The test and tryal of medicines and the different modes of medical practice. Shewing what hopes of help, from physick and physicians. By E.M. Med. D.

Mundus Errore tenetur.

MEdicines being of the greatest Importance, and the principal part of the Art of Physick: they require the greatest Consideration, serious Care, and strict Examination, for an assurance of their validity and worth; for as much as the Reputation of the Physician, and Life of the Patient, doth depend thereon: an errour or neglect herein, frustrates and baffles all the Physician's Learning; and if he be not skillful (not by Book reading, but Manual Operation) in this grand work, all his other learned qualifications are but deceit, and avail little in Curing. And since the Import of Medicines is so great, as be∣ing the immediate Instruments contending with Diseases; and from their Power and Excel∣lency, Curing is performed or frustrated; it mainly behooves the Physician (and as much it concerns the Patient) that he be compleatly provided with a stock of elaborate, excelling Medicines, reformed and well proved; such as he may confide in; to oppose the secret intestine Enemies, that prey upon Health and Life; and with which he may repair and support the Fabrick of humane Bodies, unto the period of their term, by the common Course of Nature: else it may be said, this or that Person came to an untimely end; as many do, for want of good means, or due administration. This premised, I proceed to the matter proposed.

All Medicines, that are designed and formed by Art, in respect of their Latitude, com∣prehension, and adaption; may be divided into three Ranks or Classes: and then they are either Catholic, Specific, or Appropriate.

The Catholic (or universal) is a Medicine of large extent and comprehension, applicable to, and useful in many and various Diseases, and also in divers Persons.

The Specific Medicine is such, as Nature or Art hath specificated and designed for the Cure of one particular Disease only; and that in divers Persons.

The Appropriate Medicine, is yet narrower and more restrained, being prescribed for, and adapted to the particular Case of one single Person only; under such circumstances and complicated Infirmities.

Now to compare these three sorts of Medicines, of different extensions; as touching their worth, usefulness and certainty in Curing; my Judgment and Experience determines thus.

The Catholic Medicine, that hath been studiously formed, oft revised, reformed and me∣liorated, by a skilful Artist in Pharmacy; long and often proved, and thereby approved, for its amicable, steddy, and certain operation; and most frequently attended with Suc∣cess: this excels all other; for its generous Latitude, and comprehensive Virtues; being a ready, most confiding, and advantageous assistant against many Diseases; very useful, and fitly applicable to divers Persons, though differently seized and afflicted; but requiring such manner of Operation as this Catholic performs: whether it be Cathartic, Diaphoretic, Diure∣tic, &c. thus allowing a plurality of Catholiks, distinct in their operations.

The Specific Medicine (that is truly so) having been frequently experimented, and sel∣dom failing to do its Work; is a rare good Medicine for a single Disease; but then it is bounded within that narrow compass of one particular Malady; and its virtues are not of that generous, useful, and extensive Nature, like the Catholic Medicine; and is therefore inferiour in excellency and worth, excepting only against that Disease, for which it is speci∣ficated, or peculiarly adapted.

The Appropriate prescribed Medicine, adapted to Person and Case (in the new Mode of Practice) though seemingly sounded upon much Learning, by traditional Book assistance; yet is much more casual, hazardous, uncertain in operation and success, much less to be presumed and relyed on, than the two former Medicines: for this is but a Prescript design∣ed by conjecture and probability, and an Experiment to be made at a venture, or at best by analogy, which is no certain Rule: and therefore this appropriated chance-Medicine, must come far behind the two former, in dignity and safety, because they are Medicines proved and approved; this never was proved, but waits for Sentence until the tryal be past; and whether this appropriated Recipe will prove good or bad, the Doctor cannot tell, but he hopes well: and this he will say for himself, the Ingredients are all good and harm∣less: but that is not sufficient; for granted that all these things be innocent and good in themselves, as you say, it does not therefore necessarily follow, that they must needs make a good Medicine, for such a purpose, and to operate so and so; but it may happen much otherwise.

Now the reason why this Appropriated Medicine, though contrived and appointed by learned Men, should be thus uncertain and dubious to rely on, are these: First, Because every new association of ingredients, or variety of preparation and manner of composition (to form an Appropriate Medicine) so much alters the Ingredients, in their properties and virtues, by acting and re-acting upon each other, that their single Natures and Virtues are not the same in this, as they were in another Conjunction: and every new mixture, or dif∣ferent preparation, makes such a change in their harmony and agreement, that the result or product is not foreknown by the best guessing judgment; but tryal and use must declare, whether it be good or bad: whether these things will yoak, and draw amicably toge∣ther; whether they will all concur and conspire with the intended operation: and if they will be subjugated, unite and comply with the form of the Medicine; and whether a dis∣proportion in their quantities may not appear afterwards, and some ingredient may be un∣duly exalted, and prevail over the rest, to a disgust at least, if not a greater injury; in bi∣assing the Medicine from the operation intended. He that can make all these requisites, so evenly to fall in with the Medicine, and hit it so rightly, upon the first projection (of an Ap∣propriated Medicine) is a wonderful lucky Man: and to do all this, in a quarter of an hour, at the Sick Man's Chamber, with Pen and Ink; and I cannot design and compleat a Medi∣cine at home in a quarter of a year, with the use of a Laboratory, to be well satisfied there∣in; this is strange, very strange. But look into these appropriated Recipes, filed at the Shops, and the Mystery of this does plainly appear; That they are not such as the World does believe them to be; but a sort of squinting, discordant, uncertain, unreformed Medicines, upon the view of an expert Operator in Pharmacy.

Secondly, No certainty of knowledge in the Patient you design the appropriated Medicine for (surer than the Catholic and Specific adaption) in as much as no idiosyncratical, or indi∣vidual propriety of Person is foreknown; in point of operation and agreement of Medi∣cine, farther than the tryals and experiments made upon the humane Nature of Bodies, with many other Persons: and therefore every new invented, untryed Medicine, adapted to Person and Case, are but presumed, uncertain and unsafe; and it necessarily follows, that the Catholic and Specific Medicines, are much to be preferred, and more to be relied on, be∣cause sufficiently tryed and proved, to agree and perform with many.

And thus much in short (yet much more is to be said) concerning appropriated Recipe's or Prescripts, untried new Medicines, contrived with Pen and Ink, and transmitted to the Shops to be made up: being compared with the Catholicks and Specificks, the Pharma∣ceutick Arcana's, standing Medicines, reposited in the Physicians Closet, being the result and perfection of long labour, industriously and carefully prepared in their own Laboratory, well proved and compleated, ready for Practice. And this determina∣tion, upon the comparison of Medicines in this triple division; I make from Reason, and my Experience in both the Modes of Practice, having first been conversant near ten years to∣gether in the prescribing Practice, making Experiments with Appropriate Medicines, pro re nata; and since, for above twenty years, operating in Medicinal Preparations (to be Master of Catholic and Specific Medicines, more secure and certain in their Operations) and practising therewith.

Having thus shewed you the several distinct and bounded Latitudes, the aim and scope of Medicines, in their design of Adaptation to Persons and Cases, and my Judgment thereupon; next we shall consider Medicines, in their different manner of Operation or Working; how they assist Nature against all the Diseases that assault and afflict her; and what effects we may rationally expect from their Power and Virtues. And here you will have before you, Natures Directory, for performing of Cures in all Diseases that shall present; and how she is to be relieved in her praeternatural State, and deviations from her right and regular Course.

There are six Cardinal Operations, or principal wayes, by which Medicines do operate, for the discharge and throwing off all excremental, morbific matter, that is bred or recei∣ved into the Body, viz. by Purgation, Transpiration, Ʋrination, Salivation, Expectoration and Corroboration; hereby to preserve or restore Health decayed: and these are promoted and used in Nature's Method, which she performs in the constant work of Nutrition; casting out the relicks, and superfluous matter of our food, not fit to be retained; she works by stool, transpires, urines, salivates, expectorates; and lastly corroborates, with the Quintessence ex∣tracted from Aliment; and this enables Nature to perform all the rest.

Now these Evacuations, and Roborating assistance, are to be promoted by Medicine, as Nature oppressed or decayed, doth chiefly require and stand in need of; sometimes the one, sometimes the other. In some Cases, one of these Operations, duly prosecuted, with an excellent good Medicine, is sufficient; as Purgation alone sometimes doth all that is need∣ful to restore the Person complaining: other conditions of Body may require two: as Purg∣ing, and also roborating the Faculties. Sometimes three several operations are required by turns: to restore lost Health, and sometimes four are needful; as in Contumacious and Complicated Diseases, in difficult and decayed Bodies. And by this Method all Physicians ought to go with secure well proved Medicines; and thus all Cures are regularly to be per∣formed, and not otherwise, by various, uncertain, invented Medicines.

Now these being the certain ways, and only chief Methods of Curing; the frustration and failing herein (as to the Physician's part) is from the insufficiency and defect of Medi∣cines, to operate compleatly those Intentions. And since the design of Curing, most safely and most certainly, falls under such a method and management as this; then it mainly con∣cerns

the Physician, to be furnished with a stock of such choice Medicines of his own elabo∣ration, formed, reformed, and sufficiently proved, wherewith to dispatch his Undertakings satisfactorily, and with credit: and it as much concerns the Sick and Diseased, to find out such Physicians, from whom they may expect the greatest help and relief, they are capable of; especially in difficult and deplorable Cases; and not to be Patient sufferers, and tryers of conjectural new invented Recipe's, and uncertain traditional Book Medicines, taken up upon trust, collected from Authors, and transcribed from one another.

There are three principal things which concerns a Physician to know, when he is sent for to the sick or diseased; in any of which, if he fails, the Patient may miscarry or linger.

First, By questions, and by the symptoms that present, what the Disease or Complication of Diseases the Patient labours under.

Secondly, What Operation, or Operations of Nature in Man's Body, are to be promoted, or assisted; for relief in the present Case; and which to precede.

Thirdly, With what Medicine, or Medicines, this Operation, or Operations, are to be performed by.

For the first, That is to be done at the Patient's House, in his presence. The two latter, at the Physician's House: he must make no Medicines with Pen and Ink in the Patient's Chamber; but return home, and there consider of the operation indicated, and most ra∣tional to give help in that Case; whether purging, sweating, corroborating, &c. otherwise: which having determined, the Medicine is to be sent away immediately, if so requiring: and this Medicine ought to be ready prepared (by himself and Servants) and well proved, long before the use of it was wanted, or required.

But the Prescriber, he makes Medicines upon a piece of Paper in the Sick Man's Chamber; and would have the Patient believe, that all his Complaints are put into the Medicine; something for this, and something for that, and another ingredient for the other ailment: but alas, here is a great mistake, Medicines will not be designed and formed after this man∣ner; Medicines are not to be made by Indications, though they are to be exhibited by Indications. You must not mix this and that together, as proper and suitable (in your Phancy) against this and that complicated Infirmity; the Medicinal Composition may then prove as discordant and disorderly in it self, as the Diseases in the Patient's Body were re∣pugnant, and exasperating one another. Because (you will say) the ingredients are all very good; therefore the Medicine must needs be very good: that's a non sequitur. You must steer by another Compass, if ever you will arrive at the true knowledge of Medicines, or the right Method of Curing. After your Mode of guessing at Medicines, many an unlucky Medicine hath been invented; the effects whereof are too bad: but all must then be father'd upon the Disease, that was so intractable and malignant, as to produce such un∣expected strange Symptoms: pertinent to this matter, take the following Story.

Calling at a House, where formerly I had a Patient, there was one sick at that time there; the People of the House, being my acquaintance, desired me to go up, and give my opinion of the Sick Person, which I refused, because under the charge and cure of ano∣ther Physician: but being importuned, I was prevailed upon, and did go into the Chamber; I viewed the sick, and asked some Questions; understanding who the Physician was, a Man of good Learning and Repute, I gave him his due, and said, he well knew what he had to do; and seeing some Glasses upon the Table; I tasted of one, with a Label, inscribed, The Cordial: of a maukish, flat, and sweet tast, more likely to make a Stomach sickish, than to refresh and cheer a faint languishing Stomach. I took another Bottle, and tasted a few drops upon the Pallat, turning it about in my Mouth, but swallowed none; yet this so drew my Chaps together, with such vehement astringency, that my breath was stopt a while, until I could recover my self: If any one would give me a hundred Guineas, I durst not take a Spoonful down, for fear of suffocation. I said little; only that I did not like

that Medicine; but my thoughts were full. Two or three days after, meeting a Servant of that House in the street, I asked how that Patient did; the answer returned, she was dead. Now these Medicines were prescribed by guess, at a venture, and ill composed: or else the Apothecary, or his Servant, was highly in fault: but where the miscarriage was, did not belong to me to examine; and so it past off. The Doctor was an able Man; the Apo∣thecary was an honest Man; and the Patient was become a dead Woman: and there is an end of the Story. But not a few such Casualties do fall out in the Prescribing Practice; and many People can tell such Melancholy Tales, something like to this. The Diseases, and unhappy Casualties thereupon, in and about London, if a true account could be had, would make a Weekly Bill, not inconsiderable, but worth remarking.

I see, and do hear of many learned Men, and yet I can see but a very few learned Me∣dicines: either they fail in the association; (an Ox and an Ass cannot well draw together) or by disproportion in quantities, or in the manner of Process, and finishing. If Learning be not brought down into the Medicine, what signifies Learning in point of Curing; only a varnish, and a flourish, to set off and dazel Folks Eyes: Let me see the Medicine, I'll tell you what the Doctor's Learning is worth, in the design of Curing.

The great Men of the World, that can command all the assistance and help this Art can afford; and therefore deem themselves the more secure; are oftentimes the most unfortu∣nate, under Physick, of all others; chiefly at the times of the greatest danger, in acute and peracute Sicknesses: having three or four, or more Physicians to attend them: each of them must put in for a share, in designing and forming the Medicines: one will have this, ano∣ther that ingredient, and a third, something else to be added: then the form of the Medi∣cines, and the Modus praeparandi, is not readily agreed upon, but dissent and thwarting ari∣ses there, each Man stiff in his opinion, and loth to yield; but the urgency of the Case, admitting no delay, sometimes forceth an abrupt Conclusion; not a free Consent, and ge∣neral Concurrence. Now what can you expect from these Consultations, and excogitated new Compositions, though designed by Men of Learning; for they themselves can have no assurance in them, but an uncertain conjecture; no well grounded hope: and so long as Practice thus depends upon the Invention of Remedies, whose operations will be very Casual, and then success must needs be very dubious. And now, my Lord, you have but a Chance Medicine for all your Guineas; but that's not all the loss; here is a cast thrown for your Life: it may happen well, by the benign aspect of your Stars; the good Providence that pro∣tects you; but not the Doctor's Skill: they put it upon the Venture; they can have no true knowledge of such Appropriated Medicines; and what the result of their mixture will be, is but strangely presumed, and groundlesly hoped; being formed without a Rule, and not confirmed by experimented Proofs: for although the single ingredients be good and inno∣cent in themselves, yet what their Concord will be in Composition, and what Concurrence to the intention aimed; nothing but Experience in the Tryal can determine. If then dubious Medicines be put upon dangerous Diseases, the attempt seems desperate, and the event looks fatal.

If this be the Practice of Physick, then Physick shall never be practised (after this man∣ner) upon me: then rather give me the Countryman's Pepper Posset, and I'll venture it that way. I don't like to die by Physick: then I shall know, whether my Disease be mor∣tal or not: but he that dies in the other chance Practice, who can tell, whether his Di∣sease, or his Medicines, let him slip, or thrust him out of the World. 'Tis a known say∣ing, Plures gula quam gladius: and I wish it were not as probably true, Plures Medicamenta quam morbus. I have a farther charge to exhibite against the Prescribing Practice, which you may expect at my next opportunity: then the World shall see what they have doted on, and what they have trusted their lives with.

In my former Sheet called, A serious Debate, relating to Health and Sickness: having there

set forth and aproved, that from the beginning, and for many hundred years after, Physi∣cians were all Preparers of Medicines for their own Practice. That Medicines were then celebrated with the Author's Names and Places, for the People to resort thither. That of later times, Physicians have imprudently departed from that laudable and exemplary cu∣stom; and taken up the new Mode of prescribing to the Shops: an innovation hazardous to the Patient, injurious to the Progress and Performance of this Art; rendring it uncertain and unsafe: and in the end will prove the ruine of the Professors. That although illiterate Empericks have defamed the publishing of Medicines, by spreading their trifles abroad; yet the legal Physician is not to decline his duty, because such Interlopers incroach upon his Priviledges and right; for such abuses will happen in the best of things.

And as for my self, having deserted the Prescribing Practice near thirty years, and adhe∣red to the Practice of the Antie••ts; I there made mention of some Medicines of my own Preparation, conform to the Ancient Custom of the most renowned Physicians, and there gave an account of their Virtues, Dose, and manner of use; that those who stand in need thereof, may know where such help is to be had: which perhaps elsewhere, the like may not to be purchased. In vain it is diligently to labour a long time, and earnestly pursue the acquiring of extraordinary means; and being attained, then to bury the success in obscu∣rity, and deprive the World of that relief, which many have languished for want thereof, and now are dead.

The Medicines named, were such as most generally are wanted; viz. Scorbutic Pills, and a Restoring Elixir.

The Pills, by their Purgative and Diuretick Operations, radically cleanse and purify the Body, from all Scorbutic and degenerate humours: which being evacuated and drawn forth, the various Diseases bred from those Causes, must needs wither, and will daily lessen, if duly prosecuted: They fitly apply to most Cases, requiring Purgation and urinary eva∣cuations, and readily serve upon all emergent occasions, or seasonable preventions; opera∣ting with great ease and safety, in young or aged, and the tenderest or weakest Persons, the Dose being suitable. And being of such great use, and durable in keeping; some pro∣vident People, do keep them as necessary provision, to be ready, and not to seek them at the time of need.

The Restoring Elixir performs a different operation from the Pills; but is frequently used by turns with them: for as they by cleansing carry of the impurities and noxious humours that oppress, clog, and obstruct the functions of several Parts of the Body, from perform∣ing their office; so this assisting Elixir is very useful, to quicken, strengthen, and raise up the faculties that are languid and weak; to rectify and reinforce them, when declining and deviating; giving an additional strength, for reducing them again into the true execution of their offices.

☞ I there also mentioned a Medicine very useful and proper for Ireland, against the Di∣sease frequent in that Country, and other Diseases usually attending Camps and Navies, which have proved so mortal to many now of late; which gives me cause to think, the Medicinal help hath not been so fit, and efficacious, as ought to be. If people of the best rank be meanly serv'd at home, though purchased at a considerable Charge; what will not serve to fill up a Chest, to be sent abroad for the use of Souldiers and Seamen? the formality of Phy∣sick is enough; they did not die without the use of Medicines; and to alter this course, is against some Mens Interests; therefore any thing else proposed, though ten times bet∣ter, it shall be opposed and stifled. I wish so well to the publick service, that my zeal makes me bold to offer my sentiments, which I hope will not be resented ill, because intended well.

But I hear, there is care taken for a better supply; that ten Physicians are put upon the work. If they be Pharmacopoeians, Operators in Medicines; I shall expect something ex∣traordinary

from them; but otherwise, if Readers of Medicines, and only Book Learned; I expect no more than the result of other Consultations; conjectural, presumed, chance Me∣dicines. I cannot well think, how a compleat, adapt Medicine, should be made by Con∣sultation, unless the occasion requiring, could wait upon many Adjournments, and days of tryal; to prove, reform, and meliorate their first invention: for many a Medicine that hath been thought very good and promising upon the projection, hath been found mean up∣on the tryal, and rejected.

One Mans experience in a Medicine, is better than ten Mens invention of a Medicine: take that for an Aphorism. And one Man sometimes finds out that, which a hundred cannot; and thousands never did. Here are ten Mens Heads, but where are the Hands? The Apo∣thecaries are to find Hands: If Heads and Hands do not go together, I doubt the Medicines will be spurious. But farther, you'l say, here will be ten Mens experience, and that's surer than one Mans: but then consider how hard a thing, and almost impossible it is, that the experience of many in the form, and methodical use of Medicines, should run so even, and represent each other in uniformity and likeness; but there must be some grains of allow∣ance for disparity here and there, to piece them together, for an accord and union of Pa∣rity; to stamp the certainty of one homogeneous experience upon them; and when that is done, I say, all these experiences, so modelled, and reduced into one Masse, cannot be truly cal∣led concurring experience, in omnibus, that deserves a Probatum est, and a true Copy to form experienced Medicines by; but you must call it a probable experiment to be made; and as yet wants Confirmation by proofs. If it be so, as in reason it is; then I must say, that a com∣prehensive single Medicine, well approved by one Mans Experience (si sit Artifex) is more to be relied on, than a Method of Medicines, from such a compounded Experience of many. But if I prove, you can make no true observation in your new Mode of Practice, and your experience not grounded thereupon; your judgment must needs appear fallacious, and the essential part of your ability taken away: for what is it that makes a Physician able and secure in practice, but experience founded upon true observations: and without this know∣ledge, he is but as a Novice, an uncertain conjecturing Man in the methods of Curing, although an ancient Practiser. But this I must prosecute in my next.

Since all Learning, reasoning, and designing of Medicines, must give way, and yield up to Experience; than which nothing so certain to depend on; I must then prefer my single tryed Remedy, before the methods of any learned Consultation whatever. Having seen the proofs thereof, and manner of operation, in various, difficult, and deplorable Cases: one whereof was my own, and the condition so desperate, as I would not wade through the like again, for a heap of Gold and Diamonds: when all hopes in other Medicines failed, this alone rescued me (Deo juvante) performing the whole course, and answering all the indications that remarkable cure required. The story too long to insert here; or the Con∣tumacious Diseases of others, in which this Medicine hath relieved. One part of its useful∣ness and excellency lyes here; that it is easily managed; whereas Methods of Medicines, being various, both in Method and Medicine; they always require the attendance of a Physician, upon each particular sick Person, which cannot be allowed to an Army marching, or dispersed into Quarters, or a Fleet at Sea. And as for internal Ulcers, or Wounds made by Gun-shot, or Instrument, where the Surgeon's hand cannot come to dress, but must depend upon internal means; this promotes digestion in the wounded part, and also dis∣chargeth the purulent matter, or quittour; performing the office of a Balsam, and disposeth to healing: and if a Surgeon hath such an expedient as this to work with, it facilitates and sets forward his business with all imaginable safety. This is no new Invention (to al∣lure) contrived upon the present expedition and juncture of Affairs; but I can prove it was fortunately designed some years since, upon an extraordinary emergent occasion; with its use and successes in various cases afterwards in Practice. So that I offered nothing upon bare

projection and rational probability, but grounded upon matters of fact, the greatest assu∣rance that can be given to support the credit of a Medicine.

I am the more free upon the Character of this Medicine (yet not the half of what I have to say) because I mentioned it as most advantagious for the Publick Service; that you may not think I offered a trifle, or what is ordinary: I wish there may be such a Medicine found in the Medicinal Apparatus, for Army or Navy; but I do not expect it. As for Contagious Diseases, which oftentimes do infest Armies and Fleets (the causes whereof I could assign) and begets great Mortality, and this for want of a right understanding thereof, good, pre∣ventive, and curative means, and due Administration; but few are fitted for this work. I have seen the highest Contagion that hath been known in England (Plague at London, 1665.) and voluntarily ingaged therein from first to last) when most Physicians ran away, and deser∣ted the people in that Calamity: But I being provided with Antidotes preventive and Cu∣rative, and knowing it was my Duty, I therefore feared nothing; and visited those People, seized with the Pestilence (as I do now any other Disease) my self remaining in good health during the Contagion.

I wish for a sight of the Catalogue of Medicines designed for the service; then I could say something more in this matter.

Quibusdam Remedia. monstranda sunt, quibusdam inculcanda.

Senec.

From my House in Old Southampton Buildings, over against Grays-Inn, Jan. 1690.

E. Maynwaringe.

FINIS.