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. LXXXII. Of a Dropsie.

EVery Age and Sex are sometimes troubled with a Dropsie, yet Women are more inclined to it than Men, it comes upon Men chiefly when they are old, and upon Women when they have done breeding; but it sometimes seises barren Women when they are young: The pitting of the lower part of the Leg by impression of the Finger, is not so certain Sign of a Dropsie in Women as in Men; for Women that are with Child, and such as have a stop∣page of the Courses, are often subject to the same; nor does such a Swelling certainly indicate a Dropsie; for when an old Man of a gross Habit of Body, having been a long while afflicted with an Asthma, is suddenly freed from it in the Winter, presently a great Swelling seises the Legs, yet notwithstanding, generally speaking, the Swel∣ling of the Legs is to be accounted a Sign of an approach∣ing Dropsie.

Three Symptoms accompany this Disease, Difficulty of Breathing, little Urine, and great Thirst.

There are two sorts of Tumours of the Belly that re∣semble a Dropsie, that are common to Women; the first is, a preternatural Excrescence of the Flesh in the parts within the Belly, which makes the Belly as Bulky as when Water is included in it; the other kind arises from Wind, which does not only occasion a Tumour, but also other Signs of Breeding; Widdows are most inclined to this sort, or such Women as were not married till they were in Years.

The true and genuine curative Indications are wholly to be directed, either to the Evacuation of the Water con∣tained in the Belly and other Parts, or to strengthen the Blood.

That Purging may be instituted to the Advantage of the Patient, we ought to know whether the Sick is easily purged or hardly; which can be known no other Way than by Inquiry, how purging Remedies used at other times worked.

A Dropsie, above all other Diseases, requires the strong∣est and quickest Purges, and the Sick ought to be purged every day, unless by reason of the Weakness of the Body, or the too violent Operation of the preceding Purge, he ought to rest a day or two; for you must not leave off pur∣ging, unless Necessity urge, till all the Water is quite car∣ried off.

For those that are easily purged, Syrup of Buck-thorn may be sufficient to carry off the Water.

But when the Sick is of such a Constitution, that gentle Catharticks will not work quickly nor easily, stronger must be given; for which I have frequently prescribed the following Potion with Success.

Take of Tamarinds half an ounce, of the Leaves of Senna two drams, of Rubarb one dram and an half, boil them in a sufficient quantity of Fountain-water to three ounces; in the strained Liquor dissolve of Manna, and Syrup of Roses solutive, each one ounce; of Syrup of Buck-thorn half an ounce, of the Electuary of the Juice of Roses two drams; mingle them, make a Potion.

But this Potion must be given only to strong People; it purges when other things will not, as I have found by frequent experience. Or,

Take of White-wine four ounces, of Jalap finely powdered one dram, of Ginger powdered one Scruple, of Syrup of Buck-thorn one ounce; mingle them, make a Potion to to be taken early in the Morning, and to be repeated every Day, or every other Day, according to the Strength.

But two Medicines remain, which in my Opinion are better than all the rest, for those that are difficultly pur∣ged, I mean Elaterium, and the Infusion of Crocus Me∣tallorum, Elaterium, or the Fecula of wild Cucumbers, being given in a small quantity, purge watery Humours powerfully, for two grains of it are a sufficient Dose for most People; I used to mix it with a scruple of the Pill ex duobus, and to make three small Pills to be taken in the Morning.

As to the Infusion of Crocus Metallorum, an ounce and an half of it, or two ounces for those that are difficultly vomited, given in a Morning, and repeated daily, accor∣ding to the Strength of the Sick, though it may seem at first only to evacuate the Water contained in the Stomach, yet at length it will free the Belly from the Waters that are in it.

But if the foresaid Vomit does not sufficiently purge the Belly, for it uses to purge at last, after the third or fourth Dose of the Infusion of Crocus Metallorum by it self, I sometimes though rarely, use the following.

Take of the Water of Carduus Benedictus three ounces, of the Infusion of Crocus Metallorum one ounce and an half, of Syrup of Buck-thorn half an ounce, of the Electuary of the Juice of Roses two drams; mingle them, make a Potion.

But here it is to be noted, that if the Swelling of the Belly be but small, the Water is not so easily evacuated by the Infusion of Crocus Metallorum, as when the Dropsie is great, and a great quantity of Water is heaped up; wherefore unless the Belly be much swelled, it is best to do all by things that purge downwards.

But you must take notice that it often happens, that Water is cast not only upon the Thighs and Legs, but also into the Cavity of the Belly, and yet it is not to be evacuated by Purging Medicines. For Instance, When such a Tumour follows a long Consumption, or when it is occasioned by the Putrefaction of some of the Bowels, or from the Tone of the Blood spoiled, and the Spirits ex∣hausted, or by long continuance of Fistula's in Carnous Parts, or occasioned by great Weakness and Evacuations by Sweating, Fluxing, or by violent purging, and by a thin Diet in the Cure of the French Pox, in these Cases the Patient will be rendered worse by purging; wherefore we must endeavour all we can to strengthen the Blood and Bowels: And among Remedies to this purpose, which are to be mentioned by and by, I have found by Experi∣ence that the change of the Air, and Exercise in a free Air, such as the Sick can bear, answers this Indication excel∣lently well.

And when the Sick is of a weakly Constitution, or a Woman subject to Vapours, neither Purge nor Vomits must be used, but you must endeavour to evacuate the Water by Diureticks.

I order one pound of the Ashes of Broom to be infused in the cold in three Pints of Rhenish-wine, and that a Pu∣gil or two of the Leaves of common Wormwood be added to it, let the Sick take four ounces of the Liquor filtrated daily in the Morning, at five in the Evening, and late at Night, till the Swelling goes off; with which Remedy alone I have known some Dropsies that were accounted deplorable cured, in such whose weak Constitution could not bear Purging.

But to come to the second Intention, half the Business is no more than done, when the Water is evacuated; wherefore we must endeavour to strengthen the Blood by a long and daily Course of heating and strengthening Me∣dicines to prevent a new Collection of Water, and to this end the Sick must drink Wine whilst he is under Cure after the Passages are open for the Water to go out, or instead of Wine strong Beer.

For poor People who could not provide better Medi∣cines, I use to order Srong-beer, wherein Horse-radish Root, the Leaves of common Wormwood, Garden Scurvy-grass, Sage, the lesser Centaury, and the Tops of Broom have been infused, for their ordinary Drink. Rich People may use Canary-wine, wherein the same bitter Herbs have been infused, whereof a small draught may be taken twice or thrice a day, or they may take nine spoon∣fuls of Wormwood-wine instead of it, after two drams of the following Digestive Electuary in the Morning, at four in the Afternoon, and at Bed-time.

Take of Conserve of Garden Scurvy-grass one ounce and an half, of the Conserve of Roman Wormwood, and of the yellow Rind of Oranges, each one ounce; of candied Angelica, and Nutmegs candied, each half an ounce, of Venice Treacle three drams, of the compound Powder of Wake-robin, two drams, with a sufficient quantity of Syrup of Oranges, make an Electuary.

The Sick must be sure to drink sparingly of small Li∣quors; but to take off his Thirst, he may often wash his Mouth with cold Water sharpened with Spirit of Vitriol, and he may hold Tamarinds in his Mouth now and then, or may chew a Lemon, but he must swallow neither of them.

But amongst corroborating things, Steel is not the least. Garlick is also very good; and without any Evacuatious I have known a Dropsie cured by it.

Take of Syrup of Steel a quart; let a spoonful be taken with fifteen grains of Cream of Tartar, every Morning, in five spoonfuls of the following Julep.

Take of Aqua-lactis Alexiter. one Pint, of compound Water of Wormwood, and of compound Water of Gentian, each three ounces; mingle them, make a Julep.

Take of Steel prepared, with Sulphur of astringent Saffron of Mars, each half an ounce; of Crabs-eyes, and red Coral prepared, and of Salt of Wormwood, each one dram; of Volatile Salt of Amber one scruple, of Extract of Gen∣tian a sufficient quantity; mingle them, make ten Pills of every dram, let him take four every Night at Bed-time.

'Tis to be noted, that that Dropsie which only swells the the Legs or the Belly a little, does not presently require to be cured by Vomiting, and Purging; for it's often re∣moved by the heating and strengthning Medicines above mentioned; but above all, 'tis to be minded, that when we undertake to cure this Disease by Corroboratives or Lixivial Medicines, the Patient must by no means be purged.

Topical or external Remedies, as far as I have observed do nothing considerable, and Blisters often occasion a Gangrene. To conclude, though this Disease, when it comes to a Dropsie of the Belly, has been always accounted desperate, yet it will appear, that if it be treated accor∣ding to the Method above described, it may be as certainly cured (if the Bowels are not corrupted) as many other Diseases which are not reckoned so deadly.