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. XII. Of an Asthma.

AMong the Diseases whereby the Region of the breast is wont to be infested, if you regard their tyranny and cruelty, an Asthma (which sometimes by * 1.1 reason of a peculiar symptome is denominated likewise an Orthopnoea) doth not deserve the last place; for there is scarce any thing more sharp and terrible than the fits hereof, the organs of breathing, and the Precordia themselves, which are the foundations and Pillars of Life, are shaken by this disease, as by an Earthquake, and so totter, that nothing less than the ruine of the whole animal Fabrick seems to be threatned; for breathing, whereby we chiefly live, is very much hindred by the assault of this disease, and is in danger, or runs the risque of being quite taken away.

An Asthma is denominated from 〈◊〉〈◊〉 (which is to breathe pursie, or difficultly) and may have this description, that it is a difficult, frequent, and pursie breathing with a great shaking of the breast, and for the most part without any Feaver.

The act of breathing depends as well on moving the Lungs, the Structure whereof ought to be of that sort that its passages, and all the pores may perpetually be open, * 1.2 for the free sucking in and letting out air; as from the parts or organs moving them, which by alternate turns of Systole and Diastole, do cause the hollowness of the breast, and consequently of the Lungs themselves to be dilated, and contracted: whereas there∣fore there are many and divers reasons of disturbance, whereby respiration is preju∣diced, for the most part they may all be reduced to these two heads; viz. that there is a fault either in moving the Lungs or in the parts or Instruments that ought to move them, and from hence the differences and kinds of this disease are best of all design'd; for according to the various nature and position of the morbific cause, it is called an Asthma, eith•…•…r meerly Pneumonick, proceeding altogether from the passages bring∣ing in air being obstructed, or not enough open; or it is meerly convulsive, which only arises by reason of a defect or fault in the motive organs; or mixt, when either parts conspire in the fault, which origine every great and inveterate Asthma is wont to have; of each of these we will treat in order.

1. The ancient Physicians, and for the most part hitherto the Moderns have only acknowledged the first kind of Asthma, judging the next cause, and almost the only * 1.3 cause of this Disease, to be the straitness of the Bronchia, viz. inasmuch as the spa∣ces of those passages, being either straitned together by obstruction, or com∣pression, as often as the use of breathing is required, do not admit of plenty enough of Air, wherefore, for the more free inspiration of air, as shall be needful, the organs of breathing do most difficultly labour, with throes most frequently repeated. But that some are found obnoxious to fits of an Asthma, without manifest taint of the Lungs, it was wont to be ascribed to vapours from the Spleen, Womb, Mesentery, or * 1.4 some other bowel, undeservedly enough; but surely that passion, without the strait∣ness of the Bronchia, or fault of those bowels we have in another place sufficiently evidenced to arise from Cramps of the moving parts, and shall be presently clearly made out. But in the mean time by what means it may arise also from the passages of the Trachea, obstructed, or compressed, it lyes upon me to declare.

The straitness of the Bronchia, inducing the first kind of an Asthma, is suppo∣sed to come to pass by an obstruction, as often as either thick humours and viscous, * 1.5 or purulent matter of blood extravasated, are forced in upon them; or that little swellings as Schirrus's or little Stones, stop up their passages; or finally that a Ca∣tarrh of a serous humour suddenly distils upon them. Moreover the same distemper is thought to be raised by compression, as often as matter of that kind (and of every kind of them) shall cleave to the passages of the Pneumonic Arterie or Vein. Sure∣ly, an Asthmatical disposition depends upon these various causes and manners of di∣sturbance: but all invasions of the disease, or at least the greater fits are usually pro∣voked by reason of some accidents or occasions. For while the stream of blood sliding and running down gently can be content with a small breathing, it passes through the Precordia without great labour either of Lungs or Breast. But being boyling and passing through the Lungs more impetuously, it requires a more full inspiration of air; for the freer admittance of this through strait passages presently all the breathing organs are alarmed into most frequent throes. Whatsoever therefore makes the blood

to boyl, or raises it into an efferves•…•…ence, as violent motion of the body or mind, excess of extern cold or heat, the drinking of Wine, Venery, yea sometimes meer heat of the Bed doth cause Asthmatical assaults to such as are predisposed. It is usual that those who are obnoxious to this disease oftentimes dare not enter into a Bed, only sleep in a Chair, or on a Bed, being covered with garments. The reason whereof is, * 1.6 that the body covered and heated with Bed-cloaths, the blood being a little raised into a more quick motion, and grown hot, requires a more plentiful sucking in of Air than may be supplied from the passages of the Trachea being straitned: for the more blood passes the Lungs each Systole and Diastole, by so much, for the enkindling and eventilation thereof, the Air ought to be more plentifully and quickly brought in and sent forth: to which task (when by reason of the impediments it is not easily dispatched) yet in some manner to be performed, the ultimate endeavors of all the parts appointed for breathing are made use of with a great contention of the whole breast. More∣over the blood being stirr'd, is not only an occasion, but also in some part a cause in those that are Asthmatically predisposed; for the vessels bringing blood being thereby mere fill'd and distended within the Lungs, compress the Tracheal passages being already very strait, and render them much more close.

II. A convulsive Asthma (which we judged to be the second kind of this disease, and * 1.7 to be raised without any great obstruction or compression of the Bronchia, from the me re Cramps of the moving fibres) is not limited to one place, or to any pe•…•…uliar organ, but being of a d•…•…ffused energy, it is extended to almost all the parts employed in breathing (whereof one while this, another while that, or some other is in fault.) For * 1.8 a Convulsive affection inciting an Asthmatical invasion, hath regard to the moving fibres of the vessels of the Lungs, to the Diaphragma, to the muscles of the breast, to the Nerves, which belong unto the Breast, or Lungs, nay to the origine of those Nerves planted within the Brain; and whilest the morbific matter dwells in every of these places, hindring or perverting the work of breathing, it brings on the fits of this Disease, as in another Tract we have somewhile since plainly demonstrated. For the animal Spirits destin'd to the Function of breathing, if at any time they are very much molested and constrained into irregular motions, enter inordinately into the Fibres as well nervous as moving of the organs of breathing, and make them for that cause one while to be contracted, another while to be distended irregularly, as also their solemn and equal turns of Systole and Diastole to be variously disturbed or hin∣dered.

The morbific cause or matter provoking the Spirits prepared for the Pneumonic * 1.9 work, as in divers places, so chiefly in these three, is wont to advance its force or power, viz. 1. Either in the muscular Fibres themselves, or 2. In the branches or nervous slips, or lastly within the Brain by the Origine of the Nerves.

1. As to the former, the heterogene matter being inimical to the Spirits, is some∣times * 1.10 shaken off from the Brain into the trunks of the Nerves, and from thence by their passages and slips, if perhaps it shall be in very little quantity, without very great or sensible hurt slides down to their lower ends. And when it falls in the ner∣vous Fibres, and being heaped up daily, shall at length sensibly increase into a great quantity, it begins to trouble the inmate Spirits, and provoke them into Asthmati∣cal Convulsions; which forthwith infest, and are increased by reason of evident causes, neither do they utterly cease, until the stock of matter so accumulated, be wholly dispers'd, and consumed; afterwards when it being renewed arises to a fulness, the fits of that disease return, and are for that cause most frequently periodical, as is ma∣nifest to common observation. According to this account we do deservedly suspect the cause of a Convulsive Asthma sometimes to lurk in the muscular coats of the Pneu∣monick vessels, also sometimes in the Fibres of the Diaphragma, or the Processes thereof towards the loyns. It is not very probable that the nest of this disease con∣sists within the Fibres of this or that pectoral muscle, although in Scorbutical persons from these also possessed with a Convulsive matter, we have known pains to have risen with breathing being hurt.

2. But truly (even as in another place we have not only demonstrated by reason, * 1.11 but by the Observations and Histories of the sick) a Convulsive Asthma is often incurred, as often as the morbific matter sliding down into the Pneumonic Nerves, sticks in some place within their passages, and especially about their foldings: whence as of∣ten as it is accumulated to a plenitude it begins to be mov'd and shaken; where∣fore the spirits lying lurking, and flowing into the Organs of breathing disturbed, are forced into irregularity, and those spirits presently affect other inmates of the Fibres of the Lungs and breast, and provoke them into unnequal and Asthmatical Convul∣sions. For this cause and the reason of the disturbance, we have declared that not only

invasions of this disease, but also the Precordia being disturb'd thereby the Cardiack passions do arise.

3. We have clearly unfolded by anatomical observations that the cause of a con∣vulsive Asthma sometimes consists in the hinder part of the Head near the Origines of * 1.12 the Nerves. Surely I have observ'd some Patients, who when, lying sick of other desperate diseases, they were also Asthmatick, found it necessary to be whether in bed or chair with their head always erect, or looking down, but lying on their back or leaning backwards incontinently they gaped for breath as if they were dying, and hardly breathed; the cause whereof (as appear'd by dissection after they were dead) was only a huge collection of sharp Serum which was gather'd within the cavities of the brain; which, if by reason of the head inclining backwards, it fell into the origine of the Nerves of the eighth pair, presently the Precordia, and chiefly the breathing organs were affected with horrid cramps. Moreover sometimes for this very reason it seems that Orthopnoick persons cannot lie down in their bed without danger of choaking, but are constrain'd to sit up with an erect body.

III. Although an Asthma is sometimes simple from the beginning, viz. either meerly Pneumonical, or Convulsive, notwithstanding after either disease hath for some time * 1.13 encreased, for the most part it gains the other to it self: hence it may be concluded every inveterate Asthma to be a mixt affection, stirr'd up by the default partly of the Lungs ill-fram'd, and partly by default of the Nerves and nervous Fibres appertaining to the breathing parts. For when the Pneumonic passages being straitned or ob∣structed from some cause, do not admit of a free sucking in, and breathing out of the air, for that cause also the blood, yea and nervous humour, being hindred in their courses, and compell'd to proceed slowly and to stagnate, do fasten their feculency and dregs upon the nervous parts; whence the passages of the spirits are obstructed, or perverted, and at length a Convulsive taint accrues to them. Moreover the blood, being not duly inspir'd and eventilated within the Precordia, at length being viti∣ated in its temperament supplies the brain and nervous stock but with a depraved juice, whose faults do chiefly punish the Organs of respiration before hurt and debi∣litlated. In like manner also the evil is reciprocrated on the contrary part, as oft as this disease begins by fault of the nervous stock; for as much as the motion of the Lungs is often stopt or hindred, by reason or Convulsions in the muscular fibres, both the blood and the nervous juice being restrain'd from their usual motions, do heap up dregs and filths, fastening them to the parts containing them, by which not on∣ly viscous humours and obstructing of the passages, but even Tumours and other more solid concretes vitiating the structure of the Lungs, are produced.

Therefore if when an Asthma being for some time confirmed and become habitual, * 1.14 shall attain to frequent fits, and those emergent upon every occasion; the conjunct cause thereof, and also the Procuring cause is placed as well inwardly in the Lung it self, as outwardly in the Fibres and Nerves, and in the spirits imploy'd for the function of breathing. Neither will it be difficult, by seeking diligently each of these things, to find in any case of the Patient, as well the chief nests, as nourish∣ment of this morbifick matter. But as to the evident causes they are very many, and also of diverse sorts. For hitherto ought to be referred whatsoever move, either the blood and the other humours, or trouble the animal spirits and force them into irre∣gularities. Asthmatical persons can indure nothing violent, or unaccustomed: from excess of cold, or heat, from any vehement motion of body or mind, by any great change of Air, or of the year, or from the slightest errors about the things not natural, yea from a thousand other occasions they fall into fits of difficult breathing.

As to the Prognostick part, an inveterate Asthma is difficultly or scarce ever cu∣red; * 1.15 notwithstanding the medicines and method of healing being rightly ordered, of∣tentimes great succour is afforded, viz. the fierceness of the fits is diminish'd, longer respites are procured, yea, even the dangers of life it self, seeming frequently to be imminent are removed.

The disease growing worse, either threatens a Consumption, or a Dropsie, or some drowzy, or convulsive affect; accordingly as the Serum by reason of perspiration being hindred, being more abundantly accumulat•…•…d (because the sick cannot sleep enough in their beds) it is either fixed in the Lungs, or tranferr'd into the habit of the body, or into the brain it self. For this very reason the diseased do find themselves better in Summer, when they breath more freely, than in Winter; likewise better in hot countries than in cold, the South or West-wind blowing, than the North or East.

Of the curatory method of an Asthma there will be two chief Indications, or ra∣ther * 1.16 so many distinct methods of healing, viz, Curatory and preservatory. The first

instructs what is to be perform'd in the fit it self, that the Patient may be delivered from present danger; the other by what out of the fit, we ought to endeavour the ta∣king away the morbifick cause, lest that distemper be repeated more often or more heavily.

1. Therefore a fit urging, there will be two chief intentions of curing, viz. first that * 1.17 a more free breathing be procured, as well upon the account of air, as of the Lungs, at least so far as may suffice to support life; and secondly, that the organs of breathing may be withdrawn, and restrain'd, as soon as may be, from the Convulsions begun, an•…•… usually obstinately continuing.

1. As to what respects the former, let the Patient be placed in an upright position of body, in a more open place, and pretty airy, free from Smoak and breath of by-stan∣ders; then let it be endeavoured that the Lungs being made free from all obstracti∣on, and inward oppression, and also external compression, may be able to draw and change the breath more easily. For these purposes lest the bulk of the nether bowels * 1.18 compress or straiten the Precordia, the belly is to be loosen'd by a Clyster, the apparel & what ever binds about the Breast to be loosened; also when in this case either from the blood swelling up inordinately within the Pneumonic vessels, or from the Serum distilling out of the Arteries and Glandules into the tracheal passages, they are wont to be op∣pr•…•…ssed, the impetuosity and instigations of either humour ought to be restrain'd and appeased; insomuch that if strength endure and the pulse be strong enough, Phlebo∣tomy is oftentimes convenient. Moreover those things are carefully to be administred which dispatch away the Serum and superfluities of the boiling blood by urine, as well as sweatings: to which Intention, Juleps, Apozemes, commonly call'd Pectora•…•…s, do notably conduce; yea powders of shells, mill•…•…pedes prepared, Spirits and volatile salts, are successfully used. In the mean time besides let there be administred what∣soever opens and makes slippery the passages of the Trachea, and moves expectorati∣on, and whatsoever, if need be, gives stop to a Catarrh distilling upon the same; for which purposes, Lambitives, Lohochs, pectoral Decoctions and suff•…•…migations are good.

2. As to the other intention of curing in these Convulsive fits, viz. that the organs * 1.19 of breathing may be restrained from the Convulsions begun, and may quietly return to their ordinary task, (unless this succeeds of its own accord, after the boiling of the blood and Serum in the Lungs be appeased) we must use Antispasmaticks of reme∣dies * 1.20 against Convulsions, and Anodynes: for medicines which are used to be admini∣stred in hysterical passions, do conduce in a convulsive Asthma.

Spirit of Harts-horn, of soot, and especially of sal Armoniac distill'd with gum Am∣moniacum; also the tinctures of gum Ammoniacum, of Sulphur, of Castor, of Asa fetida, Syrups of Ammoniacum, Sulphur; Oxymel of squils and such like, which because they are of an ingrateful tast or smell, as it were dissipate the spirits and withdraw them from tumults, do sometimes help notably. But if the spirits being outragious cannot by this means be appeased, we must assay Narcotics, that some of them being * 1.21 subdued the others may be reduced to order: for surely unless a stuffing up of the Lungs, with a great oppression of the Precordia do hinder, Opiates do sometimes greatly profit. In the dreadful fits of this disease, when other medicines had effected less: I have often administred successfully Diacodium, as also Laudanum Tartariz'd. But these may not be exhibited without great circumspection, because whereas more or less they hinder breathing (which already is difficult and too much hindred) they fre∣quently bring the Patient into danger of life. Besides this, that the Pneumonic spirits may be diverted from their Convulsions, it is many times expedient to molest the spi∣rits in other places; for some of the spirits being in other places afflicted most com∣monly the residue as well as those that are smitten do dismiss their irregularities: Wherefore Vesicatories, Cupping-glasses, ligatures, and painful frictions bring help; also for this reason vomits are successfully taken in the midst of a fit. The scope of healing being now design'd after what manner the Patients in an urging fit of an Asthma ought to be handled, it yet remains for us to propound some more select forms of Remedies appropriated to the same ends.

In the first place therefore to give a stop to the flux of blood and serum, and to dis∣miss * 1.22 their superfluities deriv'd from the Lungs by sweat and urine, these ensuing are prescrib'd.

Take the water of ground-Ivy eight ounces, of Rue, Pennyroyal, Dragons, of each two oun∣ces, of sal prunella one dram and a half, Syrup Byzantinus, red Poppies of each one ounce; * 1.23 make a Julep, take it three or more times in a day, the dose three or four ounces.

Take grass roots three ounces, roots of Kneeholm two ounces, candi'd Enula-campane one

ounce and a half, barly half an ounce, Raisons of the Sun, one o•…•…nce, boyl them in three pound of water to two pound, adding to your strain'd liquor sal prunella one dram and a half; swee∣ten it, if there be occasion, with Syrup Byzantinus or of Violets.

Take tincture of Sulphur three drams, the Dose six drops to ten, evening and morning in a * 1.24 spoonful of Syrup of the juice of ground-Ivy, or Violets.

Take of f•…•…cula of Aron and Briony, of each one dram and a half, flower of Sulphur one dram, flowers of Benzoin half a dram, Sugar-candy half an ounce, Liquorish two drams; * 1.25 make a powder to be taken to half a dram or two scruples twice in a day with the former Ju-lep or Apozeme: or,

Take of the powder prescribed two ounces, honey or Oxymel what will saffice, make a Linctus, take about half a spoonful evening, and morning, and at other times lick it with a stick of * 1.26 Liquorish.

Take Syrup of Horehound, of Garlick of each one ounce and a half, tincture of Safsron, Castor, of each two drams, mix them, take a small spoonful in the fits.

Take of spirit of sal Armoniack with gum Ammoniacum three drams, of snail •…•…ater, and of Earth-norms of each three ounces, Syrup of Horehound two ounces, mingle them, take by a spoonful once in four or five hours.

Take of the powder of Hedge-mustard, or of ground Ivy gather'd in the heat of the Sun one ounce, of Oxymel simple enough to make a Linctus.

2. So much concerning the method, and medicines requisite in the fit of an Asthma. * 1.27 The other indication preservatory designing the taking away of the whole procuring canses and the morbific matter contains two parts or distinct scopes of cure: both which for the most part are wont in the practice to be complicated and administred together. One of these endeavours to amend the conformation of the Lungs, if it be any way hurt or faulty, and the other to take off the irregularities of the moving parts * 1.28 and spirits, appointed for them. We shall best answer both these intentions if the remedies vulgarly call'd pectorals, are mixt with anticonvulsives, and the use of these with othermedicines respecting the preparation of the whole body and emergent symptomes be apply'd between whiles. For which purposes the method and ensuing forms of re∣medies may be administred.

Take of Aloes rosata a dram and half, flower of Sulphur a dram, salt of Amber half a dram, Tar what will suffice, make 24 pills, take 4 every, or every other, or every third night: * 1.29 or,

Take of gum Ammoniatum, Bdellium dissolv'd in venegar of squils of each half an ounce, flower of Brimstone three drams, powder of hedge-mustard and savory of each half a dram, make * 1.30 a mass with Syrup of Sulphur or Oxymel of squills; make small pills, take 3 every evening: or

Take Hog-lice prepar'd two drams, flower of Benzoin half a dram, salt of Amber two scru∣ples, extract of Enula-campane half a dram, Castor half a dram, Saffron a scruple, Venice I urpentine enough to make a mass, form small pills, take 4 every evening and morning except at the times of purging.

But if this form of Pills will not please, or the above mentioned Medicines profit little, afterwards the ensuing shall be essay'd to free the Lungs from obstruction.

Take spirit of gum Ammoniacum distill'd with sal Armoniac three drams, the syrup of Ground-Ivy three ounces, magistral Snail and Earth-worm water of each an ounce, tincture * 1.31 of Saffron two drams, mingle them and take a spoonful evening and morning. Or,

Take Tincture of Ammoniacum three drams, the dose from 15 to 20 drops in a spoonful of Oxymel, or of syrup of Ground-Ivy. Or,

Take Tincture of Sulphur three drams, dose from 7 drops to 12 or 20 in a convenient ve∣hicle at the same hours.

In like manner other spirits endued with a volatile salt, and mixt with pecto∣ral Syrups and Cephalick waters, may be prescribed successfully evening and morn∣ing.

In place of a mixture or an Asthmatical Julep from distill'd-waters in the shops, let this following magistral be prepared for frequent and several uses.

Take roots of Enula-campane, Orris of Florence, Angelica, Masterwort, of each four * 1.32 ounces, of Bryony a pound, the leaves of white Hore-hound, Hysop, of Savory, Penny-royal, Ground-Ivy of each four handfuls, Juniper and Ivy-berries of each a pound, Bay-berries half a pound, sweet Fennel, Carue, Annis, Lovage, Dill-seeds of each an ounce, Cubebs two ounces, Long-pepper, Cloves, and Mace of each an ounce, all being sliced and bruised pour on them eight

pound of Brunswick Beer, distil it in common Organs, mix the whole, and as you use it sweeten it with Sugar, or Syrup of Ground-Ivy, or with Oxymel.

Moreover in lieu of Oxymel, or any common pectoral Syrups, the ensuing forms of Medicines appropriated to an Asthma are prescribed; and in the first place the Syrup of Enula-campane invented by Horatius Augenius and called by his name, and afterwards commended by Platerus, Sennertus, Riverius and other renowned Practitioners, ought to be observed in this place, and used frequently.

Take of Enula-campane, Polypodie of the Oak prepared of each two ounces, Currance two * 1.33 ounces, Sebestens 15, Colts-foot, Lungwort, Savory, Calaminth, of each a handful, a large leaf of Tobacco, Liquorish two drams, Nettle and Silk-worm seeds of each a dram and a half, boyl them in Wine mingled with Hony and diluted to a pound and half, and with a little Su∣gar make a Syrup: take it by it self in form of a Linctus or a spoonful evening and morning, or add a spoonful to the distilled water or Apozeme.

Take Florence Orris-roots, Enula-campane of each half an ounce, Garlick peel'd four drams, Cloves two drams, white Benozin a dram and half, Saffron a scruple, slice and bruise them and digest them warm in a pound of rectified spirit of Wine for 48 hours; to it strained add fine Sugar a pound, put it in a Silver Bason upon live coals, stirring it till it flame, and let it burn as long as it will, then the flame being out make a Syrup of it to be taken as the former.

Moreover hither may be referred the decoction of an old Cock so much magnified by renouned Physicians as well Ancient as Modern, for the cure of an Asthma; which * 1.34 although Septalius damn'd for gross and of no efficacy, notwithstanding Riverius after him vindicates; and to attest the efficacy of this remedy opposes his own experience to the others. These broths are of two kinds, viz. either with or without purgers; and various Recipes of each do remain in practical Authors, all which would be te∣dious to recount here, we shall propose one or two forms.

This is the common example without purgers.

Take of Orris and Enula-campane-roots of each half an ounce, Hysop and Hore-hound dryed of each six drams, Carthamus seeds an ounce, Annis and Dill seeds of each two drams, * 1.35 Liquorish scraped and Raisins stoned of each three drams; let them be prepared and sewed into the belly of an old Cock, which boyl in fifteen pound of water until the flesh depart from the bones, strain it and let it settle: of the clear liquor the dose six ounces, with an ounce of Oxymel simple. Or if the remedy be desired to be solutive, dissolve of fresh Cassia and Manna of each half an ounce in each draught, taken for many days together, and sometimes for a whole month.

Riverius prescribes a convenient form of such a kind of purging broth.

Take Enula-campane and Orris-roots of each a dram and a half, Hysop and Colts-foot of each a handful, Liquorish and Raisins of each two drams, Figgs 4, Senna cleansed three drams, Polypodie of the Oak and Carthamus-seeds of each half an ounce, Anniseeds a dram and a half, boyl them with the third or fourth part of an old Cock, make broth for one dose to be taken in the morning, let them continue it for twelve or fifteen days.

Of many examples of Asthmaticks I shall propound only two singular ones, viz. I will describe the History of one who hath been obnoxious to fits of this disease * 1.36 meerly Convulsive, and of another partly Convulsive and partly Pneumonic. A No∣ble Person, proper and well set, and formerly healthful enough, after that by chance he had struck his side against some solid body, from that time contracted a hurt, and afterwards an Asthmatical taint. For we may suspect, a certain folding of the Nerves belonging to the Precordia placed near was prejudiced by that accident, and from such a cause afterwards this distemper derived its Origine, viz. at some incertain times the pain at first troubled him about that place, and presently a most painful Dyspnoea ensued with a laborious and lasting contention of all the breathing parts; insomuch that while the fit lasted the Patient was thought to be in the agonie of Death. I was first sent for to him after labouring for two days with such an invasion of the Asthma that he was accounted in a desperate condition; Notwithstanding finding his Lungs without hurt, our Prognostic willed as yet to hope well, and immediately by a Consultation of other Physicians it was prescribed as followeth.

Take of Spirit of Gum Ammoniacum distill'd with salt of Tartar three drams, take from * 1.37

15 to 20 drops in a spoonful of the following Julep, drinking after it five spoonfuls, repeat it every sixth hour.

Take elder flower, Cammomile, and Penyroyal water of each four ounces, Snail-water two ounces, Sugar one ounce, mingle them, between whiles he took a dose of the following powder with the same Julep or pectoral decoction.

Take Powder of Crabs-Eyes two drams, sal Prunella a dram and a half, salt of Amber half a dram, mix them, divide it in•…•…o eight doses.

Large vesicatories were applied on the inside of his arms near the Arm-pits, Cly∣sters daily administred, and frequent frictions. By the use of these he received sud∣den and unexpected help, and within a few days became wholly free from that fit. Afterwards as often as he had any preception of the first motions of this disease, pre∣sently he took a large dose of that Spirit with the same Julep 3 or 4 times aday, by which remedy often used, one while for preservation, another while for the cure sake, he was void of any outragious invasion from his habitual Asthma for above two years, in the mean while suffering some more light assaults but easily blown off.

A very Honourable old Gentleman dignified by many great Titles, himself being greater than all them, after that for some years he had liv'd every Winter obnoxi∣ous * 1.38 to a Cough and a moderate spitting, and gentle enough, at the end of the last Au-tumn returning from a long journey he was less healthful: (as it was thought by cold he had taken) for he complained of a pain in the middle of his breast next the sternon, which growing worse in an evening, as soon as warm in his bed, wholly disturbed his sleep, and most part of the night was very troublesome: notwithstanding without a∣ny Dyspnoea or evident sign of an Asthma. To take away this pain both Purging and Bleeding were used, pectorals and antiscorbuticks were daily used, liniments or fo∣mentations were applied to the place pained, yet without any great success or ease: for the alteration which happened afterwards declined rather to worse; for a difficult and obstructed breath came upon the pain's growing a little more remiss, so that from his first sleep, or inclination thereto he became Asthmatical and gaping for breath, and suffering about the Precordia he was constrained to sit upright in his bed. Moreover a dyspnoea of this kind and a Convulsive agitation of the breathing parts did not only return every evening, but from day to day were rendred more outragious and lasted a longer time; insomuch that one night waking from his sleep, for many hours he was assaulted with a most painful fit of an Asthma which had almost kill'd him. The Physicians being at a great distance from him, although desired about midnight came not while the morning following, mean while by reason of bleeding used by a Barber this worthy Gentleman revived, being redeemed from the jaws of death; but afterwards by the Consultations of the Physicians that day a slender diet and loosening the Belly by a Clyster were prescribed: In the evening and early in the morning he took of Spirit of gum Ammoniac distilled with sal Armoniac 12 drops in a proper vehicle, and continued the use for many days after; Vesicatories were applied on the inside of his Arms near the Arm-pits; moreover Juleps and Pectoral Decoctions, Lohochs, Clysters, and also mild Purges were taken by turns; also Phlebotomie was repeated after two days. Whereas formerly he was used to drink for his mornings draught a Pint of Ale with Worm-wood and Scurvy-grass, in the room of that about eight a Clock he took 15 drops of Elixir Proprietatis tartariz'd in a draught of Coffee made with Sage. By these remedies his Asthmatical fits presently abated of their fierceness, insomuch that the beginning and end of every night were quiet enough, but in the middle light troubles about the Precordia kept him from sleep, sitting upright an hour or two. Certain other Medicines were propounded by the Physicians, and others of diverse sorts privately offered by his friends, which notwith∣standing the Honourable Person utterly rejected, or soon loath'd; and that the rather, because, Winter then being almost spent, his restauration was hoped for by the coming on of the Spring and enjoyment of the Country air without the help of much Physick. Wherefore of the Medicines above mentioned he used one while this and another while that a little by turns, and sometimes kept holy-day from them all; but in the interim although his Asthmatical invasions little or nothing troubled him as formerly in the night, yet by reason his Lungs were very much obstructed, and a serous hu∣mour fallen down into his feet, he was not able to walk fast or ascend steep places, without a painful dyspnoea, being in danger of choaking; and now (while I am writing this) not so much an Asthma or Consumption, as a Dropsie is feared.

The Aetiologie of this case is clearly enough manifest from the above men∣tioned things, viz. one procuring cause of this Asthma was a lung greatly obstructed, * 1.39 insomuch, that whereas the blood boiling, passed through the precordia more

impetuously, the air requisite for its ventilation could not be admitted in plenty e∣nough; wherefore to supply this defect there was necessity that the Lungs and their motive organs should be provoked into more frequent, and more vehement throes. Afterwards from thence ensutd a convulsive disposition of the fibres moving the breast: for the heterogeneous matter descending into those parts together with the nervous juice, and being gathered to a plenitude, first excited pain and afterwards fierce and periodical convulsions in the pneumonic organs: and now al∣though this latter disposition cease (because the Elastick and spasmodical matter is blunted or extinguished by the serous illuvies) yet the other procuring cause still remains, and hath got another associate, viz. a worse Devil than it self, to wit a Drop∣sie.

Notes

• * 1.1

  An Asthma a most terrible disease.
• * 1.2

  The causes of re∣spiration hurt.
• * 1.3

  The Ancients allowed the cause of it only from the Bron∣chia obstructed.
• * 1.4

  Or vapors from the Spleen or Womb, but er∣roneously.
• * 1.5

  After what manner the straitness of the Bronchia arises.
• * 1.6

  Whatever causes an effervescence of the blood is the evident cause of an A•…•…hma. Why Asthma-•…•…cal Persons are worse in Bed.
• * 1.7

  A 〈◊〉〈◊〉 Asthma.
• * 1.8

  Its Seat mani∣fold and diffu∣sed.
• * 1.9

  The morbific matter consists in several pla∣ces.
• * 1.10

  1. In the mus∣cular Fibres.
• * 1.11

  2. Within the Nerves and their enfoldings.
• * 1.12

  3 Near the O∣rigines of the Nerves.
• * 1.13

  3. A mixt Asthma or part∣ly Pneumonic and partly Con∣vulsive.
• * 1.14

  The causes of an Asthma recited.
• * 1.15

  The Progno∣stiks of the Dis∣ease.
• * 1.16

  Two chief In∣dications.
• * 1.17

  What is to be done in the fit.
• * 1.18

  1. 〈◊〉〈◊〉 to facilitate breathing.
• * 1.19

  2. Intention to free from Con∣vulsions the moving parts.
• * 1.20

  Remedies which dissipate the Spirit profit for this end.
• * 1.21

  Or do bring them asleep.
• * 1.22

  Forms of Re∣medies.
• * 1.23

  An Apozeme.
• * 1.24

  A Tincture.
• * 1.25

  A Powder.
• * 1.26

  Mixtures.
• * 1.27

  2 The Indicati∣on preservatory proposes what is to be done out of the fit.
• * 1.28

  Suggests two Intentions of bealing.
• * 1.29

  Forms of Re∣medies.
• * 1.30

  Pills.
• * 1.31

  Mixtures.
• * 1.32

  A distill'dWa∣ter.
• * 1.33

  Magistral Sy∣rups.
• * 1.34

  The decoction of an old Cock.
• * 1.35

  Without Purg∣ers.
• * 1.36

  The first History of a Convulsive Asthma.
• * 1.37

  The Cure.
• * 1.38

  The second Hi∣story of a mixt disease.
• * 1.39

  The reason of this cause.