A continuation of the account of the nature causes, symptoms and cure of the distempers that are incident to seafaring people illustrated with some remarkable instances of the sicknesses of the fleet during the last summer, historically related : to which is prefix'd an essay concerning the quantity of blood that is to be evacuated in fevers : being the third part of the work / by William Cockburn ...

Observation XL.

Adam Littleton, was taken ill of a vomiting and going to stool for three days; he vomited a gre•••• deal of yellow and green stuff, slept little or none, all that time, and was very weak.

This being a Cholera morbus, which does not at all proceed from any heterogeneous, unconceivable mix∣ture of unnatural and improper ferments with the Blood; but ra∣ther from some nasty, sharp stuff lodg'd in the stomach, by a thou∣sand things that may be antecedent causes to it, which being affixt to its coats, does determine the ani∣mal Spirits in its nerves to Con∣vulsions, and by the greater sharp∣ness of this matter affecting the upper part of the stomach, and the pylorus makes this violent vo∣miting and purging. This matter brought upwards, is thought of some to be sincere bile, contrary to all reason or any thought of how it ought to be supplied: Indeed, the small quantity of bile, that is prest out of the Gall bladder, and brought into the stomach by this reverse motion, is very capable to colour a great deal of Lympha that's squeez'd out of the glands of the stomach, or brought from the Pan∣creas, and to affect it with its bit∣terness, without bringing us into a needless necessity of supposing

this impossible supply of Bile. Up∣on the other side, there are some who seeing how closely the Pylorus is shut, in the case of vomiting, will not allow that any Bile can at all be convey'd into the stomach, from the Gall-bladder; and would rather have all this quantity to be given from some small glands we may sometimes discover in the sto∣mach, and which contain a yellow∣ish liquor, not very bitter, and of no quantity. But not only the greater quantity we see voided here, and sometimes three or four Mouth fuls of pure gall, brought up in the end of an artificial Vomit, convince us clearly that these are not the fountains, and source of so great a provision, wheresoever it is to be brought from: But it were easie to make it very plain, how the Gall is convey'd into the stomach, if this were the proper place; and I will only remember them of something of greater bulk that uses to be con∣vey'd, without dispute, from the Guts, in an Iliack passion.

Now, since the whole cause of this Disease, is entirely lodg'd and

confin'd to the Stomach, and he had strength enough left to proceed in the surest method; I resolv'd to promote the evacuation with some∣thing that was no Vomit of it self, but that washing away the sharp stuff lodg'd in the Stomach, it might be carried off by the com∣mon course of vomiting; and when this store was exhausted, the Cure might reasonably be expected to succeed; and therefore I advis'd him to drink large draughts of Ship's-beer made blood warm, which he did to so great an advantage, that he had not drank and vomit∣ed above twice, when his vomiting left off: That evening, tho' he had the following mixture,

℞ decoct. hord. ℥ij. aq. cinam. hor∣deat. spirit. vin. an ℥j. diascord. fra∣castor. ʒss. M. ac bibat hora som∣ni.

He slept very well, and keeping up three or four days, he was purg'd with ℥vj. of the purging bitter Draught, and so recover∣ed.