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 ...

THE STORE-HOUSE OF Physical Practice.

Diseases of the HEAD.

CHAP. I. Of a Phrensie.

A Phrensie, in Latin, Phrenitis, is twofold, True and Spurious. A true Phrensie is an inflamation of the Brain and Membranes of it, with a per∣petual Delirium, and a continual Acute Feaver. A Bastard Phrensie proceeds from an hot intemperies com∣municated to the Brain from the whole Body; as in Burn∣ing Feavers, or from the inflamation of some particular part, as of the Liver, Lungs, and especially the Dia∣phragm.

The Causes of a true Phrensie proceed from Cholerick Blood extravasated.

The Signs of an approaching Phrensie, are Watchings, disturbed Sleep, immoderate Speech, Urine first Thick, then Thin and Clear; Heat and Pain in the Head, and the like.

A Phrensie is known by perpetual Raving, restless Watching, and by drawing the Breath deep, and seldom, and the Sick does not call for Drink; though there are great and apparent causes of Thirst; the Pulse is small, frequent, and quick; the Feaver is continual, and the Tongue black, yellow or rough.

A Phrensie is generally deadly, because the Noble Parts are generally affected: But there is most hopes of Recovery when they Laugh, and when all the symptoms are mode∣rate, and when the Strength is good; and if after the Disease is at height, some evacuation happens, as by Sweat, Bleeding at the Nose, or a Loosness: The following Signs shew it to be deadly, trembling of the Hands and Tongue, gnashing of the Teeth, Convulsion, and a shaking at the beginning of it, catching of the Cloaths, black Blood drop∣ing from the Nose, white Stools, and a pale Urine.

CƲRE. The Blood flowing to the Head must be evacuated, repelled, intercepted, and a revulsion of it must be made. That which is already flown in must be evacuated and discussed; the intemperies of the part must be corrected, and the strength of it, and of the whole Body must be preserved. All these things may be per∣formed by the following remedies: But first of all, and at any time of the day, Bleeding must be used.

If it be occasion'd by a suppression of the Lochia, or of the Courses▪ or of the Hemorrhoids, the Vein call'd Sa∣phena must be open'd in the Foot; afterwards you must open a Vein in the Arm, to evacuate the Blood that is put off upon the Head, Bleeding is to be repeated twice, thrice, or more, according to the height of the Disease, and the Age, and Strength of the Patient.

Note in opening of the Vein, the Orifice must be small; for otherwise the restlesness of the Sick will force the Blood out, and so make it joyn the sooner; you may apply a Plaister to it made of Aloes, the White of an Egg, and Hares Down.

After Bleeding you must endeavour to procure Sleep, by applying cooling things to the Forehead and Temples, and Anodine Medicines must be given inwardly.

Take of Lettice and Purslain Water each one Ounce, of Dia∣codium half an Ounce, or six Drams, of Syrup of Lemons half an Ounce, make a Draught to be taken at Bed-time.

The Sick may take often of the following Julep.

Take of the Waters of Lettice, Purslain, Roses, red Poppies each three Ounces, Syrup of Violets and Pomgranats each one Ounce and an half, of Sal prunella three Drams, make a Julep. The Dose is three or four spoonfuls at a time, four or five times a day.

When Bleeding cannot be used, Cupping-glasses must be applied, with deep Scarification, first to the lower Parts, viz. the Thighs, &c. then to the upper Parts, viz. to the Shoulders, &c. And afterwards you may apply them with∣out Scarification to the Legs and other parts: Blisters may be also conveniently applied to the Shoulders and Arms, and a cooling Glyster must be daily injected. For instance.

Take of the common decoction for Glysters one Pint; dissolve in it one Ounce of Lenitive Electuary, and four Ounces of Brown Sugar; make a Glyster.

Note, That the quantity of the Glyster must be varied, according to the Age and Bigness of the Patient.

Bleeding in the Nose, by pricking often with a Lancet, the Nostrils where the Hairs grow, does much good; and also Leeches applied behind the Ears, to the Nostrils and Forehead.

CHAP. II. Of Madness.

MAdness, in Latin, Mania. This Disease does not kill of it self, yet it is very difficult to Cure, especially if it be hereditary.

CƲRE. Bleeding, Vomiting, and strong Purges are to be frequently used; with which, and severe Discipline, it is frequently Cur'd: But if the Disease be mild, kind words and good usage, and gentle Physick does oftentimes the business: But in most Bleeding must be us'd to a great quantity in the beginning of the Disease, sometimes in the Arm, and sometimes in the Jugular Vein, in the Forehead, Foot, or drawn from the Hemorrhoidal Veins by Leeches▪ Vomits do also a great deal of good: But such as are

Chymical are best, because they work most powerfully, and the Sick may be easily cheated with them.

Take of Sulphur of Antimony eight or ten grains, of cream of Tartar half a Scruple; mix them and give it in a spoonful of Broth, or with Bread: Repeat this Vomit once in four days.

Strong Purges are also frequently used: As,

Take of extract of black Hellebore, and Calamelanos each one Scruple, mix them, and make a Bolus to be taken in the Morning.

Betwixt the Evacuations, such things may be used as attemperate the Blood, if the Sick will take them, as Steel-waters, Whey, and the like.

For preservation, such People as are subject to Madness, should Purge and Bleed Spring and Fall.

CHAP. III. Of Giddiness.

GIddiness, in Latin, Vertigo. There are two sorts of it; in one the Sight is taken away; in the other it is not. The Cause of Giddiness is a circumvolution of the Spirits. An idiopathick Giddiness is known by Pains, and dulness in the Head, a dulness of the Sight, noise in the Ears, Deafness, and the like. The peccant Matter is discovered by the following Signs; dulness of the outward and inward Senses, Sloth, much Sleep, much Spitting, want of Appetite, and of Thirst; a white and crude Urine shew that Flegm abounds; watching, anger, acti∣vity of Body, thirst, a quick Pulse, thin and yellow Urine, signifie that Choler is peccant; fear, sadness, disturbed thoughts, long watching, dreadful Dreams, soure belchings, and the like, signifie Melancholy abounds: The bigness and stiffness of the Veins, a florid Countenance, and heat of the Face, beating of the Temples, dulness of the Head, weariness, or a red and thick Urine, and sometimes a thin, when there is a translation to the Head, signifie that Blood abounds.

A sympathetick Giddiness is known by the absence of the Symptoms that proceed from the Head, and when there is no apparent Disease in the Brain.

Want of Appetite, nauciousness, soure Belching, Pain, or Wind in the Stomach, signifie that it proceeds from the Stomach; that a Giddiness proceeds from the Liver, Spleen, or Womb, is known by the following Signs: When it proceeds from the Spleen there are frequent and large eva∣cuations of Wind, inflation of the Belly, soure Belchings, and the like; when from the Womb, there is stopage of the Courses, or Hysterick Fits.

A Giddiness that is recent, and seldom invades, and that which is occasioned by external Causes is light, and easily Cured; that which is inveterate and frequent, most commonly ends in the Falling Sickness, or Apoplexy.

CƲRE. The Cure is much the same with the Falling Sickness: which see in the Chapter of the Falling Sickness: But when it is small it does not need so large a course of Physick as is requisite for the Cure of the Falling Sickness. But those things will be sufficient which I shall here set down.

First therefore, if Blood abounds, inject a pretty sharp Glyster, and afterwards Bleed; then Purge with the following Pills.

Take of the fetid Pills two Scruples, of Resin of Jalap five grains, with a sufficient quantity of Galbanum dissolved in Briony Water; make seven Pills to be taken in the Morning; repeat them Thrice.

But if the Patient cannot take Pills, the following Purg∣ing Potion may be given instead of them.

Take of Gerions decoction six Ounces, boil in it of the Fi∣bres of black Hellebore, and of Agarick each one Dram and an half; strain it, and add an Ounce of the Syrup of Roses Solutive, and two Drams of Compound Briony Water. Make a Potion.

Afterwards let the Patient use the following Sneesing Powder.

Take of the Leaves of Marjoram, Sage, Rosemary dried, each half a Dram, of the Roots of Pellitory of Spain and white Hellebore each one Scruple, of Musk three Grains; make a Powder.

Cupping-glasses with and without Scarification, fricti∣ons of the extream parts, Bleeding from the Hemorrhoi∣dal Veins may be used to cause revulsion. Blisters are also of use for derivation. Afterwards use such things as are proper to strengthen the Head, which you will find in the Chapter of an Epilepsie. The Conserves of the Flowers of Marrygolds is counted by some a Specifick for Gid∣diness.

CHAP. IV. Of the Falling Sickness.

THE Falling Sickness, in Latin, Epilepsia, is an uni∣versal and violent Convulsion; the Fit most com∣monly comes of a sudden, and precipitates in the twink∣ling of an Eye to the Earth, and deprives a Man of Sense and Understanding; for they seem rather forcibly thrown down, than to fall; and that part which first comes to the Ground, is most commonly bruised or wound∣ed. They gnash with their Teeth, foam at the Mouth, and often beat their Heads against the Ground; their Arms and Legs either become rigid, or tossed here or there. Some beat their Breasts violently, and some cast their Bodies impetuously hither and thither: But in most the Belly swells much. After some time, sometimes sooner, sometimes longer, the symptoms suddenly cease, as if the Tragedy were just ended, and then the Sick come to themselves again, and are sensible; but there remains after the Fit is gone off a pain in the Head, and a dulness in their Senses, and often a Giddiness.

The Fits are sometimes wont to come at set times of the day, month, or year; but most commonly according to the greater turns of the year, or according to the Conjuncti∣ons, or opposite Aspects of the Moon, or Sun, they return more certainly, and afflict more violently; and sometimes the Fits are uncertain, and come as occasion is offered, and according to the variety of evident Causes. Sometimes they are gentle, sometimes violent; sometimes, though rarely, some Signs forewarn the Epileptick person of a

Fit before he falls, as a dulness of the Head; sparkling of Fire before the Eyes, Noise in the Ears, and the like.

Sometimes a Convulsion in some outward part, as in the Arm, or in the Leg, or in the Back, or in the Hypo∣chondres, precedes, which rising from thence like a cold Air towards the Head, occasions the Fit.

CƲRE. You must begin with Purging; but if the Sick bear Vomiting well, a Vomit must be first given, and must be repeated for several months, four days before the Full Moon. Wine of Squills mixed with fresh Oyl of Sweet Almonds; or half a Scruple or a Scruple of Salt of Vitriol may be given to Infants: But for grown Peo∣ple, and such as are of a strong Constitution, the follow∣ing forms of Medicines may be prescribed.

Take of Crocus Metallorum, or of Mercurius Vitae four or six grains, Mercurius dulcis fifteen Grains, or a Scruple, grind them together upon a Stone, mix them with the Pap of a roasted Apple, or Conserve of Borrage; make a Bolus.

Or give half an Ounce, one Ounce, or one Ounce and an half of the infusion of Crocus Metallorum, or of Mer∣curius Vitae, made in Spanish Wine, according to the Strength of the Sick: Or,

Take of Emetick Tartar four or six grains.

They that are of a weak Constitution may take a Scruple or half a Dram of Salt of Vitriol, and half an hour after let them drink several Pints of Posset-drink; and then with a Feather, or with the Finger, let them provoke themselves to Vomit often. The next day after the Vomit, unless any thing forbid, draw Blood from the Arm, or by the Sucking of Leeches from the Hemorrhoidal Veins; and the next day after Bleeding, give a Purging Medicine, which afterwards must be constantly repeated four days before the New Moon.

Take of Rosin of Jalap half a Scruple, of Mercurius dulcis one Scruple, of Castor three Grains, of Conserve of the Flowers of Peony one Dram, make a Bolus to be taken in the Morning: Or,

Take of the Fibres of black Hellebore infused in Vinegar, dried and pouder'd half a Dram, of Ginger half a Scruple, of Salt of Wormwood twelve Grains, of Oyl of Ambar two drops; make a Pouder, give it in the Pulp of a roasted Apple in the Morning.

Of the days the Sick does not Purge, especially at the Seasons of the Moon, give Morning and Evening specifick Remedies.

Take of the Roots of male Peony dried and poudered, one, two, or three Drams; give it twice a day in the follow∣ing tincture, at eight in the Morning, and at four in the Afternoon.

Take of the Leaves of Misleto of the Oak two Drams, of the Roots of Peony cut, half an Ounce, of Castor one Dram; put them into a Glass, and pour upon them, of Bettony Water, or of simple Peony Water, and of White Wine each a Pint, of Salt of Misleto of the Oak, or of Com∣mon Salt two Drams: Digest them in a close Vessel in the heat of Sand for two days. Give three Ounces with a Dose of the Powder above prescribed.

At the same time make a Necklace with Peony Roots sliced, and hang it about the Neck, and the Roots fried or boiled till they are soft, may be eat daily with the Meat.

Take of Man's Skull prepared one Ounce, of misleto of the Oak, factitious Cinnabar, and of Elk's Hoof, each half an Ounce. Dose, half a Scruple, or one Scruple.

Some find benefit by Shaving the Head, and by apply∣ing to the forepart of it a Plaister.

Take of the Roots and Seeds of Peony, of Castor, of Misleto of the Oak, and of Man's Skull finely powder'd, each one Dram, of the Plaister of Bettony two Ounces, of Car∣rana, Tacamahaca, each two Drams, of Balsam Copaiba a sufficient quantity: make a Plaister spread on Leather, and apply it to the Sutures of the Head.

Anoint the Temples and Nostrils often with Oyl of Ambar, either by it self, or mixed with Oyl of Copaiba, Sneesing Powders, and Apophlegmatisms must be used every Morning.

Take of white Hellebore one ounce, of Castor and Euphorbi∣um each half a dram, of sweet Marjoram, and the Leaves of Rue each two drams, make a Powder, which you may dissolve with Mustard in a decoction of Sage, or hyssop, and with it wash and gargle the Mouth.

Glysters may be used daily upon occasion. 'Tis said that six or eight Ounces of the decoction of Gujacum taken twice a day, and the second decoction of it used for ordinary drink, as is used in the French Pox, will Cure this Disease.

CHAP. V. Of Childrens Convulsions.

CHildrens Convulsions, in Latin, Epilepsia puerorum, are so frequent, that it is almost the only Species of Convulsions.

They are chiefly subject to them in the first Month, and at the time they breed Teeth; but they also happen at other times, and proceed from other causes in such are disposed to them: Sometimes they do not come presently after the Birth, but lye hid until the breeding of Teeth, or not till a great while after, and take their rise from other evident Causes either Internal or External; as from an Unhealthy or Big-bellied Nurse, from Milk co∣agulated or corrupted in the Stomach, from a Feaverish Disposition, from Ulcers or Scabs of the Head, or of other Parts suddenly disappearing; from changes of the Air, or from the Conjunction or opposite Aspects of the Sun and Moon.

We must endeavour to prevent these Convulsions in Children and Infants, or to Cure them when they are come; for if the former Children of the same Parents have been subject to Convulsive Fits, this Disease ought to be prevented, by the early use of Remedies, in such as are born after: To this end it is customary to give to new-born Babes, as soon as they begin to breath, some Medicine proper for Convulsions: Some, upon this occa∣sion, give some drops of pure Hony; others a Spoonful of Canary-wine sweetned with Sugar, or Oyl of Almonds fresh drawn; others give a drop of Oyl of Ambar, or half a Spoonful of Epileptick water. Besides these things used at first, which certainly do good, some other Remedies ought to be administred; for instance, give a Spoonful twice a day of the following Liquor:

Take of the Waters of Black Cherries and Rue, each one Ounce and a half; of Langius's Antiepilectick Water, one Ounce; of Syrup of Coral, six Drams; of prepared Pearl, fifteen Grains; mingle them in a Viol.

The third or fourth day after the Birth, make an Issue in the Neck, and if the Countenance be florid, evacuate by bleeding, an Ounce and an half or two Ounces of Blood from the Jugular Veins, but take care that too much Blood do not flow out in sleep; rub gently the Temples with the following Linement.

Take of Oyl of Nutmegs by expression two Drams, of Balsam of Copaiba three Drams, of Ambar one Scruple, mix them.

Hang round the Neck the Roots and Seeds of Male-peony, and a little Elks hoof sewed up in a Rag: More∣over Medicines proper for Convulsions must be given daily to the Nurse.

Let her take Morning and Evening a Draught of Whey, wherein the Roots of Male-peony, or the Seeds of Sweet Fennel have been boiled.

Take of the Conserves of the flowers of Bettony, Male-peony, and Rosemary flowers, each two Ounces; of the Powders of the Roots and Flowers of Male-peony, each two Drams; of red Coral prepared, and white Ambar, each one Dram; of the Roots of Angelica and Zodoary prepared, each half a Dram; with a sufficient quantity of Syrup of Peony, make an Electuary. Let her take the quantity of a Nut∣meg Morning and Evening, and be very orderly in her Diet.

But if any Infant be actually seized with Convulsions, because the Issue does not run well, you must apply a Blister to the Neck or behind the Ears; and if the Infant be not of a cold Constitution, Blood must be drawn from the Jugular Veins by Leeches, and Linements must be used to the Temples, Nostrils and Neck, and to the Soles of the Feet; and Glisters which empty the Belly plentifully must be injected: Moreover, often in a day, namely every sixth or eighth hour, Specifick Remedies must be given.

Take of Oyl of Copaiba, and of Castor, each two Drams; of Ambar half a Dram; make a Linement.

Apply to the Soles of the Feet the Plaister, with Eu∣phorbium spread on Leather.

Take of prepared Pearls, of the Powder de Gutteta, each one Dram, mingle them for twelve Papers, whereof let him take one Morning and Evening in a Spoon∣ful of the following Julap, drinking after it one or two Spoonfuls.

Take of the Waters of Black Cherries, and of Lilly of the Vallies, each two Ounces; of Fennel-water, and Com∣pound Peony water, each two Drams; of Syrup of red Poppies, six Drams.

Take of the Powder of the Seeds of Rue, of Castor, of Assa∣faetida, each a sufficient quantity, mingle them and tye it up in a Rag, sprinkle it with Vinegar, and put it often to the Nostrils.

Ʋntzerus commends much the Gall of a Sucking Kitlin, all the Juice being taken out of the Bladder, and mixed with a little water of Lime-flowers, and given to the Child: An excellent Physician lately told me, that he had known several Children cured with this Remedy. When by reason of breeding Teeth difficultly, Convul∣sions happen, this Symptom is Secondary and less Dan∣gerous, and therefore does not require the first and chief work of Healing; for sometimes we are more Solicitous to ease the Pain, and take off the Feaverish Disposition. And therefore a thin and cooling Diet is ordered for the Eruption of the Teeth, either by rubbing or cutting the Gums, and things that are anodine are applied to the swelled and pained Parts; and here Glisters and Bleeding are often used; and we ought to procure Sleep, and to qualifie the Fury of the Blood; in the mean while Tem∣perate Medicines for Convulsions, and such as do the least stir the Humours, are to be used, and Blisters, because they evacuate the Serum too apt to be poured upon the Head, do often give relief.

When Children are seized with Convulsions, not pre∣sently after the Birth, or upon breeding Teeth, but from other Occasions and Accidents; the cause, for the most part of such, is either in the Head or in the Bowels; when the former is suspected, as is wont to be known by the signs which shew watry Humours heap'd up in the Brain, the Medicines above mentioned must be used: Moreover, for those who bear Purging well, a Vomit or gentle Purge must be prescribed, Wine and Oxymel of Squills, also Mercurius dulcis, Rubarb, and Rosin of Jalap are of good use, when the cause of the Convulsions seems to be lodged in the Bowels, or when Worms or sharp Humours in the Belly are the cause: For Worms, a Purge of Rubarb, or of Mercurius dulcis, with the Rosin

of Jalap must be given, and the following Medicines are also of use.

Take of the Roots of Virginian Snake-weed powdered one Dram, of Coral calcined till it is white half a Dram; make a Powder. The Dose is half a Scruple or a Scruple twice a day for three days following, drinking upon it the Decoction of the Roots of Grass.

Take of Hiera pitra, and of Venice-Treacle, each one Dram; make a Plaister for the Belly.

If the Convulsions are thought to proceed from sharp Humours disturbing the Bowels or Stomach, Purging up∣ward and downward by turns is to be observed; to this end a gentle Vomit of Wine of Squills, or Salt of Vitriol, is to be given.

Take of Syrup of Peony three Ounces, Salt of Vitriol two Scruples, of Compound Lavender-water one Dram, mingle them, give a Spoonful three or four times in an hour, till the Child has once Vomited or went to Stool once.

But if Evacuation downward seem most proper, give the Infusion of Rubarb, or the Powder of it, or Syrup of Succory with Rubarb, or Syrup of Roses with Agarick: And moreover Glisters are to be used frequently in this case, and External Medicines are to be applied to the Belly.

Take of the leaves of Camomil cut small, two handfuls, put them into two Bags made of fine Cloth or of Silk, which being dip'd in hot Milk and pressed out, are to be applied successively to the Belly.

CHAP. VI. Of the Night-Mare or Incubus.

IT is commonly supposed by the ordinary sort of People▪ that this Disease is occasioned by the Devil, or an Evil Spirit's lying upon their Stomachs, which perhaps may be so sometimes; but it also comes from meer Natural Causes, as is supposed, though what those are, or where the Morbisick Matter is placed, is not known, when it

is thought to come from Natural Causes, the Cure is to be undertaken in the following manner, Bleeding and gentle Purging is first to be used, and afterward things proper for the Head, as Powders of Ambar, Coral, Pearls, the Roots of Male-peony, Dittany of Crete, Contra yerva, and other things prescribed in the Chapter of the Apoplexy, and the like: But an orderly Diet is first to be pre∣scribed; windy Meats, and such as are hard of Digestion are to be avoided, and Sleep must not be indulged after Eating or Study, and large and late Suppers, and lying on the Back must be forbid.

Infants and Children are often troubled with this Dis∣ease, the sign whereof, is their starting in their Sleep, and crying out violently; and after they have had these Fits often they fall into Convulsions, wherefore a right Method of Cure ought to be administred as soon as they seem to be disordered in their Sleep: Inquiry must be made concerning the Milk they Suck, whether it be good or not, and whether it agrees with their Stomachs; after they have Sucked plentifully, they must not be suffered to sleep, the Nurse must use an orderly Diet, and let her take also Morning and Evening a Dose of a Powder or Electuary that is proper for the Head, drinking upon it a Draught of Posset-drink, wherein the Leaves of Sage or Bettany, or the Roots or Seeds of Peony have been boiled. Let the Infant take twice a day a Spoonful of Black-Cherry-water; let an Issue be made in the Neck, and let it lye sometimes on one side, some∣times on the other, and seldom or never upon the Back: And Coral, or the Seeds of Male-peony being hanged about the Neck, or upon the Pit of the Stomach, may do some good. When they start violently often in their Sleep, apply a Blister to the Neck or behind the Ears. Moreover, Morning and Evening daily give half a Scruple of the Powder de Gutteta in a Spoonful of Lime-flower-water.

CHAP. VI. Of Sleepy Diseases, Coma, Lethargy, Carus and Apoplexy.

THere are four sorts of Preternatural Sleep, Coma, Lethargy, Carus and Apoplexy, which because for the most part they proceed from the same Causes, and require the same Methods of Cure; therefore they shall be treated of together in this Chapter.

The first and principal cause of these Diseases, is a Fleg∣matick or Watry Humour, contained in the Brain con∣trary to Nature.

Secondly, Sleepy Diseases are wont to be generated by Blood abounding in the Brain, and from extravasated Blood stopping or oppressing the Ventricles of the Brain, sleepy Disease, and especially an Apoplexy is sometimes occasioned.

Thirdly, It is certain that a Comatose Disease proceeds from a Tumor that oppresses the Brain by its weight.

Fourthly, Immoderate Vapors carried to the Head, may be the cause of a Sympathetick Coma.

Fifthly, From the immoderate use of Narcotick Me∣dicines inwardly taken, so deep a Sleep is occasioned, that many, by the imprudent use of Opium, have slept their last.

That Sleepy Diseases are occasioned by Flegmatick Humours stagnating in the Brain, is known by a Flegma∣tick Habit of Body, by old Age or Childhood, by a cold or moist Season or Country, by the Suppression of the Excretion of Flegm, by the Mouth and Nostrils; and for that the Sick, before the coming of this Disease, was afflicted with a Dulness of the Head, Dimness of Sight, and Unaptness for Motion; and because in the Disease Flegm flows from the Mouth and Nostrils, or falling upon the Throat, is frequently swallowed down by the Sick.

That Blood produces a sleepy Disease is known by a Plethorick Disposition, by Redness of the Face, and by a Pain in the Head foregoing this Disease: That the Sym∣pathetick

Disease arises from Vapors elevated to the Brain, is known by the absence of those Signs, which signifie an Idiopathetick Disease, also by the signs of the peculiar disorder of the Parts, from whence Vapors are transmitted to the Brain.

A very thin Diet is to be ordered at the beginning of these Diseases, and when the Fit is off, the Sick, to pre∣vent a Relapse, must forbear all strong Liquors, and be fed with Barly and Oat-meal Broths, or with Chicken Broth; and sometimes, especially when he Purges, with Chickens, Lamb, and the like.

When a Physician is first called to a Patient, that is seized with a sleepy Disease, he must endeavour by all means to rowse him, by offering Violence to all his Senses; and therefore he must expose his Eyes to the Sun-beams, or to a clear Light; his Ears must be filled with violent Noises and Clamours, and the Sick must be sure to be called aloud by his own name; sharp things are to be blown up his Nostrils; the Sense of Touching is to be revived by Frictions, Vellications, plucking of the Hair, Ligatures, Squeesing of the Fingers together, and the like; he must be presently Blooded if he has Strength; but his Strength is not to be judged of by the present Circum∣stances, but by such as he was in before the Disease in∣vaded him. You must first Bleed in the Arm, and then in the Jugular Vein, presently after give the following Vomit.

Take of the Blessed Wine one Ounce and an half, of Carduus water one Ounce, of Spirit of Juniper-berries two drops; make a Vomit.

Inject two or three sharp Glisters in a day.

Take of the Carminative Decoction, with Bay-berries and Juniper-berries ten Ounces, of the Electuary of Bay-berries one Ounce, of Vinum Benedictum three Ounces, and of brown Sugar three Ounces, of Chymical Oyl of Juniper ten drops; mingle them, make a Glister.

If the Glister be not rendred in due time, provoke the Belly by a Suppository.

Take of Hiera picra half an Ounce, of Sal Gemma one Dram, of Hony a sufficient quantity; make Suppositories.

The Spirit of Sal Armoniack must be held to the No∣strils, and things of all kinds that cause Revulsion must be

used, not only Frictions and Ligatures, but also Cupping-glasses set on the Back, Shoulders, Arms and Thighs: But in an Apoplexy you must not apply Cupping-glasses to the Back, or to the Hypochonders, least the Muscles of the Breast and Belly should be contracted, and so Respira∣tion more hindred: Cupping-glasses applied to the Head are counted very proper; apply a Blistering Plaister with Euphorbium to the Neck: Some, according to the Custom of the Ancients, hold a red-hot Frying-pan to the Head, at such a distance as it may burn the Hair but not the Skin.

Take of the Waters of Rue, Balm and Black-Cherries, each three Ounces; of Compound Peony water, and of Com∣pound Syrup of Peony, each one Ounce and a half; of Tin∣cture of Castor one Dram, of Spirit of Sal Armoniack half a Dram; mingle them, make a Julep, give four or five Spoonfuls often.

In the general Cure of these Diseases you must take notice, that in those which proceed from Blood, Medicines that heat the least are to be used; but Bleeding is to be used more freely, and afterwards the Vein in the Fore∣head is to be opened, and things that purge Choler are to be mixed with those that purge Flegm: If the Brain be very much cooled, the Sick, after universal Evacua∣tions, may use Tablets made in the following manner.

Take of Amber-grease half a Scruple, distilled Oyl of the Seeds of Anise, Cinnamon and Nutmegs, of each three drops; Oyl of Cloves one drop; of Sugar dissolved in Orange-flower water, four Ounces; make Tablets, let him take a dram or two drams every Morning.

The following Powder is also commended and is much in use.

Take of white Ambar half an Ounce; of the Powder called Diarhodon Abbatis two drams; of the Roots of Peony one dram and an half; make a Powder, whereof give a dram in two Spoonfuls of Simple Peony water before the New Moon.

It is also proper to hold Nutmeg often in the Mouth, and to chew it; and Perfumes are to be held often to the Nostrils, especially Apoplectick Balsam; Spices are to be used with Meats, and the following Digestive Powder after Meals.

Take of the Seeds of Coriander, sweet Fennel, Caraways, each fifteen Grains, of white Ambar one Dram, of the yellow peel of Citrons, and flowers of Rosemary each one Dram and an half, of Nutmegs half a Dram, of white Sugar three Ounces; powder them grosly, and give half a spoonful after Meals.

If from too great a quantity of Blood a sleepy Disease is feared, the Patient must be sufficiently Blooded, and the utmost endeavours must be used to make the Hemorrhoids flow, than which nothing can be more advantageous.

Purging is to be ordered to prevent a Relapse.

Take of the Pill of Ambar, and of the lesser Cochie, each two Scruples, of the best Castor six Grains, of Oyl of Am∣bar a sufficient quantity; mix them and make 12 Pills. Take six for a Dose, and the other six three days after.

Or,

Take of the Pill of Ambar one Scruple, of Rosin of Jalap six Grains, of Tartar vitriolated eight Grains, spirit of La∣vender eight drops, of Elixir Proprietatis a sufficient quantity; make 4 or 5 Pills to be taken in the Morning.

After Purging prescribe the following Medicines.

Take of the Conserves of the Flowers of Male peony, and of Rosemary each one Ounce, of the Bark of Citron Candied six Drams, of the Species Diambra, and Dianthos, each one Dram, of Castor powdred two Scruples, of Compound Spirit of Lavender half a Dram, with a sufficient quan∣tity of the Syrups of Gilliflowers, and Compound Peony; Make an Electuary, give the quantity of a Nutmeg Morning and Evening daily; and let the Sick take four spoonfuls of the following Julep after it.

Take of the Waters of Black Cherries, Rue, Pennyroyal each three Ounces, of Compound Peony Water, and Langius's Epileptick Water, each one Ounce, of the Syrup of the Flowers of Male Peony one Ounce, mingle them. Or,

Take of the Powder e gutteta three Drams, of Castor half a Dram, of Syrup of the Flowers of Peony a suf∣ficient quantity; make forty Pills, whereof let him take four every Night at Bed-time, drinking upon them two spoonfuls of the following Julep.

Take of the Waters of the Flowers of Peony, Black Cherries, Rue, Pennyroal, each two Ounces, of Compound Peony Water, and of Compound Briony Water, and Tincture

of Castor, each one Ounce, of Syrup of Male Peony an Ounce and an half, mingle them.

Take of Ambar one Ounce, sprinkle the fourth part of it every Night at Bed-time upon the Head.

CHAP. VIII. Catalepsis, or Catoche.

THis Disease is very rare and very wonderful. Galen mentions an Observation of one of his Scholars, who upon hard Study was seized with a Catalepsis. He lay, says he, like a piece of Wood, extended, rigid, and in∣flexible; his Eyes were always kept open, but he could not speak.

When he recovered, he told us he could hear us speak, though not plainly; he remembred what was done, and saw all that were with him; but he said he could not speak nor move a Limb: And Fernelius mentions two Ob∣servations of this kind: He says, that a person studying very hard was seized with this Disease, and that he was so stiff, that sitting with his Pen in his Hand, and looking earnestly upon his Book, he was supposed to be hard at Study; till being called, and pull'd, he was perceived to have no Sense nor Motion. Another lay as it were Dead, who neither saw nor heard, nor felt when he was pricked. He breathed well; and whatever was put in his Mouth he readily swallowed: Being taken out of his Bed he stood alone; and being push'd he went forward; and in what manner soever his Hand, or Arm, or Leg was Bent, it stood fix'd; so that he look'd like a Statue.

The like Observations are to be found in many other Authors; from whence you may gather, that there is most commonly an abolition of the internal and external Senses, and a stiffness of the Limbs: But sometimes the Senses are not wholly abolished; for sometimes they can hear, and their Limbs may be moved by the By-standers,

The Cure is twofold, one in the Fit, the other out of the Fit: In the Fit, those things are proper which are

prescribed for Sleepy Diseases. Out of the Fit, such things as are used for Cure of Melancholy are proper; for from thence it most commonly proceeds: But if it come from a Cold intemperies, such things are proper as serve to mend such a Constitution; if it proceed from abundance of Blood, Bleeding is to be used.

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.

CHAP. X. Of a Convulsion.

A Convulsion, in Latin, Spasmus, is an involuntary and perpetual Retraction of the Nerves and Muscles to∣wards their Original.

It is twofold, one properly so called, to which the De∣finition above mentioned agrees; the other is rather a Con∣vulsive Motion; and they are thus distinguished: In a true Convulsion, the retraction of the Muscle is continual, and the Member immoveable: In a Convulsive Motion, the Member is variously agitated, as in the Falling-sick∣ness.

They also differ in their Causes; for a true Convulsion proceeds from fulness or emptiness, a Convulsive Motion from Irritation.

A true Convulsion is divided into universal and particu∣lar; an universal takes its rise either from the Brain, and then the Muscles of the Face are also seised with Convulsi∣ons; or it arises from the beginning of the Spinal Marrow, then the Muscles of the Head, or those that move the Spine forward or backward are seised with Convulsions: Upon which account there are three sorts of Convulsions; the first is called Emprosthotonos, wherein the Body with the Head and Neck are violently contracted forward, so that the Chin touches the Breast, and the Body represents the Keel of a Ship, and sometimes is bent like a Bow, and the Head touches the Knees: In this sort, two Mus∣cles that bend the Head forward are chiefly affected.

The second is called Opisthotonos; and in it the Body is bent backward: The twelve Muscles that extend the Head, or some of them, being Convulsed.

The third is called Tetanos, wherein the Muscles before and behind are equally contracted, and the Parts kept as it were in Aequilibrio. This is the strongest of all; it ari∣sing from a Contraction of all the Muscles.

A particular Convulsion is caused by the Contraction of some one part, the Nerve that serves for its Motion being ill affected, which has sometimes a peculiar Name from

the effect or symptom; as a Convulsion of the Muscles moving the Eyes is called Strabismus, that of the Jaws and Muscles of the Temples 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉. A Convulsion of the Mouth, from a Contraction of the broad Muscle arising only from one part, is called the Dog Convulsion: But if there be a Contraction in both sides, it is call'd Risus Sardonicus; but sometimes the Mouth is distorted by the Palsie, by Relaxation of the other Muscle. A Convulsion of the Yard is call'd Satyriasis, or Priapismus. Other Convulsions have no proper Names.

The immediate Causes of a true Convulsion, according to Hippocrates and Galen, are repletion and inanition, the mediate Causes which occasion a repletion, and ina∣nition are various; a Flegmatick humour flowing into the Nerves is supposed to distend them, as to their Breadth, and so they must be necessarily contracted as to their length. Another cause of Convulsion from repletion, is an inflamation of the Nervous Parts.

The Causes of Convulsions by Emptiness, are all immo∣derate Evacuations by Bleeding, Vomiting, Sweat, and a Consumption of innate Moisture, which is occasioned by Burning and Coliquative Feavers, by immoderate Labour, by Watchings and Cares, and immoderate Venery.

A Convulsive Motion proceeds from Matter that Velli∣cates and Pricks the Nervous Parts, which most common∣ly is malignant; for such a humour commonly happens in malignant Feavers: It is also occasioned by Worms, Poi∣son, and by Hysterick Fits.

A Convulsion which seises many Parts, especially near the Head, is dangerous; and that which seises the Mus∣cles of the Breast, is also dangerous; for the Sick may be suffocated by it.

A Convulsion arising from great Fluxes of Blood, or over-purging is dangerous, if not deadly; so is a Convul∣sion arising from a Phrensie, and upon a Feaver. Hypocrates says, that those who are seised with a Tetanos, die within four days; but that if they live longer, they recover.

CƲRE. The Cure of this Disease is to be varied ac∣cording to the variety of the Causes. That which hap∣pens from Emptiness is incurable. After Bleeding, or it being omitted, if it be not convenient, strong Purges must be used: but respect must be had to the strength of the Pati∣ent:

After Bleeding, apply Cupping-glasses, with Scari∣fication, if Blood has not been drawn before, otherwise without Scarification: They must be first applied to the remoter parts, afterwards to the parts near the affected part: But if the Legs are Convulsed, they must be ap∣plied to the Buttocks and Loins; if the Arms, to the Neck and Shoulders: Blysters are also applied with good success to the parts opposite to the part affected. In the mean time, after the first Purge, the Matter is to be pre∣pared, with Medicines proper for the Head. Note, that Castor ought to be added to Purges in this case. Sharp Glysters are frequently to be injected, such as were men∣tioned in the Chapter of an Apoplexy. The part affected must be anointed with the following, or some other pro∣per Linement.

Take of the Oyntment of Marsh-mallows six Ounces, Oyl of Turpentine and Camomile each one Ounce, Oyl of Lavender three Drams, of Oyl of Foxes half an Ounce, Liquid Storax two Ounces, wherewith anoint the affect∣ed part, and the Spine of the Back frequently, with a hot Hand.

After anointing the parts, wrap them in a warm Sheep-Skin, just taken from the Sheep. Sheeps Lungs, Pidgeons or Hens cut in the middle, and applied hot, are also good. It is also good to put the affected part into the Belly of an Ox, or Sheep newly kill'd, and keep it there as long as it is warm: but the use of Sulphurous Baths is most suc∣cessful.

When a violent Pain accompanies the Convulsion, use the following Linement.

Take of the Oyls of Violets, Lillies, Camomile, each one Ounce and an half, of Oyl of sweet Almonds, Mastich, and Roses, each one Ounce; mingle them, and anoint the part affected.

Sneesing Powders and Apophlegmatisms are also proper in this Case.

CHAP. XI. Of Trembling.

TRembling, in Latin, Tremor, is a depraved Motion of the Members, whereby they are involuntarily moved. The chief Cause of it is weakness of the Nerves, occa∣sioned by Old Age, by long Sickness, by immoderate Ve∣nery, by Fear, and other passions of the Mind; or by such things as are wholly offensive to the Nerves, as the Fume of Quicksilver. Hard Drinking will also occasion it, and a partial Obstruction of the Nerves by gross humours.

CƲRE. It is Cured by the same Medicines that are used in the Palsie.

CHAP. XII. Of a Catarrh.

A Catarrh, in Latin, Catarrhus, according to the Anci∣ents, is a preternatural fluxion of Humours from the Head upon the Lower Parts: But the ingenious Dr. Lower is of the Opinion, that it is put off by the Blood upon the Glands that are seated in the Throat and Jaws; and he says there are no passages to convey it from the Head.

CƲRE. Whatever precipitates the Serum through the Reins, or carries it off by Stool, or by Sweat, is good in this case, or whatever else lessens the Serum.

Wherefore, nothing is better for Curing a Catarrh, if a Feaver does not accompany it, then abstaining a long while from Drink; for several have been Cured, by not drinking in three or four days time; for by this means the source of the Disease is dried up; just as R••vulets be∣come dry for want of Rain.

But if you have reason to imagin from the Pulse, the Urine, or restlesness of the Body, that there is some Feaver:

Having first purged the Body, you must presently Bleed, and the Sick must be kept to a thin Diet; and other things are to be done which the Cure of the Feaver requires: but respect must be had to the Flux of the Serum.

But if by reason of abundance of Serum, the Catarrh continue obstinate, in this case nothing is better, then after Purging to use Diureticks; if the Catarrh yet continue, you must make Issues in the Neck, Arms, or Legs, or ap∣ply Blisters there.

But because these things require time to do the business, if need require; or if there be danger of Suffocation, you must Bleed again, and presently Sweat the Patient once, or twice a day, if his Strength will bear it; which by casting forth the serous Humour through the Pores of the Body, will perform the Cure.

Take of the decoction of Senna Gerionis four Ounces, of Syrup of Buckthorn six Drams, of Spirit of Sulphur five Drops, of Aqua Mirabilis one Dram, mingle them, and make a Potion to be taken in the Morning.

At Bed-time after Purging, give the following Pills.

Take of Pill Storax eight Grains, of the Juice of Liquo∣rish half a Scruple; make three Pills: Repeat the Purg∣ing Potion every third day for thrice.

Of the days the Sick does not Purge, let him take of the following Electuary.

Take of the Conserve of Red Roses vitriolated, of the Ele∣ctuary of Sassafras one Ounce, of Frankincense powder'd one Dram, of Diacodium a sufficient quantity, make an Electuary; let him take the quantity of a Nutmeg Morn∣ing and Evening, drinking upon it three Ounces of the following Decoction.

Take of the pectoral Decoction one Pint, add to it in boil∣ing, of Balsam of Tolu three Drams, of the Leaves of Ground-Ivy half an handful. To the strained Liquor, add two Ounces of Diacodium, and one Ounce of Spirit of Carraways; mingle them.

Diureticks, and Diaphoreticks must be also used. Lastly, He that would wholly prevent this Disease, must be well Cloathed▪ and must remove into a hot and dry Country.

CHAP. XIII. Of the Head-ach.

HEad-ach, in Latin, Cephalalgia. This word is used for all Pains of the Head in general; but properly it only signifies a new Pain of the Head. Cephalaea is an inveterate Pain of the Head: Hemierania the Pain of one side of the Head. It is also divided into external and in∣ternal; Idiopathick and Sympathick; and of these, some are pricking, others heavy, and some beating; an inward pain of the Head is seated upon the Meninges, which lies deep, and reaches to the Roots of the Eyes; but the out∣ward pain is seated upon the Pericranium, and is exaspe∣rated when the Head is prest, or the Roots of the Hair turned back.

An Idiopathick Pain is continual. This does not proceed from the disorder of other parts: but a Sympatick Pain does. What that part is which communicates the pain to the Head may be easily known by the proper Signs of the affected part. The pain of the Head proceeds from a cold Cause, and from a hot Cause. For the Cure of the former, the Flegmatick Matter is to be evacuated by the following Pills.

Take of the Pills of Ambar one Scruple and an half, of Cochiae Minor two Scruples and an half, of Tartar vi∣triolated ten Grains, of Peruvium Balsam a sufficient quantity; mingle them, make twelve Pills, give six of them once a Week in the Morning.

The Bath is very effectual in this case, the party being bathed, and his Head washed with it. Sneezing Powder is also very proper. Sudorifick Decoctions are also very beneficial in iinveterate pains.

Take of Sarsa parilla, and Gujacum, each two Ounces, in∣fuse them twenty four hours in two Quarts of Fountain Water, upon hot Ashes, and boil them over a gentle Fire till half is consumed; add to it Coriander Seeds and Li∣quorish, or of Sugar and Cinnamon as much as is suffici∣ent to give an agreeable taste. Strain it, and keep it in a Glass; let him take half a Pint hot in a Morning,

for fifteen, twenty, or thirty days; and let him have more Cloaths on than ordinary.

But this is to be noted in the use of Sudorifick decocti∣ons, that some Purging Medicine must be given once a Week from the very beginning of the Cure: Specifick Re∣medies should be used, and such an one is the following Epithem.

Take of the Powder of Zedoary one Draw, of the Waters of Bettony, Vervain, and Elder, each one Ounce; mingle them, apply it hot to the pained part, with Scar∣let Cloth.

Among the Specificks for the pain of the Head, from whatever Cause it arises, Vervain is the chief, whereof the distilled Water is applied to the Head, and taken in∣wardly to four Ounces, with four Drops of Spirit of Salt; and Forestus says, that he knew two sick People that were Cured, by only hanging green Vervain about their Necks, when other Medicines were used to no purpose.

If the pain of the Head proceed from a hot Cause, give first a Glyster, and then Bleed: But a greater quan∣tity of Blood is to be taken away when the Pain proceeds from Blood, than when Choler abounds. Afterwards some Medicines that Purge Choler must be given; not only when Choler is the chief Cause, but also when Blood is Luxuriant; for the thinner part soon turns to Choler. If by one Evacuation, the peccant matter is not sufficiently purged, the Purging Medicine must be repeat∣ed at due distances of time, in the whole course of the Disease if the Belly be not fluid, Glysters that are emollient, cooling, and gently Purging, are to be injected every day.

For pains of the Head, which come upon continual Feavers: Sheeps Lungs taken out hot and applied to the Head, do powerfully asswage the Pain: Or,

Take of the Seeds of white Poppies two Drams, of Saffron half a Scruple, of Camphor one Scruple, with a suf∣ficient quantity of Populeon Oyntment, spread them upon Leather, and apply them to the Forehead.

And after general Evacuations, derivation may be successfully used, by Bleeding in the Forehead with a Lancet, or with Leeches, and by applying Blisters to the

Neck. In the mean while, the Humours must be at∣temperated by Juleps and Emulsions.

Lastly, If the Pain be very violent, we must use Nar∣coticks outwardly and inwardly.

In every Pain of the Head, from whatever Cause it arises, and will not yield to other Remedies; the Head must be shaved, and a large Blister applied all over it.

Diseases of the EYES.

CHAP. XIV. Of a Gutta Serena.

WHen the Sight is lost, and there is no apparent fault in the Eye, it is occasioned by the hindrance of the influx of the Animal Spirits into the Eyes.

An Obstruction is the most ordinary cause of a Gutta Serena, which is generated by a Flegmatick Humour fall∣ing from the Brain into the Optick Nerves: But it is also certain, that this Disease is occasioned by the compression of the Optick Nerves; by Flegm coleated about them, or with Blood, or some other Matter heap'd up in that place, whereby Tumors are made in those places; and Experience shews, that an inflamation of the Brain, or Phrensie in malignant Feavers occasion Blindness. Lastly, Wounds in the Head, whereby the Optick Nerves are cut, hinder the influx of the Animal Spirits to the Eyes.

This Disease is known by the Eyes seeming to continue in their Natural State, only the Pupil appears blacker and larger. But there is great difficulty in distinguishing the Causes of it; for though when it proceeds from Blood, or Pus, an Inflamation, Abscess, or Wound go before, yet

no sure Sign can be given to distinguish a compression by a Flegmatick Humour from an Obstruction. Yet we may in some sort guess, because in an Obstruction only of the Optick Nerve, the Eyes are only affected: But if there be a compression by Flegmatick Humours, gathered toge∣ther about the Roots of the Eyes, and the mamillary pro∣cesses, that Matter will either seise other parts of the Brain, and then the rest of the Senses, or all of them will be in∣jured. But if it be seated only about the Optick Nerves, a Flegmatick Matter will be evacuated by the Nostrils more plentifully than is usual, and there will seem a weight to lie upon the forepart of the Head, especially about the Eye-lids.

As to the Prognosticks, if the Sight be quite taken away by an Obstruction of the Optick Nerves, the Disease is most commonly incurable; for we see that Obstructions of other Nerves whereby a Palsie is gene∣rated, is seldom or never Cured, especially in those that are Old. But if the Obstruction be partial, and the Sight be only diminished, there is more hope of Reco∣very, though a long course of Remedies, and a great deal of time is requisite for the Cure.

But if this Disease proceed from Humours collected in the forepart of the Head, it is easier Cured. Fabritius Hildanus mentions an Observation of one that lost his Sight by taking a violent Vomit, and recovered it again by taking another: For the first by its Violence stirred the Humours too much, and forced them upon the Op∣tick Nerves; but the other evacuated the Humours, and so Cured. There are other Observations of this kind; but it is reasonable to suppose, that in these cases where the Cure is so easily performed, the Humour is not stopt in the substance of the Nerves, but collected in the Brain about the Nerves.

For the Cure of this Disease; the Matter impacted into the Nerves, or adhering to them, which causes the Ob∣struction or Compression, is to be evacuated, which can∣not be, unless the whole Body be first evacuated: As Galen says, the Eye cannot be Cured before the whole Head, nor that before the whole Body.

That the Remedies may be described orderly, a Diet convenient for th•••• Disease is first to be appoin••ed, which

ought to be attenuating, and moderately drying. And first an Air inclining to hot and dry ought to be chosen; but thick, cloudy, cold and rainy Air must be carefully avoid∣ed. Meats of easie Digestion, and of good Juice, must be eaten; and such as breed a thick Juice must not be used, as Pork, Geese, Pease, Cheese, and the like; also those things that fill the Head with Vapours, as things made of Milk, and hot Spices, as Pepper, Ginger, and the like. The Bread must be made with Fennel-water, or the Seed of it must be mingled with it: But great Care must be taken, that Darnel is not mixed with the Wheat wherewith the Bread is made, which has been always accounted very injurious to the Eye. In Sauces and Broths, let the Sick use those things which have an attenuating Faculty, as Hyssop, Fennel, Marjoram, Bet∣tony, Sage, Eye-bright, and especially Nutmegs, which strengthen the Brain, and clear the Sight. Turneps should be often eaten, and also Sparrows, and Pidgeons; Cold Herbs must be avoided, especially Lettice, which is injurious to the Eyes. The Sick must be moderate in his Diet, and the Supper sparing; and once or twice a Week, let him go to Bed without Supper: At Meals, instead of Salt, let him use the following Powder.

Take of common Salt two Ounces, of Eye-bright dried two Drams, of Nutmeg one Dram, of Cinnamon two Scru∣ples; make a Powder.

After every Meal let him take one Spoonful of the fol∣lowing Powder:

Take of the Seeds of Coriander prepared half an Ounce, of the Seeds of Anise and Fennel each two Drams, of Cinnamon and Nutmegs each one Dram; of Eye-bright dried three Drams, of Sugar of Roses, twice the weight of all.

Wine is not good in this Disease; because it fills the Head with Vapours, and promotes fluxion; but a De∣coction of Sarsaparilla sweetned with Liquorish, and aro∣matized with Coriander Seeds, is a proper Drink: But all cannot abstain from Wine, or strong Beer, and there∣fore dried Eye-bright infused in small Wine or Beer, may be used sometimes.

Sleep must be shorter than usual; and lying on the Back must be avoided as much as may be; and the Sick

must not Sleep after Dinner: He must be moderate in his Exercise, and his Body must be always kept Loose.

These things being thus ordered, the Cure must be be∣gun with universal Evacuation; and he must be first purged with the following Medicine.

Take of Senna cleansed half a Dram, of the Seeds of Fennel one Dram, of the Leaves of Bettony, Eye-bright, and Ver∣vain, each half an handful; of Liquorish three Drams; boil them in Fountain-water to three Ounces, strain it, and dissolve in it three Drams of Diaphaenicon, and an Ounce of the Syrup of Roses; make a Potion to be taken in the Morning

After the first Purge, the Physician ought to consider with himself, whether Bleeding is to be used: In Old People, or such as are of a Flegmatick Constitution, cer∣tainly it is not: But in those that are young; and of a hot Constitution, especially if there be Signs of Blood abound∣ing, without controversie, if it be used in time it may do much good; and where there are such indications for Bleeding▪ After Blood has been drawn from the Arm, the particular Veins of the Head may be opened, and those which are near the Eyes, viz. the Forehead Vein, the Vein of the Temples, and in the Corner of the Eyes, near the Nose: But it is more proper to apply Leeches to the Temples; and if they are set behind the Ears too, they may do much good. Some Practitioners relate, that some blind People have been Cured by Wounds in the Forehead, whereby the turgid Veins and Arteries have been emptied.

But if a suppression of the Courses has preceded this Disease, Blood is to be drawn from the lower Veins, or Leeches must be applied to the Hemorrhoids; afterwards the Body must be purged more exactly with the follow∣ing Apozem.

Take of the Roots of Fennel, Sarsaparilla, Florentine, Orris Elecampane, each one Ounce, of the Leaves of Bettony, Marjoram, Balm, Eye-bright, Fennel, Vervain, the greater Celandine, each one handful, of Liquorish rasped, and Raisins of the Sun cleansed, each one Ounce, of the Seeds of Anise and Fennel each three Drams, of Senna cleansed two Ounces, of Gummy Turbith, and Agarick newly trochiscated, each two Drams, of Ginger and

Cloves each one Scruple, of the Flowers of St••chas, Rose∣mary, and Lavender, each one pugil; boil them in Foun∣tain-water to a Pint; strain it, and dissolve in it four Ounces of White Sugar, make an Apozem for four Doses, to be taken in the Morning; Clarifie it, and Aromatize it with two Drams of Cinnamon.

When all the Apozem is taken, give the following Pills.

Take of the Pill Coch. minor two Scruples; make six Pills to be taken early in the Morning.

Universal Evacuation being thus performed, Revulsion of the antecedent cause is to be made, and the conjunct cause is to be discussed, and carried off by derivation; to this end frictions of the extream Parts, especially the lower Parts, are to be used: Cupping-glasses are to be applied to the Back and Shoulders without Scarification, especially to the hinder part of the Head with Scarification, where∣by the Humours are so powerfully drawn from the fore••parts and beginning of the Nerves, that some upon the application of it, have immediately recovered their Sight.

At the same time, a Blister must be applied to the Neck▪ An Issue made in the Neck with a Skean of Silk is very beneficial in this case.

A Potential Cautery applied to the Coronal Suture, has been successful sometimes, when nothing else would do good.

After universal Purging, a sudorifick Diet is to be or∣dered, of Sarsa, and the like; and after the use of the sudorifick Decoction, the use of a sulphureous Bath is very proper, to Bath in, and to wash the Head with. Apo¦phlegmatisms are also of use.

During the whole Course, the Sick is to be purged often▪

And care is to be taken to strengthen the Head and Eyes; to which end, a Dram of Old Venice Treacle must be given at Bed-time, twice or thrice a Week, dissolved in Fennel, or Eye-bright Water; Nutmeg also chewed i•• a Morning Fasting is much commended; so are Candie•• Myrobalans eaten in a Morning.

In a desperate case, after all Remedies have been used to no purpose, a large Blister applied to the shaved Head has sometimes done much good, and repeated twice o•• thrice, when the Excoriation begins to be dry.

CHAP. XV. Of Diseases of the glassy Humour.

THE glassy Humour is placed under the Cristaline, and is therefore made by Nature clear, that the Spe∣cies may be conveyed pure and clear to the Optick Nerves; if therefore the perspicuity of it be sullied by the mixture of any Humour, and it become dark, the Sight is more or less diminished, proportionably to the degree of dark∣ness of it.

Moreover, this Humour may be injured by being mis∣placed, namely, if part of it by a Blow or Contusion is thrust before the Cristalin Humour; for then the Sight is darkned, for the glassy humour is thicker than the watry, and so the Species of Objects cannot be brought pure and sincere to the Cristaline Humour.

The former of these Diseases can be known by no Signs; but be imagined only by reason: For this Humour cannot be seen, nor the disposition of it known; therefore Pra∣ctitioners, when they perceive no fault in the Eye, con∣found this with the Gutta Serena, and that without any damage to the Patient; for extraneous Humours poured upon the glassy Humour must be discussed by the same Remedies wherewith a Gutta Serena is wont to be Cured. But the vitiated situation of the glassy Humour may be known, by appearing like the White of an Egg under the Pupil; but it cannot be distinguished from a suffusion, unless the antecedent and procatarctick causes are well considered; for a suffusion proceeds from a simple influx of the Humours: But this from the glassy Humour misplaced by a Blow or Wound.

This Disease is incurable by Art: But sometimes it hap∣pens to be Cured by Nature; and therefore the whole business is to be left to her.

CHAP. XVI. Of the Diseases of the Cristaline Humour.

THE Christaline Humour is the chief Instrument of Sight, and therefore more than the other Humours of the Eye, ought to retain its Purity and Perspicuity, that it may render the Sight perfect; and if it recede from that Purity, the Sight is much obstructed.

The chief Disease of the Cristaline Humour is the change of it to a grey Colour, and this Disease happens in old Age, from a drying and thickning Cause: It is known by a deep and great whiteness that appears about the Pupil, and all things are seen through a Smoak and Cloud; but it is difficultly distinguished from a Suffusion, which re∣presents such a Whiteness in the Pupil; upon which ac∣count, many Authors confound it with a Suffusion: But those that look carefully, may distinguish these two Dis∣eases; for in a Suffusion, the whiteness is in the Pupil, but in this it appears deep.

This Disease is incurable, especially in old People, in whom the driness of the Parts cannot be mended.

Besides, the Cristaline Humour may be vitiated in Situa∣tion, namely, when its broad part which is like a Lentil, is not exactly opposed to the hole of the Pupil, but is moved upward to downward, and then things appear double: But this fault of Sight is also occasioned by Vapours, or by thin Flegm, that sullies the Christaline Humour. This often happens to People that are drunk. The second ill Situation of the Christaline Humour is, when it inclines for∣ward or backward; if forward towards the Pupil, then things that are near are not plainly seen; but things that are at distance are; this happens most commonly to old People: If it be placed backward towards the Optick Nerve, things that are near are plainly seen; but things at distance not at all: This is called Purblindness, which is to be remedied only by Spectacles.

The third ill Situation of the Cristaline Humour, is when it proceeds too much to the right or left, and this is called Squinting. But this is not only occasioned by

the vitious Situation of the Cristaline Humour, but also from the ill Disposition of the Muscles that move the Eyes, which is either natural, or occasioned by a Convulsion or Palsie; which is to be cured by Paralytick Reme∣dies.

Lastly, From a greater or lesser Inversion of the Cri∣staline Humour, other Vices of Sight may proceed; as when things that are streight appear crooked; or upside down; which happened to a Physician, as Sennertus re∣lates, who looking earnestly upwards, removed the Cri∣staline Humour.

CHAP. XVII. Of the Diseases of the Watery Humour, and especially of a Suffusion.

THE watery Humour is alter'd from its natural Con∣stitution, when it is peccant in Quantity or Quality; when it is encreased or diminished beyond measure, it causes a Dilatation, or Contraction of the Pupil, which are to be treated of in their Place: But when it is vitious in quality it becomes thick; it is caused by some other Humour flowing into it; this is called a Suffusion, which is to be treated of here. This Disease, when it begins, and when the Sight is a little darkned, is called, A Suffu∣sion: But when something is collected in the Pupil, like Water, it is called Water. Lastly, when the Matter is wholly concreted in the Pupil, and wholly obscures the Sight, it is called a Cataract.

There is also a Suffusion, which is Spurious, which proceeds from Vapours, translated from the Stomach, and other Parts. A Flegmatick Humour is the chief and most ordinary Cause of a Suffusion, yet some other Hu∣mours may be mixed with it, at least in a small Propor∣tion; if Choler be mixed with it, it appears yellow; when Melancholy, black.

These Humours are wont to flow to the Eyes, wh••

they are weak, either naturally or occasionally: To the natural Weakness belongs a prominence of the Eyes; for those that have such Eyes, are subject to Suffusions; for prominent Eyes are wont to be large, and so fitter to re∣ceive Humours and Vapours. Some external Causes also occasion weakness, as a Blow, Contusion, Bathing, a Southerly and Rainy Season, long continuing in the Sun, Smoak, hard Reading, especially by a Candle, which occasions a Fluxion of Humours upon the Eyes. The differences of Suffusions arise from the thickness, quantity, or place where the Humour resides, that occasions them.

By reason of the greater, or lesser thickness, the Ob∣struction of the Sight is more or less; for if the Humour be thin, and serous, the Sight is but little obstructed; if very thick, blindness is occasion'd.

By reason of the quantity and place, the Humour pos∣sesses either all the Pupil, and then the Sight is equally obstructed, which way soever it is directed to the Ob∣jects; or it covers one part of the Pupil more than ano∣ther, and the Objects are not seen whole, by looking di∣rectly, nor many at one time: But if the Humour be very small, and is seated in the middle of the Pupil, the Ob∣jects appear as if there were holes in them: But if the Matter be torn into various Corpuscles, seated in various Parts of the Pupil, the appearance of Gnats is always be∣fore the Eyes. Also Hair, Cobwebs, Circles about a Candle, and many other things.

The Diagnostick of this Disease is first to be directed to a legitimate Suffusion, to distinguish it from a spurious, afterwards the various Sorts of a legitimate Suffusion are to be enquired into.

A true Suffusion seizes only one of the Eyes most com∣monly; or if both, not at the same time, nor alike, which happens in a Bastard Suffusion.

Secondly, in a legitimate Suffusion, something dark ap∣pears in the Pupil, which is not in a Spurious; but this Sign is not constant; for if the Suffusion be generated from a thin and serous Humour, there is no change in the Eye, that Humour being scarce thicker than the watery Humour; upon which account, Physicians mi∣stake it for a Gutta Serena. But this Suffusion is easily distinguished from a Gutta Serena; for in a Gutta Serena,

the Sight is wholly taken away, or much diminished, no fault appearing in the Eye: But in a Suffusion, which does not appear to the Sight, the Sick can see tolerably well; because the serous Humour, from whence it is pro∣duced, is thin and clear; so that the species of the Ob∣jects can pass through it like Glass; and then in a Sufful¦sion, the Sight is not for the most part obstructed in al∣the Parts of the Pupil; but the Objects are sometimes seen best, when they are placed directly opposite to the Eye, and sometimes when they are placed towards the Corner; because most commonly, there is a greater thick∣ness, or thinness, in one part of the Pupil, than in another.

Thirdly, In a true Suffusion, the Symptoms are conti∣nual; but in a Bastard Suffusion, they are encreased or lessened by intervals, as the Vapours rise more or less to the Head; and so when the Stomach is empty, they are much less, than when it is full, for then a greater quan∣tity of Vapours arise from the Head, and then the Gnats, Cobwebs, and the like, appear only by intervals. Be∣sides, in a true Suffusion, the Sight seems to pass always through a Cloud, or thick Glass, which is the proper and Pathognomonick Symptom of it: But in a Bastard Suffu∣sion, the Sight is sometimes very good.

CƲRE. The Cure is easier performed in Summer than in Winter. If a Suffusion come upon an acute Fever, after a Peripneumonia, Frensie, or violent Pains of the Head, it is very hard to cure. A confirm'd Suffusion can be cured only by Couching. In a confirm'd Suffusion, if having shut the other Eye, the Pupil is dilated, there is hope of a Cure by Couching, otherwise there is none; for then the Optick Nerve is obstructed; and so the Spi∣rits cannot come to the Pupil. A black Suffusion can never be cured; and but very rarely, a green or yellow. A Suffusion which represents the Objects by holes, is not to be Couched. Couching succeeds best when the Eye is full, and at its natural bigness, for if it be withered and small, it will not succeed. This Operation must not be attempted in old Age, or in Child-hood, nor when, the Eye being pressed with the Finger, the Suffusion appears broader, and then returns to its wonted bigness and shape; for then it is not ripe: But if, being pressed with the Finger, it does not alter its shape, it may be Couched.

When it is ripe, it is like a thin Skin, and may be wrapped round the Needle, and thrust to the lower Part of the Eye.

The Cure of a Suffusion is not to be directed only to the conjunct Cause; but also to the antecedent, and there∣fore the whole Body, especially the Brain, must be first well Purged, afterwards, the Humour obstructing the Pupil must be difcussed, or removed some other way.

Which Indications being the same in a manner, as were proposed for the Cure of a Gutta Serena, may be sought for there.

Therefore all that Cure being premised, which was in∣stituted for a Gutta Serena, we must proceed to those Remedies which respect peculiarly the taking off the Matter, that is seated near the Pupil; and though To∣pical Remedies may seem not to do much good, yet a due use of them is not to be rejected; for experience teaches, that incipient Suffusions have been cured by Topical Reme∣dies, when they have been used after general Evacuations.

First therefore, you must begin with gentle Resolvents, which must not dry too much, lest the Matter of the Suf∣fusions should be hardned, and so rendred unfit for Reso∣lution; and Emollients are therefore to be mixed with the Resolvents, to prevent the hardening of the Matter, and to render the resolving of it more easie; to which end, the following Fomentation may be used at the beginning.

Take of the Leaves of Rue, Fennel, Eyebright, and the greater Celandine, each one handful, of the Seeds of Foe∣nugreek one ounce, of the Flowers of Camomil and Meli∣lot, each one pugil; boil them in three parts of Fountain Water, and one of Wine added at the end. Strain it, and foment the Eyes with it, with a soft Spunge Morn∣ing and Evening, and the Head being covered, the Steam of the Decoction may be received into the Eyes.

At the very beginning of the Disease, when the Flu∣xion is beginning, and when Medicines are used for Re∣vulsion, it will be proper to foment the Eyes with Red Wine, to hinder the Fluxion.

In the Progress of the Disease, a Fomentation of White Wine, wherein Crocus Metallorum has been infused, is very beneficial; and the Breath of a Child, having first chewed Fennel-seeds, received into the Eyes; and a Child, or a

Whelp, licking the Eyes in the Morning, is also good; and Bread hot out of the Oven, mixed with Fennel-seeds, held to the Eyes, till they are moist with the Vapour of it. The foresaid Remedies must be used in the Morning chiefly. At Night apply the following Cataplasm.

Take of the Flower of Foenugreek-seed one ounce, of Aloes half an ounce, of Saffron one dram, make a fine Powder, mix it with White Wine, wherein Crocus Metallorum, has been infused, make a Cataplasm to be applied hot at Bed time.

Many commend Pidgeons Blood dropped hot into the Eye; but because the heat of it soon goes off, it were better to apply a young Pidgeon, before it has Feathers, cut in the middle, to the Eye. The Suffusion being cured, either by Resolving Medicines, or by Chirurgical Ope∣ration, care must be taken to preserve the Eyes; for the Eyes being much weakned by the Disease, are ready to receive Fluxions; therefore Purging is to be used fre∣quently, and Issues are to be made to turn the Humours, and such strengthening things are to be used as were pro∣posed in a Gutta Serena, and the Eyes must be washed in the Morning, with Wine held in the Mouth till it is warm, and mixed with Sage chewed in the Mouth.

Moreover, Spectacles that represent the Objects, neither greater nor lesser than they are, preserve the Sight much.

Lastly, all those things are to be avoided which injure the Sight, and such as help it are to be used.

CHAP. XVIII. Of the Dilatation of the Pupil.

THE Ʋvea Tunica is subject to many Diseases, especi∣ally Rupture, Distortion, Dilatation and Constriction.

A Rupture may be occasioned by an external Cause, as by a Bruise or the like, or by an internal, namely, by a great quantity of Humours extending, or breaking it: But this can never be cured by Art; the distorting of it happens from the first Conformation, when it sticks on

every side to the horny Tunick; and this also can never be cured.

The Dilatation of the Pupil, which is the hole of the Ʋvea Tunica, through which the Species of the Objects enter the Eye, injures the Sight, for that the Light enters in too great quantity; upon which account, such as are troubled with a Dilatation of the Pupil, see better where there is a little Light, than where there is a great deal; and this shews the natural and the ordinary changes of the Pupil, which happen according to the more or less Light of the place we are in, for in a very light place the Pupil is contracted; and this is the Reason, that when we come out of a very light Place into another that is more obscure, we can at first scarce see any thing, till the Pupil is gradually dilated to receive more light, and then things that could not be seen at first, plainly appear: and on the contrary, they that come put of a dark place into a very light place, can scarce bear the Light.

The preternatural Dilatation of the Pupil is either from the Birth, or arises from preternatural adventitious Causes, which are either internal, or external: The next and immediate of the Internals, is Extension of the Tu∣nica Ʋvea, which is either from driness, or repletion; driness stretches the Ʋvea, and renders the hole of the Pupil larger, as holes in Leather are larger when they are dry. This dry Intemperies is occasioned by long Watch∣ings, by Fevers and other drying Causes. The Repletion of the Tunica Ʋvea, it being extended on every side, renders the Pupil larger, and this is produced either by Wind or Vapours, or by Humours flowing upon the Eye, or by the watery Humour encreased above measure; and lastly from a Swelling of the Tunica Ʋva. To these Causes may be added a Convulsion of the Tunick, which chiefly appears in Fits of the Falling Sickness, and in Chldrens Convulsions.

The external Causes are a Fall, a violent Shaking, holding of the breath in Women in Travail, and in Trumpeters.

The Diagnostick of this Disease is not difficult, for the Dilatation of the Pupil may be perceived by the Eyes, especially if before the Disease, the Physician know the natural largeness of it, and also if with the largeness of

the Pupil, the Sight is obstructed; besides, the natural largeness of the Pupil is known by shutting one Eye, for then the Pupil of the other is more dilated, which does not happen in a Dilatation, that is, a Disease, because the Tunica Ʋvea is so much distended by the preternatural Cause, that it can be distended no further.

As to the Prognostick; A Dilatation of the Pupil from the Birth, is incurable; and that which arises after, is difficult to Cure, especially if Driness be the Cause.

CƲRE. The Cure is to be varied, according to the variety of the Causes; and if it come from Driness, the whole Body must be refreshed with moistning Medicines, and Nourishment, such as is used in Hectick Fevers, the Body is also to be moistned with a Bath of hot Water and new Milk, if it be also frequently drop'd into the Eyes, especially Womens Milk.

If it proceed from an Humour that fills the Eye, the-whole Body is to be Evacuated, and presently the Hu,+mour wherewith the Eye is stopped must be discussed which may be sufficiently performed by the Remedies prescribed in the Cure of a Suffusion: But after them Astringents may be used, to contract the Pupil of the Eye; to which end the following Collyrium may be used.

Take of Red Roses dried two scruples, of Saffron, Spikenard, and the Bark of Frankin••ense, each half a scruple, of Tutty prepared, Spodium, Acacia, each one scruple; re∣duce them to a Powder, and tie it up in a fine Rag, and infuse it in three ounces of Rose-water: Drop the Water in the Eyes often, and press the Rag every time you use the Water.

If it proceed from Wind, after general Evacuations, those Medicines are to be used, which expel Wind, and the Eyes may be fomented with a Decoction of Fennel, Rue, Dill, Red Roses and Myrtles, made in Rose-water, and a fourth part of White Wine. Lastly, if it be occa∣sioned by a Bruise, it must be cured like an Ophthalma, if there be an Inflammation; but if there be no Inflamma∣tion, apply at the beginning a Cataplasm made of Bean Flower, the Leaves of Plantane, Red Roses, and Rose-water: But afterwards, Pidgeons Blood must be often drop'd into the Eye; which is an excellent Remedy for all Wounds and Bruises of the Eyes.

CHAP. XIX. Of the Narrowness of the Pupil.

THE Narrowness of the Pupil is also injurious to the Sight: It is either narrow from the Birth, and then it is no great Injury; for though they cannot see so well as others in a Place where there is not much light, yet they see better in a very light Place; or the Narrowness of the Pupil is occasioned by preternatural Causes, as from too great moisture, or driness, from a Defect in the Watery Humour, or for want of Spirits.

The Cure of this Disease is the same with the former, though they produce different Effects.

CHAP. XX. Of an Albugo, Spot, and other Colours of the Cornea changed.

THE natural Constitution of the Cornea is altered, when it loses its Perspicuity, or changed into ano∣ther Colour. It loses its clearness, when it grows thick by driness, which often happens in old People, and is never to be cured: Or it is thickned by gross Humours stuff'd into it; which frequently happens in an Ophthal∣mia; when, by reason of too great an use of Resolvent Remedies, the thinner Parts of the Humours are dis∣cussed, the thick remaining behind: Or when by cooling Medicines used too often, the Humours are thickned; and then the Horny Tunick is not only thicker in that Part where the Humour is impacted; but it also turns white, and is called Leucoma, or Albugo; but such a Disease is also occasioned by the Cicatrix of a Wound, whereby the Cornea is rendred thicker, and loses its clearness▪

There are several sorts of it, as it is more or less thick; one only possesses the Superficies of the Cornea, another is seated deep, and penetrates the whole Cornea; one is greater, and possesses the whole Pupil, or the greatest Part of it; another is small, and covers only a small Part of the Pupil, and then it is called a Spot.

The Cornea is also infected with a different Colour, when Blood is poured off upon it, and then it is called Suggillatio, and then all the Objects appear red; or when Choler insinuates it self into it, which often happens in the Jaundice, and then the Objects appear yellow.

Those Diseases do not want peculiar Diagnosticks; be∣cause they are apparent.

As to the Prognosticks: An Albugo which proceeds from Flegm, or from a gross Humour remaining after an Ophthalmia, is easily cured, if it be not inveterate: But that which is occasioned by a Cicatrix, is very difficultly cured; because Parts of exquisite Sense, can scarce bear such sharp Remedies, as are necessary to take off the Cicatrix.

The Cure of an Albugo, occasioned by Flegmatick Hu∣mours, concreted in the Cornea, must be performed by emollient, discutient, and attenuating Medicines: But universal Remedies mush be premised, which carry off the antecedent Cause, and prevent a new influx of Hu∣mours, such are set down in the Cure of a Suffusion, and Gutta Serena; afterwards a Fomentation is to be applied with soft Spunges, to mollifie the concreted Matter, made of the Decoction of Foenugreek, Melilot, Celandine and Fennel, or the Vapour of this Decoction, may be re∣ceived into the Eyes: Presently after discussing Reme∣dies are to be used, such as are prescibed for the Cure of a Suffusion; and attenuating Eye Medicines, and such as resolve the Humour impacted in the Eye, especially such as are made of Honey distilled, are to be used; for the Water of distilled Honey, is very good to take out Spots from the Eyes; if the use of it be long continued. Sugar-Candy dissolved in Eyebright, Celandine, or Fennel-water, is also good, and let the Eye be often licked, with a Boy's or Girl's Tongue, they having first chewed Fen∣nel in their Mouths. Amatus Lusitanus says, that he cured a Girl of twelve Years of Age, that had thick Clouds in

her Eyes with the following Collyrium, having first used the Decoction Sarsa for three Weeks.

Take two Pound of Honey in the Comb, of the Tops of Fennel, of the Flowers of Elder, and Eyebright, each two Pugils, of Sugar-Candy two ounces; distil them in a Bath, and drop the Water into the Eyes.

The Juice of Fennel fresh drawn with one drop of Pe∣ruvian Balsam in it, discusses powerfully an Albugo; the Oil of burnt Rags mixt with the Spittle of a Boy, being applied with a Feather, is also good. This Oil is drawn by firing a Rag, and extinguishing it between two Plat∣ters; when it is cold, the drops of Oil will stick to the Platter.

But an Albugo, or a Spot, occasioned by a Cicatrix, is cured by those Remedies which mollifie, attenuate, and dissolve; but because those things that take off the Cica∣trix are Acrimonious, the greater care ought to be taken, that universal Evacuations and Revulsions are first used▪ lest Humours should flow to the Part; afterwards it will be convenient to use such Fomentations which are men∣tioned above; and then discutient and abstersive Reme∣dies are to be applied. First, those that are gentle, espe∣cially the Compound Water of Honey above described: But afterwards stronger, as the Galls of Fish, of the Pike, and the like: Also of other Animals, as of the Partridge, Cock, Goose, Bull, and the like; also the Juices of the greater Celandine, the lesser Centaury, Brooklime, and the like, which are to be mixed with Honey, both be∣cause the Honey is discutient, and abstersive, also because Liquors drop'd into the Eye, run presently to the Corners, and will not stay upon the Pupil, upon which they ought to work; but when they are mixed with Honey, they easily stick to it; but by reason of their sharpness, the foresaid Juices or Galls may be thickned with the Mucilage of Gum Tragacanth, Psyllium, or Quinces extracted in Penny-royal or Eye-bright Water, the form of a Collyrium with Juices may be such as follows.

Take of the Juice of Fennel, Celandine and Brook-lime, each three Drams, of the Juice of the lesser Centaury half an ounce, of white Honey one ounce; mingle them like a Liniment; if with the Albugo there is a redness of the Eyes, the Collyrium made of White Wine,

Salt and Wheat, described in the Chapter of an Ophthalmia, is good, or the following may be used.

Take of Aloes and Agarick, each one scruple, powder them, and tie them up in a Rag, and infuse them in Eye-bright or Fennel-water, and rub the Eyes with it, Morning and Evening. The Aloes cleanses, strengthens, and stops Fluxions, and the Agarick is very abstersive.

Suggilatio, or the red Colour of the Eyes, occasioned by Blood pour'd upon them; if it be fresh, may be easily cured, by dropping Pidgeons Blood into the Eyes, or for want of it Womans Milk with a little Frankincense and Saffron, or the Yolk of an Egg with Wine may be used. But if the Disease be obstinate, the Eye must be fomented with a Decoction of Foenugreek, Marsh mallows▪ Fennel, Rue, and Celandine; or the Steam of the Decoction may be received into the Eyes. Lastly, all those things that we prescribed for a Suffusion, are proper for the Cure of this Disease: But when the Disease is inveterate, and when that which was red begins to turn black, the Tops of Hyssop wrap'd in a Rag, and dipp'd in boiling Water, and applied to the Eye, are particularly recommended by Galen; and Experience shews, that this Remedy is so very effectual; that the Blood is apparently drawn out, and sticks to the Rag.

Lastly, the yellow Colour, which appears in the Eyes of those that have the Jaundice, goes off of its own accord when the Disease is cured: But if you desire to hasten the Dissipation of it, the Steam of Vinegar received in the Eyes, will do it.

CHAP. XXI. Of an Ophthalmia.

THE Tunica adnata is so nearly joined to the Cornea, that many Diseases possess both Tunicks, so an In∣flammation of the Eyes, though it properly belong to the Tunica adnata, yet is very often extended to the Cornea, and produces various Diseases in it, viz. Ulcers, Hypo∣pyon,

Albugo, and others, and Pustles and other Tumours and Wounds and Ulcers are common to both Tunicks: So that all the Diseases of these Tunicks cannot be treat∣ed of a part; and therefore we are forced to enter upon the Diseases of the Tunica adnata, before we treat further, of the Diseases of the Cornea.

Therefore, beginning from an Ophthalmia, which ac∣cording to the Signification of the Word, is nothing but an Inflammation of the Eye, and is called in English, Blear∣edness of the Eyes.

The conjunct Cause of an Ophthalmia, is Cholerick, Flegmatick, or Melancholy Blood, flowing into the Eyes, or accumulated there. There are many Causes of Flu∣xion, both External and Internal. The Causes of Con∣gestion, are all those things which occasion an Intemp••∣ries, or Weakness in the Eyes.

The Diagnostick of an Ophthalmia is easie; for the Blood pour'd upon the Tunica adnata, may be perceived by the Eyes; if it be occasioned by Blood, the whole Face▪ as well as the Tunica adnata, will look red, and the Veins will appear large: If it proceed from Cholerick Blood, the Acrimony of the Tears will corrode the Angles of the Eyes and the Cheeks, and there will be a violent pricking Pain: If it proceed from Flegm, the•• will be a dull Pain, and little Heat; the Tears will not be sharp, but the Eye will be much blear'd, and full of viscous Matter: If it proceed from Melancholy▪ the Tu∣mour will be small, and the redness will incline to a brown Colour, the Tears few, and the clammy Matte•• little, but thick.

If the Fluxion arise from the inward Parts of the Head, there will be a Head-ach, that reaches to the Roots of the Eyes: But if the Fluxion pass by the outward Vessels in∣to the Eyes, the Pain of the Head is more external; the Veins of the Forehead are distended, and a Pulsation is perceived in the Temples.

In order to the Cure of an Ophthalmia, a cooling and moistening Diet must be appointed, and such Meats as easily digest; and rather boiled than roasted; Spoon▪ Meats rather than solid; the Patient must avoid Acrid, Salt, and Pepper'd Meats, and such as fill the Head with Vapours; Milk, Sugar, and all sweet things, must be a∣voided.

Wine is not good in the beginning; but instead of it, a Ptisan of Liquorice and Barly, or some other cool∣ing Liquor must be used.

Sleep is very beneficial, because the Motion of the Eye then ceases, whereby the Pain and Fluxion are excited, the Sick should lie with his Head high on the well side: All Motion of the Body must be forbid; and Talking, and the Belly must be kept open: The Patient must keep him∣self free from Passions, especially from Anger.

The Air must be temperate, and pure, and free from Smoak, Dust and Winds, and the Room must be dark∣ned, and the Eye must be covered with Black, Green or Sky-coloured Cloth; the well Eye must be also covered; because, when that moves to view an object, the other is also moved.

The Course of Diet being thus appointed, the external Causes, from whence it most commonly arises, must be removed. A Collyrium must be presently prepared, made of Rose and Plantane-water, the white of an Egg, and of Womans Milk, and let it be dropp'd into the Eyes often in a Day; and a Rag dipp'd in it must be applied over at the same time Sleep must be indulged as much as may be; for it much furthers the Concocting, or discussing of the Morbifick Matter. If the Disease be not taken off with these things, Remedies for a true Ophthalmia are to be used in the following manner.

A Clyster must be first injected, and Blood must be drawn from the Part opposite to the Part affected, and Bleeding must be repeated, till a sufficient Evacuation and Revulsion are made; for this Disease has been often cured by Bleeding alone; but respect must be had to the Age, the Sex, and Constitution of the Sick; and in those that have had some accustomed Evacuation suppressed, as of the Courses or Hemorrhoids, the inferior Veins must be opened, or Leeches must be applied to the Hemor∣rhoids. But after a sufficient Evacuation of Blood has made, by Vene-section, Revulsion must be also under∣taken, by applying Cupping-glasses, with, and without Scarification, to the Back and Shoulders, Frictions and Li∣gatures are also used to the Inferior Parts; and to the foresaid Revulsions, Derivation is to be joined, which is made by opening the Veins of the Forehead and Temples,

and in the Angle of the Eye; some apply Leeches to the Temples, or behind the Ears; all which kinds of Deri∣vation are very useful after sufficient Evacuations.

Galen commends the opening of the Arteries of the Temples, when the Ophthalmia proceeds from very hot and boiling Blood: And though this kind of Remedy is seldom used in our Age; yet it is very beneficial, and without danger; for in those lesser Arteries, by Ligature only, the Blood may be stopp'd.

Blisters are also of good use applied to the Neck, and behind the Ears; and after Bleeding has been suffici∣ently used, Purging must be ordered, that the hot Hu∣mours may be evacuated; but you must Purge with gentle Medicines, and such as cool the Blood; as,

Take of Tamarinds half an ounce, of Sena two drams, of Rhubarb one dram, and an half; infuse them in Foun∣tain Water: To three Ounces of the strained Liquor, add of Manna, and of Syrup of Roses solutive, each an ounce. Make a Potion to be taken in the Morning; or the following Bolus may be used.

Take of Cassia newly extracted six drams, double Catho∣licon three drams, Pouder of Rhubarb one dram, with a sufficient quantity of Sugar; make a Bolus.

In a Flegmatick Ophthalmia, Pills are frequently pre∣scribed, as Pills of Agarick, and the like; which although they be very proper when the Disease is at its height, yet in the beginning, it is better to let them alone, lest the Humours being put in a Commotion by the sharpness of the Medicine, may cause a greater fluxion upon the Part. Neither is one Purge sufficient, but they must be frequent∣ly repeated, if the Disease prove tedious; convenient pre∣parations being premised, as Apozems and Juleps proper for the peccant Humour: In the first place, the heat of the Humours is to be temperated from the beginning of the Disease, by refrigerating and thickning Juleps, or with an Emulsion of the four greater cold Seeds, Lettice and white Poppy Seed, made with some cooling Decoction; to which may be added Rose-water.

Universal Evacuations and Revulsions being premised, Topicks are to take place, and such as are repelling from the beginning ought to be used. Nevertheless, the more rational Practitioners do advise, not to apply repelling

Collyriums at the beginning of the Disease: Because for the most part, they six the Humour that slows upon the Part, and so augment the pain and inflamation. Galen does censure an Oculist, because he proposed repelling Medicines to be used at the beginning of an inflamation. Nevertheless, astringent Medicines may be applied to the Forehead and the Temples at the very beginning of the Disease; because by them the Veins by which the Humours fall upon the Eyes are compressed, and the Humour re∣pelled. They may be made after this manner:

Take of Bole-armenick, Dragons blood, Frankincense, Ma∣stich, each one Dram; red Roses, Balaustins, and the Flower of Lentles, each two Scruples, mix them with the White of an Egg, and Vinegar of Roses. Make a Cataplasm to be applied to the Forehead and Temples.

A Cataplasm made of the Juice of Nettles, and Wheaten Flower is esteemed very effectual for stopping the Flux of Humours upon the Eye, being applied to the Forehead and Temples; sometimes the Juice of Nettles by a speci∣fick quality does stop all manner of Fluxes of Blood, be∣ing either applied outwardly to the place, or taken in∣wardly.

In the mean time, if the pain be very violent, which causes a Fluxion more and more upon the Eyes, anodine Medicines must be applied to the Eyes; of which the new Milk of an healthful Woman is the best, which is to be milk'd from the Breast into the Eye, instead of it new Cheese made of Sheeps Milk may be used: But it must be often changed, lest it turn to Butter, and so augment the inflamation.

The White of an Egg beat into Water, is greatly com∣mended by Galen, because it eases Pain, and stops the Fluxion gently.

An Apple roasted under Cinders does also greatly miti∣gate the pain of the Eyes.

The Mucilages of the Seeds of Fleabean, Quinces, and Fenugreek Seeds extracted with Rose-water, do greatly ease Pain; they must be changed once in two days, lest they become sharp. Of these, several Compositions may be made upon occasion: For example.

Take of the Pap of a sweet Apple roasted under the Cinders one Ounce, of the Mucilages of the Seeds of Psyllium

and of Quinces extracted in Rose-water, each six Drams, of the Liquor of the White of a new Egg, and Womans Milk, each one Ounce: Make a Cataplasm to be applied to the Eyes.

Pieces of Kids, Calves or Sheeps Flesh new kill'd, fre∣quently applied to the Eyes, powerfully ease Pains.

A more simple Cataplasm may be made of Crums of Bread moistned in Womans Milk and Rose-water.

But if the Pain be vehement, and intolerable, Narco∣ticks must be used, but sparingly, and with Caution; because they condense the Spirits that serve for Sight, and thicken the Coats of the Eye, and the Humours, and so dull the Sight. Amongst the Ocular Narcoticks, Trochisci Albi Rhasis with Opium, are the best, which may be pre∣scribed after this manner.

Take of Rose Water two Ounces, the White of an Egg strongly beaten one Ounce, Trochisci Albi Rhasis with Opium one Dram; make a Collyrium to be dropt into the Eyes.

After the Pain is abated, repelling Medicines are to be used, which ought to be moderate, and anodine Medi∣cines are to be always mixed with them; to this end the following Collyrium uses to be prescribed.

Take of Plantane-water, Rose-water, each an Ounce and an half, Liquor of the White of an Egg an Ounce, Trochisci Albi Rhasis, without Opium, one Dram; make a Colly∣rium to be often dropt into the Eyes.

If the Pain be more sharp, Womans Milk, and the a∣bove mentioned Mucilages may be added to the Colly∣rium.

The following Remedy powerfully abates the Inflam∣mation, and stops the Fluxion.

Take the white of one Egg, beat it with a pretty big piece of Allum in a Tin Platter; stir it until it has got the consistence of an Ointment: spread it upon a Rag, and apply it warm to the Eyes; romove it in the space of two Hours; lest by staying too long, it fix the Humours in the Eye, by the astringent force which is in the Allum.

Sal Saturni dissolved in Rose-water or Oxycrate, or mixed with Pomatum, does powerfully extinguish the Inflammation of the Eyes.

In the augmentation of the Disease, digesting Medi∣cines are to be mixed with repelling Medicines; therefore to the above-mentioned Collyriums may be added, Waters of Eye-bright, Fennel, Celandine, and the Mucilages of the Seeds of Flax, Marsh-Mallows, Foenugreek. Ga∣len chiefly commends the Decoction of Foenugreek Seeds; because it Digests, Concocts, and moderately repels.

When the Disease is at a height, Sarcocol is also added to Collyriums, which digests a little more powerfully: But because it hurts the Eyes by its Acrimony, it is fit to infuse it some days in Milk, often changed before it be used, and a small quantity of it ought to be prepared at once; for after it is long kept it turns sharp, and is hurt∣ful to the Eyes, it may be used after this manner.

Take of Flowers of Melilot, Camomil, red Roses, each one pugil, of the Seeds of Foemigreek well cleansed one dram; boil them in Plantane-water: in four ounces of the strained Liquor, dissolve a dram of Sarcocol prepared, of Tutty prepared, and Trochisci albi Rhasis without Opium, each half a dram, make a Collyrium.

There are some Waters commended by Authors, as very effectual. Quercetan in his Dispensatory, com∣mends the Infusion of Crocus Metallorum, in Eye-bright and Plantane-waters.

Crollius, and the rest of the Chymists, greatly commend Salt of Saturn dissolved in Rose-water, to which may be added some Grains of Sal Ammoniacum: It may be pre∣scribed after this manner.

Take of Sacharum Saturni three grains, of Salt Ammo∣niacum three grains, Rose-water three ounces; mix them, and drop of it into the Eyes Morning and Night.

A Water made of white Vitriol, it being dissolved in Red Rose-water or Plantane-water is commonly used; as, Take of White Vitriol one scruple, dissolve it in four ounces of Plantane or Rose-water; strain it, and drop it into the Eyes: If it be too sharp, it must be qualified by mixing more Water with it.

Many Ointments are also commended for the Cure of an Ophthalmia.

Take of prepared Tutty an ounce and an half, of Camphor one dram, of Verdigrease grains twelve; powder the Cam∣phor

and the Tutty together in a Mortar, and the Verdi∣grease by it self, all of them must be very finely pow∣dered; then take of fresh Butter one Ounce, of Rose-water one dram, boil them together gently, and having taken them from the Fire, mix by degrees, first the Tutty with the Camphor, afterwards the Verdigrease; strain them through Silk, and make an Oyntment; Anoint the inward part of the Eye-lids, especially about corners, with this Oyntment.

This is of excellent use for Inflammations of the Eyes, and for itching of the Eye-lids.

When the Disease is come to its State, resolving Re∣medies ought to exceed Repellents, and the same Reme∣d••es which were used at the beginning are also good, when it is at its height, if you increase the quantity of the Resolvents, and lessen the quantity of the repelling In∣gredients.

A Fomentation made in the following manner, is con∣venient to be used to discuss the Morbisick Matter when the Disease is at height.

Take of the Flowers of Camomil, Melilot, Roses, each one Pugil, of the Seeds of Fenugreek two Ounces, make a Decoction, wherewith foment the Eyes with linnen rags four times double.

This Fomentation may be also used at the beginning or declination of the Disease; it must be applied hot in the Winter and warm in the Summer.

The Oyl of Rags, or the Liquor which is drawn from Rags, burnt and extinguished betwixt two Platters, is excellent to discuss an Ophthalmia, a drop of it mixed with a Childs Spittle, being put into the Eye with a Feather.

And Collyria that are more resolvent may be used at the declination.

Take of Frankincense and Aloes each half a dram, of Sar∣cocol moistned with Womans Milk one dram and an half, of Saffron half a Scruple, of the Mucilage of Fenugreek Seeds half an Ounce, of Fennel and Eye-bright Water each an Ounce, make a Collyrium.

Fennel Water mixed with Astringent Wine, is good to be used in the manner of a Fomentation, to discuss the Relicks of the Disease, and to strengthen the Eye.

A Decoction of Hyssop is excellent to take off the Red∣ness which remains at last.

But an inveterate Ophthalmia, which has continued many Years, requires a somewhat different and longer Method of Cure. If it proceed from a hot Intempories, then such Remedies as correct it are to be used; after Bleeding, and convenient Purging Baths, Whey, and Vitriolick Mineral Waters, and Leeches applied to the Hemorrhoids, do much good.

But if the matter of an Ophthalmia arise only from an Intemperies of the Brain, from whence Flegmatick Hu∣mours flow to the Eyes with somewhat of Blood; then care must be taken to purge the Brain twice, thrice or four times in a Month, and a Seaton must be made in the Neck, and Masticatories are of use.

But if the Brain want to be more dried, Sudorifick Decoctions of China, Sarsaparilla, and the like, must be used, and the Resolvent Fomentation and Oyntment men∣tioned above are to be applied, and the following Water is very effectual.

Take of the best Aloes, and of Tutty prepared, each six drams, of white Sugar one Ounce, of Rose-water, and of White-wine that is not acid, each six Ounces, infuse them in the Sun for forty days, in a Glass well stop'd, drop in a few drops of this Water, not strained, into the Eye.

Sometimes in an inveterate Ophthalmia much Filth like Matter is collected in the Eyes, and in this case Cotton finely carded and well dried, and applied over the Eyes for many nights together, will draw it out.

To conclude, Zacutus Lusitanus cured a desperate Oph∣thalmia, that had continued, notwithstanding all other Remedies for a Year, with Fluxing.

CHAP. XXII. Of Matter collected under the Cornea.

INflan••ations of the Eyes, when they are Violent, and a great Tumor is raised, cannot sometimes be dissolved but turn to Matter, which is greatly to be feared; for then Ulcers succeed, and sometimes a Collection of Mat∣ter under the Cornea, which is called Hypopyon: This also often happens by Contusions of the Eyes.

This Disease is known, not only by the white colour that resembles Matter, but also by the Inflammation that went before; and when the Eye is moved, the Matter seems to move under the Cornea; the Eye looks red, and there is a throbbing Pain in it, or at least it went before.

In order to the Cure, Universal Remedies being pre∣mised, if any relicks of the Inflammation remain, they must be taken off by Remedies prescribed in the fore∣going Chapter, and afterwards use a Fomentation made of the Flowers of Camomil, Melilot, the Seeds of Psylli∣um, and Fenugreek, afterwards you may use the following Collyrium.

Take of the Waters of Vervain, Rue, Celandine, Roses, Fennel, each half an Ounce; of the best Aloes, Tutty prepared, each half a dram; of Sugar-candy one dram; powder them and mingle them, and add to them a little Womans Milk; make a Collyrium.

Drop a few drops into the Eye twice or thrice a day.

The following Medicine is also very effectual.

Take of Saffron, Aloes, Myrrh, each one dram, of Wine three drams, of Hony six drams, dissolve the Saffron in Wine, then mingle the Aloes and Myrrh, and lastly the Hony, anoint the Eyes with it.

And those Remedies are also proper, which were pre∣scribed for Spots of the Eyes, and for a Suffusion; but if the Matter cannot be discussed by resolving Medicines, other Remedies must be used. Galen mentions an Oculist of his time, that cured many of this Disease with placing

the Patient upright in a Chair, and holding his Head on both Sides, and suddenly shaking it, the Matter sunk down: But if this will not do, Galen proposes to Cure it by Puncture, as in a Suffusion: But for this Operation, the most skilful Chirurgion must be procured.

CHAP. XXIII. Of Bladders called Phlyctaenae.

IN the Tunicks, called Cornea and Adnata, as in other Parts of the Body, are wont to be generated small Bladders full of Water, like the Bladders which arise from Scaulds; they are of the bigness of Millet Seeds, and are occasioned by acid and watery Humours, they are easily known, for they appear to Sight: Those that arise in the Adnata, are of a red Colour; but those in the Cornea, are blackish, when they are placed upon the Superficies of it; but they are white, if they lie deep. Those that are seated in the Adnata, are not so dangerous as those in the Cornea, the superficial is less dangerous than they that are deep.

The Cure of then must be performed, by resolving the conjunct Matter, and by turning the antecedent Cause the other way, and great care must be taken to hinder Suppuration; wherefore universal Evacuations, Revul∣sions and Derivations, which were propos'd in the Cure of an Ophthalmia, are also of use here. Afterwards To∣picks are to be applied, which gently repel in the begin∣ning; but in the Progress of the Disease, such things as dry and and resolve are to be used, which you may see in the Chapter of an Ophthalmia.

CHAP. XXIV. Of the Ʋlcers of the Tunicks called Cornea and Adnata.

ULCERS in those Tunicks use to follow an Oph∣thalmia, when it comes to Suppuration; they also follow the breaking of the Bladders in the Cornea: They are also occasioned by sharp and corroding Humours, that fall upon the Eyes. Great variety of them are proposed by Authors, according to the various Circum∣stances.

They are easily known, because they appear to Sight: If the Ulcer be in the Cornea, it appears white in the black of the Eye; if it be in the Adnata, a red Spot ap∣pears in the white of the Eye. These Ulcers are very hard to Cure, and dangerous; but much more in the Cornea, than in the Adnata. That which is near the Pupil is most dangerous; because when it is cured, a Cica∣trix is left behind, which spoils the Clearness of the Sight.

The Cure of this Disease, as of other Ulcers, is to be perform'd by cleansing and drying Medicines, but they must be very gentle, by reason of the softness and exqui∣site Sense of the Part; but those things are to be used first which stop the Fluxion: Such are to be found in the Chapter of an Ophthalmia. If there be also an Inflamma∣tion and Pain, Medicines respecting both must be added to the former.

Moderate cleansing and drying Medicines are, Sugar, Honey, Saffron, Myrrh, Frankincense, Aloes, Sarcocol, Tutty, and Ceruss, whereof the following Forms may be composed.

Take of the Decoction of Barly and Foenugreek four ounces, of the best Hony half an ounce, or of Syrup of dried Roses one ounce; make a Collyrium, wherewith wash the Eye often; or,

Take of Vervain and Plantane Waters each two ounces, of Sugar-Candy half an ounce, mingle them for a Colly∣rium; or,

Take of Hony Water distilled in a Bath, and of Rose-water each equal Parts; or,

Take an Egg boiled hard, and clear'd from the Shell, di∣vide it into two parts, take out the Yolk, and fill the hole with Sugar-Candy powder'd, bind it up, and set it in a Cellar, and a Liquor will drop from it, which is very fit to cleanse Ʋlcers; if you would have it operate more powerfully, you must mix powder'd Myrrh with the Sugar-Candy.

In the Progress of the Disease, if it is necessary to cleanse and dry more powerfully, add to the forementi∣oned Collyria, white Troches of Rhasis, Frankincense, Aloes, Myrrh, Sarcocol, and such like in a small Dose: You may also add Milk, the White of an Egg, Muci∣lages, and other Anodyns; but Tutty is better than the rest, because it dries without causing Pain. The follow∣ing Collyrium is very drying and cleansing.

Take of Sarcocol moistned in Rose-water, of Ceruss, Aloes wash'd, Myrrh, Tutty prepared, each half a dram, of Sugar-Candy one dram, with the Mucilage of Gum Tra∣gacanth extracted in Rose-water; make a Collyrium, wherewith anoint the Eye-lids.

CHAP. XXV. Of the Cancer of the Cornea.

AS Cancers are wont to happen in all Parts of the Bo∣dy, so also they sometimes grow in the Eyes.

A Cancer of the Eye, is either occult or ulcerated: An occult is called a Cancerous Tumor; when it is ulce∣rated, it is called a cancerous Ulcer; in both there is an unequal hardness, and a leaden and livid Colour, great and pricking Pain, especially about the Temples, the Veins appear swoln like a Varix, in the Tumour, and in the Neighbouring Parts, sharp Blood frequently flows our, when the Cancer is ulcerated; and the Pain is very much exasperated by Medicines, that are never so little heating.

This Disease is incurable, both in the Eye and in other Parts of the Body when it is rooted, unless it be irradi∣cated by a Chirurgical Operation.

Two sorts of Cures are proposed by Authors, viz. a true one, and a palliative.

The true one can be performed only by Chirurgery, the palliative Cure, which mitigates the Symptoms, is per∣form'd by Evacuations and convenient Topicks. But first of all, a cooling and moistning Course of Diet must be ordered, afterwards Blood must be drawn from the Part opposite to the Eye affected, and Leeches must be ap∣plied behind the Ears of the same side, and to the Hemor∣rhoidal Veins, if they are any whit swelled: Cupping-glasses must be also applied to the Shoulders, and other sorts of Revulsions must be used.

Purging, and the prepara••ion of the Humours by Po∣tions, Apozems, medicated Brothes, and the like must be frequently prescribed: But above all, Black Hellebore rightly prepared, or the extract of it; for an incipient Cancer has been cured by using of it twice or thrice.

These Remedies hinder the influx of the Humours into the Eyes, and much lessen the Pain and other Symptoms: But Topical Remedies, such as are described in the Chapter of an Ophthalmia to ease pain, do also much good, especially Collyria made of Mucilages, of the white Troches of Rhasis, of Tutty prepared, and with the Water of Roses, Night-shade and Plantane.

The following Water is excellent for washing the Eye.

Take of the Roots of the greater Figwort, and of Herb-Robert, each two handfuls, of Ribwort, Night-shade, Borrage, Bugloss, Purslain, Eye-bright, Betony, each one handful, of green Frogs, and of the white of Eggs, each number seven, of the Seeds of Foenugreek and Quinces each one ounce; the Roots and Seeds must be beat, and the Leaves cut; then pour upon them of Rose-water and Eye-bright water, each one pint: mingle them, and distil them in a leaden Still.

The Flesh of Pullets eases the Pain much, and some say this Disease has been cured by this Remedy only.

A Lady that had an ulcerous Cancer upon all the right side of her Face a long while, and had used various Me∣dicines that were prescribed by Italian, French, German,

and Spanish Physicians, was cured by a Barber by this common Remedy. He cut Chickens into thin and broad Pieces, and applied them often in a day to the Part affected.

Lastly, The true Cure of a confirm'd Cancer can only be perform'd by the Extraction of the Eye, which Fabri∣cious Hildanus says may be safely and successfully done; and he describes at large the manner of Extirpation, and all the Circumstances of it in his Observations.

CHAP. XXVI. Of the Rupture of the Cornea.

THERE is such a Solution of the Continuum in the horny Tunick sometimes, that the watery Humour comes out of the Tunica Ʋvea; this is call'd a Rupture of the Cornea. The cause of this is either a Rupture, or a Wound, and it is most commonly incurable; but if the Wound be small, and if but part of the watery Humour flows out, the Cure may be undertaken: For Galen says that the watery Humour is sometimes regenerated.

The Cure of this Disease must be entred upon, by conglutinating Remedies: Universal Evacuations, name∣ly, Bleeding and Purging, if they are necessary, being first used; drop into the Eye the White of an Egg ming∣led with the white Troches of Rhasis, and foment the Part, with the Decoction of Red Roses, of the Leaves of Knot-grass, Brambles, Shepherds Purse and Plantane, made in astringent Wine, if there be not an Inflam∣mation; if there be, it must be made in Simple Water. Or,

Take of Quinces paired, the Seeds and Cores being taken out, half a pound, of red Roses three pugils, of Acacia two drams, of Saffron one scruple; boil them in astrin∣gent Wine, and make a Pul••ise to be applied to the Part; and to strengthen the whole, the following Collyrium must be used.

Take of Aloes wash'd, of prepared Tutty, and of Sarcocol moistned with Womans Milk, each half a scruple, Saf∣fron grains eight, with Mucilage of Gum Tragacanth; make a Collyrium.

CHAP. XXVII. Of the Falling out of the Uvea.

THE Falling out of the Ʋvea often succeeds the Rupture of the Cornea; the Cure of it is very diffi∣cult: But if it be very small, it may be oured by mode∣rate Astringents, such as are proposed in the foregoing Chapter.

CHAP. XXVIII. Of a Fistula Lachrimalis.

HItherto the Diseases of the Eyes, which happen in the Tunicks or Humours of them, have been treated of. It remains now, that we speak of the Diseases of the Eye-lids, and of the Corners of the Eyes. And first, the Tumour appearing betwixt the greater Angle of the Eye, and the Root of the Nose offers it self, it is called Oegy∣lops, and Anchylops. Anchylops, before it is broken: But Oegylops, after it is broken. This Tumor, or rather Tu∣bercle, is sometimes with an Inflammation, and some∣times without; when it is accompanied with an Inflam∣mation, it is red about and painful, and is occasioned by thin and cholerick Blood, brought by the Veins of the Temples, Forehead, and Face to the Part, and for the most part degenerates into a sinuous Ulcer, and then it is called Fistula Lachrimalis; which if it conti∣nues a Year, occasions a Caries of the Bone, which may be known by the Cavity it makes, by the stinking

Matter, and the roughness that is perceived by the Probe.

This Tubercle also comes without an Inflammation, and then it is generated by a gross and viscid Humour, that resembles Honey; then it is to be reckoned with those Tumors which are called Atheroma, Steatoma, and Meliceris, which are wont to be without Pain.

The Cure of an Oegylops is very difficult, because Me∣dicines can be hardly applied, by reason of the nearness of the Eye, and because by reason of the softness of the Parts, it easily degenerates into a Sinous Ulcer: But is yet more difficult to Cure, if the Abscess pass through the Nostrils, and Matter flow through them; because the Bones that are under, are most commonly fouled thereby.

But sometimes an Oegylops is of the Nature of a Can∣cer, which may be known by the pricking pain, the swelling of the Veins, and the hardness and livid Colour of the Skin; and then it is better not to meddle with it, for Medicines make it worse, and increase the Pain.

A new Fistula Lachrimalis, which hath an outward and plain Orifice, is cured by Medicines; but that which is deep and inveterate, and joined with a Caries of the Bone can scarce be cured without a Cautery.

The various Seasons of this Disease require different Applications and Remedies, and first at the beginning of an Oegylops, Revulsion of the Fluxion to the Part must be made by Bleeding and Purging, and at the same time repelling Medicines must be applied to the Forehead, whereby sometimes the Progress of the Disease is stopp'd, and the suppuration hindred. To which end the follow∣ing Cerate may be applied.

Take of Pomgranate Peel, of Acacia, Balaustins, Cype∣rus Nuts, Roch Allum, and Bole Armoniack each one Dram, of white Wax four ounces, of Turpentine three drams; make a Cerate.

Having used this or the like, resolving Medicines are to be applied to the Part for some time, as is the following Decoction.

Take of pure Honey, and of Aloes each two ounces, of Myrrh one ounce, of Saffron one dram and an half, of Water a quart; boil them with a gentle Fire, to the Con∣sumption

of half: dip a piece of soft Spunge, press it a little, and apply it hot, afterwards bind it on, and change it often.

If the Tumor cannot be dissolved by the foresaid Re∣medies, but tends to Suppuration, it must be helped by a Plaister of simple Diachylon, or if the Pain and Inflam∣mation be violent, a Cataplasm of Crums of Bread may be conveniently applied. If the Abscess does not break of its own accord, it must be presently opened; for other∣wise the Matter will corrode the neighbouring Parts, and occasion an incurable Fistula.

The Abscess being opened, the Ulcer must be cleansed, and cured after the manner of other Ulcers: But if it prove obstinate, and turn to a Fistula, the following Me∣thod of Cure must be used.

And first, universal Evacuations, as Bleeding and Purging are to be repeated: The Fluxion from the Head is to be averted by Cupping-glasses, Blisters, and Cau∣sticks applied to proper Places; after which a Decoction of China or Sarsa may be used for a considerable time: In the mean time, the Brain is to be dried by Suffumiga∣tions, Cephalick Powders, and other Medicines proposed in the Chapter of a Catarrh.

In place of an Issue, a Seton may be put in the Neck, by which alone a Fistula Lachrimalis was cured, accord∣ing to the Relation of Fabritius Hildanus.

In using of Topicks, the Orifice of the Ulcer is to be opened, and dilated slowly and by degrees, by a Tent made of the Pith of Elder, prepared Spunge, or the Root of Gentian. The Ulcer being sufficiently opened, the following Medicines may be used.

Take of common Hony two ounces, Verdigrease one dram, Water of Rue four ounces, the Verdigrease being pow∣dered, boil them altogether, to the Consumption of the third part. The strained Liquor warm may be put into the Eye by a Syringe solftly.

This Remedy is to be continued for three Weeks, put∣ting upon the Ulcer a convenient Plaister, and defending the Eye by washing it with Rose-water.

The Ulcer being sufficiently cleansed, the following Collyrium may be used to Incarnate and Cicatrize.

Take of Frankincense, Sarcocol, Aloes, Dragons Blood, Ba∣laustins, Allum, Antimony each one dram, Verdigrease five grains: powder them all finely, and with a sufficient quantity of Rue-water make a liquid Collyrium, to be drop'd into the Eye thrice a day; and also the Tent may be dipp'd in it, and after it is put in the Ulcer, a Plaister of Diapalma may be put over it.

If there be a Caries in the Bone, it can only be cured by an actual Cautery; the manner of applying it is ex∣actly described by Paraeus, Fallopius and Aquapendens.

CHAP. XXIX. Of Rhyas and Encanthis.

TO a Fistula Lachrimalis ordinarily succeeds another Distemper, which is called Rhyas, which is the Con∣sumption of the Caruncle of the greater Angle of the Eye, whereby it becomes larger. It is also produced by other Causes, as by sharp Humours falling upon and corroding the Part, or by cleansing Medicines which are used to Cure the Fistula Lachrimalis,

To a Rhyas is opposed an Encanthis, which is the im∣moderate growing and standing out of the above-named Caruncle; which is occasion'd by the too great abundance of Blood falling upon the Part, or from an Ulcer of that Part, not timely dried up.

A Rhyas is cured by Consolidating and Sarcotick Medi∣cines, such are the following:

Take of Red Roses one pugil, Cyperus Nuts, Myrtles, each two drams, Aloes a dram and an half, rough Wine one pint, boil them to the Consumption of the fourth part. Wash the affected Part with this Wine often: Or,

Take of Aloes, Frankincense each one dram, Dragons Blood half a dram, of Red Roses, and berries of Sumach each one scruple, Rosewater a pound; boil them to the Consumption of a fourth part, make it in the form of a Collyrium.

An Encanthis is cured by taking away the superfluous Flesh that grows in the Corner of the Eye, which is per∣formed by Medicines which eat away proud Flesh, be∣ginning with the more moderate, and proceeding to those that are more powerful.

Therefore burnt Allum is to be first applied, and if that be not effectual, Ʋnguentum Apostolorum, Aegyptiacum, or Vitriol burnt is to be used. But if these be not sufficient, the Caruncle is to be cut off, or consumed with an actual Cautery.

In taking off the Canruncle care must be taken, that it be not altogether taken away, lest the contrary Distemper, viz. a Rhyas, be produced.

CHAP. XXX. Of an Epiphora.

BY the Name of an Epiphora in general, a flux of Hu∣mours into any part whatsoever is understood. Ne∣vertheless, it is most commonly taken for the flux of a thin Humour from the Eyes, which is also called invo∣luntary Tears, which use to flow from the Corners of the Eyes continually.

To the Production of these Tears; which preternatu∣rally flow from the Eyes, the ill disposition both of the part sending and the part receiving do concurr. The part which sends is the Brain, which being affected with a cold or hot Intemperies, generates watery Humours, and sends them to the inferior Parts, which are fit to re∣ceive them.

The recipient Part is the gland by the greater Corner of the Eye, and the Caruncle placed above the same Corner: The thinness or thickness of which Parts, or any other weakness, is the Cause why they so easily receive the Humouts that flow into them.

This Humour is carried from the Brain into the Cor∣ners of the Eyes, sometimes by the internal Veins, and sometimes by the external.

The Humour causing an Epiphora is sometimes cold, and then it produces no other Inconvenience to the Sick, but the troublesomness of the Fluxion. But sometimes it is accompanied with Saltness and Sharpness; and then it produces Pain, Redness, and also the Exulceration of the Eye-lids.

As to the Prognostick; A new Epiphora, occasioned by external Causes, is easily cured, especially in those that are Young. When it is of long continuance, and in an old Person, it is very hard to be cured. That which proceeds from other Distempers, as from an Oegylops, Fistula Lachrimalis, and the like, altogether depends upon the Cure of those Diseases.

The Cure of this Disease consists in taking away of the Fluxion, and in strengthening the recipient Part.

The Fluxion is to be removed by Evacuation, Re∣vulsion and Derivation of the Peccant Humour, and the strengthening of the Part from which it is trans∣mitted.

The Peccant or Serous Humour abounding in the Brain, is evacuated by Bleeding and Purging.

Bleeding in a cold Intemperies of the Brain, is not pro∣per, unless there appears manifest Signs of a Plethora. But in a hot Intemperies, when the Humours are sharp, Bleeding is very proper, and may be repeated twice or thrice, if it be needful.

Such Purging Medicines must be used as agree with the Nature of the Patient.

Revulsion of the Humour must be made by Cupping-Glasses applied to the Shoulders often, by Blisters fre∣quently applied to the Neck, or by Issues in the hinder Part of the Head, or in the Arms. Forestus says, when the Disease is obstinate, a Blister applied to the forepart of the Head does much good.

For Derivation, Leeches applied behind the Ears are proper, and Masticatories used in a Morning.

And least the Humours once evacuated should be ge∣nerated again, the Brain must be strengthened and dried; and if it be of a cold Intemperies, such things must be used, as are proper to correct it; if of a hot, such cool∣ling Medicines must be used, as peculiarly respect the Head.

And whilst the foresaid Remedies are in use, Topical Remedies must be applied to the Part receiving, and first, if the Humour flows by the external Veins, astrin∣gents must be applied to the Forehead and Temples; and if the Fluxion proceed from an hot an acrid Humour, the following Cataplasm must be applied.

Take of Bole Armenic, Dragons Blood, Balaustines, and of Myrtles each one dram and an half, of Acacia and Hypocistis each one dram of Frankincense and Mastich each two scruples, of red Roses one pugil; pouder them, and mix them with the white of an Egg, and a little Vinegar, make a Cataplasm, wrap it in a Rag, and apply it to the foresaid Parts, and when 'tis dry re∣new it.

If it be occasioned by a cold Humour, the following Cerate must be applied.

Take of Frankincense and Mastick each one dram, and an half, of Gum Anime Tacamahacca and Blood-stone each one dram, of Gum Juniper two scruples, of Tur∣pentine and Wax a sufficient quantity, make a Ce∣rate.

But to the part affected, astringent and drying Col∣lyria must be applied, made in the following manner.

Take of Tutty prepared one dram, of Sarcocol moistned half a dram, of Frankincense and Mastich each half a scru∣ple, of Spikenard grains six; make Troches, mix them with the White of an Egg, and Juice of Quinces, and apply them to the Corner of the Eye. Or,

Take of Aloes, Cypress Nuts, Frankincense, Mastich, Myrrh, each two drams, of prepared Tutty, Sarcocol moistned, each one dram and an half, of Dragons Blood, Barberries, Summach, Red Roses each one scruple, powder them finely, and mix them with Fennel-water, and make a Collyrium.

When the Fluxion is hot, the following is best:

Take of white Troches of Rhasis without Opium, of Sar∣cocol moistned, of Acacia and Olibanum each one dram, of the Stones of Myrobalans burn'd, of white and red Coral each half a dram, of Pearls half a scruple, of the Juice of Pomgranates boil'd half away, a sufficient quan∣tity. Make a Collyrium.

If redness of the Eyes accompanies an Epiphora, the following is proper.

Take of grains of Sumach bruised one scruple, of Plantane-water one ounce, infuse them for some time; then press then out hard, and add of Rose-water, and Eye-bright-water, and of the White of an Egg well beaten, each half an ounce, of Sugar-Candy finely powder'd one scruple. Make a Collyrium.

CHAP. XXXI. Of the Disease of the Eye, called Unguis Oculorum.

IT is a hard and nervous Membrane that arises from the greater Angle of the Eye; it first covers the White of the Eye, and then the Black, and the whole Pupil, and so it hinders Sight. Sometimes it is thin, and white, and sometimes fleshy, and consists of many bloody Veins.

This Disease arises from an Ulcer of the Flesh in the Angle of the Eye, upon which account an inequality arises in the part, which in time grows to this covering.

It is difficultly cured; for the sharp Medicines that are necessary for taking it off, must be used leasurely and by degrees, by reason of the exquisite Sense of the Eye. When it is of a moderate bigness, it may be cured by Medicines; but when it hath extended it self to the Black of the Eye and is become inverate, it can be cured only by manual Operation.

When it is thick and hard, and of a blackish Co∣lour, it is of a Cancerous Nature, and can never be cured.

The Cure must be directed to the antecedent, and conjunct Cause.

With respect to the antecedent Cause, such course of Diet must be ordered, as hath been propos'd for other Diseases of the Eyes arising from Fluxion, Evacuations

and Revulsions are also to be used; and after sufficient Evacuation, such Topicks are to be applied, as may consume it, beginning with those that are gentle, such as are prescribed for taking off Spots; but if they are not sufficient, stronger must be used. Forestus commends the following Collyrium very much.

Take of the Juice of Fennel four ounces, of the Juice of Celandine three ounces, of the Juice of Rue two ounces, of the Juice of Mallows two ounces and an half, of Aloes one dram, of Vitriol two scruple, of Verdigrease one scruple, of Ginger and Cinnamon half a scruple, of the Gall of an Eele, of Ox Gall, or Hogs Gall two drams, of Sugar-Candy two scruples; boil the Juices, add the rest and clarifie them, so make a Collyrium.

But before, and after the use of these things, the Eye must be fomented with an emollient Decoction.

But if it cannot be cured by Topical Remedies, you must proceed to Chirurgical Operation; the manner whereof is describ'd by Celsus, and others.

Of Diseases of the EARS.

CHAP. XXXII. Of Deafness and Difficulty of Hearing.

WE treat of Deafness and Difficulty of Hearing in the same Chapter, because they proceed from the same Causes, and differ only in degree.

They are either occasioned by Diseases of the Head, or by a fault in the Ears.

A Cold Intemperies of the Brain, repletion or weakness, or any other Disorder, especially in that Part from whence the Nerves of Hearing arise, may occasion Deafness of Difficulty of Hearing. The fault of the Ear may be in

the inward or outward part of it. In the outward Ca∣vity, a perfect or imperfect Stoppage, by reason of a Tumor, Abscess, Blood, Matter, Flegm, or other things from within, or without, may occasion a difficulty of Hearing: But it is to be noted, that though the outward Cavity be quite stopped, yet perfect Deafness will not follow; for sounds can pass through the Mouth to the Ears: for there is an open Passage from the Pallate to the inward Cavity of the Ears, which serves for the clean∣sing the Ears, aad those that are Deaf, are wont to open their Mouths, that they may hear the better: And if Travelling by Night, you put one end of your Stick, or the point of your Sword betwixt your Teeth, and the other end on the Ground, you will easier hear a noise from a far, and Footsteps of those that follow you.

In the inward part of the Ear, Humours collected in the inward Cavity flowing principally from the Head, most commonly Flegmatick, but sometimes Cholerick, occasion Deafness, or Difficulty of Hearing: But these Humours are sometimes transmitted to the Ears from the whole Body, as in continual Fevers, especially when they are malignant; but it also proceeds from an ill Confor∣mation of the Organs of Hearing, as when the Tympa∣num is relaxed by a violent noise, or from moisture. And for this reason very many deaf People hear worst in a Southerly Constitution, because the Membrane is relaxed by the moisture of the Air: But sometimes the Tympa∣num is stretched and dried too much, as after acute Dis∣eases, Watching or Fasting, and sometimes it is broke by violent Motions, or corroded by Matter: But sometimes Matter and Blood flow from the Ear in great Concussions, without any injury to the Hearing, when they break out betwixt the Bone, and the Membrane; or if other Parts of the Ear are disordered from the Birth, or by reason of some external Cause, as from a Fall, a Blow, or the like. Lastly, a cold Intemperies occasioned by cold Air, or cold Water falling into Ear, or the immoderate use of Nar∣coticks, or of other Medicines, may occasion this Dis∣ease.

To distinguish particularly all those Causes by their Signs is very difficult, yet they may be guest at in the fol∣lowing manner.

If Deafness happen by reason of a Disease in the Head•• some other Senses are also hurt, or some peculiar Disease appears in the Brain, as pain or dulness of the Head, Apoplexy, Lethargy or the like.

The Stoppage of the outward Cavities of the Ears may be perceived by the Eyes, if by the Sun you look in∣to the Cavities; for then you may see, whether it be a Tumour or gross Matter, or any other Heterogeneous Substance; and then you may know, by the relation of the Patient, whether any thing is fall'n into the Ear.

But if the inward Cavity be filled with some Humour, we may reasonably suppose it is Flegm, if a Flegmatick Fluxion troubled the Sick before, or if he has been fre∣quently subject to such Fluxions.

But if a Cholerick Humour occasions this Disease, a Cholerlck Fever afflicts the Sick, or went before, and it is also accompanied with violent Pain, if it proceed from Blood, the Pain is heavy, and Blood abounds in the whole Body.

The looseness and moisture of the Tympanum is known by moist Causes going before, and by a moist Intempe∣ries seizing some other Part; for it can scarce be ima∣gined that moisture should only seize this part. Too much driness or tensity of Tympanum may be known by the driness of the whole Body, and drying Causes go∣ing before.

We may also guess at the Rupture or Errosion of the Drum, if the violent corroding and tearing Causes above-mentioned went before.

As to the Prognosticks of this Disease. Deafness from the Birth, or which has continu'd a long while, and is ab∣solute, is incurable. And that which is not absolute, but of a long standing, is seldom or never cured.

That Deafness which proceeds from Choler or Blood, in acute and continual Fevers, commonly goes off when the Fever ceases.

Difficulty of Hearing, if it be not soon cured, dege∣nerates into a perfect Deafness; if the Drum be broke, and if a Cicatrix be left upon it, the Deafness is incu∣rable.

That Deafness which encreases and decreases by inter∣vals, is curable.

As to the Cure: That Deafness which proceeds from a Disease of the Head, requires no other Cure than what is requisite for the Cure of the said Disease; that which arises from a Tumour that is hard and inveterate is incu∣rable: But if it be hot and inflamed, the Cure of it is proposed in the Chapter of Pains of the Ears: But if it proceed from Matter collected in the Ear, see the Cha∣pter of the things that come preternaturally from the Ear. If it proceed from driness, it must be cured by a moistning Diet, by long Sleep, and by washing the Head with warm Water, and dropping moistning things into the Ear, as Oil of sweet Almonds and the like: If it pro∣ceed from any thing dropp'd into the Ear, that must be forthwith wash'd out, shook out, or extracted; and if some little Animal has crept into the Ear, it must either be allur'd out, or kill'd. The Ears are wash'd by pour¦ing in such things as moisten, smoothen and dilate them as Milk, Oil of sweet Almonds, or some mollifying or loosning Decoction. Things are shook out of the Ears by Sneezing. It is also good in this case to bend the Ear downwards, and to hop upon the Leg of the same side; for by this means, Boys shake Water out of their Ears when they have been swimming. But if those things do not succeed, you must endeavour to extract it by care∣fully putting an Ear Pitcher beyond it, or with a pair of Forceps fitted for the purpose.

But if this does not succeed, you must endeavour to break them, and afterwards wash them out; and to this purpose, a Probe with Cotton on the end of it, and dipp'd in Turpentine, or the like, is put into the Ear, to clear the Passage; and if any of the clammy Matter remains behind, it may be cleared by an Ear-Picker. Some cut a Quill, and put one end into the Ear, and endeavour to suck out what is in it.

Animals are allur'd out of the Ear, by putting such things to it, as are pleasing to them; as a Spunge dipp'd in Milk and Sugar, or the Pulp of a sweet Apple, or Lard wherewith little Worms are much pleased, and soon come out of the Ear, if it be turned to the Sun. If a Leec•• happen to get into the Ears, it may be enticed out, by putting Blood to the Ear; Gnats may be drawn out, by putting Dogs Hairs into the Ears; but if you

cann't get them out, alive, 'tis best to kill them, because then they will not disturb the Ear so much, and may be easier drawn out; they may be kill'd by dropping Spittle or Urine into the Ear. But bitter things kill them soonest, as the Juice of Wormwood, a Decoction of Aloes, or any Gauls, sharp things do also the same, as Vinegar, the Juice of Onions, and the like.

But because a cold Intemperies is the most frequent cause of Deafness, rhe Cure must be chiefly directed to the amendment of it; wherefore an attenuating, drying, and moderately heating course of Diet being ordered, as is prescribed for the Gutta Serena; and Southerly Winds being avoided as much as possible, and the Ears defended from them; Vaporous Aliments must be avoided, especi∣ally Garlick and Onions, which are very injurious to the Hearing, and also those that generate gross and flegma∣tick Humours; these things, I say being first observed, general Evacuation must be entered upon by Head Purges. Bleeding must be also used if there be an indi∣cation for it; and if the Disease be obstinate, a Sudori∣fick Diet, afterwards particular Remedies that cause a Revulsion of the Humours, as Blisters, Issues, Sneesing Powders, Masticatories, Apophlegmatisms, but especially Masticatories.

But Sulphureous and Bitumenous Baths are peculiarly proper for the Cure of this Disease, the Body being ba∣thed, and the Head washed with them; afterwards topical Remedies are to be applied, to discuss the Matter in the Ear.

Take of the Leaves of wild Marjoram, Wormwood; Penny-royal, wild Thym, Sage, Mint, the lesser Centaury, Mallows, Marsh-mallows each one handful, of the Flow∣ers of Camomil, Melilot, Stechas, and Rosemary each one pugil, of Cinnamon and Cloves, each half an ounce; boil them in equal parts of Fountain-water and White Wine added towards the end. Strain it, and foment the Ear with it hot with a Spunge Morning and Even∣ing; and the Vapour of the Decoction may be received into the Ear through a Tunel.

It certainly does much good by passing into the inner∣most Parts of the Ear. Instead of the Fomentation, Bread made up with Carraway-seeds, cut and applied hot

from the Oven, may be used; or common Bread just taken out of the Oven, the under Crust being cut off dipp'd in Spirit of Wine, and applied as hot to the Ear as can be born, is also of good use: But the Bread will be more effectual, if with the common Flower, the Seeds of Carraways, Juniperberries, Bayberries, and Nutmegs are mixed with it.

If you'll have a stronger Decoction, you may add of the Pulp of Coloquintida, or of the Roots of white Hel∣lebore each one dram: After fomentation, some Liquor must be instilled into the Ear, and afterwards you may stop it with Cotton perfum'd with Musk.

Take of Oil of bitter Almonds, and of Rue each one ounce, mingle them, and pour it hot into the Ear. Or,

Take of Oil of Castor, and white Lillies, each one ounce, of Oil of Dill half an ounce, of white Hellebore half a dram, of Aqua Vitae one ounce: boil them in a Bath, till all the Aqua Vitae is evaporated. Strain it for the use above-mentioned.

Chymical Oils are are very effectual, as of Marjoram, Rosemary, Sage, Fennel. Spike, Cloves; but because they are very strong, they must not be used alone; but they are to be mixed in a small quantity with the fore∣going Oils, half a dram of them, may be sufficient to be mixed with two ounces of the foresaid Oils.

The Water that drops out of an Ash-stick when it is burning, is much commended for Deafness, when it pro∣ceeds from a hot Cause.

The Fat of an Eel is much in use; it is gathered from the Water wherein a Fat Eel is boil'd, being Scum'd off with a Bay-leas, and dropp'd hot into the Ear.

In applying topical Remedies, this must be always ob∣served, viz. that they are applied warm or hot, and what hath been used before must be taken out of the Ear, before other things are dropp'd in; and when any thing has been dropp'd in, the Ear must be stopp'd with Cotton perfum'd with Musk, which of it self is very good for Deafness.

CHAP. XXXIII. Of Noise in the Ears.

THE Sense of Hearing is obstructed by a Noise in the Ears; for as the Eye ought to be void of Co∣lour, that it may rightly perceive all the Colours of Ob∣jects: For if it be preternaturally affected with any Colour, as in the Jaundice, the Sight must be necessarily depraved, so the Ear should have no sound in it, that it be able to receive all Sounds that come from abroad, for if any Sound is preternaturally in the Ear, it hinders Hearing.

This Noise in the Ear proceeds from a preternatural Commotion of the inbred Air; for though this inbred Air moves naturally, yet no noise is heard from its Mo∣tion, unless we stop the Ear with the hand, or with some such thing.

The Causes of this extraordinary Motion are Va∣pours, Wind, or Spirits, transmitted to the Ear from other Parts, or bred in it; if it be brought from other Parts, it proceeds either from the whole Body, or some peculiar Part. It flows from the whole Body in Fevers, and this Sound in the Ear comes from a windy Spirit conveyed through the Arteries from the whole Body to the Ears: But it most frequently happens at the begin∣ning of Fits, and just before a Crisis by a Bleeding at the Nose. Wind is also elevated to the Ears, from some peculiar Part, viz. from the Stomach, Liver, Spleen, Mesentery, Womb, and from some other Parts; upon which account, inviolent Vomiting, Hypochondriack Me∣lancholy, and Mother-Fits, there is frequently a Noise in the Ears. It is also occasioned by windy Spirits flowing from the Head, that arise from Cold and Fleg∣matick Humours. Wind is also generated in the Ear by Flegmatick Matter contain'd there. Upon which ac∣count, difficulty of Hearing is commonly accompanied with a Noise in the Ear, for the Obstruction is occasion∣ed by Humours, Other Causes occasioning this Noise in

the Ears, are Ulcers, a hot Intemperies, Weakness, ex∣quisite Sense, a violent shaking in the Head, and violent Sounds.

The Cure of this Disease is to be varied, according to the variety of the Causes; and first the Cure of the Noise proceeding from a consent of other Parts, depends on the Cure of the Diseases of those Parts: But that which arises immediately from the Ear requires a pecu∣liar Cure; and if it be generated by a cold Intemperies, and from gross Wind, it requires the same Cure which is described in the Chapter above. If it proceed from an Ulcer in the Ears, it requires the same Cure, which is proposed for Curing the Ulcer in the following Chap∣ter. If it proceed from Weakness, after long Sick∣ness, it will decrease gradually as the Strength increases. But you must drop into the Ear Oil of Camomil, of Dill, or Oil of sweet Almonds. And lastly, if it takes its rise from a hot Intemperies, or an exquisite Sense, a cooling and moistning Diet must be ordered, and cooling things must be dropp'd into the Ear, and first a Decoction of Barly, Violets, Lettice, Water Lilies, to which may be added, to make it more penetrating a little Balm or Camomil; and if these do no good, the Juice of Lettice, Purslane, and Henbane may be used. Galen proposes the Juice of Poppies, and Opium it self; but these are to be used sparingly, least by weakning the Native Heat of the Part, they should too much dull the Hearing.

CHAP. XXXIV. Of Pain of the Ears.

PAIN of the Ears is a very violent Disease. The chief Causes of it are Intemperies immaterial and humoral, Wounds, Ulcers, and external Things falling or thrust into the Cavity of the Ear.

A cold Intemperies often occasions a Pain in the Ears; it is occasioned by cold Winds, cold Water, and other

cold thlngs; for cold things are injurious to those Mem∣branous and nervous Parts.

But a cold Matter occasioning Pains in the Ears, is ei∣ther Flegmatick, or Serous flowing from the Brain, or Wind transmitted from the Brain, or lower Parts.

Hot Matter occasioning those Pains is either Cholerick, or Sanguinious, whereby an Inflammation is raised.

If an immaterial Intemperies be the Cause, there is no weight peceived in the Ear, nor no Tumour. A cold Intemperies is known by cold Causes going before, as tra∣velling in the Winter time, the increase of Pain by ex∣ternal Cold, and its being eased by the Application of hot things. A hot Intemperies may be known, by the external things that heat, as a hot Air, the heat of the Sun, pain arising from the use of hot things.

If the pain arise from a Flegmatick Humour, there is a weight perceived in the Ear and in the Head, and a Flegmatick Fluxion has sometimes fallen upon some other Parts. Besides, cold Causes went before, as cold and a Northerly Wind, cold Aliments, Winter time, old Age and the like.

If the Pain arise from Wind, it will be violent, but not continual, and a noise of the Ear will be joined with it.

That it comes from a Serous Humour, may be known by other Diseases produced by it, and afflicting the Sick at the same time, as sharp and thin Fluxions on the Teeth, the Eyes, the Ears, the Breast, and other Parts, and by an Evacuation of serous Humour by Vomit, Stool, Urine and Sweat.

If it arises from a Cholerick Humour, it will be prick∣ing and sharp, with a sense of heat; it will be eased by cooling Medicines, and the Constitution is hot and cho∣lerick, the Sick young, the Course of Diet hot, it is Summer, and some other heating Causes went be∣fore.

An Inflammation is known by the Violence of the Pain, Pulsation, by great heat and redness, that extend them∣selves sometimes to the Cheeks and Temples; a violent continual Fever accompanies it, sometimes a Delirium, Convulsion, Fainting, and Coldness of the extream Parts.

A Wound may be known by Blood pouring from the Ear, an Ulcer by Matter flowing out: But because a Flux of Matter sometimes flows from the Brain through the Ears, there is need of distinction; for if it proceed from the Brain, the Pain of the Head, and other Signs of an Imposthume went before, the Matter is evacuated in great quantity, and is lessen'd by degrees, till at length it quite ceases. But it may proceed indeed in a great quantity from an Abscess of the Ear; but then the Signs of an Inflammation went before, afterwards an Ulcer follows, which afterwards may be known by the follow∣ing Signs, whether it takes its rise from an Abscess, or from a Flux of some sharp Humour, A small quantity of Matter flows continually, pain and heat, and pricking in the Ear, especially when the Ear-Picker is put in. Moreover, we may guess at the differences of the Ulcer; for if the Ulcer actually exists, it may be known by the thin Sanies, that is of a Citron Colour: And by the length of the Disease, you may know if it be deep by the quantity of Matter; if it be sordid, by the thickness and quantity of it; if it be virulent, by the thin Sanies; if putrid, by the stinking Matter; if corrosive, by Blood flowing out after the Sanies; if it be Fistulous, by the duration of the Ulcer, the virulent Sanies, and by the hard and callous Flesh. Things fallen into the Ear, or thrust into it, may be known by the relation of the Sick, and may be perceived in the Cavity of it.

The Prognostick of the Pain of the Ear is various, ac∣cording to the variety of the Causes; that which pro∣ceeds only from an Intemperies, is easily cured. That which proceeds from cold, flegmatick, serous, or windy Matter, is not dangerous, but is most commonly long in curing: But that which proceeds from hot Humours, and especially if they cause an Inflammation, is very dange∣rous for the Brain, by reason of its nearness, suffers by consent, and a Delirium and a Convulsion often follow; and young Men are in most danger of this Disease; for they being of a hot Constitution, and their Blood being hot, the Inflammation is so great, that it destroys the Na∣tive Heat of the Brain, and kills the Sick within a Week; but old Mens Humours are colder, and the Inflammation less, and so they are less in danger.

Ulcers in the Ears are difficultly cured, because the Brain puts off its Excrements upon them, but those that follow an Abscess are easier cur'd, and also those that yield good Matter: But when the Sanies is virulent, fetid, or otherwise ill qualified, the Cure will be very difficult, and especially if the Ulcer be Fistulous, or the Bone foul.

The Cure must be varied according to the variety of the Causes, if it proceed from a cold Intemperies alone, bo•••• Medicines applied to the Ear may be sufficient for the Cure, such as were proposed for the Cure of Deafness A hot Intemperies, if at any time it happen without Mat∣ter, may be cur'd by cooling Topicks.

If it proceed from a cold Intemperies joined with Matter viz. Flegm, or Wind, or serous Matter, the same Cure is to be administred, which was proposed for the Cure of Deafness▪

If it arise from a hot Intemperies with a Fluxion o•• Cholerick Humours; first the Humout flowing to th•• Part must be drawn away by Bleeding, whereby also th•• hot Intemperies of the whole Body, may be moderated▪ afterwards the peccant Humour must be evacuated by proper Purgers; and afterwards cooling Juleps and Broth••▪ Goats Milk, Mineral Waters, Baths of warm Water, and the like, must be used; and lastly, all those things are to be used, which are proposed for the Cure of a Head-ach, proceeding from a hot Intemperies: But the Pain must be asswaged by cooling and anodyn Topicks.

For the Cure of an Inflammation of the Ear, an emol∣lient, cooling, and loosning Clister must be injected, and so much Blood must be taken away, as may answer to the fulness of it, and to make a sufficient Revulsion of the Humour flowing to the affected Ear, the Cephalick Vein opposite to it must be opened, and a great quantity of Blood must be taken away at several times; and if the Disease seem to arise from a Suppression of the Courses, or of the Hemorrhoids, the inferior Veins must be opened, a good quantity of Blood being first taken from the Arm. And if those Causes are absent, the opening of the inferior Veins will make an excellent Revulsion to the most distant Parts, to which end Leeches applied to the Anus are also proper.

Revulsions may be also commodiously made by Frictions, and Ligatures of the Arms and Legs, and by Cupping-glasses applied to the Shoulders and Back.

And sometimes Cupping-glasses applied behind the Ears for to make Derivation, do much good.

Zacutus Lusitanus also commends Leeches applied be∣hind the Ears, four of a side, which he says, gave much relief to a certain young Man, who was afflicted with a violent Inflammation of the Ear: The opening of the Artery of the Temples has also sometimes admirable Suc∣cess. Purging is also very proper in this Disease, with Cholagoges; afterwards the whole Mass of the Humours is to be attemperated with cooling Juleps made of a De∣coction of Lettice, Purslain, Plantane, Sorrel, and the like, also of the Syrups of Lemons, Pomegranates, and of red Poppies.

In the mean time, whilst the foresaid Remedies are used, Topicks are to be continually applied, which must be always anodyn, by reason of the Violence of the Pain, the Mitigation whereof is principally to be taken care of; but at the beginning and increase, gentle Repellents are to be mixed with the anodyns; at the State and Declina∣tion, Resolvents are to be mixed with them.

Take of Womans Milk, fresh drawn, two ounces; of the white of an Egg beat to a Liquor half an ounce; mix them, and drop it warm into the Ear.

Or the Milk alone milk'd into the Ear.

Take of the leaves of Plantane, and Night-shade, each one handful; of the flowers of Camomil and Melilot, each one Pugil; make a Decoction; let the Vapour be received into the Ear by a Tunnel.

Take of Oyls of Violets, Water-Lillies and Roses, each one Ounce, mingle them, drop it warm into the Ear.

Millepedes infused in the foresaid Oyles, and press'd out, make an excellent Anodyn; for they have an ex∣cellent Faculty to ease Pain, and for that reason they are used for Pains of the Teeth, the Piles, and other Pains.

If the Heat is very violent, cooling Juices are to be mixed with the foresaid Oyls in the following manner.

Take of Oyl of Water-Lillies, and Oyl of Roses, each one ounce, of the Juice of Night-shade and Plantane, each half an ounce, mingle them, and drop it into the Ear.

Oxyrrhodinum is used by many Practitioners, made of Oyl of Roses two parts, and one part of Vinegar; but it

may be suspected as may be also all other things which repel powerfully, for there is danger, least the Humour should flow back upon the Brain; and it is a general Pre∣cept always to be observed, not to apply strong Repel∣lents in Inflammations that are near noble parts; but gentle Repellents may be mixed with Loosening and Ano∣dyn things; for so the Fluxion may be moderately sup∣pressed, and not driven far back.

But in violent Pains we are forced to use Narcoticks, but they must be used rarely, and with great caution, for they are offensive to the Head. I know a Person, says Galen, who lost his Speech and Sense by the use of Opium, nor could he be restored by any Medicines: But if there be absolute Necessity, they may be prescribed in the following manner.

Take of the Oyl of the Seeds of Poppies one ounce and an half, of Camphor and Opium each two grains, mingle them, and drop them into the Ear. Or,

Take of Oyl of Sweet-Almonds two ounces, of the Juice of Mallows half an ounce, of Myrrh half a dram, of Saffron half a scruple, of Opium three or four grains, mingle them, use it as above.

In the Application of Topicks the Precept of Galen must be carefully observed, viz. That the inflamed Ear be not touched, but Medicines must be dropt into the Ear by a Probe wrapt round with the softest Wool dipt in the Medicines, and the Sick must be ask'd whether it be warm, and whether he can bear it any hotter, and you must drop it in as hot as he can bear it; the Probe must be dipt in the Medicine and applied gently to the passage of the Ear, that it may flow into it; you must continue doing of it till the passage is full, and then apply over it to the mouth of the passage and over all the Ear, Wool dipt in the Medicine.

At the state of the Disease, Oyls gently resolving are to be mixed with Anodyns in the following manner.

Take of the Oyls of Camomil, Sweet-Almonds, and Violets, each one ounce, Oyl of Lillies half an ounce, mix them.

But Fomentations and Fumes resolve more power∣fully, which may be prepared of the following De∣coction.

Take of roots of Marsh-mallows one ounce; of the leaves of Mallows, Nightshade and St. Johns Wort, each an hand∣ful, of the Seeds of Flax half an ounce, of the Seeds of Mallows, Marsh-mallows, white Poppies, each two drams; of the flowers of Camomil, Dill and Roses, each one Pugil, make a Decoction in Water or Milk for a Fomen∣tation or Fume.

The Water drawn from Ash-sticks, being dropt into the Ear eases the pain wonderfully; it is drawn by burning green sticks in the Fire, it drops from the ends of them.

If the Tumor cannot be resolved, but tends to Suppu∣ration, which may be known by the increase of the pain a great Pulsation, and a violent Feaver, Nature must be furthered in her Motion, and the following Cataplasm must be applied.

Take of Crums of white Bread one pound, boil them in Milk to the consistence of a Poultis; then add the yolks of Eggs number two, of Oyl of Roses two ounces, of Saffron one scruple, make a Cataplasm. Or,

Take one Onyon, fresh Butter two Ounces, Oyl of Camomil and Roses, each one ounce, of Saffron one scruple; make a Cataplasm, which must be applied moderately hot to the part.

When the Abscess is broken, and the Matter comes out through the Membrane of the Ear, either rarified or cor∣roded; then the Sick should lye on the Ear affected, that the Matter may flow out easily, and such things should be dropt into the Ear, as may wash and cleanse it.

Take of the Decoction of Barly four ounces, of Honey of Roses one ounce, mingle them, drop it warm into the Ear.

If the Ulcer be generated by Acrimony of Matter, it requires a peculiar Cure, which may also be used for an Ulcer arising from Fluxion of Humours.

And first, according to the Opinion of Galen, Topical Medicines must not be applied to any Member, before the whole Body is purged; wherefore Evacuation by Bleeding and Purging being administred, agreeable to the Nature and Constitution of the Patient, and repeated through the whole course of the Cure as often as there is occasion, drying and astringent Topicks may be used, be∣ginning with the Mild, and proceeding to Stronger by degrees. For instance,

Take of the best Honey, and of old White-wine, each three ounces, boil them till all the Scum rises, drop it into the Ear; afterwards stop the Ear with Cotton dipt in the same Liquor; when you would have the Medicine stronger, mix the Juice of Horehound, Smallage, Wormwood, the lesser Centaury, or of Sow-bread with Honey; boil them gently, and drop them into the Ear. Or,

Take of the Juice of Beets one ounce, of Horehonnd half 〈◊〉〈◊〉 ounce, of the best Honey six drams; boil them a little; afterwards add two drams of Syrup of Wormwood, mingle them.

You may make a stronger Medicine in the following manner▪

Take of the Juice of Sow-bread one ounce, of Myrrh on•• ounce, of Saffron half a scruple, of Frankincense one scruple, of Verdigrease half a scruple, of old Wine one ounce an•• an half, boil them till the Wine is consumed, drop th•• Liquor into the Ear twice or thrice a day.

Note, Before any Liquor is dropt in, the Ear must be well cleansed with warm Hydromel, a Probe wrap•• round with a Cotton, being dipt in the Liquor, and used for that purpose.

The Ulcer being well cleansed it must be cicatrized by Epulotick Medicines used in the following manner.

Take of round Birthwort, of the bark of Pomegranates, and of Galls, each half an ounce, boil them in equal parts of Wine and Smith's-water to half a pint; strain it, and add to it of the Juice of Plantane and Knot-grass, each one ounce, of Honey of Roses two drams; mingle them, and drop it into the Ear; or drop into the Ear burnt Allum mixed with the Wine, for it is very drying.

If the Ulcer be very obstinate, and has continued a long while, it is certainly promoted by Fluxion, which there∣fore you must endeavour to remove, by Purging and a Diet-drink of Gujacum or Sarsaparilla, by Errhins, Masti∣catories, Issues, and by other Remedies that divert the Fluxion.

If Pain arise by reason of the Sharpness of the Remedies, Oyl of Sweet or Bitter Almonds, with Myrrh, Aloes and Saffron, must be dropt into the Ear: If the Pain be vio∣lent, a little Opium must be mixed with them, or the Oyl of the Yolks of Eggs beat in a leaden Mortar may be used.

If the Ulcer be very Sordid, Aegyptiacum must be mixed with the foresaid Juices.

If the Pain of the Ear be occasioned by something thrust into the Ear, you must endeavour to draw it out, by wrapping Wool upon a Probe dipt in Turpentine, or made glutinous by Rosin, or some other Gum: But if this will not do, warm Oyl must be often dropt into the Ear, to relax it, and to Lubricate the Matter contained in it, and so it may the easier be drawn out, and Sneesing-powder must be given, and these things must be used con∣tinually till the Sick is freed; for if any thing remain long in the Ear, an Inflammation will arise, and after∣wards it will be much more difficult to extract any thing from the Ear; and there will be besides great danger.

Lastly, If the foresaid Remedies are not sufficient, Chirurgical Instruments must be used. See the manner of Extraction in Fabritius Hildanus, Cen. I. Observ. 4, 5, 6.

Gnats sometimes insinuate themselves into the Ears, and moving in the Cavity of it, they cause much Trouble, but they may be extracted by a Probe wrapped round with Cotten, and dipt in Turpentine.

Sometimes water runs into the Ear in swimming, or when the Head is wash'd, and is often very troublesom and causes Pain, but is most commonly easily shook our, by hopping upon the Leg of the same side, and by holding the Ear downwards: But if this will not do, you must endeavour to suck it out with a Pipe wrapt round with Wool to stop the hole of the Ear, that the external Air should not enter in. It is also dried by a small soft piece of Spunge often put in.

CHAP. XXXV. Of things that come out Preternaturally from the Cavities of the Ears.

MAny Things come out preternaturally from the Ears, which must be particularly mentioned, and peculiar Remedies must be prescribed for them. First therefore, an Abscess being broken arising from an Inflammation, or from an Ulcer, proceeding from the Acrimony of Hu∣mours, Matter or Sanies, is wont to flow; the Cure of which depends on the Cure of the forementioned Diseases, which are proposed in the foregoing Chapter.

Blood also sometimes flows from the Ears, as in Wounds and Concussions of the Head, whereby the Veins of the Ears may be broken or torn: But if this Flux be moderate, it must be left to it self, for if it should be re∣tained within it might cause an Inflammation; but if it be immoderate, or continue a long while, it must be re∣strained by bleeding in the Arm, and by applying Cup∣ping-glasses with Scarification to the Shoulders; after∣wards cooling and astringent things must be dropt into the Ears, as the Juice of Plantane, Knot-grass, or the De∣coction of Bramble-tops, red Roses, Mastich, Acacia, Hyposistis, Balaustins, Sumach, and the like, in Wine and Vinegar, or Smiths Water.

A watry Humour sometimes flows from the Brain to the Ears, this most commonly happens to Children, and ought not to be stop'd, for being suddenly stop'd, it occa∣sions the Falling-sickness, or some other great Disease of the Head.

For Nature puts off Excrements, and the too great Moisture that abounds in Childrens Heads, not only by the ordinary ways appointed for this use, viz. The No∣strils and Pallate, but also through the Eyes, the Ears, and the Superficies of the Head, where Ulcers and Scabs often happen: But when such an Evacuation is Symptomatick, and when the Humour flowing to the Ears causes Ulcers in them, and hinders the Hearing, you must endeavour

to cure it by a convenient Method. And First, the Su∣perfluous Humours in the Brain must be evacuated by gentle Purges often repeated, and also by Derivation, by Blisters in the Neck, and an Issue there; afterwards the Ears must be cleansed and dried by the following Medicine.

Take of the Juice of Agrimony, and Worm-wood, each four Ounces, of Whitewine, and Honey of Roses, each one Ounce, boil them a little, and drop them into the Ear the Filth being cleansed away, afterwards the Ears must be stopped with Cotton dipt in the same Liquor.

But if a watry Humour flows from the Ears of grown People and continues so a long while; the whole Body and the Brain must be evacuated, afterwards, the super∣fluous Moisture must be dried up by Sudorifick Diet-drinks, and the Course of it must be endeavoured to be turned by Blisters, Issues, and Cupping-glasses.

Lastly, Worms are sometimes generated in the Ears, from putrid Ulcers, which being cured they cease to come out. But Because the healing of the Ulcer requires Time you may endeavour to kill the Worms in the mean while by convenient Remedies. For Instance,

Take of the Oyl of bitter Almonds, of the Juice of Smallage, and the lesser Centaury, each two Ounces, of Vinegar two Drams; boil them a little, then add of Mirrh, and Aloes, each one Scruple; mingle them, and drop it into the Ear. If you would have it stronger add ten Grains of Coloquintida.

Of Diseases of the NOSE.

CHAP. XXXVI. Of Ʋlcers of the Nostrils, and of an Ozaena.

AN Ulcer of the Nostrils is either fresh and simple, or old and putrid, which is called an Ozaena.

The fresh and simple proceeds either from extetnal Causes; as a Wound or Contusion, or from internal, viz. From Acrimony of Humours flowing thither, espe∣ally from Salt Flegm.

But an Ozaena comes from a simple Ulcer neglected, or by reason of greater Acrimony of Humours.

A simple Ulcer hath little or no Pain; and Blood flows frequently from it, especially when it is touched or rubd, or it is covered with a dry and black Scab, which is sometimes blown out; but an Ozaena is accompanied with a greater Pain, the Scab is more filthy, and the Snot stinks, and it often eats the Back Bones, and perforates the Pallat, especially if it be of a cancerous Nature, or from the French Pox, or an Elephantiasis.

As to the Cure, such a Course of Diet must be ordered as may attemperate the Acrimony of the Humours, and hinder its Generation; afterwards the whole Body must be evacuated by Bleeding and proper Purges; and Cup∣ing-glasses must be applyed with Scarification. And if the Fluxion of sharp Humours to the Nostrils be very obsti∣nate, Derivation must be made by Blisters in the Neck, and Issues there, and things that strengthen the Head must be used.

After universal Remedies, Topicks must be applyed, and first you must see whither the Ulcers are crusty, if they are, the Scabs must be taken off before you go any

farther; and first you must foment them with warm Wa∣ter, or anoint them with fresh Butter, with fresh Goose or Hens Grease, or with rhe Oyl of sweet Almonds, or the like.

When you have mollified them, they must not be forci∣bly pulled off, but you must suffer them to fall them∣selves, or gently remove them with your Finger, anoint∣ed with Oyl of Almonds.

When the Scabs are cleared, you must use drying and astringent Medicines; in a simple Ulcer it may be suffici∣ent to wash it with Barly-water sweetned with Honey of Roses, and to anoint it, with Oyntment of Tutty, or with the white Oyntment of Rhasis, or with the Oyl of the Yolks of Eggs rub'd in a leaden Mortar.

But for an Ozaena you must prepare the following Medicines.

Take of whole Barley one Pugil, of the Leaves of Agrimony, Plantane, Wormwood, and the lesser Centaury, one Handful; of red Roses half a Pugil; boil them in Smiths Water, in the Liquor strained dissolve four Ounces of Honey of Roses, make an Errhine, which must be often snuffed up.

After it hath been cleansed, the following Decoction must be used.

Take of Balaustins, and Pomegranate-peel, each two Ounces, of the Leaves of Plantane, Horse-tail, Mouse-ear, Rupture-wort, each one Handful, of the Roots of Bistort one Ounce, of Crude-alum, one Ounce and an half; make a Decoction.

The Water of Allum is also very good, and also those Medicines which are to be proposed to dry a Polypus in the following Chapter. Egyptiacum also dissolved in Barly-water is good.

Afterwards use the following Oyntment.

Take of Omphacine Oyl half an Ounce, of Pomegranate-Bark and Balaustines, each three Drams; of Mirrh, Allum, and Labdanum, each two Drams; of Chalcitis,

Aloes, and the Bark of Frankincense, each one Dram; of the Oyl of Roses, and Mirtles, each two Ounces, of red Wax, a sufficient Quantity to make an Oyntment; apply it to the Ʋlcer, or dissolve it in Wine, or Plantane-water, snuff it up often, the Mouth being filled with Water.

When the Ulcer is well cleansed, you must dry it with the Powder of red Roses snuft up. Rondeletius says, that nothing is so effectual to dry the Ulcers as Fumes of Orpiment and Cinnabar: As for Instance,

Take of Pure Labdanum, of Hypocistis, Mastich, and Mirrh, each three Drams; red Storax, and Storax calamit, of the Bark of Frankincense, Sandarach, and Orpiment, each two Drams; mix them all with Tur∣pentine, and make Troches, wherewith let the Sick be fumed, Morning and Evening in his Chamber.

It is also of great Use to burn Candles made of red Wax in the Patient's Chamber, which ought to be small, and the Windows and Doors must be kept close shut. And this Way, says Rondeletius, I have cured Ulcers which the Italian and French Physicians left off as incurable.

CHAP. XXXVII. Of a Sarcoma and Polypus.

UPon Ulcers of the Nose comes sometimes fleshy Ex∣crescences which constitute another Kind of Disease, viz. A preternatural Tumour, whereof there are two Sorts, one a Sarcoma, and the other a Polypus.

A Sarcoma is a fleshy Excrescence in the Nose, which has no certain Shape, and is much like proud Flesh in other Ulcers▪ But a Polypus is a fleshy Excrescence ari∣sing with small Roots, and afterwards spreads broad and hangs down in the Nose, and resembles the Fish Polypus, from whence it takes its Name. It is a soft Caruncle,

sometimes white sometimes red, and sometimes livid; and if it grow much, it sometimes hangs out of the Nostrils: But if it be rooted high in the Nose, it some∣times hangs down to the Pallat, and obstructs the com∣mon Passage of the Mouth, and it may be plainly seen be∣hind the Uva: It swells much in a southerly Constituti∣on, and at full Moon, and is much diminished at the new Moon: It may be distinguished from a Sarcoma, because a Sarcoma, is wont to grow at the Bottom of the Nostrils, but a Polypus near the Root of the Nose.

The Cause of both Tumours is a thick viscid and flegmatick Humour flowing from the Brain mixed with some Blood, and sometimes a melancholly Humour is mix∣ed with it, and then there is Danger lest it degenerate in∣to a Cancer. A Sarcoma is also generated often from a superfluous Nutriment of the Nostrils.

A Sarcoma is most commonly easily cured, but a Poly∣pus very difficultly: But that which is soft, and white or red, or redish, is cured most easily; but when it is hard and livid it is very hardly cured; and there is Danger least it should turn to a Cancer. That which is seated below or in the Middle of the Nostrils, is easier cured than that which grows at the Root of the Nose, because Medicines can scarce reach thither.

Both of them are to be cured the same Way, viz. The superfluous Flesh must be taken off: But first the ante∣cedent Cause must be removed, which is a Flegmatick Humour falling from the Head. To this End an atte∣nuating Course of Diet must be ordered, and universal Evacuations, Revulsion and Derivation. Afterwards the superfluous Flesh must be taken off, either by a caustick or by an Instrument, and the Ulcer remaining must be cica∣trized: But at the Beginning, when the Disease is fresh, it is sometimes cured by astringent and very drying Medicines, and such gentle Means are always to be used before you proceed to greater.

Take of unripe Grapes three Pounds, of the Bark of Pome∣granate, of Balaustins, and Sumach, each two Pounds; infuse them in Vinegar, and distil them; then add of Allum a Pound, of Vitriol three Ounces; distil them all again, and touch the inward parts of the Nostrils fre∣quently with the Water.

If this is not sufficient more powerful things must be used, and you must add Sandarach, and Orpiment to the foregoing Water; or the Polypus must be frequently touched with Spirit of Vitriol tempered with Plantane Water: But red Precipitat often washed is reckoned the best Medicine. It may be mixt with Honey of Roses, and applyed with a Tent dipt in it. Plaisters are also used in this Case.

Take of Verdigrease, Orpiment, Vitriol, Crude-alum, each one Ounce and an half, of Antimony six Drams; infuse them in Vinegar, and then powder them very fine; when they are dry, infuse them and powder them eight Times more; then lastly infuse them in Plantane Water, and dry them; afterwards take of Oyl of Roses four Ounces, of Thithargo two ounces, mix them and boyl them; and towards the End, two Ounces of the foresaid Powder, boyl it to a sticking Plaister, and make Tents of it to be put up the Nostrils.

Note, That before the Use of Causticks, the Nostrils must be defended by Galen's cooling Oyntment, or with Populeum, or with the White of an Egg mixt with the Oyl of Roses, or the like. Secondly, you must take Notice, that caustick Medicines must be conveyed through a Silver Pipe, which must incompass the Polypus so that the Medicine may work and not touch the Nostrils. Thirdly, you must take Notice, that such Medicines must be used when the Moon is waneing, for then the Tumour is much diminished, and so the Medicine may the easier reach the Root of it. Lastly, if it cannot be cured by Medicines, you must proceed to Chirurgical Operation, which is described by Cornelius Celsus and by late Au∣thors.

CHAP. XXXVIII. Of the Loss of Smelling, and other Faults of it.

SMelling, as all the other Actions of the Body is hurt three Ways, it is either diminished, abolished, or depraved.

The Cause of Smelling diminished and abolished are the same, they only differ in Degree; they are Intemperies, Obstruction and Compression.

A cold and moist intemperies, joyned with Flegmatick Matter, lessens Smelling, or quite abolishes it; upon which Account in a Catarrh and Coryza, the Sense of Smelling is frequently lessened, or wholly destroyed.

Obstruction is occasioned by a Flegmatick Humour, which stops the Passages of the Nostrils, and the Pores of the Mamillary Processes, so that Smells cannot come to them; it may also be occasioned by a Sarcoma, Polypus, or any thing else that stops the Passages of the Nostrils.

A Compression also sometimes may happen from a Flegmatick Humour collected in the fore part of the Brain, compressing the Mamillary Processes, as happens in Diminution of the Sight by compressing of the Optick Nerves. It also may happen from a natural Defect in the Confirmation of the Nostrils, as when the Nostrils are so narrow and low that there is not a free Passage.

The Cause of depraved smelling, is a bad Savour con∣tinually striking upon the Nostrils, which either proceeds from an Ulcer of the Nostrils, or from putrid Flegm gathered together about the Nostrils or the Os Ethmoides: For that Flegm that putrifies in the Sense of Smelling, or near it, betwixt the Coats of the Brain, does not affect the Sense it self, nor those that labour under it; but any one that sits near them will easily find it out, for nothing can be smelt but what is carried to the Sense from some other Place. A nasty and stinking Vapour may be car∣ried to the Processus, Mamillares from other Parts, as from the Stomach, Gums, and the Brain it self, that spoil the Sense of Smelling, so that all Savours are thought to be

such; even as the Tongue being disordered by bitter Choler, tasts all things bitter.

Any of these Causes are easily known, a cold Intem∣peries and Abundance of Flegm are known by a cold and moist Intemperies of the Brain, and a slimy Flegm dropping from the Head.

An Obstruction, if it be occasioned by Flegm, is known by the same Signs. If it proceeds from a Sarcoma, or a Polypus, the Diagnostick is to be taken from their pro∣per Chapters.

The Place wherein the Matter causing the Obstruction resides, is known from this, If it sticks in the Passages of the Nostrils, there is a Defect of the Speech, because the Nostrils do greatly contribute to the forming of Words.

But if the Matter stick in the fore part of the Brain, or the Mamillary Passages, the Speech will be per∣fect.

You may know by the peculiar Diseases of each Part, from whence the ill Scent arises that offends the Organ of Smelling.

As to the Prognostick Smelling, if it be lately lost, or if it arises from a simple Coriza, may be easily cured.

The cure must be varied according to the Variety of the Causes, if it arise from a cold Intemperies, those things are proper which are used for a cold Catarrh: But to open an Obstruction occasioned by Flegm thrust into the Passages of the Nostrils, or into the Mamillary Processes, such Remedies are to be used as purge those Parts, viz. Errhins, Sneazing-Powders, and Apopleg∣matisms.

Lastly, If the Nostrils are obstructed by a Sarcoma, or Polypus, it must be cured by the removing of them.

CHAP. XXXIX. Of an ill Scent in the Nostrils.

AN ill Scent in the Nostrils and a stinking Breath, are very different, for that comes wholly from the Nostrils, but this from various Parts, viz. From the Stomach, Lungs, Gums, or from Ulcers in the Jaws, which are either apparent to Sense, or may be known by their proper Signs,

But an ill Scent in the Nose, is occasioned by putrid Vapours, arising either from the Nostrils, as in an Ozena, a Sarcoma, or Polypus, or from Air transmitted to the Nostrils from putrid Humours contained in the Brain, and in rhe fore Part of it, or about the Mamillary Processes, or Os Cribrasum: But Flegmatick Humours putrifie in the said Parts when they are retained in them beyond Measure, especially if there be also a hot and moist Intem∣peries of the Brain, they are retained by reason of an Ob∣struction of those Parts, or too great an Oppression of them, as in those that are flat-nosed.

The Disease of the Nose occasioning such a Stink, may be known by its proper Signs. But if there be no such Disease in the Nostrils, we may conjecture that it arises from a putrid Humour contained in the Brain, or Ma∣millary Processes, or in the Os cribrosum.

The Prognostick of an ill Scent in the Nostrils, which is occasioned by an Ulcer, Polypus or Sarcoma, depends on the Prognostick of them; But that ill Scent which pro∣ceeds from Corrupt Humours contained in the fore part of the Head, if it be lately come may be easily cured, if it be inveterate, it is incureable, especially if it come from an ill Confirmation of the Nostrils, as in such as are flat-Nosed.

The Cure is performed by taking away the Causes, and by moderating the Symptoms.

The Cure of an Ulcer, Sarcoma and Polypus, are mentioned above, but a putrid Humour contained in the Brain. Mamillary Processes, or in the Os Ethmoides, must be carried off by Purging and Cleansing.

And first, universal Evacuations are to be ordered which free the whole Body and the Brain from Flegma∣tick Excrements; and if there be abundance of Humours, a Sudorifick Diet-drink must be also ordered; afterwards cleansing Errhins must be prescribed to remove the con∣junct Matter.

And first, Whitewine, wherein Centaury has been in∣fused, must be put into the Hand, and snuft up Morning and Evening, or the Juice of Beet drawn with Marjora•• Water may be used, but the following is more Powerful,

Take of the Roots of Florentine-orris half a Dram, o•• white Hellebore, and long Pepper, each half a Scruple of the Seeds of Anise, and of dried Marjoram powdered each one Scruple; of the Oyls of Nard, Wall-flower, and Violets, each as much as is sufficient: Make a soft Oyntment wherewith anoint the Top of the little Finger and anoint the Nostrils within, or a Tent besmeared with the Oyntment, may be applied.

Lastly, To palliate the ill Stink, sweet-smelling things may be often drawn up the Nostrils, as an Infusion of Nutmegs in fragrant Wine, Angelica Water, and the like.

CHAP. XL. Of a Coryza.

COryza is a sort of Catarrh, wherein the Fluxion falls on the Nostrils, it's easily known by the abundance of Moisture that is evacuated by the Nostrils, 'tis commonly call'd a Cold, or Stoppage in the Head.

It requires the same Method of Cure as is used for a Catarrh, but in this Case you must not use Errhins, least they should draw Humours to the Part affected. Masti∣catories and Apoplegmatisms may be prescribed after ge∣neral Evacuation, and some-things are reckned peculiarly proper for this Disease, as the Vapour of a Decoction of

Marjoram received into the Nostrils, or of Vinegar where∣in red Roses have been infused, the Venegar being poured upon red hot Iron, if it be occasion'd by a very cold Fluxi∣on, the Fumes of Frankincense cast upon live Coals cor∣rects the cold Intemperies of the Brain, and dries up the Superfluous Moisture.

CHAP. XLI. Of Sneezing.

THo Sneezing often happens in Health, and is generally so small a thing that it scarce deserves the Name of a Symptom, yet sometimes 'tis so very troublesome that it requires Medicines and the Physicians help, and the an∣cient Custom of saying God bless you upon sneezing, shews that some time or other it has proved dangerous; some say 'twas an Epidemical Disease in the Time of Gregory the Great, and that the Sick died sneezing.

As to the Prognostick 'tis of it self without Danger, but 'tis very injurious at the Beginning of a Catarrh or Coryza; and in Feavers when it is frequent it sometimes occasions bleeding at the Nose, but most commonly it does good by expelling Superfluities from the Brain.

When Sneezing is injurious, as in a Plurisie, Peripneu∣monia, and the like, or when it becomes a Disease, the Cure must be undertaken by Revulsions and Evacuations; and if by Reason of a hot Intemperies of the Brain, or of any other Part, sharp Vapours are transmitted to the Nostrils, Bleeding must be used and proper Purges; and to qualifie the Acrimony, and to asswage the Irritation of the Nostrils, it will be proper to snuff up warm Milk into the Nose, or to anoint the Nostrils wlth Oyl of Vio∣lets, or of sweet Almonds, or with fresh Butter.

CHAP. XLII. Of Bleeding at the Nose, or Spitting of Blood.

BLeeding at the Nose comes at any Time of the Year, and seises chiefly those that are of a weakly Con∣stitution, and have hot Blood, and oftner when they are in Years, than when they are Young; at first there are some Signs of a Feaver, which goes off by bleeding at the Nose, but a Pain and a Heat in the fore part of the Head remains; the Blood flows for some Hours, then stops a while, and afterwards breaks out again, and so it does by turns, till at length it is quite stop'd, either by the use of Remedies, or of its own accord, by reason the Quantity is diminished; but the Sick is in danger of a Relapse yearly, either upon drinking of Spirituous Li∣quors, or from being over-heated upon any other ac∣count.

In order to the Cure, I endeavour to qualifie the Head and Ebullition of the Blood, upon which account the preternatural Extravasation arises. Wherefore I bleed often in the Arm, and take away a large Quantity of Blood; I order a cooling and thickning Course of Diet, as three parts of Fountain Water, and one of Milk boil'd together, and drank cold, roasted Apples, Barly-broths, and the like; forbidding the use o•• Flesh: I also pre∣scribe thickning and cooling Juleps, and Emulsions and the like.

Take of the clarified Juices of Plantane and Nettles, each six Ounces, of the Aqua Lactis Alexiteria four Ounces, of Cinnamon Water hordeated three Ounces, of white-Sugar a sufficient Quantity, mingle them, make a Ju∣lep; let him take four Ounces in the Morning, and at four in the Afternoon, and so daily for three Days following.

Take of the Waters of Plantane, and of Cinnamon hordeated, each four Ounces, of distill'd Vinegar half an Ounce, of true Bole, and of Dragon's Blood, each half a Dram, of

London Laudanum three grains, of Syrup of Myrtles one ounce and an half; mix them, make a Julep; let him take five or six Spoonfuls every Night at Bed∣time.

Take of the Syrup of Juice of Nettles four ounces; give half an ounce in his Liquor every time he drinks, and he may drink of Tincture of Roses every time he drinks.

Take of the Seeds of Henbane, and of white Poppies, each half a dram; of Sugar of Roses three drams, of Syrup of Comfry a sufficient quantity; make an Electuary, give the quantity of a small Nutmeg twice a day, and let him drink a draught of Tincture of Roses presently after it. Or,

Take of the four greater cold Seeds, each one dram and an half; of Sweet Almonds two pair, of the Seeds of white Poppies two drams, Plantane-water eight ounces, of Red-Poppy-water four ounces, of Cinnamon-water hor∣deated one ounce and an half; make an Emulsion, to which add three drams of pearled Sugar, and half an ounce of the Juice of Citron; mingle them, give four ounces thrice a day.

I order that the Sick should keep from Bed daily for some time, and that a gentle cooling Glister be injected every day, and a Paregorick Draught to be taken at Bed∣time: But because sharp Humours often accompany such Hemorragies, besides Cooling and Revulsion, I order gentle Purging, even when the Disease is at height; and when it has done Working, I give an Anodyn that is stronger than usual; and when the Symptom is quite abated, I give another Purge.

As to External Applications, Rags four times doubled, and dipt in cold Water, wherein Sal Prunella has been dissolved, and gently press'd out, may be applied often in a day to the Neck; and after general Evacuations the fol∣lowing Liquor may be applied.

Take of Hungarian Vitriol, and of Alum, each one ounce; of the Flegm of Vitriol half a pint, boil them till all are dissolved; filter the Liquor when it is cold, and separate it from the Cristals that sometimes arise; to the re∣maining Liquor add a twelfth part of Oyl of Vitriol;

dip a Tent in this Liquor, and put it up the Nostril from whence the Blood flows, and leave it there two days.

Rags dipt in this Liquor and applied, stop Blood in any external part.

A Spitting of Blood, which I shall now treat of, seises Weakly People of a hot Constitution, whose Lungs are weak; it happens chiefly to young People in the Spring or Summer-time.

It must be cured much the same way as the Bleeding at the Nose, only Purging must not be used often, for if it be the Sick will quickly fall into a Consumption.

Take of Lucatellus's Balsam one dram, of true Bole one scruple; mingle them, and give it Morning and Even∣ing, with a draught of the Traumatick Decoction.

Take of Plantane-water two ounces, of Cinnamon-water hordeated one ounce, of distill'd Vinegar half an ounce, of red Coral prepared half a dram, of Dragons Blood half a scruple, of London Laudanum two grains, of Syrup of Myrtles one ounce; mingle them, give a Spoonful every hour till the Blood stops. Or,

Take of Tincture of Roses one pint, of Comfry one ounce and an half; mingle them, give a draught every fourth hour. Or,

Take of Conserve of red Roses, and of Comfry, each three drams; of Cutle-bone finely powdred two drams, of Crabs Eyes one scruple; boil them in half a pint of Milk to four ounces; let him eat and drink all. Or,

Take of the Lohoch of Purslain one ounce and an half; give three drams every fourth hour.

And lastly, Bleeding frequently used, a Glister every day injected, and Diacodium taken every Night at going to Bed, and also a Diet, and Medicines that thickens and cools, will perfect the Cure.

Of Diseases of the TONGUE.

CHAP. XLIII. Of an Inflammation of the Tongue, and other Tumours of it.

AS all parts of the Body, especially such as are fleshy, are wont to be inflamed, so also is the Tongue some∣times, by reason of Blood flowing into it; and as it is Pure, Cholerick, Flegmatick or Melancholly, it occasions either a Flegmon, or an Erysipelas, an Oedema, or a Scirrhus, and sometimes it ends in Suppuration; whereof Forestus mentions an Observation, of a Brewer who had a great Inflammation of the Tongue, which Suppurated.

But most commonly the Swelling of the Tongue is soft and loose, and purely Oedematous, of which Galen pro∣poses an Example, of a Man whose Tongue was so tumi∣fied, that it could not be contained in his Mouth.

And sometimes also the Tongue grows excessively big, when there is no Oedema, no Scirrhus, nor any other kind of Tumour, and without any kind of Pain, and is only an increase proceeding from too great Nourishment of the part.

The Diagnostick of these Tumours is not difficult, for they may be seen; but the differences of them may be so distinguish'd, if there be an Inflammation, Pain and Heat, and Redness attend it, and the Face is also affected there∣with; but if the Swelling proceed from Flegm, the Tongue is white, and much Flegm flows out, which tasts sweet and insipid: But if it be only an increase of the Tongue, there are no signs of other Tumours or ill Humours.

As to the Prognostick; Tumours of the Tongue, for the most part, do not endanger Life, unless they grow so

great, that Suffocation should be feared from thence, or take their rise from some Malignant Humour, which may generate a Cancer, which is known by Hardness, pricking Pain, and a livid Colour.

The Cure of an Inflammation of the Tongue, must be begun with such things as cause a Revulsion, and with repelling Medicines: And then first a loosening Glister must be injected, and a large quantity of Blood must be taken away; presently after Cupping-glasses with Scarri∣fication must be applied to the Shoulders; afterwards cooling and repelling Gargarisms must be used. Galen commends the Juice of Lettice wherewith the Tongue must be washed; or a Gargarism may be prepared, of a Decoction of Plantane, Nightshade, of Syrup of dried Roses.

After Bleeding Purging may be prescribed, with a Me∣dicine made of Cholagogs and Flegmagogs.

The Fluxion being stopt by Evacuation, Revulsion and Derivation, the Derivation of the Humour stuft into the Tongue must be endeavoured; to which end the Veins under the Tongue must be opened: But if it cannot be done, by reason of the bigness of the Tongue, a Cup∣ping-glass, with Scarification, must be applied under the Chin.

If the Tumour tends to Suppuration, it must be pro∣moted by applying a Fig cut in the middle, which must be frequently changed, or by a Gargarism made of a De∣coction of Barly, Mallows, Violets, Figs, Raisins of the Sun, of the Seeds of Quinces and Fenugreek, adding to them Syrup of Violets and of Jujubs.

Suppuration being made, if the Abscess does not break of it self, let it be opened with a Knife, and the Ulcer must be presently cleansed with a Decoction of Barly, Agrimony and Plantane, with Honey of Roses.

But a soft and loose Tumour arising from Flegm, is cured first by Revulsion made by Bleeding, if the Sick abound with Blood; afterwards some strong Purge must be given, as is the Pill Coch minor: But if the Sick can∣not take Pills, a strong Purging Potion must be used.

After these Evacuations, cooling and repelling Medi∣cines must be applied at the beginning: The Tongue may be washed with the Juices of Lemons, Pomegranates, Sorrel, of Plantane, or with Simple Oxymel, to which

may be added in the increase of the Disease, a little Ginger, Sal Gemma, or Sal Armoniack. Zacutus Lusi∣tanus in a very dangerous case, when Suffocation was feared, by reason of the bigness of the Tongue, applied four Leeches to it, and soon after a great quantity of Blood was evacuated, and the Tongue asswaged. The same Zacutus Scarrified the Tongue deep in a Boy of Ten Years of Age, when the Tongue was soft, and by that means a great quantity of Salt-water flowed out, and the Patient was presently cured.

Lastly, When the Tongue is much increased, Claudinus proposes the Cutting off the Superfluous Flesh, necessary Preparations being first used.

CHAP. XLIV. Of the Ranula under the Tongue.

THough in the foregoing Chapter we treated of the Tumours of the Tongue, yet one remains, which we thought best to treat of in a Chapter by it self, because it is of a different Nature from the others, and requires a different way of Cure.

A Ranula is a Tumour under the Tongue, in that part wherein it is joyned to its bridle; and so great is this Tumour most commonly, that it rises higher than the lower Teeth; a cleft is in the middle of it, whereby it is divided into right and left, and by this means it re∣sembles the hinder part of a Frog, from whence it takes its name: It is of the Nature of a Meliceris, and the Matter which flows from it is like Honey, and contained in a Bag, and in this Bag a Stone is sometimes found.

It is most commonly without danger, but it is dan∣gerous when it looks black and brown, and is hard, for then it is of a Cancerous Nature, and ought not to be medled with.

As to the Cure of this Disease, First the antecedent Cause must be taken away; and if it be Inveterate, then you must use Cauteries and Sudorifick Decoctions,

Afterwards you must endeavour to dissolve it by Topical Remedies.

Take of Pomegranate-peel, of dried Hyssop, and of common Salt, each two drams; make a Powder to be held under the Tongue, and to be repeated often.

Forestus says, That a Girl of Twelve Years of Age was cured by this Remedy within two days: But in grown People it is best to use Sal Armoniack, which dissolves and penetrates more powerfully.

But if the Tumour cannot be cured by Medicines that discuss, it must be opened, which most commonly must be done; for it is seldom dissolved; but a large Apertio•• must be made, that all the Matter may come out toge∣ther; afterwards the Ulcer must be washed, first with gentle things, as with a Decoction of Mallows, after∣wards with cleansing things, as with Whitewine▪ mixed with Honey of Roses: Lastly, With Oxymel: When the Ulcer appears clear, and free from the Bag, it must be cicatrized, by washing the Mouth often with Allum dis∣solved in Claret.

If the Ulcer be Inveterate, and cannot be cured by the foresaid Remedies, touch it twice a day with the Oyl of Sulphur, tempered with Rose-water, viz. Mix one drop of the Oyl with five or six drops of the Water; for so the Intemperies will be corrected, and the part dried; which may be also strengthned by washing the Mouth often with a Dissolution of Allum in Claret: But if it will not be cured by these means, the actual Cautery must be used. You may see the manner of using of it in Paraeus, Book VII. Chap. 5.

CHAP. XLV. Of Tasting diminished, abolished or depraved.

TAsting, as the other Senses, and all the Actions of the Body, is injured three ways, it is diminished, abolished and depraved. It is diminished when it scarce perceives Tasts that are not strong, and but little such as are. It is abolished when it cannot taste any thing. And lastly, It is depraved, when it supposes the Object tasts differently from what it really does.

The Causes of Diminution, and Abolition of Tasting are the same, they only differ in degree; for if they are small, they only diminish the Taste; if they are great they abolish it.

The Causes are either a Defect of the Animal Spirits in the part, or an Intemperies of the Nerve, that comes from the third Pair to the Tongue, or the Tongue it self is some way preternaturally indisposed.

The Spirits are in fault, either by reason of the Paucity of them, as in People that are Dying; or upon account of Obstructions of the Nerves of the third Pair through which they are conveyed; or by reason of a Tumour in that part of the Brain from whence the Nerves rise.

The Tongue is either covered with a moist and Fleg∣matick Humour, or it is affected with Tumours, Pustles or Ulcers; and by these its proper Action, or the Sense of Tasting, may be either diminished or abolished.

The Taste is depraved when the Tongue is affected with some vitious Humour, as in Feavers, when it is in∣fected with Choler, all things seem bitter; and when it is infected with Salt Flegm, or a Melancholly Humour, all things taste Acid or Salt; for the External Objects coming upon the Tongue move the vitious Juice of it; and so all things that are tasted seem of the same Taste with the Humour in the Tongue: But sometimes the Tongue perceives the Taste of the Juices contained in it, although no External Object come near it. This is daily seen in Feavers, when the Tongue is infected with Choler,

for if it be very bitter, there is continually a bitter Taste in the Mouth.

The Diversity of the foresaid Causes may be known by the Variety of the Tasts, and by the Disposition of the Tongue; A sweet Tast, and a Redness of the Tongue signifies Blood, bitter Taste and a Yellow Colour signifies Choler; whiteness with Sweetness Flegm; a brown Colour and Sharpness Melancholly; an abominable Taste shows ill Humours contained in the Stomach: Pustles, Tumours, and Ulcers may be easily seen. But lastly, if there be no Alteration seen in the Tongue, and yet the tast is either diminished or abolished, we must suppose that the Cause lies hid in the Brain or Nerves.

The Cure is various according to the Variety of the Causes, and therefore if the Disease be in the Brain or Nerves, such Medicines must be ordered as are used for the Cure of a Palsie: But when the Taste is depraved by vitious Humours, that Symptom most commonly proceeds from other Diseases, especially from Feavers, which being cur'd the Symptom ceases,

If the Taste be injured by Tumours, the Cure of it de∣pends on the Cure of them.

Lastly, If the Fault arise from Pustles or Ulcers of the Tongue, the Cure of those must be undertaken by bleed∣ing, and purging, and with the Application of cooling drying and astringent Topicks, in the Form of a Gar∣garism. But if the Ulcers are sordid, they must be clean∣sed with Honey of Roses, sharpned moderately with Oyl of Vitriol, or of Sulphur. But when you would dry more powerfully, the affected Part must be touched once and again with the Oyls unmixed. And so may be cured Aphthae and all Ulcers of the Mouth and Tongue presently.

CHAP. XLVI. Of a Palsie of the Tongue, and of the Motion of it Hurt.

THe chief Action of the Tongue is Speech, and that is abolished, diminished and depraved by various Causes, which have Reference to Simular, Organick, or common Diseases. As to Simular, a moist Intemperies joyned with Matter renders the Tongue too soft and loose, so that it cannot move readily; also too much Dryness hinders Speech, which happens in Feavers; but Organick Diseases are magnitude increased, as was said before of Tumours, which hinders the free Motion of the Tongue; the Figure of it faulty, as when the Tongue is naturally too short, or when the Top of it is cut off, or when the Bridle is too strait, and an Obstruction of the Nerves of the seventh Pair, which are brought to the Muscles that move the Tongue.

Lastly, Common Diseases are a Solution of the Con∣tinuum, and Wounds of the Part.

Too great a Moisture of the Tongue causes Stammer∣ing, and such so affected cannot pronounce the Letter R, and it is either native as in Children, who by reason of too great Moisture are troubled with it, and are freed from it in Progress of Time, whereby the Superfluous Moisture is consumed; But in some it remains all their Life long, and they always Stammer.

But in some Stammering is accedental, and comes from a Catarrh, and from a great Fluxion of a Flegmatick Humour falling upon the Jaws or Tongue, and is cured by Evacuation, Revulsion, and Derivation, and by strength∣ning and drying the Head.

The Cure of a Palsie of the Tongue, is performed by taking off the antecedent Cause, viz. The Humour abounding in the Brain, and by discussing the Conjunct Cause, viz. the Humour thrust into the Nerves moving the Tongue. And first, Purging must be ordered, and Bleeding must be used if Blood abound, and such a Quantity must be

taken away as is agreeable to the Age and Strength of the Patient; afterwards Cephalick things must be used, and if the Diseases be obstinate, a Sudorifick Diet-drink.

After universal Evacuations, Derivation of the Morbi∣fick Matter must be made by Cupping-glasses, and Blisters applied to the Neck, and by an Issue in the hinder part of the Head.

Avicen applies a Cupping-glass to the Chin, which is also approved of by late Authors. Bleeding under the Tongue is also used successfully after general Evacuations; and to discuss the Humour the following Gargarism is frequently used.

Take of the Roots of Florentine-orris half an ounce, of the Leaves of wild Marjoram, Sage, Staechas, Rosemary, each half an handful, of Cubebs three drams, of Li∣quorish, one ounce; boil them in equal Parts of Water, and Whitewine added towards the end; to one Pint strain it, and dissolve in it two ounces of Oxymel of Squils; mlke a Gargarism. But if it be not strong enough to do the business, two or three drams of the Roots of Pellitory of Spain, or the like quantity of Mustard-seed may be added to it. Castor also may be added if it be not too unpleasing.

The Juice of Sage is much commended the Tongue being rub'd with it, you may also add Mustard-seed to it. The following Pills may be also held frequently upon the Tongue.

Take of the Juice of Bettony, and Liquorish, each one dram and an half, of Castor, and Assa-faetida, each half a dram, of Nutmeg, and Spicknard, each one scruple, make them up into small Pills with Honey,

Fumes and Powders sprinkled into the Hair, and the like, must be used to strengthen the Brain, and to discuss the Relicts of the Flegmatick Humour.

And lastly, To hinder the Growth of new Matter, which the Intemperies of the Brain is wont to cause, after general and particular Evacuations things that strengthen the Head must be used.

Of Diseases of the Gums, Teeth, Jaws, Uvula, and Larynx.

CHAP. XLVII. Of Pains of the Teeth.

THe Pain of the Teeth is occasioned by the Influx of Humours, which are either Cold, Flegmatick, Hot, Serous, Salt, or Acrid; Worms also bred in rotten Teeth occasions Pain, and some think that the Pain proceeds sometimes from Wind.

The External and Procatarctick Causes occasioning Pain in the Teeth, are all those things which promote Fluxi∣on of Humours; the chief whereof are cold Air, or Southerly Winds, standing long in the Heat of the Sun, or abroad in the Night, surfetting, and all Errors in Diet. To these add Rottenness of the Teeth, which weakens them and renders them more apt to receive Fluxions.

The Diversity of the Causes may be known by va∣rious Signs, when the Pain arises from hot Humours it is very violent, the Constitution hot, the Age flourishing, it is Summer, there is great Heat in the Part, and often an Inflammation of the Gums, cooling Medicines give Ease; hot increase the Pain; But if the Pain arise from cold Humours, Signs contrary to these appear.

If Worms are the Cause the Pain is by Intervals, and the Motion of the Worm is sometimes perceived in the Part.

Pain is likewise produced by a Flatuous Spirit, which appears by the vehemency and tearing Pain which is felt in the Part, and which goes off in a little time,

and is easily cured, by applying discutient Remedies to the place.

The Prognostick is various according to the Variety of the Causes. A Pain which is occasioned by a hot, thin, or sharp, acrid and salt Humour, is the more vehement indeed, but sooner goes off, by reason of the sudden Changes of the Humours; that which proceeds from a cold and Flegmatick Humour, is more gentle but of long∣er Duration.

A Tumour arising in the Gums or Jaws, eases the Pain of the Teeth, by reason that the Fluxion is carried to the exterior Parts; so that it falls no more upon the Cavity of the Teeth.

As to the Cure, the Cause of the Pain must be taken away, and the Pain it self mitigated. And although Ano∣dyns have no great Effect, unless the Fluxion be taken off, yet it is often so violent, that it must not only be mitiga∣ted with Anodyns, properly so called, but also with Nar∣coticks before the Cause be removed. Therefore the Hu∣mour which flows to the Teeth must be drawn back, evacuated and repelled; that which is already flown in, must be discussed and carried off by Derivation.

First therefore, If the Pain arise from hot Humours, Bleeding must be used in the Arm of the same Side, where∣by a Revulsion of the Humour may be made; but if the Pain proceeds from cold Humours, Bleeding is not so pro∣per, but by reason of the Fluxion it may be used because it principally makes Revulsion; but a small quantity of Blood must be taken away, unless the Signs of a Plethora appear; for in that case large Bleeding may be allowed, which is the best means to ease the Pain in the Teeth, and all other Pains.

The next Day some purging Medicine must be given, that is proper for the peccant Humour; afterwards if the Pain continues, Cupping-glasses with Scarification must be applied to the Shoulders, or a large Cupping-glass without Scarification; a Blister may be applied to the Neck or behind the Ears, for it draws powerfully the Humours backward.

And to stop the Flux Astringents are properly applied to the Temples; such are the Plaisters of Gum-elemi, of Mastich alone, or ad Herniam.

The fresh Roots of Comfrey, bruised and applied to the Temples are excellent for stopping of Fluxion, also the Powder, of Allum and Galls made into a Plaister with Pitch are very effectual.

Riverius, chief Physician to Henry the Great, kept the following Plaister as a great Secret.

Take of Pine-nuts, and red Roses, of the Seeds of Cresses torrified, of Mastich, and seal'd Earth, each one dram and an half, infuse them in Rose Vinegar twenty four Hours, afterwards dry them, and add of Opium dissolved in Aqua Vitae three ounces, of Ship Pitch and Colophony, each one Ounce, of Yellow Wax melted in the Oyls of Hen∣bane, and white Poppies, by Expression a sufficient quantity, make a Plaister, which must be applied to the Arteries and pained Part.

Medicines also are put into the Ears for Pain in the Teeth, because the Arteries which nourish the Teeth do pass by the Ears; upon that account, Oyl of bitter Almonds is put into the Ear next to the Tooth affected, also a Suffumigation of Vinegar, in which Penyroyal, or wild Marjoram hath been boiled, is often used.

Vinegar is also dropt into the Ear, by which the Flux∣ion is powerfully stopped, and it is most effectual in a hot Fluxion.

But in a hot Fluxion, Juice of Garlick mixed with Venice Treacle, and dropt warm into the Ear, mitigates the Pain powerfully: Also the Root of Garlick, the Bark being taken off, and made in the form of a Suppository, and put into the Ear, produces the same Effect.

Astringents are also applied in the beginning of the Fluxion, and they ought to be cold if the Matter be hot; but if it be cold, hot Medicines mixed with those that are repelling are to be used; in whatever Cause, if the Pain be violent, Anodyns are to be mixed with Discutients. To which Purpose the following Medicine may be prescribed.

Take of the Roots of Cinquefoil, Bistort, Tormentill, each one dram, of the Leaves of Vervain, Plantain, and Mullein, each one handful, Cypress-nuts, Galls, and Cups of Acrons, each two drams, of red Sanders, a dram

and an half, of red Roses, and Balaustines, each one pugil, boil them in astringent Wine and Vinegar, fomeri•• the pained Part with this Decoction frequently.

This Decoction may be used in the beginning of a hot Fluxion, in a cold one you may add the Roots of Cyperus, the Bark of Box-wood, Ivy-leaves and the like.

A more Simple Medicine may be prepared of Plan∣tain, and Rose Water, with a little Vinegar, after the manner of an Oxycrat.

Or the Teeth must be washed with a Decoction of Galls in Vinegar. Or,

Take of Cinquefoil-roots half an ounce, of Willow-leaves half an handful, boil them in astringent Wine, and wash the Mouth with the Decoction.

This Decoction stops the Fluxion, and eases Pain.

After that these Remedies have been used which miti∣gate the Pain, and discuss the Cause of it, of which there are a great Number proposed by Authors, and also by the common People. We shall in the next Place propose those that are more effectual; of the which such Choice is to be made, that these which not only resolve, and discuss, but also stop the Flux, being mixed with astringents, in the beginning and increase of the Disease, those which only discuss in the Height and Declination.

Take of the Juice of House-leek, and Night-shade, each two ounces, of Cow or Sheeps-milk, eight ounces, Oyl of Roses, Omphacin, one ounce and an half, of OpiUm and Saf∣fron, each three grains, mix them and apply a Rag dipt in the Liquor warm often to the Jaws where the pained Tooth is. Or,

Take of the Pap of sweet Apples boiled two ounces, of Bra•• infused in Vinegar, three ounces, Oyl of Roses, Omphacin one Dram, Saffron half a scruple, of Opium two grains, mix them and make a Cataplasm to be applied to the part affected. Or,

Take of wheaten and Bean-flower, each three ounces, of Oyl of Roses compleat, and of sweet Almonds, each half an ounce, of the Juice of the greater House-leek an ounce

and an half, of Milk a sufficient quantity, make a Cata∣plasm, to be often applied warm to the Part affected. Or,

Take the Whites of two Eggs, beat them with Rose-water, with Rags whereon two drams of Pepper powdered has been sprinkled, apply them over the whole Cheek af∣fected.

Nevertheless it is carefully to be noted, that Astringents be not applied to the Jaws if they be tumified, least the Humour be repelled back, and should suffocate the Pa∣tient.

Cotton dipt in Oyl of Cloves, and put into the Hollow Tooth is frequently used to ease the Pain, Oyl of Box also does the same.

But if the Pain be so violent that it cannot be quelled with the foresaid Remedies, we must use Narcoticks, which may be applied to the pained Tooth, but they most certainly give Ease being taken inwardly; you may give three or four grains of the London Laudanum, it gives ease and stops the Fluxion.

Take of Opium, Mirrh, and Labdanum, each one Dram, powder them, and boil them in Whitewine to the Consi∣stance of a Liniment, mix Cotton with it, and stop the Hollow Tooth.

If Worms are in the Teeth, they must be killed by bit∣ter things.

Take of Aloes one Dram, of Champhor ten Grains, of Aqua Vitae half a dram, mingle them, and apply them to the Teeth with Cotton,

It is to be noted, that there is seldom a Pain in the Teeth, unless they are Hollow, and untill they are eaten through to the Nerve; wherefore that the Pain may be taken off, the Nerve must be burnt, either with an actual Cautery, or with Aqua fortis, or Oyl of vitriol put into the Cavity.

But if notwithstanding all these means the Pain con∣tinues, the Tooth must be drawn, but care must be taken

that the Tooth be not drawn when the Fluxion rushes violently upon it, or when the Headach accompanies it; or the Gums are swelled, and when the Pain is violent; and the Tooth-drawer must be admonished, that he does not pluck it out violently at once, least a concussion of the Brain shou'd follow, or the breaking of the Jaw∣bone, upon which violent Bleeding, a Feaver, and some∣times Death comes. As soon as the Tooth is drawn, the Part from whence it is taken must be pressed on every side, that it may be restored to its natural State, after∣wards let the Sick wash his Mouth with warm Oxycrat, and let him be careful least he catch cold, whereby a new Fluxion may fall upon other Teeth.

But if Blood flow so much as that it can scarce be stopt, which sometimes happens, though the Jaw be not broken, by reason of a Vein or Artery torn. This Flux of Blood is most commonly stopt by applying Lint rolled up hard, and pressing it hard down an hour or two with the Fingers. But if this does not succeed; burnt Vitriol must be ap¦plyed, and a Rag dipt in Vinegar over it, which also must be pressed down with the Finger, till it be crusted. The last Remedy is an actual Cautery, which presently stops the Blood.

But if any timerous Person cannot bare the drawing of a Tooth, but desires to have it extracted by Remedies.

Those things are to be tryed, which are proposed every where by Authors for the same purpose, as a Paste made of Frankincense powdered, a little Starch, and the Milk of Spurge, the Root of Crow-foot, the Bark of the Root of Mulberry Tree, the Ashes of Earth-Worms, Pellitory of Spain steep'd in Vinegar, the Root of wild Cucumber in∣fused in Vinegar, and the like. But Bears-foot is the most effectual, the Tooth being rub'd with the Leaf of it bruised, but great care must be taken, that the other Teeth be not touched with it; for if so, they wou'd be in danger to drop out. A certain Country Fellow being grievously afflicted with the Toothach, desired another to rub his Teeth with Bears-foot, who unwarily rub'd almost all his Teeth with it, and in a few hours almost all of them dropt out. Where∣fore if any one intends to use so violent a Medicine, I wou'd advise him to cover the rest of his Teeth with Wax to secure them.

Though the Tumour arising in the Jaws most com∣monly takes off the Pain of the Teeth, the Matter being translated to the outward parts; yet to procure Ease the sooner some Remedies must be used: The following Lini∣ment does good.

Take of Fresh-Butter and Hens-grease each one ounce, of the Powder of Florentine Orris one dram, of Saffron half a Scruple, of Oyl of Camomil, and Oyl of Sweet-Almonds, each half an Ounce; make a Liniment to be applied to the Jaws.

A Cataplasm made of Figs bread and Vinegar operate sooner.

Nettles bruised and applied to the Jaws soon ease the Pain.

This Cure is for the present Pain, but if it be wont to return frequently, the generation of Humours flowing to the part must be hindred, and the Teeth must be strengthned, that they may not so easily receive the Humours flowing to them.

CHAP. XLVIII. Of Black and Rotten Teeth.

THE Teeth are often Black, Yellow or Livid, by rea∣son of vitious Humours sticking to their Superficies, which by lying long on them corrode, and make them rotten; ill Vapors do the same, which arise from un∣wholsome Meats eaten, or from an Intemperies of the Stomach; Quick-silver used to the whole Body, or to the Face to Beautifie it, blackens the Teeth: Upon which ac∣count Women that use Paint are wont to have black or foul Teeth.

In order to the Cure, the antecedent Cause must be first removed, and if ill Humours abounding in the Sto∣mach occasion this Disease, they must be evacuated, and the Intemperies producing it must be corrected, and a

good Course of Diet must be ordered, and such Meats must be avoided as are apt to corrupt the Teeth, especi∣ally those that are Sweet.

There are a great many Medicines proposed to whiten the Teeth by Authors, which every one may make trial of; we use only one, which presently frees the Teeth from all Filthiness, and renders them white; and also preserves them from a Caries, that is, the Spirit of Vitriol or of Sulphur, in which a small Stick wrapt round with a Rag may be dipt, and the Teeth rubbed with it, and pre∣sently after the Teeth must be dried with a clean Linnen Cloth.

When the Teeth are very foul, the pure Oyl may be used, or mixed with Honey of Roses, or it may be cor∣rected with Simple Water, least the use of it corrode the Gums. Montanus relates that he learned this from a Woman at Rome, whom he had seen when he was very young, and she about the Age of Twenty; he found her afterwards when she was Fifty in the same Condition, who had preserved her Beauty and Strength by the use of the Oyl of Vitriol; and that her Teeth which were very ill in her Youth were become firm and clean in her old Age by the use of it; for she was wont daily to rub her Teeth and Gums gently with a drop or two of it.

The Ashes of Tobacco are also excellent to cleanse and whiten the Teeth.

But to preserve them and to keep them clean, they must be daily cleansed from Filth, and Meat that sticks in them, by a Tooth-picker, made of the Lignum Leutiscinum. Afterwards you must wash the Mouth with Wine, and the Teeth must be rubbed with the following Powder.

Take of the Roots of Bistort, Allum, and White Coral, each one ounce; make a fine Powder wherewith rub the Teeth.

CHAP. XLIX. Of the Errosion and Ʋlceration of the Gums.

THE Gums are eaten and ulcerated by Acrid and Corroding Humours flowing to them from the Brain, Stomach, Spleen, and other Parts. Splenetick People are more especially troubled with Ulcers of the Gums, and such as are Scorbutick; and sometimes also the Gums are corroded by Worms, or by the Humours that occasion them; so that when they continue long to be so, they signifie Worms to be in the Body. Fabritius Hildanus mentions an Observation of a Boy, that was much trou∣bled a long while with corroded Gums, and after he had tried many Medicines both inward and outward, at length he died, and his Body being opened, there were found great numbers of Worms, which had eaten through his Guts, and lay in the Cavity of the Belly.

The Cure must be first directed to the Antecedent Cause, and the Peccant Humours must be evacuated by Bleeding and Purging. The Acrid and Hot must be attemperated by Apozems, Juleps, and medicated Broths, and the like. And the Fluxions of the same Humours is to be turned, by applying Cupping-glasses to proper places. And lastly, The Diseases of the Part principally affected must be cured.

And afterwards we must use Topicks, which are to be varied according to the greatness of the Disease, for in a simple Errosion those things are only to be applied which are Astringent and dry: And first the following Lotion must be used.

Take of unripe Galls, of the Cups of Acorns, and of Ba∣laustins, each one dram; of red Roses one Pugil; of Crude-allum three drams; boil them in two parts of Smiths water, and one of rough Wine: The Teeth must be often washed with this Water, and if the Errosion is not cured with it, the following Opiat must be used.

Take of Dragons Blood three drams, of Wood of Aloes, red Roses, Spodium, Harts-horn burnt till it is white, and Cypress Nuts, each one dram; of Myrrh, and the Ashes of Tobacco, each one dram; of Allum two drams; make of all a Powder, mix it with Honey, and add to it a few drops of Spirit of Vitriol or Sulphur, make an Opiat, which you must spread upon a rag, and apply to the Gums at Bed-time.

Spirit of Sulphur either by it self or mixed with Honey of Roses, cleanses and whitens the Teeth, and cures the Corruption of the Gums.

If the Ulcer is deep or sordid, you must use the follow∣ing Balsam.

Take of choice Myrrh, and of Sugar-candy, each equal parts; powder them, and fill the white of an Egg with them first boiled hard and cut in the middle, afterwards bind it up with Thread, and hang it in a Cellar, put a Glass under for the Liquor to drop into, wherewith anoint the part affected often in a day.

But if the foresaid Remedies will not do the business, and if the Tooth near the Ulcer be rotten, it must be drawn out, and the Ulcer will be soon cured, otherwise it will be incurable.

CHAP. L. Of Blood flowing from the Gums.

BLOOD sometimes flows in a great quantity from the Gums, either Critically or Symptomatically: But though a Critical Hemorrhage seldom happens by the Gums, yet that it does so sometimes, Experience and the Observations from Authors show.

It flows Symptomatically from the Gums, by reason of its Acrimony, and of the vitious Constitution of the Spleen, and also the Scurvy: It also sometimes flows plentifully

after the drawing of a Tooth; the little Artery being torn, which was inserted into the Root of the Tooth; upon which account sometimes so much Blood flows as kills the Patient.

The Cure of a Symptomatick Flux is performed by Bleeding, and Purging, and other Remedies that correct the Disorders of the Bowels; afterwards Topicks must be used that are of an Astringent Nature, in the form of a Gargarism, Lotion, Powder, Liniment, or Opiate.

If a great quantity of Blood flows upon drawing a Tooth, Revulsion first must be made by Bleeding, and Cupping-glasses and Astringent Medicines must be applied to the part; as a Cataplasm made of Bole-armenick, Dragons Blood, sealed Earth, and other Astringents mixed with the white of an Egg.

If these things do not do, the Patient must apply his Finger to the part from whence the Blood flows, and must be kept there so long, till the Blood coagulated upon the Orifice of the Artery stops the Flux.

If the Blood cannot be stopt by these gentle means, stronger must be used. Chalcitis burnt and applied, stops Blood wonderfully, Gum-arabick powder'd, and the Ca∣vity fill'd with it, is also of use: So is also the Powder called Thuraloes, applied with the white of an Egg and Hares Down.

CHAP. LI. Of Ʋlcers of the Mouth and Jaws.

SMALL and Superficial Ulcers of the Mouth are called Aphthae, and when they are large they go under the common name of Ulcers, as those are that happen to Pocky People.

These Ulcers are wont to be generated by Acrid Humours, or Vapors translated from various parts of the Body to the Jaws. So in Malignant Feavers, such Ulcers frequently happen, and to those which are of a hot Con∣stitution, and are subject to an Intemperies of the Parts,

and to others that abound with corrupted Humours, up∣on which Account Children are frequently troubled with Aphthae.

These Ulcers are various, not only for that some are small, some greater, and because some trouble Children, and some grown People, but also because an Inflammation accompanies some of them, and others it do's not. These various Degrees happen according to the variety of Hu∣mours from whence they are generated, for either they proceed from Blood, Choler, Flegm, or Melancholy, or rather from black Choler, which is of a burning and ma∣lignant Quality.

But these Differences may be known by their proper Signs, for red Ulcers proceed from Blood, yellow from Choler, white from Flegm, livid from black Choler, a stinking Ulcer signifies Putrefaction.

As to the Prognostick, Aphthae properly so called are easily cured, but deep Ulcers, or such as are putrid are difficultly cured, and they are most dangerous in Children, both because they spread more by reason of the Softness of their Flesh, and also, because they cannot bear strong Me∣dicines; upon which account Children sometimes die of them, if they are accompanied with Putrefaction and Malignity.

And with respect to the Cause from whence they pro∣ceed, they are more or less Dangerous; if they proceed from Flegm there is little Danger, if from Blood, or Cho∣ler, there is more, if from black Choler most of all.

Black and crusty Ulcers are deadly, especially in Children.

Ulcers of the Jaws accompanied with a Feaver are dangerous.

As to the Cure, a cooling and drying Diet must be or∣dered to hinder the Generation of the Antecedent Cause; wherefore if in Children, the Disease arises from a Fault in the Milk, either the Nurse must be changed, or her Milk must be corrected by proper Meats and Drinks, and by Bleeding and purging if there be Occasion.

But you must be sure to prescribe a cooling and astrin∣gent Diet to the Nurse, as Quinces, Pears, Medlars, Lettice, and Purslain. The same must be prescribed for grown People, and they must avoid acrid, salt, and pep∣pered Meats.

Moreover with respect to the antecedent Cause, univer∣sal Evacuations must be prescribed, according to the Age of the Sick, and first, Bleeding makes a powerful Revul∣sion of Humours flowing to the Part, and attemperates their Acrimony, and cools the whole Body. Afterwards Cupping-glasses with Scarification must be applied, Leeches behind the Ears, and under the Chin, and a Blister must be applied to the Neck. The next Day after Bleeding Purging must be ordered suitable to the peccant Humour, and the Age,

At the same time, viz. From the very beginning of the Cure, Topicks must be applied; but such as are gentle must be first used, as Gargarisms, or Lotions made with the Waters of Plantain, or Honey-suckle, and sweetned with Syrup of dried Roses, or of Mulberries, or of a Decoction, of Plantain Leaves, Bramble-tops, knot-grass, Balaustins, red Sanders, and the like, with the foresaid Syrups. And if there be an Inflammation, it is proper to add the Juice of Night-shade, House-leek or of Purslain, and Sal Prunella, in such Quantity as may not sharpen it too much, or instead of them a small Quantity of Crude Allum may be mixed with it. If there be no Inflammation, Spirit of Vitriol, or Sulphur is the only Remedy which may be used by it self to grown People; The Ulcer being touched with a Stick wrapped round the top, with a Rag dipt in it, and so simple Aphthae will be cured im∣mediately.

But for Children the Spirit must be mixed with Honey of Roses to mitigate the Sharpness, and must be used with a Stick, as above directed.

If the Ulcers are very painful, and accompanied with Inflammation; the Mouth must be often gargled with Milk, or with an Emulsion of the cold Seeds, or with a Mucilage of the Seeds of Fleabean, and of Quinces extracted with Plantain and Rose-water.

Lastly, If the pain be so very obstinate that it cannot be appeased by the Revulsions and Topicks proposed; but by Reason of the Violence of it, sharp Humours are continually attracted, and long Watchings occasioned, and a Wasting of the whole Body, whereby the Life is much endangered, the last Remedy are Narcoticks, which ease the Pain, and hinders the Influx of the Hu∣mours,

they are to be dosed according to the Age and Strength of the Patient.

I cured a Boy, says Riverius, of four Years of Age, when he was just dying, by giving him a grain of Laudanum. His Jaws and Tongue were full of deep Ulcers, and the Inflammation so great, that he cou'd not bear Topick Remedies, and the Flux of Humours so much, that they flowed perpetually out of his Mouth like a Stream, and the Child cryed Night and Day.

If the Ulcer be putrid, and sordid, it must be first washed with a Decoction made of Barley and Honey of Roses, and in Children, with Milk wherein Steel has been quenched, mixed with conserve of Roses; afterwards you must use things that are stronger, Honey of Roses is the chief, made acid with the Spirit of Vitriol.

If these are not sufficient, burnt Allum may be added to the things abovementioned, or Unguentum Aegyptia∣cum, in a greater or lesser quantity, according to the Degree of the Diseases.

Lastly, If the Ulcer of the Jaws proceed from the French Pox, it cannot be cured until that is taken off.

CHAP. LII. Of the Relaxation of the Uvula.

THe Relaxation of the Uvula, happens by reason of a Flegmatick Humour, falling from the Head upon it, wherewith some Blood is often mixed, and then an In∣flammation accompanies the Relaxation, which also frequently happens to the Almonds, concerning the Cure of which Inflammations we shall say nothing; because the Cure of them is performed by the same Remedies which were proposed for the Cure of an Inflammation of the Tongue, and for Ulcers of the Mouth with Inflam∣mation.

The Flegmatick Humour falling upon the Uvula, moistens, softens, and so relaxes it, that it touches the up∣per part of the Oesophagus, and creates Nauseousness,

and those that are so affected, always endeavour in vain to swallow something that lies at the top of the Oesopha∣gus, and by this Sign without Inspection, the Relaxation of the Uvula may be known.

The Cure of it must be first directed to the anticedent cause, wherefore the Humours flowing from the Head, must be evacuated, and diverted by those Remedies which are proposed for the Cure of a Catarrh.

The Topicks which are used in the Beginning must be astringent and repellent, such as were proposed for Ulcers in the Jaws and Gums; afterwards the things that are drying and astringent must be mixed with them; and though the Gargarisms proposed in the said Places, are profitable in these Cases; yet when there is no Inflamma∣tion, the use of Powders is more effectual. For by them the relaxed Uvula is more powerfully dried and contract∣ed. And therefore the Bark of Pomegranates finely pow∣dered should be first used, and in progress a little Pepper may be used with it. Or,

Take of red Roses, Balaustines, Pomegranate-peel, each half a dram, of the Roots of Bistort, Tormentil, and unripe Galls, and of Florentine-orris, each one dram, of burnt Allum two Scruples, make a Powder.

Common Chyrurgeons apply long Pepper powdered to it, but it is not safe, for there is Danger least the Humours should be drawn violently to the Part affected, and so should occasion some great Mischief.

The manner of using these Powders is as follows: The Tongue must be depressed with a Speculum-oris, and then with a Spatula, or with a small Spoon for the Pur∣pose; the Powder must be conveyed to the Uvula, often in a Day, till the Humour imbibed be wholly con∣sumed.

But if the Uvula relaxed cannot be reduced by the foresaid Remedies to it's former State, but still continues troublesome by being so long, the top of it must be cut off; but care must be taken that too much of it be not cut off, for if so the Speech and Respiration wou'd be injured.

CHAP. LIII. Of a Quinsie.

IT comes at any Time of the Year, especially between Spring and Summer, and chiefly seizes young Men, and such as are of a Sanguine Constitution, and red hair'd People, (which I have often observed) more than any other, they shiver and shake presently, a Feaver follows, and a little after a Pain and Inflammation of the Jaws, and if the Patient be not presently relieved, he can neither swallow nor draw his Breath through his Nostrils; so that he is under the apprehension of strangling, by rea∣son the Jaws are stopt by the Inflammation and Tumour of the Uvula, Almonds, and Larynx, and is indeed in a manner suffocated. There is great Danger in this Disease, for it sometimes destroys a Man in a few Hours.

In order to the Cure, I presently take away Blood plentifully from the Arm, and presently afterwards from the Veins under the Tongue, and then I order that the inflamed Parts shou'd be touched with Honey of Roses, made very sharp with Spirit of Sulphur, and that the following Gargarism shou'd be used not after the common Way, but that it shou'd be kept in the Mouth without any Agitation till it wax hot, and then that it shou'd be spit out, and that it should be repeated now and then.

Take of Plantane-water, and red Rose-water, and of the Wa∣ter of the Spawn of Frogs, each four ounces; the Whites of three Eggs turned to a Water by beating, of White Sugar-candy three Drams, make a Gargarism.

I likewise order, that the Patient take dayly of the Emulsion prescribed in the Cure of a Pleurisie or the like. The next Morning I bleed again, unless the Feaver, and difficulty of Swallowing somewhat abate, and defer Purging till the next Day: But if both these are lessened, I presently give a lenitive Purge. If the Feaver and other Symptoms are like to be troublesome, after purging they are to be quelled by Bleeding repeated as before, by ap∣plying

a large and strong Blister to the Neck, a cooling and emollient Glister is to be injected every Morning, ex∣cept when the Patient purges, through the whole course of the Disease. The use of Flesh of all kinds, and their Broths are to be forbid, and the Patient is to be dieted with Oatmeal and Barley Broths, and roasted Apples, and the like, let him use a Ptisan of Barley or small Beer. Let him keep up some Hours every Day, for the warmth of the Bed heightens the Feaver, and other Symptoms. But it is to be noted, that such a Quinsie which is only a Symptom of a Feaver I call stationary, is to be cured by that Method which is requisite for the Feaver, and so is either to be taken off by Sweat and Transpiration, or by any other Method of Cure which is necessary for the primary Feaver whereon it depends, which is worth Ob∣servation.

CHAP. LIV. Of an Asthma.

THough an Asthma is taken for a Difficulty of Breathing in general, yet it principally Signifies that which pro∣ceeds from a stoppage of the Lungs, and an Obstruction of the Bronchia, which of its own Nature is without a Feaver, though sometimes a Feaver accompanies it.

An Asthma is divided into three Species, one is called Dyspnoea, another Asthma, the third Orthopnoea.

A Dyspnoea is a difficulty of Breathing, arising from an Obstruction of the Lungs; this is less than an Asthma, or Orthopnoea, and arises from a smaller Quantity of Matter that obstructs more the Substance of the Lungs, than the Bronchia; upon which account there is no Wheezing, which is occasioned by a Commotion of the Humour contained in the Bronchia.

An Asthma is a great and frequent Respiration, where∣in the Diaphagma, the intercostal Muscles, and the Muscles of the Abdomen are violently moved, and a Wheezing accompanies it.

But an Orthopnoea, is the greatest Difficulty of Breath∣ing, wherein the Sick can only breath, as the Word sig∣nifies, sitting upright.

The Cure of an Asthma is twofold, one in the Fit, and the other out of it; in the Fit a Glister being first given, Bleeding must be used; if Blood seem to abound in any Degree, and the Sick must be placed upright in a free Air, and Smoak, or the Breath of the Standers by must not offend him; and his Cloathes, or any thing else that covers his Breast must be loosned.

After Bleeding, or it being omitted, if it be not thought proper, a Phlegmagogue Purge must be given.

As to Vomits, though some dislike them, yet are they very proper in this Disease, as is evident by Experience, and frequently the Fit is taken off by this Remedy alone. Sharp Glisters are often to be injected to make a Revul∣sion, nevertheless their Quantity ought to be small Fricti∣ons in the inferior Parts are also to be used, and many Cupping-glasses are to be applied to them, and to the Neck; afterwards the gross Humours must be moistned and attenuated, and the Wind arising from them must be discussed, to which Purpose the following Medicines must be given.

Take of Gum Ammoniack and Bdellium dissolved in Vine∣gar of Squills, each one dram and an half of Castor, and of the Flowers of Sulphur, each half a dram, of Millepedes prepared one dram, of Salt of Ambar one scruple, of Elixir Proprietatis half a dram, with a sufficient quantity of Oxymel, make small Pills; Let him take four Morning and Evening, drinking upon them three Spoonfuls of the following Julep.

Take of the Waters of Rue, Black-Cherries, Lime-flowers, each two ounces, of compound Peony, and compound Briony-waters, and of Spirit of Castor, each one ounce, of Syrup of Staethas, and Gilly-flowers, each one ounce and an half, mingle them and make a Julep.

Take of the Nerve Plaister half an ounce, of Oyl of Am∣ber four Drops, of Balsam of Sulphur half a dram, mingle them, spread a Plaister upon Leather, and apply it to the Breast.

Take of the Cephalick, Plaister with Euphorbium a suffici∣ent Quantity, make Plaisters for the Soles of the Feet.

In the mean while, things that expectorate the gross Matter must be used.

Take of the Pectoral Decoction a quart, add to it of Spirit of Salt-armoniack half a dram, of Oxymel of Squils half an ounce, of Tincture of Castor one dram, of Ground-ivy Water three ounces, mingle them, let him take six Spoon∣fuls every two Hours. Or,

Take of the Seeds of Annise finely powdered, and of Powder of Liquorish, each three drams; of the Flowers of Sul∣phur one dram and an half; mingle them, add two ounces and an half of the best Honey, dissolved in three ounces of Cinnamon-water hordeated; make an Ele∣ctuary; add to it of Balsam of Sulphur fifteen drops; of Oyl of Annise-seeds ten drops; let him take one dram every third or fourth hour, drinking upon it five Spoonfuls of the following Decoction.

Take of the Roots of Elecampane one dram and an half, of the Leaves of Ground-ivy half an handful; boil them in three pints of the Pectoral Decoction strained; add three ounces of Canary-wine, Syrup of Maiden-hair two ounces and an half; mix them.

The Breast must be anointed with Oyntments and Lini∣ments that soften and discuss.

Take of the Oyntment of the Flowers of Oranges, and Poma∣tum, each three drams; of Oyl of Nutmegs by expression two drams; of Oyl of the Berries of Juniper and Annise, each half a dram; mingle them, make a Liniment, wherewith anoint the whole Breast Morning and Evening.

Take of the Oyntment of Marsh-mallows one ounce and an half, of Oyl of Annise-seeds thirty drops; make an Oyntment.

If the Fit Continue, apply a Blister to the Neck; when the Fit is off, the Fluxion of the Humour must be hin∣dred, and that which has already flowed upon the Lungs must be incided, cleansed away, and expectorated, and

to restrain the Force of the Fluxion, a clear and pure Air must be chosen, and Southerly and rainy Air must be avoided, and the Air in the Night; Sleeping and Watch∣ing must be moderate, and the Humour must be purged off by the following Medicines.

Take of the bitter Decoction, made with a triple quantity of Senna, three ounces and an half, Manna half a ounce, mingle them, make a Purging Potion. Or,

Take of the Pilulae Ruffi one Dram, of the Species Hiera half a dram, of Salt of Wormwood half a scruple, of Aloes Rosat, and of Rhubarb powdered, each one scruple, of Elixir Proprietatis a sufficient quantity; make Ten Pills of a dram, let him take four at bed-time.

Of the Days he does not Purge, let him take of the fol∣lowing Medicine.

Take of the Seeds of Annise finely powdered two drams, with a sufficient quantity of Lucarellus's Balsam, make Pills, of each drams Six, let him take three in the Mor∣ning, and as many at four in the Afternoon, drinking upon them four ounces of the bitter Decoction.

It is to be noted, that Purging must be often used in this Disease, and the Form of them must be varied, least Nature should be too much accustomed to one and the same Remedy.

CHAP. LV. Of a Pleurisie.

THis Disease that is as frequent as any other, comes at any time, but especially about the Spring and Sum∣mer; for at that Time the Blood being heated by the near∣ness of the Sun, rushes violently into effervescences and inor∣dinate Motions.

It chiefly seises those that are of a sanguine Tempera∣ment, and often country People, and those that are accusto∣med

to much Labour. It most commonly begins with a Shaking and Shivering, and then Heat, Drouth, and Restlessness, and other Symptoms of a Feaver follow, after a few Hours, though (sometimes it is much longer before this Symptom comes) the Patient is taken with a violent pricking Pain in one of his Sides about the Ribs, which sometimes reaches towards the Shoulder-blades, sometimes towards the Back-bone, and sometimes towards the Breast, he coughs frequently, which occasions great Pain, so that sometimes he holds his Breath to prevent coughing; the Matter which is spit up at the beginning is little and thin, and often sprinkled with Particles of Blood, but in the Process of the Disease 'tis more and more concocted and mixt with Blood; the Feaver in the mean while keeps the same Pace, and is helpt on by those Symptoms that pro∣ceed from it, and the said Feaver with all its ill Train (viz. The Cough, the Spitting of Blood, the Pain, and the like) is gradually lessened, according to the Degree of the free Expectoration of the Morbisick Matter.

But the Matter occasioning this Disease, does not al∣ways in the Process of it attain the Concoction that is due to Expectoration; for it often happens, that the Matter spit up is yet little and thin, as at the beginning of the Disease; and consequently the Feaver and other Symptoms do not at all remit till they have destroyed the Sick. In the mean while he is sometimes bound in his Body, and sometimes too loose, the Stools being frequent and very liquid; it sometimes happens when the Disease is very high, and Bleeding has not been used, the Patient is not able to Cough, but labouring under a great difficulty of breathing, is in a manner suffocated by the Violence of the Inflammation; which is sometimes so very great that he can't open his Breast large enough for Respiration, without exquisite Pain. And sometimes after a violent Inflamma∣tion, and when Bleeding has been ommitted which ought to have been used at the Beginning of the Disease, an Im∣posthume is presently occasioned, and the Cavity of the Breast is filled with Matter; in which case tho the Original Feaver either wholly ceases, or is at least lessened, yet the Patient is not out of Danger, for an Empyema or an Hectick Feaver following, the Poor Wretch dies Con∣sumptive.

But now though a Pleurisie commonly takes its rise from the proper and specifick Inflammation of the Blood, which is wont to produce it when it is an Original Disease. Yet it comes sometimes accidentally upon other Feavers, of what kind soever they be, from a Precipitation of the Febrile Matter upon the Pleura, or intercostal Muscles, and it happens for the most Part at the very beginning of the Feaver; the Febrile Matter being as yet crude, and not subdued by a fit Ebullition, and so not prepared for a due Separation; but this Inconvenience most commonly arises from an unseasonable and preposterous use of hot Medicines. For Nature being disturbed by this means, is forced to expel the Humour, as yet crude by any Way; and so sometimes the Feaverish Matter is impetuously cast upon the Meninges of the Brain, and then a Frenzy is oc∣casioned; and sometimes upon the Membrane covering the Ribs, and from thence a Pleurisie arises; especially when the Age and Temperament of the Patient, and the Season of the Year, betwixt Spring and Summer contribute to it. For certainly at that Season Feavers are prone to turn to Pleurisies.

Though this Disease has an ill Name, and is of it self more dangerous than any other, yet if it be well managed it is easily cured, and indeed as certainly as other Diseases.

As to the Cure, as soon as I am called, I order that ten ounces of Blood be taken away from the Arm of the Side affected; and afterwards, I prescribe the following Potion to be taken presently after Bleeding.

Take of Erratick Poppy-water four Ounces, of Sal Prunella one dram, of Syrup of Violets one ounce, mingle them, make a Draught.

At the same time I prescribe the following Emulsion.

Take of sweet Almonds number seven, of the Seeds of Me∣lons, and Pompions, each half an ounce, of the Seeds of white Poppies two drams, beat them together in a mar∣ble Mortar, pouring gently upon them a Pint and an half of Barley-water, of Rose-water two drams, of Su∣gar-candy half an ounce, mingle them, make an Emul∣sion, give four ounces every fourth Hour.

I also order Pectorals to be taken frequently: For in∣stance,

Take, of the Pectoral Decoction a quart, of Syrup of Violets and Maiden-hair, each one ounce and an half; mingle them, make an Apozem; let him take half a pint thrice a day.

Take of the Oyl of Sweet-Almonds two Ounces, of Syrup of Violets, and Maiden-hair, each one ounce; of Sugar-candy half a dram; mingle them, make a Linctus, of which let the Patient lick often in a day.

Oyl of Almonds by it self, or Oyl of Flax-seeds, is often used with good Success.

As to Diet, I forbid the use of all Flesh, and all Broths of it, though never so thin: I advise that the Patient be fed with Oaten and Barly-Broths and Panada, and let him drink of a Ptysan made of Barly-water, with the Roots of Sorrel and Liquorish, and the like, and sometimes Small-beer.

Moreover, I prescribe the following Oyntment.

Take of the Oyl of Sweet-Almonds two ounces, of the Oynt∣ment of Marsh-mallows and Pomatum each one ounce; mingle them, make a Liniment, with which anoint the affected side Morning and Evening, applying upon it a Cabbage-leaf.

I also order he should persist in the use of the said Re∣medies through the whole Course of the Disease.

Of the same day I am first called; if the Pain be very violent, I take away again the same quantity of Blood, or else the day following, and so the third day; and after this manner four times one day after another (unless the Patient be well before) when the Pain and other Symptoms rage violently; but if the Disease, being more moderate and less dangerous, permits me to proceed more gently; or if the Patient, being weak, cannot well bear Bleeding so often, I do not repeat it again after it has been twice used, till a day or two be past betwixt each Bleeding.

I have seldom observed, that a confirmed Pleurisie has been cured in grown People with less than the loss of forty

Ounces of Blood, or thereabout; though in Children, once or twice Bleeding is most commonly sufficient; nor does the Diarhea, which sometimes comes upon this Disease, hinder the foresaid repeated Bleeding; for indeed it may be soon stopt by this very Method, without any Astringent Medicine: But I either wholly omit Glisters, or take care that they be injected at as great a distance as may be be∣twixt the Bleedings; and they should be only made of Milk and Sugar.

All the time of the Disease, I take care that the Patient be not over-heated, and therefore I give leave that he be taken every day out of his Bed, and that he keep up some hours according to his Strength; which is of so great mo∣ment in this kind of Disease, that if the Patient be kept continually in Bed, neither this so large Evacuation of Blood, nor other Remedies, how cooling soever, will sometimes do any good for the taking off the said Symptoms.

Presently after the last Bleeding, unless perchance it happens before that all the Symptoms abate, and that the Patient (who has been kept hitherto for some days from all Spirituous Liquors and Strong Nourishment) soon re∣covers his Strength, it will be convenient to give a gentle Purge.

But now if any one should say, That proceeding in this way, we scarce touch upon Expectoration, so far are we from discoursing largely of the ways by which it is to be promoted, through the various Seasons of the Disease, he is to know that these things were not unwarily past over: But after good consideration designedly neglected; for I always thought that they were in very great danger, who committed the Cure of this Disease to Expectoration; for it often happens that part of the Morbifick Matter being concocted, and perhaps spit up, the rest remains crude; the best maturating and expectorating Medicines having been used in vain; for sometimes the Expectora∣tion goes on very well, and sometimes is wholly sup∣pressed. The Patient in the mean while being in Jeopardy on every hand, and for any power I have over Expecto∣ration, which indeed is none at all, may be adjudged for Life or Death; whereas on the contrary by Bleeding, the Morbifick Matter is in my power, and the Orifice of the

Vein may supply the use of the Aspera arteria; for I con∣fidently assert, that this Disease, which if it be treated by the Method we have spoken against, is deservedly reckon'd among the most dangerous, may be as certainly and as safely cured, by the Method I have now prescribed, as any other Disease whatever; nor could I ever find the least Injury befall any one by so large an Evacuation of Blood, though unskilful People think otherwise; but for as much as the Cure of this Disease almost wholly consists in Bleeding repeated, which being performed in places far distant from populous Towns by unskilful Sur∣geons and Farriers, Poor People are often in danger of losing their Arms, and their Lives are hazarded by the Pricking of a Tendon. I thought sit to add here the Cure of such Punctures when they happen: They whose Ten∣dons are prick'd do not presently perceive a Pain, but twelve Hours after Bleeding they complain of it, not so much in the Orifice lately made, as in the Parts tending to the Arm-pits, where at length the Pain fixes, and is chiefly perceived when the Arm is extended: But the part hurt has no great Swelling, that scarce exceeding the bigness of a Hazel-nut; an Ichor continually distills from the Orifice, which is the chief sign of a Puncture of a Tendon, I have known it cured in the following manner.

Take of the Roots of white Lillies four ounces; boil them till they are soft in a quart of Cows Milk; then take of Oat-meal, and of the Meal of Flax-seeds, each three ounces, boil the Meal to the consistence of a Pultis, in a sufficient quantity of the Milk strained from the afore∣said Roots, and mingle the Roots mash'd; make a Cata∣plasm, apply it hot Morning and Evening to the part affected.

CHAP. LVI. Of a Peripneumonia.

A Peripneumonia is an Inflammation of the Lungs, with an acute Feaver, a Cough, and a difficulty of Breathing: They that have this Disease perceive a great Inflammation in the Breast, with a Swelling of the Lungs, and sometimes a pricking Pain; they labour for Breath, and Breath is short; the Feaver is accompanied with great Thirst, Watchings, and a troublesom Cough, and the Spi••tle Bloody, or streaked with Blood.

The formal reason, and the conjunct cause of a Perip∣neumonia, consist in the Febrile Effervescence of the Blood, together with the Stopage of it in the narrow passages of the Lungs, which occasions an Inflammation there.

It is observed that a Peripneumonia frequently follows, or comes upon a Pleurisie, or succeeds a Quinsie.

As to the Prognosticks of this Disease, common Expe∣rience does attest, that 'tis a very dangerous Disease; for many either dye of it, or very difficultly recover Health; and this is manifest from its Aetiology; for a Wound with a great Extravasation or Stagnation of Blood made in the Lungs, is very difficultly cured, and the affected place is never restored to its Pristine State.

The Prognostick Signs which are of chiefest note, are taken from appearance of the Symptoms, and from the nature of things evacuated, and from the degrees of Strength.

A Peripneumonia coming upon a Pleurisie or Quinsie, most commonly is worse than when it comes of it self, or succeeds either of them. But if upon this Disease, after what manner soever begun, an acute Feaver pre∣sently follows, with great Thirst, Watchings, and an Orthopnoea; it is ill, and yet much worse, if a Deli∣rium, or Phrensie, or Convulsive Motions, or an Hemi∣plegia come upon it.

Moreover, The Patient is as much indangered if he be very Short-breathed, if he be troubled with Vomiting, or frequent Swooning away, a weak Pulse, or cold Sweats: For while these Symptoms are urgent, the Obstruction of the Blood in the Lungs is not at all removed, nothing is digested or spit up; but the Circulation of the Blood being more and more obstructed, and its Accension by Respiration hindred, the Animal Spirits are much dis∣ordered; so that at length the Strength is quite spent, and the Vital Flame extinguished.

As to the Prognosticks from things evacuated, we ob∣serve a Peripneumonia to be dangerous when nothing is spit up; Next to this, when the Spittle is thin and crude, mixed with Blood; it's far better when the Spittle is yellow and thick, streaked with a little Blood. The Urine being yellow from the beginning, and of a good Con∣sistence, with a cloud in the midst, shews that almost all the Impurities are lodged in the place affected; when from that state it is changed into a thick and turbid Urine, it shews that the Morbifick Matter is resorbed from that part into the Blood: But if such kind of Urine be suddenly changed into a thin one, then a Delirium, or Death it self, is at hand. Much Sweat, and plenty of Urine, a Diar∣rhaea, Bleeding at Nose; the Flux of the Courses, or of the Hemorrhoids, are good Signs in this Disease; yea, any of these Evacuations happening seasonably, do frequently discharge the Disease.

The condition of Strength is ever of great Moment in making a due Prognostick in this Disease; for oftentimes when there be dreadful Symptoms, as a violent Feaver, a difficulty of Breathing, with a Cough, Watchings, and other ill Signs, if the Pulse be as yet strong, and the Ani∣mal Spirits vigorous, there is more hope of the Patient, than when these things are more sedate, if the Pulse be weak, and the Spirits torpid and oppress'd.

The first Indication of Cure in a Peripneumonia, is, That the Blood impacted in the Vessels of the Lungs, and causing Obstruction and Inflammation, may be dis∣cussed from thence, and restored to its wonted Circula∣tion; but if it cannot be done, the second Indication will be, that the Matter be duly digested, or suppurated, and presently spit up.

While the former Indication prevails, the Intentions of Healing may be these following: First, That the more plentiful Flux of Blood to the part affected be prevented: Secondly, We must endeavour that the Blood stagnating or extravasated in the Lungs, be resorbed again by the Veins into the rest of the Mass, and restored to Circu∣lation: And that it may be the better done, the Blood ought thirdly to be freed from its Clamminess whereby its Fluidity is hindred. Fourthly, We must take care of the most urgent Symptoms, viz. The Feaver, Cough, Watchings, and difficulty of Breathing: But if notwith∣standing all these things, the other Indication shall come into use; it will be requisite to prescribe maturating and expectorating Medicines vulgarly so called, together with these Remedies just mentioned.

That we may answer the first and second Intention together, Bleeding is for the most part requisite in every Peripneumonia, yea, sometimes it ought to be frequently repeated; for the Vessels being emptied of Blood, do not only withdraw the Nourishment of the Disease, but do often resorbe the Matter impacted in the part affected: Wherefore if Strength remain, and the Pulse be strong enough, large Bleeding is convenient at the very beginning; but otherwise let it be used in a small quantity; which however may be repeated as occasion offers it self. It is to be noted, that Blood drawn in a Peripneumonia, and also in a Pleurisie, after it's cold, contains in its Super∣ficies a small viscous and discoloured Film. Moreover, we may observe one while the Blood entirely bad, ano∣ther while only part of it is subject to this change; for when the Blood is received in three or four Dishes, some∣times in all, but oftner in the second and third Dish, it is apparently bad, and in the first and last good enough. Wherefore it is commonly ordered, that the Blood is always to run so long, till that which is so depraved begins to come forth; and if there be sufficient Strength, the flow∣ing out is to be continued till it runs good again: Indeed as frequent Experience does approve of this Practice, so doth Reason it self; for in this Disease, seeing the whole Mass of Blood does not presently acquire that Clamminess, the depraved Portions are chiefly accumulated about the place of the Obstruction, and adhere on every side in the

lesser Vessels; wherefore the Blood first flowing out by Phlebotomy is often good: Afterwards, the Vessels being emptied, receive the other Morbifick Stagnating before, and restore it to Circulation; and when Portions of it placed near, troop together to the Orifice of the Vein, they flow out together; and after that the corrupted Blood hath flowed out, the residue more pure doth succeed. Wherefore in this case, let Incision be ever made with a large Orifice, and let the Blood be drawn out with a large and continued Stream; for otherwise, if in the midst of Bleeding, the bad Blood issuing out, the Orifice (as the Manner of some is, that the Spirits should not faint) be closed with the Finger; when it is opened again, the pure Blood will flow next, but the bad sliding by, if there be any remaining, will not presently return to that Orifice. Be∣sides Phlebotomy, many other Remedies, namely, whatever does repress that Urgency of Blood, and empty the Passages thereof, are to be used, wherefore a very thin Diet is prescribed, for the most part meerly of Barley and Oats; and though Catharticks are altogether prohibited, because they disquiet the Blood, and hurry it impetuously upon the Part affected, yet Glisters which gently loosen the Belly, and draw the Impurities of the Blood towards the Belly, ought to be daily used. Moreover Juleps, and temperating Apozems which restrain the Feaver of the Blood, and evacuate the Superfluous Sorosities of it, and gently open the Passages of the Breast, are used with good Success.

The third Intention of Healing which respects the ta∣king off the Clamminess or Obstructing Viscosity of the Blood, is wholly to be performed by Remedies, which unloose the Frame thereof too much bound, and dissolve the Combinations of the Salts, as testaceous Powders, the Tooth of a Boar, the Jaws of a Pike, and other things indued with an Alkali Salt, also Sal-prunella. I have frequently known the Spirit of Sal-Armoniack, and Harts-horn to have yielded notable Relief in this Disease, and the Infusion of Horse-dung, by reason of its volatile Salt is of great use, though it be a common Remedy.

As to the Symptoms and their Cure, very many Reme∣dies appropriated to these, fall in together with the for∣mer, for against the Feaver the same Juleps and Apozems,

which appease the Heat of the Blood, and withall recreate the Animal Spirits are to be used; to which, in respect of the Cough and Difficulty of breathing, temperate pectoral Remedies are added. The greatest Difficulty is what ought to be exhibited against want of Sleep, when it is very urgent; for Opiats because they further the Difficulty of breathing in this Disease, are scarce safely taken; yea sometimes they are very pernicious; wherefore Laudanum, and the strong Preparations of Opium, are to be shunned in a Peripneumonia, more than a Dog or a Snake.

Nevertheless, Anodyns and gentle Hypnoticks, as Water and Syrup of Red Poppies are not only allowed, but are accounted Specifick Remedies in this Disease, and in a Pleurisie; and sometimes it will be expedient to use Diacodiats, if the Strength be sufficient, and the Pulse strong enough; for the Pain of the Breast, if at any time it be troublesome, it is necessary to apply Liniments, Fo∣mentations, and Cataplasms.

The second curative Indication which intends the Di∣gestion of the Matter impacted in the Lungs, (if it can∣not be dispersed or resorbed,) and to throw it up by Spit∣tle requires ordinary, maturating, and expectorating Medicines that are temperate, such as asswage Thirst, and appease the Feaverish Heat. The more select Remedies, that are chiefly accommodated to this Disease shall be now mentioned.

The Medicines conducing to the first and second In∣tention are prescribed according to the following Forms.

Take of the Waters of Maries Thistle ten ounces, of red Poppies three ounces, of the Syrup of red Poppies one ounce, of Pearls prepared one dram, make a Julep.

The Dose is six Spoonfuls every fourth Hour.

Take of Black Cherry Water, of the Water of Carduus Benedictus, and of Baulm, each four ounces, of the Powder of Boars Tooth one dram, of Syrup of Violets ten drams, make a Julep to be taken after the same man∣ner.

Take of Grass-roots three ounces, Shavings of Ivory, and Harts-horn, each three drams; Raisons stoned one ounce

and an half, Liquorish two drams; boil them in Spring Water, from three Pints to two; to the strained Liquor add, Syrup of Violets one ounce, Sal-prunella one dram; make an Apozem. Take three or four ounces thrice a Day,

For the same Intention, viz. that the Vessels being emp∣tied may substract the Nourishment of the Disease, or re∣sorbe the morbifick Matter, Purging is prescribed by many.

The Ancients in this Disease as in many other, used after Phlebotomy, Preparatives and Purgatives in a con∣stant Course; and of late the Chymists with greater Boldness give Vomits, and prefer them before all other Remedies in Peripneumonia; yea neglecting or forbidding Bleeding, they chiefly depend on Stibiate Vomits, but I think there cannot be a more pernicious Course; for though sometimes they do no hurt in rustick and robust Bodies, yet they are without Success; but in tender Con∣stitutions they are in a manner as destructive as Poison.

But as to Purging, though it may not be convenient at the very Beginning, for indeed it's then most common∣ly injurious, yet the Fluxion of the Morbifick Matter being stopt, and the Effervescence of the Blood being appeased, we may safely evacuate the Body with a leni∣tive Purge.

Take of the Decoction of Senna gerionis four ounces, of Syrup of Roses solutive one ounce, mingle them, make a Potion. Or,

Take of the best Senna three drams, of all the Cassia, and Tamarinds, each half an ounce; of Coriander Seeds two drams, let them be boiled in a sufficient Quantity of Fountain Water to six ounces; when it is strained add one ounce of Syrup of Violets; let it be clarified with the white of an Egg, and give it.

Purgatives are not always to be given, nor ever unad∣visedly in this Disease, but Glisters are used frequently, and most commonly daily; they must be gentle and emol∣lient, such as easily move the Belly, without any great Agitation of the Humours or Blood; for this purpose,

Milk or Whey is often convenient, with brown Sugar, or Syrup of Violets. Or,

Take of the Leaves of either Sort of Mallows, of Melilot and Mercury, each one handful; of Linseed, and sweet Fennel-seeds, each half an ounce; of sweet Prunes Number six; boil them in a sufficient Quantity of Spring water to a Pint, to which add Syrup of Violets one ounce, Sugar ten drams, Sal Prunella one dram, make a Glister.

Medicines for the third Intention, viz. for dissolving the Clamminess of the Blood, are wont to be administred in the Form of a Powder, of a Spirit, or a Potion, according to the Manner following.

1. Powders.

Take of Crabs-eyes two drams, of Sal prunella one dram and an half, of pearled Sugar one dram, make a Powder for six Doses, one to be taken every Sixth Hour, with a proper Julep or Apozem. Or,

Take of the Tusk of a Boar, of the Jaw of a Pike, or of Crabs-eyes, each one Dram and an half; of the Flowers of Sal Armoniack, of the Powder of red Poppy Flowers, each half a dram; mix them for four Doses,

2. Spirits and Chymical Liquors.

Take of Spirit of Sal-armoniack distil'd with Olibanum three drams, the dose is from fifteen drops to twenty, thrice a day. Or,

Take of the Spirit of Ʋrine, or Soot, after the same manner.

Take of the sweet Spirit of Nitre three drams, the dose it from six drops to ten.

3. Potions.

Take of Carduus-water one Pint, fresh Horse-dung three ounces, dissolve it warm, and filter it; the dose is three or four ounces twice or thrice a day; add half an ounce of Syrup of Violets, or of red Poppies. Or,

• ...

  Take of the Leaves of Dandelion two handfuls bruised, and infused in half a Pint of the Water of Maries Thistle, Treacle-water half an ounce, press them out, add Pow∣der of Crabs-eyes one dram; take four or six Spoonfuls thrice a day.

The fourth Intention of Healing in respect of the Symp∣toms greatly urging, does suggest divers Sorts of Opera∣tions. First, in respect of the Feaver, the Juleps and Apozems above prescribed are convenient. Moreover the Use of Sal-prunella ought to be frequent. Secondly, for the Cough and difficulty of Breathing, Lambatives and Decoctions, or Pectoral Juleps are administred with Success.

Take of the Syrups of Jujubes, and Maiden-hair, each one ounce and an half; of Syrup of Violets one ounce, Flowers of Nitre one Scruple, make a Linctus to be lick'd now and then.

Take of Syrup of Marsh-mallows one ounce, of Diacodium, and of Syrup of red-poppies, each half an ounce; Pow∣der of Crabs-eyes two Scruples, make a Linctus to be ta∣ken the same Way.

Take of the Syrups of Hyssop, and Liquorish, each one ounce and an half; of the Powder of red-poppy Flowers one Scruple, of Crabs-eyes one dram, of the Lohoch of the Pine six drams, make a Lohoch, take the Quantity of a Nutmeg four times, or oftner in a Day.

Take of the Roots of Grass, Chervil, Marsh-mallows, each one ounce; Figs Number four, Jujubs, and Sebastines, of each Number six; Raisins one ounce, Liquorish three drams, Barley half an ounce, boil them in three Pints of Spring-water to a Quart, strain them, the Dose is three or four ounces.

Take of Raisins stoned one ounce and an half, Filberds number four, of Liquorish sliced three drams, of Hyssop Water one Pint and an half, infuse them warm in a close Vessel six Hours, strain them, and add one ounce and an half of Syrup of Marsh-mallows, make a Julep; the dose is three or four Spoonfuls often in a day, swal∣lowing it by degrees.

Thirdly, Against Watching.

Take of Red-poppy water three ounces, of Syrup of the same six drams, of Epidemick-water two drams, make a Draught to be taken at Bed-time.

If the Pulse be strong, and the Strength remains.

Take of Cowslip Water three ounces, of Diacodium half an, ounce, make a Draught to be taken at Bed-time.

Fourthly, If the Pain be much about the Place affected.

Take of Oyntment of Marsh-mallows two ounces, of Oyl of sweet Almonds one ounce and an half, mingle them, make a Liniment to be applyed with thin Paper.

Fifthly, For the last Intention of healing, (which assist∣ing the Secundary Indication prescribes Medicines matu∣rating, and expectorating) the following Forms are con∣venient.

Take of Linseed Oyl fresh drawn three ounces, Syrup of Violets two ounces, of Hissop water half a Pint, mingle them in a Glass, take two or three ounces twice or thrice a day, shaking the Glass first.

Take of Olibanum powdered one dram, put it into an Ap∣ple made hollow, roast the Apple in the Embers, let him eat it at Bed-time, repeating it three or four times.

Take of Oyl of Almonds fresh drawn, of Syrup of Maiden∣hair, each one ounce and an half; Sugar-candy, two drams, stir them in a glass Mortar till they are perfectly mixed, make a Linctus to be taken often in a day with a Liquorish Stick, also let a Spoonful be taken thrice a day in a Draught of Posset drink.

It would be easie to produce many Observations of Peripneumonick Patients, but seeing the Type of the Disease, and the Reasons of the Symptoms, are in all al∣most the same, it will be sufficient to mention only one or two; and while I was writing these Things, I was sent

for to a Patient very Sick of a Peripneumonia, he was about fifty Years old, lean and cholerick, he fell into a Feaver by taking Cold, he was troubled with a Cough, a pain in the Breast, and a Difficulty of Breathing, when he had con∣tinued thus four days without any Remedy or Physical Administration, I found him in a great Feaver, with Thirst, and a great Inflammation in the Breast, breathing very difficultly and painfully, and ratling, insomuch that he seemed in the Agony of Death; but because his Pulse was strong enough, though quick and disturbed, I present∣ly ordered him to be blooded, and that eight or ten ounces of Blood should be taken away, and seeing he was little relieved after three Hours Intermission, a Glister being first administred I ordered twelve ounces more of Blood to be taken away; moreover I prescribed Spirit of Harts horn, twelve drops of it to be given every sixth Hour with a proper Julep, and between I ordered a Dose of the following powder to be administred,

Take Powder of Crabs-eyes, and Sal-prunella, each one dram and an half; of Pearl one dram, Sugar-candy two scruples; make a Powder to be divided into eight Doses.

Moreover, he took as often as he pleased a Draught of a pectoral Apozem; by the use of these within three hours all the Symptoms began to abate, and the Night after he sweated and slept a little; the day after I repeated Phlebo∣tomy, and then continuing the same Remedies, he recovered in four or five Days; the Blood we took from him was always in the Superficies viscous and discoloured.

A certain Gentleman of a Sanguine Complexion, and of a strong Habit of Body, after immoderate drinking of Wine, fell into a Feaver with a grievous Peripneumonia, so that Heat and Thirst mightily afflicting him, sitting always upright in his Bed or Chair, and breathing short and very frequent, he could scarce draw in Air enough to sustain the vital Flame; because he could not undergo large Bleeding, I took it away by degrees, twice or thrice day after day; Glisters were often injected. Moreover, Apozems, and Juleps, also Spirit of Sal-armoniack, and Testacious Powders were given by turns; within four or five days the Feaver some what abated, also he began to

breath better, and sometimes to sleep a little; yet he did always complain of a great Heaviness of his Breast, and of an intolerable Oppression of the Lungs; wherefore when Bleeding was no longer safe, I applied very large Blisters to the Arms and Thighs; the Blisters on his Arms soon dried up, but those on his Legs did not only remain open, but after five or six days did run very much, and afterwards almost for a Month daily discharged great Plenty of a sharp Ichor; in the mean time his Lungs sensibly amended, and at length were freed of their Burden. Lastly, The little Sores raised by the Blisters were diffi∣cultly cured, and not without frequent Applications of Medicines.

CHAP. LVII. Of a Bastard Peripneumonia.

A Feaver accompanied with many Peripneumonick Symptoms, invades yearly about the beginning of Winter, but oftner at the End of it; it chiefly seizes those that are of a gross Habit of Body, and middle aged, or (which oftner happens) those that are older, and too much addicted to Spirituous Liquors, especially to Brandy; for when the Blood in such Men has been burdened with Flegmatick Humours, heapt up in the Winter, and stirr'd into a new Motion by the approaching Spring, a Cough is presently occasioned by this Means, by which the said Flegmatick Humous rush upon the Lungs; at which time, if the Patient chance to live irregularly, and continues to drink freely such spirituous Liquors, the Matter growing almost thick, which occasioned the Cough, stops the Pas∣sages of the Lungs, and the Feaver consumes the Mass of Blood: At the beginning of the Feaver, the Patient is sometimes hot and sometimes cold, is giddy, ond com∣plains of a launcing Pain of his Head; when the Cough is violent, he vomits up all liquid things when he coughs, and sometimes when he does not; the Urin is turpid and very red; the Blood taken away is like that of Pleuriticks;

he is often short breath'd: If he cough, his Head akes just as if it were cleft in Pieces (for so the Patient terms it) there is a Pain of the whole Breast, or at least a Pressure of the Lungs, which is perceived by the Standers by when the Patient coughs; the Lungs not sufficiently dilating themselves, the vital Passages are as it seems shut up by the Swelling, and the Circulation on that Account is so intercepted, and the Blood so stopt, that there are no Signs of a Feaver, though this may also happen by reason of the Plenty of the Flegmatick Matter, by which the Blood is so burdened, that it cannot rise to a perfect Ebul∣lition, especially in gross Bodies.

In curing this Feaver I count I am oblidged to take away that Blood by Phlebotomy, which occasions the Suf∣focation and Inflammation of the Lungs, and to ventilate and open the Lungs with Pectoral Remedies, and to miti∣gate the Heat of the whole Body with a cooling Diet: but whereas on the one hand the Heap of Flegmatick Matter contained in the Veins daily supplying Matter for the In∣flammation of the Lungs, may seem to indicate Bleeding often repeated; yet on the other hand I found by the best Observation I could make, that Bleeding often repeated, has succeded very ill in Feavorish People of a gross Habit of Body, especially if they have passed the Flower of their Age, and therefore I forbore the Repetition of it; and instead of it, used frequent Purging, which is well enough substituted for it, in those that abhor large and often re∣peated Bleeding.

Therefore I proceeded after this manner: I ordered that the Patient should be blooded in the Arm lying in Bed, and that he should not rise till two or three Hours after; for all Blood letting somewhat weakning and disordering the whole Body, may by this means the easier be born; for the Patient lying a Bed can better bear the taking away of ten ounces, than of six or Seaven when he is up; the next day I give the following Potion in the Morning.

Take of Cassia extracted one ounce, of Liquorish two drams, of fat Figs number four, of the Leaves of Senna two drams and an half, of Agarick trochiscated one dram, boil them in a sufficient Quantity of Water, in four ounces of the strained Liquor dissolve one ounce of Man∣na,

of Syrup of Roses solutive half an ounce, mingle them, make a Potion.

The next day I used to bleed a second time; and the next day save one, I order the Purging Potion above pre∣scribed, to be repeated, and to be given every other day till the Patient is quite well; when the Patient does not purge, I advise him to use a pectoral Decoction, and Oyl of sweet Almonds, and the like.

I forbid the use of Flesh, and the Broth of it, but es∣pecially of all spirituous Liquors; in the stead of which I allow him for his ordinary drink a Ptisan of Barley and Liquorish, and small Beer, if he desire it.

And indeed, the Bastard Peripneumonia occasioned by a great deal of Flegmatick Filth heapt up in the Blood, is to be cured by Bleeding repeated, and by Purging.

Though this Bastard Peripneumonia is something like a dry Asthma, both as to Difficulty of Breathing, and some other Symptoms; yet it is sufficiently distinguished from it; for in this there are manifest Signs of a Feaver, and Inflam∣mation, which never appear in that, though in this kind they are much less and obscurer than those which accom∣pany a true Peripneumonia.

But you must carefully observe, that 'tis by no means safe to forbid the drinking of Spirit of Wine, and such Liquors all of a sudden, when the Patient has been a while addicted to them, but they must be left off Gradually; for there is Danger of a Dropsie from an hasty and abrupt Change, which ought to be observed in all Diseases that come on this Occasion; and seeing there has been Mention made of Spirit of Wine, I will say by the by, that indeed it ought to be wished that they were either wholly prohibited, or at least used for refreshing the Spirits, and not for extin∣guishing them; or that the internal use of them was wholly abdicated, and that they should be only used by Surgeons, in Fomentations to digest Ulcers, or to be applied to Burns, in which Case they are better than any other Me∣dicine yet found out, for they defend the under Skin from Putrefaction, and so soon perform the Cure (not wait∣ing for Digestion, which requires a considerable Time) if a Rag dipt in Spirit of Wine be presently applyed to the Part hurt, with Scalding Water, Gunpowder, or the

like, and moistned with the foresaid Spirit now and then, till the Pain from the Fire be quite gone, and afterwards only twice a day.

CHAP. LVIII. Of an Empyema.

AN Empyema is a Collection of Matter within the Cavi∣ty of the Breast, whereby the Organs of Respiration are oppressed. This Collection of Matter is occasioned either by a Pleurisie, Peripneumonia, or Angina, suppura∣ted and broken.

The Signs of an Empyema, either shew it is coming, or that it is already perfectly formed. Of the former kind are these Diseases going before, from whence this usually arises, as a Pleurisie, Peripneumonia, and Angina; and sometimes also a Bruise or Wound in the Breast, and sometimes also other Diseases not well carried off; from whence there will be a greater Suspicion of an Empyema, if after a Week or two passed without plentiful Spitting, Shaking and a Feaver, and Faintness of the Spirits super∣vene; and then after fourteen or twenty Days, the Signs of a confirmed Empyema will appear, viz. Difficulty of Breathing, a Weight upon the Breast, Fluctuation of the Matter, an uneasiness from Motion, Thirst, and almost always a small Feaver, Redness of the Cheeks, Restles∣ness, and Watching.

As to the Cure of an Empyema, you must first consider whether the Signs of its being already made be certain or dubious; in the former Case there is not much use of Me∣dicines; but the Body being well prepared, we must pre∣sently open the Side; wherefore if from a Pleurisie, or a Peripneumonia not well cured, or if by reason of Blood extravasated by a Blow, a Fall, or Wound, a Fluctua∣tion of Pus, of Purulent or Bloody Matter be perceived, and the Spittle lessened, or none at all, it is to no purpose to wast Time in using expectorating and maturating Me∣dicines; but having loosned the Belly, and attemperated

the Blood and Humours, by Juleps, Apozems, and Ano∣dyns, an Aperrion must be undertaken, either by the Knife, or in tender and timerous People by applying a Caustick betwixt the sixth or seventh Vertebra; and when the Eschar is made, we must divide it gently with a Knife, and pass the Knife gently into the Cavity of the Breast; then having put in a Silver Pipe, the Matter must be eva∣cuated by degrees; but it must be let out as hastily as the Strength of the Patient will permit; for that which re∣mains within, will stink horridly in a few days; to pre∣vent which a cleaning and Traumatick Liquor must be in∣jected, with a Syringe twice or thrice a day. It is not necessary to describe particularly the Manner of the Ope∣ration, it being well known, and often practiced by skil∣ful Chirurgions, and daily practiced. After it is cut open and dressed as it ought to be, there is little more to be done by the Physician. An exact Course of Diet, a fre∣quent Loosning of the Belly (so oft as there is Occasion) by Glisters, and also these Remedies, which are Vulgarly called Traumatick, which do hinder the Dissolution of the Blood, and keeps the Seresities of it from falling upon the Breast to hurt it, ought to be prescribed. But if the Signs of this Disease are uncertain, or altogether doubtful, the Breast ought not to be opened too soon or rashly. I have known some have their Breasts opened to no purpose, when they have spit stinking Pus, and they have also la∣boured under a Dyspnaea, and a Difficulty of Breathing; therefore when an Empyema is not evident by Pathogno∣mick Signs, Medicines (such as are prescribed for the Cure of a Peripneumonia) which help Expectoration, and evacuate gently by Sweat and Urine, ought to be used for some time: If these do not any Good, and the Empyema still remains, or Augments, then the Breast must be opened.

As to the Forms of the Medicines requisite for the Cure of an Empyema before Section, the same Remedies which were prescribed for a Peripneumonia, are to be used: but after the opening of the Breast the following are chief∣ly to be used.

To prevent Fainting which may happen either in the Operation or after it, the following Julep must be in Readi∣ness, and four or five Spoonfuls of it must be taken upon occasion.

Take of the Waters of Balm, and Black Cherries, each six ounces; of Aqua-mirabilis one ounce, of Pearl powdered one dram, of Syrup of Gilly-flowers one ounce, mingle them, make a Julep.

The following Decoction must be taken twice or thrice in a day.

Take of the Leaves of Harts-tongue, Speedwell, Hemp, Agrimony, Colts-foot, Mouse-ear, Sanicle, each one handful; of the Roots of Madder, and Chervil, each one ounce; of Barley half an ounce, of red Cicers half an ounce, Raisons of the Sun one ounce and an half; boil them in two Quarts of Fountain-water till half is con∣sumed, sweeten it with Clarified Honey, or with the Sy∣rup of Mouse-ear as it is taken.

If there be no Feaver the following Pills may be used.

Take of the Powders of Crabs-eyes two drams, of Flowers of Sulphur one dram, of Sal-Prunella half a dram, of the Species Diarrhodon-abbatis one Scruple, of venice Tur∣pentine washed a sufficient quantity; make a Mass, make small Pills, take a Scruple or half a dram of them Morning and Evening; or the Turpentine being omitted, half a dram or two Scruples may be taken in the Form of a Powder twice a Day.

CHAP. LIX. Of a Consumption.

A Phthysis in general, is a Consumption of the Muscular Parts of the Body: It is twofold, either Original or Sympromatick. There are two Species of the ori∣ginal Phthysis, viz. Atrophia, and a Consumption of the Lungs.

An Atrophia is twofold, viz. Either Nervous, or arising from Inanition.

A Symptomatick Phthysis is occasioned by other Diseases going before.

An Atrophy, or Nervous Phthysis, is a Consumption of the whole Body, without any considerable Feaver, Cough, or difficulty of Breathing, but loss of Appetite and Indi∣gestion accompany it; upon which account Faintness, and a daily wasting of the Body follow. This sort of Con∣sumption sometimes happens in England, but very often to the Inhabitants of Virginia, when they return hither.

In the beginning of this Disease, the Body appears Oedematous, the Face Pale and Squalid, and the Stomach nauseates every thing but Liquors; and the Strength is so languid, that the Sick, before the Fleshy parts are evi∣dently consumed, is rendred so very Weak, that he can∣not keep from Bed, the colour of the Urine is most com∣monly of a deep Red, and very little in quantity, though sometimetimes (but rarely, as it is wont to happen in Diseases of the Nerves) it is pale, and voided in a great quantity; but no considerable Feaver can be discerned, either by the Pulse, Drouth, or Heat, how high-coloured soever the Urine is; so that the Pathognomonick Signs of this Consumption beginning, are Faintness and want of Appetite, without any notable Feaver, Cough, or short Breath; though in progress of the Disease, when the habit of the Body is wasted, some difficulty of Breathing (as is usual in all that are Faint) may be perceived.

This Disease is very difficultly cured, if the Physician be not made use of at first; it ends in an Hydropical and

Oedematous Tumour of the Body, especially of the lower parts, and then the Disease is past all hope.

The main of the business must be performed by Sto∣machick Medicines, and such as strengthen the Nerves, such are Chalybeats, Antiscorbuticks, and Cephalicks, and bitter things of every kind: For Instance, Let the Sick take, if his Body be bound, four Ounces of the bitter Decoction with Senna, and every fourth night two Ounces of Tinctura Sacra, or of the Tinctura of Hiera Picra, made in the Waters of Rue, Black Cherries, Compound Peony.

In his ordinary Drink, hang a Bag of Cephalicks, and Antiscorbuticks; an hour before Dinner let him take half a Dram of Elixir Proprietatis in a Draught of Whitewine, wherein Wormwood has been infused: Apply to the Region of the Stomach the Magisterial Stomachick Plaister, with a few drops of the Chymical Oyl of Cinnamon and Wormwood; or foment the Stomach daily with Aro∣matick Bags, made of the Leaves of Mint and Worm∣wood, Cinnamon, Mace, Zedoary, Galingal, Cyperus, and Sweet-smelling Flag, and boil'd in Claret: If it be Summer-time, let him drink Chalybeat Waters; if Win∣ter, Syrup of Steel or the Wine of it, made by quenching Filings of Steel in good Whitewine three or four times; then by infusing in it Zedoary, Galingal, Nutmegs, sharp Cinnamon, Mace, Cubebs, and Cloves grosly beaten: But amongst Chalybeats, Mynsichts extract is thought the best, which must be given in the form of a Bole, or of Pills, for the space of twenty or thirty days. For In∣stance,

Take of the Extract of Mynsicht half a scruple, Balsam of Gilead seven drops, of Haly's Powder six grains, of the Compound Powder of Wake-Robin four grains, of the Powder of Liquorish a sufficient quantity; make Pills of an ordinary size, repeat them every day once.

Opobalsamum by it self, as also Spirit of Harts-horn, and Spirit of Sal-armoniack, are very effectual in this case, because they are agreeable to the Nerves. For Instance, Let the Sick take eight or ten drops of Opobalsam, or of Spirit of Harts-horn, in a sufficient quantity of Sugar-candy.

Let him endeavour to make himself Chearful by Exercise and Company; for this Disease most commonly proceeds from Care and Sorrow; and let him live in a good and open Air: And because the Stomach is chiefly affected in this Disease, he must eat a delicate sort of Meat, and not be too long accustomed to any one.

The Consumption that proceeds from Innanition is next to be discoursed of; and first, Of that which proceeds from an Hemorrhage, whither by the Nostrils, or from the Lungs by Coughing, or from the Jaws by Hawking, or from the Stomach by Vomit, or from the Reins by Urine, or from the Hemorrhoidal or Uterin Vessels in the customary monthly Purgation, or from hard Labour; or lastly, from Wounds when there has been a great and long Flux of Blood. In this case the Hemorrhage must be first stopt by thickning Remedies, and by binding hard the extream parts; and if there be occasion, and the Sick have Strength, Bleeding must be used frequently, but sparingly; you must apply, if the part will admit of it, Galen's Stiptick Plaister, the Royal Stiptick Water, Oxycrat cold, Ink, Ashes of Hair a little burnt in a Retort, and with Vinegar made up in the form of a Cataplasm, true Bole, Dragons blood, and the like; and they must be often renewed.

Let the Sick take inwardly three or four times a day twenty or thirty drops, or more, of the Royal Stiptick-water, in a Draught of the Milk-water, and five or six Spoonfuls of the clarified Juices of Plantane and Nettles; or let him take frequently in a Spoon the following Linctus.

Take of Syrup of Purslain three ounces, of true Bole, Dra∣gons blood, of the Troches of Spodium, and of sealed Earth, each two scruples; of Japan Earth one dram, of Gum-Tragacanth a sufficient quantity dissolved in Plan∣tane-water; mingle them, make a Linctus.

Or let him take thrice a day the quantity of a Nutmeg of the following Electuary.

Take of the Conserve of red Roses one ounce, of the Troches of Ambar three drams, of true Bole, and of Dragons

blood, each half a dram; with Syrup of Myrtles make an Electuary.

Let him take also every night at Bed-time five or six Spoonfuls of the following Julep, shaking the Viol when he uses it.

Take of Plantane-water six ounces, of Cinnamon-water hordeated three ounces, of distilled Vinegar half an ounce, of true Bole, and of Dragons blood, each half a dram; of London Laudanum three grains, of Syrup of Myrtles one ounce and an half; make a Julep.

The Flux of Blood being stopt, we must endeavour by all means to raise the weak Blood with new and good Chyle, and to extinguish the Febrile Flame, if it be begun, least a Consumption should follow; wherefore the Sick must be frequently nourished with good Broths, and variety of Meats that are full of Nourishment, and of easie Digestion, and pleasant to the Stomach; but he must be sure to abstain from Wine, and from things salted and spiced; and because this sort of Sick, and all other that are inclining to a Consumption, are subject to Anger, Sorrow, Oppressions of the Hypochonders, Hysterick Passions, and want of Appetite; upon which account they can neither eat plentifully, nor digest well: They must endeavour to recreate themselves, and to take the Benefit of a wholsome and free Air, which most com∣monly does more good than Medicines.

But if the Sick be Hectick, the Peruvian bark given freely is of admirable Vertue; and if there be occasion the Sick must use a Milk Diet, or Chalybeat Waters; but you must by no means Loosen the Body.

A Consumption also often arises from a simple Gonor∣rhaea, and the Whites; also from Imposthumes and large Ulcers, and also from giving Suck, from a Loosness and Dysentery, from a Diabetes, from Salivation, a Dropsie, violent Sweating, and the like.

But a Consumption of the Lungs is the chief: The Cause in general of it, is an ill Disposition of the whole Mass of Blood, and of the Nervous Spirit, contracted by degrees by the various Procatarctick Causes, whereby the

Acrid and Malignant Serum of the Blood separated by the soft and glandulous Paranchyma of the Lungs, stuffs and inflames them, and at last causes Ulcers, which is indeed the containing Cause of this Disease.

The Procatarctick Causes are first, a Suppression of the usual and necessary Evacuations, as of the Courses, the Lochia, of old Ulcers, of Issues, of Sweat by the Soles of the Feet, and other parts of the Body, and the like, without correcting and removing the Causes on which they depend; whereby the Blood is vitiated. Secondly, Great Passions of the Mind, especially Fear, Sorrow, Anger, deep Thinking, unseasonable and too hard Study, and the like. Thirdly, Eating and Drinking too much, and unseasonably, especially Drinking too much of Wine and Spirituous Liquors. Fourthly, Neglect of due Exer∣cise. Fifthly, Long Watching. Sixthly, Marshy and gross Air, and Smoak of Coals. Seventhly, An Heredi∣tary Disposition. Eighthly, An ill Conformation of the Breast. Ninthly, Contagion. Tenthly, Stones generated Preternaturally in the Lungs. Eleventhly, Particular Dis∣eases which corrupt the Blood and Spirits.

By these and such-like Procatarctick Causes, the Body being predisposed for a Consumption, the Disease takes its rise immediately from taking Cold.

For the Cure of an original Consumption of the Lungs, Blood must be drawn from the Arm, especially if the Sick be Plethorick, or accustomed a long while to Blood-letting, and let six, seven, eight or ten Ounces be taken away. Secondly, It is requisite after Bleeding, especially if the Disease took its rise from a Surfet, or is accompanied with Nauseousness, or a Disposition to Vomiting, to give a gentle Vomit of Honey, or of Oxymel of Squills, and sometimes of the Vinum Benedictum in a moderate quan∣tity: The Vomit, especially if the Sick bear it well, and if it be necessary, may be repeated three or four times at the distance of three or four days betwixt each Vomit: It is best to give the Vomit towards the Evening, the Sick being blooded the day before; and at Bed-time after every Vomit you must give an Anodyn.

Take of Honey of Squills half an ounce, give it in a Draught of Posset-drink, and repeat twice or thrice in an hour, if the Sick does not Vomit enough.

This is proper for Children and young People.

Take of Oxymel of Squills, and of Oyl of Sweet-Almonds, each one ounce; mingle them, let the Sick, take it in a large Draught of Posset-drink, and let it be repeated twice or thrice in an hour if there be occasion. Or,

Take of Vinum Benedictum seven drams, Syrup of Violets two drams; mix them and make a Potion for Vomiting. And, if it be needful, you may give of Oxymel of Squills and Oyl of Sweet-Almonds, each half an ounce, in a Draught of Posset-drink twice or thrice, in the Ope∣ration.

Salt of Vitriol is not at all convenient in this case, because it irritates and pricks continually the Glandulous parts about the Jaws, and so promotes the Flux of the Serum, and increases the Cough. After the Vomit hath done working, give the following Opiat or the like.

Take of the Pectoral Decoction clarified four ounces, of Tin∣cture of Saffron two drams, of Helmont's liquid Lauda∣num fifteen drops, of Syrup of Violets two drams; mingle them, make a Draught; or you may give ten grains of the Pill of Hounds-tongue, or of Storax.

Thirdly, It is convenient to Purge gently by Stool the Humours by Stomachick Purges, and the like, which the least agitate the Blood. For Instance,

Take of choice Manna, and of Oyl of Sweet-Almonds, each one ounce and an half, or two ounces; dissolve them in a Pint of hot Ptisan; let the Sick drink half in Bed, and the rest half an hour after when he is up. Or,

Take of the best Senna two drams, of Cassia with the Canes broke, and of Tamarinds, each half an ounce; of the Seeds of Coriander prepared half a dram; boil them in a sufficient quantity of Fountain or Barnet water to eight ounces; dissolve in it an ounce of Manna, and

half a dram of Sal-prunella: Let the Sick take half in the Morning, and the rest half an hour after∣wards.

And every Night after Purging give an Opiate to asswage the Blood, and to quiet the Lungs, least a new Flux of Humours should fall upon the Lungs by the Agi∣tation of the Blood occasioned by the Purge.

For the same reason it is proper to mix some Opiate with Stomachick Purges to be taken at Bed Time. For Instance.

Take of Aloes-rosat one scruple, or twenty five grains, of the Pills of Hounds-tongue half a Scruple; mingle them make four Pills to be gilded, which are to be repeated every other Night after the Patient hath been blooded.

These Pills are vulgarly called Pilulae Catarrhales by the Apothecaries; for they do not only evacuate the Humours by Stool, but also hinder a new Flux of them to the Lungs. Or,

Take of the Stomachick Pills, with Gums, Aleophagin of Mastich, or of Ambar, half a dram, or two scruples; of London Laudanum one grain; mingle them, make four Pills, gild them, and let them be taken every third Night for thrice.

And if the Catarrh be very violent, and if a Difficulty of Breathing, or a straitness on the Breast does not arise from the Use of Opiates, an Opiat must be given every Night; for at the beginning of this Disease nothing con∣siderable can be done without them.

Fourthly, In this State of the Disease, Diaphorecticks do much Good; but you must take notice, that they must be never used before Bleeding, Vomiting and Purging, if they are necessary, and they must be always mixed with Opiates, and such must be chosen as are least hot.

Take of venice-treacle half a dram or two scruples, of Con∣serve of old red Roses half a dram; mingle them, make a Bolus. Or,

Take of Diascordium, and conserve of Wood-sorrel, each one dram, make a Bolus. Or,

Take of Matthew's Pill fifteen grains; make two Pills, gild them, and let them be taken at bed-time. Or,

Take of the Pill of Hounds-tongue twelve grains, of Diapho∣retick Antimony one scruple, of Tincture of Saffron a suf∣ficient quantity; mingle them, make four Pills.

These Diaphoreticks must be taken at Bed-time, and great Care must be taken that the Sick does not take Cold after the use of them: Blisters must also be applyed to the Arms, and betwixt the Shoulders, and Pectoral Medicines must be used when the Sick does not Purge.

Take of Oyl of sweet Almonds, of Syrup of Maiden-hair, of Jujubs, Violets, or of Marsh-mallows, each one ounce and an half; of White Sugar-candy one dram and an half; mingle them exactly, whereof let the Sick take a Spoonful every fourth Hour, drinking upon it four ounces of the following Apozem hot.

Take of the Pectoral Decoction clarified one Pint and an half, of Tincture of Saffron extracted with treacle-water, of Syrup of Maiden-hair, Scabious, or of Jujubs, each one ounce; mingle them, make an Apozem.

If you desire to have a more thickning Linctus.

Take of fresh Oyl of sweet Almonds, of Syrups of Comfrey, of red-poppies, of dried Roses, each one ounce and an half; of Diacodium half an ounce, of Sugar of Roses one dram and an half; mingle them, make a Linctus.

If you wou'd have a more lubricating Linctus.

Take of fresh Oyl of Flax extracted without Fire, of Syrup of Liquorish, and of Honey of Violets, one ounce and an half; of white Sugar-candy one dram and an half, mingle them exactly, make a Linctus.

If there be a Feaver, omit the Hissop and Tincture of Saffron; if there be a Loosness, use the following.

Take of the Lohoch of the Lungs of a Fox, of Colts-foot, and Purslain, each one ounce; of Syrup of Jujubs, and Maiden-hair, each one ounce and an half; of Flowers of Sulphur two drams, of Tincture of Saffron half an ounce, of the Species Diatragacanth frigid, of Diamargit frigid, of the Powder of Haly, each one dram; of Penediat Sugar half an ounce; mingle them, make a Linctus.

Take of Tacamahaca, of Balsam of Peru, each one Drain; of the Ingredients for the Pectoral Decoction a sufficient quantity, boil them in a sufficient quantity of Fountain Water to a Pint and an half; with the strained Liquor, and with a dram of each of the four Cold-seeds, with the Seeds of white Poppies, and of Henbane, each two drams; and with eight Almonds blanched, make an Emulsion to be sweetned with Pendiat-Sugar.

But if by reason of the Clamminess of the Flegm the Difficulty of Breathing is more than usual, the following Linctus must be prescribed.

Take of the Lohoch of Raisons, and of Squills, each one ounce and an half; of Syrup of Hedge-mustard, of Hyssop, and of Hore-hound, each one ounce and an half; of the Spe∣cies Diaireos, Diacalaminth, and the Flowers of Sul∣phur, each one Dram and an half; Tincture of Saffron half an ounce, of white Sugar-candy six Drams; mingle them, make a Linctus.

And if this Symptom be very violent, a dram of pure Gum-ammoniack, and a dram and an half of Flowers of Benzoin may be added.

And for these Intentions, Balsamick Medicines, with things that agglutinate are proper. For Instance,

Take of the Pulp of the conserve of red Roses, and Wood-sor∣rel, each one ounce and an half; of Olibanum three drams, of Opobalsam two scruples; mingle them, make an Electuary, whereof let the Sick take the quantity of a

Nutmeg thrice a day, drinking upon it four ounces of the following Apozem.

Take of the Leaves of Millfoil, Mouse-car, Burnet, Dande∣lion, spotted Lungwort, Scabious, each one handful; of the Flowers of St. John's-wort, Violets, the greater Daisy, red Poppies, each half an handful; of Jujubs, and Dates, each six Pair; of Saffron tied up in a Rag half a dram, of the Seeds of Annise, and Juniper-berries, each three drams; infuse them, and boil them in a suffi∣cient quantity of Fountain-water to three Pints, in the hot Liquor strained dissolve four ounces of Conserve of red Roses, which being added to the Apozem render it Balsamick and Pleasantly tasted; strain it again, and add of the Syrups of Coral, and of Oak of Jerusalem, and of Maiden-hair, each one ounce, make an Apozem.

Or instead of the foregoing Electuary the following may be substituted,

Take of the Pulp of the conserve of red Roses two ounces, of the conserve of Hips one ounce, of the Powder of Haly one dram, of Lucatellus's Balsam half an ounce, of Balsamick Syrup a sufficient quantity; mingle them, make an Electuary to be taken as before.

Let the Sick take often in a day one or two Spoonfuls of the Balsamick Syrup, which is very agreeable to the Stomach, and with every Dose of the Syrup, a scruple of the Balsam of Tolu made into small Pills, may be taken; and every Night at Bed-time the Sick may take twenty five or thirty drops of Helmont's liquid Laudanum in a spoonful of Balsamick Syrup: When there are no other Medicines to be taken, and there is nothing contrin∣dicates it, it is also very effectual to prescribe a dram of Flowers of Sulphur to be taken in a rear Egg, or Honey of Rosemary-flowers.

If a Tickling Cough, by reason of the Acrimony and Thinness of the Humuor, issuing from the Windpipe and Bronchia, be very troublesome to the Patient, the follow∣ing Tablets must be used.

Take of the Pulp of the Roots of Marsh-mallows one ounce, Pearl-sugar, Gum-arabick, Tragacanth, white Starch, dissolved in Poppy-water, each two drams; of Penediat Sugar dissolved in Rose-water a sufficient quantity; make Tablets, each weighing a dram.

But if the Cough continues long, and is violent, and will not yield to the foregoing Remedies, we must use Balsamicks. For Instance, Let the Sick take thrice a day three of the following Pills, in a spoonful or two of some proper Linctus.

Take of the Powder of Millepedes prepared three drams, of Gum-ammoniack well purified one dram and an half, of the Flowers of Benzoin two scruples or one dram, of Ex∣tract of Saffron, and Peruvian Balsam, each half a scruple; of Balsam of Sulphur anisated, or made with Turpentine, a sufficient Quantity; mingle them, make Pills of a moderte bigness, gild them, or cover them with Powder of Liquorish.

These Pills have often done good in Consumptire Coughs.

The Sick must chuse an Air that is moderately hot and dry, and somewhat thin; the diet must be of easie Con∣coction, as Mutton, and Veal, and the like; and the Sick must eat Flesh only at Dinner; at Supper he must only eat Water-gruel, Panada-broths, potched Eggs, and the like; and he must be sure to be moderate in his Diet; he must drink sparingly of small Beer, and the like; Wines must be avoided, and other spirituous Liquors; it is also convenient that his Beer be medicated with Pectoral things and the like, which are proper for the Disease; for by this means a great quantity of Medicines will be mixed with the Blood without nauseating the Stomach, or inju∣ring the Appetite, which a Physician ought to take great Care of. For Instance,

Take of the best Sarsa-parilla cut eight ounces, of the Roots of China sliced four ounces, of Polypody of the Oak, Maiden-hair, Ground-ivy, spotted Lung-wort, Colts-foot, Scabious, Oak of Jerusalem, each two handfuls; of the

Flowers of Scabious, water-lillies, and of Rosemary, of the grater Daisy, and of St. Johns-wort, each one hand∣ful; of Juniper-berries four ounces, of Raisins of the Sun stoned six ounces, of Liquorish rasped one ounce, of the Seeds of Annise two drams; mingle uhem, make a Bag for four Gallons of middling Beer, which let the Sick use for his ordinary Drink.

The Sick must exercise himself daily moderately, espe∣cially before Dinner; he must take great Care that he does not catch Cold: The Sick must be diverted as much as may be from Anger, Sorrow, deep thinking, and all other great Passions of the Mind; from Study, and unsea∣sonable Watching, always sleeping, if he can, the first part of the Night.

But in the second State of this Disease, which may be known by the Increase of the hectick Feaver, which now is often like a putrid Intermitting Feaver, and by the manifest wasting of the Flesh, by the dry Cough, a Weight upon the Breast, and difficulty of Breathing; all Evacua∣cuations by Stool, Vomit, or Sweat, are injurious; for they promote the Feaver, and Increase the Consumption: Nor is Bleeding to be used at this time, unless it be to prevent a Peripneumonia; but the Alteratives and Pecto∣rals before prescribed must be used frequently, as often as the Stomach will bear them; but especially the use of the Balsamicks before prescribed must be long continued, if there be no considerable Feaver; and by this means many Consumptive People have been recovered.

Issues are also of use, and the Shaving of the Head.

And if the Hectick heat be but small, the Sick ought to drink Calybeat Waters in the Summer-time; for by this means many have been relieved Year after Year; their Stomack, Flesh and Strength recovered, and the Hectick Heat and Cough left them, and their Breath has been freer: But these Waters are not to be used when the Lungs are evidently putrified, or when the Flesh is very much wast∣ed by Colloquative Sweats, a Loosness, or a Dropsie, for then they are deadly. And when they are proper, the Sick must use them the greatest part of the Summer, but not so great a quantity at a time as is usual in other Cases, two Quarts, five Pints, or three Quarts, may be sufficient

at a time; and the Sick must take Care that he does not catch Cold, and of Errors in Diet: Purging is not to be used during the drinking of the Waters in this Case, but if the Body be subject to be bound, the Purging Mnieral-waters must be taken three or four times, at the distance of three or four Days before and after the use of the Caly∣beat-waters. If the Waters do not pass well by Urine, or if they cause a Diarrhea, you must not continue the use of them long, unless these Inconveniences may be remedied by Art, to take off or to prevent the Diarrhea.

I use to prescribe the quantity of a Walnut of the fol∣lowing Electuary, to be taken at Bed-time every Night.

Take of the Pulp of the conserve of old red Roses, of the Electuary of Quinces, each half an ounce; of the Troebes of Ambar three drams, of true Bole, of Dragons-blood, each half a dram; of London Laudanum three grains, of Syrup of Mirtles a sufficient Quantity; mingle them, make an Electuary.

To force the Urine, I order that a scruple of the whitest Salt of Ambar, well cleansed from the Oyl, should be dis∣solved in the first Draught of Water.

It is also good, during the Course of the Water, to medicate the ordinary Drink with a Bag of Pectoral In∣gredients.

But secondly, If the Hectick Feaver be considerable, it is safer to attemperate the Blood by a Milk-Diet; but as to a Milk Diet what followeth must be observed.

First, In the use of this Diet, nothing but Milk, or things made of Milk, Bread only excepted, must be al∣lowed of; but good Quantities of it must be taken fre∣quently, least by reason of the Thinness of it, the Parts should be deprived of their due Nourishment. Secondly, This sort of Diet must be continued for the Space of a Month or two. Thirdly, Spring time is most seasonable for a Milk Course, for then the Herbs and Flowers, wherewith the Beasts are fed, flourish most.

Fourthly, But if by reason of the Ferment of the Sto∣mach being too acid, common Milk, as it sometimes happens, curdles, and so cannot be concocted; upon which account, Vomiting, Grips, and a Loosness follow;

it is better to abstain from the use of it, and to endeavour to attemperate the Blood with Asses-milk: Concerning the use of which observe the following Directions. First, Give this Milk in the Morning, and let the Sick sleep a little in Bed afterwards; let it be given again at five in the Afternoon. Secondly, Nothing of a contrary Nature, whether Diet or Medicine must be taken till the Milk is concocted. Thirdly, You must give a Pint, or half a Pint at a time, or thereabout; for a great Quanti∣ty of this, or of common Milk, can neither be received nor concocted by the Stomach, but is usually cast out presently, either by Vomit or Stool, to the great Pre∣judice of the Sick; wherefore it is prudently ordered by Physicians, that as the Stomach is by degrees accustomed to this sort of Diet, so the quantity of it should be daily increased from half a Pint to a Pint. Fourthly, If the Sick, by reason of the acid Ferment of the Stomach, is subject upon taking Asses-milk, to a Loosness•• (which frequently happens) the Milk, must be sweetned with Su∣gar of Roses, and must be milked upon a Branch or two of Mint; and if there be occasion, and nothing forbids, the Sick may take every Night at Bed-time a grain of London Landanum, or a Dose of the beforementioned Astringent Electuary. Fifthly, The Milk must be drank whilst it is warm, for if it should grow cold, and be afterwards warmed upon the Fire, it would be rendered less pleasing to the Tast and Stomach, and the Remedy would not be so effectual, by reason of the Spirits being wasted. Sixthly, During the use of Asses-milk, which also ought to be or∣dered in every Milk-diet, the Sick must abstain from all other Medicines, except Opiats and Astringents, if they are necessary to prevent a Loosness, or to quiet the Cough at Nights. Seventhly, But if the Loosness, occasioned by the Milk, cannot be taken off by the Laudanum, and the Astringents, or if after it is taken off, Vomiting or at least a continual Sickness, or Weight upon the Stomach succeed, which are the certain Signs of the Milk curdling in the Stomach: Or lastly, If there be Signs of a Schir••hus and Obstruction of the Liver, which are frequent in Scorbuti∣cal and Hypocondriack People, that have had a Consum∣ption a long while, rhey must carefully avoid all sorts of Milk; for the use of Milk, by increasing the Obstruction

of the Liver, is wont to bring upon the Consumption a Dropsie and Jaundice, whereby the original Disease is ren∣dred deplorable.

Wherefore, Fourthly, in these cases it is better to alter the Blood, and to blunt its Acrimony by the free use of Fish, and of testaceous Medicines; and also by Restora∣tive Broths made of the extream parts of Animals, and drinking freely of the Compound Waters of Milk, Ca∣pons, and Snails, and the like; though what we said be∣fore of the use of Milk is also true, with respect to these Flegmatick Waters, viz. That when the Liver is ob∣structed, the Jaundice or Dropsie is wont to follow the free use of these. Wherefore in such a case it is better to endeavour to Sweeten the Blood in the following manner. Let him eat freely of River and Sea-crabs, of Lobsters; and generally speaking of all testaceous Fish, which sort of Diet eaten plentifully, much attemperates the Acidity of the Blood, and the sharp Ferment of the Stomach▪ Of these testaceous Fish are also made very pleasant Broths, which must be taken plentifully.

Take of River Crabs number an hundred, beat them whilst they are alive, and boil them in two quarts of Fountain-water; add towards the end of boiling two or three blades of Mace, one Nutmeg rasped, and of Malago-wine half a pint; strain it for use. Jellies and resto∣rative Broths may be also used to the same purpose. For instance,

Take of the Shavings of Harts-horn and Ivory, each four ounces; two blades of Mace, one bark of an Orange candied; boil them in two quarts of Fountain-water to a quart, or a pint and an half; strain it; let the Sick take three or four Spoonfuls, either by themselves or in some hot Broth.

These kind of Jellies may be made more pleasant to the Pallate, by adding at the time of use a little of the Syrup of Baulm, Gilliflowers, Raspberries, Oranges or Lemmons; though it must be confessed Acid Syrups do not so well agree with Jellies.

The manner of making a Restorative Broth is as follows.

Take a Capon drawn and cut in pieces, of Sheeps and Calves feet, each two pair; the shavings of Ivory and Harts∣horn, each half an ounce; two leaves of Mace, one Nut∣meg cut, yellow Sanders, three drams or half an ounce; boil them all gently in one gallon of Fountain-water, till half is consumed; add towards the end of boiling a pint of Malago-Sack, and of the Flowers of the greater Daisie, Coltsfoot, Maiden-hair, Spotted Lungwort, each one handful; of fat Dates eight pair, of Jujubs twelve pair, of Sebestens ten pair, of Raisins of the Sun stoned three ounces; strain it, let the Sick take a large Draught of it twice or thrice a day.

Prepared Coral, Millepedes, Pearls, Crabs-eyes pre∣pared, the Simple Powder of Crabs-claws, and other testaceous Medicines taken plentifully, and often in a day, are good to blunt the Acrimony of the Blood.

Take of the Aqua lactis Alexiteria, of Carduus, or of black Cherry-water, one pint; of Cinnamon-water hordeated half a pint, of prepared Pearl half an ounce, of white Cristaline Sugar two ounces; mingle them, make a Julep, whereof let the Sick take four ounces (shaking the Viol always when it is used) three or four times in a day, adding, if the Stomach require it, one or two ounces of Epidemick water. Or,

Take of the Powder of Millepedes, of Crabs-eyes prepared, of the Simple Powder of Crabs-claws, each one dram; of the Powder of white Ambar half a dram; mingle them, divide it into nine Papers, whereof let him take one thrice a day in a Spoonful of the Pearl Julep.

Fifthly, If the Sick seem free from an Obstruction of the Liver, and has neither the Dropsie nor the Jaundice, but the Milk-Diet before described does not agree, by reason of a Loosness, or the Acid Ferment of the Stomach; besides the altering Medicines above described, the free use of the compound distilled Waters of Milk, Snails, a

Pig, and the like, may be ordered with success, to attem∣perate farther the Acrimony of the Humours.

The Milk-water.

Take of the leaves of Maiden-hair, Coltsfoot, spotted Lung∣wort, Speedwell, each three handfuls; of Hyssop, Goats∣rue, Mint and Wormwood, each two handfuls; of the Flowers of St. John's Wort and Scabious, each two hand∣fuls; of English Saffron one dram, three Nutmegs sliced, Dates and fat Figs, each half a pound; of Raisins of the Sun stoned one pound; cut them, and infuse them in three gallons of fresh Cows Milk, and three quarts of Malago-Sack, distill them in a cold Still, and draw off half the Liquor, and mix the Distillations, and keep them for use.

If the Consumption be Scorbutical, you may add in Distillation the tops of Pine, Water-cresses, and Brook-lime, and Ground-Ivy, with other gentle Antiscorbuticks: And instead of Malago Sack, you may use Brunswick Mum. If you would have this Water also Restorative, you must add a Capon or a Pig in the second Distillation. For instance,

Take a Capon or a Pig, (the Intrails being taken out) cut in pieces, of the Milk-water above described one gallon, distill off three parts of the Liquor.

Snail-water.

Take of Garden-Snails cleansed with Salt three hundred, of common Milk, or rather of the Milk-water above prescribed three gallons; distill them in a cold Still with a gentle Fire till the Liquor becomes Acid: And the fol∣lowing Magisterial water of Worms is not to be despised, for it will keep good a long while.

Take of fresh Milk two gallons, of Mint and Roman Worm-wood, each two handfuls; distill off one gallon: Then take of Garden-Snails, first wash'd in common water, then in Small-beer, half a peck; of Earth-worms pre∣pared

one Pint, of Angelica one handful and an half, of Agrimony, Bettony and Rue, each one handful; put the Herbs into a Still, and the Snails and Worms upon them; and at top shavings of Harts-horn half a pound, Cloves one ounce, Saffron three drams; infuse them in two quarts of Syder, and one of Malago-Sack; then distill all in a cold Still.

These Liquors are to be drank freely for the ordinary drink, mixed with an equal part of Milk, if the Stomach will bear it, and if the Sick can quench his Thirst with it. If a Julep be more pleasing, give it in the following manner.

Take of the Waters of Pig or Capon before described one pint, of white Cristaline Sugar a sufficient quantity, boil them to a Syrup.

Take of Milk, or Snail-water one pint and an half, of the Syrup just described four ounces; mingle them, make a Julep, whereof let the Sick drink freely. Or,

Take of the Water of Milk, or of Magisterial Snail-water a quart, of pearled Sugar ten drams or an ounce and an half; mingle them, make a Julep, whereof let him take freely and frequently.

But if there is not so much a Hectick Feaver as a diffi∣culty of Breathing, as it often happens to such as are afflicted with a Scorbutick Consumption, a Pectoral Hy∣dromel is better for the ordinary Drink, than distilled Waters abounding with Flegm.

Take of the roots of China sliced six ounces, of the roots of Coltsfoot gathered at a Fit-time three ounces, of the roots of Burdock and Avens, each three ounces; of the roots of Elecampane two ounces, of the leaves of Lung∣wort, all the Scabious, both the Speedwells, Meadow-sweet, and Monywort, each two handfuls; of all the Capillaries, each one handful; of the flowering tops of Bugles and Bettony, of the flowers of red Speedwell, and of Cowslips, each four Pugils; of all the Ground Ivy three

handfuls, of Jujubs, Dates, Sebestens, and Raisins of the Sun cleansed, each one ounce and an half; of Spanish Liquorish one ounce and an half, cut them all, and boil them in sixteen quarts of Fountain-water with a gentle Fire till half is consumed; strain it and clarifie it, and add to it four pound of the best Honey; boil it again, and take off the Scum; strain it again, add half an ounce of Cinnamon, six drams of Coriander-seed, of the Seeds of Annise and Sweet Fennel, each three drams; put the Liquor into a large Tub, and let it ferment, which it will the sooner do, if the Tub be placed in the Sun, for then it will be sufficiently fermented in forty days, other∣wise it will require a much longer time: The Vessel must be always kept open and full. Of this let the Sick drink a good Draught twice or thrice a day for many Months.

When the Consumption comes to its third State, the Sick very rarely is cured or lives long, unless the Ulcers are very small and benign; wherefore, though a prudent and honest Physician, being called to Consumptive People at this time, may endeavour to mitigate as much as may be the Symptoms, and may prescribe Medicines proper for the Consumption and the present Indications; yet he ought by no means to promise a Cure, but rather acquaint the Patient of his Danger; and so he will secure his own Reputation, and that of the Medical Art.

The Curative Indications at this time of the Disease are these four: First, Pectoral Medicines must be pre∣scribed, and the Cure of the Ulcers must be promoted (if they are small, benign and curable) as much as can be, in this weak and wasting Condition of the Sick.

Secondly, The Peripneumonick or Inflammatory Feaver, as often as it happens, must be taken off, with all its dreadful Symptoms.

Thirdly, The Putrid Feaver arising from the Purulent Matter of the Lungs must be mitigated.

Fourthly and lastly, The Tormenting Symptoms arising from the Putrid Feaver by reason of the Colliquation, must be removed as far as may be, that at least the Sick may dye easily.

As to the first in this State of the Consumption, Alter∣ing, Expectorating and Balsamick, or Healing Medicines

that are not too hot, (by reason of the great height of the Feaver) but always Cordials are to be given, and those are to be chosen that are most palatable, and may be taken in the smallest quantity. For instance,

Take of the Pulp of the old Conserve of red Roses, of Wood-sorrel, and of Lucatellus's Balsam, each one ounce; mingle them, make an Electuary, whereof let him take the quantity of a Nutmeg wrapt in a Wafer Morning and Evening; or let him take twice a day of the Bal∣samick Pills above described, number three.

Take of the Aqua Lactis Alexiteria eight ounces, of the Magisterial Water of Snails, of Cinnamon-water hor∣deated, each three ounces; Aqua mirabilis one ounce; of prepared Pearl two drams, of clear Ghalk one dram, of white Cristaline Sugar one ounce or ten drams; mingle them, make a Julep, whereof let the Sick take four or five Spoonfuls after every Dose of the Electuary, and of the Pills, and as often as he will.

Take of the Balsamick Syrup, which is very agreeable to the Stomach, three ounces; of Tincture of Saffron made in Treacle-water two drams; mingle them, let him take of it often in a Spoon, and in a Spoonful or two of this mixture, let him take twice a day six or eight drops of Opobalsam.

But if the Cough and Watchings are very obstinate, let him take sometimes twelve drops of Helmont's Liquid Laudanum. Nevertheless in this languid state, Opium ought to be given cautiously in small Doses, and in due distances of time; neither ought it to be given at all with∣out urgent necessity require it, least a sudden Death follow, and the Disgrace of the Medical Art. Or,

Take of the Syrup of Maiden-hair four ounces, of Aqua mirabilis half an ounce or six drams; mingle them; let the Patient take a Spoonful of it frequently, or with a Liquorish-stick, especially when the Cough is troublesome.

Jellies and Restorative Broths are to be prescribed in this case: And indeed in this deplorable Condition, Me∣dicines are rather to be taken from the Kitchin than the Apothecary's Shop.

As to the Peripneumonick Feaver, it arises always from the great Inflammation of the Tubercles of the Lungs; and therefore it uses to return frequently, viz. As often as a new Tubercle either of its own accord, or from cold taken, or from any Error committed in Diet, happens to be inflamed; and during the Inflammation this Feaver continueth, and often kills the Patient suddenly; it being accompanied with uncertain Shivering, and violent Heat succeeding alternately, with Watching, Restlesness, a De∣lirium, difficulty of Breathing, difficulty of Expectora∣tion, violent and wandring Pains of the Side, Breast and Shoulders; but when the Inflammation first begins to Im∣posthumate, which, if the Sick lives, happens usually about the seventh day of the Disease, the continual In∣flammatory Feaver is succeeded by a Putrid Intermitting Feaver, either Quotidian or Tertian, which certainly in∣dicates Matter in the Tubercles, and can never be perfectly eradicated unless they be cured.

This Inflammatory Feaver, as all others of the same kind, requires a thin Diet, that the Belly should be kept open, and Cordial and Attemperating Juleps are to be used freely; also Pectoral Apozems, and Lubricating and Inciding Linctuses, to facilitate the Expectoration of the Flegm, too much thickned by the Feaverish Heat, and to take off the painful Compression of the Lungs, and to ease the Cough. Diaphoretick Opiats are also to be used sparingly, at due Intervals, to promote the Expulsion of the Febrile Matter through the Pores of the Skin: Also Blisters and Epithems are to be used for the relief of the Brain, and Genus Nervosum, which would otherwise suffer much by Feavers of this kind. Liniments also and Anodyn Fomentations must be prescribed, to remove the Painful and Convulsive Contraction of the Muscles, and Membranes of the Breast; but above all, Bleed seasonably and largely, and it must be repeated, if there be occasion, according to the Strength of the Sick, and the present Effervescence of the Blood; and perhaps Consumptive People require Bleeding more than those that are strong.

Wherefore the Physician, though he count the Con∣sumption deadly, ought to endeavour the Cure of the Peripneumonia in the following manner: Let him order a Diet of Water-gruel, Ptisan, roasted Apples, and the like, and middling Beer with a Toast in it: But at the first Declination of the Feaver, Chicken-broth, potched-Eggs, and the like.

And the Belly, if there be occasion, must be presently loosned, with a Glister made of Milk and Sugar, with Camomil-flowers, which also must be repeated upon oc∣casion; then eight or ten Ounces of Blood must be taken away from the Arm of the pained Side; and Bleeding must be repeated every day, or every other day, according to the Effervescence of the Blood, and the Violence of the Pain in the Side, and of the difficulty of Breathing, if the Strength will permit that an Imposthumation may be hin∣dred if possible.

In the mean while, through the whole Course of the Disease, one Spoonful of the following Linctus dissolved in four Ounces of the Pectoral Apozem, must be taken every third or fourth hour hot.

Take of the fresh Oyl of Sweet-Almonds, of Syrup of Maiden-hair, each one ounce and an half; of white Sugar-candy one dram and an half; mingle them exactly and make a Linctus.

And if the Flegm be very tough, and if the Difficulty of Breathing and the Pain increase by reason of it, instead of Oyl of Almonds, Oyl of Linseed fresh drawn without Fire may be substituted, and Syrup of Hedge-mustard, or of the five opening Roots instead of Syrup of Maiden-hair, if a Flux of the Belly does not contra-indicate: Be∣sides two or three ounces of the Oyl of Linseed may be ta∣ken by it self every fourth Hour, for it does not only Lu∣bricate, but is also very Anodyn.

Take of the Pectoral Decoction clarified one Pint and an half, of Tincture of Saffron made in Treacle-water, and of Syrup of Maiden-hair, each one ounce; mingle them, make an Apozem for the use above described.

To recruit the Strength, and to attemperate the Effer∣vescence of the Blood, four or five Spoonfuls of the fol∣lowing Julep may be prescribed.

Take of the Aqua-lactis alexiteria eight ounces, of Cinna∣mon-water hordeated, and of Plague-watery each two ounces; of prepared Pearl one dram and an half, of white Sugar six drams; mingle them, make a Julep.

At Bed-time the following Anodyn and Diaphoretick Bolus may be prescribed to be taken, with a Draught of the Cordial Julep, especially if the Belly, as it often hap∣pens in this State of the Disease, be too loose.

Take of Venice-treacle half a dram, of the compound Pow∣der of Crabs-claws one Scruple, of Syrup of Gilly-flowers a sufficient Quantity; mingle them, make a Bolus.

Presently after Bleeding apply Blisters to the Neck, to the inner parts of the Arms and Legs, and a Cephalick Plaister with Euphorbium to the Soles of the Feet, to re∣lieve the Brain and Genus Nervosum.

To ease the Pain of the Side occasioned by the Convul∣sions of the Muscles and the Membrans of the Breast, the following Fomentation and Liniment may be applyed by turns to the Parts affected.

Take of the Roots of Parsly▪ and Fennel, and of Linseeds, and of Fenugreek-seeds, each two ounces; of the Flowers of Camomel, and of Melilot, each two handfuls, mix them and boil them in a sufficient quantity of Fountain Water, pour it into a fresh Ox-Bladder, let the Bladder be half full, apply it hot to the Parts affected; when the Blad∣der is taken off, apply an hot Flannel besmeared with the following Liniment.

Take of Ointment of Marsh-mallows half an ounce, of Oyl of white-lillies, and of Bricks, each three drams; mingle them, make a Liniment.

To attemperate further the Effervescence of the Blood and the Heat of the Lungs, the following Powder may be used with good Success,

Take of pure Salt-peter two drams, of white Cristaline Sugar half an ounce, mingle them, and make of them eight Papers, whereof let one be dissolved in every Draught of Beer.

As to other things they must be left to the Judgment of the Physician that attends, to be prescribed upon Oc∣casion.

As to the putrid Feaver of Consumptive People, it is to be noted, that although the Sick being treated according to the Preceeding Method, do not die of a Peripneumonia, yet the Inflammation of the Tubercles of the Lungs end∣ing most commonly in an Ulcer, presently after the In∣flammatory Feaver, a putrid intermitting Feaver arises, returning at certain Periods every day or every other day with Shivering, Heat and Sweats.

Which Feaver seems impossible to be taken quite off un∣less the Ulcer be cured from whence it arises; yet the Pe∣ruvian Bark, frequently repeated at due Intervals, is often very Successful for suppressing the Feaver for a while, and the Lives of some, by the frequent use of it, have been pro∣tracted for many Years.

Take of the Peruvian Bark finely powdered half a dram, of the Balsamick Syrup a sufficient quantity; make a Bolus, which let the Sick take in the Morning, and every sixth Hour for three days successively, drinking upon it three or four ounces of the following Apozem.

Take of the Peruvian Bark powdered three ounces, of the Balsam of Tolu two drams, of English-saffron, and Cochi∣nele, each one Scruple; boil them in a Pint of the Pect∣ral Decoction clarified to six ounces, then strain it, and put on a Pint more of the Decoction; repeat the Opera∣tion thrice, then mix all the strained Liquor, and add to it of Maligo Saek, and Balsamick Syrup, each fou•• ounces; mingle them, make an Apozem.

Repeat the use of this Febrifuge in the manner now described twice in a Month, or oftner if there be Occasion; and in the Intervals, the daily use of Balsamick and Pect∣oral Medicines must be ordered, and they must be varied according to the Temper of the Sick, and the Genius of the Disease: If the Belly be too loose, a grain of London Laudanum may be added to every Bolus to be taken at Bed-time, or instead of the Bolus's, Pills made of Di∣ascordium, and the Jesuits Powder may be substi∣tuted; but every Dose must contain half a dram of the Powder,

Yet it must be confessed that the Bark is not constantly so successful in the Consumptive Feaver as in Agues.

To take off a Loosness, and to mitigate a Dysentery, and the Gripes, Opiat Medicines must be used freqently and freely; and during these Symptoms, the Sick must ab∣stain from all sorts of Beer, and, instead of it, must use the white Decoction or Milk-water: Let him take also, if there be Occasion, every fourth Hour, the quantity of a Walnut of the Astringent Electuary described before in the use of Asses-milk; or let him take twelve Drops of Hel∣mont's liquid Laudanum,

And to attemperate the Acrimony of the Humours, that are wont to be evacuated by the glandulous Tunick of the great Guts, and to restore the Tone of the Parts weakned thereby, let a Glister be daily injected made of Chicken broth▪ or of a Sheeps-head with the Wool on, boiled in Water, or this that follows.

Take of Milk altered with red Roses, and by quenching often hot Steel in it; six ounces, of Diascordium half an ounce; mingle them, make a Glister.

But in a moderate Diarrhea, viz. when the Gripes are not very violent, especially if there be a Difficulty of Breathing, Opium must be prescribed rarely and sparingly in any Form; for most commonly upon giving it, the Breast is oppressed, and Breathing, and Expectoration are rendered more difficult, and the Stomach becomes nau∣seous.

Wherefore it is safer only to moderate the Loosness, by giving an Opiat every third or fourth Night, than to stop it quite; least a greater Injury should follow; and always after the use of an Opiat, expectorating and lubricating Medicines should be freely used; least the Matter should be so much fixed in the Lungs, that the strength of the Pa∣tient should not suffice to bring it up.

When the Cough and Watchings are very violent, the following Medicines may be used; but it is to be noted, that Opiats must be used very sparingly, and with great Caution when the Sick is very weak.

Take of Syrup of Marsh-mallows, and Purslain, each one ounce and an half; of the Species Diatragacanth frigid, of the Powder of Haly, each two scruples; of Diacodium an ounce and an half, mingle them, make a Linctus to be taken in a spoon, or with a Liquorish Stick, when the Cough is violent.

Aqua-mirabilis also mixed with Pectoral Syrups does good. Or,

Take of the Balsamick Syrup two ounces, of Helmont's li∣quid Laudanum two Scruples; mingle them, let the Sick take a spoonful every Hour or every other Hour,

The white and black Lozenges being leisurely dissolved in the Mouth, and swallowed down, are also of use.

To moderate the great and Colliquative Sweats, let the Sick sleep but little at a time, and let him take temperate Pearl Cordials often, and in a large Quantity; to which it is fit to add Chalk, Coral, Dragons-blood, and other temperating astringent and emplastick Medicines, which in some manner fix and mitigate the Ferment of the Blood. For Instance,

Take of the Waters of Tormentil, Oak-buds, each three ounces; Cinnamon-water hordiated four ounces, of Aqua-mirahilis one ounce, of Pearls, and Coral prepared, and of Chalk, each two scruples; of true Bole, and Dragons-blood each half a dram; of Jap••n Earth a scruple, of destilled Vinegar or Spirit of Vitriol as much as is suf∣ficient

to make it gratefully acid, Syrup of Mirtles an ounce and an half; Mingle them, make a Julep; let the Sick take two or three ounces of it every third or fourth hour, shaking the Viol every time it is used.

The Cloaths on the Bed must be also lessened, and the Sick must be removed into a thin, warm and free Air; let him al∣ways sleep in a large Room, and as soon as his Strength be∣gins to fail, the Sweat must be rubbed off with dry Linnen Cloaths a little warmed; and the Patient must be removed to the other Part of the Bed.

As to the violent Vomiting that seises Consumptive Persons at the latter end, there is little Help to be afforded by Art, only the Physician ought to assist by his prudent Counsels▪ since he cannot by Medicines. First therefore, The Sick ought to be ordered to eat little (though frequently) at a time. Secondly, He must eat those things that afford good Nourishment and are of easie Digestion. Thirdly, After eating he must avoid (as much as he can) Coughing, Sleeping, and lying down.

Sometimes it happens after the Putrid Feaver begins especially if the Evacuation of the Colliquative Matter by Stool or by other ways is hindered by Art, that Nature in∣deavours, tho in vain, the Protrusion of the Enemy by the Salivary Ducts, or the glandulous Tunick of the Mouth and Oesophagus, by which means a troublesome Spitting arises that continues for many Weeks. Secondly, by reason of the Acrimony of the Humour evacuated by these Parts, an Inflammation not only of the Membrane of the Mouth, but also of the Oesophagus and Stomach fol∣lows. Thirdly, By the Inflammation an Ulceration is occasioned, and from thence little Ulcers called Aphth••••, accompanied with a very troublesom Pain of the Throat. And Lastly, An Hicop that is very troublesom arises from the Inflammation and Exulceration.

Which Symptoms, as they are troublesome, so are they sometimes long, and always deadly, for the Cause from whence they proceed is incurable; yet cleansing softning astringent and Mucilaginous Gargarisms must be injected with a Syringe; and to ease the Pain of the Throat, a double Flannel worn about the Neck does much Good, by defending it from the external Cold.

CHAP. LX. Of Swooning or Fainting.

THe next and immediate Cause of this Disease, is a Defect of the Vital Spirits; and this Defect of the Spirits chiefly happens four ways, Either because there is not a sufficient quantity of them generated, or because they are dissipated and evacuated when they are generated; or they are preternaturally altered, and corrupted: Or lastly, They are suffocated and overwhelmed. They are not generated either by reason of a Fault of the Faculty, or of the Matter; the Faculty of the generating the Spirits is hurt, either by a Peculiar Disorder of the Heart or by Consent.

The peculiar Diseases of the Heart that are chiefly to to be taken Notice of, are great Intemperies overturning the native Temper of it; or destroying the Substance of the Parts, and of the Native Heat; as acute and malig∣nant Feavers, Colliquative, Pestilential and Hectick Fe∣vers, also Organical Diseases, as Constriction and too great Dilatation.

The Faculty of the Heart is hurt by Consent, as from the Brain and Liver, which have a great Sympathy with it; and also often from the Mouth of the Stomach, by reason of its nearness and Exquisite Sense, upon which account Swooning is divided into Cardiack and Stomachick; that is Cardiack which proceeds from the Heart being Primarily affected; that is Stomachick which is produced by Con∣sent of the Stomach: It also often arises from the Womb, by reason of ill Vapours transmitted thence to the Heart.

The Fault of the Matter, is a Defect or Corruption of the Air and Blood, from whence the Vital Spirits are ge∣nerated. A Defect of the Air happens from Respiration or Transpiration hurt: A Defect of the Blood from a Fault in Nutrition.

The Corruption of both is occasioned by putting on ano∣ther Quality; so from the infected Air in a Pestilential Constitution, Swooning and Fainting frequently happen,

and some ill Smells occasion the same, and sweet Smells in some Women.

The Blood is also often corrupted by unwholesome Food.

Too large Evacuations dissipate the Spirits, both sensi∣ble and insensible: sensible Evacuatioins, are first of Blood it self by the Mouth, Nostrils, Womb, Belly, Hemorrhoids, Bleeding, and great Wounds. Secondly, of other Hu∣mours, which though they are Excrementitious, yet being evacuated in a large quantity, they dissipate the Spirits and occasion Fainting. Such Humours are w••nt to be evacu∣ated by Vomit, Stool, Urine, Sweat, by opening a large Abscess, especially inwardly, as of an Empyema; and al∣so outwardly, as in a Dropsie, the Navel being open.

Insensible Evacuations are made by too great a rarity of the Skin, and by reason of Thinness or Acrimony of things contained, by immoderate Heat, Bathing and excessive Labour.

They are also dissipated by long, Watching, long Fast∣ting, immoderate Venery, Anger or excessive Joy; long and acute Sickness, violent Pains of the Heart, Stomach, Bowels, Veins, Ears, Teeth, and of all the Nervous Parts.

The Spirits are altered and corrupted by an ill Disposition of the Bowels, and by any thing that has a malignant and an inimical Quality to the Heart; as a venomous and pesti∣lential Air drawn in by the Breath, or generated in the Body by Putrefaction of Humours; Poison taken inward∣ly does the same, and the Biting of Venomous Creatures.

Lastly, A violent Reflux of the Spirits and Blood to the Heart, and the like, suffocates and overwhelms the Vital Spirits. A noble Virgin, which was very subject to faint∣ing upon every small occasion, died suddenly, by reason of a sudden Reflux of the Blood, and Spirits to the Heart, as she was about to sign a Contract of Marriage with a very handsom and accomplished Gentleman.

Fainting also sometimes happens from cold and thick Blood, heapt up in abundance in the greater Vessels.

As to the Cure, it must be varied according to the Va∣riety of the Causes; but from whatever Cause it pro∣ceeds, that which follows must be observed in the Fit, You must lay them on their Back, and sprinkle Water in their

Faces, and provoke Sneezing; put some good Wine or Cinnamon-water into their Mouths; apply Bread hot out of the Oven to their Nostrils; call them aloud, shake them, pull them by the Nose, double their Fingers, pull their Hair, use Frictions, Ligatures and Cupping-glasses.

But the Cure must be varied according to the Variety of the Causes in the following manner.

If it takes its Rise from want of Nourishment, the Sick must be refreshed with good Wine, and by a Piece of Bread dipt in it and eaten, and also by nourishing Broths, and the like.

If by reason of the Thinness of the Humours, the Spi∣rits exhale, Perfumes and meat of good Juice and Thick∣ning must be prescribed, and the Pores of the Skin must be stopt with Oyl of Roses and by the cold Air.

If it proceed from an Hysterick Disease, Remedies pro∣per for that must be given; if from a malignant Quality Cardiacks and Alexipharmicks must be used.

If from taking Poyson, things that evacuate must be used; a Vomit must be given, and afterwards Treacle must be prescribed; and then if a Heat and Erosion of the Stomach be perceived, he must take Milk or Butter, or fat Broths, or cooling Cordial Potions.

If from Immoderate Evacuation, the Sick must be re∣freshed with Perfumes, Meat and Drink, Sleep and Rest.

If from too great a Loss of Blood, lay the Sick on a Bed with his Head downward, Sprinkle his Face with cold Water, give him a little Wine diluted with cold Water.

If by over-purging, give new Treacle; or for want of it old Treacle with two grains of Opium; or rather with three grains of Laudanum dissolved in Wine. Anoint his Belly with the following Oyls.

Take of Oyl of Mirtles, and of Quinces, each one ounce and an half; of Oyl of Wormwood one ounce, of Rose Vine∣gar a little; mingle them, anoint his Belly with it often.

Inject a Glister of Calybeat Milk, adding to it the Yolks of three Eggs, of Philonium Romanum two drams; rub his Arms and upper Parts; dip a Piece of Bread in Wine and give it, or let him drink Wine it self.

And lastly, Every Evacuation, whether of Blood by the Nostrils, Womb, or other parts, or of other Humours, by Vomit or Stool, is to be restrained by Remedies de∣scribed in their proper Chapters.

That Fainting which arises from too great Sweat, must be cured by Remedies that restrain Sweat, as with cold Water, Rose-water alone, or with a little Vinegar in it cast upon the Hands and Face; the Air also must be cooled with the foresaid Waters, and with fanning; cold Epithems must be applied to the Heart, made of Rose-water, Sorrel, Borrage, and of the Powder of Diamar∣garit; frigid, and with a little Wine to make them penetrate.

Also cooling Juleps of Syrup of Sorrel, Violets, of Apples, or Lemmons, with cooling Waters, and Sal-pru∣nella, are frequently to be given; the Pores may be stopt by anointing the Skin with Oyl of Roses, Mastich and Myrtles. Let the Sick abstain from Wine; he must by no means be rubbed; let him often change place, and be lightly covered; let the Bed be sprinkled with the follow∣ing Powder.

Take of the flowers of Water-lillies, and red Roses, each three ounces; of pure Labdanum half an ounce, of Storax two drams, of Myrtles, and the Grains of Sumach, each two ounces; make a Powder.

If the Fainting arise from Suffocation of the Spirits, they must be called back to the Surface of the Body, by Frictions, Ligatures, Cupping-glasses, and the like; but if the Suffocation arise from Fullness, Blood must be drawn plentifully by Intervals; if Fainting proceed from a Fright or Fear, Blood must be also let, least an Ob∣struction or Inflammation should be occasioned.

CHAP. LXI. Of the Palpitation of the Heart, and of the Trembling of it.

THE Palpitation of the Heart is so violent sometimes, that it may not only be manifestly felt, but also seen and heard at some distance: And some Authors of note say, That by the violent Vibration of the Heart, the Ribs have been broke, or thrust out in young People.

As to the Cure, it must be varied according to the variety of the Causes.

First therefore, when this Disease proceeds from a fault in the Blood, the curative Intention will be, to exalt the watry Blood, and to render it more apt for Fermentation; to which purpose Spiritous Medicines, also Saline of every sort and Sulphurous, especially Chalybeats; and also those things which are used for the Green-sickness, or Lucophleg∣matia, and a cold Scurvy, do good.

Take of the Conserves of Roman Wormwood, of the yellow Peel of Oranges and Lemons, each two ounces; of the Winteran bark powdered two drams, of the Species Dia∣curcuma one dram, of Steel prepared with Sulphur three drams, Salt of Wormwood one dram and an half, with a sufficient quantity of the Syrup of Citron-bark; make an Electuary.

The Dose is the quantity of a Nutmeg in the Morning, and at five a Clock in the Afternoon, drinking upon it three Ounces of the following Julep, and walking after it.

Take of the Waters of Wake-robin leaves one pint, of Penny-royal and Hyssop, each four ounces; of the water of Worms, Snails, and Mirabilis, each one ounce; of Sugar one ounce; mingle them, make a Julep.

Take of the Tincture of Antimony one ounce. The Dose is twenty or twenty five drops twice a day in the same Julep.

Moreover, Tincture of Steel, or the Syrup of it, also Elixir Proprietatis are proper.

Secondly, The Palpitation of the Heart is oftner and much more violent from a fault in the Cardiack Arteries, which is either an Obstruction or a Convulsion. The first is most commonly continual, and often incurable, especially if it be occasioned by tabid Lungs, or by reason the roots of the Arteries are half filled or compressed by a Tubercle, or bony Excrescence; which Causes, when they are and can be perfectly known, it is to no purpose to endeavour to remove; and then all that can be done, is only to give ease by Hypnoticks.

Moreover, It is probable, that the passage of the Blood is hindred, sometimes by a Polypus growing within the Sinus of the Heart: But it is difficultly known, and hardly cured; when there is a Suspicion of it, Saline Medicines seem most proper, and of those such as are vo∣latile or acid: But they are not to be given together, you are to try one sort first, and if that does not do, you must try the other.

Take of Compound Spirit of Sal-armoniack, viz. distilled with Millepedes, or with other anti-asthmaticks, three drams. The Dose is from fifteen Grains to twenty thrice a day, in some proper Julep or distilled Water.

In the same manner Spirit of Harts-horn, of Soot, of Blood, and of a Scull dug up, may be tried.

Take of Spirit of Sea-salt, or of Vitriol, distilled with Spirit of Wine, impregnated with Pectoral Herbs, and often cohobated, three drams. The Dose is from fifteen to twenty drops.

Spirit of Tartar, of the Wood of Gujacum, or of Box, may be used to the same purpose.

Thirdly, The Palpitation of the Heart is often Con∣vulsive, and proceeds from the same cause as other Hypo∣chondriack or Asthmatick Passions do, and must be cured also by Antispasmotick Remedies; but respect must be had to the Constitution of the Sick.

Take of Spirit of Sal-armoniack with Ambar three drams. The Dose is from fifteen to twenty drops twice a day, in some proper Julep or distilled Water.

Tincture of Tartar, of Steel, or of Antimony, may be also given by turns.

As to the Cure of the Trembling of the Heart, Medi∣cines proper for Convulsions must be given, it being meerly Convulsive. Wherefore having made sufficient Evacua∣tion, the follow Medicines may be given.

Take of prepared Coral, and of Pearls, each two drams; of both the Bezoars, each half a dram; of white Ambar two scruples, of Ambar-grease one scruple; make a Powder. The Dose is half a Dram twice or thrice in a day, in some proper Julep or distilled Water.

Take of Compound Powder of Crabs-claws two drams, of the Powder of the roots of Male-peony, of Mans Skull pre∣pared, each one dram; of the flowers of Male-peony, and of Lillies of the Vallies, each half a dram; make a Powder to be taken the same way.

Take of Ivory, and red Coral powdered, each three drams; of the Species Diambra one dram, of white Sugar dis∣solved in a sufficient quantity of Orange-flower-water and boiled to Tablets, seven ounces; make Tablets each weigh∣ing half a dram: Let him take one or two often in a day, or when he pleases.

Take of the Conserve of the Flowers of Lillies of the Vallies six ounces, of Coral prepared, of Pearls, Ivory, and Crabs-eyes, each one dram and an half; of Vitriol of Mars one dram, with a sufficient quantity of Syrup of Coral, make an Electuary. The Dose is one or two drams twice a day, drinking upon it a Draught of the following Julep.

Take of the Waters of Orange-flowers, and of the whole Citron, each six ounces; of Orange-peels distilled with Wine two ounces, of Sugar half an ounce; make a Julep.

Take of Syrup of Steel six ounces. The Dose is one Spoonful in the Morning and at five in the Afternoon, in two ounces of the Julep above prescribed; but you must omit the Sugar.

Take of the Powder of Ivory, and of Coral, each two drams and an half; of the Species of Diambra one dram, of Salt of Steel two drams, of Sugar eight ounces, of Am∣bar-grease dissolved half a scruple; make Tablets, each weighing half a dram. The Dose is three or four drams twice a day.

Ta••e of fresh Strawberries eight Pints, of the outward Peel of twelve Oranges, of the fresh Filings of Steel half a pound, beat them together, and pour upon them four quarts of Wine: Let them ferment together in a close Vessel twenty four hours; then distill them in a cold Still.

Take of Spirit of Harts-horn, or of Blood, or the like, three drams. The Dose is twenty drops twice a day in some proper Vehicle.

Take of the Flowers of Sal-armoniack, and of Coral pre∣pared, each two drams. The Dose is one scruple twice a day.

Take of Sal-prunella two drams, of Salt of Ambar one dram, of Salt of Harts-horn one Scruple. The Dose is from fifteen to twenty grains twice a day in some proper Liquor.

Note, Such of these Medicines as agree with the Con∣stitution of the Patient are to be chosen.

CHAP. LXII. Of Weakness.

THE Cause of Weakness, is a Defect of Native Heat, and of Spirits: This Defect is occasioned by the Defect of Vital Spirits: The Vital Spirits are wanting, either when they are not generated in a sufficient quan∣tity, or because, when they are generated, they are dissi∣pated, corrupted, or suffocated, as it happens in Fainting: But the difference betwixt Fainting and Weakness is, That in Fainting the Causes produce their Effect of a sudden, but in Weakness by degrees.

The Cure of this Disease respects the taking away the Cause, and the cherishing the Heart and Vital Spirits.

The Causes are, almost all great Diseases, whereby Nature is much weakned; therefore the taking off the Causes, respects the Cure of almost all Diseases, which must be sought for in their proper Chapters.

But the Strengthning the Heart, and the Restoration of the Vital Spirits, are to be treated of a part, and some∣times to be preferred before the Cure of the Morbifick Causes, when there is danger of Death: But you must always take care, that whilst you endeavour to refresh the Spirits, you do not increase the Morbifick Causes; and therefore in a hot Disease you must give temperate Cordials, in a cold such as are hot.

And first, With Meat you must mix Cordials, as Con∣fection of Alkermes, or of Hyacinth in Broths; also Mutton Broth, the Fat and Skin being cut off, is good; also Gravy of Mutton is frequently used, and the Gravy of the Heart is mightily commended. The Italians make a Soop of Yolks of Eggs, Wine, Sugar and Cinnamon, which is very restorative. Jelly of Harts-horn is also very good. Cordial Juleps may be also prepared in the follow∣ing manner.

Take of the Waters of Bugloss, Roses, and the Flowers of Oranges, each one ounce; of Syrup of Apples, and of Lemons, each half an ounce; Confection of Alkermes half a dram, of Cinnamon-water two drams; make a Julep.

To the Stomach may be applied Bags made of Spices, and moistned with Wine; the private parts may be fo∣mented with Confection of Alkermes dissolved in Wine: The Arteries of the Temples, the Hands and Feet may be anointed with the same. And Apoplectick Balsam may be often held to the Nostrils.

CHAP. LXIII. Of Appetite depraved, diminished, and abolished.

THE Cause of an excessive Appetite, is a sharp Juice abounding in the Body, and especially brought from the Pancreas to the Intestine; and sending thence Vapors that are sharper than usual to the Stomach. This Acid is increased in the whole Body by sharp Meats, and Drinks, Cold and Serene Air, immoderate Grief continued long, violent Motion, and long Watching.

The Appetite is diminished by Fat Choler, and by Fat and Viscid Meat, by Hot or Rainy Weather, by too much Sleep, Sloath and great Cares.

The Causes that diminish Appetite will wholly abolish it, if they are extream.

Depraved Appetite is usual in the Green-sickness, and in Women with Child, and sometimes, but rarely, Men are troubled with it: It most frequently happens before the Flux of the Courses, or when they are suppressed.

In the Green-sickness they crave for Meats that are im∣proper and unusual, or they eat Chalk, Ashes, Coals, Pitch, Dirt, Leather, and many other things.

Appetite increased, is to be cured with such things as temperate the acid Juice, as Coral, Pearls, Crabs-eyes,

Filings of Steel, and the like; also Fat and Oily things, and Volatile Spirits.

Take of Coral prepared, and Pearls prepared, each one scruple; of white Chalk half a scruple, of white Sugar three drams; make a Powder to be divided into six Doses. Take two Papers in a day, three or four hours after eating, in a Spoonful of strong Wine.

If a Liquid Medicine be more pleasing, let him take a Spoonful of the following Mixture now and then.

Take of the Waters of Mint two ounces, and of Scurvy-grass-water, and of the Tincture of Cinnamon made by Infusion in rectified Spirit of Wine, each half an ounce; of Syrup of Wormwood one ounce; mingle them. Or,

Take of Oyl of Mace by Distillation, and of the Oyl of Juniper-berries, each one scruple; mingle them in a Glass: Let the Sick take two or three drops of this Oyl in a Spoonful of Malago Sack, or in any other ge∣nerous Wine, or in the foregoing mixture, and let him eat fat Broths.

Appetite diminished or abolished must be cured by Me∣dicines that evacuate, and correct Flegmatick and Viscid Humours: Acids and Spices correct them, Coloquintida, Turbith, Hermodactiles, evacuate them.

Take of Mint-water two ounces, of Cinnamon-water half an ounce, of Syrup of Fennel one ounce, of Spirit of Salt a sufficient quantity to make it pleasantly Acid. Or,

Take of Tartar vitriolated half a dram, of Cream of Tartar one dram; of white Sugar-candy two drams; mingle them; make a Powder to be divided into three Doses. Let him take one or two in a day in Rhenish-wine, or in the preceding mixture; and if he please, instead of Spirit of Salt, he may add half a dram of Elixir pro∣prietatis to be taken by Spoonfuls

They that dislike Acids, may take the following mix∣ture by Spoonfuls.

Take of the Waters of Mint, and of Fennel, each one ounce and an half; of Aqua vitae Matthioli six drams, of Oyl of Mace by Distillation three drops, of Syrup of Mint one ounce.

They that had rather take a medicated Wine, may use the following.

Take of the Roots of Elecampane, and of Acorus, each two drams; of the leaves of Sage, Marjoram, Garden-rue, each one handful; of the Seeds of sweet Fennel two drams, of Orange-peel dried one dram; being cut, and grossly bruised, put them into a Bag, and hang it in a Glass, and pour on it twenty ounces of Whitewine; after it has stood a night in a Cellar, three, four or five ounces may be taken in a Morning Fasting, or at Dinner or Supper, as every one pleases, or as they find it agrees best with them. And fresh Wine may be put on as long as the Aromatick Vertue remains in the Ingre∣dients.

When Purging is necessary,

Take of the greater Faetid Pills half a dram, of Coche one scruple, Extractum Catholicon ten grains, Oyl of Cloves two drops; mix them, make fifteen Pills, gild them, or cover them with Powder of Liquorish or Cinnamon.

Let the Sick take five of these Pills, or more, if he be hard, to Purge.

But if you design to add Chymical Medicines in form of Pills, you may prescribe in the following manner:

Take of Gum-ammoniacum, or Opoponax, or the like, cleansed by Vinegar, and afterwards thickned, half a dram; of the Troches Alhandal, Mercurius dulcis, each one scruple; mix them, make fifteen Pills, and gild them: Let the Sick, take five or more of them.

But if the form of an Apozem seem more convenient for the Sick, he having no great Aversion to bitter things, the following is convenient.

Take of Liquorish rasped half an ounce, of the Roots of Smalage one ounce, of the Shavings of Guajacum three ounces, of Laurel-berries, and Seeds of Annise, each two drams; of the Pulp of Coloquintida half a dram; boil them in a sufficient quantity of Rain-water, in thirty ounces of the strained Decoction, dissolve of Syrup of Roses solutive, with Senna of Diacnicum, each one ounce and an half; of the Salt of Tartar vitriolated two Scruples▪ Tincture of Cinnamon one ounce; mix them.

Let the Sick take three, four or five ounces of this De∣coction once or twice a day, by which the Flegmatick and viscid Humours, are both corrected and evacuated per Epicrasin. In the mean time let the Sick abstain from fat and viscid Meats: Let him use a clear Air that is hot and dry: Let Sleeping be diminished if it be too long: Let the Mind be chearful: Let the Motion and Exercise of the Body be moderate. Evacuation by Stool and Urine, daily ought to be proportionable to what is taken in by the Mouth, if it can be conveniently.

Appetite diminished by fat Choler is presently cured by correcting of it, if it abound too much it must be evacuated either by Stool or Vomit,

For correcting of this Choler, there is nothing more effe∣ctual than Elixir Proprietatis given in Wine, or any other convenient Mixture, five or six drops at a time, especially before Eating.

Those who do not love Acids, may take in place of it sweet Spirit of Salt, prepared with rectified Spirit of Wine by several Cohobations.

The same Choler is corrected by Wormwood, and Wormwood-wine; in the place of which also, other Aro∣matick Plants may be likewise infused in Wine, which may be drank in a small Quantity at Dinner and Supper.

Such Plants are Mountain-calamint, Marjoram, Rose∣mary, Garden-rue, Hyssop, Thym, Sage, and the like.

Choler is very conveniently evacuated by Vomit, by several Medicines prepared of Antimony, as Crocus Me∣tallorum, Glass of Antimony, and the Sapa Vomitoria that is made of it, Oxysarcharum, or Oxymel Vomito∣rium, Mercurius Vitae, or the like.

Rhubarb, Scammony, Tamarinds, and the like, evacu∣ate Choler by Stool.

Scammony may be prepared presently and well, if a con∣venient Dose of it, twelve or fifteen Grains, more or less, according to the Age and Constitution of the Sick, be pow∣dered in a Mortar, and a little Baulm-water, Succory-water, or the like, be poured upon it, and rubbed with it till it becomes of a milky Colour; pour it off and put more Water on, that all the Vertue of the Scammony may be extracted leaving the black Faeces at the Bottom; then add to the Liquor of Cinnamon-water, or Fennel-water, or some other Aromatick-water, two drams; of Syrup of Roses solutive, or the like, two or three drams; and so you will have a very pleasant Purging Draught; and that it may work the easier, a Scruple or half a dram of Cream of Tartar may be drank in Broth half an Hour after taking the Purging Draught.

Pleasant Tablets may be also made of Scammony in the following manner.

Take of Christals of Tartar one ounce and an half, of Dia∣gridium three drams, of Oyl of Cinnamon six drops, of white Sugar dissolved in Rose-water eight ounces; mingle them, make Tablets.

These Tablets may be conveniently prescribed for In∣fants, Children, and delicate People; the highest Dose of them is from three drams to half an ounce; an Infant must take but half a dram, or a dram, a Youth may take two drams.

They who are afraid to use Scammony or Medicines made of Scammony, though it be a kind, safe, and pow∣erful Medicine, may use Rhubarb in the following manner.

Take of choice Rhubarb rasped two drams, of the best crude Tartar half a dram, of Succory-water a sufficient quan∣tity;

infuse them all Night over ashes or in a Bath, to the Liquor strained, gently add of Syrup of Roses solutive, or of Succory with Rhubarb, half an ounce, of Cinnamon water two drams, and to take off the nauseous Smell of the Rhubarb, and to expel Wind, add of Oyl of Annise-seeds two or three drops; make a Draught.

To evacuate the over abounding Choler, those that had rather use an Electuary may take of the following.

Take of the Pulp of sharp and sweetish Prunes ten ounces, of Cream of Tartar, and the best Scammony, each two ounces; of choice Rhubarb ten drams, of sharp Cinnamon half an ounce, of Yellow Sanders two drams, of clarified Sugar a Pound; mingle them, make an Electuary. The Dose is from three drams to half an ounce; It may also be dissolved in some convenient Water, and so you may make a Potion of it.

The Cure of a depraved Appetite, depends on the Purifi∣cation of the Blood and Humours: But Volatile Salts are more successful in this case than any other Medicines, a few grains of them being taken twice or thrice in a day in Wine or some other Liquor, especially at Dinner or Supper; and to evacuate the vicious Humours, Purging and Vomiting must be used.

CHAP. LXIV. Of Nauseousness, Belching, and Vomiting.

IN perfect Health nothing is wont to be evacuated up∣wards by the Mouth, wherefore whatever comes this way signifies Sickness, whether it be Meat, Wind, or a thick or thin Liquor.

When Wind comes forth with a Noise it is called Bel∣ching, when the Meat is ejected it is called Vomiting.

Nauseousness always precedes Vomiting, and sometimes Belching.

Wind by reason of the Clamminess of its Nature, sticks to the Stomach, and is difficultly excluded, and is often accompanied with an Inflation of the Stomach.

Belching arises from windy Meats, or from other flatulent things taken inwardly, as Chesnuts, Pease, Beans, Tur∣neps, Redishes, and the like, or from Flegmatick and viscid Humours sticking to the Stomach, and rarified to Wind by taking Aromaticks.

That the material cause of Wind, is a Flegmatick and clammy Humour, is evident from the Antecedent Causes; as from Meats of a like kind, viz. Milk, Fish, especially Sea-Fish, and the Feet of Animals, and Gellies; and from the Cure, which is wholly performed by evacuating and correcting Flegmatick Humours.

As in Belching, only Wind is evacuated, so in Vomiting, either Meat crude, or more or less fermented, or various sorts of Humours, as Watery, serous flegmatick, and cho∣lerick, and the like; thin, thick, white, yellow, green, Sky coloured, or black Humours, or the like, insipid, bit∣ter, acid, rough, sweet, stinking, or Humours without Taste, and sometimes bloody Matter, or Excrements.

All Vomiting is occasioned by the Stomach being Prima∣rily or Secondarily affected.

The Stomach is Primarily affected, when the Cause of Vomiting, or of the Peristaltick Motion inverted is in it self. It is Secondarily affected by consent from other Parts; and it is provoked to the Inversion of its Peristal∣tick Motion, in Part or altogether by the Peristaltick Mo∣tion of the Guts, which is sometimes occasioned by the violent Agitation of the Diaphragma, and of the Muscles of the Belly by a violent Cough.

The Stomach is primarily disposed to vomit, first when it is inflamed, excoriated, or ulcerated; then it is easily excited to any violent Contraction of it self from any sort of Nourishment taken. Secondly, When the Nourishment by its Quantity, and chiefly by its Quality, is troublesome to the Stomach. Thirdly, when sharp Humours from he Head fall upon the S••omach, and corrode the lower Orifice, and so occasion Vomiting.

From the total Inversion of the Peristaltick Motion of the Guts, Vomiting is occasioned, as in the Iliack Passion, whereby Glisters are often vomited up.

From the same Motion inverted in Part, Vomiting is occasioned frequently, as in the Cholera Morbus, and from any other Motion upwards of Humours fermenting in the small Guts, and by Reason of the Passage of the Ex∣crements stopped.

In a violent Cough the Diaphragm being shaken violent∣ly, Vomiting is occasioned; which we think to be caused by a conjunct Compression of all the Bowels contained in the Abdomen made towards the Breast, which mightily troubles the Stomach, and forces it to the Inversion of the natural Motion.

Vomiting oecasioned by things taken in at the Mouth, is quieted of its own accord, so soon as they are vomited up, or upon use of a few Aromaticks, and Opiats, it is stop∣ped and cured. For Instance,

Take of Mint-water two ounces, Tincture of Cinnamon two drams, London Landanum two grains, Syrup of Min•• half an ounce, mingle them, let the Sick take a spoonful of this Mixture by short Intervals, and the Vomiting will presently cease.

Sharp Humours flowing from the Head upon the Sto∣mach, are to be evacuated by proper Purges mentioned before, or corrected by Medicines, that alter and tempe∣rate the Noxious Acrimony.

Vomiting of Blood occasioned by the Rupture or Erosi∣on of the Vessels of the Stomach and Intestins, is cured by conglutinating them by the following Mixture, which is also useful in other Excresions of the Blood.

Take of Plantain-water two ounces, of Cinnamon two drams, distilled Vinegar half an ounce, of red Coral prepared half a dram, of Dragons-blood ten grains, of London Laudanum two grains, of Syrup of Mirtles one ounce; mingle them.

A Spoonful of this Mixture being taken often cures most Ruptures of the Vessels, and will ••top Fluxes of Blood in a short time beyond Expectation.

But Blood collected in the Stomach, the Flux, and the Vomiting of it being stopt, will be carried off of its own Ac∣cord

by Stool; but if there is danger of the Blood's co∣agulating, to the foregoing Mixture may be added half a dram of Crabs-eyes, and one scruple of Diaphoretick Anti∣mony.

Vomiting of Matter chiefly following an Inflammation of the Pancreas, or of some neighbouring Part, or some notable Ulcer, must be cured by curing the Primary Di∣stemper.

In the mean time you may use the above described Mix∣ture, with Crabs-eyes and Antimonium Diaphoreticum.

It will be also proper to give a drop of Balsam of Sul∣phur annisated in all the Liquor he takes.

The belching and generation of Wind will be cured by, First, avoiding Flegmatick and Windy Meats: Secondly, By inciding and evacuating clammy Flegm: Thirdly, By attemperating the Choler if it be acrid: Fourthly, By dis∣cussing the Wind that is already made.

Acids and Aromaticks, and volatile Salts, incide clam∣my Flegm, and Flegmagoges purge it off. Spirit of Nitre attemperates Choler when it is acrid better than any thing else; two or three drops of it being taken in common Beer, or in some convenient Mixture.

Most Spices discuss Wind, so do the Oyls of them, but especially the Seeds, Flowers, and Barks; but Spirit of Niter is better than all, for it corrects Choler and Flegm, and hinders the Generation of Wind, and discusses that which is generated. The following Mixture is also good to ex∣pel Wind from the Stomach and Bowels.

Take of the Waters of Mint, and Fennel, each two ounces; of Spirit of Wine rectified one ounce, of the sweet Spirit of Niter twenty drops, of London Laudanum three grains, of Oyl of Mace by Distillation six drops, of Syrup of Mint one ounce and an half; mingle them.

This Mixture must be taken by Spoonfuls, often or sel∣dom according to the degree of Pain, and Quantity of Wind.

Silvius's Carminative Spirit is made in the following manner.

Take of the Roots of Angelica one dram, of Master-wort,

and Galingal, each one dram and an half; of the Flowers of Rosemary, and Marjoram, Garden-rue, and of the Herb called Basilicon, and of the Tops of the lesser Cen∣taury, each half a handful; of Bay-berries three drams, of the Seeds of Angelica, Lovage, and Annise, each half an ounce; of Ginger, Nutmegs, and Mace, each one dram and an half; of Cinnamon six drams, of Cloves, and the Bark of Oranges, each one dram; cut them and pow∣der them grosly, and pour upon them twenty quarts of Maligo Wine; digest them two days in a Bath, then distil them till they are dry, pour all again upon the In∣gredients, and distil off three Fourths.

CHAP. LXV. Of the Hickops

THe Hickops are a Convulsive Motion of the Sto∣mach.

The Matter occasioning the Hickops is either collected in the Stomach, or communicated to it from the Liver, Spleen, Bowels, or other Parts, or from the whole Body; so sharp Meats or Medicines, sharp Humours or Worms contained in the Stomach, may occasion an Idiophathick Hickop: But a Sympathick is occasioned by Inflammations of the neighbouring Parts, or from Humours, or sharp Vapours transferred to the Stomach from Diseases of the whole Body, as in acute and malignant Feavers.

The Signs of the Causes must be thus distinguished: If it be Idiopathick it is more continual, and Signs of Humours contained, in the Stomach appear, and then it is cured by Vomiting.

The Peccant Humour collected in the Stomach, may be known by Vomiting, Belching, a Taste in the Mouth, and other Signs,

If it proceed from a Disease of any other Part, the Signs of it must be sought for in the proper Chapters.

As to the Prognostick, that Hickop from any Procatar∣ctick cause, as from Meat, Drink, or Cold, is not dan∣gerous;

and also that which precedes a critical Vomiting

If it happen in a Feaver, it shews that the Disease is very dangerous: A Hickop coming after Vomiting is also dan∣gerous.

The Cure of this Disease is to be directed to the Causes of it, which as is said before, produce this Disease Sympa∣thically, or Idiopathically; the Causes that occasion a Sympathick Hickop, are the Diseases of other Parts, which being cured, the Hickop is also taken off, though those Remedies which are proper to remove the Symptom may be used in the mean while.

An Idiopathick Hickop is occasioned by Flegm, Wind, Choler, or any other acrid or malignant Humour.

That which is occasioned by a Flegmatick Humour must be cured by Remedies that incide, purge, and cleanse that Humour, and that strengthen the Stomach; to which may be added the following Medicines, which are peculi∣arly proper for the Symptom.

Take of Tincture of Castor one dram, of the Juice of Mint four ounces. Let the Sick take a spoonful or two at a time, and let his Stomach be anointed with it hot twice or thrice a day.

Vinegar of Squills may be taken frequently to incide and dissolve the Matter impacted into the Tunicks of the Stomach; or instead of it Oxymel of Squills; Cloves also held frequently in the Mouth do good; also Elixir Propri∣etatis described by Crollius is good.

Take of the Seeds of Dill two or three drams; boil them gently in eight ounces of good Wine: Let the Sick tak•• two Spoonfuls Morning and Evening.

The Seed also tied up in a Rag may be held to the No∣strils frequently; when the Disease is obstinate the follow∣ing Pills are very effectual.

Take of Castor, and Mirrh, each three drams; of Sal-gem∣ma half an ounce, of Diagridium, and Mastich, each one dram; of the fresh Troches of Agarick three drams, of choice Aloes the Weight of all; mix them with the Juice

of Mint, and make a Mass. Of each dram make six Pills, gild them, let the Sick take two or three in a Morning, two hours before Meat, twice a Week.

Pills also made of the Powder of Hiera, with Oxymel, are also good, whereof a dram may be taken at a time.

Of the days the Sick does not Purge, let him take the following Powder.

Take of the Seeds of Dill half an ounce, of Zedoary, and of Woo•• 〈◊〉〈◊〉 Aloes, of Nutmegs, Cloves, and of the Powder of D••••mbra, each one dram; mix them, let him take two scruples with a little good Wine, or adding three ounces of common Salt, let him use of it with his Meat.

Let the following Cataplasm be applied to his Sto∣mach.

Take of the Roots of long Birth-wort, of Florentine-orris, of Bayberries, of the Leaves of Rue, and dried Mint, each three drams; of Castor, and Mirrh, each two drams; of Cloves, and Hyposistis, each six drams; with Honey of Rosemary-flowers; make a Cataplasm.

Lastly, when the Disease is very obstinate, we must use a Decoction of Guajacum, and the Bath-water.

That which prooceeds from Wind, must be cured by Remedies that are proper to expel Wind: Let Cupping-glasses be applied to the Region of the Stomach, which, like a Miracle, mitigate and take off suddenly flatulent Diseases of the Lower-belly.

That which proceeds from an acrid and cholerick Humour, must be cured by Bleeding if there be a Pletho∣ra, and by Vomiting, or by Purging every third day.

Take of choice Rhubarb powdered, and moistened with En∣dive-water, half an ounce, of the Pulp of Tamarinds two drams, of the Seeds of Endive, Purslain, and Spodium, each one dram; of Yellow Sanders, and of Diagridium, each half a dram; with Syrup of Lemons, make a Mass for Pills; of half a dram, make four or five Pills to be taken in the Morning.

Of other Days let him take the Conserve of Roses and Borrage, mixed with a little of the Powder of the three Sanders.

Emulsions of the cold Seeds attemperate powerfully the Acrimony of the Humours; Syrup of Apples mixed with Syrup of Quinces is also good; hot or cold Water, or a Ptisan is also to be drank freely of.

Foment the Stomach with a Spunge dipt in Rose-vine∣gar, and apply the following Plaister to the Back and Stomach.

Take of the Ceratum Santalinum, and of Ointment of Roses, each one ounce; of Mastich half an ounce, of the Bark of Citron, and of the Flesh of Quinces, each one dram; with the Juice of Housleek; and with a little Turpen∣tine, make Plaisters.

If there be a Suspicion of a malignant Quality, Treacle or some other Alexipharmick must be prescribed; and the Region of the Stomach must be anointed with the Oyl of Scorpions.

But from whatsoever Cause the Hickops arise, the fol∣lowing Medicines are to be used. First, The Peccant Humour must be evacuated by Vomit, if the Sick can bear it, and it must be repeated, if the Disease be lessened by it, but not quite taken away: and strong Vomits must be given, if the Case so require, as Platerus teaches in his Practice, whereof he mentions an Observation in these Words. A Surgeon was seized with the Hickops, and they were so continual Night and Day, that he cou'd not sleep, nor scarce speak or eat, being extreamly weak∣ned by them, he earnestly desired we should give him a strong Chimical Vomit, which being taken, he cast up a vast Quantity of green and black Choler, the Vomiting stopt, and he recovered.

But if the Sick cannot take a Vomit, he must be purged by stool, but the Humour must be first prepared by things that incide and cleanse: Afterwards these things that fol∣low are convenient.

Cupping-glasses must be applied opposite to the Region of the Stomach, and to the Stomach.

The Stomach must be bound with a Swath-band, that

it may not be so much dilated. Ligatures of the Extre∣mities must be used.

Let him eat Anniseeds, which is thought to Cure the Hickops peculiarly.

Frequently Glisters must be injected, to draw away the Noxious Humours from the Stomach.

Young Animals must be applied to the Stomach.

Vinegar of Squills may be taken by Spoonfuls.

Sneezing casts off the Matter impacted in the Coats of the Stomach. As the Physician Chrysimacus cured Ari∣stophanes of a Hickop by provoking Sneezing, when he could not do it by stopping of the Spirits, and Gargling with cold Water.

Pills made of one dram of Aloes, and three grains of London Laudanum are good.

Platerus in his Observations says, That he cured a Boy of ten Years of Age, that had the Hickops for eight Days and Nights continually, with the Water of green Nuts distilled, with Radishes infused, first in Vinegar, which he gave him to provoke Vomiting; and though he did not Vomit at all, yet he was cured.

But to conclude, Narcoticks wiil do the Business when nothing else will.

CHAP. LXVI. Of Vomiting of Blood.

THe conjunct cause, is the Quantity or Quality of the Blood exceeding.

The external causes, are Wounds and Bruises, and vio∣lent Heat, or immoderate Cold, or unaccustomed Labour and Excercise, or Hollowing.

If the Blood flow from the Stomach, there will be almost always a continual Pain and Weight there, and the quan∣tity of it will not be much, because the Veins of the Sto∣mach are small, and Nauseousness will accompany it, and 〈◊〉〈◊〉 Blood will be mixed sometimes with Meat, sometimes with Choler, and sometimes with Flegm.

If it flow from the Head, there will be a Tickling per∣ceived about the Jaws and Pallate, and Blood will flow sometimes from the Nostrils mixed with Snot, and a Pain or Heaviness of the Head precedes.

If Vomiting of Blood proceeds from a Suppression of the Courses, it will be Periodical.

As to the Prognostick, Vomiting of Blood from what Cause soever it arises, is dangerous; for if too great a quantity be evacuated, there is Danger of Death; if it coagulate in the Stomach, and corrupt there, it occasions Fainting.

But a Vomiting of Blood from Suppression of Courses is least dangerous.

They which fall into a Dropsie by Vomiting of Blood die.

It must be cured by Medicines that cause a Revulsion of the Blood from the Stomach, and by such as attemperate it, and stop the Apertion of the Veins.

And First, Because an orderly Diet is of great use in this Case, the common Diet ought to be astringent and Empla∣stick, and also cooling, as Barley Broths, Almond and Rice Diet, Water-gruel, and Jellies, and especially Starch boil∣ed in Milk, whereunto may be added Pomegranate Juice, or a little Rose-vinegar; hard Eggs may be also used dipt in Vinegar.

Also Bread dipt in Water; Chicken Broth, with Wood-sorrel, Purslain, and Plantane boiled in it; but at the beginning of eating, some Astringent thing should be taken, as a Quince baked under Ashes, Medlars, or the like.

Let the Sick abstain from all acrid, salt, peppered, and fried Meats, and also from such things as yield a great deal of Nourishment, unless the Weakness of the Sick requires that they should be taken sparingly.

He must drink but little, and when he does, he must drink Water wherein Iron has been quenched, with a little Juice of Pomegranates in it.

The Air must be somewhat Cold, but he must not ex∣pose himself to the Winds, nor to the Rays of the Sun or Moon: He must sleep moderately, and his Body must be kept open, and his Mind free from Passion.

Bleeding must be used sparingly, and it must be repea∣ted; Frictions and Ligatures must be used, and cleansing

Glisters must be injected. Apply Cupping-glasses to the Buttocks, Legs, Loins, and Hypochondres.

Let two Spoonfuls of Oxycrat be given, if there be a Suspicion of coagulated Blood; for by the use of it, it may be easily dissolved, and driven from the Veins of the Sto∣mach, and they will be stopt thereby; foment the Region of the Stomach also with it cold; and if the Sick does not Vomit, the following Mixture may be used to stop the Veins,

Take the White of one Egg, of Rose-water, and Vinegar, each one dram and an half; shake them well, and add to them two drams of Starch; mix them, and let the Sick take it by Spoonfuls. Or,

Take of prepared Coral, sealed Earth, Bole-armonick, Blood-stone, Troches of Ambar, each one dram; of Plan∣tane-water, and Syrup of Mirtles, each two ounces; mingle them, let the Sick take it as before. Or,

Let the Sick take Morning and Evening, four ounces of the Juice of Plantane cold.

Galen says, That nothing is better than this Juice to stop any Flux of Blood.

The Juice of Purslain and Knot-grass is also good for the same Purpose.

Take of the Waters of Plantane, and Purslain, each one ounce and an half; of Syrup of Mirtles half an ounce, of Syrup of Poppies one ounce; mingle them, make a Julep to be repeated often.

Take of old conserve of Roses, and of Comfrey-roots, each one ounce; of Marmalad of Quinces half an ounce, one Mirobalan candied, Troches of Ambar, and of Lem∣nian Earth, each two drams; of Coral prepared, and of Saffron of Mars, each one dram; with Syrup of dried Roses; make an Opiat to be used frequently.

Troches of Ambar do not only bind, but also dissolve concreted Blood, and therefore are frequently to be used: Tincture of Coral, made with Juice of Lemons, is also very good.

But when the Blood is evacuated violently, and can∣not be stopt by the forementioned Medicines, Narcoticks must be taken inwardly, and injected by Glisters, and the Region of the Stomach must be anointed with Oyl of Roses and of Mirtles washed in Vinegar, and after you have anointed it, sprinkle on Powder of Coral, Bole∣armonick, and sealed Earth; or anoint the Stomach with the following Ointment.

Take of the Juices of Plantane, and Knot-grass, each one ounce and an half; Rose-vinegar one ounce, of Omphacin Oyl six ounces; boil them to the Consumption of the Juices, then add of Dragons-blood, Mastich, Pomegra∣nate peels, and Mirtles, each two drams; of Camphor one scruple, with a sufficient quantity of red Wax, make an Ointment.

Let him drink Water wherein hot Iron hath been quenched, with Syrup of Quinces and Spirit of Vitriol in it, and let his Broths be made of the same Water.

Let his Loins and Hypochondres be fomented with a De∣coction made of Plantane and Purslain in Oxycrat; and let it be used when it is almost cold; and let him put his Hands into cold Water; Afterwards let the foresaid Parts be anointed with Galen's cooling Ointment washed in Vinegar.

Bleeding being sufficiently used, gentle and frequent Purging must be ordered, whereby the Blood may be cleared from Serous and Cholerick Humours occasioning this Disease: But they ought to be made of Rhubarb, My∣robalans, Tamarinds, and the like, which Bind as well as Purge, and do not stir the Humours; they may be given in the form of a Bolus with Syrup of Mirtles, or dried Roses, or in a Potion made of a Decoction of Sorrel, Succory, Purslain, and the like.

When Purging is used, which ought to be continued for three or four days, at Bed-time, after every Purge, the forementioned Opiate, Syrup of Coral, or some other astringent and Corroberating Medicine must be used.

Lastly, For Precaution, a•• dram of Rhubarb powdered must be given once a week for a long time.

CHAP. LXVII. Of the Cholera Morbus, i. e. Vomiting and Loosness.

THis Disease was most Epidemical in the Year 1669, says Doctor Sydenham, than ever he knew it in any other Year; it comes as certainly at the latter end of Sum∣mer, as Swallows at the beginning of Spring, and as Cuckows at the Heat of the following Season. That Disease which is occasioned by a Surfeit comes at any time, the Symptoms are indeed alike, and the Cure the same, yet it is of another kind. The Disease is easily known, for there are violent Vomitings, and an Evacua∣tion of ill Humours, with great Difficulty and Trouble by Stool; there is a violent Pain and Inflation of the Belly and Guts, an Heart-burning, Drouth, and quick-pulse, with Heat and Anxiety, with great Nau∣seousness, and sometimes a Colliquative Sweat, Con∣tractions of the Arms and Legs, Fainting, a Coldness of the extream Parts, and such-like Symptoms, which great∣ly terrifie the By-standers, and kill the Patient in twenty four Hours. There is also a dry Cholera from a flatu∣ous Spirit breaking out above and below without Vomi∣ting and Loosness.

I have found, by diligent Application of Mind, and by manifold Eperience, that if on the one hand I should en∣deavour to expel the sharp Humours, that are the Fewel of the Disease, by Catharticks, I should do just as he that endeavours to quench Fire with Oyl, seeing the Operation of the most gentle Cathartick wou'd but give farther Disturbance, and raise new Tumults: And on the other Hand, should I at the first restrain the primary Effort with Narcotick Medicines, and other Astringents, whilst I hindred natural Evacuation, and detained the Humour against Nature, the Patient would be undoubt∣edly destroyed by an intestine War, his Enemy being in∣closed in his Bowels: For these Reasons therefore, I thought I must go the middle Way, that I might partly evacuate, and partly dilute the Humour. I ••ound out

this Method several Years ago, and have long experienced it, and have by it many Times reduced this Disease to good Order.

A Young Chicken is boiled in about three Gallons of Spring-water, so that the Liquor hath scarce any Relish of the Chick. The Patient is ordered to drink several large Draughts of this a little warm; at the same time a good quantity will serve for several Glisters, to be given successively, until all the Broths be consumed, and rendred upwards and downwards; an ounce of the Syrups of Lettice, Violets, Purslain, Water-lilly, may be now and then mixt with the Draughts and Glisters; though the Broth may do very well without any such Addition. So the Stomach being loaded with a considerable quantity of the Liquor, and as I may say turned, and the Injection of Glisters being reiterated, the sharp Humours are either cast out, or their Acrimony being taken off, they are re∣duced to a due Temper, the Filth being cast up by these means, which require three or fours Hours: Some Para∣gorick Medicine perfects the Cure; I use this often.

Take of Couslip-water one ounce, of Aqua-mirabilis one dram, Liquid Laudanum fourteen drops.

Instead of which any Shop-Narcotick may be made use of, and this way of diluting the Humours is much safer, and more expedite, than that which is most commonly taken to stop this most dangerous Disease; viz. either by Evacuaters or Astringents; because the Tumult is height∣ned by Evacuaters, and all things are put in a Hurly-bur∣ly by them; and the other, on the contrary, detain an Enemy in the Bowels, and of a Stranger do plainly make him an Inhabitant: To say nothing of the tedious Trouble created to the Patient, when the Disease is protracted, whereby at length the Bad Humours creep into the Mass of Blood, and easily kindle a malignant Fever.

But it is to be diligently noted, That if the Phisician be not called till the Voming and Loosness have continued many Hours, suppose ten or twelve, and the Patient is worn out, so that the extream Parts wax cold; I say in this case, all other Remedies being omitted, he must immediately fly to Laudanum, the sacred Anchor in this Dis∣ease,

which is not only to be given when the Symptoms are urgent, but also after the Vomiting and Loosness go off, and to be repeated Morning and Evening daily, till the Patient has recovered his Strength and Health.

Though this Disease be Epidemical, yet it very seldom lasts longer than August, in which it first began; on which Account I have been induced to contemplate that most subtile and elegant Artifice, which Nature uses in the Production of Epidemick Diseases; for though the same Causes wholly remain, so that many should be seised with this Disease as well in September as August, by reason of eating too much Fruit, yet we see the same Effect does not follow: And he that has carefully collected the Phaenome∣na of a legitimate Cholera, of which only we treat at pre∣sent, will confess, that that Disease which invades at any other time of the Year, though coming upon the same oc∣casion, and accompanied with some of the same Symptoms, is quite different from this now spoken of; just as if there were some secret and peculiar thing in the Air of this pecu∣liar Month, able to impress on the Blood, or on the Fer∣ment of the Stomach, some such specifick Alteration adap∣ted only to this Disease.

CHAP. LXVIII. Of a Pain in the Stomach.

A Pain of the Stomach proceeds from something that distends and gnaws it, and so causes a Solution of the Continuum.

But in the Stomach three very different Parts are to be considered, viz. The upper and lower Orifice, and the Body of it which makes its Cavity.

The upper Orifice is indued with an exquisite Sense, because a great Nerve is placed there proceeding from the sixth Conjugation, and therefore the Pains in it are very sharp, and the Heart, by reason of its nearness is also affected; and therefore this Pain is called Cardialgia, and Cardiogmos; and so great is the Agreement of the

Heart with the upper Orifice of the Stomach, that the Ancients called this Orifice 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉

But if the Membranes, constituting the Cavity of the Stomach, or if the lower Orifice be affected, it is called a Pain of the Stomach, or the Cholick of the Stomach, especially when it is occasioned by Wind.

The next cause of this Pain, is a Solution of the Conti∣nuum occasioned by things that bite and distend; and those things that chiefly and most frequently bite and di∣stend the Stomach, are Humours, or Wind, whereunto may be added Worms velicating the Tunicks of the Stomach.

Acrid and Malignant Humours, as green or Black Choler, salt Flegm, corrupt Ichor, Stinking Matter com∣ing from an Abscess of the Liver or Breast broken, and poured upon the Stomach, and all other Acrimonious Hu∣mours, may occasion a Pain of the Stomach.

Also acid Vapours arising from the said Humours may occasion the same Pain: Wind also contained in the Ca∣vity of the Stomach may occasion Inflation, and a pain∣ful Tension, but especially when it is contained within the Tunicks of the Stomach, which makes the Disease obsti∣nate, because it can be hardly discussed.

Diseases also of the Stomach, and of the neighbouring Parts are wont to occasion this Pain, as a hot or cold In∣temperies, Inflammation, Schirrhus, or any other hard Tumour occasioning a heavy Pain: And lastly, Wounds and Ulcers of the Part, and Tumours and Inflations of the Neighbouring Parts, by pressing the Stomach may occasion Pain.

But Humours and Wind that occasion the Pain of the Stomach, are either generated in the Stomach, or flow from the whole Body, or some Parts of it; from the whole Body in Feavers, or when the Body is full of ill Humours; from other Parts, but especially from the Liver, Spleen, and Brain; from the Liver flows Choler, from the Spleen Melancholly and black Choler, from the Head salt Flegm.

Also from other extraordinary and rare Causes, such a Pain may arise, as from Stones generated in the Stomach, and the like. Fabritius Hildanus relates, that a Matron having swallowed a piece of the Rine of Bacon, kept it in her

Stomach two Years, and was afflicted with continual Pain, and at length by taking a Vomit, she cast it up and was cured.

External causes occasioning this Disease, are either Meats infected with an ill Quality, or indued with a great deal of Acrimony, which are sufficient of themselves to occasion such a Pain, or they are apt to generate Winds; or taken in too great a quantity, they putrifie and be∣come Acrimonious, or they are too hot: Or strong and acrid Medicines, or such as are indued with a destructive Faculty may occasion the Pain; or when they are taken in too great a quantity, or not being well corrected, and Poisons may also occasion the same Pain.

The Diagnostick Signs are to be directed to the Part af∣fected and to the cause, and first the Situation of the Pain shews that the upper Orifice of the Stomach is affected, when it is perceived under the Xiphoid Cartilage, but the violence of the Pain occasioned by the exquisite sense of the Part shews more certainly that this Part is affected, and that it is a true Cardialgia, so do the Anxiety and Rest∣lesness, so that the Sick cannot abide in one Posture, there is also Fainting and Swooning by Reason of the Consent of the Heart, wherewith there is a great Sympathy, not only by Reason of the Nearness, but because there is a great Loss of Spirits by the violence of the Pain; some∣times also the Brain is affected by Sympathy, by rea∣son of the great Nerve that is implanted in this Part, and because acrid Vapours are elevated to the Head from the Stomach, upon which account Head-achs, Gid∣diness, and the Falling-Sickness arise sometimes.

In other Parts of the Stomach there are also sharp Pains, but they are not accompanied with so grievous Symptoms, and they resemble Chollick Pains, but they differ in Si∣tuation.

The causes occasioning these Pains are distinguished by their proper Signs, whereof the most plain are known by things evacuated; for if Flegm, or Choler, or Wind, or Worms, are ejected by Vomit or Stool, it is easie to con∣jecture that the Disease proceeds from such Causes; but though there be no Evacuation of the Morbifick Matter, we may know by peculiar Signs, when Choler, Flegm, or Wind abounds.

The Signs also of Worms may be taken from the Chap∣ter of Worms, and the peculiar Diseases of the Stomach it self, or of the Neighbouring Parts occasioning this Disease may be known by every ones proper Signs; the Humour causing the Pain may be also guessed at by the Time of the Invasion, of its Increase and Cessation; for in some the Pain is▪ worst before eating, and this signifies that Cho∣ler prevails, which when the Sick is fasting is drawn into the Stomach, or becomes more acrid thereby; in others the Pain begins presently after eating, because the crude and biting Humours, which before lay quiet in the Tu∣nicks of the Stomach, are disturbed by eating; or being seated in the bottom of the Stomach, they at that time are raised, and offend the upper Orifice, and in some the Pain is worst whilst the Meat is concocting, because acrid and biting Vapours are elevated from the Morbifick Mat∣ter by the Heat increased in the Stomach at the Time of Concoction; in others four or five Hours after eating, because the Meat is corrupted by the Concoction being de∣praved, by which means it velicates the Stomach; in others the Pain is augmented after Sleep, and this is occa∣sioned by a Catarrh, the Humour flowing from the Brain in the Sleep, which being heaped up in a great quantity occasions Pain when the Sick awakes; but the Pain is sometimes quieted by eating, the Acrimony of the Humours being asswaged by the Benignity of the Food.

As to the Prognostick, it is certain that a Cardialgia is much more dangerous than other Pains of the Stomach, by reason of the exquisite sense of the Mouth of the Stomach, and the great Sympathy that is betwixt that and the prin∣ciple parts.

The greater or lesser is the Pravity of the Morbifick cause, and the violence of the Symptoms, so is the Dan∣ger more or less.

A continual and acute Feaver, joined with a great Pain of the Stomach, threatens great Danger; for Hippocrates says, Aphor. 65. Section 5. A great Heat about the Sto∣mach, and Cardiogmos in Feavers, are ill, for they signifie a great Quantity of vitious Humours contained in the Stomach.

A Pain of the Stomach, occasioned by Worms or Wind is most commonly less dangerous, for that the Cause is not

so obstinate, and not fixed to the Part; but yet sometimes violent Symptoms arise from Worms contained in the Sto∣mach, and biting it, whereby the Sick is presently killed; and also when the Intemperies occasioning Wind is obsti∣nate, as it were habitual, it is not without Danger, because it degenerates into a dry Dropsie.

Hippocrates, Aphor. 7. Sect. 4. says, That Coldness in the extream parts, in a Cardialgia, portends Death.

The Cure of this Disease is to be varied according to the Variety of the Causes, for if it arises from the Diseases of other Parts, the Cure of them must be taken Care of; but if the Cause be seated in the Stomach it self, the Pain proceeds either from Wind or sharp and cholerick Hu∣mours, or from an Inflammation, Abscess, or Ulcer.

That which is generated by Wind, must be cured by Remedies that discuss and evacuate that flatulent Matter, and also Flegm which breeds Wind.

And first, An emollient and loosning Glister must be in∣jected, and presently after a carminative and discussing Glister made of the Decoction of the Leaves of Wild-mar∣joram, Calaminth, Penny-royal, Rue, and the lesser-cen∣taury, the Seeds of Annise, Fennel, Daucus, Cummin, and the like, wherein may be dissolved Benedictum Lax∣ativum, Oyl of Dill, Rue, and Honey of Rosemary.

If the Pain continue, a Glister must be made of Oyl of Rue, or of Nuts, and of generous Wine each equal Parts, you must add to it two ounces of Aqua-vitae, or you may prepare a Glister of Whitewine mixed with eight drops of Oyl of Juniper, Cinnamon, or of Chymical Oyl of Cloves▪ Afterwards the following Fomentation must be applyed to the Region of the Stomach.

Take of the Roots of Cyperus, Galingal, sweet smelling Flag, each one ounce; of the Leaves of Mint, wild-marjoram•• Marjoram, Penny-royal, Hyssop and Sage, each one hand∣ful; of the Seeds of Fennel, Daucus, Caraways, Bay-berries, each half an ounce; of the Flowers of Camomil, Melilot, Rosemary, and Lavinder, each one Pugil; cut them and beat them, and put them into two Bags, boil them in generous Wine, press them out and ••pply them hot to the Stomach and Belly by turns.

But when the Matter is not very cold, the following Fomentation may be prepared, which is much commend∣ed by Forestus, and he says, it will give Ease when other Medicines will do no good,

Take of the Roots of Marshmallows half an ounce, of red Roses, the Flowers of Camomil, and of the Tops of Centaury, each one handful; boil them in Fountain and Camomil-water to a Pint and an half; at last add a little good Rhenish-wine, Rose-water, and Vinegar, make a Fo∣mentation.

After the Fomentation, anoint the parts with Oyl of Rue, and Dill mixed with Aqua-vitae, and a little of the Oyl of Sage, or of Cloves Chimically extracted; after the Anointing apply the Plaister of Laurel-berries, or instead of it a Cataplasm made of Honey and the Seeds of Cummin.

In the mean time whilst these things are about, if the Stomach be nauseous, Vomiting may be provoked by some gentle Vomit, or a Purge may be given that evacuates Flegm.

After the Body is purged, Oyl of bitter Almonds mixed with White-wine may be taken, or Aqua-clareta, or Cinnamon-water.

The following Julep is very effectual to ease Pain, discuss Wind, to cleanse Flegm, and to strengthen the Stomach.

Take of the Leaves of common Worm-wood, of the lesser Centaury, and Agrimony, each half an handful; boil them to five ounces; in the Liquor dissolve one ounce of white Sugar. Let it be taken for two days in the Morning.

Amatus Lusitanus greatly commends the distilled Wa∣ter of Camomil-flowers, as a special Remedy to ease Pains of the Bowels and Stomach; three ounces of it may be taken warm; or in the place of this Water, a Decoction of Camomil-flowers may be used, which is greatly com∣mended by Forestus, who says, that he cured a certain Merchant of a violent Pain in the Stomach, with only

giving this Decoction once; he had no sooner drank it than he fell into a Sweat, belching up Wind, and in a Minute all the Pains went off, so that there was no occa∣sion for any other Remedies. A Vomit may be prepared of this Decoction, made with Seeds of Dill, or with Aga∣rick, or the Roots of Wake-robin, wherein may be dissol∣ved Oxymel, Syrup of Sorrel, or of Roses solutive, which may be given at the beginning of the Disease to mitigate the Pain by evacuation.

Galen says, that a Cupping-glass applied to the Sto∣mach removes the Pain wonderfully, but this Caution must be taken notice of, viz. That but little or no crude Humour be in the Stomach, for if there be, it will increase the Pain.

Bread fresh drawn out of the Oven, cut in the middle, and applied to the Part, does good, either by it self or sprinkled with Aromatick Powders.

But if the Disease be obstinate, you must use a Bath made of a Decoction of emollient and healing Herbs, which is safest and most effectual, for it eases the Pain by discussing the Wind, and driving it through rhe Pores of of the Skin.

But the Buisness will be sooner done, if in the Bath the Sick take some discutient Remedy, for both concurring the Cure will be effectually performed.

The Bath ought to be very hot, that the Wind may be the easier discussed, and that the gross Humours may be melted,

If Glisters cannot be injected or retained, by reason of the violence of the Pain, a Purge must be given in the Bath, where the Sick must continue half an hour or an hour till the Purge begins to operate.

But sometimes when there is danger, by reason of the violence of the Pain, Narcoticks must be given, which being prudently administred do often a great deal of good.

Some mix Narcoticks with Purgers, that the Pain may be eased, and the peccant Matter evacuated at the same Time.

Take of Diaphaenicon half an ounce, of Philonium Romanum two Scruples; with the Water or Decoction of Camomil make a Potion.

After the Pain is taken off, Purging should be repeated once or twice a Month in such as are subject to this Dis∣ease, that the Cause of Wind may be removed; corro∣borating Medicines must be also used, but if the Pain arise from Choler, it must be cured by the Evacuation of the peccant Humour, as by a gentle Vomit, or a Purging Me∣dicine; or by injecting Glisters frequently, which ought to be emollient, not sharp or hot.

Afterwards the Acrimony of the Humours is to be mi∣tigated by cooling and thickning Juleps; by Emulsions of the four greater cold seeds, by new Milk, Oyl of sweet Almonds newly drawn, by Yolks of Eggs and the like.

Strenghning Medicines must be used, and Narcoticks upon occasion, and outwardly must be applied a Cata∣plasm of White-bread Crums boiled in Milk, Yolks of Eggs and Saffron being added. Or you may apply Bread fresh drawn and cut in the middle and moistened with Vinegar; or let the part be fomented with a Decoction of the Flowers of Camomil, Violets, and of Water-lillies; or which is much better, let the Sick be bathed with warm Water, for this is very effectual for the Cure of this Disease.

If when the Pain is eased, it should chance to return again, the Sick must be purged twice a Month, and the hot Intemperies must be corrected by a cooling Diet and convenient Remedies.

But when the Pain proceeds from an Inflammation, Ab∣scess, or Ulcer, it must be cured by Remedies to be pro∣posed in the following Chapter.

CHAP. LXIX. Of an Inflammation, Abscess, and Ʋlcer of the Stomach.

THough in the Stomach, as in all other Parts, all sorts of Tumours may happen, yet here we only treat of an Inflammation or Phlegmon, which is most frequent, for other Tumours rarely happen, and may be cured by the same Method, wherewith the Tumours of other inward parts are.

An Inflammation of the Stomach is a preternatural Tu∣mour arising from Blood poured upon the Substance of the Stomach, and its Membranes. And this Blood is either pure and sincere, and then it produces a Phlegmon properly so called, or it is mixed with Choler, Flegm, and Melan∣cholly, and then it produces an Oedematous, Schirrhus, Phlegmon, or a Phlegmon mixed with an Erysipelas.

There may be many external Causes, viz. Whatsoever renders the Blood hot, as hot Medicines; drinking of Wine, or whatever forces the Blood thither, as a Bruise of the Stomach, especially when it is full of Meat; to which may be added hot and acrid things taken inwardly, as Cantha∣rides, Sublimate, and the like.

The Diagnostick Signs of this Disease are, a great Burnining, Pricking Distending, Pain with Pulsation, stretching it self to the Back. The Tumour may be felt and sometimes seen; the Shoulders are drawn backward; the Breathing, Swallowing, and Belching are difficult. Sometimes something Bloody is Vomited up; there is a violent Feaver accompanied with dreadful Symptoms.

If the Inflammation be purely from Blood it is some∣what gentler, but if it be joined with an E••ysipelas, the Symptoms are very violent, and there is an inward Fea∣ver, though the outward Parts are cold, and the Thirst is unquenchable: To this Inflammation of the Stomach that Inflammation is near of kin, which either seises that Part of the Liver, wherewjth the Stomach is covered, or that lies upon the Region of the Abdomen, which can be only

distinguished by the violence of the Symptoms; for the Inflammation of the Stomach is the most violent and most dangerous.

From what has been said, it may be easily prognostica∣ted that this Disease is very dangerous and most common∣ly deadly.

Nevertheless that is most dangerous which seises the up∣per Orifice of the Stomach, and partakes of the Nature of an Erysipelas.

If the Inflammation do not kill, and be not resolved, it degenerates into an Abscess, which is known by the Re∣mission of Heat and Feaver, the Tumour remaining.

The Abscess being broken an Ulcer is left behind, which may be known by the Evacuation of Matter by Vomit and Stool.

But an Ulcer of the Stomach does not only proceed from an Abscess broken, but also from other causes, which must be here mentioned, least any thing should be desicient in the Theory of it.

Therefore the causes of an Ulcer of the Stomach are either Internal or External; the Internal causes are acrid Humours bred in the Stomach, or transmitted from another place to it, as Yellow and Black Choler, or salt Flegm.

The external causes, are acrid and corroding Medicines or Poisons, and hither may be referred Wounds of the Stomach ill cured, which degenerate into an Ulcer; and also the Rupture of some great Vein, which can∣not be well cured after vomiting much Blood up.

An Ulcer bred in the Stomach, may be known chiefly by the Evacuation of Matter by Vomit and Stool, to which primary Sign others may be added: For first, There is perceived in the Stomach a pricking Pain with Heat, especially when any thing acrid, salt, acid, or any thing very hot or very cold is taken inwardly. There is more∣over a Loss of Appetite, Stinking, Belching, and a small and continual Feaver.

The Prognostick is most commonly deadly, unless the Ulcer be very small, and possess the Superficies, and has not a Feaver joined with it; for the Membrane of the Stomach being ulcerated is difficultly cured, and the Nou∣rishment cannot be well concocted, and it is rejected before

a due concoction; besides Medicines can do little good, for things that cleanse, which are necessary for the Cure of the Ulcer, cause Pain; and things that dry, which should satisfie the other Indication of Healing the Ulcer, are continually spoiled by the Meat and Drink, and Chyle, and other Humours which always stagnate in a weak Stomach.

The Cure of the foresaid Diseases is to be instituted particularly.

And first, The Cure of the Inflammation is to be be∣gun by Bleeding repeated in the Arm as often as the Strength will bear; and though it may seem to be dejected at first by reason of the fainting and Coldness of the extream Parts, yet this Infirmity of the Strength proceeds from an Op∣pression which requires Evacuation, and therefore Bleed∣ing ought not to be forbid.

Moreover, the opening of the Hemorrhoid Veins, if the Sick has been accustomed to this Evacuation, may conveniently cause a Revulsion of the Blood from the Sto∣mach. Cupping-glasses applied to the Back and Buttocks, both dry and moist, Frictions and Ligatures of the extream Parts, and the heating those that are wont to be cold, by applying hot Cloaths, and by anointing them with Oyl of Orris, Nard, and with other hot things, may be also conveniently used to draw the Blood from the Stomach.

But Purging is not allowed of, because it disturbes the Humours, and draws them to the Part affected. Yet Avi∣cen commends a Decoction of Tamarinds, or half an ounce of Cassia, dissolved in Endive-water, or in Whey, and would have it given daily till the seventh Day; yet it is better to abstain from all purging at the Beginning; but the Seventh Day being over, and some Signs of Con∣coction and Declination appearing, Purging may be in∣stituted with a dram of Rhubarb, and a Scruple of red Sanders infused in Borrage-water; you must add one or two ounces of the Syrup of Roses, that the Filth sticking to the Part may be evacuated.

In the mean while Lenient, cooling, and emollient Glist∣ers must be daily injected.

Take of Chicken-broth, or a Decoction of Mallows and Violets, one Pint; of Cassia fresh drawn one ounce, of Oyl of

Roses and Violets, each two ounces; of Sugar one ounce and an half, Yolks of Eggs number two; make a Glister.

The same altering and corroborating things may be taken inwardly, which were proposed for a Cure of the Pain of the Stomach occasioned by a Cholerick Hu∣mour.

But Syrup of Water-lillies, and of the Juice of Pur∣slain, are peculiarly proper, especially at the beginning; because they may serve instead of a repelling Medicine.

Emulsions also of the four cold Seeds, and of the Seeds of white-Poppies are proper, for they are lenitive, and qualifie the Heat, and so do also the following Juleps.

Take of the Waters of Roses three ounces, of Plantane two ounces, of the Juice of Sorrel one ounce and an half, of Sugar of Roses one ounce, boil them a little and strain them. Let him take two ounces twice or thrice a Day.

If the Pain be very violent, Syrup of Poppies may be taken.

Let him use for his Drink Barley-water sweetned with Syrup of Violets, which he must drink cold.

In Progress of the Disease, Medicines are to be mixed with the foregoing, which may help the Resolution; to which end the following Julep may be prescribed.

Take of the Syrups of Water-lillies, of Apples, and of the Juice of Purslain, each one ounce; of the Syrup of Ro∣man Wormwood half an ounce, of the Waters of Sorrel, Lettice, and Fennel, each three ounces; of the Species Diamargarite frigid one dram; make a Julep for three Doses to be taken twice a day▪

To these may be added restorative Opiats, Narco∣ticks and the like; all which are to be varied according to the Judgment and Discretion of the Physician.

Turpentine washed in Wormwood-water taken twice or thrice, resolves and ripens Imposthumes of the Sto∣mach.

The following Fomentation may be applyed outwardly in the beginning.

Take of the Roots of Sorrel two ounces, of the Leaves of Endive, Succory, and Mallows, each one handful; of the Seeds of Lettice, and of white Poppies, each three drams; of white and red Sanders, each half a dram; of the Flow∣ers of Violets, and of Water-lillies, each one Pugil; make a Decoction, add to it a little Rose-vinegar, fo∣ment the Region of the Stomach with it warm.

After the Fomentation, anoint the part with Oyl of Roses and Oyl of Violets mixed.

Cataplasms are not convenient in the beginning, be∣cause they oppress the part by their Weight, and by re∣taining the Heat increase the Inflammation.

If the Disease come to a Declination, and if the Tu∣mour should be resolved, which is most to be wished for, a resolving Fomentation may be applied made in the follow∣ing manner.

Take of the Roots of Florentine-orris two ounces, of the Leaves of Mint, Marjoram, Penny-royal, and of Roman Wormwood, each one Handful; of the Seeds of F••e∣nugreek and of Annise, each two drams; of the grains of Kermes one dram, of the Flowers of Staechas, Rosema∣ry, and Camomil, each one Pugil; adding towards the the end a little White-wine, make a Decoction, where∣with foment the Region of the Stomach.

After the Fomentation, anoint the Part with Oyl of Nutmeg, Wormwood, Nard, and the like; to which Wax, and the Powder of Florentine-orris, and of Cin∣namon being added, an Oyntment may be made; but Plaisters and Cataplasms are not convenient, because they oppress the Part.

But if the Tumour seem to tend to Suppuration, foment the part with a Decoction of the Flowers of Camo∣mil, and red Roses, and afterwards apply the follow∣ing Cataplasm.

Take of the Roots of Marsh-mallows two ounces, of the Leaves of Bears-breech, and of Roses, each one handful; boil them well, and then add of the Flower of Barley, and of Linseeds, and Faenugreek-seeds, and of the Pow∣der

of Camomil, each half an ounce; of white and red Sanders, each two drams; with Oyl of Roses and of Camomil, and with a little Hens-grease, make a Cata∣plasm to be renewed often.

The Abscess being broken, cleanse the Ulcer by drink∣ing Hydromel, to which must be added sometimes, ac∣cording to Galen's order, Manna of Frankincense, or Bar∣ly-water, with Sugar of Roses in the beginning in a hot Constitution.

When the Ulcer grows old, from what cause soever it prooceeds, Broths are proper, altered with cooling, and moderately astringent Herbs, Barly-broths sweetned with Sugar of Roses, new Milk sweetned with Sugar and a little Honey, Steel-waters for the ordinary drink, or Water wherein some Bole-armonick or sealed Earth has been infu∣sed; to which may be added, a little red rough Wine, if there be but little Heat in the Part; afterward the follow∣ing Apozem may be used.

Take of whole Barley one Pugil, of the Leaves of Scabious, Agrimony, Burnet, and of Maiden-hair, each half an handful; of the seeds of Melons two drams, of red Roses dried one Pugil; make a Decoction to one Pint, wherein dissolve three ounces of Syrup of dried Roses, make an Apozem for four doses to be frequently re∣peated.

For internal Ulcers, a Decoction of China is also very good, when there is no Feaver, for being taken for twen∣ty Days or more, it gently provokes Sweat, and dries the Ulcer by degrees.

But if there be danger of a Consumption, the foresaid Root must be boiled in Chicken-broth, with the foresaid Herbs, and with cleansed Barley.

When the Ulcer has continued long, Chalybeat or Purging Waters drank for a Month do good; and gentle Catharticks, as Rubarb, and Tamarinds, Myrobalans, Syrup of Roses, are to be used once a Week. Lastly, The following things are to be used.

Take of Bole-armenick, sealed Earth, red Coral, Blood-stone well washed in Rose-water, each one dram; of Dragons-blood, Gum-arabick, and Tragacanth, each half a dram; of the Seeds of white Poppies gently bruised and roasted, of Hypocistis, Sarcoco, and Frankincense, each one Scruple; of Sugar of Roses one ounce; make a Powder, whereof let him take a dram in Plantane-water, or with Conserve of Roses daily.

Or of the same Powder may be made an Opiat with Conserve of Comfry, and Roses, and with Syrup of Quinces or of Myrtles; or Troches may be made of it, with the Mucilages of the Seeds of Psyllium, or of Tra∣gacanth; of all which the Sick may take by turns, least his Stomach turn by taking of one Medicine a long while: And outwardly, to heal the Ulcer, may be applied to the Region of the Stomach, a Fomentation made of Wormwood, Roses, Pomegranate-peel, Galls, Balaustins, Myrtles, Frankincense, Mastich, and the like: And after∣wards the part must be anointed with some Astringent Oyntment, and an Astringent Plaister must be applied over.

CHAP. LXX. Of the Chollick.

IT takes its name from the Gut Colon, which is the part affected, which is long and winding, and designed by Nature to receive the Excrements of almost all the Body; and when those Excrements are retained too long, they are wont to occasion Pains of this kind.

Therefore the Causes of the Chollick is all Excremen∣titious Matter, that occasions a Solution of the Continuum, either by distending, pricking, or corroding, and is either Wind or Humours.

Wlnd generated by Crudities, or from a cold Intem∣peries of the Stomach or Bowels, if it cannot be season∣ably excluded, by reason the Feces are very hard, or by reason the Intestines are obstructed, it is heap'd up in a great quantity in the great Guts, especially in the Colon, and occasions violent Pain.

Thick Cold and Flegmatick Humours, stufft into the Tunicks of the Guts, may occasion such Pains by corroding them, if they are indued with Acrimony or by chilling them; which consequently occasions Costiveness and Con∣vulsions, as Galen says of himself, that he having a vio∣lent Chollick, evacuated glassy Flegm which was actually cold. Wind, which is easily elevated by a weak and gentle Heat from gross and clammy Humours, may also occasion this Pain.

Cholerick and Acrid Humours, and also Melancholly and Acid, may occasion these Pains, by vellicating and pricking the Intestines: But in the Action of these Causes, it may be asked how the Chollick Pain should have Exa∣cerbations and Remissions, the same Matter remaining in the Bowels, which as long as it is there should always bite and distend them. To which I answer, that that Matter does sometimes remain quiet, and then it occa∣sions little or no Pain; but sometimes is moved and excited by various Fermentations that happen to the Humours, as is wont to happen to the Falling-sickness, Hysterick Fits, and in Fits of Feavers.

But we must take notice, that the Wind or Humours do not only reside in the Cavity of the Intestines, for then they would be easily excluded by things that Evacuate and Cleanse, and by Carminative Medicines; but most commonly they are fixed in the very Tunicks of the In∣testines; upon which account it is difficult to remove them, and so they occasion an obstinate Disease. The Gross, Flegmatick and Melancholly Humours, flow by little and little through the Veins of the Intestines, and so do not presently cause Pain, till there is a quantity suffi∣cient to irritate Nature for their Expulsion, and then being moved cause Pain; or Wind occasioned by them, and included in the Coats of the Intestines distends them, and not easily getting out occasions a lasting Pain; also Choler after the same manner, poured through the Veins of the Intestines upon their Coats, and imbibed by them, causes violent Pains, which are wont to be long and ob∣stinate, because it is difficultly removed from their sub∣stance.

There is another Species of a bilious Chollick, which degenerates into a Palsie, scarce known unto the Ancients, which proceeds from a bilious Humour, not poured as the former upon the Colon, but upon the Membranes of the Abdomen which is transferred thither, either from the Gall-Bladder, or from the Mesentery in the Crisis of long Feavers, or by reason of violent Anger, or some other ex∣ternal Cause, when because of Obstructions it cannot be carried to the common Passages, but by a Preposterous Motion is put off suddenly upon the foresaid Membranes of the Abdomen: And hence great Pain arises like the Chollick, which yields neither to Glisters nor Fomenta∣tions, nor any other Remedy, but continues for many Months, by which the Body wasts, and the Sick is vexed with a sort of intermitting Feaver, and often with a slow continual Feaver; at length the Pain remitting, a Palsie succeeds, that Humour leasurely creeping through the Membranes of the Abdomen to the Spine of the Back; but this Palsie chiefly possesses the upper parts; yet there is most commonly a Pain in the Thighs and Legs, and in some few the use of them is wholly taken away, and sometimes it breaks in upon the ••ra••, and causes the Falling-sickness, from whence Death generally follows.

There are other causes of the Chollick, but less fre∣quent, viz. Stones growing in the Guts, Worms wound up in a bottom and obstructing the Intestines, a Com∣pression of the Guts by a Tumour of the neighbouring parts, and the narrowness of them, by reason of an In∣flammation, and other Tumours of the Guts, or a twisting of them occasioned by Wind, which is next to an Iliack Passion, and sometimes the Matter which causes a Chollick is Venomous and Malignant. Lastly, All hard Bodies, by obstructing the Guts, or distending them, may occasion a Chollick, as stones generated in the Guts, a great quan∣tity of Cherry-stones, hard Cheese, and the like. As Pla∣terus relates of a certain Governour, a long while troubled with the Chollick and Convulsions, who after the use of Glisters, evacuated a great quantity of hard Cheese by Stool.

The External Causes are a cold Constitution of the Air pressing and hardning the Belly, or a hot Constitution which does likewise harden the Excrements, the use of Meat and Drink unfit for the Mans Constitution, of crud•• and harsh Roots, and of gross Meats of hard Digestion, too much rest, immoderate Sleep, unseasonable Exercise, immoderate Venery, and other External Causes which may injure the Concoction of the Stomach.

The Diagnosticks of this Disease are plain, for first the Pain is violent, sometimes afflicting grievously this part, sometimes that, sometimes it possesses the Region of the Spleen, sometimes of the Stomach or Liver, or of the Reins, sometimes it is above, sometimes below the Navel, and oftentimes it is most violent in the left side; the Patient often Vomits, the Pain is increased after Eating, the Belly is most commonly bound.

The Signs of the Causes are distinguished in the follow∣ing manner, If the Pain proceed from Flegm, it is not violent, unless it be accompanied with Wind; the Sick is eased by hot things, and injured by cold things, a course of Diet before apt to increase Flegm preceded.

If the Chollick is occasioned by Wind, there is a stretch∣ing Pain, and a certain Inflation of the Belly; the Sick perceive a great deal of Wind, and a rumbling in the Belly; they are much eased by breaking Wind, a course of Diet fit to breed Wind was used before, as unseasonably

drinking cold Water, the frequent use of Pulse, Turneps, and Chesnuts, Herbs and Fruits, and the like; and if the the Wind be contained in the Cavity of the Intestins, the Pain is wandring, and not fixed to one part, and is re∣newed by Intervals. But if it be kept in within the Coats of the Guts, the Pain is fixed and is continual and obstinate because it cannot find Vent.

If the Chollick proceeds from an acrid and Cholerick Humour, it is most sharp, there is a twitching and prick∣ing Heat, Drouth, and for the most part a Feaver, the Disease is increased by hot Medicines and Diet, and is mi∣tigated by cold.

By the following Signs the Chollick and Nephritick Pain may be distinguished, if they are accurately ex∣amined.

First, The Nephritick Pain is fixed in the Kidney, and stretches it self from that to the Testes according to the length of the Ureter, but the Chollick is wandring, and painfully girds the lower Belly.

Secondly, The Chollick increases after eating, by reason of the pressure upon the Gut by a full Stomach, but the Nephri∣tick Pain is not at all increased after eating, but rather lessened, because some of the Nutritious Juice is carried to the Veins which somewhat asswages the Pain.

Thirdly, In the Chollick Vomiting is more severe, and the Belly is more bound, because the Colon lies near the Bottom of the Stomach, and the Intestines being full or violently provoked, contract themselves that they may ex∣pel the common Enemy; but either of the Symptoms is common to either of the Diseases; so that the Intention or Remission of them has a difficult Diagnostick.

For the Nephritick Pain being intense, may occasion greater Vomiting, and bind the Belly more than a remiss Chollick.

Fourthly, In the Chollick, the Patient is more eased by Vomiting and going to Stool, than in Nephirtick Pains,

Fifthly, In the Nephritick Pain, the Urine is first clear and thin, afterwards something settles to the Bottom, and at length Sand or Gravel is evacuated; bu•• in the Chollick the Urine is thicker from the beginning.

The Cure of this Disease must be varied according to

the Variety of the Causes: And first, There is the same Way of Cure for a Windy and Flegmatick Chollick, you must begin with an emollient Glister, and afterwards you must give a Carminative and discutient Glister, which must be repeated twice, thrice, or four times in a day, till the Pain be gone; but if after the use of one or two Glisters, the Sick does not go to Stool, as sometimes it happens, the Belly must be irritated by a sharp Suppository, but it is convenient to add to one of the Glisters four ounces of the Aqua-benedicta, or two or three drams of Coloquintida may be boiled in an emolient and Carminative Glister.

If Glisters do not give ease you must not obstinately persist in the use of them; for it has been observed, that when a Sick Person has taken, without any Success, twenty Glisters, another Physician having given only an ounce and an half of Manna, with two ounces of Oyl of Almonds in fat Broth has cured the Patient. But in that Pain which proceeds from thick Flegm, stronger Medi∣cines must be given.

Afterwards Fomentations, Oyntments, Baths, Plaisters and other Remedies are useful, to which must be added some Specificks.

Boil simple Water, and when it is boiling hot, add a fourth part of common Oyl, and some grains of pepper grosly beaten. Let the Sick take three or four Spoonfuls as hot as he can bear it, the pain will be gone as it were in a Moment.

Take of the best Aloes one dram, of Laudanum Opiatum grains four; mingle them, make six Pills, gild them, let the Sick take them at a convenient time, they give ease in an hours Time, and afterwards purge off the nox∣ious Humours.

Instead of the Pills, a Potion may be taken made of half an ounce of Diaphaenicon, and two Scruples of Phi∣lonium Romanum in the Water or Decoction, of Camo∣mil.

Take of the Oyl of Almonds, or of some other Oyl, for poor People, four ounces; of generous Wine one ounce, of Sy∣rup of Poppies one ounce; mingle ehem, make a Potion.

Oyl of sweet Almonds also taken with Manna in fat Broth asswages the Pain, and evacuates the Peccant Matter.

If the Disease is lasting, it may be successfully treated with a Decoction of Guajacum continued for many Days, purging now and then with Elixir Salutis, and injecting Glisters frequently.

But if the Chollick proceed from Flegm, boil the Gua∣jacum with Wine.

A Bilious Cholick is cured by emolient Glisters, and with such things as attemperate the Acrimony of the Humours.

Give Juleps of the Waters of Erratick Poppy, of Lettice and Sorrel, with the Syrups of Violets, Apples, and Le∣mons: If the Pain is very violent we must use Narco∣ticks; the Pain being somewhat mitigated.

An Infusion of Rubarb in Succory-water is to be given with Syrup of Roses, and to be repeated often, till the Stock of Matter is evacuated. If gentle Purging be not sufficient to eradicate the Disease, we must use Mercu∣rius Dulcis, which being given sometimes with purging Medicines that have Diagridium in them perfects the Cure.

They that dislike Diagridium, may give Mercurius Dulcis alone made into Pills, with Conserve of Roses, drinking upon them an Infusion of Rubarb and Senna, with Manna, and Syrup of Roses added to it.

Afterwards it will be convenient to use Tunbridge or such like Waters.

When the Pain is violent, you must fly to Laudanum, with which Catharticks may be sometimes given, but in a large Dose, because they are much blunted by Lau∣danum.

Bleeding is sometimes proper in this sort of Chollick, when there is danger, least the Violence of the Heat should occasion a Feaver; if there be a Feaver already it is presently to be used.

When there is a great Drouth cold Water must be given, according to Galens Instruction. And Amatus Lusitanus says, he wonderfully cured of a sudden such a Pain by the use of it; and Septalius declares, in two Observations, that he used it inwardly and outwardly with great Success.

For the Cure of a Chollick that degenerates into a P••lsie,

put the Patient into a warm Bath, made of a Decoction of emollient things, the Belly being loosned with various Glisters, and the first Passages opened by Catharticks, the Patient must be bathed twice or thrice, or four or five times in a day, that the Acrimony of the Humours may be attemperated, and that the Pores of the Membranes may be opened. The next day let the Humour be purged with some proper Cathartick, and then the Bath must be repea∣ted, and so you must do every other day, if the Patient be able to bear it, till the Humours being purged off, and the pain quieted, he is recovered.

In the mean time you must continue the use of Glisters, but those made with Milk are best to asswage the Pain, to which may be added Cassia, Oyl of Violets, and Oyl of Lillies.

Let the Belly be frequently anointed with Oyl of Camo∣mil, of Dill, sweet Almonds, Lillies, and with Butter. Lastly, Use Whey and Tunbridge-waters, or the like; and if the Disease continues a long while, those things may be used which are proper to cure Hypochondriack Melancholly; and Bleeding is to be used at the beginning of the Disease, and before Purging, and to be often repeated, if the Blood seem to be bad, or if something of a Rheumatism seems to be joyned wtih it.

Lastly, All those Remedies which are proposed for the Cure of a Bilious Chollick may be used in this Case; and if these things do no good, some Physicians prescribe the following Potion, which though it be loathsome, and will not go down with the delicate, yet they say it presently mitigates the Pain.

Take of Horse-dung one ounce, crumble it in small Pieces, and infuse it in a Pint of Erratick Poppy-water, to which add eight or ten drops of Spirit of Wine. Strain it gently, and divide it into three Doses to be taken when the Pain is most violent.

But if the Disease degenerates into a Palsie, you must use to the Spine of the Back, and the paralitick Parts, some resolving Balsam, and such an one as strengthens the Nerves, if there be a Feaver; but if there be no Feaver, you may apply Wooll dipt in Oyl or Ointment to the Pa∣ralitick

Parts, taking great Care that the Patient does not catch Cold, for by that means the Humour will be more fixt upon the parts, and the Perspiration of it will be hindred.

CHAP. LXXI. Of the Bilious Chollick of the Years 1670, 71, 72.

IN all these Years the Blood was much inclined to put off upon the Bowels hot and Cholerick Humours, upon which Account this Chollick was more frequent than is usual: The same Febrile Symptoms preceded this Disease as used to go before the Dysentery, that reigned in those times; and sometimes this Disease followed the Dysentery, when it had a long while afflicted the Patient, and was just about to leave him; but when it did not follow a long Dysentery, it generally took its Rise from a Feaver, which after some Hours was wont to end in this Disease; it chiefly seised Young People of a hot and Cholerick Con∣stitution, especially in the Summer the Pain of the Bowels was extreamly violent, and more intollerable than any other that afflicts poor Mortals; it sometimes binds as it were the Guts, and sometimes being contracted to a Point, it bores like an Auger; the Pain now and then remits, and presently the Fit approaches again, which as soon as the Patient perceives, he looks sadly, and bemoans himself, as if it were actually upon him. At the beginning of this Disease the Pain is not so certainly determined to one Point, as in the Progress of it; nor is the Vomiting so frequent, or does the Belly so obstinately resist Catharticks; but the more the Pain is increased, the more pertinaciously is it fixed in a Point, the Vomiting is more frequent, and the Belly more bound, till at length by the dreadful Force of these Symptoms, a total subversion of the Peristaltick Motion of the Guts, if the Patient be not relieved; and by conse∣quence an Iliack Passion is procured, in which Disease all purging Medicines become presently Emetick, and Glisters that are injected are vomited up with the Excrements.

The Matter that is cast up after this Manner, if it be sincere, and without mixture, is sometimes green, and sometimes Yellow, and sometimes of an unusual Co∣lour.

In order to the Cure, I bleed freely in the Arm, if no Blood has been taken away before, and after two or three Hours I give an Anodyne; the next day I prescribe some gentle Purge, and order that it should be repeated. The next day save one, and sometimes thrice, according as the Relicks of the Humour are more or less.

But we must take notice, that if this Disease proceeds from eating too much Fruit, or from any Meat of hard Digestion, upon which account ill and corrupted Juices are first transmitted to the Blood, and afterwards to the Bow∣els: I say in this Case the Stomach must be washed with large draughts of Posset-drink, which must be vomited up again; which being done, an Anodyne must be given and the next Day a Vein must be opened; and as to other things, you 〈◊〉〈◊〉 proceed according to the Directions above mentioned; but when the Violence of the Pain, and the Vomiting (by reason of which the Guts are as it were inverted) do resist the Operation of the Catharticks, for it is in vain to give a gentle Purge, unless the Patient is easily purged, which must be carefully inquired into; for such a Medicine being not strong enough to make its way through the Intestines, the Patient is more injured thereby; for by its ineffectual Agitation the Vomiting and the pain are increased. A lenitive purging Potion of the Infusion of Tamarinds, of the Leaves of Senna, and Rubarb, in which may be dissolved Manna, and Syrup of Roses, is to be preferred before other Catharticks, for it least exagi∣tates and moves the Humours; but if the Sick cannot re∣tain a Liquid Medicine by reason of an Aversion, or be∣cause of the Vomiting, you must necessarily use Pills; among which the Pill Coch pleases me best, for they pass best through the Body in this, and in most other Cases. But when the Weakness of the Stomach, or the Vomiting is so great, that the Pills cannot be retained, then I first order an Anodyne, and a few hours after a Purge; but there must be so much space betwixt them, that the Ca∣thartick be not quelled by the Narcotick, and so rendred ineffectual; but that it may continue so long in the Sto∣mach

as is necessary for its imparting its purgative Quali∣ty to it, that it may operate when the Vertue of the Nar∣cotick is spent, though the purge, if it could be conve∣niently done, is best given a long while after the Anodyn, for twelve hours after taking it, the patient is difficultly purged.

But because in this, as well as in most other Diseases wherein Narcoticks are indicated, a purge always increa∣ses the pain (at least when it has done working, for while it is in Operation the patient is not so ill) therefore I usu∣ally give an Anodyne as soon as the purge has done work∣ing, which I order to be taken Morning and Evening daily betwixt the purges, that I may the more certainly appease the pain, till the patient has been sufficiently purged.

The purging of the Humours being over, I endeavour to bridle the Fury of the Disease (which now only re∣mains to be done) by giving an Anodyne constantly Mor∣ning and Evening, which must be sometimes repeated oftner; nor could I ever take off violent Pains without a larger Dose than is usual, and that repeated too; for that which is sufficient to vanquish another Disease, will be al∣together insufficient in this Case, the violence of the Dis∣ease subduing the force of the Medicine: And it is indeed safe to repeat Narcoticks, while such a Pain as this con∣tinues violent, but not when it is gone off. Wherefore I repeat the Anodyne according to the degree of the Pain till it ceases, or till it be very much lessened.

Yet there must be such a Space of Time between them, that you may find what may be hoped for from the former Dose, before another be given; but for the most part unless the Pain be very violent, a Paregorick given Mor∣ning and Evening may be sufficient. Liquid Laudanum is the Anodyne I chiefly use, whereof I give Sixteen Drops in some cordial Water; or the dose may be increased ac∣cording to the violence of the Pain. But here I must ad∣monish you, that though I have said Bleeding and pur∣ging must necessarily precede this quieting Method, yet sometimes upon occasion both being omitted, you must begin with Anodynes.

For Instance, when by reason of some preceding Sickness, large Evacuations have been used not long before the Com∣ing

of the Chollick, for many Times they who have reco∣vered of another Disease have fell suddenly into this, by reason of the Weakness of the Bowels; especially if there be a great degree of Heat occasioned by drinking of Wine or some other Spiritous Liquor immoderately; I say in this Case, it is not only unnecessary, but I think it is in∣jurious, to give Catharticks again; for by them new Tu∣mults will be raised. Moreover, The Guts are most com∣monly sufficiently cleansed by Glisters frequently used, be∣fore the Physician is advised with; so that partly for this cause, and partly by reason of the long continuance of the Disease, Narcoticks seem in a manner to be only use∣ful.

But because this pain of it's own Nature is wont to re∣turn more than any other, all Occasions of its Relapse must be prevented, by giving an Anodyne twice a day for some days; but if as often as the Narcotick is intermitted, the pain now and then returns, as it sometimes happens, I do not know any thing that will so certainly perfect the Cure, as riding on Horseback, or in a Coach, with which the Patient must take long Journies; and in the mean while an Anodyne must be given constantly Morning and Evening. But Riding must not be used before the Pati∣ent has been well purged, and then it must be continued for many Days.

If the Patient be young, and of a hot Constitution, I order a cooling and thickning Diet, suppose Pulp of Bar∣ly, Panada, and the like; and every third Day, if the Stomach is craving, a Chick or a Whiteing boiled; and I allow no other Drink than small Beer, or Milk-water, and this is all I order, unless Riding necessary to recover the Health requires more nourishing Food, and more gene∣rous Liquor, whereby the Spirits exhausted by Exercise may be repaired.

But when the Disease, being unskilfully treated, has a long while afflicted the Patient, so that the Bowels become weak and infirm, and he is in a manner quite wasted, I say in this Case we find by experience, that the free use of Epidemick Water, or of Aqua-mirabilis, or any other the Patient likes best, relieves him at this Time beyond Expectation,

Moreover, As in the Cure of the Disease, so when it is over, the thin Diet we have mentioned must be observed for some time; for this Disease being more apt to return than any other, and seating it self upon the principle parts of Concoction, the least error in this kind will presently occasion much Pain: Wherefore in this and all other Dis∣eases of the Bowels, Meats of hard Digestion are carefully to be avoided, and things of easie Digestion must be taken only in such a Quantity as will suffice to sustain Life.

CHAP. LXXII. Of the Hysterick Chollick.

A Certain kind of Hysterick Disease afflicts some Wo∣men very like the Bilious Chollick, both as to the Sharpness and Situation of the Pain; and also upon the account of the Humours ejected by Vomit of a Yellow and green Colour. But least any one should take it for the Bilious Chollick just now mentioned, I will treat of it in a Chapter by it Self.

Those Women that are of a lax and crude Habit of Body, are chiefly afflicted with this Disease; and they that have lately laboured under some other Hysterick Indis∣position, (or which is very often) those that have scarce evaded a difficult and hard Labour in bringing forth a large Child, whereby the Mothers Natural Strength has been almost Spent.

A Pain, as violent almost as that of the Chollick or Iliack Passion, seises the Region of the Stomach; and sometimes it comes a little lower, and then violent Vomitings follow, and the Matter which is cast up is sometimes yellow, and sometimes green. And moreover, (which I have often observed) there is a greater Dejection of Spirit, and De∣spiration, than in any other Disease whatever. After a day or two the Pain goes off, and returns again in a few Weeks after as violent as it was before; sometimes it is accompanied with the Jaundice, which is very visible, and which goes off of its own accord in a few days, when all

the Symptoms are gone off; and when the Patient seems very well, the Smallest Disorder of Mind, whether it be occasioned by Anger or Sorrow (to both which in this Case Women are very prone) almost recalls the Pain, which may be said of walking, or any other Exercise used too soon, for by these means Vapours are elevated in a Lax and weak Habit of Body; when according to the Vulgar Opinion I say Vapours, whither they be so or no, or whither they are Convulsions of particular parts, the Phae∣nomena may be solved either way. These Vapours or Convulsions, when they invade this or that Region of the Body, produce Symptoms agreeable to the part they invade, and though they are one and the same Disease every where, yet they cunningly resemble most of the Diseases Mankind is exposed to.

Bleeding and Purging repeated, which were plainly in∣dicated at the beginning of a Bilious Chollick, are not to be used here, but the whole Business must be done by Anodyns, unless a great Quantity of Blood and Humours so resists the operation of the Narcotick, that though it be often repeated, it cannot quell the Tumult, till the Patient is blooded and purged, which I have observed in Wo∣men of a very sanguine Constitution, and in Virago's. If the Case is so, Bleeding or Purging, or perchance both, must make Way for the Anodyne; for either of these being used, a moderate dose of the Narcotick will perform the Business, which otherwise would signifie nothing, though the largest Dose is given: But this seldom happens, and these Remedies must not be repeated; and when they are used, when there is need of them, you must proceed in giving Anodynes in that Method which I have proposed in the Bilious Chollick; and they must be taken often or sel∣dom according to the degrees of Pain. But for as much as this Disease, in Hypochondriack as well as in Hysterick People, often ends in the Jaundice, and as this comes on that goes off, we must take notice that in curing this kind of Jaundice, all Catharticks are to be wholly omitted; or if they are given, you must use only Rubarb, or some other gentle Purge; for there is danger least by purging new Tumults should arise, and so all the Symptoms re∣turn; and therefore in this Case nothing must be done presently, seeing the Jaundice taking its Rise on this Ac∣count,

generally lessens of its own accord, and wholly vanishes in a short time: But if it continues a long while and seems to go off difficultly, Remedies must be taken for it. I use the following.

Take of the Roots of Madder, and of Turmerick, each one ounce; of all the greater Celandine, and of the Tops of the lesser Centaury, each one handful; boil them in equal parts of Rhenish-wine, and of Fountain Water to a quart; in the Liquor strained dissolve two ounces of the Syrup of the five opening Roots; mingle them, make an Apozem. Let the Patient take half a pint Morning and Evening till he is well.

But if the Jaundice comes of it self, the Chollick not go∣ing before it is necessary, besides the alteratives just men∣tioned.

To give Cholagogues, that is such things as purge Choler by Stool, viz. once or twice before the Patient enters upon the Apozem prescribed, and afterwards once a Week, as long as he takes it. As,

Take of the Electuary of the Juice of Roses two drams, of Rubarb finely powdered half a dram, of Cream of Tartar one scruple; make a Bolus with a sufficient quantity of Syrup of Rubarb with Succory; give it early in the Morning; let the Patient drink upon it a small draught of Rhenish-wine.

But if notwithstanding the constant taking of these things a long while, the Disease continues obstinate, the Patient must drink Tunbridge-waters, or such like, from the Foun∣tain every Morning till he recovers.

CHAP. LXXIII. Of the Iliack Passion.

THis dreadful Disease being hitherto almost in the Opi∣nion of all Mortal, takes its Rise from the inverted and preposterous Motion of the Intestines, to wit, the Fi∣bres of the Intestines, which ought to be contracted from the Superior toward the Inferior, are drawn to the Superi∣or; and whatsoever is contained in the Intestines, is not protruded to the Belly, but towards the Stomach, and is violently regurgitated to the Mouth, so that Glisters, how sharp soever become vomitive; and also Catharticks taken by the Mouth are suddenly cast up by Vomit. And in my Opinion, the exquisite and intollerable Pain coming upon this Disease, is only occasioned by the foresaid preposterous Motion of the Intestines; for whereas those Folds, which the many Circumvolutions of the Intestines make, are so formed by Nature, that they should most fitly conduce to the carrying down of the Faeces: When they, I say, are forced to give way to a Motion contrary to their Fibres, the aforesaid Pain is occasioned from thence, which is fixed to one part, and is like the boreing of an Auger, when either the Valve, which is placed at the Beginning of the Colon, hinders the going back of the Excrements to the Ilion, or any other Membrane belonging to the Sinus sustains alone the Force of this preposterous Impulse.

We may assign a twofold Cause of this Inversion, from whence the Pain arises, viz. Obstruction and Iritation.

First therefore, Whatever violently obstructs the Inte∣stines, so that nothing can pass downwards, necessarily pro∣duces this contrary Motion in them. Among these Authors are wont to reckon the Excrements hardened, gross Wind collected in a great quantity, and tying up as it were the Intestines, the Constriction of them in a Rupture: And lastly An Inflammation, and other great Tumours, which stop up the Internal Cavity of the Intestine. In the mean time we must not deny, that this contrary Motion, owing its

rise to these Causes, is rather to be accounted the Motion of these things taken in, than of the Intestines; nor is this an Inversion of the whole Duct of the Intestines, but only of those which are situated above the Seat of that Obstruction; wherefore I call an Iliack Passion proceeding hence spurious.

Secondly, I think that in the Iliack Passion, the cause of the Inversion of the Peristaltick Motion of the Intestines, is most commonly after this Manner, viz. Sharp and malig∣nant Humours are cast upon the Stomach, and the Guts that are next to it, by which the Motion of the Stomach is inverted, and forced violently to cast up what is contain∣ed in it; at length the small Guts that are joined to the Stomack being weakned, yield to the violent Motion of it, and with them at last the greater follow by Consent; the Stomach Vomiting, leading as it were the Dance, this I call a true Iliack Passion, and which is treated of now.

The Method of cureing it has been hitherto in a man∣ner unknown, whatever some boast of the use of Quick∣silver and Bullets, which besides that they do little good, are very oft injurious.

I have successfully used the following Method,

When it appears by Glisters cast up by the Mouth, and other Signs, that it is a true Iliack Passion, I endeavour these three things.

First, That the contrary Motion of the Stomach, which causes the like Motion of the Guts, may be hindred. Secondly, That the Intestines being weakned by the sharp Humour may be corroborated. Thirdly, That the Sto∣mach and Guts be freed from these Humours. And that I may Answer these Indications, I institute the Cure after this Manner. First, I prescribe one Scruple of Salt of Wormwood in a spoonful of Juice of Lemons to be taken Morning and Evening; but at other times of the Day I order some spoonfuls of Mint Water, without Sugar or any thing else, to be taken twice in an Hour; by the repeated use of which alone, the Vomiting and the Pain arising from thence will soon vanish. At the same time I order a living Kitling to lie continually upon the naked Belly. But after the Pain and Vomiting has wholly ceased for the Space of two or three Days, I give one dram of the Pill Coch-major

dissolved in Mint-water, which I also order to be used very often, all the time of the working of the Pills, that I may the more certainly hinder the Return of the Vomit∣ing; nor is the Kitling to be removed, before the Patient has taken the Pills.

I have observed, that it is to no purpose to give these Pills, or any other Purge, how strong soever, until the Stomack is strengthned, and reduced to its Natural Motion, and the Guts also to that which is proper to them; for otherwise all Catharticks taken inwardly would prove Emetick, and so do more hurt than good, and therefore I do not use Purging Medicines, until for some Time I have used those Medicines which respect the Stomach.

I prescribe a very thin Diet, for I allow onely some spoonfuls of Chicken-broath to be taken twice or thrice a day; in the mean while I order the Patient to keep his Bed all the Time of the Sickness, till the Signs of perfect Health appear; and when he is well I appoint him to persist in the use of the foresaid Wa∣ter for a long Time, and to keep his Belly warm with Flannels doubled, that there may not be a Relapse where unto this Disease is very prone.

CHAP. LXXIV. Of Costiveness.

BY Costiveness we do not understand a pefect Stoppage of the Belly, so that nothing is evacuated downwards as happens in the Iliack Passion, but only a slow and unsuit∣able Evacuation that Way, whereby the Excrements, and the Relicts of the Meat are seldom ejected, and not accor∣ding to the quantity taken in.

When the Belly is bound, Vapours arise to the Head, and Catarrhs and Diseases of the Brain are produced, the Concoction is hindred, and the Actions of other Parts.

For the Cure of this Disease the following Medicines must be used.

Take of the Roots of Marsh-mallows, and of Lillies, each two ounces; of the Leaves of Mallows, Marshmallows, Mer∣cury, Violets, Bears-breach, each one Handful; of Linseed, and Fenugreek-seeds, each half an ounce; of the Seeds of Annise one dram and an half, of sweet Prunes three pair, of the Flowers of Camomil, and Meli∣lot, each one Pugil; boil them to a Pint and an half, in the strained Liquor dissolve of Oyl of Lillies, and of Fenugreek-seeds, each two ounces; of fresh-butter half an ounce, of Catholicon Duplicatum, and of Diaprunum simplex, each six drams; make a Glister to be injected as often as there is Occasion.

But we must endeavour to loosen the Belly by other Remedies, because by the frequent use of Glisters Nature grows more slothful, and at length will never ease the Body without a Glister.

To this End sweet Prunes, or roasted Aples, are to be eaten an hour before Meals, or in a Decoction of Prunes an ounce of Mauna must be dissolved.

The following Broth certainly loosens the Belly and keeps it loose for some Days.

Take of the Leaves of Beet and Mercury, each one handful, boil them in common Broth, let it be taken an Hour before Dinner.

CHAP. LXXV. Of a Lientery, and the Caeliack Passion.

A Lientery is a sort of Loosness, wherein the Meat is voided in a short time, nothing altered, but as it was taken in at the Mouth: In the Caeliack Passion the Nou∣rishment is voided crude and imperfectly digested.

There are many Causes of the Lientery and Caeliack Passion proposed by Authors, all which may be reduced to three Heads; viz. A cold Intemperies of the Stomach and Intestines; an Irritation of those Parts, and a great Debility of the retentive Faculty, from a grievous and deadly Disease.

There is another Cause different from those mentioned, which uses peculiarly to produce the Caeliack Passion, viz. The Obstruction of the Meseraick Veins, whhich stops the Passage of the Chyle. Aetius and Celsus, and many of their followers, do propose another Cause of the Lientery, viz. A hard Cicatrix upon the Intestines produ∣ced by a Dysentery,

The Cure of this Disease is to be varied according to the Variety of the Causes producing it: And first, that which is occasioned by a Flegmatick Humour, may be Cured with the following Remedies; but you must begin by Purging Medicines made of Aloes, Rubarb, and Miro∣balans,

Take of old Conserve of Roses six ounces, of the best Venice Treacle six drams, Marmalad of Quinces a sufficient quantity, mix them. Let the Sick take half a dram in the Morning drinking nothing upon it. Or,

Take of Japan Earth one dram and an half, of red Coral and Crabs-eyes prepared, each one dram; of old Con∣serve of Roses one ounce and an half, of Balsamick Syrup a sufficient quantity; mix them, make an Electuary.

The Quantity of a Nutmeg of it may be taken Morning and Evening.

Take of Gum-caranna, of the Magisterial Stomach Plaister, each a sufficient Quantity; of the Chymical Oyl of Wormwood twelve drops; mix them, make a Plaister for the Region of the Stomach.

That which proceeds from a bilious Humour, is to be cured with the following Remedies.

Take of the best Aloes washed in Rose-water three drams, of Rubarb powdered and moistened with Borrage-water one dram, of Mastich, red Sanders, red Coral prepared, each one scruple; of Syrup of Roses solutive a sufficient quantity; make a Mass for Pills, of which let the Sick take half a dram, or one dram at a time.

Take of sealed Earth, Bole-Armenick, red Coral prepared, Pearls prepared, of the Seeds of Purslain and Sorrel each one dram, of the Shavings of Hartshorn, and of the Leaves of Mint dried, each one scruple, of red Roses half a Pugil; make a Powder to be sprinkled upon Broth, or to be taken in a Spoon with a little Water wherein Iron hath been quenched.

But if the Stools be pure Chyle, this Distemper does not proceed from the Fault of the Stomach, but from the Obstruction of the Meseraick Veins, which is very frequent, and is chiefly incident to Children, there∣fore it is to be cured with Remedies that open Obstructions.

CHAP. LXXVI. Of a Diarrhea.

A Diarrhea, is that sort of a Loosness, in which excre∣mentitious Humours, without Blood, Chyle or Ul∣ceration of the Intestines are voided by Stool.

There is another Species of a Diarrhea which is called colliquative, arising from the Colliquation of the Sub∣stance of the Body.

If a Diarrhea be critical, and is easily born, and the Disease goes off by it, or is greatly diminished, the Sick is benefited by it.

But if a Diarrhea be Symptomatical, it occasions a great deal of Pain to the Sick, the Strength greatly de∣creases, and the Disease upon which it comes is considera∣bly augmented, or at least does not decrease.

As to the Cure a Symptomatick Diarrhea rises for the most part from bad and corrupted Humours, therefore the Cure of it is to be begun with the Evacuation of the Pec∣cant Humour.

Take of the best Rhubarb six grains, of the Seeds of Corian∣der bruised two scruples, infuse and boil them in a suffici∣ent quantity of Fountain-water, to three ounces of the strained Liquor, add of Rubarb torrified one Scruple, of the Syrup of Succory with Rubarb one ounce, mix them, make a Draught to be taken in the Morning.

A Vomit is also sometimes convenient, because it makes a Revulsion and Evacuation of the Morbisick Matter.

If there be Signs of abundance of Blood, and the Body being strong, Bleeding is necessary in the be∣ginning.

The Body being sufficiently evacuated, both by purging Medicines, and the Loosness it self; astringent and strengthning Medicines are to be given, as well by the Mouth, as injected by Glisters, and applied to the Belly.

Take of Diascordium grains twenty five, of the compound Powder of Crabs-Claws grains seventeen, of Syrup of Mint a sufficient quantity, mix them, make a Bolus to be re∣peated upon Occasion.

Take of Epidemick-water half an ounce, of Cinnamon-water hordeated three drams, of black-cherry-water, two ounces, of Liquid Laudanum prepared with Juice of Quinces fif∣teen drops, Syrup of Mint a sufficient quantity; mix them, let the Sick take this Mixture after the Bolus above prescribed, and at Bed-time.

Take of Epidemick-water, and of Cinnamon-water hordeated each three ounces; of Mint-water one ounce, of Black Cherry-water five ounces, of Syrup of Mint a sufficient quantity; mingle them, let him take six spoonfuls after the Bolusses.

Take of Hartshorn calcin'd two ounces, of Nutmeg four Scru∣ples, of the Roots of Tormentil three drams; boil them in Fountain-water to three Pints, adding towards the end an ounce of White-bread, add to the strained Liquor two ounces of Doctor Stephens's water, and sweeten it with Syrup of Quinces, let him take it for his ordinary Drink. Or,

Take of Diascordim three drams, of Cinnamon-water, and simple Angelica-water, each five ounces; infuse them hot in a close Vessel to draw a Tincture, strain it, and add to it fifty drops of Laudanum Cydoniated, and a suf∣ficient quantity of Syrup of Mint; mingle them, let him take two Spoonfuls every Night at bed-time, and in the Day a spoonful after every Stool. Or,

Take of London Laudanum three grains, of Doctor Stephens's water, and of Cinnamon-water hordeated each one ounce, of Syrup of Quinces one dram, mingle them, make a Draught, let him take it at bed-time, repeat it at three in the Morning, and at eight in the Morning.

Take of the Leaves of Mint, the tops of Wormwood each four handfuls; of Zedoary, Galingal, Cyperus, sweet smelling Flag, Nutmeg, sharp Cinnamon, Mace, each half an ounce; of Cubebs, Cloves, each two drams; make two Bags to be boiled in Clarret-wine and Smiths-water, each a quart; press them hot out of the Liquor, and apply them by turns to the Region of the Stomach.

Take of Conserve of common Wormwood half an ounce, of old Mithridate Six drams, of Powder of Mastich a sufficient quantity, make a Plaister to be spread on Leather, and to be applied to the Region of the Stomach, you must spread the Margin with Paracelsus's Plaister to make it stick. Or,

Take of the Stomach-plaister three drams, of Oyl of Mace by Expression two scruples, of Chymical Oyl of Wormwood, and of Chymical Oyl of Mace, each two drops; mingle them, make a Plaister to be applied to the Stomach.

Take of Diascordium six drams, of Venice Treacle two drams▪ boil them in Cows Milk, let eight ounces of the strained Liquor be injected for a Glister, and let it be repeated thrice. Or,

Take of the Roots of Tormentil three drams, of Yellow Miro∣balans two drams, of Balaustins one dram and an half, of the Flowers of red Roses half an handful, of Rice bruised half an ounce, of Coriander-seeds half an ounce, boil them in a sufficient quantity of Fountain-water, to fourteen ounces, strain it, and make a Glister of half of it, and give the other half four hours after if the loosness con∣tinues.

CHAP. LXXVI. Of the Bloody Flux.

SOmetimes it begins with shaking and shivering, and Heat of the whole Body follows, as is usual in Feavers, and soon after the Gripes and Stools; but oftentimes there is no Appearance of a Feaver going before, for the Gripes begin and Stools soon follows; but there are always great Gripes, and a Depression of the Bowels with Pain, when the Patient goes to Stool; the Stools are frequent, with a very troublesome Descent as it were of the Guts, and they are all mucous, not excrementitious, excepting that sometimes an excrementitious Stool comes between, and that is without any great Pain, these mucous Stools are streaked with Blood, yet sometimes there is no Blood at all mixt with them through the whole course of the Disease, yet notwithstanding, if the Stools are frequent with Gripes and a mucous Filth, the Disease may be as properly called a Dysentery, as if Blood flow'd with them.

Moreover, The Sick, if he be in the Flower of his Age, or is heated by Cordials, has a Feaver, and his Tongue is covered thick with a kind of whitish Matter; and if he has been much heated 'tis black and dry; the Strength is much dejected, the Spirits are dissipated, and all the Signs of an ill favoured Feaver are present.

And this Disease does not only occasion dreadful Pains and Sickness, but, unless it be skilfully managed, it brings the Patient into great Danger of his Life; for when a great many of the Spirits, and a great deal of the vital Heat, have been exhausted by frequent Stools, before the peccant Matter can be cast out of the Blood, his Hands and Feet growing cold, he will be in danger of dying; and if he should escape Death this time, yet many Symptoms of a different kind attend the Poor Wretch. For Instance, Sometimes in the Progress of the Disease, instead of those Sanguineous Filaments which at the beginning us'd to be mixed with the Stools, pure Blood is evacuated unmingled with Slime, and in a larger quantity at every Time which is an Argument that some of the greater Vessels of

the Intestines are corroded, and so the Patient is in danger of Death: And sometimes also, by reason of the great Burning which is occasioned by a large Flux of hot and sharp Matter to the Parts affected, the Intestines are gan∣gren'd. Moreover, a Thrush at the end of the Disease does very often affect the Mouth and Jaws, especially when the Body has been a long Time heated, and when the Evacuation of the peccant Matter has been hindred by astringent Medicines, the Fomes of the Disease having not been first purged off,; and this is most commonly the forerunner of Death; but if the Patient get over the fore∣said Symptoms, and the Disease continues long, at length the Intestines seem to be affected successively downwards, till the Disease be thrust down into the right Gut, and ends in a Tenesmus. But tho this Disease is very often deadly in grown People, but especially to ancient People, yet 'tis very gentle in Children, who sometimes have it some Months, without any Injury, if it be left to Nature.

As to the Cure, When I was first called, I bled in the Arm, and at Night I gave an Anodyne, and the next Mor∣ning the following lenitive Purge.

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 Water, in three ounces of the strained Liquor, dissolve of Manna, and of Syrup of Roses solutive, each an ounce; to be taken early in the Mor∣ning.

And because 'tis very obvious, that purging Medicines, tho they be never so gentle, do heighten the Gripes, and cause a general Disorder and Depression of the Spirits, by the Adventitious Tumult they raise in the Blood and Hu∣mours, therefore I usually give an Anodyne after every Purge somewhat earlier than is customary, viz. At any time of the Afternoon if the Purge seem to have done work∣ing, whereby I may be able to quiet the Tumult I have raised. I repeat the foresaid Purge twice, to be taken every other Day, and give an Anodyne after every Purge at the Time above mentioned, and I order this to be us'd Morning and Evening when the Patient don't Purge, that

I may quell the violence of the Symptoms, and gain a Truce while I am evacuating the peccant Humours. The Anodyne I use is chiefly Liquid Laudanum, viz. Six∣teen or eighteen Drops of it in any Cordial-water for one Dose.

After Bleeding and Purging once used, I allow through the whole course of the Disease, any temperate Cordial to be taken now and then, as Epidemick-water, compound Scordium-water, and the like. For Instance,

Take of the Waters of Black-cherries and Strawberries, each four ounces; of Epidemick-water, and compound Scordium water, and of Cinnamon-water hordeated, each one ounce; of prepared Pearls one dram and an half, of Christaline Sugar a sufficient quantity, add half a dram of Damask-rose-water to make it pleasant to the Taste, mingle them, and make a Julep, of which let him take four or five spoonfuls when he is faint, and any other time when he will.

I chiefly used these things in ancient and Flegmatick People, that I might somewhat refresh and comfort their Spirits usually dejected in this Disease: their Drink was Milk mixt with three times the quantity of Water, or the white Decoction of Harts-horn, and of white-bread, each two ounces, boyled in three Pints of Fountain-water to two, and sweetned with a sufficient quantity of white Sugar, and sometimes Posset-drink; and when they were very weak, they took for their ordinary drink cold, a quart of Fountain-water boiled with half a Pint of Sack; they were dieted sometimes with Panada, and sometimes with Broths made of lean Mutton. I kept ancient People much in Bed, and permitted them to use more freely any Cordial-water they had been accustomed to, than was fit for Young People and Infants. This Method was the best I have hitherto met with for the Cure of this Disease, which seldom lasted after the third Purge.

But if the Disease was obstinate, and did not yield to these things, I prescribed the foresaid Paregorick every day in the Morning and at bed-time, till the Patient was quite well; yea, that it might be the more certainly quelled, I gave the foresaid Laudanum every eighth Hour, and a

larger Dose than I have mentioned above, viz. twenty five drops, if the former Dose was not sufficient to suppress the Flux. Moreover, I ordered a Glyster made of half a a pint of Cows-milk, and of an ounce and an half of Ve∣nice-treacle, to be injected daily, which is exceeding beneficial in all manner of Fluxes of the Belly.

Infants seized with this Disease are to be treated after the same manner, but the quantity of Blood to be taken away, and the Doses of the Purging and Anodyne Medi∣cines are to be lessened with respect to their Age, so for example, two drops of the Narcotick may be sufficient for a Child of a Year old.

The Liquid Laudanum, which as was said, I daily us'd, was prepared according to this easie Method.

Take of Spanish-wine one Pint, Opium two ounces, of Saffron one ounce, of the Powder of Cinnamon, and of Cloves, each one dram; let them be infused together in a Bath for two or three days, till the Liquor come to a due Consistence, strain it, and keep it for use.

In the Dry-gripe Dysentery, I used the following Me∣thod. If the Patient was in the Flower of his Age, and had a Feaver, I ordered him to be bled in the Arm, and after an hour or two, that he shou'd take great quantities of Liquor, as I us'd to do in the Cholera Morbus, but not Chicken-broth, or Posset-drink, as in that Case, but Whey, which I ordered to be drank cold in the same quantity as in the Cholera; but the Glisters were to be injected warm, without Sugar, or any other thing; I found the Gripes and the bloody Stools went off, with the fourth Glister: This Business being over, and all the Whey ejected (which might be done in the Space of two or three Hours, if the Sick minded his Business) I presently put him to Bed, where he soon sweated of his own Accord (by reason of the Whey mixt with the Blood) and I ordered it should be continued for twenty four hours, but not at all provoked, allowing him all the while nothing but Milk a little warmed, which he only used three or four days after he left his Bed. If either by rising too soon, or by leaving the use of Milk too soon, the Patient relapses, the same Method is to be repeated.

To conclude, 'Tis to be noted, that tho in those Years wherein the Bloody-flux is Epidemical, the foresaid Eva∣cuations are wholly necessary before we come to the use of Laudanum, yet in any Constitution, not favouring so much this Disease, they may be safely omitted, and the Cure may be performed more compendiously by Laudanum alone in the manner we have described.

CHAP. LXXVIII. Of a Tenesmus.

A Tenesmus is a continual Motion to go to Stool, where∣by nothing but a mucous Matter is evacuated.

The Cause of this Disease is an Ulcer of the right Gut, from whence a purulent Matter continually flows, and ir∣ritates the expulsive Faculty. It is not dangerous, unless it proceed from black Choler, and so shou'd turn to a Cancer, or should occasion Miscarriage in Women with Child.

The manner of Cure is much the same with that of the Bloody-flux. If there be an Inflammation (which is chiefly known by a Feaver) or an abundance of Blood, Bleeding must be us'd; and if the Inflammation remains after Bleed∣ing, and occasion a Strangury (which sometimes happens) Bleeding by Leeches in the Hemorrhoidal Veins is bene∣ficial.

Glisters are also to be Injected according to the various Seasons of the Ulcer, sometimes those that are lenient when the Pain is violent, sometimes cleansing, glutinating, or astringent; but in giving Glisters you must observe, first, that they must be given often and in a small quantity, because 'tis difficult to keep them, and then the Pipe must be put up gently, least it should anger the part and cause Pain.

And the part must be well fomented and Bathed, and Fumes, Suppositories and Oyntments must be us'd to it; a Fomentation may be made in the following manner.

Take of the Leaves of Mullein, and Wormwood, each six handfulls; boil them in new Milk, and put them into two Bags, and apply them hot by turns to the Fundament and Belly. Or,

Take of the Flowers of Camomil and Roses, each one hand∣ful, of red Wine a quart; infuse them for two Hours upon hot Ashes, foment the Fundament as hot as the Patient can bear it with Clothes four times double; afterward let hlm set upon a Spunge pressed out of the same Liquor.

Or fill two Bags with wheat-bran, and boil them in Vinegar, let the Sick sit hot upon them by turns, as he can bear them. If much Blood be evacuated, you may make a Fomentation in the following manner.

Take of the Leaves and Roots of Mullein two handfuls, of red Roses one Pugil, of the Bark of Pomegranates, and of Gauls, each half an ounce; boil them in two Parts of Smiths Water, and in one of red Wine, 'twill be more powerful if you add half an ounce of Alum.

A Bath to ease the Pain must be made of Emollients boyled in a Decoction of Sheeps-feet, and if the Heat be much, Violets, Night-shade, Goards, and pieces of Melons may be added: But to heal the Ulcer, a Bath must be made of Astringents; Fumes are proper to dry the Ulcer, made of Frankincense cast on Coals, or of a Decoction of Savine made with Oxycrate; the following is much com∣mended by Forestus.

Take of Mastich one dram, of Frankincense one Scruple, of Mirtles one dram and an half, of red Roses two scruples, make a Fume to be received through a Chair that has a hole at the Bottom.

Suppositories do much good in this Case, but they ought to be gentle, least they should exasperate the sensible Part; they may be made of Goats Suet cut into the Form of a Suppository; for it gives Ease and heals the Ulcer; but it will be more powerful to ease the Pain, if you mix with it the Seeds of white Poppies, and of Henbane bruised;

but tis much better to add, instead of the Seeds, three drops of the Oyls pressed from the Seeds, or a grain of Opium dissolved in half a Scruple of Oyl of Almonds.

But to heal the Ulcer, 'tis best to add to the Suet dissolved, Starch, and Gum-tragacanth beat or infused first in Plan∣tane-water; or it may be compounded in the follow∣ing manner.

Take of Gum-Tragacanth as much as is sufficient, pour upon it a little Plantain-water, that it may only swell, and not be too moist; add the Mucilage of the Seeds of Psyllium, or of Quinces a sufficient quantity, and the Yolk of one Egg, mingle them and make them warm; and of melted wax a sufficient quantity, to make Supposi∣tories. Narcoticks may be also added, and the Powders of Ceruss, Tutty, Bole, Balaustines, and other things that dry, and are not acrimonious, when there is a great Cor∣rosion, but they ought to be finely powdered least they should cause Pain.

Oyls and Oyntments may be also applied, as Oyntment of Roses, Populeum of the Mucilages, of Yolks of Eggs, and Oyl of Roses, and the like, to asswage the Pain and Inflammation.

Lastly, when the Disease is violent, Narcoticks must be used inwardly and outwardly; Laudanum Opiatum is best, whereof three or four grains may be given with Mastich, or sealed Earth, or mixt with a Glister made of a Decoction of Camomil Flowers.

CHAP. LXXIX. Of Worms.

THe Worms are generated in various Parts of the Body, yet because that is very seldom, and they most fre∣quently abound in the Guts, therefore we shall treat only of these.

The Signs of Worms in the Bowels are various, the fol∣lowing are most frequent and ordinary, a stinking Breath, and Excrements like Cow-dung: There are other Signs, but they are not so common, as a continual Feaver, which has Exacerbations often in a Day, with a cold Sweat, Anxiety, and sometimes with fainting, Nauseousness, Vo∣miting, and great Thirst; the Pulse are unequal, the Cheeks are red by turns, or wax livid, the Eyes shine, the Nostrils itch, the Teeth gnash, there is a small dry Cough, the Spittle is more than usual, sometimes the Head is heavy, there is a sleepy Disposition, sometimes a Delirium and Convulsive Fits, there is most commonly a pain in the Belly, like a gnawing or Biting, sometimes the Belly swells as in a Dropsie, sometimes the Body wastes beyond Measure, and sometimes there is an insatiable Appetite. The Worms called Ascarides are known by a troublesome itching about the Fundament, and they also often appear upon the Ex∣crements: To conclude, Putrefaction of the Gums is also a Sign.

The Cure of Worms is to be directed to the Expulsion of them, by purging Medicines that kill them, and expel the Matter from whence they are generated.

Take of calcin'd Harts-horn three grains, of Mercurius dulcis sprinkled with a drop of Oyl of Sulphur by the Bell grains fifteen, of Diagridium grains nine, of Cinnamon grains two, of Spirit of Harts-horn drops three; mingle them, make a Powder to be taken in the Pap of an Apple once a Week.

Take of Spirit of Harts-horn half a dram, give ten drops at Bed-time after Purging thrice. Or,

Take of the Roots of Virginian Snake-weed one Scruple, of Harts-horn calcin'd, and of Coraline, each half a Scruple, mingle them, make a Powder to be divided into three Doses, give one Morning and Evening in a small Draught of the white Decoction.

Take of Aloes, and Mirrh each one dram and an half, with a sufficient quantity of Venice-Treacle, and Oyl of Worm∣wood, make a Plaister for the Region of the Navel.

For broad Worms and Ascarides make a Glister of bit∣ter things, with Catharticks, and repeat it often till the im∣purity from whence the Worms are generated is evacu∣ated.

Horatius Augenus mentions an Observation of a Man about twenty six Years of Age, that grew extreamly hun∣gry, so that nothing would allay his Appetite, at length he voided a Worm twenty five Cubits long, and recovered a moderate Appetite; he cured him by the following Medicines, he gave him a pint and an half of fresh Oyl of sweet Almonds divided into four Doses, to be taken a quarter of an hours distance one from another; just before Dinner he gave him two Bolusses made of a dram of Hiera Picra, and one Scruple of Rubarb, and presently after or∣dered him to take six ounces of a Decoction of Sebestines; and before Supper he injected a Glister made of a quart of Goats-milk, and gave him a dram and an half of the Pill of Aloes not washed.

CHAP. LXXX. Of an immoderate Flux of the Hemorrhoides, and of the Pain of them.

AN immoderate Flux of the Hemorrhoides is very dan∣gerous, and occasions other dangerous Diseases, viz. Weakness of the whole Body, a Consumption, Cachexy and Dropsie. The same Remedies are good for the Cure which were prescribed for Bleeding at the Nose.

The Hemorrhoidal Veins ending in the Extremity of the right Gut and Fundament, are often swelled, where∣by much Pain is often occasioned.

As to the Cure, first Blood must be drawn from the Arm, that Revulsion may be made from the part affected, which being sufficiently peformed, a Vein in the Foot must be opened for Derivation.

The Belly must be kept continually open, because hard Excrements; and straining to evacuate them, exasperate the Pain; an Infusion of Cassia taken Morning and Eve is very good to loosen the Belly.

Take of the Leaves of Lettice, and Purslain, and the Tops of Mallows, each one handful; of Liquorish rasped and of Raisins of the Sun ston'd each half an ounce; of the flowers of Bugloss and Borrage and of Violets, each one Pugil; boil them to eight ounces, in the strained Liquor dissolve of Cassia fresh extracted one ounce, strain them and cla∣rifie them, and add to them one ounce of Syrup of Violets.

In the mean while various Topicks are to be applied to the Part, to asswage the Pain and Inflammation, and to discuss the Tumour, Oyl of sweet Almonds fresh drawn, applyed to the Part eases the Pain, and several Liniments and Oyntments may be prescribed for the same Purpose, whereof some ease the Pain, others dicuss and dry, and others heat the Ulcers; they are to be applyed with Lint or Cotton.

Take one Yolk of an Egg, of Oyl of Roses, or of Violets, as much as is sufficient; make a Liniment, and if you add to it Populeum Oyntment, 'twill be more effectual to ease Pain, and when the Pain is very violent, a few grains of Opium may be added to it. Or,

Take of the Mucilage of the Seeds of Psyllium and of Faenu∣greek extracted with Wine two drams, of fresh Butter three ounces, of Kid Suet one ounce, stir them together in a Leaden Mortar, make a Liniment.

Balsom of Sulphur made of the Flowers of Sulphur and Oyl of Turpentine, is excellent to ease Pain, and to discuss the Swellings, and to cleanse the Ulcers; a white Onion roasted under Ashes, and mixt with fresh Butter like a Cataplasm, eases the Pain, and dis∣cusses the Swellings; but if they cannot be easily resolved they must be opened after convenient Revulsions with a Knife, or by Leeches.

CHAP. LXXXI. Of the Jaundice.

THE Jaundice arises by the Consent of most, from an Obstruction of the Gaul-bladder.

As to the Cure, a Vomit at the beginning of the Jaun∣dice whilst the Strength and Tone of the Bowels are firm, does often good.

Take of the Infusion of Crocus Metallorum half an ounce or six drams, of Wine of Squils one ounce, of simple Oxymel half an ounce, make a Vomit.

Purging Medicines are to be used in this Disease whether it be new or old.

Take of the Electuary of the Juice of Roses six drams, of Rubarb one dram, of Salt of Wormwood and Cream of Tartar each half a Scruple, with a sufficient quantity of Syrup of Rubarb, make a Purging Bolus to be taken in the Morning. Or,

Take of the Pill Ruffi one scruple, of extract of Rudius half a scruple, make four Pills, take them in a Morning, and repeat them four or five Days, afterwards once a Week.

Take of Elixir Proprietatis one ounce, let him take twenty Drops in a glass of Wite-wine every day in the Morning, and at five in the Evening. Or,

Take of Madder, and Turmerick, each one ounce, of all the greater Celandine, and of the Tops of the lesser Centaury, each one handful; boil them in equal parts of Rhenish-wine, and Fountain-water to a quart; in the strained Liquor dissolve two ounces of the five opening Roots; let him take half a Pint Morning and Evening hot till he is well.

Silvius much commends a Decoction of Hemp-seed, and Soap dissolved; our common Remedy is Lice, nine being taken alive in a Morning five or six days following, and I have known several that have been cured this way, when other Medicines would not do the Business.

But if, notwithstanding all above mentioned, the Dis∣ease continues obstinate, the Sick must use Iron-waters, such as are Tunbridge, which he must drink at the Fountain till he is well. Moreover, Those that are afflicted with this Disease are often subject to Pains that are very troublesome, and they rage chiefly a Nights: And more∣over, the Sick cannot rest well, wherefore Anodynes are to be used.

Take of Aqua-mirabilis, and of the Water of Worms, each one ounce; of Diacodium six drams, of Tincture of Saffron half an ounce; mingle them. The Dose is one Spoonful or two late at Night when the Sick cannot rest.

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.

CHAP LXXXIII. Of a Timpany.

A Timpany is a fixt hard and equal Swelling of the Belly, that sounds when 'tis knock't upon with the Finger, it proceeds from a Convulsive Inflation of the Bowels, the Animal Spirits being obstructed in the Fibres; it generally ends in a Dropsie.

Medicines do little good in this Disease, yet they are not wholly to be rejected, the following are prescribed by Dr. Willis.

Take of Peach-flowers, and of Damask-roses, each two pu∣gils; of the Flowers of Broom, Elder, and the lesser Cen∣taury, each one pugil; of the Leaves of Agrimony, and of Sea-wormwood, each one handful; of the best Senna one ounce, of Rubarb six drams, of the seeds of Bastard-saf∣fron half an ounce, of Dwarf-elder two drams, of yellow-sanders three drams, of the Roots of Galingal two drams, cut them, and bruise them, and put them into a silken Bag, and hang them in a Glass-bottle, and pour upon them a quart of White-wine, and a pint of Saxifrage-water, and put into the Bottle, a dram and an half of Salt of Tartar; let them infuse forty eight Hours, and then take four or six ounces every third or fourth Day.

The following has been used with Success in this Disease in a hot Constitution.

Take of purging-waters four quarts, of Salt of Wormwood two drams, evaporate a quart over a gentle Heat; and to these I used to add of the Water distilled from Wine with Catharticks four ounces, the dose is four or six ounces.

Or to the Purging-water evaporated to a quart, add the Roots of Mecoacan, and Tu••bith, each half an ounce, of Rubarb six drams, of yellow-sanders two drams,

of Cloves one dram, digest them hot in a close Vessel two hours, filter them hot through Paper, the dose is three or four ounces.

Glisters are often used in this Disease, because they loosen the Belly without much provoking the Fibres.

Take of the Infusion of Stone-horse-dung, with Camomil-flow∣ers one pint, of Mercurial-honey two ounces, make a Glister. Or,

Take of Ʋrine one pint, of Sal-prunella one dram, of Venice Turpentine dissolved with the Yolk of an Egg one ounce and an half; mingle them, make a Glister.

Diureticks also seem proper.

Take of live Millepedes cleansed three ounces, one Nutmeg sliced, beat them together, and pour upon them a Pint of the following Diuretick-water, strain out the Liquor hard, the dose is three or four ounces twice a day.

Take of the green-berries of Juniper, and Elder, each six pounds; of the Tops of Fir four pounds, of green Wall∣nuts two pound, of Winteran Bark four ounces, of the yellow-Peel of six Oranges, and four Lemons, of the Seeds of Bishops-weed, Rocket, and Cresses each one ounce and an half: of Dill two ounces; cut them, and bruise them, and pour upon them four quarts of White-wine Posset-drink, distill them in a common Still, and min∣gle all the Waters.

Whilst these things are taken inwardly, Topicks must be also applied, not such things as are hot and discussing, but those things which are indued with Particles of Volatile Salt and Nitre.

Take of the Flowers of Sal-armoniack one ounce, of Sal-pru∣nella two ounces, of small Spirit of Wine a quart, min∣gle them, and dissolve them in a Bottle.

Flannels dipt in this are to be applied warm over the Belly twice a day for the space of half an hour; after∣wards apply a Cataplasm made of Cows-dung, and the powder of Dogs-dung, or the following Plaister.

Take of the Plaister of Sope, that is of the red-lead Plaister, with a sufficient quantity of Venice Sope, spread it thin upon thin Leather, and apply it to the Belly, and renew it within ten or twelve Days.

Altering Medicines are also requisite.

Take of the Filings of Steel finely powdered two drams, of the distilled Water above described a quart, of the Syrup of the five opening Roots two ounces; mingle them in a Glass, and let them clarifie by standing. The dose is three or four ounces in the Morning, and at five in the Afternoon.

Take of the Powder of the Roots of Wake-robin, and of Crabs-eyes, each three drams, of Sal-Prunella two drams, of Vitriol of Mars one dram and an half, of Anthosat Sugar two drams; mingle them, the dose is half a dram in a convenient Vehicle.

And Medicines are to be prescribed against Fainting, Difficulty of Breathing, Watching, and Drouth.

Cordials.

• Take of the Waters of Orange-flowers, of the Flowers of Marigolds, and of Camomil, each three ounces; of Dr. Stephens's water two ounces, of Tincture of Saffron two drams, of Sugar one ounce, of Pearls one dram, make a Julep, the Dose is four or five spoonfuls thrice, or oftner in a Day.
• ...Take of the Conserve of Marigold-flowers two ounces, of Con∣fection of Atkermes, and of Hyacinth, each two drams; of Pearls powdered one ounce, of the Syrup of the Juice of Citron a sufficient quantity; make a Confection, let him

• ... take the quantity of a Nutmeg Morning and Evening, drinking upon it a draught of the Julep.

Hypnoticks.

• Take of the Hysterick-water six drams, of Diacodium half an ounce, mingle them, let it be taken at Bed-time. Or,
• ...Take of Syrup of Cowslips three Spoonfuls, of compound Peony-water one spoonful, of Laudanum tartarized one dram, let a spoonful be taken in the Night, if the Sick cannot sleep.

To quench the Thirst without much drinking, which is always very prejudicial, let the Sick lick often a small quantity of the following Linctus.

Take of Conserve of Wood-sorrel pulped three ounces, of the Pulp of Tamarinds two ounces, of Sal-prunella one dram, of the Syrup of the Juice of Wood-sorrel a sufficient quan∣tity; make a Linctus.

CHAP. LXXXIV. Of an Anasarca.

AN Anasarca is a white soft Swelling of the outward parts of the Body, or of some of them, it yields to the Touch, and will pit, and is occasioned by watry Hu∣mours extravasated.

As to the Cure, there are two things chiefly to be mind∣ed, First, That the Water within the Skin should be evacua∣ted. Secondly, That Care be taken to prevent the heap∣ing up of new Water, to which End we must endeavour (the Viscera of Concoction being freed from Obstructions and Filth) that good Chyle be made and carried in a due quantity to the Mass of Blood, and that it be sufficiently fermented.

The Vital Indication is of little use in this Disease, be∣cause there is seldom Fainting or Watching for which Cor∣dials and Hypnoticks are required, and also a strengthning diet; for Fasting and Abstinence do good in this Case, and often perform the greatest part of the Cure; for the Vessels being emptied by Fasting, absorb the Waters with∣in the Skin or stagnating elsewhere, and evacuate them by the Reins or the Pores of the Skin, or otherwise.

The Sick must use purging Medicines prescrib'd for a Dropsie, and the same Diureticks.

A Decoction of the Woods is also very proper.

Take of the Shavings of Guajacum six ounces, of Sassafras two ounces, of all the Sanders each six drams, of Ivory and Hartshorn rasped each three drams; infuse them, and boil them in four quarts of Fountain-water till half is consumed, adding to it the Roots of Sweet-smelling Flag, of the lesser Galingal, of Burdock, and Butter-bur, each one ounce; of the Leaves of Sharp-sage, and of dried Ger∣mander, each two handfuls; keep the strained Liquor for use; the Dose is eight or ten ounces hot twice a Day, to every Dose add twenty or five and twenty drops of Spirit of Sa••armoniack, with Amber, or of Soot, or of the Tincture of Salt of Tartar half a dram, or a dram.

Frictions do often good in an Anasarca, wherefore the whole Body may be rubb'd once or twice a day with a course Napkin, or with Brushes made for that Purpose.

Blisters evacuate the Water plentifully, but there is Danger of a Gangrene by the use of them.

But Escharoticks may be more safely used than Bli∣sters; an Emperick often evacuated successfully Water from the Members of Dropsical People, if they were never so much swelled, in the following manner by an Escharotick, viz First, he fomented their Legs Morning and Evening with a Decoction of Dwarf-elder, Worm∣wood, Camomil, and other hot Herbs, the grounds of Beer or Wine being added to it; and betwixt the times of Bathing he applied a Cataplasm made of the Dregs of the Decoction and Bran; after these things had been used three days, he covered the Legs and Feet with a Plaister

made of Burgundine-pitch, leaving only upon each Calf a little hole about the bigness of a small Nut, in which places he applied an Escarotick Medicine to the naked Skin, made of the Ashes of the Bark of the Ash, which being taken off, after twelve hours, a small Eschar remain∣ed from the pores whereof the Water first drained gently and daily; afterwards it dropt more freely, but when the Eschar cast, it flowed as from a Fountain, till it had emp∣tied the Legs.

Another Way remains (as good as the former but less us'd) to drain the Water, viz. By pricking with a Needle, which also must be used cautiously and leisurely, lest the Flux of Waters should be too great; provide such a Needle as Tailors use, and prick the Place that is most swelled with it so as that the Blood may not come; you must prick only six or seven Holes at at a time, at the Distance of the Breadth of a Thumb, one from the other; the Water will break out drop by drop from each Hole continually, till all the Swelling about the Parts prick'd disappears; and then the next time, sometimes after twelve hours, sometimes after eighteen, and sometimes after twenty four, prick again in another part of the same Leg, or in the other; and so once or twice a day in this or that Member, in one or two or more at a time, for the Water may be drawn more plentifully and safer this Way than any other; and if the Breeding of new Water be prevented by Medicines, the Disease will be easily cured. Moreover, in a deplorable Dropsie the Life may be pro∣longed this way: An old Man of Seventy Years of Age, that was dropsical all over, kept his Head above Water, and lived many Months by this means, contrary to Expectation.

But to strengthen and restore the Blood, the following Medicines must be used.

Take of Conserve of Sea-wormwood, of Scurvy-grass, and the yellow Peel of Oranges, each two ounces; of the Win∣teran-Bark two drams, of the Species Diacurcuma one dram and an half, of Steel prepared with Sulphur three drams, of Salt of Wormwood two drams, of Syrup of the Bark of Curon a sufficient quantity, make an Electuary; the Dose is two drams in the Morning, and at five in the Afternoon.

Chalybeats do often a great deal of good in this Disease.

Take of the compound Powder of the Roots of Wake-robin, of the Winteran-bark, each three drams; of the Roots of the lesser Galingal, and of Cubebs, each one dram and an half; of Steel prepared with Sulphur half an ounce, of Sugar anthosated six drams; make a Powder to be di∣vided into twenty Parts, give one Part every Morning, and at five in the Afternoon.

Let him drink of the following Decoction instead of Beer.

Take of the Shavings of Guajacum, and Sassafras, each four ounces; of the Roots of Florentine-orris, of Sweet-smel∣ling-flag, the lesser Galingal, and of Elecampane, each one ounce and an half; of the Berries of Juniper and Bayes each two ounces; of the Seeds of Annise, Carra∣wayes, Sweet-fennel, Coriander and Dill, each one ounce; of Long-pepper, and Cubebs, each one ounce and an half; of Cloves, Nutmegs, and Ginger, each half an ounce; of Jamaica Pepper two ounces, of the dried Leaves of Sharp-sage, Wild-sage, Calaminth, Agrimony, each one hand∣ful; of Liquorish four ounces, cut them and bruise them, and boil them in four Gallons of Fountain-water till half is consumed, keep the strained Liquor in Bottles for use. Many have been cured by this Liquor.

CHAP. LXXXV. Of the Scurvy.

IN the old Treatises of Physick, there is so seldom men∣tion made of the Scurvy, and the Description of it is so small, that some have doubted whether such a Disease (that is now Endimial in many Places, and Sporadick al∣most every where, and wherewith almost every one is af∣fected, or thinks he is so) did at all exist in ancient Times; and some think its Rise is of a newer date, as are the French-pox and Rickets; but this Disease, though it had other Names, was observed by the Ancients, and the Cure of it was described by them, though not very exactly.

Many and various are the Symptoms of the Scurvy, and sometimes such as are of a contrary Nature, are imputed to it; and if any unusual Accident happens to the Body, that cannot be referred to any other certain kind of Dis∣ease, we presently pronounce it Scorbutick. And so this notorious Disease bears the Blame of all, but many truly belong to it which arise in almost every part of the Body, and therefore we will trace it from Head to Foot; it oc∣casions violent, habitual, wandering or periodick Head∣achs, sometimes a Dulness of the Spirits, and Drowsiness, sometimes Watchings, Giddiness, Convulsions, Palsie, much Spitting, Ulcers of the Gums, Loosness of the Teeth, and a Stinking of the Breath. About the Region of the Breast, Pains in various parts of the Membranes, and es∣pecially on the Breast-bone, which are often very violent for many Nights and Days; an Asthma, difficult and un∣equal Breathing, Constriction and Narrowness of the Breast, a dry Cough, an inordinate Pulse, trembling of the Heart, frequent Fainting, and almost a continual Fear of it. This Disease makes the lower Belly its principal Seat, and occasions many Disorders there, as Nauseousness, Vomiting, Wind, a Cardialgia, frequent Collicks, and troublesome Pains running hither and thither, a Loosness that is almost continual, sometimes a Bloody-flux, a Con∣sumption, and a Dropsie.

The Urine is often red, with a Crust upon it, or sticking to the Sides of the Pot, and sometimes 'tis pale and rendred in a great quantity; in the outward Mem∣bers, and over the whole Body, there are Wandring pains, and oftentimes such as are violent, especially in the Night; also Spontaneous Lassitude, a Wasting of the Flesh, a weak∣ness of the Limbs, Spots of various colours upon the Skin, Tumours, Tubercles, and ill Ulcers, Numbness and Con∣traction of the Muscels, Twitching of the Tendons, Erra∣tick Feavers, and great Hemorrhagies.

These are the common and usual Symptoms of the Scurvy, whereof sometimes more, sometimes fewer, some∣times this kind, sometimes that kind afflict the Sick, and sometimes unusual and prodgious Accidents happen.

As to the Cure, Because it is not one simple preternatu∣ral Disorder, but a Legion is to be combated with; therefore the Method of Cure consists of many Indications,

that are variously complicated, but yet they may be refer∣red to these three Heads, viz. They must be preserva∣tive to respect the Cause of the Diseases, and curative, that respect the Disease it self and its Symptoms.

And Lastly, Vital, which restore and defend the Strength of the Patient.

First, The Sick must be purged, and if there be a weight upon the Stomach, a Vomit must be given; and if the Pa∣tient be strong and lusty, and used to bear Vomiting well, the Vinum-benedictum may be given, and the like.

But if the Sick be of a weakly Constitution; you must give Wine of Squills, or Gilla Theophrasti, and the Sick must fill his Stomach with Posset-drink, and force it up with his Finger, or with a Feather.

As to Purging, If the Sick be of a hot Constitution; Me∣dicines of Aloes and Diagridium must be avoided, and such as are made of Senna and Rubarb, must be given, As,

Take of the Leavss of Senna one ounce, of Rubarb six drams, of Dodder of Thym three drams, of the Roots of Poly∣pody of the Oak, and of English Rubarb dried, each half an ounce; of yellow Sanders two drams, of Celtick Spike half a dram, of Salt of Wormwood two drams; cut them and bruise them, and infuse them in a Matrass, in the Heat of Sand, with Whitewine and Fumitory-water, each a Pint for two days; evaporate the clear Liquor strained in the gentle heat of a Bath to the Consistence of Hony, then add of the Powder of the Leaves of Senna, and of Rubarb, each one dram and an half; of the Species of the three Sanders one dram, of Cream of Tartar one dram and an half; make a Mass for Pills. The Dose is from half a dram to a dram, to be taken once a Week, or oftner.

Or let the Infusion be evaporated to the Consistence of a Syrup, adding towards the end, of Manna strained and of White Sugar, each two ounces; make a Syrup. The Dose is one or two Spoonfuls in a proper Vehicle.

They who are of a cold Constitution may take the fol∣lowing Pills.

Take of the Stomach-pill with Gums two drams, of Rosin, of Jalap, grains twenty; of Tartar vitriolated grains sixteen, of Oyl of Juniper ten drops, with a sufficient

quantity of Ammoniacum dissolved in the Water of Worms; make sixteen Pills, let four be taken once a Week.

Take of the Roots of Sharp-pointed-dock, of Polypody of the Oak, of stinging-nettles, and of Chervil each six drams; of the Leaves of Hemp, Agrimony, and Speedwell, each one handful; of yellow and white Sanders, each one dram; of the Seeds of Bastard saffron one ounce, of White-wine Tartar half an ounce; boil them in a quart of Fountain-water till half is consumed, add a Pint of Rhenish-wine, strain it presently, and add to it half an ounce of the best Senna, six drams of Rubarb, half an ounce of the Leaves of Black-hellebore, of the yellow Peel of Oranges two drams; infuse it warm in a close Vessel twelve hours; keep the strained Liquor in a Glass well stopped; the dose is five or six drams.

After Purging once or twice, if Bleeding be indicated, you must bleed in the Arm, or with Leeches.

After Bleeding many Remedies of another kind are necessary; but that you may prescribe orderly, you must consider whether the Preservatory Indications have only place here, or whether some curatory Indications, namely such as respect the Symptoms that are violent ought not to be minded between whiles. But if there be no urgent Symptom, you must wholly apply your self to the Cure according to the following Method. And as to the Cure of the Symptoms, we shall treat of them by themselves below.

Wherefore, If your chief Design be to erradicate the Cause of the Scurvy, digestive, and Specifick or Antiscorbutick Remedies must be used at all times, except on the Days the Sick purges, whereunto, if there be Occasion, Diapho∣reticks or Diureticks must be sometimes added. Various Forms are prescribed by Authors every where to answer these Intensions, but we will only mention the chiefest, which according to the twofold Disposition of the scorbu∣tick Cause, viz. The Sulphurous Saline, and the Sali∣no sulphurean Discrassy of the Blood, we will distinguish, into two Classes; And First, Of the cold Scurvy.

Among Digestive Medicines, Cream of Tartar, Salt and Tincture of it, Tartar vitriolated, Elixir Proprietatis, or either of these, may be taken twice a day. Or,

Take of the Winteran-Bark, of Wood of Aloes, of the Roots of the lesser Galingal, each two drams; of Cinnamon, Cloves, and Cubebs, each one dram; of the Seeds of Bishops Weed, and Cresses, each half a dram; bruise them, and pour upon them the following Menstruum three Fingers high; digest them in a Matrass six days in Sand, keep the strained Liquor in a Glass well stopeed. The dose is twenty drops more or less, in a Spoonful of Ca∣nary-wine, or some proper Water twice a Day.

The Menstruum is made in the following manner.

Take of Spirit of Vitriol rectified six ounces, of Spirit of Wine rectified sixteen ounces; mingle them, and distill it in a glass retort, and Cohobat it thrice, and keep it in a Glass well stopt for use. Elixir Proprietatis is made easier and better by this Menstruum, than by the common way.

Whilst these Remedies are given in a small quantity Morning and Evening, Antiscorbutick Medicines of ano∣ther kind may be taken, which are generally prescribed in a double Form, viz. Solid and Liquid to be taken together, the Solid first, and the Liquid presently after.

Take of the Conserves of Scurvy-grass, and Roman Worm∣wood, and of Fumitory, each two ounces; of the Powder of the Winteran-bark, of the Roots of Angelica, and of Wake-robin, each two drams; of the Species of the three Sanders one dram and an half, of the Powder of Crabs-eyes one dram, of Salt of Wormwood, two drams, with a sufficient quantity of the Syrup of the Bark of Citron; make an Electuary.

Take of the Conserves of the Leaves of Scurvy-grass, and Brook-lime, made with an equal quantity of Sugar, each three ounces; of the Troches of Capers, and of Rubarb, each two drams, of Salt of Wormwood, and of Scurvy-grass, each one dram; of Ivory Powdered, and Coral cal∣cined, each one dram; with a sufficient quantity of the Syrup made of the Juice of Scurvy-grass; make an Electuary.

I use to prescribe Conserves made of the yellow Peel of Lemons and Oranges, of the Purple-flowers of the Ash,

of the Leaves and Flowers of Ladies-Smock, of the Roots of sharp-pointed Dock, and of English Rubarb, made with an equal quantity of Sugar, which I give by themselves, or mixed with other Conserves or Species.

For Country and poor People, who desire Medicines that are cheap and easily prepared, I prescribe after this manner.

Take of the Leaves of Scurvy-grass, and Brook-lime, each four ounces; of white Sugar eight ounces; beat them to∣gether in a Mortar, and add to them of the Powder of the Winteran-bark half an ounce, of Tartar calcined with Niter three drams; with a sufficient quantity of Spanish-wine; make an Electuary. The Dose is the quantity of a Wallnut twice a day, drinking upon it some proper Liquor.

Take of the Leaves of Scurvy-grass one pound, of Raisins of the Sun stoned, and of White Sugar, each half a pound; of the Lees of the Root of Horse-radish two ounces; beat them together and reduce them to the Form of an Electuary.

In some scorbutical cases, where the use of Steel is in∣dicated, three drams of Steel prepared with Sulphur, or two drams of Vitriol of Mars, may be mixed with any of the Electuaries: After the taking of the Medicine once or twice a day the Body must be exercised.

Take of the compound Powder of Wake-robin one ounce and an half, of Winteran-bark half an ounce, of Cubebs, grains of Paradise, and Cardamoms, each two drams; of Salt of Wormwood three drams, of Tablets of Oranges three ounces; make a Powder. The dose is one dram in some proper liquor.

For Delicate People the following Tablets may be prescribed.

Take of the Powder of the Winteran-bark, and of Crabs-eyes, each one dram and an half; of Pearles powdered half a dram, of white-sugar dissolved in a sufficient quantity of the Water of Worms, and boiled to Tablets, six ounces; of Spirit of Scurvy-grass two drams; make Tablets, each weighing half a dram, let two be taken twice a day, drinking upon them some proper Liquor.

Tablets of Oranges are made in the following manner.

Take of Orange, Lemmon, and Citron peel candied, each one ounce; of Eryngo-roots candied half an ounce, of Pine, and Pistach-nuts, each twenty; of sweet Almonds blan∣ched number ten, of Annise-seeds powdered half an ounce; of Ginger candied two drams, of the Species Aromatick Rosat, and of Nutmegs, each one dram and an half; of the Roots of Galingal one dram, of Cloves number ten, of Ambar-grease grains four, of Musk, and Civet, each grains two; of White-sugar dissolved in Rose-water and boiled to Tablets, one pound and an half, and so make Tablets.

Antiscorbutick Wines and Beers.

Take of the Leaves of Scurvy-grass four handfuls, of Horse-radish-root rasped four ounces, of Winteran-bark bruised half an ounce, of the yellow peel of four Oranges, and as many Lemmons; put them into a glass, and pour upon them six quarts of Rhenish-wine; keep the Glass close stopt in a cold place; let a quarter of a pint be taken Morning and Evening, and at dinner-time daily, and pour off the Wine clear when you use it.

But medicated Beer is more common for the Scurvy, to be drank constantly for ordinary Drink.

Provide four Gallons of Ale, and instead of Hops, boil in it four handfuls of the tops of Pine, or of Fir; when it has done Working in the Vessels, put in four handfuls of Scur∣vy-grass, four ounces of the Roots of Sharp-pointed Dack, and the Peels of four Oranges; when it has stood a Week and is clear, it may be drank for ordinary Drink.

Diet-drinks do a great deal of good in the Scurvy, be∣cause they being continually taken with Meat they alter the Blood.

But in some Scorbutical cases, and in a hot Scurvy, Scurvy-grass, Horse-radish, and the Winteran-bark, and other acrid things, such as abound with Volatile-salt are sometimes injurious; wherefore when the Morbisick Dis∣crasie of the Blood is hot, temperate Medicines are indi∣cated.

Take of Conserves of Brook-lime, and Ladies-Smock, made with an equal quantity of Sugar, each three ounces; of the Spe∣cies of the three Sanders, of Diarrhodon Abbatis, each one dram and an half; of Ivory powdered one dram, of Pearls half a dram, of Salt of Wormwood, and Tama∣risck,

each one dram; with a sufficient quantity of Syrup of Coral, make an Electuary

Take of the Conserves of Wood-sorrel, and of Hips, each three ounces; or of the Conserve of the Roots of Sharp-pointed Dock, and of the Roots of Succory, each three ounces; of the Troches of Rubarb two drams, of the Spe∣cies Diamargarite frigid one dram and an half, of the Bark of Tamarisck one dram, of Sal-prunella one dram and an half, of Mirobalans candied number two, with a sufficient quantity of the Syrup of candied Mirobalans; meke an Electuary.

For the Poor I used to prescribe the following Electuary.

Take of the Leaves of Brook-lime six ounces, of Wood-sorrel two ounces, of White-sugar eight ounces; bruise them, and add to them half an ounce of the Flower of the Seeds of sweet Fennel, of Ivory powdered two drams, of Sal-prunuella one dram and an half, with a sufficient quan∣tity of the Syrup of the Juice of Brook-lime; make an Electuary.

Take of the Powder of the Leaves of Ground-pine, of the compound Powder of Wake-robin, each one ounce and an half; of Ivory powdered, and of red Coral, prepared with the Juice of Oranges, each two drams; of the Tablet of of Oranges two ounces. The Dose is one Spoonful twice a Day,

Take of the Species of the three Sanders, of Diamargarite fri∣gid, each one dram and an half; of Pearls powdered, Red-coral prepared, and of Ivory powdered, each one dram; of Sugar dissolved in Scordium-water, and boiled to Tablets, six ounces; make Tablets.

But if Chalybeats are to be mixed with these temperate Antiscorbuticks, two or three drams of Crocus Martis, or the like, may be added to the Electuaries: But it is often best to take Calybeats in Liquors.

Wines and mediated Beers.

Although the use of Wines in the Scurvy, caused by rea∣son of the Heat, and sulpherous Saline Discrasie of the Blood, are not very convenient; nevertheless when the Weakness of the Stomach, or Custom at least requires Wine mixed it with Water.

Such a Liquor that is temperated and medicated may be prepared. In the first place, Small Wines, mixed with

Water, and those that are impregnated with the Infusion of Baulm, Borrage, and Burnet, may be allowed. More∣over, Wines may be prepared of the Juice of Currants, of Cherries and of Garden-fruits, which may be ripened by Fermentation, and are very grateful to the Stomach, and purifie the Blood: Syder is also very good, if it be clear, and not sharp. Moreover, many ingredients may be put into clear Syder, as the Tops of Pine or of Fir, the Flowers of Tamarisck, the Raspings of Ivory or Harts∣horn, which sweeten and preserve the Liquor.

Temperate medicated Diet-drinks may be prescribed in the following Manner. Provide six Gallons of Small Ale, and instead of Hops, boil the Tops of Pine or Tamarisck in it, or the Raspings of the Wood of either of them; and when it has done working; put into a Bag sharp-pointed Dock dried, which is an excellent Medicine for the Scurvy; also the Leaves of Water-cresses, or Brook-lime, and Bank-cresses; also Citrons, or Oranges cut in Slices, and hanged in Vessels.

Hitherto we have treated about the Removal of the Morbisick cause, but when the Symptoms are very violent, they require a peculiar Method of Cure. And First, Difficulty of Breathing, with Narrowness of the Breast, and Asthmatical Fits, must be taken off by Medicines proper for the Symptom: Elixir Proprietatis is of excellent use in this Case.

Pain of the Stomach, Nauseousness, Belching and Vo∣miting, must be cured by a gentle Vomit of Wine of Squils, or of Salt of Vitriol; or the Patient must be purged with an Infusion of Rubarb, with Salt or Cream of Tartar ad∣ded to it. Elixir Proprietatis is also good in this Case.

The Collick and Gripes must be cured by Glisters, Opiats and testaceous Powders.

Take of the Powder of Crabs-eyes, and of Egg-shells, each one dram and an half; of Pearls, one dram; make a Powder to be divided into twelve Doses, whereof one must be taken every sixth hour in some Antiscorbutical-water. And in this case Epsom and Barnet-waters do a great deal of Good.

An inveterate Diarrhea which frequently happens to Scorbutical People, must not be stopt by astringent Medi∣cines, nor is it easily cured by Alteratives and Antiscorbu∣ticks.

Tunbridge-waters and the like are of excellent use in this case. Chalybeat Medicines are also very good, but Crocus Martis is the best. I have used the following Method often with very good Success. First, The Sick must be purged with the Powder or Infusion of Rubarb, with some astringent Aromaticks added to it; and it must be repeated three or four days after. On the days the Sick does not purge, he must take Morning and Evening the quantity of a Nutmeg of the following Electuary.

Take of the Conserve of Roman-wormwood, made with an equal quantity of Sugar, six ounces (in a hot Constitution Conserve of Roses may be used instead of it) of Diarrhodon Abbatis two drams, of white and red Sanders powdered, each one dram; of the best Saffron of Mars half an ounce, with a sufficient quantity of Syrup of Steel; make an Electuary.

In a Bloody-flux and Tenesmus, the like Method is to be used, especially Tunbridge-waters or the like. More∣over, Glisters made of Vulnerary Decoctions must be often injected.

I lately cured a Man of a long Disentery who daily voided many Ounces of Blood by the following Remedy.

Take of the best Rubarb powdered two drams, of Cinnamon one dram, of Crocus Martis three drams; make Pills with a sufficient quantity of Lucatellus's Balsam. He took four sometimes every day, sometimes every other day, for the space of a Fortnight, and was perfectly cured.

But he constantly drank a medicated Beer made of the Roots of Sharp-pointed Docks, and of the Leaves of Brook-lime.

A Vertigo often comes upon an inveterate Scurvy; as also frequent Swoonings, and Numbness in the Limbs; they are very difficultly cured, by reason they are produ∣ced by a Scorbutick Salt obstructing the Brain and Nerves. Cephalick Medicines, such as are proper in the Vertigo and Paralitick Distempers, which come of themselves, mixed with Antiscorbuticks, are to be given.

Therefore the Body being cleansed by Catharticks which are proper in the Scurvy, you may proceed with Medicines proper to cure these Diseases after this manner.

In the beginning of the Cure the Hemorrhoids are to be opened by the Application of Leeches; and this ought to be often repeated, unless something contraindicate.

Take of the Roots of Male-peony half an ounce, of red Cora•• prepared two drams, of Man's Skull, and Elks-hoof, each one dram; take of fine Sugar dissolved in Peony-water compound, or the compound Water of Horse-radish, and boiled to Tablets, eight ounces; of the best Oyl of Amba•• rectified half a dram; make Tablets. A dram and an half or two drams of them may be taken Morning and Night, drinking upon them a draught of the following distilled water.

Take of the Leaves of Scurvy-grass, Brook-lime, Lillies of the Valley, Sage, Rosemary, Bettony, each three handful••, of green Wallnuts one pound, the Peels of six Oranges and of four Lemmons, the Roots of Male-peony green •• Pound and an half; after they are bruised and sliced, pour upon them of Flegm of Vitriol one pound, of Who made with Syder five Pints; distil them after the common manner; mix all the Liquor together. The Dose is three or four ounces.

Fluxes of Blood often threaten great Danger in the Scurvy; therefore these Fluxes, whether they be too great, or from an inconvenient place, ought to be stop for the present, and guarded against for the future.

The common Method of stopping Blood when it flows immoderately, is generally known, and there is no pe∣culiar thing more to be done on this Occasion, than what is usual in other Fluxes of Blood. Nevertheless, to hinder these Fluxes of blood, Remedies must be used which sweeten the Blood, and contract the Orifices of the Vessels which are too lax and open. Both these Intentions are ex∣cellently performed by Steel Medicines.

Take of the Conserve of red Roses, and of Hips, each three ounces; of the Species Diarrhodon Abbatis, of the three Sanders, each a dram and an half; of Salt of Steel one dram, of Saffron of Mars two drams, of red Cora•• prepared one dram and an half, with a sufficient quantity of Syrup of Steel; make an Electuary. The Dose is the quantity of a Nutmeg three times a day, drinking upon it a Draught of some proper Liquor.

For the Poor you may prescribe after this manner.

Take of the Tops of Cypress, and of stinging Nettles, each four ounces; of Brook-lime two ounces; beat them in a Mortar with ten ounces of white Sugar; afterwards add

Filings of Steel finely powdered one ounce, of white and red Sanders powdered, each two drams; with a sufficient quantity of Syrup made of the Juice of Nettles, make an Electuary. The Dose is the quantity of a Wallnut twice a day.

When the Scurvy does infect the inward Parts of the Mouth, as when the Gums begin to swell, and their Flesh grows spungy, Medicines are presently to be used that re∣sist Putrefaction: Liquors to wash the Mouth, and Lini∣ments are of great use both at the beginning and height of this Distemper; and as they respect various Intentions, so they are to be prepared after divers manners.

Gargarisms or Waters for the Mouth are of divers kinds, which are all made for the most part of the De∣coctions of Vegetables, or the Infusion of Minerals. The Herbs and Roots which are boiled in a proper Liquor, viz. Water, or Wine, are for the most part sharp, bitter, or stip∣tick. Afterwards these Decoctions are impregnated with a Salt either volatile, lixivial, vitriolick, or chalybeat and aluminous.

When the Gums are swelled, and become spungy, a Gargarism may be prescribed after this manner.

Take of the Bark of Elder, and of Elm, each half an hand∣ful; of the leaves of Savory, Sage, Hedge-mustard, and Cresses, each one handful; of the Roots of Pepper-wort two drams. After they are cut and bruised, boil them in three pints of Lime-water to the Consumption of the third part; make a Gargarism; it may be sweetned with two ounces of Honey of Roses.

Liniments may be also prescribed for the same purpose, they are most properly applied at Night. The following is greatly commended by Authors.

Take of the Powder of the Leaves of Columbines, of curled Mint, Sage, Nutmeg, Mirrh (which is sometimes left out) each two drams; of Burnt-alum half an ounce, of Virgin-honey a sufficient quantity; make a Liniment.

If the Flesh of the Gums be dried, and falls off from the Roots of the Teeth, light Scarification is often used; the Mouth also is to be washed with this Decoction.

Take of the Tops of Madder, Cypress, of the Leaves of Sa∣nicle, Ladies-smock, each one handful; boil them in three pints of Water wherein hot Iron hath been quen∣ched,

to the Consumption of a third part; add to the strained Liquor two ounces of Honey of Roses; mingle them.

When the Gums are putrified and corrupted, and the Teeth being carious and loose, stink, stronger Medicines, and such as greatly resist Putrefaction, are to be used.

The Infusion of Vitriol camphorated, and of Lapis me∣dicamentosus, is very effectual in this case.

If deep and putrid Ulcers afflict the Gums, or any other part of the Mouth, strong Remedies must be often used; also Cotton dipt in Aegyptiacum dissoloved in Spirit, or in the Infusion of Lapis Medicamentosus, or sublimate, must be sometimes applied to the part affected.

Scorbutick People are also oftentimes afflicted with Pains in the Legs and in other Joints, especially in the Night-time, for the removing of which Pains, which are sometimes very violent, besides the general Method of cu∣ring the Scurvy, Specifick Remedies are to be used: There∣fore in such a case Purging having been rightly performed, and Bleeding, if there be occasion for it, Medicines both external and internal must be used.

As to the First, Those that evacuate by Sweat, and by Urine, are oft-times very effectual: Testaceous Powders, Crabs-eyes, the Jaw of a Pike, the Spirit, and Flowers of Sal-Armoniack, Spirit of Blood, Tincture of Antimony, and of Coral, Decoctions of the Roots and Seeds of Bur∣dock, Ground-pine, and Germander, are very proper; and such like Remedies may be taken twice or thrice a day ••n distilled antiscorbutick-waters. The distilled water of Horse-dung, with Scurvy-grass, Brook-lime, and Ground-••ine, and the like, may be conveniently used. In the mean time Fomentations, Liniments, Cataplasms, and ••uch like Applications must be applied to ease the Pain.

For a Scorbutical Gout, Henricus Petreus mentions ••wo Remedies, which are frequently used in West∣••halia.

Take nine Worms, beat them in a Mortar with two spoonfuls of Wine, press it through a Cloth, and add to it half a Measure of Wine; let three spoonfuls of it be taken in the Morning, at Noon, and in the Evening for many days.

The other is as follows.

Take of Savin two or three Branches, of Virgin-honey two spoonfuls, boil them in a measure of Wine till the Wine sink two Fingers; let four or five spoonfuls of the strained Liquor be taken thrice a day.

Certainly the Magisterial-water, of Worms, of the London Dispensatory, is very beneficial in this Disease, so are the Spirit and Salt of Harts-horn, Spirit of Blood, Flowers of Sal-armoniack, which I have often used with good Success.

Moreover, Testaceous Powders, as Crabs-eyes, Coral, Pearls, and Vegetables, which are counted good for the Gout, as the Roots of Birth-wort, the Leaves of Ground-pine, and Germander, and the like, mixed with Antiscor∣buticks conduce to the Cure of this Disease. Oyl of Worms, of Frogs and Toads, are often useful to ease the Pain. I have been told by a worthy Man, that the Water drawn from what is contained in the Stomach of an Ox newly killed, by Distillation, and applied hot with Cloaths, gives certainly ease.

For Convulsive and Paralitick Diseases occasioned by the Scurvy, Remedies proper for them must be mixed with Antiscorbuticks,

For a Consumption and a Feaver ocasioned by the Scurvy, gentle Catharticks, Digestives, and things that corroborate must be used. And because they often arise from a scirrhous Tumour in the Stomach, or Parts there∣abouts, things that open Obstructions are to be used, as Tunbridge-waters, and the like. Moreover, Fomentations, Liniments and Plaisters must be outwardly applyed; Asses or Cows-milk, diluted with Barly-water, or with some proper distilled-water is often good; so is Broth made of Snails, and Snails boiled in Milk. Moreover, Distilled waters of Milk or Whey with Snails, and Antiscorbu∣tick Herbs, do a great deal of Good in this Case. And for the Feaver, the following Medicines may be used with a thin Diet,

Take of the Raspings of Harts-horn, and Ivory, each two drams and an half; of Eryngo Roots candied six drams, of the Roots of Chervil, Dandelyon, each half an ounce; of the Leaves of Harts-tongue, Liverwort, each one hand∣ful; one Apple sliced, of Raisins one handful; boil them in four Pints of Fountain-water to the Consumption of a

third part; pour the strained Liquor upon two handfuls of Brook-lime, and a dram and an half of Sal-prunella, or of Nitre fixed one dram; let them infuse for the Space of three Hours; four or six ounces of it may be taken three times a day.

Take of the Leaves of Brook-lime four handfuls, of Wood-sorrel, of the Herb and Root of Dandelyon, each two handfuls; of Snails cleansed one pound and an half, the Peels of two Oranges: After they are bruised and cut, pour upon them six Pints of new Milk, or Whey made with Syder, or of the fresh Juice of Apples; distill them after the common Way. Three ounces may be taken twice or thrice a day.

A Scorbutical Rhumatism must be cured by Purging, but especially by Bleeding, and repeated sometimes according to the Strength of the Patient.

Diureticks and Diaphoreticks must be also used, and four or six ounces of the Infusion of Horse-dung in Wine or Ale may be taken twice or thrice a day on the Days the Sick does not purge. Spirit of Harts-horn, or of Blood, is also very good in this case.

A Scorbutical Dropsie arising from an evident Cause, or occasionally, is often cured; wherefore, if the Sick cannot sleep, Opiats must be given, and Purging must be repeated at due distances, according to the Strength of the Patient, and Glisters must be often injected to keep the Body loose.

Take of Mercurius Dulcis one Scruple, of Rosin of Jalap five or ten grains, of Cloves half a Scruple; mix them and give it in a spoonful of Panado: At other Times Diure∣ticks, and sometimes Diaphoreticks, must be given.

Take of Tincture of Salt of Tartar, impregnated with the Tincture of Millepedes, as much as you please: Give a Scruple or two Scruples twice a day in some proper Liquor.

Take of the Spirit of Sal-armoniack what quantity you please: The Dose is fifteen drops.

Take of Mille pedes prepared three drams, of Salt of Tartar two drams, of Nutmegs one dram; mix them, make a Powder. The Dose is half a dram twice a day with some proper Liquor. Or,

Take of dried Bees powdered two drams, of the Seeds of Bishops-weed powdered one dram, of Oyl of Juniper one scruple, of Turpentine a sufficient quantity for a Mass of Pills. The Dose is one scruple or half a dram to be taken twice a day, drinking upon it three or four ounces of the following Water.

Take of the Leaves of both the Scurvy-grasses, of Water-cres∣ses, of Pepper-wort, and Arsmart, each three handfuls; of the Roots of Wake-robin, Briony, and Florentine-orris, each four ounces; of the middle Bark of Elder two hand∣fuls, of the Winteran-bark two ounces, of the yellow Peel of four Oranges, and three Lemmons, and of fresh Juniper-berries, four ounces; cut them and bruise them, and pour upon them two quarts of Rhenish-wine, and of the Wine made of the Juice of Elder-berries one quart. Distill them in a common Still, and mix the Waters. The Dose is three or four ounces twice a day, after a Dose of any of the Medicines above prescribed.

There remains one Symptom, that comes, though rarely, upon the Scurvy, viz. A crackling of the Bones; but the Cure of it is not yet known.

An orderly Diet is of great moment in the Cure of the Scurvy: The Sick must only eat Meat of easy Digestion, he must avoid thick and clammy Meat, and such as are smoaked, and Pulse, Milk-meats, unripe Fruit, and things that are sugared; for the Scurvy has increased wonderfully of late by the immoderate use of Sugar.

Their Drink must be middling mild Beer, that is clear and medicated with Antiscorbuticks.

Exercise and Labour are so beneficial in the Scurvy, that many have been cured by them alone. An Air mo∣derately hot and dry, thin and pure, should be chosen.

CHAP. LXXXV. Of the Stone in the Kidneys, and of the Nephri∣tick Pain.

THE Nephritick Pain is called that whick afflicts the Reins and Ureters: The cause of this Pain is various; but the most frequent is a Stone or gross Flegm.

The less frequent causes are Clods of Blood thrust into the Ureters, or thick Matter, conveyed from the Reins or other Parts into the Ureters.

The diagnostick Signs of the Stone.

The first Sign is a fixed Pain about the Region of the Loins; the second is bloody Urine; the third thin and little Water at the Beginning of the Fit, which is sometimes succeeded by a total Suppression of Urine, if both the Ure∣ters be obstructed; the fourth is, the frequent voiding of Sand and little Stones; the fifth is, a Numbness of the Legs; the Sixth is, the drawing up of the Stones; the seventh is, Nauseousness and Vomiting.

The Cure of the Nephritick Pain, and Stone sticking in the Reins and Ureters, is peformed by dilating the Passages, by the Explosion of the Stone, or any other Mat∣ter which causes Pain; and also by removing the ante∣cedent Cause, and mitigating the Pain, to the which Indi∣cations the following Remedies answer.

Take of the carminative Decoction for a Glister ten ounces, of the Electuary of Laurel-berries, of the Electuary of Juice of Roses, each three drams; of Venice-turpentine dissolved in the Yolk of an Egg six drams, Oyl of Saint Johns-wort ten drams; mingle them, make a Glister,

After the Glister hath done Working, a Vein may be opened in the Arm.

It is diligently to be observed, that Purging Medicines are not to be given until the pain be somewhat abated, notwithstanding a Vomit may be proper at that time,

Take of Salt of Vitriol two Scruples; it may be taken in a draught of Posset-drink with Regiment.

Those Medicines are to be taken at the Mouth that di∣late the Passages and mitigate the Pain.

Take of White-wine, compound-water of Horse-radish, each one ounce and an half, of the Juice of Lemmons one spoon∣ful and an half, of Tartar vitriolated one scruple, Oyl of sweet Almonds one ounce, Syrup of Marshmallows two ounces, Powder of Nutmeg one scruple; make a draught, let it be taken warm.

Take of the Decoction of the Syrup of Marshmallows two Pints, sweeten it with Syrup of Water-lillies and Marsh∣mallows; add to it six ounces of White-wine; a large draught of it may be taken warm.

When the Pain is very violent Narcoticks must be used.

Take of the Waters of Pellitory of the Wall, Saxifrage, and Cowslips, each one ounce; Syrup of Poppies six drams, London Laudanum one grain; mix them, make a draught to be taken at bed-time.

Take of Mathews's Pill half a Scruple, of Turpentine half a dram; mix them, make four Pills to be taken at Bed-time.

But because a great quantity of crude Humours ordi∣narily accompanies this Disease, some purging Medicine must be given.

Take of whole Cassia half an ounce, boil it in a sufficient quantity of the Decoction of Senna Geronis, to three ounces of the strained Liquor, add of choice Manna one ounce; mingle them, make a Draught to be taken with Regiment. Or,

Take of choice Manna two ounces, dissolve it in four ounces of Milk-water, add to the strained Liquor two scruples of Cream of Tartar.

Anoint well with a warm Hand the Region of the Kid∣neys and Ureters, with the Oyntment of Marshmallows, and Oyl of Scorpions of Mathiolus.

The following Medicines are often used.

Take of Turpentine of Chios two drams, of Balsam of Tolu half a dram, with a sufficient quantity of Troches of Alkakengi, make middling Pills, let four of them be taken at Bed-time.

Take of the Powders of Crabs-eyes, and of Millepedes, each two Scruples; of the Seeds of Daucus powdered, and of

Sal-prunella, each one scruple; make a Powder to be di∣vided into four Parts, let one be taken at Bed-time.

To prevent this Disease, Tunbridge-waters, and the like, and Whey, drank for the Space of a Month in the Spring are good.

In the use of all Diureticks, this is perpetually to be observed, viz. They must not be frequently given.

The immoderate Heat of the Reigns may be qualified by wearing continually upon them Plates of Lead with holes in them.

CHAP. LXXXVII. Of the Stone in the Bladder.

IT is very difficult to know this Disease, especially at the beginning, when the Stone is small; but when it is great it is easily known.

The first Sign is, a pain in the Neck of the Bladder, which is exasperated about the end of making Water, and stretches it self to the Glans; it is very like a Heat of Urine, and can scarce be distinguished from it at first, till other Signs begin to appear.

The second Sign is, an itching on the Yard, which forces the Sick to handle and scratch it often.

The Third Sign is, a Weight in the Peritonaeum, and in all the Region of the Pubis, with a heavy Pain; this is when the Stone is large.

The fourth Sign, when the Stone is large, there is a great Difficulty in making Water; the Sick endeavours to make Water often, but renders it by drops.

The sixth Sign is, a Suppression of Urine in making Water, when it stops suddenly in the middle Course, the Stone being brought with the Urine to the Neck of the Bladder.

The sixth Sign is, the voiding Urine most easily upon lying on the Back, because the Stone in that Position goes farthest from the Channel of the Bladder; also when the Urine, being suppressed in making Water, flows freely;

when the Body is laid back and shook, the Stone falling then to the bottom of the Bladder.

The seventh Sign is, frequent Erection of the Penis, which prooceeds from a retention of the Urine, and from an Inflammation of the Bladder occasioned by the rubbing of the Stone.

The eighth Sign is, a Tenesmus, and a frequent En∣deavour to go to Stool, which follows the Endeavours of making Water, by reason of the consent betwixt the Sphincter of the Anus, and the Bladder; and the one being irritated, the other is so too, because they receive Branches from the same Nerve.

The ninth Sign is, that the Sick cannot rest in one place, they move their Legs alternately; and if the Stone be large, he can scarce stand upright, or ride or walk in stony places.

The tenth Sign is, that the Sick are eased by no Reme∣dies, but most commonly grow worse thereby, because all Medicines that come to the Urinary Passages increase the Disease, either by bringing new matter to the Bladder, or they rub off the Flegm which encompasseth the Stone, and then it grates harder upon the Bladder.

The eleventh Sign is, that when the Sick has been sub∣ject to Nephritick Pains, and used to void Gravel at the end of the Fit.

If after such Pain he has not voided a Stone as he was wont, it is a Sign that the Stone remains in the Bladder, and increases by degrees, and occasions the foresaid Symptoms.

The Cure is much the same with that described in the foregoing Chapter; when the Stone is small, Water distil'd from Onyons being used for forty days, has evacuated a Stone of the bigness of a Bean: But daily Experience shews, that a Stone cannot be dissolved in the Bladder by any Medicines; wherefore we are generally forced to leave such Patients to the Lithotomist; and having been inti∣mately acquainted with one of the chiefest Lithotomists in the City of London, and made some Observations upon his Practice; I find that Children bear cutting well, and generally recover; but that Men past forty Years of Age, most commonly die.

If the Sick will not undergo Cutting, or if it be not safe, by reason of his Age, gentle Medicines must be used, such as are prescribed for Heat of Urine, least the Stone should ulcerate the Neck of the Bladder by its Roughness, upon which it is often rolled; and if it happen to be thrust upon the Neck of the Bladder, and so stop the Urine, the Patient must lie upon his Back, and you must endeavour to remove it by shaking the Body and lifting up the Legs; afterwards you must use an emollient Fomentation or Bath, and you must force back the Stone with a Catheter.

CHAP. LXXXVIII. Of an Inflammation of the Reins and Bladder.

BEcause an Inflammation of the Reins and Bladder is cu∣red by the same Remedies; therefore we include them both in one Chapter,

The Signs of an Inflammation of the Reins are, a heavy Pain in the Region of the Reins, and there is sometimes a pulsation: If the place wherein the Arteries are be affected, and the Pain is extended to the neighbouring Parts, so that the Sick cannot raise himself upright nor stand, and but difficultly turn himself to the opposite side, neither can he lie upon that side nor upon his Belly, and therefore he is forced perpetually to lie upon his Back; if his Knees, or if his Body be any way moved, the Pain is much exaspera∣ted; there is a Numbness of the same side, by reason of a Nerve which goes from thence to the Leg; his Urine is hot, and in the beginning thin and yellow; afterwards red and thick. The Sick has a continual and acute Feaver, and it is often accompanied with watchings, a Delirium, Nauseousness and Vomiting.

But in an Inflammation of the Bladder, the Pain is seated upon the Region of the Pubis, and Perinaeum, in which Parts there is a Heat, and sometimes an apparent Redness, the Urine is always hot, and voided difficultly, the Passage being stopt by the Tumour; and the right Gut is affected by reason of its Nearness; upon which account

there is frequent endeavours to go to stool, and sometimes the Belly is bound: There are also other Symptoms that are common with the Inflammation of the Reins, as a Feaver, watching, and the like.

The Cure of an Inflammation in the Reins and Bladder, is performed by Medicines that cause Revulsion and Deri∣vation, and by such as cool and moderately repel, by Anodyn, resolving and suppurating Medicines.

And First, Bleeding is very necessary twice, thrice, or oftener, acccording to the Strength, until the Fluxion is stopped and the Pain abated. A large quantity of Blood being taken away from the upper Veins, the lower are to be opened also in the Foot to make Derivation. The Hemor∣rhoidal Veins are also to be opened, especially if they are swelled; and Cupping-glasses with Scarification are to be applied to the upper and lower parts to make Revulsi∣on. Frictions and painful Ligatures of the extream parts are also to be used; Emollient cooling, and moderately loosning Glisters must be injected in a small quantity.

Take of the Roots of Marsh-mallows one ounce, of the Leaves of Mallows, Violets, and Lettice, each one hand∣ful; of sweet Prunes four pair, of Barley cleansed, and of the Flowers of Violets, each one Pugil; make a Decoct∣ion to eight or ten ounces; in the strained Liquor dis∣solve one ounce of Cassia, of Oyl of Violets four ounces, of Yolks of Eggs number two, make a Glister.

The Heat of the Blood must be mitigated by Juleps and Emulsions.

Take of the Waters of Endive, Lettice and Purslain, each four ounces; of Syrup of Pomegranates two ounces, of Syrup of Water-lillies one ounce; mingle them, make a Julep, for three Doses to be taken Morning or Evening. Or,

Take of the Roots of Sorrel two ounces, of the Leaves of Mal∣lows, Plantane, Purslain, and Endive, each one hand∣ful; of the Tops of white Poppies half an handful, of the Seeds of Annise and Lettice, each one dram; of the Flowers of Borrage, Violets, and Water-lillies, each one pugil; boil them to a Pint and an half; then add of the Syrup of Pomegranates four ounces. Or,

Take of sweet Almonds blanced one ounce, of fresh Pine-nuts half an ounce, of the Seeds of Lettice, Sorrel, Purslain, and white Poppies, each three drams; beat them in a

marble Mortar, and pour upon them of the Waters of Barley, or Lettice, or Purslain one Pint and an half; in the strained Liquor dissolve one ounce of Sugar of Roses; make an Emulsion for three Doses. Syrup of Poppies may be conveniently added to this Emulsion, to restrain the Fluxion more powerfully.

Cooling Glisters must be also injected.

In the Beginning of these Inflammations, Purging is not convenient, but at the Declination gentle Purges may be used, as of Manna, Cassia, Rubarb, Tamarinds and the like.

But cooling and moderately repelling Medicines must be used outwardly at the beginning, as liquid Epithems made of the Waters or Juices of Plantane, Sorrel, Endive, Night-shade, and of Roses, with a little Vinegar, red San∣ders, and Camphor; also Liniments of Oyl of Roses Om∣phacine, and of Violets, the white Oyntment, or Popu∣leon alone, or mixed, a little Vinegar being added to them, may be applied almost cold to the Parts every hour.

If the Pain be very violent, it will not be improper to add to the Epithem or Liniment, a little Opium or Saffron.

A Cataplasm may be also made of Barley-meal, with the Juice of Endive, Purslain, and Night-shade, Oyl of Roses being added to it and Populeum Oyntment; but it must be frequently changed before it grows hot.

But here three things are to be observed: First, We must not continue too long the use of cooling Medicines; least the Expulsion of the conjunct matter by Sweat should be hindred, and the Tumours should grow Scirrhous. Secondly, in an Inflammation of the Bladder, things that are but a little cooling and astringent must be used, least a Suppression of Urine should happen, which is a Symptom that is very frequent of it self in this Disease. Thirdly, Cataplasms are not so proper in an Inflammation of the Bladder, as Liniments and Oyntments, because they op∣press the part with their Weight.

Wherefore when cooling Medicines have been used a very little while, and after Bleeding repeated, the Fluxion being pretty well stopt, we must use Emollients, and gentle Resolvents, as Fomentations made of a Decoct∣on of the Roots of Marsh-mallows, of the Leaves of Mal∣lows, Violets, Pellitory, of the Seeds of Flax, Fenugreek,

Mallows, and of Cotton, of the Flowers of Camomil, Melilot, Rosemary, and Roses; and Liniments are to be applied of Oyl of Lillies, Roses, and with a little Oyl of Camomile,

The following Pultis is very softning, and Anodyne.

Take of the Crums of white Bread one pound; boil them in Goats-milk to the Consistence of a Pultiss; then add the Yolks of three Eggs, of Oyl of Roses four ounces, of Saffron half a dram; make a Cataplasm; it must be often changed; a little Opium and Camphor may be ad∣ded to it if the Pain be very violent.

If there be danger of a Gangrene, a corroborating Cata∣plasm must be made of the Meal of Beans, Orobus, and of Lupins boiled in Wine.

But when the Inflammation is in a manner taken off, then resolving Decoction and Liniments must be used.

In the whole course of the Disease, respect must be al∣ways had to the Feaver, Pain, Watchings, Suppressions of Urine, and the like.

And to ease the Pain of the Bladder, Anodyne Sup∣positories, or Yolks of Eggs, with a little Opium, and with the Juice of Henbane, or the like, must be tied up in a rag, and put up the Fundament.

If the Inflammation of the Reins cannot be discussed, but tends to Suppuration, which may be known by the Increase of the Feaver, of the Pain, and of other Symp∣toms; also by shaking and Vomiting, and by a greater Weight about the Part, especially when the Sick bends to∣wards the well Side; the Motion of Nature must be fur∣thered by applying Cataplasms made of emollient Roots, and Herbs, of the Seeds of Flax, and of the Flowers of Camomil, to which being boiled, bruised, and pulped, Meals, Butter, Grease, and proper Oyls must be added, whereby, unless the Abscess break and cleanse it self by Urine, the Matter breaks into the Cavity of the Belly; upon which account sudden Death, or an hectick Feaver follows. Sometimes the Tumour swells outwards, and then it must be opened by a Potential Cautery, or with a Knife.

It also happens sometimes, that the Tumours become Scirrhous, the Feaver ceasing, but the Pain continuing with a greater Sense of Weight, and a Numbness of the

neighbouring Parts, which are most commonly incurable, for the Sick falls into a Cachexy and Dropsie; yet the Cure may be attempted by emollient, inciding, and di∣gestive Medicines.

CHAP. LXXXIX. Of Bloody Ʋrine.

BLood may be conveyed from many Parts to the Urinal Passages, and be mixed with the Urine, and so ren∣der it bloody; but that rarely happens, and we only dis∣course here of Diseases of the Reins and Bladder, and of that bloody Urine which proceeds from the fault of those Parts: The Blood flows from the Reins and Bladder, as from all other Parts, either by opening of the Vessells, by a Rupture, or a Solution of the Continuum, but very rarely, by reason of the Thinness of the Veins which carry Blood to these Places.

The most frequent causes, are Fullness and Acrimony of the Blood, and a Stone in the Kidneys, a Fall or Blow, the lifting or carrying of a great Weight, violent Motion of the Body, or the like.

When Blood flows from the Bladder it is little in quantity.

The Cure of this Disease must be varied according to the Variety of the Causes: And first, If it proceed from a great quantity or Acrimony of the Blood, Bleeding must be used frequently, but little must be taken away at a time; and in this case Cupping glasses, Frictions, and Ligatures must be used to the upper Parts, and Derivation must be made by bleeding in the Foot, or by opening the Hemorrhoidal Veins.

When serous and Cholerick Humours promote this Evacuation, they must be purged off by Catharticks used by Intervals.

Take of Rubarb a little torrified and powdered one dram, of Coral prepared half a Scruple, of the Whey of Goats-milk, or of Plantane-water, three ounces; make a Potion.

Take of Cassia fresh drawn half an ounce, of the Pulp of Tamarinds six drams, of Bole-armonick half a Scruple; with Sugar make a Bolus.

After due Revulsions and Evacuations, or whilst they are used, if there be occasion, such things as restrain the Blood, and heal the Veins must be given; but they must not be presently used, least the Blood should be stopt too soon, and being thickned, it should coagulate somewhere; for this Purpose the Juice of Plantane fresh drawn is much commended, four or five ounces of it being taken Mor∣ning and Evening, which is also very proper in all Hemor∣rhagies, but if it be too cold for the Stomach, it may be boiled a little with Sugar.

Sheeps-milk is also much commended, four ounces of it being taken with a dram of Bole-armenick, but after takeing it, the Sick must not sleep nor exercise himself. Decoctions also of Knot-grass, Horse-tail, Purslain, and of the Tops of Brambles, sweetned with Syrup of Quinces; or to qualifie the Heat of the Blood, the following Apozem may be used.

Take of the Leaves of Lettice, Purslain, Plantane, and Comfrey, each one handful; of the four greater and lesser cold Seeds, each one dram; of Jujubes three pair, of Liquorish half an ounce, of the Flowers of Water-lillies, of Violets, and of Roses, each one Pugil; make a Decocti∣on to a Pint and an half; in the strained Liquor dissolve of Gum-tragacanth a dram and an half; of Syrup of Violets, and of dried Roses, each one ounce and an half; of Sal-prunella half an ounce, of the Troches of Alkakengi without Opium half a dram; make an Apozem for four Doses.

To thicken and restrain the Blood more powerfully, we may add to it an ounce of Syrup of Poppies.

If the Disease be lasting, an Electuary may be made in the following manner.

Take of the Conserves of Roses, and of the Roots of Comfrey each two ounces; of sealed Earth, and Bole-Armenick, of Dragons-blood, red Coral, Blood-stone, and Troches of Ambar, each one dram; of Hypocistis, grains of Kermes, and of the Seeds of Plantane, each one scruple; with equal Parts of Syrup of Mirtles, and of Poppies, make an Electuary, whereof let him take the quantity of a Walnut

Morning and Evening, drinking upon it a little Plan∣tane-water.

Dr. Gordon's Troches are also reckoned excellent in this Case.

But because Clots of Blood are wont to be retained in the Bladder, and to occasion violent Symptoms, for the Dissolution of them, it will be convenient to drink warm now and then Mallow-water, mixed with a little Vinegar, but the quantity of the Vinegar must be so small, that it can scarce be tasted.

Outwardly Topicks must be applied to the Region of the Loins, such as are proper to cool and bind the Reins.

Take of the Roots of Bristort, and of Comfrey, each one ounce; of the Leaves of Plantane, Purslain, Shepherds-purse, Knot-grass, each one handful; of the Flowers of Pomegranates half an ounce, of the grains of Sumach, and Mirtles, and of Hypocistis, each two drams; of the Cups of Acorns, and of yellow and red Sanders, each one dram; of red Roses three Pugils; boil them in Smith's-water with a little Vinegar, strain the Liquor, and fo∣ment the Reins with it warm. A Bath may be made of the same Decoction the quantity of it being increased.

Take of the Juice of Plantane, and of Blood-wort, each two ounces; of Vinegar half an ounce, of Omphacine Oyl one ounce, boil them to the Consumption of the Juices, then add of Dragons-blood, Mastich, and of Pomegranate-peel, each two drams; of Champhor half a dram, of the Countesses Oynoment four ounces, of Wax a sufficient quan∣tity; make a Liniment.

Anoint the Loins with it frequently; at the time you use it, mix a little Vinegar with it.

Leaden Plates with many holes in them, worn upon the Reins, are very proper.

When the Voiding of Blood proceeds from the Stone, the following Method has been found very successful by Dr. Sydenham, who was much troubled with the Gout, the Stone in the Kidneys, and a bloody Urine; and I have also found it very successful, I drank, says he, two ounces and a half of Manna dissolved in a quart of Whey, swal∣lowing now and then a little of the Juice of Lemmons, while I was purging, to quicken this Cathartick, which used to work slowly, and to render it more pleasant to the

Stomach. It can scarce be said how much Ease I received about the Region of the Reins by the use of this Remedy; for though they did not always ach before, yet they were affected with a heavy and troublesom Pain; and because it succeeded so well with me, I took the same of a set day once a Week for some Months, and after every Purge I plainly found my self better, and could bear the shaking of a Coach when it went fast, and was indeed wholly freed from this Symptom. But it returning again, some time after, I took it twice a Week for three Weeks, and after∣wards only once a Week: I continued this Method some Months on set Days, and the Bleeding quite stopped: The Diet that I observed is as follows, In the Morning when I rise I drink a Dish of Tea, at Dinner I moderate∣ly refresh my self with any sort of Meat of easie Digestion that I like; a draught of small Beer is to me instead of a Supper; and when I am in Bed I take another draught, that by this Julep I may cool and dilute the hot and acrid Juices lodged in the Kidneys, whereof the Stone is gene∣rated; and I prefer at this time, and at Dinner time, small Beer that has Hopps in it, before that which has none, for though that which is not hopped is smoother and softer, and so fitter to carry off the Stone from the Kidneys, yet that which is hopped, by reason of the stiptick Quality which the Hopps impart to it, is not so apt to generate sandy and stony Matter, as that which is not hopped, the Substance whereof is more viscous and slimy. I take care to go to Bed early, especially in Winter; and to prevent a bloody Urine, I take care, that as often as I have occasion to ride a long Way upon the Stones, to drink a large draught of small Beer before I go; and also before my Return, if I be abroad a pretty while, whereby I secure my self pretty well from bloody Urine.

CHAP. XC. Of an Ʋlcer of the Reins and Bladder.

AN Ulcer is occasioned in the Reins and Bladder by three Causes, first, from an Abscess broken, second∣ly from the Acrimony of the Humours, and thirdly, from

a rough Stone, and this is the most frequent and ordinary cause.

Among the Diagnostick Signs, the first and chief is the voiding of Matter with Urine, which continuing a while, certainly shews an Ulcer in the urinary Passages; but whither the Reins or the Bladder are affected with the Ulcer, may be known by the Situation of the Pain, as whether it be in the Region of the Loins, or in the Pubis, or Perinaeum. Moreover, Matter proceeding from the Reins is better concocted, is white, light, and not at all stinking, because the Parenchyma of the Reins being fleshy concocts better, and the Matter is also in a greater quan∣tity, and more mixt with the Urine, which looks like Milk, along while after voiding it the Matter is seperated from it, and falls to the Bottom of the Chamber-pot. But Purulent Matter flowing from the Bladder, is little and not much mixed with the Urine, nor so concocted, but crude, variegated and stinks much, for the Part having little Heat, cannot sufficiently concoct the Matter, but from the Neck of the Bladder, or from the urinal Passage, pure Matter without Urine is often voided. Moreover, In an Ulcer of the Bladder or of its Neck, there is a continual Heat of Urine, and a continual Pain in the part, which is not so in an Ulcer of the Reins; for in that Ulcer the Heat of Urine and Pain cease sometimes.

When the Ulcer is deep, Blood sometimes flows out plentifully, which is difficultly stopt, and often small pieces of the Parts are voided with the Blood and Matter, viz. most commonly small Caruncles from the Reins, sometimes they are larger, and passing difficultly through the Ure∣ters, they occasion a Nephritick Pain, but from the Bladder small Scales, or small Membranous Skins flow like Bran.

And lastly, In a long and callous Ulcer of the Bladder, a mucous Flegm is produced.

As to the Prognostick, these Ulcers are very difficultly cured, because there is a perpetual Flux of Humours to the Part; for though the Serum of its own Nature is clean∣sing, yet when it is infected with other qualities it is not so, and when acrid and salt Humours are mixed with it, ••hey occasion Ulcers, or further them.

Fresh Ulcers of the Reins and Bladder may be cured, but when they are inveterate they are incurable.

In old Men they can never be cured, in young Men they may sometimes, but with great Difficulty.

Ulcers that are occasioned by the Stone cannot be cured till the Stone is extracted.

The Pain and other Symptoms which accompany these Ulcers, occasion Watchings, and waste the Body, and at length the Sick is brought into a Cachexy and Consump∣tion.

The Cure of the Ulcers of the Reins and Bladder, as of all other Ulcers, is performed by cleansing, drying, and consolidating Medicines. To which end the following things may be used.

And First, if there be a Plethora, or an Inflammation of the Part, Bleeding must be ordered, first in the Arm, and afterwards in the Foot.

Afterwards Purging must be prescribed frequently, that the vitious Humours abounding in the whole Body, and flowing to the Part affected may be evacuated; but only gentle and lenitive Medicines must be ordered, as Cassia, Manna, Syrup of Roses, Rubarb, and Agarick reduced to a Bolus, or some other solid Form, because in a liquid Form they easily run to the Urinary Passage, and so increase the Acrimony. The following Electuary may be pre∣scribed.

Take of Polypody of the Oak, and of Liquorish rasped, each half an ounce; of the four greater Cold Seeds each one dram, of the Flowers of Violets, and Borrage, each half a pugil; of Jujubes six pair, of Damask Prunes three pair, of Raisins half an ounce, of Senna cleansed two ounces and an half; infuse them a Night in Barley-water, boil them in the Morning and strain them; afterwards dissolve an ounce and an half of Manna in a sufficient quantity of the Decoction, strain it again, add to it three ounces of Cassia fresh drawn; boil them to the Consist∣ence of an Electuary, adding at last half an ounce of Ru∣barb powdered. The Dose is one ounce once a Week two Hours before eating. Or,

Take of Cassia two ounces, of Manna one ounce and an half, of the Pulp of Sebestines, and Tamarinds, each one ounce; of the Mucilage of the Seeds of Psyllium six drams,

of the four greater cold Seeds each one dram, of Juice of Liquorish two drams, with Syrup of Roses solutive make an Electuary. If you add Mercurius Dulcis to the Electua∣ries above mentioned it will succeed the better; for it is of great Vertue to cleanse and heal all inward and out∣ward Ʋlcers.

Among Purgers Turpentine is reckoned, and is much commended in this case, because it loosens the Belly, and cleanses the Ulcer; half an ounce of it washed in Plantane water must be given in Powder of Liquorish; but it is chiefly to be used when the Urine is very mucous and thick.

Vomiting is much commended by many, whereof some provoke it before Meals with warm water and Oyl, with which only Remedy often repeated, they say this Disease has been cured. But it is to be noted, that Vomiting must be only used in those that vomit easily, for violent Vomi∣ting irritates the Ulcer.

After due Evacuations and Revulsions we must come to the use of such things as cleanse, the chief of which are Whey drank in a great quantity in the Morning, and small Mead, whereof also six or eight ounces may be taken in a Morning, and it may be used for the ordinary Drink. A Decoction of Barley with Liquorish and Sugar may be used in the same manner.

If Mead be thought too hot, the greater cold Seeds, or the Roots of Liquorish, and the Tops of Mallows may be boiled in it. Asses-milk also does not only cleanse but it also consolidates; but it must not be given when there is a Feaver; or the following Decoction may be used.

Take of the Roots of Marsh-mallows half an ounce, of the Leaves of Plantane Agrimony, Maiden-hair, and the Tops of Mallows, each one handful; of the Seeds of Mal∣lows, and of Mellons, with the Barks bruised, each half an ounce; of the grains of Alkakengi six drams, of Liquo∣rish rasped one ounce, of whole Barley one pugil; boil them to a quart, in the strained Liquor dissolve of Honey of Roses three ounces, of Sugar-candy two ounces; make a Julep, whereof take eight ounces in a Morning, for ten Days. Those things which are given for Diseases of the Reins and Bladder, must be prescribed in a large quan∣tity,

for otherwise their Vertues will not reach the Parts affected.

But instead of all, Barnet or Epsom-water, or Tunbridge-waters may be used; for by the long use of them, the hot Intemperies will be corrected, and the Ulcers cleansed and cured.

Some commend to dry up the Ichor, and to cleanse and heal internal Ulcers, especially in Patients of a Flegmatick Constitution, and for such as have been at any Time in∣fected with the French Pox, and when there is no Feaver nor Flux of Blood, a sudorifick Decoction made of China, Sarsa-parilla, Sassafras, or of Guajacum, to be taken for thirty Days or more, and that the second Decoction should be used for ordinary Drink, with a thin and drying Diet. In the mean time, least the Bowels should be too much in∣flamed by the use of this Decoction, they may be qualified by cooling Broths given about the Evening, and by anoint∣ing the Reins with cooling Oyntments▪

But the following Decoction is safer and more successful in every case.

Take of the Roots of Sarsaparilla three ounces, of Lignum Lentiscinum two ounces, of Sassafras one ounce, of the Raspings of Ivory and Harts-horn, each six ounces; of Jujubes, and Sebestines, each half an ounce; of Nephri∣tick Wood four ounces, of Barley cleansed two ounces; in∣fuse them twelve Hours in five pints of Fountain-water, boil it to three, for six Doses to be taken twice a Day. Aromatise them with two drams of Cinnamon.

When the Ulcer is sufficiently cleansed, which may be known, for that the Matter is voided with the Urine in a lesser quantity, and is white, and does not stink at all, Astringent things and such as heal must be given,

Take of Bole-Armenick, of sealed Earth, and of red Coral, each three drams; of Gum-Arabick, and Tragacanth, each half an ounce; make Troches with Agrimony-Water, weighing each two drams; one of them must be taken Morning and Evening with a Decoction of Comfry.

But Dr. Gordon's Troches are better than all the rest, to cleanse and heal Ulcers of the Reins and Bladder; and at the same time ease the Pain, and take off the Heat of Urine; two drams of them may be taken at a time in Mead, or a Decoction of Barley, when you design most to cleanse; and

in Goats or rather Sheeps Milk, when you chiefly design to heal.

Consolidating Juleps may be made in the following manner.

Take of the Roots of Comfry two ounces; of the Leaves of Plantane, and Mouse-ear, each one handful; of the Tops of Mallows, and Maiden-hair, each half a handful; of Li∣quorish rasped half an ounce, of White-starch, Gum-ara∣bick, Tragacanth, and Bole-armenick, each one dram; of the Seeds of Lettice, Purslain, each one dram; of the seeds of red Roses one pugil; make a Decoction in Rain-water to one Pint and an half; in the strained Liquor dissolve four ounces of Sugar, and two ounces of Penids; make a Julep, whereof let him take eight ounces in a Mor∣ning for ten or twelve Days.

The following Pills are also very good.

Take of the Roots of Marsh-mallows, and of Comfry dried, of Gum-arabick, and of the Gum of the Cherry-tree, and Prune, each one dram; of Olybanum and Mirrh, each four scruples; of the Seeds of white Poppies, and of Alka∣kengi, each one dram and an half; of Camphor two scru∣ples; powder them finely, or with a third part of the Weight of all of Ceruss, of Antimony, and with a suffici-quantity of Venice Turpentine, make a Mass for Pills, whereof let him take a dram Morning and Evening.

If the Turpentine should cause Pain, the Juice of Liquo∣rish may be used instead of it; but new Cows-milk is the best of all, a quarter of a pint of it being taken with half a dram of Bole-armenick every Morning.

In inveterate Ulcers a Decoction of round Birth-wort in White-wine sweetned with Sugar is very beneficial.

The following Oyntment may be used outwardly to consolidate the Ulcer.

Take of the Juice of Plantane, and Night-shade, each four ounces; of Oyl of Roses Omphacine three ounces, of Vinegar one ounce, of Letharge finely powdered one ounce and an half, of Ceruss washed half an ounce, of Tutty finely pow∣dered two drams; of Dragons-blood one dram; reduce them all to the Form of an Oyntment.

Injections are peculiarly proper for an Ulcer of the Blad∣der, they must be used twice a Day: First, Such as cleanse made of Hydromel, of Whey, or a Decoction of Barley,

with a littie Honey of Roses; but afterwards astringent and consolidating Injections must be used, wherein the Roots of Comfry, Mirrh, Allum, Sarcocoll, and Traga∣canth have been boiled; Dr. Gordon's Troches dissolved in Milk are of excellent use.

Fabritius Hildanus cured a great Ulcer of the Bladder with the following Injection, and with some other Reme∣dies. See his 69 Observation, Cent. 3.

Take of the Roots of Comfry one ounce, of whole Barley one handful, of the Leaves of Agrimony, Speedwell, Scordium, Ladies-mantle, Sanicle, each half a handful; boil them to a Pint; in the strained Liquor dissolve of Honey of Roses two drams; mingle them, make an Injection.

It is to be noted, that these Injections are not to be squir∣ted in with a Syringe, because they do not penetrate into the Cavity of the Bladder, the Sphincter Muscle hindering; but a Catheter being put into the Bladder, you must syringe through it, and so the Injection will reach the Part affected.

But because these Ulcers are commonly painful, all the course of the Cure you must endeavour to mitigate the Pain with Anodynes taken inwardly, and used out∣wardly, Syrup of Poppies, London Laudanum, and the Troches of Alkakengi, which are peculiarly proper in this case, must be used inwardly: Also Emulsions of the cold Seeds, of the Seeds of white Poppies, adding if there be occasion, Syrup of Poppies. And lastly, The Conserve of the Flowers of Marsh-mallows must be frequently given.

And the following Fomentation may be used to the Region of the Reins,

Take of the Roots of Marsh-mallows, of the Leaves of Mal∣lows, Pellitory, and Violets, each one handful; of the seeds of Flax, Fenugreek, and Alkakengi, each three drams; of the Flowers of Camomil, Melilot, and Water-lillies, each one Pugil; make a Decoction, wherewith fo∣ment the Part with Flannels.

After the Fomentation use the following Liniment.

Take of Oyl of Violets, and of sweet Almonds, each one ounce and an half; of Oyl of Roses one ounce, of the Mucilages of the Seeds of Marshmallows and Fenugreek, each two ounces; of Suffron one scruple; make a Liniment.

But to ease the Pain, new Milk from the Cow, with Dr. Gordon's Troches dissolved in it injected, is the best Anodyne, for it eases the pain and cures the Ulcer.

CHAP. XCI. Of a Diabetes.

THis Disease was so rare amongst the Ancients, that many famous Physicians made no mention of it; but in our Age, wherein excessive Drinking has been, especially of Wine, so much used, there are many Instances of it.

As to the Cure, The chief intentions of Healing, are to prevent fusion of the Blood, and to take off that which is so. First, The Fusion of the Blood is hindred, when its gross and watry Parts contain one another, and are con∣tained, so that they do not too hastily separate, which may be effected by thickning Remedies; and for this Purpose Rice, Starch, and Mucilaginous Vegetables, also Gums, and some resinous things are of use. Secondly, That the Fusion of the Blood may be taken off, such Remedies are indicated as dissolve the Concretions of the Salts. I have prescribed in this Disease, the Tincture of Antimony with good success, and Lime-water, with the Seeds of Annise, Raisins, and Liquorish, is much commended by some.

A Noble-man fell into a desperate Diabetes, for besides that, he voided a Gallon and an half of clear Urine, that was almost as sweet as Honey, in the space of a Night and a Day; he was also afflicted with great Thirst, a Hectick Feaver, great Weakness, and with a wasting of the whole Body; he was cured in a short time by the fol∣lowing Medicines.

Take of the Tops of Cypress eight handfuls, of the Whites of Eggs a quart, of Cinnamon half an ounce; having cut them small, pour upon them four Quarts of new Milk, and distill them in a cold Still. Have a care of an Em∣pyrema. He took six ounces of it thrice a day.

Take of Gum-Arabick, and Tragacanth, each six drams; of Penediate Sugar one ounce, make a Powder; give one

dram, or one dram and an half, twice a day, with three or four ounces of the distilled Water.

Take of Rubarb powdered fifteen grains, of Cinnamon six grains, make a Powder; let him take it in the Morning and repeat it six or seven days after.

Take of Cowslip-water three ounces, of Cinnamon-water hor∣deated two drams, with half an ounce of Diacodium; make a draught to be taken at Bed-time every Night.

His Diet was altogether in a manner of Milk, which he eat sometimes crude, sometimes boiled, with Bread or Barley; sometimes it was diluted with a distilled water, or with Barley-water.

When he had been well a long time, he fell into the same Disease again, and the same Method and Medicines were ordered again, whereby he grew better in a few Days; afterwards he took five or six ounces of Lime-water daily thrice in a Day; and having used it four days, he voided Urine in a moderate quantity well coloured and some∣what salt. I cured another of a deplorable Diabetes by the same Method, especially with Lime-water.

CHAP. XCII. Of Incontinence of Ʋrine.

INcontinence of Urine proceeds from a fault of the reten∣tive Faculty of the Bladder; it befalls either People waking, and then the cause is great, or sleeping, and then it is less, for at that time the Animal Functions are not so freely exercised; and this happens two Ways, viz. Either by the Weakness, or Laxity of the Sphincter Muscle of the Bladder; which sucking Children are subject to, old People, and some in their middle Age, and others by false Imagination; for many there are, who by reason of excessive Drinking, or by reason of the exquisite sense of the Bladder, or sharp Urine, piss in Bed, in some sort willingly; for they imagine in their Sleep, that they are making Water against the Wall or some other Place; and they are so accustomed to this Vice, that they do it where there is no Fault either in Bladder or Muscle of it, and they

are not cured by Medicines, but by rectifying their Ima∣gination, as in Children by the Rod, and in grown People by placing some precious things upon the Places where they think they make water in their Dreams; and by shewing such things to them often.

But a preternatural Disorder occasioning an Incontinence of Urine, is seated in the Sphincter Muscle, which is either affected Sympathically, or Idiopathically, it is affected by Sympathy many Ways, as when the whole Body is weak, and the Natural Heat decayed, as when Death ap∣proaches, or when the whole Body, or half of it, is seised with the Palsie, or those Branches of the Nerves only, which arising from the Os sacrum, are communicated to the Bladder. This Resolution of the Muscles, is occasi∣oned sometimes by reason of the Nearness to other Parts affected; as in Women with Child, in swellings and Pains of the Womb, and great Diseases of the right Gut.

But the Sphincter Muscle is also affected various ways, Idiopathically, as by Wounds upon it, as it happens in cutting for the Stone, or by reason of deep Wounds that hinder the Contraction and Shutting of it; but the chief and most frequent cause, is a cold and moist Intemperies, whereby that part is weakned and relaxed. This Intem∣peries is much furthered by a natural cold and moist Con∣stitution, by Childhood, Age; the Feminine Sex, by Dis∣eases of the whole Body, or of some Parts arising from a cold and moist Intemperies, to which may be added, exter∣nal causes proper to produce such an Intemperies.

The Diagnostick Signs of this Disease, either shew a Sympathick Disease, which are to be taken from the Ef∣fects proper to produce an Incontinence of Urine mention∣ed above; and if they are present, we must suppose the Disease proceeds thence; but if they are absent we must count it Idiopathick; and if it be occasioned by a Wound, Ulcer, or any other Disorder of the Sphincter, it is easily known, but if none of these appear, we must consider whither there be a cold and moist Intemperies of the part, which may be known by the Constitution of the In∣ternal and external Causes, and by the Effects of them; as softness of the whole Body, a pale Colour, a Laxity of the Genus Nervosum, and of the genital parts by Child∣hood, Age, and a Flegmatick Cachexy, and the like.

As to the Prognostick. This Disease is incurable in old Age, in a Feaver it is dangerous; but it may be cured in Children by increase of Years, for in time the superflu∣ous Moisture may be consumed, and the lax parts rendered firm and strong.

The Cure of Involuntary Urine must be directed to the correcting of the cold and moist Intemperies, and to the Laxity of the Sphincter Muscle, for that which is occasion∣ed by Sympathy from other Parts primarily affected, must be referred to the Cure of those Diseases; and that which proceeds from a Wound, Ulcer, and other manifest Dis∣eases, depends on the Cure of them; wherefore the follow∣ing Method of Cure must be observed, both for Children and grown People; but in Children the most gentle Medicines must be used, and they must be dosed accoding to their Age.

First, Bleeding is not of use in this case, unless there be a Plethora of the whole Body in Youth, but Purges are al∣ways necessary in this case; they must be made of Phleg∣magogue Medicines, and astringent things may be mixed with them, especially such as purge too, as Rubarb, Miro∣balanes, and the like. Afterwards Electuaries, medica∣ted Wines, and the like, must be used to dry up the phlegmatick Matter, and to constringe the relaxed part.

Take of the Nuts of Cypress, and of Mirtles torrified, of the Raspings of Ivory, Coriander seeds prepared, red Coral, Ambar, each two drams; of Spodium one dram, of the Roots of Cyperus, and Galingal, each half a dram; with candied Citrons; make an Electuary, whereof let him take the quantity of a Chesnut Morning and Evening, drinking upon it a little red Wine.

Take of the Roots of Comfry half an ounce, of the Roots of Cyperus, and Galingal, each one dram; of the Leaves of Plantane, Horse-tail, five leaved Grass with the Roots each one handful; of Cypress Nuts▪ and of the Cups of Acorns, each four Scruples; of the seeds of Rue, and of the chast Tree, of Frankincense, and of the Raspings of Ivory, each half a scruple; of red Roses one Pugil, of red Wine two quarts; infuse them twenty four Hours, then strain them, and add to it half an ounce of Cinnamon, and with a sufficient quantity of Sugar make a Claret, whereof let him take three or four ounces twice a day.

Many Specificks are proposed by Authors for the Cure of this Disease, as the Brains and Testicles of a Hare burnt, also a Cockle in its Shell burnt, and drank; the Dung of a Hare, the Ashes of a Mouse burnt the Hoof of a Boar torrified, the Ashes of Date-stones, the Powder of Egg-shells, but above all the Powder of Agrimony, and the inward Coats of the Stomach of a Hen dried, which may be given a part, or together, in red Wine.

Solinander, says, he saw excellent Success by the use of a Cocks Throat torrified, the Powder was taken before Supper in a little red Wine, it was repeated for some Days.

In grown People Sudorifick Decoctions made of Gua∣jacum and Sassafrass, and used for twenty Days, are pro∣per to dry the Body. So are also Bath-waters, applied with Flannels.

The Sick must drink red rough Wine by it self, or di∣luted with Chalybeat waters, and he must drink but little at Supper, he must make Water just as he is going into Bed, in the middle of the Night, and early in the Mor∣ning.

And outwardly Topicks must be applied to the Pubis and Perinaeum, such as heat, strengthen and dry.

Take of the Roots of Elecampane, sweet-smelling Flag, of Acorus and Cyperus, each half an ounce; of the Leaves of Mint, Sage, Wild-marjoram, Calaminth, and Worm∣wood, each half an handful; of the Nuts of Cypress, Mir∣tles, Galls and Balaustines, each one dram; of red Roses one Pugil; boil them in equal parts of Smiths Water and red Wine, to one quart; in the strained Liquor dissolve of Salt and Allum, each one ounce; foment the Region of the Pubis and Perineum, Morning and Even∣ing hot.

Of the same Decoction, the quantity of it being increa∣sed, a bath may be made to be used for many days.

After the Fomentation or Bath, the Parts may be anointed with a Liniment made of Oyl of Foxes, rue, Orrise, Unguentum, Martiatum, Aregon, and with the Powder of Mastich, Cyperus, and Mirtles, or the following Plaister may be applied.

Take of Labdanum, and Mastich, each two drams; of the Wood of Alces, and of Storax calamite, of Cinnamon,

and of Turpentine, each one dram; of Mirtles, and of the Roots of Cyperus, each half a dram; of the Juice of Mint and Hors••-tail extracted with red Wine, a suffici∣ent quantity; make a Plaister.

CHAP. XCIII. Of a total Suppression of Urine, and of the Strangury.

A Total Suppression of Urine is called by Authors Ischuria, but when the voiding of Urine is lessened they term it a Strangury.

An Ischuria or total Suppression of Urine is twofold, viz. true when the Bladder is full, and false when the Bladder is empty, and nothing comes from the Reins to it.

The true Ischury depends on three Causes, the first whereof is Sense abolished in the Bladder by reason of a Palsie or Ob∣struction of its Nerve, or because the Spirits are diverted ano∣ther Way, as in a Delirium or the like.

The second cause is a cold Intemperies of the Bladder.

The third Cause is a narrowness of the Neck of the Bladder, and of this three Causes are assigned, for the Muscle incom∣passing the Neck of the Bladder is so swelled that the Passage is stopt, or a Caruncle grows in the Neck of the Bladder, or a Callus is generated there, the Passage is also obstructed by a Stone, by a thick Humour, a Clot of Blood, or by Matter. The Passage is also stopt by a Swelling of the neighbouring parts, as by a large Child in the Womb, by the Excrements hardened in the right Gut, and by the Piles much swelled.

This Suppression also happens sometimes by too great a quantity of Water retained too long, that so much distend, the whole Body of the Bladder, that it cannot be contracted to expel it; first, when any Person that is well retains his Urine for want of a Convenient Place to void it in, or when the Nerves of the Bladder are affected, so that the Bladder cannot be sensible of the Weight and Fulness.

A false ischury is occasioned by reason either the Serum is not put off upon the Reins, or not conveighed through the Ureters, they being stopt by a Stone or the like.

A true Ischury is known by a Weight and Tension of the Hypogaster, and by a Swelling resembling the Bladder.

The causes of it are known by things that go before, and accompany it; for if it proceed from a large quantity of

Urine, which hinders a Contraction of the Bladder, it is perceived by the Relation of the Sick, he having omitted to make Wa∣ter, by reason of long travelling, or by being in the presence of great Persons; and if he never had it before in those parts; but if he be delirious or paralitick, the Suppression of Urine may be imputed to either of these Diseases.

The Compression that is made by Tumours, of those or of the neighbouring parts, or by other Causes above mentioned may be known by the proper Signs of those Diseases. The Obstructions of the Channel of the Bladder may be known by probing it with a Wax Candle, or a Catheter; and if they do not penetrate, but stop in the Passage, it is a Sign that a Stone or a Caruncle, or some other Matter obstructs; and these things that obstruct may be distinguished, viz. If a Stone stop the Channel, Nephritick Pains went before, if it fell from the Reins, and if it was bred in the Bladder, or lay a long while there, the Signs of the Stone in the Bladder pre∣ceded, at least some of the gentlest of them; if a Caruncle stop the Passage, a virulent Gonorrhea preceded, or an Ulcer in the Passage of the Yard, that emitted purulent Matter for a long time. Lastly, If clotted Blood, or concreted Matter, or thick Pus, occasioned the Obstruction, small parts of them have been evacuated through the Yard, or have stuck to the Catheter, when it has been used.

A false Ischury may be known, for that there is no Tension nor no Tumour nor Weight in the Region of the Pubis, but rather a Vacuity is perceived there; there is no desire of mak∣ing Water, nor no Irritation of the Bladder; and when the Catheter is used it passes in easily; but Signs of the Stone in the Kidneys went before, or of an Inflammation of the Ureters, or of great Fullness, or large Drinking went before, but little Urine followed; upon which account the Veins were too much filled. Or Lastly, there is a burning Feaver or a Dropsie, whereby the Serous Matter is diverted.

As to the Prognostick, A Suppression of Urine is very dan∣gerous, if it exceed the Seventh Day it certainly kills, for the Serum regurgitates upon the whole Body, and the Patient is in danger of a Suffocation, or a Coma.

Suppression of Urine, occasioned by a Wound in the Spine, or by reason of a Luxation of a Vertebra is incurable.

If the Smell of Urine can be perceived from the Mouth, or Nostrils of the Sick, it is deadly.

If a Tenesmus come upon a Suppression of Urine, the Sick dies in seven Days. The Hickops also indicate sudden Death.

The Cure of a Suppression of Urine, whether it be total or partial, is to be directed to the taking off the Causes: And

First, The false Ischury, that depends on the Diseases of the Reins or Ureters, must be cured in the same manner as an In∣flammation, a nephritick Pain, or the Stone in the Kidneys: But that which proceeds from a Fulness of the Emulgent Veins must be cured by large Bleeding, and by Hydragogue Medicines.

A true Ischury must be also cured by Remedies that take off the cause producing it. And First, If it proceed from an In∣flammation of the Bladder, or neighbouring Parts, it must be cured as an Inflammation of the Bladder is; but if the Sup∣pression is caused by a Stone thrust into the Neck of the Blad∣der, it must be removed by the following Remedies. First, The Sick must be laid upon his Back, and his Legs must be elevated, and he must be shook much, and a long while, that the Stone may fall back into the Bladder; and if by this means it cannot be moved, it must be forced back with a Catheter; but if the Stone has passed into the Passage of the Yard, we must endeavour by all Ways to exclude it, by moving gently with the Fingers towards the end of the Yard, and also by dipping the Yard into warm Milk, or by placing the Sick in a Bath, to enlarge the Passage: But if it will neither go back∣wards nor forwards, Practitioners teach that it must be cut out, the upper and lower part being tied.

But an Obstruction of the Neck of the Bladder, which proceeds from an Inflammation, must be cured by proper Re∣medies for an Inflammation. But in the mean time, if the Urine be retained too long, it may be gently let out by a Wax-candle dipt in Oyl of sweet Almonds: But you must forbear the Use of a Catheter, least Pain being occasioned, you should increase the Inflammation thereby.

But the Suppression of Urine, which proceeds from a Ca∣runcle, must be cured by the Extirpation of the Caruncle.

This must be done by proper Remedies thrust in by a skill∣ful Chirurgion upon a Wax-candle. But Necessity urging, for sometimes the Caruncle swells, and obstructs the whole Channel, we must use the Catheter to evacuate the Water, though there is danger that the Part will swell more. But you must first endeavour to lessen the Inflation of the Caruncle by Bleeding and Vomiting, and by repelling Medicines applied to the Pubes and Perinaeum.

If the Suppression of Urine be occasioned by thick Flegm, Purging is first convenient, with Diaphaenicon and Rubarb made up in a Bolus, and afterwards Turpentine must be given frequently with Powder of Liquorish; afterwards a Decoction of the opening Roots may be given, with Oxymel and Byzan∣tine Syrup.

In the mean while Glisters, Fomentations, and emollien and opening Baths must be used; and all those things are pro∣per that are proposed to dissolve or expell the Stone. And amongst the rest the following are found by Experience pecu∣liarly proper.

Take of Benedictum Laxativum half an ounce, of the Tro∣ches of Mirrh two scruples, of a Decoction of Savin three ounces; mingle them, make a Potion, whereby a Suppres∣sion of Urine was cured in a short time in a certain Woman.

If there seem to be abundance of Flegm in the whole Body, a universal Purge by an Apozem prepared for three or four Days must be ordered, which is proper at the beginning, Bleeding being first used. A Julep also of the Juice of Pellito∣ry, of Sea-fennel, and of Lemmons, with Oyl of sweet Al∣monds, is also very beneficial.

Dodoneus mentions an Observation of one of eighty Years of Age, that was perfectly cured of a Suppression of Urine, by only using once a Lee made of the Ashes of Egg-shells, mixed with Rhenish-wine.

Arnoldus Villa Novanus commends Winter-cherry-wine, and he mentions a Cardinal, who had not made Urine for four Days, and was much swelled, was cured by drinking Winter-cherry-wine; the Wine was made by beating five or seven or more winter-cherries with good White-wine; afterwards it must be strained. Millepedes also beat and given in White-wine are very Effectual to provoke Urine; Oyl of Scorpions of Ma∣thiolus also forces Urine powerfully, five or six drops of it be∣ing given with Broth or some other Liquor. The frequent use of Sal-prunella does also the same, especially when there is danger of an Inflammation, which is often occasioned in the inner Coat by the Urine too long retained; Spirit of Salt also does the same, but is more effectual; the Juice of Pellitory clarified, and four ounces of it given with half an ounce of Sugar is very good; Sal-prunella, or the Spirit of Salt may be mixed with it.

If Suppression of Urine occasioned by a phlegmatick Matter often recur, nothing is better than the Bath-waters, which easily dissolve and cleanse away the Mucilaginous Matter.

A certain Nobleman, that was afflicted with a Suppression of Urine for many Days, after other Medicines used to no Pur∣pose, was freed by injecting the following Glyster, which he retained two Hours.

Take of the Roots of Smallage and Parsly, Knee holm, Aspa∣ragous Mallows, each two drams; of Pellitory two handfuls, of the Seeds of Annise, Fennel, Daucus, Bishop-weed, bastard Saffron, Rue, Cummi••, and Juniper-berries, each half an

ounce; of the Flowers of Camomil, Mellilot, Dill, and Stoe∣chas, each two Pugils; boil them in Whitewine till half is consumed; in one Pint of the strained Liquor dissolve four ounces of fresh Butter, of Honey of Roses two ounces, of red Sugar one ounce, of Benedictum Laxativum half an ounce, of the Yolk of one Egg, of Oyls of Nuts, Dill, or Linseeds, one ounce; make a Glister.

In the whole Course of the Cure Fomentations, Liniments, Cataplasms, Baths, and the like, must be used; among other things a Cataplasm of Pellitory fried with Butter, or rather with Oyl of Scorpions is good; also a Bladder half full of Oyl wherein Cantharides have been boyled. A Cataplasm made of Onyons fried in Lard and with some Oyl, is commonly applied to the Region of the Pubis and Loins.

When an Ischury proceeds from clotted Blood, Troches of Ambar, Mumny, simple Oxymel, Oxymel of Squills, Syrup of Sorrel, and the like, must be used; and Cow-dung out∣wardly applied does Wonders.

Lastly, when the Suppressions proceeds from Pus, things that cleanse and incide must be used, such chiefly as were pro∣posed for an Ulcer of the Reins and Bladder.

CHAP. XCIV. Of a Dysury, or Heat of Ʋrine.

THe next and immediate Cause of rendring Urine with Pain, is a Solution of the Continuum in the Sphincter Muscle, or Channel of the Bladder, and therefore whatsoever causes Solution of the Continuum in those Parts, occasions also a Dysury or Heat of Urine.

Among these Causes, the chief and most frequent is an Acri∣mony of the Urine, sometimes simple without the Mixture of other Humours, which a hot Intemperies of the Bowels, or of the whole Body, or the use of acrid and hot Meats, occa∣sions it. But it is most commonly from a Mixture of acrid Humours, sometimes Matter flowing from the Reins or Blad∣der ulcerated, occasion such an Acrimony in the Urine, and sometimes a white and Milky Matter that is emitted plentifully with the Urine, occasions the Heat of it; also a Stone in the Bladder, or Gravel produces the same. Lastly, An Inflam∣mation, as in a Gonorrhea, as long as the Prostratae are In∣flamed, the Heat of Urine continues.

The Signs of the Causes may be thus distinguished, If it proceeds from an Acrimony, the Urine is thin and high co∣loured, or there will be a Mixture of Purulent Matter, and an Intemperies of the Bowels went before, or hot and acrid Ali∣ments, the Heat of the Air or the like heating causes preceded. Lastly, Stones and Inflammations of these parts, may be known by their proper Signs.

As to the Prognostick, This Disease is not of it self dan∣gerous, but is very troublesome to the Patient, and is sometimes difficultly cured, especially in old Men, who, if they are de∣crepid, have it as long as they live; and if it continue long in any Age, it ulcerates the Neck of the Bladder.

The Cure is first to be directed to the taking off the Cause; and therefore if it arise from the Stone, an Inflammation, or from an Ulcer of the Bladder, or the Neck of it, the Cure must be taken from the Chapters of these Diseases; but those things which are mentioned below, may much abate the Symptom.

But that which proceeds from an Acrimony of Urine, and from hot Humours mixed with it, must be cured with the fol∣lowing Remedies.

And first, To qualifie the Intemperies of the Parts, frequent Bleeding is necessary, and it must be often repeated, if there be a great quantity of Blood, or danger of an Inflammation: Purges are also convenient in this Disease, but they must be lenitive and cooling, for otherwise they mightily exasperate the Heat of Urine, wherefore some do not dare to give any thing besides a simple Bolus of Cassia; and this is certainly to be preferred before all other things. Yet it may be made more cooling if Tamarinds are added to it, or a Decoction of Lettice, Purslain, and the Tops of Mallows with Cassia, may be taken for many Days, that the acrid Humours flowing to the Urina∣ry parts, may be by degrees turned upon the Bowels, but yet if a large quantity of ill Humours requires more Purging, we may use the following Potion.

Take of the Leaves of Lettice, Purslain, Plantane, and the Tops of Mallows, each half an ounce; of Tamarinds, half a dram, of yellow Mirobalans one dram; boil them to six oun∣ces; in the strained Liquor dissolve one ounce of Cassia fresh drawn; strain them again, and afterwards add the Infu∣sion of one dram and an half of Rubarb in Lettice water, with yellow Sanders, of Manna, and of Syrup of Roses, each one ounce; make a Potion.

Vomiting also, with gentle Remedies, is excellent, for it makes Revulsion from the Part affected, and does not occa∣sion those Disorders that Purging does; and therefore such as

can bear Vomiting well, may take a gentle Vomit once or twice a Week. Glisters also frequently injected do good.

Take of the Roots of Marsh-mallows one ounce, of the Leaves of Mallows, Violets, and Lettice, each one handful; of the flow∣ers of Water-lillies, and of Barley cleansed, each one Pugil; boil them to a Pint, in the strained Liquor dissolve an ounce of Cassia newly extracted, one whole Egg, and two ounces of Oyl of Violets; make a Glister.

The Mucilages of the Seeds of Marsh mallows, Quinces, Fenugreek, may be mixed with Glisters to ease the Pain.

But to qualifie the Heat, and to ease the Pain, Glisters of Milk by it self or mixed with the foregoing things are usually so effectual, that I have known some eased of long Pains with this Remedy only, and by the Bath which shall be mentioned by and by.

But many things may be given inwardly to asswage the Pain, and to correct the Intemperies of the Parts affected.

Take of the Waters of Purslain, Lettice, and Water-lillies, each one ounce; of the Syrup of Violets, and of Water-lillies, each six drams; Sal-prunella one dram; mingle them, make a Julep to be repeated often.

Emulsions may be also used, though they are diuretick, be∣cause they cool and gently cleanse the Urinary Passages.

Take of the four greater cold Seeds, and of White Poppies, each three drams; of Sweet Almonds blanched, and infused in cold water, half an ounce; bruise them in a Marble Mortar, and pour upon them gently a pint and an half of the Decoction of Barly, of Liquorish, and the Tops of Mallows; make an Emulsion for three Doses, adding to each one ounce of Syrup of Violets, and a dram of Sal-prunella; if the Pain be very violent, some Syrup of Poppies may be added to it, and a dram of Gum Arabick powdered.

Broths may be also prepared in the following manner.

Take of the Roots of Marshmallows half an ounce, of Mallows one handful, of Liquorish half an ounce, of the Seeds of Quinces one dram; boil them with Chicken Broth, and let it be taken for several Days together.

The Whey of Goats Milk is also very good, a large draught of it being taken at a time; and if there be no Feaver, milk it self is more effectual, especially Asses Milk.

If the Disease is inveterate, Epsom and Tunbridge-waters are very proper.

Forestus cured himself of a violent Dysury, by only using a Decoction of Mallows sweetned with Syrup of Violets; a Conserve of Mallows has also done much good, an ounce of it having been taken Morning and Evening, and three ounces

of Mallow-Water being drank presently after; the Conserve of the Flowers of Marshmallows is as good or rather better; some Practitioners commend the Troches of Alkakengi; a dram of them being taken at a Time in some proper Liquor.

When the Pain is very violent, the dipping the Yard in Milk, whilst the Urine is rendring, or in a Decoction of Mal∣lows, and the Seeds of white Poppies, does much good in this case.

A small decoction of Mallows sweetned with Syrup of Violets, or with Conserve of Roses, is very proper for the or∣dinary Drink.

And to ease the Pain, Injections may be made for the Pas∣sage of the Bladder of Milk, an Emulsion of the cold Seeds of Plantane and Whey, whereunto may be added the White of an Egg well beaten, and a Scruple of the Troches of Alkaken∣gi. External Remedies do also much good to qualifie the Heat of Urine, as Baths and Fomentations applied to the Pubis and Perinaeum, made of a Decoction of cooling Herbs; also Liniments made of Oyls of Roses, of white-lillies, and of Oyntment of Roses, and of the white Oyntment with Camphor.

CHAP. XCV. Of a Chlorosis, or the Green-Sickness.

THe Green-Sickness is a vitious Habit of the Body proceed∣ing from Obstructions, it is accompanied most commonly with a Palpitation of the Heart, Difficulty of Breathing, and a longing for absurd things, and with an Unfitness for Motion, and other Symptoms.

The Diagnostick manifestly appears by the following Series of Symptoms. First, The Face and whole Body is pale, and sometimes of a leaden, livid, and green Colour. Secondly, An Inflation, and as it were a Swelling, appears upon the Eye∣lids; the Legs also swell, especially about the Ankles. Third∣ly, There is a Dulness and Unwillingness for Motion. Fourth∣ly, There is a Difficulty of Breathing, especially when they move much, or go up Stairs. Fifthly, There is a Palpitation of the Heart upon Motion. Sixthly, There is a heavy, and often a lasting pain of the Head. Seventhly, The Pulse is quick. Eighthly, The Sick are drowsie, and incline to Sleep. Ninthly, There is a great Aversion for wholesome Food. Last∣ly, The Disease increasing, and the Obstructions being multi∣plied, a Suppression of the Courses at length follows which shews the Disease is confirmed.

As to the Prognostick, This Disease most commonly is no•• dangerous, but if it be neglected too much, it occasions great Diseases, as a Scirrhus, Tumours, a Dropsie, and other griet¦vous Diseases, which at length kill the Patient.

When the Disease is small, and chiefly arises from Obstructi∣ons of the Veins of the Womb, it is easily cured by Marriage in Young Virgins.

Women that have had this Disease a long while, are either barren, or bring forth Children that are Sickly and short liv'd.

There is great Hopes of Cure, when the Courses keep their exact Periods, and flow in a due Quantity and Quality.

The Cure of this Disease is performed by opening Obstructi∣ons, by purging off the vitious Humours, by Correcting the Intemperies of the Bowels, and by Strengthning them.

First therefore, A gentle Purging Medicine must be given that is agreeable to the Constitution, that the first Region may be only emptied; and if the Belly be bound, a Glister must be given first of all.

Afterwards Bleeding must be ordered, unless the Disease is very inveterate, and the Maid be inclined to a Cachexy.

But a Vein in the Arm must be opened, though the Courses are stopped, for at that Time if you should bleed in the Foot, the Obstructions of the Veins and of the Womb would be increased: That quantity of Blood being taken away that is necessary, pro∣per Purges must be used, viz.

Take of the Pill Coch Major two Scruples, of Castor powdered two grains, of Peruvian Balsam four Drops; make four Pills, let her take them at five in the Morning, and let her sleep after them.

Let these Pills be repeated twice or thrice every Morning, or every other Morning, according to the Strength of the Sick and their Operation.

After the purging Pills let her take the following.

Take of the Filings of Steel grains eight, with a sufficient quan∣tity of Extract of Wormwood; make two Pills to be taken in the Morning, and they must be repeated at five in the After∣noon. She must continue this Course for thirty Days, drink∣ing presently after the Pills a Draught of Wormwood Wine.

If a Bolus be more pleasing.

Take of the Conserve of Roman-Wormwood and of the Conserve of the yellow Peel of Oranges, each one ounce; of candied Ange∣lica, and Nutmegs candied, and of Venice Treacle, each half an ounce; of Ginger candied two drams, with a sufficient quantity of Syrup of Oranges, Make an Electuary.

Take of this Electuary one dram and an half, of the Filings of Steel well powdered eight grains, with a sufficient quantity

of Syrup of Oranges, make a Bolus to be taken in the Mor∣ning, and at five in the afternoon, drinking upon it a draught of Wormwood-wine.

Take of choice Mirrh, and of Galbanum, each one dram and an half; of Castor sixteen grains, with a sufficient quantity of Peruvian Balsam; make twelve Pills of each dram. Let her take three every Night at Bed time, drinking upon them three or four Spoonfuls of compound Briony water through the whole Course: But if these Pills should purge, then the following must be used instead of them.

Take of Castor one dram, of Volatile Salt of Ambar half a dram, with a sufficient quantity of Extract of Rue; make five and twenty small Pills. Let her take three every Night at Bed-time.

CAHP. XCVI. Of the Suppression of the Courses.

THere is said to be a Suppression of the Courses, when in Women of a mature Age, that neither give suck, nor are with Child, the Evacuation of Blood by the Womb, which naturally is wont to be monthly, seldom or sparingly proceeds or is wholly stopt.

The Cause of this Suppression, is to be referred either to the Womb or to the Vessels of it, or to the Blood which flows or ought to flow through them.

Various Diseases of the Womb may occasion this Suppressi∣on, namely a cold moist Intemperies, or a hot and dry Intem∣peries; also organical Diseases of the Part, as an Inflammation, or Scirrhus, or the like. The Vessels of the Womb also often occasion Obstructions, which is the most frequent cause of the Suppression of the Courses, they being stopt by cold and thick Humours, or compressed by Swellings of the neigh∣bouring Parts.

The Blood is peccant, when it is thick and Clammy, or when it is evacuated by other ways, as by the Nostrils, Vomi∣ting, Spitting, Hemorrhoides, and many other Parts. I saw, sayes Riverius, a Girl that had a Pustle in the Head which open∣ed Monthly, and evacuated a large quantity of Blood; and I have seen many, says he, that by casting up Blood Periodically from the Lungs, had the Courses that Way.

The external Causes occasioning this Suppression, are cold and dry Air, and a Northerly Season going into Cold Water, especially when the Courses flow, too little or too much Nou∣rishment

taken, also gross and cold Meats, or such as are astringent and such as are too hot, or such as are salted and spiced too much, violent exercise, immoderate Watchings, much sleep, immoderate Ease, Bleeding at the Nose, or Piles, a Loosness, and other Evacuations by Vomit, Urine, and Sweat: And lastly, violent Passions, as extream Anger, a sudden Fright, long Sorrow, great Jealousie, and the like.

The Diagnostick of the Suppression must be received from the Sick; but because it proceeds both from natural and pre∣ternatural causes, the Signs of both shall be distinctly proposed, least Physicians should be deceived by Women being with Child, by illegitimate Coition, and so prescribe Medicines to provoke the Courses rashly to Women with Child.

First therefore, Women with Child most commonly retain their natural Colour, and others do not.

Secondly, the Symptoms which use to happen to Women with Child, at the beginning abate daily; but on the contrary, in a Suppression of the Courses, the longer they are stopt, so much the more the Symptoms are increased.

Thirdly, In Women with Child, after the third Month, the Motion and Situation of the Child may be sensibly perceived, by laying the hand on the Belly; but in others the Swelling is Oedematous, and not at all hard; nor is it always contained within the Limits of the Womb.

Fourthly, If the inward Mouth of the Womb be touched by a Skilful Midwife, she will find it not exactly closed, as it is in Women with Child, but rather hard, contracted, and some∣what painful.

Fifthly, Women with Child are most commonly chearful; but on the contrary in a Suppression they are most commonly sorrowful and sad.

The Faults of the Womb which occasion a Suppression, may be seen by Inspection, and be felt by touching the Parts.

The Obstruction and Narrowness of the Vessels of the Womb, may be known by the Disorder that is felt in the Loyns, and in the Parts near the Womb, especially just before the Coming of the Courses; and if any thing flows out it is mucous, whitish or blackish. The Diseases of the neighbouring Parts, which stop the Mouth of the Womb, or the Veins, may be known by their proper Signs.

An abundance of Blood may be known by the Veins being much swelled in the Legs and Arms, if the Woman be fleshy, and of a ruddy Countenance, and has indulged her self for a long while in high Eating. But a Defect of Blood may be guessed at, if the Woman be fat, if she has had a long Feaver, and has fasted a long while▪ or has loathed he•• Meat. An ••ll

quality of the Blood may be known by an ill Habit of Body; the preposterous Motion of the Blood, viz. When it flows by contrary Passages, is manifest of it self.

As to the Prognostick, a Suppression of the Courses is very dangerous, and many desperate Diseases rise from it; some in the Womb, as Tumours Abscesses, and Ulcers; others in the whole Body, and in various Parts, as Feavers, Obstructions, Cachexies, Loathing of Meat, a Dropsie, a Cardialgia, a Cough, Difficulty of Breathing, Fainting, Melancholly, Madness, Pains of the Head, Gout, and many others; if the Suppression continue long the Belly grows hard, great quantity of Urine is voided, there is a Loathing of Meat, and long Watching, the Legs, Feet, and Belly swell, and they die of a Dropsie.

The Cure of this Disease must be varied according to the Variety of the Causes. And first, If it proceed from too great a quantity of Blood, Bleeding must be ordered in the Arm, and a large quantity of Blood must be taken away, af∣terwards it must be drawn downwards by opening the lower Veins, about the time the Woman used to have her Courses before she was ill.

Frictions, Ligatures, Cupping-glasses, with and without Scari∣fication, may be used.

If by reason of want of Blood the Courses stop, as after long Feavers, after great Evacuations, and when the Body is much wasted, you must not endeavour to provoke the Courses, till the Body is replenished, and till a sufficient quantity of Blood is bred; which being done, they generally follow of their own accord. But if it happen that Nature forget her Office, she must be roused up by opening the lower Veins, and by Me∣dicines proposed in the foregoing Chapter; but the quantity of Blood taken away must be moderate, least the Strength should be dejected, and the Sick should fall into a Consumption. But here it must be carefully noted, That every Wasting of the Body does not indicate a Want of Blood; but only that which succeeds great Evacuations, and the like; for sometimes it hap∣pens, that the Courses being suppressed, and retained in the Veins, occasion an ill quality, whereby the Blood is ren∣dred unfit to nourish the Parts; upon which account the Body wasts though the Veins are full of Blood, in which Case large Bleeding is required.

As to the Suppression of the Courses, which happens by a preposterous Motion of the Blood, when it is evacuated by Bleeding at the Nose, by Vomiting, Spitting, or the Hemor∣rhoides, and other Parts.

The Cure of it is performed by repelling the Blood from the Parts through which it flows preternaturally, and by drawing

it back to the Passage of the Womb. The first is performed, when the Blood rushes out of the upper Parts, by washing the Arms, Head, and Face with cold water, and by forbearing the Exercise of those Parts, especially Singing, and speaking aloud. The second is performed by opening the inferior Veins three or four Days before the Blood breaks out, and by Cupping-glasses applied to the Thighs and Legs, sometimes with, sometimes without Scarification, by provoking the He∣morrhoids, by Frictions, Ligatures, Walking, Fomentations, Baths made of opening Herbs, Pessaries, uterine Glisters, and by other things to be described below. But the Bath-water is especially commended, and the Sick must bath in them often a good while after Meals; but the Water must not rise above the Hypochondres, and at the same time, the upper Parts must be cooled by fanning them.

If the Blood flow by the Hemmorrhoides, the Cure is very difficult, for if you use things to draw downwards, they bring the Blood also to the Fundament; and if you use astringent things to it, they, by reason of the Nearness of the Parts, repel what should be brought to the Womb, so that the only Way of Cure, is to apply such things to the Womb as may allure the Blood thither, after you have used such things as draw the Blood downwards.

But the most frequent Obstruction of all, is that which pro∣ceeds from an Obstruction of the Veins of the Womb, the Cure whereof is in a manner the same with that of the Green Sick∣ness: But the Eruption of them must be helpt by opening a Vein in the Foot about the time they used to flow when the Patient was well; as also by Cupping-glasses applied to the Hips and Legs, instead of Bleeding with, or without Scarifi∣cation, by Frictions of those Parts, and by painful Ligatures.

Take of the Roots of round Birthwort half a dram, of the leaves of dried Savin one dram and an half, of Dittany of Crete, and of Troches of Mirrh, without Assa-Faetida, each one dram; of choice Cinnamon two drams, of white Sugar two ounces; make a Powder, whereof let her take two drams every Morning for some days, with the Broth of red Vetches wherein two drams of Cinnamon, and half a dram of Saf∣fron have been boiled.

Take of Roots of Briony, of Lillies, Cyperus, Valerian, Angelica, Asarabacca, Orris, and Parsley, each one ounce; of the Leaves of Mugwort, Bays, Rue, Savin, Thym, Rosemary, Penny-royal, Nep, Mallows, Mercury, each one handful; of the Flowers of Elder, of Wall-flowers, and of Camomil, each two Pugils; of the grains of Juniper two ounces; boil them in Water and Whitewine; with the strained Liquor foment the Belly and Thighs with a Spunge.

With the same Decoction, the quantity being increased, a Bath may be made, wherein the Sick may sit up to the Navel, and the boiled Herbs being put in a Bag, may be applied to her Belly; but you must take care that she does not sweat, for that rather stops the Courses.

Take of the Leaves of Mercury bruised one handful, of the Powder of Hiera Picra, and of Benedictum Laxativum, each two drams; of the Powder of long Birthwort one dram, with a sufficient quantity of Honey, or the Juice of Mercury; make a Pessary

Injections are also wont to be made for the Womb, which are called uterine Glisters, for they cleanse it from Filth stick∣ing to the Sides, and they open the inner Orifices of the Ves∣sels: They may be prepared with a Decoction for the Fomen∣tation above described, the acrid things being left out, or of fat Figs with Mugwort, Penny-royal, Mercury, or only of the Juice of Mercury clarified, wherein a little Benedictum Laxativum has been dissolved, for you must not use acrid things, lest they should occasion an Inflammation. And after the use of these things, which must be retained only an hour, it is convenient to inject a Decoction of Mallows, Barley, and Violets, or a little Hydromel diluted with the Whey of Goats Milk.

When the Disease is inveterate, Issues in the Leg do much good.

In the use of the forementioned Medicines some things are to be observed.

First, You must never use Remedies to force the Courses, unless general Evacuations went before. Secondly, You must begin with gentle Means, and proceed by degrees to stron∣ger. Thirdly, Medicines that are given to move the Courses must be taken in a large quantity. Fourthly, Pessaries and uterine Glisters must be prescribed only for married Women: But for Virgins Fomentations, Baths, and the following Fume may be ordered.

Take of Cloves, Cinnamon, and Mace, each two drams; of Juniper-berries half an ounce, of the Seeds of Nigella one dram, of Storax Calamit two drams; make a gross Pow∣der which must be cast upon Coals, and the Fume must be received through a Tunnel.

Lastly, In Cholerick and Melancholly Constitution, the hottest Medicines must be avoided, and only such as are gentle must be used, and things that are opening, moistening, and mollifying, must be mixed with them.

CHAP. XCV. Of an immoderate Flux of the Courses.

AN immoderate flux of the Courses invades either in Child-bed, or at other Times: As to the first, that afflicts Women most on the first Days after a diffi∣cult Labour, and is accompanied with a long train of Hysterick Symptoms; and as it happens only on the first days, so usually does not last long, for if a thickning Diet be ordered, it soon abates. The following Drink may be also used.

Take of Plantain Water, and red Wine, each one pint; boil them till a third part is consumed: Sweeten it with a sufficient quantity of white Sugar, and let her take half a pint of it twice or thrice a day, and in the mean while some gentle Hysterick Julep may be used, and the following Nodulus may be often held to the Nostrils.

Take of Galbanum and Assa Foetida, each two drachms, of Castor one Drachm and an half, of volatile Salt of Amber half a drachm; mingle them, make a Nodulus. Or two drachms of spirit of Sal Armo∣niack may be often held to the Nose.

But as to the Flux which happens out of Child-Bed, though it befals Women at any Time, yet most com∣monly it invades a little before the Time they leave them, viz. when they are about forty five Years of Age, if they had them very young, and about fifty if it was late before they began to have them: And by reason of the great quantity of Blood, which is continually eva∣cuated, they are almost continually seized with Hysterick Fits; and though in this Case Hystericks both inward and outward may be used by the by (but you must for∣bear the strongest, lest they should further the Flux) yet the Cure must be managed by such things as stop the Flux.

You must bleed in the Arm, and eight Ounces of Blood must be taken away. The next Morning the following Purge must be given.

Take of Tamarinds half an ounce, of S••na two drachms, of Rhubarb one drachm and an half, infuse them in a sufficient quantity of Fountain Water: In three ounces of the strained Liquor▪ dissolve of Manna and syrup of Roses solutive, each one ounce; make a purging Potion, which is to be repeated every third day for twice, every night at bed-time, through the whole course of the Disease; let an Anodyn be given of an ounce of Diacodium.

Take of the conserve of dryed Roses two ounces, of the Troches of Lemnian Earth one drachm and an half, of Pomgranate peel, and of red Coral prepared, each two scruples, of Blood-stone, of Dragon's-blood, and of Bole-Armenick, each two scruples; with a suffi∣cient quantity of simple Syrup of Coral make an Ele∣ctuary, whereof let her take the quantity of a large nutmeg in the morning and at five in the after∣noon, drinking upon it six spoonfuls of the follow∣ing Julep.

Take of the waters of Oak-buds, and of Plantain, each three ounces, of Cinnamon-water hordeated, and of Syrup of dried Roses, each one ounce, of Spirit of Vitrial a sufficient quantity, to make it pleasantly acid.

Take of the Leaves of Plantain, and of Nettles, each a sufficient quantity, beat them together in a Marble-Mortar, and press out the Juice, clarifie it and give six spoonfuls of it cold three or four times in a day.

After the first Purge apply the following Plaster to the Region of the Loins.

Take of the Plasters of Diapalma, and ad herniam, each equal parts, mix them and spread them upon Leather.

A cooling and thickning Diet must be ordered, only it may be proper to allow once or twice a day a small Glass of Claret; which tho' it be not so proper, because it is apt to raise an ebullition, yet it may be allowed to recover the Strength. This Method may be also used to prevent Miscarriage, but the Juices and the Purges must be omitted.

CHAP. XCVI. Of the Whites.

THis obstinate and lasting Disease may be cured by Bleeding once, and by purging with two Scruples of Pill. Coch. major four times, and by the following Corroboratives.

Take of Venice Treacle one ounce and an half, of the Conserve of the yellow Peel of Oranges one ounce, of Diascordium half an ounce, of Ginger candied, and Nutmegs candied, each three drachms, of compound Powder of Crabs-eyes, one drachm and an half, of the outward Peel of Pomgranates, of the Roots of Spa∣nish Angelica, and of the Troches of Lemnian Earth, each one drachm, of Bole-armenick two scruples, of Gum Arabick half a drachm, with a sufficient quantity of Syrup of dried Roses make an Electuary; whereof let her take the quantity of a large Nutmeg in the morning, and at five in the afternoon, and at night drinking upon it six spoonfuls of the follow∣ing Infusion.

Take of the Roots of Elecampane, Masterwort, Ange∣lica and Gentian, each half an ounce, of the Leaves of roman Wormwood, white Horehound, the lesser Centaury, and Calaminth, each one handful, of Ju∣niper Berries one ounce: Cut them small, and infuse them in five pints of Canary-Wine, let them stand in Infusion, and strain them only as you use them.

Through the whole course of Corroboratives purging must not be used, for every Evacuation spoils what the Corroborative has done.

CHAP. XCVII. Of Hysterick and Hypochondriack Diseases.

THese Diseases, if I calculate right, are the most frequent of all chronical Diseases; and as Fevers, with those Diseases that appertain to them, if they are compared with chronical, taken altogether, make two thirds; so, Hysterical Diseases, at least those that go under that Name, are half the remaining third, that is, chronical Diseases are half Hysterick; for very few Wo∣men, which Sex contains half of grown People, are wholly free from all kinds of Hysterick Diseases, if you except those who being accustomed to Labour live hardly; yea, many of those Men that live sedentary Lives, and are wont to study hard, are afflicted with the same Disease; and though, heretofore, Hysterical Symptoms were always reckoned to proceed from a vi∣cious Womb, yet if we compare Hypochondriack Sym∣ptoms, which were supposed to proceed from Obstru∣ctions of the Spleen or Bowels, or from some other I know not what Obstructions, with Women's Hysterick Symptoms, an Egg is scarce more like an Egg, than these Symptoms are like one another in all respects: But it must be confessed, that Women are much more subject to this kind of Disease, than Men.

This Disease is not only frequent, but so wonder∣fully various, that it resembles almost all the Diseases poor Mortals are subject to; for whatever Part it seats it self in, it presently produces such Symptoms as be∣long to it; and unless the Physician be very sagacious and very skilful, he will be mistaken, and suppose that t••ese Symptoms proceed from an essential Disease of this or that part, and not from an histerical Distemper.

Sometimes, for instance, it possesses the Head, and occasions an Apoplexy, which also ends in an Hemi∣pl••gy, and this seizes Women very often after Delivery; or it is occasioned by hard Labour, or some violent com∣motion of the Mind.

Sometimes it produces violent Convulsions very like an Epilepsy, the Belly and Bowels swelling toward the Throat, the Patient strugling so violently, that though at other times her Strength is but ordinary, she now can scarce be held by all the strength of the By-standers, uttering some odd and inarticulat sounds, and striking her Breast. Women who are accustomed to this Di∣sease, commonly called Mother-fits, are generally ex∣traordinary Sanguine, and have a habit of Body almost like that of a Virago.

Sometimes it possesses the outward part of the Head, betwixt the Pericranium and Skull, causing violent Pain continually fixed in one part, which may be covered with the top of your Thumb, and violent Vomiting ac∣companies this Pain: I call this Species Clavus Hysteri∣cus, chiefly afflicting those that have the Green-sick∣ness.

Sometimes falling upon the vital Parts, it occasions so great a palpitation of the Heart, that the Women who are afflicted with it, may verily believe that the By-standers may hear the sound of the Heart thumping upon the Ribs. This kind chiefly afflicts those that are of a thin habit of Body and of a weak Constitution, and who look almost tabid; and also, young Maids that have the Green-sickness.

Sometimes the Patient coughs almost without inter∣mission, but expectorates nothing. This kind of Hy∣sterick-cough is very rare, and chiefly invades Women that abound in Flegm. Sometimes rushing vio∣lently upon the Colon, and the Region under the Scrobiculum Cordis, it occasions violent Pain, much like the Iliack Passion, and the Woman vomits exceed∣ingly, ejecting a certain green Matter somewhat like that they call porraceous Bile; and sometimes Matter of an unusual colour: And often after the Sick have been almost destroyed by the said Pain, which would tire a stoical Apathy, and reachings to vomit for many days, at length it is carried off by the Jaundice tincturing the superficies of the Body like Saffron. Moreover, the Sick is oppressed by an anguish of mind, and wholly despairs of recovery, with dejection of mind, and as it were a certain desperation; as certainly accompanies

this kind of Hysterick Disease, as the Pain and Vomi∣ting above-mentioned. This kind chiefly invades those that are of a lax and crude habit of Body, and those that have suffered much in bringing forth great Child∣ren.

When this Disease falls upon one of the Kidnies, it plainly represents, by the Pain it causes there, a Ne∣phritick Fit; and not only by that sort of Pain, and by the place it rages in, but also by the violent Vomitings that accompanies it, and for that sometimes the Pain extends it self through the passage of the Ureter; so that it is very difficult to know whether these Symptoms proceed from the Stone, or from some Hysterick Di∣sease; unless, perchance, some unlucky Accident di∣sturbing the Woman's mind, a little before she was taken ill of the vomiting of green Matter, shews that the Symptoms rather proceed from an Hysterick Disease, than from the Stone. Nor is the Bladder free from this false Symptom; for it does not only cause Pain there, but it also stops the Urine, just as if there were a Stone, whereas there is none: But this last kind seizing the Bladder, happens very seldom. That which resembles the Stone in the Kidnies is not so rare; both use to invade those Women, who are much weak'ned by Hysterick Fits coming frequently, and whose health of Body is much impaired.

Sometimes falling upon the Stomach it causes c••nti∣nual Vomiting, and sometimes a Looseness, when it is setled upon the Guts. But no Pain accompanies either of these Symptoms, though oftentimes in both the green Humours appear. Both these kinds are familiar with those that are weak'ned by the Hysterick Fits coming frequently.

And as this Disease afflicts almost all the inward Parts, so sometimes it seizes all the outward Parts, and the musculous Flesh occasioning Pain, and sometimes a Tumour in the Jaws, Shoulders, Hands, Thighs, Legs, in which kind that Tumour which swells the Legs, is more conspicuous than the rest. But whereas in Hydropical Swellings, these two things may be always taken no∣tice of, viz. That the swelling is most in the Evening, and that the Finger prest upon it, leaves a pit: In this

Tumour the swelling is most in the Morning, nor does it yield to the Finger, or leave any mark behind it, and for the most part it only swells one of the Legs. As to other things, if you mind the largeness of it, or its su∣perficies, it is so very like Hydropical Swellings, that the Patient can scarce be brought to believe that it is any other Disease; nor can the Teeth free themselves from the assaults of this Disease, tho' they are not hollow, and tho' there is no apparent defluxion that may occasion the Pain, yet it is no whit gentler, nor shorter, nor easier cured. But these Pains and Tumours which afflict the outward Parts, chiefly seize those Women that are in a manner quite destroyed by a long series of Hyste∣rick Fits, and by the force of them.

But among all the Torments of this Disease, there is none so common as a pain in the Back, which most cer∣tainly all feel, how little soever they are afflicted with this Disease. Moreover, this is common to the foresaid Pains, that the place on which they were, will not bear touching after they are gone; but is tender, and akes just as if it were soundly beaten: But this tenderness goes off by degrees.

And this is worth observing, That often a notable Cold of the external Parts makes way for these Sym∣ptoms, which for the most part does not go off till the Fit ends; which Cold I have observed is almost like that by which a Carcass grows stiff, yet the Pulse is good.

And moreover, all Hysterick Women which I have hitherto taken care of, complain of a dejection and sink∣ing of the Spirits; and when they would shew the place where the sinking of the Spirits is, they point to the re∣gion of the Lungs.

Lastly, every one knows that Hysterick Women some∣times laugh excessively, and sometimes cry as much, without any real cause for either.

But among all the Symptoms that accompany this Disease, this is the most proper, and almost inseparable, viz. a Urine as clear as Rock-water, and this Hysterick Women evacuate plentifully; which I find, by diligent Enquiry, is in almost all the pathognomonic sign of this Disease, which we call Hysterick in Women, and Hy∣pochondriack

in Men; and I have sometimes observed in Men, that presently after making Water of a Citron colour (yea, almost the next moment) being suddenly seized with some violent commotion of the Mind, they make Water as clear as Cristal, and in a great quantity with a continued violent Stream, and continue ill till the Urine comes to its wonted colour, and then the Fit goes off.

And it happens to all Hysterical and Hypochondriacal People, that sometimes they belch up ill Fumes as often as they eat, tho' they eat only moderately, and accord∣ing as they have an Appetite; and sometimes the Wind that comes from the Stomach is sower just like Vine∣gar.

Nor are they unhappy upon this account only, viz. That their Bodies are so ill affected, and as it were tot∣tering like ruined Houses just about to fall; for their Minds are more diseased than their Bodies, and an incure∣able desperation is mixed with the very nature of the Disease; and what the Roman Orator said of the Su∣perstitions exactly agrees with these melancholy People, Sleep, says he, seems to be a Refuge to the Laborious and Careful, but from thence Cares and Fears arise, whilst only Funerals and Apparitions of their deceased Friends are represented in Dreams, and they are so tormented in Body and Mind that one would think their Lives were a Purgatory, wherein they were to purifie them∣selves, and to expiate Crimes committed in some other State. Nor does this happen only to mad People, but also to those who, if you except those Impetuosities of Mind, are very prudent and judicious, and who much excel for deep thought and wisdom in Speech, others, who's Minds were never excited by these Provokments to thinking. But this dreadful condition of Mind which we have above described, seizes on those only that have much and a long while conflicted with this Disease, and have been at length wholly vanquished by it, espe∣cially if Adversity, care or trouble of Mind or hard Study, or the like, join'd with an ill habit of Body, have added Oil to the Flame.

A day would scarce be sufficient to reckon up all the Symptoms belonging to Hysterick Diseases, and I think Democritus reckoned pretty right (though he mi∣stook the cause of the Disease) when he said in an Epi∣stle to Hippocrates, That the Womb was the cause of six hundred Miseries, and of innumerable Calamities.

The procatarctick or external causes of this Disease are either violent motions of the Body, or which is much oftener, vehement commotions of the Mind. But to these disorders of the Mind, which are usually the oc∣casions of this Disease, is to be added emptiness of the Stomach, by reason of long Fasting, immoderate Bleed∣ing, and a Vomit or Purge that works too much.

As to the internal, efficient Causes, in my Opinion▪ those Diseases which we call Hysterick in Women, and Hypochondriack in Men, proceed from a confusion of the Spirits. The origin and antecedent cause of this confusion, is a weak constitution of the Spirits.

In order to the Cure, I order, That 8 ounces of Blood be taken from the right Arm, and that the following Plaster be applied to the Navel.

Take of Galbanum, dissolv'd in tincture of Castor and strain'd, three drachms, of Tacamacha two drachms; mix them, make a Plaster.

The next Morning, let her make use of the follow∣ing Pills.

Take of the Pill Coch. major two scruples, of Castor powder'd two grains, of peruvian Balsam four drops; make four Pills, let her take them at five in the Morning, and sleep after them. Repeat them twice or thrice every Morning, or every other Morning, ac∣cording to their operation and the strength of the Patient.

Take of the Waters of black Cherries, Rue and com∣pound Briony, each three ounces; of Castor, tyed up in a Rag and hanged in the Glass, half a dram; of fine Sugar a sufficient quanity, make a Julep, where∣of let her take four or five Spoonfuls when she is faint, dropping into the first Dose, if the Fit is violent, twenty drops of the Spirit of Harts∣horn.

After the Purging Pills just described are taken, let her use the following.

Take of the filings of Steel eight grains, with a suffici∣ent quantity of extract of Wormwood; make two Pills, let her take them early in the Morning, and at five in the Afternoon, for thirty days, drinking upon them a draught of Wormwood-wine.

Or, if she like a Bolus better.

Take of conserve of Roman-wormwood, and of the con∣serve of the yellow rind of Oranges, each one ounce; of candied Angelica, and Nutmogs candied, and of Venice Treacle, each half an ounce; of candied Gin∣ger two drachms; make an Electuary, with a sufficient quantity of Syruy of Oranges.

Take of this Electuary one drachm and an half, of the fi∣lings of Steel well rubbed eight grains; make a Bo∣lus, with a sufficient quantity of Syrup of Oranges, to be taken in the Morning, and at five in the Even∣ing, drinking upon it a Glass of Wormood-wine.

Take of choice Myrrh and Galbanum, each one drachm and an half; of Castor fifteen grains, with a sufficient quantity of Balsam of Peru; make twelve Pills of every drachm. Let her take three every Night, and drink upon them three or four Spoonfuls of compound Briony-water, through the whole course of this Pro∣cess.

But if the Pills last prescribed move the Belly, which sometimes happens in Bodies that are very easily purged, by reason of the Gum that is in them; the following may be used instead of them.

Take of Castor one drachm, of volatil Salt of Amber half a drachm, with a sufficient quantity of extract of Rue; make twenty four small Pills: Let her take three every Night.

But here you must take notice, That Chalybeats, in whatsoever Form or Dose they are taken, occasion some∣times in Women great disorders both of Body and Mind, and that not only on the first days, which is usual al∣most in every Body, but also all the time they are taken; in this case, the use of Steel must be interrup∣ted at those times; but Laudanum must be given every

Night for some time, in some Hysterick Water, that they may better bear it.

But when the Symptoms are mild, and it seems that the business may be done without taking Steel, I think it sufficient to bleed and to purge three or four times, and then to give the altering Hysterick Pills before∣mentioned, Morning and Evening, for ten days; which method seldoms fails, when the Disease is not violent; yea, the Pills alone, bleeding and purging being omit∣ted, oftentimes do a great deal of good.

Yet we must take great notice, That some Women, by a certain Ideosyncrasy, so abhor Hysterical Medi∣cines (which give ease in most of the Symptoms of this Disease) that they don't only not receive benefit, but are much injur'd thereby; therefore, they must not be given to such; for Hippocrates says, 'Tis in vain to do any thing contrary to Natures inclination.

Which Ideosyncracy is so great and so frequent, that if we have not regard to it, the Lives of the Sick may be hazarded.

And so Hysterical Diseases are most commonly cur'd and most Obstructions of Women, especially the Green Sickness; and also, all Suppressions of the Courses. But if the Blood is so very feeble, and the confusion of the Spirits so great, that Ste••l order'd to be us'd ac∣cording to the Method prescrib'd, is not sufficient to cure the Disease, the Patient must drink some mineral Wa∣ters impregnated with an Iron Mine, such as are Tun∣bridge, and some others lately found out, for the Cha∣lybeat Vertue of these is better mingl'd with the Blood, by reason of the great quantity that is taken of them, and also because they are more agreeable to Nature, and they cure Diseases more effectually than Iron how much soever exalted by Art.

But this is more especially to be observ'd, in drink∣ing of them, that if any Sickness happens that is to be referr'd to Hysterical Symptoms, in this case the Pati∣ent must forbear drinking them a day or two, till that Symptom that hinder'd their Passage is quite gone; and it is to be noted, that Purging must be avoided all the time the Patient drinks these Waters.

But if this Disease, by reason of its Obstinacy does not yield to Steel-waters, the Sick must go to the Bath, and when she has used them inwardly three mornings following, the next day let her go into the Bath, and the day following let her drink them again, and so let her do by turns for two months; for in these and in others, of what kind soever they are, this must be care∣fully noted, That the Patient must persist in the use of them, not only till she perceives some benefit, but till she is quite well, that the Symptoms may not return again in a short time. Venice-Treacle alone if it is us'd often and a long while, is a great Remedy in this Di∣sease; and not only in this but in very many other Di∣seases, that proceed from want of heat, or concoction or digestion, 'tis perhaps the most powerful that has been hitherto known. Spanish Wine medicated with Gen∣tian, Angelica, Wormwood, Centory and other Corrobo∣ratives infus'd in it, does a great deal of good, some Spoonfuls of it being taken thrice a day, if the Woman be not of a thin and cholerick habit of Body; and tru∣ly, a large Draught of Spanish Wine by it self taken at Bed-time for some Nights, by my Advice, has been very beneficial to some Women; for by it the habit of the whole Body was render'd stronger, and they who be∣fore were Cachectical, became fresh-colour'd and brisk.

Moreover, sometimes we find that the Peruvian Bark wonderfully comforts and invigorates the Blood and Spirits, a Scruple of it being taken Morning and Even∣ing for some Weeks; but it succeeds best in that kind of Hysterick Diseases, wherein VVomen are afflicted with Convulsions. But if any of the Remedies above-mentioned don't agree well, which often happens in cholerick and thin Constitutions, then a Milk-diet may be us'd, for some VVomen (which one wou'd wonder at at first) that have been conflicted a long while with Hysterick Diseases, and even such as have frustrated all the endeavours of Physicians, yet have recover'd by dieting themselves for some time only with Milk; and especially those that labour with that Disease, I call an Hysterick Cholick; which can't be appeas'd by any thing but Narcoticks, to which, repeated by Intervals,

the VVomen are much accustom'd, the Pain returning assoon as the Vertue of the Anodyne fades.

But nothing of all I have hitherto mention'd does so much comfort and strengthen the Blood and Spirits as riding on Horse-back every Day for a long while, but though it may be inconvenient for Women that are ac∣custom'd to a slothful and delicate way of living, for they may be injur'd by Motion, especially at the begin∣ning, yet 'tis very proper for Men, and soonest reco∣vers their Health. One of our Right Reverend Bi∣shops, famous for Prudence and Learning, having stu∣died too hard a long while, fell at length into an hy∣pochondriac Disease, which afflicting him a long Time▪ vitiated all the Ferments of the Body, and wholly sub∣verted the Concoctions; he had passed through long Courses of Steel more than once, and had tried almost all mineral Waters, with Purging often repeated, and antiscorbuticks of all kinds, and very many testaceous Powders, which are reckoned proper to sweeten the Blood, and so being in a manner quite worn out, partly by the Disease, and partly by Physick, used con∣tinually for so many Years, he was at length seized with a colliquative Loosness, which is wont to be the forerunner of Death in Consumptions, and other chro∣nical Diseases, when the Digestions are wholly destroy'd. At length he advised with me; I presently considered that there was no more room for Medicine, he having taken so many already without any Relief; for which reason I persuaded him to ride on Horse-back, and that first he should take such a small Journey as was agree∣able to his weak condition. Had he not been a very judicious Man, and one that weighed things well, he would not have been persuaded so much as to have tryed such a kind of Exercise: I intreated him to per∣sist in it daily, till in his own Opinion he was well, going daily furthur and further, till at length he went so many miles in a Day as prudent and moderate Tra∣vellers, that go a long Journey upon Business, use to do, without any regard to Meat, Drink or the Wea∣ther: But that he should take every thing as it hap∣pened: To be short, he continued this Method, in∣creasing his Journies by degrees, till at length he rode

twenty or thirty miles daily; and when he found him∣self much better in few Days, being encouraged with such wonderful Success, he continued this course a pret∣ty many Months; in which Time, as he told me, he rode many thousand Miles, till at length he did not only recover, but also gained a strong and brisk habit of Body.

This is the general way of Curing this Disease, which is applied to the original Cause, viz. the weak Crasis of the Blood, and so is to be used only when the fit is off: Therefore as often as the Fit invades, joined with any one of the foresaid Symptoms, if the Disease be such, or so great an one, that it will not bear a Truce, till it may be cured by Medicines that corroborate the Blood and Spirits, we must presently make use of hysterick Remedies, which by their strong and offensive Smell recal the exorbitant and deserting Spirits to their proper Stations, whether they are taken inwardly, or smell'd to, or outwardly applied: Such are Assa Foetida, Galbanum, Castor, Spirit of Sal Armo∣niack, and lastly, whatever has a very ungrateful and offensive smell.

In the next place, you must take notice, that if some intollerable Pain accompanies the Fit, in whatever part it is; or violent Vomiting or a Loosness, than besides the Hystericks above-mentioned, Laudanum must be used, which only is able to restrain these Sym∣ptoms.

But in quieting the Pains, which Vomiting occasions, we must take great care that they are not mitigated either by Laudanum, or any other Paregorick, before due Evacuations have been made, unless they almost exceed all human Patience. First, because sometimes there is so great a quantity of Blood and Humours heap'd up (especially in sanguine Women, and in Men of a proper Habit) that is able to withstand the Operation of the most effectual Narcotick, though it be often repeat∣ed, and therefore in such Blood must necessarily be evacuated from the Veins of the Arm, and a Purge must be given before we come to use Laudanum; for when these things are duly performed, that which be∣fore given in a large Dose would do no good, does now

perform the Business in a moderate Dose; and then because I have found by frequent Experience, that when the Sick has been accustomed by little and little to Laudanum, and has not been duly evacuated before she was forced, by reason of the return of the Pain presently after the Vertue of the Medicine vanished, to take a Paregorick again, and so daily for some Years, the Dose being sometimes by degrees increased, so that at last they can by no means abstain from Lau∣danum, though thereby all the Digestions are vitiated, and the natural Functions weakned; though I do not think that the use of Laudanum does immediately hurt the Brain, or Nerves, or the animal Faculties: There∣fore I judge and speak what I have found, That Eva∣cuation ought to go before Anodynes, viz. in Virago's, and in Women that abound with Blood, a Vein must be opened, and the Body purged, especially if they have been lately seized with the Fit: But if weak Women, and those of a quite contrary Constitution, labour with such a Fit and Pain, and have been not long ago afflicted with it, it will be sufficient to cleanse their Stomachs with a gallon of Posset-drink, more or less, taken in and ejected by Vomit, and then to give a large Dose of Venice Treacle and a few Spoon∣fuls of some Spirituous Liquor, that is pleasing to the taste, with a few Drops of Liquid Laudanum to be ta∣ken presently after it.

But if the Sick has vomited a great while before the Physician was called, and there is danger, lest by fur∣ther Provocation, by Emeticks, the Spirits should be put in a rage, and the Sick too much weakned: In this case you must give Laudanum without delay, and such a Dose that is not only suitable to the Violence and Duration of the Symptom, but such an one as is suf∣ficient to vanquish it.

But here two things are to be chiefly noted; First That when you have once begun to use Laudanum after due and necessary Evacuations, it must be taken in that Dose, and often repeated till the Symptom is quite conquered; only such a space must be betwixt each Dose, that we may know what the former has done before we give another: And then when we treat the

Disease with Laudanum, we must do nothing else, and nothing must be evacuated, for the gentlest Glister of Milk and Sugar is sufficient to spoil whatever has been repaired by the Paregoric, and to occasion the return of the Vomiting and Pain. But though the Pains above-mentioned, as we have said, are apt to overcome the Vertue of the Anodyne, yet violent Vo∣miting indicates the largest Dose of it, and that it should be very often repeated; for by the inverted peristaltick Motion of the Stomach (by which that which is con∣tained in it ought to be carried downwards) the Pare∣gorick is ejected through the Oesophagus, before it can do any good, unless after every time the Sick vomits the Narcotick be given afresh, and chiefly in a solid form, or if it be given in a Liquor the Vehicle must be so small, as that it must but just wet the Stomach, so that by reason of the small quantity of the Matter it cannot be cast up. For instance, some Drops of liquid Laudanum in one spoonful of strong Cinnamon-Water, or the like; and the Sick must be admonished to keep her self quiet, presently after taking the Laudanum, and that she keep her Head, as much as possible, im∣moveable, for the smallest motion of the Head pro∣vokes Vomiting more than any thing else, and then the Medicine, just taken, is ejected; and when the Vo∣miting ceases, and is, as it were, tamed, it is expedi∣ent to give an Anodyne morning and evening for a few days, to prevent a Relapse, which also ought to be observed after a loosness, or an hysterick Pain taken off by a Narcotick; and so at length by this method we may readily cure the symptomatick Pain and Vomiting, whereby, because they are very often like other Disea∣ses, Physicians are easier imposed upon than by any other Symptoms whatever.

CHAP. XCVIII. Of an Inflammation in the Womb.

AN Inflammation of the Womb is a Swelling of that Part, from Blood poured upon it.

The Inflammation either possesses all the Womb, or a part of it; and it is occasioned either by pure Blood, and then it is called simply a Phlegmon, or it is mix∣ed with Choler, or with Flegm or Melancholy.

The diagnostick Signs are a Swelling, Heat and Pain in the region of the Womb, with a continual Fever. But because the right-Gut and the Bladder possess the same region, therefore an Inflammation of the Womb must be distinguished by other Signs, as by a Sup∣pression or Diminution of the Courses, the pale or yellow Colour of them, and by the Pain in Evacuation of them, and when the Courses are gon off, by a fetid Itchor that moistens the Privities, the inward Mouth of it will appear swell'd, drawn back and pain∣ful, and the Neck will be red and inflamed.

If all the Womb be inflamed, all the Symptoms will be more violent; if the Inflammation be most upon the Neck of the Womb, the Heat and Pain will be extended most to the Croins and Privities. If the forepart be most afflicted, the Bladder will most sym∣pathise: If the hinder part be most afflicted, the right Gut will most sympathise, and the Pain will stretch it self to the Loins: If the right part or the left part be inflamed, the Swelling and Pain will appear about ei∣ther Groin, and the Leg of the same Side will have a Weight upon it.

The Signs of the Causes are to be known in the following manner: If the Inflammation be occasioned by pure Blood, all the Symptoms will be gentle; but if Choler be mixed with it, the Fever will be high, and all the Symptoms violent; but if the Blood be flegmatic or melancholy, the Fever is not so acute, but more lasting and obstinate: Also the Signs of the Hu∣mor

predominating in the Body are to be referred to the Diagnostick.

If the Inflammation tends to suppuration, the Pain and Fever increases, and there are Shiverings which come most commonly about Evening, and all the rest of the Symptoms are increased. When Suppuration is made they all abate, but the Tumor is more increased, where∣by the Belly, and sometimes the Urine are suppressed. But if the Inflammation is discussed without Suppu∣ration, the Tumor is lessened, and the Symptoms abate.

Lastly, If it degenerate into a Scirrhus, the Fever and Pain, and the rest of the Symptoms lessen, but the Swelling grows hard, and a weight remains, not only in the Womb but also in the circumjacent Parts; so that the Sick moves difficultly.

As to the Prognostick, this Disease is very dangerous, and most commonly deadly, for the Inflammation easily turns to a Gangrene.

As to the Cure of this Disease, Revulsion and Deri∣vation must be made of the Flux of Blood to the Womb.

And it must be repelled from thence, and that which has flow'd to the part must be resolved, and if the Tu∣mor tends to suppuration, it must be furthered, and the Abscess being broken, the Matter must be evacua∣ted, which may be done by the following Remedies.

An emollient and cooling Glister being first given, the Sick must be blooded in the Arm; and it must be repeated twice, thrice or four times, according to the strength of the Patient, and the greatness of the Inflam∣mation.

After sufficient revulsion, and the increase of the Dis∣ease being over, and when there is no more fear of the fluxion, the lower Veins must be opened for derivation from the Part affected. But as long as there is any Indicati∣on for revulsion, it is safest to open the Veins of the Arm.

And for revulsion, Frictions and Ligatures of the upper Parts are proper, and Cupping-glasses applied to the Shoulders, Back and Loins.

If vitious Humours, especially Cholerick, abound in the Body, which are, as it were, a Vehicle for other Humours in the Flux, they are to be evacuated by gen∣tle Medicines; as with Syrup of Roses, Manna and Rhubarb, or with lenitive Electuary. By reason of the Fever, cooling Medicines are to be used; as Juleps and Emulsions; if there be great Watching, Pain or Restlesness, Narcoticks may be mingled with them, or they may be given apart.

After the first evacuation Topicks may be applied to the Belly, betwixt the Navel and the Pubes, or about the Reins; first, things that cool and repel in the form of a Liniment, Epithem or Cataplasm.

A Liniment may be made of Oyl of Roses wash'd in Vineger, or with Ointment of Roses.

An Epithem may be made of Waters, or of a Deco∣ction of Plantain, Sorrel, Night-shade, of the tops of white Poppies and of Roses, adding to them a little Bole-armenick, Dragon's-blood, or sealed Earth.

A Cataplasm may be made of Crums of Bread boil∣ed in Milk, to which may be added a little Oil of Ro∣ses▪ the Juice of Henbane or of Night-shade, with the yolks of Eggs, or of the Meal of Barly; of the Seeds of Flax or of Fenugreek, with Oil of Roses; to which also may be added, the Plants above-mentioned bruised.

Injections may be made for the Womb, in the follow∣ing manner.

Take of the leaves of Plantain, Water-lillies, Night-shade and Endive, each one handful; of red Roses, two pugils: Boyl them till a third is consumed, and add to them one ounce of Oyl of Mirtles, and half an ounce of Vineger; make an Injection.

Pessaries for the Womb may be made of the same Herbs bruised, and with Oyl of Roses and Vineger.

But you must not use repelling and cooling things too long, lest the Tumor grow hard, and turn to a Scirrhus; therefore, things that mollify and dissolve, must be mixed with Repellents, with this caution, viz. That the farther the Inflammation is from the beginning, the greater must be the quantity of the things that digest: To the fore-mentioned Remedies may be added, Mal∣lows,

Marsh-mallows, Mugwort, Fenugreek, Camo∣mile and Melilot; the quantity of them being increased or diminished as there seems occasion. In the mean time if the Belly be hard, it must be loosened by things that purge gently; and cooling Glisters frequently inje∣cted, do much good in qualifying the Inflammation, the Womb lying upon the right Gut. But the quantity of them must be very small, that they may be the longer retained.

Take of the Roots of Marsh-mallows one ounce, of the leaves of Mallows, Violets and Lettice, each one handful, of Night-shade half an handful, of the flowers of Violets and red Roses, each one pugil, of acid Prunes number ten; boyl them in Barly-water; to six ounces of the strained Liquor, add three ounces of Oyl of Roses; make a Glister.

If the pain be very violent, to the foresaid Glister may be added yolks of Eggs, Hens grease, Woman's milk, the mucilages of the Seeds of Fenugreek, Flax o•• Mallows, and a little Opium, and a little Saf∣fron.

Injections may be also made for the Womb, of Goats or Sheeps milk with Opium or Saffron, each Grains three or four, with a little Rose-water.

Or to the Pessaries, may be added a moderate quan∣tity of Opium with a little Saffron, yolks of Eggs, and Oyl of Roses; or Pessaries may be made of Philonium Romanum with Cotton, or an anodyne Fomentation may be prepared in the following manner.

Take of Marsh-mallows with the roots, of Mallows and Violets, each one handful; of Camomile, Melilot and Roses, each one pugil; boil them for a fomenta∣tion

The Disease decreasing, Purging must be repeated with gentle Catharticks; but if it tend to resolution, which may be known by a remission of the Symptoms, and by a lesser weight in the part, Discutients must be added in larger a quantity to the foresaid Remedies; or make the following Cataplasm.

Take of the Powder of the roots of Marsh-mallows one ounce, of the flowers of Melilot and Camomile, each two drachms, of the leaves of Mugwort powder'd, of

the Meal of Barly and Beans, each half an ounce; boil them a little in rough Wine, add to them of fresh Lard, of the Oils of Camomile and of white Lillies, each one ounce; make a Cataplasm.

A dissolving fomentation or bath is here also of use.

If the Tumor cannot be dissolved, but tends to sup∣paration, it must be furthered by the following Cata∣plasm.

Take of the powder of the roots of Marsh-mallows, of the flowers of Camomile and Melilot, of the Meal of Linseeds, Fenugreek-seeds, each one ounce, of fat Figs number eight; boil them to the consistence of a Cata∣plasm; then add of the yolks of Eggs number four, of Saffron ten grains, of Oil of Lillies and fresh But∣ter▪ each one ounce; make a Cataplasm.

The Pus being made, which may be known by the remission of the heat and pain, and by its ••loating when it is touched, the breaking of the abscess must be en∣deavoured by the motion of the Body, Sneazing, Cough∣ing, by applying Cupping-glasses, by cleansing and at∣tenuating Injections, or by Pessaries that have a faculty of breaking Tumors. For instance,

Take of Goose-fat half an ounce, of Turpentine two drachms; of the powder of the seeds of Rue, and of Orris-root, each half a drachm; mix them, and make a Pessary.

The Abscess being broken, we must endeavour to cleanse and heal the Ulcer; as shall be shewed in the following Chapter.

CHAP XCIX. Of an Ʋlcer in the Womb.

AN Ulcer follows an Inflammation of the Womb sup∣purated; it also proceeds from other causes, viz. from whatever corrodes the Womb.

Therefore, the causes of it are an Abscess broken, acrid Humours flowing to the Womb, acrid and corr••∣ding

Medicines injected, or taken inwardly, as Can∣tharides.

The antecedent causes are all those things that occa∣sion an Inflammation, as hard Labour, violent and un∣governable Copulation, acrid and long Whites, Wounds, Falls, Contusions; but especially a virulent Gonorrhaea, and the French Pox, the Contagion whereof is easily communicated to the Womb, and the neck of it.

The differences are to be sought for from the Place, Magnitude, Figure and Complication with other Di∣seases.

The diagnostick Signs are a Pain and Gnawing, and the evacuation of purulent Matter.

The cure of the Ulcer must be performed by stop∣ing the defluxion of acrid Humours, and by cleansing and conglutinating the Ulcer.

And first, if the Body be Plethorick, or if the Ulcer be accompanied with an Inflammation, a Vein must be opened in the Arm, and bleeding must be repeated as often as there is danger of a new fluxion, especially at the time of the Courses, to lessen them, which are wont to increase the matter of the Ulcer, and to promote the flux of other Humours to the Womb.

Purging is also very necessary to cleanse the Body from ill Humours; but it ought to consist of gentle Cathar∣ticks, as of Sena, Rhubarb, Tamarinds, Myrabolanes, and the like, which must be often repeated, that the vitious Humours may be diverted; and this is of so great moment, that Forestus says, That a noble Matron was cured of an Ulcer of the Womb, by taking every fourth day five ounces of the decoction of Sena, Dodder of Thym, red Roses, Indian Myrabolanes sweetned with Sugar, and by injecting a cleansing decoction into the Womb.

For common use, a magisterial Syrup may be made in the following manner.

Take of the roots of Comfry, and of fresh Polypody of the Oak, each one ounce; of the Bark of dried Citron six drachms; of the leaves of Plantain, Periwinkle, Sanicle, Sorrel and Maiden-hair, each one handful; of Liquorish rasped, and of Raisins of the Sun stoned, each one ounce; of Sena cleansed six drachms; of the

seeds of Bastard-saffron bruised, two ounces; of Aga∣rick fresh trochiscated, and tyed up in a Rag, ten drachms; of the seeds of Anise and Melon, each three drachms; of the Cordial Flowers of Rosemary and of Dodder, each one pugil; make a decoction of all, in a part of which infuse half an ounce of choice Rhu∣barb, and one drachm of Cinnamon; in a pint and an half of the strained Liquor, dissolve three ounces of Syrup of Roses solutive, and a sufficient quantity of Sugar; boil them well and make a Syrup, whereof let her take two or three ounces twice or thrice in a month, with a decoction of Agrimony and Plantain, or with an infusion of Rhubarb in Endive wa∣ter.

If the sick vomits easily, a Vomit is most useful, for it makes a revulsion of the Humours from the Womb; and the days the sick does not purge a vulnerary deco∣ction must be used a long while, made in the following manner.

Take of the leaves of Agrimony, Knot-grass, Burnet and Plantain, each half a handful; of the roots of China three drachms, of Coriander-seed one drachm, of Raisins half an ounce, of red Sanders one scruple; boil them in Chicken Broath, strain it. Let the sick take of it morning and evening. Or,

Take of the leaves of Mugwort, Plantain, Yarrow, each one handful; Rhaponticum half an ounce, of the seeds of Nettles one drachm; boil them in a measure of white Wine, and sweeten it with Sugar; let the sick take two or three ounces in a morning.

If the Fever be violent, and if a great quantity of Sanies be evacuated, Whey is very proper; half a pint or more being taken in a morning, with a little Hony of Roses.

If the Body begin to waste, and there is a hectick Fever, Asses Milk must be taken, with Sugar of Roses for a whole Month.

Sudorificks, there being no Inflammation, or a hot In∣temperies may also do good to dry the Ulcer, and to drive the serous Humours towards the habit of the Body.

Turpentine washed in some proper Water for the Womb, as in Mugwort or Feferfew-water, or in some Water proper for the Ulcer, as Plantain or Rose-water, taken with Sugar of Roses, by Intervals cleanses and heals the Ulcer.

Pills of Bdellium taken daily or every other day, are also very good.

Take of Bdellium three drachms, of Myrrh and Fran∣kincense, each one drachm; of Sarcocoll, Amber, Sto∣rax, and of Myrabolanes, called Chebule, each one drachm; of red Coral two scruples, with syrup of Pop∣pies, make a mass for Pills; to which, when the Pain is violent, may be added a little Opium.

Troches of Alkakengi with Opium, may be also used when the pain is violent; and to ease the pain, the same Remedies may be prescribed, which were propo∣sed in an Inflammation of the Womb, for the same Sym∣ptom.

The following Powder is also very effectual to dry the Ulcer.

Take of Acacia and Hypocistis, each one drachm, of Dragon's-blood, white Starch, the roots of Plantain and of round Birthwort, each half a drachm; of Bole armenick one drachm, of Mastich and Sarcocol, each half a drachm; make a fine Powder; the dose is one drachm in Plantain or Rose-water, or in some Chalybeat-water.

To cleanse, dry and heal the Ulcer, various Injections are prepared; but they must not be used till the Inflam∣mation is taken off, and till the Pain is eased; and, therefore, upon account of the Inflammation and Acrimo∣ny, Emulsions of the cold Seeds, the Whey of Goat's-milk, or the Milk it self, or mixed with the juice of Plantain or Shepherd's purse, may be injected first; if necessity requires, a decoction of Poppy-heads and tops of Mallows may be injected. Some Practitioners say, The Sick may be much relieved by injecting frequently warm Water.

The hot Intemperies, and the Pain being quieted, or at least diminished, we must use such things as cleanse, beginning with the gentle, and proceeding by degrees to the stronger.

The gentle, are Whey with Sugar, a decoction of Barly with Sugar, or Hony of Roses; but simple Hy∣dromel cleanses more.

A decoction will be a little stronger made with Barly, Lentils, Beans not excorticated, of the Leaves of Smallage, Plantain and Pellitory, a little Hony of Ro∣ses being added.

When the Ulcer is very sordid, the following deco∣ction may be used.

Take of the roots of Gentian, Rhaponticum, Zedoary, and round Birthwort, each one ounce, of white Wine three pints; boil them to the consumption of a third part; in the strained Liquor, dissolve half a pound of Sugar, and keep it for use.

If the Ulcer be very fetid, a little Ʋnguentum Aegyp∣tiacum may be added to the decoction.

When the Ulcer is well cleansed, we must use such things as dry and consolidat.

Take of the roots of Comfry and Bistort, each one ounce, of the leaves of Plantain, Horsetail, Shepherd's-purse, Sanicle, Mouse-ear, Milfoil, each one handful, of red Roses half an handful; boil them in a measure of Water for an injection.

The following Sarcotick Powder may be added to it.

Take of the roots of Orris, Birthwort and Comfry, each half an ounce, of Myrrh one ounce, of Aloes three drachms; make a Powder, whereof let half an ounce be mingled with every injection.

Take of Turpentine washed in Plantain-water, two drachms, dissolve it with Hony and the yolk of an Egg, and mingle it with the Injection. This is very effectual; but is more so, if the sarcotick Powder be also added.

Oil of the yolks of Eggs stirred well about in a lead∣en Mortar, is also very good.

Fumes must be used for deep Ulcers, for they pene∣trate to the bottom of the Womb, and dry the Ulcers.

Take of Frankincense, Myrrh, Mastick, Gum-juniper, Labdanum, each one ounce, with a sufficient quan∣tity of Turpentine; make Troches for a Fume.

When the Ulcer is very obstinat, Cinnabar must be added, which is of excellent use.

The Bath-waters have cured Women, when all other Medicines have been ineffectual.

Plasters may be also conveniently applied to the Epi∣gaster. If the Ulcer be in the Neck of the Womb, it must be anointed with Liniments, that cleanse and dry.

Take of the juice of Smallage two ounces, of hony of Roses one ounce and an half, of Turpentine half an ounce, of the meal of Barly or of Orobus, a sufficient quantity; make a Liniment.

Oyntment of Diapompholigos may be also applied, adding to it Frankincense, Mastich, Myrrh, Aloes, ac∣cording to the condition of the Ulcer: These things cleanse.

After you have sufficiently cleansed the Ulcer, you must apply a drying and cicatrizing Ointment.

Take of Tutty washed half an ounce, of Lytharge, Ceruss and Sarcocoll, each two drachms, of Oil and Wax a sufficient quantity; make an Ointment.

Sometimes the Ulcer penetrates the right Gut, and sometimes the Bladder, which may be known by the Matter evacuated by those Parts.

If it flow by the right Gut, lenitive, cleansing and drying Glisters must be injected: But if it flow from the Bladder, gentle and cooling Diureticks must be used, as an Emulsion of the greater cold Seeds, Turpen∣tine and other Remedies prescribed for an Ulcer of the Bladder.

If the Ulcer turn to a Fistula, which chiefly happens, when it is opened outwardly towards the Hip, though it may happen in the Womb it self, or in the Neck of it; in this case we must consider, whether it be best to leave the accustomed Passage untouched, through which Nature endeavours to evacuate various Excrements, or to undertake the Cure of it: But if that be thought most proper for the Sick, a Cure that is called palliative must be instituted by Purges frequently repeated, and by sweating twice a year, and by cleansing and stren∣gthening Injections, and by applying over a Plaster of Diapalma, or the like. But if there be any hopes of a

Cure, the same Remedies must be used which are pro∣per for other Fistula's.

If the Ulcer be occasioned by the French Pox, it can∣not be cured without an universal Cure; in perform∣ing which, the Fumes of Cinnabar received through a Tunnel into the Womb, are peculiarly proper; also, the anointing the inner Parts of the Womb with a mer∣curial Ointment.

In all Ulcers of the Womb, if there be a troublesome itching about the Neck, as it frequently happens, by reason of a defluction of an acrid and salt Humour to the part; a Pessary must be made to qualifie it, dipt in the Ointment of Elecampane with Mercury, or in Aegyptiacum dissolved in Sea or Alum-water, or in fresh Butter, wherein quick Silver has been extinguished; to which must be added Sulphur.

CHAP. C. Of the Scirrhus of the Womb.

THE signs of a Scirrhus in the Womb are a hard∣ness in the region of it, a sense of weight in the part, especially when the Sick stands, but there is no Fever or Pain, whereby it is distinguish'd from an In∣flammation, and if there be any Pain it is small. If it be in the body of the Womb it is easily known by feel∣ing the region of the Pubes, but if it be in the Neck of the Womb it may be touch'd with the Finger; it is distinguish'd from a Mola by the preceding Causes, also because in a Mola the Courses, if they flow, flow disorderly: But in a Scirrhus, if they flow, they keep their order. Also in a Mola, the Breasts are full of Milk, but in a Scirrhus they grow small.

As to the Prognostick, every Scirrhus is difficultly cur'd; for great hardness once contracted can scarce be mollified: Moreover the Natural Heat in the part af∣fected with the Scirrhus is very weak, so that it can scarce discuss the gross and almost stony Matter.

A great and obstinate Scirrhus occasions at length a Dropsie.

If a Scirrhus of the Womb be treated with too hot, and too moistening Remedies, it degenerates into a Cancer.

The Cure is to be directed to two things, viz. to the antecedent and conjunct cause.

By reason of the antecedent Cause, Bleeding must be ordered first in the Arm; if the Disease be not very inveterate: But afterwards in the inferior Veins, espe∣cially when the Courses are stopt.

The opening of the Hemorrhoidal Veins is also very proper, for they evacuate feculent Blood, and draw from the Womb, by reason of the Communication which they have with it.

Purging is also necessary, and it must be repeated by intervals. The Purges must be made of such things as evacuate Melancholy. First you must use such as are gentle, afterwards stronger.

But opening Medicines, and such as prepare the Me∣lancholy Humor must be given before Purges, in the Forms of Apozems, Juleps or Broaths, according to the Disposition of the Sick.

But besides common Apperitives, chalybeat Medi∣cines must be also used, whereby the great Obstruction in the Womb and other Parts may be dissolved.

And that the superfluous Humors may be diverted, Issues should be made in the Legs, and must be conti∣nued there till the Courses, which are generally stopt in this Disease, return orderly.

For the conjunct Cause emollient and resolving Me∣dicines must be applied outwardly in the following manner.

Take of the Roots of Marshmallows, and of Lillies, each two ounces; of the Leaves of Mallows, Violets, Marshmallows, and Bears-breach, each one handful; of the Leaves of Mugword and Calamint, half an handful; of the Seeds of Flax and Fenugreek, each one ounce; of the Flowers of Camomile and Melilot, each one pugil: Make a Decoction, wherewith fo∣ment the Region of the Pubes and Groin with a Spunge dipt in it and pressed out.

To mollifie more, a Decoction may be made of the Entrails of a Sheep, and the Roots of Briony and wild

Cucumber may be added: But you must begin with things that are gentle, and proceed by degrees to stronger

Of the same Decoction, the Dose of the Simples being increased, a Bath may be made, which is very effectual in this case, and more powerful than the Fomentation.

Glisters also and Injections may be made of the same Decoction, and frequently used; whereunto may be added the Oils of Lillies, Camomil and Sweet Al∣monds.

Take of the Oils of Lillies, and of Sweet Almonds, each three ounces; of the Mucilage of the Seeds of Fenugreek, extracted with White-Wine one ounce; of the Fats of Hens, Geese and Ducks, each one ounce and an half; of fresh Butter and of Lard, of each two ounces; with a sufficient quantity of Wax and Turpentine make an Ointment.

The following is approved of in all Scirrhus's.

Take of Bdellium, Ammoniacum, and Galbanum, each equal parts; beat them in a Mortar with Oil of Ben and Lillies; then add of the Mucilages of the Seeds of Fenugreek, Flax, and of Figs a like quan∣tity; make an Ointment.

Of the same Matter, Wax being added, an effectual Plaster may be made, and applied to the region of the Womb behind and before; or Diachylon with Orris may be applied. A Cataplasm may be made of the residue of the Decoction for the foresaid Bath, bruised and pulped, adding to it of the Meal of Fenugreek and Flax-Seeds, each one ounce, of Figs, number six, of the Powder of Orris Root two drachms, of Saffron half a drachm, of hens Fat and Oil of Sweet Almonds, each a sufficient quantity; make a Cataplasm.

The Mud of a Sulphurous Bath may be applied in∣stead of a Cataplasm.

But these Medicines must be used with great cau∣tion, lest the Scirrhus should be hardned; or what is much worse, should degenerate into a Cancer. So that it is best to desist by intervals; and it is to no purpose to use Medicines when the Scirrhus is without Pain, and of a stony nature.

CHAP. CI. Of a Cancer of the Womb.

A Cancer of the Womb is a hard Swelling of the Body or Neck of it, with pricking and lance∣ing Pain.

It is occasioned by black Choler collected in that part, or by a Scirrhus ill cured, which easily degene∣rates into a Cancer in that part, especially by reason of a great afflux of Blood, which being retained in the Veins near the Scirrhus, and not sufficiently evacuated by the Courses, acquires a malignant quality.

It is twofold, either ulcerated or not ulcerated.

As long as the Morbific Matter is of lesser Acrimony and Malignity the Cancer does not break; but when the Matter becomes more acrid, it causes an Ulcer.

It is easily known by what has been said; for if there be a hard Tumor in the Body or Neck of the Womb, which occasions a pricking and lancing Pain, you may pronounce it cancerous: But it is more evi∣dently distinguished, if it be seen by the Eyes, as when it is in the Neck of the Womb, by the help of a Speculum Matricis, for then an unequal, livid, or black Tumor, encompassed with Branches of Veins will ap∣pear: But if it be ulcerated it casts forth a yellow or black Sanies that stinks much, and sometimes Blood, by reason the Veins are corroded which run to it, so that sometimes when a large Vessel is opened, it flows so much that the Life of the Sick is hazarded. There is also a small Fever, Anxiety, Nauseousness, and a Heat of the Privities, and the like.

As to the Prognostick, a Cancer is incurable, whe∣ther it be ulcerated or not; wherefore seeing a perfect Cure cannot be expected, we must endeavour to hinder the breaking of it, and the increase of it when it is broken, and in both we must qualifie the Violence of the Pain; which may be done by such things as evacu∣ate the whole Body, and by other Remedies which alter

and evacuate the melancholy Humor, and black Choler, and hinder their Growth: As by bleeding in the Arm, Hemorrhoids, Foot, Potions, Apozems, Juleps, Broath, Milk, Whey, cold mineral Waters, and the like, which are commonly prescribed for any Cancer: But Purging, most especially must be repeated, that the antecedent Cause of the Cancer may be diverted.

Topicks must also be applied, which moderately bind and cool without Sharpness; they must especially be used in form of Liniments.

Take of Oyl of Myrtles, and of Roses, each two ounces; of the Juice of Night-shade, and of Housleek, each one ounce; stir them all about in a leaden Mortar, with a leaden Pestle, till they grow black; then add of Litharge, and Cerus washed in Scabious Water, each three ounces; of Tutty prepared two drachms, of Camphor ten grains; make a Liniment, wherewith anoint the Part three or four times in a day. Or,

Take of the Oils of the Yolks of Eggs and of Roses, each one ounce and an half, of Sacharum Saturni one drachm; stir them about in a leaden Mortar till they change colour.

The following is better than the rest, and with it Tumors of the Paps, which are counted cancerous, may be perfectly cured.

Take of the Oil of Yolks of Eggs two ounces, of the Juice of Night-shade and Speedwel, or of Housleek, each half an ounce, of crude Mercury two drachms; stir them about in a leaden Mortar, with a leaden Pestle, till they acquire the consistence of a Lini∣ment.

The foresaid Liniments are to be put into the Womb with a long Tent, or with a Wax-Candle, wrapt round with a Rag: But Injections may be much easier used.

Take of Barly-Water half a pint, of the Waters of Night-shade, and Plantain, each two ounces, of the Water of Speedwel one ounce, of the white Troches of Rhasis two drachms, of Sacharum Saturni one drachm: Make an injection.

If the Pain be very violent add to four ounces of the Injection one ounce of the Syrup of Popies.

Foment the part affected with the Waters of Plan∣tain and Night-shade, or with the decoction of them, whereunto may be added the Leaves of Water-lillies, white Poppies, and red Roses and Camphor; which Decoction may be also frequently injected into the Womb, and it will be much more effectual, if it be stirr'd about in a leaden Mortar, or if Sacharum Saturni be mixed with it.

Among Specificks, are commended Frogs wash'd and boil'd, and apply'd instead of a Cataplasm, or a deco∣ction of them injected; also, the decoction or juice of River-crabs injected into the Womb, or Herb-Robert taken inwardly or apply'd.

If the Cancer be ulcerated the Dose of the Minerals to be added to the foresaid Linimenss must be increas'd. and the Ashes of River-Crabs may be conveniently ad∣ded to them; but with the Injections may be mixt the white Troches of Rhasis and Barly-water.

If the Pain be very violent, Fomentations of Mal∣lows, Marsh-mallows, Water-lillies, Poppies, Henbane, green Coriander, Dill, of the seed of Psyllium, Milk, Saffron, and the like, may be used by Intervals, or a Cataplasm made of them may be apply'd, with which also Decoctions, Injections and Baths may be also pre∣par'd.

But all these things are not sometimes sufficient to appease the violent Pain, which sometimes will not suf∣fer the sick to sleep or rest, so that we are forced some∣times to use Narcoticks; and indeed, they are not in∣jurious in this Disease. I knew a Woman that was afflicted with a Cancer in her Breast, who took every Night for four Months two or three Grains of Laudanum, and was much reliev'd by it.

If much Blood flow from a Cancer ulcerated, as it often happens, inject into the Womb the juice of Plan∣tain, with a little Frankincense.

CHAP. CII. Of a Gangrene and Mortification of the Womb.

A Gangrene is an incipient Mortification; this Di∣sease is easily generated in a Womans Privities, be∣cause those Parts are very moist and soft, and easily re∣ceive the Excrements of the whole Body; it often suc∣ceeds an Inflammation, Absess or Ulcer ill cured, when the vital heat of the part is suffocated and destroy'd, it is suffocated in great Inflammations, when more Blood flows in, than the innate heat of the part can digest; 'tis destroy'd either by a cold Intemperies that extin∣guishes it, or by an hot that dissipates and resolves it.

An incipient Gangrene is known by an unusual heat that is perceiv'd in the part; a shaking and shivering al∣so invades, with a languid and frequent Pulse, and with Fainting, and because most commonly this Disease is chiefly seated on the Neck of the Womb, and so the part affected may be seen, that appears soft, livid, black and cadaverous, and may be prick'd and cut without feeling, and sends forth a fetid and cadaverous Stink.

As to the prognostick, this Disease is very dangerous and most commonly deadly. But it has been observed by many Authors, that the Womb having been corru∣pted or gangren'd has fallen off of its own accord, or has been cut off, and the Woman has done well.

The Cure is to be perform'd by the same Remedies wherewith the Gangrenes of the other parts us'd to be cur'd; if the Gangrene be in the neck of the Womb, or tend towards the external parts, Scarification must be us'd, and a decoction of Wormwood, Myrrh and the like; also Unguentum Aegyptiacum, and a Cata∣plasm made of the three Meals.

Take of the Meals of Barly, Beans and Orobus, each two ounces, of Oxymell, one pint; boil them to the consistenee of a Cataplasm, but it will be more effe∣ctual, if you add the Meal of Lupines, Myrrh, Aloes and Wormwood.

But if it be wholly corrupted it must be cut off, or in a falling of the Womb it must be bound by degrees harder and harder, till at length it falls off, of which Operations Schenkius has collected many Observations.

In the whole course of the Cure, Corroboratives must be us'd, and emollient cleansing and cooling Glisters must be frequently injected.

CHAP CIII. Of a Dropsie and Inflation of the Womb.

THE Inflation and Dropsie are confounded by al∣most all Authors, but they are to be distinguish'd; for there is a certain Inflation of the Womb which ought not to be call'd a Dropsie, viz. when the Womb is inflated and stretch'd suddenly by Wind rushing in, upon which account a violent pain is occasioned, as it hap∣pens in the Cholick; and, therefore, if this Inflation does not last long, it does not deserve the name of a Dropsie; such an one is often in hysterick Diseases.

Wherefore, a Dropsie of the Womb is twofold; one from Wind, which is like a Timpany; another, from a watry Humour, which is like the Dropsie of the Belly: Some add a third, from Phlegm.

And first of Wind, contain'd in the cavity of the Womb. Sennertus mentions an observation in a Woman, That when she thought she was with Child and about to be deliver'd, evacuated a great quantity of Wind, and her Belly presently asswag'd. He also mentions Observations of great quantities of Water, contain'd in the cavity of the Womb.

But Authors testifie, That Water is sometimes con∣tain'd in Bladders, and excluded in them, and sometimes a Dropsie of the Womb is complicated with being with Child, as Fabricius Hildanus relates of his own Wife.

As to the Diagnostick of this Disease, many things are to be inquir'd into; first, how this particular Drop∣sie

of the Womb may be distinguish'd from an universal Dropsie; secondly, how the Species of it may be known, viz. Whether it proceeds from Wind, Water or Phlegm; thirdly, Whether it arise primarily from the Womb, or be occasion'd by the fault of some other part; fourthly, Whether the peccant Matter be contain'd in the cavity of the VVomb, or within the Membranes of it, or in Bladders; fifthly, How it may be distinguish'd from o∣ther Tumours of the VVomb; sixthly, How it may be distinguish'd from being with Child; seventhly, How it may be distinguish'd from a Mola.

As to the first Question, 'tis distinguish'd from an uni∣versal Dropsie; for that in a Dropsie of the VVomb the Tumour possesses more the bottom of the VVomb, but an universal Dropsie extends equally the whole Belly; besides, in a Dropsie of the VVomb, there is not so soon a paleness and wasting of the whole Body, as in an uni∣versal Dropsie, in which also most commonly there is considerable Drought, and dryness of the Tongue, but not in a Dropsie of the VVomb; and also in this, all the Symptoms are much milder, and the hardness when 'tis from VVind, or the fluctuation when 'tis occasion'd by VVater, do not possess so great a space, as in an universal Dropsie. And, lastly, in a Dropsie of the VVomb, wind breaks out by Intervals, or a little water flows out, which manifestly shew, that wind or water is contain'd in it.

To the second Question we answer in the following manner: The Species of a Dropsie in the VVomb are thus distinguish'd; if it be occasion'd by wind, the bottom of the Belly sounds, being struck; there are pricking pains in the belly, which sometimes run through the Diaphragm, Stomach, Loins, Navel and other parts; and sometimes the wind does evidently break through the Neck of the VVomb, and the VVomen perceive the VVomb to rise up often to the Stomach like a Ball; breathing is sometimes difficult, the Disease grows worse upon eating or drinking, and they often belch, and are better after it, and they are often troubl'd with Mother-fits: They sometimes perceive a pain in the region of the Hypogaster, so that they can't bear an Hand laid upon it; these Signs are also in an inflation of the

Womb; but there is this difference, for as we said be∣fore, an inflation is but for a small space, but a Dropsie from wind continues much longer.

But if a Dropsie of the Womb is occasion'd by Water, that Region appears soft and flaccid, for Wind causes a Tension; there is a greater weight in the part, and a sound as it were of Water floating, and Water some∣times drops from the part. And, lastly, if it proceed from Phlegm, there is a greater softness and flaccidity of the part, which daily increases and afflicts the neigh∣bouring Parts, viz. the Hypogaster, the Pubes Perineum and Loins, with an Oedematous swelling.

As to the third Question, if there be Signs of the whole Bodies being ill affected, as by acute or long Fevers, by immoderate Hemorrhagies, by weakness of the Stomach, swellings of the Liver or Spleen, or by other obstinate Diseases of those parts, with which the Dropsie of the Womb began and increased with them, there is good reason to conjecture, That the matter of the Dropsie is receiv'd in those parts; but if when the whole Body is well, such a Tumour happens, and suc∣ceeds particular Diseases of the Womb, as hard Labour, suppression of the Courses, or too large an evacuation of them, or Ulcers and Tumors, we may guess that the Dropsie of the Womb proceeds from them.

To the fourth Question we answer, That the Matter which is contained in the cavity of the Womb, causes a much greater Tumor than when 'tis contain'd within the Membranes.

To the fifth Question we answer, That a Dropsie of the Womb may be distinguish'd from Tumors that pro∣ceed from a Phlegmon or an Erysipelas, because in these there is a Fever and Pain upon the least touching; it may be distinguish'd from a Scirrhus or cancerous Tu∣mour, by the hardness that resists the Finger upon touching.

To the sixth Question we answer, That when a Wo∣man is with Child, the Tumor is not equal and de∣press'd, but thrusts it self out above the Navel. Se∣condly, when a Woman is with Child, after some Months she is better most commonly; but the longer a Dropsie lasts, the worser it grows. Thirdly, in a Wo∣man

with Child, the motion of the Fetus is manifestly felt, after the third or forth Month, which does not hap∣pen in a Dropsie; yet sometimes when a Dropsie arises from Wind, a Palpitation is perceiv'd in the Womb; but it may be easily distinguished from the motion of a Child, because 'tis more equal, and is wont to possess more parts of the Belly. Fourthly, when a Woman is with Child the Breasts swell, but in a Dropsie they grow small.

To the seventh Question we answer, That in a Mola there is a weight felt in the Belly, which is not perceiv'd in a Dropsie of the Womb; and when the sick lye on either side, a weight is perceiv'd, as if a Stone roll'd thither. Moreover, in a Mola there are violent Fluxes of the Courses by Intervals, viz. every third of fourth Month, which does not happen in a Dropsy of the Womb. And, lastly, in a Mola the Breasts swell, and have Milk in them sometimes; but there is no such thing in a Dropsie.

As to the Prognostick, a simple Inflation of the Womb is not dangerous; but if it continue long, it may turn to a Dropsie.

If Wind or Water be contain'd in the cavity of the Womb, 'tis easier cur'd than when 'tis included in the Membranes or in Bladders.

The Cure of this Disease is perform'd in a manner by the same Remedies which are propos'd for the Cure of a Dropsie or the Green-sickness, but some things that are peculiar to this Disease must be added. And first, as to bleeding in a recent Disease occasion'd by an ob∣struction of the Courses, and there being a fulness of Blood, it may be proper, otherwise 'tis injurious.

But Purging is always necessary, and it must be of∣ten repeated; and after sufficient Purging, Aperitives, Diureticks, and such things as move the Courses must be us'd; to which may be added the following.

Take of the Roots of Smallage and Madder, each half an ounce, of the Leaves of Savine, Feverfew and Penny-royal, each one pugil, of the Seeds of Daucus, one drachm; boil them in the Broath of young Pidgeons, and let her take it strain'd in a Morning for many

days, but before she takes the Broath, let her swallow one of the following Pills.

Take of the best Castor, Myrrh and Madder, each half a drachm, of Saffron one scruple, with the juice of Lemons; make nine Pills.

After the use of which Medicines violent Exercise must be us'd, that thereby the Excrements bred in the Bowels and in the habit of the Body may be dissipated; and also, all that which is contain'd in the Womb, the Skins being broken by the violence of the exercise.

And if the Woman vomit easily, 'twill be proper to vomit her twice a Week, whereby not only the Humors flowing to the Womb may be recall'd and evacuated, but also the Skins sticking to the Womb, and some∣times containing a watry Humour, may perchance be broken, and so the ill Humors may flow out.

The following Bolus is very effectual to discuss the Humour contain'd in the Womb.

Take of Mineral Borox half a drachm, of Saffron half a scruple, with the juice of Savin; make a Bolus, to be taken twice a week.

Sudorificks are also very proper in this Disease, for by them the watry Humours contained in the Womb, or the whole Body, may be discuss'd and evacuated.

In the mean while the heat of the Stomach must be strengthened by things taken inwardly, and outwardly apply'd.

And outwardly must be apply'd proper topical Re∣medies to strengthen the Womb, and to discuss the Hu∣mors contain'd in it.

And first, may be prepar'd Fomentations and Baths, made of a decoction of the Roots of Briony and wild Cucumber, of the Leaves of Dwarf-elder, Mercury-elder, wild Marjoram, Calaminth, Wormwood, Rue, Sage, Marjoram, Thyme, Bays, Penny-royal, Mug∣wort, of the Seeds of Broom, Daucus, Cummin, An∣nise, Fennel, Laurel-borries and Juniper-berries, the Flowers of Camomile, Melilote and Rosemary, of which

may be made Bags to be boil'd in Wine, or the fore∣said things may be boil'd in a Lee made of the ashes of the Twigs of a Vine.

But that the foremention'd Fomentations may operate the better, they must be applied before and behind, and the Sick ought to sweat, if she can, in the Bed, or in a Bath.

In a windy Dropsie dry Fomentations are more bene∣ficial with Bags made of Gromwel, Salt, Cummin and Bran, torrefied in a Frying-Pan, and sprinkled with Wine.

After the Fomentation, anoint the Belly with the Oils of Nard, Dill, Rue, Wormwood, and Southernwood, which if they are drawn chymically will be much more effectual.

After you have anointed the Belly apply the Plaster of Laurel-berries, or a Cataplasm of Cow-Dung, Sheeps-Dung, of the Seeds of Smallage, Parsly, Cummin and boiled Hony.

For the same use is commended the Skin of a Sheep newly kill'd, and sprinkled with hot Wine.

Glisters must be also frequently injected made of a Decoction of Wormwood, wild Marjoram, Pennyroyal, Rue, Centory and the like, or with Oils of Rue, Nuts, Dill and White-wine or Mallago-Sack, wherein must be dissolv'd Benedictum Laxativum, Turpentine, Rose∣mary, Hony and the like.

Injections for the Womb may be prepar'd in the following manner, to evacuate the Humours contain'd in it.

Take of the Roots of Asarabacca three drachms, of the Leaves of Pennyroyal and Calaminth each one hand∣ful, of the Seeds of Savine one pugil, of Mechoacan one drachm, of the seeds of Annise and Cummin, each half a drachm; boil them, and in the strain'd Liquor dissolve of Oil of Orrice and of Elder, each one ounce, in six ounces of the Liquor, and make an Injection.

For the same Use Pessaries may be made in the fol∣lowing manner.

Take of Coloquintida and Mechoacan each one dracm, of Salt of Niter half a scruple, with a sufficient quantity of boil'd Hony, make a Pessary. Or,

Take of Elaterium half a drachm, of Figs bruis'd a sufficient quantity, make a Pessary.

When the Inflation is occasion'd by Wine, a Fume made of Nutmegs and conveyed through a Tunnel has done much good.

And in the same case a Cupping-Glass applied to the Navel, with much Flame, discusses Wind powerfully.

But when the Disease is humoral, Issues in the Legs discharge the Filth of the Womb by degrees.

The Bath-waters used inwardly and outwardly, are also very good, if the Body be not very hot.

For the Pain of the Womb, which often afflicts the Sick in this Disease, Amatus Lucitanus commends the Water or Decoction of Camomel, four or five Ounces, of it being taken at a time.

And lastly, if an Inflation happen after Delivery there is no need of any other Cleansing than that of the Womb; but if it does not proceed well, it must be helpt by drawing Pessaries, and by Cupping-Glasses applied to the Thighs, and by other Remedies prescrib'd for the Stoppage of the Courses; and if Wind be the cause, the Fume of Nutmegs above-proposed is very pro∣per.

CHAP. CIV. Of a Falling of the Womb.

FOR the Cure of this Distemper regard must be had to two things; the first is to reduce the Womb into its natural Place, and the second is to strengthen it, and keep it there.

For the Execution of the first, which is to reduce it, if the Womb be quite out or turned, the Woman must first of all render her Urine, and a Glister must be given, if it be necessary, to empty the gross Excrements that are in the right-Gut, that so the Reduction may be the easier perform'd; then place her on her Back, with her Hips rais'd a little higher than her Head, and then foment all that is fallen out with a little Wine and Wa∣ter luke-warm, and with a soft Rag put it up into its proper Place, thrusting back not all at once, but wag∣ing it by little and little from side to side, in case this be too painful, because 'tis already too big and swell'd; anoint it with Oil of Almonds, for the more easie re∣duction of it, being careful as soon as 'tis reduc'd, to wipe off the Oil as much as may be, to avoid a Re∣lapse: But if notwithstanding all this, the Womb can∣not be put up, because 'tis very much inflamed and tu∣mified, which happens when it has been a long time so, without the use of necessary means, during which time it is continually moistned with Urine and other Excrements, which contribute very much to its Cor∣ruption, in this case there is great danger that 'twill gangrene.

Also the second part of this Cure, which consists in the retention of the Womb in its place, and the strength∣ning of it; It will be done by a convenient situation▪ Let the Woman, for this purpose, keep her self in Bed, on her Back, having her Hips a little raised, her Legs something crossed, and her Thighs join'd together, to prevent the falling of it out again; but the best way is to put up a Pessary into the Neck of the Womb, to

keep it firm. There are two or three sorts of them made for this purpose, the Figures of them may be seen in Moriceau's Midwifery; see Page 311.

Take of Oak-Bark two ounces, boil it in two quarts of Fountain-Water, add at the latter end one ounce of Pomegranate-Peel bruis'd, red Roses, Pomegranate-Flowers, each two handfuls, and then add half a pint of red Wine, strain it, and bath the part affected with Flannels dipt in it, in the Morning, two hours before the Woman rises, and at Night, when she is in Bed; continue the use of it 'till the Symptom is quite gone.

CHAP. CV. Of Barrenness.

AS to the Cure of Barrenness, too much Fat must be corrected by an orderly Diet, and by conveni∣ent Evacuation.

Such as are of a robust and manly constitution must be reduc'd to a womanly state by all means; they must forbear strong Meats and Labour, and the Coarses must be forced, and by Bleeding and Purging, and the like, the Habit of the Body must be rendred moist and cold.

If from Distortion, Obstruction, Tumors or Ulcers of the Womb, or from its being shut, Barrenness is oc∣casion'd, proper Remedies must be applied.

If too hot an Intemperies be the cause, it must be corrected, so must immoderate siccity by Milk and Bathing.

But the most frequent Cause of Barrenness is a cold and moist Intemperies of the whole Body, and of the Womb, which the Whites often accompany, and for the Cure in this case, the Whites must be cur'd by the Method prescrib'd in the Chapter for the Whites, and

the following things must be order'd, which are pecu∣liarly proper for the said Intemperies, which may be varied according to the discretion of the Physician, so as that they may heat more, or dry more, according as Hu∣midity or Frigidity exceeds.

And first, the flegmatick Humors, stagnating in the Body, must be evacuated by Medicines that purge, sweat and force Urine; and Revulsion must be made by Issues in the Arms, Neck and Legs, and the prin∣cipal Parts must be strengthned by Treacle, Mithridate, Confection of Alkermes and the like.

Aftewards such things must be us'd as are proper by a specific quality to strengthen the Womb and to help Conception.

Take of the Roots Eryngo and Satyrion candied, each one ounce; of green Ginger candied, half an ounce; of Hazel-Nuts, Pine-Nuts and Pistaches, each six drachms; one Nutmeg candied; of the Seeds of Rocket and Cresses each two drachms; of the Ashes of a Bulls-Pisle, of the Reins of Scinks, and of the Raspings of Ivory each one drachm; of Confection of Alkermes, three drachms; of Diambra and sweet Diamoch each one ounce and an half; of Ambergrise half a drachms, with the Syrup of candid Citrons, make an Electuary; let her take the quantity of a Nutmeg at Bed-time, drinking upon it a Glass of good Wine.

Some count the Secondine of a Woman dried and powder'd very effectual, one drachm of it being taken. The Seeds of Bishop's Weed is also much com∣mended.

Many good Authors affirm, That if a Woman drink six ounces of the Juice of Garden-Sage with a little Salt, the fourth Day of her menstrous Purgation, and a quar∣ter of an hour after has Conversation with her Husband, she will infallibly conceive: And by the use of this Remedy, Aetius says, the Egyptian Women became fruitful after a great Plague.

Topicks are also to be used, but purging must always go before.

Take of Diaphenicon and Hierapicra, each half an ounce; of Turpentine and Mercurial Hony, each one ounce; of Castor one drachm: Mingle them, and reduce them to a convenient consistence, that Pessaries may be made for the Womb.

If the Womb abound with a great quantity of Excrements, a stronger Pessary may be made in the following manner: But this injection must be first used.

Take of the Leaves of Wormwood, Mugwort, Mercury and Rue, each one handful and an half; of the Pulp of Coloquintida one scruple; of Agarick trochiscated, half a drachm; of Ginger and Myrrh each one scruple▪ Make a Decoction in Water and White-Wine to a Pint, in which dissolve two ounces of Hony of Roses: Let three ounces of this Decoction be injected for three or four days, morning and evening, after the Flux of the courses; and afterwards immit the following Pessary.

Take of Hiera picra and of Benedictum Laxativum, each one ounce; of the Pulp of Coloquintida and of Agarick trochiscated, each half a drachm; of Spike∣nard and of the Seeds of Roman Nigella, and of the Leaves of Savine powder'd, each one drachm: let them be incorporated with Rosemary-Hony, and put them up in Silk, and make Pessaries; let one be put into the Privities at Bed-time, and let it remain there two hours; afterwards let the part be washed with White-wine.

To bind, strengthen and dry the Womb the follow∣ing Medicines may be us'd.

Take of round Birthwort, half an ounce; of Wood of Aloes, three drachms; of Cypress-nutts, and of the Roots of Cypress, each two drachms; of sweet-smel∣ling

Flag, one drachm; of the Leaves of Dittany of Crete, and of Savory and Myrtles, each one handful; of choice Myrrh, Storax Calamit and Benzoin, each two drachms and an half; of the Flowers of Stechas, Rosmary and Marjoram, each one pugil: Boil them in a sufficient quantity of good White-Wine; in a pint of the strain'd Liquor dissolve of the Troches of Alipta moschata two drachms; of Ambergreese and of Musk, each seven grains; of Civet five grains: Make an Injection Morning and Evening, hot, for some Days.

Before or after the Injection the following Fume may be used.

Take of the Troches of Gallia and Alipta moschata, each two drachms, of Storax Calamit, Benzoin and pure Labdanum, each half an ounce; of Wood of Aloes and of Rhodium, each one ounce; of the Seeds of Roman Nigella, Cubebs and Cloves, each four scruples, of Amber and Tacamahaca, each one drachm and an half; of Mace half a drachm: Make a Powder, and with Gum Tragacanth dissolv'd in Orange-flower-water, make Troches; whereof let one or two be cast upon the Coals, and let the Fume be received through a Tunnel.

Poor People may be fumed with equal Parts of Myrrh, Franckincense, Wood of Aloes, Storax, Benzoin, Cinnamon and Cloves. After the Injections and Fume the following Pessary may be used.

Take of Frankincense and Mastick, each two drachms; of the Troches of Gallia and Alypta Moschata, each four scruples; of the Roots of Bistort, of Cypress-Nuts, shavings of Ivory and of red Roses, each one drachm; of Storax, Benzoin and Labdanum, each two scruples; of sweet-smelling Flag and Cyprus, each half a drachm: Moisten them with Orange-Flower-Water, and with a fine Rag make two Pessaries of a due magnitude, whereof let one be used at Bed-time, the top of it being anointed with Oil of Nutmegs and Civet mixed.

Before the strengthning Injections and the Fumes, the Sick may use the following Bath.

Take of the Roots of Briony, Masterwort, Valerian, Orris, Elecampane; each three ounce; of the Leaves of Marjoram, Mugwort, Catminte, Pennyroyal, Mer∣cury, Sage, Lawrel, each four handfuls; of the Ber∣ries of Lawrel and Juniper, each one ounce: Boil them for a Bath.

But sulphurous and Bituminous Baths are the best, as our Bath-waters, and the like, to which such Women fly as to an Asylum.

After the Bath and Fume, the Region of the Pubes and Perinoeum must be anointed with the following Liniment.

Take of Nard-oil, one ounce and an half; of Oil of Wall-flowers, half an ounce; of Diambra and Di∣mosh, each one drachm and an half; of liquid Sto∣rax, one drachm; of Civet half a scruple; of Musk and Ambergrise, each six grains: with a little white Wax make a Liniment, wherewith anoint the said Parts, and anoint within with Civet, or with natu∣ral Indian Balsam.

Lastly, let Plasters be applied to the Perineum and the Loins, and let rhem be worn continually.

Take of the Plaster for the Matrix four ounces, of the Plaster of Mastick two ounces; of Gum Tachamacha and Caranna, each one ounce; of the Powder of the Roots of Tormentil and Bistort, each three ounces; of the Powder of Myrtles two drachms; of Aroma∣tic Rosat, four scruples; moisten them with Oil of Quinces, and with a drachm of Oil of Nutmegs, spread two Plasters upon Leather, the one round for the Pubes, and the other square for the Loins.

CHAP. CVI. Of Miscarriage.

MIscarriage is the Exclusion of an imperfect or un∣ripe Child, and consequently a Child dead in the Womb is not said abortive till it is excluded; so that whether alive or dead Child be brought forth not being ripe, nor having attained to the just growth in the Womb, it is to be termed abortive.

The causes of Abortion are some Internal, some Ex∣ternal; the Internal may be reduced to four Heads, viz. to the Humors, to the Child, to the Womb, and to the Disease of the Mother.

The Humors may occasion Abortion, when they offend in quantity or quality.

They offend in quantity, either by way of excess or defect.

The quantity is excessive in a Plethora; for there being more Blood than is requisit to nourish the Fetus, it flows into the Veins of the Womb, and is excluded like the monthly Courses, and so the Child comes away with it.

There is too small a quantity of the nutritious Hu∣mor when the Child's nourishment is by any means les∣sened, as by Fasting, whether volunary or forced; and when Women with Child nauseat all sorts of Food, or vomit it up again: Likewise, by reason of a thin Diet in acute Diseases, or by an immoderate evacuation of Blood: Likewise, by reason of extream leanness of the whole Body.

In respect of the Child, Abortion may happen if it be over great, so that it cannot by reason of its bulk be contained in the Womb; and for this reason little Wo∣men often miscarry, especially if they are married to Men bigger than ordinary, whose Children grow very great, and find not in the Womb a space large enough to contain them, till they come to their perfect growth;

also, plurality of Children may occasion Abortion, as when two or three, or more, are contained in the Womb at one time.

The Womb it self occasions Abortion, if it be not large and capacious enough to widen it self sufficiently according as the Child grows, or if there be any thing preternatural in the Womb, as an Inflammation, a Scirrhus, or Imposthume, or the like; or if the Womb be over moist and slack, so that it cannot contain the Child so well as it ought to do.

Abortion comes two ways from the Diseases of the Mother: First, when her Diseases are communicated to the Child, whereby it is killed or so weakned, that it cannot receive due nourishment nor growth; such are continual Fevers and Agues, the French Pox, and many such like. Secondly, when the said Diseases of the Mo∣ther cause great Evacuations, or great Commotions of the Body; as large Bleeding from what part of the Body soever, Fluxes of the Belly, grievous Swooning, Fal∣ling-sickness, Vomiting and a Tenesmus, which above all other Diseases is wont to cause Abortion.

External Causes which further Abortion, do some of them kill the Child, others draw away it's nourish∣ment, and others dissolve those Bands wherewith the Child is fastned to the Womb.

The Child is killed by great Commotions of the Mind, as by Anger, Sadness, Frights, and the like; by Meats earnestly longed for, and not obtained; by strong purging Medicines, by things that provoke the Courses, and by those things that expel the Child, and by such things as are reckoned by a Specifick Quality to destroy the Child in the Womb, by abominable Smells; espe∣cially the stink of a Candle ill put out.

Violent Exercise dissolves the Bands that fasten the Child to the Womb; as Dancing, Running, Riding, Jolting in a Coach or Cart, carrying or lifting from the Ground a heavy Weight, a violent Fall, a Blow on the Belly, vehement Motion of the Belly, by Cough∣ing, Vomiting, Looseness, Sneezing, Convulsions, Crying-out, immoderate or over-wanton Embraces, and in a word, vehement motion of the Arms, the turning a Wheel, or doing some such work, may exceedingly pro∣mote Abortion.

The Signs of present Abortion are manifest of them∣selves; but such as go before Abortion, and prognosti∣cate the same, are these: An unusual heaviness of the Loins and Hips, an unwillingness to stir, Appetite gone, shivering and shaking coming by Fits, pain of the Head, especially about the Roots of the Eyes, a straitening of the Sides and Belly above the Navel, the flagging or fall∣ing, and extenuation of the Dugs; but if frequent pains, and almost continual Torment, the Reins and Loins reaching towards the Share, as far as the Os sacrum, with endeavours to evacuate the Womb, certainly the Woman will shortly miscarry.

If from violent external Causes, such as are a Blow, a Fall, and the like, vehement Pain and Perturbation arise in a Woman with Child; she ought to keep her Bed three days or longer.

As to the Prognosticks, Women are more endangered by Abortion than by a true and timely Birth, because it is more violent and unseasonable; for as in ripe Fruit, the Stalks are loosened from the Boughs, and the Fruit falls off of it self; so in a natural Birth, the Vessels and Ligaments wherewith the Child is tyed to the Womb are loosened and untyed, as it were, of their own ac∣cord, which in Abortion must needs be vioiently bro∣ken asunder. Abortion is most dangerous in the sixth, seventh and eighth Month.

Our ordinary Women say, A miscarrying Woman is half with Child again.

The Cure of Abortion consists in Preservation; for that which is past, cannot be helpt: But all the Sym∣toms which follow Abortion, are the same which ac∣company Women duly brought to bed.

The preservation from Abortion consists principally in these two things; the one concerns the Woman be∣fore she is with Child, and the other when she is with Child.

Before the Woman is with Child, all Indispositions of the Body, which are wont to cause Abortion, must be removed; as fulness of Blood, ill Humours, and pecu∣liar Diseases of the Womb, viz. Intemperies, Swellings, Ulcers, and the like.

Fulness of Blood opens the Veins of the Womb, or strangles the Infant while it is in the Womb; this, if it be a pure and simple Plenitude, may be cured by Blood-letting, such as shall answer the quantity of Blood su∣perabounding.

A Cacochymy is either Cholerick, and partaking of Acrimony, so as to open the Orifices of the Veins, or by provoking Nature; it stirs up the expulsive Faculty, whereby the Child comes to be expelled with those ill Humours; or it suffocates the Child, by reason of plen∣ty of Excrements heap'd together in the first Region, and distending the Belly; or it vitiates the Blood in the whole Body, rendring it unfit to nourish the Child; or it fills the Vessels of the Womb which retain the Child, with a slymy moisture.

Bleeding may be also used for this Cacochymy, in a small quantity; but the chiefest way of Cure is by fre∣quent Purging, that the superfluous Excrements of the Body may be evacuated; and betwixt Purge and Purge, such things must be used as asswage the Intemperies of the Bowels, and the Acrimony of the Humors if there be any, and thicken the said Humors, in case they be too thin, and if flegmatick Humors abound, they must be discussed with Sudorificks and Diureticks, and other Remedies; howbeit, we must diligently observe, that whatever ill Humors abound, Issues are very proper to prevent Abortion; of which Zacutus Lusitanus gives a special note in these words: By most happy Experiments I have observed, That frequent Abortion caused by corrup∣ted Humors, which flow from the whole Body to the Womb, and by their evil disposition or abundance kill the Child, is hereby, as by a most present help, prevented; many Wo∣men have miscarried on this account, among whom some having oftentimes brought a Child of seven Months, or four Months growth, torn and putrified, cou'd by no other means be freed from so great a Calamity, save by Issues made in their Arms and Thighs, which were always made at the beginning of the Fluxion; by which means they went out their time, and brought forth Children healthy, and not defiled with any Infection.

The peculiar Diseases of the Womb, as over-great Moisture, Swellings, Ulcers, and such like, must be cured by their proper Remedies.

If these Diseases happen when a Woman is with Child, the difficulty is greater, because big-bellied Wo∣men cannot so easily bear all kind of Remedies; yet, lest being destitute of all help, they should remain in extream danger of Miscarriage and Death, some kind of Remedies are to be used.

In case, therefore, the Patient be too full of Blood, she must have a Vein opened, tho' she be with Child, especially in the first Months, and so twice or thrice if need be, always remembring that there never be much Blood taken away at a time.

And when there is abundance of some ill Humors, gentle Purging must be repeated, especially in the mid∣dle Months; and if a moist and flatulent, or slymy In∣temperies annoy the Patient, we may sometimes proceed to a Sudorifick Diet, at least a gentle one, in the strong∣est sort of Women.

In the mean while, these astringent and strengthening Medicines are to be used all the time the Woman is with Child, that are proper to hinder Abortion.

Take of Kermes-berries and Tormentil-roots, each three ounces, of Mastich, one drachm and an half; make a Powder, of which give now and then half a drachm, or as much as will lie on the point of a Knife.

Or, Take of red Coral, two drachms, Kermes-berries, Date-stones, each one drachm, shavings of Ivory half a drachm, of Pearls not bor'd, one scruple; make a Powder.

Or, let her take every day in the morning, some grains of Mastich.

Our ordinary Women use frequently Plantain-seed, which they take in the morning to the quantity of half a drachm with Wine and Water, or in an Egg, or Broath, or by it self, almost every day, all the while they are with Child, and with good success.

To the same purpose, very effectual Electuaries are compounded, according to the following Example.

Take of Conserve of Roses, two ounces, of Citron-peel candied, six drachms, of Myrabolans candied, of the pulp of Dates, each half an ounce, of Coral prepared, Pearl prepared, and shavings of Hartshorn, each one drachm, with syrup of Quinces; make an Electuary, of which let the Patient take often the quantity of a Nutmeg.

If a Liquor be more pleasing, a Decoction of Tor∣mentil-roots sweet'ned with Conserve of Roses, may be given successfully.

The following Lozenges are very good; for they strengthen, and by little and little free the Body from Excrements, though they do not sensibly purge some∣times.

Take of Mace, of the three sorts of Sanders, Rhubarb, Sena, Coral, Pearl, each one scruple, of Sugar dis∣solved in Rose-water, four ounces; make all into Lo∣zenges, weighing three drachms apiece. Let her take one twice a week by it self, or dissolved in a little Broath.

Ointments and Plasters are to be applied outwardly.

Take of Ship-pitch, half an ounce, of Frankincense one ounce, Mastich half an ounce, Dragons blood and red Roses, each two drachms; make a Cerecloath.

Or, Take of Oil of Myrtles and Mastich, each one ounce, of red and yellow Sanders, Hypocistis and Aca∣cia, each half an ounce, of Spodium and red Roses, each two drachms, of Bole-armonick, seal'd Earth, Ivory, each two scruples, of Turpentine washed in Plantain-water, one ounce, with a sufficient quantity of Wax; make a Cereloath, spread it on Cloath, and apply it to the Reins,

Or, Take of the Plaster for the Matrix three ounces, of Bistort-roots, Acacia, Hypocistis, Pomgranat-peels, each half an ounce, of Labdanum, six drachms; soften them with the juice of Quinces, and make a Plaster for the use aforesaid.

As to Plasters it is to be noted, That they must not be worn long together, but taken off now and then; otherwise, if they stick too long upon the Back, they do so heat the Kidnies, that sometimes they occasion an heat of Urine, and the voiding by Urine Sand, Stones, yea Blood it self.

Nor are those things to be omitted, which are accounted Specificks for retaining the Child in the Womb, as the Eagle's stone worn about the Neck, a Load-stone applied to the Navel, Corals, Jaspers, Smaragds, Bones found in the Hearts of Stags, and such like, worn under the Arm-pits or hanged about the Neck.

But that the success of these Medicines may be good, the Patient must be ordered to rest, and to keep her self as quiet as possibly she can, both in Body and Mind, and to abstain from Coition, which does much disquiet the Womb; for whilst the Womb opens it self to re∣ceive the Semen, with which it is much delighted, it drops out the tender Fetus, not yet well setled in the Womb.

But if notwithstanding the Medicines aforesaid, by reason of the vehemency of the Cause, whether it be external or internal, the Patient be ready to miscarry, we must do the best we can with these following Re∣medies. And, in the first place, so soon as Pains and Throws shall be perceived to be in the lower parts of the Belly, towards the Pubis, in the Loins, and about the Os sacrum, we must seek to allay and stop them, both by Medicines taken inwardly, and outwardly ap∣plied, according to the variety of the Causes; for if Abortion be caused by Crudities and Wind (which is most usual when it begins from an internal Cause,) a Powder must be given, made of Aromaticum Rosatum

and Coriander-seeds; and we may give of the Aqua Imperialis, if Phlegm and Wind abound.

At the same time let Carminative Medicines be ap∣plied below the Navel of the Patient; such are, Bags of Anniseeds, Fennel-seeds, Fenugreek-seeds, Flowers of Camomile, Elder, Rosemary and Stechas mixed together; or a Rose-cake fried in a Pan with rich Ca∣nary, and sprinkled with Powder of Nutmegs and Co∣riander-seeds, or the Gaul of a Wether newly kill'd, or his Lungs laid on warm,

If by these means the pains cease not, let a Glister be injected made of Wine and Oil, wherein two drachms of Philonium Romanum may be dissolved, or Narco∣ticks may be given inwardly in a small quantity, to al∣lay the violence of the Humors and Wind, as we are wont to do in the pains of the Cholick.

But if by reason of contumacious pains that will not be asswaged, or of the violence of some external cause, Blood begins to come away, Medicines that cause Re∣vulsion are to be applied to turn the course of the Blood from the Womb; such are, Frictions of the upper parts and painful Ligatures, also Cupping-glasses fastened to the Shoulder-blades under the Dugs, and under the short Ribs on both sides; and if the Woman be full of Blood, it will not be amiss to take some blood from her, when she begins to void blood, and especially before it be∣gins to come; and the blood must be taken away at se∣veral times, a little at once.

And if the flux of blood continues, we must pro∣ceed to an astringent and thickening Diet and Medi∣cines, and so the Powders and Electuaries before de∣scribed may be administred; also juice of Plantain new drawn, and syrup of Poppies to the quantity of an ounce, with Powder of Bole-armenick or Dragons-blood.

Also binding and astringent Fomentations may be used outwardly, made of Pomgranate-peels, Cypress-nuts, Acorn-cups, Baclaustins, Grape-stones and the like boiled in Smiths water and red Wine.

Or a little bag full of red Roses and Balaustins may be boiled, and applied hot to the Patient's Belly.

The above-mentioned Plasters and Cere-cloaths may be used; and to bind more, make a Pultiss of astrin∣gent Powders, with Turpentine and whites of Eggs, spread it upon Tow or course Flax, and apply it to the Navel and Reins warm: The Tow that is to be applied to the Navel must be moistened with Wine, that which is to be apply'd to the Kidnies, with Vine∣gar. The two following Medicines are accounted Se∣crets, and it is believed they will certainly retain the Child in the Womb, if they be used before it be torn from the Vessels of the Womb.

Take of Leaves of Gold, number twelve, of Spodium one drachm, the Cock's treading of three Eggs not addled; mix all very well, till the Gold be broken in∣to small pieces, afterwards dissolve them in a draught of white Wine, and give it three Mornings follow∣ing.

At the same time let the following Cataplasm be applied.

Take of Male-frankincense powdered, two ounces, the whites of five Eggs; let them be stirr'd together over hot Coals; add Turpentine to make them stick, then spread them upon Tow, and lay them upon her Navel as hot as she can possibly endure them twice a day, Morning and Evening, on the three days afore∣said.

CHAP. CVII. Of hard Labour.

THAT is said to be hard Labour which does not observe the due and ordinary course of Nature, and longer time is spent in it, and the pains are more violent than usual, and the Symptoms that accompany it are more grievous.

Many Causes may be assigned of it, both external and internal: The internal depend on the Mother, the Womb or the Child.

As to the Mother, the natural weakness of the whole Body may make the Labour difficult, or her Age, she being too young or too old, or it may be occasioned by Diseases which she had with her Big-belly, Leanness and too much dryness of the Body, or Fat compressing the Passages of the Womb; the ill conformation of the Bones encompassing the Womb as in those that are Lame, may also occasion it, Wind swelling the Bowels, a Stone, or a preternatural Tumour in the Bladder that presses the Womb, may be the cause; so may the ill constitu∣tion of the Lungs, or of the parts serving Respiration: For the holding of the Breath is very necessary to help the exclusion of the Child.

As to the Womb, various Diseases of it may render the Delivery difficult, as Tumors Ulcers, Obstructions, and the like.

As to the Child, hard Labour is occasion'd, when by reason it is dead or putrified, or any way diseased, it cannot confer any thing to its own exclusion: Also, when the Body or Head of it is large, or when there are many.

So Twins most commonly cause hard Labour, or when it is ill situated, as when the Hands or the Feet offer first, or when one Hand or one Foot comes out, or when it is doubled, or when the Membranes break too soon, so that the Water flows out, and leaves the Orifice of the Womb dry at the time of exclusion, or

when the Membranes are too thick, so that they cannot be easily broken by the Child.

The external causes depend on things necessary and contingent; things necessary are those which are com∣monly call'd Non-natural; so cold and dry Air, and a North-wind are very injurious to Women in Labour, because they bind the Body, and drive the Blood and Spirits to the inner Parts, and they are very injuri∣ous to the Child coming from so warm a place; also, hot Weather dissipates the Spirits, and weakens the Child, and causes a Fever in an ill habit of Body. Crude Aliments and such as are difficultly concocted, and those that bind, taken in great quantity before Labour, do render it difficult, the Stomach being weakened, and the common Passages contracted, which ought to be very open in this case.

Drowsiness hinders the action of the Mother and Child, and shews that Nature is weak. The unseason∣able motion of the Woman much retards the delivery; as when she refuses upon occasion to stand, walk, lie or sit, or flings her self about unadvisedly, so that the Child can not be born the right way, being turned pre∣posterously by the restlesness of the Mother.

The retention of such things as should be evacuated at the time of Labour, as of Urine that swells the Bladder, or Excrements in the right Gut; the Hemor∣rhoids also much swelled, narrow the neck of the Womb, and so hinder Natures endeavours.

And, lastly, violent Passions of the Mind, as Fear, Sorrow and Anger, make the Labour difficult.

To things contingent ought to be referred, a Blow, a Fall or a Wound, which may much obstruct Labour; also, the By-standers, which ought to assist the Woman, viz. strong Women and Maids, which may lift her up just at the time of Delivery, especially a skilful Mid∣wife, which ought to advise in every matter, for if she be unskilful she may make the Labour difficult: For sometimes the Midwife orders the Woman to endeavour an Expulsion, and to stop her Breath when the Liga∣ments of the Fetus stick firmly to the Womb, so that the Woman is tired before the time of her Delivery.

Difficult Labour is known, both by the Woman, by the By-standers, and especially by the Midwife. And, first, if the Woman continue a long time in Labour, viz. two, three, four or more days, whereas a natural Birth is finished in 24 hours. Another Sign of difficult Labour is languid pains, returning at long Intervals; also, the pains tending backward rather than forward: But the Causes of difficult Labour may be known by the Womans Relation, and most commonly upon sight. So the weakness of the Woman, or leanness, or over∣fatness, may be seen by the habit of Body. The Di∣seases of the Womb may be known by their proper Signs, the weakness of the Child by the weak and slow motion of it: But the signs of a dead Child may be known by the following Chapter. The bigness of the Child may be judged of by the stature of the Parents, especially if a gigantick Man be married to a dwarfish Woman: But when there are none of these Causes, and the Womans and Childs endeavours are strong, and yet the Labour is difficult, it is a sign that the Secundine is so strong, that it cannot be easily broken, and this will be confirmed if no water or moisture flows out in La∣bour. The preposterous figure of the Fetus may be perceived by the Midwife, and other things, as has been said, by sight.

As to the Prognostick, difficult Labour is of it self dangerous, and sometimes the Woman, and sometimes the Child, and sometimes both are extinguished.

If a Woman continue in Labour four days, she will hardly escape.

Sleepy Diseases and Convulsions coming upon hard Labour, are most commonly deadly.

Sneesing coming upon hard Labour, is good.

As to the Cure of hard Labour: First, all those things which retard it must, as much as may be, be re∣moved; afterwards, Medicines that further Labour must be methodically administred.

And first, it is common with Women to give a spoon∣ful or two of Cinnamon-water, or Cinnamon pow∣dered with a little Saffron, or half a drachm of Con∣fection of Alkerms in broath, or half a scruple of Saf∣fron alone in some broath, or every hour in a little VVine.

Or, Take of Oil of sweet Almonds and of white Wine, each two ounces, of Saffron and Cinnamon, each twelve grains, of Confection of Alkermes, half a drachm, of syrup of Maiden-hair, one ounce and an half; mingle them, make a Potion.

If these things are not sufficient, the following may be used, which I have frequently found very effe∣ctual.

Take of Dittany, of Crete, and both the Birthworts, and of Troches of Myrrh, each half a scruple, of Saffron and Cinnamon, each twelve grains, of Confection of Alkermes, half a drachm, of Cinnamon-water half an ounce, of Orange-flower-water, and of Mugwort-water, each one ounce; make a Potion.

Oil of Ambar, of Cinnamon, and extract of Saf∣fron are very effectual in a small quantity, viz. five grains of extract of Saffron, four or five drops of Oil of Cinnamon, twelve or fifteen drops of Oil of Ambar, in VVine, Broath, or some other Liquor.

Sneesing hastens Delivery; it may be provoked by the following Powder.

Take of white Hellebore, half a drachm, of long Pepper, one scruple, of Castor, five grains, make a Powder; let the quantity of a Pease, be blown up into the Nostrils.

But difficult Labour must be helpt, not only with inward Remedies proposed, but also with external; let the Midwife, therefore, frequently anoint the VVomb with the Oils of Lillies, sweet Almonds, Linseed and the like; and let the Belly be fomented with an emol∣lient decoction of the Roots of Marsh-mallows, Lillies, the leaves of Mallows, Violets, Mugwort, of Linseeds, Fenugreek-seeds, of the flowers of Camomile and Me∣lilot.

Sharp Glisters are to be injected, by the irritation of which the expulsive faculty of the VVomb will be sti∣mulated,

and the Guts being emptied thereby, there will be more room for the VVomb.

Anoint the Navel with Oil of Ambar; and such things as are thought to help Delivery by a specifick quality are to be used, as the Eagle's-stone, the Load-stone, Storax, Calamint and the like bound to the Hips; and if the Woman has any Gems about her, as in Rings or the like, they must be pull'd off; for many Women think, that such things retain the Child by a specifick Quality. If the Child seem to be weak, it must be re∣freshed, by giving strengthening things to the Mother, as hot Wine, Confection of Alkermes, Cinnamon-water, and the like.

If the Child begins to come forth preposterously, as with one Arm, or first with the foot, or the like; the Midwife must thrust them back, and turn the Child right, which may be done by placing the VVoman in a Bed upon her back, with her Head low, and her feet high; and then force the Child gently into the VVomb, and then the Midwife must endeavour to turn it right, viz. to turn the Face towards the Mothers back, and the Buttocks and Legs must be elevated towards the Mothers Navel, and so she must hasten a legitimate Birth.

But all hopes of Delivery being past, or the Mother being near Death, some Authors propose the Cesarian Section, whereof Franciscus Rossetus wrote an excellent Treatise, wherein he endeavours to shew, by many Ar∣guments, that it may sometimes succeed: But because this operation is dangerous, and very terrible, it ought rarely or never to be attempted by a prudent Physician, if he values his own Reputation.

CHAP. CVIII. Of a Dead Child.

WHen the Child is dead the Motion of it ceases, which either the Mother felt before in the Womb, or the Midwife with her Hand; a greater sense of weight with Pain afflicts the Belly; when the Woman turns from side to side, she perceives the Child fall like a Stone from one part to another, the Belly feels cold, the natural Heat being extinguish'd, and the Spirits dissipated, which were contained in the Child; the Eyes are hollow, the Face and Lips pale, the ex∣tream parts cold and livid, the Breasts flaccid, and at length, the Child putrifying, a fetid Ichor and Sanies flows from the Womb, an ill and strong smell exhales from the Woman's Body, and her Breath stinks: If the Secundine be excluded before the Fetus, it is a certain Sign that the Child is dead.

The whole Cure consists in the exclusion or extraction of the Child.

Take of the Leaves of Savin dryed, of the Roots of round Birthwort, of the Troches of Myrrh, and of Castor, each one drachm; of Cinnamon half a drachm; of Saffron one scruple: Mingle them, make a Powder, whereof let her take one drachm in Savin Water.

In the mean while apply to the Pubes, Privities, and Perineum an emolient Decoction.

After the Fomentation anoint the Parts with the Oint∣ment de Arthanita, and let a Pessary be put up the Privities.

Take of the Roots of round Birthwort, Orris, black Helebore; of Coloquintida and Myrrh, each one drachm; of Galbanum and opopanax, each half a drachm: With Ox-Gall make a Pessary.

It is also proper, if the Strength be sufficient, to give a Purge.

Angelus Sala says, That he has used with very good success Mercurius Vitae in this Case, four or five grains at a time, and that it does powerfully exclude a dead Child, and is better than other Remedies: But it must be used with great Caution, because it is a violent Medicine.

If after having tried Medicines a long while, the Child cannot be ejected, Chirurgical Operation must be used, that is perform'd either by Instruments or by the Hand alone,

CHAP. CIX. Of the Secundine retained.

IN a Natural Birth the Secundine is wont most com∣monly to be excluded presently after the Child, yet sometimes it is retained, whereby the Life is much en∣dangered.

The internal causes of this Retention are too great a thickness of the Coats, so that they stick firmly to the sides of the Womb, the swelling of them, by an afflux of Humors occasioned by hard Labour, and the shut∣ting of the Mouth of the Womb after the exclusion of the Fetus. The external causes are, coldness of the Air, whereby the Secundine is expelled, and the ori∣fice of the Womb shut; certain Perfumes, whereby the Womb is allur'd upwards; violent Passions of the Mind, as fear and sudden Frights; the perversness of the Woman, who will not abide in such a position, or use such Endeavours as are requisite; the weight of the Child, whereby the Navel is broken, the Secundine remaining within; the unskilfulness of the Midwife, who cuts the Umbilical Vessels too soon, or does not hold them in her left hand as she ought, for if they are let go they are drawn back into the Womb, and are

hid there with the Secundine, whereas it ought they serve for the extraction of the Secundine.

It is easie to be known when the Secundine is re∣tained in the Womb; but sometimes a piece of it is separated and remains in the Womb, which is not so easily found; yet it may be known, for that the Womb after delivery endeavours to eject something: But tho' its endeavours are but small, a sense of Heat and Pain is perceived in the Womb, and after a few Days a ca∣daverous Smell exhales from the Womb.

The retention of the Secundine is very dangerous, and if it continues some Days, an acute Fever, Nause∣ousness, Fainting, difficulty of Breathing, Coldness of the extream Parts, Epileptick and Hysterick Fits, and at length Death follow.

The Secundine retained is expelled by the same Re∣medies which were proposed for a dead Child, to which may be added some Specificks delivered by Authors.

Gesner and Augenius commend much the Testicles of a Horse cut in pieces, and dried in an Oven, as much of the Powder of them as may be contained with three Fingers, being taken in Chicken-Broath, and it may be repeated twice or thrice upon occasion.

Rulandus says, He has given, with success, thirty Drops of the Oil of Juniper.

Some order the Woman to bite an Onyon three or four times, and to swallow the Juice, and presently after to drink a small draught of Wine, by which she may be soon relieved.

Forestus mentions a Widwife who received the follow∣ing Secret from a Jewish Physician; He took the Leaves of Green Lovage, and pressed out the Juice with good Rhenish-Wine, and gave a Draught of it.

Angelus Sala commends Mercurius Vitae, as before in a dead Child.

To these things may be added Sneezing-Powders, Fomentations, Liniments and other things both external and internal, described above for difficult Labour. The following Decoction has been very succes∣ful.

Take of Vinegar of Roses four or five quarts, of the Leaves and Berries of Bayes, each three handfuls; one Rose-Cake cut in pieces: Boil them, and with the Decoction, hot, wash the Hips and Legs from the Groin to the Feet for a long while. To this Deco∣ction may conveniently be added of Myrrh and both the Birth-Worts, each one ounce.

But among other things the Hand of a skilful Sur∣geon may do much, before the Inflammation and Infla∣tion are increased; for so the Secundine may be gently drawn out, and the Woman freed from all the Sym∣ptoms and Fatigue of Medicines.

If the Secundine cannot be ejected by any means, but sticks firmly to the Womb, and putrifies there, Suppuratives must be injected, mixed with things that cleanse, that that which is putrified may be drawn out by degrees; to this purpose, Rondoletius commends Ba∣silicon, especially being dissolv'd in the following De∣coction.

Take of the Leaves of Mallows, with the Roots three handfuls; of the Roots of both the Birth-worts, each six drachms; of Flax-seeds and Fenugreek-seeds, each half an ounce; of Violets one handful; of the Flowers of Camomel, and the lesser Centaury, each half an handful: Make a Decoction in Water, mingle Oil with it, if you would have it suppurate much; but if you more design to cleanse, add a little Ʋnguentum Aegyptiacum.

CHAP. CX. Of a Suppression of the Child-bed Purgations.

THere is so great a Flux of Humors from all parts of the Womb, when a Woman is with Child, and during the Commotion in her Labour, that in case there be not afterwards sufficient Evacuation of them, the Woman is in great danger of very ill Accidents, and sometimes of Death it self; because these Humors cor∣rupting by their stay there, will certainly cause a great Inflammation: And this is the reason why the Suppres∣sion of the Lochia is one of the worst and most dan∣gerous Symptoms which can befal a Woman after Deli∣very, especially if they happen to be totally and sud∣denly stopt the first three or four days, which is the time they should come down plentifully; for then follow an acute Fever, great Pains in the Head, Pains in the Breast, Reins and Loins, Suffocation of the Mother, and an Inflammation, which is suddenly communicated to the Belly, which becomes very much swell'd and blown up; there happens also a great difficulty in Breath∣ing, Choakings, Palpitation of the Heart, Fainting, Convulsions, and often Death it self, if the Suppression continues, and if the Woman over-lives it, she is in dan∣ger of an Abscess in the Womb, and afterwards of a Cancer, or there may happen great Imposthumes in the Belly, also the Gout, Sciatica and Lameness, or an In∣flammation and Abscess in the Breast.

The Causes of the Stoppage of the Lochia proceed either from a great Loosness, because a great Evacu∣ation that way turns the Lochia, and makes them stop, or any strong Passion of the Mind; so do great Colds, and cold Drink.

To bring the Lochia well down, let the Woman avoid all Perturbations of Spirit, which may stop them; let her lie in Bed with her Head and Breast a little raised, keeping her self very quiet, that so the Humors may be carried downwards by their natural

tendency: Let her observe a good Diet, somewhat hot and moist, and apply an Hysterick Plaster to her Navel.

Take of the Conserves of Roman Wormwood and of Rue, each one ounce; of the Troches of Myrrh two drachms; of Castor, English Saffron, Volatil Salt of Sal Ar∣moniack and of Assa Fetida, each half a drachm: with a sufficient quantity of the Syrup of the five opening Roots; make an Electuary. Let her take the quantity of a large Nutmeg every third Hour, drink∣ing upon it three or four spoonfuls of the following Mixture.

Take of the Water of Penny Royal and Balm, each three ounces; of compound Briony-Water two ounces; of Syrup of Mugwort three ounces and an half; of Saffron two drachms; of Castor tied up in a Rag and hanged in the Glass, one scruple; mingle them.

If these things are used presently upon the Suppres∣sion, they generally take it off: But if they have been used so long that all the quantity is taken, and the Lochia are still stopt, in this case we may use Lau∣danum for once, but it is best to mix it with hysterick things: For instance,

Take of liquid Laudanum sixteen drops, in a spoonful of compound Briony-water: Or,

Take of solid Laudanum one grain and an half; of Assa Fetida one scruple and an half: Make two Pills.

But it must be carefully noted, that if upon once tak∣ing the Business is not done, Opium by no means must be repeated again: But having waited a while to see what it will do, we must return again to Emmenagoges mix'd with Hystericks, and afterwards we must Inject a Glister: But what was said before of Opium is also to be taken notice of in respect of Glisters; for unless the

first bring down the Lochia, nothing is to be hoped for from more.

These things therefore being done, it is safest, and the duty of a prudent Physician to wait and see what Time will do; for every Day the Danger will lessen, and if the Sick live over the twentieth Day, she will be in a manner out of Danger; for then she will be able to bear that Method, which is fittest to conquer the Diseases which were occasioned by the Suppression of the Lochia.

CHAP. CXI. Of After-Pains.

PAins happen so frequently to Women in Childbed, that few are free from them; but they seldom re∣quire the Physicians help, because they usually cease in two or three Days: But if they are sharp and continue longer, they are forced to send for Physicians, who before they prescribe ought to enquire into the causes of the Pains.

The chief Causes therefore of Pains after Labour are a great quantity of Blood, the Thickness and Acrimony of it, and the Narrowness of the Vessels; for when the Veins of the Womb have ceased to evacuate Blood for nine Months; and when that is heaped up in a great quantity, and also grows thick and acrimonious by it's long stay, it occasions Pain while it passes through the narrow Passages, which returns by Intervals, as often as the Womb endeavours the Evacuation of the Blood▪ And when that is over, the Pain ceases till more Blood endeavours to come out.

These Pains are also sometimes occasioned by Wind, or cold received into the Womb; but the Pain seldom happens from these Causes

This Pain is distinguished from other Pains, that are wont to afflict the Belly, by the continuance or Inter∣vals, which follow the Evacuation of Blood, and Wo∣men can easily distinguish them themselves.

The thick Blood easily coagulates, but the thin is known by its thinness and fresh colour.

If the Pain arises from Wind, it is more wandring, and possesses more parts of the Belly, nor does it follow the Intervals of the Evacuation of Blood: If cold Air be admitted into the Womb, it may be known by those things which have been done about the Woman.

These Pains are not dangerous, but are most com∣monly very troublesome, and therefore are to be taken off or asswaged as soon as may be.

As to the Cure, the Vessels of the Womb must be re∣laxed, and the thickness of the Blood attenuated, and its Acrimony qualified, all which may be done by the following means.

And first the Woman's Belly must be gently swathed, that it may subside and not move hither and thither, as it often happens after Delivery, upon so sudden an eva∣cuation, and then give of Oil of Almonds fresh drawn three ounces, mixed with an ounce and an half of Syrup of Violets.

And Glisters may be injected made of Milk and Su∣gar, and Yolks of Eggs; or they may be prepared of a Decoction of Camomel-flowers, and of Mugwort in Chicken-broath, adding to them Oil of Lillies and Yolks of Eggs.

And the Belly of the Woman must be anointed with Carminitive and Aperitive Oils, as with Oil of Dill, Rue, Jasmin, or with the following, which is very effe∣ctual, which may be prepared for this use in due sea∣son and kept in the Shops.

Take of the Roots of round Birth-wort, of Orris and Peony each one ounce, of Cyprus half an ounce, of the dried Leaves of Mugwort, Feverfew, wild Mar∣joram, Calaminth, Pennyroyal, Dittany of Creet, of Wormwood, Savin, Rue, Bettony and Sage, each one handful, of the Flowers of Rosemary, Stechas, Lavender, Camomel, Dill, S. John's Wort, Elder,

each half an handful, of the Grains of Lawrel and Juniper, each half an ounce, of Cummin, the Seeds of Rue, Peony, Daucas, of the Chast Tree, each three drachms, of Cloves, Nutmegs, Cinnamon and Gin∣ger, each two drachms, of Storax and Myrrh each one ounce: Bruise them and cut them, and infuse them in three quarts of old Oil, adding a litte White-Wine; keep them in an earthen Vessel, well stopt, for the space of a Week, then boil them upon hot Ashes four or five hours, then press out the Oil, and keep it for use. If you have it not ready pre∣pared, you may boil the Simples upon occasion with equal parts of Oil and White-Wine, to the consum∣ption of the Wine, afterwards press out the Oil.

A Fomentation may be also made of a Decoction of Mugwort, Feverfew, Baulm, of the Leaves of Bays and Calaminth, of the Seeds of Daucas, Cummin and Caraways, of the Flowers of Wall-flower and Camo∣mel made in Water and White-Wine, or in Milk: Or the following Cataplasm may be applied.

Take of Onions boil'd in Water number three or four, bruise them in a Mortar, and add to them of the Seeds of Cummin and Flax bruised, each one hand∣ful: With a sufficient quantity of the Flowers of Camomel and Barly-meal, make a Cataplasm; and if there be occasion, add a little of the Water wherein the Onions were boil'd: Spread it upon a cloath, and apply it hot to the Navel.

It is also proper to cover the Belly with a Sheep's-skin fresh flea'd off, and applied hot, for the Heat of it is very agreeable, it eases the Pain, and keeps the Belly from wrinkling. And the following things may be taken inwardly.

Take of the Seeds of Daucas powdered one drachm, of White-Wine three ounces: Mingle them and give it twice in a day. Or,

Take of Nutmegs, Aniseeds and Cinamon, each one scruple: Mingle them, make a Powder, give it with White-wine, or one scruple of Oil of Nut∣megs with Broath.

Forestus used the Flowers of Camomel in Beer, or a Decoction of Camomel and Mugwort in Chicken-Broath with good Success.

It is good presently after Delivery to give the Broath of an old Cock early in the Morning fast∣ing, for three Days, with a little Cinnamon and Saffron.

The following Powder taken presently after De∣livery, preserves the Woman from Pain, in a won∣derful manner; and some think if a Woman takes it the first Lying in, she will never be troubled in Child-bed with these kind of Pains.

Take of Comfry dried one drachm, of the Kernels of Peach-Stones, and of Nutmegs, each two scruples, of Ambar half a drachm, of Ambergrise half a scruple: Make a Powder, whereof let her take a drachm with White-Wine, and if there be a Fever with Broath.

Let her use for her ordinary Drink a Decoction of Mugwort and Cinnamon.

When the Pains arise from Cholerick and Acrid Humors, they must be cured in a manner the same way as the Cholick, occasioned by Choler. For in∣stance,

Take of Syrup of Violets and of Borrage, each one ounce, of the Mucilage of the Seeds of Quin∣ces, extracted with Violet-Water half an ounce, of Borrage, and Scorzonera-Water, each three ounces; mingle them, make a Julep for two Doses: Or,

Take of Oil of Sweet Almonds two ounces, of Syrup of Violets one ounce, of Borrage Water half an ounce: Mingle them for one draught.

External Medicines that loosen and mollifie the Passa∣ges must be applied.

Child-bed Women after Delivery are often troubled with a Pain in the Groin; it may be taken off by ap∣plying a Plaster of Galbanum and Assafetida to the Navel, in the middle whereof some grains of Musk must be placed.

CHAP. CXII. Of the Acute Diseases of Women in Child-bed.

THE Fever from Milk, whilst the Child-bed Pur∣gations proceed right, seldom lasts beyond three Days, for about that Time it usually goes off, by a great Sweat coming of its own accord: But this In∣temperies occasioned by the coming of the Milk is somewhat heightned, and continues longer, when the Milk flows plentifully to the Breasts, and is not milkt out, but repelled: For by its going back as well as its coming, there is a Disturbance in the whole Body usually, which comes more certainly, if the Milk be driven violently back by Repelling To∣picks.

Some common Rules are to be observed concern∣ing the Coming of the Milk, or in driving of it back.

If the Milk flow too freely into the Breasts, that the Inflammation of them, and the immoderate Efferve∣scence of the Blood may be prevented, a thin and spare Diet must be ordered, viz. of Broath without Flesh, and the Breasts must be often sucked, and if it be not thought convenient that the Woman should give Suck,

it is customary on the First or Third day of Lying-in, to apply over the Breasts moderately Astringent Cere-cloaths: But this kind of Remedy must be used with Caution, lest the Milk should be Excluded altogether, or too hastily, and so cause a disorder in the Blood, and a putrid or malignant Fever, of which we shall speak next.

Women with Child, by reason their Bodies are ill affected, are as it were infected with a Pestilential Contagion, and so are very subject to a putrid, or rather malignant Fever. This Fever seizes Child-bed Women at various Seasons, and upon several Occasions; some∣times presently after Delivery, especially if it has been difficult and hard; sometimes on the first, sometimes on the second, third, or fourth Week; but the later it begins, the better it goes off. It begins and proceeds, most com∣monly, in the following manner: After a previous Indi∣sposition the Fever begins most commonly, with a Sha∣king and Shivering, which Heat presently follows, and after that Sweat; the first or second day fits of Heat and Cold succeed one another, and then all the Blood being inflamed, the Lochia, if they were not suppressed before, flow but little, or quite stop. If the Disease be acute and of quick motion, it comes to its height the third or fourth day; the Heat is violent, and the Thirst very much, the Pulse vehement and quick, Watchings obstinate, there is great Restlessness, so that the Sick tumble from one side of the Bed to the other continually, the Urin is thick and red, and there are many other grie∣vous Symptoms; when this Fever is in its State, no Cri∣sis is to be expected; for I never saw this Disease go off by a critical Sweat; for when the Blood has a while Boyled, the adust Matter being presently translated to the Brain, dangerous disorders of the Genus Nervosum are occasioned, and convulsive motions of the Tendons, and inflations of the Bowels, like Mother Fits, and sometimes a Phrensie, or Delirium, and often a Stupo•• and loss of Speech follow, and the Strength is suddenly dejected, almost in all, without any manifest Cause; the Pulse is weak and unequal, and the Sick soon die: And if any chance to escape, the flux of the Courses being restored, or a Loosness happening, they recover diffi∣cultly after a long Sickness.

The acute Diseases of Women in Childbed, are not always according to the manner of the fore-mentioned Fever, but sometimes they are accompanied with some great Symp∣tom, as with a Quinsie, Pleurisie, Peripneumonia, Bloo∣dy-flux, Small-pox, and the like. Of these a Quinsie, Pleurisie, and Peripneumunia, by reason of the great similitude of the Cause and analogy of the Cure, may be considered together. Presently at their first beginning, we must endeavour, that the Blood fixed any where, and beginning to be Extravasated, be restored to Cir∣culation, lest an Imposthume should be occasioned; wherefore internal Remedies, which free the Blood from Coagulation, must be used, of which sort are Diaphore∣ticks abounding with Volatile Salt, as Spirit of Harts-horne and Soot, Urin, also Testaceous, and Bezoartick Powders, Lapis Prunella, Decoctions and Juleps, made of Vegetables that force Urine and the Courses; with all which must be mixed such things as have been found by Experience to have been proper for Uterine Diseases. Moreover Discutient Medicines, which disperse the Mat∣ter Impacted, such are Liniments, Fomentations and Cataplasms, must be carefully applied to the Parts af∣fected: In the mean while the violent Motion and im∣moderate Effervescence of the Blood must be driven far from thence, and the Filth must be driven, as much as possible, downwards. To this end Frictions, Ligatures, Epispasticks, and if there be occasion, Cupping-glasses must be applied about the Legs and Feet; if the Disease be very violent, Bleeding is indicated, and unless there be a Plethora in the whole Body, and the Inflammation be very acute in the Part affected, it will be best to open a Vein in the Foot, or to apply Leeches to the Hemor∣rhoidal Veins: But if necessity urge we may Bleed in the Arm, and afterwards, if it can be admitted, in the Foot. But you must take notice, that Bleeding must be cautiously used in these Cases; for unless it does good, which I have seldom found, the Sick is in worse con∣dition, the Pulse being thereby rendred weaker.

A Dissentery is very often deadly, and so much the rather because such things as qualifie the Blood, and that moderately bind are Indicated; but the flux of the Lochia forbid the use of them. Wherefore in this case

till she has been well Purged by a long flux of the Lo∣chia, the fierceness of the Symptoms must at present be only appeased.

The Indications of the Small-pox are not only con∣trary to those above-described, but also to one another; for the flux of the Lochia must be moderately restrain∣ed; but in the mean while the Efflorescence of the Blood and gentle Sweating must be continued: For seeing a twofold venomous Ferment is in this Disease, and the corrupt Particles of the Blood are to be carried out two ways, we must take care that the least and narrowest Passage do not draw all the Matter, or more than it can let out. Wherefore, lest the Lochia flowing plentifully should turn inward the Venom that is inclined to go off by Sweat, the course of Diet must be somewhat chan∣ged, and first such things as are of an Alexipharmick and astringent nature must be boyled with their Broaths, as the Roots of Tormentil and Bistort, also Powders, Juleps and Electuaries endued with such Vertues must be given at due Intervals; and in this case the Woman must be no ways allowed Flesh, or the Broath of it, not must she Rise, but she must be kept as quiet as is possible, and the whole Business must be left in a manner to God and Nature.

All Women in Child-bed have an inbred Venom, and they ought to be careful of it, and to avoid it as much as the greatest Malignity. Wherefore they ought to use an exact course of Diet, whereby the Impurities of the Blood and Humours may be purged in Child-bed with∣out the danger of a Fever; and that the disorders of the Womb may be heal'd, and their strength, weakned by De∣livery, may be restored: To which end three things are to be minded; First, An exact course of Diet must be or∣dered, viz. That they be fed for a Week at least with Water-Gruel, sometimes made with Beer, sometimes made with Water mix'd with Whitewine, or with Pa∣nada, and other things of easie Digestion. Secondly, They must take great care that they do not catch Cold, whereby the Pores and the Lochia may be stopt; where∣fore let them continue in Bed, at least till the Tenth day. Thirdly, The Lochia must be gently provoked; to this end Midwives, when after hard Labour, there is

danger of a stoppage of the Lochia; give Sperma Caeti, Irish Slates Powdered, or White Wine tinctured with Saffron, and they make the Gruel with Water and White Wine, wherein, as also in Posset Drink, they Boyl Marygold Flowers, the Leaves of Penny-royal or Mug∣wort.

CHAP. CXIII. Of Childrens Diseases. Of ordering them; and of the Choice of a Nurse.

A Child, which during the stay in its Mother's Belly, had no other Nourishment, but the Blood it recei∣ved by the umbilical Vessels, hath for want of that after its Birth, need to take some by the Mouth, and Suck Breast-Milk; however, it is not good to give it Suck, as soon as it is Born, to prevent that so sudden a Change, as well in respect of the difference of Nourishment, as the manner of receiving it, lest it cause some alteration in its Health. First therefore empty the Phlegm out of its Stomach, by giving it the first three or four days some Wine and Sugar to cut and loosen it, to prevent the Milk he shall take from Corrupting, it being mixed with this viscous Phlegm; wherefore it is best to stay until the next day before you give it Suck.

It were to be wished that the Mother shou'd not give it Suck until the Eighth day of her Child-bed at soonest, and it is best if she stay three Weeks or a Month, for in that time she will be well Purged by the Lochia, and the Blood will be much more pure; besides the small holes of the Nipples are not at first sufficiently opened, and therefore it is necessary for a Woman to Suck first.

But often poor People cannot observe so many Pre∣cautions, and such Mothers are obliged to give their Children Suck from the first day; and likewise others will not suffer any but themselves to do it. In this case let her Breasts be a little drawn by some old Woman,

or some lusty sucking Child, or they may Draw them themselves.

If the Nurse has much Milk, she must not give the Child any thing else, at least the first two Months. As to the quantity of Milk the Child ought to suck, it must be proportionable to his Age and Strength; in the beginning he must not suck too much, nor too often, af∣terwards by little and little let it be daily augmented, until he may take his fill; but he may suck at any time night or day.

After the Child has suck'd two or three Months, more or less, according as one finds he needs stronger Nou∣rishment, give him then Pap made of Flower and Milk, though but little at first, and not too thick, lest his Sto∣mach may be overcharged. When the Child has taken Pap thus made, which must be but once a day, especi∣ally in the Morning, or twice at most, the Nurse may give it a little suck, to the end that being washed down into the Stomach, the Digestion may be the better and easier made.

There are many Women who give their Children Pap as soon as they are Born, and Nurses who have lit∣tle Milk, ordinarily do so to hinder their Crying, as they will do when they are Hungry: But sometimes this of it self is enough to kill them, because of the Indigestion and Obstruction it occasions, which by rea∣son of its gross and viscous consistence can scarce find Passage through the Stomach and Guts, which at the beginning are weak and not sufficiently opened and di∣lated, whereby there happens to Children great Oppres∣sions, difficulty of Breathing, Gripes, Swellings, Pains of the Belly, and often Death. Wherefore do not give it the Child, till after the first or second Month at soon∣est, and if you forbore it three or four Months he would thrive the better, provided the Nurse does not want Milk.

When he is in the Cradle, let it be so turned as it may be towards the Fire, the Candle, or the Chamber Win∣dow, that having the Light directly in its Face, he may not be allured to look continually on one side; for doing so often, his Sight will be so perverted, that he will grow Squint-ey'd. Wherefore for the better secu∣curity,

throw some Covering over the head of the Cradle.

Many Children are so Grip'd that they can't forbear Crying night nor day, and some die so, and this is ve∣ry often the first and most common Disease that happens to little Infants after their Birth.

To remedy all these Pains which Women generally call Gripes, respect must be had to their different Cau∣ses: As to that which is the general cause, viz. The too sudden change of the Nourishment, you must for∣bear giving the Child Suck till the next day, lest the Milk being mix'd with the Phlegm which is in the Sto∣mach corrupt; and at first it must Suck but little until it be accustom'd to digest it, if it be the Maeconion of the Intestines, which by its long stay causes these Pains, for to help to discharge them of it, give them inwardly a little Oyl of sweet Almonds and Syrup of Roses; and to provoke it further, give it beets-Stalk cover'd with Hony for a Suppository, or a Sugar'd Almond also dip'd in common Honey, or you may give a small Glister.

And when the Child is Grip'd, give no Pap, because this Food by its Viscosity, easily causes Obstructions, which afterwards ingender Wind. If the Pain be oc∣casioned by Worms, lay a Cloath dipp'd in Oyl of Worm-wood mix'd with Ox Gall upon the Belly, or a small Cataplasm mix'd with Powders of Rue, Wormwood, Coloquintida, Aloes, and the Seeds of Citrons incorpo∣rated with Ox-gall and Flower of Lupines; and to drive them downwards if the little Infant can take any thing by the Mouth, give it a small infusion of Rubarb, or half an Ounce of Compound Syrup of Succory, ha∣ving before given a small Glister of Sugar'd Milk.

When the Gripes are caused by Wind, as it often happens, or by sharp Humours in the Guts, anoint the Child's Belly all over with Oyl of Violets, or else with Oil of sweet Almonds, or else with the Oyls of Wall∣nuts, Camomel and Melilot, mixed together, having first warm'd them, in which also a Cloath may be dipp'd to lay upon it, and a little Anodyne, or Carminative Glister may be given.

Very frequently the Milk of a Nurse that is red Hair'd, given to Wine, or very Amorous, may by its heat and acrimony, cause small Ulcers in an Infant's

Mouth, which are called Apthae, or the Thrush; and Vulgarly Cancers: Sometimes also though the Milk have no ill Quality in it self, it may however corrupt in the Stomach, because of its Weakness, or for some other In∣disposition.

Of these Ulcers some are benign, as they are caused by a simple heat of the Nurses Milk, or by the Child's Blood and Humours being a little Over-heated, or also from having had a small Fit of a Fever, and they are then very superficial, of a small continuance, and easily yielding to Remedies: Others are Malignant, such as are caused by a Venereal Venom, or that happen after a Malignant Fever, and are Scorbutick; these are putrid, corrosive and spreading, and do not only possess the Supe∣rficies of the Membranes, which cover the Roof of the Mouth and Tongue, but make deep Scabs, and are com∣municated to the internal Parts of the Throat, the Ve∣nereal ones especially, which can never be Cured by or∣dinary Remedies, but must be handled with Specificks, without which they ever augment, and soon kill little Infants, who are too weak to undergo the Remedies fit for their Cure.

To Cure these Ulcers, when they are small and with∣out malignity, you must take care to temper the Nurse's Milk, prescribing her a Cooling Diet; Bleeding and Purging also if there be occasion, and wash the Child's Mouth with Barly or Plantain Water, and Hony of Roses, or Syrup of dryed Roses, mixing with them a little Verjuice, or Juice of Limons, as well to loosen and cleanse the viscous Humours, which cleave to the in∣side of the Child's Mouth, as to cool those Parts, which are already over-heated. This may be done by means of a small fine Rag, fastned to the end of a little Stick, and dipp'd in the Remedy, wherewith the Ulcers may be gently rubb'd, being careful not to put them to too much Pain, lest by irritating them an Inflammation should be caused. The Child's Body must be kept open, that the Humours being carried to the lower Parts, so many Vapours may not ascend, as usually do, when the Ex∣crements of the Belly are too long retained.

If the Ulcers participate of any malignity, let to∣pical Remedies then be used, which do the Business speedily, and as it were in an instant. For this pur∣pose, touch the Ulcers with Plantain-water, sharpned with Spirit of Vitriol, taking great care that the Infant swallows none of it; and the Remedy must be so much the stronger and sharper, as the Ulcers are profound and malignant. As soon as they have been cauterized with this Water, by only touching them once or twice with it according to their bigness, depth or corruption, that no sharp Serosities may destil upon the parts not yet ulcerated, and upon the Infants Throat, wash its Mouth with Plantain-water, or with a decoction of Barly, Agrimony and Hony of Roses, continuing to touch and wash the Ulcers, as it may be judged con∣venient, and until you find they spread no further. To prevent that in the use of these sharp Medicines, not the least portion of them should fall upon the Child's Throat, and that by swallowing of them, you may receive no great prejudice. Some chuse rather to cau∣terize these Ulcers with small Linnen Tents dipt in boiling Oil, and if it should be swallowed, it would be no great hurt. It will not be amiss to punge the ill Humors out of the whole habit of the Child, by giving him half an ounce of syrup of Succory with Rhu∣barb.

The Teeth, which were hidden in the Jaws, usually begin to come forth, not all at a time, but one after ano∣ther, towards the fifth or sixth Month, sometimes soon∣er and sometimes also later; for to effect which, they cut the Gums wherewith they were covered. Then because of the exquisite sense of those parts, there hap∣pens so great pains to the Children, that many who were hitherto very well, are now in great danger of their Lives, and often die by reason of many mischievous Accidents, which happen to them at that time. And Hippocrates says, When Children begin to breed their Teeth, they are troubled with itching of their Gums, Fe∣vers, Convulsions and Loosnesses, and principally when they breed their Tusks or Dog-teeth, especially those Children who are fat, and full of Humors, and bound.

The Dog-teeth, commonly called the Eye-teeth, cause more pain to the Child than any of the rest, because they have a deep Root and a small Nerve, that has com∣munication with that which moves the Eye. The Teeth, which are first bred, are the Cutting or Foreteeth. The Signs when Children will breed their Teeth, are, when the Gums and Cheeks are swelled, they feel a great heat there with an itching, which often makes them put their Fingers in their Mouths to rub them, from whence much Moisture destils into the Mouth, because of the Pain they feel there. The Nurse in giving them suck, finds their Mouths hotter; they are much changed, and cry every moment, and cannot sleep, or but very little at a time. And one may feel and see small points of the Teeth through the Gums, which appear thin and pale on the top, and swelled and red on the sides; and if it happen that the Teeth are a long time 'ere they are cut, or that too many of them cut at a time, there is great danger that the Child will fall into those Ac∣cidents mentioned above. In this case two things are to be regarded; first, to preserve the Child from the ill Accidents that may happen to it, by reason of the great pain: Secondly, to assist as much as may be the cutting of the Teeth, when they can hardly cut the Gums themselves.

To prevent these Accidents, the Nurse must keep a good Diet, and use all things that may cool and temper the Milk, that a Fever may not follow the pain of the Teeth, and to hinder the falling of the Humors upon the inflamed Gums, keep the Child's belly always loose, to which purpose give him a gentle Glister, if the Belly be bound; but there is commonly no need of it: For at this time the Children are usually troubled with a Looseness.

As to the second, which helps the cutting of the Teeth, that the Nurse must do from time to time, by gently rubbing the Childs Gums with her Finger; to which end the Child it felf may be useful, if they give a little Stick of Liquorish to them, or a small piece of a new Wax-candle, which is very good to soften the Gums. Coral is also often used to this purpose, and the Teeth of a Wolf. But these things that are peculiarly proper,

what they do is by their Solidity and Roughness: But if these things do no good, the Gums must be cut with a Lancet to prevent ill Accidents.

As soon as little Infants are in the least indisposed, they very commonly fall into a Looseness, to which their natural moisture very much contributes.

For the most part the Looseness happens to them, by reason of the great Pain they have at the cutting their Teeth: It may also happen by the vitiousness of the Nurses Milk. But if the Looseness be not accom∣panied with a Fever, or some other Accident, it is not dangerous; but if it continue so long, it will not be amiss to remedy it. For this purpose, let the Child suck good Milk, and give it a slight Infusion of Rhu∣barb, or a little compound Syrup of Succory; gentle Anodyn Glisters may be also given, made of Milk, yolks of Eggs, and Hony of Violets; and after Purg∣ing, let them be made with Plantain-water, and mix the yolk of an Egg with the Pap. Anoint the Belly with Oil of Quinces, and lay on the Stomach a Compress dipt in red Wine, wherein Province Roses have been boil∣ed.

Vomiting usually happens to Children, because they often draw more Milk than their little Stomachs can easily contain or digest: A Cough does sometimes oc∣casion it, so does the swathing of the Belly too hard.

When the Vomiting is too frequent, it is fit it should be stopped; to which end, regard must be had to that which causes it, as when the Child sucks more than it should, the Nurse must not give it so much, but it must suck but little at a time, that the Stomach may the easier contain and digest what it receives. If it be oc∣casioned by an ill quality of the Milk, the Nurse must be changed for a better; if from a Cough, it must be helped by things fit to appease it. The Nurse must not dance it rudely, nor rock it fiercely after it has sucked. Care must be likewise taken, that it be not too close wrapt, and swathed about the Stomach. And it will be very convenient to purge the Infant with a gentle Infusion of Rhubarb, or with half an ounce of com∣pound syrup of Succory: And after it has been well

purged, it may take a little syrup of Quinces to fortify the Stomach, and a Compress dipt in red Wine, where∣in Province-roses, Cinnamon and Cloves have been boiled, may be applied to the region of the Sto∣mach.

Children are sometimes afflicted with Scabs in the Head and Face, but the course of these Humors must by no means be hindred by driving them inwards; be∣cause their Evacuation defends little Infants from many ill Diseases; and we ordinarily see them, whose Bo∣dies have a long time purged away such Superfluities, to be better in health, after they have cast forth all this kind of Corruption. But Endeavours must be only used to hinder the generation of more of these ill Hu∣mors in the Child; wherefore, a healthy Nurse must be provided, whose Milk is pure and cool, the Child's Belly must be kept open, and purged upon occasion with a little syrup of Roses or of Succory, that so the Humors may not be sent in too great abundance to the Head, and that the Sanies under the Scabs may not eat and corrode the Skin, and so cause deep Ulcers; it will not be amiss also to make the Scabs fall off, that there may be a freer vent or issue; for which end, fresh But∣ter is ordinarly made use of to moisten them, or Oil of sweet Almonds; afterwards, apply a Cabbage-leaf, and change it twice or thrice a day.

As to the choice of a Nurse, the first and principal of all the Qualities in a good Nurse, is, That she be the own Mother of the Child, as well because of the mutual agreement of their Tempers, as that having much more love for it, she will be much more careful than an hired Nurse, who ordinarily loves her Nurse-child but with a feigned and seeming Love, hav∣ing no other end or foundation, but the hope of the Re∣compence she expects for her Hire. Wherefore the true Mother, though not the best Nurse, should ever be pre∣ferred before a Stranger. But because there are several that either will not, or cannot suckle their own Child∣ren, there is a necessity to provide an other Nurse, which should be chosen as convenient for the Child, as may be.

Now as we see Trees produce Fruits of a different Taste, by reason of the difference of the nourishment, so the Health of Children, and sometimes their Man∣ners depend on the nourishment they receive at the be∣ginning. For as to the health of the Body, it is well known, it answers the Humors that all the Parts are nourished and maintained with, which Humors ever retain the nature of the Food whereof they are engend∣red: As for the Manners, they ordinarily follow the Temperament, which also proceeds from the quality of the Humors, and the Humors from the Food. By this consequence, as the Nurse is, so will the Child be, by means of the nourishment it draweth from her; and in sucking her, it will draw in both the Vices of her Bo∣dy and Mind. This appears very easily in Animals that suck a strange Dam, for they always partake some∣thing of the Creature they suck; being accordingly, either of a mild or fiercer Nature, or of a stronger or weaker Body, which may be noted in the Example of young Lions, tamed by sucking a domestick Animal, as a Cow, a Goat or Ass; and, on the contrary, a Dog will become more furious or fierce if it sucks a Wolf.

The necessary Conditions of a good Nurse are usu∣ally taken from her Age, the time and manner of her Labour, the good constitution of all the parts of her Body, and particularly of her Breasts, from the good Nature of her Milk; and, in fine, from her good Manners.

As to her Age, the most convenient is from twenty five to thirty five years of Age, because that during this space the Woman is most strong, healthy and vigorous: She is not fit before five and twenty, because her Body not having yet acquired all its dimensions, cannot be so robust; nor after thirty five, because not having Blood enough in so great abundance, she cannot have Milk enough for the nourishment of the Child. How∣ever, some Women are indifferent good Nurses from twenty to forty, but very rarely before or after.

As to the time and manner of her Labour, it must be at least a Month or six Weeks after it, that so her Milk

may be throughly purified; because, at that time, her Body is usually cleansed of the Lochia, which follows Labour, and the Humors are no longer disturbed with it; nor must it be above five or six Months, that so she may be able to make an end of Nursing the Child, that there may be no necessity to change her afterwards for another. She must not have miscarried, but have been brought to Bed at her full time of a healthful Son, for it is a mark of a good Constitution; and it must be her second or third Child, that she may by experience know the better how to tend her Nursery.

As to the healthful Constitution of her Body, 'tis the principal thing, and on which almost all the rest de∣pends.

In general, she must be very healthful and of a good habit, not subject to any Distemper; that she be come of Parents that never had the Stone in the Reins and Bladder, nor subject to the Gout, King's-evil, Falling-sickness, or any other hereditary Disease; that she hath no spot, nor the least suspicion of any venereal Distem∣per; that she have no Scab, Itch, Scald, or any other filth of the like nature; that she be strong, the better to watch and tend the Child in all things necessary for it; that she be of a middle Stature, neither too tall nor too low, too fat nor too lean, because a Person of such a natural Symmetry performs all the Functions more perfectly, and as is usually said, In medio consistit Virtus. But above all, she must not be with Child: Let her be of a sanguine Complexion, which may be known by her Vermilion Colour, not altogether so red, but inclining to white; of a firm Flesh, not soft; she must not likewise have her Courses, for that is a Sign that her Blood is too hot, either because her Tempera∣ment is such, or from an amorous Passion, or other∣ways; neither must she be subject to the Whites, for such Superfluities are a Sign of a bad habit; she must not be red haired, nor marked with red Spots, but her Hair must be black, or of a Chesnut brown: She must be well shaped, neat in her Cloaths, and comly in her Face, having a sprightly Eye, and a smiling Counte∣nance: She must have good Eyes, sound and white

Teeth, not having any rotten or spoiled, lest her breath should smell; she ought to have a sweet Voice to please and rejoice the Child, and likewise ought to have a clear and free Pronunciation, that he may not learn an ill Accent of her, as usually red-haired have, and some∣times also that are very black-haired and white Skins; for their Milk is hot, sharp and stinking, and also of an ill Taste: She must not have a strong Breath, as they who have a stinking Nose and bad Teeth, as we have said before, because the Nurse that constantly kisses the Child, would infect its Lungs by often drawing in her corrupted Breath: Her Breasts ought to be pretty big, to receive and concoct there a sufficient quantity of Milk, but not big to excess; they must be sound and free from Scars proceeding from former Impostumes; they must be indifferent firm and fleshy, and not flaggy and hanging: The Nurse must be broad-breasted; as to the Nipples they must be well shaped, they must not be too big nor too hard, nor gris∣ly, nor sunk in too deep, but they must be a little rai∣sed and of a moderate bigness and firmness, and with many little holes, that the Child may not take too much Pains to draw the Milk.

The quantity of the Milk must be sufficient for the Child's nourishment, it must be of a middle consistence, neither too waterish nor too thick, which may be easily judged, if the Nurse milking some into her Hand, and turning it a little on one side, it immediately runs off; but if it remains fixed, without running by turning of the Hand, it is a Mark it is too thick and viscous. As to the colour, the whitest is best; it must taste and smell sweet and pleasant.

The Nurse must not be subject to Choler nor be quarelsome; she must not be melancholy, but merry and chearful, smiling often to divert the Child: She must be sober, not given to Wine, and yet le•••• to the excess of Venery; but she may moderately use the first, and not totally abstain from the second, if her Nature requires it.

If a Nurse has all, or most part of these Conditions here specified, as well respecting her Person as Manners, and that she maintains this condition by a Diet fit for the Childs Temperament, and not contrary to her own, there is then great reason to believe she is fit to make a very good Nurse, and to bring up, in perfect Health, the Son of a Prince.

CHAP. CXIV. Of the Rickets.

THIS Disease began about fifty years ago in the West of England: It is a Disease of Children, and it seizes them when they are about half a year old.

The Diagnostick of this Disease, as of all others, depends upon the knowledge of the Symptoms, which follow.

The proportion of the parts is irregular, viz. the Head is bigger than ordinary, so is the Face, the Wit is sharper than is usual at such an Age, the external Mem∣bers, especially the Muscular, are thin and wasted, the Skin is loose and flaccid, the Bones most commonly bowed, and about, the Joins sticking out and knotty, the Spine is variously bent, the Breast is narrow and sharp, the extremity of the Ribs knotty, the Belly some∣what swelled and stiff. These things are observed out∣wardly.

As to the inner Parts, the Liver is larger than usual, so are all the Parenchyma, the Stomach and Bowels are larger than in those that are well, the Mesentery is af∣fected with Glandules that are larger than ordinary, if they are not Scrophulous; these things are observed in the Belly.

In the Breast the Lungs are stuffed and swelled, they are sometimes purulent and scrophulous, and often stick to the Pleura, the jugular Veins and the carotid Arteries

are sometimes larger than they shou'd be, but the Brain is only peccant in bigness.

To these are added a weakness of almost all the parts and unwillingness to move, for such Children will play only sitting and do not care to stand, and at length in progress of the Disease, the Head can scarce be sustain'd by the weak neck.

As to the Prognostick of this Disease, most commonly 'tis not deadly; but sometimes the Symptoms growing to a heighth, it degenerates into a Consumption, Hectic Fever, Dropsie of the Lungs or an Ascitis, and so at last is deadly; but the Prognostick may be easier insti∣tuted by the following Rules.

First, if this Disease invades before the Birth, or presently after, 'tis very dangerous, and most common∣ly deadly.

Secondly, the sooner it comes the worse 'tis.

Thirdly, the more violent the Symptoms are, viz. if the Parts are very much disproportion'd and much wasted, the Cure is the more difficult.

Fourthly, if this Disease is accompanied with the foresaid Diseases, it can scarce ever be cur'd.

Fifthly, those that are not cured before they are five years of Age, are ever after sickly.

Sixthly, an Itch coming upon this Disease, much con∣duces to the Cure.

Seventhly, in those the Symptoms are not increased, but rather lessened, the Cure need not be doubted.

As to the Cure, we must begin with Purging, because most commonly there is abundance of slegmatick Hu∣mors heapt up in the Belly, and the Bowels are fre∣quently affected with scrophulous Tumors; but Purging is to be instituted by Glisters, Vomits and lenitive Ca∣tharticks.

The use and forms of some Glisters.

If the Belly be bound, or the Bowels are troubl'd with Wind or Gripes, Glisters must be us'd frequently, which must not be only solutive, but sometimes alterative and corroborative. For instance:

Take of the leaves of Mallows, one handful, of the flow∣ers of Melilot, Camomile and Elder, each one pugil,

of the seeds of Annise and Fennel bruis'd, each half a drachm; boil them in a sufficient quantity of new Goat's Milk, to four, five or six ounces of the strain'd Liquor; add of red Sugar and of syrup of Violets and Roses, each one ounce: Make a Glister, inject it warm a good while after Eating.

Take of the roots of Marshmallows bruis'd, half an ounce, of the leaves of Mallows and Pellitory, each half an handful, of the flowers of Camomil and El∣der, each one pugil, of the Carminative seeds, two drachms; boil them in a sufficient quantity of Posset-drink to 5 or 6 ounces of the strained Liquor; add of Lenitive Electuary, or of Diacassia half an ounce, of fresh Butter six drachms; mingle them, to be inje∣cted warm.

Corroborative Glisters may be made in the follow∣ing manner.

Take of fresh Stone-Horse dung, one ounce and an half, of the flowers of Rosemary and Sage, each one pugil, of Juniper-berries, two drachms, of the seeds of An∣nise, Fennel, each half a drachm; infuse them close and warm in a sufficient quantity of Whey, in four ounces of the strained Liquor, dissolve one ounce of brown Sugar and six drachms of fresh Butter; min∣gle them, make a Glister: There may also be added, if it seem convenient, six drachms of Manna.

Take of Millepides washed number 20 or 30, bruise them, and pour upon them 4 or 5 ounces of Posset-drink made of white Wine, in the strained Liquor dissolve an ounce of brown Sugar, and a drachm of Venice-Turpentine dissolved in the yolk of an Egg; mingle them, make a Glister to be injected warm.

The use of Vomits and Forms of them.

If the Stomach be burthened with vitious Humors, and they tend upwards, Vomits must be given; but in the prescription of them, respect must be had to the tender Age, and they should consist rather of Salt of

Vitriol and the Wine of Squills, than of stibiat Medi∣cines; for it is not so safe to give these to Infants for fear of Convulsions, though sometimes they may be of use.

Take of Wine or Oxymel of Squills, half an ounce or an ounce, which being taken, give half an hour af∣ter a great quantity of Posset-drink, and provoke Vomiting with the Finger, and let it be repeated now and then. Or,

Take of Oxymel of Squills, half an ounce or an ounce, if it does not vomit in half an hour, give of Salt of Vitriol half a scruple or fifteen grains, in a draught of Posset-drink.

If the Strength will bear stronger Vomits, let them be used. As,

Take of the Infusion of Crocus Metallorum well clari∣fied by standing, one or two drachms, according to the Age and Strength, of Oxymel of Squills three drachms or half an ounce, of simple Walnut-water, or of the water of the lesser Centaury, six drachms; mingle them, make a Vomit.

Forms of Catharticks.

Some days after Vomiting, or if Vomiting be not to be used, gentle Purging must be instituted, and repeat∣ed by Intervals. As,

Take of the Augustan syrup, or of syrup of Succory with Rhubarb, six drachms or an ounce, of Cream of Tar∣tar ten or fifteen Grains, mingle them, let them be taken early in a morning, either by themselves or in a draught of Posset-drink. Or,

Take of Calabrian Manna, half an ounce or an ounce, of Tartar vitriolated five or ten grains, mingle them, let them be taken in a morning in broath or in Pos∣set-drink.

Take of the roots of Polypody of the Oak, and of sharp pointed Dock each six drachms, of the bark of the roots of Elder, and of Dwarf-elder, each half an ounce, of the roots of flowering Fern, male Fern and Succory, each half an ounce, of the herbs Agrimony, Liverwort, Speedwel, Hartstongue and Spleenwort, each half a handful; boil them in three pints of Fountain-water to the consumption of a third part, strain the Liquor into a matrass, and put to it two ounces of Senna, one ounce of Rhubarb, of Dodder, of Thyme and yellow Sanders, each two drachms, of the seeds of Annise and Fennel, each one drachm, of salt of Wormwood, one drachm and an half; infuse them hot in a close Vessel 12 hours: To the Liquor, cleared by standing, add an equal weight of Sugar, and by gentle boiling make a syrup. The dose is one, two or three spoonfuls, either by themselves, or in some proper Liquor.

Or to the above-mentioned purging Infusion, add of Cassia and Tamarinds extracted, with part of the same Infusion of Manna strained and of the best Sugar, each one ounce and an half; evaporate them over a gentle heat to the consistence of an Electuary. The Dose is the quantity of a Nutmeg, more or less, as it works.

Take of the Species hiera picra simple, one drachm, of the best Rhubarb powder'd half a drachm, of Tartar vitriolated ten grains, of Gum Ammonieum dissolved in Vinegar fifteen grains, with a sufficient quantity of Elixir Proprietatis, of Paracelsus, make a mass for Pills, of which half a scruple or a scruple may be made into Pills, and taken at Bed-time.

A Bochet made of Rhubarb and yellow Sanders, in convenient distilled Waters, may be used.

If the Sick be affected with Worms or the King's Evil, or if there be any suspicion of the King's Evil, the following Bolus may be given by Intervals.

Take of Mercurius Dulcis, from six to ten grains, Rosin of Jalap, or of Scammony two or four grains, of the chymical Oil of Juniper, one drop; make a Pow∣der, which may be made into a Bolus with the pap of a roasted Apple, or a drachm of the Conserve of Vio∣lets; let it be taken early in the morning. Or,

Take of Mercurius Dulcis, six or ten grains, of the Conserve of flowers of Succory, half a drachm; mix them, make a Bolus. Let it be taken early in the morning, drinking presently upon it a sufficient dose of the purging Infusion or Syrup.

Chyrurgical Remedies.

After gentle Purging, if the Sick be of a sanguine Constitution, Blood-letting is of use. Our Empericks use to draw a small quantity of Blood by scarifying the lobe of the Ear; which operation they rather per∣form with a blunt Knife, than with a sharp Lancet; and they repeat it twice or thrice, intermitting about the space of 7 days. Altho' Practitioners greatly praise this way by Scarification, I do not know but Leeches may be more effectual. Neither do I think it is to be fear'd that the sucking of Leeches should cause a greater afflux of Blood to the Head. For whatever Blood is drawn to the part by their Sucking, is also evacuated by it; and as to the greater afflux of Blood, by reason of the emptying of the Vessels, the same happens in bleeding by the Lancet.

Issues are also very effectual in this Disease, especi∣ally an Issue made between the first and second Verte∣brae of the Neck. The usefulness of Issues consists in that they are very effectual to evacuate the superfluous ferosity of the Brain, and also to lessen the irregular form of it, and likewise to dry up the too great moisture of the spinal Marrow, and consequently to strengthen the Nerves that arise from thence. A Seton may be put in the place of an Issue.

As to Vesicatories, it is not to be doubted, but that they give ease being applied upon the Vertebres of the Neck or behind the Ears. But their Strength is soon gone, and the use of them seems to be both troublesom and painful to Children.

Moreover, Cupping-glasses, without Scarification, apply'd along the Back-bone are very effectual to cor∣rect the moist and cold Temperies of the spinal Mar∣row, and to remove the dulness of the Nerves. And I think also that they may be applyed upon the upper Vertebres of the Neck, with a light Scarification.

Besides Purging and Chyrurgical Remedies, Specifick altering Medicines are to be used, to which sometimes Diureticks and Diaphoreticks are to be added; of which we shall add some Examples.

The specifick Remedies, that are found most effectual to cure this Distemper, are either simple or compound; among Simples, the following are most approved. Wood of Guiacum and its bark, Sassafras, Lentiskwood, Rose∣mary, the knotty parts of Firr, the roots of China, of Sarsaparilla, the three Sanders, the roots of Osmund-royal, or rather the Cloves of the roots; the roots of Sea-fern, or rather the buds of them; Grass-roots, the roots of Asparagus, Eryngo, Succory, Burdock, the barks of the roots of Cappers; the capillary Herbs, and chiefly Trichomanes, Ceterach, Wall-rue, Harts∣tongue, Liverwort, Male-speedwell, Agrimony, Brook-lime, Water-cresses; the leaves and flowers of Sage, of Rosemary, Betony, dead Nettle and of Tamarisk; also Steel prepared, or its Salt or Vitriol. Tartar, Ca∣stor, flowers of Sulphur, Earthworms, Millepides pre∣pared, and the like.

Of which Compositions may be made after this man∣ner:

Take of the Cloves of the roots of Osmund-royal, or the roots of Sea-fern, or the Twigs of the roots of it scarcely sprung above Ground, onehandful; boil them in a pint of Milk or Spring-water to the consumption of a third part. Let the strained Liquor, sweetened with Sugar, be drunk twice or thrice a day.

Take of the leaves of Tea, one drachm, of the flowers of Sage, Betony, each half a drachm; put them in a convenient Vessel, and pour upon them a pint of boil∣ing Water, let them stand close and warm about an hour. Sweeten the strained Liquor with Sugar, and let it be drunk in the same manner as the for∣mer.

Take of the Cloves of the roots of Osmund-royal, of the roots of Burdock, Grass succory, each one ounce, of the herbs Male-speedwel, Agrimony, Hartstongue, Liverwort, Maiden-hair, each half an handful, of the raspings of Ivory and Hartshorn, each an ounce, of Raisins of the Sun stoned, one ounce; boil them in two quarts of Fountain-water, to the consumption of a third part, add of White-wine or Rhenish-wine, half a pint; strain it presently, and then add to it of the leaves of Water-cresses and Brooklime, and of the tops of Fir, each half an handful, of Juniper∣berries, half an ounce; make a warm Infusion in a close Vessel for about two hours; keep the strained Liquor in a Glass well stopt, and sweeten it at plea∣sure. The dose is two or three ounces at nine in the morning, at three in the afternoon, and six in the evening.

Take of Lignum Lentiscinum, Rosemary, of the roots of Sarsaparilla, flowering Fern, or of male Fern, each three ounces, of the herbs Agrimony, Maiden-hair, Speedwel, Hartstongue, Sage, Bettony, each two hand∣fuls, of the teps of Fern and Tamarisk, each 2 handfuls, boil them in four Gallons of Ale till one is consumed; when it has done working in the Vessel, put into a bag 200 Millepides washed in Whitewine, and gen∣tly bruised, of Juniper-berries, two ounces, of Nut∣megs cut number two, hang the bag in the Vessel, and put a piece of Steel into it to make it sink. If there be any suspicion of the Scurvy, you may add of Water-cresses and Brooklime, each two handfuls; after a fortnight, let it be drunk for the ordinary drink.

But the Medicine which is most approved of in this Disease is ens veneris, five or six grains of it may be taken every night at bed time, in half a spoonful of sy∣rup of Gillyflowers.

If the Lungs are stuffed with viscid Humors, as hap∣pens often, and the Mesentery with scropholous Glan∣dules, Balsam of Sulphur may be given, three or four drops being mixed with Sugar-candy powdered, and taken morning and evening.

Sometimes the use of Steel agrees; but it must not be used in Coughs, Pleurisies, a stoppage of the Lungs and hectick Fever, and the like.

To the foresaid Remedies are sometimes added Dia∣phoreticks, as a decoction of Guaiacum or the like, which must be taken in Bed, and Sweat must be pro∣moted according to the strength.

The Bath-water also is very proper, and is excellent to take off the swelling of the Belly. The following artificial Bath is much commended. Place the Sick in a large Vessel, and put round him warm Barly ferment∣ed, which has been a while infused in boiled Water, as is usually done for making Beer; cover him well, and let him abide in it to provoke sweat.

Of the Symptoms.

Regard must be had to the Symptoms coming upon this Disease, the most frequent whereof is a Loosness; for the Cure whereof gentle Catharticks, as an infusion of Rhubarb and Tamarinds, and of Sanders, or a Bo∣lus made of them is of use: But sometimes Astringents, and gentle Opiats may be used; but Purging and sometimes Vomiting must go before. Sometimes immoderate sweating afflicts the Child, which if it fol∣low a feverish Fit, is critical, and ought not to be rash∣ly stop'd; but if it flow inordinately, it is a Sign that the Body is oppressed with ill Humors; and, therefore, this sort of Sweat must be corrected by a gentle Purge, especially with Rhubarb. A Vomit does also good sometimes in this case. Aperitives also, and such things as help Concoction, must not be omitted.

Moreover, breeding of the Teeth difficultly is fami∣liar to this Disease, which often occasions a Fever; in which case, gentle Evacuations, especially by Glisters must be made, tho' sometimes Purging and Vomiting gently are of use. If the Tooth be about to pierce the Gum, Nurses are wont to rub the Gum with a piece of polished Coral; but the roots of Marshmallows or sharp pointed Dock will do as well: But sometimes it is ne∣cessary to cut the Gum to make way for the Tooth, and to apply Blisters behind the Ears; and if there be great pain and watching, Hypnoticks must be used; as one or two drachms of Diacodium in a spoonful of Cowslip-water.

Besides internal Medicines and chirurgical Helps, ex∣ternal things also must be used, as Exercises of all sorts, and if the Child be able, walking frequently; if not, he must play sitting, or be carried about in the Nurses Arms, and the like.

Frictions are also good in this case, with warm Flan∣nels; the parts to be rubb'd are the Spine, which is primarly affected, and the muscular Parts; but with this caution, that you must not rub the Bones where they stick out; but you may rub freely the concave parts of the Bones.

Ligatures are also of use, which are to be made above the Knee and above the Elbow; but they ought to be soft and loose. Boots are also of use, but you must take care that they press a little upon the protuberant part of the bone, and scarce touch the cavity. Bodice are also to be used to keep the Body upright. Swinging is also necessary.

Lastly, we will mention some things that are to be applied outwardly. A fomentation of all sorts of Wine, also common Aqua Vitae is very good to corroborate the nervous parts, which must be used for the weak parts and especially for the Spine; which being done, the parts must be anointed with Oil, or some proper Oint∣ment, which we shall mention by and by, and instead of Wine, the following Decoction may be used.

Take of the roots of Osmund-royal, or of male-fern three ounces, of the leaves of Bettony, Sage, Rosemary,

Marjoram, Water-cresses, each one handful, of the flower of Camomel, Melilot and Elder, each one pugil, of the berries of Lawrel and Juniper, each half an ounce; boil them in a sufficient quantity of fountain Water to a quart, add of White-wine, or of com∣mon Aqua Vitae, one pint; keep the strained Liquor for use.

Take of the leaves of Elder, Lawrel, Marjoram, Sage, Rosemary, Bettony and the tops of Lavender, each two handfuls, of the berries of Juniper and Lawrel, each one ounce; cut them and bruise them, and put them into a Vessel with three pound of May butter, or of fresh butter not salted, and add to them half a pint of Aqua Vitae; boil them to the consumption of the Aqua Vitae, and while the strained Liquor is hot, add half an ounce of the Oil of Nutmegs by expres∣sion, and one drachm of Peruvian balsam; mingle them, make an Ointment. Instead of May-butter, Beef, Marrow, or Deers Suet, and Oil of Worms or Oil of Foxes, each one pound and an half, may be used.

The Ointments must be applied warm before a hot Fire and naked, with a warm hand, till the parts are dry.

If the Belly be hard and swelled, the following Oint∣ment must be applied.

Take of the Oils of Cappers, Wormwood and Elder, each one ounce, of the Ointment above described, one ounce and an half, of Gum Ammoniacum dissolved in Vinegar, half an ounce, make a Liniment.

Whilst Ointments are applied to the Hypochondres, the bowels must be handled by the Nurse.

If the Lungs are affected, the Breast must be anointed with the pectoral Ointment, or with the Ointment of Marsh-mallows, or both mixed together; and at the time of Unction a little Oil of Nutmegs by expression may be mixed with it.

The Nerve-Plaster, or a Plaster of Bettony may be apply'd to the Spine.

CHAP. CXV. Of the Gout.

THe Gout chiefly seizes those Old Men, who after they have lived the best part of their Lives ten∣derly, and delicately indulging themselves freely with splendid Banquets, Wine and other spiritous Liquors, at length, by reason of the sloth that always accompanies old Age, wholly omit those excercises of Body, which young Men are accustomed to. Moreover, they who are obnoxious to this Disease have large Skulls, and are most commonly of a gross habit of Body, moist and lax, and of a lusty and luxuriant Constitution, the best and richest foundation for Life.

Not that the Gout only seizes those that are corpu∣lent, for sometimes, though seldomer, it invades thin People; nor does it wait always till they are Old, for sometimes it seizes those that are in the flower of their Age, when they have receiv'd the unhappy Seeds of the Disease from their Parents, as it were ex traduce: Or if this be not the cause, they have too early us'd Venery, or have quite forsook violent Exercises that they us'd formerly. Moreover, they have great Sto∣machs, and have drank spirituous Liquors immoderate∣ly, and afterwards they have suddenly betook themselves to thin and cooling Liquors.

I will discourse of this Disease as it proceeds regular∣ly, and afterwards of its anomalous and uncertain Phae∣nomena. When the Gout is regular, it seizes the Pa∣tient most commonly after this manner, about the latter end of January, or at the beginning of February it comes suddenly and for the most part without giving any no∣tice, except that the Patient has been troubled with in∣digestion and crudities of the Stomach for some Weeks before. Moreover, the Body is oppress'd and puff'd up with Wind, which daily encreases till the Fit thun∣ders

upon him; but a few days before it comes the Thighs are benummed, and there is as it were a de∣scent of Wind through them, with convulsive motions; and the day before the Fit the Appetite is sharp, but not natural. He goes to Bed, and to sleep well, but at two a clock in the morning is wak'd by the pain, seizing either his great Toe, the Heel, the calf of the Leg or the Ankle: This pain is like that of a dislocated Bone, with the sense as it were of Water almost cold, pour'd upon the Membranes of the part affected, pre∣sently shivering or shaking follows, with a feverish dispo∣sition, the pain is very gentle but increases by degrees, (and in like manner the shaking and shivering go off) and that hourly, till towards night it comes to its height, accommodating it self neatly according to the variety of the Bones of the Tarsus and Metatarsus the Ligaments, whereof it seizes, sometimes in a manner resembling a violent stretching or tearing those Ligaments, sometimes the gnawing of a Dog, and sometimes a Pressure: Moreover, the part affected has such a quick and ex∣quisit pain, that 'tis not able to bear the weight of the Cloaths upon it, nor hard walking in the Chamber, and the night is not only pass'd over in pain upon this ac∣count, but also by reason of the restless turning hither and thither till two or three a clock in the morning, (viz. a night and a day being spent from the first ap∣proach of the Fit) at which time the Sick has suddenly ease; and now being in a breathing sweat, he falls asleep; when he wakes, he finds the pain much abated, and the part affected swell'd; the next day, and perhaps two or three days after, if the Matter apt to degenerate the Gout is copious, the part affected will be in pain, but 'twill be eased about the Cock's crowing; within a few days the other Foot will be in pain as the former was; and if the former has left off aking, the weakness which render'd it infirm, will presently vanish. After it has vext the Feet, the Fits that follow are irregular both as to the time of invasion and duration, yet the pain always returns in the Evening and is less in the Morning; and of a series of these small Fits, consists that which is call'd a Fit of the Gout.

But when the Gout is disturb'd by improper Methods, or by the obstinate continuance of the Disease, the very substance of the Body being as it were perverted to the nourishment of the Disease, and Nature unable to eli∣minate the same by its wonted method, then the Phae∣nomina are much different; for whereas the pain was hitherto only troublesom to the Feet (which are the genuine seat of the peccant Matter, and if it possesses any other parts, 'tis most certain that either the method of the Disease has been alter'd, or that the vigour of the Body is by little and little diminish'd;) now it possesses the Hands, Wrists, the Arms, the Knees and other Regions, tormenting these as much as it us'd to do the Feet; for sometimes distorting one or more of the Fin∣gers, it makes them like a bunch of Parships, taking away the motion by degrees, and at length it generates stony Concretions about the Ligaments of the Joints, sometimes the Matter occasioning the Disease thrust up∣on the Arms causes a whitish swelling almost as big as an Egg, which is by degrees inflam'd; sometimes fall∣ing upon the Thigh, it feels as if there were a great weight hanging upon it, yet without any considerable pain; but, passing to the Knee, it handles that more severely.

And whereas the Gout before did not use to invade before the latter end of Winter, and was wont to go off after two or three Months, now it continues upon the Sick a whole year, excepting only two or three of the hot Months.

The Sick is also afflicted with many other Symptoms, as with a pain of the Hemorrhoidal Veins, and with unsavory Belchings, and upon Yawning, especially in the morning, the Ligaments of the Bones of the Meta∣tarsus are violently pull'd; and sometimes when Yawn∣ing does not go before, the Sick just dropping asleep, suddenly feels a blow, as it were, of a Club breaking in pieces the Metatarsus.

Women are very seldom troubled with the Gout, and if they are, not till they are old, or unless they are of a masculine habit of Body.

As to the Cure, Bleeding, Purging and Sweating are not indicated; but the Intention of curing is to be di∣rected to the helping Concoction. Whatsoever, there∣fore, assists Nature in duly performing her Offices, whe∣ther in comforting the Stomach that it may rightly con∣coct the nourishment, or the Blood that it may well as∣simulate the Chile brought into it, or the solid Parts that they may the better convert it to their proper substance, the Juices designed for their nourishment and increase. Lastly, whatever preserves the various Organs of Ex∣cretion, and the Emunctories of the Body in such a state, as that they may be able to discharge duly and orderly the Excrements of each part: This, and such like, con∣duce to the answering this intention, and are properly called Digestives, whether they are Medicines or a course of Diet, or Exercise, or any other of those things which are called the six Non-naturals.

Medicines of this kind are those in general which moderately heat, and are bitter, or gently bite the Tongue; for they are very agreeable to the Stomach, they purify the Blood and comfort all the Parts. The Remedy which I use, is made in the following man∣ner.

Take of the roots of Angelica, sweet-smelling Flag, Ma∣ster-wort, Elecampane, leaves of common Wormwood, the lesser Centaury, white Horehound, Germander, Groundpine, Scordium, Calaminth, meadow Saxi∣frage, S. John's-wort, golden Rod, Feverfew, Thyme, Mint, Sage, Rue, Carduus Benedictus, Penny-royal, Southern-wood, of the flowers of Camomil, Tansie, Lilly of the Vallies, English Saffron, of the seeds of Treacle, Mustard, Garden scurvy-grass, Carraways, Juniper-berries, each a sufficient quantity; let the herbs and flowers, and roots be gathered when they have most vertue in them; let them be dried, and kept in Paper-bags till they may be finely powdered: To six ounces of each well mixed, add a sufficient quantity of purified Hony and Canary-wine, to make an Electuary: Take two drachms morning and even∣ing. Or for want of this, use the following.

Take of conserve of Garden-scurvygrass, an ounce and an half, of Roman Wormwood and of the yellow rind of Oranges, each one ounce, of candied Angelica, and of Nutmegs candied, each half an ounce, of Venice Treacle, three drachms, of compound Powder of Wake robin, two drachms; make an Electuary, with a sufficient quantity of syrup of Oranges; let him take two drachms twice a day, drinking upon it five or six spoonfuls of the following water.

Take of the roots of Horse-radish sliced, three ounces, of Garden-scurvygrass, twelve handfuls, of Water-cresses, Brooklime, Sage and Mint, each four hand∣fuls, the peels of six Oranges, two Nutmegs bruised, of Brunswick Mum, six quarts; distil them in a common Still, and draw only six pints of Water for use.

Among the Medicines commonly known, Venice-Treacle is the best; but because it contains a great ma∣ny Species that heat too much, and besides a great deal of Opium, the Electuary above-mentioned may be more commodiously prepared of the chief heating Vegetables; but we must take care to chuse such Simples as are pleasant to the taste, for the Sick must take it a long while, viz. almost as long as he lives.

Among the Simples, the Peruvian-bark is the best; for it strengthens the Blood and renders it vigorous, if some Grains of it are taken morning and evening.

A Mediocrity is to be observed in Meat and Drink, so that neither more nourishment be taken in than the Stomach can concoct: Nor, on the contrary, must the Parts by too much Abstinence, be defrauded of that propor∣tion whereby their Strength and Vigour ought to be sustained. Morever, as to the quality of the Meat, though things of easy digestion considered by themselves are to be preferred before things of hard digestion, yet regard must be had to the Patient's Palat; for we must take notice, That that which the Stomach earnestly craves for, though of difficult digestion, is sooner con∣cocted by Nature, than that which is accounted to be

of easier digestion, if it be offensive to the Stomach; but those things that are reckoned of hard digestion, are therefore to be eaten more sparingly: And, I suppose, the Patient ought to feed upon one sort of Meat at a meal; for various sorts of Flesh eaten at once, disturb the Stomach more than one sort eaten in the same quantity; as to other things besides Flesh, let him eat at pleasure, if they are not sharp, nor salted, nor spiced.

As to the times of eating, a Dinner is only necessary, for the Bed being most proper to digest the Humors, that time ought not to be wasted about concocting the Meat; therefore, they that are subject to the Gout should not eat Suppers, yet they may allow themselves a large draught of small Beer; for such are inclinable to breed the Stone in the Kidnies, the concretion where∣of is much hindred by such kind of Liquor drunk at this time, the Reins being cooled and cleansed there∣by.

The drinking of Milk or a Milk-diet, either crude or boiled without any thing else, except perhaps a piece of Bread with it once a day, has been much used this 20 years, and it has done more good to many than any other sort of Remedy for this Disease, as long as they kept to it; but as soon as they return to common Diet, though of easy digestion, the Gout returned more vi∣olently than before, and held them longer; therefore, he that intends to betake himself to this method, ought, first, to consider seriously whether he can persist in the use of it all his Life long, which perhaps is not in his power, how resolved soever he may be. For I knew a Noble Man, who after he had been dieted with Milk only a whole year with pleasure (all which time he went to Stool daily once or oftner) was forced to leave it off by reason he was suddenly bound in Body, and the temper of his Body altered, and because at length his Stomach nauseated Milk, tho' the inclination of his Mind still continued; but some Hypochondriacal Peo∣ple of a gross habit of Body, or who otherwise have ac∣customed themselves much and a long while to spiri∣tuous Liquors, can by no means bear a Milk-diet.

As to Liquors, those in my opinion are best, that are neither as strong as Wine nor as weak as Water, of which sort is our London small Beer, either with or with∣out Hops, for extreams on either hand are hurt∣ful.

But now though it may be sufficient for him that has the Gout but little and at sometimes only, to use small Beer and diluted Wine, the degree of his Disease not requiring more severe usage; yet when the whole sub∣stance of the Body is as it were degenerated into the Gout, he will be less able to conquer the Disease, who does not wholly abstain from any sort of fermented Li∣quors though small and mild; therefore, a dietetick Drink must be prescribed for his ordinary Drink. The following pleases me best.

Take of Sarsaparilla, six ounces, of Sassafras, China and the shavings of Hartshorn, each two ounces, of Liquorish, one ounce; 〈◊〉〈◊〉 them in two gallons of Fountain-water for half an hour, afterwards let them stand covered in hot ashes 12 hours; afterwards boil them to the consumption of a third part: As soon as it is taken from the fire, infuse in it half an ounce of Anniseeds; after two hours strain it, and let it stand till it is clear; keep the clear Liquor in Glass-bottles for use.

This Liquor is most conveniently us'd at first when the Patient recovers of the Fit, and he must persevere in the use of it all the rest of his Life, as well when he has the Fits as at other times; at the same time the foresaid Electuary must be us'd daily, as well in the Fits as when they are off.

Yet if the Sick, by reason of a long and too great use of intoxicating Liquors, or by reason of old Age or Weakness cannot concoct his Meat without Wine or some other fermented Liquor, he cannot leave it off suddenly without great danger, the doing whereof has been fatal to very many; therefore, in my Opinion, he shou'd not use the dietetick Apozem at all.

The Sick must go to bed early; for besides Bleeding and Purging, nothing does so much destroy the strength of Nature as watching a-nights.

Moreover, Tranquility of Mind must by all means be obtain'd; but the exercise of the Body is more pro∣fitable than all other things that are us'd to hinder the indigestion of the Humors, and to corroborate the Blood and to restore strength to the parts; but unless 'tis used daily 'twill do no good, yet it must not be violent. As to the kind of Exercise, riding on Horseback, when old Age and the Stone do not hinder, is much to be preferr••d before the rest; if this cannot be used, riding in a Coach does almost as well: And on this account, at least, it is well with gouty People, for their Riches, which enticed them to Luxury, whereby the Disease was bred, can provide them a Coach, which kind of exercise they may use, when they cannot the other: But it is to be observed, that it is best to use exercise in a good Air, viz. in the Country, and not in the City, where the Air is filled with Vapors exhaling from the Shops of various Artificers, and thickned by the close∣ness of the Buildings, as it is here in London, which is generally supposed to be the largest City in the whole World.

As to Venery, old and gouty People must not indulge themselves in it.

But notwithstanding what has been said of the uti∣lity of exercise in the Fits of the Gout; if the Sick, by reason of the violence of the Fit is as it were over∣whelmed presently by the first assault of it, which hap∣pens to those, for the most part, in whom the Gout has now come to its height, nor is yet grown gentle by a course of many years; In this case, if the Sick is confined to a Chamber, it will also be convenient that he keep his bed for some of the first days, till the violence of the pain is abated; for the bed does somewhat supply the want of Exercise: For the continual use of it does more powerfully digest the morbisick Matter in a few days, than keeping up in many, especially at the beginning of the Disease, if the Sick can abstain from Flesh without fainting or other ill Symptoms, and can be contented only with Barly-broath, small Beer, and the like. But

you must take notice, that if the Gout is inveterate and inclines the Sick to Fainting, Gripes and Loosness, and such kind of Symptoms, he will scarce avoid being de∣stroyed by one of the Fits, if he do not use Exercise in a free and open Air; for a great many gouty People, perish by these Symptoms, whereunto they have been ob∣noxious by being confin'd to their Chambers, and espe∣cially to their Beds, whereas had they bore the fatigue of riding in a Coach the greatest part of the day, they had not died so soon.

But as to the Symptoms of the Gout, we must apply our selves to those whereby the Life of the Patient is endangered, viz. the debility and faintness of the Stomach with Gripes of the Belly; for the Sickness and faint∣ness, a small draught of Canary Wine is very good.

But if any great Symptom, scarce bearing a truce, comes suddenly, by reason of striking in of the gouty Matter, and threatens Death, we must neither trust to the Wine nor to the Exercise above commended; but in this case, if it does not fall upon the Head, but up∣on the natural or vital Parts, we must presently fly to Laudanum, viz. give 20 drops of liquid Laudanum, mixed with a small draught of Epidemick Water, and let the Patient compose himself to rest in his Bed. But if the Matter occasioning the Gout produces a Loos∣ness, because it is not yet cast upon the Limbs, if it be not the crisis of a particular Fit, and if notwithstand∣ing the Laudanum above commended, and Exercise of all sorts (for these must be first used for the cure of the Diarrhaea) the Loosness continues accompanied with Sickness and Gripes, there is only one Remedy that I know of, viz. to provoke Sweat by a method, and Medicines designed for this use, which if it be done two or three days, Morning and Evening, for two or three hours at a time, it most commonly stops the Loos∣ness, and forces the Disease upon the Limbs.

There is another Symptom not so frequent, though I have seen it divers times, viz. a translation of the pec∣cant Matter upon the lobes of the Lungs, when a Winter-cough, by reason of cold taken in the time of the Fit, has by degrees drawn the Matter upon the Lungs. In this one case, the curative Indication is not to be dire∣cted

to the Gout, but this Symptom is to be treated as a true Peripneumonia, by Bleeding repeated, and cool∣ing and thickning Remedies and Diet. Moreover, the Sick must be purged betwixt the Bleedings; but Sweat∣ing does hurt in this case.

Moreover, it is to be noted, That almost all gouty People, when they have been conflicted a long while with this Disease, are subjected to the Stone in the Kid∣nies, most commonly at the declination of a general Fit. In this case, setting aside all other Medicines, let him presently take a Gallon of Posset-drink, wherein two ounces of the roots of Marshmallows have been boiled, and let the following Glister be injected.

Take of the roots of Marshmallows and Lillies, each one ounce, of the leaves of Mallows, Pellitory of the Wall, Bears-breech, and of the flowers of Camomil, each one handful, of Flax and Fenugreek-seeds, each half an handful; boil them in a sufficient quantity of Water; dissolve in the strained Liquor, of brown Sugar and syrup of Marshmallows, each two ounces; mingle them, and make a Glister.

As soon as he has rendred all the Posset-drink by Vo∣miting, and has ejected the Glister, let him take a large dose of liquid Laudanum, viz. 25 drops, or 15 grains of Mathew's Pill.

If any one inquires for external Remedies to ease the pain of the Gout, I have hitherto known none, except∣ing things meerly cooling and repelling, which are very dangerous; and I confidently affirm, That the greatest part of those who have perished in the Gout, have not so properly been killed by the Disease, as by an improper use of Medicines; therefore, if the pain be very violent, it will be better for the Sick to keep him∣self a bed till the pain is a little abated, than to use ex∣ternal Anodynes. But it will not be amiss to take a lit∣tle Laudanum in the Evening, if the pain is intollerable, otherwise it will be better to omit it.

CHAP. CXVI. Of a Rheumatism.

THIS Disease comes at any time, but especially in the Autumn, and it chiefly seizes those that are in the flower of their Age, and it begins most com∣monly upon the following occasion, viz. the Sick catches Cold after having been much heated with violent Exer∣cise, or any other way. It begins with Shaking, and Shivering and Heat, Restlessness, Thirst, and the other unhappy train of Symptoms which accompany Fevers, follow, after a day or two, and sometimes sooner, the Sick is seized with a violent pain sometimes in one Limb, sometimes in another in the Wrists, Shoulders, Knees especially, which changing place, seizes them by turns, redness and swelling remaining in the part which was last affected.

There is another sort of this Disease, though it is commonly thought of another kind, it may be properly called Lumbago Rheumatica, viz. a violent and fixed pain about the region of the Loins, which sometimes reaching to the Os sacrum, resembles the Stone in the Kidnies, only the Sick does not vomit. This violent pain, unless it be removed in the same manner the for∣mer is, lasts as long, and is full as painful.

Having seriously considered that this Disease arises from an Inflammation, I thought it was probable it might be cured by a simple cooling Diet moderately nourishing, as well as by Bleeding repeated, and a Whey-diet I found did as well as Bleeding.

Mr. Malthus, an Apothecary, an honest and ingeni∣ous Man, was seized violently with a Rheumatism; and because he was of a weakly and dry habit of Body, I was afraid he would not be able to bear large Bleed∣ing; and therefore I ordered, That he should be di∣eted with Whey alone for four days: Afterwards, be∣sides

the Whey, I allowed him white Bread for Dinner; being contented with this Diet, he continued it for 18 days, only at last he eat Bread for Supper also. He drank daily four quarts of Whey; afterwards, when he went abroad, he eat Chicken, and other things of easy digestion; but every third day he was dieted with Whey only, till he was quite well.

But how well soever a Whey-diet may agree with young People, and with those that live temperately, it is not safe to treat old People so, or such as have too much addicted themselves a long while to Wine, and other spirituous Liquors, for in such it will weaken the Sto∣mach and chill the Blood, and so cause a Dropsie. In this case, therefore, it is necessary to bleed twice or thrice, and after the second, or at most after the third Bleeding, to purge very often till all the Symptoms quite cease with Lenitives, as with Tamarinds, Sena, Rhubarb, Manna and syrup of Roses solutive; and you must give, every night after Purging, one ounce of Diacodium, somewhat earlier than is usual.

But here we must take notice of a Symptom like a Rheumatism, which also sometimes resembles a nephri∣tick pain, but it proceeds from an Ague, and must be cur'd as that is.

There is also another sort of Rheumatism which comes near the Scurvy, and requires in a manner the same Cure; and, therefore, I call it a scorbutick Rheu∣matism; the pain seizes sometimes this, sometimes that part, but seldom swells; nor is it accompanied with a Fever, nor is it so fixt, but is of a more wandering and uncertain disposition, and accompanied with irregular Symptoms: Sometimes it seizes this or that Member, and then presently it affects only the inner Parts, and occa∣sions Sickness, which goes off again, when the pain of the external Parts returns, and so afflicts the Patient by turns, and continues a long while like those Diseases that are accounted most Chronical, it chiefly seizes Women, and Men of a weakly nature.

They who for a long while have us'd the Peruvian-bark are subject to this Disease, which, by the by, is the only inconvenience I ••ver knew follow upon the use of this Remedy; but, however it be, whether the

Disease take its rise on this occasion, or from any other cause, 'tis very easily cur'd by the following Re∣medies; which should have been kept secret, if I had a greater regard to my private Advantage than to the publick Good; for by these alone, I have cured many Afflicted after the manner I have described.

Take of fresh Conserve of Garden scurvy-grass, two ounces, of Wood-sorrel, one ounce, of the compound Powder of Wake-robin, six drachms; make an Ele∣ctuary, with a sufficient quantity of syrup of Oran∣ges. The dose is two drachms, to be taken thrice a day for a month, drinking upon it three ounces of the following Water.

Take of Garden scurvy-grass, eight handfuls, of Water-cresses, Brook-lime, Sage and Mint, each four hand∣fuls, of the peels of six Oranges, of Nutmegs bruised half an ounce; infuse them in six quarts of Bruns∣wick-mum, and distil them in a common Still, and draw off three quarts for use. The precise dose of the compound Powder of Wake-robin must be observed, or, at least, it must not be les∣sened.

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.

CHAP CXVIII. Of the regular Small-Pox.

THere are two sorts of them; either they are Distinct or Confluent.

The Distinct begin with a shivering and coldness, which is presently follow'd with excessive heat, a vio∣lent pain in the Head and Back, Vomiting, a great propensity to Sweat; I mean in grown Persons, for I never yet observed any such disposition in Children, either before or after they came out; a pain at the ca∣vity of the Breast, beneath the region of the Heart, if it be pressed with the Hand, dulness and sleepiness, especially in Children, and sometimes Convulsive Fits; and if these happen to them that have all their Teeth, I reckon the Small-Pox are at hand, which most com∣monly coming out a few Hours after, sufficiently an∣swer the Prognostication: For instance, if the Child has a Convulsive Fit in the Evening, as it usually hap∣pens, the Small-Pox appear the next Morning; and moreover I have very often observ'd, that when they come immediately after these Fits, they rise in large Pustles, and are mild and favourable, and seldom flux: And these for the most part were the Symptoms which accompanied this Disease at its beginning, and preceded the eruption of the Pustles. But here it is proper to acquaint you, that sometimes it happened so, that in a looser texture of the Blood, which is easily changed, the course of separation was passed over gra∣dually without any violent sickness, before the expul∣sion of the Matter discover'd it self, by the eruption of the Pustles.

The Distinct Small-Pox usually come out on the fourth day inclusively, and sometimes a little later, but rarely before, at which time, for the most part, the symptoms are very much abated, or totally vanish, and the Patient thinks himself very well; only grown Peo∣ple are so disposed to Sweat, that they can scarce be kept from it, though they have little or no Cloaths on them, which disposition does not leave them till the Pustles begin to ripen, and then it vanishes of its own accord: The eruption is after this manner, first Pim∣ples as big as small Pins heads here and there shew them∣selves, and first of all in the Face, Neck and Breast, and afterwards in the whole Body. At this time the Jaws are affected with a pain that increases as the Pu∣stles rise, which growing daily bigger and higher, in∣flame the neighbouring skin and Flesh; for about the eighth day from the first approach of the Sickness, which I always diligently observe in this Disease, the spaces between, that before were somewhat white, now begin to be red and swell more or less, according to the num∣ber of the Pustles, with a tensive and launcing pain of these Parts, which increasing, hourly occasions the Inflam∣mation and Swelling; so that in progress of this Disease the Eye-lids are so filled up and extended, that the Patient is sometimes depriv'd of Sight, and when they are thus Tumified, they shine and are like a Bladder blowed up; and if a greater number of Pustles besiege the Eyes at the first eruption, they sooner retire to their dark Mansions; next after the Face, the Hands and Fingers, swell more or less, according to the number of the Pustles: The Pustles that were smooth and red to this day, are now grown rough and somewhat white, which is indeed the first sign of their coming to maturi∣ty; moreover, they cast out by degrees a certain yel∣lowish Matter, in colour like a Hony-comb, and the in∣flammation of the Face and hands, when it is at height, causes a very florid Colour, not unlike a Damask-Rose, in the spaces between the Small-Pox. On the Eleventh the Tumour and Inflammation of the Face manifestly diminish, and on the Fourteenth or Fifteenth day totally vanish.

That sort of Small-pox which we call the Flux, has the same Symptoms with the Distinct, only they are more violent; the Sickness, the Vomiting, the Fever, and the Restlesness, rage more violently: Moreover, a Loosness sometimes precedes the Eruption, and conti∣nues a day or two after it. This sort comes out gene∣rally on the third day, sometimes before, scarce ever after it. But it is to be Noted, when some grievous Symptom afflicts the Patient before the eruption, as a most violent pain, sometimes in the region of the Loins, like a fit of the Stone; sometimes in the Side, like a Pleurisie, sometimes in the Limbs, like a Rheumatism; lastly in the Stomach, with violent Sickness and Vomit∣ing; In these cases I have observed the Small-pox to come out later than ordinary. And in the nex place, I must acquaint you, that the Fever and other symptoms molest the sick many days after the coming out of the Pustles. This sort comes out sometimes like an Erysi∣pelas, sometimes like the Measles, and as to the out∣ward appearance they cannot be distinguished by any but those that are very conversant in this Distemper; yet he that shall diligently consider the great difference as to the time of eruption in these Diseases, and other Circumstances which he may gather from the History of each of them, will easily be able to distinguish them. These do not rise so high as the Distinct, especially those in the Face; after the eighth day they begin to change into a duskish Colour.

There are two other Symptoms that attend the Flux-pox, which are as considerable as the Pustles or Swel∣ling, viz. Salivation in grown People, and a Loosness in Children. The first of these is so perpetual a Con∣comitant, that I never knew but one that had the Con∣fluent kind and was free from Salivation; but the lat∣ter, viz. a Loosness, does not so certainly vex Chil∣dren that have this sort. Sometimes Salivation disco∣vers it self at the first coming out, sometimes not till a day or two after; first the matter is thin and easily spit up, so that the sick foul a great many Cloaths in a nights time; but about the Eleventh day it is most com∣monly

more clammy, so that it is difficulty hawked up, the Sick is thirsty, and now and then coughs as he drinks.

A Loosness does not invade Children so soon, as spitting does old People; but at what time soever it comes, if it be not stopped by Art, it continues through the whole course of the Disease.

In both kinds of small Pox, the Fever is highest from the beginning to the eruption; after which it is more moderate, till the Pustles begin to ripen, and after∣wards it totally evanishes.

I have always observed, that when the disease was violent, the sick had, as it were, a Fit in the evening; and then the Symptoms raged more cruelty.

In the next place I will treat of the irregular Symp∣toms that happen in this disease, when it is unskilfully handled.

It is to be noted, therefore, that the irregular Symp∣toms that occur on the eight Day, in the distinct small Pox, and those that happen on the eleventh in the Flux, always reckoning from the first approach of the Disease, are of very great moment with respect either to the Life or Death of the patient; and, therefore, they ought to be exactly weighed; for it is manifest that the greatest part of those that die of either sort, die on the days above-mentioned.

When Sweat is promoted much by Cordials and hot Regimen, the Particles are eliminated, which should have served to elevate the Pustles, and to swell the Face on the Eight Day; and it appears flaccid and white, and the Sweat, which flowed freely to this day, now ceases of its own accord, nor it can it be raised again with the hottest Cordials: The patient is taken light∣headed of a sudden, with Anxiety, violent Sickness and restlessness, he makes Water often, but little at a time, and in the space of a very few hours, takes leave of his Friends, and repairs to his long home.

But in the Flux the Sick is in the greatest danger, and most commonly dies on the 11th Day; for the Salivation which hitherto preserved the Patient is wont to cease of its own accord at this time: Therefore, unless the swelling of the Face persists a little longer,

and that of the Hands now manifestly beginning sup∣plies it's place, the sick must necessarily perish: But it happens too often in this hot Disease, that the Cras••s of the blood being weakened, and broke by an over-hot Regimen, and being so highly inflamed, that it is no longer able to exterminate leasurely the inflammatory Particles, (to say nothing at present of those Mischiefs that are occasioned by sweat unseasonably forced) so that either the Face or Hands do not swell at all, or the Tumour vanishes with the Salivation.

There are yet other symptoms that happen at any time of the Disease, and belong as well to the distinct small Pox as the Flux. As a Frensie, a Coma and Purple Spots, which are most commonly the forerun∣ners of Death; and sometimes there is a bloody Urin, or Blood is cast up from the Lungs, both these Hemorrhages happen most commonly at the beginning of the Disease, before the Pustles come out; some∣times also there is a total suppression of Urine. There are also other symptoms that sometimes arise from a cause contrary to those above mention'd, when the Pa∣tient has been injured by violent Cold or excessive Bleeding, or by being over purg'd, viz. the Pustles fall of a sudden, and a Loosness supervenes, so that the Patient, if he be Adult, is in great danger; more∣over, the Tumour of the Face and Hands is repell'd on this account.

But the Symptoms that proceed from taking Cold very rarely occur, for what those do that are occasioned by too hot a Regimen.

As soon as the Signs of this Disease shew themselves, I keep the sick from the open Air, and forbid them the use of Wine and Flesh, and allow them small Beer gently warmed with a Tost for their ordinary Drink, and now and then permit them to drink as much of it as they will, I order them for their Victuals, Oatmeal and Barly Broaths, and rosted Apples, and other things, which are neither too hot nor cold, nor too hard to be digested; I forthwith prohibit a hot Regimen and the use of all manner of Cordials. On the fourth day I commit the sick to his Bed; and then if they come not out well, some gentle Cordial may be properly prescri∣bed,

at least for once, to drive out the Pustles. Among the Medicines for this purpose, those they call Paregoricks, such as liquid Laudanum, Diascordium, and the like, if they be mixed in a small quantity with some proper cordial Waters excell the rest: But it is to be noted, That if I am call'd to a strong young Man, who has besides given occasion to the Disease by excessive drinking of Wine, or any Spirituous Liquor whatsoever, I reckon it not sufficient for the restrain∣ing of the ebullition of the Blood, that he abstrain from his Bed and Cordials; unless, moreover, he be blooded in the Arm.

When the Pustles first come out, I then diligently consider whether they be of the distinct or confluent kind, because they differ exceedingly one from the other, though they agree as to some symptoms. If, therefore, from the bigness and paucity of the Pustles, and the slowness of their coming out, and from the vanishing of sickness and other symptoms, which tire the Patient after the eruption of the flux Pox, it ap∣pear that they are the distinct sort, I take care that the sick be refreshed with small Beer, Oatmeal and Barly-gruel, and the like. And if the small Pox be but few, and in Summer-time, and that very hot, I see no reason why the Patient should be kept stifled up in Bed, and why he may not rather rise a few hours every day, provided the inconveniencies of too much Cold or Heat may be prevented by the place and cloathing; but if either the cold season of the Year, or a large eruption of the Pustles, put the Patient under a ne∣cessity of keeping his Bed continually, I take care that he lie not hotter nor has more Cloaths on him than when he was in health, and that he have a Fire kindled only morning and evening, unless it be Winter; nor do 〈◊〉〈◊〉 require that he should be always fixed to one place, lest he sweat, which I confidently affirm cannot be promoted without great danger.

When the Disease is going off, it is proper to give three or four spoonfulls of Canary-Wine hot, or some other temperate Cordial Medicine. At the same time also, a little hotter and more Cordial-diet may be al∣lowed. For instance, Sugar-so••s, and Oatmeal-candie

and the like; nor is there need of any other thing at all in the distinct and gentle sort, if the Patient will suffer himself to be treated moderately in this method and diet, unless by change Restlessness, or Watchings, should now and then persuade the use of a Parego∣rick.

But if the small Pox Flux, the case is very hazar∣dous; for I reckon this sort is no less different from the other than the Plague is from this; though among the Vulgar, who take names and words for things, the cure of both is said to be the same; for towards the end of the disease the sick is in great danger, viz. on the 11th Day in the common Flux-pox, on the 14th Day in a worser sort, and the 17th Day in the worst sort: But sometimes, though rarely, one the 21st Day, the Fever, the Restlessness and other symptoms invad∣ing together, whereby the sick is generally destroyed, unless Art relieve him: Wherefore, seeing there is so much danger when they Flux, the Physician should en∣deavour all he can to hinder their Fluxing, by bleeding presently in the Arm, if there be the least suspicion of the Flux-pox, and by giving a Vomit afterwards, and by keeping the sick up till the 6th Day from the first sickness. Afterwards he must be put to Bed, and keep there to the end of the disease; but he must have no more Cloaths on, nor a greater fire in his Chamber than he used to have when he was well, and he must drink freely of small Beer or other cooling Liquors. But because, notwithstanding the sick frequently grows hot, lightheaded, and restless, I give an Ano∣dyne every Night, but a little earlier than is usual; because in this Disease, a fit of heat and restlessness comes almost every day towards the evening.

But, which is to be lamented, notwithstanding these things, and all other Physical Helps, the sick is very often seized on the 11th Day, or on some other of those Days, which we said, were most fatal in the various kinds of Flux-pox, with a violent Fever, difficulty of breathing, and restlessness, and dies suddenly. In this case nothing is more effectual than the taking away of ten or twelve ounces of Blood, and in the evening a large Anodine must be given, as before; and so

afterwards morning and evening, and sometimes oftener; for it is diligently to be noted, that in some the fury of the Disease is so high, that a very large dosed Anodyne cannot stop its force in 12 hours; in which case it is necessary to repeat the Anodyne every 6th or every 8th hour.

But because it happens often at the latter end of the Disease, that the Body is bound up so much, that the sick is like to be suffocated, and consequenrly is in great danger; in this I have given successfully an ounce and an half of Lenitive Electuary dissolved in four ounces of Succory-water or the like; which Draught gives some stools before night; but if it does not, an Anodyne must be given in the evening, and sooner, not∣withstanding the Purge, if great Restlessness or some considerable sickness threaten danger.

If, therefore, the Purge does not answer the first day, it must be repeated the next, and then it seldom fails, and in this manner Bleeding and Purging may be repeat∣ed by Intervals, as occasion requires. But it is to be noted, that the sick must not be purged till the 13th day or after, nor then, unless Bleeding has gone be∣fore. For spitting of Blood and a bloody Urine coming upon the small Pox, for both these Hemorraghes come sometimes at the beginning of the Disease: After bleed∣ing largely once, give an Anodyne.

Take of red Poppy water, two ounces, of liquid Lau∣danum, 14 drops, of distill'd Vinegar, three drachms, of Diacodium, half an ounce; make a Draught to be repeated every night at bed time.

Take of Troches of Lemnian Earth and of Bole-armen∣ick, each one drachm, of sealed Earth, Bloodstone, Dragon's-blood and red Coral prepared, each half a drachm, of Mastich and Gum-arabick, each one scruple; mingle them, make a fine Powder, whereof let him take half a drachm every third hour in a spoonful of syrup of Comfry, drinking upon it four or five spoonfuls of the following Julep.

Take of the Waters of Plantain and Oak-buds, each three ounces, of Cinnamon-water Hordeate, two ounces, of syrup of dried Roses, one ounce; make it a little acid with spirit of Vitriol.

Emulsions also of the four greater cold Seeds with white Popies do a great deal of good. But after the Hemorrhage is stopt, you must proceed according to the method described in the small Pox.

Great care must be taken that the Salivation con∣tinue according to the manner of it, from the begin∣ning to the 12th or 13th day; for if it quite stop before the 11th day, the Sick is in great danger: It may be much promoted by ordering the Sick to drink freely small Beer, or any other Liquor, which is neither heat∣ing nor provokes sweat.

In the next place the Loosness in Children must be permitted, because it evacuates the morbifick matter. At last, when the Pustles are crusty and hard, I use to anoint the Face often with Oyl of sweet Al∣monds.

If in the distinct small Pox the Face does not swell, I give an Anodyne presently; but if the Patient be light-headed and very sick, and makes Water often, but little at a time, he can be relieved no other way, Death being near at hand, than by giving Narcoticks freely, or by taking away a large quantity of Blood, and by exposing the Body to the Air; but I would not be so understood here as if in every Phrensy coming upon the small Pox, there being no Symptom more frequent, that I should advise Bleeding presently; but only in that which therefore happens, because the Face does not swell in the distinct kind, tho' there be a great number of Pustles.

If in the Flux-Pox the Spitle be so thick and clammy that the Sick is in danger of being suffocated, which happens often on the 11th day, a Gargarism must ne∣cessarly be prescibed, and must be ordered to be used often Day and Night: It may be made of small Beer or Barly-water, with Hony of Roses. Or, the follow∣ing may be used.

Take of the bark of Elm, six drachms, of Liquorice, half a drachm, of Raisins of the Sun ston'd number twenty, of red Roses, two pugils; boil them in a sufficient quantity of Water to a pint and an half: In the strained Liquor dissolve of simple Oxymel, and of Hony of Roses, each two ounces; mingle them, make a Gargarism.

But when the sick is in danger to be suffocated every moment, and is stupid, an ounce and an half of the Infusion of Crocus Metallorum must be given, for a less Dose will not work, by reason of the stupidity of the sick. But this Remedy does not always do the bu∣siness.

The Coma may be easily relieved by the help of a moderate Regimen.

For a Suppression of Urine, which sometimes afflicts young and brisk People, nothing does so well as taking the Sick out of Bed; and after he has walked twice or thrice cross the Room, by the assistance of the By-stand∣ers, he will presently make Water freely, and be much relieved thereby.

But the Symptoms arising from catching cold, or by Evacuations unduly used, whereby the small Pox are struck in, must be removed by Cordials, and an agree∣able Regimen; but they must not be continued after the Symptoms are gone off: The chief of these are a flatting of the Pustles, and a Loosness in the distinct small Pox; for in the Flux a depression of the Pustles is natural; nor is a Loosness dangerous in Children. In both these cases, a Cordial-potion made of distilled Waters, Diascordium, liquid Laudanum, and the like, is proper, not only to remove these Symptoms, but also at any time of the Disease, if the Sick com∣plain of a pain at the Heart, or of sickness. But to speak the truth, Symptoms of this kind are very rare, compared with those which owe their original to the other extream, which is more fatal, though less bla∣med.

When the Patient is mending, and the Pustles are falling off, after he has 〈◊〉〈◊〉 Meat a few days, namely, about

the 21st or 22d day, I think he ought to be blooded, if the Disease has been violent; and, after Bleeding, he must be purged three or four times.

But sometimes after the Sick has recovered of the Flux-Pox, and rises daily, he has great swellings in his Legs; but they either go off of themselves, or are ea∣sily cured after Bleeding and Purging, by the use of emollient and discutient Herbs boiled in Milk, as Mal∣lows, the leaves of Mullein, Elder, Bays, with the flow∣ers of Camomil and Melilot.

The distinct irregular small Pox of the years 1670, 1671 and 1672, differed from the general distinct small Pox in the following things: First, the Eruption was generally on the third day, and then in the process of the Disease the Pustles did not arrive to a due bigness; and towards the end, when they began to ripen, they seemed black.

Moreover, there was a salivation sometimes, though rarely, when there were very few Pustles: But the flux-Pox differed in many things from the other Flux-Pox; for they came out sometimes on the second, some∣times on the third day, in the form of a redish Tumour covering the whole Face, and thicker than an Erysipe∣las, and scarce any visible distance betwixt the Pustles, with a heap of almost infinite, red, angry Pimples run∣ning into one, and disguising the whole Body between the Pustles; especially in the Thighs appeared some little Bladders very conspicuous like a burn, and distended with clear Water, which flowed out plentifully, when the skin was broken, the Flesh underneath being black like a Mortification. But this dreadful symptom seldom happened.

The Fever, and all other symptoms which either preceded or accompanied this kind of small Pox were more violent than in other sorts of Pox, and had a greater Inflammation. The free use of the white Deco∣ction and Milk-water did a great deal of good in this sort.

The Flux of the Courses, which happens often to Wo∣men when they have this Disease, requires a free use of these Liquors, if they flow at an unusual time.

A Gentlewoman that had this black sort of Pox was seized with so large a Flux of the Courses at an unusual time, that the Women about her thought she had mis∣carried, and tho' this Symptom continued many days, yet I continually used the Milk-water through the whole course of the Disease.

CHAP. CXIX. Of the Measles.

THIS Disease chiefly invades Infants, and all those that are together in the same House. It begins with shaking and shivering, and with an inequality of heat and cold, which mutually expel one another the first day; the second day it ends in a perfect Fever with violent sickness, drowth and want of Appetite, the Tongue is white but not dry, there is a tickling Cough with a heaviness of the Head and Eyes accompanied with a perpetual drowsiness, and for the most part a Humour distils from the Eyes and Nose, and this effu∣sion of Tears is a certain sign of the approaching Mea∣sles. To which this is to be added, no less certain, that tho' this Disease shews it self most commonly in the Face after the manner of little swellings in the skin, yet in the Breast rather red spots than swellings are perceived, arising no higher than the superficies of the skin; the Patient sneezes as if he had taken cold, and the Eye∣lids swell a little before the Eruption; he vomits, but is oftner troubled with a Loosness with greenish Stools: But this chiefly happens to Children that are breeding their Teeth, and they are frowarder in this Disease than they are wont to be for the most part; the symptoms increase till the fourth day, at which time generally, (though sometimes they are deferred) little red spots like Fleabites begin to come out about the Forehead and other parts of the Face, and being increased in num∣ber and magnitude branch into one another, and so

paint the Face with large red spots of various Figures, which are occasioned by little red Wheals, not far distant one from another, that are elevated a little above the superficies of the skin, and their Protuberances may be perceived by a gentle touch, though they can scarce be seen. These spots spread themselves by degrees from the Face, which at first they only possess'd to the Breast, Belly, Thighs and Legs: But they affect the Trunk and Members with redness only, without any sensible inequality of the Skin. The symptoms of the Measles do not abate by the Eruption, as in the small Pox, yet I never observed the Vomiting afterwards; but the Cough and Fever increase, with the difficulty of Breathing, weakness of the Eyes, and the defluxion on them, with perpetual drowziness and want of Appetite, continuing the same as before. On the 6th day, or thereabouts, the Skin breaking, and the Pustles drying off, the Fore∣head and Face grow rough, and at that time the spots in other parts of the Body are very large and very read. About the 8th day, the spots in the Face vanish, and are scarce perceived in the rest of the Body: But on the 9th day they totally disappear, and as we said the Mea∣sles most commonly vanish on the 8th day, at which time the Vulgar, being deceived by reckoning upon the time the small Pox use to last, affirm, They are struck in, tho' really they have finished their course, and they think that these symptoms which come upon their go∣ing off are occasioned by their being struck in so soon: For it is to be noted, That the Fever and difficulty of Breathing are increased at that time, and the Cough is more vexatious, so that the Patient can neither sleep night nor day. Children are chiefly subject to these ill symptoms, which appear now at the going off of the Measles by reason of too hot a Regimen or hot Medi∣cines that were used to force them out; and by this means they are cast into a Peripneumonia, which de∣stroys more than the small Pox or any symptom belong∣ing to it; and yet the Measles are not at all dangerous if they are skilfully managed. And among the rest of the ill symptoms, a Loosness often happens, which either presently succeeds the Disease, or continues many Weeks after it and all its symptoms are gone off, not without

great danger to the Patient by reason of a continual loss of Spirits; and sometimes after a very hot Regimen, the Measles are first livid and afterwards black; but this only happens to grown People, and they are utterly lost when the blackness first appears, unless they are presently relieved by bleeding and a more temperate Regimen.

As the Measles are much of the same nature with the small Pox, so is the method of Cure much the same. Hot Medicines and a hot Regimen are very dangerous, how frequently soever they are used by ignorant Nur∣ses to drive the Disease from the Heart. This method, above others, has been most successful in my practice, viz. That the Patient be kept in his Bed only two or three days after the Eruption, that the blood may gen∣tly breath out, according to its own genius, through the Pores of the Skin, the inflamed Particles, which offend it; and that he have no more Cloaths nor Fire than he is wont to have when he is well: I forbid all Flesh, and allow him Oatmeal and Barly-broaths, and the like, and sometimes a rosted Apple; his Drink must be either small Beer, or Milk boil'd with treble the quan∣tity of Water. I oftentimes mitigated the Cough, which almost continually accompanies this Disease, with a draught of some pectoral Decoction, or with a Lin∣ctus fitted for the purpose; but above all the rest, I took care to give Diacodium every night through the whole course of this Disease. For Example,

Take of the pectoral Decoction, one pint and an half, of syrup of Violets and Maiden-hair, each one ounce and an half; mingle them and make an Apozem, take three or four ounces three or four times a day.

Take of Oil of sweet Almonds, two ounces, of syrup of Violets and Maiden-hair, each one ounce, of white Sugercandy, a sufficient quantity; mingle them and make a Linctus, of which let the Sick lick often, es∣pecially when his Cough troubles him.

Take of black Cherry-water, three ounces, of Diacodium, one ounce; mingle them for a draught to be taken

every night. But if the Patient be an Infant, the dose of the Pectorals and of the Narcotick is to be lessened with respect to the Age.

But if by means of too hot Cordials and too hot a Regimen, the Patient be in danger of his Life after the Measles go off, which is very frequent by the violence of the Fever and the difficulty of breathing, and other Accidents that use to afflict those that have a Peripneu∣monia, I have bled the smallest Infants in the Arm, and have taken away that quantity of Blood which their Age and Strength indicated, with very great success; and sometimes when the Disease has been obstinate, I have repeated bleeding: The Loosness also which fol∣lows the Measles, is also cur'd by bleeding.

What we have now said of the Cure of those sym∣ptoms that come upon the going off of the Measles, may be sometimes also of use when they are at their height, if they are occasioned by a false and artificial heat.

I was called to visit a Maid-servant that had this Di∣sease, together with a Fever, difficulty of Breathing, and purple spots all over her Body, with very many other dangerous symptoms; all which I attributed to the hot Regimen and hot Medicines, which were too much used. I ordered her to be bled in the Arm, and I prescribed a cooling pectoral Ptisan to be taken often; by the help of which, and a temperate Regimen, the purple Spots, and all the other symptoms vanished by degrees.

CHAP. CXX. Of a continual Fever.

FIRST, I observe, That the inordinate commotion of the Blood, the Cause or Companion of this Fe∣ver, is stirred up by Nature, either that some heteroge∣nious Matter contained in it, and inimical to it, should be excluded, or that the Blood should be changed into some new disposition.

I reckon that the true and natural Indications that arise in this Disease shew, That the commotion of the Blood must be kept to that degree, which is agreeable to Nature's purpose, that it does not rise too high on the one hand, from whence great symptoms flow, nor be depressed too low on the other, by which means the pro∣trusion of the morbisick Matter may be hindred, or the endeavours of the Blood affecting a new Condition fru∣strated; so that whither the Fever takes its rise from heterogeneous Matter provoking it, or from the Blood affecting a new State, in either case the Indication is the same. These things being premised, I institute the method of Cure in the following manner.

When I am called to Patients, whose Blood of it self is weak, as it is most times in Children, or when it wants Spirits, as in old Age, and in young Men weak∣ned by long Diseases, I forbear bleeding; for if I should bleed such, their Blood being already too weak, it would be rendred altogether unfit to perform the bu∣siness of Despumation.

But when I have to do with those whose Blood is of a contrary Nature, such as is wont to be in young Men of a robust Constitution, and sanguine Complexi∣on; I order Bleeding in the first place, which cannot be omitted here without hazard; beside, in some other cases to be mentioned hereafter; for otherwise not only Phrensies, Pleurisies and such-like Inflammations may be

feared, but also by reason of the superfluity, a Stagna∣tion of the whole Mass.

As to the quantity, I only take away so much Blood as I conceive will free the Sick from such dangers he is obnoxious to by the immoderate commotion of the same; furthermore, I regulate the Estuation by repeat∣ing Bleeding, or omitting it, by using or forbidding the use of hot Cordials, and lastly by keeping the Body loose, or stopping it, as I perceive the commotion is high or low.

After Bleeding, if it be necessary, according to the cases above-mentioned, I diligently enquire whether the Patient was enclined to Nauseousness at the beginning of the Fever, and if so, I presently prescribe a Vomit, unless the tender Age, or some great Weakness of the sick forbid it: Truly a Vomit is so necessary when an inclination to Vomiting has preceded, that unless that Humour be expelled, it will occasion many difficult Symptoms, that will hinder the Physician in performing the Cure, and will very much endanger the Patient; a Loosness is the chief and most usual of these, which most commonly follows in the declination of the Fever, as often as Vomits are Indicated. The Vomit I frequently use is this following.

Take of the infusion of Crocus Mettalorum six Drachms, of Oxymel of Squills, and compound Syrup of Scabious, each half an ounce, mingle them, make a Vomit, which I order to be taken in the Afternoon, two hours after a light Dinner.

And that the Vomit may succeed the better, I appoint six or eight pints of Posset-drink to be provided, for these Medicines are dangerous, if they are not washed off; and therefore as often as the Patient Vomits or goes to Stool, he must presently take a draught of it, by which means the Gripes will be prevented, and he will vomit easier.

It is to be Noted, that if the condition of the Patient requires Bleeding and Vomiting, it is safest to bleed first, for otherwise, whilst the Vessels are distened with Blood, there is great danger, lest by violent strain∣ing

to Vomit, the Vessels of the Lungs should be bro∣ken and the Brain hurt, and so the Patient may die Apoplectick, of which I could produce some Exam∣ples, if I thought it convenient; let it suffice that I warn you to use great caution in this case.

If any one should ask, at what time of the Fever I would give a Vomit, I say at the very beginning, if I had my choice; for by this means, the Sick may be defended from those horrid symptoms that take their rise from the filth of those Humours that lurk in the Stomach and Neighbouring Parts, and perhaps we may crush the Disease in its beginning.

But if we are called in late, as we are often, so that we cannot assist the Patient at the beginning of the Fever by prescribing a Vomit, yet I have thought it proper to order one at any time of the Disease, provi∣ded the Patient has strength enough to bear the opera∣tion of it: I have given a Vomit on the twelfth day, and I should not doubt to prescribe one later, unless the weakness of the Patient forbids.

The Evening after taking the Vomit, I always en∣deavour to quiet the tumult raised in the Humours by the Vomit, and therefore I prescribe an Anodyne to be taken at Bed-time, for Instance,

Take of Erratick Poppy two Ounces, of Aqua-Mirabilis two drachms, of Syrup of white and red Poppies, each half an ounce, mingle them, make a Draught.

But if there be no fear of raising the ebullition for the future, either by reason of a great loss of Blood, or by frequent Vomiting and Stools, or by a present apu∣rexy, or debility of the Fever, or its declining State, I boldly order a large Dose of Diascordium, either by it self, or mixed with some Cordial-water, instead of the Anodyne above-described, and it is indeed an excellent Medicine, if it be given in a due quantity.

And now before I leave off discoursing of Vomits, I must acquaint you, that it is by no means safe, at least in this Fever, to give Vomits of the infusion of Crocus Metallorum to Children, or to any under Fourteen, no, not in the least quantity.

The Fatigue of Vomiting being over, I further con∣sider with my self, whether notwithstanding the prece∣ding Evacuations, the Blood continues yet to rage so much, that it is still necessary to restrain its effervescence, or whether it be so very languid that it wants to be heightened, or lastly whether the Fermentation being reduced to a due degree, may be left to it self, with∣out danger to the Patient.

First therefore if the Blood ferments so violently, that we may reasonably suspect that the Patient is either ob∣noxious to a Phrensie, or any other troublesome Symp∣tom, proceeding from too great an ebullition of the Blood; the day after taking of the Vomit, I prescribe a Glister. For Instance,

Take of the common Decoction for a Glister one pint, of Syrup of Violets and Brown Sugar, each two ounces; mingle them, make a Glister.

And I order it should be repeated upon occasion; by which it often happens that the Blood being somewhat ventilated and cooled, its effervescence is sufficiently bridled: But sometimes it is necessary to repeat Bleed∣ing once and again, viz. In those of a very Sanguine Complexion, and in the flower of their Age, or in o∣thers who have imprinted on their Blood a certain in∣flammatory disposition, by the too frequent use of Wine: But for the most part there is no need of so great a remedy as is repeated Bleeding; and except in the ca∣ses above-mention'd, the effervescence may be sufficiently suppressed by the help of Glisters; wherefore, if the Blood ferment too much, I order a Glister to be inject∣ed every day, or every other day, as the case requires, and that it he done to the tenth day of the Disease, or thereabouts; but if much Blood has been taken away, or the Patient is Aged, I order no Glisters at that time, though the Blood be very hot; for in these cases as there is no fear that by the omission of Glisters, the ebullition begun should proceed so far as that there should be eminent danger from some violent Symptom; so it is most certain, that by the use of them, the Strength, and as I may say, the Tone of the Blood, is

so much relaxed, that especially in old Men, (for Gli∣sters are not used with so good Success in old Men as in young) Nature is obstructed in her business.

But whether Bleeding has been used or omitted, if the effervescence be too languid, and wants to be stir∣red up; in this case we must wholly abstain from the use of Glisters, even before the tenth day, and much rather if it be past, for to what purpose should we en∣deavour to suppress the fermentation that is too weak already?

As to Cordials, I have found by experience, that the too early use of them has been very injurious, viz. (Bleeding having not been first used) there is danger lest the crude Matter should fall upon the Membranes of the Brain, or the like, or on the Pleura; and there∣fore I always take care that Cordials be not given, when no Blood, or but very little has been taken away, and there has been no other considerable Evacuation, or when the Patient has not passed the flower of his Age. But if the Patient be weakned by profuse Evacuations, I use to give Cordials even at the beginning of the Fe∣ver; but on the twelfth day of the Disease, things then tending to Secretion, I suppose we ought freely to in∣dulge the use of hotter Medicines, and indeed a little sooner, if there be no danger of driving the febrile Mat∣ter upon the principal Parts.

If the Fermentation proceed well, the Despumation will be finished about the Fourteenth day. But if you use Coolers too late, and so by their means suppress the effervescence, it is not strange if the Fever continue to the Twenty first day, and much longer in feeble Bodies ill managed.

The Cordials I prescribe are such as those, which I will mention by and by; those that are more moderate, I use at the beginning of the Disease, when the heat is very violent, always proceeding gradually to the use of hotter, according to the progress of the Disease, and the degrees of ebullition, always remembring that it is lawful if much Blood has been taken away, or if the Patient be Aged, to administer stronger Cordials than when bleeding has not preceded, or when the Patint was in the flower of his Age.

Those Cordials I call Moderate, are made of Distil∣led Waters. For instance, of Borrage, Citron, Straw∣berries, Treacle, compound Scordium-water, mingled with the Syrup of Baum of Fernelius, of Gilliflowers, of juice of Citron and the like; but the Stronger of Gas∣coin's Powder, Bezoar, Confection of Hyacinth, Ve∣nice Treacle and the like. These which follow are fre∣quently used.

Take of the Waters of Borrage, Citron, compound Scor∣dium, Black-cherries, each two ounces, Cinamon-wa∣water hordeated one ounce, Pearls prepared two drachms, of Christaline Sugar a sufficient quantity; mingle them, take four spoonfuls often in a day.

Take of the Waters of the whole Citron and of Straw∣berries, each three ounces, of the cold Cordial-water of Saxony, one ounce, of Treacle-water, and of the Syrups of Baulm of Fernelius, of Gilliflowers, and of the juice of Citron, each half an ounce; mingle them, and make a Julep, of which take often.

Take of Gascoin's Powder, of oriental and occidental Bezoar-stone, of each one scruple, one leaf of Gold; mix them and make a fine Powder. Take to the quan∣tity of twelve grains when there is occasion, in the Syrup of the juice of Citron, and of Gilliflowers, each two drachms, drinking upon it a few spoonfuls of the Julep prescribed.

Take of Treacle-water four ounces, of the Seeds of Citron two drachms; beat them together and make an Emul∣sion; add to the strained Liquor a sufficient quantity of Pearl-sugar, to make it grateful to the Taste. Take two spoonfuls three times in a day.

But if the Fermentation be neither too high nor too low, I leave it in that state, and use no Remedies un∣less I am forced to do something by the importunity of the Sick, or his Friends about him, that may please them without obstructing my design.

And now I must tell you, that when I was called to a poor Body, who was not able to be at the charge of going through a long course of Physick, I did nothing else, after Bleeding and Purging was over, if they were indicated, but order them to keep their Beds all the time of their Sickness, and to drink Oatmeal and Barly-broath, and the like, and that they should drink Small-beer warm, moderately, to quench their Thirst. I took care that they should have a Glister of Milk and Sugar every day, till the Tenth or Eleventh day, and towards the end of the Fever, separation being now begun, if it were slow, I permitted them now and then stronger drink to help it instead of a Cordial. And so without any more ado, except that I used to give a gentle Purge at the end of the Disease, I cured them.

If the Patient be very weak, or if there be not a perfect Despumation, so that I cannot boldly give a Purge on the Fifteenth day, I defer it to the Seventeenth, at which time I give the following, or the like, accord∣ing to the strength of the Patient.

Take of Tamarinds half an ounce, of Senna two drachms, of Rhubarb one drachm and an half; boyl them in a sufficient quantity of Water; to three ounces of the strained Liquor, add Syrup of Roses solutive and Manna, each one ounce; mingle them and make a Potion.

Purging being over, I order the Patient to rise, who has been hitherto kept in Bed by my prescription, and to return gradually to his accustomed Diet.

It happens often, especially in old Men, that the Pa∣tient, though the Fever be cured and the Body suffici∣ently purged, is notwithstanding very weak, and some∣times expectorats by Cough, and sometimes also hauks up a great quantity of clammy Phlegm, which Symp∣tom does not only affrighten the Patient, but also im∣poses upon the Physician, especially if he be unwary, and induces him to believe, that this will make way for a Consumption, though I have observed that this is not so very dangerous. In this case I order the Patient to drink Old Malago, or Muskadine with a Toast, which

takes off this Symptom in the space of a few days, as I have often Experienced.

If the fermentation proceed well, there will be a per∣fect despumation of the morbifick Matter within the time aforesaid; but if cooling Remedies or Glisters have been given too late, the Fever will continue much longer, especially in very ancient Men, ill manag'd by the Phy∣sician. I have been sometimes called to such after they have laboured under a Fever forty days or more, and have tryed all things to induce despumation of the Blood; but it was so much weakened, partly by old Age, and partly by Glisters and cooling Medicines, that I could not attain my end, either by Cordials, or any other corroborating Medicines, but either their Fever stood its ground, or if otherwise it seemed to cease, the Patient's strength was very low, and in a manner gone.

But other Remedies being unsuccessfully used, I have been often forced to take this course, and indeed with very good Success, viz. I have applied the brisk heat of young People to the Sick; neither is there any reason why any one should much wonder, that the Patient is so mightily strengthned and weak Nature relieved by this method, though it be unusual, as that it can deliver it self from the relicks of the Matter to be eliminated; seeing it is easie to conceive a transfusion of a great quantity of vigorous Es••luvia from the sound and strong Body into the withered one of the Sick. Nor have I ever found, that the repeated application of hot Cloaths could at all do that which the now mention'd me∣thod has perform'd, where both the heat applied is more agreeable to the human Body, and gentle, moist, equal and lasting: And though this way of emitting balsamick Spirits into the Body of the Patient may seem absurd, yet it has been used by others with hap∣py success. Nor truly am I ashamed to mention this Remedy, though perhaps some impertinent Men, superstitiously contemning all things Vulgar, may ridi∣cule me for it; for I think the health and good of my Neighbour is very much to be preferred before their vain Opinions.

He that prudently and with due consideration hath observed ••he method hitherto deliver'd, will free the Patient, if not from all, yet at least from most of these Symptoms, which are either wont to accompany this Fever, or to come after it. But forasmuch as such ac∣cidents often happen, either because the Sick neglected to call the Phisician in time, or by reason of the unskil∣fulness or carelesness of the Physician, I think it not a∣miss to treat briefly of their particular Cure, but will confine my self to those Symptoms that require a differ∣ent Cure proper to themselves.

And to begin with a Phrensie; if the Sick either up∣on the account of taking hot Medicines unseasonably, or by being naturally of too hot a Constitution, becomes Light-headed; or which is next to it, if he does not sleep at all; if he looks and talks fiercely; if he rakes Medicines and common drink greedily, and as it were snatches it, and lastly has a suppression of Urine; in this case I say, I bleed more freely than before, and use Glisters and cooling Medicines oftener, especially in the Spring. And though this Symptom does not ap∣pear in young People, and in those whose Blood is brisk, they admit of these Remedies without much hazard, and by the use of such Remedies I endeavour to keep up the Patient till the Disease has lasted a while, and then it is not difficult to free him at once of the Symp∣tom and the Disease too; and this may be done by giving some Narcotick Medicine in a large Dose; for though when the Fever is at the height, those things that are of a narcotick quality, do no good nor answer the Physician's end; yet being given seasonably at the de∣clination of the Disease, are very beneficial. But if the use of a Narcotick be deferred till the 14th. day, it will do the better. The Narcoticks which I am wont to use, are either London Laudanum, from one Grain, to one Grain and an half, or the following.

Take of Cowslip-flowers, one handful, boil them in a sufficient quantity of black Cherry-water, mix half an ounce of Diacodium and half a spoonful of the juice of Lemons, with three ounces of the strained Liquor. Or,

Take of black Cherry-water, one ounce and an half, epidemick Water, two drachms, liquid Laudanum, sixteen drops, syrup of Gillyflowers, one drachm; mingle them.

I will only add this, which I think worth observation, to wit, That if this symptom will grant a Truce so long, and the Fever continues a long space, so that the Pa∣tient may be safely purged before the taking of the Anodyne, it will prove more effectual; wherefore, I used to order two scruples of the Pill Coch. Major dis∣solved in Bettony-water ten or twelve hours before the taking of the Narcotick; nor is there any danger from the Tumult which that hot Pill would otherwise occa∣sion; for the vertue of the following Narcotick will appease these Commotions, and establish most gentle and sweet Peace.

But if the Watchings continue after the Fever is gone off, all the other symptoms being likewise ceased, I have observed that a Rag dipt in Rose-water, and ap∣plied cold to the forepart of the Head and Temples is more beneficial than any Narcotick whatever.

It often happens that the Sick is vexed with a Cough through the whole course of the Disease; it is first dry, because the Matter being yet thin frustrates the expulsive Faculty, but it soon grows thick, and is difficulty expe∣ctorated, because by degrees it is baked by the febrile heat; and hence it comes to pass, that the Patient is discouraged by fear of choaking, because he wants Strength to cough off this viscid Matter. In this case, I rarely use any other Medicine than Oil of sweet Al∣monds fresh drawn, unless it happens (and sometimes it is so) that the Patient has wholly an aversion to Oil, and then we must use the common Pectorals: But I think Oil of Almonds, if the Patient can bear it, is to be preferred before other Pectorals for this Reason chiefly, for that is necessary, they are given in a larger quantity, if we would do any thing to the purpose, and by this means we overcharge the Stomach, which was too weak before and inclined to be nauseous; and some∣times also, we are hindred upon the same account, so

that we cannot mind those things which are to be dis∣patched at the same time. Nor can I understand nor learn by experience, why we should abstain from the use of this Oil (which we have now mentioned) in Fevers, because it is inflammable, and therefore to be feared lest it should increase the Fever; for suppose it naturally hot, yet certainly its heat is not so great, but that the advantage of it on another account may compensate for it; for it is manifestly more pectoral than other things, and opens and lubricates the Passages, and promotes Ex∣pectoration, by which especially if it happens to be large, the Blood is both freed from a troublesome Hu∣mour now conveniently evacuated, and also somewhat cooled; and, therefore, I am not much concerned, when I perceive this Symptom: But the Oil must be given frequently, a little at a time.

Sometimes the Hickops happen, but most commonly to old Men, after large Evacuations, either by Loosness, or especially by Vomiting. In this case a large dose of Diascordium, viz. two drachms, has done the business, when I could do no good with the seeds of Dill, and other things that are cried up as Specificks.

If in the course of this Disease a Loosness arise, which uses to happen when a Vomit was indicated at the be∣ginning of the Disease, and was not taken: In this case a Vomit may be given at any time of the Disease, if the Strength does not contraindicate, tho' the inclination to Vomiting be long since past. But if a Loosness comes, tho' a Vomit has been given, I have found the follow∣ing Glister more beneficial than any other Astringent whatever.

Take of the bark of Pomgranats, half an ounce, of red Roses, two pugils; boil them in a sufficient quantity of Cows Milk, dissolve half an ounce of Diascordium in half a pound of the strained Liquor; mingle them, make a Glister.

I would not advise that a Glister should be injected in a greater quantity; for tho' it may be naturally Astrin∣gent, yet there is danger lest it should weary the Inte∣stines by its b••••••, and so provoke the Flux more.

CHAP. CXXI. Of the Scarlet Fever.

THE Scarlet Fever, tho' it may happen at any time, yet most commonly it comes at the latter end of Summer, and seizes whole Families, especially Child∣ren: They shake and shiver at the beginning as in other Fevers, but they are not very sick; afterwards the Skin is covered with smali red Spots, but they are more, and much bigger and redder, and not so uniform, as in the Measles. These Spots continue two or three days; when they vanish and go off, Scales of Skin, like Bran, cover the whole Body.

This Disease seems to me to be nothing else than a moderate Effervescence of the Blood occasioned by the foregoing Summer, or something else; and, therefore, I do nothing that the Blood may not be hindred in its despumation and injecting the peccant Matter through the pores of the Skin; only I order, That the Sick should abstain wholly from Flesh, and from all spirituous Liquors, and that he should not go out, nor contine him∣self perpetually to his Bed: But after all the Scales are fallen, and the Symptoms cease, I think it is proper to purge the Sick with some gentle Medicine agreeable to his Age and Strength; and by this simple and natu∣ral method, this name of a Disease, for it is scarce any thing else, is easily removed without trouble or danger; whereas, on the contrary, if we are over officious, by confining the sick to his Bed continually, and by giving Cordials and other Medicines unnecessarly, the Disease is increased, and the Patient killed secundum artem.

CHAP. CXXII. Of Childrens Fevers.

THE first Indication in curing Childrens Fevers, is, to prepare well the acid, that it may be the easier ejected: But this preparation must not be endeavoured by Sudorificks, properly so called, that is, such as heat the Body, which are by no means to be used for Infants or Children; but such things as absorbe the acid, and gently restrain the Ebullition, are to be used; the chief of these are Crab's Eyes and Claws, Oister-shells, Cut∣tle-bone, Egg-shells, Coral, Chalk, Coralline, Pearl, Mother of Pearl, both the Bezoar stones, Hartshorn burnt, burnt Ivory, the bone of a Stag's heart, shavings of Hartshorn, Bole-armenick, sealed Earth, Blood-stone, and the like; and among Compounds, compound Pow∣der of Crab's Claws, the Goa-stone, and Confection of Hyacinth.

Being called to an Infant of a year old troubled with a Fever or the Gripes, as they frequently are, I used to relieve them with the following Prescriptions,

Take of the compound Powder of Crab's Claws, and of Pearl prepared, each one drachm; mingle them, make a Powder to be divided into six equal parts. Or,

Take of Oriental Bezoar, prepared Pearl, and Crab's Eyes prepared, each half a drachm, of the species of the confection of Hyacinth, one scruple; make a Powder to be divided as before. Or,

Take of the simple Powder of Crab's Claws, one drachm, of Crab's Eyes prepared, two scruples, of Cochinel, six grains; mix them, make a fine Powder to be divided into six Papers; let one be taken as soon as

may be, and another two hours after, and afterwards let one be taken every fourth hour for the first two days, unless the Child be asleep: But let the Powders be taken in a spoonful of the following Julep, and give a spoonful presently after.

Take of the Aqua lactis alexiteria, four ounces, of black Cherry-water, two ounces, of compound Peony and epidemick Water, each two drachms, of pearled Sugar, half an ounce; mingle them, make a Ju∣lep. Or,

Take of Pennyroyal-water and Aqua lactis alexiteria, each three ounces, of syrup of Gillyflowers, 6 drachms, mingle them Or,

Take of sweet Almonds blanched, number ten; beat them in a marble Mortar, and pour upon them gently half a pint of Barley-water, or of Aqua lactis alex∣iteria; strain it, and add six drachms of small Cin∣namon-water, half an ounce of white Sugar; mingle them, make a Julep.

Sometimes I am wont to use, other things being omit∣ted, a Julep that hath much Pearl in it, but I order that the Glass should be well shook, before it be poured out.

Take of black Cherry-water, four ounces, of all the Ci∣tron, two ounces, of Aqua mirabilis and prepared Pearls, each two drachms, of white Sugar, half an ounce; mingle them, make a Pearl-julep; give three spoonfuls at a time.

But if the Child be troubled with the Cough, give half a spoonful of some pectoral Mixture or Linctus, and let him take less of the Powders above-prescribed.

Take of the Powder of Coralline and simple Crab's-claws, each one drachm and an half, of the syrups of Maiden-hair and Marshmallows, each one ounce, of balsam of Tolu, half an ounce, of red Poppy-water, half an ounce; mingle them,

Bole Armenick is often properly mixed with such things to good purpose, it powerfully stops Catarrhs flowing upon the Lungs; the juice of Pennyroyal heat∣ed and sweetned with Sugarcandy, is also better than most other Remedies; Oil of sweet Almonds is also very good, if Children can take it; so is Brimstone, and the Flowers of it.

The foresaid Powders are to be repeated, seldom or often, according to the degree of the Symptoms; but it is here to be noted, that the Gripes, Restlessness and the Watchings of Children are as easily appeased by testace∣ous Powders, as pains and watchings by Narcoticks in grown People.

The third day, unless the small Pox, Measles or a Scarlet Fever appear, I order a Child of one year old to be purged in the following manner.

Take of syrup of Succory with Rhubarb, two drachms, of choice Rhubarb powdered, fifteen grains or a scru∣ple, of the Aqua lactis alexiteria, one drachm, of small Cinnamon-water, thirty drops, mingle them. Or,

Take of syrup of Buckthorn, one drachm and an half or two drachms, of the Powder called Diasenna, eight grains; mingle them.

Take of the Earl of Warwick's Powder, which is also called Pulvis Cornachinus, described in the last Edi∣tion of the London Dispensatory, six grains; let it be taken in a spoonful of black Cherry-water, sweetned with a little Sugar.

Take of sweet Almonds blanched, number three; beat them in a marble Mortar, and pour upon them gently an ounce or an ounce and an half of Barley-water, or any other simple Water; in the strained Liquor, dis∣solve three drachms, or half an ounce of the best Manna; mingle them, make a purging Emulsion.

Take of Lenitive Electuary, two or three drachms, and dissolve it in an ounce of the Aqua lactis alexi∣teria.

Sometimes I order this or the like Plaister to be ap∣plied to the region of the Navel, especially, if they are troubled with Worms.

Take of Succotrine Aloes, one drachm, of the Powder of the leaves of Savin, of the tops of the lesser Cen∣taury, and of the flowers of Camomil, each one scru∣ple, with a sufficient quantity of Venice-turpentine; make a Plaister, let the margin of it be spread with the Plaister of Cummin, to make it stick the better; and sometimes it may be convenient to add to the other Ingredients, a scruple of Coloquintida.

There is no purging Medicine more proper for Child∣ren and more innocent than Rhubarb; it gently and safely evacuates the Matter occasioning their Fever, and it gently purges off the Humors that burden the Sto∣mach and whole Body, and it strengthens; wherefore, it is very proper for Infants, Children, big-bellied Wo∣men, old Men, and such as have been weakened by Diseases.

After the Purge hath done working, some Powder like the former must be given in the Evening, and af∣terwards must be repeated three or four times in a day at fit times, for two days, and on the third day Purg∣ing must be used, and it must be dosed according to the operation of the former.

These things being performed, the worst Symptoms most commonly cease, or at least are much abated.

It is to be noted, That the first Purge we give to Children that have Fevers, must not be only Lenitive, but the Dose of it must be less than otherwise it ought to be; and the night before Purging, a gentle Glister, made of four ounces of Cow's Milk, Sugar and a little Salt, must be injected, if the Belly be bound.

Moreover, to quicken the Purge, a scruple or two of Cream of Tartar may be dissolved in some spoonfuls of Water-grewel or the like, and so given.

As to bleeding of Children, tho' it may be used, when the febrile Matter is cast upon the Lungs, or in a hooping Cough, yet it is plain that it is a Remedy not agreeable to their Nature.

A Child about three years and an half old, was seized with a small Fever that was continual, and ac∣companied with Exacerbations that were very irregular; she complained of a great pain in the Head especially, and sometimes of the Belly, she nauseated all Meat, and was very sleepy, so that the Standers by thought she would have the small Pox; there was a twitching of the Nerves in sleep, and she had sometimes a dry Cough; I prescribed the following things.

Take of the Aqua lactis alexiteria, six ounces, of Epi∣demick water, half an ounce, of prepared Pearl, one drachm, of the simple Powder of Crab's Claws, two drachms, of Cristaline Sugar, half an ounce; mingle them, make a Julep, whereof let her take three spoon∣fuls every fourth hour, shaking the Glass well before using it.

Take of Succotrine Aloes, one drachm, of the tops of the lesser Centaury, of the leaves of Savin dried, each half a drachm, of Burgundy-pitch, one drachm, of Venice-Turpentine, a sufficient quantity, make a Plaister to be applied to the Navel.

The next day she persisted in the use of the Julep, and a blistering Plaister was applied to the Neck; a Glister made of six ounces of Milk, with Sugar and Salt was injected, because the Belly was bound.

Take of Aethiops mineralis, and of Mercurius dulcis, each six grains, of Marmalade of Quinces, two scru∣ples; make a Bolus, to be taken at Bed-time.

The next Morning, she took the following Cathar∣tick syrup.

Take of syrup of Buckthorn, two drachms, of the Earl of Warwick's Powder, six grains, of choice Rhubarb powdered, twelve grains, of Tincture of Saffron twenty drops, of black Cherry-water, one drachm; mingle them.

Half a drachm of Cream of Tartar was given in a draught of Posset-drink to quicken the Purge; the same night, at Bed-time, four spoonfuls of the foresaid Julep were given. On the fourth and fifth days, the follow∣ing mixture was given by spoonfuls.

Take of Coraline, two drachms, of the leaves of Mint dried and powdered, one scruple, of the simple Powder of Crab's Claws, one drachm, of balsamick syrup and of the syrup of Marshmallows, each one ounce, of Orange-water, half an ounce; mingle them.

The Evening preceding the sixth day, the Bolus be∣fore-prescribed was repeated, and the Morning follow∣ing the purging Syrup, by the vertue whereof the Child vomited up a Worm a span long, and soon ••••••er¦wards was well.

CHAP. CXXIII. Of Agues.

AS to the Cure, I have for many years taken notice how dangerous it is to endeavour to cure by Su∣dorificks, in Tertians and Quotidians, when they are new, and have not yet formed themselves, being at present like continual Fevers: For though it is well known, that upon Sweating, the restlesness and other symptoms presently vanish; yet if Sweat be forced too much, the Fever will be made continual, and the Life of the Sick will be endangered. Having therefore con∣sidered how ineffectual this method is, and the incon∣veniency of other Evacuations by Bleeding and Purg∣ing, I suppose the Peruvian Bark would do best; and I can truly affirm, notwithstanding the prejudice of the common People, and of a few Learned Men, I never perceived any injury by the use of it, nor can imagin

any; only they that have used it a long while, some∣times fall into a scorbutick Rheumatism; but this sel∣dom happens upon this occasion, and when it does, it is easily cured by the Remedies proposed for it in the Chapter of a Rheumatism.

Being called to a Patient of a Quartan Ague, for in∣stance, on a Monday, I do nothing if the Fit be to come that day, only I give the Sick hopes that he may be freed from the next Fit; and therefore on the two well days, namely, Tuesday and Wednesday, I give the Bark in the following manner.

Take of the Peruvian Bark finely powdered, one ounce, with a sufficient quantity of Syrup of Gilliflowers, or of dried Roses, make ad Electuary to be divided into twelve parts, whereof let him take one every fourth hour, beginning presently after the Fit, drink∣ing upon it a draught of some Wine. Or if he likes Pills better,

Take of the Peruvian Bark finely powdered, one ounce, with a sufficient quantity of the Syrup of Gilliflowers, make Pills of a moderate bigness, whereof let him take six every fourth Hour.

But an ounce of the Powder may be easier taken, and as successfully, mixed with a quart of Claret-wine, eight or nine spoonfuls of it being taken every fourth hour. On Friday when the Fit is feared, I give nothing, for most commonly no Fit comes; but lest the Disease should return, eight days exactly after the last Dose, I give the same quantity of Powder, viz. One Ounce di∣vided into twelve parts, according to the method above-mentioned: But though most commonly by giving the Powder after this manner, the Disease is commonly Cured; yet to secure the Patient from a relapse, it is safe to repeat it three or four times, at the same inter∣vals, especially when the Blood has been weakened by foregoing Evacuations, or by catching Cold.

But though this remedy has no purging quality, yet by reason of the peculiar Constitution of some Bodies, it often happens, that the Sick is violently purged by it; in this case it is necessary to give Laudanum with the

Powder; wherefore I give ten drops of Laudanum in Wine, after every other Dose, if the Loosness con∣tinues.

I use the same method for Tertians and Quotidians; but Tertians and Quotidians often are almost continual, and there is only a remission of those days they should intermit, especially when the Sick has been confined to his Bed, and has used too hot a Regimen, and Medi∣cines: In this case I give the Powder, as soon as I per∣ceive any remission.

But there are some that cannot bear the Bark, nei∣ther in the form of a Powder, nor of an Electuary, nor of Pills; for these I infuse in the cold two Ounces of the Bark grossly powdered in a quart of Rhenish-wine, and four Ounces of the Infusion standing some days, seem to contain the vertue of one Drachm of the Pow∣der; and because it is neither unpleasant, nor oppresses the Stomach, it may be taken as often again as any other form of this Remedy.

Sometimes it happens, that before this Disease is come to a regular Type, the Sick cannot retain the Bark in any form, by reason of continual Vomiting; in this case the Vomiting must be first stopp'd before the Bark can be given, to which end I order, that six or eight times in the space of two hours, one spoonful of the fresh juice of Limons be taken with a scruple of Salt of Wormwood; afterwards I give sixteen drops of liquid Laudanum in a spoonful of strong Cinamon-wa∣ter, and soon after, if the Vomitting stop, the Jesuits Powder. For Infants, whose tender Age would scarce bear the taking of this remedy in another form, at least so much of it as would cure the Disease; I use to pre∣scribe the following Julep,

Take of Black-cherry-water, and of Rhenish-wine, each two ounces, of the Peruvian Bark finely powdered, three drachms, of the Syrup of Gilliflowers one ounce, mingle them, make a Julep; let one or two spoonfuls of it be taken according to the age, every fourth hour, till the Ague is cured. If there be a Loosness, you must give a drop or two of liquid Laudanum with every other Dose.

As to the Diet, the Sick may eat any thing that a∣grees with his Stomach, only he must avoid cold Li∣quors and Summer Fruits, and let him use Wine mo∣derately for his ordinary drink, by which alone I have cured some Patients that could not be cured with the Jesuits Powder.

The Disease being taken off, the Sick must care∣fully avoid all evacuations, for the gentlest Purge, yea, only a Glister of Milk and Sugar, will be apt to cause a Relapse.

CHAP. CXXIV. Of the various Forms and Shapes of inter∣mitting Fevers.

THese Fevers often resemble most other Diseases, and such as are most acute, yet they yield to the Peru∣vian Bark, and if the Bark is not given, they often be∣come deadly. Sometimes they come with great Shiver∣ing and with violent Vomiting, a Loosness with Gripes, the Cholera Morbus, the Colick of the Stomach, a peri∣odical Hemicrania, Apoplexy, fainting Rheumatism, general Convulsions, Phrensie, Peripnumonia, and the like.

Mr. Amblar, dwelling at Mile-end, a Man of Fifty years of Age, that was lean and sickly, was often be∣fore subject upon slight occasions, to an obstinate Ague, accompanied with violent Symptoms, but in the Year, 1690, having taken a great Cold, he was suddenly taken with Shaking and Shivering, which was succeed∣ed by an universal Chilness, during which, his Pulse could scarce be felt; he was also violently afflicted with Vomiting, a Loosness, and with a horrid oppression and Sickness: I visited him the next Morning, and found his Face plainly Hippocratick; his whole Body was cold as clay, and a Dew upon it, the Skin looked black, by reason of the congelation of the Blood, his strength

was almost spent by the perpetual Sickness, and the e∣vacuation of divers coloured Choler by Vomit, and stinking white Excrement by Stool, of the consistence of a Cream; all things shewed that Death was approach∣ing, for the vital principal, or the animal Spirits, was so oppressed by the Venom, that there was no hope that they cou'd expand themselves: But to blunt the malig∣nant acrimony of the Humours, I ordered that he should drink Chicken-broath plentifully, and that it should be injected through a Syringe into the Anus, I also order∣ed that the Stomach should be well fomented with Aro∣matick Bags made hot, and a very cordial Bolus, with as much Laudanum in it as the strength of the Patient would bear, was given with a draught of a Cordial, and alexipharmick Julep, every fourth hour. After the third or fourth Bolus, I perceived the Pulse was much stronger, and the blackness of the skin went off, and heat returned to the extream Parts, and the evacuations were something suppressed, the colliquative Sweat was diminished, and he was more quiet, he slept a little, and was not so sick after he waked. After this remis∣sion of the Symptoms, I endeavoured to remove the Ve∣nom, by giving the Jesuits Powder mixed with Lauda∣num in the form of a Draught, every fourth hour, know∣ing well that the Sick could not bear a second Fit; but before the third Dose of the Powder, the Fit returned again unexpectedly, accompanied with the former dread∣ful Symptoms, and the poor Man died within the space of twenty four Hours.

I was called to one Mrs. Baker, an ancient Woman dwelling in Fleet-street, I found her oppressed with con∣tinual Sickness and Vomiting, and so she had been for four days: She presently vomited up all she took; she fainted often, her Pulse was quick and Weak; but her temper by reason of faintness and perpetual sick∣ness, was moderate, and in some sort cold, her Urine looked in a manner well, she could not rest, and was almost delirious, but she complained only of Nauseous∣ness and Vomiting. Having enquired carefully about every thing, I was told that this Woman had been sick six Weeks, that she was hot and cold by turns, the periods were uncertain, and that she was troubed with

a Nauseousness and Vomiting frequently. After I had prescribed a Cordial, Bolus, and Julep, and Chicken-broath for her ordinary Drink, I ordered a Julep made of Salt of Worm-wood and juice of Limons, to be taken by Spoonfuls, to comfort her Stomach; afterward I or∣dered the Peruvian Bark should be given freely in the form of a Draught and of a Tincture, adding twice or thrice a day ten or twelve drops of liquid Laudanum, upon the account of the violence of the Vomiting, and in a days time the Sickness and Vomiting were lessened, and critical white Aphtha covered the whole Mouth, the Urine was very red, and other signs of the expansion of the Spirits, and of the feverish heat were present, and soon after a tertian Ague appeared in its proper form, the cold, heat and sweat succeeding one another alter∣nately, and after two Fits, the Sick was cured by the Bark.

CHAP. CXXV. Of Over-purging.

AS Purging Medicines are sometimes necessary to loo∣sen the Belly, and to evacuate ill Humours, so if the evacuation be immoderate, remedies must be used to stop it.

To prevent it, consideration must be had of the Con∣stitution and Strength of the Patient, and of the Na∣ture and Dose of the Medicine, and while the Medicine is in operation, the Bowels and Blood and Spirits must be kept free from disturbance; wherefore at this time, gross and viscous Meats must be avoided, and much must not be eaten; Cold must be carefully avoided, and the mind must be clear and free; and after the opera∣tion of the Medicine, the Animal Spirits must be quie∣ted, and the effervescence of the Blood, by giving an Anodyne.

Take of Cowslip Flower-water two ounces, of Cinnamon-water hordeated, and of Diacodium, each half an ounce, of Pearls half a Scruple; make a Draught to be taken at Bed-time.

But if Over-purging happens, the Patient must be presently put into a warm Bed, and you must ap∣ply to his Belly a Plaister of Venice-Treacle, and he must presently take inwardly a Bolus of Venice-Treacle and burnt Claret diluted with Mint-water, of∣ten by Spoonfuls, and if he be much grip'd, a Glister must be injected, made of Milk and Venice-Treacle.

CHAP CXXVI. Of the French-Pox.

THE French-pox came first from the West-Indies into Europe, in the Year, 1493. but a violent Gonor∣rhea shewed it self first about an hundred years since. It is propogated either by Generation, as when a Child is infected by the Parents, or by touching of some soft part, as when a Child is Infected by sucking a Diseased Nurse, or a Nurse by Suckling a Diseased Child, or by a Child's lying in Bed with such as are Infected; but it chiefly comes by impure Coition: But in sound and firm Constitutions impure Coition it self is not always sufficient to Infect; for sometimes many lying with an infected Woman, some are infected and others not, though they all equally deserve it. When a Man has to do with an impure Woman, either he has a heat or inflammation of the Penis with Exc••riation, or else he finds a heat in his Urine, and in a day, two or three, a Gonorrhea, or virulent Matter issuing from the Pri∣vy parts; sometimes Chancerous Ulcers, and when the Infection has been very violent, or the Inflammation

neglected, a Gangren, and christaline Bladders arise, and the part Mortifies.

Sometimes there is no Gonorrhea, but instead of it a Bubo arises in the Groin, which according to the de∣gree of its Malignity, either proves easily curable, or else improves its Venom, and terminates in a pha∣gedenous Ulcer with jagged Lips: There are also many vene••••l Ulcers upon the Scrotum and Perineum.

A Cancer is commonly attended with breaking out all over the Body like a Flea-biting, which terminates in various sorts of ulcerous Scabs, or Tete••rs; or it may be Pustles arise in one or more places of the Body, as Head, Face▪ Arms, Thighs, or Legs, or Ulcers in the Throat; then wandring pains begin towards night to affect the Shoulders, Arms, Legs, Head; and about this time appear in the Fundament, Warts, and other kind of Proturbances; also about this time Tumours arise in the Breast, Arms, Legs, and become Ulcers that are difficultly Cured.

The pains growing more fixed, Nodes usually arise, and continually afflict them, but towards night grow more intolerable.

Co-incident with several of these later degrees, are the noise in the Ears, Deafness, a Polypus, Opthal∣mia, the Fis••ula, Lacrimalis, fierce Catarrhs, Colick, Loosness and Consumption.

Authors, upon the entrance of the Pox into Christen∣dom, generally lookt upon it as not only Incurable, but also so highly infectious, that they ran away from it as much as the Jews did from the Leprosie; but later Ages and long experience, have made it less formidable; yet even to this day, it must needs be acknowledged difficult to Cure, in consideration of its malign and contagious quality, and the ungovernable disposition of the Patients.

If the habit of the Body be strong, the cure of all the species of the Pox, whether they be Chancer, Pu∣stles, Tetters, or eating Ulcers, or Ulcers in the Throat and Nose, are much easier cured, than the same are in many other chronick Diseases; but to root out the malignity is somewhat more difficult.

If the Patient has been Clapt formerly, it will be more difficult to cure him the second time, and worse the third.

If he has passed through long courses of Mercurial remedies ineffectually, his Cure will be difficult; and if he has been Salivated by unction, and relapsed, the Cure will be hard, by reason the Mercury is become familiar to him, and his Body is for the most part wasted.

Nodes are more difficultly Cured than any of the Species above mentioned, and those whose Bones are corrupted are yet more difficult to cure; but if the habit of the Body be strong, and the Bowels sound, all the Species of this Disease are curable, if the Patient keep his Chamber, and submit to the rules of Physick and Diet; without which submission we can scarce cure the lesser Species.

If the Bowels be unsound, or the Patient hectick, the Disease is incurable.

As to the Cure, though Bleeding does not take off the Disease, yet in the very beginning of it we usually let Blood to quiet the fermentation of the humours, and to dispose them for evacuation, and prescribe a Glister be∣fore or after.

If the Disease be of long continuance, and they have been let Blood some Months before, yet if we design Salivation, we do again let them Blood, if the Body be not too much wasted; for in some of those a Fever has happened in the time of raising the Salivation, and in Bodies of a Strong habit I have often seen them to break out in heat all over in the beginning of the Flux, so that then I have been necessitated to let them Blood when it was not so proper: But when there is a Bubo in the Groin, bleeding is not proper. But purging is more Universally necessary.

Of Purges some are only lenitive, as Manna with Cream of Tartar in Whey or Posset-Drink, Tamarinds, Cassia, Senna, Rhubarb, lenitive Electuary and the like. Stronger Purges are these that follow.

Take of the Leavs of Sena four ounces, of Gummy Tur∣bith, Hermodactiles, each two ounces, of black Hele∣bore,

and of the pulp of Coloquintida, each six drachms, of the raspings of Guiacum, and Sassafras, each one ounce, of the Bark of Guiacum, of the Ber∣riei of Juniper, of the outward Peel of Citrons, each half an ounce, of Cinnamon four Drachms; infuse them in equal parts of the Water of Baulm, Meadow sweet, and Carduus Benedictus for forty eight hours; then boyl them gently, and press them out strongly; in the strained Liquor dissolve too ounces and an half of Aloes, one ounoe of Diagrydium, evaporat them to the form of an extract for use. The Dose is half a Drachm or a Drachm.

Take of Pil. Coch. min. A Scruple or half a Drachm, Mer∣curius Dulcis twenty Grains, make six Pills. Or

Take of the extract above mentioned, of Gum Guiacum half a Scruple, of Mercurius Dulcis one Scruple, with Syrup of Buck-thorn make pills.

Vomiting is of use in great disorders of the Stomach, when the foulness of that requires it, or when the Ulcers of some particular part require a sudden revulsion; so likewise when after the use of much Mercury outward or inward to Salivate, it does not rise kindly; they generally give strong Vomits if the party can bear them, viz. some preparations of Mercury, as Turbith, Mine∣ral, and the like, or Crocus Metallorum: But in weak∣er constitutions, such as we may.

The next thing which offers it self to our considera∣tion is Salivation, without which few great Cures are done in this Disease.

The methods of Salivating are diverse, but all by Mercury. Inwardly are prescribed various preparations of Mercury. When we design Salivation by Mercurius dulcis, we give it from twenty to twenty five grains, and sometimes to thirty, either in a spoonful of white Bread and Milk, or in conserve of red Roses, or the like; when we suspect it may worke by Stool, we pre∣scribe it with Diascordium or Venice-Treacle at Bed time. If after taking of it four or five Days, their Chops do not swell, it may be reasonable to move it

upward with a few grains of Turbith Mineral; accord∣ing as their Chops swell, they will Salivat; if their Mouths be much ulcerated and swelled, the Salivation may last eighteen or twenty Dayes, during which they are to be kept warm, especially about their Head Neck and Chops, and to drink Chicken Broath or Posset Ale.

Arcanum Corallinum, as it is generaly sold in the Shops, may be given from three grains to five, one Dose of it prescribed to a Woman Vomited her often, and Sa∣livated twenty Days.

Red Precipitat. is also Vomitive, but being well wash∣ed may be taken as safely as the white Precipitat. White Precipitat may be given proportionably as has been said of Mercurius dulcis. Turbith Mineral made of Vigo's Precipitat is best, twelve or 18 grains of it may be taken at a time, but that which is sold in the Shops is a rough Medicine, and must be given in a less quan∣tity.

There is also a way of raising a Salivation by suffumi∣gation, the prescription whereof is as follows.

Take of Cinnabar two ounces, of Crude Mercury one ounce, of Mastich, Frankincense, and Sandarach, each half an ounce, of Storax, Calamit, and Ben∣zoin, each three drachms; make a fine powder of all, and with Turpentine make Troches, each weighing three drachms for use.

But when the Pox is grown inveterate and affects the most solid parts with Node's, and the like, Salivation by unction must be used.

Take of Lard two ounces, of Crude Mercury one ounce, mix them well.

You must begin the unction in the following manner; the Patient must lodge in a close warm Chamber; if the Season be cold, the Windows must be covered with Blankets, and the Bed must be placed near the Fire, and encompassed with a Skreen, if the Chamber be large; you ought also to have a strong healthy Nurse,

such as has been accustomed to the employment, that she may know how to wash the Patients Mouth, and direct and encourage him in such rules, as may be necessary in the time of Salivating.

The most proper place for unction is a Stove, if it may be had, and the Patient can bear it; if he be weak, his Bed must be used, otherwise for want of a Stove, he must sit encompassed with a Screen by the Fire side, but not too near it. He must anoint himself, begining at the Feet, and then the Legs, Thighs, Hips, and so up∣wards taking in the Arms and Shoulders; the Belly must not be anointed, and indeed much of the trouble in weak Bodys may be spared; for in such the anointing of the Legs and Arms may be sufficient, the parts first anointed ought to be covered before you proceed to the next, as the Legs with Stockings, the Thighs with Trousses and the like; at last his Neck must be well wrapp'd with a Napkin tacked up to his Cap round about to his Ears and fastened before to keep his Chops warm; after this a warm Bed will be convenient and a Draught of Posset-drink to procure a breathing sweat; having reposed himself an hour or two he may rise and pro∣vide for his Dinner, which must consist of Meat of easie digestion Roast or Boyl'd, at his Dinner he may drink Beer or Ale with a Toast, the rest of the Day he must be confin'd to Posset-drink.

You must use a third part of the Ointment at a time and continue dayly to use it for three Days following; when the Patient spits you must keep him to Posset-drink or Chicken-Broath, also a Cordial must be at Hand to prevent fainting, his Mouth must be syringed with Barly-Water and Liquorice and the like. New Milk held in his Mouth or Chicken-Broath will ease the pain and digest the Sloughs that rise; a rolled Clout ought to be placed between his Teeth to keep his Chops from closing; he must be rais'd high in the Bed if his weak∣ness constrain him to it, and kept forward that the Rheum may run out of his Mouth and not down his Throat; but if he can rise he will spit the better and more plentifully. Salivation by unction commonly lasts twenty four or twenty five Days; sometimes to the thir∣tieth Day.

In the hight of it our work is to keep up the strength, and if through Costiveness they Spit little, give them a Glister, that they may Spit better, and at∣tend the washing their Mouths; but as the Sloughs be∣gin to separate, which will be towards the declension of the Salivation, prescribe them a decoction of Sarsa or the like, to drink at least thrice a day; and before the Slough is quite cast off, purge them, and as they are able to eat Meat, put them into a drying diet, and sweat them, as shall be shewed in its proper place.

It happens sometimes in anointing, that their Mouths are much Ulcerated, and their Breath smells strong, yet their Cheeks do not swell, nor do they Spit con∣siderably; in which case, forbear the anointing, and consider the cause of it, and if the body be strong and plethorick, Vomit them with Turbith, or infusion of Crocus metallorum: But if they are weak or costive, administer a Glister; and if afterwards it rise not, dispose them to Sweat with draughts of warm Posset Ale, or bath them; for that way it will sometimes a∣rise, when with the other it will not. But if they have faintness, palpitation of the Heart, shortness of Breath, Fever and the like, your best way will be to purge it off, with an infusion of Sena, and the like with the aditi∣on of Syrup of Roses solutive, or of Syrup of Buckthorn, and keep up their Spirits the while with Cordials, and good Broaths; if their Lungs be opprest, let them Blood, and prescribe Lohochs; but if there be also a suppression of Urine, or if they make but little and high coloured, purge them with Barnet or Epsom Water turn∣ed into Posset, and quicken it with some purging Syrup. If by these ways of purging the accidents remit, and the Salivation rises, it is well; but if it does not, yet there being a colliquation made, you may by well purging, strict diet, sweating and the like, obtain your end. While you are removing the abovesaid acciden••s, you must have a special regard to the Ulcers within their Mouths; for it is from the fixing of the Mercury, that those malign Ulcers are made, which the less sensible they are of them the more corrupt they are. Some∣times by raising the Salivation by unction, it passes downwards by Stool, in which case, we prescribe

Venice-Treacle, Diascordium, Laudanum, Opiatum and the like, which being given at Night will not only strengthen their Bowels. but dispose them to rest, and incourage them to go on in the anointing, a Vomit of Turbith mineral. After the unction has been some while used, does frequently raise the Salivation, and after it is well raised, you may heighten, or continue it by the application of some of the following Plasters: But if after all your endeavours to raise the Salivation it does discharge it self by a loosness, with great eva∣cuation, you are then to defend the Intestins from the acrimony of the humours, by Glister of Chicken-broath, lest the bloody Flux follows. Inwardly we prescribe large draughts of Chicken-Broath, a Decoction of burtnt Hearts-horn, and Milk-water boyled with a Stick of Cinnamon.

After the Flux is stopt, you must consider the strength of the Patient, and if the Sick be very weak, you must not insist upon Fluxing, but proceed with Sudorificks, and the like, not doubting of success in the Cure; for such a loosness does for the most part contribute as much to the Cure, as if they had Salivated.

There is yet another way of Fluxing, and that is by the application of Mercurial Plasters about the Arms Legs, and the like; they were first designed I suppose for the more tender, and delicate sort of People, who would not admit of the unction.

Take of Diachylon with Orris one pound, of Red-Lead Plaster eight ounces, of Gum Carranna, and Taca∣mahaca, each four ounces, of Benzoin, Storax Calamit, and Ambar, each two ounces, of Liquid-storax, and of Peruvian Balsam, each a sufficient quantity; mingle them over the Fire, and when it is removed from the Fire, add eight ounces of Crude Mercury extinguished with Turpentine; make a Plaster.

These being spread upon a Cloath thick, and applyed, you must then put them into a warm Bed, and with a draught of warm Posset-drink, sweat them dayly, and treat them, as has been said, in the Salivation by uncti∣on.

If it arise not by the first Plasters, you must ap∣ply fresh once in four or five days; and if there be oc∣casion you may hasten the Salivation by a few grains of Turbith Mineral. I have sometimes Salivated Per∣sons by these Plasters, but for the most part, I use them to raise a Salivation, or continue it in such, where I be∣gan it with internals, and for that purpose they are of excellent use.

The humours being evacuated by Salivation and purging, sweating will be necessary; they may sweat in Bed or out of it; the Bed is proper for the weaker sort, and there they may sweat with Bottles of hot wa∣ter, or Bricks heated and placed about them; or they may sweat under a Frame; if they sweat with Bottles or Bricks, they must have many Cloaths, as Blankets and the like to cover them close, and the Bottles or Bricks may be wrapped in Napkins, and applyed ac∣cording as you design to sweat, more particularly any one part; generally they are placed one each side near the Armpits, Hips, and at the Soles of the Feet. If you sweat with Bricks, let them be heated rather by boyling Water than Fire, lest in the Bed they burn the Patient.

The way by a Frame is this, you are to fold a well aired Sheet four double, and lay it under the Patient; then his Shirt being stripped off, the Frame must be pla∣ced over him, and a Sheet over the Frame, and Blankets over that Sheet and both Sheet, and Blankets must be brought over the end of the Frame, and be tucked down close to the Neck; then a Pan of well burnt Charcoal, or Spirit of Wine must be put in the lower end of the Frame; this being done shut the Door, and take care that the heat be kept in. His Head ought also to be covered warm that it may sweat; if he took not his Sudorifick before, he must take it now, the Diet-drink must be warmed, and may be commodiously given with a Glass pipe; a couple of Servants must attend the Patient dur∣ing his being in the Frame, the one of them must attend him with a warm Napkin to wipe the sweat off his Face, and to give him Cloaths to rub his Body with, which Cloaths ought to be thrust in and taken out at one side of the Frame; this Servant ought to have regard

his Master, that upon the least complaint, he may give warning to his fellow to renew the Fire, or to take it out according as there should be occasion. The Fire be∣ing removed, and the Sheet next the Frame somewhat cool, one of the Servants must hold the Cloaths close to the Patients Neck and Shoulders, whilst the other draws the Frame away. Then shall they both tack the Blankets and Covering close to him, and give him another draught of his Diet-drink, and continue him in his sweat half an hour or more, if he can admit it; then gradually cool him, and pull away the wet folded Sheet from un∣der him; then rub him with dry Cloaths and put on his Shirt; and if he be disposed to slumber an hour he may; otherwise he may rise and Dine at his plea∣sure. They commonly sweat three quarters of an hour in the Frame, and an hour in Bed, after the Frame is pulled away.

The ways of sweating out of Bed are by Stove, Tub, Chair, or Cradle; the Stove is most eas••y in regard they may sit, stand, or walk up and down; but when they go out of them to Bed, there is danger of taking cold.

Bathing is of great use in this Disease, whether it be new or old; in dry Bodies, where the Disease has been long confirmed, bathing is necessary to dispose them to Salivation; it is also proper after the Patient has past through the strict course of Salivation, purging and sweating; the Body being thereby dryed and wasted is hereby cooled, moistned, and restored to its natural temper.

In order to bathing, we generally let blood and purge, if there be a Plethoria; but when the Body is wasted and dry, a Glister may serve: Before the Patient enters into the Bath he may drink a draught of Caudle or Broath, and in the Bath he may take a spoonful or two of Harts-horn-Gelly, or the like.

The Vessel we bath in is a Tub wherein the Patient may sit up to the Neck, for want of such a Barrel may serve, the one end being beat out, and a stool placed in it to sit on; the bath Liquor is according to the oc∣casion, and quality of the sick. Sometimes it is all Milk, other times Milk and Water, or only Water with a Bag

of Wheaten Bran, which serves the Patient as a cushion and makes the water milky: They are sometimes Per∣fumed with Wood of Cassia, Rhodium, yellow Sanders, and the like. The Baths of Milk are apt to sowre, therefore ought to be renewed daily; the other will last longer sweet. In the time of Bathing, there ought to be plenty of hot and cold water, to continue the Bath of a moderate temper, neither too hot nor too cold; some Hoops should be fastened over the head of the Tub, whereon a Blanket or Sheet as a Canopy may be cast, in case the Air be cold; a Servant or two ought also to be attending in case of Fainting, lest he sink into the Water; therefore upon his complaint, raise him up, and casting a Sheet about him, put him into a warm Bed, where he may refresh himself, and at his pleasure rise and cloath himself, and Dine or Sup, as his appetite requires. Bathing may be used twice a day, but never upon a full Stomach.

During the cure of this Disease, it will be requisite that the Patient keep his Chamber, and that it be made temperately warm; the taking of Physick and ramb∣ling abroad in the Cold being extreamly prejudicial to their Cure, and is frequently attended with a Loosness and noise in the Ears and Deafness There is also a special care to be taken concerning their Diet, that on those days they Purge, their Dinner be of good Nourishment, Boiled or Roasted. We also allow them good Broath, and Beer or Ale to raise their Strength, so as they may be able to bear the evacuation which is required. But in the time of their Sweating, we con∣fine them to a very slender and drying Diet, only suffi∣cient to support their Spirits. A Chop of a Neck of Mutton or two Ribs dry Roasted, was the old stint. I permit them to make choice of one sort of Meat, and keep them to it; which among the better sort is, Par∣tridge, and that without Sawce, their Suppers may be Bisket, Raisins of the Sun, and a few blanched Almonds, and their Drink a Decoction of Sarsa, and the like; but in weak and extenuated Bodies, China Broath, or a mixture of Milk with their Diet-drink may be ne∣cessary.

Exercise is of use in the beginning of this Disease, and may serve to rouse the native heat, and to thrust forth the malignity, and waste superfluities; but after the Disease is more confirmed, violent exercise is hurt∣ful.

Sleep is allowed in the day to refresh them, they be∣ing for the most part disturbed in the night by their Pains, which are therefore called Nocturnal.

Venery ought to be avoided, and the Passions of the Mind.

As to a Gonorrhea, the main of the Cure is perform∣ed by Purging; but because the Disease is accompanied with an Inflammation, and cured by Purging Medi∣cines that are hot, cooling Diet must be ordered through the whole Course.

Take of the mass of the Pill Coch. Major, three drachms, of Extract of Rudius, one drachm, of rosin of Julap, and Diagridium, each half a drachm, with a suffi∣cient quantity of Opobalsamum; make six Pills of every drachm.

The Sick must take four of them at four or five a Clock in the Morning, and sleep upon them for twelve or fourteen days or more, till the heat of Urine and the yellow colour of the Matter be much lessened; af∣terwards every other day for a Fortnight, and afterwards twice a Week, till the Humour quite stop, which will not be done till a long time, though it be commonly affirmed, that that Ichor that is seen especially in a Morning at the top of the Yard being pressed, proceeds only from a loosness of the parts, by reason of the long continuance of the running: Yet the Sick will find it otherwise, if he neglect Purging before it is quite gone: For upon any small occasion, as by immoderate Drink∣ing, violent Exercise, or the like, the Gonorrhea will return.

But if the Gonorrhea does not yield to such kind of Purging, it will be proper instead of Pills, especially if the Sick are difficultly Purged, to give betwixt whiles some more powerful Medicines, as is the following Purge.

Take of Tamarinds half an ounce, of the leaves of Sena two drachms, of Rhubarb one drachm and an ha••f; boyl them in a sufficient quantity of Water, in three ounces of the strained Liquor; dissolve of Manna and syrup of Roses solutive, each one ounce, of syrup of Buck∣thorn and of Electuary of the juice of Roses, each two Drachms, mingle them; make a Potion.

If the Cure proceed slowly, give eight Grains of Tur∣bith Mineral, only twice or thrice, and at due distan∣ces, lest a Flux arises; and this Medicine is certainly the best for an obstinate running of the Re••ns.

But sometimes the Sick has such an ••ver••••on for Purg∣ing often repeated, that he cannot so much as see or smell the Medicine; and sometimes by a certain Idiosyncrasy, there is such an obstinate opposition to Purging, that a due quantity of the peccant Humour cannot be evacuated; and whilst we waste time to no purpose in endeavouring to purge the Sick, the Pox creeps on; when the case is so, we must use Glisters, and on those days the sick does not use them, we must give Cathar∣ticks by the Mouth: I proceed in the following manner, I give the foresaid Pills, or the like for two or three Mornings following, and afterwards I order the follow∣ing, Glister to be injected in the Morning, and at five in the Afternoon daily, till all the Symptoms cease; only once or twice a Week I give a Purge, omitting on those days the Glister.

Take of the Electuary of the juice of Roses, six drachms, of Venice Turpentine dissolved in the yolk of an Egg an ounce, mix them with a pint of Barly-water; to the strained liquor, add two ounces of Diacatholicon; mingle them, make a Glister.

Every night at Bed-time I give twenty five drops of Opobalsamum, mixed with Sugar, or for want of it, Cyprus Turpentine, to the quantity of a hazel-Nut.

I forbid salt Meats and other things of hard digestion, as Beef, Pork, Fish, Cheese, Roots and Herbs, and

all Summer Fruits, and instead of them, I order Veal, Mutton, Chicken, Rabbets, and the like, and the Sick must eat but sparingly of these. He must forbear Wine and all strong and sharp Liquors; but he may drink Milk boyled with thrice the quantity of Water, and a small quantity of small Beer at Meals, and betwixt the Purging, he may drink of the following Emulsion fre∣quently, to qualifie the heat of Urine, and the Inflam∣mation.

Take of the seeds of Melons and of Pompious, each half an ounce, of the seeds of white Poppies, two drachms, of blanched Almonds number eight, beat them together in a marble Mortar, pouring upon them gently, a pint and an half of Barly-water; to the strained Liquor add a sufficient quantity of Christa∣line Sugar, and make an Emulsion.

When the Sick is of a very sanguine Constitution, and when the Disease is obstinate, after I have Purged him a Month or thereabout, I order eight or nine Ounces of Blood to be taken from the Arm.

In this disease he that Cleanses well, Cures well, on∣ly Mineral waters must not be used.

But it is to be noted, if the Glans be covered all over with the Prepuce, and if by reason of the Inflam∣mation it be swelled hard and callous, so that it cannot be drawn back, it is in vain to attempt the cure of the Running, unless at the same time the Part affected be reduced to its natural State, the hardness and swelling being removed; therefore the following Medicines must be used

Yake of the roots of Marshmallows and of Lillies, each one ounce and an half, of the leaves of Mallows, Mul∣lein, Elder and Henbane, of the flowers of Camo∣mile and Melilot, each one handful, of the seeds of Flax and Fenugreek, each half an ounce, boyl them in a sufficient quantity of Fountain-water, make a Fomentation, wherewith foment the part half an hour at a time, twice or thrice a day.

After the fomentation I order that the part affected be anointed with the Oyl of Flax-seeds fresh drawn, and that a Plaster of the Mucilages be apply'd to the swell'd lips of the Prepuce; but if the Ulcer in the Lips of the Prepuce or on the Glans under it hinders it from being drawn back easily, besides the fomentation above men∣tion'd I prescribe also the following Liniment.

Take of Basilicon six drachms, of the Ointment of Tobac∣co two drachms, of red precipitat wash'd in Rose-water and well powder'd half a drachm; mingle them, make a liniment wherewith make Pledgets and apply them to the Chancres after the use of the fomentation.

But when the Scrotum is the seat of the Disease, af∣ter the use of the fomentation, if the pain and swelling be not abated, apply a Cataplasm of Oxycrate and Bean-flower; also at the same time, I use inwardly Catharticks and cooling Medicines, and order the Diet above-men∣tioned, and bleed at any time of the Disease, if the swelling in the Scrotum be great, and if the pain be violent.

If a swelling arises in the Groin, apply the follow-Plaster to suppurate it.

Take of Galbanum and Ammoniacum, each two ounces, of Opopanax and Sagapenum, each one ounce, of Mu∣stard-seed and Pellitory of Spain, each six drachms, of common Soap, two ounces, of Burgundine Pitch, four ounces, of Oil of Lillies, two ounces, of Wax a sufficient quantity; make a Plaister.

For Ulcers in the Pallate and Tonsis.

Take of all the Throatwort, three handfuls, of Holm, Self-heal and Male Speedwell, each one handful, of red Roses, one pugil, of red Sanders and the Wood of Juniper, each one ounce; make a Decoction in two quarts of Barly-water; boil it to the consumption of a third part; in the strain'd Liquor dissolve of sy∣rup of dried Roses and Diamoron, each three ounces, of Hony, two ounces; make a Lotion.

With this the Ulcer may be washed daily either by Syringing or Gargling: but if the Ulcers be behind or over the Palate, the best way to cleanse them will be to pass the Injection up into the Nostrils; but the Pati∣ent must keep his Mouth full of Water all the while to prevent Coughing.

If the Ulcers are sordid, dress them with the Lac sublimate upon an armed Probe; if there be a Caries in the bone of the Palate, touch it with Aqua divina Fernelii; if the bone be corrupted through, 'twill be ne∣cessary to wear a plate.

In Ulcers of the Nose, the matter usually mixing with the excrementitious humours dryes in the passage, and thereby prohibits the discharge, and increases the ulcera∣tion, and also the Caries, and therefore you are in the first place to supple and remove that, by casting up mucilaginous decoctions.

Take of cleans'd Barly one ounce, of the roots of Marsh∣mallows two ounces, of the Seeds of Quinces three Drachms, of Liquorish two drachms, boyl them in a quart of Fountain-water; to the strain'd Liquor add three ounces of Oyl of Almonds; let it be injected often in a day; the mucus being thus removed, inject the following Water.

Take of Sarsaparilla sliced three ounces, infuse them twenty four hours in three pints of plantain-water, then boyl half away, towards the end add of the Leaves of Agrimony, Sage and the tops of Brambles each one handful, of red Roses and Balaustines each half an handful, quench Steel often in the strain'd Liquor, and add to it two drachms of Roch Alum, and make an Injection.

This will cleanse the Ulcers, and in the mean while you may by Anti-venereals hasten the exfoliation of the Bones, and consolidation of the Ulcers. For the extir∣pation of Warts and the like Excrescencies magisterial water of Alum, lac Sublimati, Spirit of vitriol, and the caustick Stone, are proper; when these will not do the business, the Ligature and Knife and actual cautery

will; but the growing of them again must be prevented by Anti-venereals.

To cure the fluttering noise in the Ears arising in this Disease,

Take of the bark of Guiacum one drachm, of the bark of Sassafras two drachms, of Castor four scruples, of the flowers of Lavender one drachm and an half, of Cloves half a drachm, of Spirit of Wine rectified, eight ounces; make an Infusion in a glass Vessel, twenty four hours upon hot Ashes; keep the strain'd Liquor for use. Put some of this daily into the Ears warm with Cotton.

To ease Pains,

Take of Lard four ounces, of Oil of Scorpions two oun∣ces, of the Oils of Camomil, Rosemary and Sage, each half a drachm, of Petroleum and Spike Oil, each one drachm, of London Laudanum one Scruple more or less; mingle them and anoint the Part.

If Nodes cause the Pain, apply the Plaister of Frogs, with four times the quantity of Quick-silver.

CHAP. CXXVII. Of the Itch, and Spots and Pimples in the Face.

OFten and constant eating of salt Fish or Flesh, and dryed in the Sun, also Drinks that are disagreeable and poysonous, do commonly cause cutaneous erupti∣ons; also the Humour gathered in the cutaneous Glands, sometimes by meer Stagnation, becomes not only itchy, but oftentimes corruptive; wherefore, not only they that have been long kept in Prison, but also they that have liv'd a Sedentary Life and are used to Filth and Stinks, are subject to these Diseases.

As to the cure of the Itch, there are two primary In∣dications; First, that the glandulous Humour be redu∣ced to a due disposition. Secondly, that the pores of the Skin be freed from ichorus concretions.

The preservative Indication respects these two things. First that the itchy Humour does not regurgitate upon the Blood and nervous Liquor. Secondly, that itchy Humour, if it be fallen upon the noble Parts, be era∣dicated.

All these intentions of Healing, ought to be compli∣cated, or at least provided for by turns, by external and internal Remedies. You must begin and end with Purging; and Bleeding, if nothing contra-indicates, must be used at the beginning. Alteratives must be also used, and Liniments and Baths, or Topicks of other kinds. I will set down some choice forms of Medicines of eve∣ry kind, and first as to Purges; a Purge or a Vomit must be given at the beginning, and after bleeding, (if it be used) a purging Apozem, or Diet-Drink, must be taken for seven or eight days.

Take of the Electuary, called Diacarthamum, three drachms, of the Species called Diaturbith with Rhu∣barb, one drachm, of Cream of Tartar and Salt of Wormwood, each half a Scruple, of the purging Sy∣rup of Apples a sufficient quantity; make a Bolus.

Take of Sulphur of Antimony grains seven, of Scammo∣ny sulphurated, grains eight, of Cream of Tartar, half a scruple; make a Powder.

Take of the Roots of Polipody of the Oak, of sharp-pointed Dock prepared, each one ounce, of the leaves of Sena ten drachms, of Turbith, Agarick, and Dodder of Thyme, each one ounce, of the seeds of Carthamus half an ounce, of yellow Sanders two drachms, of the Seeds of Anise and Caraways, each two drachms, cut them and beat them, and digest them hot in two quarts of White-wine in a Vessel close stopped for twenty four hours; pour off the clear Liquor without pressing. The Dose is six ounces, either by them∣selves, or with a spoonful of the Syrup of Dodder of Thyme. Or,

Take the fore-said Ingredients and boyl them in three quarts of Fountain-water till half is consumed, then add a pint of White-wine, strain it presently to be taken as before. Or,

Take of the roots of Polypody of the Oak, of sharp-pointed Dock, each three ounces, of the best Sena four ounces, of Dodder of Thyme, Turbith, and Mechoacan, each two ounces, of yellow Sanders one ounce, of Coriander-seeds six drachms, prepare them according to Art, make a Bag for four Gallons of Ale, after five or six days Tap it, and take three quarters of a pint, more or less every morning for eight or ten days.

For the ordinary drink provide four gallons of small Ale, and hang in a Bag in it the following Ingredi∣ents.

Take of the tops of Tamarisk and Fumitory dryed, each four handfuls, of the roots of sharp-pointed Dock dryed six ounces, of the bark of Woody Night-shade two ounces, cut and beat them.

As to altering Remedies, there is little need of others besides the altering drink above prescribed; only the Patient must observe a good course of Diet, he must forbear salt and peppered Meats, Shell-fish, and such as are Pickled; also Wine, Strong-waters and strong Beer.

As to Ointments, the following is commonly used.

Take of the powder or flower of Brimstone, half an ounce, of Butter that is not Salted, four ounces, of Ginger powdered half a drachm, make a Lini∣ment.

The following is neater, though not much more ef∣fectual.

Take of Ointment of Roses four ounces, of Brimstone half an ounce, of the Oil of Tartar per deliquium, a sufficient quantity, make a Liniment; you may perfume it with a scruple of Oil of Rhodium.

But after all, I have found by much Experience, that Quick-silver Girdles (though they are generally much disliked) are most effectual for curing the Itch, and as Safe as any other Medicine, if they are prepared in the following manner.

Take of Quick-silver three quarters of an ounce, the White of one new laid Egg, beat them together in a woodden Dish with a Stick two hours, then spread it on a Girdle of new Flannel the breadth of three Fin∣gers; you must spread it all by degrees and dry it in the Sun, or by a moderate Fire, and it must be worn a Month or six Weeks, being sewed strait round the Waste; the side whereon the Mercury is being turn∣ed

to the Body. The Patient must be Purged once before the use of the Girdle, and once after the Itch is cured.

And by this short and easie Method, I have cured whole Families infected with the Itch, and never per∣ceived the least Injury, though I have used it frequent∣ly and several Years.

The following Water is excellent for taking off Spots and Pimples from the Face, and the redness of it, and that blackness which looks like Gunpowder in the Face, especially about the Nose and Fore-head, which is sometimes the black heads of Worms.

Take of Sublimate one ounce, put it into a tin Pot with three pints of Fountain-water, let them stand toge∣ther twenty four hours, stir them now and then with a Stick, till all the Liquor looks black; filter it through Paper, and with a Feather or the like dipt in it, touch the Face gently once in a day or two.