Praxis medicinæ reformata: = or, The practice of physick reformed Being an epitome of the whole art: wherein is briefly shewed, the true causes, signs, prognosticks, and cure, of most diseases. Published for the benefit of all persons. By Robert Johnson, Med. Professor.

CHAP. III. Of Convulsions, and the Epilepsie.

THE Cramp or Convulsion is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, in Latin Convulsio. * 1.1

It is a very painfull, involuntary Contrac∣tion of the Nerves and Muscles towards their Original.

There are generally two sorts of Convul∣sions. viz. A true Convulsion, and a Con∣vulsive motion.

A true Convulsion is either universal or particular.

Of the universal there are three Kinds.

The first is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, in Latin tentio ad anteriora; when the Body and Head is drawn forward.

The second is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, and in Latin tentio ad posteriora when the Head and Body is drawn backward

The third is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 in Greek, and distentio in Latin, in this the whole Body is inflexible.

The particular convulsions are various.

If it be in the Eye, it is called strabismus.

That of the Mouth, is call tortura oris, &c.

The Falling-sickness or Epilepsie, is called * 1.2 in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, ab 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, invado, quod sensum atque mentem pariter apprehendat.

It is called also in Latin Epilepsia vel invasio; item morbus hominem ita invadens, ut retineat & sistat sensuum actiones, because the mind and senses in this disease are suddenly surprized.

It may be called morbus caducus, a caden∣do, or morbus puerilis because it is most sub∣ject to Children; or more properly noverca puerorum, quod eos male tractat.

It is also called Herculeus, & Elephantiasis a magnitudine, because it is difficult to cure.

Some call it morbus lunaticus, because the sick are most subject to the fits at the change of the moon; but enough of the Names.

The Epilepsie is an universal Cramp or Convulsion of the whole Body, with depri∣vation of sense and motion in the time of the fit.

The parts affected are not onely the Brain, Cerebellum and Spinalis medulla, but all the * 1.3 Nerves and Museles.

The causes are either external or internal. * 1.4

The external, may be by the biting of some venemous Creature; or by a wound or puncture of a Nerve or Tendon.

Sometimes it may be caused by surfeiting or drunkenness; and also by the taking of Hellebor, &c.

It may be also caused by a mineral Gas fuming from the Mines of Lead, or Anti∣mony, &c. which infecteth the Air with noxious metalline exhalations of a vene∣mous malignity; which is many times the cause of Convulsions, as they can tell by ex∣perience, that live near those Mines.

The internal causes are acrimonious and flatuous Vapours, rising from the small guts, because of over viscous Phlegm, and the o∣ver acidity and tartness of the Juice of the Pancreas, which causeth a vitious efferves∣cency of the humours, by which the Lym∣pha is also rendred very sharp.

These sour flatuous Vapours continually ascending to the Head, together with the spirituous substance of the Bloud, and going forward into the Ventricles of the Brain, and Cerebellum, and so to the first spreading of the Nerves; and corroding them, causeth an inordinate agitation, and very fierce motion of the Animal spirits; and by a continual and grievous Irritation, urging about the be∣ginning of the Spinalis medulla, is the cause of an universal Convulsion, or Epileptick-fit,

in which all the Muscles of the Body are most vehemently contracted.

The Irritation in a particular Convulsive motion or the Cramp, which may be oft observ'd in the thigh or leg, and other ex∣treme parts, may be also ascrib'd to the same sharp and sour flatuous Vapours, carried to the beginning of the Nerves and Tendons of the said Members, fretting and gnawing them sometimes with great pain.

The signs of Convulsions are manifest. * 1.5

The preceding signs of the Epilepsie, are trembling, sadness, fearfulness, vertigo, num∣ness, debility of the senses, troublesome sleep, with great pain of the Head.

The signs of the Epilepsie presently ap∣proaching, are a vehement shaking of the whole Body, foming at the Mouth, and a sud∣den deprivation of all the Animal functions.

1. A Convulsion or Epilepsie, being here∣ditary, is incurable. * 1.6

2. If a pregnant Woman be taken with either of them, it is very dangerous; and al∣so after Abortion.

3. Children are most subject to these di∣seases, because they abound with abun∣dance of moisture, and flatulent Vapours in the Brain; and because they have Nervorum poros angustos, whereby the Brain is easily filled with such vapours; and therefore we see that Children are often troubled with

them, young People more rarely, and old Folks but seldom; and we find that Children better suffer them than either of the other, who frequently die of these fits, especially of the Epilepsie, when in their falling there follows snorting, gnashing of the teeth, a ghastly countenance, much some at the Mouth, involuntaria seminis effusio, and great cryings out.

4. Of all the kind of Convulsions, Tetanos is the most difficult to cure; because it is (as it were) composed of the other two kinds; but if a fever happen in this or any other Con∣vulsion, the sick will suddenly recover, be∣cause a fever dissolveth it; but if a Convulsi∣on should succeed a fever, it is very dange∣rous, especially from a wound, or procee∣ding from venemous matter.

So likewise it is very dangerous if it be cau∣sed by taking of Hellebor.

When a particular Convulsion is caused * 1.7 from a prick of a Nerve or Tendon; as it may happen sometimes by the unskilfulness, or precipitancy of the Chyrurgeon in open∣ing a vein, then most speedily pour into the wound or puncture, the Oil of Turpentine, with rectifi'd Spirit of Wine, both actually hot; as that famous Chyrurgeon Mr. Am∣brose Parey adviseth in his ninth Book, Chap. 11. of which I have had large experience with good success.

The like course may be taken with all other wounds of the nervous parts.

But if the wound of the Nerve or Tendon yield not to this medicine, the same is to be cut asunder cross-ways, seeing it is safer to lose the action of one part, than that the sick should be exposed to the danger of a deadly Convulsion.

When the Nerves or Tendons of the Mus∣cles are prickt by sharp splinters of bones, the grievous pains succeeding, soon cause a particular Convulsion of that part, and at length an universal Convulsion will attend the Patient, if there be not speedy help.

Wherefore if possible, the sharp fragments of the bone must be cut away; or if this have been neglected, or could not be done, and an universal Convulsion be feared, you must hasten to amputation of the member; For, Necessitas non habet legem.

If a particular Convulsion be occasion'd by a hot Tumour or any other sharp pain, which hath rais'd an inflammation; let the pain be diminisht as well by internal, as external Ano∣dines and Narcoticks, to allay the over en∣creas'd motion of the Animal spirits.

To this end you may give the sick two or three grains of Laudanum opiat. at a time, either in a Pill, or dissolve it in a little Wine or other convenient Vehicle.

And if the ingenious and judicious Physi∣cian,

or Chyrurgeon, do add a little volatile Salt, either of Animals or Vegetables, to his topical Medicaments, whether fomentati∣ons, Cataplasms, or Ointments, he will won∣der at the incredible benefit; for by the help thereof the Tumour will be mollified and dissolved, the internal obstruction loosned, and the pain eased.

If a Convulsion be caused by the taking of Hellebor, or any other venemous matter; ad∣minister an Antimonial vomit with all speed.

But if it be a Child, give it ten grains of Salt of Vitriol, or half an ounce of Oxymel of Squills, with a drachm of Oil of Almonds.

After the operation of the Emetick, (and also at other times) you may give some of this Julep.

Take of Black-cherry-water, the Water of * 1.8 Line-flowers of each two ounces; Briony-wa∣ter compound, Syrup of Peony, of each one ounce; Tincture of Castor half an ounce; Con∣fection of Alkermes one drachm, Spirit of Salt Armoniack twenty drops; mix it, and give three or four spoonfulls every fourth Hour.

Having briefly hinted at the Cure of par∣ticular Convulsions; I come now to those more universal, as likewise Convulsive mo∣tions, and the Epilepsie.

And seeing there is little difference, in the remote causes of them in the Body; these diseases may (for the most part) be cured with the same Remedies.

1. First then the peccant humours are to be temper'd, and diminisht.

2. The rising of vapours is to be hindred, and their expulsion procur'd by sweat, or insensible transpiration: By which the over motion of the Animal spirits will be restrain'd and brought to tranquillity, that is a more quiet motion.

All Aromaticks, and all things abounding with either a fixt or volatile Salt, do not one∣ly correct, and by cutting amend the viscous phlegmatick humours; but do powerfully temper and destroy the over acidity and tart∣ness of the juice of the Pancreas.

To temper and diminish these humours, I commend these medicines.

Take the Roots of Male-peony, Valerian, * 1.9 Missletoe of the Oak, and Peony-seeds, of each two ounces; Castor half an ounce; let them be all bruised, and infus'd in Peony-water compound, the Water of Line-tree-flowers, of each one pint, for the space of twenty four hours; then strain it out very strongly, and add Syrup of Peony and Stoechas, of each three ounces; Spirit of Castor half an ounce; mix it, and give three spoonfulls at a time every fourth hour, with which you may mix Spirit of Salt Armoniack, Elixir propri∣etatis, of each six drops.

Also you may give the Patient half a drachm of the following powder in three or

four spoonfulls of this Infusion, with the a∣foresaid Spirit and Elixir.

Take of Crabs-eyes, Salt of Tartar vitri∣olated, Salt prunella, of each half an ounce; volatile Salt of Harts-horn, Salt of Amber, of Man's skull prepar'd, of each two drachms; make it into a fine powder, which may be taken half a drachm at a time, morning and evening.

The peccant humours being temper'd and diminisht, by the frequent use of the above∣said medicines; the inordinate, involuntary and impetuous motion of the Animal spirits, (in Convulsive and Epileptick fits) will be the better reduc'd to a calm and vo∣luntary motion, by the help of volatile and spirituous Sudorificks, mixt with Anodines, and Narcotick medicines us'd in a small quan∣tity, and at times; which two will be ex∣pedient to be given together, because then they will the better circulate to the Animal spirits, and temper and educe the hurtfull flatuous Vapours.

For which I commend the following form.

Take of Treacle-water, Fennel-water, of each one ounce; Syrup of Peony, Syrup of * 1.10 the Juice of Scurvigrass, of each half an ounce; Antimony Diaphoretick, Bezoar mineral, Crabs-eyes in powder, of each ten grains; Laudanum opiat. four grains; Tincture of Castor one drachm; Oil of Cloves three drops;

Spirit of Salt Armoniack ten drops; mix it, and let the sick take it, being well cover'd with cloths, whereby the sweat will the easi∣er come forth.

If the Body be costive, let it be made so∣luble by a Clyster, or Suppository; such as is prescrib'd in the cure of the Apoplexy.

As often as the Stomach is naufeous, or the sick inclines to vomiting; let the Eme∣ticks before mention'd be carefully admi∣nistred; and likewise three or four days be∣fore the full of the moon.

But if the sick be averse to vomiting, and Pills or Potions are more acceptable, take the following as Examples.

Take of Extract. Rudij, pil. foetidoe ex duo∣bus, * 1.11 of each a drachm and half; Castor, black Hellebor prepar'd, of each half a drachm; Salt of Amber twenty grains; Oil of Rose∣mary twenty drops, with Syrup of Stoechas; make it into a Mass for pills; of which you may give half a drachm twice a week.

Also this purging Infusion is very effec∣tual.

Take of the best Senna, Rhubarb, and Cream of Tartar, of each an ounce and half; * 1.12 Liquorish, and the five opening Roots, of each one ounce; Guiacum, China-roots, of each six ounces; Missletoe of the Oak, Anise-seed, sweet Fennel-seed, Bay-berries, and Juniper∣berries, of each half an ounce; let them be

all bruised, and infused in Black-cherry-water, and the Water of Line-tree-flowers, of each a quart, very hot for the space of a Night; then strain it very hard, and add Syrup of Roses so∣lutive with Senna, Syrup of Succory with Rhubarb, of each three ounces; Cinamon-water two ounces; Salt of Tartar vitriolated half an ounce; mix it.

Let the sick take four ounces of this pur∣ging Infusion every morning, whereby the viscous humours and flatuous Vapours may be both corrected, and also evacuated gent∣ly by degrees.

If bloud abound, let a Vein be opened; in Women open the Saphoena in either Foot, but in Men you may apply Leeches to the He∣morrhoidal Veins. &c.

Bathing hath been often us'd (with good success) in these diseases.

A natural sulphureous Bath, such as is in the City of Bath, is excellent; but when it is not to be had, an artificial Bath may serve.

That which is set down in the Cure of the Palsie and Apoplexy, is of excellent Virtue, and very effectual in these distempers.

After bathing, let the Spina Dorsi, and o∣ther affected parts be anointed with the fol∣lowing Ointment.

Take the Oils of Euphorbium, Rue, Castor, * 1.13 Petre, Spike, Turpentine, Bricks, Dil, Chamo∣mel, of each half an ounce; Oils of Amber

and Juniper, of each two drachms; the Oint∣ments Martiatum and Aregon of each one ounce; mix them for an Ointment.

Issues are approved of, either in the Neck, or Arm; also Ventoses with Scarification, Sternutatories, Errhines and Masticatories are all commended.

This Masticatory may serve for Example. * 1.14

Take the Roots of Pellitory of Spain, Gin∣ger, Calamus aromaticus, of each one ounce; Mustard-seed; all sorts of Pepper, Nutmegs, Castor, Mastick, of each half an ounce; beat them all into fine Powder, and with fine Honey boild into a Syrup, make them into Troches according to Art.

When they are drie you may chew them one after another, when you please to draw the Rheum out of the Mouth.

When the fit is coming, or upon the party, blow up some Sneezing-powder into the Nostrils, or the Smoak of Tobacco into the Mouth.

Embrocate the Temples, Fore-head and Nostrils with Oil of Amber; and hold the Spirit of Salt Armoniack to the Nose, in a Narrow-mouth'd viol.

Make a noise in the Ears; and let the sick be kept in a light Room, with the Head up∣right.

Let the teeth be kept open with a stick, or rather with a little viscus quercinus, if it may be had.

Let the soles of the feet be well rub'd with Salt and Vineger; also Frictions and Liga∣tures may be used in the parts affected.

Some commend a Pigeon cut asunder, and applied hot to the Navel; for hereby the ve∣nemous halituous Vapours are partly drawn away.

I might add variety of medicines for the cure of these diseases; but those before men∣tioned are sufficient to give light to the inge∣nious Artist, who knows how to prepare diversity of them, as well milder for Infants and Children, as stronger for Adults.

I will therefore prescribe a powder to pre∣serve Children from Convulsive and Epilep∣tick-fits, and so conclude this Chapter.

Take the Roots of Peony, Valerian, of * 1.15 each half an ounce; the Moss that groweth upon a Man's skull, the triangular Bone of a Man's skull prepar'd, Missletoe of the Oak, Elks-hoof, the Seeds of Peony, sweet Fennel and Annise, of each two drachms; red Coral, whitest Amber, and Emerald prepar'd, of each one drachm; white Sugar the weight of them all, let them be reduc'd into a fine powder.

You may give a Child twenty grains of this powder with a little Oil of sweet Al∣monds, so soon as it is born, which may happi∣ly preserve it from Convulsions, and Epilep∣tick fits.

And because obstructions of the Belly in

Children, exposeth them to flatuous Vapours, and Gripings, and so consequently to Con∣vulsive and Epileptick-fits; I advise you to keep the Belly open, either with a little Man∣na, or a Carminative Clyster, so often as you see convenient.

Let the sick live in a serene Air, and ab∣stain from all food that breeds bad nourish∣ment, and flatulent Vapours.

Notes

• * 1.1

  Spasmus.
• * 1.2

  Epilepsia.
• * 1.3

  Partes af∣fecte.
• * 1.4

  Causes.
• * 1.5

  Signs.
• * 1.6

  Progn.
• * 1.7

  Cure.
• * 1.8

  Iulep.
• * 1.9

  Infusion.
• * 1.10

  Cordial to cause Sweat.
• * 1.11

  Purging Pills.
• * 1.12

  Infusion.
• * 1.13

  Ointment.
• * 1.14

  Mastica∣tory.
• * 1.15

  Epileptick Powder.