RHAZES -Abu Bakr Muhammad ibn
Zaka-riya al-Razij, 8507-925?
De Variolis et Morbillis.
Treatise on the Small Pox
Tr. into English by Thomas
ag
5)
and Measles. ( D
Stack, for Richard Mead ; and ed., 1755.)
{
Tn no, 3366, pp. 111-204. &
Ee ’ P :
3366. The same. A Discourse on the Small-
Pox and Measles. To which is annexed,
A treatise on the same diseases, by... Abu
Beker Rhazes. The whole tr. into English,
under the Author’s inspection, by Thomas
Stack. 2nded. 8°. Lond., 1755. ri
The Rhazes is catalogued as nos. 456-7.
FROM
LIBRARY
OF
SIR WILLIAM OSLER, Barr.
THE
OXFORD
FROM
THE LIBRARY
OF
SIR WILLIAM OSLER, Bart.
OXFORD
7S"
A
DISCOURSE
SMALL POX
M E A S-L.ES.
RICHARD MEAD,
Fellow of the Royal Colleges of Phyficians at
London and Edinburgh, and of the Royal Society ;
and Phyfician to His Majesty.
. To which is annexed,
A TREATISE on the fame Difeafes, by
the celebrated Arabian Phyfician ABU-
BEKER RHAZES.
The Whole tranflated into Englifb, under the
Author’s Infpeétion,
By THOMAS STACK, M.D, F.R.S.
SECOND EDITION.
oe
L Qo NON:
Printed for J. BR rN DLE Y, Bookfeller to his late
Royal Highnefs the Prince of Wales, in New Bond=
Street, M.DCCLY.
PREFACE.
Confiderable part of this Dit
courfe was written by me ma-
ny years fince; and the whole
had been finifbed and given to the
Public long ago, would the bufine/s of
my profeffion, in which I have been
conftantly engaged, have allowed mé
time to do it. However, I flatter
myfelf, that this intermiffion of the
work will in the main turn to the ad-
vantage of the reader : because what-
ever inconveniencies may attend age,
they are for t® moft part amply
compenfated by daily acquifitions of
knowledge and experience. Where-
fore, without farther apology, I foall
now briefly lay down the motives,
which firft induced me to write on
this fubjett. .
Az fn
iv PREFACE,
Iv the year 19717 the learned
Do&for Freind publifbed the fart and
third books of Hippocrates’s Epi-
demics, ilujirated with nine Com-
mentaries concerning Fevers. Of
thefe the feventh treats of purging
in the putrid fever, which follows
upon the confluent Small Pox; and
in fupport of his opinion, he has an-
nexed to it the letters of four phyf-
cians to himfelf on that fubjeét ; one
of which is mine. For after having
been feveral years one of the phy ficians
to St.’'Thomas’s Hofpital, iz the year
1708, I obferved, that [ome of my
patients recovered from a very ma-
hignant fort of Small Pox, even be-
yond expettation, by a loofene/s feiz-
ing them on the ninth or tenth day
of the difeafe, and fometimes earlier.
Hence I took the hint, ta try what
good might be done by opening the
body with a gentle purge on the de-
cline
rR HE FA GSE: Vv
cline of the diftemper, efpécially
where the patient had conftantly been
coftive from the beginning ; which is
far from being an uncommon cafe.
The fucce/s was in a great meafure
anfwerable to my wifbes : for by this
method I recovered many, who were
in the moft tnminent danger.
Ar that time, and indeed during
the remainder of his life, I was ftrit-
ly joined in friendfbip with Dr.
Freind ; and as we frequently con-
verfed on the bufine/s of our profe/-
fron, Lexplained this point of prattice
to him, and met with his approba-
tion. Soon after this, Ae was called
to a confultation with two other emi-
nent phyficians, on the cafe of a_young
nobleman, who lay dangeroufly ill of
the Small Pox : whereupon, he pro-
pofed my method. But they obftinate-
ly oppofed it until the fourteenth day
from the eruption, when. the cafe ap-
peering
Vi PREFACE.
pearing quite defperate by convulfr-
ons with a lethargy coming on apacey
they confented to give him a gentle
laxative draught 5 which had avery
good effec. Hereupon Dr. Freind
gave his opinion to repeat it; but that
was over-ruled, and the patient died
the feventh day after. The doétor
himfelf has given an ample. account of
this cafe (1.)
Tus affair foon made fo great a
noife, that even the gentlemen of the
faculty were divided upon it , fome
commending, others finding fault with
Dr. Freind’s advice: which fo effen-
tially affeéted his reputation, that be
thought himfelf under a necefity of
vindicating it: and therefore he en-
treated me to fend him the purport
of our former converfation in writing.
Such was our friendfbip, that I foon
(1) Freindi Opera, p. 263.
complied
rae. PA CE, Vii
complied with his requeff; and he
foewed my letter to Dr. Radcliffe,
(who at that time was very deferved-
ly at the head of his profeffion, upon
account of his great medical pene-
tration and experience, and had ho»
noured me with a confiderable fhare
of intimacy) and toldhimwithal, that
he intended to publifo bis Defence.
Whereupon, Dr. Radcliffe obtained
leave of me for Dr. Freind to annex
my letter to his book. But after two
or three foeets had been printed off, he
was prevailed on by Jome friends to
drop his undertaking ; and thus both
his work and my letter lay by for fome
years, that is, until he publifbed his
Commentaries on fevers. Whilehewas
employed in this work, he had frefh
thoughts of printing the aforefaid let~
ter with it ; for which purpofe, I re-
vifed and enlarged the letter, tran-
plated it from the original Englith
into Latin, and, in fhort,new-2modelled
4k
viii PREFAC 8H
it into the form, in which it appears
in that book.
Ir very rarely happens, that a@
new method of cure in any difeafe
gives univerfal fatisfattion : however,
not only Dr. Freind and my/elf inva-
riably perfifted in this from the firft
time I mentioned it to him 5 but fe-
veral phyficians likewife, both in
town and country, to whom we im-
parted it, found its falutary effects.
But there never are wanting fome
men of fo invidious a turn of mind,
that their principal pleafure confifts in
blackening the reputation, and decry-
ing the produétions of others; as if
what they firip their neighbours of,
was to be added to their own cha-
ratters. Thus Dr. Freind’s book had
no fooner appeared in public, but Jome
of this flamp flew to arms, as if ta
fave the common-wealth. In front of
this band ftood forth Dr. John Wood-
3 ward,
Pes &. Fs AoClk: ix
ward, phyfic-profeffor at Grefham-
College, a man equally ill-bred, vain,
and ill-natured, who, after being for
some time apprentice to a linen-dra-
per, took it into his head to makea
colleétion of fhells and foffils, in or-
der to pafs upon the world for a phi-
lofopher; thence having got admiffion
into a phyfician's family, at length,
by dint of intereft, obtained a Doétor’s
degree. This man publifbed a book,
intitled, ‘The ftate of phyfic and
difeafes (1), wherein he took great h-
berties with Dr.Friend, and thofe in
the fame fentiment with him, but point-
ed bis arrows moft particularly at me;
and thefe were neither arguments nor
experiments, of which he had none,
but bare-faced calumny and raillery,
which he poured forth in abundance.
"Tis much againft my will, that I thus
revive the remembrance of that libel,
which already is well nigh funk in-
(1) London, 1718. 8vo,
to
x PREFACE.
to oblivion; and for which the author
has been juftly expofed by Dr.Friend:
nor foould Ihave wafted paper on this
infignificant flory, had not the arro-
gance and vanity of the man extorted
it from me. And in fine, if I have
dwelt longer on this whole affair than
might be expected, my motives were,
firft, to explain who was the author
of this method of practice, and then,
how little foundation Dr. Woodward
had for bis perfonal reflettions and
brawling.
_ Now, as to what concerns this
Difcourfe, I muft inform the public,
that I have preferred perfpicuity to
flowers of language, by delivering
every precept in as few words as to
me feemed confiftent with a clear
conveyance of my notions: and I
have added fome particular rules and
cautions relating to cathartics, for
the fake of young phyficians chiefly ;
who are aften difpofed too rafbly
3 to
PREF ACE, x1
to attempt, and too eagerly to em-
brace every novelty in prattice, efpe-
cially, when handed down to them from
perfons, of whom they have a high opi-
nion. For nothing can be fo uniwverfal-
ly ufeful, as not to be liable. to fome
exception; and it is fometimes as great
a mark of found judgment, not to do
mifchief, as to do good (1). Where-
fore, not only in this cafe, but in all
others within the compa/s of our art,
the phyfician ought conftantly to rea
member that of the poet (2),
Nothing does good, but what may alfo hurt,
Wuen I had finifbed this {mall
work, I thought it might be no lefs
agreeable than ufeful to the gentlemen
of the faculty, if to it I annexed Rha-
zes’s treatife of the Small-Pox and
Mealles, faithfully tranflated from the
(1) Hippocratesinhis | (2) Ovid.Trif?.Lib.ii,
firft book of Epidemics. | ver. 266.
B2 original
Xi PREFACE.
original Arabic into Latin: as it con-
tains an ample detail of many things
relating to the nature and cure of thefe
difeafes, which, making proper allow-
ances for time and place, coincide
pretty much with the dotirines I have
laid down. And indeed, it has given
me no {mall pleafure, to fee my fenti-
ments confirmed by the greateft phyfi-
cian of the age be livedin. But I have
often wondered how it came to pafs,
that this book had never before been
ublifbed either in Arabic, or in Latin
from the Arabic. RobertStephens was
the firft who publifbed it in Greek, at
the end of his edition.of Alexander
Trallian’s Work in the year 1548 (1).
The Greek copy has been tranflated
into Latin by three feveral perfons ;
the firft of whom was Georgius Valla
of Placentia, whofe verfion was pub-
(1) The Greek title is, ‘Pain Aoy@e wept
AOHLIKS «
i
lifhed
Paw EE PA GB. Xxilk
lifbed at Venice, A. D. 1498. and
went through feveral editions. This
was followed by a fecond, done by
Johannes Guinterius of Andernac,
printed at Strafbourg in 1549: and
Nicolaus Macchellus, a phyfician of
Modena, put forth a third, printed
at Venice im 1555, and again, in
1586(1). Mow the Greck copy was
not tranflated direttly from the Ara-
bic, but from a Syriac verfion, which
latter feems to have been done for the
ufe of the common people ; and upon
comparing the Greek with this Latin
tranflation from the Arabic, which
I now publifh, it will appear very
inaccurate, by the entire omiffion of
fome things, and faulty rendering of
others; whether through the infuff-
ciency, or negligence of the Syriac or
Greek tranflator, I fhall not deter~
(1) Vid Fabricii Biblioth. grec. vol, xii. p.692.
Mune,
xiv FRE F -A-C:E:
gine. But the manner how I acquir=
ed my copy is this.
AFTER having caufed a diligent
Search to be made in our public libra-
vies for an Arabic copy of this trea-
tife to no purpofe, I wrote to my good
friend, the celebrated Dr-Boerhaave,
profeffor of phyfic in the Univerfity
of Leyden, intreating him to inform
me, if fuch an one could be found in
the public library there, which I knew
to be very rich in Arabic manufcripts.
A copy was accordingly found, which
he got tranfcribed by the Arabic pro-
feffor, and kindly fent it over to me ;
but it proved to be full of faults. This,
however, I gave at two feparate times
to two gentlemen of character, to put
it into Latin. One was Solomon
Negri, @ native of Damafcus, ex-
tremely well verfed in all the Orien-
tal tongues; the other John Gagnier,
Arabic
PREFACE. XV
Arabic reader at Oxford: and they
both performed the tafk with great
diligence. But upon comparing the
two verfions, I obferved that they dif-
fered in feveral places, not in the dic-
tion only, but even in the fenfe: where-
fore, as I have no knowledge of the
Arabic zongue, I could not determine
which of the two to prefer. This
incertainty made me apply to my
worthy friend, the rev. Dr. Thomas
Hunt, for feveral years paft Arabic
profeffor in the Univerfity of Ox-
ford, and lately made Hebrew pro-
feffor likewife, who, among his many
eminent qualities, is univer, ally ef-
teemed a great mafter of the Eaftern
languages. This gentleman, at my
requeft, gencroufly undertook the pro-
vince of ftrittly collating the two
Latin verfions above-mentioned with
the Arabic copy, im my prefence ;
and out of them he compiled this,
ae f
which
XVi TRE A CH.
which I now give to the public ; and
doubtlef; he would have made it much
better, had the Arabic copy been
more correct.
London, Sept.
29>. 1747»
>
DPISCOURSE
SMALLPOX
MEASLES.
CHAP. 1.
Of the origin of the /mall pox.
EFORE I enter on the me-
dical part of my fubjed, I
fhall briefly enquire into. the ori-
gin of the fmall pox, and the man-
ner of its propagation from thofe
countries where it firft appeared,
almoft over the whole face of the
earth, as far as I can trace it in
hiftory : for thefe points once fettled
GC W ill
2 Of the origin
will throw a confiderable light on
the nature of the ciftemper, and the
methods of cure, wiiich I fhall pro-
pofe in the fequel of the Di/cour/e.
Tua rT this is a modern difeafe,
whereby I mean, that it was not
known to the antient Greek and
Roman phyficians, is to me a mat-
ter beyond all doubt. For I think
they are widely miftaken, who ens
deavour to prove, that the anthrax,
epinyétis, and fuch like eruptions
on the fkin, were our /mall pox :
becaufe it is more than probable,
that the ancient phyficians, who
were extremely diligent in. the: de-
{cription and diftin@ive charaéteri-
{tics of all difeafes, would not have
been content with barely mention-
ing this, which is fo contagious, and
makes fuch dreadful havock among
mankind; but would have minute-
ly defcribed it, had they been ac-
quainted with it.
WHERE-
of the fmall pox. 3
Wuererore we muft have re-
courfe to the writings of the 4ra-
bian phyficians for the firft notices
of this difeafe. The chief of thefe
was Rhazes, who lived about the year
of Chrift pcccc. We havea large
volume of this great man, publifh-
ed under the title of his Cozzinenr,
a treafure of phyfic, which feems to
have been compiled from his com-
mon-place book. In this he informs
us, that a phyfician, whofe name
was Aaron (who wrote thirty books
of phyfic) had treated of the dia-
gnoftics, the various kinds, and the
method of cure of the fmall-pox(r).
Now this 4aron was born at Alexan-
dria, and in the reign of Mohammed
practifed about the year pcxx11 (2).
Whence the learned Dr. Freind con-
jectured, that pofibly the /mall-pox
took its rife in Egypt (3). But the ori-
bift. Dynaft. 2. 99.
(3) Oper. p. 330.
2 gin
(1) Contin. 419. 2.
(2) Vid. Abulpharajii
4. Of the origin
gin of the difeafe is carried farther
back than the time of this Aaron,
by Dr. ‘Fohn ames Reifke, who fays
that he read the following words in
an old Arabic manufcript of the
public library at Leyden: This year
in fine, the Jmall-pox and meafles
made their firft appearance in Ara-
bia(t). By this year he means that
of the birth of Mohammed, which
was the year of Chri? pixx.
Now upon mature confideration
of the whole affair, I am inclined
to think that there are certain dif-
eafes, which are originally engen-
dered and propagated in certain
countries, as in their native foil.
Thefe by Hippocrates are called
difeafes of the country(2); and fome
of them, fprung up in various parts
of Europe and Afia, from peculiar
(1) Hocdemum anno | inaug. Lug. Bat. 1746.
comparuerunt primum | (2) Neoquala emyu-
in terris Arabum vari-
olae et morbili. Dip.
Pie
defects
of the fmall pox. 5
defeéts in the air, foil and waters,
he has moft accurately defcribed (1):
but the more modern Greeks call
them endemic difeafes (2 ). Thefe, in
my opinion, always pee in their
refpective native places, as proceed-
ing from the fame natural caufes
perpetually exerting themfelves.
I r is found by experience, that
fome of thefe are contagious, and
that the contagion is frequently
propagated to very remote coun-
tries by means fuitable to the nature
of this or that difeafe. For fome not
only communicate the infection by
immediate contaé& of the found
with the morbid body, but have
fuch force, that they {pread their
pernicious feeds by emitting very
fubtile particles; which lighting on
foft fpongy fubftances, fack ag cote
ton, wool, raw-filk, and cloathing,
(1) Lib. de aére, aquis, | (1) Evdiyates. Vid.Galen,
ef locis. Com.i. in Epidem. Hip.
pene-
ee Of the origin
penetrate into them, and there re-
main pent up for a confiderable
time: in the fame manner as I have
elfewhere accounted for the wide
progrefs of the plague from Africa
its original country (1). Others, on
the contrary, are infectious by con-
tact alone. Wherefore the firft fort
may be fpread by commerce, but
the jatter by cohabitation only.
O ¥ this kind is the venereal dif-
eafe ; which, according to hiftorians
of the moft undoubted credit, is a
native of fome of the American
iflands, efpecially Ali/paniola, and
was brought over into Spaim near
the end of the fifteenth century:
thence, in the year mccccxev, it
was carried to/Vaples, during the war
between Ferdinand ot Aragon and
the French, by fome Spanifh troops,
who had contracted it in the afore-
(1) Difcourfe on the plague, Parti. chap. 1.
page 21. edit. 1744.
faid
of the {mall pox. y |
faid ifland. For thefe and the French
foldiers having at different times
had communication with the fame
women, according as the fame towns
alternately fell into the hands of the
two contending parties ; this filthy
difeafe firft fpread itfelf over the two
armies, thence made its way into
Italy, and has fince infe&ed moft
parts of the habitable world (1.)
Anp I very well remember, that
a certain Exgli/b merchant, who had
refided many years in Mofcovy, af-
fured me, that the venereal difeafe
was hardly known in that country
before the reign of the late Czar
Peter the Great: becaufe till that
time the traffick carried on by the
Mofcovites did not require much
communication or dealing with fo-
reigners. But after that emperor
had taken the refolution of vifiting
(r) Vid. Afruc de morbis venereis, Lib. i. cap.
10, II.
other
8 Of the origin
other parts of Europe, and had fent
many of his fubjeéts abroad to learn
trades and manufactures ;_ thefe car-
ried back with them the dire effects
of their unlawful luft into their na-
tive country ; which raged there with
the greater feverity, as inflamma-
tions and ulcers are the-more difh-
cult to be cured in cold climates.
Bur to return to the {mall pox.
I really take this difeafe to be a
plague of its own kind, which was
originally bred in 4frica, and more
efpecially in Ezhiopia, as the heat is
exceflive there ; and thence, like the
true plague, was brought into 4ra-\
bia and Egypt after the manner
above-mentioned.
Now if any one fhould wonder
why this contagion was fo long
confined to its native foil, without
{preading into diftant countries ; I
pray him to confider, that foreign
commerce
of the finall pox. 9
commerce was much more fparing-
ly carried on in ancient times, than
in our days, efpecially between
mediterranean nations: and like-
wife, that the ancients feldom or
never undertook long voyages b
fea, as we do. And Ludolfus ob-
ferves, that the Erhiopians in parti-
cular were ignorant of mercantile
affairs (1). Therefore, when in pro-
cefs of time the mutual intercourfe
of different nations became more
frequent by wars, trade, and other
caufes ; this contagious difeafe was
{fpread far and wide. But towards
the end of the eleventh century,
and in the beginning of the twelfth,
it gained vaft ground, by means of
the wars waged by a confederacy of
the Chriftian powers againft the Siz-
racens, for the recovery of the Holy
land; this being the only vifible
recompence of their religious expe-
(1) Hitt, Aethiop. Lib. iv, cap. vii.
D ditions,
10 Of the origin
ditions, which they brought back
to their refpective countries. From
that time forward, wherefoever this
moft infectious diftemper once got
a footing, there it has obftinately
held uninterrupted poffeflion. For
the purulent matter, which runs out
of the puftules, being caught in the
bed-cloaths and wearing apparel of
the fick, and there drying, and re-
maining invifible, becomes a nur-
fery of the difeafe, which foon
breaks forth on thofe, who happen
to come in contact with it; efpe-
cially, if the feafon of the year, and
{tate of the air be favourable to its
action.
I wn ‘this place, it may not be im-
proper, in confirmation of the fore-
going doétrine, to relate the follow-
ing fact, which was attefted to me
by a gentleman of great experience,
who had been for many years go-
vernor
of the fmall pox. 1I
vernor of Fort Sz. George in the
Eaft-Indies. | While he was in that
poft, a Dutch fhip put into the
Cape of Good Hope, fome of the
crew of which had had the fmall
pox in the voyage thither. The na-
tives of that country, who are called
HAfottentots, are fo wild and ftupid,
that they might feem to be of a
middle {pecies between men and
brutes ; and it is their cuftom to do
all fervile offices for the failors, who
land there. Now it happened, that
fome of thefe miferable wretches
were employed in wafhing the linen
and cloaths of thofe men who had
had the diftemper: whereupon, they
were feized with it, and it raged
among them with fuch violence, that
moft of them perifhed under it.
But as foon as fatal experience had
convinced this ignorant people, that
the difeafe was fpread by conta-
gion, it appeared, that they had na-
D 2 tural
12 Of the origin, &c.
tural fagacity enough to defend
themfelves. For they contrived to
draw lines round the infected part
of their country, which were fo
ftrictly guarded, that, if any perfon
attempted to break through them,
in order to fly from the infection,
he wasimmediately fhot dead. Now
this fa& feems the more remarkable,
as it evinces, that neceflity compel-
led a people of the moft grofs igno-
rance and {tupidity to take the fame
meafure, which a chain of reafoning
led us formerly to propofe, in order
to ftop the progrefs of the plague(r);
and which, fome time after, had a
happy effect, not only in checking,
but even entirely extinguifhing that
dreadful calamity in France, where
it broke forth, and threatened the
reft of Europe with deftruction.
(1) Difcourfe on the plague, Part ii. chap. 2.
page 109.
CH AP;
Of the nature, &e. 13
MMIII
GHA Poo
Of the nature and forts of the
Small pox.
AVING fufhiciently proved in
i the preceding chapter, that
the {mall pox isa difeafe of tke pe-
ftilential tribe; in order to a clearer
knowledge of its. nature, I will
briefly premife my notions of pe-
ftilence.
Aut fevers, which attack the
whole body, may be conveniently
ranged under the three general
heads of fimple, putrid, and pefti-
lential.
SimPxe fevers arife froma long-
continued excefs of velocity in the
motion of the blood, and its con-
fequences, a difturbance of it: due,
3 mixture,
ug Of the nature and forts
mixture, and. an interruption of the
fecretion of the humors in the fe-
veral parts of the body.
Purrip fevers are caufed, when,
together with a concurrence of thefe
circumftances, a lentor enfues in the
capillary blood-veffels; and as this
fizy blood is gradually pufhed for-
ward by the force of the circulation
into the veins, it there becomes pu
trid, and impregnates the reft of the
mafs witha malignant quality, which
is communicated both to the inter-
nal and external parts of the body.
PEStTILENTIAL fevers, in fine, I call
all thofe, which are accompanied
with fome fort of poifon. Now, of
whatever nature this happen to be,
it not only infects and corrupts the
blood, but more particularly: feizes
on the fubtile nervous liquor, which
is. called the animal {pirits. Hence
it is, that thefe fevers.act with greatet
rapidity
of the fmall pox. 15
rapidity and violence, and are much
more fatal than the other forts. “But
this one circumftance is common to
all fevers, that nature endeavours
to conquer the difeafe, by raifing
fome ftrugele or other, in order to
throw forth from the body whatever
is prejudicial to life.
Now, whereas the word Wature
is made ufe of by phyficians in the
eure of all difeafes, I will here,
once for all, plainly declare my fen-
timents of what we ought to un-
derftand by that word. That there
is fomething within us, which per-
ceives, thinks, and reafons, is ma-
nifeft beyond contradi@tion; and
yet the nature of that Something can-
not be fully and pertectly compre-
hended in this life. Wherefore I
fhall refign the difquifition of this
point to thofe, who, while they know
too little of, and care lefs for things
falling under their fenfes, take great
pleafure
16 Of the nature and forts
pleafure in inveftigating thofe things,
which human reafon is incapable of
conceiving. However, thus far the
foundeft philofophers agree concern-
ing it, that it is fomewhat incorpo-
real. For how can fluggifh matter,
which is of itfelf void of all mo-
tion, be the fource and firft caufe
of thought, the moft excellent of
all motions? Wherefore, it is fuffi-
ciently evident, that this firft mover
within us is a {pirit of fome kind
or other, intirely different and fepa-
rable from terreftrial matter, and
yet moft intimately united with our
body.
Moreover, to me it feems pro-
bable, that this active principle is
not of the fame fort-in all; that
the almighty creator has endowed
man with one fort, and brutes with
another: that the former fo far par-
takes of a divine nature, as to be
able
of the [mall pox. 17
able to exift and think after its {e-
paration from the body ; but that
the latter is of fuch an inferior or-
der, as to perifh with the body.
The former was by fome of the an-
cients called animus, the latter ayj-
mma(x); and they believed, that they
were both ingendered in our fpe-
cies: but this I take to be an erro-
neous pofition. For as their anima
fuffices for the funétions of life in
brutes, fo our animus ftands not in
need of fuch an affiftant. Now this
matter, if lam not miftaken, ftands
thus: fuch is the compofition of
our fabrick, that, when any thing
pernicious has got footing within
the body, the governing mind gives
fuch an impulfe to thofe inftruments
of motion, the animal {pirits, as to
(1) Fur. Sat. xv. 148. ] animum quogue,
Mundi Vide etiam Davifi
Principio indulfit com-\ Not. ad Ciceron. Tujc.
mums conditor ils | difput. Lib. 1. cap. 10.
Tantum animam, nodis |
E raife
18 «Of the nature and forts
raife thofe commotions in the blood
and humors, which may relieve the
whole frame from the danger in
which it-is involved. And this is
done in fo fudden a manner, that
it fhould feem to be the effe& of
inftin@, rather than voluntary mo-
tion ; though it be effected in us at
the command of the animus, and
in brutes by the power of the ani-
ma. And indeed, thofe very mo-
tions, which are commonly called
natural and vital, as thofe of the
heart, lungs, and inteftines, which
perfevere through the whole courfe
of life, even when the will cannot
be concerned in them ; as they have
their beginning from the mind, fo
they are perpetually under its direc-
tion. I could eafily bring many ar-
guments in confirmation of thefe
fentiments, but they would be fu-
perfluous in this place. Befides that
I am happily anticipated by the
learned
of the {mall pox. 19
learned and ingenious Dr. Porter-
field, fellow of the royal college of
phyficians at Edinburgh, who in a
curious Differtation publifhed fome
years fince (1), has treated this fub-
ject with fuch perfpicuity, that there
can be no room left for doubt.
Bur from philofophy I return to
medicine. Our fagacious Sydenham
was fo far of this opinion, as to af-
fert, that a difeafe is nothing elfe but
an effort of nature to throw off the
morbific matter, for the health of the
patient (2). And Hippocrates, in his
ufual manner, laconically expreffed
the fame thing thus: JVarwure is the
curer of difeafes(3). Now this I have
obferved more particularly in pefti-
lential fevers, in which the violence
(1) Vid. MedicalEffays | dic. circa morborum
publifo-d at Edinburgh, | acutorum hiftoriam, at
Vol. iti. Effay xii. and | the beginning.
Vol iv. Effay xiv. | (3) Néowv Pdores inrgots
(2) Obfervation, me- | Epidem. Lib. vi,
E 2 of
20 Of the nature and forts
of the diftemper breaks forth on the
fkin in the form of puftules, carbun-
cles, and buboes ; all which are the
very venom of the difeafe, as the
common experiment of giving the
{mall pox by inoculation plainly
demonftrates. Thus having made
it appear, that the {mall pox is an
envenomed fever, I come to explain
its different forts; for as to its hi-
ftory, I refer to Dr. Sydenham, who
was the firft that divided its whole
courfe into certain flages, and gave
the method of cure in each.
Most authors divide the /mall
pox into the diftinét and confluent
forts, and eftimate both forts by the
fize, number, and manner of eru-
ption of the puftules. But in the
prognoftic, they make fo wide a
difference between them, that they
pronounce the former fort to be al-
moft void of all danger, but the
latter
of the {mall pox. 24
latter always dreadful in its confe-
quences. ‘Thus much indeed is moft
certain, that the confluent fort are,
generally {peaking, much worfe than
the diffiné?, and that many more die
of thofe than of thefe. But yet it
fometimes happens, that a difiné&#
Jort may prove more dangerous than
the common confluent jort. More-
over, there are many fymptoms ex-
tremely dangerous, which are pe-
culiar to the di/tin& kind, as I thall
fhew anon. For the danger does
not fo much arife from the quan-
tity of the purulent matter, as from
other circumftances, which fhall be
explained in their due place.
Wuererors, in my opinion, the
Jmall pox may more accurately, and
agreeably to the nature of the dif
eafe, be divided into fimple and ma-
lignant, |
TI CALL
«
om ©6Of the nature and forts
I cat fomple all that fort, in
which the eruption is attended with
a flight fever of fhort duration, the
puftules fill kindly, make good mat-
ter in a few days, and in fine, fall
off in, dry {cabs.
Tus malignant {ort is that, in
which the eruption appears with a
malignant fever, the puftules hard-
ly come to any tolerable degree of
maturity, and either fuppurate not
at all, or if they do in fome mea-
fure, as the fever is never off, it is
with great trouble that they at
length end in little crufts.
Tat malignity appears in fuch
various forms, according to the dif-
ferent nature of the puftules, that
its characteriftic figns have given va-
rious appellations to the fmall pox:
whereof the chief differences, which
have fallen under my obfervation, are
thefe that follow. For the puftules
are
of the {mall pox. 23
are either cry/talline, warty, or bloody.
I am well aware, that authors have
run into a greater number of fub-
divifions; but I look on the reft to
be either a combination of fome or
all of thefe, or only different de-
grees of the fame kind: a thing
which frequently happens in an ir-
regular difeafe.
I carz thofe puftules cry/aliine,
which, inftead of thick, well-digeft-
ed matter, contain nothing but a
thin, pale water, and are in fome
meafure pellucid. And this fort is
fometimes obferved, not only in the
confluent, but alfo in the diffind
{mall pox.
Tey are called warty, when
the puftules contain no fluid, but
grow hard and prominent above the
{kin in the manner of warts, Thefe
are peculiar to the di/tinG fort.
24 Of the nature and forts
Tu bloody puftules are pro-
duced more ways than one. For
I have feen cafes, where, at the very
beginning of the difeafe, the puftules
were fo many {mall tubercles full of
blackifh blood, refembling thofe
raifed on the fkin, when pinched
with a forceps. And thefe were fol-
lowed by an intermixture of purple
and livid f{pots, fuch as phyficians
defcribe in the true plague. But it
more frequently happens, that pu-
ftules coming out very thick, on
the third or fourth day after, when
they ought to fill, become livid,
and a little bloody, with black {pots
fpread over the whole body; which
forebode death in a day or two, be-
caufe they are real gangrenes. It
very often falls out at this time, that
a thin blood flows not only out
of’ the patient's mouth, nofe, and
eyes, but alfo by every outlet of
the bedy; but more efpecially by
the
of the mall pox. 25
the urinary paflages, through which
it likewife iffues fometimes on the
firft days of the diftemper. Thefe
are manifeftly of the confluent fort.
To thefe Dr. Freind (1) has added
a fourth kind of {mall pox, which
he calls /liguofe, in which the pu-
ftules refemble little round, foft,
hollow bladders, and contain no
fluid. But this I place among the
cryftalline fort, the only difference
betweeri them being, that in this
cafe one part of the fluid, which
had been thrown into the puftules,
flies off through the fkin, and the
other is abforbed by the lymphatics
back into the body.
Ir is always a difficult tafk, and
fometimes a needlefs one, to inve-
{tigate the true caufes of things.
But as the public may perhaps ex-
pect, that I fhould account for the
(1) Epift. De quibufdam variolarum generibus.
above-
26 Of the nature and Sorts
above-mentioned differences in this
difeafe ; I fhall fay, that the prin-
cipal reafons of thefe differences,
which have occurred to me upon
mature confideration, are, the al-
moft infinite variety of tempera-
ments 1n various individuals; the
Jeafons of the year and their changes,
and in fine, many accidents which
befal the body, between the time of
catching the infe@ion and the ap-
pearance of the difeafe. For ino-
culation fhews, that the fmall pox
does not break forth before the
eighth or ninth day from receiving
the infection.
Possisty it may be thought
ftrange, that, in enumerating thefe
caufes, I have not mentioned a word
of the nature of the infecting par-
ticles. But, befides that the know-
ledge’of this is not attainable by us,
it feems to have no great influence
on
of the Jmall pox. 27
on the production of this or that
particular fort of the diftemper. For
we frequently obferve, in the fame
family, where one perfon catches it
from another, that fome have a fa-
vourable, and others a bad fort,
Bu r fuch is the power of sempe-
raments of body, that they defcend
to thofe of the fame blood by a fort
of hereditary right: whence fome
difeafes are found to be familiar and
fatal to certain families.
As tothe /ea/ons of the year, we
find, by daily experience, that fome
of them are fitter to produce cer-
tain difeafes than others ; that they
are the caufes of epidemic fevers ;
and that thofe chiefly, in which
fome fluid is to be thrown off by
the fkin, are the moft remark-
ably liable to be affected by their
changes.
F 2 Burt
28 Of the nature and forts
But numberlefs are the thin
comprehended in the third article,
to wit, all thofe accidents, which
happen to the body from the time
of taking the infection to the erup-
tion of the puftules. For the poifon
is far from lying quiet all this while,
but is conftantly and gradually ex-
erting its malignity, by firft cor-
rupting the animal {pirits, and then
the whole mafs of blood and hu-
mors. Wherefore, if bodily exercife,
diet, or the affections of the mind
(which have great power in this cafe)
fhould happen to make any particu=
Jar alteration in the fermenting flu-
ids, they may eafily occafion vari-
ous forts of puftules, poflibly in the
manner I am going to explain.
Tue /mple {mall pox are fuppu-
rations made, while the blood is not
fo far vitiated, but that the deriva-
tions
of the fmall pox. 29
tions of the humors into the pro-
per parts may be effected tolerably
well, and the natural fun@ions are
not entirely hurt. But in the mg-
lignant {fort the cafe is quite differ-
ent. For the whole mafs of humors
is corrupted more or lefs, according
to the nature of the difeafe ; and
the blood is in fuch confufion, that
the purulent matter cannot be
thrown upon the {kin. Now, in
this cafe, fometimes a thin fluid is
thrown. out, which, when watery,
makes cry/alline puftules; when
thick and vifcid, warty; and filiquofe,
in fine, when the fluid has been te-
forbed by the lymphatics into the
blood, and has left the puftules quite
empty. Befides, the texture of the
blood is too frequently broken to
that degree, that it is obftructed,
and flagnates in the fmall veffels-
whereupon, the fkin is ftrewed with
black
go ©6Css«Of the nature and forts
black fpots, which are fo many
real gangrenes, and hemorrhages
enfue thro’ all the outlets of the
body ; whence this is called the
bloody fort. That thefe horrid fymp-
toms are the effe@s of an acrid
poifon, appears plainly ; becaufe the
fame happen to thofe, who have been
bit by the Hemorrbhois, a Lybian
ferpent, according to Lucan’s beau~
tiful defcription :
A fierce Hemorrhois ruck both his fangs
Deep into Tullus; 2 brave valiant youth,
And fond admirer of great Cato's worth,
And as Corycian faffron, when "tis /queez'd,
Pours forth its yellow juice thro’ all the holes
Of the bard preffing boards; fo from the pores
Of all the parts flow'd ruddy venom'd gore.
His tears were bloody; nature's paffages,
For their own humors, were all fill'd with
blood.
His wae his nofe, choak’d up with filthy
clots :
Red
of the fmall pox. 31
Red fweats tranfpir'd from all the fkin in-
amd.
Eis body feem'd one univerfal wound (1).
But from thefe objeéts of terror, it
is time to pafs to thofe which may
afford comfort.
(1) Lib, ix. ver. 806.
CHAP.
Of the methods of cure
SOA MORSE IE ROR ORO
ah Ram Cah Rea? Rea it Reet” Loam Cee
C A487 Aa.
Of the methods of cure in the
Jmall poi.
| T is moft evident, that all pe-
i ftilential difeafes are accompa-
ii nied with the higheft inflamma-
tion of the blood and humors, and
therefore they all require emptying
and cooling. I begin with the /fm-
ple {mall pox, and fhall afterwards
defcend to the treatment of the sza-
lignant {ort in its feveral varieties.
Bur in this place it feems pros
| per to clear up two material points.
ei The one regards the management
t of the fick, and the other, the diet
f proper for him.
Wiru refpeé to the firft, ferious
attention: fhould be given both to
the
in the {mall pox. 33
the feafon of the year, and to the
ftrength of the patient. For the fame
things, that are done with fafety in
fummer, may be attended with dan-
ger in winter; and young lads or
robuft men eafily bear what might
deftroy infants, or weakly women.
But let this be a general rule, to
keep the patient in bed during the
firft days of the diftemper, taking
care to defend him from the incle-
mency of the winter by proper
means, and to moderate the excef-
five heat in fummer by cool air.
But to chill, and as it were to freeze
up the fick in winter, is not the part
of a prudent phyfician, but that of :
a fool-hardy empiric, trying expe-
riments at the expence of unhappy
people’s lives. Wherefore a mean
is to be obferved herein, by manag-
ing the patient, in fuch a manner,
as neither to ftifle him with heat or
eloaths, nor check the eruption and
G per{pi-
34 Of the merhods of cure
perfpiration by cold. However, great
care ought to be taken in general,
to fupply him with pure and cool
air, which he may take in plenti-
fully: becaufe a hot air caufes dif-
ficulty of breathing, checks the fe-
cretion of urine, and increafes the
number of puftules on the inter-
nal otgans of the body; the confe-
uences whereof we may juftly: ap-
rehend to be inflammations, and,
towards the end of the difeafe, gan-
orenies.
Niru regard to diet, it ought
to be very flender, moiftening, and
cooling ; fuch as oatmeal or barley-
gruel, &c. Neverthelefs, as the food
is to be adapted to the feveral ftages
of the difeafe, the beft regimen in
the beginning is that, which will
keep the body open, and promote
urine. Thefe advantages. are ob-
tained by boiling preferved fruits
with
in the (mall pox. 35
with their food, efpecially figs, da-
mafcene plumbs,and tamarinds, and
giving them fubacid liquors for
drink ; as fmall-beer acidulated with
orange or lemon juice; whey turned
with apples boiled in the milk, or
with wine; emulfions made with bar-
ley-water and almonds; Mofelle or
Rhenifh wine plentifully diluted with
water; or any other things of this
kind.
W uen this fort of diet did not
keep the body open, the Arabian
phyficians added manna to it; but
this they did fparingly, and with
caution. For it is guite neceffary,
fays Avicen, that the body be open in
the beginning (1). Which is one of the
moft important advices, that can be
given in this difeafe, if to it be add-
ed, that urine muft be made plen-
(1) De variolis et mortillis,
G 2 tifully.
36 Of the methods of cure
tifully. For there is a wonderful
correfpondence between the fkin and
the kidneys; whereby, whatever fluid
is wont to be fecreted by the cuti-
cular glands, may with great eafe be
evacuated by the urinary paflages.
Wherefore it is very proper to draw
off as much of the matter of the dif-
eafe as can be done, by thefe paf-
{ages ; in order to prevent the over-
loading of the internal parts.
Now let us pafs on to medicines,
and, in the firft place, d/cod-letting is
neceffary. But as diffentions fre-
quently arife on this fubjeét, fome
rules are to be laid down concern:
ing it.
Ir is agreed on all hands, that
this remedy is not very fuitable to
the tendereft age. But yet, as the
blood of infants is generally too
thick, and too much in quantity
for the bulk of the body ; and as
they
‘in the {mall pox. 37
they are oft-times feized with con-
vulfions, upon the appearance of
the difeafe, fome evacuation ought
to be made: which may be fafely
effected by leeches applied to the
temples, or behind the ears. Like-
wife, if blood cannot be drawn from
the arm, in moft young fubjects ei-
ther of ie jugulars may be opened
without inconvenience.
Tuar regard is to be had to the
patient’s ftrength of what age f{o-
ever, is manifeft to all. But the
weaknefs is feldom fo great, as not
to bear fome lofs of blood, unlefs
it be after fome extraordinary eva-
cuations. Nor is the pulfe to be
over-much depended on in this cafe:
for it often happens, that the thick-
nefs of the blood prevents the {e-
cretion of the ufual quantity of ani-
mal fpirits in the brain, and that the
vital fluid is not propelled from the
heart
38 Of the methods of cure
heart with due force: in which cafe,
by removing the oppreflion, the pa-
tient’s ftrength is obferved even to
increafe with the bleeding.
But in what proportion blood
is to be taken away, will be beft
determined by the vehemence of
the difeafe. Many of our phyfici-
ans imagine that they have done
their duty, when they have order-
ed one bleeding, and are vaftly cau-
tious of opening a vein at all, after
the firft appearance of the puftules ;
for fear of checking the eruption.
But this is certainly an ill-timed cau-
tion: for in youths and adults it is
often neceflary to draw blood two or
three times, only with an intermiffion
of two or three days between each
time. And indeed blood-letting is fo
far from being an obftacle to the eru-
ption of the puftules, if the patient
be not too weak, that it forwards it
confiderably; and for the very fame
reafon,
in the {mall pox. 29
reafon, that, in large abfceffes, when
there is too great a fullnefs, and the
heat too intenfe, the fuppuration is
brought on quicker and better by
taking away fome blood.
I wave often obferved, when in
the beginning a vaft number of {mall
puftules foreboded a difeafe of the
worlt kind, that the face of affairs
was fo remarkably changed upon
one or two bleedings, that the pu-
ftules increafed in fize, and dimi-
nifhed in number (the greatnefs of
the difeafe thus giving way to the
sreatnefs of the remedy) by which
means nature acquired fufficient
ftrength to expel the noxious hu-
mor. For it is moft certainly true,
that nature labors at the expulfion
of the poifon in the moft perfect
manner, that is, endeavours to make
the puftules fill up as much as pof-
fible; and for that end fhe requires
every
4.0 Of the methods of cure
every thing to be quiet within the
body, and always abhors confufion.
And indeed, the reafon why the con-
fluent {mall pox is worfe than the
diftin& fort is not, becaufe the mat-
ter of the difeafe is more abundant
in the former than in the latter, but
becaufe it is not pufhed out in a
proper manner. For upon a ftrict
examination we generally find, that
the greater quantity is difcharged
in the d:/finé# {ort.
New to conclude this head, fuch
is the benefit of large and reiter-
ated bleeding, that it is obferved
to prevent thofe evils, which often
attend the difeafe;, as a delirium,
convulfions, difficulty of breathing,
and the like. For the diffection of
dead bodies fhews, that the infeétion
is not confined to the external parts
of the body, but {feizes on the in-
ternal parts alfo. For I myfelf have
feen
in the {mall pox. 41
feen fubjeéts, in which the lungs,
brain, liver, and inteftines were thick
befet with puftules. Nor have I the
leaft doubt, but that thofe fudden
deaths, which fometimes happen to-
wards the end of the difeafe, when
there feemed to be no room left for
fear, are occafioned by the efflux
of the purulent matter from the
burfted puftules on one or other of
the nobler parts. Wherefore, no fe-
ver is attended with more uncer-
tain figns, on which to ground a
fure prognoftic, than this, of which
we are treating. Upon the whole,
there is no time of the difeafe, where-
in it may not be neceflary to draw
blood ; if the violence of the fever
require it, and the patient appear
able to bear it. For it is always bet-
ter to try a doubtful remedy than
none.
H A pbren-
42 Of the methods of cure
A phrenzy, coming on the fourth
day of the eruption, is juftly ef-
teemed of very bad omen; _info-
much that Dr. Freind fays, that be
never faw a patient recover, who
had had this /ymptom(t). But I
can pofitively declare, that I have
had better fortune; having reco-
vered many, who had been feized
with a delirium at that time, by
drawing blood immediately, and
then throwing in a clyfter.
Arrer taking away as much
blood as is requifite, it 1s proper to
purge the body; which may be
done with fafety enough, any time
before the eruption of the puftules,
But the purge muft be of the gen-
tle kind; fuch as the infufion of
fena with manna, or manna alone,
efpecially for children, For no di-
fturbance is to be raifed in the body.
(1) Epift. de quibufdam variolarum gevseribus.
But
in the fall pox: 43
But firft a vomit fhould be given,
if there happens to be any collec-
tion of phlegm or bile in the fto-
mach, or the ftomach to be loaded
with food unfeafonably taken.
As foon as it is certain, that the
eruption is near at hand, moft phy-
ficians are of opinion, that it ought
to be promoted by all means. Yet
we are to remember, that this is the
proper work of nature ; and there-
fore great care fhould be taken, nei-
ther to increafe the motion of the
blood over-much, nor fuffer it to
grow languid.
Ir was a wife faying of A/clepia-
des, that he made ufe of the fever for
its own cure(1): whereby he meant,
that the fever is to be regulated in
fuch a manner, that itfelf may throw
off whatever is noxious to the body.
(1) Celf. Lib. iii. cap. iv.
H 2 Where-
44 Of the methods of cure
Wherefore the true intention in this
cafe is, to-keep the inflammation
of the blood within due bounds,
and at the fame time, to affift the
expulfion of the morbific matter
through the fkin. For both which
purpofes a medicine, which I have
experienced to be ufeful, is a pow-
der compofed of two parts of the
bexoardic powder, and one part of
purified nitre; and fometimes of
equal parts of both An adult may
take half a drachm of this powder
three or four times ina day, dimi-
nifhing the quantity for children, in
proportion to their age. And if the
effervefcence of the blood run very
high, a proper quantity of /pirit of
vitriol may be added to the pati-
ent’s drink. But if there be any
keckings or reachings to vomit, they
will be removed by draughts con-
taining half an ounce of juice of
lemons,
in the [mall pox. 45
femons, with one fcruple of /alt of
wormwood.
Now, concerning thofe medi-
cines which eafe pain, and pro-
cure fleep, in this fevere difeafe ;
thefe are not to be ufed over-hafti-
ly : for all anodynes in fome mea-
fure obftruct the feparation of the
morbid humor from the blood,
unlefs the pain happens to be ‘ex-
ceflive: and moreover, if the vio-
lence of the fever has raifed a de/i-
rium, they generally make it worfe.
Wherefore, it is not proper to em-
ploy them, until the eruption of the
puftules be compleated; but ‘after
that, narcotics may be adminiftered
with fafety. Thus it will be right
to give the patient a dofe of tic
thebaic tin€lure, or diacodion, every
evening, efpecially if he be a youth
or an adult perfon; for thefe me-
dicines agree not fo well with in-
fants.
46 Of the methods of cure
fants. And fometimes, in cafes of
very great inquietude, the dofe is
to be repeated in the morning. For
the fuppuration of the matter, ftag-
nating in the puftules, is forwarded
by quiet and fleep. But if, towards
the end of the difeafe, the patient
happens to be feized with a fhort-
nefs of breath, or danger of choak-
ing from vifcid flime, thefe medi-
cines are to be intirely prohibited.
In the mean time, if the patient is
coftive, which is generally the cafe,
and the fever continues; the body
is to be opened with a clyfter every
fecond or third day.
Ir may be needlefs to obferve,
that, if this method is proper in
the diftin& {mall pox; it will be
found more neceffary ftill in the con-
fluent, which is attended with oreater
fear and danger.
Fron
in the {mall pox. 47
From the fmple I now pafs to
the malignant {mall pox, of which
I have already eftablifhed three forts,
to wit, the cryffalline, the warty,
and the d/ody.
N ow, this obfervation holds good
in all kinds of the difeafe, that the
more the puftules tend to fuppura-
tion, the greater are the hopes of
recovery; and therefore, when that
does not go on according to our
wifhes, all poflible means are to be
employed to throw the morbific
humor on the fkin ; with which in-
tention every thing is to be done in
this cafe, which we have propofed
in treating of the fmp/le fort. But
yet each fpecies of the malignant
fort requires a peculiar confidera-
tion.
Wuereas, in the ery/ralline fort,
the water of the puftules can never
be brought to a laudable fuppura-
tion ;
48 Of the method: of cure
tion; it ought to be carried off by
thofe’ paflages im the body, which are
naturally adapted to the fecretion of
the thinner fluids. Now I have
faid above, that there is a great cor-
refpondence between the fkin and
the kidneys. Therefore, while the
thinneft parts of this water are made
to tranfpire through the fkin, the
grofler parts ought to be drawn off
through the urinary paflages, by diu-
etic medicines. Of this tribe there
is nothing better than witre, and that
may be adminiftered three or four
times a day, in fuch quantities as
may not offend the ftomach, to wit,
afcruple, or half a drachm, diffolved
in {mall wine, which is the only fort
that agrees with this difeafe, till to-
wards the end; when it may be pro-
per to allow the patient a little Ca-
nary (Dr. Sydenham's favourite li-
quor) or any other foft and generous
wine to fupport his ftrength. But
while
in the [mall pox. 49
while zitre is thus taken, it will be
right to interpofe thofe medicines,
which cherifh the heart, and pro-
mote the flux of the humor into
the puftules : fuch as Raleigh’s cor-
dial, or the cordial confeé&tion ; the
bexoardic pouder, fometimes with a
little /affron ; and the plain fpirit of
hartfborn. Befides thefe, on the
fifth or fixth day of the eruption,
blifters are to be applied between the
fhoulders, and to the arms and legs:
for which purpofe, the difering epi-
them is moft convenient, as its foft
confiftence enables it to reach the
fkin between the puftules, and ftick
to it. For by this difcharge of the
ferofities, the fever, which increa-
fes, when there is no farther deri-
vation of humors to the fkin, is fea-
fonably prevented.
I x now irdeed, that moft of our
phyficians apply this remedy earlier,
I and
so 0 Of the methods of cure
and even on the firft days of the
difeafe, in every malignant {mall
pox ; but there is juft reafon to fear,
that the great commotion raifed in
the blood by the acrimony of the
flies might be an obftacle to the due
propulfion of the humor into the
beginning puftules,
Tue warty {mall pox is more
dangerous than the cry/falline ; be-
caufe the matter of the difeafe, be-
ing too thick, can neither fuppurate,
nor pafs off by urine. Wherefore,
it is neceflary to ufe the utmoft en-
deavours to take off the fever, and
to provoke {weat, in order to digeft
the morbid humor, by the cordial
medicines afore-mentioned. And
blifers ought to be applied in this
cafe likewife. But the 4rabian phy-
ficians pronounced this fort of the
difeafe to be always fatal (1).
(1) See Rhazes's treatise annexed, Chap. viii.
LasTLy,
in the /mall pox. 5
Lastiy, that fort, which I have
called the d/oody {mall pox, requires
peculiar attention. Now in this fort,
if there is any room for phyfic, thofe
medicines bid faireft for fuccefs,
which by their ftypticity thicken the
blood in fome meafure, and fo check
it, that it cannot break thro’ even
the {malleft arteries. The beft of
this kind arethe Peruvian bark, a-
lum, and that /pirit which is called
oil of vitriol. Now thefe are to be
ufed alternately in this manner. A
drachm of the dark may be given
every fixth hour ; and, three hours
after, a proper quantity of alum. It
will be avery powerful medicine,
if thus compounded. Melt three
arts of alum on the fire, with one
part of that infpiffated juice, which
is improperly named dragan’s blood :
when the mafs is grown cold, re-
duce it to a powder ;.a fcruple of
which, made into a da/us with com
I 2 Jerve
52 Of the methods of cure
Jerve of red rofes, will be -a proper
dofe, The moft convenient man+
ner of giving the oi/ of vitriol, is in
the sinéture of rofes; five or fix {poon-
fuls whereof may be taken feveral
times in the day. And befides, the
patient’s common drink may be aci-
dulated with it ; efpecially, if pur-
ple or black {pots appear inter-
{perfed among the puftules. And
this medicine will be of great fer-
vice, not only in the 4/sody, but in
all the other forts likewife, ‘accom-
panied with thefe {fpots. This one
thing more I will add, that I have
experienced the ufe of d//ers to be
fafe enough in this cafe, when a de-
rium requires their application. J
have indeed feen fome patients re-
cover by this method, who had dif-
charged large quantities of blood by
the urinary canal at the time of the
eruption of the puftules ; but it is
worthy of notice, that, in all thefe,
the
in the-fmall pox. 53
the difeafe terminated in fome con-
fiderable evil. For they were. tor-
tured, either with boils breaking out
in many parts of the body, or with
glandular fwellings under the ears
or arm-pits, which were not eafily
brought to fuppuration. I likewife
remember the cafe of a young man,
one of whofe tonfils was deftroyed
by a gangrenous ulcer which was
very troublefome to cure. Thus
upon the whole it is manifeft, that ~
it is extremely difficult to clear the
mafs of blood of this poifon; and
that a perfect recovery is not to be
procured without a fuppuration, ei-
ther in its due courfe of time, or in
the laft flage of the diftemper.
Bur in every fort of this difeafe,
jt is proper to open the body on the
decline, that is, on the ninth or tenth
day from the eruption; becaufe a
putrid fever generally comes on about
this
54 Of the methods of cure
this time, while the puftules are dry-
ing ; or upon the fubfidence of the
{welling of the inflamed fkin, where
there is no fuppuration; which fe-
ver cannot be taken off with equal
fafety by any other means. But
gentle cathartics alone are to be em-
ployed in this cafe, fuch as I have
advifed before the. eruption of the
puttules,
Tuts whole affair I formerly ex-
plained, and illuftrated with proper ex-
amples, in my Letter to Dr.Freind(t);
and that gentleman likewife, abun-
dantly confirmed it afterwards, by
the authorities of ancient and mo-
dern phyficians. So that whofo-
ever refufes his affent to this practice,
mutt refolve not to fee at noon-day.
All fevers have their certain. peri-
ods; and where the poifonous mat-
(1) Vid. Freind. Com- | ribus. Et Epift. de pur-
mentar. Vii. ad Hippo- | gantibus in fecunda va-
crat, de morbis popula- | riolarum febre adbibend.
ter
in the [mall pox. 55
ter has once infected the humors,
the putrid fuel of the difeafe can
hardly be thrown out of the body
early enough. And indeed, when
this rule is not obferved, we daily
fee the diftemper followed imme-
diately by a hectic fever, attended
with a cough, {pitting of purulent
matter, fhortnefs of breath, and
other fymptoms of the lungs being
affected.
Bur I muft obferve in this place,
that, however beneficial purging
may be at this time ; yet, if the body
happens to be too loofe, either from
the natural ftate of the inteftines, of
by. frequent clyfters, this remedy
becomes lefs neceffary, or at leatt,
may be poftponed for fome. days.
For great regard is to be paid to the
patient’s ftrength, which the length
of the illnefs has more or lefs im-
paired.
More-
56 Of the methods of cure
Morzover, it is requifite to be
very circumfpect, whether there be
any remains of the purulent matter
lurking under the withered fkin of
the puftules; for this is fometimes
fo manifeftly the cafe, that tho’ the
{cabs appear dry and hard; yet
upon fome of them breaking here
and there, there iflues forth very fe-
tid matter. In this circumftance,
the body is not to be purged, but
rather to -be fupported by proper
diet, until the matter is all come
away ; which I have feen continue
running to the twenty fourth day of
the difeafe, and yet the patient re-
covered. I fhall never forget the
cafe of a certain young man of a
very robuft conftitution, who had
fo dreadful a fort of the confluent
{mall pox, that when the puftules
fhould have ripened, his whole face
was become black and dry, and in
fhort, thoroughly mortified. As the
cafe
in the [mall pox. 87
cafe feemed quite defperate, I or-
dered incifions to be made to the
quick in many places, and fomen-
tations of a decoction of emollient
and warm plants, with the addition
of camphorated fpirit of wine, to be
applied to the parts: whereupon
there followed a difcharge of mat-
ter from the incifions of fo offenfive
a {mell, that none of the attendants
could bear to ftay in the room; and
having at the fame time promoted
this difcharge by proper digeftives,
and duly purged him, he at length
recovered. But his mangled face
bore the lafting marks of the malig-
nity of the diftemper, and. of the
goodnefs of the cure.
In Fine, it will be of ufe at this
time to take away fome blood, if
the heat be too great, and the pa-
tient have ftrength enough left to
bear it.
K Wuoso-
58 Of the methods of cure
Wuososver thoroughly confi-
ders all the circumftances of this
fubject, which I have hitherto ex-
plained, muft juftly wonder how the
learned Dr. Boerhaave could be in-
duced to hope, that fome time or
other, a /pecific antidote may be found
againft this contagious poifon(t Wy that
is, by which it may be fo thorough-
ly deftroyed, that though it had
been received into the body, it may
not produce the difeafe. But the
principles and elements of things
are fo certain, and fo well efta-
2 by the permanent laws of
jature, that whofoever would en-
re our to change them, would a&
like thofe philofophers by fire (as
they ftyle themfelves) who labour
hard to tranfmute Te bafer metals
into gold; and when continual dif-
appointments have convinced them
(1) Aphor. de cognofcendis et curandis morbis,
1390; 91; e? 92.
of
in the [mall pox. 59
of the vanity of their hopes, actu-
ally extract gold out of the purfes
of the ignorant and eredulous by
the fumes of their charcoal.
Tuis one obfervation I muft add,
that there is no fpecies of fever,
which requires the body to be tho-
roughly cleared of the remains of
the difeafe, more than this. Where-
fore, upon the patient's recovery,
blood is to be drawn, if his ftrength
will bear it ; and cathartics are to be
given feveral times at proper inter-
vals. After which, the body is to be
reftored to its former {tate by a courfe
of milk, efpecially that of affes, with
fuitable food, and the air and amufe-
ments of the country.
I suai clofe this long chapter
with the account of a very malig-
nant {mall pox in a youth of fifteen
ears of age, communicated to me
by my fon-in-law, the learned and
K 2 ingenious
60 = Of the methods of cure
ingenious Doctor Wi/mor; who, from
the fifth day of the difeafe, attend-
ed the patient jointly with Doétor
Connel. .
In the beginning of the fever pre-
ceding the eruption, the patient was
directed to be let blood, and to take
a vomit, and the next morning a
gentle purge: the day following,
the {mall pox flufhed out. The pu-
ftules were very numerous and {mall
all over the body, looking more like
a rank meafles than the {mall pox.
As his fever ran very high, he was
ordered draughts of Ga/coign’s pow-
der with witre, to be taken ever
fix hours; and to drink plentifully
of arley-water acidulated with Spi-
rit of vitriol.
Ow the fourth day of the eru-
ption, as he was very delirious, in
order to procure {leep, a paregoric
of fix drachms of diacodion was
given
in the fmall pox. 61
given him, which did not produce
the efted.
Tue fifth day, there was not the
leaft {welling of the face; his pulfe
was quick and full, his heat in-
tenfe, and the delirium not abated.
Wherefore he was ordered another
bleeding ; the nitrofe draughts were
continued, with the addition of Gve
grains .of myrrh to each; as lilce-
wife Jarley-water with Spirit of wvi-
triol, and the paregoric as before.
Te feventh, the appearance of
the difeafe was ftill the fame, with
the addition of an opprefflion of
his breath, and a very troublefome
dry cough. Dtafcordium was added
to his nitrofe draughts, and he was
ordered a folution of Lum ammoniac
to be taken, a f{poonful at a time,
as occafion required ; and the pa-
regori¢ continued.
THE
62 Of the methods of cure
Tue eighth, he complained much
of a moft acute pain in his head ;
his fhortnefs of breath and cough
were increafed, his pulfe low, and
there were no figns of fuppuration ;
nor the leaft {welling in the face or
hands: but the fkin of his face
looked like a piece of parchment.
Blifters were ordered to be laid on
his arms and legs, and platters,
made of equal parts of the cephalic
and blifering plafters, to be wrapt
round his feet: likewife draughts
containing of mithridate half a
drachm, and of volatile falt of am-
ber half a fcruple, to be taken every
fixth hour; and a gargle of peéfo-
val decoétion, and oxymel of {quills.
Tue tenth, as every thing was
grown worle, befides continuing the
fame medicines, 4//fers were order-
ed below the elbows.
THE
in the {mall pox. 63
Tue eleventh, his pulfe being
much lower, and the patient much
weaker, a mixture with Raleigh’s
confection was ordered to be taken
often by fpoonfuls, and the other
cardiacs continued.
On the twelfth, the pulfe being
{carcely perceptible, and his breath
opprefied to the laft degree ; when
all hopes of fuccefg were given up,
a fit of coughing, in which he was
almoft fuffocated, brought on a
{pitting of a limpid, fetid humor,
equal in quantity to a falivation
raifed by mercury. And this flux
continued twelve days without any
apparent abatement : from thence it
gradually diminifhed for four days,
when it ftopped entirely.
By the fixteenth day, the difeafe,
together with that difcharge, had fo
far exhaufted him, that he was {carce
able
64 Of the methods of cure
able to turn in his bed: and yet his
{pirits were fo much better, that
he could take plentifully of liquid
nourifhment. Whereby gathering
ftrength, his fever had now the ap-
pearance of a hectic only ; for which
he was ordered to lofe five ounces
of blood, to take draughts of /emon-
juice, and falt of wormwood, with a
little /perma cezi diffolved in them,
every four hours, and to drink affes
milk.every morning.
By this method, with the repe-
tition of Aleeding to five ounces two
or three times, and now and then
purging him gently with rhubarb ;
together with elixir of vitriol in
Briftol-water, and the country air,
he in time happily recovered.
In this cafe we have a moft re-
markable inftance of what I have
already
in the {mall pox. 65
already faid more than once, that
is, how folicitous nature always is,
at any rate to expel the poifonous
matter of this difeafe out of the
body.
L CHA P.
C HA P. Iv..
Of accidents in the Jmall pox.
ANY fymptoms and circum-
M {tances attend the fmall pox,
which, as they neither commonly
occur, mor feem to depend on the
nature of the difeafe, either affright,
or perplex the phyfician. Where-
fore it may not be impreper to
make fome remarks concerning
them.
SoMETIMES the patient is feized
with convulfions, juft before the
eruption. But this {ymptom is more
terrifying than dangerous; and in
children particularly, thofe conyul-
fions, which frequently come on be-
fore the diftemper appears, are ge-
nerally rather a good, than a_ bad
fign,
in the fall pox. 65
fign. Now in this cafe, though it
may feem ftrange, blood-letting is to
be carefully avoided ; but a blifter
is to be applied to the neck, and to
the foles of the feet pla/fers made of
equal parts of the cephalic and blif~
tering plafters : not forgetting at the
fame time to give thofe medicines
inwardly, which - experience "has
fhewn to be antifpafmodic. Of thefe
the chief are, wild Valerian F00t
Ruffian caftor, and the Spirits and
volatile falts, chemically extrated
From animals. For it has been fre-
quently obferved, that, upon draw-
ing blood in this cafe, the difeafe
ended fatally. I can aflign no other
reafon for this event, but that thofe
involuntary motions are occafioned
by the patient’s weaknefs ;_ which is
fo increafed by that evacuation, that
nature becomes incapable of throw-
ing out the morbid matter upon the
fkin. But the thing is otherwife in
L 2 adults,
i
s
P|
|
i
Hi
i
{
68 . Of accidents
adults, who, if not too weak, ought
to lofe a moderate quantity of blood,
and then be put into the foregoing
method.
Tue difeafe begins fometimes in
a different, and almoft contrary man-
ner. For the eruption appears with-
out much fever or pain; for which
reafon there feems to be no danger.
But that fond fecurity is very fre-
quently ill-grounded. For at the
time when the puftules ought to
tend to maturity, as if nature were
lazy, and not attending to her du-
ty, there is no fuppuration made:
hence the fever increafes, with in-
quietude of body, anxiety of mind,
difficulty of breathing, and a de/i-
rium ; which carry off the patient in
a few days. In this ftate, the fever
‘ought rather to be raifed than
checked ; and therefore warm me-
dicines are to be directed, which
promote
in the {mall pox. 69
promote fuppuration, by increafin
the motion of the blood, and thin-
ning the humors: fuch are the Vir-
ginian {nake-root, the Contrayerva-
root, faffron, afa fatida, myrrh, and
the like. But above all, 44/fers muft
be laid on all the limbs. Such is the
neceflity of {ome evacuation or other
in this difeafe, that if the matter of
the infection be over-abundant, as
it happens in bad cafes, nature ne-
ver fails endeavouring to throw off
the load. Thus in adults a {pitting
comes on upon the farft days of the
eruption; whereas children, who
feldom fpit, have a loofenefs almoft
through the whole difeafe. Both
thefe evacuations are of great impor-
tance, and therefore as the loofenefs
is not to be inconfiderately ftopped.
in children; fo in adults, if the {pit-
ting does not go on to our withes,
it ought to be promoted by medi-
ro)
cines, which ftimulate the glands of
the
"0 Of accidents
the mouth ; efpecially gargles made
of a decoction of muftard feed and
pepper, with the addition of oxymel.
For in the confluent and malignant
fmall pox, if this flux does not arife,
and even continue to the end of the
difeafe, it is a very bad fign,
SoMETIEs a {uppreflion of urine
makes the patient fufter great -pain,
receiving little or no relief from
diuretics. In this cafe Dr. Sydenham
directed, that he fhould be taken out
of bed, and expofed to the cool air :
which generally has a good effe@.
But the moft convenient method
will be, to open the body by a cly-
Jter, efpecially if, the puftules now
appearing, there be any fear of tak-
ing cold ; and then to infift a lit-
tle on diuretic medicines; for which
purpofe Glauber’s Jalt is particu-
larly ufeful, as it is both laxative
and diuretic.
WHEN-
in the fmall pox. 7
WHENEVER a woman with child
Is feized with the {mall pox, the
phyfician may juftly dread the con-
fequences. For he has reafon to fear
a mifcarriage, which expofes his pa-
tient to two forts of danger, the one
from the new fever, which attends
that accident; the other from the
lofs of blood, which may bring her
very low. And therefore the farther
fhe is advanced in her pregnancy,
the greater rifque the runs ; « becaufe
the delivery of a large child caufes
a greater flooding than that of a
{mall one. I can however affert from
my own knowledge, that a certain
woman was delivered of a fon at the
full time, while the was actually la.
bouring under this difeafe ; and yet
both the mother and the child did
well; but this is a cafe equally ex~
traordinary and fortunate. But {till
a good deal depends on the time of
the difeafe, when the abortion hap-
pens :
72 Of accidents
ens: becaufe the weaknefs occafi-
oned thereby is the more dangerous,
the more nearly it coincides with the
time of the ripening of the puftules.
Wherefore, if the efux be more than
nature ufually requires, thofe medi-
cines are to be given, which I have
propofed in the d/o0dy {mall pox.
Now, whereas thefe cafes fall out
various ways, and phyficians have
been divided in opinion concerning
fome of them; it may not be im-
proper to make fome animadverfions
on them feparately.
Wuen a woman in the {mall pox
fuffers abortion, the child moft com-
monly comes into the world with
the diftemper on it; but not al-
ways. The reafon of this difference
will eafily be underftood, by duly
confidering what I have already faid
concerning izfeéion (1), and com-
(1) Chap. i.
paring
in the [mall pox. 73
paring it with what I fhall hereaf-
ter fay concerning the ivoculation
of the {mall pox (1). Whereby it will
plainly appear, that the feeds of the
difeafe are fubtile particles, exhaled
from the puftules come to n aturity ;
which do not produce the*effect,
till eight or nine days after their en-
trance into a found body. Upon
which account, when the child
comes into the world, before mat-
ter is made in the puftules on the
mother, it has no vifible marks of
the diftemper. And thus it fome-
times happens, that the {mall pox,
which the infant has contraéted in
the womb, breaks forth on the fe-
cond, third, or any other day’before
the eighth from the delivery, whe-
ther the child be come to its full
time, or not; as will appear by the
following cafe, which lately fell un-
der my own obfervation.
(i) Chap. v.
M A Lapy
74 Of accidents
A L aADy of quality was, in the
feventh month of her pregnancy,
feized with fo malignant a fort of
the confluent {mall pox, that there
was no appearance of any one fa-
vourable fymptom. For fhe neither
{pit plentifully ; nor did the {well-
ing of the hands or feet come on,
upon that of the face fubfiding ; nor
in fine was fhe affifted by a flux of
urine on the decline of the difeafe ;
but on the contrary, her face was all
covered with {mall ‘pimples, which
made little or no matter. In this
condition, fhe was, on the eleventh
day of the diftemper, pretty eafily
delivered of a fon, who brought no
marks of the infection into ee rorld ;
and fhe died on the fourteenth day.
But in the morning of the fourth
day following; the infant was feized
with convulfions, the forerunners of
the eruption, which pair as the
fame day, and he died in the even-
ae
in the {mall pox. a6
ing. Inthis cafe it is plain, that
fome fuppuration having been made,
as ufual, on the eleventh day ; the
diftemper paffed from the mother
to the child, which was not to break
out till eight days after.
But in cafe there is no mifcar-
riage, the child will be free from
the difeafe during his whole life ;
unlefs he happens to be born before
the puftules were come to maturity.
For as fomething naturally inherent
in our conftitution renders the body
liable to the infeGtion ; fo, when this
debt is once paid to nature, we are
fecure ever after. But the infant in
the womb fometimes catches the
diftemper, without the mother be-
ing affected ; as I fhall prove by
this remarkable inftance, which I
well remember. A cértain woman,
who had formerly had the fmall
pox, and was now near her reckon-
ing, attended her hufband in the
M 2 diftemper.
76 Of accidents
diftemper. She went her full time,
and was delivered of a dead child.
It may be needlefs to obferve, that
fhe did not catch it on this occafion:
but the dead body of the infant was
a horrid fight, being all over co-
vered with the puftules ; a manifeft
fign that it died of the difeafe, be-
fore it was brought into the world.
Wherefore, upon thewhole, let none
entertain the leaft fufpicion, that the
fame perfon can poflibly have this
diftemper twice. But the reafon
why the body is liable to the in-
fection once, and no more, is to
me as entirely unkhown, as to the
moft ignorant of mankind. But
this I will add, that an infant in
the womb may have the good re
to go through the difea ade. and
the: marks We quite effaced before i
birth (1).
(1) Vid. Mauriceau, es a Lroffeffe et Paccou-
chement des femmes, Obf.
From
in the {mall pox. a7
From what we have faid concern-
ing. abortions, it is ea fy to compre-
hend what judgment ought to be
formed of the monthly evacuations
coinciding with the fmall poxece
circumftance, at which people are
apt to be alarmed. For this eva-
cuation is of the fame kind with the
flooding, which follows upon abor-
tion: and whether it happens at
the ufual time, or is brought on ir-
regularly by the extraordinary ef-
fervefcence of the blood; in both
cafes, it rather affords selief than
threatens danger. However, if in
either cafe the difcharge fhould
prove fo great, as to weaken the
patient over much; it muft be re-
{trained by thofe medicines, which
I have recommended in the dloody
{mall pox, without neglecting to
draw blood, if requifite. But we
know by experience, that women
have fometimes uterine difcharges
thro’ the whole courfe of the dif-
F ;
78 Of accidents
eafc, without lofs of ftrength, or
any other inconvenience.
Tue fame judgment may be
formed of hemorrhages at the nofe,
which frequently occur in the be-
ginning of the diftemper ; for they
are occafioned by the rarefaction of
the blood in the {mall veffels; and
therefore, by diminifhing the heat,
are generally more ferviceable than
detrimental, unlefs they run to ex-
cefs,
Ir happens fometimes, tho’ not
often, that the variolous fever is ac-
companied with a fingle or double
tertian intermitting fever; in which
cafe, the Peruvian bark, or, which
is More convenient, i/s extraét, is to
be given at proper diftances of time,
till the paroxyfms ceafe to return,
Nor is there any reafon to fear,
that this medicine will hinder the
maturation of the puftules: on the
contrary,
d/
in the fmall pox. 79
contrary, as this new effervefcence
of the blood, and commotion of
the humors, may eafily prove an
obftacle to the fuppuration; by
checking thefe, all things proceed
in their ufual courfe. But firft, the
body is to be opened by a cly/fer.
Now the cafe is much the fame here
with refpect to this febrifuge, as in
mortifications, in which it is known
to be of fignal fervice(1): and it was
from a reflection, that mort'fica-
tions are always accompanied with
a fever, that I have propofed the
fame medicine in the d/ody {mall
pox, interfperfed with black fpots,
or in other words, with {mall gan-
grenes (2),
Here it may not be improper to
lay down one general rule, which
is, that whatever acute difeafe comes
(1) Vid. Medical Effays, Edinb. vol. v. part te
artic. 10. (2) Chap. iii,
upon
} |
"
Sree
Hs
Se
80 Of accidents
upon the {mall By requires to be
treated with its own peculiar medi-
° 7 i wey | |
cines, and octal bears them
very well.
By this time, I hope I have thrown
fufficient light on the moft material
circumftances of this part of my
fubje&t. But before I clofe it, it
feems well worthy of notice, that
this difeafe is generally very mild,
when it is contracted foon after fome
confiderable evacuation, whether
natural or artificial. Thus a wo-
man in chi ots bed has generally a
kindly fort of the fmall pox; if the
has Secidered fomewhat of ftrength,
by the time fhe is feized with “the
diftemper ; and therefore reaps be-
nefit from her late fufferings. The
fame thing may be faid of fuch as
are newly recovered from fome
acute difeafe. And I have formerly
feen many patients in the hofpital,
who
in the {mall pox. Sr
who, after falivation for the venereal
difeafe, caught the fmall pox, while
they were yet vaftly emaciated; and
all of them went through it with
great fafety; a manifeft proof, that
any evacuation, by withdrawing fuel
from the fire, agrees particularly
well with this difeafe. Laftly, to
all that I have hitherto faid, this
one remark more is proper to be ad-
ded. ‘Though this be naturally a
dreadful difeafe; yet it is fometimes
found to produce very good confe-
quences. For in conftitutions, where
the blood is vitiated, either from an
original taint, or by the manner of
living; and glandular tumors are
occafioned by the vifcidity of the
lymph; the {mall pox, by purify-
ing the juices, contributes to a bet-
ter {tate of health for the future.
N CHAP,
82 Of the inoculation
BofA Se* SN 0 Sa Oa R OPA SE
Ge Oe Ob 6 * Reais ® Rea ea een
CHA. BY.
Of the inoculation of the {mall pox.
HE cuftom of inoculating,
or transferring the {mall pox
from an infected perfon to one that
is found, has prevailed among us
for fome years. ‘This matter has
drawn our phyficians into parties ;
fome approving, and others difap-
proving, this new practice. J fhall
therefore freely interpofe my opi-
nion in the cafe.
Our nature is fo formed, that al-
tho’ we are always inclined to avoid
whatfoever may be hurtful; yet,
when any evil is to be undergone,
which can only be fuffered once,
this we are impatient to go through,
even
of the fmall pox: 83
even with a certain boldnefs:. with
this view, that the remainder of
life may be pafied without the unea-
finefs which arifes from the conti-
nual apprehenfion of its coming
upon us,
Ir having therefore been found by
experience, that no body was feized
with the {mall pox a fecond time,
and that fcarce one in a thou-
fand efcaped having it once;
men began to confult how the dif-
eafe might be communicated ; it
manifeftly appearing to be eon
gious, and it was obvious to con-
jecture, that the feeds of that con-
tagion lay hidden in the puftules.
But FE have often wondered,
how fuch a notion could come into
the heads of ms almoft quite
ignorant of what relates to phyfic.
For, as far as | have been able to
N 2 find
84 Of the inoculation
find out by inquiry, this was the
invention of the Circaffians, the wo-
men of which country are faid
to excel in beauty; upon which
account, it is very common, elpe-
cially among the poorer fort, to
fell young ‘girls for flaves to be
carried away into the ee pits
parts. When therefore it was ob-
ferved, that they, who were feized
with this diftemper, were in lefs
danger both of their beauty and
their life, the younger they were ;
they contrived this way of infeGing
the body, that fo the merchandize
might bring the greater pr ofit. Nei-
‘te did the thing require the af-
fiftance of a phyfician or furgeon.
It was fufhcient to make a {mall
wound in the fkin, in any part of the
body, and put into it a very little
of the matter taken out of the ripe
puftules ; and this even the women
had
of the {mall pox. 85
had learned to praétife (1): in like
manner as our artifts now, making
a very flight incifion in each arm,
and putting upon it a {mall thread
of lint or cotton, imbibed with the
corruption, very rarely fruftrate the
hopes of their defirous patients.
In procefs of time, not many
years ago, this art began to be ufed
at Conftantinople, and Smyrna; not
by the Zurks, who, imagining all
things in life to come to pafs by un-
avoidable fate, think it impious to
oppofe and refift it; but among the
Grecians, Armenians, and the peo-
ple of other countries living there,
who gave the knowledge of it to
our countrymen (2).
(1) See Philofopbical
tranfactions, N°. 339,
and 34.7.
the {mall pox, London,
1722. Et Differtatio
medica de Byzantina va~
riolarum incifione, uc-
tore Le Duc. Lugd.
Bat. 1722.
(2) See Maiiland’s
Account of inoculating
Bur
86 Of the inoculation
Bur that I may omit nothing re-
lating to this affair; a learned au-
thor (1) has given an account, -that
the practice of /owing this difeafe, as
they call it, has been known to the
Ghinefe above thefe hundred years ;
and that they do it in another man-
ner, which is this. They take the
fkins of fome of the dried puftules,
which are fallen from the body,
and put them into a porcelain bot-
tle, ftopping the mouth of it very
clofe with wax. When they have a
mind to infeét any one, they make
up three or four of thefe fkins, put-
ting between them one grain of
mufk into a tent with cotton, which
they put up the noftrils.
I+ was indeed not difficult for
fuch ingenious people, when they
faw thofe, who were converfant
(1) Vid. Lettres edifiantes et curieufes des Mif=
Jionaires, Recueil xx. page 304.
with
of the fmall pox: 87
with the fick, contraét the fame
infection, to guefs that the air, taint-
ed with the foul breath of the dif-
eafed perfon did, when drawn in,
corrupt one,’ who was found ; and
therefore, they might rationally ar-
gue, that the fame contagious mat-
ter might be taken in at the no-
ftrils. Nor were they miftaken in
this point.
Ir is however certain, (whatfo-
ever the author of this narration,
more {killed in theological than in
medical learning, may ‘fay to the
contrary) that this Chinefe way of
implanting the diftemper is attend-
ed with much more danger than the
Grecian one. For the morbid par-
ticles infpired violently offend the
brain, by reafon of its nearnefs to
the nerves, which perform the of-
fice of {melling ; and we have in
another place. proved, that conta-
gion
“aan
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!
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aha
aie
Ay
}
‘Rt
vd
“i
ait
i
alg
4
Hi,
iil
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he J
im |
isi
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= SS SS rae
88 Of the inoculation
gion is propagated, not by the blood,
but by the nervous liquor (r).
I mysetr have had an opportu-
nity of making an experiment to
this purpofe. For, when in the
year 1721, by order of his facred
Majefty, both for the fake of his own
family, and of his fubjedts a trial
was to be made upon feven condemn-
ed malefactors, whether or not the
{mall pox could fafely be commu-
nicated by inoculation; I eafily ob-
tained leave to make the Chine/e ex-
periment in one of them. There
was among thofe, who were chofen
out to undergo the operation, a
young girlof eighteen years of age;
I put into her noftrils a tent, wetted
with matter, taken out of ripe pu-
ftules. The event anfwered ; for
fhe, in like manner with the others,
who were infected by incifions made
(1) Introduéiion to the mechanical account of
poifons.
in
of the fmall pox. 89
in the fkin, fell fick, and recovered ;
but fuflered much more than they
did, being, immediately after the
poifon was received into the nofe,
miferably tormented with fharp pains
in her head, and a fever, which ne-
ver left her till the eruption of the
puftules,
Stnce that time, this practice
has been followed, without much
fear, and indeed (as it ufually hap-
pens in new experiments) fometimes
with a degree of rafhnefs ; as pro-
mifing a milder kind of fmall pox,
than when taken in the natural way.
For, by the accounts colleéted by
thofe, who have inquired into the
affair, it is plain, that fcarce one
in a hundred dies by the inoculated
{mall pox ; whereas many more in
proportion are deftroyed by the or-
dinary difeaie (1).
(1) See Dr. Furin’s | between the mortality
Letter toDr.Cotefworth, | of the natural {mall
containing a comparifon | pox, and. that by ino-
A RE-
gO Of the inoculation
A REMARKABLE inftance of this
difference, and with what fecurity
this tranfplanting the diftemper may
be made, is given in the following
relation, communicated to me by a
gentleman of great credit. He was
amerchant at Sv. Chriftopher’s, in
the Weff-Indies, and in the making
of fugar, (which jis the trade of that
place) employed a great number of
flaves. Ih one year, when the {mall
pox raged with more than ordinary
violence in the neighbouring iflands,
with his own hands, he inoculated
three hundred of them, from five to
thirty years of age, with fuch fuc-
cefs, that not one of them died,
though moft of them were negroes,
And whereas all the Awericans fuf-
fer this diftemper in a moft terrible
manner ; yet experience fhews, that
it is much more dangerous, when
it attacks the natives of Africa.
culation. And his ae- inoculation in the years
eount of the fuccefs of | 1724, 25, and 26.
THINGS
of the fmall pox. Or
Tunes being thus, it may be
proper to confider, whether any
reafons can be alledged to. the con-
trary. And, in the firft place, there
are fome, who _infift upon it, that
the eruptions produced by inocula-
tion are not the genuine {mall pox,
and confequently, that they cannot
fecure any one from having the dif-
eafe hereafter. Moreover, they take
pains to bring teftimonies of pati-
ents, who, after having undergone
the artificial diftemper, have never~
thelefs been afterwards {eized with
the true one.
Now, I own, I cannot underftand
how contagion, that Is, the ver
feed of the difeafe, thould produce,
not its own proper diftemper, but
another of a quite different kind,
Neither certainly does it matter, by
which way the infe@ion is received,
provided it brings forth manifeft
marks of the difeafe. And as to
O 2 thofe,
92 Of the inoculation
thofe, who, after having been ino-
culated with fuccefs, are notwith-
ftanding this, faid to have fuffered
the fall pox ; I muft proteft, that,
after the moft diligent inquiry, I
have not been able to find out one
convincing proof of this kind. I
very well know, that a ftory is {pread
abroad, particularly by a late au-
thor, of a boy, upon whom, about
three years after he had contracted
the difeafe by inoculation, it broke
out again. But I am well affured,
that this narration is of doubtful
credit; and that there were fome
of the family, who afhrmed, that
no {mall pox appeared upon the ino-
culation; that the parents (as we
eafily believe what we with) de-
ceived themfelves, and that the by-
ftanders did not care to take away
from them this pleafing miftake.
Bur
of the {mall pox. 93
Burt to fpeak plainly, if fuch a
thing happened once, why do we
not fee it come to pafs oftener? Or
what can a fingle example, fuppof-
ing it to be true and certain, avail,
when innumerable experiments have
produced nothing like it ?. However,
fome men are infeéted with an in-
curable itch of writing, and take
great pleafure in contradicting others,
to whom they bear envy. Let us
therefore give them leave to applaud
themfelves, and enjoy their own
yain-glory,
Bur they will ftill go on to ter-
tify us, by faying, that there is dan-
ger left, together with the {mall
pox, fome other infeétious difeafe,
inherent in the blood and humors
of the fick perfon, fhould be tranf-
mitted into the found body ; all
contagion being very fubtile, and
wonderfully active, . And it is in-
) deed
94. Of the inoculation
deed not improbable, that {ome
other diftemper, befides thofe which
are cutaneous, may, by fucha way
as this, get admittance into the
fkin; and fuch perhaps are {cro-
phulous {wellings, and the venereal
difeafe. Yet I can hardly believe,
that it ever happens, that the feed
of one diftemper thould bring along
with it mixed, the procreative mat-
ter of another, of a nature quite dif-
herent tronsait, However it be, it
would be madnefs in a phyfician,
without any choice, to take the
morbid matter for this purpofe, out
of fick bodies, without diftinGion,
The moft proper fubjects are infants
or children, found in all other
refpects, as far as can be judged,
- and born of healthy parents. Be-
fides, it is, in MY opinion, more
material, into what kind of a body
the venom be infufed, than out of
what it be taken. And this J the
rather
of the Jinall pow. Qs
rather mention, becaufe I have more
than once known rath and unwary
furgeons to implant the difeafe into
bodies weak, and of an il habit,
with a fatal event, Laftly, it is of
very great confequence to take care
not to throw a new infeétion into
one already infected : for I have
obferved this to prove mortal; na-
ture being oppreffed and finking
under a double difeafe, when per-
haps fhe might have got the better
of either of them fingle,
I nave often confidered for what
reafons it is, that the inoculated is
fafer than the natural {mall pox;
and the following feem to be the
chief. Firft, the venom is commu-
nicated to a young, healthy, and, for
the age, {trong body. In the next
place, the violence of the fever,
which follows, is prevented, if there
be occafion, by bleeding, and gen-
tie
96 3 —>—OOf the inoculation
tle purging. And laftly, throtigh
the whole time, that the contagi-
ous matter is exerting its malignity
upon the humors (which is gene-
rally eight or nine days) quietnefs,
moderation in diet, and every thing
elfe is ftrialy obferved : whereas,
many incur the natural diftemper
on a fudden, when the blood is
heated with wine and exercife ; by
which means, all the fymptoms muft
neceflarily prove more fevere and
dangerous. Some have alfo been of
opinion, that the difcharge out of
the wound made to introduce the
purulent matter, and likewife from
the {mall pimples which break out
round it, may contribute fomething
to the fafety of the patient. But
the {mall quantity which runs out
this way cannot, I think, avail much.
Two bifers laid, one to an arm,
the other to a leg, will certainly do
much more; efpecially if they be
kept
of the /mall pox. 97
kept running throughout the whole
courfe of the difeafe. And I make
no queftion, but this practice would
be of very great fervice.
Ir is proper to mention, that
this artificial difeafe is ufually fo
mild, that it {carce requires any help
from medicines. But where it hap-
pens otherwife, as it fometimes does,
the fame will be neceffary, which
have been direéted in the {feveral
kinds of the natural {mall pox.
T o conclude; it ought not to
be omitted, that boils, and fwellings
under the ears, and in the arm-
pits, arife more frequently after the
diftemper procured by art, than after
that which comes of its own ac=
cord ; for this reafon, as I fuppofe,
that the venemous matter is pulhed
forward with lefs force, which dif-
advantage nature makes amends
for this way. Therefore, all pofli-
r ble
98 Of the inoculation, & c.
ble means are to be ufed to ripen
fuch tumors, of whatever kind the
are: if this cannot be done, they
muft be opened by incifion; and
when all the matter is drawn out,
the body muft be purged by proper
medicines, which are to be oftener
repeated in this, than in the natural
difeafe,
ct
CHAP.
Of the meafles. 99
EOANED IE HEIR XK OK GIR ICH Givi
See ween PeeORe ILOS
Cor wer. ee
Of the meafles.
BP NHE meafles have a reat af-
finity with the {mall pox 5
being originally bred in the fame
country, propagated in the fame
manner, by infedtion, into diftant
parts of the world, and never f{eiz-
ing any perfon more than once.
Tue hiftory of this difeafe, as it
generally appears among us, Doétor
Sydenham has defcribed with his
ufual accuracy, calling it ¢ fever,
which in its nature and method of
cure agrees very much with the Small
pox ; that is; accompanied with a
great inflammation, and in which
puftules of a particular kind are
thrown out upon the fkin.
Pa Now
100 Of the meafles.
Now this inflammation does not
only affect the furface of the body,
but the inner parts alfo, and par-
ticularly the lungs: hence follows
a cough, with a difficulty of breath-
ing. And although the diftemper
in its nature be lefs dangerous than
the fmall pox, and continues a
fhorter time; for it ufually is ended
in fix or feven days, or, at the far-
theft, in eight, very thin, and light
{cales, like fine flower, falling off
from the fkin at that time ; yet it
feizes with more violent heat, and
greater anxiety than the other does.
Therefore Rhazes obferved, that the
inflammation of the whole body,
the inquietude, and anxiety of mind,
are much more terrible in: the mea-
fles, than in the {mail pox (1).
I wave therefore often wonder-
ed, why that fagacious and experi-
(4) See bis book, at the end of ibis. Chap. i.
enced
Of the meafles. TOL
enced phyfician, whom I have fo
often mentioned with praife, did
not prefcribe bleeding in the very
beginning of the difeafe; but neg-
lected this material part of the cure
o far, that he only ordered it at
the end, when a hot regimen, and
too warm medicines, had brought
upon the patient a cough and fhort-
nefs of breath. Efpecially fince he
himfelf takes notice, that the loofe-
nefs, which often follows this fe-
ver, and which, he fays, proceeds
from hot vapors from the inflamed
blood falling upon the bowels, is only
to be cured by blood-letting (1). But
the great man deferves pardon upon
this account, that in thofe times,
phyficians never attempted to take
away blood in thofe fevers, which
were attended with any eruptions,
particularly in children, who are
the moft liable to this kind of ill-
(1) De morbillis, cap. v. page207. edit. 1685.
nefs,
Ae ee ee
Se She tee es
a
ied es >
1O2 Of the meafles.
nefs. Their reafon was, left that
emptying of the veflels fhould hin-
der the coming out of what was to
be difcharged by the fkin. But dai~
]y ly experience fhews, that this fear
is vain, and that the event is quite
contrary to what they imagined.
T o come therefore to the cure ;
as this peftilential difeafe is of kin
to the {mall pox, it requires a ma-
nagement not very different from
the fame, which we have recom-
mended in that diftemper. Blood
muft be taken away in the, begin-
ning, according to the age and
ftrength of the patient. It is beft, if
poffible, to do this before the erup-
tion of the puftules; but, if they are
already come out, it muft however
be taken away. For the greateft dan-
ger is an inflammation of the lungs,
which cannot be prevented too foon.
Therefore in the height of the fever
alfo,
Of the meafles. 103
alfo, although bleeding was not neg-
leéted in the beginning, yet it is fome-
times neceflary to repeat it. And in
the laft place, at the end of the dif
eafe, when the fkin is now growing
dry, and the feales falling off, it will
be a great error not to open. a vein
again ; that by this means, a flux of
umors upon the breaft and inte.
{tines,"and the fymptoms of a hec-
tic fever and confumption, may be
happil y prevented.
It is really a thing to be grieved
at, that phyficians, in {6 great an
inflammation of the whole furface
of the body, fhould not always have
lireéted this leflening the quantity,
and thereby checking the heat of
theblood. AndI mo of all won-
der, that Dr. Morton, who took fox
tice of the neceflity of this practice,
when the difeafe was at the higheft,
fhould abfolutely forbid it in its firft
appear =
TP Tn Tes
104 Of the meafles.
appearance. But this phyfician’s judg-
ment was perverted by a vain, and
not rightly underftood, opinion of
a malignity and venom infecting the
animal fpirits ; which had fo poffef-
fed his mind, that he thought of
nothing more, than of throwing in-
to the body hot medicines, called
cordials, as auxiliary forces againft
the fuppofed enemy (1). A bad ex-
ample, and at the fame time a con-
vincing proof, how neceflary it is,
that a man fhould be inftructed in
the principles of mechanic philofo-
phy, before he applies himfelf to
the art of phyfic.
Tue diet ought to be the fame
as is prefcribed in the {mall pox;
taking particular care that the body
be kept lax, rather than bound up,
through the whole courfe of the di-
{temper.
(1) De febridus inflammatcrits, cap. iv.
As
Of the meafles. 105
As to remedies; to thofe cool-
ing ones, which are directed in the
other difeafe, muft be added fuch
as abate the cough, and help ex-
pectoration; particularly oily linfus
and the pectoral infufion, of which,
with the addition of a little wizre,
the patient may drink frequently.
Dottor Sydenham gave diacodion,
even on the firft days of the illnefs ;
but I think he was not cautious
enough in this point; for all me-~
dicines of this kind thicken the hu-
mors, ftreighten the breath, and
retard the eruption of the puftules.’
Therefore, during the increafe of
the diftemper, they are to be ufed
very {paringly ; but at the latter end
they are of great fervice: inafmuch
as there is then a neceffity to
quiet the cough, which, from the
fharp defluxion upon the lungs,
threatens a heétic fever and confum-
Q. ption.
106 Of the meaffes.
ption. But in the mean time, gen-
tle purges are to be given at due in-
tervals. Milk, efpecially that of
affes, muft be drank. Change of
air is alfo neceflary. And laftly,
exercife, fuitable to the ftrength of
the patient, is to be daily en-
joined,
I am afraid, left I thould feem
_ vainly to court applaufe by the fol-
lowing narration ; yet it is fo much
to the purpofe, and fo happily con-
firms what I have faid, that I muft
beg leave to relate it. About forty
years ago, the meafles raged with
fo great violence in this city, that
they proved more fatal than even
the fmall pox. At that time, a phy-
fician of great eminence came to
me, defiring that I would inform
him what method I followed in this
difeafe. I afked him, whether or
not he ufed to take away blood ?
He
Of the meafles. 107
He anfwering no, becaufe Syden-
ham very feldom did it; I advifed
him to open a vein in the begin-
ning of the diftemper, or, if he was
called in later, as foon however as
he poflibly could: for, faid I, this
difeafe always brings with it a peri-
pueumony, which he very well knew
ever required bleeding, Not long
after, he met me again, returning
me hearty thanks for my counfel,
affuring me, that he had not loft
one patient, whom he had treated
in this manner. Since that time,
this practice grew fo common, that
it is now followed even by our apo-
thecaries,
In the laft place, it is proper to
take notice, that, as was obferved
concerning the fmall pox (1), that the
difeafe is more or lefs tife, accord-
ing as the feafon of the year and
(1) Chap. ii,
Qa2 ftate
ee!
ree:
Pp vara
as
Sie
108 Of the meafles.
frate of the air confpire with thg in-
feGion; fo-the like happens in the
meafles. And Dr. Morton relates, that
in the year.1672, this diftemper was
{o terrible, that in London there died
of it three hundred every week (1),
But I have at laft finifhed this
little work : which tho” it may per-
haps, to contentious and malevolent
perfons give matter for calumny and
finding fault; yetwill, [hope, prove
eneficial to mankind, efpecially to
our own countrymen. This is all
I defire ; for the confcioufnels of
having done right is beyond all
praife, carrying with it its own re-
ward: and this he always enjoys, who
confults the public good, and by his
actions fhews, that he thinks he is
Not for bimfelf, but for the whole world barn (2).
(1) Append. ad Exer. } (2) Non fibis fed toti ge-
de morbis acutis, pag. \ witum fecredere munde.
A276 Lucan L. ii, v. 383.
8 EHR, JOH HOR, OH Hh
Cot eale dos Mele wath Rate aoe
CON TENGZS
Of the preceding TreatTisz,
pres Page iii
CGHAP. 4.
Of the origin of the /mall pox. I
CHAP. i,
Of the nature and forts of the fmall
pox. 13
CHAP. II.
Of the methods of cure of the fmall
pox. 32
GHA PTV;
Of fome accidents which happen in =
Jmall pox.
GC HAP. Vv;
Of the inoculation of the Small pox.
82
CHAP, VI,
Of the meafles. 99
SOR,
ea as
le
ORICIOIOIIORIIORIOKIOK OK
RHAZE s3
TREATISE
ON THE
SMALLPOX
AND
MEASLES.
RORICIIORIIOICO OOK
PREFACE
In the Name of God, Merciful
and Gracious.
pu-Bexer MouammeD, the fon
A of Zacharias, faith thus:
Ow a certain night, at a meet-
ing in the houfé of a nobleman, of
great goodnefs and virtue, and very
fond of the explanation of ufeful fci-
ences, that they might be made
plain and intelligible for the pub-
lic benefit ; the converfation hav-
ing turned on the fmall pox, I then
fpoke what came into my mind on
that fubjeé&t. Which, when that
great man (whom may God long
referve for the good of mankind)
had heard ; he defired, that I would
write a difcourfe on that difeafe with
fufficient aptnefs, folidity, and clear-
nefs :
ears disse
Sree
om eee eae
1I4 Rhazes's Preface.
nefs: becaufe there had never yet
been publifhed, either by the anci-
ents or moderns, a fatisfactory ac-
count of it.
I THEREFORE compofed this trea-
tife, hoping to receive my reward
from the almighty and glorious
God, as the effeét of hi: good will.
Now this is the fum of its con-
tents, and the heads cf the chap-
ters.
Crap. I. Of the caufes of the finall
pox; and how it comes to pafs,
that no mortal, except by chance
here and there one, efcapes free
from this difeafe.
Cuap. II. What bodies are moft
difpofed to the {mall pox: alfo
of the feafons of the year, in
. which they moft frequently hap-
pen.
Crap,
Rhazes’s Preface. 115
Cuapr. III. Of the prognoftic figns
of the eruption of the {mall pox
and meiafles.
Cuap. IV. Of the regimen, or cure
of the {mall pox, in general.
Cuap. V. Of prefervation from the
{mall pox before the figns of them
appear; and the way to hinder
the multiplying of them after the
figns have appeared.
Cuap. VI, Of thofe things, which
haften the eruption of the {mall
pox: alfo how nature’is to be af-
fifted therein.
Cuap. VII. Of taking care of the
eyes, throat, ears, and joints, as
foon as the figns of the {mall pox
have appeared.
Cuapr. VIII. Of ripening the pu-
{tules.
Cuap. IX, Of drying tle puttules.
CHAP.
116 Rhazes's Preface.
Cuar. X. Of taking away the dry
{cabs of the {mall pox, and the
efchars from the eyes, and the
reft of the body.
Cuap. XI. Of deftroying the marks
of the {mall pox.
Cuap. XI. Of the food and diet
in the {mall pox.
Cuap. XIII. Of managing the dif-
charges of the belly, in the fmall
pox.
Cuap. XIV. Of the curable and in-
curable {mall pox and meailes.
CHAP.
Of the caufes, 8c. 117
"AoSR Ra SRO Me 0 ROR 6 Mode SR
CHAP IL.
Of the caufes of the {mall pox ; and
how it comes to pa/s, that no mor-
tal, except by chance here and
there one, efcapes from this dif
ease: alfo a brief account of what
Galen fas mentioned concern-
ing. it.
S to thofe phyficians, who af-
firm, that the moft excellent
Galen has made no mention of the
{mall pox, and therefore that he did
not know this diftemper ; furely they
have either never read his works
at all, or only very curforily ; nay,
molt of them do not know, whe-
ther what he plainly fays of it, is
to be underftood of that difeafe.
For Galen, in a certain treatife,
fays, this * * does good this and that
Wa,
118 Of the caufes
way, and alfo againft the fmall pox.
And in the beginning of the four-
teenth book Of pulfes, that zhe blood
is putrefied in an extraordinary de-~
gree, and that the inflammation runs
fo high, that it burns the fhin; fo
that the {mall pox, and peftilent car-
buncle, are bred in it, and quite con-
fume tt.
Anp inthe ninth treatife of the
book Of the ufe of the parts, he ob-
ferves, that the /uperfluous parts of
aliments, which are not turned into
blood, and remain in the members,
putrefy, and in time increafing do fer-
ment. whence, at laft, are generated
the peftilential carbuncle, the {mall
pox, and confluent inflammations.
Lastxy, in the fourth part of his
Commentary upon the Timeus of
Plato, he fays, that zhe ancients gave
the name orcyyory to every thingy
which produces redne/s, as the car-
buncle,
of the finall pox. 119
buncle, and Jmall pox; and that thefe
difeafes are bred in thofe, in whom
bile abounds.
Bur as for thofe, who alledge,
that he has propofed no remedy or
cure, nor explained the nature of
this diftemper ; they indeed fay
what is true: for he mentions no
more than what we have cited. But
God knows, whether he might not
have done it in fome other books,
which have not yet appeared in A-
rabic.
A's for my own part, I have with
great diligence inquired of thofe,
who underftand both the Syriac and
Greek language, and defired them
to inform me concerning this mat-
ter: but not one of them could tell
me more than what I have {et down,
But this indeed I very much wonder
at, and why he paffed over this dif-
temper in filence; efpecially fince
it
120 Of the caufes
it was frequent in his time, and
therefore there was great reafon for
his prefcribing remedies againft it,
as he was fo diligent in finding out
the caufes and cures of difeafes.
T ue moderns have, it is true,
propofed fome medicines for the
cure of the {mall pox, but not di-
ftinétly and clearly enough ; neither
has any one of them explained the
caufe of it, and why, except here
and there one, no body efcapes it;
nor fhewed the methods of cure in
a right order. Upon which account,
I hope that the good man, who en-
couraged me to undertake this work,
will have his recompence ; and that
my reward will be doubled, when
I fhall have defcribed whatever is
neceflary to the cure of this difeafe
in due method, afligning to every
thing its proper place; by the help
of God, ;
WHERE-
of the {mall pox. 121
Wuererore let us begin to re.
cite the efficient caufe of this dif-
temper; and why it happens, that
{carcely any one mortal efcapes it,
And then we will purfue feparately,
in the fubfequent chapters, the other
things, which relate to it; and,
with God’s affiftance, fhall fay on
each head whatever is neceflary for
its cure,
Isaythen(z1), thatthe body of man,
from the time of his nativity, till he
arrives at old age, continually tends
to drynefs ; and that therefore the
blood of infants and children, and,
in proportion, the blood of young
men, abounds much more with hu-
midity, than the blood of old men,
and is alfohotter. And this indeed
Galen teaches us, in his Commentaries
upon the Aphorifms, where he fays :
(1) Here begins the tranflation of the anonymous
Greck interpreter.
S the
122 Of the caufes
the beat of children is indeed great-
er in re ntity, than the heat of young
Met 3 but the heat of young men is
more Violent in quality. This alfo
is evident from the force of their
natura Ge ata as the digeftion of
their food, and accretion in chil-
ae
THEREFORE, the blood of chil-
dren may be compared to new wine,
in which the fermentation leading
to ripencfs is not yet begun: and
the blood of young men to the fame,
fermenting and emitting fteams, till
It is quiet and ripe. And, laftly,
the blood of old men is like towine,
whofe f{trength is gone, fo that it thes
comes vapid, and begins to grow four.
Now, the {mall pox arifes, when
the blood putreties nud te erments, and
the fermenting particles are thrown
out of it; the blood of children, like
to new. wine, being changed to that
of
of the fmall pox. 123
of young men, which isas wine per-
feétly ripened. And this fermen-
tation and ebullition is the difeafe,
Anp this is the reafon why chil-
dren, efpecially males, rarely efcape
being feized with it. For, without
doubt, as the wine naturally fer-
ments till it comes to perfection; fo
the blood undergoes the fame alte-
tation, in pafling from its firft to its
fecond ftate. And there feldom hap-
pens a temperament in an infant or
child, in which fuch a change can
be made in a {mall time, and with-
out manifeft figns of it: as may be
judged from their diet, which in in-
fants is milk ; and in children, not
milky, but their food is ftronger, in
proportion, than that of other ages,
and more compounded. ‘To which
it may be added, that in thefe there
is, after food, a greater motion of
the humors. For thefe reafons,
ee very
124 Of the caufes
very few children go into life with-
out this diftemper. Befides this,
great alterations are made here, by
different temperaments, manners of
life, and habits ; as alfo, by the con-
ftitution of the ambient air, and
ftate of the blood, both as to quan-
tity and quality: for in fome this
flows quicker, in others flower ; in
fome it abounds, in others it is de-
ficient ; in fome it is very bad, in
others in a better condition,
As to young men, whereas the
change in their blood is already
made, its maturation finifhed, and
the particles of moifture, which
fhould caufe putrefaction, are now
exhaled ; hence it follows, that this
difeafe cannot be generated in them,
at leaft but very feldom, that is, in
fuch, whofe blood ftill abounds with
too much humidity, or is very cor-
rupt, with a violent inflammation ;
: OF
of the fmall pox. 125
or who, perhaps, when they were
children, had been attacked with the
chicken-pox, when their blood had
not yet pafled from the firft fate to
the fecond ; or, laftly, who have a
moderate heat, thatis, without much
moifture ; and when they had the
chicken-pox, were of a dry tempera-
ment, and lean,
In an advanced age, the diftem-
per will fcarcely appear, unlefs_per-
haps in putrid, malignant, and pe-
ftilential conftitutions of the air, in
which this difeafe chiefly rages. For
fuch an air difpofes bodies very
much to heat and moifture; and
an inflamed air’ promotes eruptions,
by blowing up the fpirit in the ven-
tricles of the heart, and communi-
cating to it the like difpofition, which,
by the force of the heart, is fent into
the blood, which is in the arteries ;
and
1260 86=— Of'_«the caufes, Se.
and brings it into the fame ftate of
corruption,
Tuus we have fufficiently, though
fuccinélly, treated of the caufes of
the {mall pox. We fhall now pro-
ceed to fhew, what bodies are moft
difpofed to this difeafe and the
meafles.
CHAP.
Of bodies difpofed, Sc... 129
: AK CE ND HEEL \S5
GORE OER COE SEO
CHAP. IL
Of bodies difpofed to the fmall pox.
O DIES inclined to this difeafe
B are generally fuch, as are moitft,
pale, and flefhy ;_ the well-coloured
alfo, efpecially, if they are ruddy
and tending to brown, are difpofed
to it, if they are loaded with eth,
So are likewife thofe, who are
frequently liable to acute and con-
tinual fevers, to running of the eyes,
ted pimples, and boils, Proceeding
from the eating of fweet things ; as
dates, honey, figs, grapes, and all
thofe {weets, in which there is a grofs
humor; particularly, thick gruels,
food made of unground wheat, with
honey and water, or a great quan-
tity of wine and milk,
Lean,
128 Of bodies difpofed
Lran, bilious, hot, and dry bo-
dies are more inclinable to the mea-
fles, than to the {mall pox. But if
they happen to be taken with the
{mall pox, the puftules are either
few, diftiné, and favourable ; or,
on the contrary, very bad, irregular,
deceitful, dry, with putrefaction,
and no maturation.
Lastiy, thin and dry bodies, of
a cold temperament, are neither fub-
ject to the {mall pox, nor to the
meafles. And if they happen to catch
the {mall pox, they have but few,
in a moderate way, and without
danger, with a very flight fever ;
becaufe fuch conftitutions extinguifh
‘the difeafe in its very beginning.
Tue feafons of the year, in which
the {mall pox are moft frequent, are
various: they rage moft at the lat-
ter end of the autumn, and the be-
ginning of the {pring; and when
in
to the {mall pox. 129
in the fummer there are great and
frequent rains with continual fouth
winds; and laftly, when the winter
is warm, and the winds foutherly,
Wuen the fummer is exceffive-
ly hot and dry, and fucceeded by a
hot autumn, in which rains come
on very late ; then the meafles quick-
ly feize thofe, who are difpofed to
them, that is, thofe who are lean,
hot, and of bilious conftitutions.
Bur all thefe things admit of
great differences, by reafon of the
diverfity of countries and places, and
occult difpofitions in the air, which
bring on thofe diftempers, and ren-
der bodies fubje& to them. And
therefore, at fuch times, great dili-
gence is to be ufed in the preferva-
. tion from them; as we fhall fhew
in the fequel.
$2 CHAP,
130 Of the prognoftic figns
fe Aa SOT ON RO MI ROM Hh I
oe eG ee dates
CTE Pe,
Of the prognoftic figns of the eruption
of the frall pox and meafles.
a E eruption of the fmall pox
is preceded by a continual
fever, a pain in the back, itching
in the nofe, and terrors in fleep.
Thefe are the proper figns of the
approaching {mall pox, efpecially
the pain in the back, with a fever;
and alfoa pricking, which the pa-
tient feels all over his body; toge-
ther with a fulnefs and rednefs of
the face, which at times goes and
comes; a rednefs of the eyes, a hea-
vinefs of the whole body ; frequent
yawnings, a pain in the throat and
breaft, with a difficulty in breath-
ing, and ftreightnefs in the gullet ;
then a drynefs of the mouth, thick
{pittle,
of the eruption. 13t
{pittle, a hoarfenefs of the voice ;
head-ach, anxiety of mind, inquie-
tude; fick qualms, and _heavinefs
of heart: with this difference, that
anxiety of mind, fick qualms and
heavinefs of heart, opprefs more in
the meafles, than in the fmall pox,
unlefs the fmall pox be of a bad
fort; for the meafles are from a very
bilious blood. And, on the other
hand, the pain in the back, the
heat and inflammation of the whole
body, efpecially in the throat, with
a fhining rednefs, are more proper
to the {mall pox than to the mea-~
fles.
Wuerzrore, upon the appear-
ance of thefe figns, or fome of the
worft of them, you may be affured,
that one or the other of thefe dif-
eafesis nigh at hand.
As to the fafer kind of the {mall
pox; in thefe, the quantity of blood
2 is
132 Of the prignoftic figns Bc,
is greater than its bad quality : and
hence arifes the pain of the back ;
the greater blocd-veffels, which are
fituated near the vertebrae of the
back, being diftended with too great
a quantity of blood.
CH AP.
Of the regimen, or cure Bc. 13
IR ROIOIOK KOK NOOK
FRIAR AOKI OOK HO HOOK KSI SKS See
Crit AP. FV:
Of the regimen, or cure of the fmall
pox in general.
HE firft article thall be of the
= prefervation to be ufed, before
the figns of the {mall pox appear ;
and after they have appeared, how
the difeafe may be leffened.
Tue fecond, concerning the eru-
ption.
Tue third, the care to be taken
of the eyes, ears, nofe, throat, and
joints.
Tue fourth, of the Tipening of
the puftules.
Tut fifth of their drying.
Tue fixth, how the {cales and
crufts
134 Of the regimen, or cure &c.
crufts are to be cleared from the
eyes, and the reft of the body,
Tue feventh, of deftroying the
marks.
Tue eighth, of the diet in the
{mall pox.
Tue ninth, of regulating the dif-
charge by the inteftines.
Tue tenth, of curable and in-
eurable {mall pox and meafles.
Or each of thefe I fhall, God
willing, briefly, but fufficiently, dif-
courfe,
CHAP.
Of prefervation from, Bc. 135
ieee ee
Seale anal athe bite alte atte ale alte a!
OS 5 ee eee
Of prefervation from, and leffening
the difeafe.
LOOD ought to be taken away
B from children and young men,
if they have never had the {mall
pox, or have only had what is called
the chicken-pox (efpecially at fuch
feafons as we have above defcribed)
before they are feized with a fever,
and the figns of the difeafe appear.
A vein may be opened in thofe, who
are fourteen years old ; to thofe
who are younger, cupping-glaffes
muft be applied, and their lodgings
fhould be kept cool.
Ler their diet be yellow lentils,
tarts made of unripe grapes, minced
flefh-meat, drefled with vinegar and
honey, or with the acid fyrup ; to
which
136 Of prefervation from, and
which raifins, a few figs, and
chiches are fometimes added : alfo
kid-broth, veal-jellies, and boiled
wood-cocks and hens. But thefe
mutt be mixed with the juice of un-
ripe grapes.
Tuerr drink fhould be water
cooled with fnow, or clear fpring
water cold ; with which their cham-
ber may alfo be fprinkled.
Let them frequently eat acid
pomegranates, and the infpiflated
juices of acid and aftringent fruits,
as pomegranates, currants (1), and
the like.
Wuere the conftitution is hot,
and there is a great inflammation ;
barley-water, with a fourth part of
and acid juice boiled to
is Ribas, which alfo | two thirds, is called
fignifies a fort of Aapa- | Rob de Ribes, See Go-
thum acetofum, or for- | lit Lexic.
rel, of which the red
(1) The Arabic word
acid
lefening the difeafe. 137
acid pomegranate juice, may be
drank in the morning. But if the
heat be lefs, a ptyfan of barley, with
fugar, is proper; and vinegar, len-
tils, pomegranates, and the juice of
unripe grapes, may be added to the
food ; for all thefe thicken and cool
the blood, and make the diftemper
more mild.
Tuts regimen is of great fer-
vice in all times of peftilence ; for
it diminifhes the malignity of pe-
ftilential ulcers and boils ; and pre-
vents quinfeys, pleurifies, and all
diftempers arifing from bile and
blood.
Tue patient may go. into cold
water, and fwim in it about noon.
He muft abftain from new milk,
wine, dates, honey, and, in general,
from {weet things, and meats, made
by a mixture of flefh, onions, oil,
butter, and cheefe; from mutton,
U beet,
138 Of prefervation from, and
beef, thell-fith, high-feafoned things,
and hot feeds. Inftead of thefe, in
times of contagion, he may eat young
birds; and if the temperament be
hot and moift, liable to putrefaction,
or hot and dry, and apt to be in-
flamed; he muft eat as follows;
that is, in the hot and dry confti-
tution, cooling and moift garden-
herbs, purflain, mallows, beet,
gourds, cucumbers, forrel, and {mall
pompions.
As to fweet melons, they are for-
bidden; and if any one by chance
eats of them, he muft prefently
drink a fpoonful of the juice of fome
of the acid fruits. He may be al-
lowed {oft fifth, and butter-milk.
To the food of thofe, who are
corpulent, flefhy, and of a ruddy
complexion, fuch cooling and dry-
ing things, as we have mentioned,
may be added. They fhould all
forbear
leffening the difeafe. 139
forbear labour, fatigue, bathing,
venery, walking or riding in the fun
and duft, drinking of ftagnating
waters, blafted fruits,or mouldy y herbs; i
and ais figs and grapes: becaufe
thefe drive the humors to the fkin,
and, filling the blood with flatulent
{pirits, difpofe it more to fermen-
tation and ebullition. Their body
muft be opened, if there be occa-
fion, with the juice of prunes and
fugar, or with whey and fugar, If
the air be putrid and peftilential,
their face may be continually fprink-
led with the water of fanders and
eamphire; which, if it pleafes God,
will have a good effect.
As to fucking infants ; if they are
fat and ruddy, and above five months
old, let them be cupped; and let
the nurfe, as far as poflible, be ma-
naged in the manner we have men-
tioned,
U 2 I coME
140 Of prefervation from, and
I come now to thofe medicines,
which thicken and cool the blood,
and check its ebullition and putre-
faction.
Aut acid things are proper for
this purpofe, efj pecially the water
called A/-rdéib, that is, the four,
bitter water, which fwims upon but-
ter-milk expofed to the fun; and
the acid juice of citrons.
Tue fame intention is very well
anfwered by many things, which have
an aftringency joined with their aci-
dity, and thereby condenfe the blood.
Such are, four grapes, fumac, Rob
ribas, or the infpiflated j juice of cur~
rants, apples, quinces, and pomegra-
nates; jujubes, lentils, coleworts,
coriander, lettuce, poppies, endive,
night-fhade, fugar called Bambu (1),
the feeds of fleawort, and camphire.
(1) The Indian name for a concreted juice,
like fugar, in an Indian reed.
THE
leffening the difeafe. 141
Tue following compofition is
good to cool the blood, and reftrain
the heat of the liver, and efferve-
{cence of the bile.
T ax ks of red rofes beaten, ten
drachms; Bambu - fugar, twenty
drachms ; fumac, the feeds of wild
forrel, lentils peeled, berberies, the
feeds of purflain, feeds of white let-
tuce, of each five drachms; red
fanders, two drachms and a half;
camphire, one drachm.
Let thefe be mixed, and give
three drachms of this powder to the
patient every morning in his drink,
together with an ounce of the juice
of wild forrel, or of ribas, pome-
granate, or unripe grapes, and the
like.
Tue medicine 4/-/acangjabin,
that is, oxymel with fugar, is like-
wife good, which is thus prepared.
TAKR
142 Of prefervation from, and
T axe one part of red, fharp vine-
gar, depurated ; two parts of rofe-
water ; mix, and infufe in the cold
mixture, one ounce of red rofes;
half an ounce of balauftines; two
ounces of pomegranate-peel, for the
{pace of three days. Then ftrain
the liquor, adding to it, according
to the quantity of the vinegar, twice
or thrice as much of the fugar #g-
barzad, that is, white fugar-candy,
Boil it fufficiently, and ule it.
Ir will alfo be of ufe to take of
rofes and bambu - fugar, of each
ten drachms; white fanders, three
drachms ; camphire, one drachm ;
and moiften them with the muci-
lage of - the feeds of fleawort ; then
make the maifs into pills, or troches.
Of thefe, at proper times, three
drachms may be given in the
patient’s drink, together ,with one
ounce
leffening the difeafe 143
ounce of the aforefaid 4//acangja-
bin.
Brsrpes thefe, the following fy-
rup is excellent, and wonderfully
exceeds in virtue all others, which
I have feen tried; though per-
haps the fyrup of pearls, which
the Indians defcribe, and of which
they boaft more than they can have
experienced, may be more power-
ful. For they fay, that 7f any
one drinks of that fyrup, though nine
puftules have already appeared, there
will not come out a tenth.
Now the compofition of mine is this.
Taxe of red vinegar depurated,
old, and fharp, three pounds; of
the juice of acid pomegranates, the
acid juice of citrons, the juice of
unripe grapes, of ribas, of the Sy-
rian mulberries, the -expreffion of
Syrian fumac, and berberies, of each
one
144. Of prefervation from, and
one pound ; the juices of lettuce and
tarragon, of each a quarter of a
pound ; of the decoétion of red ju-
jubes, and the infufion of lentils,
each a pound and half. Mix all to-
gether, and add three pounds of
fugar ; boil the whole, and put to it
fome of the fyrup already made,
hot, working it with a peftil, till it
is diflolved: then mix it with the
whole, ftirring it continually with
a flick of camphire wood; throw it
into a mortar of ftone, or willow-
tree wood, taking out the cleareft
part all the while; having added
and mixed bambu-fugar and cam-
phire. Ufe this before the fmall pox
appears, and alfo after the appear-
ance, as we {hall direét anon. It
is alfo proper in all diftempers,
which arifé from a bilious blood, in
peftilential ulcers, boils, quinfeys,
and the like.
Wuat
leffening the difeafe. 145
Wuat I have faid, may in gene-
ral fuffice concerning prefervation
from the fmall pox, before the fe-
ver, which attends their figns, comes
on.
Tue laft mentioned fyrup repels
the difeafe from one, who is in fuch
a condition, that it can be repelled ;
fo that what comes out will be very
moderate. It alfo effets, that the
change of the blood from the firft
ftate to the fecond, fhould not be
done too haftily, and at once, with
too great ebullition, and frightful
and dangerous fymptoms ; but by
degrees and in a longer time; in
the way of maturation, not putre-
faction, without terrible and dan-
gerous fevers.
Bur when the fever, whichaccom-
panies the eruption, arifes, this regi-
men is no longer to be ufed, unlefs
with great caution and prudence ;
for
146 Of prefervation from, and
for a miftake here is very danger-
ous, for this reafon, that while the
blood is rarefied, and nature, ac-
cording to the temperament of the
patient, is endeavouring to expel
the morbific matter ; if then the re-
frigeration and condenfation, which
you intend, does not exceed the
cool ftate the patient was in before,
it will happen, that the ebullition
will break out a fecond or third
time ; and thus nature will be dif-
turbed in her work. Neither can
that ebullition be checked, without
great danger; for thofe remedies
mutt be ufed for this purpofe, which
do. in a manner congeal and coagu-
late the blood; fuch are, opium,
hemlock, a great quantity of juice of
lettice, night-fhade, and the like. And
the congelation of the blood, and ex-
tinction of natural heat, by all thefe,
is not fafe; becaufe of the excels,
which is eafily committed: for it
will
leflening the difeafe. 14.7
will be hard, at the fame time to re-
prefs the effervefcence, and _preferve
the due natural heat. In one word,
care muft be taken, not to extin-
guifh preternatural and natural heat
together.
Now I fhall.communicate a prac-
tice, which phyficians, either through
ignorance or avarice, that they only
may receive profit from it, ufually
conceal; andit is this. When you
obferve, upon the figns of the difeafe,
a diftenfion of the belly, pain in the
back, rednefs of the face and eyes,
a violent head-ach, with a full pulfe,
and alfo a ftreightnefs of breath, a
red and turbid urine, and fuch a
heat of the body, as a man feels,
who has been for fome time in a hot
bath; efpecially, if the body be
flefhy ; there is then all the reafon
in the world to take away blood.
Wherefore, draw away a good quan-
xX 2 tity,
148 Of prefervation from, and
tity, even till the patient faints away
It will be beft to do it from the bafi-
lic vein, or fome of its branches ;
but if that cannot befound, from the
cephalic vein. Sometimes, when
the bafilic does not appear, it may
be taken away from the vein in the
ankle ; but better from the bafilic
omits branches, becaufe they draw
from the greater veins in the abdo-
men more than the cephalic does.
Ir the fymptoms do not run very
high, altho’ they are manifeft, draw
blood, but fparingly ; and when they
are lefs, take away very little. Then
proceed in the cure with repelling
medicines, as has been mentioned.
Ir by thefe the feverifh heat is
removed, and the pulfe and breath
are come to their natural ftate; ftill
infift on the ufe of them, till the
heat of the difeafe is perfectly oa]
€ 3
leffening the difeafe. 149
ed, which will be done ina fhort
time.
In order more effectually to per-
form this extinction, let the patient
drink water, made cold in {now to
the higheft degree, very plentifully
and often ; fo that he may feel the
coldnefs of it in his bowels. If, af+
ter this, the fever and burning re-
turn, give this water, a fecond time,
two or three pints, or more, in the
fpace of half an hour.
Ir ftill the heat return, and the
belly be. full of water, make him
vomit it up, and then give it again.
And if the water finds a paflage,
either by {weats or urine, you may
be affured the patient is in a good.
way. |
Bur if the water does not pafs,
and the heat returns as it was at firft,
or even is more violent ; omit giv-
ing
150 Of prefervation from, Sc.
ing the water fo often, and have re-
courfe to the other extinguents,
which have been defcribed; and if
the patient finds relief, perfift in the
ufe of them. If, on the contrary,
you perceive, that they. produce an
intolerable uneafinefs and inquietude,
you may certainly know, that the
eruption of the {mall pox or meafles
is at hand. | Wherefore you mutt
quit this method, and haften to af-
fift nature, in expelling her fuper-
fluities, in the manner I fhall deliver
in the following chapter.
CHAS.
Of thofe things, which, &c. 151
Naf SRO Ro SR 0 SR 3 SOR, KOON, SO
Oe Oe OF One "Rea Kwai Ce
Ret A PVE
Of thofe things, which haften the
eruption of the {mall pox.
HE eruption of the {mall pox
and meaifles is promoted by the
followingmeans. The patient muft
be well wrapped up in cloaths, and
his body rubbed all over. He muft
be kept in a room not very cold ;
he fhould drink frequently, a little
at a time, of cold water; to pro-
voke {weat, and affift the protru-
fion of the humors to the external
parts.
Tue fick perfon muft put ona
double fhirt, the borders of which
muft be bound. Underneath him,
place two {mall bafons of very hot
water, one before, and the other be-
hind
152 Of thofe things, which
hind him; fo that the vapour may
come to the whole body, except the
face ; by which means the fkin will
be rarefied, and difpofed to receive
the erumpent humor. For the fur-
face of the body may, in this cafe,
be compared to a leech, which, to
cool its own heat, attraéts whatfo-
ever it'can. And by this manage-
ment, not only is the fkin foftened,
but the ftrength of the patient is al-
fo preferved: fo that nothing can_
be more proper.
Ass to furnaces and baths, they
are both deftrudtive at this time, by
fo over-heating and weakening, that
a {wooning follows ; by which na-
ture is diverted from its work -with
great danger, if the fit be violent
and long: for nothing is a greater
indication of the approach of death,
the natural heat retiring into the
inner parts; after which it will be
foon
haften the eruption. 153
foon oppreffed and extinguifhed by
the over-abounding humors. Like-
wife, when the hot vapour, which
I have directed, is ufed, it muft ne-
ver be fuffered to cool upon the bo
dy ; but is prefently to be wiped
and dried off, with great diligence.
This method is abundantly fufficient
to forward the coming out of the dif-
eafe, when nature is not languid, or
the humors too thick and vifcid.
Bur in cafe it happens, that the
outward fever is indeed mild, but
anxiety and inquietude continue,
and the eruption is difficult ; you
muft wait till the fifth day is over,
and then ufe thofe medicines which
promote the eruption. But this is
to be done with great caution, and
all manner of attention, in the way
which I have mentioned, when
{peaking of the rules to be obierved
in giving extinguifhing remedies ;
for
154 Of thofe things, whith
for an error here, although it be not
{o great as the other, yet is alfo dan-
gerous. And the caution confifts
in not being too hafty in giving
thefe medicines, but to infift upon
the former regimen, as long as there
is any profpect of fuccefs without
them; and as long as you are not
yet certain, that the fever is too re-
mifs in the inward parts, as well as
itis in the outward. This you will
eafily know, by the pulfe and refpi-
ration not being too quick, full, or
irregular; and if, in feeling the
breaft, you do not find it hot in
the higheft degree. For though the
fever be doubly or trebly increafed,
it will not therefore be mortal; as
you may judge by comparing this
with other fevers, which you have
obferved in perfons of the fame tem-
perament, and in the fame degree of
heat with your patient, who never-
thelefs have recovered.
‘THESE
haften the eruption. 155
Tues extinguifhing remedies
are alfo to be applied, when, as foon
as the puftules appear in the fkin,
the patient feels himfelf to be pretty
well, and his pulfe and breath are
eafy. But if, on the other hand,
the eruption goes on flowly and
with difficulty, they muft be abfo-
lutely forborn : for to ufe them,
is to ftrive againft nature, and check
the protrufion. And when any an-
xiety follows upon the ufe of extin-
guents, efpecially a palpitation of
the heart, be fure that you~ haye
committed a great error. You mult
therefore immediately take all pof-
fible pains in foftening the fkin, ig
the manner I have taught; and
give to drink frequently warm wa-
ter, either alone, or in which fen-
nel and {mallage- feeds have been
firft boiled, and the like fimples,
which conduce. to the eruption 5
according as the heat of the pati-
Y 2 ent,
156 Of thofe things, which
ent, and his ftomach will bear them;
regard alfo being had to the flow-
nefs of the pimples in coming out.
Tus is the defcription of an ealy,
gentle medicine, which, without
too much heat, promotes the eru-
ption.
Taxe yellow figs to the number
of thirty; raifins, the ftones being
taken out, twenty drachms; pour
upon them three pints of water, and
let them boil till they are diffolved.
Give to the patient of this liquor
half a pint, at three feveral times.
‘Then cover him up well in cloaths,
and foment the body, as is above
directed.
THE following is yet more pow-
erful.
Taxe of the aforefaid decoction
four ounces; of the deco@ion of
fennel and fmallage - feeds,’ two
ounces ;
haften the eruption. 169
ounces ; let the patient drink it, as
has been direéted.
One ftill more efficacious is this.
Bort fennel-feeds and {mallage-
feeds, of each ten drachms, in an
earthen vefiel, till the water is red;
{train it, and give three ounces at a
time.
Lastiy, this compofition is very
good and ufeful, at feveral times.
Take of red rofes four drachms ;
of lentils decorticated nine drachms;
yellow figs ten ; of gum tragacanth
three drachms; of white raifins
{toned ten drachms ; lack, cleared
from its fticks, and wathed, three
drachms; fennel and {mallage-feeds,
of each five drachms. Boil all thefe
in three pints of water, to one pint:
Strain the liquor, and give half a
pint of it, with a fixth part of a
drachm
POPE fm?
158 Of thofe things, which, &c.
drachm of faffron, twice or thrice,
as there may be occafion.
We fhall now {peak of thofe parts
of the body, of which care is to be
taken.
CHAP.
Of taking care, 8c. 159
TPES SR a ie
CH'A P. VIL
Of taking care of the throat, eyes, Pe.
as foon as the puftules have ap-
peared.
A S foon as ever the figns of the
{mall pox appear, particular
care muft be taken of the eyes, the
throat, the nofe, and ears, and alfo of
the limbs, in the way Iam going to
defcribe. Nay, fometimes it will be
neceffary to extend our care even to
the foles of the feet, and the palms
of the hands: for oftentimes violent
pains arife in thefe parts, the hard-
nefs of the {kin hindering the eru-
ption.
Upon the firft appearance of the
figns, drop rofe-water into the eyes
how and then; alfo wath the face
with cold water often in a day, and
{prinkle
160 Of taking care of the
fprinkle the eyes with the fame. For
if the difeafe be mild, this method
will prevent the puftules breaking
out in them. This ifideed is to be
done, for greater caution ; for in
the mild fort, it feldom happens, that
any puftules break out on the eyes.
But in a-bad fort, when you fee a
large eruption in the beginning, with
an itching of the eye-lids, and red-
nefs of the white of the eyes, fome
places of which are redder than o-
thers; you may be affured that the
{mall pox will break out there, un-~
lefs great help be given : therefore
immediately drop rofe- water, in
which fumac has been infufed, into
the eyes, feveral times in the day.
It will be ftill more effectual to
apply a collyrium, made of galls in
rofe-water, by dropping it into the
eyes ; or to inftil into the eyes
what is fqueezed from the pulp and
. {kins
throat, eyes, Sc. 161
fkins‘of the four pomegranate, firft
chewed. Then wafh the eye-lids
with a collyrium, made of the water
of quinces, the juice of unripe grapes,
boxthorn, aloe, and acacia: of each
of thefe let there be one part, and
a tenth part of faffron; and drop
fome of it into the eyes.
Bur if you obferve a turgefcence
in the humors, and the eruption to
be very copious, fo that puftules will
certainly fall upon the eyes, becaufe
rednefs appears here and there in their
white part, from the excefs of the
inflammation ; and alfo find, that
what you have applied does not re-
move that rednefs, but only leffen
it fora time; after which it returns
more violently than before, or at
leaft continues as it was, when you
began this treatment; you muft
not proceed any longer in this me-
thod, but, inftead of thefe things,
Z drop
162 Of taking care of the
drop into the eyes fome of the acid
liquor expreffed from mouldy bread,
with the Vabathean bitter, in which
there is no vinegar, or other acid.
As to the puftules, which break
out in the tunica cornea of the eye,
thefe darken the fight, and are to
be cured, according to the degree
of their thicknefs, by fuch diffolv-
ing remedies, as I am going to de-
{cribe : which indeed are fometimes
effectual, and fometimes not; the
fuccefs depending upon the matter
being more or'lefs thick, and upon
the greater or lefs firmnefs and dry-
nefs of the body.
But if large puftules fhew them-
{elves in the tunica uvea, ule the
collyrium of rofe-water feveral times
in the day and night, with great di-
lizence; or elfe that before-men-
tioned, leaving out the faffron ; in-
ftead of which, put a {mall quan-
tity
throat, eyes, &e. 163
tity of blood-ftone, to keep down
the fwelling.
Tuzse things are what ought to
be known concerning the eyes. Care
is next to be taken of the throat and
mouth, left any eruption there fhould
grieve the patient, and hinder his
breathing ; for it often happens, that
in a bad kind of the difeafe, terrible
fuffocations are brought on, which
leave no hopes of a recovery.
Tuererore, on the firft ap-
pearance of the figns of the {mall
pox, let the mouth be gargled
with the water of acid pomegra-
nates, or of fumac, or with the
juice of mulberries, or with fome of
thofe things, which we have recom-
mended, (chap. V.) under the head
of extinguent remedies ; or laftly,
if nothing elfe be ready at hand,
with pure cold water; and that very
often, to prevent a great eruption
eS into
164 Of taking care of the
imto the throat and mouth, and
ftrengthen thofe parts, or at leaft
hinder what is already broker. out
there from caufing a fuffocation. Be
quick therefore, and diligent in ap-
plying this cure, efpecially, if from
a hoarfenefs of voice, ftreightnefs in
breathing, and a pain in the throat,
a neceflity of it fhall appear,
Moreover, if the ftrength will
bear it, take away blood from the
cephalic vein; and that even after
the whole eruption is over. And
if the patient find any thing in his
mouth, or throat, which hurts him ;
and yet there is not too great < heat
there, neither are his bowel: too
loofe, let him lick by degrees of freth
butter mixed with white fugar-can-
dy. But if there be any heat and
inflammation there, give a linétus
of this kind.
TAKE
throat, eyes, &ec. 165
Take of fweet almonds decor-
ticated one part; of the feeds of
gourd two parts ; of white-fugar-
candy three parts; the mucilages of
the feeds of flea wort, and of laurel-
berries ; a linus of gum-arabic,
almonds peeled, and the feeds of the
plane-tree, and wheat-flower : mix
all thefe with a mucilage of quince-
feeds.
In the next place, let us take care
of the limbs : for upon thefe a num-
ber of very bad puftules often. arife,
whieh corrupt them to fucha de-
gree, that the mufcles, tendons,
nerves, and the bones themfelves
lie bare. Aflift therefore immedi-
ately, if you obferve the figns of the
difeafe to be violent and exceflive;
that is, bathe the limbs with fan-
ders, quince-water, Armenian bole,
rofes, camphire, vinegar, and rofe-
water: but take care not to overdo
it. If the puftules are very large,
open,
166 Of taking care of the
open them with an incifion-knife,
to let out the matter: and delay not
this operation ; for the cafe is dan-
gerous.
Now let us come to the cure of
the nofe and ears, left they fhould be
over-filled with the pimples : for this
will greatly afflia@ the patient; and
when they break out in the inter-
nal part of the ear, there is danger
of their coming prefently into the
nofe. Take therefore a cotton cloth,
upon which camphire has been bro-
ken ; by the help of this, put into
the ear fragrant wine-vinegar, to
which has been added quince-wa-
ter, or the juice of boxthorn. Do
this in the morning, and repeat it
twice or thrice a day. -
Last y, if a great pain arifes in
the foles of the feet, prepare inftant-
ly to anoint them with warm oil,
and foment them with warm wa-
ter
throat, eyes, &Fc. 167
ter and cotton. If this does not af-
{wage the pain, nor facilitate the e-
ruption, beat up decorticated fefam
with milk; anoint with it, and
bind it on with cloths, and leave
it upon the age all night. In the
morning, put the foot into warm
water ; ang repeat the fame again.
Or etait dates with butter, and ap-
ply them; or, laftly, anoint with
the lees a the fefamine-oil. For,
thefe, and the like things, foften and
relax the fkin; and by this means
diminifh the pain, and promote the
eruption.
368 Of ripening
etintok * IT WOK EDs K HeMM es
OOK EO oek Wooo AGOw
CHAP. VIII.
Of ripening the {mall pox.
HEN, after the eruption 1s
W completed, you obferve the
puftules tend too flowly to maturi-
ty, and yet that the patient is other-
wife in a very good way, as to his
refpiration and pulfe, and pretty
free from inquietude and anxiety ;
then it behoves you, to affift the
maturation of the puftules.
Bur if, together with a back-
wardnefs of ripening after the eru-
ption, you perceive the puftules to
become hard and warty, and the pa-
tient not at all better ; or if his ill-
nefs increafes; then you are to know
that the {mall pox is mortal. Where-
fore, have no thoughts of ripening
the
the fall pox. 169
the puftules ; for they are of that
kind which cannot be ripened.
Now, the maturation of the {mall
pox, if curable, is to be effected by
fomenting the body with the fteam
of a hot decoétion in water of ca-
momile, violets, melilot, marfh-
mallows, and bran, either feparate,
or collected together in two bafons;
as we have directed above, where
we treated of facilitating the eru-
ption.
Anp if then the patient feems te
find relief and refrefhment by the
fomentation, you are to abftain
from thofe fumigations, which are
commonly employed for drying up
the puftules; until they ripen of
themfelves, and are capable of bear-
ing thofe things, which contribute
towards drying them up: of which.
we are now going to treat.
Aa CHAP.
170 Of drying the puftules.
SOOO OIC OOOK IOI OIOK
$e SERIES SEER IIHR KISHORE
ed § Ga gt hae
Of drying the puftules.
F the puftules are large and very
numerous, they muft be dried ;
or the fluid contained in them muft
be foaked up with fine clean cotton,
in which there is nothing that may
hurt the patient. And then let fu-
migations be made with the leaves of
dried rofes, or with the leaves of the
ftorax-tree, or with fanders, or with
the leaves of the ivzs, or the tama-
rifk : and indeed rofes are more con-
venient in fummer, but tamarifks in
winter.
‘Fue {mall ‘e fometimes abounds
with too much moifture. When that
happens, order the patient to lie on
pounded rofes, or on rice-meal, or
on
Of drying the puftules. 27%
on millet-meal, with which a mat-
trafs of a thin texture is fluffed.
Ir the body be full of puftules,
lay moift leaves of the iv7s under the
patient ; and befprinkle him with
an aromatic powder, made of aloe,
frankincenfe, farcocol, and dragon’s
blood.
Bur if the puftules break {ponta-
neoufly, or from the quantity of the
fluid contained in them, and are
flow in drying, treat them in this
manner.
Taxe of fefamine-oil one ounce ;
of Andarene(r1) falt pounded fine, and
of alum, each two drachms. With
this liniment anoint the body, care-
fully avoiding thofe- places, which
are ulcerated or excoriated, or even
too near an approach to them; _be-
(1) Andar isa village, | white foffil falt is found.
a mile diftant from 4- | See Maundreil’s jour-
leppo, where a very | ney.
Aa2 caufe
172 Of drying the pufiules.
caufe the medicine would raife a vio-
lent inflammation. Let the. lini-
ment lie on the parts for the fpace
of an hour; then wath it off with
a decoction in water of emblic my-
robalans, white tamarifk - berries,
myrtle - leaves, and pomegranate
peels.
Ir the puftules are dried by thefe
means, it is well; if not, take the
whiteft fort of bole (not the red
bole)* add to it of Andarene falt,
and of dry bread crumbled fine,
each a tenth part. Make a liniment,
with which rub the fkin; let it lie
on for an hour or two, and then
wath it off.
Now we are to treat of taking
off the dried fcales, and crufts, or
efchars.
CHAP.
Of taking away the dry fcabs
and efcars.
W HEN the {mall pox is wi-
thered, and the dry fcales and
efchars {till remain on the fkin, exa-
mine them well; and to thofe that
are {mall and thoroughly dried up,
apply warm fefamine oil every now
and then, till they are foftened, and
fall off: but thofe of the face are to
be managed with oil of piftaches.
For the larger fort, which refemble
efchars, if you find any moifture
remaining in them, cut them off
carefully, without any application
of oil. And if the places, from
whence you have removed the ef-
chars, contain but little moifture,
it is to be dried up with foft cotton,
as
174 Of iaking away &e.
as I have already faid: but if they
contain much, they are to be dried
gradually ; befprinkling them with
the red aroriatic powder, compofed
of aloe, frankincenfe, farcocol, and
dragon’s blood, efpecially if they
begin to leffen, and fink in; and
with alum and Andarene falt) if
they are even with the reft of the
furface of the body, and do not
fink in: then wait till a new ef-
char or {cab is formed on them. If
there be any return of moifture, re-
peat the fame dreflings. And in
fine, when the moifture is entirely
exhaufted, then anoint the parts with
oil, until the crufts are foftened, and
all fallen off.
Next follows a difcourfe on de-
ftroying the marks of the {mall pox,
CHAP.
Of defiroying the marks Bc. 75
OOO 7 OG OG
GEE As Pei X:
Of defroying the marks of the
Small pox.
ap marks of the fmall pox
are of two forts: for they are
either in the eye, or on the reft of
the body. Now with ref{pect to the
eye, the part on which the {mall pox
broke out, has an opaque white-
nefs in it, as we have already ob-
ferved. If this happens in the eyes
of children, or young perfons of a
moift conftitution of body, and ten-
der fkin, it will be the more eafily
deterged.
Now the medicines, which de-
terge the eye, and take off the white-
nefs, are thefe: borax, or. nitre
made into cakes, Andarene falt, fal-
ammo-
176 Of deftroying the marks
ammoniac, glafs, the {cori of glafs,
coral, tutty, lapis hematites, verdi-
greafe; baftard fponge, the fea
crab, the dungs or excrements of
fparrows, fwallows, ftarlings, mice,
bats, and of the Arabian or Lybian
lizard; mufk, the fediment of urine;
the acorus, ebony, cornel-water, A-
rabian fugar, dregs of vinegar burnt,
myrrh, fandaracha or juniper gum,
commonly called varnifh, gums-of
the olive and bitter almond-trees,
and the milky juice of wild lettuce.
It will be beft to ufe thefe, when the
patient is juft come out of the bath,
or after holding his head over the
{team of hot water. But mild me-
dicines alone, nay the mildeft of
thefe, are to be employed, efpeci-
ally in foft and moift bodies.
T ue defcription of a mild me-
dicine, which removes the white
fpecks from the eye.
Ler
Let the eye be fprinkled with
farcocol, and white fugar-candy.
ANOTHER more efficacious.
Ler the eye be fprinkled with
baftard {ponge; farcocol, and fugar.
Anoruer ftill more powerful.
Take of verdigreafe ten drachms ;
myrrh, fagapenum, {fal ammoniac,
farcocol, of each two drachms and
half ; baftard fponge, fcorie of
glafs, and borax, or nitre in cakes,
of each three drachms. Then take
of {weet cane ten drachms, and the
fame quantity of cornel-water. Boil
thefe in ten times the weight of
water, till the decoétion becomes
thick : then diffolve the gums in it,
and mix all well together into an
ophthalmic collyrium. Afterwards,
as occafion fhall require, to this
mixture add ebony in an oil-bottle.
Cleanfe the part affected gently and
often with a needle or ftyle; taking
Bb care
of the mall pox. 177
178 Of defroying the marks
eare to apply the collyrium frequent-
ly, both before and after the opera-
tion. And laftly, fprinkle it with
the powder of the milder fort of the
medicines. But be fure to look
carefully into the eye every day.
For if it be pained, or look angry,
omit this treatment for fome days,
and then repeat it ; for this method
of cure is very powerful and effica-
Cc1oUus.
As to the medicines, which take
off the marks of the fmall pox from
the face and the reft of the body,
they are thefe: white litharge, dri-
ed reed- roots, rotten bones pow-
dered, baftard fponge, coral, farco-
col, almonds, birthwort, the ben
nut, radifh-feed, pumpion - feed,
rocket - feed, the flower of beans,
rice, lupins, and kidney-beans. On
thefe pour the agya amurce, and
barley-water.
Tue defcription of a liniment,
which
of the fmall pox. 179
which effaces the marks of the {mall
pox.
Take of the flower of chiche: and
beans, each three drachms; of pum-
pion-feed five drachms; of white li-
tharge two drachms ; of dried reed
roots three drachms. Pound all to-
gether in barley-water : then apply
it to the parts feveral times fuccef=
fively, after the patient has received
the fteam of hot water, or after
coming out of the bath. Then
again wafh him in a bath, made of
pumpion-rinds, dried violets, bran,
and pounded chiches, boiled in
water : rub him well, and apply the
liniment a fecond. time.
Tue defcription of another lini-
ment of greater efficacy.
Take of bean-meal five drachms ;
bitter almonds, fweet coftus, rocket-
feed and radifh-feed, of each two
Bb 2 drachms
180 Of deftroying the marks
drachms and half: apply it, as we
have already directed.
Anortuer liniment more effica-
cious ftll.
Taxes of bitter almonds peeled
five drachms; radifh-feed, rocket-
feed, roots of coftus, and long birth-
wort, of éach two drachms and
half; of borax, or nitre made into
cakes, three drachms ; of pepper one
drachm and half: ufethem, as we
have already directed. Afterwards,
wath the parts with radifh-water,
or with thofe things, which we have
ordered. And thofe are the medi-
cines, which efface the marks and
{cars of the {mall pox.
Bur in order to efface the pock-
holes and render them even with
the reft of the furface of the body,
do thus: let the body be anointed
with butter, and well tinged with
the herb cyperis, or with its pow-
| der :
of the mall pox. 181
der: let the patient ufe the bath
frequently, and be rubbed down af-
ceric.
Now we are to dire what ought
to be given toa patient in the {mall
pox by way of aliment, and to treat
of the medicines which haye rela-
tion to it.
182 Of the diet of patients
Cl. ats als ia 4 allenic lsd’
SE ee Re ate aie ee lle ae
Git AY... AU,
Of the diet of patients in the fmall
pox.
be ty a patient in the {mall pox it is
neceffary to give barley-water,
prepared in the fame manner, and
with the fame art, as that, which
is ufually given to perfons in acute
and hot difeafes. If the fever be
moderate, and the body fomewhat
coftive, it muft be fweetened with
white fugat-candy ; but if the heat
of the fever be intenfe, and the bo-
dy loofe, pour to it half a meafure
of the juice of acid pomegranates,
pounded with their feeds: but the
pulps and inward thin tunicles are to
be avoided ; for they are laxative.
Ir the patient be reftlefs, and
cannot
in the {mall pox. 183
cannot fleep, add to the barley-wa-
ter fome proportion of poppy. But
if the body be very loofe, add to the
barley-water one part of dry feeds of
acid pomegranates, and one part of
se 9 i de
Bur, if it be requifite to bind the
body, inftead of barley-water, take
meal of peeled barley, and the meal
of pomegranate-feeds; boil thefe in
the fame manner as barley-water is
made, and let the fick drink of this,
as he would drink of barley-water ;
either alone, or with Bambu-fugar
and gum Arabic mixed with it, if
a loofenefs fhould make it neceffary ;
er with the medicines which I fhall
defcribe anon. For barley-water,
mixed with pomegranate-juice, is
very fervieeable in the fmall pox,
and more efpecially in the meafles.
But the waters of the gourd, of the
Indian pumpion, and of the —
er;
184 Of the diet of patients
ber; the mucilage of fleawort-feeds,
and the like, of whateverkind, which
make a mild phlegm, and. eafy to
be fpit up ;. thefe waters, I fay, are
more ufeful in the meafles, than in
the {mall pox ; unlefs it be in thofe
forts of the fmall pox, which are
accompanied with a malignity and
heat, together with a violent fever
and want of fleep.
But in thofe cafes of the fmall
pox, wherein the fever and inflam-
mation are not fo vehement, thofe
things above mentioned, and. others
of the like kind, have no other ef-
fe&, but to render them flower,
and to protract the whole courfe of
the difeafe: wherefore it will be
your bufinefs to have recourfe to
this or that fort of medicines, or to
abftain from them, as occafion fhall
require. For when the {mall pox
happens to be in the higheft degree of
heat
in the fmall pox. 185
heat and putrefaction, with the ad-
dition of moifture; then thofe
things, which have a cooling, dry-
ing and condenfing quality, are
more proper; fuch as juice of pome-
granates, verjuice, and others of
the fame nature.
Bur when the difeafe is the mea-
fles, which arife from a vehement
ebullition of the bile blended with
the blood; thofe things, which have
the twofold virtue of cooling and
humeéting, are the moft proper in
their cure; inafmuch as the cor-
tupted blood is tempered and cor-
rected by their means. For the
blood of a perfon, in the meafles, is
like ftagnating water, which putre-
fies by long ftanding ; whereby its
natural texture is deftroyed, and,
by the action of the fun, it contraés
a vicious acrimony. But if thefe
waters are mixed with rain or any
Cec ether
186 Of the diet of patients
other running {weet water; they
{oon recover their former whole-
fomeneds.
Moreover, in the fmall pox
barley-gruel is beneficial, if it be
taken with fugar and pomegranate-
juice, or with a proper quantity of
julap; giving due attention to the
patient’s loofe or coftive {tate, as
likewife to his greater or leffer de-
grec of heat : except that barley-wa-
ter is lighter to take, eafier to fwal-
low, and more fuitable to the throat
and breaft. Wherefore, a&t accord-
ing to thefe directions, after you
have been apprized, that barley-wa-
ter is more proper for perfons in the
meafles, than in the {mall pox;
unlefs the fmall’ pox happen to be
of a bad fort, in the manner we
have mentioned.
Asto the reft, vetchcs well cleanfed
are good in the {mall pox, if a food
be
in the fmall pox. 183
be prepared of them with the juice
of acid pomegranates, or with vine-
gar: the meal of lentils is ufeful al-
fo, if the meal be wrought up with
cold water.
Know likewife, that cold water
is more ferviceable to a patient in
the meafles, than in the {mall pox;
as being fafer, and of a more cer-
tain effect. |
Now, when you fee the {mall
pox attended with great infamma-
tion, and a ftoppage in the pulfe
and refpiration; then give extin-
suifhing medicines, proportioned to
the fymptoms: if they are lefs ur-
gent, employ few; if very urgent,
employ many.
Bur never allow the eating of
young birds, untill the pulfe and
breath have returned to their na-
tural ftate; nor till the puftules are
Cc2 tho-
188 Of the diet of patients &ec.
thoroughly withered, and the {cabs
fallen off.
Let us now turn the difcourfe
upon loofening the belly, and re- >
ftringing the fare 3 in the {mall pox.
tL,
shy Nites oF can
~ ty ") $A x 2
CHAP;
Of managing the 8c. 189
“Bae HA SRO HOR, RH HE ye
HM Rene amt Reale wee glee,
CG bP AgiP.: - XI.
Of managing the difcharges of the
belly in the Small pox.
T HE belly.is generally loofe in
the fmal] pox and meafles to-
wards their decline, but efpecially
in the meafles. For which reafon,
every thing muft be avoided which
opens the body, after the fmall
pox and meafles are condudted to
the end ; even though the body be
bound. But if it be lax, inftantly
abftain carefully from thofe things,
which give ftools: altho’ it be ne-
ceflary in the beginning of thefe two
difeafes, and before they are on the
decline, to give a laxative. For it
is fometimes requifite to open the
body in the fmall pox, either upon
account of the excefs of heat, and
pain
190. Of managing the difcharges
pain in the head ; or in order to eafle
nature of her load, and leffen the
morbific matter, when you have
reafon to think it over-abundant.
And it will be really fo, when you
find the body, both before and after
bleeding, neither weakened nor waft-
ed; but, on the contrary, bloated
and full, with a palenefs, or a little
rednefs, and a fluctuating pulfe.
For fometimes, in fuch a ftate, bleed-
ing will not be neceflary, and it will
be fufficient to evacuate the fuper-
fluous humidity : and that efpeci-
ally, when the aforefaid figns evi-
dently appear; and befides, if
through the fluggifhnefs of the fe-
ver, the body be dejeéted, and en-
tirely void of a red colour. In this
ftate, a very proper medicine is a
Jecoétion of yellow myrobalans, if
it be drank with white hard fugar,
and the juice of an acid pomegra-
nate, (two or three, if there be oc-
cafion)
in the fmall pox. IOI
cafion) bruifed with the pulp and
internal tunicles. For it is the qua-
lity of thefe two medicines to purge
the body of the fuperfluous humors,
together with part of the bile, with-
out raifing any heat ; efpecially the
pomegranate juice; and to leave
nothing behind them in the inte-
ftines. And this is the beft medi-
cine, which can be given in this
cafe.
Bur in the meafles give the juice
of Damafcene plumbs,and the plumbs
themfelves, frefh - gathered, either
alone, or bruifed with julap, ad-
ding fugar tothem, But avoid the
medicine called Zarangioben(1): for
it is as prejudicial in the meafles,
as honey is in the {mall pox; both
upon account of the exceflive heat,
(1)°A fort of Manna | on the leaves of certain
among the Sogdians, | fhrubs, and is gather-
Medes, and Babyloni- | ed thence.
ans, which concretes |
which
192 Of managing the difcharges
which it occafions, and of increaf-
ing the naufeating and uneafinefs
éf the fick, .; In like manner, care-
By avoid giving them the juice of
ivy, or of the black violet to drink :
kecawi they both equally heighten
the diforder in the body.
N ow, whereas the firft and moft
neceflary remedy in the {mall pox
x, to draw blood, when it is too
much in quantity, or there is no
profpect of checking its ebullition
by any other means, even by ex-
tinguents; but hele is a neceflity
for taking a little away, as well for
relieving nature, as for abating the
fulnefs of the blood -veflels, and eafing
them of their over-great load, which
muft otherwife be productive of very
bad confequences; efpecially if the
blood be heated to that degree, that
2 violent inflammation might enfue:
in the fame manner, it behoves you,
in
in thé {mall pox. 193
in the beginning of the meafles, to
draw off fome of the bile, when
you perceive it over-abundant ; and
then to purfue what remains of it
by extinguents. Now the fign of
an exceflive redundancy of the bile
is, the violence of the inflammation,
and the uneafinefs, together with
the difcharge of the fame bile, both
by vomit and ftool, and a bitternefs
in the mouth.
Bur if the quantity of the bile
is not exceflive, and yet there is
an uneafinefs, and thirft, and vehe-
ment heat, without any appearance
of bile, either by vomit or ftool;
though its quantity, I fay, be'not
exceflive, we may however judge it
to be of a bad quality, in proportion
to the violence of the inflammation
and uneafinefs.
Anp this is what I have thought
proper, that you fhould know, con-
Dd cerning
194 Of managing the difcharges
cerning the management of the dif-
charges of the belly, when it is loofe
in the beginning of thefe two dif-
tempers. Now, if the belly: be lax,
give nothing laxative: for in this
cafe, any thing that increafes the
difchargesis not fafe in either of the
diftempers. But while the belly con~
tinues loofe, order the patient, in-
ftead of barley-water,to drink barley-
gruel; and if it be neceflary, boil
the barley-gruel with meal of pome-
ranate-feeds; of which let him.
drink, before he returns to the ufe
of barley-water. And if, this not-
withftanding, the loofenefs ftill in-
creafes, mix gum-Arabic and Bam-
bu-fugar in. his drink in this man-
ner.
T axe of gum-Arabic two drachms;
of Bambu-fugar one drachm: re~
duce them to. the confiftence of a
collyrium: then on four ounces of
the
in the {mall pox. 195
the barley-gruel pour fome of the
medicine, which I am going to de-
{cribe; let it ftand for an hour, and
give it to the’patient to drink.
Tue defcription of the medicine,
T axe of red rofes ground fine,
Bambu-fugar, forrel - feed, fumac,
and berberies, of each equal parts ;
alfo gum-Arabic, fealed earth, pop-
py-tinds, balauftines, or pomegra-
nate-flowers, of each half the quan-
tity: let the patient drink three
drachms of thefe, with one ounce
of the juice of acid pomegranates.
But, if the loofenefs ftill conti-
nues, and has weakened the patient,
give him draughts of 4/-raib, that
is, four fkimmed milk, with the beft
fort of bifcuit, and a littl gum-A-~
rabic.
Finatty, whenever a dyfentery
appears, the method of cure muft
d2 be
SSS eae
196 Of managing the &c.
be taken from the place, where we
have treated of that fubje@. ™
N ow it remains, that we fpeak
of thofe, who recover, and of thofe,
who die of the {mall pox and
meafles.
CHAP,
Of the curable &c. 197
EVEL AH NOVA SEH S Eee SESS EE EET
FE A: Ps KTV.
Of the curable and incurable fmall
pox and meafles.
H E {mall pox and meafles are
of the number of hot difeafes,
and therefore have many things in
common with them. Now the chief
prognoftic figns in thofe, who re-
cover, are, a freedom of refpiration,
a thorough foundnefs of mind, and
an appetite for food; an agility to
motion ; a right ftate of the pulfe ;
the patient’s good opinion of his dif-
eafe; a convenient pofture in bed ;
and but little toffing about and in-
quietude of body.
Hence a judgment may be
formed of bad figns, the greateft
part
198 Of the curable and
art of which we have related in the
‘book, intituled 4/-man/ori (1).
Turse things following parti-
cularly regard the {mall pox and
‘meafles.
Wuen the puftules of the fmall
pox are white, large, feparate, few
yn number, eafy and fpeedy in com-
ing out, and the fever not violent
or burning, nor attended with much
inquietude of body or concern of
mind; and are fo qualified, that
the heat, concern, and inquietude
diminifh upon their eruption, and
entirely ceafe, when the eruption is
completed: that fort is curable,
and threatens little or no danger.
To thefe the next in goodnefs are,
white large puftules, though very
numerous and coherent; if they
come out eafily, and their total e-
(1) There is a MS. co- | Bodleian library, Nar-
py of this book in the | cif. Marfh, N°. 376.
ruption
incurable {mall pox, &e. 199g
ruption eafes the patient of his un-
eafinefs and exceflive: heat, as. we
have already mentioned.
Burr when their eruption is per-
formed: with difficulty, and the pa-
tient does not grow better upon
their coming out, they area bad
fort: ‘although there is not fo much
reafon to be afraid, if he fhould be
ill while they are coming out, as if
he: continues fo after the: eruption.
Bur there is § bad, and: even &
fatal fort of white large puftules, to
wit, thofe which run together, and
fpread. fo that many of them unite,
and occupy large {paces of the body 5:
or become like broad circles, and in:
colour refemble fat.
As to thofe puftules, which. are
white, very {mall, coalefcing, hard,
warty, and contain no fluid ; they
are of a bad kind: and their bad-
nefs
200 Of the curable and
nefs is in proportion to the degree
of difficulty in their ripening, and
to the continuance of the fymptoms
on their eruption. But if the fym-
ptoms are not abated, after the e-
ruption is finifhed, it is a mortal
fign,
Tuose puftules alfo are all bad,
which turn green, purple, or black.
But if, befides, a {wooning and pal-
pitation of the heart come on ; this
is the worft fign of all, nay a fign
of certain death.
Anp when the fever increafes af-
ter the eruption of the {mall pox, it
is a bad fign. But if the fever ceafes
at the time of the eruption, it is a
good fign. Doubled puftules indi-
cate a great quantity of the matter
of the difeafe: and if they are of
the curable kind, they portend. re-
covery 3
incurable jmall pox, Fc. 20%
covery ; but if of the mortal kind,
death.
THoses meafles are the fafeft
which have not too much redne§ :
but if they turn pale, it is a bad
fign ; the green and purple forts are
both mortal. When either the {mall
pox or meafles fink in fuddenly, af-
ter they began to fhoot out; and
then the patient is feized with in-
quietude and anxiety, and a {woon-
ing comes on ; it is a fign of {peedy
death ; _unlefs they pufh out again,
after they have fubfided.
Ir the puftules appear on the firft
day of the fever, they will haften
their progrefs, and be of quicker
motion: if the eruption is protract~
ed to the third day, it will advance
moderately ; but if the firft appear-
ance pafles the fourth day, the eru-
ption will be completed dully and
flowly.
Ee WHEN
202 Of the curable and
W 1 £N the appearance begins on
the good critical days, it isa falu-
tary fign, efpecially if the patient
Gnds himfelf better at the end of
the eruption ; and fo on the con-
trary. But when the puftules be-
gin to'run into one another, and to
{pread ; and at the fame time the
jnquietude _increafes confiderably,
and the belly fwells or is bloated ;
then death is near at hand. When
the fmaller fort of puftules, which
contain no fluid, grow hard ; and
a delirium comes on atthe fame
time; the patient is near his end.
When it happens that the {mall pox
and meafles appear and difappear
alternately, and are attended with
anxiety anda delirium; this is a
fign of death, of what colour foever
the puftules are: but it is feldom
the cafe of white puftules, or of
thofe, which ripen quick. When to-
wards the end of the {mall pox,
there
incurable {mall pox, Ge. 203
there is a great perturbation of the
humors, and the patient is feized
with avery violent pain in a leg,
hand, or any other limb ; or the pu-
ftules are fpeedily converted intoa
green or red colour; and thereup-
on he grows weaker than he was
before, and the weaknefs ftill in-
creafes by the quick returns of the
pain, and the limb contraéts vari-
ous colours ; thefe are figns of death,
But if neverthelefs the patient grows
ftronger, he will recover, and that
limb will be cured.
Now if you fcarify that limb
the very moment, when the pain
begins to feize it, you will render
great fervice to the patient, if he
grows ftronger after the incifion ;
and the limb will alfo be preferved
from mortification.
Burt, in this dangerous cafe, no-
thing cooling muft be applied to
the
204 Of the curable, &c.
the limb, upon any account what-
foever: but either fcarify it, or
plunge it into hot water, if you
fee that the patient can bear it.
WHEREFORE, as we have run
over all the articles, which we pro-
pofed to ourfelves ; and have am-
ply enough treated, both of this
difeafe, and the method of prefer-
vation from it; we here break off
the thread of our difcourfe.
To the beflower of firength to finifh
this work, be praife without end,
as he is worthy of being celebrated
and praifed.
The END.