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. XI. Of the Yellow Iaundice.

THE Yellow Jaundice is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, ab avicula quoe 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 dicitur, * 1.1 quod ea oculos flavi vel aurei coloris habet.

It is also called Icterus in Latin; it being a spreading of a yellowish Colour over the whole body.

It was the common received opinion of the Ancients, that the chief cause of this Disease, is an obstruction of the Cystick pas∣sage to the small Gut, so that Choler is there∣by wholly hindred in its natural descent; wherefore it doth ascend to the Liver, and so to the Bloud, with which it is transfer'd to the habit and superficies of the body, where it doth shew it self in its colours.

But it may be manifested from many ob∣servations, and experiments, both Anatomi∣cal, and Practical; that the Jaundice may be produc'd without an obstruction of the pas∣sage of Choler.

Although I suppose that the Jaundice may probably be raised by an obstruction of the Meatus Hepaticus: for if there should be a great stoppage in this Vessel, by any gluti∣nous or lapidescent matter, the Choler that is generated in it may possibly regurgitate (there being no Valves to hinder it) and thereby become mixed with the Blood, by which means it may (in a short time) be conveyed over the whole Body.

But if the Meatus Cisticus should be stop∣ped by a small stone, &c. as I have sometimes seen in dissecting Icterical Patients, where I observed that the Excrements were not dyed so yellow as usual: yet it is impossible that there should be any regurgitation of Choler to the Liver out of the Gall, by reason of the three Valves looking from without inwards, which do potently hinder the recourse of it: and although the Meatus Hepaticus is with∣out Valves, yet seldom in a Jaundice, is ei∣ther that passage, or the Ductus Communis obstructed, but many times wider, as the most ingenious Salmon hath accurately ob∣served.

Wherefore that we may the better judge * 1.2 of the true Cause of this Disease, let us first consider that Man's Body abounds with an Animal salt, which doth circulate with the Blood through the whole Body, so that not onely the internal, but superficial parts are replenished therewith.

2. Secondly, it is the Nature of Volatile and Animal salts to sublime, and upon their mixture with other fit Bodies to excite or stir up new appearances of Colours accor∣ding to the Nature of the Salt; for if a soluti∣on of Salt of Tartar be mixt with a solution of sublimate in fair Water, it gives in a mo∣ment a reddish, yellowish or orange taw∣ny Colour, although both the solutions be as clear as Cristal, and with Armoniack salts in proper liquors, may be made many Colours to appear.

From whence we may judge, that if the Animal salt of Man's Body become too vola∣tile, or be too much sublimed: which may be done, either by the biting of an enraged Viper, or by the power of poyson, or from the over heating of the Body by violent ex∣ercise, or by exceeding sorrow of mind, or great passion, or by excessive drinking of hot liquors, or from burning Feavers; where∣by the universal Body comes to be inflamed, the Spirits vehemently agitated, and there∣by the Volatile saline Principle to be vio∣lently moved out of its Place or Domicil, to the Circumference of the Body; but mee∣ting with the viscous Juice of the Cutis is there hindred from flying away; and being dissolved and mixt with the Cutaneous Hu∣midity it excites the Jaundice, whether yel∣low, black or greenish, according to the Co∣lour

of the Poyson which the Patient hath casually taken, or predisposition of the Bo∣dy to so notable a mutation. Hence it is that many (who have been in perfect health) have been suddenly invaded with this Di∣sease: some by the biting of an enraged Vi∣per, others by running a race, &c. who im∣mediately after were all over as yellow as if they were dipt into the Juice of Saffron; and yet notwithstanding it could not be judg∣ed that the Gall-juice was either affected or disaffected in the least measure: for it cannot in reason be supposed, that the Venome or Poyson of the Viper should be so particularly directed to the Gall, to work such an effect in so short a time, as to distribute that vis∣cous heavy Juice so universally over the whole Body: much less can any one ima∣gine, that either the drinking of strong li∣quours, or any violent exercise, &c. should any ways so operate upon the cholerick Hu∣mour, as to volatize it, and so immediately disperse it universally over the whole humane Frame; for it is impossible that the gluti∣nous Substance of Choler should be disper∣sed in so short a time to all the superficial Parts of the Body.

Therefore it is more probable, that the volatile Animal salt of the Body, being mo∣ved, and carried out of its Domicil, by the extream heat of the internal Parts, and vio∣lent

Motion of the Spirits, and being mixt and dissolved with the cutaneous Juice (as is before mentioned) doth not onely excite the Jaundice, but may possibly be the Cause of Purple Spots in the Spotted Feaver: as also of many other sudden and great Changes in the Bodies of humane kind.

The Jaundice invading a Patient in a Fe∣ver (before the seventh, viz. the Critical * 1.3 day) is dangerous: if it comes upon an In∣flamation of the Liver, or a Schirrus and the Cure be not hastned, a Dropsie, Cachexy, or deadly pining will in a short time suc∣ceed.

If it be critical upon acute Feavers nature * 1.4 effects the Cure: if it be symptomatical, the Cure depends upon the Cure of the Disease by which it comes.

If it be essential from the obstruction of the Meatus Hepaticus, the obstruction must be opened.

If sorrow of mind or great passion be the Cause, it ought to be prevented as much as may be, both by Philosophical and Theolo∣gical reasons about any troublesome matters, and by confirming the mind, whereby the sick may be the better enabled to bear and suffer stoutly any adversity.

This ought to be observed also in all other Diseases.

If Ebriety be the cause I commend Sobrie∣ty to cure it. Sublata causa tollitur effec∣tus.

If the humours be over viscous or gluti∣nous, the following Decoction will not one∣ly alter and correct, but mildly educe the peccant humours, by which the Jaundice may in a short time be cured.

Take of Rhubarb, the Roots of Madder, Smallage, the greater Celandine, of each * 1.5 one ounce; the Flowers of Broom one hand∣full; Hemp-seed two ounces; the Seeds of Anise, Parsley and Columbines, of each half an ounce; Saffron two drachms; white Tartar three drachms; let them be cleansed, bruised and boiled in White-wine, and Foun∣tain water, of each three pints, till the third part be boiled away, then strain it, and add the best Manna, Syrup of Succory with Rhubarb, of each three ounces; mix it.

Let the sick take four spoonfulls of this three times a day, till the viscous phlegm and Choler be sufficiently evacuated, and the na∣tural colour of the body restored.

As oft as the Jaundice is caused by the poi∣son of a Viper, or any other venemous thing whatsoever, you must administer (as soon as possible) a volatile sudorifick to correct and expell the venome.

The following will serve to both indica∣tions.

Take the waters of Carduus, Fennel, Fu∣mitory, * 1.6 of each two ounces; Treacle-water, Syrups of the juice of Carduus, red Poppies, of each one ounce; tincture of Saffron two drachms; Venice-treacle half a drachm; Be∣zoar-mineral, Antimony diaphoretick, Salt of Harts-horn, of each one scruple; Spirit of Salt-Armoniack six drops; Laudanum opi∣atum six grains; mix it, and give three or four spoonfulls to provoke sweat, and after it breaks forth, give a spoonfull or two, now and then, to promote it.

Also this Decoction, or one like it may be prescrib'd for the Icterick patient, it being both Sudorifick, and Diuretick.

Take the Roots of Scorzonera, Juniper, of * 1.7 each two ounces; Roots of Master-wort, Sassaphras, of each half an ounce; Berries of Juniper and Bays, of each one ounce and half; Seeds of Nettles, Hemp and Colum∣bines of each one ounce; shavings of Harts-horn three drachms; the tops of Carduus, Scordium, Scabious, the lesser Centaury, of each one handfull; let them be cleansed, bruised and boiled in two quarts of Fountain∣water, till half of it be boiled away; then strain it, and add Syrup of the juice of Car∣duus four ounces; Treacle-water two ounces; Salt of Tartar vitriolated two drachms; mix it, and give four spoonfulls every two or three hours.

Soap of any sort, conduceth to the cure of the Jaundice, upon a twofold account, both by reason of its fixt lixivial Salt, and al∣so by reason of its fatness or oil; for the Lixi∣vial Salt doth correct and diminish the over volatileness and spirituousness of the vitiated Choler, and the oil doth blunt the sharpness of the volatile and spirituous Salt ruling in Choler.

The following mixture is very effectual.

Take of Hemp-seed two ounces; Soap two * 1.8 drachms; bruise the seed, and boil it in half a pint of new Milk, till half of it be con∣sumed; then strain it, and add Syrup of Saf∣fron half an ounce; tincture of Saffron two drachms; Laudanum opiatum four grains; mix it, and give half of it in the morning fasting, and the remainder at night, going to bed.

Notes

• * 1.1

  Icterus.
• * 1.2

  Cause. I.
• * 1.3

  Progn.
• * 1.4

  Cure.
• * 1.5

  Decoction.
• * 1.6

  Sudorifick
• * 1.7

  Diuretick Decoction.
• * 1.8

  Opiate.