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.

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

THUS much concerning the morbid exorbitancies of irregular sleep and wa∣king; which are almost proper, and as it were of the region of the Brain, and affect not the Cerebel but rarely, and that secondarily and collaterally, * 1.1 as hath been shown. But there remains a distemper, commonly called the Night-Mare, in Latine the Incubus, which is both peculiar to this Region, and also seems in some measure analogical to the sleepy diseases; forasmuch as its fits arise, for the most part from sleep, by reason of the Animal Spirits being bound in the Cerebel or suppressed; their eclipse or interruption (though short) about the exercise of the vi∣tal function, is induced.

That the subject, nature, and causes of this Disease may be the better known, we shall first consider its Phaenomena, or the appearance of it. The fits of the Incubus, or * 1.2 Night-Mare, for the most part, and indeed only falling on one in sleep, are used to be excited mostly after the stomach is loaded with undigested meats, and lying on the back in Bed. They who labour with it, seem to feel the hurt chiefly in the Breast, and about the Praecordia, for respiration being suppressed, and very much hindred, they think that a certain weight lying heavily upon their Breast, doth oppress them, which weight mocks their imaginations with the Image of some spectre or other; and this, whilst they think to shake off, or put away, by the moving of their Body or members, they are not able to stir themselves any way: But after a long space, and sometimes till they are almost dead, they at last awake with a strugling about their heart, and being more fully rouzed from sleep, the imaginary weight suddenly vanishes, and the motive force of the body is restored, but for the most part a trem∣bling of the heart remains, and frequently a swift and violent beating of the Dia∣phragma. Then the fit being over, the deception of the phantasie, conceiving the horrid image of the Incubus or spectre, is perceived.

The common people superstitiously believe, that this passion is indeed caused by * 1.3 the Devil, and that the evil spirits lying on them, procures that weight and oppres∣sion upon their heart. Though indeed we do grant, such a thing may be, but we suppose that this symptom proceeds oftenest from mere natural causes; though what they are, and in what place the Morbific matter doth subsist, is not agreed on among Authors, no•…•… indeed is it easily to be assigned.

Because the imagination is deceived, and the error being propagated further into the * 1.4 senses themselves, so imposes on the sight and feeling, that they believe they plainly see and feel a monster of this or that shape or figure lying upon them; and for that the loco-motive faculty of the whole body is hindred, in the mean time; some have placed the seat of this Disease wholly in the Brain, and would have the oppression of the breast to be merely phantastical: But although we grant the monstrous shape of the Incubus (which is conceived) to be a mere dream; the Precordia to be truly affected, is apparent, and the motion of the Pulse and breathing is suppressed or hindred; for that the heavy weight of the breast is plainly felt by most, in their waking, yea, and when thorowly fresh awaked, and when that is removed, the tremblings of the Heart * 1.5 and Di•…•…phragma, and inordinate motions follow: whence it follows that these parts labour and suffer a real hurt.

Wherefore others, that they might the more easily unloose this knot, dividing the * 1.6 Morbific Cause, assign a portion of it to the Brain, and another to the Breast; for they say, that the motion of the Lungs are hindred, by a viscous and very gross hu∣mor impacted about them, and that doth excite as it were the oppression of a bulk ly∣ing on them, with want of breathing; then Vapors being raised to the Head, do fill the principal Nerves, and so hinder the loco-motive force: which opinion (no more likely than the conceptions of those troubled with the Night-Mare) deserves not to be assented to; because there are not any signs of this humor heaped up about the Praecordia, which appear before or after the fit, yea when this region is very much bur∣thened, as in the Phthisis, Asthma, or Dropsie of the Breast, the Incubus does not therefore infest more frequently or more grievously: Further it appears not, how the matter heaped up in the Praecordia, should be only troublesome in sleep, or by what passage or way, the Vapours from thence so suddenly inducing want of motion, should

be elevated to the Head Wherefore, the Reason or Aetiology of this Distemper, I think to be taken or judged of far otherwise.

Therefore this heavy weight or load lying on the breast, seems indeed to be left, * 1.7 because the motion of the Heart, and the organs serving for breathing, is hindred; for from the motion of the heart ceasing, or being hardly performed, the Blood in its bosoms, and in the breathing or Pneumonick Vessels statgnating, and being there very much streightned, a sense of as it were a weight opresses the region of the breast: which also seems therefore the more grievous, because the Lungs, Diaphragma, and Muscles of the Thorax, being hindred in their motions, and as it were bound together, at the same time with the heart, do labour with a great endeavour, to exercise or to put forth themselves. But the most hard question yet is, concerning the Cause, by rea∣son of which the motion or action of the Praecordia is suppressed, or hindred. This seems impossible to be done by matter impacted in the organs themselves, of which * 1.8 indeed, there must be a very great deal, to suffice for the hindrance of so many parts, and some signs of it at least would appear somewhat out of the fit; wherefore, it seems that we may rather say, that the action of those parts are hindred, because the influx of the animal spirits are hindred or suppressed. This is frequently done in Con∣vulsive Distempers, as we have elsewhere declared, and have clearly shewed by Ana∣tomical Experiment, to wit, by tying the trunk of the Nerves of the eighth pair, in a * 1.9 living Dog: But in those distemper'd by the Incubus or Night-Mare, the obstruction of the Spirits, seems to be excited neither in the organs themselves, nor in their Nerves; for such a cause happening to those awake as well as to those sleeping, doth not be∣come presently moveable, but is fixed and permanent.

Wherefore, we think the fit of the Night-Mare to be induced, for that in sleeping, * 1.10 a certain incongruous matter is instilled into the Cerebel, together with the nervous Juice, which causing a certain torpor or benummedness in the first spring of the spirits, compells them immediately, by little and little, to cease from the offices of their functions; so that as it were another Lethargy being excited within the Cerebel, the vital actions suffer a short eclipse; during which, partly from a strife of the obstructed or bound together Praecordia, and partly from the blood very much heaped up and * 1.11 stagnating in them, that weight, or a sense as it were of a great bulk lying on them, is caused; then, because all the rest of the faculties depend upon the motion of the heart, therefore this being suppressed and hindred, presently those eclipses or disor∣ders * 1.12 of them follow; but especially because the flowing of the Blood into the Brain, for the making of Animal Spirits, is interrupted, therefore immediately the flow∣ing forth of these into the nervous System is suppressed, so that the sick, whilst they endeavour to shake off the imaginary load of the breast, are not able to move their Body, or any member; to wit, because the irradiation of the Spirits, (whilst they are destitute of the flowing in of the Blood) is kept from the moving parts: In the mean time, those which reside in the Brain, being spread abroad here and there, con∣ceive confused phantasms, and from the trouble impressed from the Praecordia, horrid dreams of spectres.

The fit of the Incubus is soon ended, because the matter, rarely or never entring deep∣ly * 1.13 into the Cerebel, is easily shaken off, or is supt back again into the Blood: for after the spirits became free from its embrace, and having got the liberty of motion within their wonted spaces, they repeat the exercises of their functions: wherefore, the afflux of the Blood then presently returning to the Brain, immediately the afflux or flowing forth, and emanation of the Spirits, are restored, like a light new kindled, both in its middle or marrowy part, and also in the nervous Stock: whence they be∣ing awakened, the motive force returns, and the error of the imagination is per∣ceived. But that there follow in the Heart and Diaphragma tremblings and most swift * 1.14 beatings, the reason is, because these Bodies, so long as they were hindred from their motions labouring with an endeavour of exercising, or putting forth themselves, are not able to contain themselves within their just limits, as soon as they are restored, but putting forth at once all their strength, and being too active, exceed the due per∣formance of their duty: even as a wand, being held a while bent, being afterwards let go, recovering it self with a certain force, enters into a motion of trembling or shaking.

After this manner, the fit of the Night-Mare, because it immediately stops the vital function, as it were the first moving wheel in the animal Machine, compels forth∣with * 1.15 all the other faculties to cease, yea the whole corporeal soul (more than the more grievous fits of the Apoplexy or the Lethargy) to shake, and as it were to suffer an eclipse. Notwithstanding, little danger is threatned from this Distemper, because the Morbific matter being poured forth from the Blood, into the compass of the

Cerebel, is not suffer'd to penetrate deeply; because the Spirits of that province, being always in a readiness and watchful, most swiftly run to meet the enemy, and oppose his entrance strongly, though the offices of the vital function be omitted in the mean time; further, the Animal Spirits which are in the region of the Brain, being awakened, fly presently to assist those of the labouring Cerebel: For those sick of the Incubus, if by chance they be awakened by any one lying with them, they sooner come out of the fit.

But although it is rare, that any one dyes of this Disease only; yet those often ob∣noxious * 1.16 to it, if they are taken with other Cephalick Distempers, as the Lethargy, Carus, Apoplexy, or the Epilepsie, are in far greater danger: because the Morbific matter, being poured forth from the Blood into the Brain, easily invades the Cerebel so predisposed; so that the sick therefore suffering at once an eclipse of the vital and the animal function, are brought into greater danger of their Life. Hence 'tis a vulgar observation, that those who frequently are troubled with the Night-Mare, fall into the Apoplexy.

There is wont to be another event of the Incubus, less dangerous, that leads often * 1.17 into the Cardiack passion, and other affections, commonly taken to be Hypochondriack, I knew several while young, grievously afflicted with the Night-Mare, who being freed from it in their riper Age, were troubled with the trembling and palpitation of the Heart, and other pains about the Praecordia, and Hypochondria; and also with Convulsions in those parts. We think the cause of this morbid commutation to be, because the Morbific matter, after it was wont so often to besiege the region of the Cerebel, at length an impression being made, it did penetrate more deeply into some private place, and passing thorow its frame, became impacted on the Nerves destinated to the Praecordia.

As to the Cure of this Disease, there needs no help for the fits, because they pass away quickly of themselves. The method of Cure after a considering the whole, * 1.18 suggests Blood-letting, (where it is convenient) and a gentle Purge, and chiefly the use of Remedies, which are commonly called Cephalicks. Therefore, here Powders of Amber, Coral, and Pearls, with the Roots of the Male Poeony, Cretick Dittany, Contrayerva; also Electuaries, Tablets, and Distilled Waters, Tinctures, Elixirs, and other things that are wont to be prescribed in the Lethargy and Apoplexy, have the chief place; but especially a right course of dyet being ordered, let gross and ill di∣gested meats be shunned, Pulse and Summer-fruits; nor let sleep, study, or reading be presently yielded to after eating: late and large Suppers, and lying on the back, are to be forbidden.

Because Children and Youths, are often sick of this Disease (the sign of which is, * 1.19 that they are shaken in their sleeping, and waking cruelly cry out) and more often suffer its fits, which oftentimes bring them to Convulsive passions, therefore a method of heal•…•…g them ought to be administered, as soon as they are seen to be distemper'd: you ought to inquire into the milk they suck, whether it be of it self pure and lau∣dable, and truly convenient for the Stomach: let them not sleep presently after they have sucked their fill: The Nurse using a good dyet, let her take also Morning and Evening a Dose of Cephalick Powder, or Electuary, drinking after it a draught of Pos∣set drink, with the leaves of Sage or Betony, or the Roots or Seeds of Poeony boiled in it: Let the Infant take twice a day, a spoonful of proper Distilled Water. Let him have an Issue made in the nape of the Neck, and let it lye sometimes on one side, and sometimes on the other, and rarely or never on its back. If a Neck-lace of Coral, or little balls of the Seeds or Roots of the male Poeony be worn about the Neck, or at the pit of the Stomach, it is not altogether useless; if that in sleep be∣ing often and grievously shaken, they are seen to be more dangerously troubled with this Distemper, let Blisters be raised in the hinder part of the Neck, or behind the Ears; also Evening and Morning let there be daily given a Dose of the Powder of Ammoniacum, or other proper Dose, in a spoonful of Distilled Water or Julep.

Notes

• * 1.1

  The •…•…at of the Incubus is in the Cerebel.
• * 1.2

  A Description of it.
• * 1.3

  It most often proceeds from natural causes.
• * 1.4

  The Seat of this is falsly placed in the Brain.
• * 1.5

  The Praecordia truly labour.
• * 1.6

  The cause doth not stick partly in the Brain, a•…•…d partly in the Breast.
• * 1.7

  The next cause of this is, the hin∣drance of the in∣flowing of the Spirits to the Praecordia.
• * 1.8

  This not in the Parts affected;
• * 1.9

  Nor in the Nerves them∣selves:
• * 1.10

  But happens in the Cerebel, where the first Spring of the Spirits is.
• * 1.11

  From whence the sense of the weight proceeds.
• * 1.12

  Whence loss of motion proceeds.
• * 1.13

  Wherefore the fit being so grie∣vous, is so soon ended, without leaving any e∣vil.
• * 1.14

  Whence after the Fit, the trem∣blings of the Heart and the Praecordia.
• * 1.15

  The Incubus of it self rarely dan∣gerous.
• * 1.16

  The Prognostick of the Incubus.
• * 1.17

  The Event of it is shewn.
• * 1.18

  Its Cure.
• * 1.19

  Insants and Boys obnoxious to this. Disease, how they ought to be handled.