The store-house of physical practice being a general treatise of the causes and signs of all diseases afflicting human bodies : together with the shortest, plainest and safest way of curing them, by method, medicine and diet : to which is added, for the benefit of young practicers, several choice forms of medicines used by the London physicians / by John Pechey ...

CHAP. IX. Of a Palsie.

A Palsie, in Latin, Paralysis, is a privation of Sense and Motion, by reason the influx of the Animal Spirits is hindred. There are various differences of it; for either it seizes all the parts of the Head, then it is called Paraple∣gia; or only half the Body, then it is called Hemeplegia; or it seises only one part, then it is called a particular Palsie. It is also called perfect, and imperfect: It is said to be perfect when Sense and Motion are wholly abolished; imperfect when the Functions are weakned: And then it is also called Numbness, which is a fore-runner of a Palsie. There is also another Species of an imperfect Palsie, when Motion is hurt, and the Sense remains perfect; and so on the contrary.

The causes of a Palsie in general, are all those things which hinder the influx of the Animal Spirits into the Nerves and Muscles; the most frequent of all is a Fleg∣matick Humour; which by obstructing, compressing, thickning or cooling the Nerves, hinders the said influx of the Animal Spirits.

The Pituitous humour flows from the Brain into the Nerves and spinal Marrow; so a small Apoplexy degene∣rates into a Palsie; because the humour occasioning it is cast from the Brain upon the Marrow, or beginning of the Nerves; and so it either insinuates it self into the substance of them, and shuts the insensible passages through which the Spirits pass; or passing by the Vertebra's of the Back, and spinal Marrow, and following the Course of the Nerves compresses them, and so hinders the passages of

the Animal Spirits; and the same Humour may thicken the substance of the Nerves by its Coldness; so that it cannot make way for the Animal Spirits.

There are other Causes of a Palsie, but they are not so common; as taking Cold, a Blow or Fall, the frequent handling of Quicksilver, tumors near the Spine or Nerves; cutting of the Nerves, dislocation of the Vertebra, or other Joints. The kind of the Disease is easily known; for want of Motion and Sense may be soon perceived; but the knowledge of the part affected is more difficult: But it may be known by those that are skilled in Anatomy, who know the Originations and Insertions of the Nerves. For if the right part of the Face becomes Paralytick, or the left, the other parts being sound, they know the Brain is only affected according to that part from whence the Nerves are carried to those parts: But if the parts under the Head are also afflicted with the Face, the Brain and the Spine of the Back are also affected; and if the parts below the Head are seised, and the Face well, the fault is only in the Spine; and in the beginning of it, if all the Parts are affected: But if only half the Body is Paralytick, only half the Spine is affected. When the Legs are Para∣lytick, the seat of the Disease is about the end of the Spi∣nal Marrow, near the Vertebra's of the Os Sacrum; and so in the rest, the place is to be sought for from whence the Nerves arise. And sometimes enquiry after the exter∣nal Cause much helps to find out the Part affected; of which there are two Instances in Galen, one of a certain Man, who in a Cold and Rainy Season wore a long while a wet Neckcloath about his Neck, his Hands became Pa∣ralytick. The other is of one who lost the Sense of three of his Fingers; and when Galen understood that he fell out of a Cart upon his Back, he conjectured that some Part was hurt by the Fall under the seventh Vertebra, where the Nerve begins; and therefore he applied the Medicine which was used before to the Fingers, to no pur∣pose, to that part.

The knowledge of the Causes is to be fetched from the Procatarctick Causes, the foregoing Diseases, and the Con∣stitution of the Sick; and so the external cooling and moi∣stening Causes going before, Old Age, a Flegmatick Con∣stitution, Winter, cold and moist Diet: An Apoplexy

going before, signifie that the Disease proceeds from a cold intemperies, and a Flegmatick humour.

Feavers foregoing, and sometimes a present Feaver, Cholerick, or Melancholy Constitution, Summer-time, or Autumn, the use of Spices, of Salt or hot Meats, violent and long Passions of the Mind, the excretion of Cholerick and Melancholy humours, or of Acid, or Acrid Serum, hot defluxions upon various parts, and Pains arising from thence: And lastly, when Pain and Convulsions accompa∣ny the diminution of Sense and Motion; and when such as are so afflicted are injured by hot and drying Medicines, and relieved by cooling and moistening Remedies, the Palsie proceeds from Cholerick or Melancholy humours. Tumors, and luxations; and Wounds causing a Palsie are easily known.

The Prognostick Signs.

A Palsie coming from a pituitous humour stuffing the substance of the Nerves, is difficult to Cure. A Palsie following an Apoplexy is seldom Cured, and most com∣monly turns to an Apoplexy again. A trembling coming upon a Palsie is good: If the paralytick Part be hot there is hope of Recovery; but if it be always cold it is hardly Cured. A wasting of the Part, and great Paleness renders it incurable. If the Eye of the Paralytick side be lessened, there is little hopes of a Cure. A Palsie of the Legs or Feet is easier Cured, than of the upper Parts. A Palsie in old People is incurable. A Palsie cannot be Cured in the Winter. A violent Feaver coming upon a Palsie is good, so is a Loosness coming upon a small, and new Palsie.

The Cure of a Palsie is to be varied according to the variety of the Causes; but because it chiefly comes from Flegm, and a cold intemperies, we must chiefly endeavour to remove this Cause, and you must begin with an univer∣sal evacuation of the whole Body: As to Bleeding that can scarce do any good, for the Blood is not in the fault, but Flegm; and for the most part this Disease seises Old People, such as are Flegmatick, and naturally Cold: But if an abundance of crude Blood should seem to produce the Flegmatick Humour, and to nourish it, a Vein may be opened in the Arm of the well-side: But Blood must be drawn sparingly, lest the languid Heat should be extin∣guished.

Therefore Bleeding being omitted, or used as is said, sparingly, the Cure must be begun by removing the ante∣cedent Cause, which is a cold intemperies of the Brain. To which end the following Remedies must be used.

Take of the Roots of Cyperus, Florentine Orris, Angelica, Zedoary, Elecompane, each one Ounce, of the Leaves of Bettony, Marjoram, Balm, Peniroyal, Calaminth, each one handful; of the Tops of Thym, and Sage, each half an handful, of the Seeds of Anise, Sesely, and Fennel, each three Drams; of Liquorish rasped, of Raisins of the Sun cleansed, each one Ounce; of the Leaves of Senna cleansed, and sprinkled with Aqua Vitae two Ounces; of the Seeds of Carthamus bruised, and of fresh Polypo∣dy of the Oak, each one Ounce; of Agarick newly tro∣chiscated; of Turbith, and Hermodactil's, each three Drams; of Ginger and Cloves, each one Dram; of the Flowers of Staechas, of Rosemary, Sage and Lavender, each one pugil; boil them in a sufficient quantity of Water to a Pint; dissolve in it four Ounces of White Sugar, clarifie it, and aromatize it with two Drams of Cinnamon, and make an Apozem for four Doses, to be taken in a Morning.

In the first and last Dose dissolve three Drams of Dia∣phaenicon. Or,

Take of the Mass of Pill Cochiae Minor two Scruples, moisten them with Bettony Water; make five or six Pills, guild them, and let him take them early in the Morning.

The Pills of Agarick, and of Cochiae major are used for the same purpose.

Take of Gujacum, and of Sarsaparilla, each two Ounces; infuse them twenty four hours in two Quarts of Fountain Water over hot Ashes, then boil them over a gentle fire to the consumption of half, strain it, give half a Pint hot in the Morning, and cover the Sick well that they may Sweat. The use of this may be continued for fifteen or twenty days, or longer.

In the use of Sudorifick Decoctions, this is always to be observed, viz. let some Purging Medicine be given once a Week, omitting for that day the Sudorifick Potion. Sneezing, Apoplegmatisms, Blisters, Head Powders, and Baths are also used. After the use of the Diet Drink, give the following Pills once a Week.

Take of the faetid Pill, Coch. Minor, each half a Dram: Troches of Alhandal four Grains; mingle them, and make Pills to be taken in the Morning.

But because the Humour wants preparation before every Purge, therefore two or three days before every Dose of the Pills, give three or four Ounces of the following Water, in the Morning two hours before Eating.

Take of Gujacum four Ounces, of the Bark of the same one Ounce, of Sarsaparilla one Ounce and an half, of China one Ounce, of Sassafras six Drams, of Wood of Aloes, and of Galingal each one Dram and an half, of the Roots of Angelica, Peony, and Fennel, each three Drams and an half, of the Seeds of Peony two Drams, infuse them twenty four hours in six Pints of Fountain Water, and two Quarts of White Wine. Afterwards add the Leaves of Bettony, ground Pine, Sage, each one handful; of the Flowers of the Lime-tree, Primrose, Staechas, and Rosemary, each two Pugils; of Lavender Flowers one Pugil, of Old Venice Treacle half an Ounce, of the Seeds and Bark of Citron each two Drams and an half, of Polypody half an Ounce, of Cinnamon six Drams; distil them in a Bath, to two Pints and an half of the Liquor, add four Ounces of Penids.

If the Purges abovementioned are not successful, it will be convenient to give Chymical Vomits, as Vinum Bene∣dictum, and the like, if the Sick is able to bear them.

After general Evacuation, we must use Topicks, both to the Paralytick part to recall the Heat and Spirits, and to the Spinal Marrow; where for the most part resides the Cause of the Disease; therefore let the part affected be rubbed daily gently with hot Cloaths, and let Cupping Glasses be applied to the Heads of the Muscles of the part affected, let them have a narrow Mouth, and much Flame: But they must not be kept on long, lest what is attracted should be dissipated. Afterwards apply a Plaister of Pitch and Rosin of the Pine; that what is at∣tracted may be kept in. All the Paralytick part may be Stung gently with Nettles. Afterwards the part affected may be anointed with proper Oils, Ointments, and Bal∣sams. The following Ointment is very good in this case:

Take of the Juice of Squills four Ounces, of the Juice of Wild Cucumber, and of the Juice of Rue each one Ounce, of Euphorbium, Castor, Sagapenum, Ammonia∣cum, Bdellium, dissolved all in Vinegar, each one Dram and an half; of Myrrh, Frankincense, Pellitory of Spain, Niter, each one Dram; of Oils of Elder, Turpentine, and of Euphorbium, each half an Ounce, of Wax a sufficient quantity to make an Ointment. After the anointing the part, wrap it about with hot Cloaths.

If the Disease goes not off by these means, Plaisters are to be applied to the Spine of the Back; the following is of excellent use for this purpose.

Take of Ship-pitch, Galbanum, Sagapenum, and Gum Ammoniack, each one Ounce, of the Roots of Pellitory of Spain, and of Mustard Seed each half an Ounce, of Euphorbium two Drams, of Yellow Wax three Drams, of Oyl of Turpentine a sufficient quantity; make a Plaister.

It is also very good to Sweat the Part affected by the Vapours from a Decoction of Cephalick Herbs and Roots made in White Wine; but the Decoction must not touch the Part. A Decoction of the Roots of Burdock is also much commended in this Case: These sorts of Baths are to be used twice or thrice a Week; and after Bathing you must put the Sick to Bed, and give him a Dram of Venice Treacle. The green Leaves of Tobacco infused in Mala∣go Wine, and the Parts bathed with it after Sweating, is reckoned the best outward Remedy for a Palsie.

But lastly, the Bath Waters are best; if the Sick drink of them some days, Bath and Wash the Head with them, and afterwards rub the Parts with the Infusion of Tobacco Leaves.

The Paralytick Parts must be always kept warm: If it can be, with the Skins of Foxes, Hares, or Lambs.