creates so troublesome a Cough. When this affect once seizes, it is wont to hold on its Course for a very long time, in despite of all Remedies: Pectoral Medicines commonly so called, as Syrups, Linctus', Eclegmas did little or nothing towards the Cure of this Disease, though sometimes I have thought good to use them for making the Lungs slippery, and to moisten them, lest haply they should be endangered to be torn asunder, by the violence of the Cough, and their Vessels to be broken; for sometimes in a violent fit, our Patient used to Cough forth a little Blood, though no thick Spittle. A gentle Purge in the beginning of this Disease has often done good, as also in its declination. Opening and Diuretic Medicines always work a good effect, of both which he uses what suffices throughout the whole Course of his Distemper, for his ordinary drink. Evenings and Mornings he takes some drops of the Tincture of Sulphur, with the Water of Snails lacteated: I was forced sometimes to give late at Night a Dose of the mixture of Diacodium, or of Liquid Laudanum: In two of his fits he was Blooded, from which he received no good. In the last fit, which beginning about the Autumnal Equinox, passed over somewhat more lightly and gently, the following method of Cure was observed. First of all, this Cathartick was given him, and repeated after four days. Take Calamelanos half a Scruple, Rosin of Jalup four Grains: Mix them, make a Powder, let it be taken in a spoonful of Syrup of Violets. Take China Roots sliced a Dram, Grass Roots three Ounces, Chervil Roots an Ounce, Candied Eryngoes six Drams, shave of Ivory and Hartshorn, of each three Drams, Raisins of the Sun stoned, three Ounces: Boil it in three pounds of fountain water, to two pounds, strain it, and let it be used for ordinary drink. Take Syrup of Jujubes' two Ounces, Diacodium an Ounce, Spirit of Sal Armoniac with Gum Ammoniacum a Dram: Mix them, the Dose is a spoonful going to Bed, and early in the Morning: He was much relieved by this Remedy, though he took it only every other, or every third day; and sometimes in its stead, a Dose of the Tincture of Sulphur, with Syrup of Violets was given him. The Disease declining, he was purged twice, and afterwards recovering by degrees, he grew well enough within a fortnight: But finding him subject not only to frequent relapses of Coughing, but that each fit when it came upon him was irresistible, and that its stay notwithstanding any use of Remedies was of long continuance, and threatened nothing less than a Consumption: I advised him that as well for preservation, and in case the affect returned, as for Curing it, he should Travel to a Region hotter than ours. He took my advice, and about the beginning of November went to Montpellier, where passing half a year, he had only two slight touches of illness: Since being returned to England, he enjoys, thanks be to God, a perfect Health, quite free from his Cough. CHAP. II. Instructions and Prescripts for the Cure of Spitting Blood. THe Indications for Curing a Spitting Blood, are chief these two, viz. First, presently to moderate and stay the Flux of Blood: And then in the Second place to heal the dissolution of Unity, without leaving a Consumptive Putrefaction in the Lungs. In reference to the First, These two things are chief to be procured: First, That the Blood do not flow to the part affected: Secondly, That withal the Aperture of the Vessel be some way closed. 1. To keep the Blood from flowing to the part affected, many intentions of Curing must be set upon together, viz. We must lessen the quantity of Blood, moderate its fervent boiling, altar its ill temper, retard its motion, or divert it another way: For which ends Blooding, Ligatures and Frictions most commonly do well. Moreover, Julapes, Decoctions, Emulsions, and Juicy expressions of Herbs ought to be given, and likewise moderate Hypnoticks; especially Diacodiats are taken with good success: For these by putting a stay to the motion of the Heart, alloy the fervour of the Blood. 2. To close the Aperture of the Vessel, Astringent Remedies, and Agglutinatives are most proper: The chief of these are usually given in the Form of a Linctus, so that some of its Particles in swallowing, falling on the Aspera Arteria may more immediately communicate their virtue to the part affected. But the way of this Operation seems to be of no great moment, because the Efficacy of the Medicines reaches chief, and in a manner only by the way of the Blood to the Root of the Disease: Wherefore not only Lohoches, but likewise Decoctions, Powders and Pills of Traumatick, and Balsamic Ingredients are successfully prescribed. The Second Indication, which is for preservation, having regard to the Cure of the dissolution of Unity, without leaving any blemish in the Lungs, aught to provide against two sorts of evils, viz. That the Spitting Blood (to which the Persons affected will be always subject) does not return at times; and that the Consumption, which threatens all those that Spit Blood, does not follow it: For which ends in order to the prevention of this Disease, we must take an assiduous care of, or use a constant method of Cure to the Blood and Lungs. 1. As to the Blood, its Mass ought always to be kept in a due quantity, a just temper, and a gentle and continued motion: Hence lest it abound too much, or being affected with an evil temperament, grows turgid, or deposes impure dregs in the Breast, we must sometimes use Bleeding, and a gentle Purge; an exact Form of Diet is always necessary. Moreover, drinking of Ass' Milk, or of Mineral Waters contribute sometimes egregiously to the purifying and sweetening of the Blood. Again, Decoctions, Distilled Waters, Juices of Herbs, which take away the Dyscrasies' of the Blood, and derive the Serum and other Impurities from the Lungs, and carry them forth by Sweat or Urine, must be diligently taken: Issues also mightily conduce for this end. 2. Nor must less care be taken of the Lungs themselves, that their whole frame, and especially the place affected, be preserved in a due Conformation, and right Tone: Hence all violent motion, by which Unity is farther dissolved, or its restauration hindered, is carefully to be avoided. Let the Person live in a clear and brisk Air, though it must not be too sharp and piercing. Let him abstain from gross Food, long Sleeps, large Suppers, and other errors in Diet, which cause a Repletion, or Obstruction in the Praecordia: Besides this, let Remedies be used, which are said to Cure the Lungs, by a peculiar or certain Specific Virtue. Having given you the method of Curing Blood Spitting, I shall now set down some Select Forms of Medicines, answering to each of the Therapeutic Indications, and to the various intentions of Curing that belong to them: And we justly give the precedency to those which encountering the most urgent Symptom, presently stop the flowing forth of Blood, cast out of the Lungs by a Cough, or otherwise: In the First rank of these Medicines, we place those which hinder the Blood from flowing to the part affected, and have a certain Astringency, together with an Agglutinative Virtue, by which the Aperture of the Vessel is closed; and after a clyster and Blooding (unless the weakness of the Pulse, and a deficiency of heat forbidden it) they are presently given in the form of a Julape, Decoction, Emulsion, Juicy Expression, Powder, Pills and Lohoches: I shall give you some of the choicest and most efficacious prescripts of each of these, as also of Hypnoticks, which nevertheless must not be used at random, and indifferently, but every of them methodically and seasonably, according to the various Constitution of the Patient, and Nature of the Disease, as a prudent Physician shall direct. 1. Julapes and distilled Waters. TAke the Waters of Purslain and red Poppies, of each six Ounces, Dragon's Blood finely Powdered half a Dram, Syrup of red Poppies two Ounces, Spirit of Vitriol of Mars, half a Scruple: Mix them, the Dose is three Ounces, repeating it within five or six hours. Take Plantain water a pound, the Gums Tragacanth and Arabic Powdered, of each half a Dram; mingle them and dissolve them, then add Syrup of dried Roses, an Ounce and a half: Make a Julape, the Dose is three or four Ounces every third or fourth hour. Take the Waters of Oak-buds, red Roses, and Nymphaea, of each four Ounces, Bloodstone very finely Powdered, Bole Armeniack Powdered, of each half a Dram, Syrup of Nymphaea two Ounces: Mingle them, the Dose is three or four Ounces, three or four times a day. Take of the Dew or insipid Phlegm of Vitriol a pound, Syrup of Myrtles two Ounces: Mix them, the Dose is two or three Ounces, often in the day, or in the night. Take Cypress tops eight handfuls, Willow Leaves or Flowers six handfuls, Roots of the greater Comphrey and Nymphaea, of each half a pound, Balaustia two handfuls, all being sliced small together, pour to them of fresh Milk eight pounds, distil them in Common Organs: The Dose is three or four Ounces, thrice or oftener in a day. Take of this distilled water, and of Plantain water, of each half a pound, the Gums Tragacanth and Arabic, of each two Drams: Dissolve them, the Dose is three Ounces every third hour. The following Mixture is prescribed by Frederick decker's, to be taken a Spoonful at a time, and seems to be a good Medicine. Take Plantain water two Ounces, Cinnamon two Drams, Confection of Hyacinth a Dram and a half, distilled Vinegar half an Ounce, red Coral prepared half a Dram, Balaustia, Dragon's Blood, of each half a Scruple, Laudanum Opiatum three Grains, Syrup of Myrtles an Ounce: Mingle them. Take the Waters of Plantain, red Roses and Purslain, of each four Ounces, Bloodstone and Dragon's Blood reduced into a fine Powder, of each half a Dram, Sugar Candy six Drams: Make a Julape. A Solution of common Vitriol, or of Vitriol of Mars made in fountain water, and applied to a Wound with a rag, excellently stops all Fluxes of Blood, but it is not proper to be given inwardly. 2. Decoctions, Tinctures, and Emulsions. TAke Leaves of Blood-wort, Perwincle, Mousear, Plantain, Woodsorrel, both sorts of Daisies of each a handful: Flowers of red Roses half a handful, Barley half an Ounce, Raisins two Ounces, boil them in three pounds of Water, in which red hot Iron has been quenched, till it comes to two pounds; add to the straining Syrup of St. John's wort two Ounces, or of Mousear: Make an Apozeme, the Dose is four or six Ounces thrice a day. Take Leaves of St. John's wort, Roots and Leaves of Tormentil, great Burnet, Meadow-sweet, of each a handful, Seeds of Purslane, Plantain, and Sorrel, of each a Dram, Conserve of red Roses half a pound, fountain water four pounds: Let them boil close in B. M. for twelve hours; to the straining, add Spirit of Vitriol of Mars, half a Scruple, take it after the same manner. Take Barley water with madder Roots boiled in it, a pound and a half: Put into it, when grown pretty cold, of red Rose Leaves a handful: Add Spirit of Vitriol a Scruple, let there be a close and warm infusion for three hours: Make a Tincture, to the straining add Syrup of the Juice of St. John's wort, an Ounce and a half: Take three or four Ounces, thrice or four times in a day. Take of the Decoction of the Roots of fresh Nettles, a pound and a half, Seeds of white Poppies, and of Henbane, of each two Drams, Melon seeds peeled six Drams: Make an Emulsion according to Art, sweetened with Sugar Penids: The Dose is three Ounces, three or four times a day. 3. Juices of Herbs, and Juicy Expressions. TAke Juice of Plantain Leaves half a pound: Let two or three Drams be taken thrice a day, with three Ounces of the distilled Water above written, and sweeten it at pleasure. Take Leaves of fresh Nettles, Plantain, the lesser Daisy, of each three handfuls; being bruised together, pour to them of Purslain water six Drams: Wring it forth hard, take it as the former. 4. Powders and Pills. TAke Powder of Bloodstone, of Dragon's Blood ground on a Marble with Rose-water, and of Pearl, of each a Dram, Bowl Armeniack, Terra Lemnia, of each half a Dram, Troches of Winter Cherries two Drams: Make a Powder, divide it into twelve parts; let one part be taken thrice a day with the distilled water above written. Take of the Seeds of Henbane, and white Poppies, of each ten Drams, Terra Sigillata, red Coral, of each five Drams, Sugar of Roses three Ounces: Make a Powder, the Dose is a Dram Morning and Evening. This Composition brought into a soft Consistency with some proper Syrup, is called Helidaeus' Electuary, so Famous heretofore in Germany. The foresaid Powders may also be made into convenient Pills and Tablets, by adding the Solution of Tragacanth, or some fit Syrup. The spongy Excrescency usually growing to the fruit of the Dog-Rose Tree, made into Powders, and given twice a day to the quantity of half a Dram, is a very good remedy in spitting Blood. Take Yarrow bruised and dried in the Summer Sun, what you think good: Make it into a fine Powder, and keep it in a Glass for Use: The Dose is from half a Dram to a Dram, twice a day in a fit Vehicle. The Powder of Julius Caesar Scaliger, or rather of Serapion is mightily commended: The Dose is four Drams, twice or thrice a day. 5. Lohoches and Electuaries. TAke Conserve of red Roses, and of the Dog-Rose, of each two Ounces, Powder of the Seeds of the white Poppy, and of Henbane, of each two Drams, Species Diatragacanthi frigidi, a Dram and a half, Bloodstone, Sanguis Draconis prepared, of each half a Dram, Syrup of red Poppies what suffices: Make an Electuary, let the quantity of a Chestnut be taken Evenings and Mornings, and at other times suck it with a stick of Licorice. Take Conserve of the Flowers of great Comphrey, and of Water-lilies, of each an Ounce and a half, Troches of Winter Cherries, and Diatragacanthum frigidum, of each a Dram and a half, Syrup of Jujubes what suffices; Make a soft Lohoch, of which take often with a stick of Licorice. Take of the White of an Egg well beaten two Drams, Lucatellus' Balsam half an Ounce, Troches of Winter Cherries two Drams, Syrup of red Poppies what suffices: Make a soft Lohoch, take the quantity of a Chestnut Morning and Evening. The Second Indication being for preservation, suggests to us those Remedies which keeping the Blood in a just temper, and the Lungs in a due Conformation, provide against a relapse of Spitting Blood, and an ensuing Consumption; such as regard the Blood are either gentle Evacuatives by Siege, Urine, and Sweat, or mere Alteratives. Every one of these are wont to be prescribed either in the Form of a Drink, Powder, Electuary or Pills: We shall set down some Select Forms of some of the chief of them. 1. As to Evacuatives, a gentle Purge may sometiems be ordered after this manner. Take of the best Sena three Drams, Cassia bruised with the Fistula an Ounce, Tamarinds three Drams, Corianderseeds a Dram and a half: Boil them in a sufficient quantity of fountain water to fix Ounces, to the straining add Syrup of Cichory with Rhubarb an Ounce, Clarify it with the White of an Egg. Or, Take Gereons' Decoction of Senna four Ounces, Purging Syrup of Apples an Ounce: Mix them, and make a Potion. For preserving the Blood in a good temper, and that its dreggy Excrements derived from the Lungs, may be continually discharged by Sweat and Urine, the following Alteratives, or some of them must be constantly taken; which being also of a healing Nature, relieve Lungs that are infirm, or dissolved in their Unity. For ordinary Drink, let it be pure Water, especially in a hot Constitution, or water a little tinging with Claret Wine: Those with whom this Drink does not agree, may use with as good success a Bochet of China and Sarsa, with the shave of Ivory, Hartshorn, and white Saunders in it, or sinal Beer, or Ale, with the Leaves of Heart's Tongue, Oak of Jerusalem, and the like infused in it. Let Pectoral Decoctions, or Hydromels' with temperate Traumatick Herbs be taken twice or thrice a day, to six or seven Ounces. Take Roots of fresh Nettles, and Chervil, of each an Ounce, Leaves of Heart's Tongue, Speedwell, Mousear, Ground Ivy, St. John's-wort, of each a handful: Boil them in three pounds of fountain water to two pounds, adding Raisms stoneed an Ounce and a half, Licorice two Drams; to the straining add Syrupus Byzantinus two Ounces, Clarify it with the White of an Egg: Make an Apozem to be taken to four or six Ounces twice or thrice a day for a Month. In a cold or Phlegmatic Constitution, the Licorice and Raisins being omitted with the Syrup, add towards the end two Ounces of the best Clarified Honey; strain it, and keep it for use: The Dose is the same as the former. Let these things sometimes be taken betwixt while with a distilled water appropriated to the same end; which also may be more frequently taken by some Persons, to whom Apozems are nauseous and loathsome. Take Cypress Tops, Leaves of ground Ivy, of each six handfuls, Snails half boiled a pound and a half, All the Saunders bruised, of each an Ounce: Being sliced and bruised, pour to them of new Milk eight pounds, distil it with common Organs: The Dose is three or four Ounces with a spoonful of Syrup of the Juice of ground Ivy twice a day. 2. In respect of the Lungs, viz. that the Union of its parts, and the due Conformation of the whole may be preserved without any obstruction, or opening of its Vessels, temperate Balsamicks are of chiefest use: For this end Lucatellus Balsam is perscrib'd even by the vulgar to be taken constantly, and for a long time by such as Spit Blood. Chemists and some famous Women cry up above all things a Balsamic Oil drawn by distillation, which they call Mother of Balsam. I shall now illustrate this Method of Cure by a Story. A famed young man falling from a Scorbutic Cachexia into a Palsy, and for the Cure of this Disease, having tried Remedies not only great, but likewise disproportionate to his Blood and Spirits, viz. Salivation, and the use of hot Baths, happened to be seized with a Spitting of Blood, and its fits (of all I ever knew that were not presently mortal) seemed the most dreadful. The First appearance of this Blood Spitting was after the operation of Hews' Powder, by which having for some time undergone a Salivation, though without Curing his Palsy, he was brought to a great weakness: Then being afflicted with a Catarrh, and a very troublesome Cough, he began to cast forth a discoloured Spittle, and sometimes tinged with Blood, sometimes sprinkled with it. But this Disease being mild at First, soon vanished by the use of Medicines, and afterwards the Person going into the Country, and breathing a purer Air, grew better, and in a while seeming to be sound enough in his Breast, he went to Bath to Cure his Palsy: Where Bathing every day for six Weeks in the hot waters, he got his Cough again, and soon after fell into a terrible Spitting of Blood, so that in twenty four hours space Counghing up Blood almost continually, and in a large measure, he threw forth a vast qantity. Going to see him the First time in this Condition, provision being made for the whole, I presently ordered Bleeding for Revulsion, though after its Administration (both then and ever after) his Blood Spitting either returned a fresh, or was provoked more by it. Moreover I gave Julapes, Lohoches, Decoctions, and even Hypnoticks, which doing little or no good: I ordered Ligatures about his Arms and Thighs, which first of all gave a check to the Tyranny of this Disease: And as now and then the Evil burst forth again, I persuaded him at length that forbearing the use of Beer, he should drink constantly a Decoction of Sarsa and China with Pectorals: By the almost continued use of this, observing likewise an exact Form of Diet, and abstaining wholly from Wine, hot Aliments, and Salt and Sugar, he had his health well enough for above two years. But afterwards being very much heated in a Crowd, he fell again into a terrible Spitting of Blood: A Physician being called, he was presently Blooded in his Arm, after which his Blood Spitting became more violent; and when on the Second and Third days after he was Blooded again, the Evil increased upon him each time: At length Ligatures being used (as before) and a Pectoral Decoction, and a Lohoch carefully taken, the Disease presently abated, and in a short time wholly ceased: Nevertheless he continued the use of his Pectoral Decoction, and thin Diet, viz. without any Flesh above six Weeks, and thereby obtained truce from his Enemy for three years: And when afterwards sometimes after drinking Wine, or too plentiful a Diet, the Blood growing turgid, began to burst forth of the Lungs, presently by the Ligatures, together with the use of the Decoction and Linctus, and the thin Diet, the force of it was always allayed. Nevertheless he became not so secure, but was forced to keep in a manner always watch and ward against that lurking Enemy: For not long since through the Distemper of the Season, he was seized with a very troublesome Catarrh, accompanied with a Cough, and much Spittle which was now and then Bloody, and then the former Medicines did not do: Whereupon of his own head he betook himself to new things; and First of all he took Evenings and Mornings a spoonful of the Syrup of the Juice of ground Ivy, and found thereby great good: but that Syrup, by reason of the Sugar, growing in a short time loathsome to him, he took twice a day in a spoonful of some Liquor to half a Dram, or a Dram of the Powder of that Herb well prepared; which Remedy being used a long time, he became much better as to his Catarrh and Cough, but his Blood Spitting breaking forth now and then, though it were in a small quantity, he changed his Medicine again; and took twice a day a Powder of the Tops, and especially of the hairy Excrescencies of the sweet Briar Tree: Which Medicine alone, a certain Physician formerly renowned for the Cure of Spitting Blood, had used with great success: Nor did our Patient receive a less prosperous effect from that Remedy: For by it he presently got wholly free from his Cough, Catarrh, and Blood Spitting, and so continued for a very long time, till at length thinking this Disease of his Breast wholly conquered, and therefore to be slighted, he took up arms against the other more ancient, viz. the Palsy. Wherefore whilst neglecting his Spitting Blood, he took daily to overcome that Distemper, a large Dose of hot Medicines, viz. Magistral waters distilled with Wine, Spirit of Hartshorn, of Sal Armociack, Aromatic Powders and Confections, and indulged himself likewise to a more plentiful Diet, drinking Ale and Wine moderately, the roaring Lion which seemed before a sleep, roused himself again, viz. he had not long continued that Antiparalitick Method, but the Blood Spitting returned with a very great violence, so that in the space of twenty four hours, he Coughed forth above three pounds of forty Blood; and afterwards when a Physician being called, he was presently Ordered to be Let Blood, after bleeding the Blood Spitting beginning to be abated (as it was always wont before) was provoked a fresh: Which nevertheless after the Application of the Ligatures, and the diligent taking of the Linctus and Pectoral Decoction, was presently mitigated, and in a short time wholly ceased. And when afterwards he had used above Three Months the Pectoral Decoction, and an entirely thin Diet, viz. without Flesh, and of mere Herbs, Corn, and Milk Meats, he revocered in a short time his former health, and now lives in that state, triumphing over that cruel Disease. This Person always found the use of the Pectoral Decoction to do him good: Wherefore though he changed now and then his other Medicines, he always retained the same Composition of that; and recommended it to many other Persons seized with a Blood Spitting with success. The Form of the Prescript is thus. Take all the Saunders, of each six Drams, Infuse them for twelve hours in seven pounds of fountain water, then let it boil till a third part be wasted, after add of the Leaves of Coltsfoot, Maiden hair, Mousear, Speedwell, Flowers of St. John's-wort, of each two handfuls, sweet Fennel-seeds six Drams, Licorice slit half an Ounce, Raisins stoned half a pound, boil them to four pounds; then strain it, and use it for your ordinary drink. Moreover, when the Blood Spitting was upon him, or was coming, he took thrice, or oftener in a day the quantity of a Nutmeg of the following Electuary, drinking after it seven spoonfuls of the Julape. Take Conserve of red Roses three Ounces, Conserve of Hips and Comphrey, of each an Ounce and a half, Dragon's Blood a Dram, Species of Hyacinth two Scruples, red Coral a Dram, with a sufficient quantity of Syrup of red Poppies, Mix them, and make a soft Electuary, take at Night, and early in the Morning a Dram and a half, drinking after it a draught of the following Julape; at other times let him take it with a stick of Licorice. Take of the Waters of Plantain, and of the Spawn of Forgs, of each six Drams, Syrup of Coral, and of dried Roses, of each an Ounce, Dragon's Blood two Scruples: Mix them, made a Julape. CHAP. III. Instructions and Prescripts for Curing a Peripneumonia. THe Peripneumonia is an Inflammation of the Lungs with an Acute Fever, a Cough, and a difficulty of Breathing; it is caused by a rushing of the Blood into the Ductus' of the Lungs, and its being there inflamed and obstructed. The Primary Indication in order to the Cure of a Peripneumonia is, that the Blood forced into the Vessels of the Lungs, and causing there an Obstruction with an Inflammation, be thence discussed, and restored to its former Circulation, which if it may not be done, the Second Indication will be, that that matter be duly Concocted or Suppurated, and with all expedition voided by Spittle. 1. Whilst the former Indication holds good, the Intentions of Curing will be these following: In the First place, That the excessive current of the Blood to the part affected be cut off, or some way hindered. Secondly, We must endeavour that the matter stagnating in the Lungs, or extravasated, be sucked up again by the Veins into the rest of the Mass, and restored to its Circulation: Which the better to effect. Thirdly, The Blood must be freed of its clamminess, or viscous nature, whereby its fluidity is hindered. And Fourthly, We must obviate by fit Remedies those Symptoms that are very pressing: viz. the Fever, Cough, Watch, and difficulty of Breathing: But if notwithstanding all this, the other Indication must be pursued, we must add to the Remedies before mentioned, such as they commonly call Maturating and Expectorating Medicines. 1. To satisfy the First and Second Intentions together, Blooding is requisite almost in every Peripneumonia, nay sometimes it ought to be often repeated: For the Vessels being emptied of Blood, they do not only withdraw the matter which maintains the Disease, but likewise drink up again what was forced into the part affected: Wherefore if the strength holds, and the Pulse be of a sufficient vigour, its good to bleed freely at the very beginning, but otherwise you must do it in a moderate quantity, and repeat it now and then as occasion requires: In this Distemper the Vein should always be opened with a large Orifice, and the Blood should not only Issue forth in a full stream, but its running should be continued; for otherwise if in the midst of bleeding, whilst the vitiated Blood flows forth, the Orifice be stopped with the Finger, (as some are wont to do to prevent fainting) when it's opened again, a pretty good Blood will Issue forth next, the vitiated Blood, if any such be remaining, being fallen back, and not presently returning to the Orifice. Besides Bleeding, many other Remedies are here to be used, viz. such as repress the turgid motion of the Blood, and empty its Ductus', whereby the Morbific matter may be drank up again: Wherefore a very thin Diet is prescribed, consisting almost merely of Barley and Oat-meats. And though cathartics are wholly forbidden, because they strongly exagitate the Blood, and force it more violently into the part affected: Nevertheless Glisters aught to be daily Administered which gently ease the Belly, and draw the dreggy Excrements of the Blood downwards. Moreover qualifying Julapes and Apozemes, which alloy the fervour of the Blood, and pleasantly lead off its superfluous Serosities, and likewise gently open the passages of the Breast, are taken with good effect. The Third Intention of Curing which has regard to the taking away of the obstructing clamminess, or viscous nature of the Blood, it performed wholly by those Remedies which loosen its over-close Texture, and dissolve the Combinations of its Salts. And truly those Remedies which Reason and Analogy might dictate in this respect, are used even at this time after a long expeperience: For Powders of Shells, the Tusk of a Boar, the Jawbone or a Pike, and other things endowed with an Alkalisate Salt; also Shall Prunella are prescribed by all Practitioners, both Ancient and modern. I have known Spirit of Sal Armoniac, and of Hartshorn, to have done great good in this Disease: And for the same Reason it is (viz. Because of the good effect of the Volatile Salt) that an Infusion of Horse-dung, though a vulgar Remedy, has often given great relief. Fourthly, As to the Symptoms and their Cures, a great many Remedies appropriated to these, are Coincident with the former: For the same Julapes and Apozemes which appease the fervour of the Blood, and also restore the Animal Spirits, are in most common use against the Fever: To which also in respect of the Cough, and the diffculty of Breathing, temperate Pectorals are joined: The greatest difficulty is, what must be given against want of sleep, it at any time the Person be very much molested by it: For Opiates adding to the prejudice of Respiration, which is under some stress from the beginning of this Disease, may scarce be taken with safety, nay sometimes they become pernicious: Wherefore Laudanums, and the stronger preparatious of Opium must be utterly avoided in a Peripneumonia; though in the mean time anodynes, and the more gentle Hypnoticks, as especially the Water and Syrup of red Poppies are not only allowed, but accounted Specificks in this Disease, and in the Pleurisy: Moreover we may sometimes use Diacodiats so the strength holds, and the Pulse be strong, and in a good temper: For the pain of the Breast, if at any time it proves troublesome, its proper to use sometimes Ointments, Fomentations, and Cataplasms. The Secondary Therapeutic Indication, whereof the Intentions are to Concoct, and to discharge by Spittle, the matter sticking in the Lungs, (since it cannot be discussed, or drank up again) requires Medicines commonly called Maturatives and Expectoratives; but they must both be temperate, to wit, such as rather appease than exasperate the Thirst and Feverish heat. We have given you before in the Chapter of the Cough, the kinds of these Medicines, which are properly called Pectorals. We shall now set down the choicest Prescripts, and most proper for this affect. Prescripts of Medicines. 1.2. Medicines Conducing to the First and Second Intention, are prescribed according to the Forms following. TAke Water of Lady's Thistle ten Ounces, of red Poppies three Ounces, Syrup of the same an Ounce, Pearl prepared a Dram: Make a Julape, the Dose is six spoonfuls every fourth hour. Take the Waters of Black-Cherries, Carduus Benedictus, and Baum, of each four Ounces, Powder of a Boars Tusk a Dram, Syrup of Violets ten Drams: Make a Julape, and take it after the same manner. Take Grass Roots three Ounces, shave of Ivory and Hartshorn, of each three Drams, Raisins stoned an Ounce and a half, Licorice two Drams; boil them in three pounds of fountain water to two pounds, to the straining add Syrup of Violets an Ounce, Sal Prunella a Dram: Make an Apozeme, take to three or four Ounces thrice a day. For the same Intention, viz. that the emptied Vessels may withdraw the matter maintaining the Disease, or may drink up again the Morbific matter itself, a Purge also is prescribed by some: In the Practice of the Ancients, it was a thing in constant use after bleeding, to Order Preparatives and Purgers against this Disease, as well as against most others: And Chemists of late with a greater confidence give Vomits, and cry them up before all other Remedies in a Peripneumonia. Nay further, neglecting bleeding, or forbidding it, they lay the chief stress of their Cure in Antimonial Emetics, though I know not whether any thing can be imagined more pernicious than that their rash proceeding. In rustic and robust Bodies sometimes this Medicine is given without harm, but in tender Constitutions it may be reckoned little Inferior to poison: And as to purging, though it be not proper in the very beginning, but in a manner always does harm, yet the Morbific matter ceasing to flow to the part, and the effervescence of the Blood being appeased, you may empty the Body gently with a Purging Medicine. Take Gereons' Decoction of Sena four Ounces, Syrup of Roses Solulutive and Ounce: Mix them, make a Potion. Take the best Sena three Drams, whole Cassia, Tamarinds, of each half an Ounce, Corianderseeds two Drams: Boil them in a sufficient quantity of fountain water, to six Ounces; to the straining add Syrup of Violets an Ounce, Clarify it with the White of an Egg, and give it. Let not Purges be given always, nor ever in this Disease without consideration, but Glisters must be given frequently, nay for the most part every day; but let them be only Lenitive and Emollient, so that they gently loosen the Belly without much stirring the Blood and Humours: For this end Milk, or Whey with brown Sugar, or Syrup of Violets often do well. Or, Take the Leaves of both Mallows, Melilot, and Mercury, of each a handful, Linseed, and sweet Fennel-seeds, of each half an Ounce, sweet Prunes, in number six: Boil them in a sufficient quantity of fountain water to a pound, to which add Syrup of Violets an Ounce, Sugar ten Drams, Sal Prunella a Dram: Make a clyster. 3. Medicines for the Third Intention, viz. For dissolving the clamminess of the Blood, are usually given in the Form of a Powder, Spirit, Draught, or Bolus according to the Forms following. 1. Powders. TAke Crabs Eyes powdered two Drams, Sal Prunella a Dram and a half, Sugar of Pearl a Dram: Make a Powder, divide it into six parts, take one every sixth hour, with some proper Julape or Apozeme. Take Powder of a Boars Tusk (or of the Jawbone of a Pike) Crabs Eyes, of each a Dram and a half, Flowers of Sal Armoniac, Powder of red Poppy Flowers, of each half a Dram: Mix them for four Doses. 2. Chemical Spirits and Liquors. TAke Spirit of Sal Armoniac distilled with Olibanum three Drams: The Dose is from twelve to fifteen, or twenty Drops thrice a Day. Take Spirit of Urine, or of Soot three Drams, give it after the same manner. Take Spirit of sweet Nitre, viz. often Cohobated with Spirit of Wine three Drams: The Dose is from six drops to ten, after the same manner. Take Spirit of Tartar half an Ounce: The Dose is from fifteen drops to twenty, or twenty five, with a fit Vehicle. Take of the simple Mixture an Ounce: The Dose is from a Scruple to half a Dram after the same manner. 3. Draughts. TAke Carduus water a pound, fresh Horse-dung three Ounces, dissolve it warm, and filter it: The Dose is three or four Ounces twice or thrice a day, adding Syrup of Violets, or of red Poppies half an Ounce. Take Leaves of Dandelion two handfuls, being bruised, pour to them Water of Lady's Thistle half a pound, Treacle water half an Ounce: Wring it forth hard, to which add Powder of Crabs Eyes a Dram, take four or six spoonfuls thrice a day. The Fourth Intention of Curing, having regard to the most urgent Symptoms, suggests to us various preparations of Medicines. 1. In respect of the Fever, the Julapes and Apozems before set down are proper. Moreover you must frequently use Sal Prunella. 2. For the Cough and difficulty of Breathing, Linctus', lohoch's, and Decoctions, or Pectoral Julapes are given with success. Take Syrup of Jujubes, of Maidenhair, of each an Ounce and a half, Syrup of Violets an Ounce, Flowers of Nitre a Scruple: Make a Linctus to be taken now and then with a stick of Licorice. Take Syrup of Dialthea an Ounce, Diacodium, Syrup of red Poppies, of each half an Ounce, Crabs Eyes finely powdered two Scruples: Make a Linctus to be taken as the other. Take Syrup of Hyssop, of Licorice, of each an Ounce and a half, Powder of red Poppy Flowers a Scruple, Crabs Eyes a Dram, Lohoch de Pino six Drams: Mix them, make a Lohoch, of which take the quantity of a Nutmeg four times, or oftener in a day. Take Roots of Grass, Chervil, Marsh-mallows, of each an Ounce, Figgs in number four, Jujubes, Sebestens, of each in number six, Raisins of the Sun an Ounce, Licorice three Drams, Barley half an Ounce, boil them in three pounds of fountain water to two pounds: Strain it, the Dose is three or four Ounces. Take Raisins stoned an Ounce and a half, Filberts sliced in number four, Licorice sliced three Drams, Hyssop-water a pound and a half: Make a close and warm Infusion according to art for six hours, to the straining add Syrup of Althaea an Ounce and a half: Make a Julape, the Dose is three or four spoonfuls often in a day, swallowing it down by little and little. 3. Against want of Sleep, Take of red Poppy water three Ounces, Syrup of the same six Drams, Plague water two Drams: Make a draught to be taken going to Bed. It the Pulse be strong, and the strength holds, Take Cowslip water three Ounces, Syrup of Meconium half an Ounce: Mix it, and drink it going to Bed. 4. If the pain be pressing about the part affected, Take of the Ointment of Marsh-mallows two Ounces, Oil of sweet Almonds an Ounce and a half: Mix them for a Lineament to be applied with thin Lawn Paper. Take Ointment of Marsh-mallows, and the Pectoral Ointment, of each an Ounce and a half, Oil of Linseed fresh drawn a Dram, to which add of the Emplaster of Mucilages what suffices: Make a Plaster for the Region of the Breast, to be applied on the part affected. Fifthly, For the last Intention of Curing, which answering the Secondary Indication prescribes ripening and expectorating Medicines, the Forms following are proper. Take Linseed Oil fresh drawn three Ounces, Syrup of Violets two Ounces, Hyssop water half a pound: Mix them in a Glass, take two or three Ounces thrice a day, shaking the Glass first. Take Olibanum powdered a Dram, put it in an Apple made hollow, and let it Roast in hot Embers: Let it be eaten going to Bed, and let the person do this three or four times. Take Oil of sweet Almonds fresh drawn, Syrup of Maidenhair, of each an Ounce and a half, Sugar Candy two Drams: Bruise them in a Glass Mortar, till they are throughly mixed: Make a Linctus, and take of it often with a stick of Licorice. Take also a spoonful of it thrice a day, in a draught of Posset-drink. As to the rest, the Remedies prescribed in a beginning Physic are good also here. I shall now give you an example or two of Persons affected with a Peripneumonia: Whilst I was writing these things, I was called to one very ill of a Peripneumonia: This Person being about Fifty Years of Age, of a lean Body, and a Bilious temperament; upon taking Cold fell into a Fever with a Cough, a pain in his Breast, and a difficulty of Breathing: Having so lain ill four days without any Remedy or Physical Administration; I found him in a high Fever with a Thirst, and mighty Inflammation of his Praecordia, and fetching Breath with great Pain and difficulty, his Thorax much labouring, and being troubled with a wheezing in the Windpipe, so that he seemed manifestly in the very Agony of Death: His Pulse, though quick and troubled, yet being strong enough, I presently ordered eight or ten Ounces of Blood to be taken from him: By which finding some ease, after three hours' intermission, a clyster being first Administered, I ordered him to Bleed again to twelve Ounces. Moreover, I directed him to take twelve drops of Spirit of Hartshorn every sixth Hour with a proper Julape, and betwixt while, a Dose of the following Powder. Take Powder of Crabs Eyes, and Sal Prunella, of each a Dram and a half, Pearl a Dram, Sugar Candy two Scruples: Make a Powder, divide it into eight parts. He took also a Draught of a Pectoral Apozeme often at pleasure; by the use of these things, all the Symptoms began to abate within three days, and the night following he sweated and slept a little: The Day after he was Blooded again, and afterwards the same Medicines being continued, he perfectly recovered within four or five days: The Blood taken from him was always in its surface viscous and ill coloured. A Gentleman of a Sanguine Complexion, and a strong habit of Body after immoderate drinking of Wine, fell into a Fever with a dangerous Peripneumonia; so that thirst and heat very much pressing him, and sitting upright always in his Bed, or in his Chair, and almost continually panting, he had very much ado to draw in Air enough to support Life: He being not able to lose much Blood at a time, I drew Blood twice or thrice from him one day after another, frequent Glisters were Administered. Moreover Apozemes, Julapes, also Spirit of Sal Armoniac, and Powders of Shells were given him by turns: Within four or five days the Fever abated somewhat, and he began to breathe better, and to take now and then short sleeps, though he complained still of a mighty heaviness upon his Breast, and an intolerable oppression of his Lungs. Wherefore bleeding being no longer safe, I applied large Vesicatories to his Arms and Legs: The Blisters in his Arms dried up in a short time; but those on his Legs did not only continue open, but ran mightily after five or six days, and so for near a Month daily discharged a vast quantity of a most sharp humour: In the mean time his Lungs grew better by little and little, and at length were wholly freed of their incumberance. Lastly, The Blisters raised by the Vesicatories, could very hardly be throughly Cured, and not without frequent Purging. CHAP. IV. Instructions and Prescripts for the Cure of the Pleurisy. THe Pleurisy is an Inflammation of the Pleura caused by a boiling Blood flowing into it through the Vertebral Arteries, and there growing clammy, with a continual and acute Fever, a pricking pain of the side, a Cough, and a difficulty of breathing. When a Pleurisy commencing passes into a Peripneumonia; or an Empyema, or inclines to a Physic, there is a proper method of Cure particularly set down in each of those Diseases for it: But as to what concerns our present purpose, Three Indications present themselves for a primary and simple Pleurisy, viz. a Curatory, Preservatory and Vital one. The First Indication takes care that the Inflammation or Obstruction of the Blood in the Lungs be removed by all possible means as soon as may be: Wherefore in a Pleurisy let a Vein be opened, and so the strength holds, and the Pulse be strong, let the Person bleed freely; and truly it is much better to take a large quantity of Blood at first, and every time after (as often as there is need to repeat it) than to Bleed often, and to draw a a little at a time; because a great many portions of the Blood grown clammy and degenerated into a viscous nature, are gathered together about the part affected; which unless withdrawn from thence, upon a great emptying of the Vessels by a large emission of Blood, so that the greatest part of them flow forth, the bleeding will be frustrated of its desired affect: It's all one in which Arm the Vein be opened, though it's now commonly done on the side affected. But if by reason of the weakness of the Pulse, and the failing of the Animal faculty, you ought neither to Bleed at First, nor to repeat it though the pain be very urgent; then Cupping-Glasses with a Scarification being applied to the place grieved, may very well supply its place. Moreover to take away the Inflammation of the Pleura, besides an Evacuation of Blood by breathing a Vein freely, or by Scarification, its Serous and other Excrementitious humours must also be set upon, and be gently purged forth of its Mass, and from the Bowels by Siege, Urine, and Sweat Strong Purges are justly forbidden, because they trouble the Blood, and force it farther into the Places affected; and Antimonial Vomits (though approved by some) are neither safe, nor grounded upon reason. Let Glisters be frequently, or rather daily Administered; nay and sometimes gentle Purges may be allowed so the Fever be not very great, qualifying Julapes and Decoctions, and things gently moving Sweat or Urine, such as before prescribed for the Peripneumonia, are also proper here. Let all hot things of a sharp or smart nature, whether they are Spices, or things containing a Vinous Spirit, be carefully avoided. The Second Indication being for preservation, and directed against the clamminess and effervescency of the Blood, prescribes those Medicines, which consisting of a Volatile, or Alkalisate Salt, destroy the Combinations entered into by the Acid, sixth, and otherwise Morbific Salts, with other more gross Particles: In which respect the Eyes and Claws of Crabs, the Tusk of a Boar, the Stone of Carp, the Jawbone of a Pike, the Bone in the Heart of a Stag, the Pisle of a Deer, Sal Prunella, Salt of Coral, the Volatile Salt of Urine, or of Hartshorn, Powder of Goat's Blood, Infusion of Horsedung, Spirit of Hartshorn, of Sal Armoniac, Spirit of Tartar, Mixtura Simplex, Bezoartick Mineral, Antimony Diaphoretic, Flowers of Sal Armoniac, are very famous Remedies in the Pleurisy. The Third and Vital Indication, which takes care that the strength and Vital heat be preserved in their due Tone and State, during the Course of the Disease, prescribes principally a fit Diet, and likewise Cordial Remedies and anodynes, and things which seasonably afford Relief to other Symptoms, if haply they present: First, in a true Pleurisy you must order a most thin Diet, viz. consisting of mere Oat, and Barley-meats, and for ordinary drink, Ptisan or Posset-drink is more proper than Beer alone, though in a mignty thirst, this also may be allowed in a moderate quantity. Moreover to quench thirst, Julapes, Apozemes and Emulsions may be taken at set times, to all which let Sal Prunella be added. Secondly, let only temperate Cordials be given, which may gently refresh the Animal Spirits, and not add to the Accension of the Blood which burns before too fiercely: For these intents the Waters of Lady's Thistle, Carduus Benedictus, Bawm, Borage, Cowslips, and Black-Cherries, are usually given with good success, to which the Powders of Pearl and Coral may be added. Thirdly, anodynes must be used both inwardly to procure sleep, if at any time it be very much wanted; as also outwardly to ease the pain of the side: The most usual things of the former kind are the distilled water, Syrup, and Powder of the red Poppy, which are accounted Specificks in the Pleurisy, as well as in the Peripneumonia. Moreover, when a very acute pain and watch press very much, we may give also Diacodiats: Against Pains, Ointments, Fomentations, Cataplasms, and sometimes the warm Inwards of Animals newly killed, are proper to be applied. I shall now give you Select Forms of Medicines adapted to each of these Indications. First, Therefore about the beginning of the Disease, to take away the Inflammation, Julapes, Apozemes, Powders, Glisters, and gentle Purges are wont to be prescribed. Take Water of Lady's Thistle eight Ounces, Water of red Poppies four Ounces, Syrup of the same an Ounce, Sal Prunella a Dram: Make a Julape, the Dose is two or three Ounces every third hour. Take Grass Roots four Ounces, Barley half an Ounce, parings of Apples a handful, Raisins of the Sun an Ounce, Licorice two Ounces; boil them in three pounds of fountain water to two pounds: To the clear straining add Syrup of Violets an Ounce and a half, Sal Prunella a Dram and a half: Make an Apozeme, the Dose is two or three Ounces often in a day. Take Sal Prunella two Drams, Flowers of Nitre a Dram, Powder of the Flowers of red Poppies two Scruples, Sugar Candy four Scruples: Make a Powder, the Dose is half a Dram, three or four times a day. Take of the Decoction of Mallows Roots and all, together with sweet Prunes a pound, Syrup of Violets three Ounces, Sal Prunella a Dram: Make a clyster. Take of whole Cassia bruised two Ounces, Tamarinds an Ounce, white Rose Flowers a handful, Corianderseeds two Drams; boil them in a sufficient quantity of fountain water to a pound: To the straining add Syrup of Cichory with Rhubarb two Drams: Clarify it with the White of an Egg, the Dose is five or six Ounces in the Morning, for two or three days one after the other. Secondly, To dissolve the clamminess or coagulating Viscousness of the Blood, the following things are of use, viz. in the Form of a Drink, Powder, and Spirit. Take fresh Horsedung four Ounces, Carduus water a pound and a half; make a close and warm Infusion for two hours, than filter the Liquor, to which add Syrup of the Juice of Dandelion, or of Cichory two Ounces, Spirit of Sal Armoniac a Dram, give five or six spoonfuls three or four times a day For this end Water of Horsedung does admirably well. Take Horsedung four pounds, Leaves of Carduus Benedictus, Lady's Thistle, Scabious, Pimpernel, of each three handfuls; being sliced and mixed together, pour to them of fresh Milk six pounds, distil them with common Organs: The Dose is two or three Ounces, either alone, or with other distilled Waters in the Form of a Julape. For the same use the Tinctures or Solutions of other Dungs are given by some Physicians, and are highly magnifyed by them. Helmont deservedly commends in the Pleurisy the Dung of an Ox, Panarolus Pigeon's Dung, others the White of Hen's Dung: Epiphanius Ferdinandus usually gave with good success in the Pleurisy, the Decoction of Tobacco macerated in new Wine. Valeriola used the Decoction of the Flowers of red Poppies, as a tried and familiar Remedy. Silvius prescribes the following mixture to be taken one spoonful after another, by little Intervals of time. Take the waters of Stone-Parsly and Hyssop, of each two Ounces, Fennel-water an Ounce, simple Treacle water half an Ounce, Laudanum Opiatum four Grains, Shall Armoniac half a Dram Syrup of red Poppies an Ounce: Mix them. To this composition, Frederick decker's adds Powder of Crabs Eyes, and Bezoartick Mineral of each a Scruple. Medicines very efficacious for this use, are wont to be given in the Form of a Powder; for Example, Take Powder of Crabs Eyes two Drams, Sal Prunella a Dram and a half, red Poppy Flowers half a Dram: Mix them, make a Powder, the Dose is half a Dram, three or four times in a day, with a fit Vehicle. Instead of Crabs Eyes, you may use the Powder of the Jawbone of a Pike, or of a Boars Tusk, or of a Stags or Bulls Pisle, and if these do not succeed, you may try what follows. Take Antimony Diaphoretic, or its Ceruse, or Bezoartick Mineral two Drams, Volatile Salt of Hartshorn half a Dram, Powder of red Poppy Flowers two Scruples: Make a Powder, the Dose is a Scruple or half a Dram, thrice or oftener in a day. It is for the same Intention of Curing, that Riverius gives Powder of Chimney Soot, from half a Dram to a Dram, and that others give the Powder of Pigeons or Hens Dung. Nay farther, according to this Analogy by which the Dungs of Animals stored with a Volatile Salt give relief in this Disease; its probable that the Dung of a Dog may prove no less successful in Curing the Pleurisy than in the Squinancy; and so much the more likely, because these Diseases often interchange their Types, and the one assumes the likeness of the other: Chemical Liquors endowed with a Volatile Salt, sometimes also work great effects in the pleurisy. Take Spirit of Blood two Drams, Red Poppy water three Ounces, Syrup of the same an Ounce: Mix them; give a spoonful of it every other while. Take Spirit of Sal Armoniac distilled with Olibanum three Drams, the Dose is from twelve drops to fifteen or twenty, three or four times a day in a fit Vehicle. After the same manner you may give Spirit of Urine, of Soot, or of Hartshorn. Take Spirit of Tartar three Drams: The Dose is a Scruple in a fit Vehicle. Take Mixtura Simplex three Drams: The Dose is from a Scruple to half a Dram. 3. As to the Third Indication, besides a thin Diet, Cordial Remedies, and anodynes are prescribed: Forms of the former kind may be supplied by the Julapes and Apozemes prescribed for the first Indication, and by the Spirits and Powders for the Second: Inward anodynes to be given in Watch, and in a very Intense pain are prescribed according to the Forms following. Take red Poppy water two Ounces, Syrup of the same six Drams, Spirit of Hartshorn twelve drops: Make a draught to be taken going to Bed. If we must go higher, Take Carduus water two Ounces, Diacodium from three Drams to half an Ounce, or six Drams, Spirit of Sal Armoniac with Frankincense half a Scruple: Make a draught. Sometimes, though rarely, its necessary to rise to Laudanums, which being seasonably given, have a mighty good effect, inasmuch as they procure Sleep, and move Sweat and Urine. Take water of Cowslip Flowers two Ounces, Laudanum Tartarized, from sixteen drops to twenty, Spirit of Blood half a Scruple, Syrup of Violets two Drams: Mingle them, make a draught. Outward anodynes are usually prescribed in the Form of an Ointment, Fomentation, and Cataplasm. Take Ointment of Marsh-Mallows two Ounces, Oil of sweet Almonds an Ounce, Album Graecum two Drams: Mix them by braying them together. Take of the Emplaster of Mucilages two Ounces and a half; Malax it with Oil of Linseed, and let it be applied upon Lawn Paper. Take the tops of Both Malbows, Leaves of Mercury and Beets, of each three handfuls: Boil them in a sufficient quantity of fountain water; let the straining be used for a Fomentation. Take the remaining faeces of the Herbs, after the Liquor is wrung forth, and being bruised, add to it of Oatmeal six Drams, Linseed, Fenugreek-seeds, of each two Ounces, Ointment of Marsh-Mallows two Ounces: Make a Cataplasm. I need not go far for Stories and Instances of persons troubled with the Pleurisy; for I have a notable Example of this Disease now under Cure, viz. a very fine young Woman, subject most frequently, and as it were habitually to that affect, is committed to our care. This Virgin, who is very fair, of a Sanguine Complexion, but of a weakly Constitution, has been wont for many years passed upon every slight occasion, viz. upon taking Cold, or by errors in any of the six nonnatural things, nay sometimes upon the mere change of the Season, or of the Air, to fall into a Fever, presently accompanied with pains of the Pleura, a Cough, and a difficulty of Breathing, and for the most part horrible Convulsions following them. She has been taken so very ill formerly of this Distemper, that she has been often forced to keep her Chamber six Months or more every year; but of late, though she be not freed from this affliction, yet she is seldomer tormented with it: The last year she was pretty well all the Summer, and well near all the Autumn; about the beginning of Winter she fell sick of that Disease, and now towards the end of it, is fallen ill again. The Pleuritic pain constantly possesses the right side, where the Blood sticking, and being extravasated in its passage about the Intercostal Muscles, the Irritated Fibres commence a most tormenting pain, together with a Convulsive motion of Coughing which they reiterate almost perpetually: In the mean time the Lungs being found enough, and open in their passages, readily convey the Blood, as clammy as it is, without any or stay, which often is the cause of a Peripneumonia. No Remedies are wont to do good to this person without Bleeding, which is always so particularly necessary, that every time she is ill, we are forced even whether we will or no, to repeat it two or three times, nay sometimes oftener: The Blood emitted has constantly a Viscous and whitish Film on its surface. This Disease was always a simple Pleurisy without any Peripneumonia, and for its Cure she constantly used the following method with success. Take Spirit of Sal Armoniac with Gum Ammoniacum three Drams, give from fifteen drops to twenty thrice a day, with the following Julape. Take Carduus water, Black-Cherry water, of each six Ounces, Hysterick water a Dram, Sugar six Drams: Betwixt whiles she took a Dose of Powder with three Ounces of an Apozeme. Take the Powders of Crabs Eyes, of a Boar's Tusk, of Sal Prunella, of each a Dram: Make a Powder, divide it into six parts. Take Grass Roots three Ounces, Candied Eryngoes an Ounce, shave of Ivory and Hartshorn, of each two Drams, parings of Apples a handful, Raisins of the Sun an Ounce: Boil them in three pounds of fountain water to two pounds; add to the straining, Syrup of Violets an Ounce, Sal Prunella a Dram: Mix them, make an Apozeme. Glisters of Milk with Syrup of Violets were administered sometimes every day, and sometimes every other day; if at any time Opïats, though never so gentle, were given her to allay pain, commonly afterwards an aching and heaviness of the Head, and Convulsive Affects most sorely tormented her. CHAP. V Instructions and Prescripts for the Cure of an Empyema. BY the word Empyema, according to its usual acceptation, is denoted a Collection of Pus, or corrupted matter within the Cavity of the Thorax, by which the Organs of Respiration are oppressed: That Pus commonly flowing thither, either from a Pleurisy, or a Peripneumonia (and sometimes haply from a Squinancy) suppurated and broken. As to the Cure of an Empyema, we must in the First place consider whether the signs of this Disease, as to the reality of its present Being, be certain or doubtful; if certain, there will not be much need of Physic, but only the Body being prepared, you may presently proceed to open the side. Therefore if after a Pleurisy or Peripneumonia not rightly Cured, or after an inward effusion of Blood occasioned by a stroke, fall, or wound, there be perceived a floating of Pus, or of corrupted or bloody matter within the Cavity of the Thorax, and this with little or no Spitting, we need no longer think of Maturating or Expectorating Medicines; but the Belly being loosened, and the Blood and humours duly qualified by Julapes, Apozemes, and anodynes, either order a bare Incision; or in tender and timorous persons, First, let a Cautery be applied betwixt the sixth and seventh Vertebrae, and after the Eschar being raised, let the Incision Knife be entered obliquely towards the hinder and upper parts, and that leisurely, and by little and little, till it penetrate into the Cavity of the Thorax, and then a little silver Pipe being put in, let the matter within contained, be let forth some at one time, and some at another, but so that as far as the strength will bear, the evacuation of the whole humour be as quick as may be; for a portion of it being left within, upon frequent admission of air to it, will stinch most horridly within a few days; to prevent which evil, or suddenly to remove it, let a vulnerary and adstersive Liquor be injected with a Syringe twice or thrice a day. After the Incision is duly performed with what else belongs to it, well known to skilful Surgeons, there will not be much more left for a Physician to do: He must prescribe a proper Diet, frequent Glisters to loosen the Belly (as often as occasion requires) and likewise vulnerary Medicines commonly so called, which hinder the dissolution of the Blood, and its running into Serosities prejudicial to the Breast. But if the Signs of this Disease are not certain, and (as it usually happens when a Peripneumonia, or an Impostume of the Lungs precede it) are wholly doubtful, you must not proceed to an Incision too hastily or inconsiderately: For I have known some Spitting forth a purulent matter, nay a faetid Pus, to whom an Incision of the Thorax has proved of no good effect, and not without some prejudice. Therefore till it shall appear by infallible Signs that it is an absolute Empyema you may use for a while expectorating Medicines (such as before prescribed for Curing a Peripneumonia) and also things gently moving an Evacuation by Urine and Sweat: But these at length availing nothing and the Empyema still continuing or increased (since it is better, so there be strength, to try a doubtful Remedy than none) you may proceed to the Incision. As to Forms of Medicines requisite for Curing an Empyema; before the Incision the same Remedies are proper, which are prescribed for a Peripneumonia, but the incision being over, the following will be of particular use. Against Faintings and Swoonings, which happen during that Operation, or after it: Let the following Julape be always in a readiness to be taken now and then to four or five spoonfuls. Take the Waters of Bawm, and of Black Cherries, of each six Ounces, Aqua Mirabilis an Ounce, Pearl powdered a Dram, Syrup of Clove Gillyflowers an Ounce: Mingle them, make a Julape. Let the following Decoction be taken three or four times a day. TAke Leaves of Heart's Tongue, Speedwell, Agrimony, Colts-foot, Mousear, Sanicle, of each a handful, Roots of Madder and Chervil, of each an Ounce, Barley half an Ounce, red Ciches half an Ounce, Raisins of the Sun an Ounce and a half: Boil them in four pounds of fountain water till half be consumed; when it is taken, let it be sweetened at pleasure with Clarified Honey, or with Syrup of Mousear. If there be no Fever, let the following Pills be taken at Night, and early in the Morning, to a Scruple or half a Dram. Take Powder of Crabs Eyes two Drams, Flowers of Sulphur a Dram, Sal Prunella half a Dram, Species of Diarrhodon Abbatis a Scruple, Venice Turpentine washed, what suffices: Make a Mass, and form it into Pills: or the Turpentine being omitted let the same Medicine be taken in the Form of a Powder, from half a Dram to two Scruples twice a day. CHAP. VI Instructions and Prescripts for Curing the Impostume of the Lungs. THe Morbific matter of this Vomica, or Impostume of the Lungs is always a mere Pus, which nevertheless is there engendered tacitly, and as it were unawares, without a Fever or Inflammation, and lies so private, that it scarce presents any signs of itself, but a little Cough, which at first is dry, then turns moist, which continuing some time, the Breath is drawn with some difficulty, the Spirits faint, and the Body wears away by little and little, though in the mean time the Spittle has no Pus or Blood mixed with it: But if the Impostume unexpectedly breaks, it commonly kills the Patient. If after the Impostume is broken, and the Purulent Spittle beginning to come away with ease, and the strength holding firm, there be room for any method of Cure: The Primary Indications according to the common custom in most Diseases must be these three, viz. Curatory, Preservatory, and Vital. The First, directs that the matter of the Impostume be with speed evacuated by Spitting, and that the sides of it be cleansed and made sound again as much as possible, The Second provides against a confluence of new matter to the Receptacle, and other neithbouring parts of the Lungs, whence a Consumption would be engendered. The Third relieves the faintings of the Spirits, and restores lost strength, and the Nutrition which was frustrated. In respect of the First Indication, expectorating Medicines (commonly so called) and of the hottest and smartest nature, which cleanse and dry most, and especially (since for the most part here is no Fever) Sulphureous things are proper; which also are prescribed according to the Forms following. Take Tincture of Sulphur three Drams, give from seven drops to twenty going to Bed, and early in the Morning in a spoonful of Syrup of the Juice of ground Ivy: Or, Take Syrup of our Diasulphur six Ounces, give a spoonful at the same hours. Take dried Leaves of ground Ivy, Germander, Maidenhair, Coltsfoot, Hyssop, white horehound, Savory, of each a handful, the Roots of Elecampane, Florentine Orris, Chervil, of each an Ounce, Anniseeds half an Ounce: Boil them in six pounds of fountain water to three pounds and a half, add towards the end White-wine six Ounces, the best Clarified Honey three Ounces: Let the straining be Clarified and kept for use: The Dose is six Ounces thrice a day warm. Or, Take Water of quick Lime six pounds: Put it in a large mouthed Glass with the following Bag. Take dried Leaves of Germander, ground Ivy, white, horehound, of each a handful, Roots of Elecampane and Florentine Orris sliced, of each an Ounce and a half, Annisecds bruised two Ounces, Licorice an Ounce and a half, Raisins stoned three Ounces: Let them stand cold and close covered, pour it out as you use it, still leaving the Bag behind. Take Lohoch Sanum three Ounces, Species Diaireos two Drams and a half, Flowers of Sulphur a Dram and a half, Oxymel simple two Ounces: Make a Linctus to be taken with a stick of Licorice. Take Powder of the Leaves of Hedg-musiard, and of ground Ivy, of each half an Ounce, Flowers of Sulphur a Dram and a half Syrup of Diasulphur, or of the Juice of Ivy what suffices: Make a soft L●hech. Take fine Myrrh, and white, Amber, of each half an Ounce, Sulphur vivum, Auripigment, of each two Drams, shells of Fistick Nuts a Dram and a half: Make a Powder for Fumigation; let it be used with a Paper Funnel Morning and Evening. The Second Indication which is for preservation, cutting off the Mortinck matter, and providing against the Consumption which is apt to ensue, undertakes the purifying of the Blood, and the strengthening of the Lungs; for which eads Purges, Vulnerary Decoctions, distilled Waters, and Physic Drinks are proper. Take Gereon's Decoction of Sena (with Agarick a Dram and a half) three Ounces and a half, Purging Syrup of Apples an Ounce, Aqua Mirabilis two Drams: Make a Potion to be taken once a week with governance. Let the Form of the vulnerary Decoction be the same, which is prescribed for the Empyema after the Incision; or because there is no Fever, you may give that Decoction of the shops, to four or six Ounces thrice a day. Take Fir tops six handfuls, fresh Leaves of ground Ivy, Hyssop, Savory, Rocket, Hedge-mustard, Winter Cress, of each four handfuls, Sun-flower Seeds six Ounces, sweet Fennel-seeds two Ounces, Roots of Elecampane, and Florentine Orris, of each three Ounces, being sliced and bruised, pour to them of Brunswick or Spruce Beer eight pounds, distil it with common Organs: Let the Liquor be all mixed, and when it's used, let it be sweetened at pleasure with Syrup of the Juice of ground Ivy: The Dose is three or four Ounces thrice a day. Take Roots of Sarzaparilla six Ounces, China Roots two Ounces, all the Saunders, of each six Drams, shave of Ivory and Hartshorn, of each half an Ounce, Mastick-wood an Ounce, being sliced and bruised, let them Infuse according to art, and boil in twelve pounds of fountain water, till half be consumed, adding of Licorice an Ounce, Raisins of the Sun four Ounces; let the straining be used for ordinary drink. The Third and Vital Indication prescribes Cordial and Anodine Remedies, and a fit Diet: The same Forms of Medicines in a manner that are prescribed for an Empyema after Incision, are proper here. Also the same Diet which is ordered in a beginning Consumption, and Ass' Milk often does good in this case: Concerning the Cure of this Disease, I have obferved that an Issue made in the side has often a very good effect. A Gentleman of a middle Age, having been always strong and healthy, found himself ill without any manifest cause, and in a short time fell into a languishing condition, losing his appetite, sleeping with difficulty, was thirsty, and had a heat about his Praecordia: He was a long time under the hands of some Physicians for the Scurvy, and of others as Hectical, and after various methods of Cure had been tried in vain, the Disease at length openly discovered itself: For whilst one Night being more restless than usual, he tossed himself very much in his Bed; the Impostume within his Lungs breaking on a sudden, he threw up by Coughing a vast quantity of Pus, which stunk most horribly, so that within four or five hours he had thrown up about two pounds. Moreover the Cough continuing for above two Months afterwards, he daily voided by Spittle of that Purulent, thick, and mighty stinking matter, till his Flesh being consumed, and his strength wholly spent, he was decayed, and fallen away to nothing. After the Impostume was thus broken, we carefully gave him Medicines to cleanse and heal the place where it gathered, and to mundify the Blood and the Lungs, and free them from the imminent Consumption. Our Tincture and Syrup of Diasulphur, together with Pectoral and Vulnerary Decoctions and Distillations, also Linctus' and Balsamic Pills were taken day after day in a constant method: With these Glisters, also gentle cathartics and Diuretics were interchangeably given; Vaporations first, than Suffumigations both Sulphureous and Arsenical were also used Mornings and Evenings. After these things had been carefully followed a long time without any good; we concluded to open his Thorax, and were soon directed to a place proper for it, for on the left side of his Sternum, betwixt the fifth and sixth Vertebrae a tumour appeared: Instead of a Cautery, I applied thereto a Suppurating Plaster, and within three days the top of that Swelling became red and soft, out of which being opened the next day after, first issued a thin Ichor, and a little after a yellow and well concocted Pus, and afterwards it continued daily to run in a more plentiful manner, and then the stinking Spittle began to abate, and within a Fortnight wholly ceased; the Morbific matter finding both an easy and more apt passage through that Orifice, which at length was changed into an Issue, and a Pea, or a Pill of Wood being daily put into it, there came forth continually for a year and a half a plentiful Ichor, and in the mean time the Gentleman having wholly got rid of any corruption in his Breast, and recovering his strong and fleshy habit of Body, became sound in all respects, Lastly, That Issue being remoyed to the Arm, he has nothing of that Distemper about his Breast, nor minds longer any fence against it. Shortly after this Cure, I was called to a Lady of Quality, who having been troubled with a Cough, and a heat of the Praecordia for many years, on a certain day sensibly perceived somewhat broken in her Lungs whilst she was Coughing, and presently voided by Spittle a great quantity of mere and stinking Pus; after that that Spittle with the Cough, notwithstanding any use of Remedies continuing for a Week, seemed rather increased than diminished, I advised that she would permit an Issue to be cut in her side near the place, whence she perceived the Pus to arise, which she readily giving way to, within three days mere Pus, such as she Spit forth by her Cough, began to run from the open Orifice; and afterwards the Morbific matter finding a sufficient vent by that passage, both the Cough and the Spitting of Pus entirely ceased, and within six Weeks the Patient grew perfectly well. After this I was called to a robust man, a great Drinker, who being also affected with an Impostume of the Lungs, did Spit forth a great quantity of mighty stinking Pus: He would not permit any Issue to be made in his side; yet being very free to take all sorts of Medicines, he got free at length of that Disease by a long use of them: The Medicines which chief did him good were preparations of Sulphur; wherefore our Syrup and Tincture were given him often every day: To these we gave for Vehicles, sometimes a Pectoral Decoction, sometimes a Pectoral Hydromel, sometimes Lime water, with the Infusion of Pectoral and Vulnerary Ingredients. Moreover Fumigations, especially of Sulphureous and Arsenical things, gave great Relief. CHAP. VII. Instructions and Prescripts for the Cure of the Asthma. AN Asthma is a difficult, short, thick, and pursy Breathing, with a great Agitation of the Breast, and for the most part without a Fever: And it's either merely Pneumonick, proceeding from some stoppage in the Vessels that convey the Air, or merely Convulsive, arising from some fault in the Organs of motion, or mixed when both parts are jointly faulty. As to its Cure there are two Primary Indications, or rather so many distinct methods of proceeding, viz. the one Curatory, the other Preservatory: The First teaches what is to be done in the Fit, to free the Patient from present danger; the other what out of the Fit, to take away the Cause of the Disease. 1. In the Fit there are two chief Intentions of Curing, viz. First, That care being taken as well of the Air, as of the Lungs, a more free Breathing be procured, at least as much as may suffice to support Life: And Secondly, That the Organs of Respiration be reclaimed and made to cease from the Convulsions they are fallen into, and which are wont to be continued with obstinacy. As to the former, in the First place let the Patient be set in an upright Posture of Body, in a pretty open place somewhat Airy, and free from Smoke, and the Breath of Bystanders; then endeavour that the Lungs being freed of all inward stuffing and oppression, as well as outward compression, may be able to draw and return the Breath deeper: For these ends, lest the weight of the inferior Viscera press down, and straiten the Praecordia, let the Belly be loosened by a Glister, and let the Garments and all other things covering or binding the Thorax be slackened. Moreover since in this case the Lungs are usually oppressed, either from the Blood growing too turgid within the Pneumonick Vessels, or from the Serum distilling forth of the Arteries and Glands into the Ductus' of the Trachea, the Sallies and Impetuosities of both humours ought to be restrained and appeased: Hence if the strength will bear it, and the Pulse be strong enough, Bleeding is often proper. Again let those things be carefully given, which discharge the Serum, and the superfluities of the inflamed Blood by Urine and Sweat: For which end Julapes, Apozems, and Pectorals, commonly so called, are of excellent use. Moreover Powders of shells, preparations of Millepedes, Volatile Spirits and Salts are taken with good effect. In the mean time let there be likewise given things that open the Ductus' of the Trachea, and make them slippery, and provoke expectoration; and such also if need be, as stop the Catarrh distilling on them; for which ends Linctus', Lohoch's, Pectoral Decoctions, and Suffumigations are proper. As to the other intent of Curing in Fits of the Asthma, viz. That the Organs of Respiration being reclaimed from the Convulsions they are fallen into, return calmly to their ordinary Functions (unless this follows of its own accord, after that the turbulent boiling of the Blood and Serum within the Lungs is appeased:) We must use Anti-Convulsive and Anodine Remedies; for Medicines wont to be given in Hysterick passions, are also proper in a Convulsive Asthma. The Spirit of Hartshorn, of Soot, and especially Spirit of Sal Armoniac distilled with Gum Ammoniacum; also the Tincture of Gum Ammoniacum, of Sulphur, Castoreum, Assa-foetida, the Syrup of Ammoniacum, of Sulphur, Oxymel of Squills, and the like; which being of an ungrateful taste or smell, dissipate the Spirits as it were, and withdraw them from tumultuary Efforts, prove sometimes of notable use: But if the raging Spirits cannot be appeased by this means, we must come to Narcoticks, that some of them being destroyed, the rest may return into order. For Opiates sometimes are mighty beneficial, unless a stopping of the Lungs, and a great oppression of the Praecordia forbid their use: In horrible sits of this Disease, when other Medicines have availed nothing, I have often given Diacodium, nay Laudanum Tartarized with good success: Nevertheless these may not be taken without great caution; for Respiration which is difficult and clogged before, being hindered more, and that very much by them, they often put the Patient in danger of Life. Moreover to reclaim the Pnenmonick Spirits from their Convulsions; its good sometimes to put the Spirits to torture in some other part, for when some of them are any where tormented, all the rest for the most part, being in a concern at it, quit their disorderly motions. Wherefore Vesicatories, Cupping-glasses, Ligatures, and Painful Frictions give relief: Nay for this reason Vomits taken in the midst of the fit do good. I shall now set down certain Select Forms of Remedies appropriated to each of those ends. First therefore to restrain the Fluxions of the Blood and Serum, and to discharge their superfluities, derived from the Lungs, by Sweat and Urine; let the following things be prescribed. Take Leaves of ground Ivy eight Ounces, Rue, , and Dragons, of each two Ounces, Sal Prunella a Dram and a half, Srrupus Byzantinus, Syrup of red Poppies, of each an Ounce: Mix them, make a Julape; let three or four Ounces be taken thrice or oftener in a day. Take Grass Roots three Ounces, Roots of Butchers-Broom two Ounces, Candied Elecampane an Ounce and a half, Barley half an Ounce, Raisins of the Sun an Ounce: Boil them in three pounds of fountain water to two pounds, to the straining add of Sal Prunella a Dram and a half, sweeten it if it be needful, with a sufficient quantity of Syrupus Byzantinus, or of Syrup of Violets. Take Tincture of Sulphur three Drams: The Dose is from six drops to ten at Night, and early in the Morning in a spoonful of the Syrup of the Juice of Ivy, or of Violets. Take Feculae of Aron and Briony, of each a Dram and a half, Flowers of Sulphur a Dram, Flowers of Benzoin half a Dram, Sugar Candy half an Ounce, Licorice two Drams: Make a Powder to be taken to half a Dram, or two Scruples twice a day, with the foregoing Julape or Apozeme. Or, Take of the foresaid Powder two Ounces, Honey or Oxymel what suffices: Make a Linctus, take at Night and early in the Morning, about half a spoonful, at other times take it with a stick of Licorice. Take Syrup of horehound, and of Garlic, of each an Ounce and a half, Tincture of Saffron, and of Castoreum, of each two Drams: Mix them, take about a small spoonful in the fits. Take Spirit of Sal Armoniac with Gum Ammoniacum three Drams, the Waters of Snails, and of Earthworms, of each three Ounces, Syrup of Horehound two Ounces: Mix them, take a spoonful once in four or five hours. Take Powder of Hedg-mustard, or of ground Ivy gathered in the Summer Sun an Ounce, Oxymel simple what suffices: Make a Linctus. So much concerning the Medicines and method requisite in a fit of the Asthma. The other Indication which is for preservation, undertaking to remove the Morbific cause, and the whole Morbid Root has two parts, or distinct Intents of Curing, which for the most part are both set upon together; one of these endeavours to amend the Conformation of the Lungs, if it be any way prejudiced or faulty, and the other to take away the Irregularities of the parts for motion, and of the Spirits appointed for them: Both these Intents will very well be answered, if Pectoral Remedies commonly so called are joined with Anticonvulsives, and are used interchangeably with other Medicines which have regard to the preparation of the whole Body, and to Emergent Symptoms; for which ends the following Method and Forms of Medicines may be used. Take Aloe Rosata a Dram and a half, Flowers of Sulphur a Dram; Salt of Amber half a Dram, Tar what suffices: Make Pills, in number twenty four; take four in the Evening every Night, or every other, or third Night. Or, Take Gum Ammoniacum, and Bdellium dissolved in Vinegar of Squills, of each half an Ounce, Flowers of Sulphur three Drams, Powder of the Leaves of Hedg-mustard, and of Savory, of each half a Dram, with a sufficient quantity of Syrup of Diasidphur, or of Oxymel of Squills: Make a Mass, form it into little Pills, and take three every Evening. Or, Take Millepedes prepared two Drams, Flowers of Benzoin half a Dram, Salt of Amber two Scruples, Extract of Elecampane half a Dram, Castoreum half a Dram, Saffron a Scruple, Venice Turpentine what suffices: Make a Mass, and form it into small Pills; take four every Evening and Morning, unless when you Purge. If Pills are not grateful, or the foresaid Medicines will not do; then let the following be tried to free the Lungs from obstruction. Take Spirit of Gum Ammoniacum, distilled with Sal Armoniac three Drams, Syrup of the Juice of Ivy three Ounces, Magisterial water of Snails, and of Earthworms, of each an Ounce, Tincture of Saffron two Drams: Mix them, take a spoonful going to Bed, and early in the Morning. Or, Take Tincture of Gum Ammoniacum three Drams: The Dose is from fifteen Drops to twenty in a spoonful of Oxymel, or Syrup of ground Ivy. Or, Take Tincture of Sulphur three Drams: The Dose is from seven Drops to twelve or twenty at the same hours, with a fit Vehicle. After the like manner also other Spirits endowed with a Volatile Salt, and mixed with Pectoral Syrups, and Cephalick waters may be usefully prescribed Morning and Evening. Instead of a Mixture or Asthmatical Julape of distilled waters of the shops, the following Magisterial may be prepared to be used frequently, and upon several occasions. Take Roots of Elecampane, Florentine Orris, Angelica, Masterwort, of each four Ounces, of Briony a pound, Leaves of white Horehound, Hyssop, Savory, , ground Ivy, of each four handfuls, fresh Juniper and Ivy Berries, of each a pound, Laurel Berry's half a pound, Seeds of sweet Fennel, Caraway, anise, Lovage, Dill, of each an Ounce, Cubebs two Ounces, long Pepper, Cloves, Mace, of each an Ounce; all of them being sliced and bruised, pour to them of Brunswick Beer eight pounds; distil them with common Organs: Let the whole Liquor be mixed, and when it's used, let it be sweetened at pleasure with Sugar, or the Syrup of the Juice of ground Ivy, or with Oxymel. Moreover, instead of Oxymel, or of any common Pectoral Syrup, let the following Forms of Medicines be prescribed which are more appropriated to an Asthma: And in the First place the Syrup of Elecampane, invented by Horatius Augenius, and afterwards recommended by Platerus, Sennertus, Riverius, and other famous Practitioners shall be set down here, and aught to be frequently made use of. Take Roots of Elecampane, and of Polypody of the Oak prepared, of each two Ounces, Currants two Ounces, Sebestens in number fifteen; Coltsfoot, Lungwort, Calaminth, Savory, of each a handful, one large Tobacco Leaf, Licorice two Drams, Seeds of Nettles, and of Cotton-plant, of each a Dram and a half; boil them in Wine and Honey diluted, to a pound and a half, and with the like quantity of Sugar make a Syrup: Let it be taken either by itself in the Form of a Linctus, or a spoonful at a time Mornings and Evenings, or put a spoonful of it to a Dose of the distilled water or Apozem. Take Roots of Florentine Orris, and of Elecampane, of each half an Ounce, Garlic peeled four Drams, Cloves two Drams, white Benzoin a Dram and a half, Saffron a Scruple, being sliced and bruised, let them digest warm in a pound of rectified spirit of Wine for twenty eight hours: To the straining add of the finest Sugar a pound, put it in a silver Basin on hot Coals, than the liquor being fired, keep stirring it as long as it will burn, and then the flame going out, it will become a Syrup; let it be given after the same manner as the former. Moreover, in this place we may aptly insert the Decoctions of an old Cock so much commended by famous Physicians, both ancient and modern, for the Cure of the Asthma. These Broths are of two kinds, viz. with or without Purgers, and we find various and differing sorts of both amongst Practical Authors, though I shall only give you a form or two. Without Purgers this is a common Form: Take Roots of Elecampane, and of Florentine Orris, of each half an Ounce, Leaves of Hyssop, and of Horehound dried, of each six Drams, Carthamus-seeds an Ounce, Anniseeds and Dillseeds, of each two Drams, Licorice sliced, and Raisins cleansed, of each three Drams; let them be prepared and sewed up in the Belly of an old Cock, which must be boiled in fifteen pounds of fountain water till the flesh falls from the Bones, strain it and let it settle: The Dose of the clear Liquor is six Ounces, with an Ounce of Oxymel simple; or if you would have it purge, in each draught dissolve fresh Cassia and Manna, of each half an Ounce: Let it be taken for many days together, sometimes for a whole Month. Riverius prescribes a good Form of this sort of Purging Broth. Take Roots of Elecampane, and of Florentine Orris, of each a Dram and a half, Leaves of Hyssop and Coltsfoot, of each a handful, Licorice sliced, Raisins cleaned, of each two Drams, Figs in number four, Senna cleansed three Drams, Roots of Polypody of the Oak, Carthamus-seeds of each half an Ounce, Anniseeds a Dram and a half: Boil them with a third or fourth part of an old Cock according to art, and make a Broth for one Dose to be taken in a Morning; let it be continued for twelve or fifteen days. I shall now give you a Relation of a Person, who was subject to fits of this Disease, which were merely Convulsive, and of another, who was subject to fits of the same, which were partly Convulsive, and partly Pneumonick. A Noble Man of a tall Stature, and full and strong grown, having bruised is left Side by a fall, found himself injured upon it, and afterwards fell into an Asthmatick Distemper, so that now and then, though at no set times, First a pain would seize him about that place, and presently after a great straitness of Breath followed, with a vehement and long continued straining of all the parts of Respiration, so that during the Fit, the Patient seemed to be in the very Agony of Death: I was first called to him after he had lain ill of such an Asthmatick Fit for two days, and was looked upon as almost past Cure. Nevertheless finding his Lungs to be without hurt, our Prognostic bid us still hope well, and presently other Physicians being joined with me in Consultation, it was prescribed as follows. Take Spirit of Gum Ammoniacum distilled with Sal Armoniac three Drams: Let him take from fifteen drops to twenty, in a spoonful of the following Julape, drinking after it five spoonfuls; let it be repeated every sixth hour. Take the waters of Elder Flowers, Camomile and , of each four Ounces, Snail water two Ounces, Sugar an Ounce, mix them: Between whiles he took a Dose of the following Powder with the same Julape, or Pectoral Decoction. Take Powder of Crabs Eyes two Drams, Sal Prunella a Dram and a half, Salt of Amber half a Dram, max them: Divide it into eight parts for as many Doses. Large Vesicatories were applied in the inside of his Arms near his Armpits; Glisters were daily administered, and frequent Frictions: By the use of these things he received a sudden and unexpected ease, and within a few days got wholly free of that Fit, and afterwards as often as he perceived a little touch of the said Distemper coming, he presently took a large Dose of that Spirit, with the same Julape thrice or four times a day: By which Remedy, being frequently taken sometimes for preservation, and sometimes for Cure, he has now past above two years without any great and terrible fit of his Asthma, which before was habitual, though he has now and then undergone some light touches of it, but easily blown off. An Honourable old Gentleman (upon taking cold as 'tis judged) found himself ill; for he complained of a pain in the middle of his Breast by his Sternum, which at Night as soon as he was warm in his Bed, growing worse, disturbed his sleep, and was very troublesome to him for the most part of the Night: Nevertheless without any straintness of Breath, or evident sign of an Asthma: To take away this pain he was both Purged and Blooded, Pectorals and Antiscorbutics were daily given him, Ointments and Fomentations were applied to the place pained, yet without any great good or ease: For the change that happened after, was rather for the worse; for the pain being a little abated, he was seized with a laborious and troubled Respiration, so that after his first sleep, or as he began to slumber, he was taken with a fit of the Asthma, and being out of Breath, and oppressed about the Praecordia, was forced to sit upright in his Bed: Moreover this painful Breathing, and Convulsive agitation of the parts for Respiration did not only return every Night, but daily grew more violent, and continued longer upon him: Insomuch that one Night awaking from his first sleep, he was seized with a most violent fit of the Asthma which lasted for many hours, and brought him as near death as a Man might be and live. No Physician being present, a Barber then let him Blood, which gave him some relief; in the Morning upon a consultation of Physicians, he was ordered for that day a thin Diet, and a loosning Glister: At Night and the Morning following, he took twelve drops of Spirit of Gum Ammoniacum distilled with Sal Armoniac in a Vehicle proper in that case, and continued its use afterwards for many days: Vesicatories were applied to the insides of his Arms near his Armpits: Moreover Julapes and Pectoral Decoctions, Lohoches, Glisters, nay and sometimes gentle Purges had their truns; Bleeding also was repeated after two days. Whereas before he was wont to drink for his Morning's draught about a pint of Beer with Wormwood and Scruvygrass, Instead of this, he took about eight of the Clock, fifteen drops of Elixir Proprietatis tartarized in a draught of Coffee prepared with a Decoction of Sage: By these Remedies the Asthmatick Fits presently abated of their wont fierceness; insomuch that the beginning and end of every Night were quiet enough, though about the middle of it some uneasiness about the Praecordia kept him waking, and made him sit upright in his Bed for an hour or two; at length growing weary of Physic, he took only now and then some of the Medicines above mentioned: But in the mean time, though his Asthmatick Fits troubled him little or not at all by Night as before, yet by reason of his Lungs being very much stuffed, and a Serous humour falling into his Feet he could not walk fast, or go up any steep Ascent without a great difficulty of Breathing, and danger of being choked; and at present an Asthma or Physic is not so much feared as a Dropsy. CHAP. VIII. Instructions and Prescripts for Curing the Dropsy of the Breast. IF at any time the affect of the Dropsy or Anasarca, being general, has taken possession every where, or in most places of the Flesh, and Cavities of the Viscera: It's no wonder if that filthy Mass of Waters gets possession also of the Breast; but besides this, it sometimes happens that the Region of the Thorax is either originally or alone overwhelmed with waters, the other parts in the mean time being every where sound enough, or injured only Secondarily. That Serous humour causing the Dropsy of the Breast, arises there either in the Form of a Vapour, which exhaling from the Praecordia and Sides of the Thorax is readily condensed into Water, or Secondly, the Serum is there deposed in its proper Form as it distils into that Cavity from the Mouths of the Vessels, viz. of the Arteries there opened: Or Thirdly, the Lymphducts, or sometimes, though rarely, the Chyle Vessels, somewhere opening themselves, or being broken may produce that affect. A young Man of a healthy and strong constitution, who had long used himself to violent exercises, both by riding and other ways, perceived at length a fullness, or as it were a certain windy rising in his Thorax, insomuch that the left side of his Lungs seemed to swell, and his Heart to be thrust forth of its place towards the right side; for in that part it was perceived to beat most: After he had continued in this condition some time, he percived on a certain day a Rupture as it were of some Vessel within the Cavity of his Thorax, and after it for half an hours space, he could not only perceive in that Region a dropping of humour as it were from the top to the bottom of his Breast, but it could also be head by the standers by. Notwithstanding this, finding himself otherwise well disposed, he slighted Physic; but afterward upon motion, stooping, or any stirring of his Body, he perceived in his left side a floating of waters inwardly gathered together: Nay, and the motion and sound of it was most manifestly perceived of others, both by handling, and by the ear: Hence as it was plain that this Person had a Dropsy of the Breast, so it seemed most probable that this Disease took its rise from this, that the Lymphducts appertaining to the left side of the Lungs being first obstructed near their Insertions into the Ductus Chyliferus, had swollen up to a vast bigness, and afterwards being broken, distilled forth their humour into the Cavity of the Thorax. This Gentleman not perceiving himself in danger, and having tried some Medicines without any good effect, was advised upon a consultation of Physicians, to have his Side opened: Wherefore provision for the whole being made, a Chirurgeon applied a Cautery betwixt the sixth and seventh Vertebrae, and the day following he put a Pipe into the Orifice, cut into the Cavity of his Breast, upon which presently a thick Liquor, whitish like Chyle, and as it were Milky issued forth: There were only about six Ounces taken from him the first time, and the day following as much: On the third day somewhat a larger quantity being let forth, he was presently seized with a great fainting, and afterwards being Feverish, he was ill for a day or two: Wherefore till he recovered his due temper and strength, it was thought fit to stop the egress of that matter, and afterwards a small evacuation only of the same being daily made, the Cavity of his Breast was in a manner wholly emptied, though he still carries the Pipe in the Orifice with a Tap, which being drawn forth once in twenty four hours, a little gleeting of humour still issues out: In the mean time being well disposed as to his Stomach, Countenance and Strength, he Walks and Rides abroad, and performs other exercises which he had been formerly used to with vigour enough: He used not much Physic, nor did he need it: After the Incision we prescribed him temperate Cordials, viz. Powder of Pearl, Julapes, and sometimes Hypnoticks, and afterwards a vulnerary Decoction to be taken twice every day. By this Method and Form of Medicines continued for some time the Person seemed to recover his due temper, strength, and habit of Body, nay and to be sound in his Breast; yet he still carried the Silver Pipe in the Orifice of his Side, out of which an Ichor continually issued: And when after some Months this being taken forth, that Issue was closed up, there was a gathering again of the same humour within the hollow of the Breast, as was perceivable by the sound and floating of it: But afterwards as upon the return of the Disease the same Remedy presented itself, and consequently the opening of the Side was ordered (Nature as it fell out performing the Office of a Chirurgeon) it happened of its own accord, and gave way for the matter which was ready to break forth; and now he is fain to keep that Orifice constantly open as a sink to prevent that gathering of nastiness in his Breast. As to the Cure of the Dropsy of the Breast, the Primary Indications, as usually in Curing most other Diseases, are three, viz. Curatory, Preservatory, and Vital. The First endeavours that the Waters gathered in the Cavity of the Breast be some way or other evacuated. The Second prevents the gathering of new matter. The Third takes care to restore strength, and speedily to remove the Symptoms that injure it. To satisfy the First Indication, there are only two ways or manners of evacuation, by which that filthy Mass of Waters may be cleared forth, viz. either that the Vessels of the Breast, and Ductus' of the humours being emptied, drink up again that Lympha when Rarifyed, and then convy it forth, either by the way of the Blood, or of the Breath: or Secondly that the water be all let forth in its proper Species by an Incision of the Side. The former way, though seldom, yet sometimes to my knowledge succeeds: For the Texture of the Lungs being spongy within, and outwardly very Porous, whilst upon every Diastole it is dipped in the waters lying under it, it sometimes imbibes them being converted into vapour, and so either returns them to the Blood, or exhales them with the Air continually breathed forth at the Mough; that this effect may more readily happen for Curing this Disease, Physical Aids are here used: Therefore for that intent the passates of the Blood, Air, and humours, aught to be emptied as much as may be, and to be kept open and free: For this end let gentle Purges, Diuretics and Diaphoreticks be methodically given by turns, also Thoracical and Expectorating Remedies must be used: Let the Diet be thin and heating, and let such a method be ordered in all things which may promote the exhalation of the Blood, and cause all the superfluous humours to evaporate. I shall set down some Forms of Medicines proper for these purposes. Take Roots of Chervil, Butchers-broom, Polypody of the Oak, of each an Ounce, Leaves of Agrimony, Maidenhair, Oak of Jerusalem, ground Ivy, of each a handful, Carthamus-seeds an Ounce, Roots of Florentine Orris half an Ounce: Boil them in four pounds of fountain water till a third part be consumed, then add to the straining Sena Leaves an Ounce and a half, Agarick two Drams, Mechoacan, Turbith, of each half an Ounce, yellow Saunders a Dram and a half, Roots of the lesser Galingal a Dram: Boil them close covered for two hours, then strain it, add of the best Honey two Ounces, and Clarify it with the white of an Egg: Make a Purging Hydromel, the Dose is from six Ounces to eight in the Morning, twice or thrice a Week. Or, Take Calamelanos a Scruple, Rosin of Jalap half a Scruple, Balsam of Peru what suffices: Make four Pills, let them be taken in the Morning, repeating the Dose within five or six days. Take Tincture of Sulphur three Drams, give from seven drops to ten going to Bed, and early in the Morning in a spoonful of the following Mixture, drinking after it three spoonfuls. Take the waters of Snails, Earthworms, and Compound Radish water, of each four Ounces, water of the Juice of Elderberries fermented a pound, Syrup of the Juice of ground Ivy two Ounces,: Mix them, make a Julape. Or, Take Tincture of Gum Ammoniacum, or of Galbanum: Give to twenty drops at Night, and early in the Morning with the same Mixture. Or, Take Millepedes prepared two Drams, Flowers of Sulphur two Scruples, Flowers of Benzoin a Scruple, Powder of wild Carrot, and Burdock-seeds, of each half a Dram, Venice Turpentine what suffices: Make a Mass, form it into little Pills, take four at Night and early in the Morning, drinking after it a little draught of the same Julape. At nine a Clock in the Morning, and five in the Afternon drink a draught of the water of Quicklime Compound, to four Ounces, by itself, or with some other appropriate Medicine. For ordinary drink take the following Bochete. Take Roots of Sarsaparilla six Ounces, China two Ounces, the Woods of white and yellow Saunders, of each six Drams, shave of Ivory and Hartshorn, of each three Drams, Roots of Calamus Aromaticus half an Ounce, Raisins stoned half a pound, Licorice three Drams: Let it infuse according to Art, and boil it in twelve pounds of fountain water to six pounds, strain it. I was called to a young Scholar at Oxford, who had been ill for three Weeks of a pain of his Thorax, and of a great difficulty of Breathing that constantly followed him in the Evening, which also upon a quick motion of his Body, or his going up a steep Ascent tormented him above measure; he could not rest long on either side, but was forced to lie always on his Back, and with his Head raised: And if he tried to lie on either side, presently a pain followed the Position of his Body; and if haply he rolled himself from one side to the other, the pain also being presently removed, he felt as it were waters floating from one place to another: So if he let his Body hang downwards over the Bedside, he presently felt waters falling towards his Clavicular Bones. Moreover, if at any time his Body was heated more than ordinary by motion, the heat of a Bed, or of a Fire, presently he felt in his Breast a boiling as it were of waters on the Fire, and at the same time complained of a Giddiness, and of a little fainting of his Spirits. Being well satisfied by a due consideration of these things that he had a Dropsy of the Breast, I prescribed the Method and Medicines following with success. Take Calamelanos fifteen Grains, Rosin of Jalap half a Scruple, Syrup of Roses solutive what suffices, make three Pills. He took them early in the Morning, and had twelve Stools, which gave him great ease. Then again on the third day he had only four Stools by the same Medicine, though with greater relief to him than before. He took afterwards for many days of a Diuretic and Pectoral Apozeme six Ounces: And Lastly, the same Purge being repeated, he grew perfectly ivell. SECT. 2. Of Medicines regarding the Region of the Belly. CHAP. I. Instructions and Prescripts for the Cure of the Jaundice. AS to the method of Curing this Disease, there are three Primary Indications, all which (since we are in a manner always at a loss which of them is the chiefest, and first to be put in Practice) must be prosecuted together: Therefore the Intentions of Curing must be. First, That the obstructions of the Ductus' must be opened, if haply there are any either in the Porus Biliarius, or Meatus Cysticus, or elsewhere about the Liver, or Vessels that convey the Choler. Secondly, That the Blood be reduced to its due temper and Crasis, lest it engender Choler in too great a plenty, or render it unapt for separation. Thirdly, That the strength be upheld, and that the Symptoms chief prejucicing it be provided against. 1. To satisfy the First Incication, Cathartick evacuations both by Vomit and Siege are greatly conducing, with which the descent of the Choler towards the Intestines is Irritated, and the obstructed Vessels being by this means mightily agitated, are freed from their stoppages. Secondly, We must give Medicines that are smart, bitter, and salt, and others endowed with a certain instigating virtue, which may sharply stir up the motion of the Gall gathered together in the Liver, and there stagnating. In this place also we must range such Medicines as are thought to be good against the Jaundice by a similitude of substance, and as it were by a Signature; viz. as being endowed with a yellow Juice, though many of these because they move Urine or Sweat, may aptly enough be placed in the same rank with the former, viz. amongst evacuative Medicines. The Second Indication requires altering Medicines altogether, viz. such as may depress the exaltations or wild efforts of the Sulphur and fixed Salt, and help to the restitution of the Volatile Salt which was depressed before: For these purposes Medicines containing an Acid or Volatile Salt, and likewise Chalybeats will do excellently well: Hence Spirit of Salt, of Vitriol, Juice of Lemons; also Spirit of Hartshorn, and Sheep's dung, Goose dung, Crocus Martis, and other preparations of it of divers kinds, are often prescribed in the Jaundice with good success. The Third Incication being for the support of the strength, and for removing Symptoms that prejudice it, suggests to us many and diversified manners of Curing; but to avoid tediousness, I shall only set down certain general Rules concerning Diet, and some Cordial and Anodine Remedies peculiarly proper in this case. The Therapeutic Indications being thus laid before you, it remains for us now to adjust Select Medicines, viz. both simple and compound to each of those Intentions before proposed, and to explicate the manners and ways of operating of those Remedies which are accounted of most note in this Disesse: First therefore we shall set before you the Forms of Evacuating Medicines appropriated to the Jaundice. 1. Vomits. Emetic Medicines most commonly are of good effect in a new Jaundice, whilst the tone and strength of the Viscera hold good; forasmuch as they both ease the Ventricle of its offensive load of viscous Phlegm, with which its in a manner always oppressed in this Disease, and likewise by irritating the Vessels which convey the Choler, and strongly shaking the Ductus' of the Liver, they clear them of their stoppages, and bring the Choler to pass by the ways it formerly was wont. Take of the Infusion of Crocus Metallorum, from half an Ounce to six Drams, Vinegar of Squills an Ounce, Oxymel simple half an Ounce: Make a Vomit to be taken with governance. Sometimes it is proper to give the Evening before the following Mixtrue, as a preparation to facilitate the Vomiting. Take Powder of the Roots of Asarabacca, Faecula of Aron Roots, of each a Scruple, Tartar vitriolated half a Scruple, Oxymel simple an Ounce: Mix them. Take Sulphur of Antimony seven Grains, Scammony sulphurated eight Grains, Cream of Tartar half a Scruple: Make a Powder, give it in a spoonful of Panada. Take Nine Leaves of Asarabacca; being sliced and bruised, pour to them of Whitewine three Ounces, press forth the Juice, give it in the Morning with governance. Take Cambogia prepared eight Grains, Tartar vitriolated seven Grains: Make a Powder. cathartics. PUrging Medicines have place in this Disease, whether it be new or inveterate, viz. both that the plentiful supply of Excrements, be now and then cleared from the first passages, and that the Vessels that convey the Choler be stirred up to excretion. Take Electuary of the Juice of Roses three Drams, Rhubarb a Dram, Salt of Wormwood, Cream of Tartar, of each half a Scruple, Syrup of Rhubarb what suffices: Make a Bolus. Take Roots of sharp pointed Dock prepared an Ounce, tops of Sea Wormwood, and of the lesser Centory, of each two pugils, Roots of Gentian and Turmerick, of each two Drams, yellow Saunders a Dram; boil them in a pound and a half of fountain water to a pound; towards the end, add of the best Sena six Drams, of the best Rhubarb three Drams, Agarick a Dram and a half, Corianderseeds two Drams, Whitewine two Ounces, let them boil close covered for two hours, then strain it, and let it settle till it be clear: The Dose is from four Ounces to six, with Syrup of Rhubarb an Ounce, water of Earthworms three Drams: Make a Potion to be taken for three or four days together, or every other day. In a weaker Constitution. TAke Choice Rhubarb two Drams, Agarick Trochiscated half a Dram, Cinnamon half a Scruple, Ginger half a Scruple: Make an Infusion in Whitewine and Succory water, of each three Ounces, being close covered and kept warm for three hours: In the straining dissolve Syrup of Rhubarb an Ounce, water of Earthworms two Drams. Take Rhubarb powdered, from half a Dram to a Dram, Salt of Wormwood a Scruple: Make a Powder, Take Pilulae Ruffi a Scruple, Extractum Rudii half a Scruple: Make four Pills, let them be taken in the Morning with governance, repeating them within four or five days. In the Third place follow Deopilatives, and these are Diuretics, or Diaphoreticks, of which also some are accounted Specificks for their Similitude of substance; these sorts of Medicines both promote the separation of the Choler from the Blood, and being separated, force its way through the straitest passages and Pores in the Liver: Moreover at the same time by fusing the Blood, they cause its Serosities and Bilous Excrements to be sent forth in some measure by Sweat and Urine. Take Elixir Proprietatis an Ounce, give twenty drops in the Morning, and at five in the Afternoon with a fit Vehicle: After the same manner, the Tincture of Antimony, or of Salt of Tartar are often given with success; also Mixtura Simplex in a greater Doses. For Vehicles also for the same Intention of Curing, Apozemes, distilled waters and Julapes are proper. Take Roots of the greater Celandine, stinging Nettles, Madder, of each an Ounce, tops of Sea Wormwood, white Horehound dried, Agrimony, Germander, of each a handful, Wormseeds two Drams, shave of Ivory and Hartshorn, of each two Drams, yellow Saunders a Dram and a half, Corianderseeds two Drams; boil them in three pounds of fountain water to two pounds, add of Whitewine four Ounces, and strain it, add Syrup of Cichory with Rhubarb two Ounces, Water of Earthworms an Ounce and a half: Make an Apozeme, the Dose is from four Ounces to six twice a day. Take Leaves of white Horehound dried, of the lesser Centory, of each a handful, Roots of Gentian and Turmerick, of each three Drams, Cinnamon a Dram, Saffron half a Dram, being sliced, let them be put into a Glass with White or Rhenish Wine two pounds: Make a close Infusion, the Dose is three Ounces. To this place belongs the famous Anti-Icterick of Gesner. Take Roots of the greater Nettle a pound, Saffron a Scruple: Bruise them well, and extract a Tincture with Whitewine, the Dose is three Ounces in the Morning for four or five days. Like to the former is that of Fr. Joel. Take Roots of the greater Celandine sliced two handfuls, Juniper Berries a handful, being bruised, pour to them of Rhenish Wine a pound, and extract the Juice: The Dose is four Ounces twice a day. The Juice of white Horehound is mightily commended by Dioscorides for the Cure of the Jaundice, and its Syrup by Forestus. Instead of the Elixir and other Chemical Liquors which are ordered to be taken in a very small quantity to avoid nauseousness: You may give more successfully Electuaries, Powders, and Pills to others of a strong Constitution. Take Conserve of Sea Wormwood, the outward yellow Coats of Oranges and Lemons, of each two Ounces, Species Diacurcumae an Ounce and a half, Powder of Ivory, yellow Saunders, the Lignum Aloes, of each half a Dram, Troches of Capers a Dram, Troches of Rhubarb half a Dram, Salt of Wormwood two Drams, with a sufficient quantity of Syrup of Cichory with Rhubarb, make an Electuary; the Dose is the quantity of a Chestnut twice a day, drinking after it of the following Julape three Ounces. Take Waters of the greater Celandine, Fumitory, Wormwood simple, and of Elder Flowers, of each five Ounces, Magisterial water of Snails, Water of Earthworms Compound, of each two Ounces, Sugar half an Ounce: Mix them, make a Julape. Or, Take Roots of the greater Nettle, Angelica, Gentian, of each four Ounces, the greater Celandine entire six handfuls, Wormwood, tansy, both Southernwoods, of each four handfuls, the outward Coats of twelve Oranges, and of four Lemons, Earthworms prepared, Snails, of each a pound, Cloves bruised two Ounces, being sliced and bruised, pour to them of Whitewine eight pounds, distil it with common Organs: Let the whole Liquor be mixed. Or, Take Filings of Steel a pound, fresh Strawberries six pounds, put them in a glazed Pot and stir them together, and let them stand for a day, then add of the Roots of English Rhubarb sliced a pound, the Rinds of four Oranges, being sliced, pour to them of Whitewine six pounds, and distil them according to art: Let the whole Liquor be mixed: The Dose of this and the former is three Ounces twice a day after the Electuary, or other Medicine. Take Powder of the Roots of Turmerick and Rhubarb, of each a Dram and a half, Rinds of Caper Roots, Asarum Roots, of each half a Dram, Extract of Gentian and Centory, of each a Dram and a half, Salt of Wormwood four Scruples, Seeds of Water-cresses half a Dram, of Rocket half a Scruple, Elixir Proprietatis a Dram, Gum Ammoniacum dissolved in a sufficient quantity of Water of Earthworms: Make a Mass, Form it into little Pills, the Dose is half a Dram Evenings and Mornings, drinking after it of the distilled Water three Ounces. Silvius highly commends for the Cure of the Jaundice a Decoction of Hemp-seeds in Milk, and a Solution of Soap. The Second Indication having regard to the altering, or due tempering of the Blood, that it engender Choler only in a moderate quantity, and duly separate it, requires those kinds of Medicines which depress the Sulphur and fixed Salt when too much exalted: For these ends, I know not by what chance or guidance Medicines endowed with a Volatile Salt, as Earthworms, Snails, Millepedes, nay Lice, the Dungs of Fourfooted Beasts, and of Fowl, being introduced into Practice for Curing the Jaundice, are usually given not only by Empyricks, but likewise prescribed by Physicians of the best account: These sometimes by themselves, but oftener joined with Evacuatives and Deopilatives enter the chief compositions of Anti-ictericks. Fonseca prescribes Goslings Dung gathered in the Spring time and dried, and also the white Dung of Chickens; the Powder of both which is given from half a Dram to a Dram, in a fit Vehicle. Take Powder of Earthworms prepared, Goose dung, of each three Drams, Ivory, yellow Saunders powdered, of each half a Dram, Saffron a Scruple: Make a Powder, divide it into six parts for so many Morning Doses, with some Liquor fit for the purpose. To the Anti-icterick Apozem and Tincture above prescribed, Earthworms; also Goose-dung, and Sheeps-dung, are usefully added. Take of fresh and live Millepedes, in number from fifty to a hundred, Saffron half a Scruple, Nutmegs a Scruple, being bruised together, pour to them of Celandine water four Ounces, water of Earthworms two Ounces, wring it forth hard, and drink it: After this manner let it be taken first once, afterwards twice a day for a Week. It's a vulgar and Empirical Remedy with our Country men to take Nine Lice alive in the Morning for five or six days, by which Remedy I have heard that many have been Cured when other things did no good; which certainly can give relief no other way but by restoring the Volatile Salt, which was depressed in the Blood. On the account of the same way of Curing, the Flowers of Sal Armoniac, the Volatile Salts of Amber, Hartshorn, and Soot, and likewise their Spirits are often given with great success in this Disease. Take Powder of Earthworms prepared two Drams, Species Diacurcumae a Dram, Flowers of Sal Armoniac half a Dram, Salt of Amber a Scruple, Extract of Gentian a Dram, Saffron a Scruple, Gum Ammoniacum dissolved in water of Earthworms what suffices: Make a Mass, Form it into small Pills; the Dose is three or four Morning and Evening, drinking after it of the Julape before written three Ounces. Take Spirit of Hartshorn tinged with Saffron three Drams: The Dose is from fifteen drops to twenty, with the distilled water above mentioned. In this rank of Medicines with which the Blood distempered with the Jaundice is intended to be corrected, Chalybeats also justly claim a place; for these give a considerable relief in the Jaundice, as well as in other Cachectical Distempers, not so much by opening the obstructions of the Viscera, as by depressing the exaltations of the Sulphur and fixed Salt, and by volatilizing the Blood. Therefore to the Decoction, Tincture, or Infusion above written, the Filings of Iron, or its Powder prepared (its Mineral Texture being some way loosened) or its Vitriolic Salt extracted, may be properly added; for hence it is that our Mineral waters sometimes cure even to a Miracle such as are quite given over in the Jaundice: Though these waters when drank in a very large quantity, passing through all the Vessels, open also all the Ductus' of the Liver, be they never so much shut up. Therefore also to the Electuaries, Pills and Powders before expressed, preparations of Steel, sometimes of one sort, and sometimes of another, may likewise be added in a fit proportion: Moreover, you may give to the quantity of a spoonful of its Syrup twice a day in three Ounces of the Anti-icterick Apozeme or distilled water; also the Tincture of Steel to twelve or fifteen drops may be given after the same manner with good effect. Lastly, in this rank of altering Medicines, we ought to place those which are said to Cure this Disease, not as inwardly taken, but outwardly applied either by the touch, or being put into the Urine of persons troubled with the Jaundice. As to the First, it's a common Remedy with the vulgar to take a Tench, and apply it to the right Hypochondre, or to the Ventricle as some will have it, or according to others, to the Soles of the Feet of the Person that has the Jaundice, whence they expect the Disease to vanish in a short time; though many promise a certain Cure by this means, yet it did not succeed with me, having sometimes tried it. The other Cure of the Jaundice at a distance, is said to be done by I know not what Sympathy, or secret manner of working. Take the fresh Urine of the Patient made at one time, ashes of the Ash-tree seared what suffices: Mix them, and make it into a Paste, and form it into three Balls of an equal bigness, and put them in a close place near the Fire, or a Stove; when these Balls grow dry and hard, the Jaundice vanishes: After this manner I have known this Disease successfully Cured when it was grown inveterate, and would not yield to other Remedies; this is a familiar practice with the vulgar. The reason of this Operation is, that when the Lixivial Salt in the ashes is mixed in the Urine, it presently sets free the Volatile Salt, which before was kept under in it, or entangled with other Particles, and at the same time that this is done in the Icterical Urine, it happens by Sympathy that the Volatile Salt also in the Blood of the Patient gets free from the Dominion of the fixed Salt and Sulphur, and consequently the Icterical Dyscrasy of the Blood vanishes: And thus Phil. Grulingius and Felix Platerus tell us that Making Water on warm Horsedung has Cured many Persons troubled with the Jaundice, viz. inasmuch as the fixed Salt of the Urine, and consequently of the Blood of the Patient is altered by the Volatile Salt of the fresh Horsedung, and is reduced to its due temperature. The Third and Vital Indication order a fit Diet, and likewise prescribes Cordials and anodynes, both which are often wanted. As to what concerns the First, the Diet in this Disease is wont to be more Physical than in any other whatsoever: For Vegetables, and their parts, vulgarly called Hepatick Remedies, are boiled in the Broths of persons troubled with the Jaundice; their Broths also are usually made of Worms and Snails (being accounted the Antidotes of the Jaundice) instead of other Flesh: Moreover their Ale and other ordinary Drinks are Impregnated with an Infusion of Physical things. Take Roots of the greater Nettle, and of Strawberries, of each an Ounce and a half, Candied Eringo Roots an Ounce, shave of Ivory and Hartshorn, of each two Drams, Earthworms cleansed, in number twenty, a Crust of White-bread, Mace two Drams; boil all in two pounds of fountain water to a pound: Strain it through Hypocrates Sleeve, add to it Species of Diatrion Santalon half a Dram: Make a Broth, of which take from four Ounces to six twice a Day. For ordinary drink fill a little Vessel of four Gallons with Ale, into which after it has wrought, put the following bag. Take Tops of Sea Wormwood, and white Horehound dried, of each two handfuls, Roots of sharp pointed Dock dried six Ounces, Bark of the Ash-tree, and of the Barbery-tree, of each three Ounces, the outward Rinds of eight Oranges, and of four Lemons, being sliced and bruised, let them be prepared according to art. Many Persons in the Jaundice being troubled with a great weakness and frequent faintings, stand in need also of Cordial Remedies. Take small Aqua Mirabilis eight Ounces, Earthworms four Ounces, Syrup of Orange Pills two Ounces: Mix them, the Dose is two or three Ounces. Moreover there are some who in this Disease are found subject now and then to very troublesome pains, chief tormenting them by Night, and who are often molested with want of sleep; wherefore anodynes also must here come in use. Take Aqua Mirabilis, water of Earthworms, of each an Ounce, Diacodium six Ounces, Tincture of Saffron half an Ounce: Mix them, the Dose is a spoonful or two late at Night when there is want of sleep. Take Laudanum tartarized two Drams, Aqua Mirabilis two Ounces, Syrup of Clove Gillyflowers an Ounce: Mix them, the Dose is a spoonful after the same manner. CHAP. II. Instructions and Prescripts for other Distempers of the Liver. THe Liver often uses to be faulty, especially in one of these two things, viz. either intercepting the Nutritive Juice appointed for other parts, it applies it to its proper use, as it's generally seen in Children troubled with the Rickets, and in many others leading a slothful and idle Life: Or Secondly, it too easily receives into its most inward Recesses, the filthiness of the depraved Blood, and all dreggy Excrements coming in its way, and retaining them does not only grow large, but is obstructed in its Ductus', whence oftentimes proceeds a Jaundice, or Dropsy, and tumors, and preternatural Concretions of divers kinds. Therefore we must take care of these two things, viz. lest the Liver by taking to itself too much of the Nutritive Juice, grow to too great a Bulk, and lest by retaining the filthy dregs of the Blood, it be troubled with obstructions, and preternatural tumors. Both these faults are much more easily prevented than Cured: For the former is effected only by taking care that the Blood being well constituted in its Crasis, and enjoying a free Circulation, both distributes the Nutritive Juice to the parts, and especially the outmost, and driving all its Excrements to all their respective Emunctories deposes them there: And indeed the Hepatick Medicines (vulgarly so called, though they regard the other Viscera as well as the Liver) do first and more immediately exert their virtue by purifying the Blood, rather than by correcting the Liver, or other entrails; for entering the Blood, and being immiscible with it, they so throughly exagitate it, that they make it discharge all its superfluities by their proper Emissaries; and if any Medicines are found by some specific virtue, to have respect to one part more than to another, it's because their Particles being more allied, and consequently associated to the Recrements to be separated within that entral, are carried thither together with them: For this reason Rhubarb, Turmerick, the greater Celandine, and many other things allied to the Gall, readily pass to its Ductus', and are wont to do good in the Jaundice: We have before set forth the Energies and ways of operating of these Medicines: As to other Hepaticks commonly so called, we shall briefly set down certain Forms, First of those which are said to prevent or remove the Non-natural accretion of the Liver, and then of those which do the like, in respect of its obstructions, and preternatural tumors. 1. Against the too great accretion, or disproportionate nourishment of the Liver: First, a spare and thin Diet, short Sleep, and frequent and moderate Exercises are proper. Wherefore if at any time Infants and Children are found obnoxious to this affect, as likewise to the Rickets, we order that they suck thin and serous Milk, that they are daily tossed in their Nurse's Arms, and carried from one place to another with a swift motion, or that they are put in a Chariot, or in a Chair, and swiftly driven to and fro, and that they learn to use their feet as soon as may be, and go about. Take the Waters of Snails and Earthworms, of each three Ounces, Syrup of Cichory with Rhubarb two Ounces, Spirit of Sal Armoniac with Gum Ammoniacum a Scruple: Mix them, take a spoonful at Night, and early in the Morning. Take Roots of Male Fern, Chervil, Candied Eryngoes, of each an Ounce, Leaves of Agrimony, Heart's Tongue, Male Speedwell, of each a handful, shave of Ivory and Hartshorn, of each two Drams, white and yellow Saunders, of each a Dram, Raisms stoned an Ounce and a half, Barley three Drams: Boil them in three pounds of fountain water to two pounds; to the straining add the waters of Snails and Earthworms, of each an Ounce and a half, Syrup of Cichory two Ounces: Make an Apozeme, take to two or three Ounces in a day. Take Powder of white and yellow Saunders, Crabs Eyes, Lignum Aloes, of each half a Dram, Salt of Wormwood a Scruple: Make a Powder, the Dose is from half a Scruple, to a Scruple twice a day. Take Emplastrum Diasaponis, Ceratum Santalinum, of each what suffices: Make a Plaster to be applied to the right Hypochondre. Take Vnguentum Splanchnicum two Ounces, Oil of Wormwood an Ounce: Mix them, make a Lineament for the Region of the Liver. The Remedies for most other Diseases of the Liver, are either Simple or Compound: Amongst those of the former kind, are usually reckoned all Cichories, Sorrels, sharppointed Docks, and in a manner all Vegetables which have a sort of bitterness joined with somewhat of a smartness (in which the Deopilative virtue is said to consist) as Wormwood, Germander, Ground-Pine, Fumitory, tansy, Agrimony, Liver-wort, Lignum Aloes, all the Saunders, Tamarisk-bark, Ash-bark, and the Roots of Capers, with many others which make up the greatest part of Botanics. The fixed Salts of Herbs, and the Acid Spirits of Minerals claim a chief place amongst these, because they mightily agitate the Mass of Blood, dissolve its Concretions, clear its stoppages, and make it every where permeable in all its parts. It's also manifest both by reason and experience, that preparations of Steel are often proper in Distempers of the Liver, as especially in the Jaundice, and the Dropsy. In the Antidotaries of the Ancients, we find a great many Physical Compositions which seem to be wholly designed for the Liver, as the Electuary ê scoria ferri Rhasis, etc. But passing over these, I shall now give you some Forms and Examples of Medicines which are accounted Deopilatives, according to the practice of our times. Therefore for an Opening Decoction. TAke Roots of Fern, Chervil, the greater Nettle, Dandelion, of each an Ounce, Leaves of Agrimony, Heart's Tongue, Speedwell, Oak of Jerusalem, Liver-wort, of each a handful, white and yellow Saunders, of each three Drams, shave of Ivory half an Ounce, Red Cicehs an Ounce, Coriander Seeds three Drams, Raisins two Ounces: Boil them in four pounds of fountain water, to two pounds, adding about the end Whitewine four Ounces, strain it through Hypocrates sleeve; to which put Species Diarrhodon Abbatis a Dram, our prepared Steel two Drams: To the straining add Syrup of Cichory with Rhubarb two Ounces, waters of Snails and Earthworms, of each an Ounce: The Dose is six Ounces twice a day, after a Dose of the following Electuary. Take Conserve of the yellow Coats of Oranges and Lemons, of each two Ounces, of Wormwood and Fumitory, of each an Ounce, Simple Powder of Aron Roots, Lignum Aloes, yellow Saunders, and Caper Roots, of each a Dram and a half, Crabs Eyes a Dram, Salt of Wormwood two Drams, Syrup of Fumitory what suffices: Make an Electuary, the Dose is the quantity of a Walnut twice a day, drinking after it a draught of the Apozeme before written, or of the following distilled water. Take Leaves of Wormwood, Centory, tansy, both Southernwoods, Branches of Tamerisk, of each four handfuls, green Wallnuts four pounds, green Ashen-keys two pounds, the outward Kind's of ten Oranges, and of four Lemons, Snails, Earthworms prepared, of each a pound; being all sliced, pour to them of Whitewine eight pounds, distil it with common Organs: Let all the Liquor be mixed, the Dose is three Ounces, sweeten it with Sugar, or some proper Syrup. If a Form of Pills be more grateful; the following Ecphractick Extract (as the Shops call it) seems good. Take white and clear Tartar, and fresh Filings of Iron, of each four Ounces, let them be bruised together into a Powder, then boil it in four pounds of fountain wa●●● to two pounds, (some use White-wine) to the straining add tops of Centory, Sea Wormwood, and Carduus, of each a handful, Gentian Roots half an Ounce, Species Diacurcumae a Dram and a half; let them boil close covered for three or four hours, then strain it, and let the straining evaporate by a gentle Bath heat, to a consistency for Pills, adding if you please, Troches of Rhubarb, or Species of Hiera Picra two Drams: The Dose is from a Scruple to half a Dram made into Pills, in the Evening with a fit Vehicle. For the same intent, viz. to prevent or remove obstructions of the Liver, a Purging Physic Ale to be taken Spring and Fall for many days, is highly extolled by some, and diligently used by certain Persons every year during their Lives. Take Roots of sharp pointed Dock prepared, and of Polypody of the Oak, of each three Ounces, Madder two Ounces, English Rhubarb two Ounces, Leaves of Sena four Ounces, Epithymum two Ounces, yellow Saunders an Ounce, Seeds of Carthamus and Coriander, of each an Ounce and a half, being sliced and bruised, Make a Bag according to art for four Gallons of Ale, after six days take to twelve Ounces more or less in the Morning, by which you may expect four or five Stools, Sine Regimine. CHAP. III. Instructions and Prescripts for Curing the Dropsy called Ascites. THe Dropsy called Ascites, is a tumour of the Belly, caused by a Watery Humour contained within its Cavity; which Humour probably is the Serum of the dissolved Blood, distilling forth of the Caeliack and Mesenterick Arteries into the Cavity of the Abdomen, and especially if it happens, that Scirrhous tumors, Glands, little Swell, or other preternatural Concretions are raised about the Mesentery, Liver, Spleen, Womb, or other Viscera of the Belly; for the Circulation of the Blood being stopped in those places, the Serous part of it is forced from the rest, and falls into that Cavity, and commonly the Nutritive Juice goes with it, wherefore when this Region swells, the Members are usually extenuated. Nevertheless the Blood is not always dissolved in an Ascites, as it is in an Anasarca, but is sometimes too compact in its Crasis, yet so that its forced by reason of the Obstructions of the Viscera, to depose within the Abdomen its Salt Serum, which it could not evacuate by the Pores of the Skin, and the Urinary passages. It's also likely that the Lacteous or Lymphatic Vessels being sometimes broken or opened, fill the Abdomen with a Mass of Water or Chyle. I conceive also that this Inundation of the Belly, may sometimes arise from the Nervous Liquor, distilling gently and insensibly from the Fibres and Membranes: And likewise from vapours condensed within the Cavity of the Body. Concerning the Cure of Ascites, we must consider by how many possible ways and manners, waters gathered together within the Abdomen may be evacuated: And we find that the Remedies, which according to the ordinary practice of Physic, are accounted Hydroticks, work that end by Purging, by Evacuation by Urine, by Sweeting, and by insensible transpiration, and with some Persons you must proceed this way, and with others that, or the other; and if neither of these seem possible, or succeed well, you must timely think of an Incision. I shall now consider each of these ways. First therefore cathartics seasonably given, often abate the Tumour of an Ascites, and sometimes wholly take it away; for as much as their Particles irritating the Ventricle and Intestines, discuss the Contents and Flatus' of those Viscera, and likewise the humours sticking in their Tunicles and Glands, and heaped together in the Vessels and Ductus' of their neighbouring parts, and force them partly into to Ductus' of the Intestines, and partly send them into the Mass of Blood: But it does not succeed thus, if at any time this Disease proceeds from a Lympha, floating within the Cavity of the Abdomen, or from an Inflation or Tympanitical extension of the Membranes; because Hydragogues carry forth little or nothing of those waters, and if they are strong, exasperated and increase the Flatulent Distemper. cathartics accounted Hydragogues, are either Emetics or Purgers. 1. The Hydragogue Emetics of chiefest note, are Gum Gutta, Esula or Cataputia, and diversified preparations of them: Also Hercules Bovii, & Pilulae Lunares. 2. The Purgers are Elder, and Dwarf Elder, Sea Bindweed, Hedge Hyssop, Juice of Orris, Elaterium: I shall briefly set down certain Forms and manners of prescribing, compounding, and giving each of these. 1. Gum Gutta is highly extolled for Purging Serous humours; but in regard being given by itself, it mightily disturbs the Stomach, and often weakens it, therefore to repress a little its excessive and violently Emetic force, various ways are contrived for preparing it; but it's best of all corrected with an Acid Spirit, or with an Alchalisate Salt, or by throughly tempering and compounding it with Aromaticks. Adrian Mynsicht commends its Magistery, which is made by dissolving it with Spirit of Wine, and then by drawing it off, and preciptiating it with fountain water; also by dissolving it with Spirit of Wine Vitriolated, and Tinged with Roses and red Saunders, and then by evaporating it, others prepare it with the fume of Sulphur after the manner of Scammony Sulphurated: Others grind it on a Marble, moistening it with Oil of Cinnamon, or of Cloves, or other Chemical Aromaticks: I use most its Solution, made with the Tincture of Salt of Tartar: The Does of which is from fifteen Drops to twenty or thirty. Take Gummi Gutta six Grains, Mercurius Dulcis fifteen Grains, Conserve of Violets a Dram and a half: Mix them, make a Bolus. Take Gummi Gutta twelve Grains, Salt of Wormwood six Grains, Oil of Mace a Drop, Conserve of Damask Roses a Dram: Make a Bolus. And its wont to be given with Tartar Vitriolated, or Cream of Tartar, and powder of Rhubarb. Take Gum Gutta sulphurated or vitriolated fifteen Grains, Croam of Tartar half a Scruple, Extract of Rhubarb a Scruple, Oil of Cinnamon two Drops: Make four Pills. A Woman of late being ill of a dangerous Ascites, and as it seemed to me in a desperated condition; by taking the following Medicines for six days successively, grew much better, and in a short time after perfectly recovered. Take Gum Gutta powdered twelve Grains, Oil of Cinnamon a Drop, Syrup of Buckthorn what suffices: Make a Bolus, let the Dose be increased every day, by rising from twelve Grains to twenty. Take of our Tincture of Gum Gutta a Scruple, water of Earthworms an Ounce, Syrup of Rhubarb half an Ounce: Mix them, give it Cum Regimine. Though there are various kinds of the Spurges, and all of them work violently by Vomit or Siege, by reason of their mighty Irritation of the Viscera, and consequently evacuate Serous humours in a plentiful manner; yet because of the excessive strength of most of them: The lesser or wild Spurge, is now in a manner only in use: And it's most approved preparations are the Powder of the Rinds of its Roots, and its Extract; We also add its Tincture, which is not Inferior to the rest. Take the lesser Spurge, with the Roots cleansed four handfuls, Lignum Aloes, Cloves, of each a Dram; being bruised, boil them in four pounds of fountain water till half be consumed ' let the straining Clarify by settling in an oblong Glass, then let the clear Liquor Evaporate by a Bath-heat to the consistency of an Extract; The Dose is a Scruple. Take of this Extract half an Ounce, pour to it in a Matras six Ounces of the Tincture of Salt of Tartar, digest them in a Sand Bath till the Tincture be Extracted: The Dose is from twenty to thirty Drops, with a fit Vehicle. Take Powder of the Roots of the lesser Spurge, from seven Grains to ten, Cinnamon half a Scruple, Salt of Tartar eight Grains; bruise them together in a Glass Mortar, give it by itself, or with the Addition of some fit Conserve or Syrup: Make a Bolus or Pills. 3. Praecipitatum Mercurii cum Sole, or Hercules Bovii; For as much as by its Acrimony, it mightily irritates the Fibres of the Stomach, and fuses the Blood by reason of its Mercurial and Saline Particles, it raises a violent Vomiting, and so forces a discharge of the Serous humours, which are violently drawn into the Cavities of the Viscera. Pilulae Lunares, in like manner by reason of the Vitriolic Particles of the Silver, being sharpened with other Saline Menstruums produce the like effect, viz. by much corrugating the Fibres of the Viscera, they strongly force the Serous humours into their Ductus', and causes them to be evacuated. A Solution of Silver being made in Aqua Stygia, and well purified, is reduded by a gentle evaporation into clear Crystals; which by themselves (or with the addition of Sal Nitre to repress the force of the Lunar Vitriol) are made into Pills with the Crum of Bread: The Dose is sometimes a single Pill, sometimes two or three according as they work, and as the strength will bear, these sorts of Medicines are sometimes given with success in a strong Constitution, and where the Viscera are sound, and of a good habit; but scarce ever have a good effect in tender and Cachectical Bodies, and are seldom taken by such persons without doing them hurt. Hydragogue Medicines which work merely or chief by Siege, are either mild, as Elder, Dwarf Elder, Sea Bindweed, and the Juice of English Orris, which are rarely given by themselves, but want to be quickened by such as are smarter, and for return they qualify the vehemency of the other; or they are strong, as Hedg-Hyssop, Jalap, and Elaterium. The Seeds of Elder and Dwarf Elder, being dried and powdered, and taken to a Dram, gently evacuate Serous humours by Siege; a Water and Spirit are distilled from the Juice of both their Berries fermented, and Robs and Syrups are made of it; which with many other preparations of those Vegetables are highly extolled for all Hydropical Distemper. Sea Bindweed, and Hedg-Hyssop, are now rarely used by themselves, but often enter the Compositions of other Hydragogues, and chief in Apozemes. The Juice of English Orris is a good Medicine, and the more to be esteemed because easy to be had for poor people: It's given from six Drams to an Ounce and a half, or two Ounces, either by itself in a fit Vehicle, or with other proper ingredients. Jalap is a well known and vulgar Medicine against all sorts of Dropsies. Every ordinary Man that has that Disease, presently takes a Pennyworth of the Powder of Jalap, with a little Ginger in Whitewine; and this Medicine taken a pretty many times seldom fails of success. Elaterium is justly accounted a most powerful Hydragogue, in regard that most powerfully irritating the Fibres of the Viscera, and at the same time fusing the Blood and humours by a sort of corrosive virtue as it were, it forces whatsoever Serosities the Tunicles of the Viscera, Membranes, and Vessels; also those that the Glands and Fleth contain within them, to discharge themselves into the Cavities of the Stomach and Intestines: Which Medicine working well, sometimes the swelling of the Belly fall. This indeed is the chief Instrument of the Empyricks Arsenal against an Ascites, though using it in all cases, they oftener give if to the prejudice of the Patient, than to his advantage: The Dose is from three Grains to ten or fifteen. It's taken either by itself, only with the Addition of Aromatical Correctives, or it's given with other Hydragogues in the Form of a Powder, Pills, or of an Electuary: Its Tincture and Essence are Extracted with Spirit of Wine, or with Tiacture of Salt of Tartar. These are the chief simple Hydragogues, of which being duly prepared with the Addition of other things, divers sorts of Compounds are made, some common in Shops, others Magisterially prescribed, and are every where in use, and a great many more may be ordered ex tempore on occasion. We shall here set down some few Select Forms of them, and especially such as are taken in the Form of a Potion, Powder, Electuary and pills. Take Roots of Dwarf Elder, and English Orris, of each an Ounced and a half, Leaves of Sea Bindweed, and Hedge Hyssop, of each a handful, Roots of Asarabacca and wild Cucumbers, of each two Ounces, Roots of the lesser Galingal six Drams, choice Jalap half an Ounce, Elaterium three Drams, Cubebs two Drams, being slieed and bruis; d, pour to them of small Spirit of Wine Tartarized three pounds; let them digest close luted in a sand Furnace for two days, strain off the clear, which being purified by settling; give from two spoonfuls to three with a fit Vehicle. Take Elaterium, Sea Bindweed, Ginger, of each a Scruple, Galingal, Cloves, Cinnamon, of each half a Scruple, Salt of Tartar fifteen Grains: Make a Powder for two Doses. Take Powder of the Roots of the best Jalap a Dram, Giner a Scruple, Cream of Tartar fifteen Granins: Make a Powder, give it in a draught of Whitewine. Take Rhubarb powdered a Scruple, Elaterium five Grains, Tartar vitriolated half a Scruple, Spike three Grains, with Syrup of Buckthorn: Make four Pills. Take Pilulae Aloephanginae half a Dram, Elaterium half a Scruple, Oil of Cloves three drops: Make four Pills. Let the Hydropic Pills of Bontius be given from half a Scruple, to half a Dram: They are made after this manner. Take of the best Aloes two Drams and a half, Gummi Gutta prepared, a Dram and a half, Diagredium corrected a Dram, Gum. Ammoniacum dissolved a Dram and a half, Tartar vitriolated half a Dram: Make a Mass, and form it into Pills. Certain Hydragogue Electuaries, are now every where much in use amongst Practitioners; and especially one given us by tye famous Silvius, and another by Zwelfer. This that follows likes us well. Take Rosin of Jalap two Drams, Tartar vitriolated a Dram, Extract of Rhubarb two Drams, of Esula a Drm and a half, Roots of the lesser Galingal a Dram, bruise them very well: And lastly add Conserve of English Orris Flowers four Ounces; and with a sufficient quantity of Syrup of Peach Rlowers Make an Electuary, the Dose is from half a Dram, to a Dram and a half, or two Drams. I might here give you many other Purging Hydragogues, but cathartics do not always Cure the Ascites, nay they often make it worse, and (if you insist too long upon them) render it Incurable. Therefore now let us inquire whether Diuretics will do good in this case or not. And truly any Man might easily be induced to believe that Medicines provoking Urine, contribute very much towards the Evacuation of Waters from any part or Cavity of the Body: In reality its manifest by frequent experiments, that they often Cure the Anasarca, and give relief in it before all other Remedies: Let us see therefore what they can do for draining the Cavity of the Abdomen. As to this, its manifest in the first place, that there is no immediate passage open from the Ascitical Mass of Waters to the Reins, how near soever they lie to them; but whatsoever waters are conveyed from that Mass to the Reins, must of necessity be first of all drank up again into the Blood, and be thence discharged into that receptacle of the Urine: Now little is it that the small Mouths of the Veins (if haply any of them are open) can receive? And this is that only thing which Diuretics are able to perforem viz. By fusing the Blood, and driving its Serosities to the Reins in a plentiful manner, to make it draw to itself, being so drained, the Waters floating in the Belly. In the mean time there is no less danger lest Diuretics unseasonably given, whilst they fuse the Blood too much, drive the Serum, which is forced to part from it, into the watery Mass of the Ascites, more than into the Reins, and so rather to increase than remove that deluge of the Belly. And truly I have frequently observed that this sometimes happens; and 'tis for this reason than the Ancients always mixed Astringents and Corroboratives in their Medicines for the Dropsy, not that such (as is vulgarly said) strengthen the tone of the Liver, but preserve the Crasis or Mixture of the Blood from being wholly dissolved by too much fusion. Therefore in an Ascites which happens chief, or in part, by reason that the Serous humour stuffs and mightily swells the Compages of the Viscera and Vessels, and especially the Tunicles, Glands and Fibres themselves, and the spaces betwixt them; even as Cathartieks are proper, so are also Diuretics, and are often taken with success, for as much as by the use of these, the Mass of Blood is drained (the Serum being derived to the Reins in a plentiful manner) and readily receives into itself those waters every where stagnating about the Mouths of the Vessels, and conveys them to the Urinary Common-shore: But on the contrary in a true Ascites where the Textures of the Viscera being free from such stuff with Serum, the filthy Mass of Waters fills the Cavity of the Belly, Diuretics are given either to no purpose, or with prejudice, because they fetch out nothing of the water stagnating in the Belly, and very often by fusing the Blood, drive the waters more violently thither, being apt to distil into it of their own accord. In an Ascites all Diuretics of every kind are not equally proper, nor aught to be indifferently give; for it is to be observed, that Persons troubled with this Disease make little Urine, which is also reddish, and resembling as it were a Lixivium; which is a sign that the Crasis of their Blood is so close bound by reason of the fixed Salt and Sulphur being exalted and combined together in it; and consequently that its Serum is not duly separted within the Reins, which nevertheless is thrown off in the Involutions of the Obstructed Viscera, and so is deposed in the Cavity of the Belly. Wherefore in this case we must give only those things to move Urine, which so restore and corredct the Constitution of the Blood, that the Irregularities of the fixed Salt and Sulphur being taken away, the Serous part may be separated within the Reins, and sent forth in a more plentiful manner: For which end not Acid or Lixivial things, but such as are endowed with a Volatile Salt are proper; for I have often observed in such Patients, that when Spirit of Salt, and other Acid distilled Liquors of Minerals, and when the Deliqia or Solutions of Salt of Tartar, of Broom, and of other things have rather done hurt than good; the Juice of Plantain, of Brooklimes, and of other Herbs abounding with a Volatile Salt; also the expressions of Millepedes have given relief: For the same reason Sal Nitre throughly purified, or Crystal Mineral has often a mighty good effect. You may find Forms of Medicines proper for this use in our preceding Tract, where we have set down Examples of Diuretics, in which both Volatile and Nitrous Salts are the Basis: Moreover to this place belongs that notable Experiment with which Johannes Anglus says he often Cured an Ascites from a hot Caus, which Medicine also the most experienced Physician Dr. Theodore Mayern usually prescribed in the like Case, and was wont to extol. It is as follows. Take Juice of Plantain and Liverwort, and fill an earthen Pot with it to the Brim, then stop it very close, and put it in a hot Oven as soon as the Bread is drawn, and make a gentle Fire round the sides of the Pot to continue the heat of the Oven; after it is boiled strain the Liquor, and being sweetened with Sugar, let it be drank Mornings and Evenings, and it Cures. In Imitation of this, I have often prescribed with success after the following manner: Take green Plantain Leaves four handfuls, Liverwort and Brooklimes, of each two handfuls, being bruised together, pour to them of small Compound Radish water, or of some other Magisterial water half a pound, wring it forth hard: The Dose is three Ounces thrice a day. Diaphoreticks, though most efficacious in an Anasarca, yet are of little or no use in an Ascites; for being unseasonably given, they often cause a great prejudice to the Patient, without doing him the least good, because by heating the Blood they make the waters floating in the Cavity of the Belly, to grow fervid, and to boil as it were, so that the Spirits and Humours are mightily troubled by the Vapours thence raised, and so a disorder of all the functions follows, and the Viscera themselves being sodden as it were, are very much injur': Moreover when a Sweat is thus unduly raised, the Blood being forced to a fusion and precipitation of Serum, discharges more yet into the watery Mass of the Ascites; therefore when some prescribe Fomentations and Liniments to be applied to the swollen Paunch, and order Bathing, for the most part it falls out for the worse to the Patients; for besides Feverishness, a Headache, Vertigo, faintings of the Spirits, and other ill Symptoms of the Heart and Brain, most frequently caused by such means, the Belly also swells the more by it, because the Blood being agitated and dissolved, deposes the Serum there in a larger measure: Nay, and the Mouths of the Vessels are thereby made more lose and open, so that they distil forth waters faster, they being now disposed to part from the Mass of Blood. The Remedies which are wont to be Administered with most success, when we will not proceed to an Incision, are Glisters and Plasters. The former draw the Serum out of the Vessels and Glands of the Intestines, and Mesentery, without fusing the whole Mass of Blood (which strong cathartics will do) which being so emptied, receive into them some of the extravasted Lympha; For this end the following Glister usually prescribed by us in the like case is mighty proper; in regard at the same time it irritates the Fibres of the Intestines, and draws the Serum imbibed by the Blood, or before contained in it, to the Reins. Take Urine of a sound Man that drinks Wine one pound, Venice Turpentine dissolved with the Yolk of an Egg, an Ounce and a half, Sal Prunella a Dram and a half: Make a Glister, repeat it daily. Plasters sometimes do good in an Ascites, but let them be such as strengthen the Viscera by some restringent and comforting virtue, and help to close the Mouths of the Vessels, that they do not dicharge the Serosities in too great a plenty: For this end I usually apply Emplastrum Diasaponis to the swollen Belly with good success. Or, Take Emplastrum de minio, and Paracelsi, of each what suffices: Make a Plaster to be applied to the Belly. If at any time this Disease be complicated with a Tympany, other sorts of Epithems are proper, as we shall decalre hereafter. The great and most present Remedy for an Ascites, is to make an Inision, and draw forth the water, though this practice as often Kills the Patient, as Cures the Disease; wherefore there is need of great caution in what Persons, and in what time of the Disease this aught to be attempted: In Cachectical Persons, and such as have been long ill, in whom the Conformation and temperament of the Viscera are generally vitiated, it cannot prove of any good effect to let forth the waters by piercing of the Belly; for presently upon it the Spirits faint, the strength is dissolved, nay and a fresh inundation of the Morbific humour soon succeeds it: But those who before having a good constitution of the Viscera, and being sound enough as to all other parts, fall into an Ascites upon some great evident cause, as they need not presently at first attenmpt an Incision, so they ought not to defer it long if it be judged requisite. For upon a long delay the Viscera which are immerged in the waters, and as it were sodden in them, become incorrigibly vitiated. It's besides my purpose to describe here the Administration of this Incision, whether it be performed the ordinary way, or according to the way of Silvius, with a Perforated Needle. As physicians seldom prescribe this operation, they looking upon it as dangerous, so Quacks and Empirics never consulting them, attempt it very often inconsierately and uprosperously. For conclusion, I shall here give you a relation of a true and terrible Ascites lately Cured without an Incision. A young Woman tall and slender, an Merchant's Wife, giving Suck to her Child, drank both by day and by night to increase her Mild, an immoderate quantity of Ale, sometimes plain, and sometimes made into Posset-drink; after having used this ill way of Diet for six Weeks, she feel suddenly into a cruel Ascites, the beginnings of which she never had minded; for her Abdomen being full of waters floatig within it, swelled mightily, and its Bulk when she turned herself, from one side to the other, fell without the Ilia, and the borders of the rest of her Body; in the mean time the Flesh of all her Members was mightily consumed, and she seemed not less Consumptive than Hydropical. The Child being weaned, and better Diet ordered, she entered upon Physic, and in the first place took gently Hydragogues both Purging by Siege and Urine, but without any benefit, nay after all Purging she was worse: Afterwards being Committed to our care, and almost in a desperate condition, I proceeded with her after the following method. Having wholly forbidden her the use of Ale, and all other drinks but what were Physical, I prescribed these things. Take Leaves of Plantain, Brooklimes, Clivers, of each four handfuls, being bruised together, pour to them water of Earthworms, and Radish-water Compound, of each three Ounces, wring ti forth; she took it twice a day, viz. at eight of the Clock in the Morning, and at five in the Afternoon, she continued the use of this Medicine a long time, but altered now and then the Composition, changing sometimes the Herbs, sometimes the Liquor to be poured to them. Take of the reddest Tincture of Salt of Tartar an Ounce and a half; she took twenty Drops going to Bed, and early in the Morning in two spoonfuls of the following Julape, drinking after it seven spoonfuls. Take of the reddest Tincture of Salt of Tartar an Ounce an da half; she took twenty Drops going to Bed, and early in the Morning in two spoonfuls of the following Julape, drinking after it seven spoonfuls. Take water of the Flowers of Elder, and of Saxifrage, of each six Ounces, the waters of Snails, Earthworms, and Radish Compound, of each two Ounces. On her Belly she wore a Plaster made of Empl. de Minio, & Oxycroceo. The following clyster was given her first every day, afterward every other or third day. Take Urine of a sound Man a pound, Turpentine dissolved with the Yolk of an Egg an Ounce and a half, Sugar an Ounce, Sal Prunella a Dram: Make a Glister. By the constant use of these things, in six Weeks time the swelling of her Belly came down, but her flesh daily falling away, a Consumption was feared: Wherefore to prevent it, she went into the Country and drank Asaph's Milk, and by the benefit of this nourishment and of the fresh Air, taking continually the above mentioned Medicines, she recovered perfectly within three Weeks or a Month, and lives still, and is in good health. CHAP. IV. Instructions and Prescripts for Curing the Tympany. A Tympany may be thus defined, or at least described, viz. that it is a fixed and continued tumour of the Abdomen, equal, hard, stiff, yielding a sound upon striking, taking its rise from a sort of Convulsive Inflation of the Membranous Parts and Viscera, by reason of the Animal Spirits being driven into those Fibres in too great a plenty, and there hindered from a Recess, through the fault of the Nervous Juice obstructing it: To which affect a gathering of Winds in the empty places is consequently added for completing it. That we may have timely notice of its beginning, we must understand that there are some previous affects which dispose to it, as especially a Hypochondriack, Colic, Hysterick, and sometimes an Asthmatick disposition: And if after frequent returns of Fits in any of these Distempers, a tumour of the Abdomen follows, though never so small at first, a Tympany is presently to be feared. A Tympany seldom kills of itself, but after it has continued a long time, to make more sure work, it joins to itself at length an Ascites as a forerunner of death. In order to the Cure of a Tympany, as in most other Diseases, there are three primary Indications, whereof the first and always the most pressing being Curatory, endeavours to remove the tumour of the Abdomen, by recalling the Animal Spirits from that Convulsive extension, and reducing them to order: The Second being preservatory, keeps those Spirits or others from inordinate excursions into the Nervous Fibres of the Belly, and at the same time corrects the faults of the Nervous Liquor accompanying them, as to its Crasis or Motion: The Third is Vital, and by removing the Symptoms that are most pressing, relives and upholds as much as may be all the functions that are oppressed or weakened. The First Indication is always of chiefest moment, the whole stress of the Cure consisting in it, but it's very difficult to be performed: For it does not readily occur to us with what remedies or ways of Administration it ought to be attempted. Bleeding has no place here, but in a manner always is shunned as hurtful; also cathartics for as much as they irritate the affected Fibres, and trouble the Spirits, and drive them more violently into those Fibres, do rather increase than diminish, or Cure the tumour of the Belly: So likewise Diaphoreticks force the Spirits together with the Morbific Particles deeper into those Fibres, from which they ought to be summoned forth and withdrawn. The chief means of Cure seems to be placed in the use of Diuretics and Glisters; and great things are likewise expected from Topics, because they are applied more immediately, and by contact to the Disease itself, and because we see they excellently dissolve or discuss tumors in other places; but all dissolvents are not proper here, even though in other tumors they are very Medicinable: For those that are hot, being accounted discussors, most commonly rather do hurt than good in a Tympany, whether they are used as a Fomentation, or Lineament, or applied in the Form of a Cataplasm or Plaster: For they both open and dilate the Ductus' of the Fibres, so that they lie more open to the Inroads of the Spirits; and at the same time rarify the Particles sticking in them, so that they coming to occupy a greater space, the Inflation and Swelling of the Belly is augmented. Lastly as to Alteratives, even of those which do good against other affects of the Genus Nervosum, only some few are proper in a Tympany; for where the Morbific matter sticking within the straight Ductus' cannot be driven forwards or quite through, Elastic Medicines, by fastening the matter deeper, render the obstruction still greater or more fixed: Wherefore the Spirits of Hartshorn, Soot, Shall Armoniac, and so Tinctures, Elixirs and other Medicines endowed with a Volatile Salt, or Particles otherwise active, do not only cause a very troublesome heat and drought in persons troubled with a Tympany, but also make the Abdomen swell more, because they trouble the Spirits, and fuse the Blood and Nervous Juice, so that the Particles deposed by each of these are forced into the parts affected. Nowwithstanding Physic can do so little against this Disease we must not cease to move every stone in order to Cure, or give ease to the Patient: Therefore in the First place (because it is the Custom to begin with Evacuatives) though strong cathartics always do hurt, and the more gentle are scarce ever able to carry off the Conjunct Cause; yet these latter, for as much as they withdraw somewhat of that which feeds the Disease, and prepare the way for other Medicines to exert their Energies more freely, aught to have their turns in the Practice of Physic, viz. once in six or seven days; and at other times let Glisters (the use of which is much better) he frequently Administered: Hydroticks being forbidden, let moderate Diuretics be diligently plied, to which at the same time let such things be joined which regard the altering and reducing of the Spirits and Humours, which truly make up the chiefest part of Pharmacy for a Tympany: Moreover in the mean time let not the use of Topics be neglected. We shall set down certain Select Forms of Medicines appropriated to each of these ends: For a Medicine gently loosening, use the Laxative Wine prescribed for a Tympany by the famous Greg. Horstius in the Fourth Book of his Observations, Chap. 30. or instread of it, let the following be prescribed in a shorter Form. Take Flowers of Peaches, and of Damask Roses, of each two Pugils of Broom, Elder, and the lesser Centory, of each a Pugil, Leaves of Agrimony and Sea Wormwood, of each a handful, of the best Sena an Ounce, Rhubarb six Drams, Carthamus-seeds half an Ounce, of Dwarf-elder two Drams, yellow Saunders three Drams, Galingal Roots two Drams, being sliced and bruised, sew them up in a Silken Bag, and put it in a Glass with two pounds of Whitewine, Saxifrage water a pound, Salt of Tartar a Dram and a half; let them stand for forty eight hours, then let the Patient begin to drink it, taking about four or six Ounces every third or fourth day. In a hotter constitution let the following Form be given, which I have sometimes tried with good success. Take of Purging Mineral waters eight pounds, Salt of Wormwood two Drams, let it evaporate with a gentle Bath-heat to two pounds: To this I use to add of water distilled from Purgers with Wine four Ounces: The Dose is from four Ounces to six. Or to that Liquor evaporated to two pounds, add of the Roots of Mechoacan and Turbith, of each half an Ounce, Rhubarb six Drams, yellow Saunders two Drams, Cloves a Dram: Let there be a close and warm digestion for two hours' filter it warm through lawn paper, the Dose is three or four Ounces. Glisters are of frequent use in this Disease, because they loosen the Belly without any great irritation of the Fibres. Take water of the Infusion of Stone-Horse-dung with Cammomile Flowers a pound, Honey of Herb Mercury two Ounces: After the same manner also let Decoctions or Infusions be prepared of Dogs-turd with Carminatives. Take of the Emollient Decoction a pound, Sal Prunella, or Shall Armoniac, from a Dram to a Dram and a half: Make a Glister. Take of the Urine of a sound Man a pound, Sal Prunella a Dram, Venice Turpentine dissoved with the Yolk of an Egg an Ounce and a half: Make a Glister. 2. Dinreticks, If any other Remedies, premise help in this Disease. Take live Millepedes cleansed three Ounces, one Nutmeg sliced, being bruised together, pour to them of the following Diuretic water a pound, express it strongly: The Dose is from three Ounces to four twice a day. Take of the green Berries of Juniper and Elder of each six pounds, Fir tops four pounds, green Wallnuts two pounds, Winter's Bark four Ounces, the outward Rinds of six Oranges and four Lemons, the Seeds of Ameos, Rocket, and Water-cresses, of each an Ounce and a half, Dillseeds two Ounces, being sliced and bruised, pour to them of Whey made with Whitewine eight pounds, distil it with common Organs: Let all the Liquor be mixed. Take Crystal Mineral half an Ounce, Volatile Salt of Amber two Drams, Powder of wild Carrot-seeds a Dram, Venice Turpentine what suffices: Take small Pills, take three at Night, and in the Morning, drinking after it of the foresaid water three Ounces. Take sweet Spirit of Salt half an Ounce, give from eight drops to twelve twice a day with a Draught of the same water, adding Syrup of Violets a spoonful. Take Spirit of Salt of Tartar an Ounce; give from a Scruple to half a Dram, twice a day after the same manner: So also Spirit of Nitre, and Tincture of Salt of Tartar may be given. Take Leaves of Plantain, Chervil, and Clivers, of each four handfuls, being bruised together, pour to them of the former distilled water a pound, express it strongly: The Dose is three Ounces twice or thrice a day with some other Medicine. Take Grass Roots three Ounces, Roots of Butchers-broom two Ounces, Chervil and Candied Eryngoes, of each an Ounce, shave of Hartshorn and Ivory, of each two Drams, burnt Hartshorn two Drams and a half, Burdock-seeds three Drams; boil them in three pounds of fountain water to two pounds: In the warm straining put Leaves of Clivers and Watercresses bruised, of each a handful, adding of Rhenish Wine six Ounces; let there be a close and warm Infusion for two hours; then strain it again, and add of the Magisterial water of Earthworms two Ounces, Syrup of the five Roots an Ounce and a half, make an Apozeme, the Dose is four Ounces twice a day, with some other Medicine. Whilst these things are taken inwardly, let Topics also, and outward applications be carefully Administered, not such as are hot and discussing, but such as are endowed with Particles of a Volatile and Nitrous Salt, which destroy the combinations of the other Salts, and make void the efforts of the Spirits, for which ends we propose the following things: If Fomentations ought to be used at all, let them not be applied too hot, and let them not be prepared of the vulgarly called Carminatives, but chief of Salts and Minerals. Cabrotius (quoted by Helmont) says, he Cured a Person eighty years of Age, whose Belly he fomented twice a day with a Lixivium, in which he boiled Salt, Alum, and Sulphur, and after applied Cowdung, for a Cataplasm, I use to prescribe as follows. Take Flowers of Sal Armoniac an Ounce, Crystal Mineral two Ounces, small Spirit of Wine containing much Phlegm in it two pounds: Mix them, and dissolve them in a Glass. Let a woollen Cloth dipped in this warm, be applied on the whole Abdomen, and be changed now and then, dipping it afresh: Let it be done twice a day for half an hours space, afterwards let there be applied either a Cataplasm of Cowdung, with the Powder of Dogs-turd, or the Plaster following. Take Emplastrum Diasaponis, that is, of Minium with Venice Soap what suffices: Let it be thin spread on thin Leather, and applied to the whole Belly, renewing it within ten or twelve days. The Second Indication requires chief altering Medicines, viz. such as put a stop to the Fermentations of the humours in the Viscera of the Belly, and to the wild Efforts, and irregular excursions of the Spirits, and which likewise procure the even mixtures and due motions of the Chyle and Nervous Juice: For which ends Chalybeats are principally used; and truly not only for this Disease, but for many others belonging to the Viscera of the Belly, it's usual to have recourse to Steel Medicines, though in the mean time many Empyricks confidently prescribing them, do not consider after what manner such Medicines work, or what alterations for the better may be expected from them: And indeed it very often falls out, that nature herself is destroyed, and not the Disease, when Chalybeats, of which there is a great variety, and of diversified Operations, are given without any distinction or choice, or without respect to the Temperament, Constitution, and state of the Disease in Patients. We have treated elsewhere ex professo concerning Medicines prepared of Iron and Steel, and of their virtues and manners of working; so that it's needless to repeat the same here: As to this Disease, if any of them are proper for it, certainly they are not all: For those in which the Sulphur still remains, and being free, predominates over the other principles after that the texture of the mixed Body is opened, must be wholly excluded from this number; for by their powerful fermentation, they greatly ferment the Juices of the Viscera, and put the Blood and Spirits in such a Commotion, that the whole Region of the Belly is puffed up in a greater Bulk, as though some Spirit rushed violently into it. Nor are those more proper here, from which the Sulphureous Particles are wholly driven away with the Saline, as in Crocus Martis prepared by a very strong and long Calcination; for as this Medicine is good to stay all fluxions, so it six more any Impactions of Spirits and humours, and renders them more obstinate. But there remains a Martial Remedy of a middle kind, in which the Sulphur being wholly, or for the greatest part expelled, the Vitriolic Salt remains, and has for the greatest part the Predominancy, as it has in a Solution of the Filings of Iron, or in its Infusion either simple, or in Mineral waters, in Salt or Vitriol of Mars, in our preparation of Steel, with many others, preparations and compositions of which have been often found by experience to have done great good in some cases; for these destroy the Exotic, and restore the Genuine Ferments of the Viscera; open their Obstructions, fix the Blood, and keep its Texture from much dissolution: Wherefore Chalybeate Medicines, as also some other Alteratives have haply some effect against the Procatarctick and more remote Causes of a Tympany, but do little or no good at all against its Conjunct Cause. Take of our Steel ground very fine two Drams, of the Distilled water above written two Pounds, Syrup of the five Roots two Ounces, mix them in a Glass, and let it Clarify by settling; the Dose is three or four Ounces in the Morning and at five in the Afternoon. Take Powder of Aron Roots, and of Crabs Eyes of each three Drams, Crystal Mineral two Drams, Vitriol of Mars a Dram and a half, Sugar of Rosemary Flowers two Drams: Mix them, the Dose is half a Dram, twice a Day with a fit Vehicle. Hartman highly extols the Liquor of the Flowers of the Herb Mullein as a Specific Remedy in this Disease: Put those Flowers fresh gathered into an Alembick and press them in hard, than the Vessel being carefully stopped that nothing can breathe forth, let it stand in an Oven whilst bread is baked, and afterwards the Flowers being taken forth press forth the Liquor very hard, and let it be Distilled in Balneo: The Dose is a Scruple in Decoction of the Seeds and Roots of Fennel. Certainly if this Medicine can do any thing, it ought to be given in a greater Doses. Johannes Anglicus Commends the Electuary Rosata Novella with Diatrion Santalon and Antinous Eggs; which Medicine truly being probable enough seems to promise something: In Imitation of these I shall here propose the following. Take Conserve of the Flowers of Cichory and Indian Cress of each three Ounces, Powder of Aron Roots, Lignum Aloes, yellow Saunders of each a Dram, Crabs Eyes a Dram and a half, Salt of Wormwood an Ounce, Aunts Eggs an Ounce, Liguor of male Mullein half a Dram, with a sufficient quantity of Syrup of Citron Pills make an Electuary, the Dose is two Drams, twice a Day, Drinking after it of the former Distilled water, or of the following Julape three Ounces. Take water of the Leaves of Aron, of the Juice of Elderberryes, water of Juniper and of Elder Flowers of each six Ounces Magisteriall waters of Snails and of Earthworms of each two Ounces, Syrup of the Juice of Elderberryes' two Ounces, mix them, make a Julape. The third Indication being vital Prescribes Remedies chief against Faintings of the Spirits, and difficulty of Breathing, and against Watching and Thirst: I shall briefly set down certain Forms of both kinds. 1. Cordials. TAke water of Navews, of Marigold and Camomile Flowers of each three Ounces: Dr. Stevens' water two Ounces, Tincture of Saffron two Drams, Sugar an Ounce. Pearl a Dram; make a Julape, the Dose is four or five Spoonfuls thrice or oftener in a Day in Faintings. Take Conserve of Marigold Flowers two Ounces, Confection of Alkermes and of Hyacinth of each two Drams, Pearl Powdered an Ounces, of the Juice of Citrons what suffices; make a Confection, take the quantity of a Nutmeg Evening and Morning drinking after it a Draught of the Julape. 2. hypnotics. TAke Aqua Hysterica six Drams, Syrup de Meconio half an Ounce; mix them, take it late at Night, Or, Take small Cinnamon water an Ounce, Diacodium three Ounces, Tincture of Saffron two Drams, mix them, take to the quantity of a Spoonful late at Night if Sleep be wanting. Or, Take Syrup of Cowslip Flowers three Spoonfuls, Compound Peony water one Spoonful, Laudanum Tartarizd a Dram, take a Spoonful late at Night if you cannot Sleep. Quenchers of Thirst must be frequently given in this most Thirsty Disease, but it must be in a very small quantity, that we may allay that most troublesome Symptom without much Drink, which is always pernicious: For which end, Take Conserve of Woodsorrel passed through a Sieve three Ounces, Pulp of Tamarinds two Ounces, Sal Prunella a Dram, Syrup of the Juice of Woodsorrel what suffices, make a soft Lohoch of which let him lick often. CHAP. V Instructions and Prescripts for Curing the Anasarca. AN Anasarca is described after this manner, that it is a white and soft Tumour of the whole outward part of the Body, or of some parts of it, yielding to the Touch, and leaving a Pit upon Compression, proceeding from an Aqueous Homour extravasated and heaped together, both within the Interstices of the Muscles, and within the Pores of the Flesh and Skin, and even of the Glands and Membranes. That watery Humour proceeds wholly or for the greatest part from the Blood, for being continually produced within the Mass of Blood through the defect and fault of Sanguification, it is poured forth of the Mouths of the Arteries in a greater quantity than that it can be received and carried back by the Veins and Limphaeducts and be sent forth by the Reins and Pores of the Skin, and other Emissaries of the Serous Latex. And Anasarca whilst it is simple, is the least dangerous amongst all the species of Dropsies: And a particular Anasarca occupying only the Inferior Members, so the Belly do not swell withal, is much safer than an Universal one. In order to a right proceeding towards a Cure, two chief scopes of Curing here present themselves, viz. First we must take Care that the water betwixt the Skin and the Flesh be some way Evacuated and Consumed; and Secondly that a new supply be not continually engendered and heaped together: For which end we must use what means we may both that the Viscera of Concoction being cleansed from Excrements, and free from Obstructions, prepare always a good Chyle, and supply the Mass of Blood with it in a due quantity, and likewise that the Blood, (its Principles being restored to their fermenting Power) may duly ferment and convert into its own Nature the Juice of the Chyle continually sent into it. The Vital Indication seems not necessary in this Disease as in many others, because Faintings of the Spirits, or Watch, for which Cardiacks, and Hypnoticks are required, seldom happen here: And there is little need of restoring Diets because Fasting and Abstinence do more good, and most commonly are the greatest part of the Cure; the reason is that the Vessels being drained by Fasting, drink up the waters Stagnating betwixt the Skin and the Flesh, or elsewhere, and send them forth partly by the Reins, the Pores of the Skin, and other Emissaries, and partly employ them most Advantageously for nourishing the Body, they being yet full of a Nutritive Juice. First, to perform the first Indication which is for the Evacuation of the Morbific matter, all Hydragogue Medicines both Simple and Compound, and likewise the Forms of Medicines set down before in the Chapter of the Ascites aught to be applied to use: Moreover not only cathartics and Diuretics, but likewise Diaphoreticks have often place in the Cure of the Anasarca, though for the most part they are forbidden in other kinds of the Dropsy. In a simple Anasarca you may Purge Strongly, and it often does much good. I have given you before Forms of Hydragogue cathartics of both kinds. viz. of such as exert their force both upwards and downwards, and both of a gentle and strong Operation; from whence you may take them, and apply them to the present Method of Curing. If you ask how cathartics work in this Disease, and wherefore they carry forth waters better and more efficaciously than in other kinds of the Dropsy: I say that in an Anasarca the Morbific matter (which is a Lympha) resieds partly in the Mass of Blood, and partly in the habit of the Body within the Pores and empty Spaces lying betwixt the Vessels: Wherefore a strong Cathartick being given, it presently Exagitates the Mass of Blood, fuses it, and moves it to an Excretion of any supersluous or heterogeneous thing: And at the same time irritates the Mouths of the Arteries which lie open towards the Cavityes of the Intestines, that the water cast out of the Blood may find a way forth rather by these Emissaries. Hence in the fust place the waters floating within the Mass of Blood are cleared forth in a plentiful manner, and then the Vessels being drained soon drink up the waters betwixt the Flesh and the Skin, and presently send them forth partly by seigh, and partly by Urine or Sweat: There is no fear in the mean time, lest, as in an Ascites, the Morbific matter being Exagitated, and put in Fusion by the Medicine, be driven from the Blood into the places affected, whence it cannot easily get out again; or lest, as in a Tympany, the Viscera by reason of the Fibres of the Ventricle and Intestines being too much irritated, are moved into Convulsive Extensions; for whilst the Viscera are sound, and in a good state, the Particles of the Medicament do them no hurt, but being carried thence into the Blood, do not only fetch waters from it, but by Exagitating its Mass, raise up its Active Particles before oppressed, and dispose them for recovering their power of Fermentation. Secondly, I have also set down before the Hydragogues operating by Urine, both simple and compound, and have given you Forms of Medicines prepared of both, and the ways of giving them: Wherefore I shall not repeat them here: But because all Medicines of this kind do not good alike in all affects we must here observe that Lixivials (as I have often found by experience) far exceed the rest of Diuretics in Curing the Anasarca. And now it's a much used and common Remedy for any one who has his Members swelled, to Purge first, and then to take twice or thrice a Day six or eight Ounces of a Lixivium made of White-wine with the Ashes of Wormwood or of Broom, and to continue its use for some Days: This Medicine as I have observed in many, powerfully provok's Urine, nay sometimes in such Abundance that the Patients within the space of twenty four hours making above a Gallon and a half of water, have presently recovered almost to a miracle. The reason why Medicines containing a fixed and lixivial Shall expel Urine more in an Anasarca than such as are endowed with an Acid, or Alchalisate or Volatile Salt, is, that in this Disease the watery Humours which upon failing of the Fermentation of the Blood, and of its sanguifying Virtue, are gathered together as well within its Mass as in the habit of the Body, upon stagnating there some time are turned somewhat sharp: Wherefore the Lixivial Particles of the Medicine entering the Blood presently grow in a heat with the Acids of the waters, which as they exagitate and ferment, they cause a mighty Fermentation in the whole Mass of the Blood and a following excretion. Take of the Ashes of Broom, or of Wormwood, or of the Prune of Vines calcined to a whiteness and sifted, four Ounces, put them in a Glass-bottle with two Pounds of White-wine; let there be a close and warm Digestion for three or four hours, then strain it, the Dose is from six Ounces to eight twice a Day. Take white Tartar calcined with Nitre, and after melted in a crucible till it look blue, three Ounces, small Spirit of Wine a pound and half, water of Snails and Earthworms, of each four Ounces, let them digest close luted in a sand-furnace for two Days, the Dose of the clear Liquor is two or three Ounces, with four Ounces of the Decoction of the Roots of Butcher's Broom and burdock's made in Ale. For Ordinary Drink. TAke white Ashes of Broom cleansed two Pounds, put them in a Bag, with Rasping of Sassafras three Ounces, Roots of the lesser Galingal an Ounce, Juniper berryer and wild Carrot Seeds of each an Ounce and a half, make a Bag for four Gallons of Ace, after seven or eight Days begin to draw it. Diaphoreticks' often do excellently well in a Leucophlegmatia (which gins or concludes an Anasarca) and they usually agree better in this Disease when confirmed than in other kinds of the Dropsy: And though at the beginning they are not able to move Sweat because the habit of the Body is invested with a deal of waters, however by exagitating the Blood they are a means that the active Particles implanted in it, which were dulled before, and almost overwhelmed, are raised up again, and disposed to a Fermentation, and that all the dreggy Excrements, especially such as are Aqueous, are put in Motion, so that presently breaking forth of their Receptacles in a plentiful manner, they readily pass off by Siege, or Urinal, and often in some measure by transpiration: But after that the waters being well cleared by Purging, the Morbific matter is so far diminished that the bulk of the Body and the swelling of the Members begin to abate, the remainder of the Humour is excellently consumed by moderate Sweats, and by a constant perspiration. We have given you before a List and Forms of Hydroticks; but as to our present purpose for the Cure of an Anasarca, those things are most proper which are given in somewhat a large Dose; for as to such as are prescribed in a small quantity, their active Particles being immerged in the waters are overwhelmed before they can be diffused in the Blood so as to exert their force; wherefore Spirits whether Armoniac, or Vinous, also Tinctures and Elixirs, nay and Powders, seldom come in use against this Disease; because in a small Dose they do little, and if it be made very large, they often offend the bowels by their excess in operation, therefore let those things rather be made choice of which being taken in a full Draught and warm may be able to pass the whole Blood uncorrupted, as chief the Decoctions of Woods and Roots, whose Particles agreeing well enough with the Blood, but being not to be mastered by it, pass through its whole Mass, and exert an Elastic force, putting all the Humours in a Commotion. Take Rasping of Guaiacum six Ounces, Sassafras two Ounces, all the Saunders of each six Drams, shave of Ivory and Hartshorn of each three Drams, let them infuse according to Art, and boil in eight Pounds of fountain water till half be consumed, addïng Roots of Calamus Aromaticus, the lesser Galingal, burdock's and Butterburr of each an Ounce, Leaves of Woodsage and Germander dried of each two handfuls, let the straining be kept for use, the Dose is from eight Ounces to ten twice a Day warm; to each Dose may be added Spirit of Sal Armoniac succinated, or of Soot from twenty to twenty five Drops: Or Tincture of Salt of Tartar from half a Dram to a Dram. So much of Hydragogue Medicines to be taken inwardly, which cause waters to be evacuated either by drawing them inwardly towards the Intestines, or by driving them out to the Reins, or to the Pores of the Skin: Moreover there are certain outward Administrations used, by which waters gathered together within the habit of the Body are put in motion, and so disposed either generally to pass off by Sweat, or Urine, or particularly, are presently let forth, a Vent being made in some peculiar places. In the first rank, we place Frictions, Liniments, Fomentations, Baths both dry and moist: And particular things to evacuate waters are Vesicatories, Escharoticks, and prickings by a Needle, I shall speak of each of these, or at least of the chief of them as far as they regard this Disease. Frictions prove often of good effect in a Leucophlegmatia and an Anasarca: For as the habit of the Body is not only so charged with a Glut of filthy waters there heaped together, that nothing can breathe through them, but even the outward parts grow cold upon the Blood's being hindered of an access to them, frequent and strong Frictions give a motion to the stagnating waters, and in some measure dissipate them from thence, and by opening the passages call again the Blood into those parts whence it was banished, wherefore it is good not only to rub the swollen Member, but even the whole Body once or twice a Day with a course Cloth, or with a little brush now commonly made for that purpose. In rubbing, or after it, Liniments and Fomentations are sometimes proper: They are prepared either of Salts and other Minerals dissolved, or of hot and discussing Vegetables boiled with Lees of Wine in water; and being applied hot open the Pores, give a farther motion to the accumulated Waters and discuss them, and enlarge the compass of the Blood's circuit, the watery Mass being in some measure dissipated. The Liniments consist of Sulphur and Salts of divers kinds, or of Quicklime and other Minerals, which being powdered and mixed with the Mucilaginous extracts of Smart Herbs, are made into an Ointment: To which for their better consistency let a fit quantity of Oil of Scorpions be added: Nay this Oil applied by itself (so it be right) gives often great relief. I knew a Boy swollen very much with an Universal Anasarca, who was Cured by this only Remedy: For his Mother (I know not how advised) anointed his whole Body Mornings and Evenings with Oil of Scorpions, chafing well the parts with her warm hand: Upon which within three Days he began to make a vast quantity of water, and having continued to make water so for some Days, the swelling vanishing by degrees, he grew well. Baths are scarce proper for any Dropsy but an Anasarca, nor for this but in the first Disposition to it, or as it goes off: For since by the heat of Baths encompassing the whole Body, the Blood being made very hot and instigated, puts the waters every where in motion which were stagnating before, and drinking them into itself conveys them sundry ways, there is danger lest (as it frequently happens) receiving them from the habit of the Body into its Mass, it presently deposes them in the Praecordia, or the Brain; for there is nothing more usual than that the affects of those parts, viz. an Asthma, or Apoplexy happen to Hydropical persons after bathing: But when the conjunct cause of the Disease (viz. the swelling) is moderate, or not very great, a Bath of water impregnated with Salts and Sulphur, or also a hothouse promoting a gentle Sweat, are often used with good effect. Instead of a hothouse it's better that the Patients be placed in some convenient Cells in a Salt-house near the Furnaces, in which the Mineral water is boiled into Salt, which often proves of mighty benefit to them. Vesicatories let forth the waters betwixt the Flesh and the Skin in a plentiful manner, and sometimes too profusely, these are to be applied to Hydropical persons with very great caution, for such an Epispastick applied to swollen places makes a vent too wide; upon the opening of which the water first breaking forth, often draws after it from the whole Neighbourhood a great Glut of it, whence presently follows a great Consternation of the Spirits: Moreover sometimes the place so drained on a sudden, being deprived of Heat and Spirits, in a short time becomes mortified: Wherefore this Medicine is seldom applied to the Legs or Feet of hydropical persons where the neat is weak, and the swelling very great, but sometimes to the Thighs and Arms with security, when need requires. Escharoticks are applied somewhat more safely to the swollen Places than Vesicatories, because the Flux of waters out of this Vent is not so violent and in such Abundance presently at first: But beginning moderately it grows after by little and little to a great Current, which nature (after being accustomed to it by degrees) bears better: Moreover there is less danger of a Gangrene after an Escharotick than after a Vesicatory, because in that Application, the part whose Union is dissolved is fortified by the Eschar against the loss of heat. I knew an illiterate Empiric who often by an Echarotick successfully evacuated the Members of Hydropical peasons, though never so much swollen, after the following manner. viz. First he fomented their Legs Morning and Evening with a Decoction of Dwarfe-elder, Wormwood Camomile, and other hot Herbs, the Lees of Wine or Ale being added to them, and betwixt the times of fomenting he applied a Cataplasm made of the Faeces of that Decoction with Bran: After these things had been used three Days he covered both Legs and Feet with a Plaster of Burgundy-Pitch, leaving only a small hole on each Calf to the bigness of a small Nut, in which places he put an Escharotick of the Ashes of Ashen Bark to the naked Skin: which being removed after twelve hours a small Eschar was left, out of whose Pores the Matter first Sweated gently, then daily distilled forth somewhat more freely, and at length (the Eschar falling off) it flowed forth in a plentiful Stream as from an open Source, till it was drawn from the whose Leg both above and beneath. There remains yet another way of drawing forth waters from betwixt the Flesh and the Skin, not inferior to the former, though less in use, viz. by the pricking of a Needle: Which also much be done very cautiously and by little and little, lest a headstrong and excessive Flux of waters be raised by it. Take an ordinary Needle, such as Tailor's use, and prick the Skin over with it in the place most swelled, but let it not enter so far as to draw Blood, and so make six or seven little holes at a time about an inch distant the one from the other: The water will Issue by drops forth of each little hole and so will continually Distil forth till all the swelling be gone from the place pricked: Then the next time, after sometimes twelve, sometimes eighteen, sometimes twenty four hours prick again in some other part either of the same Leg, or of the other, and so continue to make such Vents for the waters once or twice a Day in this Member, or that, one alone, or two, or at the same time in many: For after this manner the Hydropical Corruption may be drained more freely and safely than by any other exterior operation whatsoever; and if in the mean time its flesh supply be provided against by inward Physic, Physic, the Disease will be the more easily Cured: Moreover in a desperate Dropsy that Administration serves very well to prolong Life, because the waters being continually emptied forth by those outward Vents, the inward and vital Inundation is the longer delayed: A Man of late seventy years of Age, plunged in a Dropsy over his whole Body has continued in Life and kept his head above the waters for these many Months beyond the expectation of all Men by the means of this only Remedy. So far of the kinds and forms of Remedies prompted to us by the first, that is, the Curative Indication: As for the Preservative Indication which takes care to restore the Crasis, and fermenting or Sanguifying Virtue of the Blood, it suggests to us those Medicines with being endowed with hot and elastic Particles, raise up the active or depressed Principles of the Mass of Blood, or repair them being wasted; for which ends the vulgarly called Altering Remedies are wont to be prescribed in the Form of an Electuary, Powder, Pills, Distilled waters, Julapes, Apozemes, and Diets, to which also Spirits, Tinctures, Elixirs are sometimes added for the greater Efficacy: I shall give you an example or two of each of these. 1. Take Conserves of Sea-Wormood, Scurvygrass, and the yellow Coats of Oranges of each two Ounces, Winters-Bark two Drams, Species Diacurcumae a Dram and a half, Steel prepared with Sulphur three Drams, Salt of Wormwood two Drams, Syrup of Citron Pills what suffices, make an Electuary: The Dose is two Drams in the Morning and at five in the Afternoon, drinking after it a Draught of Julape, or of the Distilled water to three or four Ounces. Chalybeats very often do great good in this Disease, as in the Green-sickness: Insomuch that the whole, or at the least the chief scope of Curing Falls frequently on this Remedy: But we must note that these kinds of Medicines do not all equally agree in these cases: For those that are chief in use, viz. Salt of Steel, or Vitriol of Mars, and others prepared with Acids, and wholly deprived of Sulphur, do no good at all, because they do not promote the Fermentation of the Blood, but on the contrary rather fix it when too Exorbitant, or Elastic: But for an Anasarca, and any other oedematous Cachexia in the habit of the Body, let those Chalybeats be given, in which the Sulphury Particles are left, and are Predominant, as especially in the Filings of Iron, and in its Scales reduced into a fine Powder, and in-Steel melted with Sulphur and Powdered; these Powders being taken are presently dissolved by the Acid Salts within our Body, upon which the Sulphureous Metallick Particles being set free and conveyed into the Blood, ferment its whole Mass, raise up the Symbolous Particles there, before lying dormant, and being joined with them give a vigour to the Blood, and renew its fermenting or sanguifying power before depressed: Wherefore we find after a little use of these Chalybeats the pallid colour in the Green-sickness goes off, and turns to a Florid Aspect. 2. Take compound Powder of Aron Roots, and Winters-bark of each three Drams, Roots of the lesser Galingal, Cubebs of each a Dram and a half, Steel prepared with Sulphur half an Ounce, Sugar of Rosemary Flowers six Drams, make a Powder, divide it into twenty parts, the Dose is one part every Morning, and at five in the Afternoon with a Draught of the Sudorific Decoction prescribed before. 3. Take of the Gummous extract remaining after the Distillation of the Elixir Vitae of Quercetan half an Ounce, powder of Earthworms prepared two Drams, Roots of the lesser Galingal, Winters-bark of each a Dram and a half, Salt of Wormwood two Drams, Iron Rust two Drams and a half, Balsam of Peru a Dram, Tincture of Salt of Tartar two Drams, Balsamum Capivii what suffices, make a Mass, form it into little Pills, the Dose is half a Dram at Night and early in the Morning, Drinking after it of the Julape or distilled water following three Ounces. 4. Take Elder Flower water, and the Fermented Juice of its Berries of each a Pound, Magisteriall water of Earthworms, Radish water compound, Aqua Mirabilis of each two Ounces, Syrup of the Juice of Elderberryes' two Ounces, mix them make a Julape. 5. Take Leaves of Garden Scurvygrass, Rochet, Pepperwort of each six handfuls, Roots of Calamus Armaticus, the lesser Galingal, Zedoary, Florentine Orris, Elder, Aron, of each six Ounces, Wintersbarke, Jamaica Pepper of each three Ounces, Juniper Berryes' four Ounces, Cloves, Ginger, Nutmegs of each an Ounce. Being sliced and bruised pour to them of old Rhenish-wine eight Pounds; distil it in common Organs, let the whole Liquor be mixed. 6. 7. An Antihydropick Decoction is Prescribed before amongst Diaphoreticks: A Diet-drink to be taken instead of Beer may be made according to the Form following. Take Rasping of Guaiacum and Sassafras of each four Ounces, Roots of Florentine Orris, Calamus Aromaticus, the lesser Galingal, Elecampane, of each an Ounce and a half, Juniper and Laurel berries of each two Ounces, Seeds of Anise, Caraway, sweet Fennell, Coriander, Dill, of each an Ounce, long Pepper, Cubebs of each an Ounce and a half, Cloves, Nutmegs, Ginger of each half an Ounce, Jamainca Pepper two Ounces, dried Leaves of Salvia Acuta, Woodsage Calamint, Agrimony of each a handful, Licorice four Ounces, being sliced and bruised. Let them boil in four Gallons of fountain water to half; when the straining is cold, let it be put up in Glass-bottles for use: I have known many persons almost given over in an Anasarce who by the constant use of this Drink have perfectly recovered. Of many examples of persons Cured of Dropsies I shall now give you one. A certain Robust Man, of a middle Age, after having gotten an Epidemical Quartan Ague, and being ill managed at first, had lain under it above a year, and in the mean time had used an ill Diet, fell into an Anasarca, which afterward upon his indulging himself to Drink very freely for quenching his Thirst, (which was exceeding great) grew in a short time to a vast height; so that all his Members from the Head to the Foot, and his Belly likewise being swollen, he was not able to turn himself from on't side to the other in his Bed without the assistance of Servants. As I first visited him, and despairing of Cure, I plainly told him that unless he would abstain from Drink, he must die in a short time; upon which he promised, so I could save his Life, that he would Drink no more in a Weeks time, and was as good as his word, for though very Thirsty he scarce took any Liquid thing into him but Physic for six or seven Days: And during that time by carefully taking Hydragogue cathartics and Diuretics, and all other things Prescirbed, he grew much better; and afterwards a Method as above Prescribed being sometime followed, he was restored to his perfect Health, and now lives a sound Man after five years past. There remains certain other affects of the Viscera of the Belly, of the Remedies of which according to a due Method I should have treated here; but I have already performed this Task for the greatest part elsewhere; for we have delivered most of the Medicines that concern the Reins amongst Diuretics, and those that concern the Stomach and Intestines among the number of Emetics and Purgers: As for what respect the Spleen and the Womb we have fully set them forth in our Hypochondriack and Histerick Pathology: As for what regards the Genital parts and their Diseases, and Cure, we have thought fit to reserve it for another time and place: It concerns us next after having treated hitherto of inward Pharmacy; to discourse somewhat of outward Medicines, which we shall do in the next Section beginning with the great Remedy Phlebotomy. SECT. 3. Of Outward Medicines. CHAP. I. Of Phlebotomy. TO Discourse Methodically of this great Remedy, we must first consider how many ways and for what causes and ends an Emission of Blood happens either of its own accord, or is indicated by Physic. Then Secondly we shall acquaint you with the good and ill effects, or with the Advantages and Prejudices of this Evacuation, and shall give you likewise certain rules and cautions to be observed in the due Administration of Phlebotomy. As to the first, Spontaneous Eruptions of Blood being manifold and of divers kinds, are usually reduced to these two heads, or orders, viz. either they are Critical, nature endeavouring something good and for the Advantage of Health; or Symptomatical, which happen for the most part when she is put by of her Government, and all things are in Confusion: The Eruptions of Blood of the first kind are again distinguished, that either they come without a Fever, and are either Periodical, which often happen at set times as the Menses of Women, and in some the Flux of the Haemorrhoides, and in others yearly Bleedings at the Nose, or otherwise customary; which commonly happen upon the great changes of the year, or of the Air: Or they are erring and uncertain, as when the Blood breaks forth for our good from those places, and from many others, sometimes in this part of the Body, sometimes in that. Moreover Excretions of Blood sometimes happen in a Fever, and often determine it: In all these cases the Blood breaks forth, because growing Turgid within its Vessels, and being very much rarifled, it requires a larger space. Now the Blood grows thus Turgid on two accounts viz. both as its Liquor is Inflammable, and as it is Fermentative. 1. As to the First, that the Blood may have a due Accension for the preservation of Life, and the due performance of its Functions, its Innate Sulphureous Particles must be proportioned to the Nitrous Particles coming to it from the Air: Therefore as often as the Blood growing very hot, and being highly rarified, is much opened and loosened in its Texture, so that the Sulphur being at freedom is kindled more than ordinary, a quick and toilsome Breathing follows to draw the Nitre also in a fuller measure than usually: Now if the abounding Sulphur cannot spend itself after this manner by burning briskly, nor the vital flame be thus regulated, presently the next course for lessening the fuel of the Sulphur is that some part of the rarified Blood breaks violently forth: Hence not only in Fevers, but after Drinking Wine, Bathing, being in the Sun, and other Accidents upon which the Blood grows very Turgid, either Eruptions of Blood happen of their own accord, or it's often necessary to supply the defect of such Spontancous Evacuation by opening a Vein. Secondly, the Blood also as it is a Fermentative Liquor is apt to break forth of its Vessels, for if at any time some Heterogeneous thing, which will not mix with it, comes into its Latex, it strongly Ferments as Wine in a Hogshead, and boils in its Vessels to expel that disagreeing substance, which seeing it can neither conquer, nor send forth by Sweat, Urine, or other ways, the Blood itself throws off some portion of its own substance, as a Vehicle to carry forth that matter with it: hence divers Eruptions of Blood variously happen both in Fevers and without them; which are all raised by nature for some good intent, though it often happens otherwise through various Accidents and Circumstances; but for the most part there is a failing in Spontaneous Hemorrhages critically intended; either First, because the Blood in boiling knows no measure in flowing forth; or Secondly because the mouths of the Vessels being once opened do not presently close, or cannot presently be shut; or Thirdly because nature endeavouring an Excretion of Blood, does it by places which are most open, though often improper, as when it happens by the Lungs, Reins, Intestines, and other Viscera, which therefore from being critical becomes Symptomatical, and often Malignant. Nor only these ways, but likewise for many other Failures or Impediments of nature, Symptomatical Hemorrhages happen, in all which either the Blood itself, or the Vessels containing, or both of them together, are alwaries chief in the fault. First, the Blood besides the ways above mentioned is apt to extravasate when its Latex being some way corrupted, is not able to retain its due mixture, but being apt to coagulate or putrify, runs Into parts, whereof some break forth into Wheals or Pushes, or show themselves in Spots, others plainly make Bloody Eruptions where they can first find a Vent; as it's generally seen in the Plague, Smallpox, Measles, and in Malignant Fevers, and in some measure in Scorbutic Affects. Secondly, The Vessels conveying the Blood are many ways the cause of its Symptomatical Eruption, as first if some of them are in any place obstructed, as often as the Blood is put in a Rapid Motion, it's forced to burst forth either there, or near the place, and sometimes also in parts far distant from it; hence upon a suppression of the Menses, or Haemorrhoides, a Bleeding at the Nose often follows. Secondly, the little Mouths of the Vessels have sometimes all ill Conformation, for that the fleshy Fibres with which they are guarded are grown Lax, or resolved, so that when the ends of the Arteries gape too much, the Mouths of the Veins close; by reason of this affect scorbutical and Cachectical persons are very subject to Eruptions of Blood. Thirdly, It oftens happens that the Vessels having this ill Conformation are likewise affected with Convulsions, so that the Muscular Fibres of the Vessels being disorderly contracted, cause sudden and violent Sallies of the Blood, sometimes upwards and sometimes downwards, and consequently Eruptions: For I have observed in some, when the Current of the Blood has been slender enough, with a low and weak Pulse, that the Convulsions of the Vessels beginning in some place, and carried forward as a Wind running here and there in the Body, have driven the Blood vehemently, though never so low of itself, and forced it into violent Eruptions: And in these cases when opening a Vein, and Medicines cooling and qualifying the Blood have done no good, we have found the greatest relief from Narcoticks, Anticonvulsives, and Ligatures. To speak now of Bleeding by Art, we generally observe that Physic in some cases imitates nature, in others exceeds it, and often regulates it, and reduces it when it acts amiss; though there are some cases in which nature far exceeds the efficacy of Art in Excretions of Blood. I shall speak briefly of each of these. First therefore in whatever affects Spontaneous Eruptions of Blood use to do good, if at any time these fail, Physic the Handmaid of nature aptly suplys its place by Phlebotomy, therefore if haply the Blood by reason of its Sulphur, being too much at liberty and exalted, is kindled too much, upon opening a Vein the superfluity of that Inflammable fuel will issue forth: So likewise immoderate Turgescencies of the Blood by Reason of some unsubduable substance gotten into it, are allayed by this means: Wherefore Bleeding is presently ordered both against continual Fevers which proceed from the former cause, and against such as intermit whose fits are from the latter: And so, as often as an accustomed Evacuation at set times which is stopped, or a humour struck back from the outward parts, or a sudden stoppage of the Pores, or if a Surfeit, Drinking of Wine, and other Accidents of this nature, by crowding the Blood with Heterogeneous Particles, cause a Turgescency in it, Phlebotomy is usually a most present Remedy. Secondly, Physic does not only imitate nature in letting forth of Blood, but often exceeds it; nay and frequently aids it, and reduces it when it labours, and acts amiss. For if at any time the Blood taking a Head, rushes in a Body to one part, and there either presently breaks forth in a disorderly manner, or being gathered together in a large quantity causes an Inflammation, a Vein being opened in some remote part stops that Preternatural Salley of the Blood, and often puts an end to the Eruption, or Inflammation: Wherefore in the Pleurisy, Sqinancy, Perpneumonia, in Spitting, or Vomiting Blood, when nature either yields itself overcome, or b'ing sturck as it were uviht a Rage seems to lay violent hands on itself, Chirurgery withdrawing the Blood to some other place, and letting it forth, restores all things, when almost in a loft Condition. Moreover Physic often moderates or reduces nature when too profuse, or extravagant in the Effusion of Blood, for in Truth all immoderate Eruptions of Blood must be stayed rather than promoted: Again in regard in the Plague, Smallpox, and Measles broken forth, and in Malignant Fevers a Spontaneous Eruption of Blood always foreboads ill: Therefore in those affects Styptic Medicines restraining the Eruption of Blood are more proper than breathing a Vein. Nevertheless there are some cases of an Effusion of Blood by nature, which Physic can no way imitate, nor supply by Phlebotomy if haply they fail: In Fevers about the Crisis of the Disease, viz. after the Digestion of the matter, that is, its preparation for Separation, a Spontaneous Eruption of Blood, in regard it comes in a due nick of time, is far better than any Bleeding by Art, the due season for which is unknown: And so a flowing of the Menses and Haemorrhoides hapening by the Instinct of nature is much more Advantageous than if Blood be caused to flow thence by Art. There is this notable difference betwixt Blceding by opening a Vein, and a Spontaneous Eruption of Blood, that in this the Blood flows in a manner wholly out of the Arteries, and in the other Evacuation it's drawn only out of the Veins. So far of Phlebotomy compared with a Spontaneous Eruption of Blood: I shall now show its use and effects both good and evil in the Practice of Physic: Therefore in the first place let us show in general what sort of alteration this Evacuation causes in the Mass of Blood, and then to what Diseases either of the whole Body, or of particular parts it most immediately has respect to. Concerning the first it's obvious that the Blood after Breathing a Vein is altered both as to its quantity, and as to its Temper and Crafis, and as to its Motion. The first and most common Indication for Breathing a Vein is that by this Administration the Mass of the Blood be lessened: Hence even the vulgar growing to an overful habit of Body cause themselves to be let Blood to remove that Plethoric Disposition, but though the evils of that affect are removed or prevented by nothing better, yet the necessity or this Evacuation ought to be avoided as much as may be: Because the Blood is rendered by it more Sulphureous and less Salt, and consequently it disposes Men to a Feverish habit, and to grow Fat: Moreover the great Remedy, Bleeding, if made common on every slight occasion, will become of no effect in grand Distempers when it is needed: To which we may add that according to the observation of the vulgar, the more familiarly any one uses Bleeding, the oftener he will want it: For the Blood being let forth to avoid an overgreat fullness, the rest of the Mass soon rises again to a Plenitude, though it's worse in its Crasis, For by this means being much bereavest of its Balsamic Salt which preserves it from Putrefaction: Instead of it, it's more filled with a Fattening and Inflammable Sulphur. 2. Phlebotomy amends the Mixture and Temperament of the Blood in sundry respects: First if any Heterogeneous thing be gotten into its Mass, which can neither be mastered, nor easily separated, and sent forth, upon opening a Vein the Blood flowing forth carries with it often a great Portion of that matter: So again the Blood declining from its Temperament is often restored by Phlebotomy; for when its Mass upon the exaltation of the Sulphur, or fixed Salt, of both of them together, is degenerated into a sharp, Salt, or Salino-Sulpureous nature; a Portion of the Blood being drawn out, presently it ferments anew, and often there is such a change made of all those kinds of Particles, that thence forwards the Spirits with the Volatile Salt begin to rise again, and recover their Dominion, keeping he Sulphur, and fixed Salt under, as they ought to be: Hence Bleeding gives often great relief not only in Fevers, but likewise in the Scurvy, Jaundice, and even in a beginning Physic: For the Blood after the Vessels are emptied, as the Stomach when discharged, Concocts and Assimilates all Humours that come into it better, and more easily separates any Heterogeneous thing and sends it away. But if the mixture of the Blood gins to be much dissolved, or wholly to sink, as in the Plague, and Malignant Fevers, we must utterly abstain from Bleeding; for upon taking away of Blood the provision of the Spirits (whose only business it is to preserve the Mass of Blood from Putrefaction and Corruption) is diminished: So that all things presently tend to a pernicious Dissolution. Moreover if the Discracy of the Blood be such that the more noble Principles, viz. the Spirits, Volatile Salt, and Sulphur being depressed or spent, the watery and earthy Particles, have the Praedominancy, the Blood must by no means be let forth, but be preserved as the Treasure of Life: Hence in a Dropsy, Cachexia, Consumption and other affects, where the active Principles are mightily depressed, you had as good cut a Man's Throat as open a Vein. In the foresaid cases where the Crasis of the Blood is considered, it's easy to determine whether Bleeding be proper, or not, but in certain other cases, as especially in a Putrid continual Fever, when Life and Death depend on this point, there is need of great Deliberation. Now in this difficult case we must consider the State of the Blood, the tendency of the Morbific Matter, and the strength of nature: First as to the former, if in a Putrid Fever the Blood boiling very much causes a mighty heat, with Thirst, Watch, and a parching heat of the Jaws, and no free Sweat, or Eruption of Pushes appears, or is expected in any short time, Bleeding is so plainly indicated, that it were a crime to omit it: But on the coutrary if in a weak Body, a slow and remiss, but continual Fever arises with a weak Pulse, forbear taking away any Blood, and let it be cleansed by Transpiration, Urine, and Blistering. In a middle State of the Blood, let Bleeding, being of itself indifferent, be determined by other things. Therefore in the second place we must consider the Tendency of the Morbific matter, or its Propension, which matter if it lies dull in the Mass of Blood and unapt to separate, and so (as it frequently falls out) a Translation of it to the head instead of a Crisis happening, it threatens the Brain, and the Genus Nervosum, Bleeding aught to be seasonably Administered for the prevention of these evils: But if that matter moved with a sudden Impetus, and either rushing inwards to the Viscera of the Belly causes a violent Vomiting, or Flux, or driven outwards brings forth the Smallpox, Measles or other Pushes; every such Impetus of nature, of good ought not to be disturbed, if evil must not be rendered worse by Phlebotomy: For to let Blood in these cases is not only dangerous, but very often also Extremely Ignominious. Thirdly, concerning Bleeding in a doubtful case, we must consider the strength of the Patient; for in a sound Constitution, a Vigorous Age, the beginning of a Disease, and whilst the Functions both Vital and Animal are in a vivid or indifferent State, we may with confidence order Bleeding unless something indicateth the contrary; but when it is otherwise as to those conditions we must not inconsiderately proceed to that Evacuation. Thirdly, the disorderly Motions of the Blood, viz. when being struck, as it were with a Rage, it either rushes violently, or conveys offensive matter sometimes into one part, sometimes into another, it is excellently moderated, or reduced by Phlebotomy; wherefore for violent headaches, all Convulsive, or Sleepy Fits, for Catarrhs, Inflammations of the Eyes, and for the Cough, Asthma, Fits of the Gout, and of the Stone in the Kidneys, or for Phlegmons, Erisipela's and for many other affects caused by the Fluxions of the Blood or Serum, Bleeding is commonly prescribed, and that with good success, for upon draining the Vessels, the Blood getting a more free passage is Circulated calmly and undisturbed: Moreover whatsoever of this, or of the Serum is extravasated, is drunk up again and brought into its due course. Having thus shown you the effects both good and evil which happen to the Blood in its different State upon Breathing a Vein, we must now inquire to what chief Diseases either of the whole Body, or of some particular part that kind of Remedy had a most immediate regard to it: And first as to general affects it's well known that Bleeding is indicated by a hot and dry Distemper, and forbidden by a cold and moist. In every Fever it's usually proposed, never in the Dropsy: Next if we consider particular Diseases, there is no region or part of the Body but some time may require it: The Headaking, the Brain oppressed with Blood, or Serum (whence a world of evils spring) the Inflammation of the Eyes, Face, Mouth and Throat, all Diseases of the Breast, and Praecordia (to each of which the disorder of the Blood gives a Rise or affords Fuel; also obstructions, or inflamed affects of the Liver, Spleen, and other Viscera, so likewise both the overgreat fullness and athletic habit of the whole Body, and the tumors, and Painful, or Convulsive Passions of each particular Member seem to accuse the Blood as the Author of all the evil, and require its Emission as it were by way of satistisfaction. If at any time in these and may other affects Bleeding be manifestly indicated, before we set upon it we must consider of these four things, viz. in what place, after what manner and by what instrument, at what time, and in what quantity the Blood ought to be let forth. 1. As to the First, though according to the Laws of the Circulation of the Blood there be little difference from what Vessel it be drawn, so it be large enough; yet because besides a general Evacuation of Blood sometimes a partial Derivation properly so called (as when the Blood is to be drawn from some particular place where it is gatered together) and likewise a Revulsion, when it is to be withdrawn into this or that part, are intended, therefore in the Body of Man various limited precincts, as it were, are assigned, out of which Blood may be let according to occasion, and for most necessary uses, sometimes out of this, sometimes out of that, or the other. If therefore at any time a general Evacuation of Blood be indicated the common or middle Vein of the Arm is best to be opened for this being of a good largeness easily admits the Lancet, and the Blood flows equally from the whole Body to its wide Orisice, upon the free Emission of which not only the Plethoric Disposition is taken away, but the greater Vessels being every where emptied by this means, the blood stagnating in any place is restored again to Motion, and if extravasated is drank up again into the Veins: Wherefore in great affects, where the Blood gathered together in the Brain or about the Praecordia threatens a sudden Destruction, the best way, not only of a general Evacuation, but likewise for a Revulsion is to let forth the Blood in a full current by opening a Vein in the Arm with a large Incision. But if without any great Plethora the Blood be to be Evacuated from the whole Body, and to be withdrawn from the Superior Region of the Body to the Inferior, as in suppressions of the Menses, or Haemorrhoids, it's more to draw Blood from the Foot, or from the Haemorhoid Veins by Leeches: And if after an Evacuation of Blood from the whole, it must also be derived from some particular place where it is gathered together, let it be taken near the place affected; Hence in Cephalick Diseases we open the Vein of the Forehead, Temples, or Thorat: To Cure Tumours and Pains happening in the Joints, we either open a Vein beneath or near them, or draw froth the Blood by applying Cupping-glasses, or Leeches there: And so in affects of the Thorax and of the Belly either Cupping-glasses are applied to the Region Distempered, or Leeches to the Vessels of the Fundament. As to what is said that some Vessels have a peculiar respect to some of the Viscera in particular, as the outward Vein of the Arm to the Head, the inward to the Liver, etc. All this is a mere unlgar error, grounded on no reason or Anatomical observation: Therefore assoon as it is agreed on for opening a Vein, and of the place, make choice of some large Vessel, and very fair to the sight that it may be more easily opened, and let it not have any Artery, Nerve, and Tendon near it, that it may be Lanced more securely. Wherefore the middle Vein of the Arm is most commonly made choice of, though the Exterior called the Cephalick be more safe, being less crowded with other Vessels. The Jugular Vein, so generally opened in Beasts is most safely and easily lanced, and is as proper as any other what soever for a general Evacuation of Blood from the whole Body, besides its excellent Derivation from the Head. If you open the Vein above or near the Ankle you must take a mighty care lest you hurt the Tendon, which sometimes happens through the unskilfulness or rashness or Surgeons, to the great prejudice of the Patient: Moreover you must take care of opening a Vein near its Anastomosis with an Artery: For if this be done the Blood springs forth violently all of a Scarlet colour, and its stream is not easily stopped, nor the Orifice of the Vessel soon closed. As to the ways or Instruments with which Blood is drawn forth, it's done either by opening a Vein with a Lancet, or by Suction with Leeches, or by Cupping-glasses after Scarification. It's known by sad experience that in Lancing a Vein sometimes an Artery is pricked, whence either Death, or a cutting off of the Member sometimes follows; the reason is that an Artery ought incessantly to vibrate and beat in like manner as the Heart itself, its Fibres iterating the perpetual charges of Systoles and Diastoles, wherefore a hole made in its Ductus becomes as it were incurable by reason of the continual Motion of the Vessel, and the Efflux of Blood: It is far otherwise in a Vein whose Aperture presently closes again of its own accord; there being little stress of contraction laid on its Tunicles, and indeed only so that its Fibres being a little dilated on occasion, the Blood flowing back, may be gently driven forwards: If at any time a Physician of Patient are fearful of opening a Vein, an Extraction of Blood by Leeches, or Cupping-glasses with Scarification will aptly enough supply its defect, and often with the like Advantage; nay these Administrations for removing the Conjunct cause of a Disease, where there is need rather of a Partial Derivation, or Evacuation than a general one, are often preferred to Phlebotomy. The due season for letting Blood is often of so great moment, that whereas this Evacuation does good at one time, at another it proves mighty prejudicial: There are various respects of times to be considered concerning Bleeding, but chief these four, viz. the time of the Disease, Age, Year, and Day, the First of these chief concerns the Cure of the Patient, and the rest his Preservation. First, therefore if we ought to let Blood in any Disease, the fittest time for it will be about the beginning of it, or in its increase, but not at all, or very cautiously in its height, or Declination: For in the former whilst nature endeavouring a Crisis is extremely busied, so that the Spirits labour mightily, and the Blood ferments very much that its last effort ought not to be disturbed, and when a Disease is upon remitting, either nature being conqueress, does not stand in need of that Aid, or belng conquered will not bear such Evacuation. Secondly, if at any time we deliberate of Bleeding for prevention, Infants, Children, and aged Persons are exempted from it by the general Practice of all Nations: This Evacuation also heretofore was forbidden to Women with Cnild, but now it's very ordinarily prescribed: Men of a strong Constitution, and of a middle Age herr Bleeding well encugh, and want it very often, but ought not to admit it the first and second time without great occasion, for once begun, and then repeated, it soon passes into an Inevitable custom: Hence those who use to Bleed Spring and Fall cannot afterwards omit this Evacuation without danger: But those for whom it is good or necessary to be let Blood once or twice a Year, the most seasonable times for it will be about the beginning of the Spring and Autumn, when the Blood being apt to Ferment anew, is in danger of changing its Crasts. Bleeding in season prevents the exaltation of the Sulphur and Salts, and consequently keeps the Blood from any Feverish, Scorbutic, or otherwise vicious Distemper: And likewise from susing itself and pouring its Serous and other dreggy Excrements on the Brain, Lungs, or Viscera of the Belly. About the Solstices when our Bodies are very cold, or hot, the Blood, ●as also the Juices of all Vegetables being in a fixed State, and unapt for any Turgid Motion, ought not to be let forth unless some urgent cause requires it. 3. Whereas some religiously or rather ridiculously observe in Bleeding the Position of the Heavens and the Aspects of the Moon and Stars, it's altogether Frivolous. 4. As to the time of the Day, in Acute Diseaes when immediate Bleeding is indicated, a Physician being called, after the Body is prepared, may order that operation at any hour of the Day or Night. But if there be room for delay, then it's more proper to Bleed rather in a Morning when the Stomach is fasting and the Vessels are emptied by the Night Perspiration, so that the current of the Blood is then in a very great Calm and free from Serous Excrements: Nay though necessicy presses, let it be delayed a little till the fresh Juice of things taken into the Body be passed into the Blood; for the Vessels being emptied will draw hastily into them the Chymus not only crude, but often disagreeing with, or disproportionate to the Blood; whence not only its Motion is disturbed, but also the Vital flame is sometimes in danger of being overwhelmed: I have known some who upon Bleeding shortly after large Drinking, or pouring in of Vinous Liquors, have fell into dreadful swooning Fits, which continued a very long time, till the Vital Spirit half overwhelmed happened at length to recover. 5. As to the quantity of Blood to be taken, besrdes the manifest error of those who are sparing, or profuse of it in the greatest extremes, there is likewise an error of no small moment committed within the moderate Limits, whilst in some cases the Blood is taken too sparingly, and in others in a greater quantity than is fitting: In a burning Fever, the Pleurisy, Peripueumonia, Squinancy, Frenzy, Apoplexy, and other great Diseases rising from the Turgescency or Inflammatory Incursion of the Blood, a spare Bleeding always does more hurt than good: For besides that it does not remove the Antecedent cause of the Disease, viz. the Plethora, it moreover increases its Conjunct causes, viz. the Inflammation, or Irruption of the Blood: For it's a constant observation that after a spare Emission of Blood, it's whole Mass presently boils in a high measure, and makes new Sallies into the part affected: The reason of which is, that in a great Plethora many Portions both of the Blood and Serum being driven into straight and by receptacles, are forced to reside there, which upon the Vessels being a little emptied rush back hastily into the Mass of Blood, and trouble it mightily, driving it here and there in a violent manner. As a spare Bleeding in some cases is not only useless but hurtful, so in others a too large Effusion of Blood is seldom without danger, and sometimes proves mighty prejudicial to Health: For if at any time there be a failing of strength, or the Body labours under a great Cachexia, we must be spare of Bleeding, and it is either forbidden, or being indicated by reason of some accident it must be allowed but in a small quantity: Wherefore in Men of a tender, weak, or cold Constitution, and in Consumptive Persons, and such as are affected with a long or Malignant Fever, also in those that the Hydropical, or very Cacochymical, we must not lightly open a Vein, at least being opened we must not let forth much Blood. The quntity of Blood to be drawn being agreed upon, the next care must be, that a large Orifices being made, it flows forth equally mixed in as short a space as may be: For otherwise if it issue, forth at a slender Orifices either by Drops, or in a small stream, the Mass of Blood fermenting will separate into parts, and what is most Subtle and Spirituous will spring forth, the thicker, and more dreggy Portion remaining behind: Hence it is to be observed, that if at any time the Blood being let out of a large Orifice with a full stream be stopped a little by putting the Finger on it, and in a short while after be let run again, the Blood issuing forth the Second time will be much purer and brighter than the former, because in the interval of its running, the more subtle Particles having got free of the thicker and gatered themselves together in a Body prepared themselves for flying forth. CHAP. II. Instructions and Prescripts for stopping an Eruption of Blood. There being various and manifold kinds of Hemorrhages or Eruptions of Blood, Physic is not needful to all of them: If a great Effusion of Blood happens through a Wound, etc. Chirurgery undertakes to stop it: Moreover an Eruption of Blood, if it be Critical, ought not to be disturbed by any Medicine but to be left wholly to the governance of nature (so she be free and enjoys her power) nay in Symptomatick Bleeding, so long as it is but small, or not very prejudicial Physic is not required: But then chief and in a manner only it is needsul, if at any time the Flux of Blood be either immoderate, or breaks forth in improper places. Bloody Eruptions of the latter kind require help chief if haply the Blood be cast forth upwards by coughing, or vomiting, or be voided downwards by the Fundament, or the Urinary passages, for in these cases though the quantity of Blood voided be not commonly much feared, yet because a dangerous or pernicious Ulcer often follows the Solution of Unity so made in the Lungs, or in the Stomach, or Intestines, or in a Vein; therefore we must diligently take care of those Hemorrhages from their very first appearance, and therefore such Bloody Excretions are ranged amongst the Diseases of those parts, and we have already delivered elsewhere the Theories and Cures of Blood-spitting, and the Bloody Flux, so that there is no need for us to repeat them here, no more than that of Pissing Blood which belongs to the Pathology of Nephritick affects, wherefore I shall pass to those Passions, in which there being an immoderete Fffulx of Blood, there is a particular necessity for Medicines to stop it. The chiefest kinds of those sorts of affects are these three, viz. an Eruption of Blood from the Nostrils, and of the Menses, and immoderate Fluxes of the Haemorrhoides. The Cure of this latter belongs rather to Chirurgery than Physic, and we have thought fitting to refer the consideration of the other to the Pathology of the Womb: An Effusion of Blood by the Nostrils is the most general kind of those sorts of Passions, and what I shall here deliver for the Cure of this Eruprion of Blood may be applied to all other Hemorrhages whatsoever. Therefore concerning the Cure of an excessive Bleeding at the Nose there are three primary Indications, viz. Curatory, Vital, and Preservatory: The two former have regard to the immediate sptopping of the Symptom as often as it presses; and the later undertakes to remove the cause of the Disease that the returns of the Eruption of Blood may abate of their violence, or wholly cease: Again this Eruption of Blood must be managed one way if without a Fever, and somewhat after a different manner if joined with it. If at any time therefore without a Fever much Blood flows from the Nostrils, presently as there will be need of Remedies to stop the Blood, there will be three chief intents of Curing, all of them to be put in Practice together, viz. the Turgescency of the Blood must be so allayed that it be not prone to make disorderly Sallies: We must farther take care that its Fluxion being withdrawn from the Nostrils, be diverted eisewhere, and that the gaping Mouths of the Vessels within the Nostrils be closed: For which ends a great many Remedies both External and Interna, and of divers kinds are wont to be administered, we shall speak of the former in order and briefly. First, therefore let the Patient keep himself quiet with his Head in an upright posture, then let the Joints of his Arms and Thighs, many of them together, but not all of them be bound with straight Ligatures, which must now and then be loosened and removed to other parts; for upon their being bound all at once, and so continued a long time, I have known that terrible Swoundings have happened, by reason of the Bloods being detained in the outward parts, and kept too much from the Heart: Though otherwise this Remedy being prudently administered gives often relief. For since by this means the Blood which passes into the Members by the Arteries, is hindered from its quick return by the Veins, its violent taking to the head is stayed: Moreover by the painful Ligatures of the Joints the Muscular Fibres of the Carotid Arteries from whose Branches the Blood issues at the Nostrils are freed from the Convulsion which they often fall into. 2. To withdraw the course of the Blood from the Nostrils, sometimes it's proper to open a Vein in the Arm, or Foot, for the more Blood is carried by the Arteries to the place where a Vein is opened, the less will flow to the Nostrils: Yet this Administration does not always prove so successful but its contrary effect sometimes happens; as we have observed before, where we treat of Spitting Blood: The reason whereof is that the Vessels being suddenly, and not sufficinetly emptryed, draw into them again the disagreeing Humours before ejected, and stagnating within the Pores, by which the Blood is presently stirred up again to a greater Turgescency for Eruption. 3. Cold things applied to the Forehead and Temples, also to the Nape of the Neck where the Vertebral Arteries ascend, constringe the Vessels, and somewhat repress or repel the Flux of Blood: But it is ill done of some who advise topical coolers to be applied to the Jugular Veins, for this retarding the course of the Blood in its return, causes it to flow more plentifully out at the Nostrils: Moreover as to the usual way of applying a Linen-cloth or a Sponge dipped in Vinegar to the Share and Genitals, it gives relief only, as a Ligature of the Members, viz. in as much as it hinders the return of the Blood of the Veins. A sudden and unexpected Sprinkling of cold water on the Face by striking a Terror often stops an Eruption of Blood. 4. Cupping-glasses applied to the Hypochondres, Flanks, inward parts of the Thighs, and to the Soles of the Feet, have been accounted both by Ancient and Modern Physicians a famous Remedy for withdrawing an Eruption of Blood from the Nostrils. 5. Frictions of the extreme parts are commended in this affect by some Practitioners, which nevertheless we judge not so very good, nay scarce safe: For though they cause a greater confluence of Blood to the Hands and Feet, yet they so accelerate its return, that it endangers a more violent Sally of it to the Nostrils. 6. Zacutus Lusitanus among Revulsory Remedies proposes an actual Cautery to be applied to the Soles of both Feet, and Crato the bending of the little Finger of the same side, which last you may do well to try in regard it is done easily: Though I do not advise so of the other Remedy, unless the Cure by it were more certain, which might recompense the Pain, and Lameness that will ensue. 7. A Swooning by what means soever caused, stops presently for the most part an Eruption of Blood, be it never so refractory: Wherefore when persons seized with an Eruption of Blood and grown weak by it are pulled out of Bed, or if Blood be taken from them though in a small quantity by opening a Vein, they apprehending a danger in it, or if their Members are long bound, or they are suddenly put in a fright with some feigned Rumour, and upon any other occasion fall into a Swoon, or a Fainting Fit, the Eruption of Blood from the Nostrils presently ceases: The reason whereof it evident enough, because as soon as the Motion of the Heart fails both the Blood and Spirits presently rush thither, so that all outward Effusion is incontinently stopped and that which before was immoderate does not begin afresh. 8. In the last place we must take a view of those Remedies for repressing an Eruption of Blood from the Nostrils which are said to work after an Occult manner, and by Sympathy, and Antipathy: Of which kind chief are the Sympathetical Powder, made of Roman Vitriol Calcined to whiteness by the Sun in the Summer: Also a piece of the Wood of a Maiden or young Ash, cut about the moment that the Sun enters Taurus: The efficacy of which Remedy is attested by many credible witnesses to have been proved in stopping Eruptions of Blood in wounded Soldiers during the late Civil Wars. So a dried Toad sewed up in a Silk Bag and worn on the Pit of the Stomach is said to stop any Flux of Blood, and to prevent its return. There are many other famous Medicines for stopping Blood, whose operation is wont to be referred to Occult causes, and to some secret Virtue: As Necklaces of the Bloodstone worn about the Neck, also Vsnea, or the moss of a Man's Skull carried in the hand: Epithems of the Leaves of Nettles stamp and applied to the Soles of the Feet, and the Palms of the Hands; which Empirical Administrations being to be tried without trouble or charge, we have no reason to reject them, especially since in a dangerous case we ought to leave nothing unattempted, and in regard that those applications may do good sometimes in this respect, that they fortify the imagination of the Patient. Whilst these outward Administrations are used for repelling or withdrawing the Flux of Blood from the Nostrils, let Topics also be put into the Nostrils to close the Gaping Mouths of the Vessels, for which use Injections of Liquid things, Pledgets, Powders to be blown in, and Fumes are wont to be prescribed, which failing of effect we must come at last to Escharoticks. 9 Amongst Liquids', a Solution of Vitriol made in fountain water, is accounted not only the chief, but as good as all the rest: Some boast of this as of a great secret, and an infallible stopper of Blood: Indeed the same applied to a fresh Wound, for as much as by corrugating the extremities of the cut Vessels it closes them, it keeps back the Flux of Blood and powerfully stops it: But in regard in an Eruption of Blood from the Nostrils (where the Blood is conveyed to the gaping Mouths of the Arteries and aught to be received by the Veins, this application closes these as well, or rather than those, it does here little, or no good at all, as I have often known it tried. This Medicine is prepared of green Vitriol, viz. the Hungarian, or of that of our own Country, also of the Factitious Vitriol of Mars dissolved in a sufficient quantity of fountain water. I know some commend a Solution of Roman Vitriol, which they are wont to use not only by injecting it, but by applying it Sympathetically to a Bloody Linen-cloth: I have also known a Water prepared of an Infusion of white Vitriol with Bole and Camphire used successfully to Wounds, and often to other Eruptions of Blood. But in regard a water injected into the Nostril does not stick enough to the Mouths of the Vessels, but is washed away by the Bloods breaking forth before it can exert its Virtue; therefore it is better either that a Styptic Powder be blown into it, or that a Pledget dipped in the water of Vitriol be thrust into the Nostril to the upper part of it, either by itself, or strewed to the Nostril to the upper part of it, either by itself, or strewed with an Astringent Powder. Many Styptic Powders and of divers kinds are wont to be prescribed for this purpose: I commonly use either Crocus Martis Calcined to the highest reduess, or the Powder of Vitriol Camphorated, or a Vitriolic Soot scraped from the bottom of an old Brass Kettle, the Powder of which I have often tried with success in this case. In obstinate Hemorrhages and not yielding to other Remedies, let a Pledget having on its top a Caustick Colcother be thrust up into the Nostrils as far as it will go, that the little Mouths of the Vessels being burnt, and covered with an Eschar, all Eruption of Blood may be presently stopped. There are many other Errhines famous amongst Practitioners for stopping Blood, as Hogs-dung thrust up into the Nostrils, which is thought merely by the Nastiness of its Odour to repel the Blood ready to burst forth: Also the Fume of the Blood dropping on a red-hot Iron and returned up into the Nostrils, the Powder of which also when burnt is blown up into them. Vsnea or the growing Moss on a Man's Scull which has not been interred is highly commended by some for this effect. So much of outward Remedies for stopping Bleeding, whose Virtue ought likewise to be promoted by inward things seasonably given and cooperating. Therefore a thin Diet being prescribed, and the Patient ordered to keep himself in an erect posture, or not much leaning back, whilst the foresaid Administrations are orderly applied, let Medicines appropriated to the same end be prescribed also to be inwardly taken: Remedies of this kind have two chief scopes, viz. First to cause the Blood being kept within its Vessels to be quietly Circulated, its Effervescence, whether happening through its Accension or Fermentation, being suppressed. Secondly, to retard by fit Remora's, the violent Motion of the Heart, driving round the Blood too rapidly. 1. The first intention requires those kinds of Medicines which suppress the too great Accension of the Blood, and appease its undue Fermentation; for which uses I am wont to prescribe the following. Take the waters of Plantain, red Poppies, Purslain, and of the Spawn of Frogs of each four Ounce, Syrup of Water-lillies two Ounces, Sal Prunella a Dram; mix them, make a Julape, the Dose is three Ounces thrice or four times a Day. Take Barleywater two Pounds, red Rose-leaves a handful, Spirit of Vitriol as much as will give it a grateful Acidity, or about half a Dram, make a warm Infusion for extracting the Tincture, add Syrup of the Juice of St. John 's Wort two Ounces; the Dose is three or four Ounces to take at pleasure often in the Day time, or by Night. Take Leaves of stinging Nettles, and of Plantain of each three handfuls, being bruised pour to them of Plantain water four Ounces, express it strongly, and take it. 2. For the Second intention, viz. to retard the overviolent beat of the Heart, Hypnoticks and Opiates are proper. Take red Poppy-water three Ounces, Syrup of Diacodium half an Ounce: Mix them, make a Draught to be taken going to Bed. (Or) Take Conserve of red Roses an Ounce and a half, Powder of the Seeds of Henbane and of white Poppies, of each two Drams, Syrup of Poppies what suffices. Maek an Opiate. The Dose is the quantity of a Nutmeg every six or eight hours (Or) Take Laudanum Cydoniated a Dram, the Dose is fifteen Drops twice a Day in a proper Vehicle. So much of an immoderate Eruption of Blood, and its Cure, whilst it happens without a Fever, but when it happens in a Fever, and must be stayed because of too much loss of Blood, it is either Critical, growing to be immoderate by reason of some Accident, to which the Method and Medicines even now prescribed may be accommodated, though with some caution and a due respect to the State of the Fever: Or it is merely Symptomatical, which happening in a Malignant, or Spotted-fever, the Smallpox, Measles, or Plague, it scarcely either can or aught to be repelled or stopped by the foresaid Remedies: For letting Blood is not proper; repelling Topics, also cooling Julapes or Decoctions, or Narcoticks have no place: The chief intention of Curing will be to change the Eruption of Blood into a Sweat, for upon raising a gentle Sweat, the Flux of Blood, if it be not extremely dangerous, ceases of its own accord. Take water of Meadow-sweet and Tormentil of each four Ounces: Of the cold Cordial of Saxonius two Ounces. Treacle-water an Ounce and a half. Bezoartick Vinegar three Drams, Syrup of Coral an Counce and a half, Confection of Hyacinth two Drams, make a Julape; the Dose is six spoonfuls every third hour. Take Powder of Toads prepared half a Dram, Camphire two Grains; let it be taken with the foresaid Julape every sixth hour. (Or) Take Pulvis Pannonici Rubri from half a Dram to two Scruples give it after the same manner. Take Confection of Hyacinth three Drams, Pulvis Pannonici Rubri a Dram, Syrup of Coral what suffices; make a Confection, the Dose is the quantity of a Nutmeg every other hour. Take Roots of Bistort and Tormentil of each an Ounce, Leaves of Meadow-sweet, Burnet, Woodsorrel of each a handful, Hartshorn two Drams, Shave of Ivory and Hartshorn of each two Drams, boil them in three Pounds of Fountain water to two Pounds, add towards the end Conserve of red Roses three Ounces, sirain it, the Dose is three Ounces often in a Day. So far of the first Indication which is Curatory together with the scopes of Curing and the forms of Medicines destinated for an Eruption of Blood from the Nostrils, happening either with, or without a Fever. The second Indication which is Vital prescribes only a thin Diet, temperate Cordials, and a fit ordering of the Patient: The provision for the two For former is so small and easy, that it seems not necessary to set down a form and rules particularly for them: Concerning the latter the chief question is whether we ought to keep those that are seized with an Eruption of Blood either in Bed, or out of it: It's an unquestioned thing that those that are weak, and subject to fall often into Swooning Fits, ought not to be stirred from Bed, unless haply it, be to try a Cure (as we have intimated before: As to others that are not so weak, we say thus, those whose Blood has not an easy Transpiration by reason of the Constipation of the Pores, and upon its being put in a stronger Motion by the heat of the Bed is disposed to greater Turgescencies, and to Eruptions, it will be good for them not only to stay out of Bed, while Bleeding, but likewise sometimes to be cooled by outward Applications in the whole habit of the Body, or at leastwise in most of its Members: Wherefore Fabritius Hildanus relates how he presently Cured one of a violent Bleeding at Nose, after many ordinary Remedies tried in vain, by putting him into a Vessel of cold water: with the like success also Riverius having ordered another affected in like manner to be taken forth of his Bed, and laid on a woollen Rugg in the Floor, fomented his whole Body with Linnen-cloaths wetted in an Oxicrate: Yet this method is not generally proper for all Persons, and at all times: But on the contrary those whose Blood being of a free Transpirable disposition, and enjoying open Pores, readily evaporates, and is wont upon any moderate ambient heat to be resolved into Sweat, and consequently to become more calm, it's good for such to continue in Bed, not only whilst Bleeding, but as long as that Eruption is in danger of returning in a short time after: For this reason it is that many Persons subject to violent Eruptions of Blood live free from that Distemper during the Summer, whilst they have a free Transpiration, but when the cold of the Winter presses them, their Pores being stopped, they undergo more frequent and dreadful Fits of it. 3. The third Indication being for Preservation, which regarding the removal of the cause of the Distemper, either hinders the Eruptions of Blood, or renders them less frequent or less considerable, suggests to us these two chief intents of Curing: viz. First, that the Blood being restored to its due Temperament and Mixture, be quietly circulated within its Vessels without Turgescencies and Eruptions; And Secondly, that the Blood Vessels be kept in their due State as to their Conformations of their little Months, and the Tones of their Muscular Fibres, so that those Vessels neither cause those disorderly Sallies of the Blood to the Head, or give way to its Eruption from the Nostrils: For both these ends, in the first placelet the Redundancy of the Blood, and its great foulness be provided against by a seasonable Administration of Phlebotomy and Purgation; and then forprocuring and preserving its right Temperament let the following Alteratives be given in fit seasons for Physic. Take Conserve of red Roses, and of the wild Rose, of each three Ounces, Powder of all the Saunders, of each half a Dram, of Coral prepared a Dram, of the reddest Crocus of Mars two Drams, Sal Prunella four Scruples. With a sufficient quantity of Syrup of Coral, make an Electuary, take early in the Morning, and going to Bed the quentity of a Chestnut either by itself; or Drinking after it of the following distilled water three Ounces. Take of the tops of Cypress and Tamarisk of each eight handfuls, tops of St. John ' s-wort and of Horse-tail of each four handfuls, all the Saunders bruised, of each an Ounce, Pith of White-bread two Pounds, being sliced very small pour to them of New-milk eight Pounds, distil it with common Organs: Sweeten each Dose as you take it with a sufficient quantity of the Syrup of the Juice of Plantain. Take Leaves of Plantain, Brooklimes, and stinging Nettles of each four handfuls, being bruised pour to them of the foregoing water half a Pound, small Cinnamon water two Ounces, express it strongly; the Dose is three or four Ounces in the Morning at nine of the clock, and at five in the Afternoon. Let Medicines of this kind be taken Spring and Fall for twenty or thirty Days, giving sometimes a gentle Purge between while: But in the Summer let Mineral Chalybeat waters be Drunk for a Month, than which there is not a more excellent Remedy in this case. I shall now give you an example of one Cured of an Eruption of Blood, whose case was somewhat particular. I was lately sent to for advice for a Gentleman living far off who had been troubled a good while with frequent and violent Eruptions of Blood, sometimes from the Nostrils, sometimes from the Heamorrhoids; this person had been often let Blood by the advice of his friends, but found no good thereby, nay most commonly after opening a Vein falling into cold Sweats, and Swooning Fits, and still as liable to Eruptions of Blood, he was wont to be much worse: To this Person (not having seen him) I prescribed Julapes, and cooling Decoctions, and anodynes, also Juicy expressions of Herbs, and other things to cool the Blood, but these things also (as though all yet were far from the makr) had nothing a better success; at length being called into the country to see him, I found the affect with which he was seized to be merely or chief Convulsive, for the Blood breaking forth daily, his Pulse was weak, his Extreme parts cold, and all the Vessels were fallen, as though too much emptied: Moreover the Patient was troubled with a continual Giddiness, and a Trembling of the Heart, and was taken now and then with Swooning Fits, or with the apprehension of it: Truly it was so far from it that the Blood should break forth of the Vessels by reason of any Redundancy or Turgescency, that rather on the contrary its Current was so extremely low and small, that it seemed scarce able to maintain the Stream of Circulation: But the thing was, that often in a Day he sensibly pervceived somewhat on a sudden to pass privately sometimes up, and sometimes down his Body like a wind, and for the most part an Eruption of Blood from the Nostrils or Haemorrhoids followed the Tendency of that Motion. So that it was easy hence to conclude, that the moving Fibres of the Blood Vessels, by which they are contracted, being seized with Convulsions, drew suddenly every way in a disorderly manner the Stream of the Blood, as small and low as it was, and forced it now and then to an Eruption: Which also was the easier done, because the Lax and Gaping Mouths of the Vessels permitted the Blood driven to them to flow forth without any due stay: A Method of Cure ordered pursuant to this Aetiology confirmed it by its good success: For Bleeding, and the use of Blood-stopping Medicines being thenceforwards omitted, I prescribed the use of the following Powder whereof he took a Dose every sixth hour with a proper Julape. Take Powder of the Roots of Male Peony, red Coral, and Pearl of each a Dram, Ivory, Crabs Eyes, Bloodstone, of each half a Dram, Sal Prunella a Dram, make a Powder, the Dose is half a Dram. Take black Cherry water eight Ounces, Balm water and small Cinnamon water, of each two Ounces. Treacle water an Ounce, Syrup of Coral an Ounce and a half. I farther ordered that Ligatures should be used in due course to certain places, and now and then to others as occasion required, both to stop, and to intercept the Convulsions of the Vessels: And by these Remedies and ways of Administrations he soon grew well without any Relapse. CHAP. III. Of Vesicatories. HAving treated of the Emission, and stopping of the Blood, according to occasion, there ramain certain other Humours, to wit the Nervous and Nutritious Humours, and likewise the Serous and other Excrementitious ones which are wont to abound within the Brain, Nerves, and within the Nervous and Fleshy Fibres, and even in the Pores of the Skin, and of the Solid parts, which being often deparved or letted in their Motion, require an Emission, being otherwise apt to prove greatly prejudicial, and often to cause dangerous Distempers: Wherefore for a seasonable prevention of affects arising, or which are apt to arise from such cause, Physic has found out certain other Emissaries to derive immediately, or meidately the foresaid Humours from the parts and places where they prove offensive: And those Emissaries are either coutinual, viz. Issues of various kinds, which as everlasting Soures continually discharge that Ichor or Excrementitious Humidity; or they are Temporary, when upon occasion the Scarf Skin being removed in some part of the Body, the extremities of the Vessels in the Skin are laid naked, and withal so irritated, that they discharge in a great abundance Serous Humours of a verious Origine and Nature, and continue so too Evacuate them for some time, sometimes longer, and sometimes a shorter while. Now such a manner of drawing forth Serous Humours from the Exterior Surface of the Body, or of some certain part of it is wont to be effected by Medicines called by the Ancients Phaenigms, or Synapisms, by the Modern Vesicatories; of which (because their knowledge prepares the way to the Doctrine of Issues) we shall in the first place treat here, and shall particularly insist on the explication of, these three things, viz. first it shall be shown of what substances, and after what manner ordered, Vesicatories are prepared. Secondly, they being of various kinds, we shall declare what are the ways and manners of working in each, or at least in the chief of them: And Thirdly, we shall inquire for the Cure of what sort of affects they ought to be used, and to what places applied. 1. As to the first, the most simple Blisterers are either Fire, or Solid Bodies, or Liquors endued with Fiery Particles, which nevertheless are seldom put to this use by reason of the Terror they give, and the Imminent danger lest being roughly applied they do not so much Blister the Scarf-skin, as burn both this and the Skin, and other parts: What therefore is more safe and less to be dreaded, let Epithems made of Concrets which have smart Particles, or (as is said) Potentially Fiery, be applied to the places to be Blistered; which being either more mild were called by the Ancients Phaenigms, because the Scarf-skin being removed they made the part red: Or in respect of the matter they were called Synapisms, and were wont to be prepared of Mustard, Pigeons-dung, Squills bruised, Garlic, Milk of the Figtree, and the like; or they were more strong and for the most part consisted of Euphorbium, Cantharideses, Flammula Jovis, Batrachion, water Plantain, with many other things, which being endowed with a certain Burning or Corrosive quality are outwardly applied for the said use, but inwardly taken are Poisonous and often Mortal. The Compositions and Forms of Blisterers are manifold and of sundry sorts: Though one, or two, and the more simple the better, may suffice here, and in most cases it's all one which you use: According to our wont we shall here set down some of the more select, and most useful prescripts of these sorts of Medicines: And to say little here os Dropax's, Synapisms, and Phaenigms, which are now in a manner out of use: Almost all Vesicatories at this time made use of, have Cantharideses for their Basis. Take Powder of Cantharideses from half a Dram to a Dram, Powder of Ameos-seed a Scruple: Stolen Leaven wrought with Vinegar what suffices; make a Mass for a Plaster, spread part of it on Leather, and apply it to the part for twelve hours. This works infallibly and strongly enough; but because it is not compact, and sticking, but is apt to slide from the place where it is put, or to crumble, therefore for a more convenient application the following does very well, and is now every where in use amongst most persons. Take Cantharideses three Drams, Euphorbium half a Dram, Powder of Ameos-seeds a Dram, Melilot Plaster what suffices; let them be incorporated with a warm hand, using as much of the Powder as the Mass of Plaster will receive. Let a sufficient-quantity of this be spread on Leather, and be applied for twelve or sixpeéns hours, Some use to incorporate as much of the said Powder with Burgundy-pitch as it will receive, and to spread it on Leather, and then to cover the edges of this Plaster with another Mass of Plaster, made of Powder of red Saunders incorporated with Burgundy-pitch, so administering a Dropax and Vesicatory together: Moreover by applying continually the said Plaster to the place rubified and ulcerated after the Scarf-skin is Blistered and removed, and by wiping it clean only once or twice a Day, and presently applying it again, they make the little Ulcers, raised by Blistering, to run as long as they please, nay sometimes above a Month, and to discharge a great plenty of Ichor, or Excrementitious Humidities, Others sew up Cantharideses bruised and sprinkled with Vinegar in a little Bag of very fine Silk, and apply them to the place to be Blistered, Some Empirics instead of Cantharideses lay on the place to be Blistered a Mass of the Leaves of Batrachion, or Flammulajovis bruised, by which the Scarf-skin being Blistered, or rather eaten away, the Skin itself, as if touched with an actual Fire, is often mightily inflamed, and deeply ulcerated; whence not only a great discharge of Ichor, but sometimes an Inflammation of the whole Member, and a Feverish Disposition ensue, wherefore those things must not be used without considertation. 2. If we inquire into the manner and way how these and other Vesicatories operate, First we must show after what manner actual Fire, and things endued with Particles proceeding from Fire, cause a Blistering; and then by an easy Analogy we shall come to know the force and manner of working of those sorts of Medicines which are said to contain a Potential Fire: Therefore concerning the former we observe that Fiery Particles, not applied too roughly, Penetrating the Scarf-skin without Solution of Continuity, enter the Skin itself, where the extremities of the Blood Vessels, Nerves, and Nervous Fibres, are terminated; and there altering these from their Position, wrist them sundry ways, and pervert the Conformation of the whole Texture of the Skin: So that from all the Vessels being mightily irritated, a Watery Humour filled with Fiery Particles, and therefore rejected both from the Blood, and from the Nervous Juice, is voided in a great abundance: That Lympha, because it cannot pass through the Scarf-skin, separates it from the Skin and raises it into a Blister. Hence it will be easy to understand after what manner Vesicatories perform their operation: viz. Cantharideses (and so all other things of the same virtue) being outwardly applied, and coming to be made warm by the Effluviz's of the part they lie on, and so stirred up to exert their force, emit from them a great plenty of Smart and Fiery Particles as it were, which penetrating the Scarf-skin without breaking it, strongly fix themselves in the Skin: Where sirst they act on the Spirits and then by their means on the Humours and Solid parts: Those Particles very much irritate the Spirits and make them cause painful Convulsions of the Fibres, and they fuse the Humours and make them separtate into parts, so that the Watery part being mightily filled with those Smart, and as it were Venomous Particles, is thrown off on every side by the rest of the Latex: And the extremities of the Vessels and Fibres being either in the mean time Eaten away by Burning, or opened and emulged as it were by Twitching, that Ichor is voided in a plentiful measure from their little Mouths carrying with it the offensive Particles. Which Ichor afterwards separates the Impervious Scarf-skin from the Skin, and raises it into a little Blister. And after this is broken and removed, is plentifully voided for some time from the Ulcerated Skin. But this is not only so done, because the Serous Latex inbibing the Smart Particles of the Medicine, and conveying them forth, does not always carry them back all the same way that they came in; but sometimes being imbued with those Particles it regurgitates into the Mass of Blood, and afterwards being circulated with it, and voided with its offensive Load by other Emunctories, it offends in its passage or as it goes forth certain weak, or tender Ductus'. Hence many after the use of great or many Vesicatores having their Urinary passages thereby affected with an Acrimony or Erosion, get a Strangury which in some is most sharp and intolerable: Again in others troubled with the Stone that application sometimes causes Bloody Urine: Hence also it may be suspected, that tender Lungs, or such as are inclined to a Consumption, may be much endangered by the outward application of this Medicine: Which nevertheless I have not hitherto known happen to any; but rather on the contrary I can testify by frequent trials that it rather proves to their advantage than to their prejucice: For the smart Particles of the Catharides, upon long application being sometimes plentifully imbibed by the Blood, infect its whole Serum; which Latex nevertheless so aculeated, as long as it is mixed with the Balsamic Blood, offends no part; but being separated from it by the Reins, it sometimes hurts them, and often not only twitches the Neck of the Bladder with its Acrimony, but sometimes Corroding it fetches thence a Mucus, and little Schims', and even Blood itself: But in the Mass of Blood, those same sharp Salino Volatile Particles often do great good; because they destroy the fixed and acid Salts in it, and likewise open the too close Texture of the Blood, and so cause its Serous and other Morbific Particles before fast bound in it, to be separated from it, and to be readily sent forth by Urine and Sweat; hence in Fevers, Vesicatories long applied cause a large Evacuation by Urine and a free Sweat: Moreover the same open the Obstructed passages, and stir up the Portions of the Blood and Serum stagnating in any place, or extravased, and restore them to Circulation: Wherefore they are wont to do good not only in Distempers of the Serum, but also of the Blood, nay in the Pleurisy, Peripneumonia, and in any other Fevers whatsoever. Hitherto having shown after what manner Vesicatories work, first on the Spirits, and then on the Humours and Solid parts; I must next set down their effects both good and evil; also the manner of using them: That they work first on the Spirits it is plain from hence, that they exert no power on the Dead: And it's an ill Omen in very weak persons when Vesicatories do not work, because it's a sign that the Animal Spirits are mightily dejected, or lessened in their store. Therefore to explain well the Energy, or Virtue of this Medicine, we must consider what Humours it evacuates, or altars immediately or mediately: And then in what Diseases, and in Bodies how disposed it does good or hurt. As to the first, the Humours immediately let forth by a Vesicatory partly issue from the Pores and Glands of the Skin, and partly from the Mouths of the little Arteries, and partly from the extremities of the Nervous Fibres; haply some little of the Juice fresh received may be cast back again from the little Mouths of the Veins, though much of it cannot: The Humours mediately voided by a Vesicatory are those which the foresaid parts being emptied receive from elsewhere, and convey forth. 1. The Scarf-skin being removed by a Vesicatory from the Skin a Serous Humour is drawn from the Glands and Pores, and this not only from the place Blistered, but those Pores being pervious to others, a Portion of Serum coming from other Pores sometimes succeeds in the Cells of the first drained, and thence also distil forth, wherefore in an Anasarca the little Ulcers raised by a Vesicatory empty waters on every side in great plenty, and derive them from all the Neighbouring parts, nay sometimes from those that are very remote. 2. The Mouths of the Arteries do not only Spew forth the Portion of Serum brought to them according to common course, but the Serous Latex being imbued with the irritative force of the Medicine in the whole Mass of Blood is thereby separated from the Blood in a more plentiful manner, and carried forth by the said Mouths of the Arteries, and with it other Excrements, and sometime the Morbid matter itself in a large measure: Hence in Malignant Fevers, nay and in some Putrid Fevers of a difficult Crisis, when the Refuse and Corruptions of the Blood unapt for separation threaten the Praecordia, or Brain-vesicatories deriving it forth continually and by degrees, often give great relief: To which may be added that the same also (as we have hinted before) alter and restore the Blood degenerated or depraved as to its Salts, and likewise by opening or rarifying its Texture, dispose it to a Eucrasy: Wherefore this kind of Remedy often agrees excellently well, not only in a Feverish State of the Blood, but likewise when it is otherwise vitiated, or Cacochinical. 3. Reason and Experience convince us that Vesicatories draw from the extremities of the Nerves, and Nervous Fibres the Latex contained within their Ductus', and free it from Stagnation, and that they exagitate the Heterogeneous Particles mixed with the Latex, and deriving them from the Brain convey them forth, whence they are found of excellent use in Convulsive affects. From these things we may gather for the Cure of what Diseases this kind of Remedy is chief conducing; for in order to an Evacuation from the Pores and Glands of the Skin as often as a Serous, sharp or otherwise offensive Humour is gathered together in or near them, and being excluded from Circulating with the Blood obstinately sticks there, certainly there is no readier, or easier way of clearing the same forth than by applying a Vesicatory on or beneath the place affected; wherefore it is not only indicated in an Anasarca, and all Cutaneous foulnesses and breaking forth; but a Vesicatory is likewise required in Pains either of the Gout, or Scurvy any where sixth in the outward habit of the Body, or in some Member. Secondly, Vesicatories are always used in Malignant Fevers in respect of the Blood, both to Purge it by degrees from all Heterogeneous and Morbific matter, and to alter it from its two Acid, or Salt, or otherwise vitiated Disposition into a due Temperament: Nay they are of most excellent use in all Putrid Fevers threatening ill, and of a difficult Determination: Therefore also in the Scurvy, Leucophlegmatia, the Longing Disease of Maids, and in any other Cacochimia that kind of Remedy does often great good: Again, Vesicatories are generally applied with good success not only for correcting the Blood itself, but likewise as often as being depraved it pours its Corruptions on the other parts, and so gives a beginning to Diseases, and cause Fits of them in the Head, Thorax, Belly, or Members. Wherefore in headaches, Vertigo's, and Sleepy affects this is a known and vulgar Remedy; and so in a Catharrh, and any Defluxion either into the Eyes, Nose, Palate, or Lungs, every ordinary Man Prescribs Cantharideses for a Revulsory without advising with a Physician. I must own that myself having been often seized with a violent Cough accompanied with much and thick Spittle (to which I am Originally inclined) have not found more good from any Medicine than from Vesicatories; therefore I am wont when that Distemper presses, first to apply Blistering-plaisters on the Vertebrae of the Neck, than those little Ulcers being healed, I apply them behind the Ears, and afterwards if need requires on the Shoulderblades; for so the Serous Filth breaking forth in abundance from the dissolved Texture of the Blood, is derived from the Lungs, nay and the mixture of the Blood sooner recovers its Crasis, its irregular Salts being by this means destroyed. 3. In respect of the Humour to be evacuated or derived from the Genus Nervosum and the Brain itself, Epispastics as they are of most common use in Sleepy, Convulsive, and Pain-causing affects, so they often prove mighty beneficial: Was ever any one seized with a Lethargy, Apoplexy, or Falling-sickness, but presently his Friends or Attendants, though never so ignorant, flayed his Skin with Cantharideses? In strange Convulsive Motions, usually ascribed to no less than Witchcraft, I have applied Vesicatories with great success to many parts of the Body together, and by renewing them now and then in fresh places, I have continued them above a Month: Again fixed and cruelly tormenting Pains in the Membranous parts are seldom Cured without this AdminiAstration: For sometimes Humours and Morbific Particles, which being throughly radicated, yield not at all to cathartics, or Medicines working by Sweat, or Urine, seem to be utterly rooted out by Vesicatories, laying hands, as it were, on the Disease. Yet this Remedy though very general, does not work so readily and successfully in some Diseases and Constitutions; wherefore we must not use it inconsiderately, or indifferently to all persons; for those that have the Stone, and are subject to frequent and great Fits of the Strangury scarce ever undergo its application without prejudice. Wherefore in persons so affected we must not use Vesicatories but in Malignant Fevers, or in Acute Diseases of the Head to prevent a greater Mischief. As to the various Temperaments and Constitutions of Men, in respect of which Vesicatories agree or dissagree, more or less: Concerning these things this threefold notable difference presents itself, fiirst some in a manner always bear the use of this Medicine well, and the little Sores made in the Skin by it distil forth the Excrementitious Humidities plentifully enough without any Disury or great Inflammation of the place Blistered, and then heal of their own accord: Which effect happens only in a Blood of a good Temperament, where the Salt and Sulphur being in a moderate quantity and in a due state, there is a good plenty of Serum; whose Latex receding readily and in a copious manner from the rest of the Blood takes with it the smart Particles of the Medicine imbibed, and partly distils them forth by the place Blistered, and partly conveys them out by the Urinary passages without offending them: On this account also those good effects before mentioned are puoduced in the Mass of Blood. But Secondly, this Medicine does neither agree, nor work well with others, for it makes the place on which it is applied mighty red, or rather excoriats it with a violent Pain, and a great Inflammation: And yet the little Sores there made, though they torment the Patiented a good while, cast forth but a very little Ichor, or scarce any at all: Moreover in those to whom Blistering always proves so torturing, a cruel Stangury for the most part succeeds it: This troublesome and withal unprofitable use of Vesicatories happens very frequently to Men of a hot and choleric Temperament, whose Blood contains Salt, and Sulphur, in a great plenty, and but a little Serum, which is wholly tainted with the others: Wherefore when its Latex which ought to carry off the smart Particles of the Medicine, does not part readily, nor in a plentiful manner from the rest of the Blood (to wàsh them away presently) those Particles still sticking in the Skin, Taint and Poison, as it were, the Blood in its passage, and being thereby hindered in its Circulation, they cause it to gather together and stagnate within the extremities of the Vessels, whereby they are inflamed: Moreover the Serous Latex at length separated by the Reins, being but in a small quantity and sharp of itself, and made more sharp by the Particles of the Medicine, irritate the Neck of the Bladder, and often corrode it with its Acrimony. There remains a Third, though more rare case, of persons Blistered, in whom the little Sores raised in the Skin presently pour forth the Serous Humour in such abundance, that there is straight way need of repelling Medicines, and such as close the Mouths of the Vessels; otherwise upon the too great Efflux of waters a Dissolution of the strength, and a failing of the Spirits are endangered to ensue: I have known this to have happened so constantly in some, that they were forced for the time to come to abstain from the use of Cantharideses, how great soever the need were of them: The reason of which seems to be that the Blood being endowed with an Over-salt and sharp Serum had its Texture too easy to be dissolved: Besides this great Efflux of Serum raised upon the first application of a Vesicatory, it happening sometimes late in Malignant Fevers, and in others of an ill or no Cirsis, and continuing for some time, wholly drains the Morbific matter, and often frees the Patient from the very Jaws of Death: In such a case after that the little Sores have voided little, or an indifferent quantity of Ichor the first Days, at length nature attempting a Crisis this way, a vast quantity of Serous-filth flows from the same; and so continues to flow forth for many Days, nay sometimes Weeks, till the Patient looked upon before as given over, recovers his perfect Health: As it is not easy to heal the little Sores so flowing in abundance, so it is not safe to do it before the whole Seminal Root of the Disease be spent: Not long since a famous Dr. of Physic of London recovering with much ado of a Malignant Fever, had in many parts of his Body places Blistered, daily distilling forth a plenty of Ichor, after some time (they being troublesome and tedious to him) he applied strong Repercussives to them all, and so presently stopped all Issue of Matter: Those Sources had been scarce stopped two Days, but falling into a Relapse of his Disease, on a sudden he was seized with a Languor of the Spirits, and frequent Fainting Fits, with a cold Sweat, and a low and weak Pulse; and not being able to be relieved by any Remedies, however cordial they were, he died within three Days: The cause of which seems to be that the Malignant matter suddenly struck back into the Nervs of the Heart; whose action being thereby hindered, the Vital Function soon failed. CHAP. IU. Of Issues. VEsicatories differ from Issues in this, that these are ordered for longer continuance. Moreover the former for the most part being requisite in Acute Diseases and others, whose Morbid matter requires a speedy removal, regard chief the taking away of the Conjunct cause of the Disease, and therefore are made of a good breadth, but superficial withal, that such running Sores being large may evacuate much Matter, and then be easily Cured: But on the contrary Issurs being chielfy indicated for Preservation, are designed for removing, or overcoming the Procatarctick cause of the Distemper: Wherefore they consist of a narrower, but deeper Orifice, made through the whole thickness of the Skin, so that letting forth the Morbific matter still in less quantity, they derive it farther, and continue longer to empty it forth. Concerning Issurs there are these three chief heads of enquiry viz. First what Humours chief those Emissaries evacuate, and whence they derive them. Secondly, in what Diseases and Constitutions they agree better, or worse; And Thirdly, in what places, after what Form, and with what Instruments they ought to be made. 1. As to the former, Issues in like manner as Vesicatories Purge forth all Humours within the Skin, though lying in a less compass, or such as are conveyed through it both from the Sangui-ferous and Nervous Vessels; nor do they only like Vesicatories irritate and draw from the outward Superficies of the Skin, but perforating the whole Skin, convey forth whatsoever flows from the sides of the Orifice through the broken Vessels, and whatever comes from elsewhere under the hole: Wherefore not only the Humours gathered together within the Pores and Glands of the Skin, or conveyed thither by the Arteries and Nerves flow to Issues, but moreover the Serous Excrements under the Skin, which are wont to be conveyed, or to pass from place to place through the Interstices of the Muscles and Membranes, tend to them from all parts, and there find their way forth. Again, an Issue made in a fit place anticipates Mothisick Humours, which are wont to be conveyed to parts that are weak, and long afflicted, and so frees sometimes this part, sometimes that, from their Incursion: Hence the Gouty, or Nephritick, or Colic, nay sometimes the Paralytic, or Scorbutic matter is intercepted by Issues in its passages from its Sources to the Weakened places or Receptacles; and so the usual Fits of the Disease being evaded, is conveyed forth: And this Emissary even as Trenches cut for draining Fenny moistures, empties forth by defrees Humours sticking in any part or region of the Body, and there doing hurt, and so it prevents or cures a Morbid Disposition. 2. From these various ways of giving relief, with which Issues are wont to do good in general its easily gathered for what affects chief they are required; for though there be in a manner no Disease, in which this Remedy either does hurt, or proves useless, yet it seems more necessary in some cases than in others; it's prescribed even by the vulgar for almost every Distemper of the Head, both outward and inward: Every ordinary person advises an Issue above all things for the Convulsions of Infants and Children, for the Inflammation of their Eyes, their Swell of the Kings-evil, and so for headaches, Sleepy, Vertigious, or Convulsive affects of Adult or Aged persons: Nor is this Remedy less extolled against Diseases of the Breast; is there any one subject to a Cough, Bloody or Consumptive-spitting, or to an Orthopnaea, who has not an Issue made him? In like manner also Issues are commended for affects of the Belly, there is scarce any Hypochondriacal person, or Hysterical Woman, and no Gouty or Cahecttical person but have their Skin pierced in more places than a Lamprey. It would be a tedious thing to recount here particulary all the Distempers for which Issues are good. 3. Nevertheless this Remedy, however good and useful of itself, does not agree with all persons, nor therefore must it be indifferently prescribed to all: For there are two sorts of Men, who though they happen to be sick, may be excused from Issues; because this Emissary evacuates too much in some, and in others little, or less thanit ought, and in the mean time is mighty painful and intolerable. An Issue sometimes does not agree well because it evacuates or spends too much the Humour, or Spirits: For I have observed in some that an Issue made in any part of the Body voids forth an Ichor in quantity immoderate, and in quantity vicious; for out of it at frequent times, if not continually, a Watery, thin, and faetid Latex, often making the Pea, and cover black, flows in a great abundance, so that from its too great Efflux the Strength and Fiesh are consumed. An Issue sometimes vioding forth no very great quantity of Ichor spends the Spirits and Strength more than it ought, which is known by the effect, and sometimes not till afterward; to wit, because some upon keeping one or more Issues open, grow weak and lean, and upon their being stopped, become presently more Vigorous, and of a full habit: Moreover it's a common observation that many upon having an Issue made near the Head, have been soon after seized with some defect and weakness in their Sight, so that they were forced presently to close it up, which seems to happen for this reason, because where the stock of Spirits is but small, and their consistency very thin, little spend of them, or of the Juice out of which they are engendered, in case they are continual, are with difficulty endured. Moreover in an other, and that a different respect, Issues, as also Vesicatories are forbidden to some, or are prescribed to them with great caution; because voiding little or scarce any thing at all, they mightily torment the place in which they are made: For those who being of a Choleric, or otherwise hot Temperament, have their Mass of Blood thicker, and of a closer Texture than it ought by reason of its being but little diluted with Serum, in these persons a Solution of continuity being made, and kept in being by an Issue, the Blood (not deposing Serum enough to keep itself free) sticks itself in the passage, adn so being extravased causes a mighty painful Infsammation; and in the mean time such an Issue voiding such a very small quantity of Ichor proves as useless as troublesome. As to the places where Issues are to be made, they are to be chosen according to the ends of Curing, or the intentions required from them; which are chief these three, viz. First, a general Evacuation of Humours from the whole Body. Secondly, an Evacuation, and at the same time a Revulsion from some particular Member. Thirdly, an Evacuation and at the same time a Derivation from some particular Member. In respect of the former its proper to have an Issue cut in the left Arm; The Second intention requires it to be made far from the part affected, and the Third near it. For these ends, viz. sometimes this, sometimes that, or the other Issues are wont to be made, and that either by Incision, or a Cautery, or Perforation, in every Region of the Body, viz. in the Head, Breast, and Abdomen, and in the Arms and Legs, nay in most parts of each, and in their Orifices Peas or Wooden Peas, Pellets, or Pledgets are put, and there continued for keeping them open. By running through the Parts and Members of the Body, we shall observe the chiefest places, and kinds of Issues. Some order an Issue to be burnt by a Cautery in the Coronal Suture, and recommend it for withdrawing the Humours and evacuating them from the Brain and its Enveloping: Though some make a common Practice of this, yet I have found it not to have succeeded well in many; so that I have ordered many Issues so made on the Crown of the Head to be closed up, And this not without being taught by reason and experience: For the Blood conveys much Filthy Matter towards the place where it uses to discharge its Excrements, and deposes it in the whole Neighbourhood, and especially in the part affected (as being weaker and more apt to receive them) whence it often happens that the Disease is rather increased than Cured: For the same reason, viz. to derive Humours from the inward part of the Head outwards, others make Issues in the Bregma on the Sagittal Suture, and others in the hinder part of the Head about the beginning of the Lambdoides: But the same exception lies against these as against the former. Certainly an Issue made in the Arm much better anticipates the Morbific matter which is wont to be deposed about the inner parts of the Head, if made in the Leg it revulses it, and made a little beneath the Head it derives it thence. Hence for great affects of the Brain, and its Meninge, in Infants and Children, we cut an Issue on the Nape of the Neck: To Adult or Aged Persons we apply a Cautery on both sides the Spine betwixt the Shoulderblades: And there we often make two Issues capable of containing many Peas with great success. As to Issues cut or burnt behind the Ears, or a Setaceum past through its carneous Lobe; I have observed these things to have been seldom advantageous, but often troublesome; because a Solution of continuity made in these places neither discharges much Ichor, nor lasTs long, for the Orifice though filled with a Pea, or Pill, will be covered with a thin Skin growing over it in despite of all we can do. Issues in the Back do excellently well, not only in Diseases of the Head by evacuating and deriving the Morbific matter, but likewise in the Gout, Stone, and all Colicks, by anticipaing the Matter that feeds the Disease, and intercepting it as it passes to its lurking holes, which is plainly made appear by Experiments and Observations made in persons relieved by them. Issues betwixt the Shoulderblades are good for Diseases of the Breast; also in the Arm, or Legg to evacuate or anticipate Humours flowing towards the Lungs, and to withdraw the same there deposed; That an Issue in the Thorax cut betwixt the Ribs sometimes derives immediately the Consumptive matter from the Lungs, we have shown elsewhere. The Region of the Abdomen seems unfit to have an Issue in any part of it: Nevertheless the Practice of some, though it be rare, is much cried up, which order that a large Issue capable of containing many Peas, be burnt on the Region of the Spleen for all hypochondriacal affects; I have known this done in some without any great good, certainly not enough to recompense the trouble of such a Remedy. Some time since by an Issue in the Groin Isuccessfully Cured a mighty weakness and ache in the Loins, not yielding to any other Remedies, and in another person an inveterate Sciatica: For the Glandulous Emunctories seated in that place, imbibe a great store of Excrements of the Blood and Nervous Liquor, which if forthwith discharged from them, and that in a continued manner, it will conduce much to the freeing of the Neighbouring parts from any Morbific Seminal Root. The ●●ugh being a large Member seems fit enough for bearing many and large Issues to evacuate Humours plentifully from the whole Body, yet it does not happen so in many, partly because having a Figure too much declining like an inverted Cone, there is no convenient place for binding to keep in the Pea; and partly because a Solution of continuity made amongst the meetings of many Tendons, proves frequently Inflaming and Painful; so that it has been found necessary sometimes when an Issue has been made there to cause it presently to be closed up again to free the Person from Pain, and the trouble of Lameness: Though in some it does better, because an Inflammation does not always happen to the place perforated, and a Ligature applied to it, continueth steadfast to those that use to Garter above the Knee. Moreover we must not only make choice of a fit part of the Body for an Issue, but likewise of a fit place in the Member where it is made, which particularly requires the Judgement of a Physician, or skilful Chirurgeon: For we must be very careful that a Cautery or Incision be not admitted over, or too near the Tendons or greater Vessels: Nor must an Issue be made in the very Body of a Muscle, but in the Space or Interstice betwixt the Muscles; where the hole must pass the whole Skin and so much farther till the little Membrane of the Muscle underneath be penetrated, wherefore this operation is not to be committedindiscreetly to Quacks and others ignorant of Anatomy; for upon an ill performance herein there ensues not only a Frustration of all good, but often great prejudices thence arise, nay sometimes eve● to the hazard of Life. It's needless for me here to describe the way of preparing and compounding a Cautery, or the figure and uses of the Incision Instrument for making Issues, for these are commonly known, yet it will not be amiss to discourse somewhat here after what manner we must deal with the Symptoms which happen to those Emissaries after they are made, and hinder or pervert their Energies. There being many and sundry sorts of affects hapening to Issues, a Cure is not required for them all, but only for those of greatest moment: Therefore in the first place it is needed whenever an Inflammation happens to the part or place where it is. Secondly, if the Orifice voids more or less Ichor than it ought. Thirdly, if the Sore be apt to dry up of its own accord, and now and then to be covered with a little Skin, or to grow rank with a Spongy Flesh growing up in its Circumference. As to the lesser defaults, as when the Sore bleeds often, or if changing its place it gets by little and little into a worse, with many others in which it's wont to prevaricate, it will not be worth while to mind them here. 1. An Inflammation sometimes happens to an Issue, and that sometimes so great that it threatens a Spacelus or Mortification of the part, nay and sometimes brings it: Now such an affect comes either upon the fresh making of the Orifice, or happens afterward by reason of the Blood and Humours being upon some occasion put in a Commotion, and rushing in a throng to that place. When an Issue is first made, presently by reason of the Solution of continuity, and consequently the Blood's being somewhat letted in its Circulation in that part, some Inflammation and Soreness happen to all persons: But in some who have a very hot Blood, and little diluted with Serum, this proves much more violent, there hapening sometimes a Mortification of the part inducing a Spacelus: Or Secondly, the Blood there stagnating is changed into a Pus to be evacuated by an Abscess: Or Thirdly, which more frequently happens, and aught to be always procured in our case, the Blood causing an Inflammation is returned again into the Vessels, and restored to its Circulation by other Ductus' into which it is forced. But that it be conveyed back these two things are necessarily required, viz. First, that it be much diluted with Serum there plentifully abounding, or rather protruded into the part; And then Secondly, that the emptied Vessels behind the Tumour Drink up again the Blood diluted by the Serum, and driven back: For the Blood driven toward the Tumour, when it can go no farther forward, yet at least that upon lessening its Bulk it may go back, discharges Serum plentifully from itself, and drives it into the places obstructed; which entering into the stagnating Blood, dilutes it, and getting into tis place drives it into the Ductus' of the Vessels; and that Serum in the mean time passing forward exhales through the Pores, and so the Blood which was extravasated being diluted, and sent back by the Serum, and the Serum itself evaporated, the Tumour with the Inflammation vanish by degrees: But in case (as it often happens in hot Temperaments) the Blood extravased and driven into the Pores be not diluted with a plentiful access of Serum, it will not only stick there with obstinacy, but will cause a violently Inflamed Tumour with a Fever, and sometimes other dreadful Symptoms. Not long since a great Divine whose Blood was thick and hot, having an Issue made in the inside of his Leg, though the Skin only was cut, an Inflammation shortly followed, which grew so violent within a few Days that it could scarce be hindered from turning to a Gangreen by the use of any Remedies whatsoever. Wherefore when the Blood extravasated through a Solution of Unity, and wanting an access of Serum for diluting it, and carrying it back, tends to a violent Inflammation, Fomentations, and Cataplasms of Emollient things outwardly applied often do much good, because the moist and mild Parricles parting from them, enter the stagnating Blood, and dilute it, and so giving it a gentle motion cause it to return more readily into its Vessels; so that those moist applications outwardly used supply the defect of the inward Serum required for diluting the Blood: Nevertheless that the Blood so diluted, and put in motion be restored to Circulation, it's farther necessary that the Vessels which are to receive it be fufficiently emptied, for which end besides a slender Diet, Bleeding and Purging are often of necessary use; and indeed it is usual to Purge and often to Bleed Cacochymical, and Plethorical persons a little before, or after an Issue is made. Nor are these Remedies only proper to prevent or remove an Inflammation in case of a fresh Issue, but are likewise good whenever that affect happens to an Issue of a long standing: For if at any time the Blood being very impure, and withal Feverishly boiling enters upon an Excretory Turgescency, it often falls out that it deposes its Excrements and Filthy dregs about the Issue, being hardly to be Purged elsewhere, and that it being there hindered from its Circulation upon their being heaped together, is extravasated, and so causes a violent Inflammation: Such an affect lately hapening in an Ancient Nobleman, and at first neglected, soon turned to a Gangreen, from which nevertheless by the help of proper Medicines carefully administered both inwardly and outwardly, he escaped not without great danger of his Life. 2. If at any time an Issue discharges too much Ichor, which for the most part is thin, and of a very ill Smell, and sometimes discoloured, so that such vast Spend of Humour, and withal it's intolerable Stench requires a Cure: In such case there are two chief Therapeutic intentions, viz. First, to strengthen the mixture of the Blood that its Texture be not too prone to a Dissolution, and Fusion of Serum: And Secondly, to preserve the place Ulcerated by the Issue, and to keep it free from any Coruptive Ferment, so that no Noisome Filth there lodged may defile the Blood as it passes through in circulating, whereby being infected it may presently run into parts, and be forced to depose the Serum there in such abundance. The former scope of Curing orders scarce any thing but now and then a moderate Purge, and a good Diet, viz. that the person keep himself from all Surfeits, and irregularity as to the quantity, quality, and seasons of taking his Food; and particularly from thin Wines, Cider, and other Acid Liquors, with which the Blood is wont to be fused, and driven to flow of Serum: For Persons so affected most surely pay for any error or irregularity committed in Diet, a Pain presently being raised about the Issue. For the due Preservation of the Tone of the place where the Issue is made, and for keeping it free from Putrefaction, you must take a particular care that for avoiding all Nastiness, both the Solids to be put into the Orifice, and the Cover, be they either Plasters, Ivy Leaves, or Oyl-cloaths be changed twice a Day: For in some each of these soon gets an ill savour, and presently causes the Ulcer of the Issue to stink: In case this tends to Putrefaction, presently instead of a Pea, or Woodenpill, let a Pill of Virgin-wax incorporated with red Saunders and Verdigrease be put into it; and likewise let a Fomentation of the Decoction of St. John's Wort, Yarrow, Centory, etc. be applied Morning and Evening. 3. Sometimes it happens that an Issue even as a dried Fountain, discharges no Humour: The reason whereof usually is either because the hole being not deep enough does not penetrate the whole Skin, which is easily Cured by making it deeper; or the Sore though large and deep enough, yet still continues dry because the Serum does not readily nor freely separate from the Mass of Blood, this having too close a Texture and then the only Remedy is to wear within the Orifice, Solids more irritating, and working more strongly on the Mouths of the Vessels: For which purpose Pills are made of the Wood of Ivy, of Box, or of the Roots of Gentian, or of Hermodacts, and are often used with good success. 4. It often falls out that the Orifice of an Issue being too small, and distilling forth little Ichor is covered over with a thin Skin with the Pea included in it, and that with the hole it is healed up: For which default there is scarce a proper Remedy to be applied; wherefore (rather than still to fret the Skin to no purpose) it's better to let such an Issue close up, or to transfer it to some other place. 5. The Sore of an Issue inclining to heal, and being hindered from it, has very often about its edges, and sometimes in its Cavity a Spongy Flesh growing up; the reason whereof is that the Nutritive Juice conveyed to the ends of the Arteries, and Nervous Fibres, and not presently washed away by the Serous ichor, sticks there, and beginning to be assimilated extend, both those Vessels to fill the Cavity with Flesh; and the Blood in the mean while brought thither Forms within that Mass little Sprouts of Veins for its return; nevertheless that Flesh, as yet rough and shapeless, being kept from the greatest part of the Orifice, grows up above its Brim, and when it is risen so high that it can be no longer veiled and covered with the Skin, it continues still Naked and Spongeous: This Excrescency is easily enough Cured by sprinkling on it Escharotick Powders, of Allom, Colcothar, or Mercury Praecipitate; for these sorts of Medicines with their Acrimonious and Styptic force eat away the Flesh thus Luxuriant, repel the Nutritive Juice, and shut close the Mouths of the Vessels. When that superfluous Flesh grows continually and increases about the edges of an Issue, it's a sign that the Nutritive Juice abounds more there than the Excrementitious Humour, and consequently that in persons so affected that Emissary is not so very beneficial, wherefore under the pretext of this reason many are mightily averse from that Remedy (which certainly is inoffensive in most, though it be not equally advantageous in all.) There is now an unperswadable opinion which has taken footing amongst many here in England (I know not if it be so in other Countries) that an Issue or Issues dipose to Barrenness; wherefore to all married Women, and desirous of Children, this sort of Remedy, though otherwise never so conducing to their Health, is Religiously forbidden; though no reason is yet given for this strike Prohibition; only stories are told of certain Women having Issues who are Barren; when it is as easy to show more Barren Women without Issues, and many fertile with them: And truly I use to retort this as a chief Argument against that opinion, there being no need of any other. CHAP. V Instructions and Prescripts for Curing Cutaneous affects. IN the First place the Cuticle or Scarf-Skin being void of Life and Sense has scare any Diseases belonging to it: This sometimes being too compact hinders Transpiration; sometimes also by reason of some Accidents it becomes too gross and callous in some places: But of itself being absolutely insensible, it is not Distempered, though it be the cause that some affects, to be passed off haply by Transpiration, stick about the Superficies of the Skin; because the Recrements and Filthy dregs of the Blood and Humours being driven outward and having passed the whole Skin, when by reason of the close Texture of the Scarf-skin they are not able wholly to breathe away, fixing on the outward part of the Skin, they produce various discolourations and foul affects thereof: Of which sort chief are those we call Summer Spots, also Scorbutical and Malignant Spots, and likewise Spots and any other Stains whatever bedecking the Skin, or Scarf-skin with any Marks or Specks without any tumour or unevenness. As to the affects of the Skin itself in general, in regard they are various and of sundry sorts, they are wont to be distinguished in a various respect, and first of all that they are either with or without a Tumour: We took notice of these latter even now. Cutaneous affects with a Tumour are either universal, dispersed through the whole Body, or particular, raised in these or other Members at random, and as it were by chance. The former either happen in a Fever, as chief the Smallpox, Measles, and other Malignant Pushes, to which also may be added the Flitting breaking forth of Children which soon vanish; or they come without a Fever, as especially the Itch, the running Scab, and Leprous affects. Particular outward tumors happening sometimes in one part, and sometimes in another, for the most part are not only belonging to the Skin, but also to the parts under it, viz. sometimes to the Flesh, Membranes, or Glands, and consequently are of a various Nature and a differing Form? It would be too long to treat of all these here particularly, therefore at present I shall briefly speak merely of Cutaneous affects such as before mentioned. First, as to Summer Spots its a sign that they proceed from Choler and other yellow Recrements of the Blood, because they have: most familiar to those that are yellow Haired; again they happen to the Fairest Complexions, and in parts most exposed to the Sun and Air, because their Skin being of a subtle Texture transmits' the Humour rarified by the heat of the Sun, so far till it be stopped by a thick Scarf-skin, near the places where it should break forth: This affect as to the State of Health does not foreshow or threaten any ill: These Spots differ little or nothing from those they call Lenticular Spots. There are other large Spots about the breadth of the Palm of the Hand which defile the Skin in many places, but especially about the Breast and Back with Stains sometimes of a dun colour, sometimes wan, or blackish. These being wont to rise and go away at certain times, and as I have observed in many, in certain parts, are commonly called Liver-marks, though not properly, for these Stains happen on this account, that the Filthy dregs and Refuse of the Blood, when not sufficiently received by the Vessels of separation, are carried to the Skin together with the Serum, with which they are diluted, and there being thrown off by the Blood, and left by the Serous Latex which evaporates, they stick fast to the outward Pores and little Orifices, as a Mossy down does to the narrow passages of a River. Those Spots appear chief in the Summer, and most upon the Back and Breast, viz. at that time, and in those places that Men are most apt to Sweat in; that is to say, that Serous Latex which has carried those Filthy dregs from the Mass of Blood to the narrow Pores of the Skin, leaves them there, as being unmeet to pass forth by Evaporation. This affect has no evil joined with it, nor is it the Symptom of any present Disease, nor does it portend any shortly to ensue, and in regard for the most part coming in places out of sight it causes no deformity, or trouble, there seems little or no need of its Cure: But because an opinion is spread amongst the vulgar, that the Liver is much in danger by reason of those Spots, and that it necessarily requires help, therefore to fatisfy some importunately desiring Physic, besides outward Consmeticks we are wont to prescribe inward Hepatick Remedies; the use of which though not very necessary, yet because thereby the Blood is purified, and the Obstructions of the Bowels are opened, they are not altogether in vain. The inward Medicines useful for this purpose are set down before amongst Hepatick Remedies: The very same outward Remedies, or Topics are proper in this, as in all other kinds of Spots, of which we shall give you some choice Forms. Having treated elsewhere professedly concerning Spots of the Plague and Scurvy, I need not repeat them here; especially because the Method for these is quite dissering from that of the other: For in one kind of Spots in a manner only outward Medicines are wont to be administered without any that regard the Heart or the Viscera of the Belly, and in the other only inward things are given without applying any thing to the Skin. Therefore as to the Summer Spots, Lentiginous Spots, and the vulgarly called Liver Spots, the Art of Beautifying properly takes care of them, and for removing these Blemishes from the Skin, only Cosmetick Remedies are prescribed without any Method of Cure; there is an infinite store of these amongst curious Ladies, and others that are nice in keeping the Skin fair; but all of them having regard only to two intentions of Curing may be reduced to these two heads: viz. either by opening the Pores of the Skin, and Scarf-skin, and sometimes by excoriating this, they endeavour to draw the Humour outward, and wholly to evaporate it; or on the contrary they are administered, and that with no less success to strike back the Impure Matter which makes the Spots, and to drive it inward: I shall here set down some ordinary Forms of Topics of both kinds, which have been rationally invented, and often used suceessfully enough; since I may not without offence to great Persons unveil the more secret Mysteries of the Cosmetick Art, and prostitute them to the vulgar. First, therefore to cleanse the Skin, and to draw the Matter of the Spots outward. Take of a small Lixivium of Salt of Tartar four Ounces, Oil of bitter Almonds made by expression what suffices, let it be mixed in such a proportion that the whole Liquor presently turn white, and so let it stand: Let the parts affected be anointed and gently rubbed Mornings and Evenings with this mixture. Take fresh Roots of Aron, Briony, and Solomons-seale, of each an Ounce, Powder of Fenugreek Seeds a Dram, Camphire half a Dram, being bruised together pour to them Oil of Tartar per Deliquium three Ounces, express it, let it bapplyed with a Rag dipped in it twice a Day. Take Sulphurvive powdered an Ounce, black Soap two Ounces, bind it in a Rag, let it hang in a Pound of Vinegar for nine Days, then apply it to use, washing and rubbing the places affected with it twice a Day. Secondly, for the other intention, viz. for discussing the Spots from the Skin, and repelling the matter, and driving it inwards. Lac Virgins was a famous Medicine amongst the Ancients, and is still commended and used by many. The preparation of this is well known, viz. a Solution of lethargy made in distilled Vinegar, by the affusion of Oil of Tartar per Deliquium is precipitated into a Liquor as white as Milk: With which let the Face and Hands be washed and gently rubbed twice a Day: A Medicine like this, or the same, at leastwise of the same Virtue is prepared of a Solution of Minium or Ceruse made in the same Menstruum, and preclpitated with water of Allom, or Sal Gemm. (Or) Take Camphire sliced two Drams, bruise it in a Glass-mortar pouring on it by little and little the Juice of one Limon, then add to it of White-wine a Pound, strain it and let the Camphire remaining behind be tied in a Rag, and hung in a Glass. Take Verdigrease four Ounces, pour to it of White-wine two Pounds, being put into a Gourd-glass, let it be distilled in Sand, let the Phlegm first coming off be kept for use, wherewith let the Face be anointed twice a Day. For this purpose also the Dew or Phlegm of Vitriol distilled by itself does excellently well; some are content with the water of Bean-flowers, or the simple distilled water of Fumitory, or with the water which Bleeds from the Sprout of a Vine, cut in the Sprin: But the more curious Women and Pretenders to the mosis exquisite knowledge in the Cosmetick Art are scarce satisfied with any Remedies for the Skin but Mercurial: Wherefore the following water is highly recommended and sold by Empirics at a great rate for all Blemishes of the Face. Take Mercury sublimate an Ounce, being reduced to a Powder let it be put in a Tin-vessel with three Pounds of fountain water, let it stand for twentyfour hours stirring it now and then with a Wooden Spatula till the whole Liquor grows black, which nevertheless being filtered through Cap-paper becomes clear; a Rag or Feather being dipped into this, let the Face be gently done over with it once in a Day or two. This Medicine is of great efficacy against all foulness of the Skin, for it clears the Humours sticking in the little Pores and Orifices, though never so straight, and dissolves the obstinate and inveterate Combinations of the Salts and Sulphurs, and as to any ill Conformation of the Pores, it restores the whole Skin, and makes it freely perspirable. Wherefore it is not only good for cleansing the Stains or Blemishes of the Face, but likewise for removing Pushes, and the redness of it, and Erysipelous affects: Moreover it sometimes happens that many parts of the Face, but especially the Nose and Forehead are thick beset with blackish Specks as though burnt by Gunpowder; which nevertheless proceeds from hence, that the Sudatory Pores are filled sometimes with a black thick Humour, sometimes with little Worms having black head, (which little infects being squeezed forth of the Pores, and laid in the Sun are easily perceived to live and to move themselves) and in such an affect of the Skin, no Washes or Ointments but Mercurial are wont to do good: Nevertheless a too severe Sting often goes a long with this Honey: For the Particles of the Quicksilver, together with the Salts (with which they are minutely divided and quickened) being applied to the Face, discuss thence the offensive and defiling Matter from the Pores, and drive it away, and being struck inward they follow it, and soon insinuate themselves with ease into the Blood and Nervous Liquor (whose Crasis they injure) and through their means very frequently pass their Venom, often not to be rooted out afterward into the Brain, and sometimes into the Praecordia, and other parts: Hence it's frequently observed that Men or Women using long and much a Mercurial Ointment, become subject to the Vertigo, and Convulsive, or Paralytic affects, and that their Teeth turn black, and sometimes grow lose. CHAP. VI Instructions and Prescripts for the Cure of the Psora, or the Scab with the Itch. AFter the more simple affects of the Skin which happening without any Tumour or Sore, soil it only with Filthy Spots, I shall now speak in order of the greater affects dissolving continuity: And in the First place of the Psora or Scab which molests the Skin in most places of the Body with small Pushes, or break forth, being sometimes dry and often scally without much Itching, as in persons of a Choleric or Melancholic Constitution, sometimes moist and disposed for Ulceration with a mighty troublesome Itching, as in Persons of a moist Temperament, with a foul Blood: And this affect is most peculiarly a Disease of that part, seeing that it often has its beginning in the Skin itself by outward Contagion, and is frequently Cured by certain Remedies applied only to the Skin; at leastwise the reason of both holds good so far that it's seldom perfectly gotten, or Cured by other means. This Scab, or Itch is commonly described to be a breaking forth of Pushes here, and there through out the whole Body, proceeding from a sharp and salted Humour gathered together within the Pores of the Skin; and by reason of its mighty Itch, causing a necessity of scratching to discuss it thence. I conceive the Morbific matter of the Itch to be the Lymphick Humour constantly residing in the Glands of the Skin, but degenerated from its Genuine, viz. Salino-volatile Disposition, into an Acid, or otherwise vitiated Temper. That Lymphick Humour is wont to be depraved these three ways, and consequently falls into a Coagulative and Vicious habit with the Serum newly supplied from the Blood: viz. First, the Blood itself being very impure, and withal dissolved leaves a great store of its corrupted and Filthy dregs in the Glands of the Skin, which becoming there a Leaven more Corruptive, strongly ferment, and are coagulated with other adventitious or transient Juices, and so bring forth not only Scabby affects, but Leaprosies of divers kinds; hence frequent and continual feeding on Shellfish and others, and on Salt Meats, and such as have been dried in the Smoke or Sun: Also improper Drinks, and Venomous Medicines taken into the Body cause break out all over the Skin, and those often very dreadful. Secondly, the Humour gathered together within the Glands of the Skin sometime putrifying by mere Stagnation does not only breed Scabs, but also frequently Lice. Wherefore not only Persons long Imprisoned, but likewise such as leading a Sedentary Life use themselves withal to Stench and Nastiness, are still subject to the said affects. Thirdly, if haply those causes are wanting, that the Glandulous Humour of the Skin be neither defil'd through the fault of the Blood, nor its own Stagnation, yet a Virulent infection from without disposes it as readily to produce those Diseases, as it's daily manifested to us, the Effluvia flowing from the Pushes of a Scabby Skin, being of no less efficacy than Barm or Yeast, whereof if a very small Portion be put into new Ale unfermented, it presently ferments the whole Mass, be it never so great, and changes it into the nature of the Liquor whence it was taken. Therefore the Itch as to its Origine, either is taken by Contagion, or by reason of an ill Diet, its Incentive and Fuel is communicated from the Chyle and Mass of Blood being vitiated, or through nastiness and want of Perspiration it's generated in the Skin itself: To which we may add that Infants sometimes get this evil Hereditarily contracted from their Parents. Though this Disease be never Mortal, or very dangerous of itself, but always easy of Cure, yet it has often an ill issue, because being long continued it mightily vitiates the Blood, and the Nervous Liquor; and if Cured on a sudden, the Matter whioh is driven from the Pores being inwardly received, brings a pernicious Taint on the Praecordia and Brain, or on other Noble parts. The greatest danger from the Itch threatens Children, and Cachectical Persons, because in both these the Taint of the Cutaneous Humour is more easily sent into the Noble parts, which after the outward Contagion of the Itch is taken away, remaining within, cannot be throughly overcome but by a great deal of Physic (which neither of them can well bear) wherefore such persons ought to be preserved with all care and diligence from the Itch, as from the Plague itself. Concerning the Cure of the Itch there are two primary Indications, and both of them twofold: viz. the First being Curatory has regard to these two things, that the Glandulous Humour (its Corruptive ferment being wholly extinguished) be restored to its due Crasis. And then Secondly, that the Pores and Passages of the Skin itself being freed from those Concretions of Ichor recover their Ancient Conformation or free Perspirability. The Second Indication being Preservatory, provides against these two things, viz. First, that the Impurities and Corruptive Miasms of the Itch, which are driven from the Skin when the ferment is Purged, do not regurgitate into the Blood, and Nervous Liquor, and cause not only Discrasies' in them, but likewise (as it often falls out) bring great damage to the Brain and Praecordia. Secondly, it must be endeavoured that the infectious Taint of the Humours and Noble parts, contracted from the Scabby Matter, be eradicated at the same time that the Nasty Distemper of the Skin is Cured. All these intentions of Curing aught to be complicated, or at leastwise to be interchangeably prosecuted by Remedies both inward and outward used together, to the end that the Morbific matter being chased from its private Receptacles, may not any where retire and lie hid in any lurking places, but being pursued by Medicines in all parts both within and without, may be wholly removed; therefore Purges aught always to begin and end this Method of Cure, whatsoever Helmont says to the contrary, and I dare affirm that this Disease is scarce ever Cured easily, and never with safety without that Medicine. Moreover open a Vein one of the First things you do, unless somewhat indicateth the contrary; besides these let alteratives have their turns, such as purify the Blood, and strengthen the Viscera, and fortify them against the Ineursions of the Scabby Matter: And in the mean time let Liniments, or Baths, or Topical Remedies of other kinds, and appropriated to the Skin be applied, for without them, not only cathartics and Bleeding, but even Diaphoreticks, Diuretics, nay any kind of Medicines whatsoever evacuating or altering the Blood and Humours prove of no effect: We shall set down some select Forms of the Medicines of each kind before mentioned: And First, for due Purging give a Purging Medicine, or a Vomit the first thing you do: Also after Bleeding (if it be necessary) let the person use a Purging Apozem, or Ale for seven or eight Days. Take the Electuary Diacarthamum three Drams, Species of Diaturbith with Rhubarb a Dram, Cream of Tartar, Salt of Wormwood of each half a Scruple, Purging Syrup of Apples what suffices, make a Bolus to be taken with Governance. (Or) Take Sulphur of Antimony seven Grains, Scammony Sulphurated eight Grains, Cream of Tartar half a Scruple, make a Powder. Take Roots of Polypody of the Oak, and of sharp pointed Dock prepared of each an Ounce, Leaves of Sena ten Drams; Turbith, Agarick, Epithimum of each an Ounce, Carthamus' Seeds half an Ounce, yellow Saunders two Drams, Seeds of anise, and Caraway of each two Drams, being sliced and bruised digest them close luted and warm in four Pounds of White-wine for twentyfour hours, pour off the clear Liquor without expression, the Dose is six Ounces by itself, or with a spoonful of Syrup of Epithimum. (Or) Take the foresaid Ingredients and boil them in six Pounds of fountain water, to half, then add of White-wine a Pound, and strain it presently; make an Apozeme, give it after the same manner. (Or) Take Roots of Polypody of the Oak, and of sharp pointed Dock of each three Ounces, the best Sena four Ounces, Epithimum, Turbith, Mechoacan of each two Ounces, yellow Saunders an Ounce, Coriander Seeds six Drams, let them be prepared according to Art, make a Bag for four Gallons of Ale, after five or six Days drink it, and take to twelve Ounces more or less every Morning for eight or ten Days. For ordinary Drink let a little Vessel of four Gallons be fulled with small Ale, into which put the following Bag. Take tops of Tamarisk, Fumitory dried of each four handfuls, Roots of sharp pointed Dock dried six Ounces, Rinds of Bitter-sweet two Ounces, being sliced and bruised mix them; or let a Bouchet of the Decoction of Sarsaparilla, Saunders, with the Shave of Ivory, Hartshorn, Licorice, etc. be taken. As to altering Remedies besides the Physic Ale for ordinary Drink there seems not need of many others, only that a good Diet be observed by avoiding Salt and Peppered Meats, Shellfish and others which have been laid in Brine: Also let them forbear Wine, strong Waters, strong Beer, and all Liquors apt to trouble the Blood too much, and to ferment it: In an obstinate Scab, seizing a Cacochymical Body it's proper to give the following Electuary with the distilled water twice a Day. Take Conserve of Fumitory, of the Roots of sharp pointed Dock of each three Ounces, Troches of Rhubarb, Species Diatrion Santalon of each a Dram and a half, Salt of Wormwood a Dram, Vitriol of Mars four Scruples, with a sufficient quantity of Syrup of Cichory with Rhubarb, make an Electuary, the Dose is from a Dram to two Drams twice a Day, drinking after it of the following distilled Water three Ounces. Take Fir Tops seven handfuls, Leaves of Fumitory, Agrimony, Female Fluellin, Liver-wort, Brooklimes, of each four handfuls, Roots of sharp pointed Dock two Pounds, Rinds of Elder two handfuls, the outward Rinds of six Oranges, being sliced and bruised, pour to them Whey made with middling Ale eight Pounds, distil it in common Organs, let the whole Liquor be mixed. Ointments to be anointed on the Skin are prescribed most frequently, and that very effectually for Curing the Itch: Though those that are used to many other tumors and Sores do no good here: But Sulphur and preparations of it, seem to have a certain Specific Virtue in this Disease, so that they are ingredients in almost all Ointments for the Itch, and are the basis of the whole Composition. This is a very common receipt with the vulgar. Take of the Powder, or Flowers of Sulphur half an Ounce, Butter without Salt four Ounces, Ginger powdered half a Dram, make a Lineament. Somewhat a neater prescript, though not much more Efficacious, is after this manner. Take Vngentum Rosatum four Ounces, Sulphurvive powdered half an Ounce, Oil of Tartar per Deliquium what suffices, make a Lineament, to which add Oil of Rhodium a Scruple, to give it a scent. When you will strengthen or raise the Energy of the Sulphur by the addition of other things. Take of the Ointment of Elecampane without Mercury four Ounces, Power of Sulphur half an Ounce, Oil of Tartar per Deliquium what suffices: For the same purpose an Ointment is made of the Roots of sharp pointed Dock boiled in Butter, or Oil with White-wine till the Wine be consumed; and with Sulphur and Oil of Tartar. Moreover those Ointments are sometimes used by themselves, by curious persons abhorring the ill odour of the Sulphur. The Third kind of Lineament against the Itch is made of Mercury needing no assistance from Sulphur, or Vegetables; nay this being more than enough efficacious of itself, is not wont to be applied to the whole Body, but only to the Joints of the Arms and Legs, or being put in a Girdle is to be worn about the Loins, for so it seldom fails of Curing the Itch: Nevertheless there is danger lest this Practice (as it often happens) causes ill and pernicious Symptoms: Frequently after the Mercury Ointment a Salivation, sometimes also a Scotomia, or Sleepy, or Conunlsive affects ensue: Moreover sometimes the Poison of the Medicine produces within the Praecordia, or Viscera, horrible affects of the Asthma, Leipothymia, or Bloodyflux. The vulgar Form of a Mercural Ointment for the Itch, and very much in use, is this. Take Quicksilver reduced into minute parts with an Acid, and (as they call it) Killed, an Ounce and a half. Fresh Haggs ●ard six Ounces, incorporate them well by stirring them a long 〈◊〉 in a Stone or Glass Mortar. Nor only in the Form of a Lineament, but many other ways the foresaid Medicines may be used: For the Fume of Cinnaber (which is prepared of Mercury with Sulphur,) cast on the Coals, and taken in at the Mouth, or breathing against the Superficies of the Body, Cures the Itch: The Mercurial Cosmetick water before written made about half weaker, and applied to the Skin with a little Cloth in the Sorest places, kills the Itch: Yet the use of these is not so very safe as to be generally administered to all persons. Of Sulphur and Vegetables either separately, or conjunctly, boiled in water Baths are prepared, which Cure this Distemper, not by washing off only the Filth of the Skin as common Baths, but likewise by destroying its ferment: Besides these there is yet another easier, and much more neat way of Curing the Itch, viz. by boiling a Shift in fountain water with Powder of Brimstone, and after it is dried in the Sun, or before the Fire to wear it four or five Days next the Skin: For so that Disease is wont to be Cured without Bathing, or the Nastiness, or ill Odour of an Ointment. Poor people usually Cure themselves of this Distemper only by taking the Powder of Brimstone in Milk inwardly, and by anointing themselves with the said Powder mixed with Butter outwardly: Sulphur seems to be so Specific an Antidote against the Itch by reason of its Balsamic Virtue which destroys the Acidities, and all Exotic and Corruptive Sharpnesses of the Blood and Humours, and restores to each Latex a Benign, that is, a Mild, and as it were Oily Nature. As to Mercury, it's no wonder if medicines made of it, perfectly Cure any places of the Skin infested with the Itch wherever they are applied: For by the application hereof breaking's forth, and all Virulent Ulcers, viz. any that are Venereal and Scorbutical are wholly conquered: Moreover it seems not strange that this Medicine applied to some particular place should Cure an inveterate Itch in case it raises a Salivation; but sometimes it Cures without any such thing, as when a person wears a Girdle of it; to this we say that the Particles of the Mercury pass then into the Venous Blood, and after being diffused through its whole Mass, are driven outward from all parts, and deposed in the Skin where they kill the Itch, and when it happens that these Mercurial Particles are all again evaporated through the Skin, after the Cure is performed, than no Salivation, or other inconvenience ensues. CHAP. VII. Instructions and Prescripts for the Cure of the running Scab, or the Leprosy of the Greeks. AFter the Scab with the Itch, it follows that we treat of another affect somewhat allied to it in its breaking forth in Pushes, which is commonly called the running Scab, by some a Tetter or Ringworm, or Morphew, by others the Leprosy of the Greeks; but the Names of this affect being variously confounded, and the Nature of it haply being differing in several Countries, I shall describe it as it is now understood by us. The running Scab gins and affects persons after this manner, viz. First little red Wheals or Pushes, sometimes single, sometimes many of them joined together, arise in many parts of the Body, but especially in the Arms or Legs; and grow at length in heaps or clusters; the Surface of each Scab when grown in clusters appears rough, and somewhat whitish and scaly, so that upon scratching, Scales fall away, and a thin Ichor often issues forth, though it's soon dried again, and hardens into another crusty Scale. These clusters of Pushes at first are but small and few, as in the Arm or Legg, or some other particular Member, haply three or four appear to the bigness of a penny or two pence: Afterwards if the Disease be suffered to increase, they break forth in many places, and grow to a crowns breadth, and at length if not stopped, cover not only particular Members, but the whole Body with a whitish Leprosy, which raised to this degree was judged for the most part incurable by the Ancients. These break forth in some are only temporary, as coming in the Winter, and going away in the Summer, in others on the contrary they come in the Summer, and vanish in the Winter: In many others this Distemper is continual, having no time of remission or mean. The running Scab differs from the Itch, that in this the Pushes are generally single, and separated from each other, though but by small spaces, but in the other they rise in clusters: Again the Itch is extremely infectious, but the running Scab is not so. This Disease is also distinguished from the Leprosy, that this is likewise as infectious as the Itch, and its break out are much more violent and terrible than in the running Scab, widow viz. being crusty and scaly, and diffused in a continued manner throughout the whole Body. Hence it appears that the material cause of the running Scab is not a mere Cutaneous Humour depraved and degenerated from its Crasis by reason of some Corruptive Effluvia's received from without, or upon other occasions; because the infection is not easily communicated to others, as in the Itch, nor presently dispersed through the whole Body; but the Pushes first breaking forth about the beginning of the Disease seem to proceed from hence, that some Acido-saline Concretions happen in the Mass of Blood (like Tartar in Wine) which seeing they can neither be subdued, nor again dissolved are driven to the Skin, as to the sides of the Vessel. This Disease takes its rise for the most part on two chief occasions, viz. First, from an ill Diet, as from frequent eating of Salt Meats, Pork, Shellfish, or others, or Secondly, from the corrupted Seminaries of other Diseases left in the Body, as especially of the Scurvy, and French-pox ill or not Cured. For First, those sorts of Food either because they are rank, or otherwise disproportioned, convey Particles to our Blood, that cannot enter a due mixture with it, or are not easily mastered by it: To which Heterogenevos Particles gathered together in great abundance by long continuance of such Diet, Saline Particles of all kinds readily associate themselves, and so make Tartarous Concretions, which are driven to the Skin, and are the Seminaries of the running Scab, or Leprous affects. Secondly, the Miasms of the Scurvy and French-pox lest left in the Body, and at long run raised to the highest degree in Combinations of Exorbitant Salts and Sulphurs, engender a most plentiful Seminary of this Disease: For the corrupted Taints of the Blood, after that upon long continuance they are become wholly Heterogeneous and unsubdueable, gather to themselves at length the Saline Particles, with which growing together in that Tartarous Concretion, and driven to the Skin, they produce Eruptions of the running Scab. Concerning the Crew of the running Scab there are two primary Indications, viz. the Preservatory which regards the cause of the Disease, and the Curatory which has regard to the Symptom, viz. the breaking forth of Pushes: The Vital has seldom place in this case, unless grown altogether desperate, where there is a deficiency of Sleep and Strength: The Method of Cure ought always to begin with the Preservatory Indication, which removes the causes of the Disease by inward Remedies, for otherwise outward things are scarce ever administered to any purpose (as in the Itch) but the roots of the Disease being cut off within the Blood, the Cutaneous Pushes soon die away: Though for removing them we must proceed one way when the running Scab gins of itself, and somewhat a differing way when it comes after an inveterate Scurvy, or the French-pox, ill or not Cured: We shall consider each of these cases severally and distinctly by themselves. When therefore this Disease is simple, and primary, and fresh coming, let the evident and external cuases be removed, let the ill Diet and the Unwholesomeness of the Air be corrected; therefore let persons who have been long and too much used to feed on Salt Meats, Pork, or Fish betake themselves to a Diet of good Juice, and easy of Concoction. Moreover if they live by the Sea side, or in Marshy places, let them remove to a more dry and clear Air; and withal let them be as careful of their Drink, avoiding thick and dreggy Beer, and thin and acid Wines which are too much filled with Tartar: Finally let them take care that their Drink or Food be not prepared of Mineral waters apt to petrify. 2. In respect of the Conjunct and Procatarctick cause, viz. a Saturation of the Blood with Saline Particles of a differing Disposition and Nature, there are two chief intents of Curing; to wit, that the Blood and Humours be forthwith cleansed of their impurities: and that the Acido-saline Discrasies', of the Blood and Nervous Liquor be altered for the better to keep them from engendering a Tartarous matter: For which ends both evacuating Remedies of divers kinds, and altertives are wont to be prescribed: Nevertheless because not all but in a manner only great Remedies are here proper, therefore those that are chief in use, and found to do most good, are cathartics, Bleeding, Whey, Mineral waters coming from Iron, Juicy expressions of Herbs, Decoctions of Woods, Chalybeat Medicines and Salivation: We shall set down certain Forms of each of these, and the manners of ussing them. In the Frist place therefore, a general Purge and Bleeding (as in the Cure of the Itch) being premitted, let the following Cathartick Infusion or Tincture be prescribed, whose Doses is from six Ounces to eight, to be repeated whithin six or seven Days. Take Roots of sharp pointed Dock dried, of Polypody of the Oak of each half an Ounce, Sena ten Drams, Epithymum six Drams, Rhubaru, Mechoacan, of each half an Ounce yellow Saunders two Drams, Celtic Spike half a Dram, Salt of Tartar a Dram and a half, put them in a Glass with three Pounds of White-wine, and a Pound of Elder-flower water; let them stand close covered in a cold place for three Days, then use it, pouring forth daily a sufficient quantity of the clear Liquor, Secondly, to sweeten the Blood, and cleanse ti from its Salts, drink every Morning to two or three Pounds of Whey by itself, or with Fumitory, preparations of Cichory, and with sharp pointed Dock infused in it, and let this Drink be continued for twenty or thirty Days if it agrees with the Stomach, and withal in the Evening and early in the Morning let a Dose or the following Electuary be taken. Take Conserve of the Roots of sharp pointed Dock six Ounces, Crabs Eyes, Coral prepared of each two Drams, Ivory a Dram, Powder of Lignum Aloes, yellow Saunders of each a Dram and a half, Sal Prunella two Drams, Vitriol of Mars a Dram and a half, Syrup of the Juice of Woodsorrel what suffices, make an Electurary, the Dose if two Drams. Thirdly, for the same reason as Whey, also Mineral waters coming from Iron are prescribed against this Disease, and often do great good: For when all other Medicines have proved of no effect, I have sometimes Cured a great and almost Leprous running Scab with this alone: Moreover to add to their efficacy we may fitly join the use of Sal Prunella, or of Vitriol of Mars, or of the Electuary before written. Fourthly, in some persons having much Serun, and a Watery Constitution, where drinking of Whey, or Mineral waters is not proper, it is good for them to take constantly a Decoction of Woods at Physical hours, and likewise for their ordinary Drink. Take Rasping of Willow-wood half a Pound, Roots of Sarsaparilla eight Ounces, white Saunders, Wood of the Mastick-tree, of each two Ounces, Shave of Ivory and Hartshorn of each six Drams, Shave of Tin, crude Antimony of each four Ounces, both tied in a Rag; Licorice an Ounce, let them infuse according to Art, and boil in sixteen Pounds of fountain water of half, keep the straining for use. Fisthly, Chalybeat Medicines, because generally accounted of among the more excellent Remedies, are seldom omitted in this Disease, though they as seldom prove successful: For a great many preparatious of Iron in which the Sulphurous Particles predo minate for as much as they ferment the Blood, and put it upon Excretory Effervescencies, increase rather than diminish the Eruptions of the running Scab: Nevertheless Vitriolic Salts, Syrups, Tinctures, and Infusions in regard they fix the Blood, and somewhat restrain the Exorbitant excesses of the Salts, answer aptly enough to the intention of Curing now proposed, but being too weak cnnot master so Herculean a Disease. Wherefore Sixthly, these, and a great many other Remedies doing no good, many reommend Salivation as the stoutest Champion, and only fit to contend with so potent an Enemy: Yet the event does not always answer this mighty expectation, for I must own to have tried this Remedy myself in four persons afflicted with a grievous running Scab, not yielding to other Medicines, but without any benefit; some of these were put in a very high Salivation by a Mercury Unction, others by Pills of the Solar Praecipitate, which Salivation they lay under for about twenty Days, after which time all the Scaly break forth, and clusters of Pushes vanished: Nevertheless for perfecting the Cure a Diet Drinkd ordered of the Decoction of Sarza with frequent Sweeting under a Cradle, and dew Puring betwixt while was continued for a Month: Yet this course being ended when no footsteps of the running Scab seemed to be left behind, within the second Month a new stock of the same Disease biginning to spring forth, grew up in a short time to its wont Maturity: Moreover when one of these persons would repeat this Medicine, and another after two returns of the Di2ease would try it a third time, both of them at length despaired of Cure after they had underwent so much Misery: Whence it appears that the French-pox though Malignant in the highest Nature, and causing most Filthy and Virulent Ulcers consuming the Flesh and Bones, may much more easily and ceratinly be Cured than the running Scab. The reason of ti is, that the cause of the Pox consists in a Malignant and altogether Heterogeneous Miasin defiling, and as ti were Poisoning the Blood and Nervous Liquor for some time, though not wholly subverting their Crasis, or utterly depraving them for the future: Wherefore that Cure is performed by Salivation, or a Sweeting Diet, extirpating all that Venom, the Genuine Disposition of the Blood and Humours then remaining: But in a deep sort of running Scab the Elementary and Originally composong Particles of the Blood are corrupted, so that unless the Crasis and due Disposition of these be restored, all sorts of Evacuations, and Purge of the Malignant and Venomous matter, though never so fll and eradicative will effect little or nothing: Wherefore it is not without ground that many famous Physicians formerly have judged this Disease when coufirmed, and drawing near to a Leprosy to be hardly or never Cured. 2. No better event attends this Disease when if succeeds an inveterate Scurvy: Haply the intentions of Curing are somewhat more certainly pitched upon when this effect is supposed to be the basis or root of that: viz. the Terapeutick intention being thence taken, we insist chief on Antiscorbutic Remedies; but yet the more smart and hotter things of this kind, as Scurvygrass, Cresses, Horse-raddish, Pepperwort and other things irritating the Blood too much, in regard they more dissolve its Crasis, and drive the Tartarous Concretions more plentifully to the Skin, are always found rather prejudicial than advantageous: And for this reason the use of hot Baths or Bathing in hot waters, which in regard it evacuates the Humours of the whole Body by a most plentiful Sweat, and cleanses the Pores of the Skin, and mightily purges them, amy seem to be very available in this Disease, most commonly is so far from doing good, that the Eruptions are wont thence to be mightily increased, and exasperated: For I have known many persons not very much over-gone with the running Scab, who going to our Bath to bathe themselves in the hot waters have returned thence perfectly Leprous: Wherefore when this affect is a Symptom arising from the Scurvy, all Smart, and Elastic things being avoided, let only the more temperate, and such as are endowed with a Nitrous, Vitriolic, or Volatile Salt be administered: We shall give you some kinds and froms of each of these sorts. In the First p; ace things chief excelling in a Nitrous Sal are Crystal Mineral, the Juices or Decoctions of certain Herbs, and some Purging Mineral waters. Take Crystal Mineral, or Nitre purified to the highest degree an Ounce, Flowers of Sal Armoniac a Dram, bruise them together in a Glass Mortar, give to a Dram thrice or four times in the space of twenty four hours. Take Leaves of the great House-leek two handfuls, being bruised boil them in two Pounds and a half of fresh Milk till it turn to Whey and Curd, being strained let the clear Liquor be taken to a Pound twice a Day. Take Leaves of Dandelyon six handfuls, being bruised put them in a Glazed Earthen Pot with a cover, which put in an Oven after the Bread is draum, and let it stand for six or eight hours, than the Mass being put in a strainer let the clear Liquor run out, the Dose of which is from four Ounces to six thrice or oftener in a Day. Cucumbers being endowed with a Nitrous quality are found by experience to be good against this Disease, wherefore let store of them be often eaten, as a Salad. Moreover let three or four of them being cut into slices be infused and close stopped in three Pounds of fountain water all Night; to the clear Liquor poured off, add of Sal Prunella two or three Drams; the Dose is half a Pound thrice or oftener in a Day; for the same purpose also Decoctions of the Leaves together with the Fruit made in fountain water are proper. Some Mineral Purging waters, as especially those of North-hal, being resolved by Evaporation mainifestly show the Nitrous Salt wherewith they are imbued: And I have sometimes found by expericence that daily drinking about two quarts of them for many Days Cures a small running Scab. 2. But as I have hinted before, Mineral waters endowed with a Vitriolic Salt, as those of the Spa, and ours of Tunbridge and Astrope far exceed those Nitrous waters, nay and all other Medicines, and are of greater efficacy in the Cure of the running Scab. To those who have not the conveniency of using these waters, I ordinarily give with good success against this Disease common waters impregnated with our Steel, and so most exactly resembling those Mineral waters. It happens that Tin and Antimony by reason of their Mineral Salts, or at leastwise by reason of the Mercurial Particles in them are extolled by many for curing the running Scab, and are wont to be prescribed with other Medicines. Letoy Shave of Tin, and Powder of Antimony be infused in Beer for ordinary Drink; they enter also the Decoctions of Sarza with Woods which are ordered against this affect. The use of the Viper, and preparations of it, sufficiently recommend the excellent Virtue of Volatile Salt for the Cure of the deep sort of running Scab, nay of the Leprosy itself: For it being manifest by frequent observations that Remedies prepared of Vipers do good in the running Scab, and Leaporfie, certainly the reason of the help it affords aught to be ascribed to the Volatile Salt, with a great plenty of which this Animal is endowed: For the Particles of this destroy the fixed and acid Salts predominating in the Blood of the Diseased, and dissolve their Combinations; Nevertheless the Salt, Spirit, and Oil of Vipers Chemically extracted, by reason of their Empyreumatick, and mighty Elastic Particles, which they draw from the Fire, are not proper in this Disease; so neither the Spirit, or Volatile Salt of Harts-born, Soot, or Blood, and other such like Armoniacks, because by exagitating the Blood and Humours above measure, they cause their Crasis to be more dissolved, and their Corruptions to be driven forth more plentifully to the Skin: Wherefore the more simple preparations of Vipers, as Broths of their Flesh boiled in water, Drinks impregnated with Infusions, or Incoctions of the same, and Powders made of the same dried and beaten are rpescribed with more success against this Disease: Moreover not only the Flesh of Vipers, but of other kinds of Oviaprous Snakes being boiled and eaten for ordinary Food, give often great relief. The running Scab, or scaly break forth of Pushes, and growing in figures like clustering is so frequent and familiar a Symptom of an inveterate French-pox, that the first thing we do is to ask persons affected with the former Distemper, whether they do not conveive that there amy be something of the Malignity of the other buying hid withim them; and if it be found to be so, presently all Specificks against the former and Antiscorbutics being laid aside, we forthwith betake ourselves to Decoctions of Woods, and those doing little or no good, to Mercurial Medicines, And truly by this Method I have soon and easily Cured many persons accounted to have a running Scab, and Leprosy, who had been long under Cure, and miserably tormented with Remedies appropriated to these Diseases: And we refer this kind of running Scab to the Pathology of the French-pox, whereof it is an Appendix. The Second Indication which is Curatoyr, having regard to the Disease it sefl, and its primary Symptom, viz. the scaly break forth, and the clusters of Pushes, prescribes Topical Remedies to be applied to the Skin outwardly for removing these effects: For which purpose Baths and Liniments are peculiarly proper; though they seldom, or never Cure of themselves, unless the Procatarctick ause, viz. the Tartarous Disposition of the Blood be first cleared. There is a mighty store of these Topics to be found as well among Physical Authors, as among Empirics and Quacks: Though among them all, Baths or Liniments made of Tar far exceed all the rest of the Remedies of both kinds: So that in truth we should make use of these alone were it not for their ill smell: wherefore I shall give you certain Forms of Compositions with Tar and without it: Therefore for Baths it's a common thing to use water kept some time in Vessels in which Tar has been before, and so impregnated by Infusion. (Or) Take two Pounds of Tar, and incorporate it into a pretty thick Mass with white and sifted Ashes, which boil in a sufficient quantity of fountain water, adding Leaves of ground Ivy, Fumitory, white Horehound, Roots of sharp pointed Dock, and of Elecampane, of each four handfuls: Make a Bath to be used with governance; or let such a Decoction be prepared without Tar for persons troubled with the running Scab, and loathing the smell of Tar. Sulphurous Baths, both Natural and Artificial, are found by frequent experience not to agree, nay and the former commonly to do hurt: Moreover all Bathing whatsoever ought to be used with great caution; for in regard this Administration exagitates and heats the Blood, it endangers to dissolve its Crasis more (as is said before) and to disperse its corrupted Taints in a more plentiful manner to the Skin. 2. Liniments, whose use is more safe, and proper, are of three kinds, or degrees, viz. gentle, mean, and strong: I shall give you an example or two of each of these. 1. First, therefore in a small running Scab, where the break forth and clusters of Pushes are few and very small, fasting Spittle is recommended: Also the Liquor distilling from green Wood in the Fire: So likewise a mere rubbing with the Root of sharp pointed Dock bruised, and macerated in Vinegar. (Or) Take Oil of Tartar per Deliquium, Oil of Nuts, or of bitter Almonds by expression, of each equal parts, make a Lineament to be applied to the places affected twice a Day. 2. Liniments of the Second kind have Tar for an Ingredient which is esteemed as good as all the rest. Take Vnguentum Rosatum six Ounces, Tar two Ounces, being melted together let them let mixed. (Or) Take a good fat piece of Wether's Mutton, stick it with bits of the Roots of sharp pointed Sock, spit it, and roast it: And baste it with Tar, letting it drop leisurely on it, keep the Dripping as a most excellent Ointment for the running Scab. 3. The strongest Ointments against this affect are Mercurial, which consist either of running Mercury, or Praecipitate; let the Forms and Cmposition of the foreigner be the same as is prescribed before against the Itch. As to the other, Take white Praecipitate three Drams, Vnguentum Rosatum three Ounces: Mix them, to anoint the parts chief affected: The use of these in this Disease ought to be very much suspected: For if haply a Salivation be raised, a mighty glut of Matter sticking in the pores of the Skin will be put in motion, which if the whole, rushing too much together towards the Ductus Salivales, gathers in a body about the parts of the Throat, it will endanger Suffocation. Some years since a Virgin of a noble Family, whose Temperament was hot, as having originally a sharp and salted Blood, after having lived a very long time, almost from her Cradle somewhat touched with a running Scab, about the time of her coming to ripeness of years began to be troubled with it in a more grievous manner: For clusters of scaly Pushes did not only every where overrun her Arms, and Thighs, and other parts of the Body out of sight, but likewise made her Hands and Face so loathsome, that she was ashamed to go abroad and converse with others of her quality: An infinite number of the lesser sort of Remedies were given her without any success: By the use of hot Baths she seemed to grow better at first, but in the end she became worse after them. The waters of Astrope wells which have perfectly Cured some persons of a running Scab, did her little or no good; wherefore seeing all ordinary Methods would not do, I proposed that she should try Salivation, as being a more powerful Remedy than all the rest, and (as it's said) the last: The Patient and her Parents readily consenting to this advice, presently her Body being duly prepared by Purging and Bleeding, I gave her (after our wont manner) Pills of the Solar Praeciptitae for two Days, and after the Intermission of one, the Medicine being repeated the third time she began to Salivate very well and freely, it continuing upon her for a Month without any ill Symptom: Nevertheless to keep it in its due Tenor, I took care that a Mercurial Ointment was now and then applied to the Joints of the Limbs, sometimes to these, and sometimes to others: Before this course was ended all the breakngs forth were vanished; Notwithstanding which to perfect the Cure, and withao to extirpate the Mercury, she spent another Month in Purging, Sweeting under a Cradle, and in a Diet Drink of a Decoction of Sarsa, China, etc. at which time seeming to be perfectly Cured, she continued so for about forty Days: But from thence forwards, though she observed an exact Form of Diet, the same Disease began to spring forth afresh, and increasing by degrees, rise at length to an overgrown state as before: I, being in some confusion at this event, persuaded her to hope an alteration for the better after the flowing of her Menses, which, having not yet happened, was expected in a short time: Nevertheless after long expectation, that Excretion at length happening, and thenceforward continuing its constant course, brought no Cure or relief to that Disease, but rather made it worse: Wherefore she had recourse again to Physic, and tried sundry sorts of Remedies, almost of all kinds: Which proveing all of no effect, her Friends earnestly desired that she should enter again the course of Salivation, hoping that that Method which Cured her at first for a short time, being used again, would Cure her at least for a longer, or haply restore her to her perfect Health: Therefore according to their desire the same course of Salivation and Sweeting being repeated for the two months' space, and thereby the Pushes and Scaly break forth being every where vanished, the noble Virgin seemed then again to have recovered her Health: But within six Weeks after the course was finished, the Pushes, and their heaps, or clusters appear again, and daily increasing by degrees in number and bulk, at length rendered the Body all over in a more loathsome condition than before. I knew another, a robust Man of an Athletic habit of Body, who after he had been troubled with a running Scab many years, the Disease at length growing worse, and being risen to an overgrown state, had his whole Body covered over with a white, and as it were Leprous Scurf: So that every Night the Scales falling off in a great pleaty within the Bed like Bran, might be gathered up in heaps: This person, in order to his Cure, first tried ordinary Remedies almost of all kinds, but without any good: And then having undergone a gentle Salivation of Mercury, he found himself nothing better; afterward that Method being repeated, after a long and high Flux, he seemed restored to his Health: But within three Months the same Disease springing forth afresh, rise in a short time to its Ancient Enormous state: Nay and having undergone this irksome kind of Cure a third time, that affect seeming for a while to be driven away, returned again, and thenceforward in despite of this, and any other Method whatsoever, exercised its Tyranny during the Life of the Patient: I need not say any thing of the Leprosy, which being only a more intense degree of the former Disease, seems scarce to admit of any Cure. THE LONDON PRACTICE OF PHYSIC, Contained in Dr. WILLIS'S Tract OF CONVULSIVE DISEASES. CHAP. II. Instructions and Prescripts for the Cure of the Falling-sickness. THE Epilepsy, or Falling-sickness is thus described; First, as to the Idea of the Disease, a Fit of the Epilepsy seems to be an Universal, and only a more violent sort of Convulsion; in which the Spirits that are in the Brain being first irregularly moved, and as it were in Confusion; all the rest residing in the Appendix both Medullary and Nervous of the Brain fall together into Convulsive motions, or disorderly contractions, and continue them for some time, with frequent twitchings. The access of the Disease for the most part is by way of surprise, so that the Diseased fall suddenly on the ground, grind their Teeth, foam at Mouth, and often beat their Heads against the ground; their Arms, and Legs in the mean time, nay and their Neck and Back either presently become stiff, or are twisted in and out with various Flexions; some violently beat their Breast, others stretch forth their Arms and Legs with great force, and impetuously throw them, and sometimes the whole Body from one place to another: In many the Praecordia and Hypochondres, and all the lower Venture swell, and are greatly blown up: After some time, which is sometimes shorter, and sometimes longer, these Symptoms cease on a sudden, and then the Sick come to themselves again, and recover their Senses, there remaining nevertheless after the Fit a pain of the Head with a drowsiness, and a deadness of the Senses; and often a Vertigo and Scotoma. Epileptical Fits are wont to return sometimes, at set times of the day, month or year, but for the most part they are wont to have a more certain return, and to seize more violently according to the greater changes of the year, or the conjunctions, or opposite aspects of the Moon or Sun; sometimes the accesses are erring and uncertain according to the occasion and variety of evident causes: And the Fits are sometimes more mild, soon passing away, so that the Diseased scarce fall on the ground, or are deprived of Sense; sometimes they are more violent, keeping the person Senseless for many hours, and inducing other dreadful Symptoms. Sometimes, though seldom, certain Signs, forewarning a Fit, give notice to the Diseased before hand, as a heaviness of the Head, a flashing of the Eyes, a ringing in the Ears: Sometimes in some exterior part, to wit, in the Arm, or Legg, or also in the Back, or Hypochondres, a Convulsion precedes, which, ascending thence like a cold wind, and creeping towards the Head, seems to cause a Fit of the Falling-evil: Nor is it less usual for it to have its beginning in the Stomach, Spleen, Womb, Intestines, Genitals, and other of the Viscera, and to pass thence to the Head in like manner. It is to be observed that sometimes the Epilepsy terminates of its own accord, viz. about the time of Puberty, so that those who are not Cured before that period is past, viz. the twentyfifth year, scarce ever recover their Health: For about the time of Puberty a double alteration happens to humane Body, and therefore often a release from the Epilepsy, or any other Disease more deeply rooted: For First, at this time the Genital Humour gins to be gathered together in the Spermatick Vessels, whence it follows that the Spirituous Particles, and the Nitro-sulphureous which are wont to accompany them, and such as are Morbific, are not only deposed in the Brain, but also in the Testes, wherefore if the Heterogeneous Combination of the Spirits, before taking to the Brain, and causing the Epilepsy, be freely carried into that new Storehouse, the Brain also being more free, often shakes off the Epileptical, or otherwise Morbid Disposition. Secondly, about the time of Puberty, as the Blood conveys somewhat, which before was designed for the Brain, to the Genitals by the Spermatick Arteries, so also it receives some ferment from those said parts by way of return by the Veins, viz. some particles imbued with a Seminal Tincture are carried back into the Mass of Blood, which strengthen it, and inspire into it a new and sprightly Vigour, wherefore at that time the endowments of the Body and Mind chief exert themselves, the Hairs shoot forth, the voice becomes more sonorous: The Menses flow from Women, and other Accidents supervene, by which it manifestly appears that the Blood and Nervous Juice are impregnated with some new Fermentation: Wherefore unless the Morbific Ferments, or Seminal Roots are overcome by this new Natural Ferment, they continue afterwards unconquered to our dying Day: If the Epilepsy does not cease about the time of Puberty, nor can be Cured by the use of Medicines, it either terminates immediately in Death, or is changed into some other Disease, viz. a Palsy, Stupidity, or Melancholy, for the most part incurable. Concerning the Cure of the Falling-sickness the Indications (as vulgarly set forth) are either Curatory, having regard to the Fit, and either keep it off as it is coming, or soon force it off when it has seized: Or they are Prophylactick, and regard the cause of the Disease, which if they remove, its accesses will be kept off for the future. As to the first intention, general Evacuatives have scarce place; nor ought a Vomit, or Purge, and very seldom Bleeding to be used in a Fit; if the person continues deprived of Sense a long time, Clysters are sometimes wont to be administered; but the chief thing to be done is to fix the Animal Spirits, which are too Exorbitant and Volatile; and to suppress their beginning Explosions: For which ends two kinds of Remedies chief conduce, viz. First, Such as repress the Animal Spirits, apt to rise to an Exorbitancy and to shoot, and repel them by a certain Fumigation as it were ungrateful to them; and force them into their due course: Which Medicines endowed with a Volatile, and Armoniac Salt, or also with a Vitriolic Sulphur will effect. Of which kind are Salt and Oil of Amber, Spirit of Blood, of Hartshorn, of Soot, Tincture of Castoreum and the like: For these being inwardly taken, or held to the Nostrils often give relief; nay and are thought to drive away the evil Spirits of this Disease, even as in Tobit the Fume of the Gall of a Fish burnt did the Devil. Secondly, the Animal Spirits are diverted, or hindered from entering upon Explosions, when they are allured to, and kept employed in some work that is usual to them, wherefore in the Fit, Frictions used over the whole Body, and continued for some time often do good: But as to raising up persons seized, and wholly restraining the Arms and Legs from the Convulsive motion, or binding them in this or that Posture (as some people use to do) and so, as to blowing Sneezing-powder into their Nostrils and pouring strong Cordials into their Mouths, or applying Cupping-glasses and Scarifications, and dealing roughly with the Diseased by other ways of Administration, thus disturbing the course of the Fit: I say this sort of practice is very often ill taken in hand, because by this means Nature is doubly toiled, viz. both by the Disease, and no less by standers by, and Servants, whereas it were much better to let the Fit pass according to its course, that so the Diseased might escape with one affliction. Truly the greatest care of a Physician and efficacy of Remedies is in the Prophylactick part of this Disease, that its cause being taken away, or its root cut off, all the Fruit may whither: The Medicines required for this Indication have regard to many intents, which nevertheless may be reduced to these two chief heads, viz. First, that the fuel of the Disease supplied immediately from the vicious Blood and Nervous Juice, and more mediately from the Viscera and first passages, be cut off; And then Secondly, that the evil Disposition of the Brain, and Spirits in it, which is peculiar to the Epilepsy, be removed. As to the first thing indicated, here Vomits, and Purges, and other both Evacuatives, and Alteratives, nay and Bleeding, and Cauteries have place; for as much as by these means and ways the Impurities both of the Viscera and Humours are drawn away, and their Discrasy is corrected: For though these Medicines and Physical Administrations seldom or never Cure the Epilepsy alone, yet they remove Impediments, raise up Nature, and stir her up to set upon her Enemy: They also prepare the passages that thereby Specific Remedies may more certainly and efficaciously exert their Virtues: Wherefore when the Cure of this Disease is attempted Spring and Fall, and at other fit seasons, by Secrets and Arcana's, its usual to use betwixt whiles those sorts of Medicines. As to Specific Remedies which are affirmed even alone, though not always, to reach the cause of the Epilepsy, and to overcome it, of which kind are the Male Peony, Mistletow of the Oak, Rue, Castoreum, Elks-hoof, preparations of Man's Scull, Amber, Coral, with many others: In regard these things are taken without any sensible Evacuation, or even Disturbance following in the Viscera or Humours, it seems strange by what formal way, or Virtue of working they are wont ever to do good in this Disease. If there be any room for conjecture in this intricate and obscure thing, in regard the Procatarctick cause of the Epilepsy consists in the Heterogeneous Combination happening to the Spirits in the Brain it follows that those things which overcome, and remove such a cause are of such a Nature, that by strengthening the Brain, and constringing its Pores they keep off that Combination, and so fix, and as it were constipate the Spirits that abound in the middle of the Brain, leaving their Combination, that they are no longer apt and prone to irregular Explosions: After the like manner haply as when the Powder of Aurum Fulminans ground with Sulphur, and sprinkled with Spirit of Vitriol loses its fulminating Virtue: And in truth we may conjecture nay in some measure discover that these kinds of properties, to wit, one, or both of them together, are in many Antiepileptick Remedies; for the Peony, Mistletow, of the Oak, Rue, Lilies of the valley, with many others excel in a manifest sort of Astriction, whence it is very likely that their Particles inwardly taken, and so, by the Vehicle of the Blood, or Nervous Juice, conveyed to the Brain, so constringe and close its over Lax and Gaping Pores, that they no longer lie open for the entrance of the Morbific matter: Moreover because these concrets breath forth an Armoniac as it were, and dissipating vapour, therefore the same are said to purify the Animal Spirits, and to fix and corroborate them, having left their Heterogeneous Combination. This Virtue of purifying the Spirits, proceeding from the Armoniac Salt, shows itself most in Remedies taken from Minerals and Animals, such as are the preparations of Man's Scull, Blood, Amber and Coral; as the other Astringent Virtue appears most in the parts and preparations of Vegetables. There is no need for us here to set forth a complete Method of Curing the Epilepsy with exact Forms of Prescripts, because general Precepts and excellent Remedies are every where to be had amongst Authors, and a prudent Physician will easily accommodate both the Indications, and that plentiful Apparatus of Physic to particular cases of sick persons: But because we give a clearly new Theory of this Disease, a Therapeutic Method also adapted to the same aught to be here given; Which we shall presently fully delineate, after I have given you a story of a person troubled with the Epilepsy. The Daughter of an Alehousekeeper at Oxford had been very subject from her Infancy to a Catarrh falling on her Eyes, being otherwise strong and sound enough, she lived also daily used to hard labour; about the fourteenth year of her Age she began to be seized with Fits of the Epilepsy, whereof she underwent many, they chief following her according to the greater changes of the Moon: Being entreated to endeavour her recovery, I gave her a Vomit of the Solar Praecipitate, and advised her to repeat the same three Days before every new and full Moon, and likewise that every time, for four Days after the Vomit taken, she should take twice a Day a Dram of Powder of the Roots of Male Peony, with a draught of black Cherry water: By these Remedies the Fits intermitted so long that the Disease seemed to be Cured. When afterward they returned again, she was again recovered by the use of the same Medicines: And then her Menses happening to flow, and keeping their due course, she continued for the time to come free from that Disease. The Therapeutic Method. IN the Cure of the Epilepsy I judge we must begin by Purging, and if the Diseased easily bears Vomiting, let him take a Vomit in the first place, and let it be repeated for many Months four Days before the full Moon: To Infants and Children let Wine of Squills mixed with fresh Oil of sweet Almonds be given, or also Salt of Vitriol from half a Scruple to a Scruple: To Adult persons and such as are of a robust Constitution let the following Forms of Medicines be prescribed. Vomits. TAke Crocus Metallorum, or Mercurius Vitae from four Grains to six, Mercurius Dulcis from sixteen Grains to a Scruple, let them be ground together on a Marble, mix it with the Pap of a boiled Apple, or with a Dram of Conserve of borage, make a Bolus. Or give from half an Ounce to an Ounce and a half of the Infusion of Crocus Metallorum, or Mercurius Vitae made in Sack. Or take Mynsicht's Emetic Tartar from four Grains to six: Those that are of a more tender Constitution may take Salt of Vitriol from a Scruple to half a Dram, and after half an hour let them drink upon it many pints of Ale-Posset-drink, than a Quill, or the Finger being put into the Throat, let Vomiting be provoked, and let it be sometimes repeated. The Day after the Vomit, unless somewhat indicateth the contrary, let Blood be taken from the Arm, or from the Haemorrhoid Veins by Leeches: Then the next Day after let a Purging Medicine be taken, and let this afterwards constantly be repeated four Days before the new Moon. Purges. TAke Rosin of Jalap half a Scruple, Mercurius Dulcis a Scruple, Castoreum three Grains, Conserve of Peony-flowers a Dram; make a Bolus. Take the greater Pilulae Faetidae two Scruples, Rosin of Jalap five Grains, Ammoniacum dissolved in Aqua Hysterica what suffices; make five Pills. Take Threads of black Hellebore macerated in Vinegar, dried, and powdered half a Dram, Ginger half a Scruple, Salt of Wormwood twelve Grains, Oil of Amber two Drops make a Powder, give it in the Pap of a boiled Apple. Take Compound Powder of Hermodacts a Dram, Man's Scull prepared six Grains, make a Powder, give it in a draught of the Decoction of Hyssop or Sage. In the Days in which he does not Purge, especially about the times of the Moon's changes, let Specific Remedies be given Morning and Evening, which are said to Cure this Disease by a certain Secret and innate Virtue: There is an immense number of these, and they are prescribed according to various Forms of Compositions. Specificks. THE most simple Medicines, and which experience has proved to be very efficacious, are the Roots of the Male Peony and its Seed: Take Roots of the Male Peony dried and powdered from a Dram to two or three Drams, let it be given twice a Day in the following Tincture. Take Leaves of Mistletow of the Oak two Drams, Peony Roots sliced half an Ounce, Castoreum a Dram, let them be put in a close Vessel with Betony water, or simple Peony water, and White-wine of each a Pound, Salt of Mistletow of the Oak, or of common Mistletow two Drams, let them digest in a close Vessel by a Sand heat for two Days; let him take three Ounces with a Dose of the Powder before prescribed. Let poor people take the said Powder in a Decoction of Hyssop or Castoreum made in fountain water, or White-wine. At the same time let the Root of Peony, cut in slices, and run through with a Thread, be hung about the Neck: Let the Roots also fried in a Frying-pan, or boiled till they are tender, be daily taken with his Food. Take Roots, and Seeds of the Male Peony of each two Drams, Mistletow of the Oak, Elks-hoof of each a Dram; being sliced and bruised, let them be sown up in very fine Linen, make a Bag to be worn on the Pit of the Stomach. Amongst Specificks this Powder is greatly commended by some Authors. Take Castoreum, Opoponax, Sanguis Draconis, Antimony, Peony Seeds, of each a like quantity: Make a Powder, let it be taken from half a Dram to a Dram every Morning with Wine, or an appropriated Decoction, or with black Cherry water. Take Man's Scull prepared an Ounce, Mistletow of the Oak, factitious Cinnaber, Elks-hoof, of each half an Ounce; mix them, the Dose is from half a Scruple to a Scruple. If the Form of a Powder be ungrateful to any Person, or if it's long continued use makes it loathsome, Electuaries, Pills, Troches Spirits, and Elixirs, each of them consisting of Specific Medicines, are wont to be prescribed. Electuaries. TAke Conserve of Male Peony-flowers, of Lilies of the valley, of each three Ounces: Seeds and Roots of the Male Peony powdered of each two Drams, Coral prepared a Dram, Pearl powdered, Man's Scull prepared, of each two Scruples, Salt of Mistletow of the Oak a Dram and a half, with a sufficient quantity of Syrup of Coral, make an Electuary; let him take Morning and Evening the quantity of a Nutmeg. Take Roots of Male Peony powdered an Ounce, Seeds of the same half an Ounce, Mistletow of the Oak, Elks-hoof, Man's Scull prepared, of each two Drams, Roots of Angelica, Contrayerva, Virginia Serpentary, of each a Dram, white Amber, Coral calcined, of each a Dram, Salt of common Mistletow two Drams, Sugar-candy dissolved in a sufficient quantity of the Antiepileptick water of Langius eight Ounces, make a Confection, let him take twice a Day the quantity of a Nutmeg. Pills. LET those Powders, Salt of Amber, and of Hartshorn, being added to them, be made into a Mass for Pills with a sufficient quantity of Balsamum Capivii whereof let three or four Pills be taken in the Morning and Evening, drinking after it a draught of an appropriated Liquor. Or let an Elixir of this kind be prepared, whereof let eight or ten drops be taken twice a Day in a spoonful of an appropriated Julape, drinking after it a little of the same. Elixirs. TAke Hungarian Vitriol six Pounds, let it be distilled in a Glass Retort by a Sand heat for twentyfour hours; then let the same Retort luted with a large receiver be put in a Reverberatory Furnace, that the Acid Spirits may be forced so long by a strong Fire till they go forth: Let the whole Liquor distilled be drawn off in a less Glass Retort by a Sand heat; and in a Matrass let there be poured to it Roots of Male Peony cut in slices and dried four Ounces, Seeds of the same an Ounce, Man's Scull prepared, Elks-hoof, red Coral of each half an Ounce, Mistletow of the Oak two Drams, let it digest with a gentle heat for many Days till the Tincture be extracted; let the Liquor being decanted, be drawn off in a Glass retort till only a third part of it remains, let that which is distilled be kept apart by itself: To the remainder pour a like quantity of Spirit of Wine highly rectified, and impregnated with the Infusion of the same Ingredients, and let them digest for six Days in Horse-dung: Make an Elixir, whose Doses is from half a Scruple to a Scruple. Let the distilled Liquor be given from half a spoonful to a whole one for the same intentions. Or let an Oil be prepared of Salt of Venus according to the prescript of Henricus ab Heers, and let it be given as before. Empirical Remedies. AMongst Specific Remedies, which (in case those before do no good) may also be tried, we may account the Liver of Frogs, the Bladder of a Boar, dried with the Urine, the Powder of Briony Roots, the Powders of a Cuckoo, or of Crows; the Rennet and Lungs of a Hare, the Liver of a Wolf, Stones taken out of Swallows, the Liver of a Kite, Crows Eggs daily to be taken amongst your Food and Medicines, with many other things, a famous Catalogue of which you may find in Henricus a Brabant a Physician of Zutphen; and out of which prescripts for the poor may be taken, as being easy to be had, and of a small price. Whilst these kinds of Medicines are inwardly taken according to the foresaid Method, some Administrations outwardly applied contribute help, and are justly taken in as a part of the Cure. Wherefore always in this Disease let Issues, to wit, one or two be made in fit places, also let Vesicatories be often applied. Periapts hung about the Neck, or worn on the Pit of the Stomach are judged to be of use. Let fresh Peony Roots cut into bits and run through with a Thread be made into Bracelets, to be worn all round the Neck: Assoon as they are withered, let new ones be put in their place, and let those be made into Powder to be taken inwardly. Take Roots and Seeds of Peony of each two Drams, Elks-hoof, Man's Scull prepared of each a Dram, Mistletow of the Oak half a Dram, being grossly powdered, let them be sewen in red Silk, and make a Bag to be hung about the Neck. An Amulet of a young Shoat of Elder found growing on a Willow is greatly commended. Plasters. IT is proper for some to have their Hair shaved off, and to have a Plaster applied to the Sinciput: Take Roots and Seeds of Peony, Castoreum, Mistletow of the Oak, Man's Scull very finely powdered, of each a Dram, Betony Plaster two Ounces, Caranna, Tacamahacca of each two Drams, Balsamum Capivii what suffices; make a Mass, spread it on Leather, make a Plaster for the Sutures of the Head. Let the Temples and Nostrils often be anointed with Oil of Amber by itself, or mixed with Oleum Capivii. Let Sneezing Powders and Apophlegmatisms be constantly used Mornings. Take white Hellebore a Dram; Castoreum, Euphorbum of each half a Dram; sweet Marjoram, Leaves of-Rue, of each two Drams; make a Powder. Let a Decoction of Hyssop or Sage, with the Confection of Mustardseed dissolved in it, be gargaled in the Mouth and Throat. Let Glisters sometimes be given according as need requires. In regard Solid Medicines ought sometimes to be diluted with Liquids', or these to be drank after those, let distilled waters, Julapes, Decoctions, or Tinctures that are endowed with some Specific Virtue against this Disease be in a readiness for this purpose. Take Hungarian Vitriol four Pounds, fresh Man's Scull powdered four Ounces, Peony Roots sliced six Ounces; being bruised together in a Mortar pour to them of Sack, or small White-wine, or Wine of the Juice of black Cherries fermented in a Vessel two Pounds, let them be distilled in a Glass Retort by a Sand heat. Take Rasping of Box, Hungarian Vitriol of each two Pounds, Leaves of Mistletow three handfuls, Leaves of Rue two handfuls, being bruised together pour to them of Sack four Pounds, let them be distilled in a Gourd-glass by a Sand heat. Take common Vitriol six Pounds, Roots of Male Peony six Ounces, Mistletow of the Oak an Ounce, green Walnuts eight Ounces; being sliced and bruised let them distil in a Glazed Pot with a Glass Alembick set over it by a Sand heat: Take of this Liquor a Pound, water of black Cherries and of Lime-tree Flowers, of each half a Pound, double refined Sugar four Ounces, mix them, make a Julape: The Dose is two or three Ounces twice or thrice a Day. Oxymel of Squils', also Hydromel with Hyssop boiled in it, are very much commended by the Ancients: Or let this kind of Apozeme be prepared, whereof you may give from four Ounces to six or eight twice a Day. Take Roots of Male Peony, Angelica, Master-wort, Valerian, of each six Drams, Leaves of Betony, Sage, Lilies of the valley, of each a handful, Seeds of Rue, Gith of each three Drams, of Peony half an Ounce, Raisins three Ounces, Licorice half an Ounce, being sliced and bruised let them boil in six Pounds of Fountain water to a consumption of the third part. Towards the end add Wine of black Cherries half a Pound, or ten Ounces; strain it and let it be kept in Vessels close stopped; the Dose is from six Ounces to eight twice a Day after the Remedies above prescribed. Or let the foresaid Ingredients, the Licorice and Raisins excepted, be boiled in six Pounds of Hydromel to a consumption of the third part, the Dose is from four Ounces to six. But if the foresaid Method, consisting in the use of cathartics and Specificks being tried for some time, proves wholly without effect, we must come to Remedies of another kind, and especially to those which are called great: In this rank we place Diaphoreticks, Salivation, hot Baths, and Mineral waters. Alphonsus Ferrius says he has Cured a great many Epileptical persons, by a simple Decoction of Guaiacum, being prescribed twice a Day from six Ounces to eight, and a second Decoction of it being taken instead of ordinary Drink, as is usual in the French-pox. If to such a Decoction the Roots of Peony and other Specificks be added, haply it will be more efficacious. It seems probable that a Salivation powerfully raised by Mercury, and afterwards followed by a Sweeting Diet Drink, will infallibly Cure this Disease: What hot Baths or Mineral waters will do, is not yet known to me either from my own experience or that of others; I shall try haply some time what our artificial Mineral waters, viz. impregnated both with Iron, and Antimony being taken for many Days in a great quantity will be able to effect towards the Cure of the Falling-sickness. CHAP. II. Instructions and Prescripts for Curing the other kinds of Convulsions, and in the first place of the Convulsive motions of Children. IT happens that Infants and Children are so generally, and frequently, troubled with Convulsive affects, that this may be accounted as the chief and almost only kind of Convulsions; for those kinds of Symptoms in Adult persons are denoted by other Names, and are wont to be referred to the Epilepsy; Hysterick, Hypochondriack, or Colic passions, or also to the Scurvy; but in Children, as it were by way of excellency, they are called Convulsive motions. Concerning these we may observe, that Children are found to be very subject to Convulsions chief at two times, viz. within the first Month after they are Born, and about the time of the eruption of Teeth: Though Fits of this Disease happen also often at other times, and for certain other causes. For, in those in whom the Seeds of a Convulsive Disposition are rooted, these Seeds sometimes display themselves, and come to a Morbid Matureness either presently after the persons are Born, (as is said before) or lying hid for a while, sometimes precede in them the Eruption of Teeth, sometimes follow it at a great distance of time after, and at length in an uncertain course break forth in act for other evident causes, viz. either inward or outward, such as are an unhealthy or pregnant Nurse, Milk coagulating in the Ventricle, or degenerating into an acid or bitter Corruption, a Feverish Distemper of the Head, and Ulcers of other parts, break forth suddenly disappearing, changes of the Air, Conjunctions or Opposite Aspects of the Sun and Moon, and the like. These Convulsions in Children are wont to infest three Regions of the Body, viz. the parts of the Head and Face; the Members and outward Limbs; and the Praecordia and Viscera: And we observe that sometimes these, sometimes the others, sometimes two of them, or all the Regions together are troubled with the Morbific cause, according as the same is fixed either about the Origines, or extremities of the Nerves. And when the first of these happens, according as the superior, middle, or lower spinal part of the Medulla Oblongata, to wit, one of them alone, or more of them together are set upon by the Morbific cause. In Children obnoxious to Convulsions hereditarily, the Convulsive Fits are excellently provided against, if presently after a Child is Born an Issue be made in the Nucha, and Blood be drawn from the Jugular Veins by Leeches, for by the former the Corruptions of the Nervous Juice are conveyed away, and by the latter the impure Efflorescencies of the Blood are withdrawn from the Head: A person whose Children died all of Convuisions within three months' time, at length to prevent the like fatal Accident in a Child fresh Born, sought for Remedies: Being called after some Days after the Birth, I advised that in the first place an Issue should be made in the Nucha, and then the next Day after, that a Leech being applied to the Jugular of both sides, Blood should be drawn to the quantity of two Ounces: moreover that near each of the Conjunctions and Opposite Aspects of the Sun and Moon about five Grains of the following Powder should be given in a spoonful of Julape for three Days, Mornings and Evenings. Take Man's Scull prepared, Roots of Male Peony of each a Dram, Pearl powdered half a Dram, double refined Sugar a Dram, mix them, make a subtle Powder. Take black Cherry water three Ounces, Langius' Antiepileptical water an Ounce, Syrup of the Flowers of Male Peony six Drams, mix them. I ordered also that the Nurse at the same Physical hours should take a draught of Whey, in which Seeds and Roots of the Male Peony, and Leaves of the Lily of the valley were boiled: The Infant continued well for about four Months, but then began to be troubled with Convulsive affects: At which time the same Remedies were given in a greater Dose both to the Infant, and to the Nurse. Vesicatories were also applied behind his Ears, and Blood was drawn by Leeches from both Jugular Veins; and within two or three Days the Child grew well: afterward when within four or five Months the Convulsions returned at times, still by the use of the same Remedies he was Cured: After a year and a half the Convulsive affects wholly ceased, but about the lower part of the Backbone a Tumour without Pain grew up, whence some Crookedness of the Vertebrae, and a weakness of the Legs, and at length a Palsy were caused. It seems in this case that the Convulsive matter which was wont to assail the Origines of the Nerves, at length entering the Spinal Marrow, and being thrown down into its lower part, wholly stopped the Mouths of the Arteries belonging to it; to wit, because to the explosive Particles, other narcotick and grosser Particles had joined themselves. The Therapeutic Method against Convulsive affects in Children. IN Infants and Children we must take care either to prevent imminent Convulsions, or being already begun to Cure them. For if former Children Born of the same Parent have been found obnoxious to Convulsions, that evil aught to be prevented in the rest of the Children Born afterward by a seasonable use of Remedies: For this end it is usual to pour into the Mouth of an Infant newly Born, assoon as it gins to Breath, some Anticonvulsive Medicine: Hence some are wont to give it some drops of most pure Honey, others a spoonful of Canary sweetened with Sugar, and others Oil of sweet Almonds fresh drawn: By some persons a drop of Oil of Amber, or half a spoonful of Epileptical water is put into its Mouth. Besides these first things given Children, which truly seem to be of some moment; certain other remedies and ways of Administration ought to be used; viz. let a spoonful of a Liquor appropriated to this affect be drank twice a Day. For Example; Take water of black Cherries and of Rue of each an Ounce and a half the Antiepileptick water of Langius an Ounce, Syrup of Coral six Drams, Pearl prepared fifteen Grains, mix them in a Glass. On the third or fourth Day after it is Born, let an Issue be made in the Nucha, then if it has a Florid Countenance, let a little Blood to an Ounce and a half, or two Ounces, be drawn from the Jugular Veins by Leeches, care being taken lest he Bleed too much when he Sleeps: Let the Temples and Neck be gently rubbed with such a Lineament. Take Oil of Nutmegs by expression two Drams, Oleum Capivii three Drams, Oil of Amber a Scruple; let a Periapt of the Roots and Seeds of the greater Peony with a little addition of Elks-hoof be hung about the Neck. Moreover let Anticonvulsive Medicines be daily given the Nurse: Let her take Morning and Evening a draught of Whey in which the Roots and Seeds of Male Peony, and the Seeds of sweet Fennel are boiled. Take Conserve of the Flowers of Betony, Male Peony, and Rosemary of each two Ounes, Powder of the Roots and Flowers of the Male Peony of each two Drams, red Coral prepared, white Amber of each a Dram, Roots of Angelica, Zedoary prepared of each half a Dram, with a sufficient quantity of Syrup of Peony, make an Electuary: Let by'r take the quantity of a Nutmegg Morning and Evening. Take Powder of the Roots of Male Peony two Drams, Seeds of the same a Dram, make a Powder; double refined Sugar dissolved in the water of Lime-tree Flowers, and boiled to a consistency for Tablets three Ounces, Oil of Amber a Scruple: Let Tablets be made according to Art, each Weighing half a Dram, let her eat one every sixth hour, and let her keep an exact Form of Diet. In case any Infant be actually affected with Convulsions, because an Issue works but little and slowly, it is proper to apply a Vesicatory to the Nucha, and behind each Ear, and unless a cold Temperament forbids it, let Blood be drawn from the Jugular Veins by Leeches: Let Liniments be applied about the Temples, Nostrils, and Neck, and Plasters to the Soles of the Feet: Let Clysters be daily injected, which plentifully empty the Belly: Moreover Let Specific Remedies be taken inwardly often in a Day, to wit, every sixth or eighth hour. Take Oleum Capivii, and Oil of Castoreum of each two Drams, Oil of Amber half a Dram, make a Lineament. Take of the Emplaster Oxycroceum two parts, Galbanum dissolved one part, Oil of Amber a Scruple, make a Plaster for the Soles of the Feet: Let the Powder of Gutteta according to the description of Riverius be given twice or four times a day. Take Man's Scull prepared, Peony-seeds, Elks-hoof, Pearl prepared, of each half a Dram, Amber-greice six Grains, make a Powder, the Dose is six Grains in a Spoonful of the Liquor beneath, written three or four times a day. (Or) Take Man's Scull prepared, Pearl, of each half a Dram, Salt of Amber a Scruple, Sugar of Pearl a Dram, the Dose is half a Scruple. (Or) Take Spirit of Hartshorn three Drops, let it be given every sixth or eight hour in a Spoonful of the Julape beneath prescribed. To poor people's Children let Powder of the Root of wild Valerian be given from half a Scruple to a Scruple; let it be given twice a day in a Spoonful of Milk, or of an Appropriated Liquor. Vntzerus greatly commends the Gall of a Sucking Whelp, viz. that all the Juice of the Gallbladder be taken forth and given to the Child with a little Water of Lime-tree-flowers. A Learned Physician lately told me that he had known many Cured with this Remedy: Moreover Empirics, after the Gall is drank, are went also to give to greater Children to eat the Liver roasted. Julapes, distilled Waters, and other Appropriated Liquors may be prepared according to the Forma following. Take black Cherry-water three Ounces, Antiepileptical-water of Langius an Ounce, Sugar of Pearl two Drams, mix them. Take fresh Roots of Male Peony cut into slices six Ounces, Hungarian Vitriol eight Ounces, Man's Scull two Ounces, Antiepileptical Water of Langius half a Pound; mix them, and let them distil in a Glass Retort by a Sand heat: The Dose is from a Spoonful to two Spoonfuls. Take fresh Roots of Male Peony sliced four Ounces, being bruised in a Marble Mortar, pour to them of Spanish Wine a Pound; express it strongly, add Manus Christi perlated half an Ounce, let it be kept in a Glass close stopped; the Dose is a Spoonful or two, twice a day. When Convulsions happen by reason of a difficult breeding of Teeth, this Symptom is looked upon as secondary, and not dangerous, and therefore in the Method of Cure it is not always the first or chief thing which requires help, but sometimes we are rather solicitous of appeasing the pain, and removing the feverish Distemper, wherefore both the Patient and Nurse ought to use a thin and cooling Diet; when the Teeth are upon eruption, let the passage be made open for them, either by a rubbing, or Section of the Gums: And also let anodynes be applied to those parts when swollen and full of pain: Clysters and Bleeding often have place here: We must procure sleep, and allay the fervour of the Blood: Mean while let Anticonvulsive Remedies be used, but of the more moderate kind, and such as little trouble the Blood and Humours; Vesicatories, in regard they evacuate the Serum, which is too apt to be discharged on the Head, often give relief. When Children are troubled with Convulsions, and that neither presently upon their Birth, nor by reason of an Eruption of Teeth, but through other occasions, and accidents, the cause of such an affect for the most part lies either in the head, or somewhere about the Viscera of Concoction. When there is a suspicion of the former, as it is wont to appear by signs which show that a Mass of Serous Filth is gathered together within the head; the Remedies ought to be given in a little larger Dose; moreover in those who bear Purging well, sometimes a Vomit, and a gentle Purge may be ordered them: Wine and Oxymel of Squills, also Mercurius Dulcis, Rhubarb, and Rosin of Jalap are of excellent use. As often as the cause of the Convulsive Affect appears to be in the Bowels, either Worms, or sharp Humours causing Gripes in the Belly are found to be in the fault. Against Worms a Purge of Rhubarb, or of Mercurius Dulcis, with the addition of Rosin of Jalap is ordered. Formerly to a Child miserably troubled with Convulsions, so that he seemed even a Dying, I gave a Doses of Mercurius Dulcis with Rosin of Jalap: With his Stools, whereof he had four, he voided twelve Worms, and presently grew well. Take Roots of Virginia Serpentary powdered a Dram, Coral caloined to a whiteness half a Dram, make a Powder, the Dose is from half a Scruple to a Scruple twice a day for three days one after the other, drinking after it a Decoction of Grass Roots. Take Species of Hiera a Dram and a half, Venice-treacle two Drams, make a Plaster for the Belly, or let a Plaster of Galbanum be applied to the Navel. If the Convulsive motions are thought to proceed from the Irritation of the Ventricle, and the Intestines, caused by sharp Humours, a gentle Purge, either by Vomit or Siege, or of both, the one after the other, aught to be ordered. For this purpose let gentle Emetics of Wine of Squills, or of Salt of Vitriol be taken; to wit, if at any time the Diseased be of their own accord seized with a straining to Vomit; but if the Evacuation seems rather fit to be attempted downwards, an Infusion of Rhubarb, or its Powder, Syrup of Cichory with Rhubarb, or of Roses with Agarick ought to be given: And I have often seen a Convulsive affect in Children Cured by these Remedies when seasonably administered; moreover Clysters in this case are of frequent use: But withal let not outward Medicaments be omitted, viz. Fomentations, Liniments, and Plasters to be applied to the Belly. Take Camomile Leaves small sliced two handfuls, let them be put into two bags made of fine Linen or Silk, which being dipped into warm Milk, and wrung forth must be applied successively to the Belly. Take Tops or Flowers of Mallows sliced, boil them in fresh Butter, or Hog's Lard, and let them be applied to the Belly in the form of an Ointment or Cataplasm. CHAP. III. Instructions and Prescripts for Curing Convulsive Diseases in Adult Persons, happening by reason of the Origine of the Nerves being chief affected. THough Convulsive affects which happen to Adult Persons, being denoted by other Names, are also vulgarly accounted to have another Origine, and are wont to be referred to those they call Hysterical, Hypochondriacal, or Colic passions, or to the Scurvy; nevertheless if the thing be a little more attentively considered, it will easily appear, that certain Convulsive Symptoms frequently happen both to Men and Women, which properly and duly claim the name of a Convulsion: Now these may be variously distinguished according to the Manifold seat of the Morbific cause, but especially into these three kinds, viz. into certain Convulsions caused by reason of the Origine of the Nerves being chief affected, and into others which are caused by reason of the extremities of the Nerves being stopped with a Morbific Matter; and lastly into others whose Morbific Matter descending from the Head, gets possession of the whole, or the greatest part of the Ductus' of some peculiar Nerves, or of them altogether. We shall treat of each of these kinds of Convulsions one after the other. Therefore first of all as to Convulsions happening by reason of the Origine of the Nerves being affected, we must note first that the Morbific Matter besetting the Origines of the Nerves, sometimes passes chief into the foremost Pairs of Nerves, viz. which attend the Muscles of the Eyes and Face; and thence Contractions and tremble sometimes of the Nose, Cheeks or Lips, sometimes of the Eyes or Mouth ensue. Secondly, sometimes the Par Vagum and Intercostal chief imbibe the Heterogeneous Particles, and then Inflations or Contractions of the Abdomen and Hypochondres, and also a Palpitation and Trembling of the Heart, a difficult and interrupted Breathing, an intermitting Pulse, and other Symptoms of the middle or lower Region of the Belly chief molest us. Thirdly, but sometimes the Morbific Cause lying behind, chief affects the Spinal Marrow; and therefore the outward Members and Limbs are rendered obnoxious to Twitchings and Contractions. Moreover as we may conjecture from various Types of the Con\vulsive affect, it seems that the Convulsive Matter going to these or those Nerves, or to many of them together, either lodges itself in a manner only about their Origines, so that upon frequent Explosions of the Spirits there, a almost continual and very troublesome Vertigo arises; and so Tremble, and a short Fainting, and danger of Swooning are perceived about the Praecordia, and often Twitchings and gentle Contractions in the Bowels or Muscles: Or Secondly, the explosive Particles conveyed to the Origine of the Nerves, enter deeper into their Processes, and often falling down into the Plexus's of the Nerves, belonging to the Praecordia, or Viscera of the Belly; or also to the outward Members, make there other seats, as it were of Convulsive affects, so that as often as the Spirits are forced to Explosions about the Origine of the Nerves, presently Fits, as it were Hysterick, Asthmatick, or otherwise Convulsive arise in the Belly, Thorax, or outward Members. I shall now give you some instances of Persons in whom the Morbific Matter besetting the Origine of the Nerves, and not yet fallen deeper into their Processes, caused frequent Vertigo's, and only gentle Convulsions of the Viscera and Praecordia. 1. A Lady of great Quality, about Thirty years of Age, of a tender Constitution, and of a thin habit of Body, was wont to be sorely afflicted every Winter with a Catarrh distilling on her Trachaea and Lungs, with a Cough, Hoarseness, and great Spiting, but the last year, through a diligent care and caution used, she escaped that evil: But after the Winter solstice, upon taking cold, she was seized with a violent Headache, a ringing in the Ears, a Vertigo, with a mighty Distillation of Rheum at the Eyes and Nose, whence it easily appeared that the filthy Mass of Serum which was wont before to distil on the Breast, was then wholly deposed within the Head and Brain: The effect whereof moreover was, that as often as she began to sleep, she was very much troubled with a sort of Hysterick Fits, to which she had never before been obnoxious: For if at any time beginning to sleep, she closed her Eyes, presently it caused a rising of a heavy thing in her Belly, a Suffocation in her Throat, and Tremble and Twitchings about the Praecordia: Which affects nevertheless, when she was perfectly awaked, presently ceased, so that the Diseased was forced to abstain in a manner wholly from sleep for many days and nights together. Being called to this Lady after she was become very weak upon many days Sickness, I was forced to use only gentle Medicines: Therefore I ordered four Ounces of Blood to be taken from her Foot, and a Clyster of Milk with Sugar to be daily given her, after which she was wont to have three or four Stools: Moreover every eighth hour I gave her a Dose of Spirit of Hartshorn in a Spoonful of the following Julape. Take Water of , walnuts, black Cherries of each three Ounces, Hysterick Water two Ounces, Syrup of Clovegilly-flowers an Ounce and a half, Castoreum tied in a Nodulus, and hung in the Glass half a Dram, Pearl powdered a Scruple, mix them. I applied with good effect Vesicatories behind the Ears, and Cataplasms of Leaves of Rue, and Aron, with Bryony Roots, Sea Salt, and black Soap to the Soles of the Feet. Sometimes in the Evening I gave half an Ounce of Diacodium in a little Draught of the Julape before ordered, which was followed by a moderate sleep without being attended according to wont with Convulsions: Which kind of effect I have often experienced in such a case after Opiates given: For quenching Thirst I gave a Ptisan with Diuretic Ingredients boiled in it: By the use of these things she was very much relieved within a short time: But that which fell out much for her good was, that an Abscess in the left Ear, breaking of its own accord, first discharged a yellow Gore, and afterward for many days a vast quantity of thin Ichor: After which Evacuation the Convulsions of the Bowels and Praecordia wholly ceasing, the Disease was perfectly determined. I have known many Persons both Men and Women Diseased after this manner, who being ill of a Headache, an oppression of the hinder part of the Head, or a Vertigo, perceived in their sleep presently Convulsive motions in the Praecordia or Bowels, or in both of them together: Which happens from the Salley of the tumultuary Spirits reflected from the Brain into the Origines of the Nerves: And as an Opiate gave the Patient before mentioned a quiet sleep without the wont Sequel of Convulsions, so I have often successfully Cured terrible Convulsive Fits, both Asthmatical, and as it were Hysterical, by giving Opiates. 1. A Woman sixty seven years of Age having still a florid Countenance, and being of a gross habit of Body, and who first had lived long subject to a Swelling of the Face, and great Fits of the Headache, upon the Wether's growing very cold in the Winter, fell into a very grievous Vertigo, with a Trembling of the Heart, a Fainting of the Spirits, and a frequent striving to Vomit: Being put to Bed if she opened her Eyes, or was turned from one side on the other, she was presently seized with a mighty Scotomia, a danger of Swooning, and moreover with a cruel Vomiting. As I was to see her I did not doubt but the cause of the Disease was the Convulsive Matter conveyed from the outward Region of the Head to the inmost Recesses of the Brain, by the ill Breath, or Heterogeneous Combination of which the Animal Spirits being struck, they raised the Vertiginous affects as they made their disorderly sallies towards the Brain, and when they tumultuarily rushed into the Roots of the Nerves, they caused the Scotomia, the disorders of the Praecordia, and the striving to Vomit: The Cure of this was performed within a few days by the application of large Vesicatories to the Nucha, and behind the Ears; the daily injection of Clysters, and by a frequent use of Spirit of Hartshorn, and a Cephalick Julape. Dr. Willis gives Instances of Persons in whom some portion of the Morbific Matter which besets the Origine of the Nerves, descending from the Head, often enters deeper into the Ductus' of the Nerves, and so about their middle and extreme Processes and Plexus' makes a foams of an explosive matter, as it were of Gunpowder: But for brevity sake I omit them. It is observed that when a Convulsive Fit gins within the Brain, at the Origine of the Nerves, presently the remotest Spirits residing in the extremities of the Nerves (as many as are predisposed for that Symptom) fall upon Explosions, and so convey upwards, the Convulsive affect there more strongly begun; which happens for this reason, that when some whole Series of Spirits is disturbed, those which are in the extreme parts, are first destitute of their Original Influx, wherefore those, before others begin to grow in a tumult, and to be irregularly disposed, as when a Nerve of the Arm or Thigh is constringed by lying on it, so that it is hindered of its wont influence of the Spirits, a stupor with a sense of pricking is first perceived in the Fingers or Toes of the hands or Feet; whence it creeps upwards by degrees towards the places affected: And hence it is we find that if whilst the outmost Spirits are exploded, a strong Ligature, or Compression intercepts the succession of others into the same space, or their progress towards the parts, the Convulsion is usually hindered from ascending upward: Wherefore (as Physical Histories testify) when a stupor beginning at the top of a Finger or Toe of a hand or Foot, creeps to the upper parts with a sense of Formication, or like a cold wind; and at length taking to the Brain, causes terrible Convulsions: If presently at the first seizure the Arm or Leg be strongly bound about, the Convulsion being not able to pass that place, is hindered from getting to the Head: Nay and it's an usual thing for Hysterick Women, assoon as a Swelling of their Belly, or an ascent of a heavy lump is first perceived in their Abdomen, to bind about hard the Trunk of their Body with Swaths, and so commonly the Praecordia, and the Region of the Head are kept from being affected with the Convulsive Fit. It's likewise observable that if Blood be let forth of a Vein in the midst of a Covulsive or Apoplectical Fit, it presently seems to be congealed, so that being received in a Basin, it does not keep an even and plain Surface like Liquids', but accumulating itself drop upon drop, it rises in a heap like Tallow melted and distilled into a cold Vessel: Yet as to what some conclude hence, viz. that Convulsions depend wholly on the thickness, obstructed motion, and stagnation of the Blood, we must not allow of it: For Blood drawn from Persons that are subject to Convulsions a little before the Fit, is diluted with Serum, and fluid enough: Wherefore we may opine that that Congelation is caused by the Fit itself: To wit, because in Convulsive motions, from the excessive Contractions of the Muscles and Viscera, the Blood passing bet wixt them, its Spirit and Serum exhaling, is a little solved in its mixture, and therefore is somewhat coagulated, just as when Milk by reason of its too great agitation and Separation of parts one from another, hardens into butlter, wherefore this kind of Coagulation of the Blood seems rather to be the effect of Convulsions than their cause. The Therapeutic Method. AS to the Cure of these kinds of Convulsive affects, which in Men or Women proceed from a Morbific cause, besetting the Origines of the Nerves: The first Indication will be to withdraw the fuel of the Disease, viz. to hinder the Blood from discharging on the Head, the Heterogeneous Particles, either engendered in itself, or received from elsewhere from the Bowels. For this purpose an Evacuation, ordered both by Purging and Bleeding, unless somewhat indicateth the contrary, is wont to be administered with good success. Vomiting very often gives relief, wherefore let Vomits of the Infusion of Crocus Metallorum, or of Salt of Vitriol, or of Wine of Squills, be given in the first place. Then in a few days let Blood be drawn, either by opening a Vein in the Arm, or by Leeches applied to the haemorrhoid Veins; then afterwards let a gentle Purge be ordered either of Pills, or of a Purging Apozem, and let it be repeated in due and convenient time. Take Crato's Pills of Amber, or Bontius' Pills of Tartar two Drams, Rosm of Jalap sixteen Grains, Castoreum a Scruple, Oil of Rosemary or of Amber half a Scruple, Gum Ammoniacum dissoloed in a sufficient quantity of Hysterick-water, make sixteen Pills, let four be taken every sixth or seventh day. Take Roots of Polypody of the Oak, sharp pointed Dock prepared, and of Chervil, of each six Drams, of Male Peony three Drams, Leaves of Betony, Germander, Ground-pine, Vervain, Male Fluellin, of each a handful, Seeds of Carthamus and Burrdock, of each three Drams, let them boil in four Pounds of Fountain-water to half, add of White-wine a Pound, let it be strained into a Matrass, to which put Leaves of choice Sena an Ounce, Rhubarb six Drams, Gummous Turbith half an Ounce, Epithimum, yellow Saunders of each two Drams, Salt of Wormwood, and of Scurvygrass, of each a Dram, the outward yellow Coats of Oranges two Drams, let them digest close luted in a Sand heat for twelve hours, let the straining be kept for use: Let it be sweetened (if need be) with a sufficient quantity of Syrupus Augustanus, or with Syrup of Cichory with Rhubarb; the Dose is six Ounces once or twice in a week. Each day in which Purging is omitted, let Remedies be given for strengthening the Brain, and for guarding the Animal Spirits from incurring Heterogeneous Combinations, or from entering upon Explosions: Of which nevertheless let a certain choice be made according to the Temperament, Habit of Body, and Constitution of the Diseased: For to such as have a thin habit of Body, and a hot Blood, Medicines must be given which are not hot, and which do not stir the Blood too much: On the contrary to phlegmatic and gross Bodies, whose Urine is thin and watery, and whose Blood circulates but dully, let hot Remedies be ordered, and such as are apt notably to ferment the Humours: In the former case you may prescribe after this manner. Take Conserve of the Flowers of Betony, Tamarisk, and Male Peony of each two Ounces, Species Diamargariti Frigidi, a Dram and a half, Powder of the Roots of Peony, and of the Seeds of the same of each a Dram, red Coral prepared two Drams, Vitriol of Mars two Scruples, Salt of Wormwood two Drams, with a sufficient quantity of Juice of Oranges, make an Electuary: Let it be taked twice or thrice a day, drinking after it a little draught of the Julape beneath prescribed. Take of red Coral ground with the Juice of Oranges on a Marble, or in a Glass-mortar, and dried half an Ounce, Powder of Mistletow of the Oak, and of the Roots of Male Peony, of each two Drams, Sugar of Pearl three Drams, make a Powder; the Dose is from a Scruple to half a Dram, twice or thrice a day. Take Species Diamargariti Frigidi two Drams, Salt of Wormwood, three Drams, Aron Roots powdered a Dram, mix them, make a Powder, let it be divided into twenty parts, and let a Dose be taken in the Morning, and at four of the Clock. Take Powder of the Roots of Butter an Ounce, the Dose is from half a Dram to a Dram twice a day. Take Leaves of the Bur-dock, and of Aron, of each six handfuls, being sliced and mixed together, let them be distilled: The Dose is from two Drams to three twice or thrice a day after a Dose of the Electuary or Powder. Take of this distilled Water two Pounds, of our Steel prepared two Drams, mix them in a Glass, let them be taken after the same manner. Take Water of walnuts simple, and of black Cherries, of each half a Pound, of Snails four Ounces, Syrup of Flowers of the Male Peony two Ounces; the Dose is from an Ounce and a half to two Ounces after the same manner. Take Shave of Ivory, and Hartshorn, of each three Drams, Roots of Chervil, Bur-dock, Valerian, of each half an Ounce; Leaves of Betony, Ground-pine, Scolopendrium, tops of Tamarisk, of each a handful: Barks of Tamarisk and of Bitter-sweet of each half an Ounce, let them boil in four Pounds of Fountain-water to the consumption of a third part, add of White-wine eight Ounces, strain it into a Flagon, to which put Leaves of Brooklimes, and of Cuckow-flower, of each a handful, make a warm and close Infusion for four hours, let the straining be kept in Glasses close stopped: The Dose is six Ounces twice a day, after a Dose of a solid Medicine. Sometimes in such an Apozeme let two Drams of our Steel be infused, and taken after the same manner. In the Summer time the use of Mineral Waters is proper, for want of them let our Artificial Waters be given in their stead. But if for the reasons above cited hot Medicines are indicated, we may proceed after the following method. Take Conserve of Rosemary-flowers, and of the yellow Coats of Oranges and Lemons, of each two Ounces, walnuts, and Mirobalans condited, of each in number two, Lignum Aloes, yellow Saunders, Roots of Serpentaria, Contrayerva, Angelica and Aron, of each a Dram, Vitriol of Mars (or prepared Steel) four Scruples, Salt of Wormwood and of Scurvygrass of each a Dram, with a sufficient quantity of Preserve of walnuts, make an Electuary. Let the quantity of a Nutmeg be taken twice a day, drinking after it a Dose of an appropriated Liquor. Take Roots of Male Peony, Angelica, red Coral prepared, of each two Drams, Sugar dissolved in water of Snails boiled to a consistency for Tablets six Ounces. Oil of Amber highly rectified half a Dram, make Tablets according to Art, each weighing about half a Dram, let one or two be taken twice or thrice a day, drinking after it a Dose of an appropriated Liquor. Take Roots of Virginia Serpentary, Contrayerva, Valerian of each two Drams, red Coral prepared, Pearls, of each a Dram, Winters-bark, Roots of bastard Ditany of each a Dram, Vitriol of Mars, Salt of Wormwood, of each a Dram and a half. Extract of Centory two Drams, Ammoniacum dissolved in Hysterick-water what suffices, make a Mass for Pills. Let four Pills be taken in the Morning and at four in the Afternoon. Take Spirit of Hartshorn, or of Soot, or of Man's Blood, or of Sal Armoniac what suffices, take from ten to twelve Drops Morning and Evening in a Spoonful of the Julape, drinking after it a little draught of the same. Take Leaves of Betony, Vervain, Sage, Cuckow-flowers, Aron, Bur-dock, of each two handfuls, green walnuts in number twenty, the Coats of six Oranges and four Lemons, Cardamons, Cubebs, of each an OUnce; being sliced and bruised, pour to them Whey made with Cider or White-wine six Pounds, let it distil according to Art: The Dose is two or three OUnces twice a day after a Dose of a solid Medicine: To two Pounds of this add of our Steel two Drams. Take Water of Earthworms, and of Snails, of each six Ounces; of walnuts simple four Ounces, Raddish-water compound two Ounces, double refined Sugar two Ounces, make a Julape: The Dose is four or six Spoonfuls twice a day after a Dose of a solid Medicine. Take Millepedes cleansed a Pound, Cloves sliced half an Ounce, pour on them of White-wine two Pounds, let them distil in a Gourd-glass; the Dose is from an Ounce to an Ounce and a half twice a day. We may prescribe for poor People Remedies more easy to be had after this manner. Take Conserve of the Leaves of Rue made with an equal part of Sugar six Ounces. Let the quantity of a Nutmeg be taken twice a day, drinking after it a Decoction of the Seeds and Roots of Bur-dock made in Whey, prepared of White-wine. Or let a Conserve be made of the Leaves of the Tree of Life, with an equal part of Sugar; the Dose is from half a Dram to a Dram twice a day. Take Powder of Millepedes prepared three Drams, Ameos-seeds a Dram, make a Powder, divide it into ten parts, let a Dose be taken twice a day. Or twelve Millepedes being bruised with White-wine poured on them, let the Juice be expressed, make a draught, let it be taken twice a day. In the mean while that these Remedies are taken inwardly, it is proper sometimes to raise Blisters by applying Vesicatories on the Nucha, or behind the Ears; for so the Serous and sharp Humours are very much derived from the Head: Moreover Sneezing-powders, and Apophlegmatisms often give great relief. The drawing of Blood from the Haemorrhoid Veins, or from the Foot ought to be sometimes repeated: And during the Fit, Plasters or Cataplasms are applied to the Soles of the Feet with good effect: It is good also to apply Epispastics about the Legs and Thighs. CHAP. IU. Of Convulsive motions, whose cause lies about the Extremities, or within the Plexus's of the Nerves. THat Convulsive affects, sometimes without any fault in the Head, arise from the Irritation and Explosion of the Spirits lying about the extremities of the Nerves, it plainly appears even from this, because when Medicines smartly twitch the Coats of the Stomach or Intestines, or when Worms gnaw them, Convulsions do not only follow in those parts, but likewise Convulsive motions are sometimes retorted on the Members and outward Limbs: For as we have shown elsewhere, when a sense of great pain torments any part, and is communicated from that to the Primum Sensorium, presently upon it, the Spirits being there irritated, an involuntary and irregular motion is wont to be thence reflected; and that not only by those Nerves, by which the sense of pain was brought, but sometimes the Convulsion is reciprocated also by others, either of the same pair, or belonging to a pair wholly differing: Thus a Stone fixed in the Ureter causes Convulsions, not only in the Vessel affected, but in a manner in all the Viscera of the Belly, and cruel vomitings for the most part follow upon it: Wherefore it is not to be doubted but Convulsive Diseases also, and some such Symptoms are often caused by reason of some outward offence offered the extremities of the Nerves within the Membranes, Muscles or Viscera: Nay and if at any time in Hysterick, Hypochondriack, and certain other passions, Convulsive motions are raised through the fault of the Womb, Spleen, or some other of the Viscera, the Head being without hurt; truly those arise and are propagated on every side into various Regions of the Body only this way, viz. by the annoyances of the rest of the parts by the Way of the Nerves, and not at all by vapours conveyed to the Head. I shall now give you some instances and observations of Convulsions arising from the Extremities of the Nerves. A delicate Virgin about the sixteenth year of her Age falling from a Horse, and dashing herself against a rough Stone, sorely hurt her left Breast, whence a Swelling with a pain arose, which Symptoms nevertheless at first seemed to be mitigated by the use of Remedies, and afterwards for a long time to pass indifferently well; but after three years upon taking cold, and having used a very ill Diet, all things began to return a new; the place hurt swelling up in a greater bull, was affected with a most acute and almost continual pain, so that the Diseased, through the mighty torment, passed many days and nights without sleep; nor could she endure that the Glandules of her Breast, then become more swollen, should be touched or handled, nay nor any noise or concussion to be made in her Chamber. When to this Tumour, degenerating towards a Cancer, Fomentations and Cataplasms of Hemlock and Mandrake, and other stupifying things, and Repercussives were applied, the noble Lady began to undergo certain Convulsive affects, which often molested her: In the first place as often as a violent pain came in her Breast she felt there prickings, and likewise Convulsions and Contractions shooting in and out: Presently after the Ventricle and Hypochondres, and after that the whole Abdomen were wont to be blown up, and mightily distended with a rumbling and a straining to Vomit: By and by the same affect being conveyed by degrees to the upper parts, took away her Senses, and shortly upon it so strong Convulsions followed in her whole Body, that the Diseased could scarce be healed by three or four robust Men. These kinds of Fits at first came at random, and were only raised occasionally, viz. they ensued as often as the pain of the Breast was rendered more intense by some evident cause: Afterward those Convulsions more frequently molested her, and at length becoming periodical and habitual, they returned twice a day, viz. constantly justsomany set hours after Meals: And when Diseased had been miserably afflicted after this manner for six Months; at length she began to be troubled with a certain Vertiginous affects which continually followed her: For which evil when a Fomentation of Aromatic and Cephalick Herbs had been for some time applied, she grew better as to her Vertigo; but from thenceforwards she was continually molested with a new and very wonderful Symptom, viz. a violent dry Cough following her day and night, unless when she was fallen asleep: After this noble Virgin had tried divers sorts of Remedies, prescribed by several Physicians, without much benesit, at length upon the use of the Baths of a moderate heat at , she was relieved, and being married presently upon it, after conception and her being delivered of a Child, she recovered by degrees. As to the violent Cough above mentioned, it seems that that Symptom depended on the Origine of the nerves being affected, and not on any stuffing in the Lungs, for she spit forth nothing with the Cough; we say therefore that the Morbific matter depored near the Origint of the Nerves being rarified and moved by the Fomentation, entered deep in at the Mouths of the Nerves that go to the Lungs, and stirred up perpetual Convulsions in the Fibres and Filaments thereof. A noble Matron Fifty years of Age, after that her Menses had ceased to flow for a year and a half, first began to complain of a pricking pain in her left breast, than afterward that affect ceasing, she was taken ill about the Stomach: To wit, a hard, and as it were schirrous Tumour arose there with an oppressing pain; this was presently followed by an inflation of the Ventricle, with a difficult Breathing, a Nauseousness and frequent Vomiting. Then the Disease growing worse and worse, with a more acute pain, and shooting in and out every way, she fell into Conulsive affects of the Ventricle: To wit, the Convulsions shooting in that place several ways, she was almost continually in such a torment, as though the Stomach were torn in several pieces: Moreover a continual Perturbation of mind, and frequent Fainting Fits leading even to Death's door, accompanied with a Thirst and Watch, pursued the sick Lady; all which Symptoms she plainly perceived always to arise from that Tumour of the Ventricle (to wit, its sharp and heterogeneous Particles continually entering the Extremities of the surrounding Fibres and Nerves.) To this Person all Vomitory, Cathartick, Antiscorbutic and Hysterick Medicines, without giving any ease, seemed rather to have proved offensive and prejudicial: After Bleeding by Leeches, and the use of Ass' Milk she received some benefit, and afterward by long drinking Mineral Waters, she was very much relieved. What has been said here of Convulsions from a Morbific cause besetting each end of the Systema Nervosum will be made more clear when hereafter we shall treat particularly of the chief kinds of Convulsions, viz. of Hysterick, Hypochondriack and other Passions: In the mean while it will not be necessary to add a Therapeutic method to this Hypothesis of Convulsions happening by reason of the Extremities of the Nerves being affected; because the ways of Curing this affect may better be accommodated to those that we shall hereafter deliver in particular. I have found also by ocular evidence, that there are Convulsive affects whose cause, or Morbific matter lies within the Plexus's of the Nerves: For opening the Body of a noble Lady, who had been horribly troubled with those affects they call Hysterical a little before her decease, I found the Womb wholly without fault, but along the Nervous Plexus' of the Mesentery, which (as it seemed) had been wont to swell and rise up in a bulk, I found the Membranes of that Entral loosened and severed from each other, so that they appeared every where swollen and lax, as if blown up in little bubbles or bladders. Nor is it less probable that the pains of the Colic often proceed from a sharp and irritating matter contained in those same Plexus' Moreover such a kind of matter within the Pexus's of the Heart, seems to cause there horrible Tremble and Passions, and within the Plexus's of the Lungs or Neck, terrible Fits of the Asthma, &. CHAP. V Of Convulsive motions arising from the Liquor lying in the Nervous bodies, and irritating all their Processes into Convulsions. IT is obvious almost to daily experience, that Convulsive affects ren through the whole Genus Nervosum, and infest sometimes these parts, sometimes others, sometimes many together: For in some we may observe that the Tendons of the Muscles every where leap, and are drawn with Convulsions; in others that all the outward Members are in many places bend or extended this way, and that, with various flexions and contortions: We see some forced by a masterless and ungoverned impetus of the Spirits, sometimes being struck as it were with a rage, to run or leap, sometimes strongly to belabour the earth, or any thing that comes in their way with their Fists, which unless they did, they would fall presently into Swoonings and horrible Fainting Fits. It would be too tedious to enumerate all cases of those general Convulsions passing through the whole Genus Nervosum: But such like Symptoms, though various and manifold, may in some sort be reduced to three chief heads, viz. as they chief depend on three sorts of causes: For since in these Convulfions passing from place to place, we ought to suppose the whole Nervous Liquor to be vitiated, and the Animal Spirits, every where abounding in it, to be adulterated, and consequently to be almost continually exploded: We may observe that that taint for the most part is communicated both to the Nervous Juice, and the Spirits every where accompanying it, by one or the other of these three ways; viz. First, Either from Poison or Witchcraft; Secondly, from a malignant or ill-determined Fever, viz. in which the Morbific matter is discharged on the Brain, or Genus Nervosum; Or Thirdly, When the Nervous Liquor in long process of time, by reason of a Scorbutic or otherwise vitiated affect, degenerates from its due Crasis into a sharp, acid, or otherwise Preternatural and Convulsive Liquor. We shall here consider of each of these cases, and first of Convulsive Fits, which are product from Poison or Witchcraft. First therefore, That some Poisons act on the Nervous Liquor rather than on the Blood, and depraving it, cause chief Convulsive affects, it plainly appears from eating of Cicutaria Apium risus, deadly Nightshade, the wild Carrot, and other offensive Herbs, which is wont to be followed in a short time after with horrible Contractions of the Stomach, a Numbness, Delirium, and Twitchings and Convulsions in the whole Body of the tendons: Moreover those kinds of Convulsive affects ensue in such as are bitten by a mad Dog, and other Venomous wild Beasts when the Virulent Miasm received by the Nervous Juice, having lay n hid in it a long time, at length exerts itself, and infects and poisons with its ferment the whole Mass of the Liquor in which it is involved: And this is more clearly manifested by the wonderful Symptoms, viz. the painful Convulsions, and continual Dancing which are affirmed by Authors of Credit to ensue upon the bite of a Tarantula: Which doubtless happen, because upon the bite of that Animal, some Venomous Miasms are conveyed into the Body of Man, which nevertheless being little injurious to the Blood and vital Spirit, assoon as they have passed from it into the Nervous Liquor, presently spread themselves like a Ferment, through its whole Mass, and infect the Animal Spirits, every where abounding in it; so that they being forced apart from one another, and driven hither and thither in a disorderly manner, cause Convulsive affects, which sometimes are accompanied with a Contraction of the containing parts, sometimes with a languor and resolution of them. If it be asked why the painful Convulsions which are raised by the bite of a Tarantula, being presently appeased by Music, are wont to be changed into a Dancing, I answer, that the Venom communicated to the Nervous Juice by the bite of a Tarantula is more mild than to be able wholly to extinguish the Animal Spirits, or altogether to dissipate and force them to very violent explosions, being driven into divers parts; but can only put them to flight, and being driven hither and thither, egg them to slight, and in a manner only pain-causing Convulsions: Now Music by its gently soothing Nature, readily gathers together in one, and mutually associates the Spirits so dissipated: Wherefore when the said Spirits, by reason of Virulent Miasms sticking to them, are continually prone to Involuntary and Convulsive motions, the Melody disposes and directs them, being allured together, into such Convulsions, that entering the bodies of the Nerves in a certain feries and order, they are carried in certain limited I racts as it were, till at length the Particles of the Venom being wholly evaporated, and the fury and impetus of the Spirits wearied, they have wholly shaken off that rage: And indeed Music readily forces sound and sober Men, even against their wills, or thinking of other things, to actions emulating the Tune heard; so that a Piper no sooner gins his Lesson, but the standers by begin to move their Hands and Feet: We need not wonder therefore in Men bitten by a Tarantula, where the Animal Spirits being stimulated to motion as it were, are forced to skip and wander from one place to anothe of themselves, if upon playing on a Harp, they are put upon Dancing, and observing of regular motions. To this is a kin the Evil, which is called the Dance of S. Vitus, concerning which Horstius relates, that he spoke with certain Women, who visit yearly the Chapel of S. Vitus, which is within the Precincts of ulme's, and there exercise themselves so long in Dancing day and night, with a Perturbation of mind, till they fall on the Ground like Persons in an ecstasy: By which means they seem to be restored to themselves, so that they feel little or nothing for a whole year, till the time of May following. and then they declare themselves tormented with such a restlessness of their Members, that they are forced to betake themselves again about the Feast of S. Vitus to the foresaid place, to renew their Dancing. Indeed it is a usual thing (as I have often observed) both for Men and Women to be infested with such a restlessness, and certain rage as it were of the Members, that they are forced to walk till they are a weary, and also to dance and run up and down, by this means to avoid greater Disturbances and Swoonings, which would otherwise seize them: The reason of which seems to be, that the Animal Spirits, because stimulated in the whole Genus Nervosum from a Heterogeneous Combination, become wholly in a rage and ungovernable, which therefore ought to be so exercised and wearied, both that they themselves may be mastered, and that the Heterogeneous Combination may be shaken off. That Convulsive affects are sometimes caused by Witchcraft, it is both vulgarly believed, and every where affirmed by many Authors that deserve Credit: And to grant that wonderful affects are often produced in the Body of Men by tricks of the Devil, viz. in as much as by the wonderful subtlety in operating, in which he excels, he insinuates Atoms or Heterogeneous Corpuscles into the sensitive Soul, or the Texture of the Animal Spirits, and so sometimes stimulates its Functions, sometimes binds them, sometimes violently perverts them: Nay and farther in some manner he enters the Body of Man himself, and being as another Soul of a more powerful Nature, is co-extended to it, actuates all the parts and members, inspires them with an unwonted Vigour, and governs them at his pleasure, and stirs them up to the performance of wonderful and supernatural actions: Grant this I say, yet all kinds of Convulsions which appear prodigious, as being besides the common course of this Disease, ought not presently to be imputed to enchantments of Witches, or tricks of the Devil, for often, though appearing strange, they proceed from mere natural causes, and stand in need of no other Exorcisms for a Cure, than Remedies which are wont to be prescribed against Convulsive affects: In truth the Animal Spirits when endued with a very great explosive Combination, and discharged together by it, exert so much of strength and vigour above their proper and wont force, as a flash of Gunpowder above the burning of a common flame, so that such, who, being obnoxious to this Disease, may when they are out of the Fit be governed, carried, and led at pleasure by the guidance of one Man, when the Fit comes upon them, are not to be managed by the greatest strength and endeavours of four or more robust Persons: But if when any Person is distempered there be a suspicion of Witchcraft or Fascination, there are chief two kinds of motion which are wont to create and maintain it; viz. First, If the Patient uses such Contortions and Gesticulations of the Members, or of the whole Body, which no sound Man, even a Mimic, or any Tumbler, is wont to imitate; And secondly, if he exerts a strength, which exceeds all humane force, to which if there be joined excretions of monstrous things, as when heaps of Pins are cast up by Vomit, or living Animals are voided by siege, it comes to be without dispute that the Devil has, and acts his part in this Tragedy. CHAP. VI Of General Convulsions which are wont to be raised in Malignant, Ill-determined, and some Anomalous Fevers. EVery Man knows that Convulsions sometimes happen to Persons in Fevers, and that from thence a great Prognostic is taken of death or danger: For as in Malignant Fevers, and sometimes in ordinary Fevers of an Ill-determination, a Vertigo or Delirium arise from the Morbific Matter's being deposed from the Blood in the Brain; so from the same fallen into the Genus Nervosum, Contractions and Twitchings of the Muscles and Tendons, and also sudden shake of the Members and Limbs, and sometimes horrible stiff extensions in the whole Body ensue, which forts of Convulsive affects happen for the most part about the height of Fevers, when the Morbific Matter, first heaped together in the Blood, is conveyed thence into the Brain, and that being either presently passed through, or infected together with it, is carried into the Systema Nervosum, and thence Convulsive affects, with or without a Delirium are raised. Nevertheless besides these kinds of Convulsive affects which ensue upon Fevers, and are secondarily raised, we may observe sometimes in a Malignant Constitution of the Air, and after a breath of a pestilential Contagion, that the Nervous Liquor is infected before the Blood, or apart by itself from it, and that then a Delirium and Convulsions precede the Feverish Distemper. Moreover I have often observed that some Anomalous Fevers have been rife, in which the Blood being scarce seen to boil or to be extraordinary hot, the beginnings of a slow, and very dangerous Fever have been first laid in the Nervous Humour; which being raised by degrees to a Maturity, caused Convulsive affects with a Delirium or Mania, and other failings or exorbitancies of the Animal Spirits: For the Diseased not complaining of heat or drought, on a sudden becoming weak, and as it were enervated, were presently rendered obnoxious to a frequent Giddiness, also to Tremble and Leaping as it were of the Limbs, and likewise to Twitchings and Contractions of the Muscles and Tendons, and to pains moving from one place to another. This kind of Sickness, in regard it seems to consist in the solid parts, rather than in the Blood, is called by some Physicians a Malignant Hectic Fever, when in truth the same being chief rooted in the Nervous Humour, is better said to be a Convulsive Disease of the Nerves. Horstius mentions a Convulsive and Malignant Disease, which heretofore was Epidemical in Hassia, Westphalia, and the Neighbouring parts; those that were seized with it, without any Feverish heat, or immoderate effervescency of the Blood, as they were about their househould affairs, on a sudden scarce perceiving themselves sick, were wont to feel a Formication with a Numbness passing in and out about their Hands or Feet, and sometimes in both: Presently after their Fingers and Toes, and likewise their Arms and Legs, one while were closely contracted, another while strongly extended, as though they had grown stiff: These Contractions and Extensions followed each other alternatively, and now and then changed places, so that at one time the affect lay in this part, and then presently in another: But in case (as it often fell out) the Disease seized the whole Brain all at once, Universal Convulsions, and often Epileptical Fits infested the Diseased; Moreover they were obnoxious at certain times to a Dilirium, Mania, and sometimes to a Lethargy: This Distemper continued a long time without a Crisis, or being perfectly resolved, and could scarce ever be so throughly Cured, but ill and morbid Dispositions of the Brain and Nervous parts lasted afterwards during the whole Life. It plainly appears that this Disease and its Symptoms wholly depend on the Corruption and mighty Depravation of the Nervous Juice: And the reason why in this Nervous Fever, there happened a difficult, or rather no Grisis, or Solution at all, was because the Nervous Juice being tough and mucilaginous, as it were, and consequently slow in motion, is not purged as the Blood, by an excretory effervescence, nor does it easily fall into such a fermentation, whereby the pure is separated from the impure. I have known a Disease like this, often to have reigned in our Country, and to have passed through whole Families, at least amongst the Children and younger People. Some years since a popular Fever sorely infesting the Brain and Genus Nervosum very much reigned about Oxford, and indeed almost throughout England: The Narrative of which Disease, written at the time it reigned, viz. An. 1661. I shall here briefly insert; for from hence it appears after what manner, and by what causes Convulsive Symptoms which happen in all Fevers, are wont to be raised. An Account of an Epidemic Fever, reigning An. 1661. which chief infested the Brain and the Genus Nervosum. AFter the Vernal Equinox An. 1661. a certain Anomalous and unusual Fever, seized some Persons here and there, which nevertheless within a Month became so Epidemical, that in many places it began to be called the New Disease: Reigning chief among Children and young People, it was wont to afflict them with a long, and as it were, Chronical Sickness: Nay and sometimes though rarely it infested Persons stricken in years, and aged, but it killed them sooner, and more certainly: The affect first seizing any Person, so tacitly stole upon him, that the beginnings of the Sickness were scarce perceived: For arising without any immoderate heat or great thirst, it presently caused a great weakness in the whole Body, with a languor of the Spirits, and a deadness of the Animal Functions: The Stomach loathed all Food, and found itself oppressed by what was taken into it, and nevertheless it was not inclined to Vomit. The Diseased being indisposed to all motion, sought only to lie on a Bed, and do nothing: Within a short time, and sometimes from the first invasion of the Disease, they complained of a great Giddiness, a ringing in the Ears, and often of a turbulent motion and great perturbation in the Brain: Which sort of Symptoms were usually accounted a Pathognomick sign as it were of the sudden approach of this Disease; in case it happened that these were wanting, or remiss in some Persons, instead of the Head being affected after that manner, the Disease fixed itself deeper in the Breast, and raised a Cough, as we shall presently acquaint you: Now whilst upon the Brain and Nervous Appendix, their being affected after this manner, the Animal Spirits presently from the beginning of the Sickness waxed dull, a slow and hectic Fever as it were, was kindled in the whole Body: Nevertheless the effervescence of the Blood, which was scarce continual, but happening at random, and uncertain, was more intense in some, and more remiss in others according to the Crasis of the Blood itself: And consequently the Thirst, roughness of the Tongue, and other Symptoms, which depend on the Feverish Distemper, troubled them more or less. Sweeting did not happen of its own accord, nor could it readily or with ease be raised by Art: Nay farther, neither this kind of Evacuation or any other ever happening as it were by way of Crisis, put an end to this Disease on a sudden: But continuing for many Weeks and sometimes Months, it brought the Diseased into a mighty Atrophia, and often cast them into an incurable Consumption. About the time of the Diseases increase, which in most Persons happened within eight days, if the affect (as it often was wont) seized chief on the Brain, and Systema Nervosum, severe Symptoms, viz. a plain Frenzy, or deep Stupor, or a total insensibility commonly infested their Oeconomy: For I have frequently observed in many Children, and often in Women, after seven or eight days of their being seized, that they have wholly lost both Sense and Speech, so that they have lain for some time, nay sometimes for a whole Month's space, without knowing Persons present, and their Excrements passing from them after an insensible manner: And if the use of their judgement and reason in some measure held, yet they were troubled with a frequent Delirium, and always talked lightheaded in their sleep. But in Men, and others of a hot Constitution, upon the Morbific Matter's being conveyed to the Head, instead of a Crisis, a Fury or dangerous and often deadly Frenzy ensued: But if neither a Stupor nor violent Distraction seized them, a Scotomia, Convulsive motions, with Contractions of the Members, and Twitchings of the Tendons greatly molested them: Almost in all the Diseased, the Belly for the most part was lose, and voided plentifully sometimes yellow, sometimes thin and serous Excrements, which stank mightily. It was seldom that any were seized with a Vomiting: The Urine in the whole course of the Disease (unless when the Morbific Matter taking plentifully to the Brain, threatened a Frenzy) was of a deep red colour, so that some by reason of its deepness, judged this Fever to be absolutely Scorbutical: Which nevertheless appeared to be otherwise, because Antiscorbutic Remedies, (whereof a great many, and almost of all kinds were tried) had little or no effect: It was very much to be admired, how soon after the seizure of this Disease, the Flesh of the Sick fell away, so that they were brought to the dryness of a Skeleton, when in the mean time there was no exceeding great heat to consume the Solid parts by little and little, nor any violent Evacuation greatly to waste them. Besides these evils infesting the Region of the Head, an affect no less dangerous often seized on the Breast: For in some a very troublesome Cough, with much and thick Spittle was raised: This in some Persons happened about the declining of the Disease, viz. when the Confines of the Brain obtained a calm, the Clouds, as it were, being discharged thence on the Breast, a mighty Catarrh presently fell on the Lungs. But in some, especially who suffered little from the Disease in the Head, presently from the beginning of the Fever, a violent Cough, and a Spitting of filthy Matter, accompanied with a Consumptive Disposition, as it were, seized them, and precipitated them, suddenly and unawares into a Consumption; from which nevertheless, by a seasonable use of Remedies, they often unexpectedly recovered: I observed in some, after a long failure of the sensitive faculty, and an oppression of the Brain from the Morbific Matter, that at length tumors ensued in the Glands about the Neck, from which, assoon as ripened and broken, a thin and stinking Ichor flowed for a long time, and gave ease: I have seen also Watery Wheals saised in other parts of the Body, which have passed into bollow Ulcers with difficulty to be Cured: Sometimes small Spots; and as it were Fleabites appeared here and there: Though I have not heard that broad and livid Spots ever were to be seen in Persons sick of this Disease: However notwithstanding this Fever had not any very Malignant break forth, yet it was not free from Contagion: For in the same Family it seized almost all the Children and younger People one after the other; and often Persons stricken in years, who attending the sick, familiarly used about their Beds and Bed-cloaths, were infected with the same Disease: Yet I must say there was not so great a suspicion of infection, that for that reason the Friends of the Sick, should be wholly forbidden to visit them, or converse with them. Though all along the course of this Disease (unless when the Brain was greatly assailed) it apperned only mild, and past without any dreadful Symptom, nevertheless its Cure was always difficult, and was not performed but after a long time: For the Diseased seldom recovered within three or four Weeks, nay for the most part scarce within so many Months: But if this Disease fell on Men of a decayed Age or Strength, especially on such as were before subject to Cephalick Diseases, as the Lethargy: Apoplexy or Convulsions, it often killed them in a shorter space. Or if there were any hope of recovery, it could be carried on very slowly, (scarce any Remedies affording a sensible relief) so that the Diseased were no sooner gotten without the Sphere of this Fever, but they found themselves within the Confines of a Consumption. If the formal reason and causes of the foresaid sickness be enquired into, it plainly here appears that the Liquor which lies in the Brain and Genus Nervosum, for the most part, together with the Blood, was in fault, and was the immediate cause of the Symptoms that seemed chief pressing, viz. in as much as the Latex, presently from the first invasion of the Disease was become more impoverished than its wont, and effaete, as it were, and therefore a Languor and Enervation, with a Spontaneous Lassitude, and a Disability to motion, together with a sudden Consumption of the Body, happened to the Diseased: Though still the default of this Latex necessarily depends on the Dyscrasy of the Blood, and of the ill Constiution of the Brain [but here, as in other places, I refer you to Dr. Willis himself, for a fall Aetrology of Symptoms.] I have often observed in this Fever, after Oat Broth, a Decoction of Barley, and other thin Diet, that no less Ebullition of the Blood has been raised, than by a full Meat Broth: For indeed on one side as well as the other, the Nutritive Juice sent from the Chyle into the Blood, in regard it was not employed in the work of Nutrition, troubled the Blood, as some Heterogeneous thing that would not duly mix with it: And by reason of the Particles of this superfluous Juice, sent off in a plentiful manner with the Serum, the Urine was very thick and red, and mightily filled with Contents: And for this reason the Belly for the most part was lose, in as much as the Blood being full of a Nutritious Juice, sucked a less Portion of Chyle from the Lowels, and discharged again into the Intestines a part of that which was brought into it; moreover the Feverish Distemper stuck for so long time in the Blood, because till upon the Restitution of the Animal Governance, Nutrition was rightly performed, that superfluous Matter was heaped together in the Mass of Blood. I shall now give an instance or two of Persons affected with this Disease. A Robust and Florid young Man, about the beginning of the Spring, An. 1661. falling sick without any evident cause, soon became weak, and as it were enervated, with a loss of Appetite, and a languishing of the Spirits: Cathartick Remedies, Antipyreticks, Digestives, nay and Antiscorbutics, and others of eivers kinds, being given him, according to the prescripts of famous Physicians, did not the least good: But the Diseased still continuing in a languishing condition, lay by it for six weeks, with a slow Fever of uncertain returns, a quick and weak Pulse, and a deep red Urine. Moreover being mightily pined away, he complained of a ringing in his Fars, and an Undulation of sound, as it were, in his head: Though he was affected with a great Stupor, yet his Sleeps were very much troubled and interrupted with a talking Lightheaded. After forty days, the Fever not yet declining, it was thought good to draw about four or five Ounces of Blood from the Vessels of the Fundament by Leeches. Hereupon presently the Fever began to be very much exasperated, for the heat became more intense, with a Thirst, Watch, and an almost continual tossing of the Body, the Tongue also growing dry and rough; shortly after a troublesome Cough, with much and discoloured Spittle ensued: There were carefully given him Almond and Barley Drinks, with temperate things against the Cough boiled in them, Water of Milk distilled with Snails and Herbs appropriated to the Thorax, Powder of Shells, Niter prepared, and likewise Cordial Opiates; which nevertheless scarce giving any relief, the Diseased still became weaker: And when after this manner, having been sick above two Months, the Feverish Distemper, and the Cough also daily growing worse, he seemed to be at Death's Door, at length a Sweat hapening of its own accord, which sometimes came upon him every night, sometimes every other night, he grew better by degrees thereby, and using afterwards the foresaid Medicines, he became perfectly well within six weeks. Whilst this Person lay ill, I went to see another about Twelve years of Age, affected after the like manner; but this, when I was first called, having lain ill above a Month, was reduced to a Skeleton: Moreover he was affected with a Giddiness, a ringing in the Dares, and a Deafness, and likewise with a violent Cough th● accompanied with a yellow, and as it were Consumptive Spittle: His Pulse was quick and weak, his Urine red and thick, his Appetite very much dejected, his Spirits so faint, and his Strength so fallen, that he could not keep himself from his Bed: To this Person I gave often in a day Milk distilled with Snails and temperate Herbs: Moreover instead of ordinary drink, I ordered him daily to take an opening Decoction, such as is used in the Rickets: By the help of which Remedies he seemed to be restored to his health within a Month's space. This Fever in a certain Noble Man's Family, proved very fatal amongst his Children, who had been originally subject to Cephalick affects. About the Vernal Equinox, a Boy of about Eleven years of Age, began to fall sick. In the first place without an intense heat or drought, a loss of Appetite, and failing of Strength came upon him. Moreover an almost continual Vertigo molested him, with a frequent inclination to Fainting, so that he often thought himself ready to fall in a Swoon: To this Person, by the advice of some Nurse that attended him, Glisters were daily given: And afterward when from the foulness of his Tongue and Mouth, the manifest signs of a Fever appeared, that Empirick gave him a Vomit of the Infusion of Crocus Metallorum. And the seventh day giving him a Cordial Powder, and covering him over with , she made him Sweat: His Skin no sooner began to be moist, but presently speaking Lightheaded, he complained that his Cap was fallen into water, soon after becoming Speechless he died, (whilst I was sent for) within four hours. Shortly after, the same Disease seized his Sister who was younger; whose sickness nevertheless, because it was accompanied with a frequent Coughing and Spitting, was first thought to be only a cold taken: But within a few days, that Cough became manifestly Convulsive; for in Coughing the Diaphragm being raised upward, and so held for some time, by a repeated Systole, a mighty Shrill noise, as though she were suffocated came from her: Afterward this little Girl growing more manifestly Feverish, and complaining of a thirst and heat, past the nights without sleep, with a mighty tossing in her Bed, and after a while speaking Lightheaded, she complained as her Brother had done before, that her were fallen into the water; and as all things grew worse, she began to be troubled with Convulsive motions, first in the Limbs, shortly after in the Face, and then in the whole Body: The Fits returning frequently, viz. twice or thrice within an hour, very sorely pursued her, so that this poor Wretch died within the space of twenty four hours after the greater Convulsive affects had seized her, the 〈◊〉 of the Animal Spirits being wholly subverted. Whilst the Convulsive Fits pressed upon her, the Pulse was very much disordered, and often intermitted, and she was affected with a frequent Vomiting. Because this Fever seizes some Persons predisposed for it almost yearly, and haply hereafter may at some time become Epidemical, by reason of the ill Constitution of the year, I think it may not be amiss to delineate some method in order to its Cure. The Therapeutic Method. COncerning which in the first place, you may note, that Critical days are by no means to be observed in this Fever, as in the vulgar continual Fever: For in this the Blood, assoon as it gins to boil, presently discharges from its Embraces on the Head or Thorax, a part of the Morbific Matter, crude as it is, and not digested: Wherefore it would be to no purpose to expect that the Blood should permit its Heterogeneous Particles to be gathered together in its Mass, and then that an Excretory effort arising at set intervals of times, should purge forth the same being subtilised: Nay rather the said Blood, when boiling, Rises not to a great and open flame, but like a fire covered with Turf, emits a moist Smoke or Breath, rather than a Flame: Yet so that from thence by reason of the Nervous Juices being presently depraved in its Crasis, and often by reason of the Lungs being stuffed with a Morbific Matter, Convulsive or Ptizical Symptoms are particularly pressing throughout the whole course of the Disease. I must set down the Curative intentions according to the various times of the Disease, and the diversities of Symptoms that are chief pressing. About the beginning of this Fever, letting Blood seemed to agree in a manner with all: I have often found this Remedy of good effect in Children: For by this means a Breathing place, as it were, is opened for the Mass of Blood, which tacitly and covertly lies a boiling, and obtrudes its foul smoke on the more noble parts, and consequently its impure Efflorescencies are withdrawn from the Head and Lungs: Therefore though this ill disposed Fever be said in some sort to be Malignant, yet in as much as the Blood is not apt presently to be coagulated, but to be fused too much, and to discharge its Serosities on the noble parts, viz. the Head and Lungs, therefore Bleeding, so it be used in the beginning of the Disease, agrees in a manner with all Persons. For the same reason of Curing, Cathartick Medicines, and especially Vomits, are given presently at the beginning of the Disease, for these do not only empty the Vessels of Concoction, and so withdraw both the first, and as it were original fuel of the Disease, but likewise draw Serosities from the Blood, and so cause its filth rather to be discharged in the Stomach and Intestines, than on the Head or Lungs. Moreover in as much as the Glands which receive the Lymphducts, are twitched and strongly shaken by Emetics, the Superfluities of the Nervous Juice are thereby pressed forth into the lower Viscera, that they cannot offend the Brain, and its Appendix: And for this end, let the Belly still be kept soluble by the frequent use of Glisters. In the mean time, while the Blood, being defiled with the taint of this Disease, threatens ill to the Brain or Praecordia, it will not be safe to attempt any thing with Diaphoreticks or Diuretics, or also with strong cathartics: For these sorts of Medicines, greatly fusing the Blood, and driving its Serosities into the places most open to receive them, easily obtrude on the Brain or Lungs; if at any time they are of a weak Constitution, any dreggy filth which is apt to departed from the Mass of Blood: So in the Youth above mentioned, a Sweat being unseasonably raised, it was followed by a loss of Speech: And I have known that Sudorificks, in like manner as Chalybeats, have brought a Consumption in a Morbid Disposition of the Lungs. Therefore Bleeding, and if need be, a Vomit or Purge, viz. one of them, or both being presently ordered at the beginning of the Disease, the other intentions will be to divert the Morbific Serosities of the Blood, which are apt to flow to the Head and Breast, and to derive them, off gently by other ways of Evacuations, and to clear them forth: For this end Vesicatories ought to be applied on the Nape of the Neck, or behind the Ears, near the Armpits, in the Groin, or on the Thighs, or Calves of the Legs, viz. sometimes in this part, sometimes in that; to wit, that the little Sores made here and there, flowing continually, may plentifully discharge the Serum filled with Heterogeneous and Morbid Particles. Moreover Remedies gently conveying the Serum to the Reins and Urinary passages, are often given with good effect; for this purpost let Diuretic Apozems ans Julapes be ordered according to the following Forms. Take Roots of Scorzonera, Chervil, Grass, Eryngoes preserved, of each six Drams, one Apple sliced, Leaves of Burnet, Meadow sweet, of each a handful, Raisins an Ounce and a half, Hartshorn two Drams, being sliced and bruised, let them boil on a clear Fire, in four Pounds of Fountain-water till a third part be consumed, to two Pounds of the clear Straining add Syrup of the Juice of Citrons, or of Violets two Ounces, Sal Prunella a Dram and a half, make an Apozeme; the Dose is from four Ounces to six thrice a day. Or let that Straining be poured on fifteen sineet Almonds blanche, and on the four cold Seeds of each a Dram being lruised, make an Emulsion according to Art. Take water of Dragon-wort, and of black Cherries of each four Ounces, of Scordium compound two Ounces, Treacle-water an Ounce and a half, Syrup of Clove-gillylowers two Ounces, Spirit of Vitriol twelve drops, wake a Julape. Let Sal Prunella be giben often in a day in small Beer or Whey, from half a Dram, or two Scruples. Moreover in this Fever Medicines gently promoting Sweat, especially such as restore the Animal Spirits, and free them from any Heterogeneous Combination, are of excellent use: Wherefore either let Powder of Pearl, or Spirit of Hartshorn, or of Blood be given in a small Dose twice a day, viz. Morning and Evening. Let Glisters be injected alniost daily, and if it seems convenient, let a gently loosening Medicine be repeated twice in a week. Let none but a thin Diet be ordered, viz. such as is wont to be in other Fevers; Flesh or its Broth being wholly forbidden, let the Sick eat only Oat or Barley-broath, let his Drink be small Beer or Whey. But if notwithstanding any Physical provision, the Morbific Matter gets possession of the Brain or Lungs, or both of them together, so that a failing and disorder of the Animal faculty, or also a violent Cough come upon the Diseased, we must consider what is to be done in either state of the Disease, raised after this manner to an ill condition; for then the Curative Indications ought to respect a stupor or madness, or the Cough; and at length, if the Disease being upon declining, these Symptoms remit, let appropriated Remedies be given against the Atrophia, it being as the last fortress of this Disease. 1. Therefore if the Morbific Matter, as it frequently is wont, being brought to the Head, causes there a Stupor or Sleepy affects, Remedies ought to be carefully administered, which draw it to another place, and derive it some way or other from the Head, and likewise such as raise up the Animal Spirits, and make void the impure Combination: Wherefore in this case, let the use of Epispastics be very much increased outwardly, let Spirit of Hartshorn be given every sixth hour in somewhat a large Dose, let Blood be drawn again from the Jugular Veins, the Salvatella, or also from the Veins of the Fundament by Leeches. If the affect does not remit, the Hair being shaved off, let Emollient Fomentations be often applied to the Head: Moreover let Cupping-glasses, Plasters and Cataplasms be applied to the Soles of the Feet; and other ways of administration, such as are vulgarly indicated for Curing a Stupor, aught to be used: In like manner, if to the evil or defect of Crisis in this Fever, a Frenzy or Mania Supervene, let Remedies appropriated to those affects be administered. 2. But if, together with, or without this Detriment brought on the Head, the Lungs also are injured by the Disease, so that the Diseased, not yet freed of their Fever, seem to have fallen into a Consumption or Ptizick, with a troublesome Cough, much and thick Spittle, and that often discoloured, Medicines commonly indicated in such affects are proper; wherefore Pectoral Decoctions, Lohoches, Syrups, Waters of Milk and Snails distilled, and other Remedies of this kind, ought diliently to be used: The Forms of which are to be found in their above written cases. Hitherto we have described a continual Fever, for the most part Convulsive, and taking its rise both through the default of the Nervous Juice, and of the Blood: I shall now set before you an example of a Disease, resembling an intermitting Fever, and chief radicated in the Nervous Juice. A fine Woman, of a very tender Constitution, and a weak temper of the Brain and Genus Nervosum, and consequently very subject to Convulsive affects, after she had conceived, about the fourth Month of her Childbearing, upon taking cold, was most sorely afflicted with Asthmatick Fits, and likewise with frequent Faintings of the Spirits: But by the use of remedies endowed with a Volatile Salt, she grew well of these Distempers within a fortnight; nevertheless after six weeks were passed, an unusual, and very wonderful affect seized this Lady. On a certain morning awaking after her sleep, which had been somewhat troubled that night, she felt in her whole body a light shivering, as tho' the fit of a Tertian Ague were coming upon her: Frequent Gaping and Retching follow it with a frequent straining to Vomit: Then her Urine, which just before was of an Orange colour with a laudable sediment, became pale and watery, and was very frequently voided, viz. every munute of an hour. Moreover about the Loins and Hypochondres, and in other places, pains with light Convulsions passing from one place to another were raised. Which kind of Symptoms, being manifestly Convulsive, with the frequent making of Limpid Water continued from the morning almost to the evening: In which space of time a vast quantity of Urine, viz. thrice more than the Liquor drank, was made: In the mean while the Heat became not more intense, nor did Thirst seem pressing, nor was the pulse raised: In the eveing the foresaid affects ceased, and the Urine came again to be of an Orange colour, and in a small quantity; and she enjoyed a moderate sleep during the whole night; and then the next morning the Fit returned near the same hour, accompanied whol'y with the like Symptoms, and daily acted over the very same Tragedy. Going to see this Lady after the had lain ill after this manner for twelve days; I judged that this disease being chief rooted in the Genus Nervosum, depended on the effervescency and flowing of the Humour that lies in the Nervous parts: to this Breeding person I Prescribed Bleeding, and to take twice a day a Powder made of Coral, Pearl, Ivory, and other Cordial things in an appropriated Liquor: morning and evening she took twelve drops of the Tincture of Antimony, the effect whereof I have found to be singular in a too great Flux of Urine: by the use of these things all the Symptoms in a short time remitted. CHAP. VII. Of General Convulsions which are wont to arise by reason of a Scorbutic disposition of the Nervous Juice. SOmetimes universal Convuisions, without Poison, or a Feverrish Miasm, are caused by reason of aScorbutick or other wise vicious dyscrasy of the Nervous Juice; for the Liquor which lies in the Nerves, and Nervous parts, sometimes falling from its natural and due Crasis, is so much filled with Heterogeneous and Explosive Particles, that the Animal Spirits admitting an incongruous combination, some ways accrueing to them, are irritated to continual Explosive Convulsions; which kinds of affects of the Spirits are either divided or separate, betwixt which no Communication or dependence happens, viz. when many parts of the body are affected together with so many Convulsions peculiar to them, which do not follow each other successively, but are terminated in the same Mnscle or Member where they begin: Or secondly, The Convulsive affects which are raised together in the whole Genus Nervosum, are continual or connected, and being continued by a per petual sort of Vicissitude betwixt themselves, succeed each other, so that the disorderly motions of all the Members through a Mutual Succession when they begin at one part, presently pass into the others. We shall consider the nature of both those convulsive affects, and shall show what method of Gure is to be used in each case. 1. As to the former kind it plainly appears that such affects are not simple, but complicated, viz. of a Convulsion and Palsy, for though the Muscles and Tendons are continually intested with Convulsive Motions, yet the Diseased being Enervated cannot move strongly any Members, or the whole body: nay to these affects Pains Diffused through all the Limbs are added: hence we may infer that the Animal Spirits are endued with a Manifold Combination, viz. with particles both Explosive, and Narcotick, and in some sort irritative; so that tho' being always oppressed, they fall upon Explosions, yet neither many of them together, by reason of other Particles of another kind mixed with them, nor indeed any of them have a free and lively Explosion wherefore the Impetus of Motion does not reach far, but is always short and interrupted. A strange instance of this affect take as follows. A nobleman descended from Parents and Ancestors who had been subject to evil affects of the Brain, or other Morbid dispositions of the Nerves, about the time that his Age. began to decline, first was wont to be troubled with a weakness, a numbness, and gentle Convulsions in his Limbs, after having lain long under these affects, at length he went to for a Cure, but ufing there the hot Baths too other, instead of a cure he got only so great an exasperation of his disease; that from that time the foresaid Symptoms did no longer follow him at times, but almost constantly, viz. Convulsive Motions, and Painful Tensions incessantly occupied all his Limbs, nay and each part of his Body, so that all the Muscles together were perpetually Convulsed with repeated Twitchings, and that not without a mighty Torture: the only way of appeasing which was, that sometimes his whole Body, sometimes some of its Members were continually exercised with a local Motion: for as long as he was awake, he was forced to be kept moving in his Bed, or in his Seat, or to be carried in a Coach, or to have his Members pressed or rubbed; for which end Chairs and Beds were made for him with rockers, like children's Cradles, in which as he lay, or sat upright, he was continually rocked to and fro: without which, he was tormented with a cruel Pain, and a violent Tension of the Muscies; the diurnal oppression of this Convulsive affect was followed in the night time, and presently after sleep with much more severe Syniptoms; for he no sooner awaked, but presently his whole Body fell a shivering, the Muscles were very much toiled with painful Convulsions, and all the Limbs, as in an agony of Death, were wont to be all over in a foul Sweat, which was so Corrosive, that the sheets, unless they were presently washed, were soon eaten and rotten by it, as by Aquafortis: the sick person during this conflict, was tortured betwixt Sweeting and Shivering for many hours, till being quite tired, a sleep stealing upon him, brought some ease: but if, as the fit was coming, he was taken out of his Bed, he was better, and so he prevented the wont violence of the Fit: therefore assoon as he was awaked from his sleep, tho' this happened within half an hour, presently to escape the torture, he called his servants, and was taken forth of Bed: being well enough as to his Akppetite, he did Eat without nauseousness, nor was his Stomach troubled by what was taken into it, yet he often complained of a Cardialgia; and sometimes a troublesome Spitting, with a stinking Breath, as tho' he had taken Mercury, molested him for many days; any Hot things, as well Food as Phylick, did not agree with his constitution: he dared not so much as Sip of Wine, or Strong-beer: in the first years of his Sickness he was seized with a horror at the sight of Fire, afterward becoming weaker, her refused to sit by the Fire, even in the Winter: his Urine was always of an Orange Colour, which if Evaporated on Coals in an Earthen Pot, a Saline filth, amounting to above half the Liquor, fell to the bottom: The Belly being always Costive, never deposed its burden unless irritated by a Medicine or clyster: Moreover, besides the Convulsive Motions, a Bastard Palsy possessed all the Members of his Body, for he could neither lift up his Hands, nor walk with his Feet; his tongue faltering brought forth only imperfect words, but sometimes when on oocasion his mind was possessed with a sudden Joy, his Spirits and Strength being strangely raised, he was able on a sudden to rise from his Chair and to walk upright, and skip about without help; which interval nevertheless scarce lasted a minute of an hour, but the Members faultered afresh, and were troubled with their wont Languor and Trembling. As this person was ill after this manner above twelve years, he got the advices of the most Famous Physicians of all England, and tried a great many remedies and almost of all kinds, viz. Antiparaliticks, Antiscorbutics, Drying, and Sweeting Diets, Purges, Cauteries, Baths, Liniments, nay and was twice Salivated but could not be Cured by any of those Methods, wherefore all hope of Cure being laid aside, for the seven latter years of his life he used only remedies that had regard to some of the chief Symptoms; viz. he took thrice a week a Loosening Medicine of Sena and Rhubarb with Correctives, sometimes in the form of a Syrup, sometimes of an Extract; he used to take every night a Dose of an Opiate made of temperate Conserves and Species: Moreover he had a Julap in a readiness to be taken on occasion, when the Spirits faultered: He also Drank Oat-bear, Altered with temperate and Diuretic Herbs: By the use of these things he passed at least seven years, without any great alteration for the worse: At length Old Age pressing opon him and the Disease together, the Convulsive fits growing more violent, seized him, not as before when his sleep was over, but as soon as he was warm in his Bed, so that he was forced wholly to forbear going to Bed, and he put off his but seldom, unless it were to change Linen: Hence transpiration being hindered, the Serous and other Filthy Dregs which were wont to evaporate, were fixed on the Lungs, which first brought a thick Breathing, afterward an Asthmatick affect, and lastly a Mortla Consumption. If the reasons of the foresaid affects be enquired into: it will appear that all these Evils proceeded from the ill Constitution of the Brain, and Genus Nervosum, and more immediately from the Dyscrasy and Default of the Juice that lies in these parts. The reason is plain why this Disease, first increasing by degrees, was soon raised to a far worse state by the use of hot Baths, for it is manifest by experience that hot and sulphureous Baths very much exalt the Saline, and other Morbid Particles, that abound within the Viscera, or Humours of Human Body, and soon carry them to the highest pitch, viz. by exagitaing them they render them more wildly exorbitant, and froce them from the first passages into the Blood, and thence into the Brain and Genus Nervosum, nay and join them together being first severed, and lying idle, and stir them, up to a certain Fermentation: Wherefore such as being hereditarily obnoxious to the Gout or or Stone, have not yet felt any Fits of those affects, after the use of hot Baths, very often find that both those diseases are presently brought to a maturity in them. [You may find the reasons of the other Symptoms in Dr. Willis at large.] So much for universal Convulsions, which for the most part being joined to the Paralytic affect, are raised at once in many places separately: there remain others which we call continual, viz. because being conveyed on a sudden from these parts to others, they mutually succeed each other, and force the Members sometimes these, sometimes others, and often the whole Body to be moved involuntarily, and to be bend and agitated divers ways. I shall give you an instance or two of this affect. A Beautiful Virgin, tall and thin grown, begotten of a Father obnoxious to very great distempers of the Genus Nervosum, about the twentieth year of her Age was afflicted for many days with a very violent and Periodical Head ache, at length the Winter Solstice being near at hand the pain of her head remitted, but in its stead, a mighty Catarrh succeeded, with thin and much Spittle, and with an Ulcerous affect of the Nostrils, Mouth, and Throat; having undergone the tediousness of this for some time, at length by the advice of some old Women she drew into her Mouth the smoke of Amber through a Tube, and was presently Cured, viz. the Catarrh was suddenly stopped, but presently upon it she complained of a mighty giddiness, with a Pain of the Head, and a Ringing in the Ears: on the third day the Tendons of the Neck were Convulsed that her head was bend sometimes forward, sometimes backward, sometimes sideways, and sometimes it stood stiff and immovable, in a short time after this such a Convulsive affect seized the ontward parts of the whole Body, and the Limbs: the Arms and Hands were so wonderfully twisted, that no Juggler of Mountibank was able to imitate their Flections and Convolutions: Her Legs qand Feet were forced awry this way and that, and were made to beat against each other, and to cross each other alternatively after this manner she was perpetually affected with Convulsive Motions either sitting in a Chair, or lying in Bed, unless when she was overwhelmed with sleep; and when she contained her members a little, by much forcing herself, presently she was seized with a difficult, and short Breating, and with a danger of being Choked, yet in the mean time the Eyes, Jaws, Mouth, and inferior Viscera continued free from any Convulsion: Nor was she troubled with a Vomiting, Rumbling, nor Inflation of the Hypochondres: Moreover her mind held always sound, and she duly performed the functions of Memory, Understanding, and Imagination, she neither spoke nor did any thing showing want of Reason, or Indiscreetly: but amongst all these stupendious evils always using Pious and Virtuous expressions, she gave an admirable specimen of Christian Patience and Piety: her appetite was soon dejected, so that she was averse from all food unless very much pressed to it; but thirst continually pressed upon her, she was so very weak, she could neither stand nor go: Her Urine was of an Orange Colour, very much Impreguated with a Saltness, on the Surface of which a thin Tartareous Film grew. Being called to this Lady the sixth day after her being ill, I proceeded in order to her Cure as follows: In the first place having made a gentle preparation of the Body, I gave her a Loosning Potion of an Infusion of Sena and Rhubarb, with the addition of Yellow Saunders and Salt of Wormwood, whereby she had twelve stools which gave her great ease; the day following I drew eight Ounces of blood from her left Arm, every evening I gave her an Opiate of the Water and Syrup of Cowslip flowers with the Powder of Pearl: Moreover once within six hours I ordered her a Dose of Spirit of Heart's Horn to be taken with a little draught of the following Jalape. Take Water of black Cherries, Walnuts, and Peony Flowers of each three Ounces, the Antiepileptical Water of Langius two Ounces, Syrup of Male Peony Flowers two Ounces, Pearl powdered a Scruple, mix them make a Julape. Because she could not bear much Purging, Glisters of Milk and Sugar were frequently used: Besides Anticonvulsive Liniments applied to the Neck and Spine, we ordered Frictions of the Members affected with Woollen moistened in an appropriated Oil, and warmed. By the use of these things, within six days the diseased seemed to be very much relieved; for the Convulsive Motions in a manner wholly ceased, she could keep her Members in their due Site, and without Motion, only she was forced sometimes by a slight Contraction to bow her head gently this way and that: Moreover she was able to arise from her Chair and Walk a little, but as she Walked, she did not go upright, but inclining to one side's Parting from her at that time, I left her in a manifest state of Recovery, she seeming to be much better: But somewhat more than a week after, a boisterous North Wind arising in the night time, and blowing strongly on the diseased as she lay in her Bed, the window being not well shut; presently upon taking Cold she fell into such a relapse, that she became not only obnoxious to Convulsive affects, but likewise to a Universal and Periodical Palsy: For from thence forward her Head and Members being bend and tossed again from Morning to the Evening as before, she was made to Wind, bend and variously Wrist all her Limbs successively; till about night those Motions being wholly appeased, a Resolution or Palsy of the Members ensued, so that she could neither move Hand, nor Foot, nor any part else, or exercise any effort of Motition of the Body, lying in the Bed like a Stone, immovable: But being somewhat refreshed with sleep, about the morning, as she recovered some strength of the regular moving Faculty, viz. enough, to bend the Arms and Legs, to and fro, tho' weakly, so also the Convulsive and Involuntary Motions constantly returned, and continued for the whole day after, which in the evening were again Changed into resolutions of the Limbs. From what is said it plainly appears, that the sick Lady lay under a double disease, viz. APalsey, and Convulsions: And besides the remedies before mentioned a great many others almost of all kinds, viz. Antiscorbutics. Antiparaliticks, Sudorificks, Decoctions, Distilled Waters, Spirits, Elixirs, Tinctures, Baths, Liniments with many others were carefully administered; by the use of which the Symptoms were a little remitted, but the disease was not perfectly Cured: The Universal Palsy ceased in a short while, so that she could move her Limbs and bend them to and fro at all times; nay and the involuntary Motions of her Members seldomer molested her, yet she still continued faint and weak, and as she was of a tender Constitution, and inclined to a Consumption, and now become unapt for all exercise, the filthy Dregs of the Blood deposed in the Lungs, by reason of her letted transpiration, brought a Cough, which daily growing worse and worse, she died at length Pthisical. Many years since I was called to a noble Virgin taken almost after the same, and somewhat a worse manner. For this underwent Involuntary Motions of the Head and Members, viz. either Shakes of them, or Bend this way and that, or Wrest of them, returning almost in a constant Course: Moreover she was affected with a very troublesome, and wholly wonderful Convulfion of the Diaphragm, and Muscles that serve for respiration for every minute of an hour and oftener, the Back Bone about the middle of it was made crooked, and at the same time Breast Springing forward, and the Hypocondres contracting inward, a very Sonorous Sobbing, and the same sometimes doubled, sometimes tripled, but still less and less Shrill came from her; she was wont to continue these Motions, and Reciprocation of noise many hours, so that she was heard throughout the whole house; if at any time a short intermission of this happened, presently she was forced strongly to beat or clasp her arms and hands one with the other, sometimes her Legs and Feet, and sometimes to throw her Head after a most violent manner; by and by to hold her Neck as it were still and immovable. Sometimes in speaking her Tongue was so taken, that she repeated the same word often, nay more than at least twenty times. When the Convulsive Motions were strong in the Exterior Members she was a little somewhat free from that stridulous Sobbing affect; and she called this the space of Intermission and the time of her ease; tho' in the mean while her Head and Members were drawn every way with violent Motions: If at any time she lay on her Left Side, presently an inward Contraction of the right Hypocondre, with a Sobbing happened, within a few days, her strength being very much dejected by the assidnity of these affects, she got such a weakness in her Loins and Knees that she could neither stand nor go: The Stomach being affected either with a Languor, or Convulsion threw up all by Vomit that was put into it. Coming to her the fourth day I gave her a Vomit, after which she Vomited sever times a viscous Phlegm, with store of Yellow Choler; but without any relief: The day after I drew six Ounces of Blood from her Arm, wereupon the Blood presently taking violently to the Head, she complained very much of a Headache and Giddiness; but being Blooded in the Foot, within three days, she was better: She tooks afterwards remedies appropriated to the Nerves, viz. Spirit of Hartshorn, and of Blood, Powders of Shells, Bezoars, Anticonvulsive Julaps, and Electuaries: by the use of these things the Symptoms seemed somewhat to abate, yet continued still in some Measure according to the Forms before described: After a fortnight, by the advice of some Country Woman, she took six spoonfuls of Blood, drawn from the Ear of an Ass, in a draught of bear, wherevopn on a sudden she seemed to be Cured: For the Convulsive Motions presently all ceased, and she past twenty four hours free from them, nevertheless the disease returning shortly upon it with its wont violence, yielded not easily to that Medicine, nor indeed to any other whatsoever, therefore for the time to come she took Medicines methodically prescribed: She Purged gently once in six days, besides she took a Powder made of Bezoar, Pearl and Coral, with the Seeds and Roots of Peony, also the Electuary prescribed by Horstius against these kinds of marvellous Convulsions; and likewise Julaps and Decoctions appropriated to Convulsive affects: Glisters were frequently given: Frictions, Vesicatories and Linements, were administered with good effect; within a fortnight the Sobbing affect wholly ceased, nay and the rest of the Convulsive Motions, being rendered more mild by degrees, remitted very much; but as she was recovering of those affects she was so troubled with a Catarrh falling on her Throat, that she Spit forth almost continually a Sharp, and as it were Corrosive Spittle, as if a Salivation were raised by taking Mercury: Which kind of remedy the event proved to be extremely proper in this case; tho' I wholly forbore using it, because the diseased and here friends were not free to admit of it. After that this Copious and very troublesome Spitting had continued for many days the disease seemed to be in a manner wholly Cured: So that the Noble Lady, being free from theConvulsive Motions, walked abroad, and had a good Strength and Stomach●: Only she complained that at certain times in the day, she was affected on a sudden with a Shivering of her whole Body for about a quarter of an hour: which kind of affect, sometimes also happening by night, broke her sleep. Within a month's space this Symptom also, and likewise the Catarrh, wholly ceased: but afterward she was so afflicted, sometimes with a Sharpness in the Ventricle and Passage of the Aesophagus, sometimes also in the Jaws and Palate, that she feared lest those parts, the inner Skin being worn away, would contract an Ulcerous affect: Moreover often in her sleep, and sometimes also waking, she used to be troubled with an Incubus. I ordered her a gentle Purge to be given Spring and Fall with the use of Antiscorbutic remedies, and sometimes Chalybeats: Which kind of Method she observed with so great advantage to her, that she has enjoyed her health for many years, and enjoys it still. Among many remedies which she took against that Sharpness, and Ulcerous disposition as it were of the Palate and Aesophagus, I ordered that she should Drink every Morning her own Urine fresh made: This for the most part being very Salt, was wont to give a mighty relief; but at certain times the Urine that came from her was thin, and in a great plenty, which nevertheless was not Salt, but manifestly Acid like Vinegar, after the Drinking of which she found little or no benefit. The reason of the good effect of the one, and not of the other is this: In as much as Saline Particles of a differing state, and not those that are of the same, mutually act on each other, and weaken their strength, therefore the Salt Urine and not that which was Sharp of sour Cured the Sharpness of the Throat: And it appeared from hence that the Humour distilling on the parts of this Lady's Mouth and Throat was Acid and drew near to the nature of a Vitriolic Vinegar, because the smoke of Tobacco received in the Mouth of the Diseased seemed wonderfully Sweet as it uses or do in any that taste Vitirol before. Ten years since I went to see the daughter of a certain Nobleman, troubled with Convulsive Motions after such a manner, that some thought her obsessed with an evil Spirit: This Virgin being about sixteen years of Age, Fair, and well in flesh, but begotten of a Father troubled with the Palsy, about the winter Solstice began to be ill without any evident cause: First for some days she was affected with a Headache and a Giddiness, though in no severe manner; afterward she perceived a Trembling, and sudden Contraction in one Arm, and presently in the other, which kind of Convulsions, returning often that day, scarce lasted a moment's space: The next day after sitting by her Sister in a Chair, on a sudden she started up, and made a leap or two, and many others successively to many feets distance with a wonderful Agility: Then when she was come to the end of the Room, she stood for some while leaping up in the same place, and every time to a wonderful height, when her legs were able to hold Leaping no longer, she fell on the ground and presently threw her Head several ways, as though she would have thrown it off her Neck, assoon as she ceased from this Motion, through her being tired, presently the same fury seized her Hands and Feet, that she was forced to keep these members a going in a violent manner, striking them against the Walls and Doors, or stamping on the Floor: When through Modesty, or Reverence due to Friends, or Persons present she kept herself from these Motions by main force (for she was always present to herself and spoke with sobriety) presently the affect being conveyed inward, she was very much infested with mighty oppression of the Heart, a Sighing, and very loud Sobbing, then when she gave way to herself, presently the Rage being conveyed to the Muscles of the outward Limbs, she was forced either to Leap, or to throw her Head or Arms this way and that in a violent manner, or also to run swiftly up & down the Chamber, or to stamp on the Ground with her Feet: Thus these kinds of violent Commotions of the Limbs or Viscera mutually succeeded each other, the Tragedy of the distemper returning as it were in a Circle. Coming the fifth day after this Lady had been ill, I gave her a Vomit of the Infusion of Crocus Metallorum, Wine of Squills, and Salt of Vitriol, after which she Vomited a great store of Aeruginous Choler, with a mixture of a most Sharp, and as it were Vitriolic Humour: The next day after I drew ten Ounces of Blood from the Saphaena Vein: Moreover she took twice a day Antidotes of the Powders of Precious Stones, Man's Scull, and the Male Peony: by the use of these things seeming to be recovered, she lived for many days after free from the foresaid affects, but after a fortnight, the full Moon coming, she fell into a relapse of the same disease more violent than before, for besides the wonderful Leaps, the violent Contortions, and Convolutions of the Head, and Members, she was also forced to Run up & down in a Vehement manner in her Bed Chamber: She took at this time, by the Praescripts of others, Antihysterick Remedies, and Purges at some set intervals of time, but without any relief: Being called again, in regard thatshe was of a Robust habit of Body, and seemed affected with a mighty raging of the Spirits, I gave her a strong Vomit, after which she Vomited ten times a Choler as green as Verd●grease, with a Phlegm as Sharp as Aqua Stygia, and was suddenly relieved: I gave her afterward, every morning a draught of White-wine Diluted with Black Cherry Water, poured on Millepedes bruised, and strongly expressed. By the use of these things seeming to be Cured, she was perfectly well for a Month, and more: and when afterward she at any time perceived any forerunning signs of a return of the affect, presently by the use of a Vomit, and the same expression of Millepedes, she kept off the Fit: Within three Months she so recovered her former Health, that she has now lived many years wholly free from such Convulsive affects: But from the time that the Convulsive Passions wholly ceased, she was sometimes troubled about the parts of the Mouth and Throat with a Defluxion of a most Acid Humour, like the distilled Liquor of Vitriol: Moreover she has sometimes been obnoxious to the longing disease of Maids, sometimes also to a Cough with a discoloured Spittle threatening a Ptizick, which nevertheless were easily Cured by remedies usual in the like cases. Whilst I was writing these things, I went to see a Noble Virgin, who was troubled with Convulsive affects of another kind, and those Universal, and no less Admirable: This about the eighteenth year of her Age, being of a fresh Colour, Handsome, and before sound enough, now happening unawares to incur the danger of being infected with the Plague, it being rife hereabouts, fell into a Panic Fear, with frequent Swooning Fits, the night following the underwent such Failings and Disorders of the Spirits that she seemed even ready to Die. But having past that evil with much ado, she had afterward every day Convulsive Fits, though returning first at uncertain hours, and in several forms: But within a short time the accesses of the disease becoming regular, they returned constantly twice a day, viz. at eleven of the Clock in the forenoon, and at five in the afternoon, that no intermitting Fever keeps its periods more exactly, nay and all the circumstances of the Fit happened daily after the same manner. When she had been thus ill three weeks, I was called on a certain day, that I might observe all the Symptoms, and the whole form of the disease: Rising from her Bed at ten a Clock in the Morning, she was well, and carried herself so well in her countenance, walking, and discourse, that no man would have suspected that any thing ailed her: At eleven, a Clock she began to complain of a Plenitude, and as it were Inflation in the Brain, and a Deadness of the Spirits with a light Scotomia: by and by she felt in the left Hypocondre a mighty beating, and Springing as it were of a live Animal: I plainly felt this Motion by applying my hand to her side, than a Retching and great Crying followed, whereupon she was presently led to Bed, and given to be held by a maid servant sitting on the Bolster: This person clapping her Arms about the middle of the diseased, held her very hard in her Lap, during the Fit. Moreover servants were at hand, and relations standing about her, who sometimes held her Hands and Arms, sometimes pressed down her Belly and Hypocondres which rise to a mighty Bulk, still forcing upwards: The chief Symptoms of the disease, which being raised by turns, divided in a manner the whole Fit, were these two, viz. Sometimes violent Convulsions of the Viscera infested her, so that the Abdomen rising to a mighty Bulk, withstood the hands of standers by, pressed against it, that it could not be kept down, and withal the Praecordia being drawn upward, the Motion of the Heart and Blood was in a manner stopped: For which space of time the Virgin hanging down her head, with a weakened, and no Pulse as it were, lay Speechless and almost insensible: After two or three minutes of an hour these Fits ceased: And then the Sick raising herself, looked round her cheerfully, and for some time converted the Impetus of the disease into Discourses and Songs, both which she uttered most Pleasantly and Elegantly above her Natural disposition; she passed such Say and Scoffs on all persons about her, that there is nothing in any Comedy to be met with more facetious; then she would Sing most Sweet and Pleasant Tunes of Harmony, such as neither any person else could Sing, or herself at another time: After the she had thus past about six or seven Minutes of an hour, in Jesting and Singing, she fell again into the Convulsions of the Viscera and Hypochondres, and the loss of Speech as before: And these remitting in a short time, and the Impetus of the Spirits flying back from the inferior Nerves to the Brain, she gave herself again to the pleasantryes of Talking and Singing. When at any time she discoursed with the standers by, if any thing that was Sharp or Ignominious were replied by them, she fell into more Violent and Lasting Convulsions of the Bowels: After this manner she uses to be troubled with an alternate affect of the Viscera and Brain for about the space of an hour: Then the Fit drawing toward an end, the Convulsions of the Bowels becoming more gentle, returned three or four times with very little intermission: Afterward these wholly ceasing, the Impetus of the disease passes into the outward Members, whence presently it wholly vanishes: For the Arms and Legs undergo contractions and twitchings for a minute of an hour, and presently after the diseased rising up, comes off from her Bed, and is free from all Convulsion till a new Fit returns, nay and having an indifferent good strength, walks up and down the house, and during the interval of the affect, cheerfully performs the usual Offices of Life, still excepting that her Stomach being weak, loathes food during the day time, in the evening after the second Fit of the disease, she eats a little supper. About the beginning of this sickness of the Convulsions of the Bowels were much more violent, and she lay Senseless with them, and during their intervals she would talk absurdly, Sing Songs out of tune, and fall out a Laughing, or Crying, without any ground of reason: But at length the Animal Spirits being forced into lasting explosions, performed them so regularly, sometimes this way, sometimes that, as it was most proper, that they seemed to be done in some sort by the moderation and command of the will. After I had been again to see this Lady, having lain under these periodical Fits for many weeks, I ordered that three hours before the second Fit, ten Ounces of Blood should be drawn from the Vein of her foot, whereupon the Fit, expected in the Evening, wholly left her, nor did it ever return afterward: But the other Fit obsrving its ancient course returned daily, till upon Bleeding a little before its coming, the Patient was free of it that day, which nevertheless returning the next day after followed her for many months according to the same form: In the mean while, because the winter cold was very fevere, she delayed for some time the use of Remedies: But as the Spring came on the noble Lady being brought to Oxford was cured by the following Method. In the first place I gave her this Purge, and took care for it to be repeated every sixth or seventh day. Take Sulphur of Antimony six Grains, Mercurius Dulcis a Scruple, Rosin of Jalap four Grains, Ginger six Grains: Let them be bruised together on a Marble, then adding Conserve of Violets a Dram, make a Bolus. It was wont to make her Womit twice or thrice, and to give her three or four Stools: Her Menses constantly flowed from her at set time in a plentiful manner: Wherefore her Blood seeming to be in great plenty and hot, in the middle time betwixt the monthly periods I ordered Bleeding twice or thrice: Moreover on all those days that she did not Purge, she took four Pills of the following Mass, Drinking after it a little Draught of the Julap beneath prescribed. Take Roots of Male Peony half an Ounce, of Virginia Serpentary, Contrayerva, and Bastard Dittany of each two Drams, Man's Scult prepared a Dram and a half, Elks Hoof a Dram, red Coral prepared, Pearl Powdered of each a Dram, Salt of Wormwood two Drams, Salt of Coral a Dram, with a sufficient quantity of Syrup, of Male Peony flowers make a Mass. Take the Waters of Male Peony Flowers, Black Cherries, and walnuts of each four Ounces, the Antiepileptical Water of Langius two Ounces, Syrup of Peony Flowers an Ounce and a half, Castoreum tied in a knot and hung in hte Glass a Dram, mix them make a Julap. When she began to loathe the Pills, omitting them, she took twice a day, viz. early in the morning, and late at night, about a Scruple of the following Powder in a spoonful of the Julap, Drinking after it four or five spoonfuls of the same. Take Bezoar Stone of both kinds, White Amber, Pearl prepared, Red Coral of each a Scruple; Man's Scull two Scruples, Roots of Virginia Serpentary, Seeds of Rue of each half a Dram, mix them, make a Powder, let her take a Scruple Morning and Evening with a Dose of the Julap above prescribed. Afterward when this also began to nauseate her, she used Pills, or also Elixir Proprietatis, sometimes also Spirit of Hartshorn for many days: afterward at long run upon taking that Powder daily for some space she began to find help. Inthe mean while that this Method of Cure was followed; her Hair being Shaved off, her Head was covered only with a thin Dress, she wore the Hysterick Plaster with a mixture of Galbanum on the Abdomen: She drank for her ordinary drink a Bo●het of Sarsa and China with the Roots of Male Peony, and other appropriated things infused and boiled in Fountain Water: Within a Month the Fits remitted a little: Afterward becoming more mild by degrees and lesser, at length they ceased in a manner altogether, unless that near the time of her Menses she was wont to be troubled with an assault or two of that disease: Moreover she was troubled almost with a constant Giddiness and a loathing of Meat; in the midst of Summer the drank Astrope Waters for six weeks, and grew perfectly well. As to the way of Cure to be used in general for such Marvellous Convulsions, it is not an easy thing to assign Remedies equal to so Hereulean a Disease, or a certain method of its Cure confirmed by frequent experiments: For besides that cases like those seldom occur, we may likewise observe, that the same Medicine which did good to this sick person at one time, gave not the least relief to another person, or the same, when given at another time, the reason of which seems to be that the cause of the Disease seems to consist in the Discrasy of the Nervous Juice: Which liquor is not always perverted after one and the same manner: But from the manifold combination of the Salts and Sulphurs, gets a Morbid disosition of a various kind and condition, and often changes it: Wherefore in those difficult affects, we must not prescribe vulgar Medicines, taken from Apothecary's Shops, but Magisterial ones, as occasion requires, according to the appearances of the Marvellous Symptoms. A Gentle Vomit, a Purge, and Bleeding aught in the first place to be used, and sometimes to be repeated, as it shall seem convenient. And as to Specific Medicines, and such are appropriated in those cases, since the chief Indication will be to amend the Crasis of the Nervous Juice, we may try a great many things and sift their virtues from the effect: Therefore we may try what things endued with a Volatile or Armoniac Salt will do: For this purpose let the Spirits and Salts of Hartshorn, Blood, Soot, the Flowers and Spirits of Sal Armoniac be taken: These giving no relief we must come to Chalybeats; let the Tinctures and Solutions of Coral and Antimony be given: which sort of Medicines must be given in such a Dose, and form, and for so many times, that some alteration may be made by them in the Blood and Nervous Juice: Again, if these have not success we must proceed to Alexipharmicks, which are good against Poison and a Malignity gotten into the Humours, viz. of these we must order Decoctions, Destillations, Powders, Conserves, and other Preparations of Vegetables, and we must variously compound them the one with the other, and administer them several ways: It seems likely that those sorts of Medicines which being inwardly taken are wont to do good to such as are bit by a Viper, or by a Mad Dog, and likewise against Wolfs-bane, and Napellus, may also be of use in the above mentioned Convulsions: We may here, after the example of Gregor Horstius in his Tracts of the Malign Convulsive disease, prescribe also Magisterial Remedies in form of a Purging Electuary, also of a Powder, and Convulsive Antidote for these Marvellous Convulsions, and variously Compound the same of Simples, partly Alexipharmical and partly Antiepileptical. CHAP. VIII. Of the Affects which are vulgarly called Hysterical. IF at any time an unusual sort of Sickness, or of a very Secret Origine occurs in the Body of a Woman, so that its Cause lies hid, and the Therapeutic Indication be wholly uncertain, presently we accuse the evil influence of the Womb (which for the most part is guiltless) and in any unusual Symptom, we cry out that there is somewhat Hysterical in it; and consequently the Physical intentions and the uses of Remedies are directed for this end, which often is only a starting hole for Ignorance. The passions which are wont to be ranked in this number are found to be various andmanifold, which seldom agree in divers Women, or happen wholly after the same manner: the most common of them, and which are vulgarly said to Constitute the formalstate of an Hysterick affect, are these, viz. A Motion in the lower part of the Belly, and an Ascent as it were of some round thing there, than a Belching or Straining to Vomit, a distension of the Hypochondres and a Rumbling with a Belching forth of Wind, an uneven and for the most part a letted Respiration, a Suffocation in the Throat, a Giddiness, an Inversion, or Rotation of the Eyes, often Laughing, or Weeping, a Talking Idly, sometimes a Speechlesness and Immobility with an obscure or no Pulse, and a Cadaverous aspect, sometimes Convulsive Motions raised in the Face, and Limbs, and sometimes in the whole Body: But universal Convulsions seldom happen, and not unless the disease be raised to its worst state, for the Tragedy of the Fit is acted through for the most part without any contraction of the Members only in the Belly, Breast and Head, viz. one of them, or successively in all. Women of all Ages and Conditions are obnoxious to these affects, to wit Rich and Poor, Virgins, Wives, and Widows: I have observed those Symptoms in Girls before the time of Puberty, and in old Women after their Menses ceased to Flow, nay and men are sometimes troubled with such kind of Passions, instances of which are not wanting. The cause of these Symptoms must not be imputed to the Ascent of the Womb, and to vapours raised from the same; nor to the Impetuous rushing of the Blood into the Lungs, as the Learned Highmore has Judged; But we say that the affect called Hysterical, chief, and primarily is Convulsive, and depends principally on the Brain and Genus Nervosum being affected, and is produced wholly by the exposions of the Animal Spirits, as other Convulsive Motions. And whatever disorder or irregularities happen else about the Motion of the Blood, they are only secondary and depending on the Convulsions of the Viscera. The way of the difference whereby the kinds of this disease both differ from each other, and from the other Convulsive affects is taken from the various Origine, and chief from the extension of the Morbific Cause: for the Origine of this, as of many other Convulsive affects sometimes resides in the Head, the Womb being wholly without fault: Though sometimes this affect happens through the fault of the Womb, and sometimes through that of other parts: As to the extension of the Disease, from whatever Origine it proceeds, for the most part it chief affects the Interior Nerves, to with those that particularly regard the Viscera and Precordia and their appendices, and chief troubles the Spirits lying in them: Sometimes also, though rarely, the Spirits that presides in the Exterior Nerves and likewise those in the Brain and Cerebellum, are involved in the same affect. As to the Morbific Matter, or Explosive Combination, which, accrueing to the Spirits within the Brain, and derived with them into the Processes of the Nerves, often is the cause of the affects, which are vulgarly called Uterine, or of the Mother: We say this to be Heterogeneous Particles sent from the Blood, as in other kinds of Convulsions; and which are wont to be made to cleave to the Spirits that pass into the Origines of the Nerves, on two chief occasions, viz. either through the fault of the Spirits themselves, or through the great force of the Matter: instances of both kinds every where occur: Through the fault of the Spirits themselves as when through a sudden Passion, suppose of Fear, Anger, Sadness, they are very much Troubled and forced into Irregularities; through the Exorbitant force of the Matter, as in the evil Crises of Fevers, also in any Malignant, and Scorbutical, and other Chronical affects of an ill Determination: these causes are much upheld and promoted by an ill or weak Constitution of the Brain and Genus Nervosum, whether it be hereditary, or acquired by an ill diet, hence Women are more obnoxious to Convulsive affects than Men, and those one more than another. Tho' these they call Hysterical affects very often arise from the Brain, yet sometimes they are raised by a cause beginning either in the Womb, or in other of the Viscera; and this either by reason of a solution of continuity, through a Tumour or Ulcer, or Stimulation of the part; or by reason of the obstruction of the Nervous Juice in its Circulation; thus when some accustomed evacuation, whereby the superfluities of the Nervous Liquor were wont to be discharged, is stopped, as upon the sudden stopping of Issues, or drying up of old Ulcers without Purging, many have fallen into Convulsive affects, which sometimes also happen to Virgins and widows through a retention of the Semianl homour, which ought to be Voided its proper way: And sometimes the Nervous Juice regurgitates toward its Origine, because its passage is somewhere stopped by a Cancrous or Scirrhous Tumour. To illustrate our doctrine of the, vulgarly called, Passions of the Womb; I shall now give an instance of a person troubled with them. A Renowned Lady, extremely beautiful, and endowed with an excellent temper of mind and manners, lately lived in these parts, who for many years was obnoxius to Convulsive affects, she having contracted this valetudinary disposition from her Birth, or Hereditarily, and having found in herself these fruits of the morbid root almost every fourth year of her Age; but especially as often as she conceived with Child (as she often had, and undergone frequent Abortions) she was wont to be extraordinarily troubled with Convulsive passions, in a manner Hysterical: For presently upon the stopping of the Menses, the Heterogeneous Particles being conveyed to the Brain, and Genus Nevosum, brought violent Fits of the distemper. After that she had last conceived, in the first Months according to her ancient wont, she was often troubled with Convulsive affects, about the vinth week of her being with Child, upon taking Cold, she fell into a dangerous Fever, in which very acute Pains sorely infesting her in the Loins, and about the lower part of the Belly, seemed to threaten an Abortion: But those Pains, as it appeared at last, being rather to be judged of the Colic, proceeded from a Sharp humour, falling from the Brain into those parts by the Ductus' of the Nerves; for about the declining of the Fever, that matter being conveyed elsewhere, a Diarrhaea, Pains of the Feet, and a Blistering as it were ensued. As soon as this Lady grew well of her Fever, and Pains, the Convulsive affects returned, for every morning as she awaked from her sleep, she was wont to undergo violent Contractions and Convulsions about the parts of the Mouth and Face, and also in the Arms and Legs, which Syptoms doubtless arose from the Serous filth heaped together in the Head about the Origines of the Nerves; and deeply Imbibed by them during the sleep, together with the Juice that passes in them; and when afterward the same matter was carried again by the conveyance of the Interior Nerves, into the Plexus's of the Mesentery, and the Loins, most violent Pains of those parts, and likewise Fits as it were Hysterical sorely infested her. For those Convulsive Motions of the Face and Members ceased in a short time, yet she continued still Weak and Infirm, with a Pale Countenance, Trembling as she went, and having a mind to no Food but such as was improper, and to hot Liquors: about the end of the third Month, at which time she used constantly to Abort, her Menses broke forth, which passing from her for two or three days together, with pieces of broken Membranes, she expected the Abortion: But the Flu ceasing, Pains, like those of a person in Labour, arose in the Abdomen and Loins as before, and miserably tormented her day and night for a week: At length having used a Bath of Emollient Herbs, and then being put to bed to sweat, she was delivered of the burden of her Womb: the Conception thus passing from her with a mighty torture was as a Pea-hens Egg in bigness and figure; the outward coat of this was ragged and broken; the inward coat remaining whole, contained about half a pound of clear Water, and nothing else: And no rudiments, of a Faetus that was formed, or about ot be formed, did appear: Afterward for four or five days the Lochia flowed from her with some pieces of Membranes: Mean while Pains troubled her with their wont violence: And in regard that after a week was past, they did not cease of their own accord, at length remedies were desired for appeasing them. For this end in the first place, Liniments, Fomentations, Baths, and Glisters were frevently administered: And Medicines cleansing the filth of the Womb, on which the cause of the whole distemper was charged, were inwardly taken: Upon the use of the former, short intermissions of the Pains followed: But now and then the affect returned and was mighty tedious: Nay and within three weeks, the disease growing much worse brought many other horrible Symptoms along with it: For besides the Pains in the Abdomen and Loins, which grew daily more violent, she was now troubled likewise with a great torture in her Back, Neck, Shoulder Blades, also in the Arms and Legs, and that more severely as often as she grew warm in her Bed: Moreover she was afflicted with a frequent Giddiness, a Vomiting and Nauseousness, and often in a day with vehement Convulsive Fits, viz. First a great heavy thing seeming to Ascend in the lower parts of the Belly, presently raised up the Belly with violence: By and by, respiration being stopped, she became senseless with a Cadaverous aspect: After that she had lain thus dead, as it were, for three or four minutes of an hour, she was wont to start up on a sudden, that she could scarce be kept down or held by persons present: Then followed violent contractions and distortions in all the parts of the Mouth and Face, and in all the Members of the Body. These Symptoms were judged really Hysterical, because the noble Lady had so lately Aborted. But considering all these things, I was at length of this opinion, That the cause of both Fits, viz. the Paining, and Convulsive, depended wholly on the evil affects of the Brain and Genus Nervosum, without any fault in the Womb, to wit, that the sharp humour heaped together within the Brain, descended thence, by the passages of the Nerves, into parts very remote, and lying in the Membranes and Fibres, and fermenting with the humour coming to it from the Mass of Blood, irritated them very much, and caused violent pains: then afterwards, when the heterogeneous and explosive Particles, admitted into the Brain with that Humour, and entering the Ductus' of the Nerves, joined with the Spirits, thereupon the Convulsive disposition, now and then breaking forth into violent Fits, was caused, as it will by and by appear more at large. Directing my curative intents according to this Aetiology, I ordered the sick Lady, at the time she was extremely ill, that Blood should be drawn from the Saphaena Vein, That a gentle Purge should be given her within two days, and that it should be repeated once or twice a Week: Also on other days I gave her, Morning and Evening, Spirit of Hartshorn; and at other hours, twice or thrice in a day, Powder of Pearl and Crabs-eyes, with a Dose of the following Julape. Take Water of Snails, Magisterial Water of Earthworms, of each three Ounces, Water of Saxifrage, and of Black-Cherries, of each four Ounces; Hysterick Water, an Ounce; Syrup of Coral, an Ounce and a half; Tincture of Castoreum, a Dram: mix them. She used frequently a Bath of fresh Herbs when necessity required it; she took Opiates always with good success: Vesicatories were applied to the inward part of each Thigh, and to her Neck. Moreover Fomentations, Liniments, Glisters, Cupping-glasses, Sneezing-powders, and many other ways of Administration were prescribed, according to the exigency of Symptoms. After this method of Curing used about fourteen days, the noble Lady, being very much relieved, was wholly without the Convulsive Fits; nay, and the pains of the Bowels and Members, and other Symptoms, being very much mitigated, gave us a very fair hope of a speedy Recovery; but after this, partly by reason of an ill Diet, to which the Diseased, upon never so little an amendment, always indulged herself, but especially by reason of a sudden passion of terriour or sadness, which a severe accident happening within her own House, had raised, falling into a Relapse, the Disease was presently brought to a much worse condition; for both the Convulsions, and Pains troubled her in a more violent manner, nay, and the Stomach, being stirred up in a manner with a continual Vomiting, neither admitted Food nor Medicines: she took Asaph's Milk for some days, with some Benefit; yet in regard it turned to Choler in her Stomach, and gave her some offence, it was soon left off. At length, in despite of all Remedies prescribed with all diligence by the advice of many Physicians, the noble Patient languished daily more and more, and by degrees drew near to Death. Two days before her Decease, the pains of her Belly and Loins remitted very much, and becoming more cheerful than her wont, she had some hope of her Recovery; but in the mean while she complained of a pain and a mighty oppression of her Head; and falling into a profound Sleep, about the beginning of the Night, upon her awaking, she fell into a very horrible Convulsive Fit, which presently passed into a mortal Apoplexy, for becoming insensible and speechless, she departed this Life within twelve hours. The Body of this person being opened after her Decease, the Womb was found wholly without fault, tho' many of the Viscera were preternaturally disposed: in the Mesentery, about the midst of it, where it is fixed to the Back, and contains great Plexus' of the Nerves, a lax substance, and blown up as it were with many Bladders, was seen, it equalling a hands breadth in extent: opening this place, I found no Humour in it, but only that the Membranes were separated from each other, and that nothing was included in the spaces betwixt them but a Wind, which Separations doubtless were caused by the Convulsions and Explosions of the Spirits, sent from the Head into those Plexus': and as to those pains in the Belly, and the ascent of the great heavy thing, as it were, and the Inflation of the Abdomen in the Convulsive Affects, it is not to be doubted but the Seat of the morbific Cause lay hid in that part of the Mesentery. As to the method of Curing to be used in the Passions vulgarly called Hysterical, since the greatest part of the Symptoms of this Disease are Convulsive, it is thence plain that anticonvulsive Remedies, such as above written, are chief indicated. Nevertheless, since these Affects very often happen to the Female Sex, in which the Menses, and other accidents of the Womb, are most commonly taken in as a part of the Morbific Cause; therefore Medicines having regard to various dispositions of the Womb ought to be added to the former, and be sundry ways complicated with them. The Therapeutic Indications are either Curatory, to be used in the Fit, or Preservatory, which being prosecuted out of the Fit, remove the cause of the Disease, and prevent its Accesses. As to the former, if the Fit be but small, let it pass off of its own accord, without any farther perturbation of the Spirits; but if it so forely presses that it is needful to give aid to Nature, as being greatly oppressed, let this one thing be endeavoured, That the Spirits being made free from the Embraces of their Heterogeneous Combination, remit of their Disorders and Explosions: For this end it is very usual in the first place to apply to the Nostrils stinking and strong-smelling things, the effluvia's of which repress and reduce to order the Spirits, which are grown too wild and apt to make exorbitant efforts, nay and discuss their Heterogeneous Combination, and often wholly exterminate it. Assa Foetida, Castoreum, Galbanum, tied in a fine Linen Cloth, and held to the Nostrils, are proper; also the Feathers of Partridges, or old Shoes burnt, or Sulphur kindled: moreover the Spirit and Oil of Soot, or of Hartshorn, often give help; tho' I have known that these kinds of Suffurnigations have proved very offensive to some Women, and have increased the Fit; it's probable that sometimes they irritate the Spirits too much, and force them into greater disorders. As stinking things held to the Nostrils, so the like being poured into the Mouth, often give help; wherefore we often give with good success, to Hysterical persons, the Tincture of Castoreum, Solutions of Assa Foetida, and of Galbanum, also the Spirits of Hartshorn and of Soot, with appropriated Waters. Take Spirit of Hartshorn, from twelve drops to fifteen or twenty, let them be taken in a little Draught of the following Julape. Take Water of and Mugwort, of each four Ounces, Water of Bryony compound, two Ounces; Castoreum tied in a Nodulus, and hung in the Glass, half a Dram; double refined Sugar, an Ounce; Mix them. Take Tincture of Castoreum; from, a Scruple to half a Dram; let it be taken in a little Draught of Small-beer. Take Assa Foetida, or Galbanum, two Drams; let them be dissolved in Spirit of Wine till a red Tincture be extracted: the Dose is a Scruple in two or three Spoonfuls of Water of Featherfew, Riverius greatly extols that of Solenander; Take Musk, Dragons-blood, of each a Scruple; let more or less be taken in three or four Ounces of Water of Navews. Johannes Anglicus commends the Seeds of Parsnips, or of Columbines in Wine, or an appropriated Water, as most certain Remedies. If the Fit, continuing a long time, renders the Person senseless, or without any Pulse, let smart Clysters, as of the Roots of Briony, with Carminatives boiled with them in Water, be injected; let Frictions be used to the Legs and Feet; and if we must proceed to stronger things, let Cupping-glasses be applied to the Belly or Groin, nay and let sneezing be often provoked: it is good for some to give them, in the midst of the Fit, a Draught of cold Water, either simple, or in which Camphire has burnt. The preservatory Indication comprehends these three chief intents, viz. First, To take away, or to drive to some place else, the impurities of the Blood, which are apt to be discharged on the Brain and Genus Nervosum. Secondly, To fortify the Brain, and so strengthen the Spirits in it, that they either admit not at all the Heterogeneous Combination, or readily shake it off. Thirdly, to amend whatsoever is amiss in the Womb, and contributes to the Convulsive Disposition. 1. The first Intention is performed by Purging and Bleeding, and other common ways of Cleansing and Purging the Blood and Humours. If there be room for a Vomit, I Judge we must always begin with that, especially in Cacochymical persons, or such as are troubled with the longing disease, in whom a mighty load of Viscous Phlegm, sticking in the Folds and Coats of the Stomach, hinders the virtues of other Medicines: Within a few days after the Vomit, (unless somewhat indicateth the contrary,) let Blood be drawn, in Women of a hot temperament, presently from the Arm, and afterward, if need be, from the Foot, or from the Veins of the Fundament, by Leeches; but in Bodies troubled with obstructions and less hot, let Blood be drawn more sparingly and rarely, and only in places seated below the Womb. After these evacuations (provided always that they are indicated) being duly performed, let a Purge be given once within six or seven days according to the forms following. Take Pil. Foetidae Majores a Dram and a half, Rosin of Jalap twelve Grains, Tartar Vitriolated, Castoreum of each a Scruple, Ammoniacum dissolved in Hysterick Water what suffices, make twelve Pills for three Doses. (Or) Take Rosin of Jalap eighteen Grains, Calomelanos a Dram, Castoreum a Scruple, make a Powder, divide it into three parts for three Doses, give it in the Pap of a boiled Apple, or in Conserve of Borage: To persons of a Hot temperament a dose of our Extract, or Loosning Syrup may be properly given: For the revulsion of the Morbific matter from the Head an Issue in the Leg, or Thigh, and sometimes Vesicatories, Ligatures and Painful Frictions are wont to be used. Nor must we only have regard here to the cleansing of the Blood, and to the Revulsion of its superfluous dregs from the Head, but likewise to the alteration of its Liquor, and the reducing of it to its due Crasis: Wherefore in certain Hysterical persons Chalybeats prove beneficial, in others Mineral Waters or Whey, in some the use of Hot Baths are wont to do mighty good. 2. The second intention, viz. the rectifying of the Brain, and of the Animal Spirits, is performed by Cephalick and Particularly by Anticonvulsive Medicines, and let them be carefully given almost every day when there is no Purging, or Bleeding; There being various kinds and ways of Administration of such Medicines, I shall here give you some of the more choice forms of them. Take Faecula of Briony, Assa Foetida, Castoreum, of each a Dram, Salt of Coral, Amber, and of Jupiter of each half a Dram; Galbanum dissolved in Hysterick Water what suffices, made a Mass; the Dose is from half a Scruple to a Scruple, Morning and Evening, Drinking after it a Dose of an appropriated Liquor. Or, Take seeds of Wild Parsnips and of Nettles of each two Drams, Vitriol of Mars a Dram, extract of Gentian and Feverfew, of each a Dram and a half, with a sufficient quantity of a Syrup of Mugwort make a Mass, let it be taken to half a Dram after the same manner. If the form of a Powder be more grateful. Take roots of Virginia Serpentary and Contrayerva of each a Dram and a half, Coral prepared, Pearl, White Amber of each a Dram, mix them, make a Powder, the Dose is from a Scruple to half a Dram Morning and Evening with an appropriated Liquor. Let Opiates be made after this manner. Take Conserves of the Flowers of Lilies of the Valley, Male Peony, and Betony of each two Ounces; Peony Seeds, Red Coral prepared of each two Drams, Powder of Bastard Dittany a Dram and a half, Salt of Wormwood two Drams, with a sufficient quantity of Syrup of Citron Pills, make an Electuary. The Dose is Morning and Evening the quantity of a Nutmeg. After the same manner to the Poor, let Conserves of the Leaves of the Tree of Life, or of the Leaves of Rue be given twice aday. The Liquors appropriated to Hysterical affects, and to be Drank after the foresaid Medicines are either Distilled Waters, which may be taken by themselves, or with others in the Form of a Julape, or they are Decoctions, or Tinctures and Infusions. Take Water of Mugwort and Pennyroyal of each half a Pound, Hysterick Water four Ounces, Tincture of Castoreum half an Ounce, Syrup, of Coral an Ounce and a half mix them; the Dose is from an Ounce to an Ounce and a half with any of the Medicines above prescribed. Take Leaves of , Feverfew, both Southernwoods, Calamint, Nep, both Horehounds, of each a Handful; Briony Roots four Ounces, Parsnip-Seeds two Ounces, being Sliced and Bruised, pour to them of White-wine or Cider six pounds distil them according to Art. Take roots of Male Peony, Angelica, Valerian, of each half an Ounce, Leaves of Mugwort, Ground Pine, Calamint, Penyroyal, Misteltoe, of the Oak of each a handful; Seeds of both the Wild Carrots of each three Drams, Raisins a handful; let them Boyl in four Pounds of Fountain Water till half be Consumed; add of Whitewine two Pound and a half: Strain it, Let it be kept in Vessels close stopped. The Dose is three or four Ounces twice a day. Take Seeds of Wild Carrots bruised two Ounces, Castoreum an Ounce, put them in a Glass with two Pounds of White-wine. The Dose is two Ounces twice a day. 3. As to the third intent, which putting a stop to the disorders of the Womb, advances the Cure of the Hysterick affect: I say in the first place that what was formerly believed concerning the Cause of the Disease, and the Scope of Curing it, viz. That the Womb did Ascend, and therefore that it ought to be restored to its due place, is altogether Fictitious, as we have shown elsewhere: The descent, or falling forth of the Womb often happens, but this seldom or never produces Hysterical affects: Moreover a Dislocation of the Womb sometimes happens to Childbearing Women presently after Childbirth, viz. When the body of the Womb being enlarged and newly emptied, does not settle in a right place within its Cavity, but leans high, sometimes to the right side of it, sometimes to the left, and there being Constringed like a Purse is folded up in a great Lump, which Lump lying a long time in the side of the Inguen, is wont to Cause suspicion of another Foetus, or of the after Birth being left behind, or also of a Scirrhous Tumour there Growing but afterward, when upon the Lochia's passing away freely, the Womb is reduced to its due magnitude, that Tumour vanishes by degrees: And whilst it continues there, unless haply the Lochia are thereby stopped, it does not cause Hysterick Passions: For the quick reducing of this part to its due position, Fomentations, Liniments, and Plasters contribute much: But very often that Symptom passes away of its own accord without any further offence: We have shown elsewhere ex professo to what affects else the Womb is obnoxious after Childbirth, and with what methods of Physic we must obviate them: As to the other Distempers of this part, which happen to other Women, viz. to such as do not Bear Children; we observe those chief to be either a Disease of the Womb caused by a Solution of continuity, which is either a Tumour or an Ulcer; or to be a Stoppage of some usual Excretion, viz. either of the Sanguis Menstruus, or of the Fluor albus, or of the Seminal Humour; by reason of the Menses retained the Heterogeneous particles being often discharged on the Head Cause Convulsive Passions: In like manner when the White Humour is stopped the Excrementitious Matter being drank in again by the Blood is delivered to the Brain and Genus Nervosum. Moreover when a wont evacuation of the Seed is stopped, the superfluities of the Nervous Humour Regurgitate into the Brain, and infect the Spirits in it with a Morbific and Explosive Tincture. It will not be necessary for us to discourse particularly and at large on these particular affects of the Womb, but to Complicate Medicines and Physical Administrations appropriated to women's Diseases, with Anticonvulsive Remedies. CHAP. IX. Of Affects vulgarly called Hypochondriacal, which are shown to be for the greatest part Convulsive, and by the by of Chalybeate Medicines. AS we have shown before that the Passions vulgarly called Hysterical do not always proceed from the Womb, but oftener from the Head's being affected: So though it has been vulgarly held that the affects called Hypochondriacal are caused for the most part by Vapours arising from the Spleen, and running hither and thither; yet in truth those distempers are for the greatest part Convulsions and Contractions of the Nervous parts; which may better appear after we have considered the Symptoms. As to the affects therefore which are vulgarly called Hypochondriacal it is to be observed that they chief happen to persons of a Melancholic Constitution, with a wan aspect and a thin habit of body: It is seldom that Disease troubles persons who are well in flesh, and have a florid, or also an over Phlegmatic countenance: About the time that persons come to a set age it discovers itself with manifest signs; Men are found to be more frequently obnoxious to this than Women, in both being become habitual it is cured with great difficulty, or searce at all; in Women by reason of their weaker Constitution, it is attended with far more Convulsive affects: Wherefore it is commonly said in this Sex, that the Hysterick affect is joined to the Hypochondriacal. The Symptoms which are accounted as belonging to this Disease are commonly very many, and of a differing Nature, nor have they in all a like Origine, or the same mutual dependence on each other: For we see that in these the Viscera of the Belly, in those the Praecordia, in others the Confines of the Brain are most affected: in a great many, but not in all, the Stomach much Labours; as to appetite it has often too much of it, but is presently oppressed by what is taken into it; and when the food through slowness of Concoction tarries a long time in it, the Saline particles of it being raised to a state of flowing, pervert the whole mass of the Chyle into a Pap, sometimes Acid or Austeres, sometimes Salt or Tart: Hence a Cardialgia, a mighty store of Flatus', a Rumbling, and a frequent Vomiting ensue; and because through a defect of a Pneumatosis the Chime is not volatilised throughout, and carried forth, but a Mass of Viscous Matter, sticking to the Coats of the Stomach is left behind, a almost continual Spitting molests them, a distension in the left Hypochondre and often there and under the Ventricle a violent beating is felt, and there pains every where arise; which shoot here and there at random, and miserably torture the person with a certain pungent Pain for many hours. Mean while, from the Contractions of the Membranes and the Fluctuation of the Flatus' thence raised, Croakings and Rumbling are produced: So in the Thorax there is often a great Straitness and Constriction, so that the Breathing becomes difficult and painful upon any motion; nay farther, in some very terrible Astmatick Fits supervene: Moreover the diseased are wont to complain of a Trembling and palpitation of the heart, with a mighty oppression of the same, also frequent Failings of the Spirits, and danger of Swooning come upon them, that the diseased always think Death at hand: In this Region about the Membranes, and especially the Mediastinum, an acute Pain, which one while is determined in one part; another while is extended to the Shoulder, is a familiar Symptom of this Disease: But in the Head an Iliad of Evils for the most part troubles Hypochondriacal persons, to wit, most violent Pains Periodically returning arise; also Scotomia's, frequent Giddiness, Obstinate Watch, a Fervency and a most troublesome Fluctuation of thoughts, inconstancy of mind, a disturbed fancy, a dread and suspicion of every thing, an Imaginary being Affected with Diseases of which they are free, and many other distractions of the Spirits, nay sometimes Melancholy, and a Mania accompany this Sickness: Besides these interior Regions of the Body being beset with this Disease; wand'ring Pains, also Cramps and Numbnesses with a sense of Formication seize likewise almost all the outward parts; Night Sweats, Flushings of Blood in the Face and Palms of the Hands, Fevers of uncertain returns, and many other Symptoms of an incertain Origine on all hands arise, of which in regard it has not been easy to assign the Genuine causes and ways of their coming to pass, Physicians have charged, (though unjustly) all the blame on the Spleen: In the mean while it is to be observed that the chief Symptoms of this distemper are convulsive and depend immediately upon the Irregularities of the Animal Spirits, and Nervous Juice, rather than on the Dyscrasies' of the Viscera that serve for Concoction. As a great many have ascribed this valetudinary disposition to the only fault of the Spleen: So others making all the confines of this Entral a party in the fault, will have the Blood lying in any part soever of the Vessels of the Spleen and Epigastrick Region to give the Origine to this evil. But the renowned Highmore has charged the chief cause of this Disease wholly on the faulty Constitution of the Stomach. Concerning this opinion, though I so far agree with this famous Author, that I may grant the Ventricle to be often greatly distempered in this affect: Yet I cannot be brought to think that all the Symptoms of the Hypochondriacal Disease depend only on the Ill constitution of the Ventricle, for I have known many sorely afflicted with that Distemper, whose Stomaches were well enough; and I have known others who through an ill diet have brought their Stomaches to be greatly Distempered, yet, as to the Precordia and Animal Faculties being sound enough, they were not at all accounted Hypochondriacal. As to what the Spleen contributes to this Disease, Dr. Willis first curiously observing the use of this part, to wit that from the Blood brought to it from the Arteries, a certain Dreggy Portion, viz. consisting of an Earthly matter and a Fixed Salt, is deposed in this Entral, which being there exalted as it were by Digestion, and raised to the nature of a Ferment, is again committed to the Blood as it passes back by the Veins, which inspires it with a certain Fermentation, and performs the same thing as to its Pneumatosis, as our common Leaven does when mixed in a Mass of Meal, so that as the Leaven inables the sluggish parts in the Bread for Motion, so the Ferment of this Entral raises the sluggish Particles of the Blood to a state of activity. And secondly considering the intimate communication betwixt the Brain and the Slpeen by the means of the Nerves, of which there are a world of Plexus' and Fibres arising from them in this part; he says that the ways of affecting with which the Spleen being evil disposed, produces, or at leastwise contributes to the rise of the Symptoms of the Hypochondriacal Distemper are chief these following. Viz. First it sometimes happens that the spongy substance of the Spleen is very much stuffed and obstructed by the Faeces of the Blood sticking too much in its Pores and there Stagnating, so that afterward it does not admit into it the dregs of the Mass of Blood as much as it ought, but the same being brought thither, but not received, Regurgitate into the neighbouring Branches of the Caeliack Artery, whence presently they are conveyed into the Membranes of the Ventricle, the Caul and Mesentery, and other neighbouring parts, and are wont to stick in them, hence the Tone of those Viscera is so much perverted, that they cannot rightly execue their due Functions in order to the Concoction of the Chyle, and the Circumjacent Membranes, being very much filled with Heterogeneous and Irritative Particles, become mightily obnoxious to Convulsions arising here and there, to running Pains, Contractions, Distentions and a multitude of Flatus'. 2. Though the Slpeen should receive freely enough the Melancholy Juice brought by it from the Blood to the Arteries, yet often it does not duly Concoct the same, but the salt being very much exalted, perverts it into a humour too Sharp, or Austeres, or faulty some other way; wherewith when the whole Mass of Blood, and the stock of Nutritive Juice contained in it, are infected, the fruits of a Hypochondriacal seed display themselves throughout the whole body; the Blood boiling more than it ought, is driven violently into certain parts, and at the same time in others it is apt to stagnate: Hence some presently upon eating have Flushings in the Face, the palms of their hands burn, etc. In some again running pains with a Pricking happen in many parts of the Body. 3. From the Blood thus depraved through the fault of the Spleen, a prejudice also is often brought on the Animal function, the Heterogeneous and Convulsive particles being often discharged on the Brain and Genus Nervosum, hence persons are troubled with fancies and thoughts, with Giddiness, Scotomia's, headaches, and often Paralytic affects. Then as the Morbific matter passes from the Brain into the Genus Nervosum, Convulsive affects are raised in many parts of the Body, but chief about the Precordia, and Viscera of the Belly, the Spirits that are in the Nerves which regard those parts being greatly troubled by the passions of the mind. 4. It is also very probable that the Nervous Fibres (whereof there are a world dispersed through the Spleen, sometimes receive into them its most Sharp Juice, which creeping up the Passages of the Nerves, often is the cause of Convulsive Motions: And there being an intimate commerce betwixt the Spleen and the Brain, we judge that besides the long way of the Blood, they have a nearer way of communication by the Nerves of the Par Vagum and Intercostale by which they mutually affect each other; so that sometimes the Melancholy being disturbed in the Spleen, conveys thence the passion to the Brain, whence disorderly and Hypochondriacal fancies happen: And on the contrary, when a violent Passion of the mind, occasionally raised within the Brain, troubles the Spirits residing in it, the impression given the fancy, is conveyed to the spleen by the course and successive affect of the Spirits, lying within the Nerves of the Per Vagum and Intercostale; whence many disturbances are caused in that Entral and in the parts adjacent. I shall now give an instance of a person troubled with the Hypochondriacal affect. An honourable person of a Melancholic temperament, and always accounted to be troubled with the Spleen, complained very much of a Pain and Inflation of the left Hypochondre, with a frequent Rumbling, and a Sour Belching, also a Trembling of the Heart, a continual Giddiness, a want of Sleep, and a Troubled Fancy; about the thirty fifth year of his Age, the Disease growing worse, he began to get Sleep with difficulty, or very seldom by night, and so in the day time to be troubled with a Fervency and Inconstancy of thoughts, to be suspicious of all things and persons, and to be Scared at every thing that came in his way; the Praecordia seemed to be very much Constringed and Straitened, and to fall in, as though the Heart itself were depressed into the Belly, which Symptom pressing him he became very sad, and dejected in mind: Yet afterward, those affects of the mind remitting, he plainly felt at once both the heart to be a little raised, and the Praecordia to be Relaxed and Dilated: Moreover he had very frequently Pains and Contractions variously raised about the Muscles of the Viscera and Membranes, and passing from one place to another. He used a great many Remedies and Physical Administrations a long time for the Cure of this Affect, but without any great good; at length, being somewhat relieved by the use of Mineral Waters, and afterwards growing better by degrees, he became free from those severe Symptoms, tho' he still continues obnoxious to the Hypochondriacal Affect. The Therapeutic Method to be used against Hypochondriacal Affects, requires chief these four general Indications, viz. First, that the Impediments of the Cure be removed, which intention chief regards the cleansing and keeping of the first Passages. Secondly, We must endeavour to correct the Obstructions or other disorders of the Spleen. Thirdly, we must see that the excrementitious Dregs of the Mass of Blood be Purged forth, and that its due Crasis be restored. Fourthly, that the Irregularities of the Brain and Genus Nervosum, and also of the Humour and Spirits residing in them, contracted through the fault of the Blood and Spleen, be amended or abolished. Since we must drive at many of these Intents together, or at all of them, let fit Seasons be chosen, in which we may satisfy each of these purposes without any prejudice to, or neglect of the Rest. 1. As so the first Indication, since a great Mass of crude or adust matter is wont to be heaped together in the first passages, and since the Tone of the Stomach uses to be weakened, and its Ferment to be variously perverted, let us seasonably obviate these Evils of each kind with fit Remedies; therefore mild and gentle Evacuations, both by Vomit, if it comes easily, and by Siege, aught to be given. I advise those whose Stomach easily discharges its Contents upwards, that once in a Month, by taking the Liquor of Squills, or Salt of Vitriol, and drinking good store of Posset-drink, or warm Water, they cause themselves to Vomit several times: In the interval of time, let a gentle Purge, and only lenitive, be often given. For this end the Pilul. Tartareae Bontii, or Stomac. cum Gummis, or our Solutive Pills, may be used Take of the best Senna, an Ounce; Rhubarb, six Drams; Epithymum, three Drams; Yellow-Saunders, two Drams; Salt of Wormwood, two Drams; Celtick-spike, a Dram: being sliced and bruised, let them digest in White-wine and Fumitory-water, of each ten Ounces, for twenty four hours, let the clear straining evaporate by a gentle Bath-heat to the consistency of an Extract, adding toward the end, Powder of Senna, Rhubarb, and Cream of Tartar, of each two Drams; let them be bruised together in a Glass Mortar, and reduced to a Consistency for Pills. The Dose is from half a Dram to two Scruples or a Dram. The Remedies that regard the Tone and Ferment of the Stomach, since they are manifold, and of divers kinds, let such as are most proper for the Constitution of each Stomach be chosen; for with one Person bitter things, with another Salt, with others sharp, or haply smart things, best agree. Of the number of these Medicines (which are vulgarly called Digestives) are Elixir Proprietatis, Tinctura Sacra, the Compound Powder of Aron Roots; Salt of Wormwood, Cream of Tartar, Tartar Vitriolate, Vitriol of Mars, with many others. Besides these inward Remedies, outward applications also often give help: For to a Stomach ill disposed a fomentation of White Wine with Wormwood, Centory and other bitter Plants boiled in it; also Liniments or Plasters often give relief, of which it will not be needful to discourse particularly, and to prescribe forms of those Medicines. 2. The Indication that undertakes to amend the Faults of the Spleen, (whether the same be an Obstruction, or a Tumour or Pain, or a simple Dyscrasy) is wont to be performed, or at leastwise attempted by Remedies both inward and outward; those that are of the former kind are coincident with those that are indicated in the third place, (to wit, with which the purifying of the Blood is intended) for since the chief, or in a manner all of that which is brought into or carried out of the Spleen, is by the conveyance of the Blood, the Irregularities, both of the blood's Latex, and of that Entral, aught to be cured by an associated Operation, the virtues of the Medicines being joined together; and we shall presently show after what manner: meanwhile some outward applications, in the form of a Plaster or Lineament, or Fomentation, have a more near and immediate regard to the body of the Spleen, and often give a mighty relief, viz. in as much as they discuss the tumors, restore to Circulation the melancholy Filth there stagnating, nay and appease and restrain the Corrugatious and Convulsive Affects of the Fibres. There is a mighty store of these outward Medicaments to be found every where amongst Authors, the choice of which, in regard it ought to be ordered according to the various passions of the Spleen, and the differing Constitutions of Patients, it will not be expedient in this place to deliver particular forms of them. 3. The Remedies indicated in the third place, viz. such as take away the Dyscrasies' of the Blood, contracted by the Spleen, and withal cleanse the primary taint of the Spleen, are manifold, and of a differing kind and condition; the choice of which ought to be made according to the various taint of this and of the other. Of these some are more compounded, to be prepared according to the prescript of a Physician, as Electuaries, Powders, Apozems, Tinctures, Infusions, and the like: others are more simple, as Whey, Ass' Milk, Spaws, and hot Bath Waters. There are two chief Cases of sick persons, in which Magisterial Remedies ought to be accommodated according to their strength and qualities, viz. either the Blood is thick, coldish, and earthy, with an Obstruction of the Spleen, which requires hot fermenting, and especially chalybeat Medicines; or the Blood being manifestly adust, and intensely hot, ferments above measure, and withal the Hypochondres are in a great trouble, and the Blood and Vapours boil in them, in which state only temperate Remedies are indicated, for appensing the fervency and immoderate Fermentation of the humours, where Chalybeats are altogether to be shunned. When therefore to a cold Stomach cold Dyscrasies' also of the Blood and Spleen are joined, I use to prescribe according to the following forms. Take Troches of Rhubarb, Powder of Aron Roots, Winter's bark, of each two Drams; Roots of Virginia Serpentary, Contrayerva, Diatrion Santalon, Crabs-eyes, of each a Dram; Extract of Gentian and Centory, of each a Dram and a half; Ammoniacum dissolved in Water of Earthworms, what suffices; make a Mass for Pills: let four Pills be taken in the Morning, and at four a Clock in the Afternoon, drinking after it a little Draught of Wormwood or Chalybeat Wine, with a moderate Exercise. Take Conserve of the Yellow Coats of Oranges and Lemons, of each three Ounces; Myrobalanes Condited, in number two; Species Aromatici Rosats, Winter's bark, of each two Drams; Salt of Wormwood, two Drams; Vitriol of Mars, a Dram (or Steel prepared, three Drams) with a sufficient quantity of the Juice of Citron-Pills make an Electuary; let it be taken twice a day, drinking after it a Draught of Wormwood-wine, or of Wine in which the Bark or Flowers of Tamarisk are infused. To those that like none but nice Medicines, and in a small quantity, you may properly give the Tinctures of Antimony, of Coral, also of Steel prepared with Spirit of Wine, (the Body being first opened by fit Menstruums, and brought to a Calx) nay, and I have known that Spirit of Soot, also of Blood or of Hartshorn, taken twice a day, to twelve drops, more or less, in an appropriated Liquor, have proved mighty beneficial, above any other Medicines. Again, the assiduous drinking of Coffee, and of Tea, has done some very much good. But if a Fervency and overgreat Fermentation of the Blood be joined to the Hypochondriacal Affect, with a fervent heat of the Spleen, and a restlessness of mind. Take Conserve of Hips, six Ounces, (or of Flowers of Tamarisk, and Leaves of Woodsorrel, of each three Ounces) Species Diarrhodon Abbatis, the Confection of Alkermes, of each a Dram; Ivory Powdered, a Dram and a half; Pearl, half a Dram; Salt of Tamarisk and of Wormwood, of each a Dram; with a sufficient quantity of Syrup of the Juice of Citrons, or of Clove Gillyflowers: Make an Opiate; let the quantity of a Nutmeg be taken twice a day. Take Ivory Powdered, two Drams; Pearl powdered, a Dram, Species Diarrhodon Abbatis, and Diamargariti frigidi, of each a Dram and a half; make a subtle Powder; add of double refined Sugar dissolved in Baulm Water and boiled to a Consistency for Tablets, six Ounces; Make Tablets according to Art: Take from a Dram and a half to two Drams twice a day. Or to other Medicines of the like kind let the use of Spaw-waters be joined, which indeed in either, nay in any cases of Hypochondriack Melancholy, are in a manner always taken with good Success. For wa● of these Waters, let our Artificial Spa Waters be taken in th●● stead: nay, and let Whey, and if there be a considerable Atrophia, let Ass' Milk be daily taken. Besides these inward Remedies, and the other outward Applications above mentioned, let Bleeding or Drawing of Blood from the Vessels of the Fundament by Leeches, be frequently used, nay, and it is proper sometimes, according to the Prescripts of the Ancients, to open the Salvatella Vein. Moreover Cauteries and Issues, which continually derive forth the Recrements of the adust Blood, and discharge them by little and little, are wont to do good to all. 4. The Fourth Indication, having regard to the Affects, or Convulsive Symptoms of the Brain, and Genus Nervosum, which ensue upon the former, is seldom put in practice by itself, and apart from the others, but the Remedies appointed for this end are complicated with those above written. Liquors endowed with a volatile or Armoniac Salt, as Spirit of Hartshorn, of Soot, are very proper for this intent, and often likewise for the others, even now mentioned: Wherefore let such Remedies, unless somewhat indicateth the contrary, be daily given at a seasonable hour: Moreover, when the Spa Waters are Drunk, let Tablets or Pills, such as are above prescribed for Convulsive Affects, be taken at least twice a day. In a frequent giddiness. and Scotomia, also in Passions of the Heart, Faintings of the Spirits, with a fear, and a dread, as it were, of present Death, I have known a mighty Cure often performed by the use of Chalybeat Medicines. Of Chalybeate Medicines. SInce mention is here made of Chalybeate Medicines, it seems expedient to inquire into the various Preparations of them, and consequently into the divers sorts of Affects which they are wont to produce in the Body of Man, that hence it may appear by what means, and on what accounts, these or other Preparations of Iron mightily benefit some Hypochondriacal persons, and very much injure others. Steel or Iron consists chief of Salt, Sulphur, and Earth; it has very little of Spirit and Water; and the Particles of the former Elements, especially the Sulphureous and Saline, in the mixed, combined together with the Earth, remain wholly fixed and without Action; but being loosed, and divided from each other, they have a very efficacious Energy. The foresaid Particles are dissolved and set at Liberty for Action two ways, viz. either by Art, when Medicines are prepared, or by Nature, after they are inwardly taken. We shall consider both. 1. The Filing of Iron inwardly taken is dissolved by the Ferment of the Stomach, as by an acid Menstruum; and upon the Iron's being dissolved within the Viscera of Concoction, the active Particles, both Sulphureous and Saline, plentifully display themselves, and mixing with the nutritive Juice, are carried into the Blood, and as they are of a differing virtue, often both of them, as it were by joint Forces, conspire for the good of the Diseased. The Sulphureous Corpuscles, passing into the Blood, furnish it with a new and more plentiful stock of Sulphur, so that its Mass, if it were before depauperated and effaete, ferments more sprightly within its Vessels, and being more kindled in the Heart, acquires a Heat more intense, and a deeper colour. Thus many troubled with a Leucophlegmatia, and the longing Disease, whose Countenance is pale, and whose Blood is cold and watery, after the use of Steel soon become of a more florid Aspect, the Blood being given a more intense Tincture and Heat. Again, upon the Filing of Iron being dissolved in the Stomach, the Saline Particles also are displayed, and often produce good effects, both in the solid parts and the Humours; for being of a vitriolic and styptic nature, they astringe and corroborate the over Lax and weakened Fibres of the Viscera, and so restore their broken Tone: Moreover they stop the Impetus of the Blood, repress it's over boiling and rising to a Froth, and keep it in an even Circulation. And again, (which is their greatest Virtue) they straiten and close the over lax, open, and gaping Mouths of the Arteries so that neither the Serum nor bloody Latex may distil forth, or break off the thread of Circulation; Wherefore in Dropsies and Hemorrhages Remedies endued with the Saline Particles of Iron are of notable use and efficacy; for many Diseases proceed from this Cause, That the little Mouths of the Arteries being too open, and the Interstices of the Vessels being become too lax, the Serum or bloody Latex breaks forth; which kind of Affects are oftentimes cured by the Vitriolic Particles of Steel, they constringing and corroborating the Blood-Vessels and the Nervous Fibres. After this manner the Filing of Steel inwardly taken seems at the same time to put Spurs to, and check the Blood; but in regard that this Medicine is much more powerful in instigating than restraining, therefore it ought to be given only to those whose Blood is very thick and cold, as to Rustics and very Robust persons: It is not proper in a very hot and spirituous Blood, and in hot Bowels. Moreover in persons of a delicate and tender Constitution there is danger lest small Portions of Steel, when they are not able to be dissolved, are thrown on the Membranes of the Viscera, and sticking pertinaciously to them, cause Ulcers and mortal Gripes, which I have really known to have sometimes happened. 2. After the Filing of Iron, the next way of preparing it is by Calcining it with Sulphur, and reducing it to a Powder; in which Preparation of it, some of the Sulphureous Particles exhale: In the mean time the Saline Particles seem to be increased, new ones accrueing to them from the burning Sulphur, so that the active Particles of both kinds, viz. the Sulphureous and Saline, come near to an Aequilibrium; and since by this means this Medicine, the Texture of the Metal being loosened, may be brought to a very fine Powder, it becomes of a much more excellent use than the Filing of Iron. In many cases, where Steel ought not to be given in substance, as in a Cachexia, the longing Disease, and the like, it is proper to use this Medicine. 3. In the third place follows the Preparation of Steel with Vinegar, sprinkling the Filings of Steel with Vinegar, and drying it till it may be reduced into an impalpable Powder. In this Preparation the greatest part of the Sulphureous Particles evaporate, and the Saline are much increased by reason of others accrueing to them from the Vinegar. This Powder does little in opening the Obstructions of the Viscera, or in restoring the Ferment of the Blood; nevertheless in a hot Constitution, in Hemorrhages, and in the Hypochondriacal affect it is wont to be given with greater success, than the foregoing Preparations. 4. The rust of Iron follows, in which there being but few Sulphury Particles, it does not so powerfully Ferment the Blood, or open the obstructions of the Viscera, as Steel prepared with Sulphur, nevertheless in Hot dyscrasies of the parts or humours, it Egregiously performs the Intents required from a Chalybeate Medicine. In this Classis our preparation of Steel is justly placed, in which all the Particles of the Metal being freed from the Bond of Mixture, are contained together: Which also (the Concrete being first reduced to a Powder) are immediately dissolved in any Latex, or Menstruum. This Powder inwardly taken excels in the same virtue, as Steel Calcined with Sulphur; But to the Menstruum or Liquor in which it is dissolved, it Communicates chief and in a manner only the Saline or Vitriolic Particles, the Sulphureous flying away, and the Earthly Particles subsiding in the bottom: I use to give common Water impregnated with this dissolution instead of Natural Spa Waters, in a great quantity; And often with excellent Success: Moreover I make Medicinal Wine, Beer, Cider, Whey, and other Liquors by dissolving this Powder in them, and order them to be taken for various Physical intents. So far of preparations of Iron in which the Elementary Particles of each kind, though in a various proportion are comprehended: There remain others in which the Particles in a manner only of one kind, viz. the Saline or Earthy are left, the rest for the greatest part being driven away, of which kind chief are Vitriol of Mars, Salt of Steel, and Crocus Martis. 5. Salt of Steel prepared as you may find here in Dr. Willis, has a Sweetish Taste with somewhat of a Rough Stiptickness, and so much partakes of a Vitriolic nature, that it seems not much to differ from Green Copperas: Taken inwardly as a Medicine it somewhat ferments the Humours, and powerfully constringes the Nervous Fibres: In Cold and Phlegmatic Cachexia's, because no Particles of Sulphur are exerted, this Medicine is not proper. It is often given with success either by itself, or mixed with other Medicines as a Spur, in Hot Dyscrasies' of the Viscera, with a predominancy of adust Sulphur, also in Flitting, Scorbutical, and Irregular Boiling of the Blood, and Nervous Juice. Notwithstanding in tender Constitutions there is danger lest through its acrimony, and too great constriction, the Tone of the Stomach, and the Fibres be injured. 6. In the last place comes the astringent Crocus Martis, prepared by long Calcination in the Fire: This Medicine is of egregious use in some cases, and yields to none of the Chalybeats. viz. in every Extravasating, and too great Eruption of the Blood and Serum, as in inward, and outward Hemorrhages, in a Diarrhaea, a Diabetes, in a Vehement Catarrh, also in an Ascites or a beginning Dropsy I have known nothing more excellent than this Medicine, & I have heard it lately mightily commended by a Famous and Expert Physician of our Country, of which Medicine nevertheless in regard it is wholly destitute both of Saline and Sulphureous Particles, and in a manner only consists of such as are Earthy and Fiery, it is much in dispute with what Faculty it operates and produces so laudable an effect in humane body. For it might seem that nothing should remain in this more than the Caput Mortuum, or Terra Damnata of Vitriol, and of other Minerals distilled by a most intense Fire. To give my opinion concerning these things, it seems in the first place, that a certain activity whereby it exerts itself and displays its virtues, either by opening obstructions, or by Astringing the Vessels and Nervous Fibres of the Viscera, accrues to this preparation from the Fiery Particles being included in the most fixed Earth, and from their breaking forth within the Body. But the chief way of giving help consists in this, that the Earthy Particles being wholly deprived of the Saline, (to which they were most closely bound) most earnestly seek to be reunited to the same, or the like: Wherefore that Crocus Martis being Immerged in our Bodies, suddenly catches to itself any sorts of Salts that come in its way, and closely binds them to it, and so whilst it drinks up like a Sponge a great many Saline Particles, it takes away many Enormities chief arising from the Flow of the Salts. This way it is that Hartshorn burnt, Spodium, and Diaphoretick Antimony exert their virtues, if at any time they give help. CHAP. X. Of the Convulsive Cough and Asthma. IT is Usual in Children (and I have known it also sometimes in Men) for a Cough to arise from Mass of Serous Filth flowing in the Lungs: Which being at first Simple and Moderate afterward becomes vehement, and Convulsive, so that in Coughing the Diaphragm being contracted upward, and so held by a long, or very often repeated Systole; the Lungs are greatly straitened and very much hindered, in their motion: Mean while by reason of the respiration being hindered, and the Blood being restrained within the Praecordia, and consequently its Stagnating in other places, the Diseased are in danger of being Suffocated and often turn of a Livid or Cadaverous aspect: Moreover in this case, besides Convulsions with a violent Coughing, raised about the Praecordia, the Stomach also being often drawn in as a party concerned, throws up all by Vomiting that is contained within it; nay and I have known, in some Tenderlings affected after this manner, that the Disease now and then passing into other parts, has raised Convulsive Motions in the Face, Eyes and Limbs, and at length has become Mortal. This Convulsive Cough happens very often amongst Children, and in certain years it seizes so many, that it seems plainly Epidemical, when it has got a Root, it is very difficultly conquered with remedies, but commonly drawing out in length, is scarce ever Cured but upon the change of the season of the year. The cause of this Distemper seems to be from the Redundancy of the Scrous Humour in the Mass of Blood, and in some measure in the whole Body: A portion of which matter Distilling from the Mouths of the Arteries on the Lungs, creates an ordinary Cough; afterward when the Serous Filth, still abounding in the Blood, and being filled with Convulsive Particles, is conveyed also into the Head, the same entering the Nerves of the Lungs, raises the Simple Cough to a Convulsive one: Moreover, when it sometimes happens, that the same Matter gathered together in the Head, enters some other Nerves; then other sorts of Convulsive affects often ensue upon the Convulsive Cough. As a Cough arises, neither only, nor always through a fault in the Lungs, but sometimes from a Convulsive cause alone, though oftener from this coming upon an affect of the Lungs: So we may say the same of the Asthma; for whether this Disease be continual or periodical, in both cases the Symptom which chief presses, is a difficulty of Breathing; which indeed seems therefore to be raised, because the Lungs being too much puffed up and Distended greatly, Fill the Cavity of the Thorax, and do not subside by turns as they ought: Hence neither can the Breath which lies within be freely sent forth, nor indeed the fresh Air be easily introduced, by reason of the space being filled before. Whilst the Lungs are thus detained, for a long time in a continued, or little remitted dilatation, oftentimes the Diaphragm, against its Custom, is forced to a violent Systole, and being contracted upward, is wont to raise the Lungs more and more, and to withstand their Subsiding: Whence it happens that the Breathing becomes yet more difficult and laborious. That this affect of difficult Breathing sometimes happens through the fault of the Lungs, it has plainly appeared to us by an Anatomical Inspection; for if a mighty Mass of Serous Filth deposed in the Thorax, very much stuffs the Lungs, that the Blood being letted in its Circulation, does not pass freely the Pneumonick Vessels, than persons so affected are always short and thick Breathed. Again, as often as the Blood becoming too Hot, or being rarified by exercise, or the heat of a Bed requires a larger space for its Circulation, Then presently on such an occasion every thick Breathing, or an Asthmatick Fit is raised, which often becomes Terrible and almost Suffocative when the Serum Boils very much within the Lungs. Moreover sometimes besides the Roots of an Asthma fixed about the Praecordia, some Branches of the same disease springing from the Brain meet with the former, and being Complicated with them, produce more Terrible fruits of a difficult breathing. There are Instances enough of these affects, viz. of a difficulty of Breathing, raised through the Single and Partial fault of the Lungs: For nothing is more usual than that persons troubled with an inveterate Cough, or with some other evil disposition of the Lungs, at length upon the access of a Dropsy or Scurvy, become Asthmatical, to wit, when the Blood being rendered very impure deposes also its Serous Filth in the Head, this enters more readily and easily the Nerves of the Lungs than others, as being become Weak, and frequently Irritated in their extremities, and heaps together in them a matter for a Convulsive straitness of Breath. Moreover I have sometimes observed that great Fits of the Asthma have happened without any considerable fault in the Lungs, so that I have really judged this Disease sometimes to be merely Convulsive, and that its Fits are only raised because a Serous Filth, filled with explosive Particles, entering the Nerves that serve for the Dilatation of the Lungs, joined with the Spirits there abounding, which afterward through a fullness, or Irritation being exploded together, and for some time, the Lungs are held as it were stiff, and blown up, that they can neither perform the functions of Expiration nor Inspiration: But the Fit being ended, and also before it is begun, the Breath is drawn free and evenly enough, there appearing no signs of a Cough, or of a Valetudinary disposition of the Lungs: I shall give an Instance of a person troubled with this Shortness of Breath. A Gentleman of a Robust and Gross Habit of Body having used for some time a full and disorderly diet, without any exercise, about the beginning of Winter began to find himself ill: First he was affected with a Heaviness and Pain of his Head, with a mighty Giddiness, and danger of Swooning, believing himself now and then, even a Dying, being otherwise sound enough; within a few days these Symptoms passed into a manifest Stupor or rather Lethargy; Being let Blood in the Arm, I ordered that Cupping Glasses, Vesicatories, smart Glisters, with many other remedies should be carefully administered to him: Within the space of twenty four hours, coming to himself, he was sound in his mind and shook off all Stupidness: But though his Brain came to be clear, he was seized with a great Weakness and Deadness in his Members: which affects nevertheless were Cured in a short time with Antiparalytick, and Antiscorbutic remedies: But after a fortnight he complained again of the heaviness of his Head, and the Giddiness, and the next day after he fell into a horrible Asthma, so that the Lungs were blown up on a sudden, and rise upward; and being scarce at all able to draw his Breath, which was very short, painful, and greatly letted, he was in danger of being Suffocated every minute of an hour. This fit, as Violent as it was, passed off within twelve hours without a Cough, Spittng, or Vomit, and for above a week afterward he was without any impediment in his Thorax: But then a like fit of the Asthma returning, treated him a little more mildly, and afterward he was wont to be troubled with a like assault of the Asthma upon great changes of the Air, especially when an intense Cold and Snow were at hand. Moreover we judge that sometimes this Convulsive straitness of Breath is raised by reason of the Bronchia of the Trachea being too much straitened, and often wholly closed by the Constriction of the Nerves and stocks of Nervous Fibres, which every where compass about the Ramifications of the Aspera Arteria, that Constriction happening when those Nerves are forced to frequent Convulsions from a Morbific matter besetting them. A fine young Virgin, of a soft and tender Constitution, and of a florid Countenance, was scarce turned of eight years of age but began to be sorely troubled with Asthmatick Fits; and she lived at least four years obnoxious to them before she was committed to my care; sometimes she continues two or three Months free from any Invasion of this Disease, yet oftentimes, by reason of errors committed in Diet, or upon great changes of the Year, or of the Air, she falls into cruel Fits of straitness of Breath, so that the Lungs being blown up and raised towards the Throat, and there held by an almost continual dilatation, the Diseased can scarce breathe at all: mean while the Diaphragm and Muscles of the Breast are laboriously occupied in thick repeated efforts of motion, in order to draw the Breath by one means or other; this access, within seven or eight hours, remitting by degrees, ceases a while; but now and then within a Week or two it is wont to return either of its own accord, or on any light occasion being offered: after the violence of the Disease is past, its matter being spent in many such Fits, the young Lady continues well enough for many Weeks, nay sometimes Months, and being free from any Distemper of the Thorax, she Breathes freely. I ordered her Spring and Fall the following Method of Cure; and now she has been without any Fit of the foresaid Affect above two Years. Take our Sulphur of Antimony six Grains; Cream of Tartar, six Grains; mix them: Let it be given in the Pap of a boiled Apple. After taking this Medicine, she is wont to Vomit four or five times: After four days, she takes this Purge, which also she is wont to repeat twice, allowing six or seven days betwixt while. Take Calomelanos twelve Grains; Rosin of Jalap five Grains; Castoreum four Grains; with a sufficient quantity of Ammoniacum dissolved: make three Pills. She takes besides every day, Morning and Evening, twelve Grains of Tincture of Antimony in a Spoonful of the following Julape, drinking after it six or seven Spoonfuls of the same. Take Water of Snails, six Ounces; of Earthworms, four Ounces; Water of Pennyroyal and Rue, of each four Ounces; Hysterick Water, three Ounces; Castoreum tied in a Nodulus, and hung in a Glass, half a Dram, double refined Sugar, an Ounce: Mix them in a Glass; make a Julape. About Autumn the last Year, another young Girl of Quality, being ill after the like manner, viz. with a Periodical Asthma, was brought to me to be cured, who using the foresaid Reme dies in a little less Dose, and repeating the same the last Spring found a mighty Relief. As to the Remedies and Method of Cure that ought to be used, if at any time to a Cough, or straitness of Breath, first raised through a fault in the Lungs, Convulsive Symptoms also supervene, by reason of an injury communicated to the Brain; let care be taken that Anticonvulsive Medicines be aptly complicated with such as have regard to any intents whatsoever of the Thorax; and also sometimes, That one while, these, another while the others being given apart, the times of Curing be interchangeably observed. It will be needless to give here Bechick or Pneumonick Medicines and their forms, whereof there is a vast store every where to be found amongst Physical Authors; it will be more to our purpose to set down a method of Physic, and some select Remedies that are proper in a Cough and Asthma, which are merely Convulsive. As to the former Affect, which is chief familiar to Children, and for the most part is not Cured but with difficulty, and after a long time; the chief Indications will be, both to purge the serous and sharp Humours from the Blood and Viscera, for preventing their Incursion and discharge on the Brain, and sometimes haply on the Breast, and to strengthen these parts that they do not easily admit into them the Superfluities of the boiling Serum: for these ends Vomits and gentle Purges in a manner always are conducing, and aught by some means to be repeated. Vesicatories are often beneficial; and if the Disease be obstinate, let Issues be made in the Nape of the Neck, or in the Arm, or about the Armpits: Let Drink and Liquid Food be taken in a less quantity than usual; instead of Drink, let a Bochet of Sarsa, China, the Saunders, Shave of Ivory and Hartshorn, with Diuretic and Anticonvulsive Ingredients, be used. In this case certain specific Remedies as it were are greatly commended, of which kind are Cup Moss, given in Powder, or boiled in Milk, and so given frequently every day; the Decoction, or Syrup, of Castoreum and Saffron, the Decoctions of Peony-Root, Misteltow of the Oak, also of Hyssop, have helped many; Water of Black-Cherries, of Saxifrage, Water of Snails distilled with Whey, and appropriated Ingredients, are often given with success. 2. I have shown you before by what method, and with what Bemedies I have Cured a Periodical Asthma in some; but besides, the famous Riverius has observed that Vomits do most good to many affected with this Disease; for that Medicine, greatly shaking and irritating the Emunctories that are seated about the first Passages, strongly expresses and draws away from the same the filthy Dregs of the Blood and Nervous Juice, which were apt to be forced into, or to stagnate in the Brain and Genus Nervosum. Zacutus Lusitanus greatly extols, and not without reason. Cauteries burnt, sometimes in the Bregma, sometimes in the Nape of the Neck, or about the Armpits: Preparations of Millepedes, viz. in the form of a dry Powder, or of a Distilled Liquor, seldom want success; for such withdraw the superfluities of the Serum or Genus Nervosum from the Head, and convey them to the Urinary Passages: For the same reason gentle Purges, and such as evacuate per Epicrasin, are frequently used: for this purpose the Decoction of an old Cock, with altering and gently Purging Medicines, sown up in the Belly of it, is commended by many. Besides the Remedies hitherto mentioned, some are said to be appropriated to, and as it were Specificks for the Asthma, such as are Balsam of Sulphur Teribinthinated; also Spirit of Hartshorn, or of Soot, impregnated with the same; Syrup of Tobacco, of Ammoniacum, our Syrup of Diasulphur, Lohoch de allio, Pills of Elecampane Roots, Milk of Sulphur, Flowers of Benzoin, made up with Tar or liquid Amber; with many other things, which it would be tedious here particularly to enumerate. And now having given you the ways of curing the chief kinds of Convulsions, it seems time to put an end to this Tract; but since there remains another kind of Disease, viz. the Scurvy, which contains Passions of a mixed nature, viz. partly Convulsive, and partly arising immediately from the Dyscrasies' of the Blood and Viscera, I think it expedient to give you briefly the way of Curing that; for both these Affects, viz. the Scorbutic, and Convulsive, being placed together, will mutually illustrate each other. The Practice of PHYSIC, Contained in Dr. WILLIS's TRACT OF THE SCURVY. CHAP. I. THE Nature of the Scurvy being so diffused, and extended to so various and such a multiplicity of Symptoms, that it cannot be comprehended in one only Definition, or scarce in one particular Description, I think it fit in the first place to heap together all the Phaenomena of this Disease, or to set forth in full all the chief accidents of it, and then to accommodate some Hypothesis for duly Solving those appearances. As to the former, to consider the signs of the Scurvy from Head to Foot, we shall begin with those in the highest part: To this place belong violent and habitual headaches, and those either happening at random, or periodical; sometimes a deadness and drowsiness of the Spirits; sometimes obstinate Watch, frequent Giddinesses 's and Scotomia's, Convulsions, a Palsy, much Spitting, soreness of the Gums, a looseness of the Teeth, a stinking Breath. 2. Meanwhile about the Region of the Breast, Pains in various parts of the Membranes, and especially in the Sternum, which often being acute and pricking, miserably torture the Diseased for many Days and Nights, a frequent Asthma, a difficult and uneven Breathing, a Constriction and straitness of the Breast, a husky Cough, a disorderly Pulse, a trembling of the Heart, frequent Faintings of the Spirits, a frequent Swooning, and a continual being in danger of it. 3. In the Region of the Belly this Disease establishing, as it were, its principal Seat, produces Iliads of Evils. For there are often a nauseousness, a Vomiting, a Rumbling, a Cardialgia, Inflations and Murmur of the Hypochondres, a frequent Colic, and most troublesome Pains shooting every way, a almost continual Diarrhaea, sometimes a Dysentery or Tenesmus, an Atrophia, and sometimes an Ascites. The Urine is commonly very ruddy and lixivial, with a Scum swimming on it, or sticking to the sides of the Glass; tho' now and then, at certain times, the same being pale and Watery, is voided in a great plenty. 4. Besides these inward Affects, in the outward Members, nay in the whole Habit of the Body, wandering Pains, and often very violent, and chief infesting by night, are felt; a spontaneous Lassitude, a Consumption of the Flesh, an Ache in the Loins, and a weakness and enervation of the other Limbs, Spots of various colours in the Skin, tumors, Tubercles, and often malignant Ulcers break forth; about the Muscles a Stupor, Formication, and ascent as it were of a cold Wind, also Contractions and Twitchings of the Tendons: Moreover to Scorbutical Persons, disorders of the Blood, unconstant Boiling of it, restless distemperatures Fevers, without any constant Course, and great Hemorrhages, generally happen. Besides these common and very usual Symptoms of the Scurvy, whereof sometimes more, sometimes fewer, and those one while of this kind and fashion, another while of that, infest the Diseased, sometimes also unusual and prodigious Accidents ensue upon this Disease. As to the evident Causes of the Scurvy, though an ill Diet, a sedentary Life, a disorder of the Spleen, and Crudities heaped together in the first Passages, are very much accused, yet the unwholsomness of the Air, and the Crasis of the Blood vitiated by former Distempers are wont to be much rather in the fault; wherefore the Scurvy, in Maritime and Marshy places, is often endemious: It frequently seizes suh as are long at Sea, and use in the mean while Salt Meats, and such as are dried in the Smoke, and also corrupted Water: It every where succeeds long continued Fevers, and other Chronical Diseases ill Cured, also over great Hemorrhages and other immoderate Excretions, nay and the suppression of usual Evacuations, as of the Menses and Haemorrhoids. Moreover this Disease, without any great procatarxis is often wont to be raised by Contagion, and sometimes is hereditary. The material cause of this Disease, or the Scorbutic taint diffused through the whole Body, is founded either in the Blood, or in the nervous Juice, or in both of them together. That the Scorbutic Taint is fixed in the Blood, it's disorderly Boiling, the Eruptions of Spots and Pushes, the ruddy and as it were lixiviated Urine plainly testify; which is also shown by the diversified production of this Disease, which for the most part succeeds the depravation of the mass of Blood: That the Taint sticks also in the Nervous Liquor, is shown by the most troublesome Pains raised both inwardly in the Membranes, and outwardly in the Genus Nervosum, by the weaknesses or resolutions of the Members, the Giddiness, the Convulsions and frequent Failings of the Animal Spirits. Since therefore both general Humours are in fault, let us see which is first or chief in fault, whence it drew its Taint, and after what manner it is communicated to the other Humour, and likewise to any other Parts that are wont to be affected. As to the Blood, (in whose Mass the Scurvy seems chief to spread its Roots) we have shown elsewhere that in its Crasis it consists of the like kind of Particles, and is tempered almost after the like manner as Wines. Moreover we have intimated that as Wine, even so the Blood, for two causes chief, is ill disposed, viz. either because some extraneous thing, that will not duly mix with them, is got into this or the other, or because the Crasis or temper of the Liquor is perverted, in as much as one Element, or haply two, to which the Dominion is due, being suppressed, others which ought to be kept under, are exalted. Concerning the former, we observe in Wine, that when the Feceses, first severed and thrown to the bottom, being stirred again are raised; or if any Heterogeneous thing, as Suet or an exotic Sulphur be cast into the Vessel, a mighty working is thence caused, which unless it be appeased in a short time, the Crasis of the Wine is in danger of being subverted: In like manner there are many immiscible things, which coming into the Blood disturk its Motion and Circulation, and hinder the course of its Oeconomy from being duly performed: The Nutritive Liquor being filled with filthy dregs, Ferments the Blood in a disorderly manner: Nay and its Liquor being become degenerate, causes Fits of intermittent Fevers: The Vapoury, Serous, Bilous and Melancholy Recrements of the Blood retained within it, beget Catarrhs, the Dropsy, the Jaundice, Melancholy, and many other Affects: Now if that extraneous thing be seasonably removed, the Blood even as the Wine being free from that Extraneous Mixture, soon recovers its former Constitution: But each of those Liquors being for some time infected with Heterogeneous Contents, at length degenerates from its due Crasis, and consequently is not easily restored. Again, both Wine and the Blood fall from their due Temper for many other causes: 1. Concerning Wines we may observe, that sometimes the same do not come to a ripeness, but for want of a Pneumatosis, because the Spirits, and other active principles of Salt and Sulphur, being involved in such as are more Gross, cannot clear themselves, remain wholly Crude: Wherefore they do not become Spirituous; but being of a Gross consistency, and of an ingrateful savour, degenerate into a Flat Wine without strength: Even so the Blood, sometimes the Spirit and Sulphur being depressed, remains Crude and Watery, also without vigour, and unapt for a sprightly accension in the Heart; such a disposition causes the longing Disease, and an Hydropical Diathesis. 2. The Sulphureous part of the Wine being exalted above the rest, causes an Immoderate Effervescency, or an ebullition in the Liquor; we call it a Fretting of Wines: In like manner the Sulphureous part of the Blood being too much exalted, and consequently apt to Boyl, and be kindled in the Heart too much, brings a Feverish distemper, and is really the cause of many continual Fevers. 3. Often in Wine the Spirit becoming faint, and the Sulphur being bound, the Saline part is raised to a State of flowing, and praedominates over the rest, wherefore the Liquor, passes into Vinegar; from such an Acetous disposition of the Blood, Melancholy is caused. 4 It's a vulgar observation in Wines, that besides that they degenerate into a Flat Wine, or into Vinegar, the same sometimes upon the Spirits being depressed, and the Salt and Sulphur's being together exalted, become either Rank, or Pendulous, or Mucilaginous, we call it, Wines become over Fretted or become Ropy: In both changes, the Spirit being brought under, the Sulphureous and Saline Particles are joined together and are above the other Elements, and bring the Crasis of the Liquor to their nature: But the thing is not done in both wholly after the same manner; for in the former dyscrasy of the Wine the Sulphur is a little above the Salt, and in the latter, the Salt is above the Sulphur: Nay and either of them being in power, and having thrown off the Dominion of the Spirit, takes the other to it, and raises it above its due state. Now it's probable that the Blood is altered after the like manner in the Scorbutic affect, as Wines when upon being overheated, become over Fretted, or become Ropy, and we may conclude the Dyscrasy of the Blood, which is the Parent of the Scurvy, to be two fold as that of Wine, viz. Sulphureo-Saline, and Salino-Sulphureous. For there being a very great variety of affects, which are accounted of, as belonging to the Scurvy, all of them may be aptly enough reduced to these two, as it were, chief heads, or as the two fountains of the evil: viz. First that the Blood being touched with a Scorbutic taint, either is very hot, as in which the Sulphur having gotten the Dominion takes the Salt to it: wherefore being become rank it Boils disorderly in the Vessels, and discharges continually from itself adust Recrements, viz. the concretions of the Salt and Sulphur, and disperses them every way, which being outwardly spread, produce Spots, Wheals, Pushes, or Ulcers: But being inwardly deposed cause Vomitings, Cardialgias, Diarrhaeas or Dysenteries, and also violent pains. In this kind of Scorbutic rankness of the Blood only temperate remedies and frequent Bleedings agree; and not Scurvygrass, horse Radish, and other things of a smart and instigating Nature: After the same manner as overfretted Wines are Cured by Racking them from the Lees, and likewise by pouring Milk, Amylum, Ichthiocolla, and other Lenifying things to them. Or, Secondly in the Blood which Foments the Scurvy, the Salt having got the Dominion takes to itself the Sulphur, wherefore it is not so hot, but like Ropy Wine becomes thick and Mucilaginous, as it were, is Circulated slowly in the Vessels, and is apt to stuff the Vessels as it passes through them, Furring them with a Muddy Filth. Such as are so affected for the most part being without Pushes or Cutaneous Eruptions, become Dull, Pursy, and enervated, are troubled with a Spontaneous Lassitude, a Straitness of the Breast; nay and are found obnoxious to Passions of the heart, Faintings of the Spirits, to a Giddiness and Convulsions: And in this kind of Scorbutic disposition, Hot remedies, and such as are endued with a Volatile Salt, nay and Galybeates, which Fuse and exagitate the Blood are wont to be most of use; after the like manner as Ropy Wines are dealt with, to wit they ought to be very much stirred, and agitated and also quicklime, burnt Allom, Lime Plaster, Sea Salt Calcined, and other things of a very smart nature are put into them I shall now show after what manner the seeds of that Disease are laid in the other general humour, viz. the Nervous Juice. About the beginnings of a Scurvy, till the Crasis of the Blood, and the Tone of the Brain are wholly vitiated, that Subtle Liquor which passes in the Brain and Nerves, and is distilled from the Blood coming to the Brain, both as the Matter and Vehicle of the Animal Spirits, is yet Spirituous and Sweet, and not very unapt for any offices it ought to perform, but afterwards from the Mass of Blood become depauperated, and very much Effaete, a much thinner Latex, and inclining to a Sourness is distilled: Moreover from the Dreggy, and as it were Rank, or Muddy Blood, Heterogeneous Particles, and such as are very injurious to the Animal Oeconomy, are sent, and are admitted without difficulty into the Brain, which is become weak, and thence are diffused into its appendix both Medullary and Nervous with the Juice which passes in them: Hence follow the Fall and Eclipses, sometimes Distractions, and Painful and Convulsive Explosions of the Animal Spirits, that happen in each of the Regions. Wherefore the Palsy, Convulsions, a Giddiness, Pains, Tremble, and other Preternatural affects of the Brain and Genus Nervosum are wont to ensue upon a Scurvy when deeply rooted. Mean while, we may observe in general that the Scorbutic Taint, fixed in the Nervous Juice, Consists in these three things, viz. In some one of them or in all of them together, viz. that the Liquor lying in the Brain and Nerves becomes much more thin or poorer; that it degenerates from its Spirituo-Saline Crasis towards a Sourness; that it is stuffed with Heterogeneous and Morbific Particles. As to the Prognostic of the Scurvy, let your judgement in this case be wary, long suspended, and not rash, for many (as it has occurred to our observation) accounted for desperate, have recovered: I have seen some even ready to be Choked with a horrible Asthma; others just a dying with frequent Swoonings, nay and others seized with a Palsy or Convulsive Fits, or a terrible Colic, who were wholly freed in a short time by the help of Medicines: I have known some Scorbutical persons Swollen all over their body by the Dropsy, others brought to an extreme Leanness by an Atrophia, who were restored again to their perfect health. Therefore though persons troubled with this Disease are sometimes pressed upon with very dangerous affects, if nevertheless the Viscera are still indifferently sound, or at least not very much vitiated, you must not despair of those evils, caused merely by the Scorbutic taint: But on the contrary, when the Symptoms appear less terrible, if the contents of the Hypochondres and Abdomen are become hardened, and as it were Scirrhous, or if the Lungs begin to be corrupted, promise nothing great or favourable concerning the Cure of the Disease, Since as this affect grows to a high pitch, a manifold and diversified Morbific Matter, causing Symptoms of a various kind, and nature, is engendered, therefore let remedies not only of one kind be administered: But when any Method of Physic, though prescribed with great judgement, does little or nothing towards a Cure, the Diseased are not presently to be left, but let other Medicines, and now and then others be tried; for the same do not agree with all persons, nor always with the same person. In the affected Body the Powers and Combinations of the Salts and Sulphurs every where vary, even so let the Medicines that do no good be sometimes changed, till you light upon some one that agrees very well, and giveth help. But if notwithstanding the use of Remedies, or upon their not being well applied, the Scurvy getting ground by degrees is daily raised to a worse State; it brings at length the Dropsy or Ptisick: From this or that Disease there is a ready passage to Death; for after that the Blood is very much depraved it discharges its dreggy Excrements, when at long run they are much heaped together, either on the Lungs, or on the Viscera of the Belly, and consequently, it brings one of those two affects which are alike Mortal. CHAP. II. Of the Cure of the Scurvy. AS to the Cure of the Scurvy, since it is no one single preternatural affect, but a Legion that is to be conquered, therefore the Method of curing aught to comprehend manifold indications, and those variously complicated and subordinate; which nevertheless according to our wont we shall reduce to three heads, viz. that they be Preservatory, which have regard to, and take away the cause of the Disease; and Curatory, which have respect to, and remove the Disease itself and its Symptoms; and lastly Vital, which uphold or restore the strength and vigour of the Patient. From the very beginning of the Cure we ought to levelly against the Cause of the Disease, for this being cut off, or torn up as the root, presently the Trunk, Branches, and Fruits whither away: Since therefore we have shown that the cause of the Scurvy is founded in the dyscrasy of the Blood, viz. Sulphureosaline, or Salino-sulphureous: In the first place we must endeavour the best we may, the amendment of that dyscrasy, as well of the one kind, as of the other: For this purpose, first let the impediments be removed, then let the primary intention itself be effected: For both intents, remedies are taken from Diet, Chirurgery and Pharmacy. As to the Diet, we shall set. down a particular form of it hereafter: Mean while to proceed with the rest. The reducement of the Blood to its due Crasis by appropriated remedies is chief hindered by reason of these two things; viz. first because none but a vicious stock of nutritive juice: is continually carried into it; and secondly, because the Recrements produced within it are not sufficiently discharged by fit Common-shores; therefore we must provide both that the work of Chylification be rightly performed in the first passages, and that the Vapoury Recrements be sufficiently discharged by Perspiration, the Serous by the Reins and Lymphducts, the Bilious by the Gall Bladder, the Melancholy by the Spleen, and others of any other kind else by proper Emunctories: Afterward, these offices being rightly Instituted, let us endeavour to reduce the Dyserasie of the Blood by specific Medicines, and especially by such as are endowed with a Volatile Salt. The remedies regarding every of these intents, aught to be Complicated together, and to be applied jointly to use, but after what manner, and by what ways of administrations, I must yet more particularly set forth. 1. That Chylification may be rightly performed in the first Passages, we must take care that the load of Excrementitious Matter heaped together in them, be cleared forth, that the lost or depraved Ferments be restored, that the Passages and Pores howsoever stuffed and obstructed be opened: For these ends Cathartick, Digestive and aperient Medicines are designed. 2. When the Recrements gathered together in the Mass of Blood, are not sufficiently discharged by their proper Emunctories, let them be now and then led forth by others ways that are most proper: For this purpose cathartics also, and likewise Diaphoreticks, and Diuretics are proper. 3. Let the Scorbutic dyscrasy of the Blood be corrected by Bleeding and Specific Remedies; wherefore to draw all that concerns the preservatory indication to a Head, let the Romedies, which perform its chief intents, be cathartics, Blooding, Digestives, Aperients, Diaphoreticks, Diuretics, and Antiscorbutics, or Specificks. Moreover, in regard digestive Remedies and Aperients are often Coincident, since both are chief Imbued with Acid, Smart, or Saline Particles; Moreover in as much as those kinds of Medicines aptly enough move Sweat or Urine; therefore the Physical Apparatus required for the foresaid intentions, may be brought yet to narrower limits viz. that it may consist in a manner only of Cathartick, Digestive, and Antiscorbutic Medicines, to which Bleeding is added as occasion presents, I must now set down certain Forms and Praescripts of them, and likewise the manner of using them. cathartics. 1. LEt the method of Curing prescribed almost to all Scorbutic persons begin with cathartics; for unless the first Passages are cleansed, the Medicines designed for any other uses, will be depraved by the Filth in them; wherefore Vomiting sometimes may be no less proper than Purging. If the Stomach, (as it frequently happens) being loaded with a viscous matter that turns four or of an ill savour, endeavours to discharge upward its depraved Burden, by a nauseousness or striving to Vomit, and the Patient has been wont formerly to undergo such an Evacuation vigorously enough, and with a well bearing, nothing hinders, so the strength be not too much cast down, from giving an Emetic Medicine. To those that are strong, let an Infusion of Crocus Metallorum, or Mercurius Vitae, or the Emetic Tartar of Mynsicht, or Glaubers Sulphur of Antimony, be given. Those that are of a weak or tender Constitution, may take Wine of Squills, or Gilla Theophrasti, which being given in a small Dose, let them drink a great quantity of Whey after it, and then the Ventricle being filled to a nauseousness, let a gentle Vomit be raised by putting the Finger or a Feather into the Throat, and let it be sometimes repeated, as the person sees good. By this manner of Vomiting, the mere Contents of the Stomach are cleansed from its folds, and purged forth; neither are painful or Convulsive Twitchings caused in other adjacent Viscera or Membranes, with a Swooning, as it usually happens after Stybiate Medicines. To those whose Stomach, by reason of an ill Digestion, soon gathers together a heap of Phlegm, or of other degenerate matter, I have ordered that they procure once a Month such a Vomit, as being safe and wholesome. Where Vomiting has no place, you must begin with Purging, at least, some days being allowed betwixt while, let this evacuation succeed the other. What has been formerly inculcated by Authors, concerning the preparation of the Humours, I judge either to be superfluous, or wholly erroneous, the Circulation of the Blood being not then understood: but instead of that intention, let Medicines restoring the Ferments of the Viscera, and altering the Crasis of the Blood, be substituted: Mean while for clearing away the Filth of the first passages, and the Excrementitious superfluities of the Blood and Nervous Liquor, first, let a mild and gentle Purge be ordered, and afterward, according as the Patient bears it, let it be repeated either once within a week, or oftener or seldomer; and let the strength of the Medicine be proportioned according to the success of the first Dose: For this end Pills, Potions, Apozemes, Electuaries, Powders, and many other forms of Medicines are wont to be prescribed. If the Constitution of the Diseased be hot, and the Scurvy seems to be founded in the Adust, viz. the Sulphureosaline dyscrasy of the Blood, let all Medicines of Aloes, and Diagridium be avoided, and let only the more temperate be given, of Sena, Rhubarb, and other things that do not exagitate the Blood. Take Leaves of Sena an Ounce, Rhubarb six Drams, Epithimum three Drams, Roots of Polipody of the Oak, and of English Rhubarb dried of each half an Ounce, yellow Saunders two Drams, Celtick-spike half a Dram, Salt of wormwoed two Drams, being sliced and bruised, let them digest in a Matrace by a Sand heat with White-wine, and Fumitory-water, of each a Pound, (or with our Magistral Antiscorbutick-water two Pounds) for two days, let the clear Straining evaporate by a gentle Bath heat, to the consistency of Honey; then add Powder of the Leaves of Sena and Rhubarb, of each a Dram and a half, Species Diatrion Santalon a Dram, Cream of Tartar a Dram and a half, make a Mass for Pills; the Dose is from half a Dram to a Dram. Or, let such an Infusion be prepared, which let evaporate by a gentle heat, to the consistency of a Syrup, adding towards the end Manna passed through a Searce, and double refined Sugar, of each two Ounces, make a Syrup; the Dose is from a Spoonful to two, with a fit Vehicle. Or, let four or six Ounces of such like Tincture be given for a Dose, adding Cream of Tartar half a Dram, and if there be need of Sweetening, Syrup of Apples three Drams. Or to the Tincture prescribed, let six Ounces of cleansed Corinth's be put, and let there be a warm Digestion till the Corinth's swell, which being taken forth, let the Liquor evaporate to the consistency of a Syrup, adding Sugar and Manna passed through a Searce, of each a Dram and a half; then the Corinth's being put in again, let the Medicine be kept in a Glazed Vessel well stopped; the Dose is from a Spoonful to two. Or, to the Tincture prescribed evaporated to a half, add fresh Cassia, Pulp of Tamarinds extracted with Antiscorbutick-water, of each three Ounces, Conserve of Violets and of Damask Roses, of each two Ounces, the greater Compound Powder of Sena a Dram, Rhubarb powdered half an Ounce, Cream of Tartar, Species Diatrion Santalon, of each two Drams, let them be bruised together in a Stone-mortar, till they are brought to the form of an Electuary: The Dose is the quantity of a Walnut, more or less, according to the operation. For those whose acquaint Stomach will not receive any Medicines but in a small quantity, and nicely prescribed. Take Rosin of Scammony, from four Grains to eight, Cream of Tartar half a Scruple, Celtick-spike six Grains, mix them, make a Powder, let it be given in a Spoonful of Panada, or let it be made into Pills. To those that are troubled with the Scurvy, and are of a cold Constitution, and the Disease seems to be founded in a Nitro-sulphureous Disposition of the Blood, resembling ropy Wine, let smart cathartics, and such as are endowed with hot Particles be given. Take Pil. Stomac. cum Gum. two Drams, Rosm of Jalap twenty Grains, Tartar vitriolated sixteen Grains, Oil of Juniper half a Scruple, with a sufficient quantity of Ammoniacum dissolved in Water of Earthworms, make sixteen Pills, let four be taken at a time once a week. Take Bontius' Pills of Tartar a Dram and a half, Rosin of Jalap twelve Grains, Salt of Tartar half a Scruple, with a sufficient quantity of Syrupus Angustanus, make twelve Pills. Take Extract of Pill: Ruffi a Dram, Extract of black Hellebore a Scruple, Salt of Tartar half a Dram, with a sufficient quantity of Ammoniacum dissolved, make nine Pills, let three be taken at a Dose. Take Leaves of Sena an Ounce, Rhubarb six Drams, Mechoacan, Gummous Turbith of each half an Ounce, Threads of black Hellebore three Drams, Salt of Tartar two Ounces, yellow Saunders a Dram and a half, Winters-bark two Drams, being sliced and bruised, let them digest in two Pounds of White-wine for two days, strain it off clear without pressing it; let it be taken either by itself, from five Ounces to six, or let it be made into an Extract or Syrup, or Electuary as the Tincture above prescribed, adding Pulvis Arthriticus, or Diasena what suffices, etc. Or, Let a Tincture of this kind be prepared, which may be given to robust Men, to the quantity of a Spoonful, or of a Spoonful and a half. Take Salt of Tartar an Ounce, small Spirit of Wine a Pound and a half, let them digest till it turns yellow: To this being poured of the Faeces by inclination, infuse Leaves of black Hellebore macerated in Vinegar an Ounce; yellow Saunders a Dram, the yellow Coats of Oranges a Dram and a half, make a warm and close Digestion for three days: Let the clear Straining be distilled in Balneo to a half, let the remaining Liquor be kept for use. Take Roots of sharp pointed Dock, Polipody of the Oak, stinging Nettles, Chervil, of each six Drams, Leaves of Agrimony, Speedwell of each a handful, white and yellow Saunders, of each a Dram and a half, bastard Saffron an Ounce, Tartar of White-wine half an Ounce; let them boil in two Pounds and a half of Fountain-water, till a half be wasted, add of Rhenish-Wine a Pound, and strain it presently, into which put of the best Sena half an Ounce, Rhubarb six Drams, Leaves of black Hellebore half an Ounce, the yellow Coats of Oranges two Drams, make a close and warm Infusion for twelve hours, let the Straining be kept in a stopped Glass; the Dose is from five Drams to six. It were easy to set down here many other forms of cathartics, but there is no great variety required in these: But of the foregoing, let these or the others be given as they best agree, and now and then, let them be repeated within five or six days, as occasion requires. An over frequent and violent Purging casts down the powers of the Body, greatly impairs the strength of the Viscera, and in the mean time, does not take away the Disease. After a Purge or two, if Bleeding be indicated, let Blood be drawn from the Arm, or from the Vessels of the Fundament by Leeches: It matters not much, which Vein be opened, nor is the opening of the Salvatella Vein of as much moment as it is said: As to the large Discourses made by Authors, concerning the opening of the Liver or Cephalick Veins, rather than any others in the Scurvy, since the Circulation of the Blood has been known, it comes to nothing. Phlebotomy is indicated by a plenty and viciousness of the Blood, which it is better to let forth at several times in a small quantity, than at once in a great: For when the Liquor of the Blood is become very impure, it is corrected by no kind of Remedy, more certainly than by a frequent and spare letting of it forth; for the old corrupted Blood, as often as it is drawn forth, is succeeded by a better and clearer fresh Blood; mean while there is need of caution, that it be not drawn away at once in too great a quantity, for its store being much drained together, Sanguification fails, so that a Dropsy or Cachexia ensues. Besides Purging, and (if need be) opening a Vein, many Remedies of another kind, no less necessary, are required in the Scurvy: And that they may be prescribed in order, we must forthwith consider, whether only Preservatory Indications have place here, and whether certain Curatory Indications, viz. such as have regard to some severely pressing Symptoms, ought not to be interchangeably pursued with them: And if you are to employ the whole work of the Cure against the cause of the Discase, you may proceed after the following method: We shall show you hereafter, what sort of Cure is to be applied to Symptoms (if haply occasion requires it.) Therefore if nothing hinders, but you are to employ the chiefest stress of Physic, in rooting out the cause of the Disease, principally and by itself; for this purpose, let Digestives likewise, and Specificks, or Antiscorbutics, as we hinted before, be used at all times, unless on the days of Purging: To which sometimes, if it be needful, let Diaphoreticks or Diuretics be added: Manifold forms and prescripts of Medicines, and of various kinds for performing these intents, are every where to be found amongst Authors: I shall here set down some of the more choice of them, which I here thought good to distribute into two ranks, according to the twofold nature of the Scorbutic Cause. viz. the Sulphureosaline, and Salino-sulphureous Dyscrasies' of the Blood. And first I shall deliver such as are proper in this latter kind of affect, viz. where there is need of Medicines, endowed with a certain instigating virtue, and such as are very much filled with a Volatile Salt. Let Digestive Medicines that restore the Ferment of the Stomach, and help the Functions of that, and of other of the Viscera, which serve for Chylification, and Antiscorbutics, or Specificks, which take away the Dyscrasy of the Blood, either be joined in the same Composition, or at leastwise let them be taken the same day one after the other. Among digestive Remedies are justly counted the Cream, Crystals, Salt, and Tincture of Tartar; Tartar Vitriolated and Chalybeated, Elixir Proprietatis, the simple mixture. The use of each of these, given twice a day, oftentimes does good. Moreover you may easily make Magistral Tinctures and Elixirs of various kinds, both digestive and appropriated to the Scurvy, with the two following Menstruums. Take rectified Spirit of Vitriol, Six Ounces; Spirit of Wine Alcholized, sixteen Ounces; mix them, and Distil them in a Glass retort with three Cohobations; keep it for use in a Glass well stopped. Elixir Proprietatis is more easily and better prepared with this Compound Menstruum than the vulgar way. Take Winters-bark, Lignum Aloes, Roots of the lesser Galingal, of each two Drams; Cinnamon, Cloves, Cubebs, of each a Dram; Seeds of Bishopsweed and Watercresses, of each half a Dram; being bruised, pour to them of the foresaid Menstruum enough to cover them three Fingers over; let them digest in a Matrace in a Sand Furnace for six days; let the straining be kept in a Glass close stopped: The Dose is twenty Drops, more or less, in a Spoonful of Canary, or of an appropriated Liquor. Let it be given twice a day. Take white Amber, Gum of Ivy, Caranna, Tacamahaca, of each a Dram; Saffron, half a Dram; Cloves, Nutmegs, of each two Scruples; being bruised, pour to them the aforesaid Menstruum, and let a Tincture be extracted according to Art. The Dose is twenty Drops, as above. Take blue Salt of Tartar, four Ounces; let it digest in a Matrace with a Pound of Spirit of Wine Alcholized, till a Tincture be extracted: Let this be another Menstruum, with which you may prepare Elixirs out of Gums, Spices, etc. after the same manner as with the former Menstruum. While these kinds of Medicines are given in a small Dose, in the Evening and early in the Morning, at Physical hours, viz. at eight a Clock in the Forenoon, and at four in the Afternoon, let the Antiscorbutic Medicines of the other kind be taken, which for the most part we are wont to prescribe in a twofold form, viz. in a solid form and a liquid, to be taken all under one; so that the solid Medicine being taken first, the liquid is drank after it: there are various kinds and ways of Composition of both, viz. in a solid form, Electuaries, Confections, Powders, Pills and Tablets; in a liquid form are Decoctions, Infusions, Expressions, Distilled Waters, Physic Wines, and Ales. We shall give you some of the more select Medicines of each of these kinds. Electuaries. TAke Conserve of Scurvygrass, Roman Wormwood, Fumitory, of each two Ounces, Powder of Winters-bark, Roots of Angelica, and Aron, of each two Drams; Species Diatrion Santalon, a Dram and a half; Powder of Crabs-eyes, a Dram; Salt of Wormwood, two Drams; with a sufficient quantity of Syrup of the Juice of Citrons; make an Electuary. Take Conserve of the Leaves of Scurvygrass and Brooklimes made with an equal quantity of Sugar, of each three Ounces; Troches of Capers, and of Rhubarb, of each two Drams; Salt of Wormwood, and of Scurvygrass, of each a Dram; Ivory Powdered, Coral Calcined, of each a Dram, with a sufficient quantity of syrup of the Juice of Scurvygrass: Make an Electuary. I use to prescribe the Conserves of the outward Coats of Lemons and Oranges, also of the purple Flowers of the Ash-tree, of the Leaves and Flowers of Lady-smocks, of the Roots of sharp pointed Docks, and of English Rhubarb, to be prepared with an equal quantity of Sugar, which being mixed between themselves, or with other Conserves and Species, enter these kinds of Electuaries. Take Conserves of the Yellow-coats of Oranges and Lemons, of Flowers of the Ash, of each two Ounces, Powder of the Roots of Contrayerva a Dram and a half, of the lesser Galingal half a Dram, Roots of Aron two Drams, Species of Aromaticum Rosatum a Dram, Salt of Wormwood two Drams, with a sufficient quantity of Syrup of the Confiture of Nutmegs make an Electuary. The Dose of these kinds of Medicines is the quantity of a Nutmeg, drinking after it an appropriated Liquor. To Rustics and poor People, by whom Medicines easily prepared and cheaper are desired, I prescribe after this manner. Take Leaves of Scurvygrass and Brooklimes of each four Ounces, double refined Sugar eight Ounces, let them be bruised together in a Mortar, adding Powder of Winter's Bark half an Ounce, Tartar Calcined with Nitre three Drams, with a sufficient quantity of Spanish Wine let them be made into an Electuary. The Dose is the quantity of a Nutmeg twice a day, drinking after it an appropriated Liquor. Take Leaves of Scurvygrass a pound; Raisins stoned, double refined Sugar, of each half a pound, Faecula of the Roots of Horse-raddish two Ounces; let them be bruised together in a Mortar, and made into the Form of an Electuary. The Dose is the quantity of a Walnut, twice or thrice a day. Confections. TAke Powder of Aron Roots compound an Ounce, Winters-bark Powdered half an Ounce, Species Diatrion Santalon, Troches of Capers of each two Drams, Salt of Wormwood, and of Scurvygrass of each a Dram and a half, the Yellow Coats of Oranges preserved three Ounces, let them be bruised together in a Mortar, then add of double refined Sugar dissolved in a sufficient quantity of Water of Earthworms, three Ounces; make a Confection according to Art. Take Roots of Eringo and Scorzonera preserved of each two Drams, walnuts preserved and Mirobalanes Condited of each in number two, the Electuary of Sassaphras six Drams, Powder of Cubebs and Cardamons of each two Drams, Powder of the Roots of Zedoaria and Angelica of each a Dram and a half; Salt of Woormwood two Drams; with a sufficient quantity of Syrup of the Confiture of walnuts make a Confection. Take Powder of China Roots, of the Wood Sassaphras of each half an Ounce, Yellow and White Saunders of each two Drams, Seeds of Rocket, Cubebs, Garden-cresses, Grains of Paradise, of each a Dram and a half, Species of Dialacca, Cinnamon, Orrice, the lesser Galingal of each a Dram, Salt of Wormwood two Drams, Conserve of the Yellow Coats of Oranges, and Sugar of Rosemary Flowers dissolved in a sufficient quantity of Water of Snails, of each three Ounces; make a Confection according to art; the Dose is the quantity of a Nutmeg twice a day, drinking after it an appropriated Liquor. In some cases of the Scurvy where the use of Steel is indicated, either let three Drams of Steel prepared with Sulphur, or two Drams of Vitriol of Mars be added to each of the prescripts either to the Confection, or to the Electuary, and after the taking of the Medicines once or twice a day, let the body be exercised according as the strength will bear. Powders. TAke Powder of Aron Compound an Ounce and a half, Winter's Bark half an Ounce, Cubebs, Grains of Paradise, Cardamons of each two Drams, Salt of Wormwood, three Drams, Tablets of Oranges three Ounces; make a Powder, the Dose is a Dram in an appropriated Liquor. To the foresaid Powder add Kernels of the Indian Chocholate Nut half a Pound, let them be brought into a Mass, or Paste in a warm Mortar. The Dose is two Drams, after the manner that the confection of Chocolate is taken, viz. in Fountain Water with the leaves of Rosemary, or of Betony, or the Root of Scorzonera, or also the shaving of Ivory or of Hartshorn boiled in it. Pills. FOr those to whom a Medicine in a less Dose, and in a form of Pills is more pleasing. Take Roots of Virginia Serpentary, of Contrayerva, of each two Drams, Winter's Bark, Cubebs, Rocket Seeds, of each three Drams, Salt of Wormwood, and of Scurvygrass of each a Dram and a half, Extract or Rob of Juniper half an Ounce; with a sufficient quantity of Syrup of the Confiture of Nutmegs, make a Mass. The Dose is four Pills twice a day, drinking after it an appropriated Liquor. Tablets. FOr nice persons let Tablets or Tragaea's be prescribed after this manner: Take Powder of Winter's Bark, of Crabs eyes, of each a Dram and a half, Pearl powdered half a Dram, double refined Sugar dissolved in a sufficient quantity of water of Earthworms, and Boiled to a Consistency for Tablets, Six Ounces, Spirit of Scurvygrass two Drams; make Tablets according to Art each weighing half a Dram. Let about half a Dram be taken twice a day, drinking after it an appropriated Liquor. Tablets of Oranges which are to be sold by the Oxford Apothecaries. TAke Rinds of Oranges, Lemons, Citrons preserved of each an Ounce, preserved Eringoes half an Ounce, Pine-Nut Kernels, Fistick Nuts of each twenty, Sweet Almonds blanched in number ten, anise Seed Powdered half an Ounce, Ginger Candied two Ounces, Species of Aromaticum Rosatum, Nutmegs of each a Dram and a half, Roots of Galingal a Dram, Cloves in number ten, Ambergreice four Grains, Musk, Civet of each two Grains, double refined Sugar dissolved in Rose-water, and Boiled to a Consistency for Tablets a Pound and a half; make Tablets according to Art. So much of Medicines which are wont to be given to Scorbutical Persons in a solid form, or in a gross substance: and that their virtue may be conveyed the better into the Mass of Blood and with more benefit, Liquids are prescribed for the most part to be drank after them. Though there be a great variety of these, and a diversified way of their composition, yet the chief and most usual are such as we have hinted before, and of each of which we shall now give you forms. Decoctions. THough Decoctions are a very familiar kind of Liquid Medicines, yet they are seldom used in the Scurvy, because the Simples, which chief do good in this Disease, lose their virtues, which they have from the volatile Salt, by Boiling: Nevertheless because remedies are easily and soon prepared after this manner, they ought sometimes to be admitted; nay and experience has shown that some of them are efficacious. For Rustics and poor people this Medicine of a very easy preparation is commended by many. Take Leaves of Water-cresses three handfuls, of the lesser Sorrel two handfuls; being sliced, let them be macerated in six Pounds of Milk, and let them boil to a consumption of a third part; let it be taken twice a day, from four Ounces to eight. The Decoction of Wormwood is commended by Eugalenus and others. I have often tried the following Medicine with good success Take Broom tops three handfuls, being sliced small, let them boil in three Pounds of strong Beer to a half, let it be given from two Ounces to three twice a day, 2. Infusions. AN Infusion added to a Decoction, makes a very profitable Medicine. Take Roots of Scorzonera and Chervil, of each an Ounce, Leaves of Agrimony and Ground-pine, of each half a handful; burnt Hartshorn two Drams, Raisins half a handful; set them boil in three Pounds of Fountain-water till a third part be consumed: Add of Rhenish-wine half a Pound, and presently let it be strained into a glass Vessel, to which put Leaves of Scurvygrass and Brooklimes bruised, of each half a handful, Orange Pills preserved and sliced small half an Ounce; make a close and warm Infusion for six hours; let the straining be kept in stopped Vessels. The Dose is six Ounces twice a day after a solid Medicine. Take Whey made with White-wine or Cider a Pound and a half, in this boil Roots of Bur-dock, and candied Eryngoes, of each six Drams, Juniper-berries preserved half an Ounce. Let the Liquor, being boiled away to the consumption of a third part, be strained into a Flagon, to which put Leaves of Scurvygrass and Brooklimes, of each a handful, make a warm and close Infusion for six hours. The Dose is half a Pound twice a day after a solid Medicine. Infusions also made by themselves, are sometimes of excellent use. Take Leaves of Scurvygrass a handful, Rasping of the Root of Horse-raddish half a handful, Winters-bark bruised two Drams; let them be put in a Glass with White-wine or Cider, and water of Scurvygrass, of each a Pound, let them infuse in a Cellar for two or three days. The Dose is from six Ounces to eight twice a day, as above. 3. Juices and Expressions. THE most commendable use of Antiscorbutic Herbs and Fruits is, that their Juices and Expressions be taken by themselves, or with other appropriated Liquors twice or thrice a day: For so the entire and pure Virtue of the Remedy is presumed to be given. Take Leaves of Scurvygrass, Water-cresses, Brooklimes, of each three handfuls; being bruised, let the Juice be pressed forth, and be kept in a Glass well stopped. The Dose is from an Ounce and a half, to three Ounces twice a day in a little draught of Beer, Wine, or distilled Water. Take Leaves of Scurvygrass four handfuls, of Woodsorrel two handfuls, being bruised, let the Juice be expressed, which being put in a Glass and well stopped, will soon become clear, for the Acidity of the Woodsorrel precipitates the grosser parts of the Scurvygrass: The same thing comes to pass if the Juice of Oranges be mixed with the Juice of Scurvygrass. The Dose is two or three Ounces twice a day. Takes Leaves of Scurvygrass four handfuls, of Brooklimes and Garden-cresses of each two handfuls, long Pepper three Drams, Rasping of Horse-raddish two Ounces; being all bruised together, let them be put in a Glazed Pot with two Pounds of Rhenish-wine, or of Sack, if it be thought better: The Orifice being well stopped, let them stand in a cold Cellar for two days, then express it strongly; the Dose is three Ounces twice a day, after a solid Medicine. Take Leaves of Scurvygrass three handfuls, of Brooklimes, Garden-cress and Woodsorrel, of each a handful, being bruised, pour to them Water of Snails and of Earthworms, of each six Ounces, make a strong Expression, and keep it in a Glass well stopped. The Dose is two Ounces twice a day. 4. Syrups. FOR the same reason as Decoctions, Syrups also are disapproved of in the Scurvy, viz. in as much as the virtue of the most efficacious Simples, evaporates in boiling: Yet because sometimes there seems need of such a Medicine for sweetening appropriated Medicines for some persons, we shall here propose our preparation, the Virtues of the Ingredients being preserved as much as may be. Therefore take Leaves of Garden Scurvygrass six handfuls, the Coats of four Oranges, and of two Lemons thinly pared off, the Rasping of Raddish-roots half a handful, long Pepper powdered three Drams, all of them being bruised together, let the Juice be expressed, which presently being put in a Glass and well stopped, let it be set in a cold Cellar till it becomes clear by subsiding: Then let the clear Liquor be poured off into another Glass by inclination, and being stopped, let it be kept in the heat of a Balneum Mariae. Mean while for each Ounce of it, take of Sugar an Ounce and a half, and let its whole quantity, dissolved with a little Water of Earthworms, be boiled to a consistency for Tablets, to which, presently let the foresaid Liquor whilst warm, be poured by little and little, and let it be stirred with a Spatula; assoon as it is incorporated, let the composition be taken from the Fire, and being cold, let it be put into a Glass: Let this Nodulus be hung in the Glass. Take Cinnamon bruised, a Dram and a half, Seeds of Garden-cress, and of Rocket powdered, of each an Ounce, mix them. 5. Distilled Waters. Distilled Waters, because they are a neat and pleasant Remedy, are in a manner all in all amongst Antiscorbutic prescripts, some very profitable and neat Dispensations of these are contained in our Dispensatory, as are Radish-water compound, the Magistral Waters of Snails, and of Earthworms: Moreover there are famous Prescripts of these kinds of Waters, delivered by Quercetan, Dorncrelius, Sennertus, Doringius, and other Authors. It's also easy for every Physician to prescribe such appropriated to the condition of each Patient, as occasion requires: For Antiscorbutic Ingredients, and likewise such as regard certain Accidents and particular Affects are taken, to which, being sliced and bruised, a fit Liquor, viz. White-wine, Cider or Whey prepared of either, is poured: Then the whole mixture is distilled in a Cucurbit, or in a Rose-still: I shall here give you a form or two of such as we commonly use. Take Leaves of both Scurvy-grasses, Brooklimes, Water-cresses, tops of Broom, of each four handfuls, Leaves of Germander and Ground-pine, of each two handfuls, Roots of Horse-raddish half a Pound, of Aron, Angelica, Master-wort, of each four Ounces, the outward Coats of four Oranges, and of as many Lemons, Roots of Calamus Aromaticus, an Ounce; Cinnamon, Cloves, of each half an Ounce, being sliced and bruised, pour to them of the best Cider eight Pounds, let them digest for two days in a Glazed Pot close luted: Afterward distil them in a common Distillatory, let the Waters first and last drawn, be mixed. In the Winter season, when green Herbs are scarce, we may prescribe after this manner. Take Leaves of Scurvygrass four handfuls, tops of Broom, of the Pinetree, and of Juniper, of each three handfuls, the Middle-bark of Elder and Ash, of each four Ounces, Roots of Horse-raddish, and of Polipody of the Oak, of each three Ounces, the Rinds of four Oranges, and of as many Lemons, Winters-bark four Ounces, being sliced and bruised, pour to them of White-wine, or of Cider, or of Whey made with either of them, eight Pounds, let them be distilled. The simple Water of the Leaves of Aron, distilled in the Spring time, is an efficacious Remedy against the Scurvy, if three or four Ounces are given twice a day, with another Medicine. The simple Water of Scurvygrass, poured again on fresh Leaves bruised, and distilled, and so iterated by frequent Cohobations, becomes an efficacious Remedy. Moreover a hot Spirit of Scurvygrass is prepared after this manner. Take Leaves of Scurvygrass what suffices, being bruised, let it be made into Balls, such as are made of Woad for Dying: Then let those Balls be kept in a Glazed Pot for three or four days very close stopped in a cold place, either Water of Scurvygrass, or Wine of the same being poured to them, and covering them over above four fingers deep: Then an Alembick being put on, let the whole matter be distilled: Let the distilled Water being put into a Cucurbit, be rectified; the hot Spirit will come off first, whereof let fifteen or twenty drops be taken in a fit Vehicle. 6. Antiscorbutic Wines and Beers. I Use to prepare a simple Antiscorbutic Wine of excellent use, after this manner: In the Spring or Summer-season, Take Leaves of Scurvygrass gathered in clear and dry Wether, what you think good; being bruised, let the Juice be pressed forth, and let a Vessel containing three or four Gallons be filled; a spoonful or two of Yeast being put to it, let it ferment for two Days; then the Vessel being close stopped, let it be placed in a Wine-Cellar for six Months; and then let the clear Liquor, which will be of an Amber colour, like Spanish Wine, be drawn out into Bottles, and be kept for use; it continues good many years: The Dose is three or four Ounces twice a Day. Physic Wines, whereof a Glass or two may be daily taken at Physical Hours, or also at Dinner, may be prepared after this manner; Take Leaves of Scurvygrass, four handfuls, Rasping of Horseradish, four Ounces; Winters-bark bruised half an Ounce; the outward Coats of four Oranges, and of so many Lemons; Let them be put in a Glass, with twelve Pounds of White Wine or Rhenish, or small Spanish Wine: The Vessel being stopped, let it be kept in a cold place. Let the Wine be poured off clear as often as you use it. It's more usual to prescribe a Physic Ale or Beer to Scorbutical persons, to be drank constantly for their ordinary Drink. Let Beer be prepared to fill a Vessel of four Gallons; instead of Hops let three Handfuls of Pine or Fir-tops be boiled in it: After it has wrought in the Vessel, put into it Leaves of Scurvy Grass, three Handfuls; Roots of sharp pointed Dock prepared, four Ounces; the Rinds of four Oranges: After it has stood a Week to clear, let it be exposed to Drink. These kinds of Physic Drinks, with other Ingredients, may be variously prepared, according to the Temperament and Affect of the Patient; by which kind of Remedy, in regard the Physical Particles, altering the Dyscrasy of the Blood, are forthwith conveyed into its Mass, together with those of the Food, often much good is done in removing the Cause of the Scurvy: But since we have shown the cause of this, as also the Nature of the Disease, to be twofold, and since the Medicines hitherto proposed regard in a manner only the Salino-sulphureous Distemper of the Blood, we must next direct Medicines which are proper in the other, viz. the Sulphureosaline Dyscrasy of the Blood. CHAP. III. Of Medicines of each kind of the foregoing forms, which have regard to the Scurvy raised in a hot Constitution, and in a Sulphureo-Saline Dyscrasy of the Blood. IN certain Scorbutical persons the use of Scurvygrass, Horseradish, Winters-bark, and of other smart things, and such as are greatly endowed with a volatile Salt, is found to be very offensive; wherefore in those kinds of cases, where the Morbific Cause consists in a hot Dyscrasy of the Blood, resembling over-fretted Wine, temperate Medicines, and such as do not exagitate the Particles of the Humours, which are apt to boil too much of themselves, are indicated: Wherefore we shall set down Forms after the same order, and running as it were parallel with those before; and in the first place we shall give you solid Medicines. Electuaries. Take Conserve of Brooklimes and Cuckow-Flower, made with an equal part of Sugar of each three Ounces, Species Diatrion Santalon, Diarrhodon Abbatis, of each a Dram and a half; Ivory powdered, a Dram; Pearl, half a Dram; Salt of Wormwood and of Tamarisk, of each a Dram; with a sufficient quantity of syrup of Coral: make an Electuary. Take Conserve of Woodsorrel, and of Hips, of each three Ounces, (or Conserve of the Roots of sharp pointed Dock and of the Roots of Cichory, of each three Ounces) Troches of Rhubarb, two Drams; Species Diamargariti Frigidi, a Dram and a half; Bark of Tamerisk, a Dram; Sal Prunella, a Dram and a half; Myrobalanes condited, in number two; with a sufficient quantity of the syrup of the Confiture of Mirobalanes, make an Electuary. For poor people I use to prescribe this easy prepared Electuary, Take Leaves of Brooklimes, six Ounces; of Woodsorrel, two Ounces; double refined Sugar, eight Ounces; let them be pounded, adding Powder of sweet Fennel-seeds, half an Ounce; Ivory powdered, two Drams; Sal Prunella, a Dram and a half; with a sufficient quantity of Syrup of the Juice of Brooklimes, make an Electuary. Confections. TAke Powder of the Roots of China, and of the Male Peony, of each a Dram; white and yellow Saunders, of each three Drams; Ivory, a Dram and a half; Pearl, half a Dram; Crabs-eyes, a Dram; Coral moistened with Juice of Oranges, and ground on a Marble, two Drams; white Tartar, a Dram and a half; double refined Sugar, dissolved in a sufficient quantity of compound Scordium Water, six Ounces: Make a Confection. Take Roots of Eringo, and Scorzonera preserved, of each three Ounces, Powder of Aron-roots compound, half an Ounce; Species Diatrion Santalon, two Drams; Sal Prunella, a Dram and a half; with a sufficient quantity of syrup of Clove-Gilli-flowers: Make a Confection. Powders. TAke Powder of the Leaves of Ground-Pine, of Aron-roots Compound, of each an Ounce and a half; Ivory powdered, red Coral prepared with Juice of Oranges, of each two Drams; Tablets of Oranges, two Ounces; mix them: Make a Powder. The Dose is a Spoonful twice a day. Pills. TAke Species Diatrion Santalon, and Diamargariti Frigidi, of each two Drams; Seeds of Citrons, and of Carduus bruised, of each a Dram and a half; Roots of Bastard-Dittany, and of Male-Peony, of each a Dram and a half; Salt of Tamerisk, two Drams; with a sufficient quantity of the Jelly of Hartshorn, or of the cast skins of Snakes: Make a Mass. Tablets. TAke Species Diatrion Santalon, and Diamargariti Frigidi, of each a Dram and a half; Pearl powdered, red Coral prepared, Ivory powdered, of each a Dram; Sugar dissolved in Scordium-water, and boiled to a Consistency for Tablets, six Ounces: Make Tablets according to Art. But if with those kinds of temperate Antiscorbutics, the use of Steel be indicated, to the Electuary, or to the Confection, or also to the Mass of Pills, let two Drams of Mynsicht's Magistery of Mars, or of Extract of Steel of our preparation, be added. In some cases, about two Drams and a half, or three Drams of Crocus Martis may be added to such a Composition: though it is, often better to make the Liquors which are drank after solid Medicines Chalybeate, than the foresaid Compositions. It remains for us now to prescribe forms of Liquors. Decoctions. IN a Scurvy raised after a long Fever, these kinds of Decoctions, which purify the Blood, and plentifully move Urine, are given with good effect. Take Roots of Chervil, Scorzonera, Sorrel, Stone-Parsley, of each an Ounce; Leaves of Agrimony and Harts-tongue, of each a Handful; burnt Hartshorn, two Drams; Parings of three Apples; Corinth's, two Ounces; Liquorice, three Drams; Let them boil in four Pounds of Fountain Water till a third part be consumed; add Sal Prunella, two or three Drams: The Dose is four Ounces twice or thrice a day. Take Eringo Roots preserved, six Drams, of Grass, two Drams, Leaves of Clivers, two handfuls; Agrimony and Liverwort, of each a handful; Raisins, two Ounces; white Saunders, a Dram; Liquorice, two Drams; let them boil in four Pounds of Fountain Water, till a third part be consumed. The Dose is six Drams after a solid Medicine. To Rustics and poor People, lest after a Fever they fall into the Scurvy, I use to prescribe, That twice a day they take the following Draught, viz. That they boil a handful and a half of the Roots and Leaves of Dandelion in a Pound and a half of Posset-Drink, till a third part be consumed: Strain it for two Doses. Or, take Roots of Dandelion, half a handful; Seeds of Citrons, and of Carduus, of each a Dram: let them boil in Posset-drink, made with Apples, or a Pound and a half of Cider, till a third part be consumed. Infusions. The Apozems even now prescribed, will become more excellent, against the Scurvy, if being prepared without Licorice, they are strained into a Flagon, into which are put Leaves of Brooklimes, and of Water-cresses or Cuckow-flowers, of each a handful, then make a warm and close Infusion for six hours; the Liquor being strained again, let it be kept in stopped Vessels. The Dose is six Ounces twice or thrice a day. Also let Whey, with the Roots of Dandelion, and the Leaves of Fumitory boiled in it, be strained into a Vessel, wherein are Leaves of Brooklimes, and of small Celandine, of each a handful, make an Infusion, etc. Chalibeat Infusions are wont to be frequently in use, viz. the Salt, Magristery, or Extract of Steel, are infused in some Decoction, or distilled Water: Moreover as natural Spaw-waters, so also Artificial ones of our preparation of Steel dissolved in Fountain-water, and impregnated with the Infusion of Antiscorbutics, are drank with great benefit. Juices and Expressions. TAke Leaves of Brooklimes and Water-cresses, of each four handfuls, of Woodsorrel two handfuls, being bruised; let the Juice be pressed forth, being stopped in a Glass, it will soon become clear by subsiding. The Dose is from an Ounce and a half to two Ounces with a fit Vehicle. Take Leaves of Brooklimes four handfuls, stalks of English-rhubarb two handfuls, being bruised; let the Juice be pressed forth. Take Leaves of Brooklimes, Garden-cress, Cuckow-flower, the lesser Celandine, Woodsorrel, of each two handfuls, being bruised; let the Juice be pressed forth; add Juice of Oranges a fourth part; let it be kept in a Glass. Syrups. AS often as a Syrup is required to be added to any other Composition, we use either Syrup of the Juice of Woodsorrel, or of Fumitory, or of Coral compound: Or also a Magistral Syrup may be prepared of the Juice of Brooklimes, after the same manner as is prescribed above concerning the Juice of Scurvygrass. Distilled Waters. TEmperate Distilled Waters are prepared by changing either the Ingredients, or the Menstruum, or both of them together. As to the former we proceed after this manner. Take Leaves of Brooklimes, Garden-cress, Fumitory, Harts-tongue, Liver-wort, Bawm, tops of Tamarisk and of Cypress, of each three handfuls, all the Saunders bruised, of each half an Ounce, Roots of sharp pointed Dock, of Polipody of the Oak, of each two Ounces, the outward Coats of four Oranges, Snails cleansed two Pounds; being sliced and bruised, pour to them Whey made with Cider six Pounds; let them be distilled in a common Still. 2. When the Menstruum is weak, let the Ingredients be moderately hot. Take Leaves of Scurvygrass, Brooklimes, Cuckow-flower, Garden-cress, of each three handfuls, Rinds of four Oranges, Snails a Pound: being sliced small, pour to them common Whey, or fresh Milk six Pounds; distil them after the vulgar manner. 3. In a Scorbutic Atrophia, and Consumptive Disposition, where nothing hot, that may stir the Blood and Humours, and Spirits, aught to be admitted, let both the Ingredients and Menstruum be temperate, and lenifiers of the Blood. Take Leaves of Brooklimes, Cuckow-flower, Harts-tongue, Maidenhair, Liver-wort, Speedwell, Agrimony, of each two handfuls, Snails cleansed a Pound and a half (or the Pulp of a Capon, or of a Sheeps-heart sliced) all being half boiled and sliced, pour to them of fresh Milk (or Water of Fumitory) six Pounds; let them be distilled the common way. Physick-wines and Beers. Though the use of Wines may not seem proper in a Scurvy raised by reason of a hot, or Sulphureosaline dyscrasy of the Blood, nevertheless, if at any time the Stomach either being weak, or a long accustomance require the drinking of Wine, at leastwise being diluted with Water; a Eiquour of that kind being both temperate, and in some measure Physical, may be prepared: For especially small Wines diluted with Water, and impregnated with the Infusion of Bawm, borage, or of Burnet, or other things ought to be allowed. Moreover let Wines be prepared of the Juice of English Corinth's, Cherries, and other horary Fruits; which when they are brought to a ripeness by Fermentation, are very grateful to the Stomach, and purify the Blood: Again Cider, the familiar and genuine Wine, as it were, of our Country, so it be clean, mellow, and pleasant without any sharpness, does very much good in the Scurvy. Moreover in this Liquor drawn from the Lees; and put in small Vessels, Ingredients of various kinds may be infused: Of which kind are tops of the Pinetree, or of Fir, Flowers of Tamarisk; also shave of Hartshorn, or of Ivory, which sweeten the Liquor, and preserve it from turning four, viz. in as much as the Particles of the fluid Salt which abound in the Cider, and are apt to make it sharp, are taken up in dissolving the foresaid Ingredients. Temperate Physic Drinks may be prescribed after this manner, viz. let a small Ale be prepared to fill a Vessel of five or six Gallons; into which instead of Hops, let tops of the Pinetree, of Fir or Tamarisk, or the Rasping of either of their Woods be put; them after it has wrought, let the Roots of sharp pointed Dock dried, be put into the Vessel (than which certainly there is no Remedy more excellent in the Scurvy: To these, sometimes let the Leaves of Brooklimes, Water-cresses, Winter-cresses, etc. be added: Also Pomecitrons or Oranges cut in slices. Leaves of Harts-tongue, put into a little Vessel of middling Ale after it has wrought, gives it a grateful savour and odour. CHAP. IU. Of the Curatory Indication of the Scurvy, whereby we obviate the Disease itself, and the Symptoms that are most pressing. HItherto we have shown concerning the Cure of the Scurvy, what regards the Preservatory Indication, to wit, the removal of the Morbific Cause, viz. both the intentions of Curing, and the Remedies indicated: Which kind of method being seasonably begun, and duly prosecuted, often does the whole work; viz. in as much as the Cause of the Disease, or the Root of it being cut off, the affects depending of it die of their own accord: Nevertheless we must not go on with this course of Physic always directly, but turning aside several ways: For sometimes severe Accidents and Symptoms happen, which require a peculiar, and as it were, extraordinary Physical help, to which we must Immediately attend, and often interrupting the general Cure. Concerning these we must observe, that as affects which happen upon the Scurvy, require Appropriated Remedies, according to the Nature of each of them, and to the disposition of the Patient, yet Antiscorbutics aught always to be mixed with them: I will not be needful to order a Method of Cure against all diseases and affects, with which the Scurvy is wont to be attended, for so the whole Practice of Pyhsick would be here transcribed, but we shall have regard only to the Symptoms that are chief pressing, by which either the life of the Patient is endangered, or the principal Cure Obstructed; after what manner, and by what Medicines such are Cured, I shall now show. Of Curing a difficult Breathing, and Asthmatick Fits. A Difficult Breathing, with a straitness of the Breast and Asthmatick Fits, ought presently to be removed by appropriated Remedies, to be prescribed besides the general Method, for other wise the diseased is soon brought in danger of life. Since these sorts of evils arise in Scorbutical persons for the most part, either through the fault of the Blood stagnating in the Heart, or by reason of the Nerves of the Lungs being hindered in their Function, therefore they are Gured either by Cordial, or Anticonvulsive Medicines. Spirit of Hartshorn, of Soot, of Blood, of Man's Scull, also the Tincture of Castoreum, of Antimony, or of Sulphur, Flowers of Sal Armoniac, Flowers of Benzoin, also Elixir Proprietatis are often of excellent use in these Cases, which kind of Medicines may be frequently given with a Dose of some Antiscorbutic Liquors, appropriated also against the foresaid afects. For the appeasing of a sudden difficulty of Breathing which is merely Convulsive, if at any time it very sorely presses, I have found no more present remedy then our Tincture of Laudanum with Opium given to ten or twelve drops in a convenient Liquor: For Sleep Stealing on, the Spirits remit of their disorders, and in the mean while being refreshed, they resume afterwards their accustomed offices after a due manner. Take Roots of the great Dock, of Butterburr, and Chervil of each an Ounce: Leaves of Maidenhair, and Germander, of each a handful; Seeds of the Great Dock, of Bastard Saffron of each three Drams, Raisins two Ounces; being sliced and bruised, let them Boyl in three pounds of Fountain water till the third part be Consumed, add of White-wine four Ounces, strain it into a Flagon, into which put leaves of Scurvygrass sliced a handful, Roots of Elecampane preserved and small sliced half an Ounce, make a close and warm Infusion for three hours, the Dose is six Ounces twice or thrice a day. Of Affects of the Stomach which are wont to happen in the Scurvy. SCorbutical persons are wont sometimes to be troubled with a great Oppletion and Pain of the Stomach, also with a Nauseousness and Belching, and sometimes also with a frequent and violent Vomiting; which kind of distempers sometimes arise from the Chyle, there degenerated into a Mass of Corruption, but oftener from the Morbific Matter brought thither, either by the conveyance of the Blood, or also of the nervous Juice, and either deposed within the Cavity of the Stomach, or fixed in the Plexus's of the Nerves and in the Membranes: In these kinds of Cases, if a Viscous, Stinking, or otherwise Offensive Matter, be cast up by Vomit, and there be a suspicion that the cause lies within the Cavity of the Stomach, its proper to give a gentle Vomit of Wine of Squills, or of Salt of Vitriol; Or let the offending Humours be Purged off by Stool, either by Extract of Rhubarb, or by its infusion, with the addition of Salt or Cream of Tartar: But if the Matter sticks deeply within the Membranes, or the Plexus's of the Nerves; Diaphoreticks, or things, that moderate the effervescencies of the Salts do better; Let Elixir Proprietatis, or Flowers of Sal Armoniac, or Spirit of Soot be frequently taken with Radish Water Compound, water of Earthworms, or some other Antiscorbutic Liquor. Mean while, once or twice a day, let Fomentations of Wormwood, Centory, Flowers of Camomile, Roots of Gentian, and other things Boiled in White-wine, be applied to the Region of the Stomach, with dipped into it warm and wrung forth: The use of Glisters is proper, and Opiates often give great help. Of the Belly Ache, and the Scorbutic Colic. SCarce any affect requires a more speedy Physical help than the Colic and gripes in the Belly, which frequently happen in the Scurvy: Against these evils Glisters of various kinds, Fomentations, Liniments, and Cataplasms are administered: The use of Opiates is found to be very necessary here: Certainly in this Case that Prescript of Riverius chief has place, viz. that Purging Pills be given with Landanum mixed with them, for a plentiful Evacuation by siege, and Sleep being caused, the Fit often is taken away. Moreover Powders of Shells, by which the sharp Salts are Imbibed, or fixed, conduce very much to the removal of the Morbific cause; for example. Take Crabs Eyes and Egg Shells of each a Dram and a half, Pearl a Dram, make a Powder, divide it into twelve Doses, whereof let one be taken every sixth hour, with a Scorbutic Water, or with the Decoction of the Roots and Seeds of the great Burr Dock, as it is above described, or also with Posset-Drink, having the Roots and Seeds of the great Dock, and the Leaves of sweet Marjoram and Saxifrage Boiled in it, and the leaves of Scurvygrass infused. In the Scorbutic Colic, also in the affects of the Stomach even now described, the use of Purging Spa Waters, such as we have at Epsom and Barnet often proves of an excellent effect. Of the Diarrhaea or Looseness, and Dysenterical Affects. AN inveterate Looseness, such as frequently happens to Scorbutical Persons, aught by no means to be stopped with astringent Medicines, nor is it easily cured by altering Medicines, or by Antiscorbutics; Spaw-waters, impregnated with Iron, or Vitriol, are the best Remedy for this Affect: Next these are Artificial Spaws, or Chalybeate Medicines, which are wont to give a mighty relief: Crocus Martis, duly prepared, is justly preferred before all others. I have often used the following Method with good Success: In the first place, Let a Purge be ordered of the Powder or Infusion of Rhubarb, with the addition of Aromatic Astringents, and now and then let it be repeated, viz. within the space of three or four days; on the other days let a Dose of the following Electuary, to the quantity of a Nutmeg, be taken in the Morning, and at four of the Clock. Take Conserve of Common Wormwood, made with an equal part of Sugar, six Ounces; (in a hot Constitution, instead of this, let Conserve of Red Roses be taken) Species Diarrhodon Abbatis, two Drams; white and red Saunders powdered, of each a dram; the best Crocus Martis, half an Ounce; with a sufficient quantity of Syrup of Steel, make an Electuary. In Dysenterical Affects, and the Tenesmus, you must proceed after the like method, especially let Spaw-waters be drank, if it may be; Moreover, let Glisters, prepared of vulnerary Decoctions, be frequently used. I lately Cured a certain person troubled with a long continued and dangerous Bloody Flux, who had daily voided many Ounces of Blood by Siege for a long time, with this Remedy; Take of the best Rhubarb powdered, an Ounce; red Saunders powdered, two Drams; Cinnamon, a Dram; Crocus Martis, three Drams; Lucatellus Balsam, what suffices; make a Mass for Pills. He took four Pills sometimes every day, sometimes every other day, for a Fortnight, and was perfectly cured. To this person also I prescribed a Physic Beer of the Infusion of the Roots of sharp pointed Dock, and the Leaves of Brooklimes, to be constantly taken. Of Giddiness, and Swooning, and other Affects usually joined with it in the Scorbutic Affect. A Giddiness often happens upon an inveterate Scurvy, to which also a frequent Swooning, and almost a continual danger of it, and likewise a numbness in the Members, and a sense of Formication, running sometimes in one place, and sometimes in another, are wont to be joined; which kind of Affects proceed from the failings of the Animal Spirits in their Origine itself, and sometimes from the failings of the same with the Nerves, both belonging to the Heart, and to the Members that serve for motion: and in regard thy depend on the Brain and the Genus Nervosum, their being very much overcharged with a Scorbutic Salt, they are not easily cured. Cephalick Remedies, such as are proper in a Giddiness and Paralytic Affects raised by themselves, aught to be given with Antiscorbutics mixed with them: therefore in the first place, a Provision being made for the whole, by fit cathartics, and such as are proper in the Scurvy, you may proceed after this manner with appropriated Remedies against the foresaid Affects. About the beginning of the Cure, let Blood be drawn from the Vessels of the Fundament by Leeches; and unless somewhat indicateth the contrary, let it be frequently repeated afterward. Take Powder of the Root of Male-Peony, half an Ounce, red Coral prepared, two Drams; man's Scull, Elks-hoof, of each a Dram: Take double refined Sugar, dissolved in Peony-water Compound, or in the Water of Horse-raddish, and boiled to a Consistency for Tablets, eight Ounces; Oil of Amber excellently rectified, half a Dram: Make Tablets according to Art. Take to a Dram and a half, or two Drams, Morning and Evening, drinking after it a Draught of the following distilled Water. Take Leaves of Scurvygrass, Brooklimes, Water-cresses, Lilies of the Valley, Sage, Rosemary, Betony, of each three handfuls; green walnuts, a Pound; the Rinds of six Oranges and four Lemons; fresh Roots of Male-Peony, a Pound and a half; being sliced and bruised, pour to them of the Phlegm of Vitriol, a Pound; Whey made with Cider, five Pounds; let them the distilled after the common way; let the whole Liquor be mixed together. The Dose is from three Ounces to four. Of Hemorrhages. Hemorrhages often threaten a mighty danger in the Scorbutic butick Affect, the Diseased being thereby thrown headlong as it were into the Jaws of Death, whilst the Blood breaks froth almost to a Swooning, sometimes from the Nostrils, sometimes by the Menses, or Haemorrhoids: Moreover, being sometimes cast up from the Lungs or Stomach, it gives us a Suspicion of an Ulcer, or at leastwise of a great weakness lying hid in the part affected. Wherefore excretions of Blood, if they are either immoderate, or happen in an improper place, aught to be stopped for the present, and prevented for the future. For stopping Blood when it breaks forth immoderately, the method is vulgarly enough known, and there remains nothing more, or peculiar to be done, when happening in this Affect by reason of the Scurvy, than on other Occasions. But yet to prevent Hemorrhages, let Remedies be administered which take away the Acrimony of the Blood, and constringe the over-lax and gaping Mouths of the Vessels: both intents are excellently performed by Chalybeate Medicines: the use of Vitriolic Spaw-waters is very proper for this purpose: Moreover, Infusions, Extracts, Salts, and the like Preparations of Steel, which contain chief the saline or vitriolic part of the Iron, are always very profitable against Hemorrhages. We have shown before by what means Iron and its preparations produce these effects, and divers others, in Human Bodies. Take Conserves of Red Roses, and of the Wild Rose of each three Ounces, Species Diarrhodon Abbatis, and Diatrion Santalon of each a Dram and a half, Salt of Steel a Dram, Crocus Martis excellently prepared two Drams, Red Coral prepared a Dram and a half, with a sufficient quantity of Syrup of Steel, make an Electuary, let the quantity of a Nutmeg be taken thrice a day, drinking after it a draught of an Appropriated Liquor. To poor people I use to prescribe thus; Take tops of Cypress and of stinging Nettles, of each four Ounces; Brooklimes, two Ounces; let them be bruised in a Mortar, with ten Ounces of double refined Sugar; then add Scales of Iron very finely powdered, an Ounce; Powder of white and red Saunders, of each two Drams; with a sufficient quantity of the Syrup of the Juice of nettles, make an Electuary: The Dose is the quantity of a Walnut twice a day. Take of Distilled Water, or of a temperate Antiscorbutic Decoction, two Pounds; our Steel prepared, two Drams; mix them in a Glass: The Dose is three or four Ounces. Take tops of stinging Nettles, Leaves of Brooklimes, of each Four Handfuls; being bruised, let the Juice be pressed forth; keep it in a Glass. The Dose is two or three Ounces twice a day, with an Antiscorbutic distilled Water. Of the Distempers of the Mouth, happening by reason of the Scurvy. ASsoon as the Scorbutic Taint seizes the parts of the Mouth, that the Gums swell, and their flesh becomes Spongy, presently let Remedies be carefully administered, which may keep them from Putresaction: Amongst these, washings of the Mouth, and Liniments are of chiefest use, both when the Disease is beginning about those parts, and when it is come to a greater height there; though as they regard various intents, so they ought to be diversely prepared, viz. the flesh of the Gums, when first it swells, aught to be freed from the incursions of the Blood, or of the salt and corrupted Serum, and to be dried: afterward, the flesh of the same grown flaccid, and fallen from the Teeth, aught to be freed from Putrefaction, and also to be constringed, that it might hold the Teeth the faster. For these and haply other intents, let Gargarisms, or Washings of the Mouth be ordered, of divers kinds; of all which, in a manner the chief ingredients are Vegetables boiled, and Minerals infused: The Herbs or Roots, which are boiled in a fit Liquor, viz. in Water or Wine, for the most part are smart or bitter, or styptic; and then those Decoctions are impregnated either with a volatile, lixivial, vitriolate, Chalybeate, or aluminous Salt. I shall here set down certain forms of each kind. 1. When therefore the flesh of the Gums first swells, and becomes spongy by reason of the Influx of the salt and corrupted Blood and Serum, Take the middle Bark of Elder, and of Elm, of each half a Handful; Leaves of Savory, Sage, wild Mustard, Garden-cresses, of each a Handful; Roots of Pelitory of Spain, two Drams; being sliced and bruised, let them boil in three Pounds of Water of Lime, till a third part be consumed; if sweetening be required, add Honey of Roses, two Ounces; make a Gargarism. Or, take Vitriol Camphorated, an Ounce; (vulgarly with us it's called by the name of Captain Green's Power) Fountain-water, two Pounds; mix them in a Glass; shake it and then when the Liquor is grown clear by settling, let it be used. Or, prepare a Lixivium of the Ashes of Broom, or of Rosemary, or of Tartar and Nitre Calcined: In three Pounds of this, boil Leaves of Savory, Time, Sage, and Rosemary, of each a Handful; let the straining be poured on two Handfuls of Scurvygrass; make a warm and close Infusion for three hours: Let it be strained again, and kept for Washing the Mouth several times in a day. For the same Intent, let Liniments also be applied betwixt while, and espectally in the Night, that their Virtue may be conveyed to the Diseased even when they are asleep. Amongst Authors, a common, famous, and long tried Medicine is found: Take the Powder of the Leaves of Columbines, the Curled Mint, Sage, Nutmegs, Myrrh, (which last nevertheless may be sometimes omitted) of each two Drams; Allom, half an Ounce; Virgin-Honey, four Ounces, or what suffices; make a Lineament according to Art. 2. If at any time the Flesh of the Gums growing Flaccid falls from the Roots of the Teeth, let a Gentle Scarification be often used, and also let the mouth be washed with this Decoction. Take tops of Brambles and Cypress, Leaves of Sanicle, and Cuckoo Flowers, of each a handful, Boyl them in three pounds of Water, in which Iron has been quenched till a third part be consumed, to the straining ad Honey of Roses two Ounces mix them. Let a Lineament of this kind be applied. Take Powder of the Roots of Florentine Orris, Leaves of Sage and St. john's Wort of each two Drams. Bole Armeniack, Sal Prunella of each a Dram, warm Virgin Honey what suffices, let them be incorporated by stirring them. 3. When the Gums Putrify, and are Corrupted, and withal the Teeth being Rotten grow lose, and emit a Stinking. Smell, let stronger Medicines, and such as greatly resist putrefaction, be used, an infusion of Vitriol Camphorated, also of the Lapis Medicamentosus, have chief place here. Or, Take Roots of Gentian, and of Round Birth-wort sliced, of each half an Ounce, Leaves of the Lesser Centory, Pontic Wormwood, Savory, Columbines of each a handful, let them boil in three pounds of Lime Water, or of a Lixivial Water, also sometimes in Water in which Iron has been quenched, sometimes in Alum Water till a third part be consumed; to the straining add Crude Honey two or three Ounces; mix them. 4. If the falling out of the Teeth be chief feared. Take Barks of the Roots of the Slow Tree an Ounce, Tormentil and whole Bistort of each a handful, pomegranate Rinds and Balaustia of each half an Ounce; Boyl them in three pounds of Fountain Water; to the Straining ad Alum two or three Drams, of the best Honey two Ounces, mix them. Take Vitriol Complorated, Hartshorn of each a Dram, Nutmegs half a Dram, of the best Honey what suffices; make a Lineament. Or, Take Powder of the Roots of Bistort, Pomgranate-rinds, Bole Armoniac, Alum of each a Dram, Honey of Roses what suffices, add Spirst of Vitriol a Scruple, make a Lineament. 5. If at any time putrid and profouned Ulcers (as it sometimes happens) infests the Gums, or other parts of the Mouth, let the forementioned stronger Medicines be often administered: Moreover let a Cloth dipped in Vnguentum Egyptiacum, dissolved in Spirit of Wine, or in an infusion of the Lapis Medicamentosus, or of Sublimate, be now and then applied to the place affected. In these Cases let the Cure be committed to to a skilful Chirurgeon. Of Pains that are wont to trouble the Legs, and sometimes the other Limbs, and that chief by Night. AGainst these Pains, in regard that sometimes they are very vehement, besides the general method of Curing the Scurvy, special Remedies, and such as obviate that symptom are Indicated; therefore in such a case, a course of purging being well ordered, also the Person being Blooded (if need be) we ought to set upon the Disease both with inward Physic, and outward Topics. As to the former, such things as promote Sweat, and also an evacuation by Urine often give help, in as much as they draw another way the lixivial and sharpish Recrements of the Blood and nervous Juice, that are wont to be gathered together in the Part affected; but especially let those things be given which free both Humours from their evil Disposition, viz. both saline and sharpish: Powders of Shells, Crabs Eyes, the Jawbone of a Pike, also the Spirit and Flowers of Sal Armoniac, Spirit of Blood, Tincture of Antimony, of Coral; Decoctions of the Roots and Seeds of the great Burdock, Ground-pine, and Germander do excellently well; and let those kinds of Remedies be taken twice or thrice a day with Antiscorbutic distilled Waters. A Water distilled from Horse-dung with the addition of Scurvygrass, Brooklimes, Ground-pine, and the like, is sometimes very profitable; mean while let Fomentations, Liniments, Cataplasms, or applications of other kinds, which appease Pains, be outwardly Administered. Of the Scorbutic Gout moving from one place to another. OF this Affect Eugalenus, Wierus, Medicus Campensis, and Georgius Horstius have written peculiar Tracts: If is said to be very Common in the Northern Parts of Belgia; a certain token of which appears by putting a live Earthworm to the place affected, for its presently wont to spring, bend and knit itself, and to faint and die; which indeed I have found pretty often to happen in this Disease even amongst us; which effect seems to proceed from the very sharp, and as it were Corrosive Effluvia, that plentifully flow from the place Pained and Swollen: By Reason of the effect of that Experiment, the Cure of the Disease is wont to be undertaken by Worms, viz. by Remedies prepared of them; though I know not whether being inwardly taken they will as certainly destroy the Disease, as being outwardly applied they are dispatched by it. However, Earthworms, as also Snails, Millepedes, and other exanguious little Animals, in as much as they abound with a volatile Salt, often prove a pretty efficacious Remedy. Henricus Petraeus tells us of two Remedies very much used in Westphalia against this Disease. Take nine Earthworms, bruised with two Spoonfuls of Wine in a Mortar, and strained through a Cloth; to these let half a Measure of Wine be added, let three Spoonfuls be taken at Morning, Noon, and Night for many days. 2. Take two or three Branches of Savine, Virgin Hony two spoonfuls, boil them with a Measure of Wine, till it pitches two Fingers: Let the straining be taken to four or five spoonfuls thrice a day. To the former Medicine a certain vulgar potion, mentioned by Horstius, called, Monasteriensis is allied: Take Sage, Betony, Rue, of each five Leaves, Earthworms with Circles about their Necks, in number five, a little Savine, and Roots of Devilsbit in number two, let them be bruised with Water of Elder Flowers, and let the expressed Juice be given for raising a Sweat; A like prescript also is proposed in Forestus à Medico Campensi. Certainly in this affect, the Magistral Water of Earthworms prescribed in the London Dispensatory is of excellent use. And I have often given with good success the Spirit and Salt of Hartshorn, Spirit of Blood, and Flowers of Sal Armoniac. Moreover teslaceous Powders, viz. Crabs Eyes, Coral, Pearl, and Vegetables which are accounted Antidotes against the Gout, as Roots of round Broth-wort, Leaves of Ground-pine, Germander, and the like, being joined with Antiscorbutics conduce to the Cure of this Disease; outwardly for appeasing Pains, besides Anodynes which are used under the form of a Lineament, Fomentation, or Cataplesm: Oil of Earthworms, of Frogs, and Toads are often very availing. I have been told by a worthy Person who was very obnoxious to this Disease, that Water drawn by Distillation from the Contents taken out of the Stomach of a Beefnewly killed, and being dipped into it when Warm, and applied as a Fomentation, would most certainly give ease. Of Convulsive and Paralytic Affects, that are wont to ensue upon the Scurvy. IF at any time the Scrobutick taint passing into the Brain, and Genus Nervosum, greatly corrupts the Liquor residing in each Province; thereupon divers kind of Affects, and especially Paralytical or Convulsive are wont to arise; viz. according as the Morbific Matter brought in to be Animal Aeconomy is either Narcotick or Explosive: Which kind of Affects, though in this case they are Symptomatical, yet when they are grown to a height, they challenge both the name, and the better part of the Cure before the Scurvy their parent; so that the diseased are said to be troubled with the Palsy, or Convulsions, rather than with the Scurvy, also Medicines designed against those Affects, have the preference to any others at the same time required by reason of other intents. For Curing these kinds of Affects happening upon the Scurvy, let this chief be observed, that Remedies appropriated to those same be duly Complicated with Antiscorbutics. As to Convulsive Diseases, the Remedies that are in the foregoing Tract may easily be Transferred hither: And as to the Palsy, Lethargy, and many other Affects of the Brain, and Genus Nervosum, we shall discourse of them particulary in some other Tract. Of the Atrophia, also of the Scorbutic Fever which is often the Cause of the other, or its Effect. THere are three kinds of Causes, having some orderly dependence on each other, from one or more of which a Scorbutical Atrophia is wont to be produced without a Consumption of the Lungs, viz. either the Chyle is perverted through the fault of the first passages, so that a laudable or sufficient Store or it is not conveyed to the Blood. Secondly, or being brought into it yet through the fault of the Blood it is not duly changed into Blood and a nutritive Juice. Thirdly and lastly, the nutritive Juice prepared in the Mass of Blood, is not duly assimilated to the solid parts, through the fault of the nervous Liquor. The Remedies appropriated to this Symptom regard either the amendment of the first Passages, or the correction of the foresaid Humours. As to the former, it sometimes happens by reason of the Tone of the Stomach being broken, or its Ferment being vitiated, that the Food taken into it is not duly concocted, but passes into an unprofitable Mass of Corruption. For these sorts of evils let gentle cathartics, Digestives and Corroboratives be used: But the work of Chylification is oftener hindered by reason of a Schirrous Tumour raised sometimes in the Ventricle, sometimes in the Mesentery, or in other adjacent parts: In this Case Deobstruents and Dissolvents are proper, the use of Spaw-waters has the preferance to any other Rinds of Medicines: Moreover, Fomentations, Liniments, or Plasters ought to be outwardly applied. Again, it sometimes happens that without any Tumour raised in the Viscera, the Lacteal Vessels are so much obstructed by a gross and viscous matter sticking in them, that a sufficient store of the Chyle, though it be laudable enough and plentifully prepared, is not conveyed into the Blood. In this affect the Belly for the most part discharges Excrements plentifully, but they are White like coagulated Milk, and not as other Excrements tinged with Choler or Stinking: The reason of which is, that the Blood being depauperated, more sparingly engenders Choler, from the eflusion of which into the Intestines the Colour and Stink of the Excrements proceed: In this case Spaw-waters are chief proper; also Deobstruents being inwarldly given, let Liniments, Fomentations and Baths be outwardly used. Against the Marasmus, caused through the fault of the Blood degenerated from its Crasis, Asses or Cow's Milk, diluted with Barley Water, or a proper distilled Water often give help. Snail Broths, or Milk Drinks with Snals boiled in them; moreover Waters distilled of Milk, or Whey with Snails and temperate Antiscorbutic Herbs, are greatly conducing in this case: For this end also Decoctions of vulnerary Herbs, and Antiscorbutic Herbs infused in them, are taken with good success: Mean while let frictions be daily used to the outward parts with moistened and made Warm with Vnguenticum Resumptivum, or fresh oil of Almonds. When an Atrophia arises through the fault of the Blood, being affected, and consequently perverting the nutritive Juice, it has for the most part a Fever of irregular returns joined with it, with Night-sweats, viz. in as much as the Mass of Blood is forced to irregular and inconstant Effervescencies from that degenerated Juice, and the matter so offending is cast forth by Night-sweats; in this case, a thin Diet being ordered, let Decoctions and Distilled Waters, that fuse and purify the Blood, be frequently taken, with Antiscorbutics mixed with them. Take shave of Ivory and Hartshorn, of each two Drams and a half; candied Eringo Roots, six Drams; Roots of Chervil and Dandelion, of each half an Ounce; Leaves of Heart's tongue and Liverwort, of each a handful; one Apple sliced; Raisins, a handful; Let them boil in four Pounds of Fountain-water till a third part be consumed; let the straining be poured on Leaves of Brooklimes bruised, two handfuls; Sal Prunella, a Dram and half, or fixed Nitre, a Dram; make a close and warm Infusion for three Hours: Let four or six Ounces be taken thrice a Day. Take Leaves of Brooklimes, four Pounds; Roots and Leaves of Sorrel and Dandelion, of each two Handfuls; Snails cleansed, a Pound and a half; the Rinds of two Oranges; being sliced and bruised, pour to them of new Milk, or of Whey made with Cider or fresh Juice of Apples, six pounds; let them be Distilled after the vulgar way: Let three Ounces be taken twice or thrice a day. Of the Rheumatism. WE conclude that this Affect proceeds from the congress and mutual effervescency of Salts that are of a different origine and Nature, viz. of the fixed Salt coming from the Blood, and of the acid Salt coming from the nervous Liquor: The Subjects of both Salts are superfluous Dregs, deposed from the foresaid Humours forced into certain Turgescencies, and discharged sometimes on these Parts, sometimes on those: Wherefore that the Disease may be Cured, both let the Turgescencies of the Humours be appeased, and their superfluous Dregs be purged forth, and let the Salts degenerating both ways be reduced to a State of volatility. For the two first intents a gentle Purge and Bleeding are chief required, and now and then, as the strength will bear, they ought to be repeated; and also let Diuretics and Diaphoreticks be now and then given which any way convey forth the Saline Serosities. And that these Evacuations proceeding calmly, and with a well-bearing, and Nature assisting, may succeed the better, let Opiates frequently be used. For the other Intent in which the chief stress of the Cure consists, Alteratives, and especially such as are endowed with a volatile Salt, greatly conduce: Wherefore in this case its a vulgar, but no contemptible Medicine, to give twice or thrice a day to four or six ounces of the Infusion of a Stone-horse Dung, made in a small Wine or Ale, or in an appropriate Distilled Water: and a Medicine somewhat more grateful, and no less efficacious, may be prepared, if a Water be distilled from that Dung, with Antiscorbutic Ingredients infused in White-wine or Cider, which may be given to three or four Ounces twice a day. I have often prescribed Spirit of Hartshorn, and of Blood, in this case, with a mighty benefit to the Diseased. Of the Dropsy. WHereas we conclude the Dropsy, which is wont to happen upon the Scurvy, to be twofold, viz. habitual and occasional; Concerning the Cure of the first, for the most part all labour is lost; for no Remedies are able to restore the Liver and the Lungs, and sometimes other Viscera, wholly vitiated, and the Crasis of the Blood utterly subverted: In such a case, if any thing seems fit to be done, the Scope of Physic is very narrow; for there is no room left for cathartics, nor Diaphoreticks, nor for a strong Evacuation of any other kind: We must insist chief, and in a manner only, on Diuretics and Cordials. For these ends let Elixirs, Tinctures, Electuaries, Powders, Infusions, Decoctions, distilled Waters, etc. which consist partly of Antihydropicks, partly of Antiscorbutics be given; the forms of which I have nevertheless thought good to omit, as signifying little or nothing. The Scorbutic Dropsy, raised on a sudden from an evident cause, or on some accident, often admits of Cure; for the more easy performance of which, the tumults of Nature ought in the first place to be appeased, and its disorders composed. Wherefore if Watch continue very offensive, let sleep be procured by the use of Opiates, and now and then, as often as it seems very necessary, let it be procured again. As soon as strength will give leave for Purging, let the following Powder be taken, and let it be now and then repeated at due intervals of time: mean while let the Belly be kept soluble by the frequent use of Clysters. Take Mercurius Dulcis, a Scruple; Rosin of Julape, from five Grains to ten; Cloves, half a Scruples; mix them; let it be given in a Spoonful of Panada; at other times let Diuretics, and sometimes Diaphoreticks be carefully taken. Take Tincture of Salt of Tartar, impregnated with the Infusion of Millepedes, as much as you think good; let it be given from a Scruple to two Scruples twice a day, with an appropriated Liquor. Take Spirit of Sal Armoniac, what you think good; the Dose is from half a Scruple to fifteen drops, after the same manner. Take Millepedes prepared, three Drams; Salt of Tartar, two Drams; Nutmegs, a Dram; mix them; make a Powder. The Dose is half a Dram twice a day, with an appropriated Liquor. Or, Take Bees dried and powdered, two Drams, Seeds of Bishopsweed powdered, a Dram; Oil of Juniper, a Scruple; Turpentine, what suffices; make a Mass of Pills. The Dose is from a Scruple to half a Dram twice a day, drinking after it an appropriated Liquor. Take Leaves of both Scurvy-grasses, Watercresses, Dittander, Arsmart, of each three handfuls; Roots of Aron, Briony, Florentine Orrice, of each four Ounces; the middle Bark of Elder, two Handfuls; Winters-bark, two Ounces; the outward Coats of four Oranges, and of three Lemons; fresh Juniper-berries, four Ounces; being sliced and bruised, pour to them of Rhenish-wine three Pounds; Wine of the Juice of Elderberries, two Pounds; Distil them the vulgar way; let all the Water be mixed. The Dose is from three Ounces to four twice a day, after a Dose of some one of the Medicines above prescribed. Let Decoctions and Physick-Beers be prepared, such as above written, Antihydropick Ingredients being added to them. Of the Crackling of the Bones. THere remains yet a symptom which happens sometimes upon the Scurvy, though rarely, viz. the crackling of the Bones, into the Nature and Cure of which it seems to concern us to inquire. I have known some, though scarce above three or four, who being long Sick of the Scurvy, found themselves afflicted by it, not only in the Humours, and the Carneous Parts, but at length in the very Bones: For as often as they moved any Member any way, the ends of the Bones, as though they were bare, rubbing against each other, made a mighty noise: Moreover, when they lay in their Bed, and there turned themselves from one side to the other, a mighty Crackling was heard, as it were of a Scelleton forcibly shaken, terrifying even the persons affected. The conjunct cause of this haply may seem to be, That the soft Interstice of the Bones, viz. the Fat, Membranes, and Ligaments being greatly consumed, their Joints, as Millstones when bare without any Corn, by reason of their mutual rubbing against each other, make a noise: But the thing appears to be otherwise, because neither persons mightily consumed have this Cracking of the Bones, nor do persons troubled with this Affect always waste away; wherefore, we say rather that the immediate Cause of this Symptom is the dryness of the Bones, or the defect of the Marrow properly so called, which ought to be contained within the Cavities of the Bones, and especially within their Joints; for since all Bones include a Marrow or unctuous Humour, either in the great Cavities, or in the Pores and small Passages every where made in them, we conclude the use of this to be both, that the Bones irrigated with the same, may become less brittle, and likewise that that Humour, distilling from the Joints of the Bones, may make slippery all the Joints, as the Joints of a Machine besmeared with Grease, and may so facilitate the motions of them; wherefore the ends of the Bones, destitute of this Marrow, make a noise just as the Wheels of a Cart seldom greased. If you ask why that unctuous substance of the Joints fails; I say this seems chief to happen because the Pores and Passages of the Bones are so much obstructed by a certain extraneous Matter, haply of a Slimy or Tartarous Nature, brought to them from the Blood, that they do not sufficiently receive the Balsam designed for them, nor distil it forth for moistening their Joints; but it will not be easy (the thing being wholly in the dark) to search out the particular Reasons of this Affect. Nor are we less at a loss when we proceed to the Cure of this Disease; for though the Primary Indication, viz. the moistening of the Bones or of the Joints be obvious enough, yet it does not so plainly appear after what Manner, and by what Remedies it is performed. For in this case I have known a great many kinds of Medicines, and various ways of Administrations tried wholly in vain. A certain Ingenious Man, extremely troubled with this Disease for many years, tried the Advice of many, and those Famous Physicians; Besides the usual Remedies against the Scurvy (together with frequent Bleedings and Purge, from which he found not the least Relief) he tried moreover various and great Courses of Physic, without any success: For after a method used by one Physician for some Months without Effect, he presently betook himself to another, and so afterwards to many; mean while, by each always a new way of Curing, untried by the former, is prescribed; Fomentations, Liniments, and Frictions are applied daily to each of his Joints; he used for some time the hot Baths of ; afterward Spaw-waters of various kinds, sometimes these, sometimes others are drank: Which giving no help, a Chalybeat course, at another time a Decoction of temperate Woods, sometimes a Milk Diet; and at all time Electuaries, distilled Waters, Apozems, and other Remedies prepared of Antiscorbutics are taken: And when he had lived after this manner, above three years almost constantly, Medicè & miserè, there was not made the least progress towards the Cure of the Affect; yet in the mean time he was pretty well as to his Strength and Stomach, married a Wife, and as to the other more common Symptoms of the Scurvy he was better. So that it hence appears, how stubborn a Disease, and unconquerable by almost any Medicines, the crackling of the Bones is; which I have known confirmed also in others troubled with this Affect, and wholly eluding the endeavours of a Physician. CHAP. V Of the Vital Indication, in which are included Cordial Medicines, Opiates, and the Diet requisite in the Scurvy. HItherto we have set forth at large the Indications both Preservatory and Curatory, which belong to the Method of Curing the Scurvy; there remains yet to speak of the Vital Indication, to wit, that it may be declared by what Method, and with what Remedies the powers of the Diseased, which either being too apt to faint, may be upheld, or being weakened or dejected may be restored: For these ends Cordials and Opiates, according to the Exigencies of the Diseased, are prescribed to be taken, and moreover let a right Form of Diet, if at any time it be needful, Resumptive, and always Antiscorbutic be prescribed. As to Cordial Medicines, viz. such a exagitate the Blood stagnating in the Heart, renew its flame half extinct, restore the oppressed, or distracted Animal Spirits to their liberty and due irradiation, it is obvious that many Remedies, which are properly called Antiscorbutics, perform these intents, of which kind are, Raddish-water compound, the Magistral Water of Snails and of Earthworms, Spirit of Hartshorn, of Soot, Powders of Shells, with many other things, which may be taken with good effect, not only at certain hours, and according to a set Method, but likewise as occasion presents, as often as a Swooning, or any failings of the Spirits happen. But besides, those who are found to be very obnoxious to Passions of the Hearts, frequent Faintings, a Nauseousness, Vomiting, Trembling, Vertigo and other terrible Symptoms, may also have in a readiness, Medicines of another kind, more properly Cordial, with hich, all failings of the Spirits are immediately relieved: In this case, Quercetan's great Elixir of Life, does excellently well; the second Water in the distillation of the same Elixir being sweetened, may be given to a spoonful; also Aqua Mirabilis, Aqua Bezoartica, Gilberts temperate Water, Treacle-water, Cinnamon-water; to each of which, or to a Composition of them, let the Confection of Alkermes, the Confection of Hyacinth, Powder of Pearl, or Magistery of Coral, Syrup of Clove-gilliflowers or of Coral, of Citron-pills, of Cinnamon be added: Of these, and others of this kind various forms of Medicines are wont to be prescribed. For example; Take Treacle-water, and Aqua Mirabilis, of each three Ounces, Bawm-water four Ounces; Syrup of Clove-gilliflowers an Ounce and a half; Confection of Alkermes a Dram; mix them. The Dose is three or four Spoonfuls. Or, Take Aqua Mirabilis six Ounces; Water of Snails and of walnuts, of each two Ounces, Pearl powdered a Scruple; Confection of Hyacinth a Dram; Syrup of Clove-gilliflowers an Ounce; mix them. When Scorbutic Women are wont to be troubled with Hysterick Fits, and Men with Convulsions Take Water of Bawm and Pennyroyal, of each three Ounces; compound Briony-water four Ounces, Tincture of Castoremn half an Ounce; Tincture of Saffron a Dram; Syrup of Clove-gilliflowers a Dram and a half; Castoreum tied in a Nodulus, and hung in the Glass a Dram. The Dose is three or four Spoonfuls. For those who desire rather to have Cordial Medicines in a solid form; let Electuaries or Tablets be prescribed. Take Conserve of Clove-gilliflowers three Ounces; Confection of Alkermes half an Ounce; Pearl powdered a Dram, with a sufficient quantity of Syrup of Coral; make an Electuary. Take Species Diamargariti Frigidi, and Diarrhodon Abbatis, of each a Dram and a half; Pearl powdered a Dram; double refined Sugar dissolved in Treacle-water, and boiled to a consistency for Tablets four Ounces; Oil of Cinnamon six drops; make Tablets according to Art. As to Opiates and Anodine Medicines, in some certain affects of Scorbutic persons, I had rather be without any kind of Medicine besides, than the use of them. For not only against obstinate Pains and Watch, but in Asthmatick Fits, in Vomitings, a Diarrhaea, and also in a Vertigo and Convulsive Passions, as often as nature being irritated above measure, falls into extreme irregularities, I have found no Remedy more excellent, than to procure sleep by giving a safe Narcotick: Mean while there is need of a very great caution, that they be not taken, if at any time something in the Constitution of the Diseased, or in the nature or time of the Disease, forbids the giving of such a Medicine. Besides the Hypnoticks usual in Apothecaries Shops, viz. Laudanum Opiatum, Nepenthe, the Philonia, Diacodium, and Syrup of red Poppies, two other preparations of Opium are known to me, which I use to give in the form of a Tincture, or of a liquid Extract from ten drops to twelve with some other appropriate Liquor. The Diet, or Form of Living to be observed in Scorbutical persons, is of no small importance in the Method of Cure; for that being neglected or ill ordered, the other Prescripts of Physic do little or nothing towards Health: The Rule of Diet being extended to various things, is chief concerning the Air and Situation of the Habitation, Meat and Drink, and the motion or rest of the Body. As to the first, what kind of habitations and places of Residence, in respect of the Heavens and the Earth, cause the Scurvy, and consequently aught to be shunned, it is sufficiently manifested by what we have said before: Those that endeavour to prevent or cure this Disease, aught to take care to choose an Air moderately hot and dry, and which also is subtle and pure, and sufficiently exposed to the Winds. Such Food only is proper which has a good Juice, and is easy of Concoction, let such as is gross, viscous, and dried in the Smoke, mouldy and rank, also such as is unfermented or greatly compounded, all manner of Pulse, Milk-meats and unripe Fruits be shunned. I so much disapprove things preserved, or very much seasoned with Sugar, that I judge the invention of it, and its immoderate use to have very much contributed to the vast increase of the Scurvy in this late Age: For that Concrete consists of a very sharp and corrosive Salt, though mitigated with a Sulphur, as it plainly appears from its Chemical Analysis: For Sugar distilled by itself, yields a Liquor scarce inferior to Aqua Stygia: And if you distil it in a Vefica with a great deal of Fountain-water, poured to it, though the fixed Salt will not so ascend, nevertheless a Liquor will come from it, like the Hottest Aqua Vitae, burning and very pungent; when therefore Sugar mixed almost with any sorts of Food, is taken by us in so great a plenty, how probable is it that the Blood and Humours are rendered salt and sharp, and consequently Scorbutical by its daily use? A certain famous Author has laid the cause of the English Consumption on the immoderate use of Sugar, amongst our Countrymen: I know not whether the cause of the spreading Scurvy, may not also be rather hence derived. Let the Drink be middling Ale, mild and clear, and also let it be altered with Antiscorbutic Ingredients without an ungrateful favour: Let it not be thick and sweet, nor also too old and turning sharp: Let this be taken in a moderate quantity, and in a manner only at the set hours of Dinner and Supper: The custom which has prevailed with many, viz. that assoon as they are out of their Beds, they presently indulge themselves to drink a large Morning's Draught (as they call it) seems very pernicious: For by this means the Blood Vessels are too much filled, a store of new Chyle being almost continually sent into them, and Crudities and Filthy Morbific Dregs are engendered in the Blood, and the office of Sanguification is greatly debilitated: Truly it is better for most Men (unless it be those whose Ventricle, as long as it is empty, is wont to be plainfully contracted and corrugated) to keep themselves fasting till Dinner time: Nor is that vulgar custom less contrary to Health, to swill themselves with much Drink presently after Meat: Wines and Ciders, so they are mellow, pure, and not adulterated, being taken in a moderate quantity, do not offend: But the same being counterfeit, musty, austere, or turning sharp, there is nothing more hurtful or injurious to our Health Exercises and Labour are so notably conducing both to the cure and prevention of the Scurvy, that many by this sole Remedy, either preserve or recover an entire Health: For the Blood and Nervous Liquor of persons that lead an idle and sedentary Life, (like Stagnating Waters) contract a clamminess and mouldiness: But upon the assiduous and much motion of the Body, the Humours and Spirits become clear, and get a vigour, the Excrementitious and Heterogeneous Particles evaporate, the stuff of the Bowels are purged, and their Tone is corroborated. CHAP. VI Some Stories and rare Cases of Persons troubled with the Scurvy. A Woman of Renown, tall and graceful, about the twenty fifth year of her Age, had contracted a Scorbutic Taint, by reason of various errors committed in Diet. The signs of which were a Spontaneous Lassitude, a difficult Breathing, Pains and Spots in the Legs, and her Gums likewise swollen, and full of Blood; in the Spring time after an Abortion, falling into a Tertian Ague, she soon became in a languishing and weak condition, from which Disease nevertheless, first being Methodically proceeded with in Physic, she had soon recovered, but that indulging herself to eat Flesh and other improper things, she soon had a Relapse; and then being a weary of Physic, she took only Empirical Remedies, with which sometimes the Fits of the Ague were driven away, but often presently returned, mean while the Diseased being pale, unable for motion, and wanting Breath, continued swollen and blown up about the Ventricle and Hypochondres. About the third Month of her being sick, she began to have Gripes and bitter Tortures in her Belly; with which shooting sometimes to the Back, sometimes to the Stomach she was afflicted almost continually day and night: Moreover she was affected with a frequent Vertigo, and sometimes with Fits as it were, Hysterical: Also being troubled with a frequent Vomiting, she daily threw up a viscous and frothy Phlegm: Within a Month's space this Disease passing to its highest pitch, raised pains in the Back and Loins, and so afterward in all the parts of the Body: Besides, at this time she complained of a mighty straitness of her Breast, and a great contraction of the Viscera: Mean while the habit of the Body fell away to a mighty Leanness, so that the Bones being destitute of Flesh, scarce stuck to the Skin; the Urine was little and very ruddy; on the surface of which grew a little thin Film garnished with various colours like the Tail of a Peacock: A short while after this, a Numbness and Formication was perceived sometimes in the Belly, sometimes in the Limbs, and afterward the Gripes and Pains began to remit; nevertheless in their stead, a Palsy succeeded, which within a week's space so pervaded all the Members of the whole Body, that she was not able to bend, or any way to stir from its place either Hand or Foot, or any other part. It is obvious that those severe Symptoms proceeded from a Scorbutic Root, for by reason of the taint principally fixed on the Blood, the Spontaneous Latssiude, the difficult Breathing, nay, and the intermitting Fever happening at random, and often returning, and the Bicker of other Symptoms previous, as it were, and light, were caused: Again the Lixivial Urine, and that diversified colour of it plainly showed the Blood to be seized with a Sulphureosaline dyscrasy; which kind of Urine I have observed to be so marked in many others, affected with the like Disease: Moreover when in this sick Lady, the Morbid Seminal Root being increased in its store, and flowing into the Mass of Blood, came to spread itself on the Confines of the Brain and Genus Nervosum, the other more violent affects arose. This Lady living far hence, by the advice of a Neighbouring Physician took Medicines usual against the Colic; which doing no good, and the Disease growing worse, the Patient being brought to Oxford, tried a great many Remedies both Antiscorbutic and Antiparalyticks almost of every kind and form, though without any benefit: Since therefore any ordinary Method of healing seemed not sufficient for this Disease, it was thought good to proceed to great Remedies, and truly such as were not wholly void of danger: Wherefore we gave this sick person, as weak and worn away as she was, a Mercurial Medicine for raising a Salivation, which effect ensued according to our desire, for a Flux arising within two days, and gently continuing for many days without any ill Symptom, gave a very great relief to the noble Lady: For the Pains being mitigated, she began in some measure to move her Limbs, to have a better Stomach, and to digest here Food better, and to enjoy a quiet Sleep: The Salivation being over, she took a Decoction of Sarza and China, with Antiparalytick Ingredients for a few days: Afterward being carried to , and having there used the temperate hot Baths, for some time she recovered an indifferent state of Health. The whole Winter she constantly took Medicines against the Scurvy and the Palsy: And upon her renewing the use of the hot Baths the year following, she grew perfectly well; and since is become the joyful Mother of many Children. A Man forty years of Age, of a Melancholic Temperament, troubled with the Scurvy for many years, is wont to find at various times of the year manifold and diversified Symptoms of it: About his Legs, spots and large black marks, like those caused by a stroke, appear, Belly-achs, and a Looseness frequently trouble him, his Urine for the most part appears Lixivial, a Spontaneous Lassitude, a languishing of the Strength, a want of Appetite almost constantly attend him; besides these ordinary as it were accustomed evils, he lives moreover obnoxious to violent Fits of sickness, and those of various kinds. Above two years since, when I first went to see him, he sorely complained of a difficult Breathing, as though he were in danger of being choked, with a Trembling of the Heart, failings of the Spirits, and a frequent danger of Swooning: Moreover of any thing of these passions in the Praecordia a little remitted, for the most part he was assailed with a cruel Scotomia and a Vertigo; he seemed to have perfectly recovered of these affects, after that he had taken for sometime Anticonvulsive Remedies, complicated with Antiscorbutics: Butafterwrad within a few weeks he was affected with a Nauseousness and a Heartburning, and with an Inflation of the Hypochondres: His Urine was little and very lixivial, his Belly swelled in a short time, moreover his Feet and Legs growing mighty oedematous, showed the marks of an invading Dropsy: Afterward the like kind of Tumour seized the Thighs, also the Flesh of the Back and Arms; which affect nevertheless, though it seemed without hope, was easily cured with Antiscorbutic Remedies, cathartics and Diuretics being joined with them: Notwithstanding, this worthy Man, though restored to his Health, did not continue so long: For half a year being scarce over, he began to complain of a violent Headache, with a Vertigo, and an obstinate Watching; afterward without any evident cause, he was seized with a horrible Vomiting: In a short time after the Asthmatick Fits returned, with a trembling of the Heart, and failings of the Spirits: At this time also, when he seemed almost past hope, he recovered again in a short while by the use of Antiscorbutic Remedies: From this case it clearly appears how great evils the Scorbutic Miasm, lying hid like a ferment, both in the Blood and in the Nervous Juice, and displaying its Venom according to occasion, may cause. Which kinds of affects nevertheless, how dreadful and terrible soever they seem, so they depend only of the Humours being vitiated in their Crasis, and not on the Viscera injured in the whole, or in their conformation, for the most part they are wont to be Cured with little ado, viz. by an Antiscorbutic Method aptly ordered according to the condition of the Patient as well as of the Disease. A Renowned Lady, about Twenty five years of Age, of a Sanguine Temperament, and a thin habit of Body, fresh coloured and handsome, had been ill of a Scorbutic Affect of a long time: For besides broad Spots and red Pushes breaking forth in divers parts of the Body, she had been wont to undergo for a long time Pains and bitter Tortures, chief infesting her by night, one while in the Shins, another while in the Arms: In regard she was with Child, she had been forced to leave off a course of Physic, often begun in order to its Cure. After he last Childbirth, her Lochia flowing plentifully, she continued for many days faint and weak, with a difficult Respiration, and being out of Breath upon any motion: A Month after being delivered, being taken out of Bed, and attempting to walk, she fell into a most severe difficulty of Breathing, with a Trembling of the Heart, and a frequent Fainting of the Spirits: Being presently put to Bed, she continued almost for a whole day still Trembling, and continually Panting: Moreover the lower Limbs, as though Death were at hand, being quite chilled, waxed not warm by any Frictions or Applications of warmed : At length, after near four and twenty hours, upon the frequent giving of strong Cordials, she was better about the Praecordia, though there followed near the right Groin, in the top of the Thigh, a very acute Pain, reaching even to the Leg, and within a few hours a pretty hard swelling, resisting the touch, possessed all that space: Being called at this time, the Diseased still fetching her Breath short and with difficulty, presently having ordered a Clyster to be forthwith injected, I gave her twelve drops of Spirit of Hearts-horn in a spoonful of the following Julape. Take Water of Snails, six ounces, Hysterick Water four ounces, Water of Walnuts, simple, and of Pennyroyal, of each three ounces, Sugar one ounce, Castoreum tied in a Rag, and hung in the Glass, a Dram. These Medicines were repeated every sixth Hour. I ordered a large vesicatory to be applied to the inward part of the Thigh; then in the Evening, in regard during this whole Fit she had continued without Sleep, I gave her of Laudanum a grain, Pearls powdered six grains, confection of Alkermes without Musk half a dram: she slept quietly, and there next Morning she was much relieved, the pain and swelling of the Thigh somewhat abated, also while she lay quiet in her Bed, she was well about the Precordia, but sitting upright, or turning on one side, presently she seemed almost ready to die through straitness of Breath; she continued the use of the Spirit of Hartshorn and of the Julep, to be repeated every sixth hour for many days. Moreover, because she was pressed with Thirst, and made water always in a small quantity, ruddy, and filled with contents, she took twice a day a Dose of the following Julep to six Drams. Take roots of Grass, Chervil, preserved Eringoes, of each six drams, shave of Ivory and Hartshorn, of each two Drams, burnt Hartshorn a dram and a half, Raisins two ounces, one Apple sliced, Liquorish two drams and a half, being sliced and bruised, let them boil in three pounds of Fountain Water; till a third part be consumed: then four ounces of White-wine being added to it, let it be strained into a Flagon, to which put Leaves of Scurvygrass, and Brooklimes, of each a Handful; Salt of Wormwood two drams, make a close and warm infusion for three Hours, let the straining be kept in Vessels close stopped. Sometimes every day, sometimes every other day a Clyster was administered: By the use of these things she seemed to grow better daily, so that within a week's space arising from her Bed, she was able to sit up two or three Hours by the fire in her Chair: but if she kept from her Bed, or walked a little more than was fitting, she was presently wont to fall into a straitness of Breathing, or a fit of the Asthma, so that on a certain day having stayed out of Bed too long, she underwent a violent fit of the Disease, and was affected with a difficult Breathing, a trembling of the whole Body, and frequent Swoonings: Being called again by reason of this Relapse of the sick Lady, I gave her Spirit of Hartshorn to twenty drops, with the Julep above prescribed, and in the Evening a dose of our Laudanum: and as thereby she found herself better about the Precordia, Pains and Swell succeeded in the right Thigh and Leg, such as before had paned in the left. I ordered also vesicatories to be applied to that Thigh; and besides the Remedies hitherto mentioned, she took twice a day of our Wine of the Juice of Scurvygrass four ounces, with two ounces of the Magistral Antiscorbutic Water: Moreover, I ordered her to be purged with our Solutive Syrup, above prescribed; which doing well, I ordered it to be repeated within three or four days. By these Remedies she grew well within a Month. A Noble man about the thirty third year of his Age, seeming to be of a sanguine Temperament, tall and slender, of a very acute Wit, and quick understanidng, though he had used himself for a long time to immoderate and excessive Studies, together with a disorderly way of Diet, yet being still sprightly and full of vigour, he seemed to enjoy a sound Mind in a sound Body: a little more than two years since, when he had greatly tired himself by dancing a whole Night with Friends, and in the Morning being put in a cold Bed in a Room that was too moist, and having slept a little, he began to be sick; for upon his awake he fell into a mighty troublous Passion about the Precordia, with terrible Swoonings as though he were ready to die. After a draught of Wine and some cordial Remedies taken, he was a little better, but he often relapsed, so that all that day both himself and his Friends dreaded either a swoon without returning to himself, or an imminent Apoplexy: Moreover, after that this Fit of the Disease was past, yet still he lived obnoxious to daily passions of the Heart, and upon any great Error committed in Diet, he was wont to be afflicted again with a violent fit. Notwithstanding the use of Remedies, the Disease growing worse within a few Months, did not only infest the Precordia, but in the whole habit of the Body Expansions sometimes of heat, sometimes of cold, moreover in the Limbs a numbness or formication, or light Convulsions, and sudden contractions were raised; but of late, besides the Symtoms hitherto mentioned, which still greatly molest the Noble Person, he is moreover sorely afflicted with a frequent Vertigo, and with Distractions and Failings of the Spirits residing in the Fore-brain, insomuch that he is forced to abstain from the Studies and Politic Employs (to which he has been always addicted) and even from any strong intention of the Mind; for otherwise he feels both in the Head and in the genus nerevosum these troublous Passions, that he may fear either an invasion of the Apoplexy, or horrible Convulsive Affects: a great fit of this Disease pressing upon him, the Ventricle also for the most part is disturbed: Moreover, he has often found ease after a Vomit, either happening of its own accord, or raised by the help of an Emetic Medicine: Hence some have judged the cause of the Disease to be seated wholly about the Stomach, or Hypochondres: Nevertheless Cathartick Medicines, Emetics, Digestives, Cephalicks, Antiscorbutics, Chalybeats, and others almost of every kind, prescribed to this Person for two years by famous Physicians, and also by Empirics and Mountebanks, have not effected a cure: he lately tried Astrop Waters, but finding himself the worse by them, he presently left them off, and is now advised to drink the Sulphureous Waters at Knaresborough in Yorkshire: But what success he finds in them I know not at present. This case in regard by reason of the concourse of the various Symptoms, it does not belong to any peculiar kind of Disease else, is justly referred to the Scurvy. As to the Method of Cure to be used in this and the like cases, there are two Intentions on which we must chief insist: viz. First, we must cleanse the Mass of Blood, and withdraw the offensive Ferments conveyed to it from the Stomach, Spleen, and haply other of the Viscera. Secondly, the Brain and Genus Nervosum ought to be strengthened, lest they admit extraneous Particles: and the nervous juice that lies in those Parts, degenerating from its due Crisis to a sharp and otherwise morbid Nature, aught to be restored and rectified: the first of these is performed by cathartics, Emetics, bleeding, and especially specific Medicines, correcting or wholly taking away the scorbutic taint of the Blood. Now that the Iron or vitriolic Spaws, that famous cleanser of the Blood, did rather injury than give help to this Person, the reason seems to be, both that the Brain being become weak by reason of Cephalick Affects, with difficulty throws off the filthy glut of Waters sent into the Blood, nay, and is in danger of being overwhelmed by it, as it violently makes to its confines: and likewise, because when the nervous Liquor degenerating from its Crasis inclines to a sharpish Nature, it is wont to be more perverted by the fluid Salt of the Spa Waters. Wherefore we generally observe that in the Rheumatism and Gout the morbid Disposition is increased by the drinking of those Waters. The second Intent is excellently performed by Cephalick Remedies, and especially such as are endowed with a volatile Salt, of which kind are Spirit and Salt of Blood, of Soot, of Hartshorn, the roots and Seeds of Peony, leaves of Mistletow of the Oak, etc. with which Antiscorbutics are mixed. The London Practice OF PHYSIC, CONTAINED In Dr. Willis's Tract of the Diseases that regard the Corporeal Soul, and its subjects, viz. the Brain and Genus nervosum. CHAP. I. Instructions and Prescripts for the Cure of the Headache. SInce all Pain is an Action violated, or an irksome Sensation depending on the contraction or corrugation of the Nervous Fibres, the subject of the Headache must be the parts of the Head that are most nervous, that is, the Nerves themselves, also the Fibres and Membranes, whereof it has many, placed both upon and under the Scull; and those parts which are affected with pain are chief the two Meminges and their various Processes, the Tunicles of the Nerves, the Pericranium, and other Periostia; the Muscles, the Panniculus carnosus, and lastly, the Skin itself: As to the Brain and Cerebellum, and their medullary appendices, we conclude that these Bodies, in regard they want sensible Fibres, apt to be corrugated and distended, continue free from pain; and so the same is also to be said of the Scull. Now whenever a pain is raised any where about the nervous parts of the Head, its formal cause consists in this, that the animal Spirits being severed from each other, and put to flight, cause the Bodies that contain them to be withal convulsed and corrigated, and so raise that troublesome sensation: And that which so distracts the Spirits, that a troublesome sensation thence arises, is somewhat disproportionate, rushing against the Spirits themselves, or the Bodies that contain them, which entering the Pores or Interstices of the Fibres, severs them from each other, and withal forces the Spirits there residing to Irregularities. As to the Prognostic of this Disease; in case the morbid disposition be inveterate, so that Fits for many years have often returned of their own accord, and likewise upon any slight occasion, we predict that the diseased, though not much in danger of life, will not easily be cured: Moreover, that the Cure will be yet more difficult, if hypochondriacal, or hysterick affects often troubling them, are wont at frequent times to raise the Headache, or if the corrupted taint of an inveterate Venereal distemper be radicated in the Part affected. And if the Headache be not only inveterate, but almost continual, that we may justly suspect it to arise from a phlegmonous or schirrous Tumour, an Erysipela, Abscesses, or Worms, there remains but small or no hope of Cure. A Headache, whether continual or periodical, if it be violent, and has a Vertigo, Vomiting, and other affects, either convulsive or sleepy joined with it, giveth suspicion of great danger; forasmuch as it frequently passes into a mortal Apoplexy, and often into an Epilepsy, Palsy, Blindness, Deasness, and other Diseases, either very severe or incurable. The Therapeutic method of the Headache comprehends many Indications, and those of various kinds, according to the manifold species, causes, and differences of this Disease, which it will not be easy to digest, and place all here in an exact order. An accidental, or occasional Headache, viz. such as is wont to arise from an evident cause alone, without any Procatarxis, or previous disposition, as when it happens upon drinking Wine, Surfeiting, being in the Sun, or through a vehement exercise, also in fits of Fevers, this for the most part ceases of its own accord, upon the removal of the evident cause, and its consequences; or at leastwise is taken away by bleeding, rest, and sweeting. In every habitual Headache, whether continual or intermittent, two chief scopes of curing occur; to which all the other Therapeutic intentions ought to levelly, and with which provision is made against each cause of the morbid origine. 1. viz. In the first place, for the cutting off all the fuel of the Disease, we must endeavour, both that the matter flowing, or oftentimes apt to flow to the affected or ill disposed places of the Head, be either stopped, or withdrawn thence to some other place: and likewise that the Convulsions raised in other places, and thence wont to be propagated to the Head be prevented. 2. Then Secondly, in order to the eradicating of the Disease itself, or (if it may be) of its conjunct Cause, we must endeavour, that the places of the Head predisposed for Aches (whether only weak, or injured in their conformation) being fortified against the frequent incursions of the offensive matter, recover their ancient state and vigour; which Indication, though it be seldom ever performed on a sudden, or throughly, yet sometimes by a long and diligent care, the morbid root, how fixed and radicated soever it be, it consumed. As to the first scope of Curing, which we must first and chief have respect to, we say that the matter, or Humours, that are wont to be heaped together about the parts of the Head predisposed for a Headache, and to raise the fits of the Disease, are the Blood, or its Serum, or the nutritive or nervous juice. Moreover, with all these, vapours and effluvia, also excrements, sometimes bilous, sometimes melancholic, sometimes acid, salt, sulphureous, and others of various kinds being received into the Blood from the Viscera, sometimes these, sometimes others, are conveyed along with it to the Head; against the salleys and incursions of all which, let Physical defensatives be ordered. 1. And first, if the Procatarxis, or disposition for pains being placed about the Membranes of the Head, the Blood, as being hot, and apt for turgescencies, rushes now and then all of a sudden into the Membranes of the Head, and upon it's not easily passing them, stretches the Vessels above measure, and severs from each other the nervous Fibres, and so raises fits of this disease: (a sign of which are a sanguine temperament, heat, and a suffusion of redness in the Head about the Face, also a high and vibrating Pulse, with Veins stroutting with Blood; we must presently endeavour both that the Blood being rendered more calm, be not so readily put upon turgescencies; and also that when stirred and boiling, it be not carried with a greater sally to the Head than to other Parts, nor be not forced there to stagnate, by reason of the Sinus' of the meanings being too much filled: Wherefore, if the fit continues long, let the Person be blooded in the Arm, or in the Jugular Vein; out of the Fits it is sometimes proper to draw Blood from the Vessels of the Fundament by Leeches; to wit, that by this means the Blood haply boiling, may be drawn downward towards that place, whither it often tends of its own accord: Let Oxyrhodinums, or other Epithems be applied to the Head; moreover, let Juleps, Emulsions or Decoctions, which alloy the fervour or fury of the Blood be taken: Let the Belly be cooled and kept soluble by the use of Clysters: Morever, for prevention, Whey or the use of Spaw-waters is convenient; also drinking of Water, a thin and cooling diet do good: You must order a forbearance of Wine, Spices, Bathing, Venery, any violent motion of the Body or Mind, and all hot things: Moreover, for fixing the Blood, and preventing its effervescencies, let distilled Waters, expressions of Heerbs, or Decoctions, Electuaries, Powders, and especially Crystal Mineral be frequently used: It will not be needful to subjoin here a method, or particular forms of Medicines, because in this case almost every Person that is ill, being taught by frequent experience from things that do him good or hurt, is wont to be his own Physician. 2. It is seldom that the Blood is in the fault alone, or only by itself: Other Humours oftener, being carried to the Head by the conveyance of the Blood, and there deposed, cause the Evil: If at any time therefore a filthy glut of Serum breaking forth in abundance from the Blood, causes frequent head-aches (the signs whereof are Catarrhs at the same time infesting the other parts, viz. the Nostrils, Mouth, or Trachaea) than abstinence and rest being commanded, and the Belly being emptied by a Clyster, let the fluxion of the Serum be permitted to appease itself, and the matter discharged on the Membranes of the Head to evaporate: Which if they do not follow of their own accord, and in a short time, in a hot constitution Bleeding often is proper; viz. inasmuch as the Vessels being emptied of Blood, suck in again the extravasated Serum: But in cold Persons Vesicatories applied to the Neck, or behind the Ears, are of excellent use: Then after that the Belly is emptied by a Clyster, let the fluxion be appeased by the use of an Anodyne, or gentle Opiate: and that being appeased, it is proper to give a gentle Cathartick, and then Medicines that operate by Urine, or Sweat, or together by both, and so gently evacuate the superfluous Serosities. Medicines fit for these ends are every where to be found in Books, which nevertheless may not be used rashly and indifferently by Empirics, but they ought to be chosen, compounded, or altered, nay, and sometimes to be prepared Extempore, as occasion requires, according to the judgement and discretion of a prudent Physician, respect being always had to the Constitution, Temperament, Idiocrasis, and other accidents and circumstances of the Patient. Wherefore, in regard it would be superfluous to heap together here a great many Receipts, I have rather thought fit to rpopose here only a form or two of the Medicines of each kind, viz. of such as regard the chief Intents. Take Pills of Amber half a dram, Rosin of Jalap four grains, Balsam of Peru what suffices, make four Pills; let three be taken going to Bed, and the next morning, if the former do not work enough. Or, Take Scammony sulphurated half a Scruple, Ceruse of Antimony fifteen grains, Cream of Tartar eight grains, make a Powder, let it be taken in a spoonful of Panada early in the morning. Take Sulphur of Antimony four grains, Rosin of Jalap five grains, Cream of Tartar six grains, let them be bruised together, and with a sufficient quantity of Conserve of Violets make a Bolus to be taken early in the morning with Governance. Take roots of Butchers-broom, the great Bur-dock, Chervill, Avens, of each an ounce; preserved Eryngoes an ounce and a half, Florentine Orris three drachms, the lesser Galingal a drachm and a half, Bur-dock-seeds three drachms, dried leaves of Betony, Sage, Vervain, Fluellin, of each half a handful, Raisins stoned two ounces, boil them in four pounds of Fountain Water, will a third part of it be consumed; then add of White-wine half a pound, strain it, let it be sweetened (if need be) with Syrup of the five roots two ounces, let six ounces be taken warm twice or thrice a day a good while after meat. For such as have a Cold and Phlegmatic constitution, let a Decoction be prepared of the Wood Guiacum, Sassafras, Sarzapar: With the addition of the foresaid Ingredients make an Apozeme, whereof let six or eight ounces be taken twice or thrice a day warm. For Poor People, and often to the Rich, I use to prescribe, with good Success, a Decoction of the dried Leaves sometimes of Sage, sometimes of Betony, Vervain, or of Rosemary, made in fountain Water, and then impregnated with the Tincture of the Powder of Coffee-berries, to be taken twice a day warm to six or eight Ounces. 3. But, if with the abounding Serum, Particles also saline, acid, bilous, or otherwise infesting, are violently carried into the Membrances of the Head, either wholly from the Mass of Blood, or by the Mediation of this, as received from the Viscera, and there being fixed, cause more acute and lasting Pains; than it will be proper sometimes to repeat a spare Bleeding, and also a gentle Purging: to apply Anodyne, and mitigating Epithemes to the Places affected, and also often to give gentle Hypnoticks by frequent changes, Apozemes also, and Juices, and Expressions of Herbs, that alloy the Fervour of the Choler, and gently carry it off by Siege and Urine, are of excellent use: but in the mean time, let smart or strong Medicines, whether they operate by Siege, Urine, or Sweat, in regard they too much fuse, and exagitate the Blood and Humours, be carefully avoided. I have often observed in Persons troubled with an acute and obstinate Pain of the Head, that the Serum swimming on the Blood, when let forth, have been tinged with a Yellowness, or with bilous excrements incocated in it: and that also in this Case a spare and frequent Bleeding, and afterward a free drinking of Whey and Spaw-Waters, have given a notable Relief, and beyond other Remedies. 4. Moreover, if the Parts of the Head sister through the Fault of some one of the Viscera, as of the Stomach, Liver, Spleen, Womb, or any other, (by reason of the Transmission of the ill Ferment) then in the Cure of the Disease, let such Remedies as regard the Viscera be administered together with Cephalicks: hence, to certain Persons troubled with the Headache, whose Stomach also is in a Fault, Elixir Proprietatis, Mymsicht's Elixir of Vitrol, Tinctura sacra, Vitriolum martis, the compound powder of Aron Roots, and other things vulgarly accounted for Stomachals, often do good; to others whose Heads participate of the evils of the Spleen, Chalybeats often give help: Some Women sometime find ease of their Headache by hysterick Remedies; in like manner, when the Faults of other Parts contribute to the Headache, let the coindicated things taken from those Parts, be joined with the first things indicated. 5. Sometimes the nutritive Juice is the Cause of a periodical Headache; viz. in as much as being mixed with the Blood, and not duly assimilated, it causes a Turgescency in it by reason of its disagreeing Particles; so that the Blood boiling to the Head, throws off its Refuse in its meanings, or certain Parts of them predisposed for it; and so irritates the Fibres to painful Convulsions. For this Reason, I have known many to have been obnoxious to a daily Headache after the Measles, Smallpox, and other Fevers or Sicknesses, with which the Mass of Blood is wont to be vitiated; viz. so many Hours after Meals, sometimes sooner, sometimes later, first a flushing of Blood in the Face, than a Plentiude and Pain in the Head infested them: moreover, after drinking of Wine, or eating of turgid Food, they were more severely punished. The Access of the Distemper is wont to happen sooner or later after they have eat or drunk according as the Chyle gins to grow turgid either a little after its first entrance into the Blood, or after it has stayed some while in it. This affect is free from Danger, and for the most part is easily enough cured. After a Provision being made for the whole, a gentle Purge, and sometimes blooding being ordered, Remedies which restore the Crasis of the Blood, such as are chief antiscorbutics, and Chalybeats, prove mighty beneficial. Take Conserve of Fumitory, Tansey, Wood Sorrel, of each two Ounces, compound Powder of Aron Roots three Drams, Ivoy, Crabs Eyes, Coral prepared, of each a Dram and a half, powder of yellow Saunders, Lignum Aloes of each half a Dram, Vitriol of Mars a Dram, salt of Wormwood a Dram and a half, syrup of the five Roots what suffices, make an Electuary: let the Quantity of a Chestnut be taken in the Morning, and at five a Clock in the Afternoon, drinking after it three ounces of the following Liquor. Take Water of the Leaves of Aron, Vervain, and of the Flowers of Elder of each six Ounces, magistral Water of Snails, and Earthworms of each two Ounces, Sugar on Ounce, mix them. Various Medicines, wont to be used against the scorbutic Diseases of the Blood, may be ranged here, and given with good Success; for headaches, which are so familiar in the Scurvy, oftentimes proceed from the Fault of the Blood perverting the nutritive Humour, and discharging its Recrements in the Membranes of the Head: wherefore, the Remedies mentioned by me elsewhere against that affect, claim a place also here. 6. There remains yet another Humour, to wit, the nervous Liquor, which being carried into the Fibres of the meanings and other parts of the Head, sometimes becomes disproportionate to the Fibres by its own disagreeing nature, as it is sharp or otherwise degenerate, sometimes twitches the containing Parts and irritates them into Convulsions or painful Distentions, as it strongly ferments with some other humour, viz. the nutritious or serous Humour flowing thither. The nervous Humour, where it is thus morbific, either being vitiated in its whole Mass, brings a very great Injury on the Brain predisposed for it, or being faultless of itself, is perverted within the Fibres affected, and so becomes morbific secondarily; the Cure of which then depends on the Restitution of the containing Parts; viz. If the Weaknesses of the Fibres, or their injured Conformations be amended, the Humour irrigating them, will presently be free from Fault, With what Remedies the Defaults of the Parts predisposed for head-aches are removed, we shall presently acquaint you. Mean while, if the nervous Humour, being degenerate in its whole Mass, causes a great Offence to the Head predisposed for Pain, let those kinds of Medicines, and that method be used, with which being reduced to its due Crasis, and gently passing through those Fibres, it may irritate them little, or not at all: for which end, neither strong Purging, nor large or frequent Blooding are proper, in regard they exagitate the Blood and Humours, and impair the Strength, and consequently give a greater Acrimony and Rage to the nervous Humour which was faulty before. But gentle Loosners, and a spare Bleeding, will now and then be of use; whereby the Viscera may be cleansed, and the Mass of Blood be somewhat purged, and a way be prepared for other Medicines which will succeed the better afterwards. Now the Medicines that render the nervous Liquor more friendly and benign to the Membranes of the Head, which are wont to be offended by it, are those which are vulgarly called Cephalicks, viz. whose Particles, being active enough, and withal fine and subtle, pass the Blood without any Turgescency or Tumult; and then insinuating themselves into the nervous Liquor, gently actuate it, and cause the Ductus' of the Nerves so to open themselves, that thereby the animal Spirits more freely irradiate all Bodies both sensible and motive, and inspire them without Swoonings, Convulsions, or anomalous Distentions. These kinds of Remedies, though not always efficacious, nevertheless often remove some head-aches that are not very inveterate, and in others, though never so obstinate, they frequently do good: moreover, those things that are prescribed against Pains of the Head, are also given against Affects of the Brain and Genus Nervosum, and on the contrary, the things that are prescribed in these are also given with good Success against those; viz. the Virtue of them being displayed within the Brain, does good against the Apoplexy, Palsy, Lethargy, and other Diseases allied to them, also within are moving Fibres against Cramps and Convulsive Motions; and likewise exerting their Forces within the sensible Fibres, they often relieve Pains. Great stores of these Medicines are vulgarly set forth in Physical Books, but so, that their Plenty has brought either a Poorness or Confusion to the method of healing; those things which would do most good, often lying hid, or being concealed amon gst that confused heap of Remedies; even as Wheat is with more difficulty separated from much Chaff, than it is first gotten clean from the Ear. Therefore in this Case Provision being made for the whole, and then those things being given both by Diet and Physic, which put a stop to or presently appease the Turgecencies of the Blood, let the Medicines called Cephalicks, or such as remove the Disorders of the nervous Juice, be prescribed to be carefully taken: I shall set down some few Forms of these. Take Conserve of Flowers of Betony, and Clovegillyflowers of each three ounces, Powder of male Peony Roots half an ounce, bastard Dittany a dram, lignum Aloes, yellow Saunders of each a dram, red Coral prepared, Pearl, Ivory, of each an ounce and a half, Salt of Vervain a dram and a half, syrup of Peony flowers what suffices, make an Opiate; let the quantity of a Chestnut be taken, drinking after it of the following Julep, three ounces. Take Water of Black-Cherries, walnuts simple, Vervain, of each four ounces, Water of Cowslip-flowers three ounces, compound Water of Peony three ounces, Sugar six drams: Or, Take Leaves of Vervain, Mistletow growing on Appletrees, of each ten handfuls, male Peony Roots two pounds, Mace, Nutmegs, of each half an ounce, Coriander Seeds an ounce, being sliced and bruised, pour to them of fresh Milk eight pounds, (or of Milk seven pounds, Malaga Wine one pound) distil them with common Organs, let the whole Liquor be mixed. Let three Ounces be taken at a time. Take Powder of male Peony Roots half an ounce, red Coral prepared two drams, Ivory, Pearl prepared, of each a dram, make a fine Powder of them all, add of Sugar dissolved, and boiled to a Consistency for Tablets in a sufficient quantity of Black-cherry Water, six ounces, Tincture of Cotal a dram, make Tablets according to Art weighing half a dram, let three or four be eaten in the Morning, and at five a clock in the Afternoon, drinking after it a little draught of Tea. Or, Take Tincture of Coral an ounce, take from fifteen drops to twenty twice a day in a little Draught of the Julep or distilled Water. Those that are of a cold or phlegmatic Temperament, may take twice a day a Dose either of the Tincture of Antimony, or of Spirit of Armoniac impregnated with Amber or Coral, or of Spirit of Hartshorn, or of Soot in an appropriated Vehicle. The use of Millepedes ought not here to be omitted, or set lightly by, in regard that their expressed Juice, distilled Water, and also the Powder prepared of them, often contribute egregiously to the Cure of ancient and obstinate head-aches. I might here propose many other Medicines of various kinds; nay, transfer hither, the forms in a manner, of all those which I have formerly heaped together against convulsive Affects. But the most difficult thing of all concerning the Cure of the Headache, yet remains; viz. How the Conjunct, and fixed Cause of this Disease, consisting in the Weakness or injured Conformation of the Fibres, may be healed or removed. Now this, though it will be sometimes incurable, as when a schirrous, or callous, or some other ancient and fixed tumour, has possessed the meanings; nevertheless, since the Diagnostic of this is uncertain, and the Procatarxis of a Disease, how unconquerable soever it may seem, sometimes by a continued method of Cure is overcome; therefore in every kind of Headache, as long as the Patient will admit of Remedies, let not a Physician be backward in prescribing those things that shall seem most proper. Therefore in the first place, as we hinted even now, we must diligently endeavour, that the Fuel of the Disease being out off, and intercepted, the frequent Accesses of the Fits be stopped; for so the indisposed Fibres, whilst they are no longer molested, sometimes recover their sound state, Nature alone effecting the Cure. The helps of the Art of Physic, indicated in this Case, are taken from Chirurgery rather than from Pharmacy; for whatsoever is taken by the Mouth, passing through long Circuits, spends all its Virtue before it reaches the Membranes of the Head. amongst Chirurgical things, first Topical Remedies occur, and of those, Plasters are of most advantageous use, and often prove very beneficial. Let not these be extremely hot, which may draw the Humours more to the place affected, but moderately discussing and corroborative. I use to prescribe, Emplastrum de Minio, or Diasaponis, with a half quantity of Paracelsus' Plaster, to be applied to the Place grieved after it is shaved, and to be worn for some time. As to the Ancients frequent use of Phenigms and Sinapisms, and to the present Practice of applying Vesicatories against violent headaches, sometimes to the whole hinder part of the Head, sometimes to the Sinciput: if at any time ease has ensued these not Topics, it was for this reason, Because by those Administrations a mighty store of sharp Serum was voided from the Part affected. Liniments of Oils, and Unguents, though frevently used, do little; because (as I guess) in case they penetrate deep, they render more lax the Tones of the Fibres, whereby they lie more readily open to the Incursions of the morbific Matter; moreover, they stuff the Pores of the Skin, that the Effluvia do not evaporate: for the same Reason, in a manner, it is, that warm Fomentations, prepared of Aromatic, or other cephalick Decoctions, oftener do Hurt than Good, because they draw Humours towards the Parts affected, and withal, open the Pores and Passages, whereby they are more readily admitted; and therefore also it is, that bathing of the Head, by pumping Water on it in hot Baths, is used to Persons troubled with the Headache with no better Success: whereas, on the contrary, it would be good for many to wash their Temples, Forehead, and Sinciput, every Morning and Evening, with cold Water: nay, to bathe their Heads every Morning by pumping cold Water on it, or at leastwise, to dip it in a deep Vessel or Well. Another Chirurgical help cried up for the Headache, especially if violent and inveterate, is wont to be a burning or cutting of Issues in several parts of the Body: It's a thing without doubt, that these being made in the Arms or Legs, are both less troublesome, and prove somewhat beneficial; viz. inasmuch as they withdraw the fuel from the Part, and lead it far away from the place affected: Moreover, an Issue in the Nucha, and a Setaceum in the Neck, also in the lap of the Ear, or near it; and likewise a pellet of the Roots of Wild Black Hellebore stuck in the lap of the Ear perforated, inasmuch as they evacuate much serosity, and cause more to pass towards the emunctories, viz. the Glands are often used with benefit. But there is a great deal of talk and a greater reputation concerning Cauteries applied to the place grieved, or near it, so that large Issues are made in the crown of the Head, or near the Commissures of the Sutures. If we measure the fruit of this practice from the success, it will appear to be little and seldom beneficial, but often unfortunate; for I have not known any person cured by these kind of Cauteries, but many aching Heads to have grown worse thereby. And truly Reason dictates it; for wheresoever an Issue is burnt, a serous humour flows to that place from the whole mass of Blood, and consequently from the whole Body; and it is often heaped together there in too great a store, that it may be constantly voided by that emissary: Wherefore about Issues, Inflamed swell, pustules, and various humours every where arise: What therefore can we suspect less, than that Cauteries being applied near the place grieved of the Head, but they will cause the Morbific matter to be more heaped together there. There remains yet another Chirurgical operation, extolled by many for an obstinate Headache, but tried as yet by none (that I know) to wit, the opening of the Scull with a trepand Iron near the place of the pain: Our famous Harvey endeavoured to persuade a Lady of great quality to this, who was troubled with a terrible and inveterate Headache, promising her a Cure thereby; but neither she nor any other has been content to admit of the administration: Truly it does not appear to me what certainty we may expect from the Sculls being opened where it pains; if an Abscess lay hid there, this were the only way of Cure; but that is wont to cause the sleepy, or mortal Convulsive affects, rather than to take away the Headache: if an inflamed Swelling, or Pustules, or an Erysipela has seized the Diplois, I know not whether those tumors exposed to the naked Air will evaporate more easily, or whether remedies applied to them, when bare, will do any thing or not: And in case the pains arise by reason of the meanings being beset with tubercles, or a schirrous, or callous Tumour, I judge the opening of the Scull will turn to little or no benefit. But this being passed by till it comes in practice, let us proceed to other things: And now let us consider whether Salivation be to be used for curing old and confirmed head-aches; in truth if the pains arise from the Venereous Disease, I make no question but this way ought to be taken; but those that have tried that kind of remedy, in head-aches proceeding from other causes, have not reaped a Harvest answerable to so laborious a cultivation; I confess the examples of certain persons have scared me from trying that method in those kinds of cases. A certain Lady of great quality (whose distemper I shall set forth beneath) for curing a violent and long continued Headache, has undergone three copious Salivations, viz. first by a Mercury Ointment directed by Sir Theodore Mayern, and afterward twic by taking the late famous Powder of Charles Huis, and this without any relief, (and I wish it were not with some detriment to her) for since for many years, even to this day, she has given ground to the cruel Tyranny of this distemper growing by degrees upon her. It fell out somewhat worse than this with that excellent man. D.G.D. for the cure of whose ancient Headache, when a Mercury Ointment was applied to his Head pained, the Salivation raised thereby, made him blind, without curing the disease. Truly every man, duly considering the operation of Mercury in the Body of man, aught to dread these kinds of effects from the rash giving of it: For, not to ay that Mercury is malignant, or wholly venomous, viz. inasmuch as from its united Particles little or no hurt is caused; so that often a great quantity of Quicksilver is taken with safety enough; nevertheless, the Mercurial Corpuscles being divided, and separated from each other, (whether it be done by Chemical Salts, as in sublimated and precipitated Mercuries, or by percolation through the Pores of the Skin, when an unction is made) they presently become exorbitant and masterless, and raise more turbulent commotions in the Body of Man than any Medicines besides: they sometimes infest the Nervous Parts first, wherefore by reason of the Fibres of the Ventricle, Intestines, and other of the Viscera being fretted, Gripes, horrible Vomitings, most sharp and often Bloody Stools, Cardialgias, Swoonings, and other terrible affects frequently happen soon after the Medicine is given: But sometimes the Particles of the Mercury, when they are not presently dissolved, without offending much the Viscera, scarce exert their forces before they are conveyed into the mass of Blood: Therefore being mighty active, and displaying themselves every way, they readily enter this, and presently infecting the whole, exagitate it, and often (when they are more fully dissolved) stir it to a great effervescency: then the Blood, to clear itself of the disagreeing Particles, beginning to ferment, delivers them that way it may, to the humours contained within itself, viz. the Serum, and Nutritious Juice, and throughly mixes them in it, and withal endeavours to discharge it elf of those, being imbued with so preternatural a mixture. Now this is not done easily, or plentifully enough by Urine, or Sweat, for the Liquamina of the Blood being become more viscid and gross, from the Particles of the Mercury incocted in it, than that they may pass the small colatories of the Reins or Skin, sometimes breaking forth (unless they are stopped) by the Caeliak Arteries, pass away upon raising a Diarrhoea or Dysentery, the intent of Salivation being thus letted or frustrated; but ostner the Latex being imbued with Mercury remaining within the Blood, which is also somewhat infected, and being carried violently with it hither and thither by the Veins or Arteries, butts against various Parts, and a way being made, either breaks forth outwardly, or is hurled into the Viscera, Membranes, and other Parts, often with great prejudice. Moreover, some Mercurial Particles also seem to penetrate the Brain, and insinuating themselves into the Nervous Juice, t be diffused not only through all the inward parts of the Head, but through all the Nervous Parts, and so in some sort to ferment the nervous liquor. But in the mean while the Mercurial Serosities remaining in the Blood, are deposed for the greatest part in the Glands, which are the proper emunctories of the Arteries: Wherefore, since about the parts of the mouth both a great many, and very great Glands are placed (to which a mighty store of Serum is sent for Spittle) and from those the open Ductus' by the excretory Vessels gape into the cavity of the mouth, certainly by this way chief, the envenomed Latex of the Blood will find its passage forth, which it cannot readily do elsewhere. Wherefore, upon a Salivation being raised, the Blood long fermenting, like Wine or Beer purging itself, throws off by the Ductus Salivales, and the innumerable Meatus every where gaping into the Mouth, whatsoever extraneous and degenerate substance it may either contain within itself, or can drink up, or receive from elsewhere, be it from the Viscera, or solid Parts, or from other humours. Moreover, it is likely, that as the off-scowrings of the Blood, so also those of the Liquor that irrigates the Brain, and Nervous Appendix, being stirred upon the entrance of the Mercury, are voided forth also this way, viz. by the Ductus Salvales. Therefore a Salivation caused by Mercury, if haply it succeeds well, removeth sometimes difficult and indeed Herculean distempers, and such as will not be mastered by any other Remedies, viz. forasmuch as this operation, by a long expurgation, throughly cleanses the Blood and nervous Juice, and other humours, destroys all exotic serments, quells the enormities of Salts and Sulphurs, and also exagitates the morbific matter sticking any where, or stagnating, and often leads it forth. Nevertheless, this Medicine is not always free from danger, viz. because the Mercury being become exorbitant, and carrying with it a mighty store of most sharp, and as it were, envenomed Serum, and rushing violently into the noble Parts, and especially the Brain; with the appendices, both medullary and nervous, or into the Lungs and Praecordia, brings upon them an indelibel, and sometimes a mortal prejudice: Wherefore, in an ancient and fore Headache there is danger lest the indisposed Fibres be more irritated by the Mercury pervading them with much and Corrosive Serum, and be put upon greater Convulsions and painful Corrugations: And also, lest upon the mighty recourse of Humours to the Head, the Brain be invaded, and consequently (which happens too often) lest the sleepy or Convulsive affects be caused: I would have discoursed more concerning these things, because it is of a great concern, but that we daily expect an exact method of Salivation, and a full account of it, as to its ways and effects, advantages or disadvantages, to be set forth by the Leanred Physician, Dr. Needham. From Chirurgery there remains yet another famous remedy for curing inveterate head-aches, viz. the opening of an Artery: Some of the moderns use this, and very much extol it, it being greatly accounted of amongst the Ancients: Nevertheless, as far as it has appeared to our observation, success has often been wanting to that so much cried up operation: Nor is it a wonder, because that ground on which the Ancients relying, blamed the Arterious Blood, as differing from that of the Veins, and more exorbitant, and therefore advised it to be let forth, does not hold good: Nor indeed is thereany other reason, wherefore Blood drawn from an Artery rather than from a Vein near the place grieved, should give ease, but rather on the contrary we may expect a greater help from the opening of a Vein; because an Artery being emptied, receives and draws away nothing from the part affected; but a Vein being opened, in the place of the Blood issued forth, draws from the whole Neighbourhood, and often drinks in again, and restores to circulation the Blood, and other humours heaped together, and Stagnating near the seat of the Disease. However, lest we recede too far from the practice of the Ancients, attributing nothing to Arteriotomy, we grant that sometimes haply it gives help tho, not immediately and causally, but only by way of consequent, and per accidents, viz. forasmuch as the ends of a cut Artery grow together, so that the passage for the Blood that way is stopped for the time to come; hence in regard somewhat a less store of Blood is brought towards the place by the Arteries, and an equal quantity is still carried away by the Veins, therefore it sometimes happens that the fuel of the morbific matter is diminished, and that its flock is consumed by degrees. For this reason that administration has often succeeded well in distempers of the Eyes. Moreover, Farriers use a practice not unlike this for curing malignant tumors in Horses Legs; to wit, they take and bind the Artery by which the matter flows to the part affected; mean while that which was there sticking, partly evaporates, and partly is drunk up again by the Vein. I have heard that in a manner the same method was successfully tried by our Harvey, for curing strumous and schirrhous tumors also in the Body of man. I might here set down many other kinds of Remedies, and also Prescripts and forms of Medicines which are wont to be used both by Physicians and by Empirics, for curing Head-achet; but the Books of Physicians abound too much with these. I shall now give you some rare cases of Persons troubled with the Headache, and first some examples of a most severe continual Headache, which also, the cause being invincible, has often proved fatal. A Woman, fifty years of age, after that she had been ill for about six months with a very great pain of her Head, troubling her almost continually under the Sagittale Suture, and yielding to no Method or Medicines, fell at length into a Lethargy, with a Partial resolution of her Limbs, from which nevertheless being in a short time recovered by remedies seasonably administered, she had again the violent pain in her Head as before, and afterward within a fortnight or three weeks falling into a sleepy affect, she departed this life: The Scull being opened, on the side of the third Sinus, a schirrhous tumour three fingers broad grew to the Membranes, by the mediation of which, the Dura Menix also for some space grew to the Plam; and the Blood Vessels which ought there to open into the cavity of the Sinus, were stopped; moreover, both the outward Anfractus of the Brain, and ●its inward cavity, were filled with clear water. From these observations the invincible, and at length mortal cause of that Disease may plainly appear. I remember formerly to have observed by Anatomy a case like to this, in a certain other Person. Moreover, in regard I judge that in many Persons troubled with the Headache, the Disease depends on such an invincible cause, I shall here give you one instance that is quite fresh of that kind of affect. Some few years since I was called to see a Lady of Quality, troubled for above twenty years with a Headache, which at first was intermittent, but of lat eye almost continual. She was endowed with admirable gifts both of body and mind, so that she was excellently skilled in the Liberal Sciences, and all Learning, above the condition of her Sex; but (as though Nature thought it too much for her to enjoy so great endowments without some affliction) she has suffered very sorely from this disease: Before she was eight years of age, upon her recovery from a dangerous Fever, she became obnoxious to pains of her Head, which were wont to arise sometimes of their own accord, but oftener on some light occasion offered; the disease being not limited to one place or part of the Head, sometimes infested the right side, sometimes the jest, and often its whole circuit. During the access (which seldom ending within the space of twenty four hours, often infested her for two, three, or four days) she could not endure light, speech, sound, or any motion; but sitting upright in her Bed in a darkened room, she was able to speak with none, nor to take any rest, or food: at length, as the Fit declined, she used to fall into a deep and troubled sleep; from which awaking, she was wont to be better, and then by degrees to recover, and during the time of intermission to be indifferently well. Formerly the Fit being raised only occasionally, seldom returned within twenty days, or a month, and then afterwards much more frequently; but of late she is seldom free from them. Moreover, through many occasions, or rather evident causes (such as are the changes of the Year, and of the Air, the great Aspects of the Sun and Moon, violent passions, and errors in diet) she is sorely tormented with them. Now though this affect having sorely afflicted this noble Lady (when I went to see her) above twenty years, and pitching its Camp near the Confines of the Brain, had so long besieged its Royal Fort, however it had not yet gotten possession of it: But the diseased being free from a Vertigo, Scotomia, Convulsive affects and any sleepy symptom, had still the chief Faculties of her Soul whole and sound. In order to the obtaining, or rather endeavouring a Cure, throughout the whole progress of the Disease, a great many Remedies, prescribed by most skilful physicians, as well of our Country, as Foreigners, were used without any success, or ease: She tried all the Great Remedies of every kind and form, but always in vain: a great many years since she underwent a long-continued, and most troublesome Salivation, by a Mercury Ointment, so that she incurred a great danger of Life. Afterward a Cure was twice undertaken by a Flux, though to no effect, by a Mercury Powder, (which the famous Empirick Charles Huis generally gave): She tried hot Baths, and drank Spaw-waters almost of every Country and Nature, with the like success as the rest: She was frequently blooded, and once in an Artery; she went with many Issues, made sometimes in the Sinciput, sometimes in the hinder part of the Head: She took the Air in divers Countries, viz. besides her Native, that of Ireland and France: She took Medicines of all kinds whatsoever; to wit, Cephalicks, Antiscorbutics, hysterics, all famous Specificks, nay, and Empirical Remedies, given both by the learned and unlearned, by Mountebanks and old Women; yet she declared that she had not received any where from any remedy, or method of Cure, the least help or relief: But the refractory and obstinate Disease, being deaf to all enchantments of Medicines, would not be mastered. Moreover, having possessed so long the precincts of the Brain, though it could not enter its recesses, yet when I went to see her, extending its limits into certain other parts of the Genus Nervosum, it began to raise violent pains in the Limbs, also in the Loins and Abdomen, such as are usual in a Rheumatism, and in a Scorbutic Colic. A worthy man, about forty years of age, robust, and sound, when, upon riding a whole day in the rain, he had gotten cold, by reason of the hinder part of his Head being continually wet, soon began to feel a pain in that Part, which in a short time being very much increased, miserably afflicted the Diseased both day and night, and kept him in a manner, always without sleep. Blooding, Purging, Clysters, Vesicatories, Hypnoticks; nay, and a great many Remedies of all kinds, diligently administered by the joint advice of a great many Physicians, did little or nothing towards the Cure of this affect: When the Disease, notwithstanding all these, daily grew worse, after six weeks, Glands, preternaturally swollen and painful, arose all over the Neck, the Hemicrania in the mean while abating nothing: Moreover, the Tendons of the Neck being very much distended, and stiff, proved very tedious to him; to which in a short time, Convulsive motions, and leaping of the Tendons succeeded in various Parts, with a Delirium; and at length the Diseased being worn out with pains and watch, yielded to Death. As in the foregoing cases, the headaches proceeded from Nodes and tubercles of the meanings, so sometimes mortal and incurable head-aches arise from a Phlegmon and Abscess. A while since, a University Scholar, after he had complained for a fortnight of a very great Headache, afflicting him almost constantly; at length the Fever becoming stronger, presently Watch, Convulsive motions, and a talking lightheaded ensued; at which time a Physician being called, Blooding, Clysters, Plasters, Revulsives, Vesicatories, also inward Remedies for withdrawing the course of the Blood and Humours from the Head, being carefully administered, he could do no good, but Death in a short time followed. The Scull being opened, the Vessels spread over the meanings were filled with Blood, and very much distended, as though the whole mass of Blood had flown thither; so that the Sinus' being dissected and opened, above half a pound of Blood flowed forth: Moreover, the Membranes themselves being affected throughout with a Phlegmonous tumour, appeared discoloured: These cover being taken away, all the Anfractus of the Brain, and its Ventricles were full of clear water; and its substance being too much irrigated, was moist throughout, and nothing firm: For the Blood being there heaped together, when it could not circulate, threw off from itself a plentyof Serum, by which the whole Head was soon floated; so that the Disease, curable haply at the beginning by Phlebotomy, afterward became mortal. I remember another University Scholar, who after being constantly, and very sorely afflicted with a Hemi●●ania under the temporal Suture for three weeks, fell at last into a fatal Apoplexy. The Head being opened, a Phlegmon had grown in the Meninge near the place paining, from which at length suppurated and broken, the Sanies falling on the Brain, had affected its substance with a lividness and corruption. But though a continual Headache (especially if it be drawn in length for many weeks without intermission) be not without danger, nevertheless we must not presently despair of its Cure, because the cause of this, how fixed and immovable soever it may seem, is often cured by a long use of Remedies, nay, sometimes without them, by Time and Nature; though in a case that is almost desperate, there is need of some Physic, lest the present affect pass into a worse, viiz. into a sleepy or Convulsive distemper. So much of the continual Headache; it now remains for us to propose some Examples, and some rare Instances of an intermittent Headache. Therefore, not to set forth here cases of the Headache, whose Fits being erring and uncertain, proceed from the Blood or Serum rushing into the places affected, in regard that these are very frequent, and vulgarly known. I shall now set before you certain choice Observations of this Disease, being either periodical, or seeming to arise from some one of the Viscera, per Consensum. As to the Former, the period●●● invasions of the Headache are produced either from the nutritive Humour, or from the nervous Juice; I shall now give you example of both. A venerable Matron, in the forty fifth year of her age, being of a thin habit of Body, and a bilous temperament, after having lived for a long time obnoxious to head-aches wont to be occasionally raised; about the beginning of Autumn she began to be troubled with a periodical Headache: This affect seizing her about four a clock in the Afternoon, was wont to hold her almost till midnight, till the diseased being tired with watch and tortures, was forced to fall asleep; then after a pretty prosound sleep, upon her awaking in the morning she was well. The Diseased having undergone daily Fits of this Disease for three weeks after this manner, delayed the use of Physic, which she very much abhorred; but at length her appetite being dejected, and her strength worn away, she was forced to desire a method of Cure, and after a gentle Purge and blooding, she took twice a day, for a week or a fortnight, the quantity of a Chestnut of the following Electuary, and grew perfectly well. Take Conserve of the Flowers of Cichory and Fumitory, of each three ounces, compound powder of Aron Roots two drams and a half, Ivory a dram and a half, yellow Saunders, Lignum aloes, of each half a dram; Salt of Wormwood a dram and a half, Vitriol of Mars a dram, Syrup of the five Roots what suffices; make an Electuary. The cause of this periodical Headache doubtless was, that the assimilation of the Chime, or nutritive Humour into Blood was hindered. For when its store received into the mass of Blood could not be overcome, it was wont, after a little stay, to fall at odds, and ferment with its particles: Therefore presently the Blood falling into a turgescency, that it might shake off that incongruous mixture, deposed its recrements, as on other Parts, so chief, and with a greater sense of offence on the Fibres of the meanings, being before weak, or injured in their conformation, so that the pain lasted till the heterogeneous particles, boiling by their mutual congress, either were subdued, or did exhale A handsome, tall, and slender Woman, long and sorely obnoxious to cephalick affects, was wont to be infested sometimes for many days, nay weeks, with a violent Headache, which seized her daily at her awake early in the morning, and afflicted her for three or four hours: In the mean space she was also affected with a heaviness of the whole Head, a deadness of the Senses, and a stupidity of Mind: which affects vanishing together with the pain before Noon, like Clouds dispersed, left all things calm and serene: Till the next morning they possessed again the Brain like a sogg and dark mist: For curing these distempers, I prescribed parging Pills, a spare Bleeding, Vesicatories also, and the use of Spirit of Hartshorn, or of Soot, with Cephalick Juleps, or Waters. In this Gentlewoman the pains of the Head rather followed sleep than was cured by it; because in this morning Headache the morbific matter resided in the nervous Juice, whose greatest curdity, and aggravation about the Head, happen presently after sleep; but the other evening fit of this disease, in regard it depended on the plenitude and turgescency of the nutritive liquor within the mass of Blood, therefore happened so many hours after dinner, and was not mitigated but after sleep, which appeases the disorders of the Blood. Tho the Experience and Complaints of sick Persons manifestly show that Fits of the Headache sometimes arise by consent from the other Parts, viz. the Womb, Spleen, Stomach, etc. Nevertheless it as clearly appears from the accounts of them, and the Phoenomena being duly considered, that this is done by another means than by Vapours raised from the Viscera affected to the Head. And first, as to the pains of the Head seeming to be raised from a Womb, nothing occurs more frequently than for violent head-aches to ensue upon the suppression of the menses or lochia: moreover, though the menses observe their due course, yet some Women are wont to be afflicted with a violent pain of the Head just as they are coming, others as soon as they are passed: But yet, though at the same time that the Head is affected, the Womb is also, yet it does not follow that the Injury is conveyed immediately from this to that: but it is the Blood itself which fixes the morbific matter on the Head; viz. it sometimes perversely conveys it, being engendered within its own bosom, and designed for the Womb, into the meanings of the Brain: and sometimes withdrawing it from the Parts of the Womb, it delivers it to the Head with a greater mischief. This Aetiology agrees also with the Headache, vulgarly imputed to the Stomach, Spleen, and other Parts. A beautiful young Woman, of a thin habit of Body, and a hot Blood, having been obnoxious to an hereditary Headache, was wont to undergo frequent Fits of it, and those coming at random, to wit, some happening on a light occasion, and others arising of their own accord, that is, without any evident cause. On the day before the spontaneous access of the Disease, being very hungry in the Evening, she greedily eat a plentiful Supper, with a hunger-starved, not to say Canine appetite, most certainly foreknowing by this sign that a pain of the Head would seize her next morning, which sign never failed of Event; for as soon as she awaked, being afflicted with a most cruel torture throughout the Sinciput, she was affected likewise with a vomiting of a humour, sometimes acid, and as it were vitriolic, sometimes bilous, and extremely bitter; it hence seeming to appear that that Headache had its rise from the fault of the Stomach. To undertake to give the reason of this, in the first place it is known that a vomiting ensues upon the Head's being injured, viz. after a stroke, Wound, or a fall from an high place; nevertheless, a pain of the Head seldom or never follows a vomiting, Cardialgia, or the Stomaches being otherwise troubled, unless an effervescency of the Blood happens. Wherefore, in the foresaid case of the Person diseased, since it plainly appeared that the meanings of the Brain were predisposed for headaches, and that its Fits had raised an agitation of the Blood; hence it will be obvious to conceive, when the heterogeneous Particles by reason of the fault of Chylification, were heaped together in the mass of Blood to a fullness, presently upon its beginning to flow in order to the expulsion of that which was offensive, they being severed from the blood, as disagreeing with it, and partly being sent from the Arteries into the Ventricle, stirred up its ferment, and so produced hunger, and partly rushed into the predisposed meanings of the Brain, and there deposed the fuel, or rather incentive of the Headache which was presently to ensue. This Patient loathing all Medicines, and refusing undergo any method of Cure, became at length also obnoxious to paralitical and convulsive affects. From what is said it will be easy to give the Aetiology of any other Headache; viz. hypochondriacal, hepatical, or otherwise sympithical, so that it will not be needful to add here more Histories or Observations. CHAP. II. Instructions and Prescripts for curing the Lethargy. HItherto we have described with what Disease chief, and how diversely the precincts of the Head, or the Cover of the Brain are wont to be affected: Now, descending to its inward Parts, and to its cortical Substance, which immediately lies under those Cover, let us see to what affects chief this Part is found to be obnoxious. We have shown elsewhere that the Cortex of the Brain is the Seat of Memory, and the Entry of Sleep; wherefore we justly ascribe to the cortical part of the Brain that Disease which is wont to cause an excess of Sleep, and a defect, or eclipse of the Memory, to wit, the Lethargy. The word Lethargy is wont to signify two kinds of affects, which are only the act and disposition of this Disease; for those that are said to be troubled with a Lethargy, either altogether keeping their Beds, through a very great Invasion of it, are so far overwhelmed with Sleep, that they are scarce able to be raised by any impression of a sensible Object: nay, and if happy they open their Eyes, or raise their Limbs upon pricking, or a smart stroke, presently becoming insensible again, they sink down, and often, when they are left to themselves, falling into a perpetual Sleep they die out right: which kind of Fit has very often a Fever joined with it, though when the diseased awake, and come perfectly to themselves, for the most part it ceases of its own accord. Or secondly, those are accounted for Lethargical, who being oppressed with an immoderate deadness of the Senses, are in a manner always prone to sleep: so that in walking, nay whilst they are eating or doing any other thing, they now and then fall into a dead Sleep: and since there are divers degrees of this Sleepiness, and various manners of affecting, hence also there are made many Species of the Lethargic Disposition. at present we shall speak of the former Lethargy, and so properly called, and afterward of the continual Sleepiness, also of the Coma, Carus, and other sleepy affects allied to them: and likewise of continual Watching. Mean while you may observe, that almost in every kind of Lethargy, a Drowsiness or Sleepiness, and Forgetfulness are always present, as Pathognomick Signs, and equally attend it. Wherefore, that the formal Nature and Causes of the Lethargy may the better be known, We must first inquire here concerning Sleep and Oblivion, what they are, and for what causes they are raised. The Essence of Sleep consists in this, that the corporeal Soul withdrawing itself a little, and contracting the Sphere of its Irradiation, in the first place renders destitute the outward part of the Brain or its Cortex, and then all the outward Organs of Sense and Motion of the Emanation of the Spirits, and closes the Doors as it were; so that they being called in for refreshment sake, lie down, and indulge themselves to rest: mean while the pores and passages of the outward part of the Brain being free, and void of the Excursions of the Spirits afford a passage to the Nervous Liquor distilled from the Blood for new Stores of Spirits. In natural and usual Sleep, these two concauses conspire and happen together as it were by some mutual compact of Nature: viz. at the same time the Spirits recede, and that nervous Humour enters: but in nonnatural, or extraordinary Sleep, sometimes this cause, sometimes that is first: for either the Spirits being weary or called away withdraw themselves first, and afford an entrance to the Nervous humour heaped together in a readiness for it: or a plenty of Nervous humour coming to those Places, and making a way by force as it were, repels the Spirits, and entering their Passages, floats them as it were. Concerning Oblivion, or the Eclipse or defect of Memory, the cause of this is wholly the same as of immoderate Sleep, viz. an Exclusion of the animal Spirits from the passages of the outward part of the Brain, which are filled with some Humour, and their return prohibited for a time. Preternatural Sleep or insatiable Sleepiness (which is the chief Symptom in the Lethargy and in the sleepy Effects) seems to arise wholly from the same causes as non-natural Sleep, raised to a greater Energy, viz. either the animal Spirits being first affected leave the outward part of the Brain, and yield an entrance not only to the Nervous, but likewise to the Serous, or otherwise vicious Humour, or the serous and excrementitious Humours together with the Nervous force open the cortical Gates of the Brain, and floating as it were its Pores and Passages, repel and drive away the Spirits thence: sometimes this Cause, sometimes that is the first and chief, and sometimes both happen together. Therefore the conjunct Causes of the Lethargy are, 1. a heaping together of a redundant or incongruous Humour within the Pores of the cortical part of the Brain; which depends on other, both procatarctick and evident causes: As to the former, both the Blood uses to be in fault, in that it sends morbific matter to the Part affected, and the Brain itself, in that it admits it too easily. The evident causes which join with these are chief, Over-eating, Drunkenness, and especially immoderate drinking of Wine and hot Waters, then upon such an Excess to sit up all night, or to sleep in the open Air: Moreover, a long suppression of an usual evacuation of Serum by other ways; Also if Spaw-waters, drank in a large quantity, are not presently discharged again by Urine, they threaten a Lethargy; the same also is caused by the recrements of other Diseases, coming to an ill or no Crisis, conveyed to the Head: so that a Lethargy happens upon acute, or long continued Fevers, and other Cronick Diseases, and very often upon a Headache, Frenzy, Empyema, and Colic. 2. In regard, as non-natural, so sometimes preternatural sleep gins from the Spirits being first dejected; therefore the other Conjunct cause of the Lethargy consists in a stupefaction inflicted on the Spirits, which proceeds either from Opiates taken inwardly, or from narcotick particles engendered in the Body. The sum of what is said concerning the Lethargy, is this, that the animal Spirits residing in the outward part of the Brain being stopped from their wont motion and emanation, yield to a profound and insatiable Sleep; Now they are stopped either through their own fault, in as much as being spent, or affected with a stupefactive force, they are congealed as it were; or because their Paths or tracts are obstructed in the outward part of the Brain, and are possessed by a strange guest, so that they have not a space granted them fit for their expanson. The chief Symptoms of this Disease, are Sleep and Forgetfulness; a cessation of every other knowing, or spontaneous function, an uneven and slow respiration, a Fever, and often the affect growing worse, Cramps, leapings of the Tendons, and lastly, universal and mortal Convulsions. The prognostic of the Lethargy is included in very narrow bounds; for the Fit of the Disease being for the most part acute, is soon terminated in Death, or a Recovery, and most commonly is wont to give more cause of fear than hope. If it happens upon a Fever that is malignant, or of a difficult determinations, or if upon other cephalick or convulsive Diseases, as the Headache, Frenzy, Mania, Epilepsy, or also if on a long continued or severe Colic or Gout, the Physician can prognostic nothing but ill, nor is it less to be feared, if it happens in a cacochymical Body, or in one long subject to sickness, and in old age. In like manner, it is an ill Omen, if the Diseased being presently overwhelmed with a great deadness, and becoming almost Apoplectical, cannot be awaked, if he breathes unevenly and flowly, or with great snoaring: Moreover, if the Disease growing worse and worse, the sick Person be affected with Tremble, Cramps, leapings of the Tendons, and lastly, with convulsive motions, he is to be looked upon as in a desperate condition. But if the affect without any great Procatarxis, be raised by an evident Cause alone, as from over-eating, drunkenness, the use of Narcoticks, or from a stroke or wound of the Head that are not very dangerous, we may expect a less fatal event. Moreover, if the affect arising on such an occasion, happens to a Body which was sound and robust before, if at the first invasion it does not wholly take away the Sense and Memory, and after a little time the symptoms begin to remit, we may not despair of such a sick Person. In any Lethargy, if the cause of the Disease seems somewhat to be shaken and moved, so as plentiful and laudable evacuations by Sweat, Urine, or Siege happen by the help of Medicines, or by the instinct of Nature, and give ease; if upon the application of Vesicatories, a great glut of filthy Waters flows forth; if inflamed swell, or great bushes arise behind the Ears, or in the Neck; if a great sneezing with a dropping at the Eyes or Nose shall happen, we may thence conceive some hope of recovery. And sometimes an Empyema happening upon a Lethargy, puts an end to it, viz. inasmuch as the morbific matter which was fixed in the Head, and first caused the Lethargy, being afterward drank up again by the Blood, and deposed in the Breast, produces the Empyema: In the description of the Epidemical sleepy Fever, which reigned An. 1661. we have observed that this happened to many. Concerning the Cure of this Disease, since it allows no truce, we must not be long deliberating: After the injection of a smart clyster, presently let a Vein be opened; for the Vessels being emptied of Blood, more readily drink up again the Serum, or other humours deposed in the Brain: Moreover, I advise in this case the Jugular Vein to be opened, rather than a Vein of the Arm, because by this means the Blood very much heaped together, and haply stagnating within the Sinus' of the Head, will be more easily reduced to an even circulation. After Bleeding, other Remedies of every kind are presently to be applied to use; let large Visicatories be applied to the Neck and Legs; the Faces and Temples are to be anointed with Oil of Amber, or Cephalick Balsams; let Cataplasms of Rue, Pepperwort, or Crowfoot, well pounded together with black Soap and Sea-Salt be applied all over the Feet, let smart frictions be used to the Limbs, let Salt of Urine, or Spirit of Sal Armoniac be frequently held to the Nostrils. In the mean while let Cephalick Remedies be now and then taken. Take Water of Peony Flowers, Black Cherries, Rue, Walnuts simple, of each three ounces, compound Peony Water two ounces, Castoreum tied in a Nodulus and hung in the Glass, two drams, Sugar three drams, mix them, make a Julep; let four or five spoonfuls be taken every third or fourth hour; moreover, to each dose of this add from twelve to fifteen drops of Spirit of Hartshorn, Amber, or Shall Armoniac, or a paper of the following Powder. Take Powder of Male Peony Roots, Man's Scull, Roots of Virginia Serpentary, Contrayerva, of each a dram; Bezoar, Pearl, of each half a dram; Coral prepared a dram, make a Powder, divide it into twelve parts. Moreover, it is here to be considered, whether a purging by Vomit or Siege ought not to be ordered just at the beginning. I know that this is variously controverted amongst Authors, and I have known it used in practice with a various success: which being considered, and compared betwixt themselves, I shall briefly declare what is my opinion. If a Lethargy has arose from a fresh over-eating, or being drunk, or if from taking improper and narcotick things, presently let a vomit be raised: Wherefore, let Salt of Vitriol be given, with Wine and oximel of Squils; or in robust Persons, an infusion of Crocus Methallorum, or Mercurius Vitae, with Black-Cherry Water: and afterward, unless it works of its own accord, let a Vomit be provoked, by thrusting a Quill into the Throat. But if the invasion of the Disease happens upon a Fever, or other Cephalick affects; or if it be raised primairly, or per se, by reason of a Procatarxis first laid in the Blood, or in the Brain, Vomits and Purges given presently at the beginning, whilst the matter is flowing, are wont oftener to do more hurt than good: to wit, inasmuch as whilst the humours are in motion, those Medicines more exagitate them; and since they are not yet able to subdue them, and lead them forth, they drive them into the part affected. On the second day, if the dead sleepiness be not yet remitted, let bleeding, in case the Pulse indicateth it, be repeated, or in its stead let Blood be taken away in the Shoulderblades by Cupping-glasses after Scarification: Then a little afterward let an Emetic Medicine (if nothing prohibits it) or a Cathartick, be given. Take Sulphur of Antimony five grains, Scammony sulphurated eight grains, Cream of Tartar six grains; mix them, make a Powder, let it be given in a spoonful of the Julep prescribed. Or, Take Scammony sulphurated twelve grains, Cream of Tartar fifteen grains, Castoreum, three grains, make a Powder: give it after the same manner: Mean while let the same, or the like altering or deriving Remedies be still continued. On the third day, and afterward, those things which at the beginning of the Disease were forbidden for fear of a new fluxion, viz. Errhines, Sneezers, and Apophlegmatisms ought to be used. Moreover, than it will be sometimes profitable to apply the warm Viscera of a fresh killed Animal to the Sinciput, after that the Hair is shaved or cut, and now and then to change it; and sometimes also to foment those places with a cephalick and discussing Decoction: But beyond other Topics, I have known great relief given by a large Vesicatory, raising Sores that ran very much all over the Head: I saw two Lethargical Persons cured chief by this Remedy, after that the Disease was protracted in length, and therein having lost not only the memory, but even all knowledge: for in both, the excoriated places, in regard they could not easily be covered with an Eschar, discharged a vast quantity of a thin Ichor, to wit, daily about half a pound. It will not be needful for us to describe or set down other Medicines of this kind, they being vulgarly and every where to be found, what remains, for the illustrating of what is said before, I shall give you some Histories of sick Persons. A Husbandman about thirty years of age, of a phlegmatic temperament, inclining to a sanguine, being long obnoxious to requent headaches, about the beginning of Winter became very sleepy and drowsy; afterward, on a certain day when he was tilling a field, he laid himself on the ground, and fell into a profound Sleep; and when he could not be awaked by a Servant, and other Persons called, being carried home he was put to bed: his Friends in the mean while expecting that the Sleep being at length ended, he would awake of his own accord. After the space of twenty four hours was past, when they were not able to awake him by pinching, pricking, making a noise, and other ways, they call me; when I came, I applied a large Vesicatory presently to all the hinder part of his Neck, than Blood being drawn to sixteen ounces, I ordered a smart Clyster to be given, his Face and Temples to be anointed with Oil of Amber, Frictions, and painful Ligatures to be used to his Legs: Moreover, I prescribed Spirit of Soot to be taken often in a day with a cephalick Julep: notwithstanding he lay stupid all that day, without any sense, if, being irritated by hard pinching, he raised himself a little, and opened his Eyes, presently falling down and closing them, he yielded again to his Lethargy. About the Evening I ordered Cupping-glasses with much flame to be applied to his Shoulderblades, which being done, he began to become a little awake; and as about that time he purged freely by Siege, and the Plasters being taken off, a great deal of Serum flowed from the little bladders, we had thence a great hope of his Recovery. Therefore Remedies being frequently used afterward that night, awaking the morning following, he knew his Friends, and answered well to what was asked him: but the whole cloud did not yet vanish, for he continued sleepy and forgetful for many days, till being twice purged he perfectly recovered. a Oxford Gardener, sick of a putrid Fever, and about the height of the Disease, instead of a Crisis falling into a Lethargy, was overwhelmed with a drowsy evil for three or four Days afterward, that he could not be so roused from his Sleep by the use of any Remedy, as to become perfectly awake: but at length, when his Head being shaved, and Vesicatories being applied almost all over it, had raised a great many Sores that flowed plentifully, awaking from his Sleep, he recovered some sort of Sense: nevertheless his Memory being almost wholly abolished, he was so stupid, that remembering no one's Name, or Words, he had scarce more apprehension than a Brute. When he had lain after this manner for almost two Months void of Understanding, and full of Sleep, the cloud began by degrees to be dispersed; and he at length returning to his wont Labours became indifferently well, though he never got again the same Vigour of Mind, and former quickness of Sense, which he enjoyed before the Disease. As for a Lethargy arising from the use of Opiates, I remembr I formerly observed a good exact type of it in a Country Village, in which I was forc'd to stay a night, my Journey being stopped by reason of bad Wether: For as I was just a going to bed, my Host entreated me that I would go and see two poor People in the Neighbourhood, who were affected after such a strange and miserable manner; which Office being induced to perform, not only through Charity but also Curiosity, I was willingly led to a very small and low Cottage, where I found an aged Father and his Daughter (in two little Beds placed here and there in the same Cell) overwhelmed with a most profound Sleep, which had oppressed them the day before, after they had eaten Henbane-roots, then freshly dug up in their little Garden, which they mistook for Parsneps. To both these, after a Vomiting plentifully raised by pouring Oil and Oximel into their Mouths; and thrusting a Feather into their Throats, I prescribed tincture of Castoreum to be given frequently during the whole Night in a Spoonful of treackle-Water (which Remedies I then casually had by me); moreover that their Temples and Nostrils should be anointed with the same Tincture, and if it could be done, that a smart Clyster should be injected: the day following, first the old man, and afterward the Daughter, awaking, came to themselves, the dead sleep being wholly shaken off, in these Persons, after the remainder of the Narcotick being cast up by Vomit, lest it did farther mischief, it was only needful that the Spirits being raised up by fit Remedies (in the number of which Castoreum is justly accounted against the Poisons of Opiates) they should be freed from the Stupefaction inflicted on them. CHAP. III. Instructions and Prescripts for curing certain other sleepy affects, viz. the continual Sleepiness, the Coma, and the Carus. TO begin with the first; many Authors call this not a Disease, but a drawsie Disposition; for the affected as to other things are well enough, they eat and drink well, they walk abroad, they take care indifferently of their household Affairs, but in speaking, or walking, or eating, nay their Mouths being full of Meat, they now and then nod, and unless they are stirred by others, they are presently overwhelmed with Sleep: and after this manner they Sleep almost a continual Sleep, not only for some Days or Months, but for many years (as it is reported of Epimenides.) Wherefore we judge this Affect by which we are defrauded of more than half of our Life, to be really a Disease and to deserve a cure. The seat of sleepiness, as of the Lethargy, is to be placed in the outward part of the Brain, but with this difference, that the material or conjunct cause of this Disease, though always pressing at the entrances of the Brain, does not penetrate so deep as it is wont to do in the Lethargy; but affects in a manner only the surface of the Brain, or the mere cortical substances of the Anfractus, the medullary part within being as it were untouched; in which regard it differs not only from the Lethargy, but also from the Coma, for in the affect which we describe, though Sleep be continually pressing, yet it is easily broken off: and moreover being perfectly awaked the diseased remember a great many things, discourse with the Friends, being presently ready to fall again into their sleepiness: whence it appears that the cause of the Disease sticks only in the outward border of the Brain, nor does it enter deeply its substance, as in other sleepy affects. This affect, as I have observed in many, is not very dangerous; for either (as it is often done) it is perfectly cured, or at leastwise continuing for many years, without a Carus or Apoplexy (which are wont to be feared) it does not presently become mortal or terrible: the release of this affect often happens upon the change of the seat of the Disease: to wit, the Brain becoming clear, the morbific matter is conveyed to the Cerebellum, where lying, it produces Tremble of the Heart, the Asthma, Faintings of the Spirits, and other troublesome Symptoms accounted for Hypochondriacal. The Therapeutic method suggests chief these intentions, viz. that after a provision being made for the whole by bleeding (if it be proper) and by purging, these Remedies may be afterward carefully given, with which the Blood and Brain may be freed from their watery filth, and the later may be corroborated, that it may not for the future receive and retain serous Superfluities. For these ends let the Pilulae de Succino, or Cochiae, be given with Rosin of Jalap once or twice a Week: at other times going to bed, and early in the Morning, let a dose of a Cephalick Electuary, or of the Spirit, or Tincture of Sal Armoniac, Amber, Soot be daily taken, with a Cephalick Julep. The Forms of which may be chosen from those before written: At eight a Clock in the Morning, and at five in the Afternoon, let a draught of Coffee be taken, first boiling in the Liquor of which it is prepared, Leaves of Sage or Rosemary, till it acquires a green Tincture: for ordinary Drink let a Decoction of Guaiacum be taken, adding about the end, Leaves of Sage, Betony, and other cephalics. Moreover it will be profitable to make two large Issues betwixt the Shoulder blades, and likewise frequently to apply Vesicatories about the Neck; the Hair of the Head being cut off, let a little Cap of Cephalicks and Armoaticks be worn. Let a Vessel filled with Salt of Urine, or Spirit of Sal Armoniac, be now and then held to the Nostrils. Moreover an exact form of diet being ordered, let some Servants, attending the Diseased, not only stir him up now and then as he falls asleep, but keep him waking daily for some set Hours. A certain Gentleman, of a sanguine temperament, and, whilst he was young, of an acute and subtle understanding; afterward, in his declining age, being given to Idleness and Drunkenness, became dull and torpid, and likewise Hydropical with a great Paunch, and swell of the Thighs and Legs: but from these Diseases (into which he frequently fell) if at any time he abstained for some while from his drinking, and applied himself to Physic, he both often and soon recovered: but at length though free from his Dropsy, he was oppressed with so great and almost perpetual Sleep, that he would be sleeping in all places, and doing any thing; moreover, being awaked by his Servants or Friends, he was wont to be present enough to himself, and to discourse well enough for some Minutes of an Hour, of things proposed, falling presently again into his Sleep: To this Person, after many Medicines tried almost to no purpose, I prescribed at length that he should take every Morning and Evening a Spoonful of the Powder of the Leaves of Betony dried in the Summer Sun, and kept in a Glass, in a little Draught of Water distilled from the Flowers of Lavender: by which Remedy receiving ease within a few days, he was perfectly cured within a Month's space, and enjoyed an entire Health for four years from that time. Afterward when by reason of an ill course of Diet the same evils returned, he repeated the same Remedy, though not with so great success. But besides there being need also of other Medicines, he took sometimes Spirit of Hartshorn or of Soot, with an appropriate Julep; sometimes Electuaries of Cephalick Conserves and Powders, adding sometimes steel. As often as he would indulge himself to his wont genius of drinking, instead of Wine or Beer, he drank Coffee: moreover for his ordinary drink, he had sometimes Ale with the Leaves of Scurvygrass, Sage and Aromaticks infused in it, sometimes a Decoction made physical with Woods, Spices and Cephalick Herbs, for many years. Afterward, being in a Manner always intemperate and cacochymical, yet he lived free from the Lethargy; at length a Cachexia seizing his Breast, being cast down by degrees by a Cough with an Asthma, he died. The next sleepy affect, viz. somewhat greater than the former, and less than the Lethargy, is that which is vulgarly called the sleepy Coma: those that are obnoxious to this, for the most part are oppressed with a great sleepiness, to which in a manner always giving themselves over, they lie with the mouth open, and the lower Jaw fallen, more like to Persons dead than living: being stirred up by hard pinching or pricking, they look about them, speak to the standers by, answer to things asked, but presently sleeping again, they seem very much troubled to be hindered or disturbed from Sleep, thus pleasingly stealing upon them: and being indisposed after this manner, they continue in a sleepiness for many days, nay, and sometimes Months, without a Fever accompanying it, or following it, or an injured respiration, and being easy to be awaked, and not very forgetful, in which things they differ from Lethargical Persons: mean while they differ no less from others troubled with the affect even now described: for as much as those that have the Coma, keeping for the most part to their Bed, or a Chair, do not walk abroad, or take care of domestical Concerns, as the others. They answer appositely to some short Questions, but are not able to hold a Discourse, or deliberate of things to be done. The cause of this doubtless is of the same kind as of the former Diseases, but of a middle degree betwixt both before described. For we may conjecture that in this affect the morbific matter penetrates the Brain a little farther than in the continual Sleepiness, viz. that it invades the outward parts of the Anfractus or Gyri, together with the lesser Branches of the Medulla enclosed: but that it does not reach to the greater Sinus' of the Medulla joining to the Corpus Callosum, and which are wont to be possessed in the Lethargy. The Coma sometimes beginning primarily and of itself, as the Lethargy, either proceeds from a serous filth discharged from the Blood on the Cortex of the Brain, or from a stupefaction inflicted on the Spirits there residing: and then this affect, by how much less it is than the Lethargy, by so much is it accounted less dangerous, but more commonly this Disease ensues upon other Cronick or acute distempers, viz. the Headache, Convulsions, and most frequently upon Fevers of an ill crisis, especially in Children, old, and phlegmatic people. Some years since, in an Epidemic Fever, happening through the affect of the Nerves (which we have elsewhere described) as I observed some to be Lethargical, so many to be troubled with the Coma: of whom a great many recovered, the morbific matter being conveyed from the Head into the Breast: Moreover, in other cases this affect being of a doubtful event, betwixt hope and fear, requires the sedulous care of a prudent Physician. In a Primary Coma the Therapeutic method suggests to us the like, and in a manner the same intentions of healing as in the Lethargy: As to the morbific matter, we must endeavour, both that its new afflux to the Brain, and that which is already sticking in it, be discussed, or drawn away: Moreover, the Animal Spirits ought to be raised up, and all drowsiness or stupefaction ought to be shaken off from them. For this end we must order Purging, Blooding, Cupping-glasses, Vesicatories, Revulsing and discussing Topics, give Cephalick Medicines, and especially such as are endowed with a Volatile Salt, and use many other ways of administrations . But if this Disease ensuing upon other affects, happens to any Person whose Body is much worn away, the Blood vitiated, or greatly depauperated, we must seriously deliberate concerning letting Blood; and Purging before we order them, nay, and for the most part we must abstain from them: though sometimes, that the conjunct cause of the Disease, or the matter sticking in the Brain may be put in motion, it may be convenient to draw Blood in a small quantity from the Forehead, or from the Temples by Leeches, or from the Shoulderblades by Cupping glasses, with a Scarification: Vesicatories have a chief place here, not only to be applied to the Neck or Head, but to the Legs and Arms, and to other parts of the Body by turns. Moreover, let Spirit of Hartshorn, of Soot, or of Sal Armoniac, impregnated with Amber, Man's Scull, Coral, and other Cephalick things be frequently given, with an appropriated Julep, or other Liquor. Forms of these, and of other Medicines usual in these cases, together with stories of sick Persons, and examples of their Cures, are to be found in the description of the foresaid sleepy Fever; so that I need not here again inculcate the same, or the like. There remains yet another sleepy affect, or kind of the Lethargy, vulgarly called a Carus, which being greater than the Lethargy, and somewhat less than the Apoplexy, is so allied to this, that it often passes into it, but is wont to be distinguished from both: for those that have the Carus for the most part breath well, if at any time they are hard pinched, they move their members, sometimes raise up themselves, open their Eyes, and often speak, which Apoplectical Persons do not do; but the same, though stirred or roused up, scarce understand, or plainly discern any thing, in which respect they are distinguished from those that have the Lethargy. From what is said it seems to be manifest, that the conjunct cause, or morbific matter of the Carus, penetrates somewhat more deep toward the middle of the Brain, and to have its seat at least in the outward border of the Corpus callosum; and sometimes, as that matter gradually advances from one part to another, the Diseases successively arise, and each last is only the increase of the other. But sometimes the morbific cause, without a gradual progress through those Parts, at the first assault affects the middle part of the Brain, and there (as it sticks shallower or deeper) causes a Carus, or Apoplexy. In which case it must not be thought that the whole circumference of the Corpus Callosum, as also of the cortical part of the Brain is possessed by the soporiferous matter; for it suffices, that rushing into any one place, it has seized some part of the middle, for thereupon presently in all that Region follows an eclipse, or at least a prosternation of the Spirits. The Prognostic of a Carus for the most part is ill, especially if the Disease happens upon a malignant or long continued, or a slow Fever not determined, or on that which happens in Childbirth: Nor is less danger threatened, if it succeeds other Cephalick Diseases, or is raised by reason of a wound in the Head; though in these cases sometimes there is a Cure. The event of this Disease either for death or recovery is wont to be various: The Carus often passes into an Apoplexy, which soon kills; so that after the loss first of the animadversive faculty, in a while a deprivation of sense and mortion, and then by reason of the taint conveyed to the Cerebellum, alterations of the Pulse and Respiration, and in a short time Death itself follows. But sometimes the morbific matter sinking deeper, and falling from the Corpus Callosum into the Corpus Striatum, one, or both together, the Brain becomes a little clear; so that the Diseased look about them, speak and know things; nevertheless, in the whole Body besides, the Palsy, or Hemiplegia ensues: Neither are thus things in safety, as to Life; for often when the Brain gins to be restored, the Cerebellum is worse; so that thereupon the Spirits which execute the offices of the Vital, and mere Natural function being there ill affected, either Convulsions in the Viscera and Praecordia, or mortal let of the Pulse and respiration are caused: though sometimes when the morbific matter is neither too redundant, nor too malignant, it is partly drank up again into the Blood, and partly discussed, so that the Diseased perfectly recover. The Therapeutic method suggests the same intentions of Healing, and indicateth altogether the sanie Remedies, which are wont to be used in the Apoplexy: Wherefore it will not be needful to set down here Classes of Indications, or to heap together a mighty mass of Medicines, but that which seems more to the purpose: I shall here propose a story or two of Persons diseased, whereof I have a great many ready to relate. A worthy man, about forty years of age, having lost his health through intemperance, when he had begun to use I know not what Remedies, prescribed by an Empirick, fell into a Carus; haply because the morbific matter being stirred, and agitated by the Medicine, rushed into the Brain. Going to see him the second day, I found him buried in a profound sleep, and almost insensible; for though upon hard pinching or pricking he opened his Eyes, and moved his Limbs, yet presently falling asleep again, he perceived nothing at all of what he did, or endured. In this case, though declaring a sad Prognostic, however I did not forbear to use Physical means; abstaining from Phlebotomy, by reason of his strength being much spent, and his Blood depauperated, I presently ordered a large Vesicatory to be applied to his Neck, and a smart Clyster to be given him, of a decoction of Briony Roots, with Carminative Flowers and Seeds, adding likewise two drams of the species of Hiera: His Temples and Nostrils were anointed with Balsams: Cataplasms of Rue and Briony Roots were applied all over his Feet: Moreover, every other or third hour I gave him a dose of Spirit of Hartshorn, with a Cephalick Julep; and many other administrations, usual in this case, were carefully put in practice. To which nevertheless the Disease not at all yielding, the day following I prescribed him a Purge of Scammony prepared, to be taken in a spoonful of Broth: After which, when he had frequently and freely Purged, he began to open his Eyes, to speak, and to know standers by, and a little after, coming to himself, he fully awaked. This Disease (as I guess) was therefore cured more easily, and sooner than was hoped, because that cloud sent haply into the Brain by a Medicine, could the better be drawn thence by the help of another Medicine. A renowned man, fifty years of age, of a gross Body, and formerly abnoxious to a Vertigo, and asthmatick affects, had lived very sound for two years, having used Physic Spring and Fall, and having a large Issue near both Shoulderblades: At the beginning of Summer, he living in the Country, and his Issues being neglected for many weeks, the filth which was wont to be purged forth, ran much less from them; yet he was still in good health, till about the Solstice, when as he was sitting one morning in a Porch, and talked cheerfully with his friends, arising on a sudden he complained that he was ill: going in a doors, and setting himself down in a Chair, he vomited very much, then presently leaning to one side, he fell into a profound sleep, and lay so overwhelmed with it, that he could scarce be raised from it all that day. Coming in the Evening, I ordered Blooding, a Clyster, Vesicatories, and many other Remedies proper in such a case, carefully to be administered: The next day after, his Brain began to grow a little clear; so that he looked about, and spoke distinctly a few words: Seeming to know his Friends, he could tell no one's name; but by reason of this matter sinking deep in the Brain, a Palsy of the whole right side seized him. Moreover, a mighty sleepiness yet persisting, on that day Blood was taken from the other Arm: Other Remedies also being continued as before, on the third day, becoming less drowsy, he began to know many, and to call some by their names, to perceive his illness, and to be solicitous for Remedies: But whilst the Brain grew better, the injury communicated to the Cerebellum and Genus Nervosum discovered itself; for on the fourth day his breathing became uneven and difficult, and his Pulse weaker: Moreover, he was often affected with a shivering, and a Convulsive concussion of the whole Body: On the fifth day, the Cramps and Convulsions becoming more violent, oftener infested him; then the Pulse growing weaker by degrees, on the sixth day, though more free from sleepiness, he died: In this, and other the like cases, it's probable that the morbific matter invades the Brain and Cerebellum together; but whilst it sticks in the Cortex of this (contrary to what happens in the Brain) it causes no very sensible injury, because here the parts offended are neither the seats of sleep, nor memory: but afterward, haply about the fourth or fifth day, the matter sinking further to the Medulla of the Cerebellum; whilst as to other things the Diseased was better, the Vital function, by reason of the Spirits appointed for it being oppressed in their very source, began to fail, and afterward declining on a sudden, unexpectedly cut off all hope of recovery, which before was great. CHAP. IV. Instructions and Prescripts for curing the Watching Evil, and the Watching Coma. AS Light and Darkness, so Sleep and Watching being set together, excellently illustrate each others natures. Concerning a continual waking, or the Watching-Evil, we must in the first place here distinguish, that either it is a symptom which happens upon some other Disease, as a Fever, Frenzy, Mania, or Colic, Gout, and the like; and then its consideration and cure belong to that affect, whose offspring it is; or else immoderate Watch arising alone with out any other known cause, seems to be a Disease as it were of itself, as I have known it in some Persons, and some of these Watchers, though destitute of Sleep, seem scarce to want it, For the Spirits appear not thereby either torpid, or wearied, or exhausted: but others bearing ill watching, soon become thereupon languid, and lose their Stomaches, and are forced to have recourse to Opiates, which sometimes they use daily, and in a large dose without hurt. We have intimated before, that the cause of natural waking, which has Sleep interlaced with it, consists in these two things, viz. in one of them or both together; To wit, first, that the animal Spirits being sufficiently refreshed, and freed from the fetters of the Nervous Liquor, vigorously exert themselves, and are expanded every way, and especially from the middle part of the Brain to its circumference; then secondly, though they enjoy a clear space every where, and especially in the outmost part of the Brain, being then free from the incursions of the Nervous Juice; yet lest this expansion of the Spirits (which is being awake) be any where protracted longer than is fitting, to their too great loss, both the Spirits being now and then weary, flag, and as it were repose themselves of their own accord, and withal the Nervous Liquor coming to overspread the Cortex of the Brain, stuffs and closes their Passages. Hence it follows that preternatural and immoderate watching depends also on one or both of those two; for either the Spirits being two exorbitant, and struck as it were with a rage, do not retreat of their own accord, and withal the Nervous Liquor does not so fill and stop the Pores of the outward part of the Brain, that the Spirits may be forced thence inward to a repose: Types of both these every where present themselves to be observed. And first we may observe that the Animal Spirits becoming sometimes exorbitant, and so elastic, or otherwise irregular, cannot only be appeased and repose themselves, but are scarce able to be contained within the proper Sphere of their emanation; Wherefore being expanded in a continual watching, they so fill the Brain, and keep it extended, that the nervous Juice, though heaped together in a great plenty at the entrance, cannot be admitted; and if the Spirits are recalled inward from the Cortex of the Brain, for that to enter, presently being there restained, or making a tumult within the midst of the Brain, they raise a thousand, and often horrible Phantasms, with which Sleep is kept off; or directing farther their Tendency into the Genus Nervosum, they raise there great disorders which continually drive away, and break off Sleep, though seeming never so much to be stealing on, or to be at hand. As for the former of these, I have often observed some troubled with watching, who dreaded to begin Sleep, though it came on according to desire: for as soon as being about to sleep, they closed their Eyes, presently starting up again they cried out that a confused multitude of Phantasms made them mad, so that they found themselves necessitated to abstain from Sleep. Secondly, when the Spirits being become exorbitant, are called from the circumference of the Brain towards the inward parts in order to Sleep, sometimes they convert their Sallies into the Genus Nervosum, and then either rushing in a tumultuous manner into the Nerves that go to the Precordia, or Viscera, they cause disorders in the respective Parts; (hence to such as are so affected, as often as closing their Eyes they invite Sleep, either Tremble, Leaping, and Constrictions of the Heart, with Failings of the Spirits, and a letted Respiration happen or inflations and Swell of the Viscera, a Sense of Suffocation, and other Symptoms vulgarly accounted for hysterical) or secondly, the Spirits being called from their Watch, and converted to the Genus Nervosum, sometimes transfer their Sallies into the spinal Marrow, and thence into the Nerves that pass into all the outward Members: wherefore to some, when being a Bed they betake themselves to sleep, presently in the Arms and Legs Leapings and Contractions of the Tendons, and so great a Restlessness and Toss of their Members ensue, that the diseased are no more able to sleep, than if they were in a Place of the greatest Torture. Sometime since I was advised with for a Lady of Quality, who in the day time was wont to be afflicted with a Cardialgia, and a Vomiting, and in the Night was hindered from Sleep by reason of those spasmodick affects which came upon her as now and then she was upon the point of rest: nor indeed was she able to sleep all Night, unless she took first a pretty good dose of Laudanum: Wherefore of this Medicine which at first was allowed her only twice a Week, she took afterward daily for about three Months, receiving no injury thereby, either in the Brain, or about any other function, and when in the mean while by the use of other Remedies, the discrasies of the Blood and Nervous Juice being corrected, the animal Spirits became more benign and mild, she afterward leaving off wholly the Opium, was able to sleep indifferently well. As to the cure of the Watching-evil (which we even now described) because it cannot be long endured, therefore those things are chief to be given, which give a present relief: for this end those things are proper which sooth the Spirits, and gently appease their Disorders, as the vulgarly called anodynes, viz. distilled waters, Decoctons, Syrups, and Conserves of Flowers of Nymphea, Cowslips, Mallows, Violets, Knapweed, the Leaves of Lettuce, Purslan, the Willow, also Emalsions, or juicy Expressions. And if the restless Spirits will not be mitigated by fair means, we must force them to be quiet, by imposing Fetters as it were, and using Severity: their stores ought to be diminished, and withal the spaces in which they may freely, and without tumult expand themselves, aught to be dilated, and cleared from the stuff of other humours, viz. of Blood and Serum: for which ends opening a Vein sometimes is proper, Vesicatories in a manner always have place; moreover let Diacodium and Laudanum, in case they agree well, be frequently taken; and mean while that the Opats give truce from the violence of the Disease, let the cause of it be eradicated by the use of other Remedies, as much as may be: Wherefore day after day, at Physical hours, let things be given that take away the sharpness of the Blood and Nervous Juice, and restore them to sweetness. In which rank we account Testaceous Powders, Apozemes and altering distilled Waters of temperate Antiscorbutics, gentle preparations of Steel, spirit of Hartshorn, of Soot, and above all things, tincture of Antimony. There remains another kind of Watching-evil, whose cause consists for some part, if not mostly, in the almost continual opening or too great gaping of the Pores or Passages in the cortical part of the Brain: for besides that the animal Spirits being sharp and somewhat exorbitant, refuse to lie down of their own accord, and to yield to rest; and that they are not kept down or subjugated by the Nervous Liquor entering the Pores of the Brain, but being free and exempt from all imposed Burden, they are expanded also within the outward spaces of the Brain which are every where open for them, for which cause those that have the watching evil perceive no drowsiness or heaviness of the Sinciput, no appulse or desire of Sleep. I have known some affected after this manner, who when they had past many Night's one after the other wholly without Sleep, yet being still cheerful and brisk, having a good Stomach, and ready at business, seemed not as yet to have wanted Sleep. The cause of this doubtless is a and melancholy Blood, which supplies the outward part of the Brain with a Nervous Juice, not mild and benign, but too much scorched and filled with adust Particles, which consequently is neither apt to flay long within the Pores of the Brain, nor kindly to receive and contain the Animal Spirits: Moreover the Spirits themselves engendered from it become too elastic and restless in their Nature, so that they are neither easily appeased, nor inclined for Sleep of their own accord. Nevertheless, being of a fixed Nature, they do not readily fly away, nor are soon tired so as to flag, but last a long time and continue vigorous without any great refreshment. Concerning this sleepless Disposition of the animal Spirits, since it is the same as in Persons troubled with melancholy, we shall have a fit place of speaking somewhat more largely of it in the sequel. We may observe that Coffee also on the same account keeps Persons from Sleep, for that Drink insinuates its adust Particles (with which we find it to abound both by the taste and smell) first into the Blood, and then into the Nervous Juice, which thereupon by their Agility and Restlessness both keep the Pores of the Brain still open, and add spurs and a certain rage to the Spirits (all other Combination and Stupefaction being deposed) by which they are stirred up to a longer execution of their Functions. Again, as to what regards the prophylactick cure of this Watching-evil, or the removal of the morbific cause; we shall give it you in the Sequel, where we shall treat of Melancholy mean while for the immediate removal of that Symptom as often as it sorely presses, we observe that Opiates will not do; for being given in a good large quantity they seldom cause Sleep, and render the affected more faint and weak. It often succeeds better if going to bed they take some gentle and pleasant drink, as especially our Ale being clear and mild, or also posset drink with Cowslip Flowers boiled in it, or an emulsion of the Seeds of Melons and Almonds in a great quantity, viz. to two or three pounds. I was advised with some time since for an old hypochondriacal man, who, besides other symptoms usual in that case, had lived for many years obnoxious to a frequent, loud, and very troublesome belching: He was wont every day to fall a belching twice or thrice, for about two hours together, and with so great a noise that he was heard to a great distance: But sometimes for a week or two, and sometimes for a month, that belching was changed into a watching; for the former affect becoming much more remiss, the worthy man passed often whole nights without sleep; and when sometimes he had been constantly waking for three or more days, not yet seeming to want sleep, he complained of no drowsiness, dulness, or failing of the Spirits. Narcoticks having seldom or never given him relief, he took sometimes in the evening Posset-drink made with Ale, or Canary; at the beginning of the night he drank sometimes Ale, sometimes Distilled Waters, by the use of which a little sleep often followed; then afterward the Watching-evil vanishing by degrees, the belching returns. Whence it may appear that the cause of both was the same, viz. adust and irritating Particles sent from the mass of Blood, sometimes into the Coats of the Stomach, sometimes into the cortical part of the Brain. 2. Besides these distinct affects or exorbitancies of sleep and waking, there remain other conjunct or complicated irregularities of them, in which the acts of both functions are perverted together, which we may observe in the affect vulgarly called the Watching Coma; concerning which we shall now speak in short. Those that are troubled with the Watching Coma, though they are always inclined to sleep, yet they can scarce sleep at all, but seem, like Tantalus, to stand always up to the Lips in the River Lethe, for sipping of which, whenever they sink themselves deeper, the yielding Waters always subside lower. They feel a very great heaviness of the Head, with a drowsiness of the senses, and all the faculties; so that they are troubled to move themselves any way in their Bed, or to be disturbed by the speech of standers by, that speak to them, still expecting to fall presently into a quiet sleep: to which nevertheless when they wholly yield up themselves, and endeavour straight to embrace it, various phantasms presenting themselves to their mind, keep them still waking, nor permit them at all to enjoy that Sleep which seems always to be ready for them. To this often is added a Delirium, so that whilst the Diseased lie with their Eyes closed, they talk always absurdly and at random, and throw their Arms and Legs this way and that in a disorderly manner, and being awaked, look ghastly. It's a usual thing for such as are in Fevers to continue all night overwhelmed with a sleepiness, as it were; but so that in the mean while they are scarce silent for a quarter of an hour, but mutter various things with themselves, nay, sometimes cry out, howl, and leap out of Bed. If the reason of this be enquired into, it seems that we ought to say, that the Pores and Passages in the Brain, which are the avenues of the Spirits, are very much possessed by a gross and soporiferous matter, sent from the mass of the Blood, so that the Spirits being very much letted from their wont expansion and mutual commerce, a great and invincible Sleep seems presently to be at hand: but in as much as certain sharp and very active Particles stick to those Spirits as so many stings, they are incessantly incited to motion, and therefore some of them forcibly pass the ways, however stopped and beset with fence, and meet against each other directly or obliquely, according as they can find a way: and such their motion, though it be not able to procure a complete exercise of the animal function, yet it easily hinders its rest and cessation, so that those that are troubled with this Disease keep betwixt Sleep and wake. The Watching-coma is seldom a Disease of itself, but for the most part is a symptom, and happens upon other affects, as a Fever, the Frenzy, Lethargy, and the like, wherefore, it does not require a peculiar method of Cure; but it seems only to be needful, that to the Remedies primarily indicated, other Cephalicks be joined, which may disperse these meteors, as it were, like Clouds and Lightning; or if both of them cannot be exterminated together, let the Medicine join itself to the aid of one affect, by which that being become superior, let it presently overcome the other; so in a sleepy Watching it is proper to procure either a perfect Sleep or a perfect Watching; and in this case I have often given Narcoticks with good success. CHAP. V Instructions and Prescripts for curing the Incubus or Nightmare. SO far of the irregularities, or morbid Exorbitancies of Sleep and Watching, which being proper to, and as it were peculiarly attending the Brain, affect the Cerebellum but rarely, and only secondarily; but there remains an affect (vulgarly called the Incubus or Nightmare) which being peculiar to this Region, and in some sort analogous to the soporiferous Diseases; in as much as its Fits arise in a manner from hence, that by reason of the Animal Spirits being bound or suppressed in the Cerebellum, an Eclipse or interruption of them (though short) is caused in the exercise of the vital Function. That the nature of this Disease may be the better known, in the first place let us consider its Phoenomena. A Fit of the Incubus most commonly, and in a manner only seizing us whilst we are asleep, is wont to be raised for the most part after the Stomach's being loaded with food of ill digestion, and a lying on the back in bed: those that are troubled with it seem to perceive themselves chief offended with it in the Breast and about the Praecordia: for respiration being suppressed or very much hindered, they think themselves oppressed with a certain weight lying heavily on the Thorax, which weight cheats their imaginations sometimes with one Apparition, sometimes with another; and when they think to shake it off, or put it from them by the motion of their Body or Limbs, they are not able to stir either their Body or any Limb any way; but after a long struggling in the Praecordia, and sometimes almost to the loss of Life, at length they awake, and being fully come to themselves from their sleep, the imaginary weight vanishes on a sudden, and the moving force of the Body is restored, there remaining nevertheless for the most part a trembling of the Heart, and often a very quick and violent vibration of the Diaphragm; afterwards, the Fit being ended, the deception of the Fancy, apprehending the dreadful species of an Incubus, comes also to be known. Now, though we allow the monstrous Species (which is conceived) of the Incubus to be a mere Dream; yet it is manifest that the Praecordia are really affected, and that the motions of the Pulse and Respiration are in a manner suppressed or letted, viz. in as much as that oppression of the Breast is plainly perceived by many whilst they are awake, nay, as they are freshly stirred from sleep, and when that is removed, tremble and disorderly motions of the Heart and Diaphragm ensue; whence it follows, that these Parts are cumbered, and undergo a real damage. Wherefore, whatsoever others may think, I judge that a Fit of the Incubus is caused, insomuch as in sleeping a certain incongruous matter is distilled into the Cerebellum together with the nervous juice, which causing a heaviness or certain stupefaction to the Spirits in their first source, forces them presently to forbear a little from the performance of their Functions; so that by a second Lethargy, as it were, raised within the Cerebellum, the vital actions suffer a short Eclipse; during which, partly from the striving of the overcharged Praecordia, and partly from the Blood being very much heaped together and stagnating within them, that oppression, and sense of an incumbent weight, as it were, is caused: moreover, because all the other faculties of the whole Body depend on the motion of the Heart, therefore this being hindered and suppressed, those presently fall into faintings and disorders. Tho it be seldom that any Person dies of this Disease alone, yet those that are frequently obnoxious to it, if at any time they are seized with other cephalick affects, as the Lethargy, Carus, Apoplexy or Lethargy, they are in a very dangerous Condition, because the morbific matter, sent from the Blood into the Brain, easily invades the Cerebellum also, being so predisposed; so that the Diseased suffering an Eclipse of the vital function together with the animal, are brought into a greater danger of Life: hence it's a common observation, that those that are wont to be frequently troubled with the Incubus often die Apoplectical. Another Issue of the Incubus is wont to be less pernicious, that it often leads to the passion of the Heart, and other Affects commonly accounted for Hypochondriacal. I have known many troubled with the Incubus in their Youth, who, as they grew farther in years, being free from that, were affected with a Trembling and Panting of the Heart, and with other Griefs about the Precordia, and Hyphochondres, and very sorely with Convulsions; we judge the cause of this morbid change to be, that the morbific Matter, after having been often wont to beset the circumference of the Brain, at length, making a violent assault, penetrates deeper into some private Place, and passing its texture, rushes into the Nerves appointed for the Precordia. As to the Cure of this Disease, for as to its Fits, because they soon pass away of their own accord, there is no need of it: the therapeutic Method, after a provision to be made for the whole by blooding (where it is proper) and a gentle Purge, suggests to us the chief use of those Remedies which are vulgarly accounted Cephalicks: therefore the Powders of Amber, Coral, Pearl, Roots of male Peony, bastard Dittany, Contrayerva, also Electuaries, Tablets, distilled waters, Tinctures, Elixirs, and other things wont to be prescribed in the Lethargy and Apoplexy, have place here; but in the first place, a due form of Diet being ordered, let food that is gross, and of an ill concoction, Pulse, and horary Fruits be avoided, nor must the Person indulge himself to sleep, studying, or reading presently after eating: let large and late Suppers, and lying on the back be forbidden. Because Infants and Children are often troubled with this Disease, (a sign of which is, that they are shaken in their Sleep, and upon their awake cry out terribly) and having undergone frequent fits of it, often fall into convulsive affects: therefore as soon as they seem affected with it, let a due method of cure be used to them: let it be enquired concerning the Milk they suck, whether of itself being without fault, and landable, it agrees well with their Stomach? let them not be permitted to Sleep presently after having sucked their fill: Let the Nurse, using a good form of Diet, take also Morning and Evening a Dose of a Cephalick Powder or Electuary, drinking after it a draught of Posset-drink, with the Leaves of Sage, or Betony, or the Roots or Seeds of Peony boiled in it: Let the Infant take twice a day a Spoonful of an appropriate distilled Water: Let it have an Issue in the nape of the Neck, let it lie sometimes on one side, sometimes on the other, but seldom or never on the back. It will not be wholly without benefit, for it to wear about the neck or on the pit of the Stomach, Coral, or Bracelets made of the Seeds or Roots of male Peony: If at any time in sleeping, being often and sorely shaken, they seem to be dangerously affected with this Distemper, let Vesicatories be applied to the Neck, or behind the Ears; Moreover Evening and Morning let a Dose of the Pulvis de Gutteta, or some other that is appropriate, be daily given in a Spoonful of distilled Water, or in Juleps. CHAP. VI Instructions and Prescripts for curing the Vertigo. AFter having viewed the outward circumference of both Brains, and discovered the Diseases that beset the sensitive Soul, about the first beginnings, and the first sources of the Animal Spirits; now descending to the middle of the brain, where the Fancy and common Sense reside, let us see to what affects these Parts are obnoxious. Concerning this, let it be observed in the first place, that of the Spirits residing in those places, sometimes Troops, or rather mighty Armies, sometimes also small handfuls are affected; and than that the same, whether many of them together, or a few only are affected, either from their heterogeneous combination are made elastic, and consequently are forced into disorderly, or rather explosive motions, as in a Fit of the Epilepsy; or undergoing an Eclipse, as in the Apoplexy, are deprived of all motion: We have discoursed amply enough before of the former spasmodick affect of the Spitits; and concerning the Apoplexy we shall treat in the sequel. At present we shall speak of a certain Passion belonging to these Parts, viz. the Vertigo, in which some Files of the Spirits are affected, and their motions seem partly to be perverted and partly to be suppressed. The Vertigo is thus described, viz. that it is an Affect in which visible Objects seem to turn round, and those that are affected with it find a great trouble or confusion of the Animal Spirits in the Brain, so that they do not duly influence the Nerves: wherefore the seeing and locomotive Faculties often somewhat waver, so that the Diseased fall down and are often offuscated with Darkness. In a fit of this, it is to be observed that the Imagination and common Sense are in some sort deceived: whilst they think the Objects that stand still do move, but the rational judgement holds good, for we know our Error. That the morbific cause of the Vertigo, and the preternatural way of its happening may be known, we must inquire after what manner the same affect, how suddenly soever it comes upon us, is wont to be raised by non-natural things, for by a long turning round of the Body, by looking from an high place, passing over a Bridge, by sailing in a Ship, or going in a Coach, by Drunkenness, or taking Tobacco, and certain other ways, Persons every where become Vertiginous, or contract a Giddiness: which Affect those occasions produce, in as much as the animal Spirits being greatly disturbed in their set Series and orders, are both moved loosely and in a disorderly manner this way and that within the Passages of the Brain, and break off certain Lines or Threads, as it were, of their wont irradiation into the genus Nervosum; for those two things being in a manner always reciprocal, mutually succeed and depend on each other, viz. the Perturbation of the Spirits within the middle of the Brain, and their letted emanation into the genus Nervosum: On whatever cause either affect is produced, presently the other follows. A turning round of the Body, being carried in a Coach, or Ship, also Drunkenness, an unusual taking of Tobacco, force the Spirits to fluctuate or to reel disorderly in the Brain, which thereupon are presently hindered from their due emanation into the Nerves, so that the Persons affected are scarce able to stand or go; In like manner, a looking from an high place, passing over a Bridge, a Fainting or Swoon seizing us, recall the Spirits from their wont emanation into the genus Nervosum, which therefore falling in a tumult, or being disorderly moved within the Brain, cause a Scotomia or a running round of Objects. these things being thus premitted concerning the Vertigo, raised by reason of some accident, or by some evident, solemn, and non-natural cause; we must now inquire how, and after how many ways it is wont to be produced by an and preternatural cause. Concerning this you may observe, that the Vertigo is sometimes a symptom depending on some other affect, seated sometimes within the Brain, sometimes without it; but that sometimes it is a Disease by itself, which being raised within the middle of the Brain, is very troublesome, and often terrible, and difficult to be cured. As to the former, many Diseases of the Head, viz. an acute Pain, the Lethargy, Epilepsy, Carus, Apoplexy, with many others, have often a Vertigo joined with them, viz. inasmuch as an even expansion of the Spirits in the Brain, and their irradication thence into the Genus Nervosum, is lightly disturbed from those various morbific causes. Moreover, this symptom is wont sometimes to be produced by reason of other affects seated far from the Brain, and that chief after two manners; For first, it is usual for a Scotomia to arise by reason of the afflux of Blood called on a sudden from the Brain, as in a swoon, and great fainting, in great hunger, hard labour, a very great hemorrhagy, long fastings, violent passions of fear or sadness; nay, through other occasions, if at any time the motion of the Blood fails or falters in the Heart, so that the affected are ready to fall into a fainting of the Spirits, presently because the supply of the Vital Liquor is withdrawn, the Animal Spirits also failing in the Brain, withdraw their irradiation from the Genus Nervosum: For their Head-spring being cut off, those that remain flying back from their emanation, run to and fro confusedly in the Brain, and raise vertiginous, and often delirious affects. Secondly, a disorderly retreat of the Animal Spirits from some one of the Viscera, or some outward member into the Brain, often causes a Vertigo, viz. inasmuch as the Spirits being troubled in a long series from the Part affected by the Ductus' of the Nerves, at length trouble others inhabiting the middle part of the Brain, and force them into the like disorders: for this cause it is, that sharp humours twitching the Fibres of the Stomach, and that often an offensive and irritative matter stirred in the Spleen, Pancreas, or Intestines, and an acute pain, Ulcers, etc. in the Foot or Arm, often cause light Scotomias in the Brain. But the Vertigo is not only a symptom, but sometimes is a disease primarily, and of itself: for the through understanding of the nature of which, we must inquire into its subject, formal state, and causes. The Immediate Subject of the Vertigo are doubtless the Animal Spirits, which every person troubled with this affect perceives to be very much troubled, and to move about in a confused manner; but the mediate subject are those parts of the Brain in which Imagination and common sense reside, and whence the next way leads into the Genus Nervosum: Now these are the Corpora Callosa, and Striata. For the Animal Spirits love to expatiate themselves within these medullous Bodies; and when they smoothly flow in one series from the two extremes attending the Corpus Callosum (viz. from the Corpora Striata, and Gyri of the Brain) towards its middle part, they represent pleasant imaginations and fancies: and when in another series and haply by other Pores, they flow from the midst of the Corpus Callosum into the Gyri of the Brain, they carry thither the signatures of notions for the memory; and when they direct themselves thence into the Corpora striata, and origines of the Nerves, they actuate all the moving parts, and as often as there is occasion, convey to them the Instincts of setting upon motions. Now in a Vertigo those even emanations of the Spirits seem to be intercepted in various places, and to be diversely perverted, for some files of the Spirits are rendered obscure, others are wrested another way, and are driven this way and that into Gyri and Vortex's, and often are forcibly drawn ; wherefore by reason of the Spirits being so troubled in the Brain, confused fancies, erring and unconstant species of sensible things or turn round of them are represented: And then, according as the Irradiation into the Genus Nervosum is lessened or stopped, a Scotomia, and sailings and faultering of the locomotive function ensue. It seems probable that such disorders of the Spirits depend on two causes, viz first, that some exorbitant and extraneous particles being entered the Brain deeply together with the Nervous Juice, cleave to the Spirits, and force them into irregular motions; it being manifest to vulgar experience, that this happens to some persons after immoderate drinking of Wine, or Strong Waters, unusual smoking Tobacco, the eating of certain Vegetables, an anointing with Mercury, etc. Secondly, we may imagine that sometimes a serous glut of filth gets by degrees into the Brain, together with the Nervous Juice, and when at length it has penetrated deeply into it, it defiles these pure Medullae, and greatly stuffs its Pores: So that the Animal Spirits do not display their beams with a light that is clear and full, but such as is weak and broken, with many little Clouds, as it were, scattered here and there. In an habitual and inveterate Vertigo, the conjunct cause comprehends both these, as it appears from the things that give relief, or prove offensive. For I observe that that affect is altered for the better or worse, on two kinds of occasions: For whatsoever things inwardly taken engender turgid Particles, and such as are too exorbitant and apt to be troubled, as Wines, Strong Waters, peppered and flatulent meats, in a manner always affect vertiginous Persons: nor do they find less injury by reason of occasions by which the Brain is filled and stuffed, as are surfeiting, sleeping at Noon, or too long in the morning, a Southerly Wind, a moist, misty, and thick Air; a low seated and marshy habitation: and on the contrary, the same are very much relieved by a thin and light Diet, a clear Air, and an open Country exposed to the Winds. If we inquire into the procatarctick Cause of this Evil, viz. for what morbid predisposition this double evil is wont to be brought on the Spirits residing in the middle part of the Brain; we find that here both the Brain with the nervous Liquor, and the Blood with the Humours residing in it are in the fault. It is a common fault of the latter, that degenerating from its due Crasis into a sharp or otherwise vicious temper, it perverts the nutritive juice, and likewise heaps together within it a Serum, and filthy dregs of various kinds, which it is ready to discharge on the Head. The fault of the Brain is, that its temper is moist and weak, its texture lose and not firm, and has its Pores more open than they ought, and too much gaping, so that any heterogeneous and elastic Particles, and likewise serous, or otherwise morbid recrements, being sent from the Blood into the Head, are easily admitted into the Brain together with the nervous juice, and by reason of its passages being too open, descend without obstacle into the midst of it, viz. the Corpora callosa and striata. Moreover, such as are of a tender Constitution, easily contract this vertiginous disposition; for the Spirits of the Brain being weak, and unable to resist foreign incursions, yield a passage to any matter coming thither: Again, to others, though robust Persons, a disorderly Diet, a sedentary Life, frequent surfeiting, also immoderate Sleep and Studies, likewise the Scurvy, an inveterate Cachexia, Fevers of long continuance, and other Cephalick Diseases, often bring this ill habit of the Brain. As to the prognostic of this Disease, every new Vertigo for the most part is void of danger; but being habitual and continual, though it seldom threatens a great or imminent danger, yet because it admits not but a long and very difficult Cure, it most commonly so tires both the Diseased and the Physician, that before the Disease can be cured, one grows weary of the other. A primary Vertigo seated in the forepart of the Head, which scarce at all causes a dizziness or falling on the ground, being more safe and curable, is often changed into a Headache; sometimes also it goes off of its own accord, by a bleeding at the Nose, or a Flux of the Hemorrhoids, and is often removed by Physic. A vertiginous affect arising in the hinder part of the Head, and intercepting the irradiations of the Spirits into the Nerves, being far more dangerous, often passes into an Apoplexy, or Palsy, or into Convulsive Diseases. A Therapeutic Method does not properly belong to a Symptomatick Vertigo. It will only be necessary that certain Cephalick Remedies for discussing the Clouds of the Brain, and appeasing the disorders of the Spirits be joined to the first things indicated; or rather, to speak according to the capacity of the vulgar (which we must sometimes, though only for show) that certain Medicines against vapours be added to them. An Accidental Vertigo, or any other that is new, for the most part is cured only by Blooding and a gentle Purge, sometimes repeated: Nevertheless, for the more certain extirpation of the disease, let Cephalick Remedies likewise, such as shall presently be written, be carefully administered. For the Cure of an Habitual Vertigo, and such as is become inveterate, in a manner the like method ought to be ordered as against most other Cephalick Diseases, Which suggests these three chief intents of Healing: viz. first, we must endeavour that all fuel of that Disease being cut off, the Brain may continue free from any new afflux of morbific matter; for which end, a due form of diet being ordered, sometimes bleeding, and very often a gentle Purge given at due intervals of time will conduce: Let a dry and well ventilated Air be chosen, let immoderate and unseasonable sleep and studies be shunned; let morning and evening draughts be wholly forborn: Instead of the former, let a draught of Coffee or Tea be given, with the Leaves of Sage boiled in them; let an Issue be made in the Leg or Arm; and sometimes let the Hemorrhoid Vessels be opened by Leeches: Let the Person affected always rise early in the morning, and wash his Temples and Sinciput with cold Water, and rub them with a course Cloth. The second Therapeutic Intention will be to remove the Procatarctick cause of the Vertigo; wherefore let it be endeavoured, both that the Cacochymical dyscrasy of the Blood be taken away, and that the weak and over-lax constitution of the Brain be corrected. In order to the former, Remedies powerfully altering, as temperate Antiscorbutics, Chabyleats, and sometimes Spaw-waters, or Whey are proper: To which, always by reason of the latter thing indicated, let Cephalick Medicines, viz. such as are prepared of Coral, Amber, man's skull, the root of male Peony, Mistletoe, Peacock's dung, and the like, forms of which we shall presently give you, be added. The third Intention, and which is properly curatory, attempts the taking away of the conjunct Cause of this Disease, though it ceases for the most part of its own accord, upon the removal of the procatarctick Causes. For if the passage of every extraneous matter into the Brain be cut off, nothing will hinder, but that the Spirits being as pure as may be, and having gotten free and open spaces within the Corpus callosum, may flow thence every way. However, that we may prosecute this scope of curing together with the former, we must also interchangeably use Medicines endowed with a volatile Salt, whose Particles being very subtle and active, refresh the animal Spirits; of which kind chief are the Spirits of Hartshorn, Soot, Shall Armoniac impregnated with Amber, man's skull, etc. the tinctures of Coral, Amber, Antimony, the Elixir of Peony, etc. These things being thus premitted concerning the Vertigo in general, it seems likewise proper for us to delineate a therapeutic method more particularly, and to give an orderly process of it: And first, it shall be shown what is to be done in the Fit for curing it, and then what out of the Fit for preservation. 1. As to the former, though an invasion of the Vertigo, how violent soever it may seem, for the most part is free from danger, and often passes off easily of its own accord; yet because those that are affected with it, fearing themselves a dying, desire Physical Aid; in such a case, if the Pulse indicateth it, a Clyster being premitted, let bleeding be ordered; then a Vesicatory being applied to the Neck, let strong-smelling things, as Castoreum, Spirit or volatile Salt of Hartshorn, Urine, or Shall Armoniac be presently held to the Nostrils: moreover, let those Spirits be given twice or thrice a day, with a convenient dose of a Cephalick Julep; going to bed let a bolus of Mithridate with powder of Castoreum be taken: the day following, if the affect be not yet gone, let a gentle Purge be given; or if the Diseased be inclined, or easy to vomit, let an Emetic be taken, than which there is scarce any Remedy more excellent. Take Pillulae de Succino twenty five grains, Rosm of Jalap six grains, Tartar vitriolat seven grains, Balsam of Peru what suffices, make four Pills to be taken going to bed, or early in the morning: or, Take Sulphur of Antimony five grains, Cream of Tartar half a scruple, Castoreum two grains, make a powder, to be taken with governance, expecting a vomiting. That Vomits often do good in the Vertigo, besides the testimony of Authors, it sufficiently appears also by common observation; and since vertiginous Persons vomit often of their own accord, hence an opinion has grown amongst many, that the cause of this Disease lies hid in a manner always in the Stomach, but we have shown elsewhere that this is otherwise, and that the vomiting frequently happens by reason of the Spirits being troubled in the Brain. Now the reason why Emetics do good in this Disease, is, that by this kind of Medicine, both a very great Revulsion is made of Humours from the Brain, and that the Spirits there being in a tumult, are presently restrained. When the Membranes and Fibres of the Ventricle and the Viscera placed near it are twitched, various Humours, viz. the nervous, serous, lymphick, pancreatic and bilous, are drawn into those Parts, and so drained that the Brain continues free from their Incursions, nay, and easily throws off a great many then sticking in it; Then, as to the animal Spirits, we have shown elsewhere that there is always a very great communication and intimate accord betwixt those that reside in the Stomach and those of the Brain; so that a grateful or ingrateful affect of the Stomach from things taken, causes erections or dejections of the Spirits residing in the Brain. Opiates, whilst remaining in the Stomach, bring a sleepiness, so in the Vertigo and other Cephalick Diseases, it will not conduce a little to the redressing and regulating of the Spirits in the Brain, when all in confusion, and mightily agitated, if their consociates or relations be put in a consternation within the Ventricle by an irritating Medicine; for whilst for the aid of these, a great many are called from the Brain, the others remaining remit of their disorders, and resume their ancient Offices; doubtless it is chief for this reason, that Emetics often give great Relief in affects of the Mania, insomuch that certain Empirics use in a manner those alone. 2. But returning from this small digression, let us consider what is to be done for curing an inveterate, and almost continual Vertigo, out of the Fit: therefore in the first place a method being ordered concerning blooding and purging to be used, and repeated at fit intervals of time according to the Constitution and strength of the Patient; I also use to advise that a Vomit (if nothing indicateth the contrary) be taken once a Month; for which end, to weak Persons, after the stomach's being filled with light food, let Wine and Oximel of Squills be given, to two or three ounces, and afterwards let posset-drink with Carduus leaves boiled in it be drank in a great quantity, and let it presently be thrown up again with a spontaneous or forced vomiting: To others, let an Emetic be given of Salt of Vitriol, or of the Infusion of crocus Metallorum: Concerning Issues, Vesicatories, the opening of the hemorrhades, also of a Plaster or Cap to be worn on the Head, and of topics to be applied to the soles of the Feet, or to the Wrists, for revulsion or derivation, let a Physician deliberate. Take Conserve of the Flowers of male Peony six ounces, powder of its Roots an ounce, Peony seeds powdered two drams; Amber, Coral, Pearl powdered of each two drams and a half, Salt of Coral a dram, Syrup of coral what suffices, make an Electuary. The Dose is a dram and a half, or two drams in the evening, and early in the morning, drinking after it three ounces of the following distilled Water. Take fresh leaves of Mistletow six handfuls, roots of male Peony, Angelica, of each a pound and half; the white dung of Peacock's two pounds, Cardamum bruised two ounces, Castoreum three Drams, all being sliced small, and mixed together, pour to them of White wine, or of Whey prepared of it, eight pounds, distil it with common Organs, let the whole Liquor be mixed. Take powder of the root of male Peony half an ounce, red Coral prepared, Species Diambroe of each a dram and half, powder of male Peony flowers fresh bruised and dried in the Sun, a dram, make a powder, to which add of double refin'd Sugar dissolved in Peony water, and boiled to a consistency for Tablets ten ounces, make Tablets according to Art, weighing half a dram, let one or two be taken often in a day. Because all things do not agree with all Persons, but a Physician ought to assay divers Medicaments, and insisting on a various Method, at one time to try these Medicines, another those, therefore I shall here set down certain forms of another kind. Take our Syrup of Steel six ounces, let a spoonful be taken in the Morning and at five of the Clock, with three ounces either of the distilled Water even now described, or of some other Cephalick Water: or take from fifteen to twenty drops of our Syrup of Steel with a draught of the same distilled Water twice a day, I have known these things to have given great Relief to many. Sometimes let doses of the Spirits of Soot, Hartshorn, or Shall Armoniac, impregnated with Amber, Coral, or Man's Scull, or let tincture of Amber, Antimony, or Coral be daily given after the same manner. Take Powder of the Roots of male Peony an ounce and a half, Peony Seeds, Coral prepared, white Amber of each three Drams; Pearl prepared, Powder of male Peony Flowers fresh bruised, and dried in the Sun, of each two Drams, Sugar-candy one Ounce, make a Powder, let a Dram be taken twice a day, with a draught of Tea or Coffee, or a Decoction of Sage or Rosemary. For poor People let a Powder be prescribed of the Leaves of Misteltow growing on Apple Trees, dried in the Sun and powdered, to a dram, to be taken twice a day: or take the white Dung of a Peacock six Ounces, powder of the Flowers of male Peony an ounce, Sugar two Ounces, make a Powder, let a Spoonful be taken twice a day in a convenient Liquor. Let vertiginous Persons use for their ordinary Drink small Ale with the Leaves of Mistletow growing on Apple Trees boiled in it instead of Hops, and in a Vessel of four Gallons let a Bag be hung, in which put of Peacock's Dung half a pound, and of Cloves bruised three Drams. So frequent and daily Examples of Persons troubled with the Vertigo occur, that it seems but to little purpose to give here any instances of them: however that the Types of this Disease may be known, I shall relate here some few and rare Cases. A Divine sixty years of Age, after that he had been troubled for about three Months with a slight Vertigo, or a frequent Coruscation as it were of the Spirits in the Sinciput, at length the Disease increasing, he became affected also with a dizziness and a falling-Evil; in so much that in walking sometimes he would fall flat on the Ground; Being called to cure him, I prescribed blooding, with a gentle purge to be repeated at fit intervals of Time, moreover I diligently gave Electuaries and mixtures, such as above-written, Vesicatories and other Administrations being not neglected: after a fortnight no relief being found from these things, I gave him a vomit of Salt of Vitriol, and an infusion of Crocus Metallorum; upon which having ten easy vomits, he presently from thenceforth was better, and Cephalick alteratives being used for about a fortnight longer, he grew perfectly well, and from that time he took yearly Spring and Fall for six years a vomit, with certain other Medicines, and even at this time is in perfect Health, A certain Gentleman sixty six years old, after that he had lived for a long time obnoxious to a light Vertigo, and which was wont to be raised as it were only occasionally, about the end of Autumn being more severely troubled with that affect, became also forgetful: going to see him after he had been ill about three Weeks, I found him very much changed in his Countenance and Aspect, the vigour of both being very much broken. To this Person, who had every Evening a smart Fever, with a high and strongly vibrating Pulse, in the first place I ordered Blood to be drawn from the Arm, and after six or seven days from the hemorrhoide Veins; moreover I had Vesicatories presently applied to his Neck and incontinently after behind his Ears, and Cauteries betwixt his Shoulderblades for two large Issues to be there made: he took daily inwardly at Physical Hours Cephalick Remedies almost of every kind. Within a Month's space seeming to recover, he began to walk abroad and to take care of his domestic Affairs and other Concerns. But at the beginning of the Winter, upon taking cold, as he went daily abroad, he fell into a small Fever with a great Perturbation of the Spirits within the Brain: for every day towards the Evening being lightheaded, he scarce knew what he did, or said, nevertheless within seven or eight days, the Fever vanishing after blooding and a thin diet, the affect of the Brain was changed from its former state. For the Vertigo wholly ceasing he became very forgetful, and withal Paralytical in the whole right side. Being often asked concerning his Head, whether it was clear, and free from a Scotomia and confused Phantasms, he answered, that as to those things it was never better: for he understood well his Infirmity, knew his Friends, Relations, and others that came to visit him, but could scarce call to mind any of their Names: and when he went about to discourse of any thing, he wanted words to express the Sense of his Mind: Moreover as to the side affected, in the right Arm and Thigh, there was not only a total Resolution and Immobility, but likewise in both a very great aedematous Tumour grew, insomuch that not only almost all hope of cure was laid a side, but even of keeping him long alive; nay, others were already soliciting for the State Offices and Employs he enjoyed. However, I desisted not from proceeding with a Method of cure, and prescribed him loosening Pills to be taken by intervals: and on other days, at physical Hours, Cephalick, Antiscorbutick, and Antiparalytick Remedies: I ordered a Plaster of Gums and Balsams to be applied to his Head shaved, the parts resolved to be anointed and strongly chafed with Oils and Balsams: whilst these things were done with some kind of success, as to the greater clearing of his Understanding; I know not through what cause, in the midst of Winter he fell into a Fever, so that he was greatly troubled every Night with a heat, and mighty drought, and an interrupted Sleep, his Tongue was parched and rough, his Pulse high, his Urine ruddy, and full of contents; we abstained from blooding by reason of his old Age, and Palsy, and chief by reason of a Dropsy began in the side affected: nevertheless a thin diet and Barley and Oat Broths being commanded, we gave him day after day Juleps, Apozemes, and other Remedies moving Sweat and Urine: and as at this time the Issues made by his shoulder Blades ran plentifully, the diseased began to be better as to his Memory and Palsy, and thenceforward recovering by degrees from both these affects, and withal from his Fever, and daily growing better; within six Months he was restored to his perfect health, and at this time is very well. Being tired of late with the almost daily complaints of a certain importunate Person, troubled with the Vertigo, after a great many Remedies used to no purpose, I prescribed at length that for a Month's space he should take every day twice about a spoonful of the following Powder, drinking after it a draught of a Decoction of Sage or Rosemary, impregnated with the Tincture of Coffee. Take powder of the roots of male Peony two ounces, flowers of the same bruised and dried in the Sun, one ounce; the white dung of a Peacock half a pound, double refined Sugar, two ounces, make a powder. It is scarce credible how great a Relief he found by this Remedy. Coming to see me again a Month afterwards, he seemed to be a new, and another man; being freed from his Vertigo, he did not only walk about with confidence, but was able to take care of his Household affairs, and to manage other difficult Concerns, of which before he was wholly incapable. CHAP. VII. Instructions and Prescripts for curing the Apoplexy. THE seat of the Apoplexy seems to be within the same inward portion of the Brain, viz. The Corpus Callosum, as that of the Vertigo; to wit, in as much as in both affects the Imagination, common Sense, though in a far differing degree, are affected, viz. in the former the irradiation of the Spirits, is wont to be obscured in some places, and to be inetrrupted with little Clouds, as it were, scattered here and there, but in the latter, the same is forthwith wholly darkened, and undergoes a total Eclipse. The Apoplexy, according to the import of the Word, denotes a striking, and by reason of the stupendous Nature of the affect, as though it contained somewhat Divine, it is called a sideration: for those that are seized with it, as though they were Planetstruck, or smitten by an invisible Deity, fall on the Ground on a sudden, and being deprived of Sense and Motion, and the whole animal function (unless that they breath) ceasing, they lie dead as it were for some time, and sometimes die outright: and if they revive again, they are oftentimes affected with a general Palsy or an Hemiplegia. Tho it may seem a Paradox, it is not disagreeing with Reason to say that the Apoplexy is twofold, and that one of them belongs to the Cerebellum, and that the other has its seat in the midst of the Brain: the former happens by reason of the animal Spirits designed for the vital function, being suppressed in their very source, viz. within the Cerebellum, the motion of the Heart being often thereby letted or suppressed, as we have intimated before that this happens in some sort in the Incubus: and doubtless to this cause ought to be attributed what I have observed in some, that after a great heaviness in the Occiput, a Swooning with a sudden privation of all the animal function ensues: in which the diseased lie without Motion or Sense, with a Pulse and Respiration greatly diminished, and scarce perceivable, and being all over cold for many Hours, nay, often a Day or two, more resembling Persons dead, than living: We have sometimes known Persons so affected, who have grown cold and stiff, their Pulse and Respiration seeming wholly to be ceased, and who have been really taken for dead, and put in their Coffins, yet after two or three days to have come to life again. To inquire into the causes of the other, and the ways of its coming to pass, we must first distinguish concerning the various Invasion of this Disease; to wit, how sometimes being raised from a sudden, solemn, and invincible cause, without any previous Disposition or Procatarxis, it is for the most part mortal; against this no Procatarctick or preservatory Method can be ordered; and the method of curing it, which is ordinarily entered upon, for the most part becomes ineffications: or secondly an Apoplectic Fit, having an antecedent Cause, or a previous Procatarxis is brought into act through various Occasions or evident Causes. As to the seizure of the former kind, viz. being sudden and unawares, its conjunct, and immediate cause is either a great Solution of Continuity happening some where within or near the middle of the Brain; through which its Pores and Passages being obstructed, or compressed, all emanation of the Spirits is suppressed, or it is a great and sudden putting to flight, or extinction of the Spirits residing in the Brain. The things which are wont to cause a great solution of Continuity within the Brain, are, Blood extravasated, an Abscess suppurated and broken, and an inundation of a serous humour; and though this latter seldom or never happens of itself, yet sometimes, by reason of strong evident causes, such a glut of serous filth rushes into the Brain, that presently filling and stuffing all its medullary Pores, it renders the Person speechless, which I have known to have happened to some upon sleeping presently after having drank too largely of small Wine and Spa Waters; I have observed the like affect upon a total and long continued suppression of Urine. And in malignant Fevers the serous recrements by a critical Metastasis being conveyed to the Brain have often caused a loss of Speech with Death. Of the evident Causes by which an extemporary Apoplexy is wont to be procured, the other kind consists in a sudden profligation, or extinction of the Spirits: which strong Narcoticks, and an immoderate drinking of hot-Waters often effect. Thus much concerning the Causes of the accidental and extemporary Apoplexy, which bring a fit of it on all Persons indifferently, though not predisposed; and wherefore there can be no Prophylaxis ordered, and it is seldom that a Cure succeeds. But we observe besides, that this Disease sometimes is habitual, viz. That there remains in certain men a constant Disposition, by reason of which first slight Bicker trouble them, afterward by short intervals greater accesses come upon them: of which for the most part they die at last. As to the conjunct cause of this Disease, it consists in the sudden filling of the Pores of the Corpus Callosum, and the destroying of the Spirits by the approach of a malignant matter. It's procatarctick Causes are the like as in most other affects of the Brain, viz. both the Blood is in fault, that either engendering of itself, or taking from elsewhere extraneous Particles, and such as are very adverse to the texture, or constitution of the animal Spirits, and as it were extinctory of them, it sends them to the Brain: and moreover, the fault of the Brain is, that being weak in its Crasis, and too lax and loosened in its Pores and Passages, it always admits so easily and without resistance the morbific matter obtruded from the Blood. The Subject of this Disease being the Brain, or the Cerebellum, or both together; the Brain is shown to be most obnoxious to it, by previous and frequent Scotomias, and vertiginous Affects: the Cerebellum is argued to be ill-disposed by a frequent Incubus, an intermitting Pulse, a Swooning, and frequent Fainting. The Prognostic of this Disease is never declared but fatal and dubious: for an Apoplexy is never without danger either present, or to come, but the worst is, in which, besides all the spontaneous Functions being abolished, the Pulse also and Respiration either fail, or are carried on with much ado, and then for the most part it happens with a foaming at Mouth, and a Swooning, to which at length a sweat (which most commonly is colliquative) supervening, foreshews that Death will happen very suddenly. Those who being seized with the Apoplexy are deprived of Pulse and Respiration, and a little after growing cold, seem to be dead, ought not presently to be taken forth of Bed, or to be left without Physical Administrations: moreover, though no hope of Life appears, let them not be buried till after three or four days: for such, either of their own accord, or by the use of Remedies sometimes revive: which happens not by reason of the vital heat being raised up again in the Heart, (for it was not wholly destroyed here) but for that the morbific matter being discussed, or evaporated from the Cerebellum, the motion of the Heart is renewed, as that of a Clock upon hanging on Weights. In an Apoplectic Fit, if after letting Blood relief follows, some hope of well-doing appears: but if after this and other Remedies the affect continues above four and twenty hours without remitting, or grows worse, all hope is over concerning the diseased. If after the first seizure of a speechlesness being well over, the diseased afterward becoming more drowsy and dull, is affected with a Scotomia, and a frequent Vertigo, it is a sign that he will be obnoxious to other accesses of the Apoplexy: for the foresaid affects proceed from the morbific matter at that time deposed in the circumference of the Brain, and there floating here and there, and now and then descending by small parts only, into the midst of it, which matter, whether it be Vitriolic or Narcotick, after that it is gathered together to a fullness, brings the Apoplexy. The Therapeutic method either is curatory, for removing the fit, after it has seized, or preservatory for preventing it from returning: the former regards every Apoplexy, the other only that which is habitual. A fit of the Disease happening (if it does not proceed from an outward or violent hurt of the Head) though it be unknown whether it be raised by an invisible cause (such as are an extravasating of the Blood in the Brain, or an Abscess broken) or not: however we ought diligently to endeavour its cure. And because the Blood being too turgid is wont to induce the morbific cause, or at leastwise to increase it, and when it subsides and becomes more calm is wont sometimes to remove the same: therefore in the first place we ought to deliberate concerning the moderating of its course. And here a question arises concerning the site of the diseased, viz. Whether he ought not presently to be put to bed, or rather to be kept out of it for some time? some religiously observe the latter, nor is it without reason, because in Bed there is a greater propension to sleep, and the Blood boiling more, and burning more freely by reason of the ambient hear of the Bed, sends more of the recrementitious matter into the head affected: on the contrary, when the diseased being thinly clothed, is placed in a Chair, the Blood flows more slowly, and the subsiding Vessels seem more fit rather for drinking up humours sent from the Brain, then for sending them thither. Wherefore, if the Patient be strong enough, it may haply be better for him to stay out of Bed for six or eight Hours, till the Fluxion of the morbific Matter be past, and the course of the Blood be made more calm by blooding, and other Remedies carefully administered. But let those that are weak, and of a tender Constitution, be put presently to Bed as soon as they are seized. Let the site of the diseased, whether he be in Bed, or out of it, not be on his Back, but the Head somewhat raised, and learning sometimes to one side, sometimes to the other. Blooding, being necessary almost in all Apoplectical Persons, may not be delayed: but a smart Clyster being injected, let Blood be taken in a plentiful quantity. In the Clyster let there be dissolved Species Hierae Diacolycinth: and a thick infusion of Crocus Metallorum: let a large Vesicatory be applied to the Neck, and others to the Legs, and drawing Cataplasms to the feet: let the Temples and Nostrils be anointed with appropriate Oils and Balsams, and let painful Frictions be used to the Limbs, nay to the whole Body: meanwhile let those things be now and then given, which raise up the animal Spirits, and free them from their Fetters, viz. Spirit of Hartshorn, Soot, and the like, with a Cephalick Julep. Afterward, the diseased being put to Bed (if he seems easy and able enough to bear a Vomit) let a vomitory of Salt of Vitriol, Oxymel of Squils', or an infusion of Crocus Metallorum be given: and now and then a Quill being thrust into his Throat, let a vomiting be raised four or five times, Posset-drink by intervals being poured into him. The vomiting being over, let comforting things, as Quercitans' Elixir of Life, Spirit of Lavender, or of Treacle camphorated, Tincture of Peony, or of Amber, or Coral, be given in a fit dose, with Apoplectic and other appropriate Waters, and as occasion requires let them be repeated. On the second day the same Remedies being still continued, let dry Cupping-glasses or with a scarification, also be applied about the Shoulderblades, or in the Neck: or if more Blood ought to be drawn, let the Jugular Vein be opened; let the Clyster be repeated; Let Spirit of Sal Armoniac, or a steam of Galbanum boiled in sharp Vinegar be held to the Nostrils: Moreover, let Errhins, and Apophlegmatisms be used: afterward in the Evening let a purge of Pilulae Rudii, or the Electuary of Roses solutive dissolved in some Liquor be given. These things doing no good, though there be small or no hope, let either a burning hot Iron, or a large Vesicatory be applied to the Crown of the Head shaved; let the remaining part of it, and chief the Forehead, and Sinciput be fomented with Bezoardick Vinegar: Let Leeches be applied to the Temples, or behind the Ears; Let Spirit of Hartshorn, or of Soot be given him in a large dose, and often; we must insist on these and other ways of adminstrations till death seems to be at hand, which (as Celsus has it) those kind of Remedies often only delay, and in the mean while prove troublesome to life. The Prophylactick Method regards both those, who have been formerly set upon with one or more Invasions, and those who seem prone to them, as being born from Apoplectic Parents, or being obnoxious to the Vertigo, Incubus, or frequent Faintings, and such as have the Neck short and thick grown. Spring and Fall let purging and blooding (where it is proper) be used; as to the former let those that are easy to vomit, take first a vomitory of the Infusion of Crocus Metallorum, with Salt of Vitriol, or of Sulphur of Antimony, and then after three or four days, let a dose of Pilulae Rudii, or of Amber be given; and afterward by due intervals let it is be repeated three or four times: let two large Issues be raised near the Shoulderblades, or if those Places do not please some, let them have one in the Arm, and another in the opposite Leg. On other days free from purging, let altering and cephalick Medicines be taken twice a day. Take Conserve of the Flowers of Lilies of the valley (or of male Peony) six ounces, powder of the roots of male Peony half an ounce, man's skull prepared three drams, seeds and flowers of male Peony powdered, of each two drams, red Coral prepared, Pearl and white Amber of each a dram, Salt of Coral four scruples, syrup of the flowers of male Peony what suffices, make an Electuary: the dose is two drams morning and evening, drinking after it of the following water two or three ounces. Take roots of male Peony, Angelica, Master-wort, of each half a pound, roots of Zedoary, the lesser Galingal, of each an ounce, leaves of Mistletoe of Appletrees, Rue, Sage, Betony, of each four handfuls, the outward coats of ten Oranges and eight Lemons, cardamum's, Cloves, Nutmegs, of each half an ounce; all being sliced and bruised, pour to them of White-wine (in which two pounds of Peacock's dung hath been infused for a day) ten pounds: let there be a close infusion for three days, then distil it according to art, let the whole Liquor be mixed. Take species Diambroe two drams, powder of the roots of male Peony, choice Zedoary of each a dram and a half, Pearl a dram, Oil of pure Amber half a dram, double refined Sugar dissolved in Peony Water, and boiled to a Consistency, for Tablets, six ounces, make Tablets according to art, weighing half a dram; let the Patient eat one or two often in a day at pleasure. Within fifteen or twenty days, the Remedies, that they may be less loathsome and more advantageous aught to be changed; therefore instead of the Electuary, give for a fortnight or three weeks sometimes Spirit of Sal Armoniac saccinated, or coralliated, or impregnated with Man's Scull, or Castoreum; sometimes the Elixir of Peony, or the tincture of Amber, or Coral, or Quercitans' Elixir of Life, mixtura simplex: Also, instead of the compound Waters let them take either the Water of black Cherries, or of Walnuts, or of Rosemary, or of Lavender simple, sometimes a draught of Posset-drink with the Flowers of male Peony, or of Lilies of the Valleys boiled in it, or a draught of Tea or Coffee, in the Morning (those Ingredients being first boiled in the Water of which it is prepared) or let a Confection of Chocolate be made after this manner. Take powder of the Roots of male Peony, man's Scull prepared of each half an ounce, Species Diambrae two drams, make a Powder, to every paper of which add Cocao-nut-Kernels a pound, Sugar what suffices, make a Confection, let half an ounce or six drams of this be taken every Morning in a draught of a decoction of Sage, of Peony Flowers, or the like. Take Powder of the Roots of male Peony, man's Scull prepared of each an ounce and a half, Roots of choice Zedoary, bastard Dittany, Angelica, Contrayerva of each two drams, make a subtle Powder of all of them, add the yellow Coats of Oranges and Lemons preserved of each two ounces, let them be bruised together to a Powder, let about half a dram, or a dram be taken an Hour before and after meals. For ordinary Drink, let a Vessel of four Gallons be filled with middling Ale, in which boil the Leaves of white sweet-smelling horehound dried six handfuls, Anacardiums, Cardamums, of each an ounce and a half, being sliced and bruised, make a Bag. But especially, let an exact form of Diet be observed: Let a temperate, dry, and well ventilated Air be chosen; let food only of an easy concoction, and light, be eaten; let the Supper be spare, or none at all; let sleeping at noon, drink, and other ill accustomances about nonnatural things be shunned. I might here instance several stories of Apoplectical persons, viz. of some, who, though seized once or twice, are still living; and of others killed by the first, or second, or afterward at the third Invasion. The Right Reverend Father in Christ, Gilbert Lord Archbishop of Canterbury, lives still, who escaped above six years since from a severe Apoplectic fit, (God, to whom ever be praise, giving success to Physical endeavours,) and from that time, though he has now and then undergone light touches of the Disease, yet he has never been so prostrated by it as to become speechless, or insensible: But it's to no purpose to dwell long in setting forth this and other examples, in regard they contain nothing very rare, whence the Aetiology of the Disease may be illustrated. I have dissected some dead Bodies, but they were in a manner only of such Persons as were seized Apoplectical after the Head being greatly hurt, as by a stroke, or a fall, in all which the Blood extravasated, or an Abscess was the cause of Death: As to the opening of Persons dead of an habitual Apoplexy, we are most commonly hindered by Friends, who expecting their revival, both delay the Interment, and wholly forbidden Anatomy. But I shall give you here one notable Anatomical Observation made about five years since at Oxford. An ancient Divine, an honest and pious man, of a gross Body, and having a short and full grown Neck, being long ill-disposed in his health, and leading a sedentary life, had contracted a very Scorbutic Cacochymia; being affected with a difficult and pursy breathing, and with an unwonted heaviness and drowsiness of his Head, he was scarce able to perform any thing of labour or exercise, but to go and come daily from his Chamber to the Chapel, and Refectory: On a certain morning, entering the Chapel a little before Prayers, as he set himself on his knees, being struck on a sudden, and presently becoming speechless and insensible, he fell on the ground; but being forthwith raised up, and his taken off, he was put into a warm Bed: Myself and other Physicians being called, and coming as quick as might be, we found him not only without Sense, Pulse and Respiration, but cold and absolutely stift throughout his whole Body: Nor could he be brought to life, or to a heat by any Remedies, or ways of administration, though applied with all diligence for some time: Whence we imagined, that from his first being struck, the beat of the Heart was wholly stopped, and its flame being extinct, that presently all motion of the Blood was suppressed. The next day after we opened the Body, it appearing to be quite dead and stiff; nothing doubting but very clear footstepts of an affect so suddenly mortal, left within the Brain, would show themselves to the eye; but neither there, or in any other part, was there remaining so much as any shadow of the Disease, though very violent: the vessels irrigating the meanings were indifferently filled with blood, but without any inflammation or extravasation: the Brain, Cerebellum, and medulla oblongata, with all their processes and prominences, appeared every where firm and well-coloured throughout, both within and without: neither was there Serum nor extravasated Blood heaped together any where within their Pores and Passages, nor also within the greater Ventricles: nay, and the plexus choroeides placed both within the Cavity of the Brain, and behind the Cerebellum, seemed free from all fault, so that the morbific matter being as fine and subtle as the Spirits which it affected, remained wholly inconspicuous, and we could only argue its presence there from the effect. Nevertheless, lest it should lie hid elsewhere without the Head, after having accurately inspected all the Contents of the Brain, we came to the Thorax, where the Lungs being discoloured, and stuffed throughout with a frothy Ichor, showed manifestly enough the cause of the difficult and pursy breathing; but the Heart being sound and firm enough, was wholly free from any obstructions, or polipous concretions. Moreover, neither near it, nor in other adjacent Viscera was any Abscess or Impostume found, by whose contact or ill favour the Heart could so be oppressed, or the Vital Spirit (in case this be possible) on a sudden be suffocated. Wherefore in this case we could imagine nothing else, but that the Animal Spirits residing within the middle of the Brain were on a sudden put to flight, and extinguished as it were by certain malignant, or narcotick, or otherwise infesting Particles; so that the motion of the Heart, as of the first mover in a machine, failing on a sudden, presently all the other Functions, their impulses being taken away, wholly ceased. CHAP. VIII. Instructions and Prescripts for curing the Palsy. THE middle of the Brain, or the Corpus callosum, where we have assigned the Seats of the Vertigo and Apoplexy, seems also to be the place primarily affected in the Epilepsy; but of this, as also of convulsive Diseases, we have treated elsewhere: wherefore let us descend to other lower Regions of the Brain, and its Appendix, and next let us describe the affects that belong to the Corpora striata, medalla oblongata, and also to the nerves and nervous Fibres. These Parts execute all the Functions that regard motion and sense, wherefore the failings or enormities of these must be affects of those Bodies, or of the Spirits residing in them: now sense and motion are injured chief two ways; for both are wont to be perverted, or stopped; when motion is perverted, Cramps and Convulsions; when Sense, pains arise; when either Function or both of them together are letted or abolish, the Affect thence raised is called the Palsy; of which we must treat at present. The Palsy is described after this manner, viz. That it is a Resolution, or Relaxation of the Nervous parts from their due Tention; by reason of which Motion and Sense, to wit, either one of them alone, or both of them together cannot be exercised in the whole Body, or in certain parts of it after a due manner. The Nervous Parts are resolved because the animal Spirits do not sufficiently irradiate, raise, and actuate them with vigour: The cause of which defect is, either an obstruction of the Ductus', whereby their passage or conveyance is hindered; or an impotency of the Animal Spirits, inasmuch as being affected with a stupefaction, or being but few, they do not display themselves vigorcusly enough: By reason of these various ways of affecting, divers kinds of the Palsy arise: For first, as to motion by itself, this spontaneous faculty (which chief, and in a manner only, is obnoxious to the Palsy) sometimes in the whole Body, or in certain parts, is wholly abolished; but sometimes it being only letted, is diminished or depraved. Secondly, in like manner we observe as to Sense by itself, that either one Sense, or many together, sometimes wholly are taken away, and that sometimes they are very much diminished or vitiated. Thirdly, sometimes it happens that both powers are injured together; we shall speak of each of these in order, and in the first place of the Palsy, in which spontaneous motion is abolished; which we conclude to happen chief for two causes, to wit, by reason of the Ductus' being obstructed, or of the Animal Spirits being struck with a stupefaction, or, as it were, with a certain malignant blast. As to the former, the Interception of the Spirits from the Parts resolved by reason of the Pores being obstructed, it being always above the Parts, is wont to happen in various places, and for divers causes; but especially either in the primum sensorium, viz. in the Corpora Striata, or somewhere about the Caudices Medullares; or lastly, in the Nerves themselves; and so lightly it happens either in their origines, or in the middle of their Processes, or in their extreme parts, viz. the Nervous Fibres. When the Injury happens to the Corpora Striata, or Medulla oblongata, or Spinalis, it either obstructs the whole running of the marrow of the Backbone, whence a universal Palsy arises beneath the place affected; or one half of it, whence a Hemiplegia: or it affects the heads of some certain Nerves either in one side, or in both together, whence resolutions are caused in this or that member separately from the others. There are many ways, by which the passages of the Animal Spirits in the foresaid bodies are obstructed; viz. either, first, their Ductus' are filled with an extraneous matter forced into them; or secondly, they are compressed by extravasated Blood, a glut of serous filth, or some tumour lying on them; or thirdly, there is a solution of their continuity, as by a wound, stroke, concussion, also by an excess of heat or cold. As often as a Universal Palsy, or Hemiplegia (as is usual) ensues upon a Lethargy, Carus, or Apoplexy, it is obvious to conceive that such a change of the Disease happens by reason of the removal of the matter, viz. inasmuch as this passing at length from the pores and passages of the Corpus Callosum (which if first possessed, and falling a little lower,) enters into the medullary tracts of one Corpus Striatum, or haply of both. If it be asked why Sense is not always hindered as well as Motion in the Palsy, since both are performed by the same Nerves and Fibres, and as it seems, within the same medullary tracts, so that one faculty is only the inversion of the other; it seems here to be said, that, as Light passes through Glass where the Wind is excluded, so also Sense continuing entire, Motion often is abolished: Moreover, Sense is only a Passion, and sensible impression, which is propagated by the continuity of the nervous process, from the Organ to the sensorium commune, without any effort or force of the Spirits, which might be done, though the Sensorium Commune be somewhere obstructed, and the Spirits residing in it are grown dull; But Motion is a difficult and laborious Action, to which it is required that the Spirits display themselves vigorously, and make as it were explosive affects, not only in the moving Organs, but especially about the parts where the principle of Motion and its first Impetus is, also in the whole passage through the Nervous parts. Wherefore, whereas a few Spirits, and those disabled, suffice for Sense, many are required for Motion, and those free and prompt as to their Expansions. I have observed in many that when they were first affected with an Indisposition of the Brain, a Dulness of the Mind, and a Forgetfulness; and afterward with a Stupidity and Dotishness, they fell afterward (as I was wont to predict) into a Palsy; viz. the morbific matter being fallen by degrees, and at length heaped together to an opilative plenitude somewhere within the Caudex Medullaris, where the medullary Tracts are more straitened than in the Corpus Striatum. What before we said in the Apoplexy, we affirm now in the Palsy, that the morbid Particles are not only opilative, but sometimes narcotick, and extinguish the Spirits; thus the steams of Antimony, Mercury, and Auripigment, cause weaknesses, tremble, and often, resolutions of the Members to some using amongst furnaces of Metals. In like manner we may imagine, that in certain scorbutical and very cacochymical Persons, heterogeneous Particles, and seemingly of a vitriolic nature, enter the Ductus' of the Nerves, and subvert certain files of the Spirits, or suppress their motion; hence stupors or resolutions suddenly arise in the Members or Muscles, sometimes in these, and sometimes in those, they often removing from place to place, and sometimes a fixed Palsy is settled: And in every Palsy caused by obstruction, the morbific matter is not a gross and viscous phlegm, (as Galen and many Physicians affirm) for such does not pervade the Brain, much less the Ductus' of the Nerves; but seems to consist of subtle and very active particles, though injurious to the animal oeconomy, for the Palsy happens to men, as a blight or rust does to Plants; for some Winds endued with Vapours more than cold, viz. of a vicious or vitriolic Spirit, when they blow upon young tender Plants presently cause them to whither; viz. in as much as the tender stamina interwoven every where like Nerves in the Leaves and Branches are so throughly constringed by the blast of the malignant Air, that they no longer admit the Juice sent from the Trunk and Root, through defect of which they whither: after the like manner extraneous, and as it were, vitriolic Particles admitted within the Organs of Sense and Motion, in as much as at the same time they stop the Pores, and deject the animal Spirits, or restrain them from Motion, bring as it were a blast on the respective Parts. As to the evident causes of an habitual Palsy, viz. through what occasions those that are disposed to this Disease contract it sooner, or being already seized with it, are more severely troubled with it: I say all such things make for this, which add to the vitiating of the Blood, also which fill the Brain, and its nervous Appendix, or raise suffusions of a morbific matter in it, those things likewise which affect the Spirits with a Stupefaction, or diminish their Stores: in the number of these first occur disorders in the six non natural things, an ill form of Dyer, a drinking of strong Wines, or hot Waters, too much or unseasonable Sleep, Idleness, and a sedentary Life, immoderate Venery, too great losses of Blood, a moist and marshy Air, houses fresh plastered, metallic Fumes and Vapours, frequent use of Narcoticks, or Tobacco, an excess of Cold, Heat, or Moisture, vehement and long continued Passions of Sadness and Fear, with many other things, which I shall not here stand to relate. There is another kind of this Disease depending on the scarcity and fewness of the Spirits, in which though motion fails wholly in no Part or Member, yet it is performed but weakly only, or depravedly by any: to wit, the affected, though not become without Motion, yet they are not able to move their Members, or to sustain any Burden with strength; moreover in any moving effort they are troubled with a trembling of the Limbs, which is only the effect of Weakness, or a broken strength in the moving Faculty. Persons become subject to this affect by reason of an extreme or valetudinary old age, also through immoderate losses of Blood or Seed; and likewise by reason of being very scorbutical, or cacochymical: and many recovering with difficulty and slowly from a chronic distemper are troubled with a languishing of the Limbs, and a great resolution of the Members from their due Vigour and Strength; so that though their Stomach holds good, and their Pulse and Urine be well disposed, yet being enervated, as it were, and without Strength, they scarce dare to set upon any local motion, and if they begin it, they cannot hold it long: nay some, without any considerable sickness, keep their Beds for a long time, as Persons ready to die; whilst they lie undisturbed they discourse with their Friends, and are cheerful, but they neither will, nor dare be raised up, or walk about, nay they abhor all motion as some dreadful thing. Doubtless in these, though the animal spirits in some sort actuate and irradiate the whole Genus Nervosum; yet their Stores are so slender and loosely set together, that when many Spirits ought to be gathered together somewhere in it for motion, there is great danger lest presently in the Neighbourhood their Continuity be broken off, and consequently the tension in the Nervous Parts by'r esolved. Wherefore, in regard the Spirits residing in the Brain are conscious of the Weakness of the others placed in the Members, they refuse to impose local motion on their Companions, as being a task too difficult for them; for which cause the affected are scarce led by any persuasion to try whether they are able to go or not: but those who being troubled with a scarcity of Spirits, will force them as much as they may to local Motions, are able at their first rising in the Morning to walk, move their Arms this way and that, or to lift up a weight with strength; but before Noon the store of the Spirits which influenced the Muscles being almost spent, they are scarce able to move Hand or Foot. I have now a prudent and honest Woman in cure, who for many years has been obnoxious to this kind of bastard Palsy, not only in the Limbs, but likewise in her Tongue; This Person for some time speaks freely and readily enough, but after long, hasty, or laborous speaking, presently she becomes as mute as a fish, and cannot bring forth a word, nay, and does not recover the use of her Voice till after an hour or two. In a certain species of the Palsy the sensitive faculty is hurt by itself, motion being still entire; this is obvious enough concerning the Organs whose Nerves are only relating to Sense, as of the Sight, Hearing, Taste, and Smell, and the Reason is plain enough. But that in the uttermost habit of the Body, or the Members, sometimes the touch perishes, the locomotive Power being without hurt; as it is every where seen in Persons affected with the Leprosy, Elephantiasis, and in some troubled with the Mania who are wont to go naked, and to lie on the Ground, and who are become so insensible in the Skin and the Flesh of the Muscles, that they do not feel the cuts of a Penknife, or Needles any where thrust into them. This I say is very difficult to be explained; But concerning this it must be said, that the same Nerves haply convey forward and backward the instincts of Motions, and the Impressions of sensible things; but that the same Fibres which are locomotive are not always, or chief sensible: We have shown elsewhere that the muscular and tendinous Fibers execute the former Power, but the sensible Species is received in a manner only by the membranous Fibres; wherefore the outward Skin is the primary Organ of the touch; after this the Membrancs that cover the Muscles, and lastly, those that compose the Viscera are in the same sort affected by the tangible Object, wherefore the hurt or loss of the touch happens by reason of an Injury offered the outward Membranes; viz. when the Fibres of these are obstructed with a Vitriolic Matter, or are very much constipated by an excess of Cold, so that the animal Spirits which ought to receive their Impressions, are excluded from their Organs, and that these Inhabitants of the outward Members are only affected it thence appears, because the Members deprived of Sense do not whither as those deprived of Motion, but continue full and fleshy; which is a sign that the animal Spirits still entering the Nerves and carneous Fibres give their virtue to the Function of Nutrition: but when Motion being abolished, the Spirits are in a manner wholly banished from those parts, the Flesh withers away, because the nutritive Matter though brought to them by the Arteries, is not assimilated. As to the Prognostic of the Palsy, 1. Any Palsy that happens, the knowing and vital faculties being unhurt, ought not to be judged an acute Disease; but being free from sudden danger, admits of a cure at long run, or at leastwise of an endeavour for it. 2. This disease happening through an evident cause alone, as by a stroke, a fall from an high Place, a wound, etc. or coming upon an Apoplexy, Carus, Convulsion, Colic, or other affects of the Brain, or Systema Nervosum, if it be not altered for the better, or yields to Medicines in in a short time, for the most part proves incurable. 3. If upon the origine of the medulla oblongata being wholly obstructed, or through the Spine's being vehemently hurt, a total resolution follows and takes away Sense and Motion, the affect is cured with difficulty, or scarce at all. 4. A Palsy happening to men that are Aged, Cacochymical, greatly Scorbutical, or intemperate, though the affect be not great, is cured with difficulty. As the Types of the Palsy are many fold, and its causes divers, so its cure aught to be undertaken not always after one manner, but by a various method, viz. appropriate to each species of that Disease: for the most part there will be these three kinds of it, or rather there will be three ways of healing, whereof sometimes this, sometimes that, or the other, aught to be entered upon in order to the cure of this Disease, to wit, according as the resolution (of what kind soever, and in what place soever it be) is either first caused on a sudden by an outward accident, viz. a stroke, a fall from an high Place, a wound, an excess of cold, or the like; or secondly, succeeds some other affect, viz. The Apoplexy, Carus, Colic, or a long continued Fever; or thirdly, being a Disease primarily, and of itself, depending of a Procatarxis, or previous apparatus, is raised by degrees: we shall speak of each of these particularly. 1. When therefore a Palsy is caused by reason of some accident, with a violent hurt, there will not be many Intentions of curing, but only that the part injured may recover its ancient confirmation; and first, left the Blood and other humours flowing to it, as being affected and weak, and there staying, increase the evil, let Phlebotomy, which most commonly is requisite in this case, be presently put in practice; afterward a thin diet, if the case requires it, or a diet of easy concoction being ordered, we must insist chief on moderate Hydroticks; to wit, that whilst the diseased, put to bed, is kept in a gentle sweat, all sorts of Superfluities withdrawn from the part injured may plentifully exhale, and that the Spirits being gently agitated within the Pores and Passages of it, so opened by the warm effluvia, may recover their former Paths and Tracts. For this end, let the Powder for a fall, described in the Pharmacopoea August and be given to the quantity of about a dram in a draught of White-wine, or of Posset-drink made with it, (it being usual amongst us to give to the like quantity of Irish-slat,) and let it be repeated every six or eight Hours: Moreover let a Traumatick Decoction, if it may readily be had, either of the Roots of Madder, or Butterburr, or of the Flowers of St. John's wort in Posset-drink be frequently given. Moreover, let the place affected in the mean time be diligently searched after, which will easily be known, partly from the hurt inflicted on it, and partly from the member resolved. If any thing be dislocated in it, we must endeavour that it be presently put in its place: If a tumour, contusion, or wound be made, let relief be given them by balsas, liniments, fomentations, or cataplasms: But if nothing preternatural appears outwardly, let as much as suffices of the Oxycroceum and Red Led Plasters, mixed together in an equal quantity, be applied to the part hurt, and let the Diseased by kept at rest, and in a moderate warmth for three or four days: if the resolution continues obstinate, and an afflux of new matter be not feared, let more resolving and discussing Remedies be applied about the places affected; wherefore let fomentations, and hot liniments, nay, and natural hot Baths, if it be convenient, or at leastwise artificial ones, be used: Sometimes it is good to put the members affected in warm Horse-dung, or Grains, and to keep them there for some time: and now and then to interlace Clysters and gentle Purges with the use of these things. But if no relief follows these Administrations, this affect aught afterward to be handled with the like Method, and the same Remedies with which an habitual Palsy, or any other that is confirmed, or follows upon other Diseases is dealt with: which way of cure we shall give you beneath, in regard it is common to every Palsy deeply rooted. 2. When a Palsy, happening upon a Fever, Apoplexy, Carus, or other Cephalick or Convulsive affects is great, and comes on a sudden; we must chief use a Physical means for the removal of its Conjunct cause, which has its seat in a manner always in the Medulla oblongata, or Spinalis: Wherefore in the beginning of the Disease let Blooding and Purging (if nothing indicateth the contrary) Clysters, Vesicatories, Cupping-glasses, Sneezers, Liniments, and other administrations usual in Cephalick Diseases, viz. such as some way drive out, or withdraw the morbid matter sticking in the Caudex Medullaris, or the little Heads of the Nerves proceeding from it, be used: And if the first effort of Physic does nothing within fifteen or twenty days, the affect afterward, in regard it is firmly rooted, and become habitual, is to be overcome by a long method, and by Preservatory, as well as Curatory Indications; of which we shall presently speak. 3. An Habitual Palsy, depending of a Procatarxis, is either in fieri, or in its disposition, or in facto, or in its habit; both require a peculiar way of Cure. Of the former there are two chief cases, in both of which the Therapeutic method, regarding only the Procatarctick causes, is ordered after the like manner: to wit, whether any Person be in danger of being seized with the Palsy, or recovering from it, be in hazard of a relapse, we must insist in a manner on the same Medicines. Therefore the Intentious of Curing must be, first, that the functions of Chylification and Sanguification being duly performed, a laudable matter for the generation of Animal Spirits be sent to the Brain in a sufficient plenty: and then, secondly, that the Brain being still firm and of a due conformation, admits into it, and duly exalts into Animal Spirits all apt particles, excluding such as are heterogeneous; for these ends we have thought good to propose the following method, which ought to be varied according to the various constitutions of the Diseased. Spring and Fall, let solemn courses of Physic be entered upon, nay, and the whole year besides, let some Remedies be constantly used: Bleeding is not generally proper for all Persons: and if we forbidden this, it is not for the same reason with the Ancients, supposing the Palsy to be a cold Disease; but because the Animal Spirits are both engendered from the Blood, and become elastic within the moving Fibres, by reason of a sanguineous combination; therefore if the store of this be lessened too much, they will fail and flag. Which truly I have observed in many, and that for the most part in the Arm, from which the Blood was drawn, languish and tremble have begun. Nevertheless, a spare and moderate Bleeding sometimes agrees with some that are endued with a Blood that is hot and sharp, and apt to too great effervescencies, though they are disposed to the Palsy. About the Equinoxes, purging aught to be ordered, and to be repeated by due Intervals three or four times; but in the first place let a Vomit, if nothing indicateth the contrary, be given of Salt of Vitriol, Sulphur of Antimony, or an Infusion of crocus metallorum, or Mercurius vitae; afterward let Pillulae de succino or Aloephanginae be taken by themselves, or with Rosm of Jalap, every seventh or eighth day: At other times let Cephalick Remedies, such as we have prescribed for the sleepy affects, viz; Electuaries, Powders, Spirits and volatile Salts, Tinctures, Elixirs, with distilled Waters or Apozemes, viz. sometimes these, sometimes those, or others be frequently used. Let Issues be burnt in the Arm or Leg, nay, in gross and cachectical Persons together in both, or near the Shoulderblades. Let a Physick-drink of Sage, Betony, Stoechas, the wood Sassafras, Winter's bark etc. be drank the whole year. Wine and Venus ought either to be forbidden, or to be allowed only sparingly. But if the Palsy, after a previous disposition in the whole, or in one side, or in certain members, throughly seizes, and, notwithstanding the first encounter of Physic, comes on again; for its cure a long and complicated method, which is always requisite, often times does not suffice; for not only the Disease, or its conjunct or procatarctick Cause severally, but all together, must be assaulted: for which ends, blooding for the most part being forbidden, only a gentle purge, and that but now and then, is proper. Again, and indeed chief, against the Procatarxis of the Disease, Cephali●● and Antiscorbutic Medicines are wont to do good: but not all of these kinds agree with all Persons, but, as we have observed in the Scurvy, according to the various Constitutions of the Diseased, the Remedies also must be of a differing kind and virtue: for with bilous paralyticks, in whose sharp and hot blood there is much Salt and Sulphur, and very little Serum, hot Medicines, and such as are endowed with very active Particles, do not agree, nay often prove offensive to them; which nevertheless prove greatly beneficial to phlegmatic persons, whose blood is colder and contains a great deal of Serum, and a few active Elements. Wherefore, according to this twofold state of the Diseased, it seems fit for us to propose here a double method of Cure, and two Classes of Medicines, whereof this will do well to be given to cold paralyticks, and the other to such as are hot. In the former case, for the removal of the procatarctick Cause, after a Vomit and a Purge duly ordered, I advise to be prescribed according to the following forms. Take Conserve of the leaves of Garden Scurvygrass, and of Rochet made with an equal part of Sugar, of each three ounces, Ginger condited in the Indies an ounce, the yellow coats of Oranges and Lemons preserved of each six drams, powder of the Claws and Eyes of Crabs of each four Scruples, species diambroe two drams, winters-bark a dram and a half, roots of Zedoary, the lesser Galingal, Cubebs, the seeds of Garden-cresses, rochet, of each a dram, Spirit of Scurvygrass, and of Lavender, of each two drams, Syrup of the conditure of Ginger what suffices, make an Electuary: Let the quantity of a Walnut be taken at eight a clock in the Morning, and at five in the Afternoon, drinking after it a pound of the following decoction, or six ounces of the Tincture of Coffee, with the Leaves of Sage boiled in it, or three ounces of Viper-wine. Take Rasping of Guaiacum six ounces, Sarzaparilla, Sassafras of each four ounces, red and yellow Saunders, shave of Ivory and Hartshorn of each half an ounce, infuse them according to art, and boil them in sixteen pounds of fountainwater, to a half, adding Crude Antimony, powdered and tied in a Nodulus, four ounces, roots of Calamus Aromaticus, the lesser Galingal of each half an ounce, Florentine Orris an ounce, Cardamum six drams, Coriander seeds half an ounce, six Dates, make a Decoction, and let it be used for ordinary drink. Going to Bed, and early in the Morning, let a dose be taken either of the Spirit of Soot, or of Hartshorn, of Sal Armoniac succinated, of Blood, etc. with three ounces of the following distilled Water. Take of the Leaves or Roots of Aron a pound, Leaves of Garden Scurvygrass, the greater Rochet, Rosemary, Sage, Savory, Time, four handfuls, Flowers of Lavender three handfuls, the outward rinds of ten Oranges and six Lemons, Winter's bark three Ounces, Roots of the lesser Galingal, Calamus Aromaticus, Florentine Orris of each two ounces, Cubebs, Cloves, Nutmegs, of each an ounce, all being sliced and bridsed, pour to them of White-wine and Brunswick Beer of each four pounds, let them be distilled with common Organs, and let the whole Liquor be mixed. Sometimes instead of the Electuary, for fifteen or twenty days let a dose of the Tincture of Sulphur terebinthinated, or the Tincture of Antimony, or of Amber: sometimes also let the Elixir Proprietatis, or of Peony be taken in a spoonful of the distilled Water, drinking after it three ounces of the same. Sometimes also let the following Powders or Tablets have their turns in the course of Phyfick. Take powder of Viper's Flesh prepared at Montpellier an ounce, Hearts and Livers of the same half an ounce, Species Diambroe two ounces, make a Powder, let a dram be taken twice a day, with three ounces of the distilled Water, or with Viper Wine, with a decoction of the Leaves of Sage, of the Roots and Seeds of the great Bur-dock, and Eringo roots condited made in a sufficient quantity of Fountainwater to a half, to the quantity of six or eight ounces warm in the morning, expecting a sweat. Take Solar Mineral Bezoar half an ounce, Cloves powdered two drams, mix them, make a powder, to be divided into twelve parts; let one part be taken twice a day after the same manner; with the use of these kinds of Remedies, let gentle cathartics be pretty ften interlaced. Take powder of choice Roots of Zedoary, and the lesser Galingal of each a dram and a half, Species Diambror a dram, powder of the Seeds of Mustard, Rochet, Scurvygrass, Water-cresses, of each half a dram, make a subtle powder of all: add pure Oil of Amber half a dram, with six ounces of white Sugar dissolved in compound Peony Water, and boiled to a Consistency for Tablets, make Tablets according to Art, each weighing half a dram, let three or four be eaten twice a day, drinking after it a dose of some one of the Liquors even now mentioned. Take powder of the roots of Virginia Serpentary two drams, of the lesser Galingal a dram, of the Gummous extract from the residency of the distillation of Quercitans' Elixir of Life a dram, Flowers of Sal Armoniac (or of pure volatile salt of Soot, or of Hartshorn) a dram, Balsam of Peru a scruple, Balsamum Capivi what suffises, make a Mass, let it be made into little Pills, rolling them in species Diambrae, the dose is half a dram evening and morning. (or) Take Rosin, or Gum of Guaiacum three drams, species Diambrae a dram, Chemical Oil of Guaiacum excellently rectified a dram and a half, liquid Amber what suffices, make a mass, let it be form into Pills, to be taken after the same manner. But if a Palsy, happening in a bilous Temperament, or in young Persons, admits only mild Medicines, being wont to be exaspirated by any that are hot and elastic, the following forms will be of use for removing its Procatarxis. Take Conserve of the Flowers of Betony, Fumitory, Primrose Flowers of each two ounces, species Diambrae a dram, Ivory, Crabs Eyes, Crabs Claws of each four scruples, Powder of Peony Flowers two drams, Lignum Aloes, yellow Saunders, of each a dram, Salt of Wormwood, a dram and a half, with a sufficient quantity of Syrup of Peony Flowers make an Electuary, the dose is two drams a day, drinking after it either of the simple Water of the Leaves of Aron, or of the following compound Water three ounces, or of a Decoction of Sage, with the Leaves of Tea infused in it four or six Ounces. Take Rots of Aron, male Peony, Angelica, Masterwort, of each half a pound, Leaves of Sage, Rosemary, Marjoram, Booklimes, Water-cresses of each four handfuls, the Flowers of Primroses, Cowslips, Marygolds, of each three handfuls, the yellow coats of six Oranges, and four Lemons, all being sliced and bruised pour to them of new Milk six pounds, Malaga-wine two pounds, distil them with common Organs, let the whole Liquor be mixed. Instead of the Electuary sometimes for fourteen or fifteen days, let the use of the Syrup of Steel be interlaced, wherefore let a spoonful be taken in three ounces of the distilled Water, it may be made after this manner. Take double refined Sugar dissolved in black Cherry Water, and boiled to a Consistency for Tablets eight ounces, adding of our Steel powdered three drams; let them be stirred together on the Fire, and then pour to them by degrees, Rosemary Water warmed twelve ounces, let them seethe gently for a quarter of an hour, taking off the froth, and pour it out warm through a hair Strainer. Chalybeat Tablets also may be made after this manner; viz. To the Sugar sufficiently boiled with the Steel add Oil of Amber, or Chemical Oil of Rosemary half a dram, and presently pour it forth that it may run abroad into a Consistency for Tablets, the dose is two drams twice a day, drinking after it of the distilled Water, or of the following Apozome six ounces. Take China Roots an ounce, shave of Ivory and Hartshorn of each half an ounce, white and yellow Saunders, Mastick-wood of each half an ounce, let there be a warm and close infusion for a Night, in six pounds of Fountain-water, in the Morning add Roots of Chervil, Avens, Butchers-broom stone-Parsley of each an ounce and a half, dried Leaves of Ground-Ivy, Sage, Germander, Betony, of each a handful, Coriander Seeds three drams, let them boil to a half, then add of White-wine half a pound, and strain it into a Bottle on two handfuls of Leaves of Water-cresses bruised: make a warm and close infusion for two hours, strain it again, and keep it in a stopped Vessel. In a scorbutic Palsy Juices and Expressions of Herbs often give an excellent relief. Take fresh Leaves of Brooklimes, Water-cresses, Plantain, of each four handfuls, being bruised together, pour to them of the distilled Water even now described eight ounces, express it strongly, keeping it in a Glass, and let three or four ounces be given twice or thrice a day. At the earliest and latest physical Hours, viz. in the Evening and early in the Morning, let the following Pills be taken. Take Millepedes prepared three drams and a half, Pearl a dram and a half, Roots of bastard Dittany a dram, Venice Turpentine what suffises, make a mass, form it into small Pills, the dose is half a dram, drinking after it a little draught of the distilled water. For ordinary drink let either a Bochet be prescribed of Sarsa, China, yellow Saunders, etc. or small Ale, with the dried Leaves of Ground-Ivy boiled in it, and of Sage, with the wood Sassafras infused. While these things are done for removing the Procatarxis of the Disease, no less a curatory endeavour is required for its conjunct Cause, viz. that any places obstructed, being again opened, may admit and give a free passage to the animal Spirits, freed from stupefaction. There are two chief kinds of Remedies which conduce much for these ends; viz. the one particular and special, to be applied to the Places affected, to wit, that by Fomentations, Liniments, Plasters, and other outward Applications the stupefied Spirits may be raised up again, and their Ductus' be opened: the other universal, to wit, that the Blood and Spirits, and the other humours (and the active particles abounding in the whole Body) being very much agitated and put in a more rapid Motion, making as it were a swift current, may force from before them and remove dams, or Obstacles any where sticking, by which the Spirits are obstructed. The Administrations to be used to the outward Parts, are so generally and vulgarly known, that it would be superfluous to insist here in describing them at large. First, let Liniments of Oils, Unguents, and Balsams, more or less hot according to the temperament of the diseased, be applied twice a day with Frictions. Let Fomentations of a Decoction of Cephalick Herbs and Aromaticks in Fountain-water be sometimes used before these; adding sometimes hot Waters, Wine or Beer, or their Lees: moreover, it is proper sometimes to apply Vesica ories, Cupping-glasses, a Pication, or Urtication about the places affected. Bags, and Plasters oft do good. Again, if the case admits it, it is profitable for the resolved Members to be put into Grains, or the Dregs of Grapes remaining after pressing, or to be thrust into the Belly or Thorax of a Beast fresh killed, or also be bathed in an artificial Bath, or natural hot Baths, and to be kept in any of these for a long time. But if these things do no good, we must come to the Universal or great Remedies: such as chief are Diaphoreticks, Mercurials raising a Salivation, and strong Vomitories: of each of which we shall speak in short. There is no one of the Vulgar but every where observes that Diaphoreticks sometimes do great good in the cure of the Palsy, and that sometimes they prove very prejudicial. Wherefore it much concerns us that the reasons of so different an effect should be explicated; to the end that Indications may be thence taken concerning the use, or rejecting of them. Therefore a copious sweeting is wont sometimes to prove very advantageous to Paralyticks, chief for two reasons; to wit, that it may plentifully drive forth the impurities of the Blood, and nervous Juice, which are apt to exhale, so that the morbific Matter may no longer flow to the Brain, and the Parts affected, and that that which has already flown to them may in part be conveyed forth. And then secondly, that the effluvia of heat passing from the boiling Blood very much open the Ductus' of the Nerves before obstructed, as they pass through them in evaporating, and open ways for the Spirits. Wherefore this Administration agrees chief and in a manner only with those, whose Blood, being not filled with a fixed Salt and Sulphur, is diluted with a limpid and insipid Serum: for on the contrary, Paralyticks, whose Blood and Humours are greatly stored with wild, Exotic, and fixed Particles of exorbitant Salts and Sulphurs, and such as are unfit for exhaling, often receive a great damage from a sweat violently raised, of which effect we assign these two Causes, to wit, that the morbific Particles being too much exalted by reason of their Agitation, become more exorbitant: and then secondly, that being driven plentifully into the Brain, and Genus Nervosum, they often increase the ancient Obstructions, and not unfrequently produce new. For raising a plentiful and easy Sweat, both inward Medicines and outward Administrations are wont to be used: the former stir the Blood or Serum to effervescencies, or stimulate the Heart to quicker Motions, and thence (whether one of them, or both be performed) when the Liquor of the Blood, being rapidly circulated through the Heart and Vessels, is put into a frothy Turgescency, it cannot but discharge from itself a great many Effluvia, which are the matter of Sweat: for this end Medicines of various kinds are recommended to Paralyticks, of which those of chief note are, a decoction of Guaiacum, Sarsaparilla, etc. Spirit, and Oil of Guaiacum, mixtura simpelx, Flowers and Spirit of Sal Armoniac, Aurum Diaphoreticum, Salt, Powder, and Wine of Vipers, mineral solar Bezoar, Tincture of Antimony, etc. Outward Administrations promote a Sweeting, for as much as they raise and keep a moderate heat in the whole circumference of the Body, and then the Blood being heated, is forced to move more swiftly, and to evaporate more, and withal, the pores of the Skin being opened, more readily let forth all Particles apt to exhale; for this end, besides Bed-covering (which only keep the Effluvia of heat emitted from the Body in its circumference) a Cradle likewise with Charcoal, or Spirit of Wine, kindled, a Hothouse, and Baths of various kinds and forms, and natural Hot Baths are wont to be used; but above all, our Hot Baths at , than which (if they agree well with the temperament of the Patient) no more excellent Remedy can be imagined, which is sufficiently shown by the Crutches of a great many Persons cured of resolved Members, hung up as so many Trophies of the Conquest of this Disease. Nevertheless, as generous Medicines, if they do not prove Alexipharmicks, often pass into Poisons, so the use of hot Baths, when it has not cured some Paralyticks, has rendered them much worse; so that more Members, and such as were before affected, being more resolved, there has been no other occasion for the Diseased for leaving their Crutches there, but that being rendered more weak they could use them no longer: we have hinted the cause of this before, to wit, that bathing exagitating the Blood and all the Humours, exalts more all Morbific and heterogeneous Particles, and being rendered more exorbiant, drives them from the Viscera into the Mass of Blood: whence (in regard they cannot easily evaporate) entering the Brain, and Genus Nervosum, they increase the Paralytic affect, and often bring a Convulsion with it: for this reason Bathing sometimes first actuates a Nephritick, and Gouty Disposition, moreover, it brings to many a Blood-spitting Asthma, or Consumption, where no Disposition was; wherefore hot Baths ought not to be tried without the advice of a Physician, and being tried, if they seem not to agree, they ought soon to be left. I have it sufficiently confirmed both by my own Experience, and that of some other Physicians, that some Paralyticks are cured by a Salivation raised by Mercury, but I judge that this kind of Remedy is to be used only in an habitual Palsy, viz. which has a Procatarxis in the Blood and Brain readily enough to be moved, and a conjunct Cause in the nervous Appendix, which is not very fixed: but when that affect is caused by an outward and great hurt, or happens upon a Carus, Apoplexy, or Convulsions, Salivation is attempted in a manner always in vain, and sometimes not without a mighty Prejudice; and let not those who, having a weak or over-lax Brain, are frequently subject to a Vertigo, drowsiness, and convulsive Motions, use Mercurial Medicines inconsiderately. But sometimes a Salivation does mighty good in an habitual Palsy, and which is not very fixed, for as much as by taking away the Impurities of the Blood, it cuts off all the fuel of the Disease; and in as much as some Mercurial Particles, whilst having past the Brain, they enter the Ductus' of the Nerves, divide the Morbific matter sticking in them, and severing its parts one from another, disperse them several ways, some forward and some backward. Whereas it is a common fault of other Medicines, that often they press forward only the dam that obstructs the ways of the Spirits, and therefore if they do not force it asunder, they drive it more firmly into the places obstructed. And it is in some sort for this reason that Vomitories often do egregious service in Curing the Palsy: to wit, that they withdraw the fuel of the Conjunct Cause, and do not drive only forward the matter sticking in the Nerves, but revulse it, mightily shake it, and often break it into minute parts, so that when the Continuity of the dam is broken, the animal spirits themselves easily dissipate the Particles of the Morbific matter severed from each other; we have intimated before another reason concerning the relief of Emetics in the sleepy affects, which has also in some sort place in the Palsy. So very many Examples and Instances of Paralyticks daily happen every where, that the various Types and Histories of them (if they were described) would fill a mighty Volume, wherefore I shall only set down here some of the more rare, viz. one or two, with which each chief species of that Disease may be illustrated, and since it would be to little or no purpose to give a Relation of Resolutions of Members happening by reason of some outward Accident, as a fall from an high Place, a Wound, or a Stroke, I shall insist only in describing those Cases, where the Palsy arises either by itself after a previous Disposition, or follows upon some other Disease. Some time since, a certain Gentleman, Robust, well in Flesh, and above forty years of Age, having been in a manner always in health, at length giving himself to a sedentary Life and Idleness, and afterward becoming more dull than usual, refused any exercise and vigorous motion of the Body: moreover, being melancholy and sad, on any light occasion, nay, sometimes without any manifest cause, he was wont to break forth into a weeping and tears: this Person a short while after (which I have also observed of many others) was affected with a Weakness and a Trembling of all the Members, and afterward with a Resolution of the lower Parts, by which Disease (being melancholy and soon a weary of Physic) yielding himself overcome, and growing weaker by degrees, he died within six months. I remember many others, but especially two committed to our care, being as to the first part of their Life mighty Ingenious, and well Learned, who afterward in their declining Age, partly by reason of a Cacochymia of the Body, and partly through a trouble of mind growing dull and forgetful, at length (notwithstanding the use of Remedies in the beginning of the Disease) became Paralytical. A young man of a sanguine temperament, clear spirited, and for the most part Healthy, sitting in a Chair after a plentiful Supper, and an immoderate Drinking of Wine, was so affected with a stupidity in his right Hand, that his Glove, which he happened to hold, fell down against his will; afterwards standing up and endeavouring to go, he perceived a resolution in the Leg and Thigh of the same side, falling a little afterward into a certain dulness of Mind, and a stupidness, though without an Apoplexy, for he was always present to himself, answering aptly enough, though slowly, and with some trouble, to things asked, and doing things that were commanded him; a very skilful Physician being presently called, Blooding, Vomiting, Purging, were used in order, Cupping-Glasses, a Scarification, Liniments, Frictions, and other fit Administrations were diligently applied: nevertheless the Palsy increased, so that besides Motion almost taken away from the Members of the right side, he lost also the sight of that Eye: yet, though dull and sleepy, being still Compos mentis, he knew his Friends, and being conscious of his Infirmity, and solicitous for the recovery of his Health, he took all Remedies offered, but notwithstanding this, the animal functions daily failed more and more, and through a consent with them, at last the vital, so that about the seventh or eighth day falling ever and anon, sometimes into a Delirium, sometimes into Convulsions, and other distractions of the Spirits, at length his strength being gone, he yielded to Death. A certain Nobleman's Bailiff, about forty years of age, having a sharp Blood and a bilous temperament, and long obnoxious to a Vertigo, as he road through a certain Village in the Country, being seized on a sudden with a Scotomia, fell headlong on the ground; where being presently taken up by the Inhabitants, and put to Bed, he lay for many hours insensible, and dead as it were; but afterward awaking, he found all the members of both sides resolved into a Universal Palsy: going to see him the next day after, I presently drew about twelve ounces of Blood, and forthwith prescribed other Remedies, both as to outward administrations, and inward Medicines to be diligently used, and indeed with good success; for after five or six days he began to stretch forth, or bend his feet, nay, to move them from their place this way and that, though slowly; afterward, by the constant use of Remedies, he was able within two months to raise himself, stand on his feet, and go a little with Crutches, then having used at his house an artificial Bath for some time, he daily gained in the motion of his members, and his strength; at length, assoon as the season of the year was fit, going to , and by the use of the hot Baths perfectly recovering within six weeks, he returned sound, leaving there his Crutches. The following Relation will manifestly show that the Palsy does not only follow upon Cephalick affects, but also on the Colic and Scurvy. A handsome Woman, and young, after Childbirth fell into a Tertian Ague, this afterward becoming a Quotidian, and the cure protracted, brought a very violent Colic, and of long continuance. Pains first raged only in the Abdomen, with a vomiting and most bitter tortures: being long tormented, and almost worn away with these, at length she began to be troubled with a stupor, and a sense of pricking, such as arises in members lain on. Nor was it long after but a Palsy (which that other affect very often foreruns) followed in the whole Body. In this state being brought to Oxford, she was committed to our care; another famous Physician, D. D. Lydall, being called to join with me. Not only all the greater Members of this Diseased, but even the lesser of each Limb were so wholly resolved, that she was not able to stir from its place either Hand or Foot, or any finger of either hand. Moreover, she was so far affected with an Atrophia, that the flesh being wholly vanished, the Skin scarce stuck to the Bones, yet she still had a good Pulse and vivid Aspect, from which alone we gathered somewhat of hope. After that we had given this Person for many Weeks the choicest Medicines both Antiparaliticks, and Antiscorbutics, almost of every kind, and according to various Methods, without any success, at length we proposed to herself and her Friends a Salivation, as a Remedy more powerful than any others, but withal dangerous: not deliberating long concerning this, they resolve rather to try a doubtful Medicine than none, or which is the same, one wholly ineffectual. Therefore we gave her Precipitatum ex Mercurio cum sole in a small Dose, and repeated it the next day after: on the third day, an easy and gentle Salivation beginning, went on fairly for a Week without any malign Symptom; but then the Diseased complaining of a great Headache and Vertigo, begun to be affected with Convulsive Motions, so that we were forced presently to let fall the Salivation, and to break off this Course as soon as we could, withdrawing the fluxion of the serous latex from the head towards the other parts, which frequent Clysters, Epispastick and Revulsive Plasters applied in various places, together with Cordials and Opiates inwardly given, soon effected; and presently upon it the noble Lady being somewhat better, begun to stretch forth and bend the Joints of her Hands and Feet, and to move sometimes those members or these from their place, the Spitting ceasing: being gently purged, she took for many days a decoction of China, Sarsa, red Sannders, Ivory, etc. with the addition of the dried leaves of Sage, Betony, Speedwell, etc. with which she was wont to interlace the use of Spirit of Hartshorn, or of Soot, of a Cephalick and Cordiack confection, also of an appropriate Powder and Julep: within a Month's space she was able to stand on her Feet, and to walk a little in her Chamber being supported by Servants: moreover, getting Sleep, and taking Food indifferently, the bulk of her Flesh and her strength daily increased, and at length using the temperate hot Baths at Bath she grew well. But that hot Baths do not do good to all Paralyticks, nay (as we have intimated before) that they do great hurt to some, the following relation will plainly show: A London Merchant after a Luxation of a Joint of the Foot, became lame in that part, being otherwise sound enough, and robust: when Topick Remedies of various kinds, tried for some, time did not do, at length by the advice of a Physician going to , he began to try the temperate hot Baths, from the farther use of which (becoming forthwith worse upon it, the Palsy presently beginning in other Members) he had abstained, but the Physician being then present, assuring him that he would be better afterward, advised him to persist: wherefore he took the hot Baths again for about thirty days, till all the lower Members, to wit, from the Os sacrum to the Feet being wholly resolved, were withered, and that in the Thorax a very great and as it were Asthmatical dyspnaea was raised: for the Muscles employed in Respiration (being as it seemed affected also with the Palsy) the breast was not able to be dilated for drawing the Breath deep enough, wherefore, being always out of Breath, he laboured under continual affects of those Parts, and an Agitation of the whole Thorax. In this state departing from , he is commanded by his Physician to abstain for a whole Month from any Remedies taken from Pharmacy: which when he had religiously observed, through hope as it were of a Resurrection, that time being past, all deliberation was now late concerning the use of Medicines: for besides the Paralytic and withered Members, his Belly swelled, his Respiration was yet more difficult and letted, that the diseased was scarce able to draw his Breath: his Pulse being very weak, with frequent Swoonings, and Faintings happening upon any Motion of his Body: so that hereby scarce any place at all being left for cathartics, he must insist only on Cardiack and Paralytic Remedies: notwithstanding the use of which, the diseased within six weeks labouring under a very great dyspnaea for many hours, at length died: the immediate cause of whose decease I conceive to be Polypous Concretions of Blood in the Heart, for in regard the Motion of the Praecordia was greatly letted for a long time, nothing seems more probable than that those kinds of carneous lumps as it were, were concreted within the Ventricles of the Heart. For illustrating a little farther the Theories of the Palsy, and also of the Lethargy and Carus, I shall here give you another Example, with Anatomical Observations, which happened whilst the precedent things were printing. A child, little more than three years of Age, of a moist Brain, as it appeared by sore Inflammations of his Eyes, and watery bushes of his Face (to which he had been sometimes obnoxious) at the beginning of Autumn being ill, with a slow Fever and a dejected Appetite, became very drowsy and sleepy, so that he slept almost continually day and night; but being awaked, he knew the standers by, and answered aptly enough to things asked: meet Remedies, viz. Clysters, Vesicatories, cathartics, also Juleps, Spirit of Hartshorn, Powders, with many other things usual in this case, being forthwith, and carefully given him, did so much good, that within six or seven days the diseased being free from his Fever, waking sufficiently, and desiring Food, seemed to recover, and scarce to have any more need of Physical help, But in a short while after (I know not on what occasion) undergoing a relapse, and being drowsy again, he was presently affected with a great Stupefaction, so that being with difficulty to be awaked, he scarce knew any thing, or did any thing with Knowledge; the next day after, being utterly stupid, though being pinched hard, he would open his Eyes, and roll them this way, and that, he saw nothing: and within a day or two a Palsy of the whole right side followed: The former Remedies repeated to him, and likewise Sneezers, Apophlegmatisms, drawing of Blood, Cataplasms to be applied to the Feet, and Epispastics to the whole Head shaved, with other Medicines and ways of Administrations prescribed in order, did nothing; but the diseased, after he had lai so for three or four days insensible, the Pulse and Respiration at length failing, he died. The Scull being opened, the foremost Region of the Brain, almost as far as the Insertion of the fourth Sinus, was swollen, being covered with a limpid Water shining through the Membranes, which upon the dissection of the meanings presently flowed forth; Moreover, at that place the portions of the Brain cut off by piece-meal appeared too moist, and almost without red or bloody specks; but in the hindmost part of the Brain the Vessels were red with Blood, and the cortical Substance appeared more low and firm without a Tumour, or being floated with Water: from these things (as we have concluded before) it will manifestly appear that the Cause of the Lethargy depends on a watery glut of filth in the outward part of the Brain. The Brain being cut off piece-meal, and a hole being made into the foremost cavity, strutting with a lympha, the limped water sprung forth as though it had been penned up in too narrow a space before: whose mighty store had filled all the Ventricles to the top, and (as it seemed) by compressing the Thalami Optici had caused the blindness, and by entering or compressing one Corpus Striatum, or its Pores, had brought the Palsy. The Plexus Choroeides appeared as parboiled, somewhat white, and almost without Blood, it's probable that all the Lympha, or the greatest part of it, wherewith the Ventricles of the Brain were floated, distilled from those Vessels; though in this case if (as some think) the watery latex sinking lower from the cortex of the Brain, at length having wholly passed the Brain, could fall into those Sinus', a reason may not uneasily be thence taken wherefore the Lethargy seeming first to be cured, by and by being more violent, returned again, with a Blindness and Palsy joined with it, to wit, as at first the store of soporiferous matter fell from the Cortex of the Brain into its cavity, the animal Function grew a little clear; but afterward, when a new matter sprung in the Cortex of the Brain, and this falling into the Sinus', was gathered together to a fullness, thereupon a Relapse of the former Disease happened with the addition of a blindness and Palsy. Now though the Dropsy of the inner part of the Brain, or an inundation of its Ventricles, by compressing the corpora striata or thalami optici causes a Palsy, or blindness, or by twitching the Origines of the Nerves, Convulsive affects; yet it most evidently appeared by a late observation, that the Lethargy does not arise from such a Cause, but only from the outward part of the Brain being floated or compressed. A certain Gentleman, long sickly, after that he had been troubled almost for five Months with a Colic, or rather with a most violent scorbutic and running Gout, (in which not only the Viscera and Fibers were affected with great Gripes, but likewise the Membranes, and all the Muscles of the whole Body almost with continual Tortures) and at length suffered in his Members sometimes horrible Convulsions, sometimes Apoplectic Invasions as it were, or an offuscation of the Sight, at last his Strength being spent, and the Stores of his Spirits wholly exhausted, he died. For seven days before his decease (excepting only the last save one) being more lively as to his Sense and Understanding, he lay almost continually awake: a little before this long waking, upon a Vesicatory's being applied to his Neck, a vast quantity of water flowed to it; and thenceforward flowed forth daily, even to his death, that I may hence suspect he continued thus without sleep, by reason of the watery humour withdrawn from the Brain in too great a plenty. The Head of the defunct being opened, the inward Cavities of the Brain, or all its Ventricles appeared filled to the top, and strutting as it were with a limpid water, nay about the top of the Spine the Funis medullaris itself seemed to be surrounded with, and immerged as it were in Waters there heaped together. Without doubt for this reason such violent pains and cramps infested him in his Loins and Members, and in the whole Habit of the Body; and by reason of the deluge in the Ventricles, he became obnoxious to frequent offuseations of the Sight, and resolutions of the Limbs: nevertheless there was no Lethargy here, though the long watching was caused by reason of the waters derived in too great a plenty by the Vesicatories from the circumference of the Brain. This Person had also gotten a Dropsy in his Breast, by reason of the Lungs being much vitiated: the Liver being of a vast bigness, appeared every where with white spots, and almost without blood; so that the depravations of the blood and nervous juice ought to be ascribed in some sort to these faults of the Viscera. CHAP. IX. Instructions and Prescripts for the cure of the Delirium and Frenzy. SO far of Cephalick Diseases, by which the Animal Functions by themselves, and as they are Corporeal, are wont to be letted or perverted, without respect to the rational Soul; in some of them, viz. in the Vertigo and Palsy, the Understanding for the most part continues clear and lively: and in the rest, as an Eye placed in an obscure place, it beholds either no Species at all, or a few only set before it with a gross appearance, but is not easily carried into a great Error, or a Fury: which kind of Symptoms are generally caused by other affects of the Brain, and of the Spirits residing in it, of which we shall now treat, for if at any time the Imagination be so troubled, or perverted, that it either conceives amiss, or ill compounds, or divides the Species and Notions presented by the Sense or Memory: thereupon presently the Understanding descries, or frames only deform Conceptions and Thoughts, distracted from each other, and greatly confused, which are represented to it by the Brain ill affected, as erroneous appearances by a variegated, and distorted Glass: there being many ways with which the Imagination, and consequently the Mind and Will, and other Powers of the superior Soul are wont to be perverted or depraved, they all are denoted by the common word Desipientia. Now this Affect is distinguished into a short one, which is called a Delirium, and a long or continual one, which is either joined with a Fever and is called a Frenzy, or happens without a Fever, and to it either a Rage, or Sadness, or Stupidity is joined; and therefore it is divided into a Mania, Melancholy, and Fatuity. We shall speak of each of these in order, and at present of the Delirium and Frenzy. Tho the Delirium be not a Disease by itself, but is only a Symptom, proceeding from other affects: yet because in the cure of these on which it happens, it is usual to obviate it for the most part with appropriate Remedies; Therefore it seems to concern us to inquire somewhat strictly into its Nature and Causes. That word taken properly is the same as Dementia, and denotes such an annoyance of the animal Function, as arising in the fits of Fevers, Drunkenness, and sometimes in the Passions called Hysterical, induces men to think, speak, or do absurd things, (viz. some of these or all of them together) for a short time. A Delirium is raised in as much as the Animal Spirits either being too much irritated, or put in Confusion, are carried hither and thither within the globous frame of the Brain (where the Fancy and Memory have their Seats) in a disorderly and tumultuous manner, for so whilst the various species of the Imagination and Memory being raised together, are confounded with each other, only absurd and incongruous Phantasms are presented to the Rational Soul, and therefore the Acts of the Understanding and Will are wrought only irregularly. But reason of the Animal Spirits being irregularly moved within the Meditullium of the Brain, or the Corpus Callosum, incongruous conceptions and confused thoughts are presented to the Rational Soul, it happening in like manner, as when the Species of visible things are brought to the common sense after a long turning round of the Body, whence all things seem to run round, sometimes to be raised on high, sometimes to be depressed low; so that nothing is seen fixed and settled in its due site and position. In a Brain rightly disposed, the motion of the Animal Spirits is performed in certain numbers and measures, as it were in a Dance; while certain Spirits are moved in these tracts, others lie still in those, afterward these maintain those with a supply in motion, and the several Acts of each Faculty become as so many distinct undulations of Waters in a River, but in a Delirium all the Spirits skip about together, and meeting each other in a tumultuous manner, or taking several ways, dance about like People distracted: Moreover, even as these being struck with such a Rage within the frame of the Brain, raise manifold and very troubled thoughts: so while they are carried beyond the confines of it into the Nervous Origine, they produce an Idle talking, absurd Gestures of the Body and Members, and often Convulsive motions, yet since such a wild motion of the Spirits (otherwise than in the Frenzy or Mania) soon ceases, and after that that tumult is over, no deviating tracts are made in the Brain, the Delirium soon passes off, and the affected in a little time come to themselves again, no footsteps of the distraction remaining. If it be asked, whence this short Fury is given the Spirits residing in the Brain, that shaking off the Reins of the Mind, they are so all in confusion in their Oeconomy; we say, that they enter upon this disorder for a double reason, viz. this Rage is either immediately communicated to them from the Blood irrigating the compages of the Brain; or certain animal Spirits residing in some outward part within the Genus Nervosum, first begin a certain disorderly Motion; and afterward the same disorder being communicated to the Brain by the Nervous Ductus', and affecting in like manner the Spirits there residing, causes the Delirium. There are various kinds and causes of both these, wherefore we shall here briefly touch the chief; and first, it shall be shown how and on what occasions the Blood, either swelling with too great an effervescency, or being full of a venomous matter, becomes the Parent of the Delirium: in as much as it insinuates into the Pores and Passages of the Brain, either exorbitant and masterless Particles, or such as are malignant, and subverting the animal oeconomy, 1. As to the former, in the Fits of intermittent Fevers, and the height of such as are continual: the Blood being troubled with an immoderate burning, sometimes raises a Delirium by the mere Impetus of its Ebullition; viz. in as much as being very turgid, while it passes the small Branches of the Arteries spread all over the outward circumference of the Brain, it greatly puffs them up, and stretches them: and therefore compressing the substance of the Brain, it drives the Spirits several ways, and forces them into very confused crowds as it were. Moreover, from the Blood's growing thus turpid through a frothy Rarefaction, Effluvia of heat, and Heterogeneous Particles with them entering the Pores and Passages of the Brain, exagitate the Spirits, and carry them violently hither and thither in a tumultuous manner. 2. For a like reason in a manner to this, Drunkenness causes a deep Sleep or a Delirium: viz. In as much as the mass of Blood insinuates into the Pores and Passages of the Brain, the spirituous Particles of the Wine, which causes it to boil, and by which the Spirits residing in them, are either overwhelmed, or put into disorderly or confused Motions. 3. Nor does the Blood only ministering febrile and turgid, or vinous and masterless Particles, but sometimes such as are malign and venomous as it were, cause a Delirium with or without a Fever. As to the former, in the Plague, small-Pox, malignant Fevers, (though the heat be moderate) the malignant matter conveyed to the Head produces abrupt, incoherent, and at length distracted Notions, in as much as it dissipates the stores of the Spirits, rather than by driving them into a tumult. 4. For a like reason to this some Poisons, and venomous things inwardly taken, and (as some say) outwardly applied, soon bring a Delirium: this is vulgarly said of Solunum furiosum, Mandrake, and certain other Plants: the thing is most notorious concerning the Roots of the wild Parsnip. An intimate Friend of mine, and a Man worthy of credit, and also very learned, told me once, that he went into the House of a certain Gentleman, where the Lady, her Daughters, and all the maid Servants (one only excepted) being all delirious at the same time, ran about the House leaping and talking incongruous and absurd things; he thinking them plainly distracted, was given to understand by the Maid, who was well in her Wits, that all this happened from eating Parsnip Roots, which she alone had not touched; and the event also confirmed it; for after, being tired, they had slept, all of them awaked sober. 5. But moreover, we observe that a Delirium is sometimes raised by a scarcity of the animal Spirits, and their great dissipation; for when their Orders are broken and discomposed, they minister confused and incongruous Notions, as well as when tumultuarily huddled together. Hence we observe, that some have grown delirious after great Hemorrhagies, or long Watch, and a long Fasting: for this Reason many dying Persons speak lightheaded and incongruously. There remains the other kind of Delirium, in which the Blood being without fault, the animal Spirits residing somewhere in the Genus Nervosum, first begin to fall in disorder, and afterward the same affect creeping to the Brain by the Ductus' of the Nerves, moves the Spirits residing in its Meditullium to a Delirium: this is obvious in the Passions called Hysterical, to wit, that after a rising of the Belly, and an Oppression of the Heart, at length sometimes a privation of Sense, sometimes a talking idly, with a Weeping and a Laughter ensues. In like manner, I have observed in a violent Colic, that sometimes extreme Tortures about the Viscera or Loins have presently passed into a Delirium, than a little after this ceasing, that the Tortures returned. I knew a Girl, who after taking an Emetic Medicine was wont constantly to be delirious till it wrought: for this also makes what I often observe, that a Delirium is raised by a Gangreen, beginning in some outward Member: and this is generally accounted for a mortal sign in a Wound, or Ulcer; because it denotes the animal Spirits to be generally a kill in the part affected. Nor does that Symptom afford a better Prognostic to such as have been long valetudinary, and are almost worn away: in the Fits of intermittent Fevers, it's in a manner always safe, but in continual Fevers it's of a doubtful and somewhat a suspected event; in malignant Fevers it commonly threatens ill: in Convulsive Diseases, the first invasions of a Delirium for the most part are without danger, but a frequent access of it often begets a disposition to a Carus, Apoplexy, or Palsy. This affect, as often as it seems safe, does not require a Cure, for the Fit soon and easily passes off: but because some, whose Brain is weak and lax, and whose animal Spirits, being too dissipable, are apt to a flight and confusion being troubled on any light occasion, are wont presently to act or speak delirously; therefore there is need of Physic for these, though not of Hellebore, but of Cephalick Remedies for corroborating the Brain, and fortifying it against the incursions of the morbific Matter; also for strengthening the animal Spirits, and rendering them more fixed and stronger to resist. We have given the Forms and ways of Administration of these Medicines before, they being profitable for removing the Procatarxis of any other Cephalick Disease. A Delirium happening upon continual and malignant Fevers, requires a peculiar way of cure, for it particularly indicateth that the morbific matter, dangerously conveyed toward the Head, aught to be revulsed thence some way or other; for which end, let Vesicatories be applied to the Neck, Plasters or Cataplasms, or the Flesh or warm Viscera of Animals to the Feet: Inwardly, let Temperate Cephalicks be given, as Powders of Coral and Pearl, the Waters of Black Cherries, of the flowers of Cowslips and Poppies, and other things refreshing and soothing the Spirits. These things being thus premitted concerning the first and lightest manner of Raving, let us ascend to a higher degree of it, viz. the Frenzy, which is far greater, and more durable than the former affect. In a Delirium the perturbation raised in the Spirits, residing in the Brain, seems like an undulation of Waters in a River, upon throwing in a stone; but in a Frenzy their commotion seems as the troublous motion of the Sea-waves raging upon a tempest. The Frenzy is defined, That it is a continual raving, or a depravation of the chief faculties of the Brain, arising from an inflammation of the meanings with a continual Fever. With this Disease another allied to it is ranked, viz. the Paraphrenesis; and its cause is said to be not the Inflammation of the Membranes that cover the Brain, but of the Diaphragm; moreover, in both affects the Fever, as though it were only symptomatical, is said (as also in the Pleurisy though falsely) to arise from the same Conjunct Cause, viz. a Phlegmon of some Part: but that the Frenzy rather succeeds the Fever, both Hypocrates heretofore, and now every Vulgar Person observes, and that it is produced because the boiling Blood conveys its adust recrements to the Head; viz. forasmuch as the Urine of a Feverish Person being changed from being troubled and thick, to be thin and watery, indicateth an imminent Frenzy: of which affect therefore the cause is gathered to be the removal of the febrile matter into the Brain. But as to the Conjunct Causes of the Frenzy and Paraphrenitis, it will be easy to show, that the former does not always proceed from the inflammation of the meanings, and the latter never from that of the Septum: in Anatomical Diffections I have commonly seen the meanings, nay sometimes also the outward circumference of the Brain beset with a Phlegmonous tumour; but the diseased being not affected with a Frenzy, but on the contrary with a drowsiness, died of a Carus or other sleepy diseases. And indeed Reason plainly dictates the thing to be thus, for inflamed meanings, and much more swollen, greatly compress the Brain, and stop the passages of the Spirits, which causes a Lethargy; whereas in a Frenzy the Spirits are dilated above measure, the Pores of the Brain being all opened though it may happen by a long continuance of that Disease, that the Blood being heaped together too much within the Veslels of the meanings, and there stagnating, at length begets a Phlegmon in them; but then we suspect for that cause (by reason it frequently falls out so) that the Frenzy passes into a Carus or Lethargy, of which such as have the Frenzy often die. Nor do we less reject the inflammation of the Diaphragm, which Galen with others have assigned for the cause of the Paraphrenitis: Anatomical observations plainly make out the contrary: some time since, opening the Body of a Girl dying of a sudden Leipothymia, we found in the fleshy part of the Diaphragm, a great Abscess with a bag, full of a gore and little bladders of Water, yet she was never wont to be troubled with a delirium or frenzy. And heretofore, when we dissected the Body of a Renowned Person of the University, who died of a bastard and long continued Pleurisy, it manifestly appeared that a great Abscess in the Pleura and intercostal Muscles, being suppurated and broken inwardly, had poured a mighty quantity of Pus into the cavity of the Thorax, which corroding the subjacent Diaphragm, had made a mighty hole in it; and yet this Person in all his sickness had neither the Frenzy, nor was delirious; wherefore I judge that this affect is scarce ever produced by such a Cause: but that opinion seems to have risen thence, that oftentimes in a true Frenzy, together with a continual Raving, the motion of the Diaphragm is wont to be hindered or perverted: as may be gathered from the uneven and difficult Respiration, viz. sometimes being painful and suspended, as it were, sometimes thick and swiftly repeated with an Inspiration, sometimes doubled, which kind of symptoms, and withal the alienation of the mind are said to proceed from the Septum being inflamed, and therefore convulsed: wherefore the Ancients called the Diaphragm Phrenas: though they need not have done it, if they had considered that all the action of the Diaphragm depends on the efflux of the animal Spirits from the Cerebellum, and therefore, if when the Phrenetick matter invades the Brain, some part of it withal rushes into the Cerebellum, besides the raving, the motion also of the Septum, though in itself being without fault, will be altered. Therefore the formal nature of the Frenzy seems to consist in this, that the animal Spirits being very much irritated, chief in the whole brain, are driven into disorderly, very confused, and withal impetuous Motions; so that the acts of every animal Function are depraved, and variously perverted: the Ideas of things are confounded, etc. Moreover the Spirits, not only in the Brain, but likewise in the Cerebellum, and every where in the Genus Nervosum, being struck as it were with a rage, fall in a tumult; wherefore such as have the Frenzy do not only speak ravingly, but breath unevenly, cry out, beat their Fists, throw their Hands and Feet, and exert all their Members with a mighty strength and force: that really the whole Soul seems furiously to fret and rage in the whole Body, or rather being set on fire as it were, to be all in a flame: and indeed the Frenzy cannot be more aptly defined, than that it is a Phlogosis or inflammation of the whole sensitive Soul, or of the animal Spirits in their whole Hypostasis; This burning flame always beginning from the Spirits residing in the Brain, and thence passing into the other parts of the sensitive Soul, seems to receive both the matter which first kindles it, and the constant supply of Fuel for it from the Blood, first burning with a feverish blast; for its probable that the Blood, feverishly burning, brings into the Brain sometimes sulphurous Particles together with the spirituous; which being half kindled, and in a manner on light fire, if they have penetrated together with the others, thence presently entering all the medullary and nervous Ductus', every where cleaved to the Spirits, and render them, being so inflamed, mightily exorbitant and implacable. Certainly it is more likely that the Frenzy is caused after this manner by the inflammation of the Spirits, than by that of the meanings of the Brain, which (as I have found by frequent dissections) will more certainly bring the Headache or Lethargy, than a Fury. As to the Procatarctick Causes of the Frenzy, we shall find them partly in the Blood, and partly in the Brain, and in what resides in it. The previous disposition of the Blood disposing to a Frenzy, sometimes is simple, and sometimes twofold: the former is its hot and sharp or bilous constitution, to wit, that it contains a great many sulphureous particles in itself, which being kindled more than they ought in a Fever, are apt to inflame the Blood more, and to insinuate ills burning flame into the Brain: this disposition, when it is powerful and mightily actuated, often produces that Disease by itself; but for the most part there is another disposition of the Blood, which aids the former, and renders it more efficacious, to wit, that besides sulphureous and inflammable particles, there are others sharp and penetrative, which enter the Pores and open them, and so more readily introduce the others: Saline Corpuscles joined with sulphureous in some sort effect this; hence Choleric and melancholy Persons that are in a Fever, are more inclined to Frenzies: but much rather heterogeneous Particles, when they are in the Blood, being stirred by a Fever, open the entries of the Brain, and let in all such Particles as are inflammable: wherefore the Frenzy frequently happens upon the small Pox, and malignant and pestilential Fevers. The other Preparation for a Frenzy, belonging to the Brain, consists partly in the temper and conformation of it, and partly in the disposition of the Spirits residing in it: as to the former, those that have a hot and dry Brain are found more prone to a Frenzy; not that that Constitution is more obnoxious to an inflammation, or Phlegmon, (for it is less apt to this) but because in such a Brain, otherwise than in a hot and moist, or a cold and dry, the pores and passages are more open, and gaping too much, afford a passage to the incentive matter minitred by the Fever: Whih likewise will much more easily be admitted, if the Spirits being very apt to be put to slight, and pathetic, on any light occasion are prone to the passions of sadness, fear, anger, or hatred; so that they less withstand the incursions of the extraneous matter, and more readily take fire themselves. The evident causes of the Frenzy are either remote, viz. whatsoever things are wont to raise the febrile distemper; as Surfeiting, Drunkenness, a violent perturbation of the body or mind, solemn evacuations suppressed, with many others; or immediate, as a Fever, and its little appendices and adjuncts; viz. if it be pestilent, malignant, or ill disposed; if it arises by surfeiting with meats or drinks which are very disagreeing; or if it follows upon violent passions of love, hatred, envy, indignation, or sadness, or immoderate studies: for these kinds of occasions render the Blood and Spirits severishly boiling, very much inclined to the affect of the Frenzy. This Disease, according to the temperament of the Diseased, is said to be sanguine, bilous, phlegmatic, or melancholy; and this not improperly, for the Animal Spirits, according to their various dispositions, are wont to rage after a different manner in this Disease. The Prognostic in this distemper is always dubious, and to be made with the suspicion of an ill event: For the Frenzy is a most acute and dangerous Disease of itself; moreover, if it happens upon a pestilent, malignant, or ill disposed Fever, we may expect none but a fatal event. If a Frenzy happens to a sound Body, well in flesh, a sanguine temperament, and in youth, there is a greater hope of doing well, than if the Diseased be elderly, lean, bilous, and subject to violent passions. If a Frenzy frequently remitting, has lucid intervals, it is better than if the fury be without discontinuation: but if the Diseased seeming sometimes to be better, after moderate sleep always awake frantic, it is a sign that the Disease will be obstinate, and consequently dangerous; viz. inasmuch as a new store of incentive matter is often ministered to the Brain, which we have shown elsewhere to be done much more plentifully during sleep, than whilst waking. The Frenzy is either terminated in a short time with a Fever, by a Recovery, or Death; or being long protracted, and remaining after the Fever, it is either cured at long run, or passes into other Diseases, viz. a Lethargy, or Mania, or Melancholy. If a Fever having a laudable crisis, by a plentiful sweeting or making water be throughly solved, the Frenzy also for the most part will wholly cease; but if the Fever being not determined, still sends the morbific matter into the Brain; so that besides the animal functions being depraved, the vital begin to fail (which will plainly appear from the Pulse and respiration altered for the worse) if the Urine be pale, if frequent droppings of Blood from the Nose, if Vomitings, and Convulsions happen, the Physician may conclude that Death is at hand. Sometimes a Fever, though it be not determined at once and perfectly, yet afterward passing off by degrees and leisurely, leaves the Frenzy or raving behind; which if by its long stay it has not defaced the former tracts of the Spirits in the Brain, afterward it either ceases by degrees of its own accord, or is cured by the help of Medicines. But if by reason of the Frenzy being long protracted, the meanings, or Cortex of the Brain are at length possessed with a phlegmonous tumour, or a serous glut of filth happening from the Blood or Serum there heaped together and stagnating, the Lethargy, or the sleepy affects ensue; whose Cure is often difficult, or none at all: But if after a long Frenzy, either the Animal Spirits (though their burning ceases) contract a vicious disposition, or if the Pores and passages of the Brain are perverted, often a perpetual raving (the former Disease passing into a Mania, or Melancholy, or Fatuity) ensues: Wherefore it is vulgarly said of frantics, not soon cured, that the Brain is cracked; so that afterward they always are mad, or become delirious. In the Cure of the Frenzy, we must have regard both to the Fever and to the fury: The feverish burning, or immoderate effervescence of the Blood, which for the most part is the antecedent cause of the other affect, aught in the first place to be restrained and appeased, and withal the Animal Spirits ought to be pacified and freed from any violent excandescence. If a Frenzy happens about the beginning or middle of a Fever, in a manner the same remedies and method of Curing conduce for both ends: But if that affect happens upon this whilst it is in its greatest force or height, the ways of curing often are contrary to each other; and there is need of great caution, lest while we give help to one disease, we increase the other; in this case the vital indication concerning the preservation of the strength has the first place, and let not Blooding or Purging be used rashly, and in a large measure. In the former case, when the Fever and Frenzy are almost of the same standing, let Phlebotomy, which is seldom or never to be omitted, presently be used; and if the strength bears it, let it be sometimes repeated for nothing depresses and diminishes the immoderate flame of the Blood as much as this Remedy, and nothing more removes or withdraws its burning flame from the Animal oeconomy: Wherefore, if the case requires it, let a Vein be opened sometimes in the Arm or Hand, sometimes in the Leg or Foot, sometimes in the Neck or Forehead; sometimes haply it may be expedient to open the Artery of the Temples; and sometimes also to draw Blood from other places by Leeches or Cupping-glasses, for this is the chiefest relief: And according to Galen, this being the first and greatest of all Remedies, is wont to satisfy a great many indications in the Frenzy. Moreover, to prevent the violent recourse of the febrile matter from the Viscera to the Head, Clysters will be of chief use; with which, if need be, let the Belly always be kept soluble: Vemits and Purges, unless only such as are lenitive, have seldom place here: Let Cataplasms of Rue, Camomile, Vervain, Briony Roots, Red Poppy-flowers, with Soap be applied all over the Feet: or in their place let Pigeons slit in two be applied whilst they are warm. Mean while Juleps, Apozemes, Powders, Confections; by which both the boilings of the Blood, and the excandescence of the Spirits are appeased, aught to be prescribed according to occasion. Take the waters of Apples, Black Cherries, Cowslips, of each four ounces; of whole Citrons two ounces, Pearl powdered a dram, Syrup of the juice of Citrons an ounce, mix them, make a Julep, let three ounces be taken three or four times a day. Take Roots of Grass, Leaves of Woodsorrel, Burnet, of each a handful, Barley half an ounce; Apples sliced, Corinth's, or Strawberries, or Raspberries, a handful; let them boil in four pounds of Fountain-water to the consumption of a third part, to the clear straining add Syrup of Violets an ounce, Sal Prunella a dram and a half. Take fresh and tender leaves of Borage four handfuls, Woodsorrel two handfuls, two Apples pounded to a mash, Sal Prunella two drams, the pulp of one Orange, double refined Sugar an ounce, being bruised together pour to them of Fountain-water two or three pounds, make a strong expression, keep it in a glass to be clarified by settling: Let six or seven ounces be taken at pleasure often in a day. For quenching thirst, drink at pleasure the divine drink of Palmarius, viz. Fountain Water with Sugar, and the Juice of a Limon, or Water, or Whey with the leaves of Meadow-sweet, or Burnet infused, or boiled in them; emulsions of a decoction of the roots and flowers of Nymphaea, with the seeds of Melons, or fountain, or distilled Water, with the pulp of boiled Apples dissolved in them. Hypnoticks are often necessary in this Disease, but such as are strong are not proper presently at the beginning, nor may they be frequently used, because sleep caused by opiates brings the matter more to the Brain, and fixes it there more deeply. Take Water of Cowslip flowers four ounces, Syrup of Maeconium half an ounce, Pearl a scruple, make a draught to be taken late at night. Take white Poppy-seeds two drams, Sugar-candy a dram and a half, being bruised together, pour to them of white Poppy-water six ounces, wring it forth, and take it after the same manner. Let Narcoticks, consisting of mere cold things, be given with caution; because they do not agree with some, whose Stomaches have their fibres very tender and sensible. I have often observed that these kinds of Hypnoticks have caused a great oppression in the Ventricle, and that then presently its inflation, and a little afterward distractions and disordering of the Spirits in the Brain, nay, in the whole Body followed: So that not only a frustration of sleep, but a mighty restlessness was caused. Let a dose of liuqid Laudanum, prepared with Salt of Tartar, or the Juice of Quinces, be given in a convenient liquor. Epithemes also, which provoke Sleep, are often applied to the Temples, Forehead, and Sinciput, with success: of which kind are Oxyrrhodinum, an Embrocation of Water or Milk, liniments of the Oil of Nutmegs by expression, and unguentum populneum; to which sometimes let five or six grains of Opium be added; or a cake of Roses, or of Poppy-flowers, with Vinegar and Nutmeg, etc. Again, on this account, rather than for removing the inflammation of the meninx, the warm lungs of a Lamb or Wether, also Pigeons or Chickens cut in two, often give an excellent relief. For this use the great Burrdock bruised and mixed with Woman's Milk, and applied to the Sinciput shaved is greatly commended. Also Penotus' Epitheme of twelve grains of Musk, half a scruple of Camphire, and twenty ounces of Rose-water, impregnated with the Tincture of Red Saunders, is commended by some. Moreover, not only to the Head, but likewise to the Heart, Liver, and other parts, Epithemes are wont to be applied: Let a Sacculus of fine Linen, with lays of cordial Species and Cotton stuck in it, and irrigated with the distilled Water or Vinegar of Roses be applied to the Praecordia; also let Linen dipped in Vinegar of Roses be laid on the Testles: Let the Feet be bathed with a decoction of the leaves of Willow, Lettuce, and the heads of the white Poppy: But let these kinds of cooling and mitigating topics be used only about the beginning of the Disease; in its greatest height let Resolvents, and Emollients, as the flowers of Camomile, Melilot, Elder, etc. also the leaves of Mallows, Arach, Margerum, Hyssop, and the like be added: In the declination of the Disease let Resolvents only, and those sparingly be used. In the mean while a very great regard ought to be had of the Strength, for this being too much broken, all hope of Cure is lost: Now the strength is wont to be soon consumed by reason of great watch, perpetual agitations of the body and mind, a thin diet, and Blooding sometimes, it being often needful. Wherefore we must take a great care, lest whilst we go about to eradicate the Discase by Purging, and frequent Bleeding, we on a sudden weaken the Vital function; if this gins to waver, neglecting the Frenzy, and allowing a more nourishable Food, we must chiefly use Cardiacks. Take Tincture of Coral half an ounce, let twenty grains be taken twice or thrice a day, with a dose of a Cephalick or cordial Julep, or let the milkly solution of Coral, made with the Juice of Oranges be given to a spoonful often in a day. Take Rob, or Conserve of Rasberryes, and Barberryes an ounce, Pearl prepared, Magistery of Coral, of each a dram, Confection of Hyacinth two drams, Syrup of the Juice of Kermes what suffises, make a Confection: let the quantity of a Nutmeg be taken three or four times a day, drinking after of the following Julep three ounces. Take Waters of the Flowers of Nymphaea, red Roses, and of the Leaves of Medow-sweet, of each three ounces, Syrup of Coral two ounces, Aqua Cordialis Saxoniae a dram, mix them. Take Conserve of the Flowers of Nymphaea, of Violets of each an ounce, Lettuce Stems condited half an ounce, Powder of red Coral ground on a Marble with the Juice of Oranges, and dried, two drams, Species Diamargariti frigidi a dram, white Poppey Seeds a dram and a half, with a sufficient quantity of Syrup of the Juice of Woodsorrel, make an Electuary, let the quantity of a Nutmeg be taken often in a day. In the Frenzy not only the Belly, but likewise the Bladder, when unmindful of its Office, ought frequently to be moved or irritated to it. Wherefore the diseased are to be admonished, and a Chamber-pot being presented, to be entreated to make water; which if they do not obey, Let the Region of the Share be fomented with a Decoctionof Pellitory of the Wall, Elder Flowers, the Seeds of Parsley and wild Carrots with a Sponge, and after the Fomentation let it be anointed with Oil of Scorpions and Vnguentum Dialthaea: in a long Suppression of Urine you must put a wax Candle into the Vrethra. So many and so various Cases and Stories of Persons troubled with the Frenzy are written by Hypocrates in lib. Epidem: that it may seem to little purpose to add others here: especially because it would be a thing of an immense Labour and Tediousness to relate the various Conditions, and Gestures of frantics: mean while, as to the event of the Disease no great diversity occurs. For, for the most part either, the Fever being determined, the Frenzy ceases by degrees, or that having no Crisis or an ill one, either death or a long raving ensues: Nevertheless for the Illustration of our Hypothesis concerning the Inflammation of the Spirits, I shall here set before you one rare instance. Soime time since I was called to cure a robust Maid servant, who being in a Fever, and very much distracted, was continually kept bound in her Bed: to this Person I ordered Blood to be drawn in a plentiful manner, and afterward the blooding to be repeated, the Belly to be frequently loosened by a Clyster, and all other Administrations usual in this case to be performed in order; mean while I gave her Emuslions, Juleps, Hypnoticks: but these doing little or no good, she continued still for seven or eight days without Sleep, and extremely raving, howling, and crying out contintually for cold Drink: wherefore it being allowed her to drink her fill of cold Water, she became not at all the more appeased or less dry; Therefore (it being Summer) I ordered, that in the midst of the night, being taken up by Women and led forth, she should be put into a Boat, than her being taken off, and the Cords with which she was bound being untied, she should be dipped in the deepest part of the River, only a Cord being bound about her middle to keep her from drowning: but there was no need of that support; for she swum of her own accord almost as well as a man that had well learned: after the third or fourth part of an hour, she was taken out of the Water sound and sober, then being put to bed she slept, and sweated freely, and afterward grew well without any other Remedy. This Cure happened so suddenly and successfully, in as much as the excesses both of the vital and animal flame being increased to a vast height together, were taken away by the proper Remedy of an intense Fire, viz. a Humectation and Infrigidation. CHAP. X. Instructions and Prescripts for the curing of Melancholy. AS the Frenzy arises from the burning of the animal Spirits, or from the inflammation of their Substance; so other affects of raving proceed from their Substance being altered after other manners, and its being changed from its genuine disposition, viz. spirituo-saline, into an acetous or sharp nature, resembling aqua stygia, or into a flatness or deadness; which therefore are either Melancholy, or a Mania or Madness, or a Morosis or fatuity: of which we shall now speak ion order, and in the first place of Melancholy. Melancholy is commonly defined, a Raving without a Fever or Fury, joined with fear and sadness; whence it follows to be a complicated affect of the Brain and Heart; for, that melancholic Persons rave, it proceeds from the fault of the Brain, and the disorder of the animal Spirits residing in it; but that they are sad and timorous, this is attributed to the Passion of the Heart. There are various and sundry kinds of the Imagination'sbeing depraved in Melancholy, concerning which we may observe in general, that the affected either rave concerning all things, or at leaswise concerning most, so that they pass a right judgement in a manner concerning no subject; or they imagine amiss only in one or two particular cases, but of most others form notions not altogether absurd. First, we shall inquire concerning this affect, as it is more Universal, how the Imagination is prevaricated concerning most things, to wit, for what Causes, and with what difference of Symptoms this is wont to be done, afterward we shall speak of the particular raving. Tho the delirious affect of universal Melancholy contains manifold symptoms, yet they consist chief in these three things; first, that the affected are almost continually occupied in thinking, so that their Fancy is scarce ever idle, and at rest. Secondly, in thinking they comprehend fewer things in their mind than they were wont before, so that they often roll in their mind the same Object day and night, being nothing follicitous of other things, which sometimes are of far greater moment. Thirdly, the Ideas of Objects or Conceptions appear often deformed, and like frightful Apparitions as it were, and they are always represented in a greater Species, so that every small thing seems to them great and most difficult, and by reason of this horrid and unusual appearance, the Image once conceived is not easily, nor soon let go. The Indisposition of the animal Spirits in this affect is wont commonly to be described after this manner, to wit, that whereas they ought to be transparent, subtle and light, in Melancholy they become obscure, opake and darkish, so that they represent the Images of things covered as it were with a Shadow or obscurity. But I conceive the state of the animal Spirits in raving is most aptly explicated according to the Analogy they bear with certain chemical Spirits, as it will appear from what follows. 1. Liquors chemically distilled are of divers kinds, according as the active Elements are combined in them after various manners; the most excellent of these, by the consent of all, is said to be, in which the Spirit united to the Sal●●olatizes it, and is again acuated, and recieves somewhat of a firmness from it: of this nature are conceived to be the great Elixir and the Liquor Alkahest: and in truth, in some sort are the Spirits of Blood, of Hartshorn, of Soot, and the like, they being very subtle, volatile and penetrating, and yet not inflammable, or apt to be soon dissipated. And indeed the animal Spirits enjoying a sound and meet disposition, seem in some sort to be as the spirituous Liquor filled with a volatile Salt, which is distilled from the Blood: unless it be that to this a mighty Acrimony and Empyeuma are caused by the Fire, of which the Liquor which is in the Brain and Nerves is wholly free. 2. Other Chemical Liquors are too sulphureous and burning, as Spirit of Wine and of Turpentine, which consisting of Spirit and Sulphur combined together, are easily inflamed and readily separate from others, and take this way and that, as they find a Passage: of which kind of nature the animal Spirits in some sort participate in the Frenzy. 3. Some Liquors or Spirits are produced by Chemistry, in which the fixed salt being raised to a flowing has the Dominion: of which kind are those which are distilled from Vinegar, ponderous Woods, and certain Minerals by a gentle Fire; whose particles are very movable and restless, but of a shorter activity, so that the effluvia do not flow far from them, and if they are distilled in Baleno, nothing but an insipid Phlegm is raised into the Alembick: And indeed we conjecture that the animal Spirits have such a kind of acetous Nature with the dominion of the fluid Salt in melancholy Affects, as we shall by and by show more at large. 4. Some Liquors spagyrically drawn are sometimes extremely sharp, in which the wild Particles of a fluid Salt, and of an arsenical Sulphur combined together are exalted, as are the Stygian Waters distilled from Nitre, Vitriol, Antimony, Arsenic, Verdigrease, and the like; all which are of a wild, very penetrative and invincible Nature, so that their diffuse themselves to a great wideness: and these kinds of Liquors aptly enough resemble the Disposition of the animal Spirits acquired in a Mania, as we shall declare beneath. But at present, that we may deliver the formal nature and Causes of Melancholy, we may opine, that the Liquor distilled from the Blood into the Brain (which filling and irrigating all the Pores and Passages of the Brain, and its nervous appendix is both the Vehicle and Vinculum of the animal Spirits) has degenerated from its mild, benign, and subtle Nature, into an acetous and corrosive Disposition, such as that of the Liquors drawn from Vinegar, Box and Vitriol, and that the animal Spirits, which dispersing their Rays from the Meditullium of the Brain, both into its globous Substance, and into the Systema Nervosum, produce all the Functions of Sense and Motion both inward and outward, are disposed in like manner as the Effluvia passing from those acetous Chemical Liquors. Concerning which we may observe these three things, viz. First, that they are in perpetual Motion, secondly, that they do not flow far; thirdly, that they are not only carried by open Passages, but make new prosities in neighbouring Bodies, and insinuate themselves into them. From the Analogy of these Conditions concerning the animal Spirits it happens, that melancholy Persons are always thoughtful, that they comprehend only a few things, that they form their Notions concerning them amiss. [you may find this fuller explained in Dr. Willis at large.] So much of the primary melancholy Affect, viz. a Delirium raised through the faults of the Spirits residing in the Brain: whose beginnings tho chiefly, and often in a manner only proceed from the acetous Disposition of the Spirits; yet afterward the conformation of the Brain itself is frequently taken in as a part of the cause. viz. In as much as the Recrements of the melancholy Blood, continually sent into it, renders its substance more gross and opake, and the primary Tracts or Paths of the animal Spirits being almost defaced, new obliqne and devious Tracts are made, so that though there be a supply of the better sort of Spirits, they cannot easily irradiate the Brain, or presently recover their former Passages. Melancholy is not only an affect of the Brain, and Spirits residing in it, but likewise of the Praecordia, and of the Blood there kindled, and thence sent forth into the whole Body: and as it produces in the former a Delirium, so here a Fear and Sadness: but after what manner let us now see. In Sadness, in the first place the flamy or vital part of the Soul is straitened as to its circuit, and is restrained within a less space; and then consequently the animalor lucid part of the Soul contracts its Sphere, and has less vigour: but in Fear both are suddenly repressed, and made to stagger as it were, and to contain themselves within very small spaces: in both affects the Blood does not circulate and burn lively and with a full flame, but being apt to be heaped together and to stagnate about the Precordia, it causes there an oppression, or fainting; and in the mean while the Head and Members being destitute of its plentiful efflux, languish. Now that those Passions become habitual in melancholy Persons, the cause is partly in the Blood, and partly in the animal Action of the Heart: for the Blood, by reason of saline Particles exalted, becomes less inflammable: whence it is neither sufficiently kindled in the Lungs, nor does it burn within the Ductus' of the Heart and Vessels with a flame sufficiently clear and plentiful, but such as is apt to be repressed, and almost blown out by any puff of Wind: hence in regard the vital Flame is so slender and languishing, that it staggers and trembles at all Motion, it is no wonder if a melancholy Person, the Soul as it were subfiding and being half overwhelmed, is always sad and tlmorous. By reason of this saline dyscrasy of the Blood, melancholy Persons are seldom troubled with a Fever, but being seized with it, they are more dangerously ill by reason of the irregular burning of the Blood. Nor does it happen less through the fault of the Heart, that melancholy Persons by reason of the course of the Blood being retarded, or often drawn back, become sad and timorous: for since that Muscle is not actuated but by the influence of weak and irregular Spirits, it is not able to perform its Contractions with Strength and Constancy enough, whereby the Blood may be driven forward throughout the whole Body without stop, or flying back. Therefore the Blood and animal Spirits mutually affect each other with a reciprocal injury, and bring damage on each other: the melancholy blood, that is, consisting of saline Particles exalted, together with such as are sulphureous, engenders animal Spirits of an acetous nature, as we have shown: and these Spirits performing the vital Function amiss, cause such a dyscrasy of the Blood to be increased. So far of Melancholy in genera, viz. of its Essence, conjunct Causes, and chief Symptoms: before we proceed to the kinds and differences of this Disease, we ought to explicate from what causes both procatarctick, and evident, it is wont to arise and be fomented: and first, whence both parts of the Soul. viz. both animal and vital acquire their morbid Dispositions. Of these we have shown the former to be acetous, resembling Spirit of Vitriol, or of Vinegar, and the other to be Salino-Sulphureous, or Atrabilarious; moreover, and that as they both foment each other, so that they first engender each other: for sometimes melancholy beginning from the animal Spirits being troubled and put in a certain confusion, and persisting some time, brings a melancholy habit to the Blood; sometimes also the Blood, contracting first that discrasy, perverts the Nature of the Spirits. That Melancholy oftentimes gins from the animal oeconomy, it's easily seen in excessive Love, extreme Sadness, panic Terrors, Envy, Cares, and immoderate Studies, for on these occasions the animal Spirits being driven out of the wont Paths of their Expansions, and persisting in their error through the assiduity of their Passion, at length fall into devious Tracts, which afterward keeping to, they are with difficulty reduced into the ancient and right again. Moreover, since thereupon the Motion and Vigour of the Heart are diminished, therefore the Blood falls from its due Crasis and Pneumatosis, and thereby being rendered more fixed and salino-sulphureous, furnishes only animal spirits degenerated to a sourness; and so the Blood being depraved a posteriori, gives a Fuel to the melancholy disposition begun by the Spirits. Nor does it happen less frequently that the seeds of melancholy first laid in the Blood, give at length that taint to the Spirits: for this reason some hereditarily become obnoxious to that Disease. Moreover, a disorderly diet, the intermission of an exercise long used, solemn Evacuations, as of the Menses or Hemmorhoids, also of the Seed, or serous Ichor suddenly suppressed, and many other occasions, easily defile the Blood, and render it melancholic, whose evil Disposition will afterward of necessity be communicated to the Spirits. As to what a great many Physicians think, that melancholy rises from a melancholic Humour engendered somewhere primarily and per se and assign particular Places for its Generation; viz: the Brain, Spleen, Womb, and the whole Habit of the Body, we do not easily grant all this: for besides that no secret Stores of such a humour, lying any where, appear, unless haply in the Spleen, it is indeed the Blood itself which first conceives per se the melancholic Distemper, or any other, and afterward deposes recrements of that Nature in proper Emunctories or Receptacles: nor would the yellow Choler be stored up in the Gallbladder, or the black, so called, in the Spleen, unless the mass of Blood first engendered those Humours. If at any time these, or other recrementitious humours, some where deposed, be received by the mass of Blood, they produce its effervescence, but not presently, or easily its distemperature. 1. As to that therefore, that the origine of Melancholy is sometimes ascribed to the Head, and the distemperature of the Brain is accused by some as too hot, and by others as cold: I think we ought rather to say that the affect sometimes first gins from the Brain, and from the Soul residing in it. 2. As for the Origine of this affect being sometimes drawn from the Womb, it must not be thought that the melancholy Humour is there first engendered, but that the occasion of melancholy proceeds thence: either because by reason of the Menses suppressed, the whole Blood being defiled and become degenerate, afterwards falls into a melancholy discrasy, or for that by reason of the Stimuli of Venery restrained with a great reluctation of the corporeal Soul, the animal Spirits being long contained and kept in, at length become fixed and melancholic. 3. That melancholy is sometimes either primarily raised, or very much fomented by the Spleen being ill affected, and thereupon by a peculiar word called Hypocondriacal, it is both the common and our own Opinion; but the Blood being first in the fault, engendering in itself filthy melancholy Dregs at the beginning, deposes them in the Spleen, which afterward receiving again, being exalted into the nature of an evil ferment, it is vitiated more in its Crasis by their defilement. 4. As to that that besides, another species of melancholy, distinct from the Hypocondriacal and the former, is said to be engendered together in the whole Body, it is nothing else than that the whole mass of Blood becoming degenerate from its right Nature, by reason of errors in the six non-natural things, and on many other occasions, acquires a melancholic Discrasy (that is, where the Spirit being depressed the sulphureous Particles together with the saline, and some also that are terrene are exalted) this melancholy disposition of the Blood being very much allied to that sulphureosaline Habit, which we have shown to be often prevalent in a certain kind of Scurvy. The Prognostic of Melancholy, though, as to Life or Death, it be for the most part safe, yet, in reference to the event, it is very uncertain: for some recover soon, others are not cured but after a long time, and others not at all. This affect, raised on a sudden from some solemn evident cause, as from a vehement passion, is much safer than invading by degrees after a long Procatarixes: for if the evident cause be presently removed, that often ceases of its own accord, or is cured with little ado; but in this, in regard both the mass of Blood, and the whole troop of Animal Spirits have fallen from their due crasis, and often the conformation of the Brain, as to the tracts of the Spirits, is altered, a Cure does not happen but with great difficulty, and not but after a long time. Melancholy long protracted often passes into a Fatuity, and sometimes also into a Mania, or Madness: Moreover, sometimes it brings Convulsive affects, or a Palsy, or Apoplexy, nay, sometimes a violent Death. There is little or no hope of a Cure, if the affected, being very stubborn and refractory, refuse all Medicines, and any method of management: Moreover, scarce any thing better may be expected from those, who being sick of Diseases in a manner only imaginary, take any Remedies, and often require many, and of divers kinds, to be given them. The Cure of Melancholy, as it is always difficult, and long, so it is wont to be very intricate and perplexed; seeing that in respect of the causes of every kind, evident, procatarctick and conjunct; also by reason of the symptoms daily energing, it ought to be diversely taken in hand, and often to be varied: Nor must we only change the Remedies and method of Cure, but variously intermix with them advices, deceptions, flatteries, entreaties, and punishments. But in the first place let the evident cause of the Disease, if any notable one has preceded, be searched out; and if it may be, let it either be presently removed, or let the removal of it be some way counraised, either be appeased, or be subdued by others that are opposite. Wherefore in an excessive passion of Love, Indignation and Hatred come in as a relief; to Sadness, let baits of Pleasures, Music, the desire of vain Glory, be opposed, or also a panic terror: In like manner you may proceed with other Passions, either for curbing, or eluding them. The Therapeutic Method, fitted to the Cure of Melancholy, suggests many other Indications: Whereof the chief, and to which the rest may be best reduced, are those three so vulgarly known, viz. the Curatory, which regards immediately the disease, and its Conjunct cause; the Preservatory, which regards the procatarctick and evident causes; and the Vital, which is occupied in preserving the strength. As to the first Indication, the Physical Intentions will be, so far to raise, volatize and corroborate the Animal Spirits, being become fixed, or dejected also, and apt to act overthwartly, or go astray, that afterward being more freely expanded, they may irradiate the whole Brain with a full and steadfast beam of Light, for the acts of the Imagination, Judgement, and the other chief Faculties; and may so vigorously actuate the Praecordia, and make them vibrate so strongly, that the Blood being plentifully kindled may thence spring forward without stop or restagnation throughout the whole Body. Therefore, for the cure of the Spirits, let it be chief procured, that the Soul be withdrawn from the troublesome and forced Passion, viz. from excessive Love, Jealousy, Sadness, Commiseration, Hatred, Fear, and the like, and be composed to a Cheerfulness and delight: let a merry or jocose Discourse, Singing, Music, Painting, Dancing, Hunting, Fishing, and other pleasant Exercises be brought in ure: those to whom Delights, or Sports are not pleasing (for these are always ungrateful to some melancholy Persons) may be put upon some light Employs; mathematical or chemical Studies, sometimes also travelling does great good; moreover it is often profitable to change the Places of their Habitation in their native Soyl. Those, who must always stay at home, should be advised to look after their household Affairs, and govern their Families; to cultivate and order their Houses, Gardens, Orchards and Fields: for a Mind, employed in necessary Cares and Offices, more readily deposes vain or mad Thoughts, and at length quits them: Let melancholy Persons be seldom left alone, for if at any time they. are permitted to follow and dwell long on their Phantasms, and aereal Speculations, the Soul subsides within, and leaving the Body, and undergoing a certain Metamorphosis, endues a new species, and often contrary to the state of Man; wherefore the affected aught to be continually disturbed by the discourses of their Friends and Acquaintance, to wit, that they animal Spirits being called outward from their buy ways, be brought again into their former and usual Tracts. But if the diseased, being seduced by fantastical Illusions, imagine and firmly belived certain prodigious things of themselves; the Mind is to be withdrawn from those things by artificial Inventions, of which manner of Cures there are many Cases and Examples to be found in Books, and a prudent Physician may invent the like as occasion requires. Tho a melancholy new contracted is sometimes cured by a mere ordering and management of the Mind and the animal Spirits, yet in a lopng continued to inveterate melancholy, where the Spirits have contracted an acetous Disposition, and the Blood an atrabilarious dyscrasy, and that the Conformation of the Brain, as to its Pores and Passages is injured, and other indications, called preservatory, are required for removing the procatarctick Causes of the Disease. Concerning this thing, the Physical intentions must be in the first place to reduce the Blood to a better and genuine, to wit, a spirituo-saline Crasis; and then to give a vigour to the Brain, and, its Pores being opened, to render it clear and diaphanous, and withal to strengthen the animal Spirits, and to stir them up to a vigorous Emanation: for which ends I propose the following Method, which nevertheless ought to be varied according to the various Constitutions of the diseased. Blood-letting has place in a manner in every melancholy, and sometimes it is often to be repeated, for the adust and effaete Blood being withdrawn at times, a new and more sprituous Blood springs up in its place. Concerning the Quantity, Place, and Ways of administering this Remedy, Authors are of various Opinions; but the Motion and Affects of the Blood being duly weighed, it may suffice first to draw an indifferent quantity of it from the Arm, and afterward, if need be, a less, either from thence, or from the Vessels of the Fundament by Leeches: how the opening of the Slavatella Vein should give so notable a relief, as is said, I confess is unknown to me: if melancholy Persons are strongly persuaded that blooding there will cure them before any where else, haply it may do them good: a frequent opening of the Hemorrhoid Vessels afterward to endeavour that evacuation, which spontaneously happening (as Hypocrates tells us) often cures this disease. Purging aught to be used from the beginning, and to be repeated by intervals, in regard it withdraws the fuel of the disease from the first Passages, and removes the impediments of other Remedies: as to what some judge, that for the speedy eradicating of the Disease, we must chief use Hellebore, or the Spurges, and quote Hypocrates their Author, those things, if the success be looked upon, are not found so generally to agree; but that they often very much injure the Diseased: for strong purgers do not take away the cause of the Disease, to wit, the dyscrasy of the Blood, but rather increase it: moreover, they farther weaken and prostrate the animal Spirits before dejected. Hellebore is so frequently prescribed by Hypocrates, because scarce any other cathartics were then known, at least wise they were not in common use; but now it is far better to draw gently from the receptacles of the Humours by such as are mild and without roughness, and to cleanse the Viscera and first Passages without troubling much the Blood and Spirits. Vomitories (as in most Cephalick Diseases, free from a Fever) are wont to give relief after a peculiar manner in any sorts of Distractions; the reason of this partly consists herein, that the viscous load of the Ventricle, which (as we have shown elsewhere) greatly oppresses the mind, being cleansed forth, the Spirits thereupon being more free, expand themselves more vigorously and cheerfully. Moreover, in as much as vomiting compresses and evacuates the neighbouring Receptacles of the Humours, to wit, the Gallbladder, the Ductus of the Pancreas, and the Glands of the Mesentery, it keeps their Contents from being conveyed to the Head. Vomits. Take Oxymel of Squills an ounce and a half, wine of Squils' an ounce, Syrup of Tobacco two drams, mix them, make a Vomitory: if it works not at all, or slowly, let a Vomit be raised by a free drinking of Posset-drink having the leaves of Carduus boiled in it. Take of the decoction of the middle bark of Elder four ounces, Salt of Vitriol from one scruple to two scruples, Oxymel simple three drams, mix them: let it be taken after the same manner. To strong and well set People, give the Infusion of Crocus Metallorum, or Mercurius vitae; also the Emetic Tartar of Mynsicht, or Sulphur of Antimony. Take roots of Polypody of the Oak half an ounce, Epithymum three drams, Senna half an ounce, Tamarinds six drams, Corianderseeds, three drams, yellow Saunders two drams, let them boil in fourteen ounces of Fountain-water to ten ounces: adding Agarick two drams, Rhubarb a dram and a half; to the clarified straining add of the purging Syrup of Apples two ounces, let six ounces be taken, repeating it within three or four days. Take choice Senna three drams, Epithymum, Rhubarb, of each a dram and a half, yellow Saunders half a dram, Corinader-seeds two scruples, Salt of Wormwood half a dram, Celtic Spike a scruple, let there be a close Infusion for a Night in White-wine and water of Apples, of each four ounces; to five ounces of the clear straining add Syrup of Epithymum six drams, Aqua mirabilis two drams, mix them, make a potion. In Bodies hard to be wrought on, let there be added to these, fibres of black Hellebore macerated in Vinegar, a dram or two. Those who like better Pills, Powders, Bolus' or Syrups, may use the following. Take Quercitan's Pills of Tartar, or Crato's Pills of Amber, half a dram, Rosin of Jalap, or Scamony, six or eight grains, Tartar vitriolate half a scruple, Ammoniacum dissolved in Aqua mirabilis what suffices, make pills, let four be taken going to bed, and unless they work first, one the next morning. Take Calomelanos, extract of black Hellebore of each a scruple, Resin of Jalap six grains, Ammoniacum dissolved what suffices, make four Pills, let them be taken with governance. The Powder called Haly, is greatly commended by Valescus de Tarenta, Pereda, and others. And indeed in rustic or robust Bodies, this seems a pretty fit Cathartick. Take Epithymum half an ounce, Agarick, Lapis Lazuli of each three drams, Scammony a dram, Cloves in number thirty, make a Powder, the dese is from half a dram to a dram. Take Pulvis Diacennae, Diaturbith with Rhubarb, of each half a dram, make a powder, let it be taken in a draught of posset-drink, or in a single decoction of Epithymum, to four or five scruples. Take choice Senna two ounces, roots of Polipody of the Oak two ounces, Epithymum an ounce and a half, yellow Saunders half an ounce, Tamarinds an ounce, Corianderseeds six drams, let them boil in four pounds of Barnet-water, to an half, strain it, and let it evaporate by a bath heat to the consistency of a Syrup, adding towards the end pure Manna, double refined Sugar, of each four ounces, make a Syrup: the dose is stwo or three spoonfuls, in three ounces of a convenient distilled water, or in any other Liuqor. Or, Take of the same Liquor evaporated to the consistency of Honey, six ounces, fresh Cassia four ounces, pulp of Corinth's two ounces, Cream of Tartar, Salt of Wormwood, of each a dram and a half, pulvis Diasennae two drams, yellow Saunders powdered three drams, mix them, make an Electuary, the dose is from three drams to half an ounce. cathartics must not be used without intermission, nro too frequently, but let it suffice to give them within six or seven days, and at other times, let the belly, if it be bound, be loosened by Clysters: as to what regards other Medicines which do not evacuate, though the Ancients placed the least, we put the greatnest stress of the Cure in them; for they (with whom also many Moderns accord) concluded, that there was nothing more to be done for curing Melancholy, than to purge forth the atrabilarious Humour: Wherefore making purging the thing of chiefest moment, they ordered the rest of Pharmacy, called by them preparatory, only for the sake of this; directing thus their intentions, that as soon as the Humour was brought to a fit consistency by altering Medicines, and the ways made open enough for its excretion, then to carry it forth by cathartics: which kind of hypothesis seems not to agree with Reason or Physical Experience, to wit, in as much as melancholy Persons, after a frequent purging, how methodically soever ordered, receive rather an injury than a relief. Therefore we, placing the cause of this Disease in the dyscrasies of the Blood and Spirits, and in the weakness or ill conformation of the Brain or Viscera, put alteratives, and corroboratives in the first rank of Medicines, and sometimes interlace cathartics only for the sake of these. Purging therefore being prescribed for the due removal of Impediments, and at due intervals of time, as to the rest you may proceed after this manner. Take Conserve of Clove-gilliflowers and Borage flowers, of each two ounces and a half, myrobalan rinds condited six drams, Coral prepared, Pearl, of each a dram and a half; Ivory, Crabs-eyes, of each a dram, Confection of Hyacinth two drams, Syrup of Coral, or red poppyes, what suffices, make an Electuary, let two drams be taken, morning and evening, drinking after it three ounces of the following Julep, or distilled water. Take water of Cowslip-flowers and of Black-cherries, of each six ounces, of Bawm four ounces, Dr. Stevens' Water two ounces, Sugar six drams, mix them, make a Julep. Take leaves of Bawm, Borage, Bugloss, Fumitory, Water-cresses, Brooklimes, of each four handfuls, Clove-gilliflowers, flowers of Marigolds, Borage, Cowslips, of each three handfuls, the outward coats of six Oranges ' and four Lemons, being all sliced and bruised, pour to them of Whey made with Cider, eight pounds, distil them with common Organs, let the whole Liquor be mixed. Take powder of Pearl, Ivory, Coral prepared, of each two drams, Species loetificantis, Diarrhod. Abbatis of each a dram, Oil of Citron-pills half a scruple, double refined Sugar dissolved, and boiled to a consistency for Tablets in a sufficient quantity of Bawm-water, six ounces, make Tablets according to art, weighing a dram, let two or three be taken in the morning and at five of the clock in the afternoon, drinking after it a draught of the distilled water, or of Tea. Or, Take Roots of Chervil, Polypody of the Oak of each an ounce and a half, leaves of Hearts-tongue, Spleenwort, Ceterach, Germander, of each a handful, Tamarisk half a handful, bark of the same half, an ounce, Raisins stoned two ounces, one Apple sliced, being sliced and bruised let them boil in four pounds of Fountain-water to a consumption of the third part, towards the end add leaves of Water-cresses a handful, strain it and clarify it, let six ounces be taken twice or thrice a day, let it be sweetened with Syrup of Fumitory. Iron-Spaw-waters are wont to contribute egregiously to the Cure of Melancholy Persons; viz. in as much as being plentifully drank, they wash away the salino-sulphureous tincture of the Blood, and destroy its evil ferments. Moreover, they cleanse the filth of the Viscera, open obstructions, and which is of mighty benefit, by their astriction they both strengthen the weak or over-lax Viscera, and close the mouths of the Vessels gaping into the Brain, that a passage may not lie open into it for the extraneous matter, together with the nervous Juice: and in this respect, to wit, by corroborating the Viscera, and closing the passages into the Brain, Vitriolic Preparations of Iron are wont to be given with good effect in Melancholy, and also in the Vertigo. Take our Steel prepared three ounces, infuse it in two pounds of the water above prescribed, let three or four ounces be taken twice a day by itself, or with some other solid Medicine. Take filings of Steel an ounce, put them in a Glass with two ounces of the Juice of Oranges, let it stand for a day, shaking it now and then, then pour to it water of Apples, and White-wine of each a pound, or of small, and mild Cider two pounds, let three ounces be taken twice a day after the same manner. Take Vitriol of Mars, Cream of Tartar, Crabs Eyes, of each a dram, mix them, make a powder, divide it into nine parts, le tone part be taken every Morning in a draught of an appropiate distilled Water, or a Decoction, or appropriate Julep. Take Syrup of Steel four ounces, let a spoonful be taken twice a day in a fit vehicle. Take extract of Steel, from our Steel prepared with an appropriate Decoction three ounces, powder of Ivory, yellow Saunders, Lignum Aloes of each half a dram, Salt of Tartar two Scruples, Ammoniacum dissolved in Water of Earthworms what suffices, make a mass, let it be made into little Pills, let three or four be taken every Evening, drinking after it three ounces of Water of Apples or of Cowslip-flowers. Whey, if it agrees with the Stomach, being drank plentifully for many days, is often used with good effect, for the like reason as Spaw-waters. viz. by washing away the salt and sulphureous Particles of the atrobilarious Blood: Whey with Epithymum infused, or boiled in it, is egregiously commended by some. Let Broths be prepared of the Decoction of a Chicken, with the Roots of Polypody, Chervil, Fennel, Butchers-broom, and the Leaves of Ceterach, Hartstongue, Scolopendrium, etc. let a draught be taken in the Morning and at five of the Clock in the Afternoon, in which dissolve Vitriol of Mars from six grains to ten, Salt of Wormwood, Cream of Tartar of each a scruple. Juices and Expressions of Herbs sometimes contribute egregiously to the taking away of the Dyscrasy of the Blood. Take Leaves of borage, Water-cresses of each six handfuls, two Apples mashed, the pulp of two Oranges, double refined Sugar an ounce, all being bruised together pour to them of excellent Cider a pound and a half, make a strong expression, let it be kept in a Glass, the dose is four ounces twice or thrice a day. In the Summer, a Bath of sweet Water, inasmuch as it cleanses the filth sticking in the Skin, and promotes insensible transpiration, does great good to some. Because Melancholy persons Sleep with difficulty, and after long or frequent watch are worse, therefore let Anodynes, and sometimes gentle Hypnoticks be prescribed to be taken late at night, when there is need. For this purpose, a decoction of Cowslip-flowers or of the leaves of Lettuces, or the distilled water of the red Poppey, or Syrup of the same: Moreover, Emulsions of the seeds of the white Poppey, Syrupus de Meconio, and other things that are mild, and soothing the Spirits, are proper. There being an infinite number of Melancholic persons, as well as of Fools, I shall illustrate our hypothesis only with two examples; in one of which the Disease began from the sensitive part of the Soul, or from the Animal Spirits, and in the other from its Vital part, to wit, from the Blood. Some time since a renowned man, about forty years of age, of a florid countenance, cheerful, and quick at all business, being afflicted in mind, and very much dejected by reason of some misfortunes, became thenceforward very sad and melancholy, with a dead and fallen aspect: When first I went to see him, he complained of much trouble and distraction of his thoughts, which were so great, that his Fancy being occupied day and night without intermission, he lived wholly without sleep: and nevertheless this Person minded not at all the concerns of the Public, nor of his own Family, nor was he greatly solicitous concerning the welfare of his Soul, or the health of his Body, but rather was continually perplexed about petty things, and almost of no moment: he was so fearful of all things, that he fancied some harm, or Death would presently happen to him upon any little accident. In fine, he always lived so sad, as though he endeavoured to exceed Heraclitus in mourning. Moreover, he was troubled with so great a straitness and constriction of his Heart, that it seemed to him as though the whole Praecordia were most closely strained together as a first contracted, and he thought that he always carried a vast and very oppressive burden there, which forced him always to go forward, and stooping towards the Earth. Whilst he was discoursing with his friends, that constriction and oppression of the Praecordia was wont somewhat to remit; but then upon any unusual object striking him with a terror, it returned with more violence: Nor was he only troubled with a certain constriction in the Precordia, but in the whole Body besides, and a certain weight, as it were, seemed to lie on the Region of his Loins, also on his Shoulders and Arms. As to the Cure of this Person, after various Medicines used without any great success, at length I persuaded him, because it was Summer, to drink our artificial Spaw-waters for six weeks: Therefore in the first place, in four pounds of Fountain-water, I infused for a night, of our Steel prepared half a dram, and afterward as much in eight pounds of Water. The Diseased every morning drank the clear Liquor, and within four or five hours discharged the greater part of it by Urine. He took moreover going to Bed, and early in the morning, a dose of an appropriate Electuary, such as above-described, with a Cephalick Julep: Within two months he was m such better, and afterward came to himself by degrees. Whilst I was writing these things, a young man of Quality, lately returned from travelling beyond the Seas, and being become sickly, committed himself to our care: This Person, being formerly of a sanguine and cheerful temperament, of a gay behaviour, also of an acute wit and a clear disposition, as he traveled through Foreign Countries, and being in a certain Summer in Spain, he felt in himself a great alteration from the intense heats of that place: For first, he became obnoxious to frequent effervescencies of the Blood, with sudden flushings of heat in the palms of his Hands and the soles of his Feet, and to prickings often wont to arise in his whole Body, and presently to go away again. Afterward, finding himself worse as to his Appetite and Sleep, and likewise growing dull and somewhat sad, he began to affect less, and sometimes to shun any business or delights, nay, and conversation with his friends. At length this indisposition daily growing worse, without any manifest cause, or real trouble of mind, he became Melancholic, so that always being thoughtful, fearful, and sad, he took delight in nothing: For Studies, Exercises, Travelling, Conversation with learned men, and all other things which before he delighted in, were then wont to be a trouble or terror to him: Being affected after this manner for two years, he was so much changed from himself, as though he were another man: In order to a Cure he consulted the most skilful Physicians of Spain, France, Holland, and of late in England, and tried various methods of Curing, though scarce with any benefit. To wit, that melancholy Discrasy of the Blood, first contracted by the distemper of the Air, continuing still, caused Spirits of an acetous nature, as it were, to be supplied to the Animal oeconomy. In the first place I thought good to commend to this Person the following Remedies. Take Gerion's decoction of Senna (with Tamarinds half an ounce) four ounces, Purging Syrup of Apples an ounce, Aqua mirabilis two drams, mix them, let him take it with governance, repeating it within nine days: afer Purging let Bood be drawn with Leeches, to three ounces. Take of our Syrup of Steel six ounces, let a Spoonful be taken in the morning, and atfive of the Clock, in three ounces of the following Liquor, walking upon it for an hour or two. Take leaves of Baum, borage, bugloss, Burnet, Meadow-sweet, Harts-tongue, Water-cresses, of each four handfuls, roots of borage half a pound, Clove-gilliflowers, S flowers of each three handfuls, the outward rinds of eight Oranges and four Lemons, Mace half an ounce, being sliced and bruised pour to them of Whey made with Cider eight pounds, distil it with common Organs. Take Conserve of Clove-gilliflowers, the flowers of Betony and borage of each one ounce and half, Pearl powdered two drams, red Coral prepared a dram and a half, Species of the Confection of Hyacinth two drams, Syrup of Coral, and red Poppyes of each what suffices, make an opiate, let the quantity of a Chestnut be taken every Evening, drinking after it two or three ounces of the water of Cowslip flowers. After sixteen or twenty days, the method of alteratives being changed, instead of these let him take the following. Take powder of Ivory, Pearl, red Coral prepared of each two drams, Roots of male Peony a dram and a half: Lignum Aloes half a dram, Orange Tablets four ounces, a solution of Tragacanth made in Baum-water what suffises, make Tablets weighing half a dram, let four be eaten in the Morning, and at five of the Clock drinking after it a draught of Tea. Take of the same Powder without Tablets half an ounce, Flowers of Sal Armoniac, Salt of Coral of each a dram, with Chios Turpentine six drams, make amass, let half a dram be taken Morning and Evening, drinking after it three ounces of the distilled Water. Let him feed only on Food of a good Juice, and of an easy Concoction, let him drink small Ale, with the Leaves of Harts-tongue infused in it, he may sip a little now and then of Wine with Water in it, or of Cider. Let him lead his Life continually occupied sometimes in easy Employs, sometimes in moderate Exercises, or Recreations of various kinds. So far of universal Melancholy, in which the diseased are in a manner indifferently affected by any Object, so that in every place, by any Accidents and Circumstances they are continually perplexed with a multitude of Thoughts, with a Raving, Fear and Sadness. A Melancholy is said to be Special, when the diseased have regard to some particular thing, or to some certain kind of things: of which they in a manner always think, and by reason of all the Powers of the Soul being continually spent in this one thing, they live always pensive and sad: Moreover, they have absurd and incongruous Notions, not only concerning that Object, but also concerning many other Accidents and Subjects. In this affect the corporeal soul being altered from its proper Species, assumes a certain new one, and being not conformable to the rational Soul, or to the Body, or to itself, it undergoes a certain Metamorphosis. There are two kinds of occasions, from which a particular Melancholy chief and most frequently arises; viz. first, if at any time some severe pressure of an Evil present or at hand (whether it be true or imaginary) lies upon the Soul: or secondly, if the privation of a good before obtained, or the despair of that which is desired happen: In these opposite Cases the corporeal Soul either being allured outwardly omits all domestic care of itself, or of the Body, or of the rational Soul: or being inwardly compressed, it leaves or perverts the offices both of the Reason and of the Vital and Animal Function. It were a thing of an immense Labour to enumerate the various Cases and ways of affecting in both kinds; among the mighty store of them, those which being of greatest moment seem chief to require a physical help, are a furious Love, Jealousy, Superstition, despair of eternal Salvation, the imaginary Metamorphosis of the Body, or of its Parts, or the fantastical Goods or Evils of Fortune; we shall speak briefly of each of these. It is a vulgar and most common observation, that if any one once being taken with the Aspect and Conversation of a Woman, gins inwardly to be lovesick for her, and to desire her earnestly, and for his most devoted affection gets nothing but denials and Contempt, unless he be upheld by a very strong Reason, or being seized by other affections, be turned another way, as it were, there is great danger lest he fall into a Love-melancholy; with which Passion if he happen to be affected, presently he seems transformed from himself into a living Statue, as it were, he thinks or speaks of nothing but his Mistress; he seeks to put himself upon any of the greatest dangers of Life and Fortune for her sake; mean while he does not only neglect the care of Domestic or Public Concerns, and even of his own Salvation, but, being frustrated of his Desire, often lays violent hands on himself; or if he be content to live and survive, pining away both in Body and Mind, he almost deposes man; for the use of right Reason being lost, omitting Meat, Drink, and Sleep, and the other necessary offices of Life, he yields up himself wholly to sighing and sobbing, and to a mournful habit and gesture of Body. If we inquire into the reason of this affect, we easily find, that the Corporeal Soul of Man being obnxious to violent Passions, when it is wholly carried forth into an Object most dear to it, viz. a Woman beloved, and is not able to get and embrace her, it is delighted, or contents itself with nought besides, also paying no obedience to the Rational Soul, it wholly grows deaf, and does not hear its Dictates; and crowding the Imagination only with Tragical Notions, it dulls the edge of the Understanding. Moreover, in as much as the Praecordia (a plentiful afflux of Spirits being denied to them) fail as to their Motions, the Blood heaped together in the Sinus' of the Heart, and apt to stagnate, causes there a great heaviness and oppression, and consequently Sighs and Groans; mean while the Face and outward Members, by reason of the afflux of Blood and Spirits withdrawn from them, grow pale and languish: hence it is commonly said of Desperate Lovers, that their Heart is broken; to wit, in as much as this Muscle being not vigorously enough actuated with the Animal Spirit, vibrates slowly and weakly, and does no longer send forth the Blood with vigour into all the Parts. Such disorder of the animal Function as an excessive Love brings concerning the Acquisition of its Object, the like in a manner is brought by Jealousy concerning the keeping of the same when gotten: so that always (viz. both in the Fruition and in the Desire) Res est solliciti plena Timoris Amor. That Soul, if it be not secure of its most dear prey, presently growing troubled, casts a Cloud and Darkness on its own sereness: and afterward, being infected with a bilous Tincture, every Object seems to it tinged of a yellow colour: for as a ferment of the Stomach grown sharp perverts all things taken into it into its own Nature, so the affect of jealousy once risen, turns all Accidents and Circumstances to a food for its own venom: and since in this affect the sensitive Soul being bend awry as it were, does not become conformable to its Body, therefore the oeconomy of the Animal, Vital, and vegetative Functions, being depraved, the jealous Man raves and pines away. Superstition and despair of eternal Salvation are wont to imprint almost the like affects of Melancholy on the sensitive Soul, the Blood, and the Body, as Love and Jealousy, but somewhat after a differing way of affecting; for in those the Object whose acquisition or loss is in danger, is wholly immaterial, and its affect being first conceived by the Rational Soul, is imprinted on the other Corporeal Soul; in the prosecution of which, if this readily obeys, than no disturbance of the mind of Man arises; but if the Corporeal Soul showing a reluctancy, (as it often falls out) the Rational still presses with advice and threats, presently that growing troubled, stirs the Blood and Spirits in a disorderly manner, opposes the Corporeal goods and delights to the Spiritual, presented by the Understanding, and endeavours to draw the man to its side. And as thus there is a continual bickering between the two souls, and sometimes the Will is superior, sometimes the Sensitive appetite prevails; at length a Court of Conscience is set up by the Mind, where every act is narrowly examined; By reason of these frequent variances of the Souls, the Animnal Spirits, as being too much, and almost continually exercised, being often commanded, and as it were distracted, now this way and now that way, at length fall somewhat from their vigour and good disposition, and at last being become fixed and melancholic, in as much as they are withheld from their wont Expansion, they form buy and unusual Tracts in the Brain, and so bring a Delirium with a mighty Fear and Sadness; in those kinds of affects the corporeal Soul being violently drawn away as it were, both separates from the Body, and being modified according to the character of the Idea imprinted, is wont to assume a new Species either Angelical or Diabolical; mean while the Understanding, for as much as the Imagination suggests to it only disorderly and monstrous Notions, is wholly perverted from the use of right Reason. After a like manner of affecting as this, it happens that some melancholy Persons undergo imaginary Metamorphoses either as to their Fortunes or their Bodies. viz. Whilst one imagines himself, and acts a Prince, another a Beggar: another believes himself to have a Body of Glass, and another thinks himself a Dog or a Wolf, or some other Monster; for after that the corporeal Soul being affected with a long continued melancholy, the Mind being blinded, is wholly fallen both from itself and the Body, she affects a new species or Condition, and, as much as in her lies, really assumes it. CHAP. XI. Instructions and Prescripts for curing Madness, or the Mania. AFter Melancholy, it remains for us to treat of Mdness, which is so far allied to the other, that these affect often change turns, and each passes into the other; for A melancholy disposition growing worse brings a Fury, adn a Fury coming to abate, often ends in a melancholy disposition. Since Madness, raised withot a Fever, and with ●●●ighty annoyance of the animal Function, is wont to be continual and long-lasting, its next and immediate subject must be the animal Spirits; which being affected not per consensum, nor by another thing forcibly moving them, but per se, and habitually, fall from their proper and genuine Dissposition, viz. salino-spirituous, into a salino-sulphureous nature, resembling Aqua Stygia, as we have hinted before: and consequently they exert none but disorderly Actions, and continue so acting amiss for a long time: to this their Fault haply the Brain, the Blood, or other parts contribute something, but the Spirits themselves are first, and chief in the fault. Concerning Maniacal Persons we must observe, that thief three things are in a manner common to them all, viz. First, that their Fancies or Imaginations are perpetually occupied with the raging of impetuous Thoughts, so that mumbling to themselves, or crying out and yelling, they talk aloud various things both Day and Night. Secondly, that their Motions, or Conceptions are either incongruous, or are represented under a false or erroneous Species to them. Thirdly, that with their raving a Boldness and Fury are most commonly joined, contrary to what it is in melancholy Persons, who are always astected with a Fear and Sadness. The Depravation or maniacal Disposition of the animal Spirits, together with the Juice irrigating the Brain, is wont to arise after various manners, and for divers causes; but for the most part that affect (as we have observed in Melancholy) gins either from the Spirits themselves, or from the Blood. 1. A madness beginning from the Spirits, sometimes arises from a solemn evident cause, as from a violent Passion, sometimes also it proceeds from a Procatarxis laid in the Brain, as when it happens upon Melancholy or a Frenzy; Let us confer a little the Cases, Reasons, and the various ways of the coming to pass of both. 1. As to the former, when a vehement Passion turns any one from his right mind, that so happens to be done either because the Animal Spirits are too much cast down, and driven into confusion, or because they are raised above measure, and endeavour to expand themselves beyond their Sphere. 1. The Spirits are wont to be cast down by a violent and terrible Passion; so it many times happens, that some upon areal or imaginary seeing of a Ghost, presently being struch with a panic terour, fall into a perpetual madness. Moreover, some, by reason of some great disgrace, or reproach, others by reason of the hope of an excessive Love being frustrated on a sudden and unexpectedly, and others by reason of Vows rashly broken, and their Conscience being violated, first being mightily disturbed in Mind, become shortly after mad: the reason whereof is, that the animal spirits being driven out of their ranks and usual Passages, and put in a Confusion, frame new and buy ways for themselves, which entering, they presently form delirious Phantasms: mean while the sline Partcles of the nervous Juice fall from their volatility, the spirituous being depressed, and coming to flow, take to them the sulphureous Corpuscles sent from the Blood into the Brain, being then weak and open; whence this Liquor presently becomes most sharp like Aqua fortis, and the animal Spirits exorbitant, and very much troubled. Secondly, the animal Spirits, sometimes, whilst they are raised too much, almost after the like manner, bring both to themselves, and the nervous Juice, a Disposition to Madness; hence Ambition, Pride and Emulation have made some run and; the reason whereof is, that whilst the coproreal Soul, swelling through the Opinion and Pride of its own excellency, raises and endeavours to expand itself every way as far as may be beyond the limits of the Body, the animal Spirits tumultuarily called into the Brian, are not able to be contained within their wont Treacts, but being there refracted, and diversely reflected by reason of their too great exertion, are forced into new and wholly devious Tracts; wherefore, both themselves being disturbed from the course of their proper Emanation, and the nervous Liquor, soon acquire a sharp and irritating disposition, and consequently a madness ensues. So far of Madness raised by reason of a solemn evident cause alone: but this disease also arises often by reason of a Procatarxis praeexisting in the Brain, and chief by reason of a preceding Melancholy or Frenzy: in that the animal Spirits being exalted a little too much with the nervous Juice, and in this being a little too much depressed, acquire the Disposition to madness. 2. The Disposition to madness no less frequently has its roots in the mass of Blood, and at length is produced into act, to wit, when the Blood being mightily depraved, and nitrosulphureous, either perverts the nervous Liquor together with the animal Spirits, or furnishes such as are evil, which kind of taint of the Blood is eiter hereditary or acquired. First, it's a common observation, that men born of Parents that are sometimes wont to be mad, will be obnoxious to the same disease: and though often they have lived prudently and soberly above thirty or forty years, yet afterward without any occasion or evident cause will fall mad. The reason whereof is, that the Blood at that time being fallen from its due crasis by degrees to be nitrosulphureous, furnishes the Brain with animal Spirits, and a nervous Juice of a most sharp Nature. We heave formerly shown that the Elementary Particles in our Body persist during Life, separately from those that are scondary, supplied by Nutrition, and that they have times of their Crudity, Maturity, and Decay: wherefore we judge also, that the morbid Seminia come to a ripeness also according to the periods of ages: Moreover, we observe, that often these mobid Fruits being ripened, continue a good while, or during Life, and that sometimes they whither away again as it were of their own accord, and then that afterward, after some tract of time, new Fruits spring forth again from the miasm left behind, and rises by degrees to their height; wherefore an hereditary Madness sometimes is continual, sometimes interrmittent, and its Fits sometimes are wont to return after shorter intervals, sometimes after longer. 2. As the Procatarxis of the Mania, sticking in the Blood, is often innate or originally in it, so the same sometimes is engendered by degrees, either by an ill form of diet, or by a suppression of solemn Evacuations, by reason of a precedent Fever, or for other causes, and at length being brought to a maturity, breaks forth into a madness. It's usual in a great dearth for certain poor People who are forced to love only on disagreeing Food, or such as is of an ill digestion, at first to become sad, with a staring and wan aspect, and in a short time after to turn mad: the Flux of the Hemorrhoids or Menses being restrained, or malignant Ulcers suppressed, dispose towards this Disease. Moreover, those who originally or acquiredly are of an eager Temperament, an extravagant Behaviour, and an earnest Countenance, because of being nigh to a nitrosulphureous Disposition of the Blood, are in danger of falling mad upon some strong evident cause. 3. Venomous Ferments insinuated into the Blood and nervous Juice, as especially from the biting of Animals that are mad, or by the taking of some venomous things, are wont to cause Madness. Concerning the reason of the former, we have elsewhere proposed our Conjectures. Of late a noble Lady, and worthy of Credit, related to me of her own Knowledge, that a certain Gentleman after having eaten at Dinner the tender Leaves of Wolf-bane in a Salad with other Herbs, found himself ill in the Evening, and complaining of a great agitation and restlessness of his Blood and Spirits, entreated his Friends that a Chirurgeon might be called to open a Vein, and said that otherwise he should presently run mad: which indeed happened as he said, for, before he could be let blood, falling mad, he died within the space of twenty four hours; which deadly affect happened so on a sudden, in as much as the Poison did not only pervert both the Blood and animal Spirits as to their Crasis, but by its malign Ferment presently subverted them utterly. The reason why mad Persons are bold and very confident, so that they fly no dangers, and set upon the most difficult of things, is, that the animal Spirits being very exorbitant, and vehemently moved, both fortify the Imagination, that no Object seems greater or more terrible to it than usual, and actuate the Praecordia with Vigour, so that they strongly and swiftly convery the Blood, and briskly drive it into the outmost bounds of the Body. In this affect the Soul strives to outgo, and to springit self as it were beyond the circumference of the Body, and so making an effort every way, it bears itself undaunted against any incursions of exterior things. 2. The Reason why mad Persons are strong to a miracle, is, that Particles as it were nitrosulphureous, or otherwise very sharp, or as it were Stygian, are contained in their Blood and nervous Juice, whence the animal Spirits excel in a stupendous and incredible elastic, or explosive force, far above the natural. 3. It is to be observed, that mad Persons are hardly ever wearied, for though by raging and striving they strongly exercise their Limbs for many days and Nights, and in the mean while live without eating and sleeping, they scarce at all falter, nor desist from their struggling through a failure of Strength; which doubless so happens, for as much as the animal Spirits, though very movable and elastic, yet are not volatile and easily dissipable, but by reason of the saline Particles depressed from their volatility into a flowing state, and being combined with the sulphureous ones, become firm and fixed, and therefore hold out veryling in their Activity. 4. Almost for the same reason, many Persons, how much soever they suffer or are afflicted, are not hurt: but endure Cold, Heat, Watch, Fast, Stripes and Wounds, without any sensible damage, because the Spirits being strong and fixed, do not falter nor fly away. Moreover, the Blood having got a nitrosulphureous dyscrasy, is incapable of any other change, wherefore, though insensible transpiration be stopped, and other solemn evacuations are suppressed, or supplies of te nutritive Juice are denied, neither a Catarrh, nor Fever, nor an Atrophia, or Cacochymia lightly ensue upon Madness, for in this affect, though the Particles of the Blood are grown very turgid, yet by reason of the store of Salt, they do not take to a feverish Flame. As to the prognostic of Madness, since the affected are never obnoxious to a Fever, nor to oter Diseases besides, nor are easily hurt by outward Accidents, it is not a mortal Disease of itself: but is very of Cure, because a great alteration is to be made in the Blood and Spirits, and the Diseased are refractory to any method of Cure, being Enemies both to the Physicians, and themselves. If the Madness be inveterate or hereditary, or be caused by the bite of a mad Dog, it admits of a perfect Cure with difficulty, or not at all; that which is raised through some occasion, whether it be from an evident cause alone, or comes upon a Fever, also on which the Itch, Small Pox, Hemorrhoids, or Varix's happen, is more easily Cured. Those that are obnoxious to this Disease at times, are very much in danger about the Summer Solstice, or in the Dog days; also in great changes of the Air, as when long colds or heats are changed into opposite constitutions of the Heavens. Since there are two kinds of Madness, to with, a continual and intermittent one; the method of Curing also aught to be twofold. 1. The Therapeutic method to be used in a continual Mania, suggests to us the three primary Indications so vulgarly known: viz. the first Curatory, which, regarding the Disease if self, endeavours to correct or appease the furies and exorbitancies of the Aniaml Spirits: The second preservatory, which, levelling at the causes of the Disease, undertakes to remove or amend the sharp and nitrosulphureous Dyserasies' of the Blood and the Nervous juice, and the Stygian disposition, as it were, of the Spirit. The third Vital, which directs such a way of Diet and resumptive nourishment, that both the nutritive and vital functions may be able to be carried on and maintained as is barely necessary in this Disease. The first Indication, viz. Curatory, requires Discipline, viz. threats, bindings, or stripes, as well as Physic; and therefore the mad Person, being put into a House fit for that purpose, let him be so managed both by the Physician, and prudent attendants, that he be kept in a manner always in his due behaviour, and in meet gestures and motions, either by advice, chiding, or by punishments now and then inflicted on him; and indeed there is nothing more efficacious or necessary for curing mad Persons, than that they always dread and stand in awe of certain Tortures, as it were; for by this means the Corporeal Soul, being somewhat depressed and restrained, is forced to remit of its haughtiness and exorbitancy; and therefore afterward grows mild by degrees, and is reduced to order. Wherefore mad men are sometimes sooner and more certainly cured by punishments and tortures, in a penned up room, than by Physic, or Medicines. But withal, such a course of Physic also aught to be used, which may restrain and bring down the haughtiness of the Corporeal Soul: Wherefore in this Disease Blooding, Vomitories and cathartics, how strong soever they are, and given at rovers and boldly, very often do good. Which indeed manisestly apperars, because Empyricks, only with this kind of Physic, together with governanace, and a severe discipline, often successfully cure Madmen. Tho this rough way of handling, does not so well agree with all mad persons, but chief with such as are raving mad, oters being more remissly mad, are often cured by fair usage and gentle Medicines. But in most mad persons, it is both the common voice and general practice to bleed plentifully about the beginning of the Disease; and indeed it will be good now and then to repeat it as far as the strength will bear, and sometimes to perform the operation in the Arm, sometimes in the Jugular Vein, Forehead, or Foot; and sometimes to open the Hemorrhoid Vessels by Leeches: For these evacuations being seasonably made, both the exorbitancies of the Spirits, and te haughtiness of the Soul are excellently suppressed; and likewise the Dyscrasies' of the Blood are corrected, in regard that a new and more mild springs up in the place of that which was taken away, being sharp and corrosive. That Vomits also do great good in curing mad persons, it is passed even into a Proverb, so that all Hellebore, nay, all Anticyra is assigned to them: After what manner Emetics often do good in Cephalick Diseases, we have shown before: Quacks in this case giving a large dose of Stibium, though it be rashly and dangerously, yet have often success. In truth, Chemical things best agree here, both because they move more powerful, and because the Disased may be deceived more easily by them. Take sulphur of Antimony from eight grains to ten, Cream of Tartar half a scruple, mix them, by grinding them together, make a Powder, let it be given in a spoonful of Panada, or if it must be given craftily, and the Person not knowing of it, let it be put in a crust of white Bread, to be taken in Broth or Milk: let this vomitory be frequently repeated, viz. once within four days. Take Mercurius Vitae six or seven grains, make a Powder, let it be given after the same manner. The Emetic Tartar of Mynsicht, Hercules, Bovii, and other various preparations of Mercury, may begiven after the sme manner. Aurum Vitae, or the Solar, and also the Lunar precipitate are accounted by Chemists specific Remedies against against Madness, and indeed Mercurial Medicines, in as much as they work by Vomit, and Siege, and often also by Sweat, Urine, or Salivation, prove egregiously beneficial: a copious Spitting, and of long continuance has perfectly crued some mad persons. Strong Pruges (where the strength and constitution will bear them) in as much as they depress the exorbitances of the Blood and spirits, and much evacuate the emunctories for receiving the recrements of the Rlood and Nervous juice, often give relief also in this Disease. For this use, preparations of black Hellebore, as especially its extract, and the Wine of the infusion of its Fibres, or the pap of an Apple boiled with the Roots of it sticking in it, are very much commended. Take extract of black Hellebore, Calamelanos, of each a scruple; make; a Bolus. Take Calamelanos a scruple, Diagridium from twelve grains to fifteen, make a Powder. Take Confectio Hamec, or the Electuary of the Juice of Roses from half an ounce to six drams, let it be given in Broth. Take Gereons' Decoction of Senna, or the Decoction of Epithymum (with two drams of the roots of Black Hellebore) six ounces, make a draught. The Pulvis Diasennae two drams, let it be taken in Whey. In the mean while that these things are done, let the preservatory Indication take care of the Cause of the Disease. Wherefore with these frequent Purges and Bloodings let alterig Remedies be interlaced, for tempering the Blood and nervous Juice, and for reducing them to their due Crases; if haply the diseased, being obsequious and tractable, do not refuse to take such things methodically. Take crystal Mineral, or Nitre excellently purified two ounces, Pearl powdered two drams, Sugar-Candy two drams and a half, Camphire half a Scruple, let them all be ground into a subtle Powder; let two drams of this be put in a Glass-bottle holding a quart, with Fountain-water, or small or mild Beer for ordinary Drink, which may be given at pleasure. Let boiling Whey be poured to the Flowers of Violets or Nymphea, after an infusion for two hours let it be drank off plentifully: Spaw-waters also drank regularly and in a plentiful manner, are proper for mad Persons. Take fresh and tender tops of borage and Bugloss of each four handfuls, three mashed Apples, Sal Prunella two drams, Sugar half an ounce, being bruised together, pour to them three pounds of Rountain-water, express it strongly, let half a pound be taken thrice a day or oftener. Take Conserve of the Flowers of borage and Violets of each three drams,. Confection of Hyacinth, Alchermes of each two drams, Coral prepared a dram and a half, Pearl powdered a dram, Salt of Coral a dram, Syrup of red Poppyes what suffices, make an Electuary, wherefore let two drams be taken twice or thrice a day drinking after it of the following Liquor four ounces. Take Water of Nymphea, borage, Bugloss, black Cherries, of each four ounces, of red Poppyes six ounces, red Rose-water two ounces, Camphire tied in a Nodulus and hung in a Glass half a dram, Syrup of Coral an ounce and a half, mix them, make a Julep. Take the yellow Flowers of a Willow what suffises, distil them with common Organs, repeat the distillation, pouring the Water on fresh Flowers by three Cohobations, let it be given to four ounces twice or thrice a day, sweetening it with Syrup of Nymphaea. Take leaves of the Willow, Meadow-sweet, Burnet, borage, Baum, of each six handfuls, Flowers of Nymphaea, tops of St. john's Wort of each four handfuls, Camphire powdered three drams, all being sliced together pour to them of fresh Milk eight pounds, distil it with common Organs. Let Sheep's Brains be distilled with milk, and let the Water be given to three or four ounces, thrice a day. Moreover, let specific Remedies be applied to use, of which kind the Decoction of Pimpernell with a purple Flower is famous, also the tops of St. john's Wort, and other Decoctions, Opiates, and powders against Madness, well known by all famous Empirics. As to the cure of Madness caused by the biting of venomous or mad Animals, since it is in a manner only Empirial, and vulgarly known, there is no need for us to discourse of it in this place, we having also proposed our Conjectures concerning it elsewhere: Again, the Decoction or infusion of Apples either crude or boiled in fountain Water; the Liquor Tea, Emulsions, with many other things, forms of which we have given in the cure of Melancholy, are proper in this case. Moreover, many other helps besides Blooding are wont to be afforded from Cbirurgery for curing this Disease: Cupping-glasses, with a Scarification often do good; Vesicatories, Cauteries, both actual and potential, are commended by many. Some commend Arteriotomy, others trepanning, and others Salivation: But these kinds of administrations, besides that they are of a doubtful effect, cannot easily, and searce with safety, come in practice, by reason of the intractable disposition of the Diseased. Wherefore it would be superfluous here to inquire into the reasons of the relief or Cure to be expected from those things. It is good sometimes, the Head being shaved, to apply the warm Lungs of a Lamb or Sheep, and other fomentations to the Sinciput, and now and then to change them. But these Epithemes also, in regard they cannot be methodically applied and repeated to the Diseased, who admit them with reluctancy, often do more hury than good. 30. The Vital Indication directs how mad persons ought to be handled, as to their Government, Diet and Sleep. In this Disease, otherwise than in many others, there is no need of restoring: for neither aught the strength to be restored with Resumptives, nor the Spirits with Cordials; but on the contrary, a suppression, or as it were, a certain extlnction is to be used to both, being too exorbitant of themselves, resembling a flame, as it were, burning above measure: Therefore let the Diet be thin and not delicate, the clothing course, the lodging hard, the dealing with them severe and rigid. But Sleep, because it is very necessary, if it be wholly wanting, ought sometimes to be caused by giving Remedies; for which end, the Hypnotick Medicines prescribed before for Melancholy, are proper also in this disease, those who have an inveterate habitual Madness are seldom put to a Physical cure, but being committed to Hospitals for mad Persons, by the ordinary discipline of that Place, either return at length to themselves, or are kept there from doing hurt to themselves or others. It is not needful to illustrate the nature of this Disease with Histories and Examples, and to set forth many Types of it; but rather address yourselves to the Hospitals of mad People, where, not without a great admiration, you may behold as it were a new and monstrous Generation of Men, viz. contrary to such as are rational, and as it were our Antipodes; who, if they could all be gathered together into one place, and all the Fools and senseless Persons be joined with them, I know not whether they would not make an equal division of the whole Earth with the sober and prudent. So far of the cure of a continual Madness. But the intermittent has perfectly lucid intervals, in which the diseased return to a sound Mind, or the Fury only ceases, the Delirium still remaining, so that the affected become gentle and tractable: yet continuing still to err as to their Imagination and Judgement, they speak and do a great many absurd or incongruous things, and afterward become mad again at times. The remedy of both these affects, as to the curatory Indication, is the same as in a continual Madness, that it will not be needful to fet down here any other Method or Medicines: but as to what regards the Prophylaxis, or preservatory Indicatin, to wit, whereby the way of curing to be used out of the Fits for preventing or lessenging them is ordered, in which the Fury only intermits, the Delirium remaining, the very same physical Method and Remedies, which we have prescribed for removing the Procatarxis of Melancholy are proper. pa In a madness which intermits perfectly, as to all smptoms; at the most fit seasons, to wit, Spring and Fall, solemn courses of Physic ought to be entered upon; and also there is always need of a care and governance of the Diseased; both that as to his diet, and way of Life, lie be kept always in an even and moderate Temper; and that as soon as the signs of an imminent Fit appear, blooding and purging being presently used, its access be kept off. Therefore, at the approach of the Equinoxes, let Blood be drawn from the Arm, and then after seven, or eight days from the Hemorrhoid Veins by Leeches: Let Purges and Vomits by due intervals be given twice or thrice: moreover on intermitting days, let altering Remedies be orderly taken at physical Hours: forms of these are delivered both in this Chapter and in the foregoing for the cure of Melancholy: let the diet be thin and of good digestion; as to Sleep, Motion, and other non-natural things, let all be maderate: If at any time aperson seems to be threatened with an access of Madness, constantly before the Summer solstice, let blooding with vomiting, and a thin diet be used. CHAP. IX. Instructions and Prescripts for the cure of Stupidity or Folly. STuidity or Folly, though it chief belongs to the rational Soul, and signifies the defect of the Undertanding and Judgement, nevertheless it is not improperly placed among the Diseases of the Head, or of the Brain; to wit, in as much as that Eclipse of the superior Soul proceeds from the Imagination and Memory injured; and the failings of thofe depend on the faults of the animal Spirits and of the Brain itself. 1. As to the Animal Spirits, how they ought to be qualified of their proper and genuine Nature, and what they are by reason of a preternatural dispositio in the Frenzy, Melancholy, and Madness we have sufficiently declared; but besides, sometimes the animal Spirits being in a manner destitute of active Particles become as it were dead and essaete, to wit, whereas the spirituous Particles ought to predominate and gather to them the saline volatized; in a Stupidity as well both these as the sulphureous, being too much depressed, are almost drowned and overwhelmed in such as are watery and earthy. 2. As to the fault of the Brain, first, it's a vulgar Observation that the Wit and towardly Disposition depends somewhat on the greatness and figure of the Head, and consequently of its Brain, for as to its bulk, it is a Proverb, that too little or too much Brain argues Folly: And though this does not always happen so, yet it does frequently, the reason of which is, that in a little Brain only a few Spirits are engendered and exercised: and a great Brain, consisting for the most part of a course texture, is not fit for any acuteness of Wit. Secondly, the genuine and best figure of the Brain ought to be globous, to wit, for this end, that the Spirits may be diffused with an even efflux from the midst of it on every side to its circumference, and may be thence retorted every where with equal Agles of Reflections, but those who have a flat Head, or too copped, or otherwise disproportionate, for the most part have some notable failing in the animal Faculty. 3. The Substance of the Brain ought to be well tempered and of a laudable texture, nor only as to the qualities of Heat and cold, drought and moisture; but is't Constitution should be sublte and aereal, consistig of a plenty of volatile Salt and Spirit, with a moderate proportion of the other things, that the Spirits may readily pass the whole, and frame Tracts for themsnlves; and withal it should be indifferently firm and compact, that the Tracts and Passages may remain when made, nor presently be defaced by the subsiding of Parts too tender. But in Persons that are stupid we may imagine, sometimes an excess of some manifest quality in the Brain, as chiefly of moisture and cold, for which reason Children and aged Persons are often wont to be affected with a Dulness of the Senses; sometimes a Texture too gross and earthy, so that the Spirits cannot easily irradiate it, or make Tracts for themselves. To this gross Texture of the Brain some, born of Rustics, are frequently obnoxious, so that in some Families, looking back upon many Generations, you will scarce find one wise or witty Man. 4. Sometimes the evil conformation of the Brain as to its Pores and Passages, acquired by reason of some Disorders, is the cause that the animal Function is not duly performed: for sometimes these Pores are either wanting, or perverted, that the animal Spirits cannot duly operate. So far of the conjunct Causes of Folly, as to the procatarctick and evident Causes, there are many Occasions by reason of which the foresaid blemishes are brought on the Brain, or Spirits, or both of them. For first, Stupidity is sometimes originary, or born with a man; and so either it is hereditary, as when Fools beget Fools, the same effaete Particles concurring to frame the Animal Organs in the Son which were in the Father; or the Connate Stupidity is accidental, as it were, to wit, it frequently happens that wise and mighty ingenious men beget mere Sots, which sometimes so falls out for these reasons, either that the Parents spend their Spirits in Study and too much thinking, or weaken and enervate the Body through intemperance, luxury, and ill living: Whereas we see in other Animals, as in a good breed of Horses and Cocks, that their young ones do certainly patrizare, so that presently they are sold at a great rate, their Virtues, in regard they are not broken by a disorderly and preternatural way of living, descending in a long series to their posterity. Secondly, there are many evident causes, by which Stupidity is brought on such as are originally sound: Some at first being witty and ingenious, in their declining years grow dull and doltish; on the contrary, some at first being dull and incapable of Learning, as they grow further in years, become very witty. Thirdly, sometimes a great wound, or concussion of the Head, especially which happens by falling headlong from an high place, brings a prejudice and weakness to the animal faculty, dulling the understanding. Fourthly, frequent drunkenness and surfeiting, especially if men sleep presently on eating and drinking, very much weaken the understandings of some, and impair the use of Reason; as a frequent use of opiates has shrewdly blunted the edge of the understanding of others. Fifthly, violent and sudden Passions, such chief as an exceeding great terror coming unawares, or an extreme sadness, have rendered some doltish. Sixthly, We may observe, that some Men by reason of great Diseases of the Brain have turned Fools: this frequently happens in a severe and long continued Epilepsy; in as much as this affect possessing the Meditullia of the Brain, perverts, and so stuffs with Feculencies, and fills all the Pores and Passages by reason of the Spirits there frequently and vehemently exploded, that the Tracts of the Spirits being close shut, the Acts of the inward Senses and Motions are hindered: Moreover, I have observed Stupidity to accompany and precede the Palsy in many, to wit, the same matter which in the Corpus Striatum brings a Resolution, being gathered together in the Corpus Callosum, if it does not bring an Apoplexy or Carus, often causes Folly. There are many differences of this Disease, and first, we use to distinguish betwixt Folly and Stupidity; that those who are affected with the former, apprehend simple things well and quick enough, and keep them fast in Memory, but for want of Judgement, ill compound, or divie Notions, and far worse infer one thing from another: Moreover, by fooling, and doing, and speaking a great many things unhappily or ridiculously, they move Laughter in the Standards by: on the contrary, those that are stupid by reason of the defects of the Imagination, Memory, and Judgement, neither apprehend well, nor nimbly, nor argue well: moreover, they do not behave themselves as the former, in making Sports and Gestures, but blockishly and unfeatly, and as it were, like Apes, and consequently the simplicity of these is more, who so carry their Disease in their Countenance and Gesture. In Folly, it seems that the animal Spirits being somewhat nimble, but unsteadfast, and having only short and obliqne Tracts, do not pass the Brain with an even and constant irradiation, but making excursions this way and that after a desultory manner, kexercise only slight or ridiculous Acts of animal Functions: but in Stupidity, the Spirits of their own nature being dull and obtuse, and residing in a gross and unpervious Brain, are not able to exert themselves for duly performing the Offices of the animal oeconomy. There are many degrees of stupidity, for some Persons are accounted unfit as to the comprehension of all things, others only as to some: some being wholly unfit for Learning, and the liberal Sciences, are apt enough to mechanical Arts: others, though incapable of both these, yet readily comprehend Apriculture, and Country Affairs: others, being incapable in a manner of all business, can be taught only those things that regard eating and drinking, and the common way of living, others being mere Dolts, scarce understand any thing as all, or do any thing with Knowledge. As to the Prognostic, Stupidity contracted by birth, or hereditary, or happening through some unknown causes, if it continues to the time of Puberty, is scarce ever cured: though sometimes it happens that little Children, at first dull, and almost senseless, when the Crases of the Brain and Spirits come afterward to a maturation, become ingenious, and apt enough to jearn. The Disease raised through some sole evident Cause, as by a hurt of the Head, or a violent Passion, also happening upon an inveterate Epilepsy, if it persevers some time, is afterward incurable. That, which ensuing upon other sleepy Affects, depends chief on the hurt of the Memory, sometimes those affects being cured, vanishes of its own accord: if at any time therefore in these Cases the cure of Stupidity is ordered, in a manner the same method of healing and Remedies which we have prescribed for the preservatory indication of the Lethargy will be proper here: whereof the chief intents must be, that the animal Spirits being free from any Deadness and Stupefaction, make Pores and Passages within the translucid Brain, and duly expand themselves in them. Sometimes a Fever has cured some Fools and stupid Persons, and has rendered them more acute, Huartus relates, that a certain Fool in the Court of Corduba, being affected with a malignant Fever, arrived in the height of the Disease to so great an acuteness of Judgement and Discretion, that he put the whole Court in Admiration, and for the whole remainder of his Life continued a very prudent Person: and we have known a certain Person of a dull, and indeed Boeotian Understanding, who raving in a Fever, was very quick at breaking smart Jests, and seasoned with much Salt: the Reason of which things seems to be, that the Febrile heat sometimes rarefies and disperses the mist investing the Brain. Therefore, as to the cure of this Disease, Stupidity, whether innate, or acquired (if it be not a plain senselesness, and doltishness incapable of all Erudition) though it be not usually cured, yet it is wont to be amended. Wherefore the cares both of a Physician and Tutor must be used for polishing somewhat the Understanding of such as are so affected, and that being brought to the use of at least some little Reason, they may be exempted from the rank of Brutes. For this end, because Bards, or such as are very blockish, learn not the Notions of things more readily than Children their A. B. C. therefore they are to be instructed in all things by an assiduous and very diligent Master, and the same things are to be incultated again and again; For by this means the Spirits, though dull and torpid, will in some measure be actuated by perpetual Exercise; and being continually stirred up, will make at length for their Expansion some Tracts or Passages, though imperfect, in the Brain, how gross soever. For the better and more easy effecting of these things, physical Remedies also ought to be given for purifying and volatizing the Blood and nervous Liquor, together with the animal Spirits; and also for clarifying the Brain, and rendering it as it were diaphanous. For purifying the Blood, let a gentle purge sometimes, and letting blood in a small quantity, if the strength will bear it, frequently be used; for the same pursose, and likewise for deriving Faeculencies from the Brain, Issues are proper in the Arm, or in the Leg, or together in both: in gross Bodies, and such as have a moist Brain, it is good sometimes to cut two by the Shoulder blades. Moreover, it is on this account that some mightily extol trepanning, (to wit, whereby the Brain may transpire and evaporate the more freely) let the diet belight and attenuating, the Habitation in a free and dry Air; the Sleep moderate. After that these things have been used for some time, and in a solemn manner, if there be found no change, it will be in vain to waste any more physical Oil and Labour; but if after the use of those things, signs of benefit, or some hope appear, sometimes it seems proper to add altering Remedies, to be taken daily at Physical hours for a long time: Forms of these may be taken from our curatory part of Physic before delivered for removing the Procatarxes of most Cephalick Diseases: Moreover, I have thought good to add here besides some Magistral Receipts which particularly regard this case. Take Spirit of Armoniac succinated six drams, give from fifteen drops to twenty in the Evening, and early in the Morning in three spoonfuls of the following distilled water, drinking after it seven spoonfuls of the same. Take fresh leaves of mistletoe growing on Appletrees six handfuls, Sage, Rosemary, Savory, Wild-time, Calamint, , Marjoyam, the greater Rochet, of each four handfuls, roots of Angelica, Master-wort, of each six ounces, Zedoary, the lesser Galingal, Calamus Aromaticus, Winter's bark of each two ounces; Cloves, Nutmegs, Mace, Cinnamon, Ginger of each an ounce; Cubebs, Cardamums, Grains of Paradise of each six drams; all being sliced small and bruised, pour to them of the best Canary wine twelve pounds, let them digest cold and in a close Vessel for three days, then distil them according to Art, let the whole Liquor be mixed, and sweeten it with Sugar as you use it, the Dose is two or three ounces. After the use of Spirit of Armoniac for fifteen or twenty days, let other Medicines have their turns for about the same space of time, such as are the Spirits of Soot, Hartshorn, man's skull, the tincture of Coral, Antimony, Castoreum, Amber, Quercitan's Elixir of Life, Elixir Proprietatis, Spirit of Lavender, etc. Or, Take Conserve of the flowers of Lilies of the Valley six ounces, roots of Aromatick-reed preserved six drams, Ginger condited in the Indies, Nutmegs condited of each half an ounce, Species Diambrae two drams, Lignum Aloes, yellow Saunders, roots of choice Zedoary, Cubebs, Jamaica Pepper of each a dram and half, Coral prepared two drams, Syrup of the Preserve of Ginger what suffices, make an Electuary; the Dose is two drams morning and evening, drinking after it three ounces of the distilled Water. Let those, whose Brains abound with too much moisture, drink every morning a draught of Coffee with the leaves of Sage first boiled in it, to those whose animal Spirits are effaete and depauperated, the drink of Chocolate, such as before described, seems profitable. For ordinary drink prepare small Ale, or Beer, and in a Vessel of three or four Gallons let the following Bag be put after it has wrought. Take leaves of Salvia acuta dried four handfuls, Cubebs an ounce, Cloves, Nutmegs, being sliced and bruised, mix them according to art. Outward Applications have place here, or which kind are, a Cucupha, or Cap, Plasters, and Liniments, and sometimes let these, sometimes those, or the others be used. Take Flowers of Lilies of the Valley, Rofemary, and Staechas of each a handful, Celtic spike two drams, Roots of Cyperus, the lesser Galingal, Florentine orris of each three drams, Labdanum, Benzoin, Balsam of Tolu, Amber of each two drams, Nutmegs, Colves, Mace, Cinnamon, of each a dram and a half, make of all a jubtle powder, and sew it into a cap interlacing it with Cotton. Take of the Plaster called Flos Vnguentorum two ounces, Tachamahacha, Ceranna, Balsam of Tolu of each three drams, powder of Amber and Myrrh of each two drams, Cloves, Nutmegs, Mace, of each a dram, being melted together, let them be made into a mass, of which let a Plaster be made, to be spread on Leather, and to be applied to the Head shaved. Take Oil of Palm half an ounce, oleum Capivii three drams, Balsam of Peru a dram, oil of Nutmegs by expression two drams, oil of Amber half a dram, make a lineament for the Head. I could add here many other Medicines and ways of Administrations; but let these suffice in a Case almost desperate, where most commonly no Remedies do good, and the Cure is never perfected. CHAP. XIII. Instructions and Prescripts for curing the Gout. AMong the Diseases of the Head and Genus nervosum, we justly rank also certain Affects which are wont chief to infest the Feet and Belly, to wit, the Gout and Colic. For we may conclude from the primary symptom, viz. Pain, that the Seats of both are in the nervous parts. I shall speak in the first place of the for mer. The Gout most commonly is wont to arise about the Internodia of the Bones of the Feet; though often it happens in the Joints of the Hip, Knee, Elbow, Shoulder, Wrist, Ankle, and of other Parts. The Fits of this Affect (which in a manner is always intermittent) either seize at random, or periodically; which ending sometimes sooner, sometimes later, good lucid Intervals ensue; presently, upon the first invasion, Pains for the most part arise without any swelling; though afterward, about the height of the Disease, the Part affected often swells; the Pains about the beinning scarce yield to any Remedies, but are wont to be very much exasperated by cathartics, and not presently to be driven away, or assuaged by Topics; the Fits most commonly seize on a sudden, and without a precious affect, though sometimes it has a forerunning effervescence in the Blood, or a little Fever. The Disposition to this Disease sometimes is Hereditary, sometimes acquired through an ill Diet: the Occasions or Causes, which being wont to actuate the Disposition, raise the Arthritick Pains, are some violent alterations, or Passions inflicted on the Humours and Spirits. Hence Surfeiting, immoderate drinking, especially of acid and thin Wines, Transpiration letted, Anger, immoderate Venery, Sadness, also the Revolutions and great changes of the Year and Air, every where bring Fits of this Disease: those that are obnoxious to this, are also in danger of being sometimes troubled with the Stone or Gravel in the Kidneys, and on the contrary: moreover, the Gout increasing gathers together every where about its chief Seats, to wit, the Joints, a calculous matter, and there raises a tophous mass. The Parts affected, upon the twitching of whose Fibres the Pains are raised, for the most part are the Periostia, or the Membranes covering the heads of the Bones, also the Tendons, and haply the Ligaments there placed: but since the Pain in those Parts depends wholly on the solution of continuity, and this proceeds from a certain matter sticking in, or lying on those Bodies we must inquire, first, of what kind that morbific matter is; secondly, whence it is brought thither, and thirdly, after what manner, by solving unity in them, it causes such periodical Fits of the Gout. As to the morbific matter, it seems in the first place that it is neither the Blood nor the nervous Juice by themselves; nor also one single Humour deposed by either of them, but that in the chief Seat of this Disease many fermentative Juices, and not easily miscible, meet; and than that from their contest and effervescency painful twitchings of the nervous Fibres arise. Therefore a saline or tartarous matter, deposed from the arterious Blood about the spaces betwixt the Bowels, is as it were the feminine Seed of this Disease; which nevertheless, though heaped together in a great plenty, is wholly unfruitful of itself, till the nervous Liquor growing turgid, sends acetous Recrements, falling from it, to the seat of the former, which, as the masculine Seed, presently renders the other prolific: for, in as much as those two particles, which are of a differing state and origine, meet, and mutually contest, they twitch the Fibres of the Membranes and Tendons, and so cause the Fit of the Gout, the appeasing of which depends wholly on the mutual subduing and dissipation of the sharp Particles of both kinds. As to the evident causes for which the nutritive liquor, brought from the Blood to the Joints, is too much stored with a fixed Salt, and by reason of which these Parts become over-ready and easy to receive what is disproportioned to them, in regard they are various and manifold, we shall here briefly touch the chief of them. 1. And first, an hereditary disposition is wont to produce both the failures: for Gouty Persons for the most part engender Gouty Children; and this Disease, descending from Parents to Children, is wont to have in both not only the like fruit, and to be brought to a ripeness about the same terms of age; but for the most part it fixes its first roots in the same members, and every where observes the like progress. 2. But nevertheless, the Arthritical disposition, without an original taint, is often caused by reason of an ill diet, and errors in the six nonnatural things; for those who being given to feasting and good fellowship, delight themselves in eating and drinking much and disorderly, and especially if they feed on salt and sumptuous provisions, and drink, Wine plentifully, easily contract this Disease. For by this means none but an indigested Chyle, and such as is endowed with wild and unmeet Particles is prepared in the Viscera; moreover, after much drinking of Wine, Salt dregs and heterogeneous filth, which otherwise would stay in the first passages, being too much exalted, are conveyed into the Blood: To which irregularities in Diet, if a sedentary Life, Idleness, and much sleeping are joined, so that neither the superfluities exhale, nor the saline Impurities are blown off by exercise that they do not subside about the Joints; certainly a great store of this Alchalisate seed will be sown for producing this Disease of the Joints. The weakness and Arthritick disposition of the Joints is not only hereditary, but is frequently caused on several occasions; the falling down of the morbific matter often brings it: for if by chance it happens that the sirs fit of the Gout be in this or that Part, the peccant humour will afterward more readily fall on that member; and in a short time will make there, as it were, its nest, where it will continually lodge its brood: Moreover, solution of Continuity also, or an injury happening to some Joint by cold or moisture, a wound or luxation often cause a Gouty disposition. The evident Causes, which in respect of the Nervous Liquor, cause Fits of the Gout, either pervert the particles and Portions into an acetous nature, or being before degenerated, stir them to fluxious. 1. Many acid Liquors and small Wines ought to be avoided, and experience teaches us that Cider and stolen Beer ought of all things to be shunned by Arthritical persons, for those kinds of drinks do not only bring into act the latent cause of the Disease, but by filling the Brain and Nerves with a great many acetous particles, they contribute to its fuel, and increase the morbific matter. 2. Immoderate or unseasonable exercise of the Body, Violent passions, immoderate Venery, and a disorderly Diet, and likewise whatsoever things greatly trouble or exagitate the Spirits and Humours, and consequently raise fluxions of the nervous Juice, or of its Recrements cause Arthritick pains. 3. Solemn Evacuations suppressed, also an admittance of cold and moisture, forasmuch as by this means the Blood, and consequently the Nervous Liquor fall into effervescencies and fluxions, bring fits of that Disease. 4. For the same reason changes of the places of abode, also the revolutions of the year are wont to bring pains of the Gout, that it is become a Proverb, that Couty persons carry their Almanac in their Bones, and from their pains draw most certain prognostics of the seasons; for as often as a moist constitution of the year, and South or North Winds, or Snows are at hand, they are wont to predict those things from the accesses of their pains. Moreover, at each quarter of the year, especially Spring and Fall, they are more sorely tormented; wherefore the Aequinoxes are always religiously observed by them: The reason of these things partly consists in this, that insensible transpiration is variously altered by reason of the changes of the air and of the year; for which reason, the Effluvia, which were wont to transpire, being restrained, ferment the Blood and Nervous humour, and easily stir them to Arthritick flutions. Moreover, the humours of our Bodies, as the Juices of Vegetables, and other natural or artificial liquors, diversely ferment according to the changes of the seasons, and fall into various states, sometimes of fixation, sometimes of volatility, sometimes of flowing. The chief differences of this Disease are taken from the places affected, and therefore they are made, as it were, the distinct species of the same, viz. to wit, the Hand Gout, the Hip Gout, the Knee Gout, the Foot Gout: Mean while, pains usually raised in any other Members, go by the common name of the Gout: Whether the Toothache, the pain in the Loins, and pains of other Parts ought to be referred to this, I have not now leisure to inquire. A long continued Gout very often joins to it s Scurvy, and some Scorbutic affects so plainly counterfeit the Gout, that they cannot easily be distinguished: The reason of the former is both a like Dyscrasy of the Blood, in both affects depending on the fixed Salt; and likewise that the Scorbutical disposition easily comes upon Gouty persons; for that keeping long to their Bed or a Chair, they use no exercise. Secondly, the Scorbutic affects which initate the Gout, are a Rheumatism, and the Arthritis vaga Scorbutica, concerning which we have written in our Tract of the Scurvy. The Gout has so near a Relation to the Stone in the Rein, that both affects, as though they were of the same Origine, most commonly concur: for scarce any Person is troubled with that Disease, but he is found obnoxious to this; Moreover an inveterate Gout is wont to cause strong concretions in the Joints, such as the Nephritick Disease in the Reins: hence I think it very likely that the ache in the Reins arrises from a like, or wholly the same cause which we have assigned for the Gout to wit, that the Salino-fixt-matter deposed by the Blood in the Reins ferments with the acid humour often sent thither by the Nervous Ductus'; and that therefore Nephritick Pains are frequently caused; and that afterward the Stone is formed by both matters coagulated after fermenting. As to the Prognostic of the Gout, every man knows it to be a Disease that is safe enough, but extremely difficult to be cured. 1. As to the former, this Disease is not only void of danger as to itself, but is a prevention against most other Diseases: for gouty Persons by reason of a saline-fixt Discrasy of the Blood are not obnoxious to Fevers; Moreover they live for the most part free from other affects of the Head or Viscera, in as much as the Recrements both of the Blood and Nervous Juice are continually deposed in the Joints. 2. But as to the way of its cure, it is so diffcult, that for the removal of the Procatarxis of the Disease there is required both a most perfect amendment of the two Humours, viz. of the Blood and Nervous Juice, to wit, that they engender not any Saline-fixt, or acid Particles, and likewise a Restitution of the weakened Joints (neither of which can ever easily be done) to which may be added, that the conjunct cause of this Disease lies in parts very remote, where the Virtues of no Medicine reach. Sometimes it happens by reason of the fluxions of the Arthritick matter being suppressed or struck back, that one while gripes of the Belly or Viscera of the Abdomen, another while a Dyspnaea, Asthma, or other affects of the Breast, and sometimes also that the Apolexy, and other sleepy or convulsive Diseases are raised; from which things being observed, it will be obvious to object, that the Minera of the Gout is not such as we even now describedit, because its saline part, in regard it is the same which is appointed for the nourishment of the Joints, cannot be driven thence, or conveyed, or deposed elsewhere: when as to the other part, to wit, the acid Seminium deposed in its usual place, it seems that that cannot easily be driven back, and being suppressed by itself, or in its Passage, or conveyed elsewhere, that it will not much hurt any part; but it may easily be replied to this, that the acetous Portion of the Arthritick matter flowing in the Ductus' of the Nerves may be repelled or stopped, and that being discharged on other parts, it often causes very sore Diseases, and indeed the nervous Liquor and its Recrements, since they consist of Particles that are very subtle and active, upon any small let or repulse are driven into divers sorts of sallies and fluxions; Moreover, when those grow turgid about the noble parts, or within the Ductus' of the Nerves, or meet with Particles of other Humours of another kind, and ferment with them, they cause various affects either inducing pain, or convulsive: and often, in as much as Particles of a differing nature are coagulated together, tumors, sometimes Strummous, sometimes Cancrous, or otherwise malignant arise. Whilst I was writing these things, I was called to a renowned Matron, who formerly having been very obnoxious to the Gout, after that she had been ill of late for about three Months of a very great weakness of the Stomach with an Anorexia, a Nauseousness, and almost a continual Vomiting, at length I know not on what occasion, falling into frequent Swoonings, a little after she was often troubled with a Vertigo, with a failing of Memory, and sometimes with a slight Delirium, and when she had continued so for many days, and in the means while being free from the Gout, and having a good Stomach, she eat Broth twice or thrice, and flesh once a day with an Appetite, and digested it without trouble; this was a plain sign that the Recrements of the Nervous Humour which formerly were wont to fall by the spinal Nerves into the feet, to the seat of the Gout, afterward being deposed by the Nerves of the Par vagum and Intercostale in the Ventricle, raised continual Troubles in it, which at last partly restagnating in the Brain, and partly being conveyed into the Nerves of the Heart, were followed by those affects of the Leipothymia, Vertigo, and Delirium. The Theraputick method suggests three primary Indications, whereof the first being curatory, is used only in the Fits, for the appeasing, or sooner putting an end to the Pains: The second being preservatory, and appointed for the intervals of the accesses, endeavours to remove the Procatarxis of the Disease, so that the invasions of the Pains may return but seldomj, or more mildly, or not at all. The third being vital, orders by what kind of diet, and with what Remedies, the strength may be supported among the said Tortures, and Life, notwithstanding the frequent and almost continually troublesome oppressions of the Disease, may be prolonged, and withal reinvigorated. The first indication, viz. the appeasing of the Pains, contains these two chief intents: viz. That the Solution of Continuity be taken away, and in the mean while that the irritation or excandescency of the Fibres, or of the Spirits abounding in them, be allayed. 1. To take away the Solution of Continuity in the places affected, both the fluxions of the Humours which are apt to tend thither aught to be stopped, and the Minera already there sticking aught to be discussed or dissipated, and its Particles be restrained from their mutual Effervescencies. For these ends evacuating and altering Remedies, and both of them, as well inward as outward, are appointed: we shall-set down certain select Forms and ways of Administration of these in order. Blooding in a new Gout, or which is not very inveterate, and especially in a hot constitution, being used about the beginning of the Disease, often gives relief: but in an habitual Disease, also in a cold temperament, and in old Age, it is wont to do more hurt than Good, in as much as it depresses the vigour of the Blood and Spirits, which are not too exorbitant, without a diminution of the morbific matter. Concerning Purging about the beginning of the Disease, the thing is very much controverted, whilst some Physicians religiously abstain from all Purging, before the declination, or end of the Fit; and others on the contrary constantly give strong Purges about the beginnings of the Disease: the reason of the difference seems chief to lie in this, viz. that in some gouty Persons, who are yet firm in the Constitution and Tone of the Humours and the containing Vessels; and whose Joints are not yet weakened, as often as the Blood and Nervous Liquor are troubled by a medicine, their Superfluities and Recrements are not presently precipitated into the Minera of the Disease, but yielding to the Medicine irritating and stirring them, they are drawn from the Mouths of the Arteries into the Cavities of the Intestines; and mean while the emptied Vessels withdraw or drink up again a part of the morbific matter. but on the contrary, in tender and weakened constitutions, upon the gentlest commotion of a Medicine, the Recrements of both humours fall into the Place troubled with the Gout. To those therefore with whom purging agrees, it ought to be ordered with a strong and exagitating Medicine: for this purpose are vulgarly famous the Electuary Caryocostinum, Syrup of Buckthorn, compound Powder of Hermodacts, Pilul. ex duobus, Pil. Rhasis; which, if we may believe the Author, will make such as are not able to go, presently to walk about. Take of the best Aloes half an ounce, red Roses two Scruples, Hermodacts peeled a dram and a half, Diagridium a dram, Honey of Roses what suffises, make Pills. Rodericus a Fonseca wonderfully extols the roots of black Hellebore, and amongst other things, an Apple with the Fibres of it stuck in it to half a dram, roasted under the Embers and eaten. Take Calomelanos a Scruple, Rosm of Jalap three grains, or of Scammony three grains, Oil of Cloves a drop, Balsam of Peru what suffises: make three or four Pills for one dose. In purging, what Solenander prescribes happily may be of some moment; viz. by putting a Plaster, or some other defensive Medicine on the place, to hinder the falling of the humour to it. Vomiting, with those with whom it uses to be safe and easy, does well also in this Disease; for which end the Emetic Tartar of Mynsicht, Sulphur of Antimony, its Flowers, Mercurius Vitae, Vinum Emeticum, Gutta Gamba may be given. Moreover, in a Fit of the Gout, Powder of Stones, Bones, and Shells, and also of smart Vegetables do good, which being said to be the Antidotes of this Disease, subdue all Particles, and fermenting with them, mortify them as it were, and at length being subjugated, send them forth by Urine, or sweat. Take compound Powder of Crabs Claws two drams, Ivory, Roots of bastard Dittany, Roots of male Peony of each a dram, Lignum Aloes, yellow Saunders of each half a dram, make a Powder, let it be taken from half a dram to a dram, either by itself in a Spoonful of red Poppey water, drinking after it six Spoonfuls of the same, or let it be made into a Bolus, or Pills with Venice Treacle, or Venice Turpentine what suffises; the dose is a dram twice a day, drinking after it of the distilled water beneath prescribed, two or three ounces. Or, Take of the same Powder six drams, conserve of Clove-gilliflowers and Betony Flowers of each an ounce and a half, Diascordium two drams, Syrup of Maeconium what suffises, make an Electuary, the dose is a dram, to two drams Evening and Morning. Mean while that these things are done for withdrawing elsewhere the morbific Matter which would flow into the places affected, or for sending it forth, let altering and qualifying Medicines likewise have their turns, which may appease the Turgescencies of the Blood and Nervous Juice, and stop the fluxions of the Recrements falling from them; for this end a thin diet, and a drinking of Water (if it be proper) being ordered, let Emulsions, Juleps, Apozemes of mild things and anodynes be prescribed. As to what concerns the other Scopes of curing, viz. the discussion of the Minera sticking in the Parts, and the mitigating the excandescencies of the Fibres and Spirits; we must insist first on this latter, without the performance of which we cannot answer the other intent: for this end therefore it is expedient to use both outward things, viz. Topics of various kinds, and inward things, viz. Hypnoticks. There being a vast number of Topics, they either being only anodynes, have regard to the Pain itself; or levelling at this, together with the Tumour, they are either Repercussives, or Resolvents and Discussers; there are various Forms and Ways of Administrations of every kind of these: but those of chiefest use are wont to be Fomentations, Cataplasms and Plasters; we shall set down some of the most noted of these, and first Anodyne Applications, which moderate the Fibres and appease the Spirits by a certain soothing: for this use, a Cataplasm of Milk and Crum of Bread, or of those things with the poúndings of the Leaves and Roots of Mallows and Althaea, and the like, are every where in common Practice with the Vulgar. Others commend a Cataplasm of fresh Cowdung applied warm. Take Water of Nightshade, or of the Spawn of Frogs, of each six ounces, Saccharum Saturni a dram, mix them, let linen dipped in this be applied warm. Take of red Lead three ounces, distilled Vinegar two pounds, digest them for many days: let either this Liquor by itself, or a Water drawn from it by distillation be used for a Fomentation. Also a distilled water made of the Tincture of Verdigrease distilled in Vinegar, often appeases Pains. I was told by a Gentleman often troubled with a severe Gout, that he, in the cruel Tortures of that Disease, had always present ease from a Fomentation with a Water distilled from the contents of a Bullocks paunch newly killed. Against extreme Tortures of the Gout outward Narcoticks sometimes aught to be used. Take Leaves of Henbane, and Hemlock of each three Handfuls, let them be put into boiling Water, and as soon as they grow tender, let them be taken forth; to which, being bruised, add Powder of the Flowers of Camomile about two drams, the yolk of one Egg, make a Cataplasm. Or, Take Tincture of Saffron made in Spirit of Wine four ounces, Camphire and Opium of each a dram, let there be a close and warm digestion till they are dissolved; let the part that pains be anointed with this Liquor: there are innumerable Medicines of this kind every where to be found in Books of Physic, and are every where wont to be prescribed by every vulgar Person; which likewise may suffice for fulfilling the other intent, to wit, the repercussion of the Humours, if at any time it seems to be indicated. As to what regards resolvent, and discussing Topics, such are not required, which only open the Pores, that the Serum may evaporate, and the Blood may be restored to Circulation, as in a Phlegmon or Aedema, but whose saline Particles being destinated for strongly assaulting the saline Particles of the Arthritick Minera, may either draw them forth by laying hold of them, or, by precipitating them, keep them from their Pain, causing Effervescencies: wherefore, in this Disease, when Fomentations, or Cataplasms of Chammomil, Mallows, Marshmallows, Linseed, and Faenugreek seeds do little or no good, nay often much offend the nervous parts by relaxing them, the Dissolutions, or Stillatitious Liquors of Sal Armoniac, Sea-salt, Nitre, Vitriol, quick Lime and the like; which in other Humours and Pains are always offensive are wont to prove very beneficial. Of these kinds of Liquors to be applied to the part pained in Fits of the Gout, several are prescribed by Quercitan, Crollius, Hartman, and other Chemists; which since other famous Physicians, upon frequent trials have approved off, we conclude them to have given relief for the foresaid reason. I need not repeat here the forms of these; as I could suggest many other Preparations of the same sort, I shall here only add one or two. Take Salt of Tartar and Armoniac powdered of each two ounces, dissolve them in four pounds of Rain-water or Fountain-water: let it be used lukewarm with Linnen-Cloaths dipped in them. Take spirit of Vitriol not rectified a pound, Sea-salt calcined and powdered a pound, mix them, and distil them in a Glass Retort with a sand heat; there will come forth a pure spirit of Salt, to wit, which being driven from its seat by the distilled Liquor of the Vitriol, and leaving to it its possession, will easily dscend: to the Caput mortuum pour Spirit of Wine two pounds, make a close and warm digestion, adding of Camphire two drams, let it be applied warm to the part grieved with Linen . Take filings of Iron, Flowers of Sal Armoniac of each six ounces, mix them by boiling them together, let it be distilled in a Glass Retort till the Flowers are sublimed: to the caput mortuum bruised pour spirit of Wine, digest, and keep it for use. I have heard that some for appeasing Pains of the Gout, put the foot affected in a bag filled with Sea-salt calcined and powdered, from which they still expect a certain and quick relief. In the declination of the Fit, to strengthen the part, and to discuss the remainder of the morbific matter, Plasters are usefully applied, which nevertheless do not all agree indifferently with all Persons; but with these more hot, with othérs less hot, though with most those are wont to be most efficacious, in which are red Lead, Litharge, Mercury, and other mineral or saline things, we use chief a Plaster of red Lead, Ceruse, and Soap boiled with Oil, or take the red Lead Plaster two parts, Paracelsus' Plaster one part, mix them and spread them on Leather. Inward Remedies to be used against Pains of the Gout, are in a manner only Narcoticks, which ought to be given in a cruel and long continued Pain. Of these we most commend Preparations of Opium, with Salt of Tartar or its Tincture. Moreover, for this use Paracelsus' or the London Laudanum, Pilul. de Styrace, de Cynoglosso, Syrup of Meconium, Venice Treacle and Diascordium are wont to prove beneficial. The second indication called preservatory, has respect to the removal of the Procatarctick Causes of the Gout; so that the Fits of the Gout may molest with invasions more seldom, and less, or not at all. For this end evacuating, altering, and corroborating Remedies, together with an exact form of Diet are prescribed to be used out of the Fits. 1. Therefore Gouty persons ought to Purge solemnly Spring and Fall. and it will be convenient then to give a Vomit, if nothing indicateth the contrary, and afterward to repeat it sometimes by intervals. Those who have a strong Stomach and Praecordia may take Mineral Emetics, prepared of Antimony and Mercury: Those who are of a more tender constitution, after having eaten slippery food, may take Wine of Squills, or Salt of Vitriol with Whey: Afterward, the Stomach being filled with warm Water, or plain Posset-drink, or with the leaves of Carduus boiled in it, let a Vomiting be raised twice or thrice, or oftener. For Purging to be used also frequently at fit intervals of time, the forms of Purges above prescribed may be proper enough. Or, Take threads of black Hellebore cleansed an ounce, lignum aloes, Cloves, of each two drams, being bruised, pour to them of Spirit of Wine not rectified, two pounds; let there by a close and warm digestion for many days; the dose is two or three spoonfuls in the morning twice or thrice a week, and let Vomiting and Purging always be begun before the Equinoxes, lest haply the fit, happening first, may prevent the course of Physic. Blooding, or opening of the hemorrhoid Vessels are sometimes proper Spring and Fall to Persons of a hot temperament and a sharp Blood; Cauteries made in the Arms and near the Shoulderblades are useful in a manner to all that are obnoxious to this Disease. Moreover, altering Remedies, called by the Ancients the Antidotes of the Gout, are of excellent use, and being taken sor a long time, together with an exact governance as to the six nonnatural things, often give great relief: In this rank, Medicines endowed with a Volatile Salt, or a Balsamic Sulphur; to wit, inasmuch as these exalt the fixed Salt, and those reduce the acetous, are accounted the chief; again, bitter and astringent things, as the Herbs Germander, Groundpine, Centory, Roots of Gentian, and Birthwort, etc. (since they are approved of by experience in this Disease) seem to be profitable for this reason that they help the offices of Concoction and Chylification, and keep the saline faeculencies from being carried into the Blood. Let us set down certain forms of each of these. Take Powder of Groundpine six dram; Crabs-eyes two drams, Venice Turpentine what suffices, make small Pills, let three or four be taken in the evening and morning for thirty or firty days; drinking after it of the following distilled Water two or three ounces. Take leaves of Cypress, Fir, Misteltoe growing on Appletrees, of each six handfuls; Roots of Avens, the great Burrdock of each a pound, the outward rinds of ten Oranges and six Lemons; Nutmegs, Mace, of each an ounce, being all sliced and bruised, pour to them of fresh Milk seven pounds, Malaga Sack a pound, let them be distilled according to art; let the whole liquor be mixed. Or let a plain Water be prepared of the leaves of the great Burrdock, cohobating it twice or thrice on fresh leaves. Take Powder of the Seeds of the great Burrdock six drams, Crabs-eyes two drams, Nutmegs half a dram, Balsamum Capivii what suffices, make a mass, and let it be made into little Pills, let four be taken in the evening and morning for many days. Take Tincture of Antimony an ounce, the Dose is twenty drops to twenty five in the evening and early in the morning, with three ounces of the water even now described. To poor People I use to prescribe after this manner. Take powder of the leaves of Sage half a pound, Crabs-eyes, Saccharum Crystallinum of each two ounces: mix them, let it be kept in a glass, let a spoonful be taken twice a day with a draught of the decoction of the leaves of Sage, or of the roots of the great Bur-dock. Or, let Dornorellus his powder be prescribed to be taken after the same manner. Take powder of the leaves of Germander, Ground-pine, the lesser Centory, Marjoram, Sage, Betony, roots of Gentian, round Birth-wort, of each an ounce, Sugar a pound, mix them, make a powder. Or the Powder of Johannes Anglicus, called by him Saracenicus. Take powder of the Leaves of Ground-pine an ounce, of the Bones of Mansfoot burnt two drams, Licorice three drams, mix them. For ordinary drink let a Bochet be prepared of Sarsaparilla, Saunders, Lignum Rhodium, shave of Ivory and Hartshorn, etc. Or, let a small Ale be prepared for a Vessel of four Gallons: in which instead of Hops let the leaves of Germander and Ground-pinen be boiled: and after it has wrought, put into it of the leaves of dried Sage four handfuls, Sassafras two ounces, Roots of Avens eightounces. Among altering things, a Milk Diet does not claim the last Place; viz. that the Patient use no other Diet for three or four Months; Morning and Evening let him drink Milk as it comes from the Cow; about Noon let him Eat of it boiled with White-bread, Barley, or Oatmeal. I have known some who by this kind of Diet have found great Relief; and that others have been much worse after the use of Milk, and the Gout being not cured, to have contracted great Obstructions of the Viscera and a Cacochymia. Therefore, let not that Method rashly be entered upon without the advice, and careful observation of a prudent Physician whether it agrees or not. Not long since, it grew a vulgar Custom for Gouty Persons to drink every Morning their own Urine, which I remember to have done good to some: The reason of which relief seems of be, that the Saline latex of the Urine, passing again through the Blood, carried with it the Salino-fixt Particles, which were wont before to be conveyed to the Joints: Wherefore this Method, if at any time it give ease in the Gout, for the most part it increases the Nephritick affect. A very learned and Pious man, the Glory both of our Nation and of Learning, D. D. H. H. having lived for many years greatly obnoxious to frequent fits of Pains, Vomiting, and pissing Blood, at length, upon the constant use of the following Remedies, becoming almost free from the Nephritick affect, he lived above seven years without any very great Fit of it. The Method of Cure which a certain Gentleman had taught him, without any Physic, was thus, Abstaining from Wine and Cider, he drank for ordinary Drink a small Ale made of Oaten Malt; Moreover, once a week he took in the Morning a draught of the same Ale to about half a pound, with three spoonfuls of the Powder of Ossa Senelorum dissolved in it: by the use of these things seeming to have bid farewell to the Disease of the Stone within four Months, he presently begun to be troubled with the Gout, and was often infested with severe Fits of it during all the time of his being free from the Stone; and at length, upon every little occasion, he became so obnoxious to them, that if presently after Eating he any way exercised his Body or Mind, viz. either by walking or study, he certainly expected invasions of the Pains; the reason of which was, that the Blood being saturated to a fullness with Salino-fixt Particles, and the Nervous Liquor with Acetous, when, upon a fresh supply of Nutritive Juice, they were stirred and grew turgid, presently they deposed their Superfluities, viz. the morbific matter of both kinds in the Joints, as being very weak. Therefore that Venerable Person, being tired with so srequent and almost continual a Torture, by the Advice of a certain Friend drank his own Urine every Morning, by the use of which, within a Month or two he was tormented somewhat less with his Pains of the Gout, but by an ill change the Nephritick affect begun to come upon him again; for he was often affected with a Pain about the Loins, with a Vomiting, and Dysuria, which being not to be overcome by any Remedies, caused the Death of the Renowned Person after about a Fortnight. The Body being opened, all the Viscera excepting the Reins appeared very sound and firm, but the right Kidney seemed to have been almost consumed long before, there remaining only a little heap of Glands, all the Vessels and the Ureter growing together, and being wholly stopped, that no Urine had passed there for a long time; The left Kidney being large enough, contained a great heap of Gravel-Stones within its Cavity and Ductus'. Moreover, a round, hard, and whitish little Stone being fallen about three Inches deep into the Ureter, and there sticking, had wholly stopped the Passage of the Urine, the Membrane of the Ureter, where the Stone stuck, was become so thick and callous, and consequently without Pain, that it could not be stirred thence by any means upward or downward. It seemed in this Case, that whereas the Coagulative Particles of the Blood and Nervous Juice, viz. Salino-fixt, and Acetous first meeting together in the Reins, had long caused the Nephritick affect; afterward, by the use of that abovesaid Powder the Saline being still sent into the habit of the Body, and not readily conveyed forth, heaped together a Seminium for the Gout in the Joints, the Reins in the mean time being almost free: but at length, when by drinking his own Water the Saline-miner a was brought back to the Reins, the Disease of the Joints was changed into a fatal Nephritis. CHAP. XIV. Instructions and Prescripts for curing the Colic. OF what right we place this Disease among the affects of the Brain, and the Genus Nervosum, it is intimated in the foregoing Chapter, to wit, in respect of the Symptoms chief pressing, which are Pain and Convulsive Motions, arising thence. Concerning the word Colic taken from the Intestine Colon (which vulgarly, though falsely, is supposed to be chief affected in this Disease) we shall not contend; the affect may be described, that it is a mighty Vellication of certain Parts of the Abdomen, whence a very acute pain, to which for the most part a vomiting, also Cramps and Contractions almost of all the Viscera of the Belly are wont to be joined. For the Navel and its neighbouring parts sometimes are drawn inward as it were with a certain perforation, sometimes they swell out with an inflation, and a great springing forth as it were; the intestines, by an inverted motion of the Fibres, are often drawn upward: Wherefore the Belly, being mightily bound, discharges little or nothing at all, nay, though it be frequently provoked by Clysters, it does not easily depose its contents. That the Ventricle is likewise convulsed with the Duodenum, and gallbladder, it plainly appears from the copious vomiting and casting forth of the yellow or green Choler: sometimes also the Ureters, and the Bladder which contains the Urine are so contracted, that during the whole Fit the Urine is either stopped, or voided more sparingly: besides, in the Head vertiginous affects frequently preceded or follow the invasions of this Disease: nay, and the Colic increasing and becoming inveterate, often brings Pains in the outward Members, and at last is terminated in a Palsy: Since therefore many Parts are wont to be troubled by it, we must inquire which is primarily affected, and by the means of which the rest suffer, and show what is the conjunct Cause of this Disease; in what place it subsists, and whence it draws its Origine. As to the Part primarily affected, when the Disease presses, the whole region of the Belly is wont to be troubled, yet its primary seat ought to be placed where the pain infests chief, and sticks most obstinately. Now this is said by many Physicians to be somewhere in the Colon, because we generally observe, that the Intestines, and chief the Colon, being irritated by Flatus', by which choler and haply other humours, contained within their cavities, fall into pains and gripes; but if the pains of the Colic proceeded from the sharp and irritative contents of the Colon, doubtless those things which loosen the Belly, and copiously expel Flatus' and the Faeces, would bring a most certain relief: the contrary of which oftentimes happens, viz. that after frequent, or violent Purging, that Disease becomes worse. Wherefore, that the seat and nature of this Disease may be duly known; we must first distinguish here concerning the Gripes or Pains of the Belly, vulgarly accounted as of the Colic. For either, being merely occasional, they arise from an evident cause alone, and without a previous disposition in any Person indifferently; thus alterations about the six non-natural things, often raise mighty disturbances in the Viscera of the Belly with pains: Which kind of affect never theless ought not to be looked upon as a Disease, but only as a symptom raised from a manifest cause. But besides, the Colic properly speaking, does not only happen to any men indifferently, being produced by an accidental cause, but following some men predisposed after a peculiar manner, depends wholly on a procatarctick cause brought to a ripeness by degrees: the greater fits of the Disease for the most part have their periods, and observe the alterations of the Air, and of the Year. Moreover, being raised, they do not easily yield to Remedies, nor soon pass off: But notwithstanding the use of Epithems, or the Belly's being purged, though in a plentiful manner, by Clysters or cathartics, they often continue many days, and sometimes weeks with great violence; the pains in every fit take always to the same Part, and for the most part are attended with the like concourse of other symptoms: Moreover, Colic pains, though they have not the same seat in all; but sometimes rage's most about the Ventricle, sometimes about the Navel, or hypochondres, sometimes in the hypogastrick Region, or toward the Loins: Yet as often as they return in the same Diseased, they most commonly observe the same seat. I say now, that the Part primarily affected in the Colic is the Mesentery: We have shown elsewhere that the causes of certain convulsive motions, which are vulgarly called hysterical, oftentimes lie hid in the Plexus's of the Mesentery: and then we asserted the pains of the Colic sometimes to have their seats in the same places, and we made it plain enough from Anatomical observation. But it is not the same, but somewhat a differing matter which is wont to raise those so different affects under the same roof: in the Passions called histerical, we have set forth at large in the former Tract, that the Animal Spirits being overcharged with an Elastic Combination, burst from one another, or, are exploded as it were, and consequently that they force in despite the containing Bodies into irregular or preternatural motions: but in pains of the Colic the same Spirits being irritated by reason of a Matter annoying them, and being disproportionate to them, and thereupon being divided and severed from each other, they force the sensible fibres to very troublesome corrugations: after what manner this is done in the Colic, and what is the Conjunct cause and Procatarxis of that Disease, we shall now say somewhat more plainly. Therefore, for the Seminium or Minera of the Colic, we suppose that certain recrements of the nervous humour falling from the Brain by the Nerves, and passing into the Mesentery, and other Plexus's of the Abdomen, are there heaped together. Which, if they are so gross and viscous, that they cannot be received and sent away by the Lymphducts, or distil forth into the cavities of the Intestines by the small branches of the Vessels, then stagnating and being heaped together by degrees in those Parts, they arise at length to an irritative plenitude: Afterward, that matter becoming more degenerate, and more offensive by stagnation, and growing turgid on some occasion, or of its own accord, or haply fermenting with the Saline-fixt humour sent thither from the Blood, will torture with very troublesome and painful corrugations the branches of the Nerves and Nervous Fibres, with innumerable of which the Mesentery is stored. Which affect of them does not wholly cease till the fermenting matter either is discussed, or expressed into the cavities of the Intestines, or at length is subdued. Again, forasmuch as from the Mesentery and its Plexus', nervous branches and fibres are most thickly protended to the bottom of the Ventricle, the Gallbladder, the Ductus Choledochi, all the Intestines, and on every side almost into all the Viscera of the Abdomen; therefore, whilst the Colic matter, fermenting in its Mineras, causes there often most sharp gripes and tortures, at the same time in most other membranous Parts, Cramps and Convulsive or painful contractions will be every where raised. Hence, by reason of the Mesentery primarily affected under the Navel, there is a cruel pain, as though a stake were stuck there, or a piercer were making a hole; moreover, all about almost in the whole Abdomen, by reason of the Intestines being variously drawn forward and backward at the same time in differing places, erring pains shoot this way and that; and by reason of the motions of the Fibres being distracted or inverted, as well in those parts, as in the primary Vessels, the Belly is in a manner always bound, and there ensues sometimes a suppression of Urine, or very little is made. Moreover, the Duodenum, the Gallbladder with its Ductus', and the bottom of the Stomach being affected with a cramp, and their Fibres being drawn upward, a frequent vomiting, with a copious casting up of a yellow or greenish Choler often happens during the Fit. In a Fit of the Colic, to Pains of the Belly most violent Pains of the Loins raging in the lower part of the Back are oftentimes joined, which certainly can arise from the irritation of no Intestine, but it will be easy to conceive that they are raised from a morbific cause placed in the Mesentery: viz. in as much as certain considerable Nerves of the Loins enter the great Nervous Plexus of the Mesentery: so that hence not only painful Convulsions are conveyed by consent from one part to the other; but it is likewise probable, that certain Recrements of the Back also and of the Loins are derived into the Mesentery by this Passage, and that in some sort for this Reason scorbutical Persons are so very obnoxious to gripes of the Belly, and to its looseness. As to the Procatarxis of the Colic, it consists chief in these two things, viz. first, that many Recrements are heaped together in the nervous Liquor, and secondly, that they being chief received by the Nerves appointed to the Viscera of the Belly, and conveyed to the Mesentery, make there the morbid Mineras. First, the former of these for the most part happens through the fault and distemper of the Brain, to wit, for as much as this admits within its Precincts, together with the Nervous Juice, heterogeneous Particles, and such as trouble the animal oeconomy, and does not readily discharge other ordinary Recrements by fit common Sewers: Wherefore the incongruous matter, since it cannot be otherwise sent from the Brain, most readily rushes into the Nerves of the Par vagum, which are very open for it: and for this reason it is that Women, upon any disorder of the Brain, frequently contract the Hysterick habit; to wit, in as much as the Recrements of the nervous Liquor, whether they are convulsive and elastic, or only painful and irritative, being apt to be deposed in the Par vagum, so generally raise convulsive Symptoms, as well as those of the Colic. Secondly, that this matter running into the Par vagum of the Nerves, is deposed in the Mesentery, or in other plexus' within the Abdomen, the reason is, that many, and the greater Nerves of that Conjugation, are ultimately terminated in these Nervous Plexus'. Wherefore, if the Recrements of the Nervous Humour subsiding here as it were to the lowest place, can neither be carried back by any Vessels, nor pass into the Cavities of the Intestines, of necessity the same must make morbid Seats in this Part. The evident Causes are of two kinds, viz. First, such as being injurious to the Brain and Genus Nervosum, make a greater increase of the morbific Matter: or, secondly, such as by agitating the Blood and Humours, rouse up the Mineras heaped together and before lying still, and stir them to Pain causing Effervescencies. It would be tedious to examine here the manifold and diversified Occasions by which the Pains of the Colic are stirred up in Persons predisposed to them; for both great Disorders in the six non-natural things, and changes of the Air and of the Year, and likewise the Medicines themselves (from which relief is expected) being unseasonabely given, often bring these. As to the Prognostic of the Colic, it is vulgarly enough known, that an accidental Colic, viz. raised from an evident Cause alone, is most commonly safe, and cured without much ado; but that an habitual one is both eradicated with great difficulty, as to its Disposition, so that the Fits may no longer return, and that sometimes the Fits themselves notwithstanding Remedies are very obstinate, and persist for many Days, nay Weeks, and sometimes Months. 2. A Colical Disposition frequently ensues upon intermittent Fevers of long continuance, and upon continual Fevers of an ill determination, viz. in as much as the Nervous Liquor being mightily vitiated, heaps together many Recrements which are deposed deep in the Plexus's of the Abdomen, as Receptacles the most open: Moreover, for this Reason an epidemical Fever has reigned some years, to which a Colic has been joined as a pathognomick Sign: hence, in like manner, a long continued and growing Scurvy, for as much as it perverts the nervous Liquor, brings also the Colic. 3. After that the Colic Pains have raged some time in the Belly, they oftentimes assail the Loins, and afterward, the Disease increasing, the Limbs, and almost all the Muscles in the whole Body, and at length are often terminated in a Palsy, which certainly is a manifest sign that the morbific Matter is not conveyed by the Arteries, but by the Nerves, and that its seat is not the Cavities or Tunicles of the Intestines, but the nervous Plexus' of the Mesentery: for that the Pains of the Loins happen upon gripes in the Belly, besides that the Nerves of both Places communicate, the cause also is, that the morbific matter being much increased in the Head, gets not only into the Par vagum but also into the spinal Marrow, and falling to its lower part, it first causes Pains to arise in the Loins, and afterward many other Nerves which proceed from the Spine being affected, it causes the like in the Members, and other Muscles; finally, the Ductus' of the Nerves being stuffed by the Morbific Matter heaped together to a plenitude in them, the Palsy is caused. 4. A fierce Colic, and very violent, whose cause is an inflammation or abscess of some intestine, for the most part brings a mortal Iliack Passion. The Therapeutic Method in the Colic, as in most intermitting Diseases, suggests three primary Indications. Wherefore, the first, which is curatory, being to be used in the Fit, had regard to the appeasing of the Pains, and to the speedy and easy removal of the access of the Disease. The second being preservatory, teaches what is to be drawn out of the fit for taking away the cause of the Disease, that the fits do not often return, or prove sorely offensive. The third being vital, furnishes Remedies for preserving the strength, and refreshing the Spirits during the Gripes and cruel Tortures. We shall speak of each of these a little more at large in order. 1. We have regard in a manner only to the curatory Indication in an accidental Colic; for the evident cause, which is the irritation of the Intestines by the sharp contents being removed, the Pains for the most part cease of their own accord, nor is a Relapse feared without a like occasion: Wherefore, for the speedy cure of this Disease, there is a practice proper enough known by every vulgar Person, viz. Presently to administer emollient Clysters, topical anodynes, and Narcoticks; to which, if there be a Fever, or it be feared, blooding is often joined with benefit. We shall presently set down Forms of these and the order of using them in the cure of the habitual Colic. Therefore, for the curing the Fit of this Affect, there are two chief Intentions. viz. both the painful Solution of Continuity ought to be removed, and the Excandescence of the Fibres or Spirits in them to be appeased. On the account of the former, we must endeavour both that the matter sticking and fermenting in one or more Miner as be either discussed, or subdued, and in the mean while that the afflux of a new Matter be stopped; the second Intention, on which we must insist in the first place and without intermission, is performed chief by anodynes and Narcoticks: after what manner, and by what Remedies all these things are to be done methodically, we shall deliver. The cure of the Pain of the Colic is begun most commonly, and proper enough by a Clyster, let this in the first place be only lenifying and emollient: by which, as by an inward Fomentation, the corrugations of the Fibres may be mitigated, and the raging of the Spirits be appeased: for this end, warm Milk with Sugar, or Molossus, or Syrup of Violets: also emollient Decoctions of Mallows, Marsh-mallows, Herb Mercury, and the Flowers of Melilot, Elder, with Oil of Almonds, or of Olives, also a Decoction of a Sheehead, or Calf's Feet are proper: sometimes a Clyster of mere Oil of Olives or of Linseeds are wont to give help before all others. But in case mild Clysters do not easily come away, or not loosen the Belly, let such be used as irritate more, and press, and draw out by force as it were the Humours from the little Mouths of the Arteries: for this end, let carminative or better Decoctions be prepared, in which let the Electuary Diaphaenicon, Diacatholicon, or e baccis Lauri, or Species Hierae be dissolved. Also to those Liquors it is usual to add three or four ounces of the infusion of Crocus Metallorum: or to a pound of an emollient Decoction, add of Venice Turpentine dissolved with the yolk of an Egg an ounce, or an ounce and a half, or take Urine of a sound man a pound, Venice Turpentine dissolved an ounce and a half, Molossus an ounce, mix them, make a Clyster. I have known this often to have given a great relief; the reason of which seems to be that the balsamic Particles of the Turpentine comfort the intestines, and like wise being received by the Venous Blood, and circulated with it through the whole Body, they move Urine, so that a copious making of water often follows such a Clyster, and it always carries a smell of Violets, haply also the Particles of the Turpentine diftused every where, move the morbific, or stagnating matter, or incline that which is acetous, or otherwise degenerate, to a better Crasis. Whilst the Intestines are so washed with Clysters, and fomented, as it were, inwardly; let outward Epithems also be applied to the Abdomen. Take leaves of both Mallows, herb Mercury, walwort, of each four handfuls; flowers of Elder, Camomile, Melilot, of each two handfuls, a Calves-head cloven: Let them boil in a sufficient quantity of Fountain-water. Let the straining be used for a fomentation, with linen dipped into it as warm as may be suffered, and wrung forth, and applied by turns; repeating it as often as the pains press violently. In the Intervals of the fomentation let a Cataplasm or Lineament be used. To the magma of the Herbs bruised add Outmeal what suffices, make a Cataplasm, and let it be sewn in rows in two bags of a square figure, for covering the Abdomen: Let one of these be warmed at a time in a Platter on hot Coals, with Oil of Earthworms, or of Frogs, let it be put on warm, changing it assoon as it gins to grow cold. Or, Take Oil of Earthworms, or of Frogs, what suffices, let the Part paining be anointed after the fomentation; and let cap Paper moistened be applied and worn. The Cawl of a Lamb, or the Lungs, or other warm Viscera of Brutus' laid on the Belly, and often changed, sometimes wonderfully appease pains. I have observed in some constitutions and temperaments, that Epithems of hot thins, or applied hot; have rather increased pains, than mitigated them: Wherefore in these cases it seems necessary to order fomentations of the Solutions of Nitre, or Shall Armoniac, or of other Chemical Liquors, as in pains of the Gout, sometimes (as Septalius relates) of meet cold Water. But if the Gripes of the Belly do not remit by the use of these things, we must use hypnoticks; viz. which being given in a set dose, often give great truce: Mean while, for refreshing the strength and failing Spirits, and to order yet a greater Apparatus against the Disease. Take liquid Laudanum tartarized from sixteen drops to twenty, give it going to rest in a spoonful of the water of Camomil-flowers, drinking after it of the same six spoonfuls; let it be repeated every other or third night, if the pains are very pressing. In a hot constitution. Take water of Camomil-flowers three ounces, Syrup of Meconium half an ounce, Aqua Mirabilis two drams, make a draught to be taken going to rest. Mean while that these things are done for appeasing pains, and either for discussing, or at leastwise loosening this matter sticking in the morbid fears, let evacuating Remedies have their turns; to wit, both for wholly extirpating the Minera of the Colic, and for cutting off the supplies or fuel of it, that it grow no further. For these ends, a Vomit (where it agrees) and a gentle Purge; and also in a hot temperament, where a Fever presses, or is feared, Blooding aught to be used. Take Sulphur of Antimony, from five Grains to seven or eight, conserve of Borage a dram, give it in the Morning with Governance. In this case, according to the Judgement of a Physician present, either an infusion of Crocus Metallorum, or of Mercurius Vitae, the Emetic Tartar of Mynsicht, an expression of the Leaves of asarum, and in tender Constitutions, Salt of Vitriol, and Wine, and Oximel of Squills may be given. Let Purges, lest they nauseate the Stomach, which is distempered, be given only in a very small Dose, and in a meet Form. Take Rosin of Jalap, and of Scammony of each five grains, Cream of Tartar a Scruple, Cinnamon powdered four Grains, make a Powder, or let it be made into Pills or a Bolus with conserve of the Flowers of borage, or of Damask Roses. Take Scammony sulphured half a Scruple, Cream of Tartar fifteen Grains, Diaphoretick Antimony a Scruple, make a Powder, let it be given after the same manner. If a Fever does not press, give a dose of Stomach Pills with Gums, or of Amber, either by themselves, or with Rosin of Jalap. Take Pilulae Rudii from twenty Grains to half a dram, Laudanum one Grain, make four Pills, let them be taken going to rest: these first bring sleep, and purge in the morning. Or. Take Calomelanos a Scruple, Rosin of Jalap six Grains, Scammony four Grains, Ammoniacum what suffises, make four Pills, let them be taken going to rest. In a long continued Colic, when all other Remedies have done little or no good. I have often known this Medicine, given once or twice, to have raised a Salivation to the great relief of the Diseased: for if at any time the morbific Matter plentifully gathered together in the Nervous Plexus', and other places about the Abdomen, and there firmly sticking, is not able to be moved by other Medicines; the Mercurial Particles displaying themselves every way easily dissolve it, and divide it into minute parts, and drive them variously this way and that, and at length wholly dissipate them. Wherefore in a long continued and obstinate Colic, they may sometimes be given with success, in order to agentle Salivation. Baths and Sudorificks are generally wont to be prescribed in Pains of the Colic: tho, as far as it has appeared to our Observation, seldom with good success: for these, by exagitating the Blood and nervous Humour, make them depose more yet of Matter into the Minera of the Colic, nay, and make the Matter there deposed serment more and be more unruly, and very seldom perfectly discuss it. Diuretics are wont to be given much more advantageously, by which, in regard the Blood it fused, and its Serosities are copiously precipitated, thereby the Fuel of the Disease is cut off, and the mass of Blood being emptied, receives into it a part of the morbific Matter, so that the remainder of it is easily discussed. For this end, Take Spirit of Tartar excellently rectified half an ounce, let half a dram be given twice or thrice a day in a Spoonful of two of the following Julep, drinking after it of the fame four or five Spoonfuls. Take Water of the Leaves of the great Bur-dock, or of Aron, or Arsinart a pound, Water of the flowers of Elder and Camomile of each four ounces, compound water of Gentian and compound Radish water of each two ounces, Sugar six drams, mix them. After the same manner as Spirit of Tartar, you may give in a meet dose, sometimes Tincture of Salt of Tartar, sometimes Mixtura Simplex, or Spirit of Sal Armoniac succinated. Take Millepedes prepared two drams, flowers of Sal Armoniac tartarized a dram, Oil of Nutmegs half a scruple, Turpentine what suffises, make a mass, let it be formed into Pills, let three or four be taken once or twice a day, drinking after it a dose of the Julep, or five or six spoonfuls of the following distilled Water. Take fresh Millepedes cleansed a pound and a half, the yellow Coats of six Oranges, and of four Lemons, Nutmegs in number six, being sliced small add to them Crum of stolen white Bread a pound, all being bruised together and well mixed, pour to them of fresh Milk four pounds, Sack two pounds, distil them according to Art, let the whole Liquor be mixed, and sweetened with Sugar, or Syrup of Violets, at pleasure. In a long continued and obstinate Colic, where there are a hot Temperament and Viscera, purging Spaw-waters, or Whey with Syrup of Viclets is often wont to be drank with great relief: for both Liquors, where they agree, being drank in a plentiful manner, cool the Stomach and hot Intestines, and presently ease and relax them being contracted with Cramps, and painful Corrugations, or being convulsively extended with Flatus'. Moreover, whence (I conceive) they chief give help, insinuating saline Particles of another Nature into the morbific Minera, they conquer and subdue the Saline and Irritative Particles residing in it, and often carry them forth by purging. In this Disease, since all things do not agree with all Persons, nay, nor the same always, or a long while with the same Person; there is need of the careful observation and daily advice of a prudent Physician, that by coindications taken from things that do good good or hurt, the method of Cure may be rightly ordered, and now and then changed. The Vital Indication ought to be joined to the Curatory, and be now and then interchangeably used with it: for since the Diseased, being almost continually affected with tortures, watch, vomiting and abstinence, often fall into faintings, and are sometimes in danger of Life; let Remedies which support the strength, refresh the Spirits, and procure certain times of truce against the Fits of the Disease, viz. Cordials and Hypnoticks have their turns. Take water of the Flowers of Camomile and Elder of each four ounces, of Cinnamon hordeated, of the whole Citron of each two ounces, Pearl powdered a dram, Sugar four drams, make a Julep, let five of six spoonfuls be taken now and then. Take powder of Pearl, Crabs-eyes of each a dram, divide it into four parts, let one part be given twice or thrice a day with the Julep, or with the Decoction of the roots of Contrayerva. Take Conserve of Clove-gilliflowers an ounce, Confection of Hyacinth, Alkermes of each two drams, Pearl powdered a dram and a half, Syrup of the Juice of Citrons what suffices, make a Confection, let the quantity of a Nutmeg be given twice or thrice a day with a Julep. In Constitutions that are not hot, Spirit of Hartshorn, of Soot, of Sal Armoniac succinated, also Tincture of Antimony, or of Coral, often do excellently well. Opiates in the Colic are of necessary Use, without which the Diseased can neither live, nor the Physicians be at any rest or quiet. Take water of Cowslip-flowers three ounces, Syrup of Meconium half a dram, Aqua mirabilis two drams, mix, them, make a draught to be taken going to rest. If the pain, being very intense, will not yield to such a Remedy, you must give Preparations and Compositions of Opium. Paracelsus', or the London Laudanum, Pillul. de Styrace or Cynoglosso are proper, a Solution of Odium tartarized to sixteen or twenty drops is wont to be of chief use with me. Which Medicine I have truly given to some Persons long and miserably troubled with this Disease, sometimes for a long time, one while every night, another while every other night with good success. 3. The Preservatory Indication, having place only in the Intervals of the Fits, endeavours the removal of the present Procatarxis of the Disease, and the hindering of a future: so that the Invasions of Pains may return seldom or never afterwards. In order to these things, the Blood and nervous Liquor ought to be purified and kept in a due Crasis, that they do not engender a morbific Matter, and the Brain and nervous Plexus' of the Abdomen to be strengthened, that they do not receive it too readily. For these ends a way of dyet being ordered, Spring and Fall let solemn Courses of Physic, such as we have prescribed for the Prophylaxis of the Gout, be entered upon. Let Vomiting, if it agrees, never be omitted in this Case; as by which the Emunctories of the Viscera being emptied, they may more plentifully receive the Recrements of the Blood and nervous Liquor, which would otherwise increase the morbific Matter. And likewise that the nervous Plexus' and all the parts may be so shaken, that nothing which would turn to a Minera of the Disease may be permitted to stagnate or be heaped together there. Let purging for three or four times by due Intervals, also in a hot Constitution let blooding be used: Moreover, let altering Remedies, and chief Chalybeats, when the Person rests from purging, be daily taken at physical Hours. But above all other Medicines whatsoever, Spaw-waters coming from Iron, drank in the Summer time for a Month, are wont to give most relief: but when they are drank, diligent care must be taken that they pass off well and quick by Urine or Siege; least happily if they stay long in the Body, by taking to the Head or Feet, they cause the Vertigo or Gout, (as it frequently comes to pass.) Take our Tincture of Steel an ounce, give from fifteen drops to twenty twice a day in seven spoonfuls of the following Julep. Take water of the Leaves of Aron, of the great bur-dock each half a pound, of magistral Water of Earthworms, of Gentian compound and of Paeony compound os each two ounces, Sugar half an ounce, mix them. After the same manner, Tincture of Antimony and of Amber, nay, and many other altering Remedies, above prescribed for Cephalick Affects, also in the Preservation from the Colic, in regard its Procatarxis proceeds from the Brain, have justly place here. Being sometime since entreated to take care of the Health of a Reverend Old Man, who had been very sorely obnoxious to the Colic for many years, I used the Method and Remedies which are now described: by the careful use of which, after a Month or two, he was better, and within a Year and a half he seemed perfectly cured, that afterward he lived wholly free from fits of Pains: But the Colic Disposition had not long ceased, and he omitted the usual course of Physic, but about the Throat, in the Muscles serving for Deglutition, he had a Resolution which frequently troubled him, that oftentimes by Aliments, and especially Liquids there sticking, he incurred the Danger of Suffocation: Receiving help against this evil by Antiparalitick Remedies, for the six or seven Years following he enjoyed an indifferent health, and at last, as was travelling, being then first seized with an Apoplexy, he died: It is obvious enough in this case, that the Recrements of the Nervous Liquor, wont to be deposed about the Nervous Plexus' of the Abdomen, first raised the Colic, afterward that the same being excluded from that part, and betaking themselves to another seat, about the Nervous Plexus' Ganglioformes of the Throat, brought the Resolution or short Palsy of the Aesophagus, and at last, by reason of the same matter restagnating in too great a plenty in the Meditullia of the Brain, the mortal Speechlessness ensued. A certain cunning and subtle Lawyer, fifty years of Age, having been wont to be troubled for many years with a periodical Headache, a deadness of his Senses, and a mighty heaviness of his Head; About the midst of the Summer, being mighty ill of the foresaid Affects, upon the Application of Topick Remedies, on a sudden found ease, but a little after he had a first seizure of a violent Colic; the Invasion whereof was so fierce, that his strength failing on a sudden, he fell into frequent Faintings with a cold Seat: which Fit nevertheless within twenty four Hours vanished by degrees, without any eruption of Flatus' or Purging. But from thence forward being obnoxious to this Disease, he had frequent accesses of it: all which (as I carefully observed) were preceded by a Pain of the Head, with a Vertigo, and a Stupor, foe that he was wont to foretell hence that the Pains of the Colic were to follow soon after in a certain Fit, which continued for twelve days with a mighty fierceness, the diseased himself observed and told me, that the affect of the Abdomen coming upon him, he had found no illness in his Head, but that as the colic Passion remitted presently the Vertigo with the Headache returned: from which reciprocal Metastasis of those Symptoms from the Head to the Belly, and on the contrary, we may argue that the same morbific matter abounding in the Ductus' of the Nerves, sometimes falling downward, brought the Colic Passion, sometimes restagnating above, caused those Cephalick Affects. Not long since, a renowned young Man, studious, and using a sedentary Life, began to complain of a great deadness and dulness of his Senses, also of a heaviness of his Head, and almost a continual Sleepiness. Moreover, his Stomach was become so slow and dulled that it was wholly destitute of all appetite: whilst a cure is ordered against this evil Disposition by Remedies, which rouse up the Spirits and shake off the burden lying on them, the Person falls into a most violent Colic, to which he had never before been obnoxious, by which a violent and as it were piercing Pain, possessed the middle of the Abdomen, the Navel being drawn inwards, and notwithstanding the daily use of Remedies of all kinds, it continued with a mighty Violence for three Weeks; so that during that while he could neither sleep but by taking Narcoticks, nor receive any ease from his Pain, but by a very hot Fomentation. Certainly, in this case, it is obvious to any man to observe, that these Impurities of the nervous Liquor, gathered together to a certain fullness, were the immediate or conjunct cause of all the illness, which matter first subsisting in the Head, caused the mighty dulness of the Brain, and the oppression of the animal Function, and afterward being fallen by the conveyance of the Nerves into the Nervous Plexus' of the Abdomen, caused the violent and long continued Colic. THE PRACTICE OF PHYSIC, CONTAINED In Dr. Willis 's Tract of Fevers. CHAP. I. The Anatomy of the Blood; its Resolution into five Principles: its Comparison with Wine and Milk. A Fever is only a fermentation, or an immoderate effervescence brought on the Blood and Spirits; now that this feverish effervescence may be explicated as it ought, these three things are to be considered. First, what that Liquor is which Ferments, whether it be only the Blood, or other Humours besides. Secondly, of what principles, and of what proportion of the same that Liquor consists in its mixture. Thirdly, and lastly, with what kind of motion and turgescency of these Parts or Particles of which the Blood is composed, the Feverish effervescence is raised. 1. That the Blood boyles violently, and makes an effort in a Fever, it is evident enough, and we may Conjecture that that Juice with which the Brain and Nervous Parts are irrigated, is often also in the salt; for since this Liquor is carried by a constant motion and a certain circulation from the Blood into the Genus Nervosum, and thence by the Lymphick Vessels into the Blood, it's probable, if by reason of a Taint contracted by the Blood, that Humour is depraved in its Crasis, or is perverted from its regular motion, that thence the shivering and the pain, the convulsions, delirium, frenzy, and many other symptoms of the Genus nervosum, usual in Fevers, arise. After the Blood and Nervous juice there are two other Liquors which are to be considered, as being apt to ferment, viz. the Chime or Nutritive juice always coming to the Blood, and the Serous Latex perpetually parting from it; which, though first and last are Liquors severed from the Blood, and distinct from it, yet whilst mixed with it, they ought to be looked upon as Parts received into it, or belonging to its Accomplishment: and as long as both these are circulated with the Blood in the Vessels, they participate of the Effervescencies of the primogenious Cruor, and often begin the same on occasion, or increase them being begun. 2. As to the Principles of which the mass of Blood consists in its mixture, and what Proportion they have in it; We do not allow of the Opinion of the Ancients, That the Mass of Blood consists of the four Humours, viz Blood, Phlegm, Choler, and Melancholy; and that according to the Eminency of this or that Humour, the divers Temperaments are formed, and that by reason of their fermenting or Exorbitances, in a manner, all Diseases arise: nor has this Opinion been so generally used for solving the Phenomena of Diseases, since the Circulation of the Blood, and its other Affects, before unknown, came to light: and since those Humours consist of other Principles, viz. Choler of Salt and Sulphur, with a mixture of Spirit and Water, and Melancholy of the same, with an addition of Earth; and since the Blood is immediately composed of these kind of Principles, and is wont to be sensibly resolved into them, I have rather chosen, omitting the vulgar Acceptation of the Humours, to make use of these known Principles of the Chemists for explicating the nature and affects of the Blood: therefore there are in the Blood, as in all other Liquors apt to ferments, a great deal of Water and Spirit, a small Proportion of Salt and Sulphur, and somewhat of Earth. I shall briefly run over these Principles, and endeavour to show after what manner they constitute the Consistency, Properties, and Affects of the Blood. 1. The Spirits (which without Dispute have the first place) are the subtle, and most volatile part of the Blood: their Particles being always expanded, and endeavouring to fly away, exagitate the grosser Corpuscles of the rest in which they are involved, and keep them always in a motion of Fermentation; by the Effervescence and even Expansion of these in the Vessels, the liquor of the Blood continually boils, and the rest of the Principles are kept in an orderly Motion, and in an exact Mixture: if any thing that is heterogeneous, or unapt for mixture, comes into the Mass of Blood, presently the Spirits, being troubled in their Motion, make an Effort, exagitate the Blood, and make it boil vehemently, till that which is extraneous and immiscible with it, be either subdued, or reduced, or driven forth. 2. From the Dissolution of Sulphur in the Blood, it is likely that the ruddy Tincture of the Blood arises. For sulphureous Bodies, above all others, give the highest saturated redness to a solving Menstruum; and if at any time by reason of too much Crudity, the Sulphur is not dissolved, the Blood becomes pale and Watery, that it scarce gives a redness to Linen. The mass of Blood impregnated with Sulphur together with Spirits, is very fermentative, and when the sulphureous part is raised, and abounds too much in the Blood, it perverts its Crasis from its due state, that thereby the Blood being depraved or rendered bilous, does not rightly concoct the nutritive Juice, or being wholly inflamed, falls into heats and burn, such as arise in a continual Fever. For the Sulphur being too much exalted, and growing more turgid than it ought, raises mighty Effervescensies in the Blood; and those whose Blood is plentifully impregnated with Sulphur, are very obnoxious to Fevers: by reason of the Particles of this incocted in the Nutritive Juice, and thence applied to the solid parts, Fatness, Softness and Tenderness happen to our Body. 3. We discover Salt in the Blood by the Taste, which is there highly volatized by circulation, and if at any time in the Blood, by reason of an ill digestion, the saline Particles are not duly exalted, but continue crude and for the greatest part fixed, thereby the Blood becomes thick and unapt for circulation, so that obstructions are engendered in the Viscera and solid parts, and serous Crudities are every where heaped together: but if the Spirit being depressed or fainting, the Salt is exalted too much, and comes to a flowing, an acetous and austere disposition is brought on the Blood, such as is observed in scorbutical Persons, and in such as are troubled with a quartan Ague: also from the Salt by this means variously coagulated, the Gout, Kings-evil, the Nephritis, the Leprosy, and a great many Cronick Diseases arise. When the Salt is exalted in a due measure, the saline Particles restrain the wild efforts of the Spirits, and especially of the Sulphur; wherefore those who have the Blood well saturated with a volatile Salt, are least subject to Fevers, and so also those who are often let Blood, are more apt to Fevers. 4. By the earthy Particles in the Blood, it's too great volatilisation is stayed, and it's over quick accension is hindered: Moreover, from the terrestrial Particles of the Blood and nutritive Juice, the balk and increase happens to the Body. 5. On the watery part of the Blood its fluidity depends, for hereby its stagnation is hindered and the Blood is circulated in the Veins without growing thick; also it's too great conflagration and adustion is qualified, and its heat is allayed. What we have said even now concerning the Principles of the Blood, and the Affects to be drawn from thence, will appear more clear, if we consider a little the Blood according to its sensible Particles; and compare it with the Liquors which are frequently in use among us. Now those Liquors which have the greatest Analogy with the Blood are Wine and Milk; as to its ways of Fermentation and Effervescence, it is most aptly compared to Wine; as to its Consistency, Coagulation, and Separation of the parts from each other, it is compared to Milk. First therefore we may observe concerning Wine, that as long as it is included in a Vessel, its subtle and spirituous Parts continually exagitate and refringe the more gross, and render them apt for an exact mixture; that which is heterogeneous and unapt to be subdued, is severed by effervescence: mean while the depurated Liquor gently fermenting, is in perpetual motion, whereby all the parts expand themselves every way, and pass by a constant circumgiration from the top to the bottom, and again from the bottom to the top; by the particular fretting and refraction a great many effluvia's of Atoms part from the Liquor, which if they are kept in by a Vessel close stopped, the Liquor ferments too much, and often makes the Vessel fly in pieces. So the Blood within the Veins is pressed on by a constant circulation: the vital Spirit subtilises, refringes, and presently subdues the grosser Particles: drives forth that which is heterogeneous and immiscible: mean while from the refraction, and working of the Parts and Corpuscles, the Effluvia of heat constantly flow forth, and evaporate by the Pores: upon the closing of which, if transpiration be hindered, presently by reason of the too great effervescence of the Blood a Fever is kindled. Secondly, we observe concerning Wines, that they grow turgid if any thing that is extraneous and of a fermentative Nature be mixed with them: nay, that sometimes they are troubled more than usually of their own accord: for when by a long digestion the sulphureous part of the Wine is exalted too much, it falls into an effervescence greater than it ought, and (unless it be presently appeased) it perverts the crasis of the Liquor by its Turgescency; the same thing altogether seems to be in the feverish Effervescence raised in the Blood, which is wont to be introduced for those kinds of causes. The third observation, or comparison of the Blood with Wine is this: Wines (as many other Liquors) have their times of Crudity, Maturation, and decay, the same thing being to be observed in the Blood. [concerning which sec Dr. Willis as large.] So far of the comparison of the Blood with wine, what follows, its similitude with Milk consists in the diversity of its parts and their parting from each other, which is chief seen in it when it is let out of the Veins, and grows cold in a Vessel, For when the heat and vital Spirit, which preserve all in a mixture, are fled away, the remaining parts depart from each other, and there is made a separation of the thin from the thick, of the Serum from the fibrous Blood, etc. After having considered the Blood, we may observe, that the nutritive Juice, supplied from the Blood, and severed from its mass for the nutrition of the solid parts, sometimes by reason of its depravation and irregular motion causes many symptoms in Fevers: This nutritive Juice which is supplied from the mass of Blood, by a certain circulation, after it has passed the nervous parts, what remains of it being effaete and Poor as it were, is sent again by the Lymphick Vessels to the Blood. CHAP. II. Of the Motion and Effervescencies of the Blood. WE must next inquire concerning the Blood's motion both natural (viz. by the help of what ferments; and by what fort of turgescency of the parts, it is circulated in a continual motion through the Vessels) and preternatural, viz. for what causes, and by the efforts of what parts, sometimes it boyles above measure in its Vessels, and falls into feverish Effervescencies. Concerning the natural Motion of the Blood, we do not here inquire concerning its circulation: viz. by what knid of structure of the Heart and Vessels, as it were in a Water Engine, it is carried round in a constant course, but concerning its Fermentation, viz. by what kind of mixture of the Parts, and their mutual Action on each other (like Wine fermenting in a Vessel) it continually boyles: and this kind of motion depends both on the Heterogeneity of the parts of the Blood itself, and on the various ferments, which are inspired into the mass of Blood from the Viscera. As to the first, those things which have altogether the like Particles, do not ferment, wherefore neither distilled Waters, chemical Oils, Spirits of Wine, or other simple Liquors are stirred at all, but the Blood, consisting of various Elements of a contrary nature, and working on each other continually, ferments, and his all its Particles in a perpetual Motion. It is an Argument that Ferments are required for Sanguification, because, when they fail by nature, they are supplied by Art with good success: for fixed Salts, Alchalies, Extracts, Digestives, and especially Chalybeat Remedies give help only in this respect, that they restore a new the ebullition of the Blood either weak or almost extinct. As to what concerns natural Ferments, certainly many may be formed and stored up in divers Parts, or Viscera: for any Humour in which the Particles of Salt, Sulphur, or Spirit, being very much exalted, are contained, endues the nature of a Ferment: After that manner Yeast and Leaven come to be such, with which new Beer, and a mass of Bread are excellently fermented: In like manner, an acetous Humour in the Stomach, participating of an exalted Salt, helps there Concoction: and in the Spleen, the dregs of the Blood, by reason of the Salt and Earth exalted in them, turn to a ferment. How great a Vigour comes to the Blood from the Womb and genital Parts, appears hence, because from the Privation or dyscrasy of these in Virgins a Green-sickness, in Men a want of Beard, a weak Voice, and an amission of Virility follow, but the chief ferment which ferves for Sanguification is lodged in the Heart; for here is the greatest scat of heat, in which the more crude Particles of the Chime are kindled as it were, and acquire a volatility. Therefore the Motion and heat in the Blood, depend chief on two things, viz. partly on its proper Crasis and Constitution, whereby being plentifully composed of the active Principles of Spirit, Salt, and Sulphur, it grows turgid of its own accord in its Vessels (as Wine in a Hogshead) and partly on the ferment implanted in the Heart, which very much rarifles the Liquor, passing through its Sinus', and forces it to spring forth with a frothy Effervescency. Let thus much suffice concerning the natural Motion, Heat, and Fermentation of the Blood, in the even tenor of which the state of our Health consists: to speak now of its preternatural, or over great Effervescency, on which the Types, and Fits of Fevers depend. I call an overgreat or preternatural Fermentation, when the Blood (like a Pot boiling over the Fire) boyles above measure, and being rarified with a frothy Turgescency, swells the Vessels, raises a quick Pulse, and, like a sulphureous Liquor taking fire, diffuses on all sides a burning heat. This kind of Motion or Fermentation of the Blood is excellently illustrated by the example of fermenting Wines: for Wines, besides the gentle and even fermentation, whereby they are first depurated, at certain times boil so mightily, that they work over the Vessels: and if they are close stopped, they make them fly in pieces; after this manner, being put upon an effort as it were, unless they are presently drawn off from the Tartar, or their Lees into another vessel, they cease not to boil, till the Spirit, being very much spent, and the Sulphur or Salt too much exalted, they either become over-fretted, or degenerate into Vinegar. Such an Effervescency is wont to be raised chief for two Causes; first, when any thing extraneous and immiscible is put into the Vessel: (so some drops of Tallow or of Fat dropped into the vessel, produce this Motion) or secondly, when Wines having too much Lees or Tartar (by reason of the sulphureous parts exalted above measure) fall into an Effervescence of their own accord, and boil vehemently: for in whatsoever substance Sulphur abounds, and its Particles being loosened from their mixture, join with one another, and are kept close together, there such immoderate Effervescencies are procured. After the like (though not wholly the same) manner as Wines ferment, the Ebullition of the Blood is caused, viz. either some extraneous and heterogeneous thing is mixed with the Blood, which, in regard it is not assimilated, is wont to cause a perturbation and Effervescence, till the heterogeneous thing be either subdued, or sent forth, and the confused and troubled Particles of the Blood, are cleared again, and take to their former position and site in mixture. Or secondly, the Blood is troubled above measure, because some Principle or Element which composesit, (viz. the Spirit or Sulphur) is raised beyond the natural Temper, and becomes exorbitant, whereby the Particles of this, or that not agreeing with the rest, are loosened from their mixture, being loosed make an effort more than they ought, exagitate the Liquor of the Blood, and cause an effervescence, which is not appeased, till the Blood, being inflamed as it were, has burnt a long time with a feverish blast. But there is this difference betwixt these two boilings of the Blood, that the Effervescence which depends on the mixture of an extraneous thing with the Blood, is for the most part short, or coming by Fits; which when the heterogeneous thing is separated or subdued, ceases of its own accord, and the troubled and disordered parts of the Blood readily return to their natural Site or Crasis: but the Ebullition which arises from the disordering of the exorbitant Spirit or Sulphur, is continual: to wit, here the whole mass of Blood is so opened, and loosened from the strict bond of mixture, that taking a fire like an oily Lpquour, it does not cease to rage and flame till the Particles of the Spirit or Sulphur, or of the combustible matter are for the greatest part consumed. There remains yet a third preternatural way of effervescency, in which the Blood undergoes an alteration, which does not happen to Wine, but very frequently to Milk: viz. sometimes a coagulation of that liquor is induced by a morbific cause, so that it substance is sused, and separates into parts, and there is a secretion made of that which is thick and earthy from the thin; by reason of which the Blood is not meetly circulated in the Vessels, but its congealed portions, being apt to be fixed in the extreme Parts, or to stagnate in the Heart, interrupt its even motion, and greatly hinder it. For restoring of which, effervescencies greater than usual are raised in the Blood; to wit, such as every where occur in the Pleurisy, Plague, Small Pox, and malignant Diseases. CHAP. III. Of Intermitting Fevers. AFever may be described after this manner, That it is a disorderly motion of the Blood, and it's over great boiling, with a heat and thirst, and other symptoms besides, with which the natural oeconomy is variously troubled. As we observed before concerning the effervescence of the Blood, so we may now concerning the Fever, that its access is either short, and coming by sits; which therefore is called intermittent: or great, and drawn in length, which is called a continual Fever: We shall speak first of the intermittent. Concerning this Fever, we shall first inquire in general what kind of effervescence of the Blood it is which causes its Fit, and whence it is raised. Secondly, Wherefore the Fit consists of a coldness, with a shivering, and a sweat ensuing. Thirdly, What is the cause of the intermission, and of the set times of return. Fourthly and lastly, we shall subjoin certain irregularities of Intermittent Fevers. As to the first, We must suppose, that for an Intermittent Fever, some heterogeneous thing is mixed with the Blood, whose Particles, in regard they are not assimilated, make so long an ebullition of the same, till either being subdued, they are rendered miscible, or being subtilised, they are sent forth: wherefore, such matter being subdued or sent forth, the fit ceases; and when this matter springs a fresh, it causes a new Ebullition, and consequently a new Fit happens. Now that which causes an exactly periodical Effervescence of the Blood, must of necessity be some thing which against each of the set returns or accesses of the Fever is engendered in our Body in a set measure, and always in an even proportion, and is communicated to the mass of Blood: wherewith, when the Blood is saturated to a fullness, presently it grows turgid, and falls into an Effervescence: now whatsoever others may think, I judge this thing to be the nutritive Juice, supplied from the matter of things eaten and conveyed to the Blood in weight and measure, which, in regard it is not assimilated through defect of Sanguification, being heaped together to a fullness in the Vessels, it causes a Turgescency in the Blood for its expulsion. I have observed before a threefold State concerning the Particles of the Blood, viz. of Crudity, Maturity and Decay, that is to say, the nutritive Juice supplied from the daily Food, comes crude, being mixed with the Blood, and circulated for some time, it is assimilated, and maturated into a perfect humour; afterward waxing stolen, it runs into parts, and is separated, while the Blood is continually renewed after this even manner, and its losses are repaired, it ferments quietly, and is circulated within the Vessels without tumult or immoderate Effervescence; but if the supply of the nutritive Juice be not maturated as before, nor turns into Blood by a perfect digestion; its Particles mixed with the Blood, continue in its mass as some heterogeneous thing, and not exactly agreeing; with which, when it is saturated to a fullness, presently the Blood grows turgid, and falls into a feverish Effervescence, whereby the fresh supply of this depraved Juice is either subdued or sent forth. If it be asked for what cause the nutritive Juice, being mixed with the Blood, is not assimilated, but degenerates into a heterogeneous and fermentative matter: I judge that this is done for the most part, not through the fault of the Aliments, or of the Viscera, but of the Blood itself. For the Blood, even as Wines, sometimes falls from its native and genuine Disposition, into a sharp, acid, or austere nature, and because the Blood sanguifies, it happens that when that is fallen from its due temper, it easily perverts the store of nutritive Juice, wherewith it ought to be repaired. Secondly, as to the shivering and cold preceding the heat in this affect, doubtless the true and genuine cause of those is the flowing and turgescencie of the nervous Juice degenerated into a nitrous Matter, wherewith the Spirits and heat being charged, are obunded, and the nervous Bodies being irritated are put into a Trembling: but afterward when these nitrous Particles, being in part protruded to the Superficies of the Body, the Blood is somewhat freed from their cumbrance and oppression, the animal spirits recollect and begin to display themselves, and then a most intense heat ensues, because both the mass of Blood being opened by reason of its Effervescence with the febrile matter, and its mixture being loosened, the sulphureous Particles are freely kindled in the Heart: and because (the Pores of the Skin being possessed by the same matter protruded toward the circumference of the Body) the vapory Effluvia are inwardly restrained, which much exagitate and heat the Blood: and which heat continues still in it till the fermentative Matter being wholly burnt, and fully subdued and subtilised together with the adust Recrements remaining after the Deflagration, and joining with the Serum, they evaporate by Sweat or insensible Transpiration. Thirdly, from what is said it will be easy to show the Causes of the Intermission, and of the Set Returns, viz. the Intermission follows, because the Morbific Matter is all cleared at one fit, and so till a new be brought in place, an intermission follows of necessity. Now a new matter gins to be engendered from the time that the last Fit ceased, and when the Blood is filled again to a Turgescency, it boyles and comes to a flowing. As to the Set Returns of the Fits, these happen, because for the most part the nutritive Juice is supplied from the Viscera to the Blood passing in the Veins in an even measure and quantity, though sometimes, if the Persons who have intermittent Fevers gorge themselves too much, or are very abstemious, the Fits happen sooner or later than usual. If it be asked, wherefore the Set Returns of Fevers are not of one kind, and of the same distance, but that some come every day, some every third or fourth day; the cause is the different constitution of the Blood, whereby it is perverted from its due temper into a sharp, sometimes an acid, or austere disposition. According to this differing Dyscrasy, the nutritive Juice, fresh brought, falls more or less from its maturation, and is perverted into a matter sooner or later apt to Ferment. The Procatarctick Causes of this Disease plainly show its Origine from the temper of the Blood being changed. For intermitting Fevers are chief rife in that Season, and those places, in which the Blood receives the greatest alteration from the Air. The same thing is made out by the Cure of intermittent Fevers, whether it be natural and critical; or artificial, and be performed by the help of Medicines: As to the first, Intermittent Fevers are wont to be terminated after a twofold manner: the first is, when the temper of the Blood is altered by the Fits themselves, and it is brought to its natural state; the other way is, when the change of the Air or Place of abode brings a mighty alteration of the Blood, for so Fevers begun about the Equinoxes, are terminated about the Solstices; also the Diseased travelling into another Country often recover. As to the Cure to be performed with Medicines, it is undertaken either Empirically or Dogmatically; and in this Disease Empyrical Remedies, taken from Mountebanks or old Women, are more esteemed, and often effect more than the Prescripts of Physicians given according to an exact method of Curing. The Empyrical Remedies which are said to cure intermittent Fevers, are such as without any evacuation keep off the invading Fit: and are either taken inwardly, or are outwardly applied where the Pulses chief beat, viz. they are bound for the most part to the Region of the Heart, or to the Hand-wrists, or to the Soles of the Feet: now it is worthy to be enquired into, after what manner these work, and by what means they stop the feverish accesses. It is manifest in the first place, that the virtue and action of these things which are outwardly applied, are communicated to the Blood and Spirits immediately; and in regard they drive off the Fit by way of prevention without the evacuation of any humour or matter, of necessity the reason of this effect must consist only in this, that by the use of these kinds of Medicines the Turgescency and Fermentation of the Blood with the Febrile matter are stopped, that is to say, from the Medicine bound about the Vessels, certain Corpuscles or Effluvia are communicated to the Blood, which greatly fix, and constringe its Particles, or also by fusing and exagitating precipitate them as it were: after both ways the spontaneous Effervescence of the Blood is hindered: like as when cold Water is put into a boiling Pot; or as when Vinegar or Alum is put into new and working Beer, presently the fermentation ceases, and the Liquor acquires a new taste and consistency, and is as fit for drinking as if it had been ripened a long time. Now that these Febrifuges operate after this manner, it seems plain enough, because those that are of chiefest note excel in a styptic and astringent, or also in a precipitating Virtue: hence Sea-salt, Nitre, Sal Gemm, the Juice of Plantain, Shepherd's pouch, all astringent Herbs bruised with Vinegar, and the like things bound to the Wrists; the roots of Yarrow, Tormentill, also Camphire hung about the Neck, are said to remove this Disease: Moreover the things that are taken inwardly are of the like sort, the Juice of Plantain, red Rose-water, Alum, in as much as they fix and constringe the Blood; a Decoction of Pepper, Sal Armoniac, or of Wormwood, Spirit of Vitriol, also a sudden Passion of Anger or Fear, in as much as by fusing and exagitating the Blood, they precipitate it, often hinder the feverish access: like as a concussion and exagitation of any Liquor, or an infusion of astringent things in it hinder a spontaneous Effervescence or Effort. It is usual with some Empirics for the cure of intermittent Fevers, to make a hard Ball of Flax or Paper rolled up, and to bind it so colse to the Wrist where the Pulses beat, that the circulation of the Blood in that place is in some manner stopped, and by this means the invading fit of the Fever is driven away. I have certainly known many cured after this manner of a long continued Disease: the reason of which seems to be, that whilst the Blood is stayed in its Motion in any part, it stirs more violently in the rest, and so from that trouble raised in the whole Blood, the spontaneous Effervescence of its Liquor, which was to follow a while after, is stopped: and upon the Fits being put off twice or thrice, Nature takes to the digestion of the matter, and to its ancient regularity. The dogmatical cure for the most part is undertaken by Vomits and cathartics, also by letting Blood: with which the Diseased are miserably tormented, and the Disease is seldom brought to an end, though sometimes Tertian Fevers are taken away by a Vomit given a little before the Fit, which happens, because by this means the Blood is pretty fully cleansed of its bilous Humour: though its worthy observation that Vomits do no good in a Quartan Ague, and seldom in a Tertian, unless they are given presently at the beginning, when the febrile Disposition is yet light, and not fully confirmed. Concerning intermitting Fevers in general, there remain yet to be explained certain irregularities, of them, in which they altar from the common way: first therefore, the fits are wont sometimes to be without cold or shivering: an intermittent. Fever was rise this Autumn, whose accesses troubled the diseased only with heat, and that very intense, in many there was a violent vomiting, but no cold or sweat; after four or five returns had happened, as the fit invaded, the diseased were wont to be a little chilled, and afterward plainly to have the cold fit, and, as it went off, to sweat: the reason of this was, because by the hot summer the Constitution of the Blood was become sharp and very much burnt: wherefore the Particles of the crude Juice mixed with it were presently scorched and burnt, that they did not wax cold first with a sourness (like new beer) and then afterward burn out: but a Turgescency being raised, the whole (like dry Wood laid on the fire) presently burnt out in a light flame; but afterward, the Liquor of the Blood, after having burnt for some fits, became less torrified; that the depraved nutritive Juice was not presently scorched, but passed into a nitrous Matter, and fermenting with a sourness; which first growing turgid, brought a sense of coldness on the whole Body. There remains yet a great doubt concerning the distances of the returns, which sometimes seem to be double in the same Fever, that the first access answers to the third, and both happily in the Morning: and again, the second to the fourth, and both happen in the Evening, and so on: wherefore such a Fever is wont to be called a double tertian or quartan: It seems to me, that in this case sometimes it happens that the Fever is simple, and of one kind, and that the Types are a like, and all agreeing with each other; but that the error chief arises, because the intervals of the returns are not computed by hours, but by days: for since the intervals of the beginnings of the Fits are not distant from each twenty four hours exactly, but either sixteen or thirty hours in a quotidian, and in a tertian not forty eight hours, but forty or fifty six, more or less, or thereabout, it will come to pass that the alternate fits will happen before, and the rest after noon: to which also may be added, that the uneven way of living which the diseased use, may oftentimes produce great unevennesses of the returns, that sometimes the fit comes twice a day, as I have often observed in cachectical Persons, and such as have used a disorderly diet: nevertheless it often happens that intermittent Fevers have returns of fits which neither observe the same distance, nor keep wholly to the same sort of form: I have frequently noted in a quartan Fever, that besides the set accesses, returning about the same hour, the fourth day, certain erring and uncertain fits troubled the Diseased, that sometimes, the day preceding the wont fit, sometimes following it, another fit also (though slight) was raised anew, carrying exactly the Type of an intermittent Fever, with a shivering, a heat and sweat: and nevertheless the primary access returned at the usual time: this for the most part is wont to happen either by a diet ill ordered, especially by surfeiting and drinking of Wine, or by the ill administration of Physic: the reason of which, I take it, consists in this, that by these errors in diet more matter is heaped together, than can be cleared off at one fit. CHAP. IU. Of the kinds of intermittent Fevers, and first, of a Tertian. WE call a Tertian Fever, not that which happens at three days distance; but inclusively from the day in which one fit gins, on the third thence, another returns: mean while, sometimes if the fits are long, viz. protracted to twenty four hours, and withal come before the usual time of their accesses, the space of intermission is often less than twenty four hours. The essence of a Tertian Fever consists in this, that the Blood (like Beer made of overdryed Malt) being too sharp and burnt, does not soon subdue and ripen the nutritive Juice, which is brought into it crude, from things eaten, but perverts a great deal of it into a Nitro-sulphureous matter, wherewith, when the mass of Blood is saturated to a Turgescency, like new Beer put in Bottles, it falls a fermenting: from the flowing of that nitrous matter, which obtunds the heat and vital Spirits, and twitches the nervous Parts, first a cold is caused with a shivering: afterward, the vital Spirit prevailing again, this matter fermenting in the Blood, gins to be mastered and to be kindled in the Heart, by the burning of whilch, an intense heat is diffused throughout the whole Body: afterward its relics being severed, and mixing with the Serum, are sent forth by sweat. This disposition of the Blood consists in this, that it is impregnated more than it ought with Particles of Salt and Sulphur: Wherefore the procatarctick Causes which dispose to this disease are a hot and bilous Temperament, Youth, a very hot Diet, as an immoderate use of Wine and peppered meats; but especially the Vernal and Autumnal Seasons of the Year; tho most commonly some evident Cause besides is required for putting this Disposition in act, and we ascribe the origine of this Disease to some notable accident: Wherefore a lying on the Ground, or taking cold after sweeting, or transpiration any way hindered, also surfeiting or a troubling of the Stomach by disorderly eating, and whatsoever things cause an immoderate effervescence of the Blood, bring into act the latent disposition of this Disease: for on every such occasion the nutritive Juice heaped together in the Blood, and somewhat depraved, falls a flowing, and separating from the rest of the Blood, ferments it with a nitrous sourness, afterward being kindled and exagitated with the vital Spirit and Heat, it brings the fit with a very intense burning. A Tertian Fever is wont to be most common in the Spring, at which time the Blood is most vigorous and in best plight. A Fever happening, if it continues not long, is commonly said rather to be Physic, than a Disease, which in part is true, because by this means the impurities of the Blood are consumed, the obstructions of the Viscera are opened, and indeed the whole body is ventilated, so that it is wholly freed from any excrementitious matter, and from the seminaries of growing Diseases: but if this Disease be drawn out in length, it is the cause of many Distempers, and of a long sickness: for hereby the mass of Blood is very much deprived of the vital Spirit; and (like Wine too much fermented) in some manner loses its strength, wherefore a Jaundice, Scurvy, or Cachexia follow upon this Fever, when it is long a curing: for by the frequent fits, the vital spirit very much evaporates, which in regard it is little restored by things eaten, the Blood becomes thereby watery, and almost without strength: mean while, the Particles of the Salt and Sulphur are raised and exalted more, whence the Blood is made sharp and salt; and so more unapt for Circulation and a Pneumatosis. Moreover this Disease, protracted in length, often changes its form, and from a Tertian, becomes either a quotidian, or sometiems a quartan; and afterward, sometimes it returns from both to a Tertian: the reason of this is, the various change of the Disposition of the Blood; for when from being sharp and bilous, as it is in a Tertian, it comes to be less sharp, but more watery, and weaker in its Crasis, the increases of the fermentative matter are more quick, and the accesses return daily, but when it turns austere and pontic, the increases of the matter being more slow, the fit comes but on the fourth day. Certain Symptoms are wont to happen upon a Tertian Fever, which are vulgarly accounted for the Crises of this Disease; and in truth, sometimes those appearing, the affect either clearly ceases, or gins to remit of its wont fierceness: those Symptoms are chief these three, viz. a breaking forth of the Lips, a Jundise, and a Phlegmon suddenly raised in any part of the Body; though I have sometimes observed, that notwithstanding such breaking forth of the Lips, the Fever has continued obstinate for a long time. wherefore I think it must be said, that that eruption of Pimples denotes only a fuller Diaphoresis in the whole, whereby the gross, as well as the subtle recrements of that adust Blood, evaporate forth; for I have known in some, that in a Tertian Fever bushes have broke out all over their Body, as though they had the small Pox; and if by this free ventilation, as by a purging, the Blood is so freed, that it recovers its ancient Crasis, the Fever is come to a Crisis; but if (as it sometimes happents) some recrements, though the more gross, break forth, and others remain within, and still foment the feverish Disposition, those sores argue only a greater taint of the Blood, and an obstinacy of the Disease: therefore it is to be observed, if upon sore Lips the Fever does not remit, it will prove of long continuance and severe. Sometimes a Jaundice happens upon a tertian Fever, and puts an end to it, the reason is, because when the Blood has gottne a sharp or bilous Disposition, that thereby it perverts the nutritive Juice, and so heaps together an excrementitious matter, it is often freed from that Discrasy, when by a sudden excretion the recrements of the adust Salt and Sulphur, are freely purged: the Gall-vessels being irritated by a Medicine or spontaneously, and so plentifully clearing forth the Choer from the Blood, often perform this: for vomiting, purging, and especially a Diarrhaea conduce very much to the cure of this Disease, nay sometimes the Blood alone, exerting itself of its own accord, throws off its bilous Recrements as its refuse, and deposes it in the Skin in circulating, and so the Jaundice cures the Fever. When a Phlegmon (as it sometimes is wont) happens upon this affect, it is commonly said, that the Ague is fallen into the place swollen. Now it seems not strange that the Disease is determined by such an abscess: because the Blood by this means continually severs from its body the store of the degenerated nutritive Juice, and conveys it to the Part affected: wherefore a Belly continually lose has freed some by degrees: because by this means the Blood has presently cast forth its unprofitable Burden, still growing upon it, nor has allowed it a full increase: and sometimes also, a deafness happening on a sudden, the tertian Fever has presently ceased, viz. by reason of the continual Metastasis of the febrile matter from the mass of Blood to the Head. But if a tertian Fever neither declines by degrees of its own accord within a short time, so as to cease wholly within seven or ten returns, nor is brought to a Crisis by any of the ways , nor is removed by the help of Physic; but after ten or twelve fits continues still sorely to afflict the Diseased, it will prove a very difficult thing to cure it: for the Blood, by the continual he aping together of the febrile Matter, and by its frequent being inflamed, becomes at length so depraved, that it concocts nothing rightly for nourishing the Body and supporting its strength: nor is it able wholly to shake off the impurities and Excrements from its mass, that it may make a Crisis of the Disease; but the same daily prevailing, the Blood, besides its dyscrasy, gins to be somewhat injured in its mixture, wherefore the Flts return more frequently; nor does a perfect intermission come between, but the Diseased being very weak and faint, are in a manner always feverish, with a thirst and heat. When the thing is brought to this pass, unless Art affords a Remedy, or the change of the place of abode, or the revolution of the Year bring relief, this Affect often is terminated in Death. As to the Cure, the Method of healing commonly is directed to this only scope, viz. that the Minera of the Disease be extirpated, and that the febrile Matter be eradicated out of our Body without any remaining foams or fear of a Relapse; wherefore we diligently insist on Vomits and Purges, which, when they do little towards a Cure, but the strength of the Diseased is very much broken, they are left by the Physicians, and the whole business is committed to Nature. The Intentions (as it seems to me) ought to be these; First, the restoring of the Blood to its natural temper, Secondly, the prevention (as much as may be) of the depravation of the nutritive Juice. Thirdly, the stopping of the feverish fermentation for keeping off the Fit. And these Indications have place not only in a Tertian Fever, but in every intermittent Fever besides: which nevertheless are not to be performed by the same ways or Remedies, but by one sort and another, according to the diversity of the Disease, the condition of the sick, and the symptoms chief pressing: howsoever, in the Cure of this Disease, there is more to be imputed to Nature, and to a well regulated form of Diet, than to Pharmacy. 1. Concerning the first Intention, viz. that the Blood may be reduced to its natural temper, Vomits, bleeding, and purging are of great Use; especially if they are used in the beginning of the Disease. Vomits do good, inasmuch as they purge the Stomach, that the first concoction may be better performed, and that thereby a purer nutritive Chime may be supplied for the Matter of the Blood, and chief, inasmuch as by forcing the Choler plentifully from the meatus choledechus, they empty the Gallbladder, that thereby the Choler may be more copioussy cleared from the Blood, and so the Blood may be cleansed from the recrements of the adust Sulphur and Salt. Opening a Vein cools and ventilates the Blood, that thereby it is less torrified or parched, and is circulated more freely in the Vessels without danger of being burnt. Purging also draws plentifully the Choler from the Gall-vessels, and consequently from the mass of Blood, and by irritation them, force's it forth. For this end, (viz. the reducement of the Blood, Digestives conduce, being sharp qualifiers, inasmuch as tey fuse and alter the Blood, and allay its fervour. Sometimes also the change of the place of abode, and of the Air, egregiously corrects the evil constitution of the Blood above any other Remedies. The second Intention is excellently performed by a Diet, and an exact form of Food, which in this Disease ought to be thin and spare: wherefore Hunger is commonly said to be the best Remedy of this Disease; and we find by common Experience, that by a spare feeding the feverish access is most commonly put off beyond it usual time. There are two things chief to be observed concerning Diet; first, that the Aliments be thin, let nothing be given sulphureous or spirituous; for so the conflagration of the Blood is lessened: then secondly, that when the Fit is a coming, or has seized, no Food be taken; wherefore in fasting Persons the Fit is more mild and is sooner over. What was proposed in the third place: a stopping of the feverish access, is undertaken by Remedies which stop the fermentation of the Blood; and though this Remedy be looked upon by Physicians as Empyrical, Immethodical, and Deceitful, yet I have found by experience, that these Fevers have been oftentimes cured this way, when Medicines did nothing at all: though you must observe, that the use of these after bleeding and purging (if there be need of them) will do most good, and unless these are duly premitted, those others seldom stop the Fit: and Vomiting, Purging, and Blooding, unless they are used presently and at the beginning, do little good, nay, are oftener wont to do hurt; wherefore if the Choler about the beginning be plentifully cleansed forth, or the Blood be ventilated by breathing a Vein, it is reduced to its due Crasis; but afterward, in the progress of this Disease, (the Spirit being very much exhausted, and the Salt and Sulphur being too much exalted) if these evacuations are used, they weaken the Crasis of the Blood more; and therefore it is found by observation, that a Tertian Fever is seldom or never cured, and often passes into a Quotidian, where these Medicines are used very late. I have known myself in the Springtime that certain Persons enjoying a good entire health, have fallen presently into a Tertian Fever, after having taken a Vomit for prevention-sake, which caused a violent evacuation; and that others, who have been cured for some time of this Fever, have presently undergone a relapse upon taking a strong Purge for carrying off the remainder of the febrile matter: it may readily be said, that the Minera of the Disease lying quiet before, is roused up by this means by the Medicine, and brought into act; but if you consider this thing rightly, it seems rather to be said, that by a strong Purge the Crasis of the Blood is very much injured, and whereas before it was prone to a bilous Discrasy, so that it assimilated with difficulty the nutritive Juice, upon this evident cause it presently degenerates more, and that it forthwith perverts the Nutriment into a fermentative matter, and so incurs the feverish disposition. An Opinion has vulgarly prevailed, that a Tertian Fever can scarce be cured without a Vomit; wherefore some Medicasters' are wont, under the pretext of necessity, to give an Emetic Medicine to any Persons whatsoever troubled with this Disease (though weak and infirm) not without great danger of Life; and those whom they judge wholly unable to bear this Remedy, they leave to Nature, as not easily curable. But (as I am well satisfied by having often tried the contrary) that this kind of Practice is ill founded: and I rather think that Vomits are seldom or never required for the Cure of a Tertian Fever, unless it be in a robust Body, and readily inclined to vomit, and when it happens that the Stomach is loaded with an excrementitious matter; but instead of this, that a gentle Purge may be more properly used; for a Purge in this case does the same thing as a Vomit, to wit, it evacuates the Vessels containing the Choler, that this being plentifully exhausted from the blood, the feverish Dyscrasy may be corrected. Now when the Humour of the Gall, emptied in the Stomach, is drawn forth upward, a great offence is thereby brought on the Stomach, and a mighty perturbation is raised in the whole body: but if by a gentle Cathartick that Humour is allured downward, it is sent forth without any trouble. Moreover, if to a gentle Purge repeated once or twice, a very thin Diet, and without any meat, be added, it will often answer the Preservatory indication, that there will not be need of other Remedies for removing the cause of the Disease, but these things being duly premitted, let those things be used, which either inwardly taken or outwardly applied stop the access of the Fever. By this plain and easy form of Physic, viz. by purging with an infusion of Senna and Rhubarb, a thin diet, and a topical febrifuge applied to the Breast or Wrists, I have oftentimes known tertian Fevers cured in a short time, without the use of any other offensive Medicine. Nay, a thin diet alone, with Periapts seasonably applied, has cured very successfully a Woman with Child, aged Persons, and such as were very weak, whose strength would not bear purging. I have so frequently experienced the wished success of that method, that I do not doubt, but a tertian Fever, if it be managed this way from the beginning, to wit, before the temper of the Blood be more injured by an ill form of diet, or by Physic ill administered, it will be caured as easily as any other Disease: for proof of this I shall give the following relation. A certain noble Youth, of a choleric Temperament, was seized with an intermittent tertian Fever; as the fit came on him he vomited very much yellow and grenish Choler, afterward for many hours he was sorely troubled with a most intense Heartburning, a heat and a drought. The day of intermission, on which it was my chance to be present, eight ounces of Blood were drawn by my order from this Person, and in the Afternoon an emollient Clyster was injected: he used also, a very thin diet, (viz. only of Barley Meats) he took every Night going to rest this Opiate, viz. Conserve of Roses vitriolated half a dram, Diascordium a scruple, and every Morning a Scruple of Salt of Wormwood, in a spoonful of the Juice of Oranges: but these things not succeeding (for the fit returned somewhat more remiss, but with a violent vomiting as before) and likewise in regard this sick Person greatly dreaded a Vomit (because upon taking a very gentle Emetic not long before he had vomited about thirty times, even till being seized with a Cramp and Convulsions, he was brought to a great failure of strength with danger of Life) therefore, the day following the said fit, I gave him a potion of the infusion of Senna, Rhubard, and yellow Saunders with Salt of Wormwood in Fountain Water, by which he purged ten times with relief: the next Morning, three hours before he expected the fit, I applied febrifuge Epithems to his Wrists, and blooded him again to six onnces, from which time he had no fit of his Fever, and afterward, being purged again after the same manner, he grew perfectly well. But if a Tertian Fever, by reason of the evil constitution of the diseased, or by reason of errors committed in diet, or Physic, has laid its roots deep, that after a long continued affect the fits still grow worse and worse, and the diseased mightily languish, their strength being dejected, with a thirst, and burning almost continual, a loss of Appetite, Watchins, a weak Pulse, a ruddy Urine, and very full of contents, somewhat a differing method of Cure ought to be ordered: in this case first it must be endeavoured that the Discrasy of the Blood be removed: wherefore let the diseased feed only on thin diet, as Barley or Oat Meats, with the opening Roots boiled in them, wholly forbearing Meat Broths; let the Belly be kept soluble (if it be needful) by the use of emollient Clysters; Moreover (cathartics being omitted) it seems that we ought only to insist on digestive Medicines, which fuse the Blood, and gently lead forth the serous Impurities by Urine; and comforting Remedies, which strengthen the Viscera, and refresh the Spirits: for this end apozemes of diuretic Herbs and Roots, neatly prepared, also Opiates of temperate Conserves with Sal Nitre, or the fixed Salt of Herbs, and with testateous Powders, and Spirit of Vitriol mixed with them, excellently conduce, when the Crasis of the Blood is somewhat amended, that the Urine is clearer and less colured, also the sleep quieter, with an abatement of Thirst and Heat; then Remedies may be profitably given for stopping the fit of the Fever: Wherefore let febrifuge Epithems be applied to the Wirsts, and to the Soles of the Feet; also let the Powder of the Peruvian Bark, or of its Succedaneum, or also of the Bark of an Ash, of Tamarisk, or of Gentian, be given in White-wine with the mixture of Salts: After that the accesses are taken away, and the diseased begin to gather Strength, to have a Stomach, and in some measure to concoct what they take, gentle Purges will be of use, but let the diseased still abstain from seeding on Flesh or rich fare, and it is not to be doubted, but he will soon recover his perfect Health without violent purging or blooding. CHAP. V Of the Intermittent Quotidian Fever or Ague. NExt after a tertian Fever, by reason of their Affinity and the likeness of the Fit, follows a Quotidian. viz. whose access is wont to return every day. It is the Opinion of some that this Fever is only a double Tertian, and that it arises from the matter being dispersed, and getting possession of a twofold focus; to which nevertheless I do not agree, and I judge that its rise is to be attributed to a peculiar Discrasy of the Blood: in this the symptoms of Heat and Cold are more remiss; but the access holds longer, and is often wont to continue eighteen or twenty hours: this Fever for the most part follows upon a Tertian, for when the vital Spirit is much spent by a frequent Deflagration of the Blood, and (the feverish Disposition still remaining) the Blood is become weaker, it less concocts, or brings to perfection the nutritive Juice, and perverts it in a manner wholly into a fermentative matter: wherefore it is sooner brought to an increase, and is heaped together to a plenitude of Turgescency in half the time as before: but because the matter heaped together partakes as well of crudity as adustion, therefore the heat of the fermentation is more remiss and more uneven, and (like green Wood laid on the fire) it burns more flowly; wherefore the fit is of a longer continuance. Sometimes it happens that a Qutidian Fever arises first without a foregoing Tertian, viz. when a feverish affect seizes a Body that is cacochimical, and filled with evil Juices: for then the Blood, being poor in Spirits, perverts the nutritive Juice in a greater store, and heaps it together in a shorter time to a plenitude of Turgescency: and that which at first is a Quotidian often changes its Type, and becomes a Tertian: even as a Tertian often passes into a Quotidian, there being a great vicinity betwixt these Fevers, and their Causes; and a little change of the Constitution of the Blood makes a transition of the one into the other. An intermittent Quotidian Fever is not so easily cured as a Tertian: for whether that comes first simply, or follows upon another intermittent; however it is raised drum a stronger cause, and argues a greater Discrasy of the Blood, which does not presently yield to Remedies: Moreover, this Fever if it be of Long eontinuance, or comes upon another Cronick Disease, besides the vice of the Blood, it has most commonly joined with it infirmities of the Viscera: to wit, the Blood being vitiated, easily fastens its Impurities, heaped together by degrees on the Viscera, as it passes through their Involutions. (Hence in a quotidian Fever; a loading of the Ventricle, a tension of the Hypochondres, obstructions, or tumors sometimes of the Liver, sometimes of the Spleen, or of the Mesentery, are joined) though these kinds of Affects are not the cause of the Fever (as is vulgarly thought) but only its products. Wherefore in this Fever, besides the simple Method of Cure which is indicated in a Tertian, many other Intents or Coindicants come in consideration, viz. We must use all our Endeavours that the Ventricle be purged of its load of Humours, that the stuff of the Viscera be cleared, that their Infirmities be strengthened, and together with these, that the Discrasy of the Blood be amended, and the feverish accesses stopped, so that by reason of these various kinds of Intentions, we must proceed by a longer way to the Cure. In this case Vomits, (if the Strength will bear them) will be of use above the rest; also Purges, with which the assiduous increase of the excrementitious Matter may be sent forth, must be often repeated; besides these, digestive Remedies and deobstruents which restore the Ferments of the Viscera and of the Blood, and correct their Discrasies' are frequently to be used. Wherefore, fixed Salts of Herbs, their extracts, the acid Spirits of Minerals, and sometimes Preparations of Steel do excellently well. Concerning these means there is a difficult task, since, because of the manifold evils, many things are to be done together, whereas, by reason of the assiduity of the feverish fit, the Diseased can use only a few. In affects thus complicated, though the way of Method requires first a removal of Impediments, and then to cure the Disease, yet I have known this kind of Fever cured often without method, and empirically, in a cacochymical Body, attended with many other affects; to wit, after a light provision for the whole, febrifuge Remedies outwardly applied have first taken away the feverish access, that afterward, time, and occasions of curing, might be the better afforded for the other affects. I lately went to see a Lady of Quality, who having long had a cachectical habit of Body, and being weak and feeble, a month after Childbirth, was seized with an intermittent Quotidian; after fix or seven accesses of which, her strength was so cast down, that she was not able to rise from her bed, or scarce to be raised up in it; nor could she take ever so little food, though very thin, but it caused great disturbances in her Stomach: Moreover, the Region of the Stomach, and of the left hypochondre, was all beset with a hard Tumour, and violently paining: By reason of the strength being extremely cast down, there was no place here for evacuation besides the use of Clysters; and the Stomach being mighty weak, refused all other Remedies, unless they were pleasing, and in a small quantity. In this difficult case, and penned up within narrow limits of Curing, I advised these few things, viz. that she should take twice a day this mixture; viz. Magistral water of Earthworms two ounces, Elixir Prprietatis six drops: moreover, I ordered a fomentation to be applied to the Stomach, of the Leaves of Pontic Wormwood, Centory, Southernwood boiled in White-wine with the roots of Gentian, the Vessel covered; and that after the somentation, a toast dipped in the same Liquor should be worn on the Stomach; besides, I had febrifuge Epithems bound to her Wrists; and by these Remedies alone, on the third day she missed her Fit, and continued free from the same afterward, and then by the use of Chalibeat Remedies, she grew perfectly well within a short time. CHAP. VI Of the Quartan Fever or Ague. IN a Quartan Fever, the time for the return of the Fit is longer than in the rest, it being extended to the fourth day inclusively; and it's wont to be of longer continuance, and more difficultly cured: for this Disease is protracted for many Months, and often Years, and seldom or searce at all yields to Medicines. The Fit for the most part gins with cold, and a shaking, which are followed with a pretty troublesome heat, but more remiss than in a Tertian, Sweat for the most part concludes the access. If the Disease sticks long, it brings the Scorbutic or hypochondriack affect, and involves men in an unhealthy habit of body. The Causes which dispose to this Disesse are, first, the constitution of the Air, and of the Season; for the time of Autumn is always proper for this affect, that you shall seldom observe a Quartan Fever to arise but about the Fall: also in certain places, especially about the Sea-coast, this affect is wont to be endemious, seizing any that live there, or come thither as strangers; for this also makes a declining age, also a melancholy temperament, and which, by reason of an ill form of Diet, is obnoxious to the hypochondriack affect; moreover, Fevers of another kind, that are of a long continuance, and Chronic Diseases, often pass into a Quartan Fever. These things being considered, it seems that it must be said, that a Quartan Fever, even as other Intermittents, depends on the vicious disposition of the Blood; for the nutritive Juice, conveyed by degrees into the Vessels, is perverted into a fermentative Matter, and the effervescency of this heaped together to a plenitude of turgescency, makes the Fit of a Quartan Fever. But since in this Fever there are some things peculiar from the rest, we must inquire what sort of dyscrasy of the Blood there is in this Disease distinct from the rest, and after what manner it raises the most observable Symptoms. I say therefore, that in this Disease the Liquor of the Blood has passed from its sweet, spirituous, and balsamic nature, to be acid and somewhat austere, like Wine turning sour. That is to say, there is a scarcity of Spirits, and the earthly or tartarous part (which consists chief of Earth and Salt) is exalted too much, and being raised to a flowing, brings a sourness to the mass of Blood: the Blood degenerated after this manner from its native Disposition, does not duly concoct, and assimilate to itself the nutritive Juice, but perverts it into an extraneous matter, wherewith, when it is saturated to a sulness in the Vessels, and the nervous parts are irrigated with the Juice thence arising, there follows a flowing, and as it were a spontaeous Esfervescence of this Matter, whereby the feverish access is wont to be caused with a shaking, and a heat, as in a Tertian. In a Quartan Fever the returns have longer Intervals, because the Discrasy of the Blood being toward an acid, and therefore less smart and hot, it perverts the nutritive Juice without a contest and tumult; wherefore somewhat of it is assimilated, and the depravation of the rest does not recede so far from its natural state as in a Tertian: and hence its heaping together to a plenitude is slower, and it rises to a Turgesency in about as much time again and a half as in a Tertian. The reason why this Disease is of so difficult a cure, and so obstinately infests the Diseased, is the melancholy Constitution of the Blood, which is nor easily removed, and yields scarce to any Medicines; for there being in it a scarcity and defect of Spirits, and the Salt and Tartar being too much exalted (as when Wines turn sour) it is extreme hard to restore it, and it is in a manner of the same labour and difficulty as to renew the vinous Spirit and Vigour in Vinegar; because for restoring the Blood depraved after that manner, there is need that its whole mass be volatized, and that it spiritualises as it were anew. Wherefore in this case evacuatives do not the least good, nay by depauperating the Blood more without remedying it, they often impair the Strength: but there is need of those things which may exalt and volatise that which is fixed: and may promote a Pneumatosis in the whole mass of Blood: thence it is that in this disease the change of the Air and of the Soil most commonly give relief before any other Remedies whatsoever. For Quartan Fevers arising about Autumn are often cured by the following Spring, which doubtless happens because the changed quality of the Air is wont to alter the evil habit of the Blood for the better: and for the same reason, the change also of the place of abode most commonly cures this Affect when it will not yield to any Medicine. The Autumnal Season is most proper to produce this severish habit of the Blood, because when very much of Spirit and Sulphur has passed away by the Summer heat, and that which remains gins to be pressed upon by the Cold, the Liquor of the Blood (as Wine turning sour after too much Effervesence) easily degenerates into a pontic and sharpish Nature: this also is provured by the Air of the Sea infecting the Blood with saline Vapours, which fix the Spirits. Moreover, the affinity of this Disease which the Scurvy and the Hypochondrial affect plainly shows that the evil Disposition of the Blood is in fault, whereby it is become salt and earthy with a defect of a Pneumatosis. The last year, towards the end of the Summer, which had been very hot, an Epidemic Fever arose: then Autumn coming on, when that Disease ceased, a Quartan Fever began to be very rife, so that in many places well near the fourth part of mankind was seized with the same, and those of all Ages and Temperaments, which plainly showed that this affect did not take its rise from a melancholy Humour heaped together through the fault of the Spleen, (as some have thought) but from the Discrasy of the Blood caused through the distemperature of the Year. Tho many Physical Apparatus' were ordered against this evil, yet very few were cured within the compass of the Autumn: In some, about the first beginnings of their Sickness, before the Disease had taken root, Vomits gave relief: tho, in most, Medicines purging any ways, though repeated a hundred times, did not the least good at all: those in whom the evil was deeply rooted, received not any relief from the most exactly devised Remedies used throughout the whole Autumn; when at this time I saw the vulgar Methods of Physic put in practice in vain. To a certain noble Virgin who desired a sudden Cure to be performed by any manner of means, I proposed, that if she would undergo a Salivation for some days by a mineral Medicine, she might thence hope a speedy conquest of her Disease: she readily agreeing to this, I gave her a gentle and very safe Medicine, by which only a gentle spitting was raised, and that ended within twelve days; from the time the salivation began, she presently missed her fits; but at the times they were wont to come she found a disturbance in her whole Body, with an oppression of the Heart, and a danger of Fainting, but afterward, the spitting being ended, she seemed throughly recovered; and when after two months' time she had again certain slight accesses of this Disease, an Emetic Powder being given her twice or thrice she was perfectly cured without a relapse. After the Winter Solstice this Disease was not so violent, but began to grow mild, in some, of its own own accord, and to be more easily overcome in most others by the use of Medicines, for at this time the discrasy of the Blood, contracted by the Summer heat, is wont to be removed by degrees by the cold of Winter, and the inveterascent mass of the Blood to depose its old taint, and to return towards its natural state: but those who were of a melancholy Temperament, or had the Viscera, and especially the Spleen ill affected, or those that used an ill form of diet, received no change from this Tropic, but held their Disease to the next period of the Year, to wit, to the Vernal Equinox, and then in a great many this affect was seen to be overcome, the Blood either being renewed of itself, or its Distemperature being more easily amended by the use of Medicines; but in the mean time many aged, cachochymical, and otherwise weakly Persons, died every where of this Disease, in this whole tract of time; and some there were, who having past the Summer Solstice, had not yet shaken it off: now, though many were troubled with this, as it were, Epidemious Fever almost for a whole Year, yet none that I knew of contracted it first in the Spring, and very few recovered of it during the Autumn, that I cannot doubt but the Discrasy of the Blood was really the cause of it, and that its cure consisted in its change. The Remedies which oftentimes gave relief (at least as far as it agreed with our observation) were such as stopped the fit of the Fever: for the evil habit of the Blood being somewhat amended upon the change of the Season of the Year, in case the habitual usance of the fits be broken off, Nature recollects herself, and easily recovers her ancient state of Health by her own endeavour. And this kind of intent (viz. the stopping of the Fits) though it be sometimes performed by Vomits given a little before the access (for these often stop the feverish Motion of the Blood, by raising another contrary to it) yet this indication is far more certainly, and indeed more successfully performed by the use of those kinds of Medicines, which do not at all evacuate from the Viscera, but cause in the Blood a certain fixation, or precipitation of the feverish Matter for a time. Wherefore those, whom I undertook to cure as the Spring came on, and thence forwards, I managed with this Method (and in many with good success) a provision being made for the whole by a Medicine, sometimes Vomiting, sometimes Purging three hours before the fit, I was wont to order Epithemes to be applied to the Wrists, and withal a febrifuge Powder to be taken in Sack, and the diseased to be kept in Bed in a gentle sweat: It seldom happened but at the first or second time the access of the Fever was stopped after this manner, and afterward the same Remedy being sometimes repeated, at length the Disease wholly ceased: this kind of Practice (besides what I have found by experience) seems to be made good by the use of the Powder of a certain Bark lately brought from the Indies; which is said most certainly to cure this Disease, whereas the Virtue or operation of this, without any Evacuation, consists only in this, that it stops the invading fits of Fevers. Concerning that Peruvian Bark, because of late it gins to be in daily use, these few things which occur to common observation are to be said, the vulgar way of giving it is to infuse two drams of this, being made into a Powder, in White-wine or Sack for two Hours, the Vessel being close covered, and then as the fit approaches to let the Diseased, lying in Bed, drink the Liquor with the Powder. This Drink often removes the imminent access, though many times that coming after its usual manner, it prevents the next ensuing, howsoever, whether the fit be stopped at the first, or at the second, or third time of return, and the Disease seem to be cured, yet it oftentimes it wont to return within twenty or thirty days: and then this Powder being given again, the Invasion of the Disease is again put off for the space of about the same time; and after this manner I have known many troubled with a Quartan, to have undergone only a few accesses of it during the whole Autumn and Winter, and so to have held the Enemy foreguarded till the Spring coming on, by the help of the Season of the Year, and of other Medicines, the Disposition of the Blood was altered for the better, and so that affect vanished by degrees: those who by this means procured frequent times of truce, of the Quartan, being cheerful and sprightly, lived prompt for all business, whereas otherwise being enervated and pale, they were brought to a Languour, and a vicious habit of Body; scarce one of a hundred tried this Remedy without effect, nay, if it be taken in a half quantity, or less, viz. to the weight of half a dram or a dram, it oftentimes takes away the accesses, and suspends the same only for a shorter space, nor is it matter whether it be taken in White-wine or Sack, but with respect to the Temperaments of the Diseased; for in a hot Temperament it may conveniently be taken in a distilled Water or Whey; also it's clear infusion, the thick substance thrown away, produceth the like effect but of shorter continuance. I have ordered this Powder to be given to some made into Pills with Mucilage of Tragacanth, with the like henefit to the Diseased; after what manner soever it be taken, it cause no manifest Evacuation, unless it be in such as are apt to cast, and loath all Physic, and it takes away the fit in a manner in all; nor is it only given with benefit in a Quartan Fever, but in other kinds of intermittents, viz. in all where there intercedes a time of cessation of the Fever: It is commonly ordered, that a gentle Purge be given before the use of this; but in some who have been very weak, and kept their Beds, this Powder taken alone without a previous Purge, has procured laudable effects: mean while I must ingeniously confess, that I have not yet seen an intermittent Fever throughly cured by once giving this Powder, nay, not only fits of a Quartan Fever, but of a Tertian and Quotidian, easy to be wholly overcome by other Remedies, seeming to be driven away with this, constantly returned after a short time; for this reason those, who, when there is no case of Necessity suppress intermittent Fevers only for a short while by this Medicine, they being easy to be cured other ways, seem to proceed deceitfully in Physic, nor more to the purpose, than those who heal over a hollow Ulcer which will presently break forth again: Indeed in some cases the use of this may be proper enough, viz. when by the too great assiduity of fits, the strength of the Diseased is very much spent, times of truce may be provured by this means, whereby Nature may recollect herself, and afterward more powerfully oppose her Enemy; also this Powder is conveniently given, that the Quartan Fever may be passed over with less tediousness during the Autumn and Winter. But those who desire to be long vacant from the Incursions of that Fever, are advised to take this Powder in a great quantity and often, viz. two drams for three fits one after the other, whether the acccesses return or not, by this means they continue free the longer, but still keep the latent Enemy within them, though laid asleep. If it be enquired concerning the nature of this Bark, and of its Virtue in suppressing the fits of intermittent Fevers, we must not dissemble, but it is a difficult thing to explicate the causes of these kinds of Effects, and of the ways of operating; because we cannot find the like efficacy in any subject besides: and a general rule is not well adapted to a singular experiment, however, by a diligent conferring the Phoenomena, we shall make an orderly deduction of certain Positions, which is they do not attain the truth of this matter, at least wise may make some step towards it. In the first place it may be observed, that this Medicine inwardly taken chief exercises its force and energy on the mass of Blood: for it does not at all irritate the Viscera, nor does it cause any exertion or trouble to them; Moreover, until its virtue be communicated to the Blood, its antipyretick source is not at all exerted, wherefore the fit immediately ensuing is not always prevented, but the second or third after its being taken: and for this reason, that it may affect the Blood the sooner, it is usual, that together with the Powder a Liquor strongly impreguated with the same be given, for so its Particles are more readily conveyed into the mass of Blood. Secondly, the virtue of that Bark conveyed itno the Blood continues for some time in it, and that shorter or longer, according as a greater or lesser portion of the Medicine is inwardly taken; for the Particles of this mixed with the Cruor, are circulated a long time with it, and the more there are of them, the more they affect its mass, and produce a more lasting affect; for though Aliments, and certain other things taken inwardly, in as much as they are presently subdued by the natural heat, assimilated or cast forth, cease to operate; yet some Medicines taken into the Body, because they are not easily subdued, nor by a sudden irritation are presently sent forth, continue very active for many days, and keep the Blood and Jucies' a long time in this or that course of Fermentation; this may be observed of certain Medicines, also of Poisons, and many Antidotes; whereof one only giving is wont to affect our Bodies for many days, and the same repeated for a longer time: for it is usual after Cathartick Medicines, if at any time they do unto operate by Vomit or Siege, that Pimples and Pushes break forth outwardly, after many Weeks. Moreover, if after Toxicum being drank Death be escaped, every man knows that its virulency lurches for a very long time in the Blood and Juices. In like manner also this Powder, and haply a great many other things inwardly taken, continue still to act on the Spirits and Humours how much soever they seem lulled a sleep. Thirdly, though that Medicine acts immediately on the Blood and Humours, yet it does not throughly take away the feverish Discrasy seated in them, for as soon as its force is spent, and all its Particles are passed off from the mixture of the Blood, the affect, suppressed only for a time, breaks forth anew, and takes to its accesses after its wont manner: but for as much as nature during this time of cessation is become more strong, therefore after the relapse, the fits are wont to return (not as before) but on the third or fourth day, according to the first Type of the Disease. Fourthly, it is to be observed, that this Remedy does not stop the accesses of Fevers, as vulgar sebrisuges, by fixing or also by susing, the Blood; for then always the imminent fit, and not the second, or third to follow after would be prevented. Which things being considered, that we may subjoin some things, as a Corollary, concerning the way of operating, whereby this Medicine seems to Work, we say, that its likely that when the Particles proceeding from the same taken inwardly, are mixed with the Blood, they force it into a certain new Fermentation, wherewith whilst the Particles of the Blood are continually agitated, they are wholly hindered from heaping together an excrementitious matter, and from falling into feverish Turgescencies: for, as after the biting of a Mad-dog, or the stinging of venomous Animals, the Blood itself, and nervous Juice are long poisoned; yet Alexipharmicks taken hinder them from falling prefently into great Irregularities, by keeping their Uquours in another Fermentation, the use of which if so long continued, till the virulent Corpuscles are wholly passed away, no dreadful sumptom is feared from that taint contracted; but if the strength of the Remedy, given in too small a quantity, be first spent, presently the Pouson springs forth anew, and the ancient venom which seemed to be driven away, is again brought into act: after the like manner, when the Blood having gotten a vicious habit perverts the nutritive Juuce, and for the better expelling it when heaped together to a fullness, falls into feverish Turgesencies, that Peruvian Bark reduced to a Powder, and given, by the commerce of its Particles so exagitates, and altars the Blood, though affected with a Discrasy, by stirring a new fermentation, that it in some measure concocts the nutritive Juice, and continually evaporates its recrements, so that they are not heaped together for a matter of the fit, as before, but when the Particles of this Remedy are wholly exhaled from the community with the Blood, and all the virtue is spent, the evil Disposition of the Blood before contracted breaks forth again, and therefore the fits of the Fever return after their wont manner: haply sometimes it falls only that whilst by the use of that Powder the accesses are suppressed, that Discrasy of the Blood, by reason of the change of the Season of the Year, or by help of some other Remedy, or of nature herself, is amended by degrees, and so at length the Fever disappears of its own accord: though I have known this to have happened but seldom, that you may expect the feverish fits to return in a manner with the like certainty, as they are suppressed by that Powder. As to the sensible qualities with which this Bark is endowed, it is manifest that it excels in a bitterness, with a certain stipticity, that by the taste it is discovered to carry in a manner the like savour as is usually found in most Alexipharmicks, such as the root of Gentian, Serpentary, Contrayerva, etc. For things which are actually bitter are mighty powerful in suppressing the sources of preternatural Ferments: nay, and the Root of Gentian, which excellently resembles this Bark, was formerly of famous use for curing quartan Fevers: and now, though this Peruvian Powder be the only Alexiterion yet found for the quartan Fever, which stops the fits of it and of others (though only for a time) yet it is not to be doubted, but there are other Medicines in nature, equally febrisuges; and it may be hoped, that being led by the example of this new invention, we may be stirred up to search into the Virtues of Herbs yet unknown to us: thus while we insist on the trial of Fparticulars, and join Empirical Physic with the Rational, it is not to be doubted but the Cures of the quartan and of other Herculean Diseases will go on more prosperously: which I the more freely ensure for in this age, or at leastwise in the succeeding, because being guided by the Analogy of that Bark, I myself not long since, running through many things, lighted on a Medicine of no contemptible use for subduing Fevers: which also I give to all poor People, as a Succedaneum, with good success. CHAP. VII. Of continual Fevers. AContinual Fever is that whereof the access is prolonged to many days without any cessation: it has its times of remission and exacerbation, but none of intermission; the burning sometimes is more remiss, sometimes more intense, but the Diseased are still in a Fever, till the Disease be wholly solved by a Crisis, or an insensible recovery. Now there are three degrees or manners of Effervescency by which the Species of continual Fevers are determined: from the subtle portion of the boiling Blood, or from the Ebullition of the Spirits arises the Ephemera, also the Synocus of one or many days: from the sulphureous or oily part of the Blood too much heated and kindled, is raised the putrid Fever; thirdly, on a venomous Miasm infecting the Blood, and congealing its Liquor, malignant Fevers depend: in each of these, from the depravation or rather corruption of the nutritive Juice, fresh heaped together in the Blood, various Paroxisms, Inequalities, and critical Motions arise. If it be asked after what manner the Effervescency of the Blood in a continual Fever differs from that other which makes intermittents; I say, that the Effervescence of the Blood in the latter depends only on the mingling of some fermentative Matter with the Blood, which will not duly mix with it, and on its heaping together to a plenitude of Turgescency: by reason of the Effervescency of this with the Blood in the Vessels, and its deflagration in the Heart, the fit is caused, its difflation is followed by an Apyrexia, so that in the intervals of the fits neither the Spirits nor the Sulphur make an effort, but the Liquor circulates evenly and without tumult in the Vessels, the bond of mixture being entirely preserved; on the contrary, in a continual Fever, the Disorders of the Spirit or Sulphur, or of both of them together cause the ebullition of the Blood by their proper Effervescence, without the mixture of another thing: Wherefore, for a cessation of the hurning heat, besides the difflation of the excrementitious matter, a deflagration of the kindled Blood, and its reduction to a due Crasis, are required. The Constitution of the Blood in a continual Fever, is as that of Wines when they ferment by too rich Lees; that is to say, they are strong with Spirit, and grow turgid with an exalted Sulphur, and therefore of their own accord without the mixture of another thing, they fall into a heat and boil violently: In an intermittent Fever the Blood is stirred after such a Manner as Wines when they fall a fermenting by reason of something which is not missible being put into them: Moreover, in this Fever the Disposition of the Blood is like that of Wines, when in their declining state they become over fretted, ropy, or also sour; in which the Spirit is depressed, while the Salt or Sulphur, or both together, are above the rest, and affect the whole Liquor with their disorder: an intermittent Fever for the most part is without danger, because the parts that compose the Blood, though they have changed a little their Crasis, however keep their bond of mixture; and whilst they are at liberty, circulate evenly in the Vessels; and pervert the nutritive Juice into a matter not altogether preternatural, but rather infesting with its Plenitude and Turgescency. In a continual Fever, besides the distemperature, the mixture of the Blood, and the texture of the Liquor are somewhat dissolved, that its corruption easily follows, wherefore this Disease is often terminated in death; and the nutritive Juice is depraved to a matter wholly vicious, and altogether offensive to Nature. CHAP. VIII. Of the Ephemera Fever. I Have said that the least degree of Effervescence which brings a continual Fever is placed in the subtle and spirituous Portion of the Blood, being too much agitated and heated: for this, like Spirit of wine, boils on any light occasion, and gets a heat, being irritated either by too much Motion of the Body, or Perturbation of Mind; from an ambient heat, as that of the Sun, or of a Stove; by hot things inwardly taken, as drinking of Wine, eating of peppered Meats, and the like: for the Spirits of the Blood easily wax very hot of their own accord, and being violently moved, are not presently appeased, but exagitate, variously confound, and force to a rapid and disorderly Motion other Particles of the Blood: also by this Motion of the Spirits, the Sulphur, or the oily part of the Blood is more boiled, a little more dissolved, and somewhat more freely kindled in the Heart, whence an intense heat is raised in the whole Body, but for as much as the Sulphur is heated and inflamed only by minute Parts, and not throughout the whole, that fervour of the Spirits is soon allayed and ceases; Wherefore the Fever which is raised after this manner, is terminated for the most part within twenty four hours, and therefore is called an Ephemera. And if by reason of a greater heat of the spirituous Blood, it be prorogued longer, it seldom exceeds three days, and it is called an Ephemera of many days, or a Synochus not putrid: but if it happens to be extended beyond this time, this Fever readily passes into a putrid, to wit, from the long continued ebullition of the spirituous Blood, at length the grosser Particles of the Sulphur fall a burning, and involve the whole mass of Blood in this Effervescence. An Ephemera Fever and a simple Synochus seldom begin without an evident Cause; besides the things , immoderate Labour, Watch, a sudden Passion of the Mind, a constriction of the Pores, Surfeiting, also a Bubo or Wound, in Childbearing Women an increase of milk are wont to bring these; the procatarctick causes which dispose to them are, a hot temper of Body, an Athletic habit, a Sedentary Life, and a Disuse of Exercise. The first beginnings of this Disease depend on the presence of an Evident Cause; for either the Corpuscles of an extraneous heat mixed with Blood, make it boil like Water on the Fire or a Fever is brought by motion, or by reason of Transpiration being letted, even as when Wines being heated, or stopped close in a Vessel, are set in a strong working: after what manner soever the inflammation be first raised, presently the Spirits make an effort, and moving hither and thither, force the Blood to boil, and to enlarge itself in a greater space, with a frothy rarefaction: wherefore the Vessels are stretched, and the membranous Parts are vellicated; hence a Pain, especially in the Head and Loins, a spontaneous lassitude, and an inflation as it were of the whole Body ensue. But if with the Spirit of the Blood some sulphury Part withal be somewhat kindled, a smart heat is diffused through the whole, the Pulse becomes high and quick, the Urine ruddy; also Thirst, Watch, and many other offensive Symptoms arise. Concerning the Solution or Crisis of an Ephemera Fever, and of a Synochus not putrid, there are three things chief requisite, viz. a removal of the evident Cause; secondly, a severing or difflation of the depraved or excrementitious matter from the Mass of Blood; thirdly, an appeasing of the parts of the Blood, and their restitution to a natural and even motion and site. According as these things happen, sometimes sooner, sometimes slower, and with more difficulty, this Disease is ended in a shorter or longer time. 1. The Evident Cause, which for the most part is , is easily removed, and Diseased Persons, as soon as ever they perceive themselves injured by any thing, are wont to avoid the presence of, or continuance with that thing: no Person being in a Fever upon drinking Wine, continueth still to drink it; when any Person grows more hot than usual by the heat of a Bath or of the Sun, it is irksome to him to continue in it longer. 2. As to the excrementitious matter which ought to be separated and blown off from the Blood, this is either brought from without, as when by surfeiting, drinking of Wine, standing in the Sun, or bathing in hot Water, the Blood is infected with hot and fermentative effluvias or Corpuscles, or that matter is engendered inwardly, as when upon the deflagration of the Blood its Liquor is stuffed with adust Recrements or Particles; both these Matters must be separated and blown off from the Blood, and be sent forth either by Sweat, or insensible Transpiration, before the Fever is appeased: wherefore, when the Pores are closed, and Transpiration is hindered, the Ephemera Fever continues a longer time, and passes from a simple Synochus into a putrid Fever. 3. The Evident Cause being removed, and this degenerated Matter blown off, for a cessation of the burning heat there is required an appeasing of the Parts of the Blood, and a reducement of them to order. for a rapid and disorderly motion begun in the Blood is not presently stopped, but aught to be allayed by degrees: also the divers Particles of the Blood disordered after this manner, and being driven this way and that, by reason of the feverish effervescence, do not presently take to their former order of site and position, but it is necessary that they be extricated by degrees, and restored to their due mixture by little and little. Tho this Disease, after the removal of the Evident Cause, ceases for the most part of its own accord, yet some Physical Remedies are advantageously applied to Use, especially where there is danger lest the Ephemera Fever passes into a putrid. The chief Intentions must be to allay the fervour of the Blood, and to procure a free Transpiration, to which chief conduce blooding, a very thin Diet, or rather abstinence, cooling Drinks, a withdrawing the excrements of the Belly by Clysters; but above the rest, Sleep and Rest do most good, which if wanting, they must be seasonably procured by Opiates and anodynes. A renowned young man, about twenty years of age, of an athletic habit of Body, by an immoderate drinking of strong Wine fell into a feverish distemper, with a drought, heat, and a mighty trouble of the Praecordia; being blooded, he drank a vast quantity of fountainwater, and thereupon a copious sweat presently ensuing, he soon recovered. An ingenious young man, of a sedentary Life, and withal very much addicted to the study of Learning, when of late he had exercised himself above measure in the Summer Sun, began to complain of a Headache, a want of Appetite, a trouble of the Praecordia, and a feverish distemperature over the whole Body. To whom (in regard he loathed all Physic) I ordered a total Abstinence, unless it were from small Beer and Barley-meats: On the second day, and again more on the third, the Symptoms remitted by little and little; at length, on the fourth, he became free from his Fever without any Medicine. CHAP. IX. Of the Putrid Fever. A Putrid Fever is when the oily or sulphureous part of the Blood, being too much heated, grows turgid above measure, and is brought as it were to flame; and therefore, from its likeness to humid things putrifying which contract a fervour, this kind of ebullition of the Blood, because it causes an immoderate Heat, is called a Putrid Fever: Which name it ought properly enough to retain, because in this Fever the Composition of the Blood (as it usually happens in Liquors putrifying) is very much dissolved; and so that its Principles are in a manner wholly severed from each other by the ferment of the Heart, and the active Particles being loosened from the mixture, break forth as it were into a flame. Wherefore the Liquor of the Blood being after this manner rarified, and as it were kindled in the Heart, is carried thence with a most rapid motion through the Vessels, and with its deflagration sends a great many effluvia's of heat from it; hence the whole mass of Blood, (like water set on the fire) continually boiling, stretches the Vessels, vellicates the Brain and nervous Parts, raises Cramps and Pains in them, very much consumes the Vital Spirits by its effervescency, destroys the ferments of the Viscera, hinders the functions of concoction and distribution, often depraves the nutritive Juice sent into the Genus Nervosum, that thereby very great disorders of the animal Spirits ensue; nay, it perverts in a manner the whole oeconomy of Nature. The Procatarctick Causes which dispose to this Disease, are, a hot and moist temperament, an Athletic habit of Body, Youth, the Spring or Summer season, a plenteous and rich Feeding; moreover, an assiduous drinking of rich Wines, a sedentary and idle Life, a Body cacochymical and filled with evil Juices: but above the rest, it is observed, that a frequent letting blood renders men apt to a Fever; wherefore it is commonly said, that those who have been let blood once, unless the same be done yearly, are prone to a Fever. The reason is, that by a frequent letting blood the Sulphur is more copiously heaped together within the mass of Blood, the Salt in the mean while (which ought to moderate and keep it from growing exorbitant) being by this means withdrawn. The Evident Causes which draw the latent disposition of this Fever into act, are of the same kind as those which bring an Ephemera Fever, and a Synochus Simplex: in this rank we place chief perspiration letted, and surfeiting. By reason of the effluvia being restrained, the mass of Blood, being increased in its bulk, grows turgid, and being inspired anew with a certain ferment, as it were, falls a burning, and boils violently; thereupon presently the Pores are more obstructed by the stuffing of the effluvia: and the texture of the Liquor being dissolved, the particles of the abounding Sulphur in the Blood get free from the mixture, and are inflamed by the fermentation of the Heart, as though Fire were applied to them, and so they kindle a very intense Fever. And by surfeiting, both an immoderate fermentation is caused in the Blood, and also a nitro-sulphureous matter fit for burning, and being enkindled, is conveyed as a fuel into the inflamed Blood. In this Fever four states of time are to be observed, by which, as by so many Stages, its course is performed; and they are these, the beginning, the Increase, the height, and the declining state: these are wont to be passed over in some sooner, in some slower, and in a longer time. The beginning ought to be computed from the time that the Blood gins to grow hot, and its Sulphur to fall a burning, till the burning Heats and inflammations are diffused throughout the whole mass of Blood. The increase is, from the time that the Blood, being heated and kindled throughout, has burnt for some space, and its mass is loaded with Recrements, or adust Particles, which also increase the Fermentation. The height of the Disease is, when (after the Blood has burnt enough, and its inflammation is remitted) the long troubled Blood, as a noble Champion, its adversary somewhat giving ground, recollecting all its Forces, endeavours a subduing and separation of that adust matter wherewith it is saturated to a fullness, and a driving of it forth, a Crisis being attempted once or oftener. The declining state follows after the Crisis, in which the Blood, the inflammation growing weak, becomes less hot, and either the vital Spirit still prevailing, it subdues and purges forth by degrees what there is remaining of that adust and extraneous matter, till it be restored to its ancient vigour: or the same Spirit being too much depressed, the Liquor of the Blood is still tainted with adust Recrements, and therefore becomes troubled and depauperated; that it neither assimilates the nutritive Juice, nor continues fit for Circulation, nor for accension in the Heart, for sustaining the lamp of Life. When therefore any one is seized with a Putrid Fever, for the most part a cold stiffness or a shivering accompanies the first invasion, which is followed by a Heat which is unequal, and not as yet intense; because the Blood being yet full of crude Juices, is kindled only by parts, and therefore it burns a little and then ceases, and then gins again, like a flame burning wet straw: in this state the Disease continues for some days, the Urine becomes more ruddy than usual, by reason of the Salt and Sulphur more dissolved, and incocted with the Serum: it retains still its Hypostasis, because the coction and assimilation are not altogether depraved: it has a sediment greater than it ought, which nevertheless is easily separated, and subsides of its own accord: at this time you may let Blood, and give a Vomit or a Purge, so it be done without any great Perturbation of the Blood: It often happens upon the seasonable administrations of these kinds of Evacuations, that the greater increases of the Disease are prevented, and that the Fever is killed as it were in ovo: the limits of this stage are variously determined according to the temperament of the Diseased, and other accidents of the Disease. Sometimes within a day or two the first Rudiments of this Disease are laid; sometimes the beginning of the Disease is extended to more, if it happens in a Body well in Flesh, full of Spirit, and of a hot Blood and Juice, in the time of Youth, and in a very hot Season, in case the Disposition to a Fever be great, and a strong evident cause supervenes, the severish Effervescence once begun, soon pervades the whole Blood, and on the second or third day, the root being laid, the Disease arises to its increase: but if the feverish Indisposition gins in a body that is not hot, a Phlegmatic or melancholy temperament, in old age, or in a cold Season, it has a longer Proaemium, and scarce passes the limits of this first stage before the sixth or seventh day. The increase of this Disease is computed from the time that the burning of the Fever has got possession of the whole mass of Blood: that is, the Sulphur or the oily part of the Blood, being long heated, and boiling vehemently by parts, at length like Hay laid together wet, after a long incalescence, bursts forth all together into a flame: through the violent boiling of the Blood, at this time the Diseased complain of an intolerable thirst; Moreover, a headache, obstinate watch, often also Deliriums, a Frenzy, and convulsive Motions molest them: they loathe all Food, or cast it forth by Vomit, or if happily it be retained, being parched by the too much heat, it turns to a febrile matter; there is also a bitterness in the Mouth, an ungrateful savour, a roughness of the Tongue, a vehement and quick Pulse, a Urine very ruddy, for the most part troubled, filled with contents, without an Hypostasis or laudable sediment: the Blood at this time being in a manner wholly kindled, it engenders by its deflagration a mighty quantity of adust matter, like the ashes remaining after a Fire: whereby both the Serum, being mightily filled, yields a Urine that is thick and full of Contents: and the Blood being loaded with it to a Turgescency, is irritated into critical Motions, wherewith that febrile matter (if it may be) being subdued and separated, may be sent forth: and this brings the height of the Fever, in which judgement is given betwixt Nature and the Disease, the contest being brought as it were to a trial, and therefore the evacuation which thereupon ensues is called a Crisis. Therefore the height of a putrid Fever, is that time of the Disease, in which Nature attempts the expulsion of the adust matter remaining after the deflagration of the Blood: to this are required first, that the Blood for the greatest part has past burning, for in the midst of it, Nature is not at leisure for a Crisis, nor ever attempted it prosperously, nor is it procured by Art with good success. Secondly, that the Spirit first in some manner subdue this adust matter of the Blood, and separate it from that which is good, and render it fit for expulsion. Thirdly, that this matter be heaped together in so great a plenty, that by its Turgescency it irritates Nature to a critical Expulsion: when either of those things is wanting, the Crisis for the most part is of no effect and not to be relied on, and seldom puts an end to the Disease. A Crisis in a continual Fever is in a manner the same as the fit of intermittents; for as in these, when the mass of Blood is saturated to a fullness of Turgescency with the Particles of the nutritive Juice depraved, and unfit for Maturation, there happens a flowing, secretion, and expulsion of that matter; so in a continual Fever, after the deflagration of the Blood and nutritive Juice, a great many Corpuseles of adust matter are heaped together, with which the Blood being oppressed, when it is a little free from burning, it subdues and separates them by degrees, and then, a flowing being raised, endeavours to send them forth. Wherefore as the fits of intermittents do not happen but at a set time, and after so many hours, so also critical Motions happen from the fourth day to the fourth, or haply from the seventh to the seventh, for in such a kind of space the Blood burns off, and by its burning makes a heap of adust matter, as it were of Ashes, which being offensive to Nature, causes critical Motions by its irritation. Therefore, as to what some say, that the Crises depend altogether on the Influences of the Moon and Stars, and that they follow their Quartile, or opposite Aspects, or their Conjunctions, it is not true: because critical Evacuations are determined only by the heaping together and Turgescency of the adust matter, whose Particles, if they can easily be separated from the Blood, and the Pores of the Skin are open enough, being involved in the Serum they are sent forth by sweat: and this is the best way of a Crisis, which if it succeeds well, it often at one bout puts a perfect end to the Disease, without fear of a relapse: to this next succeeds that crisis which is attempted by an haemorrhagy, for this matter, as an Efflorescence arising with the Blood (if by reason of an unfree perspiration it be not sent forth by sweat) it is conveyed into some part remote from the Heart, and is frequently sent into the Head by an impetuous sally of the Blood, where, if there be an open passage from the Sinus' spreading into the Nostrils, the morbific matter springs forth together with a portion of the Blood: but otherwise often sticking in the Brain, it brings a Delirium, Frenzy, or other sore, and lasting Diseases of the Head: and it is to be observed, that in almost any continual Fevers, if at any time they come to an imperfect or difficult crisis, so that the Blood is corrupted for a long time with a feverish matter or adust Recrements: thereby the nervous Juice (as it seems) coming to be tainted, obstinate Affects, viz. Watch, also Deliriums, Tremble, Conlvulsive Motions, and long sticking Weaknesses of the nervous Parts follow. There are other ways of Crisis' in which Nature endeavours to expel the febrile matter, not at once and entirely, but by little and little, and by parts; sometimes by Urine, sometimes by Vomit, or Siege, sometimes by Pushes, or Buboes; which way soever it be done, that it may be with good success, it is required that the deflagration of the Blood precedes it, and that the adust matter be concocted, and rendered apt for separation. Therefore the Height of the Disease is not one and simple, nor always happens after the same manner, but with a various diversity of Symptoms, and with a tendency to events far differing: now a prudent Physician must give his Prognostic, in what space of time the Disease will come to its height, and what event it will have. If the Fever from the beginning be vehement, and on a sudden pervades the whole mass of Blood with a burning, if with the fierceness of Symptoms it presses in a constant and even manner without remission, for the most part the Blood will so much burn off within four days, that the adust matter which is to make a Crisis, rises by that time to a plenitude of Turgescency: but if the beginnings are slow, and the accension of the Blood be often interrupted, the Fever will come to its height about the seventh day: if it gins yet more remissly, the height of the Disease is wont to be protracted to the eleventh or fourteenth: mean while it is to be noted, that as the fits of intermittent Fevers return at set times, so do critical Motions in such as are continual, (and for the most part they observe the fourth day) for though a perfect Crisis be prorogued to the fourteenth, or seventeenth, or haply to the twentieth day, because all things required to a full determination of the Disease do not concur: yet in the middle space light motions happen, with which the febrile matter, rising by degrees to an increase is a little emptied, and cut off as it were by parts, till Nature is able to set upon a more full discussion of it: and since upon the Blood's burning a mighty store of adust matter is heaped together in the Vessels within four days, Nature, unless it be otherwise disturbed, every fourth day being provoked with the store of matter, endeavours to shake off a part of its burden with a certain Turgescency: wherefore, for the most part, on the fourth, seventh, eleventh, and fourteenth days, critical Motions happen, not through a direction of the Planets, but through a necessity of Nature. As to the event, whether the Crisis will be good or no, certain foreknowledges are taken from the Strength of the Diseased, the Pulse, Urine, and other signs, and the concourse of Symptoms: if the burning of the Fever pressing, the diseased holds his strength in some measure, has a strong and even Pulse, if the Urine be of a middle Consistency, with some Hypostasis, a Separation of Contents, and an easy subsiding, if the Disease makes its progress without violent Vomiting, Watch, a Frenzy, convulsive Motions, and the Suspistion of Malignity, the height of it may be expected to be laudable, with a good Crisis: if the contrary to these things happen, viz. that the strength be presently cast down, and the Diseased be subject to a frequent Fainting, Convulsions, or a Delirium, with a weak intermittent or uneven Pulse, if obstinate Watch, an intolerable Thirst, and a Vomiting continually molest the Diseased, if the Urine be thick and troubled, without an Hypostasis or a subsiding of the parts, if whilst the burning still presses, Nature be stimilated to critical evacuations, the extremity or height of the Disease will be dangerous, nor is any good to be hoped of the Crisis. Concerning the Crisis of a putrid Fever, I shall here subjoin a particular prognostic, in which, though the things that appear at the beginning promise a wished for event, a very sad one is at hand: I have oftentimes observed in a putrid Fever, which gins slowly and with a small burning, if the Urine be ruddy, and, when it is made, be presently troubled, and opake, which is neither precipitated by the cold, nor deposes a sediment of its own accord, and if at the same time the Diseased lie for many Nights without Sleep, though they are quiet, and without tossing, their state is very dangerous; and there will be a greater suspicion, if in the mean time they are not pressed with an intense Fever, nor with a Thirst, and a Heat very troublesome: for those that are affected after this manner, about the height of the Disease, for the most part fall into Deliriums, convulsive Motions, and often into a Mania, from which they are in a short time precipitated into Death, and when these Symptoms appear, the Urine is altered from being thick and ruddy, to be thin and pale, Melancholy Persons are most obnoxious to these kinds of Fevers, to wit, in which the Exorbitancies of the Sulphur are little restrained by the Salt and earthy Dregs troubled together with it; and all which being raised by little and little break forth afterward with a greater destruction. When the Disease is come to the height, either the thing is brought to a stress at one conflict, and thence forward there is a manifest tendency to Health with a Declination, or to Death: or there are frequent Bicker betwixt Nature and the Disease, and critical Motions are often attempted before the Victory falls to either fide. As to the first, if with a good forerunning of Signs and Symptoms, after that the Blood has burnt enough, and its burning has remitted, the adust matter being evenly subdued and subtilised, rises with a full increase to a Motion of Turgescency, and Nature being free from any impediment or depression, is of strength sufficient for a conflict, the feverish matter is exterminated for the most part at one motion of Efflorescence, and the Blood being become free from its Contagion and Fellowship, recovers in a short time its ancient Vigour. 2. But if Nature be irritated to a critical Motion, before the Blood has perfectly burnt off, or that adust matter be prepared for excretion, though, as to the rest, affairs are in an indifferent state, yet none but an imperfect Crisis follows hence, whereby somewhat of the Burden, or Load wherewith the Blood is oppressed is diminished; but in its stead presently another springs afresh from a new burning, and at set times afterward (haply in the space of four or seven days) as the fits of intermittents, critical Motions return haply the second or third time before that, the conflict being divided, the advantage plainly inclines to this or that side. 3. But when an ill apparatus of Signs and Symptoms preceding, the burning of the Blood still pressing, without any concoction or subduing of the feverish Matter, a critical Motion is stirred up, Nature is sometimes overthrown at the first conflict: nor does she recover herself again, but yielding herself conquered by the Disease, is precipitated into Death: nor are things in much a better state, when a Crisis at first being imperfect and of no effect, comes without any relief of the Diseased, and afterward the next to this happens to be worse, and then by another or haply another conflict the Disease prevails, till the strength being wholly broken and prostrated, there is no hope left of recovery. So much of the height or Crisis of the Disease. By the Word Declination I understand the Condition of the Diseased and of the Disease, which follows the height of it, whether it tends to a Recovery or to Death: whether the Fever, or the Life itself of the Diseased at this time declines. As to the times of the declining state, it will be necessary for us to inquire what the temper of the Blood is, and what alterations it undergoes, as often as a progress is made from a good Crisis, or an evil, to a Recovery, or Death. The vice or depauperation which the Blood contracts from a feverish effervescence, consists in these things; the Spirit very much evaporates and is lost; the sulphureous Part is too much scorched, and is much spent by the deflagration, and after its burning, an adust matter is left, as a caput mortuum, with whose Particles the mass of Blood is loaded and weakened, mean while the Saline and Earthy Parts are too much exalted; even as it is wont to happen in Wine or Beer too much fermented. The Blood being tainted after this manner, ill assimilates the stock of nutritive Juice; nay, and not duly fermenting, or being inflamed in the Heart by reason of the scorching, or defect of the Sulphur, it ill distributes the Vital Spirit; mean while, by reason of the adust Matter, and the Salt too much exalted, it boils more than it ought, and destroys itself more. 1. After a good Crisis, the Spirit, though become weak, still bears the sway; wherefore it subdues by degrees, and expels what there is remaining of feverish matter, and concocts and assimilates the nutritive Juice, (so a thin juice be administered); whence the mass of Blood is refreshed with a genuine Spirit and Sulphur. 2. After an evil Crisis the thing is otherwise, the Liquor of the Blood (like Wine too much fermented) wholly loses its strength; its Spirit is greatly diminished, what there is remaining of it for the most part is involved, and as it were overwhelmed with Particles of adust matter: whence a continual Effervescence remains still in the Blood, though without coction, or assimilation of the nutritive Juice, or a separation of that which is useless from what is good: the benign Sulphur and Food of the vital Flame is much consumed, so that the Blood is kindled in the Heart less than it ought: mean while, through adust Recrements, and raised to too great a height with Salt and Earth, it continually boyles in the Vessels, with a Drought and a Heat, and because it is daily depauperated upon the continual spending of the benign Spirit and Sulphur, and is more tainted with the Salt and earthy Faeculencies too much exalted, its Liquor in a short time grows vapid, and becomes unfit for circulation and accension in the Heart for upholding the vital Fire; wherefore Life must necessarily fail. 3. After an imperfect and doubtful Crisis, when the Diseased being broken by a long continued Weakness, recover not but after a long time, the case stands thus: the Spirituous and Sulphureous parts of the Blood are very much consumed by their long burning; the remaining Liquor being not purged from the adust Recrements and Feculencies is rendered very impure; and there remaining still somewhat of Oil for the vital Flame, and the Spirits not ceasing wholly from working upon the febrile Matter, the Blood is still circulated, and (though in a small measure) is kindled in the Heart: nay, and the Spirits recover themselves by little and little, and begin to set upon the matter remaining after the Fever, and at length wholly subdue it, and restore a sprightly Fermentation de Novo in the Heart. CHAP. IX. Of the most observable Symptoms and Signs in a Putrid Fever. THE accidents which a Physician ought chief to consider in giving a true Diagnostic and Prognostic of this Disease, may be reduced to three Classes, as it were, or common Places; that is to say, they have regard to the Viscera of Concoction, viz. the Ventricle and Intestines with their Appendices; or secondly, to the Humours flowing in the Vessels; to wit, the Blood in the Arteries and Veins, and the thin Liquor in the nervous Parts, together with the first sources of both, viz. the Heart and Brain: or lastly, those Symptoms regard the habit of the Body, with the various constitution of the Pores, and the firmness or pining away of the solid Parts; those who will exactly observe the course of the Disease, and aptly draw the Curative Intentions, must mind these three heads of Symptoms, and diligently observe what alterations happen in these distinct Regions, as it were, according to the differing times of the Fever. 1. Concerning the Ventricle and first Passages, in the whole course of this Fever, tedious affects and Disorders; as a Nauseousness, a Vomiting, loss of Appetite, Indegestion, a Diarrhoea, a roughness of the Tongue and Mouth, a bitter savour are wont to molest them; these things for the most part are attributed to the Humours, first heaped together in the Stomach and there putrifying; but besides that, the Recrements of the Chyle being burnt with too much heat, degenerate into an offensive matter; often those kinds of accidents happen, because the off-scouring and filth of the Blood and nervous Juice, whilst they ferment, are carried inwards, and being deposed within the Membranes of the Viscera, cause Contractions, and make a filthy heap of a vicious and very infesting Humour: I have often observed, that about the beginnings of Fevers, the Blood vehemently boiling, still deposed its recrments inwardly, to the benefit of the Diseased, where, though some tedious affects happened about the first Passages, yet the effervescence was thereby more mild, the Pulse moderate, and the Urine laudable; and after this manner those that were ill of a Fever, with a thin Diet and the use of gentle carriers forth of Excrements, recovered in a short time; but if in this case I gave a violent Cathartick for extirpating the Humours, that natural purging of the Blood being letted, presently the Fever became intense, with a ruddy and troubled Urine, a high Pulse, Watch, and other horrid Symptoms; also often after the height of the Disease, the adust and excrementitious matter is severed from the Blood, by this kind of inward lustration, hence sometimes a looseness, sometimes crusty break forth of the Mouth and Throat happen: wherefore concerning the accidents which happen in the first passages, there is need of caution, lest while we obviate those, we pervert the Motion of Nature: and lest whilst we fortify these Parts against the incursion of the morbific Matter, we perversely keep the same shut up in the mass of Blood. The Symptoms chief to be considered in reference to the Mass of Blood, are a heat diffused through the whole, a great trouble of the Praecordia, a ruddy Urine, a spontaneous Lassitude, a Swooning, from which, being duly considered, these following things may become known: viz. what the degree of heat is, or according to what tenor the inflamed Blood burns, what times of remission or exacerbation its effervescence observes whilst it burns; whether it retains its Crasis, or its mixture entire: what strength of the Heart suffises, and what space the Vessels afford for its burning, and the circulation of it, being kindled, in what store the Blood, whilst it boyles, heaps together adust Recrements, after what manner it subdues and severs them, or at leastwise endeavours to sever them, in fine, what way of Crisis it endeavours, and with what success. The Accidents which regard the thin Liquor, with the Brain and the nervous Appendix, are disorders about Sleep and Watching. a Weakness of the whole Body, a Trembling, a Tetanus, Pains, convulsive Motions, Contractions of the Viscera, a Stupor, a Frenzy, and the Observation of which will suggest to us, what is the Temper and Constitution of that thin Liquor; after what manner it irrigates and influences the Nervous parts, and circulates through them; how the animal Spirits perform the Functions of the Viscera; what is the state of the Brain; whether it continues free from the incursion of the feverish matter: whether it be not in danger of being overwhelmed by reason of its critical Metastasis. Concerning the Habit of the Body, we must consider the manner of its Perspiration, and the degree of it, whether it be only by vapory Effluvia, or by Sweat, or also by Pushes; whether the flesh falls on a sudden from its wont bulk, or whether it retains it a long time? what is the colour of the Face, and the Vigour, or dulness of the Eyes? from these things being duly compared together, we excellently measure the Course of the Fever, at what time it will come to the height, whether Nature will prevail over the Disease or not? with what way of Excretion, and with what success it endeavours the expulsion of the febrile matter, by these signs also we are taught by what degrees the Blood fermenting, and often being coagulated, tends towards a Putrefaction, or Corruption: whether it any ways concocts the nutritive Juice mixed with it; or whether or no it does not forthwith cast forth its whole store by Sweat, as it often happens in the declining state of this Disease. From the foresaid Symptoms and Signs a fuller instruction yet is had; if it be first known, on what causes each kind of them depends, and in what orderly course they are wont to be raised in our Body. Wherefore I have thought it expedient, particularly to set down the chief of these, and to explicate the Reasons of them, and their ways of coming to pass: Now in a putrid Synochus, or continual Fever, the Symptoms chief to be observed are, a heat in the whole Body, a spontaneous Lassitude, a great trouble of the Praecordia, an intolerable Thirst, a burning and roughness of the Tongue and Jaws, a pain of the Head and Loins, obstinate Watch, a Frenzy, convulsive Motions, a Swooning, a Cardialgia, a Vomiting, Nausecousness, loss of Appetite, a Looseness, a Dysentery, with which, not all of them together, but sometimes these, sometimes the others, this Disease is wont to be attended: Amongst the signs, the Pulse and Urine give the greatest light. I shall observe a few things concerning each. 1. The heat, which is perceived in the whole Body to be sharp and piercing, depends on the too great Effervescence of the Blood, and its accension in the Heart: for the Sulphureous or Oily part of the Blood, being exalted and falling a burning, is kindled at least in a double portion more than its wont in the Heart: When the Sulphur is not duly dissolved in the Blood, and kindled in the Heart, as in the longing Disease of Maids, the Leucophlegmatia, etc. The heat fails in the whole. 2. A spontaneous Lassitude is felt in the whole Body, to wit, by reason of the Vessels being extended with the boiling Blood, also the muscular Flesh is much siuft with Blood, and a copious Vapour, so that it is not fit for Motion: as those who are troubled with an Anasarca have their Limbs less free, by reason of the Redundancy of the serous Humour: Moreover in Fevers, by reason of the inflammation of the Blood, the Juice, which is suppsyed to the genus Nervosum, falls from its due Temper, so that it is less fit for actuating Bodies. 3. The great trouble of the Pracordia happens, by reason of the Blood being copiously kindled in the focus of the Heart, which boyles thence with a great inflammation into the Lungs; wherefore the nearer this Region is to that Focus of heat, by so much it is affected with a greater burning. 4. The almost unexstinguishable Thirst is caused both by reason of the growing inflammation in the Praecordia, and by reason of the sharp and hot Particles of the febrile matter fixed in the Ventricle by the Blood in circulating; which require to be washed off even as salt and peppered Food eaten in a plenty, or as sharp things kept sometime in the Mouth or Throat: for this kind of affect suggests a free taking in of Drink, as a Member too hot does a pouring of cold Water on it. 5. The burning and roughness of the Tongue and Throat, and often also the growing of a certain white, yellow, or black Lee upon it, doubtless happen by reason of the Heat and Fumes breathing from the Ventricle and Lungs strongly burning; and the Tongue grows white as often as that Moisture (wherewith it is naturally much imbued) grows dry, the Saliva then growing too thick and viscous: but if it happens that the Tongue be inwardly filled or outwardly tinged with a bilous Humour (as it comes to pass in Vomitings of Choler) than its Villi, in regard they are spongeous, imbibing the yellow matter, present also a like Colour: and if the Heat becomes so intense that it burns the Blood, and kindles a Fire more ardent than usual, it follows, that Fumes are raifed from the Focus of the Heart, through the breathing Pipes of the Lungs, they scarce sufficing for ventilating so great a Blast; which coming to the Roof of the Palate, strike the Tongue as it were by Reverberation, and tinge it with a blackness. 6. Sometimes in Fevers (and especially about the time of their declining) it happens, that the Tongue, Palate, Gums, nay, the Cavity of the whole Mouth and Throat, are covered with a Viscous Matter, resembling some whitish Crust; which being often cleansed, presently a new succeeds; and unless by diligently rubbing and washing the Mouth, this crusty Mtter be frequently cleared, the Diseased often incur danger of Suffocation: that kind of Affect very often happens to Infants newly born; for they are wont, for the most part, within fourteen days an outward Efflorescence, to be bedecked with large and red Spots all their Skin over; and if this overspreading of Redness does not break forth freely, or disappears sooner than it ought, for the most part, that whitish Crust ensues in the Parts of the Mouth. This Symptom, when after this manner it molests Infants, is wont to be ascribed to the fault of the Milk; in feverish Persons the same is vulgarly attributed to thick and fuliginous Vapours raised from the Stomach: but it seems more likely to me, that in both, this Affect arises from the Impurities of the whole Blood, (and haply, in some measure of the nervous Juice) deposed about these parts; for, as often as in the Mass of both Humours, somewhat extraneous inwardly mixed with them, is contained which is neither to be blown off by Sweat, nor is easily sent away by Urine, that very often is fixed about the Mouth with a serous Filth; whence catarrhous Affects, tumors, and troublesome Spitting, are raised: for in regard, for the Mastication of Food, the salival Humour ought to be plentifully discharged in this Place, Nature often endeavours to send forth here what is superfluous, or otherwise troublesome, by these open and accustomed ways of Excretion: hence, after Mercury is given, when both the Blood and nervous Juice are abundantly filled with its Particles most minutely divided, and endeavour to send them forth involved in the Serum, because they are not able to exterminate these mercurial Corpuscles, inwardly mixed with them, neither by Sweat, Urine, or other way; what remains, they strive to expel the same, mixed with the Serous Latex, by the Arteries and other Ducturs', which convey the Spittle to the Mouth. In like manuer also in Fevers, when after a long Deflagration of the Blood, the adust Matter is much heaped together, whereof a good part, remaining after the Crisis, is still mixed with the Blood and nervous Juice; or being fixed on the Brain, or other place, is again drank up by the same; it's probable that that matter, by long Coction, is so parched, and grown thikc almost like Glue; wherefore it is neither to be blown off by Sweat nor insensible Transpiration, nor is fit to be separated by the urinary Passages, but at length distils forth by degrees from the little Arteries, and other Ductus' of the Saliva, which open themselves into the Mouth, (as being the usual way of Excretion) and presently, by reason of its thickness, it settles into that clammy Humour. The same Reason holds concerning Infants, whose Blood being rendered impure, from the Filth contracted in the Womb, presently, by making an outward Efflorescence, it endeavours to purge itself; which, if by reason of the Thickness of the Matter, it does not succeed well, presently the viscous Impurities are exterminated this way, as the more open. I knew a certain Person in the Declination of a Fever, who had not only an Incrustation of this kind of a clammy Humour in the Parts of the Mouth, but a copious Salivation, as though he had taken Mercury, was raised in him for many Days, with a stinking Breath, and a swelling of the Tongue and Gums. 7. A Headache is raised in Fevers by reason of the meanings of the Brain being twitched by Vapours, and by a sharp and boiling Blood; for, the Blood being violently moved, it is carried in a greater Plenry, to the Head by reason of the straight Direction of the great Artery, than to the inferior Parts, to which it is carried obliquely. And sometimes head-aches arise by reason of the nervous Juice (which is supplied from the boiling Blood) being too sharp and pungent; wherefore, when the Membranes and nervous Parts are irrigated with the same, being twitched by its Acrimony, they are cast into Pains and Contractions. 8. In like manner also, the other Affects of the Head, as Watch, a Delirium, a Frenzy, Conyulsions, etc. sometime arise from the Blood making an Fffort, and so raising disorderly Motions in the Brain; sometimes also from the nervous Juice degenerated, and therefore become disproportionate for the Governance of the animal Spirits: but most commonly these kinds of Symptoms are rife in Fcvers by reason of a Metastasis of the febrile Matter from the stock of Blood into these Parts; for the Blood being full of adust Recrements remaining after Deflagration, endeavours (like working Wine) wholly to subdue them, and to exclude them from its Society, which when, a flowing happening, it is not able to expel by Sweat, Urine, or an Hoemorrhagie, it often conveys them into the substance of the Brain, and there fixes them: and hence chief the foresaid Affects, when they are fixed and firmly rooted, take their Rise; but, when they are light, and easily movable, they often proceed from the Causes before mentioned. 9 Convulsive Motions happen in Fevers for divers Causes; sometimes by reason of a Matter heaped together in the first Passages, which, by reason of its mighty Pravity, twitches there the membranous Parts, and afterward, by the Consent of the Genus nervosum, presently a Convulsion is communicated to the Origine of the Nerves in the Brain; and thence is retorted sometimes into these Parts, sometimes into others: after which manner, Worms gnawing in the Entrails, sharp Humours moved, and venomous Medicines, cause Convulsions; or secondly, when a Fever partakes of some Malignity: so Convulsions frequently happen in the Small Pox, Measles, or Plague; to wit, because the Blood is altered from its benign and natural temper to a venomous Nature, whereby the Nerves, and their Origines, are put upon Motions and Contractions: often also, without a suspicion of Malignity, in a Putrid Fever, convulsive Motions are caused by reason of a Metastasis of the febrile Matter to the Brain, as it was hinted even now; so I have often observed, when a Disease is not presently solved by a Crisis, the Diseased lie ill of a long Sickness, and become obnoxious to convulsive and trembling Motlons. Thirdly, for the most part, in every Fever, convulsive Motions are the sad Forewarners of Death; which I think to happen not only through the malignity of the matter, whereby the Genus Nervosum is twitched and troubled, but because the Spirits being very much exhausted and weakened, do not sufficiently influence and extend the Bodies of the Nerves; wherefore being relaxt from their wont Tension and tonic Motion through the weaker effort of the Spirits, they are still put upon a disorderly motion. 10. Swooning is wont to be caused many ways in Fevers, but chief for three Causes; viz. Either through the Mouth of the Stomach being affected, which part being interwoven with sundry Plexus' of Nerves, is very sensible; and because from the same branch of the sixth Pair, branches of Nerves are derived to the Heart and Ventricle, if the Orifice of the Ventricle, so beset with Nerves, be affected with great Pain, the offence also is communicated to the heart, and in this the Motion is either stopped, or at leastwise a disorderly one is raised, whereby the even afflux of the Blood and Spirits is interrupted for a time. I knew a certain Person, in an acute Fever, seized with a srequent swooning; which Affect, nevertheless, wholly ceased after that he had cast up, by Vomit, a long and round Worm. Secondly, a swooning also is sometime caused, because a venomous Matter is circulated culated with the Blood, which fixes and extinguishes the vital Spirits on a sudden, and congeals the Blood itself, that it is apt to stagnate in the Heart, as it is usual in the Plague, Small Pox, etc. of which we shall speak particularly beneath. Thirdly, A Swooning is wont to happen by reason of the fine Texture of the Spirits, which being very thin and subtle, easily yield to a Fainting upon any immoderate Motion or Pain: so I have known some, who lying still in their bed were well enough, but being moved to any side, presently fainted. 11. A Cardialgia happens in Fevers, when the Ventricle, and especially its Orifices, being very sensible by reason of the manifold Insertions of Nerves, are beset with a sharp and betterish, or also with an acid and corrosive Humour; for hence a Pain arises from the Acrimony of the Humour, after the like manner as when the Sphincter of the Anus is affected with a tedious Pain in bilous Dejections. 12. For the like Cause, a Vomiting and a Nauseousness are wont to be raised; to wit, the Ventricle being beset and irritated to a Contraction by a matter which is extraneous and not agreeing with itself. Such an excrementitious matter is heaped together in the Ventricle, after three manners: for, either the Aliments, partly through defect of an acid Ferment, wherewith they ought to be duly concocted; partly by reason of the burning Heat of the Ventricle, are parched into such a Mass of Corruption: or secondly, this kind of Matter is deposed into the cavity of the Ventricle, from Arteries terminated in it, as it usually happens in the Small Pox, Plague, and malignant Fevers: or thirdly, mere Choler expressed from the Meatus Choledochus into the Intestinum jejunum, by reason of an inverted, and, as it were, convulsive Motion of the Intestine, is cast up into the Stomach. The loss of Appetite also happens by reason of the Ventricle being filled with vicious Juices, and because the acid Ferment is wholly perverted by the scorching Heat. These kinds of Affects of the Ventricle and Viscera, sometimes arise from an excrementitious matter, (viz. the Alimentary degenerated whilst it was concocting) heaped together in the first Passages a long time before the Fever, which often is the occasional Cause of the Fever itself: but sometimes the Nauseousness, Loss of Appetite, Vomiting, Cardialgia, etc. are the immediate Products of the Fever; for, when the day before the falling sick the Affected had a Stomach good enough, assoon as the immoderate Effervescence is brought on the Blood, whilst that boils above measure, both the Effluvia and Recrements wont to be evaporated outwardly, and the bilous Humour flowing from the Vasa Choledocha, are poured into the Stomach, with which its Crasis is perverted; and the Relics of the Chyle, and other Contents in the Viscera, are mightily depraved, whence the foresaid Affects draw their Origine. 13. Nor is a Looseness a less frequent symptom in Fevers, which sometimes happens about the beginning of the Disease, and arises (for the most part) either from the Choler flowing from the Vasa Choledoca, into the Duodennm, or from the Recrements of the Blood and Nervous Juice poured from the Arteries and Ductus of the Pancreas into the Intestines: Sometimes also about the height of the Disease, and in its declining state a looseness is raised: and so either Nature being conqueress, the grosser off scour of the Blood are this way Critically voided, or the same being overcome, the looseness is an effect and sign of the Viscera being wholly dissolved in their strength and firm tone. Sometimes it happens in a Fever that the Belly is always bound, and unless irritated by a Medicine it discharges nothing, and though the Diseased have taken only liquid things for many days, the stools are always of a solid and hardish consistency: and this seems for the most part to be done, when the Blood burning greatly with a smart heat, consumes the moisture lying in any part like Fire; and by a copious emission of stems draws the watery matter from the Viscera into itself, and presently causes it to evaporate outwardly; wherefore the grosser part left in the Intestines, is thickened by the parching heat, as the Caput Mortuum remaining after distillation. 14. The bloody Flux is an affect so frequent in continual Fevers, that in certain years it becomes Epidemious, and being as bad as a Plague, it kills many; the cause useally is not a humour produed inwardly in the Viscera, which corrodes the Intestines with its Acrimony, (as some assert) but some Miasm passed into the Blood, and so in wardly mixed with it, that it cannot be forced from the Blood under the form of a Vapour or sincere Humour: wherefore being driven toward the Intestines, it opens the Mouths of the Arteries, and causes little Ulcers and Distillations of Blood there, as when from a feverish Blood taking toward the Skin, Pushes and inflamed Swell break forth outwardly; and it is likely that those affects of the bloody Flux which accompany malignant or epidemious Fevers may airse from a certain coaulation of the Blood. The pulse and Urine bring up the rear of the Symptoms and Signs in a putrid Fever, which are chief to be minded for knowing both the state of the Disease, and the strength of the Diseased; for there being two things by which our Life is supported, viz. Heat kindled in the heart, and Coction to be performed in the Viscera and Vessels, because the Pulse and Urine excellently show the alterations caused in both by the Fever, therefore hence a most certain Judgement is taken of the affect whether it will terminate in Death or a Recovery. First, we consult the Pulse as a Thermometer constituted by Nature for measuring the heat kindled in a Fever: which if it be intense, and raiseth a great ebullition of the Blood, the Artery has a vehement and quick beat, as long as the Spirits hold a good Vigour; afterward the same being somewhat exhausted, the strong Pulse remits, which nevertheless is recompensed by quickness, and becomes quick and small. If the Fever be mild, and be attended by a less burning, the Pulse also declines less from its natural state; and in the whole course of the Disease the moderation of this denotes a truce of Nature, nor does the Pulse only discover the strength of the Fever, as it were of the Enemy, but plainly shows also the sktrength of Nature, and its ability of resisting: as long as the Pulse is laudable, things are in safety, and it gives very good hope: but from the evil state of this a very ill omen is given, and a despair of doing well. So that without a srequent and diligent examining of the Pulse, the Physician can neither make a due prognostic, nor safely order a Medicine. 1. As to the first: he ought to know (as far as he may) what sort of Pulse a Person has according to his natural Constitution, for in some it is strong, in others weak; again in each change of Fevers he must weigh by what degrees it differs from its natural state; for one while it is more vehement than it ought, and argues the Fever to be intended: another while it's depressed lower than usual, and denotes the Spirits and Strength to be dejected. Those whose Artery has a weak and languid beat in their state of Health, when they are taken with a Fever it is not so very ill with them to have a small and weak Pulse, that we must presently despair of their well doing: those who have naturally a strong and vehement Pulse, if after the Crisis of the Disease it scarce holds a mean Vigour, though it be not altogether weak, it argures the state of the diseased to be suspected, and not safe. If at the beginning of a Fever, before the Blood has much burnt, or if after a Crisis, when part of the burden is diminished, or if at another time the Pulse becomes weak without an evident cause, it forebodes ill: but if after long Watch, or after a great Evacuation, the Pulse becomes somewhat weaker, we may not therefore despair of a Recovery: because Strength dejected or impaired by these means may be again restored, and the Spirits may be refreshed. When the Pulse on a sudden is altered for the worse, though the Diseased as to the rest of the Symptoms seems to himself to be better, you may give a sad prognostic of Death, and on the contrary, though horrid Symptoms are pressing, if notwithstanding the Pulse be laudable, we may still hope for a Recovery. If in a robust man, being in a Fever, the Pulse becomes very small and formicating, Death is near at hand. 2. In giving Medicines, Cautions and Rules of no small moment are taken from the Pulse: Purging and Vomiting are prohibited by an over quick and violent Pulse, also by a low and depressed one: for when the Blood boyles too much, an evacuation does little good, both because that which is offensive is not separated, and also for that by that Perturbation the strength is more debilitated. And when the Spirits are broken, and the Strength dejected, a Purge casts them down more, and sometimes wholly resosves them. Wherefore when a Physician thinks of an evacuation upward or downward, first let him try the Pulse, and let him set upon this work only when Nature is strong and in a calm; that it may both be at leisure for the Operation of the Medicine, and have Strength enough to bear it. Nor is there need of less Circumspection in Diaphoreticks and Cardiacks; which if they are given in the feverish fit, they too much intent the motion of the Heart, which before was violent, and very often break its strength: and when the Pulse is very faint, if hot and strong Cordials are given, Life is easily extinguished, (as when a small Flame is pressed with a strong blast of Wind) wherefore it's a vulgar observation that Cordials often accelerate Death, for that by too much exagitating the Blood, they sooner consume the Strength. There is yet need of the greatest Caution and Direction of the Pulse in giving Narcoticks; for those (because they perform their Operation by exstinguishing and fixing the over fierce vital Spirits) if they are used in a weak or wavering Pulse, either by diminishing the vital Spirits they render them wholly insufficient for the Disease; or by suffocating them too much they bring a perpetual sleep: wherefore in a languid, unequal, or formicating Pulse let Opiates be shunned of all things. The uneven and intermittent Pulse have an ill name in the writings of Physicians: yet though they are looked upon as ill, they do not so certainly portend Death as a weak Pulse: for I have known many with those kinds of signs to have escaped, who were condemned to the Grave: for the disorder of the Blood and Spirits may much more certainly and easily be restrained or appeased, than their dejection be restored. 2. The inspection of Urines in Fevers has more of certainty than in any other Diseases, and is of very great use: for hence the states of the sick Person and of the Disease are excellently known, and the physical Intentions concerning things to be done are hence best directed: some of the chief Observations and Rules concerning this matter are as follows. Concerning the Urines of Persons in Fevers, the things chief to be observed are the Colour, Consistency, Contents, and settling; the colour of the urine shows the degree or excess of heat in the Blood, which as it is increased, or is more remiss, the Urine also is more or less ruddy. Nevertheless the Urines of some are mighty ruddy, when they are but lightly feverish: and on the contrary, the Urines of others troubled with the burning heat of a Fever are less coloured. Those who abound with a vigorous heat, and a very hot Blood, or are obnoxious to the Scurvy, Ptysick, or the Hypocondriack affect, when upon taking cold, or through a Fullness, Surfeiting, or drinking Wine, they are set upon by any small Fever, they make an intensely ruddy Urine, because the Particles of the Salt and Sulphur are exalted, and half dissolved in their Blood before; wherefore, of necessity, when the Fever presses, they are more incocted in the Serum: on the contrary, those who having a cold Temperament, and a weak Pulse, are taken with a Fever, though they have a greater Effervescence of the Blood, void a Urine less coloured. The Consistency, Contents, and Settling of Vrines, being places, as it were, in the same Rank, depend altogether on the adust and recrementitions Matter, which remains in the Blood after the burning of the Fever: if there be a plenty of this, the Consistency of the Urine becomes somewhat thick; and after it has stood, it is troubled by the Cold: if either the quantity of this be less, or it be derived elsewhere than to the Reins, (to wit, if it be withdrawn by Sweat, or by a critical Metastasis into this or that part) the Consistency becomes more thin, and the Liquor remains clear. And the Particles of this matter furnish the Contents of the Urine, which are diversely disposed according as the nutritive Juice is one while somewhat concocted and assimilated by the Blood, another while is wholly perverted, and turns to a mass of Corruption. Some signs of Coction and Assimilatiturns to a mass of Corruption. Some signs of Coction and Assimilation are given in the Urines of Persons in Fevers, sometimes by a laudable Hypostasis, sometimes by certain Rudiments and Footsteps of the same. A Privation of an Hypostasis, and a confusion and troubled state of the Parts of the Urine, denote Coction to be vitiated: and as this matter is more or less parched in the Blood, the Contents are sometimes pale, sometimes of a yellowish Colour like ochre. According as the Recrements mixed with the Blood, either the Spirit prevailing, begin to be subdued and separated; or the same being too much depressed, are less able to be separated, also the Contents of the Urine are wont, more or less, sooner or later, to be separated from the rest of the Urine, and to subside towards the bottom. As to the Prognostics to be taken from the Urine, we observe, That somewhat a remiss Colour of the Urine, a mean Consistency, a sew Contents subsiding of their own accord, or readily gathering together into a little Cloud, portend Good: on the contrary, an intense Redness, a thick and troubled Consistency, gross and opake Contents, which slowly, or scarce at all, subside towards the bottom, denote a great Effervescency, a plenty of adust Matter, and its subduing and separation to be difficult, or frustrated. As to Physical Directions, the thing consists in this; that by a frequent Inspection of Urines we attend to the Motion of Nature, and readily follow it; nor must we move by Purging or Sweat, but when some Hypostasis shows signs of Coction and Separation in the Urine. CHAP. X. Of the Signs and Cure of the putrid Synochus, or continual Fever. BEsides what is said before of the putrid Synochus in general, there are moreover certain Varieties, or Irregularities (not to say Species) of this Disease, by which this Fever somewhat declines from this common Rule; and by reason of certain accidental Affects, gets new Names and Distinctions. First therefore, a putrid Synochus is wont to be divided into a symptomatick and an essential one. That is said to be symptomatick which draws its Origine from some other Affect or Disease first raised in the Body; so that the Fever is only the symptom coming upon that other Affect, as that is accounted which depends on a Squinancy, Pleurisy, Wound, Ulcer, etc. in or near some principal Part; of which we think somewhat otherwise; to wit, that in Truth there is no Putrid Fever which is merely symptomatical; occasionally perchance it may arise from some other Affect; but it is founded immediately in the sulphureous part of the Blood too much heated, and as it were kindled: for, without a Procatarxis or precedent Indisposition of the Blood, the foresaid Affects seldom, or scarce at all, bring a putrid Fever. As to the Squinancy, Pleurisy, and the like, I say that those are Products of the Fever, or Affects following it, but not Causes of it; for most commonly an evident Cause has preceded, which has produced the feverish Effervescence of the Blood, as a taking of Cold, an Evacuation restrained, etc. afterward, though the Diseased are not forthwith openly feverish, nevertheless, a greater Ebullition of the Blood than usual is raised; as we may easily gather from the Urine, Pulse, and Restlessness of the whole Body. After some Days, (sometimes sooner, sometimes later) an Inflammation is produced in this or that part; whereof a probable Reason enough is thus assigned: The Blood by reason of the Effluvia retained (which are like a Ferment) is increased in bulk, and swells its Vessels more than usually; and when through defect of Ventilation, it is straitened in the space of its Circulation, it readily finding a way, springs forth of the Arteries; and being extravasated, upon the course of Circulation its being interruptted, it is raised into a Tumour; and because by that kind of Tumour a Heat and Pain in the Part are made more intense, the Blood is more troubled in its motion, and so the Fever, first kindled, is more aggravated. Moreover, in these kinds of Fevers we may observe a certain aptness of the Blood to coagulate, whereby it becomes less fluxile, and so apt to be congealed in the lesser Vessels: even as we find in Milk when it gins to turn sour, for than it cannot be boiled nor warmed on the Fire without coagulating: in like manner we have reason to suspect in the Blood also a certain Disposition to turn sharp, by reason of which it is obnoxious to coagulation; for it plain enough appears, that in the Frenzy, Peripneumonia, Squinancy, and the like Diseases, an Inflammation or Extravasation of the Blood does not always depend on the exuberancy of the Blood, and the plenitude of the Vessels: for often with a weak Pulse, and a subsiding of the Vessels, the Blood is stopped in its Motion, and being extravasated in the side or else where, causes an acute pain. It only remains for us to inquire whether the Fever which accompanies these affects, be to be accounted of the number of those which are called putrid, or not; To this we reply, that oftentimes they are simple Synochi, in which only the subtle and more spirituous part of the Blood is inflamed, and therefore, if after a copious taking away of Blood, or the Vessels being emptied by sweat, the extravasated, Blood be restored to Circulation, presently the Effervescence is restrained, and the Fever in a short time is appeased: Nevertheless sometimes when a Predisposition happens, as in a Plethora, or mighty Cacochymia, a putrld Fever is kindled together with these kinds of affects wholly from the same occasion. Among Symptomatick Fevers they place that which is vulgarly called Febris Lenta, those that are troubled with this grow hotter than they ought, especially after Meats, or any Motion, or Exercise, the Urine for the most part is ruddly, the Spirits are weak, and the Strength dejected; as to Appetite and Sleep they find themselves indifferently well, they are without a Cough, or much Spitting: but daily (like consumptive Persons) they pine away, and without any manifest cause: the fault for the most part is ascribed to Obstructions in some one of the Viscera (suppose the Liver, Spleen, or mesentery) by whose default, the Food is not well concocted, nor duly dispen'd: but it seems to me that this kind of affect is immediately founded in the evil Disposition of the Blood, whereby it inclines to an over-salt and sharp Temper, and therefore is rendered less apt for Nutrition, and an even Circulation. But the Fever which most deserves to be called Symptomatical, is that which is raised in Ptysical Persons from an Ulcer or Consumption of the Lungs: for the Blood, whilst it wholly passes through the Lungs in its circulation, often imprints on this entral the Ideas of many Diseases; and on the contrary, from the Lungs being ill affected, it receives the same. Whatsoever impure is contained in the Mass of Blood is cast forth of the extremities of the Arteries, as the flowerings of new Wine: Wherefore, when Nature being become weak, is not able to convey its Recrements to the superficies of the Body, it deposes the same in the Lungs by a nearer way of purging itself. Hence a mighty Cacochymia, and many Cronick Diseases frequently end in a Ptysick. In like manner, when the flesh of the Lungs consumes, or abounding with an ulcerous Ichor, is become half rotten, the blood passing through it is infected with the purulent matter, or the consumptive filth, and consequently is put upon a continual Effervescence, by reason of that immiscible Substance being confounded with it, wherefore it brings an assiduous Fever, and wholly perverts the nutritive Juice: the like reason holds concerning Fevers caused from an Ulcer, or Absess often happening in other parts: for those even as the consumptive Constitution of the Lungs, often bring the Ptyfick, or hectic Fever: a full consideration of these things belongs not to this Place, wherefore let us return to the putrid Fever properly so called, or essential Fever. The essential putrid Synochus is wont to be divided into the putrid (such is above described) inot the Causus or most sharp burning Fever, and moreover into the quotidian, tertian, and quartan. The putrid Synochus even now described aught to be the Rule or Square of the rest, according to the Type of which, for the most part Fevers which are of this kind are compounded, as to the rest even now mentioned, I shall briefly set them down according as they vary their Species. A Causus or burning Fever is that which performs its course with a great burning, an intolerable Thirst, and other Symptoms showing a mighty Inflammation of the Blood: its formal Nature wherein it's different from the rest, consists in this, that the temper of the Blood in those that are affected with it, is hotter, that is, it more abounds with a combustible Sulphur; therefore when it rages, it is kindled in a greater plenty, and by its burning diffuses Effluvia's of a most intense heat throughout the whole Body; its Motion is acute, and soon comes to its height, it is attended with more horrible Symptoms than others, it has a difficult Crisis, and its event is very dangerous. Now as to what regards those periods or paroxisms in which a putrid Fever now and then at a set time is wont to have a sharp fit, and (intermitting, as it were) sometimes every day, sometimes every other, or fourth day resumes its febrile accension as it were: the reason of this which seems to me most likely, is as follows. In a continual Fever there are two chief things (as we have hinted above) which for the most part cause the Effervescence of the Blood, viz. an exaltation and acsion of the sulphureous part in the Blood; and then consequently a heaping together of the adust matter remaining after the deflagration of the Blood, to a Turgescency: on the former, the continuity of the Fever, on the other its height and critical Perturbations depend: to these sometimes a third thing is added, to wit, a fullness and turgescency of a crude Juice from Aliments fresh gathered together, which at set intervals of times causes a greater effervescence in a continual Fever (as in the fits of Intermittents.) Concerning the Cure of putrid Fevers of what kind soever, there are four general intentions, on which the whole stress of the Business lies. First, that the Blood (if it may be) be freed from its burning, and that the Flame or Fire kindled in its sulphury part be wholly suppressed, which often happens to be done about the first beginnings of this Disease. Secondly, that when the Blood, being set a burning, cannot presently be extinguished, it may go on with it at least mildly, and with as little damage as may be. Thirdly, that the burning being over, the Liquor of the Blood may be cleared of the Recrements of the and adust Matter, and be restored to its natural Vigour and Crasis. Fourthly, that the Symptoms chief pressing be seasonably obviated, without the removal of which the attempts both of Nature and Physic will be in Vain. As to the particular Remedies, with which those intentions are answered, there are various Prescripts, and Forms of Medicines every where in use, not only amongst Physicians, but likewise old Women and Empirics; from which nevertheless, in regard they are used like a Sword in a blind Man's Hands, without differences, and an exact Method of Healing, more damage than benefit often accrues to the Diseased. It will not be needful for me to repeat in this Place the Forms of Purgers. Cardiacks, or other Medicines neatly enough delivered in many Authors. I shall briefly set down some of the chief Indications, and Physical Cautions which ought to be observed in the course of this Fever, according to the various Seasons, and divers Symptoms of it. 1. About the first Invasion of this Disease, you must endeavour that the Fever be forthwith suppressed, and that the inflammation of the overheated Sulphur may be stopped; to which breathing a Vein chief conduces; for by this means the Blood is ventilated, and the hot Particles too much crowded together, and even ready to fall a burning, are dissipated from each other, as when Hay, being apt to take on Fire, if it be exposed to the open Air, its kindling is prevented: Moreover, let a thin diet be ordered: in which nothing spirituous or sulphureous aught to be used: let the Viscera and first Passages be freed from the Load of Excrementious Matter; Wherefore Clysters will be of necessary use, sometimes also Vomits, and gentle Purges, which being now and then given seasonably and with judgement, the Fever presently at the beginning, its Fuel for accension beig withdrawn, is extinguished. But if notwithstanding this Method the burning gets Ground, and daily more and more lays hold on the sulphureous Particles of the Blood: let it be procured (as far as may be) that the deflagration goes on gently without any great Commotion. 2. Wherefore, when the Fever is in its Increase, if the Blood boils too much, and very much extends the Vessels with a strong and vehement Pulse, if Watch, a Frenzy, or Headache, violently press, bleed a second time, and let as free a Transpiration (as may be) be procured: wherefore, let the Diseased, for the most part, lie in Bed, let the Diet be sare, of very thin Food; also, let the Drink be small, and plentiful, that the burning Blood may be freely diluted with Serum. Clysters are given with Safety, and indeed, with good Effect; but let Medicines, whether cathartics or Diuretics, and which too much exagitate the Blood, be avoided with the same Industry as Blasts of Wind are where Houses are on fire; nay, rather Opiates and anodynes, which fix and constipate the Blood and Spirits, are to be used: also, Juleps and Decoctions, which cool the burning Bowels, qualify the Blood, and refresh the Spirits, are frequently to be given. Acetous Liquors of Vegetables or Minerals, also Nitre purified, because they restrain the burning of the Blood, and quench Thirst, agree well: let hot and spirituous Waters, cordial and Bezoartick Powders (so the Disease be without Malignity) be let alone. In case the Blood circulates unevenly, and be carried more violently toward the Head than the Feet, Epithemes of the warm Flesh, or Inwards of Animals, applied to the Feet, do well. 3. When the Fever is at its height, let the motion of Nature be diligently minded, whether it be about to make a Crisis or not; wherefore, nothing is to be attempted rashly by a Physician: breathing a Vein, or strong Purging, are wholly forbidden: but aftenward, when the burning of the Fever is in some measure remitted after the Deflagration of the Blood, and signs of Concoction appear in the Urine, in case the Motion of Nature be sluggish, a Sweat or gentle Purge may be procured, which, nevertheless, are performed better, and with more Safety, by a Physician, when Nature before, by a critical motion, has set upon a seclusion of the morbific matter. But if all things are crude, and in a Perturbation, the Urine be still troubled without a Sediment or a Separation of Parts, if the Strength be faint, the Pulse weak, if no Crisis, or only a fruitless one, has preceded, any Evacuation, either by Sweat, or Purging, is not attempted without manifest Danger of Life: but we must expect longer, that the Spirits of the Blood may recover themselves, and in some measure subdue the recrementitious and adust Matter, and afterward, by degrees, separate them; mean while, let the Strength be refreshed with temperate Cordials, let the immoderate Effervescence of the Blood (if it be so) be stopped; and let its due Fermentation be upheld, which, in truth, is excellently performed by Coral, Pearl, and those kinds of Powders, which are dissolved by the Ferments of the Viscera, and afterward ferment with the Blood, and greatly restore its weak and wavering Motion. Mean while (whilst Nature labours) let all Obstacles and Impediments be removed, and especially let the store of Excrements heaped together in the first Passages, be withdrawn by the frequent Use of Clysters. 4. After what way or method the Symptoms chief pressing aught to be handled, it is not an easy thing to prescribe by certain Rules; because the very same sometimes require to be forthwith restrained and appeased, sometimes to be moved on faster: and those that have somewhat greater in them, haply are another time are to be left wholly to Nature. This, in some, may be obviated with assuaging and lenifying Remedies, but in others with a rough and irritating Physic: mean while, it is a Precept to be stood to in all, that we religiously follow the Footsteps of Nature: which, if it acts amiss, its Disorder is to be reduced; if rightly, but too vehemently, it is to be cheeked; and if rightly, but slower or weaker than it ought, it must be our business to encourage and aid its Effort by physical means. 5. In the declining state of a Fever, when after a perfect Crisis, Nature has gotten the upperhand of the Disease, things are in Safety; nor is there much left for a Pyhsician to do: it only remains, to propose an exact form of Diet, that the Diseased may soon recover their Strength without fear of a Relapse: also it is good to clear the Remainder of the febrile matter by a gentle Purge. Concerning the Diet, Men very often incur a Relapse, to wit, by an overhasty eating of Flesh or strong Food, the Diseased fall back into the Fever; for since the Viscera are weak, and do not easily concoct Food, (unless it be very thin) and since the Crasis of the Blood is so weak what it does not assimilate a strong nutritive Juice, if any thing disproportionate be brought to either, the oeconomy of Nature is again perverted, and all things run amiss. Wherefore, let such as are upon Recovery frobear a long time from Flesh, and let them not use it till their Urine is become like that of sound Persons, and is no longer troubled by the Cold: and indeed, than it will be better to begin with diluted Broth of Flesh, and afterward by Degrees to rise to stronger Aliments. 6 When, after an imperfect Crisits, the thing hangs in doubt, and is not yet come to a Determination, than the Physician has a hard Task: let a diligent Eye be had to the motion and strength of Nature, whether it gins to prevail over the Disease, or yields to the same: if there are signs of Concoction, and the Strength holds good, a gentle Evacuation, and only per Epicrasin, is to be put in practice: mean while, let the chief pressing Symproms be obviated by fit Remedies, let all Impediments be removed; let the Strength be upheld, as much as may-be, by Cordials, and a true method of Diet. 7. When after an evil or no Crisis all things grow worse, and when the Physician, in a manner, despairs of the Cure of the Disease, he may declare the event of it to be suspected, and greatly to be feared: nevertheless, we must not so yield to a bare Prognostic that Fear shall put us by of all things else; but still, as much as lies in the Art of Physic, let Care be taken for a Recovery, though the Case be desperate; let Remedies be used to the Symptoms that are most dangerous; let the Spirits of the Blood, almost extinct, be reinvigorated with Cordials. When we despair of a Recovery, let Life be drawn out in length as long as it may be, at leastwise let an easy Death be procured. I shall now briefly give you some few Examples having regard to each Species of the foresaid Fever. A noble Matron, about fifty Years of Age, of a thin habit of Body, a low Stature, and a fresh coloured Countenance, having clothed herself thinner than usual on the fifteenth day of June, by reason of the Summer-heat, in the Evening was taken ill, and upon it, was seized with a Nauseousness, and an Oppression of the Stomach: she had wand'ring Pains troubling her sometimes in the Shoulderblade, sometimes in the Back, being very thirsty, though without any immoderate Heat. On the second and third day she found herself almost after the same manner. On the fourth day, after a Vomit given her, viz. un ounce of the Infusion of Crocus Metallorum, she vomited four times a yellow Choler, and purging thrice by Stool, she seemed to receive ease: the following night she slept somewhat better; but the next day, the Fever being kindled throughout the Body, she complained of a Thirst, a burning of the Praecordia, and of a Pain sometimes in the Side, sometimes in the Back, presently eight Ounces of Blood were taken from her; her Urine was of a very saturated Redness, opake, and troubled, without an Hypostasis, or subsiding of the Contents; the Pulse was uneven, and often intermitting: the following Night was without Rest. On the sixth day of the Disease, early in the Morning, a small Sweat arose, whereupon the Heat became somewhat more mild, which grew more intense again in the Evening. On the seventh day there was a very sharp Heat, with a Thirst, Burning, a disorderly and intermittent Pulse also a mighty Restlessness of the whole Body. On the eighth, the Symptoms were somewhat more remiss; also in the Urine there were some Tokens of an Hypostasis: she took on that day, Whey with the Leaves of Meadow-sweet boiled in it; she sweated freely; the Fever came to a Crisis. All the time of her Sickness her Diet was only small Ale, Whey, Barley and Oat Broths; Clysters were frequently used; Drink and cooling Juleps were given her at her Pleasure. About the beginning of the Summer, Anno 1656. a worthy Man, of an athletic habit of Body, without any manifest Cause (unless that being very much addicted to Study, he used no Exercise besides) fell ill: first he complained of a Nauseousness and a want of Appetite, with a violent Headache. On the second day he was affected with a cold Shivering, sometimes with a heat coming upon him by Turns; and likewise with a Thirst, and burning of the Praecordia, with a roughness of the Tongue, and an ingrateful Savour: on that Day he took ten Drams of an Emetic Liquor, after which he vomited seven times, and threw up a mighty quantity of yellow Choler, and had four Stools: the Night following was restleAss, and in a manner without Sleep; at which time, the Diseased, the heat being increased, grew more intensely feverish. On the third Day, when the foresaid Symptoms increased, ten ounces of Blood were taken from him: his Urine was ready and thick, with a copious Sediment; the Pulse was quick and vehement; in the Night he sweated a little, with a short, but troubled, Sleep: the Morning following the seemed somewhat relieved; but in the Evening all things grew worse again, with Watch, and a most intense Heat and Drought. On the fifth day, after a light Sweat, the burning somewhat remitted; which, nevertheless, returned again with its wont Fierceness a little before the Evening; the Night again was without Sleep, with an almost continual tossing of the Body: in the Morning, upon a gentle Sweat, he found a little Relief; in the Evening again there was an Exacerbation of all things; the night also was very restless. About the beginning of the Day following a Sweat happened as before, and somewhat more plentifully: this day there was a manifest Change toward a Recovery; the Heat and Thirst abated by degrees; the Urine was less ruddy, with somewhat of an Hypostasis: afterward, for three days, the Fever leisurely declined; yet he had every Night a certain Fit, though more remiss than before. On the eleventh Day he sweated more freely, and came to a perfect Crisis. During the whole time of the sickness he used a very spare Diet, as desiring no Food but small Ale, and Whey made with it: he took now and then cooling Drinks, and Juleps of a Decoction of Barley, and distilled Waters; every day, if he had not a Motion to Stool of his own Accord, an emollient Clyster was injected: he used no Medicine beside, viz. either Cathartick or Cardiack; but the Fever being over, he was twice purged, and afterward soon grew well. A young Student, about twenty five Years of Age, of a pale Countenance, and a melancholy Temperament, without a manifest Cause, in August, 1656. began to be sick: first he complained of a feverish Distemper, with a Thirst, a spontaneous Lassitude, and a want of Appetite. On the second day he was troubled also with a Pain in the right side, and a Distension of both Hypocondres, also with an almost continual Vomiting, Watch, and a violent Headache. On the third day, a Physician being called, presently twelve Ounces of Blood were taken away: in the Evening he grew hotter and delirious; afterward a Sweat, though small, happening, he was better the next Morning. On the fourth day, he presently threw up again whatsoever was given him, and was troubled with an almost continual striving to vomit; the giving of a Vomitory being proposed by the Physician, both the sick Person, and his Friends, refused to admit of it, being taught by Experience of the Danger of it before: a Clyster being given him, he had six Stools, and seemed to be somewhat relieved, and the Night following he slept a little. On the fifth day again there was a frequent Vomiting, with a continual Thirst; he burned inwardly; but the sense of that immoderate Heat was not perceivable outwardly to the Touch, because the Recrements of the boiling Blood, which ought to have breathed forth through the skin, seemed to stagnate within, and so float the Viscera; therefore in the Evening, for provoking a Sweat, this Bolus was given, Conserve of Roses vitriolated a dram, Gascons Powder a Scruple, Laudanum dissolved in Bawm Water a Grain: That Night he slept indifferently, and a copious Sweat ensuing, the Symptoms seemed to be mitigated: nevertheless, on the sixth day all things grew bad again; a Heat throughout the whole Body, a Thirst, and a burning of the Praecordia pressed violently. On the seventh and eighth days the Pulse was uneven and disorderly: for the most part, he spoke delirious, and if he was stirred in his Bed he fell frequently into a fainting Fit. On the ninth Day the same Symptoms continued; moreover, he was troubled with a Contraction of the Tendons, in the Wrists, and with Convulsive Motions of other Parts, so that we despaired, in a manner, of his well-doing. That Morning, because Nature seemed to yield herself overcome, it concerned us to do what Art could afford; wherefore, intending a copious Sweat as the last Refuge, I gave him at one taking, a Dram of Spirit of Hartborn in a little Draught of a Cordial Julep; from thenceforward, for four Hours, being very restless and raving, he could scarce be kept in Bed; but afterward, Sleep stealing upon him, he sweated very much, and his Case was soon brought to be out of danger: the following Night, in order to continue the Sweat, I ordered a Dose of the Powder of Contrayerva to be given him every six Hours. The Fever, and the Affects of the Genus Nervosum, ceased in a short time, and the sick Person recovered. A Woman about thirty Years of Age, of a robust Body, and a melancholy Temperament (as we might guests from her very austere way of Behaviour) in the third Month after Childbirth, as she gave her Infant suck in the Night, the falling from her, took Cold, and shortly upon it fell into a cold Shivering; a Heat, greater than usual, followed it, which afterward (a gentle Sweat arising) soon remitted. On the second and third days she was very thirsty, and had no Appetite, though without any immoderate Burning, that she scarce yet believed herself in a Fever; every Night she lay quiet, but wholly without Sleep, the Urine was intensely ruddly, and somewhat thick and opake through the multitude of contents, which nevertheless being not disturbed by the cold, continued still after the same manner without an flypostasis or subfiding of the parts: on the fourth day, the heat was, kindled throughout the whole, wherefore a Physician being then first called, about twelve ounces of Blood were taken from the Arm: after the letting Blood, and the Belly being copiously emptied the same day by a Clyster given, in the Evening she fell into a Sweat, by which Nevertheless being not relieved, she passed the Night without Sleep as before, though an Anodyne Medicine were given her: on the fifth day, after a Clyster injected she had three stools, and found ease: the Urine still continued the same, ruddy and troubled: when it was prescribed her to have Blood taken from the Vein running under the Knee, the Diseased earnestly refused it, thinking herself upon a Recovery: the Night following, after that she had lain without Sleep, and restless for a long time, at length she fell into a sore fit, such as is vulgarly said to be Hysterical, and in the first place she was affected with a certain Numbness or a Sense of pricking, which seized the extreme parts of the Body, especially the Feet, Legs and Thighs, and withal with a Flatus violently distending the Intestines, Ventricle and Hypochondres: she felt in the lower part of her Belly a certain great and heavy things, as it were, to rise up gently, which when it was risen to the Heart, and thence to the Brain, presently the Diseased failed in her Understanding, and for all the Night afterward lay delirious and talked lightheaded: on the sixth day, after the Belly's being loosened by a Clyster she came to herself again, was very sound in her Mind, and seemed to be indifferently well: but in the Evening, as she was moved in her bed, she began to feel an invasion of such a kind of fit, as before, to wit, in her whole Body she had a sense of Pricking, as though she were stung with Nettles: and withal in her Belly she felt a Ball, as it were, which creeping upwards distended the intestines and Ventricle, so that store of Flatused and Belchings were thence caused: for relief she desired cold Water might be given her to drink, moreover Remedies usual in Hysterick Affects, as Castoreum, a smell of Assafoetida, Fumes of Feathers burnt, Ligatures, and Frictions of the Legs and Thighs, and the like things were used, by which she seemed for the present free from the said affect, and was wholly cleared from it for four hours; but as she lay on her Back in the Bed, settling herself to sleep, on a sudden she complained that the same Symptoms pervaded her whole Body together, and presently upon it fell into a Delirium, all the night without sleep, howling and crying, she talked lightheaded; on the day following, she lay with her Eyes open, without Motion or Speech; in the Evening again, as the Fever increased, the Diseased grew raving, that she could scarce be kept in her Bed; and so for three days, sometimes she lay delirious, orying and howling, sometimes stupid as it were without Motion or Speech, but still she was troubled with convulsive Motions about the Tendons of the Muscles; on the tenth day she feteht her Breath deep and short, with a weak, and as it were formicating Pulse, in the middle of the night she died. A Learned Young Man, of a thin habit, and a pale Countenance, in the beginning of the Spring, not being conscious of any error in Diet, began to complain of a Lassitude and a Debility in walking, also of a Drowsiness of his Head, and a Sleepiness: on the second day he was withal tormented with a Thirst, a loss of Appetite, and a burning of the Praecordia; on the third day, a Physician being called, he took a Vomitory, after which when he had thrice vomited, and had voided five times by Siege hot and bilous Excrements, he became somewhat more cheerful, and the following Night slept indifferently well: on the fourth day he bled a little at Nose: afterward the Thirst and Heat were very much increased: the Urine was ruddly, with a copious Sediment and somewhat of an Hypostasis: but because after signs of Concoction in the Urine there appeared an effort of Nature, oppressed as it were, for voiding something without a sufficient Evacuation, therefore seven ounces of Blood were taken away, and thereupon he seemed to be very much relieved: Nevertheless, in the Evening all things grew worse, and thence forward for three days the Fever seemed still to be rendered more intense, on the seventh day he complained of a great Drowsivess in his Head, and of a Dimness in his Eyes: in the Afternoon a very large haemorrhagy happened, that through the vast loss of Blood the strength of the Diseased was almost wholly spent, and there was an extreme need of physical aid for stopping the Blood: for this purpose, when Blooding in the Arm, Ligatures, Evithems applied both to the Head and the lower part of the Belly, and a great many other Remedies (the instantancous occasion of Cure pressing for it) prescribed by all Persons, were tried in Vain; at length, by the persuasion of a Woman being there by chance, a red hot Iron was held to the Nose as it dropped, and on a sudden, upon the receiving of the Fume of the Blood into the Nostrils, its Flux was stopped: I have known this Remedy used since in many others with good success: by that copious Haemorhagy the contrinual Fever came to a Crisis; though an intermittent Quotidian followed it, which afterward was soon cured according to the Merhod above delivered. A Matron sixty years of Age, lying a certain night in Sheets not well dried, began to be ill: first she was affected with a suffocating Catarth, that through the serous Mass of filth distilling on the Larynx, she could soarce breath, much less fleep: the next day after she had a Nauseousness and a want of Appetite, with somewhat of a Thirst and an Excess of Heat: on the third day an acute Pain seized her fide, with a Cough and an increase of the Fever, the Urine was ruddy, and clear, with a laudable Hypostasis; the Pulse was uneven and intermitting. A Phyfician being called, ten Ounces of Blood were taken away; also, on that day a Clyster being given, she purged freely: about night the Pain vanished, and she slept indifferently: the Urine than was ruddy, troubled, and filled with Contents. On the fourth day the Fever was somewhat more increased; in the Evening the Cough was very troublesome, being followed with an acute Pain in the same Side as before; the Urine was again with an Hypostasis: the Pain, upon letting Blood again, soon ceased. On the fifth Day the Fever was somewhat more remiss; yet the Night was restless with a Heat and a Tossing of the Body, but without Pain: the next Morning she sweated freely, and was relieved: afterward, by a thin Diet used for some Days, and being once pnrged, she recovered without a Relapse. It is worthy to be observed, that the Pain pressing, the Urine was clear, and with an Hypostasis; nor was it troubled by the Cold: which nevertheless, the same being appeased, presently grew thick and more ruddy, and filled with Contents. A robust Youngman, and well in Flesh, about the Summer Solstice, after immoderate Exercises, and then a sudden Cold coming upon the Heat, fell ill. First, he was affected with a loss of Appetite, a Nauseousness, a violent Pain of the Head, also with a Thirst, and a Heat more intense than usual. On the second day, an acute Pain in the Rightside, with a Cough and a difficult Respiration, seized him; Blood presently being plentifully drawn from the Arm of the same Side, that Pain somewhat remitted; which nevertheless, returned more violently in the Evening, with a Cough and a spitting Blood; the night passed without sleep, and very restless. On the third day Blood was taken away again; and moreover, Liniments and Fomentations were applied to the Side pained; Antipleuritick Powders, Juleps, and Decoctions, were inwardly taken: about night, the Pain, in a manner, wholly ceased; presently after, the Diseased was affected with a violent Headache, and a Vertigo. On the fourth day he bled two ounces of Blood at the Nose; after which, that Affect of the Head clearly ceased; but in the Evening the Pain returned in the Side first affected, with a greater Fierceness: mean while the Pulse was low and weak; that when it was consulted concerning letting Blood, there was danger lest the dejected Strength would not admit of such a Remedy; wherefore, Blood being taken only in a small quantity, it was prescribed, that a Fomentation and Cataplasms should be diligently applied to the Side; moreover, that twenty Drops of Spirit of Hartshorn should be given in a Spoonful of a Cordial Julep, and that the same should be still repeated every six Hours: he sweated plentifully that Night, and the Pain very much abated; the Spittle was but little, sprinkled with Blood, which wholly ceased within a Day, the Pain also vanishing by Degrees: the Diseased took twice a day a Scruple of the same Spirit of Hartshorn, and perfectly recovered within a few Days, without a Relapse. CHAP. XI. Of the Malignant or Pestilential Fever in general. BEsides the Continual Fever, such as above described, and which arises by reason of some Principle in the Blood exalted too much, and disproportionate with the rest; there is another Species of it, which is raised by reason of the Blood being tainted with some venomous Miasm, and thereupon ready to incur various Coagulations and Corruptions; in which, not only the Spirit and the Sulphur, as in a Putrid Fever, make an exorbitant Effort, and force the Blood to boil immoderately, but withal, the mixture of the Blood is forthwith dissolved, and its Liquor runs into parts; and so that horrible Symptoms, with a manifest danger of Life, are caused in this kind of Affect. Under this Rank we comprehend Malignant and Pestilential Fevers, the Plague, the Small Pox, and Measles; concerning which, it remains for us to treat at present. By the unanimous Consent of all, the Force and Power of these Diseases are placed in a venomous Matter; because, upon a Pestilential Affect, even as upon drinking Poison, we find that the Strength is suddenly cast down, and that Life is soon destroyed: and therefore, for explicating the nature of the Pestilence, it will not be amiss, first to inquire concerning Poison in general, and after what manner it affects our Bodies; and then to show what sort of Venom is dispersed in the Plague and contagious Diseases: which being premitted, we shall speak in particular of the Affects even now mentioned. We may justly give the name of Poison to whatsoever sticking in our Body, violently and after a secret manner, injures the Temper and Actions of any part, or of the whole, destroys the Spirits, or perverts their Motions, dissolves the mixture of the Liquors, causes Coagulations and Corruptions, subverts the Ferments and Functions of the Viscera, and so on a sudden, and privily, endanger Life. There is a vast store of these in Nature, which are often engendered within our Bodies, and abundantly supplied outwardly from the Earth, Air, and Water, and from the distinct Families of Minerals, Vegetables, and Animals. As there is a great variety of Poisons, so there is no less a diversity of them, as to the Subjects, and the ways of their hurting; for, though a great many poisonous things are said to be contrary to us, as to the whole Substance, so that they set upon any thing, and like a Funeral Flame, with a caustick Force reduce it, as it were, into Ashes: yet some of these, being endowed with a peculiar Force of offending, rather hurt one Part or Substance than another. The Subjects on which the Taint of the Venom fixes itself first of all, and most immediately, are twofold, to wit, the Animal Spirits, or the spirituous and subtle Liquor passiing in the Brain and ‛ Genus Nervosum, and the Blood flowing in the Heart and Vessels. When a disproportionate Object presents itself to one of them alone, or to both together, so that thereupon the Crasis of the Liquors or of the containing Parts, is subverted, whereby Functions necessary for performing the Offices of Life and Sense, are letted and this is done after a secret manner, and as it were on a sudden, these kinds of Effects we ascribe to Poison. The nervous Bodies, with the animal Spirit, are not set upon wholly after the same manner by all sorts of Poisons; for sometimes they are assailed with a Stupor, sometimes with Cramps and convulsive motions, and those of divers Kind's and Conditions. The By't of the Tarantula causes a Dancing; the force transmitted from a Tortoise by a Spear, or the Cords of a Net, stupifies the hand of the Fisher; the Roots of Wild Parsnips, or the Seeds of Dranel, eaten, make Men tun mad; Opium, Mandrake, Henbane, and the like, cause a deep, and sometimes a mortal Sleep. These, and a great many other things, without any mighty Perturbation of the Blood, or Injury brought on the Heart, fasten chief their Venom on the Animal Faculty or Spirit. There are also some Poisons which chief insinuate their Malignity into the mass of Blood; wherefore, after using some Medicines, a yellow or black Jaundice, sometimes a Leprosy, leprous Affects, or Swell of the whole Body, are produced; Vapours rising from subterraneous Vaults, also from Charcoals newly kindled, often suffocating the Vital Spirits, congeal the Blood withal, and stop its Motion; so that the Flame of Life cannot be continued in the Heart. Every Man may see how great a Corruption is communicated to the Mass of Blood from the pestilential Miasm, by the Spots and Pushes which are the infamous Marks, as it were, of the blasted Blood. If the Injury first inflicted on either, viz. the ceconomy of the Heart or Brain be light, for the most part it is brought to an end without any great Offence of either; wherefore, Convulsive Motions, a Stupor, Lethargy, Melancholy, Paralytic Affects, often begin with a landable Pulse, and without an immoderate Effervescence of the Blood; and afterward, if the Affect does not wax strong, they come to an end, and cease by little and little. There are other Poisons which often deprave the Blood, and corrupt its Mixture by dissolving it, the animal Functions in the mean time continuing whole and sound; but if the Ferment of the Poison be stronger, and lays deeper Roots, presently the Venom is dispersed from the one into the Province of the other; for when the nervous Parts are filled with a virulent Juice, a Portion of the Venom, brought back with the nervous Latex, by the lymphatic Vessels into the Veins, is readily conveyed into the Mass of Blood, and defiles it with the Corruption prevailing in it: also from the Blood greatly infected with Venom, the Juice wherewith the Nerves are irrigated in a short time becomes tained; Hence, Persons that are mad are feverish, and such as are seized with a pestilential Fever very often are assailed with a Delirium or Frenzy. Concerning these things, we must consider what kind of Alteration or Impression of Injury it is which is inflicted by Poison on the Animal Spirits with the Brain and nervous Appendix; also what on the Blood, with the Heart and the Vessels annexed to it. As to the first, we observe, that that subtle Liquor, or the Animal Spirits, with which the nervous Bodies are influenced, and by the Expansion of which, Sense and Motion perform reciprocal Actions, are easily perverted from their Continuity, and even Expansion; for, the Nerves being of a sost Texture, and the Spirits wherewith they are filled being of a very subtle Substance, they are not able to endure any sorts of Objects that are strong or vehement; wherefore, when any violent or disproportionate Thing assails them by Surprise, they are often forced from their Expansion and Excursion, to a Flight and a Retreat, and often into Irregularities of motions; wherefore, sudden Passions of the Mind distract them, and stir them to Twitching and Convulsions: when the nutritive Juice wherewith they are supplied is sent to them too sharp, acid, or austere, they undergo sometimes Resolutions, sometimes Shrink: and if some Object more contrary (such as we affirm Poison to be) presents itself, whose Particles are of such a fierce Nature, or of such a Configuration, that they violently ferment with the nervous Liquor, they strongly drive the subtle or spirituous Part of it this way and that, or wholly drive it away; and either by their styptic Force they fix the rest of the Liquor, or force it by an Ebullition into disorderly Motions; Hence necessarily arise the evil Affects of the Brain and nervous Parts, viz. sometimes a Convulsion, a Trembling, a Shivering, sometimes a Stupor, or Resolutions, and other severe Symptoms. The Things which infect with Venom the nervous Juice after this manner, sometimes are gross, and only inflict their Injury when they are applied in a very corporeal Substance; sometimes they are subtle, and being resolved into a Vapour, or even to a Breath, they disperse the Ferment of the Poison from a little Point throughont the whole Genus Nervosum. Sometimes the Poison of an ill Thing eaten first gins its Tragedy in the Stomach, but oftener by a bare Contact on the Surface of the Body, it leaves the virulent Miasm, which soon and readily defiles, with its Ferment, the Spirits dispersed through the whole. A Taint inflicted on the Extremities of the Nerves, any where, whether inwardly or outwardly, it dispersed to a distance by their ready Conveyance, presently many Sprouts of the same Branch being brought to communicate of the Evil. Often, a light Touch of a venomous Thing by the Finger, or the extreme part of any Member, presently conveys the Taint received to the Brain, and thence it is retorted on the whole Body, and the most remote Members: the Reason of this is, that the Particles both of the nervous Juice, and of some venomous Miasm, are so active and quick of Motion, that either of them pass most swiftly through the whole Mass of the others, as Rays of Light through a Diaphanous Medium. 2. As often as the Blood gets Mischief by a venomous Thing, the Venom sticking in it, either is dull and of less Activity, which does not presently discover itself, nor breaks forth into terrible Symptoms, till after a long time, when it is brought to a Ripeness by a tacit Fermentation, and has first infected the whole Mass of Blood; as we may observe in some Poisons, which are said to kill at a distance, and not but after some Months or Years: or the Poisons inspired into the Blood are imbued with a much sharper Sting, that the Taint contractef by their Contagion presently breaks forth into terrible Symptoms; and thereupon follows sometimes a feverish Effervescence, with a Vomiting, a Thirst, and a burning of the Praecordia; sometimes a puffing up of the whole, a discolouring of the Skin, often an Eruption of Pushes and Buboes; frequently also a sudden falling of the Strength, so that a sudden Death steals on without any Stir, and almost unperceived: where it is to be noted by the By, if the Spirits of the Blood provoked by the Enemy, are able to set upon him and to contend for the Victory, from this Conflict a feverish Ebullition is raised in the Blood; but, if the Particles of the Poison far exceed them in Strength, presently the Maze of Blood is corrupted, that it can neither be circulated in the Vessels, nor be duly kindled in the Heart. If it be farther enquired, what Changes in its Substance, or Consistency, the Blood infected with Poison undergoes, that thereby it is rendered unfit for the Support of Life; I answer after this manner, Some Poisons fuse the Blood, and precipitate its Serosity, as those Medicines which being destructive either by Purging, or by causing a Flux of Urine, or by a puffing up of the whole, or by a Discolouration, or an Eruption of Pushes, make a very great Separation of the Serous Latex: mean while, a great ebullition is caused in the mass of Blood, whereby the Vital Spirits are greatly spent; the Particles of the Salt and Sulphur, by the too much Contion, are exalted, and often so scorched, that a Jaundice, either yellow or black, is caused. There are Poisons of another kind far more dangerous, which congeal the Blood, and corrupt its mixture by destroying it, viz. first they bring a Coagulation on the Mass of Blood, and then a Corruption; for, when the Spirits of the Blood, put to flight by the Contagion of the Poison, are dissipated, the even mixture of the Liquor is dissolved; wherefore, the grosser Particles mutually lock with each other, and (like Milk upon Rennets being put into it, or turning sour of its own accord) they are coagulated together; hence the Blood grows clotted in the Vessels, that it is not readily circulated in them: the coagulated Portions of it being conveyed inwardly into the Sinus' of the Hearts, are there apt to stagnate, and so they cause frequent Faintings and Swoonings: being carried outward, and stuck in the Skin in circulating, sometimes, when cast on every side in a plentiful manner, they cause an overspreading of Blackness throughout the whole; sometimes being dispersed more spartingly, they cause only Spots, or black and blue Marks, and the rest of the Phoenomena of Malignity: now the Coagulation of the Blood soon disposes it to Putrefaction or Corruption, as it is to be seen in extravasated Blood, which soon turns black, and is wont to putrefy; for the Spirit being exhaled the remaining Particles of the Salt and Sulphur in the Blood begin to separate from each other, and to dissolve the Bond of Mixture, whence Putrefaction ensues. These things being thus premitted concerning Poison in general, the method of Healing requires that we set upon the Tract of Fevers, which draw their Origine wholly from a venomous and malignant Miasm: and since among these, the Plague is undoubtedly the chief, I shall begin with the Consideration of that, and shall speak afterward, in order, of Malignant Fevers, the Measles, and Smallpox. But before I give its Definition, I shall inquire briefly concerning the Pestilential Venom, of what Nature and Disposition it is; also whence it arises; and lastly, after what manner it is propagated by Contagion in others. The Essence of the Pestilential Fever is founded in a vapory and spiritual Miasm, from which Effluvia's diffused on every side so powerfully display themselves, that from the least Seminary they soon propagate a fertile Harvest of Death and Destruction. By reason of its mighty Activity, this Miasm deserves to be called, a certain Quintessence, as it were, of Poison: it's very nimble and subtle Particles penetrate all Bodies, and inspire them with their Ferment; for, whether being dispersed through the Air, or stored up in some Foams, if they come to hit upon a Human Body, though it be lightly, and as it were, with a Glance, they readily penetrate it, soon infect the Animal Spirits and those of the Blood, and thereby overspread all the Members with a Venomous Contagion. When a pestilential Breath or Vapour has assailed any one, and that Venom has first seized the Animal Spirits, or those of the Blood, or both of them together; from the subtle and thin Substance of these the Taint is soon derived into the grosser Matter, for in a short time it ferments the whole Mass of Blood, or nervous Juice, and the excrementitious Humours in any place abounding; and thence is drawn into the solid Parts, and fixes the Evil in them. If this Contagion first seizes the Animal Parts, presently the Injury is communicated to the Brain, and the Genus Nervosum, and esecially to the Ventricle; it forthwith poisons the Homour lodging in these, dissolves its mixture, perverts its regular Motion, and renders it wholly disagreeing and offensive to the tender substance of the containing Parts: thence forthwith Cramps, and Convulsive Motions, violent Vomitings, a Cardialgia, also a Frenzy, Delirium, or obstinate Watch, are raised about the first Invasion of the Disease; whereas in the mean while, the Taint being not yet dispersed through the Blood, the Diseased are not in a Fever, nor infested with a disorderly, Pulse, or a Swooning, or an appearance of Tokens; which Symptoms, nevertheless, assoon as the Blood is infected, show themselves afterward. If at any time the Spirits of the Blood are first seized with the venomous Miasm, either breathed in with the Air, or attracted by the Pores, by and by its ferment is dispersed throughout the whole mass of Blood, the infected portions presently begin to be loosened from their even mixture, to separate into parts, and to be coagulated, and the same being conveyed into the Sinus' of the Heart, to stagnate there, and to cause a Swooning, Faintings, and often a sudden Death: also being carried outwardly, and fixed about the Skin, they are wont to cause Bubo's, Pushes, and the other marks of a Venenosity, mean while the Diseased are present enough to themselves, and are not assailed with a Delirium or convulsive Motions: but if from a stronger cause an Injury be inflicted on both Parts at once, the course of the Disease is carried on with a more horrible appearance of Symptoms, and with a Frenzy infesting together. As to what regards its rise; when the Plague first arises in any Region or Tract of the Earth (whatsoeure others may think) we place the first and chief natural Seminary of this Poison in the Air, for it seems consonant to reason, that from the same Fountain from whence the Food of common Life is derived, the beginnings also of Death, which is no less diffused, should be taken: the same necessity lies upon us for breathing the Air, as for Fish of living in the Waters; wheresore, as the common Destruction of Fish dying in Multitudes is ascribed to Waters being infected with Poison, so nothing but a Taint of the Air, breathed by all, can kill Men that die without a manifest Cause, by an epidemic Destruction. For the Air, which we necessarily breath in for the Support of Life, consists of thick Steams and Vapours, which continually are breathed from the Earth; to which the exhalations of Salts and Sulphurs being mixed, they make here a thick Fog, as it were, of Atomous Corpuscles. The Motions of these being both very swift and restless, are of a manifold and very differing Figure; wherefore some of them continually encounter others, and according to their various Configurations, they close with these and are mutually combined, and are driven and fly from others: on this the Reasons of every Sympathy and Antipathy chief depend; from the divers Agitations of these kinds of Atoms near the Surface of the Earth, this or that Tract of the Air undergoes divers Alterations, with which Bodies, especially those that are living, are variously affected, for the inward Motion of the Particles of each Animal depends very much on the motion and temper of the Particles of the Air: Since these continually exagitate those, stir them up when they are drowsy, repair the Losses of those that fly away, exagitate the vital Flame with their Nitrosity, and supply it with a nitro-sulphureous Food, and eventilate it being kindled by the continual Courses of Accesses and Recesses: as long as an apt Contemperation happens for the Motion and Configuration in both, Animals enjoy a perfect Life and Health; but if the Corpuscles flying in the Air are of such a kind of Figure and Power, that they are manifestly contrary to the Spirits implanted in Animals, they loosen the mixtures of these from the rest of the Elements with which they are bound, and pervert their Motions: hence the Crases of things are destroyed, Life is overthrown, and that being scarce extinct, the Bodies incur Putrefaction; hence the Tops of Trees or Corn being struck with a Blast whither on a sudden; hence the Murrain oftentimes reigns amongst , which kills whole Herds together. For this kind of Cause the Seeds of the Pestilence first exert themelves, and threaten a universal Slaughter of Mankind; for even as venomous Corpuscles gathered together in the Bowels of the Earth, or on its Surface, produce Arsenical Mixts, or venomous Herbs; so these being resolved into a Vapour, and gathered thick together in the Air, create pernicious Blasts, from which malignant and pestilential Diseases arise: and it seems to me not improbable, that the things which first give a seminary of the Pestilence to any peculiar Tract of the Air, are the venomous Effluvia of Salts and Sulphurs grown exorbitant, and breathed forth of the Bowels of the Earth; which sometimes, being first long included in the Earth, are exhaled by degrees; sometimes, by reason of Tremble of Openings of the Earth, break forth together; of which kind also there are generally breathed from the Tents of Soldiers filled with Nastiness, by reason of dead Carcases lying unburied, or from places filled with staguating and stinking Mud. And Corupscles exhaled after this manner, by a long Putrefaction, acquire to themselves wonderful Powers and Discongruencies, that thereby they are disagreeing and heterogeneous to all others whatsoever; and so being received into to the Air, they ferment it (like a mass of Liquor) and pervert it from a'wholsome and benign into a pernicious and cursed Nature. Some Bodies easily receive the malignant Tincture of a pestilential Air, others not so readily; those who have a very great Cacochymia by reason of an ill Diet, and those who by reason of a Plethora have a Blood filled with an inflammable Sulphur, a light Blast of a venomous Air fastens the pestilential Venom on them, especially if they lie under a Fear and Sadness, which convey inwardly the lightest Parts of Contagion, as it were by a certain Infusion. On the contrary, those who have the Viscera clean, and the Mass of Blood well tempered, and those who carry a strong and undaunted Mind, do not so eafily receive this Infection; and sometimes being received they expel it again. So far of the Pestilence and its Communication, according to its first Being, and the Source of the infected Air thence drawn; it remains for us to speak of its Propagation by Contagion, as it is often communicated from some Men to others, as it were ex traduce. By Contagion we understand that Force, or Action, whereby any Affect being in one Body stirs up the like to it in another; but since this happens either immediately by Contact, as if any one lying in the same Bed with another Man seized with the Plague, gets the same Disease; or mediately, and at a distance, as if it happens that the Contagion be conveyed from one House to others at a distance; and so if the Plague assails any Person handling a Garment or Householdstuff of an infected House, after some Days, or Months, or haply Years: tgherefore, that the nature of a Contagion, and the divers manners of it, may be plainly known, let us examine first, What that things is which flows from an infected Body: secondly, How it is fisposed in the medium through which it passes: thirdly, After what manner it engenders an Affect like itself in another Body. 1. That from every Body, though of a fixed Nature, Effluvia's of Atoms constantly flow, which make, as it were, a mist or cloudy Circle about them, and invest them, as it were, like the Down of a Peach, it is so received a thing among the soundest Philosophers, that there is nothing more; and the more active Particles any thing consists of, by so much it sends from it Corpuscles of a more notable Virtue, and Energy: hence the Effluvia which part from Electrick Bodies, are albe to move other Bodies from their Places; from Sulphurs Emanations pass, which fill the whole Neighbourhood with Odours: since therefore the pestilential Venom, as is said before, though in a small Bulk, is of a mighty Efficacy and Operation, wheresoever it is fixed, certain Emanations necessarily proceed from the Bodies imbued with it, which carry the nature of the same Poison and Malignity, and diffuse it on every side according to its Sphere of Activity: but since these Corpuscles which retain the Contagion of the Pestilence, when they flow from one body, are not presently received by another, let us inquire how they are disposed in respect of their passing through the Medium. Where presently occurrs the difference of them from most others, in regard that the Effluvia, which generally evaporate, do not long retain the Nature of the body whence they flow, but either vanish in the tenuated Air, or closing with other bodies, are assimilated with them: but those Particles which part from a pestilential Miasm, are not easily absorbed by the Air, or other Body, so that they wholly perish; but among various Consusions of Atoms, and Dashing against other bodies, they preserve themselves entire: for this Poison being ina manner masterless, and insuperable by others, continueth still the same; and though it consists of a very small heap of Atoms, it does not presently vanish, but taints with its Ferment the next Corpuscles to it, and so acquires to itself new Stores, and gets Strength as it goes; whence it lies long hid in every Foams, and after a long time, when it has lighted on a fit Subject, it exerts itself, and communicating the Infection of its Venom to the other, it resuscitates anew the Disease of the Plague, which before seemed to be driven away, and though from a very small Seminary, it disperses its mortal Pouson far and near. For the Plague discloses such most certain Signs of its Contagion, that some Authors affirm it to subsist among Mortals only by this means, and that it not where arises anew, but is preserved only by a Foams, and that it is now and then conveyed from one Region into another. Histories tell us, that the Seeds of it have lain dormant for many Years in a Garment or Bed-Cloaths, that upon the same afterward being stirred, they have shown themselves, and have brought the Disease of the Pestilence, arising afresh, with a mighty Destruction of Mankind: when by reason of a Foams the Pestilence is propagated to a distance after this manner; the venomous Corpuscles which remain in the Miasm, being stirred, presently spring forth, and display their Venom on every side, as it were by a certain Irradiation: if they any where light on a humane Body, they presently seize the Spirits, and are conveyed inward by their Vehicle, and then easily enough infect the Blood, and all other Humours flowing in the Vessels with their Ferment, and in a short time cause Coagulations and a Putrefaction in them. And after this manner, by most subtle Effiuvia, there is made a certain Transmigration, as it were, of the pestilential Disease, even as when a graft cut from some Tree, and laid aside for some time, and afterward inserted in another Trunk, is able, though from a very small Bud, to produce a Tree of the same Kind and Nature. CHAP. XII. Of the Plague. THE Plague may be described after this manner, That it is an Epidemious Disease, contagious, very destructive to Mankind, taking its Rise from a venomous Miasm first received by the Air, afterward propagated by Contagion, which setting upon Men after a hidden and secret manner, causes Extinctions of the Spirits, Coagulations of the Blood, Syderations and Mortifications of it, and of the solid Parts, and brings the Diseased in danger of Life, with an Appearance of Pushes, Bubo's, or Carbuncles, and with the addition of other horrible Symptoms. There are a great many Signs occurring to us, which fore-shew that the Pestilence will happen in a short time, to wit, if the Year does not keep its Temperament, but has immoderate and very unseasonable excesses of Heat or Cold, Drought or Moisture: if the Measles or Small Pox are every where very rise, if Phlegmons, or Bubo's accompany reigning Fevers; from a preceding Famines a most certain Presage is taken of an ensuing Plague; for the like Constitution of the Year which for the most part brings a Dearth of Provisions, by reason of the Corn being blighted, is apt also to produce a Plague; also the evil sort of Diet, which such as are pressed with Hunger make use of, eating all kinds of unwholesome things without choice, disposes their Bodies more readily to receive the Contagion. Moreover Earthquakes, and fresh-opened Grottoes and Caverns upon the cleaving of the Earth, by reason of the Eruptions of a malignant and venomous Air, have often given Beginnings to Plagues. Again, as there is need of great Diligence in taking a fore-view as it were, from a Watch-Tower, of an imminent Plague, so we ought to be no less sagacious in observing the same as if first arises, and cast its first Darts; for often, being too solicitous, we dread even vulgar Fevers, if haply they end in Death, for this Contagion; and sometimes being too secure, contemning the Pestilence by reason of its Symptoms resembling those of a common Fever, we find our Dangers but too late: wherefore, for the fuller knowledge of this Disease, we shall set down its Signs and Symptoms both common and pathognomick. Besides the Signs above delivered, which by a certain Demonstration, a Priori, give a Suspicion of an ensuing Plague; there are others whose concurrence with it plainly show its Presence in a Body diseased: of these some are common to a Plague with a putrid Fever, some are more proper to this Affect; for the Impression of the Plague oftentimes stirs up an Effervescence of the Blood, and has a Fever so frequently joined with it, that by some, in the Definition of the Plague, the Fever is put as a Genus; wherefore, by reason of the Ebullition of the Blood, and the Injury brought on the Viscera, presently an Incalescence with a spontaneous Lassitude, a Thirst, a burning of the Praecordia, Vomitings often violent, a Cardialgia, Gripes in the Bowels, a Roughness or Blackness of the Tongue, a Swooning, and a sudden Fall of the Strength, ensue. Tho vulgar Fevers are oftentimes attended with these kinds of Symptoms, yet if at the same time a Plague be rife in the Neighbourhood, and a fear of the same seizes the Minds of Men, hence a greater Suspicion of this Evil is given; and especially, because, when a Plague reigns, all other Diseases leave their own Nature and pass into that: wherefore, if to the Affects even now mentioned, there be added a Communication of the same Disease to many, and many dye of it, so that it generally becomes mortal and spreads itself; and if besides, Buboes, Carbuncles, Pushes, or others Marks of a pestiferous Contagion appear, the thing is put without doubt, and we hence proclaim a Pestilence, with no less Confidence, than we do a Fire when we see a Flame burst forth through the Roofs of Houses: but because a mention is here made of Buboes, Carbuncles, and other Symptoms, it remains for us to give briefly the Causes of them, and the ways of their being produced; they are these, a Carbuncle, Bubo, Pushes, Wheals, and malignant Pustules. Concerning these, we say in general, that they are all Products of the Blood, and nervous Juice, struck with a pestiferous Venom, and coagulated by Parts in their Circulation, and variously affected with Purtrefaction; for the Spirits residing in both Liquors, especially in the Blood, are no sooner touched with the breath of a malignant Contagion, but a Coagulation is caused in the remaining Liquor, even as when Milk turns sour, or has an acid Juice mixed with it: wherefore, Portions of it being greatly tainted with Venom, soon grow clotty, and like extravasated Blood, fall into a Corruption with a Blackness; whence presently they stop the Motion of the rest of the Blood in the Heart and Vessels, and coagulate it more by reason of their Ferment. Now whatsoever is gathered together into Clots by Coagulation, unless it be presently cast forth, brings Death in a short time, by stopping the Circulation of the Blood; and being driven outward to the Circumference of the Body, is stopped in motion in the narrow Involutions of the Vessels; and either being wholly destitute of Spirit, as though it were Planet-stricken, it produces black or blue Marks by its Mortification, or by reason of the Salt and Sulphur exalted by the pestilential Ferment, and affecting new things, it grows, into tumors of various kinds. A Carbuncle is a fiery Tumour, with very smart and burning Pustules about it, infesting the Diseased with an acute Pain; which arising in various places indifferently, does not suppurate, but spreading largely round about, burns the Flesh, and at length throws off lobes of it being corrupted, and leaves a hollow Ulcer, as though burnt by an Eschrotick. The Generation of Carbuncles seems to be after this manner; when venomous Miasms light on a Blood parched with Heat before, its congealed Portions are fixed in the Superficies of the Body; and at that place, because the motion of the Blood is a little letted, first a little Tumour is made, which afterward, the malignant Venom presently spreading itself farther, being increased by little and little, creeps into the Neighbourhood, Suppuration does not follow, because the matter extravasated, and stagnating, is not concoted and digested with a gentle heat, but by reason of the Particles of the Sulphur, grown exorbitant together with the Salt exalted, being heaped together into these tumors, and by reason of the Stagnation being forthwith dissolved from mixture, an Adustion is caused, as if a Cautery were applied to the part: the pieces and lobes of Flesh, eaten as tho covered with an Eschar, fall away, because the corrosive Venom sticking to the Muscles, does not corrode them only in their Sursace, but through their whole Substance; wherefore, before the whole Flesh is consumed, the Membranes in which it is involved being eaten away, some pieces fall from the rest as though cut from it: often one, often more Carbuncles arise; sometimes they are alone, sometimes they have a Bubo accompanying them. A pestilential Bubo arises only in glandulous parts; toward the bulk of which, not only the Blood congealed by the Venom, and carried thither by the Arteries, but also the nervous Juice there heaped together, and to be carried back into the Veins, contribute. Because this Tumour happens from Juices less parched, and in a colder part, therefore it partakes of Suppuration; for, the Matter heaped together by degrees when (the vital Spirit departing by reason of Stagnation) it has lost the Form of Blood, through the Particles of the Salt and Sulphur being exhaled, and kept in the Tumour, is converted into a Pus by long Concoction. Now that these tumors only happen in the Glands, the Reason is, not that the Fuel of the Diseass is conveyed to these parts by a certain Appointment of Nature, but as the Particles of the virulent Miasm abound every where in the Blood and nervous Juice, they are heaped together there more readily, as in a common place of Retreat, where both the Blood conveyed to the Extremities of the little Arteries, is with difficulty and not so readily received and carried back by the Veins, and withal, where the nutritive Juice, to be carried back from the Nerves into the Veins, is deposed. That both done about the Glands, it is manifest, both by Experie natomical Experiments; wherefore, since both Homo Seeds of the pestilential Contagion met together in these Parts, a seat of Malignity is here made by reason of the Virulency deposed here by both. Pushes, Weals, and Purple Spots, in respect of the Venenosity, are of the same Batch with the tumors even now described; but in these the Products of the Virulency are less in bulk, though with a greater danger, by reason of the Seeds of the Venom being more dispersed: small Portions of coagulated Blood sticking in the Skin, make these lesser Phoenomena; wherefore, some of these, raised into Bladders, suppurate; others, by reason of a certain Mortification or Syderation of the corrupted Blood, turn into Purple Marks and Spots. Tho the Plague, by reason of Destruction wherewith it threatens the Diseased, both secretly, and very much on a sudden, scarce affords Place or Time for a Prognostic; and though by reason of the occult ways of doing Mischief, this Disease carries all things suspected in it; yet it is manifest, by frequent Observation, that some Signs appear in the Course of it, from which we are wont to divine a Recovery or Death. The Case is full of Danger if the Contagion suddenly passes into an universal Sickness, and makes violent Invasions; if an Haemorrrhagy, or only a small Pain happen in the beginning of the Disease; if the Urine be thick, and troubled, the Pulse unequal and weak; if a Convulsion or Frenzy présently follow; if the Vomitings, or Stools, are livid, black, or very stinking; if the Pushes at first red, afterward turn black and blue; if the Carbuncles are numerous, if the Buboes first arising, disappear; if the Strength be cast down on a sudden; if the Countenance looks dismal, or turns black and blue; if with a cold Stiffness of the extreme Parts there be a burning of the Viscera, especially if these or most of them happen in a Body very cacochymical, or in an unwholesome Season. On the contrary, the be lighter, and lefs dangerous; if the Disease happens in a sound and robust Body with a Fortitude of Mind; if Remedies are seasonably administered before the Disease has seized the whole Mass of the Blood; also, if the Course of the Disease goes on with a constancy of the Strength, a Vigour and Evenness of the Pulse, a Suppuration of Buboes, and a large Discharge of Pus, and with the absence of horrible Symptoms: mean while, though we may hope here all good, yet it is not free for us to be secure, because sometimes, with a laudable Appearance of Signs, Ambushes are privily laid for Life; and, as from a reconciled Enemy, we suffer most severely, when we seemed to have escaped his raging Threats. In the Cures of most Diseases, the chiefest Work is committed to Nature, to whose Failure Physic gives a helping hand: and the Office and Science of a Physician chief consists in this, To wait fit Occasions of giving Aid to her, when she is at a Fault. But the Plague has this peculiar, that the Cure of it is not to be left to Nature, but we must fight against it always with Remedies taken from Art; nor must we be here solicitous of a more seasonable, and as it were, a milder Time: but we must get Medicines assoon as may be, and insist on them at all Hours, and almost Minutes. But, because when a Plague reigns there is need of no less care for driving away the Contagion, than that the Contagion received, be cured: therefore a Physician has a double Task; to wit, both that he take care for the Prevention of this Disease, and for its Cure. Prophylactick Cautions either regard the Public, and belong to the Magistrate, or private Persons; by which it is taught what must be done by each Man when a Plague is feared. The public care, in a time of the Plague, chief consists in these things; That Divine Worship be duly observed; that all Matters maintaining Putrefaction be taken away; that Filth, Dunghills, and all stinking Things, be removed from the Streets, and every occasion of Contagion be most diligently avoided; that Commerce with insected Places be forbidden; and that a wholesome kind of Diet be constantly kept to by the Citizens; let the Poor, who have not a plenty or choice of Provisions, be fed at public Charges. If the Plague be already grown rife, let the venomous Force of the Air be corrected as much as may be, which will excellently be purged by a frequent burning of sulphureous things: let the infected be separated from such as are sound, and let these keep from their Carcases or Householdstuff Lastly, let skilful and meet Physicians and Attendants be gotten to supply the Wants both of those that are in Health, and of the Diseased. The Rule of a private Prophylaxis is wont to be concluded in these three things; viz. Diet, Pharmacy, and Chirurgery: The Deit regards the six non-natural things, amongst which, those of chiefest Note are the Air, and the Passions of the Mind: as to the rest, the Precept of Hippicrates suffices, viz. that Labour, Meat, Drink, Sleep, and Venus, all keep a mean: let the Pestilential Air either be avoided by removing into another place, or let it be corrected by sulphureous things duly kindled, or let it be refreshed in breathing by Fumes and odoriferous things frequently help to the Nostrils: As to the Passions of the Mind, Fear and Sadness, whilst a Pestilence reigns, are as a second Plague; for, by these the seeds of the venomous Contagion, which lie on the Superficies of the Body, as it were in the outmost Margin of the Vortex, are violently drawn inward, and delivered to the Heart; wherefore, a cheerful and confident Mind is better than the most exquisite Antidote. I have known many, who were wont to say in the Words of Helmont, That by fortifying the Archaeus with Wine and Coufidence, and using no other Alexipharmicks, they passed their Time among infected Persons without any injury by Contagion; and those who lived otherwise, imbibed the Seeds of the Pestilence, as though derived from the Stars. Among Chirurgical Things to be used for Preservation, Blooding, Cauteries, and Annulets, are usually recommended: where there is a Plethora with a great Turgescency of the Blood, or when by a long Usance Persons have accustomed themselves to be let Blood, opening a Vein agrees with them; for, by how much the less the Blood boils, and is circulated in the Vessels without trouble, by so much the slower is it infected with the venomous Contagion. Issues made by Cauteries are so much approved of by the Suffrages almost of all Men, for Preservation against the Plague, that their use is Generally received among the Vulgar; for these constantly drain the assiduous increase of the excrementitious matter: and if any Miasms of the Pestilence are inwardly admitted, they cast them forth by their open passage. Annulets, hung about the Neck, or worn about the Arm-Wrists, are thought to have a wondersul Force against the Pestilence: of these the most excellent are accounted by some, which consist of Arsenic, Quicksilver, the Powder of Toads, and other venomous Things: that the same do good in some Cases, besides the Observations of Physicians, this Reason seems somewhat to convince; the Effluvia, or atomous Corpuscles which sometimes flowing from certain Bodies, sometimes settling on others, fly about the whole Region of the Air; these being diversely figured, some of them excellently close with others; but if they jut against Corpuscles of another Form, they enter a Conflict with them, and subvert them; hence the Particles of the pestilent Miasm, which are contrary to our Spirits, excellently agree with those Corpuscles of the Poison coming to them, and readily close with them: wherefore Annulets made of Poison do this; to wit, they gather into themselves the Seeds of the Pestilence coming against us, by reason of a Simiiitude of Parts; nay, and by drawing the same from our Body to their Embraces, they in some sort free the Infected from the Malignity. The Pharmaceutick Prophylaxis has a double Scope; first, That the assiduous Increase of the excrementitious Matter, or Humours, be removed by a gentle Furge as often as there is need: secondly, That by Alexipharmicks daily taken, the Spirits and our Bodies be fortified against the Incursion of the Venom: by the former, the Food and Fuel which increase the Putrefaction caused by the Venom, are withdrawn; by the other, the first kindling of the pestiferous Contagion, as it were of a suneral Flame, is hindered: for Alexipharmicks seem to give help against the Contagion of the Pestilence under this twosold Respect; both because the Mass of Blood, and the Viscera filled with the particles of these, also the Spirits being first possessed by the same, do not easily admit the Fellowship of the venomous Miasm, and for that the Blood being quick in its Motion by the gentle Instigation of these Particles, is freed from Coagulation. So far of Preservation: it remains now for us to treat of the Cure of the Pestilence; the Doctrine whereof is either general, and comprises the Remedies which are taken for this end from Diet, Chirurgery, and Pharmacy; or special, which delivers the use, and cautious concerning the giving of those Remedies, and after what manner we must obviate Symptoms variously emerging. The Diet comprehends the use of the six non-natural things, though the chief Care and physical Cautions are concerning the Food; the primary Indications of this have not place together, and at the same time, but aught to be supplied as occasion requires, now one, now another, and according to the Exigency of Nature. In respect of the Malignity and the Dejection of the Strength, Aliments are required, which greatly refresh the Spirits, and afford a plentiful Nourishment: in respect of the feverish Distemper, a Diet seems to be required which is thin, cooling, and qualifying of the Blood. Let a Physician take care of both; but let him direct his Remedies rather against the Malignity than against the Fever. The Aids which belong to Chirurgery are Bleeding, which ought to be used seldom, and with great Caution in this Disease, because the Blood being too much exhausted, and the Vessels falling, a Sweat is not so easily procured; the place of this is better supplied by Cupping-Glasses with a Scarification; for this, and Vesicatories are aptly used for drawing forth the Venom. Moreover, against Buboes, Carbuncles, and malignant Ulcers produced by them, Cataplasms, Fomentations, Plasters, Liniments, and many other things, to be applied outwardly, are taken from Chirurgery, with which some poisonous things, as Drawers of Venom, are prescribed to be mixed by some: wherefore, Preparations of Arsenic, viz. its Oil, and Balsam, are recommended in this Case, as of excellent Use and Efficacy. Medicines, in order to the Cure of the Plague, are either Evacuatives or alexipharmics. The Intention of the first is, that the Serous Latex in the Blood, and the excrementitious Humours, which abound in the Viscera, be sent forth; and together with them, a great many Particles of the venomous Miasm every where dispersed in the Body. Now these things are performed by Vomitories and Purges, whose use is rare, and only in the beginning of the Disease; also by Diaphoreticks, which at all times, as long as the Strength is able to bear them, are indicated in the Plague: for these evacuate more fully, and withal from the whole Body, and also by exagitating the Blood, they free it from Congelation, and in regard they move from the Centre to the Circumference, they drive the venomous Ferments, and also the Corruptions of the Blood and Humours far from the Heart, and repel the Enemy from the Fort: but Vomitories and Purges evacuate less generally, and often by concentrating the malignant Matter, draw it inward, and fix it in the Viscera. Now these Medicines, whether they work by Purging, or Sweat, aught to be such as have Particles of the same kind with the venomous Miasm, rather than with our Blood or Spirits; for such a Medicine will pass through the various Involutions of our Body with its entire Force, and by reason of the Similitude of both, will certainly lay hold on the virulent matter of the Disease, and through a mutual Adhaesion of Parts, Nature being irritated, will carry it forth with itself: wherefore Medicines, whether cathartics or Sudorificks, are most recommended, which are prepared of Mercury, Antimony, Gold, Sulphur, Vitriol, Arsenic, and the like; which, in regard they are not subdued, or overcome by our Heat, become excellent Remedies against the Venom of the Pestilential Contagion; for, these do not only powerfully evacuate superfluous things, but for as much as they exert, and display on every side in our Body very strong and masterless Particles, they dissipate, and hinder from Maturation, the Ferments of the Venom gliding every way. And since the Remedies themselves, being insuperable by Nature, must of necessity be sent away by the open passages of the Body, they carry forth together with them whatsoever is extraneous and hostile. As to Alexipharmicks, which are said to resist the Venom of this Disease without a sensible Evacuation, they are for the most part such whose Particles are neither very agreeing with Nature, that they turn to an Aliment, nor are so contrary to it, that they stimulate an Excretion. The same being inwardly taken, and refracted to most minute Parts, they, by their Corpuscles, inspire as it were with a new Ferment, the Blood and Juices flowing in the Vessels and Viscera, and by moving them gently, and keeping them in an even mixture, they free them from Coagulation and Putrefaction: by the same gentle Agitation they dissipate from each other, and hinder from maturation the Particles of the Venom beginning to be gathered thick together. Lastly, by praeoccupying the Blood and Spirits, they defend them from the Ingressions of the pestilent Character: of these Remedies some Simples are recommended, as Rue, Scordium, etc. but those are esteemed far better, which are more compounded; wherefore Treacle, Mithridate, and Diascordium, whereof some consist of at least fifty Simples, are accounted Medicines so complete in all Respects. that it is esteemed a Crime to omit, in the making of them, even one Plant; the Reason haply is, That many things being put together make a Mass, whose diversified Particles, being exalted by a long Digestion, cause a greater Fermentation in our Blood and Humours. Having thus set down the Remedies with which we ought to be provided for curing the Plague, we should speak next of its method of Cure, to wit, what is to be done in the first place, and what next in order; but that all things are so precipitated in this Disease, that there is no room for Deliberalion, nor will a Physician be frequently present with the Diseased for fear of Contagion: wherefore there is no need here of many Praescripts, or a long Series of Indications. This thing is to be done quick, and must be comprehended in a few words: when therefore a Pestilence reigning, any one is infected with this Disease, God's help being implored, we must presently fly to Remedies. If the Plague happens in a Body that is not well purged, and prone to Vomit, presently let a Vomitory be taken; the Operation of which being ended, presently Diaphoreticks being given, let a Sweat be procured, and let the same be continued as the Strength will bear; afterward let it be often repeated: moreover, Alexipharmicks must be used almost every moment, till the Venom be wholly sent forth by the eruption of Pushes, Carbuncles, or Buboes; nevertheless, in the mean while, let respective and proper Remedies be opposed to the Symptoms chief pressing; but especially for the cure of Buboes and Carbuncles, let fit Aids be taken from Chirurgery. The whole stress of the Business relies on these two chief Intentions, that the pestiferous Venom be by all means expelled from within, outward; and than that the Return of it, being expulsed, be with an equal Diligence prevented. It is not an easy thing for us, in the Plague, to give Examples and Histories of Persons diseased, with exact Diaries of Symptoms; for these kinds of Sicknesses do not happen every Year, nor when they are rise is it free for every Physician, who minds his own Health, to visit the Sick with a curious Eye, or to stay long with them, that he may diligently observe every Accident, and carefully weigh the Reasons of them; which Task, nevertheless, the Famous Diemerbroch has so accurately performed, that since him, others may lawfully surcease from this Work. When heretofore in this City, viz. Anno 1645. a Plague (though not exceeding great) was rise, Mr. Henry Sayer, a Physician very learned, and fortunate in Practice, boldly went to visit all sorts of sick Persons, both poor and rich, many others refusing this Undertaking: he daily gave them Medicines, touching Buboes and virulent Ulcers with his own Hand; and so by a dliligent, though dangerous, means, cured many of the Diseased. To fortify himself against the Contagion, before he went to infected Houses, he only was wont to drink a good Draught of Generous Wine, and after he had gone his Circuit, to repeat the same Antidote. After that he had taken Care a long time of the Sick in this City, without receiving any Injury, as though he were Plague-free, he was sent for to Wallingford Castle, where this Contagion violently raged, as ā second Aesculapius, to the Governor of that place; and there, in a short space, having dared to lie in the same Bed with a certain Officer seized with the Plague, whose Society he very much delighted in, he took the Infection of the same Disease: nor could then those Arts prove of Use to their Master, which had been beneficial to all others, not without a mighty loss in the Art of Physic, did he perish by that Disease. To others seized with the Pestilence, he was wont to order this method of Cure; If he was called before Pushes or Buboes appeared outwardly, for the most part he gave Vomitories, the Praescripts of which were of the Infusion of Crocus Metallorum, sometimes with white Vitriol, and sometimes with Roman; the Vomiting being over, he caused them to be cast into a Sweat, by giving presently Diaphoreticks; and afterward, some Intervals being allowed for the restoring of the Strength, he ordered the Sweeting to be continued even to the Declination of the Disease: but if he was called to Persons affected after the Tokens appeared, Vomiting being omitted, he insisted only on Sudorificks. CHAP. XIII. Of pestilential and malignant Fevers in Specie, and other Epidemic Fevers. AFter having explicated the Nature of the Plague, according to the Order of our Tract, we ought to proceed to those Affects which seem nearest to carry its Nature; as are chief the Fevers called Pestilential and Malignant: for it is vulgarly known, that Fevers sometimes reign among the People, which for the Vehemency of Symptoms, the mighty Slaughter among the Diseased, and the force of the Contagion, scarce yield to the Pestilence; though because they imitate the Types of Putrids, nor do not so certainly kill the Affected, or infect others, as the Plague, they do not deserve the name of Plague, but in a milder Appellation, of a Pestilential Fever. Besides these, there are Fevers of another kind, whose Destruction and Contagion are more remiss; yet because they are more dangerous than Putrids, and contain somewhat of Divine in them, as Hypocrates calls it, they are called, in a lower Expression than the others, Malignant Fevers. These Fevers differ doth from the Plague, and from each other, according to the Degrees and Vehemency of the Contagion and Destruction; so that the Plague is a Disease contagious, and destructive to Mankind in the highest Degree: A Pestilential Fever is that which generally reigns with a less Diffusion of its Miasm, and with a less Mortality: when an Infection is only suspected, and only a treacherous or unsafe Crisis happens, above the Events of vulgar Fevers, it is said to be a Malignant Fever: They may be described yet more fully, thus: When a Fever vulgarly reighs, which for the variety of Symptoms carries the Nature of a Putrid so called, viz. which has a Thirst, Burning, Lassitude, restless Pain, a Roughness of the Tongue, Watch, a Frenzy, Vomiting, loss of Appetite, Fainting, Swooning, a Cardialgia, and the concourse of other terrible Accidents joined with it; if moreover, there be added to it Spots either like small Fleabites, or broad and black and blue like the Impressions of Stripes; we esteem this Disease of an ill Nature: again, if it does not discover itself after the wont way of Fevers, but the Strength of the Sick falls without a manifest Cause, and Death often happens on a sudden, and unsuspected, contrary to the Prognostic of the Physician, there grows still a greater suspicion of Malignity: but if most of the Sick dye, and those that converse with the Diseased take the Infection of the same Disease, so that oftentimes the same runs through whole Parishes and Cities, it is called, above the Appellation of a Malignant, a Pestilential Fever; of which, a farther Proof is made if it generally rages in most with some common Symptom, as with a Quinsey, a Dysentery, or if a mortal Sweat, such as heretofore was famously known in England, accompanies these kinds of Fevers. But if a Fever arises, which affects many together living in the same Region for the most part after the same manner, which nevertheless in its Course observes the laws of a vulgar Putrid, and comes to a Crisis almost after the same manner, (but that in some, troubled with a mighty Cacochymia, it discovers certain signs of Malignity by an appearance of Spots or Buboes, sometimes by a mortal Crisis, and a Contagion spreading to others) this is not called a petilent, but only a Malignant Fever. If it be enquired in which Classis of the Fevers above treated off, Pestilent and Malignant Fevers are placed, we put them only in the Rank of Continual Fevers, and exempt Intermittents from them, because by Intervals these grant such firm Truces to Nature, and likewise observe regularly and exactly their Periods, which will not consist with a venomous Diathesis: we exempt also Hectics from Malignity, because otherwise they would not protract Death so long, but, partaking of Venom, would kill sooner. Of Continual Fevers, though we do not look upon Simple Sinochi, as free, yet we assert them to be seldom touched with this Taint; but most commonly, the Fever which gives marks of a pestilent Nature or Malignity, is such as imitates the Type of that we call a Putrid Fever: for since in these Fevers, besides the Phoenomena of a Virulency, we observe a continued Effervescence of the Blood, which, as in Putrids, passes through the Stages of a Beginning, Increase, Height, and Declination, we justly conclude, that the sulphureous part of the Blood here, is heated, and kindled, and by its burning brings the Fever: wherefore, in these kinds of Fevers two things are chief to be noted, to wit, the Effervescence of the Blood, and a Malignity joined with it, of which sometimes this, sometimes that, excels, and in both there is a great Latitude, and there are many Degrees of Intention, according as the Fever becomes more or less acute, or malignant. The Effervescence happens after the same manner, as it is said before of putrid Fevers, to wit, the sulphureous part of the Blood, growing hot above measure, by its fervour, takes to a Flame, as it were; whilst it burns it heaps together a vast Store of adust Matter in the Blood; on the subduing and exclusion of which, after the wont manner of Fevers, the height and Crisis depend but besides, the Blood being infected with a certain venomous Miasm, gins, in burning, by reason of the malignant Ferment, to be coagulated, and to putrify by Parts: wherefore, besides the usual Symptoms of a vulgar Fever, by Reason of certain Portions of the Blood being congealed, or mortified, a Fainting and Dejection of the Spirits, also Appearances of Spots and Marks ensue. Moreover, the Venomous Effluvia, which part from the Diseased, by the force of the Contagion, are able to stir up the like Affect in others: wherefore, by reason of the Destruction and Contagion, and the various Degrees of the same, it is called a Pestilential or Malignant Fever. When the Blood, boiling over vehemently, is infected also with a malignant and venomous Ferment, not only Coagulations of its own Mass, with a Disposition to a Putrefaction are caused, but the nervous Liquor also readily contracts this Taint; whence being rendered disproportionate to the Brain, and for the oeconomy of the animal Spirits, it stirs up great Irregularities in them: wherefore, not only Spots and Pushes, but oftentimes a Delirium, Frenzy, drowsy Affects, Tremble of the Limbs, Cramps, and convulsive Motions, happen upon these Fevers. We often observe, that in certain Years malignant Fevers are rife, which without an appearance of Marks, show their Virulency chief about the Genus Nervosum; for in some, presently from the Beginning, a Sleepiness, with a mighty Drowsiness of the Head, in others obstinate Watch, a Disturbance of Mind, with a Trembling, and convulsive Motions: but in most, either no Crisis, or a deceitful one; and instead of it, a Translation of the sebrile matter to the Brain has followed. It has been farther observed, that these Fevers have passed by Contagion into others, and that many have died of them; so that they deserve to be called Malignant. Now these kinds of Fevers sometimes are first begun by a venomous Miasm; and the Blood being blasted with the Particles of the Poison, naturally falls into an over-vehement boiling, and is inflamed; as when any one, by a Contagion, or by breathing a malignant Air, falls into a malignant Fever, without an evident Cause, or Praedisposition: and sometimes a feverish Distemper arises from its own cause; and afterward the Seeds of the Malignity, either lying hid within the Body, exert themselves in the Blood boiling over vehemently, or come from elsewhere from a contaminated Air, as a Fuel to a Flame first kindled: for it is manifest by frequent Observation, that during the time an Epidemic Fever reigns, others, after what manner soever they arise, pass into it. Malignant Fevers, as also Pestilential, for the most part are Popular, and seize many together; but sometimes they are peculiar and sporadical, that haply they seize only one or two in a whole Country. In such a case we may imagine, that they proceed, not from an Infected Air, or Epidemic Cause, but from a morbid Disposition of the Body; for I have often observed, that when, Spring or Fall, a pretty common Fever has reigned in some City, or Village, of which a great many Sick escaped; haply some one, on whom an evil Praedisposition, and a strong evident Cause, brought the Fever, lay seized with more dreadful Symytoms, and great Notes of Malignity: in which Case, that Malignity is not to be said a common Fever, but only a sporadical and accidental one. Tho the greatest Difference whereby these kinds of Fevers are distinguished betwixt themselves, and from others, consists in their Mortality and Contagion; yet sometimes they are marked by some peculiar Symptom, from which both the note of Malignity, and the name they are called by, are taken for that time: hence in some Years an epidemic Fever reighs, which causes in most that are affected with it, a Quinsey, at another time a Peripneumonia, Pleurisy, Dysentery, or some other Affect, and that often dangerous and contagious: so that not only the Seeds of Diseases derived from Parents ex traduce, disclose their Fruits, by a certain Destiny, as it were, in the same Part or Member; but also such as are received from a venomous Miasm generally reigning, produce in all Persons Affects of the same manner and form: which nevertheless I judge to happen, not because the Seeds of the venomous Miasm regard this or that Region of the Body by some peculiar Virtue: but they affect thus the Mass of Blood after the same manner in all, forasmuch as, for washing off that taint, a Crisis must of necessity be attempted after the same manner in all; for when without Malignity, the Blood is apt to be extravasated by reason of Coagulation, or haply for other Causes, the usual Places in which the Portions of the same extravagated are wont to be fixed, are, the Throat, Pleura, Lungs, and Intestines: wherefore it's no Wonder when a Congelation, and therefore an Extravasation of the Blood is procured from a malignant Cause, if the Disease lodges itself in the usual seat of Nature. As to the Signs of these kinds of Fevers, besides by the Contagion and Mortality, the Malignity of the Fever is shown by a sudden Dejection of the Strength, a weak and uneven Pulse, an evil Affect of the Brain and nervous Parts caused on a sudden, violent Vomitings, a blackness of the Tongue, an over-spreding of Blackness over the whole Body, but especially by an appearance of Spots, Buboes, and other Marks. For the Cure of Fevers, both Pestilential and Malignant, there is need of a greater Judgement and Circumspection than in any others whatsoever; for there being two primary Indicants, to wit, the Malignity and the Feverish Distemperature, and since we can scarce provide for the one without the Detriment of the other, it will not be easy to judge which we must obviate first, and chief take care off: in respect of the Fever, Purging, Bleeding, and cooling things, chief conduce; but whilst these things are used, the Malignity, for the most part, is increased, and they being neglected, it diffuses itself farther. Against the Malignity, Alexipharmicks, and Diaphoreticks are required; but these greatly intent the Fever, exagitate, as by a blowing of Bellows, the Blood and Spirits kindled before, and put them in a manner all in a Flame: wherefore there is need here of a great Quickness of Understanding, that these things be duly compared betwixt each other, and that the curative Intentions be there directed where most danger shows itself; though so, that while one is taken care of the other be not neglected: but in these Cases, besides the private Judgement of each Physician, Experience furnishes us with the chief method of healing; for, when these Fevers first grow rise, almost every particular Person tries particular Remedies; and from their Successes compared together, it is easily learned, what kind of Method we must insist on, till at last, by a frequent Trial, as it were by the Footsteps of Passengers, a common, and Roadway as it were is made to the Cure of these kinds of Affects, being fortified with various Observations and Precepts. Besides these kinds of Fevers, which assail many together, and by reason of their Contagion, Mortality, and conspicuous Marks of Virulency, deserve to be called Pestilential, or Malignant; there are found some other Epidemic or Popular Fevers, which almost every Year, either Spring or Fall, grow very rise in certain Countries, of which a great many of the Inhabitants are wont to fall sick, and not a few, especially of the more elderly People, to die: in which, nevertheless, no Signs of a pestilent or malignant Nature appear; nor does the Disease seem so much by Contagion to pass from some incontinently to others, as to seize many together by reason of a Predisposition communicated almost to all. Now these kinds of Affects depend chief on a foregoing Constitution of the Year; for if a Season very intemperate, by reason of excesses of Cold or Heat, Drought or Moisture, has preceded, and has so continued a long time, it changes our Blood, for the most part, from its due Temper, whereby it is apt afterward to fall into severish Effervescencies; and hence a Fever, sometimes of this, sometimes of that Type and Idea, is produced, which presently becomes epidemical, because it draws its Origine from a common Cause, whereby the Bodies, in a manner, of all Men, are affected together. Now such Fevers, in as much as they depend on the Blood, getting a Disposition, sometimes sharp, sometimes austere, or of another kind, according to the Temper of the Year, for the most part they are of the number of Intermittents, though they are wont to be marked with a peculiar Apparatus of Symptoms, according to the peculiar Constitution of each Year. We cannot comprehend these under a certain common Rule, or formal Consideration, which aptly answers to each of the Particulars of this Nature, because they vary yearly according to a great many Accidents: though however, of these kinds of Fevers reigning of late Years in this Country, we shall give the Descriptions taken at that time; and shall set them down as a Conclusion at the end of this Work. It remains for us still to add to the number of Malignant Fevers, certain other private Fevers, partaking of no Contagion, as are those especially, which are wont to happen to Women in Childbed, by reason of their difficult Labour, or for that the Lochia are detained; for it is manifest enough, by common Observation, that these are very dangerous, and often mortal: for if the Parts of the Womb being injured, or upon the admission of Cold, or haply for some other Cause, the Lochia are stopped, and the Humour which ought to have been voided forth, comes to be mingled with the Mass of Blood, it foully defiles it with a certain venomous mixture, as it were, that thereby presently a Fever is raised, which for the most part is attended with an ill Company of Symptoms, viz. a Heat, and violent Drought, a Vomiting, a Cardialgia, and Watch, and generally comes either to no Crisis, or a very difficult one; because, unless the flowing of the Lochia after their wont way be again restored, after the Blood has undergone an Effervescence for some Days, the Taint is wont to be communicated to the Brain, and the Genus Nervosum; whence presently a Delirium, Frenzy, Convulsions, and other very ill Affects for the most part are caused, which often terminate in Death. But these kinds of Fevers deserve a peculiar Consideration; which we resolve to have more fully beneath, in a Discourse appropriated to this purpose: mean while we must give some Instances or Examples of the Fevers above treated of, viz. of the Pestilential and Malignant. The pestilential Fever, of late Years, has reigned more rarely in these Parts, than the Plague itself. I shall give you briefly the Description of the only one of this kind which has occurred to our Observation. Anno 1643. when in the beginning of the Spring the Earl of Essex besieged Reading, kept by the King's Garrison, in both Armies a very Epidemic Disease began to arise; though however, he pursuing his work till the Besieged were forced to a Surrender, The Affect so prevailed, that in a short while afterward there was a Cessation on both sides, and thenceforward, for many Months, there was a Conflict, not with the Enemy, but with the Disease. Essex withdrawing his Forces, seated himself at—, and the adjacent Places, where, in a short time, he lost a great Part of his Men: and the King returned to Oxford; where the Soldiers first keeping themselves in the open Field, and afterward being disposed off in Towns and Villages, he underwent a loss not much inferior; for his Foot (whom it chief seized) being lodged a great many of them together in straightened Lodgings, when they had filled all Places with Nastiness and Filth, and stinking Odours (that they seemed to have defiled even the Air itself,) fell sick many of them together, and as it were in Files: at length the Fever, reaching farther than the Soldiery, assailed every where the weak Multitude, to wit, the Persons of the Houses where the Soldiers lodged, and others, though many of them at first (the Contagion being yet but mild upon them) escaped, yet lying a long time in a very languishing Condition. About the Summer Solstice, this Fever began to psread itself with a worse Attendance of Symptoms, and to seize a great many Husbandmen, and others living in the Country: and afterward it reigned in this our City, and the whole Neighbourhood, for at least ten Miles round about; mean while, those who lived in other Countries far from hence, as though they were beyond the Sphere of the Contagion, continued free from harm. But here that Disease grew so general, that the greatest part of Mankind was infected with it: whatsoever House it entered, presently it set upon the whole, that there were scarce enough remaining in Health to attend those that were ill; such as came to them from elsewhere, or Hirelings called to attend the Diseased, were presently seized with the same Infection: that at length, for fear of the Contagion, such as lay sick of this Fever, were shunned by those that were in Health, in a manner, as Persons troubled with the Plague. Nor did a small Mortality or Destruction of Mankind attend this Disease; for a great many old Men, Cachectical, Ptysical, or otherwise unhealthy Persons, fell under this Fate: also not a few Children, Youths, and such as were full grown. I remember, that in certain Villages, all the elderly People, in a manner, were carried off this Year, that there scarce remained alive any for unpholding the Customs and Privileges of the Parish, by the Traditions rcceived from their Ancestors. When this Fever first began it carried somewhat the Type of a putrid Synochus, but it came with difficalty to a Crisis, and when it seemed to be solved by a Swear, or a Looseness, it was wont presently to wax worse again: but for the most part after a Deflagration of the Blood, continued for six or seven days, this remitting, and instead of a Crisis, the adust Matter being conveyed to the Brain, the Diseased lying a long time, sometimes raving mad, oftener with a Drowsiness and a great Weakness, and sometimes with convulsive Motions, scarce escaped at length with Life. About the middle of the Summer, beside the Contagion, and the frequent Mortality, this Disease discovered its malignant and pestilential Force, by open Signs, viz. by the Eruption of Pushes and Spots; for about this time, without any great burning of a Fever, the Pulse in many grew uneven, weak, and very disorderly; also, without a manifest spending of the Spirits, the Strength presently became languid, and very much dejected; in others, lying ill after the like manner, Pimples sometimes small and red, sometimes large and livid, appeared; in many, Buboes (as in the Plgave) about the glandulous Parts; some of these, without any great Conflict of the Spirits, or feverish Excandescence raised in the Blood, died without noise and on a sudden: mean while, others, growing presently raving mad, as long as they continued in Life, underwent horrible Distractions of the Animal Spirits. Such as escaped from this Disease, recovered not but after a long time, and that without a laudable Crisis (unless by a Sweat procured by Art) the Brain at length, and the Genus Nervosum being affected, and they being seized with a Dullness of the Senses, Tremble, a Vertigo, a Weakness of the Members, and-convulsive motions. During the Dog-days this Disease still infesting, began to be handled not as a Fever, but as a milder sort of Plague, and to be overcome only by Alexipharmick Remedies; Bleeding was always thought fatal to it: Vomitories and Purges were used now and then, though not so frequently; but the chiefest method of Cure was placed in Alexipharmicks, and a Sweant seasonably procured. For this purpose, besides the Prescripts of Physicians taken from Apothecary's Shops, certain Empirical Remedies deserved no small Praise: then first in this Country, the Countess of Kent 's Powder began to be of great Fame; and another ash-coloured Powder was not of the least note, which a certain Courtier, coming by chance to this City, gave to many with good Success, and sold it others, who approved of its use, at a great rate. The Diseased were wont, upon drinking half a Dram of this in any Liquor, to fall into a most copious Sweat, and so to be freed from the Virulency of the Disease: that Diaphortick (the Preparation whereof I learned afterward from the Author's Sister's Son) was only the Powder of Toads, cleansed with Salt, and afterward washed with good Wine, and lightly calcined in an earthen Pot. Autumn coming on, this Disease remitted by Degrees of its wont Fierceness, that fewer fell sick, and a great many of them recovered; till upon the access of Winter, a state of Health was again entirely settled in this City, and in the adjacent Country. Let us here consider the Rise, Progress, and lastly, the End of this Fever, which at first was only belonging to the Army, and at length became pestilential and epidemic: that the Disease first began in the Soldier's Camp, it seems that it ought not only to be imputed to their Nastiness and stinking Smells, but in some measure, to the common Fault of the Air; for, since these Fevers do not happen yearly, their Origine will be somewhat ascribed to the peculiar Constitution of the Year: for a light Distemperature of the Air being thereby contracted, though it does not ill affect such as use a wholesome way of living, yet in an Atmy, where, to the general Procatarxis, evident Causes, viz. a great many Errors in the six non-natural things, are joined, those kinds of Sicknesses must of necessity be more easily raised. Now the Vernal Constitution of this Year was very moist, being almost continually attended with wet Showers; to which afterward a hot Summer succeeding, both rendered still more depraved the Miasms of the feverish Contagion reigning here before, and more disposed all Bodies to receive them: wherefore, that this Distemper became in a manner peculiar to this Country, and epidemic at this time, it was long of its Seminary, arising in the first place from the Army lying round about: but in as much as becoming afterward pestilential and very epidemic, it infected the greatest part of Mankind here living, and killed not a few; the cause was, the ill Affect of the Air, which being unwholesome through the Distemperature of the year, became moreover so vicious at length, by the continual breathing forth of stinking Vapours from the Soldier's Camps, and the Cohabitation of the Diseased, that the Miasms of this Fever, dispersed in it, were greatly exalted, and rise almost to the Virulency of a Pestilence. Diemerbrochius relates, That from such a kind of Camp-Fever, raised in the Summer, in the Town of Aquitane, afterward another malignant and pestilential, and at length the Plague itself grew: and that this our Fever at last stood in competition with the Plague itself, besides the great force of the Contagion, and the great Mortality, the very ill Affects of the Blood and nervous Liquor, presently caused in all from the same, did declare; for the Strength dejected on a sudden, the weak, intermittent, and formication Pulse, the Eruption of Pushes and Buboes, argued the Coagulation, and corruptive Disposition of the Blood. Moreover, a Delirium, Mania, Frenzy, Deadness, Sleepyness, Vertigo, Tremble, convulsive Motions, and other Affects of the Head of divers kinds, showed a mighty Annoyance of the Head and Genus Nervosum. For setting forth the Type, or Idea of the Malignant Fever to the Life, there are a great many Observations or Stories of Sick Persons ready at hand: Of many Examples of this Disease, I shall here insert only a few, which some years since happened in the House of a Venerable Person, after a manner to be lamented, and not without some Admiration. About the Winter Solstice, Anno 1655. a Boy about seven years of Age, being ill without a manifest cause, was affected with a great Pain in his Head, a Sleepyness, and a mighty Heaviness; there was withal a Fever, though not intense, with an indifferent Burning, which nevertheless, by unconstant Fits, had its time of being intended sometimes once, sometimes twice within the space of twenty four Hours. Presently, from the Beginning of the Disease, he slept almost continually, he was wont also to cry out in his Sleep, to talk idly, and oftentimes to leap out of Bed; being stirred up, and sometimes awaking of his own accord, he was straightway present to himself, and always desired Drink: his Urine was ruddy, and filled with Contents; the Pulse was uneven, and strong enough; the Contractions of the Tendons in the Wrists were light: in the Neck, and other Parts of the Body, certain red Spots, like Fleabites, appeared. On the first days, a gentle Purge was ordered, and a frequent easing of the Belly by the use of Clysters: Cordial Juleps with Alexipharmicks were daily taken: Vesicatories were applied to the Neck, and other Plasters to the Soles of the Feet. On the sixth day, a little Blood dropped from the Nose. On the seventh the Fever very much remitted without a manifest Crisis, the Heat, being only mild, was perceivable by the Touch, and the Urine was pale and thin, without any Sediment; nevertheless, a Sleepyness, and Heaviness of the Head pressed far more severely, so that the Urine, and Excrements of the Belly, flowed from him insensibly: however, being called upon by Name, he knew the Standards by, and answered to things asked. Those Affects, notwithstanding Remedies, daily grew worse and worse. About the fourteenth Day the Diseased became so stupid, that he could neither understand, nor speak, yet he still swallowed down things put into his Mouth, though unminded by him, and his Pulse was laudable enough: about this time he had a Looseness, naturally happening to him, for four Days; which at length ceasing, a whitish and chalky Crust, as it were, began to cover the whole Cavity of his Mouth and Throat, which being cleansed off often in a Day, presently a new one arose. When he had been troubled after this manner for four Days, he was better as to his Understanding and Sensation; so that he could know Friends, give a Nod to what was said, and do some things he was ordered: but as the sensitive Faculty began to be restored, so the Evil increased as to the Organs of the Speech, and Swallowing: doubtless the Matter being fallen from the Brain into the Beginnings and Ductus' of the Nerves. The Heaviness and Stupidity were followed by a Palsy in the Tongue and Throat; which Affect grew so much in a short space, that afterward the Diseased was not able to swallow at all, but things put into his Mouth presently came forth again, nor did any thing descend into his Stomach; when, besides the Violence of the Disease, there was danger, lest he should die through Hunger, an Instrument was made of a flexible Whale-bone, and a Lawn Button fixed to the end of it; and this being thrust into the Throat, opened for a time its Closure, that a Passage was made for Food given; after the use of this a Day or two he could swallow again, and afterward take in Food enough; and within a few days he began to speak, to discern every thing, and growing wonderfully hungry, to desire all day long Food of all kinds, and most greedily to devour all things given him: mean while, through his long-continued Sickness, and the nervous Parts being sorely injured, he grew so lean, that at length the Skin scarce sticking to the Bones, he exactly resembled a living Skeleton; though afterward by the diligent, indefatigable, and prudent Care of his Mother, as to his Diet, he recovered a perfect Health, and continues still well. At the Time that this Boy was about the height of his Sickness, his Brother, about two years elder, fell sick almost after the same manner, on the first day of January. First, he was affected with a Dullness, and a heaviness of the Head. On the third day growing feverish, he had a Sleepiness and Stupidity: he began in his Sleep to talk lightheaded, and upon his Awake, scarce to be present to himself. After four or five Days these Symptoms increased; he could understand little, nor speak without tripping of his Tongue, and scarce arciculately: his Urine was thick, and opake, without an Hypostasis, or subsiding of the Contents: red and small Spots like Fleabites appeared, as in his Brother: the Excrements, as well of the Belly as of the Bladder, passed from him insensibly; but the Pulse held still strong and even: the Hypochondres were extended, and blown up with a Swelling of the Abdomen. About the eighth day a little Blood dropped from his Nose: On the eleventh day of the Sickness he fell into a Looseness, whereby he had seven Stools, of a bilous, thin, and very stinking matter, within five Hours; whence there was some hope, that the Condition of the Diseased would change for the better; though the next day after, the Looseness ceasing, a Pain, and Gripes, violently tormented him in his Belly, that crying and howling, he complained most sorely Day and Night: the Hypochondres and Abdomen were swollen, and very much distended like a Drum. Not receiving any thing of ease by any Remedies tried by the most exquisite Endeavours of many Physicians, he died on the fourteenth day, convulst in these Tortures. A little after the Death of this, viz. on the 15th. of January, his Eldest Brother, about eleven years of Age, a very hopeful Lad, began to be feverish, being affected with a Dullness, and a Heaviness of the Head, as the former, though less intense: but in his Blood, which was of a hot Temperament, a greater Effervescence and trouble appeared, that on the first six days, besides a Heat and Thirst, he was molested with a continual Effort of Excretion, sometimes by Sweat, sometimes by a Looseness; his Urine was ruddy and troubled; certain red Spots, as in the others, broke forth. On the seventh day an haemorrhagy happened to five ounces, which ceasing, a mighty Dullness followed, that for all that day, and the following Night, he was scarce able to open his Eyes. On the eighth day a very copious haemorrhagy of the Nostrils happened again, that there was danger of pouring forth his Soul together with the Blood; the Blood sprang forth so copiously from the left-Nostril, that, being received into a Basin, it made vast Bubbles by its fall: when he had lost above two Pounds of Blood, and being all in a cold Sweat, began to lose his Strength; Remedies being at length applied, the Flux was stopped with great difficulty; the haemorrhagy being appeased, the Lad slept a sound Sleep, and became sleepy all that Night; though often waking, he was present enough to himself, and had a quick Sense and Understanding: being asked concerning his Health, he said he was pretty well; the Urine which before was ruddy, and troubled, appeared then pale, thin, and with a laudable Hypostasis, that the Diseased (especially because free from Thirst and an immoderate Heat) seemed to be come to a perfect Crisis, and free from the Fever. The Morning following, the ninth day of the Fever, he continued still dull; but being stirred up, he seemed without a Distemperature, and to be cheerful in a state of Convalescence, only that he began a little to falter in his Speech: in the Evening, when things were not suspected, the Fever being kindled again, he fell on a sudden into a Lethargy, that he was scarce able to be awaked from his Sleep, and being pulled up, hardly to know any one, or to speak articulately: Tho so great a loss of Blood had preceded, his Pulse was again quick, high, and strong, and his Urine was ruddy; after deriving and revulsing Remedies used all that Night, this noble Youth seemed somewhat in a better state; so that the next Morning he kept himself longer from Sleep, began to turn his Eyes this way and that, and to raise himself a little, though without Speech, or Knowledge of the Standards by; before Noon, his Eyes being closed again, he wholly lost the use of every Animal Faculty, and lay, as it were, Apoplectical for three Days, with a high and vehement Pulse, a Palpitation of the Heart, and a short and broken Respiration: the Pulse at length growing less by degrees, he died on the tenth day of the Fever. On the 18th. of February, his little Sister, having a feverish Distemperature and a Thirst, began to complain of a Pain, and Gripes in the Belly, a trembling in the Hands, and a painful Tension in the Muscles of the Neck. On the last day of February, being more openly feverish, she was not able to keep out of Bed; moreover, she was affected with a running Heat, sometimes in the Hands, sometimes about the lower Parts; she became also drowsy and sleepy; awaking from her Sleep she did not forthwith come to herself. On the first of March she was gently Purged with an Expression of Rhubarb, which gave her ease; the Urine was thick and ruddy, also red Spots like Fleabites (as in the rest) were plain to be seen. We gave her afterward frequently for four days, to wit, every six hours, Ten Drops of Spirit of Hartshorn, in a Spoonful of a Cordial Julep: the foresaid Symptoms afterward remitted by degrees, and this sick Person recovered her Health, though slowly, without a manifest Crisis. About the same time a Brother of these, the youngest of all, fell sick almost after the same manner; who nevertheless, through a Looseness naturally happening, voiding bilous and green Excrements for many days, more easily recovered. Also in the same Family, a great many other Domestics, and some Strangers, who came there as Attendants, fell ill of the same Disease, the Taint, as it were being propagated by Contagion: all of which, notwithstanding, escaped at length with a difficult and long Convalescence, without any Crisis regularly made. That this Fever was malignant, it seems to be manifest, from the Contagion, Mortality, the appearance of Spots like Fleabites, and many other Tokens; though that infecting Miasm, whereby it passed from one to another, was torpid and less efficacious: for betwixt the Sicknesses of each, many Days, and often Weeks, interceded, that the Infection of this Disease, though acute, and its Propagation in many, were scarce ended within four months' space in the same House: the Fever about the first Beginnings seemed mild and gentle, not very terrible by its Burning: but the Matter heaped together after the Deflagration of the Blood, presently became masterless, and difficult to be exterminated, also offensive to the Brain and Genus Nervosum; wherefore in each, the Beginnings of the Disease were known rather by a Drowsiness and a Sleepyness, than by a Sweat and Burning: also the Crisis, though attempted various ways, to wit, by a Sweat, a Looseness, and an haemorrhagy, did not succced well; but for the most part, the Blood growing turgid by a critical Motion, was forced to transfer the febrile Matter from its own Precincts into the mansion Places of the Animal Spirits; nor did itself, notwithstanding, become purified after this manner; but about the height of the Fever, both Humours (to wit, the Blood and the nervous Juice) being vitiated together, and sorely blasted with an impure Mixture, made the Event of the Disease either fatal, or very dangerous. CHAP. XIV. Of the Smallpox and Measles. IN the rank of pestilential and malignant Fevers we place next the Small Pox and the Measles, which in Truth are mixed Affects, both according to, and against our Nature: As to their Origine, they have a seminary Connate to us; but as to the Affects, they produce preternatural Symptoms, and venomous, as the Plague itself; so that they constitute a certain peculiar sort of Fevers, which belong to all Mankind, and only to them, and that but once. If haply any one lives free from them all his Life, or some one falls often into those Affects, these are rare, and unusual Events of Nature, which do not derogate to common Observation: but it may pass for a Truth, that all, and only Mankind are obnoxious to the Measles and Small Pox, and that they are usually freed of them at one Bout. We shall speak of the Measles by themselves. 1. As to the Small Pox; The natural Praedisposition which inclines Mankind to it seems to be a certain Taint, or Impurity of the Blood, conceived in the Womb with the first Rudiments of the Foetus. All Authors, in a manner, will have this ascribed to the menstruous Blood: which Opinion does not seem altogether improbable; because in the Womb of a Woman (otherwise than in most other Animals) a certain Ferment is engendered, which being communicated to the Mass of Blood, gives it a Vigour and Pneumatosis, and afterward procures, at set Periods of Times, a Turgescency, and an Excretion of the superfluous Blood; and at the time of Conception, when the Menses wholly cease, a great deal of this Ferment is communicated to the Foetus; and its Particles, being heterogeneous to all the rest whatsoever, are disorderly confounded with the Mass of Blood and Humours, as some extraneous thing; in which being involved, and being separated from each other, they lie hid a long time; though afterward at some time being stirred by an evident cause, they ferment with the Blood, and cause in it an Ebullition, and afterward a Coagulation; from which most of the Symptoms of this Disease arise. 2. The Evident Cause which stirs these Fermentative Seeds, and oftentimes brings them into Act, is said to be threefold; viz. Contagion received from elsewhere, the Disposition of the Air, and an immoderate Perturbation of the Blood and Humours: Persons related soon infect each other; also those that are fearful, and mightily dread this Disease, fall more readily into it: for, by Fear the Particles of the Miasm are conveyed from the Surface of the Body inward: at the time that the Contagion is rife, and the Small Pox is Epidemic, all other Diseases in a manner degenerate into this. 3. As to the Conjunct Cause of this Disease, to wit, what is the formal Reason of it, or its way of coming to pass, the thing seems a little more intricate: It is vulgarly wont to be compared to the Effervescence of new Wine, or of Ale, when they are depurated in a Vessel, being put in a Fermentation by the mixture of some heterogeneous Substance; but if the thing be narrowly considered, a great difference will here appear: for, the Miasm of the Small Pox is as a Ferment, but corruptive, and forces the Flood to ferment, not towards a Perfection, but a Depravation; for when the venomous Particles of this Miasm light on a capable Subject, they presently stir up Corpuscles like themselves, and innate to us; with which being joined, they pervade the whole Mass of Blood, and make it grow mighty turgid, and boil, and after some Effervescence, to separate into Parts, and to be coagulated: to wit, the dispersed Seeds of the Venom dissolve the Mixture of the Blood, presently subvert the more pure Spirits, and afterward gather to themselves the more gross Particles of it, and congeal them, as it were, by their Adhaesion. The Portions so coagulated, together with the Seeds of the Venom mingled with them, being left by the rest of the Blood in its Circulation in the Extremities of the Vessels, are fixed on the Skin: after which manner, if Nature being strong enough, sends off the whole Venom with the congealed Blood, the rest of the Mass of the Blood, though depauperated, is nevertheless good, and capable of continuing Life; but, if the Blood being too much coagulated, cannot be cleansed after this manner; or if the Portions of the Blood closing with the Venom, do not fully break forth, they either restagnate inward again, and wholly corrupt the Liquor of the Blood, or fixing themselves on the Viscera, and especially the Heart, they destroy their Crasis and Strength. The Portions of the Blood congealed with the Venom, about the fourth day (sometimes sooner, sometimes later) begin to break forth; for the Coagulation is caused not presently, but after some time that the Venom displays itself, and by its Effervescence ferments the Blood: first light Portions of the Blood being defil'd, and those but few in number, are fixed in the Skin like Fleabites; soon after these, more appear, and those which broke forth first, by the access of new matter, and by the continual Appulse of the congealed Blood, grow bigger, and are raised into a Tumour; afterward these Pushes, which at first are red, being increased by degrees, at length turn white, to wit, the Blood extravasated with the Venom, by reason of the Heat and Stagnation, is changed into a Pus. About the seventh day after the Eruption, the white tumors turn to a dry Scab; for the more subtle Part of the Matter being evaporated, the rest grows hard, which at length, the Scarf Skin being eaten off and broken, falls from the Skin. When the Miasm of the Small Pox is once gotten into the Spirits and Mass of Blood, it is very seldom that it can be destroyed or cleared off by Medicines or Bleeding, but the latent Disposition will break forth into Act; wherefore, first it diffuses itself gently, and inspires the Mass of Blood, as it were, with a Ferment: hence an Ebullition and Effervescence are produced in the whole Body, the Vessels are extended, the Viscera are irritated, the Membranes are twitched, till the Seeds of the Contagion, by fusing and coagulating the Blood, at length being involved in its congealed Portions, are thrust forth. The Essence of this Disease will be the better known, if I set down the Signs and and Symptoms which are observed in the whole Course of it, and give you in order the Reasons of them, and the Causes on which they depend. Now these are either such as indicate the Disease present, or such as fore-shew the height of it, and its event. As to the Diagnostic of this Affect, whereby it may be known whether any one, at first falling sick, will have the Small Pox or not. There must be considered at that time, the force of the Contagion, and the Concourse of the Symptoms first appearing; for, if by reason of the malignant Constitution of the Air, this Disease generally reigns, no one is then seized with a Fever without a suspicion of the Small Pox, especially if the Person never had it before: but if this Disease be more rare, and there be no Fear of Contagion, yet its unexpected Invasion in a short time discovers itself by these kinds of Signs and Symptoms. 1. There is an inconstant Fever, coming at random, sometimes intense, sometimes more remiss, observing no set form of Increase, or coming to a height, so that the Diseased one while are mighty hot, by and by, without an evident Cause, they are without any Fever; the Cause of which is, That the sermentative Seeds are not agitated with an even motion, but like Fire half extinct, one while they have an extraordinary Flash, another while they lie quiet, and die, as it were, till the Burning spreading itself, the Flame breaks forth every where. 2. A Pain in the Head and Loins is so peculiar a sign in this Affect, that it alone, in a continual Fever, signifies an imminent Small Pox; the Cause of which, is vulgarly imputed to the great Vessels being very much extended by the Effervescence of the Blood; though it does not appear why the same Pain should not be as well caused in other Parts by reason of the like Extension of the Vessels, and why those kinds of Pains are rife in the Small Pox, rather than in the Causon, or other Fevers, where the Blood boils more. Again, you may observe, that mighty Pains are pressing, sometimes in the Head, sometimes in the Brains, when, the Blood not being turgid, the Vessels are not enlarged, viz. in the beginning of the Disease, when the Feverish Distemperature is not yet conspicuous: while the Diseased are yet walking abroad, and have a good Stomach, the imminent Small Pox first discovers itself by these Pains; wherefore, it seems that the Cause of these kinds of Pains subsists rather in the Genus Nervosum; to wit, that those Pains arise in the Brain, and spinal Marrow, by reason of the Membranes and Nervous Parts being twitched by the Particles of the Venom; for it is likely that the innate Seeds of the Small Pox are chief stored up in the Spermatick Parts, and that the first Contagion of the Miasm for the most part seizes the Animal Spirits: hence the first Effervescence is raised in the Juice wherewith the Brain and nervous Parts, but especially the spinal Marrow, are irrigated; and thence the taint is communicated to the Mass of Blood: wherefore, in the beginning of this Disease, the Head and Loins are pressed with a violent Pain; afterward, the Venom being conveyed into the Blood, the feverish Effervescence is raised in the whole. 3. A great Irksomeness and Restlessness, and sometimes a Swooning, infested the Diseased, to wit, by reason of the Motion of the Blood being troubled, and its even mixture being begun to be dissolved by the venomous Ferment, the Blood being hence apt to stagnate, and to be letted in its Circulation, causes the Affects even now mentioned. 4. A violent Vomiting, even when the Stomach is free from an impure Mass of Humours, very often accompanies this Affect; the Reason of which is, because the Fermentative seeds being put in motion, are deposed in the little Arteries which open into the Tunicles of the Ventricle, upon each Appulse of the Blood, and raise a Vomiting even as the Particles of Antimony swallowed down: but afterward, assoon as a Sweat being procured, the Venom is driven outward, this Symptom ceases, and the Diseased are well in their Stomach, without any purging forth of offensive matter. 5. To these may be added the Symptoms, which, according to the various Dispositions of Bodies, happen after a various manner, as are, a great Sleepyness, Frights in the Sleep, Deliriums, Tremble, and Convulsions, a Sneezing, Heat, Redness, a sense of pricking in the whole Body, involuntary Weep, a sparkling and itching of the Eyes, a swelling of the Face, a Vehemency of Symptoms from the beginning that the Disease seems presently to have reached its height, etc. 2. As to the Prognostic of this Disease, it is indicated either to be safe, or mortal, or doubtful, by supervenient Signs. 1. Things seem to be in safety when this Affect has benign Circumstances; to wit, when it happens in a good Constitution of the Air, and of the Year, at a time that the Small Pox is not Malignant and Pestilent; also there is less danger if it happens in Childhood, or Infancy, if in a sanguine Temperament, and a good habit of Body, if it chances in a Family to whose Predecessors the Small Pox has not been mortal: moreover, if in the whole Course of the Disease laudable Symptoms happen; if at the first Invasion there be a gentle Fever without a violent Vomiting, a Swooning, a Delirium, or other horri●●●●●●ts; if, about the fourth day, the Fever with the most pressing ●●●●ms are appeased, and then some red Spots begin to appear; 〈◊〉 second day of their coming forth, a great many more of those red Spots are conspicuous, which afterward grow by degrees into Pushes, and are ripened into a Pus; if about the tenth day, more or less, after the Eruption, the white Pushes begin to grow hard, and afterward to fall off by little and little; if after the time of their first breaking forth the Small Pox are soft, separate from each other, few, round, raised at the Top, possessing only the Skin, and not the inward Part, we may presume the case of the Diseased to be in a good State. 2. The Phoenomena, which, in the Small Pox signify the Case to be suspected and full of Danger, are these; if there be a Malignant Constitution of the Air, that this Disease is become pestilent, and many have died of it; if Persons well grown in Years are seized with it, if it chances in a cold and melancholic Temperament, or in a foul and cacochymical Body, where the Blood is neither readily circulated, nor Perspiration duly performed; or if the Hypochondres or Praecordia are obstructed, any Viscera infirm, or affected with an Ulcer; or if the Habit of the Body be too gross, the Small Pox does not happen without great danger of Life: Nor is it less to be feared, when presently at the beginning a mighty Fever, a violent Vomiting, a Swooning, a Dejection of the Strength, a Frenzy, or Delirium, assail Persons, and give not over when the Small Pox are fully broken forth; for these things signify an overgreat Perturbation in the Blood and Humours, as also a Confusion and Contumacy of the mortifying Matter, which can neither be subdued, nor easily separated, or evenly extruded from the Mass of Blood; if there be an Irksomeness, and a great Restlessness, with a disorderly Effervescence, and Ebullition of the Humours; or if a mighty Thirst, and a difficuly of Breathing, also a Looseness, or Dysentery, they show that Transpiration is letted, and that the Malignant Humours restagnate toward the inward Parts. The Small Pox breaking forth slowly, argue the Crudity and Unruliness of the Matter, and the Impotency of Nature: much more, when double and confluent, do they show that there is an excess in quantity, and a Confusion, also a disorderly and irregular Expulsion of that matter, since it is not cast forth at determinate Pores or places of Vent, but indifferently on every side. Small Pox which are hard signify the Incoctibility of the said Matter, and if flat, the weak Expulsion of it, and they are by so much the worse if black Spots appear in the midst of them; or if such Spots as are familiar in a Purple or Pestilential Fever, are mixed with the Small Pox, they show a mighty Malignity and Corruption of the Blood, such indeed, as is found in the Plague. Finally, black, livid, or green Small Pox, threaten ill; because, besides the Coagulations of the Blood, they argue its Mortifications and Corruptions, as in a Gangrene, or pestilent Carbuncle: if when th● 〈◊〉 Pox are come forth, they presently whither, and the swelling of 〈…〉 remits, it indicateth the Recess of the malignant Matter, or of th● 〈◊〉 congealed with the Venom, and its Restagnation toward the Inward Parts; whence unless, upon raising a free Diaphoresis, it be again sent forth, a sudden Death for the most part ensues: for hence the Blood being more coagulated, falls into Corruption, and is apt to be letted in its Motion, and to stagnate in the Heart and Vessels. If after the Eruption of the Small Pox, a Looseness, or haemorrhagy supervenes, it foreshews ill, because by this means the Venom, driven outward, is again called in; though I have observed, that these Symptoms have sometimes happened with a great Relief to the Diseased; to wit, Nature being before loaded and oppressed, is eased by this means, part of the Burden, as it were, being withdrawn, wherefore she sets upon the Work of Transpiration, and more readily dispatches the Expulsion of the offensive matter. As to what concerns the Cure, since the Course of this Disease has three Seasons, like so many Stages as it were, distinct from each other: the curative Intentions ought also to be accommodated to each of these; wherefore, the Therapeutic Method concerning the Small Pox, teaches first what is to be done as long as the Blood boils inwardly, and ferments by the Motion of the Fermentative Matter, and the Small Pox do not yet appear; which Period for the most part is wont to be ended in four or five Days. Secondly, what form of Diet and Physic ought to be ordered, from the time of the Eruption of the Small Pox to the height of the Disease, to wit, till the Pushes are come to their height, and being fully suppurated, begin to whither. Thirdly, and lastly, what we ought to observe in the Declination of the Disease, till the Small Pox, being dried, fall clean off. 1. As to the first, the Intention must be, that we remove all Impediments of Nature, whereby the Blood being defiled with the Ferment of the Small Pox, and apt to be coagulated, may retain still its even Motion in the Heart and Vessels, without Stagnation, and that fermenting, it may expel forth the Portions congealed with the Venom: mean while, a Caution must be had, that the work of Fermentation, or Effervescence, be neither any ways checked, nor too much irritated; for by this the Mass of Blood is forced into congealed Portions more than it ought, and by the other it is restrained too much in motion, nor are the venomous Particles sent away forth with the congealed Blood. Nature is wont to be hindered from the work of Secretion and Expulsion, by a too great heap of Excrements in the Viscera, or by an over-abounding of Blood in the Vessels; wherefore presently, at the first Invasion of the Disease, we must endeavour that an Evacuation by Vomit, or Siege, if need be, be seasonably procured: we must use only mild and gentle Medicines, that is, which do not irritate, or trouble the Humours; wherefore, at this time, sometimes Emetics, Purges, or Clysters, these one while another while those have place; opening a Vein also, if there be a Plenitude, is used with good Success. During this Effervescence of the Blood, let a thin, and moderately cooling Diet, be ordered; to wit, of Oat and Barley Meats, Posset-drink, Small-Ale, and the like; let Flesh, and Broths made of it, be avoided, with which the Blood, by reason of their too great store of sulphureous Fuel, is too much kindled; also cold and all acid things, do hurt, for these congeal the Blood more, and contract the Mouths of the Vessels by Astriction, that the Small Pox do not break forth freely: also let hot and cordial things be cautiously given, for by these the Blood and Humours are too much stirred, and put in Confusion. 2. When the Small Pox begin to appear, there are three things which we order constantly to be done to all Sick Persons; to wit, that a mild and gentle Diaphoresis be always continued in the Mass of Blood; also that the Throat and Eyes be preserved from the too great Eruption of the Small Pox; that the Blood gently boiling may push forth the Small Pox, Decoctions of Figs, of the Flowers of Marigolds, and of the Shave of Ivory, in Posset-Drink, are vulgarly prescribed, and their use has grown rife for a long time, almost among all Persons, For the same intent, we are wont to give moderate Cordials divers times in a day, but let such as are hot and strong be diligently avoided: Purging and Bleeding are here censured, and though the Pretext of necessity may press for them, Physicians scarce dare use them for fear of incurring a Blame. For a Guard to the Parts of the Gullet and Throat, we are wont to fasten outwardly a Chin-stay with Saffron sewen in, and dipped in Woman's Milk; for these, by opening the Pores, draw the Venom from the inward part of the Throat, outward: also, for this Purpose we give Gargarisms, and things to wash the Mouth, which by their restrictive Force repress the Small Pox ready to break forth inwardly. We fortify the Eyes from the Incursions of the Small Pox by Epithemes of Rose-water, Woman's Milk, Saffron, and the like, frequently iterated: Besides these, certain horrible Symptoms are sometimes pressing, which we must seasonable obviate with fit Remedies: sometimes there are Watch, a Frenzy, Hemorrhages, Vomitings, Loosnesses, Fall in of the Small Pox. A prudent Physician knows how to provide against all these, and any others whatsoever, as occasion requires; in which, nevertheless, there is need of great Caution, lest while we take care of small things, the great Work of Nature be disturbed through the overgreat disquieting of Physic: for, during all this time, there is one continued Crisis; wherefore, nothing is to be moved rashly. There is required a very great Care and Circumspection both in the Phyfician and Attendants, when this Disease is in its height; to wit, That when the Small Pox are fully broken forth, and raised to their greatest height, they do not hinder Transpiration; for then the Diseased are in danger of having their Fever renewed, and of the Restagnation of the Malignant Matter in ward, of which, while we endeavour to prevent either, we often cause the other. 3. When the Disease is in its Declination, and the Small Pox begin to whither away, and to grow hard, the Case for the most part is out of danger, nor has a Physician much to do: let the Diseased, though growing very hungry, still be content with a thin Diet, without Meat: if the Pox are slow in falling off, we are wont to hasten their Fall with Liniments and Epithemes, by which they are prevented from Pitying much. After that the Diseased, the Small Pox being wholly fallen away, is able to arise from his Bed, and to walk in his Chamber: a Purge being repeated twice or thrice, let the Filth, and excrementitious Matter left in the Viscera, and Blood, be carried off, and afterward he may be permitted a more free Diet. The Measle are so allied to the Small Pox, that amongst most Authors, they have not deserved to be treated of apart from them; but the Affects of both are delivered after the like Manner and Method together. The Essence and Cure differ as to more or less, or at leastwise accidentally; because in the Measles the Pushes are not so much raised in height, nor are they suppurated: wherefore the Disease ends sooner, and with less danger. This Affect is wont oftentimes to reign among Children, but seldom seizes such as are grown in Years, or old People; also those who have had the Small Pox before, are not afterward so obnoxious to the Measles, but in most they are allied Affects; to wit, the Taint contracted from the Womb disposes Men alone, all Men, and that but once to the Measles: A malignant Constitution of the Air, and sometimes Surfeiting, but most commonly Contagion, are wont to draw into Act the latent Disposition. There are Marks of Malignity, and the Disease often becomes Epidemical, with a Mortality, and Contagion. To give you the thing in short; it seems that the Measles are a certain light Efflorescence of an extraneous Ferment, contracted from the Womb; whereby some Particles, being stirred to motion, cause the Blood to boil gently, and to be a little coagulated: wherefore, the Pimples thence brought forth, are blown off by Evaporation, without a breaking of the Skin. But the Small Pox are a more full and strong Agitation of the same Ferment, and in all its Particles, which causing a greater Ebullition and Coagulation of the Blood, produces a great many more Pushes, and those greater in bulk, and not dissolvabe without Suppuration. When the Small Pox precede, there follows not only an Immunity afterward from the same Affect, but for the most part from the Measles also. The Measles, because they consume only a few Particles of the Ferment, leave still a Disposition to the Small Pox; wherefore, old Persons, or such as are grown in years, are not so readily infected with the Measles, because having been before infected with the Small Pox, they are freed from the Contagion; or their Spirits being robust, easily resist the light Miasm of this Affect. Of the great number of Stories and Observations relating to Persons troubled with the Small Pox, I shall in this place propose only a few Cases, and those remarkable for certain Irregularities. It is usual thing to treat all Persons, affected with the Small Pox, with the like, or wholly the same method of Healing, and form of Diet; wherefore, a Physician is seldom called to the Vulgar, but the Business is wholly committed to certain Women-Tenders, who boast that they know this Practice beyond all others; and those are wont to boil Marygold Flowers, and Shave of Hartshorn, and sometimes Figs in the Broths, and any other Liquors to be taken by the Diseased, and to give at Night a Bolus of Diascordium: such as do not recover by such a Management, are declared not to be neglected, but that they are incurable through the Violence of the Disease. But that this kind of Practice does not equally agree to all, nor is to be used to all indifferently, the two following Relations plainly show. A Youngman about twenty Years of Age, of a thin Body, and hot Temperament, began to be severish in the beginning of the Spring: in the first days violent Vomiting, an Oppression of the Heart, frequent Changes of a burning and cold Shivering, a Pain in the Loins, a Perturbation of the Fancy, and Watch, infested him: On the third day the Small Pox appearing, those Symptoms remitted, though the Fever still continued with a Thirst and Heat. To this Person, not only the Decoctions usual in this Disease, but Juleps also, neatly prepared not so much as sip of them without great loathing: as often as he took at Night Diascordium, or any other temperate Cordial, though in a small quantity, for continuing a Transpiration, he passed the Night following without Sleep, and with a great tossing of the Body, and in the Morning he had an haemorrhagy, which happening once, and then a second time through this occasion, after that the Small Pox were fully broken forth, the well-doing of the Diseased was mightily endangered; wherefore, when I had found by Experience, that the Blood of this Person was apt to boil immoderately upon a light Irritation, I ordered this Method, according as the Occasion required: All Physic whatsoever being laid aside, for quenching Thirst he took small Ale, and a simple Almond Drink at Pleasure: His Food, because he refused all Oat and Barley Broths, was only Apples boiled to a Tenderness, and then seasoned with Sugar and Rose-water, which he eaten at some certain times in the Day. Nature, content with this thin Diet, and seeming to be disturbed by any other whatsoever, performed her work successfully, that the Diseased recovered without any sore Symptom afterward, the Small Pox ripening by Degress, and then falling off of their own accord. In the midst of Autumn of the last Year, a noble Youth, having a sharp Blood, and being obnoxious to a frequent Bleeding at the Nose, fell sick of the Small Pox; his Blood naturally boiled immoderately, that the Pushes broke forth extreme thick all over his Body: in this Person, Whey with Marygold Flowers, and other things usually boiled in it, also Juleps, or nay Cordials (though temperate) gently promoting a Transpiration, did most certainly raise a Flux of Blood; wherefore I ordered him a like way of Diet as to the Diseased before mentioned, by which indeed he was better: however, in the very height of the Disease, (when, the Small Pox being fully broke forth, the Fever is wont to be renewed in all Persons by reason of a difficult Transpiration) this sick Person fell into a copious haemorrhagy; that after a large Profusion of Blood the Small Pox began to be flaccid; after that a great many Remedies for stopping Blood were tried in vain: at length, upon hanging a Bag about his Neck (in which was a Toad dried in the Sun and pounded) he first of all, and immediately, found ease; for the haemorrhagy being hereby presently appeased, and not returning afterward, (he constantly wearing thenceforward this Epitheme in his Bosom) our sick Person using always a most thin and cooling Diet, grew perfectly well: that it may really seem to be manifest hence, that though the Blood in this Affect be mighty apt to coagulate, yet as long as the Vital Spirits are strong and robust enough, and have a governing Power, relying on their own Strengty, by a certain prudent Discretion as it were, they excellently separate and send forth the congealed Portions of the Blood; and this Work is mightily disturbed when the same Spirits are to much irritated, and forced into a Confusion by hot Cordials or a hot Diet. But in the Plague it happens otherwise; for, in this, if delay be granted, the Spirits themselves are presently destroyed by the Venom: wherefore, here we must presently fight with open War; whereas, in the Small Pox a Physician rather restores things by protracting time. Concerning letting Blood just upon the coming forth of the Small Pox, it is greatly doubted. Formerly, among our Countrymen, this thing was styled sacred, nor was Blooding wont to be admitted under any pretext of Necessity: but of late it is proved by Experience, that it is altogether useful and necessary to let Blood in some Cases; which Evacuation, nevertheless, if it be used indifferently in any Constitution, or be done in too large a quantity, when there is need of it, great Damages often ensue thereby. Some years since, I went to see a Young-woman of Quality, of a florid Countenance, and a hot Temperament, who was fallen very feverish after the fourth Month of her being with Child: she was pressed with a violent Vomiting, a fierce Pain in the Loins, and also with a most intense Heat and Drought: her Pulse was very quick, with a strong and vehement Vibration: though the Small Pox no where reigned in that place, nevertheless, those Symptoms of that Affect gave us no small suspicion of them. Be it how it would, the very immoderate Effervescence of the Blood indicated, that some aught to be taken away: wherefore, I presently took about six Ounces; thereupon the Heat somewhat remitted, though the Vomiting still continued, with the violent Pain in the Loins. At the time of her going to rest, I gave her a Cordial Bolus with half a Grain of our Laudanum, whence a quiet Sleep, with a mild Sweat, and an appeasing of all Symptoms, ensued. The next Morning the Small Pox broke forth, which, though the Diseassed had very thick, yet without any dangerous Illness, or fear of Abortion, she recovered, and perfectly completed her Child. bearing. In the last Autumn, a robust Man, of an Athletic Habit of Body, though of a pale Countenance, and a cold Temperament, fell into a Fever. On the second day he was tormented with a Heat and a Drought, and a most violent Pain in the Loins; when, it was ordered that he should be let Blood in a small Quantity: a Quack Chirurgeon being called, he took from him almost a pound and a half; a little after, the Diseased began to fall all into a cold Sweat, and his Strength failing on a sudden, to be seized with a Shivering, a weak and uneven Pulse, and a frequent Fainting: being called at this time, I ordered him temperate Cordials to be taken frequently: then upon the restoring of his Pulse and Spirits the Fever was renewed, which afterward held the Diseased for many Days, nay Weeks, after a very irregular manner; for he was wont, for three or four days, to be very hot, also to be infested with Thirst, Watch, a Headache, and other Symptoms, afterward to fall into a copious, and as it were, critical Sweat, all over his whole Body, by which indeed, in half a days time, he found himself better, though afterward the Fever renewing again, frequently heaped together a new Matter, still to be blown off by a second, and afterward by a third Crisis. After that he had lain thus irregularly feverish for at least twenty days, at length the Small Pox broke forth here and there in each part of the Body, and then the Fever first began wholly to remit; though within a few days, by reason of Errors committed in Diet, a great many Pushes subsided again, a few only being brought to a Ripeness: however, in the place of the subsiding Small Pox, a mighty Bubo grew behind the right Ear; which being suppurated and broken within a short time, a great store of Pus flowed forth for many days; and so at length, the Taints of the Blood hardly to be blown off other ways, were sent forth by degrees, and the Diseased perfectly recovered his Health. CHAP. XV. Of Fevers of Women in Childbed. VUlgar Experience abundantly testifies, that the Fevers of Women in Childbed are very dangerous, above the Nature of our common Fevers: also it clearly appears from the Signs and Symptoms of them, duly considered, that the same very much differ as to their Essences, from a Synochus both simple and putrid: wherefore I have thought it not amiss, after malignant Fevers, to treat of the acute Diseases of Women in Childbed, as being very much allied to them by reason of their Mortality. But before I shall set upon the Explication of the Affects themselves, we must consider their Subjects, to wit, the Bodies of Women that bring forth Children after what manner they are predisposed, and with what Apparatus they become obnoxious to those kinds of Diseases. Concerning this, it first occurs, That to undergo a Flux of menstruous Blood belongs to Humane Kind, and that always to Women; concerning the Nature and Origine of which, it does not concern us here to inquire; but it may suffice to note, that in them the Particles of the Blood to be voided periodically, are very fermentative, which if they are retained in the Body beyond the usual Custom of Nature, they oftentimes become the Cause of many Sicknesses; still excepting, if the Woman has conceived with Child; for all the time of Childbearing the Menses stop without any great damage: and mean while, for the Nourishment of the Foetus, Milk, or a nourishable Humour, is deposed in a great Plenty about the Placenta of the Womb: but, after Delivery, that long Suppression of the Menses is recompensed by a copious flowing of the Lochia, and the Milk, within three days space, leaving wholly the Womb, flies plentifully into the Breasts; at which time, Childbearing Women are wont to be set upon by a small Fever: and if the Milk be driven from the Breasts, it restagnates again towards the Womb, and is voided forth together with the Lochia under the form of a whitish Humour. Mean while, after Delivery, the Womb itself undergoes various Affects, for often its Tone is injured, its Unity is dissolved, and a great many other Accidents are caused, which render Women in Childbed subject to a dangerous Condition: wherefore, that their acute Diseases may be duly explicated, we must chief consider these three things; to wit, first concerning the Nourishment of the Foetus, or of the Generation of Milk, both in the Womb, and in the Breast, and of its Metastasis from either of them into the other. Secondly, of the Purgation of the Maternal Blood, or of the flowing of the Lochia after the Menses being long suppressed. thirdly, or the State of the Womb after Delivery, and of its Influence on other parts of the Body. And these things being premitted, we shall speak of the Fevers of Women in Childbed; to wit, both the Lacteal, and that called Putrid, which, by reason of its Mortality, deserves to be called Malignant. First, the Milk and nutritive Humour, heaped together in the Uterine Parts for the Nourishment of the Foetus, are by Nature alike, though they differ somewhat in Consistency: the Milk indeed is the thicker, because, being to be received in the Mouth, it ought to be digested in the Stomach, and afterwards it's more tender Portion to be conveyed into the Mass of Blood. The other nourishable Humour is more thin, and like to distilled Water of Milk, because it's immediately infused into the Blood of the Embryo, by the umbelical Vessels, without a previous Digestion. Both Juices are thought to consist of the Chyle fresh made in the Mother's Stomach: that which is deposed in the Breast is grosser and whiter, by reason of the course Strainer, and its Coction in the greater Glands; it happens on the contrary in the Womb, where the straining is closer, and the Glands are very small. Now it is greatly disputed among Authors, by what Ductus' that Humour is conveyed both into the Breast, and into the Placenta of the Womb. Some say that the Milk is engendered only from the Blood freely concocted in the Glands, which nevertheless does not seem probable, by reason of the immense Spend of Milk which does not consist with the Blood. Others affirm, That the Chyle, or Lacteal Humour, is conveyed immediately into both Receptacles from the Viscera of Concoction through occult Passages, without any Alteration. But till those Ductus' appear, it seems more likely to me, that from the Food taken into the Mother's Stomach, a Portion of the Chyle thence made is presently absorbed into the Veins, which having gotten the Vehicle of the Blood, and being brought by the Arteries into the Glands destinated here and there for receiving it before it is assimilated, and being separated, is deposed again from the Mass of Blood. Secondly, as to what regards the Menses, suppressed during the time of being with Child, and the Lochia plentifully flowing after Childbirth; we say, That after the Foetus is conceived, the Menses are stopped by Divine Appointment, because their flowing often brings Abortion; and in regard the Vessels are emptied by a continual Exsudation of the nutritive Juice into the Parts of the Womb, the Mass of Blood does not easily arise into Turgescencies to be appeased by a monthly flowing. For the same reason, the Menses for the most part are stopped as long as Women give suck to Infants: in some happily, endowed with a hot Blood, the Menses flow both in the Time of their being with Child, and giving Suck; but that is wont to happen but rarely, and not without damage: though in the mean time the Menses, stopped while Women are with Child, because far less of the nutritive Humour at that Time is employed for Milk, deprave the Blood much more than the same are wont when restrained during the Time of gving Suck: nay, from those being long suppressed in the first State, a venomous Taint, as it were, is communicated to the Mass of Blood; which, unless it be purged off, presently after Childbirth, by a long flowing of the Lochia, it produces sore and very malignant Affects; wherefore, to give my Opinion of the flowing Lochia, I say, that that haemorrhagy immediately proceeds from those Vessels being broken by which the Placenta sticks to the Womb, and that by this way the Blood and excrementitious Humours, partly heaped together about the Womb during the Time of being with Child, and partly flowing from the whole Mass of Blood, are evacuated; to wit, whilst the Womb, first swollen in a Bulk, falls presently after Delivery, and is contracted into a less space, the Blood is copiously expressed from the Vessels that are open in it. And moreover, in as much as during the Suppression of the Menses, the Mass of Blood is imbued with very fermentative Particles, assoon as after Childbirth the Mouths of the Vessels are open, presently, as though a large flowing of the Menses were at hand, the whole Blood ferments, even as new Wine in a Bottle opened, and endeavours to purge from itself the extreme fermentative Particles, by a flowing of the Lochia, as it were, by an Efflorescence; and therefore, besides the Blood, which in the first days, by reason of the Vessels being newly opened, often flows forth pure; afterwards very discoloured Ichors, to wit, livid, or green, and those very stinking, are voided forth. This kind of flowing is wont to continue for fourteen days at least, nay, in some, for a month; and if by reason of any Errors it be stopped before the Mass of Blood be cleansed enough by such an Efflorescence, presently a very dangerous Fever, with a horrible Apparatus of Symptoms, is wont to be caused. The third Consideration, previous to the Doctrine of the Fevers of Women in Childbed, chief concerns the Womb itself; to wit, how it's affected after childbirth, and what kind of Influence it has over other Parts of the Body. As to the first, there are two Accidents chief on which the acute Diseases of Women in Childbed much depend; first, the settling of the Womb, or the Reducement of it to its natural Site and Magnitude from the Bulk of Ingravidation: secondly, A Solution of its Unity within its Cavity, by reason of the Connexion of the Placenta being broken. When the Foetus is deposed with its Envelloping, presently the sides of the Womb itself, before greatly enlarged, fall together, and contract themselves by degrees into a narrower space, by the help of the Fibres: By reason of this kind of Contraction the Blood and Ichors are copiously expressed from the Vessels and Pores of the Womb, and are voided forth with the Lochia; but sometimes it happens, by reason of preternatural things contained in the Womb, as are a part of the Secondine, a Mola, Clots of Blood, etc. even though after a laborious Delivery, a Contusion, or great Dilaseration happen, that the Womb does not duly contract itself, but the Motion of the Fibres being inverted, ascends upwards, and is raised into a Lump; also the Membranes being affected with a Twitching, it is still assailed with Tortures, as though the Throws of Childbirth were in being; which kind of Affects, if they continue for some time, by reason of the Orifice of the Womb being constringed with a Convulsive Motion, the Lochia also are often stopped: hence severe Symptoms ensue; and oftentimes it happens, that a Fever either thereby is first raised, or being induced by some other cause, is rendered far more dangerous. Secondly, as to the Unity dissolved by the Placenta being broken, it happens either at the due Time of Delivery, or when it is precipitated and overhasty; and then the Secondine is thrown out entire, or being broken, part of it being left behind, it comes away as it were at halfs. If a Childbirth happens at the just time, and the Foetus falls away entire, and without Violence, from the Cavity of the Womb, with its Envelloping, as ripe fruit from a Tree, the Mouths of the Vessels are somewhat opened, that the Lochia flow moderately; and hence no severe Symptom is feared. But if the Foetus, not yet ripe for Delivery, be torn away as it were by force, though the Placenta, with the Membrances are torn away entirely, yet the Vessels being broken, a great haemorrhagy, and at length the Mouths of the Vessels gleeting forth a stinking Ichor, an ulcerous Disposition ensues. And if part of the Secundine or the whole, sticks to the sides of the Womb after Delivery, and there putrifies, they gleet forth very stinking Ichors, and cause mischievous Affects: oftentimes the Orifice of the Womb is shut, and retains within Clots of Blood, and pieces of Membranes, or Flesh; which putrifying through Hear, Poison the Blood, and Humours flowing thither by Circulation from the whole Body, and by a'troublesome Irritation stir the Parts of the Womb, which are very sensible, into Contractions. Since therefore, after Childbirth an Injury is brought on the Womb after the foresaid Manners, the same is soon communicated to the other Parts, not without a Disturbance to the whole Body; which is usually done in a double Respect; for first, this happens, because the Lochia, hindered from being voided forth, presently restagnate into the Mass of Blood, and defile it with a sort of virulent Miasm. Moreover, from the Contents putrifying in the Womb, either the Substance itself of the Ichor, or the Particles departing from the cadaverous thing, are mixed with the Blood and nervons Juice, passing through them, and in a short time infect their whole Liquors, Secondly, Histerick affects are extended far and near by reason of the mighty accord there is betwixt the Womb and the Brain, with the Fibres and Membranes of the whole Body, by the means of the Conveyance of the Nerves: for when the extremities of the Nerves placed about the Uterine Parts are driven into Cramps and Convulsions by reason of the presence of the offensive Humour, the Convulsions there entered upon, presently being conveyed upward by the Efforts and Coarctations of the Nerves, creep toward the Brain: and so it happens that the Viscera are successively puft up, and violently convulsed, and at length that the Brain itself is struck with it, and that its Functions are overwhelmed as it were: hence, upon convulsive Motions began about the Womb, a puffing up of the Belly and Hypochondres, a rumbling there, he Vomiting, a Belching, a straightness of the Praecordia, and a difficult Breathing, a sense of Choking, and often a Stupor, and a loss of Speech, or at least some of these are caused: nor does the Tragedy wholly cease so, but the Brain being also offended by the continuation of the affect, the Injury is retorted thence on the other Parts, that often the whole Genus Nervosum is forced into Irregularities of Motions: for what is vulgarly said to be done by Vapours, and the affect, which creeping from below upward is called an ascent of Vapours, is nothing else, but the parts of the Membranes and Nervous ductus' forced successively into Contractions. Moreover, in these kinds of Affects the injured action does not always begin, or is first felt in that Region or Place, where the Injury is inflicted, nor do the Passions which are said to be hysterical only proceed from the Womb; for sometimes the disturbance is brought immediately on the Brain, but the Cramps and Contractions begin in the extreme parts, and sometimes the extremities of the Nerves are twitched somewhere in the Viscera, suppose the Stomach, Spleen, Reins, no less than in the Womb; in which Irregularities arising, are continued in the neighbouring Parts, and thence into the Brain: from which again Convulsions are reflected unto other Parts, and often into the whole Body: that the thing is so in Women in Childbed, and others that have Fevers, I have often observed: to wit, some by reason of the Womb being ill affected, and others by reason of the febrile matter fixed in the Brain by a critical metastasis fall into Passions in a manner hysterical: and these things being duly considered concerning the Apparatus previous to the Fevers of Women, in Childbed, we need not stay here longer, only it may be observed that the Bodies of Women in Childbed (especially those which are weak and of a tender Constitution) are very much debilitated after a laborious and difficult delivery, so that by reason of this sole occasion they easily fall into feverish distempers, and being caused this or another way, they bear them ill; now next let us speak of the Fevers themselves, with which Women in Childbed are wont to be troubled: of which affects three kinds as it were are vulgarly instanced. viz. the Lacteal Fever, the Putrid, or of that kind which is marked by some borrowed Symptoms, as especially the Pleurisy, the Quinsy, or the Small Pox, of which we shall speak in order. The Lacteal Faver. I Am of Opinion that the milky Chime made of the Aliments in the Viscera, and thence mixed with the Blood for a Nutritive Juice, is again presently separated, for the greatest part, from its Mass, by the help of the Glands in the Womb, or in the Breasts, even as the Serum is in the Reins; that it might afford Nourshment to the Foetus either in the Mother's Belly, or carried in her Arms. During the time of being with Child, though the greatest part of it be derived to the Womb, yet in the last Months, a little of it is deposed in the Breasts, but about the third or fourth day after Childbirth, the Milk is carried to the breasts more plentifully, and as it were with a certain Impetus, that it soon fills them to a Tension, and gins to load them. At this time Women delivered (though not all, yet most) are wont to be affected with a feverish Distemperature, a Thirst, Heat, and Restlessness of the whole Body: they complain of a sad Pain in the Back and Shoulders, of a fullness of the breasts, and a burning, and, unless the Mild be diligently drawn from thence, being heaped together too much, it often causes an In flammation with a following Abscess in the breasts: This Fever, so the Lochia pass as they ought, seldom last above three days, but about that time, a copious sweat spontaneously arising, is wont to be appeased: yet this Distemperature raised by the coming of the milk, is somewhat intended, and stays longer, if at any time the Milk being freeely entered into the Breasts, be not drawn away, but be again repelled thence; for upon its departure, even as upon its coming, a perturbation is wont to happen in the whole body, with a Thirst and Heat, which also more certainly comes to pass, if that happens to be violently driven away with repelling Topics: but being driven from the breast by their help, or departing thence of its own accord, it is voided with the Lochia in the form of a whitish Humour, and a Sweat, or a full perspiration exterminates the relics of the Disease. But if by this kind of distemperature, being caused by reason of the commotion of the Milk, the Lochia are stopped, or errors in diet are committed, or some evident cause happens. so that the effervescence of the blood be intended, often the Lacteal Fever, joining to it worse Symptoms, turns to a Putrid or Malignat. The Cure of this Fever is committed wholly to Nuture, and as long as the Lochia are as they ought, it passes off for the most part well enough without any physical Help: for after an effervescence of the Blood, carried on for three or four days, either a copious Sweat, or a free Transpirations, resolves this Affect: to wit, either the Particles of the lacteal Humour, degenerated in assimilating, or the adust Recrements remaining after the Deflagration of the Blood, or both of them together administering a Fuel to the Fever, are subdued by degrees, and evaporated forth, which being sent forth, the Blood being become free from its extraneous mixture, soon recovers its former state, though in the mean while some vulgar Rules concerning the admission of the Milk, or thedriving away of the same from the breasts, are wont to be observed. If the Milk springs into the breasts in too great a plenty, then to prevent their Inflammation, and an immoderate effervescence of the Blood, let the diet be thinn and spare, viz. of Broth without Flesh, and in a small quantity: also let the breasts be emptied by a frequent sucking: if it be not convenient for the Mother to give the Infant suck, it is usual on the first, or third day after delivery, to cover over all the breasts with gently astringent Cere-Cloths, as withthe red Led Plaster, etc. For so the spongy Substance of the Glands is somewhat constringed, whereby they do not so readily receive the lacteous Humour flowing thither, though this kind of Remedy ought to be cautiously used, lest if the Milk be wholly excluded, or be driven away from the breasts too much in a crowd, presently restagnating into the Blood, it causes a disorder of the same; as a forerunner of a putrid or malignant Fever: of which we must speak next. The Putrid Fevers of Women in Childbed. WOmen in Childbed, through the taint of their ill affected Body, as though they were struck with the Contagion of a pestilential Air, are found to be extremely obnoxious to a putrid or rather malignant Fever, though all do not equally receive tha taint of this Disease; for poor Women, Hirelings, Rustics, and others used to hard Labours, also Viragoes, and Whores, who are clandestinely delivered, bring forth without great difficulty, and in a short time after, rising from their Bed, return to their wont Labours: but Women that are rich, tender and beautiful, and many living a sedentary Life, asa though they partaked of the Divine Curse after a more severe manner, bring forth in Pain, and presently after their delivery lie in an uneasy and dangerous condition: the reason of which seems to lie in this, that those that use much exercise, continually exagitate, and eventilate the Blood, and therefore after the Menses are stopped, heap together fewer Miasms for the matter of the Disease; Moreover, labouring and active Women, having the nervous Parts more firm, are less subject to convulsive Mothions, and the affects vulgarly called hysterical: on the contrary, in nice Women, and such as live idly, during the time of their being with Child the mass of Blood becomes impure and fermentative: moreover, because they have the Brain and the System of the Nerves thender and weak, upon any light occasion they undergo Distractions of the animal Spirits, and disorderly Motions of the nervous Parts: and here it is to be noted by the by, that Women before Men, and some of that Sex before others, are troubled with the Affects called hysterical, not so much by reason of the fault of the Womb itself, but by reason of the weaker Constitutions of the Brain and Genus Nervosum: for in Perons so affected, Passions of Anger, Fear, Sadness; also all vehement or strong Objects easily pervert the Crases or Functions of those parts, which when they have been once injured, day afterward in a manner always accustom themselves to the same Irregularities. But to return whence we made a digression: the Fever even now mentioned is wont to infest Women in Childbed, at various thimes, and for diver Occasions; sometimes it arises presently after delivery, especially if it has been difficult and laborious, sometimes the second, third, or fourth Week; though the later it gins, the safer it it is wont to be; the Type of that effect passes after this manner: after a previous indisposition an open feverishness for the most part with a cold and a shivering makes the first invasion, which presently is followed by a heat, afterward a sweat ensues for a day haply or two, there are various reciprocations of Fits of heat and cold: afterward, the Blood being kindled throughout, the Lochia, unlefs suppressed before, either flow a little, or wholly stop. If the Disease be acute, and of a quick motion, on the third, or fourth day it comes to its height, than there is an intense heat, with a very troublesome drought, a vehement and quick Pulse, there are obstinate Watch, a great restlessness of the whole Body, so that the Diseased continually toss themselves this way and that in their Bed, the Urine is thick and ruddy, and other severe symptoms are rife: whilst the Fever is thus in its height, a Crisis is not to be expected; for I have never seen this Disease resoled by a critical sweat; nay, the case is very dangerous, so that after the Blood has boiled for some time, the adust matter presently being conveyed into the Brain, dangerous and very sore Irregularities of it, and of the Genus Nervosum straightway ensue, for convulsive Motions of the Tendons, wonderful distentions about the Viscera, and puffings up, resembling hysterick Passions, oftentimes are raised: Moreover, sometimes a Frenzy, a Delirium, often a Stupor and a Speechlessness also follow; almost in all the strength is suddenly cast down without a manifest Cause, tyhe Pusse becomes weak and uneven, and the Diseased are often precipitated into Death: if any haply escape, either the flowing of the Lochia being restored, or a Diarrhoea superventing, they recover with much ado after a long lying ill: I have known purple Spots to have appeared in some; indeed in most the symptoms which regard either the Blood or the nervous Juice, argue no small malignity. The Procatarctick Causes of this Fever, on which the malignity and mighty danger of this Disease depend, are chief two; viz. first, an evil dispostion of the Blood, after a long suppression of the Menses: secondly (after delivery) the evil affects of the Womb from the dangerous labours of Women (which make out the Divine malediction:) after the Menses being long suppressed, the Blood does not only grow turgid, and its sulphureous parts being raised too much, are rendered more apt for Inflammation, but moreover, the mass of Blood is imbued with very fermentaive Particles, so that (as is hinted before) being struck as it were with a venomous Miasm, as it ferments, it forthwith is disposed toward a putrefaction and corruptive irregularities, and besides, it may presently poison the nervous Liquor, and render it offensive to the Brain and the whole Genus Nervosum: this kind of taint communicated to the blood, aught to be purged forth by a copious flowing of the Lochia; but if after delivery the Womb be out of order, their is not only a stoppage of the Lochia, and so the Reparation of the whole blood is hindered, but besides, stinking Ichors are thence transmitted to the blood, and greatly infect it. Also by reason of convulfive motions begun about the Womb, and thence continued to the other Parts, Irregularities are raised in the Blood and Juices, which often conspire to the production or exasperation of a Fever. The evident Causes which either cause an actual effervescence in the Blood, having gotten a Dyscrasy, or trouble the whole Body with the Distempers of the Womb are divers; for these make a painful delivery, a solution of unity about the Womb, a contusion, a retention of preternatural things, an ulcerous disposition, and a great many other Accidents, which are caused through some necessity; but the occasions in the power of Patients, and easy to be avoided, which are wont to raise this Fever, are chief two; viz. an ill form of Diet, and a taking Cold. It's a usual thing to give to weak Women after Childbirth, on the first and second day, the Flesh of Animals, or their Gelly-broths, and other Food very disproportionate to their Constitutions; whence presently an indigestion and great disquietings arise in the Viscera, and feverish turgescencies in the Blood, by reason of a nutritive Juyced richer than it ought. Besides Errors committed in Diet, often an Injury is Caused, for that their Bodies, which are very tender, and by reason of the Labours of Childbirth, and the Exclusion of the Foetus, are all full of open Pores, are too unwarily exposed to the open Air: for most, being impatient of their Bed, put on their , and rise from it within a day or two, or sooner than they ought: thereby presently the Pores of the Skin being presently stopped, and the Air getting into the Uterine Parts, tanspiration is checked, and often the Lochia are suddenly stopped, either of which suffices to raise a feverish effervescence. The conjunct Cause, or formal Reason of this Distemper, comprehends chief these three things; to wit, there are present, first a mighty dyscrasy of the Blood, that growing very hot from a Fever occasionally raised, it does not burn evenly, nor does is subdue by degreeds the adust Recrements, and purge them forth critically; moreover, the boiling Blood is presently loosened in its Mixture, and its Texture being loosened, it declines toward Corruption; hence when it has a little abated of its Heat, the Spirits, being cast from their Governance, are driven into Confusion: mean while, the sulphureous Particles become masterless and exorbitant; wherefore the Strength fails without a manifest Cause, the Pulse becomes weak and disorderly. Tho from the Deflagration of the Blood a great many adust Recrements are heaped together, yet nothing is duly concocted or separated; but Nature being greatlyopprest, although the Diseased continually sweated, they often receive no ease thereby: but the Febrile Matter, which ought to be purged forth, being conveyed into the Head and Genus Nervosum, causes there very sore Perturbations of the animal oeconomy. Secondly, The Tragedy of this Disease, for a good part of it, is ascribed to the nervous Juice forthwith turning sharp, and therefore rendered disproportionate to the Brain and its Appendix; for this being defiled with a Taint contracted from the Blood, does not gently irrigate and mildly inspire its Subjects, but (as when an Infusion of Vitriol is poured on a Worm) mightily vellicates, and irrtates into Contrqactions, and as it were into Motions of Trepidatons and Leapings those tender Parts, and sometimes wholly overthrows their Functions: hence Contractions, severe Convulsions, a Delirium, Watch, sometimes a Stupor, and sleepy Affects, happen to Women after Delivery. Ihirdly, whilst these things are done, often a third Troop of Symptoms infest the Diseased; to wit, for that the Womb, being some way hurt, moves itself disorderly, and is struck with a Contraction in these or those Parts; thence presently by the Membranes and nervous Ductus' convulsive Motions pervade the whole Region of the Abdomen, wherefore the Viscera and Hypochondres are blown up, Belchings and violent Vomitings are raised; afterward the Affect creeping upward, and possessing the nervous Parts of the Thorax, a difficult and uneven Breathing, a Palpitation of the Heart, a sense of Choking in the Throat, by reaon of the Muscles there drawn together, and other Symptoms are raised throughout the whole, upon the same Injuries being communicated to the Brain. The Fevers of Women after Delivery, are scarce ever free from danger, though sometimes it happens for them to be cured about the first beginnings, by a thin Diet, and upon restoring the flowing of the Lochia: but if the feverish Distemper has laid deep Roots, that the Blood be wholly kindled, and boils immoderately, we can give but an ill Prognostic; and there will be a greater Cause of Danger, if besides a Heat diffused through the whole, the Diseased are seized with a frequent Shivering, if they are affected with a great Restlessness, and Watch, with sudden Concussions of their Bodies, or Contractions of the Tendons: if on the third or fourth Day they complain of a ringing of the Ears, with a great Repletion of the Head, you may presently gather, that a great Evil is at hand, to wit, a Mertastasis of the febrile and offensive Matter into the Brain; nor is less to be feared if there lies an Oppression and Load on the Praecordia that the Diseased cannot freely breath, nor draw their Breath deep, nor form the bottom of the Thorax; but only from the upper part of it, and that short and with a Blowing, so that in the mean while the Diseased are forced to fit upright, and to move themselves this way and that, after a restless manner; for this argues the Blood to stagnate about the Heart and Lungs, also that it is apt to grow clotty, and to be coagulated: and if worse yet Affects of the Brain and Genus Nervosum ensue, and the Pulse becomes weak and uneven, you may declare the Case to be desperate: but if (as if sometimes falls out, though rarely) after a Fever is kindled, and threatens severely, either a flowing of the Lochia, or a Diarrhoea happens with Relief, some Hope may be admitted. Concerning the Cures of these kinds of Fevers, a Physician has a very hard Task; because, among the Vulgar, all Medicines to Women in Childbed are accounted not only useless, but likewise very hurtful; wherefore, Physicians are selfom called, but when there is no place left for Medicines, and the occasion for a useful Assitstance is wholly passed: and if they are present about the first beginnings of the Disease, it will not be an easy thing to procure Health to the Diseased by vulgar Remedies; and whatsoever they try, unless it gives Help, is affirmed by old Women, and those that are about them, as pernicious, and the only Cause of their Death: that in reality, there is wont to accrue to us about the Cure of no Disease, less benefit and more Disgrace than of this. Now the method of Cure (even as in contagious Diseases) is twofold; to wit, Prophylactick and Therapeutic: the former of these delivers Precepts and Cautions, with which Women in Childbed are preserved from the Incursion of Fevers; the other suggests curative Intentions, with which the Diseased (if it may be) recover again their Health. 1. Tho this Fever, however malignant it be, is not accused of Contagion, and there be no fear in those that lie in, of a venomous Miasm being received from without; nevertheless, all Women in Childbed have an innate Minera of Virulency, and aught to have a care of the mischief of this, as a Foams of a mighty Malignity; wherefore they have need of an exact Governance, that after Childbirth the Impurities of the Blood and Humours may be duly purged without the danger of a Fever; and that the evil Affects of the Womb be healed; and that the Strength, broken and debilitated by Childbirth, may be duly restored. For these ends, these three things are to be chief inculcated in the Praescripts of Physicians: First, I think it necessary that a most exact form of Diet be ordered Women in Childbed; to wit, that at least for a Week they wholly feed on Oat Broths, sometimes prepared with Ale, sometimes of Water mixed with White-wine; because they are much emptied, therefore they may sup often of them; but let nothing of a solid or strong Food be given; for I have diligently observed that an overhasty eating of Flesh, or of a rich Food, has oftentimes brought these Fevers. For, Women in Childbed ought to be managed not only as Persons sorely woulded, but as having gotten a feverish Indisposition from a troubled Crasis and Distemperature of the Blood; for in them, the Blood being for a long time too much exalted and inspired with an impure Miasm, presently upon the Access of any sulphureous Fuel, takes a light Flame. The second Care, after Diet, must be, that the Pores be not closed, or the Lochia stopped, upon the unwary Admission of an outward Cold; for upon the lightest occasion, the way of the Transpiration being changed, the Blood, before fermenting, falls into Disorders, also the Womb being touched with the breath of the Air, contracts itself, and closes the Mouths of the Vessels, that the Lochia do not flow: wherefore in any wise Women ought to be kept in Bed five days after Childbearing. I know its the vulgar way to take Women out of Bed the third day, but I have known many to have fallen into Fevers thereby; and in truth, if we will have Childbearing Women secure from danger, the safest way will be, to keep them in Bed longer. There remains a third Scope concerning Preservation, that in Women in Childbed, by giving somewhat gently to stir the Blood, we continue a flowing of the Lochia: for this end Midwives are wont (if at any time after a difficult Childbirth that Evil be feared) to give Sperma coeti, Powder of Irish Slate, or Saffron steeped with White-wine: moreover, to prepare Broths, that they may fuse the Blood more, of Water mixed with White or Rhenish Wine, in which, or also in Whey, they boil Mary gold-flowers, Penny Royal, or Mugwort. There are a great many other kinds of Administrations in use for Women in Childbed, which I willingly pass by, as being valgarly known. The Cure of the Fever following Childbirth far differs from the Method used in Putrids: for in that it is not to be expected that the Blood being struck with a Febrile Burning, should burn on by degrees and then should subdue the adust Recrements heaped together by degrees in its Bosom, and should separate the same by a Crisis; but rather (as is best done in a malignant) assoon as the Blood boils immoderately, it is good to exagitate it, and to send forth its haeterogeneous and impure Mixtures by Remedies gently promoting Sweat; wherefore it is usual among the Vulgar (and that not amiss) to give presently Sudorificks to Women in Childbed that are feverish: by this means the Blood being eventilated, its Effervescence is appeased; also by reason of its Agitation, the Lochia, apt to be restrained, are stimulated to a flowing. It is much disputed among Authors whence the Beginnings of these kinds of Fevers ought to be computed; to wit, Whether from the Birth itself, or from the first Sense of the Feverishness: but it little matters whether it be concluded this way or that; for, since this Fever does not justly observe the wont Stages of Putrids, nor is to have a Crisis, nor at all admits the use of a Cathartick Remedy, there is no cause for us to be any ways solicitous concerning its Period or Mensuration as to days: but it will be only useful for us to distinguish concerning its curative Indications, of what things are to be done in the Beginning, Increase, and End of this Disease; what also we ought to attempt while the Strength holds somewhat good; and what in the same being depressed and greatly dejected. When therefore any Woman brought to Bed is first affected with this Fever (whose Invasion is distinguished from the Lacteal, because it gins for the most part with a cold Shivering) presently we must endeavour that the Fuel be plentifully withdrawn from the burning Blood; and, as I have advised above, let the Flesh of Animals, or Broths made of the same, be wholly forbidden: for these fix the Blood, and constipate it too much, and hinder its purging, which is very necessary both by the Lochia, and by cutaneous Transpiration: and rather, though the Fever be pressing, let Decoctions, Powders, and Confections, be given of moderately hot things: of this kind (as I said before) are the Decoctions, or distilled Waters of the Flowers of Marygolds, of the Leaves of , of Mugwort, of the Roots of Scorzonera, also bezoartick Powders, Spirit of Hartshorn, the fixed Salts of Herbs, etc. If the Lochia are stopped, we must try all ways to move them to flow again; for promoting these, Frictions conduce, and Ligatures about the Thighs and Legs, also in the Soles of the Feet, sometimes cupping Glasses, or Vesicatories about the Thighs, or Hips, also in the Soles of the Feet; sometimes also Blooding in the Ankle is good: mean while, let a Fomentation of an hysterick Decoction be applied about the Share, or let a Weathers Caul, taken forth warm, be laid on the lower Part of the Belly: it has been found by Experience, that Pessaries, and uterine Injections, have sometime done good; if the Belly be costive, let it be gently loosened by the Violet Suppository, or an emollient Clyster. We must beware of a too strong Irritation, because it is known, that in Childbed the Strength is suddenly cast down, with a Swooning, by a copious Purging, even as in a Malignant Fever. If at any time, with a Suppression of the Lochia, there be a mighty Perturbation of the Blood with a Vomiting, a Thirst, and Watch, I have often known Laudanum mixed with Saffron given with good Success. Instead of a cooling Julep, this kind of Mixture may be proper: viz. Take Water of , and of Bawm, of each three ounces, Histerick-water two ounces, Syrup of Mugwort an ounce and a half, Tincture of Saffron two drams, Castoreum tied in a Rag and hung in the Glass a Scruple. Mix them. Let three or four Spoonfuls of this be taken divers times in a day. 2. If, notwithstanding the use of these kinds of Remedies, the Fever still grows worse, and is increased by degrees with a worse Apparatus of Symptoms, so that besides the Disorders of the Blood, the Brain and nervous Parts begin to be affected, Medicines, though a great many of them of every kind are tried, oftentimes can do nothing: nay, in this ease, the Indications are in a manner coincident with those that are to be made use of in the Plague itself; for, the Lochia being a good while suppressed, they cannot easily, or searce at all, be brought again in a great Confusion of the Blood and Humours: therefore it is good quickly to raise a Sweat; to wit, That the Corruptions made in the Blood and nervous Juice, and restagnating from the Womb, may in some sort be sent forth by Sweat and insensible Transpiration: wherefore here Bezoartck Powders and Confections, Spirit of Hartshorn or of Soot, Tinctures of Coral or of Pearl, conduce. I have sometimes seen, that by the help of these kinds of Medicines, in a desperate Case, somewhat of Hope has shown itself, the Pulse and other Symptoms promising a little better; though the Cure has seldom succeeded: but when that use of Cordials was remitted, the Diseased fell headlong into Death, with a weak Pulse, and a Looseness forthwith arising. 3. When still the case of the Diseased grows worse and worse, that the Fever being increased, the Pulse is weak and uneven, and frequent Shivering, and convulsive Motions infest the whose Body, with a Delirium, or a Stupor; then let the Physician, first giving a Prognostic of Death, insist on fewer Remedies, and those, in a manner, only Cardiack: and let him wholly abstain from Blooding, Scarifying, Vesicatories, or the use of Cupping Glasses; for such Administrations bring only an ill-will and Disgrace, that thereby we are accounted by Women hardhearted and cruel. The Symptomatick Fevers of Women in Childbed. THE acute Diseases of Women brought to bed do not only follow the Type of the foresaid Fever, but are sometimes attended with some notable Symptom; to wit, the Quinsey, Pleurisy, Peripneumonia, Dysentery, Small Pox, or of some other kind; and then they are called by the Names of those Affects. It is not proper to repeat in this Place what belongs to the Natures and Essences of each of them at large, but I shall briefly set down what those Diseases, complicated with the Affects of Women in Childbed, have peculiar to them, as to their Causes or Cures. We judge that all those Symptoms proceed from a certain Coagulation of the Blood, and afterward its Extravasation: now while the Blood is extravasated in one part, every natural and critical Effiux of it is restrained in another; wherefore there is danger, lest while the Blood gins to be coagulated either in a particular and usual Focus of Congelation, or universally in its whole Mass, presently the flowing of the Lochia be stopped; which in reality happens for the most part, and therefore those Affects are most commonly mortal to Women in Childbed: nevertheless, the Cause of their Death, for the most part, happens with some difference, to wit, in the Small Pox, the flowing Lochia call inward the Malignity began to be sent forth outwardly, and wholly poison with their Taint the Mass Blood and the Heart itself; and therefore in the Small Pox those uterine Purgations ought to be stopped: but in the Pleurisy, Quinsey, and the rest, when the Stimulus of the Disease, fixed here or there in a particular Place calls to itself, and wholly derives from the Womb the Impurities of the Blood which ought to be voided by the Lochia, thereby it increases the Taint of the BLood: the Lochia restrained in the Small Pox might be sent forth by a more general way of Excretion, with the venomous Particles of the Disease; with indeed does not succeed in the rest by reason of the small and more spare way of Excretion. Among these, the Quinsey, Pleurisy, and Peripneumonia, by reason both of the great likeness of their Cause, and the Analogy of their Cure, may be considered together. When a Woman in Childbed is affected with either of these, it is to be judged, that besides the Miasms heaped together during the time of Ingravidation, there happens a certain acid disposition of the Blood, by the means of with, whilst it feverishly boils, certain Particles of it being imbued with a sharpness, fall into a Congelation in this or that place, like Milk turning sour and consequently coagulated: the Blood letted there, and hindered in its Circulation, hinders the Passage of the rest; now the Blood, being obstructed in its Motion, butts against its dam, and so being heaped together round about, and driven out of its Vessels, grows into a Tumour; thence presently whatsoever haeterogeneous and separable is contained in its Mass, is deposed in the Part affected as in a Sink: wherefore, the Corruptions of the Blood, which ought to be purged forth by the Womb, are derived thence toward the Seat of this Disease; which since they cannot be purged forth sufficiently this way, both the Liquor of the Blood is more notoriously corrupted, and a Crisis of that particular Affect, to wit, of the Quinsey, Pleurisy, or some other, is rendered more difficult. For the Cure of these kinds of complicated Diseases, presently from the very first beginning it must be endeavoured, that the Blood fixed any where and begun to be extravasated, be restored to Circulation, and do not make an Impostume, because it is very rarely that Women in Childbed, seized with those symptomatick Fevers, are cured by an Abscess or spitting forth of the Matter; wherefore, inward Remedies, which fuse the Blood and free it from Coagulation, are to be used; of which kind are chief Diaphoreticks filled with a volatile Salt, as Spirit of Hartshorn, of Soot, of Urine, and the Salts themselves: also testaceous and bezoartick Powders, Sal Prunella, Decoctions and Juleps of Vegetables promoting the menses or the Urine; in all which those things ought to be mixed, which by Experience are found to be appropriated to uterine Affects: moreover, discussing Remedies, which drive away and expel the Matter stinking in the Part affected (of which kind are Liniments, Fomentations, and Cataplasms) are carefully to be applied to it. Mean while, let the violent Motion, and immoderate Effervescence of the Blood be removed far from thence, and let its Excretions of Filth be conveyed still to the lower Parts, by what ways we may: for this end, Frictions, Ligatures, Epispastics, and (if need be) cupping Glasses, may be applied to the Feet or Legs: in case the Affect growing very much worse, blooding be indicated; unless there be a great Plethora in the whole Body, and a very acute Inflammation in the Part affected, it will be best to breathe a Vein in the Foot, or to open the haemorroid Vessels with Leeches: but if necessity presses for it to be done in the Arm, after Blooding there, let another Bleeding (if it may be admitted) follow in the Leg: nevertheless, we must give a Hint, that opening a Vein ought to be very cautiously ordered in these Cases: for unless it gives Relief (which I have seldom known to happen) presently the Pulse being rendered more weak, the State of the Diseased becomes worse. A Dysentery takes its Rise in a manner from the like Cause, as the foresaid Affects; but because in this, the extravasated Blood is presently poured forth, nor being restrained in the Body creates a mischief there, and is still more corrupted: and since this way of Excretion is performed near the uterine Efflux, and does not derive it afterward another way, hence less danger is feared from this Disease than from the others before mentioned; though oftentimes this Affect is mortal to Women in Childbed, and that the rather, because by a Dysentery things that qualify and gently astringe the Blood are indicated: and these are found too apt to stop the flowing of the Lochia: wherefore in this case, till Women delivered are in a manner purged enough by a long flowing, let the Cure of the other Disease be omitted, and let the fierceness of Symptoms be restrained only by lenifying things. The Indications of the Small Pox do not only differ from those even now above described, but are attended by some Contrary to themselves; for they require the Flow of the Lochia to be alittle stopr, (as is said before;) tho withal, that the Efflorescence of the Blood, and a gentle Sweat, be continued: for since in this Disease there is a double venomous Ferment, and the corrupted Particles of the Blood are carried forth two ways, Care is tob e taken that the less and narrower Passage do not draw to itself all the Matter, or more than it can let forth: therefore, lest the Lochia too copiously flowing draw inwardly the Venom, which is apt to make an outward Efflorescence, the form of Diet must be somewhat changed; and in the first place let things be boiled in the Broths of the Diseased, which have an Alexipharmick together with an astringent Virtue (as the Roots of Tormentil and of Bistort,) also it is good to give at due Intervals of time, Powders, Juleps, and Opiates, endowed with such a kind of Virtue: moreover, in this Case let it by no means be allowed Women to feed on Flesh and Broths made of it, or to rise from bed; but a quiet both Mind and Body being procured by what means we may, and a Diet being ordered of those things which do not exagitate the Blood, let the business in a manner wholly be committed to God and Nature. It were an easy thing to illustrate wlth Stories and Observations what is said above concerning the acure Diseases of Women in Childbed; ut the Examples which may be brought in this kind, are for the most part deplorable and of an ill Event; for those Fevers generally are terminated in Death. Now to describe these kinds of Sicknesses will neither confirm the Endeavour of a Physician, nor at all recommend the method of Physic used in them; however, since the Knowledge of these makes for the better Diagnostic of that Disease, I shall here propose certain singular Cases and Varieties of Symptoms of Women after Delivery; in which, though Forms and ways of curing seldom occur, at leastwise you will have certain Rules of Precaution of no contemptible use. A renowned Woman about twenty fix years of Age, was delivered of a sixth Child with great difficulty, and not without danger of Life. On the second day, she are a whole Chicken. On the third, being taken up from her Bed, she sat for four hours in a Chair. The night following she was ill, at which time the Milk sprang into her Breasts; which nevertheless soon disappeared upon the Application of the Diachylum Plaster. The next Morning she complained of a Lassitude, and a Pain like a Soreness of her whole Body, also of a Vomiting, a Nauseousness, and a Plenitude about the Ventricle and Hypochondres: a very troublesome Night followed. On the fifth day she was more openly severish, and felt sometimes a Shivering, sometimes a Burning all about her. She nauseated all things, had an Oppression of the Stomach, moreover, being restless, and without Sleep, the Lochia flowed but little, but a whitish Humour (vulgarly called a flowing of Milk) flowed from her. In the Evening she had a heaviness about the Forehead and Temples, as though she were sleepy, and began to sleep a little: after an hour and a half, awaking with a troubled Fancy, she complained of her Head being increased as it were to a mighty Bulk, also of her Jaws being closed that she could not open her Teeth, and of her Fifts being closely contracted; moreover, in her whole Body she seemed to perceive a pungitive sort of a Stupor: the Ventricle and Hypochondres continued still distended and puffed up. To this Person Frictions, Ligatures, cupping Glasses, and other Remedies, both inwardly and outwardly, were applied for recalling the Lochia, and deriving the Recrements of the Blood from the Head: the weak and disorderly Pulse did not admit Blooding: Powders and Juleps for gently moving a Sweat, and fusing the Blood and nervous Juice, and hindering them from Restagnations, were diligently given. Moreover, Fomentations sometimes of linen dipped in an emollient Decoction, sometimes of the tepid Viscera of Anirnals were applied to the lower Part of the Belly; mean while, stinking things (as is wont to be done to Persons troubled with hysterick Fits) were held to the Nostrils, for hindering the impetuous flowing of the Blood and Spirits to the Head. Now these things and others being carefully plied for many Hours, she seemed to perceive some ease, though she still dreaded of closing her Eyes, or preparing herself for Sleep; for, her Eye lids being closed, a thousand Phantasms came into her Head, with a noise, and a ringing in her whole Head. She passed the Night almost without Sleep; assoon as she began to slumber, presently being frighted, and being oppressed in the Praecordia, she awaked. On the sixth day, about Noon, she had a cold Shivering, with a strong Concussion of the whole Body; to which, as in the Fit of an Intermittent Fever, presently a Heat, afterward a copious Sweat succeeded, though no Relief happened to the sick Person thereby: for presently after the Sweat, the feverish Heat renewed, and convulsive Affects more infested her. The Night following, when also the other Symptoms grew worse, a Palsy was raised first in the Tongue, and then presently in the Throat, that she could not speak, and scarce at all swallow. On the seventh day, about the same Hour, a cold Shivering again, with a Heat and a Sweeting, scised her, and thenceforward the Pulse was far weaker and uneven; also a difficult Respiraion, with short Breath, seized her; she knew not the Standards by. On the eighth day she died. Many Occasions concured to the Death of this Woman, predisposed to a Fever by reason of her Ingravidation, they greatly increasing the Malignity of the Disease; for, the hurting of the Womb through the difficult Delivery, the sudden striking of the Milk from the Breasts, the eating of Flesh, and the too quick rising from Bed, all concurred, as though conspiring together, for a greater Mischief. The Blood taken with a feverish Burning begins Disorders: it drew the Lochia, and haply other Corruptions of the Womb, into itself, and thence acquired a greater Taint and a wholly venomous Disposition; the Membranes of the Viscera, whether upon their being filled with a degenerate nervous Juice, or upon Contractions being communciated to them from the Womb, were struck with convulsive Motions: for those kinds of Inflammations and Distensions about the Abdomen, are really the Effects of Convulsions: for though the direct Fibres contracting that Member, often compress it, yet when the Fibres both straight and transverse, and others placed in a various Site, are convulsed together in the Membrane compassing about the Cavity, part of it swells like a blown Bladder, into the Vacuity of which the Air secundarily passes itself. So far it is from what is ulgarly said, viz. That the Air, or Flatus' first heaped together there, are the Cause of the Distension. In our Sick Person the Blood growing hot, and soon being full of an adust and malignant matter, presently, it being incapable of being subdued, and separated by Sweat, endeavoured to fix it in the Brain; the first discharge of that Matter on the Head, by reason of the Animal Spirits being half overwhelmed, brought the Sense of the Heads being very much increased in bulk; which happens after the like manner, as when the Foot, being seized with a Stupor, seems to be felt much greater than itself: now that after some ease, by slumbering, and closing the Eyes, the Affect returned anew, the Reason is, because Watching, and the stirring of the Senses, in some sort shake off and remove from them the Matter besetting the Brain and Nerves; which nevertheless, being seated near, and in a Readiness, Sleep stealing on, is as it were imbibed by them, and throughly enters their Bodies together with the nutritive Juice. Now the Blood, though it had copiously discharged the Recrements on the Brain, yet it became not free itself; but being still full of an impure Load, fell as it were upon a critical Efflorescence, and with a Shivering, followed by a Heat and a Sweat (as is usual in a great Excretion) it tried again and again to shake off its Burden; though all it could do by that Effort was, that the Matter sticking to the Brain got deeper Root in it, and fixing itself in certain Sprouts of the Nerves, it took away Speech, and Swallowing, and then afterward Sensation; and the Mass of the Blood being depraved more and more by degrees, at length it became unable for supporting Life. A Renowned Woman, Married a little under Twenty, being with Child, and during the time of her Ingravidation having used but little Diet, and almost no Exercise, underwent in her Travail Pains and Throws, but with Intermission and a frequent Respite, for twelve Hours, and brought forth a Son; the Foetus came away with the Secundine, and all things were well about the Womb. On the first and second days she was indifferently well, but on the third, after a light Shivering, she began to complain of a Thirst and a Heat; which a Looseness followed, so that she had four Stools that day; the Night passed in a manner without Sleep, the feverish Distemper continued afterward for two days after the same manner; she daily had three or four Stools, the Lochia as yet flowing moderately. On the sixth day, when by the Persuasion of Women she had taken somewhat for moderating her Looseness, the Purge of the Womb were in a manner wholly stopped: at which time, the Fever became more intense, and Symptoms resembling Hysterical arose; for, in the Praecordia she had great and frequent Oppressions, and had a sense of Choking in the Throat. On the seventh day, there was a more intense Heat, and a difficult and more painful Breathing; and then by a Physician's Order, at that time first called, three ounces of Blood were drawn from the Forth, after which, for four Hours, she was better; for a quiet Sleep, with a copious Sweat, ensued, the Lochia, though in a small quantity, appeared again: in the Evening all things grew worse, the Strength being very much resolved, the Pulse became weaker, and uneven; she complained also of a Noise and a ringing of the Ears, with a Plenitude of the Head, moreover she had Leapings of the Tendons in her Wrists, also sudden Convulsions of the whole Body, and still the Looseness troubled her. To this Person Cordials and other Remedies and kinds of Administrations diligently used by the Prescripts of many Physicians, did not the least good; the pulse growing weaker, and the Strength decreasing by degrees, on the ninth day after Delivery she died. This Fever depended very much on the vicious Disposition of the Body, as on the procatarctick Cause; for I have often observed, that it falls out ill with Women in Childbed, who when they are with Child, unwholsomly seed on fruits and any sorts of food, and living without Motion and Exercise, indulge themselves only to Idleness and Rest: the Blood, by reason of the previous Cachexia, without any evident Occasion, fell a burning as it were of its own accord; now whilst it boiled, deposing its Recrements and Impurities still inward, it brought the Looseness: nor did its Mass become more pure from that almost continued Excretion, but its Mixture or Crasis being still more depraved, at length the Blood fell wholly from its genuine Nature, and became uncapable of fermenting in the Heart: the Looseness naturally happening was ill stopped, especially by the use of AsTringents; for I have often observed, that these things are not attempted without danger: for a Looseness has cured some that were ill, and in that Lady, and in many others (as we have sufficiently found by Experience) though it did not take away the Fever, yet it freed them from the more severe Afects of the Brain and Genus Nervosum; whence this Diseased was wholly without a Delirium, nor was she seized with convulsive Motions, till she was brought almost to the last. A worthy Matron about thirty six Years of Age, going with Child the seventeenth time, was very sad, and perplexed with Thoughts that she should die in Childbed upon her Delivery: but (as it pleased God) she was very well delivered of a Son, and was cheerful for three days after. On the fourth day, having eaten more of a Chicken than she ought, a little before Night she fell into a feverish Distemper, with a Vomiting, and the Lochia were stopped: all the night she lay without Sleep and restless; the next Morning, within an Hours space she had four Stools, and seemed to be relieved; about Noon (at which time I came) she complained again of a Heat and a Drought, also of a Palpitation of the Heart, and of the Ascent of a certain heavy thing in her Throat; the Pulse was quick and small, the Urine was ruddy, the Lochia scarce appeared. I ordered that Cordial Juleps, and things moving a Uterine Purgation, should be given to this Person; moreover, That Fomentations should be applied to the lower part of the Belly, also that the Legs and Feet should be often rubbed with warm : at the time for Sleep, I gave her a Grain of Laudanum, with half a Scruple of Saffron powdered in a Spoonful of Treacle Water. She slept quietly, and the Lochia flowed plentifully, afterward, using a thin Diet, and things gently promoting a uterine Flux for a few days, she perfectly recovered. A Noble Woman, Young, and Handsome, had a good easy Deliverance of a second Daughter, and for six days being well as to the Lochia and other Accidents, she was wholly free from the Suspicion of any Distemper; she daily are Flesh, and being taken forth of Bed she lived cheerfully in her chamber. On the seventh day, without a manifest Cause, she had a Shivering, with a Fever, and the Lochia were lessened, though not suppressed. To the tenth day after her Delivery, being only gently feverish, and the Purge of the Womb still flowing, she lived free from any severe Symptom; but then, though very feverish, she seemed more cheerful than usual, and more confident of her doing well; in the night she slept little or scarce at all; the morning following (at which time I first visited her) she was manifestly delirious, the Lochia were stopped, and the whole Body was in a Shivering, the Tendons in the Wrists were convulsed, so that her Pulse was scarce to be distinguished; which in the mean while was weak, uneven, and very quick. I declared, That this Person, unless the Hand of God unexpectedly delivered her, must die in a short time; however, six Grains of Oriental Bezoar being given in a Spoonful of a Cordial Julep, and causing a copious Sweat with a better Pulse, and afterward other Cordials given at due Intervals, gave some hope of doing well, though doubtful, and not to be relied on. After four Hours after I came, being in a languishing Condition, she had a very large Stool, then presently her Strength wholly fell, and within an hour and a half she died. A Woman of Quality, scarce exceeding twenty Years of Age, of a florid Countenance, and a thin Body, the Lochia flowing immoderately after Childbirth, used certain astringent Remedies by the Advice of the Attendants, whereby they were wholly stopped: but a Looseness followed; which increasing for three days, the Women gave her other Remedies to stop the Looseness, nor were they frustrated of Success; mean while they brought a dangerous Fever, and Affects as it were hysterical in the place of the former; for the unfortunate Woman in Childbed was affected with a Thirst, and a Heat, with Watch, afterward with a frequent Swooning, and cold Sweats. Being called at this time, I ordered Cordial Remedies, and things to promote uterine Purgations to be drank, and likewise a Clyster to be injected; the Looseness of the Belly being again procured, the Lochia also came down, and the Diseased being freed from the foresaid Symptoms, and the more severe Disease, viz. the Nurse's Remedies, soon recovered from her Fever. Here let it be observed by the By, that it's very dangerous either to stop, or to alter, or to thwart any Motion raised by Nature, though anomalous. A Woman of Note, about twenty years of Age, of a full and well-fleshed Habit of Body, aborted twice within a Years space; when afterward she had conceived with Child, by her Physician's Order, once a Month drinking plentifully of Whey, she raised a Vomiting, whereby she was wont to cast up a great deal of thick and clammy Phlegm; also during the time of her being with Child she was let Bood five times. The time of Childbearing being over, she brought forth a Boy with great Difficulty: the Secundine came away entirely, and she purged egregiously. On the second day, as she raised herself on her Feet in her Bed, that the might be put in order, she took Cold; and thenceforward the bloody Lochia were wholly stopped, and only a little serous Water flowed forth. On the third day she began to complain of an acute Pain in the rightside; the Women present applied to it Bags of Camomile made warm with Bricks: nevertheless, the Affect was very much increased with a bloody Spittle. On the fourth day after Delivery a most acute Pain, with a most difficult and very painful Breathing, seized her. By the Order of a Physician then coming from the Neighbourhood, six ounces of Blood were drawn from the Basilica, and she suddenly found Relief, and was better for ten Hours. At Midnight a pricking Pain returned with the wont fierceness: at other Physicians being called to consult, they all concluded that it was necessary to bleed again in the Arm of the Side affected. Blood being drawn to four ounces, the Pain remitted, and the Diseased breathed better: afterward Diaphoreticks being given, she fell into a copious Sweat, with a quiet Sleep; but the Pulse became more quick and weaker: also Contractions of the Tendons appeared in the Wrists. Presently afterward she talked lightheaded, and within twenty four Hours after Blood was drawn the last time, she died. That this Lady, upon the Lochia being suppressed, together with a Fever, fell into a pleurisy, the Cause in some measure seems to be the Bleeding so often used during the time of her going with Child; for by this means the Blood, accustomed to be breathed by the Arm, afterward fermenting, leaving the Womb, ran towards the wont way of being let forth; where not finding a Passage, it fixed itself in the neighbouring side as in the next seat of Extravasation. Moreover, besides the usual state of a Pleurisy, no small Malignity was added to this Disease; for the Blood being freed from Extravasation, presently began to be corrupted in its Crasis, and on the third Day of the Fever was so far depraved, that it was not able to ferment longer in the Heart, and so to continue Life. Not long since, the Wife of a certain Smith was brought to Bed at the time that her Children were sick of the Small Pox in the same House, and herself, as it seems, took the Contagion of the Disease; for, on the second day after Delivery Pushes began to break forth with a feverish Incalescence, and a Pain in the Loins; which for three days, the Lochia flowing moderately, rise up as they ought to good Wheals; and though a uterine Purgation happened copiously at this time, she had the Small Pox very thick in her whole Body; nor were they only on the Surface of the Skin, but they likewise so filled the Cavity of the Mouth and Throat, that she was scarce able to speak or to swallow. On the sixth day, after being delivered, the Lochia flowed immoderately, whereby presently the Small Pox falling, a Swooning, frequent Convulsions, and other Symptoms of an ill nature, assailed the Diseased, which threatened Death in a short time. Being called, I prescribed half a dram of this Powder to be taken constantly every three Hours in a Spoonful of the following Julep; viz. Take Roots of Tormentil powdered two drams, the best one dram, Species of Hyacynth half a dram, make a Powder. Take Water of Scordium compound, of Dragonwort, of Meadow sweet, of each three ounces, Acetum Theriacale an ounce, Syrup of Corals two ounces, Hartshorn half a dram, make a Julep. Moreover, I ordered that in her Broth, and in all things she drank, the Roots of Tormentil should be boiled; by these Remedies the uterine Purgation was wholly stopped, and the Small Pox without any severe Symptom, being ripened by degrees, fell away. This Case was really difficult, and was managed with a great deal of Danger; viz It was dangerous either for the Lochia or Small Pox to be kept in, and nevertheless, the full Eruption of either hindered the Motion of the other: as long as both proceeded moderately, the Busmesses being left to the Guidance of Nature, went on indifferently well; but when the one prevailing, the Assistance of Art was required, it was necessary to check the Lochia, and to put forward the Small Pox. CHAP. XVI. Of Epidemic Fevers. I Had designed to have put an end here to our Dissertation concerning Fevers, it being my Intent rather to write a Commentary than an entire Tract: but in regard certain Epidemic Fevers are often rise, which observe no Laws, nor can be reduced to a certain Rule of Doctrine; but being wholly anomalous, vary yearly, and therefore, as often as some one of them spreads itself, presently it is called the New Disease: therefore I have thought it necessary, because general Precepts are not to be given concerning these Fevers, to subjoin particular Relations of some of this kind: for from the various Apparatus of Symptoms whereby they are wont to be marked, the Nature, and the whole formal Reason of these kinds of Affects, will somewhat appear. Since therefore of late Years, within a little Tract of Time, three Popular Diseases have reigned in these Countries, I shall give here, as a conclusion to this Work, the particular Descriptions of them made formerly in the Tiems that those Fevers reigned. A Description of an Epidemic Fever Reigning in Autumn, Anno 1657. made in the middle of September. WE, designing a Description of a Fever violently reigning at this time, it is fit, that being led by the Example of Hypocrates, we first consider the foregoing Constitution of the Year, and its Distemperatures, and Excesses of the Qualities; for the Cause of an Epidemic Disease, raised generally among People, must be common. We must note what the State of the Year was, and the Disposition of our Body thence contracted, whereby many were affected together. Now to take the thing stom its Origine, The foregoing Spring, and the Time thenceforward to the end of the Summer, to wit, all this half years space was mighty hot and dry: but especially after the Summer Solstice the Heats were so intense for many Weeks together, that Night and Day every one complained of the Heat of the Air, and almost of a continual Sweat wherewith they were all bedewed; and that they could not breathe freely. About the end of July, this Fever being first sporadical, began to break forth in certain Places, that one haply, or two, in a Town, or Village, were seized with it: in most it carried the Type of an intermittent Tertian, to wit, the Fits returned every other Day; which nevertheless, without any forerunning Cold or Shivering, infested the Diseased with a most intense Heat; Vomitings and bilous Stools happened plentifully in most, a Sweat succeeding, but difficult, and often interrupted, whereby the feverish Access seldom went off with an Apurexia: but all the time of Intermission the Diseased continued languid and weak, with a Thirst, and a Restlessness; in some, when they began to amend, after three or four Fits, a cold and a Shivering begins the Access, and the Fever became exactly an intermittent Tertian; but in most the Disease still grew worse, and presently became obstinate, and of a difficult Solution, with an ill Apparatus of Symptoms; for the Diseased being mighty hot in their Fits, and sweeting with Difficulty, Errors were wont to be committed, which daily intended the Strength of the Disease: for through the Impatience of the Diseased, and the unskilfulness of the Attendants, the Sweat, which ought to have ended the feverish Access, being interrupted, scarce one Fit was ended, but another presently succeeded, and thereby the Disease was wont to have erring and uncertain Periods, without an Intercession of an Apyrexia, and afterward it was wont to pass into a continual Fever as it were; the State whereof was sometimes very dangerous, with an ill Affect of the Brain, and Genus Nervosum, that not unfrequently a Lethargy or Delirium, and often Cramps and convulsive Motions were raised. In the Month of August this Fever began to reign far and near among the People, that in every Part and Village, many lay ill of it; though it was far more common in the country and little Villages, than in the Confines of Cities and Towns. It still carried the Type of an intermittent Fever, only that through the Violence of Symptoms, and the Shortness of Intermission, it seemed more tedious than ordinary, and therefore was generally called the New Disease. Moreover, it was censured of some Malignity, and gave Proofs certain enough of its Contagion and Mortality; in as much as it crept from House to House, and infected many of the same Family with the same corrupted Taint, and especially such as conversed familiarly with the Sick: moreover, in many Places it carried off old Persons, and such as were come to a Ripeness in Years. If you consider the Nature and Essence of the Affect, this Fever must be placed properly in the number of Intermittents: for the Fits return at set times; also for the most part they begin with a Cold and a Shivering, and very often with a Vomiting, and presently going on with a most intense Heat, at length they are ended in a Sweat. The Urine in most appears of a Flame Colour; clear in the Fit, with some Hypostasis, out of it thick, with somewhat a ruddy Sediment: the Disease comes not to a Crisis by a Sweat, though very plentiful, and often repeated, which might be expected in a continual Fever: but the Affect holds on for many Days, and sometimes Months, to a very long time, though there happens a very great Evacuation by Vomiting, and Sweeting almost daily; which we observe to fall out often in an Intermittent Fever, seldom in a continual: out of the Fit, at any time of the Disease, Purging is conveniently ordered, which it were a Crime to attempt in a Synochus before the Signs of Concoction. Moreover, that this Fever is of the kind of Intermittents, it hence appears, because most recover of it, that scarce the thousandth part of the Diseased dies; which I think is scarce heard of an Epidemic Synochus. About the first beginnings of this Disease, it appears very like an Intermittent Tertian, though it may seem in some, by reason of a vicious Predisposition of the Body, and of Errors committed in Diet, and Transpiration, to have passed into a continual: for in those in whom the Fits do not come to a due Determination, nor end in an Apyrexia, by reason of the morbific Matter being not perfectly blown off, in those the Blood continually boils; whence it comes to pass, that the Accesses return quicker, and infest longer; till at length, by reason of the store of the Matter, and the languishing of Nature, the Blood becoming weak, is not able to grow turgid any longer, and to separate the Febrile Matter at set Hours, but endeavours to subdue it by little and little, and by a continual Effervescence. Some haply may wholly place the Cause of this so Popular a Disease in a malignant Constitution of the Air, to wit, that the Particles of the Air breathed in were infected with a certain extraneous Miasm, the Corpuscles of which Miasm being inwardly admitted, fermented with the Blood and Humours, and so caused this Fever in a great many with the same Appearance of Symptoms. But I do not think that this Fever arose from a certain Contagion communicated from the Air, and immediately fixing the Taint in Men, but rather from a certain febrile Diathesis or Predisposition communicated to our Bodies by degrees before, through the Distemperature of the Year; which at length having gotten a Maturity, is brought into Act on a light occasion; and it cannot be said so much to burst forth into this Fever, as to grow into it. For when about the Beginning of July the Air waxed immoderately hot, through a most intense Scorching for many days, it easily altered our Blood, towards a hot and bilous Distemperature; to wit, because (as in Wine fermenting more than it ought) the sweet and spirituous Part is very much spent, mean while the saline and sulphureous is too much exalted, that thereby the Liquor readily contracts a Mustiness or a Sharpness: now we have seen elsewhere, that this kind of Diathesis of the Blood, whereby from a sweet and spirituous Temperament, by reason of its too great Scorching, it inclines to a bilous, is very apt for Intermittent Fevers. Hence the nutritive Juice, which is continually conveyed into the Mass of Blood, is not duly concocted, nor assimilated into Blood, but is perverted into an extraneous, as it were, and fermentative Matter; which arising to a Fullness within the Blood, and growing turgid at set Periods, according to its Increases, brings the Fits of an Intermittent Fever. Since therefore from the scorching Heat of this Summer, the Blood almost of all Men growing hotter than it ought, was very much parched, it's no Wonder if thereby it contracted a very great Aptness to Intermittent Fevers: but why this Disease grew not rife during the great Heat, but rather afterward, the Reason is, because this Indisposition is not imprinted in our Blood at one bout, but by degrees, and not till after a long time; and therefore the Fruit, as it were, of the Disease after the foregoing Heat of the Summer, were chief brought to a Ripeness in Autumn. All do not equally contract this Aptness or Disposition to a Fever; those whose Blood being hot by Nature most abound with Sulphur, and thereby is sooner parched, and those who being given to Labours or staying much in the Sun, endured most of the Summer Heat, by reason of their Blood being more egregiously scorched, easily fell into this Disease: wherefore it first reigned among the Husbandmen, and chief in the Country: of those who had acquired an Aptness to this Fever from their Blood being scorched, haply some fell into it naturally, the feverish Diathesis being raised by degrees to a Maturity, others by reason of a light Occasion, or an evident Cause, which is otherwise wont to raise a feverish Effervescence, as upon taking Cold, Surfeiting, drinking Wine, and the like; and others fell sick by reason of a Contagion received from others; for Effluvia constantly flow from the Sick, which when they light on Bodies predisposed to the like Affect, readily raise into Act the latent Powers. That the Conjunct Cause of this Disease, and its formal Reason may be known, you must call to Mind what is said elsewhere concerning the Nature of Intermittent Fevers; to wit, we suppose that the Basis, as it were, of this Affect, is a and bilous Constitution of the Blood; by reason of which, the nutritive Juice, daily supplied as it were by Measure, is not duly concocted, but through its being scorched turns into a fermentative Matter, and not miscible with the Blood. When the Blood is saturated with this Matter to a Fullness, (which happens at set Intervals of Times, because the nutritive Juice is supplied in a set Measure as it were) it naturally falls into a Turgescency, and the Effervescency raised for the Expulsion of this Matter, brings the feverish Fit; which lasts so long, till this febrile Matter, kindled in the Heart, and as it were burnt, is wholly blown off with the Sweat. From these things premitted, it is plain, that there are some things which in this Affect, whereof we treat, happen after a peculiar manner from the common kind of Intermittents, and therefore it is not unfitly called by the Name of a new Fever; such as are, first, that about the beginnings of the Disease, the Fits begin without a Cold or a Shivering, but long afflict the Diseased with a Vomiting, a Thirst, and a most intense Heat, to which a Swear for the most part with difficulty, and partial, and often interrupted, ensues, whereby the Access is not ended but in a long time: the reason of which eught to be solely placed in the very bilous and excessively parched Disposition of the Blood; for, this proceeding from the prevailing Sulphur, wholly hinders the wont Sourness of the Blood, which follows its Turgescency, and is wont to raise the Shivering or Cold; and by reason of this kind of Temperature of the Blood, scorching too much and as it were burning the nutritive Juice, the Blood growing turgid together with that Juice, and stirred to motion, is kindled more than usually in the Heart, and by its Deflagration, it causes a most intense Heat with a Drought, which are most tedious to the Diseased. Bilous Vomitings happen not only at the Beginning, but even in the middle of the Fit, by reason of the Redundancy of the Choler wherewith the Vasa Coledocha, being oftentimes too much filled, they pour it into the Intestines; which afterward, a Contraction being raised in the Viscera, is easily sent into the Stomach: the Sweat follows with difficulty, because the Choler abounds more than the Serum; wherefore the burned Febrile Matter is not easily separated by a Sweat, but, either being mixed with the Blood, brings a long continued Effervescence, or being conveyed towards the Intestines, produces a Vomiting or a Looseness. Secondly, this Fever differs from a vulgar Intermittent, because, after a Fit ended, there is not given a full Intermission, so far as an Apyrexia, but the Diseased continue still languid and dry, being ill disposed as to their Appetite, Sleep, and other Accidents: which really happens, because by the intense Heat of the Fever, more of the Blood and febrile Matter is kindled, than that the Recrements remaining after its Deflagration can be soon blown oft, especially because a Sweat, by reason of the Drought of the Matter, with great difficulty ensues; nor is the febrile Matter, to be voided forth, sufficiently diluted with a Serous Latex: wherefore, the Blood being not perfectly freed from its Contagion at the time of the Fit, ferments still, nor the Access being ended, has it a full Truce from the Disease. Mean while that the Blood is pressed after this manner with an almost continual Effervescence, it differs from a Synochus: because in this the sulphureous Part of the Blood being too much exalted, is inflamed as it were, and makes the Fever by its Deflagration: but the continual Ebullition which happens to this Intermittent Fever, depends wholly on the Confusion of the Matter not miscible, and the difficult Secretion of it from the Blood. A Synochus happens as Wine naturally fermenting by reason of its Richness; the other like the same Wine when it falls a working by reason of some haeterogeneous thing mixed with it: wherefore we observe, that when our Fever has passed into a continual, yet it comes not to a Determination, neither by a Sweat, nor by a Looseness, though happening in a plentiful manner and frequently, because depending on the Blood depauperated, rather than being inflamed, it continues a very long time, and disposes the Diseased towards a Cachexia. The third way of difference, wherein this Fever differs from the common Rank of Intermittents, is placed in this, that it is oftentimes readily propagated by Contagion into others; the reason of which is, because here a great many Bodies are predisposed after the same manner to the same Affect; which at another time does not happen: wherefore the mere Effluvia from a morbid Body are able to stir up the like Affect in a Subject easily capable; even as certain Rays of a Flame kindle a Flame in a Matter which is very combustible: mean while, all do not contract the taint of this Fever alike; but some not prepared for it converse with the Diseased without hurt. There is another Symptom which does not constantly attend this Fever, but only happening in some Places, which distinguishes it not only from a common Fever, but changes its own proper Type, to wit, it sometimes happens that dyssenterick Affects accompany this Disease; in some bilous Vomitings and Seiges are very troublesome, as in the choleric Disease, and in others bloody Stools happen with a violent Pain and Gripes of the Belly. I have often observed the former in this our Neighbourhood; and the reason of it may be deduced from a mighty bilous Temperature; for by reason of this, the adust Matter, not to be blown off by Sweat, is copiously separated in the Liver: afterward by reason of the Vasa Choledocha being overfilled, it is sent to the Ventricle and Intestines: the other Affect of the Dysentery is found only in some Places, and there being sporadical rather than common, it has seized only some sick Persons. The Origine of it can be ascribed only to the peculiar Crasis or vicious Predispositions of some Bodies, also to the Situations of Places, or the nature of the Air. Moreover, it may be suspected that the Disease is now and then conveyed to others, not without the Communication of a certain Miasm. Concerning this Disease, there ought to be a double Prognostic; first of the Fever itself, in general, what kind of end it will have, and when; what it does threaten to our Land; whether it be not a Forerunner of the Plague, or Pestilential Diseases, (as it is vulgarly feared.) Secondly, We ought to give the Signs by which we are wont to presage a Welldoing or Danger in the various Cases of the Diseased. As to the first, because we have shown that the Origine of this Affect is not to be taken from the Air infected with a Contagion, or venomous Miasm, nor from a malignant Seminium of Vapours diffused through the Air; but only from a mighty bilous Temperature or Diathesis of our Bodies, with a Blood which is adust and mightily scorched by reason of the Summer Heats: I think there is no cause of Fear here, whereby we may dread that this Fever, being raised to a worse state through the fault of the Air, may grow at length to be Malignant or Pestilential; but rather (what the Change of the Season of the Year, and the Alteration of our Blood may make us expect) we ought to fear lest this Fever, which at first imitates the Type of a Tertian, may pass into a Quartan: which I observe has already happened to some; and think it is greatly to be feared, lest hereafter, Autumn drawing to an end, it may happen in many. As to the particular Prognostic, the Signs which happen in the course of this Fever most remarkable, and which in some manner foretell its Issue and Event, are these: If the Disease happens in a sound Body, well-tempered, and easily perspirable, if a Vomiting with a well-bearing ensues, and the Belly be lose; if the Fit gins with a light Shivering, and after a moderate Heat ends in a Sweat, and the Interval of it be with an Apyrexia, or a well-bearing; if the Pulse be strong, the Urine of a flame colour, clear, with a laudable Hypostasis, we predict that the Disease will end in a short time without danger: but if this Fever be raised in a fat Body, and of a vicious Habit; if with a troublesome Vomiting, an exorbitant Heat, and an intolerable Thirst, long torment the Diseased; if the Heat be succeeded by a difficult, partial, often interrupted Sweat, and interlaced with frequent Vomitings, and does not end in an Apyrexia, we declare this Disease to be long, and liable to Danger: but if the Diseased holds his Strength, and the Urine shows signs of Concoction, we do not despair of well-doing; especially if after four or five Returns, the Disease, as it is usual, remits of its wont fierceness. Thirdly, we observe, if this Disease happens in a Body which is cold, or broken with other Diseases, or weakened; if besides horrible Vomitings, and a violent Heat, a frequent Fainting, Swoonings, Deliriums, or Lethargic Affects happen; if after many Accesses, the Strength of the Diseased falling, the Disease remits nothing, but a continual Effervescence troubles the Blood, and very much dissipates the vital Spirits; if a dejected Appetite, obstinate Watch, convulsive Motions, with a weak Pulse, a troubled or thick Urine happen, we declare the Case to be full of Danger: but it is protracted to a good length, and it gives Time and Occasions for Nature to recollect herself, and to the Physician for giving Remedies. The Therapeutic Indications which have place in the Cure of this Fever, are chief four. First, that the Blood being become burnt, and too bilous, be reduced to its due temper. Secondly, that the depravation of the Nutritive Juice, and its alteration into a fermentative matter, be stopped, or at leastwise, be lessened. Thirdly, that about the declination of the Disease the Blood being depauperated by a frequent Deflagration, and rendered impure by the mixture of the morbific or adust matter be restored, and be rendered volatile as it ought. Fourthly, that we obviate with Remedies the Symptoms which are chief infesting in the Course of the Disease. To answer these Intentions, I advise the following Method to be used. About the first beginnings of the Disease, if a bilous Humour flowing from the Vasa Choledocha, and sent into the Ventricle, the Diseased be inclined to Vomit, when the Fit is at hand let a plentiful Evacuation of the same be raised by a gentle Emetic: Blooding and Purging ought not to be used but during the Interval of Fits; for while the Blood violently ferments, or is resolved into a Sweat, Nature ought not to be diverted from its Works begun, nor its Attempts be disturbed by the Prescripts of Physicians; wherefore after the Access is over, and the Sweat entirely ended, let a Purging be ordered by a gentle Cathartick, and let the same afterward be sometimes repeated on the like occasion: for by this Method, not only the store of the excrementitious Matter is withdrawn from the first Passages, but especially the Choler-Vessels being emptied, the Bile is plentifully drawn from the Mass of Blood, and thereby the Blood is restored toward its natural Crasis. Let Blooding, if it be indicated, be put in Practice, from the beginning; for so its Liquor growing too turgid, is eventilated, whereby it both less perverts the nutritive Juice, and when the Fit presses, it burns with a more mild Blast together with the morbific Matter: but otherwise, if after a long Sickness a Vein be opened, when the Blood being depauperated and rendered watery, has heaped together more of morbific Matter, and does not duly concoct it, and purge it forth, much is drawn from the Strength of Nature, from the Power of the Disease nothing. In the Interval of the Accesses, when Blooding nor Purging may not be admitted, let the Belly be kept soluble by a constant use of Clysters; also let digestive Remedies of acetous or saline Liquors and Powders be given, such as Cream of Tartar, the fixed Salts of Herbs, Tartar Vitriolate, Hartshorn, Spirit of Vitriol and of Salt, etc. for these restore the Ferments of the Viscera lost or grown sluggish, depurate the Blood by fusing it; also separate, and as it were, precipitate the morbific Matter: also at this time, if obstinate Watch chance to prove infesting, and impair the Strength of the Diseased, we may interlace Anodyne and gently Narcotick Remedies, but by no means give them in the Access, for than they greatly hinder the subduing, and secretion of the febrile Matter, and prolong the Fit which would sooner end. So far concerning what is to be done in the Intervals of the Fits; but in the Fit, though the Diseased then chief send for and call upon Physicians, yet their Prescripts at this time are limited within a narrow Scope: if a Vomiting (though an Emetic be given before) be still infesting, let it be freely promoted by Posset-Drink, either simple, or with bitter Herbs boiled in it; but let the chief way of the Cure be in qualifying the Heat and Drought, which are wont to torture severely the Diseased in this Fever; for whilst the Blood, fermenting with the morbific Matter, and being kindled in the Heart, springs into the Lungs, it raises there a most violent Inflammation, which requires a pouring on of cold Water as it were for extinguishing a Flame: wherefore they desire to be pouring in Drink without measure; without which the Diseased faint through the too much burning, and in a manner all their Blood, being rarefied as it were into a Flame and a Smoke, does not easily continue the thread of Circulation; wherefore, Drink by all means aught to be granted to those that are in the Fever: which nevertheless, if it be poured in in too great a quantity, first it exagitates more the boiling Blood, and again brings a Confusion of the febrile Matter began to be separated, that thereby the Work of subduing and Secretion is longer protracted, and the Fit is made longer; moreover, a great pouring in of Drink proves offensive to the Stomach, and by troubling it, and often by raising a Vomit, hinders Transpiration, and calls in a Sweat breaking forth, or haply already broken forth: wherefore, when the Heat of the Fever is first kindled, let the Diseased, though very dry, drink only by sipping, and, what they may, let them refrain it; afterward when the and subdued Matter gins to be sent off by Sweat, let them more freely gratify themselves with it; for so the Sweeting is greatly promoted, and the Fit is sooner over: as to the nature of the Drink, sometimes let Posset Drink, sometimes small Ale, or Barley Water be given; sometimes Fountain Water, either alone, or sharpened a little with the Juice of Lemons: in this case, the use of Sal Prunella is justly commended, given in any Liquor; for this, by its Nitrosity, wonderfully restrains the boiling Blood, and powerfully moves Sweat. I have often observed in the middle of the Fit, that the Diseased have fallen into a Fainting or a Swoon, where the Cordials and hot Liquors, which are wont presently to be poured in, very much increase the Violence of the Fever, and cause greater Troubles than usual, that the Fit is more difficultly ended: but these Swoonings, for the most part, happen either from the bilous Humour sent into the Ventricle, or by reason of a Sweat broken off abruptly, and against these I have always found the most present Remedy; that either a Feather being put in the Throat, a Vomit be promoted, or that a thin Liquor being drank in a plentiful Measure, the Sweat be again raised: and in the whole Course of this Fever, I am wont to give no Cordials or Alexipharmicks. A Diet in this Fever only thin, and not rich, aught to be ordered: let all Food prepared of the Flesh of Animals be wholly shunned; for these abounding with Sulphur, plentifully afford a Fuel to the boiling or kindled Blood, as Oil poured on a Flame: moreover, let nothing spirituous, as hot Waters, strong Ale, or Wine, be allowed; but let Oat or Barley Decoctions or Broths, altered with cooling Herbs, be chief used; also let Posset Drink, small Ale, or Whey, be drank by the Diseased at Pleasure: for since by this Means a very thin and watery nutritive Juice is conveyed to the Mass of Blood, the resolved Particles of the Sulphur are burnt off sooner, and with less Tumult; also the Recrements of the adust Matter are more readily sent forth from the Mass of Blood: but if on the contrary, a rich and plentiful Nourishment be used, the Effervescence of the Blood is thereby much increased, and the Blood is more infected with the Mixture of an adust Matter. When after frequent Fits, the Blood being much burnt off, and the Fever, being in its declining State, has remitted of its Fervour and Fierceness, Care must be taken, that the Diseased, while upon their Recovery, do not fall into a Cachexia, or Scorbutic Affect; for the Crasis of the Viscera being injured, and the Blood being very much depauperated, the nutritive Juice, though it be not scorched as before, yet is not duly concocted, and maturated into a perfect Blood: but through defect of a Pneumatosis, serous Excrements, imbued with a fixed Salt, are very much heaped together; and sometimes being fixed in the Viscera, sometimes in the extreme Parts, bring forth various Affects. Wherefore in a long continued languor of the Diseased, or otherwise, in order to a quicker Recovery, let Remedies be given which volatize the Blood, and either hinder the Stuff of the Viscera, or remove them being made, and restore their Ferments being almost extinct; for this Use chief conduce the Remedies and Preparations, which are vulgarly called Digestives and Antiscorbutics; by which being seasonably administered, I have known many weak, pale, and bloodless Persons as it were, to have soon recovered a sprightly Strength and Vigour. A Description, made the last Day of May, of a Catarrhous Epidemic Fever happening in the middle of the Spring, An. 1658. AN immoderate Heat of the Summer before was followed in the Winter with a Frost equally intense, so that no Man living has scarce remembered a year like this for an Excess both of Heat and Cold. From the fifth of December almost to the Vernal Equinox, the Earth was covered with Snow; and from the North Winds continually blowing, all things, set in the open Air, waxed stiff with Cold: and afterward, from the beginning of the Spring almost to the first day of June, the same Wind still blowing, the Season was more like Winter than Spring, only that sometimes haply it was interlaced with a day or two of hot Wether. During the Winter, amongst our People here (save that the Quartan Ague contracted in the Autumn infested some) the State was indifferently healthful, free from any popular Disease. In the beginning of the Spring an intermittent Tertian Fever (as it's usual in every other year) seized some. About the end of April, on a sudden an Affect showed itself, which being sent as it were by a certain Blast from the Stars, seized a great many; that in some certain Towns, in a Weeks space, above a thousand Men lay ill at once. The Pathognomick Symptom of this Disease, which first seized the Diseased, was a troublesome Cough, with a copious Spitting, and a Catarrh falling on the Palate, Throat, and Nostrils; there is also a feverish Distemperature, which for the most part is joined with a Heat and a Drought, a want of Appetite, a spontaneous Lassitude, and a great Pain in the Back and Loins: which Fever nevertheless in some was more remiss, that they walked abroad, and during all the time of their Sickness followed the usual Offices of Life, complaining in the mean time of a want of Strength and a Weakness, of a loathing of food, of a Cough and a Catarrh. Now in some a hot Distemperature very much reigned, that being confined to their Bed, they were troubled with a Burning and a mighty Drought, with Watch, a Hoarseness, and an almost continual Cough; sometimes a Bleeding at Nose, in some a Spitting Blood, and often bloody Stools, happened upon this Affect. Those who being of an infirm Body, and stricken in Years, were seized with this Disease, many of them died; but in a manner all of those that were strong and of a sound Constitution recovered: those who yielding to this Disease perished, they died for the most part by reason of their Strength being wasted by Degrees, and a Mass of serous Filth being heaped together in the Breast, with the Fevers being increased, and a difficult Breathing, like Persons troubled with a Hectic Fever. Concerning this Disease, we must inquire what kind of Procatarctick Cause it had, that it should rise on a sudden in the Spring, and that within a Month's time almost the third Part of Mankind should be affected with it. Afterward, the Signs and Symptoms being diligently compared together, the formal Reason of this Disease, also the ways of its Crisis and Cure, aught to be assigned. That the North Wind is most apt for producing Catarrhs, besides the Testimony of Historians, common Experience makes good: but why Catarrhs did not spread themselves so much sporadically during all the Tract of the Winter and Spring, but that this Affect should reign epidemically only for the space of one Month, and then joined with a Fever, the reason is not so plain. I know that many draw the Cause from the uneven Distemperature of the Air, for that Season; which though for the most part cold, yet sometimes, the Northwind remitting, for a Day or two was very hot; wherefore, on this Occasion, as upon taking Cold after being hot, many Men might fall sick: this kind of evident Cause might suffice haply for affecting some with this Sickness; but for causing an Affect arising so on a sudden, and generally reigning, besides such an occasion, a great Procatarxis or Predisposition was required: for it ought to be supposed, that all Men in a manner, were ready prepared for receiving this Disease, otherwise no evident Cause would exercise its force so powerfully on a great many: wherefore it is likely that this Disease drew its Origine from the Distemperature, and very great Irregularity of the Year: and as the intermittent Autumnal Fever above described was the Product of a preceding immoderate Heat, so this catarrhal Fever wholly depended on the Tract of the Year happening to be too cold; for the Blood being already burnt from the overhot Summer, and inclined to the Fever above described, than Autumn coming on being made more sharp, and apt to a Quartan Fever, afterward by reason of the intense Cold of the Winter being little eventilated, and hindered from its due Perspiration, it held still a dyscrasy, and was ready to suffer by it as occasion might be given. Wherefore, in regard the Blood in the middle of the Spring (as the Juice of Vegetables) being become more sprightly, and having begun to spring and display itself, by reason of its Thickness still continued, was straitened in circulating, it was prone to feverish Effervescencies; and in regard the Serous Latex abounding in the Blood, was not able to evaporate forth by reason of the Pores being still closed with the Cold, restagnating inwardly and falling chief on the Lungs (where somewhat succedaneous is performed to outward Perspiration) it raised so frequent and troublesome a Cough. Therefore the Rise and formal Reason of this Disease are chief founded in two things; to wit, that there happened together a greater Effervescence of the Blood than ordinary, caused by the Spring Season, and withal a Density, or a great Constriction of the Pores caused by the preceding Tract of Time which was too cold; that thereby there was not a free space granted the Blood springing in the Vessels: the Case was the same, as if Wine beginning to ferment, were put into Vessels close stopped; for by this means both the Vessels and the Wine are in danger of being destroyed. Wherefore, to draw the thing in short; that this Disease arising in the middle of the Spring, presently spreading very far, seized a great many, the cause was not a blast of a malignant Air, whereby the Diseased were affected as though struck by a Sideration, as some will have it, but that at this time the Blood being inspired by the Constitution of the Spring, and so apt to display itself and ferment, was straitened in its Motion, and the Efluvia being inwardly restrained, it could not be enough ventilated. Every years though temperate, it is usual in the Spring and Fall for certain Diseases to reign epidemically, to wit, because at this time, the blood being renewed, displays itself as it were anew, and therefore intermittent Fevers, and sometimes the Small Pox grow every where rife at this time; wherefore it is no wonder, after a very uneven Constitution of the Year, and differing from the natural, when in this Spring the Blood boiling strongly within the Vessels, by reason of a letted Transpiration, was not able to be circulated freely, and to be enough eventilated, if thence great Diforders follow, and a very epidemic Affect be raised from this very general Cause. As to the Symptoms joined to this Disease, the feverish distemperature and the things depending of it, the burning of the Praecordia, the Thirst, spontaneous Lassitude, the great pain in the Head, Loins or Limbs, were caused by the Bloods boiling too much, and not being enough eventilated. Hence in many the thinner part of the Blood being heated, and the remaining Liquor being only troubled, a Synochus simple, or of many days was caused: but in some having a vicious Diathesis of the Blood, or an ill habit of the Body, this kind of Fever being arisen through the same cause, soon passed into a very dangerous, and often mortal putrid. The Cough accompanying this Fever with the Catarrh, draws its origine from the serous humour heaped together along time in the Blood, by reason of Transpiration being letted, and afterward an effervescence arising, distilling in a great plenty from the little Arteries gaping inwardly: for when the Pores are constringed, the superfluous Serosities in the Blood, wont to evaporate outwardly, are poured on the Lungs by a nearer way of purifying the Blood: Wherefore upon taking cold, (as it's vulgarly said) that is upon Transpiration being outwardly letted, a Cough for the most part is raised: and in the Procatarxis for this affect, a redundancy of Serum in the Mass of Blood had almost the first Place, for from the long continued cold stopping the burning of the Blood, or the increase of choler, and hindering the Transpiration of the watery Latex, of necessity a great deal of serous Humour was heaped together in the Blood; wherefore, when the Blood, displaying itself in the Spring, fell into an Effervescence, the overflowing of the Serum, and its discharge on the inward Parts was wont to bring first a Cough, as a proper Symptom of this Disease: and in whom the Blood, being much diluted by the mixture of Serum, were very obnoxious to the Cough and rheumatic affect, those came more lightly off with the Feverish Distemper. The Prognostic of this affect, as to private Persons, for the most part is easy, that presently from its first invasion it discovers the event. For if this Sickness be raised in a robust Body and sound before, and the feverish Distemperature be moderate, and without any severe and dreadful Symptom, the Case is free from Danger, and the affect is reputed of so light Moment, that commonly it is only called a Cold taken, and for the most part neither a Physician nor Remedies are sought after, unless some that are very common, and of an easy Preparation are used. But if this Affect happens in a weak and unhealthy Body, with an ill Apparatus, and either the Fever be raised to a putrid, or the Cough growing strong, causes a difficult Breathing, and a kind of consumptive Constitution, the event of the Disease is very much suspected, and often is terminated in Death. The common Prognostic, which is taken hence concerning the future state of the Year, contains nothing very much to be feared, or threatens mighty ill; by reason of the uneven Intemperies of the Year, as great excesses of Heat, and afterward the Cold, we may fear Diseases arising from the discrasy of the Blood; but from the present state, we neither suspect the Air mightily depraved, nor infected with venomous Breathes, that we may hence ground a Judgement of a Plague, or malignant intermittent Disease. As to the Method of Cure, when this Disease seizes lightly, its cure for the most part is left to Nature: for this Fever being only a simple Synochus, is wont to be determined within a few days by a Sweat. Wherefore after a copious Sweat for the most part about the third or fourth day, the heat and Drought, the lassitude and great Pains are appeased: then the Cough, protracted longer, afterward remits by little and little, and at length the Diseased recover by degrees. If at any time this Disease has taken deeper root, there is need of fit Remedies and an exact Method of Cure; let the Fever growing strong be cured according to the Rules to be observed in a putrid, though with this difference, that because a letted Transpiration, and the discharge of the serous Humour on the Lungs are chief in the fault, therefore let Diaphoreticks, and the Remedies called Thoraciks be of frequent use; for these restrain the great flowing of the Serum from the Vessels inward, and either by opening the Pores, convey it outward, or by precipitating it from the Mass of Blood, send it away by the urinary Passages: therefore let the Method of cure for this Disease raised to a worse state, regard both the feverish Distemperature, for curing which you may direct according to the Intentions used in a putrid Fever: and the Rheumatic Affect, Which nevertheless must be the second Indicant, and does not admit any evaporating Remedies indifferently, or such as are usual against a Cough, but only of that kind, which does not intent the Fever. Let the Forms of these and the fit times of healing, be taken from the Precepts every where delivered for the cure of the putrid Fever, and of the Cough: the Aides which now by a frequent Experience are vulgarly said to have given a chief relief in this Disease, are a Diaphoresis, or a procuring of a Sweat, and a letting Blood; for the Vessels being emptied this or that way, both the immoderate Effervescence of the Blood, and the redundancy of it are moderated. A Description, made the first day of September, of an Epidemic Fever, arising about the beginning of Autumn, An. 1658. THE Vernal Fever even now described, scarce lasted above six Weeks, that it plainly seemed only a light Effervescence of the Blood, which growing turgid in the Spring, and withal being straitened in its room for want of Ventilation, boiled violently like new Wine stopped in Bottles, and afterward ceased of its own accord: but thenceforward, as the Year did not recover its due Temper, so neither did our Blood, and so a second fuel was soon heaped together for a new Fever, for after the Summer Solstice, the Northwind still blowing, the Season continued cold a long time; so that the Husbandman feared that the Fruits and standing Corn would scarce be brought to a Maturiy this Year: but after this, a little before the beginning of August, a most intense heat followed for many days; and in the Dog Days the Air was mighty parching, that it was very tedious to be in the open Field. By reason of those Excesses of Heat and Cold, the Temperature of this Year was very uneven: wherefore of Necessity our Blood must be sometimes fixed, and as it were congealed, sometimes too much parched, and therefore preverted from its natural Crasis, to be burnt, or atrabilarious: also the Pores of the Skin were very much altered from their due Constitution, that thereby insensible Transpiration was not performed after its wont manner. From the time the foregoing Fever ceased there was a healthy state, and free from any popular Disease, almost to the end of the Dog-days: but afterward, a few, first in Country Houses and Villages fell sick here and there: but afterward about the end of the Month of August, a new Fever rising on a sudden, began to be rife throughout whole Countries, on every side in our Neighbourhood; this, also the other, which reigned the Autumn before, chief raged in Country Villages, and Boroughs; fewer of the Inhabitants of Cities, and the greater Towns in the mean while falling ill of it. At the same time in other Countries far remote from hence, nay almost throughout all England, an Epidemic Fever was said to reign, and in certain other Places a far greater mortality was talked of, than here with us. Haply the Idea of this Fever now reigning, and its Apparatus of Symptoms is not in all Places alike in all things, or is it marked wholly with the same Phaenomena and Accidents, I shall set down succinctly, and briefly, whatsoever I have learned by my own Observation, or by the Communication of others, concerning its Nature as it was in our Neighbourhood. About the first beginnings of this Disease, its Type was erring and very uncertain; for in some there was a continual Effervescence, in others it was intermittent, and renewed with set Fits; but in a great many of the Diseased it happened as a pathognomick Symptom at this time to be ill in the Brain and Genus Nervosim, that presently from the beginnings of this Fever almost all complained of their Head being very bad, for some were infested with a violent Headache, others with a hardness of Hearing, and a ringing in the Ears; but to most, either a Drowsiness, and a great Sleepiness, with a vertiginous Affect, or obstinate Watch, with a Delirium, and Distractions of the Animal Spirits, were wont to happen. I have observed in some, that on the first or second Days of being sick, broad and red Spots, like the Measles, broke forth by little and little in the whole Body, which vanishing in a short time after, presently the Fever became more intense, and especially the Affects of the Head far more severe: thenceforward a Drowsiness of the Senses, and a Sleepiness seized some for many days, that they lay a long time without Speech, or Knowledge of their Friends, like Persons ready to die. I have known some to have been cast hence into a Lethargy, others into an Apoplexy, some to have fallen into Deliriums and a Frenzy. Many of the younger and stronger of these Men escaped (though not without a long continued Weakness and a doubtful Recovery) mean while, the old Persons, and those who were otherwise weak and sickly, died in all Parts: as for such who lay ill of a continual Fever as it were with these Marks of Malignity, they were but few, and only in some Houses sporadically: but the Sickness which, most generally reigning in our Neighbourhood, assailed most, and still severely rages, seems to imitate the Type of an intermittent Fever; viz. of a Tertian or of a Quotidian: for either each Day, or (which I have more frequently observed) every other day, the Diseased have Fits, which with a Cold, a Heat, and a Sweat succeeding in order, infest them a long time and severely: and these kinds of Accesses, and the whole course of the Disease, are wont to be marked with a various Concourse of Symptoms and Accidents, according to the different Age and Temperament of the Diseased: and this is common to most (I had almost said to all) that fall sick to be troubled with Cephalick Affects together with this Fever. When therefore any one is affected with this Disease (whether the Sickness be raised from an evident Cause or from Contagion, or without a manifest Occasion) a Pain in the Head, and often in the Loins, with a Drought, a want of Appetite, a spontaneous Lassitude, and a Heat, though not intense, discover its coming: if it happens in a young Body, of a florid Blood, and hot Temperament, about its Beginnings the Fits are without a Cold, or a Shivering, but they prove very troublesome with a long and sharp Burning. The Sick are often troubled with a Vomiting, and for the most part they have a violent Pain in the Head; a Sweat happens with difficulty, which often being partial, and soon interrupted, seldom ends the Fit; but when they cease to sweat, they burn again, that the Access is scarce ended in some within eighteen or thirty four Hours. Mean while, by the Bloods very much boiling the Fancy is troubled, that often a Delirium, a talking lightheaded, Watch, and a great Restlessness, are raised during the Fit; and the same being ended, during the time of the Interval, still a troublesome Drought, a remiss Heat, a failing of the Strength, and a great Weakness of the Spirits, with a Headache and a vertiginous Affect, molest them: they are scarce to be found, who, as in a common Tertian, are indifferently well in the Intervals of the Accesses. About the Beginnings of the Disease, the sharp Fits of the Fever are somewhat more mild, which afterward grow worse every time by little and little, and at length begin with a Cold or a Shivering; to which nevertheless after a long and very troublesome Burning, a Sweat with difficulty succeeds in most, so that the Fit is seldom ended in a due Temperature. Within six or seven Returns, the Strength of the Diseased is very much consumed, that being become languishing and weak, they have a hard Task to strive with the Disease; for unless Nature be aided by Art, the Fever, still prevails; and seldom or never within a short time is either solved by a Crisis, or remits by little and little, but brings the affected by a long Siege to the greatest straits, to wit, persisting so long, till the Blood being become very effaete, or rendered watery, by its frequent Deflagration, is altogether unmeet to boil too much of its own accord in its Vessels, or to be freely kindled in the Heart; and than it becomes often so vapid, and poor of Spirits, that being insufficient for continuing the Lamp of Life, it brings Death. But sometimes the mass of Blood, depraved and depaupered by this Disease, is able to continue (though with difficulty) the Vital fire hlaf extinct, and to refresh it again by little and little, and in a long time, with Spirit and Vigour, though in the mean while after the height of this Disease, when the Blood being rendered weak, and withal impure, is not able to expel forth the febrile Matter, or the adust Recrements by a critical Motion, it conveys the same to the Brain; and therefore about the increase of this Fever, a Drowsiness, and a Stupidity of the Spirits, a Sleepiness, a Vertigo, a ringing of the Ears, Tremble and Convulsive Motions, with a great Suppression of the whole animal Faculty are oftentimes caused, Those, who being of a cold Temperament, or grown in Years, are seized with this Disease, though they have not so acute a Fever, yet are wont to lie in a greater danger of Life: for in these, besides the Disposition of the Blood not easily reducible; also in the Fits, what is heaped together extraneous and not miscible, is hardly subdued, and with difficulty separated from the mass of Bood: wherefore, both the Blood is still more notably depraved in its Crasis, and in every of the Fits is more infected with an impure mixture: Moreover, the Nervous Liquor is greatly perverted from its due Temper, and is exceedingly defiled with adust Recrements continually poured on the Brain: when therefore old, melancholy, or otherwise unhealthy Persons, fall into this Fever, from the first Invasion they presently become torpid, and for the most Part Vertiginous: in the Fits, though the heat be not vehement and sharp, yet they lie restless, and tossing very much, often talk absurdly and idly: after a long Incalescence, either no Sweat, or only a partial one, and often interrupted, ensues, whereby the fit is not fully solved: but all during the Intervals the Diseased being very dry, continue to be ill disposed, with a drought of the Mouth, a roughness of the Tongue, and an overspreading of a viscous Lee: after some fits, their Strength being mightily dejected, either they are confined to their Bed altogether, or rising a little in the day time, they are scarce able to stand, or to creep about from Place to Place: mean while they are troubled with a Fainting, a difficult Breathing, a Deadness of the Senses, and a great Weakness of the whole Genus Nervosum. The Urine is intensely red in a great many, of a more saturated Colour, and a thicker Consistency than in a common Tertian; the Pulse, as long as the Strength is not wholly cast down, for the most part is strong and even; afterward, when the Diseased grow very faint, it is weak, uneven, and often intermittent, to which also Contractions of the Tendons, and convulsive Motions in the Wrists, being iovned, for the most part give an occasion for a Prognostic of Dearth. Those who being weakened by degrees decline toward Death, for some time before they die, lie for the most part without speech, or the Knowledge of the Standards by, as Persons stupid: it seldom happens in this Fever, that any one about to die, being of a good Memory and Understanding, disposes things of his Family, or bids his Friend's farewell: and those who happen to escape from a mighty Weakness, and almost from a desperate Condition, do not recover by a sudden and manifest Crisis, but wavering a long time, lie torpid and enervated, that not without a doubrful and difficult Contest, Nature at length, with much ado, prevails over the Disease, and then they recover their Strength by Degrees by a slow and long-continued Convalescence. If the nature and formal reason of the Epidemic Fever even now described be inquired into, we say that this (as that of the foregoing Year) is properly an Intermittent, for that which generally reigns, carries this kind of Type; though some continual Fevers here and there are scattered with them; of which also we shall presently give a short Touch. It will not be needful for us to derive the Seminary of this from the Air infected with some Miasm, but rather to fetch the antecedent Cause of it from the undue Constitution of the Year, and the Indisposition of our Blood acquired thereby; for Spring and Fall intermittent Fevers yearly reign, to wit, because our Blood, as the Juice of Vegetables, is wont to be moved, and to display itself at these times more sprightly than ordinary: wherefore, if the Mass of Blood, by reason of the foregoing Season of the Winter or Summer be altered from its ●ue Temper, and has contracted a sharp or atrabilarious Diathesis of another kind; it's Dyscrasies', began before, are chief maturated about the Equinoxes; to wit, when the Blood, more freely fermenting (in case it falls from its natural Crasis) does not so readily sanguify, but will be apt to pervert the nutritive Juice, mixed with it, into an extraneous and febrile Matter. Since therefore this Year very much declined from its due Constitution (that not only the preceding Dog days, but the two Solstices and Equinoxes before were altogether intemperate) is no Wonder if intermittent Fevers, more frequent than usual, and those attended with some unusual Symptoms, reign in Autumn. That therefore an Epidemic intermittent Fever reigns at this Time, I think it ought not to be attributed to the Fault of the present Air, but to the Irregularities of the foregoing Season: but on what Causes and Occasions certain peculiar Symptoms, and distinct from the common Rule of Intermittents, arise in this Fever, it is worthy to be inquired into. I have said above, that the Apparatus whereby this Fever became destructive to Mankind, consisted chief in two things; to wit, the Temper of the Year one while mighty cold, afterward happening to be very hot, both variously perverted the Crasis of our Blood, and affected the Pores of the Skin with an undue Constitution. According to the Reasons taken from both, I shall briefly explicate the Accidents of this Disease, and assign the Causes of its Phoenomina. 1. First, we observe that the Type of this Fever was various; to wit, in some with a continual Effervescence, in others with an Eruption of Spots, but in most intermitting, and like a Tertian, and sometimes (though rarely) like a Quotidian, renewing its Fits either each or every other day: we assign the Cause of this Diversity, because in this Year the morbid Procatarxis was greater and stronger, than only to produce an intermittent Fever generally usual in Autumn: wherefore in some (haply of a more depraved Habit of Body) it raised Fevers somewhat malignant; and in those to whom it brought Intermittents according to the wont Custom of the Season, it distinguished them by some peculiar Appearance of Symptoms. 2. Persons after being seized with the Epidemic Fever at this time (whether it be continual or intermittent) forthwith undergo ill Affects of the Head; to wit, they are wont to be infested sometimes with a violent Headache, sometimes with a Stupor, or a too great Distraction of the Animal Spirits; the Reason of this is, that the nervous Juice, as well as the Blood, through the Distemperature of the Year, is very much altered from its due Crisis, to wit, from its sweet and spirituous Nature, and has become sometimes dull and almost vapid, sometimes too sharp and pungitive. Moreover, the Mass of Blood also has greatly contributed to this Evil; for whilst it ferments the vapory Effluvia, which ought to be blown away outwardly, by reason of the Pores being constringed, are sent to the Membranes of the Head and the Brain: and by reason of this closing of the Pores communicated almost to all, a Sweat happens with Difficulty, and that but partial, and often interrupted in the Fits. Hence also in the height of the Disease, a perfect Crisis, or a spontaneous Solution of it, seldom, or scarce at all, happens: but instead of it, if the thing be committed to Nature, an adust Matter, or Recrements heaped together in the Blood, are conveyed to the Brain, and there raise Affects sometimes of the Coma, sometimes of the Frenzy, and those lasting and obstinate. 3. That the Fits sometimes begin without a Cold, or a Shivering, and are protracted in length with a troublesome Heat, and a difficult, partial, and often-interrupted Sweeting; afterward, that the same being ended, the Diseased grow hot again, so that the Accesses are not ended but after a long Evaporation of a dry Breath, the Cause is the too sharp and bilous Disposition of the Blood, whereby, being filled with a Salt and Sulphur, rather than with a Serous Latex, when it grows turgid, it presently takes to a light Flame, without a previous flowing of the nitrous Matter: and therefore by reason of its want of Serum, and the Pores being shut, its Deflagration is continued a long time, in a manner only with a dry Exhalation, and scarce ends at length in an Apyrexia: and therefore the Intervals of the Fits are very troublesome with a Heat and Drought, a Headache, a Vertigo, and other Affects; to wit, because the febrile Matter heaped together in the Blood, is not wholly discussed every Fit, but part of it being left after the Access, as extraneous and not miscible, brings almost a continual Effervescence. 4. It is to be observed, that those that are affected with this Fever presently fall from their Strength and the wont firm State of their Bodies, that after a Fit or two, being out of Breath and very weak, they are scarce able to stand or walk without a Staff; whereas it is usual for such as are seized with a common intermittent Fever, to be sprightly and cheerful enough during the Intervals of the Accesses: The Reason of the Difference is; because, in this Fever, both the Mass of Blood is more depraved with the impure Mixture of a degenerate Juice, and especially because the same is more perverted from its natural Crasis, and therefore when out of the Fits it does not boil, yet it does not ferment duly and evenly in the Sinus' of the Heart: wherefore, when by a quick Motion, or any Agitation of the Body, the Blood is vehemently pressed forward into the Sinus' of the Heart, because it is not all presently kindled there, and springs forth, by its Stagnation, it brings an oppression of the Heart, and great Faintings of the animal Spirits. By reason of this kind of dyscrasy of the Blood, to wit, whereby it is unfit for Fermentation, or a due Accension in the Heart, some also, and especially Horses, in the Spring of Fall, become shortwinded, and very unfit for a swift Motion. 5. It remains for us to inquire, lastly, concerning this Fever, wherefore it reigns chief in Parishes, little Villages, and in the Country, when Cities and great Towns have little of it. It might seem that this Affect might be raised from marshy and other noxious Vapours, plentifully heaped together in this or that Tract of the Air; but it is more rational to say, That the Inhabitants of those Kind's of Places having been more exposed to the Winter Colds and Summer Heats, contracted a greater dyscrasy of the Blood, and so a more apt Disposition to this Fever: for those that live in the Country scarce go out of their Houses, but are exposed to the Rays of the Sun, or to the Fervour of the heated Air. Moreover, Husbandmen, and those in the Country, being used to hard Labours (among whom this Fever chief reigned) through their Toils and immoderate Exercises in the Fields, and withal using an ill and course Diet, sooner acquire an adust and Disposition of the Blood, and therefore more apt to this Disease, than Citizens and Townsmen, who enjoying Rest and a wholesome Diet, most commonly live in Houses together, or in Streets cooled by the shadow of Houses. The truth of this Assertion is confirmed, for that not only the Epidemic Fever now reigning, but the other also of the Autumn before, raised through a dyscrasy of the Blood, was chief rife among Husbandmen and the Inhabitants of the Country; but that popular Fever which arose in the middle of the Spring, depending chief on a letted Transpiration, infested most Citizens and Towns-people: mean while, those in the Country usually procuring a more free Transpiration by Exercise and Labours, lived more free from it. The general Prognostic of this Disease only seems to threaten, that in a manner the like ill consequence will attend it, as followed the Epidemic Fever of the foregoing Year; to wit, (by a Guess taken from the Distemperature of the Blood rather than from the Taint of the Air) we may dread an imminent Quartan Fever again, but not a Plague. As to the particular Observations in it, to give you in short the Signs which promise Death or Welldoing; they chief regard the Temerature and Governance either of the Blood with the vital Spirit, or also of the nervous Juice with the Animal Spirit. If from the Pulse, Urine, Actions not injured, and the Appearance of other Symptoms, it be plainly indicated, that the Blood, as to its feverish Disposition, be not greatly perverted from its natural Crasis, that in the Fits it burns only moderately, and that in every Conflict it easily subdues the load of the febrile Matter, and wholly shakes it off from its Fellowship, that after some Accesses the Mass of the same Blood is somewhat restored toward its due Temper, that it less perverts the nutritive Juice, and sends forth that which is extraneous and not miscible, with a more mild Turgescency; and in the mean while, if the other spirituous Liquor duly influences and irrigates the Brain and nervous Bodies, that Sleep, Watch, Sensation and Motion are performed well, or at leastwise indifferently, we may hope all good things of the Diseased. But if it shall appear from the same kinds of Signs, that the Blood in this Fever has gotten a Crasis far remote from the natural, if it perverts much of the nutritive Juice, and afterward from its extraneous and incongruous mixture the Liquor of the Blood be greatly troubled, and the Spirits are driven into Confusion; if in the Fits the Blood burns too intensely, and for a long time, and does not duly subdue the febrile Matter, or send it wholly forth, but its impure Mixture is still more infected, (and in every feverish Access more and more) and withal, the Spirits being continually consumed, is become poor, we may declare the Life of the Diseased to be in a dangerous Condition. If, besides these, the nervous Juice be faulty, that being altered from its due Temper, or being dull, and vapid as it were, it does not actuate the Brain and Genus Nervosum, or being more sharp than it ought, it continually irritates the same into Cramps and Distractions; and if besides vapory Effluvia continually departing from the Blood, or adust Recrements, wont to be voided forth by a critical Sweat, are conveyed to the Head, and there cause Lethargical or Maniacal Affects, the well-doing of the Diseased stands very ticklish, and we may fear a very fatal Event. Concerning the method of Cure of this Disease, three chief curative Intents come under Consideration: First, A speedy Reducement of the Blood and nervous Juice to their natural Crasis, (as much as may be) or at leastwise a Prevention of a too great Depravation of them: Secondly, A due Management of the Diseased as to their Fits, which ought to procure; first, that less of degenerate Juice be heaped together for a Matter of the Fit; secondly, that the store of that which is heaped together be wholly blown off every Access, that the Diseased may be better in the Intervals: Thirdly, That the Body being altered for the better, the Fits be stopped with antifebrifuge Remedies: the third Intent regards the Symptoms chief pressing, which must be seasonably obviated, whereby Nature being not hindered, may reduce whatsoever intemperate is contained in the Viscera, may subdue and clear forth what is extraneous, and may soon recover its former Strength and Vigour. First therefore, for the Reducement and Correction of the Blood and nervous Juice, divers kinds of Evacuations, about the beginning of the Sickness, are wont to be used in this Disease with good Success. It is maifest by modern Practice, that Vomitories are very much more useful in this Affect, than in a common Tertian; wherefore in a robust Body, and prone to Vomit, about the beginning of the second or third Fit an Emetic Medicine is wont to be given. The Operation of this seems to do more good in this Fever, both in as much as it plentifully evacuates the filth from the Ventricle, and the yellow Choler from the Vasa Choledocha, and because it copiously expresses the Serous Latex from the Emunctories of the Genus Nervosum, placed about the Pancras and Intestines, and draws it forth by stirring them: wherefore we observe, after a Vomit given, the Diseased are better as to the Affects of the Head. Let Purging (where Vomiting is not proper) be ordered the day following the Fit, as a Succedaneum to the other: also though a Vomit be premitted, it may do well after a Fit or two; but let it be performed only with a mild and gentle Medicine, which does not trouble or exagitate the Blood. It is usual with us in these Fevers, all Aloetick or diagridiated Medicines laid aside, to give only the Infusion or Powder of Sena, Rhubarb, and yellow Saunders, with Tartar and Salt of Wormwood: and to use this kind of Purging a little after the beginning the Disease; but at other times, to make the Belly soluble by a frequent use of Clysters. That Blooding in this Disease is very good, frequent Experience has sufficiently taught us; for since, by reason of the Pores being more closed than usual in all, the Blood boiling in a Fever wants a Ventilation, letting Blood supplies the Place of a more free Transpiration, and prevents the Effluvia restrained from being so readily discharged on the Brain and Genus Nervosum. But this Remedy is chief indicated by a very hot Blood and a hot Temperament; nor ought it to be used indifferently by old Persons, such as are phlegmatic, and others very weak, unless haply it be in a small Quantity, that the Mass of Blood may be somewhat eventilated, and that the Translation of the febrile Matter into the Brain may be stopped. If it be proper to open a Vein, let it be done about the beginning of the Fever, or at leastwise before the fourth or fifth Access; to wit, before the Blood be rendered very effaete by a frequent Deflagration, and too impure by the Mixture of an adust Matter: for if Blooding be used when the Blood is mightily vitiated, the vital Spirits, and the Strength of the Diseased are thereby more debillitated; nor is there any thing withdrawn from the Power of the Disease, or its Cause. There remains another Evacuation famous in this Fever; to wit, by Blistering Plasters applied to many Parts of the Body: these are so vulgarly observed to give Relief, that such as are against them, and have a great Aversion for such a Remedy, being led by the Example of others growing better thereby, easily admit of it. After what manner they separate the scarf Skin from the Skin, and raise it as it were into a Bladder full of Water; whether they fetch the watery and limpid Humour from the Arteries, or out of the Nerves, this is not the Place to inquire: but, that they are used with benefit in this Disease, besides Experience, this Reason seems somewhat to convince; to wit, because a large Discharge of this kind of serous Humour does in some sort recompense the Defect of a free Transpiration. Moreover, this kind of Remedy opens as it were the Doors and Gates at which the Blood and nervous Juice may presently void forth the extraneous Matter mixed with them by a nearer way of Purging; wherefore in the Plague and malignant Affects, Vesicatories are esteemed very profitable. Also it is manifest by common Observation, that in this and other Fevers, happening in the same Season, they prevent the severe Affects of the Head, and are wont to relieve them being caused before wherefore in Men that are phlegmatic, aged, and of a cold Temperament, Epispastic. Plasters may be applied about the first Invasion of this Disease for Preservation; and in any others, troubled with a Drowsiness, a Vertigo, or a violent Headache, they are wont to be advantageously used for the Cure of those Affects. But in very hot Constitutions, where with a Defect of Serum, the Blood is too much burnt; and if those that are in Fevers with an intolerable Burning are obnoxious to Watch or a Frenzy, Vesicatories do not seem fit to be used. For correcting the Crasis of the Blood, and the Tone of the Viscera, qualifying and digestive Remedies have place, in intermediate times, when the Sick have rested a little from the Evacuations even now mentioned, being such as fuse the Liquor of the Blood, and separate its Foeculencies, and drive them towards the Emunctories as it were by precipitating them; for those kinds of Intents are wont to be given cooling Juleps and Decoctions, acidulated with Spirit of Vitriol, of Salt, with Tamarinds, the Juice of Oranges, or of Lemons, whereof neat Forms enough are vulgarly to be sound: and for this end conduce acetous, saline, and testaceous Powders, viz. such as are prepared of Tartar, Sulphur, the fixed Salts of Herbs, of Hartshorn, also of the Claws or Eyes of Crabs. For Example, Take Cream of Tartar three drams, Salt of Wormwood a dram and half: the Dose is half a dram in an aperient Decoction, twice a day, out of the Fit. Or, Take Cream of Tartar two drams, Powder of Crabs-eyes a dram, Nitre purified half a dram, mix them, let it be given after the same manner. Or, Take burnt Hartshorn two drams, Spirit of Vitriol as much as the Powder will receive by imbibing: the dose is a Scruple. It is of excellent use when those that are in the Fever are troubled with Worms. These kinds of Remedies promote the Secretion of the febrile Matter, and restore the almost lost Ferments of the Blood and Viscera. The second Intent, to wit, the due Management of the Diseased in the Fits, comprehends many things: first, a neat Form of Diet ought to be ordered, that a large heaping together of the degenerate Juice for a Matter for the Fit may be hindered: wherefore, let the Diseased feed only on a thin Food; let them wholly abstain from Flesh, or Broth made of it, from Eggs, generous Wine, and all rich Fare; being content only with Barley or Oat Broths, Panada, Whey, and small Ale: in regard a more plentiful Diet is not concocted, or assimilated, but it oppresses the Stomach, and being mixed with the Blood it troubles its Liquor, and forces it to boil vehemently, as the Fit comes on, and during the while it lasts, unless it be for quenching Thirst, let no Food be taken: but for qualifying the Heat and Drought, cooling Juleps and Decoctions, and especially small Ale and Whey, aught to be allowed. Secondly, a little before the feverish Access is expected, let a gentle Medicine be given, which either may keep off the Fit by preventing it, or may render it easy by procuring an easy Sweat. For this Use, the febrifuge Potion of the Learned Riverius does well, made of Carduus Water, with Oil of Sulphur and Salt of Wormwood: Or, take Cream of Tartar, Salt of Wormwood, Nettle Seeds, of each a Scruple: let it be given in a Decoction of the Roots of Sorrel. When the Fever gins to decline, and the Fits are a little more remiss. Febrifuge Epithemes outwardly applied often stop the febrile Accesses; though in the mean while, as long as the Fits return, let the Diseased be so managed, that every Access, the feverish Matter heaped together in the Blood may be wholly blown off: wherefore, when a Sweat happens with difficulty, let it be a little raised with temperate Medicines; also let the Diseased be kept in Bed with a gentle Sweat for many hours, nor let them be permitted to rise too soon: for I have often observed, that the Diseased have still grown worse, because being impatient of lying in Bed, they put on their before the watery Effluvia were exhaled enough. Thirdly, as to the Symptoms, and particular Accidents, with which the Diseased are wont to be troubled in this Fever, a great many of them are sufficiently provided against with the Remedies and Method of Cure hitherto delivered; against the Thirst, Burning, the Roughness of the Mouth and Tongue, Vomitings, the Looseness, a Swooning, or danger of Fainting, the Prescripts commonly used in other Fevers may aptly enough be transferred hither. But the Things which in this Disease seem to require a peculiar Method of Healing, are chief the Affects of the Head and Brain, with the Genus Nervosum; by which, unless seasonably obviated, the Diseased are soon brought into a great danger of Life: Concerning these kinds of Evils of the Head, the Indications are of two kinds. If it appears by a Drowsiness, a Sleepiness, a Vertigo, or a Headache, that the nervous Juice is too dull, and as it were vapid, and therefore that it does not vigorously enough actuate the Brain and nervous Bodies, besides the Remedies above delivered, and especially the Vesicatories, Medicines full of a volatile Salt, excellently conduce in this Case; wherefore Spirit of Hartshorn, of Blood, also the Salts of the same are of excellent Use: but, if the nervous Liquor be too sharp, or the Effluvia, sent from the boiling Blood, drive the Animal Spirits into Distractions, those kinds of Remedies of volatile Salt are given with benefit in somewhat a less quantity. Moreover, a frequent Letting Blood, and Medicines allaying its fervour, do good, as Emulsions, Whey, pure Water plentifully drank: let Opiates be used in this Fever with great Caution; for the Frenzy appeased by them is oftentimes changed into a Lethargy, or a deep Stupor. FINIS. THE TABLE. A. AChes in the Head, see Headache. Ache in the Belly, see Belly. Aches or Pains in the Limbs happening by Night, their cure, p. 361. Ague, see Fever. alexipharmics, see Cordials. Anasarca, its Description. p. 167. Whence it proceeds, ibid. The least dangerous of Dropsies, ibid. The two chief Scopes of curing it, ibid. Hydragogue Medicines of good use in curing it, p. 168. How cathartics work in this Disease, ibid. Lixivial Medicines the best Diuretics in this Disease, p. 169. Some Praescripts of them, ib. Diaphoreticks of use when the swelling gins to abate, p. 170. A Prescript of them, ib. p. 171. Outward Administrations to be used in this Disease, ib. p. 172, 173. Medicines for Preservation against this Disease, p. 174, 175. An Instance of a Person falling into this Disease, and recovered of it, p. 176. Antidotes, see Cordials. Apoplexy, where seated, p. 420. What the Word Apoplexy imports, p. 421. Two kinds of it, ib. The various Invasions of the Apoplexy, and the causes of them, ib. p. 422. The Subject of this Disease, ib. Its Prognostics, ib. p. 423. The Therapeutic Method for removing the Fit, ib. p. 424. The prophylactick or preservatory method, with Praescripts of Medicines. p. 425, 426. Instances of Persons seized with the Apoplexy, ib. p. 427. Ascites, its Description, and whence it proceeds, p. 150. what to be considered in order to its Cure, ib. cathartics often do well in it, p. 151. An Enumeration of hydragogue Emetics and Purgers, and Prescripts of them, ib. p. 152, 153, 154, 155. Diuretics, when proper in an Ascites, ib. p. 156. What Diuretics proper, ib. Diaphoreticks of little or no use in an Ascites, p. 157. The best Remedies, when we will not proceed to an Incision, are Clysters and Plasters, ib. An Incision in whom to be admitted, p. 158. An Instance of a Woman cured of an Ascites, ib. p. 159. Asthma, or difficulty of Breathing, its description, p. 126. Two primary Indications in the method of Cure, ib. What to be done in the Fit, ib. p. 127, 128. What to be done out of the Fit for Preservation, ib. p. 129, 130, 131. Two Instances of Persons troubled with the Asthma, and the Methods used with them, ib. p. 232. Asthma Convulsive, see Cough. Asthmatick Fits happening in the Scurvy; their Cure, p. 353, 354. Atrophia Scorbutic; its Cure, p. 363, 364. B. BElly-ach in the Scurvy; its Cure, p. 355. Blistering Plasters, see Vesicatories. Blood, its Eruption from many Parts of the Body, p. 188. It's Eruption from the Nostrils, and the Cure of it appliable to all other Hemorrhages, p. 189. An Eruption of Blood from the Nostrils to be managed one way if without a Fever, and a different way if joined with it, ib. How to be managed if happening without a Fever, ib. p. 190, 191, 192, 193. How to be managed in a Fever, p. 194. How to answer the second and vital Indication, ib. p. 195. How to answer the third Indication, being for Preservation, and for removing the Cause of the Distemper, ib. p. 196. An Instance of Eruptions of Blood cured, ib. p. 197. Blood-letting, see Phlebotomy. Blood let forth in a Convulsive, or Apoplectical fit, why seeming congealed, p. 260. Blood-spitting, the indications for curing it, p. 96. what to be done in reference to the first Indication, ib. what to be done in reference to the second indication, ib. p. 97. Select Forms of Medicines answering to the Therapeutic Indications, ib. p. 98, 99, 100, 101, 102. An instance of a Person troubled with Blood-spitting, and how managed, ib. p. 103, 104. The medicine which did him most good. ib. p. 105. Blood of Man, its Anatomy, p. 519. its resolution into five Principles. p. 520. its Spirits. ib. its sulphureous, saline, earthy, and watery Particles, p. 521. its comparison with Wine, p. 422. p. 328, 329, 330. its comparison with Milk, p. 422. its natural Motion, p. 423, 424. its preternatural Motion ib. p. 425. Bloody Flux, cured, p. 356. see Purging. Bones, their crackling, p. 367, 368. Breathing difficult, see Asthma. Breathing, difficult in the Scurvy, its cure, p. 353, 354. C. CArus, what Disease it is, p. 399. where seated, p. 400. its Prognostics. ib. its Method of cure, ib. Instances of Persons seized with the Carus, and how proceeded with, p. 401, 402. Chalybeate Medicines, see Steel. Chincough, see convulsive Cough, and Ptisick. Coffee, its effects, p. 68, 69. Colic, its Description, p. 507. the part primarily affected in it, p. 508, 509. It's Seminium or Minera, ib. The Procatarctick Cause of it, p. 510. The evident Causes, ib. p. 511. The Prognostic of it, ib. The Method of curing it, ib. p. 512, 513, 514, 515, 516. The vital Indication to be minded, ib. the preservatory Indication to be used out of the Fits, ib. p. 517. Instances of Persons troubled with the Colic. ib. p. 518. Colic Scorbutic, its Cure, p. 355. Coma, see Sleepy and Watching. Consumption of the Lungs, see Ptisick. Consumption confirmed, see Ptisick. Continual Fevers, see Fevers. Convulsions in Children, p. 250. they are chief subject to them at two Times, ib. What Parts of the Body they infest, ib. How to prevent convulsive Fits in Children hereditarily obnoxious to them, p. 251. the Therapeutic Method, p. 252. how to provide against imminent Convulsions, ib. what to be done when a Child is actually seized, p. 253. for poor People's Children, ib. what to be done when Convulsions happen upon breeding of Teeth, p. 254. what when happening on other occasions, ib. p. 255. Convulsions in adult Persons happening by reason of the Origine of the Nerves being chief affected, p. 256, 257. An Instance of a Lady troubled with Convulsions on this Account, and how proceeded with, ib. p. 258. a second Instance, ib. why Blood let forth in a Convulsive Fit seems congealed, p. 260. the method of curing these Fits, ib. p. 261, 262, 263. Prescripts for poor People, ib. Convulsion whose cause lies about the Extremities, or within the Plexus's of the Nerves, p. 264: An Instance of them, and the method used, ib. p. 265. a second Instance, p. 266. Convulsions arising from the Liquor lying in the nervous Bodies, and irritating all their Processes into Convulsions, p. 267. such Convulsions produced by Poison, p. 268. by the By't of the Tarantula, ib. produced by Witchcraft, p. 269. 270. Convulsions general, wont to be raised in malignant, ill determined, and some Anomalous Fevers, p. 271, 272. after what manner raised, p. 273, 274. the formal Reason and Causes of such Fevers, p. 275. Instances of such Fevers, p. 276, 277. The Method of curing them, p. 278, 279, 280, 281. Another Instance of a Convulsive Fever, p. 282. Convulsions general wont to arise by reason of a scorbutic Disposition of the nervous Juice, p. 283. two kinds of them, ib. A strange Instance of the first kind, p. 284, 285. the reasons of it, ib. p. 286. Instances of the second kind, and the method used with them, ib. p. 287. 288, 289, 290, 291, 292, 293, 294, 295. The way of Cure to be used in general for such marvellous Convulsions, ib. p. 296. Convulsive Cough and Asthma, p. 320. the causes of it, ib. p. 321, 322. An Instance of a Person troubled with it, ib. A second Instance, with the way of managing it, p. 323. The Remedies and Method of Cure to be used in this Disease, p. 324, 325. See Ptisick and Asthma. Cordial Medicines, improperly so called, p. 48. Kind's of Cordial Medicines for promoting the Accension of the Blood, p. 49. A Caution concerning the frequent use of such Cordials, ib. Cordial Medicines for appeasing the too great boiling of the Blood, ib. p. 50. Such Cordials for opening the Texture of the Blood, and discharging its Superfluities, ib. Cordials endowed with a volatile Salt, given in Fevers and Swoonings, ib. Cordials endowed with an Alchalisate Salt, ib. p. 51. Cordials proper in a Pleurisy, ib. Cordials whose Basis is a fluid or acid Salt, given in Fevers, ib. Cordial Medicines having a fixed or lixivial Salt for their Basis, p. 52. Cordials, Alexipharmicks or Antidotes for Preservation, ib. p. 53. Cordials, Alexipharmicks, or Antidotes for curing, ib. p. 44. Cosmeticks, p. 218, 219, 220. Cough, see Ptisick. Cutaneous Affects, various. p. 216, 217. Summer Spots whence caused, ib. Liver Marks, whence caused, ib. chief appearing in the Summer. The Cure of Summer Spots. Lentiginous Spots, and Liver Marks, p. 218, 219, 220. D. DElirium, what it is, p. 448, 449. how caused, ib. p. 450, 451. the ways of Cure hinted, ib. how to be cured when happening upon continual and malignant Fevers, p. 452. see Frenzy. Diabetes or Pissing Evil, the method of curing it, p. 28, 29. An Instance of a Person troubled with it, and the Medicines used in curing him, ib. Kind's and Prescripts of Medicines that stop Urine flowing in Excess, p. 31, 32, 33, 34. Diaphoretick Medicines, or such as promote Sweat, p. 34. What things required for a free Eruption of Sweat, ib. how Persons must be ordered for Sweeting, p. 35. Kind's and Prescripts of diaphoretic Medicines, p. 36, 37, 38. a diaphoretic Diet-drink for curing the French Pox, ib. Diaphoreticks to be prescribed in malignant Fevers, p. 39 other Diaphoreticks, ib. p. 40, 41. Diaphoreticks in a cold Constitution. p. 42. Diarrhoea, see Purging. Diuretic Medicines, see Urine. Dropsy of the Breast, whence it arises, p. 133. An Instance of a Person troubled with it, and how proceeded with, ib. p. 134, 135. the Method of Cure, ib. Prescripts of Medicines for it, p. 136. An Instance of another Person troubled with it, and how cured, ib. p. 137. Dropsy called Anasarca, see Anasarca. Dropsy called Ascites, see Ascites. Dropsy called the Tympany, see Tympany. Dropsy happening in the Scurvy, its Cure, p. 366, 367. Dysentery, see Purging. E. Emetic Medicines; see Vomiting. Empyema, what the Word imports, p. 119. what to be considered in order to its cure, ib. An Incision not to be attempted over hastily in it, p. 120. Forms of Medicines requisite for curing an Empyema, ib. A Julep against Faintings and Swoonings upon the Operation, ib. Ephemera Fever, see Fever. Epilepsy, seeing Falling Sickness. F. FAlling Sickness, its Description, p. 138, 139. Sometimes terminates of its own accord, ib. The Method of proceeding with it, p. 240. What Medicines used against the Fit, ib. p. 241. The chiefest care in the Prophylactick part, for removing the cause, ib. What Medicines to be used for it, ib. p. 242. An Instance of a Person troubled with the Falling-sickness, and with what Medicines cured, p. 243. The general Method of curing it, with prescripts of Medicines. ib. p. 244, 245, 246, 247, 248, 249. Fever, its Description, p. 426. Intermitting Fevers, whence caused, ib. why a cold and a shivering precede the heat in them, p. 427. whence their Intermission and set returns, ib. p. 528. their Cure how undertaken, ib. p. 529. Certain Irregularities of them, p. 530. Fever tertian, Instructions concerning it, p. 531, 532. Symptoms foreshowing its Remission. ib. 533. It's Method of Cure. p. 534, 535, 536, 537. Fever quartan, Instructions concerning it, p. 540, 541. Why so difficult to cure, ib. cured by raising a gentle Salivation, p. 542. Other Remedies for it, p. 543, 544, 545. etc. Fevers continual, wherein differing from Intermittents, p. 548. the kinds of them, ib. Fever called Ephemera, or simple Synochus, holding one, or many Days, Instructions concerning it, p. 549, 550. three things required to a Crisis or Solution of it, ib. p. 551. its Cure, ib. Fever putrid, its Causes, p. 552, 553. the four observable times of it, ib. p. 554, 555, 556, 557. the most considerable Symptoms and Signs in it, p. 560, 561, 562, 563, 564, 565, 566. the Pulse and Urine chief to be minded for knowing the State and Strength of the Diseased, p. 567, 568. 569, 570. The kinds of the putrid Synochus p. 571, 572, 573. its Cure, p. 574, 575, 576. Examples of Persons seized with it, and the Method used with them, p. 577, 578, 579, 580, 581, 582. Fever Malignant or Pestilential in general, wherein it consists p. 583. What parts of the Body their venom Affects, p. 584, 585. the Essence of a Pestilential Fever, in what founded, p. 587. whence it arises, 588, what Bodies apt to receive it, p. 590. how propagated by Contagion, ib. p. 591. Fevers Pestilential and Malignant in Specie, and other Epidemic Fevers. p. 601. the distinctions betwixt a Plague, a Pestilential, and a Malignant Fever, ib. p. 602. Pestilential and Malignant Fevers placed in the rank of Continual Fevers, ib. Signs of Malignity in Fevers, p. 604, 605. what to be observed in the cure of Pestilential and Malignant Fevers, ib. an Instance of a Pestilential Fever, p. 606, 607. its way of cure p. 608. Instances of the Malignant Fever, p. 609, 610, 611, 612, 613. Fevers of Women in Childbed, Instructions concerning them, p. 625, 626, 627, 628, 629. of the Lacteal Fever of Women after Childbirth, p. 630. its cure, p. 631. Putrid Fevers of Women in Childbed, ib. p. 632. their Procatarctick Causes, p. 633. the Evident Causes, ib. the Conjunct Cause, p. 634. they are dangerous, p. 635. the cure, ib. p. 636, 637, 638. Fevers Symptomatick of Women in Childbed, what those Symptoms are, p. 639. what must be done in order to their Cure. p. 640. What must be done in the Small Pox when happening, p. 641. Stories of Women in Childbed troubled with Fevers, ib. p. 642, 643, 644, 645, 646, 647. Fevers Epidemic and Anomalous, p. 648. A Description of one, ib. p. 649. its Nature and Essence, ib. p. 650, 651. its conjunct Cause, ib. what it has peculiar from common Intermittents, and a Synochus, p. 654, 653. its general Prognostic, p. 653. its particular Prognostic, ib. its method of Cure, p. 655, 656, 657. Fever Epidemic and Catarrhous described, p. 657, 658. the rise and formal reason of it, p. 659. its Symptoms, p. 660. its Prognostic, ib. the method of Cure, p. 661. Another Epidemic Fever described, p. 662, 663. its Nature, p. 665. its Accidents, p. 666, 667. the Prognostic of it, p. 668. the method of Cure, p. 669, 670, 671, 672. Fever Epidemic chief infesting the Brain and Genus Nervosum, p. 271, 272. its formal Reason and Causes, 275. Instances of Persons seized with it, p. 276, 277, 278. the method of Cure, ib. p. 279, 280, 281. An Instance of a Fever chief radicated in the nervous Juice, and its Cure, 282, Fever Scorbutic, its Cure, 363. 364. Fits of the Mother, p. 297. the various Passions vulgarly said to constitute an Hysterick fit, or a fit of the Mother, ib. those Fits are properly Convulsive, p. 298. they arise chief from the Brain and genus Nervosum, ib. sometimes from the Womb, and others of the Viscera, ib. p. 299. An Instance of a Person troubled with them, and what done in order to the Cure. ib. p. 300, 301, 302. The method of Cure to be used in the Passions vulgarly called Hysterical. ib. p. 303, 304, 305, 306. Flux, See Purging. Folly, see Stupidity. French-Pox, safely cured with a Sweeting Diet-Drink, p. 38. Frenzy, its Definition, p. 451. whence caused, ib. the formal Nature of it, wherein it consists, p. 453. another Definition of it, p. 454. the previous Disposition of the Blood disposing to a Frenzy. ib. another Disposition to the Frenzy. ib. the evident Causes of it, p, 455. the Prognostic of it. ib. p. 456. In the Cure of it regard must be had to two things. ib. Prescripts of Medicines for it, p. 457, 458, 459. an Instance of a Person Troubled with it, and how cured, ib. p. 460. G. GIddiness or running round of the Head, see Vertigo. Gout, its Fits either seize at random, or periodically, p. 495. The Dispositions to this Disease, and the Occasions or Causes which are wont to actuate them. ib. the Morbific Matter, ib. the evident Causes of it, p. 496, 497. It's near allied to the Stone in the Reins. p. 498. The Prognostic of it, ib. it often turns to Gripes in the Belly, to a difficulty of Breathing, etc. ib. p. 499. the Method of Cure, with Prescripts of Medicines. ib. p. 500, 501, 502, 503, 504, 505. An Instance of a Person troubled with it. ib. p. 506. Gout Scorbutic, moving from one Place to another, its Cure, p. 362. Gums sore, their Cure. p. 359. 360. H. Hemorrhages, see Blood. Headache, its Subject, p. 370. the formal Cause of it. p. 371. the Prognostic of it. ib. habitual Headache, two scopes of curing it. ib, p. 372. Medicines for the Cure of it, p. 373, 374, 375, 376, 377, 378, 379, 380, 381, 382. Instances of Persons troubled with it, and the Methods used with them, p. 383, 384, 385, 386. Instances of Periodical headaches. ib. p. 387. an Instance of a Headache, arising by Consent of other Parts. p. 388. Heart, its Passions. p. 54. its Panting, when happening through the fault of the Blood, how cured, ib. p. 55. the same cured when it happens through the Fault of the Arteries. ib. p. 56. Trembling of the Heart, its Description and Method of Cure, ib. p. 57 the Cure of the intermitting Pulse. p. 58. Medicines for the Heart, see Cordials. Hydragogue Medicines, p. 151, 152, 153, 154, 155. Hypocondriacal Affects shown to be for the most part convulsive, and not caused by Vapours, p. 307. the Symptoms belonging to this Disease, p. 308. what the Ventricle and Spleen contribute to this Disease, p. 309, 310. An Instance of a Person troubled with this Distemper. p. 311. the Method of Curing it. p. 312, 313, 314, 315. Hysterical Affects, see Fits of the Mother. I. Jaundice, three primary Indications in the Method of curing it, p. 138. what Medicines are proper according to those Indications, ib. p. 139. prescripts of Medicines for curing it, ib. p. 140, 141, 142, 143. Jesuits Powder, its Nature, and how it stops Fevers. 545, 546, 547. Imposthume of the Lungs, the morbific matter of it, p. 121. the three primary Indications in the method of Cure, p. 122. Physical Prescripts pursuant to them, ib. p. 123. Instances of Persons having the Imposthume of the Lungs, and the Methods used with them, p. 124, 125. Incubus, or Nightmare, it's an Affect of the Cerebellum, p. 408. its Phoenomina, ib. the Prognostic of it, p. 409. the method of Cure, ib. Infants often troubled with it, and how to be proceeded with, p. 410. Inflammation of the Lungs, see Peripneumonia. Intermitting Fevers, see Fevers. Issues, what Humours chief they evacuate, and whence they derive them, p. 207. in what Diseases and Constitutions they agree better or worse, p. 208, 209. in what Parts and Places Issues ought to be made, ib. p. 210, 211. how we must deal with the Symptoms which happen upon Issues, p. 212, 213, 214, 215. Issues do not dispose to Barrenness, ib. Itch, a Disease of the Skin, p. 221. its morbific matter the lymphick Humour in the Glands, ib. that Humour depraved three ways, ib. p. 222. dangerous in Children and cachectical Persons, ib. the Indications in order to its cure, ib. p. 223. Purging necessary in curing it, ib. Prescripts of Medicines for curing it, ib. p. 224, 225, 226. L. Leprosy of the Greeks, see Running Scab. Lethargy, where seated, p. 389 two kinds of it, ib. the conjunct Causes of the Lethargy so properly called, p. 391. the chief Symptoms of it, ib. the Prognostic of it, ib. p. 292. the Method of curing it, ib. when Vomits or Purges are proper, p. 393. Instances of Persons seized with it, and how proceeded with, p. 394, 395. a Lethargy happening by the use of Opiates, how to be dealt with, ibid. Liver its Distempers, p. 146. Medicines against its over-growth, p. 147. Remedies against other Diseases of the Liver coming from Obstructions, ib. p. 148, 149. Liver Marks, see cutaneous Affects. Looseness, see Purging. Lungs inflamed; see Peripneumonia. Lungs, their Imposthume, see Imposthume. Lungs, their Consumption, see Ptisick. M. MAdness, or the Mania, allied to Melancholy, p. 478 the Spirits chief in fault in it, ib. three things to be observed in Persons seized with it, ib. how happening upon a vehement Passion, p. 479. often hereditary, p. 480. why mad Persons are bold and very confident, p. 481. its Prognostic, ib. p. 482. the method of Cure to be used in a continual Madness, ib. p. 483, 484, 485, 486. what to be done in an intermittent Madness, ib. Malignant Fevers, see Fevers. Mania, see Madness. Measles, allied to the Small Pox, p. 621. their Essence and Cure differ but as to more or less, ibid. Melancholy, its Definition, p. 460. Universal Melancholy, its Symptoms, consisting chief in three things, p. 461. the formal Nature and Causes of Melancholy, p. 462. the evident and procatarctick Causes of universal Melancholy, p. 464, 465. the Prognostic of it, ib. 466. the method of curing it, ib. 467, 468, 469, 470, 471, 472. Instances of Persons troubled with Melancholy, and the ways of proceeding with them, ib. p. 473, 474. particular Melancholy, p. 475. two chief Occasions of it, ib. p. 476. Morphew, see Scab. Mouth, its Distempers cured. p. 359, 360. N. narcotics, see Opiates. Nervous Liquor, how tainted to cause Convulsions, p. 267, 268, 269, 270. Nightmare, see Incubus. Nitre, its Nature, and how it works its Effects, p. 25. O. OBstructions of the Liver, see Liver. Opiates, how they exert their Force, and in what their narcotick Force consists, p. 59 what they do in a small quantity, and what in a great, ib. the good Effects of Opiates, p. 60. properly indicated in a want of Sleep, in some delirious Affects, in all sorts of Pains, in an overquick or vehement Pulse or Breathing; also in a breathing interrupted, convulsive, or otherwise variously irregular, in Fits of the Asthma, in excessive Vomiting or Purging, in Catarrhs and Defluxions of all kinds, ib. p. 61. Instances of Persons cured by Opiates, ib. of the evil Effects of Opium, with Cautions concerning their use, p. 62. the principal Functions of the the Soul often extremely injured by Narcoticks, ib. p. 63. sometimes hurtful to the Praecordia and Breast, ib. sometimes very injurious to the Parts within the Belly, ib. Precepts and Cautions concerning the right use of them, p. 64, 65, 66. Kind's and Praescripts of Opiates, ib. p. 67, 68 P. PAins, see Aches, and Opiates. Palsy, its Description, p. 428. divers Kind's of the Palsy, p. 429. why Sense is not always hindered as well as Motion in the Palsy, p. 430. a dullness of Mind, Forgetfulness, and Stupidness, often Forerunners of the Palsy, ib. the evident Causes of an habitual Palsy, p. 431. a Palsy in which the sensitive Faculty is hurt, Motion being entire, p. 432. the Prognostic of the Palsy, p. 433. three Methods or Ways of curing the Palsy, ib. the method of Cure when caused by some Accident, with a violent hurt, ib. how to cure it when happening upon a Fever, Apoplexy, Carus, etc. p. 434. how to be proceeded with when it depends of a Procatarxis, p. 435, 436. Praescrips of Medicines, ib. p. 437, 438, 439, 440. Hot Baths sometimes prejudicial in the Palsy, 441. Salivation when to be used, ib. Instances of Persons seized with the Palsy, and the Methods used with them, p. 442, 443, 444, 445, 446. Paraphrenitis, not caused by the Inflammation of the Diaphragm, p. 452, 453. Passions of the Heart, see Heart. Peripneumonia, its Description, p. 105. the primary Indication in order to its Cure, ib. the Intents of curing pursuant to it, ib. p. 106, 107. the secondary therapeutic Indication, ib. Praescripts of Medicines according to the various Intents, ib. p. 108, 109, 110, 111. Instances of Persons troubled with it, and the method used with them, ib. 112. Peruvian Bark, see Jesuits Powder. Pestilential Fever, see Fever. Pestilence, see Plague. Phlebetomy, how many Ways, and for what Causes and End an Eruption of Blood happens of its own Accord, p. 177, 178, 179. how many Ways, and for what Causes and Ends it is indicated by Physic, ib. p. 180. the Uses, and Affects both good and evil, of Phlebetomy in Physic, p. 181. certain Rules and Cautions to be observed in the due Administration of Phlebetomy, p. 183, 184, 185, 186, 187, 188. Ptisick, and Consumption of the Lungs, p. 71. the divers States of this Disease, ib. p. 72. a threefold method of Cure, ib. the method of curing a new Cough happening upon taking Cold, ib. p. 73, 74. Praescripts of Medicines for it, ib. p. 75, 76, 77, 78, 79. the Chincough in Children, its Cure, ib. p. 80, 81, 82. the method of curing an inveterate Cough, when it gins to degenerate into a Consumption, ib. p. 83, 84. Praescripts of Medicines for this inveterate Cough, p. 85, 86, 87, 88, 89. the method to be used in a great confirmed Ptisick, which is commonly past Cure, ib. p. 90. Praescripts of Medicines in it, ib. An Instance of a Person troubled with a single Cough, and free from the Suspicion of a Ptisick, and the method used with him, p. 91, 92, 93. An Instance of a Person troubled with a Cough proceeding chief from the nervous Liquor, and the Method used, ib. p. 94, 95. Pissing Evil, see Diabetes. Plague, it's Description, p. 592. Signs which foreshow that it will happen, ib. Signs which show its Presence in a Body diseased, p. 593. Signs of Recovery or Death in it, p. 595. Prophylactick Cautions against it, p. 596, 597. its Cure, p, 598, 599, 600. see Fever Pestilential. Pleurisy, its Description, p. 113. the method of Cure, ib. p. 114. Praescripts of Medicines adapted to the Indications, p. 115, 116, 117. An Instance of a Person troubled with it, and how proceeded with, ib. p. 118. Poisons in general, how they affect our Bodies, p. 583, 584, 585, 586, 587. Poisons causing Convulsions, p. 268. Pox, see French Pox. Psora, see Itch. Pulse intermitting, see Heart. Purging, three Degrees of it, 〈◊〉 All Purges not to be used incoherently, ib. when improper, ib. 〈◊〉. Praescripts of purging Potiche Pills, Powders, Bolus', Ele●●●ries; some of each kind being 〈◊〉 gentle, others of a mean, and ●●●ers of a strong Operation, together with some Purges of each ●●●d of an easy Preparation for 〈◊〉 Poor, p. 9, 10, 11. purging ●●●blets, Wines, and Alice, p. 12. 〈◊〉 prevent over-purging upon gi●●●g a Medicine, what to be considered. ib. p. 13. how cured if ●●●ning, ib. excessive Purging ●●●ning without giving a Medi●●●e, for the most part symptomatical, ib. two kinds of Fluxes, ●●●ning almost yearly in London, ●●●ally called the Griping of the ●●●uts, p. 14. the proper method of ●●●ire in that which happens with●●● Blood, ib. p. 15. the method 〈◊〉 Cure in the other which is ●●●ody, ib. p. 16. the therapeutic ●●●ications into which the said ●●●thod of curing the Bloody Flux ●●●y be resolved, ib. Instances of ●●●sons cured in the Bloody Flux, 〈◊〉 17, 18, 19 Q. QVartan Fever or Ague, see Fever. Quotidian Fever or Ague, see Fever. R. RAving, see Delirium. Rheumatism cured, p. 367. Rickets, Medicines for curing it, p. 147. Ring-worm, see Running Scab. Running Scab, or the Leprosy of the Greeks, its Description as it is understood by us, p. 227. its material Cause, p. 228. whence this Disease takes its Rise, ib. the method of Cure, ib. 229. Praescripts of Medicines, ib. p. 230, 231. how to proceed with it when it arises from the Scurvy, p. 232, 233. how to proceed if it arises from the French Pox, p. 234. topical Remedies to be applied outwardly, ib. p. 235. An Instance of a Person troubled with the running Scab, and how proceeded with, ib. p. 236. another Instance, p. 237. S. SCab, see Itch, and running Scab. Scurvy, the Signs of it in all the Parts of the Body, p. 326, 326. the evident Causes of it, ib. p. 328. its material Cause, p. 329. the Prognostic of it, p. 331. Instructions in order to its Cure, p. 332, 333, 334. Purgers to be used in a hot Scurvy, or in a sulphureosaline dyscrasy of the Blood, p. 335, 336. Purgers to be used in a cold Scurvy, or in a salino-sulphureous Disposition of the Blood, ib. p. 337. Preservatory Medicines for rooting out the Cause of the Disease in a cold Scurvy, or in a salino-sulphureous dyscrasy of the Blood, p. 338, 339, 340, 341, 342, 343, 344, 345, 346. Medicines for rooting out the Cause of the Disease in a hot Scurvy, or in a sulphureosaline dyscrasy of the Blood, p. 347, 348, 349, 350, 351, 352. the Curatory Indication of the Scurvy whereby we obviate the Disease itself, and the Symptoms that are chief pressing, p. 353. the Cure of a difficult Breathing and Asthmatick Fits happening in the Scurvy, ib. p. 354. the cure of the ill Affects of the Ventricle happening in the Scurvy, ib. p. 355. the scorbutic Colic cured, ib. the Cure of the Diarrhoea, and dysenterical Affects happening in the Scurvy, p. 356. the Cure of the Vertigo, Swooning, and other Affects usually joined with them in the Scurvy, p. 357. the Cure of Hoemorrhagies happening in the Scurvy, p. 358. the Cure of Distempers of the Mouth happening in the Scurvy, p. 359, 360. the cure of night pains in the Legs and Limbs in the Scurvy, p. 361. the Cure of the scorbutic Gout, p. 362. the Cure of convulsive and paraltick Affects happening in the Scurvy, p. 363. the Cure of the scorbutic Atrophia and Fever, ib. p. 364, 365. the Cure of the Rheumatism in the Scurvy, p. 365. the Cure of the Dropsy happening in the Scurvy, p. 366, 367. the crackling of the Bones in the Scurvy, p. 367, 368. the vital Indication in the Scurvy, where Cordials, Opiates, and a fit Diet, are ordered, p. 369, 370, 371, 372. Instances of Persons troubled with the Scurvy, and the Methods used with them, p. ●●●, 374, 375, 376, 377. the Me●●● of Cure to be used in some 〈◊〉 of the Scurvy, p. 379. Skin, its Affects, see cutaneous Affects. Sleep, Medicines to procur●●● see Opiates. Sleepiness continual, the Se●●●● this Disease, and the Differ●●● from the Coma and Leth●●● p. 396. its method of Cur●●● p. 397. An Instance of a P●●● troubled with it, and the met●●● used, ib. p. 398. Sleepy Coma, wherein differ●●● from the continual Sleepiness 〈◊〉 the Lethargy, p. 398. the se●●●● this Disease, ib. sometimes b●●●ning of itself, and sometime●●●suing upon other Distemper●●●● p. 399. the Method used in 〈◊〉 marry Coma, ib. the method 〈◊〉 when happening upon other ●●fects, ib. Sleep wanting, see Watch●●● Evil. Small Pox, whence Man 〈◊〉 ●●clin'd to it, p. 614. the evi●●● Causes of it, ib. p. 615. the ●●●junct Cause of it, ib. the Dia●●● stick of this Affect, p. 616, 〈◊〉 the Prognostic of it, ib. p. ●●●. its Cure, 619, 620, 621. S●●●●s of Persons distempered with 〈◊〉, and the method used with th●●●, p. 622, 623, 624. Summer Spots, see cutaneous ●●fects. Spitting Blood, see Blood ●●ting. Spots in the Skin, see cuta●●●● Affects. Steel Medicines, or Cha●●ates, the several ways of ●●●●ring them, and their various Affects in the Body of Man, p. 316, 317, 318, 319. Stomach, see Ventricle. Stupidity or Folly, whence it proceeds, p. 489. the procatarctick and evident Causes of it, p. 490. the difference betwixt Folly and Stupidity, p. 491. many degrees of Stupidity, ib. the Prognostic of it, p. 492. the method of curing it, ib. p. 493. Praescripts of Medicines, ib. p. 494. Sudorificks, see Diaphoreticks. Sugar, the Cause of the Scurvy and Consumption, p. 372. Sweat, Medicines to raise it, see Diaphoreticks. Excessive or depraved Sweeting to cure, p. 42. such Sweeting sometimes the symptom of some other Disease then affecting the Person, as of the Ptisick or Scurvy, ib. its Cure than depends of the Cure of the Disease, p. 43. excessive Sweeting sometimes the Effect of some foregoing Disease, which is brought to an end, as of an Ague, ib. the chief Cause of frequent and copious Sweats consists in the ill Habit and depraved Accension 〈◊〉 the Blood, ib. the Method and prescripts for curing it, ib. p. 44. a Distemper relating to Sweeting, or an excessive Perspiration, whereby Persons become extremely tender to take cold, p. 45. whence this Tenderness proceeds, ib. the Method and Praescripts for curing it, p. 46, 47. Swooning cured, p. 357. Synochus, see Fever. T. TAlking lightheaded, see delirium. Tarantula, its bite causing Convulsions, p. 286. Teeth when breeding, to ease the pain, p. 254. Tertian Fever, see Fever. Tetter, see running Scab. Trembling of the Heart, see Heart. Tympany, its Description, p. 160. the previous affects that dispose to it. ib. the Method of curing it, with Prescripts of Medicines. ib. p. 161, 162, 163, 164, 165, 166. V VEntricle, its various affects in the Scurvy, cured, p. 354, 355. Vertigo, its Description, p. 411. how caused, ib. p. 412. the immediate and mediate Subject of it. ib. p. 413. the conjunct cause of it, ib. p. 414. the Procatarctick cause of it, ib. the prognostic of it, ib. the Method of curing the Symptomatick, accidental, and the habitual Vertigo. p. 415, 416, 417, 418. Instances of Persons troubled with the Vertigo, and the Methods used with them. ib. p. 419, 420. Vesicatories, of what Substances, and how made, p. 198, 199, 200. after what manner they operate. p. 200, 201. their good and evil Effects, and the manner of using them. p. 202, 203. for the Cure of what Diseases this Remedy chief conduces. ib. p. 104, 105, 106. Vomiting, what things foreshow the want of it, what permit it, and what prohibit it. p. 1, 2. Prescripts of Vomitories, ib. p. 3. if a Vomit over-work, what to be done. ib. what to be done in critical Vomiting. ib. p. 4. how to proceed when the Stomach is primarily affected. ib. Prescripts of Medicines in a belching and an acid Vomiting. p. 5. Prescrips of Medicines in a hot and tartish vomiting. ib. p. 6. Prescripts of Medicines in a bilous or bitterish vomiting. ib. what to be done in an habitual vomiting, through the debility of the Stomach arising from the Fibres themselves. ib. p. 7. what to be done in a debility of the Ventricle through the Fibres being obstructed. ib. Urine, the chief scope of Medicines that purge by it, p. 20, 21. Kind's of Diuretics. ib. p. 22. Prescripts of Diuretics which have an alchalisate Salt for their Basis, ib. Prescrips of Medicines which have a fixed Salt for their Basis. p. 23. Prescripts of Medicines which have a volatile Salt for their Basis. p. 24, 25. Prescripts of Diuretics that have salt Nitre for their Basis. p. 26. Prescripts of Diuretics which have an Alchalisate Salt for their Basis, p. 27. Sulphureous Diuretics. ib. 〈◊〉 cure too much purging by Urine. see Diabetes. W. WAshes for the Face. p. 218, 219. Water. Medicines depurge it. see hydragogue Medicines. Water's Mineral, prejudicial 〈◊〉 the Gout and Rheumatism. p. 361. Watching Evil, p. 402. on what preternatural Watching depends p. 403. the Method of curing it p. 404, 405. an Instance of a Person troubled with it. p. 406. Watching Coma, what kind of affect it is. p. 406, 407. what 〈◊〉 be done in it. ib. Witchcraft causing couvulsious p. 269, 270. Womb, its Diseases, see Fits 〈◊〉 the Mother. Women in Childbed, their ●●vers, see Fever. Worms in Children, to kill th●●●, p. 255. Worms in the Face, to kill them, p. 220. FINIS. ERRATA. PAg. 1. l. 9 r. prescripts. l. 14. for which r. what. p. 4. l. 20. r. tone. p. 7. l. 14. r. successfully. p. 5. l. 25, 26, 29. r. Jalap. p. 11. l. 31, 37, 42. r. Jalap. p. 12. l. 3. r. Di●prunum. p. 16. l. 33. etc. r. viz. l. 37. after may be, r. the first of these is performed with Diaphoreticks, and the other with fit Alexipharmicks. p. 39 l. 29. Saits, r. saline things. p. 46. l. 7. r. conformation. p. 51. l. 41. cherbet, called also, r. called cherbet, also. p. 55. l. 16. the r. a. l. 34. r. these. p. 56. l. 14. r. affect. p. 81. l. 19 r. successfully. p. 89. l. 24. r. Labdanum. p. 109. l. 20. r. sweet spirit of Nitre. p. 142. l. 3. blot out the. p. 144. l. 6. though, r. and. p. 145. l. 3. r. water of Earthworms. p. 148. l. 26. r. ciches. p. 156. l. 16. so, r. too. p. 163. l. 13. take small, r. make. p. 165. l. 31. r. a Decoction. p. 177. l. 7. r. either happens. p. 183. l. 28. blot out to it. p. 185. l. 18. r. of. p. 188. l. 4: r. orifice. l. 6. r. orifice. p. 190. l. 11. r. convulsions. p. 181, l. 23. begin afresh, r. again return. p. 193. l. 7. r. moss growing. p. 201. l. 42. r. skins. p. 208. l. 41. r. in quality vicious. p. 215. l. 18. extend, r. spreads. l. 40. r. dispose. p. 216. l. 34. r. breaking's. p. 220. l. 24. Ointment, r. Cosmetick. p. 224. l. 23. r. bochet. p. 227. l. 39 that this, r. that the later. p. 239. l. 17. r. Scotomia. p. 242. l. 13. after Brain, r. and stirring them up to preternatural explosions. l. 31, 32 dissipating, r. diffused. p. 243. l. 5. r. of a Brewer. p. 248. l. 5, 6. r. Euphorbi●m. p. 250. l. 28. r. or break forth. p. 265. l. 20. r. held. l. 28. r. the diseased. l. 30. r. affect. p. 268. l. 14. r. slight. p. 275. l. 43. the, r. that. p. 280. l. 33. from, r. p. 310. l. 18. r. to it from the blood by the. p. 316. l. 4. r. effects. p. 3.7. l. 34. deal not. p. 321. l. 27. every, r. a very. p. 327. l. 31. put a comma after distemperatures, and blot out the comma after Fevers. p. 328. l. 43. r. disturb. p. 349. l. 32. four, r. six. p. 364. l. 44. r. unguentum. p. 367. l. 1. r. Jalap. p. 375. l. 20. r. and as. p. 370. l. 18. r. meanings. p. 390. l. 39 r. affects. p. 394. l. 15. therein, r. they. p. 395. l. 29 blot out such. p. 397. l. 7. r. those. p. 398. l. 10. blot out the full point after years, p. 399. l. 14. r. brain be prevented, and that that which. p. 403. l. 26. and withal, r. or. l. 32. r. not be appeased. p. 405. l. 18, 19 and that they, r. the same moreover. p. 409. l. 20. r. or Epilepsy. l. 35. brain, r. cerebellum. p. 417. l. 28. r. hoemorrhoids. p. 420. l. 37. r. and common sense. l. 28. former, r. later. p 421. l. 2. later, r. former. p. 422. l. 19 wherefore, r. of which. p. 430. l. 13. affects, r. efforts. p. 433. l. 42. r. conformation. p. 444. l. 43. make a full point after please, and a comma only after ceasing. p. 445. l. 13. blot out the comma after some. p. 447. l. 44. tho, r. and. p. 450. l. 3. whereof. l. 17. r. turgid. p. 454. l. 13. r. cleave. l. 27. ills, r. their. p. 457. l. 23. r. an apple sliced. l. 28. two apples pounded to a mash. r. two short-start apples. p. 461. l. 26. light, r. bright. p. 467. l. 41. deal and. p. 469. l. 16, after days add for purging. p. 472. l. 22. two apples mashed, r. two short-start apples. p. 473. l. 14. first, r. fist. p. 478 l. 25. r. notions. p. 484. l. 29. mashed, r. short-start. l. 35. r. whereof. p. 491. l. 19 r. divide. p. 494. l. 10. after Nutmegs, r. an ounce and a half. p. 495, l. 42. bowels, r. bones. p. 497. l. 3. r. Acid Liquors, and many small. l. 18. places of abode, r. Heavn's, and of the Air. l. 38. blot out viz. p. 502. l. 6. or, r. and. l. 38. blot out the comma after pain. p. 596. l. 15. r. gravel and stones p. 508. l. 6. deal which. p. 512. l. 2. drawn, r. done l. 28. r. properly. p. 513. l. 27. r. moistened with it. l. 39 set, r. just. p. 514. l. 7. this, r. the. l. 2. meet, r. neat. p. 518. l. 16. make a full point before in. p. 527. l. 23. r. obtunded. p. 530. l. 12. wax cold, r. ferment. p. 553 l. 18. four states of time, r. four times. p. 555. l. 43. r. as by. p. 558. l. 19 r. decided. p. 572. l. 34. r. dispersed. p. 573. l. 18. r. such as. p. 573. l. 41, 42. r. accension. p. 571. l. 2. signs. r. kinds. p. 588. l. 8. parts, r. spirits. l. 32. appearance, r. apparatus. p. 596. l. 1. r. all ways. p. 618. l. 45. brains, r. loins. p. 626. l. 12. put a comma after milk. p. 632. l. 25. put: after ensues. p. 634. l. 13. a little abated of its Heat, r. boiled a little. p. 637. l. 36. blot out also in the soles of the feet. p. 641. l. 25. r. both of. p. 643, l. 14. r. inflations. p. 651. l. 2, 3. mustiness, r. overfretting. p. 668. l. 32. r. gefs. p. 671. l. 44. add. after vehemently. 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