A treatise of the asthma divided into four parts : in the first is given a history of the fits, and the symptoms preceding them : in the second, the cacochymia which disposes to the fit, and the rarefaction of the spirits which produces it, are described : in the third, the accident causes of the fit, and the symptomatic asthmas are observed : in the fourth, the cure of the asthmas fit, and the method of preventing it is proposed : to which is annext a digression about the several species of acids distinguish'd by their tastes, and 'tis observ'd how far they were thought convenient or injurious in general practice by the old writers, and most particularly in relation to the care of the asthma.

TO THE Learned and Judicious Physician, Dr. PHINEAS FOWKE, AT Wyrly in Staffordshire.

SIR,

I Have many Reasons for my Dedica∣tion of the following Treatise to your self: The particular Favours you have shewed me, have deserved a greater Acknowledgment, than this small Pre∣sent I make you, as a Testimony of my Gratitude; but in this Undertaking I shall Appeal to you, who are well read both in the Ancient and Modern Authors, as the most Candid and Learned Judge, concerning their Old Notions, and Pra∣ctice in the Asthma, which I shall here prefer, for their usefulness to all the Mo∣derns that have Writ on that Subject.

Sir, I think my self so much obliged to those Learned old Authors you lent

me, from that Large and Curious Colle∣ction in your own Study, that I cannot but here own the Benefit I received by Reading of them, and following their Method of Practice on my self and others; I hope this will be a sufficient Excuse for my endeavouring to justify their Notions, and Explaining of them, and for the Re∣commendation I shall give of their Me∣dicines.

Sir, I here present you with your own old Authors, dress'd up in the present new Philosophy, for that changes its Fashion in every Age; for it would not now ap∣pear Modish to express themselves in the Aristotelian way, but as to their sensible Observations, and useful Methods of Pra∣ctice, they will last for ever, as being true Descriptions of Natural Things, and confirmed by frequent Observation and Experiments.

My Design is not in this Dedication to Compliment your Philosophic way of Living, your Universal Learning, nor Greatness of Mind in retiring from all the Pleasures, and Impertinent Business of Life, that you might more freely con∣verse with your Learned Authors; Tho' these are sufficient Subjects for a large

Encomium, I must confess my self unfit for well performing of it; neither would your great Humility admit of a just Praise of your Virtues.

I know your Curious Genius requires some Variety of Thoughts to divert it, or some Philosophic Enquiry to entertain it, for which end I will here propose my following Observations, by which you will discern the design of this Treatise, and the good Performance of the Old, and the Faults of the New Writers, in treating of the Asthma.

First, I shall observe that that is the most useful Notion of the Asthma, from whence we can take our Indications for Practice, and which is deduced from an exact and full sensible History of the Dis∣ease, its Subject, Causes, and Symptoms.

I have assigned the immediate Cause of the Asthma, to the Sraitness, Compres∣sion, or Constriction of the Bronchia; and in the continued Asthma, the Causes must be constant, as Dropsy, Tubercu∣lum, &c. but in the Periodic Asthma, the Returns must depend on the Defluxi∣on of Humours on the Primae viae, where the Inflations begin, or on the Lungs and Nerves, if either were formerly weakned

by other Diseases; these Hypochondriac, or Pneumonic, or Nervous Inflations, depend all on the same Defluxion of Se∣rum; and they all frequently happen in old Asthmatics at the same time.

This Defluxion of Serum evidently ap∣pears in loose Stools, fluxes of Urine, great Spitting, and the Drowsiness of the Head in the beginning of the Asthma Fit: This Defluxion depends on the Efferves∣cence of Humours, because there is a fe∣verish Heat at that time, which rarefies the Serum, and drives it through th•• Glands. I think it not probable that the Nerves could contain so much Serum, but rather that the slimy and flatulent Ca∣cochymia irritates the Heart to stronger Pulsation, and Excretion of those Hu∣mours, as the bilious Contents do irritate the Guts. For when we find Excremen∣titious Humors evacuated, we may rati∣onally suppose that their Vellication pro∣duced their Excretion, rather than any preternatural Faults of Spirits.

The Cacochymia which irritates, we observe by the Windiness and Sliminess of Humours evacuated.

This Inflation in the Stomach, the Ef∣fervescence in the Blood, and Inflation in

the Pneumonic Membranes, comprehend the large Nature of this Disease; and con∣trary to these our Practical Notions must aim, by suppressing the Effervescence, which Cures the Defluxion at the same time; and then the flatulent and slimy Cacochymia must be Evacuated and Cor∣rected.

If the Asthma be but partially descri∣bed, and a false Hypothesis built on that Description, the Practice answering that is very Impertinent, or injurious.

Tho' the old Notion of the Asthma's being a Defluxion of serous Humours, was certainly true, because evident to our Senses, by the Evacuation of Serosities; yet the Explication of that Defluxion, by comparing the Head to a Cupping-Glass, which draws up Humidities by its Heat, and causes them after to descend on the Lungs, was notoriously false, and con∣trary to the Structure of the solid Parts, and the Circulation of the Fluids.

This fanciful Notion occasioned much impertinent Practice, by Fumes, Errhines, Apophlegmatisms, Plaisters to the Head, and Issues, which have all fallen with the Hypothesis they rose from. These Old Writers neglected the Effervescence, and

the Nervous Inflations I have mentioned.

The Age succeeding observ'd a great Viscidity in the Humours of the Lungs, and to that alone, they impute this Ster∣torous Wheesing; these endeavoured to Cure this Viscidity and the Tubercula, by prodigious pectoral Antidotes, made for the Asthma, but still they neglected the Effervescence, and nervous Inflations, and therefore had no success.

The Later Writers, as Van Helmont, and Dr. Willis, have most particularly described the nervous Symptoms of the Asthma, and built their Hypothesis on the supposition, that 'tis a Convulsion; and that what Cures that will relieve the Asthma: This false Hypothesis led them into an injurious Practice, by giving hot Tinctures, acrid Gums, and volatil Salts, and sulphur Medicines.

Some Writers, as Sylvius, and Etmuller, have observed the Hypochondriac Sym∣ptoms in the Stomach, and conclude the Asthma is a Hypochondriacal Flatus, and wants Digestives.

By these Observations I design to prove, that all our Practical Notions and Indi∣cations ought to be taken from all the sen∣sible Observations in a Disease, and then

we shall avoid the several Errors into which many Learned Hypotheses lead us▪ and then our Practice will alway be the same, though the general Philosophy, by which we explain our Notions, alters with the Age.

The old sensible Cacochymias must still be allowed, and the Method of Curing them by contrary Tastes, because very rational; therefore though the Circula∣tion of the Blood be lately discover'd, and the Circulation of the Serum through the Lymphatic Vessels, yet these Discoveries have made but little Alterations in the Pra∣ctice of Physic, but by that we can bette•• explain the Motion of Humours, and the Translation of Diseases from one Part to another; therefore this Discovery has only helped us to solve some Difficulties we knew not before, and to give Reasons for them: Yet still this is the chief Scope of our Practice, to Evacuate the Quanti∣ty, and Correct the ill Quality of the Ca∣cochymia's anciently described; and we must use the same Medicines as the old Writers advise.

The Nervous Juice is still as much un∣known as formerly, and therefore its Af∣fections are inexplicable; and though it

still be a Dispute whether the Motion of the Heart in a Fever be by an Irritation of the fermenting Blood, or the disordered Spirits, yet it will be the same thing as to Practice; for by which soever of them the Rarefaction happens in the Asthma, I must level my Method against the Ef∣fervescence, if I will cure the Fit or pre∣vent it.

If I compare our Bodies to a Watch, and the Spirits to the Spring of it, because on that all its Motions depend, as also on the Spirits in an Animal Body, as in the Watch: The reason of its going false, may be the fault of the Wheels, or many other Contrivances; and as it would be absurd, when the Watch is out of Order, to lay all the faults on the Spring, because on that depends all its false as well as re∣gular Motion; so it is in our Bodies, tho' the Spirits produce all the regular and ir∣regular Motions, yet, as in the Watch, the irregularity must depend on other Organs ill constituted, so in the Body the Lungs being oppressed, the regular Re∣spiration becomes a Dyspnaea; if the Bronchia be constringed, an Asthma; if any extraordinary thing or Fume affect the Skin of the Eyes, Tears immediately flow,

and the Saliva runs upon any Acrimony which irritates the Palate. The same Motions which are expected in the Nerves by external Objects, are produced by sharp Acrimony in the Humours, which, if bilious in the Stomach, excite Vomiting and Purging in the Cholera. If the Hu∣mours ferment in the Veins, they irritate the Heart to a violent Circulation, which raises the Fever, which lasts only till the Fermentation ceases; but in those Fevers which depend on the disordered Spirits, they are but of small continuance. And we must observe that the Animal Spirits rise from the Blood, and have both their Origine, and good or ill Temper thence; and tho' they move the Fluids, yet that external Motion only helps and promotes the intestine Motion of the Humours (as Beer and Wines are promoted in their depuration, by being carried on Ship∣board.) If the Spirits should circulate Water through the Veins (and the Hy∣dropical Serum is not much different) nei∣ther Blood nor a true natural Heat would arise in the Water by Ten thousand Cir∣culations; by which we find we must look back to the old Cacochymias, to explain the Nature of Humours, and the Diseases,

and in the Asthma we must retain the Fla∣tulencies anciently observed, and the De∣••luxion of Serum both on the Guts, the Lungs and Brains.

The Dulness and Drowsiness of the Head, is a sign of a Defluxion through the Nerves in Hysteric Cases, as well as the Flux of Urine in them; but for satisfying the Helmontians, I will confess the Hy∣steric Asthma has no Defluxion through the Glands of the Lungs, till it is an old Disease; but the Serum in this only makes its Defluxion through the Glands in the Stomach, and Guts, and Brain; there is the same Effervescencies, the same Flatulencies, and consequently the same Cacochymias in these, as in the Spitting Asthma.

If I should describe only the Nature of Spirits in Wine, all Persons would believe I talked like a Philosopher, but not much to Edify any one, who only from the Taste of the Wine can best describe its Na∣ture, whether sweet, rough, or sharp, or bitterish; and when it is vitiated, 'tis flat, or waterish, sour, roapy, windy, bitter, fetid, full of Lees, and Ferments; these are all sensible Vices in Wines, and the same in Animal Humours we call our Cacochy∣mias. And as the Vintners can Cure all

their Wines by particular Tastes, with∣out being vers'd in the Mechanic, Chy∣mical, or Microscopical Observations a∣bout Wines; so may Phisicians both un∣derstand, and cure Diseases by a rational Use of sensible Observations, and the old Galenical Practices built on them, may yet stand unmoved.

It is a very short way of Explaining Diseases, to tell us, that the Spirits, or Archeus, are either weak, or strong; in a fury, or stupid: This Philosophy is much admired, tho' not understood ei∣ther by Plebeians, or Philosophers, who ought to admit nothing either in Diseases or Medicines, but sensible Observations, and those Notions which are immediate∣ly deduced from them. These we can be certain of, and on these the Galenists built their Practice, and these two sensible Observations will always stand good;

1. That the Asthma is a Defluxion.

2. That all Medicines in the Asthma ought to be inciding without Heat.

The Invention of the Microscope has much discovered the sensible Mechanism of the solid Parts; but what Indication can I take from the Globuli of the Fluid? Tho' they may help me better to Explain,

yet I fear I shall not be inabled by their Discovery easily to cure any Disease.

All the old Notions of the Asthma grounded on sensible Observations, on which a successful Practice depends, ought still to be retained, and if it be necessary they may be better explained. So in the Asthma, we observe there is a Defluxion of Serosities, and for this Vomits and Pur∣gers were successfully used by the An∣cients; therefore the new Writers unjust∣ly explode that sensible Notion, because ill explained. In this case we must mend the Explication of a Defluxion, and not search for the Fountain of Rheum in the Head, but in the Blood, and allow the Nerves to be the Instruments of the De∣fluxion.

If it were possible for us to discern all the Mechanical Structures of the solid Parts, and all the Motions and Figures of the Fluid, we might then that way ex∣plain all our Diseases; but since that will alway be impossible to our dull Senses, 'tis not fair to trouble the Learned with fancied Figures and Motions, because possible: But by observing the sensible effects of Mechanic Motions, the Ca∣cochymias, we do as much as is necessa∣ry.

For from thence we take our Indi∣cations of those Remedies which will re∣store vitiated Humours to their natural State.

The Chymists unjustly reject the Ga∣lenic Cacochymias, and explain as well as cure all Diseases by their Mineral Prin∣ciples, which seems very absurd, since Minerals are of a very different Nature, and they are produced by different Dige∣stions and Preparations. Animal Hu∣mours are made by particular Fermenta∣tions, Circulations, Secretions, in our Or∣ganiz'd Bodies, from a pure Milk, but Minerals arise from sulphur Fumes, and stony Particles coagulated in the Earth. And all Chymical Product from them are the Effects of a violent Fire; so that by the mixtures of Chymical Medicines, we can guess but little at the diseased State of Animal Humours.

I generally observe, that all pure Chy∣mical Authors know little of Anatomy, and the Nature of Animal Humours; for Distillation alters the natural or diseased Constitutions, and therefore we cannot discover either by the Fire: The Chy∣mists wholly depend on the extolled Virtue of their Medicine; if prepared

from Antimony, or Quicksilver, it is a certain Panacea, given in all Diseases, with∣out any Method; and the Chymists im∣pute great Knowledge to their Medicine, in finding out the Disease, and making various Operations, or corroborating Na∣ture, as Nature requires, all which are more absurd than any thing in the Galenic Hypothesis, and shew the Ignorance of the Chymist in the nature of Medicines, and method of Practice.

The Empyrical Doctors reject all our Cacochymias; they want general Philo∣sophy, Anatomy, and Chymistry, and so cannot make any rational Notion of the Disease, from the Consideration of all its Symptoms; they know therefore nothing of any rational Method of Practice, but go on in the dull Road of Vomiting, Purging, the Cortex, Steel, Salivating, Medicinal Waters; whereas the true Ra∣tional Galenist, considers that Notion of the Disease which agrees with all the Symptoms, and prescribes such Tastes as will cure each Cacochymia; he considers the Constitution of the Patient, the Com∣plication of Diseases, and can give a good Reason for altering the common Method, when necessary. He with his Vegeta∣bles

more cures safely, than with Minerals; he makes no Preparations, but what Na∣ture has prepared he gives, in Powder or Decoction, &c. He is Nature's Servant, and alters his Methods to serve her, and uses the only means we have to observe her, our Senses and Experience.

I shall make this my last Observation, that the old Writers found out the most useful Medicines in the Asthma.

There is a natural Instinct, by which all Animals find out their proper Food, and by the same Method they observe what Medicines are most suitable to their Diseases.

The Stomach prepares all the Humours for the Veins, and in chusing of the Food, it naturally desires that which is like to our Humours, to nourish them; the Tongue is well pleased with those Tastes which agree with the Stomach, because of the common Membrane which covers both.

In a healthful State, the Tongue and Stomach delight in sweet Tastes, because the Blood and Saliva have that; but in a diseased State of Humours, those Tastes are most pleasant, which alter it; as when we are too hot, cool Tastes; when dry,

the Humid; and e contra, Nature teaches us to Cure our selves by contrary Tastes. And Reason and Experience tell us, that thin Humours require incrassing viscid Tastes; and the glutinous Humours, inci∣ding Acrids; and the roughness of the so∣lid Parts, Oily Lenients; and the flux of all Humours, Styptics. In Fevers we na∣turally desire Acids; and in ill Digestions, Bitters are grateful.

'Tis of no small moment in curing Dis∣eases, that our Tastes can inform us what Medicines are agreeable to the Stomach and Humours; and our Smells inform us what Medicines are suitable to our Ani∣mal Spirits. And since the Objects of these two Senses differ only in the Tenui∣ty of their Substances; for Bitters, Acerbs, Acrids, affect our Tastes in the form of a Liquor; but a Halitus from the same Medicines, affects our Smells; and be∣cause of this small difference, from the Vir∣tues of the Tastes mentioned, we may easily guess at the Efficacy of those parti∣cular Smells.

The old Writers observed, that the Cacochymia in the Asthma required Di∣gestives, because of the Wind and Slime in the Stomach, and for this they used all

the Wormwood Bitters, as Polium, Southernwood, Mugwort, and Worm∣wood it self; and all the bitter Gums, as Ammoniacum, Galbanum, &c. and Gen∣tian, Aristolochia, Briony.

The same Authors observed, that the Medicines in the Asthma must cool, as well as incide, they therefore used Vine∣gar, and mixed divers Bitters and Acrids with it, to make it more inciding, as Squills, Orris, Nettles; and they obser∣ved by their Tastes, that the Salso-acids, such as Niter, and Sal Armoniac, had both an inciding and cooling Quality. They observed the Flatulencies in the Asthma, and for that used the Carminatives steep∣ed in Vinegar, and boiled many Aro∣matics, as Thyme, Hyssop, Calamint in Oxymels.

They used Anticonvulsives, as Castor with Oxymels, and Rue mixed with Ni∣ter, in Diaspoliticum, and Briony ʒss. in a Cyathus of Vinegar. Neither did they omit the use of Opiates, but gave a Cau∣tion about them.

Sir, I must have begged your Pardon for this long Letter, if I had not now pre∣sented my self as a Patient, who have the Privilege of telling the Injury received by

the Modern Practisers, and of commend∣ing the best Doctors for the Asthma, Hip∣pocrates and Galen, because I have receiv∣ed most Benefit by their Medicines; and I believe none is more able to defend those Fathers of our Faculty, and their rational Method of Practice, against Chymists, the Empirical, and the Mechanical Do∣ctors, than your self. I desire therefore, under your Patronage, to defend the old Truths and Fundamentals of our Faculty, A rational Practice, directed by sensible Notions, and confirmed by the Experi∣ence of former Ages.

I am of Opinion, that most of the Dis∣eases incurable by the Modern Practice, as the Gout, Dropsy, Epilepsy, Leprosy, were oftner cured by the old Methods, which have been disused, and neglected upon the account of pure Chymical Medi∣cines, and new Hypotheses, recommend∣ed by great Authors; these ought to be considered, and revised by others, as I have done the Asthma.

I know your great Candor will com∣mend an Ingenious probable Hypothesis, but that your Zeal for the good of Man∣kind, cannot but regret the rejecting old approved and useful Notions, and experi∣enced

Medicines, because they will not agree with a new Doctrin. I hope you will pardon my Faults, and accept this Performance with your usual Candor, and believe me, that I present it to you, as a demonstration of my being a sincere Admirer of your Judgment and Learning, and as an acknowledgment of your kind Respect to,

Litchfield, May 25. 1698

Honoured Sir,

Your most Obliged Humble Servant, John Floyer.