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. CXVII. Of the Pestilential Fever, and of the Plague of the years 1665 and 1666.

THE Plague rarely rages violently in England of∣tener than once in the space of 30 or 40 years: The last dreadful Plague destroyed 8000 in the space of a Week, notwithstanding that two thirds, at least, of the Citizens of London fled into the Country for fear of the Infection.

Its first approach was always accompanied with shak∣ing and shivering like the Fits of an Ague, presently violent Vomitings, a pain about the region of the Heart as if it were pressed, a burning Fever, with the usual concourse of Symptoms perpetually molest the Sick, till either Death it self, or a happy eruption of a Bubo or Parotis, discharges the morbifick Matter, and so frees them from that deplorable condition. It does, indeed, now and then happen, but it is seldom that it comes without any sense of a Fever before, and suddenly de∣stroys Men, the Purple-spots, which are the Fore-run∣ners of present Death, breaking out, as they are about their Business. It sometimes also happens, That Tumors appear, when neither a Fever, nor any other grievous Symptom went before.

As to the Cure, if a Tumour has not broke out, I bleed moderately with respect to the strength and tem∣perament of the Sick, and afterwards a Sweat is easily and soon raised (whereas otherwise it is not only very difficulty procured, but there is also danger, lest the Inflammation should be heightned by it, and so the To∣kens forced out) and the benefit of the Sweat immedi∣ately following abundantly, compensates the loss of Blood, which how little soever it be, would otherwise be very injurious. After Bleeding, which must be per∣formed

in Bed (when all things are in a readiness to promote Sweat) without any manner of delay; I order the Patient to be covered quite over with Cloaths, and that a piece of Flannel be bound to the forepart of his Head; and, indeed this covering of the Head conduces more to the procuring Sweat than any one would easily imagine; afterwards, if the Patient does not vomit, I give these and the like Sudorificks.

Take of Venice Treacle, two drachms, of the Electuary of the Egg, one scruple, of compound Powder of Crabs Eyes, twelve grains, of Cochinel, eight grains, of Saffron, four grains, with a sufficient quantity of the juice of Kermes; make a Bolus, which let him take every sixth hour, drinking after it six spoonfuls of the following Julep.

Take of Carduus water, compound Scordium water, each three ounces; of Treacle water two ounces; mingle them, make a Julep.

But if the Patient be troubled with Vomiting, as he is very frequently in the Plague and other pestilential Fevers, I defer the giving of Sudorificks so long as till he begins to Sweat by means of the covering only, ex∣cepting that sometimes I put part of the Sheet over the Face to collect the Vapors, for (which is indeed very well worth Observation) when the Rays of the morbi∣fick Matter extend themselves to the circumference of the Body, the Loosness and Vomiting that were occasi∣oned by their being inwardly reflected and cast upon the Stomach and Bowels, cease presently of their own accord; so that how great soever the preceding subver∣sion of the Stomach was, the Medicines that are taken afterwards are easily retained, and procure Sweat as well as can be wished.

I order, That the Sweat should be continued for the space of a natural day, by Sage-posset-drink or Mace∣ale, now and then taken; and I strictly forbid, That the Patient should be any way cleansed; neither indeed do I permit, that the Shirt, how moist and foul soever it be, should be changed within the space of 24 hours

from the end of the Sweat, which I would have ob∣served with the greatest caution. But if the Sweat be circumscribed in a narrower compass of time, the vio∣lence of the Symptoms soon returns, and the health of the Patient is very uncertain, which a longer continu∣ance of the Sweat would have put out of danger. If any defection be perceived towards the latter end, I permit the Sick to take a little Chicken-broath, the yolk of an Egg or the like, which with Cordials and Draughts commonly used to keep up the Sweat, abundantly repair the Strength.

I admonish, that Cold be carefully avoided, that their Cloaths dry on their Body of their own acc••••d, and that all Drinks are taken somewhat hot, and that the use of Sage-posset-drink be continued for the space of 24 hours after the Sweat. The next morning I give a common Purge, viz. of the infusion of Tamarinds, of the leaves of Sena, of Rhubarb, Manna and syrup of Roses solutive; and with this method, the next year after the Plague, I recovered very many that were seized with the Pestilential Fever, so that not one died of this Disease that was under my care, after I began the use of the same.

But where the Tumor has been out already, I have not hitherto ventured to bleed, though in a Body unapt to sweat, fearing least the sudden death of the Patient should prevent the designed sweat, by reason of the mor∣bifick Matter flowing back to the empty Veins; yet perhaps Bleeding may be very safely administred, if a sweat be procured presently after it, without any man∣ner of delay, which being prolonged to the space above required, may be able to dissipate and consume by lit∣tle and little the whole bulk of the Humor, and with much less danger than when a legitimate maturation of the Imposthume (which is very uncertain and fallible in so very acute a Disease) is long waited for.