A vindicatory schedule concerning the cure of fevers containing a disquisition theoretical and practical, of the new and most effectual method of curing continual fevers, first invented and delivered by the sagacious Dr. Tho. Sydenham : also shewing by way of preliminary, the indispensible charge lying on physicians to improve themselves and the art ... : with an appendix of Sanctorius his Medicina statica ... / by Andrew Broun, M.D.

SECT. XIV. The further Helpers in Fevers considered, and how they work and confirm the Hypothesis; such as fixed and volatile Salts, Alcaline and Testaceous Concrets; and also Cup∣pings, Leeches, and Frictions. Where∣also some Phoenomena of Hurters are consi∣dered; as the continual Sweats in Fevers: And the continual lying in bed: And lying with the head much Depressed: For all which, Reasons are given confirming the Hypothesis.

IT remains in the next place to enquire into other Helpers and Hurters in Fe∣vers, how they Operate, and if the expli∣cation of such Phoenomena can bring any light to the foresaid Hypothesis: And first, as for helpers volatile, and fixed salts, are by the consent of all granted to be very effectual, which altho in the case of a copious fomes they seem not to be ••afe, yet the clearing how they work, may shew as that they are

effectual, so when they are fit: then to answer this it would be noticed, that as the state or crasis of the blood may be vitiate two wayes, so there may be so many wayes stops and bolts put so the motion thereof in∣ducing its slowness and making it need more frequent or greater pulses to drive it on to distribution; And first, when the se∣rosity of the Blood, endued with due te∣nuity serves for a fit vehicle for the globuls, but these globuls are vitiated either by their bulk, number, or in their figure; that is by scabricity, all which vi••es severally, much more when they are complicate, makes these globuls stick and stop in the small pas∣sages and channels of the vessels; and so bari∣cade up the course of the Blood, that there are raised frequent and violent pulses of the heart and arteries to remove them, and carry on the blood. The next fault in the crase of the Blood is, when the due proporti∣on in the number, bulk and figure of these glo∣buls is kept; yet the tenuity of the serum is vitiated by viscidity; and this fault also makes the Blood slow in its passage throw the small vessels; to overcome which the heart does excite great and frequent pulses likewise; In the first case, where the glo∣buls are only vitiated, and the serum intire;

the sick are infested and weakened with sweats; Because the frequent pulses drive away the serosity of the Blood out at the pores, (which is called the dissolution of the crase of the blood) leaving the globuls cru∣ded up together in the small vessels.

And in this case fixed and Alcaline salts, testaceous and marine concrets, made in sub∣tile powder seem much to help, because all these concrets consisting (as is known) of particles very rough, scabrous and rigide, the minutest particles whereof, where ever they go carrying that Figure with them: so then such being mixed with the blood and carryed along with it must necessarly, impinging on the obstructions and scabricities in the small channels, not only scoure and clear them, but likewise by their contin∣ual Attrition of the Globuls of the Blood, they must polish and grind these globuls, and make them fit for passage thorow these chan∣nels.

As to the other state and crase of the Blood where the Serosity being viscide makes the slowness of the Bloods motion, here as there are no sweats, so it's difficult to raise, & dan∣gerous to attempt them.

Before any remedie can be justly level∣led for the removal of this fault of the Blood,

it must be first inquired in what this viscosi∣ty does consist: it seemes then that viscosity being a degree of Solidity and Firmness, and the first step from Fluidity thereunto, and that Fluidity consisting in the actual and due Motion of minutest parts of the Liquors, viscidity then must Import some abatement and diminution, as of their due Fluidity, so of their Motion; And that either from the weakness of the Principle of that Motion or the unaptitude of the matter to receive and obey Impressions of that Principle; As having some glewy viscous matter mixed therewith: But whatever it proceids from, it is certain that the outward or sensible Rest in Liquores that naturally ought to be moved, is a concurring Cause to there vis∣cosity, so the agitation of Liquors does alto∣gether take off there viscosity; As may be seen in the example of Ale, which being ropie and viscuous is by tossing and agitating th••reof in a Bottle closs stoped, soon brought to leave its viscosity: So then the viscosity of the serum of the Blood seemes to be the effect of its want of due motion; And is further a cause to hinder that due motion of the efflux and reflux; And as this visco••ity seems originaly to depend upon the serum not be∣ing duely Impregnat and Irradiat by the Spi∣rits,

which do make it diaphanous and subtile; so the want of this irradiation, may depend upon its viscosity, hindering that irradiation, and so as these causes may hinder its due motion; that want of due motion also does exceedingly contribute to its viscosity, and check the influx of the Spirits: And thus e∣very one of these are mutually causes and effects to one another. Yet unto these Ef∣••ects from whatsomever of these causes they be produced, seem much conducible all such things which give copious Matter to the generation of Spirits; and also which give them being generated also Spurrs; such as are all volatile Salts, which for this rea∣son are known to break and attenuate all viscosity: But these are indeed to be used with moderation and warriness in Fevers, least we should spurr faster than we open and clear the way; and so these Spirits too much incited should waken up or exasperat all these Scenes of Confusions and Tumults to which the Blood is very prone under this state.

It is certain, that long experience has found the use of Cuppings, Leitches, and Fri∣ctions to be very beneficial in these Fevers: The cause wherereof being enquired into, will also confirm this Hypothesis: For these

being used in several places of the Body, as they alwayes are when beneficial, by their raising the Flesh and Skin, they do shake and loose throw all the circumambient parts, that congealed and clotted Blood ob∣structing the capillary Veins; which does fa∣c••litate the arterial Blood to run more easily throw them, and that by clearing these Passages of Obstruction. And for Frication and Rubbing of the Skin, that makes such Im∣pressions on the capillary Vessels, by pressing them hither and thither, that it must ne∣cessarly force the obstructing Matter into mo∣tion again: And moreover the benefit, that even in Fevers, has redounded to some by riding, yea when the Patient was necessitate to be held on Horse-back for a while, can be no other wayes accountable, but by the Impressions that the jogging of the Body makes on the fixed and coagulated Humores, to set them again a going.

Now as to these Phaenomena which are hurtful in Fevers, it is no less certain that these being duely pondered, will also con∣firm this Hypothesis, for it is clear that in many Fevers the sick are poured forth all in Sweats; And that without any ease there∣by, but rather with great hurt and weak∣ening: Therefore as our experimented

Author observes these ought not to be in∣dulged, but rather checked.

Now this Phaenomenon may be easily sol∣ved, by considering that the serosity of the Blood is in this case, by the frequent Pulses squeezed out from the Globuls, whereby the Blood being much thickned, the obstructi∣ons are increassed: while Sweats called criti∣call and giving ease (which rarely fall out in long and great Fevers: Because these are nourished of a copious and viscide fewel in the first wayes:) fall out in diseases only caus∣ed by perspirable matter first attenuat and comminuted and nixt expelled by Sweat, and as this evacuation, is altogether the effect of Nature, so it rarely succeeds happily by stimulating Medicines: Which after its wisely argued, is most reason∣bly concluded by Sydenham in his Schedula Monitoria.

And further as our Author observes and dayly experience also confirmes, it is very much Hurtful to Persons in Fevers to ly continually in the naked Bed: For the continual Heat of the Bed doth exceedingly lash, enervat, and relax the tone and firmness of the pores and fibers; Whereby they shrinke and creep

in; And so retain the perspirable matter which ought to be evacuate throw them, and this matter retained recoiling on the Blood does much increase all the tumult and dis∣orders there: But by exposing of the Body to a moderat refrigeration by putting on the Cloathes some Hours in the day, the Natural Heat is both Concentrate to expel that perspirable Matter; and the Tone and Firm∣ness of the Pores and Fibres are restored to give a free passage to it. And this is very suitable to the Experimental doctrine of Sancto∣rius, who finds and Declares reasonably that, the inward heat being by the external heat too much diffused, is not sufficiently Con∣centrate, & bended to expel the perspirable matter; as it happens in Aestival heat that is very trouble∣some to the Body, not so much because of any vehe∣ment Impressions it makes thereon, For every part of the Body is hotter of it self then the external heat affecting it; But because of the detension of the Perspirable matter through the defect of sufficient Concentration of the Internal heat to expell it. And indeed this state of the inter∣nal heat does also render i•• subject to seve∣ral indirect and refractive Motions, instead of the direct motion by which the perspirable matter should be sweeped ••orward, and ex∣pelled: so the lesion of perspiration upon these

reasons seemes in this case to be amended by the Patients keeping out of the naked Bed several hours of the day, and lying on the top of the Bed with their Cloaths on: And in that Situation rather than the up∣right posture of the Body, the vacillant re∣flux of the Blood unto the heart is also pro∣moved as was shown.

And also as our Author observes, it is hurtful in Fevers and several other Diseases to ly with the Head much depres∣sed; it being more conducible to ly with it raised somewhat; because in that posture the lighter & finner Particles of the Blood,as Des Cartes thinks are sublimed up to the brain for the generation of nervous Liquor and Spirits; and the grosser and heavier parts are carried by a descent downward: And so in that posture only there is an ascent of the Blood throw the Arteries unto the Head, in so much that the subtilest Particles thereof, prove alone obsequious to the Impulse: And if it chance that any grosser parts mixed therewith, do endeavour likewayes to ascend; they se∣cede and turn off at the axillarie Branches: So that nothing but the most sublime parts of the Blood in this posture does ascend,

like the subtile Spirits of Wine which are only carried so high, as is fit to separate them from the Phlegm: But when the head lyes level with the Body, and that especi∣ally in Sickness, and when the Blood is vitiated in its Particles and Motion; be∣cause then and in that posture there is no ascent to the Head, nor descent to the rest of the Body; the grosser parts of the Blood being carried indifferently to the Head do there generate Obstructions: Which must certainly produce all such Phoenomena as are competent to the Brain and Nerves being affected.

Notes

• Continual lying in the naked Bed why hurtful in Fevers
• Why hurtful to lye with the head too low.
• De pass. anim part. 1. cap. 10.