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.

SECT. I. CHAP. XI. Of an Imposthume of the Lungs.

AVomica of the Lungs is something a-kin to an Empyema or Peripneumonie, considering that the morbific matter is always meer Pus, which notwithstand∣ing is generated in the Lungs without a Feaver and Phlegmon, yea without * 1.1 any great Cough or Spittle, as it were silently, and without noise; and frequently this evil doth not discover it self before it kills the Patient. Galen makes mention of this in lib. 1. de locis affectis; but among Authors who have written Systemes and the practi∣cal parts of Physick, mention thereof is seldom or scarce to be met with. Tulpius in lib. 2. chap. 10. describes this distemper after this sort. This evil (meaning an Im∣posthume of the Lungs) lurks in the beginning so secretly that it scarce discovers any signs of it self, besides, in the first place, a little dry Cough, and presently moist; which continuing for some time, the breath is drawn with difficulty, the spirit fails, and the body withers by degrees, although in the mean time the Spittle makes no shew, either of pus or blood; and if the Imposthume break by way of surprisal, the man is kill'd immediately. It is wont some∣times so to happen, but I have known many who in an Imposthume rising insensibly, being maturated, and at length breaking, have spit up great plenty of fetid corruption; and though with voiding daily such a Spittle, for many weeks, nay months, they be∣came very weak, and as it were, consumptive, yet at length by the help of Medicines after the Ulcer hath been mundified, and dryed, they have recovered their health entirely.

This disease, if we search into the formal reason and conjunct cause thereof, is in truth a concourse of ill humours gathered in some part of the Lungs; whose matter although * 1.2 it be heterogene and an enemy to nature, notwithstanding from the beginning ap∣pears not sharp, or irritative. For when at first being separated from the blood, it is deposited in some hollow place of the Lungs, perhaps in some bladdery cell, it doth neither raise a Cough nor produce a Feaver; but afterwards when sensibly encreased it compresses the neighbouring Vessels bringing blood, and moreover infinuates into the very blood passing by, incongruous Effluviums; from thence a small Feaver suc∣ceeds, with a certain disquietude, and feebleness; and at length being accumulated to its fulness, and maturated by a long digestion into mere Pus; breaking its nest ve∣ry much distended before, it flows out every where all about. But if the ways are not open for the issuing of the Pus, it incontinently mingles it self with the blood, and either impoysons it, or impedes it from Circulation; or rushing by heaps into the Tracheal passages; it doth fill most of them at once, and so stuffs them, that a suffici∣ent entrance is denied to air to kindle the blood, and presently the vital flame expires:

but if this matter find passage, and flow by degrees into the Trachea, from whence a∣gain it may be presently carryed away, and spit out, there will be then some truce of life, with hope and opportunity of cure. And indeed I have known many cur'd of this disease.

The usual matter of an Imposthume of the Lungs is meer Pus, which often stinks notably, and by that differs from the Spittle which is ejected in a Peripneumonie or a * 1.3 Consumption of the Lungs. But whence that matter proceeds in the beginning there∣of, and of what disposition it was before it was ripened into Pus, I cannot so easily determine: because the seeds of this disease being privily sow'd, and growing up se∣cretly, spring wholly from an occult original; wherefore its procatarctick or more remote causes lye conceal'd, yea while it begins and encreases, can neither be disco∣vered by any pathognomical Signs, nor can any prognostick be devised, before it discovers it self with a mortal stroke, but the whole procedure thereof is treache∣rous.

Now if after the Imposthume is broke, and the Spitting up of Pus with an easie dis∣charge being begun, with a constancy of strength, there be means offer'd for some method of cure, the chief Indications according to the common custom in most diseases will be these, viz. Curatory, preservatory, and vital. The first com∣mands the matter of the Imposthume speedily to be discharg'd by Spittle, and that the sides thereof should be cleansed and healed as much as is possible. The second In∣dication provides against the conflux of new matter to that nest, or other adjoyning places of the Lungs (whence a Consumption may be engendred). The third restores the languishing of the Spirits, the lost strength, and the frustrated Nourishment.

1. As to the first Indication, remedies commonly called expectorating, and of them those that are more hot and sharp, and do very much cleanse and drye, but especially * 1.4 (for that for the most part here a Feaver is wanting) sulphureous remedies are expedi∣ent; which also may be prescribed according to the following forms.

Take of Tincture of Sulphur three drams, take from seven drops to twenty, at bed∣time, and early in the morning in a spoonful of Syrup of the Juice of Ground-Ivie, Or, * 1.5

Take our syrup of Sulphur, as before set down, 6 ounces, let a spoonful be taken at the same hours.

Take the dried leaves of Ground-Ivy, Germander, white Maiden-hair, Coltsfoot, Hyssop, white Hore-hound, Savory, of each one handful, Enula-campane, Orris and Chervil roots, of each one ounce, Anniseeds half an ounce, boyl them in 6 pound of Spring-water to three pound and a half, adding towards the end White-wine 6 ounces, clarified Honey three ounces. Let the strained Liquor be clarified, and kept for use: the dose 6 ounces warm, three times a day. Or,

Take of Lime-water 6 pound, put it in a Glass with a large mouth, hanging in it the follow∣ing bag.

Take the dried leaves of Germander, Ground-Ivy, white Horehound, of each one handful, Orris and Enula-campane sliced one ounce and a half, Anniseeds bruised two ounces, Liquorish an ounce and half, Raisins stoned three ounces, let them be stopt and stand cold. Pour out for use, the bag remaining.

Take Lohoch Sanum three ounces, Species Diaireos two drams and a half, flower of Sulphur one dram and a half, of simple Oxymel two ounces, make a Linctus to be lickt with a Liquo∣rish-stick.

Take the powder of Hedge-mustard, Ground-Ivy, of each half an ounce, flower of Sulphur a dram and half, syrup of Sulphur (or of the juice of Ground-Ivy) what will suffice to make a Lohoch.

Take of fine Mirrh, of white Amber, of each half an ounce, Sulphur Vivum, Auripigment, of each two drams, the rinds of Pistaches one dram and a half, make a powder for Fumigation, to be used in a Paper-funnel, morning and evening.

2. The preservatory Indication, abolishing the morbific matter, and so providing * 1.6 against a Phthisis prone to succeed; endeavors the purifying of the blood, and strength∣ning the Lungs, to which ends, Purgers, Vulnerarie Decoctions, distill'd waters and physical Drinks, are convenient.

Take of the Decoction of Senna of Gereon (with one dram and half of Agarick) three ounces and a half, purging syrup of Apples one ounce, Aq. Mirabilis two drams, make a potio•…•… to be taken with government once in a Week.

The form of the Wound-drink let be the same as was prescribed for an Empyema after open∣ing, or 4 or 6 ounces of the Decoction common in Shops, three times aday, (because here is no feaver.)

Take of Firr-tops 6 M. fresh Ground-Ivy, Hyssop, Sage, Rockets, Hedge-Mustard, St. Bar∣baries herb or Winter-cresses, of each four handfuls, the seeds of the Sun-flower 6 ounces, sweet Fennel-seeds two ounces, Enula Campane, Orris-roots, of each 3 ounces, being cut and bruised, pour upon them 8 pound of Brunswick Mum or Spruce-Beer, distill it in a cold Still, let the li∣quor be all mixt, and when used, sweetned at pleasure with syrup of the juice of Ground-Ivy; the dose three or four ounces, three times aday.

Take of the roots of Sarsaparilla six ounces, China two ounces, of each of the Sanders six drams, Shavings of Ivory and Hartshorn, of each half an ounce, Mastick-wood one ounce, being cut and bruised infuse them in 12 pound of Spring-water, boyl them to half, adding one ounce of Liquorish, Raisins 4 ounces, •…•…et the strained liquor be kept for ordinary drink.

3. The vital Indication prescribes Cordials, Anodynes, and a convenient course of diet. The same forms of Medicines for the most part are expedient here, which were * 1.7 prescrib'd for an Empyema after incision, and also the same diet as was ordain'd in a beginning Consumption; besides, in this case Asses-milk often-times doth much good. As to the curing of this disease, I have observed, that an issue made in the side, for the most part doth signally profit. I remember two suffering under this distemper, by coughing up plentifully mere stinking Pus or Corruption after the Imposthume broke, to have been heal'd by this Remedy in a short space of time. The Historie of the Cures shall be afterwards annexed. In both these by a shallow orifice made in the side by * 1.8 incision, meer Pus began within three or four days to flow out, and then the Spittle began to be abated; and after that flowing, encreased from day to day, for some time continued, the Spittle altogether ceased, and the Patient recovered his entire health.

The reason of this admirable Effect seems to be, that the part affected of the Lungs, or that which is bordering upon it, while the disease was arising, or before, grew to the very side, and therefore Nature had endeavoured by this way the thrusting forth of the Pus or matter contained in the Imposthume; and for that cause perhaps had made secret passages even to the superficies of the side; wherefore, afterwards an issue being laid open by a knife, the excretion of the morbific matter was conduct∣ed thither. It is also probable, that a certain part of the Lobe of the Lungs at first grew to the side in the diseased, and by reason of the cleaving thereto, afterwards the Imposthume had its arise; for whereas the part being almost immoveable, could not be stirred like to the other parts of the Lungs, the morbific matter was deposited there, and was the better able to reside or form its nest there.

Although the Imposthume of the Lungs be thought a very rare distemper with some Physicians, and by Tulpius judg'd so mortal, that when it breaks it kills out-right; yet I have known many to have labour'd under this disease, and by the help of Medicines to have recovered their pristine health. We may here describe two or three of the more remarkable Histories of them.

A Gentleman of a middle age, and before strong and continually healthful, find∣ing himself not well, without any apparent cause, contracted as it were a crazie dis∣position; for being without Pain, without Vomit, Cough or notable Feaver, in a short time grown weak, he became without any appetite unapt to sleep, full of thirst and hot about the Precordia; this person was handled a long while by some Physicians as Scorbutical, and by others as hectical; and after various methods of healing were as∣say'd in vain, at length the disease sallying out as from an ambush, appeared manifestly. For whilst on a certain night being more unquiet than usual, he tossed himself very much in his bed, all on a sudden the Imposthume breaking in his Lungs, a large quantity of stinking Pus was thrown out by Cough, so that in four or five hours he threw off about two pints. Moreover, after his Cough continuing about two months, he daily spit out purulent matter, thick and very stinking, untill his flesh being consumed, and he wholly spent, was reduced to languishing, and a notable Consumption. From the stench of his Spittle and breath the whole Chamber was so filled, that his Servants or those attending him, could not endure the ill scent thereof.

After the Imposthume was thus broken, I and two other well-known Physicians being advised with, with all circumspection we prescribed Medicines to absterge and heal the Imposthume, and to cleanse the Blood and Lungs, and redeem him from an imminent Consumption. A Tincture, and syrup of Sulphur, together with Pectoral and Vulnerary Decoctions and Distillations were taken; also Lohochs and balsamick Pills, day after day in a constant course, with Clysters, gentle Purgatives and Diureticks, were taken be∣tween

whiles: then these, Vaporations and Fumigations, as well sulphureous as arsenical, were used morning and evening. After these things being long and carefully used did help nothing, I often propounded the opening of the Thorax; but the sick man obsti∣nately rejecting this operation, said he would rather dye than be murdered; yet at length, when I assured him that this remedy, or none, was further to be attempted, he began to deliberate with himself, and immediately baring his breast, he suffered me to search a place where I might apply a Cauterie; the business was presently put out of doubt, for a Tumour appeared on the left side of the Sternon, between the 5th and 6th Vertebra. Instead of a Cautery, I applyed thereto a suppurating Plaister, and within three days the top of that swelling became red and soft: out of which, being the next day opened, first a thin ichor, and a little after a yellow and concocted Pus flowed out, and afterwards it continued daily to stream out more plentifully: from that time his stinking Spittle began to abate, and within fourteen days it ceased quite; the morbific matter obtaining through that orifice both an easie and more convenient issue. Although by the effect it was manifest, that the passage of that orifice lay open into the breast, and perhaps into the middle of the Lungs, yet no liquor cast in by a Syringe, could either penetrate or be forced in thither: so secret and intricate are the conveyances which Nature forms for her last aids, that by the same passage by which the morbific matter is exterminated, nothing more hurtful can enter. This opening of the side was at length chang'd into an Issue, and a Pease or a wooden pill being put in, there came forth daily for half a year together plentiful ichor; and in the mean time this well-known person, all corruption of the breast being shook off, and the fleshy habit of his body being recovered, became healthful in all respects; and lastly, that issue being removed to his arm, he bears no sign of that nor any other disease in his breast.

After this Cure so by chance accomplished, it hapned I performed another like it, on purpose, not less successfully; for shortly I was sent for to a noble Lady which had been for many years obnoxious to the heat of the Precordia with a Cough. One day, when she coughed she was throughly sensible of something broke in her Lungs, and presently she voided abundance of meer Pus, and that stinking; after that, this kind of Spittle continuing with a Cough, for a week, notwithstanding the use of remedies, se•…•…med rather augmented than diminished, I advised to have an Issue cut in her side, near the very place whence she perceived the Pus to ascend, which she readily granted: With∣in three days, from the orifice being opened meer Pus began to flow out, like that she discharged by Cough. Then after the morbific matter had issued out by that Fontinel, both the Cough and the Spitting of Pus wholly ceased, and within a Fortnight the Pati∣ent recovered her firm health.

After this I was sent for to another, viz. a strong man, and as strong a drinker; who being affected with an Imposthume of the Lungs, also spit up an abundance of Pus and very stinking matter. This Patient by a certain rude contumacy abhorr'd any Issue, wherefore he would not suffer any to be made in his side; notwithstanding he took any Medicines offered to him, by a long use of which Remedies he escaped free from that disease: the Medicines whereby he chiefly received help were prepared of Sulphur, as our Syrup and Tincture, taken daily and very frequently. To these for Vehicles were added one while a Decoction, another while a pectoral Hydromel, ano∣ther while Lime-water, with an infusion of pectoral, as well as vulnerary Ingredients. Moreover Fumigations and Smoaks, especially of sulphureous and arsenical Ingre∣dients, did contribute very notable help.

Notes

• * 1.1

  Vomica Pulmo∣nis a disease sel∣dom observ'd.
• * 1.2

  The formal rea∣son and conjunct cause thereof.
• * 1.3

  The morbifick matter.
• * 1.4

  First Indicati∣on.
• * 1.5

  Forms of Re∣medies.
• * 1.6

  Second Indica∣tion.
• * 1.7

  Third Indicati∣on.
• * 1.8

  Fontinels in the side very often greatly help in this disease.