Enchiridion medicum, or, A manual of physick being a compendium of the whole art, in three parts ... : wherein is briefly shewed 1. the names, 2. the derivation, 3. the causes, 4. the signs, 5. the prognosticks, and 6. a rational method of cure ... / by Robert Johnson, Med. professor.

CHAP. III. Of the consumption or Phthisick, and an Hec∣tick Fever.

THE Consumption is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, ex 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, Tabesco, because in this disease the sick doth consume or waste away.

It is called in Latin Tabes, which is a ge∣neral name for all Consumptions, whether it be Atrophia, Cachexia, or Phthisis; but it may most properly be taken for an Extenua∣tion of the whole body, caused by an Ulcer of the Lungs.

The purulent matter of the Ulcer circula∣ting with the bloud, doth infect, and by de∣grees corrupt the whole mass of it, which makes it unfit for nourishment; hence it is that all the parts of the body do waste and consume.

The causes are many, sometimes purulent matter may be communicated to the Lungs, from the Plurisie or Empiema, inflaming and corrupting them, which causeth an Ulcer.

Sometimes a salt and sharp Rheum flowing down from the Head to the Trachea Arteria, which doth not onely cause a vehement Coughing, but doth corrode the Lungs, being naturally tender; Hence an Ulcer will be caused.

Also many times Pustules, or Tubercles, are generated in the Lungs, and coming to suppuration, they break; and the matter flowing to the Bronchia, it may be spit up, if the Patient have strength; but oft times an Ulcer remaineth, which causeth a Con∣sumption.

These causes depend sometimes on Choler, sometimes on the juice of the Pancreas, some∣times on Spittle, sometimes on Chyle, some∣times on Lympha any way Vitiated, by which the mass of bloud (in time) becomes also corrupted.

When the Lungs decline from their Natu∣ral consistency, they Will soon become hard and tumorous, and so by degrees they will be corrupted, and ulcerated; and the mat∣ter of the Ulcer corrupting, and makeing the mass of bloud glutinous, in circulating with it, doth so weaken and corrupt all the parts of the body, that they become unfit to perfect natural nourishment; and there∣fore of necessity the universal body must con∣sume and pine away; sometimes it is caused by an obstruction of the lacteal veins, which hindreth the natural passage of the Chylus.

Authours mention many more causes of Consumptions; as Gonorrhoea, Nocturnal Pol∣lutions, want of Nourishment, &c.

The signs of a Consumption begun, are a great defluxion of Rheum into the sharp Ar∣tery,

causing a violent Cough, by which the Lungs are exasperated, and there follows a Hectick Fever, sometimes putrid, from the purulent matter flowing into the Veins.

To know whether the Lungs be ulcerated, let the Patient spit into water; if it sinks it is matter, which is an infallible sign of an Ulcer; for Phlegm always swims in water.

When the Ulcer is confirm'd, there is dif∣ficult breathing, and wasting of the whole body; the spittle is thick, and of various colours.

If the Ulcer of the Lungs, and Consump∣tion hath not been long, and the strength of the sick remains, there may be hopes of recovery; & e contra.

The Hectick Fever is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, i. e. ab habitu; quod in habitu corporis, vel in partibus solidis consistat.

It is an unnatural heat which hath seized upon the solid parts, and wasteth the moi∣sture of them.

The heat in an Hectick Fever is but little, and therefore rarely troublesome to the sick, except one or two hours after meat; at which time the heat is a little sharpned and increased, which may be known by an over frequent though weak Pulse; but it soon re∣turns again to its former equality.

But here it will not be amiss to shew you that there is a threefold moisture in the body,

viz. bloud in the Veins and Arteries, a dewy substance in every part, and also a glutinous moisture; which doth not onely nourish, but moistneth it, and keepeth the substance of each part together.

In the beginning when the moisture begins to fail, the Hectick Fever is not easily discer∣ned because there is still sufficient moisture to entertain the natural heat; but if (by the long continuance of the Hectick Fever) the radical moisture of the solid parts begins to consume, it may then be easily known, for there follows a continual and lingring lean∣ness of the whole body; which being re∣duc'd to its extremity, may be call'd in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, and in English an extenuating Fever.

The Latin Authours call it Marcor, which signifies Corruption or Rottenness. It is an immoderate dryness, and Consumption of the whole body, by reason of the defect of the substantial humidity.

There are two degrees of it according to Galen, the one is, when this extenuation of the body is in fieri, in consuming; the other is when it is in facto esse, or consummate; in which the body is reduc'd to such lean∣ness, that it seemeth to be nothing else but a walking Sceleton.

The causes of an Hectick Fever, are Ex∣ternal or Internal.

The External causes are all that may occa∣sion any of the other Fevers, for oft times Hectick Fevers are observ'd to follow other diseases, and especially Fevers of one day, proceeding from a great errour in Diet, and also from continual, and intermitting Fevers, when they are very vehement; but most frequently from Inflammations of the Bowels, especially of the Lungs, for when an Ulcer follows, then the whole mass of bloud is in∣fected by matter, and gets a singular gluti∣nousness; which being communicated to the other humours, spoils them with the same fault, and renders them unfit to perform the natural Functions rightly.

Sometimes Hectick Fevers are observ'd to arise immediately from excess of the nonna∣tural things, as most vehement anger, too much watchings, immoderate sorrow, con∣tinued labour, want of food, &c.

The Internal cause is, the over viscousness of the bloud and humours, because of which not onely the appetite of all food is dimini∣shed, and at length dejected, but the nou∣rishment of all the parts of the body is dayly decreas'd; for when there is loathing of food, then fermentation, separation of usefull from unusefull parts, sanguification, generation of the Animal Spirits, &c. is hindred and de∣stroyed; whence the toughness, and slug∣gishness of Choler, Spittle, the juice of the

Pancreas, and Lympha, is dayly augmented, and the evil becomes by degrees greater, and at length incurable.

If you perceive that there is so much of the radical moisture remaining, as is able to cherish the natural heat, which you may discern, if the colour of the body be fresh, if the figure be decent, if the proportion of the parts be according to nature, and the sick can (in some good measure) perform all ac∣tions, you may conceive some hopes of re∣covery.

But if the Body be extenuated, almost like a Sceleton, viz. when the body seemeth to be nothing else but Skin and Bone, (as the vulgar proverb is) acquaint the sick with the danger, least Death seize upon them un∣prepared.

Nevertheless, if the sick implore your aid of Christian Charity, withdraw not what comfort you are able to procure unto them.

The Cure of a Consumption, and Hectick Fever, will differ not a little, according to the diversity of causes producing them.

When an Hectick Fever comes with, or succeeds Fevers with or without fits, then upon their account, the cure may be varied according to the divers harm of the hu∣mours, differently peccant.

If a Consumption, or Hectick Fever, be caused by purulent matter from an Ulcer of

the Lungs, &c. then you must endeavour to free the bloud and humours from matter, which may be done by any Antimonial me∣dicines rightly prepared, perhaps before all o∣thers; whether they be Diaphoreticks, Pur∣gers, or Vomiters, as experience doth ma∣nifest; for it hath been observ'd, (even in a Phthisick, and an inveterate great Ulcer of the Lungs) to bring away a good quantity of matter, by Stool and Urine, so that then for many days, no matter was cast forth by a Cough.

Among common things, all Vulnerary plants are good used in Decoctions. Let this or one like it, be a form of a Decoction in this case.

Take the Roots of Plantain, Comfry, Round-birthwort, Liquorish, of each two ounces; Fennel, Scabious, Plantain, of each two handfulls; Figs, Raisons of the sun sto∣ned, of each four ounces; let them be all cleansed, bruised and boiled in three quarts of Barley-water till a third part be boiled a∣way; then strain it, and add Syrups of Hore-hound, and Hyssop, of each two oun∣ces; Laudanum opiatum ten grains. Mix it. Let the sick drink two ounces of this Decoc∣tion oft in a day; and if you add one or two drops of Balsam of Sulphur with Oil of An∣nise-seed to every draught, it will be the more effectual. The Balsam prepared of the truly

Sulphureous and inflameable Flowers of Anti∣mony, is most excellent in this distemper, if it may be had, which may be taken as the Bal∣sam of Sulphur.

Also those medicines may be used which mildly amend and correct the viscousness, and glutinousness of all the humours; for which I commend all mild Aromaticks, and Oily Volatile Salts, as that cut and alter every viscous humour, and reduce it into its natural state.

Those medicines are to be selected as do most conduce to, and agree with the con∣stitution of every sick person.

Vitriolated Tartar is an excellent medicine, which will agree with all constitutions, and may be taken from ten to twenty grains (e∣very other morning) in a little warm Broth.

Also the following medicine is very ef∣fectual.

Take the Powder of Cream of Tartar, and Tartar Vitriolated, of each half a drachm; Volatile Salt of Harts-horn, Salt of Amber, of each ten grains. Mix it for two doses, which may be taken in Chicken Broth, in the morning.

These choice medicines will conduce much to cleanse the bloud and humours from all purulent matter, if there be any hopes of the Patient's recovery.

All Effusions of Bloud, Seed and Milk,

are to be shun'd, except the wonted empty∣ings, which are natural and serve the indi∣vidual.

Let the motions of the Mind be moderate, and the exercise of the Body be gentle, and let sleep and watchings keep a mediocrity.

Appoint a moistning and nourishing Diet, which is of easie fermentation, as Broth, and Jellies of young Creatures, and Milk of Goats, Sheep and Cows, and chiefly of wholsome Women.

A Panado made with the Broth of a Chicken, the Crums of White-bread, and the Yelk of a new laid Egg, may sometimes be given the sick for a change.

Let ••ooling Herbs be boiled in the Broth, and Jellies; adding other ingredients that are cooling, moistning and cordial, both to strengthen Nature, and revive the Spirits.

Let the sick drink Barley-water, made pleasant with some Pectoral Syrup; and if they have been accustomed to drink Wine, let it be well diluted with water.

As for Fruit, Apples are much commended, especially Pippins, and Permains, which will much refresh the sick. If the Patient be cos∣tive, you may sometimes administer a Clyster of Milk and the yelk of an Egg.

The worst symptome that can attend these diseases, is a Loosness; if it so happen, give Goats or Cows milk, wherein steel hath been

quenched, and Rice boiled in it, adding a little Powder of Cinamon, and let the sick eat commonly of it.

Notes

• Tabes.
• Causes.
• Signs.
• Progn.
• Febris Hecticae.
• Signs.
• Liber 12. de marc. cap. 4.
• Causes.
• Progn.
• Cure.
• Powder.