MORBUS EPIDEMIUS Anni 1643. ENGLAND'S New Disease most Contagious at present in Oxford. With the Signs. Causes. Remedies. Published by His Majesty's Command. OXFORD, Printed by LEONARD LICHFIELD, Printer to the University. MORBUS EPIDEMIUS Anni 1643. OR, The New Disease. THis so frequently termed, The New Disease although as ancient as a In Epidem. Hypocrates, to define it with the times, is a Malignant, and contagious Fever, being comprised under the Genus of a putrid, continued Fever, which proceedeth from putrefaction of blood, or humours contained in the greater vessels. So that the disease may be truly called, Febris putrida, continua, maligna, & contagiosa; that is, a putrid, continued Fever, both malignant and contagious, which we shall endeavour to prove, first, Negatively by showing that it is not the Plague, (as the Relations and hopes of our enemies, and the Fears of others have suggested) which may appear by these Reasons. First, b Hip. 3. E. bid. & Gal. comm. 1. in Lib. de Vict. rat. in Morb. acat. text 9 Pectis plerosque ex iis, quos corripit, jugulat, of those that are infected with the Plague, there always die, more than escape, but of this Disease, where one dies, ten at least I may safely say more, recover. Secondly, c Inseparabile signum ë non proprium & quod non soli conven it. Pestis summè contagiosa est: as we may instance in that of the Athenians, described by the d 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. Thucyd. de Be●lo. Pelo. 'pon. Lib. 2. Historian, where the Physicians could no sooner come to their Patient's relief, but they themselves were infected.— inque ipsos saeva Medentes erup●…t clades. But in this many hundreds have visited their sick Friends without Infection; Physicians, Chirurgeons and Apothecaries, who have been daily conversant with them, not any way tainted, although some few have fallen sick, for which it cannot be denied but that is somewhat, although not extremely, contagious. Thirdly, those, which they call, Bubones and Carbunculi, are frequent concomitants of the Plague, neither was it ever known, but that the virulency of the Plague in some bodies, though not in all, betrayed itself by Carbuncles. Although I am not ignorant, but that these arise many times where the Plague is not, yet I am of e Lib. 8 de Bebr. cap. 5. Horatius Augenus his mind, that in the time of Contagion, every Bubo, (unless proceeding à Lue Venerâ is Pestilential, and so to be accounted. But wheresoever this Disease hath spread itself, I ne'er yet saw any Carbuncle to arise: yet some of late (I hear) have appeared, but very rare, and I hope, ne'er to be seen again. Fourthly, Few, or none spotted, in the Plague, escape, in this sickness, many although are spotted, very few (in comparison of them that recover) do die. Notwithstanding, I cannot approve of their Opinion; who to avoid one extreme, run into another, and because it is not the Plague, therefore conceive it not at all Pestilential, nor to contain an Malignity, or Contagion, wherefore I shall show them in the second place, Positively, that it is Malignant, as we before defined it, and Contagious. For if they allow that Morbus benignus is that, which, as Physicians say, Supra propriam naturam nullum grave Symptom habet, they must be enforced to grant, that this is Morbus Malignus, because it hath, pejora quàm pro suae essentiae ratione Symptomata, or as f L. Pro●…het. text. 14. Galen, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. And sure none upon due consideration, can deny, but that the Symptoms of this Disease are more violent, and of fare greater danger, then what ordinarily belong to putrid Fevers; which dangerous Symptoms shall be set down among these following Signs, which will undoubtedly distinguish, Malignant Fevers, from others. The first sign is Magna virium imbecillitas sine manifestâ causâ, A great weakness without any manifest cause appearing. which hath been, and is still very apparent in this Disease, in so much that strong men, in a very short time, have so much lost their vigour, as they have not been able to walk, or scarce to stand, without the help, and assistance of those about them, although there hath been no sudden evacuation to disenable them, either by Vomiting, Purging, Sweeting, or Bleeding, neither naturally, or by art. Nay, the Malignitysometimes hath so fare prevailed over the vital spirits, that there hath been, to the great affrightment of those about them, frequens Syncope, & Lipothymia, Fainting and Swooning, as often as removed from their beds. The second sign is, Pulsus frequens, parvus, & admodum debilis, formicans nonnunquam & intermittens, A quick, weak, creeping Pulse, and sometimes intermittent. It would be too long and tedious to show the cause of Simple, or Respective differences in Pulses, it will suffice to know, that the preservation, and distribution of the natural heat, and vital spirits, is by the Pulse, the use of which in general is, conservari 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 caloris nativi, or as g Lib. 1. Fen. 2. D octr 3. cap. 1. Avicen, regere spiritum. Now if the heart, being caloris & spiritus vitalis fons, domicilium, focus, & officina, and together with the Arteries the Instrumental cause, shall be affected by putrid, malign Vapours, empoisoning the stream, and current of Spirits, from this Fountain, the vital Faculty must necessarily decay, and the Pulse be found weak, and Languide, and that with several variations. It is likewise very observable, that Febris omnis, quâ Febris, pulsus facit magnos, then on the contrary it must needs arise from the Malignity, that doth parvos & debiles reddere pulsus. A great controversy there is, whither by the Urine also, Malignant Fevers may not be discerned. My opinion with some others in brief is, they cannot, because the Maligna & venenata qualitas doth insensibly steal, and seize on the heart, without any violent agitation, or perturbation of Humours, from which proceeds the alteration of Urines, so that the greatest Argument of a Malignant Disease is, the Urine to appear good, when there are very bad symptoms. Both h In Comm. 2. Pro●rhet. ad text. 2. Hipp. and Galen tell us, nullum in Vrinâ esse signum quod dilirinm portendat, and delirium is no where so frequent, as in these Diseases. Yet for the most part, Vrinae tenues, & crudae sunt, containing no sediment, or if they do, Excremento potius simile est, quàm sedimento. Many other signs there are, taken from the Symptoms, or rather are indeed the Symptoms themselves, which you may read at large in i Theodoro Angelutio a Belforte: Eustachius Rudius. Joh. Colle. Octavianus Robertus. Coyttarus. Carolus Gallus. Th. Minadous, etc. Authors, I shall, for brevity's sake, mention them together. Dolores capitis intensi, Vertigo, Oculorum caligo, narium stillicidia, Aurium surditas & tinnitus, Imaginatio laesa, somnus variis & absurdis imaginibus interpellatus, facies horrida, Cardialgia, Lipothymia, singultUs, Humorum corruptorum vomitus, vermium excretio, alvi dejecto valdè faetida, atra, livida, virescens; extrema corporis frigida. And near upon all these have I observed in this City, in particular persons; since the progress of this Disease. But what need we any farther signs than the Spots, which appear upon half the number at least of those that fall sick. Febres Petechiales, Peticulares, Lenticulares & Purpuratae, were never yet known, or otherwise accounted then Malignant. except by k In Scholiis in Meth. Med. Michaelis Joh. parchialii Lib. 1. cap. 1. Peredam. whose worthless arguments, I pass by. Nor is it to be doubted, but the Spotted Fevers were very well known to the Ancients, although no tract, extant, hath been written of them, since l Lib. 5. Meth. Med. cap 12. Galen makes mention of his ' 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and Hippocrites his 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, & 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, like to the bitings of Gnats and Fleas, the material cause of these Spots, is the most thin, and subtle part of the morbifique matter, thrust out to the skin, and although it be the strength of Nature, to send out these Spots, and therefore by some are accounted Critical; yet they argue abundance of putrefaction within, and therefore may be accounted Symptomatical. and (contrary to the common opinion) the more Spots, the more danger. Some from the colour of these Spots draw Prognostics, and tell you, that rubrae maculae, red spots arise from a good and well tempered blood, though now corrupted, and therefore are of all the most safe. Maculae flavae vel virides, yellowish or greenish Spots from putrid Choler, and therefore are of a worse condition. Maculae puniceae & nigrae, Black and blue spots from Melancholy, and adust Humours, and therefore are the worst of all. This for the most part holds true, yet oftentimes we find them escape, and die too, with Spots of all Colours. Concerning the Causes of this Disease, there are diversities of opinions; and that of Divines deserves the first place, as being most certain that Diseases are sent from God, as the punishments of sin, who hath been most merciful to this City, in sparing us heretofore, when our neighbours round about us were visited, but although with them, we acknowledge, that God may by his absolute power, and without ordinary, and second causes, send the Plague, or other Diseases among us, yet usually he doth it, according to his ordinary power, working by the mediation of ordinary, natural Causes, which we shall now farther inquire after. And first to speak of the generant, than the propagating Causes, Some attribute the cause of the disease to the Air, which this Summer, by reason of continued Rain, hath proved hot and moist, of which m 1. de 〈…〉 cap. 4. Galen speaks thus. Pestilentes (vel malignos morbos) oriri est necessarium, cùm aeris temperatura, à naturali habitu ad caliditatem, & humiditatem immoderatam fuerit conversa. of which constitution of the Air n 3. Epid. Come 3. Hypocrates likewise writes at large. Therefore if the weather were seasonable and very hot, the humidity, as some suppose, would be spent, and the Disease cease. As it is reported the Plague doth at Aleppo, and other places in the Turks Dominions. What may happen in that Continent, I know not, but in this our Island, I conceive there never wants moisture enough, to be answerable to the greatest heats, either of the Canicular days, or any other, and then the danger may be, if the season proves hotter or drier, that this disease may grow to a higher degree of putrefaction, and malignity, it being too, too often known, that these Malignant Diseases forerun the Plague. But I do not conceive those accidental properties of the Air, Heat, or Cold, to be necessarily requisite, either to the Generating or Propagating of malignant Diseases. Since we find them rage in all seasons, many years together, as that malignant o ●o. Caius, Lib de Ephemerâ Britannicâ. Sudor Anglicus, or the sweeting sickness, Anno 1486. continued Summer and Winter, near upon forty years. I am therefore of opinion with Fernelius, Platerus, and others, that the hot and Moist constitution of the Air, can be but Causa praeparans, but to make up the adequate Cause of Malignant Diseases, there is required that 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Hippocratis, which is thought to be, Aeris constitutio occulto modo & totâ naturà nobis adversa, the Air having its alteration, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 from the occult influences of the Heavens: there may be such strange malign influences of the stars, at this time, but 'tis more than we know, or more than Astrologers have foretold; if the Cause of this Disease must be found i'th' Air, I should rather attribute it to those putrid exhalations, drawn up by the Sun, from stinking matter, Dung, Carcases of dead Horses, and other Carrion, in and about the City, and were there care taken for the removing these noisome inconveniences, and keeping the Streets sweet, and clean, it would doubtless tend much to the abatement of the Disease. A Second Cause is attributed to Diet, & although there be no such scarcity of Provisions as to force us to feed upon bad meats, yet I cannot altogether excuse our Drink, being for the most part (by reason of the multitude, and concourse of people) over-new, and not ripe or fit for drinking. I could wish the Brewers would somewhat regard our health, as well as their own profit, in drying their Malt sufficiently, throughly boiling their Beer, making clean their Vessels; whereas the complaint against them is, they make use of slack-dried Malt, not half boil their Beer, add few, or no hopps, and ton it up in unwashed Vessels, which causeth the Drink to be crude, raw, and apt to corrupt within us. The Brew-houses all stand upon the Banks of the River Isis, which of itself is a cold hungry water, the source and springs of it arising from Cotsall in Glocestershire; where at the spring head, the extremity of coldness in the water is such, that as it is observed, Beasts refuse to drink of it; how great care then ought they to take i'th' boiling, whereby to alter, and amend this quality of the water. But we need not look fare for a cause, where there is an Army residing, as the old verse shows, which the p Thucy●… Lib. 2. Athenians called to mind in their Calamity; 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Or as q Iliad. ● Home speaks of his Greeks. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 It being seldom, or never known, that an Army where there is so much filth, and nastiness in Diet, worse lodging, unshifted apparel etc. should continue long with contagious Diseases. The cause of its Propagation and diffusion is, Natura eius contagiosa. That this Disease is contagious is not to be r Malignn. esse, est proprietas alicu●us ●antum ●peciei morbi c●ntagiosi. doubted, since the Rule holds constantly true, All Malignant Diseases are Contagious, though all contagious Diseases are not Malignant, the infection, & Seminum Contagij being that which the Grecian call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which are sent forth, and slow from the party diseased, sometimes per expirationem & haltum, sometimes perporos, cutis & 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, & after being transmitted, and received in corpore analogo, do operate, and produce in it the same specificiall Disease. The Question is how long these semina morbi may lie hid in the body before they s Habet se contagium Fermenti instar, quod in corpore analogo receptum, simil m dispososiliodem illi inducet. Sen. Fermentate the Humours, and break forth into action. Cardan and many others hold they may lurk not only days but some weeks, before the infection betray itself; as for example, the venomous biting of a mad Dog, doth long prece'de 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or Fear of drowning; t Lib 1. de 26. whether the Contagion be taken immediately by contact, or immediately, and at a distance, and that either per Fomitem or per Aerem, how the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or in quinamenta, do lurk in the body, and whether that body must necessarily be corpus analogù that must receive them, so that beasts cannot catch the disease of us, as we do not each the Murrain of beasts, it is not Material here to be determined. Sufficient it is for our purpose, that it appears to be Contagious by infecting whole Families, and seldom in any house, where sick Soldiers of either side are quartered, but the Inhabitants likewise fall sick of the same Disease; but if any man be yet obstinate, and will not believe it Contagious, I answer him as Proteus in Lucian did Menelaus, who would not believe he could turn himself into fire also, 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 Let him go near and try. The Remedies. It may be thought by most, but lost labour, to attempt the setting down any Remedies, since it is commonly reported, as Coyttarus writes, was of his Febris purpurata that the Physicians themselves know not the Disease, nor, the cure of it. True it is, we do not here proceed altogether in the same order and method, as in common putrid Fevers, which contain no malignity in them, but as we find altera indicantia, so we must provide altera remedia, yet we are not destitute of Rule and Method, to be observed in the cure of these occult malignant Diseases, but as n Lib. 1. cap 1. Eustachius Rudius well conceives occultis omnibus praeter naturam affectibus, tacitâ quidem & occultâ medicamentorum proprietate succurendum, non tamen Empiricorum ritu, sed arte & methodo. For as in many other things, so in the Nature, and Remedy of these diseases, we must with Scaliger have refuge to that falutare Asylum of occult qualities, who likewise tells you: x Exercitat. 218. Sect. 8. ad manifestas omnia deducere qualitates summa impudentia est, and they, which go about to endeavour it rationes ineptas, vel ridiculas adferunt, as y Lib. 1. de Nat. Fac. cap. 14. Galen saith of Epicurus and Asclepiades. These Morbi maligni are indeed, Fernelius his Morbi totius substantiae, contra quos, non calidis, frigidis, humidis & siccis, sed his quae tota substantia agunt pugnamus, That Maligna 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 contpined in them, is not to be expelled by any other Medicaments, but 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. It will there fore plainly appearere, that in the cure of this malignant Fever now raging, all our intentions ought to be directed to these two, the Malignity, & the Fever, from which of these the greatest danger may arise is chief to be considered. The Fever sometimes requires Vomiting, Purging, Bleeding; especially in the beginning, of which we shall speak more hereafter That which is principally to be regarded, is for the most part, the malignity, which being timely prevented by some alexipharmacal Medicine, there will be little danger of the ensuing Disease. I have known some who presently upon complant of Chillness, of a king and diznesse in the head, have taken a Cordial, gone straight way into bed, and sweat, and risen next day, without any distemper: which may very well be, by dicussing, and expelling the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and inqninamentum putredinale, before it have fermented, and assimilated the whole Mass. And by this means alone was cured that most fatal Disease 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or Sudor Anglicus, which raged with such destructive violence, (till constant sweeting for 24. hours, the only certain Remedy was found out) that neighbouring Countries did not believe this Island had so many inhabitants as died. It is requisite therefore to set down proper and specificiall Medicines, ad 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, or the expulsion of the Malignity. Theodoro Angelutio à Belforte, who writ his book, de Febre Maligna after his recovery from the Disease, and therefore may be the better credited, divides those Medicaments, which preserve the Heart from malignity, into fix Classes, but more compendiously, they may be divided into these two, Simplicia, and Composita: of the first sort are Angeleca Valeriana, Carduus benedictus, Scordium. Acetosa Tormentilla, Dictamus, Scabiosa, Vincetoxicum, Ruta, Morsus, Diaboli, Veronica, Pimpinella, Scorzonera, Galendula, Absynthium, Zedoaria, Imperatoria, Gentiana, Baccae Juniperi, Cornu Cervi, Os de Cord Cervi, Bolus Armenus, Terra Sigillata, Smaragdus, Hyacinthus. The second sort, or Compounds, are, Theriaca Andromachi, Mithridatium, Confectio Liberans, Electuarium de Ovo, Diascordium Fracastorii, Pulvis Saxonicus, Antidote Guidonis de Cauliaco, Pulvis, Caesaris rubeus, & Gryseus, Electuarium Camphoratum Kegleri, z Gal de Antidote is. v. and Others. Out of all which upon occasion we may make choice, select Cordials for our use and purpose, the poorer sort, and Common Soldiers, when they first find the Disease coming upon them, may take a draught of Carduus-Possetdrinke, and with it some Diascordium, Venice or, London Treacle, sweeting after it, or an Electuary may be compounded of them after this manner; R. Confect. Liberant. unc. 1. Diascord. Fracast. unc. sem. Theriac. Andromachi. Pulu. Saxon. Elect. ex Ovo. an Drach. ij. Cum Syrup. ex Acetoes. Citri. Vel Luiula fiat Electuarium. Take a Dram of it in a draught of Posset drink, in which Carduus, Angelica, Scabious, Sorrell, or Marigold Flowers, have been boiled; The Richer sort may take likewise of the same Electuary, and drink after it three or four ounces of this julep made of distilled waters, which do penetrate more, and sooner provoke sweat. R. Aq. Cardui. b. Angelice. bugloss. an. unc. iij. Sudorif. Theriacal. an. ℥ j ss. Syrup. ex Acetoes. Citr. vel è Limon. unc. ij. Luiule. unc. 1. Spirit, Vitrioli gt. 12. Misce. Some repose great confidence in costly powders, as Bezoar, Contraerua, Gas●ons Powder, Unicorn's Horn, and now a days the Lady Kent's Powder (as it is vulgarly called) is in great esteem. The ingredients of which are not commonly known, although we may guess at them. 'Tis generally found by experience, they say, that this powder is of incomparable virtue, although I have known when it hath not answered our expectation, and that Cordials fetched from the Apothecary's shop, have at last proved more effectual. Neither do I think it good to trust altogether to new inventions, when we have so many Antidotes approved of by the Ancients, and continued with happy success to these our times. Praestat benè inventis, ac probatis uti, quám nova componere; and I know not who speaks thus to the purpose. Cùm omnia illa Alexipharmaca experientiâ potius quam ratione inventa sunt, nemo suam salutem gloriosis nonnullorum promissis concredat, neque novis medicamentis, sed iis, quae á multis probata fuére, considat. For if the Bezoar stones (which are thought to give the virtue to most of those powders) be very rare and scarce among the Indians themselves, sure the great number we have must needs be cowterfeit, and very unsafe it were for any man to rely upon them alone, to save his life. What likewise that rare, treasured up Unicorns horn is, I know not, nor could yet ever learn, and have no such confidence of its virtue, as to entrust my life to it. Nor is it enough, to take Cordial Medicines once or twice, thinking than we are secure; but all the time of the Disease, as towards night, to drink this or the like Julep. R. Aq. Borrag. Acetoes. an. unc. j Bezoard. Sem. unc. Syrup. Luiule. unc. j Diascord. Fracast. Confect. liberant. an. Scrup. j Asceti scordii. drach. ij. Misce. to drink like likewise one or two ounces, every second, or third hour, of this following. R. Aq. Cardui. b. unc. iij. Luiule. Herculis Saxon. frig. an. unc. ij. Bezoard. unc. 1. Syrup, Garyoph. Luiule. E Limon. an. drach. iuj. Confect. liberant. drach. ij. Alkerm. drac. 1. M. ft julapium. These or the like may be altered upon any occasion, and made fit to be answerable both to the Disease, and the Symptoms. The shaving of Harts-Horne are of singular good use in this Disease, both to boil in Posset-Drinke and broth, or to make a decoction thus. R. Rasur. Corn. Ceru. unc. Sem. C. C. praep. drach. ij. Aq. Fontaine Lib. ij. sem. Coq. ad Tertias, addendo. Kad. Scorzonere, drac. ij. Sem. & Cort. Citri. an. ʒ jss. Santal. Citrin. Sem. drach. Affunde Aq. Scordii. unc. 5. Ebulliant semel atque iterum. Col. utm add. Snccie Limon. unc. Sem. Syrup. é Limon. unc. ij. Sp. Vitrol. q. s. ad gratam aciditatem. This Drink quencheth the Thirst, opens obstructions, and resists both putrefaction and malignity. Of which or their waters we may likewise make Cordial emulsions. R. Sem. Cardui. b. Napi. an. ℥ ● ss. Aquilegie. drach. ●. Melon. excort. unc. sem. Simul contunà. in Mortar. Marmoreo, sensim affusis. Aq. Borrag. Cardui. b. Acetose. Scabiose an. unc. ij. Pt s. a. Emulsio. cui add. Magist. Perlar. drach. sem. C. C. ust. praep. Scrup. ij. M. Dulcoretur Rotul. Manus Christi perlat. q. s. The Malignity thus provided against, we are in the next place to consider the Fever, and in this, as in other putrid Fevers, many times we find Nature endeavouring to expel the Morbific matter by Vomiting, and that very often cum aegri 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, and the great ease of the Patient, which course we may safely fallow, and help Nature in the beginning of the Disease, for which Method in Practice, we can produce more reason and experience, than authority although we are not destitute of a Gal. comm. in Hipp. Aph. 24 Lib. 1. That neither, when there is Turgida materia ad superiora vergens. And in that Malignant Camp-disease, which raged in Hungary, anno 1566. and agrees very much with this our Morbus Castrensis, Tob. Coberus, writes thus. b Obs. Castrens. Ungarie Decad. 2. Observat. 5. In morbo Vngarico ad vomitum, tanquam sacram Anchoram, mox confugiendum esse, neminem negaturum, qui curationi hujus morbi interfuerit. and draws his Argument from the copiousness of viscous, tough Humours, lodged in the stomach, and entrails, which Nature was not able to concoct, nor could they be otherwise discharged, but by this sudden evacuation. By this means usually, that Saburra vitiosorum humorum in ventaiculo & primis vi●s, is removed, and the Nausea, Dolour, Aestus, Amaritudo, Anxietas, incident to this Fever, much lessened, if not quite taken off. Yet I would wish a man well advised, before he adventure to give strong, Antimonial Vomits in this disease, gentle and easy Vomits, as Aqua tepida, Oxymel, Vinum Scyllit. Decoctum Raphani, etc. may safely be administered. But all Bodies are not apt, or fit for vomiting, and to such Lenitive Medicines, moderate purging Physic may be prescribed, as Syrup of Roses, Manna, Cassta, Tamarinds, and (Turgente Materia) Rheubarb, Agarick, Sena, or our common purging infusion, consisting of the three latter, and their correctives, with an addition of some proper Syrups to it. And these minorative medicines must be taken in the beginning of the Disease, (si turgeat materia) before the third day be past, otherwise better it is (in reference to that of c Aph. 22 lib 1. Hypocrates. Concocta movere & purgare oportet, non cruda) to forbear all these, and make use only of Clysters, or sometimes (if occasion so require) purging per Epicrasin. With these purgatives likewise Heurnius tells us, he hath admixed Alexipharmaca, d Lib. de Peste cap. 9 putting Nature to contrary motions, Purging, and Sweeting both at once, and that, with very good success. But from strong violent Purgatives, as Scammony, Colocynth, Turbith, etc. we must by all means abstain, it being known by sad experience, that they have proved fatal to the sick, by overmuch disturbing, and weakening of Nature, drawing inwards putrid, malign Humours, after which, too, too often follows, a desperate Diarrhaea, and 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉. In the beginning likewise of this Fever, the opening of a Vein is very requisite, especially for Plethoric bodies, where the Quantity of the Blood distending the Vessels is burdensome to Nature, and where Repletion is another Disease: For if fullness of Blood be of itself dangerous, as e Lib. 3● de Di●ta. Hypocrates tells us, how great must the danger be, when this fullness shall be corrupted? Wherefore f Lib 11 de Meth. Med. Galen universally pronounceth, Saluberrima est in omni putridâ febre sanguinis missio. Yet some there are, who utterly condemn letting blood, and object the horrid Symptoms, and great weakness incident to this Fever. But we find in Pestilential Fevers (where the Symptoms and weakness are not loss) g Lib. 14. de Meth. Med. cap. 10. Galen lets blood, and Rufus (more ancient than Galen) whom h Cap 25. lib. 6. suae Synopseos. Oribasius commends for so doing. So likewise i Lib. 2. c. ●6. Paulus Aegineia, k Cap 94. Aëtius, and with the Grecians consent Avicen, Averro, the chief among the Arabian Physicians. Phlebotomy therefore doth well before the fourth day be past, after which time when the Diseasehath diffused itself, and wrought a Turbulence, and confusion in the Humours, for the Generality it is observed, not so much to help, as weaken Nature, although by Leeches the Haemorroide Veins have been opened after that time with good success. And in case the Physician be not sent for till five or six days be past, Galen adviseth us (if there be Ingens morbus & virium robur) after that time to let blood. l Lib. de C●●and ratione per sanguinis ●…issionem. Quoniam quintum saepe diem, aut sextum ab initio expectant, priusquam nos ad curandum accersant, expediet nihiolo secius sanguinem detrahere, etiamsi hujus auxilii tempus sit omissum. Where there is Cacochymia, sine Plethora, we must sparingly diminish the Quantity, and (as fare as may be) endeavour to amend the Quality. And since there is no loss of blood without some loss of Spirits also, we must not unadvisedly draw blood, but seriously consider, and weigh the m Lib. eo●em 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉, set down by Galen for our direction. The Patients, Age, Strength, Constitution, Country, Diet, the time, etc. Guided by which we cannot err, nor shall ever have cause to repent of what we have undertaken. The Question is when the Spots appear, and that Nature seems to thrust out the Disease, whether we may let blood, or not? n Lib. 3 de Contagione. Cap. 5. Fracastorius Forbids it. But the Answer in brief is, we may; because the spots are only putrid evaporations, thrust out to the circumference, the seeds and matter whereof remain within, in the Centre, and are in part drawn away by letting blood: in the Small Pox or Measles, the case is fare different, for there the Putrid matter itself is thrust out to the skin, which by blood-letting would be drawn back again. But in o Lib 6. Cap. 4. Febre Petechali, johanes Colle, and Ludovicus Mercatus (if you think them Authentic) say, Semel, bis, ter vel saepius sanguinem detrahere licet, I know no reason, why the Common people account it death to sleep after letting blood, and therefore keep them waking all the day after, or at least six hours. p Lib. 2. Meth. Med. Fernelius only gives the reason thus, ne languidior calor extinguator, aut obruantur i●…inuti spiritus which after one hours' space, I think we need not fear I I am sure q Meth. Med. cap. 4. Galen when he had drawn blood from his patiented usque ad animi deliquium, within two hours let him sleep, and would not wake him, and in the greatest Haimorrhages which come of themselves, we let them presently sleep without danger. Vesicatories applied to the extreme parts, Arms, and Legs, are of good use, by drawing and diverting the virulent matter from the head, and Principal parts. Cantharideses are most in use to make them, nor did I ever yet find, which many fear, that the Bladder suffered any inconvenience from them, they may be applied safely upon any, but a Critical day. Concerning Ligatures, and Frictions, of the Legs and Thighs, setting on Cupping-glasses, scarifying, applying Pigeons to the Feet or opening Veins in the Feet, if a delirium be instant; to speak particularly of these, and to answer all doubts and objections, which may be raised, would require a Volume. There being as r Lib. 2. cap. 3. Thomas Minadous calls them, an Ocean of difficulties, De sanguis missione, saith he, de Phaenigmis, optime deus? quanta habita dissentio est, de Curbitulis, de malleolorum scarrificatione, de hirudinibus, de ipsis interdum Frictionibus, De lavacris, etc. Concerning Diet and the government of the sick, quo ad res non naturalis, some are of opinion, because those of the Northern Climates are the greatest feeders, therefore meat and the custom of feeding ought not to be prohibited in acute Diseases. But reason and experience show the contrary, Victus tenuis is here by all means to be observed, and the more violent the Symptoms are, the more sparing and slender the Diet. Nature having enough to do in concocting the peccant Morbisicke matter, cannot with security be taken off, from that employment, to concoct meat also, and who ere shall adventure to give meat, will find, that he doth not so much nourish the Man, as the Disease. But for the most part, their stomaches nauseate and abhor solid meats, therefore their chief nourishment consists of broths, altered with the shave of Harts-Horne, sufficiently infused in the water, over Embers, than boiled with these or the like Roots, and herbs, as Succory leaves, and Roots, parsley roots, sweet Fennell, and Asparagus roots, Sorrell, borage, bugloss leaves and flowers, etc. Broths in this or the like manner prepared, are as well Medicaments, as nourishments. Sometimes for exchange they may be permitted, Watergruell, Pannado, Caudle, Mace-Ale, or the like. They wrong the sick very much doubtless, who in the extremity of Heat, and drought; altogether forbidden Drink, suffering the very radical moisture to be dried, and consumed by the preternatural heat prevailing, therefore small Beer, as they may not drink overmuch, so neither must it altogether be debarred them; but because many times through negligence, it is cru'de and not well boiled, 'ttwere safer to take clear Posset-drinke, with a small quantity of sugar added, or to make it more effectual, boil shave of Harts-Horne in the Posset-Drinke, adding some few drops of the Spirits of Vitriol withal to drink sometimes Harts-Horne decoction, and other juleps before mentioned, which quench the thirst, resist putrefaction and mitigate the violent heat of the Fever. I have heard divers commend Vlmaria, or Made-sweet, and attribute so much to its virtue as the cure of this Disease, being boiled in Broth, or Posset-drinke. I know no such rare virtue it hath, yet I conceive it may conduce somewhat to those who are troubled with the Diarrhaea, or slux in this Disease, being of a styptic quality, as also cold, and dry. There is required a pure Air, void of all noisome, offensive smells, and Temperate, as not cold, to cause a constipation of the Pores, so not overhot, to increase the Fever yet the patient must be sufficiently covered with , to discuss, and breath forth Putrid Fuliginous vapours. Sleep strengthens the Spirits, increaseth the natural heat, and concocts vicious, peccant humours. Therefore if hot vapours, by inflaming the Brain, attenuate, and disperse the Animal Spirits, and so consequently cause continual waking, we may warily use Medicines to fix, quiet, and sweetly compose the same spirits, and so procure sleep. Such are Theriaca recens, Philonium, Requies Nicholai, etc. and if need require Laudanum Paracelsi. Diacodion Fracastorij admixed, doth the like. Or the temples may be anointed with Vnguentum Populeon, Oleum Violac. Nympheae, Nucis. Mosch. express. and some few grains of Opium. Repose and quietness is very requisite, Motion and exercise dissipates the natural Heat, which should be employed in concocting the Morbific matter: therefore s 6. Epid. Com. 3. text. 31. Hypocrates justly reprehends Herodicus, for that he had killed many, by advising them, to strive and use exercise in Fevers. Many inconveniences, and ill symptoms follow from the Excrements overlong retained, therefore if the body be not otherwise answerable, every other day make use of a clyster, or Suppository. Be Cheerful and Pleasant, as fare as the Disease will give leave, avoid all all sad thoughts, and sudden passions of the Mind, especially Anger, which adds fire to that Heat, inflames the Blood, and Spirits, and at length, sets the whole Fabric in Combustion. The Preservatives. After the Remedies, I conceive it may prove very beneficial, and worth labour, to set down in brief some Praeservatives, for avoiding the Disease. The Common-souldiers or poorer sort, may take a Clove or two of Garlic in the Morning, which by t 1. de distr. Febr. cap. 3. Galen himself is called Rusticorum Theriaca, and although it be no good food or nourishment, yet 'tis a good Medicament. Next they may drink Wormwood Beer in the morning, which resists putrefaction of humours, and keeps out infection, or they may eat with Butter some few leaves of Rue, or Sage, and when they accompany their sick fellow Soldiers, let them smell to Rue or Wormwood. Let them burn in the houses where they are Quartered, Pitch, Refine, Frankincense, juniper wood, or flash a little Gunpowder. The Apothecary will afford the better sort Ruffus his Pills, which are good, as against the Plague, so all malignant Diseases, make half a dram into three Pills, and take them in the morning fasting. They consist of these three things, Aloe, which strengthens the Stomach, and Intestins, freeing them from vicious ill humours. Myrrh, resists putrefaction, Saffron, strengthens the Vitals. Of these three likewise consists Elixir Proprietatis Paracelsi, only there is Oil of Sulphur added, which is also very well known, to resist putrefaction. This is doubtless an excellent Preservative being taken six or seven drops, in some Bezoardick water, or in a little glass of Sack, or White-wine. Those which go to the Sick, may do well to put some Mithridate, or Venice-Treacle into their Nostrils, to by't Zedoary, or Angelico, and hold it in their Mouths, or smell to Balls, or as they usually call them Pomanders, made of Laudanum, Benzoin, Styrac, Calamit, Lignum Aloes, Rhodium, etc. Let them burn in their Houses, the wood, and berries of juniper, Bayes, Amber, Myrrh, Benzoin. Other preservatives I could here likewise put down, but they are for the most part more Elaborate, Chemical, and not to be readily procured against this present occasion. But the best means of preserving us, and those which, (under God) we chief rely upon, are Medicamenta Alexipharmaca, Antidotes, and those that do (as we said before) totâ substantiâ agere contra Morbos malignos, as Theriaca, Diascordium, Mithridatium, etc. Those being absolutely the best Preservatives against the Disease, which are the Remedies of it. u Cap. 16. Galeu himself most excellently in his Book de Theriaca ad Pisonem approves and adviseth this course. Sanus frequenter Alexipharmacis utatur, ut exteriùs occurrentibus injuriis, & contagio corpus resistat, & si quando passum aliquid fuerit, ad fanitatem facilè reducatur. Thus for the ease and benefit of others, have I described what things are necessary and useful against this Epidemical Disease: and that I might conceal nothing material, I have descended even to the lowest and meanest Directions, which some perhaps would have permitted, as slight and trivial, but I account nothing minute and contemptible, which may conduce to the Life and Preservation of MAN. FINIS.