Dr. Willis's practice of physick being the whole works of that renowned and famous physician wherein most of the diseases belonging to the body of man are treated of, with excellent methods and receipts for the cure of the same : fitted to the meanest capacity by an index for the explaining of all the hard and unusual words and terms of art derived from the Greek, Latine, or other languages for the benefit of the English reader : with forty copper plates.

A Description of an Epidemical Fever chiefly infestous to the Brain and Nervous stock, spreading in the year 1661.

IN this Country, before the last Summer, viz. 1661. We had been free for above two years, from any popular Disease, unless such only as usually come in some places; * 1.1 but then, before the Summer Solstice, the small-Pox (a distemper here rarely Epidemi∣cal) being rise in many places, raged very much: After that Summer, which was ex∣treamly hot and dry, an Autumn moister than usual followed: and after which, a most mild Winter, almost without any cold: in all which space, the Earth was hardly co∣vered with Snow, or was ever hard frozen, above three or four days; so that within a * 1.2 few weeks, after the Winter Solstice, the Trees began to bud, and the vernal Plants to break forth from the bosom of the Earth, and to flower, and also the birds to build nests: to this mild season, not eventilated at the beginning of the spring, by the nitrous little bodies that were wont to be blown from the North, a filthiness of showers, and almost continual wet succeeded. After the vernal aequinox, a certain irregular, and un∣accustomed Fever, seised upon some, here and there, which within a month became so Epidemical, that in many places it began to be called the New Disease; Raging chiefly among Children, and Youths; it was wont to afflict them with a long, and as it were a chronical sickness: yea sometimes, old men, and men of middle Age, though rarely, were seised by it, and those indeed, it did sooner, and more certainly kill. The Distem∣per * 1.3 at first invading any one, did creep on them so silently, that the beginnings of the sickness were scarce perceived: for arising without immoderate heat, or more sharp thirst, it induced in the whole body a great debility, with a languishing of the spi∣rits, and a torpitude or numbness of the function; The Stomack was ready to loath any victuals, and to be grieved at any thing put into it, and yet not easie to vomit. The sick were unfit for any motion, and only lov'd to be idle, or to lie down upon the Bed: within a short time, also sometime at the first coming of the Disease, they complained of a heavy vertigo, a •…•…ingling of the ears, and often of a great tumult and perturba∣tion of the brain. Whick kind of symptoms were often esteemed, as it were the pe∣culiar sign of the approach of this Disease, if in some those had been wanting, or hap∣ned to be more remiss, instead of the head being affected after that manner, the Di∣sease took more deep root in the Breast, with an excited Cough, as shall be told by and by. But whilst the Brain, and the Nervous Appendix, being after this manner affected, the animal spirits, presently from the beginning of the sickness, were benummed, a slow, and as it were Hectick Fever, was inkindled throughout: but'yet the effervescency of the blood, which was hardly continual, but flitting and uncertain, was according to the disposition of the blood it self, in some more intense, in others more remiss; and therefore, thirst, the white scurf of the Tongue, and other symptoms, which ac∣company a feverish distemper, did more or less infest them: sweating did not willing∣ly follow; nor could it easily, or by a light thing be caused by Art: yea, neither this, nor any other evacuation, as it were critical, at any time succeeding, did suddenly help this Disease; but it persisting for many weeks, and sometimes months, reduced the sick to the highest Atrophie, or wasting of all parts, and often infected them with an incurable Consumption.

About the increase of the Disease, which hapned in most within eight days, if the Distemper (as it was often wont) did settle chiefly in the head, and nervous system, most grievous symptoms, in their Dominions, viz. a plain Phrensie, or deep Stupidity, or Insensibility did molest them. For I often observed, in many Children, and not sel∣dom in Women, after seven or eight days from their falling sick, that their knowledg and Speech failed them, and so the sick have lain, for a long while, yea, sometimes for the space of a whole month, without any taking notice of the by-standers, and with an involuntary flux of their extrements; but if they continued in some sort the use of Judgment and Reason, they laboured with a frequent Delirium, and constantly with absurd and incongruous Chymera's in their sleep. But in men, and others of a hotter temperament, from the morbific matter, instead of a Crisis being translated to the brain, a sury, or dangerous, and oftentimes deadly Phrensie did succeed. But if nei∣ther stupidity, nor great distraction did fall upon them, swimmings in the head, Con∣vulsive motions, with Convulsions of the members, leapings up of the tendons, did grievously infest them. In almost all the sick, the belly was for the most part loose, casting forth plentifully now yellow, now thin and serous excrement, with a great stink: it was rarely that vomiting fell upon any one: The urine in the whole process of the

Disease, (unless when the morbific matter being carried more plentifully into the Brain, did threaten a Phrensie) was highly red, so that some, by reason of the deep colour of the water, judg'd this Fever to have been plainly Scorbutick: which notwithstanding appeared to be otherwise, because antiscorbutic Remedies, (of which indeed many, and almost of every kind were tried) were little or nothing beneficial. It was most of all to be admired, how soon after the beginning of this Disease, the flesh of the sick con∣sumed, and they reduced to the leanness of a Sceleton, when in the mean time there was no great heat that might by degrees confume the solid parts, nor any violent evacuation, which might greatly take them down.

Besides these evils molesting the region of the head, a distemper no less dangerous oftentimes fell upon the breast. For in some, tho not in all, a Cough very troublesome, with abundance of spittle, and thick, was excited: this hapned in some about the de∣clination of the Disease, to wit, whilst the confines of the brain were serene, as it were the clouds sent from thence to the Thorax, a great Catarrh suddenly rained down up∣on the Lungs. But in others, who especially had little infection of the Disease in the head, presently after the beginning of the Fever, a cruel Cough, and a stinking spit∣ting, with a consumptive disposition, grew upon them, and suddenly, and unthought of, precipitated the sick into a Pthisis: from which, nevertheless, they recovered, by the timely use of Remedies, often beyond hope. It was observ'd in some, That after a long eclipse of the sensitive facultie, and oppression of the brain, from the morbific matter, at length tumors did follow, in the glandula's, near the hinder part of the neck, out of which, being hardly ripened and broke, a thin and stinking ichor or mat∣ter ran for a long time, and brought help. I have also seen watery pustles excited in other parts of the body, which pass'd into hollow ulcers, and hardly curable: some∣times little spots, and petechiales, appeared here and there: yet I never heard that any more broad or blew, of these kind, were seen in the sick. Notwithstanding, tho this Fever was not remarkable for very many malignant spots, yet it was not free from Contagion. For that in the same Family, it invaded almost all the Children and Youths successively, yea not rarely those of more ripe years, and at mens estate, who look∣ing to the sick, were familiarly conversant in their Chambers, or about their beds, were infected with the same infection: But indeed, there was not so much cause of suspition, that for it the friends of the sick should be wholly interdicted from com∣merce with, or visiting of them.

Altho the course of this Disease (unless when it intimately setled in the brain) did appear so gentle, and continued without any horrid symptom; yet its cure being al∣ways difficult, succeeded not under a long time: For the sick rarely grew well within three or four weeks, yea for the most part scarce in so many months. If this Disease fell upon men of a broken Age, or strength, especially those who were before obnoxi∣ous to cephalic distempers, as the Lethargie, Appoplexie, or Convulsion, it oftentimes kill'd them in a short space: but if there was any hope of recovering, it could be but slowly procured, (all Remedies whatsoever scarce bringing any sensible help) so that the sick did no sooner come out of the sphere of this Disease, than they fell into the con∣fines of a Consumption.

If the formal reason, and courses of this aforesaid sickness be demanded, it here easily * 1.4 appears, the watering liquor of the brain and nervous stock, for the most part both to∣gether, with the blood, to be in fault; and the immediate cause, especially of the trou∣blesome symptoms, to wit, forasmuch as this water, presently after the first assault of the Disease, was grown more poor than usual, and as it were lifeless; therefore a languishing, and enervation, with a spontaneous weariness and impotency to motion, hapned in the whole body, and with a sudden wasting of the body in the sick. Fur∣ther, forasmuch as the same Liquor was stuffed with heterogeneous Particles, viz. partly narcotick, partly explosive; therefore a numbness, a sense of pricking, leapings up of the tendons and muscles, and contractures, also the Virtego, giddiness, and other more grievous Cephalick distempers did arise. Moreover, forasmuch as by reason of the evil of the nervous juice, being not quickly or hardly to be mended, the cure or healing of the Disease became so hard and lingring. But for that the fault of this Latex, necessarily depended on the diserasie or evil disposition of the blood, also of the depraved constitution of the brain, what their morbid dispositions were, and by what means they brought sorth the beginning or tinder of the symptom of the Fever but now described, let us now see.

As to the former, it seems, that at this season, by reason of the hot and humi'd con∣stitution of the year, and no blast from the north (the little bodies of which imbue the blood and juices of our body, as it were with a nitrous seasoning, and by agitating them, desend them against putrefaction) the blood in most men, and chiefly in Chil∣dren,

Youths, and Women, became like standing-water, that so contracts a setling ve∣ry impure, stuft with heterogeneous particles, and turning to a clamminess, and wa∣trishness; in which, the more pure spirit and sulphur, being somewhat depress'd, the watery particles, being carried forth with the impure salt and sulphur, were too much exalted. Wherefore the blood, both by reason of its Crisis or constitution being vi∣tiated; also by reason of heterogeneous particles being heaped up more plentifully in its bosom, was made more fit, either of its own accord, or occasionally, or because of the contagion to receive a feverish Effervescency, so that from thence, very many sell at this time into fevers. But the blood growing hot, from the feverish taint being received, did not presently burn with an open flame, but like green wood laid on the fire, with a flame as it were suppressed, and much incumbred with smoke. Where∣fore, the morbific matter, being heaped within its mass, was not wont (as in a regular fever) to be consumed by the burning, and its reliques at the set time to be extermi∣nated by the Crisis: but yet, a little after the beginning of the feaver, a great portion of this matter being poured into the head or Thorax, or into both at once, and afterwards being continually supplied in those parts, it induced either the aforesaid distempers of the brain and nervous stock, or cough with a consumptive disposition, or both together; and for this reason, about the beginning of this disease, when a pulse quicker than it ought to be, and a high coloured urine, and full of contents, did show the blood to grow hot with a Feverish distemper, the sick did not complain of heat, or thirst, be∣cause the blood growing hot, did lay up its impurities and recrements, forthwith into the provision of the nervous Liquor, or into the Lungs; wherefore, within these recep∣tacles, the Symptoms presently became worse; but afterwards the disease growing on, a somewhat sharp heat, with scurfness of the tongue, was wont to be troublesome to some: yea, in all, a slow, and as it were hectick fever, continued throughout; which neither by sweat, nor by insensible transpiration, could be so wholly removed, but that it was daily renewed, chiefly after eating, tho never so small: which thing truly see∣med to happen, because the nervous juice being full of the feculencies brought from the blood, did not afterwards receive them in so great plenty, but that these recre∣ments, together with the nutricious humor, (and for that this was not consumed by nourishing the solid particles) remaining within the bloody mass, caused it then to grow feverishly hot.

2ly, Besides this morbid disposition of the blood, contracted from the intemperance of the year, it seems, that the brain also, from the same occasion, was made prone to the aforesaid passions. For when for a long tract of time, the southern winds did con∣tinually blow with a moist constitution of the air; from thence the passages and pores of the brain, being very much loosned and opened, and its connexion too much dissol∣ved, they gave an easie passage to serous humors, and for all sorts of heterogeneous particles; wherefore the blood being very feculent and watery, as soon as it began to grow hot from the fever, carried its serous recrements and filths, presently thorow the two open doors into the head: for whosoever he was, who did not complain of his head, being too much stuffed with a moist air, and numbness of spirits; on the contra∣ry, his pores being bound together by an intense cold, or drier air, all his senses and fa∣culties remained more quick and lively.

These things being thus premised, concerning the morbid provision of the brain and humors, to wit, of the blood and nervous humor by reason of the constitution of the year, whereby indeed, very many at that time, fell into a slow, unequal, and long con∣tinuing fever, surrounded with Cephalic and Convulsive symptoms, and hardly curable: hence also it will be easie to unfold the reasons of the rest of the symptoms and acci∣dents, chiefly to be noted in this disease.

For first of all, that this irregular Fever raged chiefly among Children, young Men, Women, and phlegmatick men, the reason was, because in those kind of bodies, the blood * 1.5 was apt to be more waterish, and less perspicable, and from thence to gather a serous 〈◊〉〈◊〉, or watry humor and heterogeneous feculencies; and also, the brain being more humid and weak, easily received any recrements of the blood. Wherefore it may be observed, that those sort of persons, were found more prone to Convulsions, ari∣sing by reason of any other occasions.

Secondly, the noted Atrophie or leaness, came so suddenly upon this fever, because by * 1.6 reason of the depravation of the nervous juice, the officies of nourishment, depending upon it (which as we have elsewhere shown, are highly active) presently failed. For altho we do not grant, the nervous humor to be only nutricious, but to dispense thorow the Arteries, a matter destinated to the nourishable parts, prepared in the bloody mass; yet it may be lawful to think, that the Liquor watering the brain and nervous stock, by means of an efficient cause, doth conduce very much to alimentation; for this grow∣ing

turgid with animal spirit, actuates and invigorates the nutricious juice, brought to every part by the blood, and admitting it into the passages, and most intimate re∣ceptacles of the body to be nourished, and as it were leading it in, assimilates or re∣sembles it; wherefore, when this houshold liquor is so depraved, that it doth not right∣ly supply the animal spirits, requisite about the work of nutrition, all the members and parts of the stomach vitiated in its tone, either spues back whatsoever nourishment is brought, or cannot receive it to its proper use: wherefore truly in this Disease, the bulk or habit of the body, however fuller or fatter, was more sooner pulled down, than in a continual Fever, where it might much more evaporate by the intense heat, or copious sweats. The reason of which is, because in a burning Fever, altho the blood growing very hot, exhales more plentifully; yet in the mean time, it continually af∣fords something of nourishment, which the several parts helped by the benefit of the nervous juice, easily received and assimulated; but in this nervous Pestilence, altho the nutritive matter was sufficiently provided, yet by the defect of the nourishment of the spirits, the nourishment was altogether inhibited.

3. For the aforesaid reasons also, this Fever being a long while protracted, was * 1.7 wont scarce ever to be critically helped, and difficultly cured, by the help of almost any Medicines: For the feverish matter creeping presently from the beginning of the Disease into the nervous liquor, could hardly afterwards, and not but of a long time, be exterminated from its bosome: for that this water, with a slow motion, and flow∣ing leasurely in the straight vessels, does not as the blood, conceive of its own ac∣cord a purifying effervescency or fermentation; neither can the forces of Medicines reach to it so easily and unmixed: but either they are first hindred by other parts, or because they are heterogeneous, they are wholly excluded from the brain, casting back whatever is incongruous. In truth for this reason, all distempers of the brain and nerves, as it were making a mock at Medicines, are most difficultly cured. Therefore in this Fever, if the evil impressed on the brain and nervous stock was taken away, ei∣ther a cruel cough with plentiful spitting, or tumors, or an imposthume in the neck did follow: to wit, the morbific matter being supped back by the blood, and again depo∣sited, setled either in the Thorax, or in the Glandula's and Emunctories, nigh the hinder part of the neck. But this Disease was the more contumacious, because the discrasie or evil constitution of the blood, was not easily mended: for altho from the begin∣ning, its Latex, the recrements being poured forth, even into the nervous Liquor, grew but little and sluggishly hot; yet afterwards, these receptacles being filled, and the morbific feculencies, and besides the nutritious matter, not imployed in nourishing the parts, being resident even in the blood, did aggravate it, and for the exclusion of this trouble, not to be immixed with it, did induce an effervescency, such as is wont to be in an hectict Fever, either almost continual, or presently apt to come again. For I have often observed in this Fever, from Grewel, Barley broth, and other slender diet, no less ebullition of the blood to be stirred up, than from broth made of flesh: whe∣ther indeed the nourishing juice supplying the blood from the chyle, because it was not imployed in the work of nutrition, carried something heterogeneous, and not rightly miscible, as a trouble to the blood; and by reason of the particles of this su∣perfluous juice, being copiously sent away with the serum, the Urine became very thick, red, and very full of contents: Also, for the same reason, the belly was for the most part loose, forasmuch as the blood, filled full of the nutritious juice, did suck forth a lesser portion of the chile from the bowels, and did pour back again part of that which had been brought to it on the intestines; the feverish Distemper did likewise stick so long in the blood, because, till the animal regiment being restored, nutrition was rightly performed, that superfluous matter was carried into the mass of blood.

We deliver the example, and the Aetiology, or rational account of this aforesaid Fever, more largely for this reason, because the same Disease did fall upon our Coun∣try-men, here and there also at other times: for that of late, in this City, all the younger people of a certain Family, were sick of it: yea, I remember, that some time past, very many laboured with such a Fever. Out of the many Histories and Exam∣ples of sick people, which it rendred when it was epidemical, I will here propose one or two.

A strong and lively young man, about the beginning of the spring, 1661, falling * 1.8 sick, without any evident cause, without any great heat or thirst, he became sudden∣ly weak, and as if enervated, with a dejected appetite, and languor of spirits. Ca∣thartick Remedies, Antipyretics or allaying of heat, digestives, and also antiscorbutics, and others of various kinds, administred by the prescriptions of the most famous Phy∣sicians, availed nothing: But, notwithstanding, the sick man hitherto languishing with a

slow and wandring fever, with a quick and feeble pulse, a deep-coloured urine, had kept his bed a fortnight; besides being reduced to the greatest leanness, he complain∣ed of a giddiness, and as it were the fluctuation of a sound in his head, and a ting∣ling noise in his ears. Altho he was troubled with a great stupor, yet his sleeps were mightily troubled with delirious fables. After four days, when the fever was not yet declined, it was thought good to take away four or five ounces of blood by Leeches, from the sedal veins; from hence the fever began to be much exasperated, for a great intense heat, with thirst, watchings, and almost continual tossing of the body, also the tongue dry, and scurfy, appeared; then quickly a troublesome cough, with abundance of discoloured spittle followed; to him were administred, almond, and bar∣ly-drinks, with temperate bechicks (or things to stop coughing) boiled in them: water of milk distilled with snails, and pectoral herbs, the shelly powders, prepared nitre, and often Cordial Opiats; which notwithstanding scarce giving any help, the sick man still became more weak; when in this manner being sick above two months space, the feverish distemperature, and cough also, daily growing worse, he seemed near death, at length a voluntary sweating arising, so that every night, or every other night, he sweat abundantly, and from thence finding himself better, using then the foresaid Remedies, he grew well within six weeks.

Till I had seen many sick people after the same manner, I suspected this disease to be altogether an hectick fever with a consumptive disposition of the Lungs; but when I saw many others at that time fall sick ordinarily, after the like manner, I easily in∣stituted * 1.9 the Aetiologie or national account of this feavour, such as I have already de∣scribed: to wit, that the blood, because of the intemperature of the year, and per∣haps from errors in diet, had contracted a vitious procatarxis or remote cause: Then it growing feverishly hot, and presently carrying its impurities to the brain, and so de∣praving the juice, watering it, and the nervous stock, induced the vertigineous distem∣pers, with a stupor, a languishing of spirits, and an atrophy of the whole body: but so long as the blood did transfer its recrements, from its own bosom, into the brain and nervous appendix, the feverish heat continued more gentle and mild; but after∣wards, when the tending downwards of the morbific matter, by the opening of the hemorhoid veins, was drawn away from the brain, the same being first retained within the bloody mass, increased the fever; then being poured on the Lungs, exci∣ted the cruel cough, with plentiful spittle: but forasmuch as the flesh of the Lungs re∣mained free from putrefaction, as soon as the serous water was sent away by a more plentiful sweating, the sick man became free, both from the fever and phthisis or Con∣sumption, that seemed so deplorable.

In the mean time, whilst he lay sick, I visited another, about 12. years of age, after the like manner affected. But this when I was first sent for, having been sick * 1.10 above a month, was reduced to the leanness of a Skelliton: besides he was troubled with a vertigo, with a noise in his ears, and deafness, and also with a violent cough with yellow, and as it were consumptive spittle: his pulse was quick and feeble, his urine red and thick, his appetite much dejected, his spirits so languid, and his strength so cast down, that he could not keep out of his bed: I gave this Youth to drink often in a day, water distilled from milk, with snails and temperate herbs: besides I ordered him an open decoction, such as is in use for the Rickets, to be daily taken instead of his ordinary drink; by the help of which Remedies, he was restored to his health in a months space. At this time I was sent for to many other people, of every age and sex, distempered by the same disease, now clearly Epidemical; for it running tho∣row whole families not only in this City and the neighbouring parts, but in the Coun∣tries at a great distance, as I heard from Physitians dwelling in other places, increa∣sed very much. Those for the most part labouring with this fever, so be they were other∣wise whole, grew well by the fit use, and order of medicine and dyet: but it hapned very often but ill to those who were indued with a weakly constitution of brain and nervous stock, or broken with age; but not seldom the case of the sick became dange∣rous because the Physitians were not wont to be sent for presently after the beginning of the disease, yea, scarcely before it had more deeply spread abroad it roots, and the opportunity of healing was past.

For that reason, this fever became very deadly, in the family of a certain Noble man among his children, originally obnoxious to Cephalic distempers. About the vernal * 1.11 Aequinox, a Boy of about eleven years of Age, began to be sick: At first without any vehement heat, or thirst, a dejection of appetite, and want of strength came upon him: Besides, an almost continual giddiness did trouble him, with a frequent danger of fainting, that he often thought he was just dying. By the advice of a certain woman

attending him, they daily gave him Clisters: then, when from the foulness of the Mouth and Tongue, manifest signs of a Fever appeared, this Emperick on the fifth day, gave him a vomit of the infusion of Crocus metallorum, and on the seventh day a Cordial Powder being administred, the incited the sick Youth covered with blankets to sweat: but presently he began to talk idly, complained that his Cap was fallen in∣to the water, by and by becoming speechless, within four hours, whilst I was sent for, he expired before I came.

A little while after, the same disease fell upon his younger Sister: whose sickness however because it was accompanied with a frequent and humid Cough, was thought at first to be only a taking of Cold; but within a few days, this Cough became plainly Convulsive: so that, whilst she coughed, the Diaphragma being carried upward, and with a renewed Sistole, held so a long time, she made a great noise as if about to be suffocated: then this little maid growing more apparently feverish, complained of thirst and heat, and lay all night without sleep with a mighty agitation of her bo∣dy, and began to talk idly, after the same manner as her brother, of her coat being fallen into the water; and when all things grew worse, she began to be tormented with Convulsive motions, first in her Limbs, by and by in her face, and then in her whole body: the Paroxysms coming by often turns, twice or thrice in an hour, did most grievously trouble her, so that this little wretch, within the space of 24. hours, after the Convulsive Distempers began to grow more grievous, her animal spirits being al∣most quite spent, she died; whilst the Convulsive fits tormented her, her pulse was ve∣ry much disordered, and often intermitting, also a frequent vomiting molested her. Being sent for to visit this maid, also too late, a little before her death; when I could contribute nothing to the proroguing of Life, I endeavoured what I could, to find out from her death, the knowledg of the aforesaid disease, therefore having got leave to diffect her body, the reasons and marks of the Symptoms chiefly urging in this fever, more clearly appeared.

Opening therefore first the lower belly, I found all the bowels in it sound enough * 1.12 and well furnisht: The Ventricle altho tired with empty vomiting, contained nothing besides the Liquor, lately taken in at the mouth: for neither in it, nor in its Appendix, were worms, or sharp humors found which are wont oftentimes to give a cause to these kind of Convulsions: the small guts, were in many places involved: to wit, the Convex superficies of one part, was thrust into the concave of another, as into a sheath, and hid far in it, which indeed I judg to have hapned wholly from the convulsive mo∣tions of those bowels: for whilst by vehement Convulsion, excited from the nervous origine, the opposite fibres being drawn together, did work the same Intestine into con∣contrary motions, it easily hapned that a part of the Intestine of the Ilion, being carried upward, might run into the hollowness of the other, being snatched down∣ward.

The Thorax being opened, the flesh of the Lungs appeared very red, and as it were sprink∣led with blood, yea in some places as it were livid, and almost black: out of the same wherever it was cut, there flow'd forth a thin and frothy matter. Certainly this shew'd, that the feverish matter, or the serous impurities of the boiling blood, being soon impacted in the Lungs, did so stuff up their pores and passagss, that the blood it self, being in its wonted and free Circulation, there stagnating, and being extravasated, did excite a certain Inflamation.

We found a no less clear tract of this so deadly disease in the head: for the shell of the skull being removed, presently the vessels, creeping through the meningae, were seen to swell very much with blood, as if almost the whole mass of blood were ga∣thered together in the head: for the veins being cut or broken, about the inwards of the lower and middle belly, little blood flowed forth: Besides, those membranes where they cloath the Cerebel, and being higher spread, divide it from the brain, being sprinkled in very many places with extravasated blood, were noted to be of a black purple colour; that it was not to be doubted, but the Phlegosis or Inflamation round about excited, was the cause of the so cruelly insesting Convulsions. These coverings being taken away, the substance of the brain was seen to be altogether moist and wa∣tered above measure with a watery humor: yea, its rine or bark being taken off, all the ventricles were full of a limpid or clear water, of which kind of very clear Liquor, there was judged to be more than half a pint.

From these appearances, the Pathologie of the aforesaid fever is easily collected: to wit, in this sickness, as also in many others, the blood feverishly growing hot, pre∣sently * 1.13 deposes its recrements, both into the Lungs, and into the brain; wherefore a serous Colluvies, or watry heap, did presently overflow the constititution of either; then, because the blood being hindred, both here and there, from its due circulation, it

began to grow into a very great heap, about the confines of the affected parts, and at length to stagnate, and to cause as it were a Phlegosis or Inflamation: hence by reason of the Serum being plentifully heaped up in the Lungs, and baked by the heat, the troublesome cough, with the thick and discoloured spittle, for the most part came in this disease; and by reason of the like affection, excited within the head, the vertigo, swim∣ming, stupifaction, and other Cephalic passions, constantly seised on the sick: which kind of Distempers in this little Maid, and in her Brother, by reason of the infirm constitution of the brain, before in either of them, being made more grievous, termi∣nated in an Apoplexy. I might easily here propose many other Histories of persons sick of this fever at that time, but from these but now recited, the Type of the afore∣said Disease may be sufficiently known: But because the same fever happens almost every year, on some predisposed; and perhaps by reason of an evil constitution of the year, may hereafter at sometime become Epidemical, it will be worth the while to re∣present some Method about its Cure.

Concerning which, first of all take notice, that in this fever no Critical days were to be observed, as in the vulgar continual fevers: for the blood as soon as it began to * 1.14 grow hot, poured out a part of the morbifick matter, as yet crude, and not overcome, from its embrace to the head, or breast: wherefore it were vain to expect that the blood should suffer the heterogeneous particles to be heaped together, in its mass to a fulness, that from thenee a flowring or putting forth arising, at the set intervals of times, it might thrust the same subtilties out of doors: yea rather this growing hot glows not with a great and open burning: but like a fire covered with chips, sends forth a moist smoke or breath, rather than a flame: But so that from thence by reason of the nervous juice being depraved soon in its disposition, and not rarely, because of the lungs being stuffed with the consumptive matter, the convulsive or phthisical or consumptive symptoms, did molest chiefly in the whole course of the disease.

It behoves us to design the curative Intentions according to the various times of the disease, and the diversities of the symptoms chiefly urging. About the beginning of * 1.15 this fever the taking away of blood seemed convenient almost to all. This kind of Remedy I often experienced with success in little Children: for that by the means as it were another breathing place is opened to the mass of blood, silently and covertly growing hot, and obtruding its soot or smoak on the more noble parts; and for that reason its impure efflorescencies or puttings forth are drawn away from the brain and lungs. Therefore altho this fever of an ill Condition may be accounted as it were malignant, yet forasmuch as the blood is not presently apt to be coagulated, but to be too much poured forth, and to bestow its serosities on the nobler parts, to wit, the brain and lungs; therefore Phlebotomy, so it be administred in the beginning of the disease, is convenient almost to all.

For the same reason, Cathartick Medicines, and chiefly vomitory, are administred at the very beginning of the disease; for these do not only evacuate the viscera of con∣coction, and so draw away the chief fomenting of the disease, and as it were its origi∣nal, but besides, they draw forth the serosities from the blood, and so effect its cleansing rather in the stomack and intestines, than in the head and lungs. Further by Emeticks, for that the receiving Glandulaes of the Lympheducts, are pulled with a great shaking, the superfluities of the nervous juice, lest they should evilly affect the brain, and its dependencies, are expressed forth into the lower bowels: also for this end the belly is to be kept continually loose by the use of Clysters. But in the mean time, whilst the blood being infected with the taint of this disease threatens the brain or praecordia, with the evil, it will not be fase to attempt any thing with Diaphoreticks, or sweating medicines, or Diureticks, or such as evacuate by urine, or also with Catharticks, vomiting and purging medicines: For these kind of medicines, forasmuch as they greatly pour out tbe blood, and compel its serosities into more open issuings forth, all the recre∣ments being apt to fall away from the mass of the blood are easily obtruded on the brain, or lungs, when they are of a more feeble constitution: So in the youth above∣mentioned, a loss of speech, came upon the raising of an untimely sweat: Also I have known that Sudorificks, no other than chaley beats in the morbid disposition of the lungs, have brought on a wasting or Consumption.

Phlebotomy therefore, and if need be, vomiting or purging either one or other, or both, being to be made use of at the beginning of the disease, the other intentions shall * 1.16 be to draw away the morbific serosities of the blood, apt to flow forth on the head or breast, and to derive them gently by other ways of evacuation, and to put them forth of doors. To this end Vesicatories or blistering plaisters ought to be applyed to the nape of the neck, or Parotida or jugular Arteries, or to the Arm-pits, or the Groin, or about * 1.17 the Thighs or Calves of the legs, sometimes in this part, sometimes in that;

to wit, that the little Ulcers being here and there excited, and continually running, might plentifully pour forth the serum, imbued with the morbid and heterogeneous particles.

But Remedies gently carrying the serum into the Reins and urinary passages, are most * 1.18 often administred with success: For this business, diuretical Apozems and Julups are to be ordained after the following forms.

Take of the Roots of Scorzonera, Cherfoil, Grass, and of Eryngoes candied, each fix * 1.19 Drams, one Apple cut, of the leaves of pimpinel, meadow-sweet, each one handful; of Raisins of the Sun, an Ounce and a half, of Harts-horn burnt two Drams; being cut and bruised, let them be boiled on a clear fire, in four pints of spring water to the consumpti∣on of the third part; to the straining being cleared two pints, add of the Syrrup of green Cytorns, or Violets, two Ounces, of Sal prunella one Dram and a half, make an Apozem. The Dose four to six Ounces, thrice in a day.

Or into that straining, put 15 blanched sweet Almonds, and of the four cold seeds, * 1.20 each one Dram; being bruised, make an Emulsion according to Art.

Take water of Dragons, and of black-Cherries, each four Ounces, of scordium com∣pound * 1.21 two Drams, of Threacle water an Ounce and a half, of Syrrop of Clove-gilliflow∣ers two Ounces, of the spirit of Vitriol twelve drops, make a Julnp.

Take oftentimes in a day, in small Beer or Posset-drink, half a Dram, or two Scru∣ples * 1.22 of Sal prunella.

Besides in this Fever, medicines gently sweating, of that sort chiefly which restores * 1.23 the animal spirits, and defends them from any heterogeneous Copula, are of very great use: wherefore, either the powder of Pearls, or the spirit of Harts-horn, or of Blood, in a moderate Dose, are administred twice in a day, viz. Morning and Evening.

Clisters are to be given almost every day; and if it be thought fit, a gently loosning * 1.24 purge may be taken once or twice in a week.

The diet prescribed ought to be slender, as in other Fevers, let them be wholly inter∣dicted * 1.25 from flesh, or broth made thereof, only let the sick feed on Grewel, or Barley∣broth, and let their drink be small Beer or Posset-drink.

If that, notwithstanding, any preventive Physick, the Morbific matter should lodge in the Brain, or Lungs, or both together, so that a dissolution, or inordination of the animal function, or also a violent Cough should assault them; it must be consider'd, what is to be done in either state of the Disease, carried forth after this manner into an evil condition; but then the curative Indications ought to respect the stupor, or mad∣ness, or cough: and lastly, if in the declination of the Disease, these symptoms do re∣mit, proper Remedies are to be adhibited against the Atrophie, as it were the last fortress of this Fever.

First, Therefore if the morbific matter, as it is often wont, being brought to the * 1.26 brain, should bring in an insensibleness, or a soporiferous or sleepy distemper, reme∣dies drawing it another way, and deriving it some way from the head; and besides, such as stir up the animal spirits, and take away the impure Copula, ought carefully to be administred; wherefore in this case, the use of Epispasticks or such things that draw the water outwardly, should be much increased, and let the spirit of Harts-horn be exhi∣bited almost every sixth hour, in a little bigger Dose; let blood be also taken by the suck∣ing of Leeches, more largely from the jugular veins, the Salvatella, or the sedal veins. If the Distemper remits not, the head being shaven, let Emollient fomentations be often applied thereto: Further, let Cupping-Glasses, Plaisters and Cataplasms be laid to the soals of the feet, and other means of administrations, such as are commonly prescribed for the curing of the stupor, or insensibleness, ought to be used: in like manner, if on the evil, or no Crisis of this Fever, a Phrensie, or madness should come, Remedies appro∣priate to those Distempers are made use of.

Secondly, But if either with, or without this sort of displeasure brought to the head, * 1.27 the Lungs also have taken the evil of this Disease, so that the sick, not yet free from the Fever, seem to fall into a wasting, or Consumption, with a troublesome Cough, with abundance of thick, and often discoloured spittle; Medicines commonly prescribed for such kind of Distempers are convenient enough; wherefore pectoral Decoctions, Ele∣ctuaries, Syrrops, distill'd waters of Milk and Snails, and other Remedies of the like na∣ture, ought diligently to be made use of; the forms of which may be found in the before∣described Cases.

Thus far we have described the continual Fever, for the most part Convulsive, and arising no less from the fault of the nervous juice, than of the blood: I will here fur∣ther propose an example of a Disease, having the likeness of an intermitting Fever, but radicated chiefly in the nervous juice; the nature of which kind of Distemper, for that it is very rare, and truly pertinent to our convulsive Pathologie, will appear from the fol∣owing History.

A noted Woman very young, and indued with a more weak constitution of brain * 1.28 and nervous stock, and for that cause very obnoxious to Convulsive Distempers, af∣ter she had conceived with Child, about the fourth month of her being big, from cold being taken, she was grievously afflicted with Astmatical fits; and besides, with a frequent sinking down of her spirits: but by the use of Remedies, indued with a volatile Salt, she grew well within a fortnights space; but after that, about fourteen days, an unwonted and truly admirable Distemper fell upon this Gentle∣woman.

One morning, awaking after an unquiet sleep that night, she felt a light shivering in all her body, as if she had had the fit of an Ague: frequent yaunings and reachings, with an endeavour to vomit followed thereupon: then her Urine, which was but now of a citron colour, and of a laudable substance, became pale and waterish, and was rendred at every turn, to wit, almost every minute of an hour: moreover, about her Ioins, and hypochondria, and in other places, pains with light Convulsions running about here and there, were excited: which kind of symptoms plainly Convulsive, with her frequent making of a lympid Urine, continued in the Morning almost to the Evening, in which space of time, a great quantity of water, at least three times more than the liquor she had taken, was rendred; in the mean time, neither was the heat great, nor did thirst trouble her, nor was her pulse encreased: In the evening the aforesaid Distempers ceased, and her Urine became citron colour and moderate; and besides, all night she enjoy'd a moderate sleep; then the morning following, about the same hour, the fit returned, accompanied altogether with the like symptoms, and so daily acted the same Tragedy.

Visiting this Gentlewoman, after she had been sick in this manner for twelve days, I framed the Aetiologie of the aforesaid case, to wit, That this Disease, chiefly radical * 1.29 in the nervous stock, did depend upon the effervescency and flux of the humour, wa∣tering the nervous parts: For it might be suspected, that this water being diffused from the blood, made degenerate by reason of the suppression of her Terms, upon the brain and nervous stock, became more sharp and serous than it ought to be, and for that cause incongruous to the containing parts: wherefore, being gathered together to a plenitude, by the nights sleep, it did stir them up or provoke them, for the expul∣sion of it, every where into wrinklings and contractions: hence shiverings, yaunings, stretchings, and wandring pains were excited in the whole body: Furthermore, from the solid parts, after this manner contracted and shaken, not only the nervous liquor, but also the nutricious every where laid up in the solid parts, but not truly assimi∣lated, were shaken off: and then, either Latex, being exterminated from its recepta∣cles, and received by the Veins, or Lymphaducts, or water carrying Vessels, was render'd to the mass of blood: from whose bosome, before it had acquired a lixivial tincture from it, being at last cast forth by the reins, constituted a clear and copious Urine: But that this Distemper observed such exact periods, the reason is, because the nervous water being supplied with an equal dimension, did arise to a fulness of run∣ning over, daily at the set time: Therefore also, the Urine appeared concocted and yellow, before and after the fit, because then its matter consisted only from the serum of the blood: Afterwards, during the Convulsive fit, the limpid humour being shaken off from the solid and nervous parts, and passing quickly thorow the blood, adulterated the colour and the quantity of the Urine. I prescribed to this big-bellied Woman, Phlebotomie, and besides, a Powder composed out of Coral, Pearls, Ivory, and other Cardiacks, to be taken thrice in a day in a proper liquor; morning and evening she took of the tincture of Antimony twelve drops (whose singular effect in the too great flux of Urine, I have many times experienced:) By the use of these, all the symptoms ceased in a short time.

Notes

• * 1.1

  The Hostory of an Epidemi∣cal Fever raging in the year 1661.
• * 1.2

  Its procatar∣tick or more remote cause.
• * 1.3

  The symptoms.
• * 1.4

  The reason of them.
• * 1.5

  Why this di∣sease chiefly invaded chil∣dren, women, and phlegma∣tick men.
• * 1.6

  The reason of the Atrophie coming upon the fever.
• * 1.7

  Why this Fe∣ver was hard∣ly curable.
• * 1.8

  1. Observation.
• * 1.9

  The reason of it.
• * 1.10

  2. Observation.
• * 1.11

  3. Observation.
• * 1.12

  The knowledg of the disease found out by dissecting the Carcase.
• * 1.13

  The Pathologie of the afore∣said Fever.
• * 1.14

  The Curatory Method.
• * 1.15

  Bleod to be taken away at the beginning of the disease.
• * 1.16

  Vomits and Purges are to be admini∣stred.
• * 1.17

  Blistering plasters.
• * 1.18

  Diureticks.
• * 1.19

  A diuretick Apozem.
• * 1.20

  An Emulsion.
• * 1.21

  Julup.
• * 1.22

  A Powder.
• * 1.23

  Gentle Dia∣phoreticks.
• * 1.24

  Clisters.
• * 1.25

  Diet.
• * 1.26

  The Curatory method in the unsensibleness and madness.
• * 1.27

  In the Cough.
• * 1.28

  A very rare Observation.
• * 1.29

  The reason of it.