The natural history of Lancashire, Cheshire, and the Peak in Derbyshire with an account of the British, Phœnician, Armenian, Gr. and Rom. antiquities in those parts / by Charles Leigh ...

SECT. II.

Of CONSUMPTIONS.

COnsumptions in general as they occur to us in daily practice may be reduced into these following Classes, (viz.) Scor∣butick, Strumous or Chylous, or they are frequently the effects of Epidemick intermitting Fevers, or Dropsies, the Rickets, Sur∣feits, Impetigo, the Chlorosis, fluor albus, Rheumatick, Scorbu∣tick, Jaundice, of an Hernia Carnosa, spitting or Vomiting Blood, and very often the Worms.

But since the Scorbutick Phthisis rages more Familiarly a∣mongst us, it shall chiefly be the subject of my present Di∣scourse.

Scorbutick Phthisis may challenge three Originals contracted either from the Air, or they are Hereditary, or proceed from some error in the six Non-naturals.

I'll speak first of those that arise from the Air, they are called Stationary, or Diseases peculiar to such a place.

In those parts which abound with Marshy grounds, or where the Air is all impleted with the smoke of Pit Coal, these Con∣sumptions are in a manner Epidemical.

This granted, it is plain this Distemper owns its rise, and Progress, to Vitriolick, Sulphureous, Saline Particles; But to il∣lustrate this Hypothesis take these following Experiments.

Drop a little Spirit of Vitriol upon Spittle, there immediately ensues a White Viscous Coagulum, like what is frequently Cough∣ed up in Consumptions.

Or take some of the Vitriolick Spring near Haigh in Lancashire, mix that with Saliva, you will then distinguish the Coagulation to be of an Ashy Colour, Parallel to that I have often observed in a Scorbutick Phthisis.

Or if you distil Kenel, there strait ascends a Vitriolick Li∣quor, mix that with the Serum of the Blood, it passes strait into a very Viscous Coagulum, the same as in a Scorbutick Phthisis.

These things premised, it is evident that by Vitriolick Parti∣cles, the Spittle, and Serum of the Blood are render'd Viscid, and in Tast, Consistence, and Colour adequate to what we find in Scorbutick cases.

Since then as is Demonstrable by Chymistry, these Vitriolick Partricles are disunited by Fire, and fill in Crouds the circumam∣bient Atmosphere, and that in such an Air the Phthisis is most general and particular, it is but a rational consequence to imagine, that then these Vitriolick Particles communicated to the Mass of Blood by the Air we breath in, begin, and cherish this Stationa∣ry Phthisis.

But now the principal difficulty to be solved is this, how the Inhabitants bordering on Salt and Marshy Coasts, become the subjects of this Distemper, and are so much infested with it, who live only upon the products of the Fields, and altogether abstain from Meats Salted, or Dryed in Smoke, how, I say, the Air here becomes saturated with saline Particles, since Marine Salts, as is plain by Evaporation, are of a more fixed Nature than to ascend by the Heat of the Sun or the force of the Winds.

Having had several Thoughtful Essays on this subject I brought it at length to this Conclusion.

It is very clear to any Man's Observation, that these Maritime Climes abound both with Sulphureous, and Saline Particles, this Hypothesis is confirmed by the subsequent Arguments.

In the first place about Even-tide in these parts are to be seen infinite flashes, like so many Phosphors bursting from out the Earth which undoubtedly argues a Sulphur to be there, in the second place very fetid smells are often emitted like what are discernable in a Mixture of Sulphur and Salt, so that from these Salt and marshy places, Sulphureous Particles continually arising, are yet so entangl'd with Saline ones, that they bear them up up∣on their Points, and by that means impregnate all the Neigh∣bouring Atmosphere; for since this Phthisis is so universal in those Airs, it is but reasonable to suppose it draws its nourishment from Sulphureous, Saline Particles.

For a farther Confirmation of this Hypothesis we may draw an Argumen te Contrario, as for instance, this Distemper is very rare where these saline Loams are wanting, hence it is that in some places of Russia, and New-England, for a whole Year toge∣ther you will scarce hear a Person Cough, though he inhabits on the Sea Coasts, and why may it not be for the same reason that the Air in Monpelier, is become so famous against Consumptions though it borders on the Mediterranean Sea.

When on the other hand in the first mention'd places not a Year passes, but Consumptions, Dropsies, Scorbutick intermit∣ting Fevers, nay whole Myriads of Diseases very severely abound, so that we may almost say of these Salt and Marshy places, as Pythagoras did of the Herb Aproxis, whose Root takes Fire like Naphtha, and by whose Effluvia the Air is renderd infectious.

It remains now that I treat of the other species of a Scorbutick Phthisis, (viz.) arising from some errour of the six Non-natnrals, and those that are Hereditary, as to the first, their causes may be explain'd by the above recited Arguments, so waving them, I'll proceed to the Scorbutick Hereditary Consumption.

It passes for an undoubted truth amongst Philosophers, and Anatomists that an Human Foetus is formed in the Ovum, but the manner how these Ova become impregnated is the Controversy.

The Ova are guarded by a double Membrane, and involved in their proper Coats, so that not one Drop can be squeezed from them, there are some that very zealously assert, they are impreg∣nated by a certain Gas Virile, or Seminal Air; certain it is, and very obvious to us in practice, that many lab'ring under this Di∣stemper have prosecuted the steps of their Fore-Fathers, although their Mothers through the whole Course of their Lives have con∣tinued strong, and healthful, some are seized with it about the same Age their Fathers were before, some perhaps sooner, some later, some have all along continued sickly and infirm, others robust, and vigorous enough, till the very seizure of the Con∣sumption, and all this according to the different Crasis of the Se∣men Virile, even as the Spirits are lodged there, or more or less depress'd, or the Saline Particles exalted, hence the very Princi∣ples

of Life form our different Constitutions, and so early or late the Person becomes Consumptive.

Upon the whole it is my Opinion, that the Semen Virile in the Uterus is absorbed by the extremities of the Vessels, and thence communicated to the mass of Blood, which by its Circu∣lation impregnates the Ova, for how is it possible the Gout or the Stone shou'd be derived from the Father by a Seminal Air? The conclusion is very evident to the contrary; but of this I have treated before.

I shall proceed now to the Symptoms of this Disease, which I will very briefly lay down as I have Experimentally found them.

A loss of Appetite, and Strength, generally attends the Pati∣ent, with a straitness or compression of the Breast, a tickling Cough, the Spittle Large, Thick, White, and sometimes Yellow, Pellucid, Sky Colour'd, Faetid, Salt, Acid, Sweet, more or less, according to the Discrasy of the Blood, and the quality of the Obstruction, with profuse sweatings in the Night time, a tabidness of the Flesh, hot and cold fits alternately succeeding, the Urine Lixivial, with a very large sediment, sometimes Yel∣low, and sometimes Red, many times a Diarrhaea, and Gripes of the Belly torment them, with swelling of the Extreme parts.

These things observed I will now endeavour to assign the rea∣son of those Symptoms, and first, as to the loss of Appetite it may thus happen, those Glandules seated in the lower part of the Stomach, which were wont to separate subacid Humours flowing from the Arteries, by which the Nervous Fibres irritated, the Appetite was excited, but they being now clog'd with viscous Humours, are render'd very unfit for that motion, hence proceeds that loathing of Meat: That there are such Humours is very ap∣parent in some Persons after taking a Vomit, if we observe the great quantity of tough flegm they discharge.

By the same Viscid Humours extravasated in the Lungs, the in∣spiration of the Air is interrupted, hence proceeds that straitness of the Breast the Person complains of; this glutinous matter separated by the tracheal Glands is often thrown up in large quantities, and

this also besmearing all the Trachaea, occasions hoarsness, the Conglobate Glandules thus stuft by these Coagulations, and the small Foramina of the Lymphaeducts at the same time obstructed; that Lympha which used to pass through them, now deprived of its proper Emunctories, regurgitates into the mass of Blood, and forces its way through unwonted Passages, and thence it happens, that by the Glands of the Wind-pipe those continued showers are distill'd as is plain in a tickling Cough.

By the same parity of reason those large sweats are so fre∣quent, and hence comes the Diarrhea, Gripes, and Swellings of the extreme parts.

Sometimes by these tough and clammy Humours, the Glan∣dules of the Mesentery become Obstructed, and even the Chyle it self is intercepted in its Passage to the Blood, whence the whole Body rob'd of its daily nourishment, the strength decays, the Patient Emaciates, and the Excrements are often White, the ve∣ry Lacteal Vessels disappear, just as we may observe the Milky Way in the Heavens, screened from us by interposing Clouds.

Some portions of the Chyle are precipitated by Saline Parti∣cles, thence happens the spittle emitted by Cough to be white, thick, and sweetish; and sometimes urged through the Kidneys, the Urine then becomes filled with a white, and plentiful Sedi∣ment.

By the subsidence of the Muscles, the Prognostication is O∣minous, as the common People apprehend, the Soul then being about to desert the Body and ready to take Wing; Hippocrates and others of the Greeks Denominate such Persons 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.

The Glands of the Liver Obstructed forbid a due separation of the Bile, which rebounding into the Blood, and Fermenting there with its Acids, thence a slow Fever ensues, and the same reason may be alleged for so large, a Yellow, or Red Sediment in a Lixivial Urine.

As to the hot and cold fits successively intervening, they may very easily proceed from such a Fermentation, and so unequal a mixture of the sour Chyle in the Blood.

The Spittle as we hinted before in this Distemper is often Thick, White, and Sweet, occasion'd by a Precipitation of the Chyle upon the Lungs, and sometimes it happens to be thin, and Pellucid, commixt with Thick, this I conclude to be the Lympha which instead of passing through its proper Ducts, by reason of the obstructions of the Conglobate Glands, forces it self through other secretory Vessels; and in this case He mightily errs, who offers obstinately to stay the the Defluxion by Opiates; He might equal∣ty pretend to check the Billows in a raging Storm.

At other times the Spittle is Sky Colour'd, Salt, and Bitter, these happen as the Bile, and Salts of different species are indif∣ferently intermixt.

There yet remains another familiar Symptom to be explain'd, how in this Distemper the Urine becoming so very Lixivial, and depositing so large, and red a Sediment, yet affords a very grateful and sweet smell, not unlike those Urines voided after the Admi∣nistration of Turpentine, and preparations of Sulphur, its super∣ficies at the same time being all over-spread with a thin Oleage∣nous Pellicle: In this case I suppose the Urine to be highly satu∣rated with Saline, and Vitriolick Particles, the Saline Particles after their Effervessence with the Bile Precipitate it, hence en∣sues that vast quantity of Sediment, and those two Bodies by Fermentation grow Red, just like Sulpher exalted by Fire, and thence it is the Deposita of the Urine appear so like Brick; The Saline Particles likewise in their Fermentation entangle some Oleagenous Particles, which in that hurry being forced through the Reins, and the Urine thus impregnated, being exposed to Air, these Oily Sulphureous Particles striving to disengage them∣selves, float upon the surface, and emit so pleasant on Odour, an instance like to this is in dulcifying Spirit of Nitre, with Spirit of Wine, which must necessarily strengthen the Hypothesis, where the like smell is very distinguishable.

But now the Query is, whether in this State the Lungs are al∣ways full of Tubercles, as the Eminent Morton proposes; I con∣fess indeed in these parts the People are generally as averse to a Dissection, as an Execution, so I neither deny nor assent to it;

yet as far as I have observed in practice, I affirm, that not one Symptom of an Inflammatory Fever has appear'd in many Persons who have sunk under this Distemper; to this Opinion the Hi∣story of Dr. Bennet agrees, taken out of Theatr. Tabidor. pag. 96. (viz.)

When I practised Physick at Bristol, in that Vaulted City Consumptions were very frequent, I met with some that with no great difficulty Expectorated a sweetish Spittle, yet in the space of three Months were grown very feeble, and ener∣vate, some indeed of these, though not all were much fatigu'd with Coughing, and so wasting insensibly dyed Tabid, for satis∣faction in this Case we opened a certain Person, who after he had ceased Spitting a Salt Phlegm, for some time Coughed up Blood, the Lungs indeed had lost their Tone, yet both them, and the other Viscera appeared sound.

However mistake me not as if I infer'd from this instance, that the Lungs in Consumptive Cases were never fill'd with Tuber∣cles, for I have often seen them Ulcerated: I only affirm this, that in this common Lancashire Consumption, where the Patient suf∣fers a daily decay, and continually throws off a Thick, and White Spittle, in the beginning, I say, and encrease of this Distemper, the Lungs cou'd not be pierced, nay I have known many die without one Symptom of an Hectick, through the whole course of the Disease, so that we may reasonably conclude their Lungs cou'd not be Ulcerated.

Proceed we now to treat of the Phthisis in a confirmed state, and here we may observe Nature every day declining, insomuch that the Mass of Blood contracting a very Vitriolic habit; the Spittle tasteth like Alom, or Salt of Steel, and now it is the Saline Particles range at Large, and know no bounds, now the Fever becomes more continued and strong, by Fermentation of the Vitriolic, and Sulphureous Particles; as when you mix Oil of Vitriol, and Oil of Turpentine together.

By this Effervescence the Capillary Vessels of the Cheeks be∣come distended, hence happens that fixed red Colour on both sides the Face, a certain signal of approaching Death; just like

the last efforts of a Lamp deprived of Oil, it flashes and expires, or like a setting Sun, gilding red all the Hemisphere.

The Conglobate Glandules thus more and more Obstructed, and a greater quantity of the Nutritious juice being daily precipi∣tated, a thicker and more plentiful Spittle follows, by the Vi∣triolic Particles commixt with the Sulphur of the Blood, and hence ensues a smell like that of Faetid Fish.

The Lungs at length oppress'd with an uncommon weight of Phlegm, the Patient becomes Asthmatical, and finds a continual burden upon his Breast, and in this case I have known the Spit∣tle to be extraordinary Faetid, yet not always proceeding from Ulcers of the Lungs, as some assure us, for how cou'd those Persons be free from a Diarrhaea, and sweats, when the Lungs are all penetrated with Ulcers; The cause of this stench may ra∣ther be attributed to Volatile Sulphureous Particles, pointed with Saline Ones, with which the Serum of the Blood abounding they commix with the Saliva, for the Sulphureous Particles apt enough to fly off, bear along with them the Saline Ones, and strike up∣on the sensory, and affect it with a Nauseous smell; When on the contrary Sulphureous Particles, per se, disentangl'd from SalineOnes, touch upon the Olfactory Fibres, produce a very grateful scent, as is Evident in the Effluvias of Aromatick and Balsamick Flowers, and now the Nutritious juice Expectorated in vast quantities, the Facies Hippocratica, and a Marasmus of the whole Body is the consequence.

The Conglobate Glands being still more Obstructed, and the Blood all degenerated into a Saline temper, the Patient is now afflicted with profuse sweats, violent Diarrhaeas, with acute pains like those in Rheumatisms almost intolerable, some complaining of Pains in the Bones, in whom there is not the least suspicion of the Lues Venerea.

One Symptom more remains not less common than the rest, and worthy our highest regard, in many Persons emaciated to meer Skeletons, and reduced even to the last Extremity, the Ap∣petite yet remains good and laudable, nor is any Hectick heat the effect of Eating, no Sweats nor Diarrhaeas nor inflation of the Stomach, attend the Patients, and yet they insensibly wast away,

throwing up a large quantity of Thick, and White Plegm.

From what has been said we may sufficiently gather, that the Natural ferment of the Stomach sharpned with the Vitriolick Particles of the Blood, irritate its Nervous Fibres: The Spirits thus excited, produce a quicker motion, and promote the Ap∣petite, which, Ostrich like, covets and dissolves whatever is in∣gested, hence passing through the Lacteals, and Chyliferous Ducts it enters the Mass of Blood, and is there by the Saline Particles precipitated into Thick, and unnutritive Humours, incapable to transpire by Sweat, or descend by Diarrhaeas, but subside in the Lungs, and by that means the party continually declines.

There is yet another remarkable Symptom under this Head, that an irregular intermitting Fever seizes very many almost spent with this Distemper, some it assaults only once, others twice or thrice in the space of Twenty four Hours; It rushes on with great dis∣order with an Itching betwixt the Scapulas and Loins: The whole Body trembling is render'd Convulsive, and an intense heat succeeds, and after that sweats, and sometimes a looseness; what can these Reciprocal returns of Heat, and Coldness proceed from? But from sharp Salt Humours extravasated upon the Nervous Mem∣branes, upon the Extremities of the Nerves, and the subcutaneous Miliary Glands, these parts being saturated to excess, and Vellicated by their Acrimony, of course produce those Chilling Pains, but at Length the Humours being absorbed by the extremities of the Vessels, and then mixing with the Blood, a new Fermentation with the Sulphureous Particles arises, and so the Feverish heat renews; The Morbifick matter at length overcome is cast off by Sweat or Siege.

I have known some who in a State of Health, have been of a very pleasing and agreeable Disposition, yet being much worn out by this Distemper, have grown very fretful and peevish, and so violently Passionate, that they cou'd scarce endure to see, or hear any one speak; this must needs be the effect of the sour juices of the Blood, that nettle, and enrage the Spirits.

To conclude, something might be added here concerning the other Species of Consumptions, those that are either Hereditary,

or arise from some errour of living, but since their Symptoms are observed to be much the same, it is but reasonable to suppose their Originals so too.

Every State of the Consumption might be Illustrated with Parallel Histories, as likewise the Methods of Cure might here be proposed, but those being accounted for before in my Phthisio∣logia Lancastriensis, to that I refer you.